Forensic medicine in Bangladesh

In this paper, we discuss the current medico-legal practice and future plan to improve the medico-legal service of Bangladesh which is rooted in the remnants of British medical jurisprudence. It includes clinical forensic medicine and forensic pathology. In Bangladesh all unnatural deaths are to be reported at the nearest police station and an appointed police officer should visit the scene of crime for investigation and to arrange postmortem if required. The forensic services of the country are delivered partly by academic staffs of Government Medical Colleges and the rest by the Civil Surgeons. Sometimes, residential medical officers in the district hospitals perform the medico-legal work. Most of them have no forensic qualifications except a long exposure in the medico-legal field. Currently academic and professional postgraduate courses are available. The chemical examiner's laboratory is situated at Dhaka with the facility of quantitative tests only. The Government of Bangladesh is trying to standardize the existing system. A Workshop on medico-legal services has been organized regularly by The Medico-legal Society of Bangladesh. A DNA profiling laboratory at the Dhaka Medical College is in the process of being set up. Such progress will be a milestone in the development of the medico-legal service in Bangladesh. However, with a few exceptions, teaching and training facilities are still lacking.     

Forensic medicine training in Tunisia

Forensic medicine is a specialty new to Tunisia since local teams started working in this field only 3 decades ago. Forensic medicine departments are now established in university hospitals, associated with the four national faculties of medicine. Medical undergraduate education includes forensic medicine as part of the curriculum because of the current lack of forensic physicians and the need for practitioners with some training in this field. Specialization is achieved by a 4-year full-training residency, including both forensic pathology and medicine. The undergraduate and postgraduate education programmes are described.     

Forensic medicine: matters of life and death

Forensic radiology uses medical imaging to answer a variety of legal questions, including questions about suspicious and violent deaths. This article traces the history of forensic medicine and forensic radiology and outlines radiology's role in investigating death. The authors discuss the physical changes that occur after death and the procedures involved in forensic autopsies, including radiography.     

Forensic medicine services in Uganda--present and future

Forensic medicine services (medico-legal services) as it is provided today in Uganda is discussed with special reference to forensic pathology and also to future plans for improvement to ensure quality service. Forensic medicine services are divided into clinical forensic medicine and forensic pathology. In Uganda, these services are rendered partly by pathologists attached to University, by pathologists and medical officers employed by police and by medical officers attached to hospitals. In Uganda, all types of unnatural deaths are reported to nearest police station and appointed investigating police officer(s) will take necessary action to have a medico-legal postmortem done as soon as possible. Currently there is no qualified forensic pathologist in Uganda. Suggestions are made with regard to the enactment of a Forensic Medicine Services Act by the Department of Health, the creation of a forensic medicine unit with, under the administrative umbrella of pathology department, in medical schools and imparting of forensic medicine training to anatomical pathologists to act as a qualified, specialist forensic pathologists.     

Nuclear medicine practice in Japan: a report of the sixth nationwide survey in 2007

Objective  The Subcommittee on the Survey of Nuclear Medicine Practice in Japan has performed a nationwide survey of nuclear medicine practice every 5 years since 1982 to provide detailed information on its present status. Methods  Questionnaires were sent to all institutions known to the Japan Radioisotope Association to conduct nuclear medicine examinations. The questionnaires addressed the number and kind of nuclear medicine examinations performed as well as the kind and dose of the radiopharmaceuticals used during the month of June 2007. The annual number of total or specific examinations was then estimated. Results  Of the institutions sent questionnaires, 1219 were for in vivo study, 49 for in vitro study, and 212 for positron emission tomography (PET) study. Of these, 92.2% provided answers. A total of 1569 gamma cameras were installed in 1119 institutions, of which 70% were dual-head cameras. The estimated total annual number of in vivo examinations expressed by the number of administered radiopharmaceuticals was 1.41 million, representing a decrease of 11.5% when compared with that of the previous survey (2002). The frequency of study with respect to single-photon emission computed tomography (SPECT) slightly increased to 42.3% from 39.9% in the previous survey. The most frequently performed scintigraphy was bone (38.3%), followed by myocardium (26.2%) and brain perfusion (14.1%). Brain perfusion scintigraphy slightly increased, whereas tumor scintigraphy decreased by one-half when compared with the previous survey. The most commonly used radiopharmaceutical for each scintigraphy was ^99mTc-HMDP for bone, thallium-201 (²⁰¹Tl)-chloride for myocardium, gallium-67 (⁶⁷Ga)-citrate for tumor, and technetium-99m-ethylcysteinate dimmer (^99mTc-ECD) for brain. The number of PET institutes increased from 36 to 212. ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG)-PET dramatically increased 14.8-fold during the past 5 years. Radionuclide therapy also increased. ¹³¹I therapy for thyroid cancer and hyperthyroidism was conducted yearly in 2373 and 4146 patients, respectively. A total of 13.1 million in vitro radioassays were carried out yearly, the number of which has been decreasing continuously since 1992. Conclusions  It was proved that the content of nuclear medicine practice in Japan has changed considerably in the past 5 years. Namely, ¹⁸F-FDG-PET and radionuclide therapy increased. This report might be useful for understanding the present trends of nuclear medicine practice in Japan.     

