Ligature Material Research Articles

A Different Case Of Suicide By Hanging - Case Study Of The Event

A thorough analysis of circumstances and examination of the death scene is crucial before determining the manner of death in cases of hanging. While there are numerous reports of suicide and homicide by hanging in India, instances where the deceased is found with hands and/or feet bound and with feet touching a chair, the ground, or a bed, are considerably uncommon, as illustrated in this particular case (figure no.1). Hanging is indeed one of the methods used in suicides due to its accessibility and the perception that it may lead to a quick death. However, it's important to note that the choice of method can vary greatly depending on individual circumstances and cultural context. It is very easy to locate the place (indoor/outdoor) as well as commonly available hanging materials like rope, long napkin, belt, saree, dupatta, and long cloth (dhoti). Partial hanging suicide with hand-tied rope/dupatta cases are very less in number. Data on suicides, such as those reported by the National Crime Records Bureau, provide important insights into patterns and risk factors for suicide, essential information for public health interventions, and policy-making aimed at preventing such deaths. A total of 1,70,924 suicides were reported in the country during 20229. Sometimes suicidal tendency of the victim is so high that he/she can tie his/her hands with ligature material so that he/she cannot escape from the suicidal situation. We can also learn about partial hanging and postmortem blisters from this case study.

Suicide by ligature strangulation and/or hanging inside a motor vehicle: a comprehensive review.

Suicide by ligature strangulation/hanging inside vehicles is uncommon, and only few cases have been reported in the literature. This study aimed to conduct a comprehensive review of reported cases of suicide by ligature strangulation/hanging inside vehicles, analyzing the features of the death scene, of the ligature and furrow, autopsy findings, and causes of death. The comprehensive review was performed following the PRISMA guidelines by using the most common scientific databases. According to inclusion criteria, a total of 20 cases of vehicle-assisted strangulation/hanging were reviewed: 13 cases were assessed as ligature strangulation resulting in 7 complete decapitations and 7 other cases as hanging. All victims were young or adult males, except for one 48-year-old female. Death was assessed as suicide in all cases, except for a possible accidental autoerotic death. In 8 cases, a history of depression or other psychiatric disorders was reported. Toxicological analysis were positive in 7 cases. Hard ligature materials (nylon, steel, plastic, hemp ropes) were used in most cases, but only 13 cases had a well-demarcated furrow. In 2 cases, no internal findings of asphyxia were found. An additional case of ligature strangulation inside a motor vehicle off is also presented, where no autopsy findings of asphyxia were observed, except for a broad pale furrow and monolateral conjunctival petechiae. This study highlights the challenges in classifying suicidal hanging and ligature strangulation in motor vehicles.

Trends of Hanging Deaths in Vadodara– An Autopsy based Prospective Study

The position of knot (typical/atypical) and type of hanging (complete/partial) play an important role in the causation of death in hanging. Ligature material and ligature mark also provides information regarding manner and cause of death.Total 1803 medicolegal autopsies were performedduring one year study period, out of which 189 (10.48%) cases were of hanging. In our study, 134 (70.89%) were male and 55 (29.10%) cases were female with male to female ratio of 1:0.4. We observed that in 104 (55.03%) cases the hanging was complete whereas 85 (44.97%) cases the hanging was partial.The typical hanging cases were 62 (32.8%) andatypical hangings cases were 127 (67.2%). Soft ligature materials were used in 143 (75.66%) cases. Hard ligature materials were used in 46 (24.34%) cases.Dupatta, a soft-ligature material mostcommonly used in all cases.

To investigate the pattern of neck injuries and the role of toxicology in cases of hanging and manual/homicidal ligature strangulation in Ireland between 2016 – 2020: A retrospective review and analysis

