RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. / Name of candidate and address / Dr. MANDAR RAMCHANDRA SANE.ROOM NO -1O8.
KIMS BOYS HOSTEL.
BANASHANKARI II STAGE.
BANGALORE – 560 070
2 / Name of the institution / KEMPEGOWDA INSTITUTE OF MEDICAL SCIENCES, BANGALORE – 560 070
3 / Course of the study and subject /
M.D. IN FORENSIC MEDICINE.
4 / Date of admission to course / 31ST MAY 20115 /
Title of the topic
/ “AN AUTOPSY STUDY OF UNNATURAL DEATHS OF ADULT FEMALES , CONDUCTED AT KIMS HOSPITAL, BANGALORE”______
6. Brief resume of the intended work
6.1Need for study
Throughout most of India’s history, women have been targeted as unimportant, burdensome, and disposable. This tragedy begins shortly after conception and continues until their deaths. Despite a number of laws aimed at protecting women , such acts of violence against women have been a growing social phenomenon in the last decade.In 2006, out of the total IPC crimes, 8.8 % are crimes against women, which included torture, sexual harassment, molestation, kidnapping/abduction, rape and cruelest of all – ‘dowry deaths’.
Unnatural causes accounted for 18 to 30 % of deaths in adult females.1 The high incidence of unnatural deaths in newly married females within first few years of their marriage is a dark spot on the noble tradition of our society. The most obvious reason behind such deaths is unending demands of dowry (cash / kinds) by their husbands and/or in laws, for which they sometimes kill or torture the bride in such a way that she commits suicide. It has thrown a major challenge to the police, medico legal experts as well as to judicial officers to wipe out this social menace.
No study on unnatural deaths in adult females has been conducted in south Bangalore. South Bangalore is primarily a residential area having majority of population among middle class and lower middle class socioeconomic strata. Among married females, unnatural deaths are more common in middle and lower middle socio-economic groups. Women due to their necessity to travel for the purpose of education, jobs or for household reasons are exposed to variety of unsafe environments not only at home and work places but also on roads.Present study is designed to determine unnatural deaths of adult females in South Bangalore.
Several factors such as age, occupation, lack of emotional and financial support,inability to bear a child, sexual jealousy and marital infidelity, failure in love and scolding by parents of unmarried girls are the reasons which may also influence the unnatural death. Hence we have undertaken the study to evaluate the causative factors.
6.2 Review of literature
SharmaBRet al reported in a retrospective study of unnatural deaths of 10 years duration, a Male: female ratio of 2.2: 1. Among those,deaths due to road-traffic accidents cases were 36%, poisoningaccounted 21%, burns claimed 18%, 3% cases died due to mechanical violence. The higher incidence was observed in unnatural female deaths due to burns in the age group of 21 - 25 years.2
PathakAet al Study of Un-Natural Female Deaths, Out of 1712 autopsies, 480 cases (28.03%) were of female deaths. Age wise distribution of female death shows that most of the incidences (35%) of female deaths were noticed in the age group 0f 20-29 years.75.63% females were married. Hindus (82.91%) comprised the single largest category, which was attributed to prevalent ‘dowry system’.Burns is the leading cause of death (45% ) followed by death due to injuries in 20.2% cases, which were caused either due to road traffic accidents or due to assault or due to fall from height or fall of heavy weight over the body.As per manner of death, in 56.46% cases manner of death was accidental in nature, followed by suicidal in 29.37% cases and homicidal in only 5.21% cases.3
SrivastavaAKet al reported in their study of suspicious deaths inmarried females died within seven years of their marriage. Most of the victims were between 18 to 26 years of age (91.65%), of which 33.57% were between21-22 years of age, followed by 26.57% in 18-20 years and 20.28% in 25-26 years age groups.Amongst the causes of death, burning (44.06%) was the commonest, followedby hanging (29.37%) andpoisoning (12.59%). As to the nature of death, about 50.35% ofunnatural deaths were suicidal, homicidal 25.17% and accidental 23.08% deaths.4
Total 3,57,021 accidental deaths in the country during the year 2009. The casualties in road accidents in the country have increased by 7.3% during 2009 as compared to 2008. The major un-natural causes of accidental deaths wereroad accidents (37.9%), railway accidents and rail-road accidents (7.8%), poisoning (8.0%), drowning (7.7%), and, fire accidents (7.0%).Male: Female victim ratio for year 2009 was— 77:23 for accidents.Males out-numbered females in all kinds of accidental casualties at the national level except ‘Fire Accidents’ (where 57.5% of those killed were females as compared to 42.5% males).
