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Comparative evaluation of two different dental age estimation methods using tooth pulp: A CBCT study. 利用牙髓对两种不同牙龄估计方法进行比较评估:CBCT 研究。
Q2 Medicine Pub Date : 2025-06-01 Epub Date: 2024-05-13 DOI: 10.1177/00258172241235466
Harmi Patel, Shilpa J Parikh, Jigna S Shah

AimTo estimate the age of an individual based on 3D radiographic evaluation of pulp width of maxillary central incisor.Materials and methodsThis study included 185 CBCT images of individuals within age range of 14-64 years. Images were evaluated for maxillary central incisors and pulp width measurements were taken from cementoenamel junction and middle third of root. Obtained data was subjected to correlation and regression analysis from which the age of an individual was predicted. Results of the present study were compared with another study by the same authors.ResultsA negative linear relationship was obtained between age and pulp width. The standard error of estimate (SEE) in sagittal section was 11.36 years and that in coronal section was 11.23 years. The coefficient of determination for sagittal section was 0.107 and for coronal section was 0.127. An obtained regression formula was highly significant. Division of samples into various age groups reduced SEE drastically.ConclusionIt can be concluded that pulp width of maxillary central incisor is a reliable indicator of age estimation.

目的:根据上颌中切牙牙髓宽度的三维影像学评估来估计一个人的年龄:本研究包括 185 张年龄在 14-64 岁之间的 CBCT 图像。对上颌中切牙的图像进行评估,并从牙本质釉质交界处和牙根中间三分之一处测量牙髓宽度。对获得的数据进行相关性和回归分析,并据此预测个人的年龄。本研究结果与同一作者的另一项研究结果进行了比较:结果:年龄与牙髓宽度之间呈负线性关系。矢状切面的估计标准误差(SEE)为 11.36 岁,冠状切面的估计标准误差为 11.23 岁。矢状切面的决定系数为 0.107,冠状切面的决定系数为 0.127。得出的回归公式非常显著。将样本分成不同的年龄组后,SEE 大大降低:可以得出结论,上颌中切牙的牙髓宽度是估计年龄的可靠指标。
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引用次数: 0
Duplex kidney: An incidental autopsy finding of clinical and medico-legal significance. 双肾脏:具有临床和医学法律意义的尸检偶然发现。
Q2 Medicine Pub Date : 2025-06-01 Epub Date: 2024-05-03 DOI: 10.1177/00258172241233403
Daideepya C Bhargava, Anupriya S Nair, Vikas P Meshram, Meenakshi Rao, Tanuj Kanchan

Duplex kidney, a rare congenital anomaly characterised by dual urinary drainage from the kidney, is typically discovered incidentally, often during radiological imaging or autopsy procedures. We report a case of a 21-year-old male who died from injuries sustained in a road traffic accident. The autopsy examination showed an incidental finding of duplex kidney on the left side. We discuss the clinical and potential medico-legal significance of duplex kidney which also has implications in renal transplantation. Notably, the presence of duplex kidney can potentially serve as an identifier in forensic investigations, given its rare incidence.

双肾脏是一种罕见的先天性畸形,其特征是肾脏有双重排尿功能,通常是在放射成像或尸检过程中偶然发现的。我们报告了一例在道路交通事故中受伤致死的 21 岁男性病例。尸检意外发现左侧有双肾。我们讨论了双肾的临床和潜在医学法律意义,这对肾移植也有影响。值得注意的是,考虑到双肾的罕见发病率,双肾的存在有可能成为法医调查中的识别标志。
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引用次数: 0
Co-occurrence of patent foramen ovale and Chiari network in a diabetic patient. 一名糖尿病患者同时患有卵圆孔未闭和 Chiari 网络。
Q2 Medicine Pub Date : 2025-06-01 Epub Date: 2024-05-01 DOI: 10.1177/00258172241230205
Hind Abouzahir, Ahmed Belhouss, Hicham Benyaich

