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Study Design: Cadaver study. Objectives: To investigate the risk of the L5 nerve injury following sacral ala decortication performed during lumbosacral posterolateral fusion surgery. Methods: Fourteen fresh cadaver pelvises were dissected through an anterior approach and the L5 nerves on both sides were explored and macroscopically examined by direct observation. Then, the corticotomy of the sacral ala was performed at 0°, 20°, and 30° angles to the sagittal plane through the posterior approach. The site of sacral ala decortication was checked on each side and its distance to the L5 nerve root was measured. Results: The tip of the osteotome was in the danger zone (5 mm medial to 5 mm lateral to the L5 nerve) in all cases (100%) where the osteotome had 0° angle to the sagittal plane. For those with a 20° angle, the osteotome tip laid in the danger zone in 83% and intermediate zone (between 6 to 15 mm lateral to the nerve) in 17% of cases. For those with a 30° angle, the tip was in the safe zone (>15 mm lateral to the nerve) in all cases (100%). Conclusion: Osteotomy of the sacral ala with 30° would not cause any injury to the nerve. It should be considered as a possible cause of iatrogenic L5 nerve injury in patients undergoing posterolateral lumbosacral fusion.

Background Given the observed olfactory and gustatory dysfunctions in patients with COVID-19 and recent findings on taste receptors possible important activities in the immune system, we elected to estimate the correlation between COVID-19 mortality and polymorphism of a particular type of bitter taste receptor gene called TAS2R38, in a worldwide epidemiological point of view. Methods Pooled rate of each of the rs713598, rs1726866, rs10246939, and PAV/AVI polymorphisms of the TAS2R38 gene was obtained in different countries using a systematic review methodology and its relationship with the mortality of COVID-19. Data were analyzed by the comprehensive meta-analysis software and SPSS. Results There was only a significant reverse Pearson correlation in death counts and PAV/AVI ratio, p = 0.047, r = −0.503. Also, a significant reverse correlation of PAV/AVI ratio and death rate was seen, r = −0.572 p = 0.021. rs10246939 ratio had a significant positive correlation with death rate, r = 0.851 p = 0.031. Further analysis was not significant. Our results showed that the higher presence of PAV allele than AVI, and a higher rate of G allele than A in rs10246939 polymorphism in a country, could be associated with lower COVID-19 mortality. While assessing all three polymorphisms showed a huge diversity worldwide. Conclusion Due to extraoral activities of bitter taste receptor genes, especially in mucosal immunity, this gene seems to be a good candidate for future studies on COVID-19 pathophysiology. Also, the high worldwide diversity of TAS2R38 genes polymorphism and its possible assassination with mortality raises concerns about the efficiency of vaccine projects in different ethnicities.

DOI: https://doi.org/10.3126/njog.v13i3.23428 Aims: To determine the clients’ profile of referred in female victims of sexual violence. Methods: In a period of 7 years (2006-2012), 2113 cases of plaintiffs complaining about women sexual violence were investigated by a questionnaire after receiving permission from Shiraz University of Medical Sciences and Forensic Medicine Organization. Data were analyzed after entering SPSS software, version 16, using descriptive statistics and chi-square. Results: The prevalence of rape has decreased in different ages. In 1668 cases, the plaintiffs were female (78.93 %) and most of the victims (36.5%) aged between 16 and 25 years old. According to Fisher test, there was a significant relationship between the age of the victims and different years of examination (p≤0.001). The highest frequency of 30% is reported at elementary education level. The highest frequency of sexual violence against women (18.3%) was reported in 2006 followed by 18.2% in 2011. In terms of occupation, the highest frequency of victims was related to students estimated as 40.52%. Conclusions: Because of the unpleasant nature of sexual violence, there is a serious need for urgent and necessary consideration of its harmful effects and root out this social dilemma by policy makers. Sexual abuse must be prevented especially using religious achievements or by developing effective control strategies detected and by experience female health care users treated. Keywords: sexual violence, victims, female forensic medicine

