Featured Articles – Expert Witness Features – page 24

Is Vasectomy safe?

IN 1890, VASECTOMY was first suggested as an alternative to castration for men with enlarged prostates. In the early 1890’s, it was also suggested as a ‘treatment’ for certain criminals and undesirables, and for a time, enforced sterilisation was legal for some. It wasn’t until 1948 that vasectomy came into common use as a form of permanent contraception. At this time, the operation was performed through an incision on each side of the scrotum, a loop of vas deferens would be brought through the incision, a segment removed and the ends tied off. In 1974, no-scalpel vasectomy (NSV) was pioneered by Dr Li Shunquang in China, carried out through a single mid-line incision or puncture wound under local anaesthetic and is now the recommended method of vasectomy in Britain.

What, really, is a hernia?

An embryological journey
If only it were so simple. After all, herniae are common in infants and young boys who hardly strain at all (except to fill their nappies) and we all strain from time to time but most of us never develop a hernia. In order for me to explain I need to take you on a journey. Come with me to the start, in a mother's womb. One of the last bits of male development in the foetus is the appearance of testes in the scrotum.

Earlier, each testis develops with its kidney on the back wall of the abdomen; but it eventually breaks free and migrates down and round to the front and then through a tunnel in the muscles of the groin, or inguinal, region. This tunnel leads to the neck of the scrotum and then on down to where most testes end up. Any problem with this leads to undescended testis, a common congenital abnormality which either rights itself in the first few years of life or needs a surgical operation to correct it.

Establishing a sound case for noise induced hearing loss

NOISE-INDUCED HEARING loss is a relatively common complaint in the elderly population and is caused by excessive exposure to noise.

The noise can be from any source, but hearing damage claims usually relate to noise from an industrial source - frequently from exposure occurring in the days before ear protection was mandatory. In order to qualify for compensation the claimant must have a demonstrable hearing loss and also a history of noise exposure.

A 21st century disability

DAMAGE TO HEARING from exposure to noise remains a common problem in the 21st century, despite the regulation of occupational noise exposure in most developed countries.

In the UK, approximately 170,000 people suffer deafness, tinnitus or other ear conditions as a result of exposure to excessive noise at work. The resulting hearing loss cannot be cured, but is preventable.

Putting legal issues under the microscope - forensic medicine

FORENSIC MEDICINE is the branch of medicine concerned with the resolution of criminal or civil legal issues by the application of scientific medical knowledge.

The specialty of forensic medicine is often referred to as legal medicine in Europe and in Spanish-speaking countries.