IntroductionThe coexistence of congenital cardiovascular anomalies provides valuable insights into the intricate nature of human cardiac anatomy and its potential interactions with underlying health conditions. This case report presents an autopsy analysis of a diabetic patient manifesting both a patent foramen ovale and a Chiari network.Case presentationA 26-year-old male with a history of type 2 diabetes mellitus was admitted with post cardiac arrest. He died despite resuscitative efforts. Autopsy revealed notable findings including a patent foramen ovale and a Chiari network. Post-mortem biochemical markers indicated elevated HbA1c level and hyperglycaemia. The absence of cryptogenic strokes or paradoxical embolism prompted exploration into potential relationships between these anomalies and metabolic disturbances, and prompts a discussion about whether the observed anatomical variations could potentially serve as risk factors contributing to the patient's death due to complications of diabetes.ConclusionThe co-occurrence of a patent foramen ovale and a Chiari network within a diabetic patient, accompanied by elevated HbA1c level and hyperglycaemia, offers a unique perspective on the convergence of congenital cardiovascular variation and metabolic health. The juxtaposition of these anomalies with biochemical markers underscores the intricate interplay between cardiac morphology and metabolic conditions.

导言:先天性心血管畸形的同时存在,为了解人体心脏解剖的复杂性及其与潜在健康状况的潜在相互作用提供了宝贵的视角。本病例报告分析了一名糖尿病患者的尸检结果,该患者同时表现为卵圆孔未闭和Chiari网络:一名有 2 型糖尿病病史的 26 岁男性因心脏骤停入院。虽经抢救无效死亡。尸检发现了卵圆孔未闭和Chiari网络等明显病变。死后生化指标显示 HbA1c 水平升高和高血糖。没有发现隐源性中风或矛盾性栓塞,这促使人们探索这些异常与代谢紊乱之间的潜在关系,并促使人们讨论所观察到的解剖变异是否可能成为导致患者因糖尿病并发症而死亡的风险因素:结论:一名糖尿病患者同时患有卵圆孔未闭和Chiari网络,并伴有HbA1c水平升高和高血糖,这为先天性心血管变异和代谢健康的融合提供了一个独特的视角。这些异常与生化指标的并置强调了心脏形态与代谢状况之间错综复杂的相互作用。
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引用次数: 0
External challenges for specialists dealing with forensic autopsies. 法医尸检专家面临的外部挑战。
Q2 Medicine Pub Date : 2025-03-01 Epub Date: 2023-10-06 DOI: 10.1177/00258172231195733
Manoj K Mohanty, Sindhu S Sahu, Sudipta R Singh, Manas R Sahu, Rajanikanta Swain, Preetam K Lenka, Biswa M Padhy, Alagarasan Naveen

Background: In addition to poor infrastructure, and human resource constraints, forensic medicine specialists in developing countries face many external challenges.

Objectives: We aimed to investigate the prevalence, type, and source of external challenges confronting them including sex, age, religion, deceased's place of residence and the number of accompanying relatives.

Materials and methods: This cross-sectional, observational study was conducted between August 2020 and July 2022 at the Mortuary of AIIMS, Bhubaneswar with the approval of the ethical committee.

Results: Of note, forensic medicine specialists faced external challenges in about one in five cases (20.5%). Most demands were to either minimise the autopsy procedure (n = 65) or to conduct the autopsy at inappropriate times (n = 58). The demands to minimise the autopsy procedure were significantly associated with the deceased's age (p = 0.046), religion (p = 0.010), socioeconomic class (p = 0.020) and manner of death (p = 0.019).

Conclusions: Our study found that forensic medicine specialists in India face significant external challenges. Avoiding unnecessary complete autopsies, implementing night autopsies, and embracing minimally invasive autopsies are recommended to mitigate these challenges.

背景:除了基础设施差和人力资源限制外,发展中国家的法医专家还面临许多外部挑战。目的:我们旨在调查他们面临的外部挑战的普遍性、类型和来源,包括性别、年龄、宗教、死者居住地和随行亲属的数量。材料和方法:经伦理委员会批准,这项横断面观察性研究于2020年8月至2022年7月在布巴内斯瓦尔AIIMS殡仪馆进行。结果:值得注意的是,法医专家在大约五分之一(20.5%)的案件中面临外部挑战 = 65)或在不适当的时间进行尸检(n = 58)。尽量减少尸检程序的要求与死者的年龄显著相关(p = 0.046),宗教(p = 0.010)、社会经济阶层(p = 0.020)和死亡方式(p = 0.019)。结论:我们的研究发现,印度的法医专家面临着重大的外部挑战。建议避免不必要的完整尸检,实施夜间尸检,并采用微创尸检来缓解这些挑战。
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引用次数: 0
A critical analysis of the impact of early marriage on girls based on published autobiographies and a contemporary scholarly text - Īḍāḥ al-bayān fī nikāḥ al-ṣibyān. 基于已出版的自传和当代学术文本对早婚对女孩影响的批判性分析- Īḍāḥ al-bayān f ā nikāḥ al-ṣibyān。
Q2 Medicine Pub Date : 2025-03-01 Epub Date: 2025-02-08 DOI: 10.1177/00258172241286642
John F Mayberry

