Displaying publications 1 - 20 of 34 in total

  1. Marroquin Penaloza TY, Karkhanis S, Kvaal SI, Nurul F, Kanagasingam S, Franklin D, et al.
    J Forensic Leg Med, 2016 Nov;44:178-182.
    PMID: 27821308 DOI: 10.1016/j.jflm.2016.10.013
    Different non-invasive methods have been proposed for dental age estimation in adults, with the Kvaal et al. method as one of the more frequently tested in different populations. The purpose of this study was to apply the Kvaal et al. method for dental age estimation on modern volumetric data from 3D digital systems. To this end, 101 CBCT images from a Malaysian population were used. Fifty-five per cent were female (n = 55), and forty-five percent were male (n = 46), with a median age of 31 years for both sexes. As tomographs allow the observer to obtain a sagittal and coronal view of the teeth, the Kvaal pulp/root width measurements and ratios were calculated in the bucco-lingual and mesio-distal aspects of the tooth. From these data different linear regression models and formulae were built. The most accurate models for estimating age were obtained from a diverse combination of measurements (SEE ±10.58 years), and for the mesio-distal measurements of the central incisor at level A (SEE ±12.84 years). This accuracy, however is outside an acceptable range in for forensic application (SEE ±10.00 years), and is also more time consuming than the original approach based on dental radiographs.
  2. Asif MK, Nambiar P, Mani SA, Ibrahim NB, Khan IM, Sukumaran P
    J Forensic Leg Med, 2018 Feb;54:53-61.
    PMID: 29324319 DOI: 10.1016/j.jflm.2017.12.010
    The methods of dental age estimation and identification of unknown deceased individuals are evolving with the introduction of advanced innovative imaging technologies in forensic investigations. However, assessing small structures like root canal volumes can be challenging in spite of using highly advanced technology. The aim of the study was to investigate which amongst the two methods of volumetric analysis of maxillary central incisors displayed higher strength of correlation between chronological age and pulp/tooth volume ratio for Malaysian adults. Volumetric analysis of pulp cavity/tooth ratio was employed in Method 1 and pulp chamber/crown ratio (up to cemento-enamel junction) was analysed in Method 2. The images were acquired employing CBCT scans and enhanced by manipulating them with the Mimics software. These scans belonged to 56 males and 54 females and their ages ranged from 16 to 65 years. Pearson correlation and regression analysis indicated that both methods used for volumetric measurements had strong correlation between chronological age and pulp/tooth volume ratio. However, Method 2 gave higher coefficient of determination value (R2 = 0.78) when compared to Method 1 (R2 = 0.64). Moreover, manipulation in Method 2 was less time consuming and revealed higher inter-examiner reliability (0.982) as no manual intervention during 'multiple slice editing phase' of the software was required. In conclusion, this study showed that volumetric analysis of pulp cavity/tooth ratio is a valuable gender independent technique and the Method 2 regression equation should be recommended for dental age estimation.
  3. Subramaniam K, Sheppard MN
    J Forensic Leg Med, 2018 Feb;54:127-129.
    PMID: 29413954 DOI: 10.1016/j.jflm.2018.01.005
    OBJECTIVES: Aortic dissection (AD) can be a challenging diagnosis. At autopsy, the aorta may not be dilated and intimal tears may be missed or found without obvious rupture or haemorrhage. We report our experience of AD at a tertiary referral centre with review of 32 cases and discuss 2 unusual complications.

    METHODS/RESULTS: 32 cases of which 12 females and 20 male and 18 out of 32 cases were aged below 40. All of the cases were examined macroscopically and microscopically. 30 out of 32 cases (93%) died due to rupture associated with the AD. Two unusual complications were proximal extension of AD into left coronary artery (CA) with intramural haematoma blocking the vessel and AD involving the ostium of the right CA resulting in avulsion of the right CA from the aorta. Mode of death in both these cases were myocardial ischemia. Sections of the aorta in all cases confirmed extensive cystic medial degeneration with disorganisation, fragmentation and disappearance of the elastin fibres with increased collagen and smooth muscle nuclear degeneration.

