مجله پزشکی قانونی
سال سی‌ام شماره 2 (پیاپی 110، تابستان 1403)

Gender dysphoria is a general description that refers to a person's dissatisfaction with their assigned gender. People suffering from gender dysphoria always suffer psychologically and emotionally, so that they have a higher suicide rate. These cases can emphasize the need for more research in this regard. The mechanisms of this disease are not well known so far, but several factors such as biological, psychological, environmental and social can be effective in it. The aim of this study is to investigate the role of genetic factors in the development of this disease. This study was a Narrative review. Twin and heritability studies have shown the influence of genetic factors on the development of gender dysphoria. Metabolic disorders such as congenital adrenal hyperplasia and adrenogenital syndrome and any genetic changes in the genes that control the secretion of androgens can be related to this disorder. According to the study, although the cause and mechanism of gender dysphoria remain unknown, the role of genetic factors in causing this disorder cannot be ignored. The creation of gender dysphoria is associated with the neurodevelopmental processes of the brain, as a result of genetic changes in the CYP21A2, CYP17 genes, as well as other genes involved in the secretion of androgens, can be one of the causes of this disorder. This study emphasizes the importance of genetic studies regarding the investigation of the cause and mechanism of gender dysphoria in future studies.

The ransom for the crime of Mamomeh is determined at the amount of one-third of the full human ransom in accordance with Clause (h) of Article 709 of the Islamic Penal Code. The amount of ransom for the crime indicates the extent of the crime. The legislator’s insistence on not retribution punishment to the Mamomeh in charge under Article 401 of the Penal Code demonstrates the sensitivity and seriousness of the crime of the Mamomeh. The scale, sensitivity and seriousness of the crime make it necessary to clarify the nature of the crime as much as possible. The realization of some crimes in Iran's jurisprudence and law system depends on how the crime was created; The main Question of the current research is that the presence of injury and damage to the skull has a place in the realization of the crime of mamumahWhat. Based on the descriptive-analytical method, the present research has evaluated the traditions and viewpoints of Imamiyya jurists and has found that the realization of the crime of mamumah depends on the penetration of the instrument of the crime into the skull; The scalp must be split and the skull fractured to introduce the instrument of crime to the border of the brain bag.

Understanding the causes of complaints against doctors and healthcare staff can effectively reduce their occurrence. This study aimed to analyze a decade of complaints against psychiatric specialists referred to the forensic medicine administration in Fars province from 2006 to 2015.

We conducted a cross-sectional, retrospective review of cases referred to the forensic medicine administration in Fars province regarding medical malpractice complaints in psychiatry from 2006 to 2015.

The study included 42 cases, predominantly involving male doctors. Twenty cases were from the 50-60 age group, and one was from the 60-80 age group. Most complaints pertained to treatment complications and drug-related issues. There were significant statistical differences in age, expertise, and workplace between the negligent and acquitted groups.

This study revealed that both psychiatrists and psychologists are susceptible to medical malpractice, potentially leading to negative treatment outcomes. Additionally, hospital staff may unintentionally commit malpractice during patient care. The findings suggest that improving doctors' understanding of treatment laws, adherence to regulations, medical ethics, continuous education, and updating knowledge can help prevent malpractice. Furthermore, enhancing skills and implementing standardized treatment protocols can reduce malpractice rates in psychiatry.

Engaging in behaviors that violate university rules and regulations significantly impacts students' lives. Therefore, investigating the underlying factors contributing to students' criminal behaviors has become a critical area of focus for researchers in the field of criminal psychology in recent years, resulting in numerous theories. The aim of the present study is to examine the role of schema modes in the intergenerational transmission of mothers' early maladaptive schemas to their daughters and the formation of criminal thinking patterns among female university students.

This study employed a descriptive correlational research design. The research population consisted of all female students enrolled at Ferdowsi University of Mashhad during the academic year 2021-2022, along with their mothers. A sample of 200 female students and their mothers was selected using a convenience sampling method. The research instruments included three questionnaires: The Early Maladaptive Schemas Questionnaire, the Schema Modes Questionnaire, and the Criminal Thinking Patterns Questionnaire. All three questionnaires were completed by the students, and the Early Maladaptive Schemas Questionnaire was also completed by their mothers. Data analysis was conducted using AMOS software to test the structural equation model.