Background: This study aimed to investigate the prevalence and characteristics of trauma in sexual assault victims aged 15 years and less referred to legal medicine centers of Fars Province, Iran. Methods: This descriptive cross-sectional was carried out on all female victims of sexual assault aged 15 years old and less referred to legal medicine centers of Fars, Iran, during 2006 - 2012. The study population consisted of 3140 victims that was reduced to 2113 due to incomplete records of some cases. To analyze the data, descriptive statistics and Chi-square test were used in SPSS, version 16. Results: The prevalence of teenage victims was 32.01%. The highest frequency was reported in 2006 and the next highest rate was reported in 2011. The ordinal place of the victims in family was between 4 and 6 in 79% of the cases. All the crimes happened in cities. In 6.4% of the cases, victims had experienced sexual assault. In 90.1% of the cases, criminals were aged 16 - 25 years old, and in 40.3% of the cases, they were familiar and had familial relationship with the victim. Sexual traumas in 57.1% of the cases were hymen tear and in 11.8% cases anal tear. Conclusions: Most adolescent sexual assaults remain hidden from the law because of fear of exclusion from the family and society. Therefore, community awareness regarding the prevalence of rape should be raised, and the necessary steps should be taken by the authorities and families to control this crime. Enforcing severe punishments for offenders can be considered as a preventive measure.

Background: In combined high median and ulnar nerve injury, transfer of the posterior interosseous nerve branches to the motor branch of the ulnar nerve (MUN) is previously described in order to restore intrinsic hand function. In this operation a segment of sural nerve graft is required to close the gap between the donor and recipient nerves. However the thenar muscles are not innervated by this nerve transfer. The aim of the present study was to evaluate whether the superficial radial nerve (SRN) can be used as an “in situ vascular nerve graft” to connect the donor nerves to the MUN and the motor branch of median nerve (MMN) at the same time in order to address all denervated intrinsic and thenar muscles. Methods: Twenty fresh male cadavers were dissected in order to evaluate the feasibility of this modification of technique. The size of nerve branches, the number of axons and the tension at repair site were evaluated. Results: This nerve transfer was technically feasible in all specimens. There was no significant size mismatch between the donor and recipient nerves Conclusions: The possible advantages of this modification include innervation of both median and ulnar nerve innervated intrinsic muscles, preservation of vascularity of the nerve graft which might accelerate the nerve regeneration, avoidance of leg incision and therefore the possibility of performing surgery under regional instead of general anesthesia. Briefly, this novel technique is a viable option which can be used instead of conventional nerve graft in some brachial plexus or combined high median and ulnar nerve injuries when restoration of intrinsic hand function by transfer of posterior interosseous nerve branches is attempted.

Background Medico legal forensic entomology is the science and study of cadaveric arthropods related to criminal investigations. The study of beetles is particularly important in forensic cases. This can be important in determining the time of death and also obtain qualitative information about the location of the crime. The aim of this study was to introduce the Saprinus planiusculus on a rat carrion as a beetle species of forensic importance in Khuzestan province. Methods This study was carried out using a laboratory bred rat (Wistar rat) as a model for human decomposition. The rat was killed by contusion and placed in a location adjacent to the Karun River. Observations and collections of beetles were made daily during May to July 2015. Results Decomposition time for rat carrion lasted 38 days and S. planiusculus was seen in the fresh to post decay stages of body decomposition and the largest number of this species caught in the decay stage. Conclusion The species of beetle found in this case could be used in forensic investigations, particularly during the warm season in the future.

Background Medical errors such as retained foreign bodies (RFB) during surgery are not well studied. To define risk factors associated with this type of error, we performed retrospective study. Methods We reviewed medical records for unintentional foreign object remaining in the body during surgery such as gender, age, surgery ward, and incident reports referred to several forensic medicine administrations as well as adverse effects of retained foreign bodies and methods for detection of them over a 3-years period from January 2008 through May 2011. Results Thirty eight patients were involved in the study to have retained foreign bodies (73% sponges and 27% other instruments including 7 (18.42%) cases of other bandages, 2 cases (5.26%) of scissor and 1 case (2.63%) of forceps). The general surgery ward was most commonly involved (47%) followed by the gynecology surgery ward (34%). Men (58%) were more involved with RFB than women (42%). Conclusion Considering the most frequent type of retained foreign bodies and also more frequent involved surgery wards besides detection methods for RFB, a mixed of preventing protocols such as regular counting of devices, post-operative X-ray with radiopaque markers and exact evaluation of surgery site should be employed to reduce the occurrence of retained foreign bodies and its complications.

