Survey of aneurismal subarachnoid hemorrhage in 26 cadavers referred to legal medicine center of Tehran [2005-2006]

Nontraumatic subarachnoid hemorrhage is a neurologic emergency, which has a high rate of death and complications and its risk factors are preventable to some extent. Risk factors, epidemiology manifestations of disease and distinction between NSH and traumatic subarachniod hemorrhage. This study is a descriptive research based on 26 persons died due to aneurismal subarachniod hemorrhage in 2005-2006 send to Legal Medicine Organization of Tehran. Variables such as age, sex, duration from initiation of disease until death, manifestation of disease, type location, amount and source of bleeding and also risk factors which are all investigated with autopsy and interview will relatives and studying clinical reports. Among 26 persons died due to aneurismal subarachnoid hemorrhage, 69% were male, 31% were female, and mean age was at 47years. The most common symptoms on the onset of disease were sudden onset of severe headache and loss of consciousness. 73% of them died within 24 hours after the event. 62% had a history of hypertention, 42% did cigarette smoking, 35% were exposed to sever excitations, 19% had a history of headache. In all cases, there was subarachnoid hemorrhage, 31% with intraventricular bleeding, 8% with intra cerebral hemorrhage. Although in 25% of cases determining the position of rupture was impossible as a result of bleeding severity, clot around vessels and brain death a few day before autopsy, in 40% of cases bleeding had happened in anterior part and in 35% of cases in posterior part of Williss cycle. It seems that serious intervention for reducing risk factors such as cigarette smoking, hypertention and sever excitation can reduce risk of rupture of an intracranial aneurysm. Rate of death within 24 hours of the onset of disease was extremely more than other countries. More researches should be done about transporting duration of patients to medical centers, determining the amount of primary bleeding, rebleeding, vasospasm and efficiency of treatment

Report about replantation of three amputated fingers caused by an occupational accident and study of determining the compensation from legal physician's point of view

Digit amputation is a physical and psychological trauma that can influence the daily living of a person. In the past 200 years, successful replantation of amputated digits has gradually moved from fantasy to reality. Now a days modern replantation is available in most large hospitals. In recent 40 years ago thousands of severed part of body of subjects have been reattached to themselves, preserving the quality of life for thousands of patients through improved function and appearance that the void remaining after amputation cannot provide. The legal aspects of determining the compensation for such patients is one of the interesting subjects of legal medicine. The patient is a 28 y/o man who was hurt while working in a factory near Tehran, on 16 July 2005, his left thumb, index and middle fingers zone 2 were totally amputated avulsion with local crush. The patient successfully treated by an experienced surgeon, his fingers was replanted and almost 50% of his ability was recovered. One year after accident, he was referred to Legal Medicine Organization for determining the compensation [Dieh and Arsh]. Considering the case, the Islamic Punishment Law has no predict for treatment charges and it seems which insurance companies must compensate the treatment costs of such patients

Epidemiologic study of deaths due to burns in Tehran [march 2005 to march 2006]

Burn injuries still produce significant mortality in Iran. In order to assist with the prevention of burn injuries, the epidemiology of fatal burns in Tehran was investigated. In a retrospective study, which was based on post mortem examination, with their clinical and juridical information, this study was carried out to analyze the epidemiology, mortality, and current etiological factors of 388 deaths due to burn, which were referred to the legal medicine center of Tehran between 20/3/2005 and 20/3/2006. Results were compared with similar information in five past years. The overall incidence rate of death was 3.3 per 100000 person-years. The mean age was 27.8 years [age range, 4 months to 77 years], and 24% of them were under 19-years-old. [61%] of all the victims were male and [390%] were female, [M/F=1.5]. The highest incidence of burns was in the 21 - 30 age group [30.4%]. Total burn surface area [TBSA] in the most of cases [86.6%] was more than 40%, and had a significant negative correlation with hospitalization length. Flame was the most common etiology of burns [90.7%]. Accidents were the major manner of death [74%]. Suicide [16.2%], murder [2.6%], and undetermined [7.2%] were other manners of death. Rate of suicide for all the patients > or = 11 years were the cause of 22.7% [34/150] of the burns involving women and of 13% [27/208] of the burns involving men. Houses were the most common sites of burning [71.1%] and major cause of them were kerosene and gas accidents. The mean length of hospitalization befor deeth was 10 days. Factors associated with an increase in mortality were suicidal burns, burn size, age, inhalation lesions and flame burns. Most of the burn injuries were caused by domestic accidents and were, therefore, preventable. Parents can play an important role in prevention of burns in children who are most susceptible to burns. People with causes identified could be educated in burn prevention, through news and the media. Decrease of mortality rate in five past years can be as sign of progress in prevention and treatment of burn injuries