Successful Suicide in a Child: Depression-Related or Paroxetine-Induced?

Background: Children and adolescents are prone to develop psychiatric problems after stressful life events. These problems need appropriate treatment because of negative consequences like disease-related suicide. Antidepressants (especially "Serotonin Selective Reuptake Inhibitors") are common treatments for psychiatric problems of children and adolescents; but different side effects, including drug-induced suicide, have been reported.Case Report: In this article, we describe a nine-year-old girl who developed depression after parental divorce and was prescribed paroxetine. During pharmacotherapy, she had suicidal thoughts and several unsuccessful attempts which have been neglected and finally last attempt was successful. This report is an evidence for physicians to prescribe antidepressants cautiously with reasonable indication. As still there is no certain contraindication of using antidepressants in pediatric patients, importance of follow-ups and screening of suicide in pediatric patients during treatment with antidepressants seems essential.Conclusion: This study discloses the magnitude of explaining the side effects of antidepressants to caregivers of children with psychiatric problems

Delayed Onset Brain Hypoxia and Subsequent Seizures: a Rare Fatal Consequence of Undiagnosed Foreign Body Aspiration

Background: Foreign body aspiration is a common medical emergency among children that can lead to lethal complications especially in neglected or misdiagnosed cases.Case Report: This article is a report of a 15-month-old child who aspirated food materials and after chocking crisis, she presented with unspecific respiratory symptoms and treated for respiratory tract infections. After five days, sudden airway obstruction led to hypoxic brain damage and seizure. Due to unavailability of bronchoscopic facilities, extraction of foreign body was postponed and persistent hypoxia led to irreversible brain damage, seizures and finally death. This report reveals the key role of physicians in prompt diagnosis and the importance of early extraction of aspirated foreign bodies, even in asymptomatic cases, to prevent later complications and related mortality and morbidity.Conclusion: This report contains warning hints for professionals in different fields of medicine that deal with pediatric patients

Gender Determination Using Diagnostic Values of Foramen Magnum

Background: Foramen magnum is a big hole in the base of the skull. Its appearance can be useful in gender determination. So far, no study has been conducted in Iran that evaluates the value of foramen magnum in sex determination and calculates the cut-off points. This study aimed to evaluating of diagnostic value of the foramen magnum and to calculate the cut-off points for sex determination.Methods: In this cross sectional study 50 male and 50 female patients referring to the radiology department of Rasol Akram Hospital in Tehran were evaluated. The required information about the sagittal diameter, transverse diameter, and diameter of foramen magnum were assessed by brain CT scan. Chi-square and independent t test was used for the comparison of different shapes and diameters between the sexes. ROC curve was used to determine the optimal cut-off point for each indicator.Results: The best cut-off point to distinguish males from females along the anterior-posterior foramen magnum was calculated as 36.45 mm, at the transverse diameter of 30.4 mm. The proper cut-off points for the area of the foramen magnum were 877.477 mm2 and 870.29 mm2, based on the Teixeria formula and Routal formula respectively. Overall, the accuracy of these indicators was calculated as 85%.Conclusion: Based on the results of this study using CT scans images, the diameter of the foramen magnum and its area had a high accuracy in sex determination

The Relationship between Environmental, Cultural and Chronological Factors with the Frequency, Cause and Type of Burn Injuries Admitted to the Trauma and Burn Center Motahari Hospital, during the Years 2007to 2011

Background:One of the most important health associated problem are events, which burns considered the most common of them. To prevent burn and reduce the complication and mortality rate, accurate information of epidemiology of burn is essential for planning properly.This study was conducted to determine the relationship between environmental and cultural factors and the type, cause and extent of burn injuries admitted to the trauma and burn center of Motahari hospital during 1386 to 1390.Methods: In this routine data base study, we recruited all burned patients whichreferred to trauma andburncenter of ShahidMotahari hospital between 2007 and 2011. Mainvariables includingeconomic conditions, season ofoccurrenceof the accident,the accident tocurriedonspecial occasions, yearof accident, accidentstatuson holidays, type of injury, cause of injury, injuryseverity, burnarea, anddemographic variables such asage and gender were entered in checklist from patient’s documents.Collected data were entered into softwareSPSS version 11 and were analyzed.Results:5511 patients were admitted to Motahari hospital during the April of 1386 to the end of 1390, from which 1448 (26.3%) cases were female and 4063 (73.7%) male. The mean age of subjects was 28.47 (SD=1.88).There was significant difference between different gender and etiology, so that men were burned more by oil, gasoline and diesel fuel rather than women.There was significant difference about the number of burned cases by the flame at different seasons of the year. Average number of people burned by gas cylinders,electricity,caraccident,bitumen was significantly different in different seasons.Conclusion:There were significant differences about burn injuries due to the gas cylinders,bitumen,electricity and car accidents in different seasons and months.To inform burn centers, principalship of these data increases their ability to manage populated and harmful days. According to the higher rate of explosive burn injury in the last month of the year producing harmless explosive materials can be so effective to support patients lives

