UNASSIGNED: This case presents a detailed forensic examination of a unique femicide case followed by the perpetrator\'s suicide.
UNASSIGNED: On a Sunday afternoon, a 52 year old man killed his 43 year old partner in their home with eleven stab wounds. A few minutes later, he committed suicide by suspending himself to a tree in their home garden by means of a rope. This unique case is interesting because of the combination of methods used for both homicide and suicide, as well as the relationship dynamics between the victim and perpetrator. The perpetrator committed homicide by stabbing and then hanged himself.
UNASSIGNED: The case adds valuable knowledge to Forensic Medicine, advocating for increased awareness and preventive measures against domestic and gender-based violence. This report provides an in-depth analysis of a homicide-suicide incident, focusing on a unique case of homicide-suicide. It serves to highlight the global crisis of femicide. The case is situated within the context of gender- based violence, illustrating how such acts are deeply rooted in societal norms. It highlights patterns of intimate partner violence, where emotional factors play a significant role. Forensic analysis uncovered the overkill nature of the homicide, indicating excessive injuries beyond what was necessary for death, reflecting the psychological turmoil of the perpetrator. It emphasizes the importance of identifying signs of potential violence in domestic settings and implementing interventions for mental health support and the prevention of genderbased violence.

UNASSIGNED: Nowadays it is estimated that worldwide more than 700 000 people die by suicide every year and a greater amount attempt this practice. Suicide is the fourth cause of death among 15-29 years old people. Sodium Hypochlorite (NaOCl) is used in household and com-mercial bleaches and due to its easy availability, accidental exposure to or intentional ingestion of NaOCl occurs frequently. In most cases health effects are only transient but if the subject ingests a large amount of this substance, this can generate severe consequences as oesophageal or stomach lesions and electrolytic imbalance. In the present study we analyse a rare case of suicide by fatal ingestion of bleach.
UNASSIGNED: Case of a caucasic 47 years old woman with a background of several suicide attempts by exogenous substance ingestion that was found death alone in her apartment. The purpose of our investigation was identifying the cause of death. A rigorous and multidisciplinary methodological approach was adopted, including an accurate judicial inspection of the environment, an anamnestic collection, an autoptic procedure completed by macro and microscopic examinations of internal organs and a toxicological examination of biological fluids. Furthermore, a literature overview of similar cases was carried out. The resulting evidence demonstrates that woman\'s death occurred after a massive bleach ingestion.
UNASSIGNED: This case report highlights the importance of forensic methodology in investigating the ingestion of exogenous substances. Crime scene investigation, a detailed post-mortem examination, toxicology and a complete histopathological study are mandatory to solve the enigma.

UNASSIGNED: Gunshot suicides are more common in those people who live in countries with greater cultural accessibility of firearms and whose weapon\'s availability and use are easier. In the case of suicide by firearm, the most typical site of the entrance hole is represented by the temple, the forehead or the submental region, while only in a smaller percentage of cases is intra-oral.
UNASSIGNED: We present a particular case of suicide of an 85-year-old man, using a single-charge, short-barrelled firearm. The shot was fired on contact, with the entrance hole located at the tongue. The bullet remained held inside the body and there was no exit hole on the skin. A rigorous and multidisciplinary methodological approach was adopted, including an accurate judicial inspection of the environment, an anamnestic collection, an autoptic procedure completed by macroscopic and microscopic examination of the entrance hole and internal organs, and a radiological examination.
UNASSIGNED: In cases of gunshot suicide involving the intra-oral region, the tongue is rarely affected. Normally, the victim points the weapon upwards and the bullet follows this direction. When the entrance hole is on an atypical site, and different from the skin, and the trajectory are inusual, the interpretation of the dynamic of the event is more complex. So, it is essential to conduct a complete investigation, including the information of the forensic examination, with the data emerged in autopsy, radiological and histological examination.

