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Drowning kills at least 3,72,000 people every year and is the 3rd leading cause of unintentional deaths. In addition to the human tragedy, drowning represents a huge economic problem with direct and indirect costs, including many Disability-Adjusted Life Years. In India, there is limited knowledge about the epidemiology of drowning. The objective of the study was to study the incidence, manner and epidemiology of deaths due to drowning in and around Vadodara region. The present study was conducted from May 2022 to April 2023 in Government Medical College, Baroda on 82 cases to study the various epidemiological parameters of drowning. In this study period, 1989 cases of post-mortem examination were done out of which 82 cases were of drowning deaths. A maximum number of cases were seen in the age group of 21-30 years with 43% cases of males, dominating the study population. 62% of deaths were accidental in nature and occurred during the rainy season. The most common place of occurrence of drowning was river (38%) followed by water canal (31%). Soddening of hands and feet was the most common external feature of drowning followed by the presence of froth at mouth and nostril. Drowning is a most ignored public hazard worldwide with serious implications for the society. Public awareness regarding safety measures and drowning prevention strategies suitable to the needs of geographical region should be adapted. [ABSTRACT FROM AUTHOR]

The diagnosis of death by drowning remains a difficult task for forensic experts at the time of postmortem examination. The presence of putrefaction and postmortem artefacts cover essential signs of drowning found on external and internal examination of dead body. This study involved gross examination of middle ear cavity for presence of haemorrhage to establish a diagnosis of antemortem drowning. It was planned considering the lack of research on this subject in the North Indian population. This study was conducted in the Department of Forensic Medicine and Toxicology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab and included drowning deaths brought for autopsy. This study helped assessing the reliability of incidence of middle ear hemorrhage to affirm the diagnosis of antemortem drowning in the absence of other external and internal signs suggestive of drowning. [ABSTRACT FROM AUTHOR]

Background: an unknown dead body always becomes a challenge to the Investigating officer and forensic expert. However, the problem of determining the identity gets aggravated and taxes for the experts, when the dead body is recovered in decomposed/ skeletonized and mutilated form. Materials and Methods: A standard proforma was designed to collect the information to ensure consistency for the whole sample. All dead bodies that were brought as unidentified were included however identified dead bodies were excluded from the study. Results: A total of 407 post-mortem examinations were conducted at the mortuary of the department during under study and amongst them, 56 cases (13.75%) were found unidentified. Of these unidentified cases, 69.64% (39 cases) were in decomposed and 30.35% (17 cases) were in fresh state. Unidentified cases comprised 80.35% males (45 cases) and 19.64% females (11 cases). Conclusion: Unidentified dead bodies were only 13.75% of the total dead bodies coming to the autopsy in the mortuary of the Department of Forensic Medicine and Toxicology, VCSGGIMS & R, Srikot, Srinagar, Pauri Garhwal, UTTARAKHAND during the study period of 5 years. [ABSTRACT FROM AUTHOR]

Objective: To identify occupational hazards and hazard control strategies adopted by inland fishers of Odisha state in India. Methods: Information on occupational hazards faced by fishers was collected by personal interviews with 90 riverine and reservoir fishers of Odisha. Through qualitative discussions with key informants and review of literature, a list of occupational hazards were prepared and classified into physical, ergonomics, psychosocial, and natural. Responses were quantified, and descriptive statistics were used for data analysis. Results: Occupational hazards faced by fishers were physical (94%), ergonomic (75%), psychosocial (50%), and natural (34%) in nature. Physical hazards include sharp fishing instruments, uneven surfaces, high temperatures, and wet/slippery areas on the vessel along with the presence of snake/leech/crocodile/fish fin rays. About 97% of reservoir and 90% of the riverine fishers reported physical hazards leading to cuts, fractures, dehydration, headache, sunburn, snakebite, leech bite, crocodile bite, and injuries due to fish fin rays. Heavy nature of work and force exerting activities caused pain in the upper back (50%), shoulders (45%), and lower back (41%). Regarding psychosocial hazard, stress (31%), and anxiety (23%) was reported. Common reasons for this were uncertainty in fish catch and extended working hours, causing tiredness, headache, dizziness, and fatigue. Natural hazards like cyclones, floods, and excessive rain caused financial loss and damage to fishing nets and boats. Regarding personal protective equipment (PPE), floating buoys were used by 26% of riverine and 43% of reservoir fishers to avoid drowning. Conclusion: Occupational hazards in the inland fishing sector were identified as physical, ergonomic, psychosocial, and natural. No particular hazard control strategy was reported to be used. Integrating the occupational safety measures in the fisheries policies is thus needed. [ABSTRACT FROM AUTHOR]

Background: Drowning is a significant public health problem globally. It is the third leading cause of unintentional injury death, the post-mortem diagnosis of drowning is achallenge to medico-legal experts as the exact cause of deathsdue to drowning is not very clearly understood. Method: 100 dead bodies aged between 10-75 years death due to drowning (60 male and 40 females) were studied by autopsy. The places of drowning external and internal post-mortem findings were recorded in both sexes. Results: 60 drowning deaths occurred in Lakes Rivers 12 in wells, 24 in house tanks, 4 in swimming pools. In the study of external post-mortem 41 cases had froth around mouth/nostrils, 4 cadaveric spasm, 25 mud/sandy body, 2 cases had mud/sandy in nails, 38 had sign of asphyxia, 50 had sign of injury. In internal findings of postmortem, 34 had forth larynx trachea, 57 had mud/sand/salt in larynx, 83 had voluminous lungs, 23 had stomach content water, 24 had stomach content food, 10 had injury. Conclusion: The present pragmatic study of autopsy will certainly help to medico-legal expert to differentiate homicide and suicide in drowning deaths. [ABSTRACT FROM AUTHOR]