    CONCLUSION: Pathologists should be thorough when examining the aorta, the aortic valve and root in AD. When a rupture site cannot be found it is important to look for unusual complications involving the CAs. Histology plays an important role to corroborate the cause of death.

  4. Mujtaba G, Shuib L, Raj RG, Rajandram R, Shaikh K
    J Forensic Leg Med, 2018 Jul;57:41-50.
    PMID: 29801951 DOI: 10.1016/j.jflm.2017.07.001
    OBJECTIVES: Automatic text classification techniques are useful for classifying plaintext medical documents. This study aims to automatically predict the cause of death from free text forensic autopsy reports by comparing various schemes for feature extraction, term weighing or feature value representation, text classification, and feature reduction.

    METHODS: For experiments, the autopsy reports belonging to eight different causes of death were collected, preprocessed and converted into 43 master feature vectors using various schemes for feature extraction, representation, and reduction. The six different text classification techniques were applied on these 43 master feature vectors to construct a classification model that can predict the cause of death. Finally, classification model performance was evaluated using four performance measures i.e. overall accuracy, macro precision, macro-F-measure, and macro recall.

    RESULTS: From experiments, it was found that that unigram features obtained the highest performance compared to bigram, trigram, and hybrid-gram features. Furthermore, in feature representation schemes, term frequency, and term frequency with inverse document frequency obtained similar and better results when compared with binary frequency, and normalized term frequency with inverse document frequency. Furthermore, the chi-square feature reduction approach outperformed Pearson correlation, and information gain approaches. Finally, in text classification algorithms, support vector machine classifier outperforms random forest, Naive Bayes, k-nearest neighbor, decision tree, and ensemble-voted classifier.

    CONCLUSION: Our results and comparisons hold practical importance and serve as references for future works. Moreover, the comparison outputs will act as state-of-art techniques to compare future proposals with existing automated text classification techniques.

  5. Syamsa RA, Omar B, Ahmad FM, Hidayatulfathi O, Shahrom AW
    J Forensic Leg Med, 2017 Jan;45:41-46.
    PMID: 27997861 DOI: 10.1016/j.jflm.2016.12.002
    Forensic entomology refers to the science of collection and analysis of insect evidence in order to determine the minimum time period since death. This study aimed to investigate the occurrence of forensically important flies on 34 human remains referred to Universiti Kebangsaan Malaysia Medical Centre over a period of three years. Entomological specimens were collected at the death scenes and/or during autopsies. Live specimens were reared into adults while preserved specimens were processed for species identification. Five families, seven genera and nine species of flies were identified from human remains. The results of the study showed Chrysomya megacephala (Calliphoridae) maggots occurred on corpses with the highest frequency (70.6%), followed by Ch. rufifacies (Calliphoridae) (44.1%), sarcophagid fly (Sarcophagidae) (38.2%), Synthesiomya nudiseta (Muscidae) (20.6%), Megaselia scalaris (Phoridae) (14.7%), Lucilia cuprina (Calliphoridae) (5.9%), Ch. nigripes (Calliphoridae) (5.9%), Eristalis spp. (Syrphidae) (5.9%) and Hydrotaea spinigera (Muscidae) (2.9%). The greatest fly diversity occurred on remains recovered indoors (eight species) compared to outdoors (three species). Whilst, single and double infestations were common for both indoor and outdoor cases, multiple infestation of up to six species was observed in one of the indoor cases. Although large numbers of fly species were found on human remains, the predominant species were still those of Chrysomya, while S. nudiseta was found only on human remains recovered from indoors. The present study provides additional knowledge in the context of Malaysian forensic entomology and the distribution of forensically important flies which is of relevance to forensic science.
  6. Abdel Aziz MH, Badr El Dine FM, Saeed NM
    J Forensic Leg Med, 2016 Nov;44:103-110.
    PMID: 27743546 DOI: 10.1016/j.jflm.2016.10.003
    INTRODUCTION: Identification of sex and ethnicity has always been a challenge in the fields of forensic medicine and criminal investigations. Fingerprinting and DNA comparisons are probably the most common techniques used in this context. However, since they cannot always be used, it is necessary to apply different and less known techniques such as lip prints.

