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M Afzal, R K Jain, A K Srivastava, P Samikkannu, G Jayashanker & P Ghosh.
Central Forensic Science Laboratory, Ministry of Home affairs, Government of India, Ramanathpuram, Hyderabad-500013.

A case of suspected theft in a house by giving the milk cake (sweet) to all the family members is reported. A variety of thefts are occurring in the society, use of drugs are most prominent because of no smell or taste so its very easy by the culprits to mix the drug with the food items like sweets, chocolates, biscuits, cool drinks and tea etc. In the present case, methyl salicylate was mixed with milk cake and served to the family members to keep them in drowsy condition. The isolation of methyl salicylate is complex from matrices like sweets and general methods available for the detection of salicylate are reported in HPLC, GC.

The new method was by using modified GC-MS method. Standard stock solutions of methyl salicylate were made to 1.0, 5.0, 10.0 mg/ml concentration with ethanol. The sweets 16 in number suspected left over at the scene were extracted by Stas-Otto process with ethanol and acidic and basic portions extracted. Colour tests: ferric chloride test – violet colour, UV spectra of the extracts and the pure salicylic acid were carried and the spectra and the UV lambda max 344 compared and matched with sample and standard. GC-MS, 2ml injection, injector port 200ºC, interface 200ºC degree, EI mode, 70 eV, Capillary column FFAP, 30 mts, 0.25 mm id, 0.25 mm film thickness. Oven programming: 70ºC hold 1 min @ 5ºC to 200ºC hold 1 min carrier gas helium flow- 1ml/min

A new methodology was adopted in the detection of methyl salicylate in milk cake seized and the gastric lavage of the four inmates. Salicylic acid was detected in the sweet samples, mass spectra matched with the NIST library spectra. The study will be useful as a reference for such type of cases encountered in forensic labs carrying out the analysis.

Key words: Methyl salicylate, GC-MS, Colour test.

Development of Qualitative Method for Detection of Lorazepam in Chocolate

R K Jain, G Jayashanker, M Afzal, S Sudhakar, A K Srivastava & R K Sarin
Central Forensic Science Laboratory, Ministry of Home affairs, Government of India, Ramanathpuram, Hyderabad.

Benzodiazepine group of drugs diazepam, Lorazepam, nitrazepam are prescribed for insomnia patients as sedative and tranquilizers. Drugs are frequently misused as in cases of theft, robbery and even to commit rape; in common public places like railways, bus stand. The drugs are camouflaged in edible items to deceive the person to cheat. Forensic scientists often confronted with the problem of detection of the specific drug in the items like biscuit, chocolate, cool drink etc to confirm the drug used to commit the crime. The identification of drugs in complex matrix depends on the sophistication of the instrumentation being used. In the present study, the level of drug Lorazepam has been found by Thin Layer Chromatographic (TLC) screening method followed by GC-MS & FT-IR method to identify the drug.

A case of detection of these drugs in chocolates in the public places was encountered and a methodology for the same has been developed. The chocolates (Coconut crunch 10 no.) were extracted with chloroform in basic condition.

Modified TLC system Chloroform: Methanol: ammonia :: 90:10:1, Sprayed with Dragon-Droff reagent compared with standard Lorazepam. GC-MS with Column 5% phenyl methyl silicone, injector port 200, interface 200 degree, EI mode, 70 eV, Mass range 40-630 amu. Oven temperature 70ºC for 1min, @ 5º C to 200ºC hold 1min, @ 10ºC up to 250ºC, carrier gas helium 1ml/min, ionization voltage: 70 eV, EI mode. FT-IR: Nicolet system with KBR pellet method was used for the determination of the drug. The IR spectra matched with the library spectra available in the system and conclusively identified Lorazepam. The series of tests confirmed the presence of drug Lorazepam lazed in the chocolates as the cause of the person unconsciousness at the railway station and subsequent theft. In this work, we attempt to detect Lorazepam-using simple, rapid, effective and easily adaptable method for screening and qualitative purpose by forensic laboratories.  The method can be used for routine examination of Lorazepam in chocolate samples encountered.

Key words: Lorazepam, GC-MS, Stas-Otto process.

Recent Advances Related to Rape Laws

Dr Mukesh Yadav, Associate Professor

Department of Forensic Medicine, M.M. Institute of Medical Sciences & Research, Mullana, Ambala-133203

Uncontrolled increase in rape incidences all over the India especially in Delhi, ironically called a ‘Rape Capital’.  The number of alleged rapes reported in 2004 crossed the 500 mark, for the first time in the Capital’s history.  Sudden spurt in incidences of rape, especially against foreigners attracted attention of media both at national and international levels.  A 36 years old Swiss diplomat was abducted and raped in her car on October 14, 2003.  On March 15, 2004 a businessman at Deer Park in Safdarjung Enclave allegedly sexually assaulted and murdered by a taxi driver near IGI Airport, barely a couple of hours after she landed from Brisbane. This paper deals with recent advances made in Indian rape laws in 2005, a brief review of amendments done in 1983 and role of DNA profile in rape cases, their impact in controlling the most heinous crime against humanity i.e. ‘Rape’.

Key Words: Crime, Heinous, Human Rights, Humanity, Rape.

Involvement of Children in Road Traffic Accidents in Eastern Nepal

Dr B N Yadav, Additional professor

Dr Manoj Kumar, Assistant Professor,

Department of Forensic Medicine, BPKIHS, Dharan (Nepal).

Since the advent of vehicles, the number of Road traffic Accidents (RTA) has risen proportionate to the number of vehicles manufactured. In many countries, motor vehicle accidents rank on the top among all fatal accidents. There are almost 885000 deaths from RTAs annually in the world. The term 'killed' (in an RTA) is defined as any person who was killed outright or who died within 30 days because of accident. In a country like ours, with poor roads, ill managed vehicles, improper rash driving, highways being the sites of play for children and inadequate teaching of traffic rules to drivers as well as its inadequate incorporation of it in school curriculum leads to increased involvement of children in RTAs. The data were taken from departmental records. Altogether 17 cases were studied and the results were analyzed with the help of computer. In child age group substantial number of deaths occurred due to RTA. Pedestrian were maximally involved. Deaths in most of our study occurred after some days of hospitalization. Head injury was found in maximum number of cases and parallel number of cases hit by vehicles.

Dactylography and Sex Differentiation

Dr Vinod C Nayak, Assistant Professor
Dr. Yoganarasimha K Professor & Head
Department of Forensic Medicine, Kasturba Medical College, Manipal.

The study on fingerprint patterns has come a long way and now it is an established fact that these patterns are unique and specific to a particular individual.  It is the single confirmatory criterion, which provides unequivocal proof regarding identity.  The ever-increasing pattern of crime has made fingerprinting an indispensable tool in the hands of investigating officers.

In this study, an attempt has been made to identify the sex of a person, using fingerprint pattern with the hope of narrowing down the field of investigation to the investigating officer.

Hereby I am presenting the data regarding a study conducted on fingerprints, which comprised of subjects belonging to Chinese, Malaysian and Indian origin.

Biomedical Waste Management: An Emerging Concern in Indian Hospitals

Dr Virendar Pal Singh, Assistant Professor
Dr JagJiv Sharma, Prof.  & Head
Department of Forensic Medicine & Toxicology, Dayanand Medical College & Hospital, Ludhiana.

The waste produced in the course of health care activities carries a higher potential for infection and injury than any other type of waste.  The present scenario of biomedical waste (BMW) management in Indian hospitals is grim.  However, there is an emerging concern regarding BMW management, particularly because of notification of Bio Medical Waste (Management and Handling) Rules, 1998 that makes it mandatory for health care establishments to ensure that such waste is handled without any adverse effect to human health and environment.  This paper intends to create awareness amongst the personnel involved in health care services, in one way or the other.

Key Words: Biomedical waste, Health Hazard, Indian Hospitals, Bio Medical Waste (Management and Handling) Rules, 1998.

Cranio-Intracranial Injuries in Fatal Road Accidents

Dr Harnam Singh, Assistant Professor,
Department of Forensic Medicine, M.M. Institute of Medical Sciences & Research, Mullana (Ambala)
Dr S K Dhatterwal, Associate Professor,
Department of Forensic Medicine, Pt. B.D.S. PGIMS, Rohtak

The present study was undertaken in the Deptt. Of Forensic Medicine at PGIMS, Rohtak, with object of studying various aspects of cranio-intracranial injuries in road traffic accidents. Out of a total of 1510 medicolegal postmortems conducted in year 2000-2001, 450 cases (29.8%) were due to road traffic accident deaths.  The commonest age group involved was 21-30 years (27.3%), males outnumbered females in ratio of 9:1; with most common victim involved was pedestrians (28.7%), followed by occupants of four-wheelers (25.8%) and motorcyclists (23.1%).  Heavy vehicles were responsible for accidents in 39.8% cases.  Most of the victims died on the spot (38.4%) and 67.8% cases died within 12 hours.  Multiple injuries are the rule in fatal road traffic accidents.  Head injuries were seen in 77.6% cases followed by thoracic (44%) and abdominal (31.8%) injuries.  The skull was fractured in 66.5% cases, the most common bone involved was temporal (60.3%) followed by parietal (56.03%).  The commonest variety of intracranial hemorrhage was subdural (57.6%) followed by subarachnoid (44.7%) and extradural (12.03%) hemorrhage.  The incidence of contusion and laceration of brain was seen in 14.9% and 16.33% cases respectively.  Herniation and compression of brain stem was seen in 15.76% cases.  These findings have been compared with the other authors.

