Forensic Medicine Experts Research Articles

A STUDY OF THE DIMENSIONS OF HUMAN ACETABULUM IN THE DRY HIP BONES OF SOUTH KERALA POPULATION

Introduction: In human anatomy the acetabulum is a cavity on the lateral aspect of the hip-bone. The purpose of this study is to record the depth and diameter of the acetabulum cavity to accumulate morphological data helpful for anthropologists, Forensic medicine experts and orthopedicians. Materials And Methods: The study was done on 88 adult human hip bones (42 right and 46 left) collected from Department of Anatomy, Govt.T.D Medical College, Alappuzha, Kerala state. The diameters and maximum depth were measured using digital vernier calliper. The measurements were compared with other studies in the world. The mean diam Results: eter of acetabulum was 48.08 ± 3.21mm, 44.16 ± 2.60 mm in male and female respectively. The mean ± S.D value of depth was 29.11± 2.37 and 27.20± 2.01 mm. in male and female respectively. The correlation between depth and diameter was signicant only in the right male hip bones. There is signicant variation in the Conclusion: anatomical parameters of hip bone between different Indian population groups. The data from this study may be used for designing population specic hip prosthesis.

Management of the dead during coronavirus disease 2019 outbreak: Practices and perceptions of forensic practitioners from India.

The coronavirus disease 2019 pandemic has mandated a response from administrative agencies and the health sector globally, however, the number of cases and deaths continue to rise. While management of the living is paramount, the management of the dead is also important. Guidelines for managing the dead have been issued and implemented by various local administrations, in accordance with national and international guidelines. This questionnaire-based research aims to develop an understanding of the knowledge, perceptions and practices of forensic practitioners from India as regards the management of the dead during the coronavirus disease 2019 pandemic. This Pan-India study included 278 forensic medicine experts (249 males and 29 females) working in various hospitals and medical institutions across the country. The questionnaire included various issues involving the management of dead bodies in cases involving coronavirus disease 2019, such as infection control practices, body screening, handling and autopsy, disposal practices, local administrative policies, and available infrastructure and resources. We found that guidelines are mostly being followed across India, barring disparity in issues relating to testing in the dead bodies, the role of local administration in the body disposal, and the use of personal protective equipment while handling bodies and during autopsies. Mortuaries now need to be upgraded, and general infrastructure requires improvement. Periodic training of all stakeholders and assessment of facilities are recommended.

REGRESSION ANALYSIS TO DETERMINE STATURE FROM HAND ANTHROPOMETRY AMONG ILOCANO POPULATION IN PHILIPPINES FOR PERSON IDENTIFICATION

Stature determination aids the person identification during forensic investigation. The human hand research is the current topic of interest among forensic scientist, forensic medicine experts and anthropologists. Based on sample size analysis, the study involved consented 60 males and 60 females, age ranged from 18 to 55 years old. Stature and hand lengths measurements were made with Stadiometer and Vernier Calipers for analysis. From each participant, ten hand length measurements, five from left and five from right hands were taken. The five length measurements in left hand are the inter-distance between the distal traverse crease of the wrist (LH) and tip of thumb (T), index finger (I), middle finger (M), ring finger (R) & little finger (L), as abbreviated LHT, LHI, LHM, LHR and LHL. Similarly, the right hand lengths indicated as RHT, RHI, RHM, RHR, and RHL. The data were statistically analyzed by using SPSS software, version 23 and column chart. The information about age, gender, name, and place of origin of the participants was coded for easy reference. This study finally developed regression equations to determine stature from hand anthropometry among Ilocano population in Philippines for person identification

Artificial Neural Networks in Forensic Medicine (review)

Thearticle deals with the possibilities and limitations of the use of artificial neural networks in forensicmedical practice. It is known that in the work of forensic medicine experts have to process and evaluatea large amount of information, which may belong to different types of data - the site inspection protocols,photographic materials, macroscopic data obtained during the autopsy of the corpse, the results of laboratorytests, medical records etc. All the received data should be studied, categorized and evaluated according tointernational standards. Modern computer technologies of artificial intelligence (artificial neural networks)can help in the handling of forensic medicine data, which, in turn, will reduce to a minimum the probabilityof mistakes in preparation of expert conclusions.The algorithms used in artificial neural networks, as a resultof processing different types of input data, can direct them to the resulting categorized outputs and structurethem.

