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.

Fatal road traffic collisions-An autopsy based study

The Deaths due to Road Traffic Collision has become a Major Public Health issue, hence Understanding the Deaths and the Factors involved is important to prevent Fatalities and at the same time Prevent Road Traffic Collision in General. The present Study is a Retrospective Study conducted during the period 2013 to November 2020. Road Traffic Accidents constituted 39.35%[n-1168] of the Cases. Males formed the Majority of the Victims contributing to 83.04% of the cases. Majority of the Victims were I the age group 31-40 years, consisting of 422 victims. The least Age Group affected were those below the age 10years and those individuals above the age 70years. Light Motor Vehicle were the Major Contributor to the Accidents, contributing to 46.40%[n-542] of the cases. Head and Neck was the Major region affected in 795 cases. The Maximum Fatality reported were due to Head or Craniocerebral Injuries in 87% of the cases. Abrasions were Present in all the Victims. Majority of the Deaths were due to Traumatic Shock reported in on the Spot Deaths or Brought Dead Victims in 35.45% [n-414] cases. The commonest Cause of Death reported after 07days of Treatment, were Septicemia, Lung infections, Peritonitis, Coma. Craniocerebral Injuries were the Main Contributors to Fatality in 87% of Accidents. Majority of Deaths were due to Traumatic Shocks due to Multiple injuries involved. Importance of Emergency Care is well understood in this study.

Retrospective study on fatal road traffic accident in Aizawl, Mizoram during 2014-2018

A traffic collision, also called a motor vehicle collision, car accident, occurs when a vehicle collides with another vehicle, pedestrian, animal, road debris, or any stationary obstruction, such as a tree, pole or building. Traffic collisions often result in injury, disability, death and damage to property as well as financial cost to both the society & individuals involved.

Retrospective study of lightning fatalities in Raigarh, Chhattisgarh

is a massive electrostatic discharge caused by the circulation of warm moisture-filled air through unbalanced electric field in the atmosphere, accompanied by the loud sound of thunder.: The present study was conducted to ascertain the pattern of lightning cases along with distribution of cases based on age, sex, season, location, activity of the victim and injury pattern in the corpse.: The present cross sectional retrospective study was carried out in the department of Forensic Medicine at Govt. Medical College, Raigarh, CG. All autopsy cases of lightning deaths from 2018 to 2019 (two years) were considered for the study.: Most of the deceased were in the age group of 31-40 years. All incidents happened in open field. High incidence of lightning deaths occurred during monsoon season and peak incidence in evening hours. In most cases arborescent mark was found as pathognomonic finding.: Lightning incidents are always accidental in nature. They are fatal and need prompt resuscitative measures. Lightning injuries have bizarre presentation in the body, therefore the autopsy surgeon needs meticulous and detailed methodical approach during autopsy.

Sexual dimorphism in digital dermatoglyphics: A qualitative analysis of bengali hindu population, West Bengal, India

Dermatoglyphic characteristics for identification of sex play an important role in forensic and medico-legal purposes. Hence, it considered to be the most precise and reliable indicators for personal and gender identification. Such types of information on Bengali speaking Hindu population are very scanty. This was tempted the present authors to assess the sex-wise variation of digital dermatoglyphic traits in a sample from West Bengal, India. A total 168 participants were recruited to obtain basic information and fingertip impression of the participants. Impressions were taken by using Ink method (Calcutta Ink) and examined with hand-lens. The mean age for male participants was 31.30 ±16.13 and for females it was 32.11±13.30. The loop pattern is observed more frequent (46.13%) compared to whorl (36.25%), arch (10.89%) and composite (6.72%). Females have a more loop (47.84%) and arch (12.26%) patterns than males (43.48% and 8.79% respectively. The whorl (39.85%) and composite (7.88%) patterns are observed more frequently in males as compared to females (33.92% and 5.98% respectively). Furuhata’s Index is more frequent in males (91.64) than females (70.9) but both the Dankmeijer’s and Poll’s Index are higher in females (36.13 and 25.61 respectively) than males (22.05 and 20.21 respectively). However, in case of Pattern Intensity Index there is slightly a sex difference for males and females (12.32 and 11.57 respectively). It was concluded that differences in the finger print pattern, combinations and indices can be used as an important tool for the determination of sex in medico-legal and forensic purposes.

Comparison of dental caries and periodontal disease with dermatoglyphic patterns and salivary p

Dermatoglyphic patterns are dermal ridge configurations present on the fingers, palm, toes and soles of human which are valuable in the diagnosis of many diseases associated with genetic disorders. Although the aetiology of dental caries and periodontal diseases is multi-factorial, we hypothesize that they may have genetic predisposition. We also evaluated its association with environmental factors like salivary pto assess any possible correlation. This study aims to Compare Dental caries (DC) and chronic generalized periodontitis (CGP) with Dermatoglyphic patterns and salivary p. One hundred patients were divided into group I (40 DC patients), group II (40 CGP patients) and group III includes 20 healthy controls. DMFT (decayed missing filled teeth) index (> 5) from group I, Russell’s periodontal index (2-5) from group II patients were taken. Finger print patterns by ink method and salivary p by p strips were recorded from all the groups and analysed with descriptive analysis. Group I showed more incidence of whorl patterns at lower salivary p than Group II and III which was statistically significant (p<0.05). Group II showed more incidence of ulnar loop patterns at slightly lower p than Group I & III which was statistically significant (p<0.05).The present study showed DC seen in people with more number of whorl patterns and periodontal disease with more ulnar loop patterns at lower salivary P. Larger scale studies are warranted to confirm our findings before applying dermatoglyphics to predict an individual prone to develop DC and periodontal disease in clinical practice.

