Pavel Timonov
Michael Ferric
In many natural and unnatural death cases, where the cause of death is not certain whether the death was accidental, homicidal, or suicidal in nature then there we
need Medical examination i.e. Postmortem examination which become necessary during the crime scene investigation to find the cause and manner of death in
cases where victim body was found dead. To perform the medico-legal autopsy the medical examiner not need the permission of the deceased family or relatives.
Manner and cause of death can be described by the various examination findings and investigations results performed under the medical officer.
Sachin Meena K
This present study was performed on cases of death due to compression of neck by any form like ligature material due to hanging, strangulation etc brought for
postmortem examination at mortuary of Government Medical College, Kota, Rajasthan, India during period of 1st January 2019 to 31st December 2019. A total of
1296 postmortem was conducted, out of which 152 were of compression of neck by means of any form. Out of them 143 cases were of hanging, 1 was ligature
strangulation, 1 was manual strangulation, 1 was of hanging with antemortem injury over body and 6 were under query as sign of asphyxia present over body
but ligature mark was not clearly visible. We observed that dribbling of saliva present in most cases of hanging but not seen in ligature and manual strangulation
cases. In query cases we had taken sample of cello tape which was taken on the paper from around the neck for presence of fiber & foreign bodies and its cross
match with ligature material. The final cause of death was given after receiving of FSL reports.
Nursen Turan
Objective: In the case of a newly born infant, either stillborn or found dead, the state of the lungs is of particular forensic
interest. The aim of this study was to determine whether lungs are adequate for pathological comment about stillbirth or
live birth of infant.
Vijay Kumar AG
Introduction: Rib fractures are the most common injury sustained following blunt chest trauma, accounting for more
than half of thoracic injuries from non-penetrating trauma. Approximately 10% of all patients admitted after blunt
chest trauma have one or more rib fractures. In United States they account for 10% of traumatic injuries and 14% of
all chest wall injuries. The incidence of flail chest is 10% to 15% of severe chest traumas. Material and Methods: In this
retrospective study, fatal cases of thoracic trauma autopsied during the period 1st January 2009 to 31st December 2010
were analyzed at the Department of Forensic Medicine & Toxicology, Adichunchanagiri Institute of Medical Sciences,
Mandya District, and Karnataka, India. Results: In the present study, 31.3% of victims belong to the 3rd decade of life.
Women were less involved than men with ratio of 1: 1.5. The mortality rate was 20.18%. The victims in most of the cases
sustained non displaced rib fractures followed by displaced fractures. 5th rib fracture were seen in eight cases followed
by 4th and 6th ribs fracture were seen in seven cases.
Helena Machado
Official technical and scientific recommendations on standard procedures and quality control in the field of testing of paternity do
not cover issues relating to methods of subjects’ identification in the processing of paternity investigations that are compulsory for
the individuals – parental testing ordered by courts. The aim of this paper is to explore the main issues posed to forensic laboratories
when collecting samples for court ordered paternity investigation and therefore contribute to the ongoing debate on social and ethical
implications of parental testing and open up new dimensions of this practice.
Dr. Bernat-N Tiffon
The present article examines in depth a practical case of murder of an 18-month-old minor perpetrated by her own parent (filicide). The singularity of the casuistry not only lies in the criminological impact of the murder itself, but also pivots on the mental state of the perpetrator and whose sentence (consult) -based on the Mental Health professionals of the public sector, as well as the Forensic Doctors and other circumstances surrounding the casuistry- not appreciate Modifying Circumstances Of Criminal Responsibility (MCCR) based on the existence of psychic alteration. On the other hand, the Experts (private) maintained their professional evaluation during the plenary session, according to which the offender presented a mental disorder based on a psychotic disorder (brief, acute and transitory), according to the clinical documentation on hand closest to the facts of the case and the testimony of the witnesses. With the majority of the article available, the article analyzes the behavior of the convicted party and compares it with the hypothesis of the defense experts, in relation to the lucid intervals that may be manifested by psychotic and/or schizophrenic disorders under the harmful influence of mental dysfunction (a circumstance which, the same Experts informed of in the actual plenary act).