1,27,151 persons in the country lost their lives by committing suicideduring the year 2009. Karnataka (9.6%) contributed of total suicide victims. Bengaluru city hasreported the highest rate of 38.1 for suicides. The overall male:female ratio of suicide victims forthe year 2009 was 64:36. One suicide for every five suicides is committed by a Housewife.The pattern of suicides reported from 35 cities showed that ‘Hanging’ (44.5%), ‘Poisoning’ (20.6%) and ‘Fire/Self Immolation’ (12.6%) were the prominent means adopted by the suicide victims in the cities.5
According to a Victimiologic study of female homicide by Mohanty AK et al, there were 39 female victims of total 162 homicides.The peak age of the female homicide victim was 3rd decade. Argument (33.3%) and dowry (30.7%) were the most frequent reasons behind the crime. 82% of the victims were from Hindu religion, majorities of them were married, illiterate, and drawn from low-socioeconomic status and rural community.6
Ambade V et al in their studied 384 victims of burndeaths to determine the trends of burn deaths.Burning accounted for 21.6% of the total autopsies. Most of the victims of burn deaths were between 11–40 years with peak at 21–30 years (47.1%). Accidental burning (75%) was the commonest manner of burn deaths followed by suicidal and homicidal burning.7
Occasionally, women commit suicide by pouring kerosene on their head and clothes before setting fire to themselves due to domestic worries, disappointment in love, or acute or chronic diseases. Sometimes suicidal burning is mode of public protest. Murder by burning is rare.8
In a study by Tirpude BH et al of profile of hanging cases, 24(77.41%) were males and 7(22.59%) were females. The male: female ratio being 3.4:1. Among females 42.85% of cases were from age group of 20-29 years.9
It is estimated that more than 50,000 people die every year from toxic exposure in India. In developed countries the rate of mortality from poisoning is as low as 1-2%, while in India it varies from shocking 15-35%. Most suicidal exposures are seen in individuals over 15 years of age and are associated with high mortality.10
Kumar V in his cohort study of 200 married female deaths, 35 (18%) deaths were due to poisoning. Among them 43% of the women were less than 35 years of age and 28.5% cases were from age group of 18-30 years.The overwhelming majority (88%) of deaths were from the Hindu community.11
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6.3Objectives of the study
1To assess the profile of unnaturaldeaths in adult females in South Bangalore.
2To assess in detail dowry deaths amongst unnatural deaths in adult females.
3To assess age pattern, marital status, educational and socio-economicprofile of deceased adult females.
4To assess the manner of unnatural deaths viz, suicide, homicides, accidents, etc.
5To determine the:-
a)Type of suicide like hanging, poisoning, drowning, etc.
b)Type of homicides like stab injuries, head injuries, strangulation, etc.
c)Type of accidents like burns, electrocution, road traffic fatalities.
6To suggest measures to prevent these unnatural deaths in adult females.
- Materials and methods:
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7.1Source of data
Data will be collected from autopsies conducted on dead bodies of females between age group 18 to 50 yearsat Mortuary, Kempegowda Institute of Medical Sciences(KIMS) Hospital, Bangalore during period of 1 year.
7.2Method of collection of data (including sampling procedure, if any.)
A.Methodology
Using pre-tested structured scheduled, all cases of unnatural deaths in females between age group 18 to 50 years brought to KIMS hospital mortuary, Bangalore for autopsy and those who fulfill the inclusion and exclusion criteria will be selected on a purposive sampling basis. The details pertaining to the age, marital status, educational qualification, and socio-economic status will be ascertained from the reliable attendants of the deceased. Details regarding the manner of death will be obtained from investigating police officer.
