Retrospective Evaluation of Forensic Medicolegal Childhood Deaths Among Children Aged 0-6 Years (2019-02-25)
Objective:The aim of this study was to analyze the epidemiological pattern and characteristics of forensic cases resulting in death among children aged 0-6 years and to discuss the solution offers in order to prevent such events that may result in death in 0-6 years of childhood.
Materials and Methods:73 cases of medicolegal childhood death among children aged 0-6 years whose post-mortem examinations, dead body examinations and/or autopsies were performed at the morgue of the Cumhuriyet University Hospital in a 8-year period between January 1, 2008 and December 31, 2016 were included in the study group and retrospectively analyzed. In all statistics, the SPSS v.20 statistical software was used, and a p value of <0.05 was accepted as statistically significant.
Results:The study included 73 forensic cases resulted in death whose dead body examinations and autopsies were performed. Of the cases, 52.1% (n:38) were female and 47.9% (n:35) were male. When the age groups were compared, it was found that the highest mortality rate was in the 0-1 age group with 65.8%. When the manner of death was compared by age groups after autopsy and toxicology/histopathological examinations performed, it was found that the majority of deaths among children aged 0-1 years was due to sudden infant death syndrome with 35.4% (n:17), drowning in water was the most common cause of death between 2-3 years of age with 35% (n:7), followed by accidental deaths due to fall with 30% (n:6), and the deaths among children aged 4-6 years was due to traffic accident...
Effect of Ethanol in Oral Antiseptic Sprays on Breath Alcohol Measurement (2019-08-26)
Objective:Breath alcohol concentration (BrAC), in routine traffic control, might be higher due to reasons which effect mouth alcohol concentration. According to Highways Traffic Regulation, there is no possibility to remeasure with technical device, in case of any objection.In this study, we aimed to answer firstly how oral antiseptic sprays effect BrAC and then what correlation between BrACs and time is.
Material and Method:This study included 30 healthy volunteers’ results. In this study, three oral antiseptic sprays (OAS) which contain ethanol and electrochemical breathalyzer are used. BrAC(Tbefore)before spray use, was taken as the reference value for each subject.Subjects sprayed 3 puffs of OAS into their mouths.Following 3 puffs, the subjects kept their mouths closed and immediately underwent a breathalyzer examination to evaluate BrAC(T0).Two more examinations were conducted 3 minutes later(T3) and 5 minutes later(T5) without any use of the sprays.
Results:The highest BrAC value(4.25permille) was attained at T0 in 12 subjects; all BrAC values(before spray use) were negligible and under 0.08 permille.The BrAC median values decreased under legal limit zero as time passed by from T0 to T3 and T5.T3 values were lower than the T0 values for all OASs and all T5 values were lower than T0 and T3 values.
Conclusıons:This research study shows that OASs may alter the results of a single breathalyzer test. Based on our results, BrAC values are effected by ethanol in the oral cavity due to prior use of OAS and this explains why BrAC decrease rate is really remarkable.
KeyWords:Breath alcohol level,Oral antiseptic sprays,Breathalyzer.
Assessment of Suicide Attempt in The Forensic Medicine Outpatient Clinic in Muğla (2019-12-12)
Introduction-Objective: Suicide attempts are causes of mortality and morbidity. Suicide attemp patients’ reports were evaluated in Forensic Medicine outpatient clinic. It was aimed to present of sociodemographic characteristics, methods, regional characteristics, develop to recommendations for proventive measures.
Materials-Methods; Between 01.06.2014-31.12.2018 were evaluated retrospectively and statisticaly.
Results: 405(5.3%) of the cases attempted suicide, 263(64.9%) were women, 142(35.1%) were men, 11.8% of them (n: 48) was under 18, 84.9% (n: 344) was under 40. The majority of the cases were in the 20-29 age range, women were more present in under 19 years, and men were more present in the 30-39 age group(p <0.001). No significant difference was found between months and seasons. The most common method was drugs (86.2%, n: 349), followed by knife wound (8.9%,n:36) hanging (2.2%,n:9). In terms of severity of injury; It was found that 3.2% of the cases had a life-threatening injury, 88.4% of them were mild with simple medical intervention and 8.4% were mild.
