Forensic Department Research Articles

Pattern of Poisoning Cases at Tertiary Care Center at Geetanjali Medical College & Hospital, Udaipur

Introduction: Poisoning is a global public health problem causing significant morbidity and mortality. Itis important to know the pattern and outcome of acute poisoning cases for proper planning, prevention andmanagement of these cases.Aims and Objective: To find out the pattern of poisoning reported in Geetanjali Medical College, Udaipur.Material and Methodology: The present prospective study had been conducted in the Department ofForensic Medicine, Geetanjali Medical College & Hospital, Udaipur, Rajasthan during the period of Twoyear from 1st Jan 2017 to 31th Dec 2018.Result and Observation: In our study majority of poisoning case [101 cases (35.69%)] were observed inthe age group of 21-30 years followed by the age group of 11-20 years. Male person [153 cases (54.06%)]most commonly affected by poison and majority of patients [184 cases (65.02%)] belongs to Rural area.In our study majority numbers of cases [128 cases (43.82%)] found in rainy season. In our studyhighernumber of poisoning cases were due to Aluminium phosphide poisoning [106 cases (37.47%)] followedby snakebite poisoning [62 cases (21.91 %)]. Among insecticides, maximum 40 cases (14.13 %) were dueto Organophosphorus compounds. Conclusion:Awareness and education about the potential toxicity ofcommonly used pesticides and drugs may help in reducing the burden of poisoning

New diagnostic signs of drowning based on virtual autopsy results

Background.The article presents a case study of the local forensic Department GBUZ MO Bureau of forensic medical examination in which the investigation of the corpse of a girl who died from drowning utilized the method of pre-sectional computed tomography (virtual autopsy), with subsequent radiological-anatomical comparison of the results.Aim.Identification of possibilities of computed tomography for establishing diagnostically significant signs of drowning; pre-sectional identification/exclusion of injuries.Material and methods.Computed tomography was performed in the Radiology Department of the district hospital at MSCT Optima of General Electric (64-slice tomograph, with 1.5-mm- and 2-mm-thick sections).Results.When studying the Russian medical literature, there was no description of the presence of fluid in the maxillary and frontal sinuses of corpses extracted from water.Conclusions.The presence of fluid in the maxillary and frontal sinuses revealed during CT examination allowed us to supplement the number of objects for the algological study. The discovery of plankton and quartz-containing particles in the fluid from the paranasal sinuses expanded the evidence base for death by drowning.

Study on the Appearance and Fusion of Iliac Crust Epiphyseal Center among Natives of Ajmer Region

Introduction:- Scientific determination of age of an individual is required for the law enforcement agenciesin both civil and criminal matters.Aims and Objects:- Statistical study on the appearance and fusion of ossification centers of iliac crustamong natives of Ajmer region and comparative study between both sexes.Material and Method:- This prospective study has been conducted on 102 subject (48 males and 54females) of the Ajmer region in Rajasthan of known age group between 13-21 years in the Department ofForensic Medicine and Toxicology in J.L.N. Medical College and Associated Hospitals, Ajmer between1stApril 2019 to31stMarch 2020.Inclusion Criteria:- Cases whom parents are born at Ajmer region. Case subjects are also residing at Ajmersince birth, consented for studyExclusion Criteria1. They should not be with any physical disability,congenital,nutritional or endocrinal anomaly.2. Person should have accurate record of their birth date.Observation:-In Males appearance of iliac crest in present study was found at the age 15yrs age in all cases. Simultaneouslyfusion of iliac crest was found at the age of 19.3 yrs in 100% cases.Similarly In female’s appearance of iliac crest in present study was found at the age 14.2yrs age in 100%cases. Similarly fusion of iliac crest was found in majority of cases appeared at the age of 19 yrs in all cases.Conclusion:- iliac crest fusion is found earlier in females of Ajmer region

Morphological Variations in the Branching Pattern of Left Coronary Artery in Adult Human Hearts using Silicon Cast Method

