Emotional and Psychosocial Problems Encountered by Children Who Have Been Sexually Abused.

The current descriptive analysis sought to identify the emotional and psychosocial problems experienced by children who have been sexually abused. Of 518 children with a history of sexual abuse who applied to the Child Protection Center, 443 were included in the study. Approximately 71.6% of children were subject to sexual abuse entailing penetration, whereas 69% were subject to sexual abuse not entailing penetration. After-effects reported included despair (46.5%), fear of reoccurrence of the incident (52.8%), distrust of others (36.8%), difficulty sleeping (32.7%), negative expectations about the future (32.1%), and self-blame (31.1%). Nurses have crucial roles and functions in the protection, improvement, treatment, and rehabilitation of the health of children who have been sexually abused. [Journal of Psychosocial Nursing and Mental Health Services, 56(2), 37-43.].

Traumatic asphyxia: An autopsy case.

Traumatic asphyxia is a form of asphyxia where respiration is prevented by external pressure on the body. A 19-year-old man was found by relatives compressed by motorboat in the garage. The death was investigated by the prosecutor; body was taken to the Morgue Department for performing autopsy. On gross physical examination; the face, neck and upper part of the chest were congested and many petechiae were observed on the conjunctivae, but not in low extremities. Autopsy macroscopic examination of lungs revealed congestion, sub pleural superficial bleeding areas. In the presented case death was reported as traumatic asphyxia by thorax compression without other lethal factors.

Evaluation of shotgun suicides in Konya, Turkey between 2000 and 2007.

The number of the suicides is increasing all around the world. In this study, the cases autopsied between 2000 and 2007 in The Konya Branch of Forensic Medicine Council were retrospectively investigated. Fifty-seven shotgun suicides were determined. The cases were evaluated in terms of their demographic characters, site of entrance wound, the type of the cartridge used, shooting distance, the place of incident, the place of death, motive for suicide, and the presence of previous suicide attempts. The most preferred site of entrance wound was the head with 34 cases (59.7%). Of 34 cases in which the entrance wound was on the head, there was indirect mandibular fracture in 16 cases (47.1%). In 11 cases (19.3%), there observed small ecchymosed abrasions on the finger surfaces, which are thought to have resulted from the trigger kicking back during triggering or the finger having been stuck between the trigger and the trigger guard. It is concluded that there is a need for a legal regulation that makes obtaining of shotguns more difficult and the people who have them are to be educated not to keep them in easily accessible places.

Bilateral long styloid process detected at autopsy (case report).

The aim of the article was to reveal the significance of prolonged styloid process detected at forensic autopsy. A-61-year-old man was found dead in his home. The crime scene investigation exposed suicide by hanging. On internal autopsy examination pulmonary edema and congestion of all internal organs were identified. Dissection of the neck structures revealed 90 mm in length on the right side, 70 mm in length on the left side, bilateral long styloid process. Distal parts of the prolonged styloid process were situated between external and internal carotid artery. Our aim was to discuss the significance of prolonged styloid process detected at forensic autopsy.

Dead bodies found in wells.

Corpses found in wells or lime pits must be identified and the cause and manner of death must be determined. There are several circumstances that may lead to the presence of corpses in wells. In this study, 3940 death examinations and autopsies, performed at the Konya Branch of Forensic Medicine Council (Turkey) between 2000 and 2007, were retrospectively investigated, and it was found that 18 (0.46%) of the bodies had been recovered from wells. The cases were evaluated in terms of their demographic features, manner of death (accidental, suicidal, or homicidal), autopsy findings, cause of death, and the characteristics of the wells in which they were found. The ages of the victims ranged from 4 to 74 years, and the average age was 40. 4 +/- 20.6 years. Of total, 16 cases were males and 2 were females. The manner of death was determined to be accidental in 10 of the cases, suicide in 6 of the cases, and homicide in the remaining 2 cases. In 7 of the cases, death had occurred as a result of drowning in water. A comprehensive scene investigation and autopsy must be performed for corpses recovered from wells and pits for both identification and determination of the cause and manner of death. Wells should be covered and kept closed at all times to reduce the number of accidental deaths resulting from falls into wells.

