Francis N.P. Monteiro

Fatal unintentional injuries among young children--a hospital based retrospective analysis.

Unintentional (accidental) injuries in childhood constitute a significant public health problem. Young children are extremely vulnerable to unintentional injuries that are vastly preventable. All cases of fatal unintentional injuries in children aged 10 years and below autopsied during 1994-2007 were retrospectively reviewed. Seventy five such cases were identified during the 14 year study period. Males accounted for 68% of cases with a male-female ratio of 2.1:1. Mean age of male and female victims was 5.3 and 4.9 years, respectively. Road traffic fatalities accounted for majority of the cases in this age group (52%), followed by those due to thermal injuries (22.7%). Flame was the cause of thermal injuries in 52.9% cases and scalds were observed in 47.1% cases. Traffic fatalities, fall and drowning were more common in school age children while toddlers and pre-school age children were relatively at a greater risk from domestic accidents (thermal injuries and poisoning). The most frequent victims of road traffic incidents were pedestrians (64.1%). Head injuries alone were the cause of fatalities in the majority of road traffic incidents (82.1%). The study highlights on the pattern of fatalities due to unintentional injuries among young children. To reduce the burden of unintentional childhood mortalities in this region, priorities for school age children are traffic injuries and for toddlers and pre-school children, thermal injuries.

Sexual dimorphism of the index to ring finger ratio in South Indian adolescents.

Sex determination from prepubertal human remains is a challenge for forensic experts and physical anthropologists worldwide as definitive sexual traits are not manifested until after the full development of secondary sexual characters that appear during puberty. The research was undertaken in 350 South Indian adolescents to investigate sexual dimorphism of the index and ring finger ratio. The index finger length (IFL) and the ring finger length (RFL) were measured in millimeters in each hand and the index and ring finger ratio was computed by dividing the index finger length by the ring finger length. Mean RFL was greater than mean IFL in both males and females. Mean RFL was significantly higher in males. The index and ring finger ratio showed a statistically significant difference between males and females (p </= 0.001). The index and ring finger ratio was found to be higher in females (0.99) when compared to their male counterparts (0.95). The index and ring finger ratio thus shows sexual dimorphism in the South Indian adolescents that may prove useful to determine the sex of an isolated hand when it is subjected for medicolegal examination. The study suggests that a ratio of 0.97 and less is suggestive of male sex, while a ratio of more than 0.97 is suggestive that the hand is of female origin among South Indian adolescents.

Mesiodistal width of canines: a tool for sex determination:

Teeth, in the living as well as the dead, are the most useful objects in the field of forensic investigation. Their ability to survive in situations like mass disasters makes them important tools in victim identification. Though the morphology and structure is similar in both men and women, there are subtle differences. Variation in dental size can give a clue about differences between the sexes. Many authors have measured the crowns of teeth in both men and women and found certain variations. Canines, reported to survive air crash and hurricane disasters, are perhaps the most stable teeth in the oral cavity because of the labiolingual thickness of the crown and the root anchorage in the alveolar process of the jaws. Measurement of mesiodistal width of the mandibular and maxillary canines provides good evidence of sex identification due to dimorphism.

Sudden death due to pulmonary aspergillosis

Sudden death due to respiratory pathology is not uncommon and tuberculosis with its complications is well known to cause death. We report a case of a male, train passenger, who started coughing out blood and died on reaching the hospital. Medicolegal autopsy confirmed the sudden unexpected death to be due to pulmonary aspergillosis in the person with past medical history of tuberculosis.

Blunt trauma to the chest- A case of delayed cardiac rupture

Blunt traumatic cardiac rupture is a relatively uncommon diagnosis and is usually associated with a high mortality rate. A case of delayed cardiac rupture is described in an elderly person who sustained blunt chest trauma following a fall into a roadside ditch. In the case reported herein, the preliminary investigations at the time of admission did not show any evidence of haemopericardium. The patient deteriorated suddenly, possibly due to a delayed rupture of the right ventricle that was diagnosed postmortem. Acute cardiac tamponade resulting from rupture of the right ventricle is a serious and life threatening state. A high index of suspicion about the possibility of delayed cardiac rupture is required during the management of a case of polytrauma where significant cardiac findings can be masked by the presence of other injuries.

Death by attack from a domestic buffalo

Attacks on humans by domestic animals causing fatal injuries are not uncommon in rural areas of India. But injuries due to buffalo gore are rarely observed in villages and are different from other casualties like stab injuries, road fatalities, etc. As the victims of buffalo attack are usually recovered from the fields or forest, the investigating officer could be mislead as to the nature of infliction of fatal injuries to a possible homicide. The injuries caused by the horns of buffaloes are of various shapes, sizes and directions. They are violent and goring in nature. The wound sustained may be contusions, lacerations, criss-cross wounds, penetration of body cavities, and sometimes fractures. In the absence of any eye witness, it becomes very difficult to believe the unsuspecting domestic water buffalo as attacker. This case is reported for its rarity, for the awareness of the possible injuries in such unnatural deaths, and factors predisposing to a buffalo attack.

The Mangalore Aircrash of 22 May 2010: Practical Problems Related to Identification of the Dead in a Populous Developing Country

It was a sad and emotional moment for the citizens of Mangalore, India when the “Dubai to Mangalore” Air India Express Boeing 737-800 flight IX-812 crashed at the Mangalore International Airport on 22 May 2010, killing 158 people on board. Identification of the victims was difficult as most of the bodies were charred beyond easy recognition. The practical problems faced by the legal authorities in identifying the charred victims in a populous and developing country like India are discussed in this paper.

Atypical wound of entry and unusual presentation in a fatal stab injury

Stab wounds encountered in medico-legal autopsies are usually caused by sharp pointed weapons. Peculiarities of the wound of entry in stab wounds, for example due to the hilt of the weapon, movement of the weapon and sometimes by the hand of the assailant holding the weapon are often described in literature. We report an unusual presentation in a fatal stab injury wherein a single atypical external wound was associated with multiple internal injuries to the organs. The exact cause of such peculiarities can never be accurately determined, rather that can be speculated upon at the time of the autopsy and recorded for the purpose of academic interest.

Eruption Pattern of Permanent Teeth in the Age Group of 5 to 15 Years of Udupi District of Karnataka

Introduction:Establishment of identity in the living and the dead individual carries tremendous medico-legal significance. Estimation of the age of an individual is an important step in establishing the identity of an individual. Identification may be complete or incomplete. Comparative techniques like anthropometry and prints involving foot, hand, nail, ear, lip, palate and fingers, superimposition technique, dental data and DNA fingerprinting help to identify an individual Materials and Methodology:Materials for the present study consisted of 1, 000 students from various schools, in the age group of 5 to 15 years belonging to Udupi district. Examination of the oral cavity was carried out. The tooth was recognized based on the morphological features. The eruption pattern of each tooth was noted in a proforma. The proof of age of the subjects were obtained from the school documents and birth certificates.Results:The sequence of eruption pattern of permanent teeth was similar in boys and girls. The mean ages for eruption in boys for first molar were 6.85 years, followed by the central incisor at 8.14 years whereas in girls it was 6.94 years, and 7.86 years, respectively. All the maxillary permanent teeth in both genders erupted first in the left quadrant, followed by the right quadrant, except the second premolar (boys) and second molar (girls), which erupted first in the right quadrant. All the mandibular permanent teeth in both genders erupted first in the left quadrant, followed by the right quadrant.