Medicolegal Aspects of Victims of Assault Admitted to a Tertiary Care Hospital in Sri Lanka

Introduction: Violence with physical assault is a common cause of morbidity and mortality prevalent but not limited to underdeveloped countries. The opinion of the forensic expert is often indispensable in such cases to determine the penalties. This study was planned to describe the pattern of presentation of the victims and evaluate the strengths and limitations in formulating a scientific medicolegal opinion based on the findings of the victim. Methods: A retrospective descriptive study based on the case records of the victims of assault admitted to Colombo North Teaching Hospital, Ragama, Sri Lanka, was conducted for four years. Results: Out of the 400 victims, the majority (72% n = 290) were males and of the age-group of 21 to 40 (n = 216). The reason for assault in the majority was sudden provocation (n = 99, 25%), followed by previous long-duration enmity (n = 89, 22%). The majority (83%) had isolated blunt force trauma, and the injuries were nongrievous (74%). Defense injuries were significantly associated with attempted defense (p = 0.000) and sharp force trauma (p = 0.002). The underlying reason for the assault was not significantly associated with the causative weapon (p = 0.228) or body region injured (p = 0.195). Conclusions: Even though the presentation and the pattern of injures are definitely of value in formulating a scientific opinion, the study identified the limitations of the forensic experts, and the need for a holistic approach at the investigations was highlighted.

Child homicide in northern Tunisia: a retrospective study of forensic autopsy cases

Background As far as we know, no previous research has investigated child homicide in Tunisia. In this context, our study was carried out to analyze the epidemiological and medico-legal characteristics of child homicide occurring in northern Tunisia over a 17-year period. Results Eighty-seven cases were collected, with a male-to-female ratio of 2.4. The mean age of the victims was 12.6 years for both sexes. We found that 56.3% of the cases were aged between 15 and 18 years. The majority of deaths under 15 years of age occurred at home as a result of intrafamilial homicide. Victims aged more than 15 years were more likely to be assaulted outside the home by a non-family member. The most frequent method of homicide was sharp force (39%) affecting mostly the heart and the lung, followed by blunt trauma (25%), which affected mainly the head. Sexual assault was diagnosed at autopsy in six victims (6.9%). Conclusions The study offers available data concerning the patterns of child homicide in northern Tunisia and may help to implement preventive measures against this kind of crime.

An autopsy study on injuries in homicidal deaths due to weapons

Homicide is defined as the intentional act of taking another person’s life. This study was conducted in a tertiary care hospital and Medical College at Pondicherry between 2004 to 2019. It included all homicide deaths with weapon autopsied in the department of Forensic Medicine. A total of 74 cases of homicide was identified and studied. The male : female ratio was 4:1. Commonest age group was 21- 30 years of age. 78% of cases had fatal injuries in more than one anatomical region and head was the most targeted region. More than one type of injuries was present in 65% of cases. In this study male victim had mostly sharp force weapon induced injuries and female victims had blunt force weapon induced injuries. It was also found that in age groups less than 10 years and more than 60 years blunt force weapon induced injuries predominated, whereas in other young adult age groups sharp force weapon induced injuries were predominately seen.

626Epidemiology of facial injuries in the context of fatal family violence in the Victorian population

Background The oral cavity is reported to be a key focus of physical injury in family violence (FV). Our purpose is to explore the potential opportunity for dentists to assist in the prevention of serious injuries in FV. This paper aims to describe the patterns of orofacial injuries in FV homicides. Methods All FV homicides in Victoria, Australia January 2006-December 2018, were identified amongst closed cases of assaults screened for eligible victim-offender relationships. Epidemiologic trends in FV in the Victorian population over the 12-year period were determined. Sociodemographic, interpersonal, incident and injury characteristics including ICD-10 coding were studied and compared across facial and non-facial injury FV subgroups. Results There was a non-significant downward trend in FV homicide over the period. Of 170 adult cases, 150 were included for facial injury analysis. Of these, 117 (78%) showed orofacial injuries in the 12-year period. Two-step cluster analysis revealed blunt force and threat to breathing injury mechanisms to be significantly associated with facial FV and sharp force with nonfacial FV. Among the additional 26 child homicides, descriptive analysis elucidated patterns in 20 cases eligible for facial injury analysis. Coding limitations were found for the FV homicide cases. Conclusions This population study reports significant involvement of the orofacial region in the FV homicide population during the 12-year study period, potentially informing dental practice and the related policy framework in Victoria and internationally. Key messages The significant involvement of the orofacial region in FV homicides may inform optimal intervention outcomes in FV in Victoria.

