A descriptive study of female suicide deaths from 2005 to 2011 in Van city, Turkey.

BACKGROUND: Female suicide is an important problem not only for women but for public health in general. METHODS: Autopsy reports from the Van Chief Public Prosecutor's Office from 2005 to 2011 were reviewed retrospectively in order to analyse female deaths from suicide. RESULTS: Sixty-six female suicide cases were recorded during 2005-2011. The mean age of the cases was 22.64 (sd = 10.09) years, and nine were below the age of 15. The most common method of suicide was hanging (44 cases, 66.7 %). Five (7.6 %) of the cases were under treatment for depression, and 12 (18.2 %) cases had a previous suicide attempt. CONCLUSIONS: Cultural suppression of females and prevention of their socialization in enclave societies are risk factors for female suicides. The number of female suicide attempts, especially recurring attempts, should be reduced via psychiatric scanning, follow-up sessions and therapy for high-risk individuals.

Analyses of suicidal deaths with shotguns in Istanbul, 1998-2007.

BACKGROUND: In previous studies, some features of suicidal firearm deaths have been described, but series of suicidal deaths using shotgun are limited in the literature. The aim of the present study was to define several characteristics of suicidal shotgun deaths. METHODS: In this study, we reviewed retrospectively 36,971 autopsy reports recorded by the Mortuary Section of the Forensic Medicine Council of Istanbul between January 1, 1998 and December 31, 2007. RESULTS: Seventy-three shotgun-related suicide cases were evaluated. Of the 73 cases, 46 (63%) were male and 27 (37%) were female. Most of the cases (n=36, 53.4%) were aged 16-20 years (p<0.001). Sixty-two of the suicides (84.9%) occurred in victims' homes (p<0.001). A suicide note was recovered in 7 cases (9.6%). While entry wounds were on the head in the majority of the cases (n=29, 39.8%) (p<0.001), in nearly half of the female victims (n=12; 44.4%), entry wound was in the abdominal region. Fifty-six shots (76.7%) were determined to be from loose-contact range (p<0.001). Ethyl alcohol was detected in 17.8% (n=13) of blood samples of the cases. CONCLUSION: Handling and usage of shotguns should be under strict control, educational efforts should be directed to early and late adolescents and their parents and psychological support centers should also be founded in an effort to prevent suicidal deaths with shotguns.

Autopsy findings of suicidal deaths committed by firearms in Ankara, Turkey.

The purpose of this study was to examine autopsy findings from suicidal deaths using firearms in Ankara, Turkey, and to compare the results with those reported from other studies. We retrospectively evaluated suicidal deaths by firearms referred for autopsy to the Morgue Department, Institute of Forensic Medicine, between 2002 and 2004. Results were subjected to discriminant analyses using SPSS 11.5 package program. One hundred and fifteen cases (83.3%) were male, the ratio of male to female was 5 to 1 and the mean age was 31.96 years (range:12-85 years). Forty cases were aged between 12 years and 20 years, 28 were aged between 0 and 18 (20.29%). One hundred and thirty-three cases (96.4%) had one bullet entry and five cases (3.6%) had two bullet entries. Out of 143 bullet entries, 116 (81.12%) were caused by gunshots fired from contact or near contact range. Regarding bullet entry sites, 103 (72.03%) were on the head with 56 (54.37%) located on the right temporal region. Gunshot related crimes are an increasing cause for concern in Turkey. However, a simple preventive measure may prevent the suicidal deaths of many young people.

[Role of anatomic and physiologic trauma scoring systems in forensic cases]. / Adli olgularda anatomik ve fizyolojik travma skorlama sistemlerinin rolü

BACKGROUND: The Turkish Penalty Law has recently been changed. The novel law asks the practitioner to report if there is any 'Situation Placing a Life in Danger '. Herein, we evaluate the anatomic (ISS, TRISS) and physiologic (RTS) trauma scores assessing mortality. METHODS: Study data were obtained from a retrospective chart screening of cases who were accepted to the emergency department in GATA Faculty of Medicine in 2007 and from archived forensic reports. Demographic features and the time period of admittance were recorded. Trauma scores were calculated. All parameters were evaluated with the reported condition of "life threat" and mortality. RESULTS: Forensic reports were completed for 373 patients and 6.16% of them were noted as being in a life-threatening condition. Mortality rate was 1.34%. A significant rate of trauma patients suffered from firearm injury and stab wounds (p<0.001). There was no statistical difference between ISS, TRISS and RTS with respect to predictive value of a 'life-threatening condition' (Area under curve [AUC] in the receiver operating characteristic [ROC] curve analysis: ISS: 0.968, TRISS: 0.922, RTS: 0.196). There was also no statistical difference between ISS, TRISS and RTS scores regarding mortality prediction (AUC in the ROC analysis: ISS: 0.992, TRISS: 0.0995, RTS: 0.005). CONCLUSION: We assume that there is no difference between physiologic and anatomic scoring systems to predict mortality for deciding a life-threatening condition.

Assessment of private security guards by Suicide Probability Scale and Brief Symptom Inventory.

