Vol 9, No 3 (2023)

Editorials

In memory of Professor Vladimir Alexandrovich Klevno

Barinov E.H., Ivanov P.L., Romanko N.A., Kononov E.V., Goryachev A.V.

Abstract

On August 25, 2023, forensic medicine in Russia suffered an irreparable loss: our colleague and friend, the editor-in-chief of the journal “Russian Journal of Forensic Medicine”, Professor Vladimir A. Klevno, passed away.

The article provides information about the life and creative path of a prominent figure of Russian forensic medicine, MD, Dr. Sci. (Med.), Professor Vladimir A. Klevno — health care organiser, head of the Department of Forensic Medicine of the Faculty of Forensic Medicine of the Vladimirsky Moscow Medical Institute, certified doctor in forensic medicine and health care organisation, academician of the Russian Academy of Medical Sciences, member of the Council of the National Medical Chamber, president of the Association of Forensic Medicine and editor-in-chief Russian Journal of Forensiс Medicine.

Russian Journal of Forensic Medicine. 2023;9(3):245-253
pages 245-253 views

Original study articles

Morphological study of fly-ash block under angular impact of 9 mm projectile

Singh M., Rohatgi D., Kumar S., Gupta D.

Abstract

BACKGROUND: Concrete structures utilized in protective buildings such as ammunition depots and bunkers are susceptible to missile impacts, necessitating a comprehensive ballistic assessment involving penetration and perforation mechanics. Most of the empirical and analytical models for projectile penetration in concrete primarily focus on determining the penetration depth, scabbing, and perforation thicknesses. Concrete structures subjected to firearm attacks exhibit distinct fracture modes that can aid in identifying the firearm used and potential firing locations.

AIM: This study aims to comprehend the effects of the angular firing of a 9 mm full metal jacketed projectile on aerated concrete blocks, fired from a 5 m range. The goal is to generate hypotheses and conclusions based solely on the observable damage resulting from bullet impacts. A meticulous analysis of the incurred damages can unveil a range of possibilities.

MATERIALS AND METHODS: The sample comprised 12 aerated concrete blocks, each subject to 9×19 mm bullets fired from four different angles: 0°, 15°, 30°, and 45°. The relationship between impact angle and entry hole dimensions was established using the best-fit ellipse method.

RESULTS: Examination of the fracture pattern revealed significant damage at both entry and exit holes for a 0° impact angle. As the impact angle increased, the exit hole diameter progressively decreased, culminating in no perforation at a 45° angle. This trend correlated with fracture patterns near entry and exit holes, along with energy dissipation at the impact site corresponding to the impact angle.

CONCLUSION: A trend was observed between projectile energy loss upon impact and resultant damage to aerated concrete block surfaces. Analysis of aerated concrete block components deposited on the bullets, including rifling details, can help link them to the gunshot openings and firearms recovered at crime scenes.

Russian Journal of Forensic Medicine. 2023;9(3):255-266
pages 255-266 views

Influence of alcohol intoxication on the survival period in patients with subdural hemorrhage

Averkin N.S., Stolyarov A.P., Kharitonov E.A., Zhivankina I.S.

Abstract

BACKGROUND: Traumatic brain injury is an urgent problem in forensic medical examination, and subdural hematoma is considered the most fatal among them. In forensic medical practice, the outcomes of subdural hematoma should be understood depending on its volume to represent the pathohistological evolution of subdural hematoma and determine the essence of brain damage at the same time.

AIM: To evaluate the influence of alcohol intoxication on the survival period in patients with subdural hemorrhage.

MATERIALS AND METHODS: A retrospective study was conducted on 42 deaths from subdural hematoma, of which two groups were identified: those who died before medical care (n=20) and those who received medical care in a hospital (n=22). The injury circumstances, the blood volume spilled under the dura mater, the presence and degree of alcohol intoxication, and the level of consciousness on the Glasgow coma scale were recorded. Histological examination of a subdural hematoma was performed to determine its prescription.

RESULTS: Subdural hematoma is commonly caused by street injuries and traffic accidents. Hematomas are combined with skull fractures in 52.3% of cases, leptomeningeal hemorrhages in 73.8%, bruises in 81%, and cerebral edema in 88%. Unilateral subdural hematoma is more common than bilateral. The fact of alcoholic intoxication was recorded in most victims, whereas the ethyl alcohol concentration in the blood of persons who died before medical care was 2 times higher. Significant correlations were observed between the degree of impaired consciousness on the Glasgow coma scale and the concentration of ethyl alcohol in the blood (r=−0.701, p <0.05) and between the volume of subdural hematoma (r=−0.526, p <0.05) and hospitalization period (r=0.559, p <0.05).

