Indian Journal of Forensic Medicine and Pathology

The focus of this study was to present methyl alcohol intoxication by citing clinical and laboratory, as well as radiological findings. A case of a 47-year-old man with a 20-year history of alcohol use disorder, brought to the emergency department in a coma. He had headache and blurred vision symptoms that started after drinking cologne and spirits. He had a Glasgow Coma Scale score of four. Increased anion gap metabolic acidosis was detected. Diffusion weighted imaging showed diffuse restriction regions in the subcortical white matter, cerebellar hemispheres, brain stem, bilateral optic nerve and putamen. He treated with hemodialyze, sodium bicarbonate, dextrose and ethanol infusion. However, the patient died on the seventh day. Bilateral putaminal necrosis is the most characteristic radiological finding, but white matter necrosis rarely reported in the literature. As in our case, such extensive involvement of the brain may be correlated with mortality in the acute period. 

Keywords: Methyl alcohol; Methanol; Intoxication; Magnetic resonance imaging.

Exposure of industrial and environmental toxic substances to air, drinking water, soil, plants, animals and food chains and their continuous release to the human environment have a negative impact on human health. When exposed to heavy metals due to these toxic exposures, many effects on body functions can occur. Generally, due to the long half-life of the metal in the body, it can accumulate biologically in soft and hard tissues/organs. Bone tissue undergoes a continuous remodeling throughout life. This involves the simultaneous action of resolution, synthesis and mineralization of the bone matrix. In general, metals have two effects on bone tissue: the first is their direct toxicity to bone cells and the second is their accumulation in the bone matrix. Their direct toxicity mainly affects osteoblasts, inhibits osteoblast differentiation, synthesis activity and mineralization of the extracellular matrix. Their effect on osteoclasts differs from that of metal, increases or decreases the activity of tartarate resistant acid phosphatase enzyme and prevents the maturation of the precursors. As a result, it causes imbalance in the bone remodeling process, reduces bone formation and contributes to the formation of bone diseases such as osteopenia and osteoporosis. Despite our knowledge of the effect of metals on bone tissue, many things are still unclear. Understanding the mechanisms of action will ensure that appropriate therapies are available to address their adverse effects on bone tissue. 

Keywords: Heavy metal; Bone; Osteoporosis.

Fluorine is the world’s 13th most abundant element and constitutes 0.08% of the Earth crust. It has the highest electronegativity of all elements. Fluoride is found naturally in soil, water, and foods. It is also produced synthetically for use in drinking water, toothpaste, mouthwashes and various chemical products. Although fl uoride is used industrially in a fl uorine compound, the manufacture of ceramics, pesticides, aerosol propellants, refrigerants, glassware, and Tefl on cookware, it is a generally unwanted byproduct of aluminum, fertilizer, and iron ore manufacture. This paper reviews the human health effects of fl uoride. The authors conclude that available evidence suggests that fl uoride has a potential to cause major adverse human health problems, while having only a modest dental caries prevention effect. As part of efforts to reduce hazardous fl uoride ingestion, the practice of artifi cial water fl uoridation should be reconsidered globally, while industrial safety measures need to be tightened in order to reduce unethical discharge of fl uoride compounds into the environment. Public health approaches for global dental caries reduction that do not involve systemic ingestion of fl uoride are urgently needed. 

Keywords: Dental fl uorosis; Skeletal fl uorosis; Fluoride poisoning.

It is aimed to reveal the occupational accident situation, PPE usage situation and, accordingly, the difficulties that may be encountered in working and social life of the employees who work as a technical staff in a state university and the current job satisfaction, in this study. To calculate the findings of the study, percentage, frequency, mean and standard deviation have been used; to compare qualitative data chi-square test has been used and significance has been evaluated at p < .05 level. Spearman correlation analysis has been used to examine the relationship between variables. According to the results of the research, the majority of the employees do not receive any occupational safety training before and after they start work. Besides, according to the results of the study, it can be said that the expected and observed negativities will be minimized if the employees receive training on OHS materials. 

Keywords: Occupational accident; Occupational disease; OHS.

