Complete Autopsy Research Articles

One Injury, Two Tracks and Two Weapons with Two Thoughts: An Exhumation Case Report

Exhumation is authorised digging out of already buried body from his legitimate graveyard. The autopsy in exhumed dead body require extreme attention and thorough examination of the corpse to determine the exact cause and manner of death. Exhumation also helps to evaluate and rule out any disease responsible for death. In the present case, authors discuss and report an unusual case of decomposed young adult male of 24-year-old, who was killed/stabbed by his younger brother. Body of deceased was buried by the perpetrator of crime without police information and medicolegal autopsy. The stab wound was altered by accused to misguide or create confusion in identifying the type of injury and weapon of offence. Later, this scenario was solved by autopsy surgeons after visiting incident scene, complete postmortem examination of the corpse and examinations of belongings.

Subgemmal neurogenous plaques of the tongue: a systematic autopsy study.

Subgemmal neurogenous plaque (SNP) is a subepithelial nerve plexus associated with taste buds, occasionally observed in tongue biopsies. There is no evaluation of the prevalence of this structure in the general population. We present a systematic study of samples obtained at random from the dorsal portion of the oral tongue in 205 consecutive complete autopsies. Each sample was about 15 mm long and 10 mm thick. Four hundred fifty-eight samples were routinely obtained and an average of 2.23±0.88 samples per case (range 1-7) was collected. The total number of SNPs observed was 556, with a mean of 2.71±2.68 per case (range 0-16). This means that for every 15 linear mm of the oral tongue, approximately 2.7 SNPs can be present. SNPs display several ages, and they do not show sex differences. The mean size of these structures was 2.1±0.94 mm (range 0.6-3.6 mm). SNP is characterized by its unique neural, zonal pattern with a superficial neurofibroma-like area and a deeper neuroma-like area. Special features of the SNPs include the presence of taste buds (49.1%), ganglion cells (26.3%), dilated thin-walled vessels (11.3%), salivary gland excretory ducts emptying on the surface of the papillae (6.1%), moderate-severe inflammatory infiltrate (6.8%), presence of lymphoid tissue in the vicinity (7.0%), and hyperplasia of the epithelial cover with pseudoepitheliomatous appearance (7.0%). The differential diagnoses include schwannoma, neurofibroma, ganglioneuroma, traumatic neuroma, mucosal neuroma, and squamous cell carcinoma. SNPs are small, normal structures that may undergo hyperplasia and are usually seen incidentally.

SARS-CoV-2 infection and persistence in the human body and brain at autopsy.

Coronavirus disease 2019 (COVID-19) is known to cause multi-organ dysfunction1-3 during acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with some patients experiencing prolonged symptoms, termed post-acute sequelae of SARS-CoV-2 (refs. 4,5). However, the burden of infection outside the respiratory tract and time to viral clearance are not well characterized, particularly in the brain3,6-14. Here we carried out complete autopsies on 44 patients who died with COVID-19, with extensive sampling of the central nervous system in 11 of these patients, to map and quantify the distribution, replication and cell-type specificity of SARS-CoV-2 across the human body, including the brain, from acute infection to more than seven months following symptom onset. We show that SARS-CoV-2 is widely distributed, predominantly among patients who died with severe COVID-19, and that virus replication is present in multiple respiratory and non-respiratory tissues, including the brain, early in infection. Further, we detected persistent SARS-CoV-2 RNA in multiple anatomic sites, including throughout the brain, as late as 230 days following symptom onset in one case. Despite extensive distribution of SARS-CoV-2 RNA throughout the body, we observed little evidence of inflammation or direct viral cytopathology outside the respiratory tract. Our data indicate that in some patients SARS-CoV-2 can cause systemic infection and persist in the body for months.

Analysis of forensic autopsy cases associated with epilepsy: Comparison between sudden unexpected death in epilepsy (SUDEP) and not-SUDEP groups.

