Iranian Journal of Forensic Medicine
Year:2008 | Volume:14 | Issue:1 (49)|Papers Count:10

Background & Aims: The aim of this study was to assess the clinical manifestation and causes of chronic posttraumatic headache. Several publications have emphasized the relationship between head trauma and chronic post-traumatic headache. However, there is little known about the etiology (psychiatric or organic), treatment and particularly legal issues of chronic post-traumatic headache. In spite of the high number of accidents and head trauma this study was performed in Iran.Materials & Methods: This was a retrospective study for 2.5 years in Neurology and Psychiatry outpatient clinic of Ghaem and Avicenna hospitals. Patients included according to the diagnostic criteria of the primary headaches in The International Headache Classification 2nd Edition.Findings: The clinical presentation of chronic post-traumatic headache in 79 patients was analyzed. 56% of patients were women. The average age of our patients was 32. Headache had an inverse relation with the severity of trauma. 62 patients agreed to follow in this study. 55% had a bad response to treatment and finally did not continue it. 10 patients were referred form the forensic department and 4 fulfilled the criteria of chronic post-traumatic headache.Conclusion: The results of this study were similar to previous researches. Most of the time headache was not associated with a severe head trauma. It is possible that microscopic brain injury in the level of cellular relation is responsible for chronic post-traumatic headache. Further studies and clinical trials are necessary to clarify the scientific bases and also legal issues of chronic post-traumatic headache.

Background &Aim: Informed consent is the process that patient realizes the treatment and then agrees on it. For progressing of relationship between patient and physician obtaining of acquit also need If the process of getting informed consent has been done correctly, it can help physician -patient relationship; as one of the bases of treatment. The goal of this study is evaluation of the processes of obtaining informed consent from admitted patients of Imam Khomeini hospitalMaterials and Methods: This study is descriptive cross-sectional study and populations are patients of department of surgery of IMAM Hospital of Tehran at winter 2006. For receiving information from patients we arrived to hospital and spoke with patients and fill questioner paper and then gathered information and analyzed with SPSS.Findings: Informed consent had been taken from all patients (250). Most of patients were illiterate (42o/J and unemployment (48%). All of informed consent had been given by clerk of wards. The most information given to patients was about type of treatment (96.8%). From patient s point of view the most important information was about rate of success (94%). Most of patient mentioned the surgeon as a best person for obtaining consent and they want to sign informed consent and acquit form while they are admitted in wards.Conclusion: According to our results obtaining the most of informed consent and all of acquit is done with nonphysician at admission time but we should get information and informed consent and acquit at time that we have less stress and do it by the surgeon and to a certain extent explain the percentage of success to patient.

Background & Aim: Midwives, as providers, have an important role in health counseling and education, not only for the women, but for the family and the community at large. A midwife s role includes education during pregnancy and preparing the parents for assuming the motherhood and fatherhood duties, which extends to some cases of gynecology diseases, birth control and child care. Midwives, because of important duties, must be notice of professional laws and regulations and observe them. Also they should be able to solve professional, legal and moral difficulties that confront with them. The purpose of this study was "The rate of midwives' awareness of working at midwifery offices, hospitals and clinics in Shiraz from Islamic Punishment Laws related to medical practitioners in 2007".Materials & Methods: In this study, the data on 157 midwives working at midwifery offices and those working at hospitals and clinics, concerning Islamic Punishment Laws relating to medical practitioners were collected by self-reporting questionnaire and analyzed.Findings: The findings showed that the total mean of midwives' awareness of working at offices and working at midwifery offices and those working at hospitals and clinics concerning Islamic Punishment Laws was at a poor level. While the total mean of awareness of those working at midwifery offices was lower than that mean of midwives working at hospitals and clinics (P=0.004).Conclusion: Thus, to prevention from any violation of medical rules, we suggest holding of refreshment courses and seminars on introduction to the contents professional laws and rules for midwives working at private and public health centers and midwifery offices so that, in addition to review the current governing laws, update their information on professional laws.

Background & Aim: In order to respect patients rights who are referred to Legal Medicine Organization, comprehensive and precise laws &regulations are needed to make uniform expertise views and consequently uniform judgments by court at different times and places. We studied the extent of uniformity in expertise views given by legal medicine experts of Tehran and their assessments of Arsh and Dieh in some selected cases to find their degree of uniformity.Materials & Methods: This study is a prospective research which uses a piloted anonymous questionnaire; by open and closed questions, it includes selected cases for assessing Arsh and Dieh.Findings: The study population was comprised of 99 legal medicine physicians working in Tehran s province legal medicine center from a roster of 120. The average age was 36.6±5.0 years, and the mean of working experience was 5.6±3.9 years. 59 were men (59.6%) and 40 were women (40.6%) all of the responders believed in identical answers in 7 of62 (11.3%) questions and there was no controversy. There was a mild controversy (75-99% similarity in answers) over 41 (66.1%) questions and a moderate controversy (50-74% similarity in answers) over 13 (21.0%) questions. Only over one (1.6%) question, there was a severe controversy (less than 50% similarity in answers).Conclusion: Although the main differences cause mild controversies, the important role of forensic medicine expertise views in judgments of court and consequently the patient s rights necessitates a higher quality and uniformity of forensic medicine prescriptions.

