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Medicine, Science, and the Law

John D Gilbert, Roger W Byard
Sotos syndrome is a rare congenital syndrome caused by deletions or mutations in the NSD1 gene (chromosome 5q35) which results in overgrowth. A wide range of manifestations may result in unexpected and/or early death, including congenital cardiac malformations and tumours, epilepsy, intra-tumoural haemorrhage or embolism and bleeding diatheses. A case of lethal pulmonary fat embolism complicating revision of a left total hip replacement following spontaneous fracture is reported in a 39-year-old man with Sotos syndrome...
April 2018: Medicine, Science, and the Law
Banwari Meel
Background Firearm-related deaths are a serious public-health problem in South Africa, which has the second-highest rate of firearm-related deaths in the world. Objective The aim of this study was to examine the trend in firearm deaths in the Transkei subregion of South Africa. Method An autopsy record review study was conducted at the Forensic Pathology Laboratory at Mthatha over a period of 23 years (1993-2015). Results Over a 23-year period (1993-2015), 27,036 autopsies were performed at the Mthatha Forensic Pathology Laboratory on people who had died from unnatural causes...
April 2018: Medicine, Science, and the Law
Nan Zhou, Qiu-Ping Wu, Terry Su, Qian-Hao Zhao, Kun Yin, Da Zheng, Jing-Jing Zheng, Lei Huang, Jian-Ding Cheng
Producing qualified forensic pathological practitioners is a common difficulty around the world. In China, forensic pathology is one of the required major subspecialties for undergraduates majoring in forensic medicine, in contrast to forensic education in Western countries where forensic pathology is often optional. The enduring predicament is that the professional qualities and abilities of forensic students from different institutions vary due to the lack of an efficient forensic pedagogical model. The purpose of this article is to describe the new pedagogical model of forensic pathology at Zhongshan School of Medicine, Sun Yat-sen University, which is characterised by: (a) imparting a broad view of forensic pathology and basic knowledge of duties and tasks in future careers to students; (b) educating students in primary skills on legal and medical issues, as well as advanced forensic pathological techniques; (c) providing students with resources to broaden their professional minds, and opportunities to improve their professional qualities and abilities; and (d) mentoring students on occupational preparation and further forensic education...
April 2018: Medicine, Science, and the Law
Andres Rodriguez Zorro, Jairo Hernando Vivas Diaz
Acute appendicitis is one of the most common surgical emergencies in paediatrics. However, acute appendicitis in early infancy is an uncommon condition. Furthermore, strangulation of the small intestine through appendicular knotting is described as very unusual in the literature and is generally not well-diagnosed in the clinical context. This article reports the case of a 23-month-old girl who entered the emergency department with a three-day history of abdominal symptoms and who died in less than 24 hours without receiving surgical intervention...
April 2018: Medicine, Science, and the Law
John Oladapo Obafunwa, Oluwatomi Ajayi, Mathias I Okoye
Medical evidence has continued to be given and evaluated in Nigerian courts since Nigeria's independence from Britain. The attitudes of the courts have been largely varied against a background of the individual judge's appreciation of forensic science and who should be considered an expert witness. The prosecution and defence lawyers equally display limited knowledge of forensic science. This paper reviews some of the decided cases, the reasons for the verdicts, forensic concerns and recommendations for the improvement of the criminal justice system...
April 2018: Medicine, Science, and the Law
Roger W Byard
Impalement injuries transfix a victim in an inescapable or helpless position. A study was undertaken at Forensic Science SA from 2002 to 2016 of all impalement deaths. There were six vehicle accidents (M:F=5:1; age 14-67 years, average age 38.5 years) involving impalements with a tree branch ( n=2; groin and chest), a metal pipe ( n=2; leg and head), a metal bridge railing (groin) and a metal fence post (chest). Two cases (both males, aged 47 and 18 years) had slipped on fences/gates, with impalements of the ankle and groin...
