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Background and Aim: To better guide the health policies, it is essential to clarify the socio‐demographic and clinical risk factors affecting the mortality rate of patients with coronavirus disease 2019 (COVID‐19). Objective: The purpose of this project is to separate hospital mortality statistics into different groups, which will definitely help in planning to reduce the mortality rate. As well, we aimed to compare factors involved in COVID‐19 death between the period before and after its outbreak. Methods: This cross‐sectional study was performed based on all death certificates of archived records in Rasool Akram Hospital during the years 2018 and the first half of 2019. A checklist was completed based on the variables, including death cases by time, gender, age, duration of hospitalization, department of place and time of death, cause of death, cases referred to forensic medicine, information of the patient, including educational and occupational level and birth certificate issuing city, neonatal death, and IUFD, classification of diseases according to the provided version of ICD 10 (international classification of diseases 10th edition). Results: A number of 2632 deceased patients were included in this study, 1511 (57.4%) patients who died before the start of the COVID‐19 outbreak, and 1121 (42.6%) patients died in the hospital after the start of this pandemic. There were statistically significant differences in gender (higher prevalence of males), increased average age, lower occupational status, decreased number of infants, increased cause of death due to COVID‐19 and increased hospitalization in Royal ICU in dead patients (p < 0.05). Conclusion: The findings show that the elderly cases are more at risk of COVID‐19 mortality than other age groups, which needs more attention to this group of society and clarifies other epidemiological factors, as well as clinicopathological and public healthcare practices. [ABSTRACT FROM AUTHOR]

Objectives: This study was aimed to evaluate the various demographic and clinical characteristics in hospitalized children with COVID-19 as well as their comorbidities. Methods: This cross-sectional study evaluated a total of 809 hospitalized COVID-19 patients under 18 years of age in the referral university based Ali-Asghar Hospital in 2020. Demographic and clinical characteristics of patients were extracted from the archived records and data analysis was performed using SPSS software version 26. Results: The mean age of patients was 4.1 years and the higher percentage of patients (57%) were male. The most common symptoms of COVID-19 in children were fever, cough, and diarrhea. As well, the most common symptoms in 22.1% of patients admitted to the intensive care unit (ICU) were gastrointestinal (GI) symptoms (79%), fever (62.6%), and respiratory distress (53.6%), respectively. The majority of patients were in the age group less than one year (52%) and mortality rate was 6.3% in total and 10% in children with underlying disease. Besides, the mortality rate of intubated cases was 13 times higher. Conclusion: The findings of present study showed that COVID-19 in children was associated with various clinicopathological manifestations. Underlying disease including respiratory distress, cancer, and kidney disease as well as GI symptoms might be guided predicting the hospitalized cases in ICU. Newborns less than one year of age are exposed to severe COVID-19 infection which is associated with higher mortality rate and it should be given special attention in the early diagnosis and management of the COVID-19 disease. [ABSTRACT FROM AUTHOR]

Anatomical and anthropological study of hyoid bones could be used in the sex prediction from skeletal remains. The aim of this study is to examine the morphometrical parameters of the hyoid bone individuals of the Iranian population. The study was carried out on 248 hyoid bones taken from cadavers Referred to Kahrizak Legal Medicine Center in 2020. Four anthropometric indices of hyoid bone were studied and have been associated with the sex and height of the individuals. The study included 179 (72.2%) males and 69 (27.8%) female cases. No significant difference was observed between the two gender groups in terms of age (P=0.678). The indexes of hyoid bones measured were compared between male and female genders, and the results show that the transverse distance between the tubercle of the greater horn, the Anterior/posterior dimension of the body, the distance between the upper and lower margin of the body in the middle (height) and the maximum depth of concavity on the posterior surface of the body, was associated with the sex determination (P<0.001). The four hyoid bone indexes measured in this study were higher in males compared with females, which indicates that hyoid bone morphometry can be used for sex determination in the Iranian population. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, road accidents have been one of the leading causes of death in Iran, with the majority of victims being motorcyclists. Accurate knowledge of the pattern of injuries to those injured is a strategy to reduce the consequences of these fatal accidents. The aim of this study was to investigate the pattern of injuries to motorcyclists. Methods: The present study was a cross-sectional study that was performed in Rasoul Akram (PBUH) Educational and Medical Center in Tehran. The information was extracted from 500 hospital records of the patients admitted due to motorcycle accidents from September 2015 to September 2016, which was recorded in the data collection checklist. Results: About 67.9% of the injured did not have head injuries and 32.0% of the sample group suffered head injuries. Out of 160 people from the head injury group, 7.2% have Abbreviated Injury Scale (AIS) index = 1 and 93.8% have AIS ≥ 2. A total of 82% of the injured had no neck injuries and 18.0% of the sample group had neck injuries. Of these, 72.2% had AIS = 1 and 17.8% had AIS ≥ 2. About 65.0% of the injured did not have facial injuries and 35.0% of the sample group suffered facial injuries. Conclusion: An accurate knowledge of the pattern of injuries to this group of injured, providing pre-hospital services, timely diagnosis and treatment and the use of corrective and effective factors, has an effective role in reducing the incidence and consequences of this deadly accident. [ABSTRACT FROM AUTHOR]

