Learning objectives.

(module-II, theme-fever & infection)

Learning objectives.
(module-II, theme-fever and infection IV)
• Medico legal issues related to HIV patient.
• Describe medico legal aspects of dactylography.
• Define DNA finger printing & its application in forensic practice.
• Write methods of collection of samples and dispatch to laboratory.
• Describe medico legal aspects of tattoo marks.
• Describe medico legal aspects of scar tissue.
• Describe medico legal aspects of superimposition.
• Describe medico legal aspects of facial reconstruction.
• Describe medico legal aspects of polygraph.
• Describe medico legal aspects of narcoanalysis.
s
Medico legal aspects of dactylography.
(Finger printing or Galton’s method)
Finger prints.
Are the impressions made by the ball of finger and is a parameter of
identification.
• Epidermal ridges in the skin of palms and soles are developed as early as
4th month of IUL (intrauterine life).
• Finger-print is a 100 per cent accurate method in establishing identity.

Finger prints found at crime scene as;

• Visible finger prints.
• Latent finger-prints (invisible finger-prints): When these latent finger-
prints are obtained at the crime scene by chance, these prints are termed
as the chance fingerprints. These prints being developed can be
preserved by lifting them up on an adhesive/gum tape.
• Plastic finger-prints: These are prints of the finger left on soft materials
such as wax, soap, dust, etc.
Classification
Sir Henry Galton (1892), depending on the arrangement of papillary ridges
classified the finger-prints into four major types.
1. Loop (65-67% of population)- ulnar loop/ radial loop.
2. Whorl (25% of population)- clock/anticlock wise, usually 2 deltas &1core.
3. Arch (6-7% of population)- plain/ tented.
4. Composite/compound (01-03% of population) is a mixed picture of all
three patterns above.
5. Accidental variety. To these four patterns a fifth one called “Accidental
variety” is added, wherein no specific ridge pattern is available.
• Finger prints are not taken in lepers and in cases of infectious
diseases.
• adermatoglyphia
Method to record.
• Fingers are washed and dried to ensure clear print.
• The print is taken with printer’s ink on unglazed white paper.
Impression can be:
a) Plain/ partial impression.
b) Rolled/ completed impression.

• Incase of criminals complete impression of all fingers are taken and

preserved by police.
• Civil- left thumb males and right females.
Advantages.
• Applicable to every person/ all age groups.
• Can be obtained even from putrified bodies.
• Absolute identification is possible.
• No special training/ expensive instruments are required.
Medicolegal value
• Recognition of chance impression left at crime scene.
• Identification of weapon used.
• Identification of habitual criminals.
• Identification of decomposed or mummified bodies of unknown
persons.
• Prevention of impersonation.
• As an extra precaution on cheques and notes.
Define DNA finger printing & its
application in forensic practice.
DNA finger printing.
(DNA profiling/DNA typing.)
• Alec Jeffrey in 1984 discovered unique application of RFLP
technology to personal identification and labelled it as DNA
fingerprinting akin to fingerprinting.
• The chances that DNA profiles in two individuals are similar are about
1 in 30 billion to 300 billion i.e. half the population of world.
• DNA profiles are unique to each individual except in monozygotic
twins.
Typing
There are four methods of analysis as:
1. RFLP technique – called as Restriction Fragment Length
Polymorphism.
2. PCR technique – called as Polymerase Chain Reaction.
3. STR method – Short Tandem Repeats.
4. Mitochondrial DNA analysis.
RFLP
(restriction fragment length polymorphism)
• Multiple repeating fragments are used to match with the sample.
PCR
(polymerase chain reaction)
• If the sample is too small then the available DNA is amplified using
PCR technique.
• Also in case of decomposed bodies, PCR technique has to be utilized
for analyzing the available DNA.
STR Method
(Short Tandem Repeats)
Tandem repeated DNA sequences are present in human genome and
they show variability in different individuals.
These tandemly repeated regions of DNA are classified depending on
the size of the repeat region such as:
1. Minisatellites – variable number of tandem repeats.
2. Microsatellites – short tandem repeats – STR – have repeats with 02
to 05 bp.

