Iranian Journal of Forensic Medicine
Year:2008 | Volume:14 | Issue:2 (50)|Papers Count:11

Background & Aim: The wide use of explosive weapon like mine in modern military conflicts causes of different damages such as auditory system injuries in victims. Considering to probable occurrence of these injuries, doing early inspection and treatment can be helpful for following legal claims and getting indemnity. This study was done for determining frequency of kinds of auditory system damage which caused by explosive remnants of war bombs in Ilam.Materials and methods: In this cross-sectional study 241 files of the explosion wounded who referred to !lam forensic medicine department in June 2001 to June2008 were investigated, then necessary information gathered and analyzed by SPSS program.Findings: 15.4% of wounded with mean age of 32.5 years old had different kinds of auditory system damage. 78.4% of them had kinds of hearing loss without outward findings and neurosensory hearing loss in frequencies more than 2000hz was the most kind of auditory system damage (75.7%) in these persons.Conclusion: This study showed that hearing loss was one of the predictable damage in explosive victims, therefore by doing early inspection and treatment in the wounded and getting primary audiogram in high risk cases can be helpful for following and demonstrating their legal claims.

Background &Aim: According to Article No: 174 of Islamic Punishment Law, alcoholic consumption is a crime and limit law must be excuted. The detection of alcoholic consumption in our countery is very important. Blood alcohol level searches in forensic medicine laboratories by two methods: 1) Gas chromatography 2) Respiratory alcohol detector but the efficacy of these methods hasn't exactly compared yet in Iran procedure: Materials & Methods: In this search 432 doubtful cases that reffered to Khorasan forensic medicine lab were tested. Both methods were done 1) Standard Gas Choromatographyand 2) Respiratory Alcohol Detector.Findings: Respiratory Alcohol Detector test was negative in 51% cases and is positive in 49% when Gas Choromatography was negative in 40% and positive in 60%. In all cases which testing process was positive on Resipiratory Alcohol Detector, in Standard Gas Chromatography was positive too. The mean alcoholic concentration (MAC) Respiratory Alcohol Detectore is 40.9±10.17 and this index in Gas Choromatography is 41.12±10.96 Conclusion: The sensitivity of Respiratory Alcohol Detector in comparison with Gas Choromatography was 80% and the specialty was 100%. Therefore, there weren't anylalse positive cases in this method but 14.6% were false negative that must be pay attention for interpretation of negative results.

Background & Aim: Standard protections of patients suffering from head injuries are very important. Any failure in cure protection of these kinds of patients is equal with deviation from the care protocols. With regard to care of these patients, the quality of services of them has been studied.Materials & Method: The study was conducted on 668 patients in emergency section of Vali-Asr hospital of Arak in 2005. Questions categorized in four groups for nursing and profession cadre including: general cure, respiratory system, homodynamic system and nervous system. Data were collected by seeing the performance of collectors and analyzed by the software spss.Findings: Physical examination and statements of the patients were not recorded by nursing and profession cadre of hospital in 98% and 86% of cases respectively. In 96.5% of cases the patients' pulses hadn't been controlled and recorded by nurses and in 99% of patients who had disorder in the urine system did not get any recommendation by profession cadre of hospital. The control of the arterial blood gases was not described in 98% of patients. Radiography of cervical vertebra was not conducted in 81% of cases. Conclusion: According to the result, taking cure of head injury patients was nearly acceptable, but in some cases there are some failures. The most important failures related to negligence of the hospital cadre that has many reasons.

Background & Aim: The difficult nature of legal procedures led to define "judicial job" as a "hard job". This study is performed to find the effective factors and relation between "burnout" and general health of the judges and prosecutors working at courts in Tehran.Materials & Method: The study was conducted on all of judges and prosecutors working at courts in Tehran. The sample was selected based on random unequal ratio sampling. In this study we applied two standard questionnaires (MBI and GHQ-28) and analyzed the data by statistical parameters such as Pearson s & spearman correlation coefficient, student t-test, regression coefficient, chi-square test and HSD.Findings: 32.7% of all the participants had some problems in general health and needed counseling services. Only 4.9% of them had severe problems in general health and needed more serious (e.g. psychotherapeutic or psychopharmacologic) interventions. Job burnout is higher in dimension of emotional fatigues and depersonalization and lower in dimension of personal functioning and occupational involvement, Also there is a meaningful correlation between general health and job burnout of the judges and prosecutors. Conclusion: One of the best ways for decreasing of job burnout and promoting the level of general health in judges and prosecutors is giving more attention to amend the managing styles, salary condition and relationship with other colleagues. In other words, rising of interest and producing motivation among judges and prosecutors will be effective in providing their general health.

