Introduction: Flexible Fiberoptic Bronchoscope (FFL) has an essential role in airway management especially in difficult intubation, unstable cervical spine due to trauma, airway examination and tracheal tube replacement. Therefore, this skill training is so important for anesthesia residents'' and curriculum. The goal of this study was to compare the teaching of endotracheal intubation with FFL by intubating mannequin and Cadaver to anesthesiology residents'.Method: This study was a randomized training trial in whole of anesthesia residents' (12 residents) in faculty of medicine in Guilan University of Medical Sciences, without preceding experience. After accomplish Pre-test based on DOPS by intubating mannequin, the residents' randomly were divided into two groups for training: intubating mannequin and Cadaver. After teaching in the base of teaching plan, post test was taken. The results were analyzed by SPSS soft ware and paired sample T-test and ANOVA.Finding: Results with paired sample t-test indicated that mean score of each enclosures, before and after teaching was promoted in Cadaver and teaching mannequin (P<0.01). But between the mean alteration scores of two groups of the learners were not significant meaningful differences before and after teaching (P>0.05).Results: Both of the intubating mannequin and Cadaver could be effective in the endotracheal intubation teaching with FFL. And both of them could be resulted to increasing the mean scores after teaching. So, applying Cadaver such as the intubating mannequin could use in endotracheal teaching with FFL in the academic and medical centers.

Background: Liver transplantation is a critical survival point for patients with end stage liver diseases. It can dramatically increase patients’ survival if the donor liver is intact. One aspect of liver health is absence of steatosis. Nonalcoholic Steato Hepatitis (NASH) and Nonalcoholic Fatty Liver Disease (NAFLD) are increasing among young adults and patients living with chronic liver diseases.Objectives: In this study, we determined the prevalence of NALFD in livers of brain-dead donors in Imam-Khomeini hospital Complex, Tehran, Iran. We assumed that the calculated prevalence would represent NAFLD prevalence in Iranian population in the age range of 20-60 years.Materials and Methods: All eligible brain dead liver transplant donors were enrolled in the survey from March 21, 2011 to March 21, 2013 in Imam-Khomeini hospital Complex. Eligible participants were donors aged 20 to 60 years without any obvious history of liver disease. Liver needle biopsy was performed at the end of the transplant operation, time zero biopsy. We calculated the prevalence of NAFLD among brain-dead donors. Moreover, the frequency of NASH was calculated based on the NAS (NAFLD Activity Score).Results: Among 116 cases, two were diagnosed as probable NASH. There was a significant association between NAFLD and male gender (P=0.04). Moreover, we found a higher steatosis level in male gender. There was a significant association between NAFLD and BMI (P=0.05). Those with BMI more than 27 had severe steatosis.Conclusions: Our comprehensive literature review showed that our study was the first investigation in Iran and the region, which determined the prevalence of NAFLD based on tissue diagnosis. We believe that the prevalence of NAFLD/NASH in our donors can represent the overall prevalence in this age group in Iran.

Background: This study aimed to determine the normal dimensions of the mitral annulus (MA) in Iranian population. Materials and Methods: This cross-sectional study was conducted using 88 fresh hearts of male and female Cadavers for six months in Mashhad, Iran. Normal data were determined by measuring the exact dimensions of the MA in fresh hearts of patients who had died of non-cardiac causes and considering some parameters such as age, gender, stature, and weight. Images of the valves and leaflets were prepared by marking the anterior (A2, midpoint of anterior) and posterior areas of P1, P2, and P3 using a needle. To analyze the data, SPSS version 16 was used. Results: The means of anatomic area, anatomic perimeter, inter-commissural distance, A2-P1, A2-P2, A2-P3, Base-P1, Base-P2, Base-P3, and Base-A were 14± 1. 28, 8. 3± 1, 2. 7± 0. 42, 2. 27± 0. 37, 2. 3± 0. 43, 2. 06± 0. 35, 1. 66± 0. 43, 1. 2± 0. 97, 1. 5± 0. 66, and 3. 2± 0. 52, respectively. Comparison of the age groups regarding valve leaflets showed that Strut-P1 and Base-P2 were significantly different. Comparison of the valve leaflets and sub-valve indicators between the two genders reflected no significant differenc-es. Age groups differed significantly in terms of Strut-P1 and Base-P2 (P=0. 004 and P=00. 1, respectively). Conclusions: A2-P3, A2-P1, anatomic perimeter, and anatomic area were found to be related to gender. A2-P1 and A2-P2 and some leaflet indicators such as Strut-P1 and Base-P2 were associated with age, whereas Base-P2 was affected by body mass index.

