Diagrammatic Reconstruction and its Application in Medico-legal Autopsies.

Head injury is a problem often encountered by both the clinicians and the Forensic Medical persons. Due to the doubtful positive outcome in case of clinicians and the consequent litigations in the court procedures, again these types of cases are generally apprehensive. Naturally the requirement of manner of the occurrences of the cases has become very important. Here lies the importance of Diagrammatic Reconstruction of such cases. Present work is a trial in this domain with an example.

Determination of time elapsed since death from the status of transparency of cornea in Ranchi in different weathers.

Determination of ‘time elapsed since death’ (TSD) is one of the important content of the post-mortem report. Although the status of transparency of cornea is variable, depending on different factors like other parameters used for the purpose of determination of time since death but it is less variable as compared to others. The study sample comprised of 238 medico-legal autopsies conducted in the department of Forensic Medicine & Toxicology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand during June 2006 to September 2007. In majority of cases cornea remains transparent & moist in 0—06 Hrs and becomes transparent & dry in 06—12 Hrs, transparent to hazy in 12—24 Hrs, hazy to opaque in 24—36 hrs and opaque in >36 Hrs. In sequence, changes occurs more in warm & moist weather then in warm & dry weather and cold & moist weather respectively and least in cold and dry weather.

A role of digital imaging in identification of unidentified bodies.

Unidentified and unclaimed bodies for medico-legal autopsy has shown increased trend. Relatives of unidentified bodies suffer a lot of psychological trauma and also suffer in settling insurance, inheritance and pension claims. When an unidentified body has injuries on face, then photograph of such deceased is not accepted by print or electronic media for publication as such photograph may cause distress to the viewers. This study was conducted on three cases of unidentified and unclaimed bodies brought for medico-legal autopsy with facial injuries making their photographs unfit for publication in print or electronic media. Photograph of the deceased face was taken; image was transferred to a computer and by using Adobe Photoshop software CS2 and the injuries present on face were removed. The result showed that in all the three cases we could establish the identity by digital imaging. Relatives of the deceased could identify their missing relative by photograph shown to them after removal of injuries. Later on police confirmed the identification by using other methods of establishing identity. This method can be an aid in identification of unidentified bodies presented with facial injuries.

Study of fusion of ischial tuberosity in Gujarati population by using digital x-ray method.

Forensic Medicine experts have to evaluate age in different medico legal situations, especially when the identity is not known, when the liability and punishment are related to the maturity. The study of epiphysial union of bones is considered a reasonable scientific and accepted method for estimation of age by the courts of law all over the world. The present study was carried out on 150 persons of age group between 17-21 years by using digital X-ray method in the Department of Forensic medicine and Toxicology at Govt. Medical College & New Civil Hospital, Surat.The present study possibly may generate the data giving shorter age intervals of fusion of centers of Ischial tuberosity (as compared to the standard text books or on the other end, may even positively reconfirm the evidential value of current data by using modern technique of digital X-ray). Anyhow, it will contribute to the better procurement and application of justice.

Correlation of risk factors with coronary atherosclerosis.

The prevalence of any disease among individuals likely to cause tissue or organ injury is related to a number of factors. The risk factors that predispose to atherosclerosis have been identified by a number of studies. This study was undertaken to correlate risk factors with the occurrence & severity of coronary atherosclerosis. The study duration was of 2 years from October 2006 to October 2008 & it includes 120 medicolegal autopsies conducted at MGIMS, over a period of 2 years. Data (age, sex, occupation, education, alcoholism, smoking, dietary habits etc) was recorded from the short history. Major coronaries were sectioned transversely by sharp knife at intervals of 0.3 cm and also longitudinally. The morphological lesions were noted in proforma and then they were sent for histopathology. The data was evaluated statistically. The study shows definite correlation between the risk factors and atherosclerosis. Certain life style modifications can decrease the incidence of atherosclerosis in the population.

Pathological autopsy: Most valuable aid in the present medical and medico-legal scenario.

It is a fact that the advancements in medicine would not have been possible without the help of autopsies, may be pathological or clinical or medico-legal. Mankind has been immensely benefited by the autopsies all these years. With the changing disease patterns, re emerging diseases, environment and social system, autopsies have become more necessary and relevant than before. The objectives of an autopsy examination are not being achieved at the highest level due to under trained medical officers who handle more than 80% of autopsy work in India and also due to the unwillingness or inertia of pathologists or clinicians to perform the autopsies. Here the in this article we try to highlight the contributions of pathological autopsies to the medical sciences & our social system. We also discuss why there is urgent need for more and well organized clinical or pathological autopsies through out the nation.

Second autopsy: The Indian scenario.

