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Age is one among the factors which is supposed to be identified in establishing identity of an unknown or deceased person. It is found to be more reliable and accurate to determine the age of a person. The determination of age can be achieved from various physical markers present in body, this includes teeth, bones, and skull. There is certain age where the long bones tend to complete their growth, the growth of skull is well marked by the time of order of their suture closures. A well-developed cranial bone depicts that it is intersected with a suture. besides the bone and skull another reliable physical marker is the human teeth, teeth is considered to be the hardest tissue in humans which is not affected by the factors such as heat, temperature, moisture etc. it is an effective identifier in cases of mass disaster where it is practically impossible to determine the identity of the person through the bones available from the crime site. Teeth is a very important factor to determine the age in disputed cases. Since the age can be estimated even from skeletal remains, teeth are preferred for estimation in certain cases as it is considered to be one among the hardest tissues of the human body. Teeth has got a very unique feature as it cannot be destroyed by heat or any thermal factors or other environmental factors. This property of the teeth has to be effectively utilized for age estimation. The following study was conducted on migrant workers working on a peeling company, the purpose behind the study is to determine whether all the workers have 18 years of age and to ensure that no or none of them are working below the age of 18. There are certain cases reporting that some of these workers have found committing impersonating forgery claiming to be above 18 years of age. The study is specifically to find the age of workers by examining the teeth and also to find if any forgery is done or not. This study was also done to check whether labor laws has been violated or not in accordance with the Constitution of India, no child below the age fourteen years of age shall be employed to work in any factory or mine or engaged in any other hazardous employment, therefore employment of a child under the age of 14 years is punishable by law (child labor prohibition and regulation act of 2012). The need of the study arises from this very fact that the proof of age is not an authenticated document. With repeated reports of forgery regarding the proof of age, submitting ration card as proof of age. And in the wake of current scenarios to ensure that no child is exploited in any kind of ways. The study was done on migrant labor population working in a factory and the estimation is carried out using the Demirjian method along with Acharya’s India specific value and the probable age of the respondents are calculated.

Current international experience has shown the vulnerability of health-care systems of developed nations, and of developing nations such as India, to coronavirus disease 2019 (COVID-19). COVID-19 pandemic is a disaster with mass casualties. International experience has revealed that, even in the countries where mass disasters are less frequent and not involved in conflicts, they are overwhelmed with COVID-19 deaths. Although, in the current scenario with fewer deaths, India’s health-care system can handle the situation of COVID-19 but should be prepared for the worst in terms of appropriate management, and adequate infection prevention measures including handling the dead without hampering the dignity of the deceased and of the surviving family. Before any crisis overwhelms responders and resources, emergency response plans should be established and activated to ensure the reliable identification and documentation of the dead. The current review was carried out to recommend the proper management of dead bodies in the COVID-19 mass disaster with a particular focus on resource-poor countries, such as India.

Background: No two people have exactly the same fingerprints. Even identical twins, with identical DNA, have different fingerprints. This uniqueness allows fingerprints to be used in all sort of ways, including background checks, biometric security, mass disaster identification, and of course, in criminal situations. This scientific examination of fingerprints for identification purposes is known as dactylography. Aim: To prove the uniqueness and study various pattern of fingerprint in an individual. Objectives: 1) To study pattern of fingerprints for identification of an individual, 2) To study different types of fingerprints and keep statistical data of loops, whorls, arches and compound/composite in a group of individual, and 3) To study different methods of fingerprinting in an individual. Methodology: The study was conducted among individuals under the age group of 25-40 years, including 50 males and 50 females. The study was conducted based on Henry Galton method. The fingerprints were taken by means of an ink pad on a blank sheet; a magnifying glass was used for clarity of the finger impressions. Result: There are 4 types of fingerprints namely loops-52.16%, whorls-34.99%, composite-10.04% and arches-2.81%. Conclusion: On this basis uniqueness of fingerprints was proved. Fingerprints are considered as secondary evidence in the court of law, even though it is used as a primary and the most basic source of identification of an individual. Also according to our study the percentage of types of fingerprints varied.

Background:Gender determination is one of the important parameters in forensic identification. Study of anthropometric characters is of fundamental importance to solve problems related to such cases. Paranasal sinuses and particularly the frontal sinuses have been utilized for this purpose. The unique nature and irregular shape of the paranasal air sinuses make them suitable for this purpose. In cases of mass disaster and criminal cases, paranasal sinuses remain intact even if the skull and other bones are badly blemished.Objectives: The present study was designed to determine sex by the use of frontal and maxillary air sinuses dimensions from CT scans of paranasal sinuses. Methods: The present work included 100 adult patients (50 males and 50 females). The measurements of the length and width of the maxillary and frontal air sinuses were done using CT scan on DICOM images using Electronic Caliper inbuilt in the DICOM viewer software. Results: Right frontal air sinus width was the most specific (specificity 86 %) and right frontal air sinus length was the most sensitive (sensitivity 94%) measure to discriminate between both genders. ROC analysis indicated that the highest sensitivity rate was obtained for left maxillary air sinus length (sensitivity 100%) and the highest specificity rate was obtained for right maxillary air sinus length (specificity 100%). The right frontal air sinus length was the best discriminate variable between genders with overall accuracy of 80% in females and 92% in males. The maxillary air sinus length was the best predictor of gender in males and females with accuracy (100% in females and 98% in males).Conclusion:The mean values of frontal and maxillary air sinuses widths and lengths for both right and left sides were statistically higher in males in comparison to females. The mean values of right side frontal and maxillary air sinuses lengths and widths were higher than those of the left side in males and females. The left maxillary air sinus length is the most specific and sensitive parameter to predict gender

SUMMARYComplementary and integrative medicine provides safe, low-cost, effective treatments for conditions ranging from everyday stress to post-traumatic stress disorder. The evidence for herbs, nutrients and mind–body practices is growing, despite disproportionately small amounts of financial support compared with funding for expensive pharmaceuticals. The unsustainable cost of conventional treatments, the moral imperative to care for millions of uninsured and the impact of COVID-19 compel us to fully explore known and potential benefits of treatments being used by complementary and integrative practitioners.