Discussion and Conclusion: The most common methods were drug. One of the striking results that, the rate of attempting suicide of women under 19 years of age is higher than men, men in the 30-39 age group is higher. In this result for women; the search for identity the roles of society expectation and the restrictions of freedom play role, for men; economic reasons, responsibilities play a role. The findings are important to shed light on protective measures. It would be useful to refer the patients who applied to social support units.
Forensic Medicine Education in Problem Based Learning: The Case of Pamukkale University (2019-11-12)
As a result of health system and legal regulations in our country, primary care physicians have a great number of responsibilities related to forensic medicine services, but it is a known fact that our physicians describe forensic medicine as the most feared task because of the insufficiency of undergraduate forensic medical education.
A horizontal and vertical integration, spiral structured training program is implemented at ...University Faculty of Medicine. While they learn the basic concepts in the first years, in the fifth grade they take active education methods through the two-week task. In this forensic medicine education, it will enable the students to develop their interest in forensic medicine and to achieve the objectives of gaining knowledge, skills and attitude in the core program. In this study, the undergraduate forensic medicine education model of ...University Faculty of Medicine is presented in detail.
Sociodemographic, Clinical and Crime-Related Actions' Characteristics in Patients with Psychotic Symptoms which Evaluated with the Claim of Committing a Crime-Related Action in a University Hospital between 2012-2018 (2019-09-17)
Objective: The aim of the study is to determine sociodemographic, clinical and crime-related actions' characteristics in patients with psychotic symptoms and to explore the effects of these characteristics on their criminal behavior and criminal responsibility.
Materials and Methods: The 597 Forensic Medicine Board Reports prepared for assessment of criminal responsibility between 2012 and 2018 were investigated retrospectively. The reports and patient files of 182 individuals diagnosed by psychotic symptoms were examined in detail.
Results: 85.7% of the cases were male. The mean age at the time of the crime was 40.87±11.78. 78.6% did not have a profession and did not work, mean duration of education was 7.98±3.19 years, 72% were single, divorced or separated, the mean disease duration of cases was 10.49±7.98 years, 22.5% had a comorbid psychiatric disorder and 14.6% of comorbid diseases were substance use disorder. Persecutory delusion was the most common delusion with a rate of 45%. 44.5% had a crime-related action history, 77.5% had committed a violent crime-related actions and most of the crime victims were familiar individuals of the patients. 67% did not have criminal responsibility, 12.1% had diminished criminal responsibility and 11.5% had criminal responsibility.
Conclusion: In the evaluation of criminal responsibility, sociodemographic, clinical and crime-related actions’ characteristics should be considered in a holistic approach. Determining the risk factors in terms of criminal activities will help us to understand the reasons for the patients to take such actions and will guide the studies in terms of mental health and forensic psychiatry in cases...
Lighter Gas Inhalation and Neurological Sequels as a Forensic Case (2019-08-28)
The use of inhalants, also known as volatile substances, is increasing all over the world. Lighter gas is one of the most frequently used inhalants, because it is easily accessible, can be bought legally and cheaply and has a pleasant effect in a short time.
In this case report, an 18-year-old case that had a cardiac arrest in the street after lighter gas inhalation about three years ago was presented. He had a generalized tonic seizure during his follow-up in intensive care unit, and had changes secondary to hypoxic ischemic damage due to inhalation of butane gas in his cranial MRI and also had severe motor and mental neurological sequelae.
In literature review, there were mostly autopsy studies of sudden death due to lighter gas inhalation. We think that presented case would contribute to the literature because it clearly reveals neurological sequelae as a result of lighter gas inhalation.
Screening of Physical and Emotional Child Abuse Risk and Protective Factors in a Group of High School Students (2019-10-31)
Objectives: Child abuse is a multidimensional phenomenon so planning prevention strategies, risk/protective factors should be obtained in a multilayered manner with regard to the individual, family, school, environment and policies. It is aimed to describe these factors among high school students
Materials and Methods: The participants’ mean age is 15.69 (Sd = .96) and 53.4% (n = 353) of them are female. The Rathus assertiveness inventory and the questionnaire included variables related to demographics, school and neighborhood, risky behaviors, family relationships/lifestyle, risky thinking styles, abuse experience in the immediate environment.
