The present study was undertaken in the Department of Forensic Medicine of the AH India Institute of Medical Sciences, New Delhi, with the object of studying various aspects of cranio-intracranial injuries in roadside vehicular accident cases. Out of a total of 3227 medicolegal post-mortem examinations conducted, the number of accidental deaths was 2279 (70·62 per cent). Vehicular accidents (1132) comprised 49·76 per cent of the total fatal accidents and 35·5 per cent of the total post-mortems. The incidence of males involved in accidents was 71·74 per cent which was about five times more than females (15·01 per cent). Children below 12 years comprised 13·25 per cent of vehicular accident victims. The most common victim involved was the pedestrian comprising 50·7 per cent, followed by the motorcyclist (18·28 percent). The commonest age group involved in fatal vehicular accidents was between 21–40 years (521 cases, 46·01 per cent). Persons between the age group 11–20 years accounted for 13·69 per cent. Trucks were responsible for accidents in 28·09 per cent of cases, buses in 17·14 per cent and cars in 22·99 per cent; these have been found to be the most common types of vehicles causing fatal accidents. Most of the victims died on the spot (36·30 per cent). A total of 72·5 per cent of the victims died within 24 hours. All victims survived up to a maximum of only 2 weeks, except one case who survived 29 days and died of pyogenic meningitis. Head injuries were responsible for causing death in 71·99 per cent of cases. Chest injuries caused death in 6·18 per cent of cases and abdominal injuries proved fatal in 7·06 per cent of cases. Death by injury to other regions occurred in 15·54 per cent of cases. The incidence of cranio-intracranial injuries was highest in cyclists (78·93 per cent), followed by motorcyclists (72–46 per cent) and pedestrians (66·02 per cent). The number of car occupants involved in fatal accidents was 65·3 per cent. Fracture of the skull was observed in 79·87 per cent of cases; the most common bone involved was the temporal bone (58·67 per cent), followed by the occipital bone (57·75 per cent). Fractures of parietal and frontal bone were almost equal, being 50·38 per cent and 49·37 per cent respectively. The commonest variety of intracranial haemorrhage was subarachnoid haemorrhage (66·9 per cent), followed by subdural haemorrhage (58·2 per cent) and extradural haemorrhage (14·2 per cent). Extradural haemorrhage was least common (14·2 per cent). Intracerebral haemorrhage was found in 22·5 per cent of cases and brain stem haemorrhage in 10·81 per cent. The incidences of contusion and laceration of the brain were almost equal, being 23·6 per cent and 24·8 per cent respectively. Fracture of the ribs was the commonest chest injury, with contusion and laceration of the lung in 18·6 per cent of cases. Laceration of the liver was commonly found in abdominal injury in 17·2 per cent of cases. These findings have been compared with other authors. An attempt was also made in the present study to correlate the post-mortem findings and the survival time in relation to those victims who gave a history of consciousness after the accident and those where there was no history of consciousness. For convenience sake, the post-mortem lesions were divided in grades as 0, I, II, IIa, III and IIIa. The maximum number of fatal cases (46·2 per cent) belonged to grade III (fractured skull, intracranial haemorrhage and brain lesion) followed by grade II (35·1 per cent) (fracture skull and intracranial haemorrhage). No relationship was established between the post-mortem findings, the survival time and the state of consciousness or un-consciousness. The grade II and grade III lesions were common in both conscious and unconscious patients. The commonest complication observed in head injury cases was bronchopneumonia.

A meticulous post-mortem review was undertaken in the department of forensic medicine at the Maulana Azad Medical College (MAMC) to find out trends in homicides during the period 1992-1996. Standard procedures for autopsies and a review of the inquest papers were carried out. Out of 3,886 medico-legal autopsies performed in the department during the said period, only 232 cases (5.9%) were homicidal deaths. The commonest age group of the victims was 21-30 years (38%). Males were victimized three times more often than females. The incidence of crime was slightly more at night than in the daytime, though evenly distributed during the winter and summer seasons. In our series, sharp weapon injuries were the most common type (34.9%) followed by blunt force injuries (15.9%). Defence wounds were present in 35 cases (15%). Violent rage/quarrel was the motive in 61 cases (29%).

The present study was undertaken by the Department of Forensic Medicine, All India Institute of Medical Sciences (AIIMS) to find out the trends in homicides during the years 1969–79. Out of 4837 medico-legal autopsies conducted during the above-mentioned period, 140 cases (2.8 per cent) were of homicidal deaths. The commonest age group of the victims was 21–30 years (39.25 per cent) followed by 31–40 years (20 per cent). Males were victimized seven times more than females. Winter was the commonest season for the crime and most homicides occurred during the night. Most deaths occurred at the scene of the event. In our series blunt force injury was the commonest type (41.42 per cent) followed by stab injury (31.42 per cent). Defence wounds were present in 28.58 per cent of cases. Robbery and financial gain were the commonest type (37.1 per cent) of motive for the crime.

Neurofilament medium (NF-M) and heavy (NF-H) chain proteins have been used as markers for maturity in the developing brain since their accumulation in axons leads to an increase in conduction velocity. Earlier studies have demonstrated immunoreactivity of neurofilaments in Layer I of the human auditory cortex at 22 gestation weeks (GW), whereas that in other layers developed between 1 and 12 postnatal years, suggesting a gradual increase in the processing of sounds. However, third trimester fetuses and infants are fairly sophisticated in their ability to discern different aspects of complex sounds. Given these contradictory findings, we decided to study the expression of neurofilaments in human auditory cortex between 15 GW and adulthood. We found that mRNA and protein for both NF-M and NF-H were present in the presumptive human auditory cortex in the second trimester and during the postnatal period (1 year--adulthood). Axons in all layers of the auditory cortex were immunoreactive for neurofilaments by 25 GW and the density of the neurofilament-rich plexus in the cortical wall became adult-like during the first postnatal year in humans (9 postnatal months). Our results suggest that in terms of neurofilament expression, axons within the preterm human auditory cortex may be more mature than previously thought.

We report sudden unexpected death in a 35-year-old woman with pregnancy of seven months duration. There was an allegation by the parents of the woman that she was subjected to an assault prior to death. Autopsy examination showed an abdominal pregnancy with a dead fetus, ruptured gestational sac, massive haemorrhage and secondary placental attachment. During her antenatal check-ups, she had persistently complained of abdominal pain and loose stools, but the diagnosis of abdominal pregnancy was missed clinically and on ultrasound scan. In this paper we discuss the diagnostic difficulties and medicolegal issues in such cases.