Medicolegal Autopsy Research Articles

Profile of Medicolegal Autopsies Conducted at Bundelkhand Medical College, Sagar (M.P.)

Death of humans is often investigated for the causes, in case of crime (such as Murder), accident or diseasethat may continue to kill other humans. Deathoccurs due to natural causes or unnatural causes. The studyof profile of medicolegal autopsies help us in determining crime rate, accident and common diseases in thatparticular area and also helpful in preventing unnatural deaths, improving healthcare system and reflectinglaw and order situation of that area. The present study was based on retrospective analysis of the autopsiesperformed during the period of January 2018 to December 2018 in the Department of Forensic Medicineand Toxicology, Bundelkhand Medical College, Sagar (M.P).A total of 349 autopsies were conducted duringthis study period, of which majority of victims were male 195 (56%) cases. Age group of 21-30 years havingmaximum number i.e. 128 (36.7%) cases. Natural death accounted for 12 (3.4%) cases and unnatural death323 (92.5%) cases. The major cause of death among unnatural deaths was burn in 116 (33.23%) cases,followed byroad traffic accident (RTA) in 106 (30.37%) cases and poisoning in 40 (11.46%) cases. Burnwas the major cause of death in our study, this may be due to smoking, defective electrical wiring, defectivekerosene stove bursts, attempted suicides by self-immolation, homicidal burns of young women by husbandor in-laws (dowry deaths).

Why men being the victim of suicidal hanging? – A prospective study

To study the epidemiological profile in Deaths due to hanging, which is a common suicidal tool. To analyze the increase incidence of male death : A prospective study consisting of 40 suicide cases of hanging during the period of January 2012 to September 2013 brought to the mortuary of Sri Ramachandra Medical College and Research Institute, Chennai. It was observed that deaths due to hanging constituted 15% of the total unnatural deaths subjected to medico-legal autopsy; young adults, of the age group 21 to 30 years accounted for the maximum cases, with a male: female ratio of 3:1. 70% of the victims preferred closed room, 77.5% of them used soft and broad ligature material. This study highlight the importance of once mentality, where male gender are being highly encounter for ending up their lives due to stress in their family life. Gender is not a criterion for depression.

The Study of Profile of Autopsy Cases of Hanging with Respect to Educational Status, Family Status and Place of Hanging of Victims in a Rural Region of Central India

The increase crime rates with stress in the day to day life is responsible for vide range of medico legalautopsies in the society. The violent asphyxial deaths are responsible for the large number of medicolegalautopsies out of which hanging is a very common in society. Hanging is the cheapest and painless formof self-destruction. It has been employed as the method of suicide since time immortal. The study underconsideration is a cross sectional study which was carried on the dead bodies of either sex. The deceasedwere brought for medico legal autopsy with the history probably revealing the cause of death due to hangingin the autopsy room at a medical college in Central India from 1st August 2011 to 31st July 2017. Thenumber of hanging cases during the study period were 101,the majority of victims 66 (65.34%) belong to thenuclear family while the 31 (30.69%) cases belong to the joint family. The family status of 4 (3.96%) casescannot be ascertained as the bodies were unidentified. The majority of victims 70 (69.30%) cases, preferredindoor place for hanging while about 31 (30.69%) cases preferred outdoor place for hanging. Consideringtheir educational status about 24.75% cases had educated upto primary school, 10.89% had upto secondaryschool, 24.75% upto higher secondary, 22.77% upto graduate or more and 11.88% were uneducated. Also in4.95% cases, the educational status was unknown.

A Five Years Retrospective Study of Incidental Findings in Medico-Legal Autopsies

Aim of the study: The aim of the study is to find out the spectrum of incidental pathological lesions inthe deceased during medico legal autopsy which are not directly related to the cause of death. This studyemphasizes the incidence of various incidental lesions which otherwise would have been unnoticed duringa person’s life.Materials and method: A five years retrospective study was conducted from 2012 to 2017 at the departmentof Forensic medicine Assam Medical College and hospital,. The organs where the pathological lesions weredetected mostly comprise of lungs, liver, kidneys and heart. The sections from organs were preserved in10% formalin and prepared for histopathological examination. The gross and histopathological findingswere noted.Results: 75 cases of cirrhosis of liver, 62 cases TB lung,93 cases of coronary artery disease and 18 casesof cystic lesions of kidney were detected where the cause of death is not directly related with these lesions.