    AIM OF THE WORK: Is to study the pattern of lip print in Egyptian and Malaysian populations and its relation to sex and populations difference. Also, to develop equations for sex and populations detection using lip print pattern by different populations (Egyptian and Malaysian).

    SUBJECTS AND METHODS: The sample comprised of 120 adults volunteers divided into two ethnic groups; sixty adult Egyptians (30 males and 30 females) and sixty adult Malaysians (30 males and 30 females). The lip prints were collected on a white paper. Each lip print was divided into four compartments and were classified and scored according to Suzuki and Tsuchihashi classification. Data were statistically analyzed.

    RESULTS: The results showed that type III lip print pattern (intersected grooves) was the predominant type in both the Egyptian and Malaysian populations. Type II and III were the most frequent in Egyptian males (28.3% each), while in Egyptian females type III pattern was predominant (46.7%). As regards Malaysian males, type III lip print pattern was the predominant one (41.7%), while type II lip print pattern was predominant (30.8%) in Malaysian females. Statistical analysis of different quadrants showed significant differences between males and females in the Egyptian population in the third and fourth quadrants. On the other hand, significant differences were detected only in the second quadrant between Malaysian males and females. Also, a statistically significant difference was present in the second quadrant between Egyptian and Malaysian males. Using the regression analysis, four regression equations were obtained.

  7. Jayaraman J, Wong HM, King NM, Roberts GJ
    J Forensic Leg Med, 2016 Oct;43:26-33.
    PMID: 27441983 DOI: 10.1016/j.jflm.2016.07.007
    BACKGROUND: Many countries have recently experienced a rapid increase in the demand for forensic age estimates of unaccompanied minors. Hong Kong is a major tourist and business center where there has been an increase in the number of people intercepted with false travel documents. An accurate estimation of age is only possible when a dataset for age estimation that has been derived from the corresponding ethnic population. Thus, the aim of this study was to develop and validate a Reference Data Set (RDS) for dental age estimation for southern Chinese.

    MATERIALS AND METHODS: A total of 2306 subjects were selected from the patient archives of a large dental hospital and the chronological age for each subject was recorded. This age was assigned to each specific stage of dental development for each tooth to create a RDS. To validate this RDS, a further 484 subjects were randomly chosen from the patient archives and their dental age was assessed based on the scores from the RDS. Dental age was estimated using meta-analysis command corresponding to random effects statistical model. Chronological age (CA) and Dental Age (DA) were compared using the paired t-test.

    RESULTS: The overall difference between the chronological and dental age (CA-DA) was 0.05 years (2.6 weeks) for males and 0.03 years (1.6 weeks) for females. The paired t-test indicated that there was no statistically significant difference between the chronological and dental age (p > 0.05).

    CONCLUSION: The validated southern Chinese reference dataset based on dental maturation accurately estimated the chronological age.

  8. Kumar V, San KP, Idwan A, Shah N, Hajar S, Norkahfi M
    J Forensic Leg Med, 2007 Apr;14(3):151-4.
    PMID: 16914354
    The main aim of this study is to determine the causes and the epidemiological aspects of sudden natural deaths. Data were collected from 545 sudden natural autopsies in UMMC, Kuala Lumpur over a five-year period, from 1st January 2000 to 31st December 2004. There were 475 males and 70 females. The largest number of sudden natural deaths was in the age group of 41-50 years. 35.8%, 30.5% and 11.7% of the patients were Chinese, Indian and Malay, respectively. A majority of the patients were married (59.8%) and came from the semiskilled-unskilled group (30.6%). The monthly distribution was almost constant. Cardiovascular diseases were the most important cause contributing 64.9% in sudden natural deaths.
  9. Ismail NA, Abdullah N, Mohamad Noor MH, Lai PS, Shafie MS, Nor FM
    J Forensic Leg Med, 2019 Apr;63:11-17.
    PMID: 30825771 DOI: 10.1016/j.jflm.2019.02.010
    BACKGROUND: In the application of scientific human skeletal variation in medico-legal matters, virtual anthropology is the current technique performed to examine skeleton and its body parts. Hence, this study was conducted to assess the accuracy and reliability of virtual femur measurement through intra and inter-observer error analysis, and comparison was made between the virtual and conventional methods.