The study area is located in Kirsehir Turkey’s blog from the tectonic units and Tertiary has been observed that epigenetic occur in the sedimentary units. Uranium mineralization is located between Akoluk, Mehmetbeyli and Temrezli Villages of Sorgun district of Yozgat. The unit consisting of conglomerate, sandstone and mudstone alternations (Paleson aged) is located on granites and the youngest unit in the region is Quaternary alluvium. 20 soil samples were taken to investigate the pollution dimensions, possible sources and spatial distribution of the elements, in the soil samples in the study area. In this study, the relationship between element values obtained by geochemical analysis (As, Cr, Cu, K, Mn, Ni, Pb, Th, U, V, Zn and Zr) was investigated statistically. A positive correlation was observed between Cr-Zn, Cu-Ni, K-Mn, Mn-Pb, Mn-Th, Mn-V, Mn-Zr, Pb-Th, Pb-V, Pb-Zn, Pb-Zr, Th-U, Th-V and U-V elements in soil samples (p < 0.01; p < 0.05). The average shale values were considered as background values in determining the metal pollution dimensions in soil samples. Enrichment factors (EF), geoaccumulation index (Igeo), Contamination factors (CF) and pollutant load index (PLI) were calculated to determine the pollution dimensions of the elements. According to the results of the analysis, the average values of Cr, Fe, U, V and Zr were below the average shale values of the world. For each element examined, the mean EF values K, Mn (in all samples), Ni (in samples 9, 16 and 17), and Zn (in samples 5, 8, 10, 14, 16 and 17) were extremely enrichement. Contamination factor values As (in all samples) elements in terms of considerably contamination and contamination were detected. Since the PLI values (except example 17) were > 1, all elements were found to contaminate the study area. According to the results obtained, the average values of the elements in the study area are K > Mn > Zn > Ni > Pb > V> Cu > As > Th > Zr > Cr > U. 

Keywords: Enrichment factor; Geoaccumulation index; Pollution; Soil.

Background: Found on the priority organic pollutants list and mono substituted derivatives of phenol, 4-chloro and 4-nitrophenol compounds are organic-origin micropollutants with toxicologic research performed due to recalcitrant properties, endocrine disrupting and lipophilic character, and tendency for bioaccumulation. As both pollutants are used in many industrial and other applications (from paper, pesticides, dye, pharmaceutical and explosives industries to chlorination of drinking water), they rapidly accumulate at all trophic levels of the ecosystem and are known to cause negative effects on organisms in the ecosystem led by aquatic systems. As a result, there are many methods developed for toxicity research of these types of priority organic pollutants, though studying the small freshwater fish species of zebrafish (embryo and adult) is chosen due to some advantages compared to other methods. Aims: To our knowledge, there are no studies performed on the embryotoxic effects of 4-nitrophenol and 4-chlorophenol derivatives on fish species. With this aim, the lethal and teratogenic effects of the phenol derivatives on zebrafish (Danio rerio) were evaluated by means of FET (fish embryo toxicity) test. Materials and methods: According to FET test, embryos at 1.5 hpf (hour post-fertilization) were exposed to 4-nitrophenol and 4-chlorophenol solutions in concentrations 1.0, 2.0, 4.0, 8.0 and 16.0 mg/L during 96 h. Every 12 hours, the embryos were observed and scored for lethal and teratogenic effects. Also, LC50 values were calculated for 48 h. Results: 48 h LC50 values were 2.409 mg/L for 4-chlorophenol and 4.581 mg/L for 4-nitrophenol. With increasing phenol concentrations, lethality and malformations increased. Teratogenic malformations more frequently produced by phenol derivatives were: incomplete body, chorda deformity, tail curvature, lordosis, scoliosis, delayed development and hatching, weak or non-pigmentation. Conclusion: 4-chlorophenol was found to be more toxic than 4-nitrophenol. Results firstly showed that the phenol derivatives caused embryotoxicity in zebrafish. 

Keywords: 4-chlorophenol; 4-nitrophenol; Zebrafish; Embryotoxicity, LC50

Background: The aim of the study was to report the pattern of patients with acute intoxication in an academic emergency department (ED). Method: The study included 180 patients with acute intoxication who admitted to the Research Hospital of Yozgat Bozok University in Yozgat. Turkey between January 2018 and January 2019. The demographic features, arrival mode, intoxication type, intent status, requested consultations, and disposition forms were retrospectively evaluated based on the patient files. Results: Acute toxic exposure was detected in a total of 180 patients during the study period. The male/female ratio was 0.68 (73/107). The median age was 26 ranging between 3 and 89. The most common acute toxic exposure presentations were due to drugs (57.2%, n = 103), venomous animal/insect bites (16.1%, n = 29) and toxic gas inhalation (13.9%, n = 25). Toxic gas inhalation included inhalations of carbon monoxide (11.7%, n = 21) and vapor of hydrochloric acid (2.2%, n = 4). The rest of the presentations (19.4%, n = 35) were due to food poisoning (7.8%, n = 14), alcohol intoxication (3.9%, n = 7) and ingested toxic agents (1.1%, n = 2). No illicit drug use was observed. Almost half of the toxic exposures (51.7%, n = 93) were considered as unintentional whereas 77.7% (n = 93) of drug intoxication cases were intentional suicidal attempts. At least one consultation was requested for 126 patients. Two or more consultations were performed for 19 patients. The most consulted division was Internal medicine (48.9%, n = 115). The most common drug intoxications were due to analgesics (24.3%, n = 25) and antidepressants (23.3%, n = 24). Conclusion: Acute toxicity is not limited to drug poisoning. It is not a rare reason for ED admission with its many sub-headings. 

Keywords: Intoxication; Poisoning; Overdose; Environmental; Drug.

