Friday, January 30, 2009

- Aerosol Arabic - Free Gaza.

The latest mural from Mohammed Ali

(aka Aerosol Arabic)

is a public graffiti mural for the people of Gaza

in the streets of Birmingham, England on

January 4th 2009.

watch the video..





Mohammed Ali (AerosolArabic) on CNN...




Wednesday, January 28, 2009

- Stapedectomy.


**Stapedectomy**


-Def :-

is a surgical procedure of the middle ear

performed to improve hearing.

-Indications:-

  • Conductive deafness due to fixation of stapes (Otosclerosis)
  • Air bone gap of at least 40 dB.
-Contraindications:-

  • Poor general condition of the patient.
  • Only hearing ear.
  • Poor cochlear reserve as shown by poor speech discrimination scores.
  • Patient with tinnitus and vertigo.
  • Presence of active otosclerotic foci (otospongiosis) as evidenced by a positive flemmingo sign.
  • Conductive deafness due to Ehlers-Danlos Syndrome (EDS).
- Complications of stapedectomy:-

  • Facial palsy.
  • Vertigo.
  • Vomiting.
  • Floating foot plate.
  • Tympanic membrane tear
  • Dead labyrinth
  • Labyrinthitis.
-surgery:-

*Preoperative:-

The patient will have a hearing test just prior

to or during admission to the hospital.

*The day of surgery:(technique):

Surgery can be done under local ansesthesia or

general anesthesia.

We prefer to use general anesthesia, i.e. the patient

is asleep during the operative procedure.

During the operative procedure the eardrum is gently lifted,

the diseased and fixed stapes is removed.

Next, a prosthesis is put in place.

The eardrum is gently put back into place and held

there by absorbable packing ointment.

*Postoperative:-

After awakening from anesthesia, the patient is

returned to his room and is usually discharged

the next morning. During this immediate post-operative

period, it is important NOT to blow the nose and

not to get the ear wet until the ear has completely healed.

This video is an Stapedectomy by Dr. Bliouras Konstantinos.




enjoy, see you...

-Seven basic types of smokers (By Russell).

Seven basic types of smokers  (By Russell)
-If you understand why you smoke, you will have a better chance to adopt appropriate strategies to stop your smoking behavior.

-According to motives for smoking smokers are:

1-sedative smokers:
As comfort in the face of unpleasant feelings or to relieve tension ....

2-Stimulative smokers:
To help thinking, increase concentration and overcome monotony .

3-psychsocial smokers:
As crutch to increase their confidence.

4-Sensory smokers:
Just satisfaction of feeling of a cigarette in mouth or fingers.

5-Indulgent smokers:
Use it for actual pleasure of smoking or to heighten enjoyment of an already pleasurable moment .

6-Addictive smokers:
To avoid the severe withdrawal symptoms of stopping .

7-Automatic smokers:
They Light cigarettes automatically whenever they face any situation.

Plz, kill yourself away from us...........

- Different forms of tobacco .

**Different forms of tobacco**

1-cigarettes:-
The most popular form allover the world.


(Source:-wikipedia)
 
2-Bidi: (0.5 gm of dried tobacco leaves)
  • hand made , in the form of rolls.
  • In : India , Bangladesh , Indonesia and Thailand.

(Source:-bullybeef)
 
3- Cigar :-
  • Made of cured tobacco leaves and surrounded by dried tobacco leave.
  •  During smoking , the burning end is introduced into the mouth.
  • In India and Latin America. (e.g Cuba)


(Source:-wikipedia)
 
4- Goza ,Hook-ah ,Hubble-bubble:
-There is burning of tobacco mixed with molasses and the resulting smoke passes through water before being inhaled.
-Usually practiced in groups (parties).
-prevalent in :

  • EGYPT and  El-sham (Goza , Hubble-bubble)
  • India and Pakistan (Hook-ah)



5-Tobacco chewing:


  • Practiced in Afghanistan , India ( usually by females for teeth cleaning).
  • In Africa especially Sudan and Gabon.


6-Snuff : 
  • The tobacco is used in the form of powder.
  • It Either inhaled by nose or kept () lower lid and  gum.
  • Practiced in India and Sudan.

(An_Antique_Pair_of_Snuffers .. Source:-wikipedia)


7-pipe: 

  consist of a chamber in which the substance to be smoked is placed, a stem and a mouthpiece through which the smoke is inhaled.

 


N.B:-
*Snuff  andTobacco chewing is smokeless form.
*Other forms produce smoke.

