Cadaveric Research Articles

The Significance of Munjayadi Dravya in Mritasanrakshana Paddhati: A Scientific Exploration of Life-Preserving Elixirs

A well-preserved body is required for the dissection of a human cadaver in order to examine the entire body, which requires both theoretical and practical understanding of human anatomy. Modern science has developed a number of methods for preserving dead bodies, however Acharya Sushruta only cites one in Ayurveda. This method is known as the "Jalnimajjan Paddhati" of Mritsanrakshana. Numerous directions are given in this paddhati, and one of them mentions some of the munjayadi dravyas from which one dravya is employed to wrap the body. Attending paper is about studying the role of these dravyas in delaying the body decaying process. Each and every Munjayadi dravya contains tannin. Tannin has inherent anti-inflammatory, antiviral, antibacterial, and antifungal properties. Due to above properties tannins containing plants helps in delaying the process of decaying of dead body.

Graft survival after percutaneous transluminal renal stenting for transplant renal artery stenosis (TRAS) is worse compared to matched cadaveric grafts without TRAS

Objectives Transplant renal artery stenosis (TRAS) is now recognized as a curable disease with a good prognosis if intervention occurs in the early stage. However, the mid-term outcomes of TRAS when treated by percutaneous transluminal angioplasty with stent placement have yet to be fully elucidated. The purpose of this study was to compare mid-term graft and patient survival of TRAS group with a control group. Patients and methods Ninety-two patients were diagnosed of TRAS between January 2016 and January 2022 in our center. Fifty-six pairs of recipients with grafts from the same donor were selected as a study group with TRAS and a control group without TRAS, respectively. All donor kidneys were from deceased organ donation rather than living donors. The primary endpoints were graft and patient survival. The secondary outcomes were changes in renal graft function. Results The mean follow-up time for the TRAS group was 43.6 months, while the mean follow-up time for the control group was 45.3 months. In the TRAS group, the age of patients ranged from 11 to 62 years with 39 males and 17 females. In the control group, the age of patients ranged from 18 to 67 years with 40 males and 16 females. In the TRAS group, there were more patients with diabetic nephropathy as the primary renal disease compared to the control group (5/56 vs 0/56), and the incidence of acute rejection was higher in the TRAS group than in the control group (12/56 vs 3/56). Eight patients in the TRAS group and one patient in the control group experienced graft loss (p = .019). Four patients in the TRAS group and four patients in the control group died with functional renal allograft during the follow-up time (p = .989). The levels of eGFR did not differ significantly between the two groups in the first three years after kidney transplant (p > .05). Patients in the TRAS group had worse graft functionality (eGFR, 44.96 ± 18.9 vs 54.9 ± 19.6 mL/min) in the fourth year when compared with the control group (p = .01). Conclusions The graft function deteriorated faster, and graft survival was lower in the TRAS group treated by stent placement when compared with a control group without TRAS over the mid-term.

Re: Management of dead bodies of COVID-19 victims

Letter to editor

Southwestward Expansion of the Pacific Sleeper Shark's (Somniosus pacificus) Known Distribution into the South China Sea.

We conducted an experiment of planting a dead cow and a metal-framed cage with cameras on the 1629 m deep sea floor off the southeast coast of Hainan Island in the northwestern South China Sea, using ROV diving and setting up a video camera on the cage to observe animals who came to eat the bait. The deep-sea cameras captured footage of eight Pacific sleeper sharks (Somniosus pacificus) swimming and feeding around the dead cow. To our knowledge, this is the first time the occurrence of such a shark species has been reported in the South China Sea. Eight individuals were differentiated based on the characteristic differences displayed in the images, with lengths of 1.9 to 5.1 m estimated. The video camera also recorded the predators' behavior of tearing at the dead cow on the seabed. It was discovered that Pacific sleeper sharks are not strictly solitary and exhibit queue-feeding behavior. This study is significant as it documents a record of a data-scarce shark species, for which little information is available in the literature. It also documents an expansion of the species' known habitat from the north Pacific Ocean into the South China Sea. Such sharks diving into the deep sea to predate on dead animals also suggests that occurrences of large chunks of dead organic bodies falling onto the deep sea might have been more frequent than we previously thought in the South China Sea. The findings have implications for understanding the geographic connectivity of large swimming animals between the South China Sea and the Pacific Ocean and provide scientific evidence for formulating conservation and management strategies for sharks and other large animals in the oceans.