April 2018: Medicine, Science, and the Law
George A Johnson, Philip Smith, Jamie Robinson, Sallyanne A Collis, Christopher Paul Johnson
Pathologists providing a coronial autopsy service are very reliant on the information, including that concerning the body at the scene, provided prior to the post-mortem examination. This ensures the case is appropriate for a non-forensic autopsy and allows proper interpretation of the pathological and laboratory findings. We present the results of an audit of the extent and accuracy of the information provided (in terms of a set of descriptors), in relation to the body at the scene; whether just the information on the coronial autopsy request form 97a is used, or if it is supplemented with details from the police form 97 and statements from attending officers and scene witnesses...
January 1, 2018: Medicine, Science, and the Law
Mohit Chauhan, Chittaranjan Behera, Sreenivas Madireddi, Shramana Mandal, Sunil Kumar Khanna
Pulmonary metastasis is a well-known complication of an invasive mole. However, sudden death due to haemoptysis resulting from a metastatic invasive mole is extremely rare. We report the sudden unexpected death of an 18-year-old primigravida following a molar pregnancy. The death event was complicated within a few days of presentation by a clinically unsuspected mole invading the lung vasculature with associated widespread metastatic calcifications in the liver and brain. Death was due to haemorrhagic shock as a result of massive haemoptysis resulting from the invasive mole metastasising to the pulmonary vasculature...
January 1, 2018: Medicine, Science, and the Law
Banwari L Meel
Background Deaths as a result of burns are unrecognised, under-reported and therefore under-estimated, especially in rural areas such as the Transkei subregion of South Africa. Burning to death is painful and preventable. Objective The aim of this study was to investigate a 20-year trend in deaths as a result of burns in the Transkei subregion of South Africa. Method A record review descriptive study was undertaken of all medico-legal autopsies performed from 1996 to 2015 at Mthatha Forensic Pathology Laboratory...
January 1, 2018: Medicine, Science, and the Law
Christopher Bass, Gregory Yates
Objective The aim of this study was to review demographic and clinical characteristics of patients with complex regional pain syndrome type 1 (CRPS) seen in a UK medico-legal setting - particularly the relationship between CRPS and somatoform disorders. Methods Fifty consecutive cases of CRPS (interviewed 2005-2016) undergoing psychiatric assessment were reviewed. A systematic assessment of mental states was conducted via interview and examination of medical/psychiatric records. Thirty patients also completed the Brief Illness Perception Questionnaire (BIPQ)...
January 1, 2018: Medicine, Science, and the Law
Alec Samuels
The brief history of causation in medicine and science. The law. Setting the scene. Negligence but no causation. Duty to warn. PROGNOSIS: Loss of opportunity. Consecutive negligence. Indivisible injury. Unknown culprits. Obstetrics. The European Court of Justice. The future.
January 1, 2018: Medicine, Science, and the Law
John D Gilbert, Roger W Byard
A 52-year-old man died soon after admission to hospital with a severe metabolic acidosis and likely sepsis. He had a past history of alcohol abuse with withdrawal seizures. An abdominal computed tomography scan showed thickened bowel loops but no obvious ischaemic changes, and a blood culture yielded a pure growth of Escherichia coli. At autopsy, the liver showed well-established micro-nodular cirrhosis with steatosis. The peritoneal cavity contained 200 mL of turbid yellow-brown fluid, and the caecum and ascending colon were unusually thickened...
January 1, 2018: Medicine, Science, and the Law
Arun Sondhi, Lisa Luger, Lina Toleikyte, Emma Williams
Introduction Detention under section 136(1) of the Mental Health Act 1983 allows for the police to arrest a person from a public place and remove them to a 'place of safety', typically an emergency department or mental-health unit if it is 'in the interests of that person or for the protection of other persons in immediate need of care or control'. Aims/objective: The aim of this study was to describe the views and perceptions of the process for people with lived experience of mental distress who have been detained under section 136 of the Mental Health Act 1983...
