Mahmut Asirdizer

Pleural effusion in bodies recovered from water

Both in saltwater and freshwater drowning cases, a common autopsy sign is pleural effusion. However, the factors that determine the amount of pleural effusion have not been well established. An attempt was therefore made to correlate the amount of pleural fluid in bodies recovered from water with several parameters registered on the judicial files as well as autopsy findings from the years 1994-1998. The number of cases with pleural fluid increase was found to be very high in saltwater drowning (P<0.001). But, when the freshwater and saltwater drowning cases with pleural fluid increase were compared according to pleural fluid amount, no significant difference was detected (521+/-340 and 768+/-536 ml, respectively). Although there was a positive correlation between the decomposition degree and the fluid in the pleural cavity, a relative decrease was detected in the amount of effusion contrary to the expectations in cases of extreme decomposition. Pleural fluid amount provides significant data about the type of water and the cause of death in early postmortem interval. And there is a link between the time spent in water and the amount of pleural effusion. With the advance of the postmortem interval, decomposition level and the duration of immersion should be taken into account in differential diagnosis.

CT study on morphometry of frontal sinus

The aim of this study was to determine the prevalence and morphological characteristics of the frontal sinus in an adult population. This study was conducted retrospectively on paranasal CT scans in the axial and coronal planes of 300 cases (123 male and 177 female). The mean age was 40.74 ± 13.34 (range 20–83). Measurements of the width, height and anteroposterior length for each sinus and total width were obtained from CT scans. Measurements were compared statistically with relation to side and sex. The cases were divided into subgroups according to age for each sex and each measurement parameter was also compared among the subgroups. All measurements tended to be larger on the left side and were significantly larger in males than females. There was a significant difference in the anteroposterior lengths of right and left sides in both males and females and height for males and width for females. In both sexes, the highest values of measurements were usually observed at the 31–40 age group and there was a tendency to decrease with aging. The larger diameters of the left frontal sinus imply that it may be more possibly violated during surgical interventions. Morphometric features differed significantly in the two sexes at different ages and comparison with previous studies presented great regional variability. The size of the frontal sinus was seen to be related to age and sex. The knowledge provided in the present study is useful for some surgical procedures and widens the anthropometric knowledge of humanity. Clin. Anat. 21:287–293, 2008.

The importance of medico-legal evaluation in a case with intraabdominal gossypiboma

Data concerning the incidence of gossypiboma tend to fluctuate and is difficult to estimate because of a low reporting rate lest medico-legal implication. Gossypiboma is frequently located in the abdominal and pelvic cavities after gynecologic and upper abdominal surgical operations but can also follow thoracic, orthopedic, and urological and neurosurgical procedures. In medical literature, there are few articles about the medico-legal evaluation of gossypiboma although it is typically subjected to a medico-legal process. In this article, we reported a 22-year-old female case with intraabdominal gossypiboma following a cesarean procedure and discussed the importance of medico-legal evaluation of gossypiboma.

A review of suspected cases of driving under the influence of drugs (DUID) involved in traffic accidents in Istanbul (Turkey)

Nowadays traffic accidents, which have high mortality and morbidity, are an important public health problem. The association between the use of alcohol and/or drugs by drivers and the increased risk of traffic accidents with a high risk of death and injury has been well described in the literature. This study aimed to review the incidence of cases of driving under the influence of drugs (DUID) among all cases of driving under the influence (DUI) of alcohol and/or other drugs involved in traffic accidents and to evaluate the type of the psychoactive drugs (with or without alcohol) detected in blood samples in Istanbul and its surrounding area. This study is the first investigation on the subject of DUID cases in Turkey. The reports of the Istanbul Toxicology Department of the Council of Forensic Medicine (Turkey) on suspected DUID cases involved in traffic accidents between 1 July 2010 and 30 June 2011 were retrospectively reviewed for alcohol and/or drug use. Alcohol analysis was requested in 4274 suspected DUI cases, whereas drug along with alcohol analysis was requested in only 91. The rate of suspected DUID cases (n = 91) among the suspected DUI cases (n = 4274) was only 2.1% and in this study, we evaluated only the DUID cases in detail. Alcohol was present in 44% of suspected DUID cases. Psychoactive drugs were present in 15.4% of cases. The incidence among 46 confirmed DUID cases was found to be 17.4% for cannabis, 8.7% for benzodiazepines, 4.3% for barbiturates, 4.3% for antidepressants, 2.2% for cocaine and 2.2% for amphetamines. Although there is a zero-tolerance approach for DUID in the Turkish regulations, it is not well recognised and not inspected by police and legal authorities who are responsible for taking measures in traffic accidents and for routine traffic controls in Turkey. It is concluded that psychoactive drugs should be checked as well as alcohol in all traffic accident cases and roadside controls.

A battered child case with duodenal perforation

Battered child syndrome can refer to children exposed to harmful, non-accidental and preventable physical treatment by those are responsible for their care which prevents the childs physical, cognitive and spiritual development. A 28 months old boy was submitted to hospital due to abdominal blunt trauma. He had been firstly applied to Isparta Children Hospital by his parents with the complaint of fever. In the first examination, he was conscious, his general condition was poor there was respiratory acidosis, and neck stiffness was present. There were several fresh traumatic lesions on his face and left arm. His complaints were thought due to meningitis and antibiotics were started. He was transported to Suleyman Demirel University Hospital after a day because of vomiting, abdominal pain, tender, distended and silent abdomen, and air-fluid levels in direct abdominal X-rays. An old fracture of the right 9th rib was detected with chest X-ray in university hospital. Additionally, abdominal ultrasound scan showed distended bowel loops filled with fluid. Laparotomy revealed a complete rupture of the junction of the third and fourth parts of the duodenum and several hemorrhagic regions on bowel loops. The patient was discharged after 42 days. This case report described the case through both medical and legal processed in Turkey.

A case of shotgun injury which occurred while an unconventional home security alarm system was being checked

Installation of devices involving shotguns is rarely encountered in forensic medicine practice. In this case report, authors aimed to present an unusual and rare case of shotgun injury due to a home security alarm system and its legal assessment. An electrical technician was invited to a summer house to check a home security alarm system installed by another firm which he worked for previously. It was an unconventional home security alarm system attached to a shotgun. The technician was injured with 18 buckshot pellets (no: 4) while checking the system. The host was convicted of a possible intent to cause a life-threatening injury to the technician. We think that this verdict will set a precedent for similar cases.

A Comparative and Comprehensive Analysis of Nonsexual Assaults

Abstract:  The aim of this study was to make a comparative and comprehensive analysis of nonsexual assaults in 488 medico‐legal cases presented to Forensic Medicine Outpatient Clinic of Celal Bayar University Hospital (Manisa, Turkey), between 2005 and 2009. There were blunt force injuries (BFI) in 262 cases (53.7%), sharp force injuries (SFI) in 163 cases (33.4%), and firearm‐related wounds (FRW) in 63 cases (12.9%). The results showed significant differences in the monthly distribution of assaults, localization of injuries, and severity of injuries depending on the types of assaults. Most of the injuries were localized to the face, head, and neck in BFI and SFI and to the lower limbs in FRW. The results of this study will help researchers to investigate characteristics of victims, offenders, and injuries and types of assaults because of nonsexual violence.