Firearm Injuries in Manipur: A Comprehensive 10-year Autopsy-based retrospective study

ABSTRACT Background: Firearm-related violence is a growing concern in India, where an estimated 40 million civilian-owned firearms exist, with only 15% legally registered. The northeastern states, including Manipur, have long witnessed firearm-related incidents due to sociopolitical factors, yet limited scientific analyses exist. This study examines the sociodemographic profile of victims and the medicolegal aspects of firearm and explosive injuries. Methods: A retrospective analysis was conducted on medicolegal autopsy records from the Department of Forensic Medicine and Toxicology, Regional Institute of Medical Sciences, Imphal, covering firearm-related deaths between January 2012 and December 2022. Data sources included autopsy reports, police documentation, requisition forms, and relatives’ accounts. Information was categorized by demographics, weapon type, injury distribution, motive, timing, and manner of death. Results: A total of 200 cases were reviewed, with an overwhelming male predominance (99%). The most affected age group was 21–30 years (39.5%), followed by 31–40 years (24%). Rifled firearms were used in 90% of cases. The head and face were the most common injury sites (21.5%), followed by combined head and thorax injuries (17.5%). Encounters (43%) and terrorism (18.5%) were the leading motives. Most incidents occurred between 6 am–12 noon (31%). In 65.5% of cases, more than two shots were fired. Homicides accounted for 88% of deaths, while suicides and accidents comprised 8% and 4%, respectively. Death was primarily due to injury to vital organs (64%), head trauma (20%), and hemorrhage/shock (16%). Conclusion: The study highlights the predominance of young male victims, the extensive use of rifled firearms, and the high rate of homicidal deaths in Manipur. The findings underscore the severity, intentionality, and public health implications of firearm violence in northeastern India, emphasizing the need for stricter firearm regulation and preventive interventions.