Abdurrahim Turkoglu

Sudden death following periorbital pellet injury

Purpose: To report an uneventful sudden death because of a periorbital pellet injury. Method: Review of autopsy findings. Results: A 20-year-old hunter was shot accidentally during hunting. At autopsy, the body showed no significant injuries or deformity except for the pellet injuries and ecchymosis on the medial side of the left lower eyelid. Skull roentgenography located a pellet in the base of the cranium. Upon craniotomy, the cause of death was diagnosed as subarachnoidal haemorrhage due to incomplete basilar artery injury. The pellet entered through the medial cantus, passed through the inferior orbital fissure than the sphenooccipital junction and basilar artery and lodged in the pons. Conclusion: A-high index of suspicion is required in order to detect an intracranial extension in periorbital injuries.

Death due to knee-elbow position in a restricted area: positional - traumatic asphyxia? case report

Positional asphyxia which evolves out of a bodyÂ’s staying in an unusual posture, is a kind of hypoxia and anoxia that occurs as a result of -partially or completely- narrowing of respiratory passage. Crime scene investigation provides significant evidences and clues to enlighten on positional asphyxial deaths. This study aims to discuss the cause of death for the case which was found stuck in knee-elbow position in a restricted area due to external factor exposure. The victim was a 37-year-old male worker. It was thought that he had left on the slaughter house at the end of the shift in the evening but he was found in the following morning as restricted in a cattle knocking box. In the examination of the case, there was no traumatic or pathologic findings to explain the cause of death, except for the apparent finding of asphyxia. It was considered that the death in the case occurred due to positional asphyxia caused by external factor exposure related to restriction in knee-elbow position. As a conclusion, in order to elucidate the death reason and the manner of death, in addition to the findings of internal and external medical examination, evaluation of crime scene investigation and history are also important.

Analysis of Tractor-Associated Fatalities

Introduction and Objective Tractor is regarded as a key equipment in agriculture, and it is also used for transportation and transfer purposes in addition to its agricultural use. Accidents resulting in death in farmlands are frequently encountered. Tractor-related fatalities are the most common ones among the deaths after farm accidents. This study aimed to evaluate the characteristics of tractor-related deaths and to discuss the measures that could be taken to prevent these deaths. Methods In this study, 42 cases who underwent postmortem examination and/or autopsy because of tractor fatalities in the province of Elazig between January 2005 and December 2016 were examined retrospectively with such variables as sex, age, month and season of incident, cause of incident, location of incident, position of case, and injured region. Results Of the cases, 36 (85.7%) were male, and 6 (14.3%) were female. The youngest case was 2 years old, and the oldest case was 83 years old; the mean age was 43.3 ± 25.0 years. Examining the deaths regarding the cause of incident showed that tractor rollover was the most common cause (42.9%). This was followed by being run over by the tractor (19.0%). Of the cases, 24 (57.1%) were drivers, 10 (23.8%) were passengers, and 8 (19.0%) were pedestrians. Conclusions Tractor-related fatalities due to tractor rollover are most often seen. To reduce the deaths caused by this reason, drivers should have special training and technical support, use helmets and seatbelts in the tractor, and have a health check at certain intervals (especially the drivers at advanced age).

Düşmeye Bağlı Yaralanmaların Adli Tıp Açısından Değerlendirilmesi

Falls are one of the leading causes of admission to emergency and deaths. There is more than one classification of the falls. In this study we classified falls according to height of the falls: High level (>5 meters) and low level (<5 meters). We didn’t include flat ground falls to our study. In this study, we reviewed 1218 fall cases retrospectively between January 2000 to December 2004 including 779 men and 439 women whose average age is 22.2 + 22.9 (the youngest is 1 age and the oldest is 95 age) years at Firat Medical Center. Nine hundred twenty seven of these cases are low level falls and 213 are high level falls. Of these falls, the level of the fall was not specified in 78 cases. The cases are evaluated according to the sex, age, age groups, the level of fall, simple medical intervention, life threatening, Glasgow Coma Score (GKS), injured body part, mortality and monthly timeframe. Sex and age differences are not significant according to the high and low level fallings (p = 0.1). 37.6% of high level falls are lile threatening compared to 20.4% of low level falls (p=0.0001). Similarly the Glasgow Coma Scores were poorer in high level falls compared to low level falls. The falls are most prevalent among children (59.2%) and lower among adults (32.7%) and elderly (8.1%). We conclude that the falls should be handled with care because of mortality and morbidity risk and burden to health system. It is often seen at childhood therefore the families have to be educated for preventive measures. Also, it is necessary to take some security precautions at the windows and balconies.Keywords: Falling, height, life threatening, glasgow coma score.Düflmeye ba¤l› yaralanmalar; acil servise baflvurmalarda ve yaralanmalara ba¤l› ölümlerde önde gelen nedenlerden biridir. Düflmeler de¤iflik flekillerde s›n›fland›r›lmaktad›r. Çal›flmam›zda, yüksek seviyeden (≥5metre) ve alçak seviyeden (<5metre) düflme fleklinde olan s›n›fland›rma kullan›ld›. Düz zemindeki düflmeler çal›flmam›za dahil edilmedi. Bu çal›flmada F›rat Üniversitesi, F›rat T›p Merkezine Ocak 2000-Aral›k 2004 y›llar› aras›nda baflvuran 779’u erkek, 439’u kad›n, yafl ortalamas› 22.2±22.9 (en küçük 1, en büyük 95 yafl) olan toplam 1218 düflme olgusu retrospektif olarak incelendi. Olgular›n, 927’si alçak, 213’ü yüksek, 78’i ise bilinmeyen bir seviyeden düflmüfltür. Olgular; cinsiyet, yafl, yafl gruplar›, düflme seviyesi, basit t›bbi müdahale, yaflamsal tehlike, Glasgow Koma Skoru (GKS), yaralanan vücut bölgesi, mortalite oran›, aylara göre da¤›l›m› aç›s›ndan de¤erlendirildi. Yüksek ve alçak seviyeden düflme aç›s›ndan cinsiyet ve yafl fark› tespit edilmedi (p=0.1). Yüksek seviyeden düflmelerde yaflamsal tehlikeye maruz kalma %37.6 iken, alçak seviyeden düflmelerde ise bu oran›n %20.4 oldu¤u saptand› (p=0.0001). Benzer flekilde yüksek seviyeden düflmelerde GKS’nin, alçak seviyeden düflmelere göre daha düflük puanlarda oldu¤u belirlendi (p=0.0001). Düflmelerin pediatrik yafl grubunda (%59.2) daha yüksek, eriflkin (%32.7) ve yafll›larda (%8.1) daha düflük oldu¤u tespit edildi. Sonuç olarak; düflmeler mortalite ve morbidite riski tafl›malar› ve sa¤l›k sistemine önemli bir yük getirmeleri aç›s›ndan dikkate al›nmal›d›r. Pediatrik yafl grubunda s›kl›kla görülmesinden dolay›; anne baba e¤itimi, oyun esnas›nda çocu¤un gözetlenmesi, pencere ve balkonlarda güvenli¤i sa¤layacak önlemlerin al›nmas› gerekmektedir. Anahtar kelimeler: Düflme, yükseklik, yaflamsal tehlike, glasgow koma skoru.