Child sexual abuse: Seven years in practice

PubMedID: 20345776The purpose of this study was to determine the socio-demographic characteristics of sexually abused children. The records of 101 cases of child sexual abuse (CSA) were retrospectively evaluated. Socio-demographic characteristics of the victims, type of sexual abuse, and psychiatric diagnosis were studied. Of the victims, 56.4% (n = 57) were female and 43.6% (n = 44) were male. The mean age was 9.57 ± 3.5, with a range of 4-17 years. Ninety-three (92.1%) of the victims had been admitted as part of the legal process. The majority (66.3%) of the victims had been abused by an acquaintance, while 33.7% had been abused by a stranger. Anal or vaginal penetration was reported in 48.5% of the cases. Post-traumatic stress disorder was the most common (54.5%) psychiatric diagnosis established after sexual abuse. Descriptive data related to the abused children and an understanding of the consequences of CSA will help authorities in planning prevention. © 2010 American Academy of Forensic Sciences

The relationship of trauma severity and mortality with cardiac enzymes and cytokines at multiple trauma patients [Çoklu travmalı olgularda kalp enzimleri ve sitokinler ile travma şiddeti ve mortalitenin ilişkisi]

PubMedID: 23138993BACKGROUND In this study, we aimed to determine the effects of trauma severity on cardiac involvement through evaluating the trauma severity score together with diagnostic tests in multiple trauma patients. A trauma score was determined using various trauma severity scales. METHODS After obtaining the approval of the ethics committee of the faculty, this prospective study was performed through evaluating 100 multiple trauma patients, aged over 15 years, who applied to our Emergency Department (ED). After determining the trauma severity score using instruments such as the Injury Severity Score (ISS), Glasgow Coma Scale (GCS), and Revised Trauma Score (RTS), the cardiac condition was evaluated using biochemical and radiological diagnostic tests. RESULTS During the study period, 100 patients were evaluated (78 male, 22 female; mean age: 33.2±15.4; range 15 to 70 years). It was determined that 92 (92%) were blunt trauma cases, and 77 (77%) of them were due to traffic accidents. The majority of cases showed electrocardiogram (ECG) abnormalities (63%) and sinus tachycardia (36%). Abnormal echocardiogram (ECHO) findings, mostly accompanied by ventricular defects (n=24), were determined in 31 of the cases. Nineteen cases with high trauma severity score resulted in death, and 14 of all deaths were secondary to traffic accidents. Trauma scores were found to show a significant difference between the two groups. CONCLUSION The ISS trauma scale was determined to be the most effective in terms of indicating heart involvement in patients with multiple traumas. Close follow-up and cardiac monitoring should be applied to patients with high trauma severity scores considering possible cardiac rhythm changes and hemodynamic disturbances due to cardiac involvement

Childhood deaths due to electrocution in Adana, Turkey

PubMedID: 17407474Aim: This retrospective study was conducted to determine the general features of childhood deaths due to electrocution, and draw the attention of community to these preventable deaths. Methods: The autopsy records of the Morgue of the Adana Branch of the Turkish Forensic Medicine Council were used. Thirty-seven cases of childhood (under 18) electrocution during the period 1999-2004 were analyzed. Results: Electrocution deaths comprised 0.8% of all the medico-legal autopsy cases (4515) during these 6 years. Thirty-one (83.8%) of the victims were male and only six (16.2%) were female. They were between 18 months and 18 years of age, and the mean age was 11.35, and all deaths were recorded as accidental. Conclusion: Medical units, and paramedical and educational centres should play important roles in formulating public health strategies to tackle preventable deaths such as electrocution. © 2007 The Author(s)

An unusual cause of death at preschool age: Scalding by hot milk

PubMedID: 20032773Scalding is one of the most painful and devastating burn injuries a child can suffer. Victims are generally scalded by splashed or spilled hot fluids in the home environment. Interestingly, scalding by hot milk is a common cause of burns in rural parts of Turkey. This study aimed to identify the general features of scalding by hot milk, and to make the authorities aware of this problem through educational programs for parents and caregivers.The records of the Council of Forensic Medicine Adana Group Administration and public prosecutor's office were used. Forty-four deaths in children of preschool age (under 6) due to scalding by hot milk during 2001-2005 were analyzed.Scalding with hot milk constituted 1.05% of all medico-legal deaths (4183) during the period considered. Twenty-five (56.81%) of the victims were male while 19 (43.19%) were female. The victims' ages ranged between 18 months and 6 years, with a mean age of 3.03.Scalding by hot milk appears to be an important public health problem, especially in rural areas of Turkey. Educational programs for families and caregivers and implementation of simple safety measures will decrease the prevalence of deaths due to such preventable injuries. Copyright © 2010 by Lippincott Williams & Wilkins

