Iranian Legal Medicine Organization Iranian Journal of Forensic Medicine 1027-1457 2383-0034 13 1 2007 4 1 Epidemiologic study of TB in Iranian prisons during April-September 2004 7 10 FA Seyed Mohammad Javad Hosseini N Saeid Morovvati morovvati@bmsu.ac.ir Y Mohammad Hassan Ghadiani N Reza Ranjbar N Marziyeh Farnia N Abstract Background & Aim: Despite the advances in medical technology has resulted in decrease of occurrence of infectious disease, tuberculosis is still the most common cause of mortality. Prisoners are at high risk of acquiring TB. The most common reasons are overcrowding, malnutrition, high-risk behaviors, addiction and HIV infection. In current study, the epidemiology and prevalence of TB in prisons in Iran was investigated. Materials and methods: Checklists were obtained from prisons throughout of Iran and data were then analyzed to determine the prevalence of TB among the prisoners. Findings: In this study, 339 patients were diagnosed with TB. All patients were older than 15 years. All except two patients were male. In 83 cases, TB infection is along with HIV. Conclusion: Because of unfavorable environment of prison the level of TB in prisons is higher than that of the civilian population. Additionally high levels of MDR-TB in prisons have been reported from some studies. The results obtained from current study indicated the prevalence of TB also is high in Iranian prisons and in 83 persons it was along with HIV infection which can make difficulty in treatment and increase the risk of MDR. These results show the important role of control and treatment of TB in prisons. Epidemiology, Tuberculosis, Prison, MDR-TB http://sjfm.ir/article-1-34-en.html http://sjfm.ir/article-1-34-en.pdf

Iranian Legal Medicine Organization Iranian Journal of Forensic Medicine 1027-1457 2383-0034 13 1 2007 4 1 The relation between clinical manifestation and pathological reports of acute appendicitis in children admitted in Hazrat Ali Asghar hospital 11 14 FA Salaheddin Delshad drdelshad@gmail.com Y Shokrollah Yousefi N Abstract : Background & Aim: Acute appendicitis is one of the commonest medical emergencies in children. Due to rapid progression of the disease and difficulty in diagnosis, different paraclinical methods including ultrasonography, radiology and CT scan etc, have been used in order to diagnosis the disease at early stage and thus prevent from any related complications. However, because of unavailability of the above mentioned paraclinical procedures in certain areas and / or it’s high cost, evaluation of clinical manifestation is very important in determining the severity of the disease. In this study the clinical manifestation of children, who had undergone surgery with the diagnosis of acute appendicitis, was compared with the pathological report. In this way by everything the clinical features, the progressing of the disease could be estimated, to large extent by pathology and thus decision in regard to surgery would be taken Materials and Methods: In this study 58 children (including both girls and boys) between the ages of 3.5 year – 14 with the primary diagnosis of acute appendicitis underwent surgery. As a retrospective study, the medical files of the patients were rewied and the clinical features were compared with the pathological reports. Findings: Clinical manifestation and the pathological reports were comparable with each other. according to results, increase in security of clinical features was associated with more rapid progression of pathology. Conclusion: In case of unavailability of Paraclinical methods such as ultrasonograohy and CT-scan more attention must be paid to clinical history and clinical sign and symptoms observe in a child suspected of having acute appendicitis. By this method, early diagnosis could be accelerated and any decision in regard to surgery would be taken accurately .As a result of unpleasant complications are prevented Acute Appendicitis, Acute Abdomen, Perforation, Rebound Tenderness, Appendectomy http://sjfm.ir/article-1-45-en.html http://sjfm.ir/article-1-45-en.pdf

Iranian Legal Medicine Organization Iranian Journal of Forensic Medicine 1027-1457 2383-0034 13 1 2007 4 1 Factors predicts tracheostomy after open heart surgery 15 20 FA Fereidoun Sabzi N Hassan Teymori Hassan30090@Yahoo.com Y Abstract Background & Aim: One of the important complication of open heart surgery due to effects of cardiopulmonary bypass on the organs and the lung is respiratory failure and this patients dependent to ventilators for long times and some of them need to tracheostomy and this patients will be at risk of tracheostomy complications such as tracheal steno sis, hemorrhage, infections, and hypoxia. Materials and methods: During a 2.5 years period of time, 1200 patients were studied. In this study logistic regression models, tracheostomy entered as depended variable and also p- value less than 5% considered as significant and odd ratio of them determinate. Findings: In this study variables with p-value less than 5% were observed which including high dose inotropic drug using, pump time ,intra aortic balloon pump using, heart failure, COPD and diabetes with odd ratio of 15.1, 12.1, 13.5, 21, 11, 16, respectively. Consequently from 25 tracheostomised patients, 18 of them patients weaned from ventilator and 6 patients died due to its complications. Conclusion: With respect to mentioned complications, diagnosis and knowledge of predicting factors of tracheostomy for preventing its mortality, is important. Cardiac Surgery, Respiratory Failure, Tracheostomy http://sjfm.ir/article-1-46-en.html http://sjfm.ir/article-1-46-en.pdf

