Indian Journal of Forensic and Community Medicine

193-197

Authors: Santhosh Chandrappa Siddappa, Anupam Datta

Background: With a sudden rise in population throughout the globe there is a surge in the medico-legal cases as well. These medico-legal cases differ among regions based on socio-economic status, cultural diversities, capability of law enforcing agencies and the prevailing standards of health care services available in the community. Aims and Objectives: To know the pattern and profile of medico-legal cases in a tertiary care hospital. Materials and Methods: This is a prospective study in which 4066 medico-legal cases were studied. This cases attended in Casualty department, J.J.M. Medical College and Bapuji Hospital from 1st October 2014 to 30th September 2015 and the information was collected with respect to their demographic profile, age and sex wise distribution, time period between injury and reporting to casualty, time of occurrence, type of injury, manner of injury, prognosis and the mortality profile. Results: Out of 4066 cases studied, 2918 (71.76%) were males and 1148 (28.23%) were females. Majority of the victims belonged to an age group ranging 21 – 30 years of age (37.67%). The urban victims constituted 2134 (52.48%) compared to the rural counterparts, 1932 (47.51%). Road traffic accidents constituted a majority of cases (47.73%), poisoning and fall constituted 16.84% each followed by assault in 6.19% of cases. Majority of the victims (51.94%) reported to the casualty within 1 hour of incident. 78.99% of the victims were discharged from the hospital after treatment. The peak time of attending to the casualty was during 12 pm to 6 pm and the manner of injuries were accidental in nature in majority of the cases (69.03%). Conclusion: This study shows the frequency of medico-legal workload in a tertiary care hospital, public attention and awareness towards medico-legal emergencies, urges round the clock availability of medico-legal experts to deal effectively with the legal responsibilities, sensitize the doctors to handle those cases including proper documentation and certification of medico-legal cases and also provides a valuable information for government, health care policy makers, law enforcing agencies to take effective measures.

203-213

Authors: Ambika Prasad Patra, Kusa Kumar Shaha, Anand P Rayamane, Sachidananda Mohanty

Aim of study: The demographics and characteristics of sexual assaultare changing. Hence, the aim of the study is to: a. To describe victim, assault characteristics for women alleging rapeaccording to the type of penal sections egistered by the police. b. To record the time between the last sexual assault and the examination, and to find out the reasons of delayed reporting of rape cases. c. To provide descriptive data on the medico-legal findings. d. And, to do a comparative review of the existing literatures. Material and method: This study is based on 244 numbers of examined rape victims reported to the Department of Forensic Medicine& Toxicology during the period from January 2010 up to December 2013. Victims were referred from investigating police authorities for evidentiary examination. Study included all cases registered under Section 376 Indian penal code (punishment for rape) by the police, with or without sections of other offences e.g. gang rape, rape followed by murder, abduction and rape, sexual intercourse made deceivingly or by an impostor; and rest all types of medico-legal cases were excluded. The prospective data regarding victim’s socio-demographic variables, detailed history of the alleged act, her relationship with the alleged accused person, date, time, place of occurrence of the crime,frequency of occurrence, reasons for delayed reporting, information regarding bathing, changing of clothing after the act, and use of any barrier methods by assailantswere collected fromthe rape victims, accompying family attendents, from the police, physical examination findings, laboratory investigation findings, and from any other available documents. Results: Most commonly alleged charge was ‘abduction and rape’ (46%), and least reported ones were gang rape, rape and murder (1%), and only ‘rape’ alleged in 8% cases. About 89% of the alleging women were 11-30 years old, with a median of 23.7 years, and mean 25 years; 57% were unmarried, 40% were educated up to the junior college level, and 55% were above the poverty line. A majority of cases (75%) were from rural and semi-urban areas. In 97% cases, the alleging woman knew the alleged accused person. Most commonly, boyfriends, friends, or the acquaintances were the culprits (70%). The fatal forms of sexual assault like gang rape, rape and murder usually done by the unknown assailants. The crime in 82% cases had occurred in Indoors. Out of which 60% cases had allegedly occurred at either victim’s home, or the alleged accused person’s home or office. Majority (47%) of cases reported during winter season, and the least (16%) in rainy season. A majority (60%) of the cases reported after 7 days of the alleged incident. The latency of reporting of cases varied from 24 hours to 2.5 months with a median of 27 days. Physical force for sexual intercourse was used in 46% of cases, but physical injuries found in 2-3% of cases only (extra-genital injuries in 2% and genital injuries in 3% of cases). The risk factor for the detection of genital injury is the presence of extra-genital injury [Odds Ratio (OR) 1.2, 95% Confidence Interval (CI)]; and, the risk factors for the presence of genital injuries in the absence of extra-genital injuries are, age below 12 years (OR 3.3, 95% CI) and beyond 38 years (OR 1.2, 95% CI). In 2%, cases seminal stain and foreign pubic hairs retrieved from the body of the victim. The victim women had witnessed use of condom by the alleged offender in 18% of cases. Conclusion: Though all age groups are prone for rape, unmarried women in their first three decades are more vulnerable. A known victim-offender relationship usually associated with the less physical or genital injuries, and less fatality. While evaluating rape cases possibility of false allegations of rape should not be ignored. Presence of physical or genital injuries is neither predictive nor essential for conviction. Medical examiners need to be circumspect while recording non-medical variables for a successful prosecution.