The knowledge of variations in the branching pattern of Left Coronary artery is an important factor in the study of coronary heart disease and mostly it is the left which is commonly involved. With the adaptation of sedentary life style and increasing stress, Coronary artery disease has become the major cause of death and coronary angiography is has become a routine for cardiologists & radiologists. This study is done to determine the branching pattern, mean length and mean outer diameter of the trunk of the Left Coronary artery using Silicon Cast technique. A Plastinate material that is Silicon is used in this study for luminal casts, this is first of its kind in India and it’s a new innovative technique for studying the arterial patterns. The present study was carried out in 110 fresh hearts, 90 males and 20 females with a mean age of 66.0 years, which were collected from the mortuary of the Forensic department of Mysore Medical College and JSS Medical College, Mysore, South India for a period of 2 years. The Silicone material was injected into the Coronary arteries; the cast was removed and the fine branching pattern of the left Coronary artery was studied and measured using Vernier digital calipers. The left Coronary artery arose from the left posterior aortic sinus in most number of cases. The mean outer diameter of the trunk at the point of origin was 3.51±0.71 (range 2 – 5.8mm). The mean length of the trunk of left Coronary artery was 10.04 ± 3.27 mm (range 4-18.5mm). Most of the branching pattern was bifurcation (62.72 %) and trifurcation (33.63%) was observed, tetrafurcation was found to be in 3.63% of cases only, no cases of pentafurcation was seen .This study will help in interventional studies by cardiologist and radiologists during diagnostic and therapeutic approach in Coronary vascular diseases.

Rethinking COVID-19 'pneumonia' - is this primarily a vaso-occlusive disease, and can early anticoagulation save the ventilator famine?

Rethinking COVID-19 'pneumonia' - is this primarily a vaso-occlusive disease, and can early anticoagulation save the ventilator famine?

Review of deaths cases due to carbon monoxide poisoning in a tertiary hospital

Background: Carbon monoxide threatens its victims with sudden anoxic death and severe neurological sequelae. Materials and Methods: This is a descriptive and analytical retrospective study on 14 cases of deaths due to Carbon monoxide poisoning collected at the Forensic Department of Ibn Rochd University Hospital in Casablanca (UHC), over a two years period from January 2018 to December 2019. Results: Among the 14 deaths, there were nine (N=09) male victims (64%) and five (N=05) female (36%), aged 25 to 44 years in 43% of cases and 45 to 64 years in 36% of cases. Vast majority of cases (86%) involved accidental household poisoning. A water heater was incriminated in 36%. The source of Carbon monoxide was related to a defective device (36%). Neurological signs such as disturbances of consciousness were the most common (92%) symptom. The peak poisoning period (50%) occurred in December. Autopsy revealed pulmonary petechial spots (14%) and congestion of most organs. Carboxyhemoglobin (COHb) was positive in 8 cases with a rate> 5%, including 3 victims with no history of smoking and > 10% among 5 smokers. The value was negative for two victims who received oxygen therapy during hospital resuscitation efforts. The COHb level was indeterminable in 4 cases of which 3 victims were in advanced decomposition and one was exsanguinated. Conclusion: Prevention is key in reducing the morbidity and mortality of Carbon monoxide poisoning that can cause sudden anoxic death and severe neurological sequelae.

Does forensic audit influence fraud control? Evidence from Nigerian deposit money banks

This study examines the importance of the application of forensic audit in controlling financial frauds that ravage or threaten the soundness and business continuity of Deposit Money Banks (DMBs) in Nigeria. The study used survey design methods, and the primary data were obtained through the administration of structured questionnaire covering seventeen (17) banks out of twenty-two (22) Deposit Money Banks (DMBs) operating in the country, which is 77.3%. In this study, the Ordinary Least Squares (OLS) method was used to analyze and test hypotheses, and the findings showed that the involvement of qualified and experienced forensic auditors would not only contribute to the amelioration of financial frauds in DMBs, but would also lead to much-needed sanity in the banking sector of Nigeria. The study recommends that regulatory agencies, within the limits prescribed by law, mandate all the banks to create a special forensic department, managed by a professional forensic auditor, which will develop and constantly implement effective and efficient internal control, timely prosecution of fraudsters by considering them to be criminals and as a deterrent to others, and work out adequate training and development programs for their staff, especially in fraud control, in order to reduce the number of fraud cases in Nigerian banks.

