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Background: Suicides are among the leading causes of death in the world and pose a major public health challenge. Mental health issues intensified during the COVID-19 pandemic, causing an increase in the number of suicides globally. Contributory factors included social isolation, loneliness, unemployment, grief due to loss of family, fear of death, and financial stress. Aim: To assess the pattern of suicide deaths following the COVID-19 pandemic as compared to pre-COVID-19 in the South and South-east districts of Delhi. Materials and Methods: Pre-COVID-19 suicide data were reviewed from April 2017 to March 2020. We collected data from police inquest papers, medical records, and the evaluation of autopsy reports. Post-COVID-19 data for suicide deaths were collected from April 2020 and March 2023. The close relatives of the deceased were interviewed using a standardized proforma. Data were analyzed using STATA version 16. Results: A total of 1435 and 1462 suicide deaths were reported in the pre- and post-COVID-19 pandemic period, respectively. Suicide deaths among males were significantly higher in the post-COVID-19 period (P = 0.001). The place of suicide was non-residence in a significantly higher number of suicide deaths during the post-COVID-19 period (P = 0.001), while there was no significant difference in terms of alcohol use (P = 0.249), and physical illness (P = 0.28) during pre- and post-COVID-19 period. The most common cause of death was hanging both in the pre-COVID-19 (93.91%) and post-COVID-19 (95.5%) period. Conclusion: There was no significant difference in the number of suicide deaths pre- and post-COVID pandemic. A significantly higher rate among males, non-residence as the place of suicide, and history of psychiatric illness was found in the post-COVID-19 period. [ABSTRACT FROM AUTHOR]

Hangings are an infrequent wounding mechanism among patients arriving alive to hospital but are frequently encountered by the Coroner's Office. It is unclear if classically described hanging injuries, such as the Hangman's fracture, are common among contemporary hangings patients who typically do not suspend from height. This study was undertaken to define patient and injury characteristics after hangings causing death. All patients presenting to the Los Angeles County Medical Examiner/Coroner's Office (January 2016 – May 2020) who died by hanging were included. Demographics, psychiatric history, hanging details, autopsy type, and sustained injuries were collected. Data variables were summarized with descriptive statistics and the diagnostic yield of a ligature mark in the diagnosis/exclusion of cervical injuries was calculated. Over the study, 1,401 patients died by hanging. Patients underwent external exam alone (n = 1,282, 92%), traditional neck autopsy (n = 114, 8%), or traditional neck autopsy plus postmortem computed tomography scan (n = 5, <1%). Home was the most frequent hanging setting (n = 1,028, 73%) followed by public spaces (n = 80, 6%) and jail (n = 28, 2%). The manner of death was almost exclusively suicide (n = 1,395, >99%) and psychiatric disease was common (n = 968, 69%). Of the patients undergoing traditional autopsy, most had a ligature mark (n = 109, 92%) and only 9 (8%) had a cervical injury (hyoid fractures, n = 6, 5%; thyroid cartilage fractures, n = 4, 3%). None had a vertebral fracture/dislocation. Sensitivity, specificity, positive predictive value, and negative predictive value of a ligature mark were 100%, 5%, 8%, and 100%. Hangings are a frequent cause of death in Los Angeles County. Patients typically have a psychiatric history and die almost exclusively from suicide. Hangings commonly occur at home, in public places, and in jail. Injuries were exceedingly rare and no patient sustained a Hangman's fracture, which may be related to the lack of significant suspension with modern hangings. [ABSTRACT FROM AUTHOR]

Hanging is one of the ten leading causes of death in the world accounting for more than a million deaths annually. The hanging deaths are one of the most important asphyxial types of death which are encountered in day to day life by forensic pathologists. Ligature mark in the neck is the principal external sign in hanging depending on body suspension from ligature point. This prospective study was conducted at the Department of Forensic Medicine, Dr.B.R.Ambedkar Medical College, Bengaluru between January 2018 to December 2018 to assess the information provided by a ligature mark in deaths due to hanging. We found that typical hanging is seen in 50 cases and atypical hanging in 225 cases. Partial hanging is seen in 73.09% deaths and complete hanging in 26.9% deaths. Ligature mark was obliquely placed in 91.3% cases and was found to be running above thyroid cartilage in 80.7% cases. Single ligature mark with a breadth of 1-2cms is observed in the maximum number of cases. In 93% of the incidents, ligature mark showed discontinuity. The colour of ligature mark was reddish-brown in 46.9% cases. [ABSTRACT FROM AUTHOR]

