Browsing by Author "Singh, PK"
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Publication Custodial Death(Kathmandu University, 2023) Singh, PK; Karki, AABSTRACT The authors report a case of death of 16 years old boy in custody of a rehabilitation center. The young boy was taken to hospital for some health issues after severe torture where he was declared dead and brought for medicolegal autopsy under the requisition of investigating authority. Autopsy examination revealed multiple abrasions and intradermal contusions of ante-mortem origin and fresh at the time of death on various parts of the body including intradermal contusions on bilateral soles, subscalpal hematoma, subdural with minimal subarachnoid haemorrhages were observed. Histo-pathological examination of bilateral kidneys revealed features of acute tubular necrosis which is due to release of myoglobin as result of skeletal muscle necrosis sustained due to repeated blunt force trauma. The cause of death was attributed to head injury. Deceased was tortured by hitting over soles which is also known as falanga, and the second most common form of torture after beating the body. The fatal maltreatment and death of people who are detained against their will often raises controversy therefore nonpartisan information on cause of death is required to conclude that human rights were abused. So, medicolegal autopsy provides scientific basis for the occurrence of injury and establishing cause of death. KEY WORDS Autopsy, Custodial death, Necrosis, TorturePublication Determination of Sex from the Foramen Magnum using 3DCT: A Nepalese Study(Kathmandu University, 2017) Singh, PK; Tamrakar, D; Karki, S; Menezes, RGABSTRACT Background Identification is of utmost importance in any medicolegal investigation with sex determination being one of the principle indicators of identity. Sexing of bones becomes easy when the skeletal remains are complete. However, the problem arises when the bones are fragmented. Many researchers have undertaken several studies in different populations to determine the sex with reasonable accuracy using numerous measurements of the skull including those of the foramen magnum. Objective The present study was aimed to find the sexual dimorphism of the foramen magnum in the Nepalese population by analyzing the antero-posterior length, transverse diameter and area of the foramen magnum. Method The antero-posterior length and transverse diameter of the foramen magnum were measured using three-dimensional computed tomography (3DCT) images of the head in a cohort of 100 Nepalese subjects. Radinsky’s and Teixeria’s formulae were used to calculate the area of the foramen magnum. Discriminate function analysis was used to analyze sex differences. Result Mean values of antero-posterior length and transverse diameter of the foramen magnum in males were higher than in females. The mean of the area calculated using Radinsky’s formula was smaller than that calculated by Teixeira’s formula and the areas calculated were higher in males. The measurements of the foramen magnum and the areas calculated showed significant difference (p<0.001) between males and females. Discriminate function analysis for the measurements of the foramen magnum and the areas calculated showed high predictability for both the sexes. Discriminate function analysis showed a maximum predictability of 75%. Conclusion Considering the percent of predictability of sex from the various variables related to the foramen magnum in the Nepalese population, it can be concluded that its restricted applicability in forensic investigations should be constrained to cases of fragmentary skull bases. KEY WORDS Foramen magnum, forensic anthropology, identification, sex determination, sexual dimorphismPublication Evaluation of Antinociceptive Activity of Ficus Religiosa Root Extract in Swiss Albino Mice(Kathmandu University, 2022) Singh, S; Sangraula, H; Singh, PK; Sarraf, DPABSTRACT Background Ficus religiosa, commonly known as peepal, is widely distributed in Indian subcontinent. It has been used as an antiepileptic, aphrodisiac, analgesic, anti- inflammatory and laxative in traditional medicine. Objective To explore the analgesic effect of aqueous root extract of Ficus religiosa using thermal and chemical models of pain in swiss albino mice. Method The aqueous aerial root extract of Ficus religiosa was prepared using soxhlet apparatus. The anti-nociceptive effect of the extract at doses of 50 and 100 mg/kg was evaluated using peripheral (acetic acid-induced abdominal writhing), spinal (tail flick) and supra-spinal (hot plate) behavioral models of pain. All data were presented as Mean ± SEM. Statistical differences between Ficus religiosa (50 and 100 mg/kg) and standard control groups were evaluated using Mann-Whitney U test. Result There was significant dose dependent increase in the mean reaction time compared to the vehicle control in hot plate and tail- flick test. In acetic acid induced writhing test, mice treated with Ficus religiosa (50 and 100 mg/kg) exhibited significant dose-dependent decrease in the mean number of writhes (57.45% and 79.20% respectively) compared to the vehicle control. The