Journal of Indian Academy of Forensic Medicine
JIAFM presents a comprehensive and meticulous exploration of the intricate facets within the realm of forensic medicine. Encompassing an extensive spectrum, the journal delves into various Forensic, medico-legal, and clinical aspects of the Specialty. It serves as a pivotal platform for scholarly investigations, discussions, and insights into ethical and social dimensions that intersect with forensic medicine. Priority is accorded to Original Research Articles, Review Papers, and impactful Case Reports that significantly contribute to the field. By spotlighting these crucial areas, JIAFM endeavors to foster a deeper understanding of forensic medicine, promote best practices
Nursing students’ knowledge and Attitude concerning Acquired Human Im- munodeficiency virus at Iraqi Nursing Colleges
Background: Acquired human immunodeficiency virus remains a global public health problem.Objectives: To determine the level of knowledge and attitudes regarding human immunodeficiency virus among students in nursing colleges in Iraq.Materials & Methods: The study applied a descriptive cross-sectional design and was carried out at four nursing faculties in Iraq, specifically in Baghdad, Babylon, Kirkuk, Tikrit, and Misan. The research employed three instruments: I: A Socio-demographic Questionnaire; II: [Insert the second tool: he Nursing Students’ Knowledge About HIV/AIDS Patient Scale was used to measure the students’ understanding of HIV/AIDS. III: The Nursing Students’Attitudes toward HIV/AIDS Patient Scale was employed to assess their perceptions, biases, and empathy levels.Results: More than half of the students in the study displayed a good level of knowledge, and three- quarters had a positive attitude towards AIDS. There were statistically significant differences (P value < 0.05) between socio-demographic characteristics and knowledge level regarding age, gender, faculty, and academic year.
Modernizing Blood Donation Policies: Challenging the Lifetime Ban on MSM and Transgender Individuals
This article will shed light on a medico-legal issue where MSM (male sex with male) are life-time debarred from blood donation on the basis of suspicion that they can have HIV infection and can transmit the same to others through blood transfusion. In the 1980s, acquired immunodeficiency syndrome, popularly known as AIDS, left the world in fear and stigma. Until 1980, the number 1 of cases and causes of HIV were greatly unknown. During the 1980s, HIV reached around 5 continents (Australia, South America, North America, Europe, and Africa), covering around 1 million people affected by it. The early detection of HIV was linked to males who have sex with males (MSM). In 1982, many gay men in southern California were diagnosed with HIV, and because of this, HIV at that time was called gay-related immune 2 2 deficiency. In 1982, CDC used the term “AIDS”. According to the WHO, around 39 million people around the 3 globe will be living with HIV by 2022. National Blood Transfusion Guidelines 2017 under Point 51 prohibits the donation of blood by people who have male-to-male sex and are 4 transgender. The same kind of prohibition on blood donation can also be seen in the USA.
Presently in India virtual autopsy service is not provided by any center. All India institute io Medical Science, New Delhi is trying to establish virtual autopsy center, they have got the infrastructure established for research purposes. In India many autopsy centres are trying to learn and explore the training related to virtual autopsy, first basic training done national forensic science university at Gandhinagar, Gujarat. Large money, training, and legal hurdles are the main barriers. Initial stage institute of national importance has funding ability to start, then slowly it will on the public demand, it would be started most of the center. As per legalities, the legal system easily adapts the scientific use of technology in the court of justice. X ray examination report taking consideration in various court judgement, indication of the virtual autopsy report is considerable in the court. India has presently two autopsy centers have their own CT scan machine they are utilizing learn for the virtopsy, 1st in AIIMS Delhi and second in St John's hospital Bengaluru, in future it's going to established in many autopsies center of India. The possibility of First will be central institute then peripheral institute. In 4 to 5 years, virtual autopsies will be implemented in numerous autopsy centers.
Law of Rape: Sec 63 of Bharatiya Nayay Sanhita: Does it require amendment? Yes.
Asingle Judge bench of M. P. High Court has recently passed a judgment which is going to have long lasting repercussions in society and would particularly affect married women and would be married women. At the same time the Parliament has passed B.N.S. (Bharatiya Nayay Sanhita). The sec 63 and related sections about rape have given expansive definition of sexual intercourse. The referred judgment talks about this expansive definition of sexual intercourse and pronounces that now no sexual intercourse is unnatural. Aliberty is given to husband in the form of Exception-2 to indulge in so many sexual acts which were unnatural and unlawful till date. In my view this has happened without the knowledge and free and fair consent of concerned women folk. Paper discusses these issues and gives an amicable short solution to resolve the problem.
