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It is important to investigate the clothing, as well as the body, to determine the range of fire of entry wounds in firearm injuries. Clothing can affect the amount of gunshot residues (GSR) reaching the body and their distribution. The amount and distribution of the GSR also vary according to the distance between the firearm and the target. Sodium rhodizonate test provides valuable data when clothing is available for examination. In the absence of clothing, light microscopic examinations may add additional information regarding the range of fire. In this study, a sodium rhodizonate test was done on 80 garment samples containing the bullet entrance. The 80 calfskin samples were processed histologically and were stained using Alizarin Red S. These were also evaluated with computer-assisted image analysis. Gross residues were seen on military camouflage clothing in samples from < or = 45-cm group. White flannel undershirts under the military camouflage contained rhodizonate-positive particles only around the contact wounds. With image analysis, however, the residues could be detected also in the skin samples of the 2.5-cm- and 5-cm-range groups. We suggest that the image analysis can be combined with other techniques and it can provide valuable data in the determination of entry wounds and also in the estimation of firing distance.

This paper describes very rare chemical poisoning and characteristics of patients with acute endosulfan mass poisoning in a rural area of Turkey and our experiences of these patients. We included 41 patients who were treated in our hospital with the diagnosis of endosulfan poisoning. After the first vital intervention they were examined in terms of age, sex, symptoms and physical examination findings, laboratory results, treatment and outcome. Forty-one patients were admitted to the emergency department (ED) after triage. Nineteen (46.3%) of the patients were female, 22 (53.7%) were male. The mean age was 27.9+/-16.0 years (1-67 years). The mean time to the ED was 4.1+/-0.9 h (3-6.5 h). The most common symptoms were anxiety (97.6%), nausea (56.1%) and vomiting (48.8%). Tests of the blood samples obtained at the ED revealed leucocytosis (11 070.6+/-4302.5/microl), increased blood glucose, LDH, CK and CK-MB levels. Toxicological analysis of blood and urine samples revealed endosulfan as the causative agent. Especially in the rural areas, cases with acute repetitive seizures should suggest endosulfan intoxication when the aetiology is uncertain even in the absence of any signs of intoxication. Health care professionals should understand the hazards associated with the pesticide use as well as diagnosis and treatment of these types of poisonings.