Background: Suicide is a multifaceted phenomenon with multiple underlying risk factors, including alcohol and/or abuse of other drugs and psychiatric illnesses. Toxicological analysis is of crucial importance even in hanging deaths where the cause of death seems to be ‘obvious’. Objective: To investigate hanging suicide deaths, focusing on toxicological findings in their postmortem specimens, over a period of six years in the Eastern Province, Saudi Arabia. Methods: The suicidal hanging deaths in the period from 2014 to 2019 were retrospectively studied from autopsy and toxicology analysis reports. Results: Of the investigated 75 hanging suicides, 64 (85.3%) were males and 11 (14.7%) were females. Most of the cases were in the age group between 31 and 40 years of age (36%). Non-Saudi nationals (57, 76%) much prevailed over Saudi people (18, 24%) and the highest is the Indian population (27, 36%), followed by Saudi nationals (18, 24%). Ethanol was the commonest detected substance in the studied specimens (45, 60%). Cannabis ranked the second (14, 18.6%) followed by antipsychotic drugs (10, 13.3%) and amphetamine (7, 9. 3%).Conclusion:The precise statistical mortality database for hanging suicides deaths may provide a valuable evidence for the importance of postmortem toxicology analysis and the role of alcohol and its effect on the aggressive behavior, human health and mortality. In the current study, Ethanol was the highest detected substance in the studied specimens (45, 60%), with predominance of non-Saudi Indian males. [ABSTRACT FROM AUTHOR]

On taking the consent from Head of the Department of Forensic Medicine, a retrospective study was conducted by analysing post mortem reports maintained in record section. Reports of post mortem examination done from 1st Jan 2017 to 31st Dec 2018 were analysed. Out of 520 cases done during this period, 105 (20.19%) were death due to asphyxia. In the same time data was also analysed with age of deceased, sex of deceased, season and manner of death. Among 105 cases of asphyxial deaths, males were more, accounting for 61 %( 64) of study cases and females were 41(39%) cases. In the present study, commonest method of asphyxial deaths was by hanging (75.1%), followed by ligature strangulation (12.3%) and 1 case each of postural and sexual asphyxia was the cause of death, accounting as a least method of asphyxia deaths. When age wise assessment done, asphyxial deaths were most common in second and third decade of life, constituting most of the suicidal cases. Asphyxial deaths were almost equally distributed among all seasons. [ABSTRACT FROM AUTHOR]

Introduction: In our country, we frequently come across many cases of deaths due to hanging and strangulation which may be suicidal or homicidal. Material and Method: In this study 272 deaths caused by hanging and strangulation were analyzed out of 3224 autopsies conducted in mortuary of S. N. Medical College, Agra from March 2015 to August 2016 for the period of one and half years. Obtained data is analyzed and reviewed with respect to cause, manner, ligature material used and comparative postmortem findings of hanging and ligature strangulation. Results: Out of 272 cases 93.4 % (254 cases) deaths were due to hanging while 6.6 % (18 cases) were due to strangulation. In most cases (193 cases of hanging and 5 cases of strangulation) soft ligature material was used while hard ligature material was used in rest of the cases (61 cases of hanging and 13 cases of strangulation). Most hanging cases (98 %) were suicidal while all strangulation cases were homicidal. Postmortem findings are divided into external and internal and studied comparatively for hanging and strangulation. Conclusion: In this study, suicidal hanging and homicidal strangulation seems to be major manner of deaths. Both these indicate frustration and rage respectively on part of population resulting in increased violence in society which needs to be addressed. On basis of postmortem findings hanging and strangulation can be differentiated in majority of cases. [ABSTRACT FROM AUTHOR]

Introduction: Compression of neck due to hanging is common cause of death. The present study was conducted to determine patho-anatomic findings and inter- related conditions in autopsies. Materials & Method: The present study was conducted on 134 deaths reported due to hanging in last 8 months. The site of ligature mark, causative factors, number of ligature mark, course and position of ligature mark on the neck, material used and the position of knot was recorded. Results: Out of 134 cases, 70 were in males and 64 in females. Maximum cases were in age group 20-30 years. Most common causes for hanging was drug addiction seen in 35 and psychiatric illness in 30. The number of ligature marks was single in 90 (67.1%) and multiple in 44 (32.9%) cases. The type of material used was chunni in 24, bed sheet in 16, rope in 62, sari in10, pant/pajama in 8 and electric wire in 14 cases. Conclusion: Compression of neck due to hanging is common cause of deaths. Authors found that most common causes for hanging was drug addiction and psychiatric illness. [ABSTRACT FROM AUTHOR]

