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   2016| July-September  | Volume 2 | Issue 3  
    Online since September 30, 2016

 
 
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CASE REPORTS
Medicolegal Investigation of Medical Negligence in India: A Report of Forensic Autopsy Case
Raktim Pratim Tamuli
July-September 2016, 2(3):167-170
DOI:10.4103/2349-5014.191471  
In general negligence means failure to take proper care over something and according to law negligence means breach of a duty of care which results in damage. Medical negligence is not very uncommon; every now and then cases of medical negligence are reported in the electronic media. Medical Negligence is doing something that one is not supposed to do, or failing to do something that one is supposed to do. Role of Forensic Pathologist in cases of Medical Negligence is always unquestionable. Forensic Pathologists need to explore and maintain a high degree of transparency between the doctors, patients and the law enforcing agencies. In the present case, a person was attacked by a wild animal and he fell down on a rough surface. Immediately he was rushed to a local hospital. The treating doctor stitched the external injury and allowed him to go home; he neither advised any investigation nor kept him under observation to rule out any internal injury. After 12 hours the victim succumbed to death. At autopsy a fractured skull with underlying subdural haemorrhage was noticed. Was not the treating doctor negligent in this case? Were the protocols followed? What should be the role of a Forensic Pathologist in such kind of cases?
  4,917 493 -
ORIGINAL ARTICLES
Lucilia sericata (Meigen) and Chrysomya megacephala (Fabricius) (Diptera: Calliphoridae) Development Rate and its Implications for Forensic Entomology
Kapil Verma, Reject Paul
July-September 2016, 2(3):146-150
DOI:10.4103/2349-5014.191466  
Forensic entomology is basically a science that is based on the scientific study of the invasion and succession pattern of arthropods with their developmental stages of different species found on the decomposed cadavers during legal investigations. The developmental rate of Lucilia sericata and Chrysomya megacephala was studied in beef liver for the correlation of time duration in each phase with the temperature and climate. The obtained data belong to L. sericata at temperatures between 22°C and 26°C (mean - 24°C) and relative humidity 50% ±10% and C. megacephala at temperatures between 23°C and 27°C (mean - 25°C) and relative humidity 55% ±10%. From the analysis of results, it was observed that in the climatic conditions of the study area, time since death assessment involving L. sericata was found to be with a potential of maximum 10-11 days and C. megacephala with 8-9 days. The data emerged as results from the present work would be beneficial for investigations involving decomposed dead body remains for the assessment of time since death.
  4,644 582 1
Primary Screening for Proteins Differentially Expressed in the Myocardium of a Rat Model of Acute Methamphetamine Intoxication
Guoqiang Qu, Sizhe Huang, Liang Liu, Tianshui Yu, Rufeng Bai, Hongxia Liu, Fangming Song, Yongqi Wen, Haidong Zhang
July-September 2016, 2(3):123-130
DOI:10.4103/2349-5014.191460  
The mechanism of myocardial injury induced by the cardiovascular toxicity of methamphetamine (MA) has been shown to depend on alterations in myocardial proteins caused by MA. Primary screening of the expression of myocardial proteins in a rat model of MA intoxication was achieved by combining two-dimensional electrophoresis and mass spectrometry analyses, which revealed a total of 100 differentially expressed proteins. Of these, 13 displayed significantly altered expression. Moreover, Western blotting and real-time reverse transcription quantitative polymerase chain reaction analyses of several relative proteins demonstrated that acute MA intoxication lowers protein expression and mRNA transcription of aldehyde dehydrogenase-2 and NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 10. In contrast, MA intoxication elevated the protein expression and mRNA transcription of heat shock protein family B (small) member 1. By combining behavioral assessments of experimental rat models with the histological and pathological changes evident in cardiomyocytes, a mechanism accounting for MA myocardial toxicity was suggested. MA alters the regulation of gene transcription and the subsequent expression of certain proteins that participate in myocardial respiration and in responding to oxidative stress, resulting in myocardial dysfunction and structural changes that affect the functioning of the cardiovascular system.