Background: The profile of medico-legal autopsy cases is crucial to determining the mortality rates in a specific location owing to new causes and also aids in addressing the demographic demands in accordance with those rates. Materials and Methods: The present study is a retrospective study of autopsies performed at Department of Forensic Medicine & Toxicology, VCSGGIMS & R, Srikot, Srinagar, Pauri Garhwal, Uttarakhand, from 1st January 2020 to 31st December 2021. During this period a total of 156 autopsy cases were conducted. Relevant information and subjective data like age, sex, marital status & manner of death have been collected from medico legal autopsy register. Results: Out of 156 cases analysed, maximum number of autopsies were in the age group of 21-30 years with 41 cases (26.28%) andmajority of were males 119 (76.2%). Accidents accounted (58.3%), suicide (24.3%) and sudden death (17.3%) cases. Maximum number of deaths were due to road traffic accidents with 82 cases (52.5%) followed by natural death with 27 cases (17.3%). Conclusion: In our study we found that majority of cases were in 3rd and 4th decade of life, majority cases were males as compared to females, and Hindus being majority in number formed bulk of cases. [ABSTRACT FROM AUTHOR]

Introduction: Adolescence is commonly regarded as a healthy time of life, with apeak in strength, speed, fitness, and many cognitive abilities. However, major shifts in health take placearound puberty as new health risks with potentially life threatening consequences become prominent. Unnatural deaths are the leading killer of today's teenage and adolescent generation, as the patterns have changed from infections to social aetiologies during the lastdecades. The unnatural deaths may be due to unintentional or intentional injuries.Unintentional injuries are mainly accidents. Intentional injuries are mainly suicidesand homicide. Aims and Objectives: To know the type, incidence, and sex wise distribution of unintentional deaths of adolescents in the age group of 10 -- 19 years. Material Methods: Department of Forensic Medicine, BMC & RI (Victoria & Bowring and Lady Curzon Hospitals) is a postgraduate institute that conducts autopsies of all sudden, suspicious, unnatural deaths which occur in and around Bengaluru. The present study is a descriptive study of unintentional unnatural death cases of Adolescents (10 to 19 years) which were autopsied at BMC & RI, Bengaluru for a period of 18 months from Dec. 2014 to May 2016. Results: Out of 148 cases of unintentional injury, 109 cases were males (73.64%) and 39 cases were females (26.36%). Among unintentional deaths majority were due to RTA 58 cases (39.19%), Accidental Scalds/Burninjuries 30 cases (20.27%), Accidental drowning 18 cases (12.16%), Electrocution 14 cases (9.45%), Accidental railway injury sustained 15 cases (10.13%), Accidental fall 11 cases (7.43%), Snakebite 1 case (0.67%), Blast explosion 1 case (0.67%). Conclusion: Adolescent age is an important stage in development. Death in adolescentage is a potential life loss to family and society to some extent and reflects socioeconomic and Medical Health Carestatus at the National and Regional levels. Accurate legal investigations is essential increating awareness among National policymakers and educators/caregivers, to prevent adolescent deaths. To conclude useful and informative determinants of adolescent death were identified in this study. Since there is very little information regarding adolescent death in developing countries like ours. This suggests that each and every center conducting autopsies should come up with such studies to reflect the magnitude of the occurrence of unnatural adolescent deaths. [ABSTRACT FROM AUTHOR]

Drowning is one of the leading causes of unintentional injury death worldwide, amounting to about 7% of all injury-related deaths. The estimated world-wide annual deaths due to drowning is said to be around 2,36,000. Children, males and individuals with increased access to water are most at risk of drowning. In India there exists proximity of people with the water bodies like rivers, canals, wells or ponds. All these water bodies are easily accessible and there are hardly any preventive or safety measures. This major public health problem related to drowning can be prevented by frequently studying data from the medicolegal registers, which is primarily the aim of this study. [ABSTRACT FROM AUTHOR]

• In India in 2018, crude rate of non-fatal drowning-related hospitalisations was 31.34 per 100,000. • Average out-of-pocket expenditure per drowning incident was INR25,421 (345.11USD). • 9% of households potentially pushed below the poverty line when impacted by a drowning event. • Prevention of drowning reduces economic burden on low-income households. Background: Drowning is a global public health challenge, with significant burden in low- and middle-income countries. There are few studies exploring nonfatal drowning, including the economic and social impacts. This study aimed to quantify unintentional drowning-related hospitalization in India and associated healthcare expenditure. Method: Unit level data on unintentional drowning-related hospitalization were obtained from the 75th rounds of the National Sample Survey of Indian households conducted in 2018. The outcome variables were indices of health care cost such as out of pocket expenditure (OOPE), health care burden (HCB), catastrophic health expenditure (CHE), impoverishment, and hardship financing. Descriptive statistics and multivariate analysis were conducted after adjusting for inflation using the pharmaceutical price index for December 2020. The association of socio-demographic characteristics with the outcome variable was reported as relative risk with 95% CI and expenditure reported in Indian Rupees (INR) and United States dollars (USD). Results: 174 respondents reported drowning-related hospitalization (a crude rate of 15.91–31.34 hospitalizations per 100,000 population). Proportionately, more males (63.4%), persons aged 21–50 years (44.9%) and rural dwelling respondents (69.9%) were hospitalized. Drowning-related hospitalization costs on average INR25,421 ($345.11USD) per person per drowning incident. Costs were higher among older respondents, females, urban respondents, and longer lengths of hospital stays. About 14.4% of respondents reported hardship financing as a result of treatment costs and 9.0% of households reported pushed below the poverty line when reporting drowning-related hospitalization. Conclusions: Drowning can be an economically catastrophic injury, especially for those already impacted by poverty. Drowning is a significant public health problem in India. Investment in drowning prevention program will reduce hospitalization and economic burden. Practical Applications: This study provides support for investment in drowning prevention in India, including a need to ensure drowning prevention interventions address the determinants of health across the lifespan. [ABSTRACT FROM AUTHOR]

Suicide is an imperative public health problem that needs social as well as medical attention. In India, 134516 people committed suicide in 2018 and also there is an increase in the number of suicide cases in Uttarakhand as well. The aim was to analyse the trend of suicidal deaths autopsied at our center concerning different parameters like age, gender, method of suicide, reason for suicide, to know the demographic pattern and its cause. The autopsy reports and inquest papers of suicidal cases autopsied at AIIMS Rishikesh were included for evaluation. Out of total 19.49% of total autopsies were of suicidal deaths. Majority of the victims were males (76.42%) compared to females (22.76%). The average age of victims was 35 years and 76.4% belonged to the age group 14 to 43 years. The risk of suicide was more prevalent in urban population. Among the total victims, 39.83% were in jobs. Regarding the reason behind suicide, family dispute was most common. The most common mode of suicide was hanging followed by poisoning and drowning. Organophosphates was the most repeated poison consumed in suicides by poisoning. About 75% cases were complete suicides and couldn't receive medical care. Majority of the cases belonged to Rishikesh police station. The important aspects of suicides among young generation is peer pressure which can be from family, institutional, or work etc. An effective strategy needs to be devised to combat the issue. [ABSTRACT FROM AUTHOR]

