RESUMEN
Introduction: Medico-legal issues are handled by every registered medical practitioner in their day-to-day medical practice but if they are not well versed with rules of managing such cases and laws behind them, they often land into criticism and are distressed at the courts while disposing of the cases. Objective: To assess the knowledge of registered medical practitioners in Meghalaya regarding the management of medico-legal cases in day-to-day medical practices. Materials and Methods: This was a cross-sectional study, conducted at the Department of Forensic Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS) for 6 months. The study group included registered medical practitioners working in the government sector who were approached through the Director of Health Services (DHS), Meghalaya. Study tools included one preformed and pretested questionnaire. Knowledge was assessed along with designation and years of experience. A P value of < 0.05 was considered statistically significant. Results: From 94 subjects analyzed for their answers, 56% had adequate knowledge. Amongst nonspecialist doctors (n = 53), 52.8% had adequate knowledge and amongst specialist doctors (n = 34), 67.6% had adequate knowledge in various aspects of management of medico-legal cases, and it was found that 6.4% had adequate knowledge in documentation, 21.2% in consent, 3.2% in the Protection of Children from Sexual Offences (POCSO) Act, 71.2% in autopsy, 88.2% in legal duties in emergency care. A total of 68.7% of those having 16-20 years of experience had adequate knowledge. Chi-square test of designation and years of experience on knowledge was found to be 0.33 and 0.75, respectively. Conclusion: Nearly half of the registered medical practitioners of Meghalaya have adequate knowledge. However, years of experience and designation have no significance with the knowledge of registered medical practitioners regarding the management of medico-legal issues.
RESUMEN
Estimation of time since death (TSD) is an important aspect of forensic medicine. Methods used so far are subjective and have human errors. Corneal opacity images using software to analyze the red, green, and blue (RGB) components of corneal color against the TSD may prove to be an objective method. This study aimed to estimate TSD from image analysis of corneal opacity from the cornea of deceased individuals brought in for medicolegal autopsy to study the factors affecting corneal opacity and to formulate a predictive equation for the estimation of TSD. This was a cross-sectional study conducted at the department of forensic medicine and toxicology of a tertiary care medical institute over two years. The study group included cadavers brought in for autopsy where the TSD was known from hospital records. For study tools, we used a digital single-lens reflex (DSLR) camera with standardized settings, a dark box made of cardboard, and open-access RGB analysis software. Images were analyzed for differences in the numeric values of the RGB color and compared against the TSD. Correlations between TSD and age, gender, and environmental temperature were checked. This study involved 30 cases; these were analyzed and showed an increase in the numeric values of RGB for the corneal color as the TSD increases. Of note, the correlation of TSD with the color red was greater than for either blue or green; age had a positive correlation while gender had nearly no correlation, and the environmental temperature had a negative correlation. Based on this, gender was excluded from our equation. Also, we noted that the variance inflation factor of green was high and, therefore, excluded it from the predictive equation. The equation derived follows: TSD = {(0.091 x Age) + (0.171 x Red) + (0.018 x Blue) - (0.019 x Environmental Temperature) - 5.263}. Using this equation, the mean error was 21 minutes. This equation further narrowed the time range, usually given as four to six hours, when determining the TSD via conventional methods. Image analysis of corneal color after death using RGB analysis software can give us a more accurate and human error-free TSD that can be digitally stored and reproduced and, therefore, could prove useful in the forensic arena in the future.