All cases will be studied with reference to:-
i)Postmortem findings with special reference to cause of death, time since death and manner of death.
ii)History obtained by police and relatives
iii)Hospital records in admitted cases
iv)Laboratory investigations including histopathology and toxicological(chemical) analysis.
v)Visit to the scene of crime if needed, and, study of photographs of scene of crime.
vi)Examination of weapon in cases of injuries inflicted like in homicides, and in some cases of suicides, or accidents.
B.Inclusion criteria
1. Autopsy on all cases of unnatural deaths in femalesbetween age group 18-50 years conducted at Mortuary, KIMS hospital.
C.Exclusion criteria
1. Autopsy on unidentified femalebodies.
2.Autopsy on decomposed female bodies.
3. Alleged unnatural deathof adult female, which later turned out to be due to natural causes.
D.Sample size- 60 cases.
E. Sampling design- Purposive sampling technique
F.Study design- Descriptive study
G.Study period- 1 year.
H.Place of study- Department of Forensic Medicine, KIMS Hospital, and Bangalore.
I.Statistical methods involved- The data obtained from this study will be analyzed statistically by presenting the data in the form of appropriate tables and graphs, computing the descriptive statistics like mean, median, and standard deviation, percentages. Wherever applicable the inferential statistics like chi-square test will be used to draw the valid inferences.
7.3Does the study require any investigations or interventions to be conducted onpatients or other humans or animals? If so, please describe briefly.
It does not require any investigations or interventions.
7.4Has ethical clearance been obtained from your institution in case of 7.3?
Yes.
8 List of References.
- Statistics on Women in India, National Institute of Public Cooperation and Child Development, 2010:168.
- Sharma BR, Singh VP, SharmaR, Sumedha, Unnatural deaths in northern India, a profile,J Indian Acad Forensic Med, 2004; 26(4):141-6.
3. PathakA, Sharma S, The Study of Un-Natural Female Deaths in Vadodara City, J Indian Acad Forensic Med,2011; 32(3):220-3.
4. SrivastavaAK., AroraP.,Suspicious Deaths in Newly Married Females –A Medicolegal Analysis, J Indian Acad Forensic Med, 2007; 29(4): 63-66.
5. National Crime Records Bureau, Accidental and Suicidal deaths, Ministry of Home affairs,New Delhi: Government of India, 2009: vi-ix.
6. Mohanty MK, Panigrahi MK, Mohanty S, Das SK, Victimiologic study of female homicide,Legal Medicine, 2004; 6(3):151-6.
7. Ambade VN, GodboleHV, Study of burn deaths in Nagpur, Central India, Burns 2006; 32: 902–8.
8. Reddy KSN, The Essentials of Forensic Medicine and Toxicology, 29thedn,Hyderabad, 2010; 293.
9. Tirpude BH, Murkey PN, Pawar VG, Shende SA, Profile of hanging cases on autopsy at a tertiary cars hospital in central India, JKar Med Leg Soc, 2010, 19(2): 3-8.
10. Pillai VV, Textbook of Forensic Medicine and Toxicology, 14thedn, Elsevier, 350-4.
11. KumarV, Poisoning deaths in married women, Journal of Clinical Forensic Medicine, 2004; 11: 2–5.
9Signature of the candidate
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10Remarks of the guide :Unnatural deaths of adult females are increasing in urban areas nowadays. So, the recommendations of this study will help the authorities in taking suitable preventive measures.
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11. Name & designation of
11.1GuideDr. ANANDA.K Professor and Head of Department Department of Forensic Medicine KIMS, Bangalore.
11.2Signature
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11.5Head of the departmentDr. ANANDA K. Professor and HOD Department of Forensic Medicine KIMS, Bangalore
11.6Signature
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12.1Remarks of Chairman and Principal
12.2Signature
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