    METHODS: A total of 15 femora were examined with four parameters i.e. maximum length of femur (FeMl), diameter of femoral head (FeHd), transverse diameter of midshaft (FeMd) and condylar breadth (FeCb). Osteometric board and vernier calipers were employed for the conventional method, while CT reconstructed images and Osirix MD software was utilised for the virtual method.

    RESULTS: Results exhibited that there were no significant differences in the measurements by conventional and virtual methods. There were also no significant differences in the measurements by the intra or inter-observer error analyses. The intraclass correlation coefficients (ICC) were more than 0.95 by both intra and inter-observer error analyses. Technical error of measurement had displayed values within the acceptable ranges (rTEM <0.08 for intra-observer, <2.25 for inter-observer), and coefficient of reliability (R) indicated small measurement errors (R > 0.95 for intra-observer, R > 0.92 for inter-observer). By parameters, FeMl showed the highest R value (0.99) with the least error in different methods and observers (rTEM = 0.02-0.41%). Bland and Altman plots revealed points scattered close to zero indicating perfect agreement by both virtual and conventional methods. The mean differences for FeMl, FeHd, FeMd and FeCb measurements were 0.01 cm, -0.01 cm, 0.02 cm and 0.01 cm, respectively.

    CONCLUSION: This brought to suggest that bone measurement by virtual method was highly accurate and reliable as in the conventional method. It is recommended for implementation in the future anthropological studies especially in countries with limited skeletal collection.

