The experiences of violence and occupational health risks of sex workers working in brothels in ankara

OBJECTIVE

The aim of this study was to reveal and discuss occupational health risks, violence against sex workers working in brothels and their working conditions in Ankara.

MATERIALS AND METHODS

The study included 138 sex workers. Data were collected at face to face interviews with a questionnaire composed of 40 questions about socio-demographic features, familial characteristics, reasons for becoming a sex worker, experiences of violence and occupational health risks.

RESULTS

Twenty-two point five percent of the women were aged 21-30 years and 39.9% were aged 31-40 years. The mean time of education was 5.9±3.5 (0-14) years. Forty-eight point five percent of the women were exposed to physical abuse and 13% of the women had been exposed to sexual abuse in their childhood. Fifty-five point eight percent of the women reported that their clients always used condoms, but 97.1% of the women noted that their clients insisted on not using a condom. Fourteen point five percent and 70.3% of the women were exposed to physical and verbal violence respectively from their clients. Ten point one percent of the women suffered sexual assault while working.

CONCLUSION

Sex workers, like other people, should have human rights, all types of violence that they face should be eliminated and the social conditions they are exposed to should be improved. Sexually transmitted diseases, the most important health risk of sex workers, should be considered as occupational diseases in the new regulations.

Stable mixed chimerism after hematopoietic stem cell transplantation in Wiskott-Aldrich syndrome

Wiskott-Aldrich syndrome (WAS) is a primary immunodeficiency disease characterized by thrombocytopenia, eczema, impaired cellular and humoral immunity, and increased susceptibility to malignancy and autoimmunity. The only curative treatment for WAS is hematopoietic stem cell transplantation, especially in the presence of a matched sibling donor or matched unrelated donor. Here, we report the case of a 2.5-yr-old boy with WAS that resulted in mixed chimerism after having received bone marrow from his phenotypically identical grandfather. Although the patient has persistent thrombocytopenia (platelet counts 50-80 x 10(9)/L), he is currently alive and doing well at 36 months post-transplant and is free of any bleeding episodes.

Sudden unexpected child deaths: forensic autopsy results in cases of sudden deaths during a 5-year period

The aim of the present study was to determine the incidence of various causes of sudden unexpected child deaths (SUCD) and to assess the importance of an autopsy in predicting the likelihood of finding a cause of death. A retrospective analysis of autopsy findings in 97 cases of SUCD between the ages of 0--11 years was undertaken at the Council of Forensic Medicine, Ankara during a 5-year period (1995--2000). Cases were classified as explained causes (80.42 per cent) and sudden infant death syndrome (SIDS) (19.58 per cent). A total of 25.77 per cent of the deaths occurred in the neonatal period, 45.31 per cent of them in the first year of life and the remaining 28.86 per cent after 1 year of life. The causes of neonatal deaths were respiratory pathology (five cases), birth complications (four cases), gastrointestinal pathology (one case), homicide (10 cases), and SIDS (five cases). The incidence of SIDS in the newborn period was 33 per cent. The incidence of unexplained causes of deaths in the postneonatal period was 31 per cent and the causes of deaths were respiratory pathology (15 cases), aspiration (five cases), gastrointestinal pathology (four cases), SIDS (14 cases), and other causes (four cases). The study of an entire population provides more reliable data regarding causes of sudden unexpected child deaths than does the study of small groups and it is also recommended that in addition to a through evaluation, a detailed autopsy must be performed for each case in experienced centers.

The identification of a dismembered human body: a multidisciplinary approach

A criminal case was directed to a multidisciplinary forensic team for identification, concerning a victim whose head, having two gunshot wounds, had been separated by a sharp instrument and was recovered 6 months later. The purpose of this research was to determine the sex and age of the victim for human identification. Primarily, macroscopic examination of the skull, tooth, and DNA analysis was conducted for sex determination. A rough assessment of age was made from the skull based on anthropological findings, however a more definitive result of age estimation was determined utilizing dental morphology. The dental data showed an age range of 32-37 from the mineral examination and the formulation of microscopic measurements. The results obtained from the skull and dental analysis matched with the physical characteristics of the victim's body, the known personal data of this person, and with the superposition of the photos gathered by a formal request. Besides, the result of DNA profiling of the victim showed male gender and direct relationship with the victim's presumed wife and daughter. Generally, research on human identification consists of sex and age determination. The sex characteristics can be precisely proved from DNA tests. However, age can be estimated by skeletal, and dental analysis. In this case the performed sex and age analysis lead the research to the selective matching of the missing person's identity.

