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ABSTRACT: Hanging is a common method of suicide/homicide in India. We report a series of three cases of suicidal hangings and one accidental strangulation case seen over 4 months in the Department of Trauma and Emergency Medicine. All our patients presented in very critical condition and were treated with early aggressive management resulting in excellent outcomes. [ABSTRACT FROM AUTHOR]

Hanging is a form of death caused by constriction of the neck by a ligature, where the force is derived from the gravitational drag of the victim's body weight. Hanging deaths are becoming increasingly important to pathologists. Injuries play a decisive role in determining the manner of death, particularly if doubt exists as to whether the cause is suicidal, accidental or by homicide. There are no standards specifically directed at post-mortem examination in cases of fatal hanging, but general autopsy guidelines are published by the Royal College of Pathologists and are applicable to deaths by this means. While the incidence of external injuries in hanging is consistent across the literature, significant variation exists regarding the presence of internal injuries. Since publication of the original version of this article, several papers have been published. This paper aims to remind the reader of the original article and to discuss relevant literature published since 2019. There are differences to the autopsy approach of victims of hanging across the United Kingdom, but full external and internal examination with focused neck dissection remains best practice despite the widespread use of post-mortem computed tomography (PMCT). Auditing of pathologists' practices may help improve the standards of post-mortem examination and subsequent reporting and clarify uncertainty regarding internal injuries. [ABSTRACT FROM AUTHOR]

The objective of the study is to understand the characteristics of people who died by different suicide methods in Toronto, Canada. Suicide cases were identified by the Office of the Chief Coroner of Ontario (1998–2020). Demographic and clinical variables were retrieved. All suicide deaths were classified into different groups based on suicide method. Bivariate analyses and multinomial logistic regressions were performed to compare their demographic and clinical characteristics. Hanging (N = 1721), jumping from height (N = 1280), and poisoning (N = 955) were the most common suicide methods in Toronto. Those who died by hanging were more likely to be married or in common law relationships, live with others, experience employment/financial/academic-related stressors and die at home. People who died by jumping from height had a higher likelihood of having a psychiatric and/or emergency department visit in the past week and having schizophrenia or related disorders/symptoms. People who died by poisoning had higher odds of being female and leaving suicide notes. They were also more likely to have previous suicide attempts, experience depression and/or bipolar disorder and have physical conditions. Specific suicide prevention strategies should be designed and implemented to account both for commonalities and differences among people who die by different suicide methods. [ABSTRACT FROM AUTHOR]

Establishing an energy harvesting device to supply sustainable energy to deep sea sensors is a challenging task due to the complex subsea marine phenomenon. To overcome this, we propose a two-magnet KMC energy harvester hanging on the cabin of the ship with a spherical bearing. The magnets connected with springs move vertically up and down when the ship is periodically actuated by surface waves, generating electricity to power the deep sea sensors through a cable. We present a case study using wave speed (Uow = 2.0 m/s), wave amplitude (Ho = 0.4 m), and wave length (λ = 4.0 m) to demonstrate the efficacy of the two-magnet energy harvester. Before optimizing the energy harvester, a sensitivity analysis is conducted on the electrical power with respect to marine parameters and the energy harvester's geometric parameters. To maximize the electrical power, we adopt a Cuckoo Search Algorithm as an optimizer. By using the objective function of root-mean-square electrical power in conjunction with the Cuckoo Search, we obtain optimal electrical power. Simulations reveal that the energy harvester produces 0.1497 Watts of power. [ABSTRACT FROM AUTHOR]

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Background Death due to hanging is commonly seen. Sometime the ligature mark will be very prominent and in some cases it might not. In those cases, the post-mortem examination with its gross morphological findings and histopathological analysis, becomes significantly important. Objective: The objective of this study was to identify the patterns of epidemiological, gross morphological, and histopathological features in hanging cases. Methods The study was conducted on 46 cases of hanging. Their sociodemographic features were collected. Gross morphological analysis of the ligature mark and various measurements were taken. Later tissue from the ligature mark was sent for histopathological analysis. Statistical analysis was performed on the collected parameters. Results Significant male preponderance was observed in hanging cases. The maximum number of cases of hanging were observed in the fourth decade of life. Daily wage workers were the most significantly affected population. Depression was cited as the cause of suicide in most cases. Carotid intimal tears and injuries to bony and cartilaginous structures were present in smaller numbers. Vital reaction was observed in all 46 cases. Classification of fwound vitality showed a correlation to known time since injury. Conclusion The results of the present study showed that socio-demographic factors play a significant role in the circumstances leading to suicidal deaths. Therefore, in reducing the burden of suicidal deaths, these factors must be addressed. To identify the cause of death as hanging analysis of various gross features and histopathology are very important and should be conducted carefully.

