Kamil Hakan Dogan

Evaluation of farm tractor-related fatalities.

Farm tractors are the major cause of occupational fatalities in agricultural regions. Fatalities typically result from being run over or crushed by the tractor, becoming entangled in the moving parts of the tractor, accidents on roadways, and tractor rollovers, which involve the tractor tipping sideways or backwards and crushing the operator. In this study, tractor-related fatalities in the Konya province of Turkey are retrospectively evaluated. Out of the 3940 cases on which a death examination and/or autopsy was performed between the years 2000 and 2007 at The Konya Branch of Forensic Medicine Council, 86 (2.2%) of the death cases were caused by tractor accidents and are included in this study. The ages of the victims varied between 3 and 80 years old with a mean age of 31.7 ± 22.3. Sixty-eight (79.1%) of the cases involved males, while 18 (20.9%) of the cases involved females. In 32 (37.2%) of the cases, the deaths due to tractor accidents occurred when the tractor overturned. In 37 (43.0%) of the cases, the tractor-related fatalities involved the passengers and the drivers were involved in 34 (39.5%) of the cases. In conclusion, tractor accidents are preventable and deaths from tractor accidents can be significantly reduced if drivers are required to wear safety belts and helmets and frequent checks are implemented to enforce the ban on carrying passengers.

A series of complex suicide

This article presents 16 complex suicide cases. Complex suicide is defined as the use of more than one method to induce death. Of the victims, 10 were men and the ages ranged from 19 to 70 years. Eight victims left a suicide note. It was observed that 13 victims realized the suicidal act in the house and 5 victims had previous suicidal attempts. It was determined that 10 victims had psychiatric disorders, one of them had alcohol dependence. Six victims were housewives, 4 victims were unemployed, followed by one each victim of student, worker, farmer, tradesman, prayer leader, and animal husbandry lines of business. Ten victims were married; 3 victims were single; and 3 victims were divorced. On investigating the methods of suicide, it was seen that 9 victims preferred sharp instrument usage; 5 victims insecticide ingestion; 4 victims each firearms, medicine overdose; 3 victims each hanging, falling from a height; 2 victims self-strangulation; and 1 victim each drowning, liquefied petroleum gas and natural gas inhalation together, fungicide ingestion, rodenticide ingestion. It was determined that 2 victims used 3 methods and the other 14 victims 2 methods in company, to realize the suicide. In this article, the data obtained from our study was discussed by comparing similar data.

Accessory spleens at autopsy

Accessory spleens (AS) may be formed during embryonic development when some of the cells from the developing spleen are deposited along the path from the midline, where the spleen forms, over to its final location on the left side of the abdomen. An accessory spleen is usually near the spleens hilum, but it may be embedded partly or wholly in the tail of the pancreas. The aim of this study was to investigate the incidence and distribution of AS during routine forensic autopsies. AS were investigated in 720 consecutive autopsy cases. Fifty‐four AS were found in 48 (6.7%) cases. AS were found in hilum of the main spleen in 28 cases, the great omentum in 13 cases, the pancreas in 5 cases, and the pelvis in 2 cases. There were two AS in two cases and three AS in another two cases. Awareness of the possible presence of AS is important because when splenectomy is performed for some conditions such as immune thrombocytopenic purpura, failure to remove the AS may result in the failure of the condition to resolve. Additionally, during medical imaging, AS may be confused for enlarged lymph nodes or neoplastic growths. In conclusion, autopsy series are useful for determining the incidences and the other features of AS in different populations, in addition to those studies using CT scans and those studies obtained during laparoscopic or open surgeries. Clin. Anat. 24:757–762, 2011.

