The magnitude of the diagnostic benefit conferred by performing histopathological examinations after medico-legal/forensic autopsies remains debatable. We have tried to address this issue by reviewing a series of histopathology referrals concerning medico-legal autopsies in real-world routine practice. We present an audit of the consultations provided to forensics by clinical pathologists at our institute between 2015 and 2018. Over this period, 493 post-mortem examinations were performed by forensic pathologists. Of these cases, 52 (11%) were referred for histopathology. Gross assessment was requested in 22/52 (42%) cases. Histopathology examination was performed on single organs in 15/52 (29%) cases, primarily on the lung and heart, whereas parenchymatous multi-organ analysis was carried out in 14/52 (27%) cases. Bone-marrow sampling was studied in 4/52 (8%) cases. Immunohistochemistry was needed in 16/52 (31%) cases, special stains in 9/52 (21%) cases and molecular analysis in 4/52 (8%) cases. Focusing on technical processes, standard methodology on pre-analytical procedures was changed in 10/52 (19%) cases in order to answer specific diagnostic questions. We showed that although most of the time the diagnosis is clear by the end of dissection on the basis of the macroscopic findings, histopathology can provide, modify or confirm the cause of death in many medico-legal/forensic cases. Therefore, it is desirable that forensic pathologists and clinical pathologists establish robust working relationships in a cooperative environment. We conclude that it is important to implement guidelines based on real-world routine practice in order to identify cases where histopathology can provide useful contributions, which in our experience applied to 11% of forensic cases.
The post-mortem resilience of facial creases was studied using donated bodies in order to establish the efficacy of crease analysis for identification of the dead. Creases were studied on normal (pre-embalmed) and bloated (embalmed) cadavers at the Centre for Anatomy and Human Identification (CAHID) to establish whether facial bloating would affect facial crease visibility. Embalming was chosen to simulate the effects produced by post-mortem bloating. The results suggested that creases are resilient and changes were only detected for creases located on the periphery of the face, particularly at areas where the skin is thick, such as at the cheeks. Two new creases not previously classified were identified; these creases were called the vertical superciliary arch line and the lateral nose crease. This research suggests that facial creases may be resilient enough after death to be utilised for human identification.
Post mortem changes are important in estimating post mortem interval (PMI). This project's aim was to study the effect of burial and type of clothing on rate of decomposition, which can contribute to estimating PMI for victims. 12 rabbits (Oryctolagus cuniculus) carcasses were separated into 3 groups: no clothing, light clothing and heavy clothing. Control subjects were placed on the ground surface while test subjects were buried at 30 cm depth graves. Soil samples prior and after decomposition were collected for soil pH and moisture analysis. Post mortem change was assessed using a Total Body Score system. The head, neck and limb regions were found to decay faster than the body trunk region. Mummifi cation occurred on body parts that were exposed directly to the atmosphere while adipocere formed on some buried subjects. Burial delayed decomposition due to lower insect activity and lower soil temperature. The soil layer also blocked the accessibility of majority of the arthropods, causing further delay in decomposition. Clothing enhanced decay for bodies on ground surface because it provided protection for maggots and retained moisture on tissues. However, clothing delayed decomposition in buried bodies because it physically separated the bodies from soil and arthropods. Higher sun exposure and repetitive exhumation showed acceleration of decomposition. The decomposition process increased soil pH and moisture percentage values. Soil pH initially increased until pH 8.0-8.4 followed by a slight decrease while soil moisture percentage changed inconsistently. Burial was significant in affecting post mortem change, F(1,11)=12.991, p<0.05 while type of clothing was not significant, F(2,9)=0.022, p=0.978 and combination of both type of clothing and burial factors were also not significant, F(2,3)=0.429, p=0.686. For validation, an accuracy of 83.33% was achieved based on soil pH and soil moisture percentage analysis.
Skeletal examination is an important aspect of forensic pathology practice, requiring effective bone cleaning with minimal artefact. This study was conducted to compare between chemical and entomology methods of bone cleaning. Ten subjects between 20 and 40 years old who underwent uncomplicated medico-legal autopsies at the Institute of Forensic Medicine Malaysia were randomly chosen for this descriptive cross sectional study. The sternum bone was divided into 4 parts, each part subjected to a different cleaning method, being two chemical approaches i.e. laundry detergent and a combination of 6% hydrogen peroxide and powder sodium bicarbonate and two entomology approaches using 2nd instar maggots of Chrysomyia rufifacies and Ophyra spinigera. A scoring system for grading the outcome of cleaning was used. The effectiveness of the methods was evaluated based on average weight reduction per day and median number of days to achieve the average score of less than 1.5 within 12 days of the bone cleaning process. Using maggots was the most time-effective and costeffective method, achieving an average weight reduction of 1.4 gm per day, a median of 11.3 days to achieve the desired score and an average cost of MYR 4.10 per case to reach the desired score within 12 days. This conclusion was supported by blind validation by forensic specialists achieving a 77.8% preference for maggots. Emission scanning electron microscopy evaluation also revealed that maggots especially Chrysomyia rufifacies preserved the original condition of the bones better allowing improved elucidation of bone injuries in future real cases.
