BODY AND POST MORTEM

What is Post Mortem

● also known as autopsy

● an examination of a dead body to determine the cause of death.

● During the procedure, the deceased person's body is opened and the organs are
removed for the examination. When the post mortem is done, the organs are
returned and the body is stiched.
● The aim of post mortem is to determine the cause of death. Post mortem provides
various information about when, how and why someone died.
Types of post mortem
● 1. Coroner's post mortem examination:
● A coroner is a judicial officer responsible for the investigation of death in certain
death. They are usually lawyers or doctors with the experience of minimum 5 years.
A death will be referred to the coroner if:
● It is unexpected, such a sudden death
● # It's violent, unnatural or suspicious, such as suicide
● # The result of accident or injury
● # It occurred during or after the hospital procedure
● The main aim of post mortem requested by the coroner is to find out how someone
died and decided whether an inquest is needed. A coroner may decide to hold an
inquest after a post mortem has been completed. Sample of organs may need to be
2. Hospital post mortem examination:
Post mortems are sometime requested by hospital doctors to provide more information
about illness or the cause of death. Sometimes the relative of the deceased request the
hospital for post mortem to find more details about the death.
● Factors affecting post mortem changes
Intrinsic factors
- involving the subject that affect postmortem changes primary include a body mass and
the surface area of the body.
Extrinsic factors
-that affect post mortem changes primary include the clothing and insulation, the
environment of the death scene and storage of body after death.
 Classification of post mortem changes
Immediate post mortem changes
It is also known as rapid changes after death. It relate to the cessation of bodily functions
including the respiratory, circulatory and nervous system. The absence of cardiac and
respiratory sounds on auscultation over a period of 5 minutes indicates a sign of death.
Early post mortem changes
The changes in eye occur during the early post mortem period include corneal turbidity
and tache noire formation. The intraocular tension falls to nil in about 2 hours after
death.
Late post mortem changes
The changes that occur in this process are on a microscopic rather than a macroscopic
level. Autolytic changes are most prominent in the pancreas and other organ with high
 Post mortem stages of death
Pallor mortis It is the first change that occur in a corpse, that is the paleness in the face
and other parts of the body. It is due to cessation of the capillary circulation. The first
sign is shown within 15 to 30 minutes of the death.
Algor mortis is the post mortem cooling of body temperature until
Livor mortis is also known as post mortem hypostasis or post mortem lividity. It is the
discoloration of the skin that varies from pink to dark purple. It begins to be apparent
about an hour after death.
Rigor mortis is the stiffening of the muscles of the body after death. Occurs 2-6 hours
after death. The rate at which rigor mortis passes off will be rapid in a hot environment
as the onset of the putrefaction is hastened in environment. Cold temperature lengthen
the duration of rigor.
 Changes in skin at the time of post mortem
Livor mortis -It is the discoloration of skin
Vibices - These are the pale marks on a dead body that are caused by dermal pressure.
Like from the rope in case of hanging death.
Tardieu spots - These are the dark pinpoint spots on the dead body which are developed
in dependent areas. Like in the case of hanging death, the lags of the hanged person due
to increased gravitational pressure.
Venous pattering - These are the prominent purple discoloration of sub dermal vessels.
Degloving- They are the thermal exposure, immersions or advanced decomposition of
skin and tissues that result in degloving of skin. It is common in hands and feet of the
dead body.
 Forensic significance

● Post mortem interval is the time between the death of a person and the time he is
found for post mortem. It is an essential tool in forensic investigation providing an
estimate time of death. It is pivotal in judicial cases and can even either incriminate
or acquit a suspect. Earlier a corpse is found, the more accurate the post mortem
interval estimation is to be.
 Type 1 Diabetes Complications

BODY AND POST PORTEMDesignate a member of the

investigating team to secure the cadaver from the scene up to
the place where the autopsy will be conducted.An investigating
officer should remain at the autopsy area to prevent the
embalming of the cadaver and to prevent anyone from touching
or removing any of the clothing from the said cadaver until the
medico-legal officer arrives.Obtain a copy of the autopsy
report.Make a detailed report to the Chief of Office regarding
the findings of the medicolegal officer.
Types and Classifications of Diabetes
TYPE 2 Diabetes
With this type, your body either doesn’t
make enough insulin or your body’s cells
don’t respond normally to the insulin. This
is the most common type of diabetes. Up
to 95% of people with diabetes have Type
2. It usually occurs in middle-aged and
older people.
 Symptoms of Type 2 Diabetes

