مجله پزشکی قانونی
سال بیست و هشتم شماره 3 (پیاپی 103، پاییز 1401)

An autopsy is a post-mortem medical procedure performed on a deceased person with the primary purpose of collecting tissue to support basic research and knowledge translation. This method is increasingly used to investigate the pathophysiological mechanisms of cancer development, metastasis, and treatment resistance. In this review article, we discuss the reason for using research autopsy in cancer research and provide evidence-based discussion of the quality of postmortem tissues compared to other types of biological samples. It also discusses the advantages of using postmortem tissues over other types of biological samples, including the large amount of tissue available and the multi-area sampling that is available, which is not possible in living patients. An autopsy helps identify the clonal origin and ways in which metastases spread. Also, the study of the effect of treatments on the tumor and the creation of rare and tumor-derived tissue banks in the patient is an integral part of forensic strategies and research autopsy.

In any country, the prevention and management of occupational injuries lead to the improvement of the health of the workers of that society. Recognizing occupational injuries is of special importance to achieve the above goal. In this regard, the present study was conducted to determine occupational injuries in the referrals to the Forensic Medical Occupational Compensation Commission of Isfahan during the years 2017 to 2022.

This descriptive, analytical and cross-sectional study was conducted in 1400 on all those who referred to forensic medicine with occupational compensation complaints. The sample size based on the number of patient visits in the last 5 years was equal to 120 people who were included in the study by the census. Data were collected by checklist and analyzed in SPSS version 22 software at a significance level of less than 0.05.

115 people (95.8%) were male, 48 people (40%) were between 40 and 50 years old, 93 people (77.5%) were married, and 58 people (48.3%)had a diploma. Most injuries were related to skeletal injuries in 66 (55%)of the patients. The work experience of 58 people (48.3%) was less than 10years, 27 people (22.5%) were from other industries and 119 people (99.2%)were from service jobs. The employment status of 88 people (73.3%) was contractual. There was a significant relationship between the organ involved and work history (P<0.05).

Considering that most injuries are related to musculoskeletal disorders, necessary measures, correct policies, appropriate training and protective equipment should be provided to reduce these injuries.

After four years of the COVID-19 disease outbreak, despite the recovery of many patients, a significant number of them are still suffering from it and its complications. In this regard, many patients are struggling with its long-term effects and cannot return to normal life. These patients experience a wide range of life-disrupting disorders, which considers the importance of examining long-term symptoms and paying special attention to these patients.

This cross-sectional study was conducted in 1400 for three months on 280 COVID-19 patients of Shahid Mostafa Khomeini Hospital in Tehran, Iran. Those whose disease was confirmed by laboratory testing (RT-PCR positive). these patients were under observation from the onset time of infection until the end of quarantine. Long-term symptoms among discharged patients were collected and compared using a questionnaire containing demographic information and patients' statements. The data were analyzed with SPSS version 21 software and the results were reported.

45.7% of patients had at least one long-term symptom and 54.3% had more than one long-term symptom. The symptom of fatigue had the highest frequency (64.4%) and the lowest frequency belonged to diarrhea with 2.7%. Significantly (P<0.050), long-term symptoms were seen in women more than men, in old people more than young people, and in obese people more than thin people. The severity of the disease was directly related to the frequency of symptoms.

In general, it can be said that there are long complications in all patients. Since among demographic indicators, "obesity", "severity of illness" and "hospitalization" have been the most important factors in increasing the frequency of long-term symptoms, paying attention to these factors and considering possible solutions to prevent can lead to improving the quality of patient’s life and reduces the duration of long-term complications.

In some cases, people claim to use insurance compensation services by causing factitious injuries. The aim of this study was to investigate the epidemiology of factitious injuries in traffic accidents in Ilam legal medicine cases, Ilam, Iran.

The data of this cross-sectional study was collected by census method from 100 cases of factitious injuries detected in traffic accidents that were diagnosed by forensic experts of Ilam city, Iran from the beginning of March 2018 to the end of February 2020. data included age, sex, education, occupation, marriage, accommodation, type of accident, location of the injured in the accident, place of the accident, time of the accident, date of the accident, location and type of injuries. binomial and Chi-square statistical tests were used to assess the significance of the research hypotheses.

In this study, 81% of the cases were men. 68% of people were 21 to 40 years old, 82% had no university education, 53% were self-employed and 75% were urban dwellers. 43% of accidents were overturned or deviated, and 39% occurred on interurban roads. 43% of people with a passenger position were present in the accident. 50% of accidents occurred in the night and early morning hours. 60% of the injuries were accidental and 71% of the people had real injuries in addition to factitious injuries.

According to this study, the age group of 21-40 years old, without university education, urbanization, rollover or road deviation type accidents and on intercity roads at night and early morning are the risk factors of creating factitious injuries. Injuries of the Harseh type and in the form of a mix with real injuries are also a risk factor of factitious injuries. Due to the lack of significant relationship between the place of injury, all parts of the body can be the place of factitious injuries.

