Thermal injuries include burns and frostbite caused by heat or cold. Burns are classified by depth and cause epidermal, dermal or deeper tissue damage. Complications include shock, infection and respiratory issues. Frostbite causes tissue freezing and damage. Hypothermia lowers core body temperature while paradoxical undressing in hypothermia is unexplained. Medico-legally, thermal injuries must be identified as accidental, suicidal or homicidal. Scalds specifically refer to burns from hot liquids or steam.
FORENSIC MEDICINE BOOKS OF
REDDY
GOUTAM BISWAS
MAGENDRAN
OTHERS
TOPICS :-
COLD INJURY
HEAT INJURY
BURN INJURY
SCALDS
ELECTROCUTION
LIGHTENING INJURY
THIS IS ONE OF MY BEST AND FAVORITE PRESENTATIONS. IT WILL SURELY HELP YOU A LOT DURING YOUR EXAMS (PROF/OTHERS). IF YOU FIND IT HELPFUL THEN LIKE IT. MY EMAIL ID IS GIVEN ON THE 2ND PAGE OF THIS PRESENTATION, IF YOU WANT PRESENTATIONS ON OTHER TOPICS (ANY MEDICAL SUBJECTS) THEN MAIL ME. I WILL WORK ON IT LOT AND WILL BE TRYING TO SHARE WITH YOU GUYS...
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FORENSIC MEDICINE BOOKS OF
REDDY
GOUTAM BISWAS
MAGENDRAN
OTHERS
TOPICS :-
COLD INJURY
HEAT INJURY
BURN INJURY
SCALDS
ELECTROCUTION
LIGHTENING INJURY
THIS IS ONE OF MY BEST AND FAVORITE PRESENTATIONS. IT WILL SURELY HELP YOU A LOT DURING YOUR EXAMS (PROF/OTHERS). IF YOU FIND IT HELPFUL THEN LIKE IT. MY EMAIL ID IS GIVEN ON THE 2ND PAGE OF THIS PRESENTATION, IF YOU WANT PRESENTATIONS ON OTHER TOPICS (ANY MEDICAL SUBJECTS) THEN MAIL ME. I WILL WORK ON IT LOT AND WILL BE TRYING TO SHARE WITH YOU GUYS...
THANK YOU
Asphyxia which means "Pulselessness" and is cause due to absence of oxygen amount in a body. The death cause by asphyxia is known as asphyxial deaths. They are Hanging, Strangulation, Suffocation and Drowning.
infanticide are quite common in India because of illiteracy as well as the female child unwanted . Now a days female sexual assault and murder is getting common in north Indian society
Starvation is defined medically in two parts that is: The act or process of starving and the condition of being starved, while ‘Neglect’ is defined as – to fail to give due care, attention, or time to someone an adult/ a child especially.
this slide contain inteoduction, definition, causes, risk factor, clinical manifestaion, types , treatment, medical management, nursing management, nursing care given in the intial stage, in case of emergency .
Asphyxia which means "Pulselessness" and is cause due to absence of oxygen amount in a body. The death cause by asphyxia is known as asphyxial deaths. They are Hanging, Strangulation, Suffocation and Drowning.
infanticide are quite common in India because of illiteracy as well as the female child unwanted . Now a days female sexual assault and murder is getting common in north Indian society
Starvation is defined medically in two parts that is: The act or process of starving and the condition of being starved, while ‘Neglect’ is defined as – to fail to give due care, attention, or time to someone an adult/ a child especially.
this slide contain inteoduction, definition, causes, risk factor, clinical manifestaion, types , treatment, medical management, nursing management, nursing care given in the intial stage, in case of emergency .
Environmental emergencies include
COLD-INDUCED INJURIES
Heat-induced injuries
altitude pulmonary edema
For Nursing students i hope it would be usefull, wish you best of luck, dont forget to join me on twitter acount Suliman_alatwi
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
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Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
4. COLD INJURY
Hypothermia
• Exposure to cold produce hypothermia which is defined as
core temperature below 35°C.
Effects of hypothermia
• Direct effects are prominent in fatty tissues and myelinated
myelinated nerve fibres.
• Indirect effects are mostly ischemic.
Clinical features
• Dulling of consciousness,loss of reflex,and fall in
respiration, heart rate and blood pressure.
