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Now showing 1 - 10 of 30
  • PublicationMetadata only
    Comparison of autopsy findings and injury severity scores in deaths due to traumatic asphyxia (perthes syndrome)
    (2018-05-01) ARSLAN, Murat Nihat; KERTMEN, Çisem; MELEZ, İPEK ESEN; MELEZ, Deniz Oğuzhan; MELEZ, İPEK ESEN
    Traumatic asphyxia is a rare clinical syndrome usually caused by sudden and severe thoracic and/or thoracoabdominal compression. It presents with craniofacial cyanosis, petechiae, and subconjunctival haemorrhages. The present study employed a postmortem retrospective methodology to analyse autopsy findings and accompanying injuries in cases of death due to traumatic asphyxia.
  • PublicationMetadata only
    Sudden death associated to hypersensitivity myocarditis induced by clozapine: an autopsy case
    (2016-04-01) EŞ, Hüseyin; ESEN MELEZ, İPEK ESEN; ÖZGÜN, Ayşe; MELEZ, Deniz Oğuzhan; KERTMEN, Çisem; CAVLAK, Mehmet; MELEZ, İPEK ESEN
  • PublicationMetadata only
    The use of underground wearing out features of organic and inorganic materials in forensic taphonomy
    (2015-04-11) ŞAHİN, Fatih; ÜNER, Hüseyin Bülent; ÇAĞDIR, Ahmet Sadi; MELEZ, Deniz Oğuzhan; ESEN MELEZ, İPEK ESEN; MELEZ, İPEK ESEN
  • PublicationOpen Access
    Evaluation of medical malpractice in emergency and elective general surgery cases resulting in death
    (2016-07-01) Akcakaya, Adem; Uzun, Ibrahim; Ozdemır, Erdinc; Melez, Ipek Esen; Melez, Deniz Oguzhan; MELEZ, İPEK ESEN; AKÇAKAYA, ADEM
    Background: General surgery is one of the branches in which the distinction between complication and malpractice is difficult to distinguish. In this study, presentation of the main forensic medical parameters considered for the evaluation of medical malpractice in cases of general surgery deaths in which medical malpractice has been alleged and discussing related concepts through the literature are aimed. Methods: Allegations of medical malpractice against general surgery physicians sent to the First Forensic Expertise Board of the Council of Forensic Medicine between January 1, 2012 and December 31, 2013 for which the relation of casuality between medical malpractice and death had been determined were retrospectively evaluated. Results: Medical malpractice was ruled in 21.9% (n=23) of 105 cases. The most common primary disease diagnoses were trauma-injury (n=32, 30.5%), cholecystitis (n=25, 23.8%) and appendicitis (n=8, 7.6%). When treatment types were compared according to malpractice decision, rate of malpractice in medicine-only treatment was found to be significantly higher compared to surgery + medical treatment (p=0.003, p<0.01). No statistically significant difference was found regarding the rate of malpractice between cases of emergency and elective surgery (p>0.05). When incidence of medical malpractice was compared between cases with clinical diagnosis and diagnosis determined by autopsy, a statistically significant difference was found (p=0.031, p<0.05). Malpractice was ruled at a significantly lower rate in cases in which diagnosis was confirmed with autopsy (p=0.028, p<0.05). Discussion: It can be concluded that physicians are as successful in emergency conditions as in elective conditions and correct administration of medical treatment is of vital importance. Moreover, the Council of Forensic Medicine considers the clinical follow-up data as well as the autopsy data in medical malpractice evaluation.
  • PublicationMetadata only
    Evaluation of the deaths secondary to entrapment under the debris in the Van earthquake
    (2013-06-01T00:00:00Z) HEKİMOĞLU, Yavuz; Melez, Ipek Esen; Canturk, Gurol; Erkol, Zerrin; Canturk, Nergis; DİZDAR, Mustafa Gokhan; MELEZ, Deniz Oguzhan; GÜLER, Osman Nuri; MELEZ, İPEK ESEN
  • PublicationOpen Access
    Sudden unexpected death in epilepsy: a retrospective autopsy study of 112 epileptic patients
    (2016-03-01) ESEN MELEZ, İPEK ESEN; ARSLAN, Murat Nihat; MELEZ, Deniz Oğuzhan; ŞANLI, Ahmet Necati; KOÇ, Sermet; MELEZ, İPEK ESEN
    Introduction: Sudden unexpected deaths comprise the most important and worthy investigation case profiles in both neurology and forensic medicine. Epilepsy, which is one of the neuropathological causes of sudden unexpected deaths, is an important disorder having mysterious aspects. The aim of this study is to make common the points of view between neurology and forensic medicine experts and to discuss the features of the findings together with the related clinical hypotheses, leading to the differential diagnosis of sudden unexpected death in epilepsy (SUDEP) by presenting autopsy findings and available medical data of patients who had a prior diagnosis of epilepsy. Methods: In Istanbul, the cases of 20334 autopsied patients who were referred to The Ministry of Justice Council of Forensic Medicine between 2007 and 2011 were identified from the complete forensic autopsy data of the city and were retrospectively reviewed. Patients who had a prior diagnosis of epilepsy were included. Both descriptive and inferential statistical analyses were performed through the parameters of demographical data, physical properties, incident features, macroscopic-microscopic autopsy findings, and cause of death initially for all cases and then separately for SUDEP cases. Results: Among the 20334 patients, 112 were determined to have a prior diagnosis of epilepsy. A possible macroscopic and/or microscopic epileptic focus was present in 23 (20.5%) of these 112 cases. The cause of death was determined to be SUDEP in 40 (35.7%) cases, while it could not be determined in 28 (25%) cases. Among patients whose death cause was considered as SUDEP, the male-to-female ratio was 1.1:1, while the mean age was 31.5±13.9 years in males and 29.6±12.9 years in females. The presence of hypertrophy and myocardial scar tissue findings in the microscopic examination were significantly more frequent among patients determined to have died from cardiovascular diseases compared to patients in the SUDEP group (p=0.001 for each finding). Besides, in 40 SUDEP cases, 38 (95%) patients underwent toxicological analysis and no antiepileptic agent was detected in 21 (55.3%) of these. Conclusion: It can be concluded that there is equality in gender distribution among SUDEP patients, that the young adult population has a slightly increased risk for SUDEP, and that the inconsistent use of antiepileptic medicines is a greater risk factor for SUDEP than polytherapy. Besides, it is important to emphasize that all clinical and postmortem parameters together should be considered for the differential diagnosis of SUDEP, particularly with cardiovascular diseases.