● More thirst ● Headaches

● More hunger ● Loss of consciousness
● Peeing often ● Infections or sores that don’t heal
● Dry mouth ● Areas of darkened skin, usually in
● Weight loss without trying the armpits and neck

● Fatigue ● Tingling hands and feet

● Blurry vision ● Red, swollen, tender gums

 Type 2 Diabetes Risk Factors

● Age. 45 or older
● Family. A parent, sister, or
brother with diabetes
● Ethnicity. African American,
Alaska Native, Native American,
Asian American, Hispanic or
Latino, or Pacific Islander
American
 Type 2 Diabetes Risk Factors
Risk factors related to your health and medical history include:
● Prediabetes
● Heart and blood vessel disease
● High blood pressure, even if it's treated and under control
● Low HDL ("good") cholesterol
Risk factors related to daily
● High triglycerides
habits and lifestyle:
● Being overweight or obese
● Getting little or no exercise
● Gestational diabetes while you were pregnant
● Smoking
● Polycystic ovary syndrome (PCOS)
● Stress
● Depression
● Sleeping too little or too much
 Type 2 Diabetes Diagnosis and Tests

● A1c. This test measures average blood glucose levels for the
previous 2 or 3 months.
● Fasting plasma glucose. This test measures how much
glucose is in your plasma.
● Oral glucose tolerance test (OGTT). This checks your blood
glucose before and 2 hours after you drink something sweet to
see how your body handles the sugar.
 Type 2 Diabetes Treatment
Managing type 2 diabetes includes a mix of lifestyle changes and medication.
Lifestyle Changes Medications
● Exercise ● Metformin (Fortamet, Glucophage,
● Watch your blood sugar levels. Glumetza, Riomet)
● Weight loss ● Sulfonylureas
● Healthy eating. There’s no specific diet ● Meglitinides
for type 2 diabetes. Focus on: ● Thiazolidinediones
○ Eating fewer calories ● DPP-4 inhibitors
○ Cutting back on refined carbs, ● GLP-1 receptor agonists
especially sweets ● SGLT2 inhibitors
○ Adding veggies and fruits to your ● GIP and GLP-1 receptor agonist
diet ● Insulin
○ Getting more fiber
 Type 2 Diabetes Prevention
Adopting a healthy lifestyle can help you lower your risk of
diabetes.
● Lose weight
● Get active/Exercise
● Eat right
● Quit smoking
 Type 2 Diabetes Complications
● Skin conditions
● Slow healing
● Hearing impairment
● Sleep apnea
● Dementia
● Heart and blood vessel disease
● Nerve damage (neuropathy) in limbs
● Other nerve damage
● Kidney disease
● Eye damage
Types and Classifications of Diabetes

Prediabetes This type is the stage before Type 2

diabetes. Your blood glucose levels are
higher than normal but not high
enough to be officially diagnosed with
Type 2 diabetes.
Prediabetes puts you at increased
risk of developing type 2 diabetes,
heart disease, and stroke.
Symptoms of Prediabetes

● More thirst
● Peeing often
● Fatigue
● Blurry vision
 Prediabetes Causes and Risk Factors

You’re more likely to get prediabetes if you:

● Are older, especially over age 45
● Have a waist larger than 40 inches around if you’re a man and 35
inches around if you’re a woman.
● Eat a lot of red and processed meat, drink sugary beverages, and
don’t eat much fruit, veggies, nuts, whole grains, or olive oil
● Are Black, Native American, Latino, or Pacific Islander
 Prediabetes Causes and Risk Factors
You’re more likely to get prediabetes if you:
● Are overweight or obese, especially if you have extra pounds around
your middle (belly fat)
● Have high cholesterol, high triglycerides, low HDL cholesterol, and
high LDL cholesterol
● Don't exercise
● Had gestational diabetes or gave birth to a baby who weighed more
than 9 pounds
● Have polycystic ovary syndrome
● Have a sleep problem, like sleep apnea, or work changing shifts or
night shifts
Prediabetes Diagnosis and Tests