Charles B. Nemeroff
Bernat N Tiffon* and Jorge González-Fernández
A unique case of the psychological profile of a child under 14 years of age is reported who, comorbidly affected by Attention Deficit Hyperactivity Disorder (ADHD) with borderline intellectual disorder (borderline) perpetrates the murder of another minor of the same age due to low tolerance to psycho-emotional frustration
Bernat-N Tiffon* and Jorge González-Fernández
A case of notorious uniqueness of neonaticide is related, illustrating the psychological profile of a young mother who, at the same moment of breaking water and giving birth to a female baby, throws it into the void from the window of the bathroom of her home when he was only a few minutes old.
Michael A. Freitas
DNA fingerprinting, likewise called DNA composing, DNA profiling, hereditary fingerprinting, genotyping, or character testing, in hereditary qualities, strategy for detaching and distinguishing variable components inside the base-pair grouping of DNA deoxyribonucleic corrosive. The procedure was created in 1984 by British geneticist Alec Jeffrey's, after he saw that specific groupings of profoundly factor DNA known as minisatellites, which don't add to the elements of qualities, are rehashed inside qualities.
Pathology is the investigation of the circumstances and end results of sickness or injury. The word pathology likewise alludes to the investigation of infection as a general rule, fusing a wide scope of science research fields and clinical practices. In any case, when utilized with regards to current clinical therapy, the term is regularly utilized in a more thin style to allude to cycles
In semantics, morphology is the investigation of words, how they are shaped, and their relationship to different words in the equivalent language. It examines the design of words and portions of words like stems, root words, prefixes, and additions.
The expression "post-mortem" gets from the Ancient Greek αá½τοψία autopsia, "to see with one's own eyes", got from αá½τÏ?ς (cars, "oneself") and á½?ψις (opsis, "sight, view")."post-mortem" has been utilized since around the seventeenth century, it alludes to the assessment of inside the dead human body to find infections and reason for death.
Bloodstain Pattern Analysis (BPA) is the field of legal science that comprises of the investigation and examination of bloodstains at a known or associated crime location with the reason with making inferences about the nature, timing and different subtleties of the crime
The clinical analyst is an appointed official in some American jurisdictions who is prepared in pathology that explores passing’s that happen under uncommon or dubious conditions, to perform after death assessments, and in certain wards to start inquests
DOI: 10.37421/2472-1026.2023.8.207
Sickle Cell Anemia (SCD) stands as a life-threatening hematological condition primarily prevalent in sub-Saharan Africa. It originates from a genetic mutation in the β-chain hemoglobin gene, leading to the substitution of valine for glutamic acid. This genetic alteration gives rise to an aberrant hemoglobin variant known as hemoglobin S (HbS). Under deoxygenated conditions, HbS undergoes polymerization, causing red blood cells to assume a rigid, sickle-like shape and significantly reducing their lifespan. Scientific investigations have underscored a robust correlation between oxidative stress, inflammation, immune response, and the development of sickle cell disease. The cumulative effects of these processes contribute to the emergence of vasculopathy, affecting blood vessels, and a range of other complications. While recent research has elucidated the pivotal role of the innate immune system in SCD pathogenesis, insights into the involvement of the adaptive immune system remain limited. This comprehensive review delves into the intricate interplay among the immune system, inflammation, oxidative stress, blood transfusion, and their collective impact on the progression of sickle cell anemia.