Introduction: Reproductive age is an important crucial period and a marker for human development and any imbalance can affect the health of next generation, social and economic development and thereby the society. Indian women have high mortality rate particularly in childhood and reproductive age the causes of which are usually natural. But unnatural causes have increased in recent times with factors affecting being relationship between spouse and family, status in society, health, education and financial independence. The aim of present study is to study the pattern of unnatural deaths in women of reproductive age and to analyse the probable reasons and the socio etiological factors involved. Materials and Method: The study period was 16 months from September 2010 to December 2011, among autopsy cases of women aged 15 to 44 years. Results: Unnatural death cases in reproductive age group constituted 17 % of which maximum numbers of cases were seen in women between the ages 20-24 years. The manner of death being suicide and hanging, poisoning and road traffic accident were the most common causes of death. Married women constituted maximum number of which 33.65% cases were within 7 years of marriage. Women belonging to grade III socio economic status constituted 57% cases of which maximum were housewives. Conclusions: Unnatural death in women of reproductive age constituted significant number of which age 20 to 24 years were vulnerable. Suicide constituted majority of the cases. Married women with marital disharmony followed by love affair, physical illness and dowry death were common reasons. [ABSTRACT FROM AUTHOR]

Life events and circumstances leading to death change throughout the life course. In this study, 4 age groups within those who have died by suicide are compared in terms method of suicide, sex, occupation, mental disorders, prior suicide attempts, and life events prior to death. Analyses were based on a database of deaths by suicide and undetermined intent based on data in the Northern Ireland (NI) coronial files from 2005–2011 (N  = 1667). Research determined that hanging is very prominent as a method of death within the under-20 age group. Women who die by suicide are more likely to have a known mental disorder than men, and the proportions increase with age group. Relationship difficulties are associated with many of these deaths and particularly for males aged under 40 years. Physical health and life events were more relevant than mental illness per se, in males aged over 61 years. For a sizeable proportion of the cases included in the current database there was no information on the life events prior to death. Understanding the factors associated with suicide across age groups is essential to informing suicide prevention strategy and programs and the development of more nuanced and effective interventions. [ABSTRACT FROM PUBLISHER]

Hanging is the most common method used by people to commit suicide. The rate of suicide is increasing at an alarming rate. This study is intended to know the magnitude of problems leading to suicide by hanging, socio-demographic profile of hanging death victims and detailed study of postmortem findings. This study involved the hanging deaths brought to SIMS RH and District Hospital, Tumakuru for a period of one year. In this study, males outnumbered females, 21-30 year age group was most vulnerable group, cloth material was the most commonly used ligature. A sincere attempt has been made in this study to achieve above mentioned objectives. [ABSTRACT FROM AUTHOR]

For long time forensic investigators have considered Hyoid and laryngeal injuries as important findings in cases of deaths due to strangulation. Further the incidence of injuries to the neck structures in such cases being related to various factors like the age, gender, the type of the hanging based on suspension and the position of the knot are well documented. Our study highlights the impact of other crucial factors which are usually overlooked, but having strong association in the deaths due to strangulations in general and hanging in particular. The study was undertaken in Central Delhi in 100 cases of hanging, where we studied the association between the hyoid and laryngeal fractures with other variables like type of the ligature material used, the number of turns around the neck, the width of the ligature mark, the type of the knot (fixed/running noose), the duration of suspension and the Body Mass Index of the individuals. In our study 42% of cases had hyoid/laryngeal injuries. These injuries were more common in those who had used hard ligature material with more than one turn around their neck and with a broader ligature mark on their neck. Hyoid and laryngeal injuries were also more common in victims who had a running noose and a prolonged duration of suspension. [ABSTRACT FROM AUTHOR]

Suicide is a great menace to the society and shows increasing trends throughout the world. One hundred and fifty cases of known dead bodies of both genders brought for medico-legal autopsy with history of Suicide by hanging were studied at the department of Forensic Medicine, Government Medical College, Madurai, Tamil Nadu, India. There was a male preponderance in the study group (73.3%) whereas in females it was (26.6%). The major cause of suicide was family dispute (30.6%), followed by ailment (26%) and economic crisis (21.3%). The majority of cases were married (66.6%). Socioeconomic status was low in majority of the cases (96.6%). [ABSTRACT FROM AUTHOR]

