Browsing by Author "Muthulingam, T."

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Medicolegal aspects of victims of assault admitted to a tertiary care hospital in Sri Lanka
(Academic Forensic Pathology, 2022) Jayasundara, M.S.; Thivaharan, Y.; Muthulingam, T.; Borukgama, N.; Kulathunga, D.L.; Kitulwatte, I.D.G.
INTRODUCTION: Violence with physical assault is a common cause of morbidity and mortality prevalent but not limited to underdeveloped countries. The opinion of the forensic expert is often indispensable in such cases to determine the penalties. This study was planned to describe the pattern of presentation of the victims and evaluate the strengths and limitations in formulating a scientific medicolegal opinion based on the findings of the victim. METHODS: A retrospective descriptive study based on the case records of the victims of assault admitted to Colombo North Teaching Hospital, Ragama, Sri Lanka, was conducted for four years. RESULTS: Out of the 400 victims, the majority (72% n = 290) were males and of the age-group of 21 to 40 (n = 216). The reason for assault in the majority was sudden provocation (n = 99, 25%), followed by previous long-duration enmity (n = 89, 22%). The majority (83%) had isolated blunt force trauma, and the injuries were nongrievous (74%). Defense injuries were significantly associated with attempted defense (p = 0.000) and sharp force trauma (p = 0.002). The underlying reason for the assault was not significantly associated with the causative weapon (p = 0.228) or body region injured (p = 0.195). CONCLUSIONS: Even though the presentation and the pattern of injures are definitely of value in formulating a scientific opinion, the study identified the limitations of the forensic experts, and the need for a holistic approach at the investigations was highlighted.
Strengthening the “Multidisciplinary Child Protection Committees” in the community
(Department of Forensic Medicine, Faculty of Medicine at University of Peradeniya, 2021) Thivaharan, Y.; Perera, W.N.S.; Muthulingam, T.
INTRODUCTION: Child abuse and neglect have been widespread since time immemorial. It is not only detrimental to the affected child, but families, societies and cultures as well. Although the exact prevalence of child abuse is not known in Sri Lanka, reported literature shows that it is a significant problem and the available statistical data on the prevalence of child abuse, is only the tip of the iceberg. CASE REPORTS: Three case reports are elaborated and its forensic clinical examination findings are discussed along with the medico-legal value of each case. These highlight the importance of empowerment with proper statutory amendments, educating the judiciary about practical background of these abuses by clinical forensic practitioners with sufficient practical experience and strengthening of the “Multidisciplinary child protection committees” for early detection of child abuse within the community. DISCUSSION: We suggest making the best use of the existing ‘praja’ committees, as first responders to recognize ‘high risk’ children within their community and reporting to a central authority such as National Child Protection Authority NCPA. Incorporating details of ‘high risk’ children into an electronic database would enhance easy reference, and electronic data linked to the ‘1929’ child-line would ensure a better outcome. Confidentiality should be maintained at all times. ‘High risk’ children and their families should be visited by the Child Rights Protection Officers on a regular basis and immediate action should be taken if any form of abuse is suspected. Representatives from schools attended to by ‘high risk’ children and the ‘Gramaseva Niladhari’ should be part of these committees. It is also necessary to register all families who have a single parent, with parents working abroad, involved in civil or criminal court cases, with psychiatric illness/addictions with the Grama Niladhari, police and local probation and childcare office. CONCLUSION: “Multidisciplinary Child Protection Committees” should be strengthened in the community under the supervision of the NCPA using existing facilities and with the participation of multi-sectorial stake holders. This will help in early detection of child abuse and community monitoring of high-risk children.
Study on evaluation of knowledge, attitude, and practice of Sri Lankan traffic police officers related to examination of drunk drivers, in two most populated districts of Sri Lanka
(Sage Women's Educational Press, 2021) Thivaharan, Y.; Kitulwatte, I.D.G.; Muthulingam, T.
Introduction: Driving under the influence (DUI) of alcohol is one of the substantial predisposing factors for mishaps among road users. A traffic police officer will be the first authoritative personnel a drunk driver encounters in the legal system. The absence of accurate skills and knowledge of these officers impedes the structuring of legal procedures and may lead to miscarriage of justice. Objective: To assess the knowledge, attitude and practice of Sri Lankan traffic police in handling and managing an alleged case of driving under influence of alcohol. Methods: This was a descriptive cross sectional study carried on a sample of 384 traffic police officers attached to the districts of Colombo and Gampaha, through a questionnaire. Results: Out of 384, only 75 of police officers knew the correct preliminaries to perform before administering a breathalyzer test. 79.7% knew the correct instructions for using a breathalyzer, but only 3.4% knew the colour changes of the breathalyzer. Significantly poor attitude was observed among the police officers, regarding the importance of producing a drunk driver for medico-legal examination (P = 0.001) Only 222 (57.8%) answered correctly that a drunk driver needs to be subjected to a medico-legal examination as early as possible. Significantly poor practice and attitude was observed in officers with longer service duration but no significant association was observed between ranks of officers and attitude and practice (P = 0.199). Conclusions: The results of our study demonstrate that the knowledge attitude and practice on efficiently handling a case of DUI among traffic police officers is poor, even though all of them are engaged in DUI duties irrespective of their service duration. The need for continuous professional development programmes was highlighted.
A Study on victims of intimate partner violence reported to Colombo North Teaching Hospital, Sri Lanka during 2019-2021
(Academic Forensic Pathology International, La Jolla, CA, 2022) Muthulingam, T.; Edirisinghe, P.A.S.; Wijewardhane, H.P.; Thivaharan, Y.; Jayasundara, M.M.S.; Borukgama, N.; Kulathunga, D.L.; Alwis, D.N.; Govinnage, P.S.; Kitulwatte, I.D.G.
Introduction: Intimate partner violence (IPV) is a common issue in any society and the reported cases are just the tip of an iceberg as most of the victims are reluctant to come to the criminal justice system. Forensic experts are often encountering the victims who chose to seek justice. Evaluation of the nature, consequences, and underlying factors are needed in planning preventive measures. Objectives: To describe the patterns and associated factors of IPV among victims who reported to Office of the Judicial Medical Officer of Colombo North Teaching Hospital and to specifically describe the patterns prior and during the COVID-19 pandemic. Methods: A retrospective descriptive study based on 471 medicolegal records of the victims who had undergone medicolegal examination following IPV during last two years (March 2019 to February 2021). Results: Out of 471, 206 cases were reported prepandemic and 265 reported postpandemic periods. Even though majority were females there were 21 males. Types of abuse were complex and often interrelated. There were 463 who had experienced physical injuries while there were 20 who had been subjected to sexual violence. Face was the commonest target of assault (63%). Substance abuse was identified as the commonest predisposing factor (56%). Even though repeated abuse was common, 42.5% of the victims had never made any complaints to the police. Despite multiple complains, 39.7% had experienced repeated violence. Conclusion: Victims of IPV are silently suffering for many long years. Failure in the response from authorities was identified. COVID-19 pandemic has become an additional risk factor for IPV. Strengthening of legal and social responses is the need of the hour.