Journal of Forensic Medicine & Toxicology
The Journal of Forensic Medicine & Toxicology (JFMT) is a peer-reviewed, hybrid, bi-annual journal with a broad international perspective. The journal is dedicated to all branches of Forensic Medicine, Legal Medicine, Toxicology and allied sciences for the administration of justice. Specifically, the Journal encourages research articles that explore principles of forensic practice in contact with judicial system, practice of toxicology; and articles related to medical litigation, medical law and medico-legal issues arising out of day-to-day practice. The journal is an official publication of Medicolegal Society (regd.). The journal was initiated in year 1984 and passing through 40th year of its publication in 2023.
The effect of Chamomile Tea on Oral Mucositis among patients Undergoing Chemotherapy: Randomized Control Trail
Background: The side effect oral mucositis from chemotherapy harms patients who receive high-dose treatment because it affects 9 out of 10 individuals. The current oral medication palifermin needs extra funding to treat patients especially in less developed healthcare settings.Aim of study: This study aimed to test if chamomile tea can lower the harm oral mucositis causes from chemotherapy.Material and Method: Babylon oncology center in Iraq ran an official experiment with 75 patients split into two groups during medicinal studies. Card method was used to assign patients randomly into different groups. During two weeks’ participants in the chamomile group needed to apply chamomile tea rinses to their mouths three times a day but only standard medical care applied to the control group. WHO Mucositis Scale was used to measure oral mucositis severity in patients both at the start, day 7, and day 14.Results: The chamomile treatment sig nificantly reduced oral mucositis pain for patients but worsened symptoms for control patients (p < 0.001). Out of the 20 participants, 75% had no more mucositis by day 14. oral mucositis severity related closely to cancer stage, length of chemotherapy treatment and patient oral hygiene practices as tested with p values under 0.05. Standard oral care protocols for chemotherapy patients should include chamomile tea integration particularly in resource-limited healthcare facilities because it effectively decreases OM severity
Karnataka’s Bold Step to Classify Sudden Deaths as Notifiable: A National Imperative in the setting benchmark.
In a significant public health development, the Karnataka government has proposed making sudden out-of-hospital deaths, particularly in individuals under 45, a notifiable condition. This initiative, driven by expert committee recom mendations, also mandates autopsies in such cases and the creation of a centralized registry. By aligning with interna tional best practices and emphasizing data-driven strategies, this model addresses India’s long-standing gaps in mortality surveillance. While ethical and logistical challenges persist, Karnataka’s policy can serve as a national blueprint for reforming death investigation and improving cardiovascular health outcomes.
Effective and Professional Handling of Medico Legal Cases in a Busy Tertiary Care Hospital Emergency Medicine Department and Solutions to Address Challenges
Medico-legal cases (MLCs) form a critical part of emergency medicine practice, requiring meticulous documentation, legal compliance, and seamless coordination between healthcare providers and law enforcement agencies. Handling medico legal cases in the Emergency Medicine department of a busy tertiary care hospital is associated with lot of chal lenges that can affect the quality of patient care and the integrity and quality of legal processes. This article examines the key aspects of effective and professional MLC management, highlighting best practices for accurate documentation, ethi cal considerations, and timely legal reporting. Common challenges, such as inadequate staff training, lack of standardized protocols, and communication gaps, are discussed. Practical solutions, including staff training, digital documentation, and streamlined communication strategies, are proposed to enhance medico-legal case handling. By implementing these strategies, emergency departments can optimize medico-legal case handling, ensuring legal integrity, patient rights pro tection, and improved emergency care services. This article serves as a guide for healthcare professionals to handle MLC complexities with confidence and professionalism
Haemothorax in the Context of HELLP Syndrome: Unravelling the Etiological Dilemma - A Rare Case Report
