25.dr pankaj kumar.cdr INTRODUCTION: Identication means xing the individuality of a person. Unidentied or unclaimed dead body means body of a deceased person , if such body has no relative or if it is not claimed by any of his relatives within 48 hrs. of his death. As and when a dead body recovered by the police is unidentied or unclaimed, the police ofcer make inquiry under section 174(14) and send it for medico-legal autopsy. The unknown body brought for autopsy is preserved in the mortuary for 72hrs from the time it came to the mortuary. If there is no claim for the body even after 72 hrs., the police ofcers are legally authorised to dispose off the body. The aim of this study is to ascertain the cause of death and other parameters in the unknown/unclaimed victim. However, the problem of nding the cause of death in unknown body get aggravated when the bodies recovered are either in decomposed form or crushed state. Post-mortem examination act as one of the investigative tool that helps in positive identication of the deceased, determination of time since death, cause of death, manner of death, time between injury and death, and to recover clues from the body. MATERIAL AND METHODS: Unidentied bodies brought for post-mortem examination to the mortuary of dept. of Forensic Medicine & Toxicology, NMCH, Patna, during the period of Jan 2016 to Dec 2017 comprise material for the study. Data regarding these cases were compiled from PM reports, inquest paper, detailed hist ory elicited from concerned I.O. at the time of autopsy. OBSERVATION & RESULTS: A total of 829 bodies (409 cases in 2016 and 420 cases in 2017) were brought for PM examination to the mortuary of FMT dept. NMCH, Patna during the study period of two years (Jan2016- Dec2017). Of these unknown/unidentied cases were 124 (67 cases in 2017 and 57 cases in 2017) comprising 14.95% of total cases (16% in 2016 and 14% in 2017). The present work was done on 124 cases, of which, 103 cases were brought directly from the NMCH Hospital while the rest were referred from nearby hospitals. Gender wise distribution shows, there were 83 cases (66.93%) of male and female contributed 33.06% (41cases) of the total cases studied. Opinion regarding the cause of death was given at the time of autopsy in 114 cases (91.9%) while in the remaining 10 cases (8.06%), additional investigations were required; so the opinion was kept reserved and viscera was send for histopathology and chemical analysis in the concerned FSL. Till the date, Out of these 10 cases, 5 cases were reported to be positive for the presence of poisonous substances by the FSL while the reports of rest 5 cases were still awaited. On including these 5 conrmed cases of poisoning in the study, there were total of 119 cases, where nal opinion to the cause of death were available, of which 40 deaths (32.25%) were natural and the rest 79 cases (63.70%)were that of unnatural deaths. Among all the 40 natural deaths (32.25%), lung disease (acute/chronic) comprising 32 cases (80%) predominated the cause of death followed by coronary artery disease in 3 cases (7.5%) and hepatic disease in 2 cases (5%). The cause of death was others (including heat stroke, hypothermia etc.) in 3 cases (7.5%). Table 3 shows that among 124 unidentied cases studied, road trafc/rail accident were most common (21.77%) cause of death. Strangulation accounted for 13 cases(10.48%), electrocution in 2 cases (1.6%) and gun shot in 1 case(0.8%). Drowning was the cause of death in 26 cases (20.96%)and poisoning and not known account for 5 cases(4.03%) each. Among all unnatural, accidental deaths (including RTA, rail accidents)were most common (55cases,69.62%) manner of death followed by homicidal 19 cases,24.05%{comprising of strangulation(13 cases,13.48%), gunshot(1case,0.8%) & trauma(5cases, 4.03%)} and suicidal 5 cases[6.32%] comprising all cases of poisoning only. The cases from the rural area constitute 62.09% (77cases) whereas the remaining 47cases (37.9%) were belonging to urban area. TABLE 1: PATTERN OF CAUSE OF DEATH IN UNCLAIMED/ UNIDENTIFIED /UNKNOWN DEAD BODIES : A TWO YEAR RETROSPECTIVE STUDY. Original Research Paper Dr. Radha Raman Singh Associate Professor, Fmt Dept., Nalanda Medical College And Hospital (NMCH), PATNA. X 13GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS Forensic Medicine Patna is one of the largest city (both in terms of population and area) as well as the capital city of Bihar. Every year thousands of people from different regions of Bihar throng to the capital city in search of job. When these people die without any identifying document, it is very difcult to establish their identity and cause of death as their past medical and other histories are not known. The present 2 yrs. of retrospective study was undertaken to nd the cause of death and its pattern in unknown/unidentied/ unclaimed dead bodies brought for autopsy at Nalanda Medical College & Hospital (NMCH), Patna, between Jan 2016 to Dec 2017. A total of 829 cases were brought for medico-legal autopsy of which unknown cases accounted for about 14.95%. The manner of death was