Drowning is a form of death in which the atmospheric air is prevented from entering the lungs due to the submersion of the body in water or any other fluid medium1,2 . Drowning can be classified as wet drowning (fresh or salt water), dry drowning, secondary drowning and the immersion syndrome or hydrocution (cold water drowning). 2,3,4,5 Drowning is an important public health issue with major impacts on human resource which is a preventable phenomenon. According to National Crime Records Bureau, Ministry of Home Affairs in 2014, in India, death due to drowning was 6.6%, making it third largest cause of death in India6 India is a vast country having plenty of water bodies and an extensive coastline and under such conductive circumstances, cause of death due to drowning is a frequent event where medico-legal experts are called upon to investigate. With a view to investigate the epidemiological factors, a study was conducted in the Deptt. of Forensic Medicine, Gauhati Medical College for a period of 1 year. In our study we found that most of the victims were males (82%) in the 31- 40 years age group (24.4%). Most of the victims had drowned in fresh water (94.5%) and running type (63.8%). A total of 34 cases constituting 26.77% had external injuries. Most of the cases were accidental in nature (78%). An exhaustive study to unearth these socio- demographical factors of drowning, hence should be conducted, to analyze their impact on population and its prevention. [ABSTRACT FROM AUTHOR]

Aim: To determine the different types of diatoms present in the waters of River Narmada flowing through 5 distinct cities of India and ending into the Arabian Sea. Different types of Diatoms were observed with change in the course of water. Objective: The study shall assist to determine the different types of diatoms present in the river Narmada. Materials and Method: The study does not require any special instruments and the technique used to extract the diatoms from the waters is also very simple to perform. In this study the acid digestion technique is not used but the technique is slightly modified in order to prevent the damage to the walls of the diatoms. Result: Various types of diatoms were seen and the diatoms present in the water collected from different cities of India are found to be different including the species unique to the area. Conclusion: The study describes the type of diatom present in the water of river Narmada collected from different places. [ABSTRACT FROM AUTHOR]

Introduction:Drowning is the 3rd leading cause of unintentional injury deaths.As drowning is a preventable cause of mortality, our aims for the benefit of society at large is to minimize the events as far as possible. Objective:A clear knowledge about factors which play a major role behind such incidences is important.It has equal forensic importance as determination of cause and manner of death require thorough investigation. Methodology: We conducted one-year study of demographic variables and the histopathological changes in relation to lung and splenic tissues in cases of drowning deaths, in the hot and humid climatic region of Eastern India.Results: The demographic findings were presented in graphs and charts. However, none of the commonly known autopsy findings (histopathological) are found to be individually confirmatory of drowning. Conclusion:Several factors inclusive of autopsy findings, biochemical examination, radiological and molecular technique,are needed to be taken together as complementary methods to conclude drowning as the cause of death when bodies are recovered from water. [ABSTRACT FROM AUTHOR]

This Arts and Medicine feature excerpts a chapter from The Covenant of Water, the new novel from Abraham Verghese, which follows the lives of a family in South India over the 20th century who have a "condition" that consigns at least 1 member per generation to death by drowning. [ABSTRACT FROM AUTHOR]

Background: During the late nineteenth century, a considerable number of young Punjabi men sought their fortunes in the Australian colonies, working as hawkers and farm labor. While in Australia they experienced marginalization and high levels of racial vilification by the Anglo-Celtic settler community. Aims: To assess the frequency and nature of suicides of Punjabi workers in nineteenth century Australia. Materials and Methods: The paper draws on archival sources and contemporary newspaper reports. Results: A wide range of methods of suicides were observed, with drowning the preferred method. Conclusions: This article is the first to collate the data on the suicides and suicide attempts by young Punjabi men working in an immigration country. It can be shown that the suicide rate among Punjabi was almost six times higher than that of the host community. [ABSTRACT FROM AUTHOR]

Introduction: Suicide is intentional taking of one's own life. It's big social issue and forms a large proportion of disease burden in world. As per WHO, suicide is responsible for death in every 40 seconds, A person attempt for it in every 3 second. Its global mortality rate is 16 per 100,000. Materials and Method: Epidemiological data of suicide are very less in Siliguri Commissionerate area, so a study was done on all suicide cases which were brought for postmortem examination in North Bengal Medical College mortuary during July 2014 to June 2015. Results: 377 cases of suicide were encountered during postmortem examination in given period. We observed that every age group are under dark shadow of suicide. Death cases due to suicide is almost similar in both the gender but higher incidence is seen in Hindu population. It not only victimized old aged person of 88year, even suicidal case of 8-year-old child is also seen. Most of the victims were of lower socio-economic class belonging to rural background and highest no of cases of suicide were among illiterate. Cases of suicide is higher in married woman, unmarried man and homemaker. Internal harmony among the family member is also responsible for the suicidal intent and is observed, in joint family and among families with higher incidence of family-violence suicide rate is higher. Hanging and burn were the most common methods employed for suicide. Most of people committed suicide in between 6 PM to 6 AM. Conclusions: So, we need to look into multidimension if we really want to control on suicide not only in India but even in whole world. [ABSTRACT FROM AUTHOR]

Introduction:An increasing death rate as a result of violence constitutes a large group in medico-legal autopsies especially deaths due to asphyxia which are one of the most important causes in violent deaths. Analysis and interpretations of cases of hanging, ligature strangulation, throttling, suffocation, traumatic asphyxia and drowning is presented in this paper. Aims and Objective: The present study was carried out with a view to study the incidence and postmortem finding of violent asphyxial deaths with regard to key features that help to differentiate between different violent asphyxial deaths. Method: A ten years retrospective study of all medico-legal autopsies of violent asphyxial deaths was undertaken between 1st January 2006 to 31st December 2015 in the department of Forensic Medicine and Toxicology, Government. Medical College, Amritsar, Punjab, India. Results: Incidence of violent asphyxia deaths is 3.98% of total autopsies. Hanging (50.37%) was most common method of asphyxiation followed by drowning (29.48%). Males (68.06%) outnumbered females (31.94%) with male to female ratio of 2.13:1. Most affected age group was 21-30 years among both the sexes. Most of the victims were married 233 (57.25%) compared to unmarried 100 (24.57%) and unknown 74 (18.18%) cases. Suicide (53.56%) was most common manner of death followed by homicide (19.90%), accidental was least common (17.20%) and in (9.34%) cases manner was unascertained. More cases 52.83% of violent asphyxial deaths were reported from rural area as compared to urban (27.76%) and residence status of 18.18% cases were unknown. [ABSTRACT FROM AUTHOR]