Suicide among children and adolescents: Data from Çukurova, Turkey

PubMedID: 17564834The purpose of this study was to investigate the general properties of suicide among children and adolescents in our region, and to evaluate the results in the light of the literature. The autopsy records of the morgue of the Adana branch of the Turkish Forensic Medicine Council were investigated retrospectively. Focus of the study was shaped by suicide cases in children and adolescents (under 18) between the years of 1997-2005. All of the cases were analyzed with regard to age, sex, method of suicide, and year. The childhood and adolescent (0-18 years) deaths comprised 24.4% (n: 1390) of all medico-legal autopsy cases (n: 6808). The origin of death in 186 (13.4%) cases involving victims younger than 18 years of age was suicide. The majority of suicide cases (62.9% n: 117) were females. Adolescents of 16-18 years of age constituted the overwhelming majority (70.43% n: 131) of all childhood suicides. Mean age was 16.13. The most frequent method of suicide was shooting in males, and poisoning in females. However, hanging was the most frequent method (34.41% n: 64) overall. © 2007 Springer Science+Business Media, LLC

Forensic geriatric deaths in Adana, Turkey

PubMedID: 19481273The World Health Organization describes geriatric age group as the population aged 65 years or older. Parallel with the development of medical and technological areas, the life expectancy gets longer and geriatric population has been dramatically increasing. In this respect, geriatric deaths are frequently encountered due to increasing risk factors and pathophysiological changes in aging process. The records of the Forensic Medicine Institution Adana Group Authority Morgue Specialty Office were used. Death certificates and autopsy records of 9007 cases autopsied between the years of 1998 and 2007 were examined retrospectively. Seven hundred and twenty-six geriatric age (?65 years) deaths were taken in the scope of the study. All of the cases were analyzed with regard to age, sex, cause of death, incident place, and the place and origin of death. Geriatric deaths comprised 8.1% (726 cases) of all the medico-legal autopsy cases (9007) during these ten years. Of all geriatric deaths, 73.8% (536) were male while 26.2% (190) were female. Ages of cases were between 65 and 96 years, and the mean age was 72.3. Majority (310 cases, 42.7%) of deaths were by natural causes, while this was followed by accidental deaths with 227 cases (31.4%). This study was aimed to discuss the general features of geriatric deaths accepted as forensic cases, in the light of the literature. © 2009 Elsevier Ireland Ltd. All rights reserved

Sexual assault in childhood and adolescence; a survey study

Children and especially adolescent females are sexually assaulted more frequent comparatively to adults according to many studies. The aim of the study was to describe demographic features of victim and assailant, sexual assault characteristics, the time between assault and the examination, to determine genital/non-genital injuries and place of assault in child and adolescent sexual assault victims to provide descriptive data on medico-legal findings and health care strategies among them. A prospective survey was carried out among sexually abused child and adolescent cases referred to Forensic Medicine Council Adana Group Administration in the period of January 2007 to December 2007. Of 141 cases, 78 cases that agreed to respond the questionnaire were taken in the scope of the study. Only eighteen (23%) of cases were examined within the first three days of abuse. Forty-two of cases expressed that they were not abused and had voluntary sexual activity. Most of perpetrators were friends of victims. The majority of cases were determined to be young female adults, aged between 16 to 18 years, which had a voluntary sexual activity. The legal issue in these cases was complaint of families of cases' to the public prosecutor. In this respect, in our country law should be more tolerant to voluntary sexual activity of close aged individuals

Striated Abrasions From A Knife With Non-Serrated Blade—Identification Of The Instrument Of Crime On The Basis Of An Experiment With Material Evidence

This paper presents an experiment with a knife seized as material evidence in a homicide case. The reason for the experiment was the necessity to determine whether the injuries of the deceased could have been inflicted with this instrument since in the course of the investigation doubt arose as to the origin of linear, parallel scratches around one of the wounds and on the abdominal integuments suggesting a serrated blade. The knife found near the crime scene had a smooth blade and small serrations only on the borderline between its blade and hilt. However, the performed experiment showed that if the knife is directed towards the integuments of the body in a special way, its serrations, even though not located on the blade itself, may leave such striated marks on the body, as those found during the autopsy, suggesting their origin from a serrated blade.PubMedWo