Dark side of customs: scalding burns in childhood due to use of traditional teacup and teapot, in Turkey.

The most common type of burn among children is scalding burn. This study aims to reveal child abuse and neglect as a specific etiological factor that specific to our country, traditional teapot- and teacup-related scalding burns. Burn cases that admitted to our Burn Center were investigated, and among these, 72 cases suffering from scalding burns were included in the study. The interview forms issued upon admission of these cases were evaluated in detail. Out of 148 scalding burn cases, 48.6% were related to the use of traditional teapots and teacups. After a detailed assessment, all cases were considered neglect-related burns. As a result of considering the role of traditional teapots and teacups in pediatric injuries in our country, parents and caregivers should be warned about these types of injuries. Also, physicians must determine the possibility of child abuse or neglect in all pediatric burn cases.

Estimation of time since deposition of semen stain on different fabric types using ATR-FTIR spectroscopy and chemometrics.

Various body fluids such as blood, semen, vaginal secretions, and saliva are frequently encountered at crime scene. In cases of sexual assault, semen stains are one of the most reliable evidence of biological origin. In this study, our objective was to develop a method for estimating the time since deposition of semen stains on five different fabric types using Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) Spectroscopy, with a focus on a time frame of up to 8 weeks. Semen samples from six different volunteers were dripped onto five distinct fabric materials, and ATR-FTIR measurements were obtained at 17 different time points. Principal component analysis (PCA) and partial least squares (PLS) methods were employed to differentiate semen stains on various fabric samples and estimate the age of semen stains. Models constructed using PCA and PLSR achieved high R2 values and low root-mean-square error (RMSE). While the performance varies depending on fabric types, it was observed that age estimation of semen stains can be made within following intervals: 0.39-0.76 days for 0-7 day range, 2.59-3.38 days for the 1-8 week range, and 3.98-8.1 days for the 0-56 day range. This study demonstrates the effectiveness of using ATR-FTIR spectroscopy in combination with chemometrics to estimate the age of human semen stains on various fabric types based on time-dependent spectral changes.

Overcoming obstacles: Analysis of blood and semen stains washed with different chemicals with ATR-FTIR.

INTRODUCTION: Blood and semen stains are the most common biological stains encountered at crime scenes. The washing of biological stains is a common application that perpetrators use to spoil the crime scene. With a structured experiment approach, this study aims to investigate the effects of washing with various chemicals on the ATR-FTIR detection of blood and semen stains on cotton. MATERIALS AND METHODS: On cotton pieces, a total of 78 blood and 78 semen stains were applied, and each group of six stains was immersed or mechanically cleaned in water, 40% methanol, 5% sodium hypochlorite solution, 5% hypochlorous acid solution, 5 g/L soap dissolved pure water, and 5 g/L dishwashing detergent dissolved water. ATR-FTIR spectra gathered from all stains and analyzed with chemometric tools. RESULTS AND DISCUSSION: According to performance parameters of developed models, PLS-DA is a powerful tool for discrimination of washing chemical for both washed blood and semen stains. Results from this study show that FTIR is promising for use in detecting blood and semen stains that have become invisible to the naked eye due to washing of the findings. CONCLUSION: Our approach allows blood and semen to be detected on cotton pieces using FTIR combined with chemometrics, even though it is not visible to the naked eye. Washing chemicals also can be distinguished via FTIR spectra of stains.

Ear as an alternative sampling site for GSR analysis following shotgun discharge.

Detection of GSR particles potentially indicates that a person fired a gun or somehow involved to a shooting event. GSR on the shooter's hand, face, and clothing may disappear within hours and with sweat secretion, washing or cleaning to remove evidences. Due to its anatomical properties, ears are relatively protected; therefore, we aimed to identify GSR particles on ears, to compare its anatomical parts of ears, and compare ears with common GSR sampling sites, based on firing frequency. A 12-gauge semi-automatic shotgun was used. In the 4-week study, one shot in the first week, two consecutive shots in second week, three shots in third week, and five shots in fourth week were fired by six participants. Samples were taken from MAE, CA, and AAECA of both ears and common GSR sampling sites. The characteristic 3-component structure (Pb/Sb/Ba) of the samples was analyzed by SEM/EDX. Right CA was the most suitable area for sampling, which might be attributed to posture of body during targeting. Right ear was the most suitable area to take samples from CA or MAE in 3-shot group. Besides, left AAECA in 1- and 2-shot groups and the left MAE in 5-shot group were the most suitable areas for GSR sampling. In conclusion, ear seems to be a valuable alternative for detection of GSR particles, due to its complex anatomical structure potentially preventing loss of GSR with daily cleaning. Findings suggested that crime scene investigation teams and criminal laboratory staff should consider ear as a valuable alternative for GSR detection.