Epilepsy is a common and chronic neurological disorder characterized by seizures that increase the risk of mortality. SUDEP is the most common seizure-related category of death. The study aimed to evaluate the key characteristics between SUDEP and not-SUDEP death cases. A retrospective study of forensic autopsy cases from 2002 to 2021, performed by the Academy of Forensic Science (Ministry of Justice, China), identified a total of 31 deaths associated with epilepsy. We compared the different characteristics between individuals who died of SUDEP (SUDEP group) and individuals with epilepsy died suddenly due to unrelated causes (not-SUDEP group). 13 cases met the general accepted definition of SUDEP; and 18 cases were classified as not-SUDEP. The mean age of the not-SUDEP group was significantly higher than that of the SUDEP groups (p < 0.05) and there were more cases without a clear cause of epilepsy in the SUDEP group than in the not-SUDEP group (p < 0.05). Death position differed significantly between the two groups, with more cases dying in the prone position in the SUDEP group (p < 0.05). Complete autopsies were performed in 24 of the 31 cases. There were no significant differences in heart, lungs and brain weights, or in ventricular thickness (p > 0.05) between the SUDEP and not-SUDEP groups. In addition, compared to the not-SUDEP group, the SUDEP group featured a significantly more cases with coronary lesions (grades 1-3, p < 0.05). Neuropathological lesions were identified in 12 of the 13 SUDEP cases (92.3%), cardiac lesions were present in 10 cases (76.9%) and pulmonary edema and pulmonary congestion were present in all cases. The primary cause of death in 13 of the 31 cases was seizure disorder or epilepsy. The primary mechanism of death in SUDEP group was mainly asphyxia while that in the not-SUDEP group was cardiopulmonary failure (p < 0.05). Patients in the prone position had a significantly higher risk of asphyxia than those who were not. Here, we investigated the key characteristics between SUDEP and not-SUDEP death cases, which may help to facilitate forensic diagnosis in presumed SUDEP cases.

Clinical Development of Senza5TM CART5: a Novel Dual Population CD5 CRISPR-Cas9 Knocked out Anti-CD5 Chimeric Antigen Receptor T Cell Product for Relapsed and Refractory CD5+ Nodal T-Cell Lymphomas

Introduction: Chimeric antigen receptor T-cell (CART) immunotherapy is FDA-approved for B-cell lymphoblastic leukemia, B-cell non-Hodgkin lymphomas, and multiple myeloma. However, CART immunotherapy for T-cell non-Hodgkin lymphomas (T-NHL) is lagging, with only limited clinical results. T-NHL have a poor prognosis and there is an unmet need for effective and long-lasting treatments. We previously presented preliminary preclinical results of anti-CD5 CAR T cells (CART5) that had CD5 knocked out (KO) (Blood (2020) 136 (Supplement 1): 51-52.). CD5 KO not only prevented CART fratricide but also dramatically enhanced CART function. Critical challenges to developing CART cells for T-NHL are CART fratricide and normal T-cell toxicity. In this study, we addressed these challenges by improving manufacturing and including a dual-population technology to mitigate toxicity. We present the development of Senza5TM CART5 an autologous good-manufacturing practice (GMP)-grade product (Fig.1) that will be tested in a phase I clinical trial for relapsed and refractory CD5+ nodal T-cell lymphomas. Methods and Results: We first identified a single guide RNA (sgRNA) that deletes CD5 in T cells with >90% KO efficiency by flow cytometry and ICE analysis. We then assessed the specificity of the KO by performing iGUIDE sequencing. We confirmed high on-target CD5 cleavage with minimal off-targets (CALCP, C20orf85, INPP4B, XPO7, and SLC10A7). These genes have little to no expression in naïve CD4+ and CD8+ T cells by RNA-seq (DICE). Targeted functional assays are ongoing. For the CAR construct, we selected a lead CAR5 among six 4-1BB-constructs based on its superior anti-tumor function in NOD-SCID IL2Rgnull (NSG) mice engrafted with a Jurkat T-lymphoblastic leukemia cell line. Furthermore, to confirm the specificity of the CAR5 for CD5, we screened CAR5 T cells for interactions with HEK293 cells expressing 5,828 human plasma membrane proteins or cell-surface tethered secreted proteins and 398 human heterodimers (Retrogenix assay). The lead CAR5 did not bind to any targets besides CD5. For an optimized GMP-grade product, we modified our manufacturing protocol, shortening it from 10 to 5 days. Moreover, KO efficiency and safety were optimized to reduce off-target activity without loss of efficiency. We also optimized the activation strategy to decrease cell loss. Functional studies were performed to demonstrate the comparability of these methods. With these improvements, we were able to achieve >90% CD5 KO with >30% CAR transduction, thereby allowing the generation of two main populations: one of CD5KO CART5 cells and the other of CD5KO normal untransduced T cells. CD5KO CART5 are expected to target CD5+ T-NHL cells but could also lead to normal T-cell toxicity. This toxicity will be mitigated by the CD5KO normal T cells that will have a survival advantage after infusion (Fig.1) and have been demonstrated to maintain reactivity against opportunistic pathogens such as CMV and EBV. To evaluate Senza5TMCART5 safety, we performed cytokine-independent CART proliferation and long- and short-term xenograft models. Senza5TM CART5 cells did not grow aberrantly without growth/survival-associated cytokines (IL2/7/15). We then used NSG mice to exclude uncontrolled Senza5TM CART5 growth and observed enhanced expansion and proliferation of Senza5TM CART5 with a xenogeneic GVHD rate similar to that of control mice with similar wild-type CART5 expansion. Since the CAR5 does not cross-react with murine CD5, we tested non-specific toxicity in tissues using an NSG xenograft model of Jurkat. On Day 10 post-CAR T injections, animals were euthanized, and a complete necropsy was performed on all animals. Senza5TM CART5 demonstrated tumor clearance with no detection of treatment-related lesions. Mice treated with untransduced T cells or CART19 demonstrated significant overall and organ-specific weight loss compared to Senza5TM CART5. Blood analyses determined no differences in their clinical chemistry profile or complete blood counts. Conclusion: In this study, we developed a novel dual-population, full-scale GMP-ready CD5 KO anti-CD5 CART product for T-cell lymphomas characterized by enhanced anti-tumor effect and a strategy to potentially mitigate toxicity. Autologous Senza5TM CART5 will be tested for CD5+ nodal T-cell lymphomas in a phase I clinical trial. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Sudden cardiac death in the young: A consensus statement on recommended practices for cardiac examination by pathologists from the Society for Cardiovascular Pathology

