Iranian Journal of Forensic Medicine
Year:2011 | Volume:17 | Issue:2 (62)|Papers Count:12

Background: Patient's medical records in hospitals have to include sufficient data such as patient characteristics, sanitary data and any treatment and drug which have been used for the patient. File processing in traumatic patients is more important and will be noticed in legal aspects. In this study we discussed file processing defects for multiple traumatic patients in Hamden's Besat hospital in 2008.Methods: We randomly reviewed 413 files of multiple traumatic patients admitted in general surgery, orthopedic and neurosurgery units of Hamden's besat hospital, and studied them in case of recording the necessary information in patient's history sheet, doctor's orders, progress notes, anesthesia sheet, surgery report sheet and burial permission in cases conducted to death. The data was analyzed with SPSS 16.Findings: Just, doctor orders with their signs or, signatures in each visit the anesthesiologist's sign or signature in the anesthesiology sheets and post operation orders were recorded completely (100%). There was no burial permission in case of dead patients.Conclusion: Despite the specific significance of file processing for traumatic patients, data recordings are defected, which will have bad consequences for patients, medical staffs. Thus, documentary processes have to be more emphasized by physicians and others.

Background: Considering the role of psychological factors like psychological / social stress on etiology of chronic headaches, this study examined the relationship between «emotional spouse abuse, as a source of stress and perceived social support, as a source of dealing with stress», and «tension headaches and migraine» in patients.Methods: This is a case-control study that implemented by purposive sampling among patients referred to medical centers of neurology department in Isfahan who were affected by tension headache and migraine.60 patients were selected and assessed through an emotional spouses abuse questionnaire and a social support scale. Questionnaires also completed by 60 healthy men and women who were selected by multi-stage cluster sampling and interview. Then means of scores between two groups were compared in running independent t-test.Findings: The results showed that patients with chronic tension headaches and migraine, had the higher scores in emotional abuse by their spouse and lower scores in perceived social support (P<0.0005), as well as a significant difference on dimensions of emotional abuse and social support with the control group (P<0.0005).Conclusion: The findings of this research, provide empirical evidence to support the relationship between life stress and migraine and chronic tension headaches. It may have a significant role to determine integral therapeutic strategies either neurologic or psychologic. Also, it may be helpful for prevention of chronic psychosomatic disorders.

Background: Physicians awareness of legal points in the acquittal and consent forms is one of the medical necessity issues and remove the potential obstacles on the way to practice, so, its compliance is essentioal for defense of physicians in dealing with legal problems.Therefore, the present study aimed to investigate knowledge of medical assistants in different fields of consent forms and innocence satisfaction.Methods: This descriptive analytical study measured the knowledge of all specialty residents in Ahvaz Golestan Hospital from the acquittal and consent forms through a questionnaire consists of 20 questions (with content validity and desired reliability coefficient Cronbach's alpha equal to 0.80) on different aspects of consent forms and acquittal in 2009 Year.Findings: The mean total score of specialty residents was 12.7±2 from the maximum score of 20. So, level of awareness of students was 63.5. Minimum and maximum score obtained were respectively 8 and 17. Data analysis showed 1% of students had good awareness, 18% moderate, 74% weak and 7.8% had very poor information about consent forms and innocence.Conclusion: This study showed that awareness (knowledge) of residents in various fields of innocence and consent forms were not desirable. Except in obvious cases, residents did not have enough information. So, the training of employed physicians, residents and students is crucial to design and implement a process leading to obtain written legal consent from their patients.

Introduction: Since urine stains found on crime scenes are one of the crucial types of evidence in finding and detecting narcotics, the present study accordingly aims to introduce a new method for detection of trace narcotic elements in the solution extracted from dried urine stain left on cotton fabrics.Method: The present study was conducted in 2009 at the reference laboratory of the Legal Medicine Department of Markazi province in Iran. Narcotic substances were traced in the 50 samples, which had positive result in screening test, through two methods. In the first method, samples were directly examined through Thin Layer Chromatography (TLC). In the second method, a piece of cotton fabric measuring 30*30 cm was soaked in a beaker filled with 7 cc of urine sample and the solution was completely absorbed by the fabric. The piece of fabric was then let to dry at a temperature of 15-20oC. Once dried, it was soaked in 10 cc of distilled water and shaken for 30 minutes with a shaker so that the stain deposits would dissolve into water. Finally, the solution was extracted from the wet fabric in a five-minute 1000 rpm centrifugal spin and admixed with an equal amount of distilled water. A TLC test was run afterward.Findings: TLC on the main samples showed the followings: morphine, codeine and other opium alkaloids were detected in 38 samples while in 7 samples only codeine was found. In five samples no especial stain on TLC plate was found. The TLC performed on the solution tapped from the cotton piece of fabric showed similar results except for the lower density of stain colors.Conclusion: The results show that narcotics may be detected in dried urine stains on cotton fabric dissolved in distilled water. Further studies are encouraged to be designed to receive a standard protocol in wich the amount of required distilled water, based on the material of the fabric and the diameter of the urine stain, would be specified, Consequently, urine stains left on patients' fabrics or any piece of fabric left on the crime scene would be detected.

