Violence against healthcare personnel in India: Covid-19 prompts stricter laws.

During the past 10 years, the "Prevention of Violence Against Medicare Persons and Institutions Act" has failed to achieve its object. With the advent of the pandemic, stricter measures were taken and on 22 April 2020, all acts of violence against healthcare personnel confronting the Covid-19 pandemic became "cognizable and non-bailable offences" by means of the Epidemic Diseases (Amendment) Ordinance, a direct statement from the Government of India that there would be zero tolerance for violence against its health care workers. The Amendment aims to fill gaps in the previous law which did not protect healthcare workers against occupational violence at the workplace and at home. The amendment of the Ordinance will have a positive impact on the medical community which is much needed, particularly during the pandemic.

Fatal captive tiger attack - A case report with review of literature.

The attacks on humans by big captive felids has been an issue of concern for the administration of zoological parks and wildlife conservationists. The theme of human-animal conflict takes a new dimension for the wild animals kept in zoos, circuses, exotic animal farms, and private custody. Despite the potential dangers involved, the zookeepers have to closely interact with the captive tigers for catering to the needs of food, general health, and wellbeing. The literature has described cases of attacks by captive tigers resulting in the death of the primary caretaker. The injuries present on such bodies include multiple punctured lacerations, traumatic amputations, damage to the vital organs of the neck, fracture-dislocation of cervical vertebrae, and abrasions secondary to the dragging of the body. We present a rare fatal case of an attack of a tiger on keeper during the night hours while he entered the cage to look after the tiger who was suffering from gastroenteritis for a few days and was not taking his feed aptly. The keeper had a twelve-year long relation with the tiger, and the discovery of his death was an astonishment for zoo administration. This case describes the autopsy findings emphasizing the distribution of injuries, along with inquiring into the scene of the incident. The details about the predatory behaviour of tigers and stereotypic behaviours in captivity have been discussed.

Cardiac pathology in fatal electrocution.

Electrocution is mostly unintentional and occurs in domestic environment or in form of an occupational hazard. Electrical burns sustained in domestic environment or otherwise are associated with significant morbidity and mortality. The present report describes the pathological changes in the heart as observed in a case of fatal electrocution.

Adenomyomatous polyp of the uterus: Report of an autopsy case and review of the literature.

Adenomyomatous polyps of the endometrium are a rare subtype of endometrial polyps. In addition to the usual features of endometrial polyps, they also contain a smooth muscle component. Grossly they appear no different than ordinary endometrial polyps. In the case reported herein, a 23-year-old nulliparous female was killed in a traffic accident. In the course of the medicolegal autopsy, a small pedunculated growth was identified in the fundus of the endometrial cavity. Histologically the mass consisted of endometrial glands intimately mixed with smooth muscle and thick walled blood vessels, consistent with an adenomyomatous polyp. There was no history of tamoxifen use in this individual. To our knowledge this is the first report of post-mortem diagnosis of an adenomyomatous polyp. Furthermore, this is the first report of an individual with this diagnosis younger than the fourth decade. In the medicolegal setting, forensic pathologists are constantly faced with entities that, while they may not have caused death, may serve to educate practitioners about rare lesions. This individual's finding serves as one of those entities. This case reiterates the importance of the autopsy as not only the answer to an individual's death, but as an avenue for the discovery of entities that may have relevance to those who are still living.

Legal terrorism in domestic violence -- an Indian outlook.

Marriage in India is a voluntary union for life of one man and one woman to the exclusion of all others. It is a social association where the husband has the responsibility to take care of and maintain his wife and not to neglect his duties. But in relation to this great institution, the problem of the "dowry" still persists. Women are ill-treated, harassed, killed or divorced for the simple reason that they do not get a dowry or do not get a sufficiently large one. To safeguard the interest of women against the cruelty they face within the four walls of their matrimonial home, the Indian Penal Code 1860 was amended in 1983 and section 498A was added. This deals with "Matrimonial Cruelty" to a woman. Matrimonial Cruelty in India is a cognizable, non-bailable and non-compoundable offence. Notwithstanding that the practice of demanding dowries was made illegal in India over 50 years ago, the (London) Times on 18 January 2012 reported that a study in 2007 concluded that "there is a dowry-related death in India every four hours". Official statistics in India show there were 8,391 dowry-related deaths in 2010, and there may well have been more. Why has leglislation that criminalises these appalling practices failed to stop them?

The Mangalore aircrash of 22 May 2010: practical problems related to identification of the dead in a populous developing country.

It was a sad and emotional moment for the citizens of Mangalore, India when the "Dubai to Mangalore" Air India Express Boeing 737-800 flight IX-812 crashed at the Mangalore International Airport on 22 May 2010, killing 158 people on board. Identification of the victims was difficult as most of the bodies were charred beyond easy recognition. The practical problems faced by the legal authorities in identifying the charred victims in a populous and developing country like India are discussed in this paper.

Younger women are affected by breast cancer in South India - a hospital-based descriptive study.

INTRODUCTION: Breast cancer is one of the most common cancers in the world among women and its effective control depends upon sufficient knowledge about its epidemiology at the regional as well as global levels. MATERIALS AND METHODS: A record based descriptive study was conducted in a tertiary care hospital situated in coastal Karnataka in South India. Cases included were all histopathologically diagnosed cases of breast cancer not otherwise specified among females that were treated in the hospital in the 3 years period of 2005-2007. A total of 112 cases were found and their data retrieved and analyzed using SPSS. RESULTS: Mean age of the subjects was 45 years (SD=10.4) (range 23 -70). Age distribution showed two peaks at 35-39 years and 50-54 years. Some 12 (11%) patients had a previous history of breast cancer and 9 (8%) had a family history. Among the patients who had history of breast cancer in the past, 61.5% were during the pre-menopausal age. CONCLUSION: The age affected by breast cancer was lower than usually seen in other parts of the world and there was more of premenopausal occurrence which has implications on their own and their relatives' chances of acquiring breast cancer later. The findings show that breast cancer control efforts and recommendations in different parts of the world have to be tailored to the regional epidemiological patterns.

