Autopsy Study Research Articles

Immunohistochemical Profile of the Pulmonary Vasculature in Subjects with Portopulmonary Hypertension: An Autopsy Study

Immunohistochemical Profile of the Pulmonary Vasculature in Subjects with Portopulmonary Hypertension: An Autopsy Study

Airway management in penetrating thoracic trauma.

Penetrating thoracic trauma accounts for 20-25% of all deaths due to trauma in the first four decades of life. About 33% of deaths from thoracic trauma occur due to penetrating trauma. In an autopsy study that enrolled 1178 trauma patients, 82% of the patients with tracheobronchial injuries died at the incidence site. In another study, 30% of those who could be transferred to the hospital died. This review aimed to revisit penetrating thoracic trauma with respect to complications and the strategies for airway management. While the risk of death in injuries with a sharp object is normally 1-8%, it reaches 25-28% when the cardiac box is included, and still, most of the patients are lost before they can come to the hospital. The consequences and management of penetrating thoracic trauma are mainly dependent on the extent of the injury to internal organs, as well as on the skill of the clinicians, airway obstruction, respiratory failure, and bleeding. Chest computed tomography (CT) is better than chest radiography in diagnosing the main bronchus or lobe/segment rupture. However, with the use of multi-channel multi-detector CT, the sensitivity of CT imaging has increased to 94% in the diagnosis of tracheobronchial injuries. While standard orotracheal intubation is sufficient in 75% of the patients, flexible bronchoscopy, intubation through the open wound or tracheostomy is required for airway provision in the rest. Clinical suspicion is the first diagnostic tool in a patient with penetrating airway trauma, and early treatment with multidisciplinary teamwork is life-saving.

Autopsy, histopathology and nano technological study of the spleen in a case of aluminum phosphide poisoning in India

Introduction: Phosphine poisoning occurs infrequently. As of 1984, 94 cases had been reported in the world literature, with 28 deaths, but its frequency has increased recently. Cases of aluminum phosphide poisoning were first reported in India in 1980. Before then poisoning by aluminum phosphide in India was unknown. These poisoning are mostly suicidal.Material and Method: A 40 year old male resident of Phulwari Sharif, Patna, INDIA consumed 3 tablets of Aluminum phosphide. The patient was referred to AIIMS Patna higher center for treatment where he died at around 7:00 p.m. His body was kept overnight in AIIMS Mortuary cold chamber. An autopsy was performed at Mortuary of AIIMS Patna, INDIA. Chemical analysis report given by FSL, Patna came out positive for aluminum phosphide. All viscera sent for histopathology to Department of Pathology, AIIMS Patna, India. Spleen was sent for electron microscopic examination to CDRI, Lucknow, India.Result: The spleen was congested and edematous weighing 140 g; on histopathology, the spleen was markedly congested and showed focal areas of exudation and small hemorrhages with necrosis. Electron microscopy of a cut section of the spleen showed that the sinusoids were dilated and congested, and the splenic mucosa showed hemorrhagic infarction followed by necrosis.Conclusion: The histopathological report of the section of spleen showed hemorrhagic infarction, which is quite possible in Celphos poisoning, as it causes widespread organ damage with congestion and petechial hemorrhages, as well as edematous organs. Splenic necrosis is a sequela of infarction of the spleen. Sinusoidal dilatation of the spleen is due to its edema and the hypoxic damage002E.

Analysis of ligature marks in hanging: A retrospective study of autopsies in the mortuary of a tertiary health-care center in North East India from 2011 to 2019

Analysis of ligature marks in hanging: A retrospective study of autopsies in the mortuary of a tertiary health-care center in North East India from 2011 to 2019

Válvula aórtica bicúspide y disección de aorta. Valor del estudio genético en patología forense

The present work collects three clinical cases of medicolegal autopsy findings in which some possible circumstances are exemplified in which the bicuspid aortic valve (BAV) can be evidenced in forensic pathology practice. Regarding them, a discussion is developed on the demographic characteristics of BAV, its debated association with the so-called bicuspid aortopathy and its complex heritability. Emphasis is placed on the importance of carrying out a complete autopsy study and having the advice of cardiology and genetics professionals in order to proceed with possible genetic studies of the deceased and preventive medical examinations of their relatives in the first degree.

