Radiological mean age of fusion of medial end of the clavicle: a parameter of age

Objective: To determine the mean age of fusion of medial end of clavicle by radiography

Study Design: Cross-sectional study

Place and Duration of Study: Departments of Forensic Medicine, Dow Medical College and Ziauddin University, Karachi, from June 2010 to May 2011

Methodology: The subjects for this study were selected from various government colleges of Karachi. The subjects were analyzed for age and further confirmation was done by interviews where birth records and other physical parameters of age were also assessed. X-rays chest PA view was taken focusing on the medial end of clavicle; and were examined by a consultant radiologist and complete fusion of the medial end was noted. P-value less than 0.05 was considered significant

Results: The mean age of fusion of medial end of the clavicle was found to be 21 +/- 1.43 years. Significant difference was observed in male to female age of fusion 21.14 +/- 1.41 years versus 20.65 +/- 1.94 years [p > 0.05]. Similarly, statistically significant differences were observed between lower to middle income class and higher income class of all society. No difference was observed among various ethnic groups

Conclusion: Socio-economic factors, such as diet and nutrition, directly affect bone growth and hence bones' age. The results of fusion of the medial end of the clavicle are not affected by ethnicity; however, it is significantly affected by gender. More studies should be conducted in various parts of the country to make a natural standard in setting up uniform criteria for assessing age at or above 21 years

Pattern of epiphyseal union at knee in the children and young adults of Peshawar

Objectives of the study were to: 1. Determine the age of epiphyseal union at distal end of femur and proximal end of tibia and fibula in the children and young adults of Peshawar. 2. Compare the pattern of epiphyseal union at knee among males and females. Non-interventional descriptive. Department of Forensic Medicine, Khyber Medical College Peshawar. In the study 120 healthy, young volunteer students of both sexes and original residents of NWFP were included. Males were 15-19 years and females were 13-17 years of age. Age was certified by means of birth record, school certificates and interview with the parents. Radiographs of right knee were taken using conventional x-rays apparatus. Non-probability purposive sampling technique was used. Radiological findings regarding epiphyseal union were classified as follow; a. Stage of non-union b. Stage of partial union c. Stage of complete Union Data was compiled and significance of results was evaluated through statistical analysis of the data using Chi-square and t-test. In males average age of epiphyseal union of femur, tibia and fibula is 16.5, 17 and 17.5 years respectively. In comparison, in females epiphyseal union of femur and tibia takes place at the age of 14 years while that of fibula at the age of 15 years. Epiphyseal union is 2.5 to 3 years earlier in females as compared to males. Epiphyseal union occurs earlier in Pakistan than in European countries. Europeans norms and standards of skeletal growth used for age estimation are not valid for Pakistani children. Further studies on pattern of epiphyseal union must be conducted to develop local reference standard that may be used for age estimation

Analysis of medico legal autopsies at Faisalabad

To collect and publish scientific information regarding different variables of MEDICO LEGAL autopsy to be used by health and law enforcement agencies for future planning. Data source: Cases autopsied at the department of forensic medicine, Punjab medical college, Faisalabad. Non-interventional descriptive Setting Department of forensic medicine, Punjab medical college, Faisalabad. Period: July 2001 to June 2002. Material and method: Study includes 236 cases of MEDICO LEGAL autopsy including both sexes. After legal formalities and examination of the clothes, a detailed external and internal examination of the dead body was conducted. Specimens were sent for further examinations where necessary. Findings were tabulated and analyzed. Majority of the victims [52.5%] was between the age of 20-39 years. Male cases outnumbered the female cases. Firearm was the most common causative agent in MEDICO LEGAL deaths. Homicide was the dominant manner of death. Maximum number of injuries was inflicted on the chest. A peak in MEDICO LEGAL deaths was noted in extreme summer. Homicide as a dominant manner in MEDICO LEGAL deaths and firearm being the commonest weapon of offence are eye openers. Strict legislation regarding holding of firearm weapons and justice without delay are the major steps which can help in improving the situation