UNASSIGNED: \"Complex suicide\" refers to suicides in which more than one suicide method is applied. The victim can either plan different and simultaneous ways of death, to prevent any failures, or change the method because the first one fails or turns out to be too painful.
UNASSIGNED: A Middle-age-man was found dead inside a car, in a field, near the seaside. Clothes were intact, wet, and smeared with mud and gravel. His shirt had dried whitish biological material on the thoracic area, referable to oedema fluid, his trousers were down to his ankles exposing external genitalia. Inside the car, a kitchen-serrated blade knife and scissors were found, both smeared with dried blood material. Cadaveric inspection showed: multiple superficial stab/cut injuries; nasal cavities leaking aqueous-like fluid; triangular and linear stab lesions all over the body; hesitation marks on both latero-cervical regions and both wrists; no defensive injuries referrable to third parties; maceration over both palmar and plantar surfaces. Autopsy showed: hemorrhagic infiltration for thoracic muscles; expanded and heavily congested lungs.
UNASSIGNED: This is the first Italian case, and one of the few cases reported in major literature (third case worldwide), of unplanned complex suicide achieved through stabbing and drowning by a man with no psychiatric or substances abuse history. Therefore, analyzing any evidence to distinguish this kind of sudden/unnatural death from accidental or homicidal ones is mandatory. Such cases require a flawless approach to judicial inspection, autopsy, and toxicological exams. Moreover, a multidisciplinary perspective including psychiatric criminological investigation is needed.

UNASSIGNED: In the hospital environment, any liability for organizational inadequacy and/or inefficiency, or again for defects in the facilities, or inadequacy of health equipment may be found in the work of the apex professional figures: Medical Director, the General Manager, and/or others. The responsibility for the internal organization of the department falls on the figure of the Director of the Complex Structure where the deficiencies have not been promptly and adequately reported to the top figures.
UNASSIGNED: A woman 61-year-old, was admitted on a voluntary basis to the Department of Psychiatry. On the third day, in the early morning hours, the patient was found on the ground floor, lying on the floor near the entrance door of the ward with a lacerated contusion wound to the head. The woman underwent total body CT examination with findings of fractured polytrauma as well as subarachnoid hemorrhage and complete fracture of the spleen, which was surgically removed. Three days later, despite the care given, death occurred. The injuries ascertained were consistent with voluntary precipitation from the second-floor stairwell window. The investigations conducted by the police and the checks carried out by the head of the Internal Prevention and Protection Service and the company\'s Risk Manager, highlighted multiple critical issues.
UNASSIGNED: The case allows for numerous considerations relating to liability profiles in the determinism of the patient\'s death, the hospital\'s company failure to implement measures to prevent the patient\'s suicide in the hospital was influential.

BACKGROUND: Suicide was the fourth leading cause of death among individuals aged 15 to 29 years worldwide in 2019, highlighting its significant impact on young people. Iran\'s suicide-related mortality rate was 5.1 per 100000 population in the same year, which is lower than the global average. This study aimed to estimate the years of life lost (YLLs) due to complete suicide in Iran. Study Design: A registry-based cross-sectional study.
METHODS: The data on complete suicide cases used in this study were obtained from the national suicide registry of the Iranian Forensic Medicine Organization (FMO) that was registered between March 21, 2016 and March 20, 2020.
RESULTS: The total number of YLL due to premature death by suicide over the four-year period was 611068 years (15.97 per 1000 persons) in males, 286847 years (7.65 per 1000 persons) in females, and 897915 years (11.86 per 1000 persons) for both genders. Moreover, the age group of 15-29 years experienced the highest YLL attributed to suicide. Furthermore, the study revealed an increasing trend of YLL due to suicide among individuals aged 30-44.
CONCLUSIONS: These findings highlight the significant impact of suicide on the loss of potential years of life in Iran. The study indicates that the young and productive age groups of 15-29 and 30-44 years are particularly affected, with the highest YLL due to complete suicide. The study provides valuable insights for designing targeted and evidence-based suicide prevention programs that can reduce the burden of suicide in Iran, particularly among young and middle-aged adults.

