Ethanol Level of Vitreous Fluid in Road Accident fatalities referred to Tehran Legal Medicine Center in 2018

Background: High risk behaviors such as substance use are among the human factors that can play an important role in fatal road accidents and deaths. Objective: To determine the status of alcohol consumption based on vitreous fluid exam in cadavers sent to Tehran Legal Medicine Organization. Materials and Methods: In this descriptive analytical cross-sectional study, all fatalities sent to the Tehran Legal Medicine Organization during 2018 were studied. A vitreous sample was used to measure the amount of alcohol. Results: Out of 676 cadavers (85% male; mean age 40.6±6.45), the toxicology results for alcohol was positive in 6.51% (91% male; mean age 37.10±15.7). There was a significant difference between the two sexes (P < 0.00) and the educational level (P1< 0.00). Most fatal accidents occurred in positive toxicology cases between 10-12 pm and on Fridays followed by Thursdays. Conclusion: The policy of non-consumption of alcohol based on Islamic teachings in Iran has played an important role in significantly reducing fatal accidents caused by alcohol

2 Years follow up Sex Reassignment Surgery: Mental Health and its Associated Factors

Introduction: Transsexualism is a gender disorder in which the patient's physical gender is in conflict with his / her mental gender and emotionally and psychologically feels that he / she belongs to the opposite sex. There are several ways to correct this disorder and improve a person's physical and mental health. Gender reassignment surgery is one of the treatment methods commonly performed for this purpose. Materials and Methods: This cross-sectional study was performed in 2019 in patients referred to the psychiatric ward of the Forensic Medicine Organization, Dr. Mir Jalali Surgery Center and the Welfare Organization. The sample size was 30 people according to the facilities of the research team, which was selected by census sampling method. After completing the informed consent to participate in this research project, all subjects completed the GHQ-28 mental health questionnaire and the researcher-made information form. Subsequently, the results were statistically analysed under SPSS21 statistical software.Results: Amongst the 30 participants (Male to Female /Female to Male = 14/16), the mean age was 27.06 ± 2.40 years, the mean time after surgery was 30.17 ± 3.18 month and the mean age of sexual identity change was 10.45 ± 3.91 year, respectively. Illicit drugs were used by 20% of these people, all of whom were amphetamines. The majority of the samples were dissatisfied with family and community support. Also, no difference was reported in the quantity and quality of intercourse before versus after surgery. The results of GHQ-28 mental health questionnaire showed that all items were lower than the community average. There was no significant difference in mental health between the two groups. Conclusion: Financial and spiritual support of family and society is very effective on Gender reassignment surgery results, especial sexual function. It seems that despite the significant advancements made in the field of sex reassignment, such operations and the resultant change in individuals’ gender have not met their needs

An Investigation of Post-radiation Gene Expression Profiles: A System Biology Study

Introduction: Genomics and bioinformatics are useful methods for exploring unclear aspects of radiation effects on biological systems. Many radiation-induced alterations in irradiated samples are post-radiation time-dependent. This study aims to evaluate the post-irradiation effects of the gamma-ray on human Jurkat cells.Methods: Gene expression profiles of the samples compared 6 and 24 hours after radiation to findthe critical differential expressed genes and the related pathways. Samples are provided from GeneExpression Omnibus (GEO) and analyzed by ClueGO.Results: Twenty-nine critical genes were determined as the important affected genes and 7 classes of related pathways were introduced. CCNE2, PSMD11, CDC25C, ANAPC1, PLK1, AURKA, and CCNB1 that were associated with more than 6 pathways were related to one of the determined pathway groups.Conclusion: Cell protecting pathways were associated with the genes (HSPA5, HSPA8, HSP90B1, HMMR, CEBPB, RXRA, and PSMD11) which were related to the minimum numbers of pathways. The finding of this study corresponds to repair processes that depend on post-radiation time. It seems these sets of genes are suitable candidates for further investigatio

