Indian Journal of Forensic Medicine and Pathology

Cardiovascular diseases are a chief cause of sudden death. Rheumatic Heart Disease (RHD) exists as a hidden burden in developing countries. It occurs as a sequelae to Rheumatic Fever caused by Group A β Hemolytic Streptococcus. Despite the existence of antibiotics and prophylaxis by Penicillin it is still prevalent. A 33 year old male was found unresponsive in his house and was later declared dead. He had a history of abdominal pain for the past 6 months for which he was on medication. There was no other relevant family and past history. He had no history of alcohol intake or smoking. Complete medico legal autopsy was done and confirmed to be RHD. RHD is an “iceberg” disease which is still prevalent in developing countries. A cross reaction between foreign antigen and cardiac proteins leads to formation of autoantibodies causing autoimmune reaction. Mitral valve is commonly involved. RHD diagnosis can be established using Jones criteria during clinical examination. RHD still exists despite use of advanced antibiotics and Penicillin prophylaxis and needs to be therefore considered as a diagnosis of sudden death of young adults.

Accidental Pesticide poisoning is an important health issue in developing country like India. Adverse health effects by pesticides are common among farmers due inappropriate handling. Plant growth regulator hydrogen cyanamide (Dormex) is used mainly for the bud-cleaving and growth promotion of grapes in north karnataka. Accidental exposure to hydrogen cyanamide may result in wide range of health hazards like irritant contact dermatitis. Here we discuss such a case where the patient suffered severe health hazards due to accidental exposure to hydrogen cyanamide

Context: Cardiovascular diseases constitute the most common cause of sudden death. In medicolegal autopsies it is proposed that every possible organ must be sampled for histopathological examination as they provide the most accurate clues to a better understanding of human cardiovascular pathology. Aims: The main aim of this study was to analyse the histopathological spectrum of cardiac diseases which play a major role as cause of death in autopsy specimens that were received in a tertiary care hospital. Settings and Design: The study was conducted at a tertiary care hospital in Bangalore, the study period was from January 2015 to December 2019 during which a total of 276 autopsies were received. Out of these 173 cases included specimens of heart and were considered in this study. Methods and Material: During the study period from January 2015 to December 2019, a total of 276 autopsies were received. Out of these 173 cases included specimens of heart and were considered in this study. Epidemiological data and post mortem findings were noted, gross findings documented and the heart opened through inflow outflow method. Microscopic findings on H and E stained sections were studied with special stains ordered wherever required. The histopathogical findings were analysed. Results: Males outnumbered females with 85% of the total cases and maximum number of cases were observed between 3rd decade to 5th decade. On histopathology, 60.4% of the cases showed atherosclerotic changes involving the coronary arteries followed by myocardial infarction (9%), myocardial hypertrophy (7%), cardiomyopathy (4.2%) cases, myocarditis (3.4%), 0.5% case each of aortic stenosis and infective endocarditis. 15% of cases showed no significant abnormalities on gross and microscopic examination. Conclusions: Atherosclerosis involving the coronaries is probably the commonest finding on histopathology of the heart in cases subjected to autopsies. Cardiomyopathy and Myocarditis presenting as sudden death is commom in the younger population.

Keywords: Coronaries; Heart; Post-mortem; Histopathology.

Introduction: Sudden death (SD) is defined by World Health Organization (WHO) as ‘death within 24 hours from onset of the symptoms’.1 It is by definition natural and it excludes all deaths due to poison and trauma. The incidence of sudden cardiac death has been steadily increasing all over the world. When SD occurs in adults and elderly persons, coronary atherosclerosis is the usual cause. These diseases are frequently concealed and discovered with surprise only at post mortem using macroscopic and microscopic examination of heart. Methods: Present study is a retrospective study, conducted in the department of Pathology, Vydehi Institute of Medical Sciences and Research Centre Bengaluru from July 2016 to June 2020. Patients of all age groups who died within 24 hours from the onset of symptoms were included. Results: A total of 483 autopsy cases were received for histopathological examination, among which there were 134 cases with history of sudden death during the study period. Age distribution ranged from 6 days to 86 years. In our study we observed male preponderance. Maximum number of cases was observed in 31 to 40 years of age. Major causes for sudden deaths observed were coronary artery diseases in 98 cases (73%) followed by pulmonary causes in 12 cases (8.96%). Conclusion: Present study highlighted the presence of increasing cases of sudden deaths among young males compared to developed countries. This will emphasize the need for research studies to find out the cause and early interventional measures to prevent the same.

