مجله پزشکی قانونی
سال پانزدهم شماره 3 (پیاپی 55، پاییز 1388)

The concept of ‘Emotional Intelligence, has been extensively popularized in the corporate world as individuals purport the potential ability to control of emotions intelligence to predict various markers of success. It seems that emotional intelligence has important role in prevention of the complaint against medical practitioners. This study tries to evaluate the doctor's emotional intelligence role in prevention of malpractice. A cross-sectional study enrolled on two 125 individuals groups, medical doctors to be accused of malpractice (anesthesiology, gynecology, surgery, internist as well as general practitioner) and medical doctors, who are never accused of malpractice. It's randomly sampled. Medical doctors who accused of malpractice in the entire component (intrapersonal relationship, interpersonal relationship, stress tolerance, adaptability and general mood) and general score of emotional intelligence as well as whole subcomponent of that, except of independency, had fewer score than others. The factors related of emotional intelligence perform important roles on prevention of the complaint against medical practitioners and increase of the patient satisfaction.

Triage and patient assessment is at the root of many risk management issues related to Emergency Department (ED). The aim of this research was to identify and analyze all the failure modes (and/or improvable points) of triage process in Rasool-e-Akram Emergency Department (ED) and propose actions in order to optimize this process. In this descriptive research, failures was identified and analyzed by the qualitative-quantitative Failure Modes and Effects Analysis (FMEA) methodology. FMEA is a team-based, systematic, proactive methodology that is used to prevent process and product problems before they occur. Gathering data was focused on groups through weekly sessions of FMEA team which its results documented on FMEA main worksheet. By FMEA methodology, 29 failure modes along 11 listed triage tasks were identified and documented. With 85% reliability (that is reducing risk of failures with Risk Priority Number (RPN) >150), 4 failures were identified as a high risk ones in this studied process which included “delayed entry of patient/patient’s family to ED” with RPN=252, “short-time triage for patient initial assessment” and “incorrect recording of patient blood oxygen” with 245 and “Delayed patient electrocardiography” with 160. The RPN of “Delayed entry of patient/patient’s family to ED” failure was reduced from 252 to 112, while some actions had taken to reduce one of this failure cause's occurrence. According to these findigs, FMEA was an efficient and effective methodology for identifying and prioritizing the improvable points of a running triage process in a crowded and complex hospital ward, such as an ED and also for predicting effective risk reduction actions.

Poisoning as an important problem in public health is one of outstanding causes of mortality in children. Whether occurring deliberately or accidentally, poisoning is fairly common in medical emergencies. Considering the high prevalence of poisoning, this study was carried out to evaluate epidemiology of poisoning in admitted children. This is a cross-sectional observational study to survey medical records on 729 children hospitalized due to poisoning over a 4-year period, from 2002 to 2006, at Urmia Imam hospital. Data including age, gender, discharging status, types and causes of poisoning, collected from documented hospital-based records and transferred to standardized check-lists. The results were analyzed using descriptive statistics via SPSS software and presented as tables and charts. Poisoning rate was similar in males (50.1%) and females (49.9%), and the highest rate was seen among <5 year old children(46%). Drugs were the major cause of poisoning (17.5%), which happened accidentally in 22.5% of cases. Drug poisoning was more common in males (11%)than females(6.6%). In age group 12-16 years, poisoning rate was higher among females (28%) than males(11%), where drug poisoning was the major cause (22%) which commonly (30%) attempted for suicide. The most common causes of poisoning in decreasing order. include drugs (49.9%), petroleum (14.1%), foods(11.7%), washing chemicals(8.1%), insect and snake bites (6.7%), herbicides (6.1%), and opium (3.4%). Overall, 2.9% of poisoning result in death. Considering the high rate of drug poisoning in both age groups of <5 years and 12-16 years, which happened accidentally in the first group and for suicide attempt among girls, it is necessary to educate families for keeping drugs out of the reach of children and adolescents. Parents should be aware of the sensitiveness of their children especially their daughters.