The Relationship Between Post-Traumatic Stress Disorder After Childbirth and Social Support and Marital Satisfaction

Background: Childbirth is among the most significant and pleasant events in a woman’s life. This event can be a traumatic event and a threat to the mother’s mental health. This study recognizes the relationship between Post-Traumatic Stress Disorder (PTSD) after childbirth and social support and marital satisfaction.Methods: This Cross-sectional analytical study was performed on a sample of 400 mothers who had delivered at Shohadaye-15-Khordad Hospital in Varamin (in two groups with & without PTSD). The research instruments include the Demographic, Midwifery, Neonatal Factors checklist, Enrich Marital Satisfaction, Weinfeld and Tigman Social Support, and the PTSD Symptoms Scale. We used SPSS to analyze the descriptive and Pearson correlation and logistic regression data. A P<0.05 was considered significant.Results: The prevalence of PTDS in this study was equal to 16.8%. There was no significant correlation between the mean of the total score of PTSD in all dimensions with social support (P>0.05). Marital satisfaction significantly affected the probability of PTSD after childbirth (P=0.001). There was a significant correlation between PTSD total score and dimension of avoidance symptoms and infant gender (P=0.038). There was also a significant correlation between gestational age and avoidance symptoms (P=0.001) and type of nutrition feeding and motivational symptoms (P=0.041) of PTSD dimensions.Conclusion: According to the relationship between marital satisfaction and PTSD, it is recommended to design suitable interventions to improve the marital status and promptly diagnose the susceptible mothers to prevent the spread of this complication

Electrocardiographic Manifestations of Benzodiazepine Toxicity

Background: The aim of this study was to evaluate and compare the clinical and electrocardiographic (ECG) manifestations of benzodiazepines (BZs). Methods: In this retrospective study, all BZ-poisoned patients hospitalized at Loghman Hakim Hospital between September 2010 and March 2011 were evaluated. Patients’ information including age, sex, time elapsed between the ingestion and presentation, and type of the BZ used were extracted from the patients' charts and recorded. ECGs on presentation to the emergency department (ED) were evaluated and parameters such as PR interval, QRS duration, corrected QT, amplitude of S wave in lead I, height of R wave and R/S ratio in the lead aVR were also measured and recorded. Results: Oxazepam, chlordiazepoxide, lorazepam, alprazolam, diazepam, and clonazepam were ingested by 9 (3%), 13 (4.4%), 29 (9.9%), 105 (35.8%), 65 (22.2%), and 72 (24.6%) patients, respectively. Mean PR interval was reported to be 0.16 ± 0.03 sec and PR interval of greater than 200 msec was detected in 12 (4.5%) patients. Mean QRS duration was 0.07 ± 0.01sec and QRS≥120 msec was observed in 7 (2.6%) cases. Conclusion: Diazepam is the only BZ that does not cause QRS widening and oxazepam is the only one not causing PR prolongation. It can be concluded that if a patient refers with a decreased level of consciousness and accompanying signs of BZ toxicity, QRS widening in ECG rules out diazepam, whereas PR prolongation rules out oxazepam toxicity

Evaluation of Prothrombin Time in Acute Acetaminophen Overdose treated by N-acetylcysteine

Background: Acetaminophen (N-Acetyl-p aminophenol; APAP) is one of the most common types of analgesics. It is also the most common xneobitic reported to poison centers. This study investigates if therapeutic doses of NAC can falsely increase coagulation tests, prothrombin time (PT) and bleeding time (BT). ​​ Methods: Thirty-six APAP poisoned patients whose acetaminophen serum concentration were in toxic zone in the Rummak-Matheiw graph were treated by NAC according to standard intravenous 21 hours protocol.  Prothrombin time (PT) and bleeding time (BT) in all cases were measured before the start of the NAC and at the 8th and 16th hour of the treatment. Results: The mean age of the cases was 21.5 ± 5.12 years old. Among them, 31 cases (86%) were female. The mean dose of ingested APAP was 9.6 ±2.0 grams (7.8 – 16.1 g). Mean of SLA was 196.0±37.7. The means of BT were nor significantly different at all evolution times (2.6±0.64, 2.6±0.62 and 2.6± 0.6. The means of PT rose at 16th hour of NAC treatment in as compared 8th hour (16.1± 1.1 s 12.3±0.6 s, respectively) (