Background: Cholestatic disorders are divided in the extra and intra-hepatic that created due to the severe liver diseases. ABCB11 encodes the bile salt export pump and this gene is mutated in several forms of intrahepatic cholestasis. So far, some molecular features of this gene was studies. Objective: Using a developed web server, we identified high number of rare codons in this gene, and four cases were related to BSEP-deficient patients which can be used for drug design. Material and Methods: By in-silico modelling of ABCB11, some of rare codons in different locations of ATP8b1 gene were identified and evaluated. Using several web servers a number of mutations that converted non-rare codons to rare codon in these patients were identified. Results: Some of these rare Codons were located at special positions by mutation of which, the new side chains do not seem suitable for protein structure and function. Furthermore, this mutation changed the protein folding rate that may have a critical role in proper folding. Thus, primary change of these codons contributes to BSEP deficiency. Conclusion: This work is a comprehensive analysis of rare codons of ABCB11 and assessment of a number of these rare codon in protein levels. Rare codons evaluation can enhance our understanding of ABCB11 structural protein of ABCB11, and help us to develop mutation-specific therapies in design of new drugs. Citation: Zarenezhad M, Dehghani S. M, Ejtehadi F, Fattahi M. R, Mortazavi M, Tabei S. M. B. Evaluation of Hidden Information in ABCB11 Gene Mutations. J Biomed Phys Eng. 2019;9(3):303-316. https://doi.org/10.31661/jbpe.v9i3Jun.680.

14.00 Background: Progressive familial intrahepatic cholestases (PFIC) are a spectrum of autosomal progressive liver diseases developing to end-stage liver disease. ATP8B1 deficiency caused by mutations in ATP8B1 gene encoding a P-type ATPase leads to PFIC1. The gene for PFIC1 has been mapped on a 19-cM region of 18q21-q22, and a gene defect in ATP8B1 can cause deregulations in bile salt transporters through decreased expression and/or activity of FXR. Point mutations are the most common, with the majority being missense or nonsense mutations. In addition, approximately 15% of disease-causing ATP8B1 mutations are annotated as splicing disrupting alteration given that they are located at exon-intron borders. Objective: Here, we describe the hidden layer of computational biology information of rare codons in ATP8B1, which can help us for drug design. Methods: Some rare codons in different locations of ATP8b1 gene were identified using several web servers and by in-silico modelling of ATP8b1 in Phyre2 and I-TASSER server, some rare codons were evaluated. Results: Some of these rare codons were located at special positions which seem to have a critical role in proper folding of ATP8b1 protein. Structural analysis showed that some of rare codons are related to mutations in ATP8B1 that are responsible for PFIC1 disease, which may have a critical role in ensuring the correct folding. Conclusion: Investigation of such hidden information can enhance our understanding of ATP8b1 folding. Moreover, studies of these rare codons help us to clarify their role in rational design of new and effective drugs. Normal 0 false false false EN-US X-NONE AR-SA

*Corresponding Author Email: saeedghmail@yahoo.com ABSTRACT Suicide is considered as the tenth cause of the death worldwide. Among different pesticides, organophosphorus pesticides (OPs) are the most widely used, but they are highly toxic, so there are increasing suicide reports about use of them. Considering the low rate of organophosphorus pesticides in the suicide reports, these two cases helped us to improve our customary methods of extraction. In this study, two cases of suicide related to a 25-yearold girl and 36-year-old man who have taken high doses of Diazinon. Both cases were dead on arrival to the hospital so no medical cases were done for them and they were brought to the Fars Legal Medicine Organization. They were suspected of using some toxins or drugs. Diazinon and Dithion were extracted using modified solid phase extraction method in the gastric content of both cases by GC-MS analysis. Modified solid phase extraction method is so helpful for toxicological analysis and detection of cause of the death in suicide, homicide or accidental died cases of organophosphorus poisoning referred to legal medicine organization.

Introduction: Smoking, alcohol, and drugs consumption has increased among the women of child-bearing age. This rise and its negative consequences on the children's health have been considered by planners and WHO health centers. This study aimed to examine the prevalence of smoking, alcohol and drugs consumption among women of childbearing age who received abortion permission with either maternal or fetal causes from forensic medicine centers. Method: This is a descriptive-analytical study which was conducted during the years 2007- 2013. The total sample size was 1,664, of which 339 and 1325 had maternal and fetal abortion causes, respectively. The items registered in the questionnaire included demographic and obstetric variables, maternal or fetal causes of abortion, the simultaneous use of hookah and cigarettes, alcohol, psychotropic substances and drugs. The data were analyzed using descriptive statistics in SPSS software, version 11.5. Results: The most frequent age for women was between 25 and 30 years (31.5%). The legal abortion rate was 8.5% among women aged under 20 years old. The prevalence of substance consumption was 40.7% among women with either maternal or fetal cause abortion. It was estimated that 78.3% belonged to cigarette and hookah, 14.62% to drug and psychotropic and finally 5.31% to alcohol beverage consumption. Conclusion: In Iran, legal abortion approval is either by maternal or fetal causes. According to this study, the coincidence of pregnancy with cigarette and hookah consumption has the most prevalence. Substance abuse prevention, treatment, and control policy are one of the essential matters related to the care both before and during pregnancy.

