Place: Mysore
Date:
From,
Dr.Kishor Kumar D.G
Post Graduate in M.D(Forensic Medicine),
Dept of Forensic Medicine,
MMC and RI,
Mysore.
To,
The Dean and Director,
MMC and RI,
Mysore.
THROUGH PROPER CHANNEL
Respected Madam,
Sub:-Acceptance of registration and forwarding of dissertation topic.
In accordance with the above cited subject, I, Dr.Kishor Kumar D.G studying
Post Graduate course in M.D(Forensic Medicine) has been allotted the dissertation topic “A
STUDY OF QUALITATIVE AND QUNATATIVE ESTIMATION OF ALCOHOL IN
DRUNKENNESS CASES” under the guidance of Dr.Chandrashekar T.N, Professor and
HOD,Dept of FM, MMC and RI, Mysore.
I request you to kindly forward the dissertation topic in the prescribed for to the
University for Approval.
Thanking you,
Yours Faithfully
Dr. Kishor Kumar D.G
Signature of the Guide
Dr.Chandrashekar T.N,
Professor and HOD,
Dept of Forensic Medicine
MMC and RI, Mysore.
1
From,
Place: Mysore
Date:
Dr.Chandrashekar T.N,
Professor and HOD,
Dept of Forensic Medicine,
MMC and RI, Mysore.
To,
The Registrar,
RGUHS,
Banglore.
THROUGH PROPER CHANNEL
Respected Sir,
As per the regulations of the university for registration of dissertation topic, the
following Post Graduate in M.D(Forensic Medicine) has been allotted the dissertation topic as
follows, by the official registration committee of all qualified and eligible guides of the
Department of Forensic Medicine.
NAME
Dr.KISHOR KUMAR D.G
TOPIC
A STUDY OF
QUALITATIVE AND
QUNATATIVE
ESTIMATION OF
ALCOHOL IN
DRUNKENNESS CASES
GUIDE
Dr.CHANDRASHEKAR T.N.
Therefore, I kindly request you to communicate the acceptance of the Dissertation
topic allotted to the Post Graduate student at an early date.
Thanking you
Yours Faithfully,
Signature of Guide
Dr.Chandrashekar T.N
Professor and HOD,
Dept of Forensic Medicine,
MMC and RI, Mysore.
2
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
Dr KISHOR KUMAR D G
1.NAME OF THE CANDIDATE
S/O GOPAL D D
ADDRESS
#214/1 KAVERI BADAVANE
1st BLOCK ,KUSHALNAGAR
KODAGU DISTRICT
PIN-571234
MYSORE MEDICAL COLLEGE AND
2.NAME OF THE INSTITUTION
RESEARCH INSTITUTE, MYSORE.
POST GRADUATE
3.COURSE OF STUDY AND SUBJECT
M.D. FORENSIC MEDICINE
31/05/2012
4. DATE OF COMMENCMENT OF
COURSE
.DATE OF ADMISSION TO THE COURSE
16/08/2012
5.TITLE OF THE TOPIC
“A STUDY OF QUALITATIVE AND
QUANTITAVE ESTIMATION OF
ALCOHOL IN DRUNKENNESS CASES”
3
6. BRIEF RESUME OF INTENDED WORK:
As we all know, drunk and drive is an offence in
some of the countries including our country. Some countries have
fixed the quantum of alcohol in the blood to charge the offence. In
addition to this, the forensic experts also would like to know the
consumption of alcohol as well as the quantum of the alcohol in the
blood in some of the criminal cases like murder, rape, accidental
deaths in the working places etc. So routinely qualitative and
quantitative estimation of alcohol in the blood is in practice. But
there are lot of confusion and controversy with respect to the method
of drawing the blood, how much of blood to be drawn, method of
preserving the blood including how much of preservative per ml of
blood is to be used and the interval between collection of blood and
chemical analysis. Lot of complaints from the experienced experts
stating that there can be an error in the method of collecting and
preserving the samples which leads to variation in the concentration
of alcohol as well as delay in subjecting for chemical analysis may
lead to postmortem deterioration of the quantum of alcohol in the
blood sample. Hence to study the real picture in the current scenario,
this study has been taken up to evaluate the rate of metabolism of
alcohol in the body as well as to conclude or exclude the possibility
of the postmortem deterioration of the alcohol in the blood sample
with respect to postmortem interval i.e. starting from the time of
collecting the sample, either in the living or dead till up to the time of
chemical analysis. This study is also planned to collect blood samples
from the decomposed bodies who have died of causes not related
with alcohol consumption like female bodies who have died and
decomposed especially like in drowning, hanging etc, to evaluate the
possibilities of alcohol production by decomposition.
