11 1027-1457 Iranian Legal Medicine Organization 597 Forensic Medicine Evaluation of Frontal Sinus Indexes by CT for Identification in Isfahanian Population Samples Ghodousi Arash Ghafari Roshanak Khademi Ghahroudi Seyyedeh Mahsa Madineii Mah Sima 1 8 2014 20 3 87 96 19 08 2014 19 08 2014 Background: Frontal sinuses are valuable for human identification especially when there are not other identification methods. The aim of the study is evaluation of frontal sinus indexes in Isfahanian population samples for identifying unknown persons.Method: In this study paranasal sinus images of 103 cases in the age range of 12-81 were collected. Then presence or absence, symmetry or asymmetry, kind of septum and superior border outline form of frontal sinuses were evaluated and FSS classification system was used for classification of indexes. Furthermore, total width of two sinuses, the distance between the highest points of the two sinuses and the distance of each sinus to its maximum lateral limit, were measured then, the data were analyzed. Findings: Bilateral and unilateral absences of frontal sinus were observed respectively 2.9% and 1.9%. Also, there were no relation between age and sex with frontal sinus presence. Most dimensions of men were larger than women. There was no relation between the age and the measurements. Probability of the frontal sinus uniqueness was 75% in our samples though, it was increased 100% by adding measurements.Conclusion: The success rate of 75% implying the classification method could be useful for practical purposes of identification especially by adding measurements to it.
598 Forensic Medicine Investigation of Relationship between Hemosiderin-Laden in Alveolar Macrophages and Drug Abuse in Cadavers Referred to Tehran Legal Medicine Center in 2009 Tofighi Zavare Hassan Ghorbani Mazaher Koolaei nejad Kiana 1 8 2014 20 3 97 102 19 08 2014 19 08 2014 Background: About 24 to 40 percent of hospital admissions are due to addiction and its complications. Determination of a marker for substance abuse, especially in cadavers is very useful for diagnosis and the cause of death.Method: This study was conducted to evaluate association between substance abuse and Hemosiderin-Laden in alveolar macrophages in all cadavers referred to Tehran Legal Medicine Center in 2009. In this study, 40 cases, referred to our medico legal center were evaluated for possible addiction to opium, Heroin or Crack, documented by Cocaine strip test or gas chromatography test. The lung autopsies were taken from both addicted and non-addicted and after staining, they were evaluated for the number of Hemosiderin-Laden macrophages had any significant difference between two groups.Findings: A total number of 40 fatal cases were studied (35 men and 5 women mean age range was 30 years). The cases had a minimum exposure range of 1 to 20 years lifetime, of which 28% had used drugs approximately 10 years. The methods for using drugs were as followed: injection (50%), oral (18.8%), inhalation (12.5%), injection and oral (12.5%), and inhalation and oral (6.2%). The most popular methods used by subjects were Heroin (25%). The number of Hemosiderin-Laden macrophages detected in lung autopsies significantly increased in addicted ones. Results showed that the difference between case and control groups is significant statistically.Conclusion: Consequently, this study confirmed previous study findings and showed that Hemosiderin-Laden in alveolar macrophages is a useful marker for diagnosing chronic drug abusers.  601 Forensic Medicine A Survey on ‘Do Not Attempt Resuscitation Order’ in Patients with Cardiopulmonary Arrest Okazi Arash Bakhshandeh Hooman Ghadipasha Masood Mehdizadeh Farzaneh Shaban nejad khas Zahra 1 8 2014 20 3 103 110 23 08 2014 23 08 2014 Introduction: Do not attempt resuscitation (DNAR) order is issued despite continuing the basic treatment in patients with a cardiopulmonary arrest. Resuscitation would not start if the patients have a previous request for DNAR by their physicians or relatives. In Iran, we don’t have any accreditation for DNAR order. So, this command is done informally and based on the physician individual opinion. In this study, current situations in our hospitals and the variables which medically affect in this order are evaluated. Method: A blind standard questionnaire in DNAR order field was completed by 62% of anesthesiology and emergency medicine specialists. Data were analyzed by 16th version of SPSS software. Results: Totally, 71 physicians were completed the questionnaire. In 61.4% of cases informal and verbal commands are issued. An underlying debilitating disease, a prior cardiac arrest, poor cardiac condition before recent cardiac arrest, an underlying poor prognosis disease, asystol rhythm taken more than 20 minutes are the main variables for having DNAR orders. Discussion: This study showed that DNAR order is done in our hospitals not based on a formal guideline. So, we need to provide a formal protocol in conjunction with jurisprudents and other related experts. 