The vermiform appendix is a narrow, muscular diverticulum of the cecum, exhibiting considerable variability in position, shape and size. It originates from the cecal fundus near the ileocecal valve at the convergence of the three taeniae coli, a key surgical landmark for identifying its base. This study aimed to determine the distance between the base of the vermiform appendix and the ileocecal junction in a Bangladeshi population across different age and sex groups. Specimens, including the vermiform appendix along with adjacent segments of the distal ileum, cecum and proximal ascending colon, were collected from medico-legal autopsies of individuals aged 5-75 years. The study was conducted in the Department of Anatomy, Mymensingh Medical College, Bangladesh, from October 2016 to March 2017. The samples were categorized into four age groups: Group A (Up to 20 years), Group B (21-40 years), Group C (41-60 years) and Group D (>60 years), with further subdivision by sex. The external distance was measured from the lower border of the terminal ileum at its junction with the cecum to the midpoint of the appendiceal base. The internal distance was recorded between the nearest edges of the ileocecal and appendicular orifices after opening the cecum. Measurements were taken using a point divider, which was then placed on a measuring scale graduated in centimeters. The maximum external distances recorded were 2.60 cm, 2.60 cm, 2.80 cm and 3.00 cm in Groups A-D, respectively, while the minimum values were 1.80 cm, 2.00 cm, 2.00 cm and 2.10 cm. Internal distances showed a similar increasing trend with age, with maximum values of 2.80 cm, 3.00 cm, 3.00 cm and 3.12 cm and minimum values of 2.00 cm, 2.00 cm, 2.00 cm and 2.20 cm across the groups. Although mean distances were higher in males, the differences between sexes were not statistically significant (p≥0.05). These findings provide population-specific anatomical data that may assist in preoperative planning and intraoperative orientation, potentially reducing operative time, minimizing iatrogenic injury and improving surgical outcomes in appendiceal and right iliac fossa procedures.

Post-mortem computed tomography (PMCT) is increasingly used in forensic investigations as a non-invasive screening tool; however, its ability to assess the vascular system remains limited. Multiphase post-mortem computed tomography angiography (MPMCTA) was developed to overcome these limitations, but its contribution to routine medico-legal investigations requires further evaluation. This monocentric observational study included 37 non-hospitalized individuals who died suddenly and underwent non-contrast PMCT, MPMCTA, and subsequent blinded medico-legal autopsy with histological and toxicological examinations at the Legal Medicine Institute of the University of Modena and Reggio Emilia. Imaging findings were correlated with autopsy and histological results. MPMCTA showed a high degree of concordance with autopsy for major vascular lesions, enabling accurate pre-autopsy visualization and localization of coronary thrombosis, aortic rupture/dissection, pulmonary arterial filling defects, and neoplastic vascular involvement. By contrast, several pathological conditions, including myocardiosclerosis, myocarditis, pneumonia, and some cases of acute or previous myocardial infarction, could only be definitively diagnosed through histological examination. These findings support the role of MPMCTA as a valuable adjunct to conventional autopsy in cases of sudden natural death. By improving the pre-autopsy assessment of vascular pathology, MPMCTA may facilitate lesion localization and support a more targeted post-mortem investigation.