Deaths by ligature have always been common in the society. The manner of death being suicidal, accidental or homicidal has always been a controversy faced by an autopsy surgeon. Due to the variability of the appearance of the external lesions in different mannerism of mechanical asphyxia's the autopsy surgeon is highly dependent upon the history and the circumstances of the death. This study was undertaken in an attempt to identify specific internal lesions in cases of ligature compression of neck. We studied 46 cases of suicidal hanging and 12 cases of ligature strangulation. All the internal lesions were categorized and their correlation was sought in various manner and mode of asphyxia. Strap muscle haemorrhages, laryngeal fractures and tongue bleed were found to be more prevalent in strangulation than hanging. Absence of external injuries points more towards the case being suicidal hanging. [ABSTRACT FROM AUTHOR]

Asphyxia is best described as an interference with respiration due to any cause - Mechanical, Environmental, or Toxic. Violent deaths resulting chiefly from asphyxia includes death due to hanging, strangulation, suffocation and drowning. The purpose of this study was to analyze recent trends related to asphyxial deaths in the Aurangabad region of central Maharashtra and to compare them with other studies. In the present study, 9910 medicolegal autopsies conducted at Government Medical College and Hospital, Aurangabad, Maharashtra, India were analysed retrospectively from October 2016 to October 2012; in that in total 802 (8.10%) were asphyxial deaths with males (76.30%) were more commonly affected than females. Highest number of deceased belonged to age group of 21 to 30 years. Hanging was most common type of asphyxial death with 69.5 % of cases, followed by Drowning with 24.2 % of cases. This analysis will provide a better understanding of epidemiology and burden of violent asphyxial deaths in society and will help to formulate comprehensive programmes and strategies to prevent same. [ABSTRACT FROM AUTHOR]

Hanging is one of the most common method of suicide in India. Whenever we get a case of hanging for medico-legal autopsy the investigating authority including judiciary expect a positive note about the fracture of hyoid bone from us. Lot of studies have been done to get the exact incidence of the fracture as the current picture varies from nil to as high as 70%. Most of the previous studies are retrospective (based on the autopsy report) in nature and all of them suggest for prospective one. Keeping above things in mind the current study has been done in a prospective manner at Government Hospital, Davangere, Karnataka, India during the period of September 2008 to February 2010. Out of 84 cases studied during the period of eighteen months only one case showed fracture of hyoid bone. [ABSTRACT FROM AUTHOR]

Suicide or self destruction occurs through out the world. The rapid nature of death in hanging makes it one of the most popular method. A total 50 cases of hanging brought to the mortuary of NIMS Medical College and Hospital, Jaipur, for postmortem examination. They were studied during the period of Sep.2013 to Aug.2015. out of 50 hanging cases there were 35(70%) males, and 15(30%) females. The maximum number of cases were found in farmers 20(40%) followed by jobless 10(20%) and students 08(16%) each. Male dominance in society is because of stress, strain, alcohol addiction, break in love affairs, unemployment, failure in examination, loss of crops by natural disaster like flood, famine are the factors contributing to more number of cases of suicide. [ABSTRACT FROM AUTHOR]

A retrospective study was conducted at North Bengal Medical College, Siliguri during a span of 2 years (2013-2014). In this study 183 cases of hanging and 16 cases of strangulation by ligature was included to know the epidemiological pattern like age, sex, religion, marital status, socio-economic status and other predisposing factors in fast changing socio-economic scenario, to study the ligature material and to analyze the morphological changes in the lungs, thyroid and adrenal glands in cases of death due to hanging and strangulation by ligature. It was concluded that highest number of hanging deaths were in the age group of 21-30 years while deaths due to strangulation by ligature was highest in 31-40 years age group. Among the age highest number of hanging death is reported in males while no such difference regarding gender was noticed in deaths due to strangulation by ligature. Our study shows on histopathological examination, hemorrhagic spots found inside the parenchyma of lungs, thyroid and adrenal glands in majority of cases of hanging deaths and death due to strangulation by ligature. [ABSTRACT FROM AUTHOR]

