Different Types of Death from the Viewpoint of Quran and Forensic Medicine

Background: The word death has been brought in several verses of Quran. The purpose of this study is to discuss and compare similarities and differences between Quran’s and forensics’ perspective in terms of death.Methods: The present study is carried out by library studies on multiple interpretations of Quran, interpretation of juridical references and comparing them with current forensics knowledge.Results: Holy Quran has mentioned different types of death: 1- certain death: death is inevitable; 2- Suspended death: occurrence of death is conditioned; 3- Optional death: optionally giving up on deeds, properties and void thoughts; 4- Ambiguous death. On the other hand, different types of death from the perspective of forensics include: 1- Apparent death: a state in which breathing and functions of the heart are slowed down; 2- Cellular death: certain and imminent death; 3- Somatic death: irreparable loss of cognitive potency which is in fact the same as Brain death; 4- Instant death: roughly instantaneous deterioration of the entire cells. From the view of forensics, manners of death are divided into two groups including natural death and unnatural death. The latter includes committing suicide, killing and accidents.Conclusion: Quran is the equivalent of Natural death in forensics. In addition, the equivalent of Suspended death in forensics is death resulted by illnesses, accidents and incidents which may appear as certain death or brain death

Acute Lithium Intoxication and Factors Contributing to its Morbidity: a 10-Year Review

Background: Lithium has been commonly used for the treatment of several mood disorders particularly bipolar disorder in the last 60 years. This study aimed to analyze patients with lithium intoxication referred to Loghman- Hakim teaching hospital.Methods: This is a cross sectional study that has been done on 108 patients with lithium intoxication during 2001 to 2010. Necessary data were collected by checklists and then analyzed by statistical methods in SPSS version 20.Results: 39.8% of patients were male and most of them were in age group 20-40 years (47.2%). The rate of lithium use in 66.7% of patients was lower than 20 grams and the level of lithium in blood was 1 mEq/lit in 44.4% of patients. The rate of recovery has been significantly relation with BUN, creatinin, Intubation, pCO2 and pH. There was a significant relation between hospitalized with pH, pCO2, Na, absorbent materials, intubation and bicarbonate.Conclusion: Results showed that we should note to the rate and time of lithium used and also severity of signs in management and treatment of patients with the lithium toxicity

Pathological Findings of Tramadol on Liver Tissue in the Cadaver Referred to Legal Medicine Organization of Tehran 2008-2013

Background: Tramadol is a synthetic opioid used to control chronic pain and pain after surgery. However, many cases of poisoning and dangerous side effects have been reported. In order to discover the causes of death in forensic medicine is usually examine tissue samples taken from the body, although the results of toxicology tests generally give us more information, but identifying the pathological effects of Tramadol on the internal organs, especially the livers can be very helpful.Methods: In this cross-sectional study, information on the history, the autopsy report and toxicology testing of patients who died due to poisoning Tramadol were studied. In this study, all of the information already provided by the use of particular forms collected and then analyzed using computer software SPSS.Results: A total of 49 cadavers were examined in this study. There were 39 dead (80%) of men and 10 of (20%) women. Most common age groups in the study were 24 to 34 years old (41%), 15 to 24 years old (39%), were reported. There were significant difference between liver microscopic spread among different ages, history of Tramadol, positive and negative toxicology tests stomach contents, urine, blood, tissue and vitreous. Most common pathological changes were in liver, degenerative changes and inflammatory cell infiltration in patients who under 35 years old.Conclusion: In this study, the majority of patients had acute poisoning with Tramadol, it can be concluded that the majority of changes in tissue obtained was as a result of acute Tramadol, respectively incidence of atelectasis and edema and alveolar bleeding in the liver were most pathological findings. In reviewing toxicology, Tramadol are also present in the stomach contents, urine, gall bladder, liver and blood were positive, the result of stomach contents will be most helpful for us

The quantitative ADAM questionnaire: a new tool in quantifying the severity of hypogonadism

Androgen deficiency is a pervasive problem in the older male population and is thought to be responsible for many symptoms once considered to be the result of normal aging. Numerous methods have been proposed to facilitate the detection of men at risk for androgen deficiency. In this article, we propose a novel screening tool, the quantitative Androgen Deficiency in the Aging Male (qADAM) questionnaire and report its successful use in quantifying the severity of androgen deficiency in a group of older men. Fifty-seven males scheduled to undergo radical prostatectomy for prostate cancer completed the qADAM as well as the Sexual Health Inventory for Men (SHIM) and the Expanded Prostate Cancer Index Composite hormonal/sexual (EPICh/EPICs) questionnaires. Thirty-four men also had serum testosterone levels measured for comparison. The qADAM showed statistically significant correlation to the SHIM (P=0.001), EPICh (P=0.016), EPICs (P=<0.001), and serum testosterone (P=0.046). The qADAM represents a viable alternative to existing questionnaires used to detect androgen deficiency and to assess response to treatment

