Coronary vasospasm and coronary artery dissection are two recognized causes of Sudden Cardiac Death [SCD] in association with Myocardial Infarction in Non-Obstructive Coronary Artery [MINOCA]. This is a case of post procedure death in a 50-year-old female during cardiac angiography, who had a family history of coronary spasm with sudden cardiac death in her mother. She went into cardiac arrest during the procedure with iatrogenic acute coronary dissection which was treated with LMS/LCx vessel stenting. However, she died in 4 days post procedure. Postmortem cardiac examination demonstrated a transmural hemorrhagic infarction of the entire circumferential wall of the left ventricle with normal coronaries both macroscopically and microscopically. Acute coronary dissection was confirmed histologically in the left main stem.Coronary vasospasm is transient constriction of coronary arteries, which causes partial or complete obstruction of the vessels. The exact pathophysiological mechanism is poorly understood, but atheroma, drugs and a genetic predisposition are common associations. This case highlights the strong genetic link of coronary vasospasm in both mother and daughter and also the complication of iatrogenic coronary dissection which is a rare, but serious complication reported in about 0.1% of coronary angiography. This is the first postmortem report of procedure-related dissection in a patient with vasospasm indicating the cause is functional. Forensic practitioners need to be aware of coronary vasospasm and the complications of coronary angiography as a cause of acute myocardial infarction. Detailed autopsy yields valuable information in this rare condition.

This review research critically assesses the evolving landscape of age estimation methodologies, with a particular focus on the innovative integration of histomorphometry and artificial intelligence (AI) in the analysis of the medial clavicle. The medial clavicle emerges as a crucial skeletal feature for predicting age, offering valuable insights into the morphological changes occurring throughout an individual's lifespan. Through an in-depth exploration of histological complexities, including variations in osteons, trabecular structures, and cortical thickness, this review elucidates their utility as viable indicators for age-related evaluations. This framework is augmented by the incorporation of AI technology, which enables automatic picture identification, feature extraction, and complicated pattern analysis. Our review of previous research highlights the promise of AI in improving prediction models for nuanced age estimates, highlighting the importance of large-scale, diversified datasets and thorough cross-validation. This thorough study, which addresses ethical concerns as well as the influence of population-specific characteristics, moves the debate around age estimate ahead, presenting insights with consequences for forensic anthropology, clinical diagnoses, and future research avenues.

The aim of the present study was to provide a forensic psychiatric characterization of perpetrators of parricide who were found not guilty by reason of insanity (NGRI). We conducted a study involving 52 NGRI patients who had committed homicide or attempted homicide within the Department of Forensic Psychiatry in Thessaloniki, Greece, between January 2015 and 2020. Subjects were categorized into two groups: parricide ( = 21) and a control group ( = 31). Our findings revealed that in the parricide group, the majority of patients were unmarried males in their thirties, with a history of prior contact with mental health services and nonadherence to treatment. Additionally, they had a background of substance abuse and exhibited violent behavior before the index crime. A notable trend observed among parricide offenders was the tendency to seek hospitalization, possibly as a means of distancing themselves from stressful family environments, based on information obtained in the interviews conducted as a part of this research. All instances of parricide involved the use of sharp weapons, and the crimes were consistently committed in private settings. Symptomatology among parricide patients was assessed as moderate to severe, with a significant long-term risk observed following the crime. The primary differences identified between the two groups were the higher pre-crime voluntary admissions and the elevated estimated postcrime risk observed in the parricide group. Early intervention, comprehensive assessment of risk factors, family support, and assistance in resolving conflicts and reintegrating patients into society are emphasized as critical interventions that can potentially prevent future tragedies.

The postmortem interval (PMI) is a crucial factor in death investigations. For PMIs exceeding 24 h the forensic pathologist must turn to other specialties that focus on decompositional ecology of animals, including humans. Primary among these specialties is forensic entomology. Here, we review the importance of forensic entomology in estimating the PMI, and we examine the factors that influence these estimates. Among key concerns are environmental factors, especially temperature, and aspects of insect biology. Additionally, we examine current methods used for calculating PMI based on insects and their development.

