Journal of Indian Academy of Forensic Medicine

Age estimation is a critical component in forensic investigations. The fusion stages of bones, particularly the medial clavicular epiphysis, offer reliable markers for estimating age, especially in individuals below 25 years. Despite the available data in the literature, population-specific standards should be developed and validated using the contemporary geographical population. This study aimed to investigate the fusion patterns of the medial clavicular epiphysis in the North Indian population using post-mortem computed tomography (PMCT) scans. This study comprised 500 samples (327 males and 173 females) with ages below 25 years. Using PMCT scans, the ossification patterns of the medial clavicular epiphysis were classified into four stages: Stage 0 (absence of ossification center), Stage 1 (appearance without fusion), Stage 2 (partial fusion), and Stage 3 (complete fusion). This study revealed a significant correlation between fusion stages and chronological age, with Spearman’s correlation coefficients of ρ = 0.819 for males and ρ = 0.797 for females, and statistically significant gender differences. Linear regression models were developed for both sexes, predicting age with mean absolute errors (MAEs) of 1.36 for males and 1.88 for females. Validation of these models demonstrated their utility in estimating age with high accuracy, though the models tended to slightly underestimate age, especially in females. This study confirms that medial clavicular epiphyseal fusion patterns are reliable indicators for age estimation in the North Indian population. The findings emphasize the importance of population-specific criteria in forensic age estimation, providing a precise tool for forensic practice.

Useful piece of forensic evidence that can help identify suspects is a handprint. In order to reduce the number of possible suspects, anthropometric study of handprints offers vital information for calculating size and sex. The goal of the current study was to investigate how stature and hand and handprint dimensions relate to comparative human identification. One hundred adults from Eastern Uttar Pradesh—fifty males and fifty females—made up the study sample. A stadiometer was used to measure the participants’ stature, and they provided handprints using ink pads. A digital vernier caliper was used to record eight anthropometric parameters for both hands. Males were 167.70 cm tall on average, while girls were 160.27 cm tall, according to statistical study. The right palm length was the best predictor of stature in females, whereas the first digit length in males had the highest connection. For both males and females, the standard error of estimation (SEE) varied from ±6.9 cm to ±8.17 cm. Measurements of handprints showed comparable dependability, with females showing smaller SEE ranges for both hands. The study demonstrates the usefulness of hand and handprint dimensions in forensic anthropology by highlighting how they can accurately predict sex and size. These results highlight the significance of region-specific anthropometric data for enhancing human identification accuracy, supporting investigations by lowering suspect pools, and aiding in the development of specialized forensic databases.

Snakebite is a significant public health concern in tropical and subtropical regions. Globally, it is estimated that 4.5–5.4 million snake bites occur each year, of which 1.8–2.7 million results in clinically evident envenomation, with an estimated mortality ranging from 81,000 to 138,000 annually. India has 52 species of venomous snakes and accounts for nearly 50% of the global deaths attributed to venomous snakebite. The incidence and pattern of snakebite vary across different geographical areas and are influenced by factors such as climate, ecology, biodiversity, snake distribution, and human population density. The present study included fatal snakebite cases subjected to medico-legal autopsy at the Department of Forensic Medicine and Toxicology, Patna Medical College, Patna. Information about demographic profile (age, sex, occupation, and socioeconomic status), geographical area, seasonal trends, site and pattern of bite, local tissue changes, and manner of bite was documented in a standardized proforma and analyzed accordingly. In this study, the majority of victims were males in the 21–30 year age group, predominantly engaged in agricultural work, and most bites were accidental in nature. Hands and feet were the most common sites affected. Most cases occurred during the rainy season. In the majority of victims, two fang marks were identified at the bite site, accompanied by subcutaneous hemorrhage, necrosis, swelling, and local cellulitis. Snakebite burden is highest among males aged 21–30 years, most of whom belong to economically weaker rural populations engaged in farming occupations.