Sudden cardiac death is, by definition, an unexpected, untimely death caused by a cardiac condition in a person with known or unknown heart disease. This major international public health problem accounts for approximately 15-20% of all deaths. Typically more common in older adults with acquired heart disease, SCD also can occur in the young where the cause is more likely to be a genetically transmitted process. As these inherited disease processes can affect multiple family members, it is critical that these deaths are appropriately and thoroughly investigated. Across the United States, SCD cases in those less than 40 years of age will often fall under medical examiner/coroner jurisdiction resulting in scene investigation, review of available medical records and a complete autopsy including toxicological and histological studies. To date, there have not been consistent or uniform guidelines for cardiac examination in these cases. In addition, many medical examiner/coroner offices are understaffed and/or underfunded, both of which may hamper specialized examinations or studies (e.g., molecular testing). Use of such guidelines by pathologists in cases of SCD in decedents aged 1-39 years of age could result in life-saving medical intervention for other family members. These recommendations also may provide support for underfunded offices to argue for the significance of this specialized testing. As cardiac examinations in the setting of SCD in the young fall under ME/C jurisdiction, this consensus paper has been developed with members of the Society of Cardiovascular Pathology working with cardiovascular pathology-trained, practicing forensic pathologists.

Causes of Mortality of Dairy Cattle Diagnosed by Complete Necropsy.

This retrospective case series summarized the primary causes of death in 857 dairy cattle necropsied from 2008 to 2019 at the Utah Veterinary Diagnostic Laboratory, from dairy farms in Utah (76%), Idaho (16%) or other states (8%), primarily in the U.S. Intermountain West. Of cattle with age provided, 74% matched with body weight based estimates for those with no age stated. Cattle ranged from fetuses at 60 days of gestation to 9 years old. Primary cause of mortality was diagnosed in 833 cattle (97%); no cause was evident in 24 cattle (3%). Sexes were female 620 (72%), male 214 (25%), not recorded 23 (3%). Seven diseases killed 80% of the animals: gastrointestinal disease (most enteritis/colitis) 318 (37%); pneumonia 166 (19%); abortion 96 (11%), peritonitis 30 (4%), omphalophlebitis (navel ill) 27 (3%), abomasitis 23 (3%), and metritis 23 (3%). Etiologic agents and specific causes varied with age categories of the animals. Young calves that died from dystocia, omphalophlebitis, or congenital abnormality often presented with no suspicion of those causes by the owners because of no external signs. Some important fatal diseases of adult dairy cows that are often diagnosed ante-mortem were diagnosed at necropsy with no suspicion by those submitting the carcasses: metritis, hardware disease, and displaced abomasum. Multicentric lymphoma was a relatively important cause of death in cows more than 4 years old. Despite use of a toxicology laboratory, toxicity was only diagnosed as causing 1% of the deaths across all ages of dairy cattle. There were numerous other causes of mortality diagnosed as well. Necropsy is a vital tool to diagnose causes of death in dairy cattle and can guide changes in management or preventive practices to reduce the rate of deaths in dairy herds.