Accidental Ligature Strangulation Due To Electric Grinder - A Case Report

Dr Shetty Mahabalesh, Assistant Professor,
Department of Forensic Medicine and Toxicology, Kasturba Medical College, Mangalore-575001, India.

A young girl was accidentally strangled when her chunni (a piece of cloth worn around the neck by most Indian women) was caught in a moving electrical grinder .She was taken to the nearest hospital where she  died within the next 9 hours, remaining unconscious throughout the hospital stay.

Accidental strangulation of this kind due to household devices or machinery is extremely uncommon and to the best of our knowledge, this is the first case of its kind to be reported. The findings of this unusual and interesting case are hereby presented.

Key words: Strangulation; Accident; Ligature; Grinder.

Study of Medicolegal Report and Examination of Clothes Fixed the Firearm

S N Sharma, Dy. Director
D P S Sehgal, Scientific Officer
Parmeel Goyal, Director
Forensic Science Laboratory, Punjab, Chandigarh.

This case relates to a dispute over common boundary wall between two parties.  At mid night about 1:30 AM, the members of party ‘x’ gathered to see the site of this common boundary wall, where members of other party ‘y’ were already present with rifles in their hands.  As soon as party ‘x’ reached the spot, there were intense arguments between the two parties over the common boundary wall.  All of a sudden, one person from party ‘y’ fired one shot; as a result, one person from party ‘X’ was injured and was taken to hospital for medical treatment.  The doctor suspected that the person in question was hit by the gunshot and he gave him necessary treatment but no projectile could be recovered by the doctor.  Both the parties approached the police with counter allegations.  The clothes of the victim were sent to Forensic Science Laboratory, Punjab, to find out the type of firearm involved in the crime to ascertain the facts in the case.

On Scientific examination of clothes of the victim, study of X-ray film and medicolegal report of the victim, it was concluded that smooth bore firearm loaded with buck-shots had been fired to inflict the wounds upon the victim.  Hence, a case of attempt to murder (inflict) U/S 307 IPC, was registered against the party ‘Y’.

Key words: X-ray film, clothes of the victim, M.L.R.

“Even Death Could Not Keep Them Apart”

Dr Luv K Sharma, Lecturer
Dr Vijay P Khanagwal, Reader
Dr Basant L Sirohiwal, Associate Professor
Dr Parmod K Paliwal, Associate Professor
Dr D R Yadav, Professor & Head
Department of Forensic Medicine, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak-124001, Haryana, India.

A skeletonized dead body was brought to our department, referred by a board of doctors from a nearby district hospital for expert post-mortem examination.  The skeleton, exhumed from a shallow grave, comprised of a few disarticulated bones, some of which showed gnawing effects over them.  The accompanying police told us that the bones were of a notorious history-sheeter who was a member of a car jacking gang.  He had been killed by one other member of the gang a couple of month’s back in inter-gang rivalry who had confessed to the police, showing the site of burial (disposal).  Just as we finishing the post-mortem examination, another skeletonized body was brought by police of the same police station.  This time the bones were of an unfortunate businessman who was murdered 10-11 months back by the since deceased criminal on whose body we had just conducted the autopsy.  After completion of autopsy, the police exclaimed that 5 years back they had brought the dead body of an unknown female for autopsy to us who had been murdered.  The case had gone cold for want of identity.  It was only now that the arrested gang member told them that she was also associated with the gang and the deceased criminal had killed her suspecting that she was two-timing him!  Thus, all the three dead persons inter-related to each other by crime in life were re-united after death by a strange twist of fate!

Forensic Medicine for the Victims and Down Trodden - In Modern Society

Dr Pratap Chandra Sarmah, Professor & HOD of Forensic Medicine & Toxicology,
Sikkim Manipal Institute of Medical Sciences, Sikkim (INDIA)  

Life is becoming more and more complicated day by day in the society at the helm of modern civilization. Persons are often victimized under various circumstances and sufferers of weaker section of society are very often deprived of sympathy and justice. Crimes are often committed in sophisticated way and Doctors have to deal with Medico legal cases even with inadequate facilities and security facing disadvantageous situation.

In this paper, various aspects of present “Forensic Medicine Service” have been discussed to draw the attention of all concerned and to chalk out effective measures to meet the challenges of society and for the benefit of all.

Facial Nerve Palsy - Result of Trauma or Not

Dr O P Saini, Senior Demonstrator
Dr P K Saini, Senior Demonstrator
Dr P N Mathur, Associate Professor
Dr R K Gahlot, Professor & Head
Christian Medical College, Ludhiana

A 28 years female patient was assaulted by blunt objects on 5th Nov. 2004.  She was having lacerated wound on left ear near tragus with swelling & abrasion on back of Right elbow.  The X-Ray skull (report No. 1109/04 dated 7 Nov. 2004) & CT scan report No.4698/04 dated 5 Nov. 2004) revealed no bony injury & normal scan of brain parenchyma.  The ENT Specialist observed blood clot in external auditory canal & redness in anterior part of pars tensa of tympanic membrane.  There were no signs of facial nerve palsy.

The patient developed left side facial nerve palsy on 8 Nov. 2004.  CT scan head and temporal bones were again advised & as per CT scan (report No 4907 Dt 19 Nov. 2004) the visualized part of facial nerve canal was normal with normal scan of head & temporal bones.  The fundus examination was found normal.  The neurosurgeon then advised M.R.I and nerve conduction velocity test.  The probabilities & possibilities shall be discussed.

Analysis of Oxytocin by GC-MS

Dr L S Rana, Dy. Director, Forensic Science Laboratory, Punjab (Chandigarh)

Oxytocin a familiar cyclic nonapeptide, frequent use of which is banned by the Government nowadays is a common adulterant of alcoholic liquors.  Apart from its illegal use in milking cattle, the compound is also being used for enlarging size of certain vegetables.  A simple method for identification of Oxytocin is described here in which Gas Chromatograph with mass spectrometer detector (GC-MS) has been used.  The process of extraction of Oxytocin from liquors and different conditions of analysis by GC-MS has also been detailed in this work.  The sensitivity of the method of analysis and effectiveness of extraction process has also been determined by carrying out different experiments.

Arsenic Toxicity – A Global Concern!

Pushpa Dhar, Department of Anatomy, All India Institute of Medical Sciences, New Delhi

In the present scenario, Arsenic is one of the fast emerging environmental contaminants. The abundant occurrence of arsenic in the environment (air, water, earth) as well as its huge production in the industrial set-up is being envisaged as a major global concern. Though the use of arsenic can be traced back to 3000 BC (Partington, 1935), currently, it is the average production of around 60,000 tones/year of arsenic which accounts for its diverse use in day-to-day life. In the recent years, the term ‘Arsenicosis’ is being used to denote arsenic toxicity. It has been established that the adverse effects of arsenic affect a multitude of organ systems and manifestations ranging from neuropathies to malignancy and teratogenicity have been reported in humans and animal models. However, the underlying toxicological mechanism remains to be understood fully until date.

We studied the effects of arsenic exposure on nervous system of Wistar rats during their adult and developmental period. Sodium arsenite in doses of 1.0, 1.5 and 2.0 mg/kg body weight was administered to Wistar rats (adults and pups) by oral and intraperitoneal route for 12 weeks and on postnatal days (PND) 4 to 10 respectively. The animals were anaesthetized and perfusion fixed with 4% Para formaldehyde in 0.1 M phosphate buffer. The spinal cords and brains were dissected out and processed for paraffin embedding. 7 µm thick sections, stained with cresyl violet (CV), were observed for morphological features and the morphometric features of various neurons were determined with image analysis system (Image Proplus software, version 4.5) attached to Nikon Microphot microscope. Enzyme histochemistry was done to observe the status of oxidative enzymes in spinal cord and TdT mediated dUTP-Biotin Nick End Labeling method (TUNEL) was used to study the pattern of programmed cell death in developing cerebellum. The observations suggest that early postnatal exposure as well as adult exposure to sodium arsenite has deleterious effects on rat nervous system.

