Pub Date : 2023-06-30DOI: 10.4038/mljsl.v11i1.7480
M. S. Siddique, J. Herath
We report a case of a 20-day-old female child who was full-term born by emergency Caesarean section due to foetal distress. The baby had intermittent dyspnoea and was pronounced dead with unsuccessful resuscitation efforts in her admission to the hospital. Post-mortem examinations revealed dilated cardiomyopathy with endocardial fibroelastosis. Histologic examination of the heart showed mild endocardial fibroelastosis and sub-endocardial and interstitial increased elastin and collagen fibre deposition. Molecular testing was heterozygous for ELAC2 (pathogenic) and PRDM16 (variant of uncertain significance [VUS] genes. Other ancillary test results are non-contributory. Based on the autopsy findings, ancillary test results, and clinicopathological correlation, the cause of death is neonatal dilated cardiomyopathy (DCM).
{"title":"Endocardial Fibroelastosis Mimicking Dilated Cardiomyopathy in a Neonate: A Case Report","authors":"M. S. Siddique, J. Herath","doi":"10.4038/mljsl.v11i1.7480","DOIUrl":"https://doi.org/10.4038/mljsl.v11i1.7480","url":null,"abstract":"We report a case of a 20-day-old female child who was full-term born by emergency Caesarean section due to foetal distress. The baby had intermittent dyspnoea and was pronounced dead with unsuccessful resuscitation efforts in her admission to the hospital. Post-mortem examinations revealed dilated cardiomyopathy with endocardial fibroelastosis. Histologic examination of the heart showed mild endocardial fibroelastosis and sub-endocardial and interstitial increased elastin and collagen fibre deposition. Molecular testing was heterozygous for ELAC2 (pathogenic) and PRDM16 (variant of uncertain significance [VUS] genes. Other ancillary test results are non-contributory. Based on the autopsy findings, ancillary test results, and clinicopathological correlation, the cause of death is neonatal dilated cardiomyopathy (DCM).","PeriodicalId":446761,"journal":{"name":"Medico-Legal Journal of Sri Lanka","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133390760","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}
Pub Date : 2023-06-30DOI: 10.4038/mljsl.v11i1.7476
B. Sanjaya, A. Vadysinghe, M. Sivasubramanium, E. Ekanayake, G. Rodrigo, Lakshika S. Nawarathna, L. P. M. Liyanage
Introduction: Sex determination using human skeletal remains is a challenging task for forensic practitioners and foramen magnum is used at lesser extents for this purpose. The aim of this study was to determine the sex by evaluating the parameters of the foramen magnum in a Sri Lankan population using computed tomography (CT).Methods: CT images of 300 individuals aged between 20 to 60 years, comprising 146 males (49%) and 154 females (51%), obtained from the Radiology Department of National Hospital, Kandy, Sri Lanka were retrieved for the study. Four parameters of the foramen magnum, namely length, width, circumference, and area, were measured/calculated using the RadiAnt Dicom Viewer 2022.1 software and analyzed using SPSS 26 software.Results: The analyses indicated that all four measurements were significantly higher in males than in females. All the parameters showed positive correlations with each other. Discriminant function analysis indicated that length was the most dimorphic single parameter for males, with an accuracy of 76%, and for females, the length also provided an accuracy of 71%.Conclusion: Results of this study show that the parameters of the foramen magnum, mainly the length, can be used for sex determination. By combining other parameters of sexing human bones, more accurate results for sex determination can be obtained.