Toxicological Analysis and Interpretation in Cases of Suspected Drug-induced Organ Toxicity: Systematic Review
When pharmacological drugs have negative effects on a particular organ or organ system, it is referred to as drug-induced organ toxicity. It is crucial to correctly recognize and comprehend these toxicities to guarantee proper medical action and the mitigation of additional injury. Through the identification of putative toxicological pathways, quantification of drug metabolites, and assessment of the connection between drug exposure and organ damage, toxicological analysis plays a crucial part in this process. This study aims to identify the critical elements of toxicological analysis of drug-induced organ toxicity, focusing on the importance of interdisciplinary collaboration for reliable findings interpretation. A digital database was employed to conduct a literature and database search for this investigation. 8,530 results from Bullion Words were returned, and 7,360 sample articles were chosen. The sample was reduced for inspection by further analysis to 1,170. 960 samples were disqualified due to download problems. After 210 articles were eliminated due to quality issues, 180 articles underwent full-text examination, and 33 papers (n=33) were ultimately chosen. Numerous methods, such as immunoassays, chromatography, mass spectrometry, and molecular biology tests, are used in toxicological investigation when there is a suspicion that a medication has caused organ toxicity. The target organ, the drug of interest, and the level of analytical sensitivity needed all play a role in choosing the best analytical technique. Considerations for interpreting toxicological data include drug concentrations, the presence of metabolites, pharmacokinetic characteristics, and the timing of the beginning of organ damage. In situations of suspected drug-induced organ toxicity, accurate toxicological analysis and interpretation are essential for effective diagnosis, therapy, and medico legal investigations. Amore accurate diagnosis of drug-related organ damage is made possible by combining cutting-edge analytical methods, including mass spectrometry, with thorough clinical and pathological examinations. We will be able to comprehend and function more effectively in this crucial field of toxicology as a result of ongoing study, technological developments, and cooperative efforts among specialists from many disciplines.
Pattern of Drug Poisoning cases reported in Poison Detection Centre at Tertiary Care Hospital, Belgaum
The trend of reported drug overdose cases in Poison Detection Centre is a critical area of research that sheds light on the prevalence, distribution, and specifics of cases of drug poisoning. Drug toxicity is a major problem for the public health that has an impact on all ages and socioeconomic groups. This study's objective is to evaluate the trends in drug poisoning cases that have been reported to the Poison Detection Centre by examining the types of drugs involved and the demographics of the affected individuals. The findings of this study will provide valuable insights into the current trends and patterns of drug poisoning cases, which can help in making informed policy decisions and guide interventions to prevent and manage drug poisoning incidents. In this study, retrospective analysis of 315 drug poisoning cases were performed. Information was collected from cases reported between January 2010 and December 2021. Microsoft Excel ® 2021 was used for analysis and the results were calculated in percentages. The study found that sedative-hypnotics like benzodiazepines and analgesics like paracetamol (acetaminophen) were the most used drugs. The current data may not accurately depict the prevalence of poisoning in India, but it does show a general trend. The Poisons Information Centre is crucial in informing doctors about commonly used, abused medications so that they are aware of them before prescribing them.
Dental Age Estimation using Cameriere's Method in Indore Population
Forensic Dentistry, which is also referred to as Forensic Odontology is defined by James cotton as the branch of dentistry, which deals with proper handling, and examination of dental evidence and the proper evaluation and presentation of dental findings in the interest of justice. Teeth are most durable structures in the human body and have been found in many archeological sites or forensic cases, as only human remnants. Due to the low variability of dental maturity indicators, they have been used for the estimation of chronological age in individuals. Age estimation using teeth plays an important role in identification of humans in mass disasters and accidents. In addition chronological age is important in most societies for school attendance, social benefits, employments and marriages. Morphological and radiological techniques are used for the estimation of age in adults. There are few radiological techniques which have been devised on American, European or French, Canadian population. These techniques need to be validated for Indian population by doing several studies in different parts of India. In the present study, an effort is made to estimate the age of individuals by non-destructive radiographic method (Cameriere's method) in Indore population.
Anthropometric Analysis of the Greater Sciatic Notch: A Radiographic Study
The pelvis is a sexually dimorphic bone due to hormonal effects that facilitate its adaptation for parturition in females. This study aimed at determining the radiographic morphometry of the greater sciatic notch (GSN) in a selected Nigerian population. ATertiary health facility in Delta State Nigeria provided permission to access its radiological database for the pelvic radiographs retrospectively examined in this cross-sectional study. The GSN of 300 patients (154 males and 146 females) were identified and the following measurements taken using digital callipers and protractors; width, depth, posterior segment, total and posterior angles. Statistical Package for Social Sciences version 22 summarised the data in means and further assessed the gender, side and age differences. The association between variables was tested using the Pearson's correlation test. Inferential statistics were deemed significant at p<5%. All variables except the depth and posterior angle were sexually dimorphic (p<0.05). The width and posterior angle varied significantly across the age-groups. All variables except the width were asymmetrical (p<0.05). All the GSN measurements lacked significant correlation with age (p>0.05). The normative values for GSN dimensions in the study population have been provided. Their sexual dimorphism highlights their utility in sex determination of unknown human remains.