Observational Study of Sociodemographic Profile on Female Autopsy Cases of J.L.N Medical College, Ajmer

Introduction:- Unnatural deaths of females in a particular geographic area is the reflection of its law andorder situation. Lower incidences indicate presence of peace, harmony and security in the society. Presentstudy is designed to determined unnatural deaths of females in Ajmer city. This study includes the varioussocio-etiological aspects of un-natural female death. The findings of our study is useful in planning ofprevention polices.Aims & objectives:- -To collect the statistical data of Autopsy cases of unnatural female death cases broughtto J.L.N. Hospital, Ajmer mortuaryObjectives:- To study the various socio demographic data of autopsy cases of un-natural deaths of females.Material and Method:- Population Universe:-All Medico-legal Autopsies conducted in Department of Forensic Medicine and Toxicology at J.L.N. MedicalCollege and Associated Group of Hospitals, Ajmer. These were total 953 medico-legal autopsies in numberCase Study:- As present study comprised 170 autopsy cases of unnatural female deathsStudy period:- 1st April 2019 to 31st March 2020Method:- Performa for study was prepared on the basis of information obtained from Autopsy, Panchnama,questionnaire of relatives and all collected data were put into the master-chart, which was prepared and thenfeed into the computer in Excel worksheet and then analyzed.Observation & Results:- More than half of victims were married (69.41%) Among the married women,maximum cases (61.86%) were of more than 7 years of marriage life. Highest number of cases (40%)was seen in Summer. Literate women comprise of about 66.47% of total cases. Highest number of cases(50.58%) was of accidental in nature. Suicidal deaths constituted more than half of deaths which occurredwithin in seven year of married life. Burns (30.58%) was most common cause of death. It was also same inroad traffic accidental deaths (30.58%). Most common poison which causes 66.66% deaths is OPC whileSecond most common was ALP (13.88%).Recommendations:-our target group for prevention of unnatural deaths should be married woman of first twoyear of married life of age segment of middle economic literate Hindu group

A Study of Patterns of Thoracic Injuries in the Victims of Vehicular Incidents Brought to the GMCH Mortuary for Medicolegal Autopsies

A Study of Patterns of Thoracic Injuries in the Victims of Vehicular Incidents Brought to the GMCH Mortuary for Medicolegal Autopsies

The Application of Mitochondrial COI Gene-Based Molecular Identification of Forensically Important Scuttle Flies (Diptera: Phoridae) in Korea.

Phoridae are a family of necrophagous flies commonly found in indoor death scene. They account for approximately 19.7% of the entomofauna in human cadavers in Korea. Additionally, this taxon is an indicator of indoor hygiene, and these flies appear in environments where access by other necrophagous insects is difficult, such as enclosed rooms. Thus, they are likely to be used as forensic evidence. Despite their importance in forensic investigations and environmental hygiene, detailed studies on the taxonomy and molecular barcoding for this family are scarce, including in Korea. Because accurate taxonomic information regarding necrophagous insects collected from a death-related scene is essential during medicolegal investigations, molecular barcoding data could be useful as well as reliable. In this paper, full-length nucleotide sequences of genes coding for the cytochrome c oxidase subunit I (COI) in 79 Phoridae larvae collected from 20 medicolegal autopsy cases in Korea were phylogenetically analyzed by comparing their sequences to the foreign barcoding data of Phoridae. Six mitochondrial haplogroups were identified, which two of them matched to foreign Phoridae fly species haplotypes, Megaselia scalaris (Loew, 1866) and M. spiracularis Schmitz 1938. Taxonomies of five other haplogroups, with nucleotide distances ranging from 1.68% to 2.26% from the M. scalaris group, could not be confirmed solely based on the molecular barcoding data. Further research should be performed to determine whether these five haplogroups are diverged conspecifics of M. scalaris or a closely related sister cryptic species of M. scalaris.