602 Forensic Medicine Perception of Patients’ Companions about Nature of Workplace Violence against Nurses in Tabriz Medical Educational Centers Babayi Nasib Rahmani Azad Mohajjel-aghdam Alireza Zamanzadeh Vahid Dadashzadeh Abbas Avazeh Marzie 1 8 2014 20 3 111 118 23 08 2014 23 08 2014 Introduction: Nurses consider patients’ companions as a main resource of workplace violence against nurses. There are no previous researches investigated the nature of workplace violence against nurses from the viewpoints of patients’ companions. So, the aim of present study was to investigate the perception of patients’ companions about workplace violence against nurses. Method: In this descriptive study, 376 companions in Tabriz medical educational centers were participated by simple randomized method. The data gathering instrument was a modified questionnaire of World Health Organization. Data analysis was performed using SPSS software (version 13) and descriptive statistics. Findings: Companions reported 149 occurrences of workplace violence in verbal (25%), cultural (5.9%), sexual (4.5%) and physical (4.3%) types. About verbal, sexual and physical violence the companions were the most representative of workplace violence. Inappropriate behavior of personnel, worries about health and long prospect for receiving health care were mains. The main reactions of nurses to workplace violence included informing guard, doing nothing and invited the offender to be calm. Conclusion: Results of this research confirmed high prevalence of workplace violence against nurses and also in many cases, such as prevalence of violence, offenders, types of violence and reactions of nurses the perception of companions were similar to the viewpoint of nurses that reported in previous researches. This project funded by research deputy of Tabriz University of Medical Sciences and approved by Regional Ethics Committee. The findings have no interest of conflict with authors. 593 Forensic Medicine Prevalence of Fingerprint Patterns in Different ABO Blood Groups 1 8 2014 20 3 119 126 09 08 2014 09 08 2014 Background: Fingerprint pattern inheritance is a polygenic one. Blood groups of people also follow a natural genetic inheritance. Some studies have been carried out on the relationship between types of ABO blood groups and fingerprint with physical features of human body. This study aims to find out prevalence of fingerprint patterns in ABO blood groups. Methods: This descriptive-analytical study was carried out on 600 healthy people in 4 blood groups of A, B, AB, O and in two blood factors of Rh+ and Rh-. The blood group and Rh factors of the people were determined by Cell Type method. Their fingerprints were specified using Henry and Galton’s dermatoglyphics method. Fingerprint patterns of people were classified into 3 major groups (Arch, Loop, and Whorl) and 9 minor fingerprint patterns. Findings: Prevalence of whorl, loop, and arch patterns in the people under study were achieved as 44.1%, 43%, and 12.8%, respectively. For whorl pattern, the most major fingerprint patterns in A, B, and O blood groups and Rh+ people were 25.7%, 27.7%, 27.3%, and 91.4%, respectively. For loop pattern, the frequency in AB blood group and Rh- people were 30.6% and 13.5%, respectively. Conclusion: The results of this study revealed that frequency of fingerprint patterns is different between ABO blood groups yet, further studies with higher sample size are recommended. 600 Forensic Medicine The Frequency and Pattern of Injuries in Occupational Accident Victims Referred to Sari Legal Medicine Center during Year 2012 Ghasempouri Seyyed Khosro Pourhossein Masood Alizade Ahad Mirmohammadi Seyyed Mohsen 1 8 2014 20 3 127 132 20 08 2014 20 08 2014 Background: Importance of Human resources as economic cycle motive is clear for everyone ،but this valuable parameter always threatened by many factors in workplace .This study is done for evaluation of annual frequency and pattern of injuries of cases who came to the examination unit of Sari legal medicine centerMethod: This was a descriptive and cross sectional study. 