P0738RELATION BETWEEN BLOOD LEAD AND CADMIUM LEVELS AND CHRONIC KIDNEY DISEASE

Abstract Background and Aims Chronic kidney disease (CKD) was one of the three reasons of mortality with the furthermost increase from 1990 to 2010 between the top 20 killers. Environmental toxins (Lead Pb and Cadmium Cd) are hidden factors incorporated in the increased prevalence of CKD. The aim of this study is to determine whether there is a relationship between CKD and alteration in blood Pb and Cd levels. Methods This is a case-control study which was held in Forensic department, Mansoura University, Egypt. The individuals were divided into 2 groups: Group I: 40 persons with normal kidney function used as a control group, group II: 40 patients suffering from CKD secondary to unknown cause who are attending to follow up at nephrology outpatient clinic, Mansoura insurance hospital. All participants were subjected to full history taking (Personal history about gender, age, residence and occupation (mechanics, plumbers, battery manufacturers, manufacturers and users of paint and electricians), The history of special habits like smoking, seafood, canned food consumption, using colored mugs and living in old houses, History about medical disorders associated with renal failure as diabetes and hypertension), laboratory investigations including serum creatinine, creatinine clearance, serum Pb and serum Cd. Results Eighty persons (49 males and 31 females) were included in the study with age range from 15 to 76 years. The majority was above 40 years and was coming from rural areas (62.5% in group I and 60% in group II) with no statistical significance (Figure 1). In group I (45.0%) was smokers and (55.0%) were non smokers while in group II (70.0%) were smokers and (30.0%) were non smokers. The difference was statistically significant (p =0.026). Among group I, (42.5%) out of them were using frequently colored food container ceramics while (65%) among group II were frequently use them and the difference was statistically significant (p =0.048). Other risk factors showed no significance (Figure 2). In group I Pb levels range from (9.51µg/100ml) to (42.67µg/100ml) while Cd levels range from (1.59µg/100ml) to (3.87µg/100ml); whereas in group II Pb levels range from (19.43µg/100ml) to (82.3µg/100ml) while Cd levels range from (2.04µg/100ml) to (6.12µg/100ml). There is statistically significant difference among both groups as regard blood Pb levels (p <0.001) with higher blood Pb levels in C.K.D patients (mean±SD=52.76±15.65) than healthy controls (mean±SD=18.06±5.61). Also, there is statistically significant difference among both groups as regard blood Cd levels (p <0.001) with higher blood Cd levels in C.K.D patients (mean±SD=4.27±0.87) than healthy controls (mean±SD=2.62±0.62) (Figure 3 & 4). There was negative correlation between blood Pb,Cd levels and patients` creatinine clearance ( for Pb;R:-0.755, p=0.001, for Cd;R:-0.712, p=0.001 ) (Figure 5, 6). There was positive correlation between blood Pb, Cd levels and serum creatinine (for Pb;R: +0.713, p =0.00, for Cd; R: +0.707, p =0.00) (Figure 7, 8). Conclusion Pb and Cd toxicity may lead to CKD and these environmental factors may explain the unknown etiology of many renal failure cases. With chronic exposure, blood level >25.8 µg/dl for Pb and >3.46 µg/dl for Cd carry the risk for renal failure incidence.

EXPERT POSSIBILITIES OF FORENSIC CYTOLOGY INVESTIGATION IN FORENSIC EXAMINATION OF MATERIAL EVIDENCE

The article presents the history of the development and implementation of forensic cytological research methods in the practice of conducting forensic examinations of material evidence in the forensic examination bureau of Ukraine. The modern possibilities of forensic cytology methods for solving investigative issues in solving crimes against human life and health are shown in the article. Due to the fact, that the object of study of expert cytologists and expert geneticists is the same substance, namely, nuclear cells of different tissues and organs, blood leukocytes, epithelial cells of saliva, vagina, rectum, sperm, and cells of the outer root vagina hair – forensic cytological studies necessitate the preservation of nuclear cells for further genetic analysis. To this end, the staff of the Forensic Cytology Department of the Main Bureau of Forensic Examination developed a method for the preparation of cytological preparations using an ultrasonic water bath, which allows increasing the number of cellular elements extracted. At the same time, the specialists of the Odesa Regional Bureau of Forensic Examination introduced a technique for conducting molecular genetic analysis of nucleated cells in cytological preparations. Such techniques allow, even with a very small amount of biomaterial, to answer most of the questions posed by the investigator to the expert.

On the Legislative Developments in Forensic Activity

The article gives a detailed analysis of the changes made by the Federal Law of 26.07.2019 No. 224-FZ to the Federal Law “On the state forensic activity in the Russian Federation” and the Federal Law “On the Investigative Committee of the Russian Federation”. These developments, primarily related to the establishment of a forensic institution of the Investigative Committee, have been criticized by the legal community since they legalize the supremacy of a criminal prosecution body over the expert offices. At that, some authors justify the need for the forensic expert departments in the structure of the Investigative Committee of the Russian Federation, especially since both in Russia and abroad forensic offices in the bodies dealing with investigating crimes do exist. The Federal Law of 26.07.2019 No. 224-FZ came into force, and till 01.01.2022, the forensic institution of the Investigative Committee of the Russian Federation is to be established, and the list of departmental forensic agencies will be extended.