activity of Ficus religiosa extract at doses of 50 and 100 mg/kg was equipotent to Standard control (Morphine and Indomethacin) used in different test models. Conclusion The extract of Ficus religiosa possesses both central and peripheral analgesic activity thus validating the traditional use of this plant in the management of pain. KEY WORDS Antinociceptive, Acetic acid induced writhing, Ficus religiosa, Hot plate method, Tail-flick methodPublication Geographic Distribution of Suicide in Kavrepalanchok District, Nepal: A Retrospective Study(Kathmandu University, 2025) Singh, PK; Karki, A; Karn, VLABSTRACT Background Suicide remains one of the oldest and most pressing public health challenges, causing profound emotional, psychological, and social trauma for affected families and communities. Common contributing factors include psychological disorders, marital and family disputes, and financial difficulties influenced by geography, gender, and socioeconomic status. While causes may vary, hanging remains the most prevalent method of suicide, followed by poisoning. Objective To examine the geographic and sex-wise distribution of suicide cases and identify high-burden municipalities in Kavrepalanchok District, based on medicolegal autopsies performed at Dhulikhel Hospital from 2nd November 2020 to 13th April 2023. Method A retrospective cross-sectional study was conducted at the Department of Forensic Medicine, Kathmandu University School of Medical Sciences, Dhulikhel. All suicide cases brought for medico-legal autopsy between 2nd November 2020 and 13th April 2023 were included in the study. These individuals were either deceased at the scene or passed away during treatment at the hospital. Cases with an unclear history of suicide or those involving decomposed or skeletonized bodies were excluded. Data were analyzed descriptively using Microsoft Excel and R version 4.4.3. Result A total of 697 autopsies were conducted over a three-year period, of which 468 (67.14%) were identified as suicide cases. Among these, 235 (33.71%) were from outside Kavrepalanchok, and 233 (50.43%) were from within the district. Hanging was the predominant method, accounting for 75.74% of cases overall. Males consistently accounted for a higher proportion of suicides (overall 61.36%) across all three years. An increasing trend in suicide cases was observed over the years, particularly with a rising proportion of suicides due to hanging. The highest number of suicides within the district was reported in Panchkhal municipality (n=32), suggesting a geographic concentration of cases. Conclusion The observed increasing trend in suicide cases over the three-year period, especially among males and through the method of hanging, highlights a significant public health concern. Targeted and coordinated interventions from both government and community stakeholders are essential to mitigate this growing burden. KEY WORDS Autopsy, Hanging, Kavre, Poisoning, Suicide distributionPublication Massive Subcutaneous Emphysema and Pneumothorax in a Case of Attacked by a Domesticated Bull – An Autopsy Based Diagnosis(Kathmandu University, 2023) Singh, PK; Shah, DKABSTRACT Subcutaneous emphysema is a condition when air or gas gets trapped within the subcutaneous layer. It is characterised by crackling feeling on palpation of the skin known as subcutaneous crepitation which is described as touching rice krispies. A 70 years male from hilly region of Nepal with agricultural background suffered multiple injuries sustained due to an attack by domesticated bull in his house. Upon the incident the injured male was taken to hospital, where he was declared “Brought Dead” by the Emergency Department of Dhulikhel Hospital, Kathmandu University Hospital. His body was brought for autopsy in Department of Forensic Medicine and Toxicology of Kathmandu University School of Medical Sciences. On complete autopsy, massive subcutaneous emphysema and pneumothorax was demonstrated. The details of finding are discussed in detail as follows. KEY WORDS Autopsy, Pneumothorax, Subcutaneous emphysemaPublication Predictability of Sex from Frontal Sinus in Nepalese Population(Kathmandu University, 2021) Singh, PK; Paudel, RC; Menezes, RGABSTRACT Background Various methods had been used for personal identification. Scientific basis of identification was initiated and progressed after 19th century which may be attributed to various scientists. With the invention of X-ray the field of identification further progressed. Modern radiological diagnostic equipments have greatly assisted in the field of forensic. Frontal sinuses are paired lobulated air cavities located posterior to superciliary arches in the frontal bone. Computed Tomography is best used to study frontal sinuses. Objective To evaluate bilateral Frontal sinus for sexual dimorphism using Computed Tomography. Method Anterior posterior length, transverse width and height of the bilateral Frontal sinus were directly measured on CT DICOM image, using Electronic Caliper in DICOM viewer software. A total 100 CT scans, 50 of each sex were collected was analysed using SPSS-20 in present study. Result The mean age distribution for male is 