Abortion has always been a controversial issue and all the religions and humanistic and medical communities have been apposed to it. The effect of illegal abortion is one of the most common of admitting to bed in developing countries. W.H.O estimates that the one eight of pregnancy death is just because of illegal abortion effects. Lack of knowledge of the medical team about the abortion regulations and rules can endanger the pregnant mothers life and also make some problems for medical communities. This study is a cross sectional study and all 143 gynecologists and midwives of Kerman have been evaluated by considering the knowledge level of rules and regulation of abortion. The questionnaire has been used in order to collect all data. After completion, the SPSS soft were has been used for analyzing data, the K & test and Fischer exact test have has been used for assumptions test. From the total number of 143, 14% were Gynecologists and 86% were midwives. The average age of Them were 33.5±6.4 and 44% employed in the universities and 56% employed in other places. 15.4% of them had an average level of knowledge and 84.6% had an acceptable level of knowledge. There is meaningful relationship between the academic study and level of knowledge and also between the job status and the level of knowledge. According to the research, it has been distinguished that the level of knowledge increases as the level of education increases, so it is very necessary to pay a special attention to the education of the midwives group and also to have more of the authorities in private centers. Having retraining and education workshops concerning the issue, increase the level of knowledge as well as the healthiness of pregnant women communities.

Landmines and unexploded ordnance (UXO) contamination are a legacy of the 1980-1988 imposed war. Stretching from lands near the Persian Gulf to the Turkish border about 600 kilometers north. Those explosives were laid particularly in large areas of 5 border provinces in western and south-western regions including Khuzestan, Kurdistan, Kermanshah, Ilam and Western Azerbaijan. A wide variety of ground types were affected, including residential, agricultural and industrial range. Decontamination process has encountered difficulties through the widespread area of contamination, unavailability of landmine arrangement maps, and climate phenomena. This is a descriptive study. We obtained data of death (677 cases) due to landmine and unexploded ordnance in 5 border provinces from April 1996 through March 2007 from Legal Medicine Organization records. In aboved provinces, 677 fatalities including 648 male (95.7%) and 29 female (4.3%) were reported Death due to landmine was the most among the explosive elements (74.7%) and explosive bullets were (5.8%). Highest death incidence was seen in military personnel, shepherds, and farmers with 36.2%, 18.6%, and 12.7% respectively. Others were clerk, student, housewife, unemployed and... Ilam and Kurdistan provinces host the highest (34.1%) and lowest (4%) of fatalities in record respectively. landmines explosions caused the highest fatality rate in war affected areas and Ilam provinces had the highest death rate. UXO is an important public health problem and appropriate education in affected areas is essentially required.

Hearing evaluations for medicolegal purposes are requested by organizations such as forensic medicine, military medical councils, insurance companies and employers for determining hearing disability. Pseudohypacusis in medicolegal population increases in order to gain compensation or advantages, such as length of treatment and exemption from combats or military service. There is no available study on prevalence of pseudohypacusis in medicolegal compensation claims in Iran. The aim of this study was determining frequency of pseudohypacusis in individuals referred by Tehran medicolegal center to audiology clinic of Loghman-e-Hakim hospital in Tehran in 2005-2006 (from 5-April-2005 to 20-March-2006). All individuals referred by Tehran medicolegal center during the year 2005-2006 (from 5-April-2005 to 20-March-2006) evaluated for possibility of pseudohypacusis or exaggeration in hearing threshold levels. We used subjective and objective conventional audiological procedures for detecting pseudohypacusis. During the year 2005, 463 people including 282 males (60.9%) and 181 females (39.1%) referred to the audiology clinic of Loghman-e-Hakim hospital. Definite pseudohypacusis detected in 21.16% of the clients. There was no significant difference between the proportions of males (20.9%) and females (21.5%) showing pseudohypacusis. Frequency of pseudohypacusis in medicolegal patients referred to Loghman-e-Hakim hospital is considerably high that require development of tertiary auditory electrophysiology section for assessment of pseudohypacusis- suspected individuals.