6.1) NEED FOR STUDY:
4
6.2) Review of literature:
- Ethanol, also called ethyl alcohol, pure
alcohol, grain alcohol, or drinking alcohol, is a volatile, flammable,
colorless liquid. A psychoactive drug and one of the oldest recreational
drugs known, ethanol produces a state known as alcohol intoxication
(drunkenness) when consumed. Best known as the type of alcohol found
in alcoholic beverages, it is also used in thermometers, as a solvent, and
as a fuel. In common usage, it is often referred to simply as alcohol or
spirits.
1. Charles L Winek and Louette J Paul’s study in 1983 proved that
ethanol concentrations in the blood sample evaluated on 1st, 2nd,7th
and 14th day of storage by gas chromatography shows no
significant change in the alcohol content. However they suggested
that blood samples taken from living human subjects for the legal
testing of sobriety would need to be evaluated immediately,
otherwise a legal defense could challenge the validity of the
results.
2. Jordan.B.Peterson, Jennifer Rothfleisch, Philip.D.Zelazo,
R.O.Pihl’s study in 1990 states that acute alcohol intoxication
causes changes in the cognitive functioning of the individual that
limit their ability to act adaptively.
3. A.R.Stowell and L.I.Stowell in 1998 have studied that blood
alcohol concentration measured about an hour and 3.5hrs after
cessation of drinking showed that the alcohol clearance rate is
about 10 to 20mg/dL/hr and they have compared the result using
the methods of a) Watson et. al., b)Lewis, c)Forrest and
d)Widmark’s methods and all are useful as long as their limitations
are understood, considering the factors which influence the
absorption ,distribution and metabolism of alcohol.
4. According to A.W.Jones and M.Fransson in 2003 studied that
deficient quantity of blood sample and the increase quantity of
5
preservative can cause the changes in blood alcohol concentration.
So they have recommended a volume of 5 to 10ml of blood sample
and the same amount of preservative is necessary for estimation of
accurate BAC in the sample.
5. According to Stefanie Muller, Daniela Piontek, Alexander Pabst
and Ludwing Kraus in 2011 they have studied that genetic factors,
gender, bodyweight play an important role in the metabolism of
ethanol and may lead to different perceptions of drunkenness at the
same level of alcohol consumption.
6. According to Maria Kala, Ewa Chudzikiewicz in 2003 they have
studied the influence of postmortem changes in biological
materials by toxicological analysis and the association of formation
of endogenous ethyl alcohol in the presence of glucose and its
break down in the decomposed bodies.
6
6.3) OBJECTIVES OF STUDY:
1. To know the quantum of alcohol in the blood drawn at the same
time, but chemically analysed at the interval of 48hrs,7days,15
days,30days,90days after the collection of blood sample .
2. To know the rate of metabolism of alcohol – quantum of alcohol in
the blood drawn at the interval of 2, 4, 6, 8, 10 hours after the
consumption of known quantum of alcoholic beverage .
3. To know the possibility, if yes how much is the quantum of
production of alcohol in the decomposed body.