Fatal hemorrhage complicated with methamphetamine poisoning and its post-mortem CT features.

The purpose of this study was to assess the incidence of fatal hemorrhage complicated with methamphetamine (MA) poisoning and to examine the postmortem computed tomography (PMCT) features of fatal intracerebral hemorrhage (ICH) with and without MA poisoning. The study also attempted to determine the differences in PMCT between those two groups. Consecutive medicolegal autopsy data from November 2011 to February 2018 were searched for 3044 cases. First, the incidence and distribution of all cases of nontraumatic fatal hemorrhage with various causes were examined. Second, cases of ICH on the basal ganglia and brain stem were extracted. The PMCT findings were compared with respect to nine parameters: volume of hematoma, ventricular perforation, midline shift distance, aortic calcification, calcification of aortic valve, calcification of coronary artery, cardiothoracic ratio, circumference of ascending aorta, and volume of bladder contents. Of the 3044 cases, 97 were nontraumatic fatal hemorrhage; of these 97 cases, 20 were classified as MA poisoning with 9 ICH cases, and 60 cases were classified as non-MA poisoning with 14 ICH cases. A statistically significant difference in ages was observed between the two groups. On PMCT comparison of ICH, statistically significant differences were evident in the midline shift distance and calcification of the aortic valve. Forensic radiologists should be aware of the possibility of ICH with MA poisoning if fatal hemorrhage is detected on PMCT. Younger age, less calcification of the aortic valve, and a remarkable midline shift may be the keys to recognition.

Increased Beat-to-Beat Variability of T-Wave Heterogeneity Measured From Standard 12-Lead Electrocardiogram Is Associated With Sudden Cardiac Death: A Case–Control Study

IntroductionThe prognostic significance of beat-to-beat variability of spatial heterogeneity of repolarization measured from standard 12-lead ECG is not well-understood.MethodsWe measured the short-term variability of repolarization parameters, such as T-wave heterogeneity in leads V4–V6 (TWH) and QT interval (QT), from five consecutive beats of previously recorded standard 12-lead ECG in 200 victims of unexpected sudden cardiac death (SCD) confirmed to be due to complicated atherosclerotic coronary artery disease (CAD) in medico-legal autopsy and 200 age- and sex-matched controls with angiographically confirmed CAD. The short-term variability of repolarization heterogeneity was defined as the standard deviation (SD) of the measured repolarization parameters. All ECGs were in sinus rhythm, and no premature ventricular contractions were included in the measured segment.ResultsTWH-SD and QT-SD were significantly higher in SCD victims than in subjects with CAD (6.9 ± 5.6 μV vs. 3.8 ± 2.6 μV, p = 1.8E-11; 8.3 ± 13.1 ms vs. 3.8 ± 7.1 ms, p = 0.00003, respectively). After adjusting in the multivariate clinical model with factors, such as diabetes, RR interval, and beta blocker medication, TWH-SD and QT-SD retained their significant power in discriminating between the victims of SCD and the patients with CAD (p = 0.00003, p = 0.006, respectively). TWH-SD outperformed QT-SD in identifying the SCD victims among the study subjects (area under the curve in the receiver operating characteristics curve 0.730 vs. 0.679, respectively).ConclusionIncreased short-term variability of repolarization heterogeneity measured from standard 12-lead ECG is associated with SCD.

PROFILE OF MEDICOLEGAL AUTOPSY CASES CONDUCTED AT TERTIARY CARE CENTRE IN BIKANER, RAJASTHAN: A ONE YEAR RETROSPECTIVE STUDY

