No abstract

On January 4, 2019 an eight-year-old girl child was bitten by a suspected rabid dog over the left parotid region. After a 17-h delay, the child was brought for rabies postexposure prophylaxis (PEP) at Civil Hospital Theog and was administered complete PEP. On January 29, 2019, the child was again brought to Theog Hospital with complaints of having fever, difficulty in walking, neck drop, and ptosis. On examination, pediatrician found photophobia, phonophobia, and hydrophobia and subsequently the patient died of cardiac arrest. On postmortem examination, the facial nerve was found dissected and injured at the inner end of the parotid gland. A severed end toward the brain was swollen and edematous. The entire brain was extracted and sent to Central Research Institute Kasauli for confirmation of rabies, where it tested positive for rabies by Fluorescent Antibodies Test and Biological Test. In situations where sensitive parts such as the face are involved, a thorough wound wash with soap and water and application of antiseptics along with immediate PEP may save some lives by not allowing the virus enough time to attach to and infect the nerve cells.

Background: Since the practice of conventional autopsy, one new method for skin incision as "fourth incision" has been added to the preexisting conventional methods of skin incisions, i.e., "I"/"Y"/modified "Y". Reconstitution of conventional skin incisions leave visible defect (disfigurement) on the dead body which gets enhanced with invariable use of additional confirmatory or releasing incisions. Mutilation in form of disfigurement of the dead body is a major reason for legal heirs to withdraw the consent for pathological or clinical autopsy and is leading to worldwide significant drop in the rate of pathological autopsies. This study was formulated to develop a new course of skin incision for autopsy with the aim to minimize the visible defect and to obviate the need of extra incisions and so that it is time friendly for autopsy surgeons. Result: On practicing this course of skin incision, the authors of study have noticed its advantages as it is cosmetically effective and time friendly and offers 100% operational area with single incision in continuity in comparison to other advocated methods. Conclusion:Its acceptability with its inherent advantages to autopsy surgeons and legal heirs of the dead body may increase the tendency to give desired informed consent for pathological autopsy. However, the validation of our method of skin incision in terms of different surgical and observer components is required to remove any bias regarding noticed advantages.