Some of the online classes taken: 

students can access the videos of the classes by clicking the following links:

Asphyxia (the whole chapter in seven video files)

Introduction to Toxicology  (in four video files)

Snakes:

The most memorable day of my life when I am felicitated by my students (PGT) for geting the FELLOW of National Foundation of Clinical Forensic Medicine, awarded to me for my incision technique “Fourth Incision: The Cosmetic Autopsy Technique”.

Thank you students, thank you all.

Toxidromes

What is a toxidrome

       It is the association of several clinically recognizable features, signs, symptoms, phenomena or characteristics which often occur together, so that the presence of one feature alerts the physician to the presence of the others.

The cholinergic toxidrome

Syndrome	Signs &Symptoms	Poisons	Antidote
Cholinergic SLUDGE	•      Salivation •      Lacrimation •      Urination •      Diarrhoea •      GI cramps •      Emesis •      Wheezing •      Diaporesis •      Bronchorrhoea •      Bradycardia •      Miosis	•      Carbamate •      Organophosphates •      Physostigmine •      Pilocarpine	•      Atropine •      Pralidoxime for organophosphates

The anticholinergic toxidrome

Syndrome	Signs &Symptoms	Poisons	Antidote
Anticholinergic Hot as a hare Dry as a bone Red as a beet Mad as a hatter Blind as a bat	•      Mydriasis •      Blurred vision •      Fever •      Dry skin •      Flushing •      Ileus •      Urinary retention •      Tachycardia •      Hypertension •      Psychosis •      Coma •      Seizures •      Myoclonus	•      Antihistamines •      Atropine •      Baclofen •      Benztropine •      Tricyclic         antidepressants •      Phenothiazines •      Propantheline •      Scopolamine	• Physostigmine  (do not use in cyclic antidepressant overdose as will worsen conduction disturbances)

Hallucinogenic Sympathomimetic toxidrome

Syndrome	Signs &Symptoms	Poisons	Antidote
Hallucinogenic	•      Disorientation •      Hallucinations •      Hyperactive Bowel •      Panic •      Seizure •      Tachycardia •      Hypertension •      Tachypnoea	•      Amphetamine •      Cocaine •      Pseudoephedrine •      Phencyclidine •      Ephedrine	•      Benzodiazepines

Sedative/hypnotic toxidrome

Syndrome	Signs &Symptoms	Poisons	Antidote
Sedative / hypnotic	•      Stupor & coma •      Confusion •      Slurred speech •      Apnoea	•      Anticonvulsants •      Antipsychotics •      Barbiturates •      Benzodiazepines •      Ethanol •      Meprobamate •      Opiates	•      Naloxone •      Flumazenil •      Urinary alkanisation for Phenobarbital

Opiate toxidrome

Syndrome	Signs &Symptoms	Poisons	Antidote
Narcotic	•      Altered mental status •      Slow shallow breaths •      Meiosis •      Bradycardia •      Hypotension •      Hypothermia •      Decreased bowel sounds	•   Dextromethorphan •   Opiates •   Pentazocine •   Propoxyphene	•      Nalaoxone

Serotonergic syndrome

Syndrome	Signs &Symptoms	Poisons	Antidote
Serotonergic	•   Irritability •   Hyperreflexia •   Flushing •   Diarrhoea •   Diaphoresis •   Fever •   Trismus •   Tremor •   Myoclonus	•      Fluoxetine •      Meperidine •      Paroxetine •      Trazodone •      Clomipramine	•      Benzodiazepine

Protocol for Autopsy Examination

Objectives:

To find out the cause of death

Mode of death

Manner of death

Nature of death

Time since death

To note the injuries present on the body

Weapons used

Recording the data for identification

In new born- live birth / still born / dead born

Rules of M.L. Autopsy

Proper authorisation papers

1. Command certificate
2. Forwarding letter
3. Inquest
4. Dead body challan

Should be done in an approved center

By authorised registered medical practitioner

Should be done in natural light

For night autopsy- written order from DC is a must

Arrangement for proper lighting must be done

Mention the time of autopsy with the order of the DC in the autopsy report

Note the following before performing autopsy:

Time of receiving the body

Time of performing autopsy

Person identifying the body with signature where of the escorting police is a must.

For identification- allow the person whose name is mentioned in the dead body challan.

External examination

Length & weight and complexion etc of the body

Wearing garment

Any stain / tear on cloth - whether these correspond with injuries on the body

Body surface - stains / discharge / foreign materials

All the natural orifices

Eyes

Finger nails - Colour Change / Foreign materials – keep nail scraping for foreign material

Injuries – type, size, shape & position

Rigor mortis

Postmortem staining - Colour, distribution

Decomposition changes

Temperature

Any other peculiarities

Internal examination

All autopsies must be complete

All the body cavities must be opened and examined

All the organs must be dissected and examined

Incisions used

I shaped

Y shaped

Modified Y shaped

4^th Incision: the cosmetic autopsy incision - for details, please go to the link bellow http://drajpatowary.blogspot.com/2007/08/fourth-incision-cosmatic-autopsy.html

For scalp- mastoid to mastoid incision in coronal plane (through the vertex).

Preservation of viscera in suspected poisoning cases

Viscera & body fluid to be preserved

• Stomach with content

• Portion of small intestine with content

• Portion of liver with gallbladder

• Half of each kidney

Viscera should be preserved in saturated solution of sodium chloride. Rectified spirit should be used in cases of poisoning by mineral acids, sodium chloride & vegetable poisons. Never use formalin as preservative.

• Blood in sodium fluoride

• Urine in thymol

Precautions to be taken in preservation of viscera

Stomach to be preserved in one container

Portion of liver and kidney in 2^nd container

Sample of preservative used in 3^rd container

All the containers are to be sealed and labeled

Sample of the seal to be sent on the forwarding letter

Blood to be sent in air tight container in death due to alcohol poisoning

Sample of tissue from injection site to be sent along with similar control tissue in separate container

Precautions to be taken during autopsy

Examine all the papers carefully- read the inquest and note the injuries mentioned.

Put signature on all the pages of the papers.

In case of disparity in the inquest and the findings on the body- call the I.O. / inquesting officer, show the disparity and take his signature. Insist on photography / video recording.

All the directions to the I.O. should be in writing, in case of inability on the part of the I.O. to comply with the directions, he has to inform that in writing.