ESTABLISHMENT OF CAUSE-AND-ACTION RELATION BETWEEN DEFECTS OF MEDICAL TREATMENT AND FATALITY

The issues of identifying cause-and-effect relation (CAER) between professional violations of medical workers and the following harm to health or fatality of a patient are quite complex, insufficiently studied and covered in available domestic scientific and medical publications. This article deals with the issues of identifying and determining CAER between defects in medical treatment (MT) and fatality. The object of the study were the 177 opinions of forensic panel examination (FPE) on the archival material of the forensic medical examination department of the «National Bureau of Expertises» of the National Academy of Sciences of the Republic of Armenia for the period from 2013 to 2018.
 In order to analyze the structure of defects of MT, we classified them as follows: diagnostics defects; defects of treatment; defects in organization of medical treatment; defects in medical record-keeping.
 According to the opinions of the 177 FPE, in 132 (74.6%) cases, various defects while MT were detected, and in 45 (25.4%), they were not registered. According to the 132 opinions of the FPE, 250 defects while MT were recorded. Diagnostics defects (34.8%) and treatment defects (31.2%) were most common, and defects in the organization of MT (12.0%) were less common.
 In the presence of defects while MT in 30.3% of cases, CAER was revealed between the frequency of defects while MT and the probability of fatality. The probability of fatality was most affected by defects in diagnosis and treatment. Thus, the relative risk was 2.41 at 95% CI (confidence interval) from 1.31% to 4.44% and 15.65 at 95% CI from 5.01% to 48.87%, accordingly.

Estimation of Stature from Footprint Length

The human foot is studied for various reasons in forensic departments, by anthropologists, anatomists etc. Footprints are of immense value in a crime scene in establishing the personal identity and in a potential link between the perpetrator and the scene of crime. Identification of a person is of prime and foremost importance in both civil and criminal cases. Time is a critical factor in crime scene investigation, so rapid identification of suspect is very important. Here, in our study, the aim is to estimate the stature of individuals based on their footprint lengths among the students (Both male and female students between the age group 18 to 22 years) 50 male and 50 female students, studying in Rajarajeswari Medical College and Hospital, Bengaluru.that the footprint length help us in estimating the stature of an unknown individual which will be helpful in investigation of various crimes. Also not much difference is statistically noted in the stature estimated by right and left footprint length in both the sexes.Stature; Foot print length; Identification

The implementation of the law 4509/2017 in the Forensic Department of the Psychiatric Hospital of Thessaloniki

According to the Explanatory Memorandum of the law 4509/2017, a significant change is being made to the current institutional framework of Articles 69 and 70 of the ECHR concerning the penal treatment of mentally ill offenders, in order to ensure a high level of treatment for perpetrators with mental or intellectual disorder. In application of the law, it was examined in court the abolishment, maintenance or replacement of the treatment measure of 47 patients from the Department of Forensic Psychiatry in Thessaloniki. The results were compared with the previous status quo. In 22 cases, abolishment was ordered for the patients to be discharged and return to their parent's home or to Psychosocial Rehabilitation Units. In 11 of them, their stay was in direct violation of the law due to exceeding the cap as defined by the severity of the offense. However, 7 patients remain voluntarily in the Department, as no beds are available in reintegration structures. 13 patients who have committed homicide remain with the psychiatrist's agreement beyond the overrunning the ten years of treatment due to the severity of the disease or the risk for violent behavior. The Public Prosecutor has provided solutions in many cases and has appointed lawyers for all patients as prescribed by law. However, the judiciary remains cautious and the trend towards exhaustion of the limits is clear, despite the fact that their fears are not confirmed by international bibliographic data. The application of N 4509/2017 attempts to change the landscape for this particular group of patients and allows visions for de-institutionalization, elimination of the stigma and personalized treatment, despite any ambiguities or potential problems that may arise. However, as the predominant social viewpoint, shown by the media, treats the mentally ill as dangerous, any positive changes are doomed to fail. In addition, it is necessary to develop psychiatric services for the treatment of patients which will not only treat psychotic symptoms but also antisocial and aggressive behavior in general.

Clinical Ethics Support Services Are Not as Well-Established in Forensic Psychiatry as in General Psychiatry.

