Ethical Considerations in Post-Mortem Sperm Retrieval: A Comprehensive Review.

This comprehensive review delves into the moral and ethical dilemmas surrounding post-mortem sperm retrieval (PMSR) and its implications for creating new individuals. The paper examines the challenges posed by unusual requests for sperm retrieval from the deceased's widow and parents, as well as the broader socio-ethical considerations associated with PMSR. These requests have often been denied due to the absence of established laws and guidelines governing posthumous sperm retrieval and subsequent births, which were once deemed impossible. While some countries have implemented institutional policies to regulate its use to some extent, there remains a lack of standardized rules and procedures for the collection and retrieval of sperm after death. It is essential to introduce institutional guidelines to facilitate requests for assisted reproductive technology (ART) following successful sperm retrieval. Additionally, the development of PMSR legislation is necessary to ensure a proper balance between the moral rights and fundamental rights of the deceased, their family, and any current or future offspring, while providing adequate protection for all parties involved.

Autopsy-Based Comparative Study of Gross and Histopathological Findings at Bone Fracture Surfaces Before and After Death.

ABSTRACT: Fractures of bones are commonly encountered in traumatic injuries, and distinguishing between antemortem (AM) and postmortem (PM) bone fractures is crucial for estimating the time since injury and has important medicolegal implications. Correct differentiation enables understanding the dynamics of the injury and, in some cases, the cause of death. The present study aims to evaluate the gross morphological and histopathological characteristics of bony fracture surfaces to determine whether they occurred before or after an individual's death.Fifty-seven sets of bone samples, including both antemortem and artificially created postmortem fractures, were collected from cadavers during medicolegal autopsies, meeting the inclusion criteria. Gross morphological and histopathological features were examined after staining the bony fracture edges with hematoxylin and eosin stain. The study revealed distinct morphological characteristics at fracture surfaces for both antemortem and artificially created postmortem fractures. In addition, signs of vital reaction were observed exclusively in antemortem fracture cases.In conclusion, the findings emphasize the importance of meticulous morphological and histopathological examination of bony fracture surfaces to differentiate between antemortem fractures and artificially created postmortem artifacts. This differentiation holds significant value in forensic investigations and medicolegal cases.

Estimation of Time Since Death Using Biochemical Markers in Synovial Fluid.

ABSTRACT: In the field of forensic medicine, estimating time since death plays an important role in helping the investigative organizations unravel the mystery of crime. Presently, many less reliable subjective parameters are being used to measure it, necessitating the need to have more specific and objective parameters. This cross-sectional comparative study was conducted at the Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Bhopal, India on 60 deceased bodies to determine the correlation between known time since death and biochemical parameters in the synovial fluid specifically sodium, potassium, lactate, and total proteins, analyzed using random access fully automated chemical analyzer (Beckman Coulter Au680) followed by estimation of correlation using Spearman correlation test.All the biochemical parameters that were tested in the synovial fluid except for sodium showed a significant correlation. The potassium and lactate showed a significant positive correlation (P < 0.001), and on the contrary, the total protein level showed a significant negative correlation with time since death (P < 0.001). This study shows usefulness of these markers in estimating the time since death. The smaller sample size and the unavailability of the results of effect of cold storage on these parameters necessitate the need of further similar studies to uncover the real practical application.

Phosphine Gas Poisoning: A Case Report.

ABSTRACT: In agrarian countries, several pesticides are used on a large scale to preserve grains. However, oftentimes, the very people using it are not aware of their harmful effects. Some pesticides produce toxic gases, which can cause poisoning by inhalation. With no specific antidotes and limited data on the benefit of therapeutic interventions, such poisonings can lead to fatalities. This case report discusses the death of an apparently healthy, 6-year-old boy who presented with multiple episodes of vomiting and loose stools and was declared dead on arrival to the hospital. His other siblings and the parents also experienced similar symptoms but survived. Further investigation revealed that the family lived in a closed, poorly ventilated room adjacent to a granary where their landlord stored grains with pesticides for the purpose of preservation. However, during rainy season, moisture came into contact with the grains and toxic gases were released. The family was exposed to these gases through a small window in the living room, proving fatal to one member of the family. This article suggests that phosphine gas was liberated from an aluminum phosphide pesticide and emphasizes the need for improved knowledge, recognition, prevention, and management in such scenario.

