Engin Deniz Arslan

Role of mean platelet volume in diagnosis of childhood acute appendicitis.

Introduction. Acute appendicitis is the leading cause of abdominal pain in children requiring emergency surgical intervention. The aim of this study is to investigate the diagnostic value of MPV in early diagnosis of acute appendicitis cases in pediatric age group. Methods. This study was performed retrospectively. Three hundred five patients operated on with the diagnosis of appendicitis and pathologically found to be acute appendicitis were classified as Group 1 and 305 healthy children were classified as control Group 2. Results. One hundred ninety-seven of 305 cases in Group 1 are males (64.6%), in Group 2, 151 of 305 cases are males (49.5%). The mean MPV in Group 1 was 7.9 ± 0.9 (fL), and whereas in Group 2 was 7.7 ± 0.8 (fL). There was no statistically significant difference regarding MPV values (P > 0.05). Conclusion. In our study we detected that mean platelet volume has no diagnostic value in pediatric acute appendicitis cases.

Epidemiologic and clinical characteristics and outcomes of scorpion sting in the southeastern region of Turkey

BACKGROUND Scorpion sting resulting in envenomation is a life-threatening emergency and causes serious health problems in tropical and subtropical regions. The aim of this study was to present the epidemiologic and clinical features of 123 cases presenting with symptoms of scorpion poisoning, a cause of preventable mortality and morbidity. METHODS This study retrospectively analyzed the epidemiologic and demographic features of a total of 123 patients who presented to Diyarbakır State Hospital Emergency Service with scorpion sting between January 2008 and December 2009. RESULTS Among 123 patients who presented to Diyarbakır State Hospital Emergency Service with scorpion sting between January 2008 and January 2009, 62.6% (n=77) were female and 37.4% (n=46) were male. The mean age of the patients was 33.5±17.3 years (2-80), and 27 (22%) patients were younger than 18 years. The place of residence was rural region in 98 (79.7%) patients and the city center in 25 (20.3%). The majority of victims were stung by scorpions while they were at active work (42.3%) or asleep (19.5%) in bed. Eleven (8.95%) patients were stung by a scorpion while putting on their own clothes. CONCLUSION This simple descriptive study will hopefully help healthcare providers take measures to prevent scorpion stings, which should take into consideration local epidemiological features.

Analysis of Trauma Cases Admitted to the Emergency Department

Aim: Trauma is a serious problem affecting especially the young population in the world. In our study, we aimed to investigate to the clinical and demographic characteristics of trauma cases admitted to our emergency department. Material and Method: The research data were collected from 1267 patients who applied to the Ankara Numune Training and Research Hospital Emergency Service with trauma. The patients’ demographic data, vital sign and symptoms at the application time, the trauma mechanism, requested consultations, and the patients’ discharge or hospitalization procedure were recorded on the forms. Results: The average age of the patients was determined as 35.3±15.4. Male ratio of the patients was 75.4%. The most frequently trauma type was resulted from motorized vehicle accident (55.8%). While the mechanism of blunt trauma was significantly at a high rate (83.1%), the most frequently exposed anatomical region was upper extremities (44.8%). Discussion: Trauma affects young adult males more frequently.

Occupational Injury Patterns of Turkey

Introduction and aimEach year, a significant number of people die or become handicapped due to preventable occupational accidents or occupational diseases. The aim of this study was to investigate socio-demographic features, mechanism, causes, injury area, and sectoral features of occupational accidents in patients presented to our department.Materials and methodsThe study was carried out retrospectively after local ethics committee approval. Age and sex of the patients, mechanism of injury, type and exact location of injuries were all evaluated. The groups were compared using Chi-Square test, Student’s T test and Kruskall-Wallis test. p value <0.05 was accepted as statistically significant.ResultsTotally 654 patients were included in the study. 93.4% of patients were male, and mean age was 32.96 ± 5.97 (18–73) years. Sectoral distribution of accidents was statistically significant and mostly occurred in industrial and construction workers (p < 0.05, respectively). There is a statistically significant relationship between educational level and sector of the worker (p < 0.05). While the most frequent cause of admission to emergency department was penetrating injuries (36.4%), the least was due to multiple traumas (0.5%). Distribution of occupational accidents according to injury type was statistically significant (p < 0.05). The mean Injury Severity Score (ISS) was 9.79 ± 8.1. The mean cost of occupational injury was

