The second edition of Gautam Biswas' Review of Forensic Medicine and Toxicology represents a truly remarkable achievement in the forensic literature. The text is divided into two parts: the first is jurisprudence and forensic medicine and the second is toxicology, with a total of 63 chapters. Professor Anil Aggrawal MD Director-Professor Department of Forensic Medicine and Toxicology Maulana Azad Medical College New Delhi, India.
About three years ago, he sought my advice on writing a textbook on forensic medicine and toxicology for MBBS students. The result is before us in the form of Review of Forensic Medicine and Toxicology. I am overwhelmed by the response from students to the first edition Review of Forensic Medicine and Toxicology.
Decompression, Radiation and Altitude Sickness
Factors Modifying the Action of Poisons 413 Diagnosis of Poisoning in the Living 413 Diagnosis of Poisoning in the Dead 414 Failure to Detect Poison 416. Management of Cases of Poisoning 417 Removal of Unabsorbed Poison 418 Administration of Antidote 420 Elimination of Poison by Excretion.
Newer Techniques and Recent
Superscripts in the text refer to answers to the MCQs given at the end of the chapters.
History
Incision 2-In the anterior wall of the right ventricle parallel to the interventricular septum Incision 3-Through the tricuspid valve. Incision 5 - Through the mitral valve, parallel to the septum (in the anterior wall) Incision 6 - Through the aortic valve.
Jurisprudence and Forensic Medicine
Section One
Seven members shall be elected from persons registered in any of the State Medical Registries. The role of IKK is only as an appeals authority to the Central Health. The existence of the doctor's duty to the plaintiff, based on the existence of the doctor-patient relationship.
Such action by the attending physician which causes the patient some suffering, harm or damage. Definition: Refers to a physical agent that causes injury or death to a patient during treatment. In civil matters, the examination may not be carried out without the consent of the person to be examined.
MULTIPLE CHOICE QUESTIONS
Prenatal diagnostic techniques should be used for the detection of any of the following abnormalities
Prenatal diagnostic techniques should be used in pregnant women, if any of the following conditions
- Is it hair or some other fibre?
- Is it human or animal hair?
- What could be the racial profile of the person?
- From what part of body is the hair originated?
- Is it male or female hair?
- What could be the age of the person?
- Has the hair being altered by dyeing, bleaching or diseased?
- Is the hair identical with hair of the victim or the suspect?
- Whether the body is of human or animal?
- Whether it belongs to one or more bodies?
- What was the race of the person?
- Whether it is male or female?
- What was the age of the individual at the time of death?
- What was the stature of the individual?
- What was the identity of the individual?
- What was the manner of separation of parts?
- What was the mode and place of disposal?
- Whether the injuries are antemortem or post- mortem in nature?
- What was the cause of death?
- What type of weapon was involved?
- What was the time of death?
Skin: General condition (rash, petechiae, color, looseness and turgor), asymmetry of any part of the body or muscle wasting. In the case of a pregnant uterus, the condition of the entire product of conception should be noted. The dura is opened longitudinally to the upper part of the incision, where it is cut circumferentially.
MULTIPLE CHOICE QUESTION
Whether the hanging was suicidal, homicidal or accidental?
The beam or branch of the tree shows signs that the rope moved from bottom to top as the body was pulled up. In judicial hanging, the ligature is placed around the neck with the knot under the chin (submental), but a subaural (under the auricle) knot is also used.7 The fall is at least the height of the victim (1.5 -2 meters). ) and the suspension is completed. Definition: It is a form of violent asphyxiation caused by narrowing of the air passage in the neck by means of a ligature or by any means other than hanging the body.
Robbery: strangulation caused by holding the victim's neck in the crook of the assailant's elbow or knee. Bansdola: Place a bamboo or stick over the back of the neck and another over the front. If a stick or foot is used, a bruise corresponding to the width of the object used can be seen in the center across the trachea.
Asphyxia due to elevation of the larynx and tongue closing the airway at the level of the pharynx. The mark, although it completely surrounds the neck horizontally, is more visible on the front and sides than on the back of the neck (since the skin underneath is thick). In the event of a fight, there may be evidence of scratches, claw marks, and contusions on the face, arms, and other parts of the body.
They are usually vertical, may be irregular or crescent-shaped abrasions, resulting from attempts by the victim to pull the ligature away from the neck. Contusion of the subcutaneous tissue and muscles of the neck, especially under the ligature and knot. Mucous membranes of the pharynx, pyriform sinuses, epiglottis and larynx usually show areas of hemorrhagic infiltration.
Fracture/dislocation of cervical vertebrae is not common, may occur in infants if associated with twisting of the neck.
Whether death was caused by strangulation?
Whether the strangulation was suicidal, homi- cidal or accidental?