Toxicological Findings of Self-Poisoning Suicidal Deaths: A Systematic Review by Countries.

The use of illicit and non-illicit substances is widespread in suicides. The toxicological data may help in understanding the mechanism of death. This systematic review aimed to analyze autopsies related to suicides by consuming poison, focusing on the correlation between substance use and the country of origin to create an alarm bell to indicate that suicide maybe attempted and prevent it. The systematic review was conducted according to the PRISMA guidelines, with the primary objective of identifying autopsies conducted in cases of suicide by consuming poison in specific geographic areas. Significant differences in substances were observed between low-income and Western countries that confirm previous literature data. In rural areas and Asian countries, most suicides by consuming poison involve the use of pesticides, such as organophosphates and carbamates. In Western countries, illicit drugs and medically prescribed drugs are the leading cause of suicide by self-poisoning. Future research should shed light on the correlation between social, medical, and demographic characteristics and the autopsy findings in suicides by self-poisoning to highlight the risk factors and implement tailored prevention programs worldwide. Performing a complete autopsy on a suspected suicide by self-poisoning could be essential in supporting worldwide public health measures and policy makers. Therefore, complete autopsies in such cases must be vigorously promoted.

Frequency and Underlying Pathology of Pure Vascular Cognitive Impairment

It is not clear how common pure vascular cognitive impairment (VCI) is in the absence of Alzheimer disease (AD) and/or other neurodegenerative pathologies. To identify participants without AD and other neurodegenerative pathologies and determine the extent to which cerebrovascular disease pathologies were associated with cognitive impairment. This clinical pathological study included participants from 2 ongoing community-based cohorts that began enrollment in 1994 and 1997. Prior to death, participants were observed for a mean (SD) of 8.4 (5.3) years with annual assessments. From 2096 participants who died, 1799 (85.8%) underwent autopsy and 1767 had complete postmortem pathological examination data at the time of data analyses. To identify participants without neurodegenerative pathologies, we categorized them in 3 subgroups. A vascular subgroup was composed of participants without significant levels of neurodegenerative brain pathologies. A neurodegenerative subgroup was composed of participants without significant levels of cerebrovascular disease pathologies. A mixed subgroup was composed of the rest of the participants. Data were analyzed from May 2021 to July 2022. Brain pathology indices obtained by postmortem pathological assessments. The primary outcome was cognitive impairment defined by presence of mild cognitive impairment or dementia. The secondary outcome was cognition assessed by 19 neuropsychological tests. Of 1767 included participants, 1189 (67.3%) were women, and the mean (SD) age at death was 89.4 (6.6) years. In the vascular subgroup (n = 369), cognitive impairment was present in 156 participants (42.3%) and was associated with cerebrovascular disease pathologies (macroinfarcts: odds ratio [OR], 2.05; 95% CI, 1.49-2.82; P < .001; arteriolosclerosis in basal ganglia: OR, 1.35; 95% CI, 1.04-1.76; P = .03) but not AD or other neurodegenerative pathologies, an indication of pure VCI. In mixed-effects models including all the pathologies, only macroinfarcts were associated with a faster cognitive decline rate (estimate, -0.019; SE, 0.005; P < .001) in the vascular subgroup. Further analyses identified macroinfarcts in the frontal white matter to be associated with faster cognitive decline rate when macroinfarcts of cortical and subcortical brain regions were examined in a single model. In this study, pure VCI was not rare. Macroinfarcts, specifically in frontal white matter, were the main cerebrovascular disease pathologies associated with cognitive decline in pure VCI.