Iranian Legal Medicine Organization Iranian Journal of Forensic Medicine 1027-1457 2383-0034 13 1 2007 4 1 Psychiatrists’ attitude to the psychiatrist’s style of dressing and addressing 21 24 FA Yousef Semnani y.semnani@sbmu.ac.ir Y Hamid Reza Shahpouri N Abstract Background & Aim: The patient – physician relationship (rapport) is one of the most important cues in daily medial practice .How a physician dresses and how she or he addresses the patients are important factors in developing rapport. This study was done to determine psychiatrists’ preference dressing style and their addressing. Materials & Methods: This descriptive - analytic study was done on psychiatrists and psychiatric residents. The psychiatrists who were intended to enrol in this study were selected and their demographic data, medical practice duration, dressing preference for male and female psychiatrist, patient aspect for psychiatrist gender preference, patients and psychiatrists addressing. Eight Photos demonstrating different styles of dressing (four, for female physicians and four for male, based on Iranian culture) were shown to everyone to select the preferred one. Findings: 77 psychiatrists (58.4% male and 41.6% female) were participated in this study. Formal attire (72.7%) was selected as a prefered dress for male psychiatrists and colored gown and scarf (32.5%) and veil (28.6%) for female. The majority of attenders (81.8%) didn’t believe in psychiatric patients don't select their psychiatrist based on his/her gender. (92.2%) of psychiatrists preferred to be addressed as Dr and Family name and (77.95%) believed that patients should be addressed ad Mr or Mrs in Front of their name and (81.8%) of them stated that using plural pronouns is better and (87%) preferred that their patients use plural verbs to address them. Conclusion: psychiatrist’s dressing and addressing based on physicians’ attitudes help improving patient-physician rapport Psychiatrist, Psychiatrist dress, Physician-Patient Relation http://sjfm.ir/article-1-42-en.html http://sjfm.ir/article-1-42-en.pdf

Iranian Legal Medicine Organization Iranian Journal of Forensic Medicine 1027-1457 2383-0034 13 1 2007 4 1 Estimation of efficiency of blood group in comparison with DNA typing tests in disputed paternity 25 29 FA Ali Reza Sabouri Isfahan@LMO.org.ir Y Hamideh Yadegari N Abstract Back ground & Aim: Blood grouping test is a tool to resolve the problems of disputed paternity. Therefore, we decided to calculate its chance of exclusion depending on the phenotype data on seven blood groups (ABO, Rh, MNSs, kell, kidd, Lutheran and P1 ) in south and central parts of Iran. Moreover, red cells tests and full STRs results for paternity disputes were compared. The main aim of this research is to evaluate the efficiency of blood grouping test in comparison with DNA typing. Materials & method: Blood Samples were obtained from 174 unrelated individuals belonging to the south and central parts of Iran. Then, DNA Typing for the 12 Loci and blood testing were performed simultaneously. Findings: The chance of exclusion in each system of ABH, Rh, MNSs, kell, kidd, Lutheran and P1 is 19.5%, 29.77%, 22.28%, 3.64%, 9.77%, 3.47% and 4.5%, respectively. From 82 paternity tested, in 42 cases no mismatch was observed for STRs that supported paternity. In 40 cases that alleged father was excluded by DNA Typing, in 22 (55%) cases, there are no mismatches in blood groups. 18 (45%) cases showed mismatches at one or more antigenic systems. Overall, two alleged farther were excluded just by red cell typing regarding to criteria of non-paternity remaining cases needed DNA Typing. Conclusion: This study shawed that considering the probability of excluding of all mentioned blood groups systems, 64.83% of them can not be used to prove paterninty. On the other hand, owing to low efficiency in exclusion, high cost, laboratory error rate and availability of DNA Typing, we recommended that routine red cell tests for court cases should be limited to AB and Rh [CcDEe] systems. Blood groups, paternity, DNA Typing http://sjfm.ir/article-1-47-en.html http://sjfm.ir/article-1-47-en.pdf

