Autopsy-based all-cause unnatural mortality during pre-pandemic and pandemic of COVID-19 in Varanasi, India: a retrospective analysis.

The COVID-19 pandemic has led to significant disruptions in healthcare systems worldwide, with Varanasi, India, experiencing profound challenges in managing mortality rates. In order to inform public health initiatives, it is important to comprehend how the pandemic has affected all-cause unnatural death in comparison to pre-pandemic patterns. This retrospective study intended to investigate patterns of all-cause unnatural mortality employing autopsy records of cases from Varanasi's Institute of Medical Sciences, Banaras Hindu University during the pre-pandemic and pandemic period (First and Second wave) of COVID-19. The analysis included 2694 cases of unnatural mortality, such as road traffic accident (RTA), poisoning, hanging and other causes. Demographic, clinical, and circumstantial data were collected and compared between the two time periods, that revealed significant as well as non-significant shifts in all-cause unnatural mortality rates. Whilst certain types of unnatural deaths, such as RTAs, witnessed a non-significant 2.03% (p = 0.34722) decrease, others like hanging exhibited an unexpected significant 3.17% (p = 0.01732) rise, burning and poisoning witnessed a significant 4.18% (p = 0.00026) and 2.37% (p = 0.0271) decline respectively. RTA was the leading cause of mortality both during and before pandemic. Male deaths (79.18%) outweighed female deaths (20.82%) by a more substantial amount throughout research periods. Additionally, variations in demographic characteristics, circumstances surrounding deaths, and healthcare utilization were observed during the pandemic period. The majority of unnatural fatalities occur in the age group of 21-30 years old in both pre-pandemic (22.62%) and pandemic conditions (26.65%). This study provides important insights into the secondary effects of the pandemic on unnatural mortality and emphasizes the need for individualized public health. Furthermore, research is warranted to explore the long-term implications and address the associated challenges for healthcare systems and public health initiatives.

Greulich and Pyle atlas: a non-reliable skeletal maturity assessment method in the North Indian population.

Forensic age assessments are crucial in the evaluation of criminal responsibility and preventing false age claims. Of all the methods available, the Greulich and Pyle (GP) atlas is most commonly used for age estimation purposes. Therefore, the current study sought to analyze the reliability and applicability of the GP standard and, additionally, to determine any possible association between the socioeconomic status (SES), food habits, and estimated skeletal maturity in the North Indian population. The study included 627 (334 males and 293 females) healthy children up to 19 years of age with varying SES and food habits. The skeletal age (SA) was estimated by three different evaluators using the GP atlas. The chronological mean age (CA) and SA were compared in different age cohorts. A paired t-test and a Pearson chi-square test were applied to show the difference between CA and estimated SA and the association of skeletal maturity with SES and food habits. The estimated skeletal age in males was retarded by 0.142 years or 1.72 months (p ≤ 0.05), whereas in females, it was retarded by 0.259 years or 3.12 months (p ≤ 0.05). In males, the GP method has significantly underestimated SA in age cohorts 3-4, 4-5, 6-7, 7-8, 8-9, and 12-13, whereas it overestimated in 10-11 and 18-19 years. However, in females, the SA was significantly underestimated in age groups 10-11, 12-13, and 14-15, respectively. Estimated skeletal maturity had no significant association with SES and food habits. The current study concludes that the GP atlas may not be applicable to North India's population. The observed difference in assessed skeletal maturity may be due to geographical region, genetics, hormonal effects, etc., which require further investigation. Hence, population-specific standards are necessary to determine the bone age of Indian children accurately.

Comparative evaluation of Demirjian's four teeth and alternate four teeth methods for the dental age estimation in children and adolescents of Varanasi region.

Background: Age estimation is an important approach in the field of forensics and medical sciences to assists in clinical practice, medico-legal cases, and in criminal cases of judicial punishment. Aim: This study aim the applicability and comparison of four-teeth method and the alternate four-teeth method of Demirjian's approach among the Varanasi population. Settings and Design: This is a cross-sectional prospective study on the population of Varanasi region children and adolescents. Materials and Methods: Four hundred and thirty-two panoramic images of children and adolescents (237 boys and 195 girls) aged 3-16 years, from the population of Varanasi region oriental was assessed using the four-teeth method and the alternate four-teeth method of Demirjian's approach, for the estimation of dental age. Statistical Analysis: Pearson's two tailed test was applied to establish the correlation between chronological age and estimated dental age and Paired t-test was applied to check the statistical significance between mean chronological age and mean estimated dental age. Results: The dental age of boys was overestimated by 0.39 ± 1.15 years (P < 0.001) and dental age was underestimated by - 0.34 ± 1.15 years (P < 0.001) among girls using the Demirjian's four teeth method. According to Demirjian's alternate four teeth method, the sample of boys overestimated the dental age by 0.76 ± 1.00 years (P < 0.001) with the statistically significant difference. While the sample of the girls had negligible overestimation of 0.04 ± 1.03 years (P = 0.580) with no statistically significant difference. Conclusion: Demirjian's four teeth method is better to estimate dental age in boys, whereas Demirjian's alternate four teeth method in girls of Varanasi region.