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Öğe Assessment of suicide probability and related factors in male incarcerated adolescents; a sample of reformatory center in Turkey(Pergamon-Elsevier Science Ltd, 2021) Karatoprak, Serdar; Ayaz, Nusret; Donmez, Yunus Emre; Dogan, MustafaObjective: Suicidal behavior in adolescents is an important public health problem, and it ranks first among the causes of prison deaths in incarcerated adolescents(IAs). The aim of this study is to determine the probability of suicide and associated risk factors in IAs. Method: Seventy-one male adolescents in a reformatory center were contrasted with a matched group of 71 male adolescent with no psychiatric disorder and no criminal record. Suicidal probability and psychiatric symptomatology were assessed with the Suicide Probability Scale, SA-45 Questionnaire, respectively. Results: It was determined that the probability of suicide was higher in IAs, and depression and hostility symptoms, the presence of another individual involved in delinquency in family had predictive effects. It was also found that there was a positive correlation between the probability of suicide and the number of delinquencies, the number of incarceration, and a negative correlation between attending to school or work while in reformatory and being visited by relatives while in reformatory. Conclusions: The results suggest that when assessing suicide risk for IAS, it may be useful to pay attention to those with symptoms of depression or hostility, those with multiple delinquencies or entrance to reformatory, and those who have family members involved in delinquency.Öğe Bipolar Bozukluk Tanılı Hastaların İzleminde El Yazısı DeğişikliklerininKullanımı(2022) Ayaz, Nusret; Celbiş, Osman; Zayman, Esra Porgalı; Karlıdağ, Rıfat; Öner, Bedirhan SezerAmaç: Bipolar bozukluk tanılı hastalarda motor beceri eksikliği ve bilişsel işlev bozukluğu vardır. Bu eksikliklerin hastalığın nörogelişimsel süreci ile ilgili olduğunu düşündürmektedir. Bu çalışmanın amacı, mani ve remisyon dönemlerinde bipolar bozukluk tanılı hastaların el yazısında değişiklik olup olmadığını incelemektir. Yöntem: Olgulardan biri tedavi öncesi ve diğeri taburcu olduktan hemen sonra olmak üzere iki el yazısı ve imza örneği alındı. İlk örnek, hastaların ilaç tedavisi öncesi manik atak ile hastaneye kaldırıldığı dönemde alınmış, ikinci örnek ise taburculuk kararı alındığında, hastanın remisyon döneminde alınmıştır. Manik dönem ve remisyon dönemdeki el yazısı değişimleri incelendi. Bulgular: İki dönem arasındaki el yazısı incelendiğinde mani döneminde yazının boyutunda, kalem baskısında, kelimelerin uzunluğunda, kelimeler arasındaki boşluklarda ve eksik ve yanlış noktalama işaretlerinde artış olduğu belirlendi. Manik döneme ait spesifik tanı için veya antipsikotik dozu konusunda herhangi bir el yazısı ölçümünde farklılık yoktu, ancak antipsikotik kullananlarda tremor sayısı yüksek bulundu (p<0,05). Değişiklik gösteren parametrelerin çoğu Young Mani Ölçeği (YMRS) puanlarıyla ilişkili bulundu. Sonuç: Bu çalışmanın sonucunda, mani dönemindeki bipolar hastaların el yazısında ciddi değişiklikler tespit edildi. Bu değişimler, hastaların taburculuk kararları verilirken ve bipolar bir hastadaki manik atağa geçiş zamanını tahmin etmek için kullanılabilir. Ayrıca manik hastalarda el yazısı parametrelerini etkileyen en önemli özelliğin alım YMRS skorları olduğu bulunmuşturÖğe A case of sudden death due to lighter refill gas ınhalation(Turgut Özal Tıp Merkezi Dergisi, 2016) Petekkaya, Semih; Ayaz, Nusret; Doğan, Mustafa; Oruç, Mücahit; Öner, Bedirhan Sezer; Göktürk, Cihan; Çelebi, Ahmet; Budak, Adalet Eda; Soylu, Özcan; Celbiş, OsmanAbstract A component of lighters refill tubes, butane is a colourless and flammable substance with gasoline-like or natural gas odour. The abuse of easily accessible lighter gas butane is increasing among children and adolescants and this abuse causes euphoric effects. Inhalants are the most commonly used drug after alcohol and tobacco among adolescents. In the literature, it is reported that butane inhalation directly affects central nervous system, respiratory and cardiovasculer systems. To prevent this increasing trend, we believe that society, especially youth, should be educated through precautionary educational activities, sales of lighter refill tubes should be monitored and be made agerestricted, and lighter refill tubes should have warning signs that everyone would understand and attract attention. We present a case of the sudden death of a seventeen-year-old male due to inhaling butane containing lighter refill gas with friends along with the autopsy findings and the results of toxicology and histopathology investigations. Keywords: Butane; Lighter Refill Gas; Sudden Death; Autopsy.