Background: Acute myocardial infarction (AMI) remains a global health burden. Early identification of individuals at high risk, particularly those with ≥70% coronary artery stenosis, can facilitate preventive strategies. This systematic review and meta-analysis aimed to evaluate the risk of AMI among patients with critical coronary artery narrowing. Methods: A comprehensive literature search of PubMed, Scopus, Embase, and Cochrane Library was conducted for stud ies published from January 2000 to December 2023. Eligible studies included adults (≥18 years) with angiographically confirmed ≥70% stenosis in at least one major coronary artery and reported AMI incidence. Data were extracted and pooled using a random-effects model. Heterogeneity was assessed using the I² statistic, and risk of bias was evaluated with the Newcastle-Ottawa Scale and the Cochrane RoB tool. PROSPERO Registration: CRD420251075342. Results: Eighteen studies (n=22,456 participants) were included. The pooled relative risk (RR) of developing AMI in patients with ≥70% stenosis was 3.45 (95% CI: 2.88–4.13), with moderate heterogeneity (I² = 48%). Subgroup analysis showed higher risk among patients with multi-vessel disease and diabetics. Funnel plot and Egger’s test (p=0.22) showed no significant publication bias. Conclusion: Patients with critical coronary stenosis are at substantially elevated risk for subsequent AMI. These findings emphasize the need for vigilant monitoring, risk stratification, and aggressive therapeutic in terventions in this high-risk cohort. Future studies should focus on novel biomarkers and predictive models to enhance early detection.

Background: Globally, over 5.2 million children under five years perished in 2019, primarily from preventable causes, with road traffic injuries ranking second among 5–14-year-olds in India in 2000. Injury and violence account for nearly 950,000 annual deaths in those under 18, with unintentional events comprising 90 percent. This study characterizes demographic, epidemiological, and medicolegal features of pediatric and adolescent fatalities in Indore. Material and Methods: In this prospective, one-year investigation (October 2022–September 2023) at Mahatma Gandhi Memorial Medical College, all medico-legal autopsies for individuals ≤18 years were reviewed. Data—drawn from police reports, family interviews, and autopsy findings—were recorded on structured proformas. Cases were stratified by age: infants (≤1 year), toddlers (2–3 years), preschool (4–6 years), school aged (7–12 years), and adolescents (13–18 years). Analyses encompassed age, sex, manner, and mode of death. Results: Of 2,423 autopsies, 120 (4.95 percent) involved ≤18 years. Adolescents predominated (64.2 percent), followed by preschoolers (10.8 percent), school-aged (9.2 percent), toddlers (8.3 percent), and infants (7.5 percent). Males outnumbered females (M: F = 1.5:1), especially in older age groups. Unintentional deaths accounted for 62.5 percent, suicides 26.7 percent, homicides 3.3 percent, natural 2.5 percent, and undetermined 5 percent. Road traffic accidents were the leading mechanism (28.3 percent), followed by poisoning (15.8 percent), asphyxia (13.3 percent), falls (11.7 percent), burns (8.3 percent), and electrocution (4.2 percent). Conclusion: In this Central Indian cohort, adolescents—particularly males—bear the highest burden of fatal injuries. Road traffic collisions and intentional self-harm are predominant. Prevention strategies should emphasize strict traffic enforcement, parental supervision during play, and accessible mental health resources.

Paraquat is a highly toxic herbicide associated with significant morbidity and mortality following ingestion, primarily due to its profound pulmonary toxicity. Acute lung injury (ALI) and progressive pulmonary fibrosis represent the hall mark pathological features, often leading to respiratory failure and death. We report a case of fatal paraquat poisoning in a young adult who presented with gastrointestinal symptoms and rapidly deteriorated despite supportive management. Laboratory investigations revealed multi-organ involvement, and imaging demonstrated diffuse pulmonary infiltrates consistent with ALI. Despite intensive care, the patient developed severe hypoxemia and succumbed within days of ingestion. This case underscores the challenges in managing paraquat poisoning, as no specific antidote exists and therapeutic strategies remain largely supportive. Early recognition, aggressive decontamination, and novel treatment modalities may improve outcomes; however, prognosis remains poor in cases with significant exposure. Clinicians must maintain high suspicion and counsel regarding the lethal potential of paraquat ingestion.