Stature Estimation from Anthropometry of Foot in Adults of Border Areas of Punjab

Background: Stature is one of the various parameters of identification of the individuality of a person. Estimation of stature from various measurements of the body is of value in medicolegal investigations as well as in anthropology. The foot measurements are important in forensic field as they can be used as body height predictors for an individual.The current study deals with developing a regression equation for stature estimation from foot breadth and foot length and to find out the correlation between stature, foot breadth and foot length. Methods: The data was collected from 500 asymptomatic, healthy adults (250 males & 250 females) belonging to border areas of Punjab region of age group ranged between 18-50 years.Results: The correlation between foot length and stature (r= 0.337) was more than foot breadth and stature (r= 0.046) indicating foot length to be a better predictor of stature. Linear regression equations were derived for estimation of stature from foot breadth and foot length.Conclusion: Both foot breadth and foot length showed positive correlation with stature as indicated by the regression coefficient. The results indicate that one can successfully estimate staure from different foot dimensions. The calculated regression formulae show good reliability and applicability of estimate which would be useful for Anthropologists and Forensic Medicine experts.

Knowledge, Attitude and Perception Regarding the Procedure of Autopsy in COVID-19 Cases among Doctors Doing Post Mortem Examination

The COVID-19 pandemic has raised challenges in dealing with the dead body of deceases who have been a suspected case or a confirmed case of Covid-19, considering the extreme shortage of trained and experienced manpower in dealing with various duties and responsibilities in the COVID-19 scenario it is very important to ensure safety of the health care workers.All the guidelines issued from time to time for control of spread and treatment of Covid-19 are speculations depending on the current trends and none are based on robust research due to lack of scientific literature and work as the Covid-19 virus in new to the human race .The main driver of transmission of COVID-19is through droplets. There is unlikely to be an increased risk of COVID-19 infection from a dead body to health workers or family members who follow standard precautions while handling body. Only the lungs of dead COVID-19 patients, if handled during an autopsy, can be infectious.1and there is no evidence so far of transmission of virus through the handling of corpses.2There are a lot of speculations in the mind of forensic medicine experts regarding the ongoing mortuary work and dead body management in the Covid-19 scenario considering the risk of acquiring the infection during handing or bodies or while conducting a medico legal post mortem examination.

“Review on Forensic Odonto-Stomatology”

Forensic Odontology has become an integral part of forensic medicine over the past decadesthat utilize dental tissue findings to serve the judicial system. Dental tissues remains can be usedfor identification as using them are cost effective, reliable and fast. Forensic odontology is abranch of dentistry that analyzes dental evidence to overlap the dental and legal profession. Thetooth has been used as weapons and under certain circumstances, may leave information aboutthe identity of the biter, age estimation and gender determination. Dentists have a major role toplay in keeping accurate dental records and providing all necessary information so that legalauthorities may recognize mal practice, negligence, fraud or abuse, and identity of unknownindividuals. This paper will try to summarize the various roles of dental experts in forensicmedicine.
 Bangladesh Journal of Medical Science Vol.20(1) 2021 p.17-23

A second autopsy revealed the silent killer: A case of fatal carbon monoxide poisoning from gas geyser

Carbon Monoxide (CO) is one of the important causes of accidental death in bathroom that occurs frequently due to installation of gas geyser. CO is emitted from a gas geyser due to defect or poor maintenance. Blockage of the exit or ‘flue’ pipe is a common fault, sometimes from bad installation or because it becomes blocked by soot or by birds’ nests. Here, we present the case of 30-year-old female found dead in her bathroom, whose second autopsy unveils the actual cause of death. Liquefied petroleum gas (LPG) or piped natural gas (PNG) are used frequently in gas geyser for heating water in developing countries such as India. CO produces anemic anoxia as well as tissue hypoxia by competing with oxygen for binding sites on oxygen carrying heme proteins like hemoglobin, myoglobin, cytochrome-c oxidase and cytochrome p-450. This case highlights the importance of the second autopsy and role of forensic medicine expert in determining the cause and manner of death so as to guiding police in proper investigation and preventing the harassment of innocent people.

