Religion, Culture, and Autopsy: A Survey With Muslim Religious Officials.

The autopsy maintains its significance both forensically and medically despite enormous developments in antemortem and postmortem diagnostic methods. The present study probes the knowledge, attitude, and behavior of religious officials in our city toward autopsy and make an evaluation of how religion and culture affect those factors.The study consists of 219 Imams (male) and 69 Quran instructors (female) who serve in urban and rural regions of Kahramanmaras and approved informed consent forms.Two hundred thirty (79%) of the participants stated that the autopsy was an appropriate process according to Islam; 1 (0.3%) stated that it was inappropriate, whereas 57 (19.8%) were observed to have no idea regarding its appropriateness.The mean knowledge score that participants had about autopsy was determined to be 7.45 ± 1.73 (min = 1, max = 10).On the other hand, 240 participants (83.3%) stated that it was important for the religious officials to inform the society about the autopsy.The negative attitude toward autopsy stems from the lack of knowledge and traditions. The religious officials could help the doctors to change the negative attitude stemming from tradition toward the autopsy.

Death by Wheat-Loaded Cartridge: A Case Report.

The materials used to produce shotgun ammunition can have different properties depending on the purpose, and ammunition can be fabricated or loaded manually. In Turkey, wheat-loaded cartridges are manufactured for use as sound cartridges. This ammunition is understood by the public to be harmless. However, we present a case of a 13-year-old adolescent boy who was wounded from a contact shot to the chest. An entrance wound measuring 7 cm and 5 cm in diameter was seen on the skin. Wheat grains could not be detected in the internal organs and were only observed between the chest muscles around the entrance wound. A plastic wad was also found in this area. The cause of death was internal bleeding due to internal organ injury. Wheat-loaded cartridges are not visible on x-ray and are difficult to detect visually in the wound.

A novel catalyst system for the synthesis of N,N'-Methylenebisacrylamide from acrylamide.

N,N'-Methylenebisacrylamide (MBAA), which is an important raw material in a widely industrial area, was synthesized using convenient catalysts. The synthesized monomer was fully characterized by the elemental analysis, fourier transform infrared (FT-IR) spectroscopy, thermogravimetric analysis (TGA), 1H-NMR, 13C-NMR, GC/MS, and high performance liquid chromatography (HPLC) analysis. Six different homogeneous and heterogeneous catalysts were used to obtain maximum monomer yield. The MBAA was obtained with 95% yield by using Cu(II) catalyst containing carboxylate groups ligands.

Effectiveness of Mortuaries in Turkey: A Questionnaire Study.

AIM: The autopsy is an important step in solutions of forensic cases. The design and effectiveness of mortuaries are of great importance in terms of proper conduction of death examinations and autopsies. In addition, the safety of evidence, protection of public and staff health, and the quality of service offered to relatives of dead people are closely related to the effectiveness of mortuaries. The aim of this study was to determine whether mortuaries in Turkey meet international criteria. MATERIALS AND METHODS: Nineteen mortuaries were included in the study. The forensic medicine experts working in these mortuaries were given a questionnaire composed of questions about standards developed by the National Association of Medical Examiners (NAME) through the website my.questbase.com. RESULTS: Most of the mortuaries outside big cities (80%) did not have their own facilities. All of them could not control the chain of evidence and did not have a separate well-ventilated autopsy room where they could keep putrefied corpses. CONCLUSIONS: Most of the mortuaries did not meet most of the NAME criteria. The mortuaries, especially those in places other than big cities, had some deficiencies and mishandlings. Autopsy facilities and accessory laboratories should be enabled to meet NAME accreditation standards.

The transrectal single port laparoscopic radical prostatectomy in a cadaver model.

