مجله پزشکی قانونی
سال هفدهم شماره 3 (پیاپی 63، پاییز 1390)

Backgroung: The most prevalent method for determining the dental age is the Demirjian method. But, different studies have been showing that this method overestimates the age so, Willems has presented a newer method. Willems has used (ANOVA) system to adapt Demirjian method to Belgian Caucasian race. The result was new tables in sex separated. Calculating the overall maturity score by summing the adapted scores for the seven mandibular teeth directly results in the estimated dental age. The purpose of this study is to determine the accuracy of Willems Method in age estimation of children by radiography of developing teeth in Esfahan. In this descriptive, cross –Sectional study, 151 panoramic radiographies belong to 54 boys and 97 girls at the age of 3 to 18 years old, were used. The samples of chronological age was obtained by subtraction of birth date from the radiography performance date. The sample of dental age which was determined by both Demirjian and Willems methods were entered to SPSS software (Ver 17) and differences with the chronological age were analysed by using a t-test and ANOVA. Fingings: The Demirjian method resulted in an overestimation of 0.63 year (boys 0.94 year and girls 0.47 year). The new adapted method resulted in a smaller overestimation of 0.11 year (boys 0.22 year and girls 0.06 year). In different age groups, the minimum difference has been in the range of 11 to 12 years old and it was 0.01 year. The maximum difference has been in the range of 17 to 18 years old and it was 1.2 year. The statistical difference between chronological age and Willems method is not significant. The adapted method was resulted in more accurate dental age estimations in this population

Brain death is an irreversible cessation of all brain activities and brain stem simultaneously, and must comply with clinical and paraclinical characteristics that may be resulted from severe head trauma, brain hemorrhage, stroke or prolonged brain anoxia. This study reviews the demographic donor members besides, a comparative evaluation of clinical and paraclinical findings in guideline of American Academy of Neurology, conducted on brain death. This is a descriptive cross - sectional study. All cases of brain death that had been agreed to award their organs from 2004 to 2010 were studied. Questionnaire included two parts, demographic information and questions assessed parameters recommended guideline by the American Academy of Neurology. In Order to determine compliance with the parameters, descriptive statistics and graphs were used. Approximately, 77% of cases were +18 and 23% were -18. The cause of brain death was car accident in 61% of cases, 13% cerebrovascular accident, 13% gun shot, 5% falling and others were electric shock or tumor of cerebellum. All cases were on coma mode and no motor response to painful stimuli was detected. In all cases there were no brain stem reflexes. All had brain CT and the basic body temperature was above 32ºC. In all cases EEG had been performed twice. Organs donated were liver and kidney in 67% of cases and in 33% was kidney only. In the comparative study between brain death and organ transplant evaluation process in Guideline of American Academy of Neurology, non tremendous difference was found. Most transplanted organs were kidney and liver. Because there are about 50 organs or tissues in a person could be donated and low rate of organs donation in the country, efficient use of organ transplant must be considered and it should not be limited to one or two organs. The growing organ donation is a positive sign and promotion of public culture is effective for it.

Death information have critical role in adjustment of health plans and cause of death coding leads to organizing and being used of this information. Purpose of this study is to review the impact of documentation errors on cause of death coding accuracy in Shahid Mohammadi hospital in Bandarabbas. This descriptive cross sectional study performed in second half of 2011 by a survey on all death certificates. At first, certificates information were written on forms separately and residents determined sequences of death certificates. Next, the researcher recorded certificates and compared his codes with primary coders. At last, the researcher referred to death certificates for extracting information about documentation errors. Data entered in SPSS and was analyzed with descriptive statistics and chi square test in 95% confidence interval. Accuracy rate of causes of death coding was 51. 7%. There was a meaningful relationship between coding accuracy and major errors (P=. 001); but, between coding accuracy and minors there was not. Among major errors, «cause of death with equal effects» has the most affect (82. 1% error in coding) and the most impact of this error was in endocrine chapter, (94. 4% error in coding). Number of death certificate lines and its language have meaningful relation with both errors. Cause of death coding is not acceptable in this hospital. Considering impact of major errors (9. 4%) on coding accuracy, physicians training in death certificate issue is required.

