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7. The learned Additional Sessions Judge, by impugned judgment went in great detail into the types of hernia, history of inguinal hernias, direct inguinal hernia, strangulated inguinal hernia and treatment thereof. She extensively quoted from standard medical literature titled as "Bailey and Love, Short Practice of Surgery, 24th Edition, Chapter 73 dealing with hernias". she also quoted from another publication i.e. "Journal of Forensic Medicine and Toxicololy, Volume 43, No.2, July-december 2006 containing an Article titled as "Sudden Death Due To Strangulated Inguinal Hernia: a Forensic Autopsy Case Report by C. Behera". In fact C.Behera is the same doctor "Chittranjan Behera" who had conducted the autopsy on the dead body of Ram Swaroop in this case. We would like to extract a portion of the impugned judgment hereunder for ready reference:

XXX XXX XXX On page 1278 of this book it has further been observed about the percentage as follows:-
"Direct inguinal hernia In adult males, 35% of inguinal hernias are direct. At presentation , 12% of patients will have a contralateral hernia in addition, and there is a fourfold increased risk of future development of contralateral hernia if one is not present at the original presentation......"

On page 1279 strangulated inguinal hernia has been further dealt with as under:-

Strangulation of an inguinal hernia occurs at any time during life and in both sexes. Indirect inguinal hernias strangulate more commonly, the direct variety not so often owing to the wide neck of the sac. Sometimes a hernia strangulates on the first occasion that it descends; more often, strangulation occurs in patients who have worn a truss for a long time and in those with a partially reducible or an irreducible hernia.

After discussing the details of this case and strangulated hernia, it has been observed in this article that at the time of first admission patient was complaining of pain in abdomen and bleeding from nose. There was no history of vomiting. On examination there was abdominal rigidity, tenderness or guarding. On ultrasound of abdomen there was no visceral injury or free fluid inside the abdomen which suggests that the patient was not having strangulation of inguinal hernia or intestinal rupture within the abdomen or inside the sac at the time of first admission. Patient was discharged on the next day in satisfactory condition. The postmortem findings are suggestive of strangulation of indirect inguinal hernia and there was no intestinal rupture. A strangulated hernia causes swear excruciating pain, forcible vomiting and gangrene formation starts as early as 5-6 years after the onset, if it is not relieved. If it occurred after the trauma in the hospital it is unlikely to be note diagnosed with the signs and symptoms. Interval between the time of assault and time of death is about one day. The process of strangulation might have occurred after being discharged from the hospital and the relationship between the trauma and the process of strangulation is ruled out."