Forensic medicine in Nepal: Past,present, and future

The practice of autopsy for medico-legal purposes in Nepal was started during the 1960s when jail doctors used to perform the autopsy. However, the medico-legal service in clinical forensic settings is less than three decades old. In Nepal, a police inquest is done for all the unnatural deaths who then subjects the body for medico-legal autopsy at the nearest government hospital. Except for a few hospitals where forensic medicine experts are available, the medico-legal work in Nepal is done by medical officers most of who have no forensic qualification. For a country with a population of nearly 30 million, there are less than 50 forensic medicine experts who are currently practicing. There are 21 medical colleges in Nepal each having a forensic medicine department engaged in teaching forensic medicine as a separate subject in the undergraduate medical curriculum. Currently, postgraduate courses are also offered in the country. However, there is a lack of uniformity in the curriculum set by different universities for both postgraduate and undergraduate education. Due to the lack of forensic medicine faculty members in some medical colleges, the undergraduate students of medicine have to undertake the exam being taught by some guest lectures and without witnessing a single medico-legal autopsy. To standardize the medico-legal services and forensic medicine education, the Medico-Legal Society of Nepal was established with an aim to conduct regular seminars, conferences, and CMEs and also various training programs for the non-forensic medicine experts who deal with medico-legal cases. This paper aims to provide a brief history of medico-legal practice in Nepal, the current situation, and future plans to improve the medico-legal service of the country.     

Forensic veterinary medicine: a rapidly evolving discipline

Forensic veterinary medicine is of increasing importance. Legal and other cases in which a veterinary input is likely to be required include those relating to unexpected death of animals, welfare, abuse, and breaches of conservation law. The principles of investigation closely follow those used in human forensic medicine, but there are some important differences.     

Nuclear medicine practice in Japan: A report of the 5th nationwide survey in 2002

The Subcommittee on Survey of Nuclear Medicine Practice in Japan has performed a nationwide survey of nuclear medicine practice every five years since 1982 to provide detailed information on its current status. METHODS: Questionnaires were sent to every institution known to the Japan Radioisotope Association to provide nuclear medicine examinations. The questionnaires address the number and kind of nuclear medicine examinations performed as well as the kind and dose of the radiopharmaceuticals used during the month of June 2002. The annual number of total or specific examinations was then estimated. RESULTS: Of the institutions sent questionnaires, 1,204 were for in vivo study, 124 were for in vitro study, and 36 were for positron emission tomography (PET) study. Out of these, 95.8% answered them. A total of 1,697 gamma cameras were installed in 1,160 facilities, of which 50% were dual-head cameras. The estimated total annual number of examinations expressed by the number of administered radiopharmaceuticals was 1.60 million, similar to that of the previous survey (1997). The frequency of study with single photon emission computed tomography (SPECT) increased to 40%, from 30% in the previous survey. The scintigraphy most frequently performed was bone (35%), followed by myocardium (24%) and brain perfusion (12%). All showed a continuous increase over the past 20 years. Tumor imaging, however, fell from third to fourth place. The most commonly used radiopharmaceutical for each scintigraphy was 99mTc-HMDP for bone, 201Tl-chloride for myocardium, 67Ga-citrate for tumor, and 123I-IMP for brain. A total of 29,376 PET studies were performed yearly. Among them, 18F-FDG rapidly increased 3.7-fold. 131I therapy for thyroid cancer and hyperthyroidism was conducted yearly in 1,647 and 3,347 patients, respectively. A total of 31.35 million in vitro radioassays were carried out yearly, the number of which has been decreasing continuously since 1992. CONCLUSIONS: It was proved that the content of nuclear medicine practice in Japan has changed in the past five years. This report might be useful for understanding the current trends of nuclear medicine practice in Japan.     

Nuclear medicine in Europe: education

The technical developments that have taken place in the preceding years (PET, hybrid imaging) have changed nuclear medicine. The future cooperation with radiologists will be challenging as well as positioning nuclear medicine in an European context. It can also be expected that education in nuclear medicine will undergo a harmonization process in the states of the European Union. In this paper, we describe how nuclear medicine education is organized in several European countries. We aim to stimulate constructive discussions on the future development of the specialization in nuclear medicine in Germany.     

Forensic autopsy practice in the Middle East: Comparisons with the west

Autopsies are performed in the majority of Arab, Muslim countries. Several of these countries face social challenges and others do not have well established academic programs to teach the science. In this article we intend to review the history and practice of the forensic part of autopsies in a few Arab, Muslim countries (Egypt, Kingdom of Saudi Arabia (KSA) and Kuwait) and compare it with the United States of America (USA) and the United Kingdom (UK), 2 countries where the practice of forensic science and Forensic pathology is well established. This was achieved by pub med literature search and the distribution of a questionnaire to colleagues in Arab countries. We recommend that Arab countries explore the field of virtual autopsy to overcome some of the social challenges related to dissection of the cadaver. Kuwait can benefit from the introduction of Forensic training given the high workload in the country.     

转化医学理念在全科医学教育中的应用探讨

转化医学强调医学基础研究成果向临床实践应用的转化,其“以患者为中心”的学科理念符合全科医学的主旨及培养教育核心内容。我们借鉴转化医学的先进理念及其领域内学科建设、教学方式、评估体系、师资培训等有效经验,结合我国国情,探讨转化医学理念与全科医学教育的契合点,探讨如何应用其特色和优势之处促进全科医学教育的全面发展。