Indian Journal of Forensic Medicine and Pathology

India is currently the fastest growing economy in the world. A fast-paced life also caters to the stress and strain, especially in metro cities. Hanging was noted as the preferred method of suicide in almost all countries in Eastern Europe and South Asia. Aims: To study prevalence and pattern of hanging in Western Maharashtra. Settings and Design: Retrospective cross-section study. Methods and Material: This retrospective cross-section study was carried out at Tertiary Care Hospital, Western Maharashtra from 1st Sept 2019 to 30th Sept 2023. Data was collected retrospectively and analysed statistically. Statistical analysis used: Microsoft Excel version 2013 Results: During the study period, 810 post-mortems were conducted, out of which 138 cases (17.04%) were hanging. Highest number i.e., 40.58% of cases reported within the age group of 21- 30 out of which 74.74% were males with a Male: Female ratio of 3:1. Males of 21 to 30 years showing the highest number of cases (36.89%). 67.39% were Urban population and 32.61% of cases were from rural. 47.83% of them were Typical Hanging where knot mark was present over the occiput, while 29.71% of cases were of Atypical Hanging, 100% suicidal with 01 case only of hyoid bone fracture. Conclusions: This study reflects the alarming data of the vulnerable age and gender, the method of hanging adapted, and the geography involved.

A descriptive cross-sectional study was conducted on all cases of deaths due to drowning autopsied at the mortuary of Pravara Rural Hospital attached to Rural Medical College, Loni, a rural region in Western Maharashtra, India. The study was conducted over a period of 4 years, two years retrospective (record based) from September 2012 to August 2014 and two years prospective from September 2014 to August 2016. Data was being collected from medico-legal autopsy records of drowning victims. The cases were studied to know the socio-demographic profile of victims, manner of death and place of drowning. The cases represented approximately 3.42% of all autopsy cases. The manner of the death in most cases(68.89%) was accidental in nature. Majority of the victims were male (57.78%) belonging to the age group of 11- 20 years (31.11%). Most of the victims (31.11%) were students followed by housewives (28.89%). Most of the drowning cases (51.11%) occurred in well, followed by river (20.0%). Deaths due to drowning can be prevented by proper education and awareness programmes. Preventive measures include teaching swimming to children as well as adults, installing barriers controlling access to water and training bystanders in safe rescue and resuscitation measures.

Context: Medicolegal autopsies are not only indispensable to identify the cause of death; they are of vital importance in discovering various interesting and rare lesions/ diseases which were unnoticed or undiagnosed during the person’s life. Whether these incidental lesions are the cause of death or not, they are of academic and research importance. Hence this study was aimed to evaluate the various histopathological findings in medico-legal autopsies and to highlight the rare incidental lesions. Method: This was a prospective cross-sectional study conducted on medico-legal autopsy specimens over duration of five years, between August 2018 August 2023, at Ramaiah Medical College Hospital, Bangalore. The viscera of each autopsy case were evaluated grossly and microscopically to identify the various histopathological findings. Results: A total of 554 histopathological lesions were identified in 549 cases, majority of which were found in cardiovascular system (47.6%), followed by pulmonary (31.3%), hepatic (12.6%), renal (6.3%), central nervous (4.3%), splenic (3.8%), pancreatic (3.5%) and female genital (0.5%) systems. The commonest lesion detected was atherosclerosis (26%) followed by myocardial infarction (11.9%) and pulmonary edema (9.6%) Rare incidental findings were observed in 5.8% of cases and incidental neoplasia was detected in 1.6% of cases. Conclusion: Varied spectrum of incidental lesions, which are not recognised during the person’s life, are discovered at autopsy. Some of these lesions are preventable; some warrant screening of close relatives and some, had they been detected before death, would have changed therapeutic management. These incidental findings are important for academic purpose, evaluating disease trends and introducing interventions.

