jiafm, 2010-32(2) april-june. - forensic medicine

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ISSN 0971-0973 J Indian Acad Forensic Med, <strong>32</strong>(2)Figure No. 1Microscopic picture of CPP showing complexbranching papillary fronds with central fibrovascularcore (H&E scanner view)Figure No.3Photomicrograph of choroid plexus papilloma inhigh power showing epithelial cells with mildnuclear atypia lining the papillary fronds (H & Ehigh power view)Figure No.2Photomicrograph of choroid plexus papillomashowing concentrically laminated psammomabodies (H & E low power view)162
J Indian Acad Forensic Med, <strong>32</strong>(2) ISSN 0971-0973* Dr.Sushil KumarCase reportSuicide by para-phenylenediamine PoisoningAbstractTwenty three cases of acute para-phenylenediamine poisoning were examined clinically at emergency wardof Rama Medical College Hospital, Kanpur (Uttar Pradesh) irrespective of age, sex and socio-economic strata alongwith route and manner of administration of the poison.Albuminuria, anaemia, hypocalcemia, leucocytosis, thrombocytopenia, increased serum bilirubin,prolonged bleeding and clotting time alongwith increased levels of liver enzymes and serum creatinine wereobserved as significant bio-chemical parameters; on investigation in respect to complete haemogram, liver functiontest, renal function test, serum electrolytes, serum CPK levels and arterial blood gas analysis.The para-phenylenediamine is the ingredient of a traditional cosmetic hair dye available with the tradename Godrej expert powder hair dye, which is orally administered mainly with an intention to commit suicide,sometimes accidentally and very rarely as homicidal poison by hair dye users. The suicidal poisoning is morecommon in females as compared to males. The systemic toxicity of PPD has serious consequences which mayeventually lead to death.The cases are reported with the advice “public education and strict control over the sale and distributionof para-phenylenediamine should be done to reduce poisoning by this agent”.Key Words: Para-Phenylenediamine, Suicidal Poisoning, Traditional Cosmetic, Hair DyeIntroduction:Para- phenylendediamine is a poison, semipermanentdye has smaller molecule and is thereforeable to penetrate the hair shaft. This Colour willservive repeated washings.Godrej hair dye, supervasmol 33, Paraphenylendiamine,are used for colouring of hair, P-phenylendiamine (PPD) is an organic compound.This derivative of aniline aromatic amine, is acolourless solid when pure. This compound is used inalmost every hair dye marketed regardless of brands.The darker the colour, usually, the higher theconcentration, some of the so-called „Natural‟ and„herbal‟ hair colours, while ammonia free containsPPD. Some product sold as henna also contains PPDParticularly black henna.Short exposure to high level of PPD maycause severe dermatitis, eye irritation and tearing,Asthma, renal failure, vertigo tremers, convulsionsand coma.Ingestion of PPD produces rapiddevelopments of edema of face, neck, pharynxtongue and larynx with respiratory distress whichoften needs tracheostomy.Corresponding Author:*Dr. Sushil KumarAssistant Professor, Forensic Medicine,Rama Medical College, Kanpur (U.P.)In the later stages Rhabdomyolysis andacute tubular necrosis with acute renal failure andhepatic failure develops.Bleeding tendency (bleedingfrom gums), sub-cunjunctival hemorrhage andbleeding from mucus membrane also occur.Material and Method:Twenty three cases of acute Paraphenylendiaminepoisoning admitted to RamaMedical College & Hospital Mandhana Kanpur U.P.were examined irrespective of age, sex,socioeconomic strata Profession along with mannerof administration of the poison.Following investigations were done:1. CBC, BT, CT2. Renal function tests:a. S. creatinineb. Blood ureac. Urine: Routine and Microscopic3. Liver function testi. S. Bilirubinii. SGPT, SGOT4. Serum electrolytes:a. Serum Sodiumb. Serum Potassiumc. Serum Calcium5. CPK6. Arterial blood gas analysis163
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