Autopsy Cases Research Articles

Histopathological study of lungs, kidney and spleen in death due to burns

Burn injuries occur universally and have plagued mankind ever since antiquity till the present day. As burns continue to be a major problem, a prospective study of demographic and pathological profile in deaths due to burns was conducted at the Department of Pathology Karnataka Institute of Medical Sciences Hubballi. To study the demographic profile, histopathological changes in lungs, kidney and spleen and to find the cause of death in cases due to burns. : The present study was carried out in the Department of Pathology, Karnataka institute of medical sciences, Hubballi, during the period of one year from 1-11-2014 to 31-10-2015. Total of 44 cases with burn injuries were used as material for study purpose and the collection of tissues were done for histopathology examination. This study includes 44 autopsy cases of death due to burn, of which majority were females. The age of the subjects ranged from 13 years to 65 years. Maximum numbers of victims were found in the age group of 21-30 years were 22 cases (50.00%).Most of the female victims were married and housewives. Most common manner of the burn were said accidental burns in 27 cases (61.36%) and 13 cases (29.54%) were due to suicidal burns, 4 cases (9.09%) were homicidal burns.Burns were more common in females most were married. Age group most commonly found was between 21-30 years of age probably related to dowry related issues, inexperience in cooking styles, house hold works, and inability to bear stress. Most common place of burns were kitchen. Most common manner of burns were said accidental. Most common cause of burns was due to said kerosene spill over or self pouring. TBSA involved more than 76%, in maximum number of cases. Maximum finding were seen in lung. Most common findings were diffuse alveolar damage, acute tubular injury and congested splenomegaly.

Profile of Cases of Death Due to Coronary Artery Disease: An Autopsy Based Descriptive Study

Background: Most common cause of sudden cardiac death is coronary artery disease, which contributes to 75 to 90%. The present study is undertaken to describe the profile of autopsy cases of coronary artery disease. Methods:Descriptive cross-sectional study was conducted in all cases of sudden and unexpected death brought for autopsy a tertiary level centre in southern Kerala during a period of one year. Gross and microscopical examination of heart and coronary arteries were studied and in cases with coronary artery disease, associated factors like previous history of illness, personal habits, family history of illness, body mass index, abdominal circumference, horizontal earlobe crease were described in detail. Categorical variables were represented as frequency and percentage, continuous variables as mean and standard deviation and association was tested using Chi square test. Conclusions: Statistically significant association (p value = 0.001) was observed between the horizontal earlobe crease and occlusive coronary artery disease. No significant association was obtained between the obesity parameters like body mass index, waist to hip ratio and occlusive coronary artery disease. Majority of the cases with significant occlusion was observed in the left anterior descending artery.The most common site of thrombus was in the proximal third of left anterior descending artery.

An epidemiological profile of medico-legal autopsies at a tertiary care center

Background: An essential and necessary component of any investigation into a sudden, suspicious death is the medico-legal autopsy. It's critical to understand the profile of medico-legal autopsy cases in order to ascertain the mortality rate from non-natural causes in a given area and addressing the demographic requirements in accordance with the region's unique mortality statistics. Material & Method: The present study was a retrospective study of autopsies performed at a tertiary care centre in southern Haryana, from January 2018 to December 2023. During this period a total of 886 medico legal autopsies were conducted. Relevant information and subjective data like age, gender, marital status & manner of death have been collected from medico legal autopsy register from January 2018 to December 2023. Results: It was observed that out of 886 cases male outnumbered females in ratio 2.06:1. Majority of the victims belonged to the age group 21-30 years. Majority of the deaths occurred due to poisoning (n=264, 29.79%), followed by road traffic accidents 26.74%. Conclusion: Majority of cases were in the 3rd decade of life, males outnumbered females. Poisoning and road traffic accidents were the leading cause of death. Public attention, awareness, preventive and remedial strategies should be undertaken to reduce similar incidents.

Investigation of triticeal cartilage anatomy in forensic autopsy cases.