  • PublicationMetadata only
    Manner of death determination in fire fatalities: 5-year autopsy data of Istanbul city
    (2017-03-01) ESEN MELEZ, İPEK ESEN; ARSLAN, Murat Nihat; MELEZ, Deniz Oğuzhan; GÜRLER, Ahmet Selçuk; BÜYÜK, Yalçın; MELEZ, İPEK ESEN
    Death resulting from burns is an important social problem and a frequent accident. However, because approximately 10% of cases are estimated to result from a fire that was deliberately started, all fire-related deaths should be treated as suspicious, and the cause of a fire should be investigated. For the bodies recovered from the scene of a fire, the manner of death could also be suicide or homicide. The objective of this study was to contribute to the clarification of controversial data present in the literature on the manner of death determination of fire-related deaths, through evaluation of autopsy findings of bodies recovered from fires. We reviewed 20,135 autopsies performed in a 5-year period, in Istanbul, as the whole autopsy data of the city and found 133 fire-related deaths. The death scene investigation reports and other judicial documents, autopsy fmdings, and toxicological analysis results were evaluated to determine the parameters of age, sex, level of the burn, vital signs [red flare; soot in the lower respiratory tract, esophagus, and/or stomach; and screening of carboxyhemoglobin (COHb) levels in the blood], toxicological substances, presence of accelerants, cause of death, and manner of death. The manner of death was determined to be an accident in 98 (73.7%) and homicide in 12 (9%) cases, whereas there was no suicide. In addition, it could not be determined in 23 (17.2%) cases. In accidental deaths, the most frequent cause of death was COHb poisoning with statistically significant blood COHb levels greater than 10%. Further, the presence of soot in the lower respiratory tract, esophagus, and/or stomach and the existence of at least 1 or 2 vital signs together were found to be valid deterministic criteria with statistical significance in terms of identifying the manner of death.
  • PublicationMetadata only
    Sudden Death Associated with Hypersensitivity Myocarditis Induced by Clozapine: An Autopsy Case
    (2016-06-01T00:00:00Z) Es, Huseyin; MELEZ, İPEK ESEN; Ozgun, Ayse; Melez, Deniz Oguzhan; Kertmen, Cisem; Cavlak, Mehmet; MELEZ, İPEK ESEN
    Eosinophilic myocarditis is a rare cause of sudden unexpected death and characterized by eosinophilic infiltration in the myocardium. Clozapine is among the agents that can cause eosinophilic myocarditis. Our case is a 48 year-old female patient who was hospitalized in psychiatry inpatient unit and died unexpectedly on the 35th day of her hospitalization while on clozapine treatment. Even though the autopsy revealed an increased heart weight, fatty streaks on aorta, and thickening of epicardial fat tissue macroscopically, no pathological macroscopic features were noted in the myocardial cross sections. Eosinophilic myocarditis findings were found in the histopathological evaluation. Toxicological assessment revealed presence of clozapine in the blood (735ng/ml clozapine and its metabolite) and the bile. In the lights of these findings, it was concluded that the patient died from clozapine-induced eosinophilic hypersensitivity myocarditis. Drug-induced eosinophilic hypersensitivity myocarditis should be considered in the sudden death cases with a history of clozapine use and/or in presence of clozapine in the toxicological analysis.
  • PublicationMetadata only
    Kesici delici alet yaralanmalarına bağlı ölümlerde orijin tespiti parametrelerinin değerlendirilmesi
    (2017-07-01) GÜLBEYAZ, Hatice; ESEN MELEZ, İPEK ESEN; MELEZ, Deniz Oğuzhan; ÜZÜN, İbrahim; MELEZ, İPEK ESEN