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Öğe Acute liver failure caused serious mortality: A case report(2006) Al B.; Güloğlu C.; Yağmur Y.; Aldemir M.; Özhasenekler A.Acute liver failure is a rarely seen liver disease and requires emergency treatment. Acute liver failure must be diagnosed rapidly with patients' past history, clinical presentation, physical examination and laboratory evaluation. Treatment should be started immediately, otherwise in a short time hypotension, hypoglycemia, sepsis, encephalopathy, coagulopathy, intracranial and gastrointestinal bleeding would develop and patient would die. Generally the diagnosis of the patient is delayed and liver parenchymal mass decreases and part of liver would be lost. Multiple organ failure would develop with other complications. At this point patient has already lost the chance of life saving procedure i.e. liver transplantation. In this article a 36 years old patient with jaundice, vomiting, weakness, abnormal speaking had resorted to a hospital. He had been treated and sent home. The patient had become worse after a short time, and had resorted to our clinic. He was diagnosed as Acute Live Failure with hepatitis B. Six days later he died.Öğe Affecting factors on early mortality in elderly patients diagnosed with pulmonary embolism in emergency department(Geriatrics Society, 2015) Zengin Y.; Gündüz E.; Dursun R.; İçer M.; Durgun H.M.; Taylan M.; Güloğlu C.Introduction: The ratio of elderly people in Turkey is rapidly growing. It is known that pulmonary embolism and venous thrombolysis incidence increases with age. Despite the major advances in pulmonary embolism diagnosis and treatment, pulmonary embolism leads to higher mortality rates in the elderly. In the present study, evaluation of socio-demographic and clinical characteristics of elderly patients diagnosed with pulmonary embolism in the emergency department and determination of factors that affect early mortality have been targeted in order to decrease mortality. Materials and Method: Between January 1, 2009, and September 30, 2014, patients who were 65 years of age and older who had been admitted through the emergency department with suspected pulmonary embolism and whose pulmonary embolism diagnosis was finalized via computerized tomographic pulmonary angiography. Results: In the study, 87 (61.8%) were female and 52 (38.2%) were male. Thirteen patients (9.4%) died during the follow-up period. The analysis of the relationship between pulmonary embolism in elderly patients and early mortality revealed that there is a statistical correlation among immobility, syncope, tachycardia, hypotension, elevated Troponin-T, coronary arterial disease, cerebrovascular disease, pulmonary embolism with massive dimension, bilateral pulmonary embolism, Wells-likely pulmonary embolism, and modified Geneva-likely pulmonary embolism were statistically related factors(p values, respectively, were 0.002; 0.033; 0.000; 0.000; 0.000; 0.037; 0.011; 0.000; 0.030; 0.023; 0.018). Conclusion: Immobility, syncope, tachycardia, hypotension, elevated Troponin T, coronary arterial disease, cerebrovascular disease, pulmonary embolism with massive dimension, bilateral pulmonary embolism, Wells-likely pulmonary embolism, and modified Geneva-likely pulmonary embolism were determined as effective risk factors affecting the early mortality of elderly patients with pulmonary embolism. © 2015, Geriatrics Society. All rights reserved.Öğe Electric injuries(2007) Orak M.; Üstündağ M.; Güloğlu C.; Uysal E.; Sayhan M.B.The electricity injury is the one of the major trauma causing mortality, and morbidity. We report 3 cases, admitted our emergiency department with electric injury caused by naked electric cable touching. All cases had compartment syndrome and undergone fasiotomy operations. They were transported to advanced intensive care units of burning. In this study, we would like to report that without any precaution and information, emergency depatment personals would be faced with interesting electric injuries that effect more than one people cases which havent been reported in medical literatures.