An audit of foeticide, neonaticide and infanticide: A retrospective study in the Department of Forensic Medicine, King Edward Medical University, Lahore

The deliberate killing of a foetus in the womb, or a child from the first 24 h of birth to one month of age, or within the first year of life, is called foeticide, neonaticide and infanticide, respectively. Socioeconomic stress, mental illness, gender selection, shame or fear of punishment of adultery or illegitimacy, grudge and jealousy with parents and negligent delivery by dai are major causative factors in such cases. This is a retrospective, descriptive, observational study, and the sample pool consisted of 35 cases. Foeticide cases were 42.9% of the total and the same percentage of cases were neonaticides, while 14.3% of cases were of infanticide. The male-to-female ratio was 1.26:1 and the major cause of death was head injury. The study shows a prevalence of foeticide and neonaticide as compared to infanticide. It also displays the prevalence of males in overall cases and a higher number of unknown cases in our setting.

Fatal wild leopard attack injuries in Uttarakhand, India

Leopard attacks on human beings is common in Uttarakhand which is an area of national conservation. The objective of this study is to examine the pattern of injuries and circumstances to encourage ways of reducing such conflicts. There were eight deaths from leopard attacks brought for autopsy to the mortuary between January 2019 and August 2020. Incidents occurred mostly in a forest close to human settlements. One tourist was among the male victims, the remainder of whom were women carrying out household duties near the forest. Leopard attack injuries present in the head and neck were ante-mortem, with abdomen, buttocks and limbs post-mortem. People living at the border of protected areas need alternative means of support to enable them to avoid using forest resources, tourists must be warned to avoid wandering in the area.

Hands-on training on exhumation – an approach to train forensic medicine residents in South Asia

Forensic anthropology utilises the knowledge gained from the examination of human remains. It is a requirement for forensic medicine residents to have knowledge of forensic anthropology and exhumation. Most of the forensic medicine residents in the Indian sub-continent graduate only with a theoretical knowledge and without a proper practical training of the process involved. We demonstrate how hands-on training would be beneficial.

The experience of drowning

Internationally, drowning is a leading cause of accidental death that features in many legal cases. In these cases, possible mitigations and the ‘pain and suffering’ in terms of the duration and subjective experience of drowning are often pivotal in determining levels of compensation and outcome. As a result, there is a requirement to understand the stages of the drowning process, and the duration and physiological and subjective responses associated with each stage. In this short review we focus on these issues.

Accidental identification of peritoneal encapsulation during an autopsy after a car accident

Peritoneal encapsulation is a rare congenital pathological condition. Typical of this pathology is the presence of an accessory peritoneal flap that encloses the entire mass of the small intestine. Subjects with this condition often do not show symptoms and, in most cases, finding of it is accidental. We report a case of peritoneal encapsulation, not previously identified and found during an autopsy; the deceased, positive for HIV and affected by a Kaposi’s sarcoma, died following a road accident. Unlike other cases in the literature, the peritoneum encapsulated all abdominal organs and not only small intestines. Notwithstanding, there were no signs of intestinal ischaemia or intestinal obstruction.

Café coronary syndrome – case report and medicolegal implications

Café coronary syndrome is a term used to describe a sudden collapse of healthy subjects during meals in the absence of any sign of asphyxia, respiratory distress, or neurological symptoms. Risk factors are advanced age, poor dentition, alcohol intoxication, and dementia or psychiatric disorders. One of the main problems with this syndrome is that, even when witnessed, it is often confused with myocardial infarction due to the absence of asphyxia symptoms. This leads to misdiagnosis and potential delays in patients’ treatment that can eventually have fatal outcomes. As a result of that, medico-legal litigation may arise. This paper presents a typical case of fatal café coronary syndrome misdiagnosed as a myocardial infarction. The legal authority that requested the autopsy asked about the potential professional negligence of the healthcare providers who took care of the patient. We discuss the clinical and medico-legal aspects of café coronary syndrome.

Menstrual health management: Practices, challenges and human rights violations

Although it is a natural biological process, menstruation and associated menstrual practices still result in a number of social, cultural and religious restrictions in many countries which sometimes markedly interfere with the implementation of appropriate menstrual hygiene management. India has been chosen as a case in point, as there are approximately 355 million menstruating women and girls in the country, many of whom still face significant barriers to a comfortable and dignified experience with their menses including lack of access to appropriate clean water and washing facilities, and having appropriately priced sanitary products available. Social and religious stigmatisation may also be strict. It is suggested that illnesses related to a lack of clean water, basic sanitation and hygiene were responsible for the deaths of almost 800,000 females globally in a single year, making it the fifth largest killer of women. With increasing population movements, this may also be an issue encountered in migrant communities. There is a need to equip adolescent girls with sound knowledge regarding safe, hygienic menstrual practices to enable them to lead a healthy reproductive life. This human rights issue has significant medico-legal implications and has to be supported by both strong legislative and public health initiatives.

Socio-demographic profile of suicidal hanging deaths in Delhi and the National Capital Region – a retrospective study

The aim of this retrospective socio-demographic analysis is to identify those at higher risk of suicidal hanging in the region of Delhi and the National Capital Region. All deaths due to suicidal hanging from January 2016 to December 2019 reported in the Vardhman Mahavir Medical College and Safdarjung Hospital were included. Suicidal hanging accounted for 2.67% of total autopsied cases; 21–30 years old represented 42.62% of the victims. Male:female ratio was 1.7:1 and 38.37% of cases were from the adjoining areas of Vasant Kunj and Vasant Vihar. Therefore, a preventive strategy should focus concern on young adults, the male sex, and areas of Vasant Kunj and Vasant Vihar.

Understanding the anatomy of a malpractice suit. In the United States this is a doctor’s best defence

In the United States, the majority of physicians have been sued and those who have not, will be. Defendants share the notion that the lawsuit is totally fallacious. To be fallacious, the outcome of a medical intervention must be an unpreventable random maloccurrence. This is the only alternative to a medical error. The conflict over outcomes that are random and outcomes that are medical errors results in 46,000 malpractice suits every year in the USA. The burden of proof is a preponderance of evidence, but this is insufficient to do more than just infer, not prove, a relationship between the medical intervention and the outcome. Plaintiffs, generally, prove a malpractice case using inductive reasoning. Inductive reasoning leaves much to intuition. They use inductive reasoning because, by definition, preponderance of evidence, also, leaves much to intuition. Deductive reasoning is objective and there is no place for intuition. With deductive reasoning, the burden of proof is now sufficient to distinguish whether or not the cause relates to the effect with 95% confidence. A model for deductive reasoning in malpractice which is completely consistent with the scientific method is presented. This should and would derail frivolous lawsuits.