Discrimination between drug abuse and medical therapy - case report of a tranylcypromine overdose-related fatality

Tranylcypromine is an effective antidepressant from the class of monoamine oxidase inhibitors and is structurally related to amphetamine. However, reports differ regarding the potential metabolism of tranylcypromine to amphetamine and methamphetamine within the human body. We report a 25-year-old woman with severe depression who died due to a fatal tranylcypromine overdose in 2016. She had been prescribed tranylcypromine one day previously and had no history of previous suicide attempts or substance abuse. The body was transferred to a forensic medicine department in Tehran, Iran for the autopsy. A urine sample was positive for tranylcypromine, amphetamine and methamphetamine using gas chromatography/mass spectrometry after derivatisation with heptafluorobutyric acid. As amphetamines were present in the urine sample, it was assumed that the tranylcypromine had been converted to amphetamines metabolically. As such, it is possible that the legitimate use of certain prescription drugs may complicate the interpretation of test results for illegal drugs

Evaluation of blood carboxyhemoglubin level and soot in airways and its application for differentiate of antemortem and postmortem burn in charred body reffered to central legal medicine organization of IRI from 2005 -2006

With attention to high prevalence of fire death and its multiple problems for determination of death cause in charred body and differentiate antemortem from postmortem burn, make use of vitality sign, at fire, example blood carboxyhemoglubin [HBCO] level and presence of soot in air ways evaluated as indicator of antimortem burn. This study is analytic, cross-sectional that conduct in central LMO of IRI at 2005 -2006 and for this study we evaluate 47 charred fire victims, with attension of family and related members history, external examination and autopsy finding, penal recordes, definite antimortem and postmortem burn separated and then evaluate HBCO and presence of soot in victim's airways. A majority of victims 93.6% [44 cases] were male, 6.4% [3 cases] female. 59.6% [28 cases] of them were between 20-39 years old, postmortem burn 29.8% [14 cases] and antemortem burn was 40.4% [19 cases]. In victims with postmortem burn 92.9% [13 cases] have negative HBCO, and 7.1% [1 case] positive HBCO. But in cases with antemortem burn and evidence of life during fire progression 42.1% [8 cases] have positive HBCO, and 57.9% [11 cases] have negative HBCO. In cases with positive HBCO 80% [8 cases] have antimortem burn but in cases with negative HBCO 35% [11 cases] have postmortem burn. With attention to results, in cases with positive HBCO, 80% of victims [8 cases] have antimortem burn that show persons was alive during fire. But 10% of victims [1 case] has postmortem burn that it possible antimortem burn disappear with stability of burn after death. This title at reverse is not conclusive. This study shows that in victims with negative HBCO, search of other cause of death such as, homicide, natural diseases or suicide [for uses of accelerator substances] is more likely nessesary