DOI: 10.37421/2472-1026.2023.8.209
Exploring the Therapeutic Potential of Stem Cell Cultured Conditioned Media: Insights from Zebrafish Embryo Evaluation Conditioned media obtained from stem cell cultures offer promising prospects as innovative therapeutic interventions against a range of diseases, owing to their rich reservoir of growth, trophic, and protective factors. Crucially, thorough in vivo assessment of these products' effects and safety is imperative. Zebrafish emerges as an ideal testing ground for high-throughput toxicological analysis, presenting an opportunity to minimize reliance on mammalian models while maintaining reliability. In this study, we delved into the biological ramifications of exposing zebrafish embryos to conditioned medium derived from Wharton's jelly mesenchymal stem cells. Employing a multifaceted approach involving molecular, embryological, behavioral, and in vivo imaging techniques, we unearthed a spectrum of outcomes arising from non-toxic/non-lethal dosages of the conditioned medium. Notably, this exposure triggered an array of responses including antioxidant fortification, anti-apoptotic activity, and pro-regenerative potential. This was underscored by the upregulation of several genes associated with antioxidant defense, glycolysis, and cell survival (bcl2l1, mcl1a, and bim). Simultaneously, the conditioned medium downregulated pro-apoptotic markers. Of note, this comprehensive investigation marks the pioneering attempt to thoroughly analyze the effects of conditioned medium on an entire organism, encompassing developmental, molecular, and behavioral perspectives. We hold a strong belief that these findings will lay a robust foundation for the future therapeutic utility of conditioned media.
DOI: 10.37421/2472-1026.2023.8.210
HIV Viral Load (VL) assessment serves as a pivotal tool in HIV clinical management, offering insights into adherence and antiretroviral effectiveness. Over time, both national and global antiretroviral treatment guidelines have evolved to recommend regular VL testing. South Africa (SA) has advocated for routine VL testing since 2004. The centralized HIV VL program, overseen by the National Health Laboratory Service (NHLS), has experienced substantial expansion. An analysis of de-identified retrospective VL data spanning from 2013 to 2022 was conducted to assess program performance. The volume of tests performed exhibited remarkable growth, surging from 1,961,720 tests in 2013 to an impressive 45,334,864 tests in 2022. Median total in-laboratory Turn Around Times (TAT) fluctuated, ranging from 94 hours in 2015 to 51 hours in 2022. The introduction of two novel assays contributed to enhanced median TATs across all laboratories. The occurrence of VL levels exceeding 1000 copies/ mL exhibited a steady decline. While experiencing initial growth, instances of VL counts below 50 copies/mL plateaued at around 70% starting in 2019, gradually decreasing to 68% by 2022. Some discrepancies among assays were noted. In summation, South Africa's VL program has achieved significant success. Remarkably, the program stands as the world's largest of its kind, offering valuable insights for future public health initiatives reliant on laboratory support for patient outcomes and program performance assessment.
DOI: 10.37421/2472-1026.2023.8.215
This study aims to investigate the influence of free-living amoebas on the excretion of both macroelements and microelements in urine. The research focuses on analyzing the concentrations of macroelements, including calcium (Ca), phosphorus (P), sodium (Na), potassium (K), and magnesium (Mg), as well as microelements like manganese (Mn), zinc (Zn), copper (Cu), iron (Fe), and chromium (Cr), during acanthamoebiasis, while taking into consideration the immunological status of the host. This groundbreaking study reveals, for the first time, notable changes in the urinary excretion of several elements in response to Acanthamoeba sp. infection in immunocompetent mice. Specifically, 16 days post-infection, there is an observed increase in the excretion of calcium, manganese, copper, iron, sodium, and chromium, alongside a decrease in potassium excretion. As the infection progresses to its later stage (24 days post-infection), there is a further reduction in urinary potassium excretion and lower levels of phosphorus in Acanthamoeba sp. infected immunocompetent hosts. In the context of acanthamoebiasis within immunosuppressed hosts, an initial increase in excretion of zinc, iron, and chromium is noted at the early phase of infection, accompanied by increased sodium excretion only at 16 days post-infection with Acanthamoeba sp. Furthermore, the immunosuppressive state of the host has an impact on the urinary concentrations of iron, chromium, zinc, copper, manganese, and calcium.
