مجله پزشکی قانونی
سال هجدهم شماره 2 (پیاپی 66، تابستان و پاییز 1391)

Violence against women is a phenomenon in which women are violated because of their sex، and causes many expenses and sociosomatic complication in them. In this research، the effect of various domestic violence against women and related factors in women who referred to the forensic medical center in Urmia city 2012-2013 was carried out. In this descriptive and analytical study، 296 women who referred to the forensic medical center in Urmia city in 2012 were studied by a questionnaire that its content validity validated by experts and the members of the scientific board and was confirmed by test completed by a some of women who referred to forensic medicine center. 89. 3% women (268) were violated. Slap in the face in 78% cases (234)، strangled in 57% (171)، beating with a rod. In 57% cases (212)، haul and hurl in 70. 7% cases (212)، punch and kick in 80% cases (240) and contort and pulling hair in 65% cases (195). In this research meaningful relationship between physical violence with unemployment of husband was significant (p<0. 001). With the increase in age of the man، the sexual violence has more meaningful relationship (p=0. 42). Physical violence in couples who lived an estate house were also had a meaningful relationship (p=0. 011). Legal and health managers must screen these cases ad establish supportive centers for women. Research must be done for study the causes of domestic violence and they try to solve these causes for better conditions. More support and intervention studies conducted in this regard is recommended.

Acute stress disorder is characterized by dissociative analysis، re-experiencing، avoidance، and hyper arousal symptoms. The purpose of the present research is to compare response inhibition and cognitive appraisal of patients with acute stress disorder. This research is a case-control study. The research sample consisted of 40 patient with acute stress disorder referred to Mazandaran Legal Medicine center and 40 normal persons، referred to this center and they exposed to accident and did not get acute stress disorder diagnosis، which were selected by available sampling. To collect the data، it were used of Composite International Diagnostic Interview، Stroop Test، The Posttraumatic Cognitions Inventory and The Impact of Event Scale-Revised. The MANOVA results showed that response inhibition and dysfunctional cognitive appraisal in patients with acute stress disorder is significantly greater than normal persons. The results of multiple regressions showed response inhibition and dysfunctional cognitive appraisal 91% had significantly predicting symptoms of acute stress disorder. The findings suggested that patients with acute stress disorder have more response inhibition and dysfunction cognitive appraisal. More negative appraisal of themselves and the world can cause threaten feeling and More response inhibition.

Gender Identity Disorders (GID) have been considered as a set of complex clinical conditions. They can lead to problematic and traumatic outcomes for the given individuals، their families and the society. In order to better understanding of GIDs، the aim of the present study was to compare attachment styles between three groups including transsexuals after Sex Reassignment Surgery (SRS)، transsexuals before SRS and nontranssexuals. Thirty five Male-to-Female (MF) transsexuals (20 transsexuals before SRS، 15 transsexuals after SRS) and also twenty nontranssexuals participated in this study. All participants were asked to complete Adult Attachment Inventory (AAI). The results revealed that the higher average scores in insecure attachment styles (avoidant and ambivalent) belonged to transsexuals before SRS، transsexuals after SRS and nontranssexuals، respectively. The difference between transsexuals after SRS and nontranssexuals was not significant in none of attachment styles. Based on these results، one can conclude that transsexuals after SRS in contrary to transsexuals before SRS، are closer to nontranssexuals in attachment styles.

Post traumatic stress disorder (PTSD) is one of the common consequences of rape experiences. The rate and severity of this disorder could be changed (decrease or increase) according to cultural and social factors. The aim of this research is to investigate the prevalence rate of PTSD in these victims in Kohgiloyeh and Boyairahmad province during (2011-2012). This research is a descriptive Study and Uses of PTSD-C and clinical interview according to DSM-ITR، which Performed on 70 people referred for complain from rape were assessed. All of victims had a history of rape with minimal six months. Data were analyzed by SPSS 19. The results showed that 91. 2% of victims had DSM-IV TR criteria for PTSD. The prevalence of PTSD was significantly more than previous studies in other areas. The mean of scores in PTSD – C were higher than cut- 0ff point (69. 71±17. 53). The higher and lower subscales were respectively hyper-arousal (4. 39±1. 10) and re-experience memories (3. 82±1. 35). the results showed that social and cultural factors could affect the prevalence of PTSD in rape victims. Accordingly the prevalence rate of PTSD in research sample was significantly higher than other areas.

