Biomedical subjects
Publications and source records attributed to B L Bhootra.
A fatal case of a homicidal penetrating head injury by retained blade of knife is reported. The blade of knife penetrated the skull bone after breaking from a knife handle and remained lodged in the intracranial cavity for 5 days resulting in death from intracranial bleeding and brain oedema. The need of proper and complete examination of the head injury and its medico-legal importance is emphasized.
Muti killings are a form of murder committed by certain African tribes in South Africa and other African countries. Body parts for medicinal and ritualistic purposes are removed whilst the victims, mostly women and children, are still alive. The authors report the case of a 10-year-old boy who was found in an unconscious state in the undergrowth near a rural village in Limpopo, South Africa. He had several injuries which included the removal of his private parts and severe head injuries. The incidence, etiological and cultural factors, predisposing conditions and legal questions arising from such deaths are discussed.
This work presents information about the current practice of medico-legal services including forensic pathology services in the Islamic state of Qatar from the author's personal experience gained during a consultation visit to Hamad Medical Corporation Hospital of Qatar. Qatar enacted a comprehensive autopsy law (Law No. 8 of 2003) on the basis of tenets of Islam, incorporating modern trends and opinion. This deals with performance of hospital/clinical, forensic post-mortems and dissection of dead bodies for educational purposes.
Death from accidental steam inhalation is quite a rare occurrence. Two cases of children who died during the inhalation of superheated steam in a closed room are reported. To our knowledge this is the first case report where children died from the injurious effects of steam while inhaling steam. At autopsy, petechial haemorrhages in brain, lungs, heart, and congestion of epiglottis, congestion and oedema of lungs were seen macroscopically. Microscopically, trachea showed swelling and oedema of mucosa and sub mucosa, focal loss of mucosal epithelium and coagulative necrosis with scanty inflammatory reaction, lungs showed congestion, oedema and haemorrhages. It is considered that these findings caused hypoxia and cause of death in these cases was accidental inhalation of superheated steam. It indicates that mucosa of respiratory tract is vulnerable to the effects of vapors of superheated steam. Moreover it would seem that fatal hypoxia occurs within a few minutes from the effects of inhalation of steam in a closed space.
Forensic medicine services (medico-legal services) as it is provided today in Uganda is discussed with special reference to forensic pathology and also to future plans for improvement to ensure quality service. Forensic medicine services are divided into clinical forensic medicine and forensic pathology. In Uganda, these services are rendered partly by pathologists attached to University, by pathologists and medical officers employed by police and by medical officers attached to hospitals. In Uganda, all types of unnatural deaths are reported to nearest police station and appointed investigating police officer(s) will take necessary action to have a medico-legal postmortem done as soon as possible. Currently there is no qualified forensic pathologist in Uganda. Suggestions are made with regard to the enactment of a Forensic Medicine Services Act by the Department of Health, the creation of a forensic medicine unit with, under the administrative umbrella of pathology department, in medical schools and imparting of forensic medicine training to anatomical pathologists to act as a qualified, specialist forensic pathologists.
Missile head injury is predominantly caused by firearms; however, small blunt objects such as a stone can be propelled into the air and cause a low-velocity-type missile injury, as described in this case report. Since the cerebral damage in low-velocity missile injuries is usually focal, there might not be disturbance of consciousness until secondary brain damage occurs; therefore, adequate medical supervision is necessary to prevent and treat potentially fatal complications in a timely manner. This is a rare case of a penetrating missile wound of the head, most likely caused by the use of a stone propelled by a slingshot that penetrated the skull and lacerated the brain with the stone embedded within the substance of the brain. The deceased died at home 2 days later from focal suppurative meningitis with cerebral abscess formation and a subdural hemorrhage.
A 58-year-old man was admitted to hospital for the investigation and treatment of pancytopaenia and anaemic heart failure but four days later he died following a sternal bone marrow aspiration procedure. The autopsy revealed a significant haemopericardium as a result of a puncture wound of the heart. The thickness the body of the sternum was 2 to 3 mm. No other significant pathology was noted and death was ascribed to a haemopericardium due to a puncture wound of the heart associated with bone marrow aspiration. An inquest was held at which the doctor who undertook the procedure was found not to be negligent.