Uğur Koçak

Fire-related fatalities in Istanbul, Turkey: Analysis of 320 forensic autopsy cases

In this retrospective autopsy study fire-related deaths whose autopsies were carried out in the Council of Forensic Medicine in Istanbul, Turkey were analyzed in order to evaluate the relationship between the mode of the death and the laboratory and autopsy findings. There were 320 fire-related fatalities constituting the 2.07% of all autopsy cases of that period. Of the 320 cases 228 (71.3%) were males and 91 (28.4%) were females, average age in age-determined group was 36.6 (SD: 21.98) ranging from 8 months to 98 years. Carbon monoxide intoxication played role in death of 104 cases (32.5%) either directly or together with other factors such as burning and lack of oxygen. In 32 cases (10.0%) burning was the only cause of death and in 90 cases (28.1%) burning and related complications during treatment period caused death. In 35 cases (10.9%) traumatic factors other than those related to fire were responsible for death. There were 31 cases of homicide (9.7%) and 20 cases of suicide (6.3%). Accidents constituted the majority of the cases in our autopsy population with a frequency of 51.9%. The relationship between the presence of soot in trachea or esophagus and the mode of death and that of CO-Hb and the mode of death was statistically significant. The internal findings and laboratory data of the study population were discussed particularly on the basis of the decision of vitality in burned cases.

Disordered eating attitudes, alexithymia and suicide probability among Turkish high school girls

We aimed to examine association between disordered eating attitudes (DEAs), alexithymia and suicide probability among adolescent females and to explore potential link between alexithymia and suicide probability in subjects with DEAs. 381 female students completed Eating Attitude Test (EAT-26), Toronto Alexithymia Scale (TAS-20) and Suicide Probability Scale (SPS). It was found that 13.2% (n=52) of the subjects have DEAs. Results indicated that total TAS-20 score and scores of Difficulty in Identifying Feelings (DIF) and Difficulty in Describing Feelings (DDF) subscales were significantly higher in DEAs group than in those non DEAs group (p<0.05). Additionally, total SPS score (p<0.001), Hopelessness (p=0.001), Suicide Ideation (p<0.001) and Hostility (p=0.003) subscales scores of SPS were significantly higher in the alexithymic DEAs than the non-alexithymic DEAs group. In order to control potential effect of depression, SPS subscales were used as covariate factors in ANCOVA. Negative Self-Evaluation subscale yielded a statistically significant difference between groups, other subscales did not. Results point out these; DEAs are relatively frequent phenomenon among female students in Turkey and presence of alexithymia was associated with an increased suicide probability in adolescents with DEAs. The results should be evaluated taking into account that depressive symptomatology was not assessed using a depression scale.

Problematic Internet use was more common in Turkish adolescents with major depressive disorders than controls.

This study compared problematic Internet use (PIU) rates in 12‐ to 18‐year‐olds with major depressive disorder (MDD) and healthy controls and explored potential links between PIU and suicide among patients with MDD.

Autopsy evaluation of coal mining deaths in the city of Zonguldak, Turkey

Background In this study, our aim was to evaluate the fatal occupational accidents that occurred in Zonguldak coal mines between the years 2005–2008. Material/Methods We retrospectively evaluated 42 fatal coal mine occupational accidents in Zonguldak (Turkey) between the years 2005–2008. The forensic records of autopsies referred to the chief prosecutors’ office during 2005–2008 were reviewed retrospectively. There were 42 cases. The cases were evaluated with respect to age, mechanism of injury, body region of wound, cause of death, and legality of the mine. Results Ages of the deceased ranged between 17 and 52 (median: 32.9 yrs). Deaths were mostly in the 21–30 (35.8%), and 31–40 (30.9%) age groups. Only 1 case was younger than 18 years of age. Review of occupational fatalities has revealed that fatal accidents occurred mostly (76.2%) in the private, and fewer (23.8%) in the public mining enterprises. Crime scene investigation findings have demonstrated that of all occupational deaths (total n=42), 27 (64.3%) were due to subsidence, followed by methane gas poisoning (n=6, 14.2%), tram crash (n=3, 7.1%), log falls (n=2, 4.8%), electrocution (n=2, 4.8%), and methane explosion (n=2, 4.8%). Conclusions Despite laws and regulations concerning mining and because of problems in their implementation, Turkey leads the world in work-related accidents, occupational injuries, and deaths. Evaluation of autopsy findings of deaths in fatal occupational accidents occurring in coal mines is quite important in planning to decrease rates of occupational fatalities.