Injuries and Deaths Occurring as a Result of Bull Attack

ABSTRACT Persons whose occupations are in animal husbandry may be seriously injured or killed while tending to animals. Bulls are among the most dangerous of these animals. In this study, seven deaths and 23 traumatic injury cases caused by bull attacks and treated in the General Surgery and Chest Surgery Department of Selcuk University Meram Medical Faculty Hospital are presented. Of the 30 total cases, 24 were male and 6 were female. The ages of the cases ranged from 33 to 86 years and the average age was 60.3 ± 12.4 (mean ± standard deviation). All of the death and injury cases occurred while engaged in the care of bulls. It was also determined that the injuries were in the chest region of five (71.4%) and in the head of two (18.6%) out of seven death cases; and in the abdominal region of 14 (60.9%) and in the chest region of nine (39.1%) out of 23 traumatic injury cases. Of the 14 cases that were in the abdominal region and treated surgically, 11 were perforation of small/large intestines, whereas hemorrhages involving the intestinal mesentery, intraabdominal hemorrhage due to perforation of the abdominal wall, and splenic laceration were determined in one case each. There were one or multiple costal fractures in all nine chest injury cases, flail chest in five cases, and hemothorax, pneumothorax, or hemopneumothorax were determined in six cases. Of the chest injury cases, tube thoracostomy was performed in six whereas the other three cases were discharged from the hospital after supportive care. It was concluded that animals such as bulls might be the cause of serious trauma ending with death for those working in the animal husbandry. For this reason, caution is required while feeding and working with bulls. Risk can be reduced by chutes, gates, restraints, special housing, and confinement facilities. Also, wearing protective helmets would be useful especially for preventing head injuries.

Ligature strangulation deaths in the province of Konya (Turkey)

In the present study, deaths by ligature strangulation in the province of Konya (Turkey) were evaluated from the medicolegal point of view between 2001 and 2006. In total 2850 medicolegal death cases, 161 (5.65%) were resulted from asphyxia and 20 (12.4%) of the deaths due to asphyxia were cases of ligature strangulation. Male:female ratio of the victims was 1:1 with ages ranging from 1.5 to 70 years and a mean age of 37.22+/-19.28 years. 17 cases (85%) were of homicidal and 3 cases (15%) of suicidal origin. The most widely used ligature material was clothesline in 6 cases (30%). On the examination of neck structures, thyroid cartilage fracture was present in 7 (35%) cases, fracture of the hyoid bone in 3 cases (15%), fracture both of the thyroid cartilage and hyoid bone in 1 case (5%), only ecchymosis in soft tissues in 7 cases (35%). In the paper, the findings determined in our cases are discussed in the light of the literature on the subject.

Sudden death due to a colloid cyst of the third ventricle: Report of three cases with a special sign at autopsy

Colloid cysts of the third ventricle are rare benign cysts but they may be potentially life-threatening. Three cases of sudden death resulting from colloid cysts of the third ventricle are presented. The first and second cases were treated for migraine headaches. In the first case, the patient was a 24-year-old woman who presented to the hospital with a severe headache and was sent back home after medical treatment. Six hours later, she was found dead in her bed. The second case was a 21-year-old woman who experienced a severe headache, dizziness and vomiting 1 day prior to her death. She was transported to the hospital, where she was pronounced dead upon arrival. The third case was a 25-year-old man who experienced headaches and vomiting and was diagnosed with and medically treated for sinusitis. He lost consciousness and was taken to hospital, where he was pronounced dead on arrival. During the autopsy of all three cases, there was a grey transillumination area observed that occurred due to the stretching of tissue at the base of brain between the corpus mamillare and chiasma opticum. Dissection of the brain revealed a colloid cyst of the third ventricle. To avoid such fatal complications, prompt diagnosis using CT or MRI is essential in patients who have a long-standing history of intermittent headaches. During the autopsy of the sudden deaths of people with medical antecedents of headaches, if a grey color is observed between the chiasma opticum and the corpus mamillare in the base of the brain, a colloid cyst should be considered and this region should be dissected and examined carefully.

Throat-cutting of accidental origin.