Unnatural deaths due to violent asphyxia contribute to majority of the cases among all unnatural deaths. Deaths due to hanging, strangulation, suffocation and drowning are common examples of violent asphyxia deaths. This study is conducted to find out the relation between violent asphyxial deaths and victims age, sex, demographic profile, marital status and manner of death. The present retrospective study has been conducted for the period of 3 years i.e. 2009, 2010 and 2011 based on autopsy records of the unnatural death cases resulting from Violent asphyxial deaths. Randomly picked 100 male cases and 100 female cases autopsied at mortuary of the District hospital, Raichur, Karnataka have been considered for the study and analyzed retrospectively. Male violent asphyxial deaths dominated over female in the ratio of 2.1:1.Predominant age group were found to be 21-30 years (34%) followed by age group 11-20 (20.5%) and 31-40 years showing (20.5%) showing that youngsters were more involved in violent asphyxial deaths. Maximum victims were from the married group (36%) followed by unmarried (13%) and marital status of (51%) people were not known. Rural population contributed 74% than urban population (10%). [ABSTRACT FROM AUTHOR]

Preventing torture in custody and ensuring strict compliance of its guidelines in custodial deaths is one of the important agenda of NHRC. This article presents data of 19 deaths in custody/prison in north Maharashtra region from the period of 15 years from 01/01/2000 to 31/12/2014. 12 deaths were caused due to suicide, 2 deaths were caused due to homicide, 5 deaths were caused due to accident. Hanging was the most common means of committing suicide. Items of clothing were the most commonly used objects, for committing suicides by hanging. Based on these findings, several measures for prevention of deaths in police custody are discussed. [ABSTRACT FROM AUTHOR]

Objective Globally, suicide is an important cause of mortality. In low- and middle income settings, it is difficult to find unequivocal data to establish suicide rates. The objective of this review is to synthesize the reporting of suicide incidence in six south Asian countries. Methods We conducted a scoping review combining peer-reviewed studies (PubMed, PsycINFO, EMBASE) with in-country searches for grey literature in Afghanistan, Pakistan, Sri Lanka, India, Nepal and Bangladesh. The review included mapping reported suicide rates, quality appraisals of the studies, use of definitions of suicide and means of committing suicide. Results In total, 114 studies and reports were included in the review, including 50 peer-reviewed publications. Reported suicide rates varied widely from 0.43/100,000 to 331.0/100,000. The average suicide rate across studies was found to be high compared to the world average, however many studies were of poor quality or not representative. The majority of studies failed to explicitly define suicide (84% of the published articles and 92% of the grey literature documents). Poisoning and hanging were consistently the most common methods of committing suicide on the sub-continent. Conclusions The reported suicide rates in South Asia are high compared to the global average, but there is a paucity of reliable data on suicide rates in South Asia. Reports are likely to diminish rather than exaggerate the magnitude of suicide rates. There is an urgent need to establish new, or evaluate existing, national suicide surveillance systems in the South Asian countries. [ABSTRACT FROM AUTHOR]

Background: Recently, suicide exceeded motor vehicle crashes as the leading cause of injury death in the U.S. However, details of this change in suicide methods and the relationship to individual demographics, such as age and societal influences, have not been reported. Purpose: To determine the characteristics of the changes in suicide rates between 2000 and 2010. Methods: Data came from CDC''s Web-Based Injury Statistics Query and Reporting System (WISQARS™). Line charts were plotted to reveal changes in suicide rates by firearm, poisoning, and hanging/suffocation (ICD-10 codes: X72–X74, X60–X69, and X70). The measure of change used is the percentage change in suicide rate between 2000 and 2010. Results: The overall suicide rate increased from 10.4 to 12.1 per 100,000 population between 2000 and 2010, a 16% increase. The majority of the increase was attributable to suicide by hanging/suffocation (52%) and by poisoning (19%). Subgroup analysis showed: (1) suicide by hanging/suffocation increased by 104% among those aged 45–59 years and rose steadily in all age groups except those aged ≥70 years; (2) the largest increase in suicide by poisoning (85%) occurred among those aged 60–69 years; and (3) suicide by firearm decreased by 24% among those aged 15–24 years but increased by 22% among those aged 45–59 years. The case fatality rates for suicide by hanging/suffocation during 2000–2010 ranged from 69% to 84%, close to those for suicide by firearm. Analyses were conducted in 2012. Conclusions: Substantial increases in suicide by hanging/suffocation and poisoning merit attention from policymakers and call for innovations and changes in suicide prevention approaches. [Copyright &y& Elsevier]