The authors present the case of a 58-year-old man found hanging from a radiator by his shoelaces. The time of death was approximately 6 h before the body was discovered. An autopsy was performed approximately 24 h after the body was found, which revealed hemorrhages in the thoracic aorta at the junctions of the posterior intercostal arteries. Before autopsy, a routine whole-body CT scan was performed. Histologic examination of the aorta and the posterior intercostal arteries revealed a fresh hemorrhage into the tunica adventitia of the aorta. To our knowledge, there is no case description of such findings in hanged persons in the literature. Conclusion: Hemorrhages into the tunica adventitia of the junction of the posterior costal arteries may occur in association with suicidal hanging. The significance of these hemorrhages as a sign of vitality may be debated. [ABSTRACT FROM AUTHOR]

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A thorough analysis of circumstances and examination of the death scene is crucial before determining the manner of death in cases of hanging. While there are numerous reports of suicide and homicide by hanging in India, instances where the deceased is found with hands and/or feet bound and with feet touching a chair, the ground, or a bed, are considerably uncommon, as illustrated in this particular case (figure no.1). Hanging is indeed one of the methods used in suicides due to its accessibility and the perception that it may lead to a quick death. However, it's important to note that the choice of method can vary greatly depending on individual circumstances and cultural context. It is very easy to locate the place (indoor/outdoor) as well as commonly available hanging materials like rope, long napkin, belt, saree, dupatta, and long cloth (dhoti). Partial hanging suicide with handtied rope/dupatta cases are very less in number. Data on suicides, such as those reported by the National Crime Records Bureau, provide important insights into patterns and risk factors for suicide, essential information for public health interventions, and policy-making aimed at preventing such deaths. A total of 1,70,924 suicides were reported in the country during 20229. Sometimes suicidal tendency of the victim is so high that he/she can tie his/her hands with ligature material so that he/she cannot escape from the suicidal situation. We can also learn about partial hanging and postmortem blisters from this case study. [ABSTRACT FROM AUTHOR]

Mortality from entanglement and hanging in fishing line or baling twine is known for many species of birds. In this note, we add to the list multiple deaths of Cliff Swallows (Petrochelidon pyrrhonota). We found 4 hanging or entanglement events of this species from 3 counties in western Kansas. In Ellis County we found 2 locations under bridges: 3 birds hung together at the nest opening with fishing line and a single bird hung from a nest from an unknown source. In Gove County a single bird was hung with baling twine that was embedded into the base of a mud nest attached to a natural rock formation. At the last location in Hamilton County, an entanglement death of a bird at a bridge was due to an unknown cause, but multiple nests had baling twine incorporated into their formation. Proper disposal of fishing line and baling twine could reduce mortality from these and other sources in the future. [ABSTRACT FROM AUTHOR]

What can be the triggers for a suicidal action? Is there a way to “notice” it in time? Is the person who ultimately threatens is more likely to carry it out? In the proposed case report, the authors examine the issue by illustrating the case of a woman who was depressed due to her divorce with her husband. She repeatedly staged a suicide attempt by hanging herself in front of her sons, later denying what she had done. Her suicidal intentions were realised after she saw herself in a video filmed by her daughter, in which she simulated hanging herself. The study addresses the complexity of suicidal behaviour, examining existing theories and challenges in diagnosis and classification. The factors involved in the woman's self-suppressive act are analysed, leading to the hypothesis that the “seeing herself again” forced her defence mechanisms, increasing her feelings of anger. Indeed, the viewing of the video may have induced a “self Werther effect”. This analysis highlights the urgent need for suicide prevention strategies with specialised and targeted interventions, especially in situations of family conflict. By understanding every aspect of suicidal behaviour, health professionals can implement preventive measures and support systems, while also educating family members to recognise the self-suppressive risk.

Introduction Suicide is one of the major causes of death in Nepal. This study examines trends in suicide methods in Kathmandu, Nepal. The study aims to understand suicidal method changes over time and guide effective prevention strategies. Methods This study is descriptive study of autopsy data from the Department of Forensic Medicine at Maharajgunj Medical Campus, Kathmandu from January 2013 to December 2022. Linear regression analyzed changes in suicide rates by gender and method over time. Chisquare tests assessed monthly frequency deviations. Data was stratified by age groups and sex to identify any potential correlations between these variables and the methods of suicide used. Results Among 2,513 males suicide, the most common method was hanging accounting for 1,633 (64.98%) cases, followed by self-poisoning at 806(32.07%) cases, with falls and self-immolation each at 1.31%. For 1,905 females suicide, hanging remained the most prevalent method with 1,215 (63.77%) cases, followed by self-poisoning at 622 (32.65%) cases, with falls (0.57%) and self-immolation (2.78%) being less common. The mean age for male suicides was 37.15(SD=15.83), while for females it was 30.94 (SD=14.20), indicating a difference of 6.21 years. Suicide rates peaked in summer (July-August) with 450 cases and dropped in winter (December-February) at 309 cases. Conclusion Hanging was the most common method of suicide across all age groups, though its prevalence declined with age. In contrast, selfpoisoning became more common as age increased. The study depicted that females tend to commit suicide at relatively younger age than males. Significant seasonal variations in suicide rates were observed. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Journal of General Medical Research is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. This case presents a detailed forensic examination of a unique femicide case followed by the perpetrator's suicide. Case report. On a Sunday afternoon, a 52 year old man killed his 43 year old partner in their home with eleven stab wounds. A few minutes later, he committed suicide by suspending himself to a tree in their home garden by means of a rope. This unique case is interesting because of the combination of methods used for both homicide and suicide, as well as the relationship dynamics between the victim and perpetrator. The perpetrator committed homicide by stabbing and then hanged himself. Conclusion. The case adds valuable knowledge to Forensic Medicine, advocating for increased awareness and preventive measures against domestic and gender-based violence. This report provides an in-depth analysis of a homicide-suicide incident, focusing on a unique case of homicide-suicide. It serves to highlight the global crisis of femicide. The case is situated within the context of gender- based violence, illustrating how such acts are deeply rooted in societal norms. It highlights patterns of intimate partner violence, where emotional factors play a significant role. Forensic analysis uncovered the overkill nature of the homicide, indicating excessive injuries beyond what was necessary for death, reflecting the psychological turmoil of the perpetrator. It emphasizes the importance of identifying signs of potential violence in domestic settings and implementing interventions for mental health support and the prevention of genderbased violence. [ABSTRACT FROM AUTHOR]

