Journal of Forensic and Legal Medicine

Aims & Scope/Editorial Board

2010-02-01

Fatal carbamazepine induced fulminant eosinophilic (hypersensitivity) myocarditis: Emphasis on anatomical and histological characteristics, mechanisms and genetics of drug hypersensitivity and differential diagnosis

Nebojsa Arsenovic, Loraine Sheehan, David Clark, Ricardo Moreira — 2010-02-01

Abstract: The most severe adverse reactions to carbamazepine have been observed in the haemopoietic system, the liver and the cardiovascular system. A frequently fatal, although exceptionally rare side effect of carbamazepine is necrotizing eosinophilic (hypersensitivity) myocarditis. We report a case of hypersensitivity myocarditis secondary to administration of carbamazepine. Acute hypersensitivity myocarditis was not suspected clinically, and the diagnosis was made post-mortem. Histology revealed diffuse infiltration of the myocardium by eosinophils and lymphocytes with myocyte damage. Clinically, death was due to cardiogenic shock. To best of our knowledge this is the second case of fatal carbamazepine induced myocarditis reported in English literature.

A half century retrospective study of homicide–suicide in Geneva – Switzerland: 1956–2005

2010-02-01

Abstract: This study provides a retrospective review from the forensic files of the University Centre of Legal Medicine in Western Switzerland in Geneva, from January 1956 to December 2005. The studied homicide–suicide cases cover a period of half a century (50years). As a rule, all police-ordered forensic examinations of violent death cases in the Canton of Geneva are conducted by the University Centre of Legal Medicine. All of the data necessary for an exhaustive retrospective study are thus readily available. During the period covered in this work, 228 homicides were perpetrated in Geneva. In 23 cases, the homicide was followed by the suicide of the aggressor. The 34 victims of these homicides (18 women, 1 man and 15 children) had either an intimate or filial relationship with the perpetrator. Most of the suicidal perpetrators were men that killed their spouses or intimate partners, with children as additional victims in some cases. Shooting was the most common means to kill, followed by stabbing. The majority of the victims and perpetrators were Swiss nationals. This retrospective study shows that in the last 50years, homicide–suicide cases in the Canton of Geneva have been a rare and an episodic phenomena with a very variable frequency from 1year to another.

Applications and limitations of Forensic Biomechanics: A Bayesian perspective

Michael D. Freeman, Sean S. Kohles — 2010-02-01

Abstract: Forensic Biomechanics is an analytic method intended for presentation in a court of law. The method consists of the reconstruction of an injury mechanism followed by a comparison between the injury risk of the mechanism and the injury tolerance of the individual. In recent years some courts have excluded such testimony based, in part, on the inability of experts to quantify the potential error of the methods they relied upon in reaching their conclusions. The application of Bayes’ Law to a forensic test of truth in a disputed matter allows for quantification of the error inherent in the method through the conditioning of the pre-test probability of the test outcome with the true and false positive rate of the test. The result of the calculation is the Error Odds (OE) for the test, or the ratio of correct to incorrect tests.We present an Error Odds analysis of seven previously published case studies in Forensic Biomechanics as an illustration of the utility of the OE as a metric for admissibility of testimony in the courts, with a minimum Error Odds ratio of 10 proposed as a threshold. The results of our analysis yielded only 1 of 7 cases of applied Forensic Biomechanics that surpassed the threshold for admissible testimony of 10, with most the cases falling below an OE of 3. The results of the present study suggest that the forensic application of biomechanics is potentially fraught with error. We suggest that an Error Odds analysis be incorporated in Forensic Biomechanics as part of the analysis as a form of quality control and as demonstrable evidence of the accuracy of the methodology.

Study of the normal internal organ weights in Tehran’s population

2010-02-01

Abstract: Objective: Examine the normal adult internal organ weight and its relationship with body height, body weight, body mass index and age.Materials and methods: Prospective analysis of data from 1222 autopsies in Legal Medicine Organization of Iran from 1st January, 2007 to 1st September, 2008. All the subjects were adult residents of Tehran died from external causes and showed no pathological changes.Results: The weight of the brain, heart, lungs, liver, spleen, pancreas, kidneys, thyroid gland, the pituitary gland, the suprarenal glands, testes, prostate, ovaries and the uterus were collected from 914 males and 308 females between 15 and 88years. The weight of all the organs was correlated statistically with at least one external parameter with the exception of the pancreas in men, the uterus, the spleen and the thyroid in women. Organ weights decreased with age except for the heart and the prostate, and increased in relation to body height and/or BMI. Except for the brain, the organ weight showed a better statistical correlation with the BMI than the body height.Conclusion: These results can be used as standard organ weights to determine abnormal evidences in Forensic and Pathologic corpses. However such results have to be regularly updated by pathologists in order to keep organ weight as a good criterion used in postmortem diagnosis.

Sex differences from fingerprint ridge density in the Indian population

2010-02-01

Abstract: Determination of individuality is one of the prime concerns in forensic investigation. The study of fingerprints is widely used in providing a clue regarding identity. The present study was undertaken to study the sex differences in fingerprint ridge density in the Indian population. The study done on 100 males and 100 females revealed that significant sex differences occur in the fingerprint ridge density. The present study shows a statistically significant difference in fingerprint ridge densities of male and female fingerprints in people of Indian origin. A mean fingerprint ridge density of 12 ridges/25mm2 or less is found to be more likely to be of males and a mean ridge count of more the 12 ridges/25mm2 is more likely to be of female origin.

