bluuebunny/crossref_metadata_2025_split huggingface dataset:
Firearms Accidents in Northern India (1980-2000)
Authors: SINGH B P 
Published: February 2010

This paper investigates firearms accidents from the last two decades (1980-2000), with information received from the three North Indian states, Chandigarh, Delhi and Himachal Pradesh and from the military and paramilitary organisations working in the region. In this study 139 cases were analysed for evaluation of various parameters such as type of accident, type of firearm used, age, sex, occupation and caste of victim, day of the week and the season in which the accident occurred, place of incident and location of wound. Information was extracted from the case histories and First Information Reports (FIR), and also from autopsy and injury reports. The accidents were self-inflicted in nine cases while another person fired the weapon in 130 cases. Most accidents occurred during hunting or from mishandling the firearm. Gun cleaning accidents rarely occurred and few cases were due to technical defects of the firearm. Shotguns and rifles caused most of the accidents. Shotgun accidents occurred mostly in rural areas whereas the cases involving rifles and handguns were from urban areas. Victims were predominantly male with a mean age of 26 and 30 years for males and females respectively. Victims' occupations were principally agricultural followed by service class and housewives. The most aggressive community was the Kshatriya caste. Most of the accidents occurred during the winter season and on days between Sunday and Tuesday. Accident locations were most commonly the forest, the fields or the home. The chest and head were the most common anatomical sites of injury. All accidental cases were the result of only one firing. It is important to mention that, based on these findings, firearm accidents could be reduced significantly if firearm holders were better trained regarding the handling and safety aspects of their guns, particularly farmers to whom firearm licences are granted specifically for the protection of crops.
Diabetic Ketoacidosis – A possible Complicating Factor in Deaths associated with Drug Overdose
Authors: BYARD R W , RICHES K J , KOSTAKIS C , FELGATE H E 
Published: February 2010

Two cases are described where diabetic ketoacidosis was found in conjunction with significant levels of prescription drugs. Case 1: A 45-year-old woman with a history of insulin-dependent diabetes mellitus was found to have Armanni-Ebstein nephropathy characteristic of hyperglycaemia with a vitreous humour glucose level of 63.1 mmol/L and a β-hydroxybutyrate level of 14.25 mmol/L. Ancillary toxicological evaluation revealed a lethal level of sertraline (2.5 mg/L), with an elevated level of methadone (0.23 mg/L). Death was due to diabetic ketoacidosis complicating mixed drug toxicity. Case 2: A 27-year-old man with a history of insulin-dependent diabetes mellitus was found to have Armanni-Ebstein nephropathy with a vitreous humour glucose level of 51.7 mmol/L and a β-hydroxybutyrate level of 18.6 mmol/L. Ancillary toxicological evaluation revealed a potentially lethal level of methadone of 0.39 mg/L. Death was attributed to diabetic ketoacidosis complicating methadone toxicity. These cases demonstrate a situation where drug toxicity led to diabetic ketoacidosis resulting in death most likely from a combination of factors. Measuring vitreous humour glucose and β-hydroxybutyrate levels is important in individuals with histories, or scene evidence, of insulin-dependent diabetes mellitus, in addition to toxicological screening when there is evidence of possible drug taking. It appears that drug intoxication in both cases had impaired the ability to administer insulin, resulting in the development over time of diabetic ketoacidotic states. Lethal mechanisms were, therefore, more complex than simple drug toxicity or diabetic ketoacidosis in isolation.
Alleged Dowry Death: A study of homicidal burns
Authors: SHAHA KUSA KUMAR , MOHANTHY SACHINDANANDA 
Published: February 2010

Homicidal burning of married women in India is a major concern for the Government, law-enforcing authorities, the judiciary, the police and medico-legal experts all over the country who are associated with dowry disputes. Dowry death, a heinous crime, is gradually engulfing and polluting the entire society. Sections 304(B) and 498(A) of the Indian Penal Code (IPC) have been introduced and Sections 174 Criminal Procedure Code (Cr PC) and 176 Cr PC have been modified but, instead of deterring dowry deaths, the occurrences are increasing day by day and the number of cases coming for post-mortem examination is rising. Both parties, that is, the parents and in-laws of the deceased, are becoming adept at manufacturing circumstantial evidence to serve their own interests. Therefore, to establish the truth and for the smooth administration of justice, reliable unbiased medical evidence has to be corroborated. This study presents retrospective research carried out in the tertiary care teaching hospital of MKCG Medical College, Berhampur, Eastern India, for a five-year period between January 1998 to December 2002. From a total of 58 burned wives, 32 (55.1%) were homicidal burns. These cases were analyzed in view of epidemiological and medico-legal aspects. The majority of the affected women (90.63%) were in the 18 to 26 years of age group. Death occurred within the first few years of marriage and most of them had no children. All the victims belonged to the Hindu religion and 62.5% of incidents occurred during the daytime. In 71.87% cases the incident occurred in rural areas. Eighty-three per cent of cases occurred in a joint family within the house. In most cases, kerosene was the accelerant and flame was the causative agent. In more than 68.75% of cases the total body surface area involved was more than 80%. Most victims died at the time of the incident, or within the subsequent 24 hours, due to hypovolumeic shock. The education status in 70.21% cases was either illiterate or under matriculation. More stringent laws and female independence both mentally and economically will reduce the homicidal burns in young brides.
Fatal Electrocution in Adults — A 30-Year Study
Authors: WICK REGULA , GILBERT JOHN D , SIMPSON ELLIE , BYARD ROGER W. 
Published: February 2010

