Yazar "Orak M." seçeneğine göre listele
Listeleniyor 1 - 13 / 13
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Continuous infusion of small-volume fluid resuscitation in the treatment of combined uncontrolled hemorrhagic shock and head injury(2007) Ozturk H.; Yagmur Y.; Tas A.; Topcu S.; Orak M.Objective: To determine the effect of continuous limited fluid resuscitation on the hemodynamic response and survival in rats in a model of uncontrolled hemorrhage shock due to Massive Splenic Injury (MSI) and Head Injury (HI). Design: An experimental study. Place and Duration of Study: Dicle University Animal Research Laboratory, Turkey, between January and February 2005. Subjects and Methods: Seventy Sprague-Dawley rats were used in this study. Group 1 rats (n=10) was sham-operated. In group 2 (n=10), only Massive Splenic Injury (MSI) was performed and untreated. In group 3 (n=10), only head injury (HI) was performed and untreated. In group 4 (n=10), HI and MSI were performed and were untreated. In group 5 (n=10), HI and MSI were performed and 15 minutes later treated with 7.5% NaCl. In group 6 (n=10), HI and MSI were performed, and rats were treated with Ringer's Lactate (RL) solution. In group 7 (n=10), HI and MSI were performed, rats were treated with 0.9 % NaCl. In groups 2,4,5,6 and 7 midline incision was reopened and splenectomy was performed at 45 minutes. Results: In group 4 rats, Mean Arterial Pressure (MAP) was decreased from 104 ± 6.1 mmHg to 75 ± 19.5 mmHg at 15 minutes; heart rate decreased from 357 ± 24.9 beats/min to 321 ± 62.1 beats/min and hernatocrit decreased from 46 ± 1.3 % to 43 ± 2.5% (p<0.01). Similar early changes in MAP, heart rate and hematocrit were observed in groups 5, 6, and 7, at 15 minutes. At 45,60 and 120 minutes, in fluid resuscitated rats (group 5,6,7) MAP, heart rate and hematocrit values were measured higher than group 2 and 4 (p<0.01 for all). At 120 min, in group 6, hematocrit was higher than group 4, 5 and 7, in group 6, total blood loss after splenectomy was calculated at 20 ± 2.4% of blood volume and was the best value compared to other fluid resuscitated group 5 and 7 (28% and 27% of blood volume) (p<0.01). Mortality was lower in all fluid resuscitated groups when compared to group 3 and 4 (p<0.05). The median survival time was again higher in fluid resuscitated groups. Conclusion: Continuous infusion of 7.5% NaCl, RL and 0.9 % NaCl following uncontrolled hemorrhagic shock with massive splenic injury and combined head injury resulted in better survival and RL did not increase abdominal bleeding before splenectomy was performed.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 Factors affecting mortality in geriatric patients with head trauma(Geriatrics Society, 2016) İçer M.; Şen A.; Zengin Y.; Dursun R.; Durgun H.M.; Üstündağ M.; Orak M.Introduction: With aging, the anatomy and physiology of the body undergo changes. This leads to a change in the body’s capabilities in response to trauma, resulting in increased traumainduced morbidity and mortality. We aimed to investigate the factors influencing the prognosis and mortality of geriatric patients with head trauma. Materials and Method: A total of 1060 patients aged 65 and above who presented with head trauma within a three-year period were studied. The patients’ collected data included gender, age, trauma presentation, Glasgow Coma Scale, Revised Trauma Score, cranial physical examination findings, localisation of the fracture in the cranial regions, cranial pathology, additional organ injury and survival/death status. Results: Of the 1060 geriatric patients enrolled in the study, 500 (47%) were male and 560 (53%) were female. Of these patients, 1005 (94.8%) survived and 55 (5.20%) died. Among the deceased patients, 37 (37.3%) were male and 18 (32.7%) were female. The most common presentation was observed in the young old group (aged 65–75) with 513 patients. According to the causes of trauma, the most common cause was due to falling. The male gender was found to be at risk of mortality in all patients aged 65 and above. According to the computed tomography findings; intracranial haemorrhage, contusion, subarachnoid haemorrhage, epidural hematoma, subdural hematoma and intracranial edema were factors associated with increased mortality. Conclusion: Males and cranial pathologies are associated with a higher mortality in geriatric patients with head trauma. © 2016, Geriatrics Society. All rights reserved.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 A local cold injury case in emergency department and literature review(2010) Gökdemir M.T.; Gülo?lu C.; Sayhan M.B.; Üstünda? M.; Orak M.Cold injuries are caused by exposure to cold weather, water, fluid or gas. Cold injuries are classified as hipothermia and local cold injuries. Mortality and morbidity in these patients are worthy to note due to lack and inadequacy of treatment. 46 years old patient who walked for 6 hours on snowy road was admitted to emergency department with loss of feeling, pain, motor deficiency, and skin discoloration. In this case report we review the epidemiology, pathophysiology, clinical presentation, and different treatment methods of accidental hypothermia.Öğe Peripheral neuropathy after burn injury.