Arneet Arora

TRIVIAL INJURIES, ASSOCIATED CONGENITAL ANOMALY AND MEDICOLEGAL INTERPRETATION OF DEATH

Congenital hypoplasia of the odontoid process is a relatively rare phenomenon. A case is presented of a 12-year-old girl who was admitted to hospital with a history of having sustained trivial external injuries when falling after an alleged push. Later, she developed signs of compression of the spinal cord in the cervical region, resulting in quadriplegia and muscle wasting. A laminectomy was performed to relieve the symptoms but the child died 2 1/2 months later. Autopsy revealed a congenital anomaly of the atlas and axis vertebrae in the form of hypoplasia of the dens. The case being associated with a criminal assault, the post-mortem analysis and autopsy were significant in resolving medicolegal issues pertaining to the assailant, the operating surgeon and the law-enforcement agencies.

4. Cerebral Venous Thrombosis in Pregnancy

Sudden unexpected death in many instances comes with stimulating or interesting findings, often in contrast to the history provided. Two cases of sudden death in pregnant females with central venous thrombosis are described, because of their rarity. The incidence, etiological factors, predisposing conditions and the ethical and legal questions arising from such deaths are discussed.

Methods to open the skull at Autopsy: An analysis

During a medico-legal autopsy, a forensic pathologist opens the skull wide at bony landmarks for better access into the cranial cavity. This helps to observe the intracranial findings of medicolegal significance and to remove the brain intact for better assessment of the findings. The various methods for opening the skull available, include-use of hammer and chisel, manual saw or electric saw; each with its own advantages and disadvantages. Comparison of time, effort and skill required for each of these methods and in the current scenario, the possibility of risk of acquisition of multi-drug resistant tuberculosis (MDR TB) or HIV infection from the deceased is being discussed. One significant issue associated with hammer and chisel method used for opening the skull includes either extension or creation of fractures (artefacts). This can be minimised by limiting the use of hammer and chisel in opening the skull. A vibrating electric saw with vacuum aspirator or bone dust collector is recommended for opening the skull for autopsies. If the facility of vacuum aspirator or bone dust collector is not available, other methods of opening the skull as compared to use of electric saw would be safer in terms of risk of exposure to MDR TB, HIV infections or others which could spread by bone aerosol generation.

Child sexual abuse (CSA): India & the world

Child Sexual abuse (CSA) is a mostly hidden but widely prevalent problem in the society. It is very difficult to understand the exact aetiology but certain factors keep children on a constant risk of falling prey to it. The magnitude of problem is quite high and scars the childs life with undesired consequences. The professionals who deal with such cases are supposed to tackle them in different ways and manner than routine cases. It requires a unique way of forensic investigation, as often these children are hesitant to tell the true story and put a challenge before us to diagnose with the available methods and techniques. The appropriate preventive, curative, supportive and legal remedies are required to pull them out from this dreaded situation and allowing them to lead a normal life. There is a need to frame uniform standard operating procedures (SOPs) to guide the medical, police, law, social service and other personnel to effectively prosecute the abusers and stopping the re-victimisation of the children.

Carotid sheath haematoma: A case report

Carotid sheath haematoma is a rare finding, sometimes the only injury found in cases of manual strangulation without any associated external or internal injury to the neck. One such rare case is reported in an 8 year old female victim where presence of carotid sheath haematoma not only helped to ascertain the cause of death but also helped in the reconstruction of mechanism of infliction of force on the neck.