The study area is located in Çorum G34 a3 and a4 section in GümüÅŸhacıköy (Amasya). 17 samples of Euphorbia cyparissias plant grown in this region and related soil samples were collected and analyzed. The metal content of the investigated soil samples is as follows: Fe > Zn > As > Mn > Pb > Cu > Sb > Cr >> Ag > Ni > Co > Cd. The soil pH controlling the metal transfer in the soil, the pH values of the examined soil samples are between 4.66 and 8.22. This range indicates that the soil samples are in acidic and basic conditions. Metal pollution (toxicity) due to increased mining activities may affect the environment and public health. The correlation coefficient was a strong positive correlation between Ni with Co and Ag, As with Sb (0.89); Ni (0.88) and Cu (0.86), Pb with Co (0.84), Cu (0.81), Ni (0.85) and Sb (0.81), Ni with Cu (0.81) and Sb (0.86), while there is a negative correlation between Mn with Ag, As, Cd, Co, Cr, Ni, Sb and Pb, and Fe with Cd, Co, Cr, Ni and Pb. The bioaccumulation factor (BAC) values of Euphorbia cyparissias have been found between not accumulate— high accumulator or hyperaccumulator plants in both root/soil and leaf/soil. The translocation factors (TF) of all metals (10 in location), Cr and Ni (3 in location), Co, Cu, Mn and Zn in the (9 in location), Ni (11 in location), and Cd, Co, Cr, and Ni values (16 in location) are less than 1. TF values calculated outside these locations are greater than 1. TF values greater than 1 showed that the metal concentration in the leaves was higher than the roots. 

Keywords: Euphorbia cyparissias; Translocation; Bioaccumulation; Metal pollution (toxicity).

Background: The scorpion sting is a condition that requires management in emergency department. Anti-allergic, analgesic and anti-venom administrations are commonly used, particularly in pediatric patients. In this study, it was aimed to present data from patients who presented with scorpion sting and underwent various treatments. Material and method: We retrospectively reviewed 50 patients who presented to our hospital with scorpion sting. Demographic characteristics, severity of clinical presentation, treatments employed and anti-venom administration were evaluated. In patients underwent anti-venom treatment, we evaluated whether or not anti-venom caused systemic signs or additional pathology. Results: Mean age was 9.88 ± 4.58 years in the study population. There were 18 girls (36%) and 32 boys (64%). It was found that electrocardiogram was performed in all patients and that there was sinus tachycardia in 6 patients (12%). No systemic sign was detected during followup. It was found that anti-venom treatment was used in only 7 patients (14%). No significant difference was detected between anti-venom treatment and other therapeutic modalities used in ED. Conclusion: Scorpion sting is one of the leading causes of insect bites presenting to pediatric emergency departments in Turkey. It was observed that, even in tertiary care settings, antivenom treatment is used in scorpion sting without systemic signs. Based on this study, no anti-venom indication was present in this patient group. Thus, anti-venom decision should be assessed by relevant unit or pediatric emergency clinicians in cases requiring anti-venom treatment. Unnecessary anti-venom use should be avoided by training clinicians in primary care. 

Keywords: Scorpion; Anti-venom; Sting; Treatment.

Vitamin D deficiency is common in the World and Turkey due to changing lifestyles. The association with autoimmune diseases such as obesity, metabolic syndrome, diabetes, cardiovascular diseases and important diseases such as cancer has made it important to prevent vitamin D deficiency. Fetuin-A is a glycoprotein produced in the liver and it is effective in the inhibition of bone mineralization, insulin resistance, obesity and calcification in smooth muscle. In the study conducted, it was aimed to investigate the relationship between the two substances in growth retardation, considering that Vitamin D and Fetuin-A are acting through similar mechanisms. The study was conducted with 50 healthy children with growth retardation. In short patients and underweight patients, vitamin D levels were found to be lower than control group (respectively p = 0,011 p = 0,036). As vitamin D value increased one unit, it was found that the risk of growth retardation decreased by 1,071 times (p = 0,21). Fetuin-A levels were higher in those with growth retardation (p = 0,035). In the preschool group, fetuin-A was higher than middle childhood (p < 0,001). In short patients, fetuin-A levels were higher than control groups (p = 0,043). There was a poor correlation between vitamin D and fetuin-A levels in those with growth retardation (rho: 0,366 p = 0,009). Fetuin-A levels were higher in short children and there was a positive relationship between vitamin D and fetuin-A levels in those with growth retardation. Vitamin D levels were lower in those with growth retardation. 

Keywords: Fetuin-A; Vitamin D; Growth retardation; Underweight, Short stature.

