Iranian Journal of Forensic Medicine
Year:2005 | Volume:11 | Issue:2 (38)|Papers Count:9

Background & Aim: Valvular Heart Diseases is an important group of Cardiovascular System Diseases all over the world. We investigated prevalence of this problem in 500 cases from April 2003 to April 2004 in Legal Medicine Organization, Tehran, Iran.Materials & Methods: In this cross-sectional study 500 cadaver of adults were investigated for signs of gross and microscopic pathology of the heart. Their past medical history was investigated and the findings were.Results: 80% of all cases these were male and 20% female. 64.8% were 19-44year old, 17.2% had over weighted heart and 5.6% of cases had valvular disease. Valvular diseases were more common in the 45-64age group and in this age group, Sclerotic Valvular Lesions were more common (2.8%), followed by Mitral Valve Prolapsed (1.4%), Rheumatic Valvular Lesions (1%), Bicuspid Aortic Valve (0.2%) and Tricuspid Bacterial Endocarditic (0.2%).Conclusion: Results of this study correspond with other studies and we found that age dependent sclerotic change of valves is the most common lesion in valvular diseases, and also most of these cases with these changes had overweight heart and positive history of Hypertension in their life.

Background & Aim: Due to the daily increase of complaints with a survey Of the symptoms acquired and a review of the demographics of the complaints may be of significance in better quality medical services and a decrease in complaints.Materials & Methods: In this descriptive-periodic and retrospective study, files of complaints reviewed in the legal medicine Organization commission (eye patients) during the years 1379 (2000) to 1382 (2003) were reviewed the information in these files were taken and analyzed.Results: In total from 79 cases which referred to the legal medicine organization against ophthalmologists, 78% of plaintiffs were males between the ages of 4 to 71. Most complaits included cataract surgery (55 instances) and after that included lasik surgery (16 instances). Most complaits were about general or systematic basic problems or congenital disorders and retinal disease and post operation inflammation insufficient insuffient instruction of the patients and only in 12 cases of the total complaints (%15.1) were the physicians found to be guilty.Conclusion: Clarification of patients prior to surgery about the possible effects of surgery as well as a review of basic problems before the operation will lead to a decline in the rate of patient’s complaints.

Background & Aim: Personal identification of unknown cadaver has a great importance in forensic medicine. At present, DNA Typing is one of the main procedures in personal identification by extracted DNA of different tissue such as blood, Muscles, Liver or Spleen. In bodies who are putried or buried for a long time, decomposition and Environment factors cause to destruction of soft tissue. So DNA is degraded by endonuclease enzymes and polymerase chain reaction is inhibited by decay products. In such cases tooth and bones are suitable sources for DNA in forensic investigations. Additionally, in the severe bruns and air accidents, tooth has an important rule in identification.Materials & Methods: In this study, DNA was extracted from five unknown cadavers by using guanidinium thiocyanate-silica (GUSCN) method some modification is carried out in standard (GUSCN) for achieving better results and reducing artifacts. For evaluation of the procedure, extracted DNA was amplified and subjected to PCR for six short tandem repeats (STRs) loci named VWA, F13, CD4, THOl, FES/FPS and TPOX.Results: This study showed that quality and quantity of extracted DNA from tooth by method mentioned above is comparable with extracted DNA from blood and the alleles of tooth and blood belonging to same individual weve compared with standard allelic ladder for each locus.Conclusions: we suggest using of this method for DNA extraction of tooth as a valuable source in forensic personal identification.

Background & Aim: Prevention of SND (sudden natural death) is one of the unsolved problems in medicine today. Recognition and determination of causes of SND are very important preventing measures.Materials & Methods: This is a descriptive retrospective study. 1536 cases which were referred to Isfahan legal medicine center for determination of cause of death are included in this study, then cases of SND were selected and the information gathered in a check list.Results: The rate of prevalence of SND is (7.16%). 25% of cases were between 60 and 70.77% were male. 51% had a positive drug history, 30% had a positive family history of SND and 39% had underlying diseases as follow: heart disease 25%, HTN 9%, DM 9%, respiratory sys. dis. 3% and others 1%. The most prevailing complaint was chest pain (24%) alone and (39%) accompanied with other complaints. The most prevailing cause of death diagnosed by attending physician on the basis of clinical signs and symptoms was MI (57%). A comparison between the cause of death determined after autopsy and clinical judgment showed that 60.9% of diagnoses were fully correct, 20% were partially correct and 10% were not correct. 56% of cases died before admission to the hospital and before any medical intervention.Conclusion: The risk factors of SND are masculinity, older age (60-70 years), and positive drug history, underlying disease and positive history of SND in the family, so it seems necessary to design studies on normal population. Because the most prevailing chief complain was chest pain it is better to plan a continuous educational programmer for physicians and EMS personnel (because more than one half died before arrival). Given that two third of SND cases were without any previous disease and problem screening interventions must be done in normal and otherwise healthy populations. The discrepancies between the diagnosis of causes of death by autopsy and attending physician revealed the very important role of clinical (hospital) autopsy for educational and research purposes and for correct determination of cause of death.

