مجله پزشکی قانونی
سال بیست و پنجم شماره 2 (پیاپی 90، تابستان 1398)

Ammonia, chloroform, and diethyl ether are the three most commonly used solvents in sample preparation and extraction processes in forensic laboratories (especially forensic toxicology laboratory). The staffs of these labs are notably exposure to these solvents. Exposure to these solvents can have deleterious effects, such as hepatotoxicity, neurotoxicity, carcinogenicity and mutagenicity. The aim of this study was to evaluate the occupational exposure of Bushehr forensic laboratories staff to these solvents.
Materials & This experimental research was performed in a cross-sectional study in 2017. Sampling was conducted individually for two consecutive weeks using individual sampling pump and adsorbent tubes. Analysis the amount of chloroform and diethyl ether was conducted using gas Chromatography with flame-ionization detector, and analysis the amount of ammonia was conducted using Spectrophotometer at 660 nm. Weight-time averages of exposure were also calculated using the relevant formulas.
Weight-time averages of exposure to chloroform, diethyl ether and ammonia in the extraction section of the laboratory on days without sample extraction were 0.021, 0.0017 and 0.17ppm, respectively and on the days with sample extraction were 7.02 32.25 and 3.63ppm, respectively. There was a significant difference between the amount of staff exposure on the days of extraction and days without extraction (p<0.05). The weight-time average of exposure for all solvents (except chloroform) was less than their allowed limitation by the country.
However, exposure levels of staffs of forensic medical laboratories in Bushehr is lower than the allowed limitation by the country, but in some cases (especially chloroform), these exposures are at the warning range.

The use of simple, low cost, high-efficiency microextraction methods are considered for sample preparation in forensic toxicology. Nowadays, the chemometrics technique can be used to determine the important and influencing factors on the response, to optimize the extraction methods. The aim of this study was to design and optimize a dispersive liquid-liquid microextraction (DLLME) method for the extraction of chlorpyrifos from the urine using a chemometrics method.
Materials & In this experimental study,  at first, a DLLME method for the extraction of chlorpyrifos in the urine sample was designed. Then, the Taguchi model was used for screening and investigating the role of effective factors on the extraction of chlorpyrifos from the urine and a central composite design was used to examine the interaction of these factors. After validation of the extracted data, chlorpyrifos was extracted from the urine using an optimized DLLME method and it detected and quantified using the high-performance liquid chromatography with photodiode array detector (HPLC-PDA).
The optimized DLLME-HPLC-PDA method was linear in the range of 0.5 to 4μg/ml, and the R2 coefficient was 0.9996. The minimum rates of detection and quantification ​​were calculated by 0.08 and 0.25μg/ml, respectively. The profitability of the method in the optimal condition was calculated by %95.6.
The optimized DLLME-HPLC-PDA method can be used as a simple, fast, inexpensive, sensitive and precise method for chlorpyrifos analyzing in urine specimens in clinical and forensic toxicology laboratories.

Social acceptance of people with sexual identity disorder in society is very difficult and these conditions can lead to depression and suicidal ideation. On the other hand, social support has a great influence on the psychological factors of these people. The aim of this study was to compare the depression, suicidal ideation, and social support between transsexuals with and without gender change.
Instruments & This causal-comparative study was carried out on 60 transsexuals with (N=30) and without gender change (N=30) of the association for the protection of Iran gender dysphoric patients in 2018. The subjects were selected using the convenience sampling method and they completed the questionnaires of the Beck depression inventory, Beck suicidal ideations, and Sherbourne and Stewart social support. Data were analyzed by SPSS 24 software through the multivariate analysis of variance test.
The mean scores of depression and suicidal ideations variables in the transsexual group without gender change were higher than the transsexual group with gender change, but the mean score of social support variable in the transsexual group with gender change was higher than another group. There was a significant difference between the two groups regarding the variables of suicidal ideation and social support (p=0.01), but there was no significant difference between the two groups in terms of depression variable (p>0.05).
The depression and suicidal ideations are in the moderate range in both transsexual groups, with and without gender change, but there were more suicidal ideations in the transsexuals without gender change, as well as the transsexuals with gender change are more likely to seek social support.