Background: The National Crime Records Bureau of India reported a decline in suicide rate from 2010 through 2014. We conducted this study to know whether our hospital data reflects the national data and to know the age and gender specific differences in selecting methods of suicide. Methods: We conducted a retrospective analysis of autopsied cases in Department of Forensic Medicine in a tertiary care hospital in central Kerala, India. Data on age, gender, cause of death of autopsied cases with alleged history of deliberate self-harm (DSH) were noted. Results: Mean age of study population was 43.4±24.4. There were 59.3% males and 40.7% females, but young females outnumbered young males. Majority of cases were hanging (n=1325), followed by poisoning (n=1169), burns (n=809), drowning (n=626) and others (n=401). Hanging and poisoning were the common methods chosen by males while burns and poisoning were the common methods by females. The number of DSH cases was 1,040, 866, 771, 837 and 826 in each year from 2010 to 2014, respectively. Number of poisoning cases was declining steadily from 350 to 163 while non-poisoning suicide was not showing any steady changes (690, 578, 514, 657, and 663). Pesticides were the most common agent recorded in the autopsy sheet while corrosives, plant toxins, cyanide, toxic alcohol and drug overdose were less common. Quinalfos, chlorpyrifos and carbofuran were the commonly identified pesticides on chemical analysis. Conclusion: There is a decrease trend in the number of suicides over the 5 years from 2010 through 2014 with a decrease in suicide due to poisoning. Though there is minimal increase in suicide due to hanging, it did not affect the total number of suicides. [ABSTRACT FROM AUTHOR]

Aim: Our aim was to improve our understanding of the contextual factors contributing to child drowning in rural West Bengal, India.Methods: This 2017 study used interviews, focus groups and observations and the participants included community leaders, household heads, parents and children aged 7-17 years from three remote villages. They included adults and children who had been directly affected by the loss of family members or friends.Results: We conducted 19 in-depth interviews, six focus groups and three informal observations in public locations where people were exposed to water. The area contained a high number of natural open areas of water, which increased the drowning risk. Participants reported that children frequently played unsupervised near potentially hazardous water, as their parents worked long hours and there was a lack of safe recreational spaces. Suggested approaches to reducing the drowning risk included parental education to improve child supervision and establishing village committees to effectively communicate the drowning risks to local government. Low-cost, community-based approaches to improving child water safety need to be developed.Conclusion: Drowning was clearly a complex issue in rural West Bengal, with a significant impact on children and their families. Community-based approaches are clearly needed. [ABSTRACT FROM AUTHOR]

Objective: Drowning is a leading cause of unintentional injury-related death in low- and middle-income countries (LMICs). This study was undertaken to know the epidemiology, intensive care needs and predictors of outcome of children with drowning.Methods: Records of children below 12 years admitted with drowning to the emergency room and/or paediatric intensive care unit (PICU) of a tertiary care hospital in North India were retrospectively analysed. 'Favourable outcome' was defined as normal neurological status at discharge (normal cognition and no motor deficits) and 'unfavourable outcome' as death or abnormal neurological status at discharge. Multivariable analysis was done for predictors of unfavourable outcome.Results: Twenty-seven children were analyzed, 14 (51.8%) were boys. Median (IQR) age was 18 months (12-30). The median (IQR) duration of submersion was 4 min (3-9). Six children (22.2%) presented in pulseless arrest, and 7 (43.7%) had both hypoxaemia (saturation <94% on room air) and encephalopathy (GCS <13) at admission. Ten children (37%) were transferred to PICU; principal indications being hypoxic ischaemic encephalopathy (HIE) (n = 6) and ventilation (n = 4). One child died, four survived with sequalae. Predictors of unfavourable outcome on univariable analysis were hypoxaemia, or pulseless arrest at admission, HIE and need for mechanical ventilation; none of these could predict outcome on multivariable analysis.Conclusion: Hypoxaemia or pulseless arrest at admission, HIE and need for ventilation predict unfavourable outcome. Appropriate on-site resuscitation and early stabilization may improve outcome in children with drowning in LMIC. [ABSTRACT FROM AUTHOR]

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Background : Accidental drowning occurs often in India, nearly 40, 000 Indians die annually from drowning. It occurs occasionally among swimmers due to their rashness in swimming, but it occurs mostly in non-swimmers who venture to go beyond their depth in the sea, rivers, canals and lakes. Many lives are lost during floods, which are so frequent. Objective : To study autopsy finding in drowning and conclude manner of death from Ranga Reddy district, Telangana Methods : A 3 years prospective study (January 2013 to December 2015) on 60 drowning cases brought to the Bhaskar Medical College and Hospital, R.R. District, Telangana were assessed. Subsequently, the medico legal autopsy was performed at mortuary of Osmania General Hospital, Hyderabad. This present study is directed to study the medico-legal aspects of violent asphyxial deaths special reference to drowning. Result : It is found that higher frequency of age group is present in the 21-30 years which is 29.1% of cases, male predominated and 41.14% were accidental in nature. Regarding the postmortem findings drowning cases, out of the total of 60 cases of drowning, cyanosis was observed in 47 (78.35%). Oozing of whitish to pinkish froth, copious in amount from mouth and nostrils was found in 53 (88.32%) cases. All the drowning cases, there were presence of heavy, voluminious, oedematous, congested lungs with weight of either lungs above 500 gm & cupious froth oozing on cut sections Conclusion : This study showed that majority drowning cases belonged to male, adolescent age group & accidental in nature. The findings of the study could be useful to develop accessible infrastructures to improve drowning intervention programs in this region. [ABSTRACT FROM AUTHOR]