Background: Estimating postmortem interval is effective forensic tool for investigating time of death useful in criminology. Many gross, microscopic and molecular methods available for estimating postmortem interval. Human prostate is last soft tissue organ to degenerate in human cadavers and its histopathology in cadavers can be used for estimation of post mortem interval. Studies reported Histopathologies of different organs to estimate postmortem intervals for purpose of calculating time since death. In our study we tried to observe Post mortem interval estimation in human cadavers with Histopathological changes in Prostrate. Objectives: To estimate postmortem interval from Histopathological examination of prostate in human cadavers and identify Histopathological changes in human prostate in relation to time since death. Methodology: Prostate from cadavers registered for autopsy in our institute were examined grossly along with histopathology as per criteria laid down for sampling. Results: Histopathological sections from total of 36 human cadavers were studied. Changes like epithelial disruption of acini, nuclear changes, inflammatory cell collection in stroma, fatty degeneration and sequential necrotic changes were reported in relation to time since death. Earliest degeneration changes in prostrate acini began at 6 hours postmortem and changes in stroma began at 12 hours. First atrophic changes in acini began at 19 hours postmortem and continued to progress till 3 days after which identification of any glandular or stromal tissue became extremely difficult. Conclusion: Significant changes in Prostrate were documented between 6 hours and 72 hours postmortem. Changes in human prostate can be used for estimating postmortem interval.

Context: Medicolegal autopsy results are determined by the pathological examination hence there is a need to check and consolidate all the factors that contribute in the interpretation of histology finding. Lung is vital organ in contributing the certain histologic pattern that can unfold the cause and manner of death. Aims: To note the role of gross and histopathological examination in ascertaining the cause and manner of death in lung autopsy. Setting and Design: Study was conducted in department of Pathology with Forensic department collaboration over the period of one year. It’s a prospective observational study including 100 medicolegal autopsy cases taken. Material and Method: Gross examination followed by histopathological examination on hemotyxilin and eosin stained slide of lung tissue were done. Special stains were used wherever required and findings noted. All variable were correlated using Chi-squared test, Fisher’s Exact and Kruskal Wallis and strength of association with Kendall’s Tau, Chi-squared test, Cramer’s V statistical tools. Results: Majority of cases were in between 20-39 yrs with male predominence. Most common gross finding was congestion followed by consolidation. In histology pulmonary edeme followed by pneumonitis were noted. Most frequent cause of death was brain injury followed by septicemia and manner of death was accidental followed by natural. There was significant association observed between histopathology and age as well as in between gross finding with cause and manner of death. Conclusion: Gross finding coupled with microscopy can link in the detection of cause and manner of death.

Background: India in last few years have grown in leaps and have undergone major economic and demographic transition coupled with increasing urbanization and motorization. Among the top ten causes of mortality in the country, Road traffic accidents was one among the tenth cause. But with the increasing urban expanse and lifestyle changes, it is projected that road traffic accidents will occupy the second position in the list of major killers among the causes of disease burden in this century. Road accidents are one of the leading cause of death globally and mainly occurs in the age group of 15 to 49 years. Methods: This cross-sectional study was carried out in 120 cases being brought in the casualty of Travancore Medical College, Kollam, from July 2023to December 2023. A detailed data of sociodemographic profile, type of skull fractures and type of intracranial hemorrhages were noted. Results: The maximum cases (30.9%) were in the age of 31-40 years (37 cases); followed by 31 cases (25.9%) from the age group 41-50years. The mean age of the patients was 33.24 (SD14.66) years. Linear fractures were the commonest type of skull fracture which were seen in 48 cases (40%), followed by comminuted fracture in 12 cases (10%) and depressed fracture in 2 cases (1.7%). Subdural hemorrhage was the commonest intracranial hemorrhage, seen in 58 cases (48.3%), followed by subarachnoid hemorrhage in 48 cases (40%).

Globally, the COVID-19 pandemic presented previously unheard-of difficulties that affected a number of aspects of daily life. This study aims to illustrate the most impacted segments of the population during the COVID-19 pandemic and investigates the suicide trend in Madhya Pradesh’s central area, providing insight into the possible effects of the crisis on mental health. India is a country with a large population and a wide range of socioeconomic backgrounds, and it has been severely affected by the pandemic. People’s stress levels increased as a result of the nation’s widespread lockdowns, economic downturns, pressure on the healthcare system, and social unrest. These elements have added to an increased psychological pressure, as have the worries of being sick, being alone, and losing loved ones. Anecdotal data and preliminary research point to a concerning spike in suicide rates in India during the pandemic. Frontline healthcare professionals, migrants, and vulnerable people are just a few of the demographic groups that have been affected. Aside from this the groups with the highest suicide rates are married people, lower middle economic class, nuclear families, jobless people, and students. Probable reason behind that according to our study is hopelessness and guilt of not able to meet family expectations due to unemployment or loss of job during covid era. Things get worse when stigma, lack of awareness, and restricted access to mental health resources are combined. To create successful treatments and support networks, it is essential to comprehend the complex relationships that exist between the COVID-19 pandemic and suicide rates in India. To address the mental health issues brought on by the epidemic in India and other comparable settings, more study is needed to determine the long-term effects and create focused mitigation mechanisms. This research demonstrates the most impacted segment of the population and the suicide trends during the COVID-19 pandemic reported to the mortuary of a tertiary care center of central region of Madhya Pradesh.