Sex Determination using Condylar Height in south Indian population - A Retrospective Study
Mandibular parameters evaluation has been used to determine sex in forensics and for treatment planning in dentistry. The present study aims to determine condylar height in a group of 20 to 70 years old males and females using panoramic radiographs for sex determination. This study was performed to measure the height of the condyle indicating that females and males showed significant differences for condylar height by 5.81 mm. The results of the present study indicate that condylar ramus height can be used effectively for sex determination.
To Evaluate the Knowledge, Attitude, and Perception of Students towards Forensic Pharmacology: A cross-sectional study
The study of forensic pharmacology holds paramount importance among MBBS students due to its vital role in the realm of legal medicine. Understanding the interactions between drugs and the human body is essential in accurately determining the cause of death or injuries in cases of poisoning, drug-related crimes, and overdose incidents. MBBS students equipped with knowledge in this specialized field can help identify the presence of illicit substances in post-mortem examinations, analyse toxicological reports, and provide crucial evidence in criminal investigations. Furthermore, a comprehensive understanding of forensic pharmacology enhances the ability to prescribe medications safely and responsibly, reducing the risk of adverse drug reactions and medical malpractice. Thus, this study is planned to determine the knowledge of Forensic pharmacology among 378 Indian medical graduates through a predesigned google form. Informed consent was obtained, and a brief objective and goals of the study were explained to the students. The obtained results were analysed, which implies that most students were aware of and comprehended the importance of forensic pharmacology. However, a lot of students had trouble understanding how forensic pharmacology would help with victim justice, law enforcement support, and the resolution of drug-related crime cases. Thus, awareness on forensic pharmacology is of utmost importance in preparing the next generation medical professionals to navigate the complex interface between medicine and law.
Feasibility of Age Estimation from Exfoliated Buccal Mucosal Cells in Adults: A Cytomorphometric Study
This study aimed to evaluate the age and gender-related cytomorphometric changes in the buccal mucosal cells of Indian adults and the feasibility of age estimation from them. Exfoliative cytology smears were collected from the clinically normal buccal mucosa of 90 individuals (30 in age groups of 21-30, 31-40, and 41-50 years). They were fixed in 95% alcohol and stained with the Papanicolaou technique. The Cytoplasmic Area (CA) and Nuclear Area (NA) in square micrometers and the Nuclear area: Cytoplasmic area Ratio (NCR) were estimated for each individual by averaging the measurements from 100 clear and unfolded cells. The age and sex-based intergroup comparisons were made with Analysis of Variance and Independent samples T-test (or their non-parametric equivalents), respectively. Pearson and Point Biserial correlations were used to assess the association of NA, CA, and NCR with age and gender, respectively. The cytoplasmic area showed a statistically significant difference (p=.04) between 21-30 years (2572.34 ± 516.54) and 31-40 years (2230.15 ± 516.12). NA and NCR did not differ between age groups. While females (0.030 ± 0.007) showed a higher NCR than males (0.026 ± 0.005, p=.009), no sexual dimorphism was noted for CA and NA. No statistically significant correlations were found between age and CA, NA, or NCR. Though the buccal mucosal cells from adults exhibited some age and gender-related cytomorphometric changes, it is not feasible to predict the chronologic age of an individual from them.
Evaluation of Accuracy of Clinical method for Age Estimation in 6–14 Year old Children in Vadodara City: An Institute based Cross-sectional Study
Age of an individual is important in order to identify a person, living or dead. Unavailability of such important detail mandates estimation of such parameters using different methods. Age estimation using teeth can be highly valuable since teeth are highly durable, resistant to putrefaction, fire, chemicals and shows minimal post mortem destruction. One such age estimation method based on teeth eruption was given by Foti B et al in French Population. However, individual growth factors like genetics, race, ethnicity, tend to exhibit difference in eruption timing and sequence in different population. Hence, the present study aimed to check the accuracy of such models in the Indian subpopulation. And to develop a more accurate and reliable age estimation formula for the children of Vadodara. 80 Children aged 6 – 14 years born in Vadodara were clinically evaluated to check the number of erupted teeth. Foti's clinical method of age estimation based on eruption status of permanent teeth was used to derive the age of each child. A new age estimation formula specific to local population was derived. A comparative evaluation of the Age_New_Formula was done with Foti's equations and chronological age. Statistical analysis revealed higher correlation between chronological age and estimated dental age using Age_New_Formula as compared to original equations given by Foti. Age_New_Formula is based on teeth eruption pattern of the local population. Hence, this equation can be more accurate and reliable for age estimation in 6-12 year of children in Vadodara City.