Insect herbivory on ferns from a midland Atlantic Rainforest locality, southern Brazil: implications for interpreting fossil plant–insect interaction

ABSTRACT This work contains the results of fern–arthropod interactions from a midland Atlantic Rainforest locality and addresses the taphonomic, morphological and ecological implications of insect damage on ferns to interpret them on fossil plant assemblages. Six functional feeding groups – margin feeding, hole feeding, surface feeding, piercing and sucking, mining and galling – are present on the three fern species inhabiting the understory of an Araucaria Forest in the Atlantic Forest biome, southern Brazil. We recognised 19 damage types (DTs), including 14 arthropod-induced DTs, three of which are newly proposed herein. Five of the DTs found were first recorded on ferns. Of the DTs found, the proportion of guilds such as mining and galling shows a significant similarity with those of an upland locality. Products of arachnids and insect behaviour on ferns made up 25% of all fern–arthropod interactions in the midland locality, which included dead bodies and byproducts from processes of arthropod life cycle, which are unlikely to be preserved in the fossil record. This rate of arthropod products consists of significant evidence of interactions to unveil deep-time relationships between arthropods and plants. Lastly, leaf damage on living ferns is more frequent than those occurring in fossil plant assemblages.

Accuracy of automated forensic dental age estimation lab (F-DentEst Lab) on large Malaysian dataset

When a disaster occurs, the authority must prioritise two things. First, the search and rescue of lives, and second, the identification and management of deceased individuals. However, with thousands of dead bodies to be individually identified in mass disasters, forensic teams face challenges such as long working hours resulting in a delayed identification process and a public health concern caused by the decomposition of the body. Using dental panoramic imaging, teeth have been used in forensics as a physical marker to estimate the age of an individual. Traditionally, dental age estimation has been performed manually by experts. Although the procedure is fairly simple, the large number of victims and the limited amount of time available to complete the assessment during large-scale disasters make forensic work even more challenging. The emergence of artificial intelligence (AI) in the fields of medicine and dentistry has led to the suggestion of automating the current process as an alternative to the conventional method. This study aims to test the accuracy and performance of the developed deep convolutional neural network system for age estimation in large, out-of-sample Malaysian children dataset using digital dental panoramic imaging. Forensic Dental Estimation Lab (F-DentEst Lab) is a computer application developed to perform the dental age estimation digitally. The introduction of this system is to improve the conventional method of age estimation that significantly increase the efficiency of the age estimation process based on the AI approach. A total number of one-thousand-eight-hundred-and-ninety-two digital dental panoramic images were retrospectively collected to test the F-DentEst Lab. Data training, validation, and testing have been conducted in the early stage of the development of F-DentEst Lab, where the allocation involved 80 % training and the remaining 20 % for testing. The methodology was comprised of four major steps: image preprocessing, which adheres to the inclusion criteria for panoramic dental imaging, segmentation, and classification of mandibular premolars using the Dynamic Programming-Active Contour (DP-AC) method and Deep Convolutional Neural Network (DCNN), respectively, and statistical analysis. The suggested DCNN approach underestimated chronological age with a small ME of 0.03 and 0.05 for females and males, respectively.

Lot quality assurance sampling survey for water, sanitation and hygiene monitoring and evidence-based advocacy in Bentiu IDP camp, South Sudan.

