Discussion on Standardization of Forensic Assessment of Olfactory Dysfunction / 法医学杂志

With the development of society, the improvement of living standards and the advancement of research methods, olfactory function has been paid more and more attention. Therefore, higher requirements for the forensic identification of olfactory function have also been put forward. Standardization construction of forensic medical examination and identification of olfactory dysfunction is urgently needed. Based on a comprehensive review of olfactory function and forensic assessment of olfactory dysfunction, this paper elaborates on problems related to the principles and timing of forensic assessment of olfactory dysfunction, the requirements of identification of traumatic olfactory dysfunction, the subjective and objective methods of examination of olfactory function. Strict control of the above issues is an important mean of standardization of forensic assessment of olfactory dysfunction.

Comparative Analysis of Visual System Disability Evaluation Criteria between China and the United States / 法医学杂志

Gradation of Disability in Human Body Injuries （hereinafter referred to as Gradation） has been released and used since January 2017, and has become the most widely used standard in forensic science practice. This paper calculates and rates the visual system evaluation provisions of the current domestic disability evaluation criteria represented by the Gradation which used the methods of Guides to the Evaluation of Permanent Impairment （hereinafter referred to as GEPI） issued by American Medical Association （AMA）. Through comparing, a good correlation between the provisions in Gradation and whole person impairment rating index in GEPI was shown. On the basis of this, suggestions are put forward to amend some provisions of Gradation, in order to provide reference for the revision and further improvement of domestic standards and provisions.

Comparison of Evaluation Results of Different Disability Standards of Long Bone Fracture / 法医学杂志

Objective To provide reference for further perfection and revision of standards relevant to limb injury by comparing the evaluation results of different disability standards of long bone fracture. Methods Thirty cases were selected from the long bone fracture cases accepted by our institution in 2018. These cases include 5 cases of shoulder, elbow, wrist, hip, knee, ankle joints, respectively, to investigate the degree of loss of function of joints after long bone fracture. Disability evaluation was made according to Classification of the Impairment Related To Injury （hereinafter referred to as Classification）, Assessment for Body Impairment of the injured in road traffic accidents （now repealed, hereinafter referred to as original Road Standard） and Identifying Work Ability-Gradation of Disability Caused by Work-related Injuries and Occupational Diseases （hereinafter referred to as Work Standard）. The disability evaluation results of every domestic standard were compared with the joint damage rate of Guides to the Evaluation of Permanent Impairment （hereinafter referred to as GEPI）. Results The functional loss rate of joints （except ankle） was 26%-48%，and the ankle functional loss rate was 51%-64%. The mean value of GEPI joint impairment rate of the joints was 13%-22%, with the fluctuation range less than 10%. The rate of level 10 disability was 100% according to the Classification. The rate of level 10 disability was 27%, the rate of level 9 disability was 6% and 67% were not disabled according to the original Road Standard. The rate of level 10 disability was 10% according to the Work Standard and 90% had a disability above level 10 （47% were classified as level 7 disability）. Conclusion The people with limb joint dysfunction in this study had evaluation results with a smaller fluctuation range and better consistency according to the Classification and GEPI. The evaluation results according to the original Road Standard and the Work Standard has a less consistency. The Classification is more similar to GEPI and is more reasonable.

An approach for identification of individuals in a mass disaster in Indian set up.

In the changing scenario of mass disaster, which has become almost one of the stories of daily news paper, Disaster Victim Identification has become important for its medico-legal as well as nations socio-economical aspects. This expertise gives the Forensic Experts a resource advice in dealing with human identification in a simpler way in Indian context. The idea of this work was born after the Ganeswari express accident that occurred in West Bengal, in May 2010, after which the situation demeaned a discussion between the Forensic Experts, Forensic Scientists and police personnel to frame a simpler guideline for Disaster Victim Identification. The recommendations made in this paper, as well as in many cited references, are intended to provide the forensic experts the minimum guidance for victim identification by photography and storing samples suitable for DNA analysis. It also gives a guideline for matching the DNA samples with the relative of the victims that will provide better chances of victim identification.

Analysis of 57 abdominal penetrating injury cases with exploratory laparotomy / 法医学杂志

OBJECTIVE@#To explore the characteristics of abdominal penetrating injuries with exploratory laparotomy, as well as to summarize the key points of injury degree, and to supply reasonable reference for the practice and criterion modification in forensic clinical medicine identification. METHODS Fifty-seven cases which were all abdominal penetrating injuries with exploratory laparotomy from July 1990 to February 2011 were retrospectively analyzed including the instrument causing trauma, amount of the hemoperitoneum, the organs of the injury, conclusion of the forensic indentification, and so on.@*RESULTS@#There was some correlation between the organ injury patterns, volume of hemoperitoneum and identification conclusion for the abdominal penetrating injury cases with exploratory laparotomy. CONCLUSION The intra-abdominal injury has important effect for the injury degree of the abdominal penetrating injury cases with exploratory laparotomy and should be considered in the practice and criterion modification of these kinds of cases.

Legal changes towards justice for sexual assault victims.