A retrospective study was undertaken of all cases of death in adults (>16 years) due to electrocution which were autopsied at Forensic Science SA, Adelaide, Australia, over a 30-year period from 1973 to 2002. A total of 96 cases were identified with 87 males (91%) (mean age = 41.6 years; range 17 to 86 years) and nine females (9%) (mean age = 49.2 years; range 20 to 76 years). Deaths were due to accidents in 66 cases (69%; M:F = 63:3), suicides in 28 cases (29%; M:F = 24:4) and homicides in two cases (2%). Both homicide victims were females, with females accounting for only 5% of the accidents and 14% of suicides. The number of accidental deaths increased until the early 1990s and then declined, whereas suicidal electrocutions were only found in the last 20 years of the study. Most deaths (N = 80; 83%) were due to low voltage circuits (<1000 volts), with deaths due to high voltages occurring in 15 cases (16%). One death was due to lightning (1%). While suicides were evenly distributed throughout the year, most accidental deaths occurred in late spring and summer (N = 42; 64%) with the lowest number of accidental deaths occurring in winter and early spring. This report demonstrates a significantly higher rate of electrocution deaths among males, with a summer predominance of accidental deaths, most likely due to increased outdoor activities in better weather. The reduction in cases over the last decade of the study may be a reflection of the success of workplace and domestic safety campaigns. Female electrocution suicides and electrocution homicides were rare events.
An Audit of a Specialist Old Age Psychiatry Liaison Service to a Medium and a High Secure Forensic Psychiatry Unit
Authors: SHAH AJIT 
Published: February 2010

The elderly prison population is increasing and there is a significant amount of unidentified psychiatric morbidity among elderly prisoners. A sizeable number of elderly subjects are referred to regional forensic units. These units are able to provide advice but are reluctant to admit frail, physically ill and vulnerable elderly into their unit because the ward environment is considered inappropriate for them. A sizeable number of inpatients in medium and high secure units are elderly. This paper is an exploratory audit of referrals from a medium and high secure forensic psychiatry unit to a specialist consultation-only liaison old age psychiatry service, which was specifically developed to service the forensic unit. The demographic and clinical characteristics of the patients seen by this specialist service were similar to elderly inpatients in medium and high secure units. All referrals were judged to be appropriate and new management advice was provided in all cases. Main reasons for referral included diagnostic advice, placement advice and treatment advice. Establishing a diagnosis of dementia was considered important because Alzheimer's disease and Lewy body dementia can be treated with cholinesterase inhibitors. Placement advice was the most difficult to provide because of paucity of residential and nursing homes able and willing to accept patients with a forensic history. There is a need for a comprehensive model of specialist forensic old age psychiatry service at a regional or supraregional level. A consensus needs to be reached on the exact configuration of such a service.
The International Criminal Tribunal for the former Yugoslavia (ICTY) and the Forensic Pathologist: Ethical considerations
Authors: DE LA GRANDMAISON G LORIN , DURIGON M , MOUTEL G , HERVE C 
Published: February 2010

Since 1991, war crimes in the former Yugoslavia have been the subject of several international medico-legal investigations of mass graves within the framework of inquiries led by the International Criminal Tribunal for the former Yugoslavia (ICTY). Forensic pathologists involved in the ICTY missions could be subjected to ethical tensions due to the difficulties of the missions, the emergent conflicts between forensic scientists of the investigating teams and the original nature of the ICTY proceedings. In order to study the nature of such ethical tensions, we sent a questionnaire to 65 forensic pathologists who have been involved in the ICTY missions. The rate of response was 38%. The majority of forensic pathologists questioned (n=18) did not know how the medico-legal data was exploited by the ICTY. Three of them have been subjected to pressures. Three of them were aware of mass grave sites knowingly not investigated by the ICTY. Fifteen considered that the ICTY respected the elementary rules of the law and four of them questioned the impartiality of the justice led by the ICTY. Two conflicting types of ethics can be drawn from these results: conviction ethics, which are shared by most of the forensic pathologists questioned, and responsibility ethics. In the former, the forensic pathologist completely agrees with the need for an international war crimes tribunal, even if such justice can be challenged regarding the respect of human rights and impartiality. In the latter, he or she needs to conduct him or herself in ways that do not infringe impartiality. As medical deontology duty requires impartiality ethics, discursive ethics are needed to ease ethical tensions and to suggest ethical guidelines. Alternatives to international justice, through a truth and reconciliation commission and by way of humanitarian missions combining victims' identification with forensic investigations for historical purposes, could be considered.
Fatal Heat Injury Incident in a Private Home for Elderly People
Authors: OHSHIMA TOHRU 
Published: February 2010