Introduction: Identification is the determination of the individuality of a person based on certain physical characteristics that exactly fix the personality. Identifying victims in cases of mass disaster, when limited human remains are present, is quite a challenging task. Usually peripheral extremities of human body are used in estimating stature. In situations where only skull is available, teeth play an important role in personal identification. The present study used Carrea’s index in stature estimation using tooth dimensions.

Forensic odontology frequently plays a significant role in identification of the victims of multi-fatality disasters, but not in all. It depends on adequate dental remains surviving the disaster and on the availability of dental records to be successful. This paper describes current practice in the techniques of identification in forensic odontology and outlines recent advances that are moving into the mainstream.Key PointsForensic odontology plays a key role in mass disaster victim identification (DVI) when good-quality antemortem (AM) dental records are available.Images including radiographs, computerized tomography (CT) data and three-dimensional (3D) scan data are considered more reliable AM records than written dental charts and odontograms.Interpretation, transcription and comparison of dental datasets are complex processes that should be undertaken only by trained dental professionals.The future of forensic odontology DVI techniques is likely to include the use of 3D datasets for comparison.

Recent studies have demonstrated that early transfusion of plasma or RBCs improves survival in patients with severe trauma and hemorrhagic shock. Time to initiate transfusion is the critical factor. It is essential that transfusion begin in the prehospital environment when transport times are longer than approximately 15 to 20 minutes. Unfortunately, logistic constraints severely limit the use of blood products in the prehospital setting, especially in military, remote civilian, and mass disaster circumstances, where the need can be most acute. US military requirements for logistically supportable blood products are projected to increase dramatically in future conflicts. Although dried plasma products have been available and safely used in a number of countries for over 20 years, there is no dried plasma product commercially available in the United States. A US Food and Drug Administration-approved dried plasma is urgently needed. Considering the US military, disaster preparedness, and remote civilian trauma perspectives, this is an urgent national health care issue.

Background: Post-traumatic stress disorder (PTSD) is one of the most frequent and severe psychiatric consequences of natural disasters, frequently associated with suicidality. The aim of this study was at examining the possible relationships between suicidal behaviors and full-blown or partial PTSD, in a sample of young earthquake survivors. The second aim was at investigating the specific role of PTSD symptoms on suicidality.Methods: A total of 475 young adults who survived the L'Aquila 2009 earthquake, one of the most severe Italian disasters of the last decades, were recruited and assessed after 21 months from the catastrophe. Participants were evaluated by two questionnaires assessing subthreshold psychopathology, the Trauma and Loss Spectrum Self-Report (TALS-SR) to investigate both full and partial PTSD, and two specific Mood Spectrum Self-Report (MOODS-SR) sub-domains exploring suicidality, namely suicidal ideation and suicide attempts.Results: The ensuing findings showed that suicidal ideation and suicide attempts were present, respectively, in 40 (8.4%) and 11 (2.3%) survivors. Rates of suicidal ideation were significantly more elevated in full-blown PTSD subjects (group 1), as compared with those suffering from partial (group 2) or no PTSD (group 3). Interestingly, group 2 subjects showed significantly more suicidal ideation than healthy individuals, and less than those of group 1, while the frequency of suicide attempts was similar across the three groups. Suicidal ideation was associated with higher scores in the following TALS-SR domains: grief-reactions, re-experiencing, avoidance and numbing, maladaptive coping, and personal characteristics/risk factor.Conclusions: The results of the present study support and extend previous findings on the role of PTSD symptoms in suicidality after a severe earthquake. However, as compared with available literature, they also highlight the significant impact of sub-threshold PTSD manifestations in increasing the suicide risk in survivors of a mass disaster.

While both direct and indirect exposure to mass trauma are increasing in the United States, relatively little is known about the potential link between mass trauma and risk of panic disorder early in life. It is also unclear whether history of prior individual trauma increases risk of panic disorder even further among those with exposure to mass trauma. The current study investigated the association between exposure to a mass trauma event (the World Trade Center (WTC) attack) and risk of panic disorder among children, how panic disorder varies by exposure severity and sociodemographic characteristics, and whether there is an interaction between individual and mass trauma exposure in the risk of panic disorder. Data were from an epidemiologic study of probable mental disorders among New York City schoolchildren exposed to the WTC terrorist attack. Severe (adjusted odds ratio [AOR] = 2.0 (1.1, 3.7)) exposure to the WTC disaster was associated with increased odds of probable panic disorder, relative to mild exposure. The prevalence of panic disorder increased with higher level of WTC exposure among all sociodemographic strata. Prior individual trauma exposure was associated with increased odds of panic disorder (AOR = 2.4 (1.6, 3.5)), but there was no evidence of interaction between prior individual trauma exposure and exposure to the WTC disaster. Preventive measures to address the widespread nature of mass disaster exposure at increasingly earlier ages and via media could mitigate the potential impact on mental health.

