Browsing by Author "Perera, W.N.S."

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The autopsy in medical education
(South East Asia Regional Association for Medical Education (SEARAME), 2021) Edussuriya, D.H.; Paranitharan, P.; Perera, W.N.S.; Thilakarathne, M.G.N.I.; Wijesiriwardena, W.M.S.Y.; Nanayakkara, C.
No Abstract Available
Autopsy review on ‘suspicious deaths' of Sri Lankans who died abroad: a study from Colombo North Teaching Hospital (CNTH)
(Sri Lanka Medical Association, 2008) Perera, W.N.S.; Edirisinghe, P.A.S.; Kitulwatte, I.D.G.
BACKGROUND: Many Sri Lankans have left as migrant workers for the past three decades. When such a person dies in the host country and the family is in doubt about the death, investigations are initiated in Sri Lanka including an autopsy. OBJECTIVE: To study the epidemiological details of the deceased persons, the difference of the cause and the circumstance of death after being subjected to an autopsy in Sri Lanka. DESIGN, SETTING AND METHODS: A retrospective descriptive analysis was carried out on suspicious deaths that occurred in other countries based on autopsy reports, and the case notes attached to them (including certificates of deaths and autopsy reports sent by host countries) at the Medico-Legal Unit of CNTH from January 2003 to March 2007. RESULTS: Out of 52 deaths examined, 69% died in the Middle East, whereas 17% and 10% died in Asia and Europe. 50% and 44% were skilled and unskilled workers respectively. The mean time interval of receiving a body was 3 weeks from the date of death. Analysis of documents revealed that only 51% deaths had a cause of death (COD) and 18%, 12%, 8% of deaths were suicides, accidents and homicides respectively. 69% of cases revealed a COD after autopsy in Sri Lanka. Majority were related to trauma (40%). Comparison of autopsy reports revealed that our injury detection was much better (p=0.001). CONCLUSIONS: Since many deaths abroad are trauma related, an autopsy examination should be made mandatory in Sri Lanka to resolve problems of insurance and compensation of these migrant workers.
Beyond autopsies: treading new horizons
(Department of Forensic Medicine, Faculty of Medicine at University of Peradeniya, 2014) Paranitharan, P.; Perera, W.N.S.; Hulathduwa, S.R.
A Clinical case of an 'alleged assault': are they fabricated injuries?
(Faculty of Medicine, University of Peradeniya, 2010) Rajapaksha, W.R.A.S.; Paranitharan, P.; Perera, W.N.S.
No Abstract Available
A comparative descriptive study on adolescents presented to Ragama and Anuradhapura Teaching Hospitals for medico-legal examination with a history of 'sexual activity'
(Faculty of Medicine, University of Kelaniya & Plan International, 2008) Edirisinghe, P.A.S.; Perera, W.N.S.; Paranithran, P.; Perera, B.P.P.; Samarasekera, A.; Waidarathna, M.D.; Jayasena, A.S.
INTRODUCTION: Adolescents engaged in sexual activity are brought for medico-legal examination as they are minors. Though some have consented for sexual activity, it is not legally acceptable. The perpetrators include boyfriends, relatives, known persons and strangers. The 'boyfriend' group is unique as the consent is not obtained by illegal means. OBJECTIVE: To find out potential predisposing factors that contribute to 'consensual' or 'non consensual' sexual activity of adolescents and to find out how 'consensual' and 'non consensual' sexual activity affects sexual health of adolescents. METHODS: A retrospective descriptive study was done using records maintained at the offices of the Judicial Medical Officers of Ragarna and Anuradhapura. The data was analyzed using SPSS statistical package. RESULTS: 202 and 154 victims examined between 2000 to 2006 at Ragama and Anuradhapura were analyzed. Male to female ratio was 1:10 in Ragama and 1:24 in Anuradhapura. The most vulnerable age group for sexual activity was 14-15 years. The majority of cases were from the low socio-economic strata. Vaginal intercourse was the most preferred sexual activity; the likelihood of an adolescent from Anuradhapura to have penetrative sex was 2.47 times more as compared to an adolescent from Ragama. Boyfriend was the assailant in 39% and 37% of cases in Ragama and Anuradhapura respectively. 63 % of victims from Ragama had eloped as compared to 19% from Anuradhapura. In both groups, nearly half of the cases had a relationship less than 6 months. An adolescent having sexual activity with a relative was 2.31 (95% CI 1.36-3.93) times greater in Anuradhapura as compared to Ragama. There were 18 and 16 pregnancies in Ragama and in Anuradapura, respectivly. 61 cases from Ragama had psychological symptoms and signs after the incident. CONCLUSIONS: Adolescents are more susceptible to engage in sexual acts around 14 years. Consented sexual activity with a boy friend resulting in legal action is a significant social problem. The high incidence of sexual activity with relatives and known persons indicate the vulnerability of adolescents to engage in sexual activity in their own environments.