CONCLUSION: Persons with subdural hemorrhage in a state of high degree of alcohol intoxication, as a rule, die before medical care is provided to them. Similarly, if help was provided, the outcome is most often unfavorable with a shorter survival period even in the presence of a small hematoma. Histological examination is currently the most optimal method in terms of determining the prescription of subdural hematoma.

Russian Journal of Forensic Medicine. 2023;9(3):269-278
pages 269-278 views

Determining the dependence of step periods on the speed of an individual over 15 years old

Kosukhina O.I., Fomina E.E., Leonov S.V.

Abstract

BACKGROUND: Issues of identity identification are relevant among the tasks solved when using these video surveillance and recording cameras. If it is impossible to carry out the identification by face, the identification by gait becomes relevant.

AIM: To define the step cycle as one of the gait personality identification parameters

MATERIALS AND METHODS: Study design: a single- and single-point (per population) observational study, with results registered in the Database of Step Cycle Characteristics (certificate of state registration no. 2022623085). The primary end-point of the study was the determination of the dependence of step periods on the movement speed of individuals, the assessment was carried out by a nonparametric criterion for Spearman correlation.

RESULTS: Comparative analysis of the obtained data revealed a decreasing pattern in all step periods separately (period of the first and second double supports and period of the first and second transfers) with an increase in the movement speed of the individual.

CONCLUSION: The obtained data make it possible to identify the possibility of using the step-cycle characteristics to identify individuals by gait when walking at different speeds. This stage can serve to further develop an algorithm for identifying a person by gait, as one of the parameters.

Russian Journal of Forensic Medicine. 2023;9(3):279-286
pages 279-286 views

Reviews

Identifying fake conclusions of forensic medical examinations using an artificial intelligence technology based on the experience in the Republic of Kazakhstan: a Review

Voyevodkin D.V., Rustemova G.R., Begaliyev Y.N., Igembayev K.A., Ayupova Z.N.

Abstract

This review discusses the legal aspects on the use of mathematical statistics and machine learning (hereinafter referred to as artificial intelligence) in forensic activities to identify both expert errors and fake expert opinions.

An attempt has been made to establish the criteria for evaluating conclusions of forensic examinations by determining their relevance, admissibility, reliability, and objectivity, as well as the objective possibility of distinguishing expert errors from deliberately false and fake expert opinions.

A SWOT analysis on the use of artificial intelligence was carried out to solve the issue of its application in the field under consideration, which revealed its advantages, and disadvantages.

The use of mathematical statistics and machine learning methods is not a universal method to identify fakes in expert opinions. However, given that this method can give both false-positive and false-negative results, its outcomes should be verified by independent experts. In addition, to effectively prevent the facts of falsification, comprehensive measures should be taken, including not only the detection of manipulations but also the prevention of the possibility of their occurrence, as well as the punishment of the perpetrators. Thus, this review proposed several amendments and additions to the current legislation of the Republic of Kazakhstan.

Russian Journal of Forensic Medicine. 2023;9(3):287-298
pages 287-298 views

Forensic and forensic aspects of childhood traumatism as a result of domestic injuries and traffic accidents: A review

Tursunov A.B., Galitskiy F.A., Begaliyev Y.N., Shakhanova A.T., Kurmangali Z.К.

Abstract

Childhood injuries are a major cause of death and disability worldwide, particularly in low-, and middle-income countries. Recent data showed that about 5 million children die from injuries per year. About 1 million children under 18 years old die of injury and more than 2000 children die per day, of which child injuries account for 5.4% (265 000–348 000) of child deaths annually worldwide. A detailed analysis of the epidemiology of childhood injuries can provide possible insights into their prevention and early intervention to reduce future disability due to childhood injuries.

In this review, the specificity of childhood body injuries in accidents and road traffic accidents and their qualitative differences from adult injuries were investigated, and current techniques for the detection, fixation, and recovery of childhood body trauma were reviewed through forensic investigation.

A literature search was conducted in the Pubmed, Scopus, Ebscohost, Medline, The Cochrane Library, SpringerLink, Web of Knowledge, Paragraph Medicine, and ScienceDirect databases to identify published studies for the last 20 years: from 1993 to 2023. Inclusion criteria were reports of randomized and cohort studies conducted on large populations, meta-analyses and systematic reviews, and articles in English, and Russian. Exclusion criteria were articles describing single cases and case series, published earlier than 1993, materials with no evidence base, abstracts of reports, abstracts, and newspaper articles. Out of 56 literature sources, 44 were selected as an analytical material for this article.

