Forensic analysis of dead bodies recovered from wells in North Tunisia: Autopsy-based study.

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Mohamed Amine ZAARA, Mariem GHARBAOUI, Ons HMANDI, Mohamed Aymen BEN FTIMA, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5256963/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : This study aimed to analyze the pattern and post-mortem findings of dead bodies found in wells in Northern Tunisia. A cross-sectional retrospective study was conducted in northern Tunisia over 15 years (2005-2019). Epidemiological features, well characteristics, autopsy findings, cause of death, and manner of death were analyzed. Results : Findings showed a male predominance (sex ratio M/F 2.38), with a median age of 37.5 years. The deceased lived primarily in rural areas (61.4%) and 27.8% were daily laborers. A history of mental illness was reported in 36.9% of the cases and a history of suicide attempts in 29 cases (16.5%). The wells were unprotected in most of the cases (91.5%). Bodies were found mainly in wells located near/in the homes of the decedents (50.3%). Putrefaction was observed in 18.2% of the cases and suggestive signs of immersion in 88.1%. The cause of death in our study was mainly drowning (82.4%). The cause of death was concluded as accidental in 58.5%. Conclusion : Deceased individuals discovered in wells remain a challenge for forensic pathologists. This study contributed to identifying the patterns of the deceased. Well Autopsy Death Forensic medicine Drowning Tunisia Figures Figure 1 Figure 2 Introduction A well is defined as a large cylindrical pit of variable depth, excavated in the ground until water is reached, for retrieving water (open water or water table) [1,2]. The surface of the well is usually protected by an encircling wall or other protective means of variable height, and a tunnel pit is built using cemented bricks or stone pieces [1,2]. In Tunisia, as in most Mediterranean countries, wells have been utilized to mitigate the effects of the arid climate and depletion of the water table, particularly in the northern region of Tunisia, which represents the most significant agricultural area. Concurrent with climate changes and depletion of water resources, the necessity to construct additional wells became urgent. According to 2016 statistics, more than 11,000 unregulated wells were constructed across the country [3]. This context facilitates the potential for an increasing number of decedents discovered in wells. A body found in a well presents complex scenarios for the forensic specialist, encompassing at minimum the identification of the deceased individual and the determination of the cause, circumstances, and manner of death. Fatalities in these cases may result from immersion in water, polytrauma, or other causes. The decedent may have been deceased prior to being deposited into a well to conceal a crime. Moreover, due to the depth of wells, corpses may not be readily visible and consequently may remain undiscovered for extended periods, resulting in decomposition and increased challenges for forensic scientists in elucidating the circumstances related to the death. Given the paucity of scientific research on this subject, identifying a pattern of casualties would assist forensic practitioners in analyzing these diverse situations. Methods We retrospectively reviewed 176 autopsy cases of corpses found in wells, examined in the Department of Forensic Medicine at Charles Nicolle University Hospital in Tunis, Tunisia, over 15 years, between January 2005 and December 2019. Charles Nicolle Hospital is the largest university hospital in the country, and its forensic department covers the thanatological activities of 10 of the 11 governorates of the north of Tunisia. In Tunisia, a medicolegal autopsy is conducted when there are suspicious circumstances surrounding a death or indications of violent death. The discovery of a corpse in a well is classified as a suspicious death, thereby necessitating a medico-legal autopsy. The data collection included cases of dead bodies found on wells, identified through autopsy reports as well as police records. Medical history of the casualties was obtained from the relatives before proceeding to the autopsy. We had the oral consent of the families to use the medical records of their next of kin with due respect to their anonymity. Cases, where only unidentified skeletal remains were found in wells, were excluded due to the impossibility of determining the medical-legal form and the cause of death. The following were studied: demographic characteristics, medical records of the deceased, characteristics of the wells, autopsy findings, cause of death, and manner of the death. Data collected included age, sex, medical history, history of suicide attempts, occupation, living areas, circumstances (place of the well), characteristics of the well (depth, whether the wells are protected or not, whether the wells are filled with water or not), autopsy findings (injury patterns, signs of drowning, state of the body, toxicological analysis), cause of death and manner of death. Manner of death was classified as homicide, accidental or suicide after collecting all the elements and finalizing the investigations. The well was classified as either proximal or distal to the residence based on the accessibility of the victims, as reported by the families. Despite the potential subjectivity of this criterion, we elected to refrain from defining a precise distance to delineate the concepts of proximity and remoteness. Some variables concerning the characteristics of the well were not studied in this report due to the lack of information in the records, such as the diameter of the well and the presence of intermediate obstacles in the wells. Data were analyzed with the software IBM SPSS V.22. For qualitative variables, data were expressed in percentages and numbers. Pearson'x2 test was used for categorical variables. In the case of non-applicability of the x2 test, non-parametrical tests were used (Mann-Whitney and Shapiro-Wilks). Significance was defined as p-value <0.05. Results The dead bodies found in the wells represented 176 cases, representing 0.63 % of all autopsies performed during the study period (a total number of 27796 autopsies during the study period). On average, 12 cases per year were reported. The median age of the decedent was 37.5 years (mean 39 ± 21.5 years). 83 decedents were between 30 and 59 years old (47.2%) (Table 1). No particular trend was observed in the distribution of cases by month with sporadic variation (R2 = 0.005) (Figure 1). The same observation was noticed in the stratification of cases by year (Figure 2). August, July, and May counted for the largest number of cases with respectively 27, 20, and 21 dead bodies observed (Figure 1). 