A Review of Applicability of Banning (Hajre) in Jurisprudence from the Perspective of Forensic Medicine

F Najari, M Ghadi Pasha, MA Emam Hadi

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 1-5

The topic of ward is among the important topics in jurisprudence and Forensic Medicine. Banning literally means prohibiting. The term of prohibition means preventing someone from being involved in financial or non-financial affairs and is called being banned. A person is banned from all affairs such as an unlettered person or some of the affairs such as a dying person. Banning has two forms; it sometimes is in the interests of the one banned from and his/her rights and sometimes for the benefit and the right of others. The objective of this brief article is an evaluation of extent banning applicability in Forensic Medicine topics and its relation with concepts and logics of the Islamic law.

Original Article

Pattern of Deliberate Self-Poisoning in Gorgan, North of Iran

M Shokrzadeh, R Hoseinpoor, A Hajimohammadi, A Delaram, M Pahlavani, M Rezaei, Y Shayeste

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 6-18

Background: Suicide is a global public health problem. Deliberate Self-Poisoning (DSP) is one of the most common methods of suicide in many countries. This study was designed to identify the trends and characteristics of DSP in Gorgan.

Methods: The study was carried out retrospectively in 5 Azar Hospital. It included 549 patients who were hospitalized in the hospital due to DSP from March 2008 to March 2015. Data were obtained from medical records. Stata software and Pearson's chi-squared test were used for data analysis.

Results: Of 549 patients, 51% were females and 50.27% were aged 20–29 years. The majority of patients (76.68%) lived in urban areas. Poisoning occurred mostly in summer and the peak was observed in August. Most of the poisoning agents were pharmaceuticals (80.51%). Among the pharmaceuticals, benzodiazepines were involved most often. Overall, 21 patients (3.83%) died. The highest number of deaths was due to aluminum phosphide poisoning (76.19%). In addition, family quarrel was the main cause of DSP (43.17%). There were significant differences between the causes of DSP and demographics. Characteristics including gender, age groups, marital status, employment status and educational status.

Conclusion: Deliberate self-poisoning (DSP) with drugs has recently been a serious social problem, especially in the younger generation in Gorgan and there is an urgent need for a prevention plan.

Status of Total Antioxidant Capacity and Malondialdehyde Level in Methamphetamine Addicts: A Cross Sectional Study

S Shadnia, N Gorgzadeh, K Soltaninejad, M Abdollahi, SA Motevalian

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 19-25

Background: Methamphetamine (MA) is an illegal amphetamine-like which stimulate the central nervous system. In recent years, MA has been widely abused worldwide. Previous studies have suggested that oxidative stress (OS) plays an important role in MA-induced toxicity. From this view, antioxidant therapy could be considered as a potential drug therapy in MA abusers. Therefore, the objective of this study was to evaluate OS status in MA abusers.

Methods: This was a cross-sectional study conducted on 21 MA abusers who referred to Iranian National Center for Addiction Studies and Congress 60 Humane Revivification Society, and 15 healthy males as a control group. The demographic data and peripheral blood sampling was obtained from both groups. The serum malondialdehyde (MDA) level as a marker of plasma lipid peroxidation and total antioxidant capacity (TAC) of plasma were analyzed.

Results: Significant decrease in plasma TAC in case group was observed (101.85±12.5 vs. 130.7±16.12 mmol/L). No significant increase in MDA serum level was detected in case group in comparison with control (27.35±2.6 vs. 26.67±2.22 µmol/L, respectively). Neither the serum MDA levels nor the plasma TAC were significantly correlated with the duration and amount of MA abuse.

Conclusion: It seems that, MA abuse is associated with prooxidant-antioxidant imbalance, which suggests evaluation the role of antioxidants administration for the prevention and treatment of MA-induced toxicity.