This study aims to determine the presence and morphology of triticeal cartilage (TrC) through autopsy cases and to examine its relationship with age, gender, and height, thus contributing to clinical practices and forensic perspective. Our study was conducted on a total of 84 autopsy cases between the ages of 20-90years who came to Tokat Forensic Medicine Institute. The laryngeal region was palpated to determine whether TrC was present. The dimensions of the TrC and the length of the upper horn of thyroid cartilage (UHThC) were measured with precise digital calipers, and its weight was measured with an accurate digital scale. The presence of TrC was identified in 56% of the autopsy cases examined. The prevalence of TrC was higher in males (61.9%) than in females (23.1%). It was determined to be bilateral in 45% of the cases and unilateral in 11%. TrCs had a cylindrical shape in 68.2%, an oval shape in 25.8%, and a pyramidal shape in 5.8%. The average weight of TrC was 67.93 ± 33.91mg on the right side and 72.67 ± 32.23mg on the left. As the individual's height increased, the weight of TrC increased (p < 0.001). Additionally, there was a strong positive correlation between the lengths of TrC and UHThC and the individual's height (p < 0.001). TrC may be confused with UHThC fractures. Therefore, we believe that knowledge of the presence and morphology of TrC will contribute to clinical approaches and forensic cases, especially in relation to the neck region.

Identifying causes and associated factors of stillbirths using autopsy of the fetus and placenta.

The study aimed to evaluate the causes of death and associated factors in cases of stillbirth, using post-mortem examination and applying a rigorous, evidence-based holistic approach. Our retrospective observational study included cases of autopsy following stillbirth that occurred at our tertiary medical center during a period of 8 years. Detailed up-to-date criteria that incorporate clinical reports, medical history, prenatal imaging, and histopathological findings were used to evaluate the cause of death and associated factors. After applying our proposed methodology, 138 cases of stillbirth were classified into eight categories based on the causes of death. A definitive cause of death was observed in 100 (72%) cases, while 38 (28%) cases were considered unexplained. The leading cause of death was placental lesions (n = 39, 28%) with maternal vascular malperfusion (MVM) lesions being the most common (54%). Ascending infection was the second most common cause of fetal death (n = 24, 17%) and was often seen in the setting of preterm labor and cervical insufficiency. The largest category of cause of death was attributed to placental pathology. Using rigorous detailed up-to-date criteria that incorporate pathological and clinical factors may help in objectively classifying the cause of death.

Sparse Asymmetry in Locus Coeruleus Pathology in Alzheimer's Disease.

Tau accumulation in and neurodegeneration of locus coeruleus (LC) neurons is observed in Alzheimer's disease (AD). We investigated whether tangle and neuronal density in the rostral and caudal LC is characterized by an asymmetric pattern in 77 autopsy cases of the Rush Memory and Aging Project. We found left-right equivalence for tangle density across individuals with and without AD pathology. However, neuronal density, particularly in the caudal-rostral axis of the LC, is asymmetric among individuals with AD pathology. Asymmetry in LC neuronal density may signal advanced disease progression and should be considered in AD neuroimaging studies of LC neurodegeneration.

Histomorphological Spectrum of Lung Lesions in Medico- legal Autopsy in a Tertiary Care Centre

Background: Organ specific pathological changes seen during autopsy give a clear idea of the cause of death. Lungs are one of the most important vital organs in the human body. They are almost always involved in terminal events of cardiovascular diseases.Autopsy is important not only to know the state of lungs but also to study the morphology of various diseases.Various studies have demonstrated that,20-30% of sudden deaths are due to underlying pulmonary pathology. Aims and objectives: The significance of this study is to highlight the spectrum of histomorphological features of lung lesions in medico-legal autopsies irrespective of cause of death. Material and Methods:This was a retrospectivestudy Medico legal autopsies over a period of 5 years carried out in the Department of Pathology in coordination with the Department of Forensic Medicine, Gulbarga Institute of Medical Sciences. Standard protocols are used for gross and histopathology processing. Results: After thorough histopathological examination, of total 100 cases, various lesions were identified in 93 cases, in 7 cases tissue was autolyzed. Majority cases seen in the age group of 20-40yrs with male predominance. The most common cause of death was Road Traffic Accident (RTA) and majority victims were males. The commonly observed pathological features congestion and oedema(44.4%), Pneumonia(26.8%),CVC(22.2%) tuberculosis(9.6%) and ARDS(6.6%). Conclusion: The present study observed and documented histomorphological spectrum of lung lesions in medico-legal autopsies and highlighted various pathological conditions which are either direct or indirect cause of death. This study emphasizes that spectrum of histopathological changes in lungs of autopsy cases irrespective of cause of death and highlights some incidental interesting findings in lungs.