Sudden cardiac death: An autopsy study

Introduction: The most common cause of sudden cardiac death is ischaemic. Such patients may have an occlusive recent thrombosis in one or more major coronary arteries. An area of stenosis of 85 per cent is the best discriminating level for increased mortality. Objective: To study the cardiac causes of sudden death. Materials and Methods: 200 medicolegal cases of sudden death requested for pathological examination of heart were studied. A careful study of the information given by the police and forensic medicine experts was done. The heart was examined macroscopically for clots, thrombi, any anomalies, tumors or any other pathological signs. The sections of the organ were studied. Results: A total of 200 cases were studied with 120 males and 80 females. Majority of them (70%) weighed less than 300 grams. Only 2 weighed more than 350 grams. Cardiomyopathies were recognized in 30 specimen. Dilated cardiomyopathy was most common among them and accounted for 20 cases. Conclusion: Personal experience of studying such patients, suggests that the majority of deaths are indeed cardiac. The various causes of sudden cardiac death must be correlated with pathological findings to arrive at a definitive diagnosis. Keywords: Autopsy, Heart, Ischemia, Thrombosis, Ventricular fibrillation.

Course of Revision of the Diagnosis and Treatment Protocol for COVID-19 and the Forensic Contribution

From January 15 to March 3, 2020, seven editions of the guidelines for the diagnosis and treatment of COVID-19 have been issued successively by the National Health Commission of the People's Republic of China, and the guidelines' name was changed from Guidelines for Diagnosis and Treatment of Novel Coronavirus Pneumonia to Diagnosis and Treatment for COVID-19. It optimized and perfected the etiology, clinical manifestations and types, diagnostic procedures and specific treatment measures of the disease, so that the clinical management of the cases was more scientific. In the revision process of guidelines for diagnosis and treatment, forensic medicine experts have also made some positive suggestions on clinical diagnosis and treatment. Especially regarding the pathological changes of COVID-19, they have repeatedly called for rapid autopsy at different levels. With the support, understanding and cooperation of all parties, pathological examination of more than ten cases of the remains were carried out, which made an important contribution to the understanding of the clinical characteristics and pathological characteristics of the disease and the improvement of treatment plans.

An Anthropometric Study of Stature Estimation from Foot Morphometry in North Indian Population

Background and Objectives: The aim of present study is to find the correlation of foot morphometry withstature and to derive the regression equation for stature estimation among two endogamous (baniya and jats)groups of North India.Material and Method: The present study was carried out at Department of Anatomy, MMIMSR Mullana–Ambala, on 400 subjects(100 males,100 females of each group) belonging to known endogamous group(baniya and jats) of Haryana, age group ranged between 21-35 years. Height and foot length,foot breadth wasmeasured. Foot index was calculated. Statistical analysis including mean, standard deviation for stature andfoot morphometry of both sides were calculated separately for both sexes. Pearson’s correlation coefficientwas calculated to find correlation between stature and different foot morphometry .To estimate stature fromfoot morphometry linear regression analysis was done.Results: The mean and standard deviation for height in males was 173.68 ± 7.336 and in females was160.73 ± 10.049 with highly significant p value. The mean foot length,foot breadth of males was higher thanfemales with statistically significant p value. In males, the foot length and foot breadth of both sides havea highly significant correlation with height. In females the correlation of height was highly significant withfoot length, foot breadth and foot index among both the groups.Conclusion: A significant correlation coefficient was observed between height and foot length in males. Infemales, a significant correlation was observed between height and foot length and foot breadth. If either ofthe measurement is known(height or foot length/foot breadth), the other can be calculated. This would beuseful for Anthropologists and Forensic medicine experts.