Air bag-mediated fatal craniocervical trauma: a case report.

This case report describes a four-year-old girl (102 cm, 17 kg) who sustained fatal craniocerebral injuries as a result of an inflating automobile air bag. The car struck the lid of the sewer system, which was 15 cm above the ground level, at a low speed, and both the driver and passenger air bags inflated. Despite the fact that air bag usage has lessened both the possibility and severity of occupant injuries in frontal collisions, case reports of serious injuries and even deaths especially in children due to air bag deployment, particularly during low speed impacts, highlight the need for changes in both system design and possibly the threshold speed of air bag deployment.

Precautions taken to avoid abandoning the act of hanging and reducing pain in suicidal hanging cases.

This study presents 17 cases of hanging with some preventative measures, when compared with usual hanging fatalities, between 2002 and 2006 in the province of Konya, Turkey. We observed in 4 cases that the victim had only tied together their hands, whereas in 1 case both the hands (with a clothesline) and mouth (with a plastic bag) had been fastened. In a further case, the oral orifice had been closed using a scarf and in the remaining 11 cases, soft materials such as a scarf, hood, the collar of a coat or shirt had been used as padding against the ligature loop. At first glance, the cases where the victim's hands and/or mouth were found tied were thought to be homicides. However, an investigation of the death scene, together with the autopsy findings and inquiry data, showed the cause of death was from suicide. Thus, in suicidal hanging cases certain precautions and preventative measures were observed. For example, tying the hands together was regarded as a means to make self-release impossible; closure of the oral orifice as a means to prevent the victim from calling out for help, and placing soft material against the ligature loop was thought to be an attempt to lessen the feeling of pain.

A series of complex suicide.

This article presents 16 complex suicide cases. Complex suicide is defined as the use of more than one method to induce death. Of the victims, 10 were men and the ages ranged from 19 to 70 years. Eight victims left a suicide note. It was observed that 13 victims realized the suicidal act in the house and 5 victims had previous suicidal attempts. It was determined that 10 victims had psychiatric disorders, one of them had alcohol dependence. Six victims were housewives, 4 victims were unemployed, followed by one each victim of student, worker, farmer, tradesman, prayer leader, and animal husbandry lines of business. Ten victims were married; 3 victims were single; and 3 victims were divorced. On investigating the methods of suicide, it was seen that 9 victims preferred sharp instrument usage; 5 victims insecticide ingestion; 4 victims each firearms, medicine overdose; 3 victims each hanging, falling from a height; 2 victims self-strangulation; and 1 victim each drowning, liquefied petroleum gas and natural gas inhalation together, fungicide ingestion, rodenticide ingestion. It was determined that 2 victims used 3 methods and the other 14 victims 2 methods in company, to realize the suicide. In this article, the data obtained from our study was discussed by comparing similar data.

Accidental decapitation: a case report.

We report a case of an accidental decapitation of an agriculture worker in a field. The scene investigation revealed that the worker had loosely tied a scarf tied over his face in an attempt to diminish his exposure to barley dust, to which he was allergic, while distributing the barley loads with a shovel upon a trailer. The trailer was simultaneously being loaded by a helix elevator machine and its rotating shaft suddenly caught the victim's scarf and pulled it down to the victim's neck. The rotating motion immediately tightened the scarf around the neck resulting in hanging/strangulation noose that, by continued tightening, caused decapitation of the victim. The victim's body was found on the ground by the trailer and the victim's head was discovered in the barley load in the trailer. Examination revealed that the neck was severed at the level of the second and third cervical vertebrae.

Unusual suicide note written on the body: two case reports.

