Mummified Dead Body in Hanging Position: A Case Report

Mummification refers to all-natural and artificial processes that bring about the preservation of the body or its parts. Such processes include mainly the drying of the soft tissues instead of liquefying putrefaction. We are presenting here a case of a medicolegal autopsy performed at the mortuary of MGIMS, Sevagram. The body was found in the jungle in a hanging position to the branch of a tree. Body was completely mummified. Facial identification could be made out as facial features were well maintained. Investigation agency has query regarding condition of the body (mummification) and what is the time since death. After performing the autopsy, police were explained regarding the factors responsible for mummification to occur in the dead body and also given opinion regarding time since death. From the time since death police investigated the various missing complaints which were present at neighboring police stations during that period. So the relatives from one of the missing person identified the body and it was handed over to relative after completion of all legal formalities by the police officials. In this case report we have discussed; autopsy finding in mummified body and factors responsible for formation mummification of the body. Hot, dry and airy environment are well known factors contributing the mummification of body but apart from this hanging of the body along with other contributing factors mentioned earlier is responsible for mummification of the body in present case.

Therapy-Related Acute Myeloid Leukemia Diagnosed at Postmortem in a Long-term Survivor of Advanced Hepatocellular Carcinoma

Acute myeloid leukemia (AML) is a common hematologic malignancy with high mortality and a short survival period in adults. About 10% of these cases, called therapy-related AML, are reported to be the consequence of chemotherapy or radiotherapy of previous malignancy. In a clinical setting, this is usually diagnosed by peripheral blood smear or bone marrow biopsy by assessing the proportion of blasts. However, postmortem blood samples are not suitable for smear analysis because of hemolysis. Therefore, ancillary tests for identifying leukemic infiltration or related molecular change can provide an alternative diagnostic clue for AML. The deceased had been treated for 3 years for a combined type of hepatocellular carcinoma with multiple pulmonary metastases. Treatments included the resections of primary and metastatic tumors, chemotherapy, and radiotherapy, which prevented further progression of his cancer. One year after the last treatment, he suddenly collapsed without any specific symptoms and shortly died. The microscopic examination of the autopsy samples revealed extensive extramedullary infiltration of leukemia, which was confirmed as an AML by a series of ancillary immunohistochemical staining. This case illustrates both the importance of careful hematologic observation in cancer survivors and the necessity of a detailed medical diagnosis in a medicolegal autopsy.

Medicolegal evaluation of pontine hemorrhage at autopsy- Highlights from a case and an overview

One in ten non-traumatic intracerebral hemorrhages (ICH) is located in the pons with chronic arterial hypertension as the leading etiology. In the forensic context, deaths related to a pontine hemorrhage (PH) are usually encountered in situations of drug abuse, excited delirium, trauma, as well as in sudden natural deaths where some hypertensive catastrophe is the usual underlying mechanism. The clinical presentation of PH may be variable, causing a failure in timely diagnosis that, if presents with unexplainable circumstances, may become the subject of medicolegal concern. The present case relates to a middle-aged man with a long history of hypertension and presents during an afternoon with an abrupt onset of deleterious symptoms. The patient was managed conservatively but succumbed to his illness and expires during treatment. A questionable diagnosis and the case circumstances, however, directed the doctors to inform the police. A medicolegal autopsy was therefore carried out that leads to the discovery of a lethal pontine hemorrhage rupturing into the fourth ventricle and involving the adjacent cerebellar tissues as well. Severe atherosclerosis of the basal arteries constituting Circle of Willis and Vertebrobasilar system was seen along with their hallmark effects that became evident during brain sectioning. Pathological stigmata of well established hypertension were found in the heart and kidneys. A clinic pathological correlation of the physical characteristics and topography of the hematoma to its severity was also carried out, based upon the known CT and autopsy findings. The possibility of a drug related or traumatic and secondary brainstem/Duret hemorrhage was ruled out.

Pulmonary thromboembolism: A momentous event in a case of polytrauma

Pulmonary thromboembolism (PTE) is one of the momentous events in a case of polytrauma. In majority cases because of sudden commencement, medicolegal autopsy shows insufficient macroscopic confirmation even though thrombo-embolism is the cause of death. During a medicolegal autopsy, the autopsy surgeon, firstly need to differentiate embolus and post mortem clot by gross examination. Histopathological examination (HPE) not only helps to establish emboli but also illuminates associated systemic changes in other organs as well. Most importantly, the correlation of autopsy findings and HPE findings with the clinical events reflected in medical records helps to scientifically explain the series of events during hospitalization. The same data is also useful in better monitoring and management of polytrauma cases in the future.

