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Death from postural or positional asphyxia takes place in circumstances when the victim's body assumes an abnormal position compromising the process of respiration. The diagnosis is usually based on circumstantial evidence in conjunction with excluding other significant underlying causes of death. This case report is about a 37-year-old man who had been drinking the previous night and was found dead in the morning in a knee-chest position. The forensic medical examiner had the opportunity to examine and photograph the scene of death while the body was still in its original position. Apart from a blood alcohol level of 290 mg/100 mL, marked congestion of the face, and petechial hemorrhages on the conjunctivae, autopsy findings were unremarkable. There were no injuries or pathological findings to account for his death. Death was certified as due to postural asphyxia secondary to intoxication by alcohol.

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This work presents important information about the medicolegal systems in two different countries through the author's personal experience during his work. In Libya, the Medicolegal Centres, attached to the Justice Department, receives all cases referred by the Director of Public Prosecution or by the Judge. These constitute a wide range of cases which include in descending order of frequency, age estimation, injuries, autopsies, sexual offences, criminal responsibility, medical mishaps, disputed paternity and nullity of marriage. In Scotland, the Department of Forensic Medicine and Science at the University of Glasgow receive only a proportion of the total number of cases investigated by the Procurator Fiscal in Glasgow. These are exclusively deaths that require medicolegal autopsies, which average 458 per year. The medicolegal Centre in Benghazi receives all referrals from the courts, which average 1780 cases per year, but autopsies constitute only 14.4% (256 cases per year). A total of 1144 autopsies performed in Glasgow during a period of 2.5 years, and 7121 medicolegal cases investigated in Benghazi during a period of 4 years (1022 of that were autopsies), are presented in 12 tables and duly discussed. The outstanding observation is the marked male preponderance in deaths from unnatural causes in Benghazi, (80% of the total), compared to less marked male preponderance in Glasgow, (60% of the total). This is explained by the fact that due to social custom in Libya, females have limited outdoor activities and lead a rather domestic life compared to females in Britain.

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