Analytical Study of Deaths Due to Suicidal Burns Based on Postmortem Examination
Heat is a form of energy which when transferred to the body causes thermal injury in the form of burns or scalds, the former due to dry heat and the latter due to moist heat. According to WHO, an estimated 1,80,000 deaths every year are caused by burns, the vast majority occur in low/middle-income countries and almost two-thirds occur in African and South-East Asia regions. According to World Health Statistics 2019, India's suicide rate stood at 17.8 suicides per 1,00,000 people, much higher than the global suicide rate of 10.5. The present study focuses on suicidal deaths due to burns to know the magnitude of the problem in our society, to identify which group of society is more vulnerable to this method of suicide and to investigate the outcome of self-inflicted burns and what measures can be taken to reduce the count. An observational study of 100 postmortem cases conducted during a period of 18 months i.e. from January 2019 to June 2020 conducted in Gandhi Medical College/hospital mortuary, Secunderabad, Telangana. The main sources of data are inquest reports, first investigation reports, postmortem reports, hospital case sheets, and death summaries (in treated cases and hospital deaths). The present study concluded that maximum deaths due to suicidal burns occurred in the age group of 31-40 years (35%) associated with equal preponderance of male (50%) and female (50%) groups. Victims whose total body surface area involved was less survived better. By providing proper timely counseling to the vulnerable population, the rate of suicides can be curbed to some extent. Also creating public awareness about the adverse effects of chronic alcoholism, if not all, few social problems can be avoided. As the rural population's preponderance is more in deaths due to suicidal burns, most of them succumb by the time they reach the hospital or health care centers. The delay in hospitalization enhances the complications of burn injuries. Providing adequate health care facilities, counseling centers for the vulnerable section of population and expansion of tertiary medical care all over the country to treat burns victims could be a major step to prevent deaths due to suicidal burns.
A Study of Road Traffic Orthopedic Injuries at Tertiary Health Care Centre of Central India: Haddon Matrix approach
Road accidents continue to remain the leading cause of deaths, disabilities and hospitalization in India, as it is home to the second largest road network in the world. This massive network serves as the nation's lifeline, transporting the majority of all goods within the country, and it is the preferred option for mobilizing the country's passenger traffic. A cross sectional study was conducted amongst ward admitted patients in the Department of Orthopedics for one year. The data was collected using a pre-designed and pilot-tested questionnaire by interviewing patients. Multi-variate logistic regression was used to find the co-relationship of various factors responsible for causing trauma. The study included 560 patients; almost 70% were young adult males. The factors causing trauma were over speeding (Odds Ratio-0.97, P<0.05), driving in an inebriated state (Odds Ratio -0.77,P=0.001), ignoring traffic rules (Odds Ratio -0.44, P=0.03) and not using safety devices (Odds Ratio -2.2, P=0.02). In most of the patients, head-on collisions, especially on straight roads, were the cause of trauma. However, distracted driving, poor weather conditions were not associated with trauma. The factors causing causalities on the road need to be identified. It is expected that with increasing freight and passenger traffic, the incidence of trauma will increase. There is a dire need to inculcate standard road etiquettes in drivers. Also, on the part of stake holders, the condition of vehicles and the maintenance of roads can prevent causalities.
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Evaluation of Inkjet Ink and Substrate Degradation in Media with Varying pH Levels
Forensic questioned document is a very important field. Forensic document expert (FDE) are generally well versed with the characteristics related to paper, ink and other writing media that helps in evaluating the case. Despite to possess great knowledge and experienced, a forensic document examiner may deals with the lot of challenges. Documents reach the forensic document examiner in different and various conditions. The documents can be torn, shredded, burnt, chemically destroy, engrave in soil or even soaked in some liquid. The document may be thrown in ponds, water tanks etc. by the criminal in order to hide the original document. During a document comes in contact with any liquid lots of destructive will happen to it. Many techniques are attempted and proposed for examination of water soaked documents and if required the restoration of content. Therefore, the present study has been attempted to evaluate the impact of soaking in different liquid medium on the different paper surfaces and printed content. The printed document soaked in liquids having different pH (Acidic, basic, neutral) were studied so as to determine the effect on printing ink and substrate. The change in characteristics of the paper and ink were noted and facilitated in estimating the age of the soaked document. The samples were examined using Olympus Stereomicroscope and under Ultra-violet light.
