Evolution of transgender rights in India: Better late than never.

The progress of transgender rights in India has seen significant strides with milestones such as the National Legal Services Authority (NALSA) judgment and the enactment of the Transgender Persons (Protection of Rights) Act in 2019. The NALSA judgment recognized the right of transgender individuals to self-identify their gender. This decision led to the formal recognition of a 'third gender', advancing legislative and social reforms. Prior to this, transgender individuals faced substantial hurdles, including limited access to education, employment, and healthcare due to a lack of legal recognition. Within a few years, The Transgender Persons (Protection of Rights) Act established a framework that safeguards the rights of transgender individuals and prohibits discrimination based on gender. This legislation requires the government to take measures like promoting education, providing vocational training opportunities, ensuring accessible healthcare services, and offering social security support. It also addresses the healthcare needs of transgender individuals thereby contributing to their overall well being. The Support for Marginalised Individuals for Livelihood and Enterprise (SMILE) program and Garima Greh are initiatives that provide spaces and empower a marginalized transgender individuals and promoting their inclusion, justice and empowerment. This article explores the progress pertaining to transgender rights and welfare, while highlighting efforts undertaken by the Indian government.

The three-parent baby: Medicolegal, forensic and ethical concerns.

In the recent past, human genetics and in vitro fertilization (IVF) have undergone various advances to combat with several congenital and developmental disorders. These advances are a boon for the families and patients who were restricted from having a child due to one or the other reasons. One such reason is the mitochondrial DNA (mtDNA) mutations, which are definitely transmitted from the mother to the child due to uniparental/maternal inheritance of mitochondria. Depending upon the range of the mutation (mutation loads) present, the mtDNA mutation leads to various devitalizing to fatal disorders, all of which are incurable. Scientists and researchers developed a technique known as mitochondrial donation technique or mitochondrial replacement therapy (MRT) to combat with the mtDNA mutations. The technique relies on the replacement of faulty mitochondria in the mother's egg with the normal wild-type from a donor female resulting in a "three-parent baby." On the other side, forensic scientists and anthropologists continuously explore the mtDNA in various medicolegal cases and in uncoupling the mystery of human origin and migration respectively. In this regard, we explored the genetic, forensic and ethical aspects of a "three-parent baby." The present communication also attempts to highlight the importance and limitations of the MRT technique/three-parent baby in a medicolegal context.

Duplex kidney: An incidental autopsy finding of clinical and medico-legal significance.

Duplex kidney, a rare congenital anomaly characterised by dual urinary drainage from the kidney, is typically discovered incidentally, often during radiological imaging or autopsy procedures. We report a case of a 21-year-old male who died from injuries sustained in a road traffic accident. The autopsy examination showed an incidental finding of duplex kidney on the left side. We discuss the clinical and potential medico-legal significance of duplex kidney which also has implications in renal transplantation. Notably, the presence of duplex kidney can potentially serve as an identifier in forensic investigations, given its rare incidence.

Ant bite artifacts in a case of hanging.

Artifacts produced by postmortem animal scavenging are commonly encountered at autopsy. Knowledge of the pattern of artifacts produced by postmortem animal scavenging is essential for the correct interpretation of the autopsy finding. In household deaths, such artifacts are usually caused by domestic animals and by small insects such as flies, ants, beetles, etc. Ants are one of the early scavengers which feed on the dead bodies. The artifacts produced by the postmortem ant activity are usually superficial and non-bleeding type. Rarely, in the congested body regions and areas of marked hypostasis, postmortem bleeding artifacts due to ant bites are possible. In the reported case of hanging, such postmortem bleeding artifacts were present over both the legs, predominantly over the left leg. Typical ant bite lesions in the form of superficial excoriations were also present over the peri-ligature area, over and around both nipples and over the lower part of the abdomen. Morphologically, postmortem bleeding artifacts produced by ant bites exhibit four patterns: droplet pattern, stripe pattern, pool pattern, and mixed pattern. In this case, a mixed pattern (droplet pattern and stripe pattern) of postmortem bleeding artifacts was observed. The presence of postmortem bleeding artifacts over the lower limbs was attributed to the pooling of the blood due to suspension of the body, followed by passive escape of blood due to ant bites. The possibility of such artifacts produced by ant bites should be considered when the origin of the lesion is unclear.