The aim of this paper was to conduct a descriptive study of the Kiss nightclub fire associated to a literature review in order to synthesize data regarding the logistics employed in the mass disaster management. A discussion comparing the scientific evidence and data from the Kiss nightclub case is presented. This paper focuses on the following aspects: role and importance of the media, management of donations, and coordination of the humanitarian logistics. In the case herein analyzed, the humanitarian response was considered adequate, especially in the survivors’ care. An efficient coordination strategy was adopted, and the media played a vital role requesting blood donations. Further research and case studies in the area of logistics are needed to achieve more effective responses in mass disasters.

One of the important issues during the response to a mass disaster is the identification of victims. In this study, we verified the use of the occlusal morphology of molars for individual identification. The aim of this study was to establish a simple new method for identifying individuals from molar data. Using Python, we developed programming that included the perceptual Hash (pHash) function and the Hamming distance (HD) between antemortem data (AMD) and postmortem data (PMD). The AMD comprised 2,215 dental models. The PMD were selected from the AMD set and comprised 17 models from the same individual with changes over time. As a result, 16 PMD models (over 90%) were ranked in the top 5%. Although identification using only a single molar is difficult, there is the possibility of narrowing down victims' identity with high accuracy through verification using multiple teeth. This system is expected to be useful as a very simple method of identification.

Forensic dentistry or odontologyis the implementation of the knowledge regarding the dentalaspects in criminal cases and mass disaster where individual identification is done by the individual’s dental records. Palatoscopy is one of the method for DVI (disaster victim identification) used in forensics. The principal behind identification via dental records lies in the fact that no two oral cavities are same. Hence the teeth, rugae, any pathologies or anomalies are unique to an individual. In this article we will discuss about Palatoscopy, its role in DVI and why it is preferred. Keywords: Forensic odontology, Palatoscopy, Disaster victim identification, Rugae.

We describe the design and implementation of a system to automate patient handling and assignment to hospitals in mass disasters involving a large number of injured victims over a wireless network. In addition, the previously developed MEDTOC system is modified and enhanced to include location-aware features at the disaster site, as well as quick classification and assignment of patients to nearby hospitals. We present the designed implementation and the results from a simulated disaster involving a fictitious 20-story apartment building located in Ras Al Khaimah, United Arab Emirates. It is expected that chaotic mass-disaster situations can be more suitably controlled and stabilized by using the techniques from this project, thus saving more lives.

In terms of preventing or reducing the mass disaster caused by chemical and biological warfare agents, establishing an efficient chemical and biological defense system is vital. South-East European countries are located in the “hot region” where some of the neighboring countries have had a chemical and biological weapons production program or do not comply with the international treaties related to the prohibition of chemical and biological weapons. On the other hand, setting up the chemical and biological defense is difficult and requires excessive expenditure, which causes a large economic hardship. The formation of a chemical and biological defense system in the South-East European countries would prevent the chemical and biological weapons threat in this region, and in addition, would be able to make a contribution to global security.

Mass casualty incident (MCI) can occur at any time and place and health care institutions must be prepared to deal with these incidents. Emergency department staff rarely learn how to triage MCI patients during their medical or nurse degrees, or through on-the-job training. This study aims to evaluate the effect of training and experience on the MCI triage performance of emergency personnel. Methodology: This was a cross-sectional prospective study that analyzed the performance of 94 emergency department staff on the triage classifications of 50 trauma patients, before and after a short training in MCI triage, while taking into account their academic background and work experience. Results: The participants were assigned initially to one of two groups: low experience if they had less than 5 years of practice, and high experience if they had more than 5 years of practice. In the low experience group, the initial accuracy was 45.76 percent, over triage 45.84 percent, and subtriage 8.38 percent. In the high experience group, the initial accuracy was 53.80 percent, over triage 37.66 percent, and sub triage 8.57 percent. Postintervention Results: In the low experience group, the post intervention accuracy was 63.57 percent, over triage 21.15 percent, and subtriage 15.30 percentage. In the high experience group, the post-intervention accuracy was 67.66 percentage, over triage 15.19 percentage, and subtriage 17.14 percentage. Conclusion: Upon completion of this study, it can be concluded that MCI triage training significantly improved the performance of all those involved in the workshop and that experience plays an important role in MCI triage performance.

The ANDE 6C Rapid DNA system could offer a potential alternative for the processing of calcified and soft tissue samples, often encountered in mass disaster scenarios. While originally designed for single source buccal swabs, interest in the performance of these instruments when using other types of single source samples continues to grow. To enhance the recovery of otherwise lesser quality samples, the manufacturer developed the investigative biochip, an alternative to the NDIS approved Arrestee biochip for reference sample buccal swabs. This study explores the viability of using the ANDE 6C system and the investigative biochip to process soft and calcified tissue, and uses conventional sample processing to contrast the results. Though the success rate obtained using the instrument's expert system was lower than expected - 0% muscle, 11% ribs, and 50% teeth -, the ANDE 6C offers an advantage over conventional calcified tissue processing in terms of turn-around time and processing complexity. If robust analysis parameters can be established to allow the evaluation of the generated data by a qualified analyst on a third party software platform, the use of the ANDE 6C and investigative biochip could be a suitable alternative for currently employed procedures. However, as is the case with conventional DNA typing, the quantity, age, type of biological material and quality of the exemplars could all play a role in the success of the ANDE 6C typing process. In addition, it appears as if the calcified tissue pre-processing protocol that provides the better opportunity for the ANDE 6C success is not appropriate to be carried out in the field or by non-trained personnel as special equipment as well as a certain level of exe expertise and technique is necessary. Nevertheless, disaster victim and unidentified human remain samples could be processed in a laboratory setting using the Rapid DNA ANDE 6C platform provided sufficient material is available to conduct a second, 'rescue' sample processing if necessary.