Fatal Plant Poisoning In Kasturba Hospital, Manipal

Pinakini KS
Department of Pharmacology, Melaka Manipal Medical College, Manipal.

Mohan Kumar TS, Vikram Palimar, Pradeep Kumar G
Department of Forensic Medicine, Kasturba Medical College, Manipal.

Human injury by plant materials may be accidental, self induced, or maliciously administered by another party. Accurate identification can be difficult and sometimes impossible. Many cases of plant poisons go undiagnosed because the clinical features mimic natural disease. Lack of knowledge of plants and different nomenclatures complicate the problem. This retrospective study presents the incidence, clinical features, causes, treatment received and cause of death of fatal plant poisoning in Kasturba hospital, Manipal.

Tsunami Disaster Victim Identification – Review of Sri Lankan Perspectives

Dr Clifford Pereira, Department Of Forensic Medicine, Galle, Sri Lanka

The Asian tsunami disaster witnessed on 26 December 2004 has caused heavy impact on wide range of issues across the countries affected. The routine life of most of the countries was completely overturned and the numbers of injured and dead were beyond imagination. The medico-legal strategies of those countries with regard to disaster management and post disaster recovery mechanisms were severely tested and their capabilities were exposed raising many unanswered queries.

In a situation where total deaths in the Asian region was exceeding 300, 000, most of the affected countries were simply unprepared in all respects to face a disaster of this magnitude. Sri Lanka recorded the second highest number of deceased in the region and soon found herself in anarchical situation. Many injured were succumbed to their injuries due to deficiencies of life saving and infra structure facilities during the acute phase of the post disaster period. In comparison, the deceased had the most disrespectful treatment. The resources of the Sri Lankan medico-legal service were minimally utilized for the disaster victim identification (DVI) purposes by the dogmatic authorities. Thousands of deceased were left unidentified and disposed in undignified ways contradicting the high local standards of human respect. The most obvious feature of the post disaster activities was the high degree of inefficiency observed in utilizing or directing existing resources for the disaster management. One of the greatest lessons taught by the tsunami disaster was the uncompromised and urgent necessity of an active disaster management scheme for the whole country.

Key words: disaster, deceased, identification

Public Justice or Culpable Homicide?

Dr D T Patil, Professor
KIMS, Karad

The rape is heinous gender crime. It is legal entity and at common law, it consists of having carnal knowledge of a woman without her consent. There may not be violence in this offence but the essential point is that conscious, free consent had not been obtained. Even woman’s permission was not negativated by vitiated by intimidation, also amounts to crime. All customs and creeds of women are subjected to the crime.

Sexually assaulted women are oppressed in hands of society. Police do not many times consider this is abominable

Serum Electrolyte Changes In Drowning Victims

Dr Mohankumar TS, Assistant Professor
Dr Pradeepkumar G, Associate Dean & Professor
Department of Forensic Medicine, Kasturba Medical College, Manipal - 576104.

Drowning is one of the common causes of unnatural deaths and accounts for 1,50,000 deaths worldwide annually. The original concept of drowning deaths was that they were asphyxial in nature with water occluding the airways. Swan and co workers suggested that death was due to electrolyte disturbances or cardiac arrhythmias, produced by large volumes of water entering the circulation through the lungs. Modell concluded that significant and persistent arterial hypoxemia is a common feature of all drowning victims, and blood volume and electrolyte changes are transient and insignificant. There are conflicting reports on the effect of drowning on serum electrolytes, which prompted us to take up this study. This ten-year (1993 to 2002) retrospective study comprised of 54 cases of near drowning victims admitted to Kasturba Hospital, Manipal. The results of our study showed that Serum electrolyte changes are within the normal range, which suggests that life-threatening electrolyte imbalances are not encountered in drowning victims.

Medicolegal Study of Mechanical Injuries in Culpable Homicides (Excluding Deaths Due To Rash and Negligent Act)

Dr Shilekh Mittal, Demonstrator
Department Of Forensic Medicine, Govt. Medical College, Chandigarh
Dr Ashok Chanana, Associate Professor
Dr Hakumat Rai, Additional Professor
Department Of Forensic Medicine, Govt. Medical College, Amritsar
Dr Adarsh Kumar, Senior Lecturer
Dr Krishan Vij, Professor and Head
Department Of Forensic Medicine, Govt. Medical College, Chandigarh

Trend of homicides by different means keeps on changing with the passage of time and development in different parts of the world.  A study was conducted on 200 alleged cases of homicides (excluding deaths due to rash and negligent act).  Different profiles from demographic and medicolegal aspects were evaluated.  The incidence of homicidal deaths was observed as 12.03%, with male preponderance (82.5) and the commonest age group affected was 21 to 40 Yrs. (51.5%).  Rural population was mainly affected. The blunt weapon (50.88%) was commonly used to inflict the injuries and ‘abrasion’ was the commonest manifestation (32.73%).  The defence wounds were present in 36 cases.  Head was the main seat of injury (13.65).  The cause of death in most cases was hemorrhage and shock (31.5%), followed by injury to brain (28.5%).  Only 16% cases of this received hospital care.  The time elapsed between injury and death was within a few minutes (53%) and within a few hours (13.5%).  This necessitates the prompt medical care to be provided in the ‘Golden Hour’ to save valuable human life.  Police patrolling for early detection of crime and shifting of injured to hospital/critical care centers and provision of prompt ambulance service by state/private hospital/NGO for medical care.

Keywords: - Homicide, Mechanical Injuries

Medical Relevance of Code of Criminal Procedure (Amendment) Act, 2005

Dr Mukesh Yadav, Associate Professor
Dr A D Aggarwal, Assistant Professor
Department of Forensic Medicine, M.M. Institute of Medical Sciences & Research, Mullana, Ambala-133203

Criminal justice administration is an important organ of the government for the smooth functioning of the society. Understanding and updating the knowledge about current trends and amendments in the law relevant to medical professional is important to keep pace with the developed world.

This paper deals with the medical relevance of Code of Criminal Procedure (Amendment) Act, 2005 like powers of magistrates, examination and investigations in sexual assault cases, issuing of copies of medicolegal examination reports, custodial death investigation, government scientific experts, etc.

Detection of Trace Elements Including Those Toxic in Nature in the Samples of Cosmetics

G Misra, Deputy Director (Physics)
Forensic Science Laboratory, Punjab, Sector 9A, Chandigarh.

Techniques of Energy X-ray Fluorescence (EDXRF) and Gamma ray spectrometry (NAA i.e. Neutron Activation Analysis) were utilized for the study of some samples of Nail polishes and Lipsticks of Indian as well as of Foreign origins for the purposes of their forensic characterization on the basis of trace elemental profile.  Elements like: Au, Ba, Br, Co, Cs, Fe, Na, Hg, Rb, Sc, Se, Zn, Min,  Mo, Hf & Ta in samples of nail polishes and elements such as: Au, Ba, Br, Co, Cs, Fe, Na, Ru, Rb, Sb, Sc, Zn, & Ta in samples of lipsticks could be detected.  Not only the Forensic characterization of samples of nail polishes and of lipsticks could be possible based on results of quantitative analysis based upon above techniques, but also, the samples of cosmetics of Indian and foreign origins could be differentiated.  Some potential toxic elements such as Cr. Hg, Sc. Se etc. could be detected which also played their role in the forensic characterization of samples of cosmetics.  While the concentration of Cr in samples of nail polishes of Indian origin was in the range £ 0.5 mg to 9 mg the concentrations of other toxic elements were comparatively quite low.

Key Words: EDXRF, NAA, Nail polishes, Lipsticks and Trace elements

A Study of Death Due To Terrorism in Eastern Nepal

Dr Manoj Kumar, Assistant Professor
Dr B N Yadav, Additional professor
Department of Forensic Medicine, BPKIHS, Dharan, Nepal

Terrorism is defined as unlawful use or threatened use of force or violence by a person or an organized group against people or property with the intention of intimidating or coercing societies or governments often for ideological or political reasons. At present terrorism is biggest threat to the world and peaceful Himalayan kingdom of Nepal is also not an exception to this. Due to terrorism, the poor country is suffering from tremendous loss in the field of economics, education, human rights, tourism and many more sectors. Above 9000, people have been killed due to terrorism till date, which includes security persons, Maoists and also civilians. This is a retrospective study done with available departmental record. .It comprised 35 cases, which were mainly from Sunsari, Dhankutta, Bhojpur and other adjoining district of eastern Nepal. Our study revealed increased incidence of terrorist activities these days as 35 victims out of 243 cases reported in the mortuary during the year 2003-2004. Hardly any disease, which has such high mortality rate (15%), as terrorism. The certainty of death in terrorist attack was due to use of modern firearm weapons targeting vital organs.