Analysis of Injury Pattern & Forensic Medicine Management in a Case of Bomb Blast Injury

Background: In 2016 midnight of summer a bomb blast occurred at ammunition depot Pulgaon. Blast wasso severe that villagers in the radius of 10km witnessed the blast wave. It had killed 19 people which includedArmy officers, soldier & fire brigade men. As per police inquest & alleged history given by eyewitness,anauthority of Central Ammunition Depot at Pulgaon noticed fire at ammunition store of the depot. For thisreason emergency task force team of the depot got activated and few army personnel including fire brigadepersonnel rushed to the spot to control the fire. But unfortunately large amount of ammunition blastedsuddenly as the fire spread inside the ammunition storage. Because of this 19 parsons were died on thespot & many were injured. To tackle the disaster civil authority were informed. When it was noted thattotal 19 personnel were died in the mishap, the District civil authority approached to Mahatma GandhiInstitute of Medical Sciences, Sevagram to send forensic medicine expert team to do spot Post Mortem (PM)examination. The main challenge before the forensic team was to establish the identity of the unidentifiedbody apart from doing PM examination, so that the body can be handed over the kin as early as possible toend the uncertainty of their loved ones.Aims & Objective: Forensic casework was carried out with aim to study the pattern of injuries in the bombblast cases, and to assess forensic management done in mass disaster.Material and Method: Study was carried out on 15 dead bodies involved in the bomb blast injury. Itincludes observation based on post mortem examination and assessment of forensic management done byour team.Result: Bomb blast injury includes complex of injuries like burn injury(100%), decapitation (33%), injuryof internal abdominal organs (40%) & chest organs (80%), fracture of bones (46%), Amputation of limbs(33%), and external mechanical injuries like contusion, abrasions and lacerations (100%). Due to destructiveinjuries identity of the victim gets obscured (40%).Conclusion: Medicolegal postmortem, sample preservation and humanitarian action of establishing theidentity of victims are the forensic management in bomb blast injury.

Educating for practice: A new redesigned pedagogical model of clinical forensic medicine

Nowadays, cultivating experts in clinical forensic medicine (CFM) has become a universal problem worldwide. In most English-speaking countries, CFM is traditionally designed as an introduction and incorporation into medical undergraduate training whereas in China it is an essential sub-specialty of forensic science. The scope, missions, and tasks of this discipline vary widely by virtue of the diversity of countries and legal environment, leading to the difference in pedagogical model, even in professional qualities and abilities. Accordingly, it is imperative to uniform and standardize the training model of undergraduate of forensic major. In this article, we describe a redesigned pedagogical model of CFM implemented by the Faculty of Forensic Medicine, which is characterized by: (a) initiating students into comprehension of CFM and raising their awareness of the professional responsibilities; (b) developing students intellectual curiosity of legal and medical issues and educating in advanced techniques of CFM; (c) cultivating students ability of expression and communication in professional terms and providing with educational resources to enhance their professional qualities; and (d) improving teachers ability of imparting knowledge and promoting the development and optimization of teaching evaluation system. In terms of forensic practical and scientific research, plentiful prominent achievements have been currently acquired resulted from this redesigned pedagogical model, which demonstrates its superiority in undergraduate education.

