Evaluation of eye and serum findings in different waters in rabbits by drowning and submersion modeling.

Background/aim: This study investigated serum, vitreous, and anterior chamber fluid electrolyte changes, corneal thickness (CT), corneal volume (CV), anterior chamber volume (ACV), and anterior chamber depth (ACD) as an auxiliary diagnostic method in the identification of drowning in fresh or salt water. Materials and methods: The study used 35 healthy, adult, male, white New Zealand rabbits, seperated into five groups (control, saltwater drowning (SWD), saltwater immersion (SWI), freshwater drowning (FWD), freshwater immersion (FWI)). CT, CV, ACV, and ACD measurements were made with Pentacam topography at 0, 2, and 4 h in all groups. Magnesium (mg), sodium (Na), and chlorine (Cl) were measured in the blood at 0 and 2 h, and in blood, vitreous fluid, and humor aqueous at 4 h. Results: It was determined that CT, CV, ACV, and ACD are not of great value in drowning diagnosis and are affected by the fresh or salt water rather than drowning. Vitreous Na, Cl, and Mg levels are ineffective in determining drowning after one h. Anterior chamber fluid may provide valuable information in the differentiation freshwater - saltwater drownings at the 4th h in corpses retrieved from water. Conclusion: Anterior chamber fluid Na and Cl levels, especially in corpses removed from salt water, can be an easily used test that can help diagnose drowning.

Analysis of injuries and deaths by trauma scores due to occupational accidents.

BACKGROUND: This study was aimed to evaluate the injury characteristics, causes, results, and hospital charges in cases of occupational accidents that were reported to judicial authorities using trauma scores. METHODS: The study was performed after obtaining permission from the judicial authorities and approval from the local ethics committee. All occupational accident cases that were reported to the judicial authorities in Bolu Province between 2015 and 2019 were included in the study. The groups were compared with the Chi-Square test, Mann-Whitney U Test, and the Kruskal-Wallis Test. P<0.05 was considered statistically significant. RESULTS: This study included 3599 cases. The majority of the cases (74.70%) were male, with a mean age of 34.90±10.50 years. Occupational accidents occurred most frequently between 8 and 16 h (n=1982; 55.10%), on Friday (n=595, 16.53%), in April (n=356; 9.89%), and in spring (n=971; 26.98%). Occupational accident-related death occurred in 29 cases (0.8%). The most common injury due to occupational accidents occurred in the food industry (n=1256, 34.90%). Blunt object injury (n=1112, 30.90%) was the most common type of occupational accident; and the upper extremity (n=2049, 54.93%) was the most common injury localization. The mean Abbreviated Injury Scale of the cases was 0.94±0.74, the mean Injury Severity Score (ISS) was 1.79±4.47, and the mean New-Injury Severity Score (NISS) was 2.11±5.28. The means of ISS and NISS were statistically significantly higher for males, life-threatening injuries, work accidents in the Construction and Agriculture-Forestry sectors, fall from height, traffic accidents, and caught-in-machinery. The total hospital charge was 1,351,339.10 TL and its average was 380.30±2418.90 TL. The mean of treatment costs was significantly higher in the agriculture-forestry and construction sectors. CONCLUSION: The evaluation of all occupational accidents that are submitted to the jurisdiction on a provincial basis may provide more useful information in the prevention of work accidents. The use of trauma scores in the evaluation of occupational accidents is a useful argument for understanding the sectors and injury types that cause severe trauma. Furthermore, trauma scores may be an important predictor of hospital costs.

Evaluation of medical malpractice claims in thoracic surgery.

BACKGROUND: Medical malpractice occurs in cases, where a patient experiences damage as a result of the doctor's deviation from the standard practice or care. As in all medical specialties, thoracic surgeons may face medical malpractice claims. METHODS: Among the files reviewed by the First Board of Specialization of the Council of Forensic Medicine between January 01, 2010, and December 21, 2015, cases with malpractice allegations against thoracic surgeons were analyzed retrospectively. RESULTS: Fifty-nine of the cases were male (72.8%), and 22 were female (27.2%). The mean age was 51.13±18.97 years, and the most common age range was >60 years (n=35, 43.2%). Medical malpractice was confirmed in 11 (13.6%) of the cases. A diagnostic error was the most common cause of error (n=7, 63.6%), and the most common cause of a diagnostic error was failure to diagnose a condition on time (n=4, 36.4%). The most frequent diagnosis was 'injuries due to trauma' (n=54, 66.7%), followed by lung cancer (n=9, 11.1%). It was found that 80.2% (n=65) of the doctors intervened with the patient as a consultant. Complications developed in 48 (59.3%) of the cases. The most common complication was pneumonia (n=7, 14.6%). CONCLUSION: This was the first study in Turkey that included cases of medical malpractice claims that involved thoracic surgeons. We think that examining cases with medical malpractice claims will help physicians not only better understand the characteristics of malpractice claims but also develop strategies to prevent malpractice claims.

Evaluation of Juvenile and Adolescent Sexual Abuse Victims: A Retrospective Study.

OBJECTIVE: This study aimed to evaluate the sociodemographic characteristics and the mental, anogenital, and physical examination findings of child and adolescent sexual abuse victims and to discuss them in the light of the literature. MATERIALS AND METHODS: This study included a total of 134 children and adolescent cases between the ages of 0 and 18 who were victims of sexual abuse, from among the reports prepared in the Forensic Medicine Clinic of Bolu Abant Izzet Baysal Training and Research Hospital between 2015 and 2019. RESULTS: This study included 134 cases: 113 (84.3%) were female and 21 (15.7%) were male. The mean age was 13 ± 3.4 years (min: 3, max: 17). The average age of the defendants was 25.6 ± 13 years (min: 12, max: 75), and all the defendants were male. The defendants were strangers in 60 cases (4.8%). Sexual abuse mostly occurred as vaginal penetration in 46 cases (34.3%). Sixty-nine (51.5%) cases were exposed to abuse more than once. Depression due to sexual abuse developed in 14 (10.4%) of the cases. CONCLUSION: Considering that many child abuse victims have normal examination findings, it should not be forgotten that the interview and psychiatric examination with the child are as valuable as the genital examination.

Medical Malpractice in Turkey: Pediatric Cases Resulting in Death.

BACKGROUND: Malpractice in medicine refers to the failure of a physician to meet a standard of diagnosis and treatment, damages/injuries caused by reprehensible ignorance, or negligence of a doctor. METHODS: Allegedly malpractice cases of pediatricians and the cases in which causal link between malpractice and death was confirmed by the decision of the First Board of Specialization of the Council of Forensic Medicine between the dates of Januray 1, 2012 and December 31, 2014 were analyzed retrospectively. RESULTS: The study revealed that in the majority of 286 cases, the infants were 0-28 days old (n = 115; 40.2%) and were hospitalized due to respiratory problems (n = 111; 38.8%). The allegations of malpractice cases were most frequently seen in private hospitals (n = 120; 42%). Malpractice was found in 17.5% of the cases (n = 50), in which the majority of cased were proved to be diagnostic errors (n = 24; 48%). The most common diagnostic error was the misdiagnosis of "healthy child" in medical malpractice cases (n = 11, 22%). CONCLUSIONS: In conclusion, it is considered to be important for the pediatricians to maintain prope communication with the relatives of the patients while monitoring their health condition, and pediatricians are expected to be more careful-especially in the diagnostic phase-in the cases involving 0-1 age group as children are most likely to be diagnosed as healthy in this age group.