DOI: 10.37421/2472-1026.2023.8.208
Numerous evidence-based health interventions, especially within low-income contexts, have not yielded the anticipated outcomes. To tackle systemic obstacles in healthcare delivery, we devised the Adaptive Diseases Control Expert Programme (ADEPT) in Tanzania. Our focus was on examining the workability, acceptability, and effectiveness of this model using tuberculosis (TB) and diabetes mellitus (DM) as prototypes. This initiative followed an effectiveness-implementation hybrid type-3 design, which was executed in the Dar es Salaam, Iringa, and Kilimanjaro regions. The approach involved a gradual training methodology facilitated by web-based platforms that incorporated Gibbs' reflective cycle. We expanded health facilities providing TB services to encompass DM diagnostic capabilities, including glycated hemoglobin A1c (HbA1c) measurements. To ensure adherence, a clinical audit was employed as an evaluative tool. To evaluate the model's adherence, acceptability, and feasibility, we employed both retrospective and cross-sectional methodologies. Our findings from 2019 to 2021 demonstrated that health facilities implementing the ADEPT intervention consistently identified a greater number of individuals with both TB and DM (median of 8, IQR 6-19) compared to control facilities (median of 1, IQR 0-3) (p=0.02). Moreover, the application of HbA1c in TB/DM cases within intervention sites proved to be clinically valuable, reaching 63% (IQR: 35-75%), while control sites exhibited no utilization at any level. Although other aspects of the standard clinical management for patients with both TB and DM showed no significant differences, the positive impact of the ADEPT intervention was evident.
DOI: 10.37421/2472-1026.2023.8.211
Allogeneic hematopoietic stem cell transplantation is a potential curative therapy often employed for patients with haematological malignancies. Over the past two decades, numerous randomized controlled trials, reviews, and meta-analyses have investigated the effectiveness of rabbit anti-thymocyte globulin in preventing graft vs. host disease. However, only a limited number of these studies have aimed to compare different formulations of r-ATG. Given that the most recent article comparing various r-ATGs for GvHD prevention dates back to 2017, we conducted a systematic review of literature published from 2017 to the present using Indexed at, Scopus, Cochrane, and MEDLINE. Our primary focus was on acute GvHD (aGvHD) and chronic GvHD (cGvHD) prevention. We meticulously analyzed five studies in total; among these, four studies examined differences between Thymoglobulin (ATG-T) and Grafalon (ATG-G), while one investigated the impact of ATG-T dosage. Overall, the utilization of different r-ATG types does not appear to significantly influence cGvHD, aGvHD grades II–IV, transplant-related mortality (TRM), overall survival (OS), non-relapse mortality (NRM), leukemia-free survival (LFS), relapse rates, overall infection rates, and reactivation of the Epstein-Barr virus (EBV). However, conflicting data exists for aGvHD grades III–IV, graft vs. host-free survival (GRFS), moderate to severe cGvHD, and reactivation of the cytomegalovirus (CMV). Through our comprehensive research, our aim was to succinctly present the latest findings on r-ATGs in allo-HCT and provide insights into the distinctions among various ATG formulations in terms of their targets and origins.
DOI: 10.37421/2472-1026.2023.8.212
Approximately 30% of patients with gastrointestinal cancer undergoing 5-Fluorouracil (5-FU)-based chemotherapy experience severe toxicity. Presently, there is a dearth of effective tools for identifying individuals at risk within this context. This study aims to fill this gap by constructing a predictive model using a Bayesian network, a robust probabilistic graphical model known for its interpretable predictions. Employing a dataset encompassing 267 gastrointestinal cancer patients, the data underwent preprocessing and was partitioned into TRAIN and TEST sets in an 80%:20% ratio. Variable importance was assessed using the RandomForest algorithm, employing the MeanDecreaseGini coefficient. The Bayesian network model was designed using the bnlearn R library, utilizing a 10-fold cross-validation on the TRAIN set, and optimizing the network structure with the aic-cg method. Model performance was evaluated through accuracy, sensitivity, and specificity, employing cross-validation on the TRAIN set and independent validation on the TEST set. The model displayed favorable performance, achieving an average accuracy of 0.85 (±0.05) and 0.80 on the TRAIN and TEST datasets, respectively. Sensitivity and specificity were 0.82 (±0.14) and 0.87 (±0.07) for the TRAIN dataset, and 0.71 and 0.83 for the TEST dataset. A user-friendly tool was developed for clinical deployment. Despite some limitations, our Bayesian network model exhibited a strong capacity to predict the likelihood of severe hematological toxicity in gastrointestinal cancer patients undergoing 5-FU-based chemotherapy. Future investigations should concentrate on validating the model using larger patient cohorts and in diverse clinical scenarios.