We present a case of skeletonised human remains. In the present case report, a body was exhumed from the ground above a cemetery. On exhumation, the body was partially-skeletonised with adipocere formation on the upper part of the body. Autopsy of the body showed two bullets in the right thigh muscle and lumbar vertebrae between L4 and L5. Postmortem changes and destruction of soft tissue made it impossible to determine direction of fire through the body, even in a careful complete autopsy.
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.
A series of experiments was conducted by exposing negative film in brand new cameras of different make and model. The exposures were repeated at regular time intervals spread over a period of 2 years. The processed film negatives were studied under a stereomicroscope (10-40x) in transmitted illumination for the presence of the characterizing features on their four frame-edges. These features were then related to those present on the masking frame of the cameras by examining the latter in reflected light stereomicroscopy (10-40x). The purpose of the study was to determine the origin and permanence of the frame-edge-marks, and also the processes by which the marks may probably alter with time. The investigations have arrived at the following conclusions: (i) the edge-marks have originated principally from the imperfections received on the film mask from the manufacturing and also occasionally from the accumulated dirt, dust and fiber on the film mask over an extended time period. (ii) The edge profiles of the cameras have remained fixed over a considerable period of time so as to be of a valuable identification medium. (iii) The marks are found to be varying in nature even with those cameras manufactured at similar time. (iv) The influence of f/number and object distance has great effect in the recording of the frame-edge marks during exposure of the film. The above findings would serve as a useful addition to the technique of camera edge-mark comparisons.
Deaths due to blunt force trauma to the head as a result of assault are some of the most common cases encountered by the practicing forensic pathologist. Previous studies have shown inflicting injury to the head region is one of the most effective methods of murder. The important factors that determine severity of trauma include the type of weapon used, type and site of skull fracture, intracranial haemorrhage and severity of brain injury. The aim of this study was to determine the characteristics of blunt force trauma to the skull produced by different instruments. Nine adult monkeys (Macaca fascicularis) skulls were used as models. Commonly found blunt objects comprising of Warrington hammer, hockey stick and open face helmet were used in this study. A machine calibrated force generator was used to hold the blunt object in place and to hit the skulls at forces of 12.5N and 25N. Resultant traumatic effects and fractures (linear, depressed, basilar, comminuted, and distastic) were analyzed according to type of blunt object used; surface area of contact and absolute force (N/cm(2)) delivered. Results showed that all investigated instruments were capable of producing similar injuries. The severity of trauma was not related to the surface area of contact with the blunt objects. However, only high absolute forces produced comminuted fractures. These findings were observational, as the samples were too small for statistical conclusions.
Detection of diatom frustules in bone marrow (diatom test) is used for diagnosing ante-mortem drowning where the usual signs of drowning are not present in dead bodies recovered from water. However, controversies over the reliability of diatom test results are continuing. There have been indications on the possibilities of diatoms entering into systemic circulation from atmospheric air, food and drink. While diatoms have been demonstrated in the gut content of edible marine forms such as shrimps and clams, the present study, for the first time, provides empirical evidence on the prevalence as well as abundance of diatom frustules in the samples of cooked non-vegetarian foodstuffs that impend human consumption in Kelantan, Malaysia. It is found that 50 g each of cleaned and cooked prawns and of clams impending human consumption contain about 8360 and 29,054 diatom frustules, respectively. A person accustomed to prawn and clam food would be ingesting an estimated 2 million diatoms in a single year. Considering the suggestion that detection of five diatom frustules in 10 g of bone marrow would suffice for concluding drowning as mode of death, and the fact that there is yet no proof that diatom frustules do not enter into the human systemic circulation through the digestive tract, the estimated number of diatom frustules routinely ingested acquires significance since entry of a few of such ingested frustules into the systemic circulation can lead to false positive test results. The findings of this research raise two important issues: first, population based routine food related diatom ingestion requires to be estimated, and, second, studies have to be initiated to categorically prove or disprove the possibility of entry of diatom frustules into the systemic circulation via the digestive tract.