STR is a PCR technique that may replace RFLP. This technique is rapid
and can be performed on small quantities of DNA.
MITOCHONDRIAL DNA (mt DNA) ANALYSIS
• can be used to examine the DNA from samples that cannot be
analysed by RFLP or STR (highly degraded samples).
• While older biological samples that lack nucleated cellular material,
such as hair, bones, and teeth cannot be analysed with STR and RFLP,
it can be analysed with mt DNA.
• In the investigation of cases that have gone unsolved for many years,
mt DNA is extremely valuable.
• Comparing the mtDNA profile of unidentified remains with the profile
of a potential maternal relative can be important technique in missing
person investigations.
Forensic applications of DNA profiling.
Murder: The blood on a weapon can be matched against the blood
of the victim. Blood stains on the clothing or the person of the accused
in a case of murder can be matched with the blood of the victim.
• Hair roots found on a weapon can be matched against the blood of
the victim and accused.
Sexual crimes
• In sexual crimes, the seminal DNA obtained from the vaginal aspirates or
swabs or from the skin or clothing of the victim is printed and compared
with the DNA prints obtained from blood samples of the suspects.
• There is no need to match semen against semen. A salivary stain or a hair
transferred from the accused to the victim can be used for comparison.
• If they match, the suspect is criminal, otherwise not.
• If a condom is recovered it should be frozen intact.
• Seminal stains and vaginal epithelial cells will identify the victim and
assailant.
• This technique has particular use in cases of serial rapists in matching
evidence obtained from different cases.
Paternity disputes
• In paternity dispute cases, the blood of the child, mother and
alleged father are printed for DNA.
• The bars in the child's code are matched first with the patterns
of the mother.
• The remaining bars are then matched with the patterns of the
father. If they correspond, he is the father.
• The parents should not have had a blood transfusion within
three months, before taking the sample.
• Mutation of the genes (non-inherited germline) in a child can
give rise to wrong results in paternity testing.
• Disputed maternity.
• Exchange of newborn in hospitals.
• Identification of mutilated remains as in cases of accidents, mass disasters,
bomb blasts, burnt bodies, putrefied bodies, etc.
• The DNA fingerprint obtained from such remains can be compared with
previous prints if available or with that of the close blood-relatives of the
deceased, which can establish links between family members.
• Extortion cases: Saliva samples from envelopes, face masks, nasal
secretions, saliva from cigarette butts, etc.
• Identification of bodies in exhumation cases.
• For tracing pedigrees and for establishing family relationship.
• For species identification and gender differentiation.
• All cases of biological identification.
• To exonerate a falsely implicated person of any crime.
• In hit-and-run traffic accidents matching DNA from blood of victim
from bloodstains on a vehicle.
• Diagnosis of inherited disorders in prenatal and newborn babies.
• To determine how the races migrated from one region to another.
• The test can be done even on very old stains or specimens.
Disadvantages
• DNA analysis depends on the presence of nucleated cells.
• Therefore it is not possible with biological specimens wherein these
cells are absent (or scarce). Such specimens include semen lacking
spermatozoa (as in vasectomized males), hair shafts, etc.
Methods of samples collection
and dispatch to laboratory.
SAMPLES (BIOLOGICAL) ENCOUNTERED
IN FORENSIC PRACTICE.
1. BLOOD: Stains on cloth/wood/metal/plastic/floor titles/wall
paper/news paper/food.
2. SEMEN: Stains on cloth/paper/ furniture/floor tiles,
anal/vaginal/buccal/penile swabs, vaginal aspirates, fur/matted hair
(pubic/axillary/scalp, etc.)
3. HAIR: Scalp/ body/pubic.
4. TISSUE: Bone marrow/muscle/spleen/ fingernail scrapings.
5. MOUTH: Swabs.
6. FOETUS: Muscle biopsy/chorionic villous samples.
7. SALIVA STAINS: Cigarette butts/envelopes/also nasal mucus stains.
Collection and forwarding of forensic samples
for analysis.
• Sterile gloves should be used while collecting samples.
• The samples collected at the crime scene along with the control
samples should be sent to the laboratory within the minimum period
of time.
1. LIQUID BLOOD: In cases of paternity, maternity disputes, biological
relationships, etc., or as control samples in criminal cases,
2 to 5 mls of i/v drawn blood should be collected in sterile, leak
proof preferably screw-capped tubes containing heparin or EDTA as
anticoagulant.
The sample should be mixed thoroughly but slowly, and placed in a
container containing ice, or a thermos flask.
• The sample tube should be sealed and labelled containing the names
of the source of the blood sample, the name of the doctor collecting
the blood sample, time and date of collection, name of forwarding
authority, etc.
• The samples should reach the laboratory within 24 to 48 hours. If the
person is suffering from visible genetic disorder, it should be
mentioned in the forwarding letter of advice.
• A blood-soaked dried gauze can be used for many years, if required.
It is sealed in polythene bag or paper bag and sent at room
temperature.
• In cases of crimes, a blood clot can be transferred by using a clean
cotton cloth. Dried blood stains on weapons, garments, etc. can be
left intact and entire object submitted.
• Dried blood stains on large immovable articles can be scraped into a
clean piece of paper, or the stain can be lifted from the surface using
adhesive tape, or sample can be eluted by rubbing the stained area
with cotton swab moistened with distilled water. The swab is air-dried
without heat.
Semen/ vaginal samples.
• Sterile cotton ear buds can be used as swabs.
• After collection, these swabs should be completely air-dried, and placed in a dry sterile tube, sealed and
labelled with necessary information.
• Other relevant information about the sample should be sent separately along with the sample.
• In gang rape cases, 3 to 4 vaginal swabs should be collected and sent in separate tubes.
• The surrounding areas of the private parts of victim should be swabbed with wet cotton swabs
moistened with sterile water. These swabs should be packed in separate vials.
• The clothes worn by the victim at the time of the offence, should be air-dried and packed in papers.
• The sample should not be dried under direct sunlight or by any artificial method.
• If there is delay in dispatching the samples to the lab, the vaginal swabs should be stored at 4°C in a
refrigerator.
• The cloth material should be stored at room temperature. The vaginal smeared slides should be packed
individually and sent at room temperature to the lab. Dried stains on immovable articles can be
collected as in the case of blood stains. The blood samples of the accused should be collected in a glass
bottle as described earlier.
Saliva
• Saliva in liquid state or stained area, as much as possible should be
sent in dried condition.