Immunohistochemical and Morphometric Analysis of Lung Tissue in Fatal COVID-19.

The primary targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the lungs are type I pneumocytes, macrophages, and endothelial cells. We aimed to identify lung cells targeted by SARS-CoV-2 using viral nucleocapsid protein staining and morphometric features on patients with fatal COVID-19. We conducted a retrospective analysis of fifty-one autopsy cases of individuals who tested positive for SARS-CoV-2. Demographic and clinical information were collected from forensic reports, and lung tissue was examined for microscopic lesions and the presence of specific cell types. Half of the evaluated cohort were older than 71 years, and the majority were male (74.5%). In total, 24 patients presented diffuse alveolar damage (DAD), and 50.9% had comorbidities (56.9% obesity, 33.3% hypertension, 15.7% diabetes mellitus). Immunohistochemical analysis showed a similar pattern of infected macrophages, infected type I pneumocytes, and endothelial cells, regardless of the presence of DAD (p > 0.5). The immunohistochemical reactivity score (IRS) was predominantly moderate but without significant differences between patients with and without DAD (p = 0.633 IRS for type I pneumocytes, p = 0.773 IRS for macrophage, and p = 0.737 for IRS endothelium). The nucleus/cytoplasm ratio shows lower values in patients with DAD (median: 0.29 vs. 0.35), but the difference only reaches a tendency for statistical significance (p = 0.083). Our study confirms the presence of infected macrophages, type I pneumocytes, and endothelial cells with a similar pattern in patients with and without diffuse alveolar damage.

Pattern of Head Injury in Fatal Road Traffic Accident: Retrospective Study

Road traffic Accident have been reported to be a major cause of morbidity and mortality. Due to increasing modernization, road traffic accidents have become exponentially more frequent and dangerous. Mortality rate from road traffic injuries accounts 29.2 per 100000 people5. This study was conducted in the Department of Forensic Medicine, Silchar Medical College, Silchar, from 1st November 2021 to 31st October 2022. The aim of the study is the pattern of head injuries in fatal road traffic accident. Out of the 981 autopsy cases were conducted during the above-mentioned period, a total of 200 cases were found deaths due to head injuries. Out of 200 cases, common age group involved was from 40-50 years, the deceased were more from rural areas. Maximum cases during winter season. Commonest injuries were scalp abrasion, linear fracture of skull and subdural haemorrhage. Head injury has become a common cause of death and disability among Road Traffic Accident cases. This further shows the need of strict implementations of traffic rules. Positive policy initiatives such as mandatory helmet legislation need reliable and consistent data to support ongoing monitoring and enforcement of such initiatives.

Intramural coronary artery and myocardial pathology in captive tigers (Panthera tigris) and African lions (Panthera leo).

There is limited published data regarding cardiovascular disease in nondomestic felid populations. To address this knowledge gap, necropsy cases of tigers and lions with representative myocardial samples submitted to a diagnostic laboratory were histologically assessed with hematoxylin and eosin and Sirius red stains. A total of 32 submissions (15 tigers, 17 lions) were identified in a 4-year period. All tigers and lions had some degree of coronary artery lesions in the left ventricle and/or interventricular septum. Major findings included moderate to marked arteriosclerosis in 8 tigers (53%) and 4 lions (24%) and moderate to marked perivascular fibrosis in 10 tigers (67%) and 9 lions (53%). Moreover, 10 tigers (67%) and 8 lions (47%) had coronary artery lesions with variable degrees of perivascular cardiomyocyte degeneration and/or loss. To our knowledge, this is the first report describing coronary artery pathology in captive tigers and lions.

