Y.P. Raghavendra Babu

Sex estimation from foramen magnum dimensions in an Indian population

Identification of skeletal remains is vital in forensic investigations. The need for methods to estimate sex from cranial fragments becomes apparent when only a part of skull is brought for identification. The present research is an attempt to study the sexual dimorphism of the anteroposterior diameter, transverse diameter and area of foramen magnum in a population of costal Karnataka region using statistical considerations. Ninety adult dry skulls of known sex (50 male and 40 female) were included in the study. Morphometric analysis of foramen magnum was conducted using vernier calipers and the area of foramen magnum was calculated. The anteroposterior diameter, transverse diameter and area of foramen magnum are found to be significantly larger in males than females. Binary Logistic Regression (BLR) analysis was performed to derive models for estimation of sex from the different measurements of foramen magnum and Receiver Operating Characteristic (ROC) curve was drawn for the predicted probabilities obtained from BLR analysis. The predictability of foramen magnum measurements in sexing of crania was 65.4% for transverse diameter and 86.5% for the anteroposterior diameter. For the area of foramen magnum that was calculated using the formula derived by Radinsky and Teixeria, the predicted probabilities were observed to be 81.6% and 82.2% respectively. When anteroposterior and transverse diameter were used together in BLR analysis the predictability of sex increased to 88%. However, considering the overlapping in the male and female values for the foramen magnum measurements it is suggested that its application in sex estimation should be restricted to cases where only a fragment of base of the skull is brought for examination. In such cases, the anteroposterior diameter and area of the foramen magnum can be employed as better tools for sexing the skulls than the transverse diameter of the foramen magnum.

Proportion of depression and its determinants among type 2 diabetes mellitus patients in various tertiary care hospitals in Mangalore city of South India

Background: Depression is found to be common among patients with diabetes and it is associated with poor outcomes in disease control. This study was carried out to find out the proportion and determinants associated with depression among patients with established type 2 diabetes mellitus (T2DM) in various tertiary care hospitals in Mangalore city of south India. Materials and Methods: This study was conducted in one government and three private tertiary care hospitals in Mangalore in December 2010. All consenting patients with confirmed diagnosis of T2DM were interviewed and screened for depression by administering the 9-item PRIME-MD Patient Health Questionnaire (PHQ-9). Results: Of the 230 T2DM patients, 119 (51.7%) were males. The mean age of all participants was 53.61 ± 10.7 years. The median duration of T2DM was found to be 12.1 ± 7.35 years. Among the participants, 71 (30.9%) met the criteria for moderate depression, 33 (14.3%) for severe depression, and the remaining 126 (54.8%) had no clinically significant depression. Only 26 (11.3%) patients were already aware that they were depressed, of whom just 3 had taken medical consultation. Among the risk factors, depression was found to be significantly associated with older age, female gender, low socioeconomic status, unskilled and retired employment status, having complications due to T2DM or comorbidities like hypertension and coronary artery disease, being overweight and being on insulin syringe injections. Conclusion: This study found a high proportion of depression among patients with T2DM. Therefore the care of individuals with diabetes mellitus (DM) should include the screening and possible treatment of depression in order to achieve and sustain treatment goals.

Sexual dimorphism of the index to ring finger ratio in South Indian adolescents.

Sex determination from prepubertal human remains is a challenge for forensic experts and physical anthropologists worldwide as definitive sexual traits are not manifested until after the full development of secondary sexual characters that appear during puberty. The research was undertaken in 350 South Indian adolescents to investigate sexual dimorphism of the index and ring finger ratio. The index finger length (IFL) and the ring finger length (RFL) were measured in millimeters in each hand and the index and ring finger ratio was computed by dividing the index finger length by the ring finger length. Mean RFL was greater than mean IFL in both males and females. Mean RFL was significantly higher in males. The index and ring finger ratio showed a statistically significant difference between males and females (p </= 0.001). The index and ring finger ratio was found to be higher in females (0.99) when compared to their male counterparts (0.95). The index and ring finger ratio thus shows sexual dimorphism in the South Indian adolescents that may prove useful to determine the sex of an isolated hand when it is subjected for medicolegal examination. The study suggests that a ratio of 0.97 and less is suggestive of male sex, while a ratio of more than 0.97 is suggestive that the hand is of female origin among South Indian adolescents.

