Indian Journal of Forensic Medicine and Pathology

Rajasthan’s southeastern part is known as “the land of Hada (Clan) Rajputs” i.e Hadoti. In this study, genetic structure of Hadoti population, who exhibited diverse ethanographic past, have been explored using 23 autosomal STR loci [PowerPlex® Fusion 6C (PPF) system] by the way of determining allele distribution and forensic efficiency parameters. Autosomal STR data was collected from the blood samples of 423 (194 females and 229 males) individuals of Rajasthani roots related to the Hadoti region. The STRs were amplified by using PPF 6C system (Promega Corporation) and the amplified samples were examined using Gene Mapper ID-X 1.6 software (Applied Biosystems) on a 3500xl Genetic Analyzer. Following Bonferroni correction, all the studied STR loci fulfilled the terms of the HardyWeinberg equilibrium. With the exception of Amelogenin and DYS391, DYS570, DYS576, this study found that among the 23 autosomal STR loci, SE 33 is the most informative (power of discrimination (PD) = 0.992), whereas TPOX locus (PD = 0.866)is the least. The obtained parameters of forensic interest demonstrated the compatibility of all the studied 23 STRs across Hadoti population of Rajasthan for forensic DNA identification and paternity testing.

Background: In cyber and digital forensic investigations, facial measurements are commonly derived from images and video evidence rather than direct physical examination. However, forensic substitution is scientifically defensible only when photographic measurements demonstrate acceptable agreement, consistency, and interchangeability with biologically grounded reference standards. Aim: To evaluate the forensic equivalence and interchangeability of live craniofacial anthropometry and AI-assisted photographic photo-anthropometry across three biological generations of Indian families. Methods: A total of 216 individuals from 48 multigenerational Indian families were analyzed using fourteen standardized craniofacial landmarks. Live measurements were obtained using calibrated vernier calipers, while photographic measurements were extracted using AI-based facial landmark detection from standardized frontal images. Z-score normalization enabled cross-modal comparison. Agreement was assessed using Bland–Altman analysis, rank consistency using Spearman’s correlation (ρ), and linear association using Pearson’s correlation (r), with analyses stratified by generation. Results: Population-level bias between live and photographic measurements was minimal across traits. However, substantial individual-level variability was observed. Only vertical skeletal traits, particularly N–Gn and Sn–Gn, demonstrated conditional agreement and limited interchangeability across modalities. Horizontal and soft-tissue-dominated traits exhibited poor agreement and inconsistent rank preservation. Conclusion: Photographic craniofacial measurements cannot be universally substituted for live anthropometry in forensic applications. The findings define modality-aware operational boundaries for AI-driven facial analysis systems and reinforce the necessity of biological validation to ensure the reliability and admissibility of facial evidence in cyber and digital forensic contexts.

Whether antemortem CT accurately reflects what autopsy later documents is a question this unit has examined before. In a prior analysis of 50 fatal TBI admissions from this tertiary care centre, CT failed to detect injuries across all 16 parameters measured, with autopsy being the reference throughout. That finding was clear enough. What remained unclear was which clinical circumstances make those failures most likely, and how large the sensitivity gap becomes under adverse conditions. This paper addresses those questions directly. The same 50 cases were re-examined with four variables in focus: GCS severity at admission, time elapsed between injury and hospital arrival, duration of survival after admission, and injury type. Non-parametric statistical tests were applied throughout, with autopsy serving as the diagnostic gold standard. Findings were consistent across all three time-related and severity-related variables. Cases with GCS ≤8 showed significantly more CT missed findings compared to moderate-injury cases. Sensitivity was higher in patients arriving within six hours than in those arriving later, and among patients who survived longer after admission, CT–autopsy agreement was notably worse. Intracranial haemorrhage and brain laceration were the injury types most often absent from CT reports, despite being present at post-mortem findings with direct medico-legal consequences.

Background: Nuclear genomic markers, like short tandem repeats (STR), are frequently employed for paternity verification and investigating crimes. As per Mendel’s law of inheritance, every living cell of an individual are expected to inherit identical DNA profile. However, extremely rare conditions such as chimerism or genetic mosaicism, arising from the fusion of two fraternal embryos in early development (Tetra gametic origin), make possible the shared existence of two genetically distinct cell populations within a single individual. Method: This paper explores a case study in which a foetus displayed both male and female genetic markers—one from the femur and another from blood— regardless of the same origin. Blood and femur bone exhibited chimerism at all twenty three informative autosomal loci tested, provided in Powerplex®-Fusion 6C PCR amplification kit (Promega). The existence of genetically male cell population in the chimeric foetus was confirmed by typing a Y-chromosome haplotype. Result: It would have been reasonable to assume that these samples came from two distinct individuals. However, after putting together data from different genetic researches and contextual information, the most plausible explanation suggested that the foetus was a chimera or a genetic mosaic due to the shared existence of two genetically distinct cell populations. Conclusion: This case underscores that chimerism may pose challenges for forensic analyses, as it can result in false paternity exclusions or render it futile to correlate the offender to a stain detected at a crime scene. Cautious data interpretation, an amended sampling plan, as well as efficient recognition of mosaics or chimeras, should enable avoiding such errors.