 Dr Ibrahim

Sunday, January 25, 2009

- Some Types of prints.

- Really there are many types of prints which help

in identification of individuals allover the world,

especially in the field of forensic medicine and crimes.

- We will take a quick review about some of them:

1- Fingerprints..from here.

2-DNA fingerprinting...from here.

3-Foot prints:

- are the impressions or images left behind by a

person walking made by sole of the foot and


skin pattern of toes and heel.

- WE can collect important information from them

that helps tell about the person that left them behind.

-Information concerning the approximate height of the

person and possibly the walking habits of the person

are two pieces of information that can prove useful

in a criminal investigation.

4-palm prints.

5-Iris print (recognition):

-Are used to screen individuals who are trying to gain

access to more highly secure places or accounts,

not to scan the general public at random.

-By using camera technology, with subtle infrared

illumination reducing specular reflection from

the convex cornea, to create images of the detail-rich,

intricate structures of the iris. Converted into

digital templates, these images provide

mathematical representations of the iris that yield

unambiguous positive identification of an individual.

6-Retinal print:the same idea of iris.

6-Voice print:

-The fact that voice follows a particular pattern,

whatever the language spoken.

- The FBI is trying to develop a system that

could make your voice as unique and recognizable

as your fingerprint called FASR system.


7-Ear print:

Burglars often listen at windows and doors,

leaving an earprint behind, which, just like

a finger print, can be used to trace them.

Ears are unique in size, shape and structure.

Scientists use these traits to develop biometric

scans of the ear. In ear scans, a camera creates

an image of the ear that is analyzed for

identifying characteristics.

8-Thermal footprint:

our bodies emit thermal energy which by special systems

can recognize the persons after their presence

in some places e.g scene if the crimes.


9- Air sinus print:

Pattern of skull's frontal air sinuses ,Outline is

unique and comparisons with antemortem X-rays are useful.

10-Lip print:-

lip print identification is generally acceptable

within the forensic science as a means of positive

identification because it appears in the scene of the crime.


see you, Dr Ibrahim

Sunday, January 18, 2009

- Gastric Lavage.

- Gastric lavage:- also commonly called Stomach wash or Gastric suction, is the process of cleaning out the contents of the stomach. It has been used for eliminating poisons from the stomach.

- Indications:-
  1. With patient has ingested a potentially life-threatening amount of a poison and the procedure can be undertaken within 60 minutes of ingestion.
  2. Cleaning the stomach before an upper endoscopy in someone who has been vomiting blood.
  3. Collecting stomach acid for tests.
  4. Relieving pressure in someone with a blockage in the intestines.
- Contraindications :-
  1. Loss of airway protective reflexes, such as in a patient with a depressed state of consciousness.
  2. Ingestion of a corrosive substance such as a strong acid or alkali.
  3. Ingestion of a hydrocarbon with high aspiration potential.
  4. Patients who are at risk of hemorrhage or gastrointestinal perforation due to pathology, recent surgery, or other medical condition, that could be further compromised by the use of gastric lavage.

- Complications:-
  • Aspiration pneumonia.
  • Laryngospasm.
  • Hypoxia and hypercapnia.
  • Mechanical injury to the throat, esophagus, and stomach.
  • Fluid and electrolyte imbalance.
  • Struggling patients may be at greater risk of complications

- Technique:-
  1. Gastric lavage involves the passage of a tube via the mouth or nose down into the stomach, followed by sequential administration and removal of small volumes of liquid.
  2. The placement of the tube in the stomach must be confirmed either by air insufflation while listening to the stomach, by pH testing a small amount of aspirated stomach contents, or x-ray. This is to ensure the tube is not in the lungs.
  3. Lavage is repeated until the returning fluid shows no further gastric contents.
  4.  If the patient is unconscious or cannot protect their airway then the patient should be intubated before performing lavage.
- Finally there are two videos which learn you how to perform gastric lavage...

1- video: Nasogastric Intubation from New England Journal of Medicine..

2- video: see this video...
Dr Ibrahim

Saturday, January 17, 2009

- Sir Hershel -1858 .



Sir William Herschel, Chief Magistrate of the Hooghly

district in Jungipoor, India, first used fingerprints on

native contracts.

On a whim, and with no thought toward personal

identification, Herschel had Rajyadhar Konai, a local

businessman, impress his hand print on a contract.




