مجله پزشکی قانونی
سال هفدهم شماره 1 (پیاپی 61، بهار 1390)

Knowing the nursing as an autonomous profession made nurses more susceptible to present in courts. The low levels of the nurses’ knowledge about the professional laws and regulations would endanger both nurses and this patients. Because of the importance of the issue and the lack of research in this regard, this study was conducted for evaluating nurses and nursing students’ knowledge of professional rules and regulations, in Kashan university of medical sciences. A cross-sectional study was conducted on 160 nurses working in the hospitals of Kashan University of medical sciences and 65 last semester nursing students in this university. Data collection was performed through a questionnaire included seven questions regarding demographic information and 20 questions regarding professional rules including job description, recording documentation, types of professional crimes and negligence, penalties and blood money, patients’ rights and primitive court tasks and how it should be treated. Data were analyzed by using chisquare, t-test and pearson correlation coefficient in SPSS 11.5. A total of 71.1% subjects were nurses and 28.9% were students. Most of them had not been trained about professional laws and regulations and 95.6% expressed the need for more knowledge and education about professional rules and regulations. None of the subjects was fully aware of the professional rules. Totally the nurses got 49.43%±8.88% of the total score and the students 48.61%±8.31% of the score. The highest score was in the domain of the patients’ rights (59.9%) and the lowest score was in the domain of types of professional crimes and negligence (36.4%). The knowledge of nurses and nursing students in the field of professional regulation was at the level of weak to moderate. This could put both nurses and clients at risk. Therefore, immediate action seems to be necessary to promote nurses awareness about professional rules and regulations.

Coronary artery bypass surgery is considered as one of the most effective treatment methods due to an increase in coronary artery disease. A cross sectional study was designed on 600 patients in two hospitals of the Baqiatallah and Jamaran Heart coronary artery bypass graft surgery were studied and important effects such as mortality, postoperative bleeding, cerebral complications, congestive heart failure, cardiac arrest, myocardial infarction, pulmonary complications and atrial fibrillation were Surveyed. Results were Shown by using tables and distribution of variables. To analyze found data, descriptive statistics tests were used. Results showed that the mean age of patients undergoing this surgery (CABG), was 58/6±10/2, years and most of them (73%) were male. Highest complication rate, 30.3% was related to atrial fibrillation after operation and the lowest 0.2% was related to deep vein thrombosis. Death rate after surgery was reported 1.5%. Coronary artery bypass surgery in one of the best options for coronary artery disease trearment; But, this method look like any other interventions might have effects that would be precisely monitored by preoperative and postoperative cares to minimize these effects.

Attitudes within the ethical principles based on knowledge of client rights and medical care leads to the client participation in the process of care, and more confidence in caregivers. Religious orders can empower patients to improve sooner. The anxiety after separation from individual religious orders also have negative effects on the course of remission and will prolong hospital stays; besides, it will cause adverse psychological effects on the patient. This study has been designed to survey the needs for religious care of patients as one of the aspects of intellectual property. A cross-sectional study was designd. Samples of the study consisted of ten percent of patients who were hospitalized for any reason at the time of implementation in a medical university hospital. After obtaining consent, the relevant questionnaire provided were placed. After data collection, the analysis was performed through SPSS software. Most cases were female and citizen with maximum age 100 and minimum 12 years old. The mean age was 44 years. Chi-square test showed significant differences (p<0.05). The one-way ANOVA in all aspects of religious requirements showed significant relationship between all civil centers. Considering the results of this study, the religious care performance in a patient is very important and necessary; consequently, it is recommended that religious cares should be considered as a part of hospital cares in the future plannings.

Medical record is a supporter for patients rights as well as medical staff. Forensics is also one of the majors which uses medical records. The aim of this study is a determination of accountability rates in referred items to Legal Medicine Organization during 1388.

This study is a descriptive and applied one. Referred cases to Legal Medicine Organization during year 1388 formed the study population. According to the number of these cases, 790 records from mentioned patients’ record have been selected randomly and determined in four fields (outpatient examinations, cause of death, medical malpractice, and psychiatry). The gathering data tool was a checklist which had been designed according to Forensic standard records. Data analyzing were done by descriptive statistics through SPSS software.

According to determinations, 43.5% of referred records were in medical malpractice, 15.8% in psychiatry, 11.5% in cause of death, and 29.1% in outpatient examinations. The efficacy of medical records in malpractice was 85.5%, in psychiatry 63.2%, in cause of death 82.4%, and in outpatient examinations was 53.5%. Also, 44% of 387 referred impairment cases has been determined.

The research findings showed an acceptable efficacy rate in medical records. The imperfections in the records could be resolved by relevant experts, during summarizing and preparing these cases for medical error commissions; also, in the absence of papers or documents, elimination of defects is done through renewed request from hospital. Based on our Findings, a significant proportion of medical records, which had been sent from medical centers, in the first stage didn’t have required documentation. Therefore, medical staffs training would be necessary in hospitals and medical centers as well as documenting and declaring legal documentations.

