Forensic medicine 2

1. Forensic medicine 2

5. Sudden infant death syndrome (SIDS): occurs between 1 month and 1 year of age, with a peak incidence at 3 to 4 months. The cause is unknown, but may relate to delayed neurologic development. The rate varies from about 0.5 to 5 per thousand livebirths.

6. it can be decreased if the baby does not sleep prone, as shown here with the doll in the lower frame. The baby should sleep on its back.

7. Carbon monoxide poisoning : is a form of asphyxia that results when CO is inhaled, diffuses across alveoli, and binds tightly to hemoglobin. Poorly ventilated houses with faulty heaters, housefires, and motor vehicle exhaust are the most common sources.( incomplete burn) small atmospheric concentrations of CO are dangerous, because CO binds to hemoglobin 200 times more than oxygen.

9. Hypothermia When core body temperature falls below 35 C. Cardiac shock and arrhythmia follows. Most common in: alcoholics , infants , old age. There are no specific gross or microscopic findings with this condition.

10. Hyperthermia In a heat-related death, core body temperature is found to be at or above 40.6 C . Occur from exposure to high environmental temperature. Affect mostly infants and old aged.

11. Thermal burn injuries From fire: The treatment and prognosis depend on the total body surface area (TBSA) involved, age of the patient, underlying diseases, and the presence of an "inhalation injury" from breathing in hot gases, which typically occurs with fires in an enclosed space such as a building.

14. Electrical injury Factors affecting the occurrence of electrical injury: Type of current , AC or DC ( AC more dangerous). Strength ( voltage) Path of current , if it pass brain or heart. Duration of contact , longer lead to more damage. Contact surface area , Larger is worse.

15. Cause of death from electrical injury: Ventricular fibrillation Respiratory failure. Mechanical asphyxia.

17. Cerebral edema with altitude sickness

18. Drug abuse and poisoning

19. Drug paraphernalia The key part of forensic pathology is the scene investigation. The appearance of the scene of injury or death it can help you to explain how the injuries occurred or provide evidence for prosecution of criminals. The "works" of an intravenous drug user are demonstrated here. A key part of forensic pathology is scene investigation. The appearance of the scene of injury or death can help explain how the injuries occurred or provide evidence for prosecution of criminals.The "works" of an intravenous drug user are demonstrated here. A key part of forensic pathology is scene investigation. The appearance of the scene of injury or death can help explain how the injuries occurred or provide evidence for prosecution of criminals.

20. Cocaine in stomach The bags of cocaine in the stomach were swallowed by the victim as a form of concealment. This method is also used by persons smuggling drugs. The container ruptures or leaks, and a drug overdose ensues, as happened here. The bags of cocaine seen here in the stomach were swallowed by the victim as a form of concealment. This method is also used by persons smuggling drugs. A latex condom is typically used as a container. Occasionally, the container ruptures or leaks, and a drug overdose ensues, as happened here. The bags of cocaine seen here in the stomach were swallowed by the victim as a form of concealment. This method is also used by persons smuggling drugs. A latex condom is typically used as a container. Occasionally, the container ruptures or leaks, and a drug overdose ensues, as happened here.

21. Hand with laceration The hand of a person with a cocaine intoxication who entered a state of (excited delirium) and began breaking doors and windows, leading to the appearance of the lacerations and blood on the fingers. Trauma can be produced in a variety of ways. Here is the hand of a person with a cocaine intoxication who entered a state of "excited delerium" and began breaking doors and windows, leading to the appearance of the lacerations and blood on the fingers. Trauma can be produced in a variety of ways. Here is the hand of a person with a cocaine intoxication who entered a state of "excited delerium" and began breaking doors and windows, leading to the appearance of the lacerations and blood on the fingers.

22. Skin of antecubital fossa and dermal hemorage at injection site The subcutaneous hemorrhage in the antecubital fossa at the elbow, revealed by multiple incisions made at the time of autopsy, is evidence that was an injection site for drugs. The subcutaneous hemorrhage in the antecubital fossa at the elbow, revealed by multiple incisions made at the time of autopsy, is evidence that this was an injection site for drugs.The subcutaneous hemorrhage in the antecubital fossa at the elbow, revealed by multiple incisions made at the time of autopsy, is evidence that this was an injection site for drugs.

23. Skin popping The white circular and irregular scars are from "skin popping" or subcutaneous injection of drugs of abuse. Complications include abscess formation, skin necrosis, and possible pneumothorax if an injection site over the thorax is used. The white circular and irregular scars are from "skin popping" or subcutaneous injection of drugs of abuse. Complications include abscess formation, skin necrosis, and possible pneumothorax if an injection site over the thorax is used. The white circular and irregular scars are from "skin popping" or subcutaneous injection of drugs of abuse. Complications include abscess formation, skin necrosis, and possible pneumothorax if an injection site over the thorax is used.