  10. Murty OP
    J Forensic Leg Med, 2009 Jul;16(5):290-6.
    PMID: 19481715 DOI: 10.1016/j.jflm.2008.12.020
    Domestic maid violence is an assault and coercive behaviour, which mainly includes physical, psychological and at times sexual too, by employer or household members of employer against a person hired as a domestic help. Maid abuse is well known but poorly documented in scientific literature. This is an important global issue. In this article, two illustrated cases of maid abuse are discussed. Their employers allegedly subjected both the victims to physical and psychological trauma. The physical examination of the victims showed poor state of clothing, nutrition, and presence of injuries of different duration. The bruises were irregular to patterned, and were inflicted by beating. Both cases had eczematous contact dermatitis over palms and soles, paronechia, and sub-ungal fungal infection due to unprotected working in wet conditions. In both cases, external ears were deformed like cauliflowers due to repeated trauma. All cases had multiple injuries of varying duration. In this paper, medico-legal and social issues related to maid abuse are also discussed in detail. A possible solution to minimise maid abuse is also suggested. This paper highlights and document maid abuse.
  11. Murty OP
    J Forensic Leg Med, 2009 May;16(4):224-7.
    PMID: 19329081 DOI: 10.1016/j.jflm.2008.12.027
    A teenager college student was fatally injured by burst tyre air pressure while waiting on a public bus stand to catch a bus to reach her college at Kuala Lumpur. She accidentally came near the wheel while boarding when tube and tyre got burst .The air pressure had blown the girl in the air and she subsequently fell on a rough surface. The iron-locking rim of the wheel acted as a missile and hit the girl. She died on her way to the hospital. A medico-legal autopsy was performed which showed extensive injuries in the cranial and chest cavity. Head had large scalp laceration with diffuse separation and gaping from in the vault region; skull bones were fractured. Chest cavity had extensive rib fractures, lacerated lungs and haemo-thorax while externally there was no obvious injury. It requires intensive care management and screening of the victims. Tyre-blast injuries are not so common. This case exposes the hazard due to burst tyre.
  12. Murty OP
    J Forensic Leg Med, 2009 May;16(4):218-23.
    PMID: 19329080 DOI: 10.1016/j.jflm.2008.07.010
    A case is presented where confusion arose about skin lesions and whether they were diabetic or electrical in origin. The deceased was a known diabetic and hypertensive man. A middle-aged person in early fifties was found unconscious in the cell and judicial autopsy was performed. He was facing trial for capital punishment of being allegedly involved in drug trafficking and money laundering. He had few marks over his fingers and foot which were considered to be electric marks produced in electric torture. also had fracture of skull and ischemic necrosis of right side of cerebrum; and contrecoup lesions. Findings are documented with photographs of the lesions. The article also depicts photographs of the scene where the victim had fallen and sustained skull fracture.
  13. Murty OP
    J Forensic Leg Med, 2009 Apr;16(3):162-7.
    PMID: 19239970 DOI: 10.1016/j.jflm.2008.07.009
    A case is presented of a fatal environmental accidental injuries of lightning. A pedestrian was struck by lightning. The macroscopic and microscopic lightning injuries are reviewed.
  14. Murty OP
    J Forensic Leg Med, 2009 Jan;16(1):35-9.
    PMID: 19061848 DOI: 10.1016/j.jflm.2008.05.017
    Condom-murder is term used to describe a homicide where a person has been killed due to his recreational sexual behaviour and the killing has strong links with the recovered condom/contraceptive material on the scene or was in personal possession of victim. It can provide immediate clue about perpetrator. We present six cases of a similar nature. Four males and two females had condoms in their vicinity at crime scene. All incidents occurred at different timings and different places but there was striking similarity in method of killing. In four cases hands were tied on the back in three cases; similarly legs were also tied in three cases. In three cases strong electric cords were used. The presence of condoms give clue for investigation, possibility of DNA identification, about type of sexual behaviour as recreational and commercial method in these cases.
  15. Murty OP
    J Forensic Leg Med, 2008 Feb;15(2):96-100.
    PMID: 18206825 DOI: 10.1016/j.jflm.2007.01.005
    In this article, five cases with pearls in penile skin are discussed. These cases were viewed from multiple angles as number, colour, position of pearls, socio-economic status, occupation, sexual behaviour, and the background of the individuals. The number of pearls varied from one to five in these cases. The penile skin examination revealed old healed scar marks indicating that probably some had even more pearls. Three persons were directly or indirectly associated with drugs. One of the victim was HIV positive. Two of the cases were of homicide; one died in police custody; one died due to ischemic heart disease; and one had died in accident. The article also discusses the common beliefs behind this practice with review of the literature.
  16. Murty OP
    J Forensic Leg Med, 2007 May;14(4):225-7.
    PMID: 16914357
    This is a case report of an environmental accident due to lightning where one school boy sustained current, blast, and flame effects of it. A bolt of lightning directly struck the pole of a football ground and the scatter struck the child. In addition to burn injuries, he showed an exit wound of lightning in left foot. The exit wound of lightning current is a very rare finding. The body of victim had flame and heat effect of atmospheric electricity on head and neck, face, and trunk. In this incidence of lightning other team mates of the victim were safe. The patient survived the attack.