Objective: To introduce Necrobia rufipes as a forensic important species in the study area. Methods: This study was performed using a laboratory bred rat (Wistar rat) weighing 352 g as a model for decomposition. The rat was killed by contusion and placed in a semi-desert location. Observations and collections of beetles were made daily during May to July 2015. Results: Decomposition time for the rat lasted 38 days and Necrobia rufipes was seen in the bloat to decay stages of body decomposition. Conclusions: The species of beetle found in this case could be used in forensic investigations particularly during the warm season in future.

Background: Childhood and adolescent injuries are among the most significant health system hazards, especially in developing countries including Iran. In this report, we evaluated the main characteristics of all cases of pediatric injury-related mortality in Shiraz in a 5 - year - period. Methods: This cross - sectional study comprised all injury- related deaths in children and adolescents up to 18 years of age, from September 2011 to September 2016 in Shiraz, Iran. The required information about demographic factors including age, sex, cause of death, the manner and location of death and time period between injury and death was collected for all the cases. Results: There were 485 cases (66% male) with mean age of 8.7 ± 5.9 years. The crude mortality rate was 21.6 per 100000 population in each year. Infants had the lowest rate during the first year (6.4%) and children between 1 to 4 years had the highest rate of death (28.7%). Accident was the most common manner of death occurring in 393 (81.0%) followed by suicide in 58 (12.0%) decedents. Mortality due to electrical injury, traffic accidents, falling down, burns, drowning and blunt trauma were more common in the 1 - 4 years age group. Suffocation, poisoning, work accident and firearm were the most common cause of death in 15 - 18 year - old children. Except for aspiration, firearm and penetrating trauma, all other causes were more common in boys. The most common location of death was at the scene of injury (48 %). The majority of deaths occurred in the first 6 hours after injury (311 cases, 64.1%). Conclusions: Most cases of pediatric injury - related mortality were secondary to preventable injuries and occurred during the first 6 hours and before arriving at the hospital. Thus, injuries should be considered as one of the priorities of the health system and preventive measures such as educating the caregivers regarding these events should be emphasized.

Background: Progressive familial intrahepatic cholestasis (PFIC) is a heterogeneous group of hepatic disorders that can progress rapidly, leading to cirrhosis and death due to liver failure. Mutations and variations in three genes, including ATP8B1, ABCB11, and ABCB4, have been reported to be the main genetic cause of three subtypes of this disorder including PFIC1, PFIC2, and PFIC3, respectively. Objectives: Therefore, the aim of this study was to investigate more common mutations and variations associated with PFIC considering clinical and Para-clinical features of the disease. Methods: Thirty-five unrelated patients with PFIC from the south of Iran were selected randomly among all PFIC patients referring to Namazi hospital, affiliated to Shiraz University of Medical Sciences. Genomic DNA was extracted from the peripheral blood lymphocytes. Sequences related to these variations were then amplified by PCR in the 35 cholestasis patients and analyzed by Sanger® sequencing. Results: The results showed that there was no variation in interest exon of ABCB4. Moreover, in ATP8B1, there was no prevalent mutation and only an unknown significant variation (c.*1101 + 366G > A) was found. However, in the ABCB11 gene, different variations were found including c.1434 + 174G > A, c.1434 + 70C > T, c.1331T > C (p.Val444Ala, a common variant proposed to be associated with cholestasis), c.1309-93G > A, c.1309-165C > T. Also, 11 and 13 cases showed heterozygote and homozygote, respectively, for V444A variation of the ABCB11 gene. Conclusions: The allele frequency of V444A in this study was 52.8%. This variation has been previously implicated with higher frequencies in ICP and DIC than normal subjects, suggesting that this variation may become disease-relevant in certain conditions.

