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Öğe Cyanide Intoxication: A Case Report(Emergency Medicine Physicians Assoc Turkey, 2010) Kocak, Sedat; Dundar, Zerrin Defne; Demirci, Serafettin; Cander, Basar; Dogan, HakanIntroduction: Cyanide is a rapid absorbable and powerful poison; even in small doses can cause death in minutes. It is used in many industrial fields; such as mining, chemical industries and agriculture. Recently, its use in gold mining and its enviromental toxicity is on the agenda of our country. Case Report: 60 years old male patient was brought to our clinic after drinking a sip of cyanide in his jewelry shop by 112 emergency team. In physical examination of patient, who was intubated at the scene of accident, general condition was poor, he was unconsciousness, arteriyal blood pressure was 80/50 mmHg and there was no spontaneous respiration. GCS score was 3. Patient's gastric lavage had started at the scene and contuined in our service, then active charcoal was given. The patient was taken to our intensive care unit and mechanically ventilation started with positive inotropic support. Blood cyanide level was >2.0 mg/L. 5 g hydroxycobalamin brought from Ankara could be given 9 hour after poisoning. The patient died at day 4. Discussion: Cyanide inhibits mitochondrial cytochrome oxidase enzyme and disrupts cellular utilization of oxygen lead to cellular hypoxia. Poisoning by oral consumption is a slow process and patient's recovery is sometimes possible. Therefore, the initiation of support and specific treatment as quickly as possible is important. In this case, although effective support treatment was started quickly; the specific antidote treatment could not be begun.Öğe Evaluation of Forensic Deaths During the Month of Ramadan in Konya, Turkey, Between 2000 and 2009(Lippincott Williams & Wilkins, 2013) Demirci, Serafettin; Dogan, Kamil Hakan; Koc, SermetRamadan is a holy month for Muslim people and includes long fasting periods. During Ramadan, practicing Muslims not only fast, but they also abstain from any kind of medication, smoking, sexual intercourse, and alcohol from sunrise to sunset. In the 10-year period between 2000 and 2009, it was determined that a total of 4881 death examinations and autopsies were performed at the Konya Branch of the Forensic Medicine Council (Turkey). All of the reports were retrospectively evaluated for demographic features of the cases and the manner of death. In the studied time period, a total of 491 deaths (10.1%) occurred in Ramadan. The manner of death was accident in 369 (75.2%) of the cases in Ramadan, 3107 (70.8%) of the other cases; suicide in 27 (5.5%) of the cases in Ramadan, 367 (8.4%) of the other cases; and homicide in 28 (5.7%) of the cases in Ramadan, 375 (8.5%) of the other cases. There was a significant statistical difference in terms of the manner of death between the deaths in Ramadan and in the remaining part of the year (P < 0.05). Our study suggested that there was an increase in accidental and natural deaths and a decrease in suicide and homicides in Ramadan.Öğe Evaluation of Postmortem Cerebrospinal Fluid S100B Protein and Serotonin Levels: Comparison of Suicidal Versus Nonsuicidal Deaths in Konya, Turkey(Wiley-Blackwell, 2016) Dogan, Kamil Hakan; Unaldi, Mustafa; Demirci, SerafettinAlthough suicide is a preventable public health problem, objective assays for suicide risk are limited. In this study, it was aimed to determine levels of S100B protein and serotonin as a marker for risk of suicide. S100B protein and serotonin levels were investigated with ELISA method in the cerebrospinal fluid (CSF) in medicolegal autopsy cases, including those of suicide cases (n = 32) and nonsuicide cases (n = 56). The CSF S100B levels were higher (9.3 +/- 2.9 ng/mL vs. 5.4 +/- 2.0 ng/mL), and serotonin levels were lower (10.4 +/- 4.9 ng/mL vs. 19.0 +/- 5.7 ng/mL) in suicide group than nonsuicide group (p < 0.05). There was no correlation between S100B protein and serotonin levels with gender, age groups, postmortem interval, and cause of death. It is concluded that both S100B protein and serotonin in CSF may be useful for determination of suicide risk.