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   2018| April-June  | Volume 4 | Issue 2  
    Online since June 29, 2018

 
 
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REVIEW ARTICLES
Brain injury biomechanics and abusive head trauma
Rudy J Castellani, Carl J Schmidt
April-June 2018, 4(2):91-100
DOI:10.4103/jfsm.jfsm_10_18  
Contemporary biomechanical theory of traumatic brain injury has its foundation in Holbourn's thesis on shear strain and Ommaya's primate experimentation demonstrating the role of rotation in a variety of lesions including subdural hematoma (SDH) and diffuse axonal injury. Empirical human observations have since confirmed, for the most part, the early concepts. Ethical concerns regarding primate research, however, have prompted in vitro models, which in turn has led to challenges with respect to the correlation between in vitro observations and the clinical data. Despite these challenges, medicolegal proceedings may call upon biomechanical engineers to reconstruct complex injury scenarios and offer opinions on the scientific plausibility of clinical disease states, such as SDH, hemorrhagic retinopathy, and cerebral edema, associated with hypothetical or proffered action sequences during the course of an unwitnessed homicide. It is important to note, however, that in vitro models by their nature are low-evidence quality studies that attempt to advance hypotheses but do not address cause and effect. As a whole, biomechanical models, as they pertain specifically to the brain and spine, are mathematically imprecise. Often, endpoints of limited relevance are relied upon (e.g., skull fracture thresholds), which predictably overestimate the in vivo risk of significant injury. Given the increasing role of biomechanical engineering in the interpretation of fatal pediatric head trauma, a heightened awareness of the limitations warranted.
  8,537 774 3
Vitreous humor: A review of biochemical constituents in postmortem interval estimation
Weichen Li, Yunfeng Chang, Zijia Cheng, Jiang Ling, Leiming Han, Xingmei Li, Yanjun Ding
April-June 2018, 4(2):85-90
DOI:10.4103/jfsm.jfsm_13_18  
Postmortem changes in the biochemical constituents of the vitreous humor have been widely used to estimate the postmortem interval (PMI) over the past several decades. However, few reviews have summarized the relationship between the postmortem vitreous biochemical constituents and time of death. Herein, the relationship between PMI and single biochemical components, including vitreous potassium, hypoxanthine, and amino acids, as well as comparisons of each statistical parameter in the formula, is summarized. We also discuss other compounds such as urea and uric acid, which have no direct relationship with PMI. Utility of multiple constituent simultaneous analysis for estimating PMI is being increasingly investigated. The promising idea of using simultaneous analysis of multiple constituents to determine PMI is proposed as a future research direction.
  7,583 957 1
ORIGINAL ARTICLES
Mental foramen: A predictor of age and gender and guide for various procedures
Vijay K Asrani, Jigna S Shah
April-June 2018, 4(2):76-84
DOI:10.4103/jfsm.jfsm_2_18  
Background: The distance from the inferior border of mental foramen (MF) to lower border of mandible remains constant throughout the life. Considering this fact the present study was carried out to determine role of MF in age and gender estimation and also its importance in planning various treatments. Aims and Objective: (1) To determine the most common type and shape of MF 2) To measure the height of the mandibular body (H), the distance between the superior margin of the MF to the alveolar crest (SM-AC), the distance between the superior margin of the MF to the inferior border of the mandible (SM-IB), the distance between the inferior margin of the MF to the inferior border (IM-IB) on the right side and left side. (3) To compare the above measurements for age and gender determination. (4) To determine effect of various factors on above measurements (5) to evaluate whether any significant difference in measurement occurs on right and left side. (6) To derive a regression equation for age estimation. Materials and Methods: A total of 300 Orthopantomogram were studied. Measurements such as H, SM-AC, SM-IB and IM-IB were carried out on both sides on type II MF in males and females in all the six age groups. Statistical analysis was carried using IBM SPSS version 24 to determine differences in measurements and linear regression analysis was carried out to determine age of individuals. Result: The most common appearance of MF was type II and shape was oval. Statistically significant differences occurred in measurements using which regressive equation for age estimation was derived for males & females. Conclusion: MF, being a stable landmark in mandible, serves as a good indicator for the determination of age and gender. Hence, using certain measurements related to MF, it can help in determining the age of the individual. Further, its position and distance from the alveolar crest serve as a guide for orthognathic surgeries, implant placement, and pre-prosthetic surgery.
  5,740 645 1
Correlation between maxillary central incisor crown form and maxillary dental arch form: A Model-Based morphometric, cross-sectional study
Jayasankar Purushothaman Pillai, Riddhi Amrutbhai Patel, Alka M Banker, J Rajarajeswari
April-June 2018, 4(2):70-75
DOI:10.4103/jfsm.jfsm_59_17  
The crown form of maxillary central incisor tooth is one of the vital phenomenon for a person's esthetics. Its crown form has been compared with other anatomical parameters such as arch form and facial form. Three different classes of tooth forms which relate to square, tapered, and ovoid forms are identified. The aim of this study was to morphometrically evaluate the correlation between maxillary dental arch form and the maxillary central incisor crown form. Dentate cast models of fifty male and fifty female normal occlusion controls in the age group of 18–23 years were analyzed. The mesiodistal (MD) dimensions of the maxillary central incisors were measured at incisal (MD_I) and at gingival (MD_G) levels. The transverse widths of maxillary casts were measured at the first molar and at the first premolar levels. The measured data were statistically analyzed using the SPSS software. The MD dimensions of maxillary central incisor were significantly greater in males than females. The ratio between the two MD dimensions also varied significantly among genders. The intermolar width (IMW) and inter first premolar width (IPmW) between males and females were highly significant (P < 0.05), whereas the ratio between these two parameters in males and females was not significant (P = 0.43). Eighty-eight percentage of the participants were found to have an ovoid type of maxillary arch, while only 45% of them had the ovoid form of maxillary central incisors. The MD_I and the IMW were found to be in the ratio of 1:5.5 in both genders. The MD_G and the IPmW were in the ratio of 1:4.7 in males and 1:4.5 in females. There was a weak positive correlation between MD_I and IMW (r2 = 0.146) and between MD_G and IPmW (r2 = 0.05). No significant concordance between the maxillary central incisor crown form and the maxillary arch form was found in this study.
