Sachil Kumar

Epidemiology and mortality of burns in the Lucknow Region, India-A 5 year study

Nearly 95% of global burn deaths and disabilities are estimated to occur in low and middle income countries of the world. Burns are extremely common and are a major public health problem in a developing country like India. The purpose of this study was to record and evaluate the causes and the magnitude of the fatal burns retrospectively. An analysis of autopsy records revealed 2225 (10.7%) cases of burns among the total autopsies done over 5 years period (1st January 2008-27th November 2012) in the mortuary of Forensic Medicine & Toxicology, K.G.M.U., Lucknow. The majority of deaths (88.8%) occurred between 10 and 49 years of age group with a preponderance of females (87.5%). The flame burns were seen in 60.1% of the victims. The majority of burn incidents were suicidal (38.6%) in nature followed by accidental (37.3%) and homicidal (24.1%) deaths. The percentages of burns with a total body surface area (TBSA) over 50% were observed in most of the cases (82.5%). In most of the cases deaths occurred within a week (82%) and most of the victims died from septicaemia and pneumonia (43.7%) followed by neurogenic shock (28.5%). The results of this study provide the necessary information to implement programmes for health education relating to prevention of burns focusing on the domestic setting.

Temperature-Dependent Postmortem Changes in Human Cardiac Troponin-T (cTnT): An Approach in Estimation of Time Since Death.

Estimation of time of death is an indispensible requirement of every medico‐legal autopsy, but unfortunately, there is not a single method by which it could be determined accurately. This study focused on the temperature‐dependent postmortem degradation of cardiac troponin‐T and its association with postmortem interval (PMI) in human. The analysis involved extraction of the protein, separation by denaturing gel electrophoresis (SDS‐PAGE), and visualization by Western blot using cTnT‐specific monoclonal antibodies. The area of the bands within a lane was quantified by scanning and digitizing the image using Gel Doc (Universal Hood). The results indicate a characteristic banding pattern among human cadavers (n = 6) and a pseudo‐linear relationship between percentage of cTnT degradation and the log of the time since death (r > 0.95), which can be used to estimate the postmortem interval. The data presented demonstrate that this technique can provide an extended time range during which PMI can be more accurately estimated.

Intentional and non-intentional burn related deaths: a comparative study of socio-demographic profile

This is a retrospective study of 1689 consecutive admissions of burn deaths to the mortuary over a period of 5 years. The socio-demographic data was collected using special Performa and interviewing the family members, relatives, neighbours and from police reports. Depending on the presence or absence of intentional intent, cases were divided into two groups and compared with regard to their socio-demographic profile. Both groups did not differ significantly with regard to age, sex and educational status. The cases with intentional deaths came from nuclear family, unmarried, student, low socio-economic status, had more stressful life events and suffered larger burns injuries compared with those who experienced non-intentional deaths. The majority of the cases were below the age of 35, unemployed and females outnumbered males in both the groups.

Role of dental expert in forensic odontology

Forensic dentistry has become an integral part of forensic science over the past 100 years that utilizes dental or oro-facial findings to serve the judicial system. This has been due to the dedication of people like Gustafson′s, Keiser-Nielson, and Suzuki for this field. They established the essential role which forensic dentistry plays mainly in the identification of human remains. The tooth has been used as weapons and under certain circumstances, may leave information about the identity of the biter. Dental professionals have a major role to play in keeping accurate dental records and providing all necessary information so that legal authorities may recognize mal practice, negligence, fraud or abuse, and identity of unknown individuals. This paper will try to summarize the various roles of dental experts in forensic medicine.

A Study of Unnatural Female Death Profile in Lucknow, India

AbstractEpidemiological and medicolegal, including forensic pathological, aspects of 456 cases of unnatural deaths of females aged 16 to 30 years were studied in Lucknow during the period of 1 year (May 2, 2011 to May 1, 2012). These constituted 62.5% of the total unnatural deaths autopsied from all ages in females. Most of the victims were young Hindu housewives killed or who died within 7 years of marriage. The most common cause was vehicular accidents followed by poisons and burns. The homicidal, suicidal, and accidental deaths were 87, 129, and 240, respectively. The common motives and circumstances were mental stress due to various reasons, family quarrel, maladjustment in married life, and cruelty by the in-laws. Level of education, joint family structure, unemployment, dependence of the woman on the in-laws, infidelity, large families, and failure in love in unmarried girls were other contributing factors affecting the incidence. The study suggests different measures to check unnatural female deaths to improve the situation.

The effect of elapsed time on the cardiac Troponin-T (cTnT) proteolysis in case of death due to burn: A study to evaluate the potential forensic use of cTnT to determine the postmortem interval

BACKGROUND After the death of an organism, intracellular enzymes cause protein to degrade into smaller fragments as the time passes, if these fragments can be isolated and visualized, and if the fragmentation is proved to be measurable and quantifiable, it can be a good sign of the post-mortem interval (PMI). The aim of this study is to evaluate the effect of PMI on Troponin-T protein degradation in cardiac tissues of cadavers through quantitative analysis of Troponin-T degradation by easily electrophoretic method and its association with PMI in case of deaths due to burn. METHODS An efficient extraction protocol to analyze the banding pattern of cTnT in post-mortem tissue was developed. The analysis involves extraction of the protein (at different PMI (~7.30, 18.20, 30.30, 41.20, 41.40, 54.30..................88.40h), from the heart muscles of cadavers (burn cases), separation by denaturing gel electrophoresis (SDS-PAGE) and visualization by Western blot using cTnT specific monoclonal antibodies. RESULTS The results specify a characteristic banding pattern amongst human cadavers (n=9), a pseudo-linear relationship between percent cTnT degraded and the time since death (r=0.87, p=0.0001). The area of the bands within a lane was quantified by scanning and digitizing the image using commonly available scanners. CONCLUSIONS The present research used a simple, easy, applicable and highly informative electrophoresis method that make it an ideal for the busy forensic laboratory. The post-mortem Troponin-T fragmentation observed in this study reveals a sequential, time-dependent process with the potential for use as a predictor of PMI in cases of burning. This result shows a potential for use as a future applied method of evaluating time since death.