Actual problems of hygiene and toxicology of pesticides based on glyphosate

Introduction. For several decades, glyphosate has been one of the most widely used herbicides in the world, but the safety of glyphosate and its commercial formulations is still controversial. Materials and methods. The parameters of acute oral and dermal toxicity of glyphosate in rats have been established. An irritant effect on the skin and mucous membranes of the eyes (rats, rabbits), a sensitizing effect on guinea pigs were studied. To establish the degree of damaging effect on the body during its long-term administration, there was made a study of the chronic effect of glyphosate acid and specially prepared soybeans at doses of 0, 0.15, 20, 200, 2000 and 20,000 ppm. The toxic effect was judged by changes in integral, hematological, biochemical and physiological parameters. After 12 months from the beginning of the experiment, pathomorphological studies of animals of all groups were performed. There was performed a complete necropsy of the bodies of rats. Results. Based on the results of the studies, the parameters of toxicity and hazard class were established, according to the hygienic classification of pesticides and agrochemicals (MP 1.2.0235-21 dated February 15, 2021) of glyphosate acid when exposed to the body of warm-blooded animals. Limitations. When setting the parameters of glyphosate acid toxicometry, the intragroup number of rats was 6-8 animals, depending on the tasks being solved, which is a sufficient reference sample. Conclusion. Based on studies performed on laboratory animals, the maximum inactive level (NOEL) of glyphosate is confirmed to be 100 mg/kg body weight, which corresponds to 2000 mg/kg feed (ppm). The foregoing indicates that the dose of 2000 ppm is much higher than the MRLs of glyphosate in soy at the level of 20 ppm (100 times) and 0.15 ppm (more than l3,000 times). Thus, it can be concluded that the maximum allowable level of glyphosate in soy of 20.0 mg/kg does not have a harmful effect and does not represent a real risk to the population.

Pulegone and Eugenol Oral Supplementation in Laboratory Animals: Results from Acute and Chronic Studies.

Essential oils are natural compounds used by humans for scientific purposes due to their wide range of properties. Eugenol is mostly present in clove oil, while pulegone is the main constituent of pennyroyal oil. To guarantee the safe use of eugenol and pulegone for both humans and animals, this study addressed, for the first time, the effects of these compounds, at low doses (chronic toxicity) and high doses (acute toxicity), in laboratory animals. Thirty-five FVB/n female mice were randomly assigned to seven groups (n = 5): group I (control, non-additive diet); group II (2.6 mg of eugenol + 2.6 mg of pulegone); group III (5.2 mg of eugenol + 5.2 mg of pulegone); group IV (7.8 mg of eugenol + 7.8 mg of pulegone); group V (7.8 mg of eugenol); group VI (7.8 mg of pulegone); and group VII (1000 mg of eugenol + 1000 mg of pulegone). The compounds were administered in the food. Groups I to VI were integrated into the chronic toxicity study, lasting 28 days, and group VII was used in the acute toxicity study, lasting 7 days. Animals were monitored to assess their general welfare. Water and food intake, as well as body weight, were recorded. On the 29th day, all animals were euthanized by an overdose of ketamine and xylazine, and a complete necropsy was performed. Blood samples were collected directly from the heart for microhematocrit and serum analysis, as well as for comet assay. Organs were collected, weighed, and fixed in formaldehyde for further histological analysis and enzymatic assay. Eugenol and pulegone induced behavioral changes in the animals, namely in the posture, hair appearance and grooming, and in mental status. These compounds also caused a decrease in the animals’ body weight, as well as in the food and water consumption. A mortality rate of 20% was registered in the acute toxicity group. Both compounds modulated the serum levels of triglycerides and alanine aminotransferase. Eugenol and pulegone induced genetic damage in all animals. Eugenol increased the activity of the CAT enzyme. Both compounds increased the GR enzyme at the highest dose. Moreover, pulegone administered as a single compound increased the activity of the GST enzyme. Histopathological analysis revealed inflammatory infiltrates in the lungs of groups II, III, and IV. The results suggest that eugenol and pulegone may exert beneficial or harmful effects, depending on the dose, and if applied alone or in combination.

A RETROSPECTIVE ANALYSIS OF MORBIDITY AND MORTALITY IN CAPTIVE BLUE-CROWNED LAUGHING THRUSHES (PTERORHINUS COURTOISI): 1998-2018.