Plants are used for many purposes from past to present. One of them is consumed by people for therapeutic purposes. Some compounds or excessive heavy metal intake during consumption can be harmful to human health. In this study, the amount of Aluminum (Al), Nickel (Ni) and Cobalt (Co), which are toxic elements in the decoction samples obtained with different sample amount (g) and decoction time (min) of Melissa officinalis L. (lemon balm) and Salvia officinalis L. (sage) were investigated. All elements were analyzed by Inductive Coupled Plasma-Mass Spectrophotometer (ICP-MS) at Yozgat Bozok University Science and Technology Application and Research Center. The calibration curve was plotted with 11 points. In both species, the amount of Al was observed to be higher than the other elements. The highest amount of Al was observed in sage plant (1155.6 ppb), while the highest amount of Ni was found in lemon balm (771.3 ppb). In contrast, the maximum amount of Ni and Al was found in the decoction samples of the lemon balm. There was no statistically significant difference between the amounts of Co element in lemon balm and sage decoction samples. In general, increased amount and increased application time of lemon balm plant were found to cause an increase in Al and Ni amounts. As a result, toxicological evaluation of such plants used for their therapeutic properties is important for human and public health. 

Keywords: Sage; Lemon balm; Toxicology; ICP-MS; Decoction.

Objectives: Glyoxal is used as a biocide and disinfecting agent in pharmacy and dye production is released to the environment, air and water with emissions. Furthermore, glyoxal is produced endogenously in non–enzyme-mediated pathways in intracellular metabolism which can be detected frequently in fermented food and beverages. For this purpose, in this study we investigated the effect of glyoxal on cell viability and proliferation in human umbilical vein endothelial cell (HUVEC) line in vitro. Method: In our study, cell culture was performed using HUVEC. Cell proliferation and viability were evaluated by spectrophotometry with tetrazolium salt (MTT) by applying different doses of glyoxal to HUVECs. Data were analyzed by SPSS 21.0 program. Results: Glyoxal in doses of 320, 16, 0.8 M significantly decreased cell proliferation when compared with control group (p < 0.05). The doses of 4 × 10–2, 2 × 10—3, 1 × 10–4, 5 × 10–5, 2 × 10–5, 1 × 10–6, 6 × 10–7, 3 × 10–7 M, were found to increase cell proliferation significantly (p < 0.05). Conclusion: According to our study, when compared to human plasma glyoxal level (0.1 – 1 M), doses of glyoxal over 1 M showed cytotoxic effect on cells, whereas doses below 1 M increased the proliferation of endothelial cells. It is accepted as an important intermediate in the formation of advanced glycation end products (AGEs) by binding to the amino groups, nucleotides and lipids of the glyoxal proteins entering the cell. AGEs modification may activate cell proliferation pathways at low doses by altering protein function and influencing intracellular signaling pathways, while at high doses it may affect repair mechanisms and apoptotic processes, leading to cell damage. 

Keywords: Cytotoxicity; Endothelium; Glyoxal; Proliferation.

A planned complex suicide is the complex action mechanism, formerly planned to protect the victim of suicide from failure. A 22-year-old female body was brought by the relative to the hospital with cut injury in the both forearms. Autopsy findings revealed cut injury in both forearms with ligature mark around the neck. Death scene investigation, Forensic science lab reports and different observations confirmed, it is a case of planned complex suicide. To the best of our knowledge combination of methods used in this case is unique and has not been reported. The sequence of events in this case was difficult to determine as both the methods used, viz. cut wrist and hanging were sufficient to cause death individually. Also the sequence of event made it more difficult to determine.

Keyword: Planned complex suicide; Cut wrist; Hanging; Death scene investigation.

Venomous and poisonous animals are a major cause of global morbidity and mortality with cardiovascular and renal toxicity as common presentation. Renal functional impairment as a result of their toxicity is manifested in form of specific histopathological changes. Regardless of vast mentioning of renal toxicity in literature previously, only few studies are currently available with an integrated approach. This paper mentions about various such animals with nephrotoxic potential describing the toxic principles in their venom and inflicted changes in renal pathology.

Keywords: Animal; Poisoning; Nephrotoxicity; Renal failure; Acute tubular necrosis

Background: Human identification using footprint is an emerging biometric technique, and footprints as valuable physical evidence in crime scenes are used to link the crime to the perpetrator. Footprints can be collected from almost all types of crime scenes and the possibility of their recovery at the scenes of sexual offenses and homicide is relatively more. Aim and Objective: To estimate stature from footprint length measurements in Telugu people of Nalgonda district at Narketpally State Telangana South India. Place of Study: Department of forensic medicine and toxicology on the consenting adult males of Nalgonda District of Telangana State. Type of Study: Descriptive cross-sectional study with analytical and comparative components. Material and method: The subjects were confirmed to be descent from Nalgonda district and were specifically selected with residence of Nalgonda district only, irrespective of their caste, religion, dietary habits and socioeconomic status. The footprint measurements collected in 150 adult males’ volunteers with age of 18 to 40 years. Observation and Discussion: In footprint first toe - heel footprint length measurement, i.e. PRT1 and PLT1 was found to be longest, i.e. 24.789 cm and 24.795 cm respectively. In our study it was observed that the footprint length from left foot was larger in comparison to footprints from right foot. In both right and left footprint the first toe length was highest and it was observed that after the great toe length both left and right footprint length measurements from toe 2 to toe 5 till hill length gradually declined, i.e. 24.795 to 20.832 respectively. Simple linear regression equations accuracy in our study verified by comparing the estimated stature with actual stature revealed that both regression equations and scatter graphs indicated the existence of statistically significant positive correlation between footprint lengths and stature of Nalgonda populations. Conclusion: The result of this investigation provided regression equations for stature estimation from footprints in Nalgonda populations. The regression equations derived for this pooled sample can be used to estimate stature, as in real crime scenarios.

