The Bulletin of Legal Medicine <p align="justify"><img src="/public/site/images/halisdokgoz/v23_i1_cvr_front.png" alt="The Bulletin of Legal Medicine" width="200" align="left" border="0" hspace="5" vspace="5"><strong><br>The Bulletin of Legal Medicine</strong> which is the official publication of the Association of Forensic Medicine Specialists in Turkey is published three times a year.</p> <p align="justify"><strong>The Bulletin of Legal Medicine</strong> contains original articles, case reports, editorials, and letters to the editor and review articles on forensic sciences. The official languages of the journal are <strong>Turkish</strong> and <strong>English</strong>.</p> <p align="justify"><strong>The Bulletin of Legal Medicine is an international peer-reviewed forensic medicine &nbsp;journal.</strong>&nbsp;</p> <p align="justify"><br>All manuscripts which will be published in the journal must be in accordance with research and publication ethics.&nbsp;All articles are subject to review by the editors and referees. If the article is accepted for publication, it may be subject to editorial revisions to aid clarity and understanding without changing the data presented.</p> <p align="justify">All authors should have contributed to the article directly either academically or scientifically. The authors must assume all the responsibility of their articles.</p> <p align="justify">"<strong>Prof. Dr. Halis Dokgöz</strong>, Mersin University Medical Faculty, Department of Forensic Medicine, Mersin, TURKEY" must be used for all kinds of correspondence.</p> <p align="justify"><strong>Manuscript submission:</strong>&nbsp;All manuscripts should be submitted by online system of journal at&nbsp;<strong></strong>&nbsp;For consideration, all articles must be submitted online. Articles submitted in other forms will not be considered. All manuscripts submitted to The Bulletin of Legal Medicine are screened by Crosscheck in terms of originality.</p> <p align="justify">E-mail: <a href=""></a></p> <div align="justify"> <ul> <li class="show"><strong>p - ISSN 1300-865X</strong></li> <li class="show"><strong>e - ISSN 2149-4533</strong></li> </ul> </div> en-US <p class="p1" align="justify">The Bulletin of Legal Medicine is an open access scientific journal. Open access means that all content is freely available without charge to the user or his/her institution on the principle that making research freely available to the public supports a greater global exchange of knowledge. The Journal and content of this website is licensed under the terms of the Creative Commons Attribution (CC BY) License. This is in accordance with the Budapest Open Access Initiative (BOAI) definition of open access.<br> The Creative Commons Attribution License (CC BY) allows users to copy, distribute and transmit an article, adapt the article and make commercial use of the article. The CC BY license permits commercial and non-commercial re-use of an open access article, as long as the author is properly attributed.<br> The Bulletin of Legal Medicine requires the author as the rights holder to sign and submit the <a title="Click to download the agreement form..." href=""><strong>journal's agreement form</strong></a> prior to acceptance. The authors retain copyright of their work and grant the Association for its publication. This ensures both that The Journal has the right to publish the article and that the author has confirmed various things including that it is their original work and that it is based on valid research.<br> Authors who publish with this journal agree to the following terms:<br> *Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.<br> *Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.<br> *Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.<br><a title="CC Attribution 4.0 International (CC BY 4.0)" href="" target="_blank"><img src="/public/site/images/drugurkocak/cc-by.png" alt="" hspace="5" vspace="5"></a></p> (Prof. Dr. Halis Dokgöz) (Uzm. Dr. Uğur Koçak) Thu, 16 Aug 2018 18:49:57 +0300 OJS 60 Editorial <p>Dear Forensic Scientists,</p> <p>We are here with the new issue of the Bulletin of Legal Medicine in 2018. Apart from being scanned by international indexes such as DOAJ (Directory of Open Access Journals); the Bulletin of Legal Medicine is currently the only forensic science journal among other fields in the country indexed within the scope of Tübitak Ulakbim TR Index once afterthe Council of Universities issued a condition according to the Application Requirements for Associate Professors of having an article published in a nationally reviewed journal indexed by ULAKBIM. As the Editorial Board of the Bulletin of Legal Medicine, we would like to express our gratitude to our valuable authors and reviewers for their contributions.</p> <p>We are happy to share with you the studies from different disciplines within the scope of the forensic science in this new issue of our journal. We are working to direct our goals to higher levels by maintaining the feature of our journal to be a scientific platform for the forensic sciences field. We would like to ask you to check carefully the journal writing rules while sending your articles to our journal.