Stature estimation from the scapula measurements using 3D-volume rendering technique by regression equations in the Northern Indian population.

The present study assessed the correlation between the stature and scapular measurements from both sides in order to develop population-specific regression equations to estimate the stature from measurements of the scapula in a contemporary Northern Indian population individually for the left and right sides. A total of 597 cadavers underwent postmortem multidetector computed tomography and subsequent medicolegal autopsy in our department between August 2021 and August 2022. Two hundred samples (100 males and 100 females) were randomly collected based on inclusion and exclusion criteria. Six linear anthropometric measurements of the scapula from either side were measured using the 3D volume-rendered technique by an electronic cursor. Each anthropometric measurement showed a significant difference between males and females (p < 0.05). Regression analysis was applied to match the taken measurements against stature. The accuracy to predict stature ranged from 3.99 to 4.94 cm for males and from 4.49 to 5.27 cm for females, respectively. Left-sided measurements were better predictors of stature than the right side in both genders. The results of this study indicate that scapular measurements could be useful to estimate the stature of Northern Indian individuals, particularly in scenarios of disaster victim identification lacking long bones, which are considered to be better predictors to date.

Epidemio-toxicological profile of fatal poisoning cases autopsied at a tertiary care centre of North India.

Background: Poisoning is an important health hazard and one of the leading causes of morbidity and mortality worldwide including in India. The study was conducted to understand the magnitude, pattern, and gender differentials of all poisoning fatalities in relation to the manner of death autopsied at a tertiary care center. Methods: A retrospective study of all fatal poisoning cases autopsied at the department of Forensic Medicine & Toxicology of a tertiary care institute in Northern India for the period 1st January 1998 to 31st December 2017 was conducted, and a profile of the victims of fatal poisoning was prepared. Data were analyzed with descriptive and inferential statistics. Results: The study included a total of 1099 cases of fatal poisoning autopsied at the department of Forensic medicine & Toxicology. Suicidal poisoning was reported in 90.2% of cases and accidental poisoning was seen in 8.9% of cases. Males were predominantly affected (63.8%). The majority of the victims were in the 3rd decade (40.0%) of life. The age of the victims ranged from 2 to 82 years with a mean age of 38.4 years. Agrochemical compounds were implicated in 44.4% of the total fatalities. Conclusion: Males in the 2nd to 4th decades of life were more prone to self-poisoning with Agrochemical compounds in the region of North India. Accidental poisoning deaths were uncommon and poisoning was not a preferred method of homicide in this region. Our approach to the study reveals that quantitative chemical (toxicological) analysis is required to further strengthen and improve the databases of the epidemiology of poisoning in this region.

A new "Stethoscope" autopsy incision in comparison to various conventional incisions along with suturing techniques and body packing methods for post autopsy reconstruction.

Post autopsy reconstruction (PAR) plays a vital role in the external appearance of dead bodies while handing over to grieving family members. Autopsy surgeons should not only be restricted to autopsy findings/techniques but should also give importance to PAR. Autopsy incision includes various conventional incisions like I, Y, and Modified Y-shaped. The most commonly used incision is I -shaped in most of the autopsy because it is easy for quick suturing but it produces a poor cosmetic appearance because suturing produces visible suture over the front of the neck and chest of a corpse and improper suturing in the skin flaps leads to gapping causes leakage of body fluids at the suture site. More often that leads to avoidable, unnecessary emotional distress for grieving family members. That creates a negative image of forensic practice in society and sometimes with administrative complaints. The authors conducted an observation based study on the medicolegal autopsy that included ten cases that involved "Stethoscope" and various conventional incisions and explored suturing techniques and body packing methods. The study observed that the proposed "Stethoscope" incision was feasible, less time-consuming for suturing, had an excellent cosmetic effect, and was cost-effective. The suturing technique revealed that invisible sutures leads to good cosmetic outcomes but is more time-consuming and costly. The body packing method showed the excellent result of no leakage of body fluid from the suture site. The authors proposed a "Stethoscope" method of incision that can be practiced and adopted for a better cosmetic appearance and humanitarian aspect for grieving relatives. The body packing method renders the body non-hazardous to the public and attendants while handling and transporting. The authors highlight the importance and sensitization of autopsy surgeon/mortuary staff to restructure the corpse with the best cosmetic appearance for the Dignified Management of the Dead and Humanitarian Forensics.

Post-mortem CT: A Useful Tool to Confirm a Case of Suspected Sudden Cardiac Death.