Öğe A comparison of health behaviours in male adolescents with and without offending histories referred for adolescent health services in Turkey(Wiley, 2022) Ayaz, Nusret; Karatoprak, SerdarBackground: Offending and incarceration are important societal problems that might be reduced by improving early intervention. Most prior work identifying risk factors has focussed on early oppositional or aggressive behaviours and environmental problems. Among adults, it is well recognised that offenders have much poorer health than the wider population. This raises questions about whether behaviours that put health at risk while a teenager may also be good markers of subsequent offending. Aims: To examine the relationship between risky health behaviours and delinquency by comparing male teenage offenders with a history of incarceration and male teenagers with no criminal involvement. Methods: In this cross-sectional study, 66 male 12-18-yearold offenders with an incarceration history who were referred for evaluation to the Forensic Medicine Polyclinic in 2021 were compared with 74 similar aged adolescents without a criminal record but attending another clinic in the same hospital, using the Risky Health Behaviour Scale (RHBS). This covers dietary, road safety and sexual behaviours as well as exercise, substance use and violent behaviours. Negative items were reverse scored so that higher scores indicated more pro-health activities. Results: Total RHBS scores were significantly lower among the offender-group than the comparison teenagers (Means 93.19 +/- 17.00: 107.20 +/- 10.83; p = 0.001). This reflected significant differences in each of the subscale scores except dietary and risky sexual behaviour. Only substance use behaviours, however, were independently related to offender group membership, as was family socio-economic status. Conclusions: Our findings add indications of risky health-related behaviours to the already extensive literature on risky social behaviours in the history of young offenders. It is possible that focussing on young offenders referred to a health service, albeit one primarily directed at mental health, has exaggerated such differences, but if substantiated in larger and more diverse samples, these findings may open new avenues for early identification of young people at risk of offending and commensurate early interventions. Focus on substance use by young people seems especially important, but low family socio-economic status needs remedies too.Öğe Comparison of substance users under judicial supervision with controls in terms of attention deficit hyperactivity disorder and emotion regulation difficulties(Klinik Psikiyatri Dergisi, 2024) Akan, Mustafa; Ayaz, Nusret; Ugur, KerimObjective: Substance abuse and addiction are reported to be approximately 2 times more common in individuals diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) compared to the general population. Adults with ADHD have been stated to have difficulties in emotion regulation as well as core symptoms of the disease. In this study, it was aimed to evaluate individuals who applied to a university hospital psychiatry clinic probation clinic in terms of attention deficit hyperactivity disorder and emotion regulation difficulties. The hypothesis of the study is that individuals who apply to the outpatient clinic will have higher ADHD symptoms and emotion regulation difficulties than healthy controls. Method: The research was conducted between 18.06.22-30.10.22. 135 male patients diagnosed with substance use disorder and 141 healthy volunteers without any psychiatric disease were included in the study. Adult ADHD selfreport scale (ASRS), Difficulty in Emotion Regulation Scale Short Form (DERS-16), and sociodemographic data form were administered to the participants. Results: The probation group's ASRS total score, attention deficit and hyperactivity/impulsivity subscale scores were found to be statistically significantly higher than the control group (p=0.004, p=0.005, p=0.007, respectively). Also DERS-16 impulse and nonacceptance subscale scores of the probation group were statistically significantly higher than the control group (p=0.001, p=0.015, respectively). Discussion: ADHD and accompanying emotion regulation difficulties may increase the risk of substance use in adults. Considering these clinical features in individuals applying to the probation outpatient clinic may make therapeutic interventions more effective.