Background: This work emerged from a need to better understand the "lived experience" of early marriage for girls and how it should impact on contemporary attitudes in the Muslim community and encourage it to support the international movement with the aim of a minimum common age of 18 years for marriage of young people.

Objective: To identify from contemporary published literature, including autobiographies and religious texts dealing specifically with early marriage, the effects of early marriage on individuals and to set this as a background to the extensive literature on its medical, psychological and social impact.Participants and setting: The setting is the published words of two women and a man who were involved in early marriages and a commentary on the topic by an Ibadi theologian.

Methods: The documents were identified through searching a range of databases using various search engines. Texts were then analysed for key terms describing the impact of early marriage and these were then grouped into themes.

Findings: The extracts raise questions linked to the issue of consent and the role of adult coercion, including physical force and threat of harm. In practice girls are given in marriage by their guardians against their wishes and international conventions on the rights and care of children, as well as that outlined in Qur'an 4 v6.

Conclusion: Modern Muslim states face a real challenge in implementing 18 as the minimum age for marriage, especially in how to manage opposition to appropriate new legislation from some traditionalist groups.

背景:这项工作源于需要更好地了解女孩早婚的“生活经历”,以及它应该如何影响穆斯林社区的当代态度,并鼓励它支持以年轻人结婚最低年龄为目标的国际运动。目的:从当代出版的文献中,包括专门讨论早婚的自传和宗教文本中,确定早婚对个人的影响,并以此为背景,广泛地研究早婚对医学、心理和社会的影响。参与者和背景:背景是涉及早婚的两名女性和一名男性的公开言论,以及伊巴迪神学家对该主题的评论。方法:通过使用各种搜索引擎搜索一系列数据库来确定文档。然后分析文本中描述早婚影响的关键术语,然后将这些术语分组为主题。调查结果:这些摘录提出了与同意问题和成人胁迫的作用有关的问题,包括身体暴力和伤害威胁。在实践中,女孩是由她们的监护人违背她们的意愿和关于儿童权利和照顾的国际公约,以及《古兰经》第4章第6节的概述而嫁给她们的。结论:现代穆斯林国家在实施18岁的最低结婚年龄方面面临着真正的挑战,特别是在如何处理一些传统主义团体对适当的新立法的反对方面。
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引用次数: 0
Informed consent in neurosurgery with particular reference to alternatives to proposed surgery. Updated case law including McCulloch. 神经外科的知情同意,特别参考拟议手术的替代方案。包括麦卡洛克在内的最新判例法。
Q2 Medicine Pub Date : 2025-03-01 Epub Date: 2025-02-11 DOI: 10.1177/00258172241275085
Nicholas Todd, James Wright-Todd

Introduction: Informed consent is a crucial element in neurosurgical practice; failures of the consenting process are a common cause of litigation in neurosurgery and judgments that have particular relevance to neurosurgical practice will be reviewed here. Guidance for consent based upon current case law is discussed.

Methods: The legal databases BAILII and WestLaw were searched using the search term "informed consent". The BAILII search yielded 86 abstracts, WestLaw yielded 33. There were 15 duplicates. Ten of the remaining 104 abstracts were commentaries, leaving 94 judgments. From those judgments a further 21 cases were added. A total of 115 judgments were reviewed by both authors.

Results: A total of 23 judgments dealing with issues of informed consent in neurosurgical and other surgical practice were selected. The cases and their implications for neurosurgical consent are discussed below.

Discussion: When proposing a surgical procedure to a competent adult, the treating surgeon must discuss the benefits, risks and alternatives to treatment with the patient. The surgeon can be guided by professional guidance from the GMC, or another professional body, and/or case law. Relevant issues include: (i) the risks and benefits of surgery; (ii) information that is accurate (or inaccurate, incorrect, missing or late information); (iii) established practice; (iv) the current state of knowledge; (v) reasonable alternative treatments; and (vi) surgery performed on a different day or by a different surgeon.