Every year, 60% of deaths from diarrhoeal disease occur in low and middle-income countries due to inadequate water, sanitation, and hygiene. In these countries, diarrhoeal diseases are the second leading cause of death in children under five, excluding neonatal deaths. The approximately 100,000 people residing in the Bentiu Internally Displaced Population (IDP) camp in South Sudan have previously experienced water, sanitation, and hygiene outbreaks, including an ongoing Hepatitis E outbreak in 2021. This study aimed to assess the gaps in Water, Sanitation, and Hygiene (WASH), prioritise areas for intervention, and advocate for the improvement of WASH services based on the findings. A cross-sectional lot quality assurance sampling (LQAS) survey was conducted in ninety-five households to collect data on water, sanitation, and hygiene (WASH) coverage performance across five sectors. Nineteen households were allocated to each sector, referred to as supervision areas in LQAS surveys. Probability proportional to size sampling was used to determine the number of households to sample in each sector block selected using a geographic positioning system. One adult respondent, familiar with the household, was chosen to answer WASH-related questions, and one child under the age of five was selected through a lottery method to assess the prevalence of WASH-related disease morbidities in the previous two weeks. The data were collected using the KoBoCollect mobile application. Data analysis was conducted using R statistical software and a generic LQAS Excel analyser. Crude values, weighted averages, and 95% confidence intervals were calculated for each indicator. Target coverage benchmarks set by program managers and WASH guidelines were used to classify the performance of each indicator. The LQAS survey revealed that five out of 13 clean water supply indicators, eight out of 10 hygiene and sanitation indicators, and two out of four health indicators did not meet the target coverage. Regarding the clean water supply indicators, 68.9% (95% CI 60.8%-77.1%) of households reported having water available six days a week, while 37% (95% CI 27%-46%) had water containers in adequate condition. For the hygiene and sanitation indicators, 17.9% (95% CI 10.9%-24.8%) of households had handwashing points in their living area, 66.8% (95% CI 49%-84.6%) had their own jug for cleansing after defaecation, and 26.4% (95% CI 17.4%-35.3%) of households had one piece of soap. More than 40% of households wash dead bodies at funerals and wash their hands in a shared bowl. Households with sanitary facilities at an acceptable level were 22.8% (95% CI 15.6%-30.1%), while 13.2% (95% CI 6.6%-19.9%) of households had functioning handwashing points at the latrines. Over the previous two weeks, 57.9% (95% CI 49.6-69.7%) of households reported no diarrhoea, and 71.3% (95% CI 62.1%-80.6%) reported no eye infections among children under five. The camp's hygiene and sanitation situation necessitated immediate intervention to halt the hepatitis E outbreak and prevent further WASH-related outbreaks and health issues. The LQAS findings were employed to advocate for interventions addressing the WASH gaps, resulting in WASH and health actors stepping in.

‘A distressing scene’? The corpse in the nineteenth-century working-class home

ABSTRACT When Edwin Chadwick released his report into burial reform in 1843 he was highly critical of the working-class practice of keeping the dead body in the home for up to a week in the period between death and burial. Chadwick argued that the English working-classes kept the body for so long for economic reasons and that as a result of living in close quarters with a corpse they picked up negative associations with death and suffered moral decline. This paper overturns this assumption by using evidence from nineteenth-century folklore collections and working-class autobiography to argue that the long-standing tradition of keeping the body in the home and rallying round to prepare it for burial held a deep significance for rural working-class people. The gradual preparation of the body for burial engaged the senses and centred on the visual appearance of the corpse enabling rural folk to confirm social bonds through the formation of collective memories, demonstrate the respectability of both the deceased and their family, accept the reality of death, and begin the mourning process.

Prevention and control of Ebola virus transmission: mathematical modelling and data fitting.

The Ebola virus disease (EVD) has been endemic since 1976, and the case fatality rate is extremely high. EVD is spread by infected animals, symptomatic individuals, dead bodies, and contaminated environment. In this paper, we formulate an EVD model with four transmission modes and a time delay describing the incubation period. Through dynamical analysis, we verify the importance of blocking the infection source of infected animals. We get the basic reproduction number without considering the infection source of infected animals. And, it is proven that the model has a globally attractive disease-free equilibrium when the basic reproduction number is less than unity; the disease eventually becomes endemic when the basic reproduction number is greater than unity. Taking the EVD epidemic in Sierra Leone in 2014-2016 as an example, we complete the data fitting by combining the effect of the media to obtain the unknown parameters, the basic reproduction number and its time-varying reproduction number. It is shown by parameter sensitivity analysis that the contact rate and the removal rate of infected group have the greatest influence on the prevalence of the disease. And, the disease-controlling thresholds of these two parameters are obtained. In addition, according to the existing vaccination strategy, only the inoculation ratio in high-risk areas is greater than 0.4, the effective reproduction number can be less than unity. And, the earlier the vaccination time, the greater the inoculation ratio, and the faster the disease can be controlled.