Background: Haemothorax denotes the pathological accumulation of blood in the pleural cavity, distinguished by the presence of pleural fluid exhibiting a haematocrit that surpasses 50% of the peripheral haematocrit. Although predominantly associated with traumatic origins, instances of spontaneous haemothorax are not without precedents. Spontaneous haemothorax encompasses a multitude of causative factors and may manifest as a complication arising during pregnancy and parturition. Spontaneous haemothorax during pregnancy can arise from diverse factors, including diaphragmatic ectopic pregnancy, gestational trophoblastic disease, peripartal hemoperitoneum, and rupture of subcapsular haematoma. However, it is noteworthy that, as per existing literature, hae mothorax secondary to HELLP syndrome characterised by “Haemolysis, Elevated Liver Enzymes, and Low Platelet counts” has not been documented. Case Presentation: In this present case, a 34-year-old multiparous woman (gravida 3, para 2) was referred to Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, presenting with a full-term pregnancy. The patient reported an alleged history of premature rupture of membranes and documented instances of self-induced falls, occurring on two separate occasions, accompanied by a noted tongue bite. She received a clinical diagnosis of HELLP syndrome, leading to the imperative intervention of an emergency lower (uterine) segment Caesarean section (LSCS), resulting in the delivery of a live baby. Tragically, the patient succumbed the very next day. This case presentation highlights a clinically overlooked haemothorax, identified solely during autopsy in a pregnancy-related fatality attributed to HELLP syndrome. The complicating factor was an antecedent trauma before being admitted to the hospital. After meticulous examination, we have excluded the possibility of traumatic haemothorax, instead attributing the gradual progression of haemothorax from the point of bleeding to be secondary to HELLP syndrome—an unprecedented cause of mortality in the reported literature. Conclusions: The conclusion drawn, indicating that the clinical presentation with a gradual progression of haemothorax from the bleeding point was secondary to HELLP syndrome, is supported by the evidence presented in the case. The recommendations for attending clinicians to consider performing ultrasonographical tests in both thoracic and abdominal cavities for pregnant women with HELLP Syndrome, particularly in the presence of low haemoglobin levels, is a valuable suggestion.
Tragic End: A Case Report of Suicidal Death Due to Aqua Regia Ingestion
Introduction-Suicide is a tragic and complex phenomenon that poses significant challenges to individuals, families, and societies worldwide. One distressing method that individuals may employ in their desperate act is suicide by corrosive acid. The Corrosive, Aqua regia, an extremely corrosive mixture of nitric acid and hydrochloric acid when used as a method of self-inflicted harm involves the deliberate ingestion or exposure to it, leading to severe injuries and often fatal consequences. This is the rare autopsy report representing the findings in case of suicidal death due to aqua regia.Aim To present an autopsy case of Suicidal death due to Aqua regia ingestion.Case report-we present a case of death due to aqua regia ingestion. It was a hospital death showing death due to corrosive ingestion, the burn percentage was near 60%. On external examination exposed surface was yellowish-brown in color. On internal examination, the abdominal cavity was filled with blood. Besides severe congestion, perforation, and brownish-black discoloration were present. Conclusion-Suicide by corrosive acid represents a distressing and complex issue that requires careful examination. The highly corrosive nature of aqua regia can cause severe damage to the GI tract, particularly the oral cavity, oesophagus, stomach and intestine. This Tragic case highlights the importance of early identification, intervention and support for individuals at risk of self-harm.
Going Beyond the Surface: A Case Report of Dressler’s Syndrome
Myocardial insufficiency is the most common cause of sudden death in young adults. Herein we discuss a case of Dressler’s syndrome whose incidence is reported to be < 1-3% and is a cause that goes unreported. We report a case of young adult of sudden death, whose cause of death on gross examination seemed to be that of myocardial insufficiency. Due to a high index of suspicion after the history given by the relatives the cause of death gave us a deeper insight into his cause of death. The relevance of this topic is to rely on the history and not ending the case on gross examination alone. A deeper understanding of the cause will also increase the incidence of such cases which seem to be rare as they are not reported.
Ingesting the future: Navigating the perils of Nano-liquid urea A case study & Review of Literature
This case study aims to present the first documented suicide attempt involving the ingestion of nano-liquid urea, a nano technology-based fertilizer recently introduced in Indian agriculture. This study examines the clinical aspects including signs, symptoms, laboratory investigations, and treatment, while simultaneously exploring the underlying psychosocial aspects. By doing so, our goal is to illuminate the intersection between technological advancement, human vulnerability, and the responsibilities that come with scientific innovation.
