A suicidal hanging with unusual findings at crime scene.

A 42 year old male, was found hanging by a plastic rope in his unbolted bed room. The rope was found attached to two suspension points (one end attached to the window panel and the other side to the ceiling knob) and the middle part of it used for the binding of neck. There was no knot present in the ligature as the right hand was found holding the ligature loop for the purpose of constriction of neck .A towel was found covering the head and underneath the ligature material on the neck used for padding. Blood stain was present on the floor below the suspended body which oozed out from the haemorrhoids. He was holding the cloth, wore in lower half of the body up to the mid thigh label, which appreciated by the authors as cadaveric spasm that developed in his flexor muscles of left hand. Detailed autopsy, crime scene examination and police investigation supported the manner of death as suicidal.

Métodos de valoración del tratamiento de la patología degenerativa cervical / Methods of assessing the treatment of cervical degenerative disease

Los cientificos trataron de elaborar una teoría del origen de la vida. Los cambios climáticos, las distintas divisiones del planeta y los elementos óseos encontrados permitieron elaborar una línea de evolución desde los "Homos" hasta el hombre actual. Con la bipedestación se manifiestan modificaciones en la estructura vertebral; características anatómicas cervicales influyen en la biomecánica. La anatomía comparada nos muestra su importancia y función, como en las apófisis unciformes. La patología degenerativa de dicho segmento no escapa a características comunes a toda columna vertebral, pero por tener una estructura y función diferentes, hay aspectos propios influyentes como: incidencia de la lordosis en el proceso degenerativo, función de las apófisis unciformes en la limitación de la rotación. Diseñamos un método de valoración del tratamiento quirúrgico de la patología degenerativa; creamos criterios de inclusión y exclusión para los 30 pacientes que formaron la muestra; revisamos nuestro trabajo de más de 15 años

SUMMARY: Scientists sought to develop a theory or the origin of life. Climate change, the various divisions of the globe and the bony elements found allowed to develop a line of evolution from the "Homo" to man today. With the standing manifest changes in the structure vertebral anatomic features affect cervical biomechanics. Comparative anatomy shows us its importance and function, as in the vertebral unciformes. Degenerative disease of the segment is no excrption to features common to all spine, but have a different structure and function, there are some influential themselves as incidence of lordosis in the degenerative process of the vertebral unciformes function in limiting the rotation. We designed a method to evaluate surgical treatment of degenerative disease; create inclusion and exlclusion critiria for the 30 patients who formed the sample, we reviewed our work over 15 years

Lesiones cervicales no cariosas asociadas a bruxismo nocturno grave: informe de un caso clínico / Non-carious cervical lesions associated with severe bruxism: report of a case report

Entre las lesiones cervicales no cariosas, la abfracción se define como la pérdida patológica de la estructura del diente en la región de unión cemento-esmalte, debido a la flexión producida por las fuerzas oclusales excéntricas, generalmente vinculadas a algunas interferencias oclusales, contactos prematuros, bruxismo y apretamiento. El presente artículo es un informe de un caso de una paciente, RFG, de 47 años, sexo femenino, que asistió a la clínica del "Servicio ATM" con la queja principal del bruxismo y la recesión gingival. En la historia clínica se informó de las actividades parafuncionales desde hace 2 años, además de episodios de depresión y ansiedad. En el examen clínico se observaron lesiones de abfracción en todos los elementos posteriores, hipertonicidad del masetero y puntos dolorosos de baja intensidad en el pterigoideo y en el esternocleidomastoideo. Para controlar los síntomas, el tratamiento inicial fue el uso de una férula neuromiorelajante. Teniendo en cuenta las manifestaciones sintomáticas relacionadas con las estructuras del sistema estomatognático, los hábitos parafuncionales y el perjuicio de los aspectos psicosociales, este trabajo tiene como objetivo establecer una relación entre las lesiones de abfracción, los factores etiológicos y las manifestaciones clínicas del trastorno temporomandibular que se incluyen en este informe de caso.

Among the noncarious cervical lesions, the abfraction is defined as the pathological loss of tooth structure at the cementoenamel junction due to the bending generated by occlusal eccentric forces, usually linked to some occlusal interference, premature contacts, bruxism and tight. This article show the case of patient RFG, 47 years old, female, who attended the "SERVICIO ATM" clinic with main complaint of bruxism and gingival retraction. In anamnesis, parafuncional activity was recorded 2 years ago, and episodes of depression and anxiety.In the clinical examination were observed abfraction lesions in all posterior teeth, hypertonicity of the masseter and painful light sites in medial pterygoid and sternocleidomastoid. For control of symptoms, initial treatment was established with occlusal plate. In view of the symptomatic manifestations involving structures of the stomatognathic system, parafunctional habits and commitment to the psychosocial aspects, this work aims to make a brief association, so little reported in the literature, among the lesions of abfraction, the etiological factors and clinical manifestations of the temporomandibular disorder found in this case.

Suicidal hanging: A prospective study.

