Forensic Science, Medicine and Pathology最新文献

Stanozolol is a synthetic anabolic-androgenic steroid commonly used by bodybuilders to increase muscle mass. However, its use can lead to serious adverse effects on the liver, including cholestasis, hepatic necrosis, and even death. In this case report, we describe a fatal case of stanozolol overdose in an otherwise healthy 35-year-old amateur bodybuilder. The patient presented with general malaise, jaundice, and a history of hematemesis after taking stanozolol tablets orally for 3 months. Upon admission, his liver function tests were significantly abnormal, and he succumbed within 48 h despite symptomatic treatment. The autopsy revealed sub-massive hepatic necrosis, focal macro-vesicular steatosis, and a cholestatic pattern of acute liver injury, with the chemical examination confirming the presence of stanozolol in the blood, liver, and kidneys. The cause of death was determined to be hepatic necrosis as a complication of stanozolol overdose. The overuse of anabolic steroids like stanozolol can cause hepatotoxicity, resulting in reversible cholestatic hepatitis or, in rare cases, fatal liver injury. The mechanism of anabolic androgenic steroid (AAS) drug-induced liver injury is obscure, but proposed mechanisms include oxidative stress and cholestasis. In this case, the recent overuse of stanozolol, a 17 alpha-alkylated (oral) AAS led to sub-massive hepatic necrosis and subsequent liver failure, proving fatal. It is imperative that healthcare providers and the public are informed about the dangers of AAS use, especially since AAS usage has increased recently due to easy online access, to prevent potentially life-threatening consequences.

Page kidney is a condition where external compression of the renal artery and renal parenchyma leads to subsequent ischaemia and activation of renin-angiotensin-aldosterone axis. A 42-year-old female with hirsutism, hypertension and diabetes was diagnosed with a right adrenal mass and underwent laparoscopic adrenalectomy. Her hypertension worsened postoperatively and was managed medically. Subsequently she developed a right flank pain on the fifth postoperative day and died suddenly the next day. Autopsy revealed a pale body with cushingoid appearance. Surgical scars were healthy. Internal examination of the abdomen revealed a haemoperitoneum of 500 ml together with a large subcapsular haematoma measuring 1000 ml surrounding the right kidney, compressing the right renal artery. Kidneys were pale and the right kidney was soft and friable. Cortical surface of the right kidney demonstrated a possible surgical puncture site with an overlying thrombus together with a contused inferior vena cava. Other organs were pale but appeared otherwise normal. Histology revealed diffuse cortical necrosis of right kidney and features of adult respiratory distress syndrome in the lungs. Haemorrhagic shock following laparoscopic adrenalectomy for right adrenal tumor was declared as the cause of death, contributed by the development of the Page kidney. Trauma of several aetiologies including laparoscopic abdominal surgery may contribute to Page kidney. It presents with flank pain, hypertension and renal mass. Since postoperative blood loss usually manifests as hypotension, resulting hypertension may mislead the attending clinicians. Once diagnosed, it can be managed with surgical drainage and antihypertensives.

In forensic practice, spinal cord injury (SCI) resulting in death has rarely been reported. Here, we present the case of a 65-year-old woman who on admission was conscious without dyspnea or dysphagia. Physical examination revealed two sharp objects penetrating the neck: a pair of scissors lodged in the neck on the right side of the thyroid cartilage and a knife embedded in the nuchal region accompanied by minor seepage of bloody exudate. Radiography showed that the scissors and knife were retained in the cervical spine. Despite a series of medical interventions, the patient died 26 days later.

Method: A systematic forensic autopsy was performed.

Results: The cause of death was confirmed to be respiratory failure associated with SCI, which was caused by the combination of scissors and a knife.

Conclusion: Based on this case, we believe that when there are multiple causes of death, forensic pathologists should determine the primary, immediate, contributory, and other causes of death to ascertain criminal responsibility.

Reference data for dental age estimate is sparse in New Zealand (NZ), with only two contemporary studies. Te Moananui et al. (J For Sci. 53(2), 2008) presented modified Demirjian percentile curves to estimate dental age of Pasifika, Māori, and European males and females (n = 1383), while Timmins et al. (Forensic Sci Med Pathol. 8:101-8, 2012) found the Demirjian method (1973) was valid for a smaller sample (n = 200) of unknown ancestry. The study presented here sought to validate the Demirjian and the Te Moananui methods for a sample of the NZ population of unknown ancestry and a subgroup of known ancestry i.e., Pasifika, Māori and European, for males and females. The Demirjian method (1976) was applied to the current study's sample consisting of 3523 individuals aged 4 to < 20 years. The seven left mandibular teeth (third molar excluded) and tooth scores were summed for each individual, with the Te Moananui methods applied to this subgroup. The results revealed these methods to be less than ideal for estimating dental age of the NZ sample, for both males and females. The probit regression form of Transition Analysis (TA) was employed to calculate the mean age entering each tooth stage, for the seven teeth, to reduce age mimicry that is commonly associated with traditional regression analysis. TA results revealed Pasifika and Māori individuals to be more advanced than Caucasian individuals. The sex groups were also compared to the mean ages presented by Demirjian and Levesque with mixed results (J Dent Res. 59(7):1110-22, 1980), highlighting the need for more research in this area.

