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Background There is a global increase in the number of deaths caused by violent neck asphyxia, which includes both suicides and homicides. This research presents autopsy-based findings and analytical demographic data that are pertinent to significant medicolegal cases. Methods A retrospective examination of 113 autopsy reports of non-accidental violent neck asphyxia reported to the forensic pathology department of Al-Balqa Governorate in Jordan within the period from January 2010 to March 2023. Age, gender, and autopsy results were documented, along with medicolegal records that included toxicology reports. Conversely, information on the manner of death was derived from police inquest records. For the purpose of this research, all the cases of throttling and ligature strangulation have been determined to be homicidal, and all cases of hanging were classified as suicide. Results Males were predominant in hanging (72%), while females were predominant in ligature strangulation (82%). The mean age group in hanging was 21-35 years (51%), while the range for throttling was 36-50 years, and that in strangulation was 2-20 years. Most hanging and throttling cases showed typical external neck findings. Seventy-two percent of hanging cases (n = 68) did not exhibit any internal neck findings, while all throttling cases yielded positive results. Both hanging and strangulation by ligature cases exhibited an absence of thyroid cartilage fracture (83%). Eighty-nine cases (95%) of hanging did not exhibit any injuries to the rest of the body. However, all cases of throttling and ligature strangulation had an almost positive external body injury. In all cases of throttling and ligature strangulation, ocular petechial hemorrhage was present, whereas one-third of the hanging cases had it. Conclusion The forensic doctor must observe the pattern of ligature marks and other signs of physical assault found on the neck, meticulously examine the rest of the body, rule out other causes of death, and cooperate with the legal authorities regarding the collection of the history and death scene findings to accurately determine the manner and mechanism of death in cases of violent neck asphyxia.
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Tuberculosis remains a major global health concern, especially in the context of emerging drug-resistant strains and the high prevalence of HIV/AIDS. Understanding the pathomorphologic changes associated with DRTB and its coinfection with HIV/AIDS is crucial for designing effective diagnostic, preventive, and therapeutic interventions. The objectives of this study were to assess the pathomorphologic changes, investigate lung function and blood circulation, and explore risk factors and clinical predictors associated with cor pulmonale in patients with DRTB and DRTB/HIV/AIDS co-infections. The study included 72 patients, with 28 having isolated DRTB and 44 having DRTB/HIV/AIDS co-infections. Microscopic examination of lung tissue samples from isolated DRTB patients revealed fibrous and productive changes with inflammatory infiltration. Histological examination of the myocardium in these patients showed hypertrophy and diffuse cardiosclerosis. Patients with DRTB/HIV/AIDS co-infections exhibited extensive destructive changes in lung tissue, along with dystrophy of cardiomyocytes and focal lymphohistiocytic infiltration in the myocardium. The frequency of cor pulmonale formation was significantly higher in the co-infection group (22.7%) compared to the isolated DRTB group (10.7%). Histological samples suggested that co-infection with HIV/AIDS exacerbates myocardial damage caused by DRTB. This research demonstrates the distinct pathomorphologic changes observed in the lung tissue and myocardium of patients with isolated DRTB and DRTB/HIV/AIDS co-infections. The study findings support the association between co-infection and increased risk of cor pulmonale development. Understanding the mechanisms underlying these differences will help identify potential therapeutic targets to mitigate myocardial damage in patients with DRTB and its co-infection.
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Background This study aimed to examine the suicide trends among Jordanians who died by suicide before and during the coronavirus disease 2019 (COVID-19) pandemic and assess their correlation with demographic data, including gender, age, marital status, and the method used for suicide, from a forensic medicine perspective. Methodology This was a retrospective, observational, autopsy-based study. Of the 731 medicolegal autopsies performed at the Al-Hussein New Hospital at Al Salt City between 2017 and 2022, 41 confirmed cases of suicide were identified. Results The study indicated that 75% of the subjects committed suicide during the COVID-19 pandemic period, of whom 13% were children. The average age of those who died by suicide was 32.1 (SD = 12.2) years. Overall, 58.5% were single, 61.0% unemployed, and 53.7% had a mental illness. Males were four times more likely to commit suicide than females. Hanging represented 60.61% of all male suicides, followed by firearms (27.27%); however, females used poisoning. Around 60% and 25% of the study subjects were in the age group of 21-40 years and 41 and more, respectively. The study also identified a statistically significant association between gender, age, and the time of suicide (during COVID-19). The findings of this study could not confirm any association between suicide and mental illness, marital status, and employment status. Conclusions The suicide rate in Jordan increased during the COVID-19 pandemic, and it is alarming that most of those who committed suicide were at a young age and in their productive years.
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BACKGROUND: Falling from a distance is an important issue worldwide, which happens in different ages, genders and circumstances. It is usually not considered a medicolegal case in many countries hence no autopsy is performed. This study focused on analyzing injuries sustained in victims of falling in relation to different distances of fall. METHODS: Retrospective study of 352 autopsy reports of falling victims brought to the forensic pathology department at Jordan University Hospital during the period from January 1990 to March 2016. RESULTS: Among 352 cases, 256 (72.7%) were males and 96 (27.3%) were females. 303 (86.1%) cases showed accidental fall, 31 (8.8%) were suicidal, 2 (0.6%) were homicidal and un-clarified death in 16 (4.5%). Time of death was directly proportionate with the distance of fall. Victims fell from distances less than 3â¯m were 123 (35%), most of them were children less than 7 years 50 (40.5%) and unemployed adults more than 45 years were 48 (39.1%). They showed multiple abrasions (62.6%), few contusions (64.2%) and absent laceration of the skin (84.5%). Victims fell from distances of 3-9â¯m were 123 (35%), most of them were male workers 56 (60.2%). They showed multiple abrasions (63.5%), few contusions (71%) and few lacerations of skin (50.5%). Victims fell from distances more than 9â¯m were 136 (38.6%), most of them were male workers 71 (52.2%) and female servants 23 (17%). They showed few abrasions (80.9%), multiple contusions (64.7%) and few lacerations of skin (48.5%). The number of fractured limbs increases obviously with distances more than 3â¯m. Skull vault fractures were found in all distances, while skull base fractures showed in distances of 3-9â¯m and more than 9â¯m. Head injury was the most common fatal injury in all distances. Chest injuries were prominent mainly in distances more than 3â¯m. While abdominal injuries were mainly prominent in distances more than 9â¯m. CONCLUSIONS: This study showed the effect of different distances of fall in causing different types of injuries in falling fatalities. Internal injuries were in a direct proportion with distances of fall, while external injuries showed a great importance in interpretation of the way of fall.