Investigating the relationship between low serum cholesterol and suicide in attempters with depression

Background & Objective: It has been postulated that depressed individuals with low total cholesterol levels may be more likely to die prematurely from suicide. This study aimed to examine the association between low serum cholesterol and suicide in depressed attempters. Materials & Methods: In this cross-sectional study, 180 suicide attempters, who met the inclusion criteria and were willing to participate in the study, were recruited in 2017. The data was collected using a demographic questionnaire and the Beck Depression Inventory-Second Edition (BDI-II). The blood cholesterol level was measured via an auto-analyzer. Results: The mean age was 26.39±10.75 years. The average cholesterol level in the moderate, severe, and serious depression groups was 151.30±35.23, 145.89±36.32, and 145.15±33.33, respectively. The mean age was higher in the group with a higher depression level, though the difference was not significant (P=0.06). The percentage of suicide attempts in single individuals was significantly higher (P=0.02). The mean cholesterol level in the group with the highest level of depression was the lowest, but the difference was insignificant (r=-.01, P=0.85). Only in females, the level of blood cholesterol showed a nearly significant difference between groups with different severities of depression (P=0.05). Cholesterol had a significant correlation with suicide frequency (P=0.008, r=0.28). Conclusion: Our results revealed no significant association between low serum cholesterol and suicide in attempters with depression; but low total serum cholesterol may be associated with depression and suicide in depressed subjects. Yet, more studies are required for verification of this causality. © 2020, Journal of Advances in Medical and Biomedical Research. All rights reserved

New Frontiers in Managing Clival Tumors — The Extended Endoscopic Endonasal Approach

Clival lesions still represent a challenge for neurosurgeons. A variety of expansive process, either benign or malignant, may be identified in the clival and paraclival region

Prevalence of isolated hepatitis B core antibody among injection drug users in Central Province of Iran

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Lack of occult hepatitis B virus infection among blood donors with isolated hepatitis B core antibody living in an HBV low prevalence region of Iran

Background: Occult hepatitis B virus (HBV) infection in blood donors is considered a potential threat for the safety of the blood supply, however conclusive studies on this issue are lacking. The aim of this study was to assess the occult HBV infection in blood donors with isolated hepatitis B core antibody (anti-HBc) living in the city of Arak, in the Central Province of Iran, as a low prevalence region for HBV. Methods: A total of 531 voluntary blood donors in Arak, Iran were included in this study. Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), anti-HBc, and hepatitis C antibody (anti-HCV) were tested in all subjects. The presence of HBV-DNA was determined quantitatively in plasma samples of cases with isolated anti-HBc (HBsAg-negative, anti-HBs-negative, and anti-HBc-positive) by real-time PCR using the artus HBV RG PCR kit on the Rotor-Gene 3000 real-time thermal cycler. Results: Of 531 subjects enrolled in this study, 11 (2.1, 95 confidence interval 0.8-3.2) had isolated anti-HBc. HBV-DNA was not detected in any of the cases with isolated anti-HBc. Conclusions: Our study showed that all the blood donors with isolated anti-HBc were negative for HBV-DNA, and occult HBV infection did not occur in the blood donors of this low prevalence region for HBV infection. © 2009 International Society for Infectious Diseases

Value of prominent flow voids without cord edema in the detection of spinal arteriovenous fistulae

Purpose: To determine the prevalence of spinal dural arteriovenous fistulae (SDAVF) in patients presenting with prominent vascular flow voids on imaging without other imaging findings suggestive of SDAVF. Methods: We retrospectively identified patients from January 1, 2005 to March 1, 2012 who underwent spinal angiography for suspected SDAVF with prominent vascular flow voids on prior imaging. We excluded patients with other major spinal pathology or other imaging findings of SDAVF including cord hyperintensity, enhancement, or expansion. We calculated the proportion of patients with positive findings for SDAVF on angiography and evaluated the prevalence of SDAVF for this finding alone and in correlation with clinical findings. Results: 18 patients underwent spinal angiography for prominent flow voids on imaging without other spinal pathology or imaging findings of SDAVF. Three had a SDAVF detected on angiography. The prevalence of SDAVF in this population was low, only 17% (95% CI 6-39%). All of the patients with positive angiography findings had myelopathy, increasing the prevalence to 100% if the additional clinical finding of myelopathy was present. Conclusions: Prominent flow voids without other imaging findings suggestive of SDAVF is poorly predictive of the presence of a SDAVF, unless myelopathy is present clinically. © 2014 Alhilali et al