Background: Hair Dyes are chemicals that are used to change hair colour. Hair colouring has become irresistible fascination to improve physiognomy especially people having grey hair. Hair dyeing is an ancient art and hair colourants are rapidly growing globally. But sometimes it is used to commit suicide. Hair dye poisoning occurs when someone swallows’ dye or tint used to colour hair. Morbidity and mortality due to poisoning have been known to pose a significant burden on the health. Aims and Objectives: To study the incidence and demographic features of hair dye poisoning in people who are admitted in Narayana Medical College Hospital, Nellore district State Andhra Pradesh South India. Type of Study: This is a two years prospective study. Place of study: Hair dye poisoning admitted in Narayana Medical College Hospital between the periods July 2012- June 2014. Material and Methods: All patients admitted and managed for hair dye poisoning were retrieved and data collected. Age, sex, incidence, residence, education and marital status were all recorded on the prepared proforma. Observation and Discussion: In our study, age wise distribution of 76 cases of paraphenylenediamine (PPD) hair dye poisoning revealed that maximum cases (56.6%) were in the age group 21–30 years with 27.96 ± 11.24 years mean and standard deviation respectively. Hair dye poisoning was common among females (76% of all cases). The incidence of hair dye poisoning was 154.84 patients of hair dye poisoning/1000 cases of all poisoning/year from July 2012 to June 2013 and 112.90 patients of hair dye poisoning/1000 cases of all poisoning/year during July 2013 – June 2014. Rural people (52.60%) consumed hair dye poison more than urban population. More common in under matriculation. Maximum persons (78.9% of all cases) were married. Conclusion: Trend of hair dye consuming is increasing now a days among young, rural population. It is common among female, married persons and increasing burden on health care institution.

Keywords: Hair dye poisoning; Super vasmol poisoning; Paraphenylenediamine.

Aims: Aim of the study was to estimate, compare and differentiate the anatomical variations according to ageing in the bizygomatic distance and dimensions of maxillary sinuses on Cone Beam Computed Tomography (CBCT) images and to assess their authenticity in age estimation that might be used as an evidence in forensics.

Settings and Design: CBCT images of bilateral maxillary sinus were obtained from 30 subjects, categorized into 3 groups of age ranging between 20-40, 41-50, 51-60 years. Methods and Material: Measurements such as bizygomatic distance and maxillary sinus dimensions namely length, height, width, area, perimeter and volume were evaluated. Statistical Analysis Used: The data was subjected to descriptive statistical analysis followed by Chi-square test, One way ANOVA, regression ANOVA, Pearson’s correlation and Post-Hoc test.

Results: The study showed a difference among mean values of different age groups but was statistically non significant. As age increased the left width, mean width of right and left maxillary sinus, left area, left perimeter, left volume and right and left mean volume of maxillary sinus decreased linearly and significantly with significant P values. The regression ANOVA revealed that volume is the true predictor of age of the subjects.

Conclusion: Age estimation with few linear measurements of maxillary sinus dimensions was possible among the study population. It was found that as the age increased few of the maxillary sinus dimensions decreased. Hence this study positively recommends the use of maxillary sinus dimensions for the purpose of age estimation in the field of forensics.

Background: Both dust inhalation and smoking combined, led to more deleterious effect on the lungs. The health of gold miners is not only eroded by excessive exposure to dust in the mines, but also by the habit of smoking. Smokers have a significantly higher risk of getting lung cancer than non-smokers. Objective: The objective of this study is to establish the relationship between smoking and lung abnormalities among ex-mineworkers in the Transkei region of South Africa. Patients and Methods: During a two years period (May 1997 to May 1999) 2080 former mineworkers were examined at the Benefit Examination Clinic at Umtata General Hospital, a tertiary hospital attached to the Walter Sisulu University in Eastern Cape Province. Radiological examinations were carried out on (466) former mineworkers, in the age group ranging from 30 years to 70-plus years. Results: Mineworkers who had smoked exhibited two to three times the number of gross lung abnormalities on radiological examination than those who had had no experience of smoking in their life. The readings taken indicated an odd ratio (OR) of 2.0 with a p value of <0.05, and Chi-square 8.3, indicative of statistically significant association between smoking and lung abnormality in the ex-mineworkers (i.e. ex-smokers, smokers, and non smokers). Conclusion: There is a strong correlation between lung abnormalities and smoking among ex-mineworkers in this study.

Keywords: Smoking; Lung abnormality; Ex-mineworkers; Dust; Lung cancer.