DOI: 10.37421/2472-1026.2023.8.213
We present a series of cases involving individuals with the homozygous MCPggaac haplotype, a genetic configuration associated with an increased likelihood and severity of atypical hemolytic uremic syndrome (aHUS), particularly when combined with other high-risk aHUS mutations. Complement blockade therapy was administered at a median age of 92 months (with an interquartile range of 36 to 252 months). Prior to initiating CBT (Eculizumab), patients experienced a median of two disease relapses. These relapses transpired within an average span of 22.16 months (median of 17.5, ranging from a minimum of 8 months to a maximum of 48 months) following the initial subsequent disease onset (observed in 6 out of 8 patients). Treatment encompassed plasmapheresis/intravenous plasma exchange (PI/PEX), occasionally supplemented by renal replacement therapy (RRT). Upon the implementation of complement blockade, the occurrence of disease relapses ceased in the pediatric population. For children possessing the MCPggaac haplotype, with or without additional genetic mutations, achieving remission was feasible through renal replacement therapy, without an immediate imperative for complement blockade. However, in cases where aHUS relapse manifested shortly after disease onset or when relapses transpired recurrently, sustained complement blockade emerged as a necessary course of action. The specific duration of such blockade, however, remains uncertain. Failure to initiate complement inhibition prior to experiencing 4–5 relapses could potentially lead to the development of proteinuria and chronic renal failure over time.
DOI: 10.37421/2472-1026.2023.8.214
Commencing in May 2021, the utilization of sotrovimab in Italy for early-stage treatment of SARS-CoV-2 infection and disease progression prevention has been established. Nevertheless, certain in vitro investigations have cast doubt on its efficacy against Omicron variants. As a result, our objective was to conduct a more extensive inquiry into the real-world efficacy of sotrovimab. Through a retrospective analysis, we gathered medical records of SARS-CoV-2 patients assessed in the infectious diseases units of Sassari, Foggia, and Bari, Italy. Our study encompassed both individuals who received sotrovimab treatment and those who were untreated throughout 2022. Our primary focus was to assess the impact of sotrovimab on curtailing disease progression (defined as the initiation of oxygen supplementation) and COVID-19-related fatalities. Additionally, we sought to evaluate the safety profile of sotrovimab.
DOI: 10.37421/2472-1026.2023.8.216
Monoclonal Gammopathy (MG) is characterized by the excessive production of monoclonal proteins, potentially leading to the onset of hyperviscosity syndrome. This study aims to evaluate retinal circulation utilizing optical coherence tomography angiography parameters in individuals with monoclonal gammopathy. The study involved OCTA measurements using the Optovue AngioVue system, analyzing 44 eyes of 27 MG patients and 62 eyes of 36 control subjects. Parameters such as superficial and deep retinal capillary vessel density (VD SVP and DVP) across the entire 3 × 3 mm macular and parafoveal region, foveal avascular zone (FAZ) area, and central retinal thickness (CRT) were quantified using AngioAnalytics software. Employing a multivariate regression model, the OCTA parameters were compared between the two groups, with adjustments for imaging quality (SQ). Age showed no significant difference between monoclonal gammopathy subjects and controls (63.59 ± 9.33 vs. 58.01 ± 11.46 years; p>0.05). After accounting for image quality, VD SVP was notably lower in the MG group than the control group (44.54 ± 3.22% vs. 46.62 ± 2.84%; p<0.05). No significant disparities were observed in the other OCTA parameters between the groups (p>0.05). The reduced superficial retinal capillary vessel density, as indicated by OCTA, in MG patients implies sluggish blood flow, diminished capillary circulation, and subsequent tissue hypoperfusion. This investigation proposes that OCTA assessment of retinal circulation in cases of monoclonal gammopathy could serve as a sensitive non-invasive method for detecting and monitoring early microcirculatory dysfunction resulting from heightened viscosity.
Journal of Forensic Medicine received 165 citations as per Google Scholar report
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