Postmortem diagnosis of acute haemorrhagic pancreatitis.

Forensic pathologists can help in the investigation of sudden unexpected deaths in co-operation with the officials responsible for the maintenance of law and order to administer justice. Sudden unexpected deaths form the subject of medicolegal investigation if they occur in apparently healthy individuals, wherein an autopsy would shed light regarding the cause of death. A 4 year retrospective review of autopsy files at the Department of Forensic Medicine, Kasturba Medical College, Mangalore, South India was undertaken for cases of sudden unexpected deaths due to acute haemorrhagic pancreatitis occurring between May 2004 and April 2008. A total of seven cases of acute haemorrhagic pancreatitis diagnosed at autopsy as the cause of sudden unexpected death during the study period are discussed herein.

Toxicoepidemiology of fatal poisonings in Southern India.

An autopsy based retrospective study was conducted from January 2000 to December 2006 at Manipal in Southern India, and a profile of the victims of poisoning was prepared. The study was done to understand the magnitude and pattern of all poisoning fatalities in relation to the manner of death in Manipal region of Southern India. The study included a total of 198 cases of fatal poisoning. Self-poisoning was reported in 92.9% cases. Fatal accidental poisoning was seen in 6.1% cases. Homicide by poisoning was not reported during the study period. Uncertainty regarding the manner of death due to poisoning was observed only in two cases. Males were predominantly affected (71.2%). The majority of the victims were in the 3rd decade (28.3%) of life. The age of the victims ranged from 2 to 82 years with a mean age of 38.4 years. While majority of the victims consumed poison during daytime, most of the poisoning fatalities were reported during summer months. Organophosphate compounds were implicated in 68.7% of the total poisoning related fatalities. Males in the 3rd to 5th decades were prone to self-poisoning with organophosphate compounds. Accidental poisoning deaths were uncommon and poisoning was not a preferred method of homicide in this region. Our approach to the study reveals that quantitative chemical (toxicological) analysis is required to further strengthen and improve the databases of epidemiology of poisoning in our region.

Sexual dimorphism of the index to ring finger ratio in South Indian adolescents.

Sex determination from prepubertal human remains is a challenge for forensic experts and physical anthropologists worldwide as definitive sexual traits are not manifested until after the full development of secondary sexual characters that appear during puberty. The research was undertaken in 350 South Indian adolescents to investigate sexual dimorphism of the index and ring finger ratio. The index finger length (IFL) and the ring finger length (RFL) were measured in millimeters in each hand and the index and ring finger ratio was computed by dividing the index finger length by the ring finger length. Mean RFL was greater than mean IFL in both males and females. Mean RFL was significantly higher in males. The index and ring finger ratio showed a statistically significant difference between males and females (p

Fatal electrocution by a support metal wire.

Electrocution is not an uncommon cause of death. A case of fatal electrocution by a metal wire that was used as a support for the insulated television cable wire is reported. Electric current flowed through the metal wire when it touched the residential power line. Electrical injury caused because of contact with the live metal wire is described with histopathological findings. This case reports the circumstances that led to accidental fatal electrocution in an outdoor setting during the rainy season. Significance of death scene investigation to confirm the cause and manner of death in cases of fatal electrocution is highlighted. Public awareness programs to lay emphasis on electrical safety in domestic environment need to be introduced to prevent fatalities resulting from ignorance and/or negligence.

Circumscribed injuries caused by an explosion in firecracker factory.

Firecracker display is used worldwide for celebrating religious festivities, New Year celebrations and various other occasions. Explosion during the manufacture of firecrackers can result in serious injuries. We, herein, report a case, where a person succumbed to injuries sustained in an explosion in a firecracker factory. Superficial to deep burns, traumatic amputation of right upper limb, and multiple abrasions and lacerations were present on various parts of the body with contusion of internal thoracic and abdominal organs. Also, multiple punctured circumscribed wounds with burnt floor and margins were present over the body.

"Atypical Suicidal" cut throat injury--a case report.

Suicide is one of the leading causes of death in the world. The incidence and pattern of suicide vary from country to country. Cultural, religious and social value plays a vital role. Hanging, poisoning, drowning are the common methods of committing suicide. Suicide by incising one's own throat without hesitation marks remains a rare, and only few cases have been reported in the forensic literature. We present here an unusual and rare case of self-inflicted cut throat injury of a 45-year old ex-military man without tentative cuts over the neck, which has resulted from a curved sharp weapon.

'Rib betrays heart'--a case report.

Penetrating or stab injuries of the chest are not uncommon and could be accidental, suicidal or homicidal. However, the present case discusses the importance of a careful examination of an unusual presentation in a motor vehicle accident. The case presented with haemopericardium and haemothorax due to penetrating rib injury to the heart, subsequent to blunt force trauma on the posterior chest wall. This case is highlighted, so that it becomes a necessary tool for the forensic experts to have an unprejudiced approach at autopsy and come to a reasonable conclusion.

Acute haemorrhagic pancreatitis - A case of sudden death.

Sudden death in young individuals is relatively uncommon and acute haemorrhagic pancreatitis as a cause of sudden and unexpected death is a rare phenomenon. A case of sudden death due to acute haemorrhagic pancreatitis is reported in a young doctor who ignored the radiating pain of acute pancreatitis for gastritis, and resorted to self-medication. The condition was discovered only at autopsy.