Use of Troponin I as a Biochemical Marker for Diagnostics of Asphictic State in Mechanical Asphyxia

The purpose of the study was to determine the quantitative content of the biochemical marker of myocardial damage (subunits of the troponin complex: Troponin I) in the blood as a diagnostic criterion for asphyxia in mechanical asphyxia. Materials and methods. To determine the presence of asphyxia, the quantitative content of Troponin I in the blood of 12 dead people was studied and analyzed, among which violent death was observed in 7 cases and non-violent – in 5 cases. The study for biochemical detection of Troponin I used a method based on enzyme-linked immunosorbent assay followed by statistical processing of the results using the MedStat package. Results and discussion. Among the biochemical markers for the diagnosis of asphyxia in hanging and aspiration asphyxia, the most indicative is the determination of the quantitative content of Troponin I in the blood, which is also used in clinical practice to substantiate the diagnosis of cardiac pathology. Therefore, it is important to conduct a differential diagnosis of changes in quantitative indicators of biochemical markers depending on the cause and genesis of death. During the study of the quantitative content of Troponin I in the blood of those who died of mechanical asphyxia (hanging, aspiration asphyxia), it was found that the content of troponin I is from 140 ng/ml to 170 ng/ml. The quantitative content of Troponin I in the blood of those who died of acute and chronic coronary heart disease (control group) is from 10.1 ng/ml to 120 ng/ml. The average value of the quantitative content of Troponin I in two samples was found: in the blood of those who died of mechanical asphyxia – 156 ng/ml±4.4 ng/ml; in the blood of those who died of acute and chronic coronary heart disease – 45.62 ng/ml±22.4 ng/ml. The study revealed a difference in quantitative indicators of biochemical markers depending on the cause and genesis of death, found that the quantitative content of Troponin I in the blood of the dead from mechanical asphyxia (hanging, aspiration asphyxia) compared with the quantitative content of Troponin I in the blood of the dead with chronic coronary heart disease is higher, at the level of significance p=0.008. Conclusion. Thus, in the course of research, the feasibility of using changes in quantitative indicators of the biochemical marker Troponin I to determine the asphyxiation in violent death (mechanical asphyxia) and differential diagnosis in cases of non-violent death (acute and chronic coronary heart disease) was proved, which significantly increases efficiency and reliability of forensic medical examinations

Homicide and corpse dismemberment: A study of one case

Homicide may be an isolated impulsive act arising from a situation or based on a previous conception, which is premeditation. Despite its nature or motivations, homicide remains a wrongful criminal act at all times and in all places. Several studies conducted in Western countries on this topic have highlighted the overriding concern of the criminal, which includes concealing the criminal offence in most cases.In Africa, apart from cases of infanticide, the discovery of the body of a homicide victim in a public place is a relatively common phenomenon, particularly if it involves mutilation.The body was examined; it was a young adult African female whose corpse was wrapped in a plastic bag. The autopsy established that the section or cutting planes were preferably lodged in the large joints.Death was caused by mechanical asphyxia. The focus of this case lies in the atypical nature of this type of postmortem manipulation in the West African context.The unusual nature of this type of homicide illustrates and underscores some reality in our development context.

ANALYSIS OF MORTALITY STRUCTURE OF MATURE STRAY DOGS (SECTIONAL STUDY)

Stray animals are such animals that are left without owner’s care, they are part of society, serving as sources of zooanthroponosis. There are no works devoted to analysis and classification of death causes of stray animals on Altai Territory. Objective of the research is to study mortality structure of stray mature dogs. The objects of research were the corpses of 41 sexually mature stray dogs from the Altai Territory, and kept by volunteers and animal protection organizations in the period 2017-2020. Research methods include registration of an animal; autopsy; photographing; statistical processing and analysis of the obtained data. The results showed that 33% of the studied stray dogs died as a result of the action of toxic substances of unknown nature (poisoning), at the age of 3-4 years and 7-8 years; 22% - infectious diseases, at the age of from 6 months up to 5-6 years old; 15% - dirofilariasis, at the age of 2 years and 4-7 years 4 10% - extensive heart thrombosis, at the age of 1-3 years, 5-6 years and over 10 years; 10% - mechanical injuries (car injuries), at the age of 3-8 years; 7% - mechanical asphyxia, at the age of 5, 6 and 10 years; 2% - cancer, at the age of 2 years. The death causes of stray dogs are the result of the action of toxic substances of unknown nature (poisoning); infectious diseases (plague of carnivores and piroplasmosis); autointoxication (sources: stomach, intestines, liver, pancreas); car injuries; closing of the larynx lumen with a foreign object and liver cancer with metastases.

