29 - Tache noire

*Tache noir is one of the important postmortem changes seen in the eye after death.

*If the eyes remain open after death, the areas of the sclera exposed to the air dry out, which results in a first yellowish, then brownish-blackish band like discoloration zone called TACHE NOIRE.

*It is seen mostly after 7 to 8 hours after death. (AP PG 2010 Question).

28 - Indices used for SEX identification by Sacrum

1. Sacral index: (Width x 100) / Straight Length

2. Curvature index: (Straight Length x 100) / Mid -ventral curved length

3. Index of body of Ist Sacral vertebra: (AP daimeter of body of S 1 x 100) / Transeverse dia of body of S 1

4. Corporo-basal index: (Transverse diameter of body of S1 x 100) / Width of sacrum

5. Alar index: (Length of ala x 100) / Transverse diameter of body of S1

6. Auricular index: (Length of auricular surface x 100) / Width of sacrum

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1. Maximum length of sacrum (Wilder's mid- ventral Straight length) -measured along the mid-line of sacrum with the sliding caliper from middle of antero-superior margin of promontory to middle of antero-inferior margin of the last sacral vertebra.

2. Maximum breadth of sacrum -measured with the sliding caliper by taking two points at the upper part of auricular surface anteriorly (or lateral most part of alae of sacrum), thus maximum breadth is measured on anterior aspect of sacrum.

3. Curved length of sacrum (Mid-ventral curved length)- measured along the mid line of the anterior surface of the sacrum (from middle of antero-superior margin of promontory to middle of antero-inferior margin of the last sacral vertebra) by the flexible steel tape.

4. Antero-posterior diameter of the body of Ist sacral vertebra - It is the maximum possible diameter of Ist sacral vertebra measured with the sliding caliper by taking one point on antero-superior border and another point on the postero-superior border of Ist sacral vertebral body.

5. Transverse diameter of the body of Ist sacral vertebra- It is the maximum transverse diameter of Ist sacral vertebra measured with the sliding caliper by taking one point on each side of the lateral most point on the superior surface of body of Ist sacral vertebra.

6. Length of alae -It is measured on both sides with the sliding caliper by taking one point on lateral most point of superior surface of body of Ist sacral vertebra and another point on lateral most part of alae. The mean of the length of the two sides is taken as length of alae.

7. Maximum length of auricular surface-It is the straight auricular length measured on lateral aspect of sacrum by means of a sliding caliper by taking one point on the upper most part of auricular surface and another point on the lower most part of auricular surface of sacrum.

27 - Differences between Antemortem and postmortem wounds

FEATURES	ANTEMORTEM WOUND	POST MORTEM WOUND
Haemorrhage	-Arterial -Blood clotted and the clot is    ~laminated    ~firmly adherent to      the lining of endothelium    ~firm, rubbery and      variegated -Copious amount -Deep staining of edges   which can't be    washed away	-Venous -Blood usually not clotted  and if clots it is    ~Non laminated    ~Weakly adherent to the       lining of endothelium    ~Soft,friable chicken       fat(yellow) or current       jelly(red) appearance    ~Homogenous -Slight amount -Staining is superficial  and can be washed away
Wound edges	Gaping,everted,swollen	Apposed,not swollen
Vital reaction	Signs of inflammation, infection(pus,slough) and healing (granulation tissue) present	Not present
Enzyme histo chemistry	Negative and positive vital reactions	Vital reaction absent
Wound serotonin and histamine content	Increased	No increase
Microscopy	-Clot has platelets -Leucocyte and  RBC infiltration in between muscle fibers	-Clot lacks platelets -No infiltration

26 - Clinical features of Organophosphorous poisoning

*Since organophosphorous compounds are powerful inhibitors of cholinesterase, their poisoning manifests as cholinergic symptoms.

*The clinical features of Organophosphorous poisoning are :

A. MUSCARINIC ACTIONS :
1. Bronchoconstriction and increased bronchial secretion - simulates bronchial asthma. Other symptoms are dyspnea, cough, pulmonary edema and cyanosis.
2. Increased sweating
3. Increased salivation
4. Increased lacrimation - tears may be red
5. Slightly bradycardia
6. Miosis, Blurring/Dimness of vision
7. Increased frequency of micturition and involuntary micturition.
8. Abdominal cramps, diarrhea, epigastric/substernal tightness

B.NICOTINIC ACTIONS :
1. On striated muscles - easy fatigue, fasciculations, cramps, dyspnea (weakness of respiratory muscles and cyanosis)
2. On sympathetic ganglia - Pallor, Occasional elevation of B.P

C. CNS ACTIONS :
1. Restlessness, irritability, apprehension
2. Fine fibrillary tremors of hands, eye lids, tongue
3. Mental confusion, convulsions
4. Coma with absence of reflexes and depression of respiratory and circulatory centres. Death usually occurs due to paralysis of respiratory muscles.