The occurrence of mass disasters has increased worldwide due to changing environments from global warming and a heightened threat of terrorism acts. When these disasters strike, it is imperative to rapidly locate and recover human victims, both the living and deceased. While search and rescue dogs are used to locate the living, cadaver detection dogs are typically tasked with locating the dead. This can prove challenging because commingling of victims is likely to occur during disasters in populated areas which will impact the decomposition process and the resulting odour produced. To date, there has been no research to investigate the process of human decomposition in a mass disaster scenario or to understand which compounds are detectable by cadaver detection dogs. Hence, the current study investigated the human decomposition process and subsequent volatile organic compound (VOC) production in two simulated building collapse scenarios with six human donors placed in each scenario. The human remains were only recovered after a period of one month, during which time VOC samples were collected and analysed using comprehensive two-dimensional gas chromatography coupled with time-of-flight mass spectrometry. A considerable degree of differential decomposition was observed upon recovery of the human remains, which was carried out as a part of a police disaster victim recovery training exercise. The location of the bodies in the disaster area was found to impact the decomposition process. The VOC profile was found to correlate with the decomposition process. Fifteen days following the simulated disaster, the VOC profile changed showing that a detectable change in the decomposition process had occurred. Overall, the changing VOC profile can inform the training of cadaver detection dogs for these unique scenarios.

Recently, natural disasters and terrorist activities have been leading to mass casualty situations unexpectedly around the globe. In addition to the traditional emergency medical services centering around medically trained and paramedic personnel, dental practitioners having vital skills and attributes may be important in responding to a mass casualty situation.This paper aims at discussing the role of dentists in disaster management and the role of forensic odontology in the disaster victim identification (DVI), its status in India and some suggestions to develop the plans for same.Articles were searched in various medical databases such as Google Scholar, Pubmed Central, Sciencedirect,Wiley online Library, Scopus, Copernicus to gather all relevant information on the subject. Various keywords were used as search tool such as 'Mass disaster', 'Forensic odontology', 'Victim identification'.The search resulted in total of 170 articles which we reviewed. Due to limitation to the list of references we have constricted our review to only 39 articles for more informative literature and supported the topic of the present manuscript 'The Role of Dentistry in Disaster Management and Victim Identification: An Overview of Challenges in Indo-Nepal Scenario' more specifically.Every disaster is unique and involves interplay of different factors and circumstances such as nature of disaster, number of victims and extent of body fragmentation that ultimately challenges the disaster response planning. Apart from the victim recovery and evacuation, the disaster response planning must include the established procedures for the identification of the victims of the disaster. The identification of victims essentially relies on forensic anthropology, radiology, DNA typing and fingerprints, as well as odontology.

Forensic odontology is a sub-discipline of dental science which involves the relationship between dentistry and the law. The specialty of forensic odontology is applied in radiographic investigation, human bite marks analysis, anthropologic examination and during mass disasters. Besides the fact that radiographs require pretentious laboratory, it is still claimed to be a facile, rapid, non-invasive method of age identification in the deceased. The budding DNA technology has conquered the traditional procedures and currently being contemplated as chief investigating tool in revealing the hidden mysteries of victims and suspects, especially in hopeless circumstances. Forensic odontology has played a chief role in solving cold cases and proved to be strong evidence in the court of law. Systematic collection of dental records and preservation of the same would marshal the legal officials in identification of the deceased. To serve the forensic operation and legal authorities, dental professionals need to be familiar with the basics of forensic odontology, which would create a consciousness to preserve the dental data. The aim of this paper is to emphasize the vital applications of forensic odontology in medico-legal issues. Conjointly the recent advancements applied in forensic human identification have been updated. Keywords: bite marks; dental records; forensic identification; mass disaster; medico-legal issues. | PubMed

The postmortem interval is probably the most important puzzle piece in clarifying the circumstances in case of death occurred in unknown conditions. Over the years, radio-imaging modalities have proved their worth in forensic field, providing additional and significant improvements and findings. CT-scan is characterized by wide availability, fast scan times and sustainable healthcare costs. Detection of gas, hemorrhage and bone fractures are points of strength of CT-scan. A reliable evaluation of the post-mortem interval is interesting in the victims of a mass disaster, also following a natural disaster, for the individuation of responsibility in the efficiency of the help and assistance. This work is based on the postmortem CT-scan evaluation of 26 people sadly died during a tragic flood occurred in 2009 in Giampilieri (Italy). In particular, the gas distribution within the skeletal bones was evaluated, with recognition of specific patterns that were then related to the time of death. The identification of intraosseous gas could represent a helpful tool in the estimation of postmortem interval.