</p> <p>We wish to raise the eligibility of our journal higher by being aware of the fact that being scientific is the only way to build up a future for forensic sciences, and we wish to continue to be a common platform sharing the latest studies in Forensic Medicine and Forensic Science areas...</p> <p><strong>Prof. Dr. Halis Dokgöz</strong><br><strong>Editor</strong></p> Halis Dokgöz ##submission.copyrightStatement## Thu, 16 Aug 2018 14:21:13 +0300 Permanent Disability Rating Determination and Clinical Regulation: Evaluation of Cases of Muğla Sıtkı Koçman University, Medical Faculty, Forensic Medicine Department <p><strong>Objective: </strong>Evaluation of the permanent disability rates and clinical regulation rates of the cases ofMuğla Sıtkı Koçman University, Medical Faculty, Forensic Medicine Department. Which disabilities are appraised and the rate of appreciation are revealed. The aim is to determine the limitations of the relevant Regulation in the application and to develop suggestions.</p> <p><strong>Materials and Methods: </strong>Between June 2015-December 2016, the reports of 259 patients who applied for disability rate determination by claiming permanent disability after a traffic accident were retrospectively evaluated. Age, gender, time between accident and medical report, disability distribution, recovery periods, which disability appraisal was applied and the discretion rates were examined. In the data analysis, descriptive statistics were used in which percentage, ratio, mean values were given. A total of 73 disabled cases (23.1%) were assessed with discretion. The disability and appraisal levels of appraisal cases are discussed in detail and the limitations of the relevant regulation were tried to be revealed.</p> <p><strong>Results: </strong>182 (70.3%) males and 77 (29.7%) females out of 259 cases who reported loss of strength in the profession according to Regulation of Permanent Disabilities. Most of the cases (45.2%) were in the 20-39-age group. The time between the accident date and the last inspection date ranged from 1 to 111 months.</p> <p><strong>Discussion: </strong>It is a limitation of the relevant Regulation that rates are not determined according to different clinical situations. We think it is necessary to revise the permanent disability rating scale by taking into consideration the current treatment approaches and a comprehensive...</p> Mehmet Resul Kadı, Gülsüm Kadı, Yasemin Balcı, Ümit Ünüvar Göçeoğlu ##submission.copyrightStatement## Sun, 11 Feb 2018 00:00:00 +0300 Difficult Decision on Tyroid Surgery of Expert Witness: Complication or Malpractice <p><strong>Objective: </strong>Recurrent laryngeal nerve (RLN) paralysis and hypocalcemia following thyroid surgery have been designated as complication or malpractice. In this study, it was aimed to evaluate surgeons’ opinions towards RLN injury and hypocalcemia after bilateral subtotal thyroidectomy (BST) and total thyroidectomy (TT) in nodular goiter and thyroid carcinoma.</p> <p><strong>Materials and Methods: </strong>We prepared a questionnaire to determine approaches of surgeons in such cases. We grouped the respondents according their thyroid surgery experiments and asked them to determine whether it is malpractice or complication in cases with unilateral or bilateral RLN paralysis and hypocalcemia after “bilateral subtotal thyroidectomy” and in cases with unilateral or bilateral RLN paralysis after “total thyroidectomy”.</p> <p><strong>Results: </strong>In all groups describing bilateral RLN injury was more common. Problems which are defined as “complication” in cancer patients, were more likely defined as “malpractice” in benign cases. However, these differences were generally not statistically significant.</p> <p><strong>Conclusion: </strong>There is no consensus about malpractice and complication discrimination among physicians. Every physician should evaluate every specific case in its own nature and conditions when asked to determine whether the case should be determined as complication or malpractice.</p> Ali Rıza Tümer, Mahmut Şerif Yıldırım, Savaş Koçak ##submission.copyrightStatement## Sun, 29 Oct 2017 00:00:00 +0300 Analysis of Suicidal Deaths in Denizli A 10-Years Retrospective Autopsy Study <p><strong>Objective: </strong>In this study, it was aimed to examine the characteristics of suicides in demographic way and to investigate whether it forms difference in various aspects mainly the suicide methods chosen in the subsequent years and especially whether there is an increase in the rate of suicide with firearms.</p> <p><strong>Materials and Methods: </strong>In this retrospective study, 444 suicide autopsies which were performed Pamukkale University Faculty of Medicine, Forensic Medicine Department between 2007 and 2016 were examined in terms of the changes in parameters such as age, gender, suicide site chosen and suicide method, the distribution of the suicides due to the seasons and years.