Body mass index (BMI) is routinely recorded in forensic autopsy practice and represents a well-established risk factor for numerous natural causes of death. However, its role as a procedural modifier influencing autopsy workflow, technical complexity, and operator cognitive performance has not been systematically investigated. This study aimed to evaluate the impact of BMI on autopsy duration, anatomical-technical difficulty, and operator vigilance under standardized medico-legal conditions.A total of 50 consecutive medico-legal autopsies performed for natural deaths were prospectively analyzed, including an obese cohort (n = 25, BMI ≥ 30kg/m²) and a non-obese control group (n = 25, BMI < 30kg/m²), matched for age and sex and examined using an identical standardized autopsy protocol. The term "consecutive" refers to all eligible medico-legal autopsies for natural deaths performed during the study period, excluding cases of violent or suspicious death and those not meeting inclusion criteria. The cases were collected over a period of approximately six months, during which all qualifying autopsies were prospectively included. Body mass index was analyzed both as a continuous variable and according to obesity severity classes. Autopsy duration was objectively measured from the first skin incision to completion of organ removal. Operator vigilance was assessed using the Mackworth Clock Test, administered to both primary and secondary operators immediately before and after each autopsy. Morphometric assessment of subcutaneous adipose tissue thickness at the thoracoabdominal incision site and qualitative evaluation of technical difficulty were also performed.Autopsy duration was significantly longer in obese cases compared with controls (mean 219.6 ± 26.9 vs. 184.2 ± 14.9min; p < 0.001), with a progressive increase across obesity classes. Within the obese cohort, BMI was a significant predictor of procedural duration, with an estimated increase of approximately 4min per BMI unit. Increased autopsy duration was associated with an exploratory signal of vigilance decrement, which was greater in obese cases than in controls. Each additional 30min of procedural time was associated with an increase of approximately one missed critical stimulus on post-autopsy vigilance testing. In all cases with BMI ≥ 35kg/m², subcutaneous adipose tissue thickness exceeded 4cm, correlating with deeper incision planes, delayed cavity access, and increased technical difficulty.These findings suggest that obesity may act as a procedural modifier in forensic autopsy practice and support further investigation of workload-related cognitive effects under standardized conditions.

Epilepsy and traumatic brain injury have a bidirectional relationship. This study aimed to report the prevalences of antemortem epilepsy diagnosis, seizure history, epilepsy-related and traumatic neuropathological findings, as well as background characteristics, among neuropathologically examined medico-legal autopsy cases with acute head injuries. The sample included 82 cases from Helsinki, Finland, from the years 2016-2022. Of the sample, 17 cases had an epilepsy diagnosis or documented seizure history ("Epilepsy/Seizure Group"), whereas 65 did not ("No Seizure Group"). The most frequent epilepsy-related neuropathological findings were hippocampal atrophy and mossy fibre sprouting. Of background characteristics, the Epilepsy/Seizure Group had a higher prevalence of old head injuries (41.2% vs. 7.7%) and chronic alcohol use (41.2% vs. 18.5%) than the No Seizure Group. There were no statistically significant differences in acute head injuries or secondary neuropathological findings, except for a lower prevalence of oedema in the Epilepsy/Seizure Group (17.6% vs. 47.7%). Even though the Epilepsy/Seizure Group had a higher prevalence of old head injuries and chronic alcohol use, the prevalences of acute head injuries were not higher. Larger studies are needed to further explore whether individuals with epilepsy or seizure history are susceptible to distinct head injury types or circumstances.

Introduction: Head injury is a major cause of morbidity and mortality worldwide, and accurate assessment of traumatic head injuries is important for both clinical management and medicolegal investigations. Computed tomography (CT) is routinely used for the evaluation of head injuries in living patients, whereas medicolegal autopsy remains the standard method for postmortem assessment. This prospective comparative observational study was conducted to compare antemortem CT scan findings with autopsy findings in fatal head injury cases.Methodology: A total of 34 cases that underwent both antemortem CT examination and subsequent medicolegal autopsy were included. Findings related to scalp injuries, skull fractures, extradural hemorrhages (EDHs), subdural hemorrhages, subarachnoid hemorrhage (SAH), brain contusions, brain lacerations, intraventricular hemorrhage (IVH), and cerebellar herniation were compared. Agreement between CT scan and autopsy findings was assessed using percentage agreement, Cohen’s kappa coefficient, and McNemar’s test.Results: Substantial agreement was observed for skull fractures, EDH, IVH, and cerebellar herniation, whereas lower agreement was observed for scalp injuries, SAH, and brain lacerations.Conclusions: Antemortem CT scan demonstrated good concordance with autopsy for skull fractures and major intracranial hemorrhages and proved to be a valuable adjunct in the evaluation of fatal head injury cases. However, a CT scan could not completely replace conventional medicolegal autopsy. These findings support the complementary role of CT imaging in forensic practice and its potential contribution to the development of CT-based virtual autopsy in head injury cases. Furthermore, by directly comparing antemortem CT findings with subsequent autopsy findings, this study provides evidence that may facilitate future integration of antemortem CT data into medicolegal practice and guide further research on CT-based virtual autopsy, particularly in resource-limited settings.

