1.Blunt force trauma to skull with various instruments
Nur Amirah Sulaiman ; Khairul Osman ; Noor Hazfalinda Hamzah ; Sri Pawita Albakri Amir Hamzah
The Malaysian Journal of Pathology 2014;36(1):33-39
Deaths due to blunt force trauma to the head as a result of assault are some of the most common
cases encountered by the practicing forensic pathologist. Previous studies have shown inflicting
injury to the head region is one of the most effective methods of murder. The important factors
that determine severity of trauma include the type of weapon used, type and site of skull fracture,
intracranial haemorrhage and severity of brain injury. The aim of this study was to determine the
characteristics of blunt force trauma to the skull produced by different instruments. Nine adult
monkeys (Macaca fascicularis) skulls were used as models. Commonly found blunt objects
comprising of Warrington hammer, hockey stick and open face helmet were used in this study. A
machine calibrated force generator was used to hold the blunt object in place and to hit the skulls
at forces of 12.5N and 25N. Resultant traumatic effects and fractures (linear, depressed, basilar,
comminuted, and distastic) were analyzed according to type of blunt object used; surface area of
contact and absolute force (N/cm2) delivered. Results showed that all investigated instruments were
capable of producing similar injuries. The severity of trauma was not related to the surface area of
contact with the blunt objects. However, only high absolute forces produced comminuted fractures.
These findings were observational, as the samples were too small for statistical conclusions.
2.Metoclopramide for Milk Production in Lactating Women: A Systematic Review and Meta-Analysis
Nik Hazlina Nik HUSSAIN ; Norhayati Mohd NOOR ; Shaiful Bahari ISMAIL ; Nur Amirah ZAINUDDIN ; Zaharah SULAIMAN
Korean Journal of Family Medicine 2021;42(6):453-463
Background:
Breastfeeding is recognized as the optimal form of nutrition for the physical and neurological development of infants and is considered the most significant way to prevent child mortality. This study aimed to assess the effectiveness of metoclopramide for enhancing milk production in lactating women.
Methods:
We searched the Cochrane Central Register of Controlled Trials and MEDLINE for randomized controlled trials comparing metoclopramide with a placebo, no treatment, or other galactagogue drugs. We included breastfeeding women with term or preterm infants.
Results:
We retrieved 164 records from our search of the electronic databases and 20 records from other sources. Eight trials involving 342 lactating women that used metoclopramide were included in this review after assessing the eligibility criteria. The meta-analysis of these trials revealed that metoclopramide did not increase the milk volume of the intervention groups compared to that of the control groups. There was a significant increase in the serum concentrations of prolactin when the mothers were administered metoclopramide. No significant adverse events were reported.
Conclusion
Metoclopramide did not improve milk production in lactating women. Therefore, we do not recommend using metoclopramide to increase milk production in lactating women.