Keywords: Stature estimation; Footprints; Linear regression.

Background and objectives: Scorpion sting is a frequent, life-threatening medical emergency in children. They constitute a significant public health problem in many underdeveloped countries, including India. This study was done to study the epidemiological factors responsible for high prevalence of scorpion sting in our community. Methodology: This is an observational study of 35 cases of scorpion sting, admitted at our institute. An epidemiological study was done to determine the factors predisposing to prevalence of scorpion sting in the community. Results: Scorpion sting is a common, pediatric emergency in our area. Rural male children, from lower socioeconomic groups, aged between 1–3 years (28%) and 3–10 years, (57%) were most commonly affected. Maximum admissions in May, June. Conclusion: Scorpion sting is a serious, potentially fatal emergency in our area. Cardiovascular manifestations are most common and life-threatening. Scorpion stings constitute a "occupational hazard" for children employed as agricultural laborers. The epidemiological factors affecting the severity of scorpion envenomation are studies in the present study. The various factors are season summer being 49% cases, rural area common being 64%, scorpion sting common in lower socioeconomic strata residing in kaccha house. Sting found more in night time and 44% were in outdoor. Sixty eight percent scorpion stings were on exposed part of body.

Keywords: Scorpion sting; Prazosin; Occupational hazard.

Introduction: Cervical cancer screening using Pap smear is the cornerstone of any cancer control program. The study aimed to know the burden of various cervical lesions which were assessed by conventional Pap smear study. Methodology: We included 500 referred symptomatic patients in the study. The history, deatiled clinical examination, per speculum examination and a vaginal examination were performed for all women. Pap smear was used to screen all women for cervical cancer. Results: Mean age of the study population was 44 years and the most common complaint was whitish discharge per vaginam (54%). Classifying patients according to the Bethesda System 2001 Guidelines, we observed 61% (n = 303) cases to be Negative for Intraepithelial Lesion or Malignancy (NILM), 36% (n = 182) as Atypical Squamous Cells (ASC), 2% (n = 10) as Atypical Endocervical Cells (AEC) and 1% (n = 05) as unsatisfactory. Of the 303 cases of NILM, non-specific inflammatory changes were seen in 63%, reactive cellular changes in 21%, atrophic changes in 10%, candidiasis in 3%, Gardnerella vaginalis in 2% and inflammation with Trichomonas in 1%. Of the 182 ASC, 30% had low-grade squamous intrapeithelial lesion, 26% atypical squamous cells of underdetermined significance, 24% with high-grade squamous intraepithelial lesion and 21% with squamous cell carcinoma. Of the 10 AEC cases, 1 case had adenocarcinoma. Conclusions: Pap smear is less invasive, cost-effective and simple procedure which can be used to detect dysplasia in the cervix.

Keywords: Cervical malignancy; HSIL; LSIL; Pap smear.

Introduction: An accurate assessment of c-erbB2 expression in invasive breast cancer (IBC) has become crucial to precisely recognize the candidates to be treated with Trastuzumab. Presently, fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) are most commonly employed methods for evaluating c-erbB2 status. Recent literature has documented a strong correlation between the two c-erbB2 diagnostic analyzes. However, discordance between both the assays has been rarely reported. Therefore, we aimed to compare and correlate FISH and IHC results for c-erbB2 expression in Indian breast cancer patients. Material and methods: A total of 388 formalin fixed, paraffin embedded blocks of invasive breast cancer were retrospectively evaluated for c-erbB2 status by IHC (DAKO) and FISH (PathVysion dual-probe system) and results were compared. Results: 92.5% cases with IHC 3+ score showed significant concordance with the FISH results; while c-erbB2 gene amplification was noted in 48.3% of IHC 2+ cases. A large number of referral cases in the study group and variation in pre-analytical and analytical factors have attributed in escalating the number of indeterminate cases expressing c-erbB2 gene amplification. Additionally, an inverse correlation was revealed between ER/ PR expression and c-erbB2 status. Conclusion: The results of the current study established a high degree of concordance between IHC and FISH in Indian breast cancer patients with 3+ immunoreactivity. However, reflex testing by FISH is recommended for IHC equivocal cases in order to avoid false results related to technical and interpretation errors, usually encountered while performing an immunohistochemical assessment.

Keywords: Breast cancer; c-erbB2; Concordance; Fluorescent in situ hybridization (FISH); Immunohistochemistry (IHC).