The Economics of Rape-A Case Report

Dr Munawwar Husain, Reader, MD, DNB, MNAMS
Dr Shaukat Arif Hanif, Reader, MD (Presenting author)
Dr Shameem Jahan Rizvi, Professor, MD
Dr Javed Ahmed Usmani, Professor & Chairman, MD (Path), MD (For Med)
Department of Forensic Medicine, JN Medical College, AMU, Aligarh 202 004

This authentic report deals with the case of a minor girl repeatedly raped by her teacher with the tacit approval of her mother. The matter came to light after the pregnant victim’s unsuccessful strangulation by the rapist.  The police intervened quickly but was aghast by the complicity and denial by the parents of the girl.  Some action alerts in law and remedial measures have been included at the end.

Crime Scene Investigation: My Experiences in Police Training

Dr R K Gorea, Professor and Head,
Department Of Forensic Medicine, Govt. Medical College, Patiala

Investigation of death is very important and investigating officers need special attention and training. Protection of crime scene & investigation of crime scene is the crux of any inquiry. Physical evidence has potential to play a critical role. Approach should be objective, thorough and thoughtful. Investigating officers must know how to recognize, recover and preserve physical evidence. Physical clues initially though irrelevant may become crucial to successful resolution of the case. It is vital to follow fundamental principles of investigation with variations depending upon local facilities.

Right To Information Act 2005 – Its Relevance To Medical Profession

Dr Mukesh Yadav, Associate Professor
Dr A D Aggarwal, Assistant Professor
Department of Forensic Medicine, M.M. Institute of Medical Sciences & Research, Mullana, Ambala-133203

In the era of privatization, globalization and availability of latest information technology the Right to Information was a much awaited basic human right. The Act provides for setting out the practical regime of right to information for citizens to secure access to information under the control of public authorities, in order to promote transparency and accountability in the working of every public authority. Democracy requires an informed citizenry and transparency of information which are vital to its functioning and also to contain corruption and to hold Governments and their instrumentalities accountable to the governed. Whereas revelation of information in actual practice is likely to conflict with other public interests including efficient operations of the Governments, optimum use of limited fiscal resources and the preservation of confidentiality of sensitive information; it is necessary to harmonize these conflicting interests while preserving the paramountcy of the democratic ideal; now, therefore, it is expedient to provide for furnishing certain information to citizens who desire to have it.

This paper deals with the various medical issues related to the right to privacy of the patient, providing of record of the patient alongwith day-to-day applicability in health care administration.

Keywords: Corruption, Information, Privacy, Right, Transparency.

Revenge by the Bites

Dr R K Gorea, Professor and Head, Forensic Medicine, Govt. Medical College, Patiala
Dr O P Jasuja, Professor, Forensic Science, Punjabi University, Patiala
Dr A D Aggarwal, Assistant Professor, Forensic Medicine, M.M. Medical College, Mullana, Ambala
Dr R Nirula, Resident, Maxillofacial Surgery, Dental College, Sunam

Bite marks are important evidences, which are often ignored by the investigating officers in India. Sometimes due to lack of this knowledge let the culprit, go Scot-free. Bite marks help to link the culprit with the crime. It is important scientific evidence which if properly collected and analyzed can help in successful prosecution of the case. Analysis of a case of bite marks is presented here by which culprit could be identified.

Female Unnatural Deaths 2001-2004 - A Retrospective Study

Dr Shalini Girdhar, Senior Resident
Department Of Forensic Medicine, AIIMS, New Delhi

Female deaths are of social importance as they are the one upon which a home is made. Delhi, as a crime capital views large no of female unnatural deaths. Here is a study from AIIMS which studies female unnatural deaths from 2001-2004.The purpose of study is to find most common unnatural cause of death in female ,age group affected, whether SDM enquiry or not and to find most common time after which postmortem is conducted after death.

Telemedicine in Patient Care

Dr Anil Garg, Resident
Dr R K Gorea, Professor and Head
Department of Forensic Medicine and Toxicology, Govt. Medical College & Rajindra Hospital, Patiala.

Telemedicine is the electronic transmission of medical images from one site to another for interpretation and consultation. Doctor can look after they are from far-flung places from their clinic. Patient has not required visiting the doctor’s clinic. The cost of per patient is reduced and speedy disbursal of specialized services to more patients and in areas of demonstrated need. Even when the patient is discharged, with the help of telemedicine he can take advice sitting at home saving a lot of money and this procedure is very useful in bedridden domicile patient and follow up in these patient is easy for the doctor.

Osteons as an Age Determinant

Dr S K Dhatterwal, Associate Professor
Department Of Forensic Medicine, PGIMS, Rohtak

Histological study was conducted on 107 subjects of both sexes (Male 55 and Female 2) from the compact portion of mandible to observe changes in the number of Osteons with age.  In majority of the cases it was observed that number of Osteons increases with age. (12 years to 57 years).

Medical Tourism: Ethico-Legal Consideration

Dr R K Bansal, Assistant Professor
Department Of Forensic Medicine, HIMS, Jolly Grant, Dehradun-248140.

Medical tourism is traveling by patients from one jurisdiction or country where treatment is either unavailable or expensive or illegal to another jurisdiction or country where they can obtain the kind of treatment they desire. Medical tourism is not a new phenomenon as such. The end of the Napoleonic Wars in 1825 ushered in a new era of relatively unrestricted British travel and tourism on European mainland. Now, more and more people than ever before are traveling to other countries for seeking apparently cheaper treatment. For example, a heart by pass surgery in India costs USD 3,000 to 6,000 while in the US it costs between USD 15,000 to 40,000. Apart from cost factor and unavailability or long delay in the treatment, some patients also seek medical treatment abroad to cash in on the liberal laws on the foreign land. This paper is an attempt to explore and review the moral and ethical repercussions of medical tourism on medical profession and global society at large.

Procedures and Protocol in Summons

Dr O P Aggarwal, Professor
Dr A D Aggarwal, Assistant Professor
Department of Forensic Medicine, M.M. Medical College, Mullana, Ambala

Summons issued by the court are served on witnesses by the Police or by the person deputed by the court. Even dasti summons can be served by the party concerned on the witness. If willfully the summons is not served on the witness by the police, the court can give notice to the SHO concerned u/s 29 Police Rules in the interest of justice.  If it is reported on the summons that the witness willfully refused to receive the summons then the court normally issues non-bailable warrants and notice u/s 350 CrPC.  If the witness willfully avoids attending courts in a criminal case then witness is forced to appear in court by issuing bailable and non-bailable warrants. Rarely notice u/s 350 CrPC is also issued in such cases. A summary trial is held by the court and sentenced with a fine not exceeding Rs.100.  In civil cases the summons are served under order 16 rule 5 CPC and if witness avoids attending court then he can be fined up to Rs.500 under order 16 rule 12 CPC.  In MACT case when doctor is summoned he should send a certified copy of post-mortem report to the court which is admissible as such and personal appearance of the doctor in such cases is not required. In this paper, we shall discuss the legal aspects as well as the personal experiences in such matters, and how to save the skin of the doctors.

Forensic Telemedicine

Dr AD Aggarwal, Assistant Professor, Forensic Medicine, M.M. Medical College, Mullana, Ambala
Dr R K Gorea, Professor and Head, Forensic Medicine, Govt. Medical College, Patiala

The development of information technology has had a dramatic impact on society. Telemedicine is the transfer of medical information and expertise via telecommunications and computer technologies, to facilitate diagnosis, treatment and management of patients. Tele-health includes distance learning, medical peer review, patient education initiatives, etc. This paper addresses the use of technology to facilitate the forensic investigations. The technology facilitates consultation with other forensic experts on difficult cases, which aids law enforcement officials in determining how to proceed with criminal prosecution. This paper enlightens forensic community of the scope and types of activities occurring, and its potential as viable and socially valued clinical service.

Expanding Horizons of Forensic DNA Fingerprinting

Mr Rajiv Giroti, .Junior Scientific Officer (Biology) E-mail:
Central Forensic Science laboratory, Ministry of Home Affairs, Govt. of India, Chandigarh.

In recent years, several technological improvements have contributed to making forensic DNA typing more informative and robust. DNA is the molecule that encodes the entire hereditary information about each individual in almost every cell of the body.

The advent of PCR-based DNA typing technologies, like that used with STR loci, allows for genotypes to be derived from as little amount of DNA. The science of identifying individuals using autosomal DNA profiling/sequence is very clear, and the probability of scientific error is extremely small. The increasing use and acceptance of DNA technology as evidence raises many issues relating to the criminal justice system. The value of the evidence depends on the quality of the DNA samples and how well medical doctors and law enforcement agencies handle them. Most legal disputes over DNA evidence challenge the handling and storage of DNA samples.