A rare cause of maternal and fetal mortality by rupture of splenic artery aneurysm – a case report
A 26 year old pregnant female was brought unresponsive to the hospital with alleged history of loss of consciousness fol lowing giddiness. On examination, pulse was not palpable and blood pressure was not recordable. Inspite of all the resus citative measures, she could not be revived. Fetal bradycardia was detected with doppler and emergency perimortem Caesarean Section was done. But the fetus was still born. At the autopsy of the mother, spleen was found to be enlarged with multiple areas of hemorrhage. The splenic artery was seen to be tortuous and showed an area of aneurysmal dilata tion and rupture, 3cm proximal to hilum with surrounding peri-pancreatic hematoma. Peritoneal cavity contained one litre of fluid blood with blood clots in the lesser sac. Histopathological examination revealed arterio-venous malforma tion in the spleen with large areas of haemorrhage. Splenic artery aneurysm is a rare clinical entity that carries the risk of rupture and fatal hemorrhage. Ruptured splenic artery aneurysm can be disastrous for both the mother and fetus
Beyond the Scalpel: The Power of Questioning in Autopsy and chasing the truth – a case series
The word autopsy is derived from the Greek term autopsia, meaning to “see for oneself ” and is the keystone of forensic medicine. The medico-legal autopsies in India are performed at the request of an investigative officer as guided under the Bharatiya Nagarik Suraksha Sanhita (BNSS) 2023, replacing the former Criminal Procedure Code (CrPC) 1973. A com plete and meticulous autopsy is always necessary, as minor omissions can lead to misinterpretation of findings, affecting judicial outcomes. Post-mortem artefacts and handling-related alterations can further complicate the interpretations, resulting in obscure or negative autopsies where no definitive cause of death is established. Incongruities among forensic experts can sometimes create professional disagreements, yet such wide-ranging outlooks can ultimately enhance justice delivery. This article presents a case series highlighting the significance of preserving trivial evidence, conducting a com plete post-mortem examination, and looking at the post-mortem case through an open-eyed approach. Through three post-mortem cases, we demonstrate how scientific rigour, DNA analysis, histopathology, radiology, and toxicology con tributed to solving complicated cases. Our findings highlight the need for a systematic and neutral approach in forensic pathology to prevent wrongful accusations and ensure reliable post-mortem examinations
As scientific knowledge expands and technology advances, certain traditional practices in toxicology have become obso lete in the current era. This article delves into some of these outdated approaches, highlighting the need for their replace ment with more modern and sophisticated methods. The article highlights the importance of toxicology as a discipline, the current scenario and practice and why we need to bring change in study material taught to undergraduate and post graduate students. The topics which are still taught and are of no relevance in the present time need to be removed and the common treatment and testing methods which could be useful in clinical practice should be given importance. By shedding outdated practices, toxicology in the current era aims to provide more accurate, reliable, and applicable insights into the potential risks posed by various chemicals on human health and the environment.
DNA profiling strategies of heavily degraded human skeletal remains: Review of comparative significance of petrous bone, femur and molar teeth
The identification of heavily challenged human remains retrieved in forensic anthropological scenarios is a difficult task. The extraction of sufficient amount of high molecular weight quality DNA from such remains, its sequencing and analy sis has greatly helped in their identification pursuits. Multiple factors affect DNA preservation in skeletal remains, partic ularly the type of bone and its anatomical positioning in human body. The literature search revealed that femur, petrous bone and molar teeth are preferable sources of ancient DNA for identification of heavily damaged human remains. Present review emphasizes the comparative importance of petrous bone, femur and molar teeth in ancient DNA research and lays a foundation for future investigations that may further unravel the complexities of forensic identification of unknown human remains. The petrous bone is a comparatively highly effective and reliable source for ancient DNA due to its distinct anatomical and structural properties. The unique value of petrous bone also enables researchers to delve deeper into historical populations, offering critical insights into the origins of humans and the evolutionary forces that have shaped our species over time.
Direct Observation of Procedural Skills (DOPS) in Forensic Learning: Usefulness, Disadvantages, Challenges, and Implementation Process
Direct Observation of Procedural Skills (DOPS) is an integral tool for workplace-based assessment (WBA) in forensic learning, providing real-time evaluation and feedback on students’ procedural competencies. This article delves into the usefulness, disadvantages, challenges, and implementation process of DOPS within forensic education. It includes practical examples to illustrate the impact of DOPS on enhancing the assessment process and preparing students for professional practice.
