Jenash Acharya

Bear-inflicted injuries - a report from Nepal

Upper Mustang in the Northern Himalayan range of Nepal is the home of brown bears (Ursusarctos). Low-plant biomass as a result of scanty rainfall in Upper Mustang is a reason for habitat overlap of humans and wild animals. Humans who enter into the wild to collect firewood and graze cattle are liable to wild animal attacks. Such attacks, especially by brown bears, are readily identified by the type of injuries. These are more commonly confined to head and neck regions. Cutting, gnawing and tearing by sharp teeth and claws produces specific pattern of injuries, which are devastating but seldom fatal. This article reports a rare case of brown bear injury inflicted upon a man from the Upper Mustang region in Nepal.

Searching for Kin Amidst Tragedy—Disaster Victim Identification Operations for US Bangla Flight 211

The nature of air disasters includes factors that exacerbate challenges in the identification process. Of the 49 deceased in the US Bangla air crash in Kathmandu, Nepal, four were intact, 11 presented with burn injuries, another 11 presented with partial charring, and 23 were completely charred. Personal belongings were useful in the identification phases for all types of victims. Fingerprints were obtainable and useful in intact victims and victims with less severe burn injuries; medical and surgical information was useful in bodies with burn injuries; finally, dental findings were useful in cases of extensive charring. Other useful methods in the process included marks of identification, physical features, and exclusion. In certain resource‐limited settings, especially in closed population disasters, where scientific identification (DNA, dental records, etc.) is not currently available, personal belongings, clothing, and physical findings analyzed by an identification team using a structured organization may be cautiously used as the primary means of identification.

Ligature mark on the face – forensic implications

In deaths due to hanging and strangulation, the position, course and direction of the ligature mark, the kind of knot used and injuries to the neck structures help in deducing the cause and manner of death. Two cases of suicidal hanging are reported where the unusual positioning of ligature and presence of the ligature mark on the face raise doubts concerning the circumstances of death. The presence of a ligature mark on the face is an unusual and rarely reported phenomenon that can have serious medico-legal implications.

Fat infiltration of left ventricle – a rare cause of sudden cardiac death:

Cor adiposum is a rare disorder of the heart, where the normal heart tissue is replaced by fibro-fatty infiltrates. We report one such case of a middle-aged female who was declared dead shortly after a syncopal episode. At autopsy, the pericardium was intact and firmly adhered to the heart. Histopathology revealed fatty infiltrates extending into the left ventricle of the heart. A post-mortem diagnosis of Cor adiposum was made which is an uncommonly reported cause of sudden cardiac death.

Faith healers, myths and deaths.

Science and myth have been closely linked and argued upon by philosophers, educationalists, scientists, enthusiasts and the general public. Faith healing, when added as an adjuvant or alternative aid to medical science, will not necessarily be confined to mere arguments and debates but may also give rise to series of complications, medical emergencies and even result in death. We present an unusual case where reliance on faith healing led to the death of a young man.

Gastro-intestinal ascariasis--an unusual autopsy case report.

Ascaris lumbricoides or roundworms’ propensity to produce large number of eggs that are resistant to extremes of environmental conditions have made them one of the highly prevalent and geographically well distributed nematodes among poor socio-economic regions throughout the world. We present an unusual case of fatal gastro-intestinal ascariasis where general neglect, and firm and prolonged reliance on traditional healing methods led to aggregation of roundworms to such an extent that otherwise seems improbable in modern times and, hence, is worth reporting.

A Study of Respiratory System Related Causes of Sudden Death

Sudden death due to respiratory illness is one of the leading causes of sudden and natural deaths all over the world, the frequency is, however, more in developing and underdeveloped countries. A retrospective study was conducted at our centre in Kasturba Medical College, Mangalore, in cases which came with the history of sudden death with the aim to study respiratory system-related causes of sudden death. The cases with gross positive findings in lungs were taken as samples for study. Out of 2,515 autopsies conducted during the study period, 274 (10.89%) were of sudden death, of which 81 (29.56%) were due to respiratory system-related diseases. Respiratory causes of deaths were seen mostly in the age group of 40–49 years (25.9%) and those above 60 years of age (25.9%). Male comprised 88.88% of death related to respiratory causes. Various forms of respiratory illness causing death were pulmonary tuberculosis (TB, 43.2%), pneumonia (28.39%) pulmonary TB with pneumonia (4.93%) and upper respiratory tract diseases association with other extra-pulmonary causes (23.45%). This study emphasizes need to create awareness among people about respiratory health and regular medical checkup.