Indian Journal of Forensic Medicine and Pathology

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Background: South Africa has one of the highest numbers of rapes in the world, and Transkei, a former black homeland, now a part of the Eastern Cape Province, is one locality with many child rapes. The unemployment, poverty and crime levels are very high in the region. Objective: To highlight the problem of sexual abuse and HIV in the Transkei region of South Africa. Case History: This report presents a victim of rape, a two-year-old female child, who was brought to the Umtata General Hospital in the evening with profusely bleeding per vaginum. She was sexual assaulted by a HIV positive caretaker adult male in his 30s, acting on a mistaken belief that sex with a virgin will cure an HIV-infected person or AIDS sufferer of his illness. The young mother of the victim has also experienced a rape in her childhood, and her husband was murdered a year ago in front of her child. She does not know about her father and was raped in her childhood by a foster father. The history, the physical examination and the uneventful antiretroviral therapy are discussed in this manuscript. Conclusions is drawn and preventive steps are suggested. Conclusion: There is a high misconception and strong misbelief in child sexual abuse and a cure of HIV infection in the Transkei region of South Africa.

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Background: Cardiovascular diseases leading to atherosclerosis are rapidly increasing in Indian population. This study was formulated to assess histomorphological atherosclerotic changes in aorta and coronary arteries and grading of lesions according to American Heart Association Classification (AHA). Materials and Methods: 57 heart specimens received for autopsy study were included in the study. Hearts were fixed in 10% formalin and dissected. They were examined grossly for atherosclerotic lesions in aorta and coronary arteries and subsequent microscopic sections were studied and graded according to AHA classification. Results: 44(77%) cases belonged to male and 13(23%) cases belonged to female. 16(28%) cases were seen in third decade followed by 14(24.6%) and 9(15.8%) in second and fourth decades respectively. Majority of atherosclerotic lesions were noted in aorta (25) followed by LAD (10). Maximum number of lesions were in grade II with 15(26.3%) cases followed by grade IV and grade III with 13(22.8%) and 10(17.5%) cases each respectively. Conclusion: Atherosclerotic lesions are rapidly increasing among younger population. Screening programs and preventive measures if implemented early can prevent these lesions and it’s complications

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Background: Covid-19 pandemic has forced the medical education to switch from traditional learning to virtual learning. Many different platforms are available for virtual learning. And like any other teaching-learning method, this new method also has its pros and cons. But the important thing is how the medical students perceive this technique. Hence, the study was planned to understand the student’s perception regarding Virtual learning. Methods: A cross-sectional study was conducted among under-graduate medical students across various medical colleges in India, via a Google form. Total 824 medical students participated in the study. Results: Out of 824 participants, 36.2% feel that students do not listen to the virtual class attentively from start to end. 79.2% agree that there is more distraction during virtual learning and 77.1% students feel that virtual learning is boring because of lack of interaction between teacher and students. Also 47.3% students don’t think that it is easy to clear doubts during virtual learning. 77.5% agree that there are more chances of scrolling the social media during virtual learning. According to 67.7% students, only the knowledge aspect is better learnt during the virtual learning. But the 50.1% students agree that virtual learning is cost-effective and time-saving. Still, 90.9% students prefer traditional learning considering all aspects of medical education Conclusion: Despite having certain advantages, medical students still prefer conventional method of learning to acquire different competencies, while the virtual learning remains supportive method. Many issues need to be addressed for wide acceptance of virtual learning.

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Introduction:Tissue preservation is important. From it forensic scientist may extract sufficient DNA for profiling. The most commonly used preservative found in the literature is formalin. However, it causes severe side-effects on its users as well as the environment; we need to find its replacement. Method:This study examined whether formalin could preserve soft tissues (fresh) stored at 4°C for 100 days and how DNA can be extracted from it. Qualification and Quantification of the presevred samples were done. Result:The results revealed that tissues preserved in formalin failed to generate sufficient quantity of DNA for profiling whereas tissues preserved in normal saline did so. Conclusion: The study concluded that there is a need to find an alternative to formalin which can preserve the tissue samples well and enable DNA profiling.