Findings: 95.5% of the students (n = 631) live with their families and perceived economic status is moderate/below (51.1%, n = 337). 59 (9.6%) mothers and 104 (16.2%) fathers were university graduates. 397 (60.1%) participants come to the school by public transport and 39.5% (n = 261) has no-one to accompany. Having a violent school-mate rate is 40.7% (n = 269). Assertiveness did not differ by gender and class. Families’ child rearing practices are harder for the upper-class boys than for the girls, the boys find their families expectations too much and feel less appreciated. 284 (43%) participants had 3 or more children who abuse emotionally (n=284, 43%) and physically (n=135, 20.4%).
Conclusion: Class and gender may affect substance use, truancy, neighborhood safety, school violence victimization. When abuse cannot be questioned directly, it can be guiding to examine whether students escape from school, whether there are close violent friends and whether they feel friends’ support.
Evaluation of Publication Rate of Forensic Medicine Specialty Theses in Turkey (2019-09-17)
Objective: The aim of this study is to investigate the publication rate of Forensic Medicine specialty theses in national and international journals.
Materials and Methods: The Thesis Center database of Council on Higher Education was searched for medical specialty theses written between 1983-2016. Another screening was done using the resident and mentor names as well as thesis title on Ulakbim, Türk Medline, Google Scholar, Web of Science, PubMed databases. The years in which the theses were done and the articles were published, database of the journal, resident’s order among the authors, type of research, thesis subjects were recorded.
Results: It was found that 77 (32.6%) out of a total of 236 theses written between 1983-2016 were published. Fifteen-point two percent of these theses were published in Science Citation Index-Expanded/Social Sciences Citation Index, 11.9% were published in international, and 5.5% in national indexed journals. The mean publication time was 2.95±2.49 years. It was also found that the resident was the first author in 85.7% of the articles, and 53.2% of the published theses were prospective studies. Most frequently article subjects were in the fields of Forensic Pathology (26%) and Forensic Psychiatry (23.4%).
Conclusion: Publishing rate of theses in Forensic Medicine was similar to the data regarding publication rates of theses in different medical specialty fields in our country and abroad; however, it is below the level desired. It is of utmost importance to generate solutions to facilitate the process including but not limited to mentors that are encouraging and instructive,...
Methyl Alcohol (Methanol) Intoxication (2020-01-27)
Methanol is a clear, colorless and highly toxic substance obtained from destructive distillation of wood. Methanol, which is generally used as solvent and antifreeze in industrial solvents, paints, varnishes, gasoline mixtures and automobiles, is a type of non-drinking alcohol due to its taste and odor. It can be produced as a by-product during the production of distilled alcoholic beverages. Accidental or suicidal ingestion of methanol can cause intoxication. Methanol often causes oral intoxications. Methanol intoxication occasionally occurs in epidemics. Metabolites of methyl alcohol are toxic. Most of the symptoms of methanol intoxication are associated with metabolic acidosis. Symptoms are usually related to the central nervous system, eyes and gastrointestinal tract and occur after a latent period. It can have serious consequences such as blindness and death. Prognosis is correlated with the degree of metabolic acidosis. The toxic dose of methyl alcohol in human is in a wide range. Hemorrhage and necrosis in the basal ganglia and hemorrhage in the putamen are the findings obtained in radiological examinations and autopsy studies. Methanol levels in the blood of the autopsy cases are quite different. In our country, there has been a significant increase in the number of intoxication cases and deaths as individuals started to produce their own drinks or turned to fake drinks due to the increasing taxes and alcohol prices. In order not to increase the number of intoxication cases and deaths, the government should make the necessary arrangements and take precautions as soon as possible.
Comparison of The Greulich-Pyle And Tanner-Whitehouse Methods for The Detection of Bone Age (2020-01-09)
Aim: The aim of this study is to compare the most commonly used Greulich-Pyle atlas and Tanner-Whitehouse methods in the evaluation of left wrist radiography for bone age determination due to its medical and forensic importance in pediatric period.
