Iranian Journal of Forensic Medicine
Year:2003 | Volume:9 | Issue:29|Papers Count:13

Background: Death in custody rises many question in minds of relatives, human rights organizations, and the public about negligence of prisoners or inadequate health care. On the other hand such cases are referred to legal medicine organization (LMO) for determining the cause of death. For a better evaluation of the condition, this study was done on the death cases in custody.Methods: This descriptive, cross sectional study was done retrospectively on the cause of cause of death in a 5-year period. There were 150 cases referred to autopsy room. The documents in LMO and the informatics center of the undersecretary on research were used for information gathering.Results: The results showed that there were 147 males and three females in this group. The most frequent age range was 54-60 years (31 cases, 20.7%). 134 cases were undergraduate. In 109 cases the method of death was natural (mostly cardiovascular diseases), in 22 cases it was suicide. In 94 cases pathologic investigations were done. 40 cases had history of addiction, 34 cases history of internal of internal diseases and 13 cases history of psychological problems. The most common crime in demised cases was narcotic drugs (60 cases), and the most common sentence was fine (40 cases, 30%). The most common time of death was between 1 to 6 months (26 cases, 17%).Conclusion: However the most common type of death corresponds with the public, but infectious diseases had causes more death than normal population. This asks for special care. Establishment of trust between prison authorities and be helpful. Causes of death should be documented by Legal Medicine Organization. This may increase public trust to the legal system. Programming for expanding the consultation program should be implemented. Other penalties should be used instead of imprisonment. In prisons, adequate health care and medical services should be present.

Background: A review of international literature examining the link between psychiatric disorders and violent criminal behavior suggest that, although a small number of patients engage in violent crimes, the vast majority is unlikely to commit homicide. Contrary to public perceptions about psychiatric patients, the previous studies have found no evidence to support the notion that mentally disordered people are more likely to kill strangers in public places for no apparent reason. In contrast, mentally ill offenders who commit a homicidal act more likely to victimize a family member in some private place.Methods: This study is based on available information in medical records of the persons who were examined in psychiatry department of Legal Medicine Organization of Tehran in a three-year duration period (100 people) and their psychiatric disorder was approved in the psychiatry commission sessions according to their psychiatric examination and past medical history.Results: The most common disorder was non-mood psychosis and only in 39% of cases, a documented reason for irresponsibility was found (Psychosis 33%, mental retardation 5% and seizure attack 1%). The final diagnosis in 32% of cases was none mood psychosis, 33% neurosis, 13% personality disorder, 13% mood disorder, 5% mental retardation and 4% epilepsy.Conclusion: In this study too, most of the offenders had killed a family member (46%) mostly at home (60%) and fact that military personnel had used guns to kill victims, notifies the importance of psychiatric evaluation before and after military employment.

Background: Increase in the number of surgical operations and their diversity together with public’s expectation from an anesthetic specialist, have led to greater responsibility against legal laws. Knowledge of adverse outcomes and causes of injuries directs us to causative agents and programming for prevention. The current study can be assumed as an step for this goal.Methods: In this study we performed a descriptive-analytic review on claims against anesthesiologists referred Tabriz Medical Council or Legal Medicine Organization from 1995 to November 2000.Results: Database was spilt into broad categories: complications or anesthetic outcomes and damaging events. Damaging events are the specific incidents that lead to adverse outcomes. Analysis of 18 claims revealed death as the most common adverse outcome (9 case, 5%), brain damage the second (7 cases 39%), and damage the third (2 cases, 11%).Damaging events leading to the adverse outcomes were predominantly respiratory (12 cases, 16.5%) and others (3 cases, 16.5%). Difficulties in management of the respiratory system were the most common cause of injury such as death and brain damage. There mechanisms of injury accounted for the majority of adverse respiratory events: inadequate ventilation (66.6%), difficult tracheal intubations (8.3%), and esophageal intubations (16.6%).Conclusion: As respiratory events were the most common cause of adverse outcomes, in order to reduce such outcomes, we recommend use of standard monitoring such as pulse oximetry (SPO2) and end-tidal CO2 (ETCO2) to diagnose and prevent respiratory adverse outcomes (decreased ventilation) and its treatment that should lead to a reduction in death and brain damage rates.