Asphyxia is a condition caused by interference with respiration or due to lack of oxygen in inspired air due to which the organs and tissues are deprived of oxygen causing unconsciousness or death. Asphyxial deaths constitute a large group of medico-legal autopsy cases with hanging and drowning at top of the list. The present study was undertaken to determine the frequency of various asphyxial deaths and the demographic profile of the victims in Mangalore, a coastal district of India. A two years retrospective study was conducted on a total of 162 cases of asphyxial deaths out of of1808 post mortems conducted from November 2014-October 2016 at Distt. Hospital Mangalore. The data was collected from the autopsy report and inquest forms. Hanging was the most common form of asphyxial death constituting 67.9% of cases followed by drowning (27.8%) and strangulation (2.4%), Smothering and plastic bag suffocation were seen in 1.2% and 0.6% of cases respectively. Male predominance was observed and the most common age group involved was 31-40 years. Majority of the hanging cases occurred in closed places and suicide was found to be the most common manner of death. The most common location for drowning was river followed by Sea. In any asphyxial death, a meticulous autopsy plays a major role to solve the case along with crime scene investigation. Education, involvement of young generations in non destructive activities, encouraging organizations which work on the reduction of addiction, appropriate management plan for those with psychiatric problem and improving the socioeconomic status of the people and providing employment are keys to prevent suicidal asphyxial deaths. [ABSTRACT FROM AUTHOR]

India is a vast country having plenty of water bodies' i.e. Rivers, ponds, wells and an extensive sea coast. So drowning is one of the most common causes of death among all manners of death in this country. This was a 2 year retrospective autopsy study of deaths due to drowning cases analyzed and tabulated. Study performed in department of Forensic Medicine & Toxicology at KIMS, Hubballi from January 2014 to December 2015. We studied total 23 cases in two years, the maximum drowning cases were of male sex - 14(60.86%), with commonest age group being 11-20 years - 06 cases(26.08%). Most of the drowning cases were accidental in nature 13(56.52%) and occurred commonly in lakes and rivers 15(62.51%). The most significant postmortem findings noted on autopsy were bleaching of skin 19(82.60%) and presence of water in stomach in 13 cases(56.52%). [ABSTRACT FROM AUTHOR]

[Display omitted] • As a result of diatom test, cause of drowning can be detected. • Chemical treatment with reverse aqua regia is suitable method. • Abundant diatoms detected in antemortem drowning. • Accidental drowning was common cause of death in Himachal Pradesh. • Seven case studies were solved. In forensic pathology, solving the crime mystery of death due to drowning still remains a challenging issue. The amalgamation of autopsy findings and comparative study of diatoms recovered from the victim's body organs and suspected drowning site help to decipher the cause of death due to drowning or post-mortem immersion. Since the correct interpretation of the cause of death is an important criterion to provide justice to the victim, therefore, the main objective of our study is to throw light on the application of photoautotrophic micro-algal organisms, known as Diatoms, in solving seven cases of victims whose bodies were recovered from various water bodies of Himachal Pradesh, India. The diatom test was conducted by using reverse aqua regia solution (15 ml HNO 3 : 5 ml HCl) on the bone marrow extracted from the organs and water samples respectively. The informative outcomes of the experimental analysis demonstrated that the diatom test acts as a beneficial adjunct to solve drowning-related crimes where the exact cause of death remains hidden even after performing an autopsy of the victims. The protocol followed by the authors can be used conveniently to recover diatoms from bone marrow as well as from water samples. Our results showed that the maximum cases were of death due to accidental drowning but for one case of suicidal drowning in extremely cold water. [ABSTRACT FROM AUTHOR]

An increasing death rate as a result of violence constitutes a large group in medicolegal autopsies. Specially, deaths due to asphyxia are one of the most important causes in violence deaths. During the 5-year period from January 2013 to October 2018, there were 134 asphyxial deaths autopsied by the Department of Forensic Medicine, ACSR Government Medical College,Nellore . Asphyxial deaths comprise 15.7% of all forensic autopsies; 20.8% of the cases are aged between 30 and 39 years, and the average age was 41.9 years. Males constitute 79.8% of all the cases. The most frequent method of asphyxiation death is hanging (56 cases, 61.8%), followed by drowning (32.6%) and More violent methods, such as ligature or manual strangulations, constitute 3.1% and 2.5% of all asphyxial deaths, respectively. Although it was varying according to the methods of asphyxiation, suicide was found to be the manner of death in the majority of the cases. [ABSTRACT FROM AUTHOR]

The deaths due to asphyxia are so wide and varied that they are challenging the autopsy surgeons on many occasions. Therefore careful study and examination of every case is important to bring wide variety of observations in death by asphyxia. This study was aimed to evaluate pattern of violent asphyxial deaths at Department of Forensic Medicine & Toxicology, Lokmanya Tilak Municipal Medical College & Lokmanya Tilak Municipal General Hospital, Sion, Mumbai. Total 2585 autopsies were analyzed during January 2013 to December 2013. Out of 2585 cases, 80 cases were of violent asphyxial deaths. Majority of the cases were of male (70%) and of hanging (91.25%). [ABSTRACT FROM AUTHOR]

A 25-year-old male was found dead in a water drum inside the bathroom of his house one morning. Autopsy revealed a fatal right wrist cut, superficial cuts on middle phalanx of left index finger and features of ante mortem drowning. Investigation revealed the victim was an alcoholic and was depressed due to financial problems. On the previous night, under the influence of alcohol, he first tried to commit suicide by cutting wrist with razor blades, but death was not immediate. He then attempted electrocuting himself by touching a live wire, inside the bathroom, which failed and finally he drowned in a water drum. The victim had left a message, written with his blood on the floor of the room, reflecting his suicidal intentions. In complex suicide, many bizarre methods are used, but this combination of methods is unusual and not found in available forensic literature. [ABSTRACT FROM PUBLISHER]

