مجله پزشکی قانونی
سال پانزدهم شماره 2 (پیاپی 54، تابستان 1388)

Valid screening questionnaires for mental health are useful tools for research and clinical practice. These instruments could play a major role in detecting patients with psychiatric disorders in medical centers. The main aim of this study was to examine the reliability and validity of a short form of the Mental Health Inventory (MHI-28) in an Iranian general population. 214 referrals to the counseling centers of Tehran University and Iran University of Science and Technology in two groups of patients (n= 107; 64 females, 43 males) and normals (n= 107; 64 females, 43 males) were included in this study. All participants were asked to complete the MHI-28, the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the General Health Questionnaire (GHQ). The MHI-28 was developed on the basis of psychometric properties of a longer form of the scale, MHI-38. Test-retest reliability and internal consistency of the MHI-28 were examined at satisfactory levels. Test-retest and alpha correlation coefficients were calculated for both groups. The coeffcients for psychological well-being and psychological disteress were from 0.85 to 0.91 for test-retest reliability and 0.89 to 0.94 for internal consistency, respectively. All correlations were significant at P< 0.001 level. Concurrent validity of the MHI-28 was calculated according to correlation coefficients between the scores on the MHI-28 and total score of the GHQ. The coefficients for psychological well-being and psychological distress were -0.87 and 0.88, respectively. All correlations were significant at P<0. 001. The results also supported discriminant validity of the MHI-28. It can be concluded that the MHI-28 is a valid measure and can be used for both research and clinical purposes by physicians, psychiatrists, psychologists and researchers in the field of healt care.

Specific Hymen examination has major individual, familial, social and cultural influences. The present study was carried out in order to survey the epidemiologic Situation of hymen referred to the woman’s examination part of Tehran Legal Medicine center during summer and autumn of 2007. This study was implemented for evaluation of hymen by filling information forms and personal interview and specific examination in persons referred, analytical descriptive method. Analysis was performed with SPSS version 13. 16-20 years old age group were the most involved among 494 cases. The most important causes of evaluation of hymen in proper order was: a survey on sexual relationship between individuals, a survey on rape, examination before marriage and divorce. The most common anatomical type of hymen was dilated circular hymen (34.4%) and the most common tearing of hymen happened (54.2%) in non dilated circular hymens with smooth border and the most common abrasion (80.2%) was in dilated circular hymens with smooth border. The most common regions of tearing and abrasion in hymen was related to 3-6,6-9 oclock (inferior semicircle). The most common occurrence time of defloration was more than 3 weeks (75.6%). There was a significant relation between hymen’s situation (intact or defloration) and cause of reference, age of the referred groups. With consider to importance of specific examination of hymen it is necessary for involved physicians and midwives to get more information and knowledge about hymen and differentiation the natural findings in comparison with abnormal findings. It is recommended to give information to the adolescent and young people about the sexual offences and specific examination of hymen before marriage consultations in propenced couple. It is also recommended to other university centers to do social research and etiologic investigations about the delay of persons referring for the examination of hymen and the specific examination's other aspects.

Personality assessment in patients with GID is effective in their diagnosis, prognosis and treatment. Surgery in patients with comorbid personality problems may be more worth their condition. This project appraised the personality patterns of GID patients. This was a descriptive-cross sectional study. The subjects of the project were 36 GID patients (22 female, 14 male). They were referred to the clinic of Tehran Psychiatric Institute & Mental Health Research Center for psychological assessment by Legal Medicine Organization. The subjects were selected using convenience sampling and evaluated by DSM based clinical interview and MCMI-II. Data were analyzed by descriptive statistical methods. The most frequencies of dual symbols were 75(obsessive-narcissistic,4 cases) & 17(schizoied-compulsive,2 cases)combinations. The most frequencies of personality patterns in GID patients were narcissistic(22%) and compulsive(29%). The frequency of personality patterns GID patients is high and this should be taken into account in the assessment and treatment planning of GID patients.

Emergency medical service (EMS) personnel encounter with their patients in stressful situations; therefore, they have high risk for workplace violence (WPV). Until now there is no relevant study investigated WPV toward Iranian EMS personnel. Therefore, the aim of present study is to determine the prevalence of WPV toward EMS personnel in East Azerbaijan Province (EAP) and WPV-related factors. This is a cross-sectional descriptive study. The study sample was consisted of 160 EMS personnel working in the prehospital setting in East Azarbaijan Province. These personnel selected to participation with simple random sampling. For data gathering, a combined questionnaire was used. This questionnaire assessed the characteristics of respondents, the prevalence of (138 questionaire) four form of WPV including verbal harassment, physical assaults, cultural harassment, sexual harassment and WPV-related factors. Questionnaires posted to subjects and resulted in 86. 25% (138 questionaire) response rate. The ethic committee in Tabriz University of Medical Sciences approved the study. In order to analyzing the data SPSS software (version 13) and descriptive statistic were used. Results showed that 103 of respondents (74. 63%) experienced at least one form of WPV during last year. Most frequently reported form of WPV was verbal harassment (71%), followed by physical assault (37. 7%), cultural harassment (8. 7%) and sexual harassment (0%). The most frequent response to WPV was «invite offender to calm» (52. 9%). Many of respondents believed that «any effort to follow up the violent events is ineffectual». This study highlights the high frequency of violent events toward EMS personnel in East Azarbaijan Province. In order to decrease the violent events, public education and continuing education for EMS personnel is recommended.

