Mukul Sharma

Abstract

Suicide, is one of the most painful way of death and even more so painful for the near and dear ones. Suicide note if recovered is heart breaking, as it becomes the last and one way communication from the deceased to his family/ friends. In almost 95% of cases it is written in own handwriting and consisting of 10-15 sentences or small paragraph. While there have been studies related to this and was observed that number of words usually doesn’t make a difference between complete and half attempt suicide. To understand a suicide note, Relevance theory was proposed which is based on a principle that "every utterance conveys the information that it is relevant enough for it to be worth the addressee's effort to process it". The note which was recovered from the deceased`s pocket and whereby mentioning that “life had become painful and stuck in a situation from where he couldn’t get out”, clearly conveys about the stress and problems in his life, though did not mention clearly or any specifics. A study conducted in USA regarding the words used in suicide notes and observed that words referencing to inclusive space like “with” or “include” are not usually used which is similar to our case and it signifies isolation or lack of belongingness. Keywords: ­ Suicide, Suicide note, Relevance theory, Lack of belongingness.

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Abstract

Violence against women has been in talks and news every now and then. Various laws are enacted world-over and in India for protection of their rights and dignity with stringent punishments of the offender. But issues arise if the offender is a mentally unsound person or a juvenile. The case is of a four-month pregnant lady who was attacked by a mentally unsound person and was brought to casualty in a low condition with unstable vitals. She had sustained multiple injuries over the body and a wooden roller stuck inside the vagina. The treating physician’s medico-legal duties and the role of state in such cases become very important. The treatment examination of victim and accused along with the legal implications make such cases worth discussing.   Keywords: Sexually violent, Sexual assault.

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Abstract

Introduction: Agriculture being the primary mode of occupation in Odisha leads to the rampant and widespread use of chemical pesticides and herbicides. Paraquat is a widely used herbicide. Ingestion of PQ irrespective of the quantity could be fatal with life-threatening effects on the gastrointestinal (GI) tract, kidney, liver, lungs, and other organs. Death is usually associated with respiratory insufficiency due to an oxidative insult to the Type-II alveolar epithelium with subsequent fibrosis. Materials and Methods: All cases of paraquat ingestion coming to AIIMS, Bhubaneswar casualty from July 2020 to November 2020 were studied for their clinical findings. The fatal cases were subjected to autopsy and findings noted. Results: Men were most commonly involved. All of the patients had self-harm intent while consuming. The most common presenting symptoms were difficulty in swallowing, Respiratory system was most commonly affected. The cause of death was attributed to respiratory and multi-organ failure. Discussion: Paraquat is widely marketed for its efficacy and low environmental toxicity. Lack of a specific antidote increases the fatality. The most common cause of death is respiratory failure. Paraquat causes renal failure by causing hypovolemia, circulatory failure, septicemia, and direct toxicity. The mainstay of treatment is supportive though the use of immune-suppressants has shown some positive results. Keywords: Paraquat, Herbicide, Pulmonary fibrosis, Multi organ failure.

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