Conflicts in marriage laws in children: medico-legal and social implications
(Medico-Legal Journal of Sri Lanka, 2019) Gunathilaka, M.M.A.C.C.; Perera, W.N.S.
ABSTRACT: The General Marriage Registration Ordinance of Sri Lanka sets the minimum age of marriage at 18 even though there is a conflict between the Muslim Marriage and Divorce Act section 23 which has no minimum legal age of marriage and allows the children under the age of 12 to be married with the approval by Quazi court. Some other situations, law of the state and rights of childhood conflicts with the societal expectations when the child is not legally permitted to marry following consented sexual relationship. Case 1: A 16-year-old Muslimgirl was missing from the home and was found by the police when she was living with her boyfriend. She had consensual sexual relationship with the boyfriend. History revealed that she was not aware of age of marriage. Case 2: A 15-year-old Muslimgirl went missing and mother made a complaint to the police. History revealed that she had eloped with her sister’s husband who had 2 children with the promise ofmarrying her. When they returned home mother was in a dilemma regarding the complaint she made to the police. Law of the state has the right to protect all the citizens specially rights of the children. Discrepancy in the marriage law according to the ethnicity has created confusion allowing charge of rape in one ethnic group and not in another ethnic group. Moreover, child marriage compromises the right to education, health and employment while creating social issues of polygamous relationship and social security. KEYWORDS: Child marriage, Marriage law, Ethnic discrepancy
Deaths following drowning in Sri Lanka - a retrospective study
(Department of Forensic Medicine, Faculty of Medicine at University of Peradeniya, 2020) Paranitharan, P.; Perera, W.N.S.; Lakmal, S.; Priyanath, D.C.; Senanayake, T.A.A.W.; Kumari, M.K.J.K.
INTRODUCTION: Deaths following drowning are a common occurrence in Sri Lanka. Individuals drown in different circumstances like suicides, accidents and homicides. A study of this nature would be useful for prevention of such incidences and as a baseline for future studies. OBJECTIVES: With regard to victims of drowning to determine; the demographic profile, circumstances, autopsy findings and contributory factors for drowning. METHODOLOGY: Information was extracted from records of 59 drowning cases in the years 2008-2017. Data were analysed using the statistical package SPSS Version 22. RESULTS: Majority of deaths (37.3%) were within the age of 11-30 years. Twenty-six-point five percent (26.5%) of accidental deaths were within the age group 11-20 years. The circumstances were accident (57.6%), suicide (22 %) and not known whether accident or suicide (20.3%). The common places of accidental drowning were sea (20%), Tank (20%) and canal (18 %.) The well was the most common place for suicides (54%). Majority of victims were unemployed (37%) and labourers (25%). Froth in the nostrils (54.2%), Emphysematous expanded lungs (63%), rib indentation on the lungs (61%) froth in the airways (61%) and pulmonary oedema (66%) were observations which were suggestive of drowning. Environmental factors (41%) and alcohol consumption (20%) are among the possible contributory factors. CONCLUSION: Majority of the deaths are accidental. Environmental factors and alcohol consumption may play contributory roles. Awareness programmes targeting young adults will minimize accidental deaths. KEYWORDS: Circumstances, Contributory factors, Deaths, Drowning
Deaths on rail roads: a study from Colombo North Teaching Hospital, Sri Lanka.
(Department of Forensic Medicine, Faculty of Medicine at University of Peradeniya, 2018) Paranitharan, P.; Perera, W.N.S.
