Elderly suicides in Denizli, Turkey: a retrospective study from 2011 to 2020

Background Although suicide rates and methods used may vary according to society, gender, and age there are epidemiological studies reporting that suicide rates increase with advanced age in all societies, particularly accelerating after the age of 65 years. This study aimed to investigate the demographic data and suicide characteristics—such as the location and method, among others—of the elderly suicide deaths among forensic deaths between 2011 and 2020 in Denizli, Turkey. Results It was determined that elderly suicides constituted 13.8% of all suicides and increased gradually over the years during the 10-year period. The vast majority of cases were male (82%). It has been observed that hanging is the most frequently used method. It is also noteworthy that although firearm suicide among men was the second most common method, women do not choose this method at all. The majority of elderly suicides (88.5%) in Denizli occurred in the home and its annexes. Conclusions Suicide prevention programmes should promote the elderly to benefit widely from social and health services. Therefore, there is a need to include widespread home care services and firearms regulations in prevention programmes.

Biochemical analyses for dental age estimation: a review

Background For various legal and forensic scenarios, establishing an individual’s age, both living and dead, plays a crucial role. Various morphological, radiographic, and molecular methods can be used for age estimation. In children and adolescents, age estimation is based on the established developmental stages. However, in adults, where the development ceases into maturation, the degenerative changes play a role in determining the age. Main body of the abstract In the natural aging process, several molecular changes occur most commonly in the long-living proteins and hard tissues like the teeth and bone. These molecular changes gradually lead to alterations in several organs and organ systems, which can be quantified and correlated with age, including aspartic acid racemization, collagen crosslinks, advanced glycation-end products, and mitochondrial DNA mutations. Short conclusion Among the above methods, the racemization of aspartic acid can be considered as the most precise method. The main advantage of using aspartic acid racemization is that the sample can be collected from tissues (teeth) protected from various environmental and nutritional factors. If all the confounding factors are stable, the utilization of advanced glycation-end products can also be considered valuable. Environmental factors like lead accumulations may also help determine the age. However, further studies need to be conducted, focusing on providing a more standardized method. This review provides a concise summary of the biochemical techniques that can be used for estimation of age.

South African and international legislature with relevance to the application of electronic documentation in medicolegal autopsies for practice and research purposes

Background Forensic and legal medicine requires all documentation to be recorded in a manner that is admissible in court. Issues surrounding privacy, confidentiality, and security mar the implementation of electronic document systems in medicine. Awareness of current legislature governing record keeping and electronic documentation especially in modern medicine and forensic medicine has not been sufficiently explored. This study explored the current South African and international laws that govern admissibility of evidence, especially relating to electronic evidence, for use in court and research, Findings Egypt, UK, Canada and the USA have similar legislation to South Africa regarding admissibility of electronic records. The South African Electronic Communications and Transactions Act no. 25 of 2002 defines data and the Criminal Procedure Act 51 of 1977 further defines the admissibility of evidence in court and the National Health Act regulates publication of deceased information after death. Conclusions Forensic medicine requires all documentation to be admissible in court and the storage of data thus requires proper custodianship and a high level of security, which can be achieved with modern technology. Modern medicine is evolving and technology can create secure and efficient methods of record keeping which will benefit forensic and legal medicine. Knowledge of the laws regarding admissibility of evidence can assist in creating electronic evidence that is permitted in court and can be used for research.

Medico-legal evidence collection in child sexual assault cases: a forensic significance

Background Every year, millions of children face sexual exploitation worldwide. In India, 109 children (National Crime Records Bureau2018) were sexually abused everyday (22% jump from the previous year). Even with advanced DNA techniques, the conviction rate remains low. The methods used for forensic DNA evidence analysis vary around the world, but the primary step of biological evidence collection plays the most vital role. Proper and timely evidence collection from the victim by a trained medical professional is important. Main body Dynamics of child sexual assault being massively different from an adult rape demands altogether different approach of evidence collection. A standard sexual kit employed for evidence collection needs urgent modifications considering genital development of pre- and post-pubertal victims. In the present study, parameters including systemic collection and evaluation of forensic evidences, medico-legal examination, and developmental consequences of sexual assault on pre-pubertal victims were assessed. Further suggestions for separate evidence collection kit during medico-legal examination were given for pre-pubertal victims and alleged accused in sexual assault cases in order to streamline and for better evaluation of DNA analysis in forensic laboratories. Conclusion The importance of expert medical practitioners plays a significant role in collection of appropriate information and evidences from the victim of sexual assault. General guidelines for evidence collection in sexual assault cases are not well suited for pre-pubertal victims. Appropriate reforms pertaining to the age and genital development of victims are required. Securing clothing as forensic evidence is essential in most cases as it turned out to be the exclusive evidence bearing material. The purpose of this article is to bring awareness about the thorough medical examination and modified sexual assault kit for pre-pubertal victims and alleged accused for a better approach in evidence collection and conviction rate.