Suicidal deaths; Assessment in Peshawar

To find out the incidence of suicide, the gender and age groups involved, the methods used for committing the act and to note seasonal trends if any. Data source: Cases brought for autopsy at the department of forensic medicine, Khyber Medical College, Peshawar. Non- interventional descriptive. Department of forensic medicine, Khyber Medical College, Peshawar. Period: January 1991 to December 2000. Materials and All 39 cases of deaths labeled as suicide on the basis of autopsy findings, police inquest and interview with relatives of the victim were selected from the autopsies. The cases were grouped on the basis of age, sex, method of suicide used, region of the body involved and the seasonal distribution of the cases. The rate of suicide in Peshawar is 0.21 per 100,000 per year. Males were the predominant victims with a male to female ratio of 2.9:1. The age most prone to suicide was 20-29 years followed by 10-19 years. The primary method used for suicide in both sexes was by firearm followed by hanging. The head was the region of the body used for suicide in 59.37% of firearm victims followed by the chest and the abdomen. Two peaks were noted in the months of September and March. The incidence of suicide in Peshawar is amongst the lowest in the world

Unnatural female deaths Peshawar

The aim of the study was to know the extent of violent deaths among females in Peshawar, the most vulnerable age group, weapons of infliction and the mode of death. Design: Non interventional [descriptive] type study. Place and Duration of Study: This study was conducted from 1st January, 2001 to 31st December, 2001 in the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar. Subjects and Out of 679 deaths, presented for autopsy at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar 89 were females. These were grouped according to age, mode of death and weapons of infliction. Females formed 13% of all the autopsies done in Peshawar. The age group most commonly involved was 21-40 years [50.56%]. Firearms were the predominant weapons of infliction [70.78%] and the intent was mostly homicidal [77.52%]. Fatal violence against women is uncommon in Peshawar. Suicide is rare. Young women are mostly killed by firearms

Five years audit for presence of toxic agents / Drug of abuse at autopsy

To know the frequency of fatal poisoning in Peshawar regarding the toxic agents mostly involved and yearwise percentage. To know the age group and the gender that is most vulnerable to fatal poisoning. Design: Non-interventional [descriptive] type. Place and Duration of Study: This study was conducted over a period of five years [1997'2001] at Forensic Medicine Department, Khyber Medical College, Peshawar. Methodology: The study included 3508 autopsies conducted at Khyber Medical College, Peshawar. Out of these, 52 cases were those caused by fatal poisoning. These were analyzed according to age, gender and the toxic agent involved. t-test was applied as the test of significance. Poisoning was the cause of death in 1.48% of the total autopsies conducted during the five years. Males were more involved than the females, 90.38%. Suicidal poisoning was present in 17.30% of the total cases and accidental poisoning was found in 80.72% cases, while homicidal cases were 1.29% only. Diacetylmorphine [heroin] was the most commonly involved agent, 65.38%, of the total cases. The incidence of poisoning was more during the third and fourth decades of life. Diacetylmorphine [heroin] was the main causative agent involved in young males due to accidental over- dosage. Accidental and suicidal deaths should not be considered as inevitable. More elaborative studies are required in this area of recent research to adopt appropriate and adequate measures to save precious lives

role of radionuclide imaging and computerized axial tomography to reveal equivocal fractures in medicolegal practice

Four hundred sixty-six medicolegal cases were re-examined during the period of 3-years from 1998 to 2000 for correctness or otherwise of the challenged medicolegal certificates issued by the first examining medicolegal officer, and referred by the Health Authorities. Out of 466 cases, 190 [40.77%] cases were decided. 15 [7.89%] cases which were initially wrongly interpreted by the concerned medicolegal officer regarding the presence of nondisplaced fractures, were reviewed by the panel of experts, and keeping in view the persistent pain following trauma where the conservative radiograph failed to reveal fracture, specialized techniques in radiology i.e., Computerized Axial Tomography and Radionuclide Imaging, were utilized which showed 100% result by revealing fractures