Shankar Bakkannavar | Manipal Academy of Higher Education (original) (raw)

Papers by Shankar Bakkannavar

Journal of Forensic and Legal Medicine, Jul 1, 2023

Putrefactive changes are known to alter the appearance of injuries that may vanish with time due ... more Putrefactive changes are known to alter the appearance of injuries that may vanish with time due to disintegration of tissues, making its interpretation difficult for the autopsy surgeon. We report two cases of hanging where the ligature mark was well-preserved in spite of putrefactive changes in the bodies. Though similar cases are not uncommonly encountered in autopsy practice, the report is an attempt to discuss and highlight the various possibilities associated with delayed putrefaction in a ligature mark.

Journal of Indian Academy of Forensic Medicine, 2021

The subject of Forensic Medicine & Toxicology is an integral part of teaching in medical curricul... more The subject of Forensic Medicine & Toxicology is an integral part of teaching in medical curriculum prescribed by Medical council of India. Since the evolution of this subject & separation of the subject from the Pathology / Community Medicine, in early 20th century no much scientific additions / developments have been taken place. At the same time the subject experts have adhered to what the subject had in beginning, only teaching under graduates in medical colleges without much medico legal work (which is present only in government medical colleges) often within college campus. Hence most of the references mentioned in common Forensic Medicine text books in India are inherited from western literature. Are these data reliable to be applied in Indian population? If yes, to what extent these references are applicable to Indian population? More and more researches are necessary in this regard.

Pathology, 2004

Twenty-six cases of granulomatous mastitis were examined to determine the common histological and... more Twenty-six cases of granulomatous mastitis were examined to determine the common histological and clinical features and the possible association with micro-organisms. A retrospective review of the clinical and histological features of these cases was undertaken, including granuloma, inflammatory cell infiltrate, multinucleated giant cells, necrosis and lymphocytic lobulitis, as well as special stains for micro-organisms including Mycobacterium, other bacteria and fungus. PCR for Mycobacterium tuberculosis DNA was also performed in 19 cases. Granulomas were present in all cases (100%) while multinucleated giant cells were seen in 17 cases (65%), background inflammatory cell infiltrate in 23 cases (88%), predominantly lymphocytes in 18 cases (69%), significant lymphocytic lobulitis in 13 of 19 cases (68%) and necrosis in three cases (11%). Special stains and cultures for micro-organisms were all negative. Clinically, four cases (15%) were associated with duct ectasia, eight (31%) with abscess, and there was no such association in 14 cases (54%). Of the 19 cases with PCR for tuberculosis, one case showed Mycobacterium DNA in the sample, raising the possibility of occult tuberculosis infection. Granulomatous mastitis is a heterogeneous group of diseases with a diverse clinical picture and association. Most idiopathic cases are not associated with specific micro-organisms.

Choking is one of the important types of asphyxia deaths. The incidences of which are not uncommo... more Choking is one of the important types of asphyxia deaths. The incidences of which are not uncommon. The choking in children could be due toys, coins, marbles, nuts and any other small hard object or even sometimes due to stuffed in plastic bags whereas in adults most of the times food bolus or hard parts of food like bone pieces are responsible. It is mostly accidental in nature. It can cause coughing or sometimes airway obstruction leading to death. We present a case wherein a mentally ill person accidentally choked to death after consumption of food.

Journal of Legal, Ethical and Regulatory Issues, 2021

Summative assessment is an assessment administered to the students at the end of a teaching perio... more Summative assessment is an assessment administered to the students at the end of a teaching period. This assessment is intended to assess students' learning ability and knowledge gained during the period based on the specific comparison of their performance with the standard learning outcome specified in the course. Various assessment formats are used in the summative assessments including class tests, end of semester examination, online assessments etc. In these formats the pattern would be either multiple choice questions or descriptive type questions are asked. To assess the practical knowledge gained during the teaching period, the conventional practical examination system is followed in most of the medical colleges. However, many of the medical colleges are now using Objective Structured Practical Examination (OSPE) pattern which is becoming more common method of practical assessment among the medical students. In the present study, pattern of OSPE employed in the center was described and the students' perception about the OSPE examination was evaluated.