This study was aimed at investigating and comparing exposure dose of workers and the surrounding workers. In addition, worker’s exposure was also measure about lens and finger. Four intraoral portable X-ray units were evaluated. The stray radiations were measured using Pitman 37D and ionization chamber (Pitman). MyDosemini (ALOKA) was used for measurement of the finger exposure dose. Without the shield became high in anterior 0.5 m. Comparing the air dose for the four models used in this study showed a high tendency for the two NOMAD models. And using the shields, the images could be taken 4.6 times of the baseline at a maximum and 3.6 times on average. The finger radiation exposure dose was low with both of the NOMAD models, with no significant difference found. By setting the baseline value without a shield, finger radiation exposure when using a shield was lower than the detection limit for the D3000, and was reduced by approximately 94–96% for other three models. All models can photograph around 100 bodies, so it is considered that it is not necessary to switch out the operator considering the operation limit. But even if it does not reach the operation limit, the stochastic effects of radiation exposure can be increased as well as the deterministic effects of the operation limit. The operator and the surrounding workers seek to protect themselves. It is important to perform exposure management that takes into account the stochastic effects to the operator and the surrounding workers.

Identifying the gender of a person is one of the fundamental tasks in forensic medicine. One possible application is right after a catastrophic event such as a mass disaster with a high victim count. In such cases it is necessary to identify the people involved which can require a high number of forensic experts, depending on the scale of the event. With panoramic dental x-ray images the biological gender of a person can be estimated by analyzing skeletal structures that express sexual dimorphism. Current methods require the manual measurement of a wide array of mandibular parameters which are then manually compared to references based on these measurements and assumed ethnicity of the people involved. We propose an automated solution based on deep learning techniques using convolutional neural networks. Our data consists of 4000 panoramic dental x-ray images of patients with European origin, with the images being taken by a wide range of orthopantomographs. Our automated method can estimate 64 images per second on contemporary hardware, it doesn't require human intervention for estimation and it achieves state-of-the-art results with an accuracy of 96.87% ± 0.96%.

Introduction This abstract discusses the experience of a Burn disaster at the largest thermal power plant of the country, which was successfully managed at our center. The experience gained will hopefully help in the planning and management of similar disaster scenes in resource-constrained developing countries. Methods In a National thermal power plant, there was an explosion in the 500-megawatt unit. Hot fuel gases and steam escaped affecting close to 100 people working around the area. Twenty-six people succumbed to death and six victims who sustained burn injuries were referred to our trauma center where they were received about twenty-six hours after the injury. Despite having no infrastructure supporting the treatment of acute burns, proper planning and coordinated effort by all sectors and persons concerned were immediately initiated and ultimately all patients were discharged in a healthy state with no incidence of mortality or significant morbidity from the burns. Results All the six patients were males ranging from 25 to 45 years age and sustained 20% to 45% deep thermal burns over their bodies. All patients were initially evaluated in the emergency where triage was conducted, and four patients out of six were found to have symptoms of respiratory burns and carbon monoxide poisoning. One high dependency unit (HDU) was immediately converted to a burn ICU(Intensive care unit), and all these patients were nursed in isolation. Two patients had severe airway burns and had to be intubated and ventilated. These patients also required hyperbaric oxygen therapy to revert the carbon monoxide poisoning. Out of the six patients, two patients underwent tangential burn wound excision of both upper limbs and skin allograft placement procured from Skin bank. The other four patients underwent debridement, and allograft application subsequently. all the patients recovered from the burn injuries and were discharged with advice to continue rehabilitation at the regional center. This was one of a kind effort where a trauma center was converted to a full-fledged burn ICU to provide the best possible burn care to the victims. A team of 20 people consisting of Plastic Surgeons, Intensivists, Physiotherapists, Nutritionists, Infection Control Nurses, Wound Care Nurses, Hyperbaric oxygen therapist, and other support staff contributed immensely for management of these patients. Conclusions planned cooperation and prepared coordination between the team of doctors and other support staff are the key in the successful management of a disaster. Applicability of Research to Practice In the event of a mass disaster a level 1 trauma center was immediately converted to a facility equipped to handle burns. This experience gained may be useful in the future in the planning and management of similar disaster scenes in developing countries with limited resources.

A disaster is an unexpected event causing death or injury to many people. In such events, a large number of casualties may take place, exposing corpses to a harsh environment for days or months. DNA profiling is recognized as one of the primary methods for identifying mass disaster victims, especially when it involves decomposed or fragmented bodies. The objective of this study was to standardize the use of urinary bladder swabs as a source of DNA for the identification of decomposing and carbonized human bodies by Forensic Genetic techniques. Samples’ DNA was extracted using both organic and Chelex® resin methods; quantified by qPCR and amplified with PowerPlex® Fusion System (Promega Corporation). The results of this study show that between the two methodologies used for DNA extraction, the organic method presented higher DNA yields in relation to the minimum acceptable for the amplification, while Chelex®, although not having a high yield, still allowed obtaining significant amounts of DNA for amplification. The use of bladder swabs has proven to be a viable source of DNA for human identification, since besides reproducible and reliable results, this type of sample allows a significant reduction in the time and cost required for analysis.