Background: Mental health care professionals deal with complex ethical dilemmas that involve the principles of autonomy, justice, beneficence, and non-maleficence. Such dilemmas are even more prominent in forensic mental health care, where the restriction of personal rights is legitimated not only by patient well-being but also by public safety interests. Little is known about either the use of formal ethics support services or specific ethical needs in forensic mental health care. Knowledge about the current structures and how they compare with those in general psychiatry would help to identify the most important ethical issues and to analyze whether there are unmet needs that might require specific ethics support.Methods: We performed a survey study in all general psychiatric and forensic psychiatric inpatient departments in Germany. The aims were to compare the availability and functioning of clinical ethics structures and to identify specific ethical needs in inpatient forensic and general mental health care.Results: Clinical ethics support was available in 74% of general psychiatric hospitals but in only 43% of all forensic psychiatric hospitals and 25% of those offering treatment for offenders with substance use disorders. Most ethics support services were interdisciplinary. The most frequently requested retrospective and prospective ethics consultations were on issues of omission and termination of treatment, coercive measures, and advance directives. Among the hospitals without access to ethics support, 71% indicated a need for training in ethics.Discussion: Our results show that ethics consultation is well established in general psychiatry, but less so in forensic psychiatry. Mental health care professionals in forensic psychiatry seem to have a need for ethics support and training in clinical ethics. We also found a difference in access to ethics structures between hospitals that treat mentally disordered offenders and those that treat offenders with substance use disorders. Further research should focus on how ethics support can be comprehensively implemented in forensic mental health care and how this might improve treatment quality and patient and staff well-being.

The applicability of Willems dental age estimation method for Indonesian children population in Surabaya

BackgroundThe applicability of dental age estimation has been expanded to meet a variety of medico-legal needs, law enforcement, and disaster victim identification. The objective of this study is to examine the applicability of the Willems method for Indonesian children.Material and methodA total of 110 panoramic radiographs of the patients (6–14 years old) who met the inclusion criteria were obtained from the Department of Forensic Odontology and Department of Radiology, Universitas Airlangga, Indonesia. Estimated dental age (EDA) was assessed using the Willems method by two blinded examiners. The statistical analysis was carried out using IBM® SPSS® Statistics version 23.0 (IBM, Armonk, NY, USA).Results and discussionThe mean of the chronological age (CA) in this study is 11.30 ± 1.43 years (boys) and 11.65 ± 1.55 years (girls). The overall mean difference between CA and EDA for boys and girls is − 0.08 ± 0.76 and − 0.31 ± 0.97, respectively. This study showed that the mean age difference in girls was more significant than in boys. The growth spurt timing between boys and girls might cause a difference in dental maturation, whereas the onset of the pubertal growth spurt in girls is about 2 years earlier than in boys. In general, girls start and finish their dental development earlier than boys end.ConclusionThe present study suggests that the dental age estimation methods proposed by Willems can be considered as an applicable method for the children population in Surabaya, both boys and girls. However, a detailed study may be required while applying this approach to the 11–14-year-old girl population in Surabaya, as a substantial underestimation was observed in this community.

Estimation of Stature from Footprint Length

The human foot is studied for various reasons in forensic departments, by anthropologists, anatomists etc. Footprints are of immense value in a crime scene in establishing the personal identity and in a potential link between the perpetrator and the scene of crime. Identification of a person is of prime and foremost importance in both civil and criminal cases. Time is a critical factor in crime scene investigation, so rapid identification of suspect is very important. Here, in our study, the aim is to estimate the stature of individuals based on their footprint lengths among the students (Both male and female students between the age group 18 to 22 years) 50 male and 50 female students, studying in Rajarajeswari Medical College and Hospital, Bengaluru.that the footprint length help us in estimating the stature of an unknown individual which will be helpful in investigation of various crimes. Also not much difference is statistically noted in the stature estimated by right and left footprint length in both the sexes.Stature; Foot print length; Identification

Criminal Responsibility among Murderer Presented to Forensic Committee in Al-Rashad Training Hospital/ Forensic Department, 2016-2017..