7
7) MATERIALS AND METHODS
7.1 SOURCE OF DATA:
1. 20 males between the age group of 20 to 30 years who are
weighing between 50 to 65 kgs are selected for the study. They are
given with fixed quantity of alcoholic beverage to consume orally
over a period of 1hr.Then exactly 2hrs after the beginning of
consumption of alcohol, 50ml of blood is collected from all the 20
members at the same time. The collected 50ml of blood sample is
equally divided in to 5 parts of 10ml each and preserved with
10mg of sodium fluoride in 5 separate vials and they have been
labeled as A, B, C, D, E and sent to RFSL, MYSORE for the
chemical analysis at various intervals like sample A to be analyzed
within in 48hrs, sample B to be analyzed on 7th day, sample C to
be analyzed on 15th day, sample D on 30th day and sample E on the
90th day.
2. 20 males between the age group of 20 to 30 years who are
weighing between 50 to 65 kgs are selected for the study. They are
given with fixed quantity of alcoholic beverage to consume orally
over a period of 1hr.Then exactly after 2hrs after the beginning of
consumption of alcohol 10ml of blood is drawn in all the 20
members at the same time and collected in the vials and preserved
with 10mg of sodium fluoride and labeled them as P. Second
sample has been drawn at the 4th hour after the beginning of
consumption of alcohol and collected in the vials and preserved
with 10mg of sodium fluoride and labeled as Q. Similarly at the 6th
hr, 8th hr and 10th hr after the beginning of consumption of alcohol,
blood has been collected in the vials and has been labeled as R, S,
P respectively and they have been properly preserved and sent for
RFSL for chemical analysis at the same time. The study also has
been planned to record the clinical findings like nystagmus,
muscular coordination etc during the different stages after the
8
consumption of alcohol and correlate them with the blood alcohol
level.
3. In the 3rd group, study has been planned for collecting the blood
and viscera from the highly decomposed female dead bodies who
have died due to the causes other than alcohol consumption, but
subjected for postmortem examination.
7.2) METHOD OF COLLECTION OF DATA:
A) STUDY PERIOD: January 2013 to December 2013
B) SAMPLE SIZE: 50
C) INCLUSION CRITERIA:
1. In the 1st and 2nd group study, male of 20 to 30years age group
who are weighing between 50 to 65 kgs are included.
2. In the 3rd group study highly decomposed female bodies that
have died of causes other than alcohol intoxication.
D) EXCLUSION CRITERIA:
1.
Persons having metabolic disorders like diabetes mellitus,
cirrhosis of liver etc, who are on chronic medication for any reasons and
renal diseases and neurological problems etc.
2. Decomposed bodies showing any evidence of alcohol
consumption like sour smell in the stomach and significant level of
quantum of alcohol in the blood detected by the chemical analysis to
suspect the alcohol consumption.
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E) DATA COLLECTION
Apparently healthy males of 20 to 30 years who are weighing between
50 to 65kgs are selected randomly. They have been selected after obtaining
the written informed consent by explaining them the pros and consequences
of the study under taken. In the 3rd group study, the decomposed bodies of
unnatural death who have been subjected for postmortem examination at
the department of forensic medicine, MMC and RI, Mysore by random
sampling over a period of 1year.
7.3) Does the study require any investigation or intervention to be
conducted on patients or other human or animal?
Yes
7.4) Has ethical clearance been obtained from your institution in case of
7.3?
-Yes- Obtained (copy enclosed)
10
8) LIST OF REFERENCES:
1.Charles
L.Winek., Louette J.Paul., Effect of short-term storage
conditions on alcohol concentrations in blood from living human
subjects,Clinical chemistry 1983,vol. 29,pp. 1959-1960.
2.Jordan B.Peterson., Jennifer Rothfleisch., Philip D.Zelazo., Pihl R.O.,
Acute alcohol intoxication and cognitive functioning,Journal of Studies
on Alcohol1990,vol. 51,pp.114-122.
3.Stowell A.R., Stowell L.I., Estimation of blood alcohol concentrations
after social drinking, Journal of Forensic Sciences1998;43(1):,pp.14-21.
