Browsing by Author "Kartal, E."

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An Autopsy Series: Lightning-Related Deaths in Van and Hakkari Provinces, Turkey
(Univ West indies Faculty Medical Sciences, 2021) Hekimoglu, Y.; Asirdizer, M.; Demir, U.; Gur, A.; Etli, Y.; Gumus, O.; Kartal, E.
Objective: To report the largest series of lightning-related deaths in Turkey, to review the literature on this subject, and to identify similarities and differences between the autopsy findings in this study and the information available in literature. Methods: In this study, autopsy reports and crime scene investigation data on 11 lightning-related fatalities that occurred in the Van and Hakkari Provinces, Turkey, from January 1, 2011 to December 31, 2015 were retrospectively reviewed. Results: Of the 1699 fatalities, 11 (2.53%) evaluated by medico-legal autopsy in the Van and Hakkari Province in a 5-year period died from lightning strikes. Of these cases, 10 (90.1%) were males and 1 (9.9%) was female (p < 0.05). All cases were in the 11 to 33 years age group. All cases were injured outdoors. Conclusion: We concluded that deaths due to lightning strikes are relatively rare in Turkey, and may be reduced with precautions such as avoiding staying under trees or in the vicinity of high towers, refraining from touching metal objects, avoiding lying on the ground, leaning on walls, and crouching outdoors.
Crime Scene and Autopsy Findings in Two Cases of Sudden Death Caused by Inhalation of Butane Gas
(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Kartal, E.; Etli, Y.; Demir, U.; Ata, U.; Asirdizer, M.
Solvent inhalation is still an important public health problem that is responsible morbidity and mortality of young people worldwide and has adverse effects on society. In Turkey, solvent inhalation is the most common substance abuse following smoking and alcohol addiction, and butane and propane have been reported to be the most frequently inhaled substances. In this study, the crime scene information is presented, with the pathology and toxicology analysis results of two cases of death due to inhalation of n-butane, one as suicide and the other accidentally. Although clinical findings were described in detail in cases hospitalized due to butane gas inhalation and in death cases, the number of articles describing crime scene and autopsy findings is limited. In this case report, it is aimed to describe of the findings that they may encounter during the crime scene and death examination, especially for general practitioners and autopsy findings of cases. Consequently, it is important for the general practitioners participating in the corpse examination to be careful about the crime scene and the findings on the corpse, for accurate toxicological analyzes and accurate determination of the cause of death. These physicians should give clues to forensic experts about signs such as thinner, glue, or gas source near the corpse, a plastic bag placed on the head of the corpse, vomit stains near the corpse or on their clothing. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The Effect of Temperature on the Suicide Rates in Turkey: A Time Series Analysis
(Yuzuncu Yil Universitesi Tip Fakultesi, 2025) Kartal, E.; Etli, Y.
Introduction: Rising ambient temperature is increasingly recognized as a potential risk factor for suicide, yet long-term, nationwide evidence from developing countries remains limited. This study investigates the association between temperature and suic ide rates in Turkey over a 24-year period. Methods: Monthly suicide data were obtained from the Turkish Statistical Institute (2000–2023), while average temperature was derived from the ERA5-Land reanalysis dataset. A Seasonal Autoregressive Integrated Moving Average with Exogenous Regressors (SARIMAX) model accounted for seasonality, autocorrelation, and temperature as a covariate. Results: All three SARIMAX models showed a statistically significant positive relationship between temperature and suicide rat es. For each 1°C increase, the suicide rate rose by 0.0038 per 100,000 population in the total group, 0.0043 per 100,000 among males, and 0.0025 per 100,000 among females. Model diagnostics (e.g., Ljung-Box, Jarque-Bera) suggested good overall fit. Despite limitations such as the lack of daily data and additional covariates, these findings underscore the robust link between ambient temperature and suici de. Discussion and Conclusion: This nationwide analysis highlights temperature as an important environmental factor influencing suicide. In light of climate change, public health strategies should consider the implications of rising temperatures. Future work inc orporating more covariates and higher-resolution data could further elucidate the complex relationship between temperature and suicidal behavior. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Hypothermia Deaths in Van Province, Turkey
(Univ West indies Faculty Medical Sciences, 2021) Hekimoglu, Y.; Etli, Y.; Gumus, O.; Kartal, E.; Demir, U.; Asirdizer, M.