220-224

Authors: Vijay Kautilya D, Sathish K V, Shruti Prabhat Hegde Vijay Kautilya D, Sathish K V, Shruti Prabhat He

Background: Abuse of psycho active substances has been a problem in the society since ages. And the patterns of substances abused keep changing in every society. Street children are a marginalized group of our society who harbour a variety of social and cultural problems. There is an urgent need to understand their problems better so as to be able to cater to their needs. Method: This is a cross sectional descriptive study where 30 street children were interviewed regarding their personal and work problems. Patterns of abuse of substances by these children was studied based on their interview. Results: Most of the children have ended up on the street to escape from exploitation at home. Due to pressure and influence from friends they take to substance abuse. They start with tobacco; proceed to solvent abuse (80%), alcohol (80%), and cannabis (63.3%). Use of tobacco and solvents starts early at an average age of 8 years. Cannabis is taken by older children. Conclusion: These children face a variety of problems at home and also at work. They are highly exploited by the community. Most children take to high risk behaviour to overcome these hardships. Better understanding of this socially out cast community is the need of the hour in order to curb this evil of substance abuse.

229-233

Authors: V. J. Aghera, K. N. Pipaliya, D. M. Dabhi, H. M. Mangal, P. R. Varu, P. J. Manvar

Background & Objectives: Poisoning is most commonly encountered cause of death in medico legal autopsies. Diagnosis of poisoning is based on post-mortem examination and chemical analysis of viscera. Chemical analysis of viscera by FSL is time consuming process and sometimes it cannot detect poison. Present study can be helpful there to make diagnosis of poison from gross mucosal findings in stomach. Methods: Present study was conducted on randomly selected 150 cases of poisoning from total autopsies performed in year 2012 at department of forensic medicine, PDU govt. medical college, Rajkot. To study gross mucosal findings of stomach, it was divided into three parts namely cardiac end, body-fundus and pylorus. Gross mucosal findings like pale, congestion, haemorrhage, erosion, flatten rugae, edema, colour changes were noted. Results: Haemorrhage and congestion of mucosa were found most commonly, irrespective of type of poison and site of stomach affected. Pylorus and body fundus of stomach were more affected in all cases of poison except ALP poison where cardiac end was more affected. Interpretation & Conclusions: On the basis of the gross findings of stomach mucosa, combining with other data (history, clinical findings) diagnosis of poisoning can be made but to confirm the nature of poison chemical analysis is must.

242-246

Authors: U B Ghaffar, Ahmed SM

Road traffic accidents (RTA) are continuing to be an occurrence of epidemic proportions both in the developed and developing world statistically becoming one of the leading causes of mortality and morbidity. In Saudi Arabia, road traffic injuries are increasing exponentially year by year in spite of advances in safety technology. This review is based on the analysis of all published articles on road traffic accident in KSA published during the last 10 years. Critical analysis revealed that most of these unfortunate events can be attributed to vehicles travelling at excess speed and or drivers disobeying traffic signals which are absolutely preventable in nature. RTA accounted for most of the trauma admissions to hospital with young adults, especially males, who are the at risk population. The most frequently injured body regions as reported in the studies were head and neck, followed by upper and lower extremities. Latest statistics of Saudi Arabia indicates that approximately 19 deaths and 4 injuries occur daily due to road traffic accidents. Hence, there arises an urgent need to compile a comprehensive demographic baseline statistics and pattern of injuries that will provide scientific evidence based information to effectively educate the public regarding road safety. It will also help to plan appropriate interventions that was previously overlooked to prevent such loss of life and lifelong disability.

251-254

Authors: Nirmalya Kumar Sinha, Uday Basu RoyChowdhury, Dulal Chandra Das, Sumandev Chakraborty, Somnath Maity

Child sexual abuse is a common and a serious public health problem in every society. It not only leaves a permanent scar on the mind and the body of the victim, but also put her entire family into shame and humiliation. The majority of sexual assault cases is never reported to avoid social stigma and the number of reported sexual assault is the only tip of the iceberg. We present a case of a victim who died from smothering after sexual assault, sustained lacerated injury over the posterior wall of the vagina at its lower part including perineum, hymen and labia minora of both sides. There were multiple injuries all over the body. We attempt to highlight a case of rape murder complex, which is of rare occurrence in the semiurban regions of West Bengal, India.