Prognosis and Complications of Attempted Suicidal Hanging

Background: Hanging is a form of strangulation, in which the body is suspended through the neck and the weight of the body acts as a constricting force. This study assessed various factors on the outcome of hanging and identification of prognostic factors related to the outcomes.Methods: Ninety-nine hanging victims from 1995 to 2015 in Iran were evaluated; then, variables such as the cause of death, distribution of mortality, duration of hospitalization, substance abuse consumption, respiratory distress, and cerebral edema were studied in these people. Finally, the data were analyzed.Results: Major cases of suicide by hanging were men. In connection with prognosis, about 12% of the deaths occurred in men and about 21% were represented in women. More importantly, in the matter of suspension, the model was largely incomplete to complete. Also, the outcomes of pulmonary stress and cerebral edema were recognized in association with the type of hanging and mortality prognosis.Conclusion: Only two risk factors, including loss of consciousness at the time of entry into the medical center, as well as the complete suspension, would be predictive operations of death and unsuccessful revival

Failures to Cure and Diagnose Cervical Cancer

Background: Cervical cancer is one of the most common cancers in developing countries and the second most common cancer in women worldwide. Using the screening test, cancer can be detected in the early stages and, thus, mortality will be reduced. Also, the early detection of cervical cancer could affect survival rate and time. But, the diagnostic and therapeutic methods of this disease are usually accompanied by errors that deduct the success rate.Methods: In this study, a variety of common errors in the detection and treatment of cervical cancer were investigated by reviewing and evaluating scientific resources.Results: Studies show the different medical failures during sampling, preparation, review, and interpretation of the sample. On the other hand, inappropriate operation and errors in the treatment pathway are common errors after diagnosis. Because of the types of these errors, preparing the information of papers investigating the possible types of errors and observing accuracy will play a significant role in reducing the failures.Conclusion: Because of the fact that cervical cancer is fully curable with proper and timely diagnosis, the early diagnosis is important and it is the responsibility of doctors, pathologists, and surgeons in this area. Therefore, monitoring and preventing errors in the diagnosis and treatment is directly associated with a reduction in the mortality rate of the disease

Hyperinsulinemic Euglycemia Therapy for Acute Nitroglycerin Poisoning: Case Report

Nitroglycerin, a vasodilator, is commonly administered to treat ischemic heart disease. Adverse effects after toxicity are light-headedness, nausea, blurry vision, and syncope due to low systolic blood pressure as well as methemoglobinemia. A 19-year-old female was admitted to our toxicology department after suicidal ingestion of 320 mg extended-release nitroglycerin about 45 minutes before the admission. She was conscious, and her initial blood pressure was 98/65 mm Hg, which was decreased to 77 mmHg within 1.5 hours despite administration of 1 liter of normal saline. Due to severe hypotension, norepinephrine infusion was started for systolic blood pressure maintenance above 80mm Hg; however, she started complaining of palpitation and chest pain. So, the dose of norepinephrine was reduced, and glucose, insulin, and potassium protocol were started. After 3 hours of therapy, her hemodynamic condition stabilized with systolic blood pressure above 90mm Hg; hence norepinephrine was discontinued. She was discharged on the 3rd day after the psychiatric consultation, with regular clinical and paraclinical examinations

Epidemiology of Completed Suicides Referred to Forensic Pathology Organization of Tehran, Iran, During March 2011 to March 2016

