Vikram Palimar

Self-inflicted burns fatalities in Manipal, India.

Death due to burns is an important public health problem. Suicide by burning is uncommon in the Western world compared with Asian countries. This study presents retrospective research carried out in the tertiary care teaching hospital of Kasturba Medical College, Manipal, Southern India, between January 1993 to December 2003 (11years). Out of a total of 343 burns deaths during the above-mentioned period, 39 were victims of suicide. The majority of deaths (46.1%) occurred in the 21-30 years age group, with a preponderance of the female sex (79.5%). Most of the victims belonged to the Hindu religion and the incident occurred mostly during the daytime. In the overwhelming majority of cases, the incident occurred at home (97.4%). In all cases kerosene was the accelerant and flame was the causative agent. In more than fifty per cent of cases, the total body surface area (TBSA) involved was more than 80%. Dowry demands and harassment were the reasons for committng suicide in 12 cases. More stringent laws and empowering female independence, both mentally and economically, will reduce suicidal burns in young women.

Unusual methods of suicide: complexities in investigation

Differentiation between suicide and homicide often becomes difficult owing to the unusual methods of suicide used by the victim and the complexities thus posed. Investigating the cases of unusual suicides provides a considerable challenge to the authorities concerned. The issue of homicide should often be ruled out in such cases, which require careful evaluation. This is best done by correlating the morbid anatomical findings at autopsy with the death scene analysis coupled with psychological autopsy. Many forensic practitioners have reported unusual methods of suicide at their respective workplaces. Various types of unusual methods of suicide and the complexities involved in their investigation are presented and discussed.

Wounds due to a modified shot gun (home-made): A case report

In a case of firearm fatality, the autopsy surgeon is required to opine as to the range of fire in addition to the cause of death which will help in reconstruction of the events. Problems may arise in estimating the range of fire based on wound ballistics when there is an alteration or modification in the internal ballistics. We encountered such a case in the department of Forensic Medicine, Kasturba Medical College, Manipal, which is discussed.

Autopsy study of fatal deliberate self harm

A retrospective autopsy study of fatal deliberate self harm (FDSH) was undertaken in the mortuary of Kasturba Hospital, Manipal, Southern India over a period of 12 years (1993-2004). Out of 1917 cases autopsied, 21.2% were deaths due to deliberate self harm (DSH). The male sex (66.1%) and victims in the third decade of life (35.9%) predominated. More than two-thirds of the decedents were married. More fatalities were observed during the winter season (35.8%) and in the day time (62.2%). Dispair with life (61.9%) was the most common motive for FDSH. The majority of fatalities were due to poisoning (73.5%), where organophosphorous compounds topped the list (71.9%). About one-third of the victims survived for 18 to 24 hours after DSH.

A comparative analysis of suicide and parasuicide

A prospective study was conducted to analyse the spectrum of suicide attempters and completers at Kasturba Hospital, Manipal, India, over a period of three years (January 2001 to December 2004). The present study comprised a total sample population of 246 cases, of whom 90 died and 156 survived the attempt (1:1.73). Men outnumbered women in the deceased group and women surpassed men in the survivor group. The mean age for the deceased group was 42 years compared with 30 years for the survivor group. Prior attempted suicide in the deceased group was 6.6%. Eighty-three percent of the total population studied opted for ‘chemical methods’, where insecticides topped the list (64.6%) in both the deceased and the survivor group. Among those who preferred ‘physical methods’, 50% died and 50% survived. In the current study, 17% of the subjects had received a psychiatric consultation, of whom 91.3% were diagnosed in the spectrum of ‘depressive disorders.’ Knowledge about the legalities of suicide was lacking in 65% of victims and their kin.

A case series of tuberculosis related sudden death

Tuberculosis is one of the most common infectious diseases in India. Deaths due to its complications are rare but reported. Sudden deaths due to tuberculosis constitute a major public health problem in the developing countries. These cases pose a danger to the community both during life as well as after death. Three cases of sudden death due to tuberculosis are discussed.

