The Rules of Forensic Medicine Examination in Diagnosis of Electrical injury in Childhood

Background: History taking is a duty that must get out in different situation as child's parents or in adults by themselves, to able provide the best helps in minimum time. Certainly, the information come out from history have significant effects on management plans. Case Presentation: A 16 months baby that transfers to ER department with complete cardiorespiratory arrest and after response to resuscitation the medical management was done for him. As history taking, he found unconsciousness near dress pan with wet dressing in bathroom. In physical exam the little impact traumatism on his/her head and face was detected. In blood and urine samples, there were not significant findings for toxicological screening. The physician requested for forensic specialist consultation for ruling out any child abuse doubt. The future examination was done by forensic team and they found the hyperkeratotic nodules on palmar surface of first phalange of right index finger due to electrocution. Conclusion: The history taking and following physical exam have greatest significant moment and the detailed and exact physical examination include whole parts of body, especially in children who couldn't present and complain about their problems completely

Characteristics of traumatic brain injury among accident and falling down cases

Motor vehicle and falling down are responsible for the most number of traumatic injuries. This study aimed to compare the characteristics of traumatic brain injury among accident and falling down cases. In this analytical cross- sectional study, data were collected from the records of cadavers who died due to accident or falling down and referred to Kahrizak dissection hall, Tehran forensic medicine organization during 2013. A total of 237 subjects (183 (77.2) accident and 54 (22.8) falling down) with a mean age of 35.62 (SD=15.75) were evaluated. A number of 213 (89.9) were male. From accident group, scalp injury was seen in 146 (79.8), scalp abrasion in 122 (66.7), scalp laceration in 104 (56.8), sub skull bruising in 176 (96.3), skull fracture in 119 (65), hemorrhage in 166 (90.7), Subdural hemorrhage (SDH) in 155 (84.7), Subarachnoid hemorrhage (SAH) in 161 (88), Epidural hemorrhage (EDH) in 41 (22.4), contusion in 140 (76.5), and skull base fracture in 140 (76.5) of cases. In falling down group scalp injury was seen in 42 (77.8) cadavers, scalp abrasion in 38 (70.4), scalp laceration in 30 (55.6), sub skull bruising in 49 (90.7), skull fracture in 39 (72.2), Hemorrhage in 49 (90.7), SDH in 43 (79.6), SAH in 47 (87), EDH in 10 (18.5), contusion in 33 (61.1), and skull base fracture in 39 (72.2) of cases. There was no significant difference between these two groups (P Value> 0.05). Accident and falling down had no difference in terms of any injury or hemorrhage. © 2015 Tehran University of Medical Sciences. All rights reserved

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

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

Electrical Burn Patients According to Electrical Voltage in Shahid Motahari Burn Center

Background: Electrical injuries are rarely happened but it makes more harmful lesions comparing to other thermal injuries. The aim of this study was to report electrical burned patients according to electrical voltage in Shahid Motahari Burn Center.Methods: This Routine data base study was performed on patients with electrical burns which were admitted to Shahid Motahari Burn Center from April 2010 to March 2012. Demographic and clinical data had gathered from medical records. Association between voltage and morbidity or mortality was evaluated used SPSS v. 16.Results: Mean total body surface area of 287 patients (283 (98.60%) male and 4 (1.4%) female) with mean age of 30±0.7 years was 13.56±0.76% (range 1-100). There were 203 patients (70.7%) with low and 84 patients (29.31%) with high voltage injury. There was significant association between voltage and place of injury (p=0.001).Conclusion: High voltage injuries constitute large number of electrical injuries which more of these injuries occurred outdoor and in workplace and need more hospitalization. High voltage injuries are related with more amputation, so people and authorities should pay more attention to such injuries

Review of Fall Injuries and Related Factors in Patients Admitted to a Trauma Referral Hospital in Tehran, Iran

Background: Falls are important causes of mortality and morbidity in urban areas and put a high burden on societies. We investigated patterns of fall traumas and related factors in a referral trauma hospital in Tehran, Iran.Methods: In this routine-data-based study, all documents of fall cases in Hazrate-Rasool hospital, Tehran, Iran, during October 2014-2015 were investigated. Information on demographic factors of patients, fall conditions and outcomes were collected. Data were analyzed by SPSS 11.5. The statistically significant level was considered ≤ 0.05.Results: Of the 307 cases, 70% were male. Median (interquartile range) age was 32 (22-51) years. Of cases, 91% were undergraduates. The mortality rate was 2.6%. Suicide attempts reported in 17 (5.5%) cases and only 2 (12%) of them were successful. Injured body organs in order of frequency were extremities, head and neck, thorax, vertebras, abdomen and pelvis. Outcome (in terms of injured body organs) was related to age and gender of patients alongside with height and reason of the fall. Falls at workplaces, in suicide attempts and among males happened for significantly higher distances. High distance falls and low GCS at admission were related to higher mortality. Majority of falls on a same level happened at home among old women.Conclusion: In our region, fall was a problem of people with low socioeconomic status. Our mortality rate is similar to the highest mortality rates in the world. Personal characteristics along with trauma-related factors are both important in the outcomes of fall cases. Safety equipment at high risk jobs is essential to prevent falls

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

A Simple Modification of Homotopy Perturbation Method for the Solution of Blasius Equation in Semi-Infinite Domains

A simple modification of the homotopy perturbation method is proposed for the solution of the Blasius equation with two different boundary conditions. Padé approximate is used to deal with the boundary condition at infinity. The results obtained from the analytical method are compared to Howarth's numerical solution and fifth order Runge-Kutta Fehlberg method indicating a very good agreement. The proposed method is a simple and reliable modification of homotopy perturbation method, which does not require the existence of a small parameter, linearization of the equation, or computation of Adomian's polynomials

Epidemiology of orthopedic trauma in children and adolescent in a referral center in Tehran: A prospective study

Background: Orthopedic trauma is a common type of injury in children and may cause deep and permanent psychological and physical damage both for the patient and the parents. This study aimed to analyze the epidemiology age, gender distribution and the mechanism of injury in patients presenting to a level I trauma center in urban population of Tehran. Methods: In this prospective descriptive study, the patients under 19 years old with orthopedic trauma who were hospitalized in Tehran Shafa University Hospital were entered. This hospital is the main orthopedic referral center in Iran. The patients were prospectively evaluated from April 2013 to March 2014. The data were collected and analyzed. Results: The study included 1081 patients under 19 years old. There was a male predominance (76.8 n= 830). The boys had a higher mean age 11.04±5.06 year, versus girls with mean age 8.67±4.63 year (P< 0.05). The peak age of boys was 18 and the girls had two peaks at three and nine. The fractures occurred in upper limb in 70.8 (n= 621) and 29.2 (n= 256) in lower limb of patients. There were 27 cases with joint dislocation, 5 cases with knee ligamentous injuries, 128 cases with soft tissue injuries and 44 cases with spine injuries. The most frequent mechanism in both gender were falls from standing position (48.5). The most common fractures were foreman both bone fractures (n: 146 16.7), elbow supracondylar fractures (n: 134, 15.3) and distal radius fractures (n: 84, 9.6). The most fractures occurred in summer (30.1) and the least in winter (18.1). Conclusion: Evaluation of epidemiologic factors can lead to the best prediction and treatment planning of trauma. Early recognition of injury, even minor, and expected care using specialized teams will help to improve outcomes for these patients. This study determines the most at risk children for trauma and fractures and may help the parents to prevent damage. © 2015, Tehran University of Medical Sciences. All rights reserved