Journal of forensic and legal medicine
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We report a case of vaso-occlusive sickle cell crisis in a young schizophrenic man with undiagnosed sickle cell trait who was restrained. Prior to being restrained he had locked himself in his apartment for two days without food or water. He was subsequently restrained, and transferred to hospital while handcuffed to the stretcher. ⋯ There were no injuries present. We conclude that the death was due to vaso-occlusive sickle cell crisis secondary to dehydration. It is important for the forensic pathologist to remember that death may occur suddenly during restraint from an unexpected mechanism other than excited delirium leading to cardiac arrhythmia or restraint asphyxia.
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The incidence of suicide and homicide is on the increase worldwide, including India. One million people die annually due to suicides and homicides alone. A comparison of the results between suicides and homicides was performed. ⋯ Majority of the accused were having close family relationship with the victims of suicide in contrast to homicides in which most of the assailant were having no family relationship with the victims. 'Acquaintance' were the accused in majority of the victims of homicides in contrast to 'self' in suicides. Most of the victims of homicide were killed outdoor in contrast to victim's own domicile in suicides. In both suicidal and homicidal deaths, most of the victims were found in summer season, but the peaks were noticed in the months of April and May in suicidal deaths and October in homicidal deaths.
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Injuries missed at initial diagnoses or operations have the potential to cause disastrous complications in trauma patients. Understanding the etiology of unrecognized injuries is essential in minimizing its occurrence. For this purpose, we scrutinized the treatment and the autopsy records of the trauma deaths from 2000 to 2004 to determine the frequency, body regions, severity and causes of injuries that escaped recognition during the initial assessment, primary, secondary and tertiary surveys by the clinical team in patients who died of trauma. ⋯ Abdomen (40%) and head (29%) were the more common regions of the body where injuries were frequently missed. System related errors (68%) and patient related factors (32%) were responsible for the injury remaining unrecognized. It was concluded that the injuries may be missed at any stage of the management of patients with major trauma and repeated assessments both clinical and radiological are mandatory not only to diminish the problem but to avoid litigation as well.
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In December 2003, two young men decided to go shooting in the countryside near Montpellier, France. One accidentally shot the other. Upon crime scene examination and autopsy of the victim experts observed, at the right thorax, two round wounds, distanced 5mm from each other, presenting typical characteristics of entry wounds of bullets shot from a distance. ⋯ The screw had obviously been changed, and the new screw was longer and therefore extended into the barrel, causing a small obstacle to the bullet when exiting the barrel. Shooting tests were performed, allowing the authors to conclude that a single bullet had fragmented before entering the body into two fragments. This lead the Procurator to consider the lesions consistent with an accident.