Time Of Death
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Neeraj Singh ◽  
Bhavesh Bohra

Background: In the present study analysis of changes in level of sodium in cadaveric synovial fluid is done, which is correlated with increasing post-mortem interval and this study have not been done in south east region of Rajasthan so far. Methods: This study was carried out in department of Forensic Medicine and Toxicology, Jhalawar Medical College, Jhalawar. This study was done on 50 cases with known time of death who was brought in the mortuary of department of Forensic medicine and Toxicology for autopsy. The information regarding time of death were collected from hospital records. Ethical permission has been taken from college ethical committee. Results: Deaths due to road traffic accidents & its complications constituted majority of cases 44.00% followed by poisoning 40.00% Conclusion: This study helps to interpret different types of medico-legal autopsy cases, thereby providing an insight to the policy-makers, law custodians, and the community to look into the specific aspects of the cases and then to take proper measures to reduce mortality. Keywords: Death, Post mortem, Age

Fabio De-Giorgio ◽  
Gabriele Ciasca ◽  
Gennaro Fecondo ◽  
Alberto Mazzini ◽  
Marco De Spirito ◽  

Abstract Using postmortem CT (PMCT), changes in the volume of the lateral cerebral ventricles (LCVs) and modifications of the radiodensity of cerebrospinal fluid (CSF) have been examined to identify a possible relationship between these changes and the time of death. Subsequent periodical CT scans termed “sequential scans” for ten corpses at known time of death were obtained, and a 3D segmentation of the entire LCV was carried out to measure its volume and radiodensity over time from ~ 5.5- h up to 273-h postmortem. A linear decrease of the LCV volume for all the cases was observed in the investigated time range, together with an overall logarithmic increase of radiodensity. Although a larger sampling should be performed to improve the result reliability, our finding suggests that the postmortem variation of CSF radiodensity can be a potentially useful tool in determining postmortem interval, a finding that is worthy of further investigation.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 24-24
Arielle R. Urman ◽  
Mary K. Buss ◽  
Robert J. Besaw ◽  
Laura E. Dodge ◽  
Kathleen A. Lee ◽  

24 Background: Palliative care (PC) improves outcomes for patients with advanced cancer, and current ASCO guidelines recommend early outpatient referral. However, recent data show that PC teams at many cancer centers see more inpatient consults than outpatient visits; the comparative impact of inpatient versus outpatient PC is not well-described. For this reason, we conducted a retrospective cohort study of hospitalized cancer patients to quantify exposure to inpatient/outpatient PC, and to describe associations between PC exposure and end-of-life (EOL) quality measures including hospice utilization, advance care planning (ACP), and intensity of care. Methods: We identified all patients admitted to one cancer center’s inpatient oncology unit during one fiscal year (10/1/2017-9/30/2018). Demographics, admission statistics, inpatient/outpatient PC visits, and EOL outcomes were abstracted from the electronic medical record. Decedents were identified through chart review and public obituaries. Results were summarized by descriptive statistics, and standard statistical tests were used to evaluate associations between PC exposure and EOL outcomes. Results: 842 patients were hospitalized in one year. 522 patients died by the study end-date of 10/1/2020 and were included in analysis. 50% of decedents had any PC exposure prior to death, but only 21% had an outpatient PC visit. Patients seen by PC were younger at time of death, (median: 67 vs 72 years; p <.001) and more likely to be female (52% vs 42%; p =.03). Compared to patients never seen by PC, patients with any PC exposure were significantly more likely to enroll in hospice (78% vs 44%; p <.0001), have do-not-resuscitate status (87% vs 55%; p <.0001), have scanned ACP documents (53% vs 31%; p <.0001), and die at home or inpatient hospice instead of in the hospital (67% vs 40%; p <.01). PC exposure was not associated with differences in 30-day re-admissions, systemic cancer therapy in the last 14 days of life, or intensive care (ICU) utilization in the last 30 days of life. Notably, PC exposure was associated with longer hospital length-of-stay (LOS) (8.4 vs 7.2 days), but this association was reversed for patients seen by outpatient PC versus all others (6.3 vs 8.2 days; p <.01). Patients seen by outpatient PC also had longer hospice LOS (46.5 vs 27.1 days; p <.01) and less EOL ICU use (6% vs 15%; p <.05) compared to all others. Conclusions: In this large retrospective study of hospitalized patients with cancer, PC exposure was associated with significant improvements in multiple EOL quality measures. The subset of patients seen by outpatient PC experienced additional benefits, including shorter hospital LOS, longer hospice LOS, and less EOL ICU utilization. These findings point to differential effects between inpatient and outpatient PC, underscoring the importance of early, longitudinal PC involvement.

