The ligature mark is the most relevant feature of hanging. This study was undertaken with a view to determine the characteristic features of hanging and its association with ligature material or mode of suspension. Of a total medicolegal deaths reported at an Apex Medical Centre, hanging was noted in 4.1% cases, all suicidal with mortality rate of 1.5 per 100,000 population per year. The hanging was complete in 67.7% with nylon rope as the commonest type of ligature material used for ligation. The hanging mark was usually single, situated above thyroid cartilage, incomplete, prominent, and directed toward nape of neck. The mark of dribbling of saliva was seen in 11.8% cases. Facial congestion, petechial hemorrhage, and cyanosis were significantly seen in partial hanging. Though occasionally reported, the argent line was noted in 78.7% hanging deaths with neck muscle hemorrhage in 23.6% cases. Fracture of neck structure was predominant in complete hanging.
Background: Carbofuran is a widely-used carbamate insecticide which is listed as highly hazardous (Class 1b) by the World Health Organization (WHO) classification of pesticides. We report the poisonings among children following exposure to carbofuran crystal form, which is used as a household remedy for head lice infestation. Methods: The medical case records from June 2016 to January 2019 of a Tertiary Care Hospital in rural Maharashtra, India, were examined for the pediatric poisoning due to exposure to blue crystals in sachets being sold as medication for head lice infestation and its confirmation as being carbofuran. A total of 14 such exposures were found among 64 cases of pediatric poisoning (excluding bites and sting envenomation), recorded in the above period. The children were evaluated for their presentations, manner of unintentional poisonings, clinical profile, and outcomes. Results: The results in carbofuran poisonings showed universal unintentional exposure with the majority of patients being infants and toddlers. It was the most significant single cause of poisoning, excluding bites and envenomation, in the above period. The clinical features of excessive cholinergic activity were consistent with the characteristics of carbamate poisoning. Comparison with other poisonings during the period did not show significant differences concerning variables such as age, sex, religion, and length of hospital stay. Conclusion: Unintentional poisoning of the class1 pesticide carbofuran, among younger children, is associated with misuse and availability in the environment. Our obtained data about the agent, host, and environmental factors related to the poisoning are consistent with data available on the literature.
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