Age determination by spheno-occipital synchondrosis fusion in Central Indian population.

The spheno occipital suture synchondrosis is a vital contributor to adolescent and adult age estimation in that it can provide an upper or lower age bound depending on its state of fusion. The present study evaluates the utility of the spheno-occipital suture fusion in age estimation of the Central Indian population. The sample includes 198 (117 males and 81 females) cadavers aged between 8 to 26 years. Grading was done using Mitra-Akhlaghi Scale as - Open, Semi closed and Closed. Our study demonstrates that a significant linear correlation exists between the age of an individual and spheno-occipital suture closure for both the sexes and observation of the degree of fusion of this single suture allows the prediction of age in mature individuals.

Distribution & diagnostic efficacy of cardiac markers CK-MB & LDH in pericardial fluid for postmortem diagnosis of ischemic heart disease.

The aim of the present study is to evaluate the diagnostic efficacy of biochemical markers creatine kinase-MB (CK-MB) and LDH in pericardial fluid for postmortem diagnosis of ischemic heart disease (IHD). We studied 119 medico-legal autopsies selected during a period of 2 years. Subjects were assigned into diagnostic groups upon final cause of death as follows: (1) sudden cardiac death due to IHD's (n = 52), (2) violent asphyxia (n = 24); (3) polytraumatic deaths (n = 20); (4) natural deaths excluding cardiac causes (n = 23). Pericardial fluid samples were tested for estimating enzyme levels. Histological examination was performed with hematoxylin and eosin (H&E) stain on myocardial tissue samples. We observed highest levels of CK-MB & LDH in deaths due to IHD's. Kruskal-Wallis test revels significant differences in activities of CK-MB (P = 0.0001) and LDH (P = 0.0065) amongst all diagnostic groups. Mann-Whitney test showed highly significant (P < 0.0001) levels of CK-MB in group 1 as compared to other diagnostic groups. However, LDH levels were non-discriminatory (P = 0.0827) between cases of IHD's and cases of other natural deaths. CK-MB levels were statistically non-significant between cases divided as myocardial infarction (MI) and severe coronary artery disease in group 1, hence its role for postmortem detection of MI is somewhat limiting. However, sensitivity and negative predictive values of its cut off level obtained in cases of IHD's are nearly equal to diagnostic efficacy in clinical settings. Hence, it can be useful additional diagnostic tool for autopsy diagnosis of IHD's. Whereas, LDH is not useful for postmortem diagnosis in these cases.

Quantitative analysis of injury characteristics in victims of interpersonal violence: an emergency department perspective.

Violence runs into the fabric of society. In recent years, violence has been identified as an important health problem in industrialised societies. In the present study, conducted to analyze injury characteristics, 813 victims of interpersonal violence presenting to emergency department at a Government Medical College and Hospital from a major city in Central India were interviewed and examined over a period of one year. Central to the quantitative analysis of the data collected was the extraction of specific injury characteristics from the sample population. The group included 606 men and 207 females, most of them were resident of urban areas, aged between 11 and 30 years. Most of attacks occurred at nights, with minimal seasonal variation. Males were more commonly attacked outdoors by a single stranger male while females were mostly attacked indoors by spouse. Blunt trauma was more commonly seen in females as compared to males. Head neck and face region was the most preferred anatomical site by the assailants. Hard and blunt weapons were used more commonly at homes (184 of 269 incidents) than at streets (301 of 561 incidents). Sharp edged and pointed weapons were most commonly used at streets. Firearms were rarely used. Occurrence of physical assaults in this region more or less follows the pattern seen in other parts of the world with local and socio-cultural differences that need to be further delved into and considered during the planning and implementation of injury prevention programs.