Bachground & Suicide is an important public health problem representing one of the first ten leading cause of death in the world. The purpose of this study is to describe demographic characteristics and methods have been used by suicide victims and to estimate suicide mortality rates that occurred in Ardabil during 1998-2007. This is a cross-sectional descriptive study. Data on deaths by suicide that occurred in Ardabil from 1997 to 2006 were obtained from the legal medicine center. Reports contained sociodemographic information, characteristics of death and the method used. We calculated mortality rate and rate ratio inorder to compare age, sex and area specific rates. Data were analyzed by SPSS 15 software The period from 1997 to 2006 a total of 185 suicide death occurred in Ardabil. The mean age was 29.6 ± 15 years old. 73.5% of victims were male and 73% of them were from urban area. The suicide mortality rate was 4.2 per 100000. For the recorded years, the rates of suicide mortality had a decreasing trend. The rate ratio of male suicide to femal was 2.6 and rural to urban was 1.3. Hanging, poisoning and burning were the most common methods used among victims respectively. The study shows that suicide rates in Ardabil are lower compared with national rates with a decreasing trend and in contrast to most studies the suicide mortality rates in rural area of Ardabil are higher than urban area.

Drowning must be recognized as a major global public health problem with significant opportunities for prevention. In Order to examine the incidence and characteristics of drowning, we analyzed data from the Legal Medicine Organization of Tehran through a cross sectional study from 2002 to 2006. During five years, a total of 292 cases (241 male & 51 femal) suffered fatal drowning in Tehran. Mean age was 21.7±15.7 years and M/F ratio was 4.7:1. The most common age groups of drowned victims were 0-4, 15-24 and 5-14 years (1.5, 1.2 and 1.1 per 100 000 population/year, respectively). Children under the age of 15 years comprised 32.2% of all drowning deaths. Canals and public natatoriums were the locations with the highest number of drowned victims (24.7% and 21.2% respectively). Overall 85.3% of all drowning deaths were occurred in summer and spring. 87% of victims were dead at the places of drowning (p≤0.01). There was correlation between decedents’ motives with their age, sex and education (p≤0.01). Also there was correlation between manner of death with age, sex, educational state and marriage status (p≤0.05). The manner of death was found as following: 88.0% accidental, 5.5% suicidal, 1.4% homicidal and 5.1% undetermined. Tehran has a mean drowning rate 0.7 per 100 000 population/year which is not a high rate in the drowning related mortality. Yet drowning is a public health problem which involves young population. Prevention of drowning in Tehran, like other parts of our country, requires programming and policies that address known risk factors

Domestic violence is one of common causes of physical injury and emotional trauma to women, in addition, It can influence on future generation health directly or indirectly and individuals with certain personal, familial and socio- economic characteristics may be at high risk. This survey designed to determine the prevalence of domestic violence against women and relationship with couple’s characteristics among women who came to family health clinics in Tehran (2007). This study is a descriptive cross sectional survey, 811 women were chosen with stratified random sampling sampling method. Data collection’s instrument was questionnaire that was filled out by interviewing. Descriptive and inferential statistics such as X2 and Fisher exact test were used for data analysis. The prevalence of domestic violence was 88.3% (95%CI, 86.1% -90.5%), physical abuse 25.4% (95%CI, 22.4%-28.3%), emotional abuse 87.3% (95%CI, 85.1%-89.5%) and sexual abuse 39.1% (95%CI, 35.8%-42.4%) was experienced by participants. significant association was seen among violence and a number of variables such as: woman’s marriage age [24 years old or less] (p<0.001), husband’s marriage age [younger than 30 years old] (p=0.023), husband’s education [high school graduate or less] (p=0.016), husband’s smoking (p=0.002), woman and husband’s psychological disorder (p=0.016), abortion history (p=0.012) and drug use by woman and husband (p=0.02) (p=0.004) respectively. With regard to high prevalence of domestic violence and it’s association with some of variables and since intervention can decrease violence and it’s adverse outcomes, women routine screening, in particular, high risk women about violence experience is recommended

Ingested corrosive substances produce different injuries, ranging from minor gasteroesophagial and airway burns to death, depending on the agent type, amount, concentration. The purpose of this study was to investigate the outcomes and different causes of mortality in patients who died following ingestion of caustic substances. As a descriptive retrospective study, between (1999- 2006) 62 patients 15 to 107 year-old who died from corrosive agent ingestion in Loghman medical center have been studied. 68% of patients were male and 32% were female. Mean age of male patients were 53 years old and in female were 37 years old. Also the mean age was lower in females. 84% of cases were suicide attempts. 49 patients had been died with acid ingestion and 13 patients died with alkaline ingestion. The most common comorbid condition with caustic ingestion was psychiatric problem. The most common symptoms in caustic ingestion were GI manifestations. The most common GI symptoms were dysphasia (85%) and drooling (73%). 27 patients had been operated. Cause of death in operated patients and non-operated was different. Overall airway burning was the most common cause of death.. Early dyspnea was found less in those who died of air-way burning. Neither the aforementioned points nor grading of endoscopy had any clear prognostic value in death In cases of caustic ingestion, early admission and airway protection with surgical intervention, if indicated, can reduce the mortality rate.