Iranian Journal of Forensic Medicine
Year:2003 | Volume:9 | Issue:30|Papers Count:8

Background: Spinal cord injury (SCI) is one of the causes of mortality and morbidity in youngsters and results in socioeconomic problems. Trauma is the most common cause of SCI, where penetrating trauma by sharp objects results in complete or incomplete SCI. We performed this research targeted to study on the penetrating SCI by sharp objects. Methods: This cross-sectional study was performed on 20 patients with penetrating SCI by sharp object during 1999-2003. All patients were examined during the first visit and during medical and surgical treatment periodically. X-ray and MRI examinations were done for all patients. Results: The majority of patients with mean age of 27.8 years were males (90%) and 65% were single. 35% of patients were jobless, and 85% were under diploma. The common site of involvement were cervical spine with frequency of 45%, and then thoracic and lumbosacral region with 35% and 20%, respectively. 40% had complete injury and the remaining (60%) had incomplete injury. Having completed the course of treatment, 75% of patients with complete SCI had no improvement and 25% could walk only by accessory equipments. 75% of incomplete SCI recovered completely and 25% had partial recovery up to 3.5 in involved limbs. Conclusion: Announcements to youngsters about etiology and complication of SCI and using the ways of prevention is recommended.

Background: Late luteal phase dysphoric disorder (LLPDD) is among the most common psychiatric problems within female population. There have been several different suggestions for its treatment with nebulous results. Present study, which was conducted in Iman Hossein hospital compares the efficacy of lithium carbonate and pyridoxine the LLPDD aiming at treating premenstrual syndrome. Methods: Regarding DSM IV Criteria, fifty patients were included in this cross over clinical trial study. Studied population was divided into two different groups and was randomly treated for three consecutive menstrual cycles with one of the following regiments: Pyridoxine (100-200 mg/day) or lithium (600 mg/day), each for seven days. Patients in each group were assessed for premenstrual symptoms with LLPDD checklist based on DSM-IV for these three months. After being drug free for a month, all patients received the second drug. Results: This research showed drug effect in premenstrual syndrome improvement (63.8 percent for lithium therapy Vs 48.1 Percent for pyridoxine therapy), especially in moods symptoms (98.7 percent for lithium therapy compared 49.4 percent for pyridoxine therapy).Conclusion: Comparing with pyridoxine, lithium is more effective in reducing the general symptoms of the luteal phase, especially mood symptoms (p value<0.05). No significant side effect of lithium was observed in this study.

Background: Assault- related eye injuries rend to be more severe than other ocular injuries and create enormous costs to the victim and the society. This study aims to describe the pattern of assault- related ocular injuries in a referral center in Iran.Methods: 114 patients participated in a one- month prospective study of assault- related ocular trauma conducted at a referral outpatient forensic medicine clinic. A questionnaire was filled in for each patient on demographics of patients and assailants, place, time and reason for assault and the type of eye injuries.Results: 84.2% of cases were male with a mean age of 30.89 years. A significant percent of assaults occurred from 4-8 PM followed by 8 PM – 12 MN. 93 percent of assailants were male with a mean age of 28.82 years. The majority of assaults had occurred in streets. The most common sites of injuries were lid and conjunctival injuries. The object causing most of the injuries was the fist. Apparently, in half of our cases, the reason of violence had not been familial or even economical. Instead, the assailant had lost one's temper due to some trivial reasons.Conclusion: It is difficult to propose effective strategies to prevent assault- related eye injuries, especially those originating from impulsive behaviors. Education of the community- which has been recently started in Iranian primary schools- for managing their anger in social occasions sounds to be effective.

Background: Nowadays, traffic accident mortality is a critical problem in our country, so that the mortality rate related to traffic accident has been increased up to 10-15 percent annually during the recent years. In accidents, pedestrians are the most vulnerable and the risk of disability and death is very high. The present study was conducted to evaluate the pedestrian mortality and relevant factors in our country.Methods: We gathered the information of pedestrians passed away in traffic accidents in 1999. We obtained information from department of statistics in Iranian legal medicine organization and entered them in a checklist.Results: Of 15482 mortality in traffic accidents, 5015 were pedestrians who constituted one-third of victims. 72.7 percent of Pedestrians were males. 37.5 percent were under 15 years and 27.6 percent were above 61 years. More than half of victims died in accident area or during which they were transferred to hospital. 45.6 percent passed away in hospital. Head trauma was the main cause of death. In 46.6 percent of cases, they had been run down by automobile.Conclusion: It is concluded that mortality rate of pedestrians in traffic accidents in Iran is several times higher than developed countries and even more than other middle east countries. Children and aged person are at higher risk. Thus, we can solve this problem by developing appropriate facilities in high-accident- rate areas, prudent training in schools and media and reinforcement of emergency aid services.