Evaluation of Relative Frequency of Pulmonary Hypoplasia and Various Anomalies Associated with Pulmonary Hypoplasia in Fetal Autopsy Study.

Pulmonary hypoplasia (PH) is one of the commonest causes of neonatal morbidity and mortality. The suggested diagnostic criteria for PH are the Lung Weight:Body Weight (LW:BW) ratio ≤ 0.012 and/or Radial Alveolar Count (RAC) ≤ 4.1. The present study was done to determine the relative frequency of PH in fetal autopsy study by the LW:BW ratio and RAC along with evaluation of the defects/anomalies associated with PH. A prospective observational study was done on fetal autopsy specimens in the Department of Pathology. Examination and grossing were done as per the standard format of fetal autopsy study. Evaluation of PH was done using the LW:BW ratio and RAC. Diagnostic criteria for PH were taken as LW:BW ratio < 0.012 and/ or RAC < 4.1. Chi-square test, Student T test and Kruskal Wallis test were used in statistical analysis. A diagnosis of PH was made in 45 cases. Concordance between the LW:BW ratio and RAC was observed in 33 cases amounting to 73.33%. The mean LW:BW ratio was the lowest in oligohydramnios. The mean RAC was the lowest in congenital cystic adenomatoid malformation. A diagnosis of PH was rendered in a greater number of cases when evaluation was done by considering both the LW:BW ratio and RAC. Hence, evaluation by both the LW:BW ratio and RAC provides a reliable index of lung growth and should be an essential part of fetal autopsy study.

Maternal deaths: A medicolegal autopsy study in a tertiary care hospital

Maternal deaths: A medicolegal autopsy study in a tertiary care hospital

Pattern of Injuries in Road Traffic Accident Death Cases in Western Haryana-An Autopsy Study at Maharaja Agrasen Medical College, Agroha, Hisar

Pattern of Injuries in Road Traffic Accident Death Cases in Western Haryana-An Autopsy Study at Maharaja Agrasen Medical College, Agroha, Hisar

The tangled story of carotid disease, carotid revascularization, and Alzheimer's disease: The plot thickens.

Arias et al1 present an autopsy study showing that increased neurofibrillary tangle accumulation as commonly seen in Alzheimer's disease was associated with the diagnosis of carotid artery stenosis. Similar to other studies, they did not see increased β-amyloid plaque in patients with carotid disease.2,3 Tantalizingly, they further show that patients who underwent carotid endarterectomy for their carotid disease had significantly lower neurofibrillary densities compared with those who did not undergo carotid intervention.

Pathological findings in COVID-19: A conventional autopsy-based study from India.

Background & objectives:Autopsy study has been considered the gold standard method for studying the effects of any disease on the body. Since COVID-19 is a novel disease, autopsy is crucial to understand its pathophysiology. This study was conducted to analyze the microscopic and macroscopic findings of various organs in COVID-19 and to associate those findings with clinical observations and laboratory findings.Methods:Conventional invasive autopsies were performed on 33 patients with COVID-19 from September 7, 2020 to December 23, 2020. All the organs were removed by routine dissection techniques and preserved in 10 per cent formalin. The tissues were processed and stained according to standard practices using haematoxylin-eosin (H & E) and periodic acid-schiff (PAS) stain.Results:The study included 28 males and 5 females with a median age of 61 yr (range 30-90 yr). Massive pulmonary oedema and thrombi in the lungs were the characteristic features macroscopically. On microscopic examination, diffuse alveolar damage in the exudative/proliferative phase was found in 29 (87.88%) cases. Among the other notable microscopic findings were bronchopneumonia and lung abscesses due to secondary bacterial infection (n=17, 51.52%), acute tubular injury (n=21, 63.64%) and thrombi in the lungs, heart, and kidneys.Interpretation & conclusions:COVID-19 primarily affected the respiratory and the renal systems in the vast majority of severely affected patients in our study. We also found signs of hypercoagulability, as evidenced by widespread thrombi in multiple organs, along with a raised d-dimer level and a hyperinflammatory state manifested by elevated inflammatory markers. Our autopsy findings and altered laboratory investigations support the role of immune-mediated cellular injury along with direct virus-mediated cellular damage.

