Indian Journal of Forensic Medicine and Pathology

Introduction: An Autopsy doesn’t always yield cause of death easily. In 20-25% cases detailed
history, visit to scene of incident, histological, toxicological& microbiological investigations
might be required. Even then circumstantial evidence plays important role.
Case Reports: Article presents and discusses four cases, two of electrocution, one natural neonatal death and one accidental phosphorous poisoning. How challenging it can be to ascertain cause of death at rural hospital set up.

Discussion: Various natural and unnatural causes can lead to death without any evident pathology or signs such as sudden infant deaths, biochemical disturbances, functional disorders like epilepsy, electrocution, concealed trauma, certain poisonings, vagal and anaphylactic shocks.

Conclusion & Recommendations: All necessary and possible investigations should be done in obscure deaths to exclude such causes and to prevent allegations that the death was not investigated as fully as it should have been. Special efforts are needed to raise awareness regarding use and storage of hazardous materials to prevent accidental deaths.

Introduction: There is an increasing rate of mortality and morbidity amongst the medicolegal cases in India. Knowledge of these cases is necessary to initiate a medico-legal case, treat such cases and further disposal in hospital. It is also needed to implement changes in the law and safety at work, home and roads. The saim of the study was to determine the epidemiological profile of medico-legal cases reported to Tertiary Centre in West Bengal during the study period and to study the epidemiological profile of different medico-legal cases in the hospital.

Methodology: This study is a retrospective hospital based observational study which was conducted in the casualty of tertiary hospital in Eastern India from November 2018 to January 2021. It is a tertiary care centres with referrals from in and around the state.

Results: In our study we saw a decreasing trend of Medico-legal cases as the years passed by. A male preponderance of the cases (60%) compared to females.

The ratio of males: Female was 1.5:1. 57% of our Medico-legal cases were road traffic accident and 18% were fall from height and found dead cases respectively. 36% (505) cases were in the 31- 40 years age group followed closely by the 41-50 years age group 30% (421). This was followed by 51-60 years (11%) and 21-30 years and 61-70 years (10% each).

Conclusion: The aim of raising a Medico-legal case is to inform the police and application of medical knowledge in practice. The attending doctor needs to tackle the case with medical bent of mind and describe the alleged circumstances in simple language and describe relevant findings.
 

Locating and retrieving gunshot residue from the scene of the crimeis important for the investigation of shooting-related crime incidents. The presence of gunshot residue on the glass that can be hit as anintermediate target is occasional but not collected commonly because of its nature and the amount found on the glass. They may be found in crimes such as shooting where the target involves windowpanes or windshields among many other shooting related incidents. It is indicative that gunshot residues provide an exemplary source of partially burnt, completely burnt, and unburnt residues of primers and propellants that can help establish the manufacturer’s
details. Gunshot residues are deposited on the hands, face, and clothing of the shooter and are commonly found on the entry hole of the targets. These residues can be recovered from the surface of intermediate targets through which the bullet travels. Detection of gunshot residue from these intermediate targets can be useful for forensic investigation. They can be promising in absence of other pieces of evidence such as cartridge cases, bullets, or firearms. The current study was performed to explore the detection of gunshot residue on glasses fired at 25 metres range. Lead, barium, and antimony were successfully detected on all samples fired at 25 metres range. The analysis provided consistent evidence that gunshot residue detected can be helpful to obtain reliable data for forensic investigation. The statistical analysis of the data revealed a significant difference in the diameter of entry, number of radial fractures, diameter and thickness of mist zone with types of glass.

Context: The ability to determine the sex of an unknown person is extremely useful because it narrows the search to nearly half of the population. Teeth are excellent choice for identification since they are resistant to putrefaction and are well protected anatomically.

Aims: The study is aimed at presence of sexual dimorphism in different tooth measurements in the lower jaw.

Settings and Design: Cross sectional study

Methods and Material: The study was conducted on 51 male and 54 female participants. Exclusion criteria for the subjects were: Dental caries, Crowded or excessive spacing in the anterior teeth, Orthodontic treatment, Occlusal abnormalities, Any trauma to lower jaw. Measurements were taken clinically using geometric divider and digital callipers. Odontometric dimensions included in the study taken from the lower jaw only are: Mesiodistal width (MD) and Buccolingual width (BL) for canine, central incisor and first molar (both left and right) and inter canine width (ICW).

Statistical Analysis used: Jamovi Software version 2.3.24 was used for statistical analysis. Independent sample t and Binomial logistic regression was applied to see the accuracy of predictive measures for different dimensions in identifying sex of an individual.

Results: Mesiodistal and buccolingual dimensions of canines, central incisor and first molar in the lower jaw differ significantly in males and females. Mesiodistal dimensions are more accurate in identifying the sexes. Mandibular canines are more sexually dimorphic compared to mandibular central incisors and first molars.

Conclusions: The study findings indicate that the Mandibular dental measurements and canine indices can be used as supportive adjunct rather than the sole criteria for sex determination in forensic investigations.

Background: Sexual assault is a rising medico-legal issue and also an important social problem. Medico-legally sexual violence can be Penetrative sexual assault, Non penetrative Sexual assault and Sexual harassment. Thorough knowledge about manner and traits of sexual assault is vital for forensic examination. Keeping this in view, the study was taken up with the aim of analysing the circumstances and factors associated with sexual assault.