2011 and 2010 counted for the largest number of cases with respectively 18 and 16 (Figure 2). Males accounted for 70.5% of casualties (N=124) with a sex ratio M/F of 2.38. Decedents living in rural areas accounted for 108 (61.4%). Most casualties worked as daily laborers (49 cases; 27.8%) and farmers (16 cases; 9.1%). There was a medical history of mental illness in 47 cases among 58 suicidal deaths (81%) and reported episodes of seizures in 11 cases (6.3%) among all deaths. The decedents had a history of suicide attempts in 27 of the 58 suicidal deaths (46.55%). Seventy-seven (50.3%) decedents were found in wells located near their homes, while forty-six decedents (30%) were found in wells located in abandoned places (Table 2). We proceeded to a distribution of the location of wells by the age of the deceased. Within the pediatric population, 18 of 32 decedents were found in wells near homes / close to homes. The results showed that in decedents aged 05 years or less, the wells were located near the homes in 07 cases and far from the homes in 03 cases. The same observation was noticed in decedents aged between 06 and 13 years, and 14-18 years old, where wells were near homes in 07 cases, and 05 cases respectively. The wells were filled with water in 161 cases (91.5%). Information about well depth was missing in 64 cases. In the remaining cases (n= 112), the depth ranged from less than 5 meters to 10 meters in 69 cases (61.5%) and more than 20 meters in 18 cases (16%) (Table 2). The median depth of the wells in this study was 9 meters (mean 12.64 ± 12.55 meters) (1 – 70 meters). (Table 2). We noticed the absence of protection around the well in 86 cases, whereas the information was missing in 68 cases. Protection measures around the wells were missing at all depths and mostly at less than 10 meters depth (N=52; 60.4%). In depths from 15 to more than 20 meters, protection measures around wells were present in just two cases among 27 cases. Thirty-two (18.2%) dead bodies were in an advanced state of decomposition at the time they were found. Fourteen decomposed bodies were found during the summer period. Signs of immersion in water were observed in 155 cases (88.1%) (Table 3). Traumatic injuries were present in our study in 28.4% of the cases. The cause of death in our study was drowning in 145 cases (82.4%) and polytrauma in 14 cases (8%). The rest of the cause of death (n = 17) was listed in Table 3. Accidental death was listed as the most frequent form of death (58.5%), followed by suicide (33%) (Table 3). Among the 07 cases of homicides, 05 were found in abandoned wells. Two of the homicides were due to sharp force while two were due to strangulation. Regarding suicidal deaths, 16 among 58 decedents were also found in abandoned wells. Suicides were observed at all well depths. A depth of 05 to 10 meters depth counted for the highest number of decedents who committed suicide (N = 14), followed by less than 05 meters (N = 8). Regarding accidental deaths, among 100 cases, 82 occurred in the absence of protection around the wells. In both suicide and accidental deaths, drowning was the most common cause of death (N=51; N=86 respectively), followed by polytrauma (N=5; N=8). Toxicological samples were collected in 69.5% of the cases. Among the samples collected, ethanol and Benzodiazepines were present in, respectively, fifteen and four cases (Table 3). Toxicological analysis showed a COHb rate superior than 66% in two cases where the death was attributed to a COHb intoxication. The distribution of traumatic injuries according to the depth of the wells is illustrated in Table 4. Rib fractures (N=15) and skull fractures were observed in all depths of the well (N = 8). Cervical spine injuries were seen mainly in less than 10 meters depth. Regarding injuries to the thoracic and lumbar spine, 50% of the fractures were seen at 5-10 meters depth. Internal organ injuries accounted for 17 cases and were mostly observed in falls between 5 and 10 meters. All types of fracture could be seen in less than 5 meters according to our study, with no significant variation between the type of injury and the depth of the well (p>0.05). Discussion In this study, several 176 dead bodies were recorded with an average of 12 cases per year. These numbers were higher than those found in two studies from Turkey [1,4] and a study from China [5]. The relatively high prevalence of dead bodies found in the wells in our study, and in a previously published study in the Kairouan region in the center of Tunisia [2] compared to other countries, may be attributed to the abundance of wells in the northern and central regions of our nation. The northern part of Tunisia is characterized by its extensive rural areas, agricultural activity, and depletion of water resources. The summer season exhibited the highest incidence of bodies found in wells. This observation could be partially explained by the fact that the hot and arid climate in summer accelerates the decomposition process, thereby indicating the presence of a deceased individual within the well [6]. The year 2011 recorded the highest number of fatalities. This period coincided with the Tunisian revolution; consequently, fatal incidents resulting in criminal deaths and accidental deaths occurring in proximity to residences could partially elucidate this finding. In our study, the median age of the decedent was 37.5 years and, the most represented age class, was adults aged between 30 and 39 years, followed by children (<18 years old). These findings were consistent with a previous report from the center of Tunisia [2], as well as from a study in Turkey [7], where the average age was 29 and 27 years respectively. Our findings were also consistent with reports from New York [8] showing that 69% of the cases were aged between 21 and 50 years of age, and a study from Finland [9] showed that 69.6% of the cases were aged between 25 and 64 years of age. The high number of children in our study was expected, as it was shown that children living in houses without wells are seven times more susceptible to drowning compared to those living in houses without wells [10]. Regarding the deaths among the pediatric population, results indicated that more than 50% of the wells were situated in or near residences. The presence of water wells in close proximity to or within households constitutes an additional risk factor and poses a significant hazard to children. This vulnerable population may exhibit curiosity and attempt to explore or even submerge themselves in wells. The absence of supervision and inadequate well protection could be contributing factors in these cases. Additional precautionary measures must be implemented, and protective strategies must be addressed, such as securely sealing wells and providing appropriate education regarding the associated dangers [4]. The predominance of male victims in our series was consistent with previous reports from the centers of Tunisia [2], New York [8], Finland [9], and Turkey [4]. One potential explanation for this gender disparity could be attributed to the higher proportion of men employed in agriculture and construction, thereby exposing them to increased risks of well-related falls. The majority of the bodies were discovered in water-filled wells near the decedent's residence. Similar findings were reported in previous studies [1,2]. This phenomenon can be attributed to the ease of access to these wells. However, deceased individuals found in wells located in remote or abandoned areas may be indicative of intentional concealment, particularly in cases of suicide or homicide. Such wells are also frequently lacking protective measures such as walls or barriers, which increases the risk of accidental falls, especially during nighttime. This explanation is particularly relevant as the majority of wells included in our study were found to be unprotected, presenting an additional risk factor for accidental falls, especially for children. The predominant cause of death in our study was determined to be drowning (82.4%). It is well-established that drowning does not produce specific physical or histological features [9,11]. In our cases, this diagnosis was retained after excluding other causes and, examining the circumstances of death as well as accounting external and autopsy signs of bodies found in the water. This included in our cases, external foam, diluted intestinal contents and Svechnikov sign. Schneppe et al [4] reported the most frequent macromorphological findings in bodies found in a water and concluded that forensic pathologists should take into account influencing factors in order to retain the diagnosis of drowning. Specificity and reliability of diatom remain controversial to retain drowning diagnosis [12]. Furthermore, their detection cannot be performed in our country. In