C Behera

Fatal accidental fall from height in infants and children: a study from South Delhi.

One hundred and seventy-four deaths of infants and children due to accidental fall from height received from South Delhi for autopsy were studied during the 10-year period from January 1998 to December 2007 at the All India Institute of Medical Sciences, New Delhi. Data were analysed with regard to age, sex, location of fall, height of fall, pattern of injury, cause of death and seasonal variation. These cases represented approximately 22.56% of all deaths due to a fall from height and 1.31% of all medicolegal autopsies conducted during the period. There were 106 male (60.9%) and 68 female (39.1%) victims. Age-specific rate of fall showed that the highest rate was in toddlers (39.65%), followed by 26.43% each in preschool children and school-going children and the least in infants (7.47%). The head and face was the most frequently injured body region (93.67%) and the skull was the commonest bone fractured (59.19%). The most common cause of death was head injury (84.48%). Major fall sites in decreasing order of frequency were rooftop (38.50%), balcony (24.13%), household furniture (21.26%), staircase (6.89%), window (4.59%), wall (1.72%), rickshaw/bicycle (1.15%) and tree (0.57%). Most fatalities due to a fall from height were reported in the rainy season.

Deaths of homeless unclaimed persons in South Delhi (2001-2005): a retrospective review.

Homeless people are at increased risk of death for several reasons. We reviewed 735 cases of homeless, unclaimed persons found dead in public places in South Delhi who were brought for autopsy at the Department of Forensic Medicine, All India Institute of Medical Sciences, New Delhi, during the study period from 2001-2005. Most of the deceased were male (n=645, 87.75%) with a M: F ratio of 7.17:1. The commonest age group involved was 31-40 years (n=228, 31.02%). Most victims (n=451, 61.36%) died from natural causes, followed by accidental deaths (n=233, 31.70%) and homicides (n=26, 3.54%). The majority of deaths were reported in the rainy season (n=284, 38.64%). The deceased were mostly recovered from the road or road side (n=352, 47.89%). Few studies on this subject have been published in India. More research is needed to identify the health-related problems of such people and possible contributory factors to mortality.

2. An Unusual Suicide by Stabbing

A 50-year old cobbler, employed in a paramilitary unit, was found dead in a pool of blood in his shop inside the unit line in the morning. He had multiple stab wounds on his chest and was alleged to have committed suicide by repeated self-stabbing on the chest with a sharp iron chisel, which was found clenched in his right hand by the investigating officer. Fifteen wounds were communicating with the chest cavity, injuring the vital anatomical structures. The individual, according to the unit personnel, was not suffering from any physical or mental disorder and was not on any medication.

Suicide note on the palm: Three case reports and discussion of medico-legal aspects

Suicide notes are usually written by the victim on paper or readily accessible things such as notebooks, walls or mirrors. Though writing may be found on the body of the deceased, suicide notes in a structured manner written on the palm have not been reported in forensic literature. In all the three cases presented here, we found a handwritten note on the palm of the deceased at the time of autopsy. The victims had written a brief note in their own handwriting, citing the reasons for ending their lives. The suicide note in one case also mentioned details regarding the custody of the victim’s children to be given to her mother. Since we have not found similar cases in the literature, we present and discuss our three cases herein.

Suicide pact by drowning with bound wrists: A case of medico-legal importance:

Suicide pacts are uncommon and mainly committed by male–female pairs in a consortial relationship. The victims frequently choose methods such as hanging, poisoning, using a firearm, etc; however, a case of a suicide pact by drowning is rare in forensic literature. We report a case where a male and a female, both young adults, in a relationship of adopted “brother of convenience” were found drowned in a river. The victims were bound together at their wrists which helped with our conclusion this was a suicide pact. The medico-legal importance of wrist binding in drowning cases is also discussed in this article.

E-suicide note: A newer trend and its medico-legal implications in India

Rapid advancements of information and communication technology in the form of electronic mails, mobile phones, social networking sites, etc have an increasing impact on peoples day to day life. It has been observed that these readily available applications are used frequently to express suicidal intentions. There are many studies on conventional handwritten suicide notes but suicide note in electronic format is an emerging issue and an under-researched phenomena. The authors have termed it as “E-suicide note” and discuss its medico-legal implications in India with examples from their observations.

Antitubercular drug-induced violent suicide of a hospitalised patient

We present a case where a young adult male, on treatment for multidrug-resistance tuberculosis (MDR-TB), developed drug-induced psychosis. The psychiatric symptoms were ascribed to the anti-TB drug and were duly withdrawn by the treating doctors and supplemented with other drugs. However, the victim continued to have psychiatric symptoms and committed suicide in the hospital. He ended his life in a violent manner by stabbing and cutting himself with a kitchen knife. The case is briefly reported in this paper with a discussion on anti-TB drug-induced psychiatric effects leading to suicide.

Cardiac rupture delayed for a week in an asymptomatic child following blunt trauma

A two-year-old child was hit by a car outside his home and was immediately taken to hospital. There were no external injuries present over the body except two small abrasions on the occipital region of head. A computed tomography scan of the head was performed which revealed no cranio-cerebral injury. He was discharged from the hospital within few hours apparently well. The child was absolutely asymptomatic for a week, after which he suddenly died while playing at home. Autopsy revealed left ventricular free wall rupture and pericardial haematoma. This case report discusses the rare incidence of delayed cardiac rupture due to blunt trauma resulting in haemorrhagic tamponade in an asymptomatic child.

An Adolescent with Bestiality Behaviour: Psychological Evaluation and Community Health Concerns.

Bestiality is a serious but less commonly reported form of animal cruelty occurring in a society. It is a punishable sexual offence in India. Bestiality has received little attention in recent psychiatric literature, and even though case reports have been published, an elaborate psychological assessment is often missing. This case report of 18 year old male presented here highlighted the importance of psychological assessment to emphasize on its implications for the further risk assessment of the person, family psycho-education and non-pharmacological intervention for bestialists. The overall assessment suggested of absence of any brain dysfunction and active psychopathology, average intelligence (IQ) and intact cognitive functioning. The findings portrayed physical and sexual inadequacies, emotional and sexual immaturity, difficulty in emotional attachment, internalized hostility, voyeuristic tendencies and infantile social behaviour, excitement seeker, inability to delay gratification of impulses, lacks empathy, poor self-discipline, less conscientiousness and less sensitive to criticism. The report also emphasized the role of child sexual abuse on sexual behavior later life. The importance of including the topic within the community health/sexual and reproductive health education programmes was highlighted.

Triple hanging in filicide-suicide: An unusual case report

Filicide-suicide is a special category of homicide-suicide event where the victim(s) are children and the perpetrator is one of the parents or both. It is not extensively documented or adequately defined in literature. In developed countries, shooting is a common method of homicide and suicide. Uses of knives, blunt objects, strangulation, poisoning and drowning are other methods frequently employed by the perpetrator. Homicide by hanging in filicide-suicide is rarely reported in forensic literature. We present a rare case of filicide-suicide, where the mother killed both her children by hanging them one by one from a ceiling fan in the same room and later committed suicide by hanging in another room.