125 cases that referred to clinical examination unit of Sari legal medicine center were studied through a questionnaire.Findings: %97of cases were male with mean age of 35yares old, %84.8 in married state, %67.2 were educated up to diploma,%86.4 without technical vocational training. The most events had occurred in industrial studio (%40.8), concern to June (%17.7) and morning shift (%56.5). %56/8 of them had less than one year training, injured in collision with animate mechanical forces (%52). The most common injuries were in upper limbs with %39.2 and lower limbs %27.2 %44 of them had bone fractures. Also, this study showed% 82.4 of accidents happened in work place with less 10 worker and %14.4 had a previous history of occupational accidents.Conclusion: On the basis of this study, young men devoid of vocational training in small work shop had the most common exposure to occupation accidents. The results of this study have conformity with the findings of similar studies in Iran and other countries. 599 Forensic Medicine Ricin Poisoning from Forensic Toxicology Viewpoint Soltaninejad Kambiz 1 8 2014 20 3 133 152 19 08 2014 19 08 2014 Background: Ricin is a glycoprotein and one of the most toxic produced plant toxins derived from the castor plant. Accidental and criminal poisoning and bioterrorism due to ricin have been considered as the most important type of intoxications in forensic toxicology. In this article, the origin, history, biochemistry, toxicity and analytical procedures for determination of ricin in clinical and forensic cases are reviewed.Findings: Due to a high toxicity, the relative ease of production and availability of plant, economic methods for extraction of ricin from plant, non-specific clinical presentations and lack of specific antidote for treatment of the poisoning, ricin has been used in criminal poisoning and bioterrorism. In recent years, many Al Qaeda's illegal clandestine laboratories for production of ricin in Afghanistan and other countries have been detected. Also, sending of ricin-contaminated letters to some governmental important people such as USA president has been reported. This fact represents the importance of continuous threat due to ricin bioterrorism. Analysis of ricin in biological and non-biological samples is necessary for confirmation of poisoning especially in forensic cases. Immunoassay techniques have been used for screening of samples and combination of high tech chromatographic and mass spectrometric methods could be used for confirmatory analysis in clinical and forensic cases.Conclusion: Due to continuous threat of our country by terroristic groups and possibility of use of ricin in modern terroristic acts, there is a necessity for continuous medical education of health care providers and forensic medicine specialists about ricin poisoning from medical and forensic aspects.  594 Forensic Medicine Ogilvie’s Syndrome and Following Medical Incidence Claims Jafari Gholam Ali Adibzade Abdoraouf Gharedaghi Jaber 1 8 2014 20 3 153 156 11 08 2014 11 08 2014 Background: Ogilvie Syndrome is considered as a rare complication of post operations. It is an acute functional obstruction without any mechanical causes. Obviously, in a late or mismanagement, this could lead to a fetal peritonitis. As our data base searches, most studies of this syndrome have shown its cause and management so, this study, through a survey on a medical incident case presentation, could be considered a new one from the forensic medicine viewpoint.Case Presentation: A 34 years old woman in her 32th weeks of pregnancy came to emergency room because of a massive vaginal bleeding. Cesarean section delivery was done due to an incidental decidual abruption diagnosis. The patient and her new born baby were discharged in a good condition. Three days following discharge, the patient admitted in the hospital due to an acute peritonitis partial colectomy was done. Following the second surgery, the patient was admitted in ICU for next 35 days. The patient was discharged in a good condition and claimed for her problems which came to her due to her obstetrics physician negligence.Conclusion: This syndrome should be considered as one of the post operation complications in a patient who has abdominal distention and other obstruction signs. Careful and suitable care and management following surgeries like a cesarean delivery should be done by surgeons and physicians are responsible for possible negligence in care steps. It is known that even a request for a surgical consultation besides fair care and in time management following a susceptible diagnosis, could save both patients and physicians from the future problems.