3D CT based age estimation from the pubic symphyseal surface in an Indian population using the Chen et al. method.

The pubic symphyseal surface is one of the reliable parameters used to estimate age, as it consistently shows degenerative observational variations throughout the lifespan, particularly from the 3rd decade onwards. These changes have been extensively studied to generate population-specific models for forensic age estimation. In the past, there have been many studies used to estimate age at death from the pubis symphysis using skeletal remains. However, due to dearth of contemporary skeletal repositories, and the resource intensive maceration process required for obtaining examination quality bones, studies on cadaver are difficult to conduct. Moreover, due to recent advancements in the science of medical imaging, newer radiological modalities like computed tomography (CT) can be used to visualize previously inaccessible areas such as the pubic symphysis in cadavers and the living alike, and subsequent age estimation is feasible. Recently, Chen et al. (2008, 2011) conducted a study on the cadaveric Chinese Han population in both males and females separately by using nine morphological changes and scoring them according to the changes that occurred. The present study aimed to estimate an individual's age using CT images of the pubic symphysis, by applying the scoring method for its morphological changes given by Chen et al. The present study was conducted on 263 randomly selected participants (Males = 154, Females = 109), who came for diagnostic purposes to the hospital. The CT images of these individuals were collected after obtaining ethical approval and proper consent from the study participants. Each of the morphological indicators was assessed, and appropriate scores were given according to criteria given by Chen et al. In the present study, both linear and multiple regression models to estimate age using the pubic symphyseal morphological changes were developed. From the results of the present study, it was concluded that the Chen et al. scoring method can be used to accurately estimate age from 3DCT images of the living, and the models derived in the present study could be applicable to individuals from the Indian subcontinent.

Global adoption of facial recognition technology with special reference to India-Present status and future recommendations.

The face is the most essential part of the human body, and because of its distinctive traits, it is crucial for recognizing people. Facial recognition technology (FRT) is one of the most successful and fascinating technologies of the modern times. The world is moving towards contactless FRT after the COVID-19 pandemic. Due to its contactless biometric characteristics, FRT is becoming quite popular worldwide. Businesses are replacing conventional fingerprint scanners with artificial intelligence-based FRT, opening up enormous commercial prospects. Security and surveillance, authentication/access control systems, digital healthcare, photo retrieval, etc., are some sectors where its use has become essential. In the present communication, we presented the global adoption of FRT, its rising trend in the market, utilization of the technology in various sectors, its challenges and rising concerns with special reference to India and worldwide.

Medical termination of pregnancy: A global perspective and Indian scenario.

Abortion has always been a vital issue in reproductive and legal medicine. Globally, medical termination of pregnancy (MTP) is allowed primarily on six grounds: (1) to save the life of a woman, (2) risk to the physical and mental health of a woman, (3) pregnancy due to rape or incest, (4) risk of a child being born with a serious fetal anomaly, (5) socio-economic reasons, (6) a woman's request. Most countries have standard legal abortion policies, yet there remains disparity with respect to prohibition, gestational age limit, specific grounds, etc. Abortion laws are constantly changing globally based on regional social and economic viewpoints. Recently, some countries have liberalised their abortion laws, while a few have further restricted theirs. While some countries still completely prohibit MTP. Like some others, India amended its MTP law in 2021. We consider the medico-legal and ethical issues and examine existing MTP laws both globally and as generally applied in India.

Spontaneous retroperitoneal and intracranial hemorrhage following streptokinase therapy in acute myocardial infarction: An autopsy case report.