简介:知情同意是神经外科实践的关键因素;同意过程的失败是神经外科诉讼的常见原因,与神经外科实践特别相关的判决将在这里进行审查。讨论了基于现行判例法的同意指导。方法:以“知情同意”为检索词,检索法律数据库BAILII和WestLaw。BAILII检索得到86篇摘要,WestLaw检索得到33篇。有15个副本。剩下的104份摘要中有10份是评论,剩下94份是判断。从这些判决中又增加了21个案件。两位作者共审阅了115份判决书。结果:共选取了23例涉及神经外科及其他外科实践中知情同意问题的判决。下面将讨论这些病例及其对神经外科手术同意的影响。讨论:当向有能力的成年人建议手术时,治疗外科医生必须与患者讨论手术的益处、风险和替代治疗方案。外科医生可以由GMC或其他专业机构的专业指导和/或判例法指导。相关问题包括:(i)手术的风险和收益;(ii)准确的信息(或不准确、不正确、缺失或延迟的信息);(iii)既定惯例;(四)知识的现状;(五)合理的替代治疗方法;以及(vi)在不同的日期或由不同的外科医生进行的手术。
{"title":"Informed consent in neurosurgery with particular reference to alternatives to proposed surgery. Updated case law including <i>McCulloch</i>.","authors":"Nicholas Todd, James Wright-Todd","doi":"10.1177/00258172241275085","DOIUrl":"10.1177/00258172241275085","url":null,"abstract":"<p><strong>Introduction: </strong>Informed consent is a crucial element in neurosurgical practice; failures of the consenting process are a common cause of litigation in neurosurgery and judgments that have particular relevance to neurosurgical practice will be reviewed here. Guidance for consent based upon current case law is discussed.</p><p><strong>Methods: </strong>The legal databases BAILII and WestLaw were searched using the search term \"informed consent\". The BAILII search yielded 86 abstracts, WestLaw yielded 33. There were 15 duplicates. Ten of the remaining 104 abstracts were commentaries, leaving 94 judgments. From those judgments a further 21 cases were added. A total of 115 judgments were reviewed by both authors.</p><p><strong>Results: </strong>A total of 23 judgments dealing with issues of informed consent in neurosurgical and other surgical practice were selected. The cases and their implications for neurosurgical consent are discussed below.</p><p><strong>Discussion: </strong>When proposing a surgical procedure to a competent adult, the treating surgeon must discuss the benefits, risks and alternatives to treatment with the patient. The surgeon can be guided by professional guidance from the GMC, or another professional body, and/or case law. Relevant issues include: (i) the risks and benefits of surgery; (ii) information that is accurate (or inaccurate, incorrect, missing or late information); (iii) established practice; (iv) the current state of knowledge; (v) reasonable alternative treatments; and (vi) surgery performed on a different day or by a different surgeon.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An uncommon case of self-strangulation by ligature and the importance of a crime scene visit by a forensic pathologist. 一个罕见的案件,自我勒死的案件和法医病理学家访问犯罪现场的重要性。
Q2 Medicine Pub Date : 2025-03-01 Epub Date: 2023-04-25 DOI: 10.1177/00258172231164293
Aditya Anand, Manav Sharma, Vikash Chandra, Mukul Sharma, Ankit Kumar

Self-strangulation is an uncommon method of suicide. The body was found lying on the floor in front of the "multi-gym" inside the gym in the basement of the deceased's house. It was initially presented as a case of sudden death, but during autopsy, a ligature mark was noted over the deceased's neck and bilateral temporal regions along with findings supportive of ligature strangulation. A visit was made to the crime scene. A plausible reconstruction of events suggested that the deceased had used the metallic rope of the multi-gym for this purpose. The rope was connected to weights from one end, passed through a pulley and connected to a rod at the other end. Its width and pattern matched with the ligature mark. The deceased wound the rod end of the rope around his neck and entangled the rod to the rope over his head so that the weight attached to the other end tightened the rope around his neck and strangled him. As the rope unravelled, gravity caused the body to fall to the ground while the rope with the rod resumed its normal position due to the pull of the weight attached at the opposite end. This case is reported for its rarity and the unusual means used to commit suicide by self-strangulation.

