The forensic evaluation of dental injuries in Istanbul, Turkey

When a person is wounded in Turkey, he first attends hospital for treatment. The hospital is responsible for a report describing his injuries and their treatment and prognosis. The patient is then scanned by a specialist in forensic medicine who provides a final official report. In that report the lesions, the prognosis (including whether the injuries are life threatening or not) and the projected days away from daily activity are shown. In this study 18,317 cases which were examined in the second and the third Specialization Board of the Council of Forensic Medicine during 1996 were analyzed. Among them 112 cases were dental injuries. Dental injuries are reviewed according to their sex, causation, detail of injury, and they are compared to other studies.     

Suffocation due to foreign body aspiration visualized by post-mortem CT

The aspiration of a foreign body is a high-risk event in the life of an infant or toddler, which needs fast clinical diagnosis and therapy. If the respiratory tract is massively obstructed, the aspiration can be fatal, as shown in the case of an 18-month-old child. The little boy choked on a fragment of a hazelnut shell. Besides radiography and bronchoscopy, a CT scan can be of special value to visualize the foreign body. Based on the data obtained, a virtual bronchoscopy can be calculated. Compared with conventional radiography, the advantages of computed tomography are better image quality, higher indicative value and the possibility to exactly localize the foreign body in the respiratory tract. In the presented case, the nutshell could be visualized in the larynx before autopsy.     

Fatalities Caused by Spherical Bullets Fired from Blank Cartridge Guns in Istanbul, Turkey

Abstract:  Blank cartridge guns are generally regarded as being harmless and are not considered to be firearms in the legal sense in most countries. To show the danger of these guns upon simple modifications, we report 59 fatalities resulting from these simply modified blank cartridge guns in Istanbul, Turkey. The great majority of the victims were males and the age of those ranged from 11 to 61 years. In 55.9% of these cases, homicide was the origin followed by suicide (39%). The right temporal region was detected to be the preferred region in suicidal shots by blank cartridge guns with a frequency of 56.5%. In trial shots, all these guns were detected to discharge steel or lead spherical objects, generally 4 or 5 mm in diameter, successfully. Our findings strongly suggest that these guns should also be considered as handguns in the legal sense.     

Heroin Overdose Deaths and Heroin Purity Between 1990 and 2000 in Istanbul,Turkey*

Abstract: Turkey has continuously experienced problems with abuse of, and addiction to, opium derivatives. In this study, we analyzed the relationship between heroin overdose deaths and the characteristics of seized opium derivatives. Data were gathered from the Council of Forensic Medicine of the Ministry of Justice in Istanbul from 1990 to 2000. There were 636 heroin‐related deaths during this period, 595 of which were classified as heroin overdose deaths. Mean crude and weighted heroin purities remained relatively constant and were calculated to be 46% (57–34%) and 51% (39–59%), respectively. The weight of heroin and the number of heroin seizures, but not the heroin purity, were significantly associated with the number of heroin‐related deaths. Prevention strategies are needed to reduce the number of deaths caused by overdoses in countries situated on drug trafficking routes. These strategies should focus on drug trafficking, by providing increased levels of, and support for, law enforcement, stopping the supply of precursor chemicals, and combating corruption among border officials.     

Death, after swallowing and aspiration of a high number of foreign bodies, in a schizophrenic woman

A 46-year-old woman who had had a long-term schizoid psychosis collapsed on the street. Upon admission to the hospital, she was determined to have an acute abdomen. The chest radiograph showed metallic foreign bodies in both main bronchi; foreign bodies in the stomach were not observed clinically. The woman died from repeated cardiac arrest shortly after hospital admission. At the autopsy a screw and a nail were found in both main bronchi. The abdominal cavity contained 2 L of greenish purulent fluid and a massive fibrinoid peritonitis was observed. Two perforations of the stomach, each 1 cm in diameter, were detected. The stomach was completely filled with a mass of metallic foreign bodies, greenish fluid, and a bezoar of a total weight of 1,400 g; 422 distinguishable and mostly metallic foreign bodies were counted. Death was attributed to cardiac arrest in delayed shock after massive purulent peritonitis caused by two gastric perforations combined with obstruction of the airways by aspirated foreign bodies. Cases of massive swallowing of foreign bodies are mainly restricted to mentally handicapped persons, especially schizophrenics, whereas acute impaction of the larynx by large food particles occurs nearly exclusively in heavily intoxicated adults.     

An Evaluation of Childhood Deaths in Turkey Due to Yellow Phosphorus in Firecrackers

Yellow phosphorus (YP) is a powerful protoplasmic poison used in the manufacturing of matches, pest poisons, firecrackers, firework cracker, lights for watches, military ammunition, and agriculture fertilizer. YP is extremely flammable and toxic and easily absorbed from the gastrointestinal tract. In this study, we examined childhood deaths from 1997 to 2012 resulting from the ingestion of firecrackers. The patients ranged from 2 to 15 years of age and were admitted to the hospital with a variety of symptoms. Those that presented with nausea, vomiting, and hypotension rapidly deteriorated and entered a coma. An autopsy was performed in all but one of the 16 cases reviewed. Macroscopically, the livers had a yellowish discoloration with petechial bleeding. Histopathologic examination revealed acute toxic hepatitis. In conclusion, these firecrackers are found in corner shops throughout Turkey, may cause death in children with little warning, and should be banned to prevent further deaths.     