Materials and Methods: For this study, 150 girls between 11-16 years of age and 210 boys between 11-18 years of age are chosen. A total of 360 cases are separated into 12 groups according to their sex and age. The left wrist radiographs of the cases are evaluated retrospectively. The bone age in these cases are determined with the GP atlas, the TW2 and TW3 methods. RUS scores that are mostly applied in TW methods are used. The relation between methods and chronological age, difference and usability are researched.
Results: In general, TW2 overestimated and TW3 underestimated the ages. In GP method, the differences between chronological age and bone age are not significant whereas in TW3 method the differences are significant.
Conclusion: According to the results, the GP atlas was the more applicable method for the age groups included in this study.
Investigation of Streptococci in Oral Flora in Terms of Identification in Forensic Sciences (2019-11-13)
Forensic Microbiology which is a new field and mentioned about this microscobic evidences in forensic science; comes into question in terms of defined of microorganisms with protected innocents and defined guilty at the result of changing social life. Located in mind that study of oral microflora streptococcus that we might be made on various objects; named in identification of microorganisms used and can not be used, planned to investigate.
This study; 50 people in the mouth, apples, cigarettes and chewing gum swabs cultivation operation, including 200 different swab broth is made. All of microorganisms that have been investigated in the oral microflora of people. According to the obtained data; as the predominant species in these microorganisms has been determined that alpha hemolytic streptococci. It is unique flora in the mouth of people the rare microorganisms in the mouth that some people are determined to make it special in terms of identification. In this case, the bite mark left in any place, in any event and any objects it has been possible to say that an evidence of the gain will betray that person.
As a result; so much in terms of clinical and forensic science is important to us that these bacteria Streptococcus, we aim to contribute with a different approach in terms of forensic microbiology.
A Forensic Glance to Children’s Virtual Privacy in Web 3.0 (2019-11-12)
With the social media era considering as a turning point for communication age sharing has become unlimited. Many families have being chosen technological devices rather than a safe play area for their children. It has been considered that children is hang by a thread regarding easily accessibility and personal info via YouTube which is considered the biggest video sharing platform and another recent micro-film applications which is popular with under 18 years old children.
It is necessary that children and adolescents to get connect with their peers. The children and adolescents who are lurking in online world without any guidance may join social media movements so called “trends”.
The other thread which children and adolescents could face is the video-sharing sites which turned into trading sector. While children are online, their parents who have an urge to get goods from those sites give their children a chief part in those videos.
In some videos, children are forced to behave unnatural regarding unmatched behaviors to their mental and physical development by their parents. Another negativity for children who have a role in these videos is destructive comments that are typed under videos. Some comments which are filled with jealousy and anger can be labeled as “cyber-bullying”
Consequently, when the severe usage of YouTube and video-sharing sites because of widespread use of Internet is considered, it has been a necessity to protect children’ personal information and their privacy. The harm which is stemmed from sales policy has to be spoken by...
Evaluation of Sexually Transmitted Diseases in Sexual Assault and Abuse Cases (2019-11-11)
It is important to evaluate sexual assault and sexual abuse cases in terms of sexually transmitted diseases (STD) as well as physical and psychological trauma. In these cases, the physical examination is generally limited to the determination of trauma findings and sample collection for identification of the assailant. Although there are many sexually transmitted infections such as Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Hepatitis B virus, Human immunodeficiency virus and syphilis, there is no standardized guideline for screening tests and prophylaxis practices in our country. Therefore, the risk of infection transmission should be considered in all cases and, if necessary, treatment and prophylaxis practices should be evaluated. In addition, in cases where the assailant can be reached, the examination of these persons should be performed in order to determine the need for medical care of the victim for STDs and to establish the causality and the judicial process of the assailant. In this review, it is aimed to draw attention of healthcare workers, with medicolegal aspects, to the subjects of the evaluation of sexually transmitted diseases in sexual assault and sexual abuse victims and examination of the assailant.
Suicide with Potassium Cyanide Bought on The Internet: A Case Report (2019-11-04)
Cyanide is one of the most toxic substances known. Although acute intoxication isn’t common, suicide with cyanide often results in death. In this study, it was present a 27-year-old man who suicide by buying potassium cyanide from the Internet. A cup with white contamination was found at the scene and an invoice and a credit card payment slip documenting that he had purchased 1 kg of potassium cyanide from a company selling chemical materials over the internet. In autopsy, nonspecific findings such as submucosal congestion and focal fresh bleeding areas and severe hyperemia in other tissues were found and the toxicological examination revealed that he died of oral cyanide poisoning. This study is presented in order to draw attention to the fact that cyanide, which is the most toxic substance known, can easily be bought over the internet and to emphasize that access to these substances should be strictly controlled.
