Journal of Forensic and Legal Medicine

Aims & Scope/Editorial Board

2012-02-01

Sexual assault consultations – From high risk to high reliability

Nicola Cunningham — 2012-02-01

Abstract:

Autopsy following death by homicide in 644 cases

2012-02-01

Abstract: The objectives of this study are to determine the cause of death and based on the wounds, to analyze the different epidemiological variables on homicide in Dakar.Included were all homicides cases where an autopsy was performed and these results recorded in the autopsy register. The data collected in our work included, identity, sex, age, place of crime (location), the cause of death (the causative agent and the anatomical region injured) and the mechanism of death (the pathophysiological phenomenon causing death).On average 56 cases of homicide a year are reported, ranging from 44 cases in 2005 to 80 cases in 1999. Extrapolated to the population of Dakar this corresponds to 1.9 homicides per 100,000 inhabitants. Victims aged over 55 years represented only 4.03% of all victims. 6.52% of cases were infanticide. The crimes mainly took place in the suburbs of Dakar (51.42% of cases). Hand held weapons were used in 578 cases (89.7%) followed by firearms in 44 cases (6.8%).The study of the age of the victims has some interesting points. The homicide of elderly people in Senegal was relatively low in contrast to what is found in a developed country. The youthfulness of our population also explains the large number of homicide victims between 21 and 25. Infanticide is a particular problem in Senegal. In our study, 50.6% of homicides were found in the suburbs of Dakar followed by the peripheral area which accounted for 29.3% of homicides. The incidence of homicide can be directly correlated with the level of economic development. This frequency is much higher where incomes are low and particularly affect young males.The study of this phenomenon should lead to better prevention. The victim-type in Dakar is a young man, aged 20–25 years, killed by an instrument with an injury to the skull, neck, heart or main arteries, causing bleeding and death.

Sex identification in Egyptian population using Multidetector Computed Tomography of the maxillary sinus

Mohammed F. Amin, Eman I. Hassan — 2012-02-01

Abstract: Forensic anthropology involves the building of an antemortem profile of an individual from skeletal remains. This includes sex, race determination, and age and stature estimation. Because most bones that are conventionally used for sex determination are often recovered either in a fragmented or incomplete state, it has become necessary to use denser bones that are often recovered intact, eg, the maxillary sinus. The present work was performed to investigate the possibility of estimation of sex from some radiologic measurements among a known cross-section of Egyptian population. In this study, by the use of Multidetector Computed Tomography (MDCT) scan, eight maxillary sinus measurements were assessed in 96 living non-pathologic Egyptians comprising 48 males and 48 females aged 20–70 years referred to the Radiology Department. These were subjected to statistical analysis. Two variables showed significant differences: cephalo-caudal and size of the left maxillary sinus. The study concluded that the correct predictive accuracy was 70.8% in males and 62.5% in females. In conclusion, MDCT measurements of cephalo-caudal and size of the left maxillary sinuses are useful feature in gender determination in Egyptians.

Talus measurements as a diagnostic tool for sexual dimorphism in Egyptian population

Shereen Abd-elhakim Abd-elaleem, Mostafa Abd-elhameed, Ashraf Abd-elazeem Ewis — 2012-02-01

Abstract: Measurements of talus have been shown to be sexually dimorphic in South African blacks and whites and Prehistoric New Zealand Polynesians. Since several studies have demonstrated that discriminant function equations used to determine the sex of a skeleton are population specific, the purpose of the present study was to derive similar equation for the tali of Egyptians. The sample consisted of 110 tali (67 male & 43 female) whose age at death ranged between 20 and 60 years. The tali were obtained from Anatomy departments of Minia and Cairo Universities and also from Forensic Medicine department of Justice Office in Minia governates – Egypt. Twelve measurements were taken for every talus. Data were analyzed by SPSS version 16. All measurements showed significant sexual differences (P < 0.05) except calcaneus articular surface width and navicular articular surfaced width. Talar length was found to be the most sexual dimorphic (90.9%). Combination of talar length, talar width and neck width gave a percentage of accuracy of 85.5%. Finally, it is concluded that the talus of Egyptian population is useful for sex estimation.