Death due to ricochet firearm injuries as a result of Soaring Gun Culture in India: A Hidden Evil in Indian Society and Its Implications: A Review with case report
Gun Culture indicates that there is normalization of gun in society, but unaware of the consequences it holds for every one. It refers to exploitation of firearms due to easy availability and supply of illegal weapons from overseas at very low cost. Different states like UP, Bihar, Punjab, J&K and Rajasthan had witnessed operation of unlicensed weapons. Due to gun in many states India faces a serious issue. There are very strict laws for firearms in India, there are many loopholes from where criminals and normal citizens acquire guns. There are so many reasons from portraying themselves as pow erful person or to threatening someone or to protecting and even killing someone. Few surveys shows that the numbers of licensed firearms are very low as compared to unlicensed firearms. So many sever measures taken by government and police to bring an end to the gun culture, but corruption and politics have given hope to the culprits. Thus, this mixed article tries to bring out this situation, reasons and solutions for the prevailing evil form of gun culture in India with a case report. In our case there was multiple open firing done with country made firearm at Jam-Packed place over a pity argument between two local bhai/goons leading to death of one amongst them. After conducting a detailed postmor tem examination at our esteemed institute, it took a whole new different path in which Two Entry wounds & single Exit wound is found with no evidence of any bullets, pellets or any other projectile object inside any body cavity. Internal ricochet phenomenon was observed
Medico-Legal Perspectives on Ocular Injuries in India: Challenges and Implications for Clinical Practice and Forensic Evaluation
Introduction:Ocular trauma is a significant public health concern, often leading to vision impairment or blindness. In India, medico-legal considerations play a crucial role in the assessment and management of ocular injuries, necessi tating a comprehensive understanding of forensic evaluation, legal obligations, and clinical responsibilities.Objective: This review explores the medico-legal aspects of ocular trauma in India, analysing the epide miology, forensic assessment, legal implications, and challenges in clinical practice.Methods: A systematic review was conducted using electronic databases such as PubMed, Scopus, Google Scholar, and Indian Kanoon, focusing on studies published in the last 30 years. The review included peer-reviewed arti cles, legal statutes, forensic guidelines, and judicial precedents related to ocular trauma. Results and discussion: The incidence of ocular injuries remains high, particularly among males in occupational and road traffic accidents. Classification systems, such as the Ocular Trauma Score (OTS) and BETT classification, aid in prognosis and documen tation. Legal aspects include requirements for informed consent, medico-legal documentation, expert witness testimony, and liability in cases of medical negligence. The review highlights challenges in maintaining proper records, ethical considerations, and the need for increased medico-legal awareness among ophthalmologists.Conclusion:Medico-legal knowledge is essential for ophthalmologists to ensure legal compliance and ethical practice. Proper documentation, adherence to forensic guidelines, and understanding the implications of medical negligence can help safeguard both patients and practitioners.
Clinical evaluation of female victims of sexual assault suffered from physical and genital injuries – A Retrospective study.
Sexual assault and indecent behaviour towards women have been occurring from before the rinderpest era to the present day. Due to the traumatic nature of these incidents and the associated social stigma, fewer than 10% of survivors of sexual assaults seek justice in court of law. Judiciary requires medical evidence along with the victim’s testimony to corroborate the incident and provide justice for those who are in need. The present study aims to acquire data regarding incidence of the physical injuries as well as genital injuries in sexually assaulted victims. This study is a retrospective review with analysis of case sheet records documented by doctors. It examines women who reported sexual assault to the Department of Obstetrics and Gynaecology (OBG) at tertiary health care center between January 2018 to December 2022. The main outcome measures are the presence of physical-injuries as well as injuries over genitalia. A total of 222 victims of sexual assault were included. Out of these 222 cases, 122 victims suffered from only physical injuries, 62 victims suffered from both physical injuries as well as genital injuries, and 38 victims did not have any kind of injuries. This study shows that approximately 54.9% of the victims examined by doctors exhibited evidence of only physical injuries, 27.9% exhibited evidence of genital injuries, and 17.1% did not show any injuries. It is important to remember that the absence of injuries (physical injuries and genital injuries) does not exclude the possibility of rape.
Age Estimation Between Ages 1–18 Years by Radiological Study of Epiphyseal Union Around the Elbow Joints in North Indian Population
Introduction: Age estimation is the most important parameter in clinical forensic medicine during human identification. Age estimation can be done from early physiological changes in the body, teeth development and radiological examina tion of ossification centers. Methodology & Results: This study was done on dead bodies which are brought for autopsy to the mortuary, Dept. AIIMS, New Delhi. A total of 70 patients were observed, out of which 41 were male and 29 are female. The ossification centers around Elbow joint completely fuse earliest at the age of 15 years, while in females, it is at 13 years. Complete fusion of proximal end of radius and ulna has occurred 2 years earlier in females, as compared to males. Conclusion: Total sample size for the study is not large enough, to make proper inferences regarding the ossification of joints. The Tanner-Whitehouse method and Greulich-Pyle method should be modified as applicable to the Indian pop ulation to make a more scientific assessment of the ossification status of joints.
