IntroductionDespite high efficacy and safety of tramadol as a pain relieving analgesic, some minor side effects have been reported following its consumption. However, very rarely, serious and life-threatening side effects may appear following administration of tramadol.Case PresentationThis research describes a case of tramadol poisoning that appeared with acute seizure needing emergent and intensive cares. In the described case, using a low dose of tramadol (200 mg, orally), the patient experienced generalized tonic colonic seizure followed by loss of consciousness and shoulder dislocation due to trauma, requiring admission to the intensive care unit.ConclusionsAs shown in the study, even using a low dose of tramadol might lead to acute generalized seizure with loss of consciousness and the need for intensive care.

PURPOSE: Sex determination is one of the most important aspects of the personal identification in forensic medicine. The present study thus aimed to assess the value of cephalogram in determining sex by applying eleven linear and an angular cephalometric variables measured on lateral cephalograms among Iranians.METHODS: In a cross-sectional study, 11 linear and 1 angular cephalometric measurements were studied. Those are: basion to anterior nasal spine, upper facial height, length of cranial base, total face height, frontal sinus height, mastoidale to sella-nasion plan, mastoidale to porion-orbital plan, mastoid height from cranial base, mastoid with at the level of cranial base, mandibular effective length (central condyle to prognation), occipitofrontal diameter, and gonial angle. Measurements were assessed in 150 individuals (75 males and 75 females) aged 25 to 54 years. After preparing lateral cephalograms, the cephalometric measurements were analyzed using PACS software. SPSS version 22.0 was used for analysis. P values of 0.05 or less were considered statistically significant.RESULTS: With the exception of gonial angle, comparison of lateral cephalometric indices between two sexs showed greater values in males than in females (p<0.001). In general, almost all of the cephalometric measurements were found reliable to distinguish between male and female sex skulls with a high sensitivity (100%) and specificity (97.3% to 1000%).CONCLUSION: The cephalometric measurements used in this study are able to differentiate with high specificity and sensitivity between male and female skull

We described a neonate with severe and multiple abnormalities following use of isotretinoin, in spite of the mother's previous knowledge of drug complications. Initial physical examination after delivery showed congenital absence of both eyes and both auricles as well as anal atresia and a cleft palate. Due to severe respiratory distress and atresia of the anus, the neonate was admitted to a neonatal intensive care unit and underwent reconstructive surgery. The drug should not have been used during pregnancy. Using this drug within pregnancy with awareness of its side effects may have legal consequences.

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