自缢是一种罕见的自杀方式。尸体被发现躺在死者住所地下室健身房“多功能健身房”前的地板上。最初被认为是猝死,但在尸检过程中,在死者的颈部和双侧颞区发现了一个勒痕,同时发现支持勒死的证据。有人去了犯罪现场。一个可信的事件重建表明,死者使用了多功能健身房的金属绳来达到这个目的。绳子的一端与重物相连,穿过滑轮,另一端与一根杆子相连。它的宽度和图案与捆绑痕迹相符。死者把绳子的杆子一端绕在脖子上,把杆子和头顶上的绳子缠在一起,这样绳子另一端的重量就把他脖子上的绳子拉紧了,把他勒死了。当绳子解开时,重力使身体掉到地上,而带杆的绳子由于另一端附加的重物的拉力而恢复到正常位置。据报道,这种情况很罕见,而且自杀的方式也很不寻常。
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引用次数: 0
Jaw bombs: Rampantly used indigenous explosives causing human-wildlife conflict in a few regions of India and Sri Lanka. 下颚炸弹:在印度和斯里兰卡的一些地区,肆意使用的本地爆炸物造成了人类与野生动物之间的冲突。
Q2 Medicine Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1177/00258172241264779
Devendra Jadav
{"title":"Jaw bombs: Rampantly used indigenous explosives causing human-wildlife conflict in a few regions of India and Sri Lanka.","authors":"Devendra Jadav","doi":"10.1177/00258172241264779","DOIUrl":"10.1177/00258172241264779","url":null,"abstract":"","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"55-56"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Secondary victims liability in medical negligence: Ring-fenced or unfenced? 医疗过失中的次要受害者责任:围篱还是不围篱?
Q2 Medicine Pub Date : 2025-03-01 Epub Date: 2025-02-11 DOI: 10.1177/00258172241274437
Rachael Mulheron
{"title":"Secondary victims liability in medical negligence: Ring-fenced or unfenced?","authors":"Rachael Mulheron","doi":"10.1177/00258172241274437","DOIUrl":"10.1177/00258172241274437","url":null,"abstract":"","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"5-13"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Highly cited forensic practitioners in the Nordic countries and their composite citation scores based on six different citation metrics. 北欧国家法医学从业人员的高引用率及其基于六种不同引用指标的综合引用分数。
Q2 Medicine Pub Date : 2025-03-01 Epub Date: 2023-02-08 DOI: 10.1177/00258172221145109
Alan W Jones

Forensic science is a multidisciplinary field that involves the use of various scientific methods and techniques for the investigation of crimes. Forensic scientists are often required to testify in court as expert witnesses and explain the meaning of chemical, physical, and/or medical evidence to a judge and jury. This article took advantage of a citation database to identify the most highly cited forensic practitioners in four Nordic countries within the discipline of legal and forensic medicine. The starting point was 7 million scientists indexed in the SCOPUS database, each of whom had their name on at least five entries. Six different citation metrics were used to calculate a person's composite citation score. Those within the top 2% of their primary research discipline were considered highly cited.

法医学是一个多学科领域,涉及使用各种科学方法和技术调查犯罪。法医学家经常需要作为专家证人出庭作证,向法官和陪审团解释化学、物理和/或医学证据的含义。本文利用引文数据库,找出北欧四国法律和法医学学科中引用率最高的法医。起点是 SCOPUS 数据库收录的 700 万名科学家,每个人的名字至少出现在五个条目中。我们采用六种不同的引用指标来计算一个人的综合引用得分。在其主要研究学科中排名前 2% 的科学家被视为高被引者。
{"title":"Highly cited forensic practitioners in the Nordic countries and their composite citation scores based on six different citation metrics.","authors":"Alan W Jones","doi":"10.1177/00258172221145109","DOIUrl":"10.1177/00258172221145109","url":null,"abstract":"<p><p>Forensic science is a multidisciplinary field that involves the use of various scientific methods and techniques for the investigation of crimes. Forensic scientists are often required to testify in court as expert witnesses and explain the meaning of chemical, physical, and/or medical evidence to a judge and jury. This article took advantage of a citation database to identify the most highly cited forensic practitioners in four Nordic countries within the discipline of legal and forensic medicine. The starting point was 7 million scientists indexed in the SCOPUS database, each of whom had their name on at least five entries. Six different citation metrics were used to calculate a person's composite citation score. Those within the top 2% of their primary research discipline were considered highly cited.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9222532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Medico-Legal Journal
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