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Tuesday, April 7, 2009

Determining the time of death


Determining the time of death
There are several ways to determine death time of the murder cases. Please note that while the death of the victim is arround between when the victim last seen alive in the circumstances and when the victim found dead

Marks that can be used to estimate time of death are:
- Post-mortem temperature decrease
- Livid corpse (livor mortis)
- Stiff corpse (rigor mortis)
- The process of decomposition
- Something which found during the examination in time and place of occurrence otopsi.

decomposted body

Which can be found in the examination at the scene of an accident:
a. Investigation at the scene of an accident:
- The date on the letter mail or newspapers
- The rest of the food that is found, is still good or have become.
- Degree of coagulation milk in bottle
- The state of parasites in the body of the victim, for example, head lice:
- Head lice can live on dead bodies 3-6 days, when all lice have been dead more than 6 hours
b. Investigation in outdoor
- If the plant / grass under the pale corpse appears, it means that there remains in place more than 8 hours.

What can be found at otopsi?
a. Larva fly
To estimate the time of death by determining the age flyblow in the cycle.
Condition: there can be no flyblow cocoon and fly the most.
Death time= Age at death flyblow (days) + 1 day
b. the process of food digestion in the stomach
If found stomach is not contain food, rectum full of faeces and the bladder is full, time of the victim died early in the morning and not wake up. If the stomach contains food found roughly means the victim died within 2-4 hours after last meal.
c. Hair and beard
Hair on the speed of life has grown 0.5 mm / day, and after death, it does not grow again. Beard hair examination should be done in the first 24 hours for more than 24 hours of hair and skin furrow can show more skin on the chin, so if the hair is still growing.

otopsi of woman body



There is case that should be solved by four detectives. Detective Sherlock Holmes, Poirot, Kindaichi and Conan Edogawa. On 28 January 2009 at 07.00 am, the male dead body found recumbent position. Livid corpses in the back, stiff joints all the dead body, and decaying. When was the victim die?


answer: victim was murdered, between 27/1/2009 at 1.00 pm until 28/1/2003 at 1.00 am.
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Saturday, April 4, 2009

Carcinoma Thyroid

patient carcinoma thyroid


Carcinoma Thyroid is including the violence with relatively good prognosis. Although it has been agreed that thyroidectomy is the first step must be done in carcinoma thyroid treatment, at this time there is no agreement how best form of treatment of Carcinoma Thyroid suspected malignant goitre.


Histology
According to the WHO thyroid epitel malignant divided to be:
1. follicular carcinoma
2. papillary carcinoma
3. medullar carcinoma
4. anaplastic


papillar carcinoma thyroid


Clinic
Clinical suspicion of thyroid carcinoma based on the observation that pathologies confirmed with the examination, the suspicion is divided in high, medium and low.
A. High
- Historical multiple endocrine neoplasm in family
- Rapid growth of neoplasm cell
- Hard nodule when palpated
- The area around the fixation
- Paralysis vocal cords
- enlarging lymphanody regional
- The remote metastasis
B. Medium
- Age less than 20 years old or over 60 years
- History neck radiation
- Male with solitary nodule
- Diameter greater than 4 cm and cystic
C. Low
- In addition to the above mentioned

There are Clinical symptoms frequently found
- The emphasis of organ
- Interference and pain swallow
- Difficult to breathe
- Hoarse voice
- Limphadenopathy neck

Metastasis which is most often in the lungs, bones and heart.

thyroid carcinoma prognosis depends on:
- Type of carcinoma
- metastasis or not
- Age
- Sex (number of women have a better life)
- Genecology DNA tumour


how to diagnostic



Thyroidectomy


Handling
A. Operation
- total Thyroidectomy (recommended)
- partial Thyroidectomy / nodulektomy / lubektomy
B. radiation
1. external
- for carcinoma thyroid residues with large and may not be operating
- Using cobalt-60
2. Internal
- using radioactive iodine
C. Chemotherapy
- for anaplastic carcinoma
- Using adriamisin single dose or combination with cyspaltinum
D. Hormonal
- To press the TSH allegedly had a role in stimulating proliferation of growth cells malignant

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Monday, March 30, 2009

Typhoid Fever (TIPES)

Three months ago, my job partner’s daughter got “tipes”. Whats that? If you were Indonesian people, you knew that is Indonesian name for Typhoid fever. she appeared to feel weak and sore when I touch her stomach. Is it a dangerous disease?

Typhoid fever is acute alimentary tract infections caused by bacteria. Salmonella typhi and Salmonella partyphi are bacteria that cause typhoid fever. Actually “tipes” name is taken from “tifus” , a desease caused by Ricketsia. However, caused the signs and symptoms are same, Typhoid be called tifus (the meaning of –oid is same). Typhoid fever is transmitted through the fecal-oral.

What are signs and symptoms of typhoid fever

  1. Remitten fever

Whats it mean remitten? Remitten fever is fever that shows significants variations in 24 hours without return to normal temperature. Typically typhoid fever is high temperature when after midday until night, the morning, temperature gets down. Temperature of fever getting up slowly Onset fever is 10-14 days.

  1. Abdominal pain

Why do typhoid patient get abdominal pain? Salmonella typhi has O somatic antigen and HH flagella antigen. In intestine Salmonella penetrates into ileum then catched by mononuclear cell. In Retyculoendotelial system, salmonella gets replication. Interaction between Salmonella and macrofag makes inflammation mediators. So patch of payer in intestinal wall get hyperplasia, necrosis and ulcer. It can be intestinal wound. So patient feel stomach pain.

  1. Gi tract signs

Diarrhoe, constipation, vomit. They are caused by malfunction of intestine.

  1. in second week. We can find dirty tongue, white plaque in middle tongue and red light on the tongue edge.
  2. many cases, we can find red spot on chest skin
  3. liver and spleen enlargement

treatment and therapy for typhoid

  1. bed rest, 3 weeks minimum
  2. antibiotic. Cefotaxim, chloramphenicol, erytromicin. The drug of choice is Chloramphenicol. For women who is get menorrhea, used erytromycin.
  3. Healthy carriers should be excluded from handling food.
  4. don’t eat more fiber, ex vegetables and fruit!!!!!! FORBIDDEN.

Attention

If Salmonella can inside into gallbladder, the patient can be the carrier of disease.

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