The diversity of dental patterns is a fundamental topic in disaster victim identification. The current scientific literature, however, is scarce of data regarding young individuals. This study aimed to assess the radiographic diversity of dental patterns, considering missing, unrestored, and filled teeth in young individuals. The sample consisted of 7219 panoramic radiographs of individuals between 12 and 22.9 years. The permanent teeth, except third molars, were coded as missing, unrestored, or filled and odds ratios (OR) were calculated based on sex, dental arch, and age. The sex-combined sample had 1.116 distinctive dental patterns. "All unrestored" teeth was the most common pattern (OR: 0.437) followed by the sequence of unrestored teeth except restored mandibular first molars (OR: 0.021). Females had more distinctive dental patterns than males (< .001), while males had more unrestored teeth (< .001). In the age category of 12-12.9 years, the OR for finding a distinctive dental pattern was 11%, while in the age category of 22-22.9 years it increased to 58%. On the other hand, the OR for "all unrestored" gradually decreased according to age (74% in the younger category, and 23% in the older age category). The distinctiveness of dental patterns among young individuals is affected by the predominance of unrestored teeth. However, registering a single filled tooth in a remaining unrestored dentition can reduce exponentially the probability of finding an identical pattern of missing, unrestored and filled teeth.

Ever since patients started to be admitted into mental institutions, absconding from such institutions has been a fact of life. Also, clear statutory authority to retake absconders has existed since county asylums, the forerunners of today's mental hospitals, started to be built following the County Asylums Act 1808. At present section 37 of the Mental Health Act 1983 concerns patients detained under a hospital order without restrictions on their discharge, etc. Section 3 of the Act, on the other hand, governs patients who are non-offenders but who are compulsorily detained in hospital for treatment. In the past, where a detained patient absconded from hospital and stayed at large beyond the period during which he could be retaken, he was deemed automatically discharged (i.e. 'discharged by operation of law'). Regarding sections 3 and 37 patients, such discharge was effectively abolished by the Mental Health (Patients in the Community) Act 1995. Not much attention has been given to this topic in the literature. This article adopts a solely legal perspective. It looks briefly at when the power to retake absconders from mental hospitals may be exercised and then examines the concept of discharge by operation of law and its abolition. It concludes that the abolition of discharge by operation of law in the case of patients detained under sections 3 and 37, Mental Health Act 1983 was, though long-overdue, sensible and must be applauded.

Femicide, the killing of women, girls, and infants, is a pervasive problem affecting all global societies. Policy and research are impeded by inaccurate and missing prevalence data, gaps in understanding of femicide, especially for hard-to-reach marginalized populations, and conflicting perceptions between jurisdictions. Leveraging on a combined socio-ecologic model and Public Health approach, the paper spans the methods of a computed tomography-based injury study, an in-depth media-analysis, a legislation evaluation study, and a data barriers' study. Injury patterns, media depiction, and end-user consultations will close the loop on residual problems such as implementation, data gaps, and cultural perceptions. By mixed methods research representing multiple regions, and stakeholders, this project will enhance knowledge on interpersonal, institutional, and societal factors of femicide, advancing the humanitarian forensic discipline. The research method will identify emerging trends and facilitate improvements in tertiary prevention of femicide, specific to resource settings.

This article provides an analysis of the legal rights and protection accorded to fetuses under the Nepali law and the comparative common statues. It also analyses the abortion law in Nepal, which aims to balance the needs of women seeking abortion with limited protections for late-term fetuses. The article considers the case, "Lakshmi Dhikta v. the Government of Nepal," which held that access to abortion was a constitutionally formed right. However, barriers to this right still exist, especially among disadvantaged women. Globally, the debate continues between those who advocate for the rights of the fetus and those who put the autonomy of the women first. While some countries grant the fetus limited legal rights, others grant the fetus personhood rights. It is therefore pertinent to discuss the ethics of prenatal harm, sex-selective abortion, and the possible conflict between maternal and fetal interests. The multifaceted law should regulate maternal health, the interest of the fetus, and discrimination while ensuring feasible and affordable abortion.

