Pattern Of Infections In Custodial Deaths � A Forensic Autopsy Study

Background: In a country like India, the prisoner cells are not well structured. For instance prisons are known to be a high risk environment for infections like tuberculosis (TB), HIV, HCV, HBV etc. due to overcrowding, low levels of nutrition, poor infection control and lack of accessible healthcare services. This study is an effort to know about the pattern of infections in custodial death cases detected during post mortem examination. Aims and Objectives: To determine the common infections and to know the mortality caused by infections among prisoners in custody, people in police custody and mentally ill patients in mental health institute in Punjab.Methods:This cross sectional study of 100 cases of custodial deaths from 1st Jan 2019 to 4thMay 2021, was carried out in the Forensic Medicine department in collaboration with department of Microbiology, Govt. Medical College, Amritsar.Results:Klebsiella Pneumoniae (37.5%) is more common in age group of 10-30 years while Staphylococcus Aureus (35.9%) infection was more common in the age group of 31 to 50 years. Incidence of positive growth of infections was slightly more in female inmates (76.9%) as compared to the males (75.9%). Inmates from urban area background showed more growth of Staphylococcus Aureus (35.7%) than from rural area background(25%).Conclusions:Timely medical diagnosis and treatment of each prisoner with availability of good doctors are the important issues relating to the healthcare of the individuals in custody.

Clinico-pathological profile in deaths due to burns.

Burn injuries occur universally and have plagued mankind since antiquity till the present day. Burns represent an extremely stressful experience for both the burn victims as well as their families. An extensive burn profoundly affects the patient's physique, psyche, financial situation and family. Patients with extensive burns frequently die, and for those with lesser injury, physical recovery is slow and painful. In addition to their dramatic physical effects, burn injuries frequently cause deleterious psychological complications. In all societies including developed or developing countries, burns constitute, a medical and psychological problem, but also have severe economic and social consequences not only to them, but also to their family and society ingeneral.24% cases were not hospitalized. 40% cases died within 24 hours of sustaining burns. 38% cases were unconscious before death. 66% cases had given dying declaration Mechanical injuries were present in 10% cases. 84% cases of total cases were alleged cases of accident. The major cause of death was Septicemic shock in 56% cases.

Death due to swine influenza: A forensic autopsy report.

A 29 year male who was working in army (soldier) at Pune, came to his house at Tarntaran (Punjab) on vacations to meet his family where he developed high grade fever, cough, dyspnoea, and was admitted in a private hospital. He was clinically suspected to be suffering from bilateral viral pneumonitis but the diagnosis of viral pneumonitis was never confirmed by laboratory tests in spite of admission in a hospital. Later on he died & the police was informed about his death. The police completed the inquest U/S 174CrPC & the dead body was shifted to the mortuary of Govt. Medical College, Amritsar for post mortem examination. A team of autopsy surgeons conducted the post mortem examination. The dead body was examined; nasal & pharyngeal swabs along with blood sample were taken from deceased and were sent to virology Deptt. , Post Graduate Institute, Chandigarh. The laboratory report mentioned the findings in favor of H1N1 virus & cause of death was declared as asphyxia as a result of viral Pneumonia (Species Swine Flu).

A two-year burns fatality study.

A severe burn injury is the most devastating injury a person can sustain and yet hope to survive. It is a common catastrophe today as burn injury cases are one of the common emergencies admitted to any hospital. There are several social, economic, cultural and psychological factors interplaying which influence the reporting, treatment, management and if the patient dies the further investigations. As the etiological factors of burn injuries vary considerably in different communities, careful analysis of the epidemiological features in every community is needed before a sound prevention programme can be planned and implemented. When stratified by age, more females were found in most age groups. Most burns were domestic, with cooking being the most prevalent activity. The maximum incidence of burn injuries in males were noted in the age group of 21-30 years. 56% cases who suffered burns were housewives.26% females had 91-100% burns. Smell of kerosene was present in 4% cases. Maximum burns were of 3rd degree with 28% males and 54% females. Head & neck were involved in 94% cases Extremities were involved in all cases.

