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2018| September-December | Volume 1 | Issue 3
December 19, 2019
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Measuring the awareness of emergency department physicians toward the management of medicolegal cases in Jeddah, Kingdom of Saudi Arabia
Mamdouh Kamal Zaki, Khaled Abdelfattah Bayoumi, Mohammed Ibrahim Rawas, Ziyad Nami Alshutayri, Ethar Adnan Kensarah, Ammar Mohammed Jamal, Mansour Ali Zughbi
September-December 2018, 1(3):61-67
Worldwide, there is a great discrepancy between the hospital and forensic reporting. The medical team priority is saving the lives of victims especially in case of fatal or dangerous wounding. Hence, minimal documentation will be expected under these conditions.
The aim of this study was to measure the awareness of emergency department (ED) physicians toward the legal and ethical aspects of the management of medicolegal cases, assessment of physical and sexual abuse, photo-documentation, and management of forensic evidence in emergency circumstances. This is the first study to investigate this critical topic in Jeddah City, Kingdom of Saudi Arabia.
The authors accomplished a cross-sectional study in EDs in major Jeddah hospitals during April–May 2017. The authors used a self-administrated questionnaire and used the Survey-Monkey engine and SPSS Statistics for data gathering and statistical analysis, respectively.
A total of 137 ED physicians from the main four general hospitals in Jeddah participated in the study. Most of the physicians were males. Most of the participants did not receive any training program in writing medicolegal reports in ED. About two-thirds of the respondents were certain that their workplace provided a specified protocol about collecting evidence from a medicolegal case until referral to forensic medical centers. On the other hand, 86.1% did not have any training program in evidence collection in EDs. Most of the participants believed that they needed more training programs concerning management of medicolegal cases at ED.
Although the level of awareness is significantly high, more than half of the physicians considered that the current approach of medicolegal cases was inappropriate. Medical students and residents need more training programs in medicolegal reporting and chain of custody as well as for specialists and consultants.
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Screening of psychoactive components in fresh khat using direct analysis in real time-time of flight-mass spectrometry
Abdulrhman M Dhabbah, A Yacine Badjah-Hadj-Ahmed, Ali I Alawi, Waleed Abdulaziz Al Angari, Basel F Alrayes
September-December 2018, 1(3):45-50
Khat (Catha edulis Forsk) is a shrub endemic to East Africa and the Arabian Peninsula that is widely consumed for its psychoactive properties. Due to the increase of illicit drugs consumption in the world, there is a need for fast investigation techniques in order to rapidly characterize the huge number of seized samples. In the recent years, direct analysis in real-time mass spectrometry (DART-MS) proved to be a useful and convenient method which allows recording mass spectra of various samples without any preparation.
The present work describes a convenient procedure for rapid characterization of fresh Khat samples by identification of cathinone and cathine which are the most active constituents in different parts of the plant.
Materials and Methods:
A fresh sample of C. edulis was cut into small pieces with separation of leaves and stems; each part was investigated using DART-time-of-flight (ToF)-MS. The fresh samples were submitted to a stream of hot helium as vaporization and ionization gas, without any extraction or prior treatment.
The obtained spectra showed many peaks corresponding to the mass range from 100 to 600 Da. Cathinone and cathine which are known to be the main psychoactive components in C. edulis were found in all parts of the fresh samples; their protonated peaks appeared at 150 and 152 Da, respectively. The peak intensity of these two characteristic alkaloids was notably different between leaves and stems; it roughly decreased from lower to upper leaves, while their highest content was obtained in the upper stem.
The present work showed that DART-ToF-MS is a powerful tool for fast investigation of real samples, particularly in the field of forensic sciences.
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Effects of postmortem interval and cause of death on organ weights
Yosuke Usumoto, Keiko Kudo, Akiko Tsuji, Yoko Ihama, Noriaki Ikeda
September-December 2018, 1(3):55-60
Visceral congestion is a characteristic autopsy finding of some causes of death, and the congestion changes the organ weight. Therefore, comparing the measured organ weights against standards can provide useful information.
We sought to generate accurate organ weight standards according to the postmortem interval (PMI) and the cause of death, with particular focus on brain and lung weights.
Settings and Design:
Cadavers and Methods:
We included data from 489 (320 males and 169 females) forensic autopsy cases with known PMIs; within 4 days. We considered gender, age, height, body weight and PMI in our organ weight estimations. In addition, we used longitudinal (243 males and 131 females) and transverse (243 males and 130 females) skull diameters in constructing an equation for brain weight estimation.
Statistical Analysis Used:
Chi-square test, Welch's
-test and stepwise regression analysis.
Causes of death such as intracranial injury and bleeding, intoxication and drowning tended to increase lung weight; other causes tended to decrease lung weight. When we focused on cases with 1-day PMI, the brain and lung weights increased with longer PMIs, probably due to the brain oedema and pulmonary congestion and oedema in the early post-mortem period.
Ours was the first report on the increase of brain weight with the increase of PMI in the early postmortem period. Further studies on the effects of PMI and the cause of death on organ weight are required to expand our understanding on the mechanisms of death.
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A Study to estimate forensic age by kreitner and kellingaus main stages method from epiphyseal ossification of the iliac crest by digital radiography
Soumeek Chowdhuri, Riju Bhattacharjee, Saikat Das, Ritwik Ghosh
September-December 2018, 1(3):51-54
The objective of this study is to establish the study of radiographs of the iliac crest epiphysis as a possible criterion for forensic age estimation, using Kreitner and Kellingaus main stages and substages method.
We scanned 157 participants, comprising 92 males and 65 females in the age bracket of 10 and 25, using X-ray in the Indian Bengali population.
Minimum, maximum, mean, and standard deviation were defined. Ossification appeared within the age bracket of 14–17 years, and complete bony fusion took place at the 20
year of life. Intra- and inter-observer agreements were determined by calculating the kappa coefficients.
This study can be used for forensic age diagnosis, but its accuracy is limited when the medicolegally significant age of 18 years has to be determined.
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