The pattern of neck injuries sustained in fatal cases of external compression to the neck is recorded during Post Mortem Examinations (PME), to assist in the interpretation of the circumstances that led to death. In this study, the PMEs performed for 298 cases of hanging and strangulation occurring between 2016 and 2020 in Ireland were retrospectively reviewed for the purpose of recording and collating the external and internal neck injuries observed during each PME, as well as the toxicology results for each decedent. Statistical analysis was performed to investigate potential novel associations between anthropometric variables pertaining to the decedents and the PME findings in cases of hanging and strangulation, serving to add further data to the existing body of research in this area and to assist in the resolution of future cases of hanging or strangulation where there are conflicting findings. In completing statistical analysis, it was found that there was no discernible association between the occurrences of cartilaginous neck fractures (CNFs) with increasing ligature width. Positive associations between increasing weight and BMI of the decedents were identified, and a significantly positive association between the increasing height of the decedent and the incidence of CNFs were identified. Analysis of the toxicology demonstrated that antipsychotics were implicated most frequently in cases of incomplete and complete hanging associated with CNFs and that opioids were implicated most frequently in cases of manual and ligature strangulation associated with CNFs. ObjectiveTo record the pattern of neck injuries sustained in retrospective cases of hanging and manual/ligature strangulation and to collate these findings so as to provide scientific evidence to support the interpretation of the findings in future cases of suicidal hanging and homicidal manual/ligature strangulation for the purpose of medicolegal investigation. To analyse the associations between the occurrence of neck fractures and anthropometric variables pertaining to the victims in cases of complete hanging. Study designThe reports of 298 Post Mortem Examinations (PMEs) performed for cases of hanging and manual/homicidal ligature strangulation between 2016 and 2020 in Ireland were retrospectively reviewed. Pseudoanonymised data sets were recorded for each report, which included the following parameters: neck injuries (soft tissue and cartilaginous), weight, height, BMI and ligature width, toxicology, noose position, ligature material, tongue protrusion, sex and age. Permission for the use of this data was sought from the pathologists and coroners involved in these cases. The data was analysed according to descriptive statistical methods and logistic regression analysis. ResultsLogistic regression analysis was undertaken to examine the associations between unit increases in ligature width and increases in a set of physical characteristics of the decedents (weight, BMI and height) with the occurrence of CNFs. Increasing ligature width was not found to increase the likelihood of a CNF occurring, where the Odds Ratio (OR) for this event occurring was 0.9596. Unit increases in body weight and BMI were found to increase the likelihood of the occurrence of a CNF with ORs of 1.0166 and 1.0607 respectively. Increasing height of the decedent yielded an OR = 4.64, demonstrating that CNFs are significantly more likely to occur with increasing height (CI 95 %: 0.2915, 73.9559). ConclusionsAccording to the statistical analysis performed for this study, increasing weight, height and BMI are parameters of the decedents which increase the likelihood of the occurrence of CNFs in cases of complete hanging.

Living together in heaven: A case report of suicidal pact of loving couple

The loving couple mentally decide to tie the knot to live together in heaven in optimism thinking that to be the real world for them. A loving couple age around 18 year, wanted to live together by fear of being opposed from both the families as they belonging to different caste, the loving couple disappointed to leave the world for heavenly abode. Subsequently tied together with a single ligature material dupatta and hung them from the branch of a tamarind tree. The inspection of spot of occurrence in undisturbed condition, coupled with PM report and chemical analysis from SFSL report could confirm the death of the loving couple was pact of suicidal hanging. This present report highlights the death of loving couple with the crime scene examination. Being a forensic expert, we visited the crime scene to differentiate the suicidal pact and homicidal death.

Suicidal strangulation with uncommon ligature material – two case report

Strangulation is one type of asphyxia death in which compression of neck with ligature material without suspension of the body and commonly homicidal in nature. Self-strangulation by ligature is uncommon. It must be differentiated from homicidal strangulation, accidental strangulation and from sexual asphyxia. The ligature material in suicidal strangulation may be knotted or multiple circle around the neck or tightened like a tourniquet. The uniqueness in the present study is the use of ‘self-retaining’ nature of the ligature material. The ligature material was found in situ, completely encircled the neck. Two cases of self-strangulation are discussed here. One case was found inside closed room and other was found on the bank of the river. In both cases two self-locked ligature material was used. Both cases were meticulously investigated by postmortem examination, scene of crime and circumstantial evidences, all are suggestive of suicidal strangulation.

