Introduction: Investigation into explosions is one of the major areas in forensic medicine and pathology. Medico legal issues associated with these deaths are diverse and forensic experts are often expected to make clarifications. Assistance of a methodical scientific investigation of such a death in evaluation of unanswered medico legal issues, of an autopsy of one of the victims of Easter Sunday explosions is discussed. Case history: The deceased was a 15-year-old girl who was participating in the Easter mass at St. Sebastian’s Church - Kattuwapaitya, Negombo, Sri Lanka when a suicide bomber blew himself up. The mother of the deceased noticed the deceased being rushed to the hospital. However, she was pronounced dead on admission. Pre-autopsy radiology revealed spherical shrapnel in the temporal region. At autopsy, the fatal injury was found on the head and a detailed study revealed skull fractures associated with penetration by 3 shrapnels. There was a keyhole lesion among the penetrations. Internal examination revealed an extensive dural tear underlying the compound fracture. The brain was grossly edematous with lacerations on the frontal and parietal lobes associated with localized subarachnoid hemorrhage. There were multiple underlying contusions on bilateral frontal white matter. Small subarachnoid haemorrhage was noted on the basal aspect of the brain. Discussion: Careful evaluation of the autopsy findings assisted in formulating the opinion scientifically on event reconstruction including the proximity of the victim to the epicenter of explosion and nature of explosive device, period of survival, mechanism of causation of skull fractures and the mechanism of death in addition to the cause of death. Conclusion: A forensic pathologist following a meticulous autopsy examination, along with a team of ballistic experts and specially trained police personnel play a pivotal task in analyzing a scene of explosion and an autopsy of a victim, in concluding the case and in bringing justice to all the victims and survivors of the catastrophe.
Lockdown measures during the COVID-19 pandemic resulted in restrictions on people’s ability to move, allowing more time for intimate partners—this increased opportunities for intimate partner violence (IPV), especially against women. The study aimed to evaluate the characteristics of IPV against women during and after the lockdown period. A prospective, descriptive study on female victims of IPV presented from March 2020 to February 2022 to a leading teaching hospital in Sri Lanka. Out of the 876 patients admitted during the period, details could be obtained from 300 victims. Ninety-four (31%) were during the lockdown, while 206 (69%) were post-lockdown admissions. The mean age of the victim in both groups was 33.5 years. Even though physical abuse was high throughout, the prevalence of sexual abuse was significantly higher ( p < 0.0001) during the lockdown period (31.9%) than during the post-lockdown period (3.4%). Financial problems (46.6%), followed by substance abuse (35%), were the most common risk factors during the post-lockdown period, while morbid jealousy (34%) was the most common risk factor, followed by extramarital relationships (33%) during the lockdown. Psychological consequences due to IPV were observed in 76.5% of victims during the lockdown period and only 11.2% during the post-lockdown period. The prolonged lockdown has significantly influenced mental and sexual health, changing the pattern of IPV against women. The need to have services to ensure the mental and sexual well-being of the community was highlighted.
Introduction: Violence with physical assault is a common cause of morbidity and mortality prevalent but not limited to underdeveloped countries. The opinion of the forensic expert is often indispensable in such cases to determine the penalties. This study was planned to describe the pattern of presentation of the victims and evaluate the strengths and limitations in formulating a scientific medicolegal opinion based on the findings of the victim. Methods: A retrospective descriptive study based on the case records of the victims of assault admitted to Colombo North Teaching Hospital, Ragama, Sri Lanka, was conducted for four years. Results: Out of the 400 victims, the majority (72% n = 290) were males and of the age-group of 21 to 40 (n = 216). The reason for assault in the majority was sudden provocation (n = 99, 25%), followed by previous long-duration enmity (n = 89, 22%). The majority (83%) had isolated blunt force trauma, and the injuries were nongrievous (74%). Defense injuries were significantly associated with attempted defense (p = 0.000) and sharp force trauma (p = 0.002). The underlying reason for the assault was not significantly associated with the causative weapon (p = 0.228) or body region injured (p = 0.195). Conclusions: Even though the presentation and the pattern of injures are definitely of value in formulating a scientific opinion, the study identified the limitations of the forensic experts, and the need for a holistic approach at the investigations was highlighted.
Introduction: Child abuse and neglect have been widespread since time immemorial. It is not only detrimental to the affected child, but families, societies and cultures as well.Although the exact prevalence of child abuse is not known in Sri Lanka, reported literature shows that it is a significant problem and the available statistical data on the prevalence of child abuse, is only the tip of the iceberg.Case Reports: Three case reports are elaborated and its forensic clinical examination findings are discussed along with the medico-legal value of each case. These highlight the importance of empowerment with proper statutory amendments, educating the judiciary about practical background of these abuses by clinical forensic practitioners with sufficient practical experience and strengthening of the "Multidisciplinary child protection committees" for early detection of child abuse within the community. Discussion:We suggest making the best use of the existing 'praja' committees, as first responders to recognize 'high risk' children within their community and reporting to a central authority such as National Child Protection Authority NCPA. Incorporating details of 'high risk' children into an electronic database would enhance easy reference, and electronic data linked to the '1929' child-line would ensure a better outcome. Confidentiality should be maintained at all times. 'High risk' children and their families should be visited by the Child Rights Protection Officers on a regular basis and immediate action should be taken if any form of abuse is suspected. Representatives from schools attended to by 'high risk' children and the 'Gramaseva Niladhari' should be part of these committees. It is also necessary to register all families who have a single parent, with parents working abroad, involved in civil or criminal court cases, with psychiatric illness/addictions with the Grama Niladhari, police and local probation and childcare office. Conclusion: "Multidisciplinary Child ProtectionCommittees" should be strengthened in the community under the supervision of the NCPA using existing facilities and with the participation of multi-sectorial stake holders. This will help in early detection of child abuse and community monitoring of high-risk children.
Introduction: Driving under the influence (DUI) of alcohol is one of the substantial predisposing factors for mishaps among road users. A traffic police officer will be the first authoritative personnel a drunk driver encounters in the legal system. The absence of accurate skills and knowledge of these officers impedes the structuring of legal procedures and may lead to miscarriage of justice. Objective: To assess the knowledge, attitude and practice of Sri Lankan traffic police in handling and managing an alleged case of driving under influence of alcohol. Methods: This was a descriptive cross sectional study carried on a sample of 384 traffic police officers attached to the districts of Colombo and Gampaha, through a questionnaire. Results: Out of 384, only 75 of police officers knew the correct preliminaries to perform before administering a breathalyzer test. 79.7% knew the correct instructions for using a breathalyzer, but only 3.4% knew the colour changes of the breathalyzer. Significantly poor attitude was observed among the police officers, regarding the importance of producing a drunk driver for medico-legal examination ( P = 0.001) Only 222 (57.8%) answered correctly that a drunk driver needs to be subjected to a medico-legal examination as early as possible. Significantly poor practice and attitude was observed in officers with longer service duration but no significant association was observed between ranks of officers and attitude and practice ( P = 0.199). Conclusions: The results of our study demonstrate that the knowledge attitude and practice on efficiently handling a case of DUI among traffic police officers is poor, even though all of them are engaged in DUI duties irrespective of their service duration. The need for continuous professional development programmes was highlighted.
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