Background: Organ transplantation has transformed the management of endstage organ failure, yet the number of available organs in India remains far below the clinical demand. There continues to be a mismatch between increasing public awareness and the relatively low rate of actual organ donation, which may be influenced by gaps in knowledge, sociocultural beliefs, and mistrust in the system. Objectives: To evaluate awareness, knowledge, attitudes, and practices related to organ donation among adult patients attending a tertiary care hospital in Kelambakkam, Tamil Nadu, and to identify determinants of willingness to donate organs. Methods: A descriptive, hospital-based cross-sectional study was carried out among 370 adults attending the outpatient, inpatient, and emergency services of Chettinad Hospital and Research Institute (CHRI). Information was obtained using a structured, pre-validated questionnaire. Data were summarised using descriptive statistics, and associations were examined using the Chi-square test, with p < 0.05 taken as statistically significant. Results: Almost all participants (98.9%) had heard of organ donation, and 77.7% were aware of the concept of brain death. However, only 22.3% knew about the Transplantation of Human Organs and Tissues Act. Although most respondents expressed favourable attitudes towards organ donation, only 62.9% reported being willing to register as organ donors in future. Actual engagement in donation-related practices was low; 2.9% had formally registered as organ donors and 3.4% had discussed organ donation with family members. Misconceptions, concerns about misuse of organs, and poor understanding of legal procedures were commonly cited barriers. Conclusion: The study highlights a wide gap between general awareness and actual practice regarding organ donation in this setting. Focused educational strategies that emphasise legal aspects, promote open family discussions, and strengthen trust in healthcare services are required to enhance organ donation rates in this region.

Introduction: A global social concern that is both common and pervasive is child sexual crimes. India has a problem with underreporting child sexual abuse. Over 3 million kids experience maltreatment every year. The POCSO Act 2012 (Recent amendments 2019) addresses all types of child sexual abuse and the fundamentals of treating the child in an organised manner. The knowledge of medical practitioners has been found to be inadequate in several instances when handling such sensitive cases. Aim: To analyse the knowledge gap among medical practitioners about the POCSO Act. Methodology: A 15-question questionnaire-based study was conducted. 346 doctors and interns took part in the research. The questionnaire was focused on their knowledge, comprehension, attitudes, and practices regarding child abuse and the POCSO Act of 2012. Results: Most respondents correctly answered basic questions about the POCSO Act: 90% knew its full form, 93% knew it is gender-neutral, and 97% knew reporting abuse is mandatory. However, knowledge of procedural aspects was limited— only 18% knew where trials are held, and 55% knew the punishment for failing to report. Conclusion: While awareness of general provisions was high, gaps were evident in legal responsibilities and in adherence to protocol among medical professionals. Although the foundational awareness of the POCSO Act among medical interns and practitioners was satisfactory, notable deficiencies in procedural knowledge were observed. This includes poor understanding of trial venues, punishment for non-reporting, and the first steps in handling abuse cases. These gaps highlight the urgent need for curriculum enhancements, targeted training programs, and institutional protocols to better equip healthcare providers.

Background: The prostate gland is a vital male reproductive organ, and its diseases, particularly benign prostatic hyperplasia (BPH), prostatitis, and carcinoma, are common with advancing age. Autopsy-based studies provide valuable insights into latent and subclinical prostatic pathology. Aim: To evaluate histopathological changes in the prostate with respect to age and to determine the prevalence of BPH, prostatitis, and carcinoma in autopsy cases. Materials and Methods: This prospective study was conducted on 200 male autopsy cases above 35 years of age at Government Medical College & Rajindra Hospital, Patiala. Prostate specimens were retrieved, examined grossly, and subjected to histopathological analysis. Data were analyzed with respect to age, residence, and associated lesions. Results: The majority of cases were in the 36–45 years age group (53.5%). BPH was the most common lesion, observed in 84.5% of cases, with increasing prevalence with age. BPH with prostatitis was found in 5.5% of cases. No cases of carcinoma were detected. No significant rural–urban difference was observed. Conclusion: BPH is highly prevalent in males above 35 years and increases with age. Prostatitis is less common and often associated with BPH. Autopsy studies are valuable in detecting subclinical prostatic changes.

