Celal Bütün

A nonrandom sample of 55 sexual abuse cases in Sivas

Background Sexual abuse in childhood is a significant public health problem because of the destructive results both to the individual and to the community. The aim of this study was to examine the sociodemographic characteristics of children who were victims of sexual abuse, the relationship of the victim and abuser, and the findings of sexual abuse. Material/Methods An examination was made of the results of forensic medicine and psychiatric evaluations of child victims of sexual abuse. The sociodemographic characteristics of the cases and the characteristics of the incidents of sexual abuse were evaluated at the Forensic Medicine Department of Cumhuriyet University between 2013 and 2016. Results A total of 55 cases were included in the study, comprising eight males (14.5%) and 47 females (85.5%) in the age range of 5–17 years. The vast majority of the cases were high school students. The place of the abuse incident was the home of the victim or the perpetrator in 29 cases (52.7%). The sexual abuse was determined to be bodily penetration in 32 cases (58.1%). In 32 cases (58.1%), the perpetrator was known to the victim. Conclusions The study findings that the perpetrator of the sexual abuse was known to the child, that predominantly female children were attacked, and the low sociocultural level of the cases were consistent with other studies reported in the literature. To prevent sexual abuse of children, to make an early diagnosis, and to provide rehabilitation for the abused children, it is essential that the evaluations of these cases are made using a professional multidisciplinary approach.

Troponin: the Valuable Assay in Post Mortem Investigation of Ischemic Heart Disease

Sudden, unexplained and unexpected but natural deaths are more common in adults than it can be presumed with no age or sex exemption. It is found more common in younger one. History or circumstances are nonspecific to give cause of death. In such type of incidences meticulous postmortem examination is necessary with various laboratory investigations like histopathology, bacteriology, biochemistry, serology and toxicology. Amongst natural sudden deaths, coronary atherosclerosis and/or its effect(s) is the most common cause. In such cases of sudden death Meticulous & detailed Autopsy is necessary with all above cited laboratory investigations. In cardiac death, Troponin is the best biomarker to detect cardiac damage as there is increase in Troponin in blood after cardiac damage & Troponin levels if raised are highly specific for cardiac damage or injury. In our study, we aimed to find out the role of Troponin assays to establish the cardiac damage at the time of autopsy.

The Role of Forensic Medicine Durıng Organ Extraction Process on the Judicial Cases

When medico-legal cases occurred brain death are potential donor candidates for organ transplantation, various problems concerning forensic medicine, judicial needs and ethics are confronted. In this paper, the problems encountered during organ extraction process in a judicial death case are reported.In the emergency service, physical examination of a case with attempted suicide to the head by firearm, revealed visible brain parenchyma through a bone defect on the right fronto-temporal region, a wound defect on the left frontal region, multiple cranium fractures and brain hemorrhage. The case immediately underwent operation, the bone defects were closed and the wounds were sutured. Approximately one day after the operation, a diagnosis of brain death was made in the intensive case unit. As the case is a potential donor candidate for organ transplantation, an interview with his family members was made, resulting in agreement for organ donation. When the public prosecutor asked to the Forensic Medicine Department for the acceptability of organ extraction, after the evaluation of judiciary and medical records, we decided that the organ extraction would not preclude the determination of the cause of death in this case. After the approval of the public prosecutor, an external examination was made just before organ extraction. Thereafter, the case immediately underwent operation for organ extraction. The autopsy was performed on the deceased, after the operation. In conclusion, it is obvious that, when medico-legal cases occurred brain death are potential donor candidates for organ transplantation, the collaboration of public prosecutors with forensic medicine experts would be beneficial for both the organ extraction and the judicial processes.Key Words: Judicial case; brain death; organ transplantation; autopsy; forensic medicine.When medico-legal cases occurred brain death are potential donor candidates for organ transplantation, various problems concerning forensic medicine, judicial needs and ethics are confronted. In this paper, the problems encountered during organ extraction process in a judicial death case are reported. In the emergency service, physical examination of a case with attempted suicide to the head by firearm, revealed visible brain parenchyma through a bone defect on the right fronto-temporal region, a wound defect on the left frontal region, multiple cranium fractures and brain hemorrhage. The case immediately underwent operation, the bone defects were closed and the wounds were sutured. Approximately one day after the operation, a diagnosis of brain death was made in the intensive case unit. As the case is a potential donor candidate for organ transplantation, an interview with his family members was made, resulting in agreement for organ donation. When the public prosecutor asked to the Forensic Medicine Department for the acceptability of organ

A Case of Suden Death due to Rupture of Dissecting Aortic Aneursym

Aortic dissection of the aorta is the most common fatal disease requires urgent diagnosis and treatment. The most important step in the diagnosis of aortic dissection which is characterized by sudden onset of chest pain in predatory manner is the clinical suspicion. Especially in patients who present with atypical symptoms is difficult to diagnose. The mortality rate is increasing by 1-2% every hour if left untreated. In this study we presented a fifty-two-year-old female case with atypic symptoms, such as nausea and vomiting, admitted to the emergency room. The patient admitted to the emergency department with only nausea and vomiting complaints and at the end of the examination it was decided that there were no cardiac pathology. Six hours later, the overall situation has deteriorated, and the patient died. In the autopsy we revealed two pericardial rupture in the front pericardial area, also there was 8.5 cm long identified ruptured aortic dissection beginning from the ascending aorta to the root of aorta, which was the cause of death. Delays in diagnosis of aortic dissection can lead to death, also the physicians can face with important legal issues. Early diagnosis of patients, who died suddenly and unexpected, can avoid unnecessary judicial proceedings.