• STAINS FROM SCENE OF CRIME: Stains from body fluids at the scene
of crime or large objects should be swabbed with sterile cotton buds
moistened with sterile water, air-dried and placed in a clean bottle
and sent to lab at room temperature.
Stains- blood/ seminal/ urine
• stains from individuals or in field conditions- blood/semen from
the individuals could be collected in sterile conditions and
spread on sterile bandage cloth folded several times so as to
make it absorb all the body fluid. This should be air-dried in
shade and placed in a clean envelope, sealed, labelled and sent
to lab at room temperature.
• Liquid semen found in the vagina or elsewhere should be
recovered with a fine pipette, placed in a small plain tube and
frozen.

• URINE: Urine about 10 mls should be freezed, or stain as

available should be sent in dried condition.
• HAIR: Hair(10 to 20 strands) can be picked up by using a forceps without
damaging the root.
• VISCERAL SAMPLES: In mutilated bodies, samples of 100 g of muscle
should be dissected using sterile instruments and placed in a sterile glass
or polypropylene tube containing normal saline as a preservative.
• In cases of mass disasters, air crashes, bomb blasts, etc., where several
pieces of body are found, sufficient amount of muscle may be collected
individually and sent as separate exhibits.
• In exhumations when dry tissues are present, they should be placed in a
sterile tube without preservative and sent at room temperature to the lab.
• In case of foetus, the placenta should be removed and only foetus sent in
normal saline or DMSO (dimethyl sulfoxide). The jar containing foetus
should be placed in a thermocole box containing ice and sent to the lab.
BONES AND TEETH
• Femur and humerus yield more bone marrow and are preferred.
• Bones should be packed in clean paper or cloth. No preservative is necessary.
• If skull containing teeth are found, molar teeth from upper and lower jaws should
be detached and sent. If molar teeth are not available, other teeth may be sent.
• Teeth should be placed in a clean polythene cover.
• Skull containing teeth, which has been used for superimposition test is not useful
for DNA analysis.
• As such few teeth should be extracted from upper and lower jaws before cleaning
for superimposition.