Comparison of the Viewpoints of Midwives Working in Teaching Hospitals and Health Centers in Tehran City about Management Factors Associated with Midwifery Errors (Iran)

Background and Objectives: Midwifery errors are associated with several problems for mother and fetus, which can lead to deadly consequences. On the other hand, if the causes of these errors are not identified, it is not possible to make appropriate decision to reduce or eliminate them. Therefore, identifying the factors associated with these errors is of particular value. The aim of this study was to identify the management factors that cause midwifery errors and the role of each factor in the occurrence of midwifery errors from the viewpoints of midwives working in Tehran city.   Methods: This descriptive study was performed on 252 midwives working in Tehran city (2014). The data collection tool was a researcher-made questionnaire, which its face and content validity, were determined by calculating CVR and CVI indices. The reliability of the tool was confirmed by a test-retest method and calculation of Cronbach's alpha.   Results: In this study, 176 midwives (69.8%) or their colleagues had the history of committing midwifery errors; 209 subjects (82.9%) believed that wrongdoer person reports his/her error; and 176 subjects (69.8%) stated that error report form is filled out. Moreover, the overall effect of management factor on the occurrence of midwifery errors, showed no significant difference from the viewpoints of midwives participating in the research.   Conclusion: According to the results of the present study, management factors as the major cause of occurrence of midwifery errors, require more attention in order to reduce midwifery errors.   &nbsp

The comparison of spiritual health and self-esteem in women with and without sexual violence

Background and aim: Sexual violence is a serious public health problem which is common around the world. The aim of this study was to evaluate spiritual health and self-esteem in sexual violence victims. Methods: This cross-sectional study was performed on 66 subjects in the group of sexual violence women and 147 subjects in the group of women with no experience of sexual violence who referred to Tehran Forensic Medical Center and the health centers of Shahid Beheshti University of Medical Sciences respectively, in 2015, in Tehran, Iran. Sexual violence was considered as vaginal or anal penetration. Paloutzian & Ellison spiritual health questionnaire and Rosenberg self-esteem scale were used for data collecting. Data were analyzed using IBM-SPSS version 21. The Kolmogorov Simonov test was used for normality distribution of variables. Descriptive and the Mann-Whitney tests were used to analyze the data. Statistical significance was set to p<0.05. Results: Sexual activity in both groups was started at 20 years old. Most of the abused subjects were single (48.8%), with education level below diploma (55.2%), unemployed (67%) and with an average annual income of 200 million Rials ($7,000). Familiarity with the offender was mostly as friendship (42.4%), and the offence had occurred through deception (37.8%). No significant difference was found between the total mean scores of self- esteem in the two groups (M1: 21.89, M2: 21.02; p=0.76) while a significant difference was seen between the mean scores of spiritual health, which indicates a lower level of spiritual health in women with sexual violence (M1: 74.59 (2.03), M2: 86.39 (3.12); p<0.001). Conclusion: The results of the present study highlight the importance of spirituality in sexual violence so policies to promote spiritual health are recommended to protect wome

Elektrokardiografske manifestacije kod akutnog trovanja metanolom ne mogu predvidjeti smrtnost