Background & Aim: Because of its ability to demonstrate the nature, extent, sites, and multiplicity of brain injury, computed tomography (CT) is now the primary diagnostic method for head trauma. Although there have been numerous reports on the CT findings of most types of intracranial injuries, the findings in brainstem injuries have not been well described. This study aimed at comparing the autopsy findings of brainstem in head trauma in comparison with CT scan results.Materials &Methods: Two hundred patients with head trauma, who expired after a period of time of hospitalization, were assessed in a diagnostic value study. Brain stem involvement was determined by autopsy as well as CT scanning of the brain during their hospitalization. The results of the two methods compared with each other, emphasizing the type and the location of probable lesions in the brain stem. Considering the autopsy as the method of the choice, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CT scan in brain stem lesions of patients with head trauma were calculated. The effect of primary cause of head trauma, survival time and Glasgow coma scale (GCS) were evaluated, as well. Findings: Brain stem lesions detected in 39 (19.5%) patients in autopsy. However, CT scan revealed brain stem lesions in 23(11.5%) cases. The sensitivity, specificity, PPV and NPV of CT scan was 59%, 1000/0, 100% and 91% respectively. The most common lesions of the brain stem region were as contusion of pons (8.5%), medulla (5%) and midbrain (4.5%). There were 6 (3%) cases of pon to medullary junction tear and 1 (0.5%) case of cervicomedullary junction tear. Admitting GCS and survival time were significantly lower in patients with brain stem lesion (p<0.001 for both of them); however, the initial mechanism of trauma did not significantly differed between the two groups (p=0.343).Conclusion: CT scan is a specific method of evaluating patients with probable brain stem injuries after head trauma, but low sensitivity limits its efficacy our results are in conformity with the reports in the literature.

Background & Aim: As there was no study on the role of meteorological variables on suicide, quarrel and psychiatric hospitalization in Iran, this study have evaluated the relationships between meteorological variables and aggression variations in Mashhad.Materials & Methods: This is an analytic descriptive study in which the daily hospitalization rates of Ibn-e- Sina psychiatric hospital, daily rates of murder, suicide, and quarrels were obtained from the hospital archive files and Legal Medicine Department of Mashhad in 2005. Meteorological data were taken out of the daily reports of the Meteorology Organization of Khorasan Province. The meteorological variables of each day divided to 4 equal groups; then data were analyzed by SPSS software and underwent statistical tests such as ANOVA and POST HOC. Findings: There was a significant statistical relationship between the average daily temperature, moisture, air pressure and the number of quarrels and hospitalizations at Ibn-e-Sina psychiatric hospital during the year 2005 in Mashhad. There were direct correlation between the average number of quarrels and hospitalizations and the average daily temperature (P=0.00) and indirect correlation with minimum and maximum moisture and air pressure (P=0.00). Also, the statistical data indicated that no meteorological variable had any effect on the rates of murder and suicide in the city.Conclusion: According to this study and investigations, there was a significant relationship between the meteorological variables and the rates of quarrels and hospitalizations at Ibn-e-Sina psychiatric hospital. Yet there was no relationship with the rates of murder and suicide.

Background & Aim: Head trauma is one of the most prevalent causes of brain death in accidental events. Annually, in our country, more than 15000 of brain death cases happen because of the accidents which less than 10% of them are organ donors. The number of organs donation has been less than in Europe or America because of the transplantable donatives organs there for so many people lose their lives every year. In this study, we tried to study the physician attitude as someone who can educate and encourage the people to donate organs.Materials & Methods: This cross sectional study has been done in 2007 in order to appoint the level of information & knowledge in physicians with regard to organ donation in brain death cases in Kerman. Self made questionnaire & random sample survey have been used to collect data. The questionnaire has being arranged in 3 parts which includes demographic traits, the evaluation of view points, and the evaluation of knowledge. Generally, 400 physicians are being studied in Kerman and all the questions have been completed and SPSS software and K & T test have been used to analyze data.Findings: In this study, about 55% of physicians agreed with the organ transplant in brain death but only about 80% agreed with filling and signing the organ donation card. 49.6% of physicians had high level of information and 11.4% had low level of information. 65.5% had positive opinions and 2.3% had negative opinions. According to an accurate study, it has shown that there is a meaningful relationship between the level of information, and attitude (P < 0.001).Conclusion: With due attention to the important role of physicians in organ donation process, it has strongly being recommended to have educational planning in order to increase the level of information and reinforce their motive and their self esteem to make a better relationship with the brain death relatives.

Introduction: Neurofibromatosis type1 is an autosomal dominant disorder which involves different portions of the body including bones, nervous system, soft tissue, skin and vessels. Vascular involvement of this disorder comprises stenosis, aneurysm and arterio-venous fistulas.Case Presentation: In this report, a 39 years old male is presented suffering from neurofibromatosis type1  with multiple manifestations of bones, nervous system, skin and vessels, and was under radiotherapy for malignant mediastinal neurofibromas for 2 months, and died suddenly due to rupture of dissecting aortic aneurysm about 1month after the end of radiotherapy.Conclusion: Considering the vascular involvement in neurofibromatosis which occasionally can be life threatening, it seems that vascular involvement in these patients must be considered more seriously.