• FINGERNAIL SCRAPINGS: The palm of the victim should be placed on a

clean polythene sheet and the inner portion of the fingernails scraped with a
toothpick, etc. and placed in a polythene sheet.
SAMPLE PRESERVATION
• Freezing is simplest procedure.
• For long storage -70°C up to 5 weeks, up to 5 days storage in ice.
• The tissue samples should be wrapped in aluminium foil, placed in
plastic bags and frozen.
• Fixation by formaldehyde is not recommended.
• Dried stains should be collected in clean envelops and maintained dry
or frozen.
AUTHENTICATION AND FORWARDING
• Blood samples in cases of paternity disputes and in cases where they
are used as control samples for identification purposes should be
collected in the presence of judicial officer.
• The samples should be sealed, and a specimen of the seal on paper,
should be sent along with the samples for verification.
• The identification card and the forwarding note should be filled,
certified and sent to the lab along with the samples.
• In persons who had blood transfusion within three months preceding
the date of collection, the samples are not useful.
• The material can be forwarded to the lab by Executive or Judicial
Magistrates, S.I. of Police, Asst. Civil Surgeons and above ranks.
Tattoo marks
Describe medico legal aspects of tattoo marks.
Tattoo marks
Tattoo means to mark.
• These are the designs, effected by multiple small puncture wounds
made through the skin with needles or similar penetrating tool
dipped in a dye.
• Design found on any part of the body and variety of pattern reflects
individual’s intentions.
Permanency of tattoo marks depends upon;
i- Type of dye used. Black, red and blue dyes are commonly used
because they are durable and permanent.
ii- Depth of penetration. The optium depth of penetration is up to the
superficial layers of the dermis.
iii- Part of body tattooed. Common sites are chest, back, shoulders,
arms and forearms.
Medicolegal importance of tattoo marks.
• Identification.
• Personal events of life.
• Profession.
• Behaviors.
• Social status.
• Political convictions etc.
• Religion.
• Race.
Removal of tattoo marks.
Various artificial means are used for elimination.
- Dermabrasion.
- Application of caustic substances or CO2 snow.
- Electrolysis.
- Surgery.
- Exposure to laser beams.
The former 04 methods will leave scar but there will be no scar in case
of laser beams.
 Scars
Describe medico legal aspects of scar tissue.
Scars
‘A scar is a fibrous tissue covered by epithelium, formed as a result of
healing process of a wound or injury when there has been a breach of
continuity in tissues.’
OR
‘A product of healing of a wound by fibrosis and cicatrisation.’

It has no hair follicles or sweat glans but it is slightly vascular, owing to

presence of a few capillaries.
Characteristics of scars.
In general it resembles the shape of wound e.g.
1- In incised wound it is linear and triangular. It is straight if the wound has
healed by first intention. If the wound has healed by granulation, then scar is
wide and thicker.
2- if incised wound is on loose skin such as scrotum etc. scar will be irregular
and may be smaller than original wound.
3- in lacerated wound, scar is broad and irregular.
4- in extensive burns, scar is large irregular and keloidal.
In bullet wound, scar of entrance is small than that of exit and is irregular.
In stabbing, scar is triangular and smaller in size than the blade of weapon.
Appearance of scars
• Appearance of scar depends upon nature, size of wound, vascularity
of the part, method of healing of wound, age and health of the
person.
Time of appearance of scar.
• In superficial cuts, scar is formed in 4-5days.
• In clean surgical wounds 14days.
• In supprative wounds, from 2weeks to 2-3months.
Age of scar
• Difficult to assess.
• First it is red, tender, covered by scab, then it turns brown and later
white and glistening (due to obliteration of capillaries) in 3-4months.
It remains permanently there onwards.

Growth of scar.
• Those produced in childhood grow with age especially those of chest
and limbs.
Medicolegal importance of scar
• Helps in identification.
• Identification of weapon causing wound.
• Time of occurrence of event (crime).
SUPERIMPOSITION
Medico legal aspects of superimposition.
Superimposition
• If a photograph of a missing person (front profile) is available and the
skull with mandible is both recovered, this technique may be used in
ruling out that the skull belongs to the person in the photograph.
• In a number of instances a skull is produced by the police and the
forensic experts are posed with tricky query of whether it could
belong to the dead person.
• There are two methods of identification from skull, the reconstructive
and comparative methods.
• The former aims at determining age, race, gender and as many other
criteria of individuality as possible.
• The comparative method makes use of antemortem records like
photographs and X-rays to which the skull may be compared.
• A refinement of this is the superimposition technique where the life-
size photograph of the head of missing person is superimposed on
that of the skull under scrutiny.
• In a number of cases this method has been successfully used to aid in
identification of a deceased.
The Technique
• The technique comprises of following steps:
• Enlarge the photograph to ‘life size’, the enlargement factor being
based upon the measurements of the fabric of the deceased, or other
measurable items seen in the photograph, or the focal length of
camera lenses used, or the dimensions of the anterior teeth, etc. The
skull is adjusted in such a way that the inclination and orientation are
same as that of the head in the photograph. A life size picture is taken
and superimposed on the transparency of life size antemortem
photograph, making allowances for soft tissue and hair thickness. The
anatomical landmarks are then compared for a positive match.
Examine the following characteristics in the superimposed photograph
1. Outlines of skull and mandible fit into the outlines of head and face in
portrait.
2. Vault of the skull to hair line.
3. Eyes to orbits.
4. Nasion with origin of nose.
5. Nasal aperture with nose.
6. Nasal spine in centre which is little above the nose.
7. Prosthion in the central line.
8. Upper border of the upper jaw i.e. below the tip of the nose.
9. Teeth in relation to lips.
10. Zygoma over the highlights below the eyes.
11. Tip of the mandible (Gnathion) with chin.
12. Position and shape of upper jaw with general contour of cheeks.
Medicolegal importance.
• Pan-American Health Organization (PAHO) and World Health Organisation (WHO)
in one of their joint publication on management of the dead bodies of mass
disaster victims, highlights the facts on utilizing this technique for establishing
personal identity mention that… “the interpretation of some tests can be
misleading.
• For example, superimposition of skull and ante mortem photographs can only
exclude the remains recovered; however sample coincidences in this test do not
confirm the identity of the subject…”
• Thus, arriving at a positive match does not always mean a positive identification,
since photographs of any other person with similar craniometry can produce a
successful match with the same skull.

