Vol 8, No 4 (2022)

ORIGINAL STUDY ARTICLES

A radiomorphometric evaluation of age-related changes in mandibular morphology

Harshitha N., Patil K., Sanjay C.J., Nagabhushana D., Viveka S.

Abstract

AIMS: The main aim of this study was to determine, compare and differentiate the morphologically related changes of the mandible in dentate males and females among different age groups on digital panoramic images and to assess their authenticity in age estimations to provide evidence in forensics.

MATERIALS AND METHODS: Digital panoramic images were made of 620 subjects, belonging to into four groups of ages ranging between 12–18 years, 19–40 years, 41–60 years, and older than 60 years. Measurements such as gonial angle, condylar length, ramus length, cortical bone thickness, and ramal notch width were measured and evaluated. The data obtained was then subjected to descriptive statistical analysis followed by a Paired t-test and a Two-way ANOVA test to arrive at the results.

RESULTS: On measuring an angular and four linear measurements a statistically significant differences were found among all the age groups with p <0.05 and also increased on aging except for the gonial angle. Among all the parameters, the gonial angle, ramus length, and ramal notch width depicted a statistically significant difference between the right and left sides and with p <0.05.

CONCLUSION: Age estimation with linear and angular measurements of the mandible was possible among the study population. It is found that all parameters except gonial angle are reliable for age determination. It was found that as age increased, the mean value of all the parameters increased and showed a significant difference between all age groups except the gonial angle. Hence, this study positively recommends the use of all parameters except gonial angle for the purpose of age estimation in the field of forensics.

Russian Journal of Forensic Medicine. 2022;8(4):5-14
pages 5-14 views

Damage to neurons of the cerebral cortex in acute poisoning with baclofen and its combination with ethanol

Romanova O.L., Golubev A.M., Churilov A.A., Sundukov D.V., Kislov M.A., Ershov A.V.

Abstract

BACKGROUND: The number of poisoning with a muscle relaxant baclofen has increased recently. The brain is one of the target organs in baclofen poisoning.

AIM: To identify and quantify cerebral cortex neuron damage in baclofen and baclofen ethanol poisoning.

MATERIAL AND METHODS: A histological study of rat cerebral cortex was performed. The controls (n = 5) received neither baclofen nor ethanol. Groups 1 and 3 received baclofen (85 mg/kg), whereas groups 2 and 4 received baclofen (85 mg/kg) and ethanol (7 ml/kg). Groups 1 and 3 were euthanized 4 h after the drug administration, whereas groups 2 and 4 were euthanized after 24 h. Histological sections were stained with hematoxylin and eosin and by the Nissl method and examined by light microscopy (×400). The number of damaged neurons was calculated. Statistical processing was performed by the nonparametric Mann–Whitney method.

RESULTS: Neurons with reversible and irreversible changes in the controls accounted for 13% and 9%, respectively. At 4 h after baclofen administration, neurons with reversible and irreversible changes accounted for 22% and 21%; 4 h after baclofen and ethanol administration, 24% and 29%; 24 h after baclofen administration, 25% and 37%, respectively. Baclofen and ethanol administration caused an increase in the share of neurons with reversible (27%) and irreversible (41%) changes. The differences between group 3 and the control group were significant, and the difference was significant when group 4 was compared with the control group and group 3.

CONCLUSION: Understanding the processes in the brain during baclofen and baclofen ethanol administration will allow the provision of medical care to this category of patients more effectively. The signs of brain neuron damage, along with the results of forensic chemical analysis, can be used to establish the immediate cause of death.

Russian Journal of Forensic Medicine. 2022;8(4):15-24
pages 15-24 views

Determination of human sex by odontometric characteristics using equations of logistic regression

Ibragimov A.S., Musayev S.M.

Abstract

BACKGROUND: The development of methods for identifying a person based on bone remains, which are adapted for diagnosing the population of Azerbaijan, is a priority in view of the incompleteness of solving this problem. In this situation, a new way to quickly determine the sex by teeth appears to be in demand because it should increase the efficiency of the work of forensic doctors.

AIM: To develop a modern technique for diagnosing a person’s sex using odontometric signs.