TRAUMA AND HANGING- AN UNUSUAL CASE OF COMPLICATED SUICIDE

Suicidal deaths are very frequently encountered by forensic experts in day-to-day practice. Here, we shed light on an unusual complicated suicide case, with features of hanging, head trauma and traumatic asphyxia. Allegedly, a dead body of a 65 years old man was found stuck in a shaft between the elevator and a wall, in a multistorey building, with ligature material placed around his neck. The ligature material was torn in two parts and the other part was found tied over the railing upstairs, in proximity to the elevator shaft, in front of his room. Suicide notes were found with the body. During the autopsy, two loops of faint ligature marks were present on the neck and on further exploration, extravasation of blood was present over the strap muscles of neck and carotid sheath. Upper part of the body was congested and there was a clear line of demarcation. Head injury was also present with skull fractures and cerebral haemorrhages. Signs of asphyxia were seen on the internal organs. This case, illustrating a peculiar pattern of injuries is reported for future reference of pathologists to help in identifying and anticipating such injuries in similar cases of suicide.

Socio-demographic and medico-legal study of hanging and strangulation deaths in South Kerala

Hanging is a quick and very effective method used to commit suicide. The ligature material used for hanging is one of the important factors that determine the type of ligature mark or the pressure abrasion. The study was carried out at the Department of Forensic Medicine and Toxicology, Govt. Medical College in Thiruvananthapuram. The demographic characteristics of victims of hanging and strangulation as well as medico-legal findings in such situations were the key variables of the study. There were total 75 asphyxial fatalities, out of which 70 were caused by hanging and 5 by strangulation, were examined. According to the study's findings, men and young people between the ages of 21 and 40 are more likely to die violently from asphyxia. Suicidal hanging was a prevalent method among the unemployed. In the married group, hanging and strangulation deaths are more common. In most cases, a current psychological issue was the cause of suicide. Ligature marks from hanging were usually clearly defined, higher than the thyroid cartilage, discontinuous, and free of internal neck injuries.

Mysterious death of student in hostel: A case report and its medico -legal aspect

Smothering is a form of asphyxia, caused by either closing or blocking the external respiratory orifices i.e. mouth and nose. Deaths from smothering may or may not be accompanied by physical signs of evidence during autopsy depending upon the manner or circumstances making the autopsy surgeon’s task a daunting challenge. A strangulation is a form of violent asphyxia death caused by constriction of air passage at the neck by means of ligature or by any means other than suspension of the body. Suicide by strangulation is rare. In the absence of signs of violence and marks of a struggle, the task becomes more difficult. Here we report one such case of a student staying in a hostel who died in a mysterious circumstance, whose dead body was found lying in a car outside the hostel premises and the manner concluded after studying the injuries tediously in summation with the detailed history of the case and FSL report of visceral chemical analysis, ligature material report and report of the scene of incidence.

A study on hanging in 167 Cases

Background: Hanging signifies an asphyxiation form which, by a noose or another constricting band tightened by body weight, is secondary to compression or restriction of the neck structures. Death due to hanging is always suicidal until and unless otherwise specified.
 Objective: To evaluate the socio-demographic characteristics in cases of death due to completed hanging in Bangladesh.
 Materials and Method: This descriptive study was conducted in the Department of Forensic Medicine, Dhaka Medical College Hospital. The period of study was from July 2020 to June 2022. A total number of 167 autopsies were done during this period on dead bodies that died due to hanging. Points regarding knot of ligature material, injury to neck structures, ligature mark, and stomach condition were noted during post-mortem examinations. All information was noted in a structured data sheet. Data were analyzed using a computer-based programme statistical package for social science (SPSS) for windows version 25.
 Result: This study shows maximum number of hanging cases 34.1% were in the age group of 21-30 years. Among the 167 suicide cases by hanging, the majority (69.5%) were male. Majority (56.9%) of the cases were married. Family disputes were most common motive 66(39.5%) and in females, the most common motive was marriage related harassment, particularly in married women 38(22.8%). Soft material like cloth, saree, orna, and dupatta was the preferred material for hanging in this study (85.6%) followed by firm materials (7.8%) like a rope. Hard material like iron wires, cable wires, etc were used very rarely (2.4%) and the victims who used these were almost always male.
 Conclusion: This culture has a great socio-economic burden due to the high incidence of suicidal hanging among young adults. The private essence of hanging and convenient access to ligature points and ligature supplies renders suicide avoidance challenging. Marital disappointment, organic disease issues, and dowry abuse are the primary reasons behind suicide hanging. Social, legal and psychiatric interventions are required to prevent suicide.
 Central Medical College Journal Vol 6 No 2 Jauly 2022 Page: 77-81

