Vinod Ashok Chaudhari

Positional Asphyxia: Death Due to Unusual Head-Down Position in a Narrow Space.

AbstractDeath due to a head-down position with hyperflexion of the neck is a rare event. A person accidentally falling into a narrow space and remaining in an upside-down position with no timely recovery may experience positional or postural asphyxia. It is a critical condition arising out of particular body positions, leading to mechanical obstruction of respiration. The precipitating factors are intoxication due to alcohol, drugs, obesity, psychiatric illnesses, and injuries. A 30-year-old unmarried woman, weighing 82 kg and with a body mass index of 31.24, was found in a narrow space between the bed and the wall in a naked state and in a head-down position with hyperflexion of the neck. The distribution of lividity was consistent with the position of the body at the scene. Blood was oozing from the mouth and nostrils, and signs of asphyxia were present. The toxicological analyses of viscera, blood, and urine were negative for alcohol, drugs, and poisons. Glucose levels in the blood (86 mg/dL) as well as urine and vitreous humor levels (68 mg/dL) were within normal limits. On microscopic examination, there were no findings of coronary atherosclerosis, whereas the brain and lung were edematous. After meticulous examination, we ruled out sexual assault, autoerotic asphyxia, epilepsy, psychiatric illness, diabetes, toxicity, and coronary artery disease. Death was attributed to the accidental fall of the obese individual being stuck in a narrow space, resulting in positional asphyxia. It is imperative to recognize the precipitating or risk factors before labeling positional asphyxia as a cause of death.

Blending of rodenticide and battery acid – a rare and fatal suicide mix

BackgroundSelf-poisoning usually occurs by the ingestion of a single lethal compound and majority of the poisoning cases in our country are due to the pesticides. Suicide by ingestion of more than one poisonous substance is rare except alcohol and multiple drugs. To the best of our knowledge, suicidal ingestion of a mixture of rodenticide and battery acid has not been reported before in medical literature.Case presentationHere we are discussing a case of simultaneous ingestion of two poisonous substances, i.e., aluminium phosphide and battery acid. In general, an acid is mainly locally acting while metal phosphide is a systemic poison. Features suggestive of both these poisonous substances were noticed on clinical, autopsy and histopathological examination and supported by a positive chemical analysis report of viscera. Moreover, we analysed the possible reactions which may occur between these two compounds and their by-products outside and inside our body.ConclusionIn cases where, combination of poisons is suspected a proper history, meticulous autopsy and ancillary investigation including histopathogy and analytical toxicology are required to conclude the cause of death and mechanism of poisoning.

Occupational death due to bilateral carotid artery occlusion – A medico-legal case report

Occupational deaths are work-related deaths and usually occur in the work place of an individual. A case of occupational death in a female factory worker has been described, where the saree she was wearing accidentally got entangled in the moving belt and caused ligature strangulation. She was unconscious throughout indicating bilateral occlusion of the carotids and died a day after the incident. The authors have described the correlation between the distribution of the injuries on the body and the manner a saree is worn. Investigation of the workplace revealed that the place where she was standing was located between two machines, and the space was inadequate for normal movement. Some suggestions have been offered which may decrease the incidences of occupational ligature strangulation due to entanglement of dress materials in the moving machineries.

Atypical Exit Wound in High-Voltage Electrocution

Abstract Electrocution fatality cases are difficult to investigate. High-voltage electrocution burns resemble burns caused by other sources, especially if the person survives for few days. In that case, circumstantial evidence if correlated with the autopsy findings helps in determining the cause and manner of death. In addition, the crime scene findings also help to explain the pattern of injuries observed at autopsy. A farmer came in contact with a high-voltage transmission wire and sustained superficial to deep burns over his body. A charred and deeply scorched area was seen over the face, which was suggestive of the electric entry wound. The exit wound was present over both feet and lower leg and was atypical in the form of a burnt area of peeled blistered skin, charring, and deep scorching. The injuries were correlated with crime scene findings, and the circumstances that lead to his electrocution are discussed here.

Comprehensive Care for Victims of Child Abuse - Multi Disciplinary Child Protection Center (MCPC) in Mumbai, India

Cases of child abuse are very common in occurrence in India. But very few cases of child abuse are reported to the authorities, even when the problem gets identified, lack of social awareness on the gravity of this issue and ways to deal with it makes it difficult to ensure any kind of support to the victimized child. The vulnerable population often approach hospitals with health related complaints. The health service providers are in a position to identify signs of abuse upon their patients. Thus the medical system is potentially powerful and capable of providing treatment beyond physical healing.