The blue-crowned laughingthrush (BCLT) (Pterorhinus courtoisi) is a species of critically endangered passerine that is part of a Global Species Management Plan and experiences high mortality rates in some collections. Complete necropsy and medical records from 15 European institutions that housed BCLT between 1998 and 2018 were assessed to evaluate morbidity and mortality in the captive population. Medical records for 407 BCLT were received; a total of 191 morbidity events were recorded from 111 individual BCLT. The most common cause of morbidity was coccidial disease, including systemic isosporosis (30.4%, n = 58). Age was a significant factor contributing to mortality, with 53% of deaths occurring between 0 and 14 d old and 78% by 1 yr of age. The most common cause of death was trauma (22.8%, n = 31), followed by systemic isosporosis (22%, n = 30). Of the 343 deceased birds for which records were provided, 50.4% had a necropsy performed and 40.5% had histopathology carried out postmortem. Based on these findings, BCLT should be managed carefully to mitigate risk of trauma, and screening for isosporosis should be performed. Institutions should carry out standardized necropsies and histopathology on every BCLT that dies in their collection to elucidate the etiology of disease in this critically endangered species.

Causes of neonatal mortality using verbal autopsies in rural Southern Nepal, 2010-2017.

The burden of neonatal mortality remains high worldwide, particularly in South Asia. Verbal Autopsy is a method used to identify cause of death (COD) where vital registration capabilities are lacking. This study examines the causes of neonatal mortality in a large study population in rural Southern Nepal. The data used is from a larger cluster-randomized community-based trial. The study includes 984 neonatal deaths with complete verbal autopsy information which occurred between 2010 and 2017. The InterVA-5 software was used to identify COD. COD included severe infection (sepsis, pneumonia, meningitis/encephalitis), intrapartum related events (identified as birth asphyxia), congenital malformations, and other. The neonatal mortality rate was 31.2 neonatal deaths per 1000 live births. The causes of neonatal mortality were identified as prematurity (40%), intrapartum related events (35%), severe infection (19%), congenital abnormalities (4%), and other (2%). A high proportion, 42.5% of neonatal deaths occurred in the first 24 hours after birth. Over half (56.4%) of deaths occurred at home. This large prospective study identifies population level neonatal causes of death in rural Southern Nepal, which can contribute to national and regional COD estimates. Interventions to decrease neonatal mortality should focus on preventative measures and ensuring the delivery of high risk infants at a healthcare facility in the presence of a skilled birth attendant.

Challenges in Diagnosing COVID-19-Associated Pulmonary Aspergillosis in Critically Ill Patients: The Relationship between Case Definitions and Autoptic Data.

Critically ill COVID-19 patients can develop invasive pulmonary aspergillosis (CAPA). Considering the weaknesses of diagnostic tests/case definitions, as well as the results from autoptic studies, there is a debate on the real burden of aspergillosis in COVID-19 patients. We performed a retrospective observational study on mechanically ventilated critically ill COVID-19 patients in an intensive care unit (ICU). The primary objective was to determine the burden of CAPA by comparing clinical diagnosis (through case definitions/diagnostic algorithms) with autopsy results. Twenty patients out of 168 (11.9%) developed probable CAPA. Seven (35%) were females, and the median age was 66 [IQR 59–72] years. Thirteen CAPA patients (65%) died and, for six, an autopsy was performed providing a proven diagnosis in four cases. Histopathology findings suggest a focal pattern, rather than invasive and diffuse fungal disease, in the context of prominent viral pneumonia. In a cohort of mechanically ventilated patients with probable CAPA, by performing a high rate of complete autopsies, invasive aspergillosis was not always proven. It is still not clear whether aspergillosis is the major driver of mortality in patients with CAPA.

Partial hanging with multiple pesticide poisoning: A case report of a complex suicide