Accurate medical diagnosis is an important issue for an appropriate treatment. The aim of this study was to compare clinical diagnosis and autopsy findings in patients who died in a university hospital in Tehran. In this cross-sectional study, the data were collected in two parts. Medical records and autopsy findings of 380 dead cases, who were referred for postmortem examination to determine the cause of death, were extracted from 1021 yearly dead one files in a university hospital. First part of information included demographic data (age, sex), clinical records of hospitalized patients and the first clinical diagnosis and cause of death by the physician. The second part was related to autopsy findings (both pathology and serology) and definite cause of death. Postmortem examination revealed acceptable clinically diagnosed cause of death in 47.6% and incorrect ones in 27.7%. In 23.7% of cases, the cause of death was uncertain in which determined after autopsy. Considering the low rate of correct clinical diagnosis of cause of death in this study, post-mortem examination remains a valuable source of pertinent information. It is recommended to design a process to inform hospital physicians about the final cause of death. It may improve the management of hospitalized patients base on better diagnosis in similar situations.

Identification is the starting point of criminal investigation and height estimation based on foot dimentions plays an important role in forensic identification; also, it can be used to determine gender and age. A review on researches revealed little once had estimated the height by using the anatomical markers. The purpose of this study is to estimate the height by using longitudinal, transverse and angular index of the foot. This is a semi-experimental study. The static footprint of 20 males,10 to 12 years old, using ink system-paper was recorded. Then, by using ImageJ software, quantitative indices were achieved. Height was estimated through Linear Regression Analysis. Results showed that, the best variable for a predictive equation in height estimatin is CACL-A4 (SEE = 2.46, R2 = 0.51). Based on the findings, MPJ Width in metatrsophalangeal joint area is the weakest one for height estimation (R2 = 0.26). Results in a static footprint showed, the best index estimate the height is CACL-A4; while, in transverse indices, the arch width index is the best predictor.

Traffic injuries are noticable events because of high prevalence and mortality. In Iran, traffic injuries after heart disease are the second cause of death and first cause of wasting life and it will lead to the most important problem that threats our health. The Pedestrian are the most vulnerable people in traffic injuries among them death and disability are high. The purpose of this study is to evaluate the demographic characteristics of pedestrians who died of traffic accidents over a period of six years (2004-2009) in Kurdistan province of Iran. In this cross sectional study (descriptive- analytical), by census method, all 654 cases of dead pedestrians were studied. Then by using a check list for demographic characteristics, location, time of the incident and the cause of death collected and data analyzed by spss software finally. Of the 654 dead pedestrians, more than two thirds (69.1%) were male. According to age, the majority of cases were 65 and older (27.8%). Half of the fatal accidents occurred in urban roads (59.8%). There was a significant relationship between sex of victims and the location of incident (p<0.05). Also, most of the victims died before transferring to the hospital. Based on the findings, according to the high rate of death among older pedestrians and pre-hospitalize phase, some helpful proceedings such as training, installation of pedestrian bridges, suitable for the elders, and traffic signs besides, empowerment of medical aid system will reduce death in pedestrians.

Regarding redundant magnitude of non-food poisoning phenomenon in Iran, it seems a simple review of related documents in different type of this poisoning, gives a precise estimation about this subject for a correct policy- making in this field. For access to qualified and scientific information, we referred to the Iranian and international electronic databases including Irandoc, Iranmedex, Integrated Library, Scopus and Sciencedirect. A systematic search by using the most sensitive and relevant keywords including toxicity (Poisoning or Toxicity or Intoxication), non (Non-Food) and suicide (Suicide or Self-harm) was done. Then the selected studies were evaluated by a standard checklist of STROBE. Finally data extraction conducted for qualified studies. In this study, among 220 found articles, 29 articles with 72024 people were evaluated. The maximum cases of intentional poisoning (86%) were in 15-24 years old age group and also maximum cases of accidental poisoning (79%) were in under 15 years old age group. A background in poisoning or mental disorders were the main and significant factors for future poisonings. Respecting a simple review of national documents about morbidity and mortality of non-food poisoning in Iran, we can say attempts to legalize sale and consumption of poisons and drugs and chemical materials, low use of poisons and high use of safe controlling methods, a change in attitude and an attempt to increase general knowledge in people about poisoning and producing proper educational programs by mass media are among the main actions. If they are done, it could decrease the number of poisoned cases in Iran.

Aluminum phosphide is a cheap and highly toxic pesticide which is commonly used for grain preservation. In Iran, it is known as the “rice tablet”. Ingestion of only 1.5 g of a standard tablet (3000 mg) can be lethal in human due to multiple organ failures. Unfurtunately, this high potent substance is easily available in our country. Its usage for suicidal attempts has been increasing significantly in recent years. According to the availability of garlic deragee, herbal rice tablet (Banan) and aluminum phosphide, all three in Iranian market as "garlic tablet", we may meet unintentional fatal poisoning caused by accidental ingestion of aluminum phosphide in some cases.In this manuscript, we report a successful treatment in two patients with accidental poisoning by aluminum phosphide which had happened due to nominal similarity