Enrichment of layer chicken environment with physical, sensory, or stimulatory additions reported to have numerous beneficial effects. Hanging readily available tropical leguminous leafy materials such as Moringa and Sesbania in layer chicken pens can provide an additional amount of nutrients while serving as an environmental enrichment means. This study investigated the effects of hanging Moringa and Sesbania leaves as edible cage enrichments on performance, physical and organoleptic properties of egg and litter characteristics. Giving a completely randomized design experiment, 75 weeks old RIR layers (n=80) were allocated into 16 pens. Treatments were hanging two bundles of Moringa oleifera (MOL) leaves (T1), one bundle of MOL and one bundle of Sesbania grandiflora (SGL) leaves (T2), two bundles of SGL (T3) and no leaves hanging (T4). Egg production, and feed and leafy material intake were recorded for 42 days. Eggs were analyzed for physical properties. A semi-trained panel (n=25) conducted a sensory evaluation for eggs. The frequency of visiting feeders, drinkers, and leaves bundles was recorded using scan sampling techniques. Results showed that birds more preferred to eat SGL than MOL. Hanging of MOL or SGL alone or as two separate bundles increased body weight, egg weight, percentage of egg albumen, egg length, and eggshell thickness significantly. Colour, flavor, and overall acceptability of yolk color and flavor and aroma of egg white were positively influenced (P<0.05) by the hanging of leafy materials. Birds in pens with MOL and SGL exhibited more exploratory behaviors toward leaf bundles. Hanging of leafy materials increased the litter nitrogen content (P<0.05) as well. The study concludes that hanging MOL or MOL MOL leaves in layer chicken pens has positive impacts on physical and organoleptic properties and welfare while increasing litter nitrogen content. [ABSTRACT FROM AUTHOR]

Suicide is a serious global public health issue. Suicide refers to the act of intentionally causing one's own death. The aim of the study is to find the pattern of suicidal deaths and to identify the high-risk groups. The study was carried out in the Department of Forensic Medicine and Toxicology, Gandhi Medical College, Secunderabad, Telangana. This was based on the observation of 200 deaths due to suicides in 18 to 45 age group during the study period January 2020 to July 2021. It is observed that majority of victims were aged between 18-25 years (33.50%) and married (61.50%). Males (77.00%) are more victims as compared to females. The leading motive behind suicide was emotional factors (32.5%) and most commonly adopted method to commit suicide was hanging (41.50%). Health education, counselling, timely crisis intervention either by medical or social methods will reduce the number of suicide victims. [ABSTRACT FROM AUTHOR]

Introduction: Suicide is an important health hazard across the world. The SDR (Suicidal Death Rate) observed in Indian females is over three times higher than the rate expected globally for regions with similar socio-demographic profile. Objectives: This study is aimed at analysing the pattern, probable motives, and socio-demographic factors of female suicidal deaths across all age groups subjected for autopsy to the Forensic Medicine department, M.S Ramaiah Medical College. Materials and Methods: Detailed information regarding the deceased and the circumstances of death were collected from the police and relatives by a standard proforma questionnaire. Data was analysed using computer software, Statistical Package for Social Sciences (SPSS) version 20.0. Results: Total of 93 cases of female suicides were autopsied in the study period, and the most common age group observed was 21-30 years (30%), commonly educated up to high school (32.2%), majority of cases falling within class IV socio-economic status with 38.7% cases (Modified Kuppuswamy's classification). Married women comprised 41.9% cases. Hanging(76.3%) was the most often used method, commonly occurring at the time periods of 6AM-12PM and 6PM-12AM with 29 cases (31.18%) each. Frequently motivatedby monetary reasons with 18.27% and mental illnesses accounting for16.12%. Conclusion: The increasing suicide rate creates a challenging obstacle for public health personnel. This study is a step toward a larger multi-centre study where deeper analysis and necessary interventions can be postulated. [ABSTRACT FROM AUTHOR]

The phenomenon of complex suicide is well-known and defined as the use of more than one suicidal method to cause death. It accounts for 1.5 to 05 % of all suicidal deaths. In complex suicides, planned and unplanned acts are differentiated. In unplanned suicides, one or more methods are used consecutively after the previous method failed and did not result in death. The present case report discusses the unplanned suicide of a young, extremely obese, 18-year-old boy. The boy was found in an unconscious state at his home in the bathroom, in sitting position on the floor with his neck suspended to the shower head with a rope with multiple cut marks over his body. During the autopsy, external examination revealed a ligature mark around neck and multiple superficial incised injuries over his face, neck and both wrists. Detailed autopsy examination confirmed the cause of death as asphyxia due to suicidal hanging with multiple incised injuries over the body. It is of utmost importance for the forensic investigator to have in-depth knowledge about different unusual suicidal methods. This will prevent unnecessary criminal investigation and help in the concrete establishment of the manner and cause of death. [ABSTRACT FROM AUTHOR]