Death due to Hanging: A Retrospective Medico-legal Study at a District level in Bangladesh

Background: After suicidal poisoning, death due to hanging is one of the common modes of suicide encountered in medico-legal procedure in Bangladesh. Objective: To study on demographic and autopsy findings associated with suicide by hanging at Manikganj district, Bangladesh. Methodology: This retrospective cross-sectional study was conducted in the District hospital, Manikganj, Bangladesh during the period of January 2019 to December 2020. Results: A total of 381 medico-legal autopsies were analyzed, out of which 169 were deaths due to hanging. Out of 169 cases, the maximum (69, 40.8%) deaths were due to hanging in the age group of 21-30 years. Majority (101, 59.8%) of the cases were observed in females and among them, maximum were housewives (60, 35.5%). Most of the death bodies (47, 27.81%) were brought from Manikganj police station. Regarding the ligature material used, majority (133, 78.7%) of victims had used soft ligature material, like Dopatta (orhna) (56, 33.1%). Considering the autopsy findings, cyanosis of fingertips and nail bed was the commonest (163, 96.4%), followed by subcutaneous tissue under the ligature mark found pale, white, hard and glistening (159, 94.0%), and dribbling mark of saliva in case of asphyxial death due to hanging (144, 85.2%). Conclusion: Suicidal hanging was commonly encountered in younger age group and in many cases of financial problem, followed by family disputes were commonly observed. J Monno Med Coll June 2022;8(2): 31-35

Asphyxiophilic death due to masochistic behaviour in a video game addict teen: A case report and reviews.

The disorder of internet gaming is increasingly being blamed on major psychological problems affecting youth. Action video games are enjoyable for masochists. Video game chores that practise bondage and other acts that cause pain and anoxia may be masochistic in nature in order to promote player satisfaction. Asphyxia will result in pleasure in asphyxiophilia, a dangerous and occasionally lethal form of sexual masochism. Constriction of the neck with ligature materials is a frequent method of causing hypoxia. The subject of this case study was a compulsive player of online video games. During the masochistic act, along with a recording of it, he unintentionally died. Given that he was naked, had a ligature around his neck, had his wrists and legs bound, and had two fabric-holding clamps on his scrotum, asphyxiophilia was determined to be the cause of his death. At the scene of death, neither pornographic materials nor proof of frequent use of this kind of behaviour were discovered. Along with recording, the subject's cell phone's flash was on to help with the dim lighting and he may have been videotaping these masochistic acts as part of a videogame task. The results of the autopsy, circumstantial evidence, police inquiry and witness accounts all support accidental death.

Ligature Strangulation in a Vehicular Accident Due to the Entanglement of a Shirt: An Autopsy Case.

Among the various types of asphyxial deaths, strangulation is one of the commonly encountered cases as structures in the neck make it vulnerable to fatality. In most such cases, ligature material, usually cloth, is used for the commission of the offense. Clothing may be associated with a wide range of both accidental and deliberately induced deaths. Accidental strangulation due to entrapment of the neck in clothing, especially in relation to vehicular accidents, has also been described in the literature, but these cases are mostly associated with long scarf-like clothing. Loose clothing and intoxication act as critical factors in entrapping the person in such an event. This case report highlights the rare occurrence of accidental strangulation due to the entanglement of clothing other than a long scarf consequent upon road traffic incident.

A Retrospctive Cross Sectional Study of Deaths Due to Hanging in Bilaspur Region of Chhattisgarh

A retrospective cross-sectional record-based study is conducted from December 2018 to November 2020 atChhattisgarh Institute of Medical Sciences Bilaspur, Chhattisgarh. The study constitutes 8.5% (204 cases) of total2398 autopsy done during the given period. The key objective of the study is to find out the prevalence of theproblem within the study area and to determine factors associated with hanging cases. in which 79% (161) are male& 21% (43) are female, 59% (120) cases were married & 41% (84) cases were unmarried. High incidence of 39% (80)cases of age group between 21-30 years followed by age group 11-20 years constituting 21% (43) cases. Peak ofcases are seen at the month of August and March (13%) cases. Most common ligature material used is gamchha in28% (56) cases followed by nylon rope constituting 24% (50) cases.