PERSPECTIVES FOR THE USE OF ARTIFICIAL NEURAL NETWORKS IN FORENSIC MEDICINE (LITERATURE REVIEW)

It is known that in the work of forensic medicine experts have to process and evaluate a large amount of information, which may belong to different types of data – the site inspection protocols, photographic materials, macroscopic data obtained during the autopsy of the corpse , the results of laboratory tests, medical records etc. All the received data should be studied, categorized and evaluated according to international standards.Aim of the work. Analysis of possibilities and limitations of application of artificial neural networks in forensic practice.Conclusions. Modern computer technologies of artificial intelligence (artificial neural networks) can help in the handling of forensic medicine data, which, in turn, will reduce to a minimum the probability of mistakes in preparation of expert conclusions. The algorithms used in artificial neural networks, as a result of processing different types of input data, can direct them to the resulting categorized outputs and structure them. The structure of artificial neural networks allows them to be used in the forensic identification of an unknown person, thus eliminating errors that may be made by a specialist and, accordingly, increasing the effectiveness of such examinations.

Forensic Autopsy is reviewed from the Aspects of Ethics, Medicolegal and Humanities

This article is motivated by the importance of learning about forensic autopsy. A forensic autopsy is carried out on the body of someone suspected of dying due to an unnatural cause such as in cases of accidents, homicides, or suicide. Forensic autopsy includes external and internal examinations relating to respect for a deceased human body. The controversy surrounding autopsy often occurs in the community. For reasons of culture, customs and religion, there is often a refusal to do autopsy. This article discusses the importance of autopsy and aspects related to ethics, humanities and medicolegal. The medicolegal police asked to do a forensic autopsy on forensic medicine experts to find the cause of death of the victim. The purpose of this article explains about the ethical, medicolegal and humanities aspects related to forensic autopsy.

Forensic Medicine: A source and pathway of recognition in disaster victim identification

A mass fatality is commonly construed as a hazardous event resulting in a large number of martyr victims who needs to be identified and subjected to medico legal investigation. During the hazardous consequences of mass fatality incident, it is a necessity to identify the accused sensitively so as to provide judicial assurance and a support to the family members. DVI (Disaster victim identification) team work in an interdisciplinary manner, engaging the services of experts in various disciplines, comprising of forensic medicine, pathologists, anthropologists, odontologists, radiologists, fingerprint and DNA experts to substitute the work in the examination of victims. In accordance to the internationally recognized INTERPOL (International police) DVI guide, the basic quality of standards should be applied and victims must be treated with dignity and respect. This paper focuses on the dynamic applications and significance of forensic medicine which acts as an efficient source of recognition, particularly in the DVI process in setting up a procedure for temporary controlled burial for all the unidentified remains. Different case studies included in this paper reveals the fact that the extensive field of forensic medicine provides a pathway in linking the victims and managing the fatality. Further the reviews relating this field are incorporated in this domain.

Knowledge, attitude and practice regarding the use of digital photographs in the examination of the dead and living among doctors practicing forensic medicine in Sri Lanka

BackgroundForensic medical photography alludes to creating images of injuries/ conditions to be used in the legal process. In many parts of the world obtaining digital forensic medical photographs are done by trained police officers. in Sri Lanka, such practice is not seen. Thus, it is not uncommon to see many forensic medicine experts develop skills of taking photographs related to injuries in the living or dead. ObjectivesTo study the knowledge, attitude and practice on medico-legal usage of digital forensic photographs among doctors practicing forensic medicine in Sri Lanka. MethodA cross-sectional descriptive study was conducted using a self-administered questionnaire among doctors who engage in forensic work in all provinces of Sri Lanka. The study was conducted mainly as an on-line survey from October to December 2018 while some returned the survey via post. ResultsOut of 170 forensic doctors 135 participated the study. Half of them (n=68, 50.4%) were medical officers with basic MBBS degree where 23.6% (n= 36) had more than 10 years of experience. Even though the majority (n=98, 72.6%) stated that they have a Digital SLR camera in their institutions most of them (n=110, 81.5%) didn’t have external light sources. More than half of them (n=73, 54.1%) used camera phones instead of DSLR (n=48, 35.6%) to take forensic photographs. The main purpose of obtaining photographs was for the recording of evidence for later usage (n=126, 93.3%) followed by as reviewable materials for a second opinion (n=120, 88.9%). The study showed 112 doctors (83.0%) used their personal computers to store photographs whereas, 57 (42.2%) saved them in their institutional computers too. Evaluation of basic technical knowledge on exposure triangle and camera sensor showed only 13.5% (n=18) doctors were having satisfactory knowledge. The knowledge of legal aspects showed a significant difference between doctors with postgraduate qualifications and those who are either in PG training or grade medical officers. Further, there was a significant difference in the belief that including photographs in reports will provide unnecessary information to defense lawyers resulting in questioning among PG qualified and Non-PG qualified doctors. ConclusionThis study showed a big gap in the technical knowledge of taking good quality digital photographs by forensic doctors while the usage of camera phones is getting popular. There are many gaps in the practice from storage to usage. There are negative attitudes among doctors of using photographs to courts especially among grade medical officers and PG trainees. A robust educational programme followed by guidelines on quality medico-legal photographs is the need of the hour.