Background & Objectives : Suicide is a conscious attempt to end one’s life. Evidence suggests that nearly one million people die due to suicide worldwide each year. The aim of present study was to describe the epidemiological and demographic data of suicide victims and related factors in Fars Province. Methods: In this cross-sectional study, the demographic and epidemiological data of suicide victims in Fars Province during the 5-year period from April 2007 to March 2011 was collected by a questionnaire. Finally, the data was statistically analyzed. Results : The victims were 934 cases. The mean and standard deviation of age for the cases was 32.12 ± 81.29 years. About 72.5% & 27.3% were men & women, respectively. The most common methods of suicide were hanging (n=472, 5.50%) for men and self burning (n=103, 16%) for women. Most of the people who committed suicide (n=411, 44%) were in the third decade of life (20 to 29 years). The most common etiology (53.5%) was unknown. Conclusion: Due to the high incidence of suicide in young people and unmarried individuals, authorities need to consider these groups in social planning in Fars Province.

Objectives To determine the epidemiological characteristics of fatal traffic accidents in Fars province, Iran. Study design This cross-sectional study included 3642 traffic accident deaths in Fars province, Iran between November 2009 and November 2011. The data source was the Fars Forensic Medicine Registry, which covers the entire province. According to Iranian law, all deaths resulting from injuries or accidents must be investigated to determine the exact cause of death by autopsy. All such deaths are referred to forensic medicine centres in each city, and all data are sent to the main centre in Shiraz, the capital city of Fars province. Results Males accounted for 78.3% of the decedents (sex ratio of almost 3.6:1), and the mean ± standard deviation age of all decedents was 32.2 ± 20.3 years. Autopsy reports indicated that head trauma was the most common cause of death. Most collisions were vehicle–vehicle crashes (52.3%), with cars and motorcycles being the most prevalent modes of transport (39.6% and 24.6%, respectively). Fatal accidents were most common during the summer. Most fatal injuries (61.4%) occurred on outer-city roads and 27.4% occurred on inner-city roads. Significant associations were found between decedent's status (car driver, motorcycle driver or passenger, pedestrian or passenger) and interval between injury and death, light conditions at the scene of the accident, place of death, site of injury and cause of death. Conclusion Although the clinical management of trauma patients has improved in Iran, coordination between trauma system organizations is required to decrease the burden of injuries.

Healthy sex is the basic need for the human being and constant interruption in it due to some chronic illness might end up the martial relationship. This study was aimed to compare the relationship between couple burnout, sexual assertiveness, and sexual dysfunctional beliefs in women with hypertensive and non-hypertensive husbands. The survey was conducted in the internal clinic, Jahrom university of medical sciences. Total 200 participants have included out of which 100 women were with hypertensive husbands and the others were with non-hypertensive husbands. Data were collected through demographic characteristics’ questionnaire; couple burnout Measure, Hulbert index of sexual assertiveness and sexual dysfunctional beliefs Questionnaire. The proper statistical analysis was applied to evaluate the differences between 2 groups. Results concluded to one of the most important factors which contort and increases couple burnout are the wrong sexual beliefs regarding sexual function and sexual decisive in women regarding their husbands’ sexual dysfunction.

