...On the whole, this marvelous book, while professing to be just a self assessment and review utilizing multiple choice questions, is in fact a very valuable reference work in forensic medicine and toxicology...
Self Assessment and Review of Forensic Medicine and Toxicology [MCQs with Explanations and Discussions], 1st Edition, by Anil Aggrawal. softcover, 23.4 x 18 x 2.2 cm.
Peepee Publishers and distributors (P) Ltd, 7/31, Ansari Road, Daryaganj, Post Box-7243, New Delhi-110002, India. Phones 55195868, 9811156083, Email: firstname.lastname@example.org; email@example.com. Publication Date 30 Oct 2006. viii + 680 pages, ISBN-10: 8188867853. ISBN-13: 978-8188867851. Price £14.99, Indian Rupees 295.00
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This delightful tome is a paper bound book published by the Peepee Company of New Delhi. It is nicely bound and the pages lie flat when folded open.
The contents are amazing in both their breadth and depth. While MCQ’s (multiple choice questions) are not something which I think are the best way of testing for knowledge of a subject area, the use of MCQ’s is really ubiquitous and seems to be employed more and more given the ease with which the answers can be graded. Unfortunately, the emphasis upon MCQ’s can pervert the learning, and teaching process, as has come to be appreciated in the United States in the “No Child Left Behind” program which seems to be degrading the quality of primary and secondary education.
An answer to the critics of these MCQ driven programs may be found in the work written by Professor Aggrawal. He has accumulated the common questions used in MCQs in the area of forensic medicine and toxicology and has arranged them by subject area and for each subject area has a series questions with 4 possible answers. In reading the book from cover to cover one can read the question and the answers and then use that as a self test guide.
The true value of the book is in the answers. These are displayed immediately after the section with the questions. All of the answers include the correct answer. The best part of the book is the discussion of the reason for the answer being correct, plus some advice of possible alternative questions utilizing the same basic facts.
The discussions of why the answers are correct make this book a very helpful tool in learning the field of forensic medicine and toxicology. It is a much richer addition to the library of forensic medicine and toxicology than it would appear at first blush.
For me, a forensic pathologist trained in the United States, the knowledge base is far richer than my own formal training. As with most of the world, and certainly in the English speaking world, forensic medicine involves both the determination of the cause, manner and time of death of persons, but in addition encompasses what can be called clinical forensic medicine dealing with questions involving the living.
The work is written by an Indian professor primarily for the Indian market of forensic medicine trainees. However, it is an extremely useful work for those of us outside the Indian subcontinent. Approximately 9% of the work deals with questions having to do with statutory provisions of the modern Indian Civil and Penal Codes. While not precisely important to the non-Indian, the differences found in Indian law and that of the United States is educational, and demonstrates pointedly that the way laws are shaped is determined in large part by the society which is governed by the laws. Nowhere is this demonstrated more clearly than in Professor Aggrawal’s discussion concerning juries in India. It appears that the jury was dispensed with in criminal cases after the Kawas Nanavati verdict came down 8 to 1 for acquittal. This was considered by the appellate court and in 1959 the use of juries in criminal trials was abolished, along with Mr. Nanavati’s conviction being upheld.
I can recommend Professor Aggrawal’s work with enthusiasm for the entire English speaking world. Because of the outstanding discussions of the correct multiple choice questions, the book can quickly convey a great body of knowledge to the novice as well as the old hand in forensic medicine and forensic pathology.
Looking at the work in detail, there are seven chapters, 275 pages, on forensic medicine and five chapters, 134 pages, on toxicology. There are three review test papers which take some of the most common questions and repeat variants of them and a further discussion. The index is comprehensive and extremely useful as a quick reference to a particular question.
My only criticism is the lack of references in the discussion. However, in a work of this sort, it would add a great deal of thickness to the book without adding much additional information of real interest to the vast bulk of the readers.
I found only one glaring error, and it is really a typographic error which unfortunately conveys a really erroneous fact. Page 30, in discussing the Declaration of Sydney, “It was decided that the ECG was the most helpful diagnostic aid in the diagnosis of death, …” I believe that the discussion of this meeting of the World Medical Assembly was concerning the diagnosis of death in persons who are “brain dead” and the EEG is the most helpful (or was thought to be so then) test which was available. Careful perusal has failed to turn up any other such error. This is a remarkable achievement for such a work.
A few words on some of the more interesting parts of the work are in order. The discussion of the difference between cognizable and non-cognizable offenses was fascinating. This seems to follow, somewhat, the distinction between felonies and misdemeanors as is found in United States law, but is somehow different as well.
The section on osteology is rich with diagrams and mnemonics to assist the reader in remembering the order of ossifications and other details of this fascinating subject.
The chapters on firearm injuries and cutting and stabbing also have wonderful diagrams illustrating the points made.
The way in which Indian medico-legal practitioners handle the body after the conclusion of the autopsy is fascinating. In the United States, the medical examiner or coroner’s pathologist returns the body to the next of kin. In Indian law, the body is handed over to either the police of the magistrate, depending upon who initiated the autopsy request, to sort out who should receive the body. This is a fascinating difference.
The tests of Magnus, Icard and Winslow, all which were proposed during the 19th century as a means to determine whether a particular body was dead or alive are discussed at great length. This sort of discussion makes the book extremely worthwhile as a reference work, even without references.
The questions and discussion on suggilation are extremely interesting, particularly as this word is occasionally seen in autopsy reports in United States but is rarely really defined and more rarely understood to be from the term suggilate meaning to beat black and blue.
There is a very nice discussion of Sturner’s method, (Sturner and Gantner more accurately) for determining the time of death from ocular fluid potassium levels. Unfortunately, this method and its progeny are not very useful, as is explained in the discussion.
Puppe’s rule, which I knew of but did not know of Puppe, for determining the order of gunshot wounds in the head, is diagramed and explained,
There is even a great discussion of Taché noir de la sclerotique, which I have personally seen to be described as a kind of injury, but which in the discussion is correctly attributed to a dying artifact of the sclera.
The discussion of the lethal doses of opiates, the same for barbiturates, are extremely useful to have at hand, and are easily found from the index.
The ratio of ethyl alcohol levels in various fluids and organs, compared to blood is clearly explained in text and table.
On the whole, this marvelous book, while professing to be just a self assessment and review utilizing multiple choice questions, is in fact a very valuable reference work in forensic medicine and toxicology.
Dr. Ronald K. Wright is Associate Professor of Pathology and Director of Forensic Pathology Division at Jackson Memorial Hospital Miami, Florida. He can be contacted at firstname.lastname@example.org. Dr. Wright is on the left as you look at the photograph.
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