Vascular variations and the accidental cutting of veins and arteries potentially create problems during surgery and medical treatment. The surgeon's awareness of a vascular variation in the kidneys is essential during renal surgery and transplantation, color Doppler imaging, gonadal surgery and in the presence of an abdominal aortic aneurism. This awareness can improve the patient's recovery process. The Surgical Department should implement a study of these variations and their statistics in order to present them to students to increase their awareness of such variations.During a routine dissection of the abdominal region of a 35-year-old Iranian male Cadaver, we observed right accessory renal vessels. The most common variation of the renal artery is the presence of an accessory renal artery that is upward and on the right side, crossing the inferior vena cava anteriorly toward the kidney. This variation occurs in approximately 30% of cases. This case report highlights the importance of awareness of renal artery variations in the event surgical procedures are performed in this area of the body.

Background: Anatomic attainment of anterior cruciate ligament (ACL) to the femoral notch is not quite easily visible due to the synovial covering. There is no information on femoral attachment of ACL in Iranian population. Our aim is to study the topography of this ligament in a group of fresh Cadavers.Methods: Ten fresh Cadavers that were all younger than 50 years of age and had no evidence of trauma to or surgery on their knees were chosen for the study. The knees were dissected and the presence or absence of double AOL strands was evaluated. The ligaments were then taken off the femur and insertion sites were carefully studied and documented by digital photography. The distances were measured using a ruler.Results: In 90° .flexion with distal traction onto the ACL, the ligament was like a twisted interwoven cord. The twist would decrease by releasing the traction or decreasing the knee bent. Two separate bundles (antero-medial and poster lateral) were identified in 7 Cadavers. In the 3 remaining ones in gross inspection and without dissection one could not recognize two separate bundles in the ACL's. The femoral attachment sites were curve, triangle or oblong. In cross-sectional, however, they were oblong.Conclusion: Anterior cruciate ligament could have both variable femoral attachment sites and also different bundle patterns in different individuals.

Introduction: The newly deceased patients have long been used in medical schools to teach clinical skills without any challenges as it helps to train skilled doctors. Nowadays, the use of moulages and simulators are common in teaching clinical skills since these tools provide the opportunity for frequent practice without any pain and injury.There are specific procedures which still require the use of Cadavers. However, the increased significance of patient rights has generally challenged the practicality of using the deceased bodies for this purpose. This study was designed with the aim of determining to what extent clinical skill training is dependent on the recently deceased patients.Methods: This was a cross-sectional mixed-method triangulation design conducted in two phases. In the first phase, a researcher-made questionnaire was used to collect quantitative data of the medical students and residents. The data were used to assess the frequency of experience. In the second stage, semi-structured interviews were conducted with faculty members and fellows in order to evaluate the educational impact of this type of procedure and the influential factors. The quantitative data were analyzed using statistical software, and the qualitative codes were extracted following a content analysis. Finally, a comparative analysis was performed.Results: Twenty five residents (26%) and seven medical students (14%) had the experience of performing procedures on the recently deceased patients for training purposes. About half of the residents and 33% of the medical students had observed their colleagues practicing procedures on Cadavers. In the qualitative phase, the main categories included professional ethics, law and educational requirements.Conclusion: A relatively low number of medical students and residents had experienced procedures on the newly deceased patients. In this regard, ethical, religious and legal concerns might have played a part despite the desire to learn. It would be effective to direct these educational experiences toward procedures that cannot be mastered through moulages and simulators, and to lay the legal and executive ground so that performing these procedures under the supervision of professors, and with a level of documentation would have no legal challenges.

