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Öğe The dynamics of prehospital/hospital care and modes of transport during civil conflict and terrorist incidents(W B Saunders Co Ltd, 2017) Celik, S.; Dursun, R.; Aycan, A.; Gonullu, H.; Adanas, C.; Eryilmaz, M.; Gonullu, E.Objective: Prehospital and hospital care during incidents of mass violence and civil conflict involve a number of aspects that distinguish it from care during times of peace. We aimed to analyze the dynamics and outcomes of prehospital and hospital care during ongoing conflicts. Study design: Multicentric prospective observational study. Method: Patients enrolled in the study, which was conducted in Turkey, were all injured in armed conflict and taken to level 1 trauma centers. On admittance, patients were requested to complete a semistructured questionnaire containing questions on patient demographics, transport type, weapons used, injury severity score (ISS), and other incident-related factors. We analyzed patient outcomes (mortality, morbidity, complications, and length of hospital stay) and transfers of patients between hospitals. The present study evaluated the cases of 390 victims enrolled over a 9-month period and followed up for 6 months. Results: The majority of patients were transported by ambulances (n = 334, 85.6%); other transport modes were helicopters (n = 32, 8.2%) and private vehicles (n = 24, 6.2%). Nearly half of patients (48.7%) did not benefit by changing hospitals. During transport to hospitals, 4.1% of the vehicles in the study were involved in accidents. Using multiple regression analysis, only ISS (odds ratio [OR]: 1.098, 95% confidence interval [CI]: 1.044-1.156) and the Glasgow Coma Scale (OR: 0.744, 95% CI: 0.639-0.866) were found to affect mortality. In Receiver-operator characteristic analysis, a cutoff value of 22.5 for ISS had a sensitivity of 100% and a specificity of 89.6% for mortality. Conclusions: Despite lower ISS values, patient outcomes were worse in terror incidents/civil conflicts. Transport modes did not significantly affect outcomes, whereas hospital transport was found to be inefficiently used. (C) 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.Öğe Effect of L-ornithine L-aspartate on Liver Injury Due to Acute Ethyl Alcohol Intoxication in Rats(Univ West Indies Faculty Medical Sciences, 2015) Durgun, H. M.; Ozhasenekler, A.; Dursun, R.; Basarali, M. K.; Turkcu, G.; Orak, M.; Ustundag, M.Objective: Ethyl alcohol is a substance that is widely used worldwide and known to exert toxic effects on liver. In this study, we aimed to examine the effect of L-ornithine L-aspartate (LOLA) on the toxicity of a single dose of ethyl alcohol in rats. Subjects and Method: We used 32 randomly selected male Sprague-Dawley rats weighing 200-250 g. The rats were grouped into four groups with each group containing eight rats: Group 1: the control group, Group 2: the ethyl alcohol group, Group 3: the LOLA group and Group 4: the ethyl alcohol+LOLA group. Ethyl alcohol was administered orally through a nasogastric tube at a dose of 6 g/kg after diluting with distilled water. One hour after ethyl alcohol administration, LOLA was administered to pre-specified groups orally through a nasogastric tube at a dose of 200 mg/kg after diluting with distilled water. Liver tissue and blood samples were obtained from all rats 24 hours later to study total antioxidant capacity (TAC), total oxidant status (TOS) and oxidative stress index (OSI) levels in liver samples, and aspartate aminotransferase (AST), alanine transferase (ALT), TAC, TOS and OSI levels in blood samples. Results: Serum TAC, TOS and OSI levels were higher in the groups that were administered ethyl alcohol. In addition, tissue TAC level was higher and TOS and OSI levels were lower in groups that were given ethyl alcohol. No significant changes were observed in serum and tissue TAC, TOS, OSI, ALT and AST levels in the LOLA administered groups. Conclusion: This study showed that LOLA was not biochemically effective and exerts no oxidative stress reducing activity in liver injury due to acute ethyl alcohol toxicity.