Birol Demirel

The Prevalence of Domestic Violence Against Women Among a Group Woman: Ankara, Turkey

This study determines the frequency of the spousal domestic violence among 1,178 married women who applied to some first level medical institutions located in Ankara, the capital of Turkey. 77.9% (n = 918) of the women who participated in the study have stated that they have been exposed to at least one of the types of spousal violence during their lifetime. The most reported type of domestic violence suffered by women throughout their lives is economic violence (60.4%). The prevalence of controlling behaviors, emotional violence, physical and sexual violence are 59.6%, 39.7%, 29.9% and 31.3% respectively.

A Prospective Study of Serotonin Transporter Gene Promoter (5-HTT Gene Linked Polymorphic Region) and Intron 2 (Variable Number of Tandem Repeats) Polymorphisms as Predictors of Trauma Response to Mild Physical Injury

The aim of this study was to examine the effect of both promoter and intron polymorphisms of the serotonin transporter (5HTT) gene on posttraumatic stress disorder (PTSD) development. For this purpose, two polymorphisms of the 5-HTT gene, which are found in the promoter (5-HTT gene-linked polymorphic region) and second intron (variable number of tandem repeats) of the gene, were analyzed in 100 patients who were admitted to the Emergency Department after a mild physical trauma. None of the 5-HTT polymorphisms studied have an effect on PTSD development after a mild physical injury, but having L allele for 5-HTT gene-linked polymorphic region may cause milder hyperarousal symptoms in those patients who have developed PTSD.

Farewell to the world: suicide notes from Turkey

There has been limited study of suicide in Islamic countries. This paper marks the first study of suicide notes in Turkey, an Islamic country. Using a classification scheme, 49 suicide notes (a rate of 34.5%) were studied. The results show that note writers do not differ greatly from other suicides. Further analysis of younger (<40) and older (>40) suicide note writers reveal few significant differences. Our results, together with the results of classification studies in different countries, suggest that caution is in order in transposing findings from one country to other countries. Future study of suicide notes should, in fact, focus on cross-cultural investigation.

Establishment of interdisciplinary child protection teams in Turkey 2002–2006: Identifying the strongest link can make a difference!

OBJECTIVES The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year outcome. METHODS A team of instructors evaluated needs and held training activities in Turkey annually, and provided consultation when needed. Descriptive analysis was done via Excel and SPSS software. RESULTS Eighteen training activities were held with 3,570 attendees. Over the study period, the number of MDTs increased from 4 to 14. The MDTs got involved in organizing training activities in their institutions and communities. The number of medical curriculum lectures taught by MDTs to medical students/residents, conferences organized by the MDTs, and lectures to non-medical professional audiences increased significantly (R(2)=91.4%, 83.8%, and 69.2%, respectively). The number of abuse cases assessed by the MDTs increased by five times compared to pre-training period. CONCLUSIONS A culturally competent training program had a positive impact on professional attitudes and behaviors toward recognition and management of child abuse and neglect in Turkey. The need to partner with policy makers to revise current law in favor of a greater human services orientation became clear. PRACTICE IMPLICATIONS Pioneers in developing countries may benefit from collaborating with culturally competent instructors from countries with more developed child protection systems to develop training programs so that professional development can improve recognition and management of child abuse and neglect.

The analysis of hormones and enzymes extracted from endocrine glands of the neck region in deaths due to hanging.

Our study was designed to determine whether the hormone and enzyme levels that we have mentioned in serum specimens can be used in postmortem examinations of the cases of hanging or not. Our research includes the postmortem results of the thyroid tissue pathologic examinations, serum levels of triiodothyronine (fT3), thyroxine (fT4), thyrotropin (TSH), thyroglobulin, parathormone (PTH), calcitonin, and amylase in cases of death due to hanging. The mean of fT3 and thyroglobulin levels were higher in hanging cases than those of sudden death cases. This difference was statistically significant (P < 0.05). In our study, we obtained data demonstrating that high postmortem levels of free T3 and thyroglobulin may be indicators of vital reaction in hanging cases. In such cases of death, it seems that applying pressure on the neck region where the thyroid gland is located causes the leakage of thyroglobulin as well as fT3, the active form of the thyroid hormone.