UNASSIGNED: Suicide is considered a global health emergency by the WHO. In suicide, the collection of testimonial data often encounters the refusal of family members to accept the hypothesis of a self-harming event and to provide clear information on the matter. The psychological autopsy is an investigative tool historically known for collecting information on the deceased, although to date there is no standard methodological protocol for conducting interviews with family members/next of kin.
UNASSIGNED: We present three dubious suicide cases: fuel-related death; hanging during a party; throat cutting with multiple stab wounds. During the interview the operators avoided pressing or direct questions about the event, preferring the interview with free discussion about the deceased (stream of consciousness).
UNASSIGNED: Initially, the relatives showed an attitude of clear rejection of the suicidal hypothesis with insistent requests for clarity on what had happened. Subsequently, through the use of free-form interviews, it was still possible to intercept, in the stories, predictive signs of suicidal ideation or psychiatric comorbidities previously un-treated and probably not accepted by the relatives, especially through the description of daily acts and household habits and environmental conditions of the deceased. The cases demonstrate the importance of using standardized methods with the use of free interviews with family members in order to indirectly investigate the event.

UNASSIGNED: In recent years, the improvement of common standards of forensic practice has received attention to promote an unambiguous and better-quality forensic investigation method. Although most hanging deaths are attributed to suicides, cases occasionally occur due to accidents or homicides. From an investigative point of view, hanging deaths are usually straightforward, but unusual circumstances may raise suspicions of crime. This includes complex suicides, which are rare events pursued by victims with two or more different fatal methods and can be classified as planned or unplanned, depends on whether the methods are applied simultaneously or sequentially. The multiplicity of injuries detected can often lead to misinterpretations, thus making a multidisciplinary approach extremely important.
UNASSIGNED: A 44-year-old man, after requesting law enforcement, has been instead found inside a garden of an uninhabited property located a few kilometers away from his own property, suspended from a beam with wire; the wire created a noose at the back of his head, his hands were placed at his neck, and stab wounds were found.
UNASSIGNED: The crime scene investigation, interview of relatives, autopsy, histological and toxicological examinations, and GAP led to the determination that the death was suicide. This comprehensive approach emphasizes the importance of meticulous investigation and analysis to reach accurate conclusions in forensic cases.

UNASSIGNED: Plastic bag suffocation may represent a very complex enigma for the forensic pathologist. The aim of this work is to highlight how the resolution of plastic bag suffocation cases is possible through the use of various forensic investigations, including psychological one (psychological autopsy) and toxicological examinations, in order to be able to define the manner of death.
UNASSIGNED: A 70-year-old man was found by his daughter lying on the bed, with his head inside a plastic bag knotted around his neck. The daughter claimed to have immediately removed the bag, but the father was already dead. An autopsy was performed. The clinical history of the victim was analysed in search of reason that could lead to suicide. The statements of the people on the death scene were examined. Results were compared with the scientific literature: a literature review was performed on the search engine Pubmed, Scopus and Google Scholar using the keywords \"plastic bag suffocation\" and \"death\". The autopsy showed no typical signs of asphyxial death. Toxicological examinations revealed benzodiazepines in the urine. Investigations revealed that the victim had been suffering from severe depression.
UNASSIGNED: The literature review confirmed that the most used wrapper is the supermarket shopping bag. We emphasize that plastic bag suffocation is a very quick event that does not leave any evident sign: this rapidity does not allow to appreciate the typical elements of asphyxiated death (petechiae, cyanosis). It seems that the fatal mechanism is a cardio-inhibitory, rather than a hypoxic process.

UNASSIGNED: Despite being relatively rare in our country, murder-suicide phenomena have garnered increasing media attention over the years. However, actual data on their prevalence and characteristics remain limited. This study aims to describe and characterize all murder/suicide events reported at the Institute of Forensic Medicine in the Province of Messina, with a particular focus on distinguishing between cases of filicide/suicide and dyadic deaths.
UNASSIGNED: A retrospective observational analysis of judicial cases from 2018 to 2023 was conducted. Injuries were primarily localized to the head, neck, and chest for women, and to the head for men. In the case of filicides, death occurred through an asphyxiation mechanism, followed by the mother\'s suicide by hanging or falling.
UNASSIGNED: Within the scope of the medical examiner\'s activities, it is clear that acquiring more information through a standardized technical investigation and adopting a uniform approach could enhance the quality of the forensic service provided daily. This improvement, which would be in the interest of institutions and civil society, could be achieved through the sharing of procedures at both national and international levels.