An Autopsy Based Retrospective Analysis of the Profile of Poisoning Cases at a Tertiary Health Care Centre in Central India Region
Acute poisoning is a crucial medical emergency and has remained one of the commonest causes of unnatural deaths. The earlier the initial resuscitations, gastric decontamination and use of specific antidotes, the better the outcome. The aim of this study was to characterize the poisoning cases admitted to the tertiary care health centre in Vidisha district. All cases brought for autopsy between the period January 2022 to December 2023 were evaluated retrospectively. We reviewed data obtained from the medical records as well as the data entries made in the pre-structured formats filled at the time of performing autopsy. It was found that 38% of all medico-legal deaths were due to poisoning. Males constituted 71.27% cases. Maximum victims, 31.38% belonged to the 21-30 years age group. 65.95% of the total victims were found to be married. The place of incidence was found to be indoors in 82% cases and history of addiction was provided in 20% cases. About 39% cases were brought alive to the hospital and the survival period in about 55% of the brought alive cases was less than 24 hours. By means of this study, poisoning has been recognised as one of the most common cause of suicidal mortality. Strengthening of peripheral health centres by means of better treatment modalities along with better access for psychological support and regulation on sale of agricultural poisons can help in curbing the mortality caused as a result of poisoning.
Study of Perceptions toward Humanitarian Forensic: a novel - Humanly Approach
Humanitarian Forensic Action, is a concept which has been brought by the International Committee of the Red Cross (ICRC), it refers to the applicability of forensic science and technology to address the needs of the victims of catastrophes for humanitarian, rather than criminal, purposes. Most of time Forensic Medicine and science is viewed in relation to crime, offence and justice involving victims or offenders. The concept of humanitarian forensic is predominantly focussed on dignified management of victims and grieved society. Forensic and forensic approaches are not much appreciated by community. There is a widely prevailing myth in the society that forensic is about investigation, crime, postmortem etc. People avoid taking help of forensic investigations unless it is absolutely essential. We started this project with the hypothesis that there are prevailing myths in community about forensic and lack of awareness about humanitarian forensics. We have collected 100 responses randomly in hospital settings. Out of which 62 respondents were male and 28 were female. Out of 100 respondents, 55 were from age group 20-30 years and with reasonably good education status. Validated 15 statements were asked for participant to respond on the Likert scale of 1-3 (agree, partially agree to disagree).
Prevalence of Major Depressive Disorder in Survivors of Sexual assault Examined in a Medical College of West Bengal
Rape is a heinous crime committed against women which has an impact on physical health as well as mental health. Post-traumatic stress disorder and major depressive disorders are commonly encountered by the survivors. This study tries to overview this and find out the prevalence of major depressive disorder in survivors of sexual assault. In general, developing countries are in dearth of data regarding this and the objectives of this study were to find the prevalence of major depressive disorder in adult and adolescent survivors of sexual assault. The study was based on a pre-validated Public Health Questionnaire and scoring was done accordingly. The instruments used were PHQ-9 and PHQ-A in English, Bengali and Hindi. The sample size of the study was 41, out of which 5 refused to give consent. Out of the 36 survivors, 21 (58.33%) were adults and 15 (41.66%) were adolescents. The legal cut-off of 18 years, as prevalent in India was used to classify the study population between adolescents and adults. In 15 adults and 12 adolescents, the perpetrator was known. In 6 adults and 3 adolescent the perpetrator was unknown. Multiple incidences of offence were committed in 24 (66.66%) subjects. Tentative diagnosis of depression was made in 15 (71.4%) adults and 6 (40%) adolescents. In adults, 40% suffered from mild form of major depression. In adolescents, 50% had minimal symptoms and 50% suffered from severe form of major depression. From the study, it can be concluded that Major Depressive Disorder is very much prevalent in the survivors of sexual assault. Interventional, longitudinal studies are required in this field for the proper follow-up and assessment of the survivors.