MATERIALS AND METHODS: Teeth sizes were studied at the craniological collection of Azerbaijanis. On the seven teeth of the upper and seven teeth of the lower jaw, three parameters were measured (while symmetrical teeth were considered a single array). Each of the 14 anatomical teeth was represented by 80 male and 80 female teeth. A digital caliper (Mutitouyo; accuracy 10 microns) was used for odontometric procedures. Odontometry results were analyzed by statistical methods using receiver operating characteristics curve analysis. Mathematical modeling was conducted using the MATLAB statistical software package.

RESULTS: With the help of the receiver operating characteristic curve (ROC) analysis, the data obtained in the course of odontometry were studied. Six odontometric signs were related to sex. The most sex-related parameters were the buccolingual diameter of the upper canine, heights of the crowns of the second lower molar, lower incisors, lower canine, and upper central incisor. Using mathematical modeling, six logistic regression equations have been implemented, which help determining the sex of an individual by the size of his teeth possible. The predictive potential of the equations was also assessed using the ROC analysis.

CONCLUSION: Based on odontometric indicators and ROC analysis, diagnostic equations for determining the sex of a person by the teeth size were obtained. The equations have not yet been verified on independent samples; therefore, they cannot yet be unconditionally recommended for practice. Nevertheless, the authors count on the high legitimacy of their models because they used a fairly powerful mathematical apparatus.

Russian Journal of Forensic Medicine. 2022;8(4):25-36
pages 25-36 views

Forensic medical analysis of the dynamics of death rates in suicides

Giyasov Z.A., Makhsumkhonov K.A., Bakhriev I.I., Islamov S.E.

Abstract

BACKGROUND: The increase in the number of completed suicides associated with multiple risk factors is a worldwide concern. The rates of completed suicide in both sexes, according to different researchers, differ significantly.

AIMS: To investigate the sex characteristics of death rates of completed suicide.

MATERIALS AND METHODS: Mortality rates using information from official reports on the activities of forensic medical institutions from 1992 to 2019 were analyzed retrospectively.

RESULTS: The results of the analysis of suicide mortality rates indicate that suicides have natural features of development, i.e., a cyclical change in the states of indicators, namely, rise, decline, wave-like flow, characterized by certain periodicity, and constancy (stability of the occurrence of the phenomenon on a national scale). During the study period, completed suicides accounted for 14.0% of the total number of examinations of corpses and 21.4% of all cases of violent death. An analysis of the absolute number of suicide-related deaths by sex revealed a clear predominance of suicides in men (n = 33,888) compared with women (n = 16,036), which counted for 67.9% and 32.1%, respectively. The ratio of the absolute number of completed suicide cases in the group of men and women was approximately 2:1. Suicide mortality rates make it possible to conclude about the nature of this phenomenon in the country as permanent and sustainable.

CONCLUSION: The results of the study of completed suicides in Uzbekistan for the period 1992–2019 allow us to assert that completed suicides as a phenomenon have their natural features of development, namely, the constancy of changes (stability of the occurrence of the phenomenon) and cyclicity (cyclic change of the states of indicators, i.e., rise, decline, wave-like flow, and certain periodicity).

Russian Journal of Forensic Medicine. 2022;8(4):37-46
pages 37-46 views

Detection of clobazam and its metabolites in urine during poisoning using HPLC-QqQ-MS/MS

Volkova A.A., Kalekin R.A., Orlova A.M.

Abstract

BACKGROUND: Determining the incidence of acute and lethal poisoning with clobazam remains an urgent task of analytical toxicology. The medicinal substance clobazam belongs to the group of benzodiazepines, which is included in the list of psychoactive substances whose turnover is limited because of its high toxicity profile in overdose and abuse.

AIM: To propose a simple, reliable, and sensitive technique for the identification of clobazam and its metabolite in the urine by the modern high-performance liquid chromatography-tandem mass spectrometry (HPLC-QqQ-MS/MS).

MATERIALS AND METHODS: We have described a simple and sensitive HPLC-QqQ-MS/MS method for the qualitative determination of clobazam in the urine.

RESULTS: The retention time in the selected chromatography conditions for clobazam was 5.17 min, and its metabolite (norclobazam) in urine was 4.56 min. The base peaks for clobazam and norclobazam were 259 m/z and 245 m/z, respectively.

CONCLUSION: For the first time, this study provides a validated method of chemical-toxicological examination for poisoning with clobazam by HPLC-MS/MS, tested both on a model mixture and real biological matrix of the patient’s urine after taking clobazam. This technique can be a confirmatory research method in addition to the clinical picture in forensic medical examination.