ABSTRACT: In Sri Lanka railway related deaths are reported throughout the year. Most accidental deaths occur due to negligent behaviour of pedestrians and drivers. Fatal train impacts cause extensive visceral and musculoskeletal injuries due to the nature of the object as well as the amount of force transmitted during impact. A study of this nature would help ascertain demographic details of victims, characteristics of the incident of fatal train crashes and recognize the injury profile. An autopsy based retrospective study was done using postmortem reports of 10 years. Seventy autopsy reports from Colombo North Teaching Hospital between July 2006 and July 2016 were analyzed. Data regarding demographic details of victim and incident, external and internal injury distribution, cause and manner of death as determined at autopsy were extracted. Majority of victims were males between 20-39 years (43.7%, n=32) of age and were married (64.3%, n=45). Most victims of accidents were trespassers 68.8% (n=33). 68.6% (n= 48) and 31.4% (n=22) respectively were due to accidents and suicide. The highest number of fatalities 64.3% (n=45) were observed between 2 pm to 10 pm. The number of external injuries were more in accidents than suicides. The most common cause of death was multiple injuries. Majority of the deaths were accidental. Transections of neck, chest and traumatic amputations of extremities were common in suicides than accidents.
Do the print media help the medical science? An analysis of forensic related contents in newspaper articles
(2012) Paranitharan, P.; Perera, W.N.S.; Ranantunge, I.D.J.; Ratnayake, W.R.A.D.T.D.
General public get a considerable amount of information about medical science related topics from the media. Communicating with the public through the media can be vexing for medical professionals because they lack direct control over the final reporting1.It is the reporter's view of the information and his or her words that reach the public, rather than the scientist's or the clinician's. Moreover, there is a mismatch between the expectations of the scientist and those of the reporter. Scientists expect journalists to share their concern with scientific norms relating to the provisional nature of scientific knowledge and recognition of the collegial nature of scientific endeavour2. However sub specialty such as in forensics there are diverse concerns about published material in the print media. Issues are more or less the same in other specialties as well.
Elder abuse among out patient department attendees in a tertiary hospital
(Sri Lanka Medical Association, 2009) Edirisinghe, P.A.S.; Paranitharan, P.; Perera, W.N.S.; Shehan, W.
BACKGROUND: Abuse of older people is a hidden problem in society. Older people are frightened or embarrassed to report its presence. The extent of the problem is not studied adequately in Sri Lanka. METHODS: A cross sectional descriptive study was conducted at the North Colombo Teaching Hospital, outpatient department on 530 consecutive adults over 60 years of age. The Hwalek-Sengstock Elder abuse screening test which was assessed for face validity and content validity among 50 older persons and modified, was used for data collection along with a brief demographic questionnaire. Those with a mini-mental state examination score of 23 or less were excluded from the study. Data was collected by trained medical officers after informed written consent from the subjects. Confidentiality of the information provided was assured. RESULTS: 348 females (65%) and 182 males (35%) were included in the study. The mean age was 68.5 years. 26 (5.6%) reported physical abuse of whom 14 (2.6%) had been struck, slapped or kicked and five had received medical attention for injuries. Three had made a Police complaint. Up to 136 (25%) had perceived emotional abuse. 53 (10%) had experienced derogatory remarks and 12 (2. 3%) had been threatened with punishment and institutionalisation. 20 (3.7%) claimed neglect and 116 (22%) claimed their caregiver was financially dependent on them. There was no significant difference among the sexes. CONCLUSIONS: Physical, emotional and financial abuse of elders is present in our study population. The numbers although small, may represent only the tip of the iceberg.
Elder abuse among outpatient department attendees in a tertiary care hospital in Sri Lanka.
(Sri Lanka Medical Association, 2014) Edirisinghe, P.A.S.; Paranitharn, P.; Perera, W.N.S.; Williams, S.S.
OBJECTIVES: Abuse of older people is a hidden problem. Some believe that it is less in Asian societies as the extended family is a protective factor. The real extent of the problem however, is not researched adequately in Sri Lanka. METHODS: A cross sectional descriptive study was conducted at the North Colombo Teaching Hospital on 530 consecutive adults above 60 years of age attending the out-patient department. The Hwalek-Sengstock elder abuse screening test with modifications to address socio-cultural differences was administered. A brief demographic questionnaire and questions on past and present abuse were also included. RESULTS: Out of 530 elders studied, 32 (6%) were above 80 years of age and the mean age was 68.5 years. Male to female ratio was 1:2. Abuse, either physical, psychological, verbal or neglect was reported by 239 (45%) elders. Physical abuse was reported by 5.6%. The screening test revealed that the study population was vulnerable to psychological and financial abuse. Total overall rate of abuse was 38.5%. Loneliness was reported by 26%. Of the caregivers, 22% were financially dependent on the elders. Having more than three children was a risk factor for psychological and financial abuse and being single was a risk factor for psychological abuse. CONCLUSIONS: Physical, emotional and financial abuse of elders were reported in our study population. A limitation of this study was that it studied elders who sought treatment at a tertiary care hospital. Community studies will be needed to establish the true prevalence of elder abuse.