The vegetative life or grey matter death is a situation in which due to the damaged cells of the brain’s cortex، an individual is unable to manage his/her body’s autonomic activities. The situation has fundamental differences compared to brain death or coma. Medically، the damaged cells of the brain’s cortex will not revive. However، with the intact brain stem، the blood circulation system، respiration، digestion and the like will still function and the patient may even survive without any respiration devices. The difficulties in taking care of such patients and the irrevocability of the activities of the brain’s cortex cells have left doctors and jurists with many obscurities. These obscurities have caused different tribunal procedures. Since، in addition to the damaged brain cortex all or some body parts and patient''s senses are also damaged; difficulties arise in determining the patient’s blood money. A number of jurists consider full blood money for reason and each sense while on the other hand there have been other opinions and the probability of receiving compensation for surplus blood money exists. Thus this research has been conducted with the aim to investigate the necessity of determining multiple amounts of blood money for patients suffering from brain death. In order to reach this aim a researcher-made questionnaire was employed. The statistical population consisted of all justice department judges، department for public prosecution، Isfahan courts (equal to 30 people) and also forensic physicians in the forensic medicine administration (equal to 61 people) and the sample mass included 60 people consisting of 30 judges and 30 forensic physicians. The data analyses of the research were carried out using two statistical levels namely; descriptive and illative. On the descriptive level، the analysis included statistical indexes such as; frequency and authentic percentage and on the illative level the square K test was used. The above mentioned operations were performed by 19th edition of the SPSS software. The conclusion of the research suggests that it is more suitable to determine one specific amount of blood money for patients suffering from brain death than multiple amounts، and to compensate for other damages such as therapy and retention expenses one must hold the government or the insurance company and the convict، either individually or in communion، responsible for the compensation of the damages incurred.

Atherosclerosis is a common cardiovascular disease causes many deaths worldwide. In this study، we tried to measure the uniaxial mechanical properties of healthy and atherosclerotic human coronary arteries using a tensile test machine. These are including، maximum stress and strain as well as physiological and maximum elastic modulus. In this study stress and strain are defined as the ratio of predefined force per area of sample، and the variation of sample’s length per its initial length. In addition، elastic modulus is defined as the ratio of stress per strain in the linear part of obtained stress-strain diagram. Furthermore، the force-displacement diagram of human coronary artery is obtained to discern the alterations between the healthy and atherosclerotic arterial wall stiffness. In this study، 22 coronary arteries were excised from human cadavers during autopsy، including 14 healthy and 8 atherosclerotic arteries. The obtained arteries were carried out on a uniaxial tensile test machine and load was applied until breakage occured. Finally، the force-displacement of each artery was obtained and plotted separately The results show that the atherosclerotic arteries bear 44. 55% more stress and 34. 61% less strain compared to the healthy ones. The physiological and maximum elastic moduli of healthy arteries are 2. 53 and 2. 91 times higher than that of atherosclerotic arteries، respectively. It is believed that the formed plaque in a coronary artery during atherosclerosis brings about the obtained stiffness. This could have substantial asset in the elastic behavior of artery during blood supply and can affect its performance. These results could be utilized to understand the extension and rupture mechanism of coronary arteries and has implications for interventions and surgeries، including balloon-angioplasty، bypass، and stenting.

Nasal endoscopies are used for diagnosis of bacterial sinusitis، other pathogenic processes in sinonasal area and sinusitis bacterial recognition and also for practical endoscopic surgery of sinusitis. the aim of present research is to study endoscopic variations of sphenoid sinus، sellar region and Hypophysis in adult cadavers that are needed، for endoscopic transsphenoidal surgery of hypophysial tumors from sellar area. 82 cadavers (64 males and 18 females) aged above 18 were studied in the time period between October 2011to March 2012. After uncineotomy and Anterior and posterior etmoidectomy and the exposition of sphenoid sinus with 0 and 30 degree endoscopies important anatomic landmarks were identified inside sphenoid sinus and questioned criterions were measured by pre-made tools. The average distance of sphenoid ostium from Anterior Nasal Spine (ANS) was 71. 08±1. 92 mm and 18. 59±2. 52 from upper age of choana. Average distance of hypophysis from sphenoid sinus bottom was 19. 43±1. 58 mm and 21. 59±1. 32 mm from sphenoid ostium. Sella average diameter was 1. 91 mm. There was 15. 9% dehiscence in right optical canal، 13. 4% in left optical canal، and 11 % in right carotid canal and 14. 6% in left carotid canal. Middle blade tenacity and sphenoid sinus septum was 22% to optic canal and 20. 7% to right carotid canal، 14. 6% to optic canal and 13. 4% to left carotid canal. There was a punctual statistic difference between sphenoid ostium from ANS (P=0. 009)، hypophysis gland from sphenoid bottom (P=0. 034) and hypophysis from sphenoid ostium (P=0. 029) in both male and female. Thia distance was in males more than females. Due to punctuality of some distances in both sexes and other obtained results، being aware of these anatomic differences would help us to use endoscope to preregister in Paranasal sinuses’ areas.

