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Copyright: © 2012 Bruce-Chwatt RM. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. HIV man jailed. Helsinki: “A Finnish man was sentenced to 10 years in prison for having unprotected sex with at least 12 women and not telling them he was infected with HIV. George Mensah, 50, who was born in Ghana, was also found guilty of rape and assault”[1].

Despite repeated warnings, newspaper reports of fatalities and public health and safety campaigns; accidental deaths from carbon monoxide poisoning continue to occur. They can be from accident, ignorance, criminal negligence or foolhardiness; what ever the reason such deaths are tragic and often avoidable. The case presented here was some of these. The physiology and biochemistry is discussed as well as other unusual causes of death by suffocation. This includes the use and abuse of helium from party balloons and nitrous oxide from the misuse of whipped cream dispensers provoking near suffocation and the occasional deaths, though fortunately rare. The request to attend a "sudden death", al though the death may often be many days, if not weeks old, is never pleasant. However, it is always instructive and often the most interesting, challenging and satisfying of all the work that a forensic medical examiner (FME) does. The approach should be methodical and with care and attention to detail. An awareness of the causes of injuries, forms and types of self-harm, presence of knives, drugs or weapons, and the changes after death are all part of the consideration that the experienced FME can bring to bear in assisting the police. Initial assessment if this is a natural death, a death by misadventure, a death by suicide or perhaps murder is all part of the work of the FME. Paramedics are now increasingly allowed to pronounce life extinct without any of the experience or forensic training of the FME and, in the case presented here, it is doubtful if the former would have spotted what had actually caused this death.

There are at present 1.7 billion people worldwide infected with Mycobacterium tuberculosis and 1.7 million die every year. In the UK tuberculosis not yet endemic, but cases have doubled in the last 10 years to more than 9,000 in 2010. The main source of TB being from the immigrants and asylum seekers, both legal and clandestine, who come to the UK in ever increasing numbers. They are often seen by forensic medical examiners (FMEs) following arrest. The detainees present a problem of diagnosis and risk management for all in the custody system. Despite TB being the most common cause of illness and death among people with HIV and Aids in the European region, very few co-ordinates the treatment of the co-infection properly, due to poor patient chemo-compliance and rising costs.

The risks of traveling by motorcycle are well recognized, both in terms of excess speed and relative lack of physical protection. Legislation since 1903 has been on-going to try to reduce the carnage on the roads and to recognize the financial problems that such a death leaves behind for the families of the victim. An overview of speed cameras currently in use is given with the more frequent use of ANPR (automatic number plate recognition) cameras for surveillance of known and suspected criminals, valid car insurance verification, current Ministry of Transport mechanical certificates and, increasingly, for with average speed calculation between camera sites. The latter resulting in the surprising and unexpected penalty notice in the post often many days after the incident, though to be legal in England and Wales, it must be served with 14 days of the infraction. Discussed in this case, and of considerable interest, is the hypothesis that a full-face helmet for a motorcyclist may be potentially more dangerous in a crash, due the increased weight, inertia and pendulum effect result in an increased risk of fatal basal skull ring fractures.

An illegal immigrant repeatedly slammed his head against a wall, breaking his neck in three places to avoid being deported. Amadov Nyang, a 34-years-old African, was being held in a cell at Tinsley House immigration removal centre near Gatwick. He is on a ventilator in hospital [1]. Areas of high immigrant population are ideal places for the illegal immigrant to gravitate to as he or she is less likely to stand out or be noticed by skin colour or poor or even non-existent language skills of the host country, creating ghettos of necessity, not choice. Being an illegal they will, of course, be vulnerable to threats of blackmail, coercion, prostitution, violence and resorting to crime to survive as they have no legal way of earning money. As such they are at high risk of being arrested and it is at this time that their immigrant status emerges. Illegals fear any contact with officialdom, including the NHS. The examining forensic physician is frequently faced with their considerable medical problems often including TB and HIV for which they have, as yet, sought no help. There are now many such areas in large towns in the UK with identical problems. The forensic physician is increasingly drawn into the decision of whether the prisoner is fit to detain and charge, as is more often the case, as well as whether they are fit to be deported by air having been served with a deportation order. After all the legal avenues, including the Human Rights Act, [2] have been exhausted, then under the Immigration, Asylum and Nationality Act 2006, under paragraph 10, schedule 2, there is authority to remove [3].

Bite wounds are common from dogs, cats and humans, subsequent infection depending on the degree of tissue damage and the delay in seeking treatment. Antibacterial therapy is either oral or parenteral depending on the degree of infection, with surgical wound debridement if necessary. Tetanus and anti-rabies treatment need also to be considered. The organisms from cats and dogs are P. multocida, Staph. aureus, Strep. spp., Prevotella spp. and Fusobacterium spp. Those from human bites are; Strep. spp., Staph. aureus, Prevotella spp, Peptostrep. spp. and Fusobacterium spp., especially Vincent s organisms; F. fusiforme and occasionally Borrelia vincenti.

This medical Calvary begins in the small town of Dien-Bien-Phu in northeast Vietnam in February 1954, towards the end of the first Indochina war between French Union forces and Vietnamese communist forces. Dr Paul Grauwin, waiting for a transport ship back to France, volunteers to spend two weeks with the garrison at Dien-Bien-Phu. He flies in and is then trapped, by the military situation and by the desperate moral situation of attending to the medical needs of the injured and dying. Viet Minh leader General Giap uses classic siege tactics to surround and overwhelm the French. As the outer …

Editor’s Note—An occasional item where forensic texts from previous years are reviewed. Such texts may be available via specialist booksellers. Similar contributions are welcomed.