Varicocele – a case for early intervention [version 1; referees: 3 approved]

Testicular varicocele, which is defined as the dilation of the veins draining the testicle, has long been associated with a detrimental effect on testicular function. Despite a lack of high-quality, prospective data, recent evidence has shed light on potential links between varicocele and male infertility and serum testosterone levels. Similarly, varicocele repair has increasingly been shown to have a beneficial impact on pregnancy rates, semen parameters, and on improving serum testosterone in adult men. Numerous studies have assessed the optimal technique for varicocele repair and the bulk of the evidence has shown the microsurgical inguinal/subinguinal approach to have the highest success rates, the lowest overall complication rates, and the lowest recurrence rates. The management of varicocele in adolescents remains a clinical conundrum, but contemporary evidence suggests early deleterious effects of varicocele on testicular function in some patients. Well-designed prospective trials are critical to delineate the true impact and role of varicocele repair on male infertility and hypogonadism in adult and adolescent men

Effects of repetitive transcranial magnetic stimulation on lower extremity spasticity and motor function in stroke patients

Purpose: To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on lower extremity (LE) spasticity, motor function and motor neurone excitability in chronic stroke patients. Method: This study was a randomised sham-controlled cross-over trial with 1-week follow-up. A total of 20 post-stroke patients were randomised to receive active (n = 10) or sham (n = 10) rTMS. Fourteen of them (7 in each group) crossed over to the sham or active rTMS after a washout period of 1 month. Interventions consist of five consecutive daily sessions of active or sham rTMS to the unaffected lower extremity motor area (1000 pulses; 1 Hz; 90 of the tibialis anterior motor threshold). Outcome measures were modified modified ashworth scale (MMAS), the H-reflex, lower extremity section of Fugl�Mayer assessment (LE-FMA) and timed UP and GO (TUG) test. All outcomes were measured at three levels in each intervention period: pre- and post-intervention and 1-week follow-up. Results: Friedman�s test revealed significant improvement in MMAS score only after active rTMS. This improvement lasted for one week after the active rTMS. Repeated measure analysis of variance (ANOVA) showed significant time*intervention interaction for LE-FMA. There are no differences between groups for the MMAS and LE-FMA. No significant change in Hmax/Mmax ratio and TUG test was noted. Conclusion: Low-frequency rTMS over the LE motor area can improve clinical measures of muscle spasticity and motor function. More studies are needed to clarify the changes underlying this improvement in spasticity.Implications for Rehabilitation Spasticity is a common disorder and one of the causes of long-term disability after stroke. Physical therapy modalities, oral medications, focal intervention and surgical procedures have been used for spasticity reduction. Beneficial effect of the repetitive transcranial magnetic stimulation (rTMS) for post-stroke upper extremity spasticity reduction and motor function improvement was demonstrated in previous studies. This study shows amelioration of lower extremity spasticity and motor function improvement after five daily sessions of inhibitory rTMS to the unaffected brain hemisphere which lasted for at least 1 week following the intervention. © 2016 Taylor & Francis

Pilot study on the correlation of multiphoton microscopy of human testicular tumors with histology.

338 Background: Partial orchiectomy is becoming more accepted for indications such as a solitary testis, and small nonpalpable testicular masses found incidentally on scrotal ultrasonography. Unfortunately, intraoperative frozen-section pathological analysis is often unable to accurately predict the presence of malignancy. Multiphoton microscopy (MPM) enables in vivo imaging of tissue without the use of labeling techniques and could potentially diagnose testicular tumor pathology. We performed a non-randomized, non-controlled study to evaluate the feasibility of MPM to image testicular biopsies. Methods: Two men with testicular masses underwent radical orchiectomy for primary testicular tumor from June to August 2011. A total of six specimens from testicular tumor and uninvolved testes were imaged with MPM. In order to assess the diagnostic accuracy of MPM, we performed a blinded assessment by three uropathologists. The diagnosis rendered based on these images was then correlated with the findings seen on hematoxylin and eosin (H&E) staining. Results: Our diagnosis based on MPM correlated with H&E in five of six (83%) specimens. Images of seminoma acquired with the MPM are easily distinguished from those of teratoma and normal testicular parenchyma. Images of seminoma show abnormal architectural and cellular changes compared to cystic structures often seen with teratoma. Conclusions: Multiphoton microscopy can be used to reliably differentiate between teratoma, seminoma and normal testis tissue in our pilot group. MPM imaging could be potentially applied in intra-operative diagnosis of testicular tumors especially in testis-sparing surgery. Additional imaging of non-seminomatous germ cell tumors and non-germ cell tumors need to performed to verify the ultimate role of this technology