Introduction: Job satisfaction is a main factor to increase efficiency, productivity, and individual satisfaction in the organization. The purpose of this study is to determine the forensic expertise amount of job satisfaction and to compare them with other specialists in different. Materials and Methods: In this cross-sectional study, 150 individuals were included in three groups of specialists including forensic, internal medicine, and pediatric. Data were collected by Brayfield and Rothe Job Satisfaction Questionnaire. SPSS software version 23 was used for statistical analysis. Results: High levels of job satisfaction among forensic professionals were higher than low job satisfaction, but the same was true for the other two groups. In this study, job satisfaction status in the three groups of specialists was not significantly correlated with their type of expertise (P = 0.19). There was no significant relationship between job satisfaction and gender (P = 0.19). In addition, the mean age of the specialists with low and high job satisfaction was not significantly different (P = 0.99). In this study, although the mean of work experience in professionals with high job satisfaction was higher than those with low job satisfaction, this difference was not significant (P = 0.23). Conclusion: The results of this study showed that job satisfaction was high among forensic medical professionals and was not significantly different from other specialist groups including pediatric and internal medicine. In addition, job satisfaction was not significantly different in terms of age, gender, and work experience. [ABSTRACT FROM AUTHOR]

Background: Studies have shown that Iran has a high rate of opiate abuse and the most prevalently used is opium. This study was aimed to evaluate risk factors in patients with acute opium intoxication who referred to Loghman Hakim Hospital, Tehran, Iran, in 2011. Methods: A total number of 383 patients with acute opium overdose, who were referred to the Emergency Department of Loghman Hakim Hospital in Tehran during 2011, were enrolled into this descriptive, crosssectional study. Clinical data including level of consciousness, vital signs, mode of consumption, medical management, and laboratory results were recorded. Independent t-test was used to analyze the results. Findings: Level of consciousness at admission was lower in patients who expired compared to survivors (P = 0.020). Respiratory depression and tachycardia were both more common among patients who expired compared to survivors (P = 0.001). Increase in urea, creatinine, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), serum glutamic oxaloacetic transaminase (SGOT), and serum glutamic pyruvic transaminase (SGPT) was more common among patients who died compared to survivors and the relationships between death due to opium poisoning and increase in these factors were all statistically significant (P ≤ 0.001). Conclusion: The findings of this study clarify the importance of clinical and laboratory findings of patients with opium poisoning in predicting their outcome, although further studies in this context are appreciated. [ABSTRACT FROM AUTHOR]

In some relationships, pregnancy is a risk factor for intimate partner violence (IPV). We present a case of a 34-year-old, 28-week-pregnant woman who was admitted to the emergency department with multiple traumas due to IPV. Her husband had hit her with a power cable after abusing methamphetamine. There were multiple ecchymoses and lacerations on her body. On questioning, the patient revealed a low socioeconomic status. The couple had been married for five years, and the abuse began 11 months earlier, after the husband became addicted to methamphetamines. In this instance of abuse, the husband was suspicious of the wife's pregnancy and believed that the child had been fathered by another man. Her husband's methamphetamine abuse had resulted in previous incidences of non-physical IPV, but, in the present incident, the combination of abuse coupled with partner jealousy resulted in physical abuse. During admission, there were no significant changes to the patient's health, and the fetus was deemed to be healthy and unharmed. After discharge, the patient decided to divorce her abusive husband. Screening and counseling for interpersonal and domestic violence is especially recommended during pregnancy to protect the mother and her fetus. In Iranian civil law, IPV is regarded as "osr-o-haraj" or severe and intolerable hardship, and women may cite it as grounds for divorce in cases such as spousal drug addiction and certain forms of spousal abuse. When intimate partner assault is repeated and petition for khula is presented to the courts, the court can order the man to divorce his wife and, if he refuses, the court judge can grant the khula without the husband's consent. [ABSTRACT FROM AUTHOR]