A Medico-legal autopsy is conducted to ascertain the cause of death, time of death, identification of the deceased, etc. in unnatural and/or suspicious deaths. However, the very purpose for which an autopsy is conducted may either not be served or appear to be poorly served in many a cases. In such times, another autopsy is requested and conducted on an already autopsied body commonly known as second autopsy. Rules are still unclear & varying for medico legal autopsy at different places resulting in unwarranted issues. This has resulted in a surge seen in cases of second autopsy or re-postmortem examination. With no rules governing the conduct of even a second autopsy and the sorry state of medico-legal autopsies as such in India, a lot of issues, wanted and unwanted, creep up while conduct of a second autopsy. An effort is made to draw attention towards the issues associated with the conduct of a second autopsy in India and few suggestions proposed to overcome those difficulties.

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.

Profile of deaths due to electrocution: A retrospective study.

We carried out a retrospective analysis of deaths due to electrocution from the medico-legal deaths reported to our institution. Majority of the victims were males belonging to the age group of 11-50 years. Almost all deaths were accidental and most of them were concentrated in the period of monsoon implicating the important role of wetness in causing these deaths. In contrast to the studies done in the West, bathtubs, heaters or hair dryers were not involved in any of the deaths. The mortality rate due to electrocution was significantly higher at 4.4 per one lakhs (100000) population in the present study as against the figures of 0.94 and 0.14 from Bulgaria and Canada respectively. Most of the deaths were either instantaneous or immediate and most of the deaths were preventable by electrocution. It signifies that people living at home did not have elementary knowledge of risks of electrocution; therefore awareness about use of good quality electric appliances and cables is the need of the hour.

Original research paper comparative study of hepatic injury and its different aspects in medicolegal autopsies.

Liver being an important and highly vascular organ, hepatic injury causes huge blood loss from the body for which the condition of victims becomes grave. So it is important to know which type if force or trauma causes which type of injury and also its extent to the liver. This paper deals with different types of injuries to the liver following trauma of different origin. In case of unnatural death resulting from trauma there are many authors who worked with injuries over different part of the body but a few of them has highlighted over hepatic injuries. That is why we liked to give our attention over hepatic injury. In present study we have dealt with 100 dead bodies with mechanical injuries in Calcutta Police Morgue under Medical College Calcutta during June 2008 to December 2009. This paper can also assist the care givers of the victim with the knowledge of the golden hour of management and also to find out the site of primary injury over liver.

An approach to sudden natural deaths in medicolegal autopsies at karamsad, Gujarat.

The Forensic autopsy is a medical procedure. Unfortunately, it is too often thought of only in reference to violent or unnatural deaths. The present prospective study was aimed to know the effectiveness of post-mortem examination to find out cause of death and its correlation with histopathological examination. It was also intended to deduce various epidemiological parameters and their logical relevance. Total 825 autopsy cases were performed during January 2007 to December 2009 (3 years), out of which 63 (7.64%) were of sudden natural deaths. Most of cases were found in 31-50 years age group and male preponderance was seen in all age groups. A majority of deceased were married. Cardiovascular diseases were the most important cause contributing 58.73% in sudden natural deaths. These cardiac cases were mainly due to coronary artery disease, coronary thrombosis and acute myocardial infarction. The 90.49% cases were brought dead to the hospital. In majority of cases (95.24%) postmortem was performed within 24 hours of death.

The medico-legal autopsy -It‟s religious and social attitudes.

An autopsy is a post-mortem assessment or examination of a body. It is performed by a physician trained in the specialty and authorized by law. The approach of the forensic pathologist to the investigation of a death is different from that of the hospital pathologist. Several health care areas are dependent on people's willingness to dispose of their body or parts thereof after death, and the issue of procedures involving corpse‟s entails important and, to some extent, growing problems. At this time there were still strong religious and social objections to the autopsy. There are also difficulties in providing corpses for anatomy education. The reasons behind these problems are probably manifold; some would be connected with the attitudes of people in general. This short review paper describe briefly only of its practical aspect of medicolegal autopsy with a brief historical review on its “Religious and Social Attitudes”.

Histo-pathology examination in medico-legal autopsy pros & cons.

Medico legal autopsy examination is performed by the forensic expert with a view to searching primarily for the cause of death. It is performed on the instructions of legal authority in circumstances relating to suspicious, sudden, obscure, unnatural, litigious or criminal deaths and the information so derived, to be applied for legal purpose to assist the course of justice. Medico legal autopsies differ in the purpose and procedure from pathological autopsies but sometimes they overlap with each other at various levels. Histopathology examination is commonly asked by autopsy surgeon to establish the cause of death when he recognizes any morbid anatomical changes in tissues and suspect that it may be the reason for cessation of vital functions of deceased. During the period of three years from 2005-2007, a retrospective study was conducted at PDU Medical College, Rajkot to know weather routine histo-pathological examination is essential in medico legal autopsies or it is creating only an extra burden over the pathologists, autopsy surgeon and law enforcing agencies in any way.

