Department Of Forensic Medicine Research Articles

Anatomical variations and embryological basis of arch of aorta and aortic valve.

Variations in the arch of the aorta and aortic valves among fetal, cadaveric, and post-mortem specimens present a spectrum of anatomical configurations, posing challenges in establishing a standard norm. While some variations hold surgical significance, many bear little functional consequence but provide insights into embryological origins. The aortic arch exhibits diverse branching patterns, including common trunks and different orders, relevant for endovascular surgeries. Meanwhile, malformations in the aortic valve, affecting the aorta, may lead to ischemia and cerebral infarction, warranting understanding of coexisting arch and valve anomalies to predict complications like aortic dissection. Studies in the Indian population mirror global variations, underscoring the need to explore embryological, clinical, and surgical implications for safer vascular surgeries involving the aortic arch and valves. The study's objectives included examining branching patterns, diameters, and distances between arch branches and exploring aortic valve variations. Employing a cross-sectional design, the study was conducted across Anatomy, Forensic Medicine, and Obstetrics and Gynecology departments. A sample of 100, comprising cadavers, fetuses, and postmortem specimens, were gathered. Specimens ranged from 14weeks of intrauterine life to 85years, with intact thoracic cages as inclusion criteria. Methodology involved dissection, specimen fixation, and macroscopic examination for variations and morphological parameters. Results showed aortic diameter increase with age, with significant gender differences. A statistically significant association between arch variations and anomalous valves was observed, suggesting mutual predictability. Individuals with valve anomalies should undergo comprehensive cardiology evaluation to avert complications like aortic dissection during endovascular surgeries. While atheromatous plaques were prevalent in younger groups, their frequency rose with age, necessitating vigilant vascular monitoring. Careful handling during surgeries is paramount, given potential adverse outcomes resulting from variations. Overall, the study underscores the importance of comprehensive anatomical understanding in clinical contexts, guiding effective management strategies and ensuring patient safety in vascular surgeries.

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

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.

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

Analysis of injuries in aircraft accident victims in 2002–2022 based on the resources of the Jagiellonian University Department of Forensic Medicine in Kraków = Analiza obrażeń ofiar katastrof lotniczych w latach 2002–2022 na podstawie danych pochodzących z materiałów Zakładu Medycyny Sądowej Uniwersytetu Jagiellońskiego w Krakowie

Aim: The study aimed to analyse the most common injuries of victims of aviation accidents and compare it with the most recent literature. Methods and materials: Retrospective analysis of autopsy protocols of aircraft crash victims from the Forensic Medicine Department from years 2002–2022. The case selection has been made by two independent researchers. After applying the exclusion criteria 27 cases were obtained. Further searched for features that the bodies of victims had in common. There were analysed sex, age, circumstances of the incident, injuries, presence of psychoactive substances (alcohol, drugs), and blood concentration of carboxyhemoglobin. Results: Among 27 cases we found 19 airplane crashes, 4 glider accidents, 3 motor glider accidents, and one helicopter crash. The 1 case had no information about the type of aircraft. The injuries that emerged in each of the victims were typical results of direct impact forces. The most common were rupture of the lungs 63.0 % (n = 17/27), heart 55.6% (n = 15/27), liver 51.9% (n = 14/27), aorta 40.7% (n = 11/27) and spleen 29.6% (n = 8/27). Common bone traumas included fractures of the ribs 77.8% (n = 21/27) upper limbs 77.8% (n = 21/27), skull 74.1% (n = 20/27), pelvis 59.3% (n = 16/27) and spine 51.9% (n = 14/27). Injuries of the cervical spine occurred in victims who violently tilted their heads back. Conclusions: In most cases, the immediate cause of death was extensive multi-organ injuries, followed by thermal burns or brain injuries. In almost half of the victims, the presence of carboxyhemoglobin in the blood indicates that they were alive during the crashes. Knowledge of injury patterns can improve aviation safety and guide in reconstructing the mechanisms and sequences of the accidents.

Comparative analysis of unnatural deaths in Faisalabad during 2018-2022 – A raising trend.