Background Hepatitis B virus (HBV) as an infectious disease that has nine genotypes (A - I) and a 'putative' genotype J. Objectives The aim of this study was to identify the rare codon clusters (RCC) in the HBV genome and to evaluate these RCCs in the HBV proteins structure. Methods For detection of protein family accession numbers (Pfam) in HBV proteins, the UniProt database and Pfam search tool were used. Protein family accession numbers is a comprehensive and accurate collection of protein domains and families. It contains annotation of each family in the form of textual descriptions, links to other resources and literature references. Genome projects have used Pfam extensively for large-scale functional annotation of genomic data; Pfam database is a large collection of protein families, each represented by multiple sequence alignments and hidden Markov models (HMMs). The Pfam search tools are databases that identify Pfam of proteins. These Pfam IDs were analyzed in Sherlocc program and the location of RCCs in HBV genome and proteins were detected and reported as translated EMBL nucleotide sequence data library (TrEMBL) entries. The TrEMBL is a computer-annotated supplement of SWISS-PROT that contains all the translations of European molecular biology laboratory (EMBL) nucleotide sequence entries not yet integrated in SWISS-PROT. Furthermore, the structures of TrEMBL entries proteins were studied in the PDB database and 3D structures of the HBV proteins and locations of RCCs were visualized and studied using Swiss PDB Viewer software®. Results The Pfam search tool found nine protein families in three frames. Results of Pfams studies in the Sherlocc program showed that this program has not identified RCCs in the external core antigen (PF08290) and truncated HBeAg gene (PF08290) of HBV. By contrast, the RCCs were identified in gene of hepatitis core antigen (PF00906 and the residues 224 - 234 and 251 - 255), large envelope protein S (PF00695 and the residues 53-56 and 70 - 84), X protein (PF00739 and the residues 10 - 24, 29 - 83, 95 - 99. 122 - 129, 139 - 143), DNA polymerase (viral) N-terminal domain (PF00242 and the residues 59 - 62, 214 - 217, 407 - 413) and protein P (Pf00336 and the residues 225 - 228). In HBV genome, seven RCCs were identified in the gene area of hepatitis core antigen, large envelope protein S and DNA polymerase, while protein structures of TrEMBL entries sequences found in Sherlocc program outputs were not complete. Conclusions Based on the location of detected RCCs in the structure of HBV proteins, it was found that these RCCs may have a critical role in correct folding of HBV proteins and can be considered as drug targets. The results of this study provide new and deep perspectives about structure of HBV proteins for further researches and designing new drugs for treatment of HBV.

BACKGROUND The hepatitis C virus (HCV) has six major genotypes. The purpose of this study was to phylogenetically investigate the differences between the genotypes of HCV, and to determine the types of amino acid codon usage in the structure of the virus in order to discover new methods for treatment regimes. METHODS The codon usage of the six genotypes of the HCV nucleotide sequence was investigated through the online application available on the website Gene Infinity. Also, phylogenetic analysis and the evolutionary relationship of HCV genotypes were analyzed with MEGA 7 software. RESULTS The six genotypes of HCV were divided into two groups based on their codon usage properties. In the first group, genotypes 1 and 5 (74.02%), and in the second group, genotypes 2 and 6 (72.43%) were shown to have the most similarity in terms of codon usage. Unlike the results with respect to determining the similarity of codon usage, the phylogenetic analysis showed the closest resemblance and correlation between genotypes 1 and 4. The results also showed that HCV has a GC (guanine-cytosine) abundant genome structure and prefers codons with GC for translation. CONCLUSIONS Genotypes 1 and 4 demonstrated remarkable similarity in terms of genome sequences and proteins, but surprisingly, in terms of the preferred codons for gene expression, they showed the greatest difference. More studies are therefore needed to confirm the results and select the best approach for treatment of these genotypes based on their codon usage properties.

To investigate the pattern of mortality caused by road traffic accidents and its associated factors.The retrospective cross-sectional study was conducted in the Fars province of Iran and comprised data of all people having died in road traffic accidents from March 21, 2011, to March 19, 2012. Using census method, all files related to deaths in road accidents were reviewed at the Legal Medicine Centre. Data was analysed using SPSS20.Of the 1668 people dead, 1291(77.4%) were male and 377(22.6 %) were female. The highest rate related to the age group 21-30 with 454(27%) killed. As for education level, the highest rate of mortality was 410(24.5%) for illiterate people and the least was 9(0.5%) for those having Masters degree or higher. In terms of time of year, the highest rate of mortality was 167(10%) between August 23and September 22, while the least was 82(5%) between July 23and August22. Head trauma was reported as the most important cause of death in 1191(71.4%) cases.Despite some minor differences, all provinces in Iran have the same patterns of death related to road traffic accidents.

Non-suicidal self-harm includes cutting, scratching, burning and minor overdosing. There have been few studies that have examined the rate and pattern of self-harm among different individuals of the society. We performed a population-based study to determine different aspects of non-suicidal self-harm in cases referred to legal medicine organization of Fars Province and south Iran. In a population-based longitudinal survey, we applied data from cases referred to legal medicine organization of Fars province. The survey included questions about the history, method, frequency, age of onset and help-seeking for non-suicidal self-harm. The data about non-suicidal self-harm were collected since 2007 to 2011 and analyzed using students' T-test for continuous data and χ2 for binary or categorical data using SPSS ver. 21.0. Totally 2166 individuals were diagnosed who had ever harmed themselves. Self-injuries such as cutting, scratching and self-hitting were the most common forms of non-suicidal self-harm (83.2%). The mean age of onset was 25.7 ± 2.6 years. Self-injury was more frequent in males and individuals with lower education levels mostly unemployed. The most frequent injury site was posterior side of the body for example shoulders (157; 9.8%) and the most type of the injury was bruise in 398(55.26%) cases. Hard objects (1197; 55.26%) were the most used devices for self-injury followed by cutting and sharp devices. Among those who reported non-suicidal self-harm, 56% had sought help while self-injury. We found a high prevalence of non-suicidal self-harm in different individuals of the society in Fars province since 2007 to 2011. Many mental-health symptoms as well as legal and financial gains should be evaluated for any association with this behavior.

