Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item A Forensic-based study on low angled AK rifle bullet entry wounds using a porcine model(Elsevier, 2020) Nishshanka, M.B.; Paranitharan, P.; Shepherd, C.ABSTRACT:An entry wound normally carries more macroscopic evidence than found in exit wounds. In addition to common wound characteristics of an entry wound such as an abrasion collar, burn marks etc., large amounts of trace evidences from the bullet and gun such as gunshot residues, powder tattoo, grease ring (bullet wipe) etc., are also present in entry wounds making them a richer source of evidence than exit wounds. This forensic-based study explores the low-angled entry wound characteristics of AK rifle bullets (7,62 mm × 39 mm) on porcine skin. This demonstrated a special entry wound characteristic similar to the commonly reported "abrasion ring" but differs in structure with an abraded area around the entry wounds and more significantly damaged outer margins. A significant inverse relationship between the AK bullet's approaching angle and the length of the external entry wound has also been reported in this work, with each finding contributing new knowledge to the forensic pathology of gunshot wounds. The findings of this study also have the potential to aid in shooting incident reconstructions. KEYWORDS: Gunshot wounds; Low angled entry wounds; Porcine skin; Rifle entry wounds; Wound ballistics.Item An Analysis of medicolegal reporting in workman injuries referred for medicolegal examination in a Tertiary Care Hospital of Sri Lanka(Wolters Kluwer Medknow Publications, 2020) Kitulwatte, I.D.G.; Edirisinghe, P.A.S.INTRODUCTION: A reasonable number of workman injuries are reported for medicolegal examination every year. In addition to report on the degree of severity and consistency of the injuries with the historical evidence, the medical officers are expected to opine on degree of disability as well. However, routine Medicolegal Examination Form or Report used in Sri Lanka to report these cases does not carry a section for disability or impairment. Objective: To gain an insight into the pathology of workplace injuries and to evaluate the role of medicolegal examination and reporting among the victims presented with injuries at work. Methods: A retrospective descriptive study was carried out on workmen who were referred for medicolegal examination during a period of 5 years in a Tertiary Care Hospital in the Western Province of Sri Lanka. Results: Out of 172 subjects who got injured at work, none had claimed for a report of compensation. 47% (81) of the injured workers were in the age group of 19–30 years. 81% (139) were males. Factory workers were the most vulnerable workers (34%) followed by drivers (15%). A majority 39% (67) of injuries were located on upper limbs. 52% (90) of the victims had grievous injuries. However, a majority 61% (105) had no permanent disability. Conclusions: Disability is not a direct reflection of the category of hurt. Therefore, testifying on routine medicolegal reports on cases of workman compensation will not serve justice to the patient. KEYWORDS: Category of hurt, disability, injury, medicolegal examination, workmanItem Forensic based empirical study on ricochet behaviour of Kalashnikov bullets (7.62mm×39mm) on 1mm sheet metal(Elsevier, 2020) Nishshanka, B.; Shepherd, C.; Paranitharan, P.ABSTRACT: Bullet ricochet off a surface in a shooting scene occurs in diverse conditions and affected by array of factors. Therefore ricochet analysis of a particular incident demands case by case analysis supported by the knowledge of existing subject knowledge and empirical testing. In this view, existing empirical test results on bullet ricochet experiments have become always assisted and referred by investigators during scene reconstruction and in Courts. This forensic based research was aimed to understand the ricochet behaviour and related aspects of Kalashnikov bullets (7.62mm×39mm) on 1mm sheet metal. 1mm sheet metal was selected as the target surface of the study, based on its greater possibility of existing in concurrent urban environments as vehicle bodies, electrical appliances, road signs, boundary walls, partitions, walls of mobile houses etc. The research added brand new knowledge to the firearm investigation field in general and specifically to AK shooting investigations and scene reconstruction. The ricochet angles and critical angle of 1mm sheet metal and AK bullets, relationship of different impact feathers and angle of incidences are some of the main findings of the research. The double head impact mark which produces as a result of bullet's interaction with the target and it's specific relationships with the incident angles is the other most important results of the research which has not reported so far in a bullet ricochet study. In addition to the contribution of knowledge to the field of forensic sciences in general and forensic ballistic in particular, this research