Background: Completed or successful suicide is the worst outcome of suicide attempts. This study is an epidemiologic investigation of successful suicides in Tehran, Iran.Methods: In this routine-data-based study, the records of successful suicides in Forensic Pathology Organization of Tehran were investigated with respect to confidentiality of information during March 2011 to March 2016. The obtained data were analyzed by SPSS 11.5. Statistically significant level was considered at less than 0.05.Results: A total of 1773 cases with mean (SD) age of 33.19(13.11) years and male-to-female ratio of 3.1 were included in the study. The mean age of male victims was greater than that of female ones (P=0.01). Of victims, 821(46.3%) were single and 807(45.5%) were unemployed/housewife. Methods of suicide were hanging in 962(54.6%), poisoning in 640(35.8%), falling in 88(5%), burning in 35(2%), shooting in 29(1.6%) and others in 19(1%) cases. Of poisoned cases, 283(44%) were victims of aluminum phosphide ingestion. Generally, frequency of married victims was greater than single ones but by comparing genders, relative frequency of single victims was greater among males (P<0.001). There was statistically significant association between suicide methods and age (P=0.001), gender (P<0.001), and occupation (P<0.001) of victims. Among different methods, shooting and poisoning were used by the youngest cases. Relative frequency of females was greatest in victims of burning and poisoning. Regarding occupational categories, poisoning was most frequent in students.Conclusion: In this study, the majority of successful suicides happened in people with occupational uncertainty, thus preventive measures should prioritize this issue. It seems that women with marital problems are also prone to suicide and social support programs should target this group, too. Association between the method of suicide and demography of victims will help us to recognize common methods in various groups of the society and establish appropriate preventive measures. While limiting access to supplies of suicide (like legislation on distribution of drugs for prevention of poisoning) is valuable, fundamental interventions at community level will be more effective in prevention of all kinds of suicide

Gender Identification Based on the Parameters of the Sternum Bone in the Cadavers

Background: Identifying identity in the absence of large bones becomes more difficult and complicated; accordingly, it is highly beneficial to use the features of the sternum. The present study aimed to evaluate the dimensions of the sternum and its relation with gender in the Iranian population.Methods: This cross-sectional study was conducted on 200 cadavers (100 men and 100 women). By performing an autopsy, the sternum bone was first cut in the midline using a vibrating saw, and the different dimensions were measured using a caliper.Results: Among different dimensions related to the sternum, the mean length of manubrium, mesosternum, the largest width of manubrium, and the shortest width of manubrium were significantly higher in men compared to women. Regarding the value of each sternal diameter in discriminating male and female gender, the highest discriminative value was specified to the shortest width of manubrium (cutoff: 26.75, sensitivity: 100%, specificity: 84.0%), followed by the length of sternebrae 1 (cutoff: 8.45, sensitivity: 76.0%, specificity: 21.0%).Conclusion: Measuring various indices of sternum bone, particularly the shortest width of the manubrium and the length of sternebrae 1, leads to gender identity accurately

Estimating Stature and Gender by the Length of the Third, Fourth, and Fifth Fingers of Dominant Hand in Iranian Adults

Background: Stature and gender are essential parameters of forensic anthropology. Moreover, their estimation is critical for medico-legal investigations to identify unknown remains. The present study aimed to estimate stature and gender by the anthropometric dimensions of the Iranian population’s third, fourth, and fifth fingers.Methods: In this cross-sectional study, 199 individuals (99 men & 100 women) were included. Individuals’ demographic information was recorded. A caliper measured the length of the fingers. An anthropometer was used for the measurement of stature. The obtained data were analyzed using SPSS. A multivariate linear regression test was used to predict the stature of individuals based on finger length.Results: In males and females, a solid and positive direct relationship was observed between the length of the third, fourth, and fifth fingers of the hand with the stature of individuals and between the length of the fingers with each other. In the coefficient table of the regression model of this study, in males, the length of the fingers was not predictive of stature, and only the length of the third finger in females had a predictive effect on stature.Conclusion: According to the obtained results, stature is predictable in women through the third finger length using the derived regression equation

Survey of Factors that Affect the Arteriovenous Fistulas Survival in Semnan and Mahdishahr, Iran

Background: First step in chronic dialysis is establishing a suitable dialysis access. Arteriovenous fistula (AVF) has been known as the gold standard for hemodialysis; and due to complex interaction of factors that affect thesurvival time of fistula, we decided to evaluate survival time and affective factors among the dialysis patients.Methods: In a historical cohort study, we analyzed 52 patients of the Semnan and Mahdishahr Dialysis Centers. The data recorded by history taking and physical examination.Results: The survival of fistula was 83%, 80%, 67%, and 40% after 1, 3, 5, and 10 years respectively. Our results showed that the survival time of fistula was higher among patients with left-side AVFs. Factors such asage, gender, underlying disease, dialysis session per week, the time that patients started dialysis after installing fistula and fistula infection did not statistical significant affect the survival time.Conclusions: The survival time of AVF among dialysis patients of Semnan and Mahdishahr is satisfying, and installing the fistula in left hand lead to higher survival

