مجله پزشکی قانونی
سال دهم شماره 4 (پیاپی 36، زمستان 1383)

One of the tasks of forensic medicine is to study the cases of death during or following surgical operations invasive diagnostic procedures or anaesthesia. The study was done on 400 cases of post-op death using examination, autopsy and toxicologic analytic tests. Death was most common among 20-29 year olds (21%), and happened more in men (84%) Than in women (16%). The most common cause of operation was subdural haematoma (34.89%). It was seen more in emergency surgeries (91.8%) Than in elective ones (8.2%). The commonest age group was 20—29 years old people with %21; death for men %84 and for women %16. The commonest reason for surgery operation was subdural hematoma (%34.89). %91.8 of emergency surgery operations and %8.2 of elective ones was led to death. Cases of death caused by operation in emergencies were mostly in neurosurgery and general surgery with %58 and %34.6 of occurrence respectively. Also in nonemergency cases, neurosurgical operations (%45.5) and orthopedic operations (%30.3) led to death more than other types of operation. Cases of death in emergency and elective surgeries with %68.9 and %60.6 of occurrence have occurred in public hospitals. Among 400 cases of death caused by surgery only %3.5 died during the operation. Among these 400 cases, %84.3 died of blunt trauma injuries, %5.5 of injuries by pointed or sharp-edge weapons and primary illness led to death in %10.2. The most common cause of death was head injury because of blunt trauma(%49). In this study, the main reason for having a surgical operation was bleeding in brain membranes (%44.6) but in similar foreign studies operation death was mostly related to gastrointestinal and cardiovascular disorders. The difference is possibly due to the large number of accidents in Iran.

In health care, emphasis on Basic Human Rights is specially important. Patient’s privacy protection becomes important when the human is exposed to shortcomings of social and health systems. It seems that in health and treatment services the «Patient’s Bill of Rights» has been ignored to the extent that the patients have no information about their rights. Recently «Patient’s Bill of Rights» compiled by Iranian Ministry of Health, which has a lot of shortcomings, was published. To propose a complete «Patient’s Bill of Rights» for our country, it seemed necessary to study «Patient’s Bill of Rights» in some developed countries. This research was a comparative and descriptive case study. Research population included the U. S. A (States of New York, Florida, Missouri, Minnesota, Texas), England, France, Canada and Iran. Data gathering was done through internet and e-mail. Findings of research showed that patients’ rights of accessibility to treatment and health care, privacy, consent for treatment and protection (the Right of Claim) were included in «Patient’s Bill of Rights» of all the countries under investigation, except Iran. The Right of Confidentiality is considered in all studied countries. The Rights of Having Translator and Pain Relief just were seen in some states of the U. S. A. The appropriate solutions were suggested for «Patient’s Bill of Rights» in Iran.

Mortality rate of scorpion bite in the world is about 5000 each year: and most of victims are children. Mortality rate in our country is about 40 cases annualy 80% of which occur in Khozestan and the greatest mortality is related to Gadium Scorpion. The purpose of this study is evaluation of pathologic changes after Gadium scorpion bite in animals.

This experimental study was performed in Kashan University of Medical Sciences. Fifty-one rats were selected as cases and 50 rats as controls. After injection of Gadium scorpion toxin to rats, the pathologic changes in liver, spleen and kidneys, local changes in skin and alterations in RBC, WBC and HCT were evaluated.

Most pathologic change were detected in liver (70.6%), then in kidney (35.3%) and then least in spleen (27.4%). The most prevalent histopathologic change in liver and kidney were congestion (49% and 43.2%) and in spleen was hemorrhage (15/7%). Skin changes as wound were detected in 55% of cases; which was not found in controls (that were injected with normal saline instead of toxin). The average of RBC and HCT decreased and the average of WBC increased and both were statistically significant.

Gadium scorpion toxin causes the various pathologic changes in animal organs and type and percentage of these changes differ from organ to organ. The increase in WBC indicates that toxin is a potent stimultants of immunologic system and decreasing of RBC and HCT indicates hemolytic activity of the toxin.