Background: Gujarat registered 40.7 % of accidental deaths in 2007 and nearly 10% of them are due to drowning. For implementing preventive measures, research related drowning data and its implicating factors are required. So we attempted to carry out this study with objective of generating profile for all drowning autopsies. Methods: The study was conducted at Rajkot from 1st November 2004 to 31st October 2006. Out of total 2934 autopsies, drowning was found in 100 cases. Detailed and complete postmortem examination of corpses was done and a proforma was filled in. Data were entered and analyzed with SPSS 15.0 version software. Results: Out of total 100 drowning cases, 58% were from urban area. 43% deaths were suicidal and 36 % were accidental in nature. Out of 88 identified cases, 60.2 % were unmarried. 67% cases were in 15-30 years of age group and male: female ratio was 2.7:1. Literacy rate was 69.3% with higher education only in 2.2% cases. Most frequent occupations were study (31.8%) and labor work (22.7%) with 59.1% belonged to lower socio-economic class. Factors affecting mental status and behavior like addiction, family problem and mental illness were found in 33%, 35% and 10.2% cases respectively. Injuries and animal or aquatic animal bites over the body were in 5% and 12% victims respectively. Conclusion: The high rates of drowning deaths in Rajkot and their specific circumstantial profiles suggest that drowning deaths could beneficiate from basic prevention programs and legislation. [ABSTRACT FROM AUTHOR]

Objective To determine the mortality burden associated with unintentional injuries among children younger than 5 years of age in India. Methods The Registrar General of India conducted verbal autopsy for all deaths occurring in 2001e2003 in a nationally representative sample of over 1.1 million homes. These verbal autopsy reports were coded by two of 130 trained physicians, who independently assigned an ICD-10 code to each death. Discrepancies were resolved through reconciliation and, if necessary, adjudication. The probability of death during the first 5 years of life (per 100 000 live births) was estimated from the 2005 United Nations' population and death estimates for India, to which the proportions of deaths from the mortality study were applied. Results Unintentional injuries were the sixth leading cause of death among children under 5 years of age. In 2005, unintentional injuries led to 82 000 deaths (99% CI 71 000 to 88 000) among children under 5 years of age, a mortality rate per 100 000 live births (MR) of 302 (99% CI 262 to 323). Mortality was higher in rural areas (MR=339, 99% CI 282 to 351), mostly due to more drowning deaths, than in urban areas (MR=173, 99% CI 120 to 237), where falls were the leading cause of child injury mortality. Conclusion Unintentional injuries, specifically drowning and falls, lead to substantial mortality in children younger than 5 years of age in India. There is a need for continued monitoring of the injury burden and investigation of risk factors for evidence-based effective injury prevention programmes. [ABSTRACT FROM AUTHOR]

An increasing death rate as a result of violence constitutes a large group in medico-legal autopsies. Specially, death due to asphyxia is one of the most important causes of violent deaths. Domestic violence plays a great role in suicidal and homicidal violent asphyxia deaths. Various epidemiological and demographical parameters of the study are described in the present article. In this study, 585 cases of violent asphyxial death were studied. Incidence of asphyxial deaths was averagely 146 cases per year. In violent asphyxial deaths, 73% of total cases were of male while only 27% of cases were of female. Majority of victims were in age group of 21 to 40 years. 80% of cases were of suicide and among them 68.4% of victims made suicide by hanging followed by drowning. Incidence of homicidal asphyxial death was quite rare. Ligature strangulation was the most commonly employed method for homicidal asphxial deaths. The prime motive behind violent asphyxial deaths was financial problems/disputes. Indoor places were the commonest places used by victims of hanging. Sari, dupatta and cotton rope were commonly used as a ligature material in hanging cases. Ceiling fan and ceiling hook were the ideal suspension point seen in hanging cases. Only in 0.93% of hanging cases hyoid bone fracture was present. [ABSTRACT FROM AUTHOR]

Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa's roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs) were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%), which were mainly of the nature of accidents or assaults (17%) and fever related (17%). Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa. [ABSTRACT FROM AUTHOR]

Introduction: Behavior pattern influences the risk of unintentional injuries. This study was conducted to identify the pattern of household unsafe behavior in different socioeconomic strata, in Pune city, India. Materials and Method: Population-based, cross-sectional study. Behaviors influencing the risk of burn, poisoning, drowning, and road traffic injuries were questioned from 200 randomly selected households. Results: Nearly 28% of the households did not have a separate kitchen, 37.5% cooked at the ground level, 33.5% used a kerosene pressure stove, 12% used unprotected open fire as a source of warmth in winter, and 34.5% stored inflammable substances at home. Ninety one percent of the households reported storing poisonous chemicals in places that could not be locked. In 68.3% of the households with children below five years, these chemicals were kept in places accessible to children. Nearly 21% of the individuals, who could swim, did so in unsafe places and 25.2% of them were not trained in swimming. In 35.5% of the households, children used streets as playgrounds. Among all two-wheeled vehicle riders, 35.6% reported not having a helmet and 57.7% of those who had a helmet did not use it regularly. Socioeconomic status was strongly associated with the unsafe behaviors related to burns, drowning, and road traffic injuries. Conclusion: The study identifies the sociocultural and behavioral factors leading to unsafe behaviors, placing individuals at risk of unintentional injuries, which can be used as a first step toward prevention. [ABSTRACT FROM AUTHOR]

Introduction: Drowning is the process of experiencing respiratory impairment from submersion/ immersion in liquid; outcomes are classified as death, morbidity and no morbidity. Material and Method: In this retrospective study, total of 13 drowning cases which have been registered in the casualty of Krishna Institute of Medical sciences were analyzed at the Department of Forensic Medicine & Toxicology, KIMS, Karad. Discussion: In the present study, maximum number of cases belongs to 11-20 year age group. Age is one of the major risk factors for drowning. This relationship is often associated with a lapse in supervision. Conclusion: Drowning prevention strategies should be comprehensive and include: engineering methods which help to remove the hazard, legislation to enforce prevention and assure decreased exposure, education for individuals and communities to build awareness of risk and to aid in response if a drowning occurs, and prioritization of research and public health initiatives to further define the burden of drowning worldwide and explore prevention interventions. [ABSTRACT FROM AUTHOR]