An aborted case suspected to CHARGE Syndrome; A rare case with cardiac, intestinal and kidney abnormalities

Background CHARGE syndrome is a life-threatening congenital anomaly. The syndrome associations consist of coloboma, heart disease, atresia of the choanae, retarded growth and development, genital hypoplasia/genitourinary anomalies, and ear anomalies and or hearing loss. The aim of this paper is to describe and discuss a rare case of CHARGE syndrome. Case presentation During the routine dissection, atrial septal defect, overriding aorta from both ventricles, patent ductus arteriosus, duodenal anomaly, absent pancreas, right side descending and sigmoid, intestinal herniation in lesser sac, and left kidney anomaly were observed. Conclusions This rare case is of importance in re-considering the criteria of CHARGE and understanding the importance of the orchestrated morphologic driving forces of embryonic development.

Fatality in a body packer: the first reported case in Saudi Arabia

Background Body packers use different methods and materials to pack drugs inside their bodies. These could be simple or sophisticated to ensure a successful transfer or concealment of the drug with minimal risk to the packer. Different drugs were reported with cocaine and heroin being the most common. The packer presents to health facilities whenever they develop complications like drug leakage or intestinal obstruction, or they can be detected after a fatal event as an incidental finding in autopsy. Case presentation A body packer who was in detention suffered pain and died shortly after that. The autopsy not only revealed severe coronary atherosclerosis but also unveiled 10 rubber packages filled with methamphetamine and cannabis, and one package was found ruptured in the mouth. Toxicological analysis showed a blood level of methamphetamine 3.66 mg/L which was considered a cause of death. While methamphetamine was reported in cases of body packers, cannabis is rarely concealed by body packers for several reasons including its cost compared to the risk of packing. Conclusions This is the first reported case of fatality in body packers in Saudi Arabia and Arab countries. This should put into consideration the need for screening suspicious cases who are involved or suspected to be involved with drugs. Effective screening in specific facilities is needed to reduce fatalities and at the same time lowering drug smuggling.

Identification of body fluids—menstrual blood, saliva, and nasal secretions—over different periods of time, using mRNA

Background Forensic examination of biological samples started at the beginning of the twentieth century by applying the ABO blood group system in evidence related to crimes or human identification. In the present study, real-time PCR multiplex was used to identify dried and stored swabs (saliva, nasal secretions, and menstrual blood) through the target genes of saliva (histatin 3 and statherin), nasal secretions (statherin and BPIFA1), and menstrual blood (metalloproteinases 10 and 7). Results The expressions of histatin 3 and statherin in the dried saliva decreased over days of storage with a significant p value of <0.001. BPIFA1 was highly expressed in nasal secretions, and the expression level significantly decreased throughout the study with a significant p value of <0.001. The MMP7 and MMP10 genes were highly expressed in the menstrual blood, and the expression level decreased over days of storage with a significant p value of p<0.001. Conclusions Dried swabs of the saliva, Nasal secretions, Menstrual blood can be identified over the storage duration of the study using mRNA profiling of specific markers.