Background: Medico-legal autopsies form an integral and indispensable part of an investigation of sudden suspicious death. The profile of medico legal autopsy cases is important in order to know the death statistics in a region due to unnatural causes and also help to address the demographic needs according to the mortality statistics specific to that region.
 Material and Method: The present study is a one year retrospective study of autopsies performed in the Department of Forensic Medicine and Toxicology at Sardar Patel Medical College & P. B. M. Hospital, Bikaner, Rajasthan, India from January 2018 to December 2018 comprising 810 cases.
 Aim: This study was conducted to find out the profile of different types of cases and to assess the manner & cause of their death.
 Result: Out of 810 cases, maximum number of autopsies were in third decade of life (260 cases, 32.10%). Male cases predominated over the female cases, which were 638 (78.77%). Hindus were majority in number with 734 cases (90.62%). Accident, Suicide and Homicide deaths were 504 (62.22%), 177 (21.85%) & 24 (02.96%) cases respectively. Maximum number of deaths were due to road traffic accidents with 313 cases (38.64%) followed by poisoning with 140 cases (17.28%).
 Conclusion: It is observed that majority of cases were in 3rd decade of life and Preponderance of male sex is seen over female sex. The most common cause of death is road traffic accident, probably owing to higher frequency of transportation.
 Keywords: Autopsy, Road traffic accidents, Poisoning, Burn, Hanging.

Pulmonary alveolar capillary dysplasia in infants: A rare and deadly missed diagnosis

The pulmonary alveolocapillary dysplasia (ACD) with pulmonary vein misalignment (PVM) is a rare condition characterized by a congenital anomaly of the development of the pulmonary parenchyma. We present a case of an 8-month-old infant who died quickly from acute respiratory failure complicating an unknown ACD. We also describe its epidemiological characteristics in infants and we discuss the diagnosis's difficulties. In this case, a pulmonary arterial hypertension was decompensated by an infection. A medico-legal autopsy was performed. As for the Histological examination, it showed the features of ACD/PVM.

Recent trends of medical negligence – An autopsy based study at lady hardinge medical college, New Delhi

Due to rise in public awareness, reporting of medical negligence cases increased many folds in India. Medical Negligence is absence of reasonable skill, misconduct by a medical practitioner by not providing enough care (act of omission or commission) resulting in breach of their duties and harming the patients. This is a retrospective study of all autopsy cases conducted during the period of 2013-17 in the Department of Forensic Medicine and Toxicology at Lady Hardinge Medical College, New Delhi. The case of Medical negligence was decided based on history enumerated by Investigation Officer.The highest number (1.23%) of alleged medical negligence deaths were reported during year 2016. Maximum numbers (42%) were observed in age group of 0-10 years followed by 21-30 years i.e. 23%. Female were outnumbered to male constituting 55% of total medical negligence deaths. 23% death cases were observed in Medicine and Pediatrics departments followed by Obstetrics and Gynecology. Viscera for chemical analysis and histopathology were preserved in majority of cases i.e. 77% and 74% respectively. Pediatrics, Internal Medicine, Obstetrics and Gynecology and General Surgery are the branches facing most suits of negligence. Careful attention, empathy, clear communication, soft skills and consent is helpful to avoid allegations and medicolegal autopsy should be conducted in all alleged cases of negligence.

Study of socio-demographic profile of victims in cases of deaths due to homicide

: Present prospective study was carried out with the aim to study socio-demographic profile of victims in cases of Deaths due to homicide in Nagpur. Total 179 medico legal autopsy cases of homicidal deaths conducted at department of Forensic Medicine and Toxicology of Indira Gandhi Government Medical College, Nagpur over a period from January 2013 to October 2014 were studied. Study protocol was approved by the institutional ethical committee.Out of total number of autopsies (3412) conducted during study period 179 cases (5.24%) were of death due to homicide. Maximum number of cases 70 (39.11%) were recorded in the age group of 21-30 years followed by 47 (26.26%) cases in the age group of 31-40 years. Out of total reported cases, males outnumbered females. Out of the total 179 cases of homicide, 147 (82.12%) victims were males and 32 (17.88%) were females. Male to female ratio was 4.59:1. Maximum cases 62 (34.64%) of males were reported in the age group in 21-30 years age group followed by 40 (22.35%) cases in 31-40 years. Similarly amongst female’s maximum victims were 8 (4.47%) in the age group 21-30 years followed by 7 (3.91%) cases in 31-40 years. Most of the victims were illiterate primary or secondary educated married, labourers or unemployed persons belonging to lower socio economic strata of the society.: Most of the victims of homicidal deaths were males. Most common age group was of bread and butter earning productive period. Uneducated, unemployed, married and persons with social dysharmony were commonly involved.