Research journal of pharmaceutical, biological and chemical sciences, 2016

The malarial infection leading to morbidity and mortality is common throughout the world. Sudden ... more The malarial infection leading to morbidity and mortality is common throughout the world. Sudden deaths due to malarial infection are not uncommon. These unexpected sudden deaths pose a challenging task to the forensic pathologist. Such deaths are more commonly due to Plasmodium falciparum. However deaths due to Plasmodium vivax are also reported in the literature. The Plasmodium vivaxinfection can lead to cardiac functional abnormality in already compromised heart. We present a case of sudden death wherein post mortem analysis of blood revealed the Plasmodium vivax infection helping us to ascertain the cause of death.

Pituitary adenoma is the most common tumour occurring in the pituitary gland. The slow-growing, h... more Pituitary adenoma is the most common tumour occurring in the pituitary gland. The slow-growing, hormonally inactive adenomas are usually asymptomatic and may be observed as an incidental finding at either radiological or postmortem examination. The adenomas that grow rapidly produce pressure on nearby structures resulting in clinical manifestations such as visual disturbances, symptoms of raised intracranial pressure and hypofunction of the target organs under its control. Herein, we report a case of pituitary adenoma which was incidentally found at autopsy in a case of road traffic mishap, in which the possibility of visual impairment caused by the pituitary adenoma contributing to the road traffic mishap could not be ruled out.

Issues related to dowry have assumed epidemic proportions and the morbidity and mortality arising... more Issues related to dowry have assumed epidemic proportions and the morbidity and mortality arising from dowry-related issues constitute a major public health problem throughout India. Deaths among married women reported as alleged dowry-deaths for medico-legal autopsy were analysed to observe the regional trend in terms of victim-profile and to identify the cause and manner of such deaths, in Manipal, South India. In the present retrospective study, 1727 medicolegal cases autopsied at the Department of Forensic Medicine, Kasturba Medical College, Manipal, from January 1, 1995 to December 31, 2005 were reviewed. A total of 17 deaths were identified as alleged dowry-deaths forming the cohort of the present study. Dowry-death peaked between the ages of 21 and 25 years (58.8%). 70.6% of the victims were Hindus, 17.6% were Muslims, and 11.8% were Christians. Over two-third of the victims (70.6%) had a rural background. Nearly 60% of the cases occurred between 6 AM and 10 PM. The survival period of the victims following the incident varied from less than 24 hours (5.9%) to more than 7 days (23.5%). The occupation of the victims revealed that 94.1% were house-wives, and one victim was a doctor (5.9%). Burns was the most frequent method of causing dowry-death (82.3%), followed by poisoning (11.8%), and hanging (5.9%). The manner of death was suicide in 70.6% and homicide in 29.4% of the cases. With a regional understanding of the victim-profile and the cause and manner of dowry-deaths, it may be possible to foresee, and hopefully prevent, future cases of dowry-deaths among the young, married women who form an integral section of our society.

Attendance rate for hospital outpatient appointments plays a pivotal role in operational efficien... more Attendance rate for hospital outpatient appointments plays a pivotal role in operational efficiency of a hospital. Strategic interventions like ‘reminder systems’ prior to the scheduled appointment has proved to be an effective strategy for outpatient appointment ‘show-ups’. This study is designed with an objective to assess the effectiveness of SMS reminders as an intervention to enhance the effectiveness of hospital outpatient attendance. Method: The survey was conducted at Columbia Asia Hosiptal, Bangalore.We surveyed 60 patients who had a scheduled outpatient appointment in Department of General Medicine, Department of Obstetrics and Gynecology and the Orthopedics department, as these departments had a heavy patient flow and had higher contributions to the top line of the hospital. Results: Majority (64%) of the patients preferred to be sent an SMS reminder on the outpatient appointment schedule.37 (61%) respondents stated that the ideally, reminders could be effective only if they are sent 24-48 hours prior to the appointment schedule. 41(68%) respondents were of the opinion that a minimum of two reminders would be necessary to ensure patients show up for the appointment. 1% level of significance. It also observed that there is strong association between age and preference on mode of reminder (P=0.002).

