Journal of Forensic and Legal Medicine RSS feed: Current Issue. The Journal of Forensic and Legal Medicine is part of Elsevier's forensic package. For more information, go to: http://www.elsevier.com/locate/forensics The Journal of Forensic and Legal Medicine provides a forum for the rapid publication of topical articles on legal medicine and all clinical aspects of forensic medicine and related specialities. The Journal carries definitive reviews, original communications, hypotheses, learning points of important issues, offering critical analysis and scientific appraisal. All submissions are peer-reviewed by at least two independent reviewers, and the Journal is listed in MEDLINE/Index Medicus. All aspects of legal medicine, the coronial system and the medical principles of care and forensic assessment of living individuals, whether adult or child, in contact with the judicial system are examined and the Journal has a broad international perspective. Topics covered in the journal include, but are not necessarily limited to, the following, particularly with relevance to the clinical setting: forensic medicine forensic pathology forensic science forensic toxicology forensic odontology forensic anthropology forensic psychiatry forensic genetics death and care in custody training, forensic nursing occupational health of police, fitness to interview death investigation and causes of death forensic medicine national systems human identification entomology and palynology taphonomy mental health criminology, profiling child abuse and neglect interpersonal violence, assault and injury, personal injury, elder abuse, domestic violence sexual assault suicide, parasuicide and deliberate self-harm restraint injuries drug and alcohol misuse drink and drug driving traffic medicine, transportation medicine, refugee and asylum medicine medical law, medical ethics euthanasia and end of life issues consent confidentiality clinical negligence professional regulation patients'complaints procedures medical disciplinary procedures the coronial system clinical governance clinical risk management clinical performance review procedures criminal charges arising from clinical practice such as murder, manslaughter and indecent assault the sick doctor the validation, licensing and certification of doctors mass disaster, war graves torture extra-judicial deaths human rights http://www.jflmjournal.org/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Journal of Forensic and Legal Medicine1752-928X173April 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.jflmjournal.org/article/PIIS1752928X10000119/abstract?rss=yesAims & Scope/Editorial Board10.1016/S1752-928X(10)00011-9Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6iihttp://www.jflmjournal.org/article/PIIS1752928X09001978/abstract?rss=yesAbstract: A substantial part of the pedestrian accident problem arises from intoxicated pedestrians. Possible countermeasures are reviewed, organised into: (a) prevention of high levels of intoxication in pedestrians, (b) minimising pedestrian activity in the intoxicated, and (c) minimising risk of injury among intoxicated pedestrians. It is concluded that improved safety of intoxicated pedestrians is most likely to come about by making the environment safer for all pedestrians, drunk or sober. The measure that would be expected to have the greatest effect quickest is a reduced speed limit, especially in locations where traffic is busy and there are many pedestrians.Countermeasures to the problem of accidents to intoxicated pedestriansT.P. Hutchinson, C.N. Kloeden, V.L. Lindsay10.1016/j.jflm.2009.11.004Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Review115119http://www.jflmjournal.org/article/PIIS1752928X09002169/abstract?rss=yesAbstract: A 36-year old male was found dead inside a pub bath lying in a pool of blood.A small single-edged knife was discovered on the top of the water cistern. Multiple sharp weapon wounds at the usual sites of self-inflicted injuries were reported. It was possible to hypothesize a carotid artery injury as a bloodstain pattern compatible with high pressure blood exiting from a severed artery.At autopsy 39 stab and incised wounds were found: the left forearm showed 13 incised wounds, one of which deep enough to sever the radial artery, while 14 ones were found on the right forearm. Neck observation revealed three deep cut injuries but none reached the internal jugular vein or the carotid artery. On the chest there were nine stab wounds, one of which injured the heart apex leading to a 80ml haemopericardium. Toxicological screening resulted as negative.Death was attributed to haemorrhagic shock following left radial artery injury.On the basis of circumstantial evidences and autopsy findings, there was no doubt that this was a suicide.The authors suggest that a complete forensic approach by means of scene investigation, autopsy as