Parikh' Textbook of Medical Jurisprudence Forensic Medicine and Toxicology

25 - Signs and Symptoms of chronic LEAD poisoning

1. Facial pallor : This is the earliest symptom.
2. Colic and Constipation : This is the first symptom that armbouses suspicion of plumbism
3. Anemia : This is associated with punctate basophilia
4. Lead line (BURTONIAN LINE) : A bluish-black line due to epithelial deposition of lead sulphide granules on the gums at the junction with the teeth. (not on teeth). Similar line may also be seen with Mercury, Copper, Bismuth, Iron and Silver poisoning.
5. Paralysis : Usually a late manifestation. Commonly causes wrist drop (extensor muscles of wrist) but may cause foot drop (peroneal muscles).
6. Lead encephalopathy : Frequently seen in children (not so common in adults).
7. Reproductive system : Menstrual disorders, abortion/still births, degenerate offsprings and sterility.

24 - Differences between Male and Female pelvis

BONY FRAME WORK	Massive and heart shaped	Less massive, rounded
PELVIC INLET	Deep and narrow	Shallow and wide
ILIUM	Less expanded, hence walls are not splayed	More expanded, hence walls are splayed
ILIAC FOSSA	Shallow	Deep
ASIS	Not widely separated	Widely separated
PUBIC ARCH	Narrow, V shaped, angle less than 70,less distance between ischia	Wide, U shaped, angle greater than 90, more distance ischia
ISCHIAL TUBEROSITY	Inverted	Everted
OBTURATOR FORAMEN	Ovoid with base upward	Triangular with apex forward
GREATER SCIATIC NOTCH	Narrow, deep, angle less than 90	Wide,shallow, angle greater than 90
PREAURICULAR SULCUS	Narrow,shallow, without marked edges	Broad,deep, in parous women
SACRUM	Long,narrow,has greater than 5 segments,well marked promontory	Wide,short,has 5 segments,promontory less marked
CURVE OF SACRUM	Equal over entire length, S-index less than 112	Straight in first 3 segments, the curve being confined to a point below the centre of 3rd sacral vertebra (J-shape)
ISCHIOPUBIC INDEX	73-94	91-150
ARTICULAR SURFACE OF SACRUM EXTENDS TO	2.5-3 Vertebral bodies	2-2.5 vertebral bodies
ACETABULUM	Wider and deeper	Narrow and shallow

23 - Causes of Post mortem caloricity

*Post mortem Caloricity is a condition where the temperature of the body remains raised for the first two or so hours after death. In certain conditions, instead of promoting the process of cooling of the body, act in a way, so that, the body temperature is either high at the time of death or is increased for sometime after death, so that, at a particular time after death the body may appear disproportionately warmer than what it should have been. This is termed as Post Mortem Caloricity and the conditions are

1.      Post mortem Glycogenolysis

a.       This is a normal phenomenon and the rise is 3.6^oF or 2^oC

2.      Various Causes of Death such as

a.       Septicaemia,

                                                              i.      Infectious diseases,

                                                            ii.      Bacteremia

                                                          iii.      Tetanus, Rabies, yellow fever

b.      Asphyxial Conditions

c.       Severe convulsions

                                                              i.      Tetanus

                                                            ii.      Strychnine

d.      Hyperpyrexia at death

                                                              i.      Heat Stroke (sun stroke)

                                                            ii.      Pontine Haemorrhage

e.       High Atmospheric Temperature

f.        Peritonitis, Meningitis, Nephritis

g.       Alcohol poisoning

22 - Cognizable and Non-Cognizable offences

A cognizable offence in the criminal justice system of India is one in which the police is empowered to register a FIR, investigate and arrest an accused involved in cognizable crime without a court warrant. As defined in Cr.PC, a non-cognizable offence is one in which police can neither register a First Information Report (FIR) nor can investigate or effect arrest without the express permission or directions from the court.

 A cognizable offence is a case where the Police can arrest without a warrant. All cognizable cases involve criminal offences. Murder, Robbery, Theft, Rioting, Counterfeiting etc. are some examples of cognizable offences. Non-cognizable offences are those criminal infractions, which are relatively less serious. Examples of non-cognizable offences include Public Nuisance, Causing Simple Hurt, Assault, Mischief etc. The Police cannot register criminal cases or cause arrests with regard to non-cognizable offences. In all such cases, the Police have to take permission from a magistrate for registration of a criminal case.