Iranian Journal of Forensic Medicine
Year:2007 | Volume:12 | Issue:4 (44)|Papers Count:11

Background & Aim: Self harm is a deliberate, impulsive and nor fatal action that hurts person's body and appears in different forms. The most widespread forms are injury or rupture of tissues that called self mutilation. Self mutilation is seen in the varieties of mental or personality disorders. However some mutilate themselves for purpose of reparations or prosecution. This group is referred to forensic medicine. This research is done for detection of personality characteristics of the recent group.Materials & Methods: Filthy clientele were diagnosed as self mutilation in Forensic Medicine Center and fifthly quarreler and fifthly vehicle accidental, were selected by simple random sampling and assessed by short form type of MMPI (71 items).Result: Finally there are significant difference between self mutilation group and accidental group in scale of Hs or hypochondrias is (P=0.032), Hy or hystery (P=0.030) and Pa or paranoia (P=0.007), but there isn't any difference with quarreler group.Conclusion: Based on the results, self mutilators that referred to Forensic Medicine Centers have following characteristics: They are egoist and narcissit. They project their anger and hostility to the others. They criticize others. For their own sabotage, they culpable the others they are superficial in their social relations. They need the others' attention and emotional support. They use their body for attract the others' attention and for influence the others. They don't show anxiety and depression disorders.

Background & Aim: In every society, injuries and events increase along with development and progress. In Iran, death due to accidents is in second grade after death of infectious diseases. Tehran with over 10 million populations and without any programming in development confronted with increase in economic and human loss at recent years. In Iran despite of physical and geographical expansion of cities and forming new event arising from elaborated societies, moreover existence of numerous sky scrapers in mega cities we don’t enjoy reinforcement troops, proper equipments and facilities proportionate to accidents and events. Reinforcement at the time of accident is an important factor to reduce damages and loss at a prominent rate. Fire department has a fundamental role in reinforcement on critical circumstances. Our objective is epidemiologic examination of reported events to Tehran fire departments, human and economic damages caused by it, furthermore to reveal obstacles and problems during the time of reinforcement in every event.Materials & Methods: At this cross- sectional and observational study, all reported events to fire departments stationed have been examined in different areas of Tehran in 1379. These findings have been used in analysis. We have compared situation of events in 1379 with previous years with Chi- Suare test and descriptive schedule by using excel and spss software.Results: Comparison of events in 1379 are trending upward in comparison with 10 years ago. The time of getting to the location 9min, 8 7sec' on the average and obstacles were more due to traffic jam and lack of sufficient and suitable equipments for firefighters like wise narrow alley and avenue. Furthermore, injuries arising from events were more directed toward men. Distribution of events in different areas was not the same. Events in some areas were more in comparison with other areas. most of events toke place in summer season especially on mordad and events on azar were less than other months.Conclusion: In the light of trending upwards of events, it is emphasized on expanding of rescue station network in different areas of Tehran and equip them improved reinforcement equipment, increase in skilled human resources, moreover public training of citizens.

Background & Aim: Appendicitis has been considered as one of the reasons of mortality and morbidity in human and in spite of advances it still remains as a considerable problem.Acute appendicitis is the most common cause of acute abdominal pain and patient’s reference to the hospitals.Correct and on time diagnosis and appendectomy will help the patients to improve, on the other hand incorrect diagnosis will cause harmful complications and even death.Materials & Methods: This descriptive - Analytic and retrospective study was conducted in accordance to the content of medical records for patients affected by appendicitis in shahid Behesti and Yahyanejad Hospital between 1380-1382.The acquired data and information were analyzed statistically by SPSS software package and chi-square and Fishers Exact statistical test.Results: Evaluating the content of 1311 medical records patients affected by appendicitis resulted these findings: Out of 1190 cases of acute non perforated appendicitis the highest rate of occurrence (64.3o/oJ (767 patients) were among the 15-34 age group, 727 patients affected by un-perforated appendicitis were male and the other were female.Out of 121 patients affected by perforated appendicitis the highest rate of occurrence (49.5%) (60 patents) were again among the 15-34 age group and 85 of these patients (70.2% f were male.In the age group 65< the highest percent of perforated appendicitis and non-perforated appendicitis were 21.5% and 78.4% respectively. Conclusion: This study started to other risk factors different from those of mentioned in common scientific resources, this study also showed that place of residence and seasons of year are the important risk factors in acute appendicitis diseases. In this study 16.5% and 83.4% of perforated cases of appendicitis were seen in urban and rural population respectively. Perforated cases of appendicitis referred to the physicians in the first six months of the year and the second six months of the year were 74.3% and 25.6% respectively.