Many of the legal problems that dentists face is rooted in a lack of knowledge about dental professional law. Sometimes it has led to legal cases. This study was conducted to assess the knowledge and practice of dentists of legal issues related to dentistry field.

By using a researcher-made 24-item questionnaire that was standardized with experts and obtaining information from the Qazvin Medical Council Organization, Iran, we refferd to all centers and dental offices in Qazvin and if it was not possible, we used an electronic questionnaire. Data of 181 dentists were recorded and the results were analyzed at a significance level of 0.05, analysis was done by SPSS version 24.

The mean age of dentists was 33±4 years and the mean work experience of dentists was 5.5±2. The average score of all dentists in the field of medical law was 10.5 out of twenty points and their average knowledge score was 11.5 and the performance score was 9.5 out of a maximum score of twenty. The degree of dentists had a significant relationship with the level of knowledge and practice (P=0.001). The age of the dentist was not related to the level of knowledge and practice (P=0.085). The gender of dentists was not significantly related to the mean scores (P=0.071). The general dentist's work experience had a significant relationship with the level of knowledge and dentists with a longer history scored higher. (P=0.044)

The level of knowledge of dentists about legal issues is lower than the average score, and it seems that due to the importance of this field, we need appropriate retraining courses and revising of related courses in the general dentistry course.

Child abuse refers is a wide range of destructive behaviors include not meeting emotional needs, physical punishment, sexual abuse, malnutrition, and neglect of child health. The aim of this study was to determine the status of child abuse and mental health in children of psychiatric patients.

This descriptive cross-sectional study investigates child abuse in the children of patients with psychiatric disorders admitted to Zare Hospital in Sari, Iran in 2020. The questionnaires used in the study were SDQ and the CASRS. All data analysis was performed using SPSS software version 25. Significance level is considered P<0.05.

Patient’s age were 22-61 with mean and SD of 34±6.7 years and children were 12.1±2.6 years. 182(51.9%) children were girls and 169 (48.1%) were boys. The highest frequency of psychiatric disorder in patients was mood disorder 144 (41%), and schizophrenia 127 (36.2%). According to the CASRS scale, the mean and standard deviation of the subscales were 7.0±5.4 for physical abuse, 0.4±0.9 for sexual abuse, 8.5±2.1 for emotional absuse, and 8.8±5.0 for neglect. The scores of the SDQ of a healthy parent and the child themselves had a mean and standard deviation of 15.4±5.8 and 15.8±5.4, respectively.

The results of this study showed that the incidence of child abuse in the children of patients with psychiatric problems is high and this group needs social support as a shield and protective factor against the negative consequences of abuse that can prevent violence cycle and the occurrence of psychological disorders to victims.

Stroke is the third most common cause of death in developed countries and the most common neurologically debilitating disease. The aim of this study was to investigate the 5-year epidemiological prevalence of stroke cases in Ahvaz, Iran.

In this descriptive cross-sectional study, the files of patients admitted to the neurology ward of Golestan Hospital in Ahvaz, Iran who were diagnosed with stroke based on clinical symptoms and CT scan during the years 2015-2019 were reviewed. Relevant data were analyzed by SPSS software and statistical tests.

The mean age of patients was 66.58±14.31 years and 55.2% were male. 22.9% of patients were smoker, 4.4% consumed alcohol and 10.9% consumed opioids. Also, 95.1% of patients lacked regular physical activity. In terms of comorbidities, 68% of patients had hypertension, 42.4% had diabetes, 19% had dyslipidemia and 8.1% had autoimmune diseases. In addition, 26.3% of patients had a previous history of stroke, 34.1% had a history of heart attack and 43.5% of patients had a family history of stroke. Re-stroke was significantly associated with family history of stroke (P<0.05) but was not significantly associated with gender and age.

In patients with stroke, low physical activity, high blood pressure and diabetes were high, which shows the importance of attention and correction of these risk factors to prevent stroke.

Despite the increase in the death rate due to methadone abuse, this drug is still used in most drug rehabilitation center as a maintenance drug to treatment drug addiction. This study is the epidemiological investigation of deaths caused by methadone abuse, so that by analyzing and planning needed the death rate and costs caused will be reduced.

 This research is a descriptive-analytical cross-sectional study on 5,901 deaths caused by methadone use in 2020 and 2021, which were referred to the Legal Medicine Organization. The demographic and epidemiological information of these people was collected using a checklist and analyzed with SPSS version 19 software.

The results show that deaths caused by abuse of methadone increased 8.7 percent in 2021 compared to the previous year. On the other hand, the highest mortality rate is related to middle-aged men, unmarried, with low education and no stable job, in the provinces of Kermanshah, Lorestan and Kohgiluyeh and Boyer-Ahmad.

Increasing the awareness of patients treated with methadone maintenance, especially the high-risk groups, about the high probability of death if this drug is used more than the allowed amount or taken simultaneously with other compounds is too important.