Introduction: The teeth are one of the durable parts of our body which can withstand more assaults than any other part of the body and there exists a relation between tooth crown length and body height. The study aims to determine the possible correlation between tooth dimensions and stature estimation using Carrea’s index. Materials and methods: The study group comprised about 67 subjects above 18 years. Alginate impressions were made for mandibular arch and height was assessed. The mesiodistal widths of mandibular anterior teeth were measured and substituted in the formula given by Carrea to obtain the minimum and the maximum estimated height of a person. Results: On comparison of the Carrea’s index in right side, females showed 9.3% successful prediction, on left side 8.3% showed successful prediction in males than in females. The height was accurately predicted when average values of left and right side were considered. Females showed 55.8% accuracy and males showed 37.5% which was statistically significant. Discussion: Teeth could be used as a reliable source for stature estimation especially in those forensic cases where other body parts are not available. In the present study the average values from right and left side were considered for both genders to predict the height of the individual. Our findings could be explained on the basis that perfect bilateral symmetry seldom exists on right and left side arches which could be due to congenital or environmental factors or both. The Carrea´s index for stature estimation is a convenient, simple and inexpensive method, and can provide valuable information to the forensic investigation.

Keywords: Carrea’s index; Stature; Forensic Odontology.

Background: Autopsy study of liver aids in the knowledge of pathology by revealing lesions that were asymptomatic during life. Due to enormous functional reserve, many liver lesions are silent till late in the course of disease. Hence histopathological study of all liver specimens is necessary. Material and methods: The present study included 260 liver specimens from medicolegal autopsies received over a period of two years from August 2014 to July 2016. Thorough gross examination was done followed by microscopy. Result: The most common lesion was steatosis, accounting for 78 (30%) out of 260 liver specimens. There were 43 (16.5%) cases of congestion, 20 (7.8%) cases of hepatitis and 17 (6.5%) cases of steatohepatitis. Ten (4%) cases of cirrhosis were noted. Other lesions included microabscesses 7 (2.6%), granulomas 6 (2.3%), and one case (0.3%) each of bile duct hamartoma, sickle cell anemia, disseminated intravascular coagulation, extramedullary hematopoiesis, disseminated cryptococcosis and microfilarial infection. Conclusion: The present study showed that fatty change was the most common lesion encountered in liver specimens from medicolegal cases, followed by congestion and hepatitis. Hence histopathology of every liver specimen is must.

Keywords: Medicolegal autopsy; Fatty change; Cirrhosis.

The therapeutic perception of access to medicines and health care in government hospital of Union Territory of Jammu and Kashmir (UToJ&K) is an empirical study of Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar in right based approach underpinned in Patents (Amendment) Act, 1970, Patents (Amendment) Act, 1999, Patents (Amendment) Act, 2002 and Patents (Amendment) Act, 2005, Essential Commodities Act, 1955 and Drug Price Control Order, 1995. On the other hand consumer law perspective are rooted in Consumer Protection Act, 1986, J&K Consumer Protection Act, 1987 and Consumer Protection Act, 2019. The broad parameters are access to medicines, health care system, health delivery services, patient satisfaction and utility and doctor – patient relationship. It is estimated that substantial section of population in Union Territories of Jammu and Kashmir is health deficient and medicine starved due to unavoidable contingency, spiraling cost shifting and inordinate health care infrastructures. The therapeutic perception needs a closer analysis of attendance and care of patients, diagonostic methods of treatment and access to medicine in the context of medico-legal profiling of SKIMS, Srinagar.

Keywords: Therapeutic perception; Access to medicines; Health care; Diagnostic methods of treatment; Doctor–Patient relationship.

Introduction: Granulomatous mastitis (GM) is a rare, chronic inflammatory condition of obscure etiology, varied clinical and pathological features. Methods: This was a restrospective, three-year analysis, of the clinical and histological parameters of diagnosed cases of GM. Results: An analysis of age at presentation revealed the mean age as 35.3 yr. Clinical data was available for 26 patients and the mean lesional size was 5.3 x 4.3 cm. The most common presenting complaint was as a lump, with diffuse swelling and nipple discharge next in frequency. Clinical diagnosis varied widely from benign to malignant. Treatment administered included incision and curettage, lumpectomy and simple mastectomy. Thirty-eight cases reviewed showed granulomas in all the cases. Caseous necrosis was absent. Special stains for tubercular bacilli and fungi had been done in 26 cases and were negative. Follow-up ranged from 3–5.5 years. Recurrence was documented in 57.6% of patients. Conclusion: GM, generally, is a disease of young women that is of particular significance since it can easily be mistaken for malignancy. Histopathological diagnosis is confirmatory.

Keywords: Corticosteroids; Granuloma; Lobulocentric; Mastitis; Necrosis.

