Iranian Journal of Forensic Medicine
Year:2007 | Volume:13 | Issue:3 (47)|Papers Count:10

Background & Aim: Autopsy of fetus and neonate has a special importance and can provide important information to gynecologists, pediatricians and clinical genetics counselors. Also it helps the safety of next pregnancies. The attitude of parents on postmortem examination has a main role infrequency of perinatal autopsies. On the other hand, cultural, religious, economical and social factors influence on parents attitude. So we want to assess the parents' views about the autopsy of perinatal death in this search.Material & Methods: This is a cross-sectional study and the sample was selected at random. In this study the attitude of one hundred parents who loss pregnancy or neonate about postmortem examination was assessed by questionnaire method at three maternity hospitals of Tehran.Findings: From 100 cases of perinatal death in 66 cases the cause of death by physicians was unknown, in 15 cases was congenital abnormality and in 19 cases were other diseases. From 100 couples (60 mothers and 40 fathers)with new perinatal death, 68 cases (66.6% mothers and 70%fathers) agreed with autopsy, of those who agreed with autopsy, to know the cause of death (45.30/,),worried about next pregnancy (35.80/,)and assessment of congenital anomalies of fetus (18.90/,)were the main causes. 32% of parents refused to autopsy (33% mothers and 30%fathers). The main reasons for declining in mothers were concerns about emotional factor (77.70/,), and in fathers were economic reason (46.20/,)Conclusion: The parents who experienced baby death had more negative attitude on autopsy those who experienced fetus death, the parents with negative attitude had lower education than that of positives.This study showed that most of parents were agreed with autopsy and if the necessary qualifications for autopsy be prepared, many of those of confronted with perinatal death will be agreed with it. Also this study showed that the main causes of negative attitude by parents are emotional and economic factors, so we believed that the parents knowledge on benefits of autopsy will be elevated by educational programs in obstetric centers by expert counselor.

Background & Aim: The main reason that necessitated the research study was the increase in the number of complaints lodged against medical personnel in particular general practitioners (as the largest and most important group of physicians) in recent years as well as the increase of high-risk treatment measures taken by this group. The study aimed at establishing mechanisms to decrease the level of general practitioners' negligence and teaching such mechanisms to this group of physicians.Materials and Methods: The study was carried out by study of complaints referred to the Forensic Medicine Commission of Tehran Center and statistical analysis of information gathered.Findings: The most common type of general practitioners 'negligence related to lack of proficiency and the highest rate of negligence recorded ranged between 1-10%. 87.3% of the general practitioners against whom a complaint had been lodged were male and the rest were female. The percentage of negligence among male physicians was more than that among the female group. The most cases of complaint against general practitioners related to medical treatment at the office and the least at public hospitals. The highest percentage of negligence had occurred at private hospitals, while the lowest percentage related to public hospitals. The highest percentage of complaints concerned medical treatment by general practitioners in the field of cardiovascular diseases (15.5%), while the highest percentage of negligence related to the fields of dermatology (77.8o% and plastic surgery (75o%. Among all the complaints, the patient died in 49.1% of the cases.Conclusion: Based on the research results, general practitioners should:First, pay more attention when preparing medical histories, performing complete clinical examination and referring the patient on time to a specialist and a more equipped medical center;Second, avoid high-risk medical treatments such as injection of aesthetic gel, performing aesthetic surgeries and spinal cord injections; Third, in cases With Probability of cardiac ischemia, proceed with more examinations and avoid releasing the patient soon.It was also determined that the Ministry of Health and Medical Education should exercise more supervision on aesthetic surgeries and skin laser therapies conducted by general practitioners especially at their offices.

Background &Aim: This research has been conducted to assess the prevalence rate of personality disorders in the males &females dealt with opioid substance traffic imprisoned in Kermanshah Central Prison.Materials and Methods: In this research 413 males and 45 females, imprisoned in KCP due to drug traffic were randomly chosen and assessed through Millon multiaxial questionnaire. Final diagnosis was made by psychiatrist soon after clinical interview through the signs and symptoms based on DSM-IV-TR. The data were analyzed through x2 & T tests, and the SPSS 11.5 software.Findings: The result obtained from this survey represented 85.15% of the testers to be involved in personality disorders in which the most common were demonstrative personality disorder, and antisocial disorder, 42.36% & 40.39% respectively. The least common disorder was schizophrenia personality disorder (14.63%). This study also revealed 52.62% of the prisoners involved in mix personality disorder. There was also a significant relation among career, education, marital status and the opioid substance traffic.Conclusion: The prevalence of psychiatric disorders, especially in its mixed type, is much more common in the prisoners involved in opioid-substance than the other people in society.

Background & Aim: Nowadays we hear the word suicide more than past. However, those who commit it are those who dare to interface with it. Committing suicide has been done from the writhen history and the view to it was variable depend on the time, culture and motivators. Increasing the rate of suicide made us to explain the suicide and its etiologies briefly.Materials & Methods: In this study 274 cases in the first 6 months of 2004 which were suspicious to committed suicide, separated from the autopsies; we Contact with deceased relatives which 260 cases of suicide were confirmed After documenting the suicide as the reason for death, related questionnaires were completed Finally, the data of this study were statistically analyzed with SPSS and Excel software.Findings: Among 260 suicide death, 180 cases were male and 80 cases were female, and the most common age to attempt suicide was in 3rd decade of life and the most common etiology which their relatives explained was mood disorders (specially depression), another etiologies were: family problems, low economic state, and the most common way totally was hanging.Conclusion: According to findings if this investigation and other social investigations in our country, it is obvious that there are many factors like age, gender, material state, income, education, etc, which affect suicide. In order to reduce suicide, education and social training are of importance and families and trainers should observe children s and adolescents behavior in a kindly and meticulously manner. Consult center should be developed and finally community should lead to social needs of individuals.