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Introduction:Plasma transfusion is required to arrest or prevent bleeding, for various congenital and acquired cases of coagulopathies such as inherited factor deficiencies, disseminated intravascular coagulation, liver disease, post major trauma, etc. Leukocyte reduced blood components are indicated to prevent the febrile nonhemolytic transfusion reactions, Human Leukocyte Antigen (HLA) alloimmunization, transmission of infections such as cytomegalovirus (CMV), and adverse transfusion reactions due to storage lesion. In the present study, the effect of plasma filtration on eight coagulation factors viz. fibrinogen, factors II, V, VII, VIII, IX, X and XI has been studied.Materials and Methods:The plasma separated from the whole blood donation from each of 25 donors was separated into two aliquots. Group-1 included unfiltered fresh frozen plasma; group-2 included fresh frozen plasma which was subjected to pre-storage leukocytereductionbyfiltration.ThelevelsofthecoagulationfactorsFibrinogen,II,V, VII, VIII, IX, X, XI were estimated in each sample in both the groups.Results:There was no statistically significant difference in the levels of any of the coagulation factors included in this study, between the unfiltered and the leukocyte reduced plasma. Group O positive individuals were found to have higher levels of all the coagulation factors. Conclusion:Filtration of plasma has no effect on the coagulation factors. This is the first study where the effect of plasma filtration on eight coagulation factors has been studied. Blood group O positive individuals were found to have higher levels of all the eight coagulation factors.

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Background: Neural tube defects (NTDs) are congenital disorders with multifactorial etiology that increase the risk of death as well as disability in early neonatal period and infancy. Objective: The study was conducted in a tertiary care referral hospital to analyse the disease burden of neural tube defects and to study the associated anomalies in the affected fetuses. Materials and Methods: This study was conducted retrospectively from January 2011 to December 2020 on a total number of 402 fetal autopsies received after abnormal ultrasonographic findings and intrauterine deaths diagnosed prenatally. Results: Out of the total 402 cases of fetal autopsies, 42 neural tube defects were detected, 33(79 %) were open type and 9(21%) were closed type neural tube defects. Out of the open type, majority were meningomyeloceles with 18 (43% of NTDs) cases, 11(26% of NTDs) cases were of anencephaly. Arnold chiari malformation was associated in 4 cases and a rare case of craniorachischisis was encountered. Among the closed type, 6 (14%) were meningoceles and 3(7%) were encephaloceles. A case of Meckel Gruber syndrome with an associated encephalocele was diagnosed. Conclusion:The present study would contribute to the prevalent disease burden of neural tube defects in Southern India, proving to be useful in the design and implementation of appropriate comprehensive preventive strategies including nutritional fortification, swift antenatal diagnosis and prompt intervention to reduce the morbidity.

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Introduction: Cases of child sexual assault are rising day by day and it remains one of the serious offences against children of tender age. However, it's reporting within 24 hours is yet to improve and needs betterment in various aspects. Material and Methods: This is a prospective observational type of study conducted on alleged cases of sexual assault with ageless than 18 years, during the study period, where valid consent to participate in the study was present after approval from the institutional ethics committee. Results:Out of total 534 victims, 217 (40.64%) victims registered the complaint within 24 hrs of the incidence and females constituted the majority of the cases (89.40%). The majority of the victims (65.90%) were from urban-dwellings and percentage of case reporting was highest (100%) in the age group of 0-6 years, which declined with an increase in age. Reporting in urban population was higher (42.68%) and mother was the primary complainant in majority cases (41.47%). In majority of cases, the assailant was known to the victim and boyfriend was most common assailant (37.33%) with predominance in 12-18 years age group (88.89%); while known family members were significant assailants (35.08%) for age group 6-12 years. Conclusion:It seems that, rather than strangers, known members are more often involved in such cases and parents along with children from such vulnerable age groups should be actively made more aware of related facts through education and other means.