</p> <p><strong>Results: </strong>Seventy-nine-point one percent of the events are male and 20.9% of them are women. The suicides are seen mostly in 19-30 age group. Hanging was seen to be the most chosen suicide method with 52.3% and the use of firearms follows this with 28.4%. It was noted that the method of firearm suicides increased in the subsequent years and this increase rate was found to be higher in young men.</p> <p><strong>Conclusion: </strong>It is observed that a significant increase in the suicides depending on firearms. The fact that the adolescents and young adult males form the risky group indicates that it should be careful about the individuals in this group. New regulations related to the possession and conveyance both the shotgun and firearms and the effective struggle with all kinds of unlicensed gun should also be included in the suicide prevention programs and protocols.</p> Sümeyra Demir, Mustafa Eray Yazar, Ayşe Kurtuluş Dereli, Kemalettin Acar ##submission.copyrightStatement## Wed, 07 Feb 2018 00:00:00 +0300 An Evaluation of Legal Capacity in 18-65 Years Old Population <p><strong>Objective: </strong>In modern societies, civil law defines specific rights and capacities for individuals. The legal capacity of a person to use those rights encompasses the rights and functions required to be able to acquire responsibilities. When individuals do not have legal capacity for various reasons, the legal system takes the view of those with specialist medical knowledge. To the best of our knowledge, there are no studies in literature which have evaluated the legal capacity of age groups other than geriatrics.</p> <p><strong>Materials and Methods: </strong>A retrospective examination was made of the forensic reports of 18-65 years old patients who were referred to the Forensic Medicine Department for evaluation of legal capacity in the period 01/01/2015-31/12/2016.</p> <p><strong>Results: </strong>A total of 108 cases were evaluated in the age range of 18-64 years. According to the anamnesis taken, the medical records examined, the tests applied and the psychological status examination, the decisions given were that 56 (51.9%) were restricted in the context of item 405 TMK (Turkish Civil Code), 3 (2.8%) could be restricted on request in the context of item 408 TMK, 11 (10.2%) could be taken into custody in situations determined as threatening him/herself or his/her family with hardship or poverty through extravagance, poor lifestyle and poor management of assets, 4 (3.7%) were defined as eligible for the appointment of a legal advisor and 34 (31.5%) were not determined with any state requiring custody.</p> <p><strong>Conclusion: </strong>In this study, it was found that the most common disorder in people between...</p> <p>&nbsp;</p> Halil İlhan Aydoğdu, Mehmet Askay, Güven Seçkin Kırcı, Erdal Özer ##submission.copyrightStatement## Sat, 30 Sep 2017 00:00:00 +0300 Poisoning cases who admitted to the pediatrics emergency unit in the last 5 years: Evaluation of 1734 cases <p><strong>Objective: </strong>Childhood poisoning is an important public health problem that can suddenly appear and it can lead to serious morbidity and mortality. In this study, we evaluated the children admitted to our pediatric emergency department due to poisoning within the last five years.</p> <p><strong>Materials and Methods: </strong>Between January 1,2013 and December 31, 2017, the records of 1734 children who applied to our pediatric emergency department due to poisoning were examined retrospectively. The cases were evaluated in terms of age, gender, reason for poisoning, pharmacological agents and management.</p> <p><strong>Results: </strong>In our study, the ratio of poisoning cases to all pediatric emergency admissions was 0,68%. Of those, 1020 (58.8%) were female and 714 (41.2%) were male (female to male ratio: 1.4). The mean age of the children was 9.68 ± 2.85 years (5 months-18 years) and the mean age of female was higher than that of the male (12.61 ± 2.7 years and 8.14 ± 3.7 years, respectively p= 0.07). The most frequent (%59.4) causes of poisoning were drugs and the most of them was analgesics (21.5%). 571 of the cases (32.9%) had suicide attempts. The cases were treated at pediatric emergency unit (66.2%), pediatrics department (10.9%), pediatric intensive care unit (3.5%) and pediatric surgery department (18.7%).</p> <p><strong>Conclusion: </strong>Our findings showed that the most common poisoning agents in children were drugs. A considerable part of these events was suicide attempt. The measures to be taken by environment, family, drug manufacturers and physicians may prevent childhood poisoning.