Estimation of Stature from the Arm Span of an Individual in South Indian Population

Background: Body height is a vital measure of body size and gives an assessment of the nutritional status of an individual. But, the precise body height cannot always be determined by the normal method because of several malformations of the extremities, or in patients who have undergone amputations or similar injuries. In such cases, an estimation of body height can be derived from other reliable anthropometric indicators, such as hand length, foot length, and arm span of the individual. Objective: The aim of this study is to observe the body height in both sexes of the South Indian population and the relationship between arm span and body height. Materials and Methods: The study was carried out on of 30 postmortem cases that came for autopsy. Their height and arm span was measured using a measuring tape. The data was statistically analyzed by computation to find out its normative value. The relationship between body height and arm span will be determined using simple correlation coefficients. Results: There was a significant correlation between the height of an individual and the arm span, in males (P value: 0.000) as well as in females (P value: 0.009). Conclusion: This study will be significant to forensic experts, human biologists, and physical anthropologists for the determination of stature from the arm span of the individual.

Stature Estimation using Interacromial Length in South and North Indian Population

Objective: In medicolegal autopsies, establishing personal identity of the dead is often necessary and assessment of the stature from extremities plays a vital part in identifying the dead in forensic examinations. The aim of the present study was to derive a regression equation for estimating stature using the interacromial length. Materials and Methods: 200 normal human subjects belonging to south and north indian population from kasturba medical college, Manipal were used for the study. Their age ranges from 16-23 yrs. The stature and interacromial distances were measured with a measuring tape. The statistical analysis was carried out and a regression equation for estimating the stature from the interacromial length was derived for both males and females. Results: The mean interacromial distance in males and females was 36.98 ± standard deviation (SD) cm and 32.5 ± SD cm, respectively, and the mean height in males and females was 176 ± SD cm and 160.5 ± SD cm, respectively. Regression equation formulae were derived from the present study to estimate stature from the interacromial distance in South and North Indian population. Conclusion: In forensic investigation, difficulties are experienced in the stature and gender assessment of bodies injured in mass destruction. The present study may be useful for forensic experts in identifying the stature from fragmentary remnants of the thorax whenever the same are recovered.

A morphometric study of measurements of heart in adults and its relation with age and height of the individual: A post-mortem study

Objective: Reconstructive and replacement operations of diseased cardiac valves are commonly practiced these days. It may be noted that the choice of proper reconstructive intervention and prosthetic replacement might require the normal morphometric measurements of heart in relation with general body parameters, like age and height. So, this study was undertaken to measure various measurements of heart and its relation with age and height of the individual. Materials and Methods: Sixty five normal post-mortem hearts of adults were taken from the mortuary of Department of Forensic Medicine. Age of the individual was noted. Length of the deceased was measured with a measuring tape from the level of vertex to the outer border of heel. Length (from apex to base), breadth (at broadest diameter) and thickness of the heart were measured with slide callipers. Weight was measured with weighing machine. Results: The mean length, breadth, thickness of heart in males and females are 11.25, 8.78, 3.97 cm and 10.60, 8.31, 3.63 cm. The mean weight of heart in males and females was 323 and 276 gms. There was significant correlation with weight of individual and weight of heart in males. There was significant correlation with age of individual and length of heart in females. Conclusion: This study will be helpful for cardiothoracic surgeons while doing surgery on hearts.

Excavation of the chest due to railway mishap

Injuries sustained due to railway mishaps are well documented. In these mishaps, ascertaining the cause of death is usually not difficult, but frequently circumstances do raise questions as to the manner of death. It is a real challenge for an autopsy surgeon to correlate the alleged history with injuries present on the body, thereby helping the investigating officer to come to a conclusion on the manner of death. Here, we present a case of an unusual excavation injury to the chest due to train impact, and discuss the mechanism of causation of this injury and the manner of death.