Öğe Evaluation of Shotgun Suicides in Konya, Turkey Between 2000 and 2007(Lippincott Williams & Wilkins, 2014) Demirci, Serafettin; Dogan, Kamil Hakan; Deniz, Idris; Erkol, ZerrinThe number of the suicides is increasing all around the world. In this study, the cases autopsied between 2000 and 2007 in The Konya Branch of Forensic Medicine Council were retrospectively investigated. Fifty-seven shotgun suicides were determined. The cases were evaluated in terms of their demographic characters, site of entrance wound, the type of the cartridge used, shooting distance, the place of incident, the place of death, motive for suicide, and the presence of previous suicide attempts. The most preferred site of entrance wound was the head with 34 cases (59.7%). Of 34 cases in which the entrance wound was on the head, there was indirect mandibular fracture in 16 cases (47.1%). In 11 cases (19.3%), there observed small ecchymosed abrasions on the finger surfaces, which are thought to have resulted from the trigger kicking back during triggering or the finger having been stuck between the trigger and the trigger guard. It is concluded that there is a need for a legal regulation that makes obtaining of shotguns more difficult and the people who have them are to be educated not to keep them in easily accessible places.Öğe Ingestion of Fireworks: Rare Cause of Poisoning in Children(Lippincott Williams & Wilkins, 2019) Yukseldraya, Hasan; Gummy, Melton; Yucel, Aylin; Energin, Meltem; Demirci, SerafettinBackground Mistaken ingestion of all manner of toxic matter is common in childhood, but poisoning with fireworks and matchsticks is rare. Fireworks usually contain 10% yellow phosphorus and 50% potassium chlorate. Potassium chlorate is an extremely reactive and toxic agent that is used in fireworks and matchstick heads. Methods Eleven cases (7 females and 5 males; median age, 36 months [ranging from 24 to 48 months]) of poisoning after ingestion of fireworks and matchstick(s), between February 2008 and June 2014, were reviewed. Results The most common initial symptom was vomiting except for 2 cases in this group. Biochemical tests indicated that hyperphosphatemia was present in all patients, 8 patients (72.7%) had subclinical hepatic injury, 1 (9%) had acute hepatic failure, and 2 patients had no clinical or biochemical evidence of hepatic damage. Three patients had renal impairment, but none of them required dialysis. All of the patients recovered with supportive therapy except for 2 cases. One patient underwent cadaveric liver transplantation, whereas the other died because of circulatory dysfunction and respiratory failure due to pulmonary alveolar hemorrhage. Conclusions Without prompt intervention, poisoning with fireworks carries high morbidity and mortality in children. It can cause pulmonary hemorrhage, in addition to other organ damage, including liver and kidney. Hyperphosphatemia is common, as it was seen in all of the study patients.Öğe MAJOR ANATOMIC VARIATIONS OF PULMONARY FISSURES AND LOBES ON POSTMORTEM EXAMINATION(Sestre Milosrdnice Univ Hospital, 2015) Unver Dogan, Nadire; Uysal, Ismihan Ilknur; Demirci, Serafettin; Dogan, Kamil Hakan; Kolcu, GirayThis study was aimed at determining major accessory fissures (MAF) and absence or incompleteness of lobar or major fissures (MF) during routine forensic autopsies. Prior to starting this prospective study, forms were prepared to collect data on pulmonary lobes and fissures. In this study, 420 lungs of 210 autopsy cases were examined for incompleteness and absence of MF and complete accessory fissures. Horizontal fissures were incomplete in 18 right lungs. Incomplete oblique fissures were noted in three right and two left lungs. Unidentified abnormal fissures were determined in one left lung and five right lungs. The most common fissural abnormality was less than half complete horizontal fissure. Four right lungs had four lobes and two left lungs had three lobes because of complete accessory fissures. The number of lobes in the left and right lungs and the morphological features of both incomplete MF and MAF were determined in detail and the variations were photographed. It is concluded that, in addition to studies on computed tomography scans, autopsy series are useful for determining the variations of MF and MAF of the lungs in different populations.