Forensic autopsy is of great importance in various processes of the criminal justice system. The death of a person may be natural or unnatural, and autopsy findings have considerable bearing on the legal implications. Trauma resulting from accidents, assaults, and violent asphyxia fatalities is the primary cause of unnatural deaths in India. This was a prospective descriptive study aimed to analyze the epidemiologic profile of medico-legal autopsies (n = 1510) conducted at a Government Royapettah Hospital, Chennai, during the year 2024. Natural death was seen in 51.58% (n = 779) of cases, with the respiratory system (36.8%) and cardiovascular system (34.7%) involved in most of these cases. Male predominance was observed, and most cases belonged to the age group between 41 and 50 years (n = 587), followed by 31–40 years (n = 291). Among unnatural deaths (n = 731), asphyxia deaths formed the bulk of cases, with 346 cases of hanging and 74 cases of drowning. Other major contributors were road traffic accidents (n = 139), followed by falls from height (n = 41), poisoning (n = 39), and electrocution (n = 27). Deaths due to assault, mechanical injuries, and snakebites formed the rest. The results reflected the prevailing mortality pattern in the region. Respiratory and cardiovascular causes formed the bulk of natural deaths. Among the unnatural deaths, a high frequency was noticed in young married males, attributable to various social stressors, family responsibilities, and work conditions. Such deaths could have been prevented or minimized by creating safety awareness and hazard alertness among the population at risk.

Stature estimation is an essential component of forensic anthropology, aiding in personal identification from skeletal remains. While appendicular skeleton measurements are commonly used, in cases of mutilation or trauma, alternative reliable indicators such as the foramen magnum (FM) become crucial. To determine the correlation between stature and the dimensions of the FM and to derive regression equations for stature estimation in the Western Indian population. This prospective observational study was conducted on 106 medicolegal autopsies (76 males and 30 females) in a tertiary care center in Mumbai. Cadaveric stature was measured in the supine position. Anteroposterior (AP) and transverse diameters of the FM were measured post-brain removal using vernier calipers. Data were analyzed using SPSS v17.0 to derive regression equations. Strong positive correlations were observed between FM dimensions and stature in both sexes. In males, AP and transverse lengths showed very strong correlations (R = 0.89 and R = 0.91, respectively), while in females, correlations were slightly lower (R = 0.84 and R = 0.75). Regression equations were derived for each sex. The FM offers a valuable parameter for stature estimation, especially in cases involving fragmented or mutilated remains. This study provides population-specific regression equations useful for forensic investigations in the Western Indian population.

Fingerprint evidence is one of the most reliable biometric tools in forensic identification due to its uniqueness and permanence. Fingerprints are frequently encountered at crime scenes in both partial and complete forms. An emerging morphological feature of interest is fingerprint ridge density, defined as the number of ridges within a specified area of the fingerprint. The present study aimed to evaluate sex-based differences in fingerprint ridge density across three anatomical regions of the fingerprint: Radial (R), ulnar (U), and lower (L) in the Indian Tamil population. The study was conducted on 274 individuals (137 males and 137 females) aged between 18 to 60 years. Fingerprints were collected from all 10 fingers of each participant. Ridge density was measured in three defined regions of the fingerprint: R, U, and L areas. Statistical analysis was carried out using the independent t-test to compare ridge density values between males and females in each region. The findings revealed that females exhibited significantly higher ridge density than males across all three regions of the fingerprint. Among the studied regions, the L area demonstrated the highest mean ridge density, followed by the R and U regions. These differences were consistent across both hands and all fingers, although slight variations were observed in a few anatomical areas. Overall, the results strongly indicated the presence of sexual dimorphism in fingerprint ridge density. The study concludes that fingerprint ridge density is a reliable morphological parameter for sex differentiation in the Indian Tamil population, with females consistently showing higher ridge density than males. The L region of the fingerprint was found to be the most dependable area for distinguishing sex.

