[Forensic medical characteristic of articular injuries].

Is to refine the mechanism of major joints' damage formation and qualification criteria of harm degree to the health in articular injuries. The number of patients equal 246, suffered in different circumstances, were examined. Damages of skin and soft tissues in the joints region without affection of internal structures (47%), intraarticular fractures with impaired articular surface congruence (18.

Intersection of forensic odontology and psychology.

Forensic odontologists are expected to deal with challenging demands which can affect their mental health while dealing with forensic activities. This study aimed to explore the psychological impacts of forensic activities on forensic odontologists and students undertaking training. Firstly, it of an integrative review (part I) on the psychological effects of forensic odontology practice.

Forensic medical characteristics of firearm exit wounds in cases with armour protection.

Background: The very limited literature about the characteristic morphology of the firearm ammunition wounds in the body armored victims led authors to conduct an experimental study to understand this issue of great forensic and medico-legal importance.

Purpose: An autopsy of a male sniper was fraught with a challenge to differentiate between a firearm ammunition entry and exit wound. He was wearing body armour when shot at during a hostage rescue operation.

Computer assisted three-dimensional reconstruction of scene in firearm homicide.

Worldwide advances in computer techniques are not yet recognised in the practice of forensic medicine. A promising application is their use in making a three-dimensional reconstruction of the crime scene. This study analyses this technique in a homicide by firearm.

Quantification of dental macrowear using 3D occlusal surface topographic measurements in deciduous and permanent molars of children.

Objectives: Childhood paleodietary reconstruction via dental macrowear analysis is limited in part by available methods to measure dental macrowear. We describe a method to quantify dental macrowear progression (in both deciduous and permanent molars) using a handheld intraoral scanner and two 3D occlusal topographic measurements. We assess the agreement of our macrowear proxies with an established qualitative wear scoring system and their relationship to age.

Metal dust deposition in a shotgun wound associated with barrel modification.

Contact-range gunshot wounds commonly demonstrate deposition of black soot in and around the wound. Deposition of other visible pigments originating from the firearm has not been specifically described. In the current case, an adult male was found dead adjacent to a shotgun fixed in a vice grip with a modified, shortened barrel.

Unusually extensive head trauma in a hydraulic elevator accident: post-mortem MSCT findings, autopsy results and scene reconstruction.

Accidental or intentional falls from a height are a form of blunt trauma and occur frequently in forensic medicine. Reports describing elevator accidents as a small subcategory of falls from heights are rare in the medical literature and no report on injury patterns or scene reconstruction of such an accident was found. A case of an accident in a hydraulic elevator with a man falling 3m was examined using post-mortem multi-slice computed tomography (MSCT) and autopsy.

Fatal cerebral infarction complicating therapeutic embolisation of a facial cavernous haemangioma: a case report.

An eight-year-old female developed cerebral infarction, with eventual brain death, as a consequence of therapeutic embolisation of a large facial haemangioma. Post-mortem histological examination revealed the presence of identical foreign body emboli, consistent with at least one of the embolic agents used in the procedure, within the haemangioma and both cerebral hemispheres. It is possible that some of these particles might have entered the cerebral circulation through anastomoses between the right external and internal carotid arteries, and subsequently crossed over from the ipsilateral to the contralateral cerebral vasculature via the Arterial Circle of Willis.

Post-anaesthetic maternal death in a patient with mediastinal large B-cell lymphoma: a case report.

A 32-year-old female underwent laparoscopic salpingectomy of an ectopic (third) pregnancy under general anaesthesia, at approximately six weeks' amenorrhoea. She developed severe respiratory distress after extubation and died on the second postoperative day. It appears that she had a history of a mild, persistent productive cough for a period of about a month prior to the operation that was attributed to an upper respiratory tract infection.

A survey of buprenorphine related deaths in Singapore.

Buprenorphine is available in Singapore as substitution treatment for opioid dependence since 2002. This study surveys buprenorphine related deaths in Singapore between September 2003 and December 2004. The aims are to establish the autopsy prevalence of buprenorphine related deaths and the demographical and toxicological profile of the cases.

After the Indian Ocean tsunami: Singapore's contribution to the international disaster victim identification effort in Thailand.

This paper describes the international disaster victim identification (DVI) response mounted in Thailand, with particular reference to Singapore's contribution to this process, in the wake of the Asian tsunami of 26 December, 2004, which devastated parts of more than 10 countries in and around the Indian Ocean and claimed more than 200,000 lives. Although Singapore was unscathed by this natural calamity, over 30 Singaporean visitors were counted amongst the thousands of deceased victims, mostly in Thailand. The systematic application of forensic pathology, forensic dentistry, DNA profiling, and fingerprinting to human identification, especially of the bodies of various nationalities that were in advanced states of putrefaction, was crucial to the entire DVI process.

