From Death to Life/Back to the Future: Detailed Premorbid Clinical and Family History Can Save Lives and Address the Final Diagnosis in Sudden Unexplained Deaths With Negative Autopsy.

Sudden cardiac death is a sudden, unexpected death developed by one of the many different causes of cardiac arrest that occur within 1 hour of the onset of new symptoms. Sudden unexplained death (SUD) comprises a normal heart at postmortem examination and negative toxicological analysis. SUD often arises from cardiac genetic disease, particularly channelopathies. Channelopathies, or inherited arrhythmia syndromes, are a group of disorders characterized by an increased risk of sudden cardiac death, abnormal cardiac electrical function, and, typically, a structurally normal heart. They share an underlying genetic etiology where disease-causing genetic variants may lead to the absence or dysfunction of proteins involved in the generation and propagation of the cardiac action potential. Our study aimed to evaluate the importance of next-generation sequencing in the postmortem investigations of SUD cases. In this study, 5 forensic SUD cases were investigated for inherited cardiac disorders. We screened a total of 68 cardiac genes for the sibling of case 1, as well as case 2, and 51 genes for cases 3, 4, and 5. Of the 12 variants identified, 2 likely pathogenic variants (16.7%) were the TMEM43 _ c.1000+2T>C splice site mutation and the SCN5A _ p.W703X nonsense mutation. The remaining 10 variants of uncertain significance were detected in the TRPM4 , RANGRF , A KAP9 , KCND3 , KCNE1 , DSG2 , CASQ1 , and SNTA1 genes. Irrespective of genetic testing, all SUD families require detailed clinical testing to identify relatives who may be at risk. Molecular autopsy and detailed premorbid clinical and family histories can survive family members of SUD cases.

Why do people hang themselves on trees? An evaluation of suicidal hangings on trees in Konya, Turkey, between 2001 and 2008.

Hanging 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.

Evaluation of shotgun suicides in Konya, Turkey between 2000 and 2007.

The 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.

Dead bodies found in wells.

Corpses found in wells or lime pits must be identified and the cause and manner of death must be determined. There are several circumstances that may lead to the presence of corpses in wells. In this study, 3940 death examinations and autopsies, performed at the Konya Branch of Forensic Medicine Council (Turkey) between 2000 and 2007, were retrospectively investigated, and it was found that 18 (0.46%) of the bodies had been recovered from wells. The cases were evaluated in terms of their demographic features, manner of death (accidental, suicidal, or homicidal), autopsy findings, cause of death, and the characteristics of the wells in which they were found. The ages of the victims ranged from 4 to 74 years, and the average age was 40. 4 +/- 20.6 years. Of total, 16 cases were males and 2 were females. The manner of death was determined to be accidental in 10 of the cases, suicide in 6 of the cases, and homicide in the remaining 2 cases. In 7 of the cases, death had occurred as a result of drowning in water. A comprehensive scene investigation and autopsy must be performed for corpses recovered from wells and pits for both identification and determination of the cause and manner of death. Wells should be covered and kept closed at all times to reduce the number of accidental deaths resulting from falls into wells.

Decapitation and dismemberment of the corpse: a matricide case.

Dismemberment of a corpse has always been viewed by society to be a more hideous crime than the homicide itself. In this study, we present a case of a 57-year-old woman who was decapitated and her right arm and both hands were dismembered. It was determined that the victim was murdered and dismembered by her 33-year-old daughter, who had been receiving treatment for schizophrenia for 15 years. On the victim's head and back there were 71 incised and stab wounds in total. They were superficial, except the five stab wounds which were connected to the right chest cavity and which incapacitated the victim. Although there is not a regulation for the act of dismembering the corpse in the Turkish Penal Code, since this type of case is rare, the crime scene and the autopsy findings were evaluated together with other pertinent data available in the literature.

Evaluation of farm tractor-related fatalities.