Background: The insanity defense, also known as the mental disorder defense, is a defense by excuse in a criminal case, arguing that the defendant is not responsible for his or her actions due to an episodic or persistent psychiatric disease at the time of the criminal act. This is contrasted with an excuse of provocation, in which defendant is responsible, but the responsibility is lessened due to a temporary mental state. The aim of current study was to find out the results of criminal responsibility assessment for the murderers and related mental illness as well as to study a sociodemographic and personal criterion for murderers. Methods: The study was conducted in AL-Rashad Hospital, forensic department in Baghdad. It was a descriptive retrospective study. Case files of (70) murderers, examined by the forensic committee during the period from 1st, January 2016 till 31st, December 2017, were studied. Comprehensive data were collected and analyzed by the SPSS version 23. Results: The study showed that murderers were mainly young adults within age group (20-40) years that were married, illiterate/low educational level and had no job or unstable type of jobs. About 30% of victims were 1st degree relative and 30% of them were family in law. The main weapon was used in the murder was gun (45.7%) and knife (40%). According to murderers who presented to the committee, about 38.6% had no mental illness, 17.1% had personality disorder, 32.9% had psychotic disorders and 8.6% had neurotic disorders. The majority of murderers (52.9%) presented to committee were considered responsible, 8.6% had partial responsibility and 28.6% considered irresponsible. Conclusions: This study showed that about more than half of murderers presented had full criminal responsibility and insanity defenses were succeeded only in one third of the cases. The studied murders appeared to be obvious among young adult age groups, with no job or unstable financial resources, and illiterate or had low educational level. The victims were more likely to be from 1st degree relatives or family in-law. The available weapon (gun and knife) was mostly used.

Skate or die: Unusual circumstances surrounding a natural cause of death

In a forensic pathologist's mind, a suspicious death scene involving inflicted injuries and a weapon always raises three possible hypotheses regarding the manner of death—homicide, suicide, or accident; the latter is slightly less common. We present a case of a 43-year-old homeless man with a history of chronic alcohol abuse who was found dead in a skate park in Geneva. He was inflicted with a stab wound to his abdomen, with a knife found in situ. With the suspicion of homicide, a crime scene investigation team, including a forensic pathologist, was summoned to the scene. However, further examination of the body revealed a deep cut with hesitation marks on the left forearm. This discovery raised the hypothesis of a suicide. Here, we have described the investigations made by the police and forensic department, along with the circumstances and autopsy findings that determined the cause of death as an effect of a natural disease.

Learning styles of undergraduate medical students - A cross sectional study using VARK questionnaire

Learning is an individual's way of perceiving, processing and retaining new information. VARK (Visual, Aural, Reading/writing and Kinesthetic) is a tool for assessing learning style. VARK study helps in assessing learning preference of students and guide teachers to modify their teaching approach to enrich the domains of learning namely knowledge, skill, attitude and communication according to AETCOM, thus aiding implementation. To find out preferred learning style in the study population and to ascertain genderwise variation of preference. A cross-sectional prospective study in Department of Forensic & State Medicine, Medical College Kolkata was performed on 4th semester students over two months. All the students present in demonstration classes during data collection and gave their consent to take part in study were included. A pretested and validated VARK questionnaire (version 3) containing 13 questions were distributed among undergraduates. Data collected were evaluated according to proposed evaluation guideline dividing into 4 predominant groups namely ‘V’, ‘A’, ‘R’, ‘K’. Total 192 students, (Male=116, Female=76), response rate 73%, aged between 19–25 years participated, among which females were ‘R’ and males ‘K’ predominant. Batch wise preference analysis showed on Monday and Friday batch was ‘A’ and other batches were ‘K’. Kinesthetic was the most one all over, reading/writing being the second, auditory third and visual the fourth. Bimodal and trimodal responses were also found in few and ‘RK’ was most common. This study for implementation of competency based medical education (AETCOM) is first of its kind which is helpful to start new MBBS curriculum in a more effective approach.

Maxillo-facial Trauma: Epidemiological Study and Legal Implications

In Tunisia, as all over the world, intentional traumas resulting from assaults represent a growing social scourge especially after the revolution of January 2011. Facial trauma occupies a special place due to its psychological impact on victims. This study aims to examine the demographics, pattern and management of maxillofacial injuries due to interpersonal violence. It’s about a retrospective study, interesting all cases of isolated intentional maxillofacial traumas collected in the Forensic Department of the University Hospital Habib Bourguiba of Sfax - Tunisia during six months between July and December 2017. We collected 270 cases of isolated facial trauma with a prevalence of 7.3%. Victims were mainly young men with low socio-economic class. Bruise was the most frequent lesion (67.4%). Orbital region was the most common site of lesions (52.2%). Total temporary disability (TTD) average was 10.81 days. Permanent partial disability (PPD) was predicted in 34.8% of cases. Despite the low prevalence of isolated facial trauma, it is considered as a major public health problem. Consequences of the complaint lodged by the victim depend on conclusions of medicolegal expertise.