The Department of Forensic Medicine and Toxicology (FMT) of Amrita Institute of Medical Sciences (Amrita Hospital), Kochi, has some unique features when compared to any other FMT Dept in the state of Kerala and elsewhere in India. The Medical Council of India has specified that every FMT Dept must address 3 major areas of this medical speciality: forensic pathology, clinical forensics, and toxicology. Forensic pathology is mainly concerned with medicolegal autopsies, while clinical forensics deals with issues relating to medicolegal aspects of clinical practice and medical ethics, and toxicology deals with clinical, forensic and analytical aspects of poisoning. Most if not all the FMT departments of government medical colleges in India confine themselves to forensic pathology. Also, many private medical colleges do not even undertake medicolegal autopsies citing lack of Govt authorization as the reason. The Amrita FMT dept has succeeded in obtaining Govt sanction for medicolegal autopsies and performs such autopsies as and when requested by the police. The FMT department in Amrita has also succeeded in establishing a world class toxicology division (Poison Control Centre) with state of the art poison information and analytical laboratory resources, besides a busy clinical forensic unit that works in close coordination with the Emergency Medicine department to take care of all medicolegal issues relating to hospital clinical practice. The Medical Council of India has permitted (and recognized) the admission of 2 postgraduate residents every year. Amrita is the only private medical college in Kerala where a PG training program exists.
Poison Control Centre (PCC):
- The Poison Control Centre (PCC) of Amrita Hospital serves the entire state of Kerala and neighbouring states in matters relating to poisoning.
- This is the first time that such a centre has been started in a hospital in the entire state of Kerala, and has been listed in the Global Directory of Poison Control Centres of the World Health Organization from 2003 onwards. The PCC of Amrita Hospital is the only full-fledged centre in India with information resource, analytical, and research facilities.
- Poison Information Unit: Both healthcare providers and the public can contact the Poison Control Centre for any queries (free of charge) relating to poisons, poisoning (acute and chronic), drug overdose, drug adverse effects, drug abuse, food poisoning, etc., via telephone, e-mail, postal mail, personal contact, etc. The Poison Information Unit has access to detailed information on poisons and poisoning by utilizing the following databases: TOXBASE (UK), TOXINZ (New Zealand), and CHEMINFO (World Health Organization), which together has information on more than 1 million poisonous substances encountered world-wide.
- The Analytical Toxicology Laboratory is part of the Poison Control Centre (PCC), and offers unique testing facilities in the area of toxicology (poisons and poisoning) to all hospitals, government doctors, and private practitioners of Kerala state and neighbouring regions. It is fully equipped with instruments such as UV-Spectrophotometer, High Pressure Liquid Chromatograph, etc.
- The Analytical Toxicology Lab is accredited by the National Accreditation Board for Testing and Calibration Laboratories (NABL), and is in fact the only such accredited clinical toxicology laboratory in the entire country.
- The Analytical Toxicology Lab analyzes various samples (including body fluids from living victims of poisoning) for toxins/chemicals/drugs/poisons, besides undertaking the analysis of water samples for pesticides and contaminants, and evaluation of medicinal and commercial products for adulterants. Almost any chemical (including heavy metals, pesticides), toxin (including plant-based), or drug (including pharmaceuticals, substances of abuse) can be tested by the laboratory. The toxicology lab has created its own standard operating protocol (SOP) for toxicological analysis.
- A one-week certificate course is conducted by the PCC: Analytical Toxicology Certificate Course. Several hundred candidates have taken this course in the last few years.
- The Poison Control Centre is the current headquarters of The Indian Society of Toxicology. This organization has a composite membership of more than 500 professionals drawn from varied fields who are engaged in the research or practice of toxicology. Scientific conferences, symposia, workshops, etc across India are organized regularly by the Society. The Society also brings forth a half-yearly peer reviewed journal dedicated to toxicology – Journal of the Indian Society of Toxicology.
- Instant access to detailed information on poisons and poisoning through telephone, e-mail, postal mail, personal contact, etc. This information is available free of charge to doctors, paramedics, hospital staff and even the lay public across India. Expert guidance on diagnosis and treatment of all kinds of poisoning is provided to healthcare professionals, including acute and chronic poisoning, drug overdose, drug adverse effects, substance abuse, and food poisoning.
- The analytical toxicology lab of the PCC analyzes various samples (including body fluids from living victims of poisoning) for toxins/drugs/chemicals/poisons, besides undertaking the analysis of water samples for pesticides and chemicals, and evaluation of medicinal and commercial products for adulterants or contaminants.
- Almost any chemical (including heavy metals, pesticides), toxin (including plant-based), or drug (including pharmaceuticals, substances of abuse) can be tested by the laboratory.
- The department has an attached forensic DNA Typing Unit with facilities for DNA extraction and amplification.
- A one-week certificate course is conducted by the PCC: Analytical Toxicology Certificate Course.
Procedure for Submission of Samples for Toxicological Analysis:
- Body fluids: Blood (5-10 ml in vacutainer), Urine (25-50 ml in sterile container), Stomach contents (aspirate, washing, vomitus; 25-50 ml in sterile container). No preservative must be added to any sample. If more than 6 hours is likely to elapse from collection time to submission time, cooling of samples is desirable.
- All cases are accepted, including medicolegal cases; however, viscera samples from dead victims are generally not accepted.
- Commercial products (e.g., medicinal or food samples) for detecting presence of poisons or drugs.
Staff of the PCC:
Dr. V.V. Pillay who heads the Poison Control Centre is also the Professor & Head of the Dept of Forensic Medicine & Toxicology in Amrita School of Medicine.
Technical Personnel in the PCC:
- Arathy S L – Sr. Research Officer (I/C Analytical Toxicology Lab)
- Aswathy A – Scientific Assistant
- Pramod Mohan – Scientific Assistant
- Sobha A C – Sr. Data Entry Operator
- Jaitha Jayan K – Lab Assistant
- Athira T S – Jr. Research Fellow
How to Contact the PCC:
Dr. V. V. Pillay, MD, DCL
Chief, Poison Control Centre
Professor & Head, Forensic Medicine & Toxicology
Amrita Institute of Medical Sciences & Research
Cochin, Kerala 682041
Phones: +91-484-2858050 (Personal: direct line); +919895282388 (Official: mobile number)
EPABX: +91-484-2851234, Ext: 8050, 8056 (Toxicology Office) 8190 (Poison Control Centre); 8096, 8102 (Analytical Toxicology Lab)
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