Farm tractors are the major cause of occupational fatalities in agricultural regions. Fatalities typically result from being run over or crushed by the tractor, becoming entangled in the moving parts of the tractor, accidents on roadways, and tractor rollovers, which involve the tractor tipping sideways or backwards and crushing the operator. In this study, tractor-related fatalities in the Konya province of Turkey are retrospectively evaluated. Out of the 3940 cases on which a death examination and/or autopsy was performed between the years 2000 and 2007 at The Konya Branch of Forensic Medicine Council, 86 (2.2%) of the death cases were caused by tractor accidents and are included in this study. The ages of the victims varied between 3 and 80 years old with a mean age of 31.7 + or - 22.3. Sixty-eight (79.1%) of the cases involved males, while 18 (20.9%) of the cases involved females. In 32 (37.2%) of the cases, the deaths due to tractor accidents occurred when the tractor overturned. In 37 (43.0%) of the cases, the tractor-related fatalities involved the passengers and the drivers were involved in 34 (39.5%) of the cases. In conclusion, tractor accidents are preventable and deaths from tractor accidents can be significantly reduced if drivers are required to wear safety belts and helmets and frequent checks are implemented to enforce the ban on carrying passengers.

A series of complex suicide.

This article presents 16 complex suicide cases. Complex suicide is defined as the use of more than one method to induce death. Of the victims, 10 were men and the ages ranged from 19 to 70 years. Eight victims left a suicide note. It was observed that 13 victims realized the suicidal act in the house and 5 victims had previous suicidal attempts. It was determined that 10 victims had psychiatric disorders, one of them had alcohol dependence. Six victims were housewives, 4 victims were unemployed, followed by one each victim of student, worker, farmer, tradesman, prayer leader, and animal husbandry lines of business. Ten victims were married; 3 victims were single; and 3 victims were divorced. On investigating the methods of suicide, it was seen that 9 victims preferred sharp instrument usage; 5 victims insecticide ingestion; 4 victims each firearms, medicine overdose; 3 victims each hanging, falling from a height; 2 victims self-strangulation; and 1 victim each drowning, liquefied petroleum gas and natural gas inhalation together, fungicide ingestion, rodenticide ingestion. It was determined that 2 victims used 3 methods and the other 14 victims 2 methods in company, to realize the suicide. In this article, the data obtained from our study was discussed by comparing similar data.

Precautions taken to avoid abandoning the act of hanging and reducing pain in suicidal hanging cases.

This study presents 17 cases of hanging with some preventative measures, when compared with usual hanging fatalities, between 2002 and 2006 in the province of Konya, Turkey. We observed in 4 cases that the victim had only tied together their hands, whereas in 1 case both the hands (with a clothesline) and mouth (with a plastic bag) had been fastened. In a further case, the oral orifice had been closed using a scarf and in the remaining 11 cases, soft materials such as a scarf, hood, the collar of a coat or shirt had been used as padding against the ligature loop. At first glance, the cases where the victim's hands and/or mouth were found tied were thought to be homicides. However, an investigation of the death scene, together with the autopsy findings and inquiry data, showed the cause of death was from suicide. Thus, in suicidal hanging cases certain precautions and preventative measures were observed. For example, tying the hands together was regarded as a means to make self-release impossible; closure of the oral orifice as a means to prevent the victim from calling out for help, and placing soft material against the ligature loop was thought to be an attempt to lessen the feeling of pain.

Is daily shaving of axillary and pubic hair a feature of suicide in the Muslim community?

In the Islamic context, "fitrah" refers to humanity's innate disposition toward virtue and the ability to differentiate between right and wrong. A common quote regarding fitrah, from the Prophet is "The fitrah consists of 5 things: circumcision, trimming the moustache, cutting the nails, plucking the armpit hairs, and shaving the pubic hairs."In this study, our aim was to determine the status of axillary and pubic shaving in medicolegal death cases that took place in the Konya Province of Turkey and to evaluate the relationship with the origin of suicide. Of 2850 medicolegal death cases, 206 (7.2%) were of suicidal origin. It was observed that the average age in the cases of suicidal origin was 36.76 +/- 17.72 years, and 146 of 206 cases (70.9%) were men. As a method of suicide, hanging was the chosen method in 100 cases (48.5%), whereas firearm injuries occurred in 54 cases (26.2%), and intoxication was involved in 37 cases (18.0%). Daily axillary and pubic shaving was observed in 26 of 2644 (1.0%) death cases that occurred with nonsuicidal reasons, but in 65 of 206 were (31.6%) suicidal cases. Because suicidal notes were present in 25 (12.1%) of all of the suicidal cases, the ratio of daily axillary and pubic shaving was significantly higher than that of the suicidal notes.In investigating the cases of suicidal origin for medicolegal purposes, evidence showing that this action was committed by the victim, the presence of a suicide note at the death scene and, a history of a previous suicidal attempt, it was thought that the presence of daily axillary and pubic shaving on external examination of the victim's body, when of Muslim faith, could also be considered a feature of suicide.