instances where the corpse exhibited advanced decomposition, determining the cause of death presented significant challenges. Traumatic injuries accounted for 50 cases in our study, with polytrauma being the cause of death in 14 cases. When a body falls into a well, it may sustain various traumatic injuries, such as fractures, abrasions, and contusions. A meticulous autopsy should be conducted to differentiate between antemortem and postmortem lesions, as the deceased could have been murdered and subsequently disposed of in the well. In every case, a full autopsy with anterior and posterior incisions on the limbs and a posterior laminectomy was performed. This situation typically presents a challenge for the forensic pathologist in accurately determining the cause of death. Among the traumatic injuries, rib fractures and internal organ injuries were the most observed lesions. Bodily damage is possible when falling into wells as the body can hit intermediate and surrounding obstacles. This would be even more serious when the well is not filled with water, leading to a fall from a height that causes fatal damage to the corpse. In both cases, this can cause death by blunt trauma [4]. A fall from height with a reception in water can cause extensive injuries in some cases, depending on the height of the fall and the force of impact into the water [13]. According to a study by Simonsen et al. [13] Rib fractures were the most observed type of bone fractures in falls onto a water surface. Rowbotham et al. [14] reported in a study that rib fractures were observed frequently regardless of the height of the fall. The same study [14] stated that rib fractures were more likely to occur in obese individuals because they were more likely to land horizontally. Other studies stated that rib fractures have been commonly associated with landings in water [13,15–17]. Previous reports stated that water impact on feet-first can cause less trauma than an impact in lateral or transverse positions due to the smaller surface area and thus the longer deceleration involved [18]. Skull fractures were observed in eight cases in our study, and there was no statistically significant correlation between skull fracture occurrence and well depth. This finding diverged from reports from central Tunisia [2], where skull fractures increased proportionally with fall height. This discrepancy may be attributed to variations in landing positions, ground surface characteristics, and the potential presence of intermediate obstacles. Additionally, it may be associated with well diameter, as narrower wells may increase the likelihood of impact with the well walls during descent. Rowbotham et al. [14] identified maxillary fractures as a significant type of skull fracture in high-fall cases. Skull fractures and brain injuries are potentially more lethal in instances of direct head impact, whereas craniofacial injuries resulting from foot impact are generally less fatal and are typically attributed to a decelerating force propelling the spine upward [18]. Internal organ injuries were documented in 17 cases in our study, primarily involving the liver and spleen, which aligns with previous findings [19–21]. The predominant manner of death in our study was accidental death (58.5%), consistent with a report from Turkey [1]. However, the study conducted in the center of Tunisia [2] reported that suicide was the most common manner of death. In accidental deaths and suicides, death is more often caused by drowning. This was consistent with the findings of Dogan et al. [1] and different from the Kairouan findings in the region in Tunisia [2], where polytrauma was the most common cause of death in both suicide and accidental deaths. This discrepancy may be attributed to the presence of water in the majority of wells in our study. The higher frequency of accidental deaths can be attributed to the prevalence of unprotected wells and the high proportion of child decedents. The suicide cases, accounting for 33% of our report, may be explained by individuals' desire to conceal the suicidal act and avoid rescue attempts. A history of mental disorders and previous suicide attempts is a predisposing factor for suicide. In the general population, drowning and falling from heights are not the most common suicide methods in Tunisia or European countries [22,23]. We were unable to explain the higher frequency or proportion of suicidal deaths in wells reported in the study conducted in the region of Kairouan in the center of Tunisia. The epidemiological profile emerging from this study regarding the suicidal decedent, corresponded to a male subject, aged between 30 and 59 years, with mental disorders or/and a history of suicide attempts, falling into wells less than 10 meters depth and dying by drowning. In our study, 5 out of the 7 decedents of homicide were found in wells far from their homes in abandoned places. This observation confirms the paradigm that throwing a corpse in a watercourse or a well remains a classic mode to hide a crime. Two of the homicides were perpetrated by a sharp force. Ben Khelil et al. [24] stated that sharp force is the most common method of homicide in Tunisia. Among accidental deaths, two decedents were killed from CO intoxication. In forensic investigations related to dead bodies found in wells, the analysis of air samples should not be overlooked [25]. The bottom of wells is typically characterized by the presence of toxic gases, including carbon dioxide (CO₂), carbon monoxide, hydrogen sulfide, and other toxic gases that may induce asphyxia. The concentration of oxygen decreases with increasing depth, which may result in death. In the two cases of CO intoxication, the diagnosis was retained following positive toxicological results (more than 66%). Positive toxicological results were predominantly observed in decedents who had committed suicide or accidentally drowned. It is hypothesized that the presence of these substances within decedents can alter their state of consciousness, leading to accidental deaths. Similarly, these substances may act as a motivating factor in the decision to commit suicide. Conclusion decedents found in wells remain a difficult situation facing the forensic specialist. The possibility of a corpse thrown after a homicide, as well as the possibility of advanced putrefaction due to a long period before the corpse being found, represents one of the most complex dilemmas in determining the date of death, the cause of death, and which arguments could be in favor of the manner of death. In the present study, the majority of decedents were young males who died accidentally as a result of falling into a non-protected well or by suicide by jumping into an abandoned well. It would be beneficial for future studies to focus on the differences between drowning in wells and in watercourses, as well as on the prevention of such cases. Abbreviations COHb Carboxyhemoglobin Declarations Ethics approval and consent to participate: Ethical approval was waived according to the national law number 2004-63 on the protection of personal data, with confidentiality and anonymity of the analysed data guaranteed. Consent for publication: Oral consent from the next of kin of the deceased was taken to use the medical data with due respect to their anonymity, according to the national law of the Protection of Personal Data (no identification of the deceased in the manuscript). Funding : No funding was needed. Author Contribution M.A.Z: investigation, methodology, writing - original draft, M.G: writing - original draft, O.H: visualization, conceptualisation, M.A.B.F: investigation, M.B: investigation, M.B.K: supervision, validation, M.A: supervision, validation. 