Sharp weapon is defined as any instrument designed or adapted for use to cause injury through a cutting edge. Fatalities due sharp weapons injuries are mostly seen in homicides followed by suicides and rarely in accidents. The injuries by sharp weapon suggest a high degree of intention and overkill, which is often associated with strong emotional triggers such as anger, jealousy, or revenge. In India where sharp instruments are commonly used in daily life, their involvement in violent crime warrants focused research attention. The study was conducted with the basic aim to analyze the deaths due to injuries by sharp weapons. Deaths involving sharp weapon injuries, the vast majority were as homicidal, accounting for 86.2% deaths. More than one-quarter of homicides were attributed to injuries sustained from sharp-edge weapons. Impulse or Momentary rage was the commonest motive behind homicide, suicides were linked to drug addiction and accidental deaths were attributed to machinery accidents. Multiple stab wounds were the most frequent wounds, and chest injuries constituted the most common cause of death. Prevention of fatalities from sharp weapons injuries requires a multidimensional strategy, integrating the rigorous enforcement of sale and possession regulation and implementing youth-focused counseling programs.

Background: Breast lumps require prompt and reliable assessment because malignant lesions may be clinically indistinguishable from benign conditions at presentation. Fine-needle aspiration cytology (FNAC) remains a practical first-line investigation in many hospitals because it is quick, inexpensive and minimally invasive. The International Academy of Cytology (IAC) Yokohama reporting system groups breast FNAC findings into five diagnostic categories linked to an estimated risk of malignancy (ROM). Rapid on-site evaluation (ROSE) can additionally confirm whether aspirated material is adequate before the patient leaves the procedure area. Objective: To determine the diagnostic performance of the IAC Yokohama system for breast FNAC at three cytological positivity thresholds. Additional objectives were to describe the distribution of cases within the five Yokohama categories, estimate the ROM for each category and examine the usefulness of ROSE in prospective samples. Methods: This cross-sectional analytical study was undertaken in the Department of Pathology, JSS Medical College, Mysore, over 42 months. A total of 180 patients with palpable breast lumps and available cytological and histopathological diagnoses were studied. The dataset included 86 retrospective cases and 94 prospective cases. In the prospective arm, FNAC was performed using aseptic precautions and smear adequacy was checked on site with toluidine blue staining. Each cytology specimen was assigned to category C1, C2, C3, C4 or C5 according to the IAC Yokohama system. Histopathology was treated as the reference standard. Diagnostic indices were calculated for three positive-test definitions: C5 alone; C4 plus C5; and C3 plus C4 plus C5. Results: Of the 180 aspirates, 8 (4.4%) were categorized as C1, 106 (58.9%) as C2, 14 (7.8%) as C3, 2 (1.1%) as C4 and 50 (27.8%) as C5. The category-wise ROM was 25% for C1, 0.94% for C2, 35.7% for C3, 100% for C4 and 98% for C5. The most inclusive threshold (C3-C5 positive) yielded the greatest sensitivity (98.3%), whereas the C5- only and C4-C5 thresholds both showed a specificity of 99.1%. The best overall diagnostic accuracy was obtained when C4 and C5 were regarded as positive (95.3%). Among cases assessed with ROSE, inadequate smears accounted for 3.2%. Conclusion: Classification of breast FNAC using the IAC Yokohama system produced clinically meaningful ROM estimates and showed strong agreement with histopathology, especially for benign and malignant categories. A positivity threshold that included suspicious and malignant aspirates provided the most balanced diagnostic performance. ROSE was associated with a low proportion of inadequate samples in the prospective component and may improve the efficiency of FNAC-based evaluation.

Background and Objectives: Statistics show that most children have faced some form of sexual abuse at some point. This study aims at studying this pattern among the urban college students so we can work towards formulating better policies to educate children and their parents regarding this relevant psychosocial issue. Material and Methods: This was a cross sectional study done among medical students from ACMS, New Delhi with consent; with approval of the IEC. Google forms were used. The questionnaire assessed demography, occurrence of prior CSA, details, knowledge of POCSO, actions taken, etc. None of the questions breach their anonymity. Results: Out of 230 participants who consented to the study, 52 reported to have experienced some form of sexual abuse during childhood, most of the victims were adolescent females, most victims had experienced inappropriate touch and groping. All the abusers were male with maximum being known to the victim. Most victims did not report their experience, and even in the reported cases, no action was taken. Most victims experienced fear and shame following the incident. Knowledge about POCSO was present in almost 50% of the participants, and most participants had not been educated about recognising signs of sexual abuse by their parents or guardians. Conclusion: Child sexual abuse is a dark reality that is common in India and adversely impacts mental health. This study highlights the crucial and underdiscussed issue of CSA within urban populations, exploring knowledge and experiences that shape understanding and response to this grave concern.