Evaluation of Patterns of Comorbidities Among Patients Admitted for Elective and Emergency Surgery for Avoiding Medico-Legal Conflict
Comorbidity, defined as several diseases in a patient connected through proven pathogenic mechanisms, necessitates identifying the diseases requiring primary and subsequent treatment. The comorbid condition may invite unnecessary conflict while treating surgically, which needs special pre and post-operative attention. The present study aims to evaluate the prevalence and the patterns of comorbidities among patients admitted for elective and emergency surgery to avoid medico-legal conflict. The present hospital-based prospective observational study was undertaken at the Department of Surgery, Gauhati Medical College and Hospital (GMCH), Guwahati, from June 1, 2018, to May 31, 2019. All patients admitted for elective or emergency surgery, with neither or at most two comorbid conditions fulfilling the inclusion-exclusion criteria, were included in the study. The data were analysed using SPSS V 21. A total of 309 cases were selected for the study. Most of the cases belonged to the age group 20-49 years, males (73%) and belonged to lower socioeconomic status (63.7%). Among females, chronic calculous cholecystitis (62.7%), while among males, hollow viscus perforation (35.4%) and unilateral and obstructed inguinal hernia (23.0%) were mainly reported. Almost 53% of the cases had comorbidity. Anaemia (18.1%), hypertension (16.9%) and type 2 diabetes mellitus (12.0%) mainly were reported comorbidities among females, while among males, type 2 diabetes mellitus (15.0%) and chronic obstructive pulmonary diseases (11.5%) were the most common. Comorbidities were prevalent among the study group. The adult age group is more prone to having one or more comorbidities. Controlling comorbidities in the preoperative phase is crucial in surgery for a better outcome.
Study of Suicide Cases in Bhopal Region: An Autopsy Study
The act or incident of voluntarily and intentionally taking one's own life. Suicide is not a new phenomenon in human history; suicide is as old as mankind itself, and its origins may be traced all the way back to the dawn of civilization. The present study was conducted in the department of Forensic Medicine and Toxicology Gandhi Medical College, Bhopal, Madhya Pradesh on a total of 686 cases of suicide brought to the mortuary for post-mortem examination. Highest proportions of cases 243 (35.3%) were in their third decade of life, implying that suicide is most common in younger age group, followed by people in their fourth decade of life 160 (23.3%). Male victims predominated (68.6%). Present study predicts unemployment and poverty as being one of the important risk factors for suicide. Most of the victims belonged to the Hindu religion (93.6%). In my study maximum proportion of cases were married 490 (71.4%), When we look at the presence of any past illness, 19.4% cases were having some form of chronic physical and mental disorders at the time of committing suicides. Although seasonal variation is also significant, the present study reveals highest number of cases in summer season (75.7%). Most common mode of committing suicide was hanging 306 (44.61%), followed by poisoning 283 (41.25%). Least proportion i.e., 1 (0.15%) of deceased chooses firearms as mode of committing suicide.
A Study on Injury Patterns among Motorcyclists Presenting to a Tertiary Care Hospital in South Kerala
High traffic levels on the road and the low costs of procurement and usage make motorcycles attractive in India. However, motorcycle riders and passengers are more vulnerable to traffic accidents. The present study, which was conducted in a tertiary care hospital in South Kerala, focused on injury patterns related to motorcycle accidents, including the factors associated with such accidents. The results found that males (80%, 212) were more often victims of motorcycle accidents than females (20%, 53). The most affected age group was 20–39 years, at 41.5% (110). Most victims who came to the hospital had fractures (73.2%). Based on the fracture site, the head and neck areas were the most affected (48.5%). Based on external injury, the head and neck areas were again the most affected (63.9%).
A Study on Pattern of Coup-contrecoup Head Injury in Autopsy Cases
Head injuries constitute a significant number of cases brought to the casualty department of a hospital and also contribute majorly to deaths caused by transportation injuries. Understanding the mechanism and patterns of such injuries and their relation with the manner of infliction is of utmost importance to formulate preventive measures. This study was conducted to throw light on the dynamics and pattern of coup and contrecoup head injuries. A total of 263 cases fulfilling the inclusion criteria were studied prospectively with a male preponderance of 86%. Majority of the subjects were in the age range of 21 to 30 years (20.91%) followed by the age range of 41 to 50 years ( 17.87%). The most common pattern of injury was subdural haemorrhage (SDH) only followed by presence of both SDH and subarachnoid haemorrhage (SAH). Among 263 cases studied, At the time of impact, in 249 cases head was in a state of motion and in 14 cases, at rest. Statistical analysis concluded that proportion of contre-coup injury is more in cases where head was in motion during impact. Brain contusion was also seen more in cases of contrecoup injury than coup injury.