Study on the Relationship between Fingerprint Pattern and Intellectual Performance

K R Siddapur

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 26-31

Background: The concepts of ‘Intelligence’ and ‘intellectual performance’ though seem alike, but are different. Intelligence assessment of an individual is technical, is done by the application of multiple, reliable and validated, IQ (Intelligence Quotient) tests on the same individual in different settings (date, place and time). However, ‘Intellectual performance’ (IP) has a reference only to the present study, wherein, multiple choice questions (MCQs) test was conducted to analyse intelligence of the participants in a single setting. Loop, Whorl, Arch and Composite form the 4 main patterns of a fingerprint system. From the data reported by authors of the previous studies, it was evident that relationship existed between fingerprint pattern and an individual’s intelligence. Thus, the present study was taken up with the goal to assess the relationship.

Methods: The present study was descriptive-correlational, and was approved by the Institutional Ethics Committee (IEC) of Velammal Medical College Hospital and Research Institute, and included consenting medical (MBBS) students (aged between 19 to 21 years) of the same institute. The population was 138 students, of which, 137 students (sample size) participated in the study with the implementation of the inclusion criteria. Sample size being 137, of a total population of 138 students, meant Confidence Level as 95% with Confidence Interval as 1.

Results: It was observed that participants with Arch fingerprint pattern performed better. To assess the statistical significance, Chi Square Test was applied. The test was significant with p value = 0.034553 (< 0.05), which meant, participants with arch pattern performed significantly better than others. Further statistical analysis revealed that it was female participants with Arch fingerprint pattern, who significantly (p value=0.007872) contributed to the overall better performance of the participants with Arch fingerprint pattern.

Conclusion: loops were more frequent (44.5%) amongst the participants. However, in the present study, loops and whorls were less frequent, whereas, arch and composite were more frequent in comparison to standard distribution of occurrence. It was observed that participants with Arch fingerprint pattern performed better.

Epidemiological Profile of Complete Suicidal Poisoning Cases Autopsied at Autopsy Centre, RIMS, Ranchi

B Singh, K Kishore, A K Chaudhary

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 32-42

Background: Suicidal behaviour is any deliberate action that has potentially life-threatening consequences, such as taking a drug overdose, deliberately consuming poison, hanging, drowning, burn etc. The aim of this study was to illustrate the epidemiological profile of complete suicidal poisoning cases autopsied at Department of Forensic Medicine and Toxicology, Rajendra Institute of Medical Sciences, Ranchi, India.

Methods: All cases autopsied at autopsy centre of department of forensic medicine and toxicology between April 2013 to October 2014 evaluated. Data obtained from the Information regarding the socio-demographic, mode of suicides, time of incidence, place of incidence, occupation, etc were gathered from the police papers like inquest report, dead body challan etc, and through detailed interviews of the relatives, neighbours, friends, and police officials accompanying the dead bodies.

Results: Total 3492 cases were autopsied, out of which only 180 cases were due to acute self-poisoning, suicidal in nature. This was 5.2% of the total cases autopsied at centre. The ratio of male and female suicide by poisoning was almost equal (M: F = 1.22: 1). The majority of victims were married, unemployed, from joint family and middle economic class. The most important agents of poisoning were agrochemical pesticides among these majorities were due to organophosphate.

Conclusion: More than 50% of victims from both male and female were in between 15 years to 30 years. The maximum victims were consumed poison at evening (between 4 PM to 8 PM) during summer season. The Agrochemicals were the preferred agents with organophosphates alone responsible for about 50% of suicidal mortalities followed by aluminium phosphide.

Effectiveness of Self-Talk Technique and Positive Empathy on Deficient Attitudes, Hopelessness, and Suicidal Thoughts in Women with Breast Cancer

A Babakhanloo, M Jalilvand, B Shoghi

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 43-53

Background: Problems stemming from individuals' reactions to the diagnosis and treatment of breast cancer have various effects on the different dimensions of individuals and families' lives such as deficient attitudes, hopelessness, and suicidal thoughts. The study aim was determining the effectiveness of self-talk technique and positive empathy in reducing symptoms and modifying deficient attitudes, hopelessness, and suicidal thoughts in women with breast cancer in Tehran.