Socio-demographic profile of head injury victims in road traffic accidents, an autopsy based study at SAMC & PGI, Indore

Globally, deaths and injuries following Road Traffic Accident are a significant and increasing public health concern. Death due to road traffic accidents is becoming alarming in India and rest of the countries. A prospective study has been conducted at Department of Forensic Medicine & Toxicology, Sri Aurobindo Medical College & Post Graduate Institute, Indore, Madhya Pradesh. The study was carried out from October 2015 to March 2017. The study was undertaken to analyze Socio-demographic profile in fatal road traffic accident victims. Total 102 cases of both sexes and all age groups having head injuries due to road traffic accident, brought to our postmortem centre for medico-legal autopsy were included. Out of total 102 cases, male to female ratio was 5.8:1 and commonest age group affected was 21-30 years (36.8%). Among total victims, majority of cases were Hindu (93.1%). 28.4% of the victims were educated up to secondary school and 28.4% were farmer & laborers by occupation. Most of the deaths occurred due to accidents on Highway roads (47.1%). Most of the victims were on two wheeler (61.8%) and majority of them were without helmet (97%). Accidents were most common in summer months of March, April, May and June (39.2%). This study aims to provide epidemiological facts in head injury victims involved in vehicular accidents.

Medico-legal autopsy study of alleged dowry deaths - a two year cross-setional study

In India, dowry is a rising social evil contributing to female mortality.: To evaluate the socio-demographic profile of alleged dowry victims.Cross-sectional study of 84 alleged dowry deaths stratifying the socio-demographic pattern of alleged dowry deaths.57.1% were from 21to30 years of age group. Maximum females were illiterate (39.3%), housewives (77.4%) and from lower socio-economic strata of society. Victims were brought dead with 50% cases involving 71-90% of total body surface area. 29.8% were hospitalized. In 88.57 % of suicidal cases, menstruation was noted.39.29% deaths were within 1st year of marriage. In 84.84% cases, dowry was provocating factor. In 50 % cases, Asphyxia was the cause of death.Domestic abuse and dowry were significant provocative factors for dowry deaths.

Pesticide poisoning deaths: a 19-year retrospective study of medicolegal autopsies in center Tunisia

BackgroundPesticide poisoning is recognized as an important public health problem worldwide, especially in the developing countries, such as Tunisia, where these products are massively used in agriculture. The objective of our study was to document the forensic deaths caused by pesticides reported from a forensic center located in the coastal region of Tunisia.MethodsThis is a 19-year retrospective descriptive study of lethal pesticide poisoning victims autopsied in the Department of Forensic Medicine at Farhat Hached University Hospital in Sousse, Tunisia, from 1991 to 2009.ResultsOne hundred thirty deaths were collected. The majority of the victims were female (62% vs 38%). The mean age was 27.46 years with the highest frequency of poisoning deaths occurring in the 21-30 years age group (34%). Eleven percent of the victims were found in a state of coma and 4.6% suffered from respiratory distress. Signs observed during the external examination of the bodies were as follows: bluish discoloration of the lips and the limbs (n = 130, 100%), leakage of urine (n = 13, 10%), foaming at the mouth or the nose (n = 66, 50.8%). The most frequent signs found during autopsies were pulmonary edema in 88.4% of the cases and multiorgan congestion in 86.9%. Toxicological screening of the stomach content was positive for pesticides in 126 cases. Intoxication was mainly caused by cholinesterase inhibitor insecticides: carbamates (50%) and organophosphorus compounds (31.5%). In 92% of cases, death was in a context of suicide.ConclusionsThis study shows that a large proportion of pesticide poisoning deaths are preventable. Prevention is, on the one side, by restricting the availability of pesticides and on the other side by promulgating more vigorous legislation concerning the manufacturing, the marketing, and the use of these products.