Background: Hanging is the most frequently used method of suicide in the UK and has high case fatality (>70%).Aims: To explore factors influencing the decision to use hanging.Method: Semi-structured qualitative interviews with 12 men and 10 women who had survived a near-fatal suicide attempt. Eight respondents had attempted hanging. Data were analysed thematically and with constant comparison.Results: Hanging was adopted or contemplated for two main reasons: the anticipated nature of a death from hanging; and accessibility. Those favouring hanging anticipated a certain, rapid and painless death with little awareness of dying and believed it was a 'clean' method that would not damage the body or leave harrowing images for others. Materials for hanging were easily accessed and respondents considered it 'simple' to perform without the need for planning or technical knowledge. Hanging was thus seen as the 'quickest' and 'easiest' method with few barriers to completion and sometimes adopted despite not being a first choice. Respondents who rejected hanging recognised it could be slow, painful and 'messy', and thought technical knowledge was needed for implementation.Conclusions: Prevention strategies should focus on countering perceptions of hanging as a clean, painless and rapid method that is easily implemented. However, care is needed in the delivery of such messages as some individuals could gain information that might facilitate fatal implementation. Detailed research needs to focus on developing and evaluating interventions that can manage this tension. [ABSTRACT FROM AUTHOR]

It has been proposed that filmed hangings may hold the key to a better understanding of human asphyxia, and The Working Group on Human Asphyxia was formed to systematically review and compare these video recordings. This study analyzed eight filmed hangings. Considering time 0 to represent the onset of the final hanging, rapid loss of consciousness was observed (at 8–18 sec), closely followed by convulsions (at 10–19 sec). A complex pattern of decerebrate rigidity and decorticate rigidity then followed. Between 1 min 38 sec and 2 min 15 sec, muscle tone seemed to be lost, the body becoming progressively flaccid. From then on, isolated body movements were observed from time to time, the last one occurring between 1 min 2 sec and 7 min 31 sec. As for the respiratory responses, all cases presented deep rhythmic abdominal respiratory movements (last one between 1 min 2 sec and 2 min 5 sec). [ABSTRACT FROM AUTHOR]

In cases of hanging, the exact mechanism leading to death has yet to be elucidated. Most of our contemporary knowledge is still based on writings from the end of the 19th and the beginning of the 20th century. This article reviews the historic experiments that shaped our current theories. Medico-legal textbooks written in English and French from 1870 to 1930 were reviewed. Various animals, such as rabbits, mice, and dogs, have been used to develop animal models of hanging. Limited human studies on cadavers and judicial hangings have provided some additional insight into the pathophysiology of death by hanging. The main pathophysiological theories described were respiratory asphyxia, interruption to cerebral blood flow because of occlusion of vessels in the neck, and cardiac inhibition secondary to nerve stimulation. The relative contributions of each of these theories to death in cases of hanging is still debated today. [ABSTRACT FROM AUTHOR]

Abstract: Hyoid is a U-shaped bone present in the ventral aspect of neck at the level of fourth cervical vertebra. It is a small bone placed between the root of tongue and the thyroid cartilage. Fracture of hyoid has great significance and importance in forensic pathology. It is well documented that fracture of hyoid is a recognized finding and indicator of strangulation (more common in manual or throttling than by ligature). Fracture of hyoid is less frequently reported in hanging. Discriminant function analysis was used with all predictors (width of hyoid, antero-posterior length of hyoid and length of greater cornu) were entered together. The analysis showed that 96.0% of original grouped cases could be correctly classified. [Copyright &y& Elsevier]

The study of the pattern of unnatural deaths was undertaken to find out the various causes of unnatural death in relation to the age and sex of the victim. The paper presents the retrospective study of 500 post-mortem cases in District General Hospital, Raichur, during the span of five years. The commonest cause was burns (38 % Cases). Rest of cases was of head injury (30 % cases), poisoning, drowning, hanging, etc in descending order. It was found that majority of victims were males, young adults (21-30 years) were more involved. Majority of male deaths were due to injuries and majority of female deaths were due to burns. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To evaluate laryngoscopic findings in hanging cases and to compare them with magnetic resonance imaging (MRI) and forensic autopsy results. Materials and methods: Postmortem nasolaryngofibroscopy and MRI of five people who died from hanging were performed. Three people who died from other causes than hanging were also examined with a flexible laryngofibroscope. The results were compared with injuries discovered during forensic autopsy. Results: In all five hanging cases, laryngofibroscopic investigation showed a vocal fold position in complete adduction confirmed by MRI. This position did not seem to be influenced by the intensity of the forces applied to neck or postmortem delay and cadaveric phenomena. The vocal cords of the three non-hanging deceased were found in the intermediate position. These findings could suggest that pressure applied to the cervical nervous and cartilaginous structures or their elongation during hanging could lead to closure of the glottis with vocal cord adduction maintained after death. Conclusion: Laryngofibroscopic examination in hanging cases could be very useful in confirming the vital character of the hanging and understanding asphyxial phenomena in incomplete suspension without laryngeal crush. [Copyright &y& Elsevier]