Objective: To assess the pattern of unnatural deaths in Faisalabad during the last five years, to determine the gender and age group mostly affected and to explore the increasing trend if any. Study Design: Retrospective Cross-sectional Descriptive study. Setting: Department of Forensic Medicine and Toxicology, Punjab Medical College, Faisalabad. Period: January 2018 to December 2022. Methods: Subjects of the study were victims of unnatural death in areas covered by Police stations where the postmortem was performed in the Mortuary of Punjab Medical College / Faisalabad Medical University. Data was collected from respective official Police records, FIRs and Postmortem reports and recorded on pre-structured proformas. It was categorized on the basis of manner of death, type of weapon involved, age groups involved and gender. Results: Out of a total of 1340 autopsies conducted, 1024(76.4%) were males and 316(23.6%) were females. The male to female ratio was 3.2:1. Majority of the victims belonged to the 30–39-year age group i.e. 338 (25.2%) followed by the 20-29-year age group with 333 (24.8%) cases. The manner of death was homicidal in 896(67%) cases followed by 320(24%) accidental and 77(6%) of suicide. Firearm was the most commonly used weapon claiming 490 (36.6%) lives followed by RTA with 254 (19%) cases. September was the month in which maximum cases were reported (140,10.4%). Conclusion: Males are the major victims of unnatural deaths, with firearm weapons claiming the majority of lives. There is a rising trend in the number of unnatural deaths as the years go by and strict measures need to be implemented to keep a check and balance on the availability and easy access to firearms and strict traffic rules should be implemented.

Vulva lesions seen at a tertiary health centre in southwest Nigeria

Background: Some researchers have emphasised the need for more studies on vulvar cancers. The aim of our study is to describe the vulvar lesions identified in biopsies seen in our department over a five-year period to serve as baseline data for future studies. Methods: We conducted a five-year cross-sectional study on all vulva specimens received by the department of Morbid Anatomy and Forensic medicine at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria. From the departmental records, we retrieved data on the patients' biodata, medical history, and vulva lesion diagnosis. Results: We recorded 15 vulva biopsies during the study period, with an age range of 13 to 80 years. Two cases were benign tumours, and two cases were inflammatory in nature. A case of a pre-malignant lesion was seen. Nine cases were malignant tumours, all of which are epithelial in origin. We saw two non-neoplastic lesions. These are acute on chronic inflammation and lichen sclerosus et atrophicus. Of the malignant tumours seen, five were well-differentiated squamous cell carcinoma (SCC), two were moderately differentiated SCC, and two were cases of verrucous carcinoma. One case of verrucous carcinoma and a well-differentiated SCC had a background HIV. Conclusion: Vulva lesions are rarely seen at our centre. The absence of preinvasive lesions in our study may be due to the late presentation of cases in clinics or the reluctance of gynaecologists to take biopsies of non-tumoral lesions of the vulva. HIV may be associated with an increased risk of HPV-related cancers.

Violence-Related Injuries: The Most Common Cases in Hyderabad, Pakistan

The law influences every aspect of human activity, including medical practice. The nature of casualty is affected by geographical regions, cultures, and social values. Determining characteristics of casualty can guide health policy and can assist in managing healthcare resources. Objective: To profile the cases at casualty department of a tertiary teaching hospital. Methods: The study was conducted at the casualty department of Liaquat University Hospital Hyderabad, Pakistan and Department of Forensic Medicine & Toxicology LUMHS, Jamshoro, over a period of one year from January 2021 to December 2021. A total of 3,487 cases were recorded and categorized into violence-related, transportation-related, substance-related, and sexual assault-related injuries. Results: The majority of cases were violence-related incidents (84.65%), followed by transportation-related accidents (14.65%), substance-related injuries (3.61%), and sexual assault-related injuries (0.69%). Violence-related injuries were divided into assault cases, firearm incidents, and police torture. Transportation-related injuries were categorized as road traffic accidents and train accidents. Assault and road traffic accidents were the leading cause of violence-related and transportation-related injuries, respectively. The highest numbers of cases were observed in April, June, and May. Conclusions: A substantial portion of cases at casualty department of Liaquat University Hospital, Hyderabad is contributed by violence-related injuries

Enhanced autopsy triage (EA-Triage) in drug-related deaths: integrating quick toxicological analysis and postmortem computed tomography.