Indian journal of forensic and community medicine, 2015

Paraquat is one of the most dangerous poisons in the medical field as Ingestion of small quantiti... more Paraquat is one of the most dangerous poisons in the medical field as Ingestion of small quantities (>10mL) may damage lung irreversibly and also lead to renal failure causing to death. The paraquat is sold in more than 130 countries around the world to be used in small as well as large farms. The easy availability of this poison makes it a commonly employed agent for suicide. More than 93% of deaths due to paraquat poisoning are suicidal in nature and most of them are occurring in developing countries. The clinical features vary from case to case based on the amount and type of compound consumed. As it is a fatal condition, early diagnosis and proper management is warranted which can reduce the morbidity and mortalities. But sometimes early diagnosis may not save the victim as in our case. We present a case wherein the victim succumbed to acute respiratory distress following consumption of paraquat.

Journal of Indian Academy of Forensic Medicine, 2012

The present research aims to highlight the pattern of thoraco-abdominal injuries sustained by the... more The present research aims to highlight the pattern of thoraco-abdominal injuries sustained by the victims of fatal road traffic accidents (RTA) in Manipal, South India. The study is an autopsy based observation of thoraco-abdominal injuries in victims of fatal road traffic accidents during 1999–2003. Road traffic accidents accounted for most of the injury related deaths (77%) during the study period. A male preponderance (86%) was observed with a male-female ratio of 6: 1. Individuals in the age group of 21 to 50 years formed the most ...

Rodenticides are pesticides that kil rodents.ratol is a rodenticide available in past from and th... more Rodenticides are pesticides that kil rodents.ratol is a rodenticide available in past from and the main ingredient is yellow phosphorous. other possible compostion in rodenticides are zinc phosphide and coumarin derivatives. among all these yellow phosphorous has more lethal effects.they are not uncommon agents for poison to commit suicide in india. But in our case, through self-consumed , it was noy with the intention to die. A 22 year old female consumed ratol poison just for fun.Later on she realized the seriousness of it luclily survived with proper management.

Foramen magnum is an important anatomical landmark, but the anthropological importance of foramen... more Foramen magnum is an important anatomical landmark, but the anthropological importance of foramen magnum is under assessed. Few studies in the past have tried to correlate the value of foramen magnum in the estimation of sex and endocranial volume. This study tries to evaluate the value of foramen magnum in estimating the stature of an individual, as it could be of immense value in assessing the stature, in case of fragmentary remains. We have formulated a multiple regression equation using the length, breadth and area of foramen magnum. Based on the analysis it was found that breadth of foramen magnum was a better tool of stature estimation than area and length of foramen magnum.

Nature Communications

Snakebite envenoming is an important cause of preventable death. The World Health Organization (W... more Snakebite envenoming is an important cause of preventable death. The World Health Organization (WHO) set a goal to halve snakebite mortality by 2030. We used verbal autopsy and vital registration data to model the proportion of venomous animal deaths due to snakes by location, age, year, and sex, and applied these proportions to venomous animal contact mortality estimates from the Global Burden of Disease 2019 study. In 2019, 63,400 people (95% uncertainty interval 38,900–78,600) died globally from snakebites, which was equal to an age-standardized mortality rate (ASMR) of 0.8 deaths (0.5–1.0) per 100,000 and represents a 36% (2–49) decrease in ASMR since 1990. India had the greatest number of deaths in 2019, equal to an ASMR of 4.0 per 100,000 (2.3—5.0). We forecast mortality will continue to decline, but not sufficiently to meet WHO’s goals. Improved data collection should be prioritized to help target interventions, improve burden estimation, and monitor progress.

Reiner RC Jr, Hay SI. Mapping geographical inequalities in childhood diarrhoeal morbidity and mor... more Reiner RC Jr, Hay SI. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395: 1779–801—In this Article, the author byline has been amended to Local Burden of Disease Diarrhoea Collaborators. This correction has been made to the online version as of June 4, 2020, and the printed version is correct