Child abuse cases in mythology

The child abuse is an important public health problem. It constitutes all kinds of non-accidental physical or emotional ill-treatment, sexual abuse, neglect or negligent treatment, or commercial or other exploitation applied by the child’s parents or caretakers, that is harmful to the child’s health, development or dignity. That treatmentshould be inconsistent with cultural values of that society and confirmed as child abuse by the experts. In memory of humanitys common and secret mythology, old traditions, as well as the relationship between the archaic religions, the origins ofthe gods, their heroes and ancient peoples ideas about how the world exists the relationship between holistic science. Making story and transfer of real events by the people we find in mythology. The most famousGreek-Roman Mythology and mythological narratives of child abuse in which we find here. This paper is intended to show that child abuse is as old as human history.

The School Bullying in Sivas-Questionnaire Study -

Violence among bullying, although not a new concept has increased steadily in the last period. This study, 9 and 10 in the grade of 1200 students applied to study through a survey of school violence prevention and inter-flow prevention was intended to put forward proposals for the solution in the center of Sivas. In determining the number of students included in the study stratified sampling method used and the selection of students was done with simple random sampling method. Questionnaire; sociodemographic characteristics and violence against the approach consists of containing the problem. Data SPSS (Ver: 10.0) were evaluated using the khi-square test. 722 of students (60.2%) men, 478 (39.8%) and girls, ages between 14-18 years and mean age 15.75 ± 0.85. Between gender differences in terms of violence and brute force is significant (p

Çocuk İstismarı Tanısında Görüntüleme Yöntemlerinin Değeri

Child abuse and neglect that caused serious injuries and even deaths, being a major public health problem, present medical, legal, and social aspects. Due to difficulties in diagnosing child abuse because of various narrations of the abusive event(s), controversial testimonies, and consultations to different health care centers each time, maintenance of high degree of suspicion has been advocated. In suspected cases of child abuse, and neglect, as emphasized in our case report, use of proper imaging modalities is crucial in order to recognize, and document the signs of abusive act. X-rays of all skeleton to evaluate bony structures, and computerized tomography (CT), magnetic resonance imaging (MRI), and ultrasound to detect visceral organ injuries should be preferred. Nowadays, imaging techniques of nuclear medicine have been introduced for the diagnosis of child abuse. In cases with child abuse accurate diagnosis should be established using objective medical evidence. Failure in diagnosis of child abuse causes the child to reside in the environment of abusive acts which consequently leads to more serious health problems or even death of the child. Misdiagnosis of child abuse will lead to unnecessary and unfair accusation of an innocent individual. In both conditions, legal, and ethical obligations, and responsibilities of the physicians will be interrogated. Establishment of accurate diagnosis using objective evidence in cases with child abuse is important with respect to proper treatment, and from the perspectives of ethical, and legal obligations. In conclusion, every possible medical opportunity should be used in order to diagnose child abuse, and clarify the judicial case. Guidelines and algorithms are available within the frame of good medical practice. The important benefits provided by imaging techniques as documentation, legal protection, and if deemed necessary, reevaluation of relevant information, and findings in cases with child abuse should not be forgotten.Key words: Child abuse, radiology, imaging techniques, virtopsy, forensic medicine.

Av tüfeği ile intihar eden olgudan otopsi sırasında “müdahale” ile silahın çıkarılması

Ozet Atesli silahlarla yaralanma ve olum olgulariyla siklikla karsilasilir. Atis mesafeleri; bitisik, yakin ve uzak atis olarak siniflandirilmaktadir. Bitisik atislarda namlu agzi deriye tamamen temas halinde ise tam bitisik, deri ile namlu arasinda 3cm’ye kadar mesafe varsa bitisige yakin olarak tanimlanir. Bu calismada, av tufegi ile ksifoid alt bolgesine bitisik mesafeden gerceklestirilen atis nedeniyle olen ve hastaneye namlu ucu deri altina girmis durumda getirilen olgudaki atis mesafesine ait bulgular tartisildi. Ayrica olgunun uzerindeki silahin guvenlik tedbirleri alinarak cikarilmasinin onemi vurgulandi. Anahtar sozcukler: Av tufegi, atis mesafesi, bitisik atis, intihar, adli tip Abstract Injury or death cases often occur with firearms. The discharge distances are classified as adjacent, close and distant. In adjacent discharges; it is defined full adjacent if the mouth of gun barrel is completely in contact with skin, it is defined near adjacent distance if there is up to 3 cm. distance between skin and gun barrel. In this study, this case died in adjacent discharge to the bottom of xiphoideus with shotgun and was brought together with shotgun, whose gun barrel settling in the subcutaneous soft tissue, used during the event to the hospital morgue. They were also pointed out the findings concerning the discharge distance on the case and the importance of removal the shotgun in the body of the case by the safety measures. Keywords: Shotgun, discharge distance, adjacent discharge, suicide, forensic medicine