Iranian Legal Medicine Organization Iranian Journal of Forensic Medicine 1027-1457 2383-0034 13 1 2007 4 1 A survey on physical signs of domestic violence and their severity in women referred to Tehran Legal Medical Center in 2003 30 32 FA Shahla Najafi dolatabad shahlaiss@Yahoo.com Y N Abstract Background & Aim: Despite the great revolutions of 20th century discrimination and abuse against women are continuing around the world that seems to have cultural root. Battering can cause various physical injuries such as brain trauma, fractures, hematomas, swelling, visceral organ injuries, tissue rupture and etc. Materials & Methods: This is a descriptive study which is planned to determine physical signs due to battering in women and girls referring to Tehran Legal Medicine center. In this study, 171 subjects referring to Tehran Legal Medical center were selected based on the objective using the population sampling method. The data was collected by questionnaire and checklist which was filled by researcher and then checklist was completed to determine the intensity of injuries by physical examination of patient with diagnosis of a Frensic medicine specialist. Findings: The results showed that 40.4% of subjects were between 26-35 years old (mean age of 29.58). 68.4% of subjects were housekeepers and 1.2% were workers. 47.4% were literate and 508% illiterater. 74.3/% of them were married, 19.9% single, 4% widow and 1.8% divorced. Physical signs due to battering were hematoma in 68.13%, abrasion in 24.5%, bone fracture in 3.43% and rupture of tympanic membrane of ear and muscle rupture in 3.43%. Intensity of this injuries evaluated in 66.8% moderate, in 23.4% mild and in 9.9% relatively severe. Conclusion: Battering of women can cause problems including physical injuries, mental problems, depression, carelessness toward children and etc. as a result it is necessary to seek a remedy for prevention of these social problems. Battering, violence, women http://sjfm.ir/article-1-43-en.html

Iranian Legal Medicine Organization Iranian Journal of Forensic Medicine 1027-1457 2383-0034 13 1 2007 4 1 Study of respecting patients rights from nurses point of view employed in Yazd hospitals 33 37 FA Khadijeh Nasiriani nasiriani@gmail.com Y Farahnaz Farnia N Fatemeh Nasiriani N Abstract: Background & Aim: Respecting patient’s rights are those factors that they expect from health centers. It means that the patients regardless to their age, sex, race, and other differences have some rights such as: knowing, selecting, being respected, confidentiality, territoriality and receiving efficient care and objection. Nurses duty also is to respect patient, rights. Materials & Methods: This is a cross-sectional study which is done in order to determine the nurse’s level of respect for the patient’s rights. This study carried out on 280 nurses was selected through stratified randomized sampling. Data was collected via a questionnaire about demographic information and patient’s rights situations for measured level of respect, which is Analized via SPSS soft were. Findings: The result showed moderate respect for patient’s rights. In more than half of cases (9.78±2.60) The result indicated a meaningful different between respect for patient’s rights and work (p=0.006). Conclusion: Results show that patient’s rights regarding the importance of matter is at medium level which isn’s satisfactory and to increase. These recipients of health care it is necessary to do some neasures such as: approval of laws related to patient’s and nurses rights & creation sanctions in order to observe better & qualified patient’s care Respect, Patient’s Rights, Nurse http://sjfm.ir/article-1-50-en.html http://sjfm.ir/article-1-50-en.pdf

Iranian Legal Medicine Organization Iranian Journal of Forensic Medicine 1027-1457 2383-0034 13 1 2007 4 1 Electrocution and complications 38 44 FA Mehrzad kiyani N Shabnam bazmi sh_bazmi2003@Yahoo.com Y Abstract Introduction: Electrical injuries is one of the major causes of death annually. Electrical injuries happens when the body is a part of electrical circuit and consequently broad symptoms are revealed. Discussion: Agents like voltage, amperage, type and pathway of current (direct or alternative), tissue resistance and passage time are important factors in severity of these injuries. The result of such injuries may be: paralysis, syncope, bone fractures, electrical burns, injuries due to falling down, renal failure, and at last death. The researches has shown that alternative current , humidity and anxiety increases the risk of electrical fatalities. At Autopsy there are no definite sign of death due to electrocution but some things such as presence of electrical mark, visceral petechia and congestion and some histological findings (epidermal cell elongation with nuclei oriented horizontally stretched) may help to find out the cause of death To prevent such injuries one must concerned about safety of electrical devices specially at high risk places like bathroom (because of the presence of vapor and water). If the victim’s life is saved checking vital signs, usage of broad spectrum antibiotics and other drugs to relieve pain and amendment of wounds, long time physical therapy may be useful in improvement the function of injured part of the body. Conclusion: If we know how dangerous Electrical injuries can be and know about agents that take part in the severity of injuries we can prevent it by making safe environment with proper preveventive programs and treatment plans in such cases we can reduce mortality a of electrical injuries. Electrocotion, Electric Mark, Injury http://sjfm.ir/article-1-52-en.html http://sjfm.ir/article-1-52-en.pdf

Iranian Legal Medicine Organization Iranian Journal of Forensic Medicine 1027-1457 2383-0034 13 1 2007 4 1 45 46 FA N b_md@ yahoo.com_mstz Y N N N http://sjfm.ir/article-1-53-en.html