Forensic Medicine and Toxicology (FMT) in India is undergoing a paradigm shift, with growing recognition of the need for super-speciality training to address the rising complexity of medico-legal challenges. Advances in Forensic Toxicology, Forensic Pathology, Forensic Radiology, Molecular Diagnostics, and Toxico-genomics, alongside judicial demand for precise scientific evidence, highlight the limitations of existing postgraduate curricula. This editorial article explores the future perspectives of super-speciality courses in FMT in India, examining the need, driving factors, chal \lenges, local and global opportunities. Current developments in premier institutions, including AIIMS and the National Forensic Sciences University, are paving the way for structured super-speciality training, though gaps in infrastructure, faculty expertise, and regulatory frameworks persist. International benchmarks demonstrate the potential for integrat ing advanced technologies such as artificial intelligence and digital Forensics into medico-legal practices. Initiation of super-speciality programs may further add value to the subject, strengthen its scope and recognise position of India as a global leader in Forensic field. The future of super specialty courses in Forensic Medicine in India looks promising, with several developments indicating growth and recognition of the field.

The Medical Certification of Cause of Death (MCCD) is a critical document serving legal, statistical, and public health purposes by recording the medically certified cause of death. However, certifying deaths becomes particularly challeng ing when individuals are “brought in dead” (BID) or declared “dead on arrival” (DOA) at hospitals. In such cases, the absence of prior medical history and unclear circumstances make it inappropriate for primary practitioners to issue MCCD without further evaluation. Certifying such deaths carries legal and ethical implications, especially in suspected unnatural deaths, where police inquests and post-mortem examinations under BNSS Section 194 are required. As per the Registration of Births and Deaths Act, 1969 [Section 10(2) & (3)], only registered medical practitioners who attended the patient during terminal illness are authorized to issue death certificates. As per National Medical Commission guide lines (Professional Conduct, Etiquette and Ethics Regulations, 2002) personal examination of the body before certifi cation is mandatory. Despite its importance, MCCD coverage and quality in India remain inadequate, averaging only 20%. Common deficiencies include incomplete, incorrect, or illegible entries. Strengthening hospital protocols, involving forensic experts, and providing regular training to medical staff are essential tools to improve accuracy. Additionally, establishing audit committees to review MCCD documentation can enhance accountability. Improving awareness and adherence to existing guidelines will enable MCCD to function more effectively as a tool for justice, health surveillance, and public policy.

ObjectiveThis study examines suicide patterns in the Northeastern states of India, often referred to as the Seven Sisters. The aim is to assess whether demographic factors such as gender, marital status, and income group can explain suicide trends, and to explore broader systemic influences. The findings are intended to support forensic medicine professionals, policymakers, and public health authorities in their work.MethodPanel data from the National Crime Records Bureau (2014–2022) were analyzed using a Linear Mixed Model (LMM). This method evaluates both the direct role of demographic variables and the hidden, state-specific influences that may affect suicide rates, such as culture, economy, policies, and social conditions.FindingsThe analysis reveals that demographic factors alone (male/female, married/unmarried, rich/ poor) are not strong predictors of suicide rates. Instead, large-scale, state-level conditions play a more decisive role. Each state shows unique patterns shaped by its own social and systemic environment.ConclusionThese findings emphasize the importance of considering state-specific factors in forensic investigations of suicide. Forensic pathologists and medico legal experts may benefit from this perspective when conducting psychological autopsies, interpreting case patterns, and providing expert opinions. The study also underlines the need for region-specific suicide prevention strategies that can inform both forensic practice and public health policy.

In India, Medicolegal cases require meticulous examination and evidence collection to support legal investigations, yet the absence of a standardized national medicolegal code leads to inconsistent practices. Currently, only a few states and institutions have developed their own codes, leaving many healthcare facilities, particularly in resource-limited settings, reliant on outdated or ad-hoc protocols. This variability complicates workflows, especially for junior consultants, medical graduates working in district hospitals performing medicolegal duties and foreign-trained medical graduates unfamiliar with Indian procedures, risking suboptimal evidence collection and documentation. A national medicolegal code is proposed to standardize protocols for examination, sample preservation, and stakeholder responsibilities, ensuring unifor mity and clarity. Such a code would align with updated criminal laws, address logistical challenges like evidence storage, and incorporate guidelines for diverse medicolegal scenarios, including sexual violence, autopsies, and disaster victim identification. Despite challenges in enforceability due to state jurisdiction over law and order, voluntary adoption by states, endorsed by the Union government, could streamline practices, ultimately improving medicolegal service quality and aiding the justice delivery system across India. This review article discusses several practical difficulties in medicole gal practice, challenges in creating a national medicolegal code, and proposes recommendations to move forward.