Russian Journal of Forensic Medicine. 2022;8(4):47-55
pages 47-55 views

Characteristics of injuries in cyclists injured when other vehicles collide with the side of the body of moving bicycles

Indiaminov S.I., Abdumuminov K.N., Boymanov F.K.

Abstract

BACKGROUND: Bicycle injuries, as a separate type of traffic accidents, require forensic medical examinations to establish the mechanism, duration, and severity of injuries. Forensic medical aspects of cycling injuries are insufficiently covered in the literature.

AIM: To study the nature and features of the injury formation in cyclists who sustained injured when other vehicles hit the side of the moving bicycle.

MATERIALS AND METHODS: The results of forensic medical examinations of 51 cyclists who died when the moving bicycles collided with the side of vehicles.

RESULTS: The most frequently observed injuries in cyclists are traumatic brain injury (21.56%) and combined injuries, namely, head and chest (15.68%), lower extremities with trauma to the head, and chest (11.76%). Nearly all deceased cyclists sustained damage to the head (96.0%), which was characterized by the formation of a severe contusion of the brain with fractures of the parietotemporal and occipital bones. Damage to the chest and chest cavity organ was also observed frequently (50.69%). Rib fractures were noted in 74.2% of cases. Injuries to the abdominal organs were detected in 20.15% of the cases, such as liver rupture and hemorrhage in the ligaments of organs. Diaphyseal comminuted fractures of the bones of the lower leg and femur were also observed.

CONCLUSION: The most common types of injuries in deceased cyclists in a side collision of other vehicles with a moving bicycle are traumatic brain injury and combined injuries of the head, chest, and fractures of the bones of the lower extremities in combination with a head and chest injury. Damage to the head was characterized by the formation of linear, depressed, and comminuted fractures of the parietal–temporal and occipital bones. Damage to the chest was characterized by fractures of the upper ribs and bruises of the lungs. Damage to the skin, resembling a picture of a “road rash,” was noted on the anterolateral body parts.

Russian Journal of Forensic Medicine. 2022;8(4):57-65
pages 57-65 views

REVIEWS

Perspectives of the study of cutting and stabbing damages caused by knives with various spine thicknesses

Potankina T.V., Lysenko O.V., Klevno V.A.

Abstract

Injuries caused by pointed or bladed objects cover the biggest part of all injuries caused by sharp objects.

The last decades of scientific studies in forensic medicine have dedicated to forensic medicolegal traumatology due to a steady growth in the number of forensic examinations connected with mechanical injuries. Data about the morphology, mechanism, and biomechanical causation of cutting and stabbing damages have been studied and summarized. Some morphological features of cutting and stabbing damages of osseous tissue appeared according to material cutting theory. Forensic identification of pointed or bladed articles was examined according to features of injuries on human tissues and clothes.

Nowadays, scientific literature shows that a knife’s spine is considered the traumatic part of a blade. In the identification and examination of the pointed or bladed trace-forming objects, “a spine zone” is used. There has been an overview on the influence on the trace-formation process of knife edges. However, the morphology of pointed or bladed injuries of the bones according to the thickness of a blade has not been examined comprehensively.

To improve forensic research of injuries of flat bones (os planum) caused by pointed or bladed articles based on a complex of morphological features, experimental studies using cadaveric materials are needed.

Russian Journal of Forensic Medicine. 2022;8(4):67-75
pages 67-75 views

Electric scooters and associated injuries: forensic aspects

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

Abstract

Examinations in relation to living persons and of corpses of persons injured in incidents involving ground wheeled vehicles remain one of the leading places in the practical activities of forensic medical experts. Over the past 3–5 years, the means of individual mobility have become increasingly widespread. The use of means of individual mobility naturally leads to an increase in road accidents.

To date, coverage of issues related to automobile, motorcycle, and even bicycle injuries is sufficient. However, no data on scooter trauma in the domestic forensic literature is limited, which cannot be said about the work of foreign authors.