The biological evidences that have been collected and stored in ideal conditions, making sample quality and quantity rarely an issue. Those ideal conditions are usually not met in DNA typing analysis of forensic biological evidence, as there is no control over the amount of biological material left at crime scene or its level of degradation or contamination due to exposure to various environmental conditions. Forensic biological samples may accompany challenges for DNA typing analysis; even with almost care without crime scene evidence recovery and storage. In addition, these samples may frequently consist of mixtures of bodily substances originating form more than one individual. Therefore, beyond having to provide very discrimination potential values, one major requirement imposed on forensic DNA typing technologies is the development of interpretation genotypes from limited, compromised samples. This approach is also helpful in analyzing poor-quality DNA for evidence samples collected from dirty crime scenes.

In addition to technological advances enabling the identification of a DNA in highly degraded samples, new application such as the use of mitochondrial DNA and interpretation of V-chromosome specific markers(especially in rape cases) and genetic markers capable of predicting the geographical origin of unknown suspects are expected to become routine techniques in the next coming.

Importance of Firearm Injuries and Their Evaluation

Dr S K Jain, Assistant Director (Ballistics) CFSL, Chandigarh
E-mail: Phone: 0172-2610334(0), 2663368(R)

When a firearm is discharged on a human being, primarily, it is the projectile (bullet or pellet) that causes the injuries. The physical and dynamical attributes of projectile such as mass, shape, velocity etc. therefore, affect the formation of wound. Velocity of projectile has great influence on the nature and the extent of damage caused to the body tissues. At close ranges of firing, in addition to the fired shot, certain effects are produced by efflux of hot powder gases and firearm discharge residues emerging from the muzzle. In evaluating firearm injuries it becomes necessary to take into consideration the contribution made by these factors also as they tend to modify the character of wounding at close ranges of firing. The injury caused by distance shot is, of course, entirely due to the bullet.

Irrespective of type of firearm and the range of firing, a bullet discharged from a firearm on a human being in general creates a wound of entrance, a channel through the body and a wound of exit. There may be instances when the bullet lodges itself in the body in which no exit wound is seen or bullet may fragment into pieces in which more than one exit wound are found. Moreover, firing can be done in contact, close and from distant ranges, in such cases type of injuries caused vary from one another. Thus from medico-legal point of view careful consideration is, in general, required to be given to; a) wound of entrance, b) wound of exit and c) path of bullet in human body.

In some of the shooting cases, it is important to determine whether the wound present on the human body could be inflected by the victim himself. To decide this issue careful consideration is required to be given to the factors such as location, character of the entrance wound and direction of the track etc. As a general principle, it is always desirable to bear the possibility of homicide in mind unless the contrary is proved because homicidal shooting is found to assume a variety of forms.

The evaluation of the firearm injuries is very important to decide whether a particular shooting is homicide, suicide or accident. Before the nature of shooting is classified, it is necessary that postmortem findings furnished by medico-legal experts are supplemented by police investigation and other forensic evidence of firearms expert. If this is not done a wrong conclusion can be drawn. Although it is difficult to formulate a set of rules to decide about the nature of shooting because each case presents its own problems. In some cases it has been found; i) Bullets are fired from shotguns by improvisation, ii) Some country made pistol can chamber and fire the cartridges of different calibers. These cases require utmost care while forming the opinion regarding nature of firearm used in causing injury. In my current talk various topics such as effect of projectile velocity in formation of wound, phenomena of close range firing, collection and preservation of evidence, some important shooting case studies and interpretation and classification of injuries will be discussed.

Forensic Neuro-Psyco-Psychological Interview for Detection of Deception

P Paul Ramesh, Junior Scientific Officer
Central Forensic Science Laboratory, Directorate of Forensic Science, Sector-36A, Chandigarh.

In principle, different ways of catching a liar. The first way is by observing liars non-verbal behaviour. The second way is by analyzing speech content, that is, by analysis what is being said. The third way is by recording the statement of Uar under the hypnotic state and assessing it. The fourth way is by examining physiological responses blood pressure, heart rate, palmer sweating and so o~): The fifth way is by studying a brain electrical activity. In this paper, I will present some aspects of how to catch a liar by interviewing. I will start with discussing how good people are at detecting lies and what are the draw backs in poor detection of deception. Research has shown that people are generally not very good at detecting lies, and I will give some reasons to explain this. Then, I will discuss how to make people better lie detectors if they take them into account when they try to detect deceit with essential techniques. I will try to discuss some of the scientific lie detecting instruments which are available. Finally I will discuss advanced scientific lie detecting instruments which are emerging in, the field of detection of deception.

Reconstruction of Digital 2-D Facial Image from the Skull in Blind Murders

Sanjeev, HOD Biology & DNA Fingerprinting Unit, CFSL, Chandigarh
Daisy Sahni and Vijay Bakshi
Department of Anatomy, PGIMER, Chandigarh.

Digital facial reconstruction of a human skull is applied to identify the victim in blind murders, where the DNA profiling technique cannot be applied due to non-availability of reference blood samples of the close relatives. A graphic computer and high resolution digital camera are required to undertake this technique. The age, sex and height of the victim are estimated from the skull by applying forensic techniques. Craniometric measurements of the skull are also recorded. The facial soft tissue thicknesses at various landmarks are applied from the actual MRI (Magnetic Resonance Imaging) data collected by the authors since 2000 in the Northwest Indian population. Thereafter, the facial template is drawn on the digital image of the skull on the computer screen.

The facial features are drawn based on the morphology of the skull by taking above mentioned craniometric measurements from the skull. Different facial proportions and ratios of the drawn facial features are taken into consideration, while making the facial digital reconstruction.

This technique has been applied to various forensic cases received in this laboratory e.g. Chhindwara murder case (M.P.), Kirandul case (Chhatisgarh), Bhind case (M.P.), Tripura Murder case etc.

Forensic Audio Video Evidences-Its Importance in Investigation

Dr C P Singh, Junior Scientific Officer (Physics) CFSL, Chandigarh

Ever increasing use of tape evidence in criminal prosecutions, especially in organized crime and drug cases, underscores the importance of establishing the tape integrity. Authentication of tape recording refers to the examination of recording to find out whether it is the original i.e. one time recording or an edited version or a copy of the original. There is always a possibility of intentional alteration in the contents of a recording, which convey a different meaning and leads to misinterpretation. The autopsy process may require being video graphed for future reference in some of the highly sensitive cases examined by medical professionals. Any alteration present on a video recording, knowingly or unknowingly produced during the process of recording may lead to unauthenticity of the video recording. Thus, establishment of authenticity becomes necessary in all forms of electronic recording for accepting as evidence in the court of law. Tape-recorded material may be subjected to linear (Analogue/Digital) or non-linear (Digital) editing. However, non-linear digital editing of both audio and videotapes greatly complicates the issue of authentication. Present day editing practices include physical splices, electronic editing, over recording or erased a portion of recording and the original recorder stopped and restarted inappropriately. CFSL, Chandigarh is conducting a Project in order to establish Laboratory facilities for Audio/Video Tape Analysis for Authentication during the Tenth Five Year Plan. A recording is said to be Authentic when there exist no intentional STOP/PAUSE activity in between, which otherwise should be declared by the operator during recording. The original recording should contain all the information at the moment in time that the event occurred and further not contain any break in its continuity or content. However, accidental interruption due to the operational error or malfunction of the recorder does not contribute to falsification. Conventional methods of analysis of audio recordings for authentication include physical inspection of the magnetic audiotape for detection of physical splicing followed by critical listening of the contents of the tape to point out any abnormal change in either in foreground/background sound, followed by waveform analysis and spectrum analysis. Forensic examinations of videotapes usually consist of both visual and aural examination. A waveform monitor, which is a specialized oscilloscope that can display the signal aberration and a vectorscope for the measurement of chrominance, luminance and burst of multiple signals to locate edit points. For measurement of video synchronizing information, a cross-pulse monitor is to be used. Examination of audio/video recordings sometimes requires establishing the identity of the speaker through their voice. The methods for speaker identification are generally of auditory and spectrographic method, which when combined gives rise to one of the scale factor of identification/elimination. The acceptable scale factors followed in most of the countries are positive identification, probable identification, possible identification, no opinion, possible elimination, probable elimination and positive elimination. One of these scale factors can be arrived by the combined methods of auditory and spectrographic analysis.

Poisoning Scenario in Chandigarh Zone: Some Important Problems and Their Possible Solutions

Dr Prabh Sharan Singh, PG IInd Year
Dr Dasari Harish, Reader
Dr B R Sharma, Reader
Dr Krishan Vij, Professor & Head
Department of Forensic Medicine & Toxicology, Govt. Medical College & Hospital, Sector 32, Chandigarh.

