Muhammad Iqbal, Javed Iqbal Khokhar, Imran Jawad, Sadaf Nadir.
Hanging: The Commonest Cause of Suicide in All the Fatal Compressive Traumas to the Neck in Lahore.
Med Forum Jan ;2(5):78-81.

Objective: This study was carried out to find out the commonest cause of death amongst all the asphyxial deaths in Lahore and to compare it with other studies previously carried out on this subject. Study Design: Experimental study Place and Duration of Study: This study was carried out at Forensic Medicine Department, KEMU, Lahore during the period from Jan. 2006 to Dec. 2008 Materials and Methods: Out of total 2979 medico-legal autopsies carried out at Forensic Medicine Department K.E.M.U. Lahore, 220 cases of fatal compression to the neck were selected. The autopsy reports, police documents and hospital records were studied. Results: Out of total autopsies compressive trauma to the neck was in 220 cases (7.39%). Hanging was the commonest cause 42.27%, ligature strangulation 29.09% and manual throttling 23.64%. The manner of death out of 104 cases of hanging was 68.50% (68 cases) with predominance of males (Male/Female ratio 2.78:1). 3rd decade showed higher incidence in males than the females which were more in 2nd decade. No hanging was seen in the 1st decade. The strangulation was common in 2nd, 3rd and 4th decades of life. Males showed higher incidence than females in hanging in 3rd and 4th decade. Females showed higher incidence in 2nd, 3rd and 4th decades in ligature strangulations than males. In throttling males showed higher incidence in 3rd decade than females in 4th decade. The homicidal deaths were 57.27%, suicidal 30.90% and un-determined were 11.82%. Ligature strangulation and throttling were the methods used in homicidal manner (57.27%) while hanging was used for suicide (30.97%). In hanging the position of the knot was at occiput in 62.50% cases and 23.08% had lateral position. In ligature strangulation 78.13% showed the knot on the front and 21.87% lateral. Conclusion: Hanging is a common method of suicide in our country while ligature strangulation and throttling are used in homicide. The autopsy findings above the thyroid cartilage are in favor of death due to hanging and throttling. Whereas their presence at or below the thyroid cartilage indicate ligature strangulation. Fracture of hyoid bone if present, is a strong evidence of death due strangulation.

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