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Tables Table 1 Socio-demographic features of the casualties N Percentage (%) Age range (years) 70 16 9.1 Living areas Urban 68 38.6 Rural 108 61.4 Sex Male 124 70.5 Female 52 29.5 Occupation Farmer 16 9.1 Student 22 12.5 Daily laborer 49 27.8 Housewife 26 14.8 Unemployed 38 21.6 Medical records Mental illness 65 36.9 Diabetes 5 2.8 Alzheimer 3 1.7 Seizures 11 6.3 Ischemic heart disease 9 5.1 Suicide attempts Yes 29 16.5 No 147 83.5 Table 2 Cases according to the features of the wells N Percentage (%) Place of well Near home 77 50.3 Near work place 16 10.4 Public place 14 9 Abandoned place 46 30 Presence of water Yes 161 91.5 No 14 8 Not mentioned 1 0.5 Protection around the well Yes 27 15.9 No 142 84 Well depth 20 m 18 16 Not mentioned 64 36.4 Table 3 Distribution of cases according to the autopsy findings N Percentage (%) Signs of putrefaction Yes 32 18.2 No 144 81.8 Signs of immersion Yes 155 88.1 No 21 11.9 Traumatic injuries Yes 50 28.4 No 126 71.6 Cause of death Drowning 145 82.4 Polytrauma 14 8 CO intoxication 2 1.1 Hanging 2 1.1 Stab wound 2 1.1 Drowning and polytrauma 3 1.7 Electrocution 4 2.3 Strangulation 2 1.1 Strangulation and polytrauma 1 0.6 Suffocation by a foreign object 1 0.6 Manner of death Accidental 103 58.5 Suicide 58 33 Homicide 7 4 Indetermined 8 4.5 Toxicological analysis Positive 19 10.7 Negative 64 36.2 Not performed 40 22.6 Not collected 53 29.9 Not mentioned Toxicological results Alcohol Benzodiazepines 1 15 4 0.6 78.9 21.1 Table 4 Distribution of traumatic injuries according to the depth of wells Skull fractures Rib fractures Cervical spine fractures Thoraco-spine fractures Lumbar spine fractures Upper limbs fractures Lower limbs fractures Internal organ injuries 20 m 1 2 0 2 1 0 1 2 Total 8 15 10 6 4 4 7 17 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5256963","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":376204301,"identity":"887f416e-37e6-4f70-a466-ca6ac6f5ccab","order_by":0,"name":"Mohamed Amine 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21:53:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5256963/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5256963/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":70506711,"identity":"c4587dbb-b8d8-4f6e-ac7b-1680392c8cde","added_by":"auto","created_at":"2024-12-03 23:40:45","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":29769,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of the cases according to the month\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5256963/v1/750ed0888e08a586f1c54564.png"},{"id":70506712,"identity":"ce3bba7f-0386-4f1d-94b6-76c9e214bb7d","added_by":"auto","created_at":"2024-12-03 23:40:45","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":26588,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of the cases according to the year\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5256963/v1/300fe56d1576d7b1c5033a5b.png"},{"id":73334216,"identity":"09e822dc-4a6e-41d6-a8ff-1474fe993fb4","added_by":"auto","created_at":"2025-01-09 04:01:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":822544,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5256963/v1/9a60c99e-3a67-4ca4-8540-477733fb59e4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Forensic analysis of dead bodies recovered from wells in North Tunisia: Autopsy-based study.","fulltext":[{"header":"Introduction","content":"\u003cp\u003eA well is defined as a large cylindrical pit of variable depth, excavated in the ground until water is reached, for retrieving water (open water or water table) [1,2]. The surface of the well is usually protected by an encircling wall or other protective means of variable height, and a tunnel pit is built using cemented bricks or stone pieces [1,2]. In Tunisia, as in most Mediterranean countries, wells have been utilized to mitigate the effects of the arid climate and depletion of the water table, particularly in the northern region of Tunisia, which represents the most significant agricultural area. Concurrent with climate changes and depletion of water resources, the necessity to construct additional wells became urgent. According to 2016 statistics, more than 11,000 unregulated wells were constructed across the country [3].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis context facilitates the potential for an increasing number of decedents discovered in wells. A body found in a well presents complex scenarios for the forensic specialist, encompassing at minimum the identification of the deceased individual and the determination of the cause, circumstances, and manner of death. Fatalities in these cases may result from immersion in water, polytrauma, or other causes. The decedent may have been deceased prior to being deposited into a well to conceal a crime. Moreover, due to the depth of wells, corpses may not be readily visible and consequently may remain undiscovered for extended periods, resulting in decomposition and increased challenges for forensic scientists in elucidating the circumstances related to the death.\u003c/p\u003e\n\u003cp\u003eGiven the paucity of scientific research on this subject, identifying a pattern of casualties would assist forensic practitioners in analyzing these diverse situations.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eWe retrospectively reviewed 176 autopsy cases of corpses found in wells, examined in the Department of Forensic Medicine at Charles Nicolle University Hospital in Tunis, Tunisia, over 15 years, between January 2005 and December 2019. Charles Nicolle Hospital is the largest university hospital in the country, and its forensic department covers the thanatological activities of 10 of the 11 governorates of the north of Tunisia.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn Tunisia, a medicolegal autopsy is conducted when there are suspicious circumstances surrounding a death or indications of violent death. The discovery of a corpse in a well is classified as a suspicious death, thereby necessitating a medico-legal autopsy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe data collection included cases of dead bodies found on wells, identified through autopsy reports as well as police records. Medical history of the casualties was obtained from the relatives before proceeding to the autopsy. We had the oral consent of the families to use the medical records of their next of kin with due respect to their anonymity. Cases, where only unidentified skeletal remains were found in wells, were excluded due to the impossibility of determining the medical-legal form and the cause of death. The following were studied: demographic characteristics, medical records of the deceased, characteristics of the wells, autopsy findings, cause of death, and manner of the death. Data collected included age, sex, medical history, history of suicide attempts, occupation, living areas, circumstances (place of the well), characteristics of the well (depth, whether the wells are protected or not, whether the wells are filled with water or not), autopsy findings (injury patterns, signs of drowning, state of the body, toxicological analysis), cause of death and manner of death. Manner of death was classified as homicide, accidental or suicide after collecting all the elements and finalizing the investigations. The well was classified as either proximal or distal to the residence based on the accessibility of the victims, as reported by the families. Despite the potential subjectivity of this criterion, we elected to refrain from defining a precise distance to delineate the concepts of proximity and remoteness. Some variables concerning the characteristics of the well were not studied in this report due to the lack of information in the records, such as the diameter of the well and the presence of intermediate obstacles in the wells.