Cough and respiratory distress due to foreign body aspiration in children is a common problem that is associated with diagnostic problems. This case presented for emphasis on sign and symptoms، diagnostic findings، necessary measures to prevent misdiagnosis or failure to diagnose in these cases in order to notice that more accurately care for safety of these patients is necessary. Case report: A، two-year-old boy corpse which admitted to hospital with history of respiratory symptoms following the ingestion of dates and discharged from hospital after performing chest radiographs but less than 12 hours after it died due to severe respiratory symptoms and apnea. At autopsy palm seed and obstruction in the tracheal bifurcation were found. Attention to the clinical sign and symptoms and considering the likely absence of radiological findings and more observing these cases and performing more diagnostic modalities can help physicians in avoiding pitfalls and ignoring the correct diagnosis and has life-saving role in these patients.

In paranoid schizophrenia the delusions are often grandiosity، and harm or damage. Some types of psychotic disorders، hallucinations and delusions materialize has been seen in the form of somatic delusions external object ingestion in patients with schizophrenia. However، so far there has not been a case of ingesting magnets in order to remove paranoid delusions. In the following report، the case of a patient who suffers from schizophrenia is introduced. He has eaten magnets in order to prevent the movement of iron in his stomach، which has been placed by others. A 43 – year- old married man، during a party، felt of an external object placed in his body. He took measures to eat a few pieces of magnets، which were stuck in his stomach. For the first time the magnets were removed by endoscope. But due to lack of appropriate anti – psychotic treatment، the Patient again used the magnets، which this time caused intestinal perforation and he had to have laparoscopic surgery. Proper and in time treatment of patients with paranoid schizophrenia، can prevent re – occurrence of events in addition reducing the costs of hospital and reduce physical harm.

Backgruond: Klinefelter’s syndrome (47،XXY) is a chromosomal abnormality in which the affected male babies have an extra X chromosome. It is also the most common abnormality related to sex chromosomes and is the second chromosomal abnormality after the Down syndrome. It''s prevalence is 1 in 500 to 1 in 1000 in different populations. According to reports، the risk of Klinefelter''s syndrome is increased with increasing maternal age just like other chromosomal abnormalities. This retrospective study was performed in Nilou Medical Laboratory (Tehran، Iran) during the years 2006-2009. According to many reports maternal biochemical markers used for Down''s screenings are influenced in other chromosomal abnormalities such as Klinefelter''s syndrome، too. The aim of this study was to determine: how many fetuses were affected with klinefelter''s syndrome and how this abnormality influenced on maternal biochemical markers'' pattern (in quad screening tests). For 29100 pregnant women (from 50 different cities) who referred to Nilou Medical Laboratory، the Quad screening test was performed and the risk for Down''s syndrome was calculated. Women with screening positive results، after their gestational age was confirmed by their physicians، were referred to genetic centers for amniocentesis. All those women were contacted 6 months later and asked about their pregnancy outcome and their baby gender and its health status. (out of 29100 babies born alive 14751 cases were boys and 14349 were girls). 7 babies out of 29100 had been diagnosed with Klinefelter’s syndrome (via amniocentesis). In those cases، maternal biochemical markers'' pattern was similar to the cases with Down syndrome (High hCG and inhibin A Moms، with low AFP and uE3 Moms). however; the decrease in AFP and uE3 Moms was not as much as with Down''s syndrome. Regarding to the official birth consensus statements during the years (2006-2009، the sex ratio obtained in this study (102/80) showed no significant difference with the sex ratio in the whole population (104/95). This study showed that in mothers with an affected fetus with Klinefelter''s syndrome the biochemical markers'' pattern was similar to those whose fetuses are involved with Down syndrome (High hCG and Inhibin A Moms while the AFP and uE3 Moms are slightly low or near normal value). Regarding to the Klinefelter''s syndrome prevalence (1 in 1000)، it was expected that 14. 7 babies (male) would have been involved with this syndrome، among which 7 babies were diagnosed through amniocentesis (after maternal screening tests performed)، So the detection rate of our tests for klinefelter''s syndrome was 47. 6%. This figure shows no significant difference with those reported by Schmit et al (41. 1%) in Germany. Besides; none of the 7 cases with Klinefelter''s syndrome، had abnormal findings in their prenatal sonography reports at all. This finding also correlates with those by De Viga C et al (Paris، 2001).