Epidemiological study of homicidal firearm injury in Manipur, the Northeast region of India: A 10-year retrospective study

Background: Firearm injuries are a major cause of homicidal deaths globally and represent a significant medico-legal and public health concern. Accurate interpretation of gunshot wounds is essential for determining the cause, manner, and range of fire, which has important legal consequences. In Manipur, India, the persistent problem of insurgency and recent ethnic violence have contributed to a marked increase in firearm-related fatalities. Objectives: To analyze the demographic characteristics, circumstances of occurrence, weapon details, wound patterns, and causes of death in cases of homicidal firearm injuries subjected to medicolegal autopsy in a tertiary care center of Manipur. Materials and Methods: This retrospective study was conducted over a period of ten years (May 2014 to April 2024) in the Department of Forensic Medicine & Toxicology, Regional Institute of Medical Sciences, Imphal. A total of 135 cases of homicidal firearm deaths were included. Information regarding age, sex, ethnicity, marital status, occupation, time and place of occurrence, motive, type of firearm, range of fire, number and site of entry wounds, associated injuries, and cause of death was collected from post-mortem records using a predesigned proforma. Data were analyzed using Microsoft Excel 2007. Results: Of the 135 cases studied, 97% were males, with the majority belonging to the 21–40-year age group. Most victims were married and from the Meitei ethnic group. Incidents predominantly occurred between 5 pm and 12 am, with communal riots being the leading circumstance. Rifled firearms were used in 90.37% of cases, and distant-range firing was most common (76.29%). Multiple entry wounds and involvement of multiple body parts were frequently observed. Brain injury was the leading cause of death, followed by multiple organ injuries and shock with hemorrhage. Associated blunt and sharp force injuries were also noted. Conclusion: Gunshot deaths form a major proportion of homicides. Comprehensive socio-economic development, employment generation, and effective conflict-control strategies are essential to reduce firearm-related mortality.