As a part of a study of suicide in children aged 17 years and under in three centers-Hennepin County in the United States (US), Auckland in New Zealand (NZ), and South Australia in Australia (AUS) from 2008 to 2017 it was decided to characterize potential risk factors and to determine whether these differed by jurisdiction. Reviewed data included a history of psychiatric illness, symptoms prior to suicide, events preceding suicide, previous suicidal ideation or suicide attempts, and communication of suicidal intent. The most common events preceding suicide were arguments with family/friends and relationship issues; in addition depression with or without expressed suicidal ideation, self-harming behavior, sadness, distress, drug/substance abuse, and anorexia were documented. Suicidal intent was on occasion communicated via technological means. In 79.5% of cases in South Australia decedents had a previously diagnosed psychiatric illness, with 62% in Hennepin County. This compared to a much lower proportion of cases in Auckland (23.8%). Whether this reflects more limited access to psychiatric services or a reluctance to seek support and therapy in Auckland is unclear. It does, however, demonstrate that risk factors for child suicide are not uniform among communities and so extrapolation of data from one area to another may not be appropriate. Disturbingly parents/carers were not aware of the decedent's suicidal intent in 84-87.2% of cases.

Xylazine, a non-opioid veterinary anaesthetic tranquillizer that is not licensed for human use, has been linked to an increase in overdose fatalities worldwide. The study delves into the forensic aspects of xylazine usage, emphasizing on chemical, clinical and toxicological analyses of drug seizures, bodily fluids and tissues. It advocates for validated analytical methods for determining xylazine. This study provides supporting material to pave the path for the usage and development of relevant and verified alternative screening and confirmation methods for laboratories. Google Scholar, Scopus, Science Direct and PubMed were searched for relevant articles and case reports in relation to xylazine misuse and established analytical methods for forensic investigation until April 2023. A total of 79 articles were evaluated, and 40 publications met the inclusion criteria. The most prevalent xylazine exposures recorded were incidental and intentional misuse/abuse. Common symptoms upon presentation were hypotension, bradycardia, drowsiness and lethargy, although mortality was less prevalent. Solid-phase extraction and liquid-liquid extraction are two extensively used sample preparation techniques. These techniques are used to extract desired analytes from complex matrices. Several analytical techniques have been stated, including GC-MS, LC-MS/MS, HPLC-DAD and others. The analytical procedures used are determined by the matrices involved, the amount of xylazine present, interfering compounds, the degree of precision required and the laboratory infrastructure. In the present context, the LC-MS/MS methods are preferred as the gold standard. In the near future, many analytical techniques such as capillary electrophoresis, PSI-MS, immuno-analytical techniques and SERRS may show significant potential.

Autolytic and putrefactive processes can cause considerable alterations to soft tissues and internal organs that may complicate forensic assessments. An overview was undertaken of the range of taphonomonic changes and processes that may result from postmortem putrefactive gas accumulation. The most commonly encountered phenomenon was purging of putrefactive fluids from the nose and mouth that was on occasion confused with bleeding from antemortem trauma. Much less common was putrefactive 'rigor mortis' where the limbs extend due to the accumulation of soft tissue and subcutaneous gas. This may sometimes be associated with alteration of the position of a body suggesting that it had been deliberately moved. Distension and stretching of the skin and subcutaneous tissues may cause recently sutured surgical incisions to dehisce, raising the possibility of inflicted incised wounds. Raised intra-abdominal pressures may cause diaphragmatic herniation of small intestine and has been associated with so-called 'coffin birth' where a fetus is expelled from the uterus after death due to pressure on the fundus. Gas accumulation on postmortem computed tomography examination may be confused with air embolism or the effects of trauma. All of these changes are the result of anaerobic bacterial action generating gases such as methane, carbon dioxide and hydrogen sulphide resulting in pressure gradients.

A case of septic pulmonary thromboembolism arising from thrombophlebitis of the prostatic venous plexus associated with long-term urinary catheterisation in a 51-year-old man is reported. Despite a previous autopsy having been conducted in the country where he had been resident overseas, a re-examination showed histological evidence of mild patchy chronic prostatitis with a florid, focally purulent, thrombophlebitis of the periprostatic venous plexus with abscess formation and evidence of bacterial overgrowth. Corresponding microscopy of the lungs showed septic microthromboemboli within small pulmonary arteries with variable degrees of necrotising acute inflammation and thrombosis. Death was not due to 'acute pulmonary oedema' as had been originally certified but to septic thromboembolism. This case demonstrates the need to carefully evaluate the prostatic venous plexus at autopsy, and also the type of problems that may arise at the time of the re-examination of repatriated remains.

