Fifty-six cases of sudden death from myocarditis were reviewed to characterize the range of histologic appearances of myocarditis. All autopsy cases of myocarditis over 13 years (1996-2008) in the Toronto Forensic Pathology Unit, Ontario Forensic Pathology Service, were studied. In each case, historical documentation and histological slides were reviewed. The severity of myocarditis was graded qualitatively and quantitatively (the inflammatory index). We established the inflammatory index in order to classify the severity of myocarditis, by counting the mean number of inflammatory foci per section of myocardium. Based on the inflammatory index, myocardial inflammation was classified into four grades. Based on this classification, 47% of the cases were classified as marked myocarditis having an inflammatory index over 5, with the number of foci per slide varying from 3 to more than 10, while 20% were classified as mild myocarditis with an inflammatory index between 1.1 and 1.9 with the number of foci per slide varying from 0 to 6. The diagnosis of mild myocarditis is dependent on adequate sampling. We believe that the use of this inflammatory index enhances the post-mortem diagnostic sensitivity of myocarditis, especially in its mild form and correlates with qualitative assessment of the histologic severity of myocarditis.
Introduction An unnatural death is an intentional or unintentional death due to external causes. This can often be violent, mutilating or destructive. When the unnatural death involves a female, it shatters the lives of the survivors or the family. Traumatic injuries among females remain under-reported globally and studies on this area are scarce. We planned a retrospective descriptive study to find the epidemiologic patterns of traumarelated mortality among females for the first time. Objectives The aim of the study was to analyze the traumatic deaths among females to determine the circumstances, causes and epidemiology of these deaths and also to find the factors influencing them. Methodology A retrospective descriptive study was conducted on the post mortem records of the female victims of trauma during last 3 years (2013-2015) reported to a tertiary care hospital of Sri Lanka. The historical details, scene findings, findings of autopsy: external and internal examinations, the results of the post-mortem investigations and the opinion and conclusions given were obtained to fill the pro-forma. Results Out of the 139 deaths reported for medicolegal examination during the period, the majority 71(51%) were less than 40 years of age. The commonest manner of death was accidents 56 (40%), especially road accidents, followed by suicides amounting to 45 (32%). Poisoning was the commonest method of suicide 14 (31%) followed by hanging 12 (26%). Sharp injuries accounted for the majority of murders 13 (39%). Family disputes and love affairs were the main reason for 21 (47%) suicides and 13 (39%) murders. Conclusions Comprehensive research into occurrence of unnatural fatalities assists authorities in the prevention of such deaths. The study highlights the importance of timely interventions on road safety and the need for effective and timely counseling services on family matters to prevent most intentional deaths of women.
The morphology in coronary atherosclerosis of the young is significantly different from the old. Coronary atherosclerosis in the young commonly shows an eccentric distribution with associated inflammation. Thrombosis is commoner among the young, whereas plaque hemorrhage is commoner among the old.
Accidents accounted for the majority (or greatest number) of tragic childhood deaths. The presence of drowning as the most common cause of death indicates that an immense responsibility lies with the parents and caregivers to prevent such deaths.
We report a case of air embolism in an industrial worker complicating a deep electrical injury in the neck. He was found dead in an upright position while his chest and head were resting on top of a live transformer. At autopsy, there were multiple electrical burns involving the face, neck, chest, and arms. There was a deep electrical burn associated with hemorrhage in the neck involving the skin, underlying subcutaneous tissue, strap muscles, and the thyroid gland. The internal examination showed a prominently bulging right atrium, which was filled with air and not blood. At autopsy, when the pericardium was filled with water and the right atrium opened, a large number of bubbles emerged. We concluded that death was due to air embolism complicating electrical damage to the neck veins. This case illustrates that acute complications of electrical burns rather than electrocution-related cardiac arrhythmia can be the mechanism of death in rare electricity-related deaths. It also reveals the difficulties encountered by the pathologist in determining the exact mechanism of death when there are competing mechanisms.
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