Background & Aim: Medical malpractice includes of failure in diagnosis, treatment or disease management of disease and the claims resulting from medical malpractice creates a part of referrals of Legal Medicine Organization, Medical Council Organization, and judiciary system in I.R./RAN Guidelines reducing medical malpractice and promoting doctors' defense ability include scientific and practical education of medical team regarding concept and principals of medical malpractice and medical errors in their field, patient s claims, increasing their knowledge to rules and regulations and ways of increasing safety of medical team.Materials & Methods: This article has been specialized to patient s claims from dentists and with a review on concept and principals of medical malpractice and medical errors, and how to investigate about this matter, provides essential information for dentists to increase their legal knowledge and reduce the claims of their services and if sued, they could defend rationally and effectively. Observing scientific and technical standards in diagnostic and remedial measures is the most important criterion which is used at courts and disciplinary committees.Findings: Several centers including courts, Legal Medicine Organization, and Medical Council Organization are investigating patient claims of dentists and other doctors. These claims are evaluating based on Islamic Punishment Law, criminal law, Medical Council Organization and other governmental disciplinary regulations. The punishments mainly include DIEH (mulct or blood-money) and/or regulation punishment. Conclusion: Standardized of dentistry s services, overview of dentist s duties, provide a logical dentistry s practices payment, control over quality of dentistry services, increasing knowledge of dentists about malpractice and medical errors and investigating of them, specializing the court of medical crimes, reform of Islamic Punishment Law, and finally consulting forensic medicine specialists and covering with professional insurance organizations can improve this situation.

Background & Aim: Treatment of gender identity is complex and rarely successful when the goal is the reverse the disorder. Consequently number of these patients can get permission to change their gender through surgery, as a definite and treatment irreversible. On the other hand, 30%male and 20%female patients after surgery are unsatisfied.Reasons of this unsatisfaction are different. Mental disorders comorbidity is one of these causes. So, diagnosis and treatment of these disorders may improve the satisfaction level in these patients before and after surgery.Material & Methods: Sampling method was counting all patients with GID who appealed to "Legal Medicine Organization of Islamic Republic of Iran for change of gender through 2004-2005 consisted population of study. Consequently 55 patients with GID were selected (30female and 25 male) and analyzed for mental disorders with SCL-90-R questionnaire.Findings: This study indicates that mental disorder prevalence in patients with GID is around 20%- The most common comorbidity was paranoid thoughts. Other common comorbid condition was panic attack, somatization and interpersonal sensitivity, respectively. Also, this study indicated, on most measures; in males comorbid condition is more common. This difference was more significant particularly of interpersonal sensitivity and paranoid disorders.Conclusion: Mental disorders prevalence is not much more common than general population and for male this pate is higher.

Background & Aim: The existence or absence of the semen in the samples referred to forensic laboratory is detected by tests such as sperm-finding test, acid phosphatase (AP) activity test, prostatic specific anti-gene (PSA, P30) test. Among them acid phosphatase tests and PSA are the most applicable. In this study, the sensitivity and specificity of these two tests was examined and compared.Materials &Methods: This study includes two sections: first, vaginal swabs were obtained from 52female cases referred to infertility clinic for post coital test (as positive control group) and from 58 women who did not have intercourse for at least one week (negative control group) The samples from two groups, after their becoming dry, were referred to laboratory for acidphosphatase and PSA test in order to compare the results; second, vaginal swabs were obtained from 79 cases who have been referred to esfahan legal medic in center for investigation of sexual assault.Findings: The results suggest that the PSA sensitivity and specificity for semen detecting are quite effective. For the quantitative acid phosphatase test (the result is recorded, precisely 2 minutes after adding substrate), the sensitivity rate of the method amounts to 88.4% and the specificity is determined 74.1 %. These two parameters for the qualitative phosphatase test in which the result is recorded after the exact 2 minutes, are found to be 98% for sensitivity and 5.1%for specificity.Conclusion: According to the study, utilizing the semi-quantitative phosphates test as a presumptive biomarker to discover semen cannot be reliable due to its high sensitivity (88.4%) and low specificity (74.1%). Therefore, in order to gain trustworthy results and to prevent false positive and negative reports another method should be used. We suggests that, according to the findings and the well-proven applicability of the PSA test as a definitive biomarker in detecting semen, Legal Medicine Organization of Iran (LMO) use this antigen in its laboratories as a confirmatory for the result of semi-quantitative acid phosphates test.

Introduction: Ethanol analysis is one of the most frequent tests in forensic toxicology laboratories. blood, urine, vitreous humor and breath are routine biological samples for this analysis. Discussion: Due to the simplicity in operation, portability and producing rapid results, breath analyzing instruments have been used extensively for the determination of ethanol in medico-legal investigations. In breath alcohol analysis, concentration of breath alcohol may be affected by Blood Alcohol Concentration: Breath Alcohol Concentration ratio(BAC: BrAC ratio), hematocrit, body temperature, respiratory diseases, drugs and breathing style just prior to delivery of breath sample to breath alcohol analyzer. In this article we reviewed effects of many factors which alterate results in breath alcohol analysis.Conclusion: According to the simplicity in operation, portability and producing rapid results, following correct usage of professional breath alcohol analyzers, these instruments can be used in qualitative and quantitative analysis of breath alcohol in forensic toxicology laboratories.