Death due to poisoning is one of the commonest medico-legal cases encountered by forensic experts. Committing suicide by ingestion of poison is one of the common method adopted. So in order to know the burden of this, a retrospective study was carried out in Forensic Medicine and Toxicology Department, Shri M P Shah Government Medical College and Guru Gobindsingh Government Hospital, Jamnagar. Study was conducted for 1 year from December 2021 to January 2021. The data is collected by analysing various epidemiological parameters. According to this study, 168 people died due to poisoning out of 1062 autopsy performed in the Forensic Medicine and Toxicology Department, Jamnagar. Male predominance is seen in this study which includes 63.09% male and 36.91% female. Organophosphorus compound was main compound followed by Aluminium phosphide for death due to poison. And among this 88.09% was suicidal in nature. Death due poisoning is a major public health related issue. Death due the poisoning is a partially preventable situation. Therefore by proper identification and knowledge of trend of the poisoning, early management can be given to prevent morbidity and mortality.

Background: The neonatal period (<28 days) is most vulnerable for child survival. Globally among all the deaths under five years in 2018, 47% are neonatal deaths. Most of these deaths are due to preventable and treatable causes like infections and intra-partum injury. It is important to understand underlying causes of neonatal death. The role of autopsy is very crucial in establishing the facts about death which helps to plan national and global health strategies. Aims: To evaluate the spectrum of neonatal pathology, estimate frequency of neonatal pathology and to address the most common neonatal pathology. Material and Methods: A retrospective observational study of neonatal medicolegal autopsy cases received from January 2022 to December 2022 in autopsy section at Tertiary health care centre, Pune. Gross and microscopic examination was done. All the results were tabulated and analysed. Results: 93 cases were studied, out of which 73 early neonates (<= 7 days), 20 late neonates (>7 days), M:F = 1.06:1. The most common cause of death was lung pathology 96.7% cases, pulmonary haemorrhage (24.44%) and meconium aspiration (24.44%) were predominant lesion, pulmonary oedema (17.77%) and pneumonia (15.55%). Central nervous system (CNS) manifestations 10.75% and Liver Pathology 6.45%. Rare pathologies include Congenital Heart Disease (1.07%) and Renal pathology (1.07%). Conclusions: It is vital to study the spectrum of histopathological features in neonatal deaths as it provides adequate diagnosis which helps to plan appropriate resource and management strategies in tertiary health care centre.

Background: Extramedullary Involvement (EMI) in acute leukemia refers to the infiltration of leukemic cells into organs or tissues outside of the blood or bone marrow compartments. This phenomenon manifests in various locations such as the skin, bones, and lymph nodes. Case report: We present an uncommon occurrence involving a 46-year-old male, wherein extensive myeloid infiltrates were identified during autopsy examination. Literature review: EMI is believed to manifest in approximately 3-8% of adults diagnosed with Acute Myeloid Leukemia (AML).1 Clinical relevance: It highlights the diagnostic complexity of AML and emphasizes the need for meticulous gross and microscopic examination during autopsy with clinicopathological correlation and utilization of special tests like immunohistochemistry in diagnosing such rare entities.

The psychological autopsy aims to provide a comprehensive analysis of the psychological, emotional, and behavioural history of the deceased before death, shedding light on potential factors contributing to the untimely demise. This case report delves into the application of a psychological autopsy in understanding the circumstances and psychological factors leading to the unnatural death of a 29-year-old male who was found dead under mysterious circumstances. This report examines the methodology involved in conducting a psychological autopsy, emphasizing the importance of gathering information from various sources, including medical records, interviews with family and friends, and exploration of the individual’s past mental health issues, stressors, and life events, which helped in shedding light as to the manner of death and guiding the forensic pathologist to send for the necessary ancillary biochemical investigations.