In 2006, unexpected discoveries of buried World Trade Center (WTC) debris and human remains were made at the World Trade Center mass disaster site. New York City's Office of Chief Medical Examiner (OCME) was given the task of systematically searching the site for any remaining victims' remains. The subsequent OCME assessment and archaeological excavation conducted from 2006 until 2013, resulted in the recovery of over 1,900 victims' remains. In addition, this operation demonstrated the essential skills archaeologists can provide in a mass disaster recovery operation. The OCME excavation data illustrates some of the challenges encountered during the original recovery effort of 2001/2002. It suggests that when understood within the larger site recovery context, certain fundamental components of the original recovery effort, such as operational priorities and activities in effect during the original recovery, directly or indirectly resulted in unsearched deposits that contained human remains.

Identification of humans, especially in mass disaster is a challenging aspect for team members of the disaster victim identification (DVI) unit. Identification is necessary for humanitarian and emotional reasons and for many legal issues, particularly for family members. In the modern day, all possible methods have been applied for establishing the identification of deceased individuals. The DVI team comprises specialists from different disciplines. The forensic dentist plays a major role in the identification of victims in disaster. To establish a simple, faster and time saving procedure for Postmortem dental identification in mass disaster. In this article, we present a simpler and faster method, which helps in gaining access into the oral cavity that helps in the recording of postmortem oral findings where required.

Introduction: The modern high-resolution imaging has been used as a well described aid in the setting of post-mortem investigations. In developed countries Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are now being evaluated as complementary means for cause-of-death determination. Objective: This paper explores the implication of virtual autopsy from ethical and technical point of view. Methods: Published literature with strict inclusion and exclusion criteria were extensively reviewed through use of general and Meta search engines to elucidate the applications and implications of virtual autopsy. Discussion: Virtual autopsy introduces a new era in autopsy examination. It utilizes the technological innovation of modern imaging system to obtain high quality 3 Dimensional images of the body in multiple plains without mutilation of the human body. The Virtual Autopsy can be applied in a broad number of forensic situations, such as thanatological investigations; carbonized and putrefied body identifications; mass disaster cases; age estimation; anthropological examinations and skin lesion analyses, determining cause of death determination; decedent gender, identification in 001 JAFMC Bangladesh. Vol 9, No 2 (December) 2013 difficult forensic cases; body length and Individual decedent feature identification; identifying distinct foreign bodies – retained bullets, blades, etc.; identification of injuries and forensic reconstructions – three dimensional reconstructions, bullet tract identification; education and clinical performance improvement process; and research. Conclusion: Due to its minimal invasive procedure, virtual autopsy is very much acceptable to the society. In USA and European countries virtual autopsy is likely to replace conventional autopsies in future. We can also utilize this modern technology to upgrade the century old investigation system in our country. DOI: http://dx.doi.org/10.3329/jafmc.v9i2.21848 Journal of Armed Forces Medical College Bangladesh Vol.9(2) 2013

A fire is an important cause of mass disasters, involving various forensic issues. Before dawn on an early morning, 16 male visitors in their twenties to sixties were killed in a possibly incendiary fire at a ‘private video parlor’ consisting of small compartments in a building. The main causes of death as determined by forensic autopsy were acute carbon monoxide (CO) intoxication for all of the 15 found-dead victims, and hypoxic-ischemic encephalopathy following acute CO intoxication for a victim who died in hospital. Burns were mild (

Forensic dentistry delineates the overlap between the dental and the legal professions. Forensic identifi cations by their nature are multidisciplinary team eff orts. Odontologists can examine the structure of the teeth and jaws for clues that may support anthropological age estimates. Apart from dental identifi cation, forensic odontology is also applied in the investigation of crimes caused by dentition, such as bite marks. The importance of pedodontist in forensic odontology is to apply his expertise in various fi elds like child abuse and neglect, mass disaster, accidental and non-accidental oral trauma, age determination, and dental records. The aim of this paper is to discuss about the pedodontist perspective in forensic dentistry.

Recent developments have shown that disasters have the tendency to grow both in size and frequency all over the world. Earthquakes in Eastern Mediterranean region denote a major hazard. It is well known that this area hosts very complex active tectonics, accommodates major seismic sources and suffers from many deadly earthquakes. One of the main challenges after a mass disaster event is the care for the directly or indirectly affected population, gathering rapidly in great numbers at specific areas. For the appropriate organization of the emergency shelters, components such as coordination, communication and medical care are considered very important. The medical needs of evacuees must be identified and appropriate care and support must be provided. This paper presents the Information and Communication Technologies (ICT) developed to support emergency services and temporary accommodation in order to speed up the initial procedures and improve the provided help to the affected people.

Due to diversification of ships and limited space of pier, when ships come alongside the shallow water or narrow pier, sea area with small mooring facilities and floating matter is frequently applied. Through these, coming alongside the various space is capable and cost effectiveness is enhanced. However, when ships, applying small mooring facilities and floating matter, come alongside, there can be some impulse by waves between the floating things and ships which possibly leads to mass disaster. Therefore, there should be forecasts and analysis of the movement caused by waves. On this study, we develop measuring system for movement analysis of mooring and floating matters which provides base data with movement traits by measuring 3-D exercise information and acceleration at mokpo maritime university marina facility. Also, the composition and principles of the developed system is explained.

