No abstract

When dealing with cases of sharp force penetrating injuries, survival of the victim depends on injury to major blood vessels or major organs resulting in internal or external hemorrhage. Stab with intention of homicide although common, self inflicted stab injuries are less reported. We present an unusual self inflicted stab injury over an abdomen extending from front to back of the abdomen over epi-gastric region by a 52 years old male who managed to survive as it missed all the major blood vessels and solid organs that lied in between. On observation of characteristics of the wound, we have made an attempt to opine that the incident was self- inflicted with suicidal intentions.

A bullet which has been lodged in the body encapsulated by dense fibrous tissue for a long time without causing ill effects is a souvenir bullet. The bullet cartridge is divided into 3 parts: bullet, cartridge case holding bullet with gun powder and detonator at the base. Medicolegal consultation was done with Forensic Medicine Department where cartridge case acted as projectile and accidentally got embedded into the chest of the victim. In an attempt of making an ornament from the casing of bullet which was separated from bullet mechanically and gunpowder was partially removed from the bullet case. When he heated the bullet case to melt and mould, the remaining gun powder ignited with release of large amount of gas which resulted in forceful propulsion and acted as the projectile. An oval penetrating keyhole appearance injury measuring 2 cm x 1.5 cm was present on left side of the chest of the victim. The projectile was found just above the 6th rib and was confined within inter-costal muscle. Although late complications may arise from the metallic toxicity from the bullet case showing manifestations like abdominal pain, anorexia, chronic renal failure, abdominal pain, osteomyelitis, and fistula formation in bones, the projectile was left within the body as a souvenir to be intervened in case complications arise during follow-ups, as manipulating it could cause unanticipated therapeutic complications.

Background: Poisoning is one of the most common causes of increased morbidity and mortality worldwide and also one of the common causes of Emergency Department visits. It has now become a major public health issue.  Objectives: To assess the poisoning survivor cases and various associated parameters like most common poison, the circumstance of poisoning, age and gender distribution, and triggering factors. Methods: A retrospective study was done in 94 cases of poisoning, from whom reliable history could be obtained, admitted to Kathmandu Medical College, over the period of 12 months, from April 2019 to March 2020. After obtaining ethical clearance secondary data were collected from the medicolegal examination reports. The data were entered and analysed in Statistical Package for Social Sciences (SPSS) v.18. Results: Majority of the victims were females (9, 62.8%), mostly homemakers (31, 33%). The mean age of the population was 30.35 ± 13.48 years and median age 26 years. Organophosphorus was the most frequent agent (44, 46.8%). The commonest triggering factor was a quarrel with family members (56, 65.1%) and in most cases the agent was already present in their home. The act of poisoning was impulsive in these cases.  Conclusion: In this study, the most common agent causing poisoning was still organophosphorus which was already present in their homes. Most poisoning cases were intentional. Females especially homemakers were the most common victims. Cases of poisoning can be reduced if the authorities properly monitor the buying and selling of these common agents of poisoning.