Medico-Legal Journal最新文献_第3页

Bradycardia and heart block due to lithium toxicity. 锂中毒导致的心动过缓和心脏传导阻滞。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-05-13 DOI: 10.1177/00258172261439612

Rupert Nithin Fernando Edwin, Bhagya Sree Velamala, Michelle Pierce, Fiona Harman, Vedamurthy Adhiyaman

{"title":"Bradycardia and heart block due to lithium toxicity.","authors":"Rupert Nithin Fernando Edwin, Bhagya Sree Velamala, Michelle Pierce, Fiona Harman, Vedamurthy Adhiyaman","doi":"10.1177/00258172261439612","DOIUrl":"10.1177/00258172261439612","url":null,"abstract":"Lithium remains a cornerstone in the management of mood disorders, including bipolar disorder, mania and schizoaffective disorder, owing to its proven efficacy in relapse prevention and mood stabilisation. However, its narrow therapeutic index necessitates close serum level monitoring to prevent toxicity. Neurological and renal adverse effects of lithium are well recognised, but cardiac complications such as symptomatic bradycardia and varying degrees of heart block are under-recognised, yet they are potentially life-threatening manifestations of lithium toxicity, even at therapeutic or mildly elevated levels. These conduction abnormalities may present insidiously and can be easily overlooked, particularly in elderly patients or those with underlying cardiac disease. Early recognition is critical, as prompt discontinuation of lithium typically leads to rapid clinical and electrocardiographic improvement, often obviating the need for pacing. This highlights the importance of maintaining a high index of suspicion, routine cardiovascular assessment and individualised risk-benefit evaluation in patients receiving lithium therapy to prevent serious morbidity and mortality.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"185-187"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934003","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

Fatal postoperative bowel ischaemia following abdominal aortic aneurysm repair: Medico-legal implications of a rare complication. 腹主动脉瘤修复后致死性术后肠缺血：罕见并发症的医学-法律意义。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-04-21 DOI: 10.1177/00258172261441437

Paranavidana Roshel Claude Wijenayaka, Pradeep Rohan Ruwanpura

{"title":"Fatal postoperative bowel ischaemia following abdominal aortic aneurysm repair: Medico-legal implications of a rare complication.","authors":"Paranavidana Roshel Claude Wijenayaka, Pradeep Rohan Ruwanpura","doi":"10.1177/00258172261441437","DOIUrl":"10.1177/00258172261441437","url":null,"abstract":"Ischaemic large bowel necrosis is a rare but severe complication following open abdominal aortic aneurysm (AAA) repair. Postoperative deaths from this condition often prompt medico-legal evaluation. We report a case of a 75-year-old hypertensive male who underwent elective open repair of an incidentally detected infrarenal AAA. On the fourth postoperative day, he developed progressive abdominal distension, oliguria and metabolic acidosis. Despite intensive management, including intravenous antibiotics, vasopressors, fluid resuscitation and haemodialysis, he deteriorated and died on the seventh postoperative day. Medico-legal autopsy revealed transmural necrosis and perforation of the rectum with generalised purulent peritonitis. The aortic graft was intact and appropriately positioned. Advanced atherosclerosis and chronic infrarenal dissection were present. The findings were consistent with Grade III ischaemic colitis, culminating in septic shock and multi-organ failure. This case highlights the importance of structured forensic evaluation in distinguishing recognised postoperative complications from potential negligence and emphasises the need for careful medico-legal evaluation.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"177-180"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783367","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

Sudden death following a single coronary ostium located below an aortic valve leaflet: A rare autopsy case and review of the literature. 主动脉瓣小叶下方单一冠状动脉开口后猝死：一例罕见的尸检病例及文献回顾。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-03-04 DOI: 10.1177/00258172251410833

Jihad Aarab, Azeddine Essadi, Mohammed Ouali, Rabi'a Benyousef, Elias Numbi, Badreddine Zarhouni, Samir Nya

引用次数: 0

When the internet wields the scalpel: Do-It-Yourself surgeries turning tutorials into tragedy in the digital era. 当互联网挥舞着手术刀：在数字时代，diy手术将教程变成悲剧。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-07-10 DOI: 10.1177/00258172261438225

Alok Atreya, Layasha Tuladhar, Samata Nepal, Ritesh G Menezes, Kishor Parajuli

引用次数: 0

Fatal colloid cyst of the foramen of Monro: A forensic case report. 致死性门罗孔胶体囊肿1例法医报告。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-05-19 DOI: 10.1177/00258172261443892

Nirmal Nagar, Yatiraj Singi, Gurwinder Kaur, Dipen Dabhi, Ammu M G, Jasmine Jain

引用次数: 0

Death of a female 'drug mule' from peritonitis: A case report and literature review. 1例女性“药骡”死于腹膜炎：1例报告及文献复习。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-07-11 DOI: 10.1177/00258172261443898