Bleeding complications following thrombolytic treatment for acute myocardial infarction (AMI) are not infrequent, among which intracranial hemorrhage is commonly reported. In contrast, retroperitoneal hematoma following the administration of thrombolytics is rarely reported in the literature. We are reporting a case of a middle-aged man, who presented with left-sided chest pain and was diagnosed with acute coronary syndrome with anterior wall ST elevation AMI. The patient was administered with thrombolytic drugs, including streptokinase and heparin. Percutaneous coronary intervention in the form of Coronary angioplasty with stent insertion was done to the left anterior descending artery, given coronary artery disease. The blood investigations showed elevated activated partial thromboplastin time and prothrombin time. The patient developed vomiting, altered sensorium, and left-sided weakness, and a non-contrast computerized tomography brain was done, which showed acute hemorrhage involving the right frontal lobe with intraventricular extension, so the ventricular drain was placed. The patient developed cardiac arrest and died on the third day. On autopsy examination, the brain showed subarachnoid hemorrhage, intraparenchymal hemorrhage over the right frontal lobe, and clotted blood in all the ventricles. A retroperitoneal hematoma of around 1500 cc was seen over the left side of the peritoneal cavity. This case highlights that although intracranial hemorrhage is a known complication after administrating thrombolytic therapy, clinicians should also be aware of the possibility of retroperitoneal hemorrhage. This case emphasizes the value of an autopsy in determining the cause of death in such situations.

ChatGPT: Forensic, legal, and ethical issues.

Artificial intelligence (AI) refers to a group of technologies that enable people to perform a variety of activities, including observing, comprehending, analysing and translating data, among other things. Nowadays, practically every school of thought is interested in AI. One such innovation, a chatbot by the name of ChatGPT (Chat Generative Pre-Trained Transformer), launched by OpenAI recently, has taken the internet by storm. It had one million users within 1 week of its launch. The present communication explores the practicability and versatility of the ChatGPT in forensic examinations and scenarios, and also addresses the ethical and legal issues surrounding its usage. The observations suggest that the said technology, in its current form, has limited relevance in the realm of forensic science and the law. Only human critical thinking, expertise, and practical experience can provide the information and competencies needed in the realms of forensics, research, clinical and legal practices. Thus, the ChatGPT should be used with utmost caution in the disciplines of medicine, forensic science and the law, irrespective of its many positive attributes.

Applicability of the Suchey-Brooks method for age estimation in an Indian population: A computed tomography-based exploration using Bayesian analysis and machine learning.

Age estimation occupies a prominent niche in the identification process. In cases where skeletal remains present for examination, age is often estimated from markers distributed throughout the skeletal framework. Within the pelvis, the pubic symphysis constitutes one of the more commonly utilized skeletal markers for age estimation, with the Suchey-Brooks method comprising one of the more commonly employed methods for pubic symphyseal age estimation. The present study was targeted towards assessing the applicability of the Suchey-Brooks method for pubic symphyseal age estimation, an aspect largely unreported for an Indian population. In order to do so, clinically undertaken pelvic computed tomography scans of individuals were evaluated using the Suchey-Brooks method, and the error associated with the method was established using Bayesian analysis and different machine learning regression models. Amongst different supervised machine learning models, support vector regression and random forest furnished lowest error computations in both sexes. Using both Bayesian analysis and machine learning, lower error computations were observed in females, suggesting that the method demonstrates greater applicability for this sex. Inaccuracy and root mean square error obtained with Bayesian analysis and machine learning illustrates that both statistical modalities furnish comparable error computations for pubic symphyseal age estimation using the Suchey-Brooks method. However, given the numerous advantages associated with machine learning, it is recommended to use the same within medicolegal settings. Error computations obtained with the Suchey-Brooks method, regardless of the statistical modality utilized, indicate that the method should be used in amalgamation with additional markers to garner accurate estimates of age.

Development, detection and decipherment of obfuscated fingerprints in humans: Implications for forensic casework.

Fingerprints have been widely used and accepted as an effective method of human identification. This biometric tool aids in criminal investigations for personal identity for over a century. Whilst the Automatic Fingerprint Identification System (AFIS) has bolstered security efforts, it has also opened doors to potential scams, affecting both civilian and law enforcement operations. Despite extensive research on fingerprint authentication issues, very little attention has been given to addressing the problem of fingerprint alteration or obfuscation. Fraudsters, with the guidance of experts, have developed new techniques to obscure their fingerprints intentionally. Fingerprint obfuscation is the deliberate alteration of fingerprint patterns with the aim of concealing their true identity, raising concerns amongst security and investigative organizations. The objective of the current communication is to highlight the numerous techniques used for obfuscation, forgery and alteration of fingerprints in humans. It further accentuates the need for identification and interpretation of these altered fingerprints and recommends notifying law enforcement agencies of potential threats.