The literature review demonstrated that the absolute number of major childhood injuries has not declined over the past decade. Road traffic crashes remain the leading cause of injury and death in children. Adolescents are at greatest risk of serious injuries. Appropriate use of child restraints and safety equipment remains a key factor of the prevention. The adaptation of the urban environment is also a promising approach to child injury prevention among pedestrians and cyclists. As the social environment is a strong determinant of collisions, new road safety interventions must be implemented and evaluated with equity in mind to ensure safe roads for all.

Russian Journal of Forensic Medicine. 2023;9(3):299-308
pages 299-308 views

Trinitroaromatic explosives: Modern application, toxicological characterization, and methods of determination

Pogosyan N.G., Shormanov V.K., Kvachakhiya L.L., Omelchenko V.A.

Abstract

Explosives such as tetryl and picric acid, which were common in the past, now have lost their combat relevance. However, they are often used for peaceful purposes individually and in combination with other trinitroaromatic compounds (e.g., trinitrotoluene). As a result of their use, environmental pollution occurs, followed by intoxication of plants, animals, and people. Cases of explosive poisoning during their production are also described.

The symptoms of poisoning include both of general disorders and specific phenomena such as skin staining, impaired physiological efficiency of NADPh-dependent enzymes, genotoxicity, and immunotoxicity.

Previous scientific studies established a trend toward the development of chemical-analytical probes. Various options for the sensor surface of the device and methods for detecting compounds are considered. To determine the explosives, ion mobility spectrometry is widely used, which is very rare for the chemical–toxicological analysis of other groups of compounds.

Simultaneously, methods commonly used in the analysis of narcotic and psychotropic substances (gas chromatography/ combination of high-performance liquid chromatography and mass spectrometry methods) are also applicable to determine trinitroaromatic explosives. However, the presence of nitro groups in their structure complicates such an analysis. This problem can be resolved by injecting cold samples directly to the column.

Despite the availability of various developed techniques and methods, the possibility of their application to study biological matrices remains insufficient.

Therefore, further studies of the chemical–toxicological nature should be conducted to establish the optimal conditions for extracting the substances in question, the parameters of instrumental analysis, and the possibility of storing samples and for solving other problems of forensic medical examination.

Russian Journal of Forensic Medicine. 2023;9(3):309-318
pages 309-318 views

Case reports

Pedestrian electric-scooter fatality: A case report

Siedin M.S., Plis S.S., Klevno V.A.

Abstract

Electric scooters are one of the most popular means of individual mobility. The active use of this two-wheeled transport on sidewalks and public roads is naturally reflected in the number of road incidents, including fatal ones. No information has been provided about the damage received by pedestrians as a result of the collision of electric scooters, and the question of the most traumatic parts of the human body with such injuries today remains to be elucidated.

This case report describes a 75-year-old patient from practice that demonstrates the mechanism, type, and nature of injury sustained at a pedestrian when an electric scooter hits him. Citizen A sustained a head injury during the fall and was hospitalized in a medical institution, where he subsequently died. During autopsy, changes were found about the exact mechanism of their formation in a scooter injury.

According to the literature, injuries associated with the collision of electric scooters mainly occur during the fall with the formation of bone fractures in the upper and lower extremities. Torso injury, according to various authors, is extremely rare, and the nature of the damage and the category of victims in these studies are generally not detailed. This case confirms the possibility of the formation of primary and secondary contact injuries in various parts of the body of a pedestrian. In addition, the case allows the possibility of identifying the means of individual mobility based on the presence of a steering wheel.

Russian Journal of Forensic Medicine. 2023;9(3):319-327
pages 319-327 views

Intracranial foreign metal body (sewing needle): A case report of infanticide attempt

Mehdiyev E.S.

Abstract

During a mandatory examination of a 25-year-old soldier in a psychiatric clinic, psychopathy features were observed, and an intracranial foreign metal body, a sewing needle, was found. The patient and his parents did not know the existence of the intracranial sewing needle until the examination. The parents could not give any anamnestic information to the doctor regarding the existence of the sewing needle in the intracranial region.

Clearly, the sewing needle can be entered into intracranial region only till the period in which the sinciput becomes firm. As the needle tip was pointing down, the needle was deemed pricked intentionally. Further investigation showed that the patient was the only grandson in the family, near relatives enviously placed the sewing needle into his intracranial region from the sinciput to murder him while he was still a baby. The accident was evaluated as a result of an unsuccessful crime.

Thus, instrumental examinations (roentgenography of the skull in two projections, computed tomography, nuclear magnetic resonance examination, etc.) are necessary for patients with psychiatric problems.

Russian Journal of Forensic Medicine. 2023;9(3):329-336
pages 329-336 views

Issues on forensic diagnostics for pyrethroid lambda-cyhalothrin poisoning

Chizhikova I.O., Gornostaev D.V., Shigeev S.V.