Assessment of Non-Fatal Occupational Injuries at a Tertiary Care Hospital
Occupational injuries are responsible for more lost time from work, productivity and working years of life than any other health conditions. The fatality due to occupational injuries are increasing but nonfatal injuries due to same cause are much more larger in number and most of them go without reporting. An effort has been made in this study to determine the pattern of nonfatal occupational related injuries. It is a cross sectional study. Data was collected from OPD and IPD patients of occupational related cases which had come to hospital. Qualitative color test for alcohol was performed. 50 cases of patients with non-fatal occupational injuries were studied. Majority of cases in agriculture occupation sector i.e., 29 cases (58%). 90% of cases were male and 10% of cases were female and age group between 18-27yrs (34%) followed by 30% of cases between 28-37 yrs and 24% between 38-47yrs. Majority of accidents occurred between 12pm-4pm and 4pm – 8pm i.e., 19 cases (38%) and 16 cases (32%) respectively. 60% of cases occurred in workers who had work experience of >5years, followed by 24% in 6 months 2 years of work experience. In majority of cases safety equipments were not available (72%) and 14% of cases had the habit of alcohol consumption and 8% of cases were tested positive for colour test of alcohol. Among cases, predominant type of injury was punctured wounds (36%), followed by laceration/avulsion (16%) and predominant body part affected were upper limbs (36% of cases) and lower limbs (30% of cases). Analysis of the data in our study revealed a number of factors that were strongly associated with occupational injury. Particular care should be exercised in educating the workers about workplace hazards, training and experience of workers employed in dangerous jobs, pre-recruitment medical check up and screening health examinations should be conducted regularly at work place.
Amussat's Sign in Hanging – A Morphological and Histopathological Study
Amussat's sign is typically a transverse laceration of the intimal layer of carotid arteries described in cases of hanging. Subtotal laceration of the carotid artery is not strictly specific for hanging and can be also caused by blunt neck trauma, extreme overstretching, or whiplash injuries. The aim of this study is to find out the occurrence of Amussat's sign on morphological and on histopathological examination in cases of hanging. This is an observational cross-sectional study conducted in Tertiary care hospital during time period of January 2021 – June 2022 which consisted of 115 cases of hanging. Out of 115 cases of hanging, 93 (80.9%) cases were complete hanging. Males (n-78) were affected more than females (n-37). The most affected age group was 21-30 years contributing to 39.1%. Most common ligature material used was odhni (31.3%). Most common position of knot was at occipital region in 62.6% cases. Tear in carotid artery was seen in 14 (15.05%) cases on naked eye examination and all 14 cases were of complete hanging. On histopathological examination carotid intimal tear was seen in 73.3% (n-84) cases. Amussat's sign was mostly seen in anterior hanging cases on both gross (28.6%) and histopathological examination (85.7%). In present study Amussat's sign was present in 73.3% cases and most of them were identified by histopathological examination rather than naked eye examination and results shows incidence of carotid tear more in complete hanging.
An Unconventional Method of Suicide by Corrosive Ingestion vis-à-vis Medicolegal Aspects – Autopsy based Brief Research
Defining the word suicide is just misconstruing the gravity, essence and biology behind the mood, thought and behaviour of developing it. Suicide is not an act but a complex behaviour. As per literal meaning, it is just killing of oneself by himself. The method of suicide chosen by the victim depends on their availability of method and intensity of impending impulse of suicide. The authors here are discussing various autopsy cases of fatal ingestion of corrosives. The autopsy findings over the body, proper history and pattern-distribution of injuries over the body are correlated to each other to know the cause and manner of death. The injuries sustained over the gastrointestinal tract due to corrosive ingestion are compared with the findings observed by the authors in different cases. The legal aspect of the acid related injuries are also discussed. This method of suicide by corrosive ingestion is quite rare. The clinical symptoms, investigative observation and treatment outcome varies widely with case to case depending upon the patient profile, tissue affected and concentration of corrosive. However, detailed history taking, psychological profile of patient and medical expert's eye can diagnose the case on time which can save the patient with better prognosis.
Stripped of Dignity and Murdered: A case report
India has shown utter disregard and disrespect for women - rape, marital rape, sexual assault, harassment, female infanticide and dowry death are the best examples to cite this. These issues have been on debate for years after years with no definite result. Nearly 31,000 complaints of crimes committed against women were received by the National Commission for Women (NCW) in 2022, the highest since 2014.This is a case of an unidentified woman of about 24 years approx. who was found dead in the Jungles, Shillong. She was referred for post mortem examination to the department of Forensic Medicine in a tertiary hospital in North-East India. Autopsy findings revealed abrasions and bruises on the head and neck region with a ligature mark on the front and right side of neck. Internal organs were congested. Uterus and ovaries showed contusions. Fresh hymenal and perineal tear seen. There was evidence of spermatozoa in vaginal smear on microscopic examination. Assault against women is related with harmful health consequences and is regarded as a major public health problem. It is also a barrier for sustainable development goal of women on gender equality empowerment. The women facing brutality are more likely to view health workers as trustworthy for disclosure of abuse, hence it should be properly structured.
