Indian Journal of Forensic Medicine and Pathology

 Major component of Forensic Pathology is its ability to recognize and interpret the injuries and determineits role in causing death. It becomes more complicated in sudden deaths, wherein there are both significant external mechanical injuries and internal natural lesions. Meticulous autopsy plays an important role in unravelling such deaths. Sudden death due to cardiac cause is the most common pathology encountered at autopsies. Diseases of the heart account for approximately 90% of all sudden deaths due to natural disease, with atherosclerotic coronary artery disease being the underlying cause of approximately 75 - 90% of sudden cardiac deaths. Autopsy studies indicate that 8 – 20% of deaths following myocardial infarction are due to free wall myocardial rupture. We here by present a case of sudden death of 75 years old lady who was brought dead to hospital with external injuries to head after fall in bathroom. But after autopsy we were able to attribute cause of death due to rupture of left ventricular wall and not due to head injury.

Keywords: Sudden deaths; Myocardial Infarction; Haemopericardium

 Evaluating firearm injuries for its manner of infliction is of major concern for the forensic surgeon as well as investigating agencies. The profound morbidity and significant mortality not only invites various forensic perspectives to be addressed, but also poses a challenging task to the forensic surgeon to deduce the manner of death. A case of fatal firearm injury, in an adult man with four firearm wounds in the neck is reported and discussed. The case apparently raised suspicion regarding the manner of death as ‘suicide’ due to the nature and disposition of wounds. A forensic autopsy supplemented with a retrospective evaluation of scene of occurrence and weapon of offence, reconstructed the event as deliberately inflicted by self. 

Key words: Deliberate; Firearm injury; Scene of occurrence; Retrospective scene visit; Weapon.

A great deal of controversy continues to surround sickle cell trait and its association with stress-related morbidity and sudden death. Most of the death mechanisms are related to the biological consequences of diffuse microvascular occlusion due to sickling, although a significant number of such sudden deaths remain unexplained even after thorough autopsy. We present a case of unexpected death in a young male with undiagnosed sickle cell trait, who met with a road traffic accident and was diagnosed only after the postmortem. The death was attributed to vaso-occlusive sickle cell crisis secondary to stress and infection.

Key word: Sickle cell trait; Sudden death; Vaso-occlusive crisis.

To estimate postmortem prolactin levels in cases of completed suicides and find if the postmortem prolactin levels are raised and associated with antemortem stress in completed suicides. Material and Methods: The present research was conducted in the Department of Forensic Medicine, Kasturba Medical College, Mangalore during May and July 2010. Postmortem blood samples were collected from the right femoral vein of male victims of suicide before the start of the autopsy and in vitro quantitative analysis of non-hemolysed blood sample was done using the principle of electrochemiluminence. Most of the victims of suicide were aged between 30 and 49 years and hanging was the commonest method of suicide. Mean postmortem serum prolactin level was found to be marginally higher in suicidal deaths suggestive of a possible association of serum prolactin, stress and suicides.  The prolactin levels using postmortem blood samples in completed suicides were successfully determined. Our preliminary investigation is suggestive of a possible trend and an association of postmortem serum prolactin levels with antemortem stress and completed suicides. The association however is not strong and needs to be studied further in future studies.

Keywords: Suicides; Antemortem stress; Prolactin; Postmortem.

Head injury is the commonest phenomenon on road resulting from high velocity automobiles and these injuries account for about one fourth of all deaths due to violence and are responsible for 60% offatal road accidents. The application of computed tomography to the early diagnosis of head injured patient offered great promise. So this study is aimed to compare the CT (Head) scan with autopsy findings in head injury cases.  Post-mortem examination was conducted in 65 fatal cases of head trauma, which were admitted and died while on treatment in the department of neurosurgery at JSS hospital Mysore. In the present study CT scan and autopsy would detect skull fractures 44%, intracranialhemorrhages 76% and brain lesions 95% of cases. This study showed that CT scan is a very useful investigation in head injury cases to detect brain lesions, intracranial hemorrhages and to some extent skull fractures.

Keywords: Autopsy; C T scan; Head injury.