OBJECTIVES:The aim of the study was to determine (a) most common sites of torture, nature of injuries and their complications and (b) psychological and physical effects of torture on the prisoner’s mental and physical health. METHODOLOGY: It was a cross-sectional descriptive study. The study was conducted on 193 prisoners admitted at District Police Hospital Peshawar over a period of one year. These prisoners were the victims of torture under police captivity. Majority of the victims were prisoners. The data was collected on a Performa mentioning age, duration of captivity; nature of injuries (simple, grievous), weapon used for physical torture (blunt, sharp) and prisoners were interviewed and examined by the medical officers and co-authors. SPSS 20 was used for data analysis. RESULTS: One hundred and eighty (93.2%) of the 193 subjects were male. Average age was 27.4 ±4 years. Hundred (51.8%) prisoners were physically tortured and 92 cases (47.6%) were due to physical assault among prisoners. Out of 92 cases 12 (13.04%) prisoners showed injuries due to strenuous physical work, mostly on palms and soles in the form of blisters. These injuries were carefully examined and correlated with history. Torture methods observed in this study were beating with hands on face (35.6%), whipping with rod (61.6%), kicking on buttock and abdomen (16.4%), forceful dragging (16.4%), burning with cigarettes (12.3%), hanging with hand cuffs (13.7%) and whipping on palms and sole (6.9%). Majority of the cases (74%) were tortured in custody, (12.3%) in prisons, (9.6%) on the street and (4.1%) at home. The impact of physical and psychological torture was variable depending upon the duration of captivity and nature of torture. Patients kept for a longer period 42 (42%) had developed post captivity psychosocial stress syndrome. Physical torture has taken 07 (3%) lives and 24 (12.4%) victims were permanently disabled in this year. CONCLUSION: A wide range of different types of injuries were observed on various parts of the body. Blunt trauma was most frequent. Violation of Istanbul Protocol for violence against torture under police custody was also clear.

OBJECTIVE:The aim of this study is to determine the trend of poisoning due to household substances in Peshawar.METHODOLOGY:This was a retrospective observational study. All the information related to poisoning including mode of transmission, duration of poisoning, demographic information, duration of hospital stay, name of poison, amount of poison ingested, inhaled and intension of poisoning was from the medical record room of Khyber Teaching Hospital (KTH) casualty department. The cases reported with a history of household poisoning were recorded for a period of one year from February 2016 to January 2017.RESULTS:Among the total 217 patients, males female ratio was 1.3:1 where male 114 (51%) whereas 104 (49%) females, whereas intensity to commit suicide is more in females. Tablet overdose cases were 73 (34%) and poisoning due to common household poisons such as mosquito repellant, rat killer poison, kerosene oil, detol and detergents were 87 (36%). Victims inhaled and ingested Organophosphorous accidently and intentionally were 62 (28%). Suicidal tendency was determined to be a hallmark among females. The age group between 18 to 31 year were found highly motivated to harm themselves. It was showed 196 (91%) patients consume with intention of suicide and only 20 (9%)were found accidental victims of poisoning.CONCLUSION:It was concluded that easy accesses to anti psychotic drugs without registered doctor’s prescription, self medication, over dosage and rat killing pills were found the most prevalent cause of poisoning among victims belonging to low socioeconomic status. It was also indicated in the study that most of the accidental incidents happed at home when victim was either alone or left unattended.

Objective: To assess the demographics, clinical features and outcomes of PPD poisoning in such patients. Design of the Study: It was a prospective study. Place and Duration of Study: In this cross-sectional study, the prospective study data of 47 cases were collected from Department of Forensic Medicine and Toxicology, Loralai Medical College, Loralai. Patients and Methods: From 2019 to 2022, data of 47 cases was taken worth of information were gathered from hospitals' medical records for this prospective study. Information on the subject's demographics, ingestion method, clinical features, and mode of administration was recorded using a standardized format. In addition to monitoring mortality rates, hospital stays, tracheostomies, and the efficacy of mechanical ventilation, a number of other metrics were collected. For continuous variables' means and standard deviations (SDs) were calculated. However, percentages were calculated for categorical variables. Results of the Study: Out of 47 patients, 38 (80.85%) were females and 9 (19.15%) were males. During first year of the study, only six cases were reported while in succeeding years cases increases rise rapidly and reached to fifteen in last year final year of the study. Majority of the patients 16 (34%) belong to age group 20-24 years. Nearly, 85% of the patients belong to the rural areas. Moreover, the rate of PPD poisoning in married women increases alarmingly from one case in 2019 to nine cases in 2019. Practical Implication: Currently, there is limited data available on this poisoning as it has emerged as a new tren in our local hospitals. So, the rationale of this study is to evaluate the clinical presentation and outcome of the PPD poisoning in our part so that effective preventive and treatment strategies can be implemented at the onset which would certainly decrease the morbidity and mortality associated with this deadly poisoning. This study can lay down a base for local administrative authorities to consider formulating a law for strict handling of the PPD poisoning at local level and for education of the population. Conclusion: There is a significant amount of distress and death that comes along with PPD poisoning. In order to effectively handle poisoning situations, doctors must be aware of the clinical features and therapeutic choices. In addition, PPD-containing hair colours should be banned because they are so dangerous. Keywords: Poisoning, Suicide, Hair-Dye, Cervicofacial Edema, Paraphenylenediamine, Kala Pathar

