ABSTRACT
Objective: To identify errors in forensic reports and to describe the characteristics of traumatic medico-legal cases presenting to the emergency department [ED] at a tertiary care hospital
Methods: This study is a retrospective cross-sectional study. The study includes cases resulting in a forensic report among all traumatic patients presenting to the ED of Adiyaman University Training and Research Hospital, Adiyaman, Turkey during a 1-year period. We recorded the demographic characteristics of all the cases, time of presentation to the ED, traumatic characteristics of medico-legal cases, forms of suicide attempt, suspected poisonous substance exposure, the result of follow-up and the type of forensic report
Results: A total of 4300 traumatic medico-legal cases were included in the study and 72% of these cases were male. Traumatic medico-legal cases occurred at the greatest frequency in July [10.1%] and 28.9% of all cases occurred in summer. The most frequent causes of traumatic medico-legal cases in the ED were traffic accidents [43.4%], violent crime [30.5%], and suicide attempt [7.2%]. The most common method of attempted suicide was drug intake [86.4%]. 12.3% of traumatic medico-legal cases were hospitalized and 24.2% of those hospitalized were admitted to the orthopedics service. The most common error in forensic reports was the incomplete recording of the patient's "cooperation" status [82.7%]. Additionally, external traumatic lesions were not defined in 62.4% of forensic reports
Conclusion: The majority of traumatic medico-legal cases were male age 18-44 years, the most common source of trauma was traffic accidents and in the summer months. When writing a forensic report, emergency physicians made mistakes in noting physical examination findings and identifying external traumatic lesions. Physicians should make sure that the traumatic medico-legal patients they treat have adequate documentation for reference during legal proceedings. The legal duties and responsibilities of physicians should be emphasized with in-service training
ABSTRACT
Objective: The aim of this study was to investigate the adequacy of colored Doppler ultrasonography [CDUS] and the capability of emergency department [ED] doctors in managing testicular torsion [TT], which is a urologic emergency
Design: The study was conducted retrospectively between January 2012 and December 2015
Setting: The study group consisted of patients who presented to Adiyaman Research and Education Hospital at the ED
Subjects: Patients with acute scrotal or testicular pain and a presumptive diagnosis of TT which was later confirmed by colored Doppler ultrasonography
Intervention: None
Main Outcome Measure[s]: Capability of ED doctors in requesting colored Doppler ultrasonography for diagnosis of TT
Results: Two hundred and twenty-five male patients, with a mean age of 24.1 +/- 17.6 were included in the study, all of whom underwent CDUS. A female doctor, who was the patient's primary physician, examined 18 [8%] of the patients, and a female radiological operator evaluated 24 [10.7%] of the CDUS images. Of the 225 patients, 9 [4%] were confirmed radiologically as having TT. The most prevalent diagnosis was epididymo-orchitis [EO] [n = 87 [38.7%], p < 0.005], and the least common diagnoses were hydroceles and testicular masses [both n = 3 [1.3%], p < 0.001]. The gender of the attending physician or radiological operator and the time of the CDUS [day/night shift] did not influence the diagnosis of TT [p > 0.05, each one]
Conclusion: The results suggest that ED doctors are not sufficiently familiar with performing genital exams and managing TT. This may lead to unnecessary delays