AIM: The aim of the present study was to investigate the influence of suicide probability and relevant sociodemographic features and to provide information for preventing suicide in private security guards working under the stressful conditions and continuous exposure to the negative and traumatic life events. METHODS: 200 private security guards and 200 personnels of Ankara University participated in the study. A sociodemographic information questionnaire, the Suicide Probability Scale (SPS) and the Brief Symptom Inventory (BSI) were used to collect the data. RESULTS: Gender, marital status, income, religious beliefs, experiencing a life-threatening situation, history of a suicide attempt, smoking and not having a chronic disease caused statistically significant differences in the scores for SPS between the private security guards group and the controls. Moreover there was a statistically significant positive correlation between the total scores of the subscales of SPS and the total scores of BSI. CONCLUSIONS: Like police officers and gendarmes, private security guards are at high risk of committing and attempting suicide because of being at stressful work settings and also suffering from secondary trauma. It is required that they should be aware of their tendency to commit suicide and have regular psychiatric screenings.

Road traffic accidents and disability: a cross-section study from Turkey.

PURPOSE: To investigate socio-demographic features, lesions which caused disabilities and the rate of disabilities caused by particular lesions and thus to reveal how disabilities are evaluated and general characteristics of disabilities due to road traffic accidents in Turkey. METHOD: In this study we retrospectively reviewed 563 victims of road traffic accidents evaluated by the Department of Forensic Medicine, Ankara University, between 1 July 1993 and 31 December 2002 to determine whether they had disabilities and to estimate the rate of disabilities. We collected data about age, gender, trials outcomes, affected body parts, surgical interventions, lesions taken into account in estimation of disabilities, the rate of disabilities. RESULTS: 64.7% of the cases were male and 35.3% were female. The mean age of the cases was 33.11 (SD:16.70) years. The most frequently affected body part was lower extremities and 73.6% of lesions taken into account in estimation of the rate of disability were located in the pelvis and lower extremities. CONCLUSIONS: In order to prevent these injuries, the mechanisms of the injuries should be determined and to this aim findings obtained at the scene, hospital records and findings obtained at the physical examination of the victims should be linked. Larger studies are needed to determine preventive measures for elimination of the causes of accidents, prevent permanent disabilities, plan education programs and make recommendations about the preventive measures.

Infant and adolescent deaths in Istanbul due to home accidents.

Adolescent and infant deaths due to home accidents pose an important social problem and can be prevented significantly by appropriate measures. The aims of this study about adolescent deaths under the age of 18 and infant deaths due to home accidents were assessment of risk factors and proposals for protective measures. Toward these aims, 414 autopsy reports (Provided by Mortuary Section, Council of Forensic Medicine, Istanbul Turkey, 1996-2000) were reviewed, as well as scene investigation data and information from eyewitnesses. Determination of risk factors, appropriate education, as well as legal regulations for manufacturers of household articles may significantly reduce the number of infant and adolescent deaths due to home accidents.

Deaths in Turkish military services, 1998-2000.

The aim of this study was to evaluate the causes of death in the military in Turkey and to evaluate the previously obtained data relating to the characteristics peculiar to the army in those cases of death that have acquired a juridical attribute. In this study, the cases presented in the years 1998 and 2000 have been investigated retrospectively. Seventy military cases investigated within a period of 3 years were all men. Except for the 20 cases in which the cause of death could not be determined, 30 of 50 cases in our study are included in the group of "natural deaths" and 20 are included in the group of "forced deaths." In conclusion, natural causes are still the leading cause of death in Turkey, and regarding this, it can be suggested that these deaths could be preventable by better health care and more careful premilitary health examinations.

Differences in the number of autopsies and causes of death between the months of Ramadan and control months and between two cities, Ankara and Bursa in Turkey.

AIM: To investigate differences in the number of autopsies and causes of deaths affected by spiritual factors and concentration during Ramadan and to compare the results from two cities, Ankara and Bursa. METHODS: Autopsies performed in morgue departments of the Council of Forensic Medicine, Ministry of Justice, in Ankara and Bursa during Ramadan and non-Ramadan (control) months between 2003 and 2006 were retrospectively investigated for age, sex, cause of death, manner of death and blood toxicological analyses. RESULTS: The number of autopsies was significantly higher in Ramadan months than in the control months in Bursa, but low and insignificant in Ankara. A significant decline in traumatic deaths was observed during Ramadan (p less than 0.05). CONCLUSION: During Ramadan, while rates of homicidal deaths displayed a relatively steep decline in females, the rates of homicide were increased in males. This might be due to a decrease in natural deaths and accidents. To make further comments, conducting studies evaluating detailed socio-demographic features and assessing relevant psychological states of the victims can be beneficial.

Evaluation of forensic perinatal and neonatal autopsies in Istanbul.