Background Estimation of body height from its segments or dismember parts has important considerations for identifications of living or dead human body or remains recovered from mass disaster or other similar conditions. Objective Stature is an important consideration in determining the identity. Our aim of the study was to investigate the relationship between foot length and body height and to derive a regression equation for stature estimation from foot length and to find out the correlation between body height and foot length. Methods The present study was conducted on 200 medical students of age group 18 to 23 years studying in MGM Medical College, Navi Mumbai, Maharashtra. India. Body height and foot length were measured in centimeter. All the measurements were taken by using standard measuring devices and standard anthropometric techniques. Results Correlation coefficients between stature and foot dimensions were found to be positive and statistically highly significant. Prediction of stature was found to be most accurate by multiple regression analysis. Conclusions In population similar to our subjects, stature and gender estimation can be done by using foot measurements and it will be helpful for Anatomists, Anthropologists and forensic experts to calculate stature based on foot length. DOI: http://dx.doi.org/10.3126/jonmc.v3i1.10058 Journal of Nobel Medical College Vol.3(1) 2014; 66-70

ntroduction: Preparedness against mass and technological disasters is a fundamental obligation of contemporary hospitals. Aim: The investigation and evaluation the degree of preparedness in mass accidents and disasters of a General Hospital in Attica. Material and Methods: A cross-sectional study was conducted where the data collection was based on stratified sampling, with a self-completed questionnaire, and lasted from August to September 2015. The study sample consisted of 300 members of hospital staff. A structured questionnaire was used, where the higher the score the higher the hospital's degree of preparedness. Results: Τ he majority (58.3%) declared that the hospital has experience in dealing with the consequences of a mass disaster. However, a small percentage (21.7%) was aware of the business plans. 42.7% has been trained in first-aid care, but only 7.7% has been involved in activity of major accident and disaster. Also, 50.6% believed that the staff’s responsiveness is good/very good, while 44.3% believed that it is moderate. Hospital preparedness was rated good/very good by 46% and moderate by 41%. However, the total preparedness of hospital was 11 (± 4.7), which means moderate and in particular 41.7% of the participants scored their preparedness from 6 to 10 degrees. Furthermore,theanalysishasshownthatthehospital’sdegreeof preparednessisinfluencedbyage, professional status, responsibility, and years of experience. Conclusions: The preparedness of hospital was moderately assessed. It is therefore necessary to inform and train staff in managing major accidents and disasters.

There are many non-cryogenic tissue preservatives that have been employed for human and non-human specimens and in this review we examine their potential for use in field-based forensic operations such as disaster victim identification (DVI). A number of preservatives show promise for short tandem repeat (STR) profiling of human tissue including FTA paper, solid salt, DMSO, ethanol, buffers and proprietary preservatives. Their use will be governed by considerations such as user safety, cost, ease of use and transport. © 2013 Australian Academy of Forensic Sciences.

Aim The benefits of denture marking include rapid identification of the victims in mass disasters as well as in locating the misplaced dentures in the hospitalized patients, patients in long-term care facilities or in dental laboratories The purpose of this study was to test the use of patient's photograph and memory card with patient's information as denture marker for identification of both the edentulous victims in mass disaster as well as the misplaced dentures in day to day life. Material and methods A patient's photograph (10 mm × 8 mm × 0.4 mm) was placed on the micro SD memory card (15 mm × 11 mm × 0.7 mm) in which the patient's information was already saved. The memory card and photograph were covered with cellophane sheet and inserted in the palatal aspect of the maxillary denture. The photograph and the memory card were evaluated after 6 months. Results After 6 months it was observed that there was no harm to photograph and the memory card. The patient's information in the memory card was completely readable, making its use effective. Conclusions There are several advantages of this innovative, dual purpose denture marking system. It is cost effective, not technique sensitive, does not interfere with the esthetics, oral function or the strength of the denture. It can be used effectively in forensic and non-forensic identifications. The photograph can be used in day to day identification and memory card incorporated in the denture can be used for identification of victims in mass disasters as the patient's information will remain stable in the memory card.

Geographic Information Science (GIScience) technology has been used to document, investigate, and predict patterns that may be of utility in both forensic academic research and applied practice. In examining spatial and temporal trends of the mass disaster that is occurring along the U.S.-Mexico border, other researchers have highlighted predictive patterns for search and recovery efforts as well as water station placement. The purpose of this paper is to use previously collected spatial data of migrant deaths from Arizona to address issues of data uncertainty and data accuracy that affect our understanding of this phenomenon, including local and federal policies that impact the U.S.-Mexico border. The main objective of our study was to explore how the locations of migrant deaths have varied over time. Our results confirm patterns such as a lack of relationship between Border Patrol apprehensions and migrant deaths, as well as highlight new patterns such as the increased positional accuracy of migrant deaths recorded closer to the border. This paper highlights the importance of using positionally accurate data to detect spatio-temporal trends in forensic investigations of mass disasters: without qualitative and quantitative information concerning the accuracy of the data collected, the reliability of the results obtained remains questionable. We conclude by providing a set of guidelines for standardizing the collection and documentation of migrant remains at the U.S.-Mexico border.

Unknown people who have died in suspicious circumstances or in mass disaster often have no evidence to indicate chronological age. Using bone has been being mostly used by an experienced doctor to identify age since it provides the most accurate result compared to other diagnoses. However, due to manual identification, the doctor requires tremendous amount of time and the result is highly subjective to the doctor decisions and experience. In this paper, an automatic identification of person age is performed only from a hand-wrist bone structure. It provides a simpler way and reliable as compared to use full-hand bone structure. An active contour with balloons model is studied to extract hand-wrist bone parts namely epiphysis and metaphysis. From these parts, the width ratio is employed to identify person age. Experiments show encouraging results for the proposed method to automatically identify person age. We believe this can benefit for the future of forensic identification.