The objective was to assess the diagnostic accuracy of an enhanced autopsy triage (EA-Triage) setup consisting of postmortem computed tomography (PMCT), simulated quick toxicological analysis (sQTA), external examination, and case information in determining cause of death (COD) in persons with past or current use of illegal drugs (drug-related deaths). Information on drug-related deaths selected for medico-legal autopsy in 2020-2021 at the Department of Forensic Medicine, Aarhus University, Denmark, was analyzed retrospectively. The included cases underwent conventional autopsy, PMCT, and systematic toxicological analysis. A board-certified forensic pathologist, who was blinded to the internal examination and COD from the medico-legal autopsy, determined COD based on the EA-Triage setup. 154 cases with a median age of 40.6 years (range 17-70 years, 82% males) were included. The COD determined by medico-legal autopsy and that determined by EA-Triage matched in 113 cases (73%), including those with an unknown COD. EA-Triage and medico-legal autopsy determined unknown COD in 45 (29%) and 5 cases (3%), respectively. Excluding cases with an unknown COD, EA-Triage predicted COD in 109 cases (71%); of those, 72 (66%) had no unexplained case circumstances or suspicion of a criminal act. In these 72 cases, the CODs determined by EA-Triage and medico-legal autopsy matched in 71 cases (99%), and the sensitivity and specificity for detecting lethal intoxication were 100% and 90%, respectively. EA-Triage showed strong diagnostic accuracy for determining COD in drug-related deaths. This method may be suitable for enhancing preautopsy triage and guiding police investigations at an early stage.

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

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

A Study of Death Due to Railway Accidents: An Autopsy Based Cross Sectional Study Conducted in a Tertiary Care Hospital

A train accident is defined as “Collision, Derailment, or any other event involving the operation of n- track equipment”. To estimate the pattern of injuries in Railway Accidents and to estimate the Cause of death and Manner of death in Railway Accidents. The present study is conducted in Department of Forensic Medicine, Government Stanley Medical College from January 2020 to December 2020 in all the cases of Railway Accidents subjected to postmortem examination. During the study period, 61 cases were subjected for autopsy, the most common age group is 20 to 40 years. The most commonly injured organ is Brain followed by Liver and most of them died within 12 to 24 hours prior to post mortem examination. The railway fatalities were more of accidental in nature, less frequently suicidal and rarely homicidal. Internal organs commonly involved Brain followed by spinal cord, liver etc., It is also found that injuries to the upper half of the body are more common when compared to that of lower half of the body. The most common cause of death was hemorrhage shock from Multiple injuries, followed by Head injury, Thoracic injury, and Abdominal injury.

Relationship Between Menstrual Cycle and Suicide Based on Histo-Pathological Study of Cadaver Uterus in a Tertiary Care Center, South India

Suicide is a global health concern. The risk of suicide is more in females compared to males. Reproductive health related factors are the major reason for this increasing risk. The aim of the study is to find out the relationship between menstruation and suicide and to find out if there is any relationship exists between any of the other phases of menstrual cycle and suicidal behaviour. Hospital based cross sectional study was conducted in the Department of Forensic Medicine, Government Medical College, Thrissur which is a tertiary care centre . The study was done for a period of one year, from August 2015 to July 2016. The final sample size attained i.e the uterus specimens of reproductive age group during the study period is 100. Thus 50 were taken as cases and the other 50 who died of any other cause other than suicide were taken as control. Majority of the study participants belongs to 20 years of age group among cases. Most of our study participants were married in our study, majority of the study participants were above poverty line, no specific history of motivation towards suicide was found in majority of the study participants followed by psychiatric problems and family problems. Hanging was the most common method used for suicide. Among the cases majority of the study participants were in the late proliferative phase. In our study majority of the study participants committed suicide in the early proliferative phase.