Knowledge of consent for sexual activity among Kelaniya University entrants: is it different depending on study stream?
(University of Kelaniya, 2011) Edirisinghe, P.A.S.; Perera, W.N.S.; Paranitharan, P.; Kitulwatte, I.D.G.; Gunathilake, L.R.K.
A positive and respectful approach to sexuality and sexual relationships is essential to a university entrant because „age‟ coupled with „free environment‟ gives many opportunities to obtain life experiences. Consent is an important concept in sexual relations and lack of knowledge can lead to unhealthy sexual practices and problems related to law. The objective of this study is to assess the level of knowledge on „consent for sexual activity‟ among different study streams of university entrants of Kelaniya University. A cross-sectional, descriptive study was conducted from August to October 2009, based on self-administered questionnaires after obtaining approval from the Ethics Review Committee, Ragama. 150 students from each faculty (Medicine, Science, Commerce & Management, Social Sciences & Humanities) were randomly selected. Core knowledge was assessed by analysis of marks obtained for 7 questions. The results demonstrate that the majority of the study population was above 20 years (86%) with male to female ratio of 1:1.6. 76% stated that they did not have any sexual experience while 10% had „more than adequate experience for their age‟. 73% (n-546) stated that consent is needed before sexual intercourse/any other sexual act, but lesser amount (57%) stated that it is needed once married. The knowledge of consenting age for sexual intercourse resulted in only 5% (n-40) giving the correct answer i.e. 16 years. The analysis of marks revealed that only 1.3% (n-10) get full marks for core knowledge while 63% of medical entrants had adequate knowledge. The least scored were Commerce and Management students (43%) while others scored between 50-59%. There was no significant difference among science and non science streams (p-0.121). The study showed that the knowledge of consent for sexual intercourse among university entrants was poor and many were not aware of the legal age or basics of law related to the concept. Thus, a session on sexual health during the familiarization/orientation course will fill the gaps.
A Maternal death due to an illegal abortion
(Faculty of Medicine,University of Peradeniya, 2011) Perera, W.N.S.; Paranitharan, P.
Medical ethics applied in forensic research: a revisit to ethical guidelines
(College of Forensic Pathologists of Sri Lanka, 2015) Perera, W.N.S.; Paranitharan, P.
The knowledge on recent advances in research ethics is mandatory for the forensic community comprising mainly forensic pathologists, forensic scientists and members from the legal fraternity who support the smooth functioning of the medico-legal system. A revisit to the recent developments in medical ethics and understanding the implications towards forensic research would keep Sri Lanka in equal platform with other countries. The main objective of this paper is to revisit the recent developments in medical ethics and to understand the ethical principles applied in forensic research. The review article briefly explores the ethical aspects of research involving clinical patients, research involving dead bodies and skeletons, laboratory investigations in research and publications of research findings. The existing ethical norms in research practice had evolved over a long period of times. The sound knowledge of the internationally accepted ethical principles would make sure forensic researches are developed according to the accepted standards and be more scientifically valid.
Medical ethics during COVID-19 pandemic: An experience with death investigation.
(Department of Forensic Medicine, Faculty of Medicine at University of Peradeniya, 2022) Jayasinghe, J.M.Y.K.; Jayasinghe, J.A.G.K.; Perera, W.N.S.; Paranitharan, P.