External signs are abrasions and bruises on the front and sides of the neck and are usually on each side of the laryngeal prominence and just below the jaw line. With prolonged pressure, the classic signs of asphyxia may appear - cyanosis, edema and congestion of the face, Tardieu's spot in the eyes and face, and sometimes bleeding from the nose and ears. They can be oval or round and 1.5-2 cm in size (can be more if the bleeding continues).
Design History of Previous Unsuccessful No such history is available. Suicide attempts are possible. Multiple scrapes on the neck can also be the result of using the victim's hands in an attempt to break the attacker's grip. These curvilinear marks usually lie near areas of bruising and are often horizontally oriented.
A grip with the right hand causes a contusion by pressing the thumb over the cornue of the hyoid bone/thyroid gland on the anterolateral surface of the right side of the victim's neck, and several contusions on the fingertips and overlying abrasions on the nails on the left side; directed obliquely downwards and outwards, usually one below the other (Fig. 10.10). Struggle and resistance can cause bruises and abrasions to appear on the victim's face, nostrils, lips, chin, cheeks, forehead, and lower jaw. These can also be caused in an attempt to prevent the victim from screaming or crying for help.
It is therefore important to examine the victim's fingernails and nail shavings from the alleged assailant whenever possible so that they can be compared to the victim's tissue type. In the mucous membrane of the larynx, epiglottis, pharynx, and peritonsillar area, hemorrhages can be found, varying from punctate ecchymoses to extensive extravasation. A carotid sheath tear and carotid artery inner sheath tear may occur.
Fractures of the superior horn of the thyroid cartilage are not limited to fatal neck compression.
Whether death was due to throttling?
Fracture of the superior horns of the thyroid cartilage is common, although both horns do not fracture at the same time.
Whether throttling was suicidal, homicidal or accidental?
How much force an assailant could have used?
- TYPICAL OR WET DROWNING
- ATYPICAL DROWNING 1. Dry drowning
Plastic bag suffocation results from reduced oxygen concentration in the available inspired air and physical obstruction of the mouth and nose. Mechanism: Initially there is stridor, respiratory distress, coughing and the inability of the victim to speak. It is a condition of accidental choking where a bolus of food causes complete obstruction of the larynx.
Overlay or compression asphyxia results from compression of the chest, nose and mouth to prevent breathing. But the displacement of blood in the valveless veins of the head and neck causes rupture of the distal capillaries. Most signs do not specifically indicate death due to drowning, but rather are signs of submersion of the body underwater for a period of time.
Washerwomen's hand is the wrinkled, soaked, bleached appearance of palms, palmer aspect of fingers and soles of feet including plantar surface of toes due to immersion of the body. Examination of the skin for blunt injuries should be delayed until the body is dry. Gettler test: Normally the chloride content of the right and left side of the heart is almost the same, about 600 mg/.
In the case of freshwater drowning, the chloride content of the blood in the left heart will be lower than in the right due to dilution with water. It may also be due to postmortem relaxation of the gastroesophageal sphincter, which allows water to enter the stomach. Middle ear: Presence of water and bleeding in the middle ear is claimed to be one of the positive proofs of antemortem drowning.
Ethmoid and sphenoid sinuses: Water can enter the respiratory sinuses; the jugum sphenoidale can be removed to expose the contents of the sphenoid sinus.
Whether death was due to drowning?
Asphyxia 161 circulation via the gastrointestinal tract (as contaminants in foods such as salads, watercress and shellfish) or via the respiratory tract (diatoms are usually present in small amounts in the air, in some paints, plasters and dust).
Whether drowning was accidental, suicidal or homicidal?
Evidence of abnormal sexual behavior and nudity of the deceased with the presence of pornographic material. When a person hangs himself from a knot located in the occipital region, this is a hanging. Imprint Abrasion (Impact/Contact/Pattern Abrasion): Occurs when force is applied perpendicular to the skin, the epidermis crumples at the point of impact and bears the imprint of the object that caused it.
When someone is hit by a car, a pattern of the radiator grille, headlight bezel, or tire track may be visible on the skin.7 Imprints of a bicycle chain and a serrated knife are other examples. Pressure ulcers/decubitus (pressure sores): These are caused by pressure necrosis of the skin when confined to bed, caused by prolonged compression of soft tissue between the protruding bone and the external surface. In cases of sexual violence, abrasions can be found on the breasts, genitals, inner thigh and around the arms.
Cullen's sign: Blue-black discoloration of the periumbilical skin due to extensive retroperitoneal or intra-abdominal hemorrhage. Bruising may indicate the nature of the weapon, especially if death occurs shortly after the wound is inflicted. Sucking or biting the sides of the neck or breasts during sex/intercourse causes bruises with an elliptical pattern.
Internal organs can also become confused; contusion of the brain can cause confusion, coma and death. Location Occurs over a large area of damage. Occurring at the site of and around the injury, most dependent parts can occur anywhere on the body. Effect of pressure Absent in areas of the body that are slightly above the area of pressure or support.
Bruising of the shoulder blades indicates strong pressure on the body against the ground or other resistant surfaces.