Comparison of Postoperative Chronic Groin Pain After Repair of Inguinal Hernia Using Nonabsorbable Versus Absorbable Sutures for Mesh Fixation.

BACKGROUND: Inguinal hernia repair is one of the most common operations performed in general surgery. Lichtenstein mesh hernioplasty is a commonly practiced technique for open inguinal hernia repair. Out of many other complications postoperatively, chronic groin pain is one of the patients' most common postoperative complaints. There is no direct evidence to explain the cause of post-mesh hernioplasty pain. Only a few studies have been done to judge the effect of suture material used for mesh fixation on chronic groin pain. AIMS AND OBJECTIVES: To compare the postoperative groin pain level in mesh hernioplasty using nonabsorbable versus absorbable sutures for mesh fixation at predetermined intervals using a visual analog scale (VAS) score. METHODS:  A prospective, single-center, non-randomized, observational study was conducted. All patients per inclusion and exclusion criteria of inguinal hernia planned for surgery were admitted electively on the day of surgery and were operated on in minor OT under local anesthesia for open mesh hernioplasty. The VAS score assessed the postoperative pain level. RESULTS:  This observational study was done to look for any difference in postoperative chronic groin pain after mesh fixation with either nonabsorbable, prolene sutures (PS) or absorbable vicryl sutures (VS). One hundred and ten patients fulfilling the department of general surgery inclusion criteria were admitted to the study. In our study, postoperatively, the incidence of chronic groin pain was assessed and followed up to six months. After six months, 25%of patients had pain. Of this 25%, the majority (70%) of patients had mild pain, 15% had moderate pain, and 15% had severe pain. There was no statistically significant difference between the two groups of mesh fixation by nonabsorbable versus absorbable sutures. CONCLUSION: Inguinal hernia is one of the most typical conditions seen in general surgery clinics with male predominance. Definitive management of inguinal hernia is surgery. There is no difference in postoperative chronic groin pain with either type of suture material i.e., nonabsorbable or absorbable (prolene vs vicryl) sutures. To conclude, fixation material for mesh does not influence chronic inguinodynia. However, further studies are required for the same.

Suicide linked to PUBG video gaming: A case report.

PUBG is an online multiplayer battle game played in India. It is causing addiction in teenagers and adolescents and they refuse any kind of interruption while playing. We report a college student who committed suicide by hanging when scolded by his parents for playing PUBG on his mobile phone and whose parents would not provide the internet pack recharge for it. There have been other cases in India, inviting a discussion to prevent addiction with a law to regulate its use.

Problems arising from PPE when worn for long periods.

In the context of Covid-19, personal protective equipment is much needed and often in short supply as a protection against the virus, but nobody until recently was discussing the downside of its prolonged use by its wearers. Increasing numbers of health care workers feel unwell using it and are overheating and some have fainted. Will it impair their professional performance? This article considers this aspect of PPE based upon the personal experience of a Forensic team at AIIMS Bhopal in India who wore it during autopsy work and proposed recommendations to minimise it.

Dead body management amidst global pandemic of Covid-19.

Covid-19 has reached almost all the nations in the world. More and more people are dying from it and in some countries, even the army has been called upon to help dispose of the dead as there is a shortage of coffins, and undertakers are overwhelmed. Therefore, it is essential to have measures in place to contain the spread of infection while handling dead bodies. In view of this, different guidelines and protocols have been proposed bearing in mind the limited information we have about the virus. This review article sets them out for better reference.

A Representative Study of Deaths of North Indian Migrants and Its Medical Certification Across the World.