Suicide notes are commonly written on some materials, such as notebooks, papers, and mirrors. Additionally, suicide plans have been communicated in face-to-face conversations, by speaking on the telephone, recording on CDs or video cassettes, and sending messages through text messaging. In this article, 2 suicide death cases are presented in which suicide notes were written on the bodies of the victims. The first case, a 32-year-old man, was a university graduate and had been unemployed for years; he committed suicide in his house by hanging. On the external examination, it was seen that there were some words on the body written with a pen; specifically "DONKEY" was written on the forehead; coursing up-and-down along the chest, "HODJA" was on the right, "DO NOT" was on the sternal region, and "WASH" was on the left; and undecipherable handwritings were on both zygomatic regions. The second case, a 39-year-old woman, was a housewife who was being physically abused by her husband and committed suicide by ingesting an insecticide. It was observed that on the left leg, a note was written with a pen saying that she could not stand being beaten by her husband on account of the inheritance dispute between him and her elder brother; there was purple ecchymoses in the periphery of the right eye and in the right gluteal area. Since we have not found any reports of suicide notes written on the body in the literature, we present and discuss our cases herein.

Suicide by ligature strangulation: three case reports.

Suicide by ligature strangulation, which gives the initial impression of a homicide, is very rare. In this article, 3 suicidal death cases caused by ligature strangulation in Konya between 2001 and 2006 are presented. The first victim was a 68-year-old man who suffered from depression and lived alone in a cottage house. He terminated his life by applying a tourniquet to his neck after leaving a suicide note. The second victim was a 70-year-old woman who was found dead on the floor of the living room in her house. After she cut the vessels in her wrist, she tied pantyhose with 3 knots around her neck. It was reported that she had been intermittently receiving treatment for bronchial asthma and depression for 20 years. The third victim was a 30-year-old woman who suffered from schizophrenia for 6 years. She tied a scarf around her neck with 3 knots and died in the hospital after 1 day due to "hypoxic brain syndrome." As a result of the death scene investigations, autopsies, and judicial inquiries, it was concluded that death was by suicide in all 3 cases. Because the use of the ligature strangulation method, and particularly the tourniquet method, in suicidal cases is extremely rare in the literature, our aim is to present and discuss these cases.

Postmortem findings after anaphylactic reactions to drugs in Turkey.

AIMS: To determine the frequency of anaphylactic deaths at autopsies performed in Turkey between January 2001 and June 2006 and to review the circumstances of death and autopsy findings. METHODS: The Council of Forensic Medicine database in Istanbul was searched for anaphylactic deaths. Postmortem reports and medical records were reviewed to determine the circumstances of death. Data about basic demographics, medical history, drugs responsible for allergic reactions, and pathologic findings at autopsy were collected. RESULTS: A total of 36 anaphylactic deaths from drugs were identified for the study period. Death was due to antibiotics in 26 cases, analgesics in 7 cases, an intraoperative drug in 1 case, an H2 receptor in 1 case, and intravenous contrast medium in 1 case. Out of 36 cases, 19 were male and 17 female. They were aged between 1 and 74 years with the median age of 26.7 years. Death occurred within 1 hour of the onset of anaphylaxis in 27 cases. Findings at autopsy included nonspecific pulmonary edema and congestion, upper airway edema, cerebral hypoxia, and cutaneous edema. Serum tryptase levels were not measured in all cases. CONCLUSION: Anaphylactic reaction is an uncommon cause of sudden death. In many cases, no specific macroscopic or microscopic findings were detected at autopsy. When serum tryptase levels cannot be determined, in the presence of typical clinical records, eye witness reports and autopsy findings can be useful diagnostic aids.

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.

[The effect of firearms in inducing stress in high school students in the city of Düzce (Turkey)]. / Atesli Silahlarin Adolesans Döneminde Stres Yapici Faktör Olarak Etkisi.

