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Undiagnosed rheumatic carditis causing sudden death in a young adult: A case report and review. 未确诊的风湿性心脏病导致一名年轻成人猝死：病例报告与回顾
Medico-Legal Journal Pub Date : 2025-09-01 Epub Date: 2024-05-01 DOI: 10.1177/00258172241230207
Bajrang K Singh, Jitendra S Tomar, Ravi Jain, Surya Prakash, Suyasha Narayan
{"title":"Undiagnosed rheumatic carditis causing sudden death in a young adult: A case report and review.","authors":"Bajrang K Singh, Jitendra S Tomar, Ravi Jain, Surya Prakash, Suyasha Narayan","doi":"10.1177/00258172241230207","DOIUrl":"10.1177/00258172241230207","url":null,"abstract":"<p><p>Acute rheumatic fever-related acquired heart disease in children and young adults is a worldwide issue, but it poses a serious public health threat in developing nations like India. We present a case report of a young adult who collapsed suddenly during a routine walk and was declared dead in an emergency ward on arrival. There was no significant past medical history. On autopsy, massive cardiomegaly and a \"butter and bread\" appearance of the pericardium, along with findings suggestive of mitral stenosis and aortic regurgitation, raised suspicion about rheumatic heart disease. Rheumatic carditis was confirmed by a microscopic examination that showed Aschoff bodies in the left ventricle, mitral valve and interventricular septum, in addition to uncommon Anitschkow cells in the left ventricle. A sudden death due to undiagnosed rheumatic carditis causing such massive cardiomegaly is rare. This case highlights the need to keep rheumatic carditis as a cause of sudden death.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"143-146"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Distal femoral metaphyseal fractures in children: A systematic review and meta-analysis of their significance in the context of child abuse. 儿童股骨远端干骺端骨折：系统回顾和荟萃分析其在儿童虐待背景下的意义。
Medico-Legal Journal Pub Date : 2025-09-01 Epub Date: 2025-03-27 DOI: 10.1177/00258172241293885
Shrayash Khare
{"title":"Distal femoral metaphyseal fractures in children: A systematic review and meta-analysis of their significance in the context of child abuse.","authors":"Shrayash Khare","doi":"10.1177/00258172241293885","DOIUrl":"10.1177/00258172241293885","url":null,"abstract":"<p><p>BackgroundDistal femoral metaphyseal fractures in children pose diagnostic challenges due to potential accidental and non-accidental aetiologies. This review aims to critically analyse the evidence on the association between distal femoral metaphyseal fractures and child abuse, as well as fracture patterns aiding in distinguishing inflicted injuries from accidental injuries.MethodsA systematic review of studies involving children with distal femoral metaphyseal fractures was conducted, examining the reported associations with child abuse, fracture patterns and proposed mechanisms.ResultsThe review revealed a significant association between distal femoral metaphyseal fractures and child abuse, particularly in non-ambulatory infants. However, some fractures may occur accidentally, often from short falls with direct impact on the knee. Certain fracture patterns, such as transverse or oblique configurations, suggest abuse, while spiral or buckle patterns are more likely accidental. Case series and retrospective studies reported varying findings, with some studies supporting a strong association with abuse and others highlighting the potential for accidental mechanisms.ConclusionsA comprehensive evaluation, including history, physical examination, skeletal survey and multidisciplinary collaboration, is crucial for accurate diagnosis and management. Healthcare professionals should maintain a high index of suspicion for child abuse while recognising accidental mechanisms. Specific recommendations for healthcare professionals and future research directions are provided.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"137-142"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Suicide contagion and psychosocial risks among Nepali youth through a near-hanging case study. 通过近乎上吊的案例研究尼泊尔青年的自杀传染和社会心理风险。
Medico-Legal Journal Pub Date : 2025-09-01 Epub Date: 2024-06-13 DOI: 10.1177/00258172241243169
Alok Atreya, Tanya Mahato, Samata Nepal, Sharad Paudel, Bhaskkar Sharma, Bishnu Acharya, Dikshya Bashyal
{"title":"Suicide contagion and psychosocial risks among Nepali youth through a near-hanging case study.","authors":"Alok Atreya, Tanya Mahato, Samata Nepal, Sharad Paudel, Bhaskkar Sharma, Bishnu Acharya, Dikshya Bashyal","doi":"10.1177/00258172241243169","DOIUrl":"10.1177/00258172241243169","url":null,"abstract":"<p><p>The phenomenon of suicide contagion: some individuals, especially vulnerable young people, exhibit increased susceptibility to suicidal ideation when exposed to the suicide of other people. Significant research suggests that exposure to media portrayals, suicide groups and peer suicides may lead to suicide contagion. Prevalent psychosocial and cultural factors in Nepal such as interpersonal conflict, domestic violence, gender inequity and social exclusion probably contribute to suicidal behaviour. This case study investigates a high school student in a rural mountainous community in Nepal, who attempted suicide by hanging following his girlfriend's suicide, and demonstrates how peer suicide exposure prompts imitative behaviour in a vulnerable young person and confirms suicide grief as an underrepresented risk factor. Prompt, supportive interventions for high-risk grievers and societal prevention strategies tailored to adolescents are essential to curb imitative deaths.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"153-156"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Injury pattern(s) in electric iron-related fatal electrocutions in the home. 家庭中与电铁相关的致命触电的伤害模式。