Weapon injuries in the crusader mass graves from a 13th century attack on the port city of Sidon (Lebanon)

Archaeological excavations close to St Louis’ castle in Sidon, Lebanon have revealed two mass grave deposits containing partially articulated and disarticulated human skeletal remains. A minimum of 25 male individuals have been recovered, with no females or young children. Radiocarbon dating of the human remains, a crusader coin, and the design of Frankish belt buckles strongly indicate they belong to a single event in the mid-13th century CE. The skeletal remains demonstrate a high prevalence of unhealed sharp force, penetrating force and blunt force trauma consistent with medieval weaponry. Higher numbers of wounds on the back of individuals than the front suggests some were attacked from behind, possibly as they fled. The concentration of blade wounds to the back of the neck of others would be compatible with execution by decapitation following their capture. Taphonomic changes indicate the skeletal remains were left exposed for some weeks prior to being collected together and re-deposited in the defensive ditch by a fortified gateway within the town wall. Charring on some bones provides evidence of burning of the bodies. The findings imply the systematic clearance of partially decomposed corpses following an attack on the city, where adult and teenage males died as a result of weapon related trauma. The skeletons date from the second half of the Crusader period, when Christian-held Sidon came under direct assault from both the Mamluk Sultanate (1253 CE) and the Ilkhanate Mongols (1260 CE). It is likely that those in the mass graves died during one of these assaults.

How Decomposition and Processing Affect Metallic Particles From a Bullet in Gunshot Defects

A significant portion of forensic anthropological cases involve decomposed or fragmented human skeletal remains. When testifying in a courtroom, often the focus is on trauma interpretation and distinguishing between blunt force trauma, sharp force trauma, or high-velocity projectile trauma. Therefore, forensic anthropologists need to understand how various factors and processes alter human remains during the decomposition process and how those changes affect the interpretation of skeletal trauma patterns. The primary research question addressed in this study is: how does the decomposition and processing of human remains impact the preservation of metallic fragments from gunshot trauma? Fifteen hog (Sus scrofa) crania were shot using hollow-point and full-metal jacketed 9mm ammunition with an 8-foot firing distance. Eight skinless slabs of hog ribs were shot using the same ammunition types as the crania. All hog samples decomposed in an outdoor environment under metal cages to prevent scavenging. Radiographs were taken of each hog sample before and after decomposition and after processing. The results show metallic fragments from the bullet embedding in the soft tissue more frequently than in the hard tissue. Scavengers, mummification, and processing are three critical factors that were found to influence the removal/preservation of metallic fragments during the decomposition process.

The Evaluation, Management and Outcome about an Experience with Sharp Force Abdominal Injury

<p><strong>Background and Objective:</strong> Sharp force injuries (SFI), inflicted by cutting or stabbing, result in variable outcome depending upon the nature and site of the injury. This study evaluated the cases of SFIs and their outcome with reference to the time of presentation, demographic data, wounded organs, and surgical procedure performed.<br /><strong>Methods:</strong> This retrospective study analyzed the clinical data of 20 patients who presented with sharp force injury (knife stabbing and penetrating abdominal trauma) and were admitted between April 2015 and November 2016. The management and outcome of patients were recorded.<br /><strong>Results:</strong> All patients in this study were male and aged between 21 and 30 years. Knife stabbing was the only mechanism of injury in all cases. Colon (50%) was the commonest organ injured followed by intestine (40%) and liver (30%). Mortality rate was 10%. There were two cases with negative laparotomy (10%). Wound sepsis (10%) was the commonest complication.<br /><strong>Conclusions: </strong>SFI involving abdominal area are managed either conservatively or with primary repair and laparotomy to save internal organs. Early presentation and prompt management leads to reduced chances of complications and mortality.</p>