Harmonizing Definitions and Perspectives in Extreme Liver Surgery

Objective: To propose to our community a common language about extreme liver surgery. Background: The lack of a clear definition of extreme liver surgery prevents convincing comparisons of results among centers. Methods: We used a two-round Delphi methodology to quantify consensus among liver surgery experts. For inclusion in the final recommendations, we established a consensus when the positive responses (agree and totally agree) exceeded 70%. The study steering group summarized and reported the recommendations. In general, a five-point Likert scale with a neutral central value was used, and in a few cases multiple choices. Results are displayed as numbers and percentages. Results: A two-round Delphi study was completed by 38 expert surgeons in complex hepatobiliary surgery. The surgeon´s median age was 58 years old (52-63) and the median years of experience was 25 years (20-31). For the proposed definitions of total vascular occlusion, hepatic flow occlusion and inferior vein occlusion, the degree of agreement was 97%, 81% and 84%, respectively. In situ approach (64%) was the preferred, followed by ante situ (22%) and ex situ (14%). Autologous or cadaveric graft for hepatic artery or hepatic vein repair were the most recommended (89%). The use of veno-venous bypass or portocaval shunt revealed the divergence depending on the case. Overall, 75% of the experts agreed with the proposed definition for extreme liver surgery. Conclusion: Obtaining a consensus on the definition of extreme liver surgery is essential to guarantee the correct management of patients with highly complex hepatobiliary oncological disease. The management of candidates for extreme liver surgery involves comprehensive care ranging from adequate patient selection to the appropriate surgical strategy.

The Use of Deconstructive Parody in Muriel Spark’s Novel Not to Disturb

The prolific British-Scottish novelist Muriel Spark depicts the plight of the owners of a Gothic-style chateau in Geneva, the Baron and Baroness Klopstock, and their servants in her purposefully brief and infinitely suggestive novel Not to Disturb (1971). The approaching tragedy that will encompass the deaths of Klopstocks and Victor, their secretary and lover, is something the butler Lister is bracing himself for. Servants of the chateau are not permitted to bother these three captives who are detained in the library for the night. While the servants are the ones who planned the murder with the intention of inheriting a fortune, due to the expectant housemaid Heloise’s marriage to the lunatic and sole heir to Klopstock’s fortune residing in the attic, they nevertheless seem to be shocked and saddened by the discovery of three dead bodies the following morning. This paper argues that Not to Disturb, in this sense, offers a brilliant deconstructive parody of the Gothic novel and Jacobean drama genres by dissecting their essential elements, cliches, and traditions and then reincorporating them into the story in a whole new twentieth-century self-reflexive light.

Spectrophotometric evaluation of postmortem lividity: a proposal of a model for negroid ethnic race.

The interpretation of tanatochronological data is a fundamental aspect of the medico legal diagnosis, because it allows to trace back the interval of death. Traditionally, the evaluation of the hypostasis plays a relevant role in the interpretation of such information, despite its well-known limits and fallacies. In order to evaluate the degree of hypostatic area discoloration, the methodology currently used is highly subjective and influenced by several variables. The hypostasis pattern in individuals with V-VI phototype is useless because their post-mortem lividity is not estimable due to the color of the skin. This makes much harder to estimate the interval between the death and the detection of the tanatochronological data. This study is aimed at defining a highly accurate procedure to develop an objective method to estimate the hypostasis' degree of fixation with scientific accuracy on people with darker skin. The technology used is spectrophotometry Antera3D: this device is able to analyse the hypostasis by measuring the mean hemoglobin quantitative level in the skin either before and after a standardized compression, thus obtaining a numerical value that is directly related to the time of death. The method here presented allows analysing the hemoglobin amount in the skin of a dead body, without the influence of the melanin pigment in the definition of the hypostatic area color, therefore enabling us to overcome the objective limits of the direct and empiric estimation of the hypostasis decoloration. By creating a standardized method it's possible to reduce the operator-dependent error and to introduce a valid and applicable procedure in order to estimate the post-mortem interval.

