AFLP, though rare, is an obstetric emergency which carries a high incidence of maternal and perinatal mortality, despite optimal care. We report a case of a 23-year-old primi mother, who presented to us with vague symptoms of feeling unwell and abdominal pain, was diagnosed with AFLP, and was managed accordingly with the highest level of care available but succumbed a few days into her illness though timely delivery was able to save the baby. By this case report we once again wish to emphasize the value of a timely diagnosis with a high level of clinical suspicion and supportive laboratory investigations including imaging; the need for early termination of pregnancy; and adequate supportive care as the key management options for AFLP. Further, we wish to explore the current treatment options available for AFLP and discuss a few novel therapeutic strategies such as plasma exchange in treating such cases and the pros and cons associated with these treatment modalities.

Introduction: Homicide, killing one person by another, is considered the most devastating violence. Legally homicide can be either murder or culpable homicide, where the difference lies in the degree of knowledge and intention. This study describes the demographic features and medico-legal significance of the injury and evaluates the social background of the victims of homicide.Methods: A retrospective descriptive study based on a post-mortem report was carried out on all the cases examined at the JMO office, Jaffna, from June 2014 to June 2022. The data were analyzed using SPSS statistical package.Results: Among 105 post-mortem examinations alleged to be homicides, 77% (n=81) of deaths were recorded in the Jaffna district, while 23% (n=24) were recorded outside the Jaffna district. There was a male predominance63% (n=66) with a male-to-female ratio of 7:4. The commonest weapon or force used in homicide was blunt 51% (n=54, while sharp was the second highest (32%, n=34). Cut and laceration were the nature of injury for 26% (n=27) and 22% (n=23) of homicides, respectively. Consequences of craniocerebral injury (32%, n=34) were the major cause of death, while head and neck regions were commonly involved in 38%(n=40) and 25%(N=26), respectively. Regarding the nature of the injury, burn injuries (90%, n=10), mechanical airway obstruction (78%, n=07)), and lack of breathable air (100%, n=05) showed female preponderance (p value<0.05). In contrast, cut injury (61%, n=17), laceration (78%, n=19), stab injury (100%, n=05), and firearm injury (100%, n=04) were predominantly seen in the male population. Considering the cause of death, consequences of cranialcerebral injury (79%, n=25) were commonly seen in the male gender (p<0.05), and asphyxia-related deaths (85%, n=12) were more in the female gender (p<0.05). Conclusion:The nature of the injury and the cause of death in homicides had a significant relationship with the gender of victims.

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Acute cyanide (CN) poisoning leads to deterioration of body functions and often results in death. It can be accidental, suicidal, and at times homicidal. Since the historical period, CN has been the cause for several deaths, including fire accidents, industrial waste leakage, suicides of famous persons, and planned massacres. Several sources can lead to CN poisonings, such as smoke from the fire, mining and other industries, nitriles, and plants. The primary function of CN is to inhibit the cytochrome oxidase a3 enzyme due to the high binding affinity of CN to the ferric iron found in the haem moiety of the cytochrome oxidase a3 leads to uncoupling the mitochondrial oxidative phosphorylation and inhibiting the cellular respiration. Clinical signs and symptoms are primarily dose-related and range from gastrointestinal involvement to coma and death. In addition to decontaminating the poison and essential supportive treatment, effective antidotes are available. Last six years, fifteen Fatalities following CN poisoning were reported at Teaching Hospital, Jaffna. Social support and an adequate legal framework for controlling CN-containing substances could reduce the burden of cyanide toxicity.

This study aimed to understand the prevalence of road traffic accident (RTA)-related death in the northern province of Sri Lanka, exploring the demography, vehicle involved, and hospital admission.A Hospital-based cross-sectional descriptive study done and data were collected retrospectively from 210 autopsies and case notes at Teaching hospital Jaffna.Motorbike riders were more vulnerable, with an incidence of 55.2%. Age above 61 years contributed significantly to death after hospitalization with a P-value of < 0.005. The influence of alcohol at the time of the incident markedly contributed to the loss of life before hospital admission.In conclusion the motorcycles were deemed to contribute to the mortality and alcohol influence and age contributing to the pre-and post-hospitalization deaths, respectively.