• Red patches and pallor of the skin and edema of the face
5. Chilblain
• These are red, itching,skin lesions, usually in the
extremities,caused by exposure to cold.
• They may be associated with with edema and blistering
and are aggravated by warmth.
6. Immersion syndrome (trench/immersion
foot)
• Immersion foot/hand results from prolonged exposure to
severe cold(<10°C)
• Seen in soldiers during warfare, especially in trenches.
• Extremities are affected in these conditions.
7. Frostbite
• Frostbite is Injury due to freezing and formation of
ice crystals and obstruction of blood supply within
tissues.
• It occurs due to exposure to great extremes of
cold (-2.5°C).
• Typically evident ad blue-black discoloration of
fingers.
• Symptoms are numbness,prickling and itching.
8.
9. PARADOXICAL OR RECIPROCAL UNDRESSING:
• Rare and strange condition linked with accidental
hypothermia, especially in old persons.The person take off
some or all of their clothing.The cause big the condition is not
known,but it may be due to long exposure to severe cold
which causes failure of vasoconstriction of arterioles of the
skin,which results in a flow of blood from the central part of
the body,thus giving an exaggerated sensation of warmth.
Because of the great discomfort,the person may undress
himself.In such case, there may be suspicion of sexual offence.
MEDICO-LEGAL IMPORTANCE
10. The Hide and Die syndrome
• In some cases of hypothermic deaths,the disoriented,dying,
hypothermia victim,who while attempting to protect himself from the
cold may hide himself in corners, cupboards or under piles of furniture
or household goods.
• More commonly,a naked or partly clothed old person is found amid
scene of Utter confusion with furniture pulled over and drawers and
cupboards emptied out.This may lead to suspicion of homicide and
robbery.
11. Neonatal cold injury
• It results from a failure of the metabolism to prevent a fall in temperature
in a body kept in an unsuitable cold environment.
• The symptoms appear usually in the first week of life.
• Rectal temperature – 32°C.
Features
• Swelling and widespread edema of the extremities, particularly the hands
and the feet,and the eyelids.
• Pulsation of peripheral arteries is absent.
• Respiration is shallow,slow and may be irregular.
MLI – It is a method of illegitimate and unwanted infants.
12. HEAT INJURY
1. Heat cramps.
• They are due to fluid and electrolyte depletion.
• Occurs in workers in high temperature
When sweating has been profuse.
• Cramping results from dilutional hyponatremia,as
Sweat losses are replaced with water alone.
Clinical features
• Onset is sudden.
• Severe and painful paroxysmal skeletal muscle contractions.
• Face is flushed and pupils dilated.
• Skin is moist and cool.
13. Treatment
• Patient should be moved into cold environment.
• Given oral saline solution to replace both salt and
water.
• Rest for 1-3days.
14. Heat Exhaustion
• It results from prolonged strenuous activity
With inadequate water or salt intake in a hot
environment.
• Characterized by dehydration, sodium depletion.
Cinical features
• Nausea, vomiting,malaise and myalgia may occur.
• Headache, dizziness, fatigue.
• Anxiety,impaired judgement and occasionally psychosis.
15. Diagnosis
• Prolonged symptoms.
• Rectal temperature>37.8°C
• Increased pulse and moist skin..
Treatment
• Pt is treated in cool environment.
• Adequate hydration (1-2 lit over 2-4 hours)
• Oral salt replenishment and active cooling (ice packs
etc)
• IV fluids if necessary.
16. Heat hyperpyrexia/Heat stroke
• Heat stroke is a life threatening medical emergency
resulting from failure of the thermoregulatory
mechanism.
• Characterized by cerebral dysfunction with
Impaired consciousness,high fever (rectal temp>41°C.
Clinical features
• Onset is sudden, with sudden collapse and loss of
consciousness.
• Skin is hot and initially covered with perspiration,
Later it dries.
• Tachycardia and hyperventilation
• Pupils are contraced.
17. Treatment
• Immediate measures should be taken to lower the
core temperature.
• Pt is unclothed to the minimum.
• Immersion in an ice water bath is very effective.
• Treatment should be continued until the rectal temp
drops to 39°C.
• Chlorpromazine(25-50mg IV) or diazepam (5-10mg
IV)-to control shivering.