The stages of decomposition and the faunal succession on rabbit carcasses in three different habitats, namely jungle, rural, and highland areas, were studied. Three New Zealand White rabbit (Oryctolagus cuniculus) carcasses weighing ∼2 kg were sampled daily until the decomposition process was completed. Representative specimens of adult flies, larvae, pupa, and mites were collected from the carcasses and processed in the laboratory. There were differences in decomposition rate and faunal succession between the carcasses. The fastest rate of decomposition was recorded in rural area, and the slowest rate of decomposition was recorded in highland area. The carcasses exhibited the same pattern of colonization by adult flies, but the dominant species of larvae and adult flies on each carcass in specific habitats were different. The primary species of flies recorded in jungle were Chrysomya megacephala F., Chrysomya rufifacies (Macquart), Chrysomya chani Kurahashi, Chrysomya villenuevi Patton, Chrysomya nigripes Aubertin, Chrysomya pinguis (Walker), Hemipyrellia ligurriens (Wiedemann), Hemipyrellia tagaliana (Bigot), Hypopyiopsis fumipennis (Walker), Hypopygiopsis violacea (Macquart), and Hydrotaea spinigera Stein represented by both adults and larvae. Musca domestica L., Atherigona sp., Lioproctia pattoni (Senior-White), Lioproctia saprianovae Pape & Bänziger, and Seniorwhitea princeps (Wiedemann) were represented by adults only. The biodiversity of flies in the rural area were C. megacephala, C. rufifacies, H. ligurriens, Fannia canicularis L., Hydrotaea chalcogaster (Wiedemann), and Hyd. spinigera represented by both adults and larvae, meanwhile M. domestica, Atherigona sp., Boettcherisca peregrina (Robineau-Desvoidy), Parasarcophaga taenionota Wiedemann, Parasarcophaga scopariiformis Senior-White, and S. princeps were represented by adults only. The species of flies collected in the highland area were Lucilia porphyrina (Walker), C. megacephala, C. rufifacies, C. villenuevi, C. pinguis, H. ligurriens, Hyd. spinigera, Hyd. chalcogaster, F. canicularis, and Boettcherisca highlandica Kurahashi & Tan represented by both adults and larvae, whereas C. nigripes, Chrysomya thanomthini Kurahashi & Tumrasvin, M. domestica, Atherigona sp., Parasarcophaga albiceps Meigen, P. taenionota, Sepsidae, Phoridae, and Millichidae were represented by adults only. Faunal succession followed the sequence of dominant flies, i.e., Calliphoridae, Sarcophagidae, Muscidae, Sepsidae, and lastly Stratiomyidae for jungle, or Sepsidae for rural and highland studies. Mites, from suborders Mesostigmata, Prostigmata, Astigmatina, and Oribatida, were also recovered throughout decomposition, which could be used for future implementation in forensic investigations. The data obtained from this study could provide more accurate indicators for local forensic scientists in solving criminal cases especially on the determination of time and primary location of death.
Forensic entomological specimens collected from human decedents during crime scene investigations in Malaysia in the past 6 years (2005-2010) are reviewed. A total of 80 cases were recorded and 93 specimens were collected. From these specimens, 10 species of cyclorrphagic flies were identified, consisting of Chrysomya rufifacies (Macquart) -38 specimens (40.86%), Chrysomya megacephala (Fabricius) -36 specimens (38.70%), Chrysomya villeneuvi (Patton) -2 specimens (2.15%), Chrysomya nigripes (Aubertin) -2 specimens (2.15%), Chrysomya pinguis (Walker) -1 specimen (1.08%), Hermetia illucens (Linnaeus) -1 specimen (1.08%), Hemipyrellia liguriens (Wiedemann) -5 specimens (5.37%), Synthesiomyia nudiseta (Wulp) -1 specimen (1.08%), Megaselia scalaris (Loew)-1 specimen (1.08%) and Sarcophaga ruficornis (Fabricius) -4 specimens (4.30%). In two specimens (2.15%), the maggots were not identifiable. Ch. megacephala and Ch. rufifacies were the commonest species found in human decedents from three different ecological habitats. S. nudiseta is an uncommon species found only on human cadavers from indoors. A total of 75 cases (93.75%) had a single fly infestation and 5 cases (6.25%) had double fly infestation. In conclusion, although large numbers of fly species were found on human decedents, the predominant species are still those of Chrysomya.