Background. In recent years, the improvement of common standards of forensic practice has received attention to promote an unambiguous and better-quality forensic investigation method. Although most hanging deaths are attributed to suicides, cases occasionally occur due to accidents or homicides. From an investigative point of view, hanging deaths are usually straightforward, but unusual circumstances may raise suspicions of crime. This includes complex suicides, which are rare events pursued by victims with two or more different fatal methods and can be classified as planned or unplanned, depends on whether the methods are applied simultaneously or sequentially. The multiplicity of injuries detected can often lead to misinterpretations, thus making a multidisciplinary approach extremely important. Case Report. A 44-year-old man, after requesting law enforcement, has been instead found inside a garden of an uninhabited property located a few kilometers away from his own property, suspended from a beam with wire; the wire created a noose at the back of his head, his hands were placed at his neck, and stab wounds were found. Conclusions. The crime scene investigation, interview of relatives, autopsy, histological and toxicological examinations, and GAP led to the determination that the death was suicide. This comprehensive approach emphasizes the importance of meticulous investigation and analysis to reach accurate conclusions in forensic cases. [ABSTRACT FROM AUTHOR]

Background: Suicide rates in the United States have been increasing. Work‐related factors may contribute to risk for suicide. These work‐related factors may be reflected in a varied risk for different suicide methods between occupations. This study sought to assess occupational differences in suicide rates according to the method used. Methods: Death certificate data about suicide deaths in Massachusetts between 2010 and 2019 were used to calculate mortality rates and rate ratios with univariable and multivariable models controlling for age, sex, race ethnicity, and educational attainment for suicides overall, and for three specific methods of suicide (hanging/strangulation/suffocation, firearms, and poisoning) by occupation. Results: In multivariate models, the risk for suicide was significantly elevated for workers in arts, design, entertainment, sports, and media (relative risk [RR] = 1.84, 95% confidence interval [CI] = 1.53, 2.22); construction trades (RR = 1.68, 95% CI = 1.53, 1.84); protective services (RR = 1.49, 95% CI = 1.26, 1.77); and healthcare support occupations (RR = 1.55, 95% CI = 1.25, 1.93). Occupational risk for suicide differed across different methods. For hanging/strangulation/suffocation, workers in arts, design, entertainment, sports, and media occupations had the highest RR (2.09, 95% CI = 1.61, 2.71). For firearms, workers in protective service occupations had the highest RR (4.20, 95% CI = 3.30, 5.34). For poisoning, workers in life, physical, and social science occupations had the highest RR (2.32, 95% CI = 1.49, 3.60). Conclusions: These findings are useful for identifying vulnerable working populations for suicide. Additionally, some of the occupational differences in the risk for suicide and for specific methods of suicide may be due to workplace factors. Further research is needed to understand these workplace factors so that interventions can be designed for prevention. [ABSTRACT FROM AUTHOR]

Suicidal hanging is common in Pakistan and is considered a serious challenge globally. We conducted a content analysis of reports about suicidal hangings published in six English-language newspapers in Pakistan between 1 January 2021 and 31 December 2022, employing a web-searching technique. 124 news reports were yielded; suicidal authors were males (68.5%), Muslims (69.4%), and unmarried (31.4%), aged 16- 30 years old. Ligatures employed in hanging suicides were ropes (28.2%), fabrics (20.9%), and electric wires (20.1%). The most frequent leverage-points selected in suicides were ceiling fans (37%) followed by trees (11.2%). Familial discords (19.2%) and poverty (9.6%) were the leading risk factors for hanging suicide. Most of the suicides (58%) occurred equally in the spring (29%) and autumn (29%) months. These evidences suggest that psychological interventions on families are crucial. Also, dealing with poverty and other social consequences in Pakistan as in the rest of the world may probably reduce the rate of yearly suicides. [ABSTRACT FROM AUTHOR]

Traumatic injury in children often involves traffic accidents, falls from height, bicycle accidents, abuse, and sports. We present our experience with a 6-year-old girl who bruised her abdomen by falling while running with a thermos bottle hanging diagonally across her neck and left shoulder, crossing in front of her body. After the injury, she was rushed to the hospital and plain abdominal computed tomography revealed free air, suggesting intestinal injury due to blunt trauma. She was transferred to our hospital, where abdominal examination revealed a bruise and redness at the umbilicus. There were signs of peritoneal irritation and guarding throughout the abdomen. Upright chest X-ray showed free air in the right subdiaphragmatic region. Laparoscopic inspection revealed one perforation and two serosal injuries. The damaged serosa was repaired, and the perforated intestine was resected and anastomosed. The patient was discharged on the 11th day following an uneventful postoperative course. [ABSTRACT FROM AUTHOR]

Asphyxia is a condition caused by interference with respiration due to lack of oxygen in inspired air due to which the tissues are deprived of oxygen causing unconsciousness or death which could be due to any of the following causes such as Mechanical, Environmental or Toxic. To estimate the incidence and pattern of mechanical asphyxia deaths with epidemiological data such as age & sex wise distribution, various methods, manner, aggravating factors and substance abuse history of victim and to formulate certain measures for prevention. The autopsies of mechanical asphyxia deaths conducted at the mortuary of Government Stanley Medical College and Hospital, Chennai-01, during the period of 3months (October to December 2020). Information gathered from police inquest, postmortem reports, relevant history from relatives and friends of the deceased. During the period of study period, 581 deaths were autopsied in the mortuary, out of which 167 were of mechanical asphyxial deaths and the incidence was 28.74%. The most common form of mechanical asphyxial death was hanging (74.25%) followed by drowning (17.36%). The sex wise distributions of mechanical asphyxial deaths were most common in males 147 cases (88.02%) than females 27 cases (16.16%). Most of the deaths due to asphyxia were suicidal followed by accidental and most of the cases were suicidal hangings which is increasing day by day. With pattern of mechanical asphyxia deaths, we should also adopt certain measures for the prevention. Advised to the Public to cope up with the present scenario's causing mental stress in turn caused by unemployment, financial problems, family disputes etc. [ABSTRACT FROM AUTHOR]

