PubMed Health⌕ Search

Biomedical subjects

M A Elfawal

Publications and source records attributed to M A Elfawal.

12 recordsLinked to original sources
PubMed2000

Sudden unexplained death syndrome.

A retrospective investigation of 51 cases of sudden unexplained death syndrome (SUDS) reported to the Medico-Legal Centre in Dammam during the period January 1995 to June 1997 was carried out. The vast majority of SUDS victims were Indians (43%). The study reports SUDS in non-East Asian subjects, including indigenous Saudis, for the first time. Autopsy examination was carried out on 22 subjects and did not reveal any significant pathological lesions which could fully explain the sudden death. However, seven cases showed mild to moderate cardiac hypertrophy (of whom two had mild to moderate coronary stenosis), and another four showed a similar degree of coronary narrowing without any evidence of myocardial hypertrophy. Severe pulmonary congestion and alveolar haemorrhage were noticed in 18 of the autopsied cases. Microbiological tests were performed on different specimens from 27 subjects and showed significant bacterial growth in seven cases. The paper reviews different hypotheses explaining SUDS and suggests areas of further study in such deaths.

Adult↗
PubMed1999

Trends in fatal substance overdose in eastern Saudi Arabia.

Two hundred and forty-nine deaths owing to substance overdose were reported to the Medico-Legal Centre, Dammam, Saudi Arabia in the 8 year period from 1990 to 1997. All cases were subject to a full forensic autopsy with toxicological and histological studies. The overall male:female ratio was 7.9:1 and males predominated in all age groups. Saudis outnumbered other nationalities and accounted for 191 (77%) of the cases. Four main categories of overdose fatalities were identified: opiates, prescribed medication, alcohol and carbon monoxide. Opiates accounted for 116 (47%) of all overdose deaths, although such fatal overdoses have been decreasing since 1993. Medically-prescribed drugs accounted for 50 (20%) of the fatalities (21 deaths from antidepressants, 19 from tranquillisers, five from hypnotics, three from paracetamol and two from amphetamines). Ethyl alcohol accounted for 27 deaths (11%) and carbon monoxide for 26 deaths (10.5%). This study shows a sharp fall in overdose fatalities in eastern Saudi Arabia during the last 5 years, which probably reflects the influence of a combined policy of strict legislations against drug trafficking and tight control over prescription of drugs.

Journal Article↗
PubMed1999

Trauma and arteriovenous malformation of the brain - a problem in medico-legal practice.

Legal difficulties can always arise when a death, owing to a pre-existing natural disease, follows trauma. Arteriovenous malformations of the brain are well known to rupture spontaneously, causing severe and often fatal cerebral haemorrhage. When such rupture is preceded by head injury, it is necessary to consider whether the rupture was coincidental or a direct result of the physical injury sustained. The standard of evidence required for criminal conviction in such cases must be 'beyond any reasonable doubt'. The present article discusses the relationship between physical trauma and cerebral arteriovenous malformation in an adult male who died following an alteration with a colleague that resulted in his being punched in the face, falling down and hitting his head.

Journal Article↗
PubMed1999

Cultural influence on the incidence and choice of method of suicide in Saudi Arabia.

The present study was undertaken to explore how racial and cultural factors could possibly influence suicidal rates and patterns in Saudi Arabia. During the 10-year period from 1986 to 1995, 221 cases of suicide were examined at the Medico-legal Center, Dammam, Saudi Arabia. The suicide rate for the entire population averaged 1.1/100,000 population per annum. The male-to-female ratio was 4.5:1. The highest suicide rate was among the age group from 30 to 39 years (44.3%), followed by the age group from 20 to 29 years (32.6%), and the lowest suicide rate was among the age group <20 years (1.8%). The rate in the group >60 years was also low (3.2%). Immigrants formed 77% of the cases, and of these, Asians accounted for 70% of the overall cases and Indians showed the highest suicidal rates (43%). The most common means of suicide chosen was hanging (63%), followed by jumping from heights (12%) and gunshot injuries (9%); death from poisoning accounted for only 6% of cases. This study showed an increasing rate of suicide during the second 5-year period compared with the first 5-year period.