This report presents a case in which an 84-year-old elderly female resident of a private home for the aged was fatally injured by a young male member of staff. The deceased suffered from senile dementia, and died from heat shock due to prolonged exposure to an electric fan heater. The heater had been placed immediately in front of the woman's body for approximately 2.5 hours, and the deceased could not escape from the heat by herself. Major autopsy findings were marked second degree burns (predominantly) and smaller areas of first degree burns observed on the anterior body surface (chiefly the face, lower abdomen, forearm and thigh). The burns area exceeded one-third of the entire body surface. Only a small amount of dark red blood (36 g) remained in the heart cavity: this was fluid but remarkably condensed. Petechial bleeding was observed in areas such as the palpebral conjunctivae and renal pelvic mucosae. This case generated great public attention as the assailant, who had been employed exclusively for three nights' duty per week, had been regarded as very diligent and kind; inflicting such a lethal injury appeared out of character. Several important issues related to managing residential care facilities for the elderly (in particular, the stress associated with night duty caring for the aged with senile dementia, and the mental health care of the staff themselves) were disclosed and are discussed herein from a medico-legal viewpoint.
Euthanasia and Assisted Suicide: Comparison of legal aspects in Switzerland and other countries
Authors: BURKHARDT S , LA HARPE R , HARDING T-W. , SOBEL J 
Published: February 2010

The purpose of this paper is to present the legal aspects associated with assisted suicide in Switzerland and compare them with those in other countries. Like euthanasia, assisted suicide is a subject that induces much discussion in many countries. While the law is very liberal in some countries, such as Belgium and the Netherlands (where both euthanasia and assisted suicide take place), these practices are very controversial in other countries, such as France, where they remain taboo subjects. In the United States of America, the laws concerning assisted suicide can differ greatly from one state to another. For example, in Oregon, assisted suicide is allowed if applied by a medical doctor; in others, this act is illegal. In Canada, it is punishable according to the Criminal Code. In Switzerland euthanasia is punishable by law. However, the penal code does not condemn assisted suicide, whether carried out by a medical doctor or another person, provided it is not carried out through selfish motives. The application of these practices has become simplified in recent years and societies for the right to die with dignity based on this principle have come into being (Exit and Dignitas). In the French- and German-speaking parts of Switzerland the association Exit assists individuals living in Switzerland with serious progressive and incurable disease in their engagement to end their life. The association Dignitas, in the German-speaking part of Switzerland, also undertakes – in the same circumstances – to assist individuals coming from foreign countries. Dignitas welcomes several such individuals every year, especially from Germany, where a similar approach does not currently exist.
Variation in proportion indices and angles between selected facial landmarks with rotation in the Frankfort plane
Authors: Kleinberg Krista F. , Vanezis Peter 
Published: February 2010

A number of different techniques are employed in facial image comparison of living persons. In this study, the effect of rotation on angles and proportion indices between selected facial landmarks is evaluated as a first step to assess whether facial anthropometry could be usefully applied to facial image comparison. The faces of five volunteers were photographed in the Frankfort plane at different angles of rotation from 0° (frontal) to 90° (side view), rotating every 10° both clockwise and counter-clockwise. Four landmarks were used: right and left ectocanthions, nasion, and stomion. The proportion indices of the measurements between these landmarks were calculated as well as the angles created by the lines connecting the same landmarks. The results show a consistent and predictable variation between the five subjects. With rotation, the greatest variation is seen where horizontal landmark connecting lines are combined with the ectocanthion/stomion lines or nasion/stomion. There is less variation in the proportion indices for vertical and diagonally orientated landmark connecting lines.
Lightning fatalities in the Transkei sub-region of South Africa
Authors: Meel B.L. 
Published: February 2010