Introduction: Snake bite is a preventable public hazard of the country. Community awareness & empowering healthcare workers can reduce snakebite associated mortality. A well-timed first aid is always decisive in the management of snake bite. Material and Methods: An observational cross-sectional study based on questionnaire of 20 questions done, data tabulated, analysed and compared in order to determine the awareness in study group about the identification of type of snakes, first aid, management, traditional practices performed in case of snake bites. Results: A total of 906 persons participated in survey. Most of them answered to all of the 20 questions with very few skipping 1-2 questions. Snake bite mark identification is important for early and effective treatment. 785 (86.64%) persons identified poisonous and non-poisonous snake bite from two images. Identifying important early symptom of neurotoxic snakebite is paramount for quick life saving measures. 514 (56.85%) identified drooping of eyelids as early warning sign. Reassuring and calming of the snakebite victim helps to prevent anxiety and helps correctly observing signs-symptom; 550 (60.70%) participants agreed to this reasoning. Conclusion & Recommendations: Although most of the participants were able to identify commonly known snakes like cobra, venomous bite mark and common treatment methods, but many were unaware about features of uncommon sea snakes, misconceptions regarding treatment and complications. Inclusion of snakebite first aid measures in educational curriculum at early level might help to improve outcomes.

This prospective descriptive cross-sectional study analysed 100 assault victims presenting to the casualty department of Chettinad Hospital and Research Institute (CHRI), Kelambakkam, Tamil Nadu, over a one-year period. The study aimed to describe the demographic profile, incident characteristics, injury patterns, treatment requirements, and medico-legal aspects of assault cases. Young adults were predominantly affected, with the highest proportion in the 21–30 years age group (43%), and males constituted 71% of victims. Street-related assaults (40%) and home-based assaults (38%) were the most common settings, while 57% of victims identified the assailant as a known person. Personal conflict emerged as the leading motive (57%), followed by intoxication-related violence (23%). Blunt force trauma was the predominant mechanism of injury, and grievous injuries accounted for 65% of cases, with the head and neck region frequently involved. Hospital admission was required in 75% of patients, reflecting the significant clinical burden of assault-related trauma. Medico-legal procedures, including MLC registration and police intimation, were appropriately followed in most cases. The findings highlight the substantial healthcare and forensic burden of assault injuries and emphasise the need for targeted violence prevention strategies, public awareness, and strengthened coordination between healthcare and law enforcement systems.

Distinguishing suicide, homicide, and accidental death on railway tracks remains a persistent forensic challenge, because decapitation, transection, and mutilation produce overlapping injury patterns regardless of the underlying manner of death. We present four cases of railway fatalities in which scene investigation, autopsy findings, toxicological analysis, and circumstantial evidence were integrated to establish the manner of death. In Case 1, a suicide note and corroborative driver testimony confirmed suicide following financial distress. In Case 2, eyewitness accounts of a preceding family dispute established suicidal intent. In Case 3, a toxicologically confirmed blood alcohol level explained the impaired judgement underlying an accidental decapitation on a narrow-gauge track. In Case 4, a physically disabled woman was fatally struck during a routine daily activity, consistent with accidental collision. This series illustrates a reproducible, evidencebased framework combining injury morphology, scene reconstruction, toxicology, and corroborative history to support classification of railway fatalities and potentially reduce the risk of misclassification between suicide, homicide, and accident.

Introduction: Autopsy continues to play a significant role in understanding disease processes and identifying clinically silent pathological lesions that may remain undetected during life. Several of these lesions remain clinically silent throughout life and are detected only during autopsy. The present study was undertaken to evaluate incidental neoplastic and non-neoplastic lesions detected on histopathological examination of medicolegal autopsies. Aims and Objectives: 1. To evaluate histopathological lesions detected during autopsy and assess their association with the cause of death. 2. To classify the cause of death according to the various organ systems. 3. To classify the cause of death according to age and gender. Materials and Methods: A retrospective observational study was carried out in the Department of Pathology at a tertiary care centre over a period of one year from February 2024 to January 2025. The study included all the medicolegal autopsy specimens and viscera received for histopathological examination during the study period. A total of 303 cases were evaluated. Representative tissue sections from organs including brain, heart, lungs, liver, spleen, and kidneys were routinely processed and stained using hematoxylin and eosin stain. Microscopic examination was performed to identify pathological lesions and correlate findings with the clinical and autopsy details. Results: The present study consisted of a series of 303 autopsy cases from the Department of Pathology in a tertiary care hospital conducted over a period of one year. The internal organs of a total of 303 autopsies were sent for histopathological examination. The most commonly involved age group was 30-40 years, with a male preponderance. Neoplastic lesions were identified in 4.95% of cases. Conclusion: This study has contributed valuable insights to the spectrum of both neoplastic and non-neoplastic lesions, encompassing incidental as well as clinically significant findings. Routine autopsy histopathology facilitates identification of clinically unsuspected lesions and contributes valuable information regarding disease patterns and cause of death.