Background: The clinical autopsy is a common term used to help in the identification of person’s clinical conditions and causes of deaths, however, the autopsy plays a vital role in the justice and jurisprudence. Objective: To determine the knowledge, beliefs and understanding of medical students regarding the autopsy Study Design: Descriptive, cross-sectional study. Place and Duration of Study: Dhanalakshmi Srinivasan Medical College and Hospital; 01/06/25-31/08/25. Methodology: 350 students from first year to CRMI were recruited based on random sampling method. Results: Among 350 students, 100% (n=350) correctly identified determining cause and manner of death as the primary purpose of forensic autopsy. 94% (n=332) knew death due to known chronic illness under hospital care is not an indication, while 4% (n=10) selected death in police custody and 2% (n=8) selected sudden unexpected death. 97.4% (n=341) recognized court order/police requisition as the authorizing document. Knowledge of BNSS 2023 was high: 71% (n=250) identified BNSS as the authority for medico-legal autopsy, 85% (n=296) knew Section 194 governs police inquest, and 88% (n=308) knew Section 196 covers magistrate-ordered exhumation. 89% (n=309) had witnessed ≥1 autopsy; of these, 36% (n=127) attended 1–2, 53% (n=184) attended 3–5, and 1% (n=1) attended &gt;5. Major knowledge sources were textbooks 44% (n=154), practical demonstration 35% (n=124), and lectures 20% (n=71). Regarding benefits, 52% (n=183) cited gaining knowledge about forensic pathology and 46% (n=162) cited understanding legal aspects of medicine. Attitudes were positive: 92.3% (n=323) agreed/ strongly agreed autopsies are essential for justice; 90.9% (n=316) agreed/strongly agreed exposure enhances clinical diagnostic skills. Cultural/religious discomfort was low: 47% (n=165) strongly disagreed and 25% (n=87) somewhat disagreed that observing autopsies is uncomfortable. On post-mortem exposure, 40% (n=140) were neutral, 23% (n=82) somewhat comfortable, and 11% (n=40) very comfortable. Only 22.6% (n=79) strongly agreed MBBS training is adequate, while 47% (n=165) somewhat agreed. Misconceptions existed: 57% (n=199) incorrectly stated histopathology is not part of standard forensic autopsy. 95% (n=331) were aware of virtual autopsy. Key learning outcomes reported were understanding cause and manner of death 60% (n=211) and correlating clinical diagnosis with autopsy findings 33% (n=114). 86% (n=302) felt this research improves medical education, patient care, and forensic autopsy guidelines. Conclusion: The autopsies and experiences regarding the autopsies was integral part of medical curriculum. The studies of autopsies are helpful to understand the human anatomy and reasons of deaths. The student's perceptions supported the medical autopsies as important part of curriculum and teaching particular anatomy of human subjects.

Mucormycosis is an aggressive opportunistic fungal infection that primarily affects immunocompromised individuals and is associated with high mortality when diagnosis and treatment are delayed. Although commonly reported in clinical settings, autopsy-based documentation remains important for understanding fatal, clinically unrecognised cases. We report a fatal case of angioinvasive cerebral mucormycosis identified during medico-legal autopsy in a middle-aged individual with underlying diabetes mellitus. The decedent had a recent history of facial trauma and clinical deterioration prior to death. Autopsy examination revealed significant pathological changes in multiple organs, with histopathological evaluation demonstrating broad, pauciseptate fungal hyphae with angioinvasion consistent with mucormycosis, most prominently involving cerebral vessels and parenchyma. Secondary bacterial infection was also identified in clinical investigations, suggesting a possible contributory role in fulminant progression. The findings highlight the aggressive vascular invasion characteristic of mucormycosis and the diagnostic challenges encountered in the clinical setting. This case emphasises the critical role of meticulous autopsy examination and histopathological analysis in identifying invasive fungal infections that may remain undiagnosed during life. Recognition of such infections in medico-legal investigations is essential for accurate determination of the cause of death and for improving awareness of rapidly progressive opportunistic infections.