Childhood Trauma,Type of Marriage and Self-Esteem as Correlates of Domestic Violence in Married Women in Turkey

The aim of this study is to determine childhood trauma, the type of marriage, and level of self-esteem as correlates of domestic violence in married women in Turkey. The study sample consisted of 750 women aged 20 and over, selected through face to face interviews. Results More than half the women were exposed to domestic violence, which increases with factors like lower economic status, teenage and arranged marriages and a large number of children. According to the logistic regression model, arranged marriages, sexual problems and physical abuse during childhood lead to an increase in the occurrence of domestic violence, while this decreases as the partners age. The Rosenberg Self-Esteem Scale scores were significantly lower in women subjected to domestic violence and this decrease became statistically significant as the level of abuse experienced during childhood increased.     

Identification of a tooth-like foreign body in Swine sausage

A tooth-like foreign body (FB) was found inside a sausage bread. Analysis aimed to investigate whether the FB was a tooth and its origin. The FB was measured, weighed, photographed, and radiographed. Macroscopic findings were suggestive of an anterior tooth. Histological slides of undecalcified cross-sections of the FB and samples of human and swine teeth were prepared. Histological features of the FB (in light microscopy, 125× magnification) were discrepant from human tissues. Compared histological analysis displayed majority of features consistent with a hypsodont swine tooth, probably a canine. Cellularized cementum in crown region, adjacent to the enamel, and shape of the cementocytes were the main criteria excluding the possibility of human origin of the FB. Scanning electronic microscopy and energy-dispersive spectroscopy were not performed because of fewer features to be analyzed and FB size. It was concluded that the FB may have been incorporated during meat grinding of the sausage.     

Sudden death following foreign body entrapment in the esophagus]

Case report about a 53 year old man, suffering from sudden suffocation, caused by inflammatory laryngeal edema following a foreign body traping in the esophagus with consecutive abscess and phlegmona of the esophageal wall.     

Foreigners Dying in Istanbul

Abstract:  The study included 411 deaths selected from 14,647 medicolegal deaths autopsied in the Morgue Department of Forensic Medicine Institute Directorate, affiliated with the Ministry of Justice, between 1998 and 2002. Data were collected from court documents, coroner's investigation reports, and autopsy reports. The parameters of age, gender, nationality and origin, cause and place of death in foreigners dying in Istanbul were evaluated in the study. Out of 14,647 medicolegal deaths, 3.5% were foreigners from 34 different nationalities. The nationality with the highest rate of foreigner deaths (34%) was Romanian. Out of 411 deaths, 74.3% were male and 25.7% were female. Of all cases, 64.4% were tourists visiting Istanbul and 35.6% had a job in Istanbul. Of 146 foreigners employed in Istanbul, 94.5% did not have a work permit, while only 5.5% had a work permit.     

Impacts of realized volatility of oil price over foreign trade related activities in Turkey

Since 1973 oil crises, especially, small open economies have considered sudden and highly volatile movements in currencies and current account deficits. Oil prices have been breaking new historical price records since second quarter of 2014, especially from last quarter of 2015 to first quarter of 2016, which have gradually put pressure on political, geographical, and currencies risks in the Middle East and Eastern European countries. Similarly, because Turkish economy has been experienced serious current account deficit problems especially since 2002, the effect of decline in oil prices and increased volatility has been worth of investigating. For 2003M1–2015M7 period, export–import ratio, real exchange rate index, realized volatility in oil prices calculated based on monthly OPEC basket price, industrial production index, and consumer price index were collected to analyze these effects and causality relationship among these variables. Test results of unit root test with and without structural break, ARDL bound test and co-integration test were sorted out among variables. Initial result is that price volatility increases and total import decreases more sharply than total export after the decline in oil prices; thus, export–import ratio increases. Another is that there is a negative relationship between real exchange rate index and export–import ratio for real economy because of low oil substituents. As expected, inflation has an adverse effect on foreign trade ratio. Consequently, because of lower pressure of energy-induced inflation, economy policy makers will have some ability to change their priorities from inflation issue to other structural problems.     

An unusual foreign body in the distal small intestine: case report

A case of a deceased 77-year-old woman presenting to the coroner for postmortem examination scribed. A plastic tie used to seal loaves of sliced bread and other plastic-wrapped food stuffs was found clamped by its "teeth" to a length of small bowel proximal to the cecum, resulting in localized mucosal ulceration, thickening, and edema of the bowel wall. There was also infarcted small bowel due to aortic atherosclerosis, which was submitted as the cause of death. The presence of the bread tie probably did not significantly contribute to death but was as an unusual finding at postmortem examination and has not been previously described.     

Deaths among homeless people in Istanbul

The number of the homeless people in Istanbul, one of the largest cities in the world, is at present unknown. There has been no previous study in Turkey on cases and causes of death occurring among these individuals. In this paper, documents and autopsy reports of the Mortuary Section of the Council of Forensic Medicine, Istanbul, covering the period January 1st, 1991-December 31st, 1995, were reviewed. We established that there were 126 cases of death among homeless individuals in Istanbul during this period, 120 of them being males (95%), four (3%) females, and two (2%) transsexuals. Ninety-four corpses were found outdoors, 32 indoors. No personal documents, such as identity cards, were found in 110 individuals (87%), whereas only 16 individuals could be identified. Most deaths occurred in the age group of 41-50 years. One hundred and three of the cases (82%) died in the cold season between October and April. The deaths of 98 cases were attributable to natural causes, whereas the remaining 28 cases died from unnatural causes. Respiratory tract diseases occupied the first rank among cases of death from natural causes (44%). Alcohol abuse and other infections were further striking factors contributing to the fatal outcome. This is the first retrospective study on this topic in Turkey. However, more detailed and anterospectively programmed studies on this subject, a growing social problem, should be carried out.