Abstract

This is a case of poisoning with lambda-cyhalothrin, a synthetic pyrethroid, in a family of three (2 deaths). A postmortem examination revealed biochemical and micromorphological markers of lambda-cyhalothrin poisoning. In addition, an experimental model using laboratory animals (rats) was created to confirm the possibility of developing these lesions during the course of synthetic pyrethroid poisoning. Indeed, not only a similar clinical picture but also the same laboratory results were obtained.

Russian Journal of Forensic Medicine. 2023;9(3):337-348
pages 337-348 views

Forensic medical cytological examination of the trace evidence on the knife’s blade in the case of multiple penetrating stab/cut wounds in the chest with lung damage: a case report

Kidralieva A.P., Fedorovtsev A.L., Kidraliev R.R.

Abstract

Various trace evidence are often found on the instruments of mechanical injury, including microparticles of human’s damaged organs and tissues. The detection of cells and microparticles of organs and tissues on the instrument of injury confirms its contact with the human body, which is of great evidentiary value.

The article presents the results of forensic medical cytological examination of biological evidence taken from the knife’s blade in the case of multiple penetrating stab/cut wounds in the chest that result in lung damage. Microscopic preparations were made from the traces on knife’s blade, which were stained with fluorochrome solutions (0.0005% aqueous solution of atebrine and 0.01% solution of acridine orange). The study was performed using the luminescent microscope Leica DM2500 (20× and 60× lenses, 10× eyepiece). The examination of microparticles of the striated skeletal muscle revealed areolar connective and fat tissues with capillary and arteriole fragments. The isolated mesothelial cells and type II pneumonocytes were also detected. Fibers of the striated skeletal muscle tissue looked like long multinucleated cells with distinguishing cross-striation. The areolar connective tissue was represented by loosely arranged fibers embedded in the ground substance. Fragments of the fat tissue looked like the clusters of round and oval large cells, tightly pressed together, with capillaries, and arterioles in between. Y-chromatin was detected in the nuclei of most cells. In addition, human blood was found on the knife’s blade.

Thus, the study revealed that tiny particles of tissues and isolated human cells of the male genetic sex were detected, their organ–tissue affiliation was established, which is a valuable diagnostic finding, because it confirms the contact of the trauma instrument with the human body.

Russian Journal of Forensic Medicine. 2023;9(3):349-354
pages 349-354 views

Book reviews

Review of the textbook “Forensic medical assessment of traumatic brain injury” V.A. Klevno, V.V. Frolov, I.A. Frolova

Maksimov A.V.

Abstract

The author gives a review of the textbook prepared by the team of authors V.A. Klevno, V.V. Frolov, and I.A. Frolova titled “Forensic medical assessment of traumatic brain injury.”

This textbook serves as a good addition to the textbooks on forensic medicine and contains basic information about various types of traumatic brain injury required by a forensic medical expert in the production of the most common forensic medical examination of corpses and living persons with head injuries.

The publication is intended for residents studying in the specialty “Forensic medical examination” and can also be recommended to teachers of the departments of forensic medicine, practicing forensic medical experts, graduate students, medical specialty students, and a wide range of readers.

Russian Journal of Forensic Medicine. 2023;9(3):357-362
pages 357-362 views

Review of the book “Radiology in Forensic Medicine. From Identification to Postmortem Imaging” translated from English under the editorship of Professor V.A. Klevno

Tsiatsiuyeu A.M.

Abstract

The book “Radiology in Forensic Medicine. From Identification to Postmortem Imaging,” translated from English under the editorship of Professor V.A. Klevno, is reviewed.

The review aimed to objectively evaluate the content of the scientific and practical publication and to determine its value for science and practice.

The book consists of 29 chapters. Each chapter includes a list of references. The history of forensic radiology is briefly described, and the advantages, and disadvantages of traditional autopsy versus postmortem imaging are reviewed. This book focuses on postmortem imaging in forensic medicine and special forensic radiology, including imaging of corpses after various types of external exposure, during sudden death, of fetuses, and newborns and of putrefied and charred corpses. Several chapters are devoted to imaging in clinical forensic medicine to assess injuries, detect drug smuggling by body packers, and diagnose some occupational diseases. The role of postmortem imaging in identifying victims of mass disasters is discussed. The authors critically evaluate the advantages and limitations of “virtual autopsy.”

Given the advancements of interdisciplinary approaches in forensic medicine and the increasing role of radiologists in forensic practice, the publication of this book in Russian is more relevant than ever. It will be of interest to both forensic physicians and radiologists.

Russian Journal of Forensic Medicine. 2023;9(3):363-367
pages 363-367 views


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