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Öğe Clinical importance of ultrasonographic pelvic fluid in pediatric patients with blunt abdominal trauma(Turkish Assoc Trauma Emergency Surgery, 2010) Orak, Murat; Ustundag, Mehmet; Guloglu, Cahfer; Gokdemir, Mehmet Tahir; Erdogan, Mehmet Oezguer; Al, BehcetBACKGROUND The aim of this study was to evaluate the significance of the ultrasonographic finding of pelvic fluid as a predictor of organ injury in pediatric patients with blunt abdominal trauma. METHODS We reviewed retrospectively the medical records of 85 consecutive pediatric patients who admitted to the Emergency Department of Dicle University from January 2008 to December 2008 with blunt abdominal trauma. Age, gender, mechanism of injury, isolated injuries, surgical interventions, hospitalization, and mortality were evaluated according to the location of fluid. RESULTS A total of 85 pediatric patients (63 male, 22 female; mean age: 7.88 +/- 3.403 years) with blunt abdominal trauma were included in the present study. Forty percent of the patients had intraperitoneal fluid, while 60% had pelvic fluid. The majority (35.3%) of patients applied due to falling from height. The difference between the mechanism of the injuries and location and presence of the fluid was not statistically significant (p>0.05). Twenty-nine patients had solid organ injuries. Splenic injuries showed the highest association with intraperitoneal fluid (p<0.001). Of the patients, 15.3% underwent exploratory laparotomy and 44.7% required blood transfusion. The presence of intraperitoneal fluid statistically increased the probability of the exploratory laparotomy and necessity of blood transfusion (p<0.001). Mortality rate was 4.8%. CONCLUSION In ultrasound examination, it was determined that the probability of solid organ injury was lower in the presence of pelvic fluid, while it was higher in the presence of intraperitoneal fluid outside the pelvis.Öğe Evaluation of Suicide Attempts in Southeast of Turkey, Around the Sanliurfa Region(Aves, 2011) Soeguet, Oezguer; Sayhan, Mustafa Burak; Gokdemir, Mehmet Tahir; Kaya, Halil; Al, Behcet; Orak, Murat; Ustundag, MehmeObjective: Suicide is one of the leading causes of death following traffic accidents, especially in the young. The aim of this study was to evaluate the frequency of suicides, death ratios and sociodemographic features in our city (Sanliurfa province, Turkey). Materials and Methods: In the study, subjects who applied to the emergency department due to suicide between 01(th) June 2008 and 31(th) May 2009 were analysed retrospectively. Data on sociodemographic features, methods used for suicide attempts and reasons were obtained by reviewing the medical files of the cases. Results: Of 53.678 patients who applied to the emergency department, 499 (0.9%) were found from the records to apply with suicide. 417 (88.7%) of the subjects were females and 82 (16.3%) were males. Suicides were found to increase in the 30-28 age group (60.4%). Methods used for suicide attempts were drug overdose or toxic substance ingestion in 96.9% (n= 484), gunshot wounds, stab wounds, jumping off or hanging in 3.1% (n= 15). The most commonly preferred agents were anti-inflammatory drugs in suicide attempts with drugs (45.9%). Ratio of death was 3.8% (n= 19) among all cases and 68.4% (n= 13) of the dying subjects were males. Most of the deaths occurred due to organic phosphorus ingestion (47.3%) ( n= 9). Conclusion: In our study, suicide attempts were found to be a social problem for our region and it was more common in the productive population between the ages of 20-28 years and in females. However,, ratio of suicide attempts resulted in death was found to be higher among males.