The results demonstrated a direct and significant impact of mothers' early maladaptive schemas on their daughters' schema modes (P<0.05, β=0.20), daughters' early maladaptive schemas (P<0.05, β=0.43), and criminal thinking patterns in daughters (P<0.05, β=0.45). Additionally, the mediating role of schema modes between mothers' early maladaptive schemas and daughters' early maladaptive schemas, as well as between mothers' early maladaptive schemas and daughters' criminal thinking patterns, was confirmed.

As the statistical results indicated, mothers and their early maladaptive schemas play a significant role in the formation of criminal thinking patterns that contribute to university misconduct. Therefore, to prevent student violations, educational planners should focus on developing specialized educational programs for mothers.

Poisoning is a prevalent cause of death based on available forensic medicine data in Iran. In this study, we investigated the types of substance abuse in individuals who died from poisoning across different age groups.

The research was carried out in a cross-sectional, descriptive, and analytical way through a census based on the files available in the Forensic Medicine of Isfahan province. In this study, all the deaths caused by substance abuse poisoning referred to Isfahan Forensic Medicine in 2022 were investigated.

 The study revealed that among the types of substance abuse leading to death, the highest mortality rates were associated with methadone abuse (28.4%), followed by narcotics compounds (21.5%), drugs misuse (9.2%), and methanol poisoning (8.8%). Notably, there was a statistically significant difference between the type of substances consumed and gender (P<0.05). In men, the most frequently consumed substances included methadone, narcotics compounds, alcohol, aluminum phosphide, and cyanide. Conversely, women consumed narcotics compounds, drug misuse, and methadone. Additionally, a significant statistical difference was observed between the type of substances consumed and age group (P<0.05). The highest frequency of deaths occurred in the age groups of 41 to 50 years and then 31 to 40 years. Most deaths in these age groups were attributed solely to methadone use. Notably, drug misuse was the primary cause of death among women aged 41 to 50 years.

 Considering the high incidence of deaths resulting from methadone poisoning, effective management of methadone consumption, particularly among older age groups, is crucial. Furthermore, intentional drug poisoning should be recognized as a public health concern, and targeted intervention programs should be developed based on examining the factors that are effective in it.

Craniopharyngioma is a group of primary sellar and suprasellar neoplasms that are usually observed in two separate age groups. It begins in childhood from 5 to 15 years old and in adulthood from 45 to 60 years old and can manifest with various neurological, visual and endocrine symptoms. The present study was conducted with the aim of determining the frequency of visual disturbances and headache in patients with craniopharyngioma tumor after surgery.

The present study is a cross-sectional descriptive study that was conducted in 1402. In this study, the files of all patients with craniopharyngioma tumor who were referred to teaching hospitals in Isfahan between 1392 and 1401 were examined. The sampling method was census and included 41 patients.

During the post-operative follow-up, after the surgery, one of the children had diplopia and three children had decreased visual acuity. In adults, one person had diplopia and 5 people had decreased visual acuity. Also, three people were identified with defects in the field of vision. Classical headache (early morning) was not observed in the patients and most of the headaches were in the evening. Tension headaches were observed in three children and four adults. In fact, surgery can significantly reduce headaches in these patients.

In the end, this study intends to emphasize the role of post-operative follow-up in reducing or ideally eliminating headache, vision disorders and tumor recurrence, leading to a better prognosis in patients.

This study aims to assess several medical malpractice cases and the punishment of imprisonment or non-imprisonment of  Multiple Sclerosis (MS) patients, to investigate the legal processes of dealing with medical malpractice cases of this category of patients and provide criteria for determining the tolerance of punishment of imprisonment or non-imprisonment for them which will reduce malpractice in the process of diagnosis and treatment and also increase the awareness of the medical community.

Case Report:

 Regarding the issue of medical malpractice, the cases of two women were investigated, in the first case, medical malpractice was proved due to not using the correct diagnostic process, and in the second case, medical malpractice was not  proved due to the use of the correct diagnostic process despite the incorrect diagnosis. Regarding the issue of tolerating imprisonment or non-imprisonment punishment, the cases of two criminals were also assessed, and after evaluating the severity of the disease, it was found that the first case which is imprisonment punishment was tolerable and the second case which is non-imprisonment punishment was found to be intolerable.

Failure to diagnose MS disease on time and subsequent mistakes in the treatment plan will lead to filing a complaint against the attending physician, therefore, the use of correct diagnostic processes and management of complications of treatment plans are emphasized. A series of specific criteria were presented to create a uniform procedure in the issuance of medical expert opinions regarding the case of serving the tolerance of punishment imprisonment, or non-imprisonment regarding the patient's condition.