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eData were analyzed with the software IBM SPSS V.22. For qualitative variables, data were expressed in percentages and numbers. Pearson\u0026apos;x2 test was used for categorical variables. In the case of non-applicability of the x2 test, non-parametrical tests were used (Mann-Whitney and Shapiro-Wilks). Significance was defined as p-value \u0026lt;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe dead bodies found in the wells represented 176 cases, representing 0.63 % of all autopsies performed during the study period (a total number of 27796 autopsies during the study period). On average, 12 cases per year were reported. The median age of the decedent was 37.5 years (mean 39 \u0026plusmn; 21.5 years). 83 decedents were between 30 and 59 years old (47.2%) (Table 1).\u003c/p\u003e\n\u003cp\u003eNo particular trend was observed in the distribution of cases by month with sporadic variation (R2 = 0.005) (Figure 1). The same observation was noticed in the stratification of cases by year (Figure 2). August, July, and May counted for the largest number of cases with respectively 27, 20, and 21 dead bodies observed (Figure 1). 2011 and 2010 counted for the largest number of cases with respectively 18 and 16 (Figure 2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMales accounted for 70.5% of casualties (N=124) with a sex ratio M/F of 2.38. Decedents living in rural areas accounted for 108 (61.4%). Most casualties worked as daily laborers (49 cases; 27.8%) and farmers (16 cases; 9.1%). There was a medical history of mental illness in 47 cases among 58 suicidal deaths (81%) and reported episodes of seizures in 11 cases (6.3%) among all deaths. The decedents had a history of suicide attempts in 27 of the 58 suicidal deaths (46.55%). \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSeventy-seven (50.3%) decedents were found in wells located near their homes, while forty-six decedents (30%) were found in wells located in abandoned places (Table 2). We proceeded to a distribution of the location of wells by the age of the deceased. Within the pediatric population, 18 of 32 decedents were found in wells near homes / close to homes. The results showed that in decedents aged 05 years or less, the wells were located near the homes in 07 cases and far from the homes in 03 cases. The same observation was noticed in decedents aged between 06 and 13 years, and 14-18 years old, where wells were near homes in 07 cases, and 05 cases respectively.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe wells were filled with water in 161 cases (91.5%). Information about well depth was missing in 64 cases. In the remaining cases (n= 112), the depth ranged from less than 5 meters to 10 meters in 69 cases (61.5%) and more than 20 meters in 18 cases (16%) (Table 2). The median depth of the wells in this study was 9 meters (mean 12.64 \u0026plusmn; 12.55 meters) (1 \u0026ndash; 70 meters). (Table 2). We noticed the absence of protection around the well in 86 cases, whereas the information was missing in 68 cases. Protection measures around the wells were missing at all depths and mostly at less than 10 meters depth (N=52; 60.4%). In depths from 15 to more than 20 meters, protection measures around wells were present in just two cases among 27 cases.\u003c/p\u003e\n\u003cp\u003eThirty-two (18.2%) dead bodies were in an advanced state of decomposition at the time they were found. Fourteen decomposed bodies were found during the summer period.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSigns of immersion in water were observed in 155 cases (88.1%) (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTraumatic injuries were present in our study in 28.4% of the cases. The cause of death in our study was drowning in 145 cases (82.4%) and polytrauma in 14 cases (8%). The rest of the cause of death (n = 17) was listed in Table 3. Accidental death was listed as the most frequent form of death (58.5%), followed by suicide (33%) (Table 3). Among the 07 cases of homicides, 05 were found in abandoned wells. Two of the homicides were due to sharp force while two were due to strangulation. Regarding suicidal deaths, 16 among 58 decedents were also found in abandoned wells.\u003c/p\u003e\n\u003cp\u003eSuicides were observed at all well depths. A depth of 05 to 10 meters depth counted for the highest number of decedents who committed suicide (N = 14), followed by less than 05 meters (N = 8). Regarding accidental deaths, among 100 cases, 82 occurred in the absence of protection around the wells. In both suicide and accidental deaths, drowning was the most common cause of death (N=51; N=86 respectively), followed by polytrauma (N=5; N=8).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eToxicological samples were collected in 69.5% of the cases. Among the samples collected, ethanol and Benzodiazepines were present in, respectively, fifteen and four cases (Table 3). Toxicological analysis showed a COHb rate superior than 66% in two cases where the death was attributed to a COHb intoxication.\u003c/p\u003e\n\u003cp\u003eThe distribution of traumatic injuries according to the depth of the wells is illustrated in Table 4. Rib fractures (N=15) and skull fractures were observed in all depths of the well (N = 8). Cervical spine injuries were seen mainly in less than 10 meters depth. Regarding injuries to the thoracic and lumbar spine, 50% of the fractures were seen at 5-10 meters depth. Internal organ injuries accounted for 17 cases and were mostly observed in falls between 5 and 10 meters. All types of fracture could be seen in less than 5 meters according to our study, with no significant variation between the type of injury and the depth of the well (p\u0026gt;0.05).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, several 176 dead bodies were recorded with an average of 12 cases per year. These numbers were higher than those found in two studies from Turkey [1,4] and a study from China [5]. The relatively high prevalence of dead bodies found in the wells in our study, and in a previously published study in the Kairouan region in the center of Tunisia [2] compared to other countries, may be attributed to the abundance of wells in the northern and central regions of our nation. The northern part of Tunisia is characterized by its extensive rural areas, agricultural activity, and depletion of water resources. The summer season exhibited the highest incidence of bodies found in wells. This observation could be partially explained by the fact that the hot and arid climate in summer accelerates the decomposition process, thereby indicating the presence of a deceased individual within the well [6]. The year 2011 recorded the highest number of fatalities. This period coincided with the Tunisian revolution; consequently, fatal incidents resulting in criminal deaths and accidental deaths occurring in proximity to residences could partially elucidate this finding.\u003c/p\u003e\n\u003cp\u003eIn our study, the median age of the decedent was 37.5 years and, the most represented age class, was adults aged between 30 and 39 years, followed by children (\u0026lt;18 years old). These findings were consistent with a previous report from the center of Tunisia [2], as well as from a study in Turkey [7], where the average age was 29 and 27 years respectively. Our findings were also consistent with reports from New York [8] showing that 69% of the cases were aged between 21 and 50 years of age, and a study from Finland [9] showed that 69.6% of the cases were aged between 25 and 64 years of age. The high number of children in our study was expected, as it was shown that children living in houses without wells are seven times more susceptible to drowning compared to those living in houses without wells [10].