Adult↗
PubMed1998

Examination and significance of 'tied up' dead bodies.

Examination of dead bodies found with parts of the body tied or bound can pose a real problem for the investigators in that it may not be possible to differentiate between suicide, homicide or accidental death. This article reports five such cases.

Journal Article↗
PubMed1997

Firearm fatalities in Eastern Saudi Arabia: impact of culture and legislation.

A study of all firearm fatalities in the Eastern Province of Saudi Arabia during the 10-year period from 1985 to 1994 is presented. The overall number of cases was 71 (0.35 per 100,000 population), of which 48% were homicides, 28% were suicides, and 24% were accidental. Most victims were young male Saudis; most were shot in the chest (41%) or the head (34%). Hand guns were responsible for all suicides, 56% of homicides, and 71% of accidental deaths. The study shows some resemblance between the homicide and suicide groups with regard to the age of victim, type of weapon used, and site of entrance wound. The findings in the present study are comparable to reports from other Middle East countries, but different from those in communities with different cultural and legislative backgrounds. Our findings may support the argument that more strict firearm legislation is helpful in limiting the number of firearm fatalities in the community.

Accidents↗
PubMed1994

An unusual case of suicidal asphyxia.

A case is presented of a psychiatric in-patient who committed suicide on the first day of admission to hospital by entrapping his neck in the hydraulic device used for raising and lowering a hospital bed. Death most likely was due to mechanical asphyxia, from persistent compression of the neck. The danger of such potential self-harming devices in psychiatric wards is emphasized.

Adult↗
PubMed1994

Sudden cardiac ischaemic death associated with systemic lupus erythematosus.

Association between systemic lupus erythematosus and coronary atherosclerosis has been reported only rarely in the medical literature. Sudden ischaemic cardiac death in such cases is an uncommon terminal event, particularly in young patients. The severity of coronary atherosclerosis in these cases may be similar to those seen in the classic coronary disease. A case of a 22-year-old female systemic lupus patient is presented in whom sudden death was found at autopsy to be due to extensive coronary atherosclerosis.

Adult↗
PubMed1994

Deaths from hanging in the eastern province of Saudi Arabia.

An analysis of cases of hanging in the Eastern Province of Saudi Arabia over a period of five years is presented. Of 61 victims investigated there was a high incidence of suicidal hanging among expatriate males of lower socio-economic classes especially Asians, and in particular, Indians. Two distinct patterns of suicidal hanging were observed in this series. The first used a seemingly popular plastic clothes line, with complete body suspension. This produced a narrow ligature mark, commonly deep and high up in the neck, often with internal cervical injuries. In the second, soft cotton cloth was used with partial suspension of the body, which produced a broad, low, ill-defined ligature mark with facial congestion and petechial haemorrhages, but minimal or absent deep neck injuries. Classical external injuries of asphyxial death (congestion of the face and petechial haemorrhages) were more common in cases of partial suspension than in complete suspension. While the mechanism of death in the majority of cases of partial suspension was apparently due to airways or vascular obstruction, death in cases of complete suspension appeared to result from, in addition to obstruction (airways or vascular), vagal stimulation or carotid sinus pressure, or a combination of these. No fracture of the hyoid bone, thyroid cartilage or cervical vertebrae was detected in any of the victims in this series.

Accidents↗
PubMed1989

Diagnosis of sudden coronary death in the autopsy room: guidelines for forensic pathologists.

The pathological techniques employed in examining cases of sudden coronary death can vary widely. Visual assessment of coronary narrowing can lead to over-estimation of the true stenosis and may result in overdiagnosis of sudden coronary death. On the other hand, inappropriate examination of the whole epicardial coronary tree while searching for acute coronary lesions may lead to underdiagnosis. The approach recommended in this paper should minimize the possibility of such errors in the diagnosis of sudden coronary death.

Autopsy↗