Mandar Ramchandra Sane

Survival of a victim of Isadora Duncan syndrome: A case report

Incidents of accidental strangulation by uncovered (open-spoked) wheels of vehicles are not uncommon but survival following such incidents is quite a rare phenomenon. The possibility of death from strangulation by a scarf getting caught in the wheel spokes of a vehicle was brought to the public’s attention when the world famous dancer Isadora Duncan died on 14 September 1929. Cycle-powered rickshaws, bicycles and bullock-carts remain common forms of transport in India. However, the uncovered spokes of the vehicle wheel can trap the dupatta/chunni/odhani (long scarf worn around neck) worn by Indian women. A number of cases of fatal accidental strangulation have been described by different authors involving vehicles like cycle-powered rickshaws, bicycles and bullock-carts, with very few cases of reported survivors. Here we report a case of accidental strangulation involving a young girl with the dupatta getting caught in moving wheel of a bullock-cart, in which the victim survived in spite of severe injury to neck structures.

Quenching tank: Accidental drowning in hot quenching oil

We describe an unusual case of drowning in fluid other than water in an industrial setting. A 26-year-old man was working in an industry which performs surface treatment of mechanical steel parts with quenching oil. He fell into the quenching oil (which was hot due to immersion of red hot metal parts), and as he was working alone in the particular section, there was a fatal outcome. A medico-legal autopsy was performed. The causes of death were found to be multiple, with the association of drowning, extensive superficial burns and asphyxia due to laryngeal oedema. To our knowledge, it is the first report of drowning in hot quenching oil, and only nine previous observations of drowning in industrial environments have been reported in the international literature. Even though rare, these kinds of accidental deaths can be prevented in dangerous industries with proper precautions and strict adherence to standard operating procedures.

Non-vehicular homicides masquerading as road traffic accidents

Interfering with or planting evidence to disguise the cause of a death is not uncommon in forensic practice. Homicides staged as road accidents are, however, rarely encountered by crime scene investigators. We report two homicides which were presented as road traffic accidents. Case 1: Dead body of a 35-year-old male was brought for autopsy with history of road traffic accident. Primary police inquiry suggested that the victim was knocked down by a speeding four-wheeler, while walking by the side of a high way with his friends. On postmortem examination the deceased’s death was found due to homicidal smothering staged as a road traffic accident. Case 2: Dead body of 40-year-old male was brought for autopsy with history of road traffic accident. It was an unwitnessed crush by a speeding four-wheeler. However, on postmortem examination, the deceased was found to have died from homicidal multiple stab wounds with his death staged as a road traffic accident. Importance of meticulous autopsy to determine accurately the cause of death is emphasized.

Serial murder: An unusual stereotype

Serial murders attract attention from the media, mental health experts, academia, and the general public. We present a case of serial murders that took place in a limited area and which caused public anxiety and anguish in central India. All the victims were homeless beggars, who were bludgeoned to death (crush injury). Individual murders were initially investigated by different police stations; fortunately, since they sent all the bodies to a common autopsy centre, a forensic pathologist was able to link all the cases, the first person to do so. This emphasises the need for sharing information among police stations and autopsy centres.

Fatal Paint thinner ingestion-A case report

Household poisons can cause serious damage to the health of children. Turpentine is a volatile hydrocarbon used in polishes, solvents, paints and textile industry. It is capable of causing serious toxicity, whether ingested or inhaled. When hydrocarbons are aspirated into the lung, they cause chemical pneumonitis, acute respiratory distress syndrome (ARDS), and rarely pneumatoceles and pneumothorax. We report a case of accidental ingestion of turpentine oil by a 13 year old female child brought to SAMC and PGI, Indore, leading to aspiration pneumonitis and ultimately causing death after 6 days of hospitalization.

Profile of Death in Burn Cases: A Post-mortem Study

Deaths due to fire or burns usually result from application of dry heat to the body. In India there are several thousands of deaths occurring due to fire or burns. Unfortunately vast majority of these cases occur in the home and are due to smoking, defective electrical wiring, defective kerosene stove bursts, attempted suicides by self-immolation, homicidal burns of young women by husband or in-laws (Dowry deaths/bride burning). The present study was based on retrospective analysis of burn cases in the period from January 2013 to December 2013 from autopsies done in the Department of Forensic Medicine and Toxicology, SAIMS Medical College & PG Institute, Indore, M.P. It was observed that more than half of the victims died of burn injuries were married women. Females are mostly involved in cooking and most common cause is accidental burn. Burns having total body surface area (TBSA) more than 40% were fatal. The different aspects of burn deaths are analyzed and discussed in detail.

Estimation of coronary artery calcium by multislice spiral CT scan in asymptomatic high risk cases above forty (40) years of age

Hypertension, diabetes mellitus, smoking, obesity and family history of coronary artery disease are among known risk factors of coronary artery disease. Computed tomography (CT) quantifies the relative burden of CAC deposits as a marker of atherosclerosis. Methodology: This was a case control study conducted at Indira Gandhi Medical College and Hospital, Nagpur from June 2004 to June 2006, with aim to find out the utility of multislice spiral computed tomographic (CT) scan for detection of coronary artery calcium in asymptomatic coronary high risk cases and attempts has been made to correlate CAC Score with various risk factors and has been compared with CAC Score of controls Results: The maximum numbers of cases were in group of 41-50 years (n=31, 53.4%). The male to female ratio was 1.52:1. Among the risk factors studied, dyslipidemia (65.5%) was most common risk factor. Mean CAC score of all cases was significantly higher than, mean CAC score of all controls (p value= 0.0004). There was a progressive increase in the mean CAC score with increasing age. When all the risk factors were individually compared with controls, all showed higher CAC score and all the differences were statistically highly significant. Conclusion: Coronary artery calcium increases with increasing age and male sex. It also increases with presence of major risk factors for coronary artery disease (CAD). Hence, multislice spiral CT scan, being a non-invasive test can be recommended as a screening test for demonstrating significant atherosclerosis in susceptible subjects even when asymptomatic. Keywords: Coronary artery diseases, Coronary artery calcium, Ct scan risk factors

Pseudo-precipitate labour: myth or reality.

Spontaneous deliveries into toilet bowls always carry a special forensic significance. Forensic pathologist has to differentiate between a genuine precipitate labour and concealed birth or a neonaticide. Circumstances are challenging when a nullipara claims misapprehended precipitate labour. We report a similar case where a primigravidous unmarried girl delivered in a lavatory pan misjudging labour pains as that of bowel evacuation. Detailed obstetric history, postnatal maternal behaviour and visit to scene of incidence resolved the unnecessary charges of neonaticide on the embarrassed mother.

Myocardial infarction and concurrent chest injuries: Two case reports

Two cases of sudden death due to myocardial infarction which were associated external injuries on the chest are discussed here. Injuries were in the form of abraded contusions on the anterior part of chest. Both the cases were declared dead on arrival to the casualty section (Accident and Emergencies Department). In these cases, mention of injuries was not made in the inquest report. In both the cases, suspicion of foul play or the trauma induced myocardial infarction were ruled out by inquiring into the incidents by the autopsy surgeon. The cases highlight the importance of detailed history by the autopsy surgeon in cases of sudden death with associated injuries on the front of the chest.