Medico-Legal Journal Pub Date : 2025-09-01 Epub Date: 2025-03-26 DOI: 10.1177/00258172241288019
Sangram S Yadav, Mohit Chauhan
{"title":"Injury pattern(s) in electric iron-related fatal electrocutions in the home.","authors":"Sangram S Yadav, Mohit Chauhan","doi":"10.1177/00258172241288019","DOIUrl":"10.1177/00258172241288019","url":null,"abstract":"<p><p>Although an electric iron will be found in almost every home, injuries from this useful and low-cost device are unexpected. There is little data on electric iron contact burns (non-electrocution) in children and an absolute lack of literature dealing with accidental fatalities from electric irons. This study sets out to describe the causes and patterns of domestic fatalities in females from electric irons.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"162-165"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pendulums in medical practice. 医学实践中的钟摆
Medico-Legal Journal Pub Date : 2025-09-01 Epub Date: 2025-03-27 DOI: 10.1177/00258172241304558
Mathias E Kant
{"title":"Pendulums in medical practice.","authors":"Mathias E Kant","doi":"10.1177/00258172241304558","DOIUrl":"10.1177/00258172241304558","url":null,"abstract":"<p><p>Medicine is taught as a science, but in reality, as with other areas that undergo much public scrutiny, it is often more of an art than a science. Particularly when dealing with controversial areas, physicians often attempt to employ the \"standard of care\" as a guide to practising medicine, and to protect themselves. However, the standard of care itself is often a reactive and temporary construct. A number of practices serve as good examples of accepted patient care that has swung completely from one extreme to another. The history of opiate prescribing in this country exemplifies a complete swing in practice fundamentals among US physicians, where opiates have been repeatedly embraced, and then vilified. Numerous other practices demonstrating this phenomenon can be cited, including the use of electroconvulsive therapy for depression, and hormone replacement for postmenopausal women. Research funding itself has been subject to pendulum swings, such as occurred during the recent pandemic. Currently, there are a number of similar, very active issues of debate, such as marijuana for widespread medical use, and the employment of hallucinogens for addiction and other mental health disorders. Considerable harm has occurred to some patients when extremes of these pendulum swings have impacted their medical care. It is urged that in practising medicine, physicians consider the entire body of medical evidence accumulated during these pendulum swings, and then have the courage and wisdom to represent the best interests of their patients.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"124-129"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Capacity and the exercise of patient autonomy. 能力和病人自主权的行使。
Medico-Legal Journal Pub Date : 2025-06-01 Epub Date: 2025-03-27 DOI: 10.1177/00258172241304559
Benjamin Andoh
{"title":"Capacity and the exercise of patient autonomy.","authors":"Benjamin Andoh","doi":"10.1177/00258172241304559","DOIUrl":"10.1177/00258172241304559","url":null,"abstract":"<p><p>Capacity, often linked with the exercise of patient autonomy, was considered again recently by the Court of Appeal in <i>Thirumalesh Chellamal Hemachandran and Another v Sudiksha Thirumalesh (Deceased)</i> <i>(By her litigation friend, The Official Solicitor) and Others</i> ([2024] EWCA Civ 896). This paper reviews that case and comments on it in the light of the two related key themes of capacity and patient autonomy. The paper concludes that only patients with capacity can exercise patient autonomy because a patient who lacks capacity cannot make a decision regarding their medical treatment.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"82-85"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing trauma evaluation: Comparative analysis of post-mortem computed tomography and autopsy findings in abdominal stab wounds. 加强创伤评估：腹部刀伤死后计算机断层扫描与尸检结果的对比分析。
Medico-Legal Journal Pub Date : 2025-06-01 Epub Date: 2024-07-29 DOI: 10.1177/00258172241245556
Darshan Galoria, Srushti Shukla, Shridhar Dave, Preeti Tiwari, Prateek Rastogi, Pradeep Rana, Dhara Goswami, Arijit Datta
