Ertan Mert

Effects of antiepileptic drug therapy on heart rate variability in children with epilepsy.

Impaired cardiac autonomic function may contribute to the risk of sudden unexpected death in epilepsy. Heart rate variability (HRV) is a useful tool for the detection of sympathetic-parasympathetic balance of autonomic nervous system. In the present study, epilepsy patients who had never received antiepileptic medication and those whose seizures have been successfully controlled with antiepileptic drugs were compared with each other and a control group in order to investigate the effects of epilepsy and various antiepileptic drugs on HRV. HRV were tested via 5 min ECG monitoring in 92 patients and 83 controls. Time domain parameters including SDNN, RMSSD and the frequency domain parameters including HF (reflects parasympathetic activity) and LF (reflects sympathetic activity) were assessed. In this group, 78 patients were using antiepileptic drugs including valproic acid (n=33), oxcarbazepine (n=19), phenobarbital (n=11), combined regimens (n=10) and other drugs (n=5), while 14 patients had never received antiepileptic medication. For both of the epilepsy patients groups with or without treatment, time domain parameters were found to be significantly suppressed. In addition, parasympathetic activity was found to be decreased (HF was decreased, LF/HF ratio was increased) in epilepsy patients without antiepileptic drug therapy. Our results indicate that seizure control with antiepileptic drugs may help to improve the cardiac autonomic function impairment in epilepsy patients.

Demographical, aetiological and clinical characteristics of poisonings in Mersin, Turkey

Background: As acute poisoning continues to be an important public health problem, and represents a frequent cause of admission in emergency departments, there is a constant need to have up to date information about it. The aim of this retrospective study was to evaluate the demographical, aetiological and clinical characteristics of acute poisonings who were admitted to a university hospital in the south part of Turkey. Methods: The data of 195 acute poisoning patients who were admitted to the Emergency Department of Mersin University were retrospectively studied. Results: Most poisonings occurred in the age range 0–6 years (57.5%) for children and 17–25 year (46.7%) for adults. The overall female to male ratio was 1.26. Drugs were the most common cause of poisonings (55.4%). Among the drug poisonings, psychotropics (41.7%) were the most frequent agent, followed by analgesics (20.4%). 67.7% of the cases presented to the emergency department within 3 hours of poisoning and the procedures for elimination of poison were performed in most of them. The clinical status of the patients on arrival was generally good. 69.2% of the patients were hospitalized. The mean duration of hospitalization was 2.49±2.8 days. 41.8% of the suicidal cases had a history of psychiatric disorders; 92.8% of the patients were discharged home after toxicological treatment; 2.6% of the cases died. Conclusion: Further studies are necessary to collect more data and these data will be helpful not only for determining risk factors of acute poisonings but also for developing education and prevention programmes.

The usefulness of trauma scores in determining the life threatening condition of trauma victims for writing medical-legal reports

Objectives: In the Turkish legal system the severity of the victim’s injury determines the severity of the criminal penalty, and the life threatening condition stated in the medical-legal report is one of the main determinants for injury severity. The aim of this study is to investigate the effectiveness and usefulness of the trauma scores in determining the life threatening condition of trauma victims from the forensic aspect in order to write accurate medical-legal reports. Methods: Data of 296 forensic cases with blunt and penetrating trauma were obtained. The life threatening condition of patients stated in the medical-legal reports according to the criteria based on traditional forensic opinion were examined. For each case, Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) were calculated. The ROC curve analysis was used to investigate the success of the trauma scores in distinguishing patients with/without life threatening conditions. Logistic regression analysis was performed to measure the association between trauma scores and life threatening conditions. Results: The relations between all scores and groups (with and without life threatening risk) were found statistically significant. ISS was the most successful method in distinguishing traumatised patients both in a life threatening or non life threatening condition. Conclusions: Trauma scores can be used for making more objective, standardised, and accurate judgement on whether the injury was a life threatening one or not. These advantages of using trauma scores in such situations will also be helpful for the conclusion of the lawsuits shortly, but further studies are needed to confirm these findings.

Evaluation of growth and neurodevelopment in children with congenital heart disease.

Background:  Children with congenital heart disease are under risk of delayed growth and development. We evaluated physical growth parameters and neurodevelopment in these patients in comparison with normal children and examined the effect of hemodynamic status.

Evaluation of the effects of disabilities due to traffic accidents on the quality of life using SF-36 health survey

OBJECTIVE The purpose of this study was to investigate the impact of disabilities caused by traffic accidents on quality of life using the SF-36 health survey. METHODS The study group included 168 patients (30 females and 138 males) injured in traffic accidents referred to the Department of Forensic Medicine to obtain health reports indicating their degree of disability. One hundred twenty-two cases comprised the control group. The degree of disability for the injured body parts was determined based on the related section of the Disability Regulation for patients regarded as recovered based on examination and consultation. Quality of life was calculated using the SF-36 survey. Patients were additionally evaluated using the physical and mental component summary PCS/MCS) scores. RESULTS A statistically significant difference was observed between the groups in terms of the injured body parts. The femur, tibia and/or fibula, vertebrae, radius and/or ulna and the humerus were the most frequently fractured bones. The degree of disability in the patient group was 19.22 ± 17.73. Together with the scores of the eight subscales of SF-36, the PCS and MCS score in the patient group were significantly lower when compared to the control group (p<0.05). CONCLUSION An update is required in the Disability Regulation, including the addition of items on deterioration in the quality of life and pain, and the use of the SF-36 scale may be beneficial in this regard.

Regulation of Dietary Habits: The effect of losing weight on quality of life

Objective: This study aimed to investigate the effects of regulation of nutritional habits on quality of life by applying Short Form (SF-36) Quality of Life Scale. Methods: SF-36 was administered through face-to-face interviews to a total of 129 individuals (112 female, 17 male) aged 18-65 years. Anthropometric measurements, body mass index, and waist circumference measurement were undertaken simultaneously. The changes in weight, body mass index, waist circumference measurement, and SF-36 scores were compared at baseline and three months after modification of dietary habits. Results: At three months after the regulation of dietary habits, a statistically significant decrease was found in weight, body mass index, and waist circumference measurements (p<0.05). Overall improvement was observed in all the quality of life parameters assessed with SF-36, and among them, the sub-scales of general health, bodily pain and vitality were statistically significant (p<0.05). The improvement in these sub-scale scores was similar to the literature. Conclusion: The individuals who lost weight through adopting healthy dietary habits had increased SF-36 scores, indicating the positive effect of regulating diet on their quality of life.