Aspartic acid racemization with correlation to age: a forensic perspective

Objective: To estimate age through aspartic acid racemization of human dentin for forensic analysis, and to calculate the margin of error between chronological age and estimated age by racemization method

Study Design: Cross-sectional comparative study

Place and Duration of Study: Dental Outpatients' Department, Ziauddin Hospital, Karachi, from 2011 to 2014

Methodology: Patients from dental orthodontics department were selected. Verbal expressed consent was taken from the participants. Preliminary data was entered in a specially designed performa having name, chronological age, gender, socio-economic status. L and D ratio of aspartic acid were quantified in dentin for each tooth by High-Pressure Liquid Chromatography technique. Results of 100 samples with known age were used during study to estimate co-efficient of racemization. Regression equation was derived by plotting 85 samples of known age and KR as independent and dependent variables and least square equation was derived - Age = -4.391 +347.396 [co-efficient of racemization]

Results: The estimated co-efficient of determination was 0.74, meaning thereby that the regression equation was 74% correct for estimating age. The calculated correlation between chronological age and co-efficient of racemization was 0.834, which is interpreted as a very strong and positive correlation. The co-efficient of racemization increased with the age. The mean chronological age [38.44 +/- 13.22] years were statistically similar to the mean calibrated age [37.52 +/- 12.36] years. The median of actual and calibrated age was found to be 3.4 with inter-quantile value of 13. No statistically significant difference was observed among gender [p=0.837], or socioeconomic status [p=0.35]

Conclusion: Racemization of human dentin could be used as one of the reliable method for estimating age. HPLC is a reliable technique to estimate the co-efficient of racemization because it is highly reproducible, cost-effective and convenient. However, the procedure should be optimized and standardized within all laboratories for quality assurance

Radiological mean age of fusion of medial end of the clavicle: a parameter of age

Objective: To determine the mean age of fusion of medial end of clavicle by radiography

Study Design: Cross-sectional study

Place and Duration of Study: Departments of Forensic Medicine, Dow Medical College and Ziauddin University, Karachi, from June 2010 to May 2011

Methodology: The subjects for this study were selected from various government colleges of Karachi. The subjects were analyzed for age and further confirmation was done by interviews where birth records and other physical parameters of age were also assessed. X-rays chest PA view was taken focusing on the medial end of clavicle; and were examined by a consultant radiologist and complete fusion of the medial end was noted. P-value less than 0.05 was considered significant

Results: The mean age of fusion of medial end of the clavicle was found to be 21 +/- 1.43 years. Significant difference was observed in male to female age of fusion 21.14 +/- 1.41 years versus 20.65 +/- 1.94 years [p > 0.05]. Similarly, statistically significant differences were observed between lower to middle income class and higher income class of all society. No difference was observed among various ethnic groups

Conclusion: Socio-economic factors, such as diet and nutrition, directly affect bone growth and hence bones' age. The results of fusion of the medial end of the clavicle are not affected by ethnicity; however, it is significantly affected by gender. More studies should be conducted in various parts of the country to make a natural standard in setting up uniform criteria for assessing age at or above 21 years

Police encounters in Karachi - an autopsy based study

Background and Objective: A unique study conducted in Karachi with actual facts and figures based on autopsy findings of killings in Police encounters during last three years, also highlighting the number of killings which occurred during last three years along with age group, parts of body involved in such deaths along with areas of Karachi, so as to give an overall picture of these encounters. More over the root causes of these encounters, along with recommendations to improve the prevailing law and order situation in Karachi enabling people to per sue their daily routine without any fear or threat to life and property

Methods: The study is an autopsy based descriptive cross-sectional study conducted at Mortuaries at Civil hospital, Jinnah Postgraduate Medical Center and Abbasi-Shaheed Hospital of Karachi. The duration of study is based on three years, from 1st Jan 2011 to October 31st 2014. Records were gathered from the office of the Police Surgeon, Karachi and each post mortem report was scrutinized by the authors who are senior Forensic Experts themselves. All cases of police encounters that were brought for autopsy were included in the study while any case which was not autopsied was excluded. Aside from this custodial deaths have been excluded in the study