Age estimation by assessing the vertebral osteophytes with the aid of 3D CT imaging

The primary objective of this study was to assess the effect of age and sex on the severity and localization of osteophyte formation from three-dimensional (3D) volume rendered (VR) multidetector computed tomography (MDCT) images of thoracolumbar vertebrae. 3D VR MDCT images of thoracolumbar vertebrae of 564 adult living individuals (285 female and 279 male) with ages ranging from 20 to 84 years were studied. The study population was divided into seven groups according to age, and the severity of osteophytosis scored using a scale from 0 to 4 for each vertebra. Osteophyte scores were significantly correlated with age between 40 and 70 years of age in both males and females. Of the four vertebral regions (upper, middle, and lower thoracic, lumbar) the severity was highest in the middle thoracic region between 20 and 70 years of age and in the lower thoracic region between 70 and 90 years. Lower thoracic vertebrae presented a significant sex difference. The localisation and severity of osteophytosis varies with age and shows sexual dimorphism. Our findings will be useful for forensic work in age and sex determination.

Gender-Related Factors for Depressive Symptoms in Turkish Adolescents

PROBLEM Currently more adolescents suffer from mental health problems than compared to the past. PURPOSE This study was designed to extend the knowledge of depressive symptoms in adolescence and to determine the gender-related factors associated with it. METHODS The study sample consisted of (N = 487) adolescents. The Childrens Depression Inventory (CDI), Multidimensional Scale of Perceived Social Support (MSPSS), Strengths and Difficulties Questionnaire (SDQ-S), and UCLA loneliness scale (UCLA-LS) were completed by the participants. FINDINGS Among the study population, 26.6% (n = 130) scored ≥ 19 on the CDI, which was the cut-off point. UCLA-LS, hyperactivity and conduct problems, and peer problems subscale scores of SDQ-S were found significantly higher in males (p < .05). Emotional symptoms, pro-social behavior subscale scores of SDQ-S, and a family member, a friend subscale scores of MSPSS were found significantly higher in females (p < .05). For males, loneliness and hyperactivity and conduct problems, while for females, emotional symptoms and loneliness (p < .05) were predictive variables. Pro-social behavior and perceived family member support were protective variables for females scoring high enough to be diagnosed with depression (p < .05). CONCLUSION We suggest further studies to confirm these results as well as establishing strategies for better detection of depressive symptoms when working on adolescents.

A case of severe long-term selective mutism in a child with intellectual disability

Objectives: Selective mutism (SM) is a rare, debilitating condition usually seen in children. Selective mutism is typically found in more girls than boys at a young age, which is unlike many of the childhood disorders. Selective mutism cases have a high prevalence of comorbid psychiatric disorders. The specific manifestations and severity of these comorbidities vary based on the individual. Results: Here, we report a rare case of a Turkish adolescent male with intellectual disability (ID) presenting continuous mutism for about 2 years. Conclusion: He had significant improvement in his social interactions after the addition of psycho-educational and behavioural interventions to his fluoxetine treatment. The case is discussed in light of the related literature.

Evaluation of Child and Adolescent Psychiatry Consultations in a University Hospital

Objective: Main objective was to address the issue by presenting the reasons of child and adolescent psychiatry consultations, clinical and socio-demographic characteristics of the cases and the treatments suggested. Method: Patient information related to the consultations requested from the department of child and adolescent psychiatry by the clinics of pediatric, and other clinics in the Afyon Kocatepe University, Faculty of Medicine between February 2014 and January 2015 were retrospectively screened. Results: In the past year, 137 child and adolescent psychiatry consultations were requested. 43.8% (n = 60) of the cases were male, 56.2% (n = 77) were female. While mean age was 10.9±4.3 years. Consultations were most often requested from the clinics of pediatric (27.8%; n:38), and pediatric intensive care unit (16.7%; n:23). Of the cases, 29.2% had not received any psychiatric diagnosis. Psychiatric diagnoses were mostly depressive disorder (12.4%), adjustment disorder (8.0%), and attention deficit hyperactivitydisorder (7.3%). Medical treatment was administered to 70.2% (n:97) of the evaluated cases. Conclusions: Our study reveals that psychiatric disorders, mainly depressive disorder and adjustment disorders, are frequently seen in patients with physical diseases. Outcomes of our study emphasized the merit of these consultation demands, and importance of collaboration between disciplines.Holding more educational meetings on this issue might contribute to enhancing the cooperation between clinics.

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.