The history of the College of Medicine and Tan Teck Guan Buildings.

For 60 years from 1926, the College of Medicine Building (COMB) was the centre of medical education in Singapore. The history of medical services and medical education is intimately intertwined, with the history of the COMB and the Tan Teck Guan Building. This article reviews the history of the 2 buildings.

A fatal case of hepatic failure possibly induced by nitrosofenfluramine: a case report.

A 42-year-old female developed fulminant hepatic failure after having ingested an undetermined quantity of a herbal product over a period of approximately four months prior to the onset of her illness. Clinically, the cause of liver failure was assessed to be drug-induced and she eventually underwent total hepatectomy, with porto-caval shunting, in anticipation of a living-unrelated liver transplant. Unfortunately, her condition deteriorated and she died less than 48 hours post-operatively, approximately three weeks post-admission.

Homicidal and dyadic falls from a height: rarities in Singapore.

A review of homicidal falls from a height, over a ten-year-period (1991-2000), demonstrated the rarity of such deaths in Singapore, despite the high frequency of fatal falls from a height that prevails in the city-state. During that time, there were four cases (involving five individuals) of pure homicide and nine episodes (involving 19 individuals) of dyadic death involving vertical deceleration from a considerable height in the approximate range of 17-31 m (6-11 floors) and 17-50 m (6-18 floors), respectively. The index cases were gleaned from a total of 533 homicides and 3,963 fatal falls from a height.

Fatal pulmonary thromboembolism in Singapore: has anything changed?

A previous study of fatal pulmonary thromboembolism (PE) during a five-year period (1989-1993) in Singapore found a low post-mortem prevalence of fatal PE (1.05%). The present study investigated cases of fatal PE among 10,097 coroner's post-mortems conducted between 1994 and 1998 at the Centre for Forensic Medicine, Health Sciences Authority, Singapore, and compared the results with the previous study.

A case of sudden death from primary intracranial germinoma complicated by microvascular disease of the heart.

A coroner's autopsy conducted on an 11.5-year-old girl, with a history of hypopituitarism, manifesting as growth hormone deficiency associated with short stature, demonstrated the presence of an undiagnosed hypothalamic intracranial germinoma, showing hypophyseal and mesencephalic invasion, together with histological evidence of microvascular (small coronary artery) disease of the heart. The substantive, or primary, cause of her sudden death was clearly the intracranial germinoma, which was acutely haemorrhagic and necrotic.

Massive hepatocellular [correction of hepatocullular] necrosis: was it caused by Orlistat?

Orlistat (tetrahydrolipostatin) is a lipase inhibitor which is used, in conjunction with appropriate dietary control, for the treatment of obesity. It is generally deemed to be a safe drug, which mainly exerts a topical action on the stomach and small bowel, with negligible systemic absorption and oral bioavailability. Consequently, its adverse effects have largely been limited to relatively mild gastrointestinal disorders.

Fatal pulmonary haemorrhage from a perforated and possibly iatrogenic thoracic aortic aneurysm.

A 56-year-old man, with Noonan's syndrome, underwent surgical correction of an aortic co-arctation almost two decades before his sudden and unexpected demise. The immediate cause of death was massive pulmonary haemorrhage, which was preceded by recurrent mild haemoptysis that was attributed to pneumonia, clinically. Autopsy revealed the presence of a saccular thoracic aortic aneurysm, arising from the apparently weakened anastomosis left by the previous operation.

Are maternal deaths on the ascent in Singapore? A review of maternal mortality as reflected by coronial casework from 1990 to 1999.

Introduction: In Singapore, published maternal mortality rates (MMR) over the last decade (1990 to 1999) have been so low (0.0 to 1.0 per 1000 live births and still births) as to imply that maternal deaths are rare to the point of being non-existent in some years.

Did he drown or was he murdered?

An unemployed, 60-year-old Singaporean gentleman died during a brief overseas trip to another South-East Asian country. He had, presumably, drowned in the bathtub of his hotel room, which he shared with his then 44-year-old companion, who was supposedly his nephew. The relevant public health and medico-legal authorities of the host country conducted an external examination of the body at the scene, whereupon they agreed with the police that his death was probably due to accidental drowning following an episode of syncope.