OBJECTIVE: This study aimed to examine the behaviors of high school students exposed to firearms and firearms- related violence, which they had perpetrated or witnessed, and whether or not these events were related to stress. METHOD: The study was conducted in Düzce province, which is characterised by the widespread use of firearms. A questionnaire was prepared to ascertain students' attitudes and behaviors towards owning firearms, their thoughts about firearms- related violence, and whether or not they had been a victim or witness to firearms- related violence. After a stress level scale was added to the questionnaire, it was administered to 791 students randomly chosen from the 8304 students that were attending all high schools in Düzce. The results were evaluated with using SPSS v.11.0 software. RESULTS: The level of stress in students that had contact with firearms, whether or not they were faced with a violent act, may be reached the adaptation difficulty level. Aggressive behaviors like hectoring occurred between coequal groups and brothers/sisters, affectedstress levels. Exposure to and witnessing violent acts had important roles on level of stress. Gender, income level, and lack of a private room at home for adolescents affected stress levels. Contrary to expectations, the presence of firearms at home or in their surroundings did not have an effect on stress levels. Hearing the sound of gunfire was one of the most important factors related to stress levels. CONCLUSION: Because of its ability to induce stress in adolescents, they must be protected form exposure firearms and their use, which is widespread in Düzce.

Is daily shaving of axillary and pubic hair a feature of suicide in the Muslim community?

In the Islamic context, "fitrah" refers to humanity's innate disposition toward virtue and the ability to differentiate between right and wrong. A common quote regarding fitrah, from the Prophet is "The fitrah consists of 5 things: circumcision, trimming the moustache, cutting the nails, plucking the armpit hairs, and shaving the pubic hairs."In this study, our aim was to determine the status of axillary and pubic shaving in medicolegal death cases that took place in the Konya Province of Turkey and to evaluate the relationship with the origin of suicide. Of 2850 medicolegal death cases, 206 (7.2%) were of suicidal origin. It was observed that the average age in the cases of suicidal origin was 36.76 +/- 17.72 years, and 146 of 206 cases (70.9%) were men. As a method of suicide, hanging was the chosen method in 100 cases (48.5%), whereas firearm injuries occurred in 54 cases (26.2%), and intoxication was involved in 37 cases (18.0%). Daily axillary and pubic shaving was observed in 26 of 2644 (1.0%) death cases that occurred with nonsuicidal reasons, but in 65 of 206 were (31.6%) suicidal cases. Because suicidal notes were present in 25 (12.1%) of all of the suicidal cases, the ratio of daily axillary and pubic shaving was significantly higher than that of the suicidal notes.In investigating the cases of suicidal origin for medicolegal purposes, evidence showing that this action was committed by the victim, the presence of a suicide note at the death scene and, a history of a previous suicidal attempt, it was thought that the presence of daily axillary and pubic shaving on external examination of the victim's body, when of Muslim faith, could also be considered a feature of suicide.

The effects of low thyroid hormone levels on the formation of stress gastritis: an experimental study on the rats.

BACKGROUND: The aim of this study was to investigate the effect of low circulating thyroid hormone levels on the development of acute stress gastritis in rats. METHODS: Sixty adult Sprague-Dawley rats were divided into six groups: Control group, surgically thyroidectomized group, stressed group, surgically thyroidectomized + stressed group, surgically thyroidectomized + T4 + stressed group, and surgically thyroidectomized + T3 + stressed group. Damage to the gastric mucosa was studied using millimetric acetate papers on photographs enlarged 3.5 times and the number and the size of the lesions was recorded. RESULTS: Acute stress gastritis was significantly increased in stress + surgically thyroidectomized rats as compared to rats that were only put under stress (group III) (stress gastritis scores; group IV: 44, group III: 16, p<0.001). The stress gastritis score in group VI was significantly decreased compared to rats in group IV (stress gastritis scores; group VI: 10, group IV: 44, p<0.001). CONCLUSION: Low circulating thyroid hormone levels in rats increased the development of stress gastritis. This effect could be prevented by thyroid hormone replacement therapy.