well as toxicological analysis is fundamental in discriminating between homicide and suicide.A fatal case of suicidal stabbing and cuttingFrancesco Ventura, Alessandro Bonsignore, Massimo Gallo, Federica Portunato, Francesco De Stefano10.1016/j.jflm.2009.12.006Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Review120122http://www.jflmjournal.org/article/PIIS1752928X09001966/abstract?rss=yesAbstract: Air weapons whether rifles or pistols are, potentially, lethal weapons. The UK legislation is complex and yet little known to the public. Hunting with air weapons and the laws controlling those animals that are permitted to be shot with air weapons is even more labyrinthine due to the legal power limitations on the possession of air weapons. Still relatively freely available by mail order or on the Internet, an increasing number of deaths have been reported from the misuse of air weapons or accidental discharges. Ammunition for air weapons has become increasingly sophisticated, effective and therefore increasingly dangerous if misused, though freely available being a mere projectile without a concomitant cartridge containing a propellant and an initiator.Air gun wounding and current UK laws controlling air weaponsRobert Michael Bruce-Chwatt10.1016/j.jflm.2009.11.003Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Clinical Practice123126http://www.jflmjournal.org/article/PIIS1752928X09002194/abstract?rss=yesAbstract: The increasing role of DNA sampling of the saliva on and around the tooth marks on skin or other objects has perhaps led some to rely on this as too much of a gold standard to the detriment of more established and well-tried methods of odontological forensic detection.Forensic odontology should not become, as Geoffrey Pyke (1893–1948) the maverick inventor during the Second World War, once described such lost knowledge: “A lesson in collective forgetfulness”. This was said about the use of self sterilizing sphagnum moss as a field dressing due to a content of phenolic compounds. One amongst many of perhaps 350 species of the genus Sphagnum; Sphagnum angustifolium, was used as a highly absorbent wound dressing in both World Wars, the Spanish Civil War and before.A brief history of Forensic odontology since 1775Robert Michael Bruce-Chwatt10.1016/j.jflm.2009.12.007Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Clinical Practice127130http://www.jflmjournal.org/article/PIIS1752928X0900016X/abstract?rss=yesAbstract: Modern Greek society appears to be split regarding the legalization of euthanasia. The Greek Orthodox Church maintains a negative attitude. Research shows that some forms of euthanasia are carried out “behind closed doors”. There is no specific legal provision. The government avoids bearing the political cost of regulating this marginal issue. According to the dominant view of Criminal Law jurists, some forms of euthanasia are considered permissible de lege lata, under certain conditions. The safety of the concurrence of these conditions, safeguarding of the acceptability of forms that are considered permissible and – mostly – the need to regulate the prohibited forms in exceptional cases, all force the legislators to promptly fill any legal vacuums.The issue of euthanasia in Greece from a legal viewpointPolichronis Voultsos, Samuel N. Njau, Maria Vlachou10.1016/j.jflm.2009.01.014Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Original Communications131136http://www.jflmjournal.org/article/PIIS1752928X09001590/abstract?rss=yesAbstract: Some consider the terms “forensic” and “legal” medicine to be synonymous but this is counter to the title of the Faculty of Forensic and Legal Medicine or the dual strands for progression to fellowship of the Australian College of Legal Medicine. The paper examines a very brief historical background to legal medicine and develops a definition of the strands thereof, namely legal and forensic medicine. It demonstrates that the two are different components of the application of medical knowledge upon the legal system. Legal medicine has greater relevance to civil and tort law, impacting upon patient care, whereas forensic medicine relates to criminal law and damage to, or by, patients.What is legal medicine – Are legal and forensic medicine the same?Roy G. Beran10.1016/j.jflm.2009.09.011Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Original Communications137139http://www.jflmjournal.org/article/PIIS1752928X09001760/abstract?rss=yesAbstract: This retrospective clinical audit reviews cases of adult sexual assault where the victim alleges that they were penetrated with a foreign object. These assaults were more likely to have positive genital and non-genital findings recorded by the clinician compared to assaults where no object was used. There is a suggestion that these assaults may be more violent with multiple assailants more common and an association with more