Rapid development in science and technology and the equally vast growth in industrial and agricultural sectors have immensely increased the availability of numerous poisonous substances. Increased frustrations due to inability of people to keep pace with the demands of the modem society have only added fuel to the fire. Even though various hospitals are witnessing a spurt in the poisoning cases these days, many difficulties still exist in the diagnosis and treatment of such cases. The reports provided by the chemical analyzer are also not without faults. The estimation is always qualitative, not quantitative.

"Mere presence of a drug! Poisonous substance in the blood and viscera does not imply that the concentration of the substance has surpassed the fatal limits”.

A retrospective study of cases from January 1994 to December 2004, in the Department of Forensic Medicine and Toxicology at Govt. Medical College Hospital, Chandigarh revealed that poisoning was responsible for 18% of the unnatural deaths. The incidence of poisoning deaths has shown a steady increase from 13% in 1994 to 25% till December 2004. Young adults, both males and females, amounted to 29% of cases, followed by adolescents 21%. The male: female ratio was 1.7:1: 62% of the victims were from rural background. 55% males and 75% females were married. Aluminum Phosphide was responsible for 54% deaths, followed by insecticides 25%. Suicide was the most common mode of poisoning - 93% cases.

It was concluded that a special toxicology wing should be established in all major Govt. hospitals and in the Medical Colleges. Regular refresher courses should be started for all the Medical Officers working in both the Govt. dispensaries and hospitals. This paper gives the details of the 10 year study and the various suggestions to improve the standard of medico legal investigation of the poisoning cases and their treatment.

The Mystery behind the Death of a Bride

R S Verma, Director
R M Tripathi, SSO
A K Dalela, JSO
Central Forensic Science Laboratory, Sector-36A, Chandigarh.

In a case of poisoning a small quantity of gastric lavage was made available for analysis and detection of poison. Keeping in view limited amount of sample available and indications from postmortem examination, only targeted analysis was carried out cautiously. Exhibit was containing pesticide beyond the limits of conclusive identification by conventional methods. On faint indication of poison to be carbamate pesticides or phenolic compounds and to avoid contamination of GC­ MS, sample was purified by TLC method. The presence of just three ions allowed the poison to be identified again by processing and analyzing the standard by the same method. The poison responsible to kill the lady could be identified in spite of limitations of availability of samples and application of conventional method.

When Disaster Management Worked! - Sarojini Nagar Bomb Blast

Dr Alexander F Khakha, MD, Senior Specialist
Department of Forensic Medicine & Toxicology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi

41 dead bodies and more than 100 injured coming to the casualty within an interval of half an hour can be a nightmare for any hospital.

On 29-10-2005, at around 6:00 PM, Safdarjung Hospital Burns Casualty experienced a sudden outpour of victims being brought from Sarojini Nagar Bomb Blast site. Anticipating a huge administrative, health and medicolegal challenge, the hospital authorities jumped into action. The crisis situation was handled in such a way that the routine work of most of the departments of the hospital was hardly affected. All criticism and controversies that usually arise in such a situation, especially from the press and media turned into appreciations. How did this happen? The trick was - Abide by the rules of disaster management in its strictest mode.

This paper aims to present, (i) how disaster management was implemented, what was the outcome, what were the medicolegal lessons learnt and (ii) to discuss how to further improve on what was done. These and other questions will be discussed when the paper is presented in the conference.

Victimology of High Altitude Religious Excursions

Dr Jagdeep Singh, Medical Officer, 16Bn BSF, Avantipur

Dr R K Gorea, Professor & Head, Forensic Medicine, GMC, Patiala

Dr A D Aggarwal, Assistant Professor, MMIMSR, Mullana

                The high altitude religious excursions are very common in India, like Amarnath, Vaishnodevi, Kailash Mansarovar, Hemkunth Sahib, etc. To avoid fatalities government has made it mandatory to undertake a medical checkup before allowing any pilgrimage. Due to over enthusiasm, many people try to conceal their illnesses and they face serious emergencies during this pilgrimage, posing a serious problem to the organizers and the authorities. The situation is further aggravated by difficult terrain, lack of infrastructure and acclimatization. A broad discussion is done here to prevent such emergencies and fatalities arising due to pulmonary oedema, hypothermia, diabetic ketoacidosis and myocardial infarction.

Victimology of Deaths by Drowning

Dr Amandeep Singh, Resident
Dr KK Aggarwal, Additional Professor
Dr RK Gorea, Professor and Head
Department of Forensic Medicine, Govt. Medical College, Patiala

Death by drowning is not an uncommon phenomenon when stresses of the modern day life compel the person to end the life. In the regions where water sources are in abundance, e.g. rivers, canals, lakes, ponds and places near sea, these are readily available for such persons to end their lives. Homicides may also effected by pushing a person into well or canal. Accidents do occur when a person is walking or driving along a water source. We have to find out the reasons, by doing proper epidemiological studies, to find out ways to prevent such unnatural deaths.

This study was done with a view to address wide ranging issues such as injury prevention, waterways safety promotion, suicide prevention, leisure related and sport safety, disaster management, etc. 

Males were more prone to die by drowning and married persons had more deaths by drowning. Females did not prefer to die by drowning. Distance of water source from the residence mattered a lot in deaths due to drowning. Those living near the water source had more deaths as compared to persons who lived at distance from water source. Percentage age of deaths decreased as the distance of water source from the residence increased. We suggest that water sources near residences should have barricades so that there is not an easy access to water sources when an impulse arise to commit suicide Automatic Sensors be installed or guards should be posted along the water sources near the populated areas. Psychiatric help should be readily available to people in stress. Mass education should be provided so that seeking of psychiatric help should not be considered a taboo. It should be preferable if water conduits are covered rather than open canal system particularly near the inhabited areas. On the bridges there should be adequate lighting so that accidental drowning may be avoided. Modern guard/guide rail, traffic barrier w-beam, appurtenances and impact attenuators should be installed which enhances the road safety and causes diversion of the vehicle away from waterways. Bridge railing crash tests should be conducted before inaugurating bridges. Modern in-vehicle warning systems should be mandatory to prevent such accidents. Most of rural deaths were from agricultural background, and deaths were in post-harvesting season, with some relation to monetary problems, so steps are necessary from the governments to ease loans and benefits to such communities.  

Injury Pattern in Sarojini Nagar Bomb Blast Case

Dr Sarvesh Tandon, Specialist,
Department of Forensic Medicine & Toxicology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi

On 29-10-2005, Safdarjung Hospital witnessed the tragic victims of Sarojini Nagar Bomb Blast Case. About 42 postmortems were conducted by the Department of Forensic Medicine & Toxicology. Some interesting findings and injury patterns were observed

This paper aims to discuss the various findings and injury patterns, steps taken to eliminate the problems of identification and other medicolegal aspects related to the incidence. These and other questions will be discussed when the paper will be presented in the conference.

Preventing Injury: Role of Forensic Medicine

Dr S K Verma, Professor, Department of Forensic Medicine,
University College of Medical Sciences, Dilshad Garden, Delhi-110095.

Scientific literature time and again has stressed on the preventable aspect on injuries. A forensic medicine expert can play key role in preventing injuries as they are in a unique position of having access to the circumstances that lead to causation of injuries, nature of injuries on the body and their outcome. The paper will stress on the preventable nature of injuries through three illustrative cases. These cases exemplify how the specialty of Forensic Medicine can be utilized in preventive medicine. All these aspect along with details of cases will be presented in the paper.

Role of Technical Assistant in DNA Fingerprinting

Anupma Raina, Ajay Balayan* & TD.Dogra

DNA Fingerprinting is a very complicated procedure. The technical Assistant is extremely important in carrying out this test in laboratory set up. The most of the desk work is carried out by the technical staff though the interpretation part is done by Scientist thus the technical assistant in DNA Finger printing is a specialized expertise.

In this paper the role, responsibilities, right from receipt of samples, maintaining the chain of custody, preservation of exhibits, storing of data and technicalities of the technical Assistant shall be discussed.

Key Word - DNA Fingerprinting, technical Assistant

Epidemiology of Firearm Fatalities in Chandigarh Zone of India: A 25 Years Autopsy Experience from a Tertiary Care Hospital

Dr. Dalbir Singh, Head, Department of Forensic Medicine,
Postgraduate Institute of Medical Education & Research, Chandigarh


To analyze incidence and factors influencing firearm-injuries as observed in a hospital setting.

To suggest preventive measures which possibly could reduce incidence of these injuries.

To provide base line data to policy makers in planning human habitations, highways, industries and to equip health care institutions accordingly.