Analysis of HumFABP2 as a polymorphic human genetic marker in the Turkish population.

OBJECTIVE: To examine the allele frequencies of HumFABP2 locus in 155 individuals from different regions of Turkey. METHODS: The study was carried out in Cumhuriyet University Hospital, Sivas, Turkey, between March and June 2006. The allele and genotype frequencies for HumFABP2 were determined by polymerase chain reaction (PCR) using the manufacturer's recommended protocol, and using the commercially available Macherey-Nagel DNA isolation kit. The PCR amplification was carried out in a Perkin-Elmer GeneAmp PCR System 9600 thermal cycler following the manufacturer's recommendations. The allele frequencies in the Turkish population was computed, and the heterozygote rate was calculated. RESULTS: In this population study of 155 samples, we found 75 (48.39%) heterozygote and 80 (51.61%) homozygote. The results showed heterozygotic cases as 150/250 bp, and homozygotic cases as 150 bp. CONCLUSION: Allele frequency data of HumFABP2 as a PCR-based genetic marker could be used in identity testing to estimate the frequency of a multiple PCR based profile in the Turkish population.

[Secondary victimization of traffic accident victims: getting buried without the declaration of forensic case and without having performed autopsy]. / Trafik kazasina maruz kalan olgularda ikincil magduriyet: Adli olgu bildirimi yapilmadan veya otopsi uygulanmadan defnedilme.

BACKGROUND: In this study, it was aimed to analyze the cases of traffic accident related deaths, buried without performing autopsy, in order to increase awareness of the physicians about declaration liability of forensic cases and also emphasize the declaration of the forensic case and autopsy importance. METHODS: In the First Specialization Board of Council of Forensic Medicine, 542 cases of death, reported between the years 2004-2008, who were involved in traffic accidents and buried without an autopsy performed, were evaluated retrospectively. RESULTS: It was found that 69.4% of the cases (n=376) were males, whereas %30.6 (n=166) were females; mean age was 58.5±20.9 (range, 3-98 years). Age 61 and above was the most frequent age group with 301 cases (55.5%). Of the cases, 336 (62.0%) had died in hospital, 241 (44.5%) had died in 1-12 months following the accident and medico-legal corpse examination was performed only in 123 (22.9%) cases. Three hundred fourty-four (63.5%) of the cases were not reported as forensic cases and death certificate was signed by any physician other than medical examiner without being declared as a legal case. According to the decisions of Board, since an autopsy was not duly performed, the cause of death could not be determined for 95 cases (17.5%) and for 57 cases (10.5%), it was not possible to determine whether there was causality between the accident and death. DISCUSSION: Our findings emphasize the importance of declaration of forensic cases and performing autopsy in time in traffic accident victims.

Forensic nursing in Bolu, Turkey: a survey.

Forensic nursing is generally considered to be the application of the forensic aspect of health care combined with the bio-psychosocial education of the registered nurse in the scientific investigation and treatment of trauma and violence. In 1990 the term forensic nursing was established in the USA and has been developing in many countries as a subdivision of forensic sciences a nursing since. The first masters thesis with the subject of forensic nursing was written in 1997 at Istanbul University, Institute of Forensic Sciences. The aim of this survey is to outline the approach to forensic nursing by nurses in the province of Bolu, Turkey, and to determine the influence of education at undergraduate level and continuing education programs lectured in Istanbul. In this study, a questionnaire has been applied at random to clinical nurses and nursing educators, a total of 101 participants. 11 out of 18 questions, has also been compared with results acquired from Istanbul in 2002. The results were defined using SPSS and Primer statistics software. The results of this research revealed, that no formal training/education in clinical forensics has been received. It is suggested that formal education programs have to be developed at both, undergraduate and postgraduate levels, providing initial and continuing education.