Omics era in forensic medicine: towards a new age

Background/aim: Forensic medicine and sciences is a multidisciplinary branch of science, which frequently benefit from novel technologies. State of the art omics technologies have begun to be performed in forensic medicine and sciences, particularly in postmortem interval, intoxication, drugs of abuse, diagnosis of diseases and cause of death. This review aims to discuss the role and use of great omics (metabolomics, proteomics, genomics and transcriptomics) in forensic sciences, in detail. Materials and methods: A detailed review of related literature was performed, and studies were subdivided as per the type of omics. Results and conclusion: Omics seems as a revolutionary step in forensic science and sure carries it towards a new age. The number of forensic studies utilizing omics steadily increases in last years. Omics strategies should be used together in order to gather more accurate and certain data. Additional studies need to be performed to incorporate omics into routine forensic methodology.

Nanotoxicity: a challenge for future medicine

Background/aim: Due to nanomaterials' potential benefits for diagnosis and treatment, they are widely used in medical applications and personal care products. Interaction of nanomaterials, which are very small in size, with tissue, cell and microenvironment, can reveal harmful effects that cannot be created with chemically identical and larger counterparts in biological organisms. In this review, a challenge for future medicine, nanotoxicity of nanomaterials is discussed. Materials and methods: A detailed review of related literature was performed and evaluated as per medical applications of nanomaterials their toxicity. Results and conclusion: Most authors state "the only valid technology will be nanotechnology in the next era"; however, there is no consensus on the impact of this technology on humankind, environment and ecological balance. Studies dealing with the toxic effect of nanomaterials on human health have also varied with developing technology. Nanotoxicology studies such as in vivo-like on 3D human organs, cells, advanced genetic studies, and -omic approaches begin to replace conventional methods. Nanotoxicity and adverse effects of nanomaterials in exposed producers, industry workers, and patients make nanomaterials a double-edged sword for future medicine. In order to control and tackle related risks, regulation and legislations should be implemented, and researchers have to conduct joint multidisciplinary studies in various fields of medical sciences, nanotechnology, nanomedicine, and biomedical engineering.

Surface enhanced Raman spectroscopy as a novel tool for rapid quantification of heroin and metabolites in saliva

Background: Heroin can be detected and quantified by certain analytical methods, however, forensic professionals and criminal laboratories study for cheaper and faster detection tools. Surface-enhanced Raman spectroscopy (SERS) rises as a possible alternative tool with its widening application spectra. There are few studies regarding Raman and SERS spectra of heroin and its metabolites, which are unfortunately controversial. In this study, we compared five different surfaces in order to find out more efficient Raman-active substrate for opiate detection and rapid quantification of heroin and its metabolites in saliva. Materials and methods: Morphine standard material was used to identify proper surface for SERS analysis of opiates. Heroin and its metabolites (morphine, morphine-3-ß-glucuronide and 6-monoacetyl morphine) were calibrated between 50 ppb and 500 ppm and quantified on AuNRs with signal enhancement of silver colloids in saliva. Raman microscope with a 785-nm laser source was used. Results and Conclusion: Obtained results showed that heroin and its metabolites can be detected and quantified in saliva samples using a SERS-based system. Additionally, the present study revealed that synergetic effect of a specific gold nano-surface with ability controlling liquid motion and silver nanoparticles increase band numbers and intensities. Therefore, we suggest a fast, accurate and cost-effective method to detect and quantify heroin in biological fluids

The unexpected effect of Syrian civil war in Turkey: Change of forensic postmortem case pattern.

In the last decade, the whole world has witnessed a chaotic process characterized by uprisings, revolutions, and wars in the Middle East. The Syrian civil war, with its local and global consequences, is the most destructive of these events. Social and economic aspects of the effects of the Syrian civil war were discussed in detail. However, the change in forensic postmortem case pattern of neighboring countries remains unclear. Here, we aim to discuss the effects of the Syrian civil war on forensic postmortem case patterns in Turkey as a neighboring country, with possible causes and suggestions. The postmortem case patterns of the 5-year period before the beginning of the Syrian war (2006-2011) and the next 5-year period after the start of the war (2012-2016) were investigated retrospectively. This aims to reveal the possible effects of the Syrian civil war on forensic postmortem case pattern of Turkey in relation to the assault deaths of statistics of Turkey. We found that explosion-related and firearm-related death cases significantly increased after the Syrian civil war. The dramatic increase in the explosion-related deaths can be attributed to terrorist attacks. Wounded civilians during the civil war were admitted to health units and hospitals in the south and southeast parts of Turkey, which consequently result in a crisis in the application of health services. There was no significant difference in Turkish death statistics, however forensic case pattern was affected.