Background & Aim: Physicians and pediatricians in particular are in the first line of diagnosis of child abuse. This study was conducted to evaluate the awareness and attitude of pediatricians and pediatric residents regarding child abuse, a topic rarely explored in our country.Materials & Methods: This cross-sectional study was done by a semi-structured questionnaire that was developed based on child abuse literature. The validity and reliability of questionnaire was assessed. Pediatricians and pediatric residents in Kerman participated in this study.Results: Forty-nine physicians participated in this study, only 49% of them had good knowledge of the subject. The agreement with corporal punishment was low. There was a significant difference regarding to gender, female had higher objection toward child abuse. Also non faculty pediatricians had a better attitude than residents. A significant relation was revealed between knowledge and attitude.Conclusion: Results of this research suggest the necessity about child abuse in educational programs of medical profession of training.

Background & Aim: Accidents and related injuries which contribute 30% of hospitalizations are considered as a major health problem due to high mortality and morbidity costs and lost economic opportunities they cause. Since prevention programming necessitates valid data, this descriptive study was implemented to identify incidence rate, mechanism and contributing factors of non intentional injuries resulted in hospitalization in emergency departments of Markazi province-Iran.Materials & Methods: All of non intentional injured people admitted in emergency departments from March 2002 to March 2003 in the province were assessed by ED nurses using data sheets. The data was analyzed with statistical package for social science (SPSS) using descriptive statistics and X2 test.Results: 8856 injured people were hospitalized in ED during the study period, thus incidence rate of non intentional injuries was estimated 692 per 100000. Males were injured three times more than females. Most of admissions were in the mornings (39.1%) and the evenings (31.4%) with more frequency in the spring and summer than the other seasons. Traffic accidents and falls were two major causes of injuries and contain 44.5% and 31% of injuries respectively. 49.4% of all injuries were happened in roads and streets. The type of vehicle and the situation of the injured person in the accidents had significant correlations (p<0.001). While 64.3% of people injuring due to motorcycle accidents were motorcyclists, the pedestrians were more injured (40.7%) in automobile accidents.Results showed significant correlation between mechanism of injuries and demographic variables of sex, age and job) p<0.001).Conclusion: Traffic accident as the most important cause of non intentional injuries should be concentrated in preventing programs.

Introduction: Methyl alcohol (Methanol-Wood alcohol) is a kind of alcohols which can be led to MA intoxication due to intentional, accidental or criminal consumption of antifreeze components, industrial colourful solvents and adulterant alcoholic beverages to MA intoxication. The start of symptom is variable between 40 minutes until 72 hours and 30 to 90 minutes after drinking with empty stomach of serum level reaches peak level. Methanol poisoning may produce serious degrees of acidosis; damage the retina, ganglion cells. Giving rise to scotoma, vorying degrees of blindness, dilated unreactive pupils and edema. The most important aspect of treatment is the IV administration of large amounts of sodium bicarbonate, hemodialysis injection of folic acid and sponsorship measures.Case Report: This case is expressed about a 24 years old single man that after consumption of methanol indigestion, symptoms caused blurred vision and rapid progressive lethargic. Acidosis and severe decreased bicarbonate level in ABG was characteristic feature. In neuroradiologic evaluation extensive cerebral injuries occurred to basal ganglia, brainstem and cerebralfalx. After establishment of the disease, in spite of on time diagnosis of MA intoxication and remedial attempts, because of high level serum methanol, the patientm eventually with hypophonia and bilateral optic atrophy and clear triplegic with the acceptance of physiotherapy was discharjed

Introduction: Medical malpractice includes of failure in diagnosis, treatment or disease management and the claims resulting from medical malpractice creates part of referrals of medico legal organ. One of guidelines reducing medical malpractice, is creation of specific electronic information system in order to referred claims due to medical malpractice that is effective in line with decreasing malpractices in order to facilitate the data, processing, storage, restore, entrance of information by using of on time and decreasing frequent practices.Discussion: This article is review study using paper and electronic documentation related to subject that expresses the importance of medical malpractice and necessity of creation of electronic information system for claims being referred to medico legal organ directed to decreasing the rate of medical malpractice and finally suggest essential elements for systematic form of claims being referred due to medical malpractice which is the infrastructure of this information system. Four necessary elements for generation of information systematic form of claim due to medical malpractice are indicated:A: Identity information of plaintiff patient.B: Information regarding to a doctor who the complaint is related to him.C: Information regarding with the kind and cause of medical malpractices.D: Information regarding to how to respond to the complaints which expressing and explaining about those have been included in the article.Conclusion: Information of this system can classify medical malpractice based on frequency in order to facilitate creating protocol of decrease medical malpractice for medical society for decrees of medical malpractice cases and improve general informational approach identify reasons of medical malpractice. Also if abundance of medical malpractice limited to expertise's of special medical ,prescription of specified medicine or special geographic area, It will be preventive by helping this information before increase of abundance in first stages of appearing.