Öğe Early Stage Pulmonary Embolism Because of Stab Wound Injury Without Vascular Penetration(Aves, 2017) Petekkaya, Semih; Ayaz, Nusret; Dogan, Mustafa; Oruc, Mucahit; Okdemir, Erdem; Celbis, OsmanIntroduction: Pulmonary embolism, occurring as a result of acute obstruction of the pulmonary artery system, may vary from the frequently observed asymptomatic clinical state to sudden death and is a disease with high morbidity and mortality rates. Pulmonary embolism is most commonly observed within 5-7 days of trauma and has been occasionally reported before 4 days. Case Report: A 40-years-old female was admitted to emergency service with a knife wound injury. Her vital and laboratory values were normal. Physical examination revealed a knife wound injury, measuring 2 x 1 cm, on the femoral midline of the left leg. Then, she was discharged. After approximately 6 h, she presented to another emergency service with complaints of chest pain and syncope. During evaluation, she developed cardiopulmonary arrest and died because of pulmonary embolism. Conclusion: This report presents a case of early stage pulmonary embolism that developed because of circulation disruption caused by the effect of pressure as a result of a localized hematoma owing to an indirect effect of a stab wound injury with no vascular penetration injury.Öğe Evaluation of home accidents of forensic nature among children(2020) Ayaz, Nusret; Turgut, Kasım; Turtay, Muhammet Gökhan; Güven, Taner; Oruç, Mücahit; Celbiş, OsmanTo examine the clinical and demographic characteristics of forensic home accidents and fatal injuries. Hospital and forensic records were examined and patients aged ?16 years, referred to our hospital after a home accident, were included in the study. The age, gender, type of injury, injured body area, month of accident, outcome, and department of admission were recorded for each patient. Then, the forensic records were examined and the cases were divided into two groups as those with and without fatal injuries.The characteristics of the two groups were compared using the chi-square test, and the statistical differences were determined.In a three-year period, a total of 453 home accidents considered to be forensic cases were identified. The mortality rate was calculated as 1.8%, and according to the forensic reports, 33.3% of the cases had fatal injuries.While blunt traumas were most common with a rate of 54.1%, burn injuries were found to be most fatal (p<0.001). The majority of injuries were seen in the head and neck, and the risk of fatal injuries was higher in multiple trauma cases in which two or more body systems were affected (p<0.001).Pediatric home accidents are most seen in the age range of 3-6 years, and the risk of fatal injuries is higher in patients with burns and injuries affecting more than one system.Öğe Evaluation of Incest Cases: 4-Years Retrospective Study(Routledge Journals, Taylor & Francis Ltd, 2020) Celbis, Osman; Altin, Ismail; Ayaz, Nusret; Bork, Turgay; Karatoprak, SerdarIncest is specific type of sexual abuse. The aim of this study was to evaluate the sociodemographic data and examination findings of cases referred to our hospital as forensic court cases of incest, and to measure the effect on mental health disorders of the nature of the sexual abuse. Retrospective examination was made of the records of 40 cases of incest victims. Evaluation was made of the age, gender, incident suffered, the perpetrator, form of abuse, examination findings, and mental status. The cases comprised 36 girls and 4 boys. Without penetration sexual abuse was determined in 25 cases and with penetration sexual abuse in 15 cases. At least one mental health disorder was determined in 20 of the cases of simple sexual abuse and in 11 of the major sexual abuse type cases. The most frequently seen mental health disorder was post-traumatic stress disorder (PTSD) in 21 cases. Mental health disorders were determined in 77.5% of the incest cases in this study, at a greater rate 80% in cases of without penetration sexual abuse than in cases of with penetration sexual abuse 74.33%. Therefore, all cases of incest must be followed up carefully without differentiation of without or with penetration abuse.