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRegarding the deaths among the pediatric population, results indicated that more than 50% of the wells were situated in or near residences. The presence of water wells in close proximity to or within households constitutes an additional risk factor and poses a significant hazard to children. This vulnerable population may exhibit curiosity and attempt to explore or even submerge themselves in wells. The absence of supervision and inadequate well protection could be contributing factors in these cases. Additional precautionary measures must be implemented, and protective strategies must be addressed, such as securely sealing wells and providing appropriate education regarding the associated dangers [4].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe predominance of male victims in our series was consistent with previous reports from the centers of Tunisia [2], New York [8], Finland [9], and Turkey [4]. One potential explanation for this gender disparity could be attributed to the higher proportion of men employed in agriculture and construction, thereby exposing them to increased risks of well-related falls.\u003c/p\u003e\n\u003cp\u003eThe majority of the bodies were discovered in water-filled wells near the decedent\u0026apos;s residence. Similar findings were reported in previous studies [1,2]. This phenomenon can be attributed to the ease of access to these wells. However, deceased individuals found in wells located in remote or abandoned areas may be indicative of intentional concealment, particularly in cases of suicide or homicide. Such wells are also frequently lacking protective measures such as walls or barriers, which increases the risk of accidental falls, especially during nighttime. This explanation is particularly relevant as the majority of wells included in our study were found to be unprotected, presenting an additional risk factor for accidental falls, especially for children.\u003c/p\u003e\n\u003cp\u003eThe predominant cause of death in our study was determined to be drowning (82.4%). It is well-established that drowning does not produce specific physical or histological features [9,11]. In our cases, this diagnosis was retained after excluding other causes and, examining the circumstances of death as well as accounting external and autopsy signs of bodies found in the water. This included in our cases, external foam, diluted intestinal contents and Svechnikov sign. Schneppe et al [4] reported the most frequent macromorphological findings in bodies found in a water and concluded that forensic pathologists should take into account influencing factors in order to retain the diagnosis of drowning. Specificity and reliability of diatom remain controversial to retain drowning diagnosis [12]. Furthermore, their detection cannot be performed in our country. In instances where the corpse exhibited advanced decomposition, determining the cause of death presented significant challenges.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTraumatic injuries accounted for 50 cases in our study, with polytrauma being the cause of death in 14 cases. When a body falls into a well, it may sustain various traumatic injuries, such as fractures, abrasions, and contusions. A meticulous autopsy should be conducted to differentiate between antemortem and postmortem lesions, as the deceased could have been murdered and subsequently disposed of in the well. In every case, a full autopsy with anterior and posterior incisions on the limbs and a posterior laminectomy was performed. \u0026nbsp;This situation typically presents a challenge for the forensic pathologist in accurately determining the cause of death.\u003c/p\u003e\n\u003cp\u003eAmong the traumatic injuries, rib fractures and internal organ injuries were the most observed lesions. Bodily damage is possible when falling into wells as the body can hit intermediate and surrounding obstacles. This would be even more serious when the well is not filled with water, leading to a fall from a height that causes fatal damage to the corpse. In both cases, this can cause death by blunt trauma [4]. A fall from height with a reception in water can cause extensive injuries in some cases, depending on the height of the fall and the force of impact into the water [13]. According to a study by Simonsen et al. [13] Rib fractures were the most observed type of bone fractures in falls onto a water surface. Rowbotham et al. [14] reported in a study that rib fractures were observed frequently regardless of the height of the fall. The same study [14] stated that rib fractures were more likely to occur in obese individuals because they were more likely to land horizontally. Other studies stated that rib fractures have been commonly associated with landings in water [13,15\u0026ndash;17]. Previous reports stated that water impact on feet-first can cause less trauma than an impact in lateral or transverse positions due to the smaller surface area and thus the longer deceleration involved [18].\u003c/p\u003e\n\u003cp\u003eSkull fractures were observed in eight cases in our study, and there was no statistically significant correlation between skull fracture occurrence and well depth. This finding diverged from reports from central Tunisia [2], where skull fractures increased proportionally with fall height. This discrepancy may be attributed to variations in landing positions, ground surface characteristics, and the potential presence of intermediate obstacles. Additionally, it may be associated with well diameter, as narrower wells may increase the likelihood of impact with the well walls during descent. Rowbotham et al. [14] identified maxillary fractures as a significant type of skull fracture in high-fall cases. Skull fractures and brain injuries are potentially more lethal in instances of direct head impact, whereas craniofacial injuries resulting from foot impact are generally less fatal and are typically attributed to a decelerating force propelling the spine upward [18].\u003c/p\u003e\n\u003cp\u003eInternal organ injuries were documented in 17 cases in our study, primarily involving the liver and spleen, which aligns with previous findings [19\u0026ndash;21].\u003c/p\u003e\n\u003cp\u003eThe predominant manner of death in our study was accidental death (58.5%), consistent with a report from Turkey [1]. However, the study conducted in the center of Tunisia [2] reported that suicide was the most common manner of death. In accidental deaths and suicides, death is more often caused by drowning. This was consistent with the findings of Dogan et al. [1] and different from the Kairouan findings in the region in Tunisia [2], where polytrauma was the most common cause of death in both suicide and accidental deaths. This discrepancy may be attributed to the presence of water in the majority of wells in our study.\u003c/p\u003e\n\u003cp\u003eThe higher frequency of accidental deaths can be attributed to the prevalence of unprotected wells and the high proportion of child decedents. The suicide cases, accounting for 33% of our report, may be explained by individuals\u0026apos; desire to conceal the suicidal act and avoid rescue attempts. A history of mental disorders and previous suicide attempts is a predisposing factor for suicide. In the general population, drowning and falling from heights are not the most common suicide methods in Tunisia or European countries [22,23].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe were unable to explain the higher frequency or proportion of suicidal deaths in wells reported in the study conducted in the region of Kairouan in the center of Tunisia. The epidemiological profile emerging from this study regarding the suicidal decedent, corresponded to a male subject, aged between 30 and 59 years, with mental disorders or/and a history of suicide attempts, falling into wells less than 10 meters depth and dying by drowning.