Background Gender identity disorder (GID) is considered as a very complicated clinical case and there are usually various variables in the inside-family-communication atmosphere. Objectives The aim of this study was to determine attachment styles in people with GID and compare them with normal people in Fars province, Iran. Materials and Methods This case-control study with accessible sampling was conducted in Fars province, Iran, in 2014 using 60 visitors to the Fars province forensics head office who had been diagnosed as having GID by the commission of psychology (the case group) and 204 individuals in dispose, whom psychologists diagnosed as having no psychological disorder and in synchronization with the sample group (controls). The demographic questionnaire and Collins and Read attachment style questionnaires were used in both groups. Data were collected and then analyzed using the SPSS software version 18, Kormogrov Smirnov’s normality test and Pearson’s correlation coefficient. A significance level of P < 0.05 was considered significant. Results Findings showed that the highest frequency (71%) in terms of secure attachment and the lowest frequency (0%) in terms of avoidant attachment were observed in patients with GID who had been operated and the highest frequency of avoidant attachment (62.1%) and the lowest frequency of secure attachment (0%) were observed in patients with GID who had not been operated. Conclusions According to the findings of this study, GID patients who have been operated are more secure in attachment styles than those who have not been operated, and there is a significant correlation between age, education and gender with attachment style among these individuals.

Background : Hymen examination has divers individual, family, social and legal effects. Thus epidemiology of hymen for physicians and obstetricians is important. Materials and Methods: In an analytical cross-sectional study of women referred to women's forensic medical examination part of Shiraz from 2008 to 2009 were examined. Results: A total of 823 samples with a mean age of 21.78±2.98 years and 16-20 years old were the most frequent age group among the cases. 53.58% of hymens were dilated circular and 46.17% of them were non dilated circular and 2 had no hole.From view point of anatomical type, 86.99% were in dilated circular hymens with smooth edges and the most frequent time of defloration of 80.33% of the cases was 3 weeks before examination. A significant relationship was observed between age and health status of the hymen. Also the relationship between age and time of defloration was significant. Conclusion: There is a variety in anatomical shape of hymen ,and distinguishing normal findings from abnormal findings in the examination of hymen is a matter of importance.

Background: To compare the results of final renal function by two methods of treatment in patients diagnosed as posterior urethral valve (PUV) (valve ablation vs. vesicostomy). Materials and Methods: Fifty-four boys diagnosed with PUV participated in this study. They were divided into top two groups. Thirty-one of the total were treated with primary valve fulguration (Group 1) and 23 were treated with vesicostomy (Group 2). One-year-creatinine level and glomerular filtration rate (GFR) were measured. Also, they were taken ultrasonography detecting hydronephrosis. Data analysed in IBM SPSS21 with t-test and Chi-square test. Presented with 95% of confidence intervals. Results: Fifty-four boys diagnosed with PUV participated in this study. The mean age of patients in Group 1 was 3.8 ± 1.48 days and Group 2 was 4.7 ± 1.85 days. One-year Cr level was 1.57 ± 1.45 in Group 1 and 1.57 ± 1.45 in Group 2 which was not statistically significant (P < 0.8). Also 1-year GFR level was 31.1 ± 4.4 in Group 1 and 33 ± 4.7% in Group 2 (P < 0.10/23) in Group 2 (43.47%) had severe hydronephrosis and 14/31 (45.16%) in Group 1 had severe hydronephrosis. Graded ultrasound results were not significantly different (P = 0.24). Conclusion: The results showed no significant difference. Vesicostomy might be a more favourable method due to less complication and follow-up in early neonatal life. Hence, the condition of the patients and decision of the surgeon are effective parameters in choosing an optimal method in patients diagnosed with PUV.