The idea was merely "... to frighten [him] out of

all thought of repudiating his signature." The native was

suitably impressed,

and Herschel made a habit of requiring palm prints

--and later, simply the prints of the right Index and

Middle fingers--on every contract made with the locals.

Personal contact with the document,

they believed, made the contract more

binding than if they simply signed it.

Thus, the first wide-scale, modern-day use

of fingerprints was predicated,

not upon scientific evidence,

but upon superstitious beliefs.

As his fingerprint collection grew,

however, Herschel began

to note that the inked impressions could,

indeed, prove or disprove identity.

While his experience with fingerprinting was

admittedly limited, Sir Herschel's private

conviction that all fingerprints were

unique to the individual, as well as permanent

throughout that individual's life,

inspired him to expand their use.

Source here....

Monday, January 12, 2009

- DNA fingerprinting.


- The chemical structure of everyone's DNA is the same.

- The only difference between people (or any animal)

is the order of the base pairs.

- There are so many millions of base pairs in each

person's DNA that every person has a different sequence.

-There are high diversity due to presence of non encoding

areas in the strand either in the genetic area

or outside it see here...

- Using these sequences, every person could

be identified by the sequence of their base pairs.

- Each person has a unique DNA fingerprint,

except monozygous (identical) twins.

- DNA fingerprint is the same for every cell,

tissue, and organ of a person. It cannot be

altered by any known treatment. Consequently,

DNA fingerprinting is rapidly becoming the primary

method for identifying and distinguishing among

individual human beings.

- These patterns do not, however, give an

individual "fingerprint," but they are able to

determine whether two DNA samples are from the

same person, related people, or non-related people.

Scientists use a small number of sequences of DNA

that are known to vary among individuals ,

and analyze those to get a certain probability of a matching.

------------------------------------------------

**Practical Applications of DNA Fingerprinting**



1. Paternity and Maternity :

when a father deny that a certain child is belonging

to him Or tow sets of parents claim on one child.

2. Criminal Identification and Forensics:

- In living (strong evidence of involvement

in assault,rape, disputed paternity)

as DNA isolated from blood,hair, skin cells,

or other genetic evidence left at the scene

of a crime can be compared with the

DNA of a criminal suspect .

- In Dead (DNA survives in bone for many years,

comparison of DNA with family members)

3. Personal Identification .

Enjoy it,see you,

Ibrahim

Sunday, January 11, 2009

- DNA strucure and terminology.

Chromosomes are thread-like structures located inside the nucleus of cells. Each chromosome is made up of DNA tightly coiled many times around proteins called histones that support its structure.

see the picture which illustrate that also show the true genetic content & non genetic areas....

Promoters: are DNA sequences adjacent to the beginning of the genes and control gene activation.
 
Introns are sequences inside the gene although they do not code for protein sequence they are necessary for correct coding.
 
Exons are the regions inside the gene between introns that contain the coding DNA sequences. 
 
Most of the harmful mutations occur in exons and as a consequence change the structure of the coded protein.
 

Friday, January 9, 2009

- Fingerprints.



-friction skin (i.e. palms and soles) have a

impressions due to presence of ridges & grooves .

- These impressions made by dermal papillae in the dermis.

- Finger prints appear in the 4th month intrauterine life.

-Sweat glands open through minute openings on the

summits of the ridges. The sweat contains fat.

- When the skin is applied to a glistening

non-absorbable
surface an impression is left behind.


Principles of fingerprint identification :

-fingerprint patterns are unique

(1 in 64 billion chance of 2 prints being identical).

-FBI has over 100 million records, no two of which are alike.

-Fingerprint pattern of an individual remains

unchanged throughout life.

-Reversible atrophy occurs in certain diseases

(coeliac disease, dermatitis).

- Some people have some skin diseases which

prevent normal formation

of fingerprints (may be genetically ).

-Permanent impairment occurs in leprosy and after

exposure to radiation.

-Attempts to mutilate fingerprints are sometimes made.

- If only the epidermis is destroyed there is no

alteration in ridge pattern.

-If dermis is destroyed additional points of

identification are created.

Types:

1-Arches.

2-Loops.

3-Whorls .

4-composite: of more than one type
.


-----------------------------
poroscopy
Def: study of the pores of the sweat glands which
present at the ridges of the prints.


Position of the pores requires higher resolution scanner.

---------------
N.B: There are artificial finger prints which
used by criminals for misleading.

see you,
Dr Ibrahim

Sunday, January 4, 2009

- IDENTIFICATION (4).