Background & Aim: Forensic dentistry is one of the branches of forensic medicine and a new professional line of dentistry which descript the use of dentistry in Criminal affairs. One of its subdivisions is identification by teeth. The Iranian population is composed of population from different regions so they are good samples to analyze dental dimensions and sexual variations. This study was performed to examine the mentioned hypothesis.Materials & Methods: This analytic, cross-sectional study was composed of 100 stone cast from Iranian population of either sex ranging from 19 to 23 years. Mesiodistal breadth from 14 teeth (11 through M2 of the maxilla and mandible) are taken from the left side and analyzed using the discriminant function statistics.Findings: Results of the study revealed that males exceeded females significantly in dimensions stepwise discriminant function statistics suggested that upper C' lower C, upper M2 and lower M2are the most contributory teeth to the function. Overall accuracy of sex diagnosis ranged from 64% to 78% for men and 60% to 67% for women.Conclusion: While dental difference between the sexes in Iranian population has been found highly dimorphic; and, the accuracy of this classification remained at about 73% in Iranian this methods can be used as an alternative with other sex determination methods.

Background & Aim: The probe into the reasons causing children and juvenile deaths, and eliminating the preventable cases can play an important role in the health and productivity status of a society. According to WHO, every person under 18 years old is defined as a child. Considering the existing differences in the distribution of the causes leading to the deaths among children and juveniles in different countries, and regions, it is necessary that the information related to each region be regarded to lead the way for macro-policy making.Materials & Methods: This study is retrospective; cross-sectional that covers the causes of death among the children and juveniles of 0-18 years of age who were referred to the autopsy theater of Tehran Forensic Organization in 2005 to investigate the causes of death. That results analyzed by SPSs.Findings: Out of the total of 760 children and juveniles studied, 34.6% were female and 65.4% were male. Different types of traumas were found to be the most common cause of death, including 58.4% of cases. It is then followed by miscellaneous reasons, poisoning, asphyxia to rank as common causes of death among the children and juveniles studied. The study found significant differences in the causes of death resulting from trauma, poisoning and miscellaneous factors among the cases aging below 11and those above it.Conclusion: Deaths caused by trauma are highly prevalent in our country. This rate has also been reported high in some neighboring countries; however, it bears some differences in the distribution of the causes of death in other countries with that rate common among the children in Iran. This necessitates taking fundamental nationwide measures to prevent accidents, which lead to the death of children and the juveniles.

Introduction: Somnambulism is a legal and medicine subject, therefore, the study of this topic from psychiatric and the law viewpoint is important, because in some criminal records somnambulism is considered as a defense against attributed charges. The aim of this research is to explicate the topic (Somnambulism) from psychiatric, religious and legal viewpoints and to compare it with other legal systems.Discussion: Many researches have shown that persons who suffer of somnambulism should be considered as no guilty for probable criminal act during sleep walking, because they have no volition and are not alert of the quality and nature of their act and not aware of the results; Consequently, they are free of criminal liability.Conclusions: One can come to the conclusion that when reviewing or compiling Islamic Criminal Law, sleep must explicitly considered as a factor removing criminal responsibility and consecutively removing criminal liability from those who commit a crime while sleepwalking (both natural or magnetic) or being affected by psychiatric disorders, due to lack of guilt and mental aspect of the crime; so as to prevent punishment of those commit crimes without any intensions and volitions.

Introduction: Intestinal duplication is a congenital disorder of Alimentary tract that can occur in any part of gastrointestinal tract (GIT) in both Cystic and Tubular form. Based on its site, size and associated complications, it has various clinical presentations. The most important clinical features of the thoracic duodenal duplication include nausea, vomiting, colicky abdominal pain, weight loss, dyspnea and cough. Hemorrhage due to peptic ulcer can also add up to the problem.Case Report: The case was a 2- year- old boy that presented with dyspnea, colicky abdominal pain, nausea, vomiting and occasionally high grade fever. Chest Xray and CT scan demonstrated a cyst in the right hemithorax. However there were no positive findings in favor of hydatid cyst or abscess in laboratory investigations. Right thoracotomy incision demonstrated the above mentationed cyst in right hemithorax. The cyst extended to the diaphragm and in to abdomen being attached to duodefium. After giving a Medline incision the cyst was separated from the duodenum. The patient was discharged on the 8thday. However he returned with pleural effusion, for which chest tube was placed.Conclusion: The thoraco - abdominal type of duodenal duplication is the rarest type gastrointestinal tract duplications. In addition to GI symptoms such as nausea, vomiting and abdominal pain it is associated with respiratory features, making its diagnosis difficult. Treatment is surgical; they are removed by both thoracotomy and laparatomy incisions. In the long run, the most important complication of these cysts are conseqvently hemorrhage and perforation. Fortunately on time diagnosis and surgery of this patient spared him the mentioned complication. The pathological evaluation of the duplicated cyst mucosa demonstrated intestinal, gastric, lymphoid and ureteral cells.