Medicolegal evaluation of a maternal filicide attempt: a case report.

Foto-Özdemir D, Balseven-Odabasi A, Teksam Ö, Karadag F, Akçan F, Yilmaz E. Medicolegal evaluation of a maternal filicide attempt: a case report. Turk J Pediatr 2019; 61: 622-628. Filicide mainly refers to the murder of a child by his/her parents. Even though filicide is a rare event, outcome of filicide is more severe compared to other types of murders. In this report, we aim to discuss the factors in which the case of a woman who attempted to kill her 2.5-year-old daughter along with the demographical characteristics. Twenty-nine-year-old mother attempted to kill her daughter by hanging. Even though the victim did not die as the mother, regretted her action the triggers and the plot of the case discussed within the filicide framework. Therefore, the presented case report would contribute to the understanding of the nature of the filicide, and it might bring a different perspective, because of the different development process of filicide, sharing the disorder and interwoven motivations between the child and mother. In this respect, we aim to draw attention of pediatricians, child psychiatrists and forensic pathologists about the importance of filicide.

Hepatotoxicity of illegal home-made alcohols.

OBJECTIVE AND AIM: Alcohol-related hepatotoxicity is not only caused by excessive alcohol consumption but also caused and even accelerated by hepatotoxic ingredients other than ethanol. Concentrations of hepatotoxic substances might be significantly high, particularly in illegally produced home-made alcohols. In this study we aim to analyze the hepatotoxic effects of a home-made alcohol traditionally called "bogma raki" in Turkey. MATERIALS AND METHOD: Fifty Wistar albino male rats were used. Five groups were randomly formed with ten animals in each. Besides laboratory diets, groups were fed as follows: Group 1 (control group) distilled water; Group 2 bogma raki with distilled water (%44 (v/v), 9.2 ml/kg/day); Group 3 bogma raki with distilled water (%44 (v/v), 9.2 ml/kg/day)+walnut (10 g/kg/day); Group 4 whisky with distilled water (%40 (v/v), 9.2 ml/kg/day); Group 5 distilled water + walnut (10 g/kg/day), for 28 days. The toxicological analysis of The spirits were analyzed using Hewlett-Packard (Palo Alto, CA) GC/MS system with HP 6890 gas chromatograph, an HP 5972 mass selective detector (MSD) and an HP 6890 automatic liquid sampler GC/MS; the pressure of the carrier gas helium was 6.0 bar and the split value with a ratio of 1:100. The injection unit temperature set to 250 °C and MS quadrupole temperature set to 280 °C. The MS quadrupole detector ionization energy set to 70 eV. The initial column temperature was 60 °C (for 4 min) programmed by 6 °C/min to final temperature 160 °C and kept for 8 min at 160 °C. Utilized whisky and bogma raki samples were analyzed for the amounts of trans-anethole, ethanol, methanol, 1-propanolol, butanol, 2-butanol, 2-methyl-1-propanolol (isobutanol) and 3-methylbutanol (isoamyl alcohol). Histopathological changes in liver tissues were graded as follows; normal = 0 (<10%), mild = 1 (10%-40%), moderate = 2 (40%-70%), severe = 3 (above 70%). RESULTS: Chemical composition of illegally produced raki sample (%v/v) was as follows: trans-anethole %1.93, ethanol %95.70, 2-methyl-1-propanolol (isobutanol) %0.19, asetic acid %0.25, 3-methylbutanol (isoamyl alcohol) %0.77, and others %1.16. Chemical composition of commercial whisky sample (%v/v) was as follows: ethanol %97.72, 2-methyl-1-propanolol (isobutanol) %0.57, asetic acid %0.23, 3-methylbutanol (isoamyl alcohol) %1.28, and others %0.2. No traces of trans-anethole were detected in whisky. Normal liver morphology was recorded in control and walnut groups. However, bogma raki caused significant congestion and inflammatory cell infiltration compared to control and walnut group. On the other hand, whisky administration caused mild degeneration including inflammation in a limited area. CONCLUSION: Obtained findings suggest that trans-anethole containing alcoholic beverages are more hepatotoxic compared to commercial alcoholic beverages.