Introduction Medical ethics is a key element in the practice of medicine. This study highlights the application and conceptualization of those principles in the process of death investigation during the COVID-19 pandemic. Objective To identify different ethical principles and their application in deaths during the COVID-19 pandemic. Methodology Autopsy information of 41 deaths from 2020-2021, which came for inquests with positive Polymerase Chain Reaction (PCR) test for COVID-19 or positive rapid antigen test was analysed. The death investigation process was conceptualized against the ethical principles; justice, autonomy, beneficence, and non-maleficence. Results The majority of deaths (36.59%) were aged between 71-80 years, with less gender disproportion (M:F- 51:48). Home deaths (63.41%) were commoner, while deaths of non-vaccinated people (80.49%) were predominant. PCR was done in <24 hours after death in 36.59% and within 24-48 hours in 58.54%. Comorbidities were present in 78.05%. Cycle threshold (Ct) value <30 group was 75.61% with the primary cause of death being related to COVID-19 infection in 83.87%, while the duration of illness was >3 weeks in 12.9% and 2-3 weeks in 3.23%. Ct value >30 group was 17.07% with COVID-19 infection being a contributory cause of death in 57.14%, while all had a duration of illness of <2 weeks. Conclusion Justice has prevailed in this cohort. The PCR report influences the autonomy in claiming and releasing the bodies to the relatives. A higher Ct value may suggest less infectivity, which may be considered when releasing the body after excluding lung changes in an autopsy. Therefore, more research is needed with regard to Ct values and infectivity of dead bodies.
Perceptions of medical students on autopsy and its significance as a teaching-learning method
(The Kandy Society of Medicine, 2021) Edussuriya, D.H.; Paranitharan, P.; Perera, W.N.S.; Thilakarathne, M.G.N.I.; Wijesiriwardena, W.M.S.Y.; Nanayakkara, C.
BACKGROUND: Performance of autopsies as a learning experience for undergraduate medical students is declining in most developed countries. Sri Lankan universities continue to employ autopsies for teaching purposes. Perceptions of medical students towards this exercise has not been explored in the recent past. OBJECTIVES: To determine perceptions of medical students towards autopsy and its significance as a learning experience. METHODS: An online questionnaire to determine the perceptions of 4th year medical students who had completed the clerkship in Forensic Medicine on autopsy and its significance as a teaching-learning method was administered to students of two faculties of medicine in Sri Lanka. RESULTS: Medical students considered the autopsy as a positive learning experience in terms of learning anatomy and pathology. They felt that they should witness more autopsies and assist in dissections during autopsy. However, a significant proportion was not sensitive to the emotional nature of the experience and a majority were not comfortable in the autopsy environment and process and stated that they would not consent to an autopsy of someone close to them if the need arose. CONCLUSION: It is necessary to make the best use of the undergraduate autopsy experience by increasing exposure to autopsy, allowing students to assist at autopsy and drawing the attention of students to the emotional aspect during the experience and promoting the specialty while highlighting the role of the Forensic Pathologist in ensuring justice.
A Prospective study on clinical forensic cases examined at North Colombo Teaching hospital ; new challenges for the 21st century
(Department of Forensic Medicine, Faculty of Medicine at University of Peradeniya, 2015) Paranitharan, P.; Perera, W.N.S.; Rajapaksha, W.R.A.S.; Perera, W.P.P.
The specific objective of the study is to do a quantitative analysis of forensically relevant clinical cases examined at North Colombo Teaching Hospital with a view of identifying lapses in the medico-legal management and suggest recommendations to improve the system. The data was collected by analyzing the completed Medico-legal Examination Forms (MLEF) and personal notes made by the examining doctor attached to Department of Forensic Medicine at the North Colombo Teaching Hospital. The study revealed that the majority of the victims were male (73.3%) and belong to the age group of 19-59 years (84%). The victims who were examined had sustained injuries mainly due to assaults and accidents. (71%) Wife battery amounted to 5.9% of the cases. A sound medico-legal service is important for the existence of a good criminal justice system. MLEF is an important tool to gather vital information. A modified MLEF, Forensic Nurse, Basic infrastructure facilities for all medico-legal centres with necessary equipment, statistics and costing of injured patients and prevention programmes to minimize accidents and violence are some of the recommendations from the authors.
Remarks documented on medico-legal examination forms on sexual abuse cases; are they properly comprehended by the police?
(College of Forensic Pathologists of Sri Lanka, 2013) Kitulwatte, I.D.G.; Rajapaksha, W.R.A.S.; Edirisinghe, P.A.S.; Perera, W.N.S.; Wijerathne, N.A.S.P.; Sihanada, A.A.S.; Bulathsinhala, B.A.A.R.; Gunathilake, R.