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

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

A Research Study on Histopathological Changes that are Seen in Lungs of Victims Who Died of Drowning

Drowning is considered to be the leading cause of death in water and the third most common cause of accidental death worldwide, with the highest drowning rates in developing countries. The WHO defines drowning as the process of experiencing respiratory impairment from submersion/immersion in liquid. For forensic experts, death in water is a multifaceted issue presenting a challenge to them. Since all the circumstances from natural death to homicide are possible in the water, critical examination and interpretation of all abnormal findings found during autopsy are of great importance.Drowning is a diagnosis of exclusion, based on ruling out all other causes of death via complete autopsy and toxicology. Drowning causes hypoxemia, loss of consciousness, apnea and ultimately cardiac arrest. Fluid aspiration results in lung injury and acute respiratory distress syndrome. Acute Respiratory Failure is the main component of drowning pathophysiology. Near drowning results in multiple complications including aspiration pneumonia which is often life-threatening. Hence the histopathological changes in the lungs provide good corroborative evidence of death due to drowning. Nevertheless, for the examined drowning signs, no high diagnostic certainty could be observed. However, these findings can increase their diagnostic value if forensic doctors take influencing factors into consideration.From the central record section of the Department of Forensic Medicine, Siddhartha Medical College, Vijayawada, Andhra Pradesh, about 80 medicolegal postmortem reports of death due to drowning in undecomposed bodies were selected in which one whole lung was sent for histopathological examination during the past two years i.e, 2020 - 2022. Parameters like Age, Sex and Marital Status were also studied. Histopathological examination of drowned lungs showed that congestion was seen in 92% of cases, oedema in 96% cases, dilatation of alveoli in 86% of cases, thinning of septa was seen in 84% of cases rupture of alveoli seen in 64% of cases and hemorrhage is seen in 46% of cases. Mostly males are affected and drowning deaths are seen more in 26 – 40 years age group. The histopathological investigations must be performed on all the organs of non-putrefied bodies with the aim of making the difference between death by drowning and other causes of death. The lung examinations can show over-distension of the alveoli, thinning of the alveolar septa and compression with narrowing of the capillary network.

Study of Postmortem Pericardial Fluid Concentrations of Troponin T (cTnT) in Sudden Natural Death

Background: Cardiovascular diseases are the most common cause of sudden natural deaths. Cardiac troponin T is a specific biochemical marker of myocardial injury. It may help in diagnosis of early myocardial ischemia when macroscopic or microscopic evidence of necrosis is not available after autopsy. Aim of this study was to assess the effectiveness of pericardial fluid troponin T in predicting the cause of death in sudden natural death and in estimating the post mortem interval. Materials and methods: It was a pilot study. Sudden natural deaths brought to Forensic Medicine department of GMCH Nagpur for autopsy were included in this observational cross sectional study. Deaths were grouped into cardiac and non cardiac deaths. Pericardial fluid samples were collected by opening pericardial sac with sterile syringe and processed on Roche Cobas e411 autoanalyzer for estimation of levels of Troponin T. Results: There was a statistically significant difference seen for the values between the groups (p<0.05) for Trop-T (ng/ml) with higher values in Cardiac cause. There was a statistically non significant correlation between postmortem interval vs Trop T (p>0.05). Conclusion: Estimation of pericardial fluid Troponin-T may be used to predict the cause of death in sudden natural death.

Videoautopsy-A Minimally Invasive Autopsy Method Using Endoscopic Techniques in Forensic Medicine: Clinical Features.

In light of falling global autopsy rates, one of the causes of which is the resulting body disfigurement, it has become crucial to search for new, minimally invasive post-mortem diagnostic tools. One of these methods is videoautopsy, a minimally invasive autopsy technique using endoscopic methods. In the years 2020-2023, 15 videoautopsies were conducted at the Department of Forensic Medicine of the Poznan University of Medical Sciences in order to determine the usefulness of the method in forensic approaches. Each post-mortem examination included laparoscopy and thoracoscopy, followed by a classic autopsy to assess the effectiveness of the method. In total, the endoscopic examination allowed for determining the cause of death in 53.3% of cases, and when the cause of death was located in the abdominal cavity or chest, the percentage increased to 80%. Traumatic lesions had good recognition efficiency. In addition, it was also possible to collect material for histopathological and toxicological tests. Retroperitoneal organs were difficult to assess. The main limitation of the method is the inability to assess the inside of the skull and the structures of the central nervous system. Videoautopsy may become an important tool in post-mortem diagnostics and in forensic cases, especially when the alternative is to not perform an autopsy. Further research is necessary to standardise the examination protocol, optimise the instrumentation, and assess the potential synergistic effect with other methods of minimally and non-invasive post-mortem examination.