Background: Sexual dysfunction in refers to problems with erection, ejaculation or both. Erectile dysfunction is called: impotency, The synonym "Enan" in our religion. As Sexual dysfunction is of conditions that provide the permission of divorce by legal authorities, hence patients are referred to Legal Medicine Organization for the diagnosis to be verified. So we decided to make a survey on the frequency of impotency in those referred to Legal Organization (LMO).Methods:In this research we studied 300 cases referred to LMO during 2 years. Evaluation included an interview and filling a questionnaire (from) which was filled by researchers. Physical examination and evaluation of laboratory data was done by a physician. Complementary and NPT tests were performed in Kowsar infertility center and Sina hospital. Papaverin injection test was asked whenever indicated and physiological consultation recommended in those with positive NPT tests. The spouse was also interviewed and examined.Results: Most cases (142 patients) were 21-30 years old. 292 had one spouse, 216 had no children. Only 19 patients accepted their problem. Most spouses (97 spouses) were 21-30 years. NPT result was positive in 150, weakly positive in 96, and negative in 27 patients. Positive and 85 tion in negative and weakly positive cases revealed 36 positive and 85 had negative results. In conclusion, 91 patients had psychological and 85 had organic impotence while 97 were not impotent.Conclusion: problems in married life mostly occurs during primary after marriage period that is usually 30-40 years age range. On the other hand organic impotency increases in middle-ages and it seems that men deny declaring it. In this study about one-third of patients had patients had psychological cause. This may disclose a full of tension relationship between couples that had led to formal complaint.

Background: Dichlorodiphenyltrichloroethane (DDT) was introduced as a pesticide in the late 1930s. after then other organic chlorinated pesticides were introduced to the market. The remnants of these compounds have been found in air, water, food and bodies of human and animals and biological-environmental consequences has been ascribed to them. With regard to the long term toxic effects of these toxins and their accumulation in fat tissues, we measured organic pesticide remnants in corpses referred to Tehran Legal Medicine Organization in summer and fall 1380.Methods: Random specimens were collected from abdominal fat of corpses. Gas layer chromatography was used to determine concentrations of eight major organic chlorinated compounds (lindane, dieldrin, alpha-endosulfan, beta-endosulfan, OP' DDT, PP' DDT, PP'-DDE, PP' DDD). Extraction was done by liquid in liquid extraction by organic solvents using decanter funnels. Thin layer chromatography was used for screening, and confirmation of the method of reporting measures was perfomed by gas layer chromatography. Results: Analysis of 64 samples (32 male, 32 female) revealed the following results: 26 samples contained, 59 had dieldrin, 10 had alpha-endosulfan, 10 had beta-endosulfaten, 4 disclosed OP' DDT, 3 revealed PP' DDT in them, 7 had PP' DDE, and at last 2 samples showed some measure of PP DDD.Conclusion:The results clearly show that all samples contained one or more of the investigated toxins. Concentration of dieldrin in 60 years old people was significantly higher than younger ages. No relationship was found between sex and toxins concentrations in fat tissues.

