Narabali: A rare case of human sacrifice.

With modern civilization and the rise in literacy, cases of human sacrifice are rarely encountered by forensic practitioners. Human sacrifice, also called 'Narabali' in India, involves an act of deliberately killing an individual due to ritualistic beliefs for the appeasement of the Gods, spirits, or ancestors. Human sacrifice and ritual murder are often considered synonymous, but ritual murder further involves offering the body part to the deity after killing. Diverse methods were historically adopted for human sacrifice across the globe, strongly influenced by their superstitious, religious, and cultural beliefs. Cases of human sacrifice mostly involve children. We report the rare case of human sacrifice involving an adult victim assaulted by a sharp weapon over the posterior aspect of the neck. The deceased succumbed due to the transection of the cervical spine and corresponding spinal cord. Corroboration of circumstances of death and profiles of the deceased and the perpetrator with autopsy findings were essential in the investigation. This case report discusses extreme superstitions and beliefs, resulting in homicide.

Delayed Death Due to Lightning: An Autopsy Case Report Highlighting Diagnostic and Medicolegal Issues.

The incidences of lightning strikes are not infrequent. The electric discharge of the lightning strike produces extreme heat and high amperage current, but fatality is reported in only about 10% to 30% of lightning cases. The spectrum of injuries due to lightning strikes can vary from no external injuries to typical external injuries. Merely the presence of superficial injuries due to lightning should not be considered sufficient to dismiss the case as non-serious. Rather clinicians should be wary of internal damage due to the effect of the lightning current as well as delayed complications of the lightning which can be fatal. Similarly, during an autopsy, the forensic pathologist should also investigate for the changes/damage in the internal organs due to the effect of lightning current. The present case reports the incidence of death due to delayed complications of a lightning strike which primary doctors initially overlooked. This case also discusses the histopathological changes in the internal organs due to lightning which can be helpful in the autopsy diagnosis of lightning, particularly in cases with no external or nonspecific injuries.

Age Estimation in Sportspersons From the Epiphyseal Fusion Around Wrist, Elbow, and Pelvic Joints.

Background Age estimation of an individual is an integral part of medicolegal work. Out of many scenarios for which age estimation is performed, competitive sports is the one emerging field where experts are consulted for providing accurate age of the athlete. Owing to the chances of deliberately increasing (padding) or decreasing (shaving) the age of the athlete for his own advantage, accurate age estimation is crucial. The Sports Authority of India (SAI) mandates age verification from experts prior to participation in sports events in various age group categories. One of the widely used methods of age estimation in athletes is the radiological examination of the ossification centers of bones. Methodology The study was performed on 134 athletes (72 males and 62 females) with an age range of 12-18 years old with due permission from the Sports Authority of India (SAI) for this study. These participants compete at state, national, and international levels in squash, handball, swimming, cricket, and judo in under-14, under-16, and under-19 age categories. X-rays of the wrists, elbows, and pelvis were analyzed using the Schmeling five-stage method for the fusion of ossification centers. Results A greater degree of correlation between the fusion stages of all regions of interest and chronological age was observed in males than in females. The highest correlation in both sexes is observed between the fusion score of the head of the radius and the age (R = 0.814 for males and R = 0.647 for females). The lowest correlation for both males and females is seen between the fusion score of the lateral epicondyle of the humerus and age (R = 0.754 for males and R = 0.441 for females). Multiple linear regression models showed a standard error of estimate (SEE) of 1.093 years for the elbow joint, 1.147 years for the wrist joint, 1.039 years for the pelvis joint, and 1.030 years for all three joints. Conclusion Regression models generated for estimating the age of sportspersons from the ossification centers of the elbow, wrist, and pelvis in the present study can be applied for the age estimation of individuals aged between 12 and 18 years. Future population-specific studies on the age estimation of sportspersons with greater sample sizes are necessary to validate the findings of the present study.

Ligature Strangulation in a Vehicular Accident Due to the Entanglement of a Shirt: An Autopsy Case.

