Sait Özsoy

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.

Evaluation of social and demographic characteristics of incest cases in a university hospital in Turkey.

Background Incest is defined as any sexual activity between close blood relatives including step relatives and family members who are forbidden by law to marry. It is a problem that can be seen in all the social classes in developed and undeveloped societies. The World Health Organization classifies this problem as a silent health emergency. Father-daughter incest is reported to be the most common incest type followed by the other types like brother-sister, sister-sister and mother-son incest. Material/Methods Subjects for this study were recruited from a sample of incest cases referred to Forensic Medicine Department of Gaziosmanpasa University Medical Faculty Hospital between 2008 and 2012. Data involved social and demographic characteristics and clinical features of victims, perpetrators and the families. The ethical committee of the faculty of medicine approved the study. Results The study sample consisted of 43 incest cases (36 females and 7 males) with an age rage 4–40 years. Two third of the victims were under 18 years old. All perpetrators were males. Father – daughter incest (34.9%) was found to be most common incest type followed by brother – sister incest (14%). 75% of the perpetrators were family members and relatives with consanguinity while 25% of them were not consanguineous but faithful and intimate relatives to victims. Conclusions Increasing awareness about incest and its damaging effects is so important and clinicians should keep in mind sexual abuse or incest when examining the risky population. Multidisciplinary approach is necessary for determining short term or long term results and preventing the negative consequences of incest.

Electrocution fatalities in military personnel in Ankara, Turkey

Objectives: To investigate various cases of death caused by electrical injuries among Turkish military personnel. Methods: We retrospectively reviewed fatality cases of military personnel between 1994 and 2013 at the Department of Forensic Medicine, Gulhane Military Medical Academy, School of Medicine, Ankara, Turkey, the only forensic medicine center for the Turkish Armed Forces. Medical records and autopsy reports of cases of electrical fatalities were reviewed and analyzed in terms of age and gender-specific incidence, voltage, contact details, body region distribution, location, and season of incident, site, and severity of injuries sustained, and histopathological and toxicological findings. Results: Sixteen (3.5%) out of the 450 autopsy cases involved electrocution. All deaths were accidental and most frequently occurred outdoors (75%). Eight (50%) died due to high voltage while 6 (37.5%) died due to low voltage. The entry and exit lesions were determined most frequently in cases with high voltage injury. The low voltage deaths commonly occurred at the scene of the event (66.6%), while almost all high voltage deaths occurred in the hospital (87.5%, p=0.03). Electrical burns were most commonly detected in the upper extremities (32.6%, n=14). Conclusion: The present study shows that deaths due to high voltage electrocution are more frequent than low voltage electrocution among military personnel.

The relationship between nonsuicidal self-injurious behavior and manners of death: a multicenter autopsy study

Background/aim: This study aimed to determine the relationship between nonsuicidal self-injurious behavior (NSSIB) and manners of death.Materials and methods: This study retrospectively evaluated 6604 autopsy cases evaluated at forensic medicine institutes of six major cities of Turkey. The study group consisted of all cases with NSSIB findings. The control group was created from cases without signs of NSSIB. Results: We found that the numbers of possible suicide and homicide cases in the NSSIB (+) group were significantly higher than in the NSSIB (-) group. The possibility of death due to suicide was 3.213 times and homicide was 2.004 times higher than natural deaths in the NSSIB (+) group compared with the NSSIB (-) group.Conclusion: The presence of NSSIB might increase the risk of death due to suicide and homicide, especially in adolescence.

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.

Relationship between self-injurious behaviors and levels of aggression in children and adolescents who were subject to medicolegal examination

Aggression, which is defined as a behavior causing harm or pain, is a behavioral pattern typically expected in children and adolescents who are involved in criminal activities. The aim of this study was to examine the relationship between aggression and self‐injurious behavior (SIB) in children and adolescents. The study was performed in 295 cases which were sent for medicolegal examination. The mean age of the subjects was 14.27 ± 1.05 years (age range 10–18 years). The aggression levels of the subjects were determined using the Aggression Questionnaire (AQ), which is an updated form of the Buss‐Durkee Hostility Inventory. The mean total AQ score of the subjects with and without SIB was 78.04 ± 21.0 and 62.75 ± 18.05, respectively (p < 0.01). There were significant statistical differences between the two groups with respect to their subscale scores (p < 0.01). It was concluded that the levels of aggression increased in children and adolescents who were involved in criminal activities when the SIBs increased.

Deep Neck Infection Associated with Peritoneal Sepsis A Rare Death Case

Sorumlu Yazar: Doç.Dr. Sait Özsoy GATA Adli Tıp AD. Başkanlığı, Ankara E-posta: sozsoy@gata.edu.tr Geliş: 20.03.2015 Düzeltme: 24.06.2015 Kabul: 29.06.2015 1. Giriş Derin boyun enfeksiyonları; boyun potansiyel boşlukları ve kas fasiaları arasında meydana gelen apse veya selülit oluşumlarıdır. Her yaş grubunda görülebilen, tanıda güçlüklerle karşılaşılan ve komplikasyon oranı yüksek enfeksiyonlardır. Sıklıkla üst solunum yolu ve odontojenik enfeksiyonlara bağlı gelişmektedir (1-3). Dental enfeksiyonlara bağlı gelişme oranının %22.7-43 arasında olduğu bildirilmektedir (4). Nadir görülen bu enfeksiyonların çoğu, drenaj ve antibiyotik tedavisi ile tam olarak tedavi edilmelerine rağmen en ciddi komplikasyon mediastinit gelişmesidir (2). Geç tanı konulması durumunda mortalite oranının yüksek (%40-50) olduğu bildirilmektedir (2-6). Özet Derin boyun enfeksiyonları, sıklıkla üst solunum yolu ve odontojenik enfeksiyonlara bağlı gelişebilirler. Gastrointestinal sistem perforasyonları ise birçok nedenle meydana gelebilir ve erken tanı ve acil cerrahi tedavi gerektiren durumlardır. Her iki durumda da geç veya yanlış tanı, artmış morbidite ve yüksek mortaliteye neden olabilir. Diş apsesine bağlı derin boyun enfeksiyonu gelişen ve yatarak tedavi edilen bir olgunun “septik şok ve çoklu organ yetmezliği” sonucunda hayatını kaybettiği bildirilmiştir. Otopside “retrofaringeal apse” tanısı doğrulanmış ve ilave olarak antemortem dönemde tanı almamış “duodenum perforasyonu” tespit edilmiştir. Otopside tıbbi uygulama hatasına ait bulgu tespit edildiğinde, bunun otopsi raporunda açıkça bildirilmesi gerektiğini düşünmekteyiz. Anahtar Kelimeler: Diş apsesi; Retrofaringeal apse; Peptik ülser perforasyonu; Peritonit; Sepsis; Otopsi. Abstract Deep neck infection often develops due to upper respiratory tract and odontogenic infections. Gastrointestinal System perforation can occur for many reasons and is in need of early diagnosis and prompt surgical treatment. In both cases late or incorrect diagnosis may lead to increased morbidity and high mortality. An inmate suffering from a deep neck infection which developed from a tooth abscess and resulted in multiple organ failure and septic shock died while being treated in a hospital. The autopsy confirmed “retropharyngeal abscess” and revealed in addition findings of duodenal perforation that was missed during clinical examination. According to Turkish Criminal Code, a finding of a misdiagnosis should not just be reported as the cause of death but clearly stated in the report.