  4,268 444 2
The application of next-generation sequencing to validate D12S391 microvariation
Qingxia Zhang, Jinjie Liu, He Ren, Shuai Sun, Yi Zhao, Chong Chen, Li Jia, Yacheng Liu, Jiangwei Yan
April-June 2018, 4(2):67-69
DOI:10.4103/jfsm.jfsm_62_17  
Objective: In a paternity case, the D12S391 locus was reported as a mismatch. To confirm the existence of mutations and mutations come from father or mother. Methods: STR and next-generation sequencing technology were used to validate the sequence. Results: NGS showed the loss of one adenine between the 19.3 allele of the child and allele 20 of the mother. Conclusion: The NGS can be applied in the paternity to validate the mutation.
  3,833 396 -
CASE REPORTS
Is rotational trauma the only relevant pathogenic mechanism in hemorrhagic retinopathy of shaken baby syndrome?
B S Arushi Tripathy, Stephanie Dean, D O Joyce L de Jong, Carl J Schmidt, Rudy J Castellani
April-June 2018, 4(2):104-107
DOI:10.4103/jfsm.jfsm_11_18  
The pathogenesis of ocular hemorrhage in abusive head trauma/shaken baby syndrome (AHT/SBS) is complex. Whereas severe hemorrhagic retinopathy has a robust association with AHT/SBS, mild disease is less specific. We report the ocular and cerebral findings in an 8-month-old girl with spastic torticollis who presented following confessed, violent sagittal plane acceleration-deceleration with impact. Autopsy revealed subdural hemorrhage over the convexities, ischemic brain injury, and preexisting polymicrogyria. Ocular examination showed extensive but unilateral retinal hemorrhage, extending broadly to the ora serrata, with perimacular retinal folds and retinoschisis. The retina of the right globe was entirely normal. The findings in this case, suggest that movement of the globe within the orbit with acceleration-deceleration, in this case greater on one side due to torticollis, may be the primary factor for severe hemorrhagic retinopathy associated with AHT/SBS. The findings argue against putative global mechanisms, such as intracranial hypertension.
  3,617 331 -
Death of two military pilots in Hawk-108 fighter jet crash
Chng Kay Ly, Mohd Yusmiaidil Putera Mohd Yusof, Ahmad Hafizam Hasmi, Mohd Shah Mahmood
April-June 2018, 4(2):101-103
DOI:10.4103/jfsm.jfsm_91_17  
Deaths associated with emergency seat ejection are rare. This is the first case reported in Malaysia since 1980 involving the death of two renowned fighter pilots postejection as safety measures. Ejection mechanism involves several phases which last for splits of seconds. Each phase has its own setback despite serving as a safety mechanism. Both the pilots' death was as a result of the canopy separation, windblast effect, G-force effect (gravitational force) as well as acceleration effect. High speed and high altitude would have further contributed to the death.
  3,526 344 3
Epileptic seizure-induced cardiac injury as a cause of sudden unexpected death in epilepsy: Evidence from pathological analyses
Tao Song, Shisheng Zhu, Jianbo Li
April-June 2018, 4(2):108-110
DOI:10.4103/jfsm.jfsm_14_18  
Sudden unexpected death in epilepsy (SUDEP) is the most frequent cause of death in people with epilepsy. The detailed mechanisms of SUDEP have not been elucidated. Moreover, it is still difficult for clinicians to predict and prevent the occurrence of sudden death in patients with epilepsy. Seizure-related cardiac complications were considered to play a significant role in the physiological changes that lead to SUDEP. This report described a case of sudden death of an 11-year-old boy with epilepsy. Detailed autopsy and pathological analyses were performed to determine the cause of death. Seizure-induced myocardial fibrosis was observed and deemed to be the cause of SUDEP. This study clearly showed the importance of improving the protection of cardiac function in the reductions of sudden deaths among patients with epilepsy. In addition, further studies in the pathophysiology of patients with epilepsy may help in improving our understanding of the mechanisms of SUDEP and adding new insight into the development of seizure-induced cardiovascular and respiratory changes that may contribute to sudden death in epileptics.
  2,704 269 -
BRIEF COMMUNICATION
Genetic diversities of 23 Y-Chromosome short tandem repeat loci in a han population in the Beijing Region
Shicheng Hao, Xuan Zhang, Yan Liu, Di Lu
April-June 2018, 4(2):111-114
DOI:10.4103/jfsm.jfsm_12_18  
We investigated the polymorphisms of 23 Y-short tandem repeat (STR) loci in a Han population in the Beijing region. Blood samples were collected from 255 unrelated Han males. DNA templates were amplified using the PowerPlex® Y23 system, and the amplification products were detected with a 3130 genetic analyzer. A total of 254 haplotypes were detected from the 255 unrelated Han males in the Beijing region. The gene diversity of these 23 Y-STR loci was 0.3952–0.9721. The haplotype diversity was 0.99996 and discrimination capacity (DC) was more than 99.6%. The 23 Y-STR loci used in this study are highly polymorphic in Han individuals in the Beijing region and are therefore suitable for paternal kinship identification. Studying allelic deletions such as DYS448 and DYS549 are important for examining Y-STR polymorphisms and forensic testing.
  2,562 232 -