Background & Aim: Violence against health staff is a widespread problem occurring in different ways and has multiple consequence son health personnel, health systems and even patient care Emergency Department (ED) personnel especially nursing staff have a higher risk of being exposed to violence, but due to the lack of any recording and reporting system of such incidents, the history of related studies in our country is limited. This exploratory study was conducted in EDs of three major hospitals of Tehran University of medical sciences in 2004, in order to determine the frequency of violence against nurs.ing staff.Materials & Methods: Data of this cross sectional study were retrieved by questionnaire from 136 nurses working in the ED of three hospitals, Imam-Khomeini, Shariati and Sina. The questionnaire consisted of questions on socio-demographics, previous experience of different types of violence and its reporting. Data were analyzed using statistical software (SPSS) version 11.5.Results: Of study participants, 66.9% were female and 31.6% were male. The overall experience of violence was rather high (98.60/,): 97.8% verbal violence, 39. 7% physical violence and 86% other types of violence.Reporting of physical violence was more than the other types. The reasons of underreporting of violence according to the participants were belief in inefficacy of any actions in this regard and their intentions for not magnifying the incident in the workplace. Most of the nurses believed that the possible explanations for the violence incidents they faced were prolonged waiting time in ED, high direct costs, inadequate health insurance, and finally inadequate number of personnel in ED. A majority of nurses had worries about being assaulted in the ER in the future (91.1%). Conclusion: Exposure to violence especially verbal violence among nurses working in EDs is high, but despite the high prevalence of worrying about reoccurrence of violence, most of the cases remain unreported and don't result in a legal action. It seems that arrangement of systematic educational courses concerning prevention of violence and conflict resolution for ER staff, empowerment of security systems like guards, adoption of strategies to support assaulted staff and take effective legislative actions against aggression and violence in the health systems may be effective to reduce the burden problem.

Background & Aim: Nontraumatic subarachnoid hemorrhage is a neurologic emergency, which has a high rate of death and complications and its risk factors are preventable to some extent.Aim of this study is to investigate: risk factors, epidemiology, manifestations of disease and distinction between NSH and traumatic subarachnoid hemorrhage.Materials & Methods: This study is a descriptive research based on 26 persons died due to aneurismal subarachnoid hemorrhage in 2005-2006 send to Legal Medicine Organization of Tehran. Variables such as age, sex, duration from initiation of disease until death, manifestation of disease, type, location, amount and source of bleeding and also risk factors which are all investigated with autopsy and interview will relatives and studying clinical reports.Results: Among 26 persons died due to aneurismal subarachnoid hemorrhage, 69% were male, 31% were female, and mean age was at 47 years. The most common symptoms on the onset of disease were sudden onset of severe headache and loss of consciousness. 73% of them died within 24 hours after the event. 62% had a history of hypertention, 42% did cigarette smoking, 35% were exposed to sever excitations, 19% had a history of headache. In all cases, there was subarachnoid hemorrhage, 31% with intraventricular bleeding, 8% with intra cerebral hemorrhage. Although in 25% of cases determining the position of rupture was impossible as a result of bleeding severity, clot around vessels and brain death a few day before autopsy, in 40% of cases bleeding had happened in anterior part and in 35% of cases in posterior part of Willis cycle.Conclusion: 1t seems that serious intervention for reducing risk factors such as cigarette smoking, hypertention and sever excitation can reduce risk of rupture of an intracranial aneurysm. Rate of death within 24 hours of the onset of disease was extremely more than other countries. More researches should be done about transporting duration of patients to medical centers, determining the amount of primary bleeding, rebreeding, vasospasm and efficiency of treatment.

Background & Aim: The aim of this study is the report of our experience in diagnosis of the opium body packers with CT scan.Materials & Methods: For 12 cases that confessed to opium packet ingestion, we did abdominal and pelvic CT scan without contrast and evaluated the presence, number and location of opium packets and also measured the density of packets in Hounsfield unit (HU).Results: Mean age of our cases was 28.2±5.9 years (ranging 17 - 35 years). Eleven (91.6%) of patients were male and only one case was female. In all patients, the packets were visualized in gastrointestinal (GI) lumen by CT scan.The mean of minimum HU was 163.8±19.6 and the mean of maximum HU was 205.3±32.8. We had mortality in an eighteen years old female due to opium overdose.Conclusion: CT scan could be a suitable imaging modality in identifying opium packets similar that reported for cocaine and heroin.

Background & Aim: Gender identity disorder and parapilia and related therapies are of debatable issues in psychiatry. The authors introduce some of the disorders which to be cured via behavioral techniques.Materials & Methods: In all of patients the diagnosis was compatible with DSMIV criterion. Therapeutic method considered for them was cognitive behavior regardless of any type of co morbidities.Results: The mentioned therapeutic technique resulted in considerable improvement signs (except for one case) in these patients.Conclusion: Positive effects of CBT in almost all of these patients mean that morphological treatment could be considered as an effective therapeutic approach. Although good compliance in patients was not ignorable for successful results, considering CBT in any patients should be a role before nonreversible treatments such as surgery or stigmatizing patients as treatment resistant case.

Introduction: The aim of this study is to scientific investigation of crime scence.Discussion: In crime scene investigation there are several main steps that are very important. These steps are: Reaction, Security, Search, Analysis, and final step.Conclusion: Studding of different sources showed that crime scence investigation is a group work which must be done coordinately and by a specialized group. In the most of these steps psychologists can play prominent role. This article will explain the five steps and the role of psychologists in all of these steps and in the crime scene investigation.