</p> Gülçin Bozlu, Necdet Kuyucu ##submission.copyrightStatement## Tue, 10 Apr 2018 00:00:00 +0300 Necrophagous Diptera Diversity in Samsun During Summer Season <p><strong>Objective: </strong>Necrophagousinsects are colonized cadavers immediately after death. Knowledge of the distribution, biology and behavior of necrophagous insects found at a crime scene can provide important trace about death. The most common application of insect evidence on body is the estimate the minimum time elapsed since death. The objective of this work was to to characterize the assemblage of Diptera, its richness, relative abundance in SamsunProvince, northern Turkey.</p> <p><strong>Materials and Methods: </strong>3 traps (total 6) of 150 g liver were placed at two different natural areas selected from Samsun in June, July and August of 2017 and materials were collected consecutive days. The material was identified according to Spilza’s identification key. In our study, Shannon Wiener and Simpson Diversity Indexes were used to determine the biodiversity index of species in the sample groups of both regions.</p> <p><strong>Results and Conclusion: </strong>During the study, 2877 samples of 6 species belonging to 3 different families of Diptera group were collected from two different regions C. vicina, L. sericata, S. argyostoma, S. similis, Ch. albiceps, M. domestica were collected from the baited trap. Significant differences weren’t found between all species that were seen in both regions during the summer season. L. sericata was found to be the most abundant species in two locations during summer seasons. Ch. albiceps were recorded from July 15 to August 15 at OndokuzMayıs University Campus. S. similis were present during August. C. vicina, L. sericata, S. argyostoma were captured at two field during summer.</p> Meltem Kokdener, Ünal Zeybekoğlu, Eylem Gündüz ##submission.copyrightStatement## Thu, 16 Aug 2018 15:01:14 +0300 Sudden Infant Death Syndrome and Forensic Nursing Approach <p>Sudden infant death syndrome (SIDS), is a sudden death of infants under one year of age with no health problems and unexplained autopsy. The frequency of SIDS in the world varies according to societies. SIDS may develop due to developmental, environmental and biological risk factors. Preterm birth of infant, mother’s tobacco use, bed-sharing and prone sleeping position are some of the factors that increase the SIDS risk the risk of. In the case of suspected SIDS cases that require further investigation and evaluated within the scope of the forensic case, the educated forensic nurses in the forensic medicine to be included in the research team has an important role in the evaluation and resolution of the case. The forensic nurse should explain to the parents that the questions in the interviewing are designed to gather information and determine risk factors, not accuse the parents. Parents have difficulty in accepting the death of their baby and experience stress, anger and guilt. In this context, it should be allowed to express the feelings of the family, to explain that death is not is not the result of their own fault and to reduce family’s guilt feelings.</p> İlknur Yıldız ##submission.copyrightStatement## Thu, 16 Aug 2018 15:05:45 +0300 Baby Death Due to Esophagotracheal Fistula Created by An Alkaline Battery: A Case Report <p>There is a limited number of case presentations in literature related to esophagus burns and complications as a result of swallowing an alkaline battery. The main purpose of this case presentation was to discuss the autopsy findings of late-developing complications of swallowing an alkali battery in the light of the relevant literature.</p> <p>On the chest radiography of a 9-month old baby with complaints of vomiting for three days, an opacity was observed consistent with a foreign body in the esophagus. Esophagoscopy was applied and the swallowed battery was removed. On the fifth day after the operation, no complication has been observed to oral feeding was started and on the following day the patient was discharged. Four days after discharge, the patient was again brought to hospital with complaints of blood in vomit and was again hospitalized with a diagnosis of chemical esophageal burn. The patient died on the following day....</p> Hacer Yaşar Teke, Muhammet Can, Tülay Renklidağ, Nevriye Temel, Asude Gökmen ##submission.copyrightStatement## Thu, 16 Aug 2018 15:13:34 +0300 Death Due to Tianeptine Injection Through Inguinal Incision: Two Case Reports <p>In recent years, drug use has come to the forefront as one of the most important problems of public health. Tianeptine is an antidepressant that is structurally similar to tricyclic antidepressants and is used for the treatment of depression but is also abused because its pleasing feature has been recognized by drug users. Two forensic cases were autopsied with an interval of 25 days. One case had unilateral unusual inguinal lesions. The other case bilateral unusual inguinal lesions. It was understood that these lesions were preformed, improved surgical catheter incisions in order to facilitate intravenous injections for drug abuse. This application, which was detected in the inguinal region, was found to be interesting. It is aimed to raise the awareness of this application, which is not found in the literature. As a result of the intense human transit, substance abuse habits and methods have also been transferred to citizens...