Deaths by ligation around the neck are in practice from the time immemorial and before adventure of civilization. Hanging is that form of asphyxia, which is caused by suspension of the body by a ligature which encircles the neck, the constricting force being the weight of the body or a part of the body weight. Due to population explosion, poverty and increasing stress and strain in our daily life, we frequently come across cases of suicides, homicides and accidents. The present study aims towards analyzing socio-demographic pattern, causes& precipitating factors for committing suicide by hanging in this region. Due to population explosion, poverty and increasing stress and strain in our daily life, we frequently come across cases of suicides, homicides and accidents22. According to the World Health Organization (WHO), over eight hundred thousand people commit suicide every year all over the world. In India, every year >1 lakh people commit suicide, and it accounts for 17.5% of all suicidal deaths in the world. Hanging is the most common method of committing suicide as it is believed to offer a rapid and relatively painless death, and there is no cost involvement other than that of the ligature material2. According to NCRB reports the incidence of suicides by hanging increasing every year by India, 31.5% in 2010, 32.2% in 2011, 37.0% in 20122. The present study aims towards analyzing socio-demographic pattern, causes precipitating factors for committing suicide by hanging in this region. [ABSTRACT FROM AUTHOR]

Hanging is one of the most common methods of committing suicide all around the world. This is retrospective study conducted between June 2014 to December 2016, which included 50 cases of Hanging which were autopsied in Mortuary of Government Medical College associated Hospital, Ambikapur, Sarguja, Chhattisgarh during this period. Out of 50 cases of Hanging, 26 (52%) cases were males and 24 (48%) cases were females. Maximum number of victims 16 (32%) were in the age group of 21-30 years. Maximum 48 (96%) cases occurred in closed place and least number of cases occurred in open place 02 (4%). Cyanosis was seen in 46 (92%) of cases and face congestion seen in 24 (48%) cases. Ligature mark present above the level of thyroid cartilage in maximum number of cases 48 (96%). Fracture of hyoid bone present in 1 (2%) case. Aim of the study was to find out incidence, trends and patterns of hanging in Chhattisgarh. [ABSTRACT FROM AUTHOR]

The position of knot (typical/atypical) and type of hanging (complete/partial) play an important role in the causation of death in hanging. Ligature material and ligature mark also provides information regarding manner and cause of death.Total 1803 medicolegal autopsies were performedduring one year study period, out of which 189 (10.48%) cases were of hanging. In our study, 134 (70.89%) were male and 55 (29.10%) cases were female with male to female ratio of 1:0.4. We observed that in 104 (55.03%) cases the hanging was complete whereas 85 (44.97%) cases the hanging was partial. The typical hanging cases were 62 (32.8%) andatypical hangings cases were 127 (67.2%). Soft ligature materials were used in 143 (75.66%) cases. Hard ligature materials were used in 46 (24.34%) cases.Dupatta, a soft-ligature material mostcommonly used in all cases. [ABSTRACT FROM AUTHOR]

The "faciesympathique" is a vital sign first described by Etienne Martin in 1899 referring to unilateral miosis, with or without ptosis, at the opposite side from the knot in hanging. This mark is scarcely reported in legal medicine textbooks and scientific papers. Moreover, when cited, it is referred to differently from its original meaning, both as unilateral contraction (miosis) and dilatation (mydriasis) of the pupil depending on the antemortem firmness of the ligature's neck pressure in hanging with little attention to ptosis. Due to the sympathetic nervous pathway supplying the eye, the review of this ocular sign in hanging supports the importance of revitalizing the "facie sympathique" in research on lesion vitality in mechanical asphyxia. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of hanging has increased over the last ten years and is the most common method of suicide. Because of its multifactorial causation, the reason behind hanging remains unfolded unless the victims leave a suicidal note. In the present study, the psychodynamic factors of hanging were assessed among the survivors of suicidal hanging. Materials and Methods: The cross-sectional study was conducted at S.C.B Medical College and Hospital, Cuttack, India, over a period of three years. Eighty-two individuals admitted in medicine ward of this tertiary care hospital to receive treatment for the complications as a sequel of hanging and willing to participate in study were included after obtaining informed consent. The information was recorded in a pre-designed pro forma. Results: Subjects from rural areas (87.8%) and low socio-economic backgrounds (67.1%) attempted suicide more often. Most of the victims were in the age group of 21--30 years, followed by less than 20 years. The most common cause of attempted suicide by hanging was family-related issues, and mainly by immediately available materials like dupattas, saree, lungi, and other fabrics. Females in rural areas and males from urban areas attempted suicide by hanging in significantly higher proportions (P = 0.041). Conclusion: Most people commit suicide at a younger age due to failure to cope with the different stressful situations. The most common reason for attempted suicide by hanging was family-related issues. Early intervention in family disputes in developing countries, especially in younger individuals, may help to curb suicide. [ABSTRACT FROM AUTHOR]

