Evaluation of forensic medical aspects of medical interventions and damages caused by unauthorized persons.

BACKGROUND: Medical interventions are procedures that are conducive to creating danger on people's life and body immunity due to their characteristics. We aimed to raise awareness and make contributions by revealing the fact that serious bodily and mental harms occur due to medical interventions by the ones who do not have the authority to perform. METHODS: We evaluated 210 cases appealled to our institution between the years of 2017 and 2022 who suffered damage after medical interventions by people who do not have any authorization or license. The damages that occurred in the cases were evaluated in terms of medical and legal aspects. Analysis of the data were done with SPSS 25.0 for Windows and the statistical alpha significance level were accepted as p < 0.05. RESULTS: 76.7% of the cases were women, 87.1% were young individuals under the age of 40 Of the medical interventions, 91.9% were for aesthetic/cosmetic purposes (laser epilation, tattoo removal, botox, dermapen, cold lipolysis), 8.1% were for therapeutic purposes (bone setter intervention, tooth extraction/prosthesis, intramuscular injection, cupping pull) was found. It was found that 87.1% of the medical interventions were performed in beauty salons, 12.9% in hairdressers, home, medical markets, pharmacies and dental clinics. CONCLUSIONS: All over the world and in our country, serious bodily and mental injuries occur in people after medical interventions by unauthorized persons. Therefore, it is necessary to see this situation as an important problem, and raise awareness in the society to make legal arrangements.

Treatment of angiokeratoma of Fordyce with long-pulse neodymium-doped yttrium aluminium garnet laser.

BACKGROUND: Angiokeratomas are typically asymptomatic, blue-to-red papules with a scaly surface located on the scrotum, shaft of penis, labia majora, inner thigh, or lower abdomen. The treatment of angiokeratomas may be necessary if they bleed and lead to patient anxiety. OBJECTIVE: To determine the safety and effectiveness of long-pulse 1,064 neodymium-doped yttrium aluminium garnet (Nd:YAG) laser for the treatment of angiokeratomas of Fordyce. MATERIALS AND METHODS: Ten consecutive patients with angiokeratoma of Fordyce were treated with long-pulse Nd:YAG laser in two to six sessions. The three authors independently assessed improvement of the lesion based on digital photographs taken before the treatment and 2 months after the end of the treatment. RESULTS: Significant (>75%, <100%) and moderate (>50%, <75%) improvement was seen in six and two patients, respectively. Complete improvement was achieved in one patient. Transient swelling, purpura, bleeding, and some pain in the treated area were noted in all patients as short-term side effects. There were no permanent side effects. CONCLUSION: The long-pulse Nd:YAG laser is a highly effective and safe treatment for angiokeratoma of Fordyce.

A randomized comparison of acitretin-narrow-band TL-01 phototherapy and acitretin-psoralen plus ultraviolet A for psoriasis.

The combination of retinoids with phototherapy enhances the efficacy of phototherapy and reduces the cumulative ultraviolet dose and duration of the therapy needed to treat chronic plaque psoriasis. Although TL-01 phototherapy has been used widely, there are few data about the effectiveness of the combination of acitretin with TL-01 in treatment of the disease. The aim of this study was to compare acitretin-narrow-band TL-01 phototherapy with acitretin-psoralen plus ultraviolet A (acitretin-PUVA) in psoriasis. We studied 60 patients with moderate to severe plaque psoriasis who were randomly allocated to three times weekly treatment acitretin-narrow-band TL-01 or acitretin-PUVA. The efficacy of treatments was assessed using the Psoriasis Area and Severity Index by a blinded observer. Clearance of psoriasis was achieved in 56.6% of patients treated with acitretin-narrow-band TL-01 and in 63.3% of those treated with acitretin-PUVA. All of these patients remained clear of psoriasis 3 months after finishing the treatments. Mucocutaneous side-effects, such as dry lips and mouth, were the most common complaints in both groups. In conclusion, acitretin-narrow-band TL-01 is an effective and well-tolerated treatment for moderate to severe plaque psoriasis, with a therapeutic effect equal to that of acitretin-PUVA.

Evaluation of application of multiple needle pricks on the pathergy reaction.

BACKGROUND: The pathergy reaction (PR) to a needle prick is a well-known feature of Behçet's disease (BD). Although PR is accepted as a major criterion in this disease, there is a lack of a standardized method to measure PR. The aim of this study was to evaluate the effect on the positive rate of PR of the application of numerous (one to six) needle pricks. METHODS: Six needle pricks were performed on 105 patients with BD. The results of the test were noted from the proximal to the distal region for each area of each patient. The positive rates of all combinations (one, two, three, four, five, and six needle pricks) were calculated as percentages by a computer-based program (SPSS version 13 for Windows), and the mean percentage rates were obtained. RESULTS: There was an increase in the percentage of positive PR rates in each combination relative to the former combination. When one needle prick was performed, the mean percentage positive PR rate was 13%. The positive PR rates were 19%, 24%, 28%, 30%, and 33% for two, three, four, five and six needle pricks, respectively. The greatest increase in the mean percentage of positive PR rates was detected for the application of the two needle prick combination. CONCLUSION: There is no consensus about the number of needle pricks required to detect PR, and multiple needle pricks have been used in many studies. We suggest that two needle pricks are suitable for the PR skin test as a useful adjunct to the diagnosis of BD.