Evaluation of organ weights and ventricular thicknesses in electrocution related deaths based on autopsy reports: A biophysical approach.

OBJECTIVE: To evaluate autopsy reports of the deaths due to electrocution in terms of body mass index, body surface area, and organ weights with a biophysical perspective. METHODS: The retrospective study was conducted in Malatya, Turkiye, and comprised autopsy reports of electrocution cases that were obtained from the local branch of the Council of Forensic Medicine related to the period from 2012 to 2019. Organ weights and ventricular thicknesses were compared in terms of body mass index and body surface area. Electrical marks were also evaluated in detail. Data was analysed using SPSS 18. RESULTS: Of the 45 cases, 36(%) were male and 9(%) were female. The overall mean age was 39±13 years (range: 20-71 years). There were no significant differences in organ weights and ventricular thicknesses in different body mass index groups (p>0.05). The weights of head and heart were significantly different in relation to body surface area (p<0.05), but no significant difference were found for other organs and ventricular thickness (p>0.05). CONCLUSIONS: Comparing the organ weights in electrocution autopsies to normal organ weights may help decide the cause of death. During autopsy, electrical marks should be evaluated by considering the characteristics of the electrical current.

An experimental rat model of electric shock injury with isolated electric shock and water conduction: the histopathological changes on the skin and internal organs and the effect on biochemical parameters.

It is difficult to determine the cause of death in electric shock injuries when no trace can be determined on the skin, and this is accepted as a reason for negative autopsy. We aimed to determine useful parameters in the definition of the cause of deaths associated with electric shock and particularly those formed with water conduction. This study used a total of 42 rats, applied with fatal electric shock formed of isolated electric shock at 220 V and with water conduction. The serum NT-ProBNP and H-FABP levels were examined together with histopathological changes in the brain, cerebellum, brainstem, heart, liver and skin and the Bax, caspase-3 and HSP-60 antibody status in these tissues. A statistically significant difference was determined between the groups in respect of the serum H-FABP values and the immunohistochemical staining of the samples taken from the organs. In conclusion, this study is the first in literature with an experimental model of electric shock with water conduction. Using immunohistochemical and biochemical markers in deaths associated with isolated electric shock and electric shock with water conduction, the results of this study can contribute to the clarification of one of the reasons for negative autopsy in forensic medicine.

A 9-year retrospective review of lightning deaths from the Eastern Anatolian Region of Turkey.

In this study, deaths from lightning strikes in Eastern Turkey revealed distinct patterns in lifestyle and physical injury. Farmers, sailors, and those engaged in outdoor sports are all at risk of being struck by lightning. Death from a lightning strike is associated with cardiovascular and central nervous system damage. This study examines cases of autopsies that were performed on bodies that had suffered a lightning strike, including sociodemographic data, burns on the body, injured regions, histopathological findings, and causes of death. This retrospective evaluation included 17 cases. The cases comprised 88.2% males and 11.8% females, with a mean age of 41.5 years. The person's occupation was farmer in 29.4% of the cases and shepherd in 70.6%. Their deaths occurred most frequently in the summer months. Deaths associated with lightning strikes are more frequent in east of Turkey than in other regions, as agriculture and livestock are common sources of income. The majority of the victims among the cases were males working outside because of their occupations. Histopathologically, subarachnoid fresh bleeding was seen in five cases, subpleural fresh bleeding in the lungs in five cases, and interlobular rupture in the lungs in three cases. Deaths associated with lightning strikes have been correlated with a low level of education in this subject. This study is the largest case study of deaths associated with lightning strikes in Turkey.

Comparison of Cardiac Wall Thicknesses and Coronary Artery Obstructions Between Deaths Resulting From Acute Myocardial Infarction and Deaths From Other Causes.