Accurately estimating the post-mortem interval (PMI, also known as time since death) remains a major challenge in forensic science due to substantial biological and environmental variability in human cases. While animal models provide controlled conditions for identifying PMI-related metabolic changes, their translational value for human forensics is unclear. This study bridges controlled rat metabolomics with real-world human autopsy samples using LC-MS-based metabolomics and machine learning. We analyzed femoral blood from 435 medico-legal autopsies (PMI 1-10 days) and employed two complementary modeling strategies. An untargeted Lasso model using all 3450 detected features achieved R2 = 0.51 and identified 51 consistently selected PMI-informative molecular features. To assess cross-species robustness, we reanalysed rat samples using the same analytical platform. Eighteen of the 51 human-derived features were detected in rats, showing clear PMI-dependent trends and strong correlations with PMI. Two metabolites achieved level 2 annotation and matched known PMI biomarkers from previous animal studies, demonstrating meaningful human-to-rat biochemical overlap. In contrast, a targeted Lasso model based on biomarkers identified in rats performed poorly in humans (R2 = 0.10), underscoring limited direct rat-to-human translation. Overall, human-derived biomarkers validated robustly in the controlled rat model proved far more reliable. These findings highlight both the potential and limitations of cross-species PMI biomarker discovery and emphasize the need for improved metadata, especially temperature history, to advance PMI modeling in forensic practice.

Assessing postmortem brain edema: A comparative evaluation of estimation techniques.

Falls from a height usually cause blunt trauma involving multiple body regions, but penetrating injuries are relatively uncommon; they occur when a rigid object penetrates the body. This can cause catastrophic internal damage depending on the structures involved. We report a fatal case of isolated thoracic impalement in a 49-year-old man who reportedly fell from a tree onto a pointed wooden stave. He was pronounced dead on arrival at hospital. Medico-legal autopsy revealed a penetrating injury traversing the thorax from the left posterolateral chest to the right upper anterolateral chest, with a flat wooden stave found in situ along the wound track. Internal examination demonstrated lacerations of the left lung, pericardium and posterior walls of both ventricles. No additional injuries were identified, and toxicological analysis was negative. Scene investigation confirmed that the wooden stave had been secured to the base of the tree to support a creeping plant and its orientation corresponded with the trajectory of the wound track. The injuries were incompatible with survival and death would have occurred rapidly due to catastrophic cardiac damage. The death was therefore determined to be accidental. This case highlights the importance of correlating autopsy findings with scene investigation when evaluating unusual penetrating injuries associated with falls from a height.

Aortic stenosis (AS) is the most common valvular heart disease and typically progresses slowly, often becoming symptomatic in older people. Sudden death in previously asymptomatic individuals is rare, particularly in middle-aged adults. We report a case of a 48-year-old male carpenter who collapsed while engaging in his routine work. He was pronounced dead shortly after arrival at hospital. Medico-legal autopsy revealed a markedly enlarged heart weighing 682 g. The aortic valve was severely stenosed, heavily calcified and distorted, producing an orifice of approximately 1 cm. The valve appeared to have two cusps, suggesting possible congenital bicuspid morphology, though definitive confirmation was precluded by advanced calcification. The left ventricle demonstrated symmetrical concentric hypertrophy with a wall thickness of 2.5 cm. No right ventricular hypertrophy, septal asymmetry or pulmonary oedema were observed. Histology confirmed hypertrophied myocardial fibres without myofibrillar disarray or fibrosis. Urine toxicology was negative. Death was attributed to severe aortic stenosis, with the probable mechanism being fatal arrhythmia precipitated by exertion. This case highlights the silent but potentially fatal nature of severe AS, the importance of thorough autopsy examination, and the value of forensic insight in sudden unexpected deaths.

Splenic artery aneurysm (SAA) rupture is a deceptive cause of sudden unexpected death presenting significant medicolegal challenges. This retrospective case series and comprehensive literature review analyzes the clinicopathological features of six nontraumatic fatal SAA ruptures. Clinical presentations were predominantly nonspecific, resulting in diagnostic delays and medicolegal inquiries in two cases. A size-rupture paradox was observed, as fatal hemorrhage occurred across a wide diameter spectrum (3-12 cm), proving that small aneurysms also carry lethal potential. The literature review elucidates the multifactorial etiopathogenesis of SAA, encompassing genetic, hormonal, hemodynamic, and inflammatory factors. Furthermore, the clinical trajectory of delayed fatality is explained by the double-rupture phenomenon, which creates a deceptive lucid interval. Histochemical evaluation utilizing Elastic Verhoeff-Van Gieson (EVG) staining was pivotal, demonstrating severe internal elastic lamina loss to confirm spontaneous degenerative rupture and exclude trauma. Consequently, meticulous celiac trunk dissection and routine EVG histochemistry must be integrated into forensic autopsy protocols evaluating unexplained hemoperitoneum to accurately determine the cause of death and address liability disputes.