Diagnostics of mechanical asphyxia – experience of foreign countries (literature review)

The aim of this study is to establish modern, global trends in the diagnosis of mechanical asphyxia. Materials and methods: search and bibliographic method (theoretical analysis, systematization and classification of library catalogues, printed and electronic sources on mechanical asphyxia) from open anchor databases Scopus preview, Web of Science and using information retrieval systems Google Scholar, Open Ukrainian Citation Index (OUCI), ScienceDirect on the Internet. Results: mechanical asphyxia, as one of the most common types of violent death, ranks first among deaths from mechanical injuries. Its study is of great interest among medical scientists in various fields, especially for resuscitators and forensic experts. Establishing the causes of asphyxia, clinical and morphological manifestations, and the consequences that unfortunately most often lead to death. With the rapid development of society, science is also developing rapidly, and the latest sensitive methods of diagnosing diseases are emerging. However, unfortunately, in the post-Soviet space, the diagnosis of most pathological conditions, including asphyxia, is determined by experience and sensory organs, which are determined using instrumental research methods in compliance with the requirements of evidence-based medicine. Given the peculiarities of the pathophysiological processes of the asphyxiation state and their manifestations in the body, doctors should rely primarily on general knowledge about hypoxic and asphyxiation disorders, which are determined using instrumental research methods in compliance with the requirements of evidence-based medicine. Conclusions: at present, the diagnosis of asphyxia consists of many morphological features. Failure to take into account the state of the body, the presence of chronic diseases, and drug or alcohol intoxication at the time of asphyxiation complicate the diagnosis. Detection of individual clinical manifestations or morphological features does not allow asserting its lifelong origin. Therefore, it is necessary to use modern research methods that should expand the possibilities of forensic diagnosis of the viability of injuries in terms of evidence-based medicine and provide forensic experts with a scientific basis for their results. One such method is immunohistochemical, which is gaining popularity and consolidating its position in the EU, China, Japan and America. In addition, this method is well-established and widespread in morphological studies of differential diagnosis of tumours. Some scientific works prove the expediency of using the immunohistochemical method to solve the problems of forensic expert practice, which is an actual scientific and practical task

Metabolomics improves the histopathological diagnosis of asphyxial deaths: an animal proof-of-concept model

The diagnosis of mechanical asphyxia remains one of the most difficult issues in forensic pathology. Asphyxia ultimately results in cardiac arrest (CA) and, as there are no specific markers, the differential diagnosis of primitive CA and CA secondary to asphyxiation relies on circumstantial details and on the pathologist experience, lacking objective evidence. Histological examination is currently considered the gold standard for CA post-mortem diagnosis. Here we present the comparative results of histopathology versus those previously obtained by 1H nuclear magnetic resonance (NMR) metabolomics in a swine model, originally designed for clinical purposes, exposed to two different CA causes, namely ventricular fibrillation and asphyxia. While heart and brain microscopical analysis could identify the damage induced by CA without providing any additional information on the CA cause, metabolomics allowed the identification of clearly different profiles between the two groups and showed major differences between asphyxiated animals with good and poor outcomes. Minute-by-minute plasma sampling allowed to associate these modifications to the pre-arrest asphyxial phase showing a clear correlation to the cellular effect of mechanical asphyxia reproduced in the experiment. The results suggest that metabolomics provides additional evidence beyond that obtained by histology and immunohistochemistry in the differential diagnosis of CA.

Epidemiological aspects and a current approach to the problem of carbon monoxide poisoning

Background: Carbon monoxide (CO) poisoning is the leading cause of death from poisoning (accidental and intentional). The number of cases of CO poisoning is increasing day by day. Aims: The aim of the study was to analyze the epidemiological situation of CO poisoning and identify the urgent aspects of this problem. In the article, the author provided a retrospective analysis of 117 cases of CO poisoning, registered in a number of regional branches of the Republican Scientific and Practical Center of the Forensic Medical Examination of Uzbekistan, after he studied and analyzed the world literature on the epidemiology of CO poisoning. It has been revealed that fatal poisoning ranks third after mechanical injuries and mechanical asphyxia and constitutes 6.3% (513 cases) in the range of deaths by violence (8078 cases). Therefore, CO poisoning is considered as one of the most prevailing (51%) causes of mortality. Conclusion: This is a global problem, with young males at risk. Further studies on the current clinical and forensic aspects of CO poisoning are required, and the necessity for regular analysis of epidemiological data for taking comprehensive measures to prevent CO poisoning is emphasized.

Cutaneous wound metallic residues pattern analysis with SEM-EDX in a forensic case of overkill

The term overkill identifies the infliction of massive injuries that greatly exceed those needed to kill the victim both in number and intensity. We present the case of a Peruvian transsexual, who was choked and hit by 11 sharp-force wounds all in the facial area. The scanning electron microscopy with energy dispersion X-ray analysis carried out on the skin of the facial wounds proved crucial in proving that two different point-and-edge weapons were used, following the finding of metallic micro-traces of heterogeneous composition. This discovery and the autopsy highlighted the use of two distinct types of injury (mechanical asphyxia and sharp-force trauma) showed that this murder amounted to o verkill.

FORENSIC MEDICAL ANALYSIS OF POPULATION MORTALITY

To study the mortality rate, a retrospective analysis of 973 conclusions of the forensic medical examination of corpses was carried out in 2019 in the Samarkand regional branch of the Republican Scientific Practical Center for Forensic Medical Examination and its regional units. According to the forensic medical service, the structure of mortality is dominated by mechanical trauma, as well as mechanical asphyxia and cardiovascular disease. Among the mechanical damages, the main part was a transport injury, especially an automobile one. A certain part is death from a traumatic brain injury, mainly as a result of a car injury and exposure to blunt objects. In gender terms, it prevails in men, in the age aspect in people of working age.