Computed tomographic age estimation from the iliac crest and ischial tuberosity in an Indian population using supervised machine learning approaches.

Within the pelvis the iliac crest and ischial tuberosity display delayed ossification and fusion, thus, presenting as reliable maturity indicators. Amongst the different iliac crest and ischial tuberosity age estimation methods, the modified Kreitner-Kellinghaus stages constitute one of the more promising methods. The present study was directed towards establishing the applicability of the modified Kreitner-Kellinghaus method using five supervised machine learning approaches. Clinical CT scans of consenting individuals were collected and scored using the modified Kreitner-Kellinghaus method for the iliac crest and ischial tuberosity, independently. Age was subsequently estimated using different machine learning models. Cumulative scores computed from both markers were additionally employed for age estimation using machine learning. For iliac crest age estimation, Random Forest and Gradient Boosting Regression furnished lowest mean absolute error (2.42 years) and root mean square error (3.06 years). For ischial tuberosity age estimation, Gradient Boosting Regression garnered the lowest computations of mean absolute error (2.60 years) and root mean square error (3.09 years). For cumulative score based age estimation, Support Vector Regression and Gradient Boosting Regression yielded lowest mean absolute error (2.48 years) and root mean square error (3.07 years). Obtained error computations indicate that the iliac crest is a more accurate age marker in comparison to the ischial tuberosity. Additionally, cumulative score-based approaches garnered similar/ marginally more precise results in comparison to the iliac crest with all five models. This marginal improvement is not sufficient to justify employing the relatively more complicated cumulative score-based approach for age estimation. Hence, whenever available, the iliac crest should be preferred over the ischial tuberosity/ cumulative score-based approaches for age estimation.

Applicability of the six-phase method for auricular age estimation in an Indian population: A CT-based study.

Age estimation plays a crucial role in human identification. Amongst numerous age markers located throughout the skeletal framework, the auricular surface of the ilium presents as a resilient structure, with different methods for auricular age estimation currently in practice. Amongst these methods, the Osborne method is believed to permit accurate age estimation through its use of robust age categories and discrete phase descriptors. The present study aimed to assess the applicability of the Osborne method in an Indian population through a computed tomographic (CT) examination of the auricular surface, an aspect presently unreported. In order to do so, CT scans of 380 individuals were collected and evaluated using the Osborne method. A CT-based examination indicated that surface texture described by Osborne is difficult to appreciate through 3D CT images. Indistinct definitions associated with certain features, and the mosaic display of features within each phase further prevents applying the method effectively. Overall accuracy percentages of 99.47% and 98.90% were obtained using the method in males and females, respectively, with corresponding inaccuracy values of 10.10 years and 9.04 years. Significantly reduced accuracy percentages were obtained with alternate, more robust age brackets presented within the original study, demonstrating the limited reliability associated with the method. Inaccuracy and bias values computed for each decade indicate the relative utility of the method in aging 40-59-year-old individuals. Low accuracy percentages, high error rates and different methodological hindrances encountered within the present study illustrate the limited applicability of the Osborne method in aging an Indian population.

ChatGPT: ethical concerns and challenges in academics and research.

INTRODUCTION: The emergence of artificial intelligence (AI) has presented several opportunities to ease human work. AI applications are available for almost every domain of life. A new technology, Chat Generative Pre-Trained Transformer (ChatGPT), was introduced by OpenAI in November 2022, and has become a topic of discussion across the world. ChatGPT-3 has brought many opportunities, as well as ethical and privacy considerations. ChatGPT is a large language model (LLM) which has been trained on the events that happened until 2021. The use of AI and its assisted technologies in scientific writing is against research and publication ethics. Therefore, policies and guidelines need to be developed over the use of such tools in scientific writing. The main objective of the present study was to highlight the use of AI and AI assisted technologies such as the ChatGPT and other chatbots in the scientific writing and in the research domain resulting in bias, spread of inaccurate information and plagiarism. METHODOLOGY: Experiments were designed to test the accuracy of ChatGPT when used in research and academic writing. RESULTS: The information provided by ChatGPT was inaccurate and may have far-reaching implications in the field of medical science and engineering. Critical thinking should be encouraged among researchers to raise awareness about the associated privacy and ethical risks. CONCLUSIONS: Regulations for ethical and privacy concerns related to the use of ChatGPT in academics and research need to be developed.