• Fluid administration to ensure high urinary output.
• Mannitol administration (0.25 mg/kg) is
recommended.
18. Postmortem findings
Deaths related to hyperthermia have no specific
autopsy.
• Lungs: congested.Intrathoracic petechiae may be
present, particularly in infants and children.
• Heart: subendocardial hemorrhages may be seen.
• Brain: congested and edematous.
Medico-legal aspects
• Deaths are usually accidental.PM is done to rule out
any other cause of death.
19. Heat prostration (heat syncope/collapse)
• It results from Salt depletion and dehydration due
to excess of sweating and cutaneous vasodilation
with consequent systemic and cerebral
hypotension,but without any rise of temperature,
despite exposure to excessive heat.
Clinical features
• Patient suddenly feels weak,giddy and sick.
• Nausea, dizziness, flushed face, throbbing headache
etc.
• Systolic BP<100mmHg
20. BURNS
• Burn is an injury caused by heat,or by a chemical or physical
agent having an effect similar to heat.
Types of Burns
• Contact Burns Chemical Burns
• Flame burns Electric and lighting Burns
• Scalds. Microwave burns
• Radiant heat Burns
• Ionizing radiation Burns(X rays,UV rays)
21. Degree of damage Dupuytren's Wilson’s
Erythema 1° Epidermal
Vesication with blister
formation
2° Epidermal
Destruction of superficial
skin
3° Dermo-
epidermal
Destruction of whole skin
including dermis
4° Dermo-
epidermal
Destruction of deep
fascia, muscles
5° Deep
Complete charring
involving vessels,nerves
6° Deep
Classification of
Burns
22. Effect of Burns
• Degree of heat applied
• Duration of exposure
• Assessing the size(Wallace rule of nine)
• Site
• Age
• Sex
Rule of nine Total
Head 9%
Torso 18%
Back 18%
Each arm 9%
Each leg 18%
Perineum 1%
23. Features First Second Third
Depth Epidermis Epidermis and
dermis
Deeper to dermis
Colour Red/pink Dark red White/grey/black
Pain to stimuli Painful,tender Very painful Painless
Blanching Yes Yes,but slow No
Blisters Not present Present May or may not
Appearance Dry Moist Dry/leathery
Healing time 3-6 days 3 weeks Small areas may take
months,large areas need
skin grafting
Scar No scar Yes Yes
Cause Sunburn,scald etc Scalds,flash Burns Hot liq, chemical,
electric etc
Medico-legal
aspect
Simple Grievous Grievous
25. Postmortem findings
External findings
• Clothing should be removed and examined for presence of kerosene,
petrol etc
• Site, distribution and extent of burning are recorded.
• Face- usually distorted and swollen
• Postmortem staining is cherry red in colour from presence of carbon
monoxide,if the individual was alive and breathing during fire
• Pugilistic attitude (boxing, fencing or defence attitude)
26.
27. Internal findings
• Skull – heat hematoma
• Brain-congested and appears swollen
• Larynx,trachea and bronchioles – contain carbon and
soot particles And the mucosa is congested with frothy
mucus secretions.
• Pluera- congested and inflammed with serous effusion
• Lungs- congested and edematous
• Heart- chamber full of blood,cherry red in colour due
inhalation of CO.
28. MEDICO-LEGAL QUESTIONS
Whether the Burns are suicidal/accidental/homicidal/self
inflicted?
• Suicidal Burns:common among indian women. They pour
kerosene on their heads and cloths before setting fire to
themselves.
• Accidental Burns: common among children and elderly people.
Accidents may results from smoking, stove bursting etc
• Homicidal Burns: quite common in India.Custom of dowry leads
to young brides being murdered by pouring kerosene and
setting on fire.
30. SCALDS
• Definition-A scald is a form of thermal injury which
results from application of liquid >60°C or from
steam,and involves only the superficial layers of skin.
Types of scalds
• Immersion Burns : accidental or deliberate immersion
in hot liquid, usually water.
• Splash or spill Burns: usually accidental.
• Steam Burns: exposure to superheated steam.
31.
32. THANK YOU
Guided by:. Presented by:
Dr Adarsh. Adavayya pujar
Dr Shivanand Shreyas Gowda DC