Many Indians is moving to other nations of the world in the search of employment, education or other reasons. The process of globalization along with the faster mode of traveling and communication has facilitated this movement in the hope of getting more opportunities and earning of easy money abroad, than in India. Unfortunately, sometimes they meet a tragic end and their families in India get only their dead bodies back from abroad. This study focuses on these kind of unfortunate tragic events faced by Indians in different countries and thereby raise a concern on their safety abroad and necessitate the need of relooking in to the quality of medical certification of death and medico legal investigations to find out the real reasons of deaths to avoid any kind of doubt in mind. Data was collected from medical death certificates and passports of the deceased Indians. There was a total of 711 dead bodies/human remains received in 2012 at IGI airport New Delhi. The Middle East countries together contributed a total of 398 (55.98 %) cases. The distribution as per manner of death shows that in maximum number of cases (269), the manner of death was ambiguous with unspecified aetiology. The study therefore recommends for upgradation of the level of medico legal investigations in form of 2nd autopsy in recipient country and proper medical death certification.

Severing of skull cap: A rare trauma attributed to transportation of bulldozer.

Bulldozer fatalities are usually due to accidental crushing of the body at the workplace. However, severance of the skull cap simulating a chopping injury to head is rare in the literature. Medico-legal investigation may be posed with different challenges when carrying out an autopsy of a victim with this devastating head injury. The police will seek an opinion about the type of weapon responsible for the injuries, the nature of injuries produced and manner of death. In the present case, the victim was hit at dusk by a protruding part of the bulldozer blade as he crossed in front of a bulldozer that was approaching his tractor from the opposite side of the road. His skull cap was severed and he died instantly. This report considers the circumstances of his death, its mechanisms and strategies for preventing such deaths.

Sudden Cardiac Death of a Body Packer Due to Cocaine Cardiotoxicity.

This article presents a case of sudden cardiac death due to the effects of cocaine concealed in the body of a male drug smuggler in his 40s, a so-called body packer. A total of 57 body packets filled with cocaine powder were discovered in his body cavities. The detailed autopsy examination, including histopathology and toxicology findings, is discussed with the aim of describing the mechanism of cocaine intoxication in the body packer and an analysis of cocaine-induced cardiotoxicity and sudden death.

A Study on Mortality Profile among Fifty Plus- (50+-) Population (FPP) of India: A 5-Year Retrospective Study at New Delhi District.

Objectives. To find out the mortality profile vis-a-vis different epidemiological factors at the time of autopsy among the 50+-Population. Material and Method. A five-year retrospective evaluation of medicolegal records between 2006 and 2010 was done at Lady Hardinge Medical College, New Delhi. Results. A total of 493 (17.78%) cases belonged to 50+-Population age group out of total 2773 autopsies performed. The proportion of unidentified/unknown persons among this age group was 36.51%. The unnatural and natural causes constituted 44.62% and 55.38% cases, respectively. The unspecified pneumonitis (50.18%) was reported as the commonest cause followed by coronary artery disease and respiratory tuberculosis among natural ones and the transport accident (57.27%) followed by accidental and intentional self-poisoning and exposure to noxious substances and falls among the unnatural ones. Conclusion. The findings reveal that this age group most commonly dies of natural causes rather than the unnatural ones even in autopsy cases. They have definite cure with timely interventions. The study also points out the need to devise the road and home safety measures to reduce mortality among the study population.

Triple hanging in filicide-suicide: an unusual case report.

Filicide-suicide is a special category of homicide-suicide event where the victim(s) are children and the perpetrator is one of the parents or both. It is not extensively documented or adequately defined in literature. In developed countries, shooting is a common method of homicide and suicide. Uses of knives, blunt objects, strangulation, poisoning and drowning are other methods frequently employed by the perpetrator. Homicide by hanging in filicide-suicide is rarely reported in forensic literature. We present a rare case of filicide-suicide, where the mother killed both her children by hanging them one by one from a ceiling fan in the same room and later committed suicide by hanging in another room.