Thanatochemistry: Study of synovial fluid potassium

Death interval estimation is one of the major attributes obtained from thanatochemistry. Body fluids like vitreous humour have been consistently used to estimate death interval from regression equations, but these may be useless when dealing with eye trauma, ocular disorders or in mutilated remains. Until recently, there was no consistent assessment of the reliability of measurements of the synovial fluid for death interval estimation. The purpose of this paper is to test previously developed regression formulae for estimating death interval based on synovial fluid potassium and to assess its reliability in estimating death interval. Synovial fluid potassium was measured on a sample of 308 individuals. Death interval was regressed on synovial fluid potassium and a regression formula was obtained. The regression model provided a 95% confidence interval of ±3.0 h and a correlation coefficient of 0.739. Compared to other studies, regression formulae based on the synovial fluid potassium in the present study provided considerably less standard errors.KEYWORDS Thanatochemistry; Cadaveric; Synovial fluid; Potassium; Postmortem interva

Fatal Accidents of Children Falling into Abandoned Borewells: An 11-Year Review of Data and Literature

Abstract The escalation of child fatalities due to falling into borewell has been in news in recent years. A Borewell which is a digging structure, is created by digging, driving, boring, or drilling the ground to access groundwater from underground aquifers. When these borewells don’t fetch enough water they are abandoned without taking proper measures to seal them. Children might get accidentally stuck and trapped in the tubing or the hole of the borewell through which they are unable to extricate themselves. Due to this, if immediate rescue is not done, chances of survival of the little victims get diminished. Cases of children falling in borewells were studied from year 2006 to 2016. Data were reviewed from available literature, national crime record bureau of India, the news published in press media either as hard print, e- news, television etc. A total of 43 incidents of victims who had fallen in borewells were studied. Most of these cases were of children below 6-years with male preponderance. In most of the cases, victims died due to asphyxiation due to wedging of the body in the narrow space of the borewell. In few cases (rather 2 cases) there was water in the borewell which may have drowned the victims

Fatal Accidents of Children Falling Into Abandoned Bore Wells: An 11 year review of data and literature.

The escalating children fatalities due to falling into bore-well has been in news in recent years.  Bore-well which is digging structure, is created by digging, driving, boring, or drilling the ground to access groundwater from underground aquifers.   When these borewell doesn’t fetch enough water they are abandoned without taking proper measures to seal it.  The children’s might get accidentally stuck and trapped in the tubing or the hole of the borewell through which they are unable to extricate themselves. Due to this if immediate rescue is not done chances of survival of the little angels get diminished. Cases of children falling in borewell were studied from year 2006 to 2016. Data was reviewed from available literature, national crime record bureau of India,  the news published in press media either as hard print, e- news, television etc.  A total of 43 incidents of victims fallen in borewell were studied between period of 2006 to 2016. Most of these cases were of children's below 6 years with male preponderance.  Most of the cases died due to asphyxiation due to wedging of the body in the narrow space of the borewell. In few cases (rather 2 cases) there was water in the borewell which may have drowned the victims. Fatalities of children falling in abandoned borewell had been rising. Such fatalities needs urgent attention in form of understanding of risk, prevention, rescue and other legal sanctions to prevent further such incidents in the coming year

Postmortem Sperm Retrieval and Assisted Reproduction: Issues without Solutions?

The issue of request for post-mortem sperm retrieval [PMSR] for reproductive purposes has gained momentum in the recent past in India and other countries. There are various methods for postmortem retrieval of sperm. Modern medicine has progressed to a stage where posthumous gamete retrieval with subsequent reproduction has become a possibility. However, very little has been discussed regarding guidelines orethical, social, and medical issues related to such a procedure. The procedure is a boon for families who might have become saddened by the untimely death of their son. The procedure can be useful for not only the spouse of married individuals but also to their parents. Also, such a procedure can be very helpful to the parents of their unmarried son, who was their sole support. However, there is no discussion of using such PMSR techniques in married as well as unmarried individuals if requested by close relatives. The present paper discusses the issues regarding PMSR in deceased individuals and the various issues that may arise

Study of fetal malnutrition in full-term small for gestational age babies

Introduction: Fetal malnutrition (FM) is a risk factor for increased neonatal morbidities and mortalities worldwide. Clinician’s comes across the challenge to identify small for gestational age (SGA) babies whose health is endangered in utero due to a hostile intrauterine environment and to monitor and intervene appropriately. Objectives: This prospective observational study aimed to know the prevalence of FM and to study the occurrence of adverse perinatal events in term SGA babies. Materials and Methods: The studyenrolled 903 term SGA neonates. Clinical assessment of nutrition (CAN) score was applied and anthropometric evaluation was carried out between 24 and 48 h of birth. Babies with adverse perinatal events were treated according to standard hospital protocol. Results: The prevalence of FM in the present study was 34.21% in term SGA babies. All anthropometric parameters such as birth weight, length, head circumference (HC), and ponderal index (PI) were significantly lower in SGA babies with FM as compared to those without FM. There was significantly higher occurrence of FM in SGA babies. Risk of FM was 3.17 times higher in SGA babies with length <3rd centile and risk 2.07 times higher when HC was <3rd centile. The risk of FM was 4.27 times higher when PI <2.2. When PI was compared to CAN score for FM, it had low sensitivity and specificity. Conclusion: CAN score is the better index for the detection of FM and for predicting high risk of perinatal morbidity in term SGA babies. Our study demonstrates that predicting malnutrition is more meaningful than birth weight alone

Macroscopic Cranial Suture Closure in An Adult Population: Is It Reliable for Estimating Age?