{"title":"Sex Determination by Evaluation of Foramen Magnum on Computer Tomography Scanning Among Sri Lankan Population","authors":"B. Sanjaya, A. Vadysinghe, M. Sivasubramanium, E. Ekanayake, G. Rodrigo, Lakshika S. Nawarathna, L. P. M. Liyanage","doi":"10.4038/mljsl.v11i1.7476","DOIUrl":"https://doi.org/10.4038/mljsl.v11i1.7476","url":null,"abstract":"Introduction: Sex determination using human skeletal remains is a challenging task for forensic practitioners and foramen magnum is used at lesser extents for this purpose. The aim of this study was to determine the sex by evaluating the parameters of the foramen magnum in a Sri Lankan population using computed tomography (CT).Methods: CT images of 300 individuals aged between 20 to 60 years, comprising 146 males (49%) and 154 females (51%), obtained from the Radiology Department of National Hospital, Kandy, Sri Lanka were retrieved for the study. Four parameters of the foramen magnum, namely length, width, circumference, and area, were measured/calculated using the RadiAnt Dicom Viewer 2022.1 software and analyzed using SPSS 26 software.Results: The analyses indicated that all four measurements were significantly higher in males than in females. All the parameters showed positive correlations with each other. Discriminant function analysis indicated that length was the most dimorphic single parameter for males, with an accuracy of 76%, and for females, the length also provided an accuracy of 71%.Conclusion: Results of this study show that the parameters of the foramen magnum, mainly the length, can be used for sex determination. By combining other parameters of sexing human bones, more accurate results for sex determination can be obtained.","PeriodicalId":446761,"journal":{"name":"Medico-Legal Journal of Sri Lanka","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115672344","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}
Pub Date : 2023-06-30DOI: 10.4038/mljsl.v11i1.7478
U. Mayorathan, T. William, R. Harruff
Introduction: The adipose tissue in the right ventricle is frequently found during forensic autopsies. However, the pathological significance of right ventricular lipomatosis was not well studied in the available literature. This study aims to study identify the relationship between right ventricular lipomatosis and sociodemographic factors, BMI, and waist circumferenceMethods: Assessment of the fatty infiltration and fibrosis was performed by two pathologists who read all specimens separately. The average of the two values was taken for analysis.Results: A total of 100 decedents were examined in this study, of which 70 were male,76 were Caucasians thirteen were black, nine were Asian, and two were Native American. Among the population 76 were older than 30. Seventy-one out of a hundred recorded a BMI of more than 25, and 63 decedents had a normal waist circumference. Fat infiltration of the anterior wall and lateral wall and average fat infiltration of the right ventricle showed significant association with the female sex and the Caucasian population at a 95% confidence interval. Neither cause of death, past medical history, nor fibrosis of the right ventricle walls showed significant association with the fat infiltration of the right ventricle. Yet, age above 30 years and body mass index over 25 showed a significant association in the fat infiltration of the posterior wall (p-value < 0.05). At the same time, higher waist circumference was significantly associated with the average right ventricular fat infiltration (p-value < 0.05).Conclusion: Right ventricular lipomatosis is significantly associated with BMI and waist circumference in our study. At the same time, it was positively correlated with age, sex, and race.