Extent of fatalities because of firearm is a gross indicator of the socio-economic conditions as well as mental health of the society. A number of studies on various aspects of firearm have been reported from different parts of India but there is a scarcity of such information from Chandigarh zone of North-West India .The present study, based on autopsy experience from a tertiary care hospital of north-west India is an attempt to analyze various factors influencing this avoidable mortality as seen in a hospital setting


The present study is a retrospective analysis of the autopsy records of the subjects, admitted and died because of the firearm injuries and autopsied at Post Graduate Institute of Medical Education and Research Chandigarh between 1stJanuary, 1979 to 31stDecember 2004. Information regarding age, gender, demography, mode and time of occurrence, survival time and cause of death were  have a further confirmation from the treatment  records, victim’s relatives, friends and police.


Mortality because of firearm constituted fifth leading cause of unnatural deaths, its incidence was at peak between 1979 and 1994, and there after showed a decreasing trend.  Maximum number of victims were from the state of Punjab (54.7%) followed by Haryana (26.4%), Chandigarh (13.2%) & Himachal Pradesh (5.7%). 49% subjects were between the age group of 16-35 years with male preponderance (92.4%).  74.3% victims were married and 54.3% belonged to rural area. Homicides and terrorisms related acts (67%) followed by suicidal (16%) and accidental (8%) were the most common manner of fatalities.  The proportion of suicidal deaths increased from 5.2% (1979-84) to 17.2% (1999-2004, x3.6 in females, and x2.2 in males). Among the males, 24.9% agriculturists, 18.1% unemployed , 16.5% businessmen, 16.2% industrial workers, 15.1% professionals and 9.2%  students   whereas among females, homemakers (45%), and unemployed (38%) were main victims of fire arm injuries . Though statistically insignificant incidence of fire arms injury were more in late evening hours and winter seasons.


Firearm injury is fifth major cause of preventable mortality in Chandigarh zone of India. As about half of firearm injuries were in the most productive age group i.e. between 16-35 years the initiatives desired to focus primarily on it and secondarily on suicide prevention.




Dr.S.K.Dhatterwal, Associate Prof. Forensic Medicine, PGIMS, Rohtak


The study was carried on 450 cases of fatal road accidents in Haryana to know relationship of vehicular accidents with place and seasons.  More than half of accidents occurred on high speed National and State highways.  Maximum accidents occurred in winter season followed by summer and rainy seasons.  The study revealed that maximum accidents took place between 8-10AM, followed by 6-8 PM time and least number of accidents occurred around midnight.


Dr.Anup Kumar,  P.G. Student
Dr.B.R.Sharma,  Reader
Dr.D.Harish,  Reader
Dr.K.Vij,  Professor and Head
Dept of Forensic Medicine and Toxicology,
Medical College & Hospital,Chandigarh


The concept of medical negligence arose mainly in the later part of the 20th century as a result of multiple factors including the increasing level of awareness among people about their rights and equating health care with consumer oriented services in which the focus shifted from the person as a patient to the person as a consumer. The present day scenario involves the interests of a large number of people apart from the patient and physicians, including nursing staff, paramedical and other supporting staff in hospitals, nursing homes or other health care entities, health care organizations, and even big corporate managers such as the insurance firms.


Various Indian case laws that have tried to set the parameters required to establish negligence viz., Poonam Verma Vs Ashwin Patel and Ors. 11(1996) CPJI(SC), S.K.Kumawat and Anr Vs Dr(Smt) Sunil Jainl and Ors: II (1994) CPJ90, C.Oswal Vs S.K.Memorial Hospital and Ors: (1995) CPJ 42, Dr.V.Rugmini Vs State of Kerala and Ors: (1987) CRI.L.J.200, Arunaben D.K. and Ors Vs Navdeep Clinic and Ors: III(1996) CPJ 605, Rajmal Vs State of Rajasthan and Anr: II (1996) ACT 1166, A.Varghese Vs D.B. Dr.V. Varghese and Ors: I (1997) CPR 310, Spring Meadows Hospital and Anr Vs Harjot Ahluwalia; JT 1998(2) S.C. 620, Joseph and Ors Vs Dr.G.Moonjely and Ors: I (1995) ACJ 253 etc. were studied in detail. Various aspects like those related to emergency care, consent, payment of fees etc have been adequately addressed in all these caselaws by the honourable courts of our country


On studying these caselaws it can be safely concluded that proving medical negligence is easier said than done. Merely saying that there was negligence doesn’t prove the prosecution’s case. It won’t be wrong to say that alongwith the corporatisation of healthcare, grew another subsidiary i.e. medical negligence which has almost taken the shape of a business with everyone from patient, patients’ attendants or guardians or relatives and legal professionals and legal firms just waiting for a chance to make some money out of the misery of another person. The only way to put curbs on this on-growing menace is to be careful about various aspects associated with such cases like reasonable skill and care at each and every step by every person involved in the health care delivery, understanding that Informed Consent, which is an ongoing process rather than plain blanket consent forms, is the need of the hour and also the right of the patient and appreciating the importance of adequate and complete documentation of all these processes involved in providing health care to the patient.


Raina A, Pramanik P & Dogra TD. Department of Forensic Medicine, AIIMS, New Delhi


The seminal stains recovered on fabrics are one of the most important evidence in rape cases. Stained clothing’s, undergarments and swab’s on fabric material taken from vagina and surrounding regions, are submitted for DNA Fingerprinting test to compare it with the blood sample of the accused person. Many a times, isolation of DNA from such stains particularly when the stains are old is not possible. The causes could be degradation or decomposition of the biological material, which depends mainly upon the environmental conditions. The other possible factors could be nature of clothing’s. In the present study, it was observed that maximum DNA recovery was from cotton clothing’s even when stored for long duration’s followed by tricot material.

Key words: seminal stains, DNA Fingerprinting and duration
Please note that the full-length paper has be submitted to the IIJFMT, official journal of the ICFMT.
Permission of the editor has been taken.
Genetic polymorphism at 16 STR loci in Delhi’s population and their impact on forensic DNA Typing
Anupuma Raina, Bhuvnesh Yadav*, Ajay Balayan and TD Dogra
Department of  Forensic Medicine, AIIMS, New Delhi


Forensic DNA Typing is being widely used for the medico-legal purposes. This is entirely based on the 0.1% difference in genetic makeup that makes every individual unique. The population database are being generated with the help of the STR markers. India have diverse ethinic, linguistic and geographical populations. It nacessiates the study of the genetic poplymorphism.

Our study included the estimation of allelic frequencies for 16 STR loci from Delhi’s population. The result also included the calculation of observed and expected heterozygosity, Power of Discrimination, Degree of Paternity Exclusion and Polymorphism Information Content using these STR loci. The results indicates that all the 16 STR loci are highly polymorphic in this population. Thus suggesting that this set of STR can be used for forensic purposes like peternity testing and individual identification.

Key words: DNA Fingerprinting, Population and STR


Dr. Y. S. Bansal, Dr. Puneet Setia, Dr. Sreenivas M., Dr. Dalbir Singh
Deptt. Of Forensic Medicine, PGIMER, Chandigarh, INDIA


AIDS is different from any other disease which a physician encounters in his routine practice. This is because of its special status in the society due its incurable nature, the social stigmata attached and other legal problems attached with it. If the physician is not vigilant while dealing with such cases, he might have to face legal consequences. These may include penalties as per provisions of Sec. 269 and Sec. 270 IPC, dealing specially with the transmission of disease and also Sec. 201 of IPC according to which a doctor can be booked for destruction of evidence pertaining to the case. These also include provisions as to when the doctor has to conduct the tests, whether he should disclose the findings of the tests, whether he can refuse to treat the patient if he turns out to be HIV positive etc. The doctor must be aware of both his as well as the patient’s rights else he might have to face court cases. Therefore there are certain guidelines that every doctor must follow when he is dealing with a case of AIDS. These are simple procedures which can be easily incorporated in the day to day practice of the physician that can go a long way in making the doctor legally safe, while he is dealing with a case of AIDS. .

Key words:, HIV, AIDS, , Indian Penal Code, Indian constitution


Dr. Puneet Setia, Dr. Y. S. Bansal, Dr. Sreenivas M., Dr. Dalbir Singh
Deptt. Of Forensic Medicine, PGIMER, Chandigarh, INDIA


Blood transfusion is one of the most important life saving measure in medical practice. The more dramatic its results, the more risky its use is. The presence of various complications like allergic reactions, mismatched transfusion, transmission of blood related disease/infections like AIDS, hepatitis B etc. has made blood transfusion a much more hazardous procedure than it used to be. With the public getting more aware about their rights and the advent of laws like the Consumer Protection Act, every misadventure that takes place from the hands of the doctor puts him in all sorts of legal problems. While nobody can guarantee a error free and mishap free practice, there are certain guidelines that have to be followed by every medical practitioner while undertaking blood transfusion so that such errors are reduced to the minimum and the chances of the doctor being implicated in malpractice and negligence suits are reduced to the bare minimum. Proper cross matching of blood samples, keeping a proper record, undertaking the transfusion in front of the doctor, managing even the slightest of adverse effects efficiently are some such guidelines that must be followed.