  2,601 249 -
Radiographic Comparisons between Middle Phalanx of the Third Finger and Cervical Vertebrae Maturation for the Assessment of Skeletal Maturity
HC Meghana, KN Sri Charan, GV Pramod, L Ashok
July-September 2016, 2(3):141-145
DOI:10.4103/2349-5014.191465  
Sexual maturation characteristics, chronologic age, dental, and skeletal development are some of the more commonly used means to identify stages of growth. Hand wrist radiograph and cervical vertebrae maturation index (CVMI) are more reliable for skeletal development assessment. This study was conducted to compare the skeletal maturity using the maturational stages of middle phalanx of the third finger (MP3) with cervical vertebrae and then to evaluate the reliability of MP3 as a sole skeletal maturity assessment method. Chronological age group of the 112 subjects was 8-16 years for females and 10-18 years for males were selected for the study. Lateral cephalometry and intra oral peri-apical radiograph of MP3 of the left hand of each patient were taken. Then, statistically it was correlated which was highly significant. Skeletal maturation of MP3 and cervical vertebrae stages progress with advancing chronological age. Female subjects were advanced on an average of 2 years earlier than male subjects at every stages of growth spurt. These results suggest that MP3 can substitute CVMI for skeletal maturity evaluation to determine optimal treatment time for various orthodontic procedures. The developmental stages of the MP3 could be used as a sole indicator in assessing the skeletal maturity.
  2,507 340 -
CASE REPORTS
Use of Different Murder Weapons by a Single Murderer: Two Case Reports
Eradil Orazhkan, Tao Pu, Longlong Wang, Zhimin Wang, Zhiwei Zhu, Rufeng Bai
July-September 2016, 2(3):160-163
DOI:10.4103/2349-5014.191469  
Homicide is an extremely serious crime, and although the offender usually uses the same weapon to initially injure and complete the killing, there are exceptions. We report two cases in which a single murderer killed a victim using different weapons and summarize several situations in which a murderer might use different weapons to kill. The number of murders should be determined and estimated after a comprehensive complicated investigation of the scene, careful examination of the victim's injuries, and evaluation of evidence reported by eyewitnesses.
  2,474 234 -
REVIEW ARTICLE
Examining Scientific Evidence in US and Chinese Courts: A Comparative Study
Bangda Chen
July-September 2016, 2(3):151-159
DOI:10.4103/2349-5014.191468  
The critical examination of scientific evidence is crucial in attempting to distinguish genuine science from "junk science" and provides judges with an important basis upon which to determine the credibility of expert witnesses giving scientific evidence. From studying the law in the USA, we learn that the process for examining scientific evidence in court is based upon full discovery of the proposed evidence before trial and the availability of expert witnesses at trial to testify orally and be examined and cross-examined. Empirical studies suggest that the opportunities to critically examine scientific evidence in Chinese courts are not so freely available. Discovery is neglected, thus limiting the effectiveness of cross-examination, and current rules do not encourage oral testimony or effective cross-examination. To solve these problems, the disclosure duty should be put on the prosecution, rather than on the defendant. Scientific evidence should be discovered. Disclosure must include the basis, process, material relied upon, and methods of forensic appraisals. In the trial process, the prosecution has transferred the case file to court, where the defendant will be able to copy the scientific evidence. The neutrality of expert assistants established by article 192 of the new Criminal Procedural Law should be strengthened.
  2,421 207 -
ORIGINAL ARTICLES
Suicide Deaths in China: An Analysis of Forensic Cases
Dong Zhao, Longlong Wang, Kun Wang, Zhimin Wang, Eradil Orazhkan
July-September 2016, 2(3):131-135
DOI:10.4103/2349-5014.191462  
Suicide cases are often encountered during death investigations in forensic medicine. In this study, through a comparative analysis of our own data of 98 suicide cases and previous reports from various forensic institutions in China, we analyzed the risk factors of Chinese suicides and explored the implications thereof from a forensic point of view. Moreover, the age and sex differences, means, causes, and other concerns regarding suicide are discussed along with a review of the literature.