Acute renal failure associated with dysfunctioning detrusor muscle in multiple sclerosis

1729.57 ± 8178.3. There was statistically significant difference between the sectors with respect to cost. Seventy-one patients (10.9%) recovered with permanent sequel and two (0.3%) died in hospital.ConclusionOccupational accidents are most commonly seen in young males, especially in primary school graduated workers, and during daytime period.

Lingual angioedema after alteplase treatment in a patient with acute ischemic stroke.

Patients with multiple sclerosis (MS) typically have neurogenic lower urinary tract dysfunction. Most patients present with bladder hyperreflexia and failure to empty the bladder secondary to detrusor-distal sphincter dyssynergia. This case study is unique in the literature in reporting on a patient presenting with acute renal failure (ARF) due to vesico-sphincter dysfunction associated with MS. A 64-year-old man with MS presented in the emergency department with the chief complaint of a marked decrease in urinary output for 2 days and weakness. He had been treated for MS for 7 years. A mass compatible with a full bladder was palpated in the suprapubic region on examination. Digital rectal examination disclosed grade I-II prostate hypertrophy. Urinary catheters were inserted and urinary output was monitored. The residual urine was drained and recorded as 1100 mL. Initial laboratory findings, such as the BUN/creatinine ratio, urinary sodium concentration, and urine gravity, were compatible with ARF. The patient recovered rapidly in 24 hours following urinary catheterization and prompt medication in the emergency department. He was admitted to the neurology ward with a diagnosis of acute urinary outflow obstruction resulting in ARF due to detrusor dysfunction complicating an MS attack. ARF may complicate the course of patients with MS and associated detrusor-external sphincter dyssynergia. Renal recovery of these patients may be facilitated by urinary catheterization and supportive treatment.

Temporomandibular Joint Dislocation after Gastroendoscopy: A Case Report

BACKGROUND In recent years, thrombolytic therapy has become the main treatment of ischemic stroke. But the increasing use of alteplase in ischemic stroke has made some complications more evident. Angioedema is a rare but potentially life-threatening complication of alteplase treatment. Only a few studies have examined the incidence of angioedema after treatment with alteplase for stroke. METHODS A 75-year-old man complaining of right hemiparesis was admitted to our emergency department. He was diagnosed as having acute ischemic stroke, and alteplase infusion was given two hours after the onset of stroke symptoms. Immediately after the completion of infusion he was noted to have a large swollen tongue. RESULTS His neurological symptoms resolved gradually within 4 hours, whereas his upper extremity strength improved to 4/5 and lower extremity 5/5. Lingual edema resolved within 16 hours without any complication. He died from presumed nosocomial infection 5 days later. CONCLUSIONS Lingual angioedema may appear as a possible complication in patients who were treated with alteplase. The management of these patients should be very careful.

An unusual presentation of ruptured abdominal aorta aneurysm

Temporomandibular joint (TMJ) dislocation is defined as excessive forward movement of the mandibular condyle beyond the articular eminence with complete separation of the articular surfaces and fixation in that position. A 54 years old man attended our Eme rgency Department (ED) with complaints of slurred speech and inability to close his mouth after upper gastroendoscopic procedures. Lateral craniography was obtained and illustrated bilateral anterior dislocation of the patients mandibular condyles. To con firm the diagnosis urgent radiographic imaging is required without delay as the risk of complications occurring increases as time elapses.