Simultaneous analysis of some club drugs in whole blood using solid phase extraction and gas chromatography–mass spectrometry

André L. Castro, Sónia Tarelho, Armando Silvestre, Helena M. Teixeira — 2012-02-01

Abstract: The use of psychoactive substances to improve social relations and increase body energy, in Rave Culture, has raised many legal and health public concerns, both for illicit trade and consumption. Therefore, forensic toxicology plays an important role in this area, mainly linked to the detection and quantitation of these substances, both in vivo and in post-mortem samples. In fact, at the moment, forensic sciences have been under public authorities’ scrutiny and critical look, due to the increasing attention of the media and public opinion, always applying for the use of scientific knowledge to help solving forensic cases. However, forensic toxicology results are only reliable to solve legal cases if all the analytical methodologies used are appropriately validated.In this work, a methodology for the extraction and analysis of 7-aminoflunitrazepam, buprenorphine, flunitrazepam, ketamine, methadone, phencyclidine (PCP) and d-propoxyphene was developed for whole blood samples, with solid phase extraction (SPE), using OASIS® MCX SPE columns, and gas chromatography coupled to mass spectrometry.The procedure presented here proved to be reliable, specific, selective and sensitive, with good LODs and LOQs and good precision.The adoption of a SPE procedure with an automatic SPE extraction device, allowed an increased level of automation in sample treatment, being contemporarily less time-consuming, increasing productiveness, and allowing good recovery and appropriate selectivity being, also, simple and reproducible. The simultaneous detection and quantitation of all compounds by the same extraction and detection methodology is crucial and has a great potential for forensic toxicology and clinical analysis.

Incidence and outcome of prone positioning following police use of force in a prospective, consecutive cohort of subjects

2012-02-01

Abstract: The safety of placing suspects in the prone position following police use of force has been debated extensively, particularly in the context of sudden in-custody death. The proportion of individuals who remain in the prone position following police use of force is not known, nor has the epidemiology of sudden in-custody death in any position after police restraint been documented. Using a consecutive cohort of individuals in whom police used force, we prospectively documented the number of individuals who were placed in a prone versus not-prone position, and the prevalence of sudden in-custody death in either position. Data were collected for three consecutive years, through a single urban police service, in a city of over 1.1 million citizens. Officers prospectively documented the final position of the subject, among other data points, via electronic study forms embedded in standard use of force report forms. Final resting position was available for 1255/1269 subjects. The majority of subjects are male and demonstrated one or more abnormalities at the time of the event. We found that the majority (57.2%) of subjects were left in a not-prone position; the remainder were left in prone position. One subject died in a not-prone position, no subjects died in the prone position. The sudden in-custody death rate following police use of force was low overall (0.08%, 95% confidence interval (CI) = 0.002, 0.44) and the difference in the proportion of subjects who died suddenly in either position was not significant at 0.14%, (95%CI = −0.8, 0.9). Our results indicate that prone positioning was common and was not associated with death in our cohort of consecutive subjects following police use of force.

Suicide with two shots to the head inflicted by a captive-bolt gun

Laurent Fanton, Bernd Karger — 2012-02-01

Abstract: An exceptional case of suicide with two shots to the head inflicted by a captive-bolt gun is reported here. The pathophysiology observed, and related literature, indicate that the capacity of the victim to fire a second shot depended on the depth of skull penetration by the first shot and the extent of damage to nerve structures. In this case, an ante mortem multi-detector computed tomography was possible. From discussion with the radiologist and a 3D reconstruction, the two-shot suicide scenario could be confirmed.

What may be happen after an organophosphate exposure: Acute myocardial infarction?

Edibe Karasu-Minareci, Nuran Gunay, Kenan Minareci, Gulay Sadan, Gul Ozbey — 2012-02-01

Abstract: The increase in accidental organophosphate poisoning as well as the rise in the number of cases of suicide attempts with organophosphate compounds is due to primarily to the widespread use of these compounds in agriculture. Organophosphates are anti-acetycholinesterase agents and their toxicity affects many organs, including the pancreas, liver and heart. Cardiac complications often accompany poisoning with these compounds and may be serious and often fatal. However, little is known about the myocardial infarction risk associated with exposure to pesticides. Herein, a rare case of acute myocardial infarction due to acute exposure to organophosphate compound is documented with electrocardiogram, enzyme and clinical characteristics in this report.

The value of radiocarbon analysis in determining the forensic interest of human skeletal remains found in unusual circumstances

2012-02-01

Abstract: The case under analysis refers to the remains of a young adult female found in a shallow grave during the construction work of a hospital in Northern Portugal. The forensic interest of the finding could not be ruled out since distinguishing features pointing to an archaeological grave were lacking. For example, absence of archaeological artefacts could not establish its forensic significance with certainty, together with the absence of modern objects, such as remnants of clothing or personal objects. In addition, although the remains were badly preserved, the condition may not have resulted from a long post-depositional period, but instead could be explained by the geology of the site and the presence of plant roots. The radiocarbon analysis of the remains was meant to establish the death of the individual to before or after the mid-1950s, from comparison with bomb-curve content values. A value of 0.9789 ± 0.0044 for F14C (pmC = 97.19 ± 0.44% Modern or Δ14C = −28.1 ± 4.4‰) was obtained, which placed the death of the individual in the pre-mod-1950s period. This report illustrates the use of radiocarbon analysis in establishing whether the human remains are contemporary or not and describes evidence for what appears to be an historic clandestine grave.