Results: Total number of encounter deaths autopsied during the period of study are 260, with 135[51.92%] autopsied at JPMC, 95[36.54%] at Abbasi Shaheed Hospital and 30[11.54%] at Civil Hospital Mortuary. Identity of deceased was known in 108 cases [41.54%] and 152[58.46%] remained unidentified. Majority of cases were between 25-30 years [n=135, 51.92%], next in order of frequency were 31-35 years [n=46, 17.69%] and least in 36 and above years [n=37, 14.23%]. On autopsy the pattern of frequency of body parts involved is ; bullet injuries in chest and abdomen in 110 cases [42.31%], only chest in 74 cases [28.46%], head in 17 cases [6.54%] and abdomen in 25 cases[9.62%].District wise Malir was venue of most of the encounter deaths 115[44.23%], followed by District South with 44 [16.92%] deaths, District East with 35[13.46]. A comparison between 2013 and 2014, showed that the frequency of Police encounters has increased from 19.23% i.e. from 50 deaths in 2013 to 57.69% i.e.150 deaths in 2014, up to October 31[st] 2014

Conclusion: The word life has not been defined in the Constitution of Islamic Republic of Pakistan, but it does not mean nor can it be restricted only to vegetative or animal life or mere existence from conception to death. Life includes all such amenities and facilities which a person born in a free country is entitled to enjoy with dignity, legally and constitutionally. So it is the duty of the state to provide safety to public. Although it is a good attempt to clean the city from notorious elements in the city of Karachi, but the main thing is that law enforcing agencies carry it without political discrimination and in cases of police encounters the action should be justified to rule out extra judicial killings. Speedy trial of those apprehended in courts of law and protection to witnesses will be of great help

Amino acid racemization in human detine as an estimator of chronological age - a study in Karachi Pakistan

Background: Amino acid racemisation is a reliable method to estimate age in developed countries. This pilot study was designed to determine the coefficient of amino acid racemisation [AAR] with reference to age in our population. Also as no such study has been conducted in our setting, the study also aims to discuss reproducibility of this study on a larger scale

Objectives: To determine the coefficient of amino acid racemisation [AAR] with reference to age; To measure the mean error in calculating age using this method; To identify any differences from earlier observation and discuss the reproducibility in our setting

Methods: Teeth were obtained from subjects between the age of 15 and 60 years who had come for routine extraction procedure or for orthodontic procedures. Incisors, canines, premolars and, first and second molars were included. Carious tooth and third molar were excluded. Samples were stored, dried, de-mineralised, hydrolysed, and derivatised. High-Pressure Liquid Chromatography [HPLC] was performed to quantify the L- and D- forms of aspartic acid in dentin. Correlation and regression was then tabulated based on the quantification, and was compared with data from other studies

Results: Based on the analysis of selected samples, a strong positive correlation of 0.93 was observed between co-efficient of racemisation and chronological age. The regression line derived was Age = 200 [KR] + 17.306 [where KR= coefficient of racemisation].The computed regression line was tested by using coefficient of racemisation for 8 samples selected during the study and the mean error [difference between actual and calibrated age] determined came out to be 3.99 +/- 5.77

Conclusion: The correlation coefficient was strongly positive. The results strongly suggests that aspartic acid racemisation of human dentine is a precise method for estimation of chronological age in living and in dead. The methodology should be standardized to make the results more accurate and prevent fallacies. However it remains an expensive procedure, especially the laboratory equipment that would not be available in most cities of Pakistan

killing of women without weapon: 5 year medico-legal study of rape cases in Karachi

Background: Rape is amongst the most prevalent sexual assault against women in Pakistan.1i These bullets when fired damage the physical, psychological, social, and economical well being of the victim, culminating often into problems culminating in a myriad of social, psychological and medical problems

Objective: To analyze the various medico legal parameters and dimensions of alleged rape cases in metropolis of Karachi and present this analysis in relation to the demographic parameters of the alleged cases

