Iranian Journal of Forensic Medicine
Year:2006 | Volume:12 | Issue:2|Papers Count:12

Background & Aim: Accident is one of the most important causes of death & disability in the world and it is necessary to pay deep attention to this problem from several aspects. Different tensions such as accidents, quarrels, and occupational injuries can be influential in economical and social issues, insecurity, unrest, lack of social welfare and disabilities. Since the majority of accidents take place in juvenility and the major part of Iranian current population are juvenile, tight control and consideration of various aspects of this task can be effective.Materials and Methods: In this study 9828 persons who referred to legal medicine center of Hamedan, were exposed to trauma. The injured who recommended from police or judicial authorities, toke medical examination and their injuries filled up and wrote in questionnaire. Then in case of physician had discretion about reevaluation and reexamination of patients they toke check up in specific interval times until the recovery or disability or death are created.Results: Totally, 76% of cases were male and 24% were female. The most ages of referral with 3218 persons had been 20-29 years old. The most causes of referral were quarrel which the main stimulant was unknown in most cases (43.5%). The most common devices were hard objects (91.2%). Trauma was most likely to occur at the evening between 12 Am and 6Pm in (43.5%) cases. Approximately, 32.3% of patients who referred to legal Medical center came in summer especially in August (11.4%). The most common sigh was ecchymosis (46.5%). 99.4% of patients had been cured and only 0.6% of them were dead due to severity and morbidity.Conclusion: The results show that car accidents and quarrels have been increased in society that could potentially wasting effects of man power and useful time and lead to disability and morbidity. The most important way to prevent the development of these accidents and tensions are enculturation and appropriate strategies.

Background & Aim: Recently motorcycle not only produces massively but also used as a popular transportation in middle class of society. 42% of all transport injuries in Tehran are related to motorcycle accidents. This study evaluates motorcycle accidents in Uremia.Materials & Methods: A retrospective study was conducted on all patients injured in motorcycle accidents who were admitted to the Shahid Motahari during two-years period since 1382.Results: The 695 patients admitted due to motorcycle-induced trauma in Shahid Motahari Medical center with 16.6% increased rate of admission in 1383 compared to 1382. 96% were men, the 391 patients were in 15-24 age groups. 94% were not wearing a helmet. Motorcyclists who don't wearing a helmet had an increased risk of brain concussion and facial bones fracture. Lower extremity fracture is the most common motorcycle induced injuries in transportation crash. In this study showed the rate of brain concussion, lower extremity fracture, facial bone fracture were 645, 41% and 77% respectively. The most common cause of death was brain concussion.Conclusion: With plan to encourage use of helmet we can reduce brain concussion and by modified motorcycle design and leather dressing, lower extremity fracture is prevented in motorcycle induced trauma.

Background & Aim: The external genital traumas may lead to emotional and physical complications which can be prevented in case of knowing the types and common creating causes. This study was carried out to determine the frequency of external genital trauma in patients who were admitted to Motazedi hospital at Kermanshah University of Medical Sciences in 1376-1382.Materials & Methods: This descriptive study was carried out by available data. The data was collected by information form that contained some variables such as patient's age, job, menarche situation, season, cause of trauma and related complications. The records of all of the patients who were admitted to Motazedy hospital in 1376-1382 were studied. The collected data was analyzed by descriptive statistics.Results: The study on 82 patients showed that 30.5% were students, 68.3% housewives, 64.4% lived in cities, the maximum frequency of genital trauma in summer and spring were 30.5% and 24.4% respectively. The most common trauma was due to first coitus (47.6%) and the damage was most often located at the vulvovaginal (67.1%) as well as urethra (31.1%).Conclusion: This study showed the most common cause of genital trauma is due to first coitus, thus it is recommended to plan a well educational program to increase knowledge and prepare young person before getting married.

Background & Aim: The tumors of sella turcica are among the common causes of pituitary enlargement. In selected autopsy series up to 25% of pituitaries have a small incidental microadenoma. No comprehensive study concerning the prevalence of these tumors has been conducted in Iran previously. In this article the prevalence and distribution of sella turcica tumors in 20 years and more old cadavers dissected in the legal medicine center of Tehran in 1383-1384 have been studied. Materials & Methods: In this cross-sectional and descriptive observational study, 186 pituitary glands from cadavers dissected during the second half of 1383 and throughout 1384 were studied with a view to presence of tumor, type of tumor and size of adenomas and in relation to the age and sex of cadavers.Results: The overall prevalence of pituitary tumors was 10.2% (19 of 186 glands) among which was 4.3% adenoma (8 cases), 4.3% craniopharyngioma (8 cases), and 1.6% meningioma (3 cases). Maximum prevalence of pituitary tumors (6 cases) was in 3rd decade and then in 8th decade afterwards (5 cases). The prevalence of pituitary tumor was 11.26% (8 Cases) of 71 cadavers in females and 9.56% (11 Cases) of 115 codavers in males. Among 8 observed tumors in females 5 were craniopharngioma , and 3 adenoma. Among 11 observed tumors in males 5 were adenoma, 3 meningioma, and 3 craniopharyngioma. Among 8 observed adenoma, 7 were microadenoma (diameter less than 10mm) and 1 was macro adenoma (diameter more than 10mm).Conclusion: In this study, no statistically significant relationship was observed between sex of the cadavers and the prevalence and type of tumors. The overall prevalence of adenoma and craniopharyngioma was equal. The relationship between tumor prevalence and age was statistically significant .Microadenoma was significantly more prevalent than macroadenoma.