Pattern of Death Due Hanging Special Emphasized on Neck cartilages

introduction: Commonest form of asphyxial death come across during autopsy in the country is Hanging. The present study was carried out to studying the pattern of fracture in hyoid bone and neck cartilage (thyroid cartilage and cricoids) in deaths due to hanging in the Department of Forensic Medicine, M. P. Shah Govt. Medical College, Jamnagar. We found that death due to compression of ligature seen maximum in the age group of 21-30 years (36.9%), males are accounted for 43% as compared to 57% in females. Ligature material used was dupatta in 43.68% of cases. In hanging ligature mark was oblique, above thyroid cartilage, going backward and laterally. In the majority cases, the ligature mark was above the thyroid cartilage (88% cases), followed by at and above the thyroid cartilage (10% cases) and only in 1 case the ligature mark was below the thyroid cartilage. In maximum cases, the position of the knot was present at the occipital region of the neck (49% cases), followed by the left mastoid region (30% cases). In the majority of cases, the ligature mark was prominent and discontinuous. Hyoid fracture was found in only 8.05% cases. There was only 1 case with thyroidcartilage fracture and no case of cricoidcartilage fracture.

Retrospective Study of Ligature Material on Suicidal Hanging

Background: Hanging is one of the most common methods of suicide. It is always suicidal unless otherwise proved. Recent evidence showed that the incidence of suicide by hanging has increased especially among young adults. Ligature material plays an important role in leading investigation in hanging. The ligature material depends on its accessibility and availability. Various ligature materials are being used like nylon rope, cotton rope, wire, synthetic saree, lungi etc.
 Objective: Present study is a humble effort to find out the choice of ligature material used by the victim at Dhaka Medical College.
 Materials and methods: A retrospective study was conducted at the mortuary of Forensic medicine department, Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2017 to December 2018. During this period data were collected from 112 cases of medicolegal autopsies by purposive sampling.
 Result: A total of 112 medicolegal autopsies were analyzed. In this hanging death, the most common ligature material used was rope in 58% of cases followed by dupatta (13%), lungi (11%) and saree (9%). Electric wire and kamiz were other ligature material used for hanging. The consistency of ligature material observed was hard (71%) & width is narrow width is (71%). Majority of cases (71%) were observed is male. Complete hanging was seen in 67% of cases & among them 85% cases are atypical hanging.
 Conclusion: Hanging is always suicidal unless otherwise proved. It is the form of painless violent asphyxia death that is widely practiced method of suicide. The most used ligature material is rope. Rope is chosen as ligature material due to its availability and accessibility. Young people in the justice system may need personal and psychological support to reduce the incidence of suicide.
 Eastern Med Coll J. Jan 2023; 8 (1) 12-14

Analysis of Post Mortem Findings in Suicidal Hanging- Study in a Tertiary Care Hospital

Background: Suicide is the act of intentionally taking your own life. Hanging is always suicidal unless otherwise proved. It is a from of violent asphyxial death. It produces painless death for the victims so that it is a widely practiced method of suicide. Every year, 8 lac people die for hanging. In Bangladesh hanging in one of the Commonest methods of suicide. Objectives: The objective of this study was to find out Socio-demographic characterizes of victims, common ligature materials used by victims and post mortem findings. Materials and method: A retrospective cross sectional study was done in Shaheed Suhrawardy Medical College mortuary during the period of July 2018 to December 2020. During this period data were collected from 1815 cases of medico legal autopsies by purposive sampling. Results: A total of 1815 medico legal autopsies were analysed of which 818 (45.06%) were deaths due to hanging. out of these 818 cases maximum 395(48.28%) deaths due to hanging were in age group of 21-30 years. Majority of the cases 546(66.74%) were observed in female and others in male 272(33.25%). Majority 425 (51.95%) of victims had used Dopatta (Orna) as a ligature material. Cyanosis of finger tips and nail beds was the commonest 797 (97.43%) finding in cases of asphyxia death due to hanging. Conclusion: In this study all the cases of hanging were suicidal and no case of post-mortem hanging was documented. Majority of the victims were between 21-30 of age (48.28%). Twothirds of them were females. Most frequent occupation was students. More than two thirds belonged to low socio-economic condition and none of the case were from higher socio-economic condition. More than 70% victims were found inside house with locked door. In more than threefourth of the cases, the ligature material was dopatta (orna), apparently because of cost and availability. In most cases the point of suspension was ceiling fan. Complete hanging was most frequent type of hanging. Other external and internal autopsy findings were like book picture. J Shaheed Suhrawardy Med Coll 2021; 13(1): 36-40