Background: Cephalometry is one of the active subjects in medicine and forensic medicine. One of the important indices in cephalometry is skull cephalic index which forms the basis of the international standard categorization of the skull. Length and width of skull are its most important dimensions and it is through these dimensions that we can determine the cephalic index. Different factors such as age, race, economic and social status affect the skull index. Therefore, this research was done to determine the influence of the educational level and residential area on cephalic index in young males and female and females aged 20-24 years in Tehran during 2001-2002.Method: This descriptive research was performed by observation and interviewing. The individuals were chosen accidentally from five different areas in Tehran (North, South, Center, East, and West). 1862 youngsters (967 male, 895 female) in several educational levels (such as under diploma, diploma, over diploma) and 1822 youngsters (943 males and 879 females) residents of different areas in Tehran, were studied without considering their education level. The samples were sane without any musculoskeletal diseases. Data was analyzed with SPSS for windows software.Results: The mean and standard deviation of the cephalic index in males with under diploma, diploma, over diploma were: 81.5±6.4, 81.6±6.6, and 82.9±6.8 respectively In females they were: 78.9±5.7, 81±6.0 and 82±6.2 respectively. The mean and standard deviation of the cephalic index in male residents of the north, south, center, east, west of Tehran was: 82.7±6.2, 83.1±5.8, 81±6.0, 81.2±6.8, 82.0±6.1 respectively and it was 81.0±6, 81.8±5.8, 82.3±6.3, 81.5±5.9 and 83.2±5.8 in females. These indices in males and females, with different educational levels and residential areas, were compared with "student t. test" and p<0.05 was considered significant.Conclusion: Cephalic index increases in line with education in both sexes. Mean cephalic index is greater in males than females in all educational levels. This index is significantly different in residents of different areas, but this observation needs additional studies due to the confounding effects of factors such as social and economic status.

Background: On of the important factors in knee stability is its ligaments and in particular cruciate ligaments. They relax during standing up or walking to prevent abnormal displacement of the bony parts of the joint. So knowledge of their actual length and width is vital. Good information about their binding with tibia and fibula is also important to apply during ligament repair of knee prosthesis. In addition proper information about tibia and fibula connection can be helpful in understanding the biomechanics of knee joiner and used in knee prosthesis modeling.Methods: In this study 60 Iranian cadavers were analyzed. A U-shaped incision was used to provide access to joint space and after determining every ligament, place of attachment with bone their length was measured.Results: The mean length of anterior ligament was 29.6±2.86mm and its mean width measured in midway point was 7.62±1.45mm. Mean posterior ligament length was recorder 26.62±4.19 with mean midway point width of 7.75±1.8mm. The from of their binding to femur was semicircular and their concavity is toward is joint margin. Length of insertion site of anterior and posterior ligament with femur was 11.5 and 1.5mm respectively. Distance between ligament dome to joint margin was 5mm for anterior and 4mm for posterior ligament. Insertions to tibial bone were band like for both and were in anterior and posterior sites.Conclusion: Different studies provided different measures of anterior and posterior cruciate ligaments. Part of this difference can be due to racial differences. Exact determination of their bone insertion can be helpful in understanding the reasons the reasons for the firmness or laxity of their fibers during movement. Cruciate ligaments are very important in biomechanics of knee movements and actually most of the knee stability is facilitated through these ligaments.

Poisoning with tricyclic antidepressant drugs (TCA) is a common situation and their hypotention and myocardial depression is refractory to conventional medical therapies. The most common cause of death is refractory hypotension. We introduce a patient referred with coma, filliform peripheral pulses, shallow breathing and not detectable blood pressure. After intubation and primary resuscitation measures, the patient was connected to ventilator and in addition to usual detoxification routines dopamine and noreadrenaline infusion was used to increase blood pressure but proved to be unsuccessful. With glucagon administration blood pressure was indeed corrected.

Forensic Medicine Specialist, Vice Dean for Education, Legal Medicine Organization, Iran Alcohol (ethanol) analysis is the most common experiment done in forensic medicine toxicology laboratories. Usually finding of alcohol due to its use prior to death is confounded by production after death. Many bacteria and produce alcohol from corpus’s substrates, especially when environment temperature is high and there is adequate time from death autopsy. These factors cause diagnostic in differentiating pre-death from post-death alcohol. Talking the fact that many crimes are related to alcohol use into consideration, the importance of proper diagnosis will be augmented. In this article we discuss methods to distinguish alcohol used before death from the one produced after it. The used are person history, specimens’ condition, current specimens, ethanol diffusion in body fluids and tissues, ethanol concentration and use of specific diagnostic methods. We concluded that provided attention is paid to the aforementioned factors and conditions, it is possible to discriminate the pre or post death source of alcohol.