Background: The Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region., Methods: A community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for children aged 1 to 4 years and 5 to 9 years. A community knowledge approach was used. Meetings were held with community residents and key informants to identify drowning deaths in the population. Identified deaths were verified by the child's household through a structured survey, inquiring on the circumstances around the drowning death., Results: The drowning mortality rate for children aged 1 to 4 years was 243.8 per 100 000 children and for 5 to 9 years was 38.8 per 100 000 children. 58.0% of deaths were among children aged 1 to 2 years. No differences in rates between boys and girls were found. Most children drowned in ponds within 50 metres of their homes. Children were usually unaccompanied with their primary caretaker engaged in household work. A minority of children were treated by formal health providers., Conclusions: Drowning is a major cause of death among children in the Sundarbans, particularly those aged 1 to 4 years. Interventions keeping children in safe spaces away from water are urgently required. The results illustrate how routine data collection systems grossly underestimate drowning deaths, emphasising the importance of community-based surveys in capturing these deaths in rural low- and middle-income country contexts. The community knowledge approach provides a low-resource, validated methodology for this purpose., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

When a phenomenon of homicide-suicide occurs involving mother as perpetrator, many questions arises and need attention, many facts need consideration and many circumstances need evaluation. The anecdotal Indian literature has described homicide-suicides episodes involving male as a perpetrator but only few reports with mother as assailant had been published. The present case reports are being reported with an attempt to evaluate these episodes so that preventive measures could be initiated or adopted. In the present report, in every case, homicide was followed by suicide of the perpetrator. All the perpetrators were mother and the victims were their children in the age group of 18 months to 6 year. All homicide-suicide episodes took place in urban area. Homicide-suicide episodes are complex phenomenon and multidimensional events associated with the additive or multiplicative effects of many circumstances including psychopathological, psychosocial, economical, cultural or environmental stressors. [ABSTRACT FROM AUTHOR]

Drowning is public health issue requiring global, national and community responses. The multisectoral nature of drowning prevention reinforces the need for multidisciplinary research, which can play a key role in identifying patterns, factors and interventions and contributes to evidence-informed prevention. This study presents a biometric analysis of drowning research published in 1995-2020 and identifies temporal trends in research themes, journals, countries and authorship to assist in the planning of future research. This study identified 935 studies, representing authors from 80 countries. Publications grew 103-fold, and 41.2% ( n = 385) were published since 2014. The top 20 journals are all injury prevention, public health, or medical journals. The top 5 accounted for 24.5% ( n = 229) of total publications (TP). Research from the United States (TP = 313, 25.0%) and Australia (TP = 192, 15.3%) dominates the field. Growth is highest in low-middle-income countries (LMICs) including China (TP = 54, 4.3%, 32-fold), India (TP = 30, 2.4%, 17-fold) and Bangladesh (TP = 47, 3.7%, 7-fold). The study identifies significant growth in epidemiologic studies reporting burden and risk factors. Research in LMICs is increasing but lags relative to the burden. The role of multilateral and nongovernment organisations in evidence generation is evident and needs investigation, as do gaps in evidence for interventions and partnerships to progress the drowning prevention field.

Background: Unintentional injuries account for 10% of deaths worldwide; the majority due to road traffic injuries, falls, drowning, poisoning and burns. Effective surveillance systems provide evidence for informed injury prevention and treatment and improve recovery outcomes. Our objectives were to review existing sources of unintentional injury data, and quality of the data on the burden, distribution, risk factors and trends of unintentional injuries in India and to describe strengths and limitations of health facility-based data for potential use in injury surveillance systems., Methods: We searched national and international organisations' websites to identify unintentional injury-related mortality and morbidity data sources in India. We reviewed and evaluated data collection methods for surveillance attributes recommended by World Health Organization (WHO). We visited health facilities at all levels from public and private sectors, emergency transport centres, insurance offices and police stations in settings reporting significant number of injuries. In these sites, we interviewed key stakeholders using an explorative approach on current data collection processes and challenges to establishing an injury surveillance system based on WHO guidelines., Results: Major gaps were highlighted in injury mortality and morbidity data in India, including ill-defined causes of injury deaths and lack of standardisation in classification and coding. Site visits revealed that reporting standards of injuries varied, with issues around clarity of definitions, accountability, time points and lack of reporter/coder training. Major challenges were lack of dedicated staff and training., Conclusions: There is an important need to build human resource capacity, integrate data sources, standardise and streamline data collected, ensure accountability and capitalise on digital health information systems including insurance databases.

Despite legislation, dowry is still widespread in many parts of India and adjacent countries. It refers to the transfer of goods, money, and property to a bridegroom, his parents, or his relatives from a bride's family as a condition of the marriage. One of the consequences of the dowry system has been the murder or abetted suicide of young wives, either because more dowry goods were not provided to her husband or his family, or to secure the goods after marriage. In 2015 7634 women died due to dowry harassment, representing approximately 21 cases per day in India. The majority of dowry deaths occur within the first three years of marriage. Common types of dowry death homicides involve fire ('bride burning', drowning, poisoning and hanging/strangulation. In addition to legislation, an organized and multipronged approach is need by investigating police officers, women's' welfare organizations, responsible public servants, and the judiciary with consistent applications of deterrent penalties. Full and properly conducted medicolegal investigation is mandatory which must include scene examinations, full autopsies with photographic documentation and ancillary investigations such as headspace analyses. Significant burns in young Indian women living in traditional circumstances should raise the possibility of dowry-related crime., (Copyright © 2020 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Background: Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017., Methods: Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality from drowning., Results: Globally, unintentional drowning mortality decreased by 44.5% between 1990 and 2017, from 531 956 (uncertainty interval (UI): 484 107 to 572 854) to 295 210 (284 493 to 306 187) deaths. Global age-standardised mortality rates decreased 57.4%, from 9.3 (8.5 to 10.0) in 1990 to 4.0 (3.8 to 4.1) per 100 000 per annum in 2017. Unintentional drowning-associated mortality was generally higher in children, males and in low-SDI to middle-SDI countries. China, India, Pakistan and Bangladesh accounted for 51.2% of all drowning deaths in 2017. Oceania was the region with the highest rate of age-standardised YLLs in 2017, with 45 434 (40 850 to 50 539) YLLs per 100 000 across both sexes., Conclusions: There has been a decline in global drowning rates. This study shows that the decline was not consistent across countries. The results reinforce the need for continued and improved policy, prevention and research efforts, with a focus on low- and middle-income countries., Competing Interests: Competing interests: Dr. Franklin reports receiving airfare reimbursement from Royal Life Saving Society - Australia, during the conduct of the study. Dr. Bhaumik reports grants from Royal National Lifeboat Institution, UK, outside the submitted work. Dr. Driscoll reports grants from World Health Organization, during the conduct of the study. Dr. Ivers reports grants from Royal National LifeBoat Institute, outside the submitted work. Dr. Khubchandani reports grants from Merck Research Laboratories, outside the submitted work. Dr. James reports grants from Sanofi Pasteur, outside the submitted work., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)