Wischnewsky spots are considered strongly associated with postmortem diagnosis of hypothermia with an unclear pathophysiology. Recent studies have suggested an association between Wischnewsky spots and diabetic ketoacidosis, yet no systematic data exist about Wischnewsky spots in other ketotic states besides hypothermia. To elucidate the pathogenesis of Wischnewsky spots, we studied their presence in relation to ketosis/ketoacidosis, glucose, urine catecholamines, and toxicological factors. We included all medicolegal autopsies (n = 1903) with an ancillary glucose metabolism assay in the database of Forensic Medicine Unit, Finnish Institute for Health and Welfare, Oulu, Finland in 2019-2023. Cases were divided into hypothermia deaths, diabetes-related deaths, alcohol-related deaths, and other causes of death. The presence and extent of Wischnewsky spots were estimated from the autopsy reports. Concentrations of β-hydroxybutyric acid (BHB), glucose, ethanol, acetone, isopropanol, urinary adrenaline and noradrenaline, and the presence of cyclooxygenase-1 inhibitors were assessed. Mean BHB concentrations were higher with sparse, moderate, or extensive Wischnewsky spots compared with those with no Wischnewsky spots documented. Odds ratios for Wischnewsky spots were 3.7 with BHB concentration ≥ 0.5 mmol/L, 3.6 with BHB concentration > 2.5 mmol/L, 4.8 with positive blood acetone, 3.6 with positive urine acetone, and 2.2 with adrenaline-noradrenaline ratio > 0.1876. Our findings showed a clear, concentration-dependent association between BHB concentration and the presence of Wischnewsky spots irrespective of the underlying cause of death. Our results indicate that Wischnewsky spots are linked to disturbances in glucose metabolism, not exclusively to hypothermia, highlighting the diagnostic importance of postmortem BHB measurement.

Stature estimation is an important component of forensic identification, particularly when incomplete skeletal remains are encountered. Although long bones are the preferred skeletal elements for stature estimation, cranial parameters may provide supplementary information when conventional skeletal remains are unavailable. The potential relationship between cranial suture length and stature remains insufficiently explored.This exploratory study aimed to evaluate possible associations between cranial suture lengths and stature and to assess their potential supplementary role in stature estimation in a North Indian population. This prospective cross-sectional autopsy-based study included 80 medico-legal autopsy cases aged ≥21 years. Coronal, sagittal, and lambdoid suture lengths (CSL, SSL, and LSL) were measured ectocranially using a thread-and-caliper method. Supine body length was recorded as stature. Pearson correlation and linear regression analyses were performed to evaluate associations between suture lengths and stature. Regression assumptions were assessed prior to model interpretation. The study included 80 individuals (54 men and 26 women) aged 21-80 years. Mean stature in male subjects was 1698.7 ± 80.9 mm, whereas in female subjects, it was 1585.4 ± 92.9 mm, with a statistically significant difference between sexes (p = 0.0005). SSL and LSL demonstrated statistically significant but weak positive correlations with stature in the combined sample (r = 0.302 and 0.297, respectively). CSL showed no statistically significant association. Sex-specific analyses did not demonstrate significant correlations. Linear regression analysis produced the following equations for stature estimation: Stature (mm) = 1356.151 + 2.219 × SSL (mm) Stature (mm) = 1401.116 + 1.506 × LSL (mm) Regression models demonstrated low explanatory power (R² < 0.10), indicating limited predictive capability. Cranial suture lengths demonstrated statistically significant but weak associations with stature in the combined study population. However, the low predictive accuracy and limited explanatory power indicate that these measurements possess restricted forensic utility when used independently. Cranial suture measurements should therefore be considered supplementary rather than primary indicators for stature estimation. Further validation studies with larger populations are required.