Background: Sexually transmitted diseases (STD) constitute important source of morbidity in incarcerated persons. So, we decided to determine incidence of syphilis among female prisoners in Tehran province prisons (Evin, Varamin & Rajayii shahr) in order to specify risk factors, precipitated factors and prophylaxis methods.Methods: This descriptive study was performed on 500 randomly selected women. Initial data including age, marital status, economic status, dwelling place and IV drug abuse were all recorded. Then they were examined, and laboratory evaluation including RPR and FTAabs were achieved.Results: Eight female prisoners had syphilis infection (positive RPR and FTAabs). Age, marital status, economic status and IV drug abuse were revealed to be significantly associated with acquiring syphilis.Conclusion: Our results have revealed that syphilis is not rare in female prisoners. So, Screening of high risk prisoners and exerting proper management is recommended.

Background: Suicide with plaster is a new strange way of suicide which has been only committed in Lorestan province during the recent years. Regarding to uncertainty of borders of this issue, characteristics of victims, signs and symptoms and suitable management, this study was done.Methods: This descriptive (cross- sectional) study was performed on patients who committed suicide with ingestion of plaster and referred to Shohadaye Ashayer hospital during 1997-2000. A questionnaire including demographic properties, signs and symptoms, type of treatment and patient's outcome was filled out for all patients. Results: Of 40 patients, 57.5 percent were females and 42.5 percent were males. Majority of patients were in range of 10-19 years (45 percent). Suicides frequently occurred in summer and among students (37.5 percent). Half of patients were treated by gastric washing with normal saline that only one of them referred for surgery. Totally, seven victims underwent surgery (laparotomy, gastrotomy, excision of plaster mass, gastrorrhaphy). Half of patients had no sign and symptom. For remaining, the most common symptom and sign were abdominal pain (42.5 percent) and abdominal mass (17.5 percent) in palpitation, respectively. Only one case died who had been intoxicated with organophosphate poisoning at the same time.Conclusion: It seems gastric washing by 2 liter of normal saline immediately at the beginning of treatment and then applying conservative management and continuous following up by daily examination and taking plain abdominal X-ray are consecutively suitable management to rescue such patients.

Nowadays, smuggling of illicit drugs has the most financial gain, and has been increased during the last decade in the world. One of the unusual ways that has become a common problem is swallowing or inserting of illicit drugs into the rectum or vagina so that it is difficult to detect. Intestinal obstruction and opioid intoxication due to rupture of packs are the most important and life threatening complications. In this study, we reported an Iranian dead case, which was discovered as mummified cadaver in Kavir-e-Yazd.

Background: In spite of using anticoagulant drugs such as unfractionated heparin (UFH) and low molecular weight heparin (LMWH) in the treatment of acute ischemic stroke, the efficacy of them has not been documented. Regarding to the frequent administration of these drugs, the evaluation of efficacy, advantages, and hazard of them is much important.Methods: We reviewed articles about this type of treatment including randomized clinical trials, meta-analyses, original articles, systematic reviews and review articles published in MEDLINE and EMBASE during 1997-2003.Results: In the short- and long- term follow up, UFH and LMWH don't result in considerable decreasing mortality, progression of stroke and early relapse risk. They don't result in considerable improvement in clinical and functional status of patients. In spite of considerable decreasing of deep vein thrombosis (DVT) and pulmonary emboli (PE) by administration of UFH and LMWH, it is established that they increase risk of intra- or hemorrhage. There is no valid document that immediate administration of anticoagulants (particularly intravenous and high dose) has helpful outcome. Conclusion: UFH and LMWH are not recommended in the majority of cases with stroke particularly during the first 24-48 hours of attach. Subcutaneous administration of UFH and LMWH is helpful in preventing DVT and PE, while they increase risk of systemic and intracranial hemorrhages. Immediate treatment is not recommended in any type of cerebrovascular accident (CVA).