Letting contracts are those in which, their main effect is making permission. In this type of contracts, at the result of offer and acceptance, permission is obtained. Of the features of permission, is its dependence on the will of the contracting parties. Thus, in any case, that the will of person disappears, permission is void. Permission void, causes terminating legal operation. The study of brain anatomy shows that the cortex is the source of human will and in the cases that the activity of brain, named cortex, is stopped, the will disappears, the permission is missing, and the contract is terminated. Civil law, knows death and madness, and insanity, as the tools of letting contracts termination. But in other cases, the person in whom, his will is affected, and the content of CONSCIOUSNESS is reduced, it is silent. The study in this case show that, when the activity of bran stops, or his CONSCIOUSNESS reduces as madness, because of alcohol, drugs, psychotropic substances, the permission is missing, and the contract is terminated.

When a child presented with decreased LEVEL of CONSCIOUSNESS in the emergency room, taking the right approach is one of the most important skills that every emergency physician should have. Ideally, there should be a defined diagnostic and therapeutic algorithm in the emergency room for managing these children in order to minimize difficulties diagnostically and maximize time spent helping the child. This article describes the history-taking, and physical and neurologic exams the affected child should be assessed with and explains the potential etiologies of a decreased LEVEL of CONSCIOUSNESS. These factors are classified into traumatic and non-traumatic agents. Infectious causes of encephalopathy and the applied classification of them has been emphasized.

Permission contracts are being told that the main effect is to make leave or permission. These contracts are based not only on the composition but also on the willingness of people. In fact, the permission must be supported by its source, and if deprived of the support stand, it'll lose its life and identity. So this will result in the end of the legal acts. In the matter of dissolution of permission contracts in the civil law, legislator has called certain factors which provide the abolition of legal acts and permission through impeding the permission and its creator and source. The study of the following basics of abolition of permission contract indicates that the stipulated cases have been told to be allegorical and refer to common factors, in this extend. Investigate the function of human brain and identify the origin of intentional acts show that the part of brain that called the cerebral cortex in cases where the activity is stopped, the will of a person is gone, and the contract is abolished.

Introduction: The Z-drug zolpidem is an imidazopyridine hypnotic that is prescribed widely for short-term treatment of sleeping problems. However, there have been various cases affected by the side effects of this medication. Case Presentation: Further to the extant reports of zolpidem adverse reactions, in the current manuscript, two cases of zolpidem toxicity in 2016 in Tehran are presented. They had both taken 20 mg of zolpidem and as a result, they began to develop an altered LEVEL of mentality. Conclusions: Zolpidem use may affect the mental status and results in performing unconscious behaviors.

Background & Aim: High frequency of traumatic and non-traumatic brain injuries in one hand and improvement of the health care condition to restore patient's life in the other hand has increased the frequency of comatose patients in ICU. These patients often experience physical, cognitive, behavior or sensory defects, and the sensory input reduction in intensive care units expose them to cognition disorders. It seems that using sensory stimulation programs may be effective in preventing from sensory deprivation and facilitating recovery process.Methods & Materials: In this quasi-experimental study, 30 comatose patients who were hospitalized in ICU in Shariati and Sina hospitals were sought to be studied. The subjects were selected randomly using matching that was placed in case and control group. In the intervention group, patients received an auditory stimulation for 2 weeks, 6 days of a week, 2 times a day. The auditory stimulator was a recorded tape (5-10 minutes) of a familiar voice for 30 minutes. The Glasgow Coma Scale (GCS) was used for measuring the LEVEL of CONSCIOUSNESS (LOC). LOC was measured before and after each intervention 4 times a day. The control group LOC was measured in a similar manner to the case group. At the same time, homodynamic symptoms (blood pressure, pulse rate, and mean arterial pressure) were measured. Non-parametric test was used for analyzing data. The data was analyzed through SPSS V.11.5 computer software.Results: The findings indicated that there was a significant difference in LOC of the intervention group at the first day and after fourteen days of the intervention (P<0.001), but not in the control group (P=0.769). Although 2 groups were similar in LOC of the first day (P=0.605) but there were a significant difference between their LOC at the fourteenth day (P=0.001).Conclusion: The results showed that the auditory stimulations with familiar voice were effective in increasing LOC in the comatose patients. It is suggested that nurses expose comatose patients with auditory stimulations using a recorded tape of familiar voice in ICU.

Background/ Objective: The purpose of this study was to determine CT scan findings in acute craniocerebral trauma and the relation between these findings and the LEVEL of CONSCIOUSNESS.Patients and Methods: In this retrospective study, 800 patients with acute (less than 24 hours) craniocerebral trauma were studied over a period of three years. The patients’ LEVEL of CONSCIOUSNESS (GCS) was determined and a brain CT scan without contrast agent was performed. A third generation General Electrics (GE) CT scanner was utilized and 10-mm and 5-mm sections were obtained for the supratentorial and infratentorial parts, respectively.Results: From 800 patients studied, 641 (80.1%) were males and 159 (19.9%) were females. The peak age was 25 and the mean age was 26.80 ±18.30. The most common mechanism of head trauma was motor vehicle accidents (60.1%).80. Mild head injury was seen in 75% of patients, while 14% and 5.25% had moderate and severe head injuries, respectively. In 14.1%, the CT scan was normal. The most common lesions were as follows: epidural hematoma (EDH) 27.1%, subdural hematoma (SDH) 13.3%, subarachnoid hemorrhage (SAH) 11.4%, contusion 32.9% and pneumocephalus 12.1%. Intracranial hemorrhage, IVH and subdural hygroma were seen in less than 10 percent of patients. The presence of mixed lesions and midline shift regardless of the background lesions were related to statistically significant decreases in GCS.Conclusion: As one of the leading causes of mortality in Iran, craniocerebral trauma needs more considration, this is true especially for road accidents, which are the main cause of multiple traumas. In lower LEVELs of CONSCIOUSNESS, one should consider more complicated lesions and probable surgical intervention. The presence of mixed lesions and midline shift regardless of the underlying lesion on CT scan were accompanied by lower GCS, which may be due to major energy transmission and diff use brain tissue damage and compression of the brain stem.

Introduction: LEVEL of CONSCIOUSNESS is an important factor in management of critically ill patients and predicting outcome. However there is no quantitative, reproducible measure for evaluation of CONSCIOUSNESS. F wave persistence can be influenced by LEVEL of CONSCIOUSNESS according to some studies.Objective: Survey the correlation between F wave persistence and LEVEL of CONSCIOUSNESS in stroke patients.Materials and Methods: In this cross sectional study, 114 patients within 72 hours of stroke onset were divided according to their LEVEL of CONSCIOUSNESS either with GCS and qualitative method. F wave persistence was obtained in each Tibial nerves. Effects of background variables including side of study, side of hemiparesis, type of stroke, and sex were evaluated. Data were analyzed by SPSS 14.0 and ANCOVA statistic model.Results: A significant correlation were found between F wave persistence and LEVEL of CONSCIOUSNESS, either with GCS or qualitative method (P<0.001). These results were independent of the side of study, side of hemiparesis, type of stroke, and sex.Conclusion: F wave persistence can be influenced by LEVEL of CONSCIOUSNESS. F wave study may be a useful objective and quantitative measure in documenting the severity of CONSCIOUSNESS impairment.