Krishan Vij’s research while affiliated with Government Medical College & Hospital and other places

Suicide patterns and rates differ in various populations and cultures. It has been reported that developing countries have lower suicide rates, possibly because of a lower level of environmental stress but the Indians have a very high suicide rate (Elfawal, 1999). The choice of method used to commit suicide depends on availability of means, knowledge about lethal effectiveness, and the victim's motivation and intent. The present work was designed to investigate the different methods of self-destruction, the age and gender susceptibility to suicide, the groups particularly affected and the underlying motivating factor for such an extreme step among the North Indians. Various suggestions relating to decreasing the tensions of the modern mechanical life-style, educating the public in general and the availability, use and storage of agrochemicals have been put forward. Marriage counselling and the concept of family planning are also advocated.

Background: Head Injury is the single most common cause of mortality in vehicle accidents. Its outcome is a product of different mechanisms, types and amounts of head injuries and their anatomical locations. Objective: To analyze the pattern of fatal head Injury in road traffic accidents. Design: A retrospective autopsy based study conducted in correlation with the relevant clinical records and the reports from investigating agencies. Subjects: Cases of Road Traffic Accidents subjected to medico-legal autopsy at the department of Forensic Medicine, Government Medical College and Hospital Chandigarh, India - a tertiary care center. Main outcome: Young adults (both males and females) in their most productive years of life, are especially prone to head injury, as a result of vehicle accidents. Results: Vehicle accidents comprised 35% (632) of the total medico-legal autopsies. Fifty-eight percent (367) had sustained head injury, 76% (279) had a Glasgow Coma Score of 8 or less at the time of presentation in the emergency, 72% (273) survived less than 24 hours. Subdural (62.40%), Subarachnoid (23.5%), Extradural (16%) and Intracerebral (9%) haemorrhages were the major causes of death. Skull fractures were detected in 88.1%, while cerebral contusions and lacerations occurred in 23.7%. Six percent developed intracranial infections. Conclusion: For prompt treatment of such cases immediate Glasgow coma Scoring, radiological evaluation, surgical Intervention and Intensive care is required. Establishment of trauma teams and proper infrastructure at the primary health care level is recommended.

A twenty-one years retrospective study (1980–2000) of acute poisoning deaths carried out at the Department of Forensic Medicine and Toxicology at Government Medical College Hospital, Jammu and Govt. Medical College Hospital, Chandigarh — the two demographically different zones of Northern India. Union Territory of Chandigarh, which is the capital of Punjab and Haryana states, is one of the most developed parts of India, whereas Jammu primarily represents the rural India. The study is an attempt to analyze the various changing trends in acute poisoning in these zones with the aim that it will help immensely the health policy-makers to equip health care institutions accordingly. The present study reveals a steep increase in the number of acute poisoning cases and a change in the trends of the most commonly used poisons with the passage of time. Males outnumbered females and youth formed the majority of fatalities. The main victims were unemployed youth and students, followed by agricultural and domestic workers. Despite India's predominantly rural character, the urban preponderance of deaths by poisoning may reflect the role of leading a more stressful life in urban areas.

The study was carried out between 1994-2000 with three objectives, viz. a) to ascertain the various aspects of deaths due to poisoning, b) to analyze the probable reasons for the same and c) to find remedial measures to bring down the incidence of deaths by poisoning. Only those cases with a positive history of intake of or contact with some poisonous substance, thereby causing death, were included in the study. Age, Sex, Socio-economic and marital status, the poison alleged to have been consumed and its approximate quantity etc., were ascertained from various sources. The incidence in deaths due to poisoning was found to be persistently increasing. The age-group of 21-25 years, followed by 15-20 years, was the most prone to poisoning deaths. Male: female ratio was 2.5:1. Rural: urban ratio was 1.7:1. Among the male victims, married outnumbered the unmarried in rural community, while in the urban, reverse was observed. Among the females married outnumbered the unmarried in both the rural and urban communities. Aluminium Phosphide was found to be the drug of choice for suicides and suicide was the most common mode of poisoning. Based on the conclusions of the study various suggestions relating to decreasing the tensions of the modern mechanical life style, equal status for women in the society, educating the public in general, the rural population and the girl child, in particular; the use, storage and availability of the various insecticides and rodenticides, etc. have been put forward.

The present study, carried out in the department of Forensic Medicine & Toxicology at Govt. Medical College & Hospital, Sector 32, Chandigarh, India was aimed at studying the various parameters of the road traffic fatalities on Chandigarh roads, with a view to suggest a role model for bringing down the rate of vehicular accidents and accidental deaths in other places. During the period of study; 1994-2000, 1885 autopsies were performed at the Department. Deaths due to road traffic accidents comprised 42.18% (795) of these cases. The study revealed a steep decrease in the percentage of deaths due to road traffic accidents, from 59.50% to 32.10%. Young adults of the age group 21-30 years, were the major victims, 270 (33.96%). Males were involved in 643 (80.88%) deaths. 335 (42.14%) victims were pedestrians, followed by two-wheeler users - 312 (39.15%). Buses were the most common offending vehicles, 210 (26.42%), followed by cars, 156 (19.62%). 490 (61.63%) people died within 24 hours of the accident and head injury was the most common cause of death, 568 (71.45%). A continuing decrease in the rate and a persistent increase in the female fatalities following road traffic accidents, were concluded.

Injuries and fatalities occur in all forms of transportation, but numerically, road-traffic accidents account for the great majority worldwide. There is little that the autopsy surgeon can contribute to the elucidation of factors leading to the accident as it is largely the circumstantial and forensic laboratory evidence which is likely to reveal a non-accidental cause. However, the doctor's role in detecting the compatibility/incompatibility of the injuries with those usually sustained in traffic accidents (to detect any which are ‘atypical’, e.g. focal depressed fracture of the skull), distinguishing antemortem from postmortem injuries, demonstrating the presence of any disease capable of creating sudden incapacity and analysing samples for alcohol/drugs, etc., can go a long way in assigning roles to the human and to some extent vehicular and environmental factors. This warrants that a meticulous autopsy be conducted and not merely a catalogue of injuries. It must be appreciated that a fatal accident is likely to result in litigation and the extent of litigation cannot be anticipated at the time of the autopsy. One must, therefore, aim at the close study of any accident victim and a careful assessment of the case is always rewarding. The present study was undertaken in the Department of Forensic Medicine at (a) Government Medical College, Jammu (1991–93), (b) Mulana Azad Medical College, New Delhi (1993–95) and (c) Government Medical College, Chandigarh (1994–June 2000), with the object of doing a comparative analysis of the various aspects of the road-traffic accidents and accidental deaths in three topographically and demographically different cities in India and to suggest remedial measures to bring down the accident rate.

The medical officers in general and the Forensic Experts in particular deal not only with criminal, suicidal, accidental or suspicious deaths but are also confronted with a wide range of deaths where a significant natural element is revealed at autopsy. Rarely, such cases may sustain some injury due to fall or otherwise and the effects may be merely incidental to dying process. Claims for compensation or allegations of homicide may be initiated by the relatives although there may not be any factual basis. The proximity of cause and effect is often obvious/easily traceable in most of the cases. However, circumstances, though infrequent, can be there where the relationship is hazy and may be traced only with concerted efforts. Subdural Haematoma appears to be most notorious in this aspect as will be highlighted from the cases under presentation.