Postmortem concentrations for total blood carbon monoxide (TBCO) as novel biomarker for carbon monoxide (CO) poisonings.

Total Blood Carbon Monoxide (TBCO) showed promising results in improving accuracy of CO determinations in blood and presenting better stability to different storage conditions. Therefore, it was proposed as alternative biomarker to carboxyhemoglobin (COHb) for CO poisoning diagnosis. However, given that current interpretation reference values exist for COHb only, it is difficult to implement TBCO analysis in routine. Therefore, we aimed at determining TBCO reference values for postmortem CO poisoning cases. A previously validated method for TBCO analysis via gas chromatography-mass spectrometry was applied to cardiac, peripheral, cranial and spleen blood samples collected from 92 autopsies. Autopsy cases included 21 non-CO related and 71 CO-related cases with varying postmortem intervals (PMI). Statistical analyses were performed using statistical software R Studio. When comparing lower to higher PMI for non-CO related cases, no significant differences were found, which suggests that CO formation or degradation at low PMIs does not occur. Spleen blood showed potential as alternative matrix for CO determinations in cases with sample availability issues, but needs to be evaluated for CO positive cases. Results for cardiac blood in CO-related autopsies showed a positive correlation between COHb and TBCO values (R = 0.78). This value is lower than what is found in the literature, suggesting that even though COHb and TBCO are correlated, a potential underestimation of the true CO exposure might occur if only COHb values are taken into consideration. Samples were divided into CO exposure groups based on COHb concentrations and with the data obtained, classification into following TBCO concentration groups are proposed: no significant CO exposure case <6 µmol/mL, medium CO exposure case 6-20 µmol/mL, high CO exposure case >20µmol/mL. Even if a higher number of samples in each group would enable to increase the confidence, these results are very promising and highlight the importance of TBCO measurement.

Clinical and Pathological Features of FTDP-17 with MAPT p.K298_H299insQ Mutation.

MAPT is a causative gene in frontotemporal dementia with parkinsonism linked to chromosome 17 (FTDP-17), a hereditary degenerative disease with various clinical manifestations, including progressive supranuclear palsy, corticobasal syndrome, Parkinson's disease, and frontotemporal dementia. To analyze genetically, biochemically, and pathologically multiple members of two families who exhibited various phenotypes of the disease. Genetic analysis included linkage analysis, homozygosity haplotyping, and exome sequencing. We conducted tau protein microtubule polymerization assay, heparin-induced tau aggregation, and western blotting with brain lysate from an autopsy case. We also evaluated abnormal tau aggregation by using anti-tau antibody and PM-PBB3. We identified a variant, c.896_897insACA, p.K298_H299insQ, in the MAPT gene of affected patients. Similar to previous reports, most patients presented with atypical parkinsonism. Biochemical analysis revealed that the mutant tau protein had a reduced ability to polymerize microtubules and formed abnormal fibrous aggregates. Pathological study revealed frontotemporal lobe atrophy, midbrain atrophy, depigmentation of the substantia nigra, and four-repeat tau-positive inclusions in the hippocampus, brainstem, and spinal cord neurons. The inclusion bodies also stained positively with PM-PBB3. This study confirmed that the insACA mutation caused FTDP-17. The affected patients showed symptoms resembling Parkinson's disease initially and symptoms of progressive supranuclear palsy later. Despite the initial clinical diagnosis of frontotemporal dementia in the autopsy case, the spread of lesions could explain the process of progressive supranuclear palsy. The study of more cases in the future will help clarify the common pathogenesis of MAPT mutations or specific pathogeneses of each mutation.

Storytelling of Myocarditis.