General Characteristics of Child Sexual Offenders in Hatay, Turkey.

OBJECTIVE: Child sexual offenders are a poorly studied and relatively neglected population in our country. This study aims to evaluate the relationship between criminal behavior and socio-demographic characteristics of a series of child sexual offenders. MATERIALS AND METHODS: The records of social worker interviews with 48 child sexual offenders between 2009 and 2013 were used. The reports issued by social workers regarding child sexual offenders were retrospectively examined, since these reports were relatively the most thorough documents including offenders' personal and familial characteristics, and criminal event information. Cases were investigated in terms of socio-demographic and psychosocial characteristics. RESULTS: There were 48 children interviewed based on an alleged sexual crime, during four-year of study period. All of the cases were male and their ages ranged between 12 and 17 years. Of these, 50% were students at any grade of school. Five cases were living in social service facilities. Only two cases involved incest. Of all, three offenders were accused of repeated sexual crimes. Type of sexual assault was anal penetration in 20 (41.7%) cases. Of all cases, 19 were cigarette smoker, while 4 were drug abusers. The families of 12 (25%) cases suffered from low socio-economic status, while 23 (47.9%) offenders were members of broken families. According to social worker reports, 47 cases had criminal responsibility based on their psychosocial development. Out of all cases, 7 children were suspected of suffering from impulse control disorder and one was suspected to be mentally retarded. Twelve cases were reported to need consulting and social protective services. CONCLUSION: The rate of offenders with interrupted education was considerably high. Interestingly the number of male victims and the frequency of cases involving anal penetration were high. Obtained results suggest that male children of broken and scattered families, and particularly those lacking father's supervision were more likely to commit a sexual crime.

Violence against women: A series of autopsy studies from Istanbul, Turkey.

Death is the most severe consequence of violence against women. The purpose of this study was to determine the frequency of violence-related deaths among women and the general characteristics of fatal violence cases against women in Istanbul, Turkey. A total of 20,486 forensic autopsies performed between 2006 and 2010, in Istanbul, were retrospectively analyzed. Of these, 537 violence-related deaths among women were included in the study. The victims were investigated in terms of sociodemographic characteristics, exposed type of violence, and autopsy findings. Out of all female deaths (n = 4165), 12.9% were due to violence against women, which comprised 2.6% of all autopsies (n = 20,456) performed during the study period in Istanbul. The median age of the victims was 43 years, and a significant proportion of victims (49.7%) were between the ages of 21 and 40 years. The deaths occurred most commonly in private residences (51.2%, n = 275), whereas the street was the crime scene for 14.5% (n = 78) of cases. Firearm injuries (50.1%, n = 269) were the most common cause of death, followed by stab wounds (28.3%, n = 152) and strangulation (8.4%, n = 45). Among the identified perpetrators, 52.3% were victims' spouses or boyfriends. The perpetrators were female in 4.4% (n = 16) of cases. Istanbul is the most important and cosmopolitan city of Turkey, representing the country's cultural characteristics. Therefore, the data obtained in this study may be strong indicators of violence against women in Turkey.

Idiopathic giant cell myocarditis in childhood: A case report.

Idiopathic giant cell myocarditis is a rare entity of unknown origin, which causes sudden death in more than half of the affected patients. It is rarely seen in childhood, and might result in death due to heart failure and ventricular arrhythmias. Idiopathic giant cell myocarditis is mostly diagnosed at autopsy incidentally. Here we present a rare case of childhood idiopathic giant cell myocarditis. A 10-year old boy found dead in his bed in the morning. Interview with family members revealed death the boy was in good health conditions apart from being overweight. At autopsy, external examination was completely normal. Internal examination revealed normal findings; the heart was 297g and macroscopically normal. No traces of any toxic agents detected in complete toxicological analyses. Areas characterized with granulomatous lesions, lymphocytes, histiocytes, and multinucleated giant cells were observed in myocardium at histopathological examination. No necrosis was observed in granulomatous areas. Tuberculosis was negative in the PCR assays. There were no signs indicative of fungal infection, and clinical status of the case was not compatible with the sarcoidosis. In this respect death was attributed to idiopathic giant cell myocarditis.

Analysis of methanol and its derivatives in illegally produced alcoholic beverages.