ChatGPT in medical research: challenging time ahead.

Since its launch, ChatGPT, an artificial intelligence-powered language model tool, has generated significant attention in research writing. The use of ChatGPT in medical research can be a double-edged sword. ChatGPT can expedite the research writing process by assisting with hypothesis formulation, literature review, data analysis and manuscript writing. On the other hand, using ChatGPT raises concerns regarding the originality and authenticity of content, the precision and potential bias of the tool's output, and the potential legal issues associated with privacy, confidentiality and plagiarism. The article also calls for adherence to stringent citation guidelines and the development of regulations promoting the responsible application of AI. Despite the revolutionary capabilities of ChatGPT, the article highlights its inability to replicate human thought and the difficulties in maintaining the integrity and reliability of ChatGPT-enabled research, particularly in complex fields such as medicine and law. AI tools can be used as supplementary aids rather than primary sources of analysis in medical research writing.

Machine learning and regression analysis for age estimation from the iliac crest based on computed tomographic explorations in an Indian population.

Age estimation constitutes an integral parameter of identification. In children, sub-adults, and young adults, accurate age estimation is vital on various aspects of civil, criminal, and immigration law. The iliac crest presents as a suitable age marker within these age cohorts, and the modified Risser method constitutes a relatively novel and unexplored method for iliac crest age estimation. The present study attempted to ascertain the applicability of this modified method for age estimation in the Indian population, an aspect previously unexplored, through computed tomographic examination of the iliac crest. Computed tomography scans of consenting individuals undergoing routine examinations of the pelvis/ abdomen for various clinically indicated reasons were collected and scored using the modified Risser stages. Computed tomographic examinations of the iliac crest indicate that the recalibrated method accurately depicts the temporal progression of ossification and fusion changes. Different regression and machine learning models were subsequently derived and/or trained to evaluate the accuracy and precision associated with the method. Amongst the ten regression models derived herein, compound regression exhibited the lowest inaccuracy (4.78 years) and root mean squared error values (5.46 years). Machine learning yielded further reduced error rates, with decision tree regression achieving inaccuracy and root mean squared error values of 1.88 years and 2.28 years, respectively. A comparative evaluation of error computations obtained from regression analysis and machine learning illustrates the statistical superiority of machine learning for forensic age estimation. Error computations obtained with machine learning suggest that the modified Risser method is capable of permitting reliable age estimation within criminal and civil proceedings.

Diagnostic Dilemma in Fatal Paraquat Poisoning: An Autopsy Case Report.

Paraquat is a highly toxic agent used as an herbicide worldwide. Despite its easy and widespread availability, data regarding cases of paraquat poisoning in India is limited. Diagnosis often becomes difficult without a clear history, owing to its rather nonspecific and varying presentation. In the present case, a 22-year-old man was brought with a history of high-grade fever, sore throat, and oral ulcers for around a week. He was symptomatically treated at multiple hospitals and was worked up for suspected diagnoses like diphtheria and influenza (H1N1). Later during treatment, it was revealed that "Paraxzone" was procured online by the patient himself two weeks before the onset of his symptoms. Thence, the treatment regimen was modified following suspicion of paraquat poisoning. However, the delay in diagnosis led to the worsening his condition, and the patient succumbed to death due to pulmonary and renal complications after 16 days of survival. The postmortem examination, supplemented with histopathological evaluation, supported the diagnosis of paraquat poisoning. Paraquat poisoning can mimic a myriad of clinical conditions. Thorough history taking, a high degree of suspicion, and collaborative work with the investigating agency are of paramount importance while dealing with cases of suspected paraquat poisoning in hospital settings.