Forensic Science, Medicine and Pathology最新文献

Gelsemium alkaloids, such as gelsemine and koumine, are highly toxic compounds that can induce rapid respiratory and cardiovascular failure. Their clinical manifestations-dizziness, ptosis, and sudden collapse-closely resemble those of acute myocardial infarction, presenting diagnostic challenges in forensic practice, especially in distinguishing between poisoning and cardiovascular events. We describe a sudden death in a middle-aged male following a restaurant meal. The decedent developed acute dizziness and eyelid drooping shortly after ingestion and died within hours despite resuscitation. Autopsy revealed pulmonary edema, systemic congestion, and coronary atherosclerosis with ischemic changes, but without acute infarction. Toxicological analyses identified gelsemine and koumine in meal remnants and biological samples, which were confirmed by LC-MS/MS with validated parameters. The concentrations detected were within reported toxic ranges, supporting a fatal exposure. On the balance of evidence, the death was most consistent with poisoning from Gelsemium alkaloids, rather than primary cardiac disease. This case emphasizes the importance of integrating toxicological confirmation with pathological findings to distinguish poisoning from cardiovascular causes in sudden deaths.

In forensic entomology, postmortem interval (PMI) estimation relies on the age, development, and succession patterns of insects on decomposing remains; however, the presence of drugs in the body can disrupt insect development and compromise the accuracy of these estimates. Paracetamol, a commonly used over-the-counter drug in Southern Africa, is often implicated in both intentional and accidental overdose cases. This study investigates the effects of paracetamol on insect development using spiked pig carcasses as experimental models to simulate human overdose. Three pigs received paracetamol at ascending doses 75 mg/kg (toxic), 150 mg/kg (lethal), and 300 mg/kg (double lethal), and the fourth pig served as an untreated control. The experimental carcasses were placed in separate metal cages in a natural outdoor environment during the autumn season, and insect samples were collected daily over a 32-day period. Observations and morphological measurements of the length, width, and weight were recorded for selected dipteran and coleopteran species of forensic value. Results showed that Chrysomya putoria and Chrysomya megacephala exhibited an increased larval length, width, and weight at double lethal doses. Lucilia sericata showed significant reductions in weight at all paracetamol doses (p = 0.012, 0.001 and 0.001) in comparison to the control, while Chrysomya albiceps and Thanatophilus micans were not affected by the drug. Furthermore, results showed that the mortality rates of newly emerged Ch. putoria, Ch. megacephala, Ch. albiceps and L. sericata were higher in paracetamol-treated groups compared to those observed from the control group, with the rates of 22.2% at the toxic dose, 35.0% at the lethal dose, 45.0% at the double lethal dose, and 11.1% in the control group. Morphological abnormalities were observed in newly emerged adults of Ch. putoria and L. sericata that showed progressive wing deformities at the toxic and lethal doses and discoloration at the double lethal dose. Ch. albiceps exhibited no observable deformities across all doses. These findings show that paracetamol disrupts critical developmental processes in certain species in a dose-dependent manner, highlighting the need to study its effects on other forensically important insects. Moreover, these findings contribute towards enhancing PMI precision and advancing forensic entomotoxicology in the region by generating local baseline data for KwaZulu Natal province, South Africa.

As an effective alternative therapy, acupuncture is increasingly recognized and utilized worldwide. While acupuncture is used to treat neurological, respiratory, and circulatory disorders, its clinical efficacy is influenced by various factors. Even minimal stabbing wounds may cause physical injury or be life-threatening if done improperly. We report the case of a young man who died suddenly after receiving acupuncture treatment. Autopsy revealed multiple needlestick wounds in the bilateral lungs, liver, and spleen, leading to traumatic pneumothorax and hemoperitoneum, and the man ultimately died of respiratory failure. Notably, the case documentation mentioned only dorsal acupuncture. However, during the autopsy, we discovered additional puncture sites in the bilateral lateral regions, with dimensional discrepancies compared to the dorsal needlestick. We hypothesized that these discrepancies were caused by the use of needles of varying sizes and raised reasonable suspicion of multiple perpetrators. A subsequent law enforcement investigation confirmed that the man's dorsal and lateral acupuncture were performed separately by a masseur at a private clinic and by his partner. A detailed analysis clarified how injuries to different anatomical regions contributed to the fatal outcome, providing a foundation for legal accountability. The uniqueness of this case lies in the involvement of multiple suspects, multiple organ injuries, and unlicensed medical practice. This case not only enriches the report on adverse events associated with acupuncture but also highlights the critical importance of meticulous forensic examination and comprehensive case investigation.