In 1900, Fiedler first reported autopsy cases with peculiar inflammation of the myocardium, which he named interstitial myocarditis. He postulated an isolated cardiac inflammation of the myocardium in the absence of multiorgan involvement and with a poor prognosis due to invisible microorganisms, which years later would have been identified as viruses. The revision of original histologic sections by Schmorl showed cases with lymphocytes and others with giant-cell inflammatory histotypes. The in vivo diagnosis of myocarditis became possible thanks to right cardiac catheterization with endomyocardial biopsy (EMB). The gold standard for diagnosis was achieved with the employment of immunohistochemistry and molecular investigation by Polymerase Chain Reaction (PCR), which allows for the detection of viruses as causal agents. Both RNA and DNA were revealed to be cardiotropic, with a common receptor (CAR). A protease, coded by coxsackie virus, disrupts the cytoskeleton and accounts for cell death. Unfortunately, vaccination, despite having been revealed to be effective in animal experiments, has not yet entered the clinical field for prevention. Cardiac Magnetic Resonance turned out to be a revolutionary tool for in vivo diagnosis through the detection of edema (inflammatory exudate). Myocarditis may be fulminant in terms of clinical presentation but not necessarily fatal. The application of ExtraCorporeal Membrane Oxygenation (ECMO) allows for relieving the overloaded native heart.

Prediction model for anabolic androgenic steroid positivity in forensic autopsy cases - a new tool to the autopsy room.

Non-prescription use of anabolic androgenic steroids (AAS) is associated with an increased risk of premature death. However, these substances are seldom screened in connection with forensic cause-of-death investigation, unless the forensic pathologist specifically suspects use, often based on a positive AAS use history. Since AAS use is often concealed from others, this practice may lead to mistargeting of these analyses and significant underestimation of the true number of AAS positive cases undergoing forensic autopsy. Thus, more accurate diagnostic tools are needed to identify these cases. The main objective of this study was to determine, whether a multivariable model could predict AAS urine assay positivity in forensic autopsies. We analyzed retrospectively the autopsy reports of all cases that had been screened for AAS during forensic cause-of-death investigation between 2016-2019 at the Finnish Institute for Health and Welfare forensic units (n = 46). Binary logistic regression with penalized maximum likelihood estimation was used to generate a nine-variable model combining circumferential and macroscopic autopsy-derived variables. The multivariable model predicted AAS assay positivity significantly better than a "conventional" model with anamnestic information about AAS use only (area under the receiver operating characteristic curve [AUC] = 0.968 vs. 0.802, p = 0.005). Temporal validation was conducted in an independent sample of AAS screened cases between 2020-2022 (n = 31), where the superiority of the multivariable model was replicated (AUC = 0.856 vs. 0.644, p = 0.004). Based on the model, a calculator predicting AAS assay positivity is released as a decision-aiding tool for forensic pathologists working in the autopsy room.

Abstract LB416: IncreasedTP53somatic evolution in the fallopian tubes of individuals at high risk of ovarian cancer

