Medicolegal aspects of deaths due to fatal traumatic heart injuries

Traumatic injuries account for the majority of unnatural deaths throughout the world with cardiac trauma being the leading cause of death among these victims. Understanding the mechanisms of injury as well as complications associated with cardiac trauma is important from both clinical and legal point of view. Traumatic cardiac injuries are considered one of the most commonly overlooked injuries in patient who died from trauma. This study aimed to investigate the cases of fatal traumatic heart injuries that had been received at morgue of Cairo during the period from January 1st 1996 to December 1st 2000. The aim was to find out the incidence of fatal traumatic heart injuries, the type of traumatic heart injuries, the causative agent, the manner of infliction in fatal traumatic heart injuries and if there is a pattern of fatal traumatic heart injuries, whether it could be possible to find out the risk factors of these injuries. In this study, the incidence of cardiac injury have constituted [183] 7.5% of all cases [2, 410] that were dissected in the same period of the study. The mean age of the cardiac injuries victims was 29.7 years. Male represent 167 [91.3%] of 183 cases whereas female represent 16 [8.7%] cases. Penetrating trauma form 171 [93.4%] of all cases, whereas blunt trauma have constitute 12 [6.6%] of all cases. The causes of cardiac injuries were: stabbing 140 [76.6%], firearm [shooting] 31 [16.9%], fall from height [5 = 2.7%], other blunt [5 = 2.7%] and traffic Accident [2 = 1.1%]. Knife was the main causal instruments represent 138 [75.5%]. Manner of death in fatal cardiac injuries was: homicide in 159 [86.9%] of cases, accidental in 15 [8.2%] of cases, suicidal in 8 [4.4%] of cases and undetermined in 1 [0.5%] of cases. The left ventricle was the most common wounded chamber. Represent 82 [44.8%] followed by right ventricles 60 [32.8%] then Right atrium 7 [3.8%] and lastly Left Atrium 2 [1.1%.] About 118 [64.5%] of cardiac injuries victims died at scene of crime and 22 [12.0%] during transportation whereas 43 [22.5%] reach hospital alive and then died. Regard Iry cases of death the isolated cardiac injury represent 157 [85.8%]. At the end of our study we noticed that cardiac Injuries are very important due to: high incidence low mean age of the victims and high prevalence of homicidal cases

Can vitamin E be used in prevention of amiodarone pulmonary and hepatic toxicity?

Sixty mature albino rats were divided equally into two test groups and onecontrol group. Amiodarone, a widely used antiarrhythmic agent, was givenorally to rats of the first test group at a dose of 40 mg/kg body weight for30 days. The rats of the second test group were given the same dose ofamiodarone in combination with vitamin E at a dose of 50 mg/kg body weightintraperitoneally for the same period. Blood urea and serum creatinine wereinsignificantly elevated in the two test groups which also showedinsignificant ultrastructural and histopathological changes in the kidneys,heart and brain. On the other hand, the statistical analysis of the values ofserum ALT, AST alkaline phosphatase and total bilirubin showed a significantelevation in the group given amiodarone alone and insignificant changes, whenvitamin E and amiodarone were given concomitantly except AST as compared withthe control group. These biochemical results coincided completely andconfirmed by the ultrastructural and histopathological findings in the liversof the two test groups. Also, amiodarone induced pulmonary toxicity wasreversed when it was given in combination with vitamin E. These resultsindicated that chronic amiodarone therapy can induce pulmonary and hepatictoxicity, which can be prevented or reduced by a simultaneous administrationof vitamin E with amiodarone. Thus, when ever possible, chronic treatmentwith this drug should be avoided or vitamin E is given in combination with thedrug to prevent its toxicity

Effect of guanfacine on kidney, heart and GABA level in DOCA and salt hypertensive rats

Experimental hypertension, was induced in rats by intramuscular injection of desoxycorticosterone [DOCA] in a dose of 50 mg/kg body weight/week for six weeks, in addition to salt in drinking water. Guanfacine was given to normotensive and hypertensive rats intraperitoneally in a daily dose of 0.09 and 0.18 mg/kg body weight for 30 days. Induction. of hypertension resulted in significant reduction in the neurotransmitter gamma aminobutyric acid [GABA] concentration in the brain, hypertrophy of the cardiac muscle and nephrosclerosis with impaired renal function. However, these histophathological and biochemical changes were paradoxically decreased after giving guarifacine in a daily dose of 0.09 mg/kg body weight for 30 days, as a result of marked decrease of blood pressure. The hypertensive rats treated with 0.18 mg/kg body weight of guanfacine for 30 days showed marked increase in the incidence and severity of cardiac and renal histopathological changes, due to the combined toxic effect of guanfacine and hypertension. The increased GABA concentration in the brain and the reduction in blood pressure after giving the drug were more significant with the low dose. In normotensive groups, rats treated with guanfacine in a daily dose of 0.18mg/kg body weight for 30 days showed moderate renal toxicity, while no biochemical or histopathological changes were observed with 0.09 mg/kg body weight of guanfacine. The two doses of guanfacine induced insignificant changes in both blood pressure and GABA concentration in the brain as compared to control non-treatment rats. Thuse law dose of guanfacine is considered more effective and safe and so it is superior to high dose in the ambulatory treatment of hypertension

Light and electron microscopic studies of rabbit lungs in fresh water drowning and near-drowning

This study was designed to investigate the light and electron microscopic changes which occur in the lung of the rabbit in case of drowning and near-drowning. Thirty male healthy adult rabbits were used in this work. They were divided into three equal groups. The first group was used as a control group. The second group was anesthetized and endotracheal tube was introduced and 6 ml/kg of fresh water was instilled into the endotracheal tube. The animals were sacrificed after 29 minutes. The third group was also anesthetized and intubated, and fresh water was instilled into the endotracheal tube. Specimens from the lungs of the three groups were taken and processed for both light and electron microscopic processes. The results showed mainly vascular damage in near-drowning and marked alveolar cell damage in case of drowning