The Silent Witnesses: Forensic Entomology in the estimation of time since death”- A cross-sectional study from a tertiary hospital mortuary in South India
Forensic entomology is the application of the biology of insects and their arthropod relatives that interact with humans, human remains, and the associated physical environment, to aid in the investigation of crimes, deaths, and other legal matters. Despite its importance, forensic entomology remains under-utilized because of its limited awareness and lack of region-specific data. This study bridges this gap by exploring entomological evidence applications in forensic investigations within South India’s unique geo-climatic conditions. This cross-sectional study analyzed 153 autopsies of decomposed dead bodies with entomological evidence conducted at a tertiary hospital mortuary in South India from January 2021 to December 2021. This study demonstrates the application of forensic entomology in estimating the time since death and highlights its potential in aiding forensic investigations. We used two distinct methods to estimate the post-mortem interval: Analyzing successional waves of insects for bodies over a month old and focusing on maggot developmental stages for corpses under a month old. A comparative analysis was conducted to assess the validity and reliability of entomological analysis in estimating post-mortem interval. The study systematically compared post-mor tem interval estimates derived from entomological evidence with those obtained from other post-mortem changes, as well as information provided in autopsy reports. Utilizing Pearson correlation heat map analysis, the results revealed a significant positive correlation between entomological estimates and those derived from other post-mortem changes and autopsy reports. The findings of this study confirm entomological analysis as a reliable, complementary method for determining post-mortem interval, highlighting its forensic utility.
Cephalic Index among medical students of Tripura studying in Tripura Medical College.
The cephalic index is a crucial anthropometric measurement used to classify head shapes and assess race in various pop ulations. It has broad applications in forensic anthropology, clinical craniofacial analysis, and anthropological research. This study aimed to determine the mean cephalic index among undergraduate medical students of Tripura Medical College who are permanent residents of Tripura, and to analyse differences based on gender and ethnicity. A total of 323 students participated, including 175 females and 148 males. Standard anthropometric tools were used to measure skull length and breadth, and the cephalic index was calculated as the ratio of maximum cranial breadth to maximum cranial length multiplied by 100. The mean cephalic index observed was 80.87 ± 3.49, indicating a predominance of the brachycephalic type (65%), followed by Mesocephalic (30%) and dolichocephalic (5%) skulls. Although females showed a slightly higher mean cephalic index (81.05 ± 3.48) compared to males (80.65 ± 3.50), the difference was not statistically significant (p = 0.315). However, a significant difference was found between ethnic groups, with non-Bengali students showing a higher mean cephalic index (81.75 ± 2.85) compared to Bengali students (80.44 ± 3.70) (p = 0.001). These results suggest that ethnicity plays a notable role in cranial morphology, whereas gender does not significantly influence cephalic index. The findings provide valuable regional data for forensic and clinical applications and contribute to the anthropometric profiling of populations in Northeast India.
A cross-sectional study on knowledge, attitude & practice towards organ & tissue donation among patient’s attendant in tertiary care hospital.
Background: Organ transplantation is one of the life-saving treatment needed for survival but the disparity in the number of recipients and donors are expansive & unequivocal. This study aims to assess the knowledge, attitude & prac tice of organ & tissue donation among patient’s attendant in a tertiary care hospital. Material & Methods: A descriptive cross-sectional study was conducted among patient’s attendant in tertiary care hospital. The interview was carried out vis-à-vis using a 25 structured questionnaire and analysed using SPSS (IBM version 20, Armonk, NY, USA) Results: 100 consenting patient’s attendants were interviewed in the median age of 21-30years (43%) with a male: female sex ratio of 1:1.6. Majority of the interviewees were aware of organ transplantation however 52% did not know about donor registry. It was also observed that 37% didn’t know about cadaveric organ donation & 76% were willing to donate organs after death. Majority (87%) of the participants think that donating one’s organ adds meaning to one’s life yet 66% had not pledged/signed for donating organs. It is also detected that 49% of unwillingness for organ donation is due to unawareness while 21% had their reservation due to organ mutilation. This study also reflected that 59% were of the believe that organ donation will affect their lifestyle. Conclusion: At the end of the study, it is observed that majority of them had the knowledge on organ donation but were unaware of its process for registering as organ donor.