An autopsy study of the pattern of unnatural deaths among youth at a tertiary care teaching hospital in south India

Mortality among youth owing to unnatural causes is on the rise. Hence, the present study was undertaken to estimate the number of such deaths, and assess the manner of death and the commonest cause of death. A total of 255 cases of unnatural deaths among youth aged between 15 and 29 years, autopsied at a tertiary care teaching hospital in South India were studied for a duration of 18 months from November 2015 to April 2017. Unnatural deaths among youth constituted 25.91%, l/4th of all medico-legal autopsies. Males outnumbered females. Most of the victims were 24 to 26 years old male and 21 to 23 years old female. Most of the victims were Hindu. Socio-economically, most of the victims belonged to the middle class. Most of them were urban residents belonging to nuclear families. The majority of the victims were secondary school students. Most of the unnatural deaths were suicides; with victims aged 27 to 29 years. Hanging was the most commonly preferred method of committing suicide. The commonest reason was ill-health. Road traffic accidents claimed 43 lives, victims were mostly 24 to 26 years old and died due to head injury. Homicides accounted for 5.49% of unnatural deaths. Most of the homicidal deaths were due to injuries inflicted by sharp weapons, consequently, the majority of victims succumbed to shock and hemorrhage due to multiple injuries.

Patterns of Cardiac Rupture in Blunt Cardiac Injuries and Coronary Artery Disease: A Retrospective Autopsy Study

Cardiac rupture is the most severe form of blunt chest injury and coronary artery disease and that leads to a devasting medical emergency, Becker and colleagues identified three types of myocardial rupture, in Govt Stanley medical college and hospital, 2017-2019 cases with the postmortem findings and hospital records suggestive of cardiac rupture, were studied retrospectively and the Information were collected and analyzed. In the retrospective study population 426 cases had blunt chest trauma in that cardiac rupture seen in 28 cases amongst Becker type I rupture seen in 26 cases and type II rupture seen in 2 cases. Amongst 792 cases of coronary artery disease with myocardial infarction 13 cases had cardiac rupture in that Beckers type I rupture noted in 5 cases and type II were noted in 8 cases. Beckers type III rupture cases were not presented in the retrospective study population. Male cases were predominantly seen in both blunt chest injuries and in coronary artery disease and most of the cases were in the age group of 31-60 years. Among blunt chest injury traffic accidents were most common cause for cardiac rupture and in coronary artery disease left anterior descending artery occlusion was the most common cause for cardiac rupture, In the present study it has been proved that a diseased heart is more susceptible to traumatic injury than a normal one. The diseased heart is more likely to rupture at the fragile myocardium sites ,The presence of fatal cardiac trauma in head on collision cases emphasizes the utility of safety belts while driving. The present study is undertaken to identify the exact pathophysiology and bio mechanism of cardiac rupture

An Epidemiological Burns Autopsy Study Along with its Source and Severity in a Tertiary Care Hospital

An Epidemiological Burns Autopsy Study Along with its Source and Severity in a Tertiary Care Hospital

Membrane Autopsy Study to Investigate Membrane Fouling of Reverse Osmosis Membrane Used in a Full-Scale Industrial Zone Wastewater Reuse Plant

Membrane Autopsy Study to Investigate Membrane Fouling of Reverse Osmosis Membrane Used in a Full-Scale Industrial Zone Wastewater Reuse Plant

An autopsy study of determination of sex from measurements from hyoid bone

Whenever unknown or decomposed or mutilated dead bodies or isolated body parts or skeletal remains are found, the first step of the police investigation is to establish the identity of the deceased. Determination of sex from dismembered body parts can play a vital role in the identification of the person. The present study was done to find out the usefulness of various measurements of the hyoid bone to determine the sex and to derive an appropriate formula to determine sex from measurements of hyoid bone for a population in and around the Rajkot region of Gujarat. The present study was conducted in the Forensic Medicine and Toxicology Department at P.D.U. Govt. Medical College, Rajkot, during the period of January 2015 to December 2015. The study population were randomly selected and conducted on a total of 150 individuals, 75 male and 75 female adults varying in age from 17–75 years. All the studied parameters were greater in males than in females. Distance from anterior middle of the body to line that connects distal parts of greater cornua shows highest gender difference (74.6%) followed by distance from anterior middle of the body to the line that connects distal parts of lesser cornua (66%), distance between distal parts of greater cornua (60%), length of left greater cornua (58%).