A Essadi, E Numbi, B Zarhouni, M Ouali, R Benyousef, J Aarab, S Nya

{"title":"Death of a female 'drug mule' from peritonitis: A case report and literature review.","authors":"A Essadi, E Numbi, B Zarhouni, M Ouali, R Benyousef, J Aarab, S Nya","doi":"10.1177/00258172261443898","DOIUrl":"10.1177/00258172261443898","url":null,"abstract":"Concealing drugs inside the body to transport them covertly, known as 'body packing', can be fatal. Intestinal occlusion and poisoning are common; fatal gastric perforation is unusual. We present a rare case involving a 54-year-old female 'drug mule' (body packer) who died from peritonitis resulting from gastric perforation. The deceased (from Sweden) was discovered dead in her hotel room. A forensic autopsy revealed diffuse peritonitis due to a 2 cm hole in the superior part of the gastric lesser curvature. There were 70 rigid plastic capsules, about 6 cm long and weighing between 3 and 4 g each, inside the stomach, intestines and in the subphrenic space. This case serves as a stark reminder of a rare but serious complication associated with body packing; the volume of the capsules may have exerted enough strain to cause stomach wall ischaemia and rupture. Drug mules are more commonly young men who present with acute signs of poisoning, so the type and site of complication, the victim's sex and relatively older age make this report stand out as unusual. In conclusion, we need to recognise that gastric perforation poses a serious, life-threatening danger in cases of body packing, particularly if a 'mule' swallows large, stiff packets and it is crucial that forensic pathologists and doctors keep this possibility in mind and involve multiple disciplines when dealing with these very high-risk situations. Interdisciplinary policies should be created to manage the care of body packers and to prevent a recurrence.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"200-203"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424779","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

Olanzapine-induced de novo type 2 diabetes mellitus with acute kidney injury in an autistic female: A case report. 自闭女性奥氮平诱导的新生2型糖尿病合并急性肾损伤1例。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-07-10 DOI: 10.1177/00258172261436931

Maryam, Sameera Tarannum, Ifrah, Shayesta Nishath, Madiha Naazish

{"title":"Olanzapine-induced de novo type 2 diabetes mellitus with acute kidney injury in an autistic female: A case report.","authors":"Maryam, Sameera Tarannum, Ifrah, Shayesta Nishath, Madiha Naazish","doi":"10.1177/00258172261436931","DOIUrl":"10.1177/00258172261436931","url":null,"abstract":"Olanzapine, a second-generation antipsychotic widely used in psychotic and autism spectrum disorders, is associated with significant metabolic side effects including hyperglycemia, dyslipidemia and weight gain. We present a rare case of olanzapine-induced de novo type 2 diabetes mellitus (DM) complicated by acute kidney injury (AKI) in a young female with autism. A 31-year-old female with a known history of autism spectrum disorder on long-term olanzapine (10 mg/day) presented with a recent fall, decreased urine output, poor appetite and generalised weakness. Laboratory evaluation revealed severe hyperglycaemia (GRBS 600 mg/dl), elevated HbA1c (9.8%) and serum creatinine (5.9 mg/dl), confirming acute kidney injury secondary to uncontrolled hyperglycaemia. Olanzapine was discontinued upon suspicion of drug-induced metabolic dysregulation. The patient was managed with insulin therapy, haemodialysis, intravenous antibiotics and fluid management. Risperidone (2 mg/day) was initiated for behavioural control. Gradual improvement was observed in glycemic profile, renal function and overall clinical status over 12 days. Early recognition and drug discontinuation are critical in preventing irreversible metabolic and renal damage. Substituting lower-risk agents such as risperidone can maintain psychiatric stability while minimising metabolic burden. This case underscores the importance of baseline and periodic metabolic screening in patients receiving atypical antipsychotics. Clinicians should remain vigilant for symptoms of hyperglycaemia or renal dysfunction. Prompt withdrawal of olanzapine and initiation of insulin therapy can reverse metabolic derangements effectively.","PeriodicalId":35529,"journal":{"name":"Medico-Legal Journal","volume":" ","pages":"208-211"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424843","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

Impact of independent scrutiny on the death certification process in England and Wales. 独立审查对英格兰和威尔士死亡证明程序的影响。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-07-26 DOI: 10.1177/00258172261448316

Vedamurthy Adhiyaman, Indrajit Chattopadhyay, Radha Sundaram

引用次数: 0

Death associated with miliary tuberculosis (Koch's disease): A case report. 军人结核（科赫氏病）所致死亡1例

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-02-16 DOI: 10.1177/00258172251414234

Erna Ahsan, Dhinesh Saravanan, Amit Jangid, Yashpal, Ravi Hari Phulware

引用次数: 0

When palliative becomes curative? An ethical dilemma in end-stage heart failure treated with compassionate stem cell therapy: A case report. 什么时候可以治愈？同情性干细胞治疗终末期心力衰竭的伦理困境：一例报告。

Medico-Legal Journal Pub Date : 2026-09-01 Epub Date: 2026-02-16 DOI: 10.1177/00258172251414075

Ameenathul M Fawzy, Peysh A Patel

引用次数: 0