Ahmet Nezih Kok

Sudden Death Due to Ruptured Hydatid Cyst of the Liver

The cyst stage of Echinococcus granulosus is commonly located in the liver, which frequently results in a long symptomless period. We present a sudden death due to a freshly hemorrhagic hydatid cyst following blunt trauma to the liver in a 19-year-old boy. The possible mechanism was thought to be an anaphylactoid reaction to the leakage of the cyst fluid.

Turkey's Physicians' Attitudes Toward Euthanasia: A Brief Research Report

Euthanasia and assisted suicide are subject to an ongoing debate and discussed with various aspects. Because physicians are in a profession closely related to euthanasia, their attitudes toward this subject are significant. Thus, research intending to explore their opinions is carried out in many countries. In this study, opinions of the physicians regarding euthanasias definition, contents, legal aspects, and acceptable conditions for its application are addressed. The questionnaire was given to 949 physicians, more than 1% of the total working in Turkey. Of the physicians who participated in the study, 49.9% agreed with the opinion that euthanasia should be legal in certain circumstances. In addition, 19% had come across a euthanasia request and the majority of physicians (55.9%) believed that euthanasia is applied secretly in the country despite the prohibitory legislation. In conclusion, the authors infer from the study itself and believe that euthanasia should be legal in certain circumstances and that the subject, which is not in the agenda of the Turkish population, should continue to be examined.

Non-thrombotic Pulmonary Embolism Due to Liver Hydatic Cyst: A Case Report.

Background: A non-thrombotic pulmonary embolism is defined as embolization to the pulmonary circulation. It may be caused by microorganisms, foreign bodies, different cell types or gas in the pulmonary circulation. Pulmonary hydatid cyst-induced embolization is a rare complication of heart or liver hydatid cysts. Case Report: We describe the fatal case of a 15-year-old boy without any known prior illness who was admitted to the hospital after feeling unwell and dropping to the ground while playing ball. During the autopsy, a lesional mass, with dimensions of 13x6 cm, was observed in the left lobe of the liver. The histomorphological examination of pulmonary sections showed scolices observed in pulmonary vessel lumina, thus a non-thrombosis hydatid embolism was diagnosed. Based on the findings, the cause of death was recorded as a non-thrombotic hydatid embolism. Conclusion: The present case is interesting because a non-thrombotic pulmonary embolism rarely results in sudden death, and a definitive diagnosis was possible only by a histopathological examination.

Bullet Migration from Fascial Space of Femoral Vein to Common Iliac Vein Bifurcation

Introduction: Migration of a retained bullet in the body is rare. Some studies have reported regarding embolism induced by intravascular bullet migration. Here we present a case of lead bullet migration through the external surface of the right femoral vein. Case Report: A 31-year-old male was referred to our department for clinical forensic medical evaluation. He was assaulted while working at his office and thus was subsequently taken to the emergency department. Physical examination revealed that the bullet first entered from the left thigh and passed through the medial part of the right thigh with its own kinetic energy, and after 7 h, it passively moved up to the common iliac vein via the femoral space of the right femoral vein. Conclusion: This case report is important as it demonstrated that the lead bullet retained in the body may have passively migrated toward proximal and abdomen via the external surface of the vein between the fascia and intermuscular structures

How will amendments in crimes against sexual privacy and failure to evaluate the mental health of the victims will affect them? [Cinsel dokunulmazliga karsi suclarda yapilan kanun degisikligi ile ruh sagliginin degerlendirilmemesinin magdurlara etkisi ne olacak?]

The concepts of physical or mental health were removed from the articles regulating the crimes against sexual immunity in the Turkish Penal Code. Today, judicial authorities don’t require forensic medical evaluation of physical or mental health of the victims. In this study, it is aimed to investigate the effect of the amendment on psychiatric examinations in the forensic medical examination of victims of sexual crimes. The data of 292 cases, who were evaluated by a committee established in accordance with 7th, 23rd and 31st Articles of Institute of Forensic Medicine Act between January 1, 2012 and July 30, 2015 at Ataturk University Faculty of Medicine to see if there is any negativities in the physical or mental health of the victims, were reviewed retrospectively. In these evaluations, psychopathology was identified in 58.6% (n=171) of the cases due to sexual trauma. Before the evaluation of the committee, the judicial authorities asked for both physical and mental results of sexual trauma of 62.6% (n=183) of the cases and psychiatric results of sexual trauma of 37.4% (n=109) of the cases as part of the forensic medical assessment. The psychiatric examination of these 109 cases was done by this committee for the first time and psychopathology was identified in 56.9% (n=62) of these cases due to sexual trauma. Psychiatric examination of victims of sexual crimes is a medical obligation independent from the legal process. Although the law changes, forensic medical examination of the victims should be done to include psychiatric examinations with a multidisciplinary approach.

Factors affecting adherence to treatment and follow-up of burns in children: A single centre experience.

Aim: Children are prone to burn injury. Burns can be seen as a part of child abuse. The aim of this study was to investigate the factors affecting adherence to the treatment of burn patients, and to emphasize the role of the physician in identifying childrens non-accidental burn injuries. Materials and Methods: Children who were hospitalized in the burn unit were analyzed retrospectively. Results were assessed for significance using the Chi-square test. Results: A total of 189 patients were included. Some patients (n = 52; 27.5%) were discharged against medical advice (DAMA) before completion of treatment. Although we could not demonstrate a relationship between non-accidental etiology and DAMA group, it was significant that these patients did not contact the outpatient clinic after discharge. It was evident from records that two of these cases were abused. The reasoning of the parents in the DAMA group for the early discharge was siblings at home, financial and accommodation problems. Conclusion: Although burns in children commonly occur due to an accident, each burn case should be examined for a non-accidental etiology and findings suggesting abuse should be noted. Physicians should be alert for the detection of signs of burn related child abuse.

Sciatic nerve injury: Legal cases

Objective: Sciatic nerve (SN) injuries may occur as a result of traumatic events or in result ofmedical interventions during the injections. This study was carried out to determine the causesof sciatic nerve injury which was subject to judicial scrutiny.Method: 16,827 cases were analyzed between the years 2002 and 2011 which were sent toDepartment of Forensic Medicine of Ataturk University were evaluated retrospectively. A totalof 21 SN injury cases were evaluated Results: The reason of SN injury were in 10 cases (47.6%) intramusculer (IM) injection. InEMG of these 10 cases (47.6%) were identified as tibial-peroneal nerve injury. Physicalexaminations showed foot drop in 7 cases (33.3%) and dorsiflexion or plantar flexion weaknessin 8 cases (38.1%).Conclusion: More than half of the cases of SN injury were due to IM injection. For that reason,IM injection should be made by authorized medical staff and these staff should be well educated

The detrimental effect of neck pain followed by solitary plasmacytoma resulting in spontaneous quadriplegia: a case report

After complaining of neck pain for 3 weeks, a 36-year-old man suddenly become quadriplegic during a massage session in a traditional Turkish bath. He was immediately transferred to hospital, where the initial examination consisting in plain radiography and magnetic resonance imaging revealed a compression fracture of the fourth cervical vertebra. The patient was immediately treated by anterior vertebral decompression and bone grafting from the iliac crest. Unfortunately, the patient did not respond to surgical intervention and died. Solitary plasmacytoma of the fourth cervical vertebrae was detected at autopsy during forensic examination. Pain and spinal cord compression resulted from solitary plasmacytoma of the vertebral column. However, paralysis, especially quadriplegia, occurs seldom. In this case report, solitary plasmacytoma of the vertebral column associated with neck pain is presented with the relevant pathological and clinical aspects.