Modified Differential Extraction Protocol for the Identification of Suspect: A Case of Sexual Assault
DNA fingerprinting is a standard recognized technology for individualization of suspect in criminal justice system. The identification of male contributors from high female and low male ratios through different body fluid mix's is still a major issue to address in forensic DNA laboratories. Traditional methods of separation of the male-female fraction are time-consuming and labour intensive and might give variable results. Currently, there remains scope to refine the method of differential extraction for better results. In the present case study, differential extraction was modified and it was noted that total male DNA yield was 1.561 ng/µl and 2.675 ng/µl in the spermic fraction of the vaginal slide and underwear of the victim, respectively. Although the underwear of the suspect contains female DNA in the non- spermic fraction was 7.864 ng/µl from the underwear of the suspect. Therefore, complete autosomal STR DNA profile of suspect was obtained from the victim vaginal slide and underwear due to significantly reducing the excessive quantity of female DNA using modified differential DNA extraction process. Thus, a modified method is recommended for a better male autosomal STR DNA profile in sexual assault cases.
A Retrospective Analysis of Age Assessment using Visual and Radiological Methods in South Indian Population
Teeth are one of the most important biological indicators of ageing due to their high mineral content and resistance to change after death. Dental maturity indicates biological age for criminal, forensic, and anthropological purposes. When no information is known about the deceased, forensic human identification requires age estimation. This study used Lamendin's and Kvaal methods to evaluate and construct a regression model for dental age assessment in extracted single-rooted mandibular premolar teeth in south Indian population. Mandibular extracted first premolars were obtained from the patient from 15 to 75 years old. The patient details were blinded before analysis. The root height, root translucency, and periodontosis parameters were measured using Lamendin et al's technique. Based on the method proposed by Kvaal et al the morphological measurements of the teeth were calculated with six measurements for each tooth. In the results to determine the mean and standard deviation, descriptive statistics were used, and unpaired t-tests /Pearson correlation were used to compare age to other parameters and P-value <0.05 indicated as significant. South Indian population had a greater standard error of estimated age using Lamendin et al. and Kvaal's approach. Then modified Lamendin's and Kvaal's formula was used to South Indians and yielded accurate findings. This study concludes that the formula which was derived from the French population(Lamendin's) and the Norwegian population(kvaal's) does not apply to the South Indian population.
Determination of Sexual Dimorphism using Panoramic Radiograph –A Cross Sectional Study from Kerala, India
Morphological features of mandible have a vital role in forensic anthropology. The objective of the study was to determine whether morphometric mandibular ramus measurements like minimum ramus width, maximum ramus width and condylar height from digital radiography can be used for the assessment of sexual dimorphism. Cross-sectional study from the 300 clear panoramic radiographs without any artefacts with the permanent dentition of adults between the age group 21 to 60 were included. Mandibular measurements were carried out using the standard inbuilt imaging Ez dent imaging software using anatomical points in the radiograph. Discriminant function analysis (DFA) was used to build a predictive model group based on gender. Receiver Operating Characteristics (ROC) curve was used to classify the gender with all three mandibular measurements. Males have higher values for all three measurements compared to female sex. Maximum ramus height coefficient (0.962) with large absolute values corresponds to variables with greater discriminating ability; while minimum ramus width (0.232) and maximum ramus width coefficient (-0.110) had lesser discriminatory function. ROC curve failed to discriminate gender for all three mandibular variables. Mandibular maximum ramus height was the most important predictor to assess sexual dimorphism in the present study. Morphometric measurements were accurate and in present study, DFA correctly classified 73.7% cases from Kerala population.
Perceptions of Medical Faculty towards Teaching Aids- Blackboard versus Power Point (PPT)
Lectures were the most common form of teaching-learning method in medical school. It has its own merits and demerits. Use of black board in lecture was traditional method since ages. With the advance of technology, use of Power point presentation and smart boards became popular and preferred teaching aid than black board. In recent times the use of electronic media has become commonplace in Universities, as well as secondary and primary schools. Recent studies have sought to determine whether using PowerPoint or other such media are superior forms of delivery for lecturing over the traditional 'chalk and talk'.Many studies have reported about perceptions of students towards teaching learning aids PPT and chalk board. Present study was done to know perception of medical faculty (Clinical & Pre, Para clinical) towards teaching aids black board v/s Power Point Presentation. Total 90 faculty members were interviewed by prepared questionnaires using Likert scale. 87 faculties felt that PPT is an appropriate instructional aid for teaching present generation as against 59 for black board teaching. Majority of faculty agree that PPT helps better to organize the class instructions than chalk and talk method. 46 out of 90 faculty said that they need more time to prepare for the classes if they have chalk and talk as instructional aid as against 26 for PPT. Majority of them (84) feel that current generation of students usually prefer PPT as instructional aid than black board. Many agree that. Both instructional aid helps the students to be attentive throughout the session.