The objective of the present study was to estimate the proportion of hanging victims presenting with limb lesions, to compare this rate between hanging in restraint spaces and in more open settings, and to describe the usual pattern of limb lesions associated with hanging. Two hundred and seven cases of suicidal hanging were retrospectively reviewed and compared to 45 homicidal nonhanging strangulation victims. Bruises incidence was significantly lower in hanging victims (19.8%) compared to homicidal strangulation victims (55.6%). Bruises were more commonly encountered in restraint areas such as closets and staircases (56.3% and 66.7%, respectively) than in more open settings such as barn, bridge, fence, and park. Limb bruises on hanging victims were generally located on the posterior upper limb or the anterior lower limbs, whereas strangulation victims did not display this preferential bruises concentration. Possible suspicion criteria for limb bruises distribution are discussed, in relation to physiopathology of human asphyxia by hanging. [ABSTRACT FROM AUTHOR]

Abstract: We experienced suicidal hanging cases without a ligature in front of the neck. We conducted several anatomical autopsies and the magnetic resonance imaging (MRI), and studied the dynamics behind hanging by applying an apparatus to cadaver and creating a dummy. MRI revealed that the vertebral artery protrudes diagonally upward from the second vertebra to the first one. We also found that this area was not covered with any bony tissue. The average length between the first and second transverse processes was 2cm. We measured the minimum required force to obstruct the blood stream in both carotid and vertebral arteries exerting 130mmHg. The required force was 6kg for the carotid artery and 7kg for the vertebral artery. Compared to the reported cases, there was not a significant difference in the force to obstruct the carotid artery, however, that of the vertebral artery was lower than the force reported so far. With an experiment of pressure sensitive plastic-sheet, we learned the lateral sides of the neck are compressed more. The results obtained from this study show that the complete and fatal obstruction of the carotid and the vertebral arteries may easily occur when the ligature transects at the lower part of mandible angle. [Copyright &y& Elsevier]

Background: Suicide prevention is a health service priority. Suicide risk may be greatest during psychiatric in-patient admission and following discharge.Aims: To describe the social and clinical characteristics of a comprehensive sample of in-patient and post-discharge cases of suicide.Method: A national clinical survey based on a 4-year (1996-2000) sample of cases of suicide in England and Wales who had been in recent contact with mental health services (n=4859).Results: There were 754 (16%) current in-patients and a further 1100 (23%) had been discharged from psychiatric in-patient care less than 3 months before death. Nearly a quarter of the in-patient deaths occurred within the first 7 days of admission; 236 (31%) occurred on the ward, the majority by hanging. Post-discharge suicide was most frequent in the first 2 weeks after leaving hospital; the highest number occurred on the first day.Conclusions: Suicide might be prevented among in-patients by improving ward design and removing fixtures that can be used in hanging. Prevention of suicide after discharge requires early community follow-up and closer supervision of high-risk patients. [ABSTRACT FROM AUTHOR]

A case of sexual asphyxial death by hanging is presented. A 35-year-old male, found dead lying on his face in a bed of a truck cab, had hanged himself from a window frame using a leather belt. He was completely naked. There were pornographic and sadomasochistic magazines beneath his face, opened to pages depicted nude photographs of a woman. Autopsy findings revealed a ligature mark on the neck and petechial hemorrhages in the conjunctivae, but there were no hemorrhages in the neck muscles or fractures of the hyoid bone or the thyroid cartilage. The alcohol levels in the blood and urine were 0.78 and 0.45 mg/ml, respectively. The circumstances suggested that his death was accidental, and due to asphyxia by hanging performed to enhance sexual gratification during masturbation. Sexual asphyxia is reviewed and discussed. [Copyright &y& Elsevier]