Collection, preservation and forwarding of biolgical samples for toxicological analysis in medicolegal autopsy cases : A review.

Collection of proper autopsy specimen is an essential step in the process of toxicology case work¹. Improper collection of these specimens can greatly alter or negate chemical and toxicological analysis. This article is an update about the standard methods of biological specimen collection procedures for toxicological analysis which will be helpful for the forensic pathologist and forensic scientists.

Dilemma for autopsy surgeon.

Postmortem artifacts are commonly encountered problems in routine. They had to wrong interpretation in number of cases especially at the hands of an inexperienced autopsy surgeon and hence may mislead the course of justice. So it is suggested that all the doctors concerned with medicolegal work, especially autopsies, should be well versed with these artifacts. Then only our opinion will be conclusive and aid in the administration of justice.

Study of fatal burn cases in medico- legal autopsies.

The burn autopsies form the major bulk of autopsies carried out at most of the hospitals in India. A medico–legal study of fatal burn cases was carried out at Nanded (India) during the period of 3 years. These constituted 18.2% of the total medico–legal autopsies carried out during the same period. The majority of burn deaths were observed in the age group of 11 – 40 yrs (83.11%), with peak incidence in 21 – 30 yrs (39.5%) of age group. Female preponderance was seen in all age groups with male to female ratio 1:2.5. Most of the cases were from rural area (76.3%). In 189 cases (41.4%), total body surface area involved was more than 80%. Majority of the subjects died as a result of flame burns (92.3%), followed by electric burns (5.3%) & scald (2.4%). In 406 cases (89%), Kerosene oil was involved leading to fatal burns. Accidental burns were most common (70.8%), followed by suicidal (18.2%) and homicidal burns (10.9%). The majority of deaths due to burns were observed within 1 week (66.2%).

Analysis and consider of technical identification for 32 cases medical tangle in medical association / 法医学杂志

OBJECTIVE@#To analyze cause of medical accidents and actuality of technical identification in medical tangle.@*METHODS@#32 cases (17 death, 15 survive) of medical tangle by technical identification (according to sex, age, mostly diseases, sequel) and identified results (whether or not mistake, cause and effect connection, duty degree) have been studied.@*RESULTS@#13 cases of 32 medical accidents have been determined.19 cases have been attributed to no medical accidents. Causes of medical accidents were most due to negligence of sense of duty.@*CONCLUSION@#The incidence rate of medical accidents can be decreased by strengthen colligated stuff of medical affairs personnal. We suggest that our state bring out more perfect legislation of autopsy in order to gain positive effect of technical identification in medical tangle. The medical mistake among grade of medical accidents should be added so that justice of identification could be improved.

Delayed death in a case of attempted strangulation mechanism of cerebral thrombosis and infarction -A case report.

Throttling is usually a homicidal act and generally the assailant continues the compression until the victim is dead. Pressure applied on the neck for about 3 -4 minutes consistently or more, is considered to be sufficient to cause death; the survival time depending upon the degree and duration of compression of the neck. The death may either be instantaneous or may be delayed for a few hours to a few days but in rare circumstances, the victim may survive, if rescue measures and treatment are promptly instituted. One such case of a male aged about 60 years, who was hospitalized after attempted manual strangulation for about 19 days and died thereafter, is being discussed. Medico legal autopsy findings of such a case are being evaluated in the light of existing literature.

An epidemiological study of road traffic accident victims in medicolegal autopsies.

Unnatural deaths of any kind i.e. suicidal, homicidal, accidental can cause severe emotional reactions to the near relative of the victim immediately after the event and later. Of all types of unnatural deaths road-traffic accidental death probably has the highest incidence worldwide.

Violation of children's rights: Can forensic medicine help.

"Today's child is tomorrow's citizen" so goes a popular saying, stressing the need for proper care and protection of the children. India has ratified the UN convention on the Rights of Child, which came into force on 2nd September 1990 and our own National Policy for Children was adopted way back in 1974. However, if we look at the outcome of all the measures that have been taken "on paper" the record is dismal. Child abuse goes unabated in our country, right in front of the eyes of the Law. The present study was undertaken to assess whether our specialty - Forensic Medicine - can bring to focus the atrocities perpetuated on children. During the 5-year period of the study, 155 cases were examined medicolegally in the Emergency department of the Govt. Medical College Hospital, Sector 32, Chandigarh; of which 6% were referred for medicolegal autopsy. Physical abuse accounted for 70% cases and sexual for 30%; the police brought 61% of the children to the hospital. Boys were more at risk in cases of physical abuse, however of the cases of sexual abuse, 23% were boys. Maximum cases of abuse - both physical and sexual occurred at the home/ eighborhood of the victim. It was concluded that the society as a whole, including the Govt. NGOs, Parents, teachers, elders etc. has the responsibility for the proper upbringing of the child and until and unless all of us shoulder the responsibility with sincerity, the children will continue to be abused.