Intellectual disability is a term used when a person has certain limitations in mental functioning and skills. Autism is a group of developmental brain disorders, collectively called autism spectrum disorder (ASD). Teenagers with learning and physical disabilities are more likely to have menstrual problems compared to the general populations. The parents of a 12-year-old girl with autism spectrum disorder and intellectual disability referred to the coroner due to her numerous problems of puberty (menstruation) including: poor hygiene and polluting herself and the environment, not allowing to put or change the pads and changes in mood and physical health prior period, requested for the surgery (hysterectomy). In legal medicine organization after reviewing the medical records, physical exams and medical consultations with a gynecologist and psychiatric, surgery was not accepted. Hysterectomy (surgery) due to the age of the child, either physically or morally is not recommended. The use of hormone replacement therapy has side effects such as osteoporosis. In these cases, it seems noninvasive methods (behavioral therapy and learning care skills) under the welfare experts is also more effective and morally. [ABSTRACT FROM AUTHOR]

Motor vehicle and falling down are responsible for the most number of traumatic injuries. This study aimed to compare the characteristics of traumatic brain injury among accident and falling down cases. In this analytical cross- sectional study, data were collected from the records of cadavers who died due to accident or falling down and referred to Kahrizak dissection hall, Tehran forensic medicine organization during 2013. A total of 237 subjects (183 (77.2%) accident and 54 (22.8%) falling down) with a mean age of 35.62 (SD=15.75) were evaluated. A number of 213 (89.9%) were male. From accident group, scalp injury was seen in 146 (79.8%), scalp abrasion in 122 (66.7%), scalp laceration in 104 (56.8%), sub skull bruising in 176 (96.3%), skull fracture in 119 (65%), hemorrhage in 166 (90.7%), Subdural hemorrhage (SDH) in 155 (84.7%), Subarachnoid hemorrhage (SAH) in 161 (88%), Epidural hemorrhage (EDH) in 41 (22.4%), contusion in 140 (76.5%), and skull base fracture in 140 (76.5%) of cases. In falling down group scalp injury was seen in 42 (77.8%) cadavers, scalp abrasion in 38 (70.4%), scalp laceration in 30 (55.6%), sub skull bruising in 49 (90.7%), skull fracture in 39 (72.2%), Hemorrhage in 49 (90.7%), SDH in 43 (79.6%), SAH in 47 (87%), EDH in 10 (18.5%), contusion in 33 (61.1%), and skull base fracture in 39 (72.2%) of cases. There was no significant difference between these two groups (P Value> 0.05). Accident and falling down had no difference in terms of any injury or hemorrhage. [ABSTRACT FROM AUTHOR]

Background: Damages caused by scald burns are common and can cause severe complications and death. The purpose of this study was to define risk groups and then methods of prevention and treatment is designed to fit. Methods: Data for this retrospective study of hospitalized patients in Shahid Motahari Hospital in Tehran from 2007-2011 were compiled. Data including age, sex, cause of burn, and degree of burn and ultimate fate of the victims were collected from scald burns. Burns caused by boiling water and hot food (Scald), in two age groups: 12 and under 12 years (children) and more than 12 years (adults) were compared in terms of statistics. Results: A total of 1150 patients consisting of males (57.9%) and females (42.1%) were studied. The most common age was 1 year old and 50% of patients were under 3 years of age. 87.9% burned with boiling water and 12.1% had experienced burns with hot food. Incentive to burn was 0.3% cross burning and 99.7% incident. A maximum number of burns in children 12 years and younger males (42.1%) and a minimum number in men over 12 years (15.7%) were observed. Mean percentage of burns was 11% in over 12 years group and 30.9% in 12 and under 12 years group. The average hospital stay was 11.4 days and the mortality rate was 4.8%. The final status of the patients was as fallows: full recovery 904 cases (78.6%), partial recovery 134 (11.7%), clearance with personal consent 41 (3.6%), death 55 (4.8%) and 16 cases (3.1%) were among other reasons. Conclusion: In general it can be said, scald burns incidence in individuals aged 12 and younger were more than the older ones and the mean of burns was lower in individuals with over 12 years old. There was a sexual preference for males under 12 years. Mortality rate in the two groups has not any statistically significant difference. There was no statistically significant association between sex and mortality rate. Some of our findings are depending on cultural, social and economic conditions, so generalized this findings to other geographical areas should be done with caution. [ABSTRACT FROM AUTHOR]