Öğe Epidemiological characteristics of electrical injuries of patients applied to the emergency department(2006) Al B.; Aldemir M.; Güloğlu C.; Kara I.H.; Girgin S.BACKGROUND: In this study, we planned to determine the factors affecting the mortality, and morbidity of electrical injuries. METHODS; Medical records of 165 patients (126 males; 39 females; mean age 21.1 years; range 2.5 to 62 years), who were admitted to the Emergency Department of Dicle University School of Medicine for electrical injuries, between January 2003 and April 2004, were retrospectively reviewed. RESULTS: Among these patients, 60 (36.4%) were children, under 12 years old; 95 (57.6%) were adolescents and adults, and 10 (6%) were aged. Of the victims of electrical accidents, 29 (17.6%) were illiterate and 36 (21.8 %) were educated. Ninety-seven (58.8 %) patients were either graduates or still students of elementary, secondary or high school. The cause of exposure to electricity was accident in 99 (60%), and carelessness and parents' negligence in 66 (40%). Sixty-nine (41.8%) patients were exposed to high voltage, and 96 (58.2 %) to low voltage. Because of electrical injury 16 patients had first degree, 96 patients had second degree, and 86 patients had third degree burns. The most frequent complications were contractures of extremities (10.9%) and compartment syndrome (3.6%). Mortality rate was 9.1% (n=15). Eighty percent of the deaths were due to exposure to high voltage. A positive correlation was demonstrated between mortality and complications (p<0.001). Escarotomy was performed in 10 patients, fasciotomy in 16, and amputation in 9. Two of 5 patients who had intraabdominal hemorrhage underwent surgery. CONCLUSION: A serious education of the society with respect to conscious use of of electricity is the most efficient method to decrease electrical accidents.Öğe Factors affecting mortality in patients with gunshot injuries(2009) Eriş S.; Orak M.; Al B.; Güloğlu C.; Aldemir M.Objective: We planned this study in order to determine the factors affecting mortality in patients with gunshot injuries in more than one organ. Methods: We retrospectively reviewed the hospital records of 714 patients admitted to the Emergency Department of Dicle University, between January 2000 and December 2004. The factors that we considered would affect mortality such as age, sex, attempts suicide, long barrelled gun injuries, pellet injuries, contact/near contact shot, delayed admission time, presence of serious anemia and shock during admission, more than four entrance wounds, injury areas, serious cranial, thorax and abdominal injuries, vascular injuries in the extremities, administration of multiple transfusion, and trauma scores as GCS, RTS, PATI were analyzed. Results: As a result of unvaried statistical analyses, we determined that suicide attempts (p=0.001), presence of serious anemia (p=0.001) and shock (p=0.001) during admission, presence of serious cranial (p=0.001), thorax (p=0.001) and abdominal (p=0.001) injury, femoral artery injury (p=0.001), multiple blood transfusion (p=0.009), , GCS 0-7, GCS 8-12 (p=0.001) and low RTS (p=0.001)were significant factors affecting mortality. Conclusion: Multivariate analysis showed that serious anemia during admission, serious cranial injury, serious abdominal injury and low RTS were independently significant in predicting mortality (p<0.05).Öğe Frostbite a case report(2007) Orak M.; Üstündağ M.; Güloğlu C.; Doğan H.; Altunci Y.A.Background: Frostbite is an injury that results from exposure to temperatures that are low enough to cause crystal formation in the exposed tissue. Frostbite is the acute freezing of the skin and tissues and usually develops following exposure to temperatures below -2°C for more than one hour. The anatomical sites most susceptible to frostbite are hands and feet, which constitute 90% of frostbite injuries. So far there has been no certain treatment for frostbite. Case Report: An 18 years old man in good general health suffered frostbite from 09.00 to 21.00 while working in a snowy beet field in December. He was directly in snow for 5-6 hours of that 12 hour. His shoes were too hard for his feet especially left foot. He complained when he arrived home intensive pain, discoloration, lack of sensitivity and limited movement on his toes. He walks for a while and thaw feet near an owen. A day after frostbite he admitted regional hospital. At first we clean feet. But no blister debridement. Elevation, antibioterapy, analgesia (morphine sulphate 5 mg 1x1), enoksaparine 0.4 cc 1x1, pentoxiphiline 600 mg/day and aspirin 300 mg 1x1 were ordered in treatment. Tenth day patient's effected areas lesions improve and all laboratory parameters were in normal range so patient discharged. Conclusions: Effective treatment of frostbite has not yet been exactly defined. The aim of frostbite treatment must be to salvage more reversibly injured cells.