</p> Hüseyin Çetin Ketenci, Emel Çakır, Nazım Ercüment Beyhun, Halil Boz, Hasan Okumuş, Gökhan Cingöz, Bülent Şam ##submission.copyrightStatement## Fri, 30 Mar 2018 00:00:00 +0300 Aluminium Phosphide Poisoning which Occuring with an Unusual Accident and Resulting in Death: Case Report <p>Aluminium phosphide is an insecticide that shows highly toxic activity when it reacts with water or moister and becomes phosphine. Because it has high diffusion capacity, it can kill all the organisms in different growth phases in the area that it is used. However, it is used frequently due to not to find rests on plants. There is not a specific antidote for aluminium phosphide and mortality from 30% to 100% in poisoning and it is related with exposure. In this study, we present 13 years girl case who was poisoned by aluminium phosphide. He was found in his apartment which is at first floor, after fumigation of food store at the basement. We aim to evaluate by autopsy findings, chemical and histopathological findings together and to discuss with literature results. In addition, we want to discuss about solution of uncontrolled dealing and using of aluminium phosphide in our country.</p> Hülya Karadeniz, Halil Boz, Hüseyin Çetin Ketenci ##submission.copyrightStatement## Fri, 16 Mar 2018 00:00:00 +0300 Violence Against Healthcare Workers: Case Series <p>The violence against health workers has been increasing worldwide and in Turkey, and is becoming a significant occupational health problem. The violence at healthcare settings is defined as “the threat behavior, verbal threat, economic abuse, physical aggression or sexual assault committed by the patient, patient’s relatives, or another individual, and causes risk for healthcare workers”. Our objective is evaluating the violence against healthcare workers who presented to outpatient clinics of Department of Forensic Medicine at … Five healthcare workers who presented due to the committed violence by the patient/patient’s relative were evaluated. The patients were aged between 26-47 years, and the mean age was 30.8 years. One patient was male. Three were physicians, one was a nurse, and the other was a caregiver. Physical violence in four patients, and psychiatric trauma in four patients were detected during the forensic examinations. Health workers have almost become the main responsible for the....</p> Cüneyt Destan Cenger, Atiye Börtlüoğlu, Birgül Tüzün, Mustafa Cihad Göktepe, Ayşen Ufuk Sezgin, Şebnem Korur Fincancı ##submission.copyrightStatement## Mon, 19 Feb 2018 00:00:00 +0300 Chylopericardium Detected by Forensic Autopsy <p>The purpose of this case report is to discuss a case of a 72-year- old woman with chylopericardium determined at forensic autopsy, together with the medicolegal dimensions and a brief review of the literature. She presented to a hospital with gastrointestinal symptoms five days after an assault resulting in injury that could have been resolved with a simple medical intervention. Following surgical treatment of incisional hernia and perforated colonic diverticulitis, the patient’s hemodynamics were stable, and monitoring and treatment were maintained. However, the patient died on the second day of hospitalization. Autopsy revealed that the pericardium was tense and that the cavity was filled with white, chylous fluid. A surgically sutured wound, areas of ecchymosis, membrane and point hemorrhage and adhesive areas were observed in the abdomen. No significant macroscopic findings of peritonitis were observed. Histopathological examination revealed edema in the lungs, expansion of the myocyte cytoplasm in the heart....</p> Ertuğrul Gök, Recep Fedakar, Okan Akan ##submission.copyrightStatement## Thu, 16 Aug 2018 15:37:47 +0300 Kongrelerden <p>International Academy of Legal Medicine’in (IALM) 24. Kongresi 5-8 Haziran 2018 tarihlerinde Japonya’nın Fukuoka Kentinde yapıldı. 300’ün üzerinde bildiri sunulan kongrede 500’den fazla katılımcı olduğu deklare edildi. Ana salonda gün boyu süren ve dünya çapında isim yapmış davetli konuşmacıların sunumları yer alırken, paralel salonlarda mono-disipliner oturumlar şeklinde tek bir tema üzerinde odaklanmış konuşmacı sunumları yer aldı (Özellikle bu oturumlar genç araştırmacılar tarafından fevkalade ilgi gördü).</p> <p>Sözel sunum sayısı çok fazla olmamakla birlikte bilimsel derinliği büyüleyici olan çok nitelikli sunumlarla karşılaştım. Bunların birçoğunu 30 yaş civarında genç araştırmacıların, hem de büyük bir ustalıkla sunuyor oluşu beni bir yandan şaşırtırken, diğer yandan geleceğe dönük umutlarımın büyümesini sağladı, sunumları dinlerken sonraki uluslararası kongrelerde ülkemizden genç adli bilimcileri de sözel sunumlar yaparken hayal ettim.....</p> Kemalettin Acar ##submission.copyrightStatement## Thu, 16 Aug 2018 15:48:39 +0300