● Fasting plasma glucose test

● Oral glucose tolerance test
● Hemoglobin A1c test
 Prediabetes Treatment
● Eat a healthy diet and lose weight
● Exercise at least 30 minutes a day, 5
days a week
● Stop smoking
● Get your blood pressure and
cholesterol under control
● Take medication like metformin
(Glucophage) to lower your blood sugar
if you’re at high risk of diabetes.
 Prediabetes Prevention
Exercising and eating foods low in carbohydrates, sugars,
fats, and salt can also help prevent prediabetes. Other tips
include:
● Don’t smoke.
● Don’t have more than one alcoholic drink a day.
● Take blood sugar medications as your doctor
prescribes.
 Prediabetes Complications

● Kidney disease
● Blindness
● High blood pressure
● Nerve problems (peripheral neuropathy)
● Loss of a limb (amputation)
Types and Classifications of Diabetes
Gestational Diabetes
This type develops in some women
during their pregnancy. Gestational
diabetes usually goes away after pregnancy.
However, if you have gestational diabetes
you're at higher risk of developing Type 2
diabetes later on in life.
There are two classes of gestational
diabetes. Women with class A1 can manage
it through diet and exercise. Those who
have class A2 need to take insulin or other
medications.
 Symptoms of Gestational Diabetes

● Thirstier than usual

● Hungrier and eat more than usual
● Peeing more than usual
Gestational Diabetes Cause

When you eat, your pancreas releases insulin, a hormone that helps
move a sugar called glucose from your blood to your cells, which use it
for energy.

During pregnancy, your placenta makes hormones that cause glucose

to build up in your blood. Usually, your pancreas can send out enough
insulin to handle it. But if your body can’t make enough insulin or stops
using insulin as it should, your blood sugar levels rise, and you get
gestational diabetes.
 Gestational Diabetes Risk Factors
You’re more likely to get gestational diabetes if you:
● Were overweight before you got pregnant
● Are African-American, Asian, Hispanic, Alaska Native, Pacific Islander, or
Native American
● Have blood sugar levels that are higher than they should be but not high
enough to be diabetes (this is called prediabetes)
● Have a family member with diabetes
● Have had gestational diabetes before
● Have polycystic ovary syndrome (PCOS) or another health condition linked
to problems with insulin
● Have high blood pressure, high cholesterol, heart disease, or other medical
complications
● Have given birth to a large baby (weighing more than 9 pounds)
● Have had a miscarriage
● Have given birth to a baby who was stillborn or had certain birth defects
● Are older than 25
 Gestational Diabetes Diagnosis and Tests

● Oral glucose tolerance test (OGTT)

 Gestational Diabetes Treatment
If you have gestational diabetes, you’ll need treatment as soon as possible to
keep yourself and your baby healthy during your pregnancy and delivery. Your
doctor will ask you to:
● Check your blood sugar levels four or more times a day
● Check your urine for ketones, chemicals that mean that your diabetes
isn’t under control
● Eat a healthy diet
● Make exercise a habit
● Your doctor will keep track of your weight and your baby’s development.
They might give you insulin or another medicine to keep your blood sugar
under control.
 Gestational Diabetes Prevention

You can lower your risk before you get pregnant by:
● Eating a healthy diet
● Staying active
● Losing extra weight
Gestational Diabetes Complications to the Baby

● Excessive birth weight

● Very large babies
● Early (preterm) birth
● Serious breathing difficulties
● Low blood sugar (hypoglycemia)
● Stillbirth (baby's death either
before or shortly after birth)
Gestational Diabetes Complications to the Mother

● High blood pressure and preeclampsia

● Having a surgical delivery (C-section)
● Future diabetes
REFERENCES:

● https://www.webmd.com/diabetes/type-1-diabetes
● https://www.nhsinform.scot/illnesses-and-conditions/diabetes/type-1-diabetes#about-type-1-diabetes
● https://www.healthline.com/health/type-2-diabetes#diagnosis
● https://www.webmd.com/diabetes/what-is-prediabetes
● https://www.webmd.com/diabetes/gestational-diabetes
● https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339
● https://www.cdc.gov/diabetes/basics/risk-factors.html
● https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193