Homicides by sharp weapons.

In the present society, which is gradually becoming over democratic it is natural that old values of sanctity of life changes and personality problems develop due to consequent stress of life. This ultimately results in violence. Killing of a human being is one of the most serious or major crimes. Since very long time, different judicial authority to prevent crime and its further occurrence framed laws. The laws were made according to the religious make up of the society but later the laws were according to the emperor’s own convenience. In spite of all these, there has been a phenomenal rise in the incidence of homicide all over the world and also in India. The study was conducted on 200 alleged cases of homicides. The incidence of homicidal deaths was observed as 13.03% with male preponderance and the commonest age affected was 21 to 40 yrs. Out of different weapons used to inflict the injuries on dead bodies of homicides, 31(10.88%) sharp cutting weapons were used. Incised wounds were present maximum 38(29.69%) on head and face. Defence wounds were present in 72(36%) of homicide deaths.

Current trend of poisoning--a hospital profile.

A one-year study was carried out among the poisoning cases admitted in the emergency wing of Guru Nanak Dev Hospital attached to Government Medical College, Amritsar during the period from 10-5-1997 to 9-5-1998. Out of 10,664 admitt emergencies, 3.19% were poisoning cases. Male to female ratio was nearly 3:1. Majority (45.59%) of the victims were in the age group of 21-30 years, 69.12% were married and 51.47% belonged to urban area. At the time of admission 61.47% cases were conscious, 26.17% were partially conscious and 12.36% were unconscious. Majority (76.47%) of the victims committed suicide, in 20.88% cases manner of death was accident and homicide was reported in 1.76% cases. Commones poison was aluminium phosphide (38.23%) followed by organophosphorus compounds (17.64%). The study observed increasing trend of suicide by aluminium phosphide and organophosphorus compounds, whereas other poisons for committing suicide were less commonly used.

Cost of medical treatment triggering homicide on attempted suicide.

Modern science has opened lot of venues to save the precious lives. The media is responsible for wide spread acquaintance of these developments even to the economically down trodden. These highly advanced methods of intensive care are definitely very costly are beyond the reach of even a middle class family but this notion do not immediately restrict anybody from obtaining such kind of aids.

Medicolegal study of mechanical injuries in culpable homicides (excluding deaths due to rash and negligent act).

Trend of homicides by different means keeps on changing with the passage of time and development in different parts of the world. A study was conducted on 200 alleged cases of homicides (excluding deaths due to rash and negligent act). Different profiles from demographic and medicolegal aspects were evaluated. The incidence of homicidal deaths was observed as 12.03%, with male preponderant (82.5%) and the commonest age affected was 21 to 40 yrs (51.5%). Rural population was mainly affected. The blunt weapon (50.88%) was commonly used to inflict the injuries and 'abrasion' was the commonest manifestation (32.73%). The defence wounds were present in 36% cases. Head was the main seat of injury (13.65%). The cause of death in most cases was hemorrhage and shock (31.5%), followed by injury to brain (28.5%). Only 16% cases of these received hospital care. This necessitates the prompt medical care to be provided in the 'Golden Hour' to save valuable human life. Police patrolling for early detection of crime and shifting of injured to hospital/critical care center and provision of prompt ambulance service by state/ private hospital/ NGO's for medical care.

Conversion to hijrah (EUNUCH) is it need based or a crime.

Young boys were allegedly kidnapped and kept under illegal custody for months together. After demoralization had set in due to prolonged confinement, surgery was done on their private parts and female hormones were given to the persons. The converted person were made to wear female garments and performed in groups as a female dancers and earned money while in captivity. After a few years the person approached the police that this heinous crime had been done against their will.

Corpus delicti: A case report.

Genesis of crime is multifactorial. It may have trivial background or may be well planned. With mens rea having all the components like motive, preparation and execution etc. Sometimes identification is big problem in dead bodies and in other cases so right identification altogether changes the scenario of the Crime.