certied as natural in 32.25% of cases in which chest and abdominal disease combined were mainly responsible with a predominant pathology in the lungs (80% cases). Of all unnatural deaths (63.70%), road/rail accident injuries were most common (21.77%) cause of death followed by drowning (20.96%). There was a clear predominance of males cases (66.93%) over female one. The government should take initiatives at large to prevent unnatural deaths in unidentied or unknown persons. The study suggest an urgent need for creation of a National Missing Person Database as well as DNA database to aid the identication of unidentied/unclaimed/unknown bodies. ABSTRACT KEYWORDS : Unknown, Unclaimed, Unidentied, Death, Autopsy, Pattern. VOLUME-9, ISSUE-3, MARCH-2020 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Dr. Pankaj Kumar* Associate Professor, FMT Dept., Patna Medical College And Hospital (PMCH), PATNA. *Corresponding Author Dr. Ranvir Ranjan JR III (PG), FMT Dept., PMCH, Patna. Manner of death (among unnatural deaths) No of cases % 1)Homicidal (strangulation, gunshot, trauma) 13+5+1=19 24.05 2)Suicidal(poisoning) 5 6.32 3)Accidental(RTA+ Rail accidents ,drowning , electrocution) 27+2+26=55 69.62 Total 79 100 14 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS TABLE 2: Table3: PIE-CHART 1: PIE-CHART 2: PIE-CHART 3: Bar chart 1: distribution of known vs. unknown cases during 2016 & 2017 DISCUSSION: Unidentied cases brought for PM examination at NMCH account for although less no of cases but were very signicant one. Most of the cases among unnatural deaths were due to road/rail accidents probably because i) beggers and destitudes reside at the road side and are usually physically challenged ii) hit and run accidents with crushing of head and face, hindering identication iii)body being dismem bered when run over by a heavy vehicle or train iv)a person being involved in a fatal accident just on arrival in a completely new place v) close proximity of the hospital to the National Highway, Gandhi Setu and Patna Junction which because of being in capital are highly crowded. The RTA was followed by drowning which can be attributed to the closeness of the Hospital to the river Ganges. Among unnatural deaths , the lung pathology predominated and rural cases exceeded the urban one. CONCLUSION: The ndings of our study revealed that road/rail accidents is most important cause of mortality in unknown cases in the study area. Male were most affected population and most of the cases belong to rural area. As far as manner of death is concerned, accidental was most common followed by homicidal and suicidal. More deep studies are required to nd the actual cause of accident for preventing its effects on morbidity and mortality, which will in turn help in providing better health care facilities to the homeless. Apart from it, effort should also be made by the police to present the unknown/unclaimed bodies for autopsy without delay so that the decomposition and other artefacts do not set in and obscure the valuable ndings regarding the cause and manner of death besides the identication. Along with publishing missing notices in dailies by police personnel, the simple technique of preserving records like colour photographs{of dead body as well as clothes}, marks of identications (at least 2), tattoos, scars, deformities, dental records, whole body radiographs{to reveal old fracture or implants}, ngerprints, DNA analysis(by preserving sternum), blood samples for cross matching, pulp of ngers ( preserved in formalin) also help a lot in identifying the deceased even years after their deaths/post-mortem. DECLARATION OF CONFLICTING INTERESTS: None declared FUNDING: This research received no specic grants from any funding agency in the public, commercial, or not for prot sectors. REFERENCES: 1. Vij K. Textbook of Forensic Medicine & Toxicology, Principles and practice , 5th edition ,INDIA; El Sevier:2018 p35-37. 2. Reddy KSN: The Essential of Forensic Medicine and Toxicology 28th ed, Hyderabad,INDIA , Page 112-113. 3. Job C, Determination of cause of death in decomposed bodies- A regional study.Indian Academy for Medicine 2009,31(1):11-17. 4. Kumar A, Tyagi A, Aggarwal NK, sex determination using adult talus and calcaneum bones. J Forensic Medicine & Toxicology,2009,12(1): 04-12. 5. Shepherd R,Guidelines for autopsy and exhumation, SIMPSON`s Forensic Medicine 12th ed,London page 187-193. 6. Kumar A, Harish D, Chavali KH, Singh A,Pattern of cause of death in unknown dead bodies : A three year study in a tertiary care hospital. J Indian Academy of Forensic Medicine OCT-DEC 2012;34(4). VOLUME-9, ISSUE-3, MARCH-2020 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra CAUSES OF DEATHS (Natural) No of cases % 1.Lung ds (acute/chronic) 32 80 2. Coronary Disease 3 7.5 3. Hepatic Disease 2 5 4. Others 3 7.5 Cause of deaths No of cases % 1.Natural 40 32.25 2. Road trafc/rail accidents 27 21.77 3. Gunshot 1 0.8 4. Trauma(head, abdominal, chest injuries) 5 4.3 5. Drowning 26 20.96 6. Strangulation 13 10.48 7. Electrocution 2 1.6 8. poisoning 5 4.03 9. Not known 5 4.03