Öğe Pseudoaneurysm originating from left ventricle aneurysm: An autopsy case and review of literature(Elsevier Sci Ltd, 2013) Dogan, Kamil Hakan; Demirci, Serafettin; Tavli, Lema; Buken, BoraRupture of the free wall of the left ventricle is a catastrophic complication of acute myocardial infarction. Rarely, free wall rupture is contained by overlying adherent pericardium, producing a pseudoaneurysm of the left ventricle. In this report, a case of a left ventricular pseudoaneurysm due to a previous myocardial infarction is described. A 55-year-old woman had a severe chest pain 11 months prior to death. No cardiac investigation was performed. Three days prior to death, she suffered from fatigue and weakness, and had a witnessed sudden cardiac death. At autopsy, a 8.5 x 10 x 8 cm pseudoaneurysm of the left ventricle was found. There was severe coronary artery atherosclerosis. There were extensive adhesions between pericardium and pseudoaneurysm wall. The cause of death was attributed to heart failure and resulting arrhythmia. The case illustrates the rare event of left ventricular pseudoaneurysm first diagnosed at forensic autopsy. (C) 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.Öğe Suicide in two patients with epilepsy and cystic degeneration areas of their brains(Romanian Legal Med Soc, 2013) Dogan, Kamil Hakan; Demirci, Serafettin; Baba, Z. Fusun; Buken, BoraSuicide is an important cause of death among patients with epilepsy. In this report, we describe two patients with epilepsy whose brain examinations revealed cystic degeneration areas. The first case was a 42-year-old man who had been treated for epilepsy for five years. It was reported that his epilepsy attacks had increased over the six months prior to his suicide, and that he had severe conflicts with his wife during the last two months. He committed suicide by hanging. An autopsy revealed two cystic degeneration areas on the left temporal lobe, and one cystic degeneration area on the right parietal lobe. The second case was a 30-year-old man who had been receiving epilepsy treatment for 10 years. It was reported that his epilepsy attacks had increased in the four months prior to his suicide, and his wife had left home because of continuous arguments. He committed suicide by drinking rodenticide (aluminum phosphide). An autopsy revealed a cystic degeneration area on the right temporal lobe. Neither of the two cases had a history of head injury, and the cystic areas are evaluated as border zone infarcts due to prolonged hypoxemia caused by recurrent status epilepticus attacks. In conclusion, in case of the determination of the cystic degeneration areas in patients with epilepsy in computed tomography or magnetic resonance imaging examinations, it will be beneficial to follow these patients in terms of epileptic attacks and psychiatric defects.Öğe Why Do People Hang Themselves on Trees? An Evaluation of Suicidal Hangings on Trees in Konya, Turkey, between 2001 and 2008(Wiley, 2015) Dogan, Kamil Hakan; Demirci, Serafettin; Deniz, IdrisHanging is the most common method of suicide in the world, and many public places offer a means or opportunity to carry out the activity. Of 4,452 death examinations and autopsies, there were 378 (8.5%) suicides and suicide method was hanging in 185 (48.9%) cases. In 20 of these (10.8%), the suspension point was the branch of a tree. The incident location was the garden of the victim's house in nine cases, the woodlands in seven cases. The suicides were attributed to psychiatric disorders in nine cases, economic problems in six cases, and family problems in five cases. It is concluded that hanging on a tree as a suicide method is often committed by males and the underlying motive may be different in suicidal hangings on trees occurring at daytime and night. For preventional purposes, the reporting of such suicides in public places by the media may be restricted by local authorities.
