An Evaluation within the Context of the Istanbul Protocol of the Medico-Legal Examinations of Turkish Detainees during the Recent State of Emergency in Turkey.

The present study evaluates the reported medical examination procedures in Turkish detention facilities of Turkish detainees who sought asylum in Germany after their detention in Turkey and the present process of medico-legal reporting, to evaluate compliance with the principles of the Istanbul Protocol and to discuss the issue in the context of the literature. Fifty-one participants were asked questions related to the examination steps specified in the Istanbul Protocol. 61% of participants were examined in an inappropriate place according to Istanbul Protocol. 42 participants (82.3%) claimed they had been mistreated through beatings, improper application of handcuffs, being forced to stand up for a long time, lying on bare concrete floors, staying in confined spaces without fresh air, and psychological torture. The answers given by the participants revealed that not all medical examinations conducted by the Turkish authorities during the detention were carried out in accordance with the Istanbul Protocol.

Diabetes and driving safety.

Diabetes is one of the most common chronic disease in the world. The complications of diabetes both during the disease progression and treatment may cause problem escpecially in traffic. A training on driving safety should be given to diabet patients after diagnosis. Necessary training and legal arrangements should be made in order to increase the awareness in both driving schools and care centers of diabetic patients.

Death in childhood and adolescence: Accident!

In childhood and adolescence periods, individuals encounter many dangerous situations caused by not completing their biological and psychological development. Some of them are pathological deaths such as accidents, poisoning, and traumatic actions for children. Awareness of the number and causes of death is an indicator that reflects the health status of our society. It is also vital in-service planning for both preventive and therapeutic medical professions. The purpose of this article is to evaluate death cases between the ages of 0-18 in terms of forensic medicine. As a result, it has been understood that accidents are an important cause of death in childhood. In particular, developing policies to protect against common accidents will reduce the mortality rates of children.

Precautions in postmortem examinations in Covid-19 - Related deaths: Recommendations from Germany.

The Covid-19 pandemic is also a considerable risk for forensic workers, among other healthcare providers. The risk of contamination is serious in post-mortem procedures. SARS-CoV2 is a microorganism classified as Hazard Group 3. However, the lack of adequate scientific work on Covid-19 should prompt us to be even more cautious when handling potentially infected persons or materials. Before starting the post-mortem investigation a risk assessment should be carried out and the suitability of facilities, personnel and equipment should be evaluated. An autopsy room conforming to BSL 3 standards would be ideal but is not mandatory. For suspicious or approved cases however a number of procedural changes must be made concerning the body's removal, storage and inspection procedures. Facilities, equipment and training issues need to be revised against existing and potential risks of infection. In addition to proper ventilation and insulation, personal protective equipment, aerosol reduction measures and disinfection applications are required. As of yet it is still unclear how long this public health issue, which has grown to become a pandemic, will last. This article highlights preventive measures to be taken into consideration in post-mortem processes when a Covid-19 infection is suspected or confirmed. It should be noted that there is no standard guide yet in this regard. A guide should be created according to international standards and revised according to changing conditions.

Evaluation of medical examination of forensic medicine specialists during / after detention within the scope of Istanbul Protocol.

INTRODUCTION: The Istanbul Protocol is a document prepared by many scientists from different countries and accepted by the United Nations thematising the medical reporting of torture. Normally, forensic specialists are responsible for medical examinations of torture victims, but this study looks at forensic specialists who were themselves subject to torture and mistreatment. It aims to analyze and evaluate, especially with regard to the Istanbul Protocol, the medical examinations performed on them while they were in detention. MATERIAL/METHOD: This study includes experts in forensic science who were detained during and after the state of emergency that was declared in 2016 in Turkey. Participants were asked questions regarding the examination steps specified in the Istanbul protocol. The Google Forms system (Google Inc., CA/USA) was used for the surveys, sent to the participants via text message. RESULTS: Twenty-two forensic scientists who were detained during and after the state of emergency in Turkey participated in this study. 45.5% of the participants were not asked for identification before their medical examination in detention. 36.4% of the participants stated that police were present in the examination room. Only 13.6% of participants found the privacy conditions during the examination appropriate. 90.9% stated that the time allocated for the examination was insufficient. The medical examinations lasted from 10 s to 10 min. Most participants were examined in less than 5 min. When asked if they were abused, 22.7% stated that they were not tortured, and 77.3% stated that they were subjected to torture or mistreatment practices, such as beatings, inappropriate use of handcuffs, being forced to wait or being rushed unnecessarily, being abandoned in isolating or hostile environments. In addition, the questions required to assess the psychological indications of torture and maltreatment were never asked in 40.9% of the cases. DISCUSSION AND CONCLUSION: Although torture is prohibited by international and humanitarian law, it has not completely disappeared. Medical personnel play an important role in torture assesment and prevention. The testimony of the forensic experts, who were fired and detained, revealed that the medical examinations during and after the State of Emergency in Turkey did not comply with the Istanbul Protocol and ethical rules. Medical examinations not carried out in accordance with the Istanbul Protocol lead to the denial of many rights and health problems. A worldwide awareness and sensitivity is needed to solve this problem.

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.

The Prevalence of Hepatitis B and C Among Prisoners in Kahramanmaras, Turkey.

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are among the most important health issues in Turkey. Human immunodeficiency virus (HIV) infections are less frequently observed in the country. The individuals who had blood transfusions, patients undergoing hemodialysis, and intravenous drug addicted individuals, people who had tattoos/piercings, communal living environments, contamination of a family member, and prisoners are the main risk groups. OBJECTIVES: The current study aimed to discuss the prevalence and the genotypes of hepatitis and HIV infections among a specific group, namely individuals incarcerated in prisons. PATIENTS AND METHODS: Two-hundred and sixty-six prisoners sentenced for crimes such as robbery, sexual assault, assault substance abuse or selling drugs in the Kahramanmaras closed prison were recruited for the study. Demographic data and the presence of hepatitis B, hepatitis C and HIV were investigated in the study subjects. RESULTS: Out of the 266 cases included in the study, 89.5% were male, 10.5% were female and the mean age was 31.21 ± 8.99 years. Risk factors were detected in 27.4% of the subjects. Out of the 73 subjects, among whom the risk factors were detected, 20.3% had intravenous substance use, 3.8% had a history of operation/transfusion, 1.9% had a history of indentation and 1.5% had unprotected sexual contact. The rate of hepatitis B surface antigen (HBsAg) positivity was 2.6%, the ratio of anti-HBs positive subjects was 35.0% and immunity was achieved with vaccination in 43% of the subjects. Anti-HCV was positive in 17.7% of the prisoners and the genotype 3 and genotype 1 were 68.1% (n = 32) and 2.1% (n = 1), respectively. CONCLUSIONS: Continued substance abuse among most of the drug addicted individuals in prisons, common use of injection materials, tattoos and other circumstances that cause blood contact increase the risk of blood-borne infections.

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.