A suicide where the deceased has employed more than one means of ending his or her life is defined as a complex suicide (CS). Forensic practitioners may face difficulties caused by the articulated mechanisms underlying this event. Among CS, the combination of hanging and gunshots is unusual. In this study, we present three unique cases of such planned complex suicides (PCS) that we have encountered in our 28 years of activity at the Bureau of Legal Medicine of Milan. Careful inspection of the death scene, precise analysis of the anamnestic-circumstantial data, and accurate medico-legal autopsy examination were the starting points for a better understanding of the causes and manner of death. In particular, the presence of vital reactions of tissues involved in the two different means used, the coherence of the areas involved with a self-inflicted wound, and the absence of signs of third party intervention allowed us to classify these events as suicides. As for the chronology of events, the lethality of the cerebral lesions caused by the gunshots in all cases, in accordance with the cervical lesions caused by hanging, led us to conclude that we were dealing with PCS and catalogue these three cases as unusually planned complex suicides avoiding incorrect and superficial classification. [ABSTRACT FROM AUTHOR]

IntroductionPostmortem computed tomography (pmCT) prior to forensic autopsy has become increasingly important in recent decades, especially in forensic documentation of single injuries, injury patterns, and causes of death. Postmortem decomposition gas formation can also be detected in pmCT scans, which might affect cochlear implant research in postmortem human temporal bones (TBs).Material and methodsFifty non-putrefied hanging fatalities within a 2-year period (January 2017 to December 2019) were included with 100 TBs. Each body underwent whole-body pmCT prior to forensic autopsy. PmCT scans were analyzed with respect to the presence of intracochlear gas despite the lack of putrefaction at autopsy by an experienced fellow neurotologist.ResultsPmCT revealed gas formation in two individuals despite the lack of head trauma and putrefaction at postmortem examination and autopsy. Both individuals showed enclosed gas in the vestibule and the cochlea on both sides.DiscussionIntracochlear gas formation, most likely related to decomposition, may occur despite the lack of putrefaction at postmortem examination and autopsy and can be detected by pmCT. This finding seems to be rather rare in non-traumatic death cases but might affect cochlear pressure research in postmortem human TB.

Background: Suicide is defined as a fatal self-injurious act with some evidence of intent to die. Despite the evolution of sophisticated methods to commit suicide, hanging remains one of the commonest methods to commit suicide across the world. To evaluate the individuals using hanging as a method of suicide and identify the contributing factors for this behaviour. Material and Methods: The study was carried out in a tertiary care hospital, over a period of 1 year on the suicide attempters using the method of hanging. Semi-structured in-depth interviews were conducted with all the 46 attempters. The questions focused on the precipitating events present before the attempt. After the in interview the risk factors of the conversations were identified, tabulated and categorized using descriptive analysis. Results: Findings from descriptive analysis reveals that significant age group using this method was below 19 years followed by 20-29 age group, female attempters were more compared to male. Psychiatric diagnosis was present in 8 attempters and 4 attempters had alcohol/substance dependence. The most common personality component in attempters was impulsivity. The most common immediate stressor found were financial stress, conflict with family, spouse, humiliation, substance abuse, exam stress and domestic violence. Conclusion: This study demonstrates that the reasons for suicide attempt by hanging is multifactorial. which includes, psychiatric diagnosis, personality factors, immediate stressors, ease of use, and accessibility, Overall, our study adds to understanding the intricates of this method and will help in developing effective suicide prevention strategies.

We examined sexual orientation and sex differences in seven methods of suicide among adult suicides reported in the United States National Violent Death Reporting System (2012-2015; N = 59,075). Overall, most sexual minorities (i.e., lesbians, gay men, bisexuals) identified in the dataset used hanging (38%) followed by firearm (30%) and drug or poison ingestion (20%). Sexual minorities were more likely than heterosexuals to be younger, female, and Black/African American. Multivariate sex-stratified analyses in the overall sample showed that strong sexual orientation differences in lethal methods existed among men but not among women. However, when we compared sex differences in lethal methods among sexual minorities only, we found that lesbian/bisexual women, as compared to gay/bisexual men, were more likely to use a firearm or drug or poison ingestion than hanging. Findings suggest that the higher rate of suicide mortality among sexual minorities is likely driven by hanging, a method of suicide that is not particularly amenable to lethal method restricted-access prevention approaches. Future research directions, clinical training recommendations, and intervention opportunities are discussed.

Planned complex suicide constitutes a very rare mode of suicide. They are highly likely to be mistaken for murder. We report a case of a 22-year-old female that was brought dead to RIMS mortuary after being reported dead at her home, An Autopsy conducted showed a ligature mark which was suggestive of hanging. Greenish-colored fluid in the stomach with wall congestion at places with erosions and bleeding suggestive of Copper Sulphate poisoning (paint ingestion). An in-utero dead fetus was also found when the enlarged uterus was thoroughly examined. Suicides and suicide attempts are a big public health problem that have progressed in the last two decades and are ever increasing since then. Planned complex suicides, therefore indicate the mental dropout of individuals and social failure. Role of depression hovering around people nowadays cannot be denied. When people die committing such suicide, surviving family is left with shock, anger, grief, symptoms of depression and anxiety and may even experience thoughts of suicide themselves. [ABSTRACT FROM AUTHOR]

Establishing the manner of death is one of the most challenging tasks for forensic pathologists. We present the case of a 24-year-old woman found dead in the early morning on a flyover. The body was sitting on the ground with the back leaning against a wall. The neck was encircled by a white phone charger cable knotted to the staircase’s handrail. The victim had argued with her boyfriend and tried to jump out of his car while coming home from a wedding party the night before. After that, she left home alone with her phone charger in her hand. Due to self-harm behaviors, the first hypothesis was suicide by hanging. However, the ligature crossed immediately beneath the thyroid cartilage and encircled the neck twice horizontally; the two ends of the cable overlapped, forming a cross-over point in the front-right of the neck. Then, the ligature passed obliquely through the nape, gradually disappearing, forming a gap in the mark. The mark was sharply defined, stiff, yellow, and parchment-like. The investigators performed a three-dimensional scene reconstruction using the Trimble X7 Laser Scanner and the PC-Crash Multibody System. Even though the geometry of the ligature mark in the present case raised doubts about the manner of death, the three-dimensional reconstruction confirmed that the hanging was feasible without any external intervention.