Compared to death by hanging, fatal cases due to pesticides intake with hanging is hardly seen. Here, we are reporting a rare case where the victim had used this combination to terminate his life as a complex suicide. The deceased was a 44-year-old man, who had ingested the pesticides and hung himself with nylon rope. A complete death investigation, including scene investigation and complete autopsy examination, was carried out. Autopsy report revealed the presence of greenish brown colour liquid with kerosene smell in stomach which was later confirmed by the chemical and instrument analysis with GC-MS as pestecides (Organophosphorus and Pyrethroid). The cause of death was although anti-mortem hanging but also due to the presence of massive amount of pesticides in visceral tissues, ingested by the victim. The method of death was more towards planned complex suicide. GC-MS Gas Chromatography-Mass Spectroscopy: Agilent 7890B GC with Mass Detector 5977A was used to analyze all the exhibits. The setting of the instrument is as described: Column- HP-5MS (30 M × 0.250 mm × 0.25 μ) Oven Temperature started from 100 °C for 1.5 min then rate of 7 °C/min till 300 °C for 10 min, Injection Temperature–280 °C, Injection volume–1 μL, Mode–Split, Carrier Gas–Helium, Flow Rate–70.9 ML/min., MSD parameters included EI tune type, temperature of MS source–300 °C, temperature of MS Quad- 150 °C, Start Mass-29.00 End Mass-400. Total run time for a cycle was 25 min. Mass spectral library:- National Institute of Standards and Technology (NIST). All exhibits and standard of Organophosphorus (Chlorpyrifos) and Pyrethroid (cypermethrin) were analysed by GC-MS after TLC. GC-MS analysis of exhibits showed by the peaks at Organophosphorus (Chlorpyrifos) RT 15.83.24 and Pyrethroid (cypermethrin) RT 27.75. No endogenous interference was observed during the determination of Organophosphorus and Pyrethroid. Hanging with poisoning are reported as the most complicated manner of suicide and the value of toxicological analysis should not be underestimated in these cases. This case further highlights the responsibility of various stake holders to ban highly hazardous pesticides. So, that it may not be used for of suicidal intent.

First Report on Abortion Caused by Salmonella enterica subsp. enterica Serovar Enteritidis in Water Buffalo (Bubalus bubalis).

Salmonella enterica subsp. enterica Serovar Enteritidis is one of the major pathogens associated with enteric diseases in animals and humans. Thus, due to the importance of Salmonella spp. infections for animal production and public health, the aim of the present study was to describe the first detection of S. enteritidis in an aborted water buffalo fetus in southern Italy by characterizing the phylogroup profile and the antimicrobial susceptibility of the isolated pathogenic strains. The different clinical manifestations of salmonellosis in animals include diarrhea, abortion, pneumonia, septic arthritis, meningitis, and others, depending on the virulence of the serovars, infectious dose, and host immunity. This study reports the first case of abortion caused by Salmonella enterica subsp enterica serovar Enteritidis in water buffalo (Bubalus bubalis) in the Campania region, southern Italy. Complete necropsy was performed on the aborted water buffalo fetus under study, and samples and swabs from different organs were collected. Samples were processed by microbiological and molecular analyses to detect bacterial, viral, and protozoarian pathogens possibly responsible for abortion. Whole genome sequencing (WGS) was carried out to further characterize the isolated S. Enteritidis strain. Our findings highlight the crucial role of S. Enteritidis as a potential abortive agent in water buffalo and its presence should therefore be investigated in cases of bubaline abortion.

The role of psychological autopsy in investigating a case of atypical suicide in schizophrenia: a case report with a brief review of literature

BackgroundSelf-harm typically is without lethal intent. Death can occur rarely, with suicide taking on an atypical form that raises the suspicion of hetero-aggression. Our study aimed to identify the link between self-harm and suicide intent and also to outline the positive diagnosis of an atypical suicide case which has raised the suspicion of hetero-aggression. For this purpose, the psychological autopsy method should be used regularly in suicide investigation because it not only allows a positive diagnosis of suicide but can also provide a detailed picture of mental degradation and associated suicide risk factors.Case presentationThe case of a 26-year-old man from a rural area, found dead in the basement, at home, naked, barricaded inside, is described.MethodsThe on-site investigation and a complete forensic autopsy were performed. In addition, we apply the psychological autopsy method which gathered enough information to outline the positive diagnosis of suicide. We also made a brief literature review on the suicide risk factors and the behavioral changes that occurred during the COVID-19 pandemic in schizophrenic patients.ResultsThe forensic autopsy revealed that he presented a complex craniofacial trauma as the cause of death (with scalp lacerations, frontal fracture, subarachnoid hemorrhage, and frontal cerebral contusions) associated with torso trauma (with self-inflicted stabbed wounds) with bruises and abrasions on the limbs. The injuries that caused death were self-inflicted and ensued repeatedly hitting his head against blunt objects. Using the psychological autopsy method, we found out that he presented multiple psychiatric hospitalizations for schizophrenia for almost 10 years, recently with reduced compliance to treatment. We also documented two previous suicide attempts and a gradual deterioration of his mental health.ConclusionsWe highlighted the role of the psychological autopsy (in addition to the judicial investigation and the forensic autopsy) for the diagnosis of committed suicide, for making a rigorous differential diagnosis between accident, hetero-aggression, and suicide, and also in pin-pointing the suicide risk factors.