Fatty liver disease (FLD) is the most prevalent form of liver disease worldwide. Overnutrition can induce nonalcoholic fatty liver disease (NAFLD), a spectrum of conditions ranging from simple steatosis [or nonalcoholic fatty liver (NAFL)] to nonalcoholic steatohepatitis and cirrhosis. Some of the epidemiological and pathological studies have also suggested an association between the presence of fatty liver and sudden death. A 37-year-old man was found dead when he was asleep in the bed at home. According to his family, he was single and a costermonger. He was not an athlete, and there was no history of any physical and mental disorder. He was not addicted and did not use any drugs or alcohol. The positive points, in this case, were: a large heart with mild coronary stenosis and steatohepatitis in autopsy and sudden death. Since steatohepatitis did not have any complication such as fat embolism, it can be concluded that the combination of steatohepatitis and cardiovascular disorder led to sudden unexpected death. Heart more than 450 gr is susceptible to arrhythmia, and fatty liver disease can cause cardiovascular changes. [ABSTRACT FROM AUTHOR]

Introduction: Identifying the people who try to hide illegal substances in the body for smuggling is of considerable importance in forensic medicine and poisoning. This study aimed to develop a new diagnostic method using artificial intelligence to detect body packs in real-time Abdominal computed tomography (CT) scans., Methods: In this cross-sectional study, abdominal CT scan images were employed to create a machine learning-based model for detecting body packs. A single-step object detection called RetinaNet using a modified neck (Proposed Model) was performed to achieve the best results. Also, an angled Bbox (oriented bounding box) in the training dataset played an important role in improving the results., Results: A total of 888 abdominal CT scan images were studied. Our proposed Body Packs Detection (BPD) model achieved a mean average precision (mAP) value of 86.6% when the intersection over union (IoU) was 0.5, and a mAP value of 45.6% at different IoU thresholds (from 0.5 to 0.95 in steps of 0.05). It also obtained a Recall value of 58.5%, which was the best result among the standard object detection methods such as the standard RetinaNet., Conclusion: This study employed a deep learning network to identify body packs in abdominal CT scans, highlighting the importance of incorporating object shape and variability when leveraging artificial intelligence in healthcare to aid medical practitioners. Nonetheless, the development of a tailored dataset for object detection, like body packs, requires careful curation by subject matter specialists to ensure successful training., Competing Interests: The authors declare no competing interests.

Background: A Medical Certificate of Cause of Death (MCCD) is a legal and enforceable document issued by the attending physician. However, according to the instructions, in many cases such as sudden, unexplained, and extraordinary deaths, along with some uncommon causes, such as cases suspicious of murder, the deceased patient must be referred to the Iranian Legal Medicine Organization (ILMO). Moreover, the unnecessary referral of corpses to ILMO can increase the workload of the staff, finally confronting the family of the deceased with high emotional and financial costs., Methods: In this cross-sectional study, the medical records of all deceased patients referred from Hazrat Rasool Hospital to the ILMO (565 cases) in a three-year period from April 2016 to March 2019 were investigated and analyzed using SPSS22 software with chi-squared and T-test., Results: Among all the patients who passed away during this time (4,239 patients), 565 were referred to ILMO, accounting for 13.3% of deaths. The most common causes of referral were car and motorcycle accidents, with a total prevalence of 27.1%, dead-on-arrival (DOA) prevalence of 21.3%, and death with an unknown cause prevalence of 15.3%. Significant correlation was also detected between causes of referral with gender, time of death, and age. For example, Car accidents and lawsuits against medical staff were more common in men and women, respectively., Conclusion: Car and motorcycle accidents, DOA, and unknown causes were the most prevalent causes of referral in this study. In general, few studies have been conducted regarding the causes of referral of the deceased to the Legal Medicine Organization. In this study, we collected relevant variables to investigate this issue thoroughly., Competing Interests: The authors declare that they have no competing interests., (© 2024 Iran University of Medical Sciences.)