January 1, 2018: Medicine, Science, and the Law
Rajanikanta Swain, Shivani Dhaka, Munish Sharma, Mantaran Singh Bakshi, O P Murty, Asit Kumar Sikary
Accidental cut-throat injuries are extremely rare and usually involve a sharp-edged weapon. In this paper, two cases of a cut-throat wound to two auto-rickshaw drivers are presented where the broken windshield of the auto-rickshaws was responsible for the wounds. In both the cases, fatal incised wounds were present over the neck, cutting the soft tissue along with the major vessels. The death occurred due to exsanguination caused by neck-vessel injury in one case and trachea along with neck-vessel injury in the second case...
January 1, 2018: Medicine, Science, and the Law
Roger W Byard
A study was undertaken to investigate the range and nature of deaths that may result from explosions in a civilian population that has not been exposed to terrorist attacks or significant military activities. A search was conducted of autopsy files at Forensic Science SA, Adelaide, Australia, from July 2000 to June 2017 for all cases where death had been attributed to an explosion. Twenty cases were identified, consisting of 10 accidents, five suicides, two homicides, one murder-suicide with two decedents and one case where the manner of death was undetermined...
January 1, 2018: Medicine, Science, and the Law
Himanshu Khajuria, Biswa Prakash Nayak, Ashish Badiye
Background and aims Hair analysis for drug detection is one of the widely accepted imperative techniques in the field of forensic toxicology. The current study was designed to investigate the efficacy of chromatography for detection of drugs of abuse in hair. Method A comprehensive review of articles from last two decades on hair analyses via PubMed and similar resources was performed. Issues concerning collection, decontamination and analytical techniques are summarised. Physiochemical nature of hair, mechanism of drug incorporation and its stability in hair are briefly discussed...
January 1, 2018: Medicine, Science, and the Law
Fumiko Satoh, Motoki Osawa
Double-suicide cases have long been common in Japan, particularly among lovers. Classical studies conducted in the 1950s are well known. According to a report by Ohara, the double-suicide rate in Japan was recorded as 3.1% in 1954. Nevertheless, recent tendencies have not been reported. To assess the latest trends of double suicide, extensive studies were conducted in a populous area of Kanagawa, Japan, during 1999-2011. Suicides during the period in the domestic area claimed 23,195 victims. In all, 82 cases of double suicide were extracted, with 170 victims, meaning that double suicides occurred with incidence of 0...
January 1, 2018: Medicine, Science, and the Law
Keith J B Rix
No abstract text is available yet for this article.
January 2018: Medicine, Science, and the Law
Vaibhav Sonar, Sachin Patil
Choking is a form of asphyxia which is caused by an obstruction within the air passages. Here, we report a case of obstruction of the upper respiratory tract due to assassin bug ( Cydnocoris gilvus) where allegations of medical negligence were made by relatives of the deceased. Autopsy findings demonstrated that an insect was present inside the larynx, lodged at the epiglottis. Multiple haemorrhagic patches were present at the base of the tongue, larynx, epiglottis, vocal cords and tracheal bifurcation. As Reduviidae can be successfully used as a biological pest-control agents, they should be used with due precaution...
January 2018: Medicine, Science, and the Law
Si-Lei Tan, Shu-Ya Peng, Lei Wan, Jie-Min Chen, Wen-Tao Xia
Dental injuries, especially of the incisors, caused by punches in violent criminal attacks could be seen in daily forensic casework involving the identification of injuries to a living body. Sometimes, when there is neither circumstantial evidence nor information about the surrounding circumstances, it is difficult to discern the cause of these injuries and the manner in which they were inflicted. As an example of clinical forensic medicine, we present the case of a 58-year-old woman whose teeth were injured when fighting with her son-in-law over household affairs with no witnesses present...
January 2018: Medicine, Science, and the Law
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