This literature review provides some epidemiological data and information on the mechanism and type of damage in cases of injuries involving electric scooters. This kind of road incidents, including fatal ones, was statistically analyzed. Scooter trauma is characterized by its seasonality with an upward trend mainly in the warm months of the year (summer and early autumn). Young persons who directly control electric scooters are often injured. Falls in the predominant type of incident. The most “traumatic” parts are the head and limbs. Injuries are isolated in nature and can be both external (such as abrasions, bruises, and wounds) and internal (such as fractures). Visceral injuries in scooter injuries are extremely rare.

Russian Journal of Forensic Medicine. 2022;8(4):77-88
pages 77-88 views

CASE REPORTS

Possibilities of diagnosing stab-cut wounds in living persons using computed tomography results

Leonov S.V., Pinchuk P.V., Shakiryanova J.P., Troyan V.N.

Abstract

Currently, modern research methods such as computed tomography and magnetic resonance imaging have been introduced into the medical and diagnostic practice of large hospitals. These research methods are used almost everywhere for the diagnosis of various injuries, and their results, together with the medical documents of the victims, law enforcement officials, and courts provide state forensic medical expert institutions for the production of forensic medical examinations. The study of computed tomography and magnetic resonance imaging results allows solving expert questions in examinations and studies of living persons.

The article presents a case from expert practice demonstrating the possibility of establishing the morphology and localization of stab-cut injuries, number of traumatic effects, and direction of wound channels using the results of in vivo computed tomography and three-dimensional modeling. In the described expert case, initially, in the submitted medical documents, data were contradictory about the number, localization and mechanism of formation of wounds. To eliminate existing contradictions, the scars on the victim’s body and results of a computed tomography upon admission were examined. For a more complete visualization of external injuries, a three-dimensional model of the victim’s body was recreated from computed tomography data. The results of computed tomography and three-dimensional modeling made it possible to clearly recreate the picture of the victim’s injuries and answer questions about the mechanism and conditions of their infliction.

The described case demonstrates the possibilities of expert research and new methodological approaches to solving forensic problems, which is currently quite relevant, since virtopsia has been actively developing in forensic medicine in recent years. The proposed research techniques applied to a corpse with stab wounds will make it possible to more accurately visualize the direction and shape of the wound canal.

Russian Journal of Forensic Medicine. 2022;8(4):89-96
pages 89-96 views

Clinical and morphological features of malignant hyperthermia: a rare case from practice

Anichkov N.M., Kalinina E.Y., Davydova Z.V., Shcherbakova E.V., Yagmurov O.D.

Abstract

Malignant hyperthermia, is one of the most serious complications of modern anesthesia, which is a pharmacogenetic disease phenotypically manifested by skeletal muscle hypermetabolism and rhabdomyolysis during or after general anesthesia using inhalation anesthetics. An unexpected increase in CO2 concentration at the end of exhalation is the most common initial sign of malignant hyperthermia. Atypical forms of this pharmacogenetic disease are observed much more often than lightning or fulminant. In Russia, malignant hyperthermia currently remains a problem.

We present a case of malignant hyperthermia in a 19-year-old girl who underwent surgery for nasal breathing disorders and received Sevoran anesthesia as support. The patient died 1 h 25 min after the surgery during withdrawal from anesthesia caused by a clinically confirmed syndrome of malignant hyperthermia. Forensic autopsy confirmed this diagnosis. The morphological changes in the skeletal muscles using both plain and elective histological stains were described.

The presented observation is valuable owing to the rarity of lightning-fast forms of malignant hyperthermia and the high lethality accompanying these pathologies. This expert case demonstrate how a competent and comprehensive histological examination, including the use of genetic testing, allows correct formulation of a diagnosis and, if necessary, reasonably answer questions from law enforcement agencies.

Russian Journal of Forensic Medicine. 2022;8(4):97-104
pages 97-104 views

GUIDELINES

II Scientific and practical conference of the Interregional Thanatoradiological Society “Radiological diagnostics for pathological anatomy and forensic medicine: from lifetime to postmortem”

Shchegolev A.I., Tumanova U.N.

Abstract

Brief report on the II Scientific and practical conference of the Interregional Thanatoradiological Society “Radiological diagnostics for pathological anatomy and forensic medicine: from lifetime to postmortem,” which took place on October 7–8, 2022, in Moscow on by the Avtsyn Research Institute of Human Morphology of Petrovsky National Research Center of Surgery.

Russian Journal of Forensic Medicine. 2022;8(4):105-110
pages 105-110 views


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