Impact of winter savory extract (Satureja montana L.) on biochemical parameters in serum and oxidative status of liver with application of the principal component analysis in extraction solvent selection.

Satureja montana L. is traditionally used as spice and for treatment various diseases. Many studies have shown antioxidative effect of Satureja species. Our thorough study in an animal model was performed through measurement of biochemical parameters in the serum, histology analysis and determination of oxidative status of the liver, coupled with investigation of extraction solvent selection using principal component analysis (PCA). Winter savory dry extract (500 mg/kg) dispersion and saline solution were given to Wistar rats for 7 days after exposure to oxidative stress using toxic doses of paracetamol (600 mg/kg). Rats were sacrificed, after which a complete autopsy was performed, the blood obtained was used to determine biochemical parameters, and the liver was sliced for histological analysis and determination of oxidative stress enzymes. Indicators of hepatic and kidney functions, as well as the concentration of oxidative stress enzymes, were statistically significantly lower in animals treated with Satureja montana L. extract compared to the paracetamol group alone before the toxic dose of paracetamol. Liver enzymes were unaltered by pre-treatment with the extract, but the level of lipid peroxidase was decreased, and the level of catalase, glutathione reductase and superoxide dismutase increased proving in vivo antioxidant effect. In addition, the number of inflammatory cells is decreased coupled with activity of CYP2E1 enzymes proving hepatoprotective effect. Satureja montana L. extract in our research has shown hepatoprotective, anti-inflammatory and antioxidative effect. PCA analyses indicated that extraction mediums have a great impact on the antioxidative effect.

Descriptive autopsy of suicidal deaths resulting from alcohol intoxication in Kenya

This study sought to find out the magnitude of fatalities resulting from suicide and their relation to alcohol intoxication to inform public health policy on the need for their prevention. Materials were all the bodies that fulfilled the criteria of violent fatal outcomes between June 1 2009, and May 31 2010. Bodies were categorised by gender and divided into 10 age groups of 10 years each. A complete forensic autopsy examination was done on each. This is a prospective study of suicidal deaths in Nairobi from June 1, 2009, to May 31, 2010. The study was undertaken at the city Mortuary, Nairobi. All cases of suicidal deaths for twelve consecutive months were included. Alcohol level estimation was done on a total of 400 study subjects. The 400 were consecutively selected as every fifth subject. This was a purposeful sampling. Data was entered on a proforma datasheet. The study concluded that violent deaths are a preventable public health problem in Kenya. Suicide contributes to violent deaths, the commonest mode of committing suicide is hanging, and suicidal deaths in Kenya are associated with alcohol intoxication. The study recommends that substance abuse should be interrogated more as a cause of self-destruction.

MUTILATED AND SKELETONISED DEAD BODIES POSTMORTEM EXAMINATION: CHALLENGES AND NEED OF ADVANCED FORENSIC TECHNOLOGIES- A CASE SERIES

Introduction- Determination of the identity is the determination of the individuality of a person. According to the Universal Declaration of Human Rights, everyone has the right of recognition everywhere as a person before the law either living or dead [1]. Identication in living and dead can be established by various data and examination but in rare cases of mutilated bodies, dismembered body parts or skeletonised body its get difcult to establish identity and cause of death. Main purpose of this study is to establish identity of person in relation toAim of study- age and sex, to know the cause of death and to recover evidential material samples from the corpse which may help further in crime investigation and reconstruction of crime scene. Method and Methodology- We analysed postmortem examination done at Mortuary of S. N. Medical College, Agra of 2 different cases brought here for medicolegal autopsy to be conducted by a panel of doctors including one Forensic expert. Postmortem examination of burned, mutilated, decomposedResult and Conclusion- or skeletonised remains raises several questions. Complete autopsy examination including a dental examination is very benecial in these cases. In few cases even a small postmortem nding alone proves benecial to derive the cause of death but sometimes autopsy examination alone is insufcient in establishing identication particularly in skeletonised and mutilated corpses. In such cases, collobaration of recent advanced technologies like Forensic DNA analysis, Forensic imaging and Facial recognition techniques with Forensic medicine may open the doors of hope to extract best possible information helpful in crime investigation.