Short tandem repeat (STR) DNA, one of which is the FGA locus, can be used as a profiling tool for personal identification analysis in the forensic field because it has many allelic combinations based on the complex repetitive pattern of DNA sequences. The FGA locus was reported to have the highest discrimination power in the Indonesian population. The aim of this study was to understand the ability of personal discrimination from the FGA locus sequences in a DNA forensics testing scenario of Indonesian subjects. The specimens were used towels (T), toothbrushes (TB), and hair ties (HT) from certain people and buccal swabs (BS) from the same people and two others as controls whose identities were analyzed. DNA extraction using the Phenol CIAA (chloroform isoamyl-alcohol) method followed amplification of the DNA of FGA loci that targeted repetitive sequences, agarose gel electrophoresis, and Sanger sequencing of FGA loci. The amplification showed the DNA bands from the FGA loci were around 350 bp. The sequencing results showed that the number of repetitions of the FGA allele from samples T, TB, and HT was identical to BS1, which was 19 repetitions, while BS2 and BS3 were 22 and 21 repetitions, respectively. Thus, the sample items T, TB, and HT are owned by individual BS1. The FGA gene sequenced by the Sanger method can be used in a limited way, only detecting repetitive sequences on the longest allele as a differentiator between one individual and another.

Problem-based learning (PBL), introduced in the 1960s, is a vital and often debated aspect of medical education. PBL is a highly effective educational method, often expressing a preference for it over traditional lecture formats. We aim to implement modified PBL in Forensic Medicine and compare the performance of II MBBS students using both traditional and modified approaches to enhance learning outcomes. A survey was conducted among 2nd MBBS students in their 5th semester to assess the effectiveness of a modified PBL approach. Utilizing a five-point Likert scale for data analysis, the findings revealed that a significant majority of students in batches C1 (45%), C2 (50%), and C3 (55.56%) believe that modified PBL is more effective than traditional learning methods. Furthermore, 60% of C1 students, 66.67% of C2 students, and 61.11% of C3 students reported improved communication skills resulting from this approach. Additionally, a notable percentage of students acknowledged an enhanced understanding of course material, with 52.50% from C1, 61.11% from C2, and 66.67% from C3 expressing this viewpoint. Modified PBL is an effective approach to enhancing student engagement and enriching education in preclinical and paraclinical sciences. It promotes interactive learning and develops essential problem-solving skills. Implementing modified PBL requires a spacious demonstration hall and a round table to foster discussions and interactions among students.

This narrative review examines the escalating opioid crisis, particularly focusing on the role of fentanyl and its analogues in opioid-related overdose deaths in the United States and Asia. Data indicates a significant increase in fatalities linked to opioid misuse, with fentanyl being 50–100 times more potent than morphine, and a staggering 82.3% of opioid-related deaths in 2020 were attributable to overdoses. The article analyzes contributing factors to opioid toxicity, including dosage, tolerance, combination with other substances, administration routes, individual physiological responses, and polydrug use. It highlights the epidemiology of opioid toxicity across the USA and various Asian countries, identifying similarities and differences in prevalence, risk factors, and governmental responses. The review discusses the efficacy of current prevention strategies, such as the Prescription Drug Monitoring Programs (PDMPs), opioid substitution therapy (OST), and harm reduction initiatives, while emphasizing the need for improved public education and awareness. Furthermore, it addresses the challenges in managing opioid toxicity, such as rapid onset of action, risk of co-ingestion, and the importance of naloxone administration. The article advocates for a coordinated, multi-faceted approach that includes data sharing, policy harmonization, international collaboration, and technological innovations, particularly artificial intelligence, to mitigate the opioid crisis and enhance patient safety. Ultimately, it underscores the necessity for a balanced approach to opioid regulation that considers both legitimate medical use and the complexities of misuse and addiction.

Road traffic accidents are becoming increasingly common due to rising economic status, a growing number of vehicles, and the pressures of modern life. Autopsy surgeons determine the cause of death through post-mortem examinations; however, they are often unaware of findings from the accident scene. In India, road traffic accident reconstruction is rarely performed. In some instances, homicides are staged as road accidents to conceal the crime. The examination and reconstruction of accident scenes play a crucial role in distinguishing between accidental deaths and those resulting from foul play.

