E Tuberculosis (TB) and other Respiratory illnesses 1993-2018 ,u ,p vkj lh % iPphl o’kZ&vla[; vk’kk,a Nhrc : Twenty Five Years-billion Hopes 33. What are the directions of NHRC regarding periodic medical examination of the prisoners? All the prison inmates should have periodic medical check-up particularly for their susceptibilities to infectious diseases and the irst step in that direction would necessarily be the initial medical examination of all the prison inmates either by the prison and Government doctors and in the case of paucity or inadequacy of such services, by enlisting the services of voluntary organizations and professional guilds such as the Indian Medical Association. Whatever be the sources from which such medical help is drawn, it is imperative that the State Governments and the authorities in-charge of prison administration in the States should immediately take-up and ensure the medical examination of all the prison inmates; and where health problems are detected to afford timely and effective medical treatment. 34. What symptoms necessitate investigation for tuberculosis? Early suspicion of disease like tuberculosis which is very common in India especially when the patient presenting with un-resolving fever and respiratory symptoms. In such cases chest X-ray should be used as a screening tool and a sputum test for con irmatory microbiological diagnosis of TB. Enhanced case inding should be undertaken in certain “high risk” populations such as prisoners. It has been commonly observed during medical investigation at NHRC, the prescription of prisoners generally lack proper history taking about the duration of cough and examination indings. But simultaneously the antibiotics (suggestive of respiratory infection) were being prescribed on multiple occasions. This practice creates doubt in the mind of investigators about non initiation of timely screening for TB. It is suggested that in prison, history taking and examination indings should be done as well as properly recorded. In cases of unreliable history (which may often be a case at prison), multiple episodes of respiratory infections over a short duration of 1-2 months or nonresolving respiratory symptoms/infection (cough>2 weeks) should also be taken as indication for TB screening. History of contact with prisoner having tuberculosis should also be investigated for TB. FORENSIC INVESTIGATION | 39