The crime of rape is a major problem in India, evident from the reports in the press as well as official statistics. The accused has often gone free, because the victim did not file a complaint, or because of poor evidence gathering and well as lacunae in the law. This paper presents an overview of the laws applicable to sexual assault cases and amendments in these laws, specifically in terms of the roles and responsibilities of healthcare providers to bridge the gap in providing medical evidence to the courts.

Medico-legal assessment of blood accumulation in human abdominal cavity caused by penetrating wounds / 法医学杂志

When primary injuries caused by penetrating violence and secondary injuries by faulty medical procedures are both present, it is important to distinguish "avoidable" from "unavoidable" secondary injuries. The primary and "unavoidable" secondary injuries rather than the secondary "avoidable" injuries should be included as evidence for assessment of the degree and grade the injuries. The basic principles to assess blood accumulation after injury have been stated in the seventy-two clause of "The Assessment Criterion of Severe Human Body Injury". However, it dose not distinguish abdominal blood accumulation caused by primary penetrating wounds from that resulted from secondary medical procedures. An amendment to the clause might be necessary.

Docencia e investigación en Medicina Legal: Situación actual y desafíos para las Facultades de Medicina de Chile / Training and research in Forensic Medicine: Present situation and future challenges

Background:Lawyers need some medical knowledge and physicians must know about forensics. Aim: To explore training and research programs in forensic medicine in Chilean universities. Material and methods: Deans of all Medicine Faculties in Chile were contacted by e-mail and invited to answer a questionnaire containing 21 questions. A survey of Chilean publications on forensic medicine was performed in Medline, Lilacs and SciELO databases. Results: Fourteen deans answered the questionnaire. In all the responding faculties, forensic medicine is an obligatory course, generally during the fifth year and mostly combining theory with practice. In seven faculties, forensic medicine concepts are included in other courses. Forensics is taught in only two of 10 dental schools, two of 17 nursing schools, one of nine midwives schools and one of nine medical technology schools. It is not taught in phonoaudiology, kinesiology and nutrition schools. There are 74 physicians that teach the specialty but only 10 are certified by the National Board of Medical Specialty Certification (CONACEM). Treatment of most topics on forensics is insufficient. Thanatology is the strongest topic and forensic dentistry is the weakest. There are 52 publications in the area, mostly on "medical law". Conclusions: Forensic medicine is taught in medical schools mostly as thanatology. The knowledge of forensics among medical students is limited and must be improved.

Validation of qualitative test for phosphine gas in human tissues.

Phosphine has been known to science since the birth of modern chemistry. WHO reports that the technical product usually has a foul odour, like "fishy" or "garlicky" because of the presence of substituted phosphines and diphosphine (P2H4). Many medico-legal autopsy cases have been reported positive for aluminium phosphide even though there was neither any suspicion of consuming aluminium phosphide nor any clinical findings, postmortem findings or circumstantial evidences. The present study was carried out to validate the qualitative test, presently applied in many laboratories for testing phosphine. It was observed that 65% of human tissues in saturated solution of common salt show positivity for phosphine gas on the first day of autopsy.

Role of autopsy surgeon in determination of time since death in criminal cases.

Importance of determination of time since death is very important for the investigating agencies, autopsy surgeons and legal authorities in criminal cases or when a foul play is suspected behind a death. There are many variabilities and probabilities in determination process but the following points are to be read and analysed carefully so that it can be easier to ascertain the time since death: History and circumstances of death; somatic and molecular signs of death; emptying time of stomach and state of digestion of food in the stomach; biochemical investigations, etc. The individual points are narrated in a nutshell in this article.

Study on consistency of assessed results according to the Standard of Evaluated Injured Severity / 法医学杂志

OBJECTIVE@#To explore the consistency of assessed results according to Standard of Evaluated Injured Severity, finding out some factors that influenced appraisal conclusion.@*METHODS@#102 cases examined by Beijing Institute of Forensic Medicine and Science in 1998 were re-evaluated respectively by nine appraisers.@*RESULTS@#The results showed that distinction of appraisal conclusion between appraisers in the same institute was small, but in different institute was big. The work experience and professional train were important to reduce errors.@*CONCLUSION@#Standard of Evaluated Injured Severity strong take on character of profession. Veracity of assessed injured severity is related with unitive authoritative explanation, training and experience of appraiser.

El secreto médico: apuntes sobre el secreto profesional del médico forense en Costa Rica / Medical secret: notes on the proffesional secret of the forense physician in Costa Rica

La determinación de lo que puede reputarse como secreto no puede depender exclusivamente de la revelación del confidente sino que es un dato objetivo derivado de la misma pericia, donde se establezca que todo lo que exceda del objeto peritaje deberá mantenerse en secreto por irrelevante que parezca. Lo que es secreto es el conocimiento adquirido, no importa de qué forma, si por revelación del sujeto o por descubrimiento intencional o accidental. El divulgar información profesional que puede causar daño de cualquier tipo: físico, patrimonial, móvil, etc., es delito aún cuando ocurriere otro daño distinto al previsto (dolo eventual) En pericia sólo se debe consignar lo que se peticione. Palabras clave: Secreto, revelación, dictámenes, médico, dolo, información, pericia perseguible