An autopsy study of suicidal hanging

Hanging is the most preferred method of Suicide. Individuals are known to use different Ligature material and suspend completely or partially. hence, it is important to understand the Parameters involved in it. Large number of Suicidal death are reported. To Understand Suicidal Hanging by studying different parameters involved in it like Ligature Material, Type of Knot. Sex and Age Group, involved, kind of Suspension and Position of knot. A total of 634 cases were studied . Crime scene examination was done only in those cases where their were Suspicion on the Suspension Deaths. Rest of the cases the crime scene photographs and investigating officer records were the inputs. Only Suicidal Hanging were Considered for the Study. Suicidal Hanging contributed to 6.5% of the Total Cases. The Ropes[27%%] and Stole [36%]Contributed to the Most Preferred Ligature Material and Shoe Lace contribute[0.5%] to the least preferred Material for Self Suspension. Complete Suspension was observed in 62% of cases. The Majority of the Victims were Females contributing to 62% of the Deaths. The Major Age Group[50.76%] Involved was between 21-30years and the Uneffected Age group were those in the Extremes of Life i.e 1-10 and 61-70years. A Slip Knot was used on 97.73% of suspensions. In 78% of Suspension the Position of the Knot was situated over the [Typical Hanging]Nape of Neck. Married Victims Contributed to 37.45% of cases. The different Parameters of Suicidal Hanging are necessary to understand the Suicidal Nature of Hanging.

A prospective study of medicolegal autopsies to establish profile of burn deaths

Burns injuries have been a one of the major cause of concern since prehistoric time to the present era of modern medicine. Burn is considered to be the commonest cause of unnatural death in India.Burns are injuries produced by application of dry heat such as flame, radiant heat or some heated solid substance like metal or glass to the body. Dry heat, application of hot bodies, licking by flames resulting in simple burns causes local injury to the body. Moist heat leading to scalds, corrosive poisons resulting in corrosive burns. Electric spark, discharges, flashes and lightning leads to electric burns.Present study aim to know the magnitude of burn deaths in the region of southern marathwada region. Two years prospective study was conducted at Government Medical College Latur. Study of medico legal autopsies to establish the profile of burn deaths was carried out. In the present study, it is found that burns are commonly found in female (72.04%) than in females. Housewives (43.52%) were common victims followed by works (9.80%). Most of the incidences took place in morning hours (45.53%). Most common place of incidence was house (83%). Kerosene (57.63%) was the most common accelerant used to cause burn. If percentage of burn increases, the survival period decreases and vice versa. Most common alleged manner of death was accident (53, 6%).

An epidemiological study of poisoning trend in sonipat Haryana region-A one year study

Poison is a substance that causes damage or injury to the body and endangers one’s life due to its exposure by means of ingestion, inhalation, or contact and it is an important public health problem causing significant morbidity and mortality throughout the world. Hence, this study was done at tertiary care Hospital in north India (Haryana region) from year 2012 to 2013. 59 cases of acute poisoning in adults due to chemicals were included. Data on age, sex, marital status, occupation, locality, type of poison, were recorded and analyzed by descriptive method. Among 120 postmortem cases, 59 cases were of poisoning. Males (40 cases) outnumbered females (19 cases) and 46 cases were married. Peak occurrence was in the age group of 31-40 years (18 cases). Occupation wise poisoning was commonly found among male laborers (25.4%) and farmers (20.3%) followed by house wives (28.1%) and students (6.8%). Organophosphorus was the commonest agent (42.4%). The incidence of poisoning and its morbidity and mortality can be reduced by developing and implementation of effective prevention strategies.

Study on pattern of medicolegal cases in casualty of government medical college KolhapurMaharashtra

Medico-legal case is any quite case where the accompanying registered medical practitioners (RMP), after obtaining a detail history and examining the patient, thinks that some investigation or procedure by law enforcement agencies is required to establish and the responsibility for the case in accordance with the law or legal ground. This study is run to hunt out the frequency and pattern of medico-legal cases reported at a tertiary care hospital and to spotlight the vulnerable gender, age, residence and the cause. This is often retrospective study during which all the MLC cases registered in MLC record during a period of two years (1 January 2018– 31 December 2020) were included. Non medico-legal were excluded. Variables such as gender, age, time period between injury and reporting to casualty, were considered Findings were expressed in numbers and percentages. The total 2450 cases were registered as “medico-legal” out of which 1866 (79.4%) were males and 484 (20.6%) were females. Maximum cases were from the age bracket of 21-30 years i.e., 905 (36.93%). Most of the medico-legal cases registered were because of road traffic accidents 1154 (47.10%), fall (41.5%), and assault (6.73%) snake bite (6.4%), poisoning (14.81%)