Methods: A descriptive and cross sectional study on a total of 1210 cases of alleged sexual assault, that were reported from January 1, 2007 till December 31, 2011, at the three authorized medico legal centers of Karachi: Jinnah Post Graduate Medical Center, Abbasi Shaheed Hospital and Civil Hospital Karachi

Results: Amongst the total of 1210 cases, majority involved unmarried females [n=898; 74.21%], whereas married cases were 312[25.79%]. On an average 20% of the cases were reported per year [n=292], with peak incidence in 2011 when the percentage rose to 21.65%[n=262] and the minimum being at 17.27%[n=209] in year 2007. Most cases were reported 0-6th day post incident with the percentage being 35.70%.[n=432]. The cases in which examination was carried out between 1 week to 1 month after incident were 64.29%[n=778]. The negative cases came out to be 62.56%[n=757] and positive cases came out to be 37.43%[n=453], on the bases of clinical findings [i.e. tears local injuries] and laboratory investigations. Sexual assault is more common, in the age group of 15-20 years [n=586; 48.42%]

Conclusion: Rape as sexual assault is still a major concern in our region. Most of the cases reported were however not proved to be positive; Reasons being many, especially when the victim report their cases late or the nature of cases being such [as in rape after abduction] that relevant physical findings were rendered useless to provide evidence. There is a need to provide safeguards to such victims so that they may seek legal and medical attention sooner, and measures to provide social security to such sufferers so that their physical and mental health can be restored in due time

Spectrum of medico-legal deaths in metropolis of Karachi: an autopsy based study

Background: The number and variety of medico-Iegal deaths has inflated tremendously in the recent years in relation to acts of terrorism using explosive material and street crimes which often result in tragic death

Objectives: To determine the frequency, causes and manners of medico-legal autopsies at three major mortuaries in Karachi

Methods: A case study, involving the medico legal deaths autopsied at three major mortuaries in Abbasi Shaheed Hospital, Jinnah Postgraduate medical center and Civil Hospital, from March 01, 2008 to February 28, 2009. A detailed autopsy was conducted in each case to determine the cause of death. The bodies were first examined externally followed by dissection of body cavities in accordance with Robert Virchow's technique. The results were collected from the respective institutions on a structured performa and were statistically analyzed using SPSS version 15. The Mean +/- SD was calculated for age

Results: Out of total 2,090 autopsies c0nducted during the period of study, 98.7% of the deaths were found to be due to unnatural causes. Homicides accounted for 54% of the deaths where as 39.3% were accidental deaths. Firearms were the most common cause of deaths [44.6%], followed by road traffic accidents [27.7%]. Male to female ratio was 9:1 with 88.8% of the victims being males. Majority of the victims belonged to age group 19-32 years [47.3%]

Conclusion: Homicides were the most common manner of death [54%], followed by accidents [39.3%]. Frequency in relation to cause of death revealed firearm injuries accounting for 446% deaths followed by road traffic accidents [278%]

Death in the home: domestic violence against women in Khyber pakhtunkhwa

Domestic or Interpersonal Violence [IPV] remains a major global problem often resulting in morbidity and mortality. The present study was conducted to determine the scope of deaths related to domestic violence in the Khyber Pakhunkhwa province, Pakistan. Data were collected on all reported female fatalities due to domestic violence for the years 2009-2011 from the records of the department of Forensic Medicine, Khyber Medical College Peshawar for analysis. A total of 305 deaths were reported, showing an increasing trend of 115 deaths for 2009-10 and 190 deaths for 2010-2011. The majority, 182 [59.7%] belonged to the rural areas and 123 [40.3%] to urban areas of the province. Victims were generally of the younger age groups [17% below age 16 and 42.3% between 17-32 years]. Homicide was the manner of death in 293 [96.1%] while the most common causative agent was firearm injury [235, 77.1%]. Head and neck injuries were most common [52.6%] followed by the chest and abdomen [31.6%] while multiple sites and extremities accounted for 15.8% of injuries. Young and adult females of KPK province of Pakistan are susceptible to homicidal deaths due to domestic violence, perpetrated through firearm injuries to the head and neck regions.