further emphasises the need for case by case empirical study to understand the ricochet behaviour of different bullet and target combinations. On the other hand, this study very deeply convinced firearms investigators on the risk of applying general bullet ricochet theory on yielding and nonyielding surfaces to reconstruct all bullet ricochet incidents which would result in wrong interpretations, critical errors in shooting scene reconstruction and finally for false testimonies. KEYWORDS: 1mm sheet metal; 7.62×39mm AK; Bullet; Bullet ricochet; Forensic ballistics; Shooting incident reconstruction.Item Usage of digital photographs in forensic work in Sri Lanka(Sri Lanka Journal of Forensic Medicine, Science & Law, 2018) Nadeera, D.R.; Edirisinghe, P.A.S.; Kitulwatte, I.D.G.ABSTRACT: Forensic photography refers making of images to record objects, scenes and events to be used in the legal process. With popularization of digital cameras, forensic photography is being increasingly used as a tool in record keeping as well as evidence. The objective of this study was to evaluate available facilities and current practice of using digital photographs in forensic work by medico-legal doctors in Sri Lanka. A cross sectional descriptive study was conducted using a self-administered questionnaire among doctors engaged in forensic work in Sri Lanka. The study was conducted as an on-line survey from October 2018. Out of 102 doctors who participated in the survey, 51% (n=52) used camera-phones instead of DSLR cameras to take forensic photographs, although 72% (73) had a DSLR camera in the institution. The majority (96%) used a measuring scale in their photographs, but only 43% used a colour scale. 66% took more than two photographs for a single injury but only 26% used an external light source. 80% took photographs in all magisterial autopsies but only 48% incorporated them in their reports. Majority (74%) knew that forensic photographs are admissible in courts. Basic technical knowledge of functions of a camera was poor in a majority (85%) of doctors. Although basic technical knowledge of photography was poor in doctors engaged in medicolegal practice, many use photographs to compliment autopsy reports. Since comprehension of events using visual images is better than verbal descriptions, improving the quality of photographs submitted to courts should be the way forward. Therefore, forensic photography training should be encouraged.Item A comparative descriptive study on adolescents presented to Ragama and Anuradhapura Teaching Hospitals for medico-legal examination with a history of 'sexual activity'(Faculty of Medicine, University of Kelaniya & Plan International, 2008) Edirisinghe, P.A.S.; Perera, W.N.S.; Paranithran, P.; Perera, B.P.P.; Samarasekera, A.; Waidarathna, M.D.; Jayasena, A.S.INTRODUCTION: Adolescents engaged in sexual activity are brought for medico-legal examination as they are minors. Though some have consented for sexual activity, it is not legally acceptable. The perpetrators include boyfriends, relatives, known persons and strangers. The 'boyfriend' group is unique as the consent is not obtained by illegal means. OBJECTIVE: To find out potential predisposing factors that contribute to 'consensual' or 'non consensual' sexual activity of adolescents and to find out how 'consensual' and 'non consensual' sexual activity affects sexual health of adolescents. METHODS: A retrospective descriptive study was done using records maintained at the offices of the Judicial Medical Officers of Ragarna and Anuradhapura. The data was analyzed using SPSS statistical package. RESULTS: 202 and 154 victims examined between 2000 to 2006 at Ragama and Anuradhapura were analyzed. Male to female ratio was 1:10 in Ragama and 1:24 in Anuradhapura. The most vulnerable age group for sexual activity was 14-15 years. The majority of cases were from the low socio-economic strata. Vaginal intercourse was the most preferred sexual activity; the likelihood of an adolescent from Anuradhapura to have penetrative sex was 2.47 times more as compared to an adolescent from Ragama. Boyfriend was the assailant in 39% and 37% of cases in Ragama and Anuradhapura respectively. 63 % of victims from Ragama had eloped as compared to 19% from Anuradhapura. In both groups, nearly half of the cases had a relationship less than 6 months. An adolescent having sexual activity with a relative was 2.31 (95% CI 1.36-3.93) times greater in Anuradhapura as compared to Ragama. There were 18 and 16 pregnancies in Ragama and in Anuradapura, respectivly. 61 cases from Ragama had psychological symptoms and signs after the incident. CONCLUSIONS: Adolescents are more susceptible to engage in sexual acts around 14 years. Consented sexual activity with a boy friend resulting in legal action is a significant social problem. The high incidence of sexual activity with relatives and known persons indicate the vulnerability of adolescents to engage in sexual activity in their own environments.