2021 ◽  
Vol 21 (2) ◽  
pp. 124
Christina L Salaki ◽  
Herlina Wungouw ◽  
Henny V Makal

Penelitian ini menguji efektivitas kombinasi biolarvasida minyak atsiri serai wangi (Cymbopogon nardus) dengan daun cengkeh (Syzygium aromaticum l.) Terhadap larva nyamuk Ae. aegypti. Penelitian ini bertujuan untuk: (a) menganalisis pengaruh pemberian kombinasi biolarvasida minyak atsiri serai wangi dan daun cengkeh terhadap perkembangan larva Ae. aegypti, (b) menganalisis uji daya bunuh kombinasi biolarvasida serai wangi (sw) dan daun cengkeh (dc) terhadap larva Ae. aegypti, (c) menganalisis uji patogenisitas dari kombinasi biolarvasida serai wangi dan daun cengkeh terhadap larva Ae. aegypti. Uji kombinasi biolarvasida ini dilakukan terhadap larva nyamuk Ae. aegypti instar III  dengan perlakuan variasi kombinasi konsentrasi “SW 2% (P)”, “ SW 0,75% ” + “DC1,25% (P1)”, “SW 1%” + “DC 1% (P2)”, “SW 1,25 %” + “DC 0,75% (P3)” , “DC 2% (P4)”. dan Kontrol air (P-). Themepos (P+). Parameter yang diamati meliputi gejala, persentase mortalitas dan waktu kematian.  Mortalitas larva diamati pada jam ke-6,12,18,24  setelah aplikasi. Perbedaan proporsi mortalitas antar tingkat konsentrasi dengan control diuji dengan metode chi-kuadrat sedangkan lT50 dengan analisis probit.  Hasil penelitian menunjukkan masing-masing kombinasi bahan uji (P,P1,P2,P3 dan P4) tidak memiliki perbedaan pengaruh yang sginifikan sebagai biolarvasida dengan taraf signifikansi sebesar 0,05.. Kesimpulan hasil penelitian ini bahwa kelima konsentrasi bahan uji tersebut tidak memberikan perbedaan pengaruh yang signifikan sebagai biolarvasida. Hal ini menunjukkan bahwa minyak atsiri serai wangi dan daun cengkeh baik diaplikasi secara tunggal maupun dikombinasi memiliki efektifitas larvasida yang sama dengan temephos dalam membunuh larva nyamuk Ae. aegypti. Waktu kematian (LT50)  ekstrak serai wangi 12,72 jam, daun cengkeh 6,71 jam dan kombinasi 6,38 jam.Kata kunci: Biolarvasida; efektifitas; konsentrasi; patogenisitas The Effectiveness of Biolarvacide Essential Oil of Vitronella (Cymbopogon nardus) with Clove Leaves (Syzygium aromaticum.L.) on Ae. aegypti Mosquito Larvae ABSTRACTThis study tested the effectiveness of the biolarvicide combination of citronella essential oil (cymbopogon nardus) and clove leaf (syzygium aromaticum L.) against the larvae of Ae. aegypti. This study aims to: (a) analyze the effect of giving a combination of biolarvicides of citronella essential oil and clove leaves on the development of Ae. aegypti, (b) analyzing the killing power of the combination of citronella (sw) and clove leaf (dc) biolarvicides against Ae. aegypti, (c) analyzing the pathogenicity test of the combination of citronella and clove leaf biolarvicides against the larvae of Ae. Agypti. This biolarvicide combination test was carried out on the larvae of Ae. aegypti instar iii with treatment variations in the concentration combination “SW 2% (P)”, “SW 0.75%” + “DC1.25% (P1)”, “SW 1%” + “DC 1% (P2)”, “SW 1.25%” + “DC 0.75% (P3)” , “DC 2% (P4)”. and Water control (P-). Themepos (P+). Parameters observed included symptoms of mortality percentage and time of death. Larval mortality was observed at 6, 12, 18, 24 hours after application. The difference in the proportion of mortality between concentration levels and control was tested by the chi-square method while the lt50 method was tested by probit analysis. The results showed that each combination of test materials did not have a significant difference in effect as a biolarvicide with a significance level of 0.05. The conclusion of this study was that the five concentrations of the test material did not give a significant difference in effect as a biolarvicide. This indicates that the essential oils of citronella and clove leaves, either applied singly or in combination, have the same larvicidal effectiveness as temephos in killing the larvae of Ae. aegypti. Time of death (lt50) citronella extract 12.72 hours, clove leaf 6.71 hours and the combination 6.38 hours.Keywords: Biolarvicides; effectiveness; concentration; pathogenicity