Comparison of the completeness of ICD-10 Coding of medicolegal deaths before and after the implementation of ‘History taking’ Proforma- A two year study
ICD – 10, also known as the International Statistical Classification of Diseases, is the international standard for defining and reporting diseases, conditions and external causes that lead to the mortality or morbidity, thus aiding in comparison and sharing of health information using a standardized, common language. ICD is used by physicians, nurses, research ers, health information managers and coders, health information technology workers, policy makers, insures and patient organizations. Most countries use this system to report mortality data, which is a key indicator of health status. The pres ent study has been conducted as a one-year retrospective study and one year prospective study, giving emphasis on the history taking part of medicolegal postmortem examinations conducted in GMCH, Chandigarh. The aim of the study was to identify the defects in history taking by the use of Chapter XX of ICD-10, which focuses on the external causes of mortality.
Autopsy Analysis of Renal Lesions: A Histomorphological Perspective
Objectives: The study aimed to evaluate the histomorphological spectrum of renal lesions in autopsy cases to determine the prevalence and distribution of renal pathologies among individuals who died suddenly and unexpectedly. Material and Methods: This cross-sectional, observational study was conducted over one year in the Department of Forensic Medicine and Toxicology at Government Medical College, Amritsar. A total of 160 autopsy cases were included, excluding those with autolyzed kidneys. Detailed gross and histopathological examinations were performed on all kidney samples, with additional PAS staining employed as necessary. Data on age, sex, and circumstances of death were recorded, and findings were statistically analysed using SPSS software. Results: Among the 160 cases, 70.3% exhibited histopathological abnormalities. Acute pyelonephritis was the most common lesion (24.975%), followed by acute tubular necrosis (14.85%). Glomerular sclerosis was observed in 11.25% of cases, and renal cell carcinoma in 2.7%. A male predominance was noted, with the highest frequency of renal pathologies in the 41-60 years age group. Gross examination revealed congestion in 61.25% of kidneys and cystic changes in 36.45%. Conclusion: The study underscores the significant incidence of renal pathologies, many of which remain undiagnosed during life, particularly among middle-aged males. The findings emphasize the critical role of autopsy in detecting occult renal conditions, offering insights that could improve the management and prevention of renal diseases
Statistical Designs for Stature Estimation by Cephalic and Nasal Metrics Among Jordanians
This study was carried out to evaluate a group of cephalic and nasal metrics as stature predictors among a sample of living adult Jordanians; 352 males and 391 females. The subjects were chosen from three northern Jordanian governorates. The three cephalic; length, width and circumference, and two nasal morphometrics; nasal breadth and height were measured and analyzed statistically by SPSS 22. The findings revealed that Pearson’s correlations of stature with all measures were significant, but weakly associated. Correlations of stature were (0.277, p< 0.01) with cephalic length, (0.238, p < 0.01) with width, (0.165, p < 0.01) with circumference, (0.534, p < 0.01) with nasal height, and (0.440, p< 0.01) with nasal breadth. Multiple linear regression (MLR) model was conducted for the combined data of both sexes. The findings showed that R square was 34.9%. In addition, all dimensions, except head circumference, contributed to the model significantly. The second model for stature estimation was designed by principal component analysis (PCA), which reduced the five cephalic and nasal dimensions into two components. Results of MLR on both components revealed a lower R square of 32.8%. We concluded that the designed models of stature prediction by cephalic and nasal metrics were weak, and to improve their strength, they should be combined with another stature proxy.
Study of Hyoid Bone, Thyroid Cartilage and Common Carotid Artery In Death due To Hanging in Bengalee population
Introduction: Hanging is a form of asphyxia death due to constriction of the air passage at the neck, as a result of suspen sion of the body by a ligature in the form of a noose, applied in such a manner, when weight of the body or other part of the body e.g. head, acts as a constricting force. The present study has been done to describe the macroscopic changes which occur in the Hyoid Bone, Thyroid Cartilage and Common Carotid Artery in cases of Hanging. Methodology: The present study is an institution based observational study done during 1 year period from 1st April 2012 to 31st March 2013 and included 91 deceased selected by purposive sampling. Any unnatural deaths of both males and females of all age groups due to Hanging were included in the study, while asphyxial deaths other than due to Hanging or those with any anatomical anomaly or those in decomposed condition were excluded. Results and Discussion: Out of total 91 cases, most of hanging deaths were between 21- 30 years of age (27.5%). Only 4 had fractures of Hyoid bone each one belonged to the age group: 51-60 years, 61-70 years, 71-80 years and 81-90 years. Conclusion: This study was based only on macroscopical findings. If microscopical study is carried out on Common Carotid artery, which is beyond the limit of the present study, many more tears of the intima of the same artery could have been detected which was not identified in this study.