  2,085 379 -
CASE REPORTS
Two Forensic Autopsy Cases of Liposarcoma
Kino Hayashi, Kumiko Asakura, Nao Miyashita, Akihiko Hamamatsu, Akio Shigeta, Tatsushige Fukunaga
July-September 2016, 2(3):175-178
DOI:10.4103/2349-5014.191473  
Primary liposarcoma outside thighs is rare. We present two forensic autopsy cases of clinically undiagnosed primary liposarcoma (Case 1: Mediastinum, Case 2: Mesentery). Case 1 was a thin male in his 60s who had a well-differentiated liposarcoma (850 g, 23 cm × 20 cm × 10 cm) in the superior mediastinum. Case 2 was a thin female in her 50s who had a pleomorphic liposarcoma (10 kg, 40 cm × 25 cm × 11 cm) in the abdominal cavity with liver metastases. The cause of death in Case 1 was airway obstruction due to liposarcoma of the neck; that in Case 2 was complications of liposarcoma with metastasis. Because liposarcoma often appears in deeper tissue without pain, it will grow quite large before it is noticed.
  2,113 188 -
Lethal Consequences in an Infant with Myelomeningocele Following an Inadvertent Treatment
Xuemei Wu, Libing Yun, Min Liu, Xufu Yi
July-September 2016, 2(3):164-166
DOI:10.4103/2349-5014.191470  
Myelomeningocele (MMC) is a protrusion of spinal cord contents and meninges through a vertebral defect. Iatrogenic deaths of patients with MMC are rarely encountered in forensic practice. In our case, a 3-month-old female was born with a lumbosacral cyst, the size of which had been increasing gradually over age. There was no neurological, orthopedic, or urologic dysfunction. On the day of her death, she received a repetitive and rapid lumbosacral cyst puncture drainage procedure, performed by an illegal medical practitioner. Postmortem autopsy findings confirmed a diagnosis of MMC and the cause of death to be cerebellar tonsillar herniation. This is a pathetic case of preventable infant death. This report suggests that the possibility of MMC should be considered in infants born with a lumbosacral cyst, and aspiration is inadvisable. Besides, forensic autopsy has a valuable role in determining the exact cause of death, identifying, or excluding iatrogenic factors that may be relevant to death following a medical procedure. A final point is that prevention programs should be developed, especially by the health care sectors to reduce such tragedy.
  2,113 172 -
ORIGINAL ARTICLES
Impact of Locus of Control and Job Type on the Perception of Autopsy among Medical and Nonmedical Workers in a Nigerian Tertiary Health Institution
Uwom Okereke Eze, Mfon E Ineme, Helen O Osinowo
July-September 2016, 2(3):136-140
DOI:10.4103/2349-5014.191463  
The impact of locus of control and job type on the perception of autopsy among medical and nonmedical workers in University College Hospital, Ibadan, was investigated. Ninety-two medical and 46 nonmedical workers from the hospital participated in the study. An ex post facto design was used. The Autopsy Perception Scale and Locus of Control Scale were used as instruments. The t-test result (t[136] = −2.03; P < 0.05) showed that hospital workers with an internal locus of control reported to have a more positive perception of autopsy than those with an external locus of control; the t-test result (t[136] = −2.29; P < 0.05) showed that medical workers reported a more positive perception of autopsy than nonmedical workers. However, the t-test result (t[136] = −0.82; P > 0.05) showed that there was no significant difference between workers who had had an autopsy conducted on their deceased relatives and those who had not. The results were discussed in line with existing literature.
  2,066 186 -
CASE REPORTS
Infiltration and Fat Droplet Phagocytosis by Macrophages in the Alveoli may be the Most Likely Characteristics of Fat Embolism
Bin Wang, Fu Zhang, Ning Xiao, Xiang Xu, Qi Wang, Xiao-Hui Tan, Tao Wang, Hui-Jun Wang, Dong-Ri Li
July-September 2016, 2(3):171-174
DOI:10.4103/2349-5014.191472  
We report a case of nontraumatic fat embolism syndrome with large amounts of macrophages with phagocytized fat droplets in the alveoli. A 46-year-old male presented with a glass-cut injury in his little finger. The wound was debrided and sutured at the hospital, but he was found dead 43 h after treatment. Autopsy results showed that the patient had steatohepatitis, accompanied by histological findings of fat droplets in the pulmonary capillaries. In the alveoli, we found a large number of macrophages with phagocytized fat droplets that showed stained. To the best of our knowledge, this is the first report of such a case, and the paper proposes that fat droplets phagocytized by a large number of macrophages may be a characteristic feature of fat embolism, which may be relevant to forensic pathology practice.
  2,001 204 -