Sudden death due to pulmonary aspergillosis

Sudden death due to respiratory pathology is not uncommon and tuberculosis with its complications is well known to cause death. We report a case of a male, train passenger, who started coughing out blood and died on reaching the hospital. Medicolegal autopsy confirmed the sudden unexpected death to be due to pulmonary aspergillosis in the person with past medical history of tuberculosis.

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.

Colchicine poisoning: a case report and review of literature

Colchicine, a natural pseudo-alkaloid found in plants such as the Colchicum autumnale and Gloriosa superba has tremendous medicinal properties, but if misused by an unqualified person can result in fatal consequences. We report a case of colchicine poisoning in an adult man as a result of consumption of the herb G. superba by a 50-year-old man and review the literature.

The Mangalore Aircrash of 22 May 2010: Practical Problems Related to Identification of the Dead in a Populous Developing Country

It was a sad and emotional moment for the citizens of Mangalore, India when the “Dubai to Mangalore” Air India Express Boeing 737-800 flight IX-812 crashed at the Mangalore International Airport on 22 May 2010, killing 158 people on board. Identification of the victims was difficult as most of the bodies were charred beyond easy recognition. The practical problems faced by the legal authorities in identifying the charred victims in a populous and developing country like India are discussed in this paper.

Mortality among homeless and unclaimed bodies in Mangalore city – An insight

Homelessness is a social as well as legal stigma on a Countrys development index. In addition homeless people are exposed to increased incidence of diseases and accidents. Mangalore city, a bustling city located in Southern costal region of India, has seen tremendous growth in the past few years; with this the problem of migrants and homeless has also increased. This has invited a spectrum of problems relating to law and order including frequent incidences of unclaimed dead bodies, both due to natural and unnatural causes. This autopsy based study tries to highlight the situation of picture of homeless deaths in Mangalore and the problems faced by the Law enforcing authorities.

Adenomyomatous polyp of the uterus: Report of an autopsy case and review of the literature

Adenomyomatous polyps of the endometrium are a rare subtype of endometrial polyps. In addition to the usual features of endometrial polyps, they also contain a smooth muscle component. Grossly they appear no different than ordinary endometrial polyps. In the case reported herein, a 23-year-old nulliparous female was killed in a traffic accident. In the course of the medicolegal autopsy, a small pedunculated growth was identified in the fundus of the endometrial cavity. Histologically the mass consisted of endometrial glands intimately mixed with smooth muscle and thick walled blood vessels, consistent with an adenomyomatous polyp. There was no history of tamoxifen use in this individual. To our knowledge this is the first report of post-mortem diagnosis of an adenomyomatous polyp. Furthermore, this is the first report of an individual with this diagnosis younger than the fourth decade. In the medicolegal setting, forensic pathologists are constantly faced with entities that, while they may not have caused death, may serve to educate practitioners about rare lesions. This individuals finding serves as one of those entities. This case reiterates the importance of the autopsy as not only the answer to an individuals death, but as an avenue for the discovery of entities that may have relevance to those who are still living.

Sudden unexpected death due to strangulated inguinal hernia

Sudden unwitnessed, unexpected deaths when the bodies are found in public places require a complete and meticulous medicolegal autopsy to ascertain the cause and manner of death to avoid further unnecessary investigations by the legal authorities. Such deaths attributed to gastrointestinal causes at autopsy are relatively uncommon. We report a case of sudden unexpected death due to strangulated inguinal hernia in a 60-year-old man. The body was discovered in a public area near a place of worship. The present case illustrates a potentially preventable sudden unexpected death due to a surgically correctable gastrointestinal condition. In the present case, the individual feared being hospitalised for treatment of his scrotal swelling with potential surgery and the eventual loss of daily income. In our opinion, such apprehensions may have delayed the potentially life-saving hospital surgical intervention in the individual.