Background: Burns are a global public health problem, accounting for an estimated 180,000 deaths annually.1 The majority of these occur in low- and middle-income countries and almost two thirds occur in the WHO African and South-East Asia Regions. Non-fatal burns are a leading cause of morbidity, including prolonged hospitalization, disfigurement and disability, often with resulting stigma and rejection. According to the Na tional Burns Programme, 91,000 of these deaths are women; a figure higher than that for maternal mortality. Women of child bearing age are on average three times more likely than men to die of burn injuries. Females have slightly higher rates of death from burns compared to males. This contrasts with the usual injury pat tern, where rates of injury for the various injury mechanisms tend to be higher in males than females.2 Along with adult women, children are particularly vulnerable to burns. Burns are the fifth most common cause of non-fatal childhood injuries.3 Methods: Retrospective study involving 53 cases of burn injuries were included in this study over a period of 3 years. Results: Out of 53 cases, 37 individuals were females depicting female preponderance.

The integration of clinical microbiology into forensic medicine and toxicology has revolutionized investigative method ologies, enhancing the precision of criminal investigations. This review examines the role and impact of clinical micro biology in forensic contexts, focusing on its applications, technological advancements, challenges, ethical considerations, and future prospects. Forensic microbiology has proven invaluable in various forensic investigations, such as identifying pathogens in unex pected deaths, analysing soil microbiomes to infer crime scene geolocations, and utilizing the human microbiome for individual identification. Advances in next-generation sequencing, artificial intelligence, and machine learning have significantly enhanced the capabilities of forensic microbiology, enabling faster and more precise analyses. These tech nologies facilitate a deeper understanding of microbial evidence, contributing to more accurate forensic conclusions. However, the field faces challenges, including the need for standardized methodologies and protocols, rapid pathogen identification, and handling complex microbial ecosystems. Ethical considerations, particularly regarding the privacy of microbiome data and its legal interpretation, are also pivotal. Future research directions emphasize developing rapid on-site testing methods, expanding microbial databases, and establishing robust ethical frameworks for microbiology’s use in forensic science. These advancements are anticipated to further refine forensic microbiological methods, ensuring their responsible and effective application in legal investiga tions. In summary, the integration of clinical microbiology into forensic medicine and toxicology marks a significant ad vancement in forensic science. It offers enhanced capabilities in crime scene analysis and pathogen identification, while posing challenges that require careful consideration and ongoing research. The continued evolution of this field prom ises to significantly contribute to the efficacy and integrity of forensic investigations.

This study aimed to perform morphometric analysis of the mental foramen and mandibular ramus on digital panoramic images and find a highly significant parameter in determining an individual’s sex. A total of 150 digital panoramic images of 75 males and 75 females, aged between 20 and 50 years, were carefully selected based on inclusion criteria from the Dental Screening program data at the Radiology Department of the National Forensic Sciences University in Gujarat. Morphometric analysis of the mental foramen and mandibular ramus was performed, and measurements were taken on the right and left sides of all the O.P.G. images. Measurements of distances from the superior border of the mental foramen to the lower border of the mandible height (SBM-LBM), inferior border of the mental foramen to the lower border of the mandible height (IBM-LBM), condylar height, projective ramus height (P.R.H.) and coronoid height were taken. The obtained data were subjected to statistical analysis, and regression function analysis was used to estimate the efficiency of each variable in sex determination. Our study revealed a highly significant relationship in SBM-LBM, IBM LBM distance, and projective ramus height on both the right and left sides. The left side values were higher than the right side in both males and females. SBM-LBM, IBM-LBM, and ramus height values were higher among males than females. SBM-LBM, IBM-LBM, and projective ramus height showed significant sexual dimorphism.