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Background Cardiovascular diseases, especially ischemic heart disease, are the most frequent cause of sudden and unexpected death that constitute a significant portion of the autopsies conducted in our country. Though these deaths may be natural as well as unnatural, they carry medico-legal importance because they occur in a person who has been apparently healthy before the supervening of death, and the cause of death is difficult to ascertain. An infarction can be missed by gross and histological examination within the first few hours of sudden death. 2,3,5-triphenyl-tetrazolium chloride (TTC) is a sensitive histochemical method for diagnosing myocardial infarction within four hours of sudden death. The use of such dyes, hence, can possibly aid in ascertaining the cause of death in such cases wherein there are no known preceding factors. Aim The aim of this article was to study the occurrence of myocardial ischemia by histochemical staining method - 2,3,5-triphenyl-tetrazolium chloride (TTC). Methods This study involved patients who underwent postmortem examination in the Department of Forensic Medicine and Toxicology, Sri Ramachandra Medical College and Research Institute, Chennai. Results Of 62 cases, 31 cases were found to be positive for TTC staining, and those heart slices were subjected to histopathological examination. The maximum number of cases (77.4%) showed the age of infarction within zero to four hours, which was detected early by TTC staining compared to microscopic changes in the heart. Only seven cases were positive for myocardial infarction by histopathological examination, proving that it is difficult to detect acute infarction if the age of infarction is less than four hours. Conclusion This suggests that for all sudden death cases, 2,3,5-triphenyl tetrazolium chloride could be used as a better tool for the identification of early infarcts.
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Suicide, the act or instance of voluntarily and intentionally taking one's own life, is a leading global cause of death. Complex suicide involves the use of more than one method and can be either planned or unplanned. Frequently seen methods include the ingestion of a toxic substance in combination with hanging, the use of firearms with hanging, drowning combined with injuries from knives, and jumping from heights. We present a case of complex suicide in which the victim used hanging and a self-inflicted incision wound on the wrist. This case highlights the significance of a detailed medicolegal death investigation, including interviews with relatives and a thorough forensic autopsy to ascertain the cause and manner of death.
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In recent times, there has been a concerning rise in the incidence of sudden death among individuals in middle age. Predominantly, cardiovascular diseases emerge as the leading cause behind such untimely fatalities. Myocardial infarction and its subsequent complications stand out as the most frequently encountered scenarios in these tragic events. Despite being a relatively uncommon occurrence, cardiac tamponade represents one of the rare yet fatal complications that can ensue following a myocardial infarction. This condition manifests when the pericardial cavity becomes filled with either blood or blood clots, impeding the heart's normal functioning. Typically, patients experiencing cardiac tamponade are often reported to have succumbed to sudden death, with a preceding history of chest pain being a common indicator. The definitive diagnosis of cardiac tamponade usually occurs during post-mortem examinations. We consider the case of a 38-year-old man who was discovered unconscious at his residence and was pronounced dead upon arrival at the hospital. Subsequent autopsy findings unveiled the presence of both blood and blood clots within the pericardial cavity, in conjunction with a rupture in the right ventricle and occlusion of the left coronary artery. Histopathological analysis further confirmed the root cause of this tragic event as an acute myocardial infarction.
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ABSTRACT: A cross-sectional study of the wound age estimation from the forensic skin wound samples was performed immunohistochemically with a sample size of 40 (n = 40). The samples were segregated according to the appropriate stages of wound healing with the help of hematoxylin-eosin staining. Later, they were subjected to immunohistochemistry staining with anti-AQP3 antibody. Quantification of the expression of AQP3 in the injured and uninjured formalin-fixed skin tissues was done semiquantitatively and manually under 400× magnifications. The AQP3-positive cells were correlated with the duration of injury, and the results were statistically analyzed. More AQP3 expressions were found in the proliferative phase than the inflammatory and maturation phase of wound healing. Neither the diversity in age group nor the sex differentiation showed any specific correlation with the expression of keratinocytic aquaporin cells. Likewise, parameters such as the type of injury, mode of injury, and the postmortem interval also did not show any significant relationship with the expression of the aquaporin positivity. Thus, it is revealed that skin wounds between 5 and 10 days expressed aquaporin cell numbers of more than 300. Hence AQP3 estimation helps in determining the time since injury with a more accuracy.
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Acuaporina 3 , Acuaporinas , Humanos , Inmunohistoquímica , Estudios Transversales , Acuaporina 3/metabolismo , Piel , Acuaporinas/metabolismoRESUMEN
OBJECTIVE: Suicide is a significant public health issue and a major cause of death in all ages worldwide. Previous studies have shown the involvement of genetics in suicidal behaviour. This study aimed to assess the role of the genetic variants of the serotonin transporter genes (5HTTLPR, SLC6A4 intron 2) and receptor gene (5HTR2AT102C) in individuals who died of suicide. The study compares the serum levels of serotonin between the cases and controls. METHODS: We conducted a case control study with 120 cases and 126 controls. Socio-economic details of the subjects were collected using a semi-structured proforma and psychological autopsy was used to collect details of medical and other clinical conditions. Blood was drawn after taking informed consent and serum levels of serotonin were estimated by ELISA. Genotyping was performed using appropriate primers followed by polymerase chain reaction (PCR) and a restriction fragment length polymorphism (RFLP). RESULTS: Mean age was 32.59 ± 12.58 for cases and 33.64 ± 9.78 for controls. The risk associated LL genotype of 5HTTLPR was higher among cases. The heterozygous 12/10 genotype of SLC6A4 intron 2 polymorphism was increased among controls. Serum levels of serotonin were lower among cases. Variant genotypes of all the 3 polymorphisms showed significant interaction (OR= 39.26) indicating that this model may increase suicidal tendency. CONCLUSION: The findings of this study suggest that low serum levels of serotonin and two variants of the serotonin gene may influence suicide behaviour in a south Indian population.