Key words: blood transfusion, consumer protection act, medicolegal aspects, mis matching of blood

Medical Negligence: Civil v/s Criminal. The issue is settled.

B.D.GUPTA, M.B.B.S., M.D., Prof and Head, Dept of Forensic Medicine, M.P. Shah Medical College, Jamnagar, Gujarat, India


This paper critically discusses the issues of negligence in medical profession and its inference as regard to civil v/s criminal against physician  as seen by the Supreme Court of India first in Dr. Suresh Gupta v/s Govt. of NCT of Delhi and then in Jacob Mathew v State of Punjab and Anr cases. Therefore it refers to various aspects of medical negligence and law like negligence as a tort, negligence as a crime, negligence by physician (professional), existing provisions of criminal law related to medical practice like IPC s 88, 92, 93., difference between negligence for compensation and negligence for crime, difference between ‘profession’ and ‘occupation’, parameters to prove civil case as against criminal case and so on. This paper also deals with the advantage as well as disadvantages of filing a case against physician in Indian context from a patient’s point of view. In the opinion of author it is a win- win situation if a case filed only for civil liability both for patient as well as physician.


Dr Mukta Rani* (Jr Specialist),
Dr P.C.Dikshit** (Dir, Prof & head) and Dr Sunil** (S.R.), *
L.B.S. Hospital, Maulana Azad Medical College, Delhi.

Deaths from bull horn injuries are common in rural India but are not frequently witnessed in the the metropolitan city of Delhi. A 65year old male and a 45 year old female was gored to death by a raging bull when they were on a morning walk. The male was brought to the hospital where he was declared dead on arrival. The autopsy examination of this elderly male revealed mainly thoraco-abdominal injuries. The pattern of injuries that mainly depend on the height of the bull and the position of the victim at the time of the attack. The paper also discusses the steps to be taken to prevent such fatalities from occurring.

Forensic Taphonomy: an important investigative tool

Dr. Dasari Harish, Reader,
Dr. B. R. Sharma, Reader,
Dr. K. H. Chavali, Senior Lecturer,
Department of Forensic Medicine, Government Medical College, Chandigarh.


Putrefaction or decomposition is the last stage in the resolution of the body from the organic to the inorganic state brought about by two processes—autolysis and bacterial action. When tissues die, there is a rise in certain enzyme levels which soften and liquefy the various tissues of the body. This process of autolysis commences 3-4 hours after death and continues steadily for 2-3 days, some times longer. Bacteria also produce a large variety of enzymes that assist in the decomposition. It is not unusual to receive the bodies in different stages of decomposition in medicolegal practice. However, careful examination always yields important information in all such cases. Taphonomy is one such science that deals with the decomposed and skeletonised bodies to extract the requisite information for forensic purposes.

‘Taphonomy’ was coined by a Russian scientist Yefremov in 1940 to mean the study of death assemblages in the fossil record or the ‘laws of burial. It implies the understanding of multiple factors that play a role in the disintegration and scatter of a dead body until they have been environmentally recycled. This means the understanding of the events close to the time of death, events that transpired at the time of death, and events in the immediate or long-term period after death.

This paper discusses this relatively new field of Forensic Medicine and its contribution to the law enforcing agencies, viz, locating and defining the scene, ensuring maximal recovery of the evidence at the scene, collecting and documenting all relevant evidence, etc.

Euthanasia and the dignity of life

Dr. B. R. Sharma, MBBS, MD, Reader,
Dr. D Harish, MBBS, MD, Reader,
Dr. K. H. Chavali, Senior Lecturer,
Department of Forensic Medicine, Government Medical College, Chandigarh

Seneca, the great Roman Statesman of 1st century AD said:
"I will not relinquish old age, if it leaves my better part intact. But, if it begins to shake my mind, if it destroys its faculties one by one, if it leaves me not life but breath, I will depart from the putrid or tottering edifice. ------- If I must suffer without hope or relief, I will depart, not through fear of the pain itself, but because it prevents all for which I would live". The same meaning was once again conveyed by Justice Benjamin Cardozo, though in a slightly different manner:” Every human being of adult years and sound mind has a right to determine what shall be done with his body” ; while laying down the foundation of  the Doctrine of informed consent and informed refusal (of treatment), in 1990, almost 2000 years later.

Euthanasia is defined as the administration of drugs with the explicit intention of ending the patient’s life, at the patient’s explicit request.  Physician-assisted suicide is defined as the prescription or supplying of drugs with the explicit intention of enabling the patient to end his or her own life. These definitions exclude the concept of allowing death to occur by withdrawing or withholding life-supporting treatment.

Originally, Euthanasia (‘A Good Death’) was defined by the spiritual state of mind of the dying patient, not as a method of dying. Physicians focused on ensuring the psychological well being of their patients, with less concern for the physical process of their demise. The meaning of euthanasia has evolved over the centuries to focus on a “good way” of ending the life of a suffering patient, with less emphasis on the patient’s psychological state of well being.

To engage in killing patients destroys the essence of what it means to be a physician. The International Code of Medical Ethics states that the “physician shall always bear in mind the obligation of preserving human life and maintaining the dignity of life.”

This paper details the various definitions of Euthanasia, theories in support and against, its relation with the “Dignity of Life” and the views expressed by the Hon’ble Supreme Court of India about Article 21 and the Right to Live.


Dr. K. H. Chavali, Sr. Lecturer,
Dr. Dasari Harish, Reader,
Dr. B. R. Sharma, Reader,
Dept. of Forensic Medicine and Toxicology, Govt. Medical College & Hospital, Chandigarh

The recent announcement by our Honourable Central Health Minister to introduce the teaching of Indian System of Medicine in the curriculum of MBBS has stirred a hornet’s nest and raised many voices – mainly those of opposition. Notwithstanding the objections raised by our “clinical” brethren, from a forensic perspective, the integration of the curriculum should come in handy as the doctors will be better aware of the medico-legal issues arising out of the doctor-patient relationship in the Indian system of medicine also. Moreover, as the law of our country does not permit qualified ayurvedic practitioners to handle medico-legal cases, integration of curriculum may be a right step forward in helping the doctors engaged in the forensic field in understanding and trying to settle, for example, cases of negligence arising out of ayurvedic practice.

The medico-legal implications of the integrated curriculum will be discussed.

Trials and Trivails of Medical Witness

Dr.D.R.Kothari, Saraswati Nagar, Asad Society Ambawati, Ahmedabad, Gujrat.

The subject is vast and fathomless. Often, the medico legal expert is required to walk on the razor's edge.

The medical witness helps the society to impart justice. His scientific knowledge helps achieve this end.

But, often there are obstacles which make the path of the medical witness difficult.

The speaker from his long and vast experience of medico legal work selected three cases where he was involved, and where he was not happy about the forces that interfered in his work. He has tried to show how the personal biases/prejudices, pressure from authorities that be, insincerity, subjectivity, ego etc makes the work of the medico legal expert difficult.

The speaker, at the end will emphasis the character and principles that should guide the medico legal expert in his work.


 Keywords: Key Words:- Summon, Court, Doctor, Clinical Case, Postmortem, Medico-legal.

Sanjeev Lalwani*, B Sridhar, R Rautji, T D Dogra,
Deptt. of Forensic Medicine, All India Institute of Medical Sciences, New Delhi


In India, medico-legal documents prepared by the doctors are to be proved in the court of law, by personal attendance. Result is receipt of large number of summons. 1624 summons were attended by department of Forensic Medicine of All India Institute of Medical Sciences, New Delhi in year 2004. 910(56.03%) were pertaining to clinical cases and 714(43.95%) to postmortem reports. 842(51.85%) received from Magistrate's court, 722(44.46%) from session's court and 60(3.69%) from the Juvenile justice board. Offences against body, sexual offences, road traffic accidents, culpable homicide or murder and juvenile offences were the common situations. 615(37.87%) were attended after 1-3 years of preparing the document. Summons put additional burden on the already overworked department. The AIIMS authorities and others approached to the High and Supreme Court on this issue, but the practice of summoning doctors

continues. In the present study authors have analyzed the present scenario regarding summons to the doctors.

I will send you Dr. Kothari’s, Dr. Vij’s, Dr. Tripathi’s, Dr. Mukundan’s, Dr. Kurvey’s Guest lectures and Dr. Vishal’s free paper (Conducting Autopsy in HIV +ve Cases). Please send your topic and Abstract to be presented in CME

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