Background: In forensic pathology, asphyxia presents a problem as frequently as it is thorny and challenging. Some knowledge in forensic pathology is still considered to be traditionally acquired and is not critically assessed with modern statistical or technical tools. In this study, we seek to examine the injuries that are considered to be typical of cases of hanging (neck lesions, haemorrhages, and pleural and epicardial petechiae). Methods: We evaluated whether there was, indeed, a statistically significant association between these injuries and deaths from hanging as compared to non-hanging deaths. We collected 399 cases (32 deaths by hanging and 367 cases of non-hangings), built contingency tables and performed chi-square tests for each variable (lesion) examined; we also analysed this association in various subgroups of the sample (according to sex, age and weight ranges). Results: Our results did not deviate from the expected outcome based on traditional knowledge, although they do provide a more detailed demonstration and clarification of traditional knowledge regarding this topic. Conclusions: These findings provide valuable insights for future discussion, examination and deepening of knowledge that is traditionally accepted but often undersupported in the literature. [ABSTRACT FROM AUTHOR]

Hanging is a violent death, very often suicidal and highly lethal. It may be complete (total suspension of the body) or incomplete (the lower limbs or the lower part of the trunk resting on the ground orsome othersupport). We report the case of a 58-year-old woman found hanging from a tree, by a tie attached to a branch. It was a complete cervical hanging. External examination revealed a hanging groove and signs of asphyxia. The autopsy revealed cervical lesions with fractures of the thyroid cartilage and hyoid bone, and sub-pleural ecchymosis. Death was due to asphyxia following vital hanging [ABSTRACT FROM AUTHOR]

Background: The second wave of coronavirus disease (COVID‑19) in 2021 was devastating for low‑ and middle‑income countries (LMICs). This led to increased suicide rates among the young, economically productive age group. We analyzed the cohort of attempted suicidal hangings needing admission to the intensive care unit (ICU) and compared the data from the pre‑COVID‑19 era. Materials and Methods: We conducted a retrospective, observational, cohort study of suicidal hanging cases according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Six‑month data of such cases admitted to the neurological ICU after the lockdown of the second wave of COVID‑19 from July 2021 to January 2022 were collected. Demographic data along with the cause of attempted hanging, severity of sickness from hanging, and its outcome were gathered and compared with similar data acquired during 2003–2015 by the same authors in the same ICU. Results: There was a threefold increase in the incidence of suicidal hangings needing ICU care, from 9 to 27% in the pre‑ and post‑COVID‑19 era. A shift toward older aged males, in the third decade of life, was observed. The common cause of attempted suicide was a familial dispute (P = 0.03). Among the younger age group (18–25 years), increased screen time led to fights in the family. The cohort was also sicker with more severe lung involvement, longer ventilation, and hospital stay (P < 0.001). Conclusion: The increased incidence of hanging among young adults, amid the socioeconomic effects of COVID‑19, needs urgent attention. Suicide prevention measures need novel strategies aimed at de‑addiction from electronic gadgets and reducing screen time. [ABSTRACT FROM AUTHOR]

Background: The aim is to study the pattern of suicidal deaths, demographic profile including various contributary factors of victims and analyze the magnitude of deaths in and around Vijayawada part of Andhra Pradesh so that preventive measures can be set up to avoid such situation. A death by suicide is defined as the deliberate termination of life. For a death to be a suicide, it should be an un-natural death, the desire to die should originate within the person, and there should be a reason for ending their life, according to the National Crime Records Bureau. While India's suicide rate of 14.04/lakh population in 2019 puts it at 49th rank globally, the grim reality of the highest numbers of suicides being reported annually from India cannot be overlooked. When you look at suicide deaths, the highest suicide rates are in the south. In central India, including Maharashtra, Madhya Pradesh and Rajasthan, you have "middling suicide rates", and the rate falls up north, in Uttar Pradesh and Bihar. Material & Methods: A five years retrospective and cross-sectional study was conducted in Forensic Medicine and Toxicology Department, Siddhartha Medical College, Vijayawada, Andhra Pradesh. All the autopsies conducted on victims of suicidal deaths during the period from Jan, 2016 to Dec, 2020 were studied from the available data. Inclusion criteria includes all the suicidal deaths due to poisoning, hanging and self-immolation by burns. Exclusion criteria includes suicidal deaths from causes other than poisoning, hanging and suicidal burns like drowning, electrocution, fall from height etc. Results: It is clear that committing suicide by consuming poison accounts for major number of deaths followed by committing suicide by hanging and least followed by committing suicide by self-immolation. It is also clear that committing suicides has increased year by year from 2016 to 2020 irrespective of committing suicide by hanging, poisoning. Coming to sex pattern, suicide by hanging was observed more in males. Sex pattern in suicidal deaths due to poisoning clearly showed that females outnumbered males. Sex pattern in suicidal deaths due to selfimmolation clearly showed that females outnumbered males with high margin. Coming to the age pattern in committing suicidal deaths by hanging, 30 - 45 years age group showed highest incidence year by year followed by 45 - 60 years and least among 15 - 25 years age group. Where as in case of suicidal deaths by poisoning and self-immolation, incidence was highest in 30 - 45 age group followed by 15 - 30 years age group and least among 45 - 60 years group. Conclusion: According to the World Health Organization, in India, suicide is an emerging and serious public health issue. Suicide rates in India have been rising over the past five decades. India's contribution to global suicide deaths increased from 25.3% in 1990 to 36.6% in 2016 among women, and from 18.7% to 24.3% among men. In 2016, suicide was the most common cause of death in both the age groups of 15-29 years and 15-39 years in India. Factors such as frustration, family problems, love affairs, poverty, harassment, sexual violence, social boycott, chronic diseases and bankruptcy were studied as the main reasons leading to committing of suicides in people. The need for a strategy which will raise awareness and help make suicide prevention a national priority has to be recognized. Such a national strategy will need a comprehensive approach that encompasses the promotion, coordination, and support of activities to be implemented across the country at national, regional, and local levels. The program would need to be tailored for populations at risk. [ABSTRACT FROM AUTHOR]