Registered Medical Practitioners: Perception of Professional Secrecy
Confidentiality is the foundation of the physician-patient relationship, safeguarded by ethical and legal guidelines glob ally. This study evaluates Registered Medical Practitioners’ (RMPs) awareness and perception of professional secrecy, which is crucial for preventing legal and ethical violations. This cross-sectional survey-based study was conducted at a tertiary health care teaching hospital, which included 342 RMPs from various specialties. The participants’ knowledge was assessed using a standardized questionnaire, with responses categorized based on accuracy. The findings indicated that while RMPs were well-informed about confidentiality in cases of notifiable diseases (75.43%), their awareness dimin ished in complex situations such as disclosing patient information to employers, insurers, or in court (71.92% to 60.52% incorrect responses). RMPs showed better understanding when the patient’s guardian or hostel warden was involved (61.11%) but lacked knowledge in areas such as the disclosure of information without patient consent for non-commu nicable diseases. The study identified gaps in the legal and ethical frameworks guiding professional secrecy, highlighting the need for enhanced training in medical jurisprudence during medical education. Recommendations include manda tory medical jurisprudence training during both undergraduate and postgraduate education to address these knowledge gaps. The study underscores the importance of continuous education to ensure RMPs comply with ethical standards and legal requirements, ultimately safeguarding patient privacy and public health.
An Autopsy-Based Study for Estimation of Stature From Anthropometry of Percutaneous Length of Femur in Male Population of Central India Region (M.P.)
Estimation of stature holds a special attention in the field of forensic medicine & forensic anthropology. Among the various parameters of identification, individual’s stature is an inherent characteristic. It becomes very difficult to predict the physical identity of an individual when only mutilated and dismembered remains of dead body are brought for post mortem examination. The aim of the present study was to find the correlation between anthropometry of percutaneous length of femur and stature in males and to derive a regression equation formula and multiplication factor to estimate the stature from percutaneous length of femur anthropometry in the Central India region Madhya Pradesh. This cross-sectional study was carried out on 250 deceased males of age between 20-60 years, brought for postmortem examination to the mortuary of Forensic Medicine Department, M.G.M. Medical College and M.Y. Hospital, Indore (M.P.). The mean right and left percutaneous femoral length found 39.73 ± 1.613 and 39.74 ± 1.606 cm respectively, whereas the mean stature was found to be 165.83 ± 7.98 cm. In this study, the maximum stature in males was found to be 185.0 cm and the minimum stature was found to be 150.0 cm. The correlation between percutaneous femoral length and stature was found to be positively correlated and the association was highly significant. The multiplication factor for percutaneous femoral length was found to be 4.17. Multiplication factors become essential in cases of forensic analysis when only limb or fragmented body part with soft tissue is available for analysis
Histopathological Analysis of Neck Muscles in Suicidal Hanging: A One-year Prospective Study
Hanging is the most common way used to commit suicide in India. The ligature mark is the main finding at the external examination, but the internal neck examination shows a very few visible findings on the gross examination. This study aimed to compare between gross features and histopathological findings in neck tissue and to analyze various micro scopic findings such as congestion, hemorrhage, muscle fiber breakdown, and leukocyte infiltration in the mylohyoid, sternohyoid, and sternocleidomastoid muscles. A total of 34 cases of suicidal hanging were taken for the study. There is a significant difference between gross features and histopathological findings in neck tissue. The congestion was found in sternohyoid and sternocleidomastoid muscles in 18 cases (52.94%) and 15 cases (44.11%), respectively, and was less evident in mylohyoid muscle only in 9 cases (26.47%). The hemorrhages were found in the sternocleidomastoid muscle in 16 cases (47.05%), in the sternohyoid muscle in 9 cases (26.47%), and in the mylohyoid muscle in 3 cases (8.82%). The muscle fiber breakdown was present in sternocleidomastoid muscle in 19 cases (55.88%), in sternohyoid muscle in 16 cases (47.05%), and mylohyoid in 11 cases (32.35%). The leukocyte infiltration is seen in only one case in the ster nohyoid muscle. All the above findings were absent only in 4 cases (11.76%). Microscopic examination, particularly of anterior neck muscles, can become significant evidence of the antemortem nature of hanging in cases when gross vital signs are absent.
