Hydrogen sulfide (H2S) toxicity is a known occupational/industrial hazard in organic decaying disposal, sulfur springs, natural gas well and coal pits. We report two deaths due to acute accidental hydrogen sulfide poisoning. Two males 40 and 36 years old were found dead in two different water treatment plants after spilling of sewage. Autopsy revealed greenish discoloration of skin and brain in one individual and pulmonary oedema in both. Toxicology revealed lethal levels of thiosulfate which is a metabolite of H2S. Death investigation concluded that both fatalities were due to toxicity of H2S in an accidental manner. Toxicological investigations are important in cases where occupational hazards are suspected.
Introduction: Firearms are often used to commit suicide, especially in countries where firearms are easily available. This research was conducted to identify the patterns of suicide firearm deaths; socio-demographic profile, past history, circumstantial facts, weapons used, autopsy, and toxicology analysis.Methodology: A descriptive-cross-sectional study was conducted. All autopsy reports with investigative narratives, police reports, scenes, and autopsy photographs were perused from 2016 to 2012 using data collection forms. Purposive sampling was used to collect 200 suicide firearm deaths.Results: Out of 3150 deaths, 12% (n=391) were suicides. Of them, 200 (51%) were suicide firearm deaths. There were 90% males. Ages ranged from 13 to 91 years and 51% were less than 40 (<40) years victims. According to circumstances, 13% notified by suicide letters, 74% occurred at home, and eye witnessing (p=0.003) and hearing (p=0.021) of the suicide were significantly associated with age <40 years. Past history included; medical illnesses (19%), suicide attempts (10%), domestic issues (31%), and occupational familiarity with firearms (31%). Occupational familiarity was significantly associated with whites (p=0.034) and <40 years victims (p=0.001<0.05). Automatic pistols were used by 57% and revolvers by 27%. The use of handguns was significantly associated with females (p=0.029). The Head was the commonest region involved (88%) and the entry wound in the head was significantly associated with <40 years of victims (p=0.003<0.05). Blood for alcohol was positive at 16%. Performing toxicology tests significantly associated with age <40 years (p=0.000), occupational familiarity (p=0.001) and absence of medical illnesses(p=0.018). A full autopsy was performed on 66%. Head injury as the cause of death is significantly associated with age <40 years (p=0.018<0.05). Conclusion:Age, gender, race, medical conditions, and occupational familiarity are significantly associated with suicide firearm deaths. The white race is significantly associated with familiarity with firearms. Females have more predilection to handguns. Performing toxicology is higher with the absence of medical illnesses, occupational familiarity, and age <40 years.
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