ABSTRACT
Background & objectives: The burden of cardiovascular diseases is high in Kerala, India, and a considerable proportion of these occur in young people. The objective of this study was to estimate the severity of atherosclerosis in autopsies done for accidental and suicidal deaths in victims below 40 yr of age. Methods: Coronary arteries from 77 autopsies done for unnatural deaths in a population below 40 yr were graded, and the degree of stenosis, intimal thickness index (ITI) and the intima-media ratio (IMR) were measured. Results: There were 65 males and 12 females in the sample. The American Heart Association (AHA) type 3-6 (pathological intimal thickening) was seen in 55.4 per cent [95% confidence interval (CI): 42.5-67.7%] of males and 25 per cent (95% CI: 5.5-57.2%) of females and advanced lesions (type 4-6) in 44.6 per cent (95% CI: 32.3-57.5%) of males and 8.3 per cent (95% CI: 0.2-38.5%) of females. Types 5 or 6 lesions were seen in 32.2 per cent (95% CI: 21.2-45.1%) of males. The mean stenosis was 57.3 per cent in males and 40.6 per cent in females. More than 40 per cent stenosis was seen in 76.6 per cent cases, more than 50 per cent in 54.5 per cent cases and more than 75 per cent stenosis in 14.3 per of the sample. The mean ITI (MIT) was 1.85 and the mean IMR was 4.11. The degree of stenosis, MIT and IMR were significantly associated with male sex, overweight and smoking. Interpretation & conclusions: Morphometric data showed that the degree of atherosclerotic narrowing of coronary arteries in young non-diseased population was high. It portends a danger to the community unless preventive measures are taken up.
ABSTRACT
Suicide rate is increasing all over the world; but the rate is disproportionately higher in Kerala. One hundred and eighty one cases of known dead bodies of both genders brought for medico-legal autopsy with history of suicide by hanging, were studied at the Department of Forensic Medicine, State Medico Legal Institute, Government Medical College, Thruvananthapuram, Kerala, India. There was a male preponderance in the study group (71.3%) and majority of males were young or middle aged (82.1%) whereas females were adolescents or young adults (73.1%). Among the males, only 2.3% were farmers. Alcoholism was noted in 75.2% of males. Immediate psychological problems were the reason for suicide in 33.7% of cases, majority of them being married (55.8%). Soft materials, that were easily available, were used as ligatures (48.6%) which were tightened around neck by slip knots (58%) on the sides of neck (53%).