Age estimation is a key factor for the estimation of true sketch of an individual. Generally speaking, assessment of the age of a person either alive or dead is very important in medicolegal and forensic scenarios. The purpose of the present study was to examine the chronology and mold of union of cranial sutures, specifically sagittal, coronal, and lambdoid, and to find out the association between cranial suture closures with the age of the dead. An attempt was also made to see the applicability of the Acsadi and Nemeskeri method in an Indian population. A total of 193 adult calvarias (133 males and 60 females) were studied from autopsy cases. The degree of closure was studied in the three main sutures of the calvarium namely sagittal, coronal and lambdoid. The ectocranial sutures closed after the closure of endocranial sutures in all three studied sutures in various age groups. The sagittal suture showed earlier closure than coronal and lambdoid sutures on the scoring scale. When the Acsadi and Nemeskeri method was analysed using our data, it showed that scale of 0 to 4 worked fairly well with increasing age, with a score near 0 in younger populations and a score of 4 in older populations. Thus, we can conclude that closure of sutures occurs with advancing age in sagittal, coronal and lambdoid sutures. The sagittal, coronal, and lambdoid sutures are usually open in younger populations below 28 years of age while they are almost always closed in the age grou

Giving Contents From an Unlabelled Plastic Bottle Containing Toxic Substance: A Case Report

Accidental exposure to toxic chemicals is a major concern for all of us, particularly for our children. Many households in different parts of the globe store chemicals/drugs right from medicine, toiletries, corrosives, etc. in bottles of various sizes, shapes, and substances. Many a time such bottles are either newly purchased or are empty bottles of previously-stored liquids or other contents. Such used bottles or containers are frequently used for preserving corrosives or household cleaning substances in homes. Such unlabelled or used bottles can become culprits for causing accidental poisoning to anyone, especially children leading to grave harm to their health and safety. In the present case, a 3-month-old male infant was brought to our pediatric emergency unit with a history of difficulty of breathing, blackening of the tongue, with sudden onset of crying, and inconsolability after being given water from a plastic bottle by his aunt. After a detailed assessment, it was found that the infant has a blackish color corrosive injury in and around the mouth involving the anterior half of the tongue, and lips with evidence of trickling drop type corrosive injuries over the right side of the neck and right supraclavicular region.  Internally, except for epiglottic edema, no other significant findings were noted. On follow-up examination, the complication was noticed as the process of healing of the corrosive injury in and around the mouth as a fish mouth appearance. Upon investigation, it was found that the infant was sick with fever for which he was given contents from an unlabelled plastic bottle containing battery acid (sulfuric acid, H2SO4) thinking it was the water of Zam Zam. Dispensing contents from unlabelled containers can be a potential threat to the lives of children as well as adults

Ligature material in hanging deaths: The neglected area in forensic examination

The hanging mark is the most relevant feature of hanging and its characteristics are well known in the literature. Most of the time, the ligature material is not available during autopsy examination in hanging. Hence, the features of the ligature material are not submitted to systematic analysis. However, the type and position of the knot plays an important role in the mechanism of death and autopsy findings in hanging. Out of the total hanging deaths, complete hanging was seen in 67.7% of the cases, but a typical hanging was noted in only 10.2% of the cases. The commonest type of ligature material used for ligation around the neck was nylon rope followed by odhni and jute rope. The fixed knot was noted in 64.6% of the cases and a running (slip) in 21.3% of the cases. The commonest position of the knot was at nape of the neck, followed by the left side of the neck at mastoid process. The number of turns/loops of a ligature around the neck was one turn in 72.4% and two in 25.2% the hanging deaths. Most victims committed suicide by hanging in their homes, and the commonest ligature points were trees, flowed by beams and ceiling hook/fans

Study of different facets of electrocution deaths: a 5-year review

Abstract Background Deaths due to fatal electric injuries are quite common due to extensive use of electricity in home and industries. Hence, every single case of electrocution should be thoroughly investigated. Result This study was conducted from 2012 to 2016 to study the manner of deaths, seasonal variations, place of occurrence, source of contact, electrical injury, survival period, autopsy findings, and histopathological findings of skin of contact. During this period, a total of 5431 autopsies were carried out. The ratio of electric burn injuries to total burns was 1:6.5 while the ratio of electric burn injuries to total unnatural death was 1:49. Out of this, 88 cases of electrocution were analysed. In this study, majority of the victims were men (86%) aged between 21 and 40 years (63.6%). In 47.7% cases, victims were electrocuted at home. All these cases (100%) were found to be accidental in manner. Most of these cases were in contact with uninsulated source of electric wire. Out of the total cases, 22.7% cases were alive and got treated in hospital before death whereas 77.2% of people were declared brought in dead condition. Histopathological examination of electric contact skin in 67.04% cases showed all features suggestive of electric injury, i.e., infiltration of inflammatory cells, streaming of nuclei, coagulative necrosis, and epithelial separation. Conclusion Death due to electrocution is a medico-legal case which demands close attention not only to document the true cause of death of the unfortunate victim but also to detect defective condition which should be remedied in order to prevent future electrocution at the same site. Every such death is potentially avoidable, since every such injury is due to either equipment malfunction or victim error

Cutaneous cut sign: A clue to self inflicted carving on the body by sharp object

Suicide notes are usually written with pen or marker on a paper, notebook, wall or mirror. However, suicide notes written on one’s own body is very rare, and suicide note engraved with some metallic object on the body has not been reported yet. In the present suicidal death, the victim while carving some letters on the left arm with a razor had an incidental cut on right thumb. This incidental cut on the palm may be referred as “cutaneous cut sign” which gives a clue that the carving on the body with a sharp object was written by the victim himself. It also provides an additional importance of examination of palm for the presence of supportive evidences