Forensic Analysis of Suicidal Hanging Cases: Study in a District Hospital

Introduction: Hanging is a very common method of suicide in Bangladesh as well as around the globe. The rate of suicide cases by hanging is increasing daily in Bangladesh. Suicide by hanging means killing oneself intentionally by suspending themselves from an anchor point by a ligature or by jumping from a height with a noose around the neck. As hanging is a simple method that does not require any complicated techniques, and the materials are also easy to come by, many choose this as their suicide method. The objective of this study was to observe the demography of hanging cases, its distribution according to age group, sex, and common ligature materials used by victims, observe post-mortem findings, and in this way, try to identify the causes and develop the preventive measures that are essential to reduce death due to hanging. Methods: This was a retrospective study done on the basis of the 3rd copy of postmortem reports preserved at the Department of Forensic Medicine, Pabna Medical College Hospital, Pabna, Bangladesh from January 2018 to December 2018 for the period of 1 year with proper permission from the autopsy surgeon. Result: 72% of the suicide victims were female, and 53% of those 115 victims were married. Most of the victims were from the age group of 21-30 years. Marital disharmony was the biggest common cause. The commonly used ligature material was Orna (dupatta). Conclusion: The number of deaths by suicide is on a rise, and to reduce this, a well-designed program is needed. This can help identify the causative factors f suicide by hanging and could help in preventing suicide cases.

The Effect of Ligature Type on Lateral Tooth Movement during Orthodontic Treatment with Lingual Appliances-An In Vitro Study.

(1) Background: One of the most challenging parts in lingual orthodontics is the control and correction of the tip of anterior teeth, due to the occlusal open vertical slot of the incisors in lingual systems. The presented experimental in-vitro study was performed to determine the maximal tipping moment of the anterior teeth between two types of lingual brackets, the Incognito™ Appliance System (Incognito, TOP-Service, Bad Essen, Germany) and Tip-Bar™ system (Incognito, TOP-Service, Bad Essen, Germany). Furthermore, twelve different ligation methods and two different ligature materials were investigated. (2) Methods: The measurement was performed by assessing the stiffness and ultimate strength of the ligature in a uniaxial material testing machine (Instron, Norwood, MA, USA) using a 0.025 × 0.018 inch stainless steel wire. (3) The results showed that the highest precision for control tipping of anterior teeth was determined for the 0.010 inch Stainless Steel Tie (Pelz and Partner). Furthermore, the Tip-Bar™ brackets increased the maximal moment by 33.8% for elastic and steel ligatures. (4) Conclusions: The lateral tooth movement is highly dependent on the type of ligature and applied material during orthodontic treatment with lingual appliances. The use of 0.010 inch steel ligatures and the Tip-Bar™ bracket design results in better alignment in the anterior teeth segment.

Meeting on February 26, 1933

1) Ave.-Assoc. E. D. Ruzsky made a report on the shortcomings of submerged silk sutures applied to the aponeurosis during laparotomy. The report was based on 4 cases of the appearance of late after a month or more inflammatory infiltrates in the skin wound with the formation of fistulous passages and the expelling of silk sutures after well, even by primary intention, of the healed abdominal wall incisions during laparotomies. The suppuration lasted for a long time from 7 months. up to 2 years, until all the sutures came out, and the patients remained disabled all this time. The speaker sees the reason for these complications in the properties of silk threads, namely, in their non-absorbability, porosity and ability to drain. In view of all this, he does not advise using silk as a ligature material for suturing the aponeurosis of the abdominal walls during laparotomy.