Objective: The risk factors for myocardial infarction (MI) can be separated into three general categories: non-modifiable factors, modifiable risk factors, and lifestyle. This study aimed to investigate whether or not there was any effect of cardiac wall thickness and coronary artery obstructions on acute MI. Methods: In this retrospective study of histopathological examinations of autopsies, two groups were formed. The first contained 28 cases diagnosed with acute MI and the second 28 cases with no heart pathology and the cause of death was reasons other than heart disease. The subjects in the two groups were similar in age, height, weight, and body mass index. The groups were compared in terms of the left and right ventricular wall thicknesses and the degree of obstruction of the right, left, anterior descending, and circumflex coronary arteries. Results: The mean left ventricular wall thickness was 1.461±0.2767 cm in the acute MI group and 1.386±0.2460 cm in the control group, with no statistically significant difference found between the two groups (p=0.289). A statistically significant difference in the degree of obstruction of the coronary arteries was found between the groups. Conclusions: Although the mean cardiac wall thickness was greater in the acute MI cases, no statistically significant difference was found between the two groups.

An examination of the sociodemographic and psychiatric characteristics of children who have suffered penetrative and non-penetrative sexual abuse in Malatya, Eastern Turkey.

Penetrative and nonpenetrative sexual abuse can cause short- and long-term psychiatric problems in victims. This study aimed to examine the sociodemographic characteristics and psychiatric diseases of children in Malatya, eastern Turkey, according to whether the abuse was penetrative or nonpenetrative. A retrospective examination was conducted on the records of 115 cases of sexual abuse that had been referred to judicial authorities from January 1, 2012-July 30, 2019. The subjects were evaluated by a committee formed of 5-7 separate specialized department faculty members. It was determined that 51.3% (n = 59) of the cases had suffered nonpenetrative sexual abuse, and 48.7% (n = 56) had suffered penetrative sexual abuse. The majority of the perpetrators were known to the child from their close environment. A psychiatric diagnosis was made by the committee in 20.3% (n = 12) of the nonpenetrative cases and in 42.9% (n = 24) of the penetrative cases. There was a significant difference between penetrative and nonpenetrative sexual abuse in terms of psychiatric diagnoses. Of the cases of penetrative sexual abuse, 87.5% (n = 14) had attempted suicide. As a result, early diagnosis of sexual abuse, which has devastating effects on mental health in the early and late periods before it penetrates, can reduce the devastating effects on the child. For this reason, it is crucial for doctors, psychologists, social workers, and teachers who work with children to be informed about this issue.

Association of BDNF / TrkB and NGF / TrkA Levels in Postmortem Brain with Major Depression and Suicide.

BACKGROUND: Suicide Attempts are the main complications of Major Depressive Episodes and are difficult to predict. There is still a lack of knowledge about its neurochemical aspects. There is increasing evidence that Brain-derived neurotrophic factor (BDNF) and Nerve growth factor (NGF) play a role in the pathophysiology and treatment of depression by binding and activating cognate receptors Tyrosine Kinase B (TrkB) and Tyrosie Kinase A (TrkA), respectively. This study was conducted to examine whether BDNF and / or TrkB as well as NGF and / or TrkA expression profiles were changed in the hippocampus of postmortem brain of individuals with depression who committed suicide. SUBJECTS AND METHODS: This study was conducted with the brain tissue of 61 victims who died as a result of suicide due to depression and 25 people who died due to traffic accidents. The psychiatric history of the cases was determined by the psychological autopsy method. Samples were taken from the hippocampus region of the brain at the forensic medicine institution. After storage under appropriate conditions, protein and mRNA levels of BDNF, TrkB, NGF and TrkA were determined in the genetics laboratory. RESULTS: Average age of the suicide group was 30 and the average age of the control group was 24.5. The suicide group consisted of 70.5% male and 29.5% female cases. There was no significant difference between the groups in terms of age (p=0.062) and gender (p=0.718). BDNF, NGF, TrkA and TrkB values were found to be lower in the suicide group compared to the control group and there was a significant difference between the groups (p≤0.001; p=0.001; p=0.001; p=0.011). CONCLUSION: Given the importance of BDNF and NGF and their cognate receptors in mediating physiological functions, including cell survival and synaptic plasticity, our findings regarding decreased expression of BDNF, TrkB, NGF and TrkA in both protein and mRNA levels of postmortem brains of suicide victims suggests that it may play an important role in the pathophysiological aspects of its behavior. Further studies in this context may be useful both in understanding the molecular basis of suicide and in designing therapeutic models targeting these molecular pathways.