4.Jones A.W., Fransson M., Blood analysis by headspace gas
chromatography:Does a deficient sample volume distort ethanol
concentration,Journal of Med.Sci.Law2003,vol.43,pp.241-247.
5. 6.Stefanie Muller., Daniela Piontek., Alexander Pabst., Ludwig
Kraus., The relationship between alcohol consumption and perceived
drunkenness: a multilevel cross-national comparison in samples of
adolescents,Alcohol and Alcoholism 2011,vol.46,pp.399-406.
7.Maria Kala., Ewa Chudzikiewicz., The influence of postmortem
changes in biological material on interpretation of toxicological analysis
results,Problems of Forensic Sciences,Institute of Forensic
Research,Cracow2003,vol. LIV,pp.32-59.
8. Sec 85 IPC, Sec 86 IPC, Sec 375 IPC, Sec 377 IPC etc., The Indian
Penal Code,28th edition by Rathanlal and Dhirajlal The Indian Penal
Code by Justice Y V Chandrachud.
9. Sec 184,S.185,r/w sec.177 of Indian Motor Vehicle Act of 1988,95th
edition, by A.C.Mathur.
11
9. SIGNATURE OF THE CANDIDATE
:
10. REMARKS OF THE GUIDE
:
11. NAME AND DESIGNATION OF :
11.1
GUIDE
:
DR. CHANDRASHEKAR T.N
MBBS, M. D (FORENSIC MEDICINE)
PROFESSOR AND HOD
DEPT OF FORENSIC MEDICINE
MYSORE MEDICAL COLLEGE
AND RESEARCH INSTITUTE,
MYSORE.
11.2 SIGNATURE OF GUIDE
:
11.3 CO-GUIDE (IF ANY)
:
S.K.KRISHNARAJU
DEPUTY DIRECTOR
REGIONAL FORENSIC SCIENCE
LABORATORY, JALPURI,
MYSORE.
11.4 SIGNATURE OF CO-GUIDE
:
12
11.5 HEAD OF THE DEPARTMENT
:
DR. CHANDRASHEKAR T.N.
MBBS,M.D(FORENSIC MEDICINE)
PROFESSOR AND HOD
DEPT OF FORENSIC MEDICINE
MYSORE MEDICAL COLLEGE
AND RESEARCH INSTITUTE,
MYSORE.
11.6 SIGNATURE OF HEAD OF THE
:
DEPARTMENT
12. REMARKS
12.1
:
REMARKS OF THE DEAN AND
:
DIRECTOR
12.2
SIGNATURE OF THE DEAN AND
DIRECTOR
13
:
ETHICAL COMMITTEE CLEARANCE
1. TITLE OF DISSERTATION
:
“A STUDY OF QUALITATIVE AND
QUANTITAVE ESTIMATION OF
ALCOHOL IN DRUNKENNESS CASES”
2. NAME OF THE CANDIDATE :
Dr. KISHOR KUMAR D.G
3. SUBJECT
:
M.D FORENSIC MEDICINE
4. NAME OF THE GUIDE
:
Dr. CHANDRA SHEKAR T.N
PROFESSOR AND H.O.D
DEPT OF FORENSIC MEDICINE
MYSORE MEDICAL COLLEGE
AND RESEARCH INSTITUTE,
MYSORE.
5. APPROVED/NOT APPROVED :
APPROVED
(If not approved, suggestion)
14
MEDICAL SUPERINTENDENT
MEDICAL SUPERINTENDENT
K.R.Hospital, Mysore
Cheluvamba hospital, Mysore
MEDICAL SUPERINTENDENT
PROFESSOR AND HOD
PKTB Hospital, Mysore.
Dept of Medicine
Mysore Medical College and
Research Institute, Mysore.
PROFESSOR AND HOD
Department of Surgery.
Mysore Medical college and
LAW EXPERT
Research Institute, Mysore
DEAN AND DIRECTOR
Mysore Medical College and
Research Institute, Mysore.
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