{"title":"Right Ventricular Lipomatosis: A postmortem study","authors":"U. Mayorathan, T. William, R. Harruff","doi":"10.4038/mljsl.v11i1.7478","DOIUrl":"https://doi.org/10.4038/mljsl.v11i1.7478","url":null,"abstract":"Introduction: The adipose tissue in the right ventricle is frequently found during forensic autopsies. However, the pathological significance of right ventricular lipomatosis was not well studied in the available literature. This study aims to study identify the relationship between right ventricular lipomatosis and sociodemographic factors, BMI, and waist circumferenceMethods: Assessment of the fatty infiltration and fibrosis was performed by two pathologists who read all specimens separately. The average of the two values was taken for analysis.Results: A total of 100 decedents were examined in this study, of which 70 were male,76 were Caucasians thirteen were black, nine were Asian, and two were Native American. Among the population 76 were older than 30. Seventy-one out of a hundred recorded a BMI of more than 25, and 63 decedents had a normal waist circumference. Fat infiltration of the anterior wall and lateral wall and average fat infiltration of the right ventricle showed significant association with the female sex and the Caucasian population at a 95% confidence interval. Neither cause of death, past medical history, nor fibrosis of the right ventricle walls showed significant association with the fat infiltration of the right ventricle. Yet, age above 30 years and body mass index over 25 showed a significant association in the fat infiltration of the posterior wall (p-value < 0.05). At the same time, higher waist circumference was significantly associated with the average right ventricular fat infiltration (p-value < 0.05).Conclusion: Right ventricular lipomatosis is significantly associated with BMI and waist circumference in our study. At the same time, it was positively correlated with age, sex, and race.","PeriodicalId":446761,"journal":{"name":"Medico-Legal Journal of Sri Lanka","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114334519","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}
Pub Date : 2023-06-30DOI: 10.4038/mljsl.v11i1.7479
W. Gunasinghe, J. Warushahannadi
Introduction: Long bone fractures pose an increasing challenge to the health care system and the financial status worldwide.Objectives: To study long bone fracture (LBF) types, fracture patterns, prevalence, and associated factors in relation to road traffic accidents (RTA), assaults, and falls.Methodology: The study was a descriptive cross-sectional, prospective study in patients aged 18- 60 years, over one-year period.Results: The study group consisted of a total number of 300 patients. Most 78%(n=233) of the patients were males. The majority 26 %(n=77)were between 18 – 24 years of age. Most of the LBF patients 79%(n=236) were due to RTA. Male predominance was noted. The incidents of assaults (42) revealed, fractures were due to blunt forced weapons in 93%(n=39) and the majority 77%(n=17) of LBF occurred at 6-8 meters of height falls. In RTA the commonest victims of LBF 56% (n=132) were riders followed by drivers 31%(n=73). The tibia was the most fractured bone in riders 33%(n=113). In this study, 426 long bone fractures were revealed. Tibia was the most fractured bone 45%(n=191). Simple fractures were the commonest 98% (n= 417). Oblique fractures were the commonest 56%(n=235). There were (94%(n=399) of closed fractures. Lower limb bones are the most vulnerable bones in riders. In assaults and falls upper limb fractures could be seen frequently.Conclusion: Young adult males are more vulnerable in long bone injuries especially following RTA.
{"title":"Trends and Patterns of Long Bone Fractures in Relation to The Road Traffic Accidents, Assaults, and Falls Among Patients Admitted to Emergency Treatment Unit in Teaching Hospital Karapitiya","authors":"W. Gunasinghe, J. Warushahannadi","doi":"10.4038/mljsl.v11i1.7479","DOIUrl":"https://doi.org/10.4038/mljsl.v11i1.7479","url":null,"abstract":"Introduction: Long bone fractures pose an increasing challenge to the health care system and the financial status worldwide.Objectives: To study long bone fracture (LBF) types, fracture patterns, prevalence, and associated factors in relation to road traffic accidents (RTA), assaults, and falls.Methodology: The study was a descriptive cross-sectional, prospective study in patients aged 18- 60 years, over one-year period.Results: The study group consisted of a total number of 300 patients. Most 78%(n=233) of the patients were males. The majority 26 %(n=77)were between 18 – 24 years of age. Most of the LBF patients 79%(n=236) were due to RTA. Male predominance was noted. The incidents of assaults (42) revealed, fractures were due to blunt forced weapons in 93%(n=39) and the majority 77%(n=17) of LBF occurred at 6-8 meters of height falls. In RTA the commonest victims of LBF 56% (n=132) were riders followed