Research Paper: Gender Identification With Knee Bicondylar Width and Vertical Diameter of the Femur Head Based on Radiography Assessment

Background: Some skeletal criteria especially for bones of lower limbs are considerably different between men and women that may help in identifying the gender. We studied two lower limbs parameters, i.e. bicondylar width and vertical diameter of the femoral head based on radiographic assessment in gender identification.Methods: Bicondylar width and vertical diameter of the femoral head of 280 radiographs taken from people aged 30 to 75 years were measured. Additionally, gender and age subgroups were recorded and added to the measured anthropometric parameters in the checklist of the study.Results: The mean width of both left and right bicondylar bones as well as vertical diameter of both left and right femoral heads were significantly different between men and women. Considering two parameters of bicondylar width and vertical diameter of femoral head, the measurements could differentiate gender, with 96.7% sensitivity, 72.2% specificity, and 96.0% accuracy.Conclusion: By measuring bicondylar width and vertical diameter of the femur head, it is possible to determine gender with a high discriminative capability

Investigating Emergency Nurses’ Awareness on the Differentiation Between Acute Methanol and Ethanol Intoxication

Background: Alcohol intoxication is among the leading and preventable causes of death, disability, and injury in numerous societies. Ethanol and methanol are the most commonly used types of alcohol. Increasing nurses’ awareness about the difference between intoxication with these two alcohol types will prevent the occurrence of dangerous and deadly complications of intoxication. We investigated the awareness of the nurses respecting the difference between acute methanol and ethanol intoxication in clinical manifestations, diagnosis, and treatment.Methods: A cross-sectional study was performed in 2020 on the emergency nurses from two educational hospitals. A total of 100 nurses participated in this study. The data collection tool was a researcher-made questionnaire, including demographic characteristics and questions concerning the identification and differentiation of acute methanol from ethanol intoxication. Moreover, the obtained data were analyzed using SPSS v. 20 at the significance level of P<0.05. Results: The present research results suggested that 21% of the examined nurses had a low level of awareness (<7) and 79% had a moderate level of awareness (8-13). The mean score of awareness was measured as 8.71 (range: 2-12). Nurses’ awareness was not related to age, gender, the duration of working experience, and educational level (P>0.05).Conclusion: The awareness of nurses regarding alcohol poisoning is moderate. Due to the importance of differentiating ethanol from methanol toxicity, considering the outcomes of the patients, nurses’ awareness should be increased

The Value of Foramen Magnum Diameters for Gender Identification Among Iranian Population

Background: By assessing the size of the foramen magnum, it is possible to distinguish two genders, as well as the intergenerational interdependence of the affected individuals. The present study aimed at assessing the value of diameters of foramen magnum for gender identification among the Iranian population.Methods: This analytical comparative cross-sectional study was performed on 200 Iranian cadavers (100 men and 100 women) referred to Kahrizak Autopsy Hall in Tehran between 2017 and 2018. In each case, the foramen magnum was measured by observation and its parameters were measured in a longitudinal anteroposterior and transverse diameter, using a calibrated caliper.Results: The Mean±SD anterior-posterior diameter of the foramen magnum in men and women were 35.59±0.49 mm and 33.90±1.07 mm, respectively, which was significantly higher in men (P<0.001). Similarly, the Mean±SD transverse diameter of the foramen magnum in males and females was 29.49±0.56 mm and 28.5±0.50 mm, respectively, which was significantly higher in men (P<0.001). Based on the area analysis under the Receiver Operating Characteristic (ROC) curve, the anterior-posterior and transverse diameters of the foramen magnum had a high value in the differentiation of the male and female genders (AUC=0.953 and 0.896, respectively, P<0.001). The Mean±SD foramen magnum index in men and women was 84.15±3.02 and 82.87±1.95, respectively, which had a significant difference between the two genders.Conclusion: Given that the anterior-posterior and transverse diameters of the foramen magnum in Iranian men are far more than Iranian women, these diameters can be used to distinguish between the two genders in the precise legal field