Background: Four million people living in the Indian Sundarbans region in the state of West Bengal face a particularly high risk of drowning due to rurality, presence of open water, lack of accessible health systems and poor infrastructure. Although the World Health Organization has identified several interventions that may prevent drowning in rural low-and middle-income country contexts, none are currently implemented in this region. This study aims to conduct contextual policy analysis for the development of a drowning program. Implementation of a drowning program should consider leveraging existing structures and resources, as interventions that build on policy targets or government programs are more likely to be sustainable and scalable., Methods: A detailed content review of national and state policy (West Bengal) was conducted to identify policy principles and/or specific government programs that may be leveraged for drowning interventions. The enablers and barriers of these programs as well as their implementation reach were assessed through a systematic literature review. Identified policies and programs were also assessed to understand how they catered for underserved groups and their implications for equity., Results: Three programs were identified that may be leveraged for the implementation of drowning interventions such as supervised childcare, provision of home-based barriers, swim and rescue skills training and community first responder training: the Integrated Child Development Scheme (ICDS), Self-Help Group (SHG) and Accredited Social Health Activist (ASHA) programs. All three had high coverage in West Bengal and considered underserved groups such as women and rural populations. Possible barriers to using these programs were poor government monitoring, inadequate resource provision and overburdening of community-based workers., Conclusions: This is the first systematic analysis of both policy content and execution of government programs to provide comprehensive insights into possible implementation strategies for a health intervention, in this case drowning. Programs targeting specific health outcomes should consider interventions outside of the health sector that address social determinants of health. This may enable the program to better align with relevant government agendas and increase sustainability.

Background: We report on incidence of drowning deaths and related contextual factors in children from a population-based study in the Indian state of Bihar which estimated the causes of death using verbal autopsy (VA)., Methods: Interviews were conducted for deaths in 1-14 years population that occurred from January 2012 to March 2014 in 109 689 households (87.1% participation) in 1017 clusters representative of the state. The Population Health Metrics Research Consortium shortened VA questionnaire was used for interview and cause of death was assigned using the SmartVA automated algorithm. The annualised unintentional drowning death incidence, activity prior to drowning, the body of water where drowning death had occurred and contextual information are reported., Findings: The survey covered 224 077 children aged 1-14 years. Drowning deaths accounted for 7.2%, 12.5% and 5.8% of all deaths in 1-4, 5-9 and 10-14 years age groups, respectively. The adjusted incidence of drowning deaths was 14.3 (95% CI 14.0 to 14.7) per 100 000 children, with it being higher in urban (16.1, 95% CI 14.8 to 17.3) areas. Nearly half of the children drowned in a river (5.9, 95% CI 5.6 to 6.1) followed by in a pond (2.8, 95% CI 2.6 to 2.9). Drowning death incidence was the highest while playing (5.1, 95% CI 4.9 to 5.4) and bathing (4.0, 95% CI 3.8 to 4.2) with the former accounting for more deaths in 1-4 years age group. Sixty per cent of children were already dead when found. None of these deaths were reported to the civil registration system to obtain death certificate., Interpretation: The findings from this large representative sample of children document the magnitude of and variations in unintentional drowning deaths in Bihar. Urgent targeted drowning interventions are needed to address the risk in children. Gross under-reporting of drowning deaths in children in India needs attention., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

An experimental case was designed at Ballygunge campus pond (22°31'N, 88°21' E) of the University of Calcutta, India for determining the applicability of fresh water diatoms in solving aquatic crime related cases. One volunteer acted as a "Victim" and another as an "Assailant". Several items were collected as physical evidences (fragment of rope near the crime scene, mud encrusted shoes and water soaked clothes of the "Victim", the "Prime Suspect (Assailant)" and also shoes of two unknown suspects who were not involved in this experiment). Pond sediments and water samples were collected from the experimental pond and three other ponds of adjoining places viz., Baruipur (22°22' N, 88°26' E), Garia (22°27' N, 88°23' E) and North Dumdum (22°38' N, 88°24'E) of West Bengal, India. The study revealed diverse types of diatom taxa viz., Hanzschia sp., Nitzschia sp., Cyclotella sp., Navicula sp., Stephanodiscus sp., Melosira sp., Pinnularia sp. and Amphora sp. Diatom assemblages of the experimental pond and other three ponds were different from each other and the diatom assemblages recovered from shoes of two unknown suspect volunteers were also different from the experimental pond. Interestingly diatoms from the experimental pond were quite similar with the diatom profiles of rope, shoes/clothes of the "Victim" and the "Prime Suspect". Present study suggests that the mud encrusted shoes and water soaked clothes of the "Prime Suspect" ("Assailant"), "Victim" and the rope originated from the same pond/locality and thus confirms that diatom study may be successfully used in future forensic investigations in India. [ABSTRACT FROM AUTHOR]

Aim: To examine the burden and risk factors for fatal and non-fatal drowning in India., Methods: Relevant literature was identified through a systematic search of 19 electronic databases and 19 national and global, institutional, organisational and government sources of injury data. Search terms used pertained to drowning, injury, trauma, morbidity and mortality in India., Results: A total of 16 research articles and five data sources were included in the review. Three national data sources provided counts of drowning deaths, reporting a range of 1348-62 569 drowning deaths per year. A further three national data sources provided information on drowning-related morbidity; however, each source presented different outcome measures making comparison difficult. Ten research studies investigated risk factors associated with drowning in India. Key risk factors reported were male gender, young age (0-5 years) and individuals residing in the North-Eastern part of the country who have high exposure to water sources within community settings., Conclusion: Drowning-related morbidity and mortality have a significant impact on India, with risk factors identified for this setting similar to those within other low-income and middle-income countries. Regional data which look beyond routinely collected data are required to accurately investigate the burden and impact of drowning, to inform targeted, context-specific approaches for drowning reduction initiatives., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)