To Establish the Cause, Manner and Modalities of Death in Medicolegal Autopsies Performed at Lahore General Hospital

Objectives: To evaluate and compare findings with special reference to mode, manner and cause of different cases of autopsies conducted at Lahore General Hospital during a particular time period. Study Design: Cross sectional. Place and Duration of Study: Autopsy Section of Lahore General Hospital, Lahore 1st January 2019 to 31st December 2020. Methodology: Fifty (74% males, 26% females) medicolegal autopsies were collected. The observations recorded in predesigned Performa with an emphasis on age and sex of subjects, type of injuries, identify fatal injuries, and month-wise variation in performing autopsies. Results: 30% of the deaths were found to be due to non-apparent causes of death. Firearm accounted for 12% of the deaths whereas 9% were asphyxial deaths. Majority of the victims belonged to age group 20-30 years (22%). Majority of the cases came on the month of August. Conclusion: In majority of the medicolegal autopsies, male population was involved and caused by Firearm injuries (Homicidal) although number of cases where there was no apparent cause define was also high. Most affected age group was 20-30 years (22%). August and October were the months where majority of the cases came. Keywords: Medicolegal autopsy, Cause, Manner, Modalities

Socio-demographic profile of drowning deaths in a rural region - An autopsy based study

Drowning is one of the forms of violent asphyxial death due to aspiration of fluid into air-passages, caused by submersion in water or other fluid. Fatal drowning cases are subjected to medicolegal autopsy. During autopsy, many times the findings are nonspecific and hence the diagnosis of drowning rests on combination of circumstantial evidences and autopsy findings. The purpose of this study is to analyze socio-demographic factors of drowning deaths in rural region and to suggest the preventive measures. It is a five-year retrospective autopsy based study carried out in the Department of Forensic Medicine, Swami Ramanand Teerth Rural Government Medical College and Hospital, Ambajogai Dist. Beed, Maharashtra, India from 1 January 2014 to 31 December 2018 to study the various socio-demographic factors such as age, sex, seasonal distribution, education, marital status and residence in drowning deaths.Predominance of males was seen i.e. 50 cases (58.8%). Age group 11-20 years was the most commonly involved i.e. 20 cases (23.5%). Maximum deaths were reported from well/pond 37 cases (43.5%). Least deaths (2.4%) were observed in post graduates. Maximum deceased were living in rural region i.e. 62 cases (72.9%).Drowning deaths are commonly encountered in autopsy practice.It was seen commonly in males and in age group 11-30 years, in summer season and in well/pond. Students were more commonly involved. Maximum deceased were married and belonged to rural region. Proper safety precautions and water safety education can decrease incidence of accidental drowning.

Medicolegal Autopsy: Histopathological Examination of Medicolegal Autopsy Cases and Its Correlation with Causes of Death

Objective: The aim of this study is to determine the histopathological examination of medicolegal autopsy cases and its correlation with causes of death. Study Design: Retrospective/observational Place and Duration: This study was conducted at department of Pathology, Khairpur Medical College Khairpur Mir's for duration of eight months from 15thMay, 2020 to 15thJanuary, 2021. Methods: Hundred cases of both genders were presented in this study. Cases were aged between 15-75 years. Cases detailed demographics age, sex and body mass index were calculated after taking informed written consent from authorities. Autopsy laboratory was used to take medicolegal autopsies of enrolled cases. 10% formalin solution was used for histopathological examination of all the specimens. In the course of the post-mortem investigation we examined the histopathology results for five major organs, such as the brain, heart, lung, liver and kidneys and compared them with gross anatomical results. Complete data was analyzed by SPSS 24.0 version. Results: 62 (62%) cases were males and 38 (38%) patients were females. Mean age of the participants were 30.52±13.17 years with mean BMI 24.52±16.21kg/m2. Most of the participants 40 (40%) were aged between 25-35 years of age followed by 27 (27%) were aged between 36-45 years. Most of the participants 70 (70%) were from urban area and the rest were 30 (30%) from rural area. Instant death was the most common cause found in 35 (35%) cases, followed by traffic accidents 24 (24%) cases. Most frequent effected organs were lung 29%, heart 26%, liver 21% and brain 18%. In lungs pneumonia was the most common effected pathology among 20 (68.97%) and in heart atherosclerosis was the most common effected pathology among 21 (80.77%). Conclusion: In medicolegal autopsy cases, histopathological analysis may be regarded as a useful method. The most common organ in these cases were the heart, liver and lungs. In certain cases, the histopathological exam of these bodies has been useful in identifying the cause of death. Often pathological results included pneumonia, atherosclerosis and congestion. Keywords: Histopathology, Medicolegal, Cause of death, Autopsy

Sudden Death from Primary Cerebral Melanoma: Clinical Signs and Pathological Observations

Primary cerebral tumors rarely provoke sudden death. The incidence is often underestimated with reported frequencies in the range of 0.02 to 2.1% in medicolegal autopsy series. Furthermore, primary cerebral melanoma is an uncommon neoplasm. It represents approximately 1% of all melanoma cases and 0.07% of all brain tumors. This neoplasm is very aggressive, and its annual incidence is about 1 in 10 million people. In the present study, a 20-year-old male was admitted to hospital with vomiting, headache, paresthesia and aggressive behavior. A computed tomography (CT) scan of the head was performed showing a hyperdense nodule in the right parietal lobe with inflammation of the Silvian fissure. A complete autopsy was performed 48 h after death. A blackish material was displayed on the skull base, and posterior fossa. Microscopic examination diagnosed primary brain melanoma. A systematic review of the literature was also performed where no previous analogous cases were found. The forensic pathologist rarely encounters primary cerebral melanoma, and for these reasons, it seemed appropriate to describe this case as presenting aspecific clinical symptoms and leading to sudden unexpected death. Histopathological observations are reported and discussed to explain this surprising sudden death caused by a primary cerebral melanoma.