Fatal idiopathic pulmonary haemosiderosis in association with pregnancy – Medico-legal evaluation

Klára Törő, Irén Herjavecz, Edit Vereckei, Margit Kovács — 2012-02-01

Abstract: Idiopathic pulmonary haemosiderosis is a rare disorder characterised by repeated episodes of intra-alveolar bleeding in association with consecutive anaemia, pulmonary fibrosis, pulmonary hypertension and respiratory failure. Pregnancy may exacerbate the symptoms of idiopathic pulmonary haemosiderosis typically worsening in the third trimester. A 32-year-old female after delivery was admitted to hospital with progressive dyspnoea of about 1-month duration. Sudden circulatory collapse caused fatal complication. During the post-mortem investigation, lung haemorrhage and histologically abundant iron deposition in macrophages and interstitial fibrosis were found. Medico-legal post-mortem evaluation of fatal cases may support the clinico-pathological context of the diagnosis of this entity.

Unusual case of right atrial reinfarction

Nemanja Radojevic, Slobodan Savic, Vuk Aleksic, Dragana Cukic — 2012-02-01

Abstract: It is well known that atrial infarctions are rare comparing to the ventricular. They cannot easily be verified on ECG and the standard autopsy technique does not include a detailed review of the atrial wall, so the atrial infarction often remains undiagnosed. A 63-year-old male was treated and died in an intensive care unit due to decompensated liver insufficiency and cardiac disease following long-lasting alcohol abuse. At autopsy, the extreme cardiomegaly was found, severe atherosclerosis of the anterior descending branch of left coronary artery. The posterior wall of the right atrium was thickened (cca 9 mm) in diameter of cca 3 × 3 cm, and this area was yellowish in the luminal part, while the central part was filled with dark red blood. A detailed dissection of the coronary arteries showed the complete occlusion of the atrial branch of the right coronary artery wreath as far as the place of sinoatrial artery branching, which corresponded anatomically to the described area of infarction on the posterior wall of the right atrium. Histopathological examination of the previously described area of the posterior wall of the right atrium, showed four zones of heart muscle changes: 1. zone of partially preserved structure of the heart muscle, 2. zone of cellular (immature) connective tissue, 3. areas of bleeding in cellular connective tissue, and 4. zone of acellular (old) connective tissue. These histopathological changes indicated that the posterior wall of the right atrium was affected by myocardial necrosis in at least two and possibly more times. It is reasonable to think that bleeding in the third zone of the posterior wall of the right atrium contributed greatly to the death due to the anatomical proximity to the sinoatrial node. It was confirmed by the existence of bradycardia with a prolonged PR interval, PR segment elevation in D1 and aVL lead and PR depression in the D3 lead on the ECG. These ECG changes appeared immediately before asystolia and the death of the patient, but not ventricular fibrillation or electromechanical dissociation due to ventricular infarction. The presented case shows that detailed autopsy examination of atrial wall and blood vessels can sometimes be crucial in disclosing the cause and mode of death if the ischemia and necrosis attack only the atrial wall, especially in the region of the heart conduction system.

Accidental penetrating brain injury through anterior fontanelle: A rare phenomenon

Shahbaz H. Faridi, V.K. Srivastava, M.F. Hoda, Mohd Khalid — 2012-02-01

Abstract: Penetrating injuries of the anterior fontanelle are exceedingly uncommon and are most often associated with inflictedinjury. This report of a 7-month-old male infant, whose father was working with a knife which accidentally slipped from his hand and penetrated the infants anterior fontanelle and frontal lobe, demonstrates that accidental injuries may also occur rarely.

Alcimedes

2012-02-01

The dubiously-named practice of “Honour Attacks,” which can range from beatings to murder, has once again hit the headlines. A recent Freedom of Information (FOI) study by the Iranian and Kurdish Women’s Rights Organisation (IKWRO) has concluded that the number of such attacks in the UK has increased to 2823 in the past year. Causes for the attacks include refusing an arranged marriage, having a relationship of which the family disapproves, being the victim of a sexual assault, and seeking a divorce.