use of threats and weapons. It is important to ask about the penetrative use of foreign objects in a sexual assault history and for clinicians to be aware of the greater possibility of injury in these cases.Characteristics of sexual assaults in which adult victims report penetration by a foreign objectElizabeth Ann Sturgiss, Alexandra Tyson, Vanita Parekh10.1016/j.jflm.2009.11.001Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Original Communications140142http://www.jflmjournal.org/article/PIIS1752928X09001772/abstract?rss=yesAbstract: Introduction: Forensic experts are frequently asked to comment on the age of injuries and interpretation may have significant medico-legal consequences. The purpose of this study is to determine the accuracy with which forensic experts can visually age a bruise from photographs produced under standard conditions.Methods: Bruises were produced on the upper arms of 11 subjects by a suction pump. Sequential photographs were taken daily until they were no longer visible to the naked eye. Fifteen forensic experts who did not know the age of the bruises were asked to estimate their ages and also to place them in chronological order.Results: Hundred and thirty-two images of 25 bruises were produced, ranging from 0 to 209h in age. There was considerable inter- and intra-observer variability in accuracy (median difference between the estimated age and the real age=26.0h (95% C.I. 24.0–31.0h). There was greatest accuracy for bruises photographed between 0 and 12h. No significant differences were seen between male and female observers (p=0.553) and performance was also unaffected by the age of the observer (p=0.160). Of the bruise images placed in chronological order >80% of the observers made between 0 and 2 errors.Conclusion: Bruise age estimates by forensic experts, from photographs, are unreliable. However, it appears that the vast majority of observers are better able to place bruises from the same subjects in their chronological order.Visual assessment of the timing of bruising by forensic expertsM.L. Pilling, P. Vanezis, D. Perrett, A. Johnston10.1016/j.jflm.2009.10.002Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Original Communications143149http://www.jflmjournal.org/article/PIIS1752928X0900198X/abstract?rss=yesAbstract: Objectives: Heretofore, sex determination has been carried out on skeletal remains to identify individuals in forensic cases and to assess populations in archaeological cases. Since it has been shown that not all bones are found in a forensic case, discriminant function equations should be derived for various bones of the body to assist in sex determination. The aim of this study was to derive discriminant function equations for sex determination from measurements of the patella.Methods: In a prospective study, dimensions of patella were measured using the fresh cadavers of Iranian population as referred to the Tehran’s Legal Medicine Organization.Results: A total sample of 113 (57 male, 56 female) patellae were measured using three measurements. Stepwise and direct analyses were performed with the average accuracy of 92.9% for sex classification, thereby making the patella useful for sex determination.Conclusions: The results of this study confirm the high accuracy of using the measurement of the patella for sex determination. Until further data collected suggests otherwise, the results expected in present study are limited to forensic cases of the Iranian population.Identification of sex in Iranian population using patella dimensionsMitra Akhlaghi, Ardeshir Sheikhazadi, Ali Naghsh, Gholamali Dorvashi10.1016/j.jflm.2009.11.005Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Original Communications150155http://www.jflmjournal.org/article/PIIS1752928X09002145/abstract?rss=yesAbstract: Estimation of stature from extremities plays an important role in identifying the deceased in forensic examinations. This study examines the relationship between stature and hand and phalanges lengths among Egyptians. Stature, hand and phalanges lengths of 159 subjects, 82 males and 77 females (18–25years) were measured. Statistical analysis indicated that bilateral variation was insignificant for all measurements. Sex differences were significant for all measurements. Linear and multiple regression equations for stature estimation were calculated. Correlation coefficients were found to be positive, but little finger measurements of male and distal phalanges of female fingers were not correlated with stature. Regression equations were checked for accuracy by comparing the estimated stature and actual stature.Stature estimation from hand and phalanges lengths of EgyptiansSahar Refaat Habib, Nashwa Nabil Kamal10.1016/j.jflm.2009.12.004Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Original Communications156160http://www.jflmjournal.org/article/PIIS1752928X09001577/abstract?rss=yesAbstract: A case is discussed of an adolescent presenting with a rectovaginal fistula secondary to a sexual assault 2 years earlier. The fistula resulted from a retained foreign body (bottle cap) inserted into the vagina during the assault. The adolescent did not disclose the presence of the foreign body at the initial examination.Foreign body sexual assault complicated by rectovaginal fistulaRobyn Carey, Clare Healy, Dawn E. Elder10.1016/j.jflm.2009.09.009Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Case Reports161163http://www.jflmjournal.org/article/PIIS1752928X09001759/abstract?rss=yesAbstract: In clinical medicine, plane radiography is used for detecting the remains of medications in the stomach in oral medication intoxication cases. Since postmortem computed tomography (CT), performed prior to autopsy, is currently intensively entering the forensic routine, the technique was applied to three fatal cases of oral medication intoxication. Here we report CT and autopsy findings for these cases.In all three cases, hyperdense areas within the stomach content were documented. The measurement of Hounsfield Units (HU) beyond 74HU showed mean values of 338, 88 and 98HU. Postmortem CT also showed brain edema and pulmonary aspiration in one case. At autopsy, tablet remains in the stomach were detected microscopically in all three cases. The ex vivo CT scans of the ingested medicaments showed similar HU values.Despite the fact that further case studies are necessary beyond this one, and in spite of its limitations, postmortem CT was found to be a useful screening and documentation method for stomach contents in oral medication intoxication.Radiopaque stomach contents in postmortem CT in suicidal oral medication intoxication: Report of three casesEmin Aghayev, Christian Jackowski, Andreas Christe, Michael Thali10.1016/j.jflm.2009.10.001Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Case Reports164168http://www.jflmjournal.org/article/PIIS1752928X09002121/abstract?rss=yesAbstract: Firecracker display is used worldwide for celebrating religious festivities, New Year celebrations and various other occasions. Explosion during the manufacture of firecrackers can result in serious injuries. We, herein, report a case, where a person succumbed to injuries sustained in an explosion in a firecracker factory. Superficial to deep burns, traumatic amputation of right upper limb, and multiple abrasions and lacerations were present on various parts of the body with contusion of internal thoracic and abdominal organs. Also, multiple punctured circumscribed wounds with burnt floor and margins were present over the body.Circumscribed injuries caused by an explosion in firecracker factoryK.R. Nagesh, Ritesh G. Menezes, B. Suresh Kumar Shetty, Anand Menon10.1016/j.jflm.2009.12.002Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Case Reports169171http://www.jflmjournal.org/article/PIIS1752928X09002133/abstract?rss=yesDear Sir Each individual possesses a unique set of minute raised ridges on volar pads called ‘friction ridge skin’. These clear and apparent unique outlines of the ridges are called fingerprints. Fingerprints are highly individualistic and forms the basis for personal identification in forensic examinations. Recent studies have reported that females have a significantly higher ridge density than males. This information facilitates the investigating officer to narrow down the investigating process in a particular case and direct the criminal investigation towards suspects belonging to the most likely sex. The higher ridge density in females has been attributed to the level of ridge thickness and it is opined that females tend to have finer epidermal ridge details. Consequently, the females have significantly higher finger ridge density than males in a given area.Sex differences in fingerprint ridge density – Causes and further observationsKewal Krishan, Abhik Ghosh, Tanuj Kanchan, Chitrabala Ngangom, Jaydip Sen10.1016/j.jflm.2009.12.003Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Correspondence172173http://www.jflmjournal.org/article/PIIS1752928X09002157/abstract?rss=yesDear Editor, We read with interest a recently published research entitled “Autopsy Profiles of Malpractice Cases.” We are impressed with the study bringing out the details of the doctors and specialties implicated in malpractice cases in Turkey. However, we have some reservations.A response to “Autopsy Profiles of Malpractice Cases” [16(1) (2009) 7–10]Tanuj Kanchan, K. Pradyumna Majumdar, Ritesh G. Menezes10.1016/j.jflm.2009.12.005Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Correspondence173173http://www.jflmjournal.org/article/PIIS1752928X10000223/abstract?rss=yesAlcimedes10.1016/j.jflm.2010.02.006Journal of Forensic and Legal Medicine 17, 3 (2010)2010-04-01Journal of Forensic and Legal Medicine2010-04-01173S1752-928X(10)X0002-6Correspondence174174