Metabolites ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 643
Lana Brockbals ◽  
Yannick Wartmann ◽  
Dylan Mantinieks ◽  
Linda Glowacki ◽  
Dimitri Gerostamoulos ◽  

Postmortem redistribution (PMR) can result in artificial drug concentration changes following death and complicate forensic case interpretation. Currently, no accurate methods for PMR prediction exist. Hence, alternative strategies were developed investigating the time-dependent postmortem behavior of diazepam, nordiazepam, morphine, codeine, mirtazapine and citalopram. For 477 authentic postmortem cases, femoral blood samples were collected at two postmortem time-points. All samples were quantified for drugs of abuse (targeted; liquid chromatography-tandem mass spectrometry LC-MS/MS) and characterized for small endogenous molecules (untargeted; gas chromatography-high resolution MS (GC-HRMS). Trends for significant time-dependent concentration decreases (diazepam (n = 137), nordiazepam (n = 126)), increases (mirtazapine (n = 55), citalopram (n = 50)) or minimal median postmortem changes (morphine (n = 122), codeine (n = 92)) could be observed. Robust mathematical mixed effect models were created for the generalized postmortem behavior of diazepam and nordiazepam, which could be used to back-calculate drug concentrations towards a time-point closer to the estimated time of death (caution: inter-individual variability). Significant correlations between time-dependent concentration changes of morphine, mirtazapine and citalopram with individual endogenous molecules could be determined; no correlation was deemed strong enough for successful a posteriori estimation on the occurrence of PMR for specific cases. The current dataset did successfully lead to a significant knowledge gain in further understanding the time-dependent postmortem behavior of the studied drugs (of abuse).

2021 ◽  
Vol 12 ◽  
Tong Wu ◽  
Zan Jiao ◽  
Yixuan Li ◽  
Jin Peng ◽  
Fan Yao ◽  

BackgroundBrain metastasis from differentiated thyroid cancer has followed a similar increasing trend to that of thyroid cancer in recent years. However, the characteristics and treatments for brain metastases are unclear. The aim of this study was to understand this disease by analyzing patients with brain metastases from differentiated thyroid cancer (DTC).MethodsBetween 2000 and 2020, the database of the Sun Yat-sen University Cancer Center was searched for differentiated thyroid cancer patients. We identified a cohort of 22 patients with brain metastases. The characteristics of the patients, histological features, treatments, and time of death were reviewed. The overall survival (OS) rate was calculated using the Kaplan Meier method. Survival curves of different subgroups were compared according to baseline characteristics and treatments received.ResultsA total of 22 (1.09%) out of 2013 DTC patients in the Sun Yat-sen University Cancer Center database were identified as having brain metastases. The overall median survival time was 17.5 months (range from 1–60 months) after diagnosis of brain metastasis. Performance statue (PS), tumor site, and neurosurgery impacted survival, according to Kaplan-Meier analysis. Prognosis of skull metastasis was superior to that of intracranial types. Neurosurgery was the only type of treatment that had an impact on patient OS.ConclusionsBrain metastasis from differentiated thyroid cancer has a poor prognosis. However, it can be improved by comprehensive treatment. PS of the patients can greatly affect survival. Skull metastases have improved prognosis over intracranial types. Radioiodine therapy (RAIT) appears to effectively improve the prognosis of patients with skull metastases from DTC.