Characteristics of physical violence against pregnant women - analysis of medico-legal data and literature review.

Pregnancy is a period which is especially sensitive to physical violence and its aftermath. Subjecting a pregnant woman to violence can have negative effects on both the mother as well as the child. In Poland, there are programs, such as the Blue Card, aimed at protection against violence, however the phenomenon is underestimated. Documentation covering forensic examinations carried out at the request of the police or privately at the Department of Forensic Medicine in Poznan in the years 2015-2020 was analyzed. Out of 7,689 cases, 22 were concluded to meet the criteria of violence against pregnant women. The cases were then further analyzed, consideration of the victim's age, professional status, relations with the perpetrator, form of physical violence, and medical assistance. The average age of the women at the time of the incident was 31.1 years. In 90.1% of the cases, the perpetrator was a known man, usually a current or former partner. The most common injuries were abrasions and bruises, while the most common locations of injuries were the head, neck, and arms. The most common forms of violence were grappling, kicking, and hitting with an open hand. Over 72% of the women sought medical attention after the incident. There is a need for educational programs concerning the effects of violence during pregnancy and ways to help. Gynecologists and midwives play an especially important role, by having direct contact with the patient, thus being able to quickly identify victims of violence and take actions to secure safe environment for the woman and the child.

Pattern and distribution of injuries associated with road traffic accident in Haldwani (Nainital) - An autopsy based study

Indiais one of the fastest growing economies. There is a rapid inflation of vehicles on the road that range from motorcycles to heavy vehicles which also shows an active surge in the fatal road accidents. This study is focussed to find out the pattern and distribution of injuries in fatal road traffic accident cases in Kumaon region of Uttarakhand as to plan at the time of policy making and traffic law implementation.: The present study was conducted in the department of Forensic Medicine & Toxicology of Government Medical College, Haldwani from January 1 2019 to December 31 2019, on total 110 cases of RTA brought to mortuary for medico-legal post mortem examination.: Maximum number of cases sustained head and neck injuries (42 out of 110 externally) followed by extremities injury (28 out of 110). Total 38 cases out of 110 sustained head and neck injuries internally, followed by abdominal injuries (28 cases). Abrasions (30 cases) and laceration (29 cases) were commonest type of external injury noted in RTA cases followed by contusion (22 cases) and fracture (19 cases). Most common cause of death among RTA victims was head injury (40 out of 110 cases) followed by shock and haemorrhage (37 out of 110 cases).

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

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

PREVALENCE OF SEXUAL VIOLENCE AND RELATIONSHIP BETWEEN ACCUSED AND VICTIM CASES ATTENDED IN ONE STOP CRISIS MANAGEMENT CENTER OF CENTRAL NEPAL

Background: Sexual violence is a global public health issue, drawing more concern compared to other forms of violence. Evidence indicates that adolescents face an increased risk of encountering both physical and sexual violence. Despite this, there is a scarcity of nationally representative research on sexual violence in Nepal, hindering the development of informed interventions. This paper seeks to determine the prevalence of sexual violence and relationship between accused and the victim cases attended in one stop crisis management center of central Nepal. Methods: A retrospective cross-sectional study was carried out in the department of Forensic Medicine of College of Medical Sciences in Bharatpur, Chitwan, Nepal, from January, 2023 to January 2024. Ethical approval was taken from institutional review committee of College of Medical Sciences, Bharatpur, Chitwan. Data was entered and analyzed by using descriptive statistical tools in SPSS-16. Results: The prevalence of sexual violence was 41.97% (with 95% CI as 36.31% to 47.62%). Out of 123 sexual violence cases majority (40.65%) of them were in the age group less than 14years followed by 38.21% in the age group 15-18 years. Majority of the victim were female (99.2%) by gender and Janajati (52.8%) by ethnicity. majority (78.9%) were victim of forcefully sexual intercourse. Most of the accused person (20.3%) were stranger followed by boyfriend (17.9%). Conclusions: The prevalence of sexual violence is almost half among all type of violence. Majority of the victim were Adolescence girls and they were from janajati. One out of ten victim had present of body injuries while two out of ten had genital injuries. Most of the accused person were known person (boyfriend, Neighbors, Uncle and cousin). The statistically significant variables were age and gender.