Iranian Journal of Forensic Medicine
Year:2005 | Volume:11 | Issue:3 (39)|Papers Count:10

Background & Aim: Regarding the hazard of the issue of suicide, concerning as a psychiatric emergency, and also its known stresses and side effects, this study has been conducted on children referring to Loghman Hakim Hospital due to suicide.Materials & Methods: The method of study was retrospective (in 1999-2002) and the cases were children who certainly diagnosed as suicidal cases. Age, sex, the exact time and means of suicide, the way of parents' awareness and source of suicidal behavior were all collected in a data sheet. In case of file impairment, it would be removed.Results: 60 children, 6-13 years old, had met our criteria where 62% were male and the remaining 38% female.Results have revealed that autumn was the most common season, in the meantime, suicide attempts occurred in weekends and during 6pm till 11pm more frequent than other time. We have faced disintegrated families and academic difficulties as the main stress factors. Suicide attempts were mainly practiced through the use of drugs (93.4%).Depression comprised the most common underlying disease. Meanwhile, children had learned about suicide attempts by watching TV, or witnessing suicidal attempts in their family members, specially their mothers.Conclusion: More studies to determine the exact role of psych iatric, social an biological aspect of this problem are strongly recommended, however, an experimental study to assess family training could be helpful.

Background & Aim: Our statistics shows increased consumption of stimulants especially amphetamine pseudo drugs in Iran. It seems that there is not enough knowledge among interns.Materials & Methods: In order to assess clinical judgment, treatment plan and complication of ecstasy in Interns of Shaheed Beheshti University of Medical Sciences a cross sectional study regarding various aspect of ecstasy was carried out on 101 medical interns from 7 offiliated hospitals by a self completing questionnaire including 18 questions in year 2005.Results: 59.4% participants knew that ecstasy belongs to sympatomimethics but 5.9% knew the exact chemical formula and 2% dosage.Regarding mental, acute and chronic complication of ecstasy 82.2%, 59.4% and 56.55 had acceptable knowledge respectively. 65.4% believe that abuse of ecstasy could create addiction and 68.3% thought this substance have an antidote.40% of participants collected their information by friends and family, 17% by university classes, 11% by newspapers and magazines, 8% by TV and radio and finally 20% by other route including their internship in poison wards. 22% of participants experienced ecstasy overdose patients which have meaningful information compare to other participants. 97% believe they need a training program in this field.Conclusion: It seems that there is not enough knowledge in Shaheed Beheshti interns regarding stimulant and psychoactive drugs and they need more training.

Background & Aim: Midwife as a provider of services such as premarriage consultation. Pre-and- post delivery cares, caring for neonatal and treatment of some obstetric diseases, should be familiar with the legal aspects of her duties. Correct knowledge about the rule and regulation tends to the reduction of offence and its consequences.Meanwhile study of the midwifes knowledge provides opportunity for proper educational planning which can be an important index of in evaluating the treatment condition of the cases under study. The aim of this study was to determine the level of knowledge about the legal aspects of the duty in midwives employed in Mazandararn province.Materials & Methods: In this descriptive study 140 midwives employed at private and governmental hospitals were collected in question divided in two sections comprising individual information (5 questions) And knowledge assaying (55 questions with three choices) and the scores foregiven as 0- 55 the validity and accuracy of the questionnaire were confirmed using a index of kronkenbakh (78%) in a pilot study. The obtained data were analyzed using descriptive analysis and SPSS software.Results: From total of 140 midwives 10.7% had post diploma study certificate, 86.4% had BSc and 2.9% had MSc. Their experiences varied from 1 to 30 years (mean 11.1 years). The mean knowledge of the cases under study was 41.2 and the lowest and highest obtained scores were 14 and 51 respectively. It was found that 64.2% of them had good knowledge (41-55 scores), 35% medium knowledge was poor in some aspects and percentage of correct answer to some of the question was less than 50.Conclusion: knowing that knowledge of 40% cases under study was poor to medium identification of the causes is very important. Therefore these questions with less correct answer should be considered more, and in order to make the information more applicable and increase sensitivity of midwives towards rules certain management be implemented.

Background & Aim: Spinal cord injured men (SCI), besides ejaculatory dysfunction, suffer from poor semen quality. Among different possible causes, Recent investigations suggest the negative role of seminal plasma constituents on sperm quality. We compared the seminal plasma Zinc concentration as a prostatic secretary marker in SCI men and normospermic controls.Materials & Methods: The study included 30 SCI men (mean age 36±2.3 years) and 30 noninjured normospermic men (mean age 34±3.2 years). After 3 days abstinence, Fasting blood and semen samples were obtained (antegrade portion of electroejaculatein SCI men). Sperm parameters, seminal pH and seminal plasma osmolality were measured.Serum and Seminal plasma Zn2+ concentrations were measured by flame atomic absorption spectrophotometry.Results: Mean seminal plasma Zn2+ concentrations were (120.74±42.9 and 156.88±49.9 mg/l, Pvalue<0.05) in SCI men and normospermic men respectively. serum zinc concentrations were (1.62±1.23 and 2.01±0.8 mg/l respectively, Pvalue>0.05). Seminal PH and osmolality were (7.87 ±0.23 and 322.4±1.2 vs 7.58±0.26 and 382.5±21.1 respectively, Pvalue<0.05). seminal plasma Zn2+ concentration was correlate with sperm count (r=-0.277, Pvalue<0.05), viability (r=0.404, Pvalue<0.05), normal morphology(r=.332, Pvalue<0.05), total motility (r=0.422, Pvalue<0.05) progressive motility (r=.386, Pvalue<0.05) significantly, Seminal pH (r=0.39, Pvalue<0.05) and Seminal plasma osmolality (r=0.474 Pvalue<0.05).Conclusion: Our findings indicate decreased seminal plasma zinc concentration and osmolality, and increased seminal pH, in SCI men compare to normospermic controls. These findings may indicate the prostatic secretory disfunction following SCL that can be the couse of poor semen quality in this patients.