Lightning is a particularly unsettling product of bad weather. It kills more people than other natural disasters such as floods, hurricanes, and tornadoes, but, because lightning usually kills people one at a time, it tends to be an underrated hazard. High risk groups are uneducated, unsheltered and rural people. This study was carried out to determine the incidence of lightning fatalities in the Transkei sub-region. It is a review of records between 1993 and 2004 from the medico-legal autopsies at Umtata General Hospital (UGH). During the study period there were 10,860 autopsies performed on those who died of trauma and other unnatural circumstances which included 151(1.4%) lightning fatalities. This represents 0.31 deaths per million per year. The highest (0.5/million) was in 1999, and the lowest (0.13/million) in 1997. The age of the victims ranged from 1 to 82 years, with a mean of 22 years. Males and females were almost equally represented (50%). The highest number of deaths (26.5%) was in the age group of 11 to 20 years, and the lowest number (2.7%) in the age group of 70+ years. There is a high incidence of lightning fatalities in the Transkei sub-region of South Africa. People need to be educated to disregard the myths of lightning strike.
Elderly suicide rates: cross-national comparisons and association with sex and elderly age-bands
Authors: Shah Ajit , Bhat Ravi , McKenzie Sheena , Koen Chris 
Published: February 2010

Suicide rates generally increase with age. Examination of cross-national variations in elderly suicide rates may allow the generation of aetiological hypotheses. Suicide rates for males and females in the age-bands 65-74 years and 75+ years were ascertained from the World Health Organisation website for all the listed countries. Cross-national variations were examined by segregating different countries into four quartiles of elderly suicide rates. Suicide rates between males and females and between the two age-bands were compared across different countries. The main findings were: (i) there is wide cross-national variation in elderly suicide rates; (ii) elderly suicide rates were the lowest in Caribbean, central American and Arabic countries, and the highest in central and eastern European, some oriental and some west European countries; (iii) suicide rates were higher in men compared to women for both the age-bands; and, (iv) suicide rates were higher in the age-band 75+ years compared to the age-band 65-74 years for males and females. Potential explanations for regional and cross-national variations in elderly suicide rates include cross-national differences in genetic and environmental factors, prevalence of mental illness in the elderly, life expectancy, socio-economic deprivation, social fragmentation, cultural factors, the availability of appropriate healthcare services, and public health initiatives to improve the detection and treatment of mental illness, mental health and suicide prevention.
Pattern of skeletal injuries in cases of falls from a height
Authors: Venkatesh V.T. , Kumar M.V. Pradeep , Jagannatha S.R. , Radhika R.H. , Pushpalatha K. 
Published: February 2010

Differentiating the injuries exclusively due to falls from a height is difficult if no proper history is provided. Some clinical studies and case reports have been published on the subject, but an autopsy-based approach to the subject is missing in the literature of recent decades. A retrospective study was carried out on 80 cases of fatal falls from a height brought for autopsy. In selected instances police reports, suicide notes, medical records and scene photographs were reviewed. The principal aim was to look for a pattern of skeletal injuries formed as a result of falls from a height. The majority of the victims were male, aged between 20-30 years and labourers by occupation. Most of them fell from a height of 0-10 feet. The head is the most vulnerable structure with fractures of the vertex being common. As the height of falls increases, fractures of the ribs and sternum are also found. Finally, it is concluded that falls on the head are more likely and the most fatal of all. However, it cannot be taken as a sole indicator of the manner of death. Risk assessment should be carried out before any work at a height is undertaken.
Sleep-related automatism and the law
Authors: Ebrahim Irshaad Osman , Fenwick Peter 
Published: February 2010

Crimes carried out during or arising from sleep highlight many difficulties with our current law and forensic sleep medicine clinical practice. There is a need for clarity in the law and agreement between experts on a standardised form of assessment and diagnosis in these challenging cases. We suggest that the time has come for a standardised, internationally recognised diagnostic protocol to be set as a minimum standard in all cases of suspected sleep-related forensic cases. The protocol of a full medical history, sleep history, psychiatric history, neuropsychiatric and psychometric examination and electroencephalography (EEG), should be routine. It should now be mandatory to carry out routine polysomnography (PSG) to establish the presence of precipitating and modulating factors. Sleepwalking is classified as insane automatism in England and Wales and sudden arousal from sleep in a non-sleepwalker as sane automatism. The recent case in England of R v. Lowe (2005) highlights these anomalies. Moreover, the word insanity stigmatises sleepwalkers and should be dropped. The simplest solution to these problems would be for the law to be changed so that there is only one category of defence for all sleep-related offences – not guilty by reason of sleep disorder. This was rejected by the House of Lords for cases of automatism due to epilepsy, and is likely to be rejected for sleepwalkers. Removing the categories of automatism (sane or insane) would be the best solution. Risk assessment is already standard practice in the UK and follow up, subsequent to disposal, by approved specialists should become part of the sentencing process. This will provide support for the defendant and protection of the public.