Abstract:  Incised wounds of the neck can be accidental, homicidal, or suicidal. In this paper, a death case has been presented where a spinning circular saw of a cutting machine in a workshop came off its place and cut the throat of a 30‐year‐old male who was operating the machine. There was an incision (15 cm × 5 cm) that began in the middle of the neck down the thyroid cartilage, extended horizontally to the left of the neck and ended on the outer part of the neck in the outer left side of m. trapezius. Death occurred because of exsanguination caused by the cutting of carotis artery and jugular vein. In the case we presented, although the cut in the neck initially suggested homicide, it was found to have occurred as a result of an accident after the autopsy and death scene investigation.

Is Daily Shaving of Axillary and Pubic Hair a Feature of Suicide in the Muslim Community

In the Islamic context, “fitrah” refers to humanitys innate disposition toward virtue and the ability to differentiate between right and wrong. A common quote regarding fitrah, from the Prophet is “The fitrah consists of 5 things: circumcision, trimming the moustache, cutting the nails, plucking the armpit hairs, and shaving the pubic hairs.” In this study, our aim was to determine the status of axillary and pubic shaving in medicolegal death cases that took place in the Konya Province of Turkey and to evaluate the relationship with the origin of suicide. Of 2850 medicolegal death cases, 206 (7.2%) were of suicidal origin. It was observed that the average age in the cases of suicidal origin was 36.76 ± 17.72 years, and 146 of 206 cases (70.9%) were men. As a method of suicide, hanging was the chosen method in 100 cases (48.5%), whereas firearm injuries occurred in 54 cases (26.2%), and intoxication was involved in 37 cases (18.0%). Daily axillary and pubic shaving was observed in 26 of 2644 (1.0%) death cases that occurred with nonsuicidal reasons, but in 65 of 206 were (31.6%) suicidal cases. Because suicidal notes were present in 25 (12.1%) of all of the suicidal cases, the ratio of daily axillary and pubic shaving was significantly higher than that of the suicidal notes. In investigating the cases of suicidal origin for medicolegal purposes, evidence showing that this action was committed by the victim, the presence of a suicide note at the death scene and, a history of a previous suicidal attempt, it was thought that the presence of daily axillary and pubic shaving on external examination of the victims body, when of Muslim faith, could also be considered a feature of suicide.

Livestock-Handling Related Injuries and Deaths

Handling livestock is a dangerous activity. Few farm people look upon their livestock as a source of danger. However, a number of serious injuries and deaths occur every year as a result of animal-related accidents. Livestock handlers are involved in a variety of activities such as feeding, moving animals to different locations, loading animals on trucks/trailers, artificial insemination, shearing, grooming, basic animal care such as hoof care, dehorning, and cleaning animals, roping animals, applying topical insecticides, giving vaccinations, applying topical or administering oral medications, castrating, pulling teeth, ear tagging, milking, branding, shoeing, assisting with delivery of newborns, and assisting veterinarians with treatment or handling of injured animals. Other activities involving animals may include work tasks such as plowing fields; pulling equipment such as wagons to transport farm goods; riding animals, primarily horses, for farm or ranch activities such as corralling cattle; teaching others to ride; butchering animals for food; and, rarely, euthanizing or destroying sick or aggressive animals (Langley & Morrow, 2010).

Accidental decapitation: a case report.

We report a case of an accidental decapitation of an agriculture worker in a field. The scene investigation revealed that the worker had loosely tied a scarf tied over his face in an attempt to diminish his exposure to barley dust, to which he was allergic, while distributing the barley loads with a shovel upon a trailer. The trailer was simultaneously being loaded by a helix elevator machine and its rotating shaft suddenly caught the victims scarf and pulled it down to the victims neck. The rotating motion immediately tightened the scarf around the neck resulting in hanging/strangulation noose that, by continued tightening, caused decapitation of the victim. The victims body was found on the ground by the trailer and the victims head was discovered in the barley load in the trailer. Examination revealed that the neck was severed at the level of the second and third cervical vertebrae.