  17. Ramli R, Oxley J, Noor FM, Abdullah NK, Mahmood MS, Tajuddin AK, et al.
    J Forensic Leg Med, 2014 Aug;26:39-45.
    PMID: 25066171 DOI: 10.1016/j.jflm.2014.06.007
    Motorcycle fatalities constitute the majority of road traffic deaths in Malaysia. The aims of this study were to describe the pattern of fatal injuries among Klang Valley fatal motorcyclists and to describe the factors associated with fatal (vs non-fatal) injuries.
  18. Mohd Yusof MY, Cauwels R, Deschepper E, Martens L
    J Forensic Leg Med, 2015 Aug;34:40-4.
    PMID: 26165657 DOI: 10.1016/j.jflm.2015.05.004
    The third molar development (TMD) has been widely utilized as one of the radiographic method for dental age estimation. By using the same radiograph of the same individual, third molar eruption (TME) information can be incorporated to the TMD regression model. This study aims to evaluate the performance of dental age estimation in individual method models and the combined model (TMD and TME) based on the classic regressions of multiple linear and principal component analysis. A sample of 705 digital panoramic radiographs of Malay sub-adults aged between 14.1 and 23.8 years was collected. The techniques described by Gleiser and Hunt (modified by Kohler) and Olze were employed to stage the TMD and TME, respectively. The data was divided to develop three respective models based on the two regressions of multiple linear and principal component analysis. The trained models were then validated on the test sample and the accuracy of age prediction was compared between each model. The coefficient of determination (R²) and root mean square error (RMSE) were calculated. In both genders, adjusted R² yielded an increment in the linear regressions of combined model as compared to the individual models. The overall decrease in RMSE was detected in combined model as compared to TMD (0.03-0.06) and TME (0.2-0.8). In principal component regression, low value of adjusted R(2) and high RMSE except in male were exhibited in combined model. Dental age estimation is better predicted using combined model in multiple linear regression models.
  19. Leong YH, Ariff AM, Khan HRM, Rani NAA, Majid MIA
    J Forensic Leg Med, 2018 May;56:16-20.
    PMID: 29525581 DOI: 10.1016/j.jflm.2018.03.007
    This study analyses the incidences and patterns of paraquat poisoning from calls received at the Malaysia National Poison Centre (NPC) since 2004 following the ban of the herbicide (2004-2006) and subsequent restriction up to year 2015. Related reported cases to the centre over twelve years (2004-2015) were retrieved and studied in respect to socio-demographic characteristics, mode and type of poisonings, exposure routes and location of incident. Ages of poisoned victims range from 10 months old to 98 years with males being intoxicated more frequently than females (ratio male to female = 2.7). The age group mainly involved in the poisoning was 20-39 years. The most common mode was intentional (62.8%) followed by unintentional (36.9%). Among the 1232 reported cases, suicidal poisoning was the highest (57.2%); accidental poisoning (30.8%) and occupational poisoning (3.3%). The findings showed an upward trend of suicidal poisoning over the years, clearly emphasizing the need for more stringent and effective enforcement to ensure the safe use of paraquat.
  20. Wong YL, Khoo LS, Ibrahim MA, Mohamad Noor MH, Mahmood MS
    J Forensic Leg Med, 2021 Oct;83:102253.
    PMID: 34543893 DOI: 10.1016/j.jflm.2021.102253
    BACKGROUND: Blast related deaths are often shrouded by diagnostic and medicolegal complexities requiring multidisciplinary expertise in order to gauge accurate identification of the victims and document scientific investigations comprehensively. In the advent of more sophisticated technology, anthropologic methods can now be applied into post mortem imaging interpretation. The traditional imaging roles of characterizing osseous fragmentation, detecting and localizing foreign bodies can be expanded to simulate and support physical anthropologic examination to assist in documentation for court proceedings.

    CASE PRESENTATION: An assemblage of unidentified, incomplete, highly fragmented skeletal remains were found scattered on a bare area of land in a forest. There was evidence of an explosion given the pattern of scattered evidentiary material of explosive and ballistic nature. Laboratory analysis of white powder found within the explosive material confirmed the presence of high impact C4-explosive trace containing cyclotrimethylene trinitramin [Royal Demolition Explosive (RDX)] & pentaerythritol tetranitrate (PETN). It took meticulous multidisciplinary efforts to confirm the identity of the victim that was marred by the severe fragmentation and skeletalization of the remains. The initial radiologic interpretation focused more on identification of foreign bodies and supporting documentation of fragmentation. With the current availability of post computed tomography (PMCT) in our center, we reexamined the value and potential of PMXR and PMCT as an adjunctive tool for biological profiling.

    CONCLUSION: This was the first case of C4-blast related death reported in Malaysia. The multidisciplinary approach in efforts to identify the victim may serve as a guide in managing, coordinating and maximizing the expertise of different forensic specialists, with emphasis on anthropologic and radiologic collaboration.

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