OBJECTIVE: Autopsy findings play an important role in prevention of perinatal and neonatal deaths. Therefore, we attempted to reveal demographic and forensic features of these deaths in Turkey. METHODS: We retrospectively reviewed autopsy reports for 184 cases of perinatal deaths released from Istanbul Forensic Medicine Institute Morgue between 2000 and 2002 and investigated demographic and medico-legal features of the cases. RESULTS: The mean age of the cases was 2.98 +/- 6.41 days. Fifteen point two percent (15.2%) of the cases were of murder, 52.7% of the cases were illegitimate children and 41.3% had the ability to survive. CONCLUSION: It can be suggested that autopsy and post-mortem examinations should be performed in order to determine the real causes and contributing factors of perinatal and neonatal deaths. Data obtained in autopsies and postmortem examinations will make great contributions to the prevention of these deaths.

Establishment of interdisciplinary child protection teams in Turkey 2002-2006: identifying the strongest link can make a difference!

OBJECTIVES: The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year outcome. METHODS: A team of instructors evaluated needs and held training activities in Turkey annually, and provided consultation when needed. Descriptive analysis was done via Excel and SPSS software. RESULTS: Eighteen training activities were held with 3,570 attendees. Over the study period, the number of MDTs increased from 4 to 14. The MDTs got involved in organizing training activities in their institutions and communities. The number of medical curriculum lectures taught by MDTs to medical students/residents, conferences organized by the MDTs, and lectures to non-medical professional audiences increased significantly (R(2)=91.4%, 83.8%, and 69.2%, respectively). The number of abuse cases assessed by the MDTs increased by five times compared to pre-training period. CONCLUSIONS: A culturally competent training program had a positive impact on professional attitudes and behaviors toward recognition and management of child abuse and neglect in Turkey. The need to partner with policy makers to revise current law in favor of a greater human services orientation became clear. PRACTICE IMPLICATIONS: Pioneers in developing countries may benefit from collaborating with culturally competent instructors from countries with more developed child protection systems to develop training programs so that professional development can improve recognition and management of child abuse and neglect.

Determination of gender by measuring the size of the maxillary sinuses in computerized tomography scans.

BACKGROUND: Identification of corpses is a difficult forensic procedure and it is mandated by laws and social rules. Comparison of ante mortem and post-mortem medical records, such as dental documents, plays an important role in the identification of corpses. However, typical identification methods may be inconclusive, especially when certain extreme post-mortem changes have developed. Gender has long been determined from the skull, the pelvis and the long bones with an epiphysis and a metaphysis in unknown skeletons. The aim of this study was to investigate whether the width, the length and the height of the maxillary sinuses could be used for determination of gender. MATERIALS AND METHODS: The width, the length and the height of the maxillary sinuses were measured in 127 adult patients who were admitted to the Department of Radiology for computed tomography scans of their sinuses. Of 127 patients, 62 (48.8%) were females and 65 (51.2%) were males. The width, the length and the height of the maxillary sinuses were measured in Computerized Tomography scans (Hitachi Radix Turbo computed tomography) when the patients were in prone position without sedation or contrast medium. The data were subjected to a discriminative analysis using the SPSS package program (Version 11.5). RESULTS: The discriminative analysis showed that the accuracy of maxillary sinus measurements-i.e. the ability of the maxillary sinus size to identify gender-was 69.4% in females and 69.2% in males. CONCLUSION: Computerized Tomography measurements of maxillary sinuses may be useful to support gender determination in forensic medicine; however, with a relatively low-accuracy rate (less than 70%).

Medico-legal child deaths in Istanbul: data from the Morgue Department.

BACKGROUND: Before determining health policies, finding solutions to problems and taking precautions, one should define the problems and their regional and national dimensions. Data about causes of death vary from country to country and, therefore, it is clear that precautions should be based on regional data and needs, which will be more effective. METHOD: The authors reviewed deaths among children aged 1 month to 18 years, whose autopsies were performed in the Morgue Department, State Institute of Forensic Medicine, Istanbul, Turkey, between 2000 and 2002. RESULTS: The authors evaluated autopsy reports about 736 child deaths. The mean age of the children was 8.77 +/- 6.25 years and 62.8% of the children were male. As to causes of death, the most frequent was asphyxia. Almost half of them were caused by mechanical asphyxia due to drowning. A total of 48.5% of the deaths were accidental. There was a significant difference in causes of death between children aged 11 years or younger and those aged over 11 years. Death due to nontraumatic conditions and poisoning was predominant among children aged 11 years and younger, while death due to gunshot wounds and stab wounds was predominant among children aged more than 11 years. There was a significant difference in causes of death between females and males. CONCLUSION: Asphyxia, poisoning and blunt traumatic injuries were found to be the leading causes of death, which can be prevented or decreased by certain precautions. As a result, new regulations should be enacted to protect children against accidents, injuries and hazards and a child protection program is needed in Turkey.

Unusual torture methods and mass murders applied by a terror organization.

This study aims at describing autopsy findings of 19 victims killed by various torture methods applied by a terror organization after they had been kidnapped by this organization, as well as the unusual and unique binding style applied during these killings. The present study also aims at describing the unusual killing method of binding for literature and discussing international descriptions of torture.