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Öğe Dicle University Hospital's hospital disaster plan and emergency service management: Kahramanmaras earthquake experience(Oxford Univ Press, 2024) Yaman, Mahmut; Ulgut, Silan Goger; Sen, Abdullah; Ulgut, Ali Firat; Belek, Sema; Durgun, Hasan MansurBackground: Hospitals, being establishments with varying functions and capacities, must have disaster plans that reduce vulnerability, ensure the continuity, and possibly increase the capacity of healthcare services; these measures are crucial for reducing mortality and facilitating the normalization of life after a disaster. In this study, the aim was to analyze the operational process of the disaster management plan at Dicle University Faculty of Medicine Hospital following the earthquake in Kahramanmara & scedil; on 6 February 2023. Methods: This is a retrospective observational study. The study focused on determining the role of the hospital's disaster plan in crisis situations, specifically examining the emergency service task distribution and management. Results: The study included patients aged 1 to 85 years (median 34, mean 36.9 +/- 19.0), with 52.5% being female. The median injury severity score was 17 (mean 20.1 +/- 19.2). Hospital admission was 65.7%, with nephrology and orthopedics being the most common departments. Higher injury severity scores were significantly associated with mortality (P < .05), and dialysis and surgery rates were significantly higher in deceased patients (P < .05). No significant differences were found in age, gender, or comorbidities between groups. Conclusion: The earthquake highlighted the importance of disaster preparedness in hospitals for effective patient care, collaboration among disciplines, and resource management. Detailed data on the hospital's disaster plan and its operational process during the earthquake were provided to underscore its critical role in managing the crisis. Lessons learned will shape future disaster response protocols, stressing continual evaluation and improvement in healthcare disaster readiness.Öğe Effects of Carvacrol on Experimental Testicular Torsion-Detorsion Model Investigation by Immunohistochemistry(Sci Printers & Publ Inc, 2020) Dursun, Recep; Sen, Abdullah; Yaman, Mahmut; Durgun, Hasan Mansur; Asir, FiratOBJECTIVE: To investigate the protective effects of carvacrol on an experimental testicular torsion-detorsion rat model. STUDY DESIGN: Wistar male rats (n=48) weighing 230-250 g were assigned to 4 groups (8 per group): control, torsion, torsion-detorsion, and torsion-detorsion + carvacrol-treated groups. Control group animals did not undergo any surgical operation. For the torsion group, the scrotum was opened (under general anesthesia) and the left testis twisted 720 degrees clockwise and in the last 30 minutes of 3-hour ischemia; i.p. saline was injected. In the torsion-detorsion group, after ischemia the left testis was reperfused for 2 hours. The torsion/ detorsion +carvacrol group protocol was similar to that of the torsion-detorsion group but in the last 30 minutes of 3-hour ischemia, i.p. 20 mg/kg carvacrol was administered. RESULTS: Malondialdehyde (MDA) was highest in the torsion-detorsion group (p <0.01). The lowest catalase (CAT) value was found in the torsion-detorsion group. Decrease in glutathione (GSH) levels of the torsion and torsion-detorsion groups as compared to those of control and carvacrol groups was significant (p<0.01). The highest superoxide dismutase (SOD) value was in the control and carvacrol groups. Increased apoptosis and degeneration of spermatogenic cells with hyperplasic nuclei were mainly observed in the torsion and torsion-detorsion groups. The torsion-detorsion + carvacrol group mostly showed regular histology, but Leydig cells were degenerated. ET-1 expression was increased in endothelial cells in the torsion and detorsion groups but negative in the carvacrol group. Bax expression was positive in luminal spermatogenic cells in the torsion group but negative in interstitial cells in both torsion and torsion-detorsion groups. In the carvacrol-treated group some luminal spermatogenic cells in seminiferous tubules showed positive Bax expression but weak in basal membrane cells and Leydig cells. CONCLUSION: Carvacrol influences spermatogenic cells with strong mitotic activity in basal membranes of seminiferous tubules and may prevent apoptotic development and signaling of these cells.Öğe Evaluating the McMahon score for predicting mortality in earthquake-induced rhabdomyolysis: a retrospective study(Oxford Univ Press, 2024) Yaman, Mahmut; Sen, Abdullah; Durgun, Hasan Mansur; Eynel, Eren; Belek, Sema; Ulgut, Silan Goger; Orak, MuratBackground: In natural disasters like earthquakes, building collapses can trap individuals, causing crush syndrome and rhabdomyolysis. This life-threatening condition often leads to acute kidney injury. We aimed to determine the effectiveness of the McMahon score in predicting mortality due to rhabdomyolysis in patients affected by the earthquake. Methods: This is a retrospective observational study. In this study, the clinical and laboratory data of patients who presented to the emergency department due to the earthquake were analyzed. The McMahon score was calculated by evaluating factors such as creatine kinase, serum creatinine levels, age, and gender. Results: The study included 151 patients, of whom 74 (49.0%) were male and 77 (51.0%) were female. In the univariate model, significant (P < .05) effectiveness was observed in differentiating between patients with and without mortality for McMahon score and the risk of acute kidney injury. At a McMahon score cutoff of 6, significant effectiveness was also observed, with an area under the curve of 0.723. At this cutoff value, the sensitivity was 80.0% and the specificity was 64.5%. Conclusions: The use of the McMahon score in emergency medicine and disaster management plays a crucial role in rapid decision-making processes due to its effectiveness in predicting mortality. Key messages What is already known on this topic center dot Rhabdomyolysis, often associated with crush syndrome and acute renal failure, leads to elevated serum creatinine levels due to muscle breakdown, frequently seen in trauma and earthquake victims. What this study adds center dot The McMahon score helps predict mortality and acute kidney injury in rhabdomyolysis patients, particularly after earthquakes, by evaluating key clinical and demographic factors. How this study might affect research, practice, or policy center dot This study highlights the McMahon score's reliability in predicting mortality in rhabdomyolysis patients, potentially guiding future research on early intervention strategies and trauma management, informing clinical practices for rapid assessment and treatment.Öğe FACTORS AFFECTING MORTALITY IN GERIATRIC PATIENTS WITH HEAD TRAUMA(Gunes Kitabevi Ltd Sti, 2016) Icer, Mustafa; Sen, Abdullah; Zengin, Yilmaz; Dursun, Recep; Durgun, Hasan Mansur; Ustundag, Mehmet; Orak, MuratIntroduction: 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.