by drivers 31%(n=73). The tibia was the most fractured bone in riders 33%(n=113). In this study, 426 long bone fractures were revealed. Tibia was the most fractured bone 45%(n=191). Simple fractures were the commonest 98% (n= 417). Oblique fractures were the commonest 56%(n=235). There were (94%(n=399) of closed fractures. Lower limb bones are the most vulnerable bones in riders. In assaults and falls upper limb fractures could be seen frequently.Conclusion: Young adult males are more vulnerable in long bone injuries especially following RTA.","PeriodicalId":446761,"journal":{"name":"Medico-Legal Journal of Sri Lanka","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133563575","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}
Pub Date : 2022-12-31DOI: 10.4038/mljsl.v10i2.7470
P. D. Palipana
{"title":"Diagnostic and Management Challenges and Medico-legal Impacts of Multiple Dento-Alveolar Injuries: A Case Report","authors":"P. D. Palipana","doi":"10.4038/mljsl.v10i2.7470","DOIUrl":"https://doi.org/10.4038/mljsl.v10i2.7470","url":null,"abstract":"","PeriodicalId":446761,"journal":{"name":"Medico-Legal Journal of Sri Lanka","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117244336","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}
Pub Date : 2022-12-31DOI: 10.4038/mljsl.v10i2.7467
U. Mayorathan, S. Pranavan, J. S. A. Niroshini, M. Moganalukshan, A. M. Jiffry
{"title":"An Analysis of Medico-Legal Autopsies Alleged to be Homicide: A Study from the Northern Province of Sri Lanka","authors":"U. Mayorathan, S. Pranavan, J. S. A. Niroshini, M. Moganalukshan, A. M. Jiffry","doi":"10.4038/mljsl.v10i2.7467","DOIUrl":"https://doi.org/10.4038/mljsl.v10i2.7467","url":null,"abstract":"","PeriodicalId":446761,"journal":{"name":"Medico-Legal Journal of Sri Lanka","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121468902","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}
Pub Date : 2022-12-31DOI: 10.4038/mljsl.v10i2.7469
I. Pathirannahalage, M. Vidanapathirana, A. Subashinghe
{"title":"Artificial Intelligence for Forensic Medicine","authors":"I. Pathirannahalage, M. Vidanapathirana, A. Subashinghe","doi":"10.4038/mljsl.v10i2.7469","DOIUrl":"https://doi.org/10.4038/mljsl.v10i2.7469","url":null,"abstract":"","PeriodicalId":446761,"journal":{"name":"Medico-Legal Journal of Sri Lanka","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115113262","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}
Pub Date : 2022-12-31DOI: 10.4038/mljsl.v10i2.7460
R. Samaranayake, S. Gunawardena, S. M. H. D. Senadhipathi, N. V. Ewaduge, M. A. D. P. K. Abeyratne, T. Siriwardena
{"title":"Fatal Myocarditis Following Administration of Zoledronic Acid: A Case Report","authors":"R. Samaranayake, S. Gunawardena, S. M. H. D. Senadhipathi, N. V. Ewaduge, M. A. D. P. K. Abeyratne, T. Siriwardena","doi":"10.4038/mljsl.v10i2.7460","DOIUrl":"https://doi.org/10.4038/mljsl.v10i2.7460","url":null,"abstract":"","PeriodicalId":446761,"journal":{"name":"Medico-Legal Journal of Sri Lanka","volume":"156 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116270185","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}
Pub Date : 2022-12-31DOI: 10.4038/mljsl.v10i2.7468
P. Appuhamy
{"title":"Challenges in Forensic Sampling in The Pre-Analytical Phase While Maintaining Chain of Custody in Sri Lanka and System Improvement in the Medico-Legal Unit of District General Hospital, Matale, Sri Lanka","authors":"P. Appuhamy","doi":"10.4038/mljsl.v10i2.7468","DOIUrl":"https://doi.org/10.4038/mljsl.v10i2.7468","url":null,"abstract":"","PeriodicalId":446761,"journal":{"name":"Medico-Legal Journal of Sri Lanka","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124307510","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}
Pub Date : 2022-12-31DOI: 10.4038/mljsl.v10i2.7471
P. D. Palipana, A. Adikari
{"title":"Prolonged Effects of Dental Trauma Managed by Conservative Means and Their Medico-legal Implications: A Case Report","authors":"P. D. Palipana, A. Adikari","doi":"10.4038/mljsl.v10i2.7471","DOIUrl":"https://doi.org/10.4038/mljsl.v10i2.7471","url":null,"abstract":"","PeriodicalId":446761,"journal":{"name":"Medico-Legal Journal of Sri Lanka","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122041352","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}
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