- 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

- Identification (2).

4•Age estimation:

A- from skull :

- dimensions:-

-eg , at full term

• circumference =13 inches
• length =5 inches
• width = 4 inches

- fontanelles closure :-

• Anterior fontanelle close at 2 years.
• posterior fontanelle close at 9 months (full term).

- suture fusion.


B- from union of the epiphysis:

- Sex has to be taken into account as;bone development and epiphyseal
fusion is different between the sexes.

- The pattern of fusion of bone ends (epiphysis) to bone shaft (metaphysis) in each bone indicates age.

C- from ossific centers of the bones.

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

5•RACE DETERMINATION:

- The skull is the only reliable bone.

• Caucasian (all whites)
• Negro (all blacks - African, American, Negroes and West Indians)
• Mongoloid (Chinese, Japanese, American Indians)

- Thus skulls of British, Germans, French or
Swedes cannot be distinguished from one another.
- Similarly Japanese skulls are similar to Chinese skulls.

see identification (1) here...

see identification (3) here...

see identification (4) here...

- Identification (1).

Identification( الإستعراف)

-Def:- recognition of a person (living or dead) through certain characters that
differentiate him from all other persons.

-Include :-

• Skeletal remains( Bony collection),
• Identification of the living person,
• Identification of the dead body or part of dead body.

-Identification of Skeletal remains( Bony collection)

1•Are the remains human or animal?

- If complete bone....by anatomical features.

- If piece of bone (where there is no anatomical features) do Precipitin test.

-N.B:- Precipitin test:-

• Crushing a small piece of bone & suspending it in saline.
• The saline extraction is examined against human antiserum.
• This test not working with burned bone due to destruction of proteins.

2•How many bodies? ( Number of persons)..

Through:

- Repetition of the same single bones

e.g (2 skulls,2 mandibles,2 sternii..etc).

- Different sex ,age,race,Postmortem interval.

3•sex differentiation:

A) From height of long bone.

B) Based on appearance of :-

Skull,Mandible,Sternum, Pelvis,Hip bone,sacrum.

Before puberty:- It is impossible to differentiate

the sex from bone.As sexual characters aren't manifested yet.

After puberty:-It is possible to differentiate the sex from bone.

A) From height of long bone.

• By the height of the bone we can suggest sex.
• By using Karl Pearson's formula: -

Femur= 25% of height.
Humerus = 18% of height.

-Skull :

-Mandible:-

-Sternum:-

- Hip bone :-

- sacrum :

see identification (2) here...

see identification (3) here...

see identification (4) here...

-Plummer-Vinson Syndrome.

Plummer-Vinson Syndrome

- Synonyms:-

Chronic Pharyngo-oesophagitis or Patterson-Brown-Kelly's disease.

-Definition:-

Chronic inflammation of the mucous membrane of the hypopharynx and upper oesophagus.

-Aetiology:-

Unknown, may be iron deficiency anaemia, vitamin deficiency or autoimmune.

- Incidence:-

Commonly in females above 40 years.

-Pathology:-

Atrophic mucosa and submucosal fibrosis leading to formation of webs.

-Clinical picture:-

Symptoms: gradual progressive dysphagia.

Signs:-

• Angular stomatitis with fissured angles of the mouth
• glossitis: (smooth glazed dry tongue)
• glazed atrophic mucosa of the hypopharynx and upper oesophagus with mucosal webs
• splenomegaly
• spooning of the nails (Koilonychia).

-Investigations:-

• Blood picture shows hypochromic microcytic anaemia.
• Gastric secretions: achlorohydria due to atrophic gastritis may be caused by vit. B12 deficiency.
• Hypopharyngoscopy: web formation and stenosis.

- Complications:-

• Submucosal fibrosis leading to web formation and stenosis.
• Pre-cancerous leads to Post-cricoid carcinoma.

-Treatment:-

• Iron and vitamin B complex by injection.
• Repeated endoscopic dilatation.
• Regular follow up to detect early post-cricoid carcinoma.

Return to list of medical syndromes here.

- Herpes zoster oticus (Ramsey- Hunt syndrome).

Herpes zoster oticus

(Ramsey-Hunt syndrome)

-Aetiology:-

• herpes zoster viral infection of the geniculate ganglion of the facial nerve.
• It is caused by reactivation of herpes zoster virus that has previously caused chickenpox in the patient.

-Clinical picture:-

• Pain in and around the ear
• vesicles on the auricle and in the external auditory canal
• Lower motor neuron facial nerve paralysis due to affection of the geniculate ganglion of the facial nerve.
• May be associated with sensory-neural hearing loss and vertigo due to affection of the cochleo-vestibular nerve (Ramsey-Hunt syndrome).

-Treatment:-
1.Anti-viral therapy as acyclovir (oral and local).
2.Corticosteroids (oral and local) in severe cases with affection of the facial and or cochleo-vestibular nerves.

Return to list of medical syndromes here