Objective: The research aimed for examining the safety and effectiveness of distal trans-radial access (dTRA), a new coronary intervention procedure, in individuals with low BMI. Methods: The design of this study was a cross sectional study design. This study was conducted at Mayo Hospital Lahore and the duration of this study was from December 2020 to December 2022. The participants of this study was 67 patients who had a coronary intervention. The patients were divided into two groups: 38 patients had traditional trans-radial access (cTRA) and 29 patients got direct trans-radial access (dTRA). Results: The research outcomes indicated that the success rates for puncture procedures in both groups, dTRA and cTRA, were not significantly different. Specifically, the success rate for dTRA was found to be 96.6% while cTRA recorded a success rate of 97.4%. This difference was not considered to be statistically significant as the p-value was 0.846, which means there was an 84.6% chance that the results were due to random chance and not a true difference between the groups. This indicates that both dTRA and cTRA are effective in puncture procedures and can produce similar results in terms of success rate. It is crucial to consider these results alongside the limitations of the research. Despite the overall results indicating a similar success rate between the two groups, there was a disparity in success rates for single-needle puncture procedures. In this aspect, the cTRA group outperformed the dTRA group with a success rate of 81.6% compared to 51.7% for the dTRA group. This difference was statistically significant with a p-value of 0.020, indicating that the results were not due to random chance. However, the dTRA group did have some advantages over the cTRA group. The compression hemostasis time, the time required for the bleeding to stop, was faster for the dTRA group, with a p-value of 0.01. Additionally, the incidence of radial artery occlusion was less frequent in the dTRA group compared to the cTRA group, with a p-value of 0.007 (4% compared to 33.3% in the cTRA group). Practical Implication: The study examines the first-time use of dTRA in low BMI people and looks at efficacy and safety. With a success rate of 96.6% in the dTRA group and a success rate of 97.4% in the control group (cTRA), the puncture success rate was found to be comparable between the two groups. The success rate was lower in the dTRA group compared to the cTRA group, and it took them longer to penetrate the skin with a single needle. The two groups' puncture-related side effects, such as bleeding and hematoma, were not significantly different from one another. Even though the dTRA group's patients reported more comfort, the dTRA group's compression hemostasis time and Visual Analog Scale (VAS) ratings were lower. Conclusion: The research shows that in individuals with low BMI, coronary intervention with dTRA is both secure and efficient. This approach offers a less complicated, more effective, and efficient alternative to conventional trans-radial access. Keywords: Conventional Trans-Radial Access, Body Mass Index, Percutaneous Coronary Intervention, Bleeding, Puncture

Objective: To assess for any peculiar lip prints in relation to the lip shapes of individual, and determine the most common lip print type among the members of biological families. Study Design: Descriptive study. Setting: Department of Forensic Medicine & Toxicology, Women Medical & Dental College, Abbottabad. Period: January 2018 to June 2018. Material & Methods: A total of 216 individuals (father, mother, both children’s), who underwent descriptive study of lip impression collection without any anesthesia or drug, were enrolled into the present study. Father, mother and two babies of each family were selected. Lip prints of Father, mother and both babies of each family were recorded. Each lip of 54 offspring’s was compared with the corresponding lip of his/her father mother and other baby. The segments of each lip of the offspring’s that matched/ resembled with either of father mother and biological babies were recorded. Results: Out of 54-total families, biological babies of 19(35.18%) families observed resemblance with father, whereas biological babies of 35(64.81%) families observed resemblance with mother. There was no definite identical lip print observed in any of the children. Furthermore, the prevalence of Type II lip prints was higher type present in males and in females. We observed that lip shape 7 was the most frequent lip shape type in most of individuals. Conclusion: Lip prints of study participants did not clearly match with each other, evenly distributed in both genders and distinctive similar to finger prints. The data did not show any specific association of the lip print type with lip shape. It is considered feasible to apply lip prints features in personal identification.