24. Alcohol consumption Alcohol is metabolized at a constant rate of 11-22 mg/dL/hr by alcohol dehydrogenase in the liver. If blood ethanol concentration has reached 100 mg/dL the alcohol dehydrogenase enzyme system is saturated, and ethanol consumption will increase the blood concentration. The most common form of fatal drug overdose is ethanol ingestion The "Soggy Dollar Bar" at Jost Van Dyke in the B.V.I. is itself an illustration of the kinetics of alcohol (ethanol) metabolism. The drinks are served at a constant rate, no matter how many boats anchor and patrons swim ashore. Likewise, alcohol is metabolized at a constant rate of 11-22 mg/dL/hr by alcohol dehydrogenase in the liver. In general, once the blood ethanol concentration has reached 0.1 gm% (100 mg/dL, or 100 mg%, or 0.1 g/dL), the alcohol dehydrogenase enzyme system is saturated, and further ethanol consumption will increase the blood concentration. In most states in the U.S. and many other countries, legal intoxication while driving a vehicle is defined at 0.08%. Some degree of impairment can begin at 0.03%, and reaction times are impaired above 0.07%. Above 0.3%, stupor and coma can occur, and deaths may result from levels above 0.4%. The most common form of fatal drug overdose is ethanol ingestionThe "Soggy Dollar Bar" at Jost Van Dyke in the B.V.I. is itself an illustration of the kinetics of alcohol (ethanol) metabolism. The drinks are served at a constant rate, no matter how many boats anchor and patrons swim ashore. Likewise, alcohol is metabolized at a constant rate of 11-22 mg/dL/hr by alcohol dehydrogenase in the liver. In general, once the blood ethanol concentration has reached 0.1 gm% (100 mg/dL, or 100 mg%, or 0.1 g/dL), the alcohol dehydrogenase enzyme system is saturated, and further ethanol consumption will increase the blood concentration. In most states in the U.S. and many other countries, legal intoxication while driving a vehicle is defined at 0.08%. Some degree of impairment can begin at 0.03%, and reaction times are impaired above 0.07%. Above 0.3%, stupor and coma can occur, and deaths may result from levels above 0.4%. The most common form of fatal drug overdose is ethanol ingestion

25. Methanol poisoning Methanol is metabolized at one-fifth the rate of ethanol, making it more toxic. Acute methanol poisoning is characterized by weakness, nausea, vomiting, headache and epigastric pain, but not typically inebriation and metabolic acidosis occurs. The toxic metabolites damage the retina, and permanent blindess may result from ingestion of only 10 mL, while fatalities occur with as little as 30-60 mL and lethal blood levels occur at 80 mg%. Administration of fomepizole (an inhibitor of alcohol dehydrogenase) or ethanol as a competitive binder to the enzyme, is used to treat methanol poisoning. Methanol poisoning is not common and is usually accidental. Methanol is metabolized at one-fifth the rate of ethanol, making it more toxic. Acute methanol poisoning is characterized by weakness, nausea, vomiting, headache and epigastric pain, but not typically inebriation. Metabolic acidosis occurs. The toxic metabolites damage the retina, and permanent blindess may result from ingestion of only 10 mL, while fatalities occur with as little as 30-60 mL. Lethal blood levels occur at 0.08% (80 mg%). Administration of fomepizole (an inhibitor of alcohol dehydrogenase) or ethanol as a competitive binder to the enzyme, is used to treat methanol poisoning. Methanol poisoning is not common and is usually accidental. Methanol is metabolized at one-fifth the rate of ethanol, making it more toxic. Acute methanol poisoning is characterized by weakness, nausea, vomiting, headache and epigastric pain, but not typically inebriation. Metabolic acidosis occurs. The toxic metabolites damage the retina, and permanent blindess may result from ingestion of only 10 mL, while fatalities occur with as little as 30-60 mL. Lethal blood levels occur at 0.08% (80 mg%). Administration of fomepizole (an inhibitor of alcohol dehydrogenase) or ethanol as a competitive binder to the enzyme, is used to treat methanol poisoning.

26. Poisoning at home Poisoning: Children are most often affected by poisoning and child can grab and ingest or swallow a toxic substance in just a few seconds. Iron: Iron may contain 325 mg of ferrous sulfate per tablet and lethal dose is 300 mg/kg, so only 10 tablets may kill an infant.

27. lead: it is found in plumbing pipes, paint (in old houses), poorly glazed pottery, and the atmosphere from industry and leaded gasoline. Ingested or inhaled lead accumulates in bone, blood, and soft tissues, but toxic effects are primarily the result of neurologic impairment from demyelinating injury to neurons, especially in children. Other heavy metals, such as arsenic and mercury, also can cause neuropathy.

28. Chlorinated Hydrocarbons: are minimally toxic to humans, but they accumulate in the environment, enter into the food chain, may be ingested by humans, and can lead to CNS depression. Organophosphates: is acetyl-cholinesterase inhibitors that do not persist long in the environment but are capable of producing more acute disease including paralysis, arrhythmia, and respiratory failure.

29. Special thanks to our supervisor: Prof. Aiman Zaher