Objective: Helminthiasis is one of the most prevalent parasitic infestations worldwide posing a major threat to public health. The control of these nematodes has relied largely on the use of a limited number of anthelmintics. However, emerging resistance and side effects to the currently available anthelmintic drugs is a major concern and discovery of newer anthelmintics with a novel mode of action is the need of the hour. The present study is aimed to evaluate the anthelmintic activity of ethanolic extract of Centella asiatica Linn. (EECA) on Indian earthworms (Pheretima posthuma). Methods: The earthworms were divided into 4 groups with 6 worms in each group. The anthelmintic activity of EECA at two different concentrations (25 mg/ml and 50 mg/ml) was evaluated by assessing the time of paralysis and time of death of the worms. Albendazole was used as standard and 2% gum acacia as control. Results: Albendazole at 25 mg/ml showed the highest anthelmintic activity and had significant difference (p<0.001) with EECA at both 25 mg/ml and 50 mg/ml. Conclusion: Both doses of the test drug showed anthelmintic activity but the extract at either dose was found to be less effective than the standard drug. Further studies with higher doses of the extract should be done to evaluate the anthelmintic activity in a dose-dependent manner.

2021 ◽  
pp. 101970
Tamara Gelderman ◽  
Erik Stigter ◽  
Tristan Krap ◽  
Jens Amendt ◽  
Wilma Duijst

2021 ◽  
Vol 12 (1) ◽  
pp. 9
Hafiz Fauzana ◽  
Rizky Aulina Harahap

Aphis gossypii Glover is the main pest that attacks chili plants. Control efforts that are often carried out are by using synthetic insecticides. Safe pest control is the use of vegetable insecticides. Srikaya is a plant that can be used as a botanical insecticide. The purpose of this study was to obtain an effective concentration of srikaya leaf powder extract against A. gossypii pest mortality. This research was conducted at the Plant Pest Laboratory of the Faculty of Agriculture, Riau University from March to July 2019. The study was conducted experimentally using a completely randomized design (CRD) with 6 treatments and 4 replications. The treatments given were extracts of srikaya leaf flour with the following concentrations: Srikaya flour with a concentration of 0 g.l-1 water, 20 g.l-1 water, 40 g.l-1 water, 60 g.l-1 water, 80 g.l-1 water, 100 g.l-1 water. The parameters observed were the initial time of death of Aphis gossypii, Lethal time 50 (LT50), daily mortality, total mortality, Lethal concentration (LC50), temperature and humidity. The results of this study indicate that the application of the extract of srikaya leaf flour (Annona squamosa L.) on concentration of 40 gl-1 srikaya leaf meal was an effective concentration to control A. gossypii which can cause total mortality of 82.5% with LC 50% is 1.37% or equivalent to 13.7 gl-1, and the right concentration to kill. 95% of pests is 6.37% or equivalent to 63.7 gl-1.

Ultrasound ◽  
2021 ◽  
pp. 1742271X2110358
Mohsen Mosadegh ◽  
Mehdi Khazaei ◽  
Zohreh D Abdollahpour ◽  
Sam Alahyari ◽  
Yashar Moharamzad ◽  

Introduction Post-mortem rigidity of the tissues is one of the basic principles in forensic medicine to estimate the time of death. Qualitative methods to determine the stiffness of the corpse may have some limitations. Methods that provide quantitative values may be useful. We intended to evaluate the applicability of ultrasound shear-wave elastography of the tissues to estimate the post-mortem interval (PMI). Methods For 80 corpses, shear-wave elastography of the liver, sartorius muscle, testis, thyroid and parotid was performed before autopsy. Based on the forensic reports as the reference method to define post-mortem interval, the corpses were divided into four groups: group 0 (PMI < 24 hours), group 1 (PMI ≥24 hours and <48 hours), group 2 (PMI ≥ 48 hours and <72 hours), and group 3 (PMI ≥ 72 hours). There were 24, 38, 13, and 5 corpses, respectively, in groups 0, 1, 2, and 3. Results A significant rise in the elasticity values in comparison to elasticity of normal tissues in live adults was seen very early in the post-mortem period. Between-group comparisons showed that a significant difference in the liver elasticity was present among the groups. The mean (SD) liver elasticity was 10.29 (±0.83) in group 0, 14.98 (±1.56) in group 1, 12.49 (±1.09) in group 2, and 15.64 (±1.68) kilopascals (kPa) in group 3 ( P = 0.035). Nevertheless, elasticity measurements in other tissues were not helpful in distinguishing post-mortem interval groups. Conclusion It is possible to use liver quantitative shear-wave elastography to estimate the time of death.

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