{"title":"Enhancing trauma evaluation: Comparative analysis of post-mortem computed tomography and autopsy findings in abdominal stab wounds.","authors":"Darshan Galoria, Srushti Shukla, Shridhar Dave, Preeti Tiwari, Prateek Rastogi, Pradeep Rana, Dhara Goswami, Arijit Datta","doi":"10.1177/00258172241245556","DOIUrl":"10.1177/00258172241245556","url":null,"abstract":"<p><p>In cases of traumatic deaths, accurate assessment of injuries is essential for both legal and medical purposes. This case report compares the findings of post-mortem computed tomography with conventional autopsy methods in assessing abdominal stab wounds. A 34-year-old woman with multiple stab wounds in the abdomen underwent post-mortem examination, including computed tomography imaging. Computed tomography revealed specific breaches in the skin's continuity and internal injuries, including perforation of the stomach. A conventional autopsy confirmed the presence of multiple stab wounds and associated injuries to internal structures. However, additional injuries to major blood vessels, such as the abdominal aorta and inferior vena cava, were only detected during manual exploration of the peritoneal cavity. This case highlights the complementary roles of post-mortem computed tomography and conventional autopsy in evaluating traumatic injuries. While computed tomography imaging offers non-invasive visualisation of injuries, manual examination remains essential for identifying certain injuries, particularly those affecting major blood vessels. The integration of computed tomography imaging with traditional autopsy methods enhances the accuracy and reliability of forensic assessments in cases of traumatic deaths, particularly in complex cases involving multiple injuries. Understanding the strengths and limitations of these techniques is crucial for improving forensic investigations and ultimately enhancing medico-legal outcomes.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"105-109"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heat, drought and death - communal responsibility? 炎热、干旱和死亡——共同的责任？
Medico-Legal Journal Pub Date : 2025-06-01 Epub Date: 2025-03-27 DOI: 10.1177/00258172251323740
Diana Brahams, Eleanor Jane Turner
{"title":"Heat, drought and death - communal responsibility?","authors":"Diana Brahams, Eleanor Jane Turner","doi":"10.1177/00258172251323740","DOIUrl":"10.1177/00258172251323740","url":null,"abstract":"","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"59-61"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Histopathological and medico-legal aspects in a case of death related to an undiagnosed cerebral large B-cell lymphoma. 一例与未确诊的脑大 B 细胞淋巴瘤有关的死亡病例的组织病理学和医学法律问题。
Medico-Legal Journal Pub Date : 2025-06-01 Epub Date: 2024-07-29 DOI: 10.1177/00258172241245856
Rosario Barranco, Anna Roncallo, Sara Candosin, Rita Bianchi, Giulio F Orcioni, Francesco Ventura
{"title":"Histopathological and medico-legal aspects in a case of death related to an undiagnosed cerebral large B-cell lymphoma.","authors":"Rosario Barranco, Anna Roncallo, Sara Candosin, Rita Bianchi, Giulio F Orcioni, Francesco Ventura","doi":"10.1177/00258172241245856","DOIUrl":"10.1177/00258172241245856","url":null,"abstract":"<p><p>We report an unusual and undetected case of primary central nervous system lymphoma presenting as multiple lesions in the periventricular occipital lobe in an immunocompetent host, which had manifested as a stroke. The neoplastic diagnosis was made only after death following a thorough autopsy and histopathological examinations which enabled the diagnosis of a rare cancer (primary cerebral lymphoma) which remained undetected and undiagnosed during life.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"110-112"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The eye in forensic practice: In the dead. 法医实践中的眼睛：在死者身上。
Medico-Legal Journal Pub Date : 2025-06-01 Epub Date: 2024-05-01 DOI: 10.1177/00258172241230210
Alok Atreya, Navneet Ateriya, Ritesh G Menezes
{"title":"The eye in forensic practice: In the dead.","authors":"Alok Atreya, Navneet Ateriya, Ritesh G Menezes","doi":"10.1177/00258172241230210","DOIUrl":"10.1177/00258172241230210","url":null,"abstract":"<p><p>Post-mortem examination of the eye provides valuable forensic information yet is often overlooked. This brief review focuses on determining the cause/manner of death and post-mortem interval. External eye findings like corneal haziness and tache noire, combined with post-mortem changes in the iris, lens, retina and vitreous humour, can help estimate time since death. Ocular biometrics (iris/retinal scans) may facilitate identification. Age-related ocular changes can provide insights. The eye offers clues into personality (corneal tattooing, trichotillomania) and cause of death (petechiae in strangulation, retinal haemorrhages in abusive head trauma). Ocular trauma and underlying eye disease may be evident. Toxicology of vitreous humour can detect drugs/poisons. As a window into systemic disease and age-related changes, the eye aids pathology interpretations and, accordingly, post-mortem examinations have value. Ocular findings should not be overlooked in forensic examinations as they provide distinct information in determining cause/manner of death and post-mortem interval.</p>","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"86-90"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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