Öğe Lack of education or abuse?(2019) Celbiş, Osman; Sener, Serpil; Bork, Turgay; Ayaz, Nusret; Dündar, Ahmet Sedat; Altın, İsmailAbstract: Child abuse is a significant public health problem nowadays. The case is here presented of an unemployed stepfather, with significant risk factors for child abuse, who caused physical abuse to a child with hot water as a result of incorrect toilet training. In this case, the mother tried to hide the event and as a result of the history taken from the child and findings of lesions in the physical examination, it was learned that these had been made by the stepfather because of urine incontinence. In similar situations to this case, healthcare personnel establishing close communication with the child must pay attention in respect of child abuse, and must inform the authorities in all suspicious cases.Öğe The Relationship Between Suicide Attempt andGonadotropins, Gonadal Hormones, and Cortisolin Females(2021) Akan, Mustafa; Ayaz, Nusret; Taşkapan, Mehmet Çağatay; Bulut, Nilüfer; Gönenir Erbay, LaleObjective: The aim of this study was to examine the relationship between suicidal behav ior and gonadotropins, gonadal hormones, and cortisol in females.Methods: The study included 3 groups of 23 females each, aged 18-45 years; one groupcomprising those who had attempted suicide, another group of females matched for age,menstrual phase, and body mass index, with depression but no suicidal tendencies, anda control group of 23 healthy females. For all participants, a sociodemographic informa tion form was completed, and the Beck Depression Inventory, the Beck Anxiety Inventory,and the Beck Hopelessness Scale were used. Blood samples were taken at 8 am (in theattempted-suicide group, within 24 hours of the attempt), and follicle-stimulating hor mone, luteinizing hormone, estradiol, testosterone, progesterone, and cortisol levels weremeasured. Results: No statistically significant differences were observed between the groups withrespect to gonadotropin and gonadal hormone levels. There were statistically significantdifferences in the cortisol levels between the attempted suicide and control groups andbetween the depression and control groups (P < .05). The cortisol levels negatively cor related with all scale scores. Conclusion: Studies on suicidal patients should pay more attention to the potential role ofhypocortisolism. More studies with larger samples are needed to investigate the relation ship between gonadotropins, gonadal hormones, and suicidal behavior.Öğe The Use of Handwriting Changes for the Follow-up of Patients with Bipolar Disorder(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2022) Ayaz, Nusret; Celbis, Osman; Porgali Zayman, Esra; Karlidag, Rifat; Oner, Bedirhan SezerIntroduction: Patients with bipolar disorder have motor skill deficiency and cognitive dysfunction. It is suggested that these deficiencies are related to the neurodevelopmental course of the disease. The aim of this study was to examine whether or not there was a change in the handwriting of patients with bipolar disorder in periods of mania and remission. Method: Two samples of handwriting and signature were taken from the cases, one on admission before treatment and one just after discharge. The first sample was taken in the period when the patients hospitalised with manic episode before medications and the second sample was taken in remission when the decision for discharge was made. The handwriting changes betwen the manic episode and the remission period were examined. Results: In the examination of the handwriting between the two periods. there was an increase in the size of the writing, pen pressure, the length of words, the spaces between words, and missing and incorrect punctuation marks in the manic episode. There were no differences in any handwriting measure on function of the specific diagnosis or the antipsychotic dose but tremor count was higher in patients using antipsychotics (p<0.05). Most of the parameters showing a change were found to be related to the Young Mania Rating Scale (YMRS) scores. Conclusion: The results of this study determined severe changes in the handwriting of patients with bipolar disorder in a period of mania. Handwriting features can be used to screen patients for discharge and can be used for prediction when a patient might switch into manic episode. Also intake YMRS scores were found as the most important feature that affect handwriting parameters in manic patients.