Among the various types of asphyxial deaths, strangulation is one of the commonly encountered cases as structures in the neck make it vulnerable to fatality. In most such cases, ligature material, usually cloth, is used for the commission of the offense. Clothing may be associated with a wide range of both accidental and deliberately induced deaths. Accidental strangulation due to entrapment of the neck in clothing, especially in relation to vehicular accidents, has also been described in the literature, but these cases are mostly associated with long scarf-like clothing. Loose clothing and intoxication act as critical factors in entrapping the person in such an event. This case report highlights the rare occurrence of accidental strangulation due to the entanglement of clothing other than a long scarf consequent upon road traffic incident.

Anthropometry of the sternum: An autopsy-based study for sex determination.

Sex determination is one of the key components for establishing the individual's identity in forensic anthropology casework. It is a known fact that anthropometric assessment can have population-specific variations. The present autopsy study was conducted on the sterna of 102 cadavers (52 males and 50 females) of age more than 25 years at a tertiary care centre in Central India. Anthropometric measurements included the length of the manubrium (M), mesosternum (B) and combined length of manubrium and mesosternum (CL). Applicability of Hyrtl's law, Ashley's rule and the sternal index were also assessed for sex determination. A statistically significant correlation (p < 0.001) was observed between sternal measurements and the sex of the study population. The highest coefficient of correlation was seen between sex and the combined length (r = 0.726), followed by mesosternal length (r = 0.620), and manubrial length (r = 0.509). The difference between the means of the sternal index in males and females was not statistically significant (p > 0.05), and the difference between the means of the ratio of the body with manubrium in males and females for Hyrtl's law is also not found to be statistically significant (p > 0.05). It is concluded that the length of the body and the combined length of manubrium and mesosternum are valuable criteria for sexing the sternum in an adult population of Central India. The sternum can be useful for sex determination, particularly when bones like skull, pelvis, or long bones are not available or fragmented.

Identification of skeletal remains by orthopaedic implant: A case report and brief review of the literature.

Establishing identity from skeletal remains is a challenging task for forensic experts. Identification in such cases can be achieved by dental records, post-mortem radiography and DNA profiling. However, these methods require additional data for comparisons. Positive identification can also be achieved using implanted medical devices. This is a rapid and inexpensive method, as long as a central database is maintained for effective tracking of such devices. We present a case report in which identity was established from skeletal remains using information furnished on the implanted metallic dynamic hip screw and side plate. This case report discusses the legal scenario in India and globally with regard to medical devices and their utility for forensic application. It emphasises the need for legal provision relating to medical devices in India, which would compel the manufacturer to use unique identification numbers for each medical device and to maintain a person-specific database.

Fatal Aspiration of Barium Sulfate in a Case of Myasthenia Gravis: A Case Report and Review of Literature.

Barium contrast radiography is a usual procedure performed for detecting lesions of the digestive tract using barium sulfate on X-ray irradiation. The aspiration of barium contrast is an uncommon but well-documented complication occurring accidentally during examinations of the upper gastrointestinal system using contrast media. Certain conditions that affect the anatomical and functional integrity of the oropharynx and esophagus can be predisposing factors. Barium is an inert material that can cause symptoms varying from an asymptomatic mechanical obstruction to severe respiratory distress that can result in death when aspirated. Sudden death due to aspiration of barium is rarely reported in the literature. We report a case of a 50-year-old female who suddenly developed difficulty in breathing, followed by loss of consciousness during barium swallow procedure due to aspiration of barium contrast. She could not be revived and died within a few minutes of the episode. The predisposing factor was the weakness of the muscles of deglutition due to myasthenia gravis. We also reviewed the literature available on cases resulting from the aspiration of barium sulfate during the barium study procedures. We considered the factors like the age, indications, the distribution of barium in the lungs, clinical presentation, the period of survival, and cause of death. We came across only four cases of death within 24 h following the aspiration of barium. This case report and review of literature emphasize the importance of consideration of predisposing factors before conducting barium contrast radiography and also the possibility of sudden death.