Medico-Legal Journal最新文献

Ascariasis is one of the most common parasitic infections in the world. The route of infection is faeco-oral and most occurs in areas with poor hygiene and sanitation. The most common helminth is Ascaris lumbricoides. In our case a 40-year-old female with ascariasis infection underwent an exploratory laparotomy in consequence of post-operative bleeding following a laparoscopic cholecystectomy. Post extubation patient suffered cardiac arrest. At autopsy multiple roundworms were found in the oropharynx region, blocking the respiratory passage.

Septic cerebral venous sinus thrombosis is a rare but often fatal complication caused by bacterial meningitis and paranasal sinusitis.We report a particular case of the sudden and unexpected death of a six-day-old infant from unrecognised acute meningitis that caused a thrombotic occlusion of the venous sinuses (with the particular involvement of the torcular Herophili at the confluence of sinuses) resulting in subdural haemorrhage.This case report alerts paediatricians and neonatologists to the importance of promptly considering a possible diagnosis of meningitis without delay to avoid the fatal complications described here. As in all cases of sudden infant death our case study underlines the need for a thorough autopsy, accompanied by histological analysis, in order to identify the causes of the underlying pathological mechanisms causing death and to ensure an adequate differential diagnosis.

This paper addresses the fundamental legal question as to who can act as an expert witness when procedures are performed by a range of clinical professionals. Endoscopies are performed by gastroenterologists, surgeons, radiologists, nurses and physician associates. There is a growing tendency for defence teams to seek the court's approval for assessment by an expert from the same background. Such an approach needs to be rigorously rejected. All endoscopists undergo a common training program and their practice is monitored by the same body. To suggest that different standards should apply to different professional groups would seriously undermine the current training standards and the confidence of patients undergoing endoscopic procedures.

Sexual harassment has plagued humanity for centuries. Legal scholars, philosophers, and social scientists who attempt to address the problem need the support of medical, forensic and psychiatric professionals. Law and medicine must combine to deal effectively with sexual offenders and scientific evidence may help prevent sexual offences and recidivism. This article reviews the benefits of medical and forensic science, castration laws and pharmacological interventions, and analyses their interrelation with the law, globally.

Positional or postural asphyxia results in a violent asphyxial death when the body (e.g. neck and/or chest) suffers kinking of the airway and obstructed normal gas exchange. Accidental deaths from positional asphyxia are poorly described in the literature. They are more common in infants unable to break free from the restraint position. We present a case of an 85-year-old woman discovered trapped with her neck compressed under a lift-up bed storage. The death scene investigation, the medical history of the subject, and the post-mortem findings enabled the cause of the death to be ascribed to accidental positional mechanical asphyxia.

Acute rheumatic fever-related acquired heart disease in children and young adults is a worldwide issue, but it poses a serious public health threat in developing nations like India. We present a case report of a young adult who collapsed suddenly during a routine walk and was declared dead in an emergency ward on arrival. There was no significant past medical history. On autopsy, massive cardiomegaly and a "butter and bread" appearance of the pericardium, along with findings suggestive of mitral stenosis and aortic regurgitation, raised suspicion about rheumatic heart disease. Rheumatic carditis was confirmed by a microscopic examination that showed Aschoff bodies in the left ventricle, mitral valve and interventricular septum, in addition to uncommon Anitschkow cells in the left ventricle. A sudden death due to undiagnosed rheumatic carditis causing such massive cardiomegaly is rare. This case highlights the need to keep rheumatic carditis as a cause of sudden death.

BackgroundDistal femoral metaphyseal fractures in children pose diagnostic challenges due to potential accidental and non-accidental aetiologies. This review aims to critically analyse the evidence on the association between distal femoral metaphyseal fractures and child abuse, as well as fracture patterns aiding in distinguishing inflicted injuries from accidental injuries.MethodsA systematic review of studies involving children with distal femoral metaphyseal fractures was conducted, examining the reported associations with child abuse, fracture patterns and proposed mechanisms.ResultsThe review revealed a significant association between distal femoral metaphyseal fractures and child abuse, particularly in non-ambulatory infants. However, some fractures may occur accidentally, often from short falls with direct impact on the knee. Certain fracture patterns, such as transverse or oblique configurations, suggest abuse, while spiral or buckle patterns are more likely accidental. Case series and retrospective studies reported varying findings, with some studies supporting a strong association with abuse and others highlighting the potential for accidental mechanisms.ConclusionsA comprehensive evaluation, including history, physical examination, skeletal survey and multidisciplinary collaboration, is crucial for accurate diagnosis and management. Healthcare professionals should maintain a high index of suspicion for child abuse while recognising accidental mechanisms. Specific recommendations for healthcare professionals and future research directions are provided.

The phenomenon of suicide contagion: some individuals, especially vulnerable young people, exhibit increased susceptibility to suicidal ideation when exposed to the suicide of other people. Significant research suggests that exposure to media portrayals, suicide groups and peer suicides may lead to suicide contagion. Prevalent psychosocial and cultural factors in Nepal such as interpersonal conflict, domestic violence, gender inequity and social exclusion probably contribute to suicidal behaviour. This case study investigates a high school student in a rural mountainous community in Nepal, who attempted suicide by hanging following his girlfriend's suicide, and demonstrates how peer suicide exposure prompts imitative behaviour in a vulnerable young person and confirms suicide grief as an underrepresented risk factor. Prompt, supportive interventions for high-risk grievers and societal prevention strategies tailored to adolescents are essential to curb imitative deaths.

Although an electric iron will be found in almost every home, injuries from this useful and low-cost device are unexpected. There is little data on electric iron contact burns (non-electrocution) in children and an absolute lack of literature dealing with accidental fatalities from electric irons. This study sets out to describe the causes and patterns of domestic fatalities in females from electric irons.