OBJECTIVE: To explore the feasibility of laparoscopic trans-rectal Natural Orifice Transluminal Endoscopic Surgery (NOTES) radical prostatectomy in a cadaveric model and to define anatomical landmarks of this surgical route. MATERIALS AND METHODS: After the ethical clearance, the study was conducted in Turkish Council of Forensic Medicine. With the cadaver in an exaggerated lithotomy position, a full thickness incision was made on the anterior wall of the rectum. The anteriorly visible Denonvilliers' fascia was incised sharply, exposing the posterior surface of the prostate. A single-port device (GelPOINT(®)Path) was inserted transanally passing the incision on the anterior wall of the rectum, into the bluntly created space between rectum and prostate. Three, 10 mm ports were placed through the GelPOINT(®)Path, at 3, 6, and 9 o'clock positions. A 5 mm, 0° degree lens was introduced at 6 o'clock position; followed by laparoscopic scissors and laparoscopic grasper. Prostatic and periprostatic anatomy was defined as encountered during each step of the procedure. RESULTS: Exposure of the posterior surface of the prostate and seminal vesicles was easily achieved. No additional openings of the rectal wall were made. Surgical specimen was extracted keeping its integrity. CONCLUSION: Transrectal radical prostatectomy is technically feasible in the cadaver model, being facilitated by previous experience with perineal surgery. Anatomical observations during the present experimental study suggest that the transrectal NOTES route provides good exposure of the operative field and easy access to the posterior surface of prostate, Future experimental endeavors should focus on reproducibility of this approach and feasibility of lymph node dissection using trans-rectal route.

Spontaneous Coronary Artery Dissection: Report of 3 Cases and Literature Review Hormonal, Autoimmune, Morphological Factors.

The number of cases with spontaneous coronary artery dissection (SCAD) is considered to be being underestimated because of a large amount of SCAD leading to sudden death without previous diagnosis. Besides, not only in clinics but also in autopsy practice, correct diagnosis of SCAD is important to prevent forensic malpractice.The article is intended to discuss the pathological findings through the forensic point of view for improving the malpractice expertise in scope of clinicians' timely antemortem diagnosis according to risk factors and in scope of forensic pathologists' the cause of death determination ability according to macroscopical and microscopical findings of the autopsy.In 3 cases reported, the main characteristics were the female sex, pregnancy history and a sudden death without any trauma. However, although there are many women giving birth or using oral contraceptives, only some of them are facing with SCAD. This suggests the possibility of some hereditary factors, whereas hereditary characteristics may be understood in many different ways like hormone-releasing regulating mechanisms as well as immunity, morphology, or any other mechanism. For instance, autoimmunity has been also a hereditary underlying factor for vessel injury considered in presented cases.

Accidental deaths by hanging among children in Istanbul, Turkey: retrospective analysis of medicolegal autopsies in 33 years.

Hanging is a type of strangulation by means of rope or any other similar material. This kind of ligature strangulation occurs by weight of the body dragging due to gravity and applying force to the neck. Hanging almost never occurs by accident, but occurs mostly as a way to commit suicide.A total number of 82,871 autopsies were performed in the Council of Forensic Medicine of the Republic of Turkey Ministry of Justice (Istanbul) between 1979 and 2012, and 4500 (5.43%) of these deaths occurred as a result of hanging. Thirteen of these reported cases have been observed and resulted in death occurring by accident. Seven of these victims were males, and 6 of them were females. Examination of their ages revealed that 3 of these victims were aged 1 year, and 3 victims were aged 6 years. The oldest victim was aged 13 years, and the youngest one was aged 1 year. It has been recorded that 8 of the deaths occurred with rope, 2 with sweater, 2 with scarf, 1 with belt, and 1 with tights. Investigation of the incidents revealed that 3 of the cases occurred by tangling in a rope swing and 2 with a head scarf. Ligature marks on the neck from aforementioned materials and ecchymosis on soft tissue were observed on all of the victims, and the thyroid cartilages and cervical vertebrae were intact. No substance was found in the toxicological analysis performed on all victims.In conclusion, our study showed that although accidental death by hanging took place rarely in these ages, all of the victims were between the ages of 1 and 13 years who recently started walking and entering their teenage years. It is important not to leave the children at home or in the playgrounds alone for a long time (unsupervised at home or in the playgrounds). Precautionary measures must be taken against danger, and the design of materials manufactured for this age group must be reconsidered.

Dynamic article: surgical anatomical planes for complete mesocolic excision and applied vascular anatomy of the right colon.