Resuscitation and conjunctival petechial hemorrhages

H. Maxeiner, R. Jekat — 2010-02-01

Abstract: In recent years, cardiopulmonary resuscitation (CPR) has been discussed as a cause of petechial hemorrhage in eyelids and conjunctivae, which could be of substantial significance to forensic expertises in cases of suspected strangulation. In the reported series or case observations, the combination of CPR and petechiae seemed to be sufficient to explain such a causal connection. Nearly all presented cases were victims for which the mechanisms resulting in death were themselves well-known causes explaining the development of such petechiae; and said mechanisms can frequently be observed in victims that did not receive CPR. An earlier, also retrospective, analysis of a series of forensic autopsies did not confirm CPR as a significant cause of conjunctival petechiae. Now we present the result of a prospective examination of 196 resuscitations of adult patients with separate assessment of petechiae being present even prior to resuscitation. Petechiae were present in 12 cases – but in eight of them prior to resuscitation already. Three other persons with petechiae found only after CPR were in the group of successfully resuscitated persons and exhibited petechiae hours after CPR during therapy in intensive care units – during a phase of ongoing cardiac insufficiency, which obviously caused them. The only case with petechiae observed neither immediately prior to nor after unsuccessful resuscitation, but during a follow-up examination one day later, needs to be discussed. It is not interpreted as reliable evidence for the causality of CPR though. Our interpretation of reports in literature as well as our experiences confirm the absence of actual proof of petechiae being generated by CPR and in the presence of generally significant doubts of this relation.

Y-chromosomal STR haplotype diversity in males from Santa Catarina, Brazil

2010-02-01

Abstract: One-hundred and nine unrelated and healthy males from Santa Catarina, Brazil were included in this study. Allele frequencies and gene diversities for the loci DYS456, DYS458 and DYS448 were calculated. A comparison between our population and others was performed.

Chlamydia trachomatis infection in children: Do not forget perinatal acquisition: A case report of a 7-year old girl, C. trachomatis infected, presumed sexually assaulted

2010-02-01

Abstract: A 7-year old girl suspected of having been sexually abused owing to the presence of anal condyloma was found to be infected by Chlamydia trachomatis. Microbiological analysis and anamnesis were consistent with the infection having been acquired at birth. This case confirms that untreated infection acquired at birth can persist for months or years and highlights the value of examining those involved in the suspicion of sexual abuse of the child.

Chronic hepatitis C – Assessment in civil law: A case study

2010-02-01

Abstract: This article describes the case of a 58-year-old man who asked for an assessment of physical damage of a civil nature, having been diagnosed with chronic hepatitis C for which he blamed a blood transfusion, supposedly contaminated with hepatitis C virus (HCV). After studying the documentary information, a number of presuppositions were drawn up with a view to determining the causal nexus, but this could not be proved. The assessment of situations like this is not common in civil law. This article is intended to add to the body of information on the forensic assessment of similar cases.

Death by attack from a domestic buffalo

2010-02-01

Abstract: Attacks on humans by domestic animals causing fatal injuries are not uncommon in rural areas of India. But injuries due to buffalo gore are rarely observed in villages and are different from other casualties like stab injuries, road fatalities, etc. As the victims of buffalo attack are usually recovered from the fields or forest, the investigating officer could be mislead as to the nature of infliction of fatal injuries to a possible homicide. The injuries caused by the horns of buffaloes are of various shapes, sizes and directions. They are violent and goring in nature. The wound sustained may be contusions, lacerations, criss-cross wounds, penetration of body cavities, and sometimes fractures. In the absence of any eye witness, it becomes very difficult to believe the unsuspecting domestic water buffalo as attacker. This case is reported for its rarity, for the awareness of the possible injuries in such unnatural deaths, and factors predisposing to a buffalo attack.

Contribution of teeth in human forensic identification – Discriminant function sexing odontometrical techniques in Portuguese population

2010-02-01

Abstract: We investigate the accuracy of odontometric methods in sex determination, using a sample from the Portuguese population. Measurements were made on dental casts using a digital caliper, and various odontometric indexes have been defined using upper incisor and canine teeth.Comparison of the means in both sexes was performed using Student’s t-test. Significant differences (p<0.05) were found in all variables except for the “Incisor Index”. The canine showed the greatest sexual discriminant characteristics. In the presence of one or both canines the distobuccal–mesiolingual crown diameter and the “Robustness Value” allowed discrimination between sexes in the studied population. We also provide further arguments on the debate on whether sex determination is population specific.

Paraphilias and sexual offences in the Bible

Alan John Lyons — 2010-02-01

Dear Sir, Aggrawal has written an excellent account of paraphilias and sexual crimes in the Bible. However, there are two more incidents he might have included.

How much do Hong Kong emergency physicians know about common legal situations?

2010-02-01

Dear Editor, The emergency department is often the first place where victims of accidents and violence and patients with medical emergencies seek help in our healthcare system: the spectrum ranges from life-threatening conditions to minor injuries, from the newborn to the elderly.

Alcimedes

2010-02-01