Comparative study of dermatoglyphics among the students of Ziauddin University

To determine the distribution of finger print among students of Ziauddin University belonging to different ethnic origins specifically pertaining to different ABO blood groups and also to correlate any relation between fingerprint pattern with ethnicity and ABO blood groups. Cross sectional study. This study was conducted at Ziauddin University Karachi from 1st Jan. 2010 to 30th June, 2010. This comparative study was carried out at Ziauddin University Karachi. 250 students, 50 students each from 1st year to 5th year were included by simple random technique. Students within age range of 19-24 years, belonging to any gender, ethnic group or any ABO blood groups were included in this study. Students suffering from eczema, chronic dermatitis, leprosy were excluded from study. Also students with permanent scars on their fingers and thumbs and deformities on finger either due to acquire or congenital traumas were also excluded. Fingers prints of both hands including thumbs were taken on a plain paper with a stamp pad by plain method. ABO Blood grouping of each student was performed. A Performa was made in which name, age, gender, ethnicity, type of blood group and type of finger print pattern were tabulated. 138 students were males and 112 were females with ratio of 1:2:1. Age range was between 19-24 years. Loop pattern were predominant [48.8%], followed by whorl pattern [32%] and then arch [19.2%]. Blood group B was most frequent [47%], followed by O group [27%], A group [18.8%] and AB Group [6.8%] respectively. Applying chi square test the p value obtained in variables i.e. finger prints with blood groups and fingerprints with ethnicity, no significant correlation was found. No significant association was found in types of finger prints with ABO blood groups and type of ethnic origin respectively. This study requires to be done at larger scale with larger sample size representing true indicator of population

Homicidal deaths by firearms in Dera Ismail Khan: an autopsy study

Determine homicidal deaths due to firearm injuries in the district of Dera Ismail Khan [D. I. Khan] of the North West Frontier Province [NWFP] of Pakistan. District Head Quarters [DHQ] Teaching Hospital and the Department of Forensic Medicine and Toxicology of the Gomal Medical College. D. I. Khan. The study was conducted over 1 year. Data collected included all reported unnatural deaths from the urban areas of the district on which autopsies were conducted in the department. A total of 97 autopsies were conducted in 2004 of which 63 were homicidal deaths [64.9%]. All homicidal deaths were caused by firearm injuries and all were males. The most common firearm weapons [87.3%] were high velocity firearms [Kalashnikov, rifles, pistols] followed by low velocity rifled weapons [9.53%] and shot guns [3.17%]. A total of 77 injuries were found on different areas of the bodies, giving an average of 1.2 injuries per person. The head, neck and face sustained the highest number of injuries [49.1%], followed by thorax and abdominal area [19.4% and 18.1% respectively]. Extremities including buttock and genital areas were least affected [18.1%]. All reported homicides were caused by firearm injuries. The issues of possession of legal as well as illegal firearms and their use in cultural activities needs to be changed in order to reduce violent deaths

Homicide in Abbottabad

Homicide is one of the oldest crimes in human history. Although a large number of dimensions have been added to this crime, the age-old factors like revenge, rage, jealousy and honour persist even today. This study was conducted jointly at the attached hospitals of Women Medical College and Ayub Medical College, Abbottabad to know the various dimensions of the victims of homicide. The present study encompasses all 40 cases of homicide, which presented for autopsy at DHQ hospital and Ayub Medical Complex Abbottabad during the year 2002. The manner of death was categorized as homicide on the basis of police inquest and the autopsy findings. The homicide rate in Abbottabad was found to be 4.22/100,000 per year. Males were the primary targets usually in their prime of youth with 40% victims between 20-29 years. Firearms formed the major weapon of offence. Most victims died before reaching the hospital. Deaths were more common during the daytime and in summer months. Homicide rate is on the lower side in Abbottabad amongst places where firearm possession is not strictly controlled, but can be further reduced. Limiting firearm possession alone can go a long way in this goal