Pathological findings in COVID-19: A conventional autopsy-based study from India

Background & objectives: Autopsy study has been considered the gold standard method for studying the effects of any disease on the body. Since COVID-19 is a novel disease, autopsy is crucial to understand its pathophysiology. This study was conducted to analyze the microscopic and macroscopic findings of various organs in COVID-19 and to associate those findings with clinical observations and laboratory findings. Methods: Conventional invasive autopsies were performed on 33 patients with COVID-19 from September 7, 2020 to December 23, 2020. All the organs were removed by routine dissection techniques and preserved in 10 per cent formalin. The tissues were processed and stained according to standard practices using haematoxylin-eosin (H & E) and periodic acid-schiff (PAS) stain. Results: The study included 28 males and 5 females with a median age of 61 yr (range 30-90 yr). Massive pulmonary oedema and thrombi in the lungs were the characteristic features macroscopically. On microscopic examination, diffuse alveolar damage in the exudative/proliferative phase was found in 29 (87.88%) cases. Among the other notable microscopic findings were bronchopneumonia and lung abscesses due to secondary bacterial infection (n=17, 51.52%), acute tubular injury (n=21, 63.64%) and thrombi in the lungs, heart, and kidneys. Interpretation & conclusions: COVID-19 primarily affected the respiratory and the renal systems in the vast majority of severely affected patients in our study. We also found signs of hypercoagulability, as evidenced by widespread thrombi in multiple organs, along with a raised d-dimer level and a hyperinflammatory state manifested by elevated inflammatory markers. Our autopsy findings and altered laboratory investigations support

Profile of fatal road traffic accidents in Rajkot city.

Road traffic injuries are recognized as a major health problem in developing countries accounting for the maximum morbidity and mortality following trauma. The present prospective study was conducted at the Department of Forensic Medicine, P.D.U. Medical College and Associated Hospital, Rajkot from January 2008 to December 2008. The objective of this study was to analyze the trend of fatal road traffic accidents and to find out the measures for the prevention of their causative factors. During that period out of 2159 autopsies, 298 cases of Road Traffic Accidents were selected for the present study which accounts 13.8% deaths. Our study shows that 99(33.22%) victims were male of middle age group (21-30 years), male: female ratio was 10.5:1. 114(38.26%) cases were observed during working hours between 12.01 p.m. to 6.00 p.m. 101(33.89%) victims were pedestrians, followed by occupants of heavy four wheelers, two wheelers and three wheelers. Head injury in 161(54.03%) followed by hemorrhagic shock in 51(17.11%) were main causes of death. 141(47.32%) victims were died within one hour after accident.

Pattern of ligature mark in cases of compressed neck in Rajkot region: a prospective study.

Ligature mark may be the only evidence available in cases of asphyxial deaths due to either hanging or strangulation. A through examination of the ligature mark and analysis of the information provided by it is therefore, a must to arrive at the most probable cause of death and differentiate between hanging and the ligature strangulation. A prospective study was conducted at the Department of Forensic Medicine, P.D.U. Medical College & Hospital, Rajkot from January 2008 to December 2008. During that period out of 2159 cases, 90 cases of hanging and 7 cases of ligature strangulation were selected for the present study. We found that deaths due to hanging constituted 4.17% of the total unnatural deaths subjected to medicolegal autopsy; young adults of the age group 21 to 30 years accounted for the maximum cases 40% and the male: female ratio was 2:1. Chunni (34.44%) was the most common ligature material used. The mark was obliquely placed (100% cases) above thyroid cartilage (80% cases). In all the cases of ligature strangulation the mark was transverse and below the level of thyroid cartilage.