Morphometry of chordae tendineae of mitral valves and annulopapillary distance for mitral allografts.

Background: Mitral valve is the complex variable structure with 2 cusps and 2 papillary muscles which are connected by collagenous structure chordae tendineae supporting the entire free edge of the valvular cusps. Aims & Objective: To study the morphological and morphometric analysis of chordae tendineae and to compare the morphometric measurements among cadaveric and autopsied heart specimens of south Indians and the effect of formalin in causing shrinkage of chordae tendineae. The annulopapillary distances were measured for mitral allografts. Material and Methods: The prospective study was done on 45 cadaveric and 15 autopsied heart specimens. The left atrium and left ventricle were cut open and the measurements of the Mitral valve chordae tendineae were taken using Vernier calliper and recorded. The chordae tendineae was measured from tip of papillary muscles to the edges of the cusp. The annulopapillary distance was measured from tip of papillary muscles in 2 o', 4 o', 8 o', 10 o' clock positions to that of mitral annulus. The data’s were analyzed using student’s t test to compare between the cadaveric and autopsied heart specimens. Results: Aortic cusp chordae tendineae of both specimens were approximately same 1.6 to 1.8cm, whereas in mural and commissural cusp mild difference of 2-3mm was observed 1.5 to 1.7 cm. The annulopapillary distance was equal in both the specimens 2cm. Two heart specimens showed complete absence of commissural chordae and 6 hearts showed absence of basal chordae. Conclusion: Many studies were done on morphometry of mitral valve but the present study on morphometry of chordae tendineae of mitral valve did not show any significant changes among cadaveric and autopsied heart specimens. The data will be of great use to cardiac surgeons for surgical reconstruction of mitral valves and annulopapillary distance for mitral allografts.

Estimation of stature from shoe print length while walking in females.

In Forensic Anthropology, estimation of stature from feet dimensions plays an important role in establishing individual’s identity. The foot length reflects a biological correlation with height suggesting that height may be estimated from shoe print length also. Various anthropometric studies have been conducted on foot in relation to growth and development, ergonomics, evaluation, orthopedics and other medical sciences. However, there is only little investigation, which focused on forensic importance of shoe print. Analysis of shoe prints can reveal very important clues, which can be used as forensic evidence in crime scene investigation. To study the relationship between Stature and Shoe Print length while walking, total 500 females from Karnataka in the age group of 18 to 21 years were examined. The stature estimation was done with linear and multiple regression equations. Recorded shoe print length was measured along parallel axis. The multiplication factors were also computed. The regression formula was checked for their accuracy and reliability. Highly significant and positive correlation was observed between stature and Shoe Print length while walking.

Forensic view on aluminium phosphide poisoning.

In India, acute aluminium phosphide poisoning (AAlPP) is a serious health care problem. This study aimed to determine the characteristics of AAlPP and the predictors of mortality at the time of patients' admission. We studied consecutive admissions of patients with AAlPP admitted to the intensive care unit (ICU). We noted 38 parameters at admission to the hospital and the ICU and compared survivor and non-survivor groups. A total of 54 patients were enrolled comprising 10 females and 44 males and the mean ingested dose of poison was 0.75 ± 0.745 grams. The mortality from AAlPP was 59.3%. We found the following factors to be associated with an increased risk of mortality: a serum creatinine concentration of more than 1.0 mg % (P = 0.01), pH value less than 7.2 (P = 0.014), serum bicarbonate value less than 15 mmol/L (P = 0.048), need for mechanical ventilation (P = 0.045), need for vasoactive drugs like dobutamine (P = 0.027) and nor adrenaline (P = 0.048) AAlPP causes high mortality primarily due to early haemodynamic failure and multi-organ dysfunction.

Suicidal acid injury: A case report.

Deaths from exposure to caustic substances are infrequently reported in the Forensic Medicine literature. A case of death due to Sulphuric acid ingestion in a patient of Major Depressive Disorder is being reported. This patient was planned for Electro-convulsive therapy, prior to the procedure he had been to bathroom. And when planned to prepare for the procedure on the ECT table, his mouth has smell of pungent odour. This made the psychiatrist to withhold the procedure and subjected him for observation. Later he complained of severe chest pain and restlessness, for which he has been shifted to emergency ward with possible precautions taken before shifting. He was provisionally diagnosed of acid ingestion but there was no history either from patient or from his relatives, as patient has consumed in the bathroom just before the Electro convulsive therapy. Diagnosis was confirmed only after autopsy report. The legal issues concerning suicide in mentally ill patient, autopsy findings, forensic issues and Patho-physiology concerning death by acid ingestion have been discussed.