Öğe Factors Associated with Morbidity and Mortality in Patients with Mechanical Bowel Obstruction(Emergency Medicine Physicians Assoc Turkey, 2012) Halis, Nurkal; Sogut, Ozgur; Guloglu, Cahfer; Ozgonul, Abdullah; Gokdemir, Mehmet Tahir; Durgun, Hasan MansurObjective: The aim of this study was to investigate the factors affecting morbidity and mortality by evaluating the demographical, etiological and clinical characteristics of patients with mechanical bowel obstruction. Materials and Methods: Data for 171 mechanical bowel obstruction patients were evaluated retrospectively. The patients were assessed in mortality (n=21), morbidity (n=55) and recovery (n=95) groups. Results: Of the patients, 70% were men; and 27.4% were =55 years of age. While gender had no impact on mortality and morbidity, age did. Adhesion was observed to be the leading cause (45.6%) of mechanical bowel obstruction, followed by incarcerated hernia in 17.5%. Intestinal necrosis was associated with mortality but not with morbidity. Late presentation and multiple concomitant diseases had no impact on mortality but were associated with morbidity. The presence of a concomitant disease and leukocytosis or leukopenia had a significant impact on both mortality and morbidity. Conclusion: Older age and presence of a concomitant disease, leukocytosis or leukopenia were established to be associated with mortality and morbidity. Late presentation and multiple concomitant diseases were associated only with morbidity. The presence of intestinal necrosis was associated only with mortality. Establishing the risk factors well will be beneficial in lowering the incidences of morbidity and mortality.Öğe Pentraxin 3 level in acute migraine attack with aura: Patient management in the emergency department(W B Saunders Co-Elsevier Inc, 2020) Gokdemir, Mehmet Tahir; Nas, Cemal; Gokdemir, Gul SahikaObjectives: We investigated the state of inflammation, PTX3 level and other routine inflammatory markers (high sensitivity C-reactive protein [hsCRP], and white blood cells [WBC]), in patients who presented to the emergency department (ED) with migraine. We also investigated the relationship between the clinical presentation, PTX3 level, and other routine inflammatory markers in the emergency management of these patients. Methods: The study included 44 patients (group 1) who presented to the ED due to a migraine attack with aura and 44 controls (group 2) with similar demographic characteristics. Results: The WBC count was 8.82 +/- 2.10 x 109/L in group 1 and 7.85 +/- 2.04 x 109/L in group 2. The mean PTX3 level was 11.57 +/- 3.99 ng/mL in patients who presented at the ED with a migraine attack, and 4.59 +/- 1.28 ng/mL in controls. The differences values of WBC and PTX3 between the two groups were significant (respectively; P = 0.031, P < 0.001). ROC analyses indicated significant results for PTX3 as a marker for acute migraine attack. It had a sensitivity of 93% and specificity of 84% at a cut-off value of 5.80 ng/mL. Conclusion: This is the first study to investigate plasma levels of PTX3 in patients with acute migraine. PTX3 as a biomarker may be used as an additional examination to the current subjective criteria to support the diagnosis of patients presenting to the ED with an acute migraine attack. (C) 2019 Published by Elsevier Inc.Öğe Predictors of Emergency Blood Transfusion in Esophageal Variceal Bleeding(Emergency Medicine Physicians Assoc Turkey, 2014) Erdogan, Mehmet Ozgur; Ozturk, Engin; Erdogan, Baris; Gokdemir, Mehmet Tahir; Colak, Sahin; Orak, Murat; Guloglu, CahferObjective: Esophageal variceal bleeding is the most important and common complication of cirrhosis. Predicting the indication of emergency transfusion in patients with esophageal variceal hemorrhage is controversial. The aim of this study is to identify predictors of emergency transfusion by comparing the differences in demographic characteristics, vital signs, complete blood count, biochemistry, Partial thromboplastin time values, use of medication, and the insertion of nasogastric tubes in transfused and non-transfused esophageal variceal bleeding patients. Material and non-transfused esophageal variceal bleeding patients. Methods: The files of 51 esophageal variceal bleeding patients admitted to the emergency department between 2000 and 2009 were reviewed retrospectively. Vital signs of the patients, whole blood counts, biochemistry, PTT, INR values, emergency department blood transfusion, medications, and mortalities were recorded. Data were analyzed with SPSS version 17.0. Categorical variables were analyzed with chi-square test, and nonparametric data were analyzed with Mann-Whitney U-test. Results: The incidence of transfusion was significantly higher (p=0.02) in patients with a decreased albumin/globulin ratio. Patients requiring emergency transfusion had significant tachycardia (p=0.016). Age (p=0.026) and hematocrit value (p=0.00001) also predicted the need for emergency transfusion. Conclusion: Low albumin/globulin ratio, tachycardia, and age over 60 in patients with esophageal variceal hemorrhage predict the indication of emergency transfusion.