The aim of this retrospective observational case series was to determine electrocardiographic (ECG) manifestations in patients poisoned with methanol and see whether they could predict mortality. We also wanted to see whether there was an association between ECG changes and time elapsed between ingestion and treatment, age, sex, seizure, coma (Glasgow Coma Scale ≤8), arterial blood gas (ABG) parameters, and serum potassium levels on hospital admission. The study included 42 patients aged 31.14±12.5 years. Twenty-five survived and 17 died. Almost all patients had one or more abnormal ECG findings, including heart rate, rhythm, and conduction abnormalities. However, we found no significant difference between survivors and non-survivors. QTc interval did not correlate with time elapsed between ingestion and treatment, age, sex, seizure and coma, HCO3-, or serum potassium level. Similarly, T waves showed no correlation with serum potassium. ECG abnormalities did not correlate with coma or seizure. Even though cardiotoxicity in methanol poisoning is high, none of the ECG abnormalities found in our study predicted mortality. This however does not rule out the need to routinely run ECG for cardiotoxicity in every single patient poisoned by methanol.Cilj je ovog retrospektivnoga opservacijskog istraživanja bio utvrditi elektrokardiografske (EKG) manifestacije u bolesnika otrovanih metanolom te vidjeti mogu li one poslužiti kao pretkazatelji smrtnosti. Također smo željeli utvrditi postoji li povezanost između promjena na EKG-u i vremena proteklog od unosa metanola do liječenja, zatim dobi, spola, epileptičkog napadaja, kome (≤8 prema ljestvici Glasgow), nalaza plinske analize arterijske krvni te razina kalija u serumu u trenutku hospitalizacije. Ispitivanje je obuhvatilo 42 bolesnika u dobi od 31.14±12.5 godine. Dvadeset i petero je preživjelo trovanje, a 17-ero umrlo. Gotovo su svi bolesnici imali jedan abnormalni EKG parametar ili više njih među kojima brzinu otkucaja srca, srčani ritam i provodljivost. Nismo međutim našli značajnih razlika između preživjelih i umrlih. QTc interval nije korelirao s vremenom proteklim od unosa metanola do liječenja, s dobi, spolom, epileptičkim napadajem, komom, HCO3- odnosno razinama kalija u serumu. Isto tako, T valovi nisu korelirali s kalijem u serumu. Abnormalni EKG nalazi nisu korelirali s komom i epileptičkim napadajima. Premda je kardiotoksičnost značajna kod trovanja metanolom, nijedan abnormalni EKG nalaz nije mogao predvidjeti smrtnost. To međutim ne isključuje potrebu za rutinskim EKG pregledima radi otkrivanja kardiotoksičnosti u svih bolesnika otrovanih metanolom

Cerebrospinal Fluid Indices in Acute Drug Intoxication; Do They Predict the Patients’ Outcome?

Introduction: In some intoxicated patients, cerebrospinal fluid (CSF) is examined due to the prolonged loss of consciousness, focal neurologic findings, and fever of unknown origin. We aimed to evaluate the probable relationship between the different toxicity causes and the CSF indices in poisoned patients and determine if they could predict the patients’ outcome. Methods: All patients who had been admitted to the toxicology intensive care unit of Loghman-Hakim hospital between March 2006 and March 2011 and had undergone lumbar puncture (LP) were included into this retrospective study. The patients’ demographic data and results of CSF evaluation (level of glucose, lactate dehydrogenase, protein, and white blood cells in CSF fluid) were evaluated. The data was analyzed using SPSS software version 17. Results: A total of 111 patients were evaluated. Mean age of the patients was 37±15 years. Thirteen (11.7%) had deceased. No relation was found between the cause of poisoning (medication involved) and the changes in CSF indices. A statistically significant difference was found between the survivors and non-survivors in terms of CSF protein, LDH, and WBC. However, such a difference was not detected between these two groups regarding CSF glucose. Conclusion: In intoxicated patients with prolonged decreased level of consciousness or prolonged fever, early evaluation of CSF can help early diagnosis of complications such as meningitis and prompt treatment. Also, high level of protein, LDH, and WBC in the CSF can predict higher mortality rates in these patients