Background: Metric and non-metric analysis of the human dentition have played an important role in human biological research and have formed a central focus in the field of dental anthropology for over a century. This study intends assess the degree of sexual dimorphism in permanent anterior teeth in south Indian origin student population. Aim: The purpose of this study is to analyze the mesiodistal crown width of permanent anterior teeth and assess the degree of sexual dimorphism in permanent anterior teeth in south Indian origin student population. Materials and methods: Materials for this cross-sectional study consisted of 210 students belonging to various parts of South India (Karnataka, Kerala, Tamil Nadu, Andhra Pradesh, and; union territories of Lakshadweep and Pondicherry) comprising of 100 males and 110 females in the age group of 18–25 years studying at A. J. Institute of Medical Sciences and Research Centre, Mangalore, Karnataka who are willing to participate in the study. Methods for the study consisted of measuring the maxillary and mandibular incisor and canine widths of these students using a digital caliper with a resolution of 0.01mm with the provision to fix it in position to the desired position so as to avoid any errors in recording the exact measurements of canines. Results: 100 males and 110 female students in the age group of 18–25 years, from various parts of South India were examined to predict the sex from the mesiodistal widths of permanent anterior teeth for both the arches. The mean mesiodistal width of mandibular central incisor was greater in males (Right: 5.55 ± 0.39 mm; Left: 5.59 ± 0.38 mm) than females (Right: 5.43 ± 0.34 mm; Left: 5.44 ± 0.34 mm). The mean Mesiodistal width of maxillary central incisor was greater in males (Right: 8.60 ± 0.52 mm; Left: 8.60 ± 0.58 mm) than females (Right: 8.29 ± 0.52 mm; Left: 8.24 ± 0.67 mm). The mean Mesiodistal width of mandibular lateral incisor was greater in males (Right: 6.07 ± 0.45 mm; Left: 6.10 ± 0.38 mm) than females (Right: 5.83 ± 0.41 mm; Left: 5.86 ± 0.37 mm). The mean Mesiodistal width of maxillary lateral incisor was greater in males (Right: 6.90 ± 0.62 mm; Left: 6.86 ± 0.63 mm) than females (Right: 6.58 ± 0.57 mm; Left: 6.59 ± 0.56 mm). The mean Mesiodistal width of mandibular canine was greater in males (Right: 6.62 ± 0.54 mm; Left: 6.78 ± 0.51 mm) than females (Right: 6.21 ± 0.54 mm; Left: 6.35 ± 0.47 mm). The mean Mesiodistal width of maxillary canine was greater in males (Right: 7.52 ± 0.58 mm; Left: 7.60 ± 0.54 mm) than females (Right: 7.33 ± 0.45 mm; Left: 7.28 ± 0.49 mm). Conclusion: This study shows that the Mesiodistal crown width of permanent anterior teeth can be used as tool for determining the sex.

Keywords: Dentition; Mesiodistal crown width; Metric and non-metric analysis; Permanent anterior teeth; Sexual dimorphism.

Objectives: The study was contemplated to ascertain the trends of dermatoglyphic pattern in individuals with different ABO and Rh blood groups and to evaluate the relationship between the pattern of fingerprints and blood groups. Methodology: The study was carried out in the Department of Forensic Medicine at Government Medical College of southern Haryana. Medical students of the age group 18–24 years knowing their blood group and considering their accessibility to the department of Forensic Medicine were randomly selected for the study. Plain and rolled fingerprints for all digits of both hands were taken with ink pad on non-glazed paper. Results: The study revealed that loop was most frequently seen fingerprint followed by whorl, arch and composite. B positive is the most common blood group, and loops pattern of the fingerprint is predominant in all blood groups and Rh-positive and negative subjects, followed by whorls. Conclusion: Each fingerprint is unique; hence, it can be effectively used for corroborative identification of an individual in mass disasters as well as in other forensic applications. More studies with larger sample size should be conducted to enhance the reliability of correlation of dactylographic pattern with sex and blood group.

Keywords: Fingerprint; Dactylography; Dermatoglyphics; ABO blood group; Identification

Introduction: Hashimoto’s/Lymphocytic thyroiditis is a common autoimmune disorder which has female preponderance. Autoimmune thyroiditis is considered as a complex interaction and interplay between various genetic and non-genetic factors. Molecular basis of Hashimoto’s thyroiditis is not known. Fine needle aspiration cytology being first line of investigation for thyroid lesions is helpful in diagnosing these lesions as well. However, few potential pitfalls in cytology may lead to cytohistologic discordance. Materials and methods: This is a retrospective study of one year where all histologic proven cases of Hashimoto’s/ Lymphocytic thyroiditis with their corresponding fine needle aspiration cytology slides from pathology database were studied. All FNACs were analyzed in depth and reviewed for cytohistologic correlation. The reasons of cytohistologic discrepancies and discordant cases were analyzed. The genetics of autoimmune thyroiditis was also reviewed from literature. Results: Out of total 38 cases of HT/LT analyzed in this study, 89% were females and 11% were males. Mean and median age was found to be 44.4 years and 44 years respectively. Correlation of cytology and histology showed that 50% FNACs’ correlated with their respective histologic diagnosis. Major causes of the discrepancies and discordance are reporting on suboptimal smears, cystic fluid samples, and giving over emphasis on a single cytologic feature in rare cell clusters. Conclusion: Autoimmune thyroiditis is frequently encountered lesion. Fine needle aspiration cytology is useful in deciding the management of thyroid lesions. In order to restrict the discrepancies and cytodiagnostic errors, one must adhere to the adequacy criterion along with primary fixation, quality of the smear and cellularity. Cytopathologists should be aware of the possible pitfalls and differentiating clues when overlapping features between different lesions are encountered. Also an integrated multidisciplinary approach can be used to minimize potential pitfalls. Many a time the condition can be diagnosed after death as seen in case of few sudden deaths. The unexpectedly brought in thyroid dysfunction is expected in such cases. So the forensic pathologist must keep this entity in mind while dealing with cases of sudden death.