Objective: To evaluate autopsy findings in hypothermia-related deaths in Van Province, Turkey, a city near the Turkey-Iran border. Methods: Autopsy reports on 43 hypothermia fatalities were retrospectively reviewed. Data regarding age, gender, nationality of the cases, seasonality of the deaths, crime scene findings, autopsy findings, manner of deaths, risk factors for hypothermia, other traumatic lesions, and toxicology were obtained from autopsy records and scene investigation records. Results: There were 36 males and 7 females. The mean age was 20.5 years. More than half of the cases died or were found dead in the spring months. All but one of the cases was found dead outdoors. There were common red-coloured livor mortis in 33 cases (76.7%), antemortem traumas in 16 cases (37.2%), cold erythema in 26 cases (60.5%), myxedema in 1 case, bloody discolouration in the synovial fluid in 11 (84.6%) cases, and Wischnewski spots in 32 cases (74.4%). Conclusion: The study showed that illegal refugees are an important social problem in Turkey. Hypothermia should be considered as a cause of death for refugees when they are found, especially in the cold provinces. In the diagnosis of hypothermia, bloody discolouration of the synovial fluid is confirmed to be a valuable finding. Wischnewski spots remain valuable for positive identification.
Neck Vascular Lesions in Hanging Cases: a Literature Review
(Churchill Livingstone, 2022) Asirdizer, M.; Kartal, E.
The aim of this review was to investigate the types and rates of vascular lesions occurring in cases of completed hanging and near-hanging, defined in literature. In the literature to date, 6 specific types of vascular injuries have been defined in cases of death as a result of hanging. These are Amussat's sign, Etienne Martin's sign, Dominguez-Paez sign, Friedberg-Lesser sign, Ziemke-Otto's sign, and Lupascu sign. As a result of this study, it was determined that the most defined finding was the Amussat sign, and it was concluded that the other findings were not sufficiently recognized. Likewise, considering that the proportional differences are due to the differences in the rates of autopsy practice and autopsy protocols between countries, it can be suggested that international joint autopsy protocols should be developed at the meetings in which national professional associations participate. © 2021 Elsevier Ltd and Faculty of Forensic and Legal Medicine
The Protective Effect of Ramadan on Suicide: A Study Based on Monthly Suicide Statistics of Turkey
(Yuzuncu Yil Universitesi Tip Fakultesi, 2025) Kartal, E.; Etli, Y.
Ramadan is one of the months in the Islamic lunar calendar and is considered the most sacred month. Ramadan brings significant changes to the daily lives of Muslims, and previous studies have identified various alterations in health-related parameters during this period. This study analyzed the relationship between Ramadan and suicide, a topic that has been relatively underexplored. This study analyzed monthly national suicide statistics in Turkey from 2003 to 2022 to investigate whether there was a statistically significant difference in suicide rates between months with Ramadan days and those without. As a result, it was found that suicide rates in months with Ramadan days were significantly lower in the total population and the male population. Although the rates were also lower in the female population compared to months without Ramadan days, the difference was not statistically significant. Religious sentiments and social environments during Ramadan may protect Muslims from suicide. Future studies using time series analysis could provide valuable insights and data free from the influence of seasonal effects. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Sex Determination Using Image Processing Reveals Elliptical Features of the Female Pelvic Inlet
(Nature Research, 2025) Etli, Y.; Kartal, E.; Demir, U.; Etli, E.; Hekimoglu, Y.; Aşırdizer, M.
The pelvic inlet is one of the critical constraints within the relatively narrow birth canal for the passage of the fetal head. This study tested the hypothesis that the shape of the pelvic inlet differs between females and males, with the expectation that the female pelvic inlet is more elliptical than its male counterpart. Abdomino-pelvic computed tomography images from 600 cases, equally distributed by sex and age groups, were analyzed. Using 3D reconstruction, image processing, ellipse fitting, and a genetic algorithm, we evaluated whether the proposed measures of elliptical similarity in pelvic inlet shape varied by sex. Additionally, discriminant analysis was employed to assess the accuracy of sex determination based on these measures. The results demonstrated significant differences between the two sex groups for all proposed measures. Discriminant analysis achieved a maximum sex determination accuracy of 79.7%. These findings support the hypothesis that the female pelvic inlet has evolved to be more elliptical compared to the male pelvic inlet. If validated by future studies on diverse populations, this hypothesis may gain broader scientific acceptance. © 2025 Elsevier B.V., All rights reserved.