The objective of this study was to focus on various factors associated with suicide by hanging at Chennai, India; with a view to identify the areas of intervention. A prospective study was carried out on 65 cases of death due to suicide by hanging which was received by the Institute of Forensic Medicine, Madras Medical College, Chennai, India, during the period of August 2008- July 2009. In the present study, 84.7%% of the cases were below the age of 40years, time of hanging in 50.8% of the cases was 3am-12noon, place of hanging in 95.5% of the cases was their residence, 92.3% were living with their family and 69.2% were married. Most frequent precipitating factors were marital unhappiness (33.8%), problems associated with organic disease (18.5%) and dowry harassment (16.8%). To reduce the incidence of suicides by hanging, there is urgent need to focus on these factors.

Forensic medicine identification of manual strangulation: an analysis of 21 cases / 法医学杂志

OBJECTIVE@#To analyze and summarize the rule of manual strangulation, as well as to look for the key points of injury identification, in order to provide information for formulating and revising the identification regulations.@*METHODS@#Twenty-one cases of manual strangulation from 1963 to 2004 in Xiangfan were reviewed and analyzed according to the characters, symptoms and appraisements.@*RESULTS@#The majority of assaulters in manual strangulation was young adult male and often could find the counteracted wounds on them. The throttling mark reaction usually could be found in victims and the cardinal symptoms were contusion in throat and asphyxiation in ocular region.@*CONCLUSION@#The degree of injuries is mainly moderate and slight. There is some inadaptability in the current regulations.

Hemangioma deformante cervical derecho: a propósito de un caso / Deformans right cervical hemangioma: a purpose of a case

Masculino de 32 años de edad, con aumento de volumen progresivo en la cara lateral derecha del cuello, de 20 años de evolución. Se sometió a resolución quirúrgica sin complicaciones. La histopatología reveló un Hemangioma Cavernoso, un tumor vascular benigno poco común, que puede causar molestias estéticas y funcionales de acuerdo a su localización, así como complicaciones sistémicas relacionadas con síndromes asociados. Comúnmente aparece en etapa neonatal puede hacerlo en el adulto. No existe tendencia a la regresión. La cirugía es el tratamiento definitivo, siempre que la lesión sea circunscrita y no afecte a órganos vitales.

The application of radiological imaging in the forensic pathology about cervical part / 法医学杂志

Multislice spiral computed tomography (MSCT) and magnetic resonance imaging (MRI) are useful to analyze cervical injury. Especially in injury of skeleton and soft tissue, it has equal value with conventional autopsy. Even they can reparation some shortcoming consisted in the cervical part autopsy. In some difficult postmortem examination of decomposed, charred or highly infectious cadavers and in some religion country, they should be a useful alternative way to examine injury in cervical part of cadaver such as mechanical asphyxia, whiplash injury, vertebra injury, or vascular injury.

What influences outcome of patients with suicidal hanging.

AIM: Suicidal hanging is an uncommon medical emergency with significant neurological morbidity. The aim of the study was to identify factors that have a bearing on the final outcome. MATERIALS AND METHODS: Retrospective analysis of 37 consecutive cases of suicidal hanging admitted to our ICU from July 1996 - December 2002 was performed. Outcome at discharge was defined as good (complete neurological recovery) or poor (death or incomplete neurological recovery). Three clinical variables (at presentation) namely Glasgow Coma Scale (GCS) at presentation, time lapse (in hours) from the incident to arrival at our hospital and the presence of Hypotension (defined as a systolic blood pressure < or = 90 mm Hg) at admission were recorded and tested individually for an association with the outcome. Statistical analysis was done using the Odds ratio (OR +/- 95% Confidence Intervals) and Chi-square test of significance for categorical data. RESULTS: Patients with suicidal hanging constituted < 1% of ICU admissions (mean age 27 years). 34/37 survived giving a survival rate of 92%. Of those who survived, 31 patients (91%) had complete neurological recovery at the time of discharge from hospital. Among those who presented <4 hours of the incident (25 patients), 2 had an adverse outcome as compared to 4/10 patients who presented 4 hours or more after the incident (OR 7.6,95% CI 1.12-52.3). A low GCS (GCS <7) at presentation was also statistically associated with a poor outcome (OR 10.4, 95% CI 1.08-102.1). Hypotension was present in approximately 33% of patients (12/37) at presentation. Of these 12 patients, 3 had an adverse outcome as opposed to 3 patients among the remaining 25 (OR 1.6, 95% CI 0.41 - 14.47, NS). CONCLUSIONS: Suicidal hanging is an unusual medical emergency that is common among young individuals in developing countries. Our study indicates that a delayed presentation to a medical facility and a low GCS at presentation predict a poor outcome.

Strangulation injury, a fatal form of child abuse.

Strangulation is a common method of committing murder, though underreported in Indian literature. We managed a girl child, victim of child abuse who later succumbed to its neurological complications. This case report describes the clinical features associated with such injuries and complications which should be anticipated in such cases.