The concerted use of Greek-derived medical terms in the present day allows us to facilitate effective communication while honouring the historic roots of Western medicine. The word autopsy derives from its third century B.C. Hellenistic Greek etymon αὐτοψία ("to see for oneself"), later borrowed into Neo-Latin as autopsia and Middle French as autopsie. Throughout its etymological journey, autopsie underwent semantic narrowing from the passive sense "self-inspection of something without touching", to a purposeful action by an operator performing "an examination of the human body itself", to specifically "dissection of a dead human body". These curious turning points for the meaning of autopsie produced an auto-antonym: the same word now has multiple meanings, of which one is the reverse of another. The French autopsie used in the latter sense predates that documented for the English autopsy (attested 1829). Since the early nineteenth century, attempts were made to remedy the discrepancy between conflicting senses either by adding determining adjectives to the existing noun, or by substituting it with another word altogether. This review explores the etymological journey of autopsy, considers which related terms have been popularised throughout history, introduces the concept of lexical ambiguity and suggests unambiguous English compound (necropsy and necrotomy) and Latin-derived (non-invasive and invasive postmortem examination) alternatives to satisfy a recent appetite for clarity in international professional and next-of-kin communication.

This case report presents a rare case of an atypical head stab wound suffered by a drug addict and inflicted with a screwdriver during drug-induced psychosis. It describes the diagnostic and treatment procedures in the hospital and the findings of the subsequent autopsy. It also analyzes the review of the interpretation of the CT scans made upon admission and the subsequent treatment by an independent medical review panel, which revealed signs of medical mismanagement. Therefore, it also discusses the legal consequences that the case may have involved for the attending physicians in addition to the consequences for the suspected perpetrator. The report raises many issues encountered in the case in terms of the clinical treatment and forensic determination of the manner of death in cases of injuries caused by sharp instruments and highlights the importance of comprehensive evaluation of the circumstantial evidence together with the clinical or autopsy findings, since such evidence may sometimes be overlooked in clinical practice.

This article explores the development and challenges of forensic medicine in Africa, comparing it to developed countries. It addresses limited resources, funding, and a shortage of trained professionals. The growth of forensic investigation capabilities and the challenges of funding and technology access are discussed. Training and education have improved, but disparities remain. Partnerships with developed countries and international organizations are crucial to bridge the gap. A comprehensive legal framework is important, but disparities exist among African countries. Harmonizing forensic laws would enhance cooperation. The role of forensic medicine in the criminal justice system is examined, emphasizing the need to build trust in forensic evidence. International collaboration and capacity building are key to advancing forensic medicine in Africa. Investments in infrastructure, funding, training, and legal frameworks are required. By leveraging partnerships, Africa can develop its forensic medicine capabilities for a fair and effective criminal justice system.

Etomidate is a nonbarbiturate sedative derived from imidazole. Prolonged and excessive use of etomidate can lead to the suppression of adrenocortical function, myoclonus, and even death. This report describes a rare case of a 47-year-old man who died from acute intoxication after oral ingestion of liquid containing etomidate. The cause of death was conclusively attributed to etomidate based on a comprehensive investigation, including autopsy, histopathological examination, toxicological analysis, and biochemical analysis. This is the first reported case of a fatality solely resulting from the oral ingestion of etomidate, which can provide valuable insights for future forensic investigations involving etomidate poisoning. Therefore, it is imperative to share this case with the scientific community.

These two case reports are of fatal injuries from less-lethal weapons (tear gas guns) using pebbles as an unconventional ammunition. Reported here are the fatal outcomes of two 19-year-old males, one with head trauma and the other with abdominal trauma. They were admitted to the ED and subjected to immediate exploratory operations, but they passed away. On autopsy, the first case demonstrated a right frontal bone fracture with subdural hemorrhage and a 3 × 2.5 cm pebble retained in the skull. The second case showed severe liver laceration in close vicinity to a cubical pebble (3.2 × 3 cm). The mechanical forces involved in skull fracture and autopsy are discussed. In the current cases, the relatively larger weight and size together with the surface configuration of the pebble projectile were the main influential factors that contributed to the severity of damage and fatality.These case reports are a working example of the effect of the mass of projectiles in increasing the power of penetration. The direct shooting to the head and the abdomen together with the misuse of these weapons are capable of inflicting fatal injuries.

The trio elements found in Gunshot Residue (GSR) are considered the key elements that are characteristic of GSR. To date, most forensic laboratories have mainly concentrated on employing carbon stubs analyzed by Scanning Electron Microscopy (SEM) coupled with Energy Dispersive Spectroscopy (EDS) to find IGSR on the hands and clothing of a person. A little elevated from the normal practice, this work is focused on the evaluation of compositional and morphological variations of GSR collected from muzzle end, trajectory, and target obtained by firing the ammunition of choice (9×19 mm Indian ammunition). Even though there may be variations in IGSR compositions within various locations of a weapon, this hasn't been investigated or documented up to this point. To ascertain whether it is possible to identify any variation in GSR particles gathered from these three different locations, the objective of this study is to investigate the structural characteristics and elemental composition of GSR to identify the distinctive parameters that allow for comparison and to establish the composition of the primer. The study also focuses on assessing any possible surface modification that may occur to GSR upon striking the target and establishing a correlation between GSR particles and propellant powder. The collected GSR samples were analyzed using a digital microscope, SEM/EDS, and EDXRF. It was discovered that the primer type showed a strong correlation to the elemental composition and morphology of GSR. By analyzing the GSR particles collected from the various sites as mentioned above, it was possible to identify the primer mixture used in the ammunition and its diversity in elemental concentration. The obtained GSR samples were not spherical but showed an elongated structure and possessed a diameter ranging from 695.4 µm-1.640 mm, 536.2 µm-1.412 mm, and 775.8 µm-1.772 mm respectively. However, the morphology and the size distribution of the particles collected from all three different points showed slight deviation as moving from ME towards TG. The obtained results could identify the primer mixture and diversity in its elemental concentration. The morphology and size distribution of GSR collected from three different points showed deviations.