• As a result, this test can help only in ruling out (exclusion) rather than confirming
(conclusion) the identity.
Disadvantages of Superimposition Technique.
1. Slight variations in magnification of antemortem photograph or
slight change in angulations of the skull from that of photograph
can lead to major discrepancies resulting in a mismatch.
2. The method is laborious and time consuming. To avoid these
problems, use of a methodical proforma based approach or video
superimposition technique can greatly improve results minimizing
the human errors.
Facial Reconstruction
Describe medico legal aspects of facial reconstruction.
 Facial Reconstruction
• Forensic sculptors working with skeletal remains and modelling clay can
reconstruct facial features often sufficiently close to permit identification.
• Computer programmes are available to simulate aging as well as
reconstruction of appearance, so that if the interval between disappearance
and death or discovery is long, a more accurate depiction of facial features is
possible.
Polygraph
Describe medico legal aspects of polygraph.
Polygraph
• A polygraph ('lie detector') is a device which makes a continuous
record of several physiological variables, such as blood pressure, heart
rate, respiration and electrodermal reaction, while a series of
questions are being asked, in an attempt to detect lies.
• The above measurements are believed to be indicators of anxiety due
to sympathetic stimulation that accompanies the telling of lies.
However, if the subject exhibits anxiety for other reasons, a measured
response can result in unreliable conclusions.
• A polygraph test is also known as a psychophysiological detection of
deception (PDD) examination.
Medicolegal importance.
(Admissibility of Polygraphs in the Court)
• While lie detector tests are commonly used in police investigations in
US(united states), no defendant or witness can be forced to undergo the
test. The US Supreme Court left it up to individual jurisdictions as to
whether polygraph results could be admitted as evidence in court cases.
• In most European jurisdictions, polygraphs are not considered reliable
evidence and are not generally used by police forces.
• In Canada, the use of a polygraph is sometimes employed in screening
employees for government organizations. However, in the 1987, the
Supreme Court of Canada rejected the use of polygraph results as evidence
in court.
• The Australian High Court has not yet considered the admissibility of
polygraph evidence.
 Narco-Analysis
Describe medico legal aspects of narcoanalysis.
Narco-Analysis
‘’It is a scientific procedure to obtain information from an individual in a
natural sleep-like state.’’
Principle: The narco-analysis procedure dwells upon the effect of bio-
molecules on the bioactivity of an individual.
• A person is able to lie by using his imagination. During the test, the
subject's imagination is neutralized by making him semi-conscious. In this
state, it becomes difficult for him to lie and his answers would be restricted
to facts he is already aware of.
• The subject is not in a position to speak up on his own, but can answer
specific and simple questions.
• In such sleep-like state, efforts are made to obtain 'probative truth' about
the crime.
Legal Aspects
• Supreme Court has recently declared that narcoanalysis, polygraph
tests and brain-mapping cannot be done without the consent of the
individual. If the person consents for such methods, then any
information obtained can be used for further probe.
• Results of such tests will not be admissible as evidence, even if done
with consent.
• Use of such methods are illegal and as against constitution. As per
Article 20(3) of the Constitution ‘No person accused of any offence
shall be compelled to be a witness against himself’. Therefore, a
suspect of the crime cannot be compelled to disclose facts which he
can recall from his memory, and likely to implicate him in a crime in
which he was involved.