Öğe Factors affecting dural penetration and prognosis in patients admitted to emergency department with cranial gunshot wound(Springer Heidelberg, 2017) Icer, M.; Zengin, Y.; Dursun, R.; Durgun, H. M.; Goya, C.; Yildiz, I.; Guloglu, C.To explore the effect of admission physical examination findings, anamnesis, and computed tomography on dural penetration and prognosis in patients with cranial gunshot wound (CGW). In this study, the medical data of 56 subjects who were admitted to the Emergency Department of Dicle University Hospital with CGWs between January 2011 and December 2013 were retrospectively reviewed. The effects of type of incident (suicidal vs non-suicidal), pupil diameter and light reflex, hemodynamic status, type (bullet or pellet), velocity, trajectory of foreign material, trauma scores, and imaging findings on dural penetration and mortality were explored. The mean age of the study population was 24.8 +/- 13.50 years. Thirty (53.6 %) patients had penetrating injuries and 26 (46.4 %) had non-penetrating injuries; 9 (16.1 %) patients died and 47 (83.9 %) survived. Suicidal injury, pupil diameter and light reflex, bullet as foreign material, and high velocity and lateral trajectory of foreign material significantly affected dural penetration and mortality (p < 0.05). In addition, dural penetration, bilobar, multilobar, or bihemispheric involvement of brain parenchyma, presence of intracranial hemorrhage, subarachnoid hemorrhage, ventricular hemorrhage, fracture, shift, edema, and trauma scores significantly affected mortality (p < 0.05). In CGWs, dural penetration and prognosis can be predicted by physical examination findings and patient characteristics on initial admission.Öğe Protective effect of montelukast sodium in acute ethyl alcohol-induced hepatic injury in rats(Univ West Indies Faculty Medical Sciences, 2021) Zengin, Y.; İçer, M.; Gündüz, E.; Dursun, R.; Türkçü, G.; Yüksel, H.; Özhasenekler, A.; Orak, M.; Güloğlu, C.Objective: Ethyl alcohol (EA) is a substance that is used commonly worldwide and known to have toxic effects on the liver The aim of this study was to investigate the effect of montelukast sodium (MK) on acute hepatopathy induced by a single dose of EA in rats. Methods: The study consisted of four groups each containing eight Wistar albino male rats. The groups were classified as follows: the control group received distilled water; the EA group received 6 g/kg EA diluted with distilled water orally by gavage; the MK group received 30 mg/ kg MK orally by gavage; the EA + MK group received, 2 hours after the EA administration, ie 30 mg/kg MK orally by gavage. After 24 hours, all the rats were sacrificed, and their blood and liver tissue samples were taken for biochemical and histopathological examinations. Results: The administration of EA caused a statistically significant increase in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels compared with the control group (220.50 +/- 66.90 and 92.38 +/- 5.90 versus 84.88 +/- 15.66 and 43.75 +/- 10.22). The administration of EA + MK caused a statistically significant decrease in the AST and ALT levels compared with the EA alone group. Ethyl alcohol administered to the rats caused lesion in the liver including congestions, hydropic degeneration and irregular shaped area caused coagulation necrosis. The histopathological changes seen in the EA group were not detected in the EA + MK group. Conclusion: Consequently, these data suggested that MK had beneficial effects in alleviating EA-induced hepatotoxicity in rats.Öğe Protective effect of wolfberry extract on acetic acid-induced colitis in rats(Univ West Indies Faculty Medical Sciences, 2021) İçer, M.; Gündüz, E.; Zengin, Y.; Dursun, R.; Durgun, Hasan Mansur; Alabalık, U.; Kaplan, I.; Güloğlu, C.Objective: To investigate the protective effect of wolfberry (WB) against acetic acid-induced colitis in rats. Methods: The rats were divided into four groups with eight rats in each group: the control group, WB group, colitis group and WB + colitis group. Distal colitis was induced in rats by intracolonic instillation of 4% acetic acid. Woliberry + colitis group received 100 mg/kg of WB extract dissolved in saline through the intraperitoneal route for 7 days. Acute colitis was created on the 8th day, and the rats were sacrificed 48 hours later Colonic damage was assessed by macroscopic and histological criteria as well as biochemical markers. Results: Mean total antioxidant capacity (TAC), total oxidant status (TOS), tumour necrosis factor (TNF)-alpha, interleukin (IL)-1 beta and IL-6 levels were significantly higher in the colitis group compared with the control and WB groups (p < 0.05). The WB + colitis group had significantly lower TAC, TOS, TNF-alpha, IL-1 beta and IL-6 levels compared with the colitis group (p < 0.05). The analyses of the histopathological findings indicated that the colitis group had a significantly higher histopathological damage score than the control group (3.12 +/- 0.45, 0 +/- 0.00, respectively; p < 0.05). Histopathological damage score was significantly higher in the WB + colitis group than in the control group and statistically significantly lower than the colitis group (1.62 +/- 0.44, 0 +/- 0.00, respectively; 3.12 +/- 0.45, respectively; p < 0.05 for both comparisons). Conclusion: Wolfberry extract is an agent that is effective for preventing acetic acid-induced colitis in rats.