Öğe Prognostic importance of paraoxonase, arylesterase and mean platelet volume efficiency in acute ischaemic stroke(Pakistan Medical Assoc, 2017) Gokdemir, Mehmet Tahir; Karakilcik, Ali Ziya; Gokdemir, Gul SahikaObjective: To study the prognostic importance activity of paraoxonase and arylesterase, and the value of mean platelet volume in patients with acute ischaemic stroke. Methods: This case-control study was conducted at Harran University Hospital, Sanliurfa, Turkey, from January to June 2014, and comprised patients with symptoms of acute ischaemic stroke who presented to the emergency department. Paraoxonase activity, expressed in units per litre, or U/L, of serum, was evaluated in the absence of basal activity, and arylesterase activity was defined as micromoles, of phenol generated/min, and was expressed as U/L of serum. Mean platelet volume was measured as a routine parameter. SPSS 20 was used for data analysis. Results: Of the 94 participants, 48(51%) were patients with acute ischaemic stroke and 46(49%) were control subjects. Moreover, 27(56.3%) patients were females and 21(43.7%) were males. In the control group, 26(56.5%) were females and 20(43.5%) were males. The mean age of patients was 68.39 +/- 11.83 years compared to controls' 65 +/- 9.95 years. Decreased activity of prognostic importance and arylesterase were significant in patients than in the controls (p=0.016 and p=0.001, respectively). The median platelets of patients was significantly lower than that of the controls (p=0.004). However, the median mean platelet volume values were similar in the both groups (p=0.568). Binary logistic regression analyses showed that the paraoxonase and arylesterase were risk markers for the patients. Conclusion: Decreased paraoxonase and arylesterase activity and decreased platelet counts were observed probably due to increased oxidative stress in acute ischaemic stroke patients.Öğe A Rare Type of Suicide Attempt in East Turkey: Acute Zinc Phosphide Poisoning(Aves, 2013) Gokdemir, Mehmet Tahir; Kaya, Halil; Sogut, Ozgur; Orak, Murat; Ustundag, Mehmet; Karasu, MehmetObjective: The purpose of this study was to predict the clinic and demographic profile of patients who attempt suicide by poisoning with zinc phosphide. Material and Methods: All cases presenting to the ED from January 1st 2009 to April 3th 2011 due to Acute Zinc Phosphide Poisoning were retrospectively reviewed. Results: All cases had taken the pharmaceutical product in an attempt to commit suicide. The average age of the cases was 25.4 years. Sixteen of the cases were female (76%), and five (24%) were male; all of the cases who died were female. In terms of marital status, 4 (19%) of the cases were single or unmarried. A total of 8 (38%) cases were unconscious and had low pH levels (< 7.35), and 9 (43%) cases had signs of shock, such as hypotension and tachycardia. The average level of bicarbonate in the arterial blood gas of the cases was 23.20 mmol/L and the average amount of time (admission time) taken to bring the patients from the place where they were poisoned to the ED was 2.40 hours. According to the autopsy results of the dead patients, there were findings of liver congestion, liver necrosis, pancreatic edema and hemorrhagic points together with inflammation in the kidneys. Conclusion: Although it is a rare form of suicide attempt, the mortality rate for patients with zinc phosphide poisoning is high. Early resuscitation can have positive effects on morbidity and mortality. Patients who suffer from zinc phosphide poisoning must be monitored under intensive care conditions.