People's satisfaction from the services provided by government agencies in the executive and administrative systems in Iran is considered as one of the main indicators of efficacy in the growth and development of the system. Achieving public satisfaction with receiving services from the organization increases public confidence, which is the largest capital and support for the administrative system. The aim of this study was to assess the client satisfaction rate with the performance of physicians in the top 10 provincial centers of the forensic medicine organization in Iran.
Instruments & This descriptive research with a survey method was carried out among people referred to the top 10 provincial centers of the forensic medicine organization in Isfahan, Fars, North Khorasan, Khorasan Razavi, Kermanshah, Kerman, Gilan, East Azarbaijan, Tehran and Mazandaran provinces in 2015-2016. The subjects were selected using the simple random sampling method, and they completed the researcher-made questionnaires. 1785 questionnaires were completed. The collected data were analyzed by SPSS 22 software through the one-sample t-test.
The mean score of clients 'satisfaction with physicians' performance, informativeness, specialty and skill, commitment, courtesy and respect, space and medical and non-medical equipment of the organization were 4.25±0.62, 4.19±0.72, 4.17±0.70, 4.13±0.67, 4.27±0.73 and 4.24±0.74, respectively.
From the viewpoint of the clients, the performance of physicians in the top 10 provincial centers of the forensic medicine organization of the country is at a favorable level.

 Addiction as a social problem is a phenomenon that destroyed the ability of society to organize and maintain the order of actual affairs, and it is one of the major causes of early death. The aim of the present research was to determine the mortality rates due to substance and stimulant abuse in the deceased submitted to the forensic medicine department of Kohgiluyeh and Boyer Ahmad who died due to substance abuse in 2013-2018.
Instruments &  This cross-sectional descriptive research was carried out on all portfolios of the deceased submitted to the forensic medicine department of Kohgiluyeh and Boyer Ahmad, who died due to substance abuse in 2013-2018. Data were collected from the medical cases of the subjects. Data were analyzed by SPSS 21 software, through the descriptive statistics and chi-square test.
 Of the 123 studied cases, 93.5% were male and the rest were female (6.5%). Most of the deceased referred to the forensic medicine department were related to the 20-30 (37.4%) years age group, single people (54.5%), people with diploma (35.8%) and middle school certificates (32.5%), people with the freelance job (42.3%) and unemployed (26.0%). Opium (39.0%), methadone (27.6%) and tramadol (17.9%) had the highest frequency of drug use, respectively. The highest concurrent drug use was observed in opium-methadone (28.4%). There was a significant difference between opium, heroin, glass, tramadol and methadone consumables between 2013 and 2018 (p<0.05).
 The deceased are young people with low education, low income and unemployed as well as addiction to methadone and tramadol has an increasing trend over the years.

Due to the accidental nature of carbon monoxide poisoning, the number of victims of such events may be more than one person and in many cases, the victims have a kin relationship. According to the Iranian civil laws, determining the death time priority is essential for the diagnosis of inheritance, and therefore inquiries should be taken from forensic centers. The aim of this study was to determine the death time priority and its diagnostic criteria in victims of carbon monoxide poisoning.
Instruments & This research is a descriptive cross-sectional and retrospective study. In this study, all cases of death due to carbon monoxide poisoning, referred to the forensic medicine centers of Tehran province during 2012-2016 were investigated and the records of deceased in the joint events were separated. Then the information was recorded in the checklist and analyzed by SPSS 19 software.
Of the 846 deaths due to carbon monoxide poisoning in 674 accident, 131 (35.8%) cases had more than one victim. There was some kind of kin relationship between the victims in 65.6% of cases and this relationship was of a first-degree kinship (82.6%). In 23.3% of events involved the victims with a kin relationship, inquire about the death time priority was conducted and in 70.0% of the cases, the results were reported as relative and the highest diagnostic criterion was only age (40.0%) and in 20.0% of cases, the conditions were merely environmental.
It is necessary for forensic examiners to know probable the inquiries about the death time priority in such events and they should pay enough attention in their expert opinions, to the role of individual and environmental factors and their impact on accelerating the process of death.

Often, many young people and teenagers impose huge costs and time on families and society on cosmetic surgery, while their action is not based on the origin of the disease and doesn't provide health for them. Lack of balancing and preventive laws for the prevention of exceeding these actions causes numerous judicial cases and causes the medical community to ignore its original mission, in spite of their oath to ensure the health of the community. Now, the question is what basis of responsibility for cosmetic surgeons is more consistent and closer to justice? Therefore, the aim of this research was to investigate the responsibility of cosmetic surgeons with three bases of fault statistics, fault theory, and risk theory. The research was conducted with the descriptive-analytical method by searching in the relevant sources.
Among the types of principles of responsibility for cosmetic surgeons, in the more or less complicated process of medical practices, the risk theory is closer to the social justice and social interest of the target community.