The possibilities of forensic histology under expertise of defects of medical care provision

The article presents systematic analysis of the possibilities of forensic medical histology under examinations of defects of provided medical care and recommendations based on application of mentioned method. The analyzed data related to criminal and civil cases of defects of provided medical care which used conclusion of non-state forensic experts and forensic medicine experts. The following methods of investigation were applied: microscopic, logical-analytical, logical-synthetic, comparative, systematic and analytical. The proposed histological optimal strategy allows to determine the failure of which body functions was became crucial in the event of death and which of several pathological processes played major role in tanatogenesis. This information is indispensable for establishing causal relationships of defects of provided medical care with unfavorable outcomes. The defects of organization of forensic-histological examinations were established. For the first time, the proposed means of increasing informativeness of forensic-histological findings in cases of defects of provided medical care with involvement of non-state forensic experts. The number of concrete scientific and organizational approaches to improve the actual situation was proposed.

The evaluation of medical malpractice claims: Creating a Standard Approach Model Using the Delphi Method

Complaints about alleged medical malpractice have increased over time in Turkey, as well as other countries around the world. And it is often the subject of debate in health law and medical law.It can be seen that discussions are underway on “standard of care” which is highlighted in the finalization of claims for medical malpractice. In this case, the expert opinion offered to be the key point for the cases. In the expert opinion, there seems to be differences in approach and procedure. However, the period of determination of whether health professionals provide the expected minimum standard of care needs to be analyzed in a standard way. In addition to standard, objective and scientific evaluation of the evidence of liability for the medical malpractice claims by the experts, it is aimed to create an algorithm that will facilitate the evaluation by the judicial authorities.The aim of this research is to provide minimum common denominator which will be the standard approach model for the experts in the evaluation of medical malpractice claims.The Delphi method was used as a tool for the panelists to express their opinions freely without being under the influence of each other and to reveal different ideas. The research conducted with 11 panelists consist of forensic medicine experts, clinicians, and a lawyer between January 2017 and September 2017.This research will impact the forensic science and law community by serving the evaluations of the experts in medical malpractice claims whether evaluations are based on methodological and logical considerations and the scientific validity of the evaluations is objective or not.

Suspicious death – trace evidence identified the complainant as accused: A real crime scene report

Unnatural death incidents are reported to police wherein the dead body appearance confuses the first officer in the crime scenes. Generally, the forensic medicine experts are not involved in crime scene visit, but waiting for the body at the autopsy room. Anyhow, the forensic crime scene investigators or mobile forensic scientists have an active part in the examination of the crime scene and the body under suspicious condition. Through keen crime scene observation, they may able to link the physical evidence in the scene with the dead body in the suspicious death cases and solve the mystery. In the present suspicious death case study, a woman was found hanged in her residence under suspicious condition. The complainant husband alleged that his wife committed suicide by hanging while he was away from home. The examination of physical evidence and the dead body in the crime scene indicated it as a homicidal hanging rather than suicidal hanging as alleged by husband. This fact was confirmed by the forensic medicine expert in the autopsy examination.