Divorce is among the most tragic social events, which as different recent studies show its incidence is increasing in our country. There exists different causes for divorce and none of them can be regarded as the most important one considering the importance of the subject. We are to investigate the most common cause of divorce, and as a result possibly find a way to reduce its rate. During year 2000, from couples among 411 who came to Legal Medicine organization in Hamedan, through interview and the forms filled out, the data has deen collected, and then it has been statiscally analyzed by SPSS soft ware. Based on this study, the most common reasons for divorce are: the low level of education of couples the addiction, childlessness unemplayment, poverty low age of couples at marriage time. In this study, the causes of divorce in %50 of the cases was addiction which has significantly increased campared to the result of previous studies. The results of this study, like those of previous once. Indicate that the divorce has different reasons and we can reduce the rate of divorce. Through careful studies on its causes and giving consultation services to those couples who are deciding to divorce. On the other hand, considering the fact that after divorce the family and specially the woman go under very strong pressures, relevant social organizations must support these people.

Rabbits given orally ethanol in different concentrations showed signs and symptoms of toxicity. Mild clinical signs were produced. These signs increased gradually following a medium dose of 20% ethanol and reached a maximum level at the highest dose of 40%.The clinical signs comprised rectal temperature, heart beat and respiratory rate. Affected animals showed also signs of dullness and depression. They developed sternal recumbency and refused eating and drinking. The following day prior to dosing, the animals seemed to be active. They ate, drank and moved inside their pens in a normal manner. Blood changes, haematological findings, post-mortem and histopathological changes, and electron microscopic findings were taken.

Introduction & Use of appropriate fillers to correct soft tissue defects, wtinkles and scars has long been one of the plastic surgeon’s ambitions. This material is effective and suitable if only has characteristics such as being permanent, inherently inert, capable of forming well, easily injectable, being fixed in place, disintegrable, absorbable, not prone to infection, being cheap and economically suitable, not making any disorder in clinical and paraclinical studies and if the patient does not wish to have it anymore, it could be easily removed. Since 1977 after introduction of collagen, other injectable fillers have come to the market but due to complications and ineffectiveness, their use was abandoned. These difficult situations has been the cause that the world of fillers has not changed significantly during these years. This retrospective study has been done to evaluate the patients who have undergone injection of gel to correct facial wrinkles or fill the soft tissue defects but developed moderate to severe complications. This evaluation has been done by taking history, physical exam, follow up of patients’ appearance and medicosurgical attempts. In this study which has been done on 44 patients several complications such as swelling, abscess formation, lumpiness, change of facial appearace, change in gel location after injection, and sensitivity have occurred. the fact that the use of this gel is somewhat new and complete evaluation of its complications has not been performed completely and also treatment with several surgical procedures have not been successful, we recommend its abandoments for the present time.

Subarachnoid haemorrhage (SAH) from ruptured intracranial aneurysms of the circle of Willis is a common cause of death in patients with autosomal dominant polycystic kidney disease (ADPKD). It has a mortality rate of over 25% and an additional high risk of permanent disability. In this article, we present a 36 years old male patient with polycystic kidney disease and hypertension who died from SAH due to a ruptured saccular aneurysm of the right middle cerebral artery and complete post-mortem examination carried out in mortuary of Iranian Legal Medicine Organization. Based on literature review, we also discuss the indications, benefits and risks of screening and prophylactic treatment of asymptomatic intracranial aneurysms in patients with polycystic kidney disease.

All physicians specially forensic pathologists encounter many infections like AIDS, tuberculosis and hepatitis. These infections can cause severe disease in human beings and therefore should be considered as a potential hazard in organ transplantation. The microorganisms can enter the victims body by many routes including respiration, eating, inoculation and via conjunctiva. Physicians should observe simple rules to protect themselves such as proper usage of gloves, gowns, protective glasses, disinfectant materials and safe autopsy techniques. Given the importance of these points and since many in the medical profession are engaged in these situations this article is an attempt to warn them against infections due to atuopsy and mention some methods of prevention.