Background: We aimed to investigate the suicide rate led to death in the elderly population of Iran between 2008 and 2014. Study design: A cross-sectional study. Methods: The present study was conducted on all suicide-related deaths in elderly people (≥65 yr) during the years 2008 to 2014 reported to the Iranian Legal Medicine Organization. For data collection, legal medicine standard form was used and the cases were classified by age, gender, suicide way and time (year). The incidence of death from suicide was calculated by age and sex. Statistical soft-ware stata12 was used to analyze data. The significance level has been considered to be 0.05. Results: Overall, 1,601 suicide-related deaths were investigated throughout the country. The mean age was 70.36 ± 0.17 years. The incidence trend (per 100,000 people) of the elderly suicides in Iran indicates that successful suicides have been on the rise, rising from 3.7 in 2008 to 4.37 per 100,000 people in 2014. Conclusions: It is necessary to identify and treat suicidal important predisposing factors of suicide such as psycho-social illnesses including depression and also implement prevention programs and policies for this fast-rising population age-group.

Objectives Unsafe abortion is one of the most important causes of death and disability among mothers in countries where abortion is illegal. These conditions have changed since then. The present study has investigated the cases who were referred to the legal medicine organization to receive abortion permission. This country level cross sectional retrospective study, investigated all the cases who were referred to the legal medicine centers of Iran for abortion permission during 2015 to 2017. The results were analyzed using SPSS software version 21. Results From 21477 applicants, 15617 (72.71%) received permission including 14367 (91.99%) for fetal abnormalities and 1250 (8.01%) for maternal diseases. The most common fetal abnormalities/disorders were nervous system malformations (26.4%), chromosomal abnormalities (18.4%) and of maternal diseases were circulatory system diseases (43.9%), neoplasms (13.4%) and genitourinary system diseases (9.9%). The most common reasons for not permission were lack of supplementary documents to prove (38.8%), not competency with the criteria (33.9%), and gestational age of more than 19 weeks (25.8%).

Background: During the first wave of COVID-19, many Iranians were poisoned by ingesting hand sanitizers and/or alcoholic beverages to avoid viral infection. To assess whether the COVID-19 pandemic resulted in an increased prevalence of accidental hand sanitizer/alcoholic beverage exposure in children and adolescents, we compared pediatric hospitalization rates during COVID-19 and the previous year. For poisoning admissions during COVID-19, we also evaluated the cause by age and clinical outcomes. Methods: This retrospective data linkage study evaluated data from the Legal Medicine Organization (reporting mortalities) and hospitalization data from nine toxicology referral centers for alcohol-poisoned patients (age 0 to 18 years) for the study period (February 23 to June 22, 2020) and the pre-COVID-19 reference period (same dates in 2019).Results: Hospitalization rates due to ethanol and methanol exposure were significantly higher in 2020 (n = 375) than 2019 (n = 202; OR [95% CI] 1.9 [1.6, 2.2],

Objectives: Unsafe abortion is one of the most important causes of death and disability among mothers in countries where abortion is illegal. These conditions have changed since then. The present study has investigated the cases who were referred to the legal medicine organization to receive abortion permission. This country level secondary patient data analysis, investigated all the cases who were referred to the legal medicine centers of Iran for abortion permission during 2015 to 2017. Results: From 21,477 applicants, 15,617 (72.71%) received permission including 14,367 (91.99%) for fetal abnormalities and 1250 (8.01%) for maternal diseases. The most common fetal abnormalities/disorders were nervous system malformations (26.4%), chromosomal abnormalities (18.4%) and of maternal diseases were circulatory system diseases (43.9%), neoplasms (13.4%) and genitourinary system diseases (9.9%). The most common reasons for not permission were lack of supplementary documents to prove (38.8%), not competency with the criteria (33.9%), and gestational age of more than 19 weeks (25.8%).

A methanol poisoning outbreak occurred in Iran during the initial months of coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the epidemiology of the outbreak in terms of hospitalizations and deaths. A cross-sectional linkage study was conducted based on the hospitalization data collected from thirteen referral toxicology centers throughout Iran as well as mortality data obtained from the Iranian Legal Medicine Organization (LMO). Patient data were extracted for all cases aged > 19 years with toxic alcohol poisoning during the study period from February until June 2020. A total of 795 patients were hospitalized due to methanol poisoning, of whom 84 died. Median [interquartile ratio; IQR] age was 32 [26, 40] years (range 19–91 years). Patients had generally ingested alcohol for recreational motives (653, 82.1%) while 3.1% (n = 25) had consumed alcohol-based hand sanitizers to prevent or cure COVID-19 infection. Age was significantly lower in survivors than in non-survivors (P < 0.001) and in patients without sequelae vs. with sequelae (P = 0.026). Twenty non-survivors presented with a Glasgow Coma Scale (GCS) score > 8, six of whom were completely alert on presentation to the emergency departments. The time from alcohol ingestion to hospital admission was not significantly different between provinces. In East Azerbaijan province, where hemodialysis was started within on average 60 min of admission, the rate of sequelae was 11.4% (compared to 19.6% average of other provinces)—equivalent to a reduction of the odds of sequelae by 2.1 times [95% CI 1.2, 3.7; p = 0.009]. Older patients were more prone to fatal outcome and sequelae, including visual disturbances. Early arrival at the hospital can facilitate timely diagnosis and treatment and may reduce long-term morbidity from methanol poisoning. Our data thus suggest the importance of raising public awareness of the risks and early symptoms of methanol intoxication.