Background & Aim: Traditional depilatory agent has been rarely used as a means of suicidal attempt in Iran. Its complications arise from its corrosive effect, and systemic arsenic intoxication. This study was conducted to assess intoxication and mortality rate with depilatory agent in 1370-1382. Materials & Methods: In this retrospective study we collected published statistics from poisoning department of Loqman Hakim hospital and analized the patients' registries.Results: The number of poisoned patients' referred to Loqman Hakim hospital increased from 12000 in 1370 to 24000 in 1382. Meanwhile the relative frequency of poisoned patients with depilatory agent in comparison to all of the poisoning in mentioned time was decreased (0.6% in 1370 to 0.4% in 1382). 97% of patients used it for suicide attempt. During these years mortality rate from poisoning increased from 0.99% in 1370 to 1.27% in 1382, but mortality rate from depilatory agent decreased from 22% to 5.7%. After 1377 no case of surgery has been observed as a treatment whereas during previous years about 20% of patients need surgery.Conclusion: Elimination of arsenic from depilatory agent caused in decreasing of complications (Including surgical intervention) and mortality rate among the poisoned with this substance.

Background & Aim: Postischemic reperfusion may profoundly alter cardiac function. Principal mediators of this complication are oxygen radicals and neutrophils. Vitamins C and E has a role such as water-soluble and lipidsoluble chain-breaking antioxidants, respectively. They also protect lipids, proteins or membranes from oxidative damage. The purpose of this study is to evaluate the effect of Vitamins C and E on diastolic dysfunction of left ventricle and inhomogeneity of repolarization in patients with acute myocardial infarction treated with streptokinase.Materials & Methods: In this clinical, randomized study 59 patients with first acute anterior MI treated with streptokinase were enrolled and assigned to control group without antioxidant treatment and test group with vitamin C and E (600mg/day each) treatment, starting on the first day of acute MI and lasting for two weeks. The diastolic function of left ventricle was assessed by examining the flow pattern of mitral valve by echocardiography, The aboves factors were measured on 3rd and 14th day, and in homogeneity of repolarization was also assessed by examining QT interval dispersion (QTd) on the first and 14th.Results: In test group, vitamins C and E improved diastolic dysfunction of left ventricle. The values of Peak A, 0/64±0/1 (mean±SD), and IVRT, 82/26±11/28 at 14th the day was significantly smaller than their values on the 3th day 0/84±0/17 and 102/48±22/23, respectively (P<0/01). The values of Peak E and E/A ratio at the 14th day increased significantly compare to the values of 3rd day (P<0/01). Treatment with vitamins C and E also decreased The values of QTd at the 14th day compared with first day (P<0/001), but in control group there was not significant difference.Conclusion: These results suggest that combined treatment with antioxidant vitamins C and E in patients with acute myocardial infarction might be protective against oxidative stress.

Introduction: By appearing religious jurisprudence, the Muslim thinkers have taken the responsibility resulting from medical treatment into consideration and have inspected it from different points of view.Discussion: Based on the Islamic lawyers opinion, if a physician, who is not competent or proficient or despite being proficient treats a patient without his/her permission or without his/her guardian s permission and casually the treatment result in casualty, physician will be responsible.Islamic lawyers also have consented to the responsibility of a physician neglecting in his/her treatment, even if he/she has been permitted by patient. But, there are two major theories about the responsibility of a physician who has causally caused casualty in spite of being permitted for treatment and observing all specialty ruled: the majority of the jurisprudent believe in responsibility of guiltless physician.Conclusion: According to proofs, the majority s idea is more reliable and compatible with rules, but it must be confessed that accepting the well known theory will socially result in corrupt succession.

Introduction: Health care securing as a main target of professional nursery can be obtained with new & up-to date ethical and science method and proper communication with patients. Negligence can provide patient discontent & complaint. So legal information about that, will be nursing profession basis.Discussion: Behavioral agents, expensive hospital care, nurses economic necessity, patients negative conception to medical personal and increase information of people ... be affected rising of complaints. Nurses will be responsible about their patients directly or indirectly. Nursery Community Organization activation is marked law train necessity in this society.Acquaintance with job description of different nursing groups based on health and care ministry act and its observance can be definitely not caused of bring proceedings or being exonerated of them from charge. Article 59, 60, 319 and ... of slamic penal code, in regard to security or responsibity of medical community in exchange for malpracticing, exactly has been stated.Malpractice divide to four types: a) carelessness b) improvidence c) in attention to directions. D) lack of skill. Malpractice is approved by existence of four situations, 1) damage 2) type of 3) divect relation between error and damage 4) disobeying on order.Conclusion: Acquaintance of nurses' community, with new medical science and intimate at duties & current law can be cause, operation without any default or malpractice.