Retrospective Analysis of Indication of Bone Scintigraphy Performed in Our Clinic

Patient: Female, 65 Final Diagnosis: Ruptured abdominal aorta aneursym Symptoms: — Medication: — Clinical Procedure: After surgery the patient was discharged without sequelae Specialty: Surgery Objective: Unusual clinical course Background: Rupture of an abdominal aortic aneurysm is the most frightening and potentially life threatening complication of an abdominal aorta aneurysm (AAA). Patients present with atypical symptoms such as abdominal or flank pain, gastrointestinal hemorrhage, or shock. Case Report: A 65-year-old woman presented to our emergency department with gradually increasing left flank pain for 4–5 days. Her laboratory, radiologic, and physical examination revealed no significant pathology, so she was discharged, but 3 days later she was readmitted because her symptoms returned. Further research revealed a ruptured AAA and the patient was hospitalized for surgical intervention. Conclusions: Emergency physicians should keep in mind that AAA and its rupture can present with a wide range of symptoms that appear to be simple.

Investigation of Seatbelt use Frequency of Healthcare Providers in Ankara

DOI: 10.4328/JCAM.2051 Received: 11.09.2013 Accepted: 28.09.2013 Printed: 01.05.2015 J Clin Anal Med 2015;6(3): 324-6 Corresponding Author: Füsun Aydoğan, Mustafa Kemal Üniversitesi Tıp Fakültesi, Nükleer Tıp A.D. Hatay, Türkiye. T.: +905056579710 E-Mail: drfusunay@yahoo.com Özet Amaç: Kemik sintigrafisi sık kullanılan radyonüklid görüntüleme yöntemlerindendir ve birçok hastalığın tanı ve takibinde başarıyla kullanılmaktadır. Çalışmamızın amacı kliniğimizde yapılan kemik sintigrafisi çekimlerinin endikasyonlarını ve çekim protokollerini belirlemektir. Gereç ve Yöntem: Çalışmaya Aralık 2011 ve Haziran 2013 tarihleri arasında kliniğimizde kemik sintigrafisi çekimi yapılan 252 hasta (132 erkek, 120 kadın) dahil edildi. Hastaların yaş ortalaması 50.1±20.2 idi (yaş aralığı 6-84). Sintigrafik protokoller hastalığın çeşidine göre geç statik tüm vücut görüntüleme ve üç fazlı kemik sintigrafisi olmak üzere iki şekilde yapıldı. Çekim endikasyonları ve sintigrafik protokoller tesbit edildi. Bulgular: 102 hastaya (% 40,5) metastatik kemik hastalıklarının tanı ve takibi amacıyla, 57 hastaya (% 22,6) ortopedik uygulamalar amacıyla, 29 hastaya (% 11,5) primer kemik tümörlerinin tanı ve takibi amacıyla, 17 hastaya (% 6,7) osteomyelit tanısı amacıyla, 12 hastaya (% 4,8) protez enfeksiyonu ve gevşemesi ayrıcı tanısının yapılması amacıyla, 14 hastaya (% 5,6) greft canlılığının araştırılması amacıyla, 9 hastaya (% 3,6) romatoid artrit-sakroileit gibi romatolojik hastalıklar nedeniyle, 4 hastaya (% 1,6) osteoporoz-vertebralarda patolojik kırık araştırılması amacıyla, 2 hastaya (% 0,8) metabolik kemik hastalığı nedeniyle, 5 hastaya (% 1,98) otitis eksterna tanısı amacıyla ve 1 hastaya (% 0,4) sedimantasyon-CRP yüksekliği gibi nedenlerden dolayı malignite şüphesi nedeniyle kemik sintigrafisi çekimi yapıldı. Hastaların 136’sına (% 54) geç statik tüm vücut görüntüleme, 116’sına (% 46) ise üç fazlı görüntüleme protokolü uygulandı. Tartışma: Kemik sintigrafisinin en sık kullanıldığı alan metastatik kemik hastalıklarının tanı ve takibidir. Bunu ortopedik uygulamalar, primer kemik tümörlerinin tanı-takibi ve osteomyelit tanısı gibi nedenler takip etmektedir.