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Introduction:Child sexual offences, as well as neglect, is one of the most prevalent and crucial social issues worldwide. The child sexual abuse is an offence which is commonly under-reported in India. It is found that more than 3 million children become victim of abuse each year.1Many more cases among them are unreported. The newly adopted POCSO Act, 2012 deals with all forms of sexual abuse of children and the principles to handle the child in a systematic way and it is the most detailed law regarding this problem. The current study aims to analyze the level of knowledge & attitude and awareness about various practical issues of CSA in context of the POCSO Act, 2012. Methods: This is a questionnaire-based study conducted amongst the Medical practitioners of Ahmednagar city. A questionnaire was prepared on Google form consistingof10questionsaboutPOCSOAct2012.About157medicalpractitioners from Ahmednagar city participated in study. The questionnaire distributed to the doctors & it was focused on knowledge, understanding, their attitude, and practice toward child abuse and POCSO Act 2012.Result:Out of total 10 questions average points scored was 6.11/10. Most disappointing observation made is majorly 57 % RMP doesn’tknowaboutthepunishmentifhe/shefailstoreportthecaseunderPOCSOAct. Conclusion:The study showed that knowledge& attitude about POCSO Act 2012 amongstmedicalpractitionerinAhmednagarcitywassatisfactory.Butinadditionto strengthening of legislature, more in depth knowledge regarding child sexual abuse among medical professionals will help to eradicate this sensitive childhood social issue

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-Road traffic accidents are the major cause of premature death and disability all over the world and motorized two-wheelers accidents account for the majority of such cases particularly in developing countries like India. The aim of the present study is to analyze the pattern of injuries with a focus on head injuries and the environmental factors leading to events. Methodology:A cross-sectional analytic study was conducted in the Department of Forensic Medicine at Osmania General Hospital, Afzalgunj Hyderabad during the period January 1st, 2018 to December 31st, 2018. Results: Abigmajorityofvictimsconstituteaworkingandeconomicallyproductiveage group of 20-40yrs with male predominance (72.46%). Most accidents (22.6%) occurred during 6-9 pm. Hit by other vehicles (44%) followed by self-skid (32%), and hitting the barriers, or stoppers, sudden interruption by animals and pedestrians, the influence of alcoholallconstitutetheremaining.Aboutnearly87%ofinjuriesaremultipleandhead injuries. Skull fractures were seen in the majority with Sub dural Haemorrhage (47.1%) and Sub arachnoid Haemorrhage (43.6%) which lead to death. Conclusions: The involvement of economically productive males was a major concern. Major responsible factors are nighttime driving, road conditions, barriers, sudden interruption by animals, pedestrians, and the influence of alcohol. Injuries were highly frequent in Head and neck region followed by extremities. There is a need to emphasize on use of helmets and improvement in road conditions and safety measures.

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-Introduction: The accelerated spread of the COVID-19 Disease has become a major cause of concern for the medical profession. The objective of this study is to assess the knowledge, attitude and practice of COVID-19 management and awareness regarding doctor's privilege, patient’s right, and prevailing laws. Materials and Methods: Atotalof250respondentsfromthehealthcare Institutecompletedaquestionnaire-based survey.The questionnaire was prepared from the current guidance for medical professionals published by the US Centre for Disease Control and Prevention (CDC)and MOHFW Govt. of India. A suitable sampling method was used for data collection and distribution. Descriptive statistics were carried out for all groups based on the percentage of correct responses. Individual pairwise comparisons were done using the Median test. Results: In the Present study 94.60% of the participants had knowledge regarding COVID-19 infection but less than 90% of the total participants could correctly defined “close contact.” The responses related to doctor's privilege, patient’s right, prevailing laws during pandemic were 83.33%. Out of that, 90.55% of correct responses were from senior faculties. However, awareness regarding recent ordinance and changes in exiting Epidemic Diseases Acts were very low (74.92%) in Junior Faculty. There were 100% correct responses regarding awareness about Transmission and conduction of Medico-Legal Autopsy on COVID-19 Positive Dead Bodies. However, the Knowledge of survival of SARS-CO-2 on Dead body were very low (84.46%). Conclusion: There is a needforregulartrainingprogramsonCoronaManagementandAwareness Regarding Doctor's Privilege, Patient’s Right, Prevailing Laws.