Drowning is a form of asphyxial death where air entry into lungs is prevented due to submersion of mouth and nostrils into water or any fluid medium. Thus drowning constitutes impairment of tissue oxygenation consequent to submersion in the fluid medium. Complete submersion is not necessary because the process will be complete even if the nose and mouth are submerged [3].Three major factors influencing the human reactions to the drowning process include: pre-existing state of the body of the victim, chemical components of water and the amount of solution inhaled. Complete submersion of the body is not necessary. Death due to drowning can take place when nostrils and the mouth are occluded by water or any other fluid. To put it otherwise, one can drown in a sea/river or in a bath tub a few inches deep [4].

A prospective study was conducted in the department of forensic medicine at our tertiary care centre for a period of four years from September 2011 to August 2015. During this period more than ten thousand cases of autopsy examination were conducted in our tertiary medicolegal centre. During the same period the author had conducted about eight hundred autopsy examinations. Of these autopsy cases a total of 32 cases of death due to drowning were conducted by the author in the mentioned period of four years.

Necessary permission for the present study was obtained from institutional ethical committee. Consent is not required for conducting medicolegal autopsies in our country. All the cases were studied prospectively during routine medicolegal autopsies conducted in the institute and hence consent to participate was not required.

The cases were studied in relation to the gender, age, manner of death, internal injuries causing deaths and the months in which the cases were autopsied. History of the case, the details of the cases, circumstances of the death and other relevant information related to the study was obtained from the respective investigating agencies.

Table 1: Age group wise and Gender wise distribution of drowning case

Majority of the cases were in the age group 20-69 years. There were 7 (21.8 %) cases in the age group 30-39 years while 6 (18.8 %) cases were each in the age group 20-29 years, 40-49 years, 50-59 years and 4 (12.5 %) cases were in the age group 60-69 years. There were 1 (3.1 %) cases each in the age group 0-9 years, 10-19 years and 70-79 years each. Majority of the cases were males accounting for 26 (81.2 %) cases while 6 (18.8 %) cases were females.

Table 2: Known and Unknown distribution of drowning cases

07 (21.9 %) cases were unknown at the time of doing autopsy examinations while 25 (78.1 %) cases were known with identified details by the investigating agencies.

Table 3: Month wise distribution of drowning cases

A large number of cases i.e 10 (31.1 %) cases were in the month of September. In other months cases of drowning were spread out more or less evenly. There were 3 (9.4 %) cases in the month of April, June, October and December. There were 2 (6.3 %) cases in the month of May, July and November. While there was 1 (3.1 %) case in the months of January, February, March and August.

Table 4: Manner of deaths in drowning cases

22 (68.8 %) cases were of suicidal manner. 8(25 %) cases were of accidental manner and 02 (6.3 %) cases were of homicidal manner of death.

Table 5: Injuries in drowning cases

In only 01 (3.1 %) case there was head injury in addition to drowning death findings. In all other cases of drowning there were no any internal injuries which could have caused death.

Age group wise and Gender wise distribution of drowning cases

In our study majority of the cases were males. [6] Found male as the majority cases accounting for (71.02%) cases.  Males are the earning members of the family and hence are subjected to financial stress. This could be the reason for more male cases for suicidal drowning. Also males go more in numbers for outdoor activities in water thus increasing their susceptibility in accidental drowning.

In our study majority of the cases were in the age group 20-69 years.[5]found  maximum number  of  cases  were  reported  in  21-30  years  group and closely competed by 31-40 and 11-20 years group. They also found very minimal or negligible numbers of cases in age groups 1-10, 61-70 and 71-80. [6] Found commonly seen cases in age groups of 21-30 years (27.84%) followed by 31- 40 years and 41-50 years.

The probable reason behind preponderance of 20-69 years could be financial stress, carelessness while swimming or doing recreational activities in or around water source leading to accidental deaths and also familial and financial stress in life.

Known and Unknown distribution of drowning cases

In our study 07 (21.9 %) cases were unknown at the time of doing autopsy examinations. This could be due to the fact that people may go a long distance away from their residence for swimming or doing recreational activities.

Also a suicide may go a long way from his home to commit suicide by drowning. Such persons may also get away a long way from their place of drowning if the water source is running like that of river.

Month wise distribution of drowning cases

[5] found large  number  of  drowning  deaths  in   the   month   of   March,   August   and   October   i.e.,   summer  month  of  March  and  monsoon  months  of  August and October.

[6]found maximum number of drowning deaths in rainy season (43.75%) followed by summer season 32.95% cases and winter season 23.30% cases.[7][8][9],found maximum cases of drowning deaths in rainy season.

In our study a large number of cases i.e 10 (31.1 %) cases were in the month of September. In other months cases of drowning were spread out more or less evenly. The month of September is a month of rainy season and a lot of people are drowned in this month.

Manner of deaths in drowning cases

[5] Found the manner at inquest and based on  circumstances,  drowning  deaths  show  accidental  (41cases  i.e.,  68%)  as  most  common  manner  in  males  and suicidal (10 cases 53%) as most common manner in females.

In our study 22 (68.8 %) cases were of suicidal manner. 8(25 %) cases were of accidental manner and 02 (6.3 %) cases were of homicidal manner of death. The two homicidal cases of drowning were that in one case the victim was poisoned and then thrown in river while in the second case the victim was injured by inflicting trauma to head and then thrown in pond.

Injuries in drowning cases

In only 01 (3.1 %) case there was head injury in addition to drowning death findings. This case was a homicidal case where the victim was injured by inflicting trauma to head and then thrown in pond.

In our study majority of the cases were males in the age group 20-69 years. A large number of cases were in the month of September. In our study (68.8 %) cases were of suicidal manner, (25 %) cases were of accidental manner and (6.3 %) cases were of homicidal manner of death.

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