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   Table of Contents - Current issue
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April-June 2020
Volume 6 | Issue 2
Page Nos. 49-77

Online since Thursday, July 9, 2020

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EDITORIAL  

COVID-19 and forensic medicine in China p. 49
Dong Zhao
DOI:10.4103/jfsm.jfsm_38_20  
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Influence and challenge of COVID-19 in forensic identification p. 50
Bin Cong, Xin Liu
DOI:10.4103/jfsm.jfsm_32_20  
During the COVID-19 epidemic, the professionals in the field of forensic pathology, forensic sciences in general, and clinical forensic medicine have been performing medicolegal investigation in their communities. The forensic medical personnel who carry out such investigation/identification are facing a great risk of potential infection. Therefore, forensic institutions and forensic examiners should improve their awareness of infection risk and take universal precautions to prevent infection and spread of coronavirus. In addition, forensic experts should abide by the laws when they deal with social unrest and also strengthen research on COVID-19-related medical issues.
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Forensic identification of cases with infectious diseases such as novel coronavirus pneumonia p. 53
Xin Liu, Wen Liu
DOI:10.4103/jfsm.jfsm_36_20  
Deaths or other legal disputes caused by novel coronavirus pneumonia (COVID-19) may require forensic pathological autopsy or forensic clinical identification. During daily forensic identification of cases in which individuals died of infectious diseases, forensic identification agencies and experts should be fully aware of the risk of infection when dissecting and examining such cadavers. Furthermore, forensic identification personnel should always adopt effective protective measures. As a novel infectious disease, research and information on COVID-19 are updated rapidly. Therefore, guidelines should be carefully selected for forensic identification. In addition to the above aspects, this paper has also discussed other common issues during the forensic autopsy of patients who died of infectious diseases, such as professional ethics, informed consent, insurance claims, and environmental protection.
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COVID-19: A challenge for forensic and pathological researchers p. 58
Huang Sizhe, Wang Rongshuai, Wang Yunyun, Zhang Junchao, Zhang Youyou, Guan Chuhuai, Zhang Jie, Yu Yalei, Tian Qishuo, Qu Guoqiang, Liu Qian, Zhou Yiwu, Ren Liang, Liu Liang
DOI:10.4103/jfsm.jfsm_27_20  
Coronavirus disease 2019 (COVID-19) emerged in Wuhan, Hubei province, in December 2019, then spread rapidly in a very short time resulting in thousands of deaths. Unfortunately, details about the pathological mechanisms involved in the disease – including those associated with death – are currently scant. It is important to perform autopsies and pathological examinations of patients who have died from COVID-19 as soon as possible. This is the responsibility of forensic and pathological researchers, but it does pose various challenges. Such autopsies should be conducted in an isolated operating room under constantly maintained negative pressure. The examiners should be protectively equipped in accordance with biosafety level 3 requirements. It is essential to disinfect the room, facilities, instruments, and materials after the procedure and to dispose of all wastes appropriately. Cautious and precise operations during autopsies and pathological examinations will minimize the possibility of viral transmission. As many autopsies of COVID-19 patients as possible should be performed, until a detailed understanding of the mechanisms involved in COVID-19 pathogenesis and death has been attained.
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Perspectives on the construction of forensic autopsy laboratories designed to handle infectious diseases p. 62
Jian Zhao, Yong Niu
DOI:10.4103/jfsm.jfsm_31_20  
Coronavirus disease 2019 has already infected tens of thousands of people in China. The existing autopsy laboratories are not qualified to perform autopsies on individuals confirmed or suspected to have died from an infectious disease. When dealing with corpses with uncertain health conditions or unknown contact with a pathogen, the forensic medical practitioners face severe risks of being infected. To meet the requirements of performing autopsies on such bodies, ensure the health and safety of forensic medical practitioners, and study the pathophysiological changes of infected patients, it is necessary to improve the construction requirements and regulations for forensic autopsy laboratories.
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Facing COVID-19: Forensic doctors of public security departments should improve infected cadaver identification and personal protection procedures p. 65
Jian-Bin Fu, Jian Wang
DOI:10.4103/jfsm.jfsm_35_20  
Because of the nature of the human identification system, forensic doctors working in public security departments are responsible for cadaver examination and conducting crime scene investigations. These processes contain inherent risks, which often include various injury, poisoning hazards, and probable exposure risks with virus such as COVID-19. This paper discusses the occupational protections used for forensic doctors, such as crime scene corpse identification, autopsy building construction, risk assessment, and protective measures. Finally, we suggest the introduction of relevant rules and regulations that could guarantee the stability and safety of crime scene investigations and cadaver examinations. These measures may be helpful for forensic institutes and doctors working in public security departments.
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Autopsy procedure and standards for deaths of unknown cause during the COVID-19 pandemic p. 69
Hongbing Pang
DOI:10.4103/jfsm.jfsm_37_20  
At any time during the current coronavirus disease (COVID-19) pandemic period, forensic pathologists of public security departments in China may come in contact with corpses of unknown or unclear disease history. When these forensic pathologists perform autopsies on corpses with unknown cause of death, they inevitably face a high risk of severe acute respiratory syndrome coronavirus 2019 (SARS-CoV-2) infection throughout the autopsy process. In the present paper, the various aspects of the autopsy procedure for corpses with unknown cause of death, including preautopsy preparations, personnel protection, autopsy operations, postautopsy disinfection, and equipment requirements, were explored on the basis of relevant laws and regulations such as the Law of the People's Republic of China on Prevention and Treatment of Infectious Diseases, characteristics of the novel coronavirus and COVID-19, guidelines for epidemic prevention and control, the guiding opinions on the regulation of on-site inspection and handling processes during the COVID-19 pandemic period issued by the ministry of public security, and the current practices of public security forensic pathologists. Recommendations for the autopsy procedure and protection measures for public security forensic pathologists during the COVID-19 pandemic period have been proposed to provide a reference for frontline forensic pathologists and judicial authenticators.
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Risk identification and protection during high-risk forensic autopsy p. 75
Xia Liu, Jilong Zheng, Shengjie Yang, Cunrui Wei, Xuesong Feng
DOI:10.4103/jfsm.jfsm_25_20  
“High-risk” autopsies are those in which the anatomical examination of a corpse entails a substantial risk of contracting a serious infectious disease. Herein, we discuss the risks of infection associated with high-risk autopsies and factors pertaining to risk identification in high-risk autopsies, and we suggest potentially preventative measures focused on anatomy room protection and virtual imaging.
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