Sex determination (male/female) is one of the most important parts of human identification and sometimes it is not easy to be determinate, therefore; anthropometeric studies can be helpful. Evaluatin of dimensions of the hand will be very useful without spending a long time and complex examinations.The final goal of this anthropometeric study is the determination of sex by hand dimensions (Hand Index). This study was conducted with a case series design. 200 healthy Iranian students of Hamedam university of medical sciences aged between 18 to 25 years (100 male & 100 female) were investigated during 1389(2010-11). Both hands length and width were measured by caliper with 0.01 centimeter of precision and the hand index was calculated by dividing the width and length then multiplied by 100. Finaly, the collected data were analyzed by SPSS software 16th version. In males, the length of the right hand varied from 16.25 cm to 21.10 cm (mean: 18.96 cm) and in the left hand from 16.28 cm to 20.86 cm (mean:18.98 cm) and the width of the right hand varied from 7.24 cm to 9.45 cm (mean:8.80 cm) and in the left hand from 7.32 cm to 9.45 cm (mean:8.87 cm). In females the length of the right hand varied from 14.86 cm to 20.56 cm (mean:17.30) and in the left hand from 14.86 cm to 20.58 cm (mean: 17.28 cm) and the width of the right hand varied from 6.72 cm to 8.86 cm (mean: 7.56) and in the left hand from 6.62 cm to 8.75 cm (mean:7.48 cm). The hand index was calculated and it was more than 44 in all males (P=0.000) and less than 44 in all females in both hands (P=0.000). The results of this study showed that measurement of the hand dimensions and estimation of the hand index as a simple and useful method for determination of sex could be done in a short time in conjunction with other anthropometric and laboratory studies.

In Legal Medicine Organization of Tehran, the accepted requests for therapeutic abortions are registered and the data of rejected requests would not be recorded. So, the data of all requests for therapeutic abortions, the frequency of accepted and rejected ones and their causes are not clear. In this study, all the requests for therapeutic abortions referred to Legal Medicine Organization of Tehran during 2008 were evaluated.

This cross-sectional study was conducted on all pregnant women who referred to gynecologic ward of Legal Medicine Organization of Tehran for therapeutic abortion during 2008. The data related to fetal and maternal age, history of previous pregnancies and indications for acceptance or rejections of the requests were gathered by the examiner physician. The data were analyzed using the SPSS ver. 13.

During the study period, 774 requests for therapeutic abortions were evaluated; 556 requests (71.8%) were accepted and 218 requests (2.28%) were rejected. Fetal abnormalities and maternal illnesses were the indications for request acceptance in about 80% and 20% of cases respectively. The most common fetal abnormality was anencephaly, which accounts for 21.5% (99 cases) of fetal indications. In maternal illnesses, cardiovascular disorders were the most frequent one (26 cases). In 90 cases, the requests were rejected due to increased age of the fetus. Other causes of request rejection were drug usage of the mother (30 cases), infectious diseases in the mother (18 cases) and exposure to ionizing radiation (17 cases).

The results of this study showed that requests for therapeutic abortion were not accepted in about one third of cases and the most common cause of request rejection was the increased age of fetus. Providing educations about the law of therapeutic abortion, on time screening for fetal abnormalities and early referral of the cases in whom therapeutic abortion is indicated would be necessary.

Puberty is determined as a condition for criminal responsibility in the Islamic Penal Code of Iran. This study was done to determine the minimum age of ability of control and applying emotions as a proposed basis for determining criminal responsibility. In a pilot study some indicators of emotional quotient were evaluated in Iranian persons in the ages between 16 to 25 in three different areas of Iran by using Bar- on questionnaire. The sample was 420 persons, both female and male, 140 samples in each area. The data were analyzed through SPSS 15 software. According to the results, the minimum age for developing abilities such as problem solving, stress tolerance, emotional self awareness, reality, self confidence, social responsibility and impulse control is 21 for males and 18 for females. In other words, the persons obtain abilities to distinguish and control of their own behavior. It seems Iranian adolescents in the age of puberty have not enough social and psychological abilities for avoiding criminal behaviors. The results of our study offer further researches for determining criminal age by emphasizing emotional quotient indicators.

One of the important methods for identification is the use of their photography and radiography. Studies show that the investigation, analysis and comparing of the photographs and radiographs with each other, could be useful for identification of an anonymous person. Super imposition is widely used for identifications. The aim of the present study is the using “MATLAB” software as a new simple method, in identification thought a case report. At first, control and study photographs were selected. Then, seven clear points (land mark) on each photo were determined and the length of line segments between these points also, the ratio between the lines were calculated in accuracy of two decimal places. Finally, the correlation coefficient between the facial ratios of two images were determined through SPSS software. Due to the resulting number of lines defined, the similarity between two images was 85% through SPSS software by the method of calculating the correlation coefficients. The introduction of computer softwares has led to new methods for forensic identification and anthropology. Using “MATLAB” software with the methodology explained in this study, as a cost-effective one, is capable of identification precisely and is recommended.