Oxidative stress and NF-KB/iNOS inflammatory pathway as innovative biomarkers for diagnosis of drowning and differentiating it from postmortem submersion in both fresh and saltwater in rats

BackgroundFinding a dead body in water raises an issue concerning determining the cause of death as drowning because of the complex pathophysiology of drowning. In addition, the corpse may be submersed postmortem.ObjectiveEvaluate the role of oxidative stress markers and NF-KB/iNOS inflammatory pathway as diagnostic biomarkers in drowning and whether they could differentiate freshwater from saltwater drowning.MethodsThis study included forty-five adult male albino rats classified into five groups: control group (C), Freshwater-drowned group (FD), Freshwater postmortem submersion group (FPS), saltwater-drowned group (SD), and saltwater postmortem submersion group (SPS). After the autopsy, the rats' lungs in each group were prepared for histological, immunohistochemical (caspase 3, TNF-α, NF-kB, COX-2 & iNOS), biochemical studies; MDA, NOx, SOD, GSH, VCAM-1, COX-2; and RT-PCR for the relative quantification of NF-kB and iNOS genes expression.ResultsLung oxidative markers were significantly affected in drowned groups than in postmortem submersion groups. Inflammatory pathway markers were also significantly increased in the drowned groups, with concern that all markers were significantly affected more in saltwater than in freshwater drowned group.ConclusionsIt is concluded that the tested markers can be used accurately in diagnosing drowning and differentiating it from postmortem submersion with a better understanding of the mechanism of death in drowning as both mechanisms, inflammatory and oxidative stress, were revealed and involved.

Vom innerjüdischen Appell zur öffentlichen Kampagne. Joel Bril Löwes Sendschreiben an die Brüderschaften und der Beerdigungsfristenstreit in Breslau, 1793–1800

Abstract The danger of burying only apparently dead bodies when following the Jewish custom to bury the deceased within a day was a hotly debated topic in the eighteenth century. Joel Bril Löwe participated in this debate with an open letter to the burial brotherhoods of all Jewish communities. The article reconstructs the dispute between the traditionalists, who argued for the Jewish custom of immediate burial, and the modernizers, who argued for its abandonment. Despite Löwe’s efforts to mediate between the fronts and to convince everyone to allow three days until the funeral were not successful, the dispute escalated, particularly in Breslau. In a number of German and Hebrew journals, Jewish supporters of the three-day limit ran campaigns, some of them rather aggressive, which led to the founding of new burial societies and attracted the attention of the Prussian authorities. The practice of early burial could only be brought to an end by state order.

Animal attack, concocted for monetary benefits: A case report.

Injuries from animal attacks usually occur when animals feel provoked, surprised or threatened. They may range from minor bruises and contusions to deep extensive injuries caused by biting, kicking or trampling, etc. The scenario differs from animal to animal and between species; by comparing the pattern of injuries it may be possible to work out the animal involved. We present a case where a story of an animal attack was conceived for monetary benefits. Determining the circumstances surrounding death may not be possible in all post-mortem cases but a medical examiner should strive to elicit as much information as possible from the dead body.

Farewell to the Young: Early Iron Age Mortuary Practices in the Middle Danube Region

ABSTRACT The study of burials and mortuary practices in the past provides essential information on the role and treatment of children in past communities. This study aims to better understand the status of children by reviewing the material culture provided by child burial contexts. Early Iron Age (800–300 BC) mortuary practices in the southern Middle Danube (present–day eastern Croatia and northwestern Serbia) are characterized mostly by the cremation of the dead. The Iron Age is an important time for funerary transitions. The standard practice of cremating the dead was replaced by the practice of inhumation during the 6th century BC. The manner of treatment of the dead body affected the preservation of objects and data in the graves. This paper studies 74 burials with child remains, costumes, jewellery, tool items, and pottery grave goods. In Early Iron Age mortuary practices, children were treated just like the adult members of the community.