The victim, a 63-year-old prosperous businessman from Labasa, of the Northern Island (Vanua Levu) of Fiji Islands, was found completely decapitated in the early hours of morning in 2004. Initial police investigation did not reveal any history of any medical or family calamity. Further inquiry by the police revealed that on the previous day the deceased had visited all his friends and relatives, and his behavior was not out of the ordinary. The police suspected it to be a case of homicide. On visit to the scene, a completely decapitated body was found in a van on a downhill road. Tire marks were found on the road. A nylon rope was used for ligature strangulation. At autopsy, the decapitation wound of the head and the torso articulated well. The face was congested, and there was tongue bite. Wound margins were clear-cut, with well-demarcated abrasion and multiple imprints of the nylon rope on the neck. The upper one third of the larynx was attached to the head. No other injuries were found on the body. From the findings, it was obvious that asphyxiation was involved in the death before decapitation.
In estimating the postmortem interval (PMI) using maggots obtained during autopsy, the forensic entomologist makes decisions regarding the effects of low-temperature storage of the body on the insects. In this case report, a corpse was found in an abandoned house in the residential area of Bukit Mertajam, Penang, Malaysia. The maggots were found to be alive inside the mouth of the deceased although the corpse had been in the morgue cooler for 12 days. The maggots were reared and identified as Chrysomya megacephala (Fabricius). The emerged adult flies were kept as a stock colony, and the duration of development under the indoor fluctuating temperature regime was studied. The total duration of developmental process of this species was 9.5 ± 0.5 days, and the PMI estimated was 3.2 ± 0.6 days. This case report demonstrates the survival of Ch. megacephala maggots for 12 days and their growth inside the morgue cooler.
In Penang, Malaysia, the Oriental and Afrotropical Megaselia curtineura (Brues) and the Oriental and Japanese Megaselia spiracularis Schmitz are reported from human corpses, these being the first reports of these species in such forensic cases.
The likelihood of dipteran maggots colonizing a corpse due to nocturnal oviposition can be used to challenge the postmortem interval (PMI) estimated assuming diurnal oviposition. Earlier experiments tested nocturnal oviposition behavior by exposing fresh baits once during a single night. In this pilot study, oviposition behavior was studied using beef baits, which, simulating the decay of the body seen in case situations, decomposed inside cages designed to open and close at scheduled intervals during consecutive night or twilight periods. Freshly hatched maggots from diurnally oviposited eggs emerged in control baits on the third day, while a limited number of maggots attributable to nocturnal or twilight oviposition were observed in experimental baits only on the fifth or sixth day, indicating a categorical delay. These results suggest that such delayed and limited nocturnal oviposition is not forensically significant since the larger maggots deriving from diurnal oviposition would be the ones considered when estimating PMI.
Electrocution is one of the rarest modes of suicide. In this case, one school going adolescent committed suicide by electrocution using bare electric wire. This is a rare case of suicidal death by applying live wires around the wrists, simulating the act of judicial electrocution. He positioned himself on armed chair and placed the nude wire loops from a cable around both wrists and switched on the current by plugging in to nearest socket by foot. There were linear electric contact wounds completely encircling around the both wrists. In addition to these linear electric burns all around wrists, there were electrical burns over both hands. This death highlights the need of supervision and close watch on children for self-destructing activities and behavior. This case also highlights unusual method adopted by adolescent to end his life.
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.
Death by hanging is believed to be a painless method of committing suicide. In most cases the noose has a knot and on this basis only it can be labeled as atypical or typical hanging. A 35 year Chinese man committed suicide by hanging with a ligature material made of electric wire where there was no knot present on the noose.
Forensic entomology applies knowledge about insects associated with decedent in crime scene investigation. It is possible to calculate a minimum postmortem interval (PMI) by determining the age and species of the oldest blow fly larvae feeding on decedent. This study was conducted in Malaysia to identify maggot specimens collected during crime scene investigations. The usefulness of the molecular and morphological approach in species identifications was evaluated in 10 morphologically identified blow fly larvae sampled from 10 different crime scenes in Malaysia. The molecular identification method involved the sequencing of a total length of 2.2 kilo base pairs encompassing the 'barcode' fragments of the mitochondrial cytochrome oxidase I (COI), cytochrome oxidase II (COII) and t-RNA leucine genes. Phylogenetic analyses confirmed the presence of Chrysomya megacephala, Chrysomya rufifacies and Chrysomya nigripes. In addition, one unidentified blow fly species was found based on phylogenetic tree analysis.
We hereby present a case of planned complex suicide. In this case study, we report a teen-aged girl who committed suicide by strangulating herself, and subsequently fell from the 13th floor of a housing apartment. The planned complex suicide was substantiated by the presence of a suicide note and a photograph captured in a mobile handset. To the best of our knowledge, it is the first case involving self-strangulation and fall from height, in which the photograph was stored in the handset. This is to further emphasize that objects like mobile handsets can be important in determining the cause and manner of death. The available evidence at the site of incident should be explored meticulously in order to arrive at a proper conclusion.