Estimation of Time Since Death from Rigor Mortis - An Autopsy Study in Tertiary Care Hospital of Malwa Region of Punjab state of India

Background: Postmortem interval estimation is an important tool in forensic medicine. Estimating time since death is extremely important in cases where there is doubt about the period of death. After death, many changes occur in a regular sequence and can be used to arrive at an approximate time since death. When a post-mortem is conducted, doctor conducting the post-mortem examination has to give his opinion about post-mortem interval i.e. the probable time that elapsed between death and post-mortem examination even in cases of decomposed dead bodies. While giving this opinion, we always think we should have some other dependable methods to be more accurate in answering this question. Algor mortis, Rigor mortis, and Livor mortis have been the basis for ascertaining the post-mortem interval collectively. Among them, Rigor Mortis is an important indicator of post-mortem interval. Although it is a dependable tool for estimating post-mortem interval, it is influenced by many endogenous and exogenous factors like nature of death, nature of the body, temperature, humidity etc. Time of death is almost always asked by investigating authorities to connect the crime with criminals. Determining the death time has always been a topic of keen interest amongst forensic pathologists from its inception to date. Many workers in forensic medicine have tried to investigate to determine the time of death based on post mortem findings. To date, it is still an important and fascinating criterion to ascertain the time since death. With this study, we aimed to demonstrate the intricacies of Rigor Mortis with fluctuating temperature and humidity of the local region. We planned to estimate and compare the post-mortem interval based on Rigor Mortis in different body muscles. Materials and Methods: This study was conducted in the Department of Forensic Medicine and Toxicology at G.G.S. Medical College, Faridkot after taking clearance from the institutional ethics committee. Thirty medico-legal autopsy cases were included in the study where the exact time of death was known and included only hospital deaths. The relatives of the deceased were explained the purpose and nature of the study and provided with the patient information sheet and informed consent was taken. The details of the cases were noted from the hospital bed head ticket, relative interview and the police inquest papers. The exact temperature and humidity were noted at the start of autopsy using a digital hygrometer. Results: A total of 30 cases were observed out of which males outnumbered the females by approximately 3:1. Maximum cases consisted of Roadside Accidents (43.3%) followed by poisoning, assault and hanging, in that order. The average temperatures during the study months varied from a maximum of 41.3°C (June) to a minimum of 33.7°C (July). The average humidity varied from a maximum of 62.6% (July) to a minimum of 29.3% (May). The average temperatures during the study months varied from a maximum of 41.3°C (June) and a minimum of 33.7°C (July). The average humidity during the study months varied from a maximum of 62.6 % (July) and a minimum of 29.3% (May). Fully established Rigor Mortis was observed at a minimum of 10 hours and a maximum of 29 hours in May and June.

An Autopsy Study of Examination of Neck Injuries &amp; Face, in deaths due to Suicidal Hanging

This Study on Injuries to the Neck Structures was conducted on over 634 cases of Suicidal Hanging during the Period 2009 to 2020. The Aim of the Study is to Understand the Damage to the Neck structures Externally and Internally, with Particular Reference to Sternocleimastoid Muscle, Internal Carotid Artery, Thyroid, Cricoid, Laryngeal Cartilage and Hyoid Bone. The Cervical Spine was also Examined for Fractures. The Thyroid Gland and Parotid Gland Were Studied Microscopically. The Ligature Mark changes and the Conjunctiva were Examined. The Changes in complete and Partial Suspension was Examined and Compared. The Neck dissection technique, as advocated by Prinsloo and Gordon was undertaken to study the injuries to the thyro-hyoid complex, strap muscles, carotid vessels, etc. Females Formed the Major Number 62% of cases. In Complete Hanging Injury and Hemorrhages of the Sternocleidomastoid muscles at sterna end was noted in 86% of cases whereas it was recorded in only 8% of cases in Partial Hanging. The protrusion of Tongue and Dribbling of Saliva was well appreciated in 98% and 92% of cases respectively in Complete Hanging,wheras it was appreciated in 38% and 46% respectively, in Partial Hanging cases. The Obliquity of Ligature Mark was well appreciated in All the cases of Complete Hanging whereas it was reported in only 72% cases of Partial Hanging. Capsular &amp; Parenchymal Hemorrhages of the Thyroid and Parotid Gland was reported in 68% cases of Complete Hanging, but only 8% of Partial Hanging reported the Histological Changes. The epithelial structures over the Ligature Mark along its Margins were displaced upwards and downwards in 91% of Complete Hanging whereas it was reported in 29% of Partial Hanging. Hence Understanding the Structural Damage to the Neck is always important to understand the Suicidal Hanging.