Can Planktonic Organisms be Useful for Determining the Drowning Depth in Fatal Diving Accidents? (2020-01-13)
Objective: Although the triggering factors are various, most of the fatal diving accidents result in drowning. If drowning depth is known, it will contribute the clarification of underlying reasons of the accidents. In this experimental study, it has been investigated whether planktonic organisms can be used to determine the drowning depth in fatal diving accidents.
Materials and Methods: Planktonic organisms in water samples taken from the surface and 30 meters depth of Marmara Sea were investigated. In addition, rats in one of the two groups of 8 Wistar Albino species were drowned in the water sample obtained from surface at pressure of 1 ATA, and rats in the second group were drowned in the water sample obtained from 30 m depth at a pressure of 4 ATA in a hyperbaric chamber and planktonic organism was investigated in the lungs of drowned rats.
Results: In the examinations, 22 phytoplankton and 5 zooplankton taxa were detected in the samples obtained from the surface and 7 phytoplankton taxa were detected in the sample obtained from 30 m depth. In the autopsies planktonic organism was not found in the lungs of rats. It was observed that the lungs of the rats that drowned at 4 ATA were more bulging and bleeding. The absence of a planktonic organism in the lungs was thought to be due to the fact that the rats aspirated a very small amount of water and the plankton density in the samples was low....
Gender Estimation in Anatolian Population from Scapula Measurements Using Volume Rendering Technique with 3D Computerized Tomography (2020-01-14)
Objective: The aim of this study is to evaluate the sexual dimorphism of the scapula and to measure the accuracy of the results of the measurements performed by computed tomography imaging of the thorax for gender estimation in the modern Anatolian population.
Materials and Methods: Multidetector CT images of 302 cases (164 males, 138 females) with ages between 20 and 93 and taken between February 2019 and April 2019 in Radiology Department of Muğla Sıtkı Koçman University Training and Research Hospital were used. Longitudinal lengths (LU), transverse lengths (TU), and spina scapula lengths (SSU) of the right and left side scapulae were measured and evaluated. The effect of measurements on gender determination was determined by Logistic Regression analysis.
Results: Scapula measurements were higher in males than in females (p <0.001). Statistically significant difference was found between transverse lengths of the right and left scapula in females and statistically significant differences in all 3 measurements in males. The longitudinal, transverse and spina scapula lengths of the scapula were found to be statistically significant when the measurements were used for gender determination. Accordingly, it was seen that the right scapula longitudinal length was the highest accuracy rate.
Conclusion: This study demonstrates that scapula bone is an important bone in sex prediction in Anatolian population. Therefore, if skull, long bones and pelvic bones cannot be found in forensic medicine and anthropological studies, scapula can be used alone or in combination with other skeletal elements for sex estimation methods.
Investigation of the Emergency Physicians’ Exposure to Violence and Forensic Events (2020-01-27)
Objective: The aim of this study is to determine the exposure of the emergency department physicians to violence and forensic events and related factors.
Materials and Methods: The population of this cross-sectional study was 248 emergency service physicians working at 31 different health institutions in Adana city center. Between 01 July and 31 December 2016, 202 emergency department physicians were interviewed face-to-face. Data collection tools were; the sociodemographic knowledge of the doctors, the history of violence and their approach to forensic events. Frequency analysis and Chi Square test were used for data evaluation.
Results: The mean age of the participants was 38.3±9.6 years and mean working time in emergency departments was 8.9±7,7 years and 75.7% of the emergency physicians in our study were male. The rate of exposure to violence during the working life was 88.1%. The most common types of violence were verbal violence with 88.1% and physical violence with 30.7%. It was determined that physicians were mostly violated by patients and their relatives, also it was determined that half of the physicians went to court at least once during their professional life due to medical practices. Statistically significant relationship was found between physicians being violent and being plaintiff (p<0,05). It was stated that 20.8% of the doctors had a forensic investigation and 85.6% were concerned about the malpractice.