\u003c/p\u003e\n\u003cp\u003eIn our study, 5 out of the 7 decedents of homicide were found in wells far from their homes in abandoned places. This observation confirms the paradigm that throwing a corpse in a watercourse or a well remains a classic mode to hide a crime. Two of the homicides were perpetrated by a sharp force. Ben Khelil et al. [24] stated that sharp force is the most common method of homicide in Tunisia.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAmong accidental deaths, two decedents were killed from CO intoxication. In forensic investigations related to dead bodies found in wells, the analysis of air samples should not be overlooked [25]. The bottom of wells is typically characterized by the presence of toxic gases, including carbon dioxide (CO₂), carbon monoxide, hydrogen sulfide, and other toxic gases that may induce asphyxia. The concentration of oxygen decreases with increasing depth, which may result in death. In the two cases of CO intoxication, the diagnosis was retained following positive toxicological results (more than 66%). Positive toxicological results were predominantly observed in decedents who had committed suicide or accidentally drowned. It is hypothesized that the presence of these substances within decedents can alter their state of consciousness, leading to accidental deaths. Similarly, these substances may act as a motivating factor in the decision to commit suicide.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003edecedents found in wells remain a difficult situation facing the forensic specialist. The possibility of a corpse thrown after a homicide, as well as the possibility of advanced putrefaction due to a long period before the corpse being found, represents one of the most complex dilemmas in determining the date of death, the cause of death, and which arguments could be in favor of the manner of death. In the present study, the majority of decedents were young males who died accidentally as a result of falling into a non-protected well or by suicide by jumping into an abandoned well. It would be beneficial for future studies to focus on the differences between drowning in wells and in watercourses, as well as on the prevention of such cases.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eCOHb\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCarboxyhemoglobin\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was waived according to the national law number 2004-63 on the protection of personal data, with confidentiality and anonymity of the analysed data guaranteed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOral consent from the next of kin of the deceased was taken to use the medical data with due respect to their anonymity, according to the national law of the Protection of Personal Data (no identification of the deceased in the manuscript).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eNo funding was needed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eM.A.Z: investigation, methodology, writing - original draft, M.G: writing - original draft, O.H: visualization, conceptualisation, M.A.B.F: investigation, M.B: investigation, M.B.K: supervision, validation, M.A: supervision, validation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDogan KH, Demirci S, Erkol Z, et al. Dead Bodies Found in Wells 2010;31:0\u0026ndash;4. \u003c/li\u003e\n\u003cli\u003eMlayeh S, Ben S, Firas A, et al. Deadly falls into wells : A retrospective study of 72 autopsy cases from Kairouan , Tunisia 2020:1\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eTunisie : 11.200 puits anarchiques recens\u0026eacute;s | Webmanagercenter n.d. Available at https://www.webmanagercenter.com/2016/12/29/400913/tunisie-les-puits-anarchiques-atteints-11200-puits/ (accessed November 4, 2021).\u003c/li\u003e\n\u003cli\u003eSimone Schneppe, Martin Dokter, Britta Bockholdt. Macromorphological findings in cases of death in Water: A critical view on \u0026quot;drowning signs\u0026quot;. Int J of Legal Med, 2021 Jan;135(1):281\u0026ndash;91.\u003c/li\u003e\n\u003cli\u003eWen-juan CWZ. Forensic Analysis of 52 Corpses Found in Wells. Fa Yi Xue Za Zhi 2019;35:44. \u003c/li\u003e\n\u003cli\u003eRW B. Putrefaction: An Additional Complicating Factor in the Assessment of Freshwater Drownings in Rivers. J Forensic Sci 2018;63:899\u0026ndash;901. \u003c/li\u003e\n\u003cli\u003eGoren S, Subasi M, T\u0026yacute;rasci Y, et al. Fatal falls from heights in and around Diyarbakir, Turkey. Forensic Sci Int 2003;137:37\u0026ndash;40. \u003c/li\u003e\n\u003cli\u003eJonathan Lucas, Lara B Goldfeder, James R Gill. Bodies found in the waterways of New York City . J Forensic Sci 2002;47:137\u0026ndash;41.\u003c/li\u003e\n\u003cli\u003eLunetta P, Smith GS, Penttila A, et al. Undetermined drowning. Med Sci Law 2003;43:207\u0026ndash;14. \u003c/li\u003e\n\u003cli\u003eCelis A. Home drowning among preschool age Mexican children. Inj Prev 1997;3:252. \u003c/li\u003e\n\u003cli\u003eLawler W. Bodies recovered from water: a personal approach and consideration of difficulties. J Clin Pathol 1992;45:654.\u003c/li\u003e\n\u003cli\u003eJ H Modell, M Bellefleur, J H Davis. Drowning without aspiration: is this an appropriate diagnosis? . J Forensic Sci 1999;44:1119\u0026ndash;23.\u003c/li\u003e\n\u003cli\u003eSimonsen J. Injuries sustained from high-velocity impact with water after jumps from high bridges. A preliminary report of 10 cases. Am J Forensic Med Pathol 1983;4:139\u0026ndash;42. \u003c/li\u003e\n\u003cli\u003eRowbotham SK, Hons MAS, Blau S, et al. An Anthropological Examination of the Types of Skeletal Fractures Resulting from Fatal High 2018:12\u0026ndash;4. \u003c/li\u003e\n\u003cli\u003eLukas GM, Hutton JE, Lim RC, et al. Injuries sustained from high velocity impact with water: an experience from the Golden Gate Bridge. J Trauma 1981;21:612\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eAbel SM, Ramsey S. Patterns of skeletal trauma in suicidal bridge jumpers: a retrospective study from the southeastern United States. Forensic Sci Int 2013;231.\u003c/li\u003e\n\u003cli\u003e\u0026Ccedil;etin G, G\u0026uuml;nay Y, Fincanci SK, et al. Suicides by jumping from Bosphorus Bridge in Istanbul. Forensic Sci Int 2001;116:157\u0026ndash;62. \u003c/li\u003e\n\u003cli\u003eR G Snyder CCS. Fatal injuries resulting from extreme water impact . Aerosp Med 1967;38:779\u0026ndash;83.\u003c/li\u003e\n\u003cli\u003eObeid NR, Bryk DJ, Lee T, et al. Fatal Falls in New York City An Autopsy Analysis of Injury Patterns. Am J Forensic Med Pathol 2016;37:80\u0026ndash;5.\u003c/li\u003e\n\u003cli\u003eVelmahos GC, Toutouzas KG, Radin R, et al. Nonoperative treatment of blunt injury to solid abdominal organs: a prospective study. Arch Surg 2003;138:844\u0026ndash;51. \u003c/li\u003e\n\u003cli\u003eMiller PR, Croce MA, Bee TK, et al. Associated injuries in blunt solid organ trauma: Implications for missed injury in nonoperative management. J Trauma 2002;53:238\u0026ndash;44. \u003c/li\u003e\n\u003cli\u003eBen Khelil M, Gharbaoui M, Farhani F, Zaafrane M, Harzallah H, Allouche M, et al. Impact of the Tunisian Revolution on homicide and suicide rates in Tunisia. Int J Public Health 2016;61:995\u0026ndash;1002. \u003c/li\u003e\n\u003cli\u003eHegerl U, Wittmann M, Arensman E, van Audenhove C, Bouleau JH, van der Feltz-Cornelis C, et al. The \u0026ldquo;European Alliance Against Depression (EAAD)\u0026rdquo;: A multifaceted, community-based action programme against depression and suicidality. World J Biol Psychiatry 2008;9:51\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eBen Khelil M, Farhani F, Harzallah H, Allouche M, et al. Patterns of homicide in North Tunisia: A 10-year study (2005-2014). Inj Prev 2018;24(1):73\u0026ndash;77.