INTRODUCTION: Illegal alcohol production remains as a common issue worldwide. Methanol poisoning mostly occurs because of the methanol used in production of counterfeit alcohol instead of ethyl alcohol due to its low price or by drinking the liquids containing methyl alcohol. Pectolytic enzymes results in an increase of methanol levels in many fermentation products such as ciders or wines. Methanol poisonings are infrequently encountered in forensic medicine practice. However, sporadic cases due to methanol intoxication as well as epidemic cases have been reported. In this study, we aimed to identify existence of methanol and its metabolites in illegally produced alcoholic beverages used in Antakya region. MATERIAL AND METHODS: Twelve legally produced alcohol samples and Fifty-six different illegally produced alcohol samples were collected from the markets and local producers. Existence of methanol, formic acid, methyl amine, methyl formate and trioxan were determined using GC-MS method in these samples. RESULTS: Fifty-six different illegal alcohol samples were analyzed in this study and methanol was detected in 39 (75%) of samples. Formic acid was detected in 3, formamide in 1, methyl amine in 6, methyl formate in 10 and trioxan in 2 samples. CONCLUSION: Overwhelming majority of illegal alcoholic beverages was detected to contain methanol. Interestingly this study also revealed the presence of trioxane, which has not previously reported among toxic agents in illegal alcohol samples.

Forensic medicine evaluation of Alzheimer patients: a series from Ankara, Turkey.

BACKGROUND/AIM: Pathophysiological changes due to Alzheimer disease and increasing age might result in situations requiring forensic evaluation in the elderly. Judicial bodies might need forensic evaluation of trauma and the decision-making capacity of Alzheimer patients. This study aimed to determine the demographic and clinical characteristics of Alzheimer patients seen for forensic evaluation. MATERIALS AND METHODS: Forensic records issued by the Department of Forensic Medicine of Hacettepe University in 2012 and 2013 were investigated. Patients with Alzheimer disease were included in the study and were analyzed in terms of age, sex, reason for application, comorbid medical conditions, occupation, and place and status of living. RESULTS: There were 30 Alzheimer patients examined in the study period. Of these, 17 (56.6%) were male and 13 (43.3%) were female. The patients' ages ranged between 51 and 90 years, and the mean age was 78.7 years. The majority of cases (25, 83.3%) were transferred for evaluation of decision-making capacity, while only 5 (17.7%) were referred to our department for forensic reporting of bodily damage. CONCLUSION: Forensic reporting of bodily damage in Alzheimer patients is similar to common injury cases. However, in conditions requiring evaluation of decision-making capacity in Alzheimer patients, all records should be carefully examined and a complete neuropsychiatric evaluation should be performed.

Elderly deaths in Ankara, Turkey.

According to World Health Organization, the life expectancy at birth is increasing. An increase in life expectancy might result in increased morbidity and mortality in elderly. The increase in the elderly population also leads to an increase in medico-legal problems, as well. Autopsy is of high importance for determination of cause of death in clinical and forensic cases. The purpose of this study was to find out general characteristics elderly deaths by examining forensic autopsy records. Out of 7033 forensic autopsies performed between years of 2007 and 2011, 1324 were elderly deaths and were included in the scope of the study. The records of public prosecutor office, crime scene investigation and autopsy findings were examined. The majority of victims (70.6%) were male, while 29.4% were female, with a male to female ratio of 2.4/1. Victims' ages ranged between 65 and 96 years, and the mean age was 74.8 years. A great number of presented elderly deaths were due to unnatural causes, followed by natural deaths cases. Out of unnatural deaths, 63.2% were related to accidents, 23.7% were suicides, and remaining 13.1% were homicides. More than half (56.6%) of all suicidal deaths were due to hanging. Of natural deaths, the majority (82.7%) were due to cardiovascular system disease. In the presented series the cause of death was determined in 90.9% of all elderly deaths, which validates the need for a forensic autopsy. Data obtained through autopsy procedures is of high importance for death statistics.

Fatal aorto-esophageal fistula in child: a case report.

Esophageal foreign body ingestion is especially frequent in childhood and may cause fatal complications in case of late diagnosis and delayed treatment. We present a case of 2-year old girl who was admitted to emergency department with massive bleeding. However, she died due to an unrecognized foreign body resulted an aorto-esophageal fistula. At autopsy an aorto-esophageal fistula was detected by gross examination. Tissue samples were obtained from the organs and fistula region. In histopathological examination, a calcified body with multinucleated giant cell and surrounding granulation tissue was detected at the bleeding site. An ulcerated fistula tract ran from the intima to the adventitia, passing through layers of esophageal wall was also noticed. The mortality rate for foreign body ingestion is less than 1%, except in cases of perforation. Therefore the presented case is among rare examples of fatal foreign body ingestions.