Hekimlerin Yasal Sorumluluğunun Yüksek Sağlık Şurası Açısından İrdelenmesi

Bu çalışmada Yüksek Sağlık Şurası tarafından görüş bildirilen olgular değerlendirilerek hekim sorumluluğunun irdelenmesi amaçlanmıştır. Yüksek Sağlık Şurası tarafından 1991-1995 yılları arasında görüş bildirilen 532 olguya ait raporlar retrospektif olarak değerlendirilmiştir. Hakkında görüş istenen hekimlerin çoğu kadın hastalıkları ve doğum uzmanı, pratisyen hekim ve genel cerrahi uzmanıdır. 305 (%57.33) hekimin ceza sorumluluğunun olmadığına karar verilmiştir. 186 (%34.96) hekimin TCK m.455 veya 459’a göre kusurlu, 41 hekimin (%7.71) görevini ihmal ve yürürlükteki kanuna muhalefet suçunu işledikleri bulunmuştur. Yüksek Sağlık Şurası’nın bilirkişilik işlevinin sürmesi hekim ve diğer sağlık personelinin haklarının korunması yönünden gereklidir. Ancak Yüksek Sağlık Şurası’nın, çelişkili durumlarda veya karmaşık olduğu belirlenen olaylarda görüş bildiren bir kuruluş olarak görev yapmasına yönelik yasal düzenlemelerin yapılmasının yararlı olacağı inancındayız.Anahtar Kelimeler: Hekim sorumluluğu, hekim hataları.

[Demonstration of Chlamydia trachomatis IgG using ELISA in transsexuals and homosexuals]

In this study, 27 sera samples collected from transsexuals and homosexuals have been searched for Chlamydia trachomatis IgG antibodies with ELISA. Anti-Chlamydia IgG have been found positive in 18 cases (66.7%). In our study group there were no clinical symptoms except one case of transsexuals. Seropositivity rate of homosexuals (8/15) and transsexuals (10/12) were found to be important for transmitting the disease.

[Demonstration of cytomegalovirus (CMV) IgG and IgM in homosexuals and transsexuals using ELISA]

In this study, 27 sera which belong to 15 homosexuals and 12 transsexuals have been searched for CMV IgG and CMV IgM antibodies with ELISA. 25 transsexuals and homosexuals were within 18-30 age group and the other two transsexuals were 36 years old. 12 cases of transsexuals have been operated on vaginoplasty before this search. These cases have been given anamnesis with generally continuing sexual course after they were 12 years old. There weren't important clinical signs and symptoms in 27 cases which were searched for sexual identity and other reasons in Ankara University, Medicine Faculty of Forensic Medicine Department. In 24 cases of studying groups have been found CMV IgG positive (88.9%) and 6 cases have been found CMV IgM seropositive (22.2%). Although CMV IgG have been found positive in all of transsexuals, ELISA-CMV IgM have been found 3 homosexuals and 3 transsexuals. We have accepted CMV IgM seropositivity which was a sign for acute, active and reactive infectious disease. Although CMV IgM have been found negative in 21 cases, 18 cases have been found CMV IgM seropositivity which have been accepted for a sign of earlier infectious disease. 3 cases have been found to be negative for both CMV IgG and IgM. Homosexuals had several sexual contact diseases such as bacterial, protozoal and viral infection. CMV infection must be kept in mind when mentioning about community health which deals with latent and active CMV infectious diagnosis.

[Demonstration of herpes simplex virus (HSV)-2 IgG and IgM using ELISA in transsexuals and homosexuals]

In this study, the sera of 12 cases of transsexual with vaginoplasty and 15 cases of homosexual have been investigated with ELISA from the view point of HSV-2 IgG and IgM antibodies. Twenty-five cases were within the 18-26 age groups and the other 2 transsexuals were 36 years old. Our studying group have no significant clinical pathology. In all the 27 cases of transsexual and homosexual have been found to be positive for HSV-2 IgG. In 7 cases, HSV-2 IgM have been found positive, the other 20 cases have been found negative results. In the one third of the transsexuals and one fifth of the transsexuals HSV-2 IgG have been found positive. Twenty-six per cent of seropositivity in transsexuals and homosexuals show that they form significant risk group from the point of view of HSV-2 infection.

[Detection of herpes simplex virus 2 (HSV) IgG and IgM using ELISA in transsexuals and homosexuals]

In this study, the sera of 12 cases of transsexuals with vaginoplasty and 15 cases of homosexuals have been investigated with ELISA from the view point of HSV-2 IgG and IgM. Twenty-five cases were within the 18-26 age groups and the other 2 transsexuals were 36 years old. Our study group has not significant clinical pathology. All of the 27 cases of transsexuals and homosexuals have been found positive for HSV-2 IgG. In 7 cases HSV-2 IgM have been found positive, the other 20 cases gave negative results. In the one third of the transsexuals and one fifth of the homosexuals, HSV-2 IgG have been found positive. Twenty-six percent of seropositivity in transsexuals and homosexuals show that they are the significant risk group for HSV-2 infection.