Abstract High-grade serous carcinoma (HGSC), the most common and pervasive subtype of ovarian cancer, originates in the fallopian tube epithelium from precursor lesions carrying somatic TP53 mutations. These lesions may evolve into carcinomas, eventually spreading to the ovary and peritoneum. Recent research in normal tissues and gynecologic liquid biopsies of individuals without HGSC has demonstrated that somatic TP53 mutations accumulate and clonally expand with age, suggesting that TP53 somatic evolution is part of the normal aging process​. To date, however, TP53 somatic evolution in the normal fallopian tube epithelium has not been characterized and it is unknown whether TP53mutations are more abundant in individuals with germline mutations in BRCA1 or BRCA2 (BRCA carriers) who are at a higher risk of developing HGSC​. In this study, we aimed to characterize age-related TP53 somatic mutations in the normal fallopian tube epithelium across the human lifespan and to determine whether the TP53 mutational landscape is altered in BRCA carriers. Our cohort consisted of 46 autopsy cases (age: 0-91 years) from individuals at low-risk of developing ovarian cancer and 48 prophylactic surgery cases (age: 32-69 years) from BRCA carriers. Fallopian tube tissues were collected, frozen, and macrodissected using a 1mm biopsy punch, enriching for the fallopian tube epithelium. DNA was extracted from each sample and sequenced for TP53 using ultra-deep duplex sequencing (mean depth: ~12,000x). Pathogenicity was determined using a machine learning algorithm (AlphaMissense) and a well-established predictor of TP53 pathogenicity (Seshat). Preliminary analyses in the normal fallopian tube epithelium collected across human lifespan demonstrated that the mutational profile (e.g. indels, splice, nonsense, missense, and silent mutations) in the aging fallopian tubes mirrored the mutational profile of HGSC. We also observed that the number of unique TP53 mutations and pathogenic clones increased with age, revealing TP53 somatic evolution. Additionally, the number of large TP53 mutant clones (&amp;gt;2 duplex mutant reads) increased exponentially with age, staring at age 30. When comparing the fallopian tubes of BRCA carriers to age-matched normal fallopian tubes, the percentage of pathogenic large clones in BRCA carriers was 22.8% vs. 6.0% in low-risk individuals (Fisher exact test, p &amp;lt; 0.0001), suggesting increased TP53 somatic evolution in the fallopian tubes of BRCA carriers. Altogether, our research demonstrates that TP53 somatic evolution is a normal aging phenotype in the fallopian tube, with more and larger pathogenic clones occurring later in life. Preliminary analyses in BRCA carriers indicate that somatic evolution is more prominent in these individuals, which may provide a biological explanation to the increased risk of HGSC and open new venues for better cancer prediction and prevention. Citation Format: CoohleenAnn Coombes, Brendan F. Kohrn, Jeanne U. Fredrickson, Elena Latorre-Esteves, Emma Hazard, Shreya Suresh, Marc R. Radke, Melanie Dillon, Anh P. Vo, Katherine Lai, Ronit Katz, Barbara M. Norquist, Elizabeth M. Swisher, Elizabeth U. Parker, Rosana Risques. IncreasedTP53somatic evolution in the fallopian tubes of individuals at high risk of ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB416.

The prevalence of pulmonary and extrapulmonary tuberculosis in forensic autopsies in a teaching hospital in South India

ABSTRACT Introduction: An autopsy is a valuable tool for finding the cause of death, exploring the clinical diagnosis, documenting unexpected findings, and resolving diagnostic questions. However, this may subject the forensic pathologist and other workers to a wide variety of blood-borne and aerosolized pathogens. Tuberculosis (TB) is the most common cause of illness and death, resulting in infection transmission in the autopsy room. Our objective in this study was to estimate the prevalence of pulmonary and extrapulmonary tuberculosis among forensic autopsies in a tertiary care hospital in South India. Material and Methods: We identified positive TB cases from acid-fast bacteria staining and culture (Mycobacterium Growth Indicator Tube and Lowenstein–Jensen medium) out of 380 autopsy cases. Results: The prevalence of tuberculosis was 2.4% (n = 9), among which 2.1% of cases were positive for only pulmonary tuberculosis (n = 8), and 0.3% of cases had both pulmonary and extrapulmonary involvement (n = 1). In the bivariate analysis of TB cases, sex, occupation, family history of TB, habit of smoking, BCG vaccine scar, period of hospital stay, and cause of death were potentially significant. Conclusion: The prevalence of TB in forensic autopsy cases were similar to forensic autopsy-based studies, and it was less as compared to the prevalence of TB in the general population.

IJCM_384A: Sudden death due to a ruptured ectopic: An Autopsy case

Background: An Ectopic pregnancy occurs when fertilized ovum is implanted outside the uterine cavity. Typically, the site of this ectopic pregnancy is the Fallopian tube in about 93-97% of ectopic pregnancies. Only 50% of patients present with the classic clinical triad of ectopic pregnancy i.e., pain, amenorrhea, and vaginal bleeding. It is extremely important to diagnose a case of ectopic pregnancy to prevent rupture and internal bleeding Case Report: A 35-year-old Female, was brought to a hospital, gasping, complaining of pain abdomen, and abdominal distension. Pulses could not be felt, GCS was 3/15, blood pressure was not recordable. She was shifted to the Intensive Care Unit and intubated. Fluid correction was attempted and ionotopes were started. USG abdomen showed a hemoperitoneum, pelvic hematoma, and ruptured right adnexa. The patient was taken up for an emergency laprotomy and had a cardiac arrest on table, but could not be resuscitated. Following an Medicolegal case the body was subjected for postmortem examination, the relevant findings at autopsy will be discussed.