BACKGROUND: Lower local recurrence rates and better overall survival are associated with complete mesocolic excision with central vascular ligation for treatment of colon cancer. To accomplish this, surgeons need to pay special attention to the surgical anatomical planes and vascular anatomy of the colon. However, surgical education in this area has been neglected. OBJECTIVE: The aim of this study is to define the correct surgical anatomical planes for complete mesocolic excision with central vascular ligation and to demonstrate the correct dissection technique for protecting anatomical structures. DESIGN AND SETTINGS: Macroscopic and microscopic surgical dissections were performed on 12 cadavers in the anatomy laboratory and on autopsy specimens. The dissections were recorded as video clips. METHODS: Dissections were performed in accordance with the complete mesocolic excision technique on 10 male and 2 female cadavers. Vascular structures, autonomic nerves, and related fascias were shown. Within each step of the surgical procedure, important anatomical structures were displayed on still images captured from videos by animations. RESULTS: Three crucial steps for complete mesocolic excision with central vascular ligation are demonstrated on the cadavers: 1) full mobilization of the superior mesenteric root following the embryological planes between the visceral and the parietal fascias; 2) mobilization of the mesocolon from the duodenum and the pancreas and identification of vascular structures, especially the veins around the pancreas; and 3) central vascular ligation of the colonic vessels at their origin, taking into account the vascular variations within the mesocolonic vessels and the autonomic nerves around the superior mesenteric artery. LIMITATIONS: The limitation of this study was the number of the cadavers used. CONCLUSIONS: Successful complete mesocolic excision with central vascular ligation depends on an accurate knowledge of the surgical anatomical planes and the vascular anatomy of the colon.

Simultaneous homicide-suicide: a case report of double drowning.

Homicide-suicide is a tragic phenomenon which typically does not result in a criminal charge or trial. However, correct diagnosis and classification of homicide-suicide cases are important to determine the perpetrators and dynamics of each category properly. The deaths in the homicide-suicide acts can be divided into two categories with respect to the number of involved individuals: dyadic deaths and triple or multiple deaths. These two categories can also be divided into two subgroups according to the chronology of the incidents: simultaneous deaths and consecutive deaths. Herein, a simultaneous homicide-suicide case of a father and daughter where both deaths occurred through drowning which was not found in the selected literature review and where the victim was a child is presented. The article aims to clarify the term discrepancies about multiple death cases in the literature and to discuss the pathological and psychosocial characteristics of the simultaneous dyadic death cases.

Determining the number of intraparotid lymph nodes: postmortem examination.

BACKGROUND: The parotid gland is one of the metastatic drainage areas for malignant tumours of the head and neck area. In this study, we aimed to define the accurate number and distribution of intraparotid lymph nodes in the 84 glands of 42 fresh cadavers for implementing the data for the clinical practice. METHODS: Bilateral total parotidectomies were performed. The lobes were separated, fixed with formalin, cut into thick slices, embedded in paraffin and serially sectioned. 2 µm thick sections were stained and examined histopathologically. RESULTS: No nodes were found in 4 of 84 superficial parotid lobes and in 58 of 84 deep parotid lobes. CONCLUSIONS: Sentinel lymph node biopsy failure may be related to the absence of intraparotid lymphoid tissue. Although the superficial intraparotid lymph nodes are a first echelon of head and neck tumours, involvement of these does not allow us to exclude the possibility of involvement of the deep lobes.

Fatal cranial shot by blank cartridge gun: two suicide cases.

Blank firing pistols are generally considered to be harmless and these guns are not accepted as being firearms in most countries. Due to lack of legal regulations these guns are easily purchased by anyone aged over 18 years. Reports of serious injuries and even fatalities due to these guns are increasing in the literature. These guns when modified or even unmodified can cause serious and potentially fatal injuries. Without doing any changes to the barrel, using blank or tear gas cartridges, firing at contact range can cause penetration of gas into the body including bone originated from gun powder. We report two suicide cases shooting themselves at temporal region with a blank cartridge gun at contact range. There was no foreign body on radiological examination and there was no trajectory of a bullet inside the brain. In both cases the wound was at the right temporal region and there was defect at temporal bone. There was circular soot around this bone defect. The injury of the brain tissue was localized at the level of the defect but there was widespread subarachnoidal bleeding. We discussed the potential danger of these guns and stressed the need of legal regulations concerning these guns.