Background & Aim: Regarding the invasiveness of medical cares provided by surgeons, they are the main target of malpractice claims. So acquainting surgical team including surgeon and anesthesiologist with litigation predisposing factors and predicting factors of physician incrimination at lawsuits is of great importance. The purposes of this study are determining risk factors of physician incrimination and evaluating efficiency of judgments of Mashad Medical Council.Materials & Methods: Data about patient, physician, disease, management, litigation, and judicial authority were obtained from the latest 100 malpractice claims judged at medical council of Mashad in which surgeon or anesthesiologist was sued. Data were analyzed by SPSS software.Results: of 1057 lawsuits during a five years period (1999-2003) 56% were against surgical team. Of 100 cases studied, 10% resulted in physician s incrimination. In a univariate analysis predicting factors of physician s losing the case were: occurrence of negligent complication, providing substandard medical care, working as an anesthesiologist, plaintiff being juridical, litigating at other authorities in addition to medical council, occurrence of complication during the first 24 hours of treatment, litigating during the first 3 months after treatment. In multivariate analysis only the first two factors had independent predicting values.Conclusion: Negligent complications and substandard medical care are the two major risk factors of surgical team incrimination at malpractice claims; so it can be concluded that judgments of Mashad Medical Council are properly efficient compared to some other studies. Preventive effects of malpractice claims should be increased by improving sensitivity and specificity of judicial authorities.

Background & Aim: Anal incontinence or lack of voluntary control of gas and fecal passage through anus, is one of the relatively common medical symptoms. Sphincterotomy surgery which is performed for anal fissure is one of the etiologies of this problem. As a result of relatively high number of patients who undergo this surgery, we decided to evaluate the prevalence of gas and fecal (both liquid and solid) incontinence and related variables of this complication following Open Internal Lateral Sphincterotomy.Materials & Methods: Among 352 files, 100 patients were able to be followed. Existence or non existence of incontinence was investigated by referring or calling with patients. Variables such as age, sex, number and types of previous deliveries and other accompanied anal surgeries were evaluated. Data were processed with SPSS software. Results: Among 100 patients (42 male and 58 female) gas incontinence was found in 7 patients, consist of 4 men (9.5%) and 3 women (5.1%). Three of them suffered from liquid incontinence as well, but none of them had solid fecal incontinence. Average age of incontinent patients was 44. They were all older than 20 years old. In addition, 2 out of 7 incontinent patients were older than 60. From the view point of previous numbers of deliveries, incontinent females had at least one delivery. Gas incontinence was found in 2 patients (7.7%) following sphincterotomy in conjunction with hemorrhoidectomy.Conclusion: In general, gas incontinence had greater prevalence than liquid and solid fecal incontinence. In our research, prevalence of incontinency in the male group was higher than the female group which in contrast with other studies. The elderly had the biggest percentage of incontinence. Hemorrhoidectomy was the most common accompanying surgery with sphincterotomy.

Background & Aim: According to WHO predictions, without increased efforts and new initiatives, Road traffic injuries, over the next 20 years will rise in rank to Sixth place as a major cause of death and Third leading cause of DALYs lost. In Iran, in 1380, Road traffic injuries have been caused of 7/89% of death, and were one of the most important causes of death. With due attention to the highly prevalence of drug abuse in drivers and Lack of strong evidence that the use of drugs constitute a significance road crash risk, there is a need toper form this research.Materials & Methods: This study is a Case-Crossover analysis on drivers of traffic injuries in Kerman. The purpose of this study is estimation of the effect of consumption of one dose of opium (until 6 hours after consumption) on the risk of road traffic injuries resulting in hospital attendance. Among 220 drivers who agreed to participate, and were interviewed, 63 persons report opium consumption 6 hours prior to injury.Results: Two analytical strategies were used in these analyses, the pair matching approach and the usual frequency approach. In the first approach, we estimated the odds ratio of road traffic injuries according to opium consumption 6 hours prior to injury. This figure was 4 (95% confidence interval: 0.85-18/8). Second approach was practicable only in addicted persons. Nevertheless, the risk ratios of these accidents in addicted persons in 6 hour period after opium consumption were estimated as 3/2 (95% confidence interval: 1/91-5/45). We also repeated usual frequency approach for individual hour until 6th hour. 3rd hour after consumption had the highest estimated relative risk. It seems that, the number of use time per day is one of the most important effect modifiers in this association.Conclusion: According to this finding, it can be concluded that, in addicted persons the risk of occurrence of traffic injury leading to hospital attendance in 6 hours after consumption is more than three-fold relative to other times.

Introduction: Age estimation is a role of forensic medicine in both developing and developed countries. This role is very important in application of many penal rules all over the world. We can estimate the age by examination of teeth, evaluation of ossification centers and secondary sexual features.Discussion: Age estimation is highly accurate in the first twenty years of life. The Time of appearance of primary and permanent teeth has made the age estimation so simple and is apparent in OPG graphy. Appearance of ossification centers and fusion of them gives helpful information for age estimation in living individuals. For age estimation in senile subjects, fusion of cranial sutures is important.Conclusion: Secondary sexual features are helpful not accurately. The main aspect of an expert report for age estimation should contain the most likely age for the person examinated and/or determination of the degree of coordination between estimated and real age and whether the age is more thanpenal age or not.