Critical Congenital Heart Disease Sadly Diagnosed at Autopsy in Calabar, South-South Nigeria

Congenital heart disease (CHD) is the most common type of birth defect causing more deaths in the first year of life than any other birth defect. Medical practice in a third-world country is faced with numerous challenges, created by poor health facilities and the unavailability of basic imaging studies at the community level where the majority of the poor resides. We present a case series of 4 neonates with a ratio of 1: 3 admitted into the neonatology unit of the University of Calabar Teaching Hospital, Calabar, Nigeria. Two of the patients were delivered at home by a traditional birth attendant via spontaneous vertex delivery and the rest two were booked cases in a private and obstetric unit of the University of Calabar Teaching Hospital. Their age ranged were 18 hours to 27 days of life and their common presentation were poor sucking, difficulty in breathing, central cyanosis and failure to thrive. A fetal echocardiogram was carried out for one of the cases and there was strong clinical suspicion of congenital heart disease but the precise type is unknown. The other three could not afford the necessary investigations required. They were all oxygen-dependent till death. Pathologic-anatomic findings showed a rare Critical congenital heart defect of the univentricular heart chamber of various types for the three cases and a case of TGA. The Immediate cause of death for all four cases was congestive cardiac failure.

Pathologic changes in patients infected with SARS-CoV-2: a review

Severe acute respiratory syndrome­coronavirus-2 (SARS-CoV-2) enters cells using the angiotensin converting enzyme 2 (ACE2), which are expressed by the respiratory tract endothelium, epithelial cells of the stomach, duodenum, ileum, rectum, cholangiocytes, and hepatocytes. Pathological examinations of these organs are not feasible method of diagnosis but can explain pathological changes, pathogenesis of the disease, and the cause of death in COVID-19 cases. In this review, we performed a literature search for COVID-19-related pathological changes seen during post-mortem examinations in different organs of the body including the lungs, gastrointestinal tract, liver, kidney, skin, heart and blood. Our findings showed that SARS-CoV-2 has damaging effects on many organs, probably due to the host immune responses to the presence of the virus. It is recommended that both antiviral and immunomodulatory agents should be considered in the management of COVID-19 patients for better prognosis, and clinical outcome

Hypothermia Deaths in Van Province, Turkey

ABSTRACT Objective: To evaluate autopsy findings in hypothermia-related deaths in Van Province, Turkey, a city near the Turkey-Iran border. Methods: Autopsy reports on 43 hypothermia fatalities were retrospectively reviewed. Data regarding age, gender, nationality of the cases, seasonality of the deaths, crime scene findings, autopsy findings, manner of deaths, risk factors for hypothermia, other traumatic lesions, and toxicology were obtained from autopsy records and scene investigation records. Results: There were 36 males and 7 females. The mean age was 20.5 years. More than half of the cases died or were found dead in the spring months. All but one of the cases was found dead outdoors. There were common red-coloured livor mortis in 33 cases (76.7%), antemortem traumas in 16 cases (37.2%), cold erythema in 26 cases (60.5%), myxedema in 1 case, bloody discolouration in the synovial fluid in 11 (84.6%) cases, and Wischnewski spots in 32 cases (74.4%). Conclusion: The study showed that illegal refugees are an important social problem in Turkey. Hypothermia should be considered as a cause of death for refugees when they are found, especially in the cold provinces. In the diagnosis of hypothermia, bloody discolouration of the synovial fluid is confirmed to be a valuable finding. Wischnewski spots remain valuable for positive identification.

A comparative study of clinical and autopsy findings (clinical audit) in 100 cases died of trauma.

Clinical audit is the systematic analysis of quality of any aspect of patient care with the aim of identifying possible improvements. In the present study one aspect of clinical audit - a comparison of clinical findings and autopsy findings was done in 100 cases died of trauma and brought for autopsy to Medical College, Trivandrum. This Study was conducted to find out the frequency of discrepancy and the type of co-existing injuries along with the missed injury. The discrepancies were classified according to the classification by Battle et al and Andersen et al. No discrepancy was observed in 62%, class I discrepancy (Major) in 25%, class II (Major) in 3%, and class III & IV (Minor) in 5% each. The injuries very rarely over looked were head injuries (11.4%) and spinal injuries (16.7%). The most frequent missed ones were abdominal injuries (64.3%) and chest injuries (63.9%). In majority of missed injuries head injury was a common occurrence i.e. 88.8% of missed abdominal injury, 78.1% of missed chest injuries, and all cases of missed spinal injuries.

Aluminium phosphide poisoning autopsy findings.

At prospective study to observe the gross and histopathological findings in Aluminium Phosphide Poisoning was undertaken on medicolegal autopsy cases brought to the department of Forensic Medicine. Gandhi Medical College, Bhopal. The study was undertaken, as Aluminium Phosphide Poisoning has become the commonest poisoning in central India over the last few years. 50 chemically confirmed autopsy cases were included in the present study and were examined grossly in detail and samples of tissue from various organs were stained by haemotoxylin eosin and observed microscopically. Several gross autopsy findings have been observed and are included in this paper. The present study is the largest autopsy series reported on Aluminum Phosphide, which includes the histopathological findings of various organs. and observations made earlier by the workers have also been compared.