Tuberculosis Prevalence in Forensic Autopsies

Introduction:According to the 2008 World Health Organization report, in 2006, 9.2 million new cases were determined, and 1.7 million people have lost their life due to tuberculosis (TB) in all around the world. In our country (Turkey), it is estimated that 35,000 to 40,000 people have TB disease annually. The Ministry of Health could just determine 18,500 of these cases, and only 6500 patient could be treated effectively. According to the Tuberculosis Dispensary records, the incidence for TB in Turkey is 28/100,000. Materials and Methods:It is aimed to determine the infection with Mycobacterium tuberculosis using acidoresistant bacilli microscopy, TB culture, and histopathological methods in tissue samples that were obtained from lungs of forensic cases whose autopsies had been performed in Council of Forensic Medicine Ankara Department Morgue Specialized Committee. Results:A total of 3 tissue samples that were obtained from lungs of randomized 302 cases, were positive for TB in Löwenstein-Jensen medium. Granuloma with caseating necrosis was found in histopathological examination and acidoresistant (+) bacilli (1+, 2+, and 2+, respectively) in microscopically analysis were also demonstrated in this 3 tissue samples. Discussion:For this reason, we think that autopsy workers have to be careful about tuberculosis during their autopsy working.

Suicide in Different Cultures: A Thematic Comparison of Suicide Notes From Turkey and the United States

Suicide is a global concern, hence, cross-cultural research ought to be central; yet, there is a paucity of cross-cultural study in suicidology. A thematic or theoretical-conceptual analysis of 60 suicide notes drawn from Turkey and the United States, matched for age and sex, was undertaken, based on Leenaars’s empirical-based multidimensional model of suicide. The results suggested that there were more culturally common factors than specific differences; yet, not consistent with previous cross-cultural studies of suicide notes, differences emerged in Turkey notes expressing more indirect and veiled communications (indirect expressions). Specifically, Turkish notes expressed that there may be more reasons to the act than the person writes. It was concluded that the model may be applicable to suicide in both countries, but also much greater cross-cultural study is warranted on specific cultural risk factors. A question raised is whether the findings are related to collectivism versus individualism.

Nuclear morphometry in epidermal changes due to electrical current and thermal energy: trial for usage of image analysis in histological sections.

Distinguishing between injuries resulted from electrical current versus thermal energy is not only a difficult, but also a controversial issue in forensic medicine practice.In this study, an electrical current and a cautery were applied to dorsal skins of 10 rats and biopsies were taken from the injured sites as well as normal skin. In the histologic sections; some planimetric variables such as the perimeter, area, diameter equivalent circle, minimum feret, maximum feret, and the circular form factor of the nuclei located in normal and injured epidermis were measured with the aid of the computer-assisted image analysis.When compared with normal skin, all of the variables -nuclear area, perimeter, diameter equivalent circle, minimum feret, maximum feret, and circular form factor seemed to be decreased both in the electrical current- and cautery-applied skin samples.The differences between the variables measured in normal skin and in electrical- or cautery-applied skin samples were statistically significant (P < 0.05). However none of the variables showed any meaningful differences between the electrical- and cautery-applied areas.It was concluded that the nuclear changes due to electrical current and thermal injury are identical and morphometric analysis seems not to make any further contributions in the differentiating from each other. Therefore, conventional and more established methods for detection of metallization would be more effective.

The first fatal dengue virus infection case in Turkey: Autopsy findings

Dengue is the fastest spreading arboviral infection in the world. It is responsible for about 50 to 200 million infections annually. Turkey is accepted in the World Health Organization European region and dengue is now endemic in all World Health Organization regions except for the European region, but people can travel anywhere in the world and they can catch a disease easily. Approximately 2.5 billion people live in dengue endemic countries; therefore, it may be endemic in Europe as well in the near future. It might be seen with increasing frequency in forensic mortuaries soon. In such a situation, the autopsy staff have to keep dengue virus infections in mind to protect themselves from contamination and to detect the cause of death. A case of a 65-year old Thailand citizen male who died in Turkey is presented. He had skin rashes all over the body. His internal examination revealed, 1900 ml, 1700 ml and 80 ml sero-hemorrhagic fluid in the right chest, left chest and pericardial cavities respectively. The sectional cuts of the lungs showed hemorrhagic fluid leakage. Ecchymosis due to intubation was found in the upper tracheal region. Mesocolon transversum showed hemorrhage as well. Blood test results showed Dengue Virus Immunoglobulin G (IFA) and Immunoglobulin M (IFA) positive, Japanese encephalitis virus Immunoglobulin M (IFA) negative and Immunoglobulin G (IFA) positive.