Epidemiology of suicide: Autopsy audit of five years in an industrial city of Punjab.

Objective: To determine the epidemiological pattern of suicidal deaths in an industrial city of Punjab Province over a period of five years as well as to determine the gender and age group mostly affected. Study Design: Retrospective Cross-sectional Descriptive study. Setting: Department of Forensic Medicine and Toxicology, Punjab Medical College, Faisalabad. Period: 1st January 2019 to 31st December 2023. Methods: Subjects of the study were victims of suicidal death in areas covered by Police stations where the postmortem was performed in the Mortuary of Punjab Medical College / Faisalabad Medical University. Data was collected from respective official Police records, FIRs and Postmortem reports and recorded on pre-structured proformas. It was categorized on the basis of manner of death, type of weapon, gender and age groups involved. Results: A total of 1329 autopsies were conducted during the Five-year time period from 2019 to 2023 in which 82 cases (6.17%) were labelled as Suicide on Autopsy and Police inquest. The highest percentage of suicides was recorded in year 2020 with 19 out of 254 cases (7.48%). Among the suicidal cases, 81.7% were males predominantly in the age group 20-29 years. It was found that 57.3% cases were reported from the rural areas. Hanging accounted for 65.8% of suicidal deaths making it the major method employed to commit suicide. Conclusion: Our study concluded that 6.71% cases of suicide were reported among all autopsy cases during the five-year time period of 2019-2023. Among these, young males in age group 20-29 years from rural areas were in majority and hanging was the most common method of suicide employed.

An autopsy case of lung adenocarcinoma with immune checkpoint inhibitor-induced pneumonia and fulminant myocarditis following pembrolizumab administration: a case report

An autopsy case of lung adenocarcinoma with immune checkpoint inhibitor-induced pneumonia and fulminant myocarditis following pembrolizumab administration: a case report

Morphofunctional characteristics of the vessels of the small circle of blood circulation in those who died from severe and extremely severe forms of new coronavirus infection

BACKGROUND: An important feature of COVID-19 is the development of pronounced hypercoagulation with an increased risk of thrombotic damage to the pulmonary vascular bed, mainly the pulmonary arteries. Thrombosis of the pulmonary blood vessels causes a local violation of hemodynamics with the development of hyperemia, edema, which leads to a decrease in ventilation of the lung tissue area and serves as one of the causes of respiratory failure.&#x0D; AIM: This study aimed to conduct a morphological and morphometric analysis of the vascular bed of lung tissues in deceased with severe and extremely severe forms of new coronavirus infection who were on inpatient treatment in the period 2020-2022.&#x0D; METHODS: A pathomorphologic study of 129 autopsy cases with a confirmed diagnosis of a new coronavirus infection COVID-19 was performed. Morphometric analysis and statistical data processing of the pulmonary vascular system in histologic preparations stained with hematoxylin and eosin stain, orcein stain and Martius Scarlet Blue (MSB) stain was performed. The control group consisted of 14 patients who died of cardiovascular disease with bilateral focal confluent pneumonia.&#x0D; RESULTS: It was found that the proportion of thrombosed vessels in the lung tissues of the deceased was 27.6%. In 87.2% of cases, thrombosis develops in small arteries (lumen diameter 30-500 microns) and small veins (lumen diameter 40-500 microns). The vascular-functional indices of Kernogan and Vogenworth were statistically significantly increased in small arteries and small veins of the 4th order (p=0.001), small arteries (p=0.001) and small veins of the 5th order (p=0.014) compared with the control group.&#x0D; CONCLUSION: Diffuse involvement of small caliber blood vessels in the pathological process reflects the severity of specific hemocoagulopathic disorders in the lung tissue. Such disorders lead to the development of ventilation-perfusion disorders and entail an increase in right ventricular failure.