Background: Death is considered sudden or unexpected when a person not known to be suffering from any dangerous disease, injury, or poisoning is found dead or dies within 24 hours after the onset of terminal illness, as per the WHO definition. In such cases, an autopsy plays a crucial role in determining the exact cause of death and helps the bereaved relatives rule out any suspicion of foul play. The present study aims to analyse the age, sex and system-wise distribution of causes of sudden death. Methodology: - This retrospective study was carried out at a tertiary care hospital, from 1st January 2023 to 31st December 2023. We reviewed autopsy reports and inquest papers and documented demographic details and cause of death. The data was analyzed statistically. Observation: During the study period, a total of 556(24.7%) sudden death cases were recorded out of 2246 medico-legal autopsies. Most of the sudden deaths (82.7%) were observed in the 31- 60 years of age group with a male-to-female ratio of 3:2. The most common system involved in sudden death was the cardiovascular system (64%) followed by the respiratory system (23%), gastrointestinal system (10%) and CNS (3%). In the cardiovascular system, coronary artery disease (79.5%) was the leading cause of death.

Ischaemic large bowel necrosis is a rare but severe complication following open abdominal aortic aneurysm (AAA) repair. Postoperative deaths from this condition often prompt medico-legal evaluation. We report a case of a 75-year-old hypertensive male who underwent elective open repair of an incidentally detected infrarenal AAA. On the fourth postoperative day, he developed progressive abdominal distension, oliguria and metabolic acidosis. Despite intensive management, including intravenous antibiotics, vasopressors, fluid resuscitation and haemodialysis, he deteriorated and died on the seventh postoperative day. Medico-legal autopsy revealed transmural necrosis and perforation of the rectum with generalised purulent peritonitis. The aortic graft was intact and appropriately positioned. Advanced atherosclerosis and chronic infrarenal dissection were present. The findings were consistent with Grade III ischaemic colitis, culminating in septic shock and multi-organ failure. This case highlights the importance of structured forensic evaluation in distinguishing recognised postoperative complications from potential negligence and emphasises the need for careful medico-legal evaluation.

Background: Traumatic brain injury (TBI) is a leading global cause of death and disability. Sub-Saharan Africa bears a disproportionately high TBI-related mortality, with homicide contributing significantly, yet data on the region's neuropathological patterns of homicidal head trauma remain limited. Objective: To describe the mechanisms of injury, demographic characteristics, and neuropathological patterns of homicidal head injuries in Nairobi, Kenya. Materials and Methods: This prospective descriptive study was conducted over one year at Nairobi City Mortuary (July 1, 2009-June 30, 2010). Data on age, biological sex, and circumstances of death were obtained from police reports and identification documents. All violent deaths undergoing medicolegal autopsy were reviewed, and cases with confirmed homicidal head injuries were analyzed. Autopsy findings, including skull fractures and intracranial injuries, were documented, entered into Statistical Package for the Social Sciences, and summarized using frequencies, percentages, means, and standard deviations. Results: During the one-year study, 2278 cases of violent death were examined, of which 1060 (46.5%) involved head injuries. Among these, 630 cases (59.4%) were confirmed as homicidal. The mean age of victims was 26.9 ± 9.4 years, with the 20 to 29 year age group representing the largest proportion (46.1%). Males predominated, accounting for 96.1% of cases. The leading mechanism of injury was gunshot (50.3%), followed by blunt force trauma (46.7%) and sharp force injuries (3.0%). Skull fractures occurred in all victims, most commonly involving the frontal bone (23.2%). Brain contusions (19.7%), lacerations (18.6%), and epidural hematomas (15.2%) were the most frequent intracranial injuries. Conclusion: Homicidal head injuries represent a substantial proportion of violent deaths in Nairobi and predominantly affect young adult males. Characteristic neuropathological patterns observed during autopsy include multiple skull fractures and intracranial hemorrhages associated primarily with firearm and blunt force trauma.