Variations in arterial anatomy are less frequent, contrary to the venous system, and most of these variations affect visceral arteries. Variations in the brachial artery are the most frequently reported and so far a minimum of six different patterns have been described. The most common of these patterns is the superficial brachial artery, which lies superficially to the median nerve. Much less prevalent is the high origin of the radial artery (brachioradial artery) or the existence of a doubled brachial artery (accessory brachial artery). The current study presents a pattern of brachial artery variation which was previously undescribed. During dissection of the right upper limb of a 50 year-old male embalmed Cadaver, the bifurcation of the brachial artery in the proximal portion of the middle third of the arm was observed. In this case, the medial branch reaches the medial aspect of the arm, posterior to the median nerve. Afterwards, this medial branch redirects laterally and crosses the median nerve again, this time lying anterior to the nerve till it reaches the lateral aspect of the arm. At the elbow level, the medial branch originates from the radial artery. The lateral branch of the brachial artery remains lateral to the median nerve and continues as ulnar artery and originates from the interosseous artery. It was also observed that the left brachial artery was smaller in size, and bifurcated high in the arm into the superficial radial and ulnar arteries. It was also interesting to note that the common interosseous artery was originated from the left radial artery in the cubital fossa, which descended deep to pronator teres where it was divided into the anterior and posterior interosseous arteries. These variations are discussed comprehensively and compared with the previous reports. Also, it is asserted how clinically the findings are significant.

Introduction & Objective: About 12% of complications of cholecystitis are reported to be the fistula between the gall bladder and the gastrointestinal tract. In this article, a case of inflammatory adhesion between the gall bladder and the transverse colon is reported. Due to the importance of this phenomenon, the literature has been reviewed in order to highlight anatomical relation between these two viscera. Case: A case of inflammatory adhesion between the gall bladder and the adjacent part of transverse colon was observed during routine dissection of abdominal cavity of a male middle age Cadaver. The adhesion fold contained multiple fistulae between the fundus of gall bladder and the adjacent part of transverse colon. Through the round openings of these fistulae, the green bile material appeared to have been passed from the gall bladder to the colon. Conclusion: In cases of untreated chronic cholecystitis, this kind of inflammatory adhesion between the gall bladder and the adjacent part of transverse colon and subsequent fistulae used to be a usual complication. Because of low level of hygiene and medical services, the frequency of these complications, was not uncommon in the past, but their occurrence has decreased in recent decades. Meanwhile, due to the possibility of occurrence, the emphasis on anatomical relation of these two viscera, and drafting an integrated discussion of anatomy, developmental and clinical aspects of heptorenal pouch is mandatory in the educational areas.

Forensic entomology is one of the established sciences in forensic medicine. In recent years, some scientists have done interesting investigations of the use of Mites in forensic medicine. Mites are a group of arthropods that belong to sub order: Acarina. These studies clearly prove that these arthropods can be used as a tool for detection of the place of a crime and estimation of Post-Mortem interval (PMI). Mites are scattered everywhere and they have a diversity that depends on environmental conditions; so, they can provide very valuable information about the place of murder and the place where a corpse was kept. In so many places the insects are absent, or they can’t reach the corpse; but, mites can be in such places. This new field of forensic sciences is called “forensic acarology”. This article is a review of this field studies.

Doubtlessly one of the major problems in Iran is drug abuse or substance abuse. The transmission of HIV/AIDS has made the problem so complicated that has created an urgent need for a campaign against this awful phenomenon. The objective of this study-that was carried out through the cross-sectional method- is considering the situation of the addict death and the related factors. The target population consists of the corpses of the addicts referred to the Legal Medicine Organization of Tehran during 2007 and 2008. The Cadavers were examined in the preliminary stage. The blood, urine and the contents of the gall-bladder, stomach and viscera were collected and sent to the toxicology laboratory to examine and find narcotics metabolites and other drugs. The samples of the brain, heart, lungs, liver and kidneys were sent to the pathology laboratories. All of the extracted data were recorded and analyzed using SPSS software. It was diagnosed that 248 cases (79.7%) out of the total 311 in this study, died of substance abuse. Totally 300 cases were reported as male addicts (96.5%). The oldest and youngest addicts were 49 and 17 respectively. The most frequent drugs used were heroin and combination of heroin and opium. No meaningful difference was observed between the death cause of different groups of drug abusers. It seems that the increase in the population of the substance users is the main cause of frequency changes of the addicts' deaths.