Identification of a person with the help of bite mark analysis

Forensic dentistry is an essential part of Forensic science, mainly involves the identification of an assailant by comparing a record of their dentition (set of teeth) with a record of a bite mark left on a victim. Other uses in law for dentists include the identification of human remains, medico-legal assessment of trauma to oral tissues, and testimony about dental malpractice. While the practice of human identification is well established, validated and proven to be accurate, the practice of bite mark analysis is less well accepted. The principle of identifying an injury as a bite mark is complex and, depending on severity and anatomical location, highly subjective. Following the identification of an injury as a bite mark, the comparison of the pattern produced to a suspects dentition is even more contentious and an area of great debate within contemporary odontological practice. Like fingerprints and DNA, bite marks are unique to an individual - such as distance and angles between teeth, missing teeth, fillings and dental work. This type of impression evidence can be left in the skin of a victim and also can be in food, chewing gum and other miscellaneous items such as pens and pencils. The advent of DNA analysis and its recovery from bite marks has offered an objective method of bite mark analysis.

Estimation of postmortem interval using the data of insulin level in the cadaver׳s blood.

An assessment of levels of Insulin in cadaveric fluids, to estimate the postmortem interval (PMI) was carried out. To profile postmortem changes of Insulin, it was extracted at different intervals i.e. (0, 3, 6, 12, 24 h), from the heart of 22 human cadavers. The cases included were the subjects of accidental deaths without any prior history of disease and their exact time of death was known. Immunoanalyzer Cobas e-411 instrument was used to detect the relationship between the amount of Insulin and PMI. Level of Insulin was measured in cardiac blood. Statically, significant correlations between levels of Insulin and PMI were studied and correlation coefficients were calculated. SPSS (version 12.0) was used for statistical analysis. Insulin levels in cadaver blood are correlated significantly with PMI with a p value of <0.001. When insulin level increases by 1 unit the duration decreases by 0.93 units. The least square regression line is: [Duration(Y)=22.71−0.93 Insulin level (X)]

Homeless and unclaimed persons' deaths in north India (Jan 2008–Nov 2012): A retrospective study

Objectives Homeless and unclaimed dead bodies are a social as well as legal stigma on a countrys development index. In addition, homeless people are exposed to increased incidence of diseases, accidents and mortality. Lucknow city, a city situated in the heart of the great Gangetic plain in the northern region of India, is surrounded by rural towns and villages and has seen tremendous growth in the past few years; with this the problem of migrants and homelessness has also increased. This has resulted in a spectrum of problems relating to law and order, including frequent incidences of unclaimed dead bodies, both due to natural and unnatural causes. Few studies on this subject have been published in India. Study design Observational retrospective study. Methods Data was collected from the files of the Department of Forensic Medicine & Toxicology between 2008 and 2012. Results A total of 20877 autopsy cases were registered, out of which 3169 (15.17%) were unclaimed bodies. The majority of cases belonged to males (2218, 69.99%) as compared to females (951, 30.01%). Most unclaimed bodies were in the age group of 41–60 years (47.24%) and the least affected age group was 1–20 years (265, 8.36%). The most common manner of death was accident (1098, 34.64%), followed by suicide (1062, 33.51%), natural (927, 29.25%) and homicides (82, 2.59%). The most common cause of natural death in both males and females was chronic lung disease. Railway and road traffic accidents accounted for 516 (68.25%) accidental deaths in males, whereas in females they accounted for 301(88.01%). The most common mode of suicide among males was by poisoning (391, 48.81%), while poisoning (149, 57.08), hanging (78, 29.88%) and drowning (23, 8.81%) were the main modes of suicide in females reported in our study. Majority of the cases of deaths were reported during rainy season (2209, 69.70%). Conclusions This autopsy-based study tries to highlight the picture of homeless deaths in Lucknow and the problems faced by the law enforcing authorities. More research is needed to identify the health-related problems of such people and possible contributory factors to mortality.

The maxillofacial injuries: A postmortem study

Objectives: The aim of our study is to evaluate the incidence and etiology of maxillofacial fractures in autopsy cases of KGMU, Lucknow. Materials and Methods: The sample consisted of 444 autopsy cases with maxillofacial injuries, who were brought to the mortuary of KGMU, Lucknow, for postmortem in the last year. Parameters such as gender, age, cause, type, and site of injury are evaluated. Result: The results of this study show that road traffic accidents are the main reason for maxillofacial injuries in the deceased, followed by railway accidents. Maxillofacial injuries are more common in adult males than in females. Majority cases also involved maxilla and zygomatic along with mandible. The most common type of facial fracture was Le Fort-2 fracture. Conclusion: Maxillofacial injuries are commonly seen in adult males, due to RTA, involving maxilla, zygomatic and mandible and presenting as Le Fort-2 fracture.