34.74±8.66, and for females 35.34±8.88. The mean of all the measurements take was larger in males in comparison to females with p < 0.00. The paired t test showed left side is larger than right. The discriminant function showed high significance for each measurement and also when all the measurements were combined. Conclusion Though the study being unique for Nepalese population, caution should be taken when frontal sinus is used as the only parameter. However in combination with other morphometric data is advised. KEY WORDS Computed tomography, Frontal sinus, Identification, Lobulated air cavities, Sexual dimorphism, Superciliary archesPublication Self-Perception of Halitosis among Undergraduate Students of Kathmandu University School of Medical Sciences - A Questionnaire Based Study(Kathmandu University, 2018) Humagain, M; Dixit, S; Bhandari, B; Khanal, S; Singh, PKABSTRACT Background Halitosis is a frequently reported oral health problem worldwide with a prevalence rate of 10-30% in the general population. It is defined as the disagreeable or foul smelling breath originating consistently from a person’s oral cavity. It not only effects the normal daily life activities of the patient but also bring humiliation, reduced self- esteem, ultimately resulting into decreased quality of life. Objective To determine the self-perception of halitosis among undergraduate students of different medical branches of Kathmandu University School of Medical Sciences (KUSMS); Kavre, Nepal. Method A descriptive cross-sectional epidemiological survey was conducted among undergraduate students of Physiotherapy, B.Sc Nursing, Bachelor of Nursing Sciences (BNS), MBBS and BDS program of Kathmandu University School of Medical Sciences, Dhulikhel. A self-administered questionnaire was developed and were distributed among 500 undergraduate students. Result Out of total 500 distributed questionnaires, 406 were completely filled and returned giving an overall response of 81.2%, in which 70 (89.7%) male and 280 (85.4%) female students from different medical branches were aware of the term halitosis. Among them 29 (7.14%) of students think that they suffer from halitosis. Similarly 178 (43.84%) students had severe impact of halitosis on their social life while 153 (37.68%) and 62 (15.27%) students had moderate and mild impact respectively. Conclusion Due to the multifactorial complexity of halitosis, further longitudinal studies including objective assessment of malodor are required to determine its prevalence and to further investigate the association of this problem with other etiological factors in the context of Nepal. Also, curriculum of different fields should be modified to include this simple but very necessary topic. KEY WORDS Halitosis, Multifactorial complexity, Self-perceptionPublication Sex Determination From the Bicondylar Width of the Femur: A Nepalese Study Using Digital X-ray Images(Kathmandu University, 2016) Singh, PK; Karki, RK; Palikhe, AK; Menezes, RGABSTRACT Background One of the important components of forensic identification is sex determination. The prediction of sex becomes easy with a complete skeleton. The problem arises with mutilated and incomplete skeletal remains. The skull and pelvis are preferred for sex prediction, but not uncommonly, long bones are brought for forensic examination. The femur out stands as the most dimorphic long bone. The literature on sex determination from the femur in different population groups is in abundance. The forensic anthropology literature suggests that longitudinal dimensions are often less discriminating than the breadth and circumference of long bones. Many researchers have suggested that the bicondylar width of the femur is the most dimorphic dimension. Objective To evaluate the sexing potential of the bicondylar width of the femur in the Nepalese population using digital X-ray images. Method A sample of 200 digital X-ray images of the knee belonging to 100 males and 100 females was used to measure the bicondylar width of the right femur. These digital X-ray images were those of Nepalese patients who visited the Department of Radiology at the affiliate hospital of Kathmandu University School of Medical Sciences, Dhulikhel, Nepal for diagnostic and treatment purposes. Result The resent study reveals a statistically significant difference for the bicondylar width of the femur between males and females. A regression equation was derived with sectioning point 77.84. Using the regression equation the prediction of sex was 68% with an overlapping of 32%. Having a low prediction in comparison to other studies in different populations, 95% confidence interval for the mean was used to get a range of measurements of the bicondylar width for males and females. The range stated in the present study is 79.47 mm to 82.20 mm for males and 73.75 mm to 75.93 mm for females. Conclusion The bicondylar width of the femur cannot be individually recommended for sex determination in the Nepalese population, but could be considered if analyzed along with the other morphometric traits for sex determination. KEY WORDS Bicondylar width, dimorphism, femur, forensic anthropology, identification, sex determination