Disaster victim identification (DVI) poses unique challenges for forensic personnel. Typical scenarios may involve many bodies or body parts to identify in remote locations with limited access to laboratory facilities and in extreme temperatures. Transportation of tissue samples to a forensic laboratory for DNA profiling can take weeks without refrigeration. As well as protecting DNA for subsequent analysis, tissue preservation methods ideally should be safe, readily available and easy to transport to the scene at relatively low cost. We examined eight tissue preservatives (salt, DMSO, ethanol, ethanol with EDTA, TENT buffer, RNA later ® , DNA Genotek Tissue Stabilising Kit and DNAgard ® ) and compared the quantity and quality of DNA recovered from human tissue and preservative solution stored at 35°C. Salt, DMSO, ethanol solutions, DNA Genotek and DNAgard ® produced full Identifiler ® genotypes up to one month from DNA extracts. In addition, DMSO, DNA Genotek and DNAgard ® produced full profiles from aliquots of the liquid preservative.

The provision of critical care in any environment is resource intensive. However, the provision of critical care in an austere environment/mass disaster zone is particularly challenging.While providers are well trained for care in a modern intensive care unit, they may be underprepared for resource-poor environments where there are limited or unfamiliar equipment and fewer support personnel. Based primarily on our experiences at a field hospital in Haiti, we created a short guide to critical care in a mass disaster in an austere environment. This guide will be useful to the team of physicians, nurses, respiratory care, logistics, and other support personnel who volunteer in future critical care relief efforts in limited resource settings.

Identification of individuals in crime or mass disaster is a daunting task for the forensic experts. The purpose of this study is to evaluate the feasibility of using a memory card for the forensic identification of dentures. The memory card was programmed with all the relevant information regarding the patient identification and the photograph of the patient. A recess was made in the maxillary denture’s polished surface on the palatal aspect. The card was wrapped in cellophane, placed in the recess and then covered with pink auto polymerizing acrylic resin. On retrieval of the card from the denture, the entire data could be read as before without any distortion. The identification cards did not pose any problems in function and speech and were esthetically acceptable by the patients.

Medical resources may be overwhelmed in a mass disaster situation. Intensive care resources may be limited even further. When the demand for a certain resource, like ventilators, exceeds its availability, caregivers are faced with the task of deciding how to distribute this resource.Ethical dilemmas arise when a practical decision necessitates ranking the importance of several ethical principles. In a disaster area, the greatest good for the greatest number principle and the goal of equal distribution of resources may take priority over the needs of the individual. Nonetheless, regardless of the interventions available, it is a prime goal to keep the patients' comfort and dignity as much as possible.In the mass disaster of the Haiti earthquake of January 2010, The Israeli Defense Forces Medical Corps field hospital was one of the first to respond to the call for help of the Haitian people with surgical and intensive care capabilities. It was the only facility able to ventilate children and neonates in the first week after the earthquake, although this ability was relatively limited. SPECIAL ARTICLE: Five case scenarios that we confronted at the pediatric ward of the field hospital are presented: two children with respiratory compromise due to pulmonary infection, one premature baby with respiratory distress syndrome, an asphyxiated neonate, and a baby with severe sepsis of a probable abdominal origin. In normal circumstances all of them would have been ventilated but with limited resources we raised in each case the question of ventilating or not.To help in the evaluation of each case we used a decision-support tool that was previously developed for ventilator allocation during an influenza pandemic. This tool takes into account several factors, including the illness severity, prognosis, and the expected duration of ventilation.Applying ethical priorities to analyze the decision-making problems leads to the understanding that an individualized approach with an ongoing assessment of the patient condition and the availability of resources, rather than a strict predefined decision rule, will give patients a better chance of survival, and will assist in allocating scarce resources.

A Major earthquake and giant tsunami occurred on 3.11, which broadly affected the eastern Japan area along the Pacific Ocean. A large elderly population was confined to their place of refuge and faced a high risk of disuse syndrome due to immobility. Elderly survivors aged 65 and over who were markedly found in an inactive state due to immobilization were regarded as the “risk group” for inactive lifestyles, possibly leading to disuse syndromes. Intervention by means of rehabilitation assistance was required in approximately one third of these inactive survivors (“high risk group”), a rate which was significantly higher in the elderly over 65 years than in younger survivors. Establishment of a rehabilitation assistance system for use in the event of a mass disaster is one of the critical lessons learned following 3.11, which will contribute to serve as a prophylaxis against disuse syndromes arising from inactivate locomotive function. Legal reform of relief actions in mass disasters is highly required to also include physical therapists as official members.

Automated dental identification system is computer-aided software for the postmortem identification of deceased individuals based on dental characteristics specifically radiographs. This system is receiving increased attention because of the large number of victims encountered in the mass disasters and it is 90% more time saving and accurate than the conventional radiographic methods. This technique is based on the intensity of the overall region of tooth image and therefore it does not necessitate the presence of sharp boundary between the teeth. It provides automated search and matching capabilities for digitized radiographs and photographic dental images and compares the teeth present in multiple digitized dental records in order to access their similarity. This paper highlights the functionality of its components and techniques used in realizing these components.