\u003c/li\u003e\n\u003cli\u003eEsiyok B, Balci Y, Ozbay M. Bodies recovered from wells, sewerage systems and pits: what is the cause of death? \u003cem\u003eAnn Acad Med Singapore\u003c/em\u003e. 2006;35:547\u0026ndash;551.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSocio-demographic features of the casualties\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge range (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19\u0026ndash;29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u0026ndash;39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u0026ndash;49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50\u0026ndash;59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60\u0026ndash;69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving areas\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e38.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e61.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e70.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDaily laborer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHousewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedical records\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMental illness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAlzheimer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSeizures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIschemic heart disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSuicide attempts\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e83.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eCases according to the features of the wells\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of well\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNear home\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNear work place\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePublic place\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbandoned place\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of water\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot mentioned\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eProtection around the well\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eWell depth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;5 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u0026ndash;10 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u0026ndash;15 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u0026ndash;20 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;20 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot mentioned\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDistribution of cases according to the autopsy findings\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSigns of putrefaction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e81.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSigns of immersion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e88.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eTraumatic injuries\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCause of death\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrowning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePolytrauma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCO intoxication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHanging\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStab wound\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrowning and polytrauma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eElectrocution\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStrangulation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStrangulation and polytrauma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSuffocation by a foreign object\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eManner of death\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAccidental\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSuicide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHomicide\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIndetermined\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eToxicological analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot performed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot collected\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot mentioned\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eToxicological results\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAlcohol\u003c/p\u003e\n \u003cp\u003eBenzodiazepines\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003cp\u003e78.9\u003c/p\u003e\n \u003cp\u003e21.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDistribution of traumatic injuries according to the depth of wells\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSkull fractures\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eRib fractures\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCervical spine fractures\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eThoraco-spine fractures\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eLumbar spine fractures\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eUpper limbs fractures\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eLower limbs fractures\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eInternal organ injuries\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;5 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u0026ndash;10 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u0026ndash;15 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16\u0026ndash;20 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;20 m\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Well, Autopsy, Death, Forensic medicine, Drowning, Tunisia","lastPublishedDoi":"10.21203/rs.3.rs-5256963/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5256963/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: This study aimed to analyze the pattern and post-mortem findings of dead bodies found in wells in Northern Tunisia.\u003c/p\u003e\n\u003cp\u003eA cross-sectional retrospective study was conducted in northern Tunisia over 15 years (2005-2019). Epidemiological features, well characteristics, autopsy findings, cause of death, and manner of death were analyzed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Findings showed a male predominance (sex ratio M/F 2.38), with a median age of 37.5 years. The deceased lived primarily in rural areas (61.4%) and 27.8% were daily laborers. A history of mental illness was reported in 36.9% of the cases and a history of suicide attempts in 29 cases (16.5%). The wells were unprotected in most of the cases (91.5%). Bodies were found mainly in wells located near/in the homes of the decedents (50.3%). Putrefaction was observed in 18.2% of the cases and suggestive signs of immersion in 88.1%. The cause of death in our study was mainly drowning (82.4%). The cause of death was concluded as accidental in 58.5%.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Deceased individuals discovered in wells remain a challenge for forensic pathologists. This study contributed to identifying the patterns of the deceased.\u003c/p\u003e","manuscriptTitle":"Forensic analysis of dead bodies recovered from wells in North Tunisia: Autopsy-based study.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-03 23:40:41","doi":"10.21203/rs.3.rs-5256963/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"48d155d8-529f-4e38-b402-1395cbdfb06e","owner":[],"postedDate":"December 3rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-09T03:53:38+00:00","versionOfRecord":[],"versionCreatedAt":"2024-12-03 23:40:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5256963","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5256963","identity":"rs-5256963","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}