IDENTIFICATION OF THE DEAD

Through:
  • Primary Physical Characteristics
  • Secondary Physical Characteristics
  • IDENTITY of DECOMPOSED or SKELETAL REMAINS
1- Primary Physical Characteristics:

- characteristics which are very difficult for a person to change during life.
Some of these characteristics will appear to alter postmortem:

-Sex.
-Age :- external appearances, internal degenerative disease, bones, joints.
-Height or stature :-
N.B. height of Body differs from that in life by up to 2-3 cm, due to joint and muscle relaxation.

-Weight :- Body often appears of different build to that in life
-Race.
-DNA (unique to every individual.)
-Fingerprints

2- Secondary Physical Characteristics:

-characteristics which can change during life,either deliberately by deceased or as a result
of medical/dental interference.
-Some of these characteristics will appear to alter postmortem:-

-Skin colour (alters post mortem).
-Eyes :- more useful in caucasians than negroid & mongoloid races.
Colour can alter PM
-Teeth :- very resistant and bear much useful information.
-Hair :- colour, style, length, beard/moustache.
-Scars :- surgical procedures and prostheses.

-Tattooing :- seen even if the body is putrefied.

-External peculiarities :- circumcision, moles, warts.
-Deformities.
-Clothing and other objects as Jewelery,Cosmetics.


-------------------------------------------

IDENTIFICATION OF THE LIVING

METHODS OF IDENTIFICATION:

The above of dead +

1-Personal impression (visual identification):

Personal impression depends on features such as

hair, moustache and beard,any gait particularities,

voice characters or hand movement during speech .

2-Photography.

3-Handwriting:

-Possible for experts to identify a person .
-we can know either the person left or right handed.
-Methods used include :
  • photographic enlargement,
  • analysis of ink,
  • analysis of paper.
see identification (1) here...

see identification (2) here...

see identification (3) here...



Thank you for attention,


"The end of IDENTIFICATION"

Dr Ibrahim

Saturday, January 3, 2009

- IDENTIFICATION (3 ).

DETERMINATION OF STATURE FROM BONES

- Long bone length (femur, humerus) is proportional to height.

- There are sex, race, nutrition and personal variations to consider

- By karl pearson formula.

Humerus = 18% of stature
Femur = 25% of stature

-----------------------------

Determination of postmortem interval from bone.

- postmortem interval (PMI) : period () death & examination.

- Are they ancient or modern bones?

(i.e. greater or less than 50 years )

-Rate of skeletonisation is highly variable.

  • In the tropics a body can be reduced to a skeleton in 3 weeks.
  • Remarkable preservation of body is seen in acidic peaty soil
(e.g. "Pete Bogg" from Cheshire was 200 years old!).

Thus, environmental conditions have to be taken into account.

-Naked eye appearance is unreliable:
  • Tags of soft tissue, periosteum, ligaments etc, indicate less than 5 years old.
  • Soapy texture of surface indicates age less than a few decades.
  • Light, crumbling bones are likely to be a century or more old.
---------------------------------------
Individualizing skeletal features
  • Bone disease (Paget's disease, tumours) Previous injury to bone (fracture callus, prosthesis, metallic fragments).
  • Comparison of trabecular pattern of bone.
  • Pattern of skull's frontal air sinuses ,Outline is unique and comparisons with antemortem X-rays are useful.
- Facial reconstruction:-
  • Skull can be scanned into a computer and "fleshed" by computer reconstruction to give likely facial appearance in life.
  • Unfortunately eye colour, hair colour and lips are independent of bony structure.

- Laboratory tests –

1.precipitin test :
Immunological reaction between bone extract and anti human serum ceases within months of death.

2.If blood pigments are present bones are usually less than 10 years old.

3.Up to 20 amino acids may be identified in bones less than a century old.

4.Fluorescence of freshly sawn bone surface under UV light diminishes after 100 years.

5.New bones contain 4.0 - 4.5 gms% nitrogen; 2.5 gms% indicates approximately 350 years.

6.Radioactive carbon dating indicates which century.

see identification (1) here...

see identification (2) here...

see identification (4) here...

- New year with success..

In the name of Allah.

Year left & a new year come but we still unchanged ,

this is a big mistake ,

so the intelligent who try to change

themselves to the best as time passes.

The intelligent who throw their bad experiences behind &

start with success.

The intelligent who put the final target

in front of their eyes, but before that

they try to do the stages before the final target

" Rely on Allah then working hard"

Dr Ibrahim