Study of Unnatural Deaths of Women Brought to Raichur Institute of Medical Sciences for Medico-Legal Autopsy

Discrimination against women in our society is deeply embedded within family context of the women.
 Women are subjected to violence from husbands and from their relatives in their natal as well as marital
 homes. This study was designed to determine unnatural deaths of females in Raichur during the year 2017.
 total 362 cases were autopsied where as 77 women of unnatural deaths were autopsied. Third and fourth
 decade were common age group. Most of the unnatural deaths were suicidal and road traffic accidents.
 This study reflects the susceptibility of women to unnatural deaths, thus needs to enhance the multipronged
 protective system, to curb these potentially preventable unnatural deaths of females

Heatstroke due to Vehicular Entrapment: An Autopsy Case Report

Heatstroke is defined as severe heat illness with elevated body temperature greater than 40.6?C associated with central nervous system dysfunction. In children, heatstroke as a result of vehicular entrapment is commonly encountered. We report a case of a six-year-old boy who was accidentally left in a school van under scorching hot afternoon for several hours. Upon discovery, he was rushed to a hospital where he was pronounced dead. His body temperature taken at the Emergency Department was 40.3?C. The body felt warm in spite of apparent presence of post mortem changes such as rigor and livor mortis. His clothes were drenched in sweat. A medico-legal autopsy was performed. On general examination, his body was pale and the lips were also parched and pale. Internally, there was subdural haemorrhage and petechial haemorrhages on the lungs and the epicardial surface of the heart. The cause of death was given as heatstroke as a result of vehicular entrapment. We wish to emphasize and appeal to the public that this tragic incident is preventable. Public and private sectors should help creating awareness of dangers in leaving a child unattended in a car

Profile of Medicolegal Autopsy Cases Conducted at Tertiary Care Centre, Kalaburagi, Karnataka

Objectives: The profile of medico legal autopsy cases is important in order to know the death statistics in a region due to unnatural causes. The main objectives of the study were: a) To ascertain the various aspects of unnatural deaths, b) To analyze the probable reasons for the same & c) To find remedial measures to bring down the incidence. Materials and Method: The present study is a retrospective study of autopsies performed at GIMS, District Hospital, Kalaburagi, Karnataka from January 2018 to December 2018. During this period a total of 647 autopsy cases were conducted. Relevant information and subjective data like age, sex, marital status & manner of death have been collected from medicolegal autopsy register from January 2018 to December Results: Out of 647 cases analyzed, maximum number of autopsies were in the age group of 21-30 years with 204 cases(31.5%). Majority of victims were males 437(67.5%). Hindus were majority in number with 540 cases(83.4%), married were 432(66.8%) & unmarried were 215 cases(33.2%). In our study 73% were rural residents & only 27% were urban. Accident, Suicide and Homicide deaths were 282(43.6%), 331(51.2%)& 34(5.2%) cases respectively. Natural deaths were seen in 14% cases. Maximum number of deaths were due to road traffic accidents with 212 cases (32.8%) followed by poisoning with 85 cases (13.1%). Out of total 647 cases maximum number of autopsy cases 317(49.1%) were conducted in the month of May to August. Conclusion: In our present study it is observed that maximum cases were in 3rd decade of life, Males outnumbered females, rural residents were more in number. Hindus being majority formed bulk of cases. RTA, Poisoning & burns were seen as leading cause of death & maximum deaths were in the month of May to August.

Analysis of Homicidal Deaths among Medicolegal Autopsies Conducted at a Tertiary care Hospital in Karnataka: A Prospective Study

A Prospective study was conducted in the Department of Forensic Medicine and Toxicology, JJM Medical College and Cigateri General Hospital, Davangere Karnataka, from 2010 to 2014 with regard to demographic, injury and mortality profiles among Medicolegal autopsies conducted in homicidal deaths and the same are presented in this paper. Results showed that male victims of the age group 31-40 years were more in number, with personal revenge being the usual motive of the perpetuators. Most of the deaths were due to combination of both blunt and sharp weapons with hemorrhagic shock as the most common cause of death.