(2013) Tamam Y.; Tamam C.; Tamam B.; Ustundag M.; Orak M.; Tasdemir N.Peripheral neuropathy is a well-documented disabling sequela of major burn injury. These lesions are associated with both thermal and electrical injuries that may be frequently undiagnosed or overlooked in clinical settings. The purpose of this study was to evaluate the prevalence of burn-related neuropathy in our database and to investigate the clinical correlates for both mononeuropathy and generalized peripheral polyneuropathy. Out of 648 burn patients, admitted to our clinic forty-seven burn patients with the diagnosis of peripheral neuropathy were evaluated retrospectively. The demographic and clinical data collected were gender, age, degree, site and percent surface area of burn, type of burn, and the results of electrodiagnostic examination, including electromyography and nerve conduction assessments and associated pathology if existed. Peripheral neuropathy is the most frequent disabling neuromuscular complication of burn, that may be undiagnosed or overlooked. In current study, peripheral neuropathy associated with burn all of our patients were identified by electrodiagnostic study. After treatment in Burn Unit, clinical and electrodiagnostic studies were applied. Motor and sensory distal latencies were prolonged and sensory nerve action potentials reduced in amplitude. The findings of our study have shown that polyneuropathies and axonal neuropathy were more frequent than mononeuropathy and demyelination.Öğe Plasma D-Dimer levels in acute ischemic stroke: Association with mortality, stroke type and prognosis(2010) Üstündağ M.; Orak M.; Güloglu C.; Tamam Y.; Sayhan M.B.• Objective: The purpose of this study is to examine the correlation between mortality, stroke sub-types, neurological disability and D-Dimer values measured before a specific treatment is given to patients in the emergency department. • Material and Method: In the first 24 hours after stroke symptoms started and before anticoagulant treatment started, the serum D-Dimer levels of every patient were examined. The stroke sub-type of every patient was determined according to TOAST criteria and clinical classification was made according to the Oxfordshire Community Stroke Project (OCSP). The Rankin scale was used to determine the neurological disability of the surviving patients. • Results: Ninety one patients were included in the study. There was a significant difference between the D-Dimer levels of patients who died and who survived (4.50+2.80 and 1.39+1.36 ng/ml respectively, p=0.003). According to the TOAST criteria, average D-dimer levels of cardioembolic and atherothrombotic stroke patients were higher than the control group. (4.35±3.03/ 3.11±1.69 and 0.43±0.26 respectively, p=0.000). According to OCSP classification, average D-dimer levels of patients with total anterior circulation infract (TOCI) and partial anterior circulation infract (PACI) were higher than the control group. (3.67±2.14, 4±3.03 and 0.43±0.26, respectively, p=0.000). The evaluation of surviving stroke patients in terms of neurological disability revealed that average D-dimer levels of patients with serious neurological disability Rankin score=3-5) were higher than patients with slight neurological disability (Rankin score=0 and Rankin score=1-2), (2.85±1.69; 0.79±0.56; 0.81±0.44 respectively, p=0.000). • Conclusion: We reached the conclusion that D-dimer levels in the acute period can be a leading factor for clinicians in predicting the direct results of cerebral infarct and deciding the type of treatment.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 A rare case of Chilaiditi syndrome presenting "free air under diaphragm" and mimicking a perforated viscus(2009) Sogut O.; Orak M.; Sayhan M.B.; Ustundag M.; Ozgonul A.Background: Chilaiditi syndrome (CS) is the interposition of the right colon between the liver and the right hemidiaphragm. The incidence of CS in the general population is very low and it is seen more frequently in adults than in children. Here a case is presented of Chilaiditi syndrome presenting with abdominal pain and vomiting; its initial diagnosis was perforated viscus. Case Report: A 36-year-old man was admitted to a state hospital with abdominal pain and vomiting which began three days before without any history of prior trauma. On chest x-ray, free air under the right hemidiaphragm was diagnosed as a perforated viscus. Upon physical examination in the authors' hospital, his abdomen was distended, with normal bowel sounds, but no rebound tenderness were detected on palpation. CS was subsequently confirmed by a chest x-ray and abdominal ultrasound. The patient was managed conservatively and his symptoms resolved over the next 24 hours. Conclusions: CS may be mistaken for more serious abnormalities, which may lead to unneeded exploratory abdominal surgery. This case emphasizes the importance of considering CS by emergency physicians or surgeons in the differential diagnosis of free air under the right hemidiaphragm on a chest x-ray. © The American Journal of Case Reports.Öğe Severe metabolic acidosis secondary to zinc phosphide poisoning(2008) Orak M.; Ustundag M.; Sayhan M.B.[No abstract available]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.