Technology Enhanced Learning in Forensic Medicine: Reforms for the Digital Age
Technology-Enhanced Learning (TEL) is redefining the landscape of medical education, and its integration into Forensic Medicine marks a significant advancement in how future professionals are trained. This article explores the transforma tive impact of TEL tools on the teaching and learning of Forensic concepts. Challenges, demerits and future directions are also discussed. By embracing TEL, forensic education becomes more accessible, interactive, and effective, ultimately preparing learners to meet the evolving challenges of medico-legal practice in a digital age.
Exploring the Effect of Disruptive Behavioral Disorders on Quality of Learning Among School Children: Across-sectional Study
Background: disruptive behavioral disorders among primary school children is oone of the most popular, which has negative social, psychological, educational, and physical repercussions on children and families. Objective: This study sought to determine effect disruptive behavioral disorders quality of learning among school chil dren. Methods: A descriptive cross-sectional design study was conducted at Baquba primary schools in Diyala Governorate, and the study period was extended from October 6th, 2024, to January 15th, 2025. A nonprobability purposive sample was used to include 275 teachers working at selected Baquba primary schools, Iraq. Data were collected using a self-admin istered questionnaire, two components of the study instruments. Initially, the demographic sheet contained the individ uals’ sociodemographic data. An explicit children’s emotional and behavioral problems scale is included in the second section. The collected data were analysed using SPSS version 26. Results: The results showed that areas were within a moderate disruptive behavior level for: aggression, hyperactiv ity, and learning problems, and area was within a low disruptive behavior level for Physical problems. The average scores for these areas are 2.05, 2.39, 2.30, 1.52 respectively and total average scores for these areas is (2.16). The findings demonstrated a robust and positive association between the age group and disruptive behavior disorders among primary schools’ children. However, the statistical analysis indicated that there was significant correlation between sociodemo graphic factors and DBD regarding of gender. Conclusion: In summary, students with disruptive behavioral disorders have lower academic achievement and gradu ation rates than students without disabilities. The majority of the children polled in this study reported moderate levels of DBD.
KNOWLEDGE, ATTITUDE, AND PRACTICE ON MEDICO-LEGAL AUTOPSY AMONG UNDERGRADUATE STUDENTS IN A MEDICAL COLLEGE IN NASHIK, INDIA: A CROSS-SECTIONAL ANALYTICAL STUDY
Background: Forensic medicine integrates various medical disciplines, providing a holistic understanding of human anatomy, Physiology. Medico-legal autopsy is a crucial aspect of forensic medicine that plays a vital role in unraveling the mysteries surrounding suspicious deaths. This paper aims to assess the knowledge, attitude, and practice of medico-legal autopsy among medical students. Method: A cross-sectional questionnaire-based survey was done among the 2nd and 3rd year undergraduate Medical students. Result: A total of 159 (66.3%) participants out of 240 responded during the data collection. It was found that the male students (59.1%) are more in favor of in-depth study of Forensic Medicine than the females (40.9%). Further, statistically significant gender differences in positive responses were seen in issues such as autopsy skill training from 2nd year (M-19.5%, F-(20.1%)), active participation in performing autopsies (M-59.1% F-40.9%) and conducting an autopsy under observation should be a part of the internship (M-48.4%, F-39.6%) among other findings. Conclusion: By integrating medical knowledge with legal and investigative skills, forensic medicine can provide a unique and rewarding career path for those interested in making a difference in both the medical and legal fields.
Copyright (c) 2025 Tej Bahadur Chhetri, T. Ramalingamma Chhetri, Syed Meraj Ahmed
THE CONCEPTUALISATION OF MEDICAL STUDENTS TOWARDS ONLINE EDUCATION
Globally the education system after COVID-19 pandemic has undergone swingeing changes by substituting traditional class room teaching to online platforms. This research intent to reconnoitre the ideas of medical students towards digital/online education, their implication, and potentials for enhancement. A questionnaire was designed, validated, and distributed to students of Tertiary Health Care Teaching Hospital and Medical College, India. The collected data were analysed using descriptive statistics. Out of total 250 participated students, 200 were considered for the final analysis after implementing inclusion and exclusion criteria. The findings showed higher incidence of depression among third-year MBBS students. Significant statistical correlations were found between the student's response to online teaching and evaluation with factors like attendance (0.00), health (0.009), reliable assessment (0.02) and a preference for Multiple Choice Questions over Long & short answer questions (0.003). While online medical education presents with both advantages and disadvantages. Therefore, a blended learning approach of both online and traditional education will be most effective educational strategy moving forward.
Copyright (c) 2025 Senthil Kumaran M, Shreemata Kumar Dash, Arun Kumar Siddamsetty, Bedanta Sarma, Venkatesh.J