Keywords: Autoimmune; Cyto-histologic discordance; Fine needle aspiration cytology; Genetics; Hashimoto’s thyroiditis

Introduction: Ovarian tumors are a group of diverse neoplasms with a varied clinical, morphological and histological feature. The varied anatomy, histogenesis and its peculiar physiology including the cyclical changes from puberty to menopause give rise to number of cell types, each of which may give rise to tumors. Materials and methods: A 3-year retrospective study of histologically proven ovarian neoplasms where the tumors were classified according to World Health Organization (WHO) 2014 classification and their clinical and histopathologic parameters were analyzed. Results: Of all 138 ovarian tumors studied, 94 (68.12%) were benign, 13 (9.42%) borderline and 31 (22.5%) were malignant in nature. Benign tumors chiefly presented with abdominal pain with median age of 39. Mature cystic teratoma was found to be the most common benign tumor. Borderline tumors presented at a median age of 37. Borderline serous and mucinous tumors (30.76%) were the most common borderline tumors. Malignant tumors presented frequently with abdominal mass and at median age of 48. According to WHO classification of tumors based on cell of origin, surface epithelial tumor were the most common ovarian neoplasms, accounting for 63.04% cases, followed by germ cell tumor (24%) and sex-cord stromal tumors (8.7%). Conclusion: Surface epithelial tumors were the most common histopathological subtype of ovarian tumors. Benign and borderline tumors were predominantly found in reproductive age, whereas malignant tumors were seen in perimenopausal and postmenopausal women. Since the prognosis, therapeutic strategies including multidisciplinary approach depend primarily on the histopathologic diagnosis, an accurate pathological evaluation and classification is of prime importance. The multidisciplinary approach employed has its own medico legal implications.

Keywords: Neoplasm; Epithelial Cancer; Ovarian

Background: The Protection of Children from Sexual Offences (POCSO) Act was enacted in 2012 with a view to curbing the menace of sexual assault, sexual harassment and pornography on children. The present study gives a profile of cases registered under the Act and subsequently brought to the Forensic Medicine Department for the purpose of medicolegal age estimation. Material and methods: Research was conducted in the Department of Forensic Medicine, NEIGRIHMS, Shillong. Data was extracted from records maintained in the office and analyzed using statistical software SPSS version 11 by descriptive analysis. All cases brought for age estimation under the POCSO Act, 2012 for the period May 2013 to June 2018 were included. Results: Medical examinations were performed in compliance to police requisitions from four districts of the state of Meghalaya. A total of 26 (twenty-six) individuals were brought for age estimation during the study period. Among those examined, 81% were victims and 19% accused in sexual offences. The majority of victims were female children in the 6–15 age group. Conclusion: These findings should draw the attention of doctors and healthcare workers to the problem of sexual crime against children and prompt them to work together with law enforcement and social organizations in securing justice for the vulnerable.

Keywords: POCSO Act; Sexual offences; Forensic medicine department; Age estimation

Introdution: Autopsy is recognized as a necessary part of medicine to establish final diagnosis, and relate the cause of death to the associated pathologies and the interaction between the two. Aim: To study and highlight the histopathological changes in lungs seen in autopsy cases. Methods: A cross-sectional study was done in the department of Pathology in a tertiary care hospital in Bangalore. A total of 100 lung specimens received from the department of forensic medicine for clinical autopsy over 3 years (January 2016 to January 2019) were studied. After noting the patient details and autopsy findings, the specimens were examined grossly and based on the gross findings, representative bits were given for histopathological examination. The histopathological findings were noted and results were statistically analyzed. Results: Amongst the 100 lungs studied, the commonest lesion was Congestion and/ Pulmonary edema (64%), followed by non-tuberculous pneumonia (15%), chronic bronchitis (5%), emphysema (4%), tuberculous pneumonia (4%), autolytic changes (2%), pulmonary embolism (2%), lung abscess (1%) and an immature lung (1%). Conclusion: This study highlights the various lesions in lungs from patients with history of varied causes of death and the lung lesions contributing directly or indirectly to the cause of death.

Keywords: Autopsy; Lung lesions; Histopathology