An alternate novel approach to classify lip prints

Background The wrinkles and grooves present on the sulci labiorum of human lips form characteristic patterns. As previous authors claimed, these can be used for personal identification in forensic cases because they are unique, permanent, and classifiable. Many scientists had devised different systems to classify the lip prints (Suzuki and Tsuchihashi, Martin Santos, Renaud, Afchar Bayar, and Jose Maria Dominguez). These systems were based solely on the shape of patterns present on the whole lip. However, sometimes, lip prints affected by either habitual smoking or any other pathological conditions are encountered. The investigator may have to form an opinion on partial lip print to identify the culprit. Therefore, in the present study, an alternative comprehensive system to classify even the partial prints has been proposed. Lip print samples were collected from 500 individuals (400 females and 100 males, respectively) using the tape lifting method. The whole lip print (Klein’s zone) was divided into 10 quadrants (five each on upper and lower lips) to study the whole pattern area thoroughly. The sample-wise and quadrant-wise frequency of all the patterns was statistically calculated. Sexual dimorphism of the lip print patterns was also assessed statistically. Results The method used emphasizes the consistency of patterns, which have been divided into Basic and Combination Patterns. Detailed examination of lip prints revealed that all the quadrants tend to have 7 types of Basic Patterns and 43 types of Combination Patterns despite similar appearance. These patterns can be further categorized into various subtypes based on the direction and orientation of wrinkle lines constituting the original pattern. Most of the Basic and Combination Patterns were widely distributed in all the analysed lip print samples and showed significant dependence on the sex of the subject. Conclusions The lip print patterns examined in the present study can be useful as an alternative to the existing systems to classify even partial lip marks recovered at the crime scene.

Age estimation with cemental incremental lines in normal and periodontally diseased teeth using phase contrast microscope: an original research

Background Age estimation is an important factor in forensic science for human identification. Teeth are considered to play a vital role as they resist decomposition at death unlike other tissues. This resistance and the gradual structural changes that take place throughout the life of an individual have made teeth useful indicators for age estimation. Dental cementum shows continuous apposition throughout the life of an individual. Tooth cemental annulation is a microscopic method for the determination of an individual’s age based on the analysis of incremental lines of cementum. Light microscopy as well as specialized microscopic methods have been employed to enhance the assessment of the cemental annulations. Periodontal disease is the most common dental problem affecting millions of people. Assessing the efficiency of the tooth cemental annulations method in periodontally diseased teeth is an important requisite. This study aims at assessing and evaluating the tooth cemental annulations in normal and periodontally diseased teeth using phase contrast microscopic method for age determination. Results A total of 60 teeth were included in the study and out of which 30 teeth were normal (sound teeth without any associated pathologies) and 30 were periodontally involved teeth respectively. Longitudinal ground sections were prepared and observed under phase contrast microscope. Measurements were made using an image analyzer software. The total width of the cementum was divided by the distance between two incremental lines. The eruption age of the tooth was then added to this to obtain the chronologic age for each individual. The results in the present study showed that tooth cemental annulations are applicable to periodontally sound teeth as well as in periodontally diseased teeth. There was no significant difference of estimated age from the actual age in both periodontally sound and periodontally diseased teeth. Normal teeth showed a reliability value of 92% and periodontally compromised teeth showed 96% respectively. There was no substantial influence of periodontal health on the estimated age. Conclusions The study concludes that the use of phase contrast microscopy in conjunction with image enhancement procedures improves the accuracy of age estimation and may serve as a reliable aid in forensic identification.

Orthodontists in forensic facial approximation (FFA): current inter-disciplinary perspective

Forensic odontology has contributed significantly in forensic investigations and involves various branches of dentistry including orthodontics. The current communication presents evidence-based perspective highlighting synergistic union of different specialties for Forensic Facial Approximation (FFA). It brings forth commonality in principles of anthropology, forensic science, anthropometry, anatomy, paleontology, forensic odontology, with orthodontics, used in FFA. Various attributes and skills of orthodontists’ aid in dental and skull profiling and the corresponding sex, age, and ethnicity-based soft tissue assessments for facial soft tissue thickness (FSTT), may aid a life-like appearance. They can assist hard tissue profiling by their expertise in growth of skeletal and soft tissue, along with the evolutionary trends in occlusion, and diet formulations. Their knowledge in identifying teeth patterns, dental/skeletal jaw relationships, cranial/facial indices, vertical/horizontal facial proportions, can help prepare skull for orientation and reconstruction. The dental, photographic, and radiographic records maintained by orthodontists and general dentists are instrumental in data retrieval, used in various software, clinical, or research areas. These can provide normative values for comparative analysis or facial recreation. The orthodontists can also assist anthropologists and forensic specialists in the virtual reconstructions due to their ease in using latest digital technologies including three-dimensional (3D) facial scan, stereo-photogrammetry, 3D printing, automated soft-tissue landmarks, growth, and age predictions. Thus, the current study established the commonality in concepts of various forensic disciplines with orthodontics, which can strengthen both forensic on-field facial approximations and hard/soft tissue research to further enhance the accuracy of contemporary digital software used in FFA.