INTRODUCTION: Expert medical evidence is widely used in sexual abuse cases, but its contribution to the progress of legal cases is unclear. Poor understanding of the remarks given by the medical officers in a Medico Legal Examination Form (MLEF) in alleged sexual abuse cases by the police officers may affect effective administration of justice. OBJECTIVE: This study is mainly aimed at assessing the degree of understanding by the police officers’ when reading three commonly expressed medico-legal remarks in cases of alleged sexual abuse. Secondly, to identify the areas of poor understanding, for which interventions need to be carried out. STUDY DESIGN: Cross sectional descriptive study was conducted among 64 police officers, in the rank of police constables and sergeants from western province, who are attending to routine work of a police station (criminal investigations, children and women’s desk and traffic unit). Data collection was done by self administered questionnaire after a briefing regarding the study and instructions on how to fill the questionnaire. RESULTS: 72% of the officers believed that they understood the statements written on Medico-Legal Examination Form (MLEF) when it is in native language while only 32% believed so for statements in English. However the analysis of the correct responses revealed that only 28.9% of officers understood the exact meaning in native language while it was 10.4% for English. The understanding about the statement on absence of medical evidence to confirm or exclude the allegation when given in Sinhala was 26.6% while it was 10.9% in English. The statement on evidence of vaginal penetration has been correctly understood by 20.3% in Sinhala while it is 7.8 % in English. CONCLUSION: Statements made in native language are approximately three times better understood than the ones made in English. However, overall understanding of the remarks made by doctors was very poor. It is high time we take necessary actions to intervene if our goal is effective administration of justice.
A Retrospective analysis of facial injuries in victims of road traffic fatalities.
(Department of Forensic Medicine, Faculty of Medicine at University of Peradeniya, 2018) Paranitharan, P.; Perera, W.N.S.; Perera, A.A.B.S.; Paranavithana, S.S.; Samanpura, L.
ABSTRACT: Facial injuries play a significant role when it comes to medico-legal interpretation, category of hurt, cause of death and for compensation purposes. Road traffic accidents had been identified as a major contributor towards facial injuries. The main objectives were to identify the different facial injuries such as abrasions, contusions, lacerations and fractures, injury pattern, the distribution and to correlate the facial injuries with vulnerable road users. A pre-prepared questionnaire was used to extract information from the autopsy reports of road traffic accidents involving 59 victims covering a period from 2005 to 2014. Majority of the victims were males (79.7%) and belonging to the age group of 21-30 (22%) and 41-50 (22%). The vulnerable road users were mostly pedestrians (39%), followed by motorcycle riders (28.8%). Only few (6.8%) of the victims had teeth injuries. Most of the victims had injuries on the right forehead (44%) and right peri-orbital area (37.3%). The commonest type of facial injuries were abrasions which were 44 (grazed abrasions 30.5% and other types of abrasions 44.1%) followed by lacerations 38 (64.4%). The most common injuries on the right forehead were abrasions (20.3%) and lacerations (16.9%) while on the right peri-orbital area it was contusions (18.6 %). Majority of the victims were pedestrians and motor cycle riders. Most of the injuries were observed on the right forehead and right peri-orbital region and the commonest facial injury type was abrasions. A specific type of injury pattern was not identified to retrospectively suggest the involvement of a pedestrian or others.
A retrospective descriptive study on deaths due to firearm injuries
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Alwis, D.N.; Govinnage, D.P.S.; Kulathunga, D.L.; Perera, W.N.S.; Paranitharan, P.
Introduction: Using firearms is one of the methods of committing a homicide. In Sri Lanka use of firearms was prominent among terrorists and underworld criminals. The analysis of the injury pattern will help to find the trends related to firearm injuries. Deaths that deviate from the routine pattern of injuries will be highlighted. Objectives: The objective of the study was to identify injury patterns in firearm related deaths. Methods: The data from 40 firearm related autopsy reports belonging to the investigators from the years 2000 to 2019 were entered to SPSS statistical package for analysis, based on a pre-prepared questionnaire. Results: Majority were in between 21 and 40 years (75%) and male (97.5%). Head alone was involved in 25% of deaths and head in combination with other regions was involved in 40% of the deaths. Cause of death (COD) in 50% of cases was head injuries alone and in 12.5% cases COD was from head injuries in combination of other injuries. Main motive was homicide in 72.5% of cases. Rifled firearm was the commonest weapon (90%). Range was distant in 65% of cases followed by close range in 17.5% of cases. Range was decided by the history, if available, appearance of entry wound and other observations. Conclusions: Scientific evaluation of deaths following firearm injuries demands proper assessment of range based on modem technology. This becomes more relevant if there is an incompatibility with the history and the appearance of the wound, especially when deciding circumstance of death.