The study is based on an extensive review of research articles, books, and online resources. The article was searched on Google Scholar, PubMed, and the Google search engine, and the Medical Subject Headings (MeSH) terms used were road traffic accidents (RTA), crime scene, and forensic engineering. Incident site analysis, when correlated with autopsy findings, can help determine whether a death was caused by an accident or was homicidal. Proper preservation of evidentiary material at the scene aids in identifying the vehicle, driver, victim, and the exact location of impact. The study’s main objective is to know how crime scene reconstruction and forensic engineering play a vital role in determining the manner of death.

The eagerly awaited Surrogacy (Regulation) Act of 2021, following extensive deliberations and amendments during its legislative journey, disappointingly neglects the essential rights of egg donors, notably in terms of health insurance coverage and safeguarding their well-being throughout and after the egg retrieval process. The Act lacks provisions for addressing reported instances of medical complications and, tragically, even the unfortunate demise of egg donors. This significant oversight not only infringes upon the fundamental rights of these contributors but also underscores a disproportionate emphasis on the rights of surrogate mothers within the framework of the Surrogacy (Regulation) Act, 2021. This research endeavor seeks to illuminate the deficiencies within the Act as it pertains to the rights of egg donors and, in response, proposes viable remedies for consideration.

Forensic ballistics involves the examination of firearms and related evidence and their interpretation for judicial procedures. When reconstructing a crime scene, forensic ballistics can help determine the shooter, the weapon used, the range, and the approximate time of the incident. In spite of its contemporary literary connotations, forensic ballistics has been practiced for decades. Black powder and gunpowder predate forensic ballistics. Forensic ballistics is a combination of various scientific disciplines such as physics, mathematics, statistics, computers, photography, forensics, and medico-legal. This is a unique and practical field that is used in the scientific and judicial investigation of offenses related to weaponry. Its contributions to legal and medico-legal studies are widely recognized. Although there is a wealth of information available about the development of forensic ballistics worldwide, there is a dearth of information and substantial gaps in the literature. To describe the development and dissemination of forensic ballistics throughout India, this review study consults outdated but useful literature. This review may be helpful to criminal investigators, prosecutors, and anyone interested in comprehending firearm evidence and legal investigation, since forensic ballistics is of importance to the legal, social, and scientific sectors. Researchers and students who are interested in the subject can learn more about the development and dissemination of forensic ballistics in India from this review.

Firearms are dangerous weapons and are often used to commit homicides as well as suicides. Every case of a firearm is unique, and its wound pattern provides insights into the type of weapon used, range of firing and direction of shot. The demise of a 25-year-old male police constable during his duty hours under suspicious circumstances raised the question of whether it was a homicide or suicide. The most important findings were the signature imprint created by the flash suppressor around the entry wound resembling a flower petal pattern, and the trigger position of the right-hand index finger. Injuries produced by flash suppressors are less reported in the literature, so forensic experts should be aware of these patterns of firearm wounds, as they can even mimic multiple entry wounds.

The COVID-19 pandemic, like other highly contagious outbreaks, has forced us to rethink and adjust many aspects of daily life. In the medical world, most fields have quickly developed new methods or adapted existing ones to reduce the risks posed by the virus. Forensic pathology, which often involves high-risk aerosol-generating procedures (AGPs) during autopsies to investigate deaths from unknown causes, faces the same challenge. The need to protect healthcare workers in this area has become more critical than ever.

In light of this, the authors present an alternative method for removing the brain during autopsies in post-craniotomy cases, eliminating the need for the traditional approach of sawing through the skull. This technique reduces the risk of generating aerosols, which are a primary mode of transmission for airborne infections. Importantly, the method can be applied to all cases, regardless of whether the deceased is suspected of carrying an infectious disease, making it a versatile and safer option.

This innovative approach shows how forensic pathology can evolve to meet the safety demands of the pandemic without sacrificing the quality of the investigation. By reducing the risk of exposure to infectious agents, forensic pathologists and other professionals involved in post-mortem procedures are protected. In a time when infection control is a top priority, such changes to traditional practices help ensure that crucial medical examinations can continue safely.

