ISSN 0971-0973 J Indian Acad Forensic Med, <strong>32</strong>(2)It shows that in very few cases (5.56%)histo-pathology examination was helpful to affect theapparent cause of death in autopsy. Mollina et al [8]has also reported almost same conclusion in her studydone on 189 routine Forensic cases. Table-5 showsthat histopathology examination did not affect thelegal status of all studied cases by any means weatherit was a Natural or UN-Natural death. It shows thatthe legal status of the cause of death in any of thecase is not changing even after the histo-pathologyexamination, which is well supported by otherauthor‟s also. [6, 7, 8]In few of the cases studied, we have noticedthat morbid anatomical findings observed duringautopsy examination were not supported by histopathologyexamination further, which creates anunwanted contradiction in the opinions of two expertsand it also provides a valid ground to get some legalbenefit by the accuse party.Because of such bitter experiences in courtand advanced knowledge in postmortem to diagnosethe pathology may help the <strong>forensic</strong> experts to avoidthe histo-pathology examination in routine autopsycases. In most of the pathological deaths legalauthorities prefer to conduct the medicolegal autopsyof the deceased to rule out the causes of death otherthan pathology and once it is established duringautopsy that it is a case of pathological death (Naturaldeath) then they are also not interested to know theexact pathology and its significance as it will notaffect the legal status of case in future.There may be number of reasons of thiscontradiction between autopsy and histopathologyexaminations, few of them are discussed here:‣ Improper sampling/ preservation of tissuesduring autopsy.‣ Autolysis of the tissues is quite common.‣ Sections for histo-pathological examination maybe taken from the site where lesion is notpresent.‣ Necrosed tissues which are visible during grossexamination in autopsy may slough out duringpreservation or during processing of tissues formicroscopic examination.‣ Most of the tissues received for histopathologicalexamination show non specificfindings e.g. congestion, cloudy swelling,inflammatory cells etc., which may not behelpful to establish the cause of death.‣ Insufficient priority given to histo-pathologicalexamination of autopsy specimens by technicalstaff and pathologist already burdened withincreasing workload of surgical resections,biopsies and cytology.‣ Some pathologists do not want to indulgethemselves in medicolegal complications and toavoid legal queries further they may not writeany specific opinion about the pathology found.Conclusion:An autopsy can be helpful to the family andrelatives to understand about the cause of death oftheir loved one and it might also benefit futuregenerations of the family, if deceased person diedbecause of an inherited disorder. On the other hand itfacilitates doctors and law enforcing agencies to replyon various facts of the death especially when it is acase of sudden death, where the deceased is usually ahealthy person and died because of some unknownreason. Our study shows that the autopsy should becarried out to a much higher standard and it should bedirected to answering the specific questions asked bythe law enforcing agencies in relation to the legalmatters not about the pathology.Therefore, now the trends are changingregarding the utility of histopathology examinationwhere the autopsy surgeons are inclined to addressthe specific questions asked by legal authorities inregard to cause of death not to know the exactpathology and its future use. Autolysis of tissues,improper sampling and non-specific or incompleteinformation in histopathology report etc. may be thereasons to support them further. Thus, we feel thatroutine microscopic examination in <strong>forensic</strong> autopsyis avoidable and should rather be used rationally asand when the circumstances are indicating its worthand demand.References:1. Kotabagi RB, Charati SC and Jayachandar MD. Clinicalautopsy Vs Medicolegal autopsy. MJAFI. 2005; 61: 258-63.2. Rao NG. Practical Forensic Medicine. 3 rd Edition, 2007.149.3. Aggrawal A. Histopathological changes in electrocution.Anil Aggrawal's Internet J Forensic Med and Toxicol [serialonline], 2002; 3(2):11.4. Job C, Revi NG and Chandran MR. Regional study ofparquet poisoning during 1997. Indian Acad Forensic Med.2000; 23(1): 63-68.5. Sutay SS and Tripude BH. Pattern of histopathologicalchanges of liver in poisoning. J Indian Acad Forensic Med.2008; 30(2): 63-68.6. Gupta BD & Jani CB. Status of histopathologicalexamination in medicolegal postmortem examination: Indianscenario. J Forensic Med Toxicol. 2003; 20(2): 15-18.7. Jani CB, Gupta S, Gupta M, Patel K and Shah M.Forensic Histopathology: Bane or a Boon. J Indian AcadForensic Med. 2009; 31(3): 222-29.8. Molina DK, Wood LE and Frost RF. Is routinehistopathological examination beneficial in all medicolegalautopsies? Am J Forensic Med Pathol. 2007; 28: 1-3.9. Vij K. Textbook of Forensic Medicine and Toxicology. 3 rdEdition; 2005: 149.10. Reddy KSN. The Essentials of Forensic Medicine andToxicology, 27 th Edition. K.Saguna Devi, Hyderabad, 2008,133.130
J Indian Acad Forensic Med, <strong>32</strong>(2) ISSN 0971-0973Table-1Age and sex wise distribution of casesAge Group Male Female Total0-10 04 01 0511-20 04 04 0821-30 11 12 2331-40 17 07 2441-50 08 03 1151-60 07 01 0861&above 06 05 11Total 57 33 90Table-2Distribution of cases according to major systeminvolvedSystem InvolvedNumber of CasesNervous System 04 (4.44%)Cardio-Vascular System 36 (40.0%)Respiratory System 27 (30.0%)Gastro-Intestinal System 06 (6.67%)Renal System 01 (1.11%)Genito-Urinary System 09 (10.0%)Not Known (Negative Autopsy) 07 (7.78%)Total 90Table-4Effect of histo-pathology examination on cause ofdeathCause of Death No. of CasesAfter Autopsy Apparent 74 (82.22%)Not Apparent 16 (17.78%)After HistoPathology Discrepancy Found 05 (5.56%)ExaminationDiscrepancy Not 85 (94.44%)FoundTotal 90 (100%)Table-3Distribution of cases according to pathologyobservedOrgansPathologyObservedDuring Histo-PathologyExaminationNo. ofCases (%)No. ofCases (%)Brain Congestion 70 (77.7%) 38 (42.2%)Oedema 09 (10.0%) 03 (03.3%)Lungs Congestion 72 (80.0%) 52 (57.7%)Oedema 34 (37.7%) 30 (33.3%)Pneumonia 28 (31.1%) 22 (24.4%)Tuberculosis 08 (8.89%) 12 (13.3%)Heart CoronaryAtherosclerosis21 (23.3%) 23 (25.5%)Valvular Heart 04 (4.44%) 04 (04.4%)DiseaseMyocardial 00 (00%) 08 (08.8%)InfractionLiver Congestion 63 (70.0%) 44 (48.8%)Fatty Changes 05 (5.55%) 08 (08.8%)Necrosis & 02 (2.22%) 06 (06.6%)InflammationCirrhotic 01 (1.11%) 02 (02.2%)ChangesKidneys Congestion 63 (70.0%) 42 (46.6%)Coagulative 04 (4.44%) 38 (42.2%)NecrosisChanges of 03 (3.33%) 03 (03.3%)Renal FailureSample AUTOLYSED 11 (12.2%) 11 (12.2%)Table-5Effect of histo-pathology examination on legalstatus of cause of deathLegal Status of No. of CasesCaseAfter Autopsy Natural 66 (73.33%)After Histo PathologyExaminationUN-Natural 24 (26.67%)Natural 66 (73.33%)UN-Natural 24 (26.67%)Total 90 (100%)131
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