DefinePK

Research Objective

To compare the optimum imaging modality to assess the various kinds of Shajjah hurt in medicolegal (MLE) cases of head injuries.

Methodology

Cross-sectional study conducted at the Department of Forensic Medicine and Toxicology at Gambat Medical College. 164 medicolegal cases of moderate to severe head injuries (Glasgow Coma Scale score of 12 or less) were included. Injuries were categorized by age, gender, type of Shajjah, and diagnostic modality (X-ray and CT scan).

Methodology Flowchart

                        graph TD;
    A["Inclusion of 164 medicolegal cases of head injuries GCS <= 12"] --> B["Categorization of Injuries"];
    B --> C["By Age, Gender, Shajjah Type"];
    C --> D["Diagnostic Modality Assessment"];
    D --> E["X-ray Analysis"];
    D --> F["CT Scan Analysis"];
    E --> G["Identify X-ray limitations and misdiagnoses"];
    F --> H["Identify CT scan accuracy and findings"];
    G --> I["Compare Modalities"];
    H --> I;
    I --> J["Conclusion on Optimum Modality"];                    

Discussion

The study highlights the superiority of CT scans over X-rays in diagnosing Shajjah hurt in medicolegal cases. CT scans provide more detailed anatomical information, leading to fewer missed injuries and more accurate diagnoses, which are crucial for medicolegal certification under the Qisas and Diyat Act. The discussion also touches upon the demographic profile of head injury victims, with a preponderance of males and young adults.

Key Findings

X-rays failed to detect Shajjah hurt in at least one-fourth of the cases and misdiagnosed several types of Shajjah injuries. CT scan accurately diagnosed all types of Shajjah hurt, with specific percentages for Shajjah hashimah (9.76%), Shajjah Munaqillah (12.2%), Shajjah Ammah (48.17%), and Shajjah Damighah (29.88%).

Conclusion

CT scan demonstrates superior performance compared to X-ray in correctly identifying the type of Shajjah hurt. It is effective in detecting skeletal lesions and providing crucial information about intracranial damage, such as extradural hemorrhage and rupture of membranes, which are associated with more severe categories of Shajjah hurt.

Fact Check

1. Number of cases: 164 medicolegal cases of moderate to severe head injuries were included in the study.
2. X-ray failure rate: X-rays failed to detect Shajjah hurt in at least one-fourth of the cases.
3. CT scan diagnosis of Shajjah Ammah: CT scan accurately diagnosed 79 (48.17%) cases as Shajjah Ammah.

Mind Map