Tire service stations present serious hazards, especially during high-pressure air inflation. While tire bursts are known to cause fatal injuries, metal rim ejections due to improper disk locking are underreported. This case highlights the risks associated with unsecured metal disks and underscores the need for safety measures in the form of a daily check-up of the machine before starting the work. Here a 40-year-old mechanic sustained fatal injuries when a loosely fitted metal rim was propelled by high tire pressure during air inflation. With the remolding machine door left open, rising pressure dislodged the poorly locked disk, sending the rim six feet, striking his head and face. The injuries matched the distorted rim found at the scene. He was hospitalized, unconscious, and died five hours later. This case highlights the dangers of improper locking during tire inflation, emphasizing the need for strict safety protocols. Secure disk fittings, protective barriers, and adherence to guidelines are crucial. Raising awareness, proper training, and enforcing safety regulations can help prevent fatal injuries in tire service stations.

Cornelia de Lange syndrome (CdLS) is a rare genetic disorder (1 in 10,000–30,000 births) often linked to gastrointestinal (GI) complications such as perforation. The most common GI complication in CdLS is gastroesophageal reflux, caused by improper valve function between the stomach and esophagus, allowing stomach acid to flow back. Mutations are usually sporadic and not inherited. Forensic awareness is vital to avoid misinterpretation as abuse, account for intellectual disability and consent issues, and recognize risks of sudden death from undiagnosed malformations such as intestinal obstruction. At autopsy, features such as facial anomalies, limb defects, and GI pathology can indicate CdLS as a factor in unexplained deaths or related conditions. Given its genetic complexity and potential mosaicism, careful evaluation, even postmortem, is essential for accurate cause of death determination. We describe a case of a 25-year-old female with genetically confirmed lifelong intellectual disability who presented with sudden abdominal pain, vomiting, and melena, followed by unconsciousness. She was declared dead at a tertiary care hospital. Autopsy findings revealed ileal dilatation with perforation. CdLS is a rare genetic disorder with drastic involvement in the GI system. Thus, prompt inquiry of case details and investigations, coupled with a thorough post mortem examination is of paramount importance in such cases.

We report the case of a 37-year-old male whose burned body was discovered under suspicious circumstances in an abandoned location. Postmortem examination revealed the body in a pugilistic attitude with extensive burns, sparing the upper half of the face, portions of the scalp, and parts of the back. The absence of a line of redness at the junction of burnt and unburnt areas indicated that the burns were sustained in the postmortem period. Multiple lacerated wounds and fractures of the facial bones with ecchymosis of surrounding structures were noted, confirming antemortem blunt force trauma. The tracheal mucosa was unremarkable, with no evidence of soot deposition, thereby ruling out antemortem inhalation of smoke. Internal examination revealed subarachnoid and subdural hemorrhages over the left cerebral hemisphere and at the base of the brain, findings consistent with fatal cranio-cerebral injury resulting from blunt force trauma. Correlation of external and internal findings established that death resulted from cranio-cerebral damage due to multiple blunt force injuries, with postmortem burning inflicted to conceal the homicidal nature of the death.

The authors reported a case of a body packer death due to heroin leakage in the stomach from a leaked package. The body packer was trying to transport the drug by hiding it in his gastrointestinal (GI) tract. The body was recovered after 6–7 days of the incident. A total of 50 egg-shaped packages were found in the body: 48 similar egg-shaped packages were found in the stomach, out of which one was leaked, one egg-shaped package was in the jejunum and one egg-shaped package was in the descending colon. The total weight of 50 capsules was 468 g. Toxicological analysis of the powder samples from the damaged package and the other 49 packages was performed and found positive for diacetyl morphine (heroin), monoacetyl morphine, caffeine, dextromethorphan and acetyl codeine. This case shows the difficulties during examination of a narcotic deceased postmortem and the importance of the history of the victim before the autopsy, a proper postmortem examination, the findings of toxicological tests and forensic photography. The cause of death was ‘acute drug overdose due to rupture of filled capsule in stomach’, which makes this case special. It indicates that body packing is an existing problem in India.