Conclusion: Emergency physicians, who are faced with violence and forensic events very often and undertake great medical and legal responsibilities, can feel anxious and lonely. Legal sanctions on violence against...
Deaths from Firearm Injuries Under Age of 18 (2019-12-16)
Introduction: Childhood deaths due to the firearm injuries are rising in our country and worldwide. In this study, our aim was to examine the deaths related to firearm injuries in an age group 18 and under, in İzmir and neighboring provinces between 01.01.2006 and 31.12.2015 and the information such as sociodemographic aspects, the types of the firearms, origin, region of injury, place of death, shooting distance, and the owner of the firearm.
Materials and Methods: In our study, autopsy report and forensic investigation files of 1.876 firearm injuries in and around İzmir were retrospectively reviewed and 114 (6,07%) of these cases were referred as deaths of 18 years old or younger. The data were evaluated using SPSS version 22 program. Percentage, ratio and chi-square statistics were used in the data analysis.
Results: The ages of the cases varied from one to 18, 79 (69,3%) of the cases were male, mean age is 14,04 ± 4,23, and male / female ratio was 2,25. Guns and shotguns were used in 39 cases (34,2%) and in 75 cases (65,8%) respectively. When the cases were evaluated corresponding to their origins; homicide was the first with 37 cases (32,5%). It was found that deaths occurred most frequently in winter (n: 32, 28,1%). Most of the cases occurred in rural areas such as villages and towns (n=48, 42,1%) and the incidence mostly took place within houses (n=54, 47,4%). In 35 cases (30,7%) the owner of the weapon was the father of the victim.
Discussion and Conclusion:...
Legal Cannabis, and Then… (2020-01-10)
Recently, it is seen that the regulations regarding the use of psychoactive substances such as cannabis are considered just as a public security problem in specific periods and it is expected to be controlled by legal precautions. However, with the realization that the problem of substance use and addiction is not a mere public security problem, treatment and prevention activities have started to be given importance. In recent years, it has been observed that people who both regulate medical treatment, and work on the legal framework and related to the psychosocial dimension of the incident, have been working sensitively on legal regulations and new developments. From now on the substance use is evaluated within “public health and society safety”, and along with this, especially cannabis regulations are being changed rapidly and the issue is still being discussed in many countries. It is thought that it will be difficult to predict the long-term consequences of these practices as the basis of both individual and societal in terms of public health and public safety. This article is written in order to summarize the individual and social consequences that may arise if the use of recreational cannabis is allowed by compiling the studies regarding the subject.
Age-related Metric Changes in Ear Size and Position (2020-03-04)
In this study, age changes in human face and ear were examined metric in both sexes. The data that have statistically significant results were included in the study, and we focused on the data with increase/decrease with age.
In the study, measurements were made on the face profile and ear images of 369 volunteers (166 female and 203 male). Linear distance measurements were taken using 19 anthropometric points along with Body Mass Index (BMI), and face profile and ear area calculations. The data were recorded in SPSS 20.0 (Statistical Package fort he Social Sciences) and analyzed.
Generally, the linear distance measurements taken from the ear region in both genders were observed to increase with age. While there was no statistically significant difference in the measurements taken on the side of the face, in men, only 4 of 13 measurements were observed to increase continuously.
The aim of this study is to examine the changes in the human face profile and ear with age as a metric and to contribute to the future prediction studies.
Suicide with Hara-Kiri Like Method: A Case Report (2020-03-04)
Suicide is defined as “a person’s giving an end to his own life due to emotional, psychological, or social effects”. Many factors such as cultural structure, ethnic group, age, gender and accessibility are effective in the choice of suicide method. The most common suicide method is hanging, followed by firearms, jumping from heights and chemical intake. While the suicide with the sharp intruments constitutes %2 of all suicides, the incidence of suicide with the sharp intruments which is similar to Harakiri is % 0.2. What makes our case valuable is that the person belongs to the Turkish race and has chosen a suicide method as harakiri that is special to the Japanese race. A 56-year-old man diagnosed with psychotic disorder died of peritoneal, small intestine and mesenteric injuries due to abdominal and chest penetrating stab wounds and hypovolemic shock due to bleeding.