Medico-Legal Cases (MLC) Presented at a Tertiary Care Center and Acute Symptoms of Post-Traumatic Stress Disorder among the Survivors

Objectives:  An observational, prospective study was conducted to determine the incidence and risk factors associated with victims of physical assault and symptoms of post-traumatic stress disorder (PTSD). Material & Methods:  All the registered medico-legal cases reported to the emergency department of Gambat hospital were included in the study. The data was collected on a predefined questionnaire including age, gender, mode of injury, weapon of the injury, type of assault (blunt or penetrating), firearm injuries, and road traffic accidents from medico-legal registers. Impact of Event Scale (IES) was used to assess Post-traumatic stress disorder. Results:  The mean age (SD) of victims was 29.3 (10.25) years. Blunt injuries were experienced by 47 (31.33%) victims. The majority of the victims suffered road traffic collision injuries, 59 (39.33%). Forty-eight (32%) victims had substantially higher IES scores (above 37) that confirmed severe PTSD that may contribute to the suppression of the immune system’s functioning among survivors. The majority of the victims were between 18 and 40 years. Conclusion:  The most common cases were related to road traffic collisions followed by blunt injuries. The incidence rate of PTSD was also prevalent in these individuals. Thus, strategies should be developed to prevent such incidents and those who suffer from such traumatic events must be offered psychiatric consultation

The Role of Radiology (X-Ray versus Computed Tomography) in Medicolegal Cases Presented at a Tertiary Care Hospital in Pakistan

Objectives:  A prospective observational study was aimed to assess the role of plain radiographs and computed tomography in detecting head injuries presented at the medicolegal office at the Forensics and Radiology Departments, Gambat Medical Hospital, Sindh. Material and Methods:  All cases referred from the Medicolegal Office (MLO) with head injury were included. All victims underwent X-ray head and computed tomography skull was done with 1 or 1.5 cm thick axial sections without administration of intravenous contrast. The radiological reports of X-ray head and CT scans were documented and comparatively evaluated. Results:  Mean age was 38.63 ± 3.91 years. In 51 (45.13%) cases, X-ray was able to detect skull fracture, while CT scan detected 64(56.64%) skull fractures. There were 54 (84.3%) true positives, 3 (2.6%) false positives, 10(8.8%) false negatives, and 40 (40.7%) true negatives. The accuracy of X-ray to detect skull fracture was 88.50%. Conclusion:  X-ray had a sensitivity and specificity of 84.38% and 93.88%, respectively. It is a reliable tool to detect skull fractures in victims of assault in comparison with CT scans. X-ray is also associated with low dose radiation exposure as compared with CT scan which delivers 70 times more exposure than the former