Profile of Medico legal Autopsies Conducted at Tertiary Medico-legal Centre in Northern India

The present study is a retrospective study of medico-legal autopsies conducted in the Department of Forensic Medicine and Toxicology MMIMSR Mullana, Ambala, India, from Jan 2016 to December 2020. During this period, 793 cases of medico-legal autopsies were done in the mortuary of MMIMSR, Mullana, Ambala. The majority of victims were male 670 (84.48 %) cases and female 123 (15.52%) cases. A maximum number of post mortem done in the age group 20-40 years was 385(48.56 %) cases and minimum in age group 0-10 year were 18 (02.26%) cases. In our study, 601 (75.78%) were married, 169 (21.31%) unmarried, and unknown 23 (02.99%) cases. Hindus were 660 (83.22%), Muslim 50(06.30%), and Sikh 83 (10.48%) cases. The total number of deaths from rural areas was 406(51.20%) cases, which is slightly higher than urban area 387 (48.80%) cases. Manners of death due to natural causes were 38 (04.97%) cases and unnatural 755 (95.20%) cases. In unnatural, (accidents 551 (69.44%), Suicides 186 (23.44%) and homicides 18 (02.24%) cases). A maximum number of death due to Head injury were 235 (29.64%), shock and hemorrhage 188 (23.70%), poisoning 124 (15.64%), others-skeleton and visceral injuries 81 (10.22%), hanging 44 (05.54%), heart attack 38(04.78%), Drowning 23(02.90%), Electrocution 14 (01.76%), strangulation 13(01.64%), burns 11(1.38%), alcoholic 10(01.26%), septicemia 10(01.26%) and snake bite 2(00.26%)cases. A maximum number of deaths occurring between 0-6 hrs of injury was 395(49.82%) cases, and a minimum number of deaths in 24-48 hrs of injury was 22(02.77%) cases.

Review and Thinking on Forensic Pathological Changes of Coronavirus-Infected Diseases.

Since the beginning of this century, three types of coronavirus have widely transmitted and caused severe diseases and deaths, which strongly indicates that severe infectious diseases caused by coronavirus infection are not accidental events. Coronavirus-infected diseases are mainly manifested by respiratory symptoms, with multiple organ dysfunctions. Precisely investigating the pathological process, characteristics and pathogenesis of coronavirus-infected diseases will be beneficial for us to understand clinical manifestations and provide targeted suggestions on prophylaxis and treatment. This paper briefly reviews the pathological findings of three known coronavirus-infected diseases, and attempts to construct the pathological spectrum of coronavirus-infected diseases, aiming to provide reference and thinking for autopsy, histopathological examination and animal infection model study of coronavirus-infected diseases.

Deadly stays: A 10-year autopsy study of deaths in hotels in Antalya, Turkey.

The hotel industry is essential for travelers, for both touristic and business purposes. Deaths in hotel rooms, which can occur in various manners from various causes, can result in serious problems for the industry. This study evaluated 8137 autopsies performed by the Antalya Group Administration of the Turkish Council of Forensic Medicine between January 1, 2010, and December 31, 2019. All deaths occurred during a hotel accommodation and within hotel borders, including their respective beach areas, and those who collapsed during their hotel stay and died shortly afterward in a hospital or on their way to a hospital were included. A total of 900 cases were identified and ultimately included in this study. According to the autopsy reports, the decedents who died during their stays were from 42 different countries and had a mean age of 54.3±18.55years. Most decedents were from Russia (n=251, 27.9%). The most common manner of death was natural causes (n=552, 61.3%) followed by accidents (n=284, 31.6%), suicides (n=40, 4.4%), and homicides (n=7, 0.8%). Existing cardiovascular diseases (n=379, 42.1%) were the leading cause of death, followed by drowning in the sea (n=116, 12.9%) or a pool (n=58, 6.4%). Most of the causes of deaths identified within this study are preventable with timely intervention or resuscitation. Providing medical personnel 24/7 with adequate equipment in accommodation options, and enabling hotels to take appropriate measures may decrease preventable deaths and improve international travel.