Background: Self harm is a deliberate, impulsive and non fatal behavior that leads to injury and the most common form of it is a tissue laceration which is called self-injury.Methods: Among all 3922 of violence injured cases in the year 2007 at Sari Legal Medicine Center, 84 nonconflict-related records were studied and variables such as gender, age, lesion type, injuring tool, lesion locations and any other traumatic injuries were surveyed. Data were analyzed in SPSS 11.5.Findings: 78 (92.9%) male and 6 (7.1%) female were studied. Average of the age was 28.80±9.39 and half of them were 20 to 25 years old. The most common injuries were scratches and bruising (57.1% and 32.1% respectively). The most common harming tools were ridged hard objects (50%), sharp peaked tools (36.9%) and solid objects (13.1%). The most common place was arm (22.6%), while neck (19%) and forearm (19%) came next.59 persons (70.2%) had traumatic lesions too.Conclusion: Self injury during non-conflict conditions should never be neglected during assessment a patient in forensic medicine. Traumatic lesions would never refute self injury in other parts of the body.

Background: Doctors visit people even in the worst physical and psychological conditions and they experience work related violence. Violence has adverse effects and significant impact on both doctors and health care system.Also, violence can result in jeopardizing medical service and people health. This study tries to determine the amount and causes of violence against doctors in hospitals of Khoramabad.Methods: This is a descriptive and cross sectional study.86 Doctors filled out questionnaires and data collected. Then data was analyzed in SPSS software (version 18).Results: 86 doctors participated in the study included 69.8% male and 30.2% female, 55.8% general physicians and 44.2% specialist. Verbal violence was the most common form of work- related violence with 82.6 %.19.8% of physicians reported exposure to at least one act of physical violence during the previous year. In 79.7% of cases, violences are done by relatives. Common causes of violence were disagreement with the physician (60.9%), unreasonable demands of relatives (39%) and long waiting time (27.5%). Physician's age, gender, locality, to be a native or non-native and education were not significantly associated with any type of work-related violence. Work-related violence was significantly associated with physicians who-worked at night (54.5%).Conclusion: Work-related violence exposure is common in hospitals of Khoramabad. Providing more information and Cultural changes via TV and Radio programs, newspapers and schools, may be required. The number of security guards must be increased at a sensitive area like an emergency unit and sensitive time like nights. It needs to pass laws to protect doctors.

Background: One of the important dangers which threaten people's life is the increased risk of intentional and non-intentional accidents. Annually, more than 1.3 million people die as a result of these accidents. It is estimated that around 300 still 0000 still 0 deaths occur daily due to traffic accidents which more than half of them are not about even passengers. Considering the importance of car accidents in Iran and its burden, we decided to investigate the trend of traffic accident mortality in a five years period in Khuzestan province.Methods: All Five years data (2006-2010) related to death following accidents, referred to Khuzestan Legal Medicine Center, have been analyzed in STATA software version 11. The trend of traffic accident mortality has been investigated in details of cities during this period.Results: Totally, around 6675 deaths has occurred following traffic accidents in the five years period beginning from 2006. The incidence of deaths decreased from 36.4 in 100, 000 in 2006 to 29.6 in 2010. On the whole, 18.17% of them were female and 81.38% were male. The cause of death in 46.84% was head injury, in 11.79% was head injury and bleeding, in 6.05% was multiple fractures and in 60.04% was just bleeding. Totally, 45.06% of the fatalities were the drivers of vehicles and 32.83% were other passengers.Conclusion: Seven percent decrease in risk of mortality in spite of increased number of vehicles in the province is a sign of relative improvement in driving culture, roads situation and medical and emergency facilities, but still many actions have to be done to reach to the ideal position. Inter-organizational cooperation would be essential for improvements.