The suicide rate among the Iranian population has increased over the past few decades. Descriptive information about this public health challenge could inform health policymakers to prioritize prevention strategies. We described the last updated data from the Iranian forensic medicine between 2016 and 2018. We obtained the data on the fatal suicide cases from the national suicide registry of the Iranian Forensic Medicine Organization (FMO), validated by death certificates and harmonized for epidemiologic studies. This study included 9,021 nationally registered suicide deaths from March 21, 2016, to March 20, 2018. A descriptive statistical approach was used to present the findings. Of 9,021 registered suicide deaths with age range between 10 to 94 years [median=31], 44.6% [n=4,015] was in the category of ≤ 29, 48.0% [n=4,328] between 30 to 59, and 7.4% (n=666) in the category of ≥ 60 years old. The percentage of fatal suicide was obviously higher in men (71.2%, n=6,424). Hanging was the most common method of suicide, both among men (57.7%, n=3706) and women (37.6%, n=976). The frequency of fatal suicide was significantly higher in married than single cases (52.6% vs. 42.9%). Overall, at the national level, the most common suicide method was hanging (51.9%), followed by self-poisoning (25.8%) and self-immolation (6.8%). We found evidence of age- and gender differences in suicide mortality across the country. Men, people in younger age groups, and married couples could be considered as the target population for preventive interventions in Iran.

COVID-19 is a contagious disease that attacks many organs but the lungs are the main organs affected. The inflammasome activation results in the exacerbation of inflammatory response in infectious disease. The aim of this study is to investigate the formation and activity of the NLRP3 inflammasome complex and the histopathological changes caused by the coronavirus in the lung of deceased persons with COVID-19. In total, 10 corpses; 5 corpses with no history of any infectious diseases and COVID-19 and 5 corpses with the cause of death of COVID-19 were included in this study. Lung tissue samples were harvested during autopsy under safe conditions. Fresh tissues in each group were used to measure the genes expression and proteins level of NLRP3, ASC, Caspase-1, IL-1β, IL-6 and TNF-α and a routine hematoxylin and eosin staining was performed for histological assessment. Data are represented as the means ± SD. Statistical significance difference was accepted at a p-value less than 5%. The NLRP3, ASC, Caspase-1, IL-1β, IL-6 and TNF-α genes expression and proteins level were elevated in the lung of the COVID-19 group in comparison with the control group. Histological findings presented the increasing number of polymorphonuclear leukocytes, macrophages and also pulmonary fibrosis in the lungs of corpses with the cause of death of COVID-19. High expression of NLRP3 inflammasome components and its relation with the pathophysiology of the coronavirus-infected lung suggested that targeting the NLRP3 inflammasome could be helpful in achieving a more effective treatment in patients with COVID-19.

Background: The suicide incident has had an increasing trend in Iran over the past years. This study mainly aimed to investigate and visualize the spatial variations of registered suicide cases at the province level. A two-step modeling approach was employed in order to estimate the relative risks (RRs) and model the age of fatal suicide across provinces in Iran. Study design: An applied ecological study. Methods: This study used the suicide death data recorded by the Iranian forensic medicine organization from March 21, 2016, to March 20, 2018. Furthermore, a Bayesian spatial approach - Besag, York, and Mollie (BYM) model- was applied to estimate the RR of suicide across provinces in Iran. Results: This risk was found to be significantly higher than the average in both men and women in the west of Iran. For women, higher population density (mean: 0.003; 95% CrI: 0.001-0.005) and lower urbanization rate of provinces (mean: -0.025; 95% CrI: -0.038, -0.012) were associated with increased RR of suicide. Based on the log-normal model fitted to the data, the overall mean age of the fatal suicide at the national level was 34 years. Conclusions: The magnitude of gender and age differences was quantified, and many spatial variations were identified in suicide mortality across provinces in Iran. Given the heterogeneity in suicide mortality risk among different subgroups of age and gender, our findings point to the urgent need in developing gender- and age-specific suicide prevention strategies. Moreover, efficient allocation of healthcare resources for suicide prevention can be attained by targeting provinces with higher risk.