Materials and Methods: The present prospective cross sectional study was conducted in the Department of Forensic Medicine, M.S. Ramaiah Medical College Bangalore from January 2018 and December 2020. All victims of alleged sexual assault brought for medical examination to the Department of Forensic Medicine were interviewed through a detailed questionnaire after taking consent.

Results: 82 victims of alleged sexual assault were examined. 80 of them were females and 2 were boys who were less than 12 years. Children and adolescents in the age group of 12-18 years constituted 65.85% of the cases. Penetrative sexual assault (peno-vaginal type) was reported by 62 of the victims (75%). Anal intercourse was alleged in 2.5 % (n=2) of the victims.

Conclusion: Peno-vaginal type of sexual assault in the minors less than 18 years is the most common type of sexual assault reported. Health care professionals and others involved in providing care and support in all forms should be thoroughly trained and informed about the current laws. Preventive campaigns and sex education programmes in schools and colleges should be taken up the concerned authorities to create awareness amongst the teenagers.

Context: Pesticides are chemical compounds used for crop protection and poisoning with them is a very common occurrence in farmers. In an emergency setting, the identification of quick and powerful prognostic markers can be of high significance in the management of these patients.

Aims: To assess the severity of Pesticide Poisoning by assessing the leukocyte count, neutrophil count, neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) and its comparison with levels of Plasma Cholinesterase (PChE) as an aid to clinical diagnosis, for early treatment of the patients.

Settings and Design: Hospital based Cross-sectional study. Study period 1st November 2018 - 30th May 2020

Methods and Material: Study was done on 148 confirmed cases of pesticide poisoning overa period of 1.5 years. Blood samples were collected in EDTA and plain vacutainers within 24 hours of admission and the values of total leukocyte Count (TLC), neutrophil count, NLR, PLRand PChE were measured and compared. The severity of poisoning was assessed according to Peradeniya Organophosphorus (POP) scale.

Statistical Analysis used: Mean ± SD, Chi square test for association, Comparison of mean
using ANOVA test for comparison between and among groups, Sensitivity and specificity analysis.

Results: 89.86% and 10.14% of cases were due to poisoning by Organophosphorus compounds and carbamate respectively. The severely poisoned patients according to POP
scale had more leukocyte count, neutrophil count, NLR and PLR; and less plasma cholinesterase level as compared to the patients with mild and moderate poisoning.

Conclusions: Total Leukocyte count, indian journal of forensic medicine and pathology. volume 17, number 1, january - march 2024 26 neutrophil count, NLR and PLR are simple and easy to use parameters for estimating the severity of pesticide poisoning and assessing its prognosis. In resource limited setups, along with the clinical history, these basic CBC parameters can be useful and patient’s immediate treatment can be started as early as possible.

Autopsy survey of 110 cases of kidney specimen over a period of 2 years done in Vyedhi
institute of medical science and Research centre, Department of Pathology, Bangalore. Kidney
diseases are due to sequelae of primary or secondary accumulation of risk factors such as diabetes,
hypertension, dyslipidaemia and obesity. Autopsy helps in the establishment of diagnosis and
determines the cause of sudden death of known and unknown aetiology. Histopathological
examination of renal tissue in autopsy gives valuable information for identifying the risk factor
for various renal diseases and to monitor the disease trends.

Context: Medico-legal autopsy is performed to find out the cause, time of death and identify
diseases which could have contributed to the death. Gross and microscopic examination,
toxicological analysis and laboratory investigations will aid in establishing the cause of death.
Histopathological analysis is considered as the gold standard in finding out a cause of death in
cases of sudden death or when there is no history of any previous illness.
Methods and Material: Four infant autopsies were conducted and their respective organs
which included lungs, liver and brain and were received in our department.
Statistical Analysis used: Results were tabulated, analyzed, and subjected to statistical
analysis using SPSS (Statistical Package for Social Sciences) Software (Trial version).
Results: First case showed fat emboli which was an incidental finding. Second was a case of
hyaline membrane disease in a newborn. Third one was a case of steatohepatitis in a 9 month
old child and the last one was an incidental finding of gemistocytic astrocytoma which was
undiagnosed antemortem.
Conclusion: The precise cause of death must be determined with reference to clinical, autopsy,
and forensic findings before reporting histopathological finding. Histopathology in autopsy plays
a vital role in the study of some of the rare lesions contributing to the knowledge of pathology.
This study highlights the various incidental and rare cases in autopsies, which are of critical value
in academic and research purposes.

Introduction: The questionnaire based study was carried out with the objective to know the
present knowledge of students regarding autopsy, attitude towards autopsy and probability of
choosing forensic medicine as a career which can enable to find out ways to make autopsy an
enriching academic exercise and further increase the acceptability of our subject.
Methodology: A questionnaire based cross-sectional study, was carried out among the 2nd
year medical students at IMS and Sum Hospital, Bhubaneswar. The first part of questionnaire
comprised of items in form of simple statements for which response recorded dichotomously
as true or false. The first nine statements were on knowledge component and second nine items
were on attitude of the students. The second part of questionnaire comprised of eight items
which contained the eight reasons for forensic medicine of not choosing forensic medicine as
career.
Results: A majority of students were found to have reasonable knowledge of the basic autopsy
procedure. 88% of the students were of the opinion that autopsy has utility in medical education.
68% of the students were confident of independently performing an autopsy. 88% of students
proactively searched for information on autopsy. However only 11.54% students reported that
they plan to pursue a career in Forensic Medicine.