As quoted by many standard textbooks of Forensic Medicine, in cases of Judicial hanging, the cause of death is fracture of C2 - C3 vertebra. Here, in our institute, PESIMSR, Kuppam, we have received a case of fall from height with fracture of C2 vertebra. The patient is alive with quadriplegia. There are also other articles in literature which state that cause of death in judicial hanging being other than fracture of cervical vertebra. In cases where the death in judicial hanging fracture of cervical vertebra is reported, the cause of death is complete or partial transection of the spinal cord. Usually either in suicidal or judicial hanging there is no fracture of cervical vertebra, even if present is not usually the cause of death. It is asphyxia or cerebral anoxia which is the cause of death. Since Asphyxia is more painful than death by transection of spinal cord, it is our suggestion to the State authorities to consider other painless forms of execution. [ABSTRACT FROM AUTHOR]

In case of asphyxial deaths either due to hanging or strangulation, a ligature mark may be the only external evidence available. Therefore a through examination of ligature mark is needed to ascertain hanging as a probable cause of death. A retrospective study was conducted at the Department of Forensic Medicine and Toxicology, North Delhi Municipal Corporation Medical College, Hindu Rao Hospital, New Delhi from January 2014 to December 2014. During that period we found, death due to hanging constituted 26 (12.09%) of total deaths (215),which were subjected to medicolegal autopsy. Young adults of age group 21 to 30 years accounted for maximum cases, 57.69% while male to female ratio was 1:1.16. Ligature mark was obliquely placed in 88.46% cases and was found to be running above thyroid cartilage in 69.23% cases. On dissection of neck, soft tissue injuries were found in 19.23% cases while fracture of hyoid bone was present in 7.69% cases. [ABSTRACT FROM AUTHOR]

The article discusses a study on the suicide methods of elderly people in England and Wales based on their ethnic groupings. The data on suicides used in the study, which were from the Office of National Statistics, were limited to first-generation migrants rather than the whole black and ethnic minority (BME). The study has revealed that hanging and drug overdose were among the commonest methods of suicide in older people in England and Wales.

The human pathophysiology of asphyxia by hanging is still poorly understood, despite great advances in forensic science. In that context, filmed hangings may hold the key to answer questions regarding the sequence of events leading to death in human asphyxia. Four filmed hangings were analyzed. Rapid loss of consciousness was observed between 13 sec and 18 sec after onset of hanging, closely followed by convulsions (at 14–19 sec). A complex pattern of decerebration rigidity (19–21 sec in most cases), followed by a quick phase of decortication rigidity (1 min 00 sec–1 min 08 sec in most cases), an extended phase of decortication rigidity (1 min 04 sec–1 min 32 sec) and loss of muscle tone (1 min 38 sec–2 min 47 sec) was revealed. Very deep respiratory attempts started between 20 and 22 sec, the last respiratory attempt being detected between 2 min 00 sec and 2 min 04 sec. Despite differences in the types of hanging, this unique study reveals similarities that are further discussed. [ABSTRACT FROM AUTHOR]

This article presents news from the U.S. Centers for Disease Control and Prevention (CDC). In this report, the CDC examines the suicide trends among teenagers and young adults in the U.S. from 1990-2004. The study found that the combined suicide rate for people aged 10-24 years went down overall but during 2003-2004 the rate increased. Suicide rates for females aged 10-14 and 15-19 years and males aged 15-19 went up. The number of deaths from hanging or suffocation and poisoning increased dramatically over the one year.

Hanging is a common mode of suicide and homicidal hanging is rare and is usually possible in the children, thin, elderly and in adults under the influence of drugs or alcohol. We here present a case that appeared like homicidal hanging due to the unusual presence of the ligature material around the face and neck. On detailed examination and from circumstantial evidence it was found to be suicidal. A thorough autopsy examination of the body and meticulous examination of the scene are crucial in such cases where there is doubt regarding the manner of hanging. [ABSTRACT FROM AUTHOR]

Abstract: A case of a combined suicide by oxydemeton-methyl (Metasystox®) ingestion and hanging is reported. Dimethyl phosphate (DMP) proved to be a stable product of oxydemeton-methyl; for its determination a gas chromatographic/mass spectrometric procedure was performed. DMP levels were quantified in several liquids and tissue samples: measured concentrations were 103.31μg/ml DMP in gastric contents, 0.10μg/ml in blood, 1.40μg/g in liver, 2.87μg/ml in bile and 0.80μg/g in kidney. No DMP was found in either urine or cerebrum. On the basis of the distribution of the poison in the organism, and particularly due to the fact that no DMP could be detected in the urine and that also an amount of DMP was found in the gastric contents, it can be assumed that there was a close temporal connection between ingestion of poison and hanging. Therefore, it is a case of a primary combined suicide. [Copyright &y& Elsevier]