Methods: The present study was semi-experimental with a pre-test post-test design along with a control group in Tehran from 2014 to 2015. The statistical population consisted of 20 women with breast cancer who were randomly divided into two groups: experiment group (10 individuals) and control group (10 individuals). The experiment group received 12 sessions (each session=90 minutes) with educational structures of self-talk and positive empathy techniques. Data collection tools included Wizeman and Beck's deficient Attitudes Scales, Beck's Hopelessness, and Beck's Suicidal Thoughts Measurement. Data were obtained using SPSS19 software in two sections: descriptive and inferential (variance analysis with repeated measurement and Post Hoc test LSD).

Results: The interactive effect of test time and group of each dependent variable was significant. The mean difference between pre-test and post-test in measuring all three dependent variables was significant. On the other hand, the mean difference between post-test and control test was not significant in any of the dependent variables. However, the mean difference between pre-test and control test was significant in all three variables.

Conclusion: Teaching self-talk and positive empathy techniques had positive effects on reducing deficient attitudes, hopelessness, and suicidal thoughts. In addition, results proved the sustainability of intervention effects on the size of dependent variables.

Epidemiology of Poisoning in Northeast of Iran (2004-2013)

M Khadem Rezaiyan, R Afshari

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 54-58

Background: Poisoning is a major concern, especially in developing countries. We aimed to focus on poisoning trends based on registry data for the recent 10 years.

Methods: This cross-sectional study was performed on registry database of Imam Reza Hospital in Mashhad, Iran. All cases of toxic exposure or poisoning during 2004 to 2013 were included (49189 patients). Data from two national censuses were used for calculating rates. SPSS 11.5 was used for data analysis. P<0.05 was considered statistically significant.

Results: There were 49189 admissions during the 10-year period with a mean age of 26.21±14.97 years out of which 50.3% were female. The prevalence rate had increased three times in women and four times in men. Pharmaceutical toxins (63.5%) had the highest proportional mortality ratio, which mostly occurred in winters. The mean age of admission began to decline again in recent years.

Conclusion: Analyzing data on secular trends can always enlighten the healthcare decision makers for real health problems. Designing the proper population-based interventions can be one of the many uses of these findings.

Case Report

Role of Diatoms in Diagnosis of Death Due to Drowning: Case Studies

N Kaushik, S K Pal, A Sharma, G Thakur

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 59-65

Background: The most frequent use of diatoms in forensic science is the diagnosis of death due to drowning. The basic principle of diatom test in drowning is based on the inference that diatoms are present in medium where drowning took place and the inhaled water enters the alveolar spaces of lungs and penetrates from the alveoli into the blood circulation, thus microscopic unicellular algae called diatoms get transported to different organs of body. The diatoms found inside the body of drowned victim may serve as corroborative or even conclusive evidence to support the diagnosis of death. It can be ascertained whether the drowning is ante-mortem or post-mortem.

Case Report: The present study was conducted in Biology and Serology Division of State Forensic Science Laboratory, Shimla Hills Junga, Himachal Pradesh, India. Water sample from putative site of drowning as well as hard bones (sternum, clavicle, femur), soft tissue (spleen, liver, kidney) and peritoneal/pleural cavity fluid after post-mortem examination of dead body was sent to the Laboratory for the detection of diatoms. Cases were opened and processed following standard methodology. In the present study, 17 cases of drowning were examined for detection of diatoms. Out of seventeen cases, there were 15 males and 2 females aged between 11-63 years. 12 cases revealed the presence of diatoms (death due to drowning) while 5 were found to be negative (death other than drowning).

Conclusion: The present study revealed the importance of diatom test in forensic investigation and diagnosis of death due to drowning. Diatom test proved very significant application in forensic science in solving the drowning cases.