During forensic examinations to establish the cause of death by asphyxiation in various types of mechanical asphyxiation, especially hanging, the greatest attention is paid to changes in the lungs. Despite the complexity of the genesis of death in mechanical asphyxia, the most common cause of death is asphyxia. Therefore, an important link in the progression of the asphyxia process is its eff ect on a vital organ such as the lungs. In order to address issues related to the development of pathological changes in the lungs, histochemical studies aimed at detecting markers of mechanical asphyxia are becoming increasingly important, in addition to the generally accepted macro- and micromorphological studies. The aim of the study is to analyse the current research on changes in the lungs during death by mechanical asphyxia due to hanging. Results. When establishing the cause of death with signs of mechanical asphyxia due to hanging, attention is drawn to the macromorphological manifestations of asphyxia genesis in the form of general signs of asphyxia that are not specifi c to this type of death. However, it has been found that their appearance is associated with the release of a number of biologically active substances into the body, since the process of dying by hanging is a strong stress factor. This is also indicated by micromorphological changes in various organs. The lungs receive the most attention in the study, as they are a crucial link in the asphyxiation process. The lungs are known to perform a number of important non-respiratory functions in addition to their primary function of gas exchange. The lung is an organ of biosynthesis and metabolism of many biologically active substances, regulating their levels in the blood. Some of these substances are released into the bloodstream in pathological conditions and signifi cantly aff ect metabolic processes both in the lungs and throughout the body. Therefore, such substances can be used as biomarkers to prove the asphyxial genesis of death. Conclusions. Since the course of the asphyxiation process signifi cantly aff ects the function of the lungs, which are the organ of biosynthesis and metabolism of many biologically active substances, the possibility of using these substances as markers of the asphyxial genesis of death in mechanical asphyxia, especially in hanging, has been demonstrated. [ABSTRACT FROM AUTHOR]

The present study aimed to verify the time series (2000–2017) of death rates by suicide and its associated factors in 4 municipalities in the extreme south of Brazil. Data were obtained through the analysis of medical reports and police report bulletins at the Instituto Médico Legal, in the city of Rio Grande. The suicide rate in the Rio Grande region varied from 4 to 11 suicides per 100,000 inhabitants and it is estimated that by 2030 this rate could reach 16.5 suicides per 100,000 inhabitants. The rural cities of Santa Vitória do Palmar and Chuí present even higher suicide averages when compared to Rio Grande, the most populous city of the four. The death rate from suicide increased gradually in the period analyzed, with the prevalence rising among the youngest and the elderly population. A more comprehensive understanding of the influences of environmental issues on suicidal decisions constitutes an important action that needs to be taken, both because of regional vulnerabilities and the target population identified. Evidence indicates that knowledge of factors affecting individuals residing in this Brazilian region where increased suicide rates are recorded needs to be recognized as a priority. [ABSTRACT FROM AUTHOR]

Establishing the manner of death is one of the most challenging tasks for forensic pathologists. We present the case of a 24-year-old woman found dead in the early morning on a flyover. The body was sitting on the ground with the back leaning against a wall. The neck was encircled by a white phone charger cable knotted to the staircase's handrail. The victim had argued with her boyfriend and tried to jump out of his car while coming home from a wedding party the night before. After that, she left home alone with her phone charger in her hand. Due to self-harm behaviors, the first hypothesis was suicide by hanging. However, the ligature crossed immediately beneath the thyroid cartilage and encircled the neck twice horizontally; the two ends of the cable overlapped, forming a cross-over point in the front-right of the neck. Then, the ligature passed obliquely through the nape, gradually disappearing, forming a gap in the mark. The mark was sharply defined, stiff, yellow, and parchment-like. The investigators performed a three-dimensional scene reconstruction using the Trimble X7 Laser Scanner and the PC-Crash Multibody System. Even though the geometry of the ligature mark in the present case raised doubts about the manner of death, the three-dimensional reconstruction confirmed that the hanging was feasible without any external intervention. [ABSTRACT FROM AUTHOR]