The growing use and improved accessibility of noninvasive imaging modalities have increased the detection of incidental intracranial findings, such as unruptured brain arteriovenous malformations (AVMs). At the same time, existing literature presents conflicting findings regarding whether the incidence of ruptured AVMs has increased or decreased. Considering these developments, we hypothesized that the detection rate of unruptured AVMs has increased, and the detection rate of ruptured AVMs has changed over the period of 18 years, potentially reflecting shifts in underlying vascular risk profiles and preventive health behaviors. In this retrospective population-based study, we identified all hospitalized and nonhospitalized (prehospital sudden death) individuals with AVMs in Southern Finland between 1998 and 2015 from the National Cause of Death Register autopsy reports (using ICD-10 codes I60.8, I61.0-I61.9, Q28.0-Q28.3) and the Helsinki AVM Register. European Standard Population age-standardized detection rates with 95% CIs were determined in 3-year intervals for both ruptured and unruptured AVMs. Significance in detection rate trends was analyzed with Poisson regression on 3-year sliding averages. Between 1998 and 2015, 288 individuals (minimum age 0.2 years, mean age 41.1 years, SD = 18.0 years, 48.3% women) with AVMs were identified; 284 were hospitalized, and 4 died from AVM at home (diagnosed at medicolegal autopsy). The overall (men and women) detection rate of both ruptured and unruptured AVMs decreased from 0.91 (95% CI 0.66-1.17) to 0.40 (95% CI 0.24-0.56)/100,000 person-years during 1998-2015. The annual decrease for ruptured and unruptured AVMs was 5.7% in men (95% CI 3.6%-7.8%), 5.9% in patients <30 years (95% CI 3.2%-8.7%), 4.8% in patients aged 30-59 years (95% CI 2.7%-7.0%), and 2.2% in women (95% CI 0.0%-4.3%). Detection rates decreased by 4.6% annually for ruptured AVMs (95% CI 2.6%-6.6%) and 3.1% for unruptured AVMs (95% CI 0.7%-5.4%). Contrary to our hypothesis, we observed a decline in the overall detection rate of unruptured AVMs over the 18-year study period. Moreover, we found a substantial reduction in the number of ruptured AVMs among men, women, and patients younger than 60 years. The reasons for these rapid changes remain unclear and warrant further investigation.

Drug consumption is a recognized risk factor for morbidity and premature mortality worldwide. Toxicological findings in medico-legal death investigations provide important epidemiological insight into patterns of substance exposure within a population. This retrospective study aimed to characterize the prevalence and distribution of drugs detected in peripheral blood among decedents undergoing medico-legal autopsy in the Bío-Bío region of Chile between 2016 and 2020. Cases were identified from the regional office of the Servicio Médico Legal. Decedents were included when at least one drug was detected and confirmed in peripheral blood. A total of 678 decedents had at least one drug detected during the study period. The most frequent certified causes of death were disease (29.2%), trauma (26.8%), asphyxia (15.0%), and suicide (10.6%). Men represented 82.6% of cases and women 17.4%. The most commonly detected substances were cocaine (45.7%), benzodiazepines (28.3%), and tetrahydrocannabinol (THC) (12.7%). Ages ranged from 1 to 96 years, with 84.5% of cases older than 31 years. Benzodiazepines and amitriptyline were more frequently detected among older decedents, whereas cocaine and THC predominated in younger age groups.

This paper only for the intention of achieving the freight and measure the real story of suicidal behavior in rural area of Banglidsh. Hanging or self suspension is a form of ligature strangulation where the pressure is produced by the weight of the body. This study driven in the rural area but the risk factors might be very different in urban Bangladesh. The objective of this study was to find out socio-demographic characteristics of victim common age, sex, ligature materials used by victim and post mortem findings. This retrospective cross sectional study was done in Rajshahi Medical College mortuary during the period of January 2017 to January 2018. During this period data was collected from 2776 cases of medico-legal autopsies by purposive sampling. A total of 2776 medico-legal autopsies were analyzed of which 110(3.96%) were death due to hanging. Out of this cases maximum 43(39.09%) death due to hanging where the age group of was between 21-30 years. Majority of this cases 57(51.81%) were observed in females. Majority 38(34.54%) of victims had used Dopatta(orna) as a ligature material. Cyanosis in the fingertips of nail beds was the common 42(38.18%) findings in most cases of asphyxial death of hanging. Here typical hanging found more in 62(56.36%) cases, complete hanging in 71(64.54%) cases, death more in rural area 70(63.63%), death in SSC level 38(34.54%), 43(39.09%) death more in lower economic people and suicide more in the marital discord is 32(29.09%). Self suspension or suicidal hanging occurred in most cases within the young age group ranging from 21-30 years which was executed in this study. So awareness at the level of all family and community should be increased to cide should also be investigated for this stoppage.