Sudden cardiac death (SCD) is defined as the unexpected death of an individual, not due to any extracardiac cause, occurring within one hour of symptom onset or within 24 hours of last being seen in good health if the death is unwitnessed. Forensic pathologists routinely encounter several SCD cases in their practice. The presentation of such cases can be of two types; firstly, with typical signs and symptoms suggestive of cardiac pathology, and secondly, devoid of any presentation history. This history helps forensic pathologists look for relevant findings during the autopsy examination. The authors intend to explore the feasibility of using advanced radiological techniques like post-mortem CT (PMCT) in determining the cause of death through a minimally invasive approach. In the present case, a 65-year-old male was found unresponsive at his residence on the morning of his death. He had a history of dull chest pain for the past two days, which had resolved after he self-prescribed a few medications. The presenting complaint of chest pain had started the intervening night prior to his death. The deceased was a known case of hypertension and was not compliant with treatment, as stated by the relatives. He was declared as brought dead by the treating emergency medicine physician at the Fortis Flt. Lt. Rajan Dhall Hospital and the body was sent by the authorities to the mortuary of the Department of Forensic Medicine, AIIMS, New Delhi for autopsy examination since an autopsy should be conducted by a government hospital or institute by law. PMCT depicted an alternate hyperdense and hypodense region circumferentially surrounding the heart, indicating hemopericardium. It was followed by a traditional autopsy and histopathology examination, which confirmed the presence of hemopericardium and left ventricular rupture associated with acute coronary insufficiency. Such cases with an indicative history, circumstantial evidence, and PMCT findings can be considered for minimal invasive autopsy. If the external findings indicate the application of physical force, then an explorative dissection could be done. Therefore, we conclude that PMCT can be used as a reliable tool for determining the cause of death in SCDs on a case-to-case basis.

Leg massage by mother resulting in fatal pulmonary thromboembolism.

We report the sudden death of a 23-year-old male with hairline ankle fracture after massage of the leg by his mother. Autopsy confirmed the cause of death as pulmonary thromboembolism due to deep vein thrombosis of the leg veins which was dislodged and travelled to his lungs consequent to the leg massage. The treating doctors did not warn the patient of the risk of developing pulmonary thromboembolism.

Jumping Together: A Fatal Suicide Pact.

In suicide pact, two or more victims mutually agree and execute to end their lives together by predetermined method, preferably by hanging, drowning, gunshot, or poisoning. The victims are usually spouses, lovers, or friends, and the reasons behind such steps are various. In this reported suicide pact, husband-wife duo jumped from the terrace of a 12-meter-high building with their wrist bound to each other. Although they jumped together, the injury patterns were completely different. The man landed on head sustaining mainly craniocerebral injuries, and the wife landed on feet sustaining long bone injuries. They left a suicide note pointing out sudden demise of their only child as the reason for the suicide, and it was signed by both of them. Jumping from a height in suicide pact has not been reported in the scientific literature yet.

Start-up of sequencing batch reactor with Thiosphaera pantotropha for treatment of high-strength nitrogenous wastewater and sludge characterization.

Biological treatment of high-strength nitrogenous wastewater is challenging due to low growth rate of autotrophic nitrifiers. This study reports bioaugmentation of Thiosphaera pantotropha capable of simultaneously performing heterotrophic nitrification and aerobic denitrification (SND) in sequencing batch reactors (SBRs). SBRs fed with 1:1 organic-nitrogen (N) and NH4+-N were started up with activated sludge and T. pantotropha by gradual increase in N concentration. Sludge bulking problems initially observed could be overcome through improved aeration and mixing and change in carbon source. N removal decreased with increase in initial nitrogen concentration, and only 50-60 % removal could be achieved at the highest N concentration of 1000 mg L-1 at 12-h cycle time. SND accounted for 28 % nitrogen loss. Reducing the settling time to 5-10 min and addition of divalent metal ions gradually improved the settling characteristics of sludge. Sludge aggregates of 0.05-0.2 mm diameter, much smaller than typical aerobic granules, were formed and progressive increase in settling velocity, specific gravity, Ca2+, Mg2+, protein, and polysaccharides was observed over time. Granulation facilitated total nitrogen (TN) removal at a constant rate over the entire 12-h cycle and thus increased TN removal up to 70 %. Concentrations of NO2--N and NO3--N were consistently low indicating effective denitrification. Nitrogen removal was possibly limited by urea hydrolysis/nitrification. Presence of T. pantotropha in the SBRs was confirmed through biochemical tests and 16S rDNA analysis.