Undiagnosed, uncomplicated foreign body in abdominal cavity – A case of medical negligence

When a retained surgical foreign body occurs, it poses significant risks to patients, potentially resulting in life-threatening complications. This paper presents the case report of dead body of a female of about 32 years of age brought for medicolegal post-mortem examination with a history of sudden death. Internal examinations revealed adhesion present around the right ovary, right fallopian tube, ceacum, omentum and large intestine with 100 ml free fluid in abdominal cavity. On careful blunt dissection of adhesion, a gauze piece was observed in the abdomen cavity that too is having firmly adherent to the surrounding organs. On removing it was of size 29 × 15 cm, yellowish - white in color. This underscores the need for continuous vigilance and adherence to established counting procedures throughout the surgical process to minimize the risk of such adverse events. Excellent communication among surgeons, nurses, and anesthetists during the procedure is key to success.

An Assessment of Death Profile of Unknown Dead Bodies, Brought for Autopsy to the Department of Forensic Medicine and Toxicology in Government Medical College of Garhwal Region, Uttarakhand: A Retrospective Study

Background:an unknown dead body always becomes a challenge to the Investigating officer and forensic expert. However, the problem of determining the identity gets aggravated and taxes for the experts, when the dead body is recovered in decomposed/ skeletonized and mutilated form. Materials and Methods: A standard proforma was designed to collect the information to ensureconsistency for the whole sample. All dead bodies that were brought as unidentified were included however identified dead bodies were excluded from the study. Results:A total of 407 post-mortem examinations were conducted at the mortuary of the department during under study and amongst them, 56 cases (13.75%) were found unidentified. Of these unidentified cases, 69.64% (39 cases) were in decomposed and 30.35% (17 cases) were in fresh state. Unidentified cases comprised 80.35% males (45 cases) and 19.64% females (11 cases). Conclusion:Unidentified dead bodies were only 13.75% of the total dead bodies coming to the autopsy in the mortuary of the Department of Forensic Medicine and Toxicology, VCSGGIMS & R, Srikot, Srinagar, Pauri Garhwal, UTTARAKHAND during the study period of 5 years.

Estimating Time Since Death From Post Mortem Lividity: An Autopsy Study Conducted in Government Medical College and Ssg Hospital ofCentral Gujarat State of India

Background: Evaluation and estimation of time since death is a fundamental part of medico-legal investigations. Post mortem lividity or post-mortem staining is a bluish or reddish-purple discoloration due to capillo-venous distension with blood, at the under surface of the skin on the dependant parts of the body, as a result of settling of blood in those areas following pulling by gravity, after circulation of the blood in motion ceases. A study was conducted in the department of forensic medicine, GovernmentMedical College and SSG hospital, Vadodara to evaluate time since death by method of studying post mortem lividity. This was prospective and observational study conducted on 256 dead bodies brought for post mortem examination from November 2021 to August 2022. It was observed that the Post mortem Lividity starts appearing as a patchy form by 1-7 hours and well develops by 7-13 hours. Post mortem Lividity gets fixed by 8-18 hours following death. It was concluded that compared to other methods, the post mortem lividity assessment can be used as the most conventional, easy and quicker method for estimating time since death

Morphological Parameters of Gallbladder are Correlated with Age

Introduction: Gallbladder issues are prevalent globally, particularly in Bangladesh, and become more common with age. Diagnosis involves clinical assessment and confirmation through noninvasive and invasive methods. Understanding gallbladder features is crucial for effective investigation, diagnosis, and management. Objectives: To find out relation between morphological parameters of human gallbladder with age. Materials and Methods: This cross-sectional descriptive study was conducted in the Department of Anatomy in collaboration with the Department of Forensic Medicine, Sylhet MAG Osmani Medical College, Sylhet from January 2014 to December 2014. Fifty human postmortem gallbladders were selected. Dead bodies autopsied within 36 hours of death. Considerable signs of decomposition or decomposed dead body, presence of gross gallbladder disease and any history of poisoning cases were excluded. All the specimens were examined to detect the length, breadth, weight and thickness of the gallbladder; and length and diameter of cystic duct. Results: The study included cadavers ranging in age from 11 to 55 years, with a mean age of 35.02 ± 19.98 years. Of the total, 29 (58.0%) were male, and 21 (42.0%) were female. The length and thickness of the gallbladder increased significantly with age, as did the length and diameter of the cystic duct. But the weight and breadth also change with age, although not significantly. Conclusion: The length and thickness of the gallbladder; the length and diameter of the cystic duct were varied with age; but no variation in weight and breadth. Medicine Today 2023 Vol.36 (1): 31-35