Shaken baby syndrome resulting in death: a case series.

BACKGROUND: The aim of this study was to raise the awareness of all healthcare personnel, primarily Emergency Department physicians, forensic physicians, and paediatricians about cases of shaken baby syndrome (SBS), which can be difficult to diagnose, require a high level of suspicion in diagnosis and there is a high likelihood of missed diagnosis. METHODS: A retrospective examination was made of 3400 forensic cases applied with autopsy between 2012 and 2018 to the Forensic Medicine Institution of Malatya Group Directorate. RESULTS: Of the total cases, 113 were aged < 2 years and head trauma was determined in 35. Eight cases were determined as SBS. Of the 8 cases that resulted in death, 75% were male and the mean age was 8.3 months. The trauma had been perpetrated by the father in 50% of cases. There was a history of seizure in 67.5% of the infants and 75% were taken to the Emergency Department with cardiopulmonary arrest. Subdural hematoma and subarachnoid hemorrhage were determined in 37.5% of the cases, subdural hematoma, subarachnoid hemorrhage and intracranial hemorrhage in 50%, and epidural hemorrhage and subarachnoid hemorrhage in 12.5%. In the microscopic examination of the medulla spinalis, focal subdural fresh bleeding was seen in 50% of cases. Bleeding around the optic nerves was determined in 37.5% of cases bilaterally and in 37.5% unilaterally. Retinal hemorrhage was determined in all the cases, which was bilateral in 75%. CONCLUSIONS: The actual worldwide incidence of SBS is not known, and in Turkey, it is thought to be much higher than has been determined. The most important reason for this is thought to be that the diagnosis of child abuse is difficult and physicians do not have a sufficient level of knowledge.

Sudden death as a result of colon perforation; Ehlers-Danlos type IV case with postmortem diagnosis.

Ehlers-Danlos Syndrome (EDS) is a connective tissue disease with heterogeneous subgroups. In type IV EDS, also known as vascular EDS (VEDS), the underlying genetic anomaly consists of a mutation of the COL3A1 gene encoding the type III procollagen. As a result of the mutation, pathological findings due to excessive brittleness of the tubular organs or vessels occur. In our case, we present a patient with sudden death due to colon perforation which was diagnosed with EDS type IV after further examination in the autopsy. Forensic medicine experts should consider the possibility of EDS type IV after the detection of spontaneous ruptures in the internal organs during the autopsy. We think that it would be appropriate to report this autosomal dominant and potentially fatal condition to family members.

Psychiatric disorders and characteristics of abuse in sexually abused children and adolescents with and without intellectual disabilities.

The purpose of this study was to compare sexually abused children and adolescents, with and without intellectual disabilities (ID), in terms of post-abuse psychiatric disorders, features of the sexual abuse, and sociodemographic characteristics. The study included sexually abused children aged 6-16 years, who were sent to three different child mental health units for forensic evaluation; there were 102 cases (69 girls and 33 boys) with ID and 154 cases (126 girls and 28 boys) without ID. Researchers retrospectively examined the files, social examination reports, and the judicial reports of the cases. It was determined that in the group with ID, sexual abuse types including penetration and contact had higher rates, they were exposed to more frequent repeated abuses, the abuses were revealed with their own reports at a later period and lower rates, and post-abuse pregnancies were more frequent. It was also determined that the abuser was a familiar person and a family member at lower rates and more than one abuser was encountered more frequently, compared to the group without ID. While no difference was determined between the two groups in terms of the frequency of post-abuse post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), conduct disorder (CD) was observed more frequently in the group with ID. This study emphasizes that sexual abuse, which is an important problem in individuals with ID, has different features and effects.