Öğe Haemopneumothorax due to blank cartridges gun injury(2007) Orak M.; Üstündağ M.; Sayhan M.B.; Taş M.; Güloğlu C.Blank cartridge guns, which are considered harmless, can be easily purchased by adults due to lack of legal regulations. We present this case because injuries caused by gunshot from modify blank cartridges may be fatal and are rarely encountered in emergency departments. A 20-year-old boy was brought to the emergency department since he had a wound on his left thorax by modify gunshot from blank cartridges. He had a moderate general condition, respiratory distress and pale appearance. There was an irregular edged, defective wound at left hemithorax localization with a dimension of 3×4 cm. Computed tomography of the thorax revealed contusion in the basal of the left lung. A mass education on danger and harm of these guns as well as legal regulations for restricted use seem to he necessary. Also, physicians should keep in mind that blank cartridge guns can cause fatal injuries.Öğe The management of patients with acute respiratory distress syndrome due to near-drowning: A case report(2006) Al B.; Güloğlu C.; Özhasenekler A.; Güllü M.N.Remaining under water causes serious morbidity and mortality. Drowning is a case of asphyxia caused by obstruction of airways due to fluid aspiration into lungs and/or laryngospasm within 24 hours after remaining under water resulting in death. Semi- drowning, however can result in death, partial or complete recovery. Even if little amount of water has been aspirated, acute respiratory distress syndrome (ARDS) and damage of lungs due to hypoxia and anoxia occurs. In this study we wanted to discus a case that had fallen down from a height and remained under water unconscious which developed acute respiratory distress syndrome after 8 to 10 hours. The case had been brought to a small town hospital. Although he had shortness of breath he wanted to be discharged by himself. At home he had become worse, and aspirated his vomitus. Afterwards, he was taken to our emergency room as acute respiratory distress syndrome. However, despite of all treatments he was lost.Öğe A poll study about emergency department stuff's job satisfaction(2009) Orak M.; Üstündağ M.; Güloğlu C.; Sayhan M.B.; Gökhan Ş.Job satisfaction means that employee's content or discontented about their job. It is important to learn about emergency department stuff's job satisfaction for problems and new positive suggestions. In this study; our aim is to determine Dicle University Medical faculty Emergency Department stuff's job satisfactions according to their social and demographic characteristics or conditions of employment, and effective factors on this satisfaction or unsatisfaction. We prepared an eighteen questions survey sheet and administered to Dicle University Medical Faculty Emergency department stuff that constituted with doctors, nurses, nurse's aides, security guards, cleaning workers and medical secretaries totally 54 workers, between November2006 and December 2006. Age, gender, job, status, service life, duty times and frequency, work load, supervisor pleasure, monetary and morale satisfaction, attending to social activity in free times are the factors that effects job satisfaction.Öğe Thoracic ectopia cordis(2007) Orak M.; Üstündağ M.; Güloğlu C.; Sayhan M.B.; Taş M.Heart positioned outside the chest wall is known as ectopia cordis. Thoracic ectopia cordis (TEC) is extremely rare with a reported incidence of 5.5-7.9/million live births. It is classified as cervical, cervico-thoracic, thoracic and more commonly the thoraco-abdominal or abdominal types. TEC is classified as complete and incomplete. In complete thoracic ectopia cordis the naked heart is displaced outside thoracic cavity without pericardial coverage. In partial thoracic ectopia cordis the heart can often be seen to pulsate through the skin. In this study, we present one case of TEC and review the literature on this subject.