This article describes the utility of postmortem CT and MRI in diagnosing pediatric bowel obstruction (BO) as the cause of septic shock-induced death. Six pediatric cases with confirmed septic shock were retrospectively analyzed. Postmortem CT scans revealed clear signs of BO in all cases, with volvulus, intussusception, diaphragmatic hernia, or Meckel's diverticulum identified. MRI scans, performed in three cases, did not provide additional diagnostic information. The presented case series highlights the potential of postmortem CT for diagnosing BO in children, potentially aiding in understanding the cause and manner of death. While MRI offered limited additional benefits, its role in conjunction with CT and autopsy warrants further exploration. Combining these modalities could enhance diagnostic accuracy and provide a more complete picture of the cause of death in children.

In the recent past, human genetics and in vitro fertilization (IVF) have undergone various advances to combat with several congenital and developmental disorders. These advances are a boon for the families and patients who were restricted from having a child due to one or the other reasons. One such reason is the mitochondrial DNA (mtDNA) mutations, which are definitely transmitted from the mother to the child due to uniparental/maternal inheritance of mitochondria. Depending upon the range of the mutation (mutation loads) present, the mtDNA mutation leads to various devitalizing to fatal disorders, all of which are incurable. Scientists and researchers developed a technique known as mitochondrial donation technique or mitochondrial replacement therapy (MRT) to combat with the mtDNA mutations. The technique relies on the replacement of faulty mitochondria in the mother's egg with the normal wild-type from a donor female resulting in a "three-parent baby." On the other side, forensic scientists and anthropologists continuously explore the mtDNA in various medicolegal cases and in uncoupling the mystery of human origin and migration respectively. In this regard, we explored the genetic, forensic and ethical aspects of a "three-parent baby." The present communication also attempts to highlight the importance and limitations of the MRT technique/three-parent baby in a medicolegal context.

Many people are living in prison with a range of social care needs, for example, requiring support with washing, eating, getting around safely, and/or maintaining relationships. However, social care for this vulnerable group is generally inadequate. There is uncertainty and confusion about who is legally responsible for this and how it can best be provided, and a lack of integration with healthcare. We used realist-informed approaches to develop an initial programme theory (IPT) for identifying/assessing social care needs of, and providing care to, male adults in prison and on release. IPT development was an iterative process involving (a) an initial scoping of the international prison literature; (b) scoping prison and community social care policy documents and guidelines; (c) full systematic search of the international prison social care literature; (d) insights from the community social care literature; (e) stakeholder workshops. Information from 189 documents/sources and stakeholder feedback informed the IPT, which recommended that models of prison social care should be: trauma-informed; well integrated with health, criminal justice, third-sector services and families; and person-centred involving service-users in all aspects including co-production of care plans, goals, and staff training/awareness programmes. Our IPT provides an initial gold standard model for social care provision for people in prison and on release. The model, named Empowered Together, will be evaluated in a future trial and will be of interest to those working in the criminal justice system, care providers and commissioners, local authorities, housing authorities, voluntary groups, and service-users and their families.

Opioid abuse is a leading cause of drug-related morbidity and mortality worldwide. It has been suggested that the age of opiate users in Australia is rising. To evaluate this further in a local population, toxicology and pathology case files from Forensic Science SA, Adelaide, South Australia, were examined for all cases with lethal opioid levels from 2000 to 2019 ( = 499; M:F 2.3:1; age range 18-91 years, median age 42 years). The median age of opiate deaths increased significantly by approximately 16 years (= 0.007, = 0.34) with a significant increase in total deaths in the 45-54 years and 55-64 years age groups (= 0.009, = 0.32) (= < 0.001, = 0.54). Deaths due to heroin overdose showed the lowest median age (39 years,  = 184), with deaths from tramadol toxicity having the highest (50.5 years,  = 32). Recent changes in the demographic profile of opioid users in cases of lethal overdose involve an aging population. Forensic and clinical practitioners should be aware of significant opioid abuse in certain individuals at older ages as this raises the possibility that this may exacerbate the effects of age-related chronic diseases in this group and/or contribute to fatalities.