Situs inversus vis-à-vis sudden death.

Situs Inversus, a rare congenital anatomical abnormality although is not directly related to Sudden Death. However, 3-5% of people with Situs Inversus have associated functional heart defect & 25% have an underlying condition i.e. Primary Ciliary Dyskinesis presenting as Kartagener's Syndrome; are prone to Sudden Death. Two cases of Situs Inversus on which medico-legal autopsy was conducted are reported. In first case, death was attributed to cardiac component (massive cardiomegaly, narrowing of coronaries and an old, healed apical scar) and in the second, due to respiratory complications (infection of lungs with areas of pus formation) with Blood Alcohol Concentration as 241.50 mg % ; being another significant finding. Apart from discussing the various aspects of the condition, vital medico-legal issues varying from 'Negligence' to 'Assessment for Insurance purpose' are being discussed.

Trauma score: A valuable tool for documentation of autopsy reports of trauma victims.

Trauma related morbidity and mortality is an age old reality, however, with the passage of time, advances in medical science and technology, man has succeeded to control / minimize the extent of damage caused by trauma. Vehicular accidents continue to be the commonest presentation of trauma related mortality and morbidity, the other causes being mechanical violence, industrial accidents, etc. According to the World Health Organization, accident is an event, independent of human will power, caused by an external force that acts rapidly and results in bodily or mental damage. Objective of the present study was to analyze the suitability of Anatomic Injury Scoring system particularly Injury Severity Score (ISS) on autopsy among the cases of road traffic accidents with the aim of improving the autopsy data in trauma related deaths, thus assisting policy planning for better trauma care systems.

Ligature mark on neck: How informative.

Many a times, a ligature mark may be the only evidence available in cases of asphyxial deaths due either to 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 retrospective study was conducted at the Department of Forensic Medicine and Toxicology, Government Medical College & Hospital, Chandigarh, between 1997 to 2004 to assess the information provided by a ligature mark in such cases. We found that deaths due to hanging constituted 3.4% of the total unnatural deaths subjected to medicolegal autopsy; young adults, of the age group 21 to 25 years accounted for the maximum cases, 27%; and the male: female ratio was 2:1. Chunni was the most common ligature material used. Majority of the victims preferred multiple knots (61%) and fixed knots (58%) and a single loop (93%). The mark was obliquely placed (98% cases) above the larynx (85% cases). In all the cases of ligature strangulation, the mark was transverse, below the level of thyroid cartilage. Imprint over the groove when present, corresponded with the ligature material used in all the cases. It was concluded that a thorough, scientific examination of the ligature mark, though not conclusive, but is the most important part of the postmortem examination of deaths due to hanging and ligature strangulation.

Unnatural deaths in northern India a profile.

A ten-year retrospective study was carried out on the cases of unnatural deaths subjected to medicolegal autopsies from 1994 to 2003. The main objectives of the study were: a) To ascertain the various aspects of unnatural deaths, b) To analyze the probable reasons for the same & c) To find remedial measures to bring down the incidence. The incidence of unnatural deaths was found to be persistently increasing. Maximum number of such deaths 1342 (47%) belonged to the age group of 21 - 30 years. Male: female ratio was 2.2: 1. Rural population was more prone to poisoning whereas the urban became victim of road-traffic accidents. Males preferred poisoning and hanging whereas females preferred self-immolation (burns) to end their awn lives. Suggestions relating to road safety, decreasing the stress of the modem mechanical life-style, educating the public in general and regarding the availability, use and storage of poisonous substances in particular have been put forward, while highlighting the social evil of dowry system prevailing in India.

A critical analysis of stab wound on the chest A case report.

Penetrating Injuries on the chest may be homicidal, suicidal or accidental in nature. There are certain features that are quite reliable pointers to the nature of these injuries. However differentiation is difficult particularly when the characteristics of stabbing are perplexed and information related to circumstances of the incident is misguiding. The present case projects the importance of careful examination of the stab wounds on the chest particularly when the information provided to the autopsy surgeon is ambiguous.

Multiple wounds by a single bullet: A case report.

A 19 year old boy with multiple entry and exit wounds was brought to the hospital where he succumbed to his injuries. According to the relatives he suffered a gun shot injury due to careless handling of firearm by his father. On autopsy it was found that a single bullet resulted in multiple wounds. The objective of this paper is to highlight the importance of careful examination of firearm wounds and to keep in mind the possibility of correlation between distantly present wounds.