Mesiodens: an Identification Aid in Skeletal Remains Examination: a Case Report

M Kiran, M Shetty, Sh Manipady

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 66-68

Background: Forensic Odontology is that branch of dentistry which plays a vital role with regard to anthropological studies and human identification. In the cases of mass disasters or cases where only the skeletal remains are found, bones and teeth will be the only source of information for the identification of the dead.  Any aberrations or any variations from the normality become a distinctive feature in the identification of the deceased.

Case Report: Unknown skeletal remains were received by the forensic department for the purpose of identification. It was estimated to be a male of 50-60 years old with a stature of 164±2 cm and the skull had a mesiodens. Due to this particular feature, the identity of the individual was traced out.

Conclusion: This; like always, again proves that a meticulous odontological examination, and the anthropological findings followed by confirmation by DNA finger printing can successfully result in positive identification.

Background: Chaff cutter, a commonly used fodder cutter machine in rural parts of India is responsible for a significant number of agricultural-related accidents. Mostly, these accidents lead to amputation of the upper extremities and the fatal injuries are extremely rare.

Case Report: This article presents a very unusual case of fatal head injury and crush injury to right leg sustained by a farmer while working with a self-assembled chaff cutter machine in his field. His leg caught between the belt and the wheel of the diesel engine when he tried to cross it and resulted in such kind of fatal injuries.

Conclusion: Despite existing rules regarding the quality norms for the farm machinery in India and the availability of high-quality, safe machinery in the market, self-assembled chaff cutters are still in use and are posing a risk to any person working around. Apart from explaining the mechanism of the fatal injuries, this paper also stresses mainly on the need for ensuring the use of government prescribed safe machines and conducting regular training programs for farmers regarding the safe handling of farm machinery to reduce these kinds of fatalities.

Minor Fall Leading to Fatal Rupture of Solitary Giant Sub-Capsular Cavernous Haemangioma of Liver: a Case Report

A Menon P, A Balachandran

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 73-76

Background: The liver which is a vascular organ can easily be lacerated or crushed, depending on the severity of trauma.

Case Report: A 55 year-old lady who fell down was taken to a hospital within one hour and died two hours post-trauma. An autopsy revealed rupture a large sub capsular vascular lesion situated on the right lobe of liver with hemoperitoneum. There was a deep contusion on the abdominal wall adjacent to the costal margin on the right side, roughly overlying the rupture, but the skin showed no evidence of injury on external examination. Histopathology revealed that the lesion was a giant cavernous haemangioma of the liver which was undetected prior to the incident.

Conclusion: Certain conditions like fatty liver disease, polycystic disease and cavernous haemangioma can predispose liver injury, even with considerably less amount of force than is ordinarily required.

Rupture of Heart in a Cannabis Addict: an Autopsy Case Report

S Vidhate, H Pathak, R Kamble

International Journal of Medical Toxicology and Forensic Medicine, Vol. 7 No. 1(Winter) (2017), 3 May 2017 , Page 77-80

Background: Cannabis sativa or indica also known as Indian hemp is most widely used illicit drug in the world in its various forms such as bhang, majoon, ganja, charas or hashis. It affects various systems of human body on virtue of its active principle i.e. delta-9 tetrahydrocannabinol (THC). Its effect on cardiovascular system such as dose dependant increase in heart rate, arrhythmia and increased occurrence of myocardial infarction are well known.

Case Report: In present case, a 42 years old male, addicted to ingestion of ‘bhang’ and suffering from psychiatric illness was brought to the hospital with history of headache and vomiting since last 12 hours. There was history of his violent behaviour, hence he was kept locked in a room for few hours and then relieved. He was treated for few hours and succumbed to death. On autopsy, patent coronaries and rupture of anterior wall of heart, in the vicinity of inter-ventricular septum was revealed.

Conclusion: To the best of our knowledge, no such case was found in the literature. Treatment of patients with history of cannabis addiction must be focused in the view of acute cardiac conditions.

Letter to the Editor

I found one article on the website of IJMTFM, which had studied the consequences of aspiration of gastric contents in acute poisoning patients (1). It was informative. Unfortunately, there are some errors in that article, which I would like to bring to your kind attention.