Kenan Kaya

Enjeksiyon Sonrası Gelişen Nöropati: Komplikasyon/Malpraktis Ayrımında İnce Bir Çizgi

Enjeksiyon sonrasi gelisen noropati; ozellikle gelismekte olan ulkelerde yaygin saglik sorunlarindan biri olmakla birlikte yuksek morbiditeye sebep olmasi dolayisiyla da ayrica onem arz etmektedir. Saglik calisanlarinin karsisina malpraktis davasi olarak cikan bu durum icin oncelikle komplikasyon/malpraktis ayrimi yapilarak,xa0 saglik calisanlarinin da bu konuda gerekli egitimi almasi, gerekli hassasiyeti gostermesi gerekmektedir. Saglik calisanlarinin suclanmasina neden olan ve basinda daima ‘yanlis igne vuruldu, felc oldu’ seklinde sunulan bu durum hakkinda enjeksiyon sonrasi bir kusur olustugu, oyleyse ortada bir ‘suc’ oldugu ve dolayisiyla bir de ‘suclu’ oldugu seklinde dusunulmekteydi. Ancak son yillarda adli tip uygulamalarinda; enjeksiyon endikasyonunun varligi, dogru yer, dogru ilac ve dogru miktarda uygulandiginda gelisebilecek olumsuz bir durumun komplikasyon olarak degerlendirildigi gorulmektedir. Bu nedenle, bu tur iddialar soz konusu oldugu olgularda hasta kayitlarinda bu durumun gosterilmesi, ileride dogabilecek hukuki durumlar icin yararli olacaktir.

Sudden Cardiac Death: Coronary Artery Spontaneous Dissection

Spontaneous coronary artery dissection (SCAD) is a rare pathology that can result in acute coronary syndrome and sudden cardiac death.1,2 Many cases have been reported since Pretty described SCAD for the first time in 1931 at the autopsy of a 42year old women who had suffered chest pain.3 The actual incidence is thought to be higher as majority of cases is diagnosed at autopsy. The causes of SCAD are classified into 3 main subgroups: atherosclerotic disease, peripartum period, and idiopathic. It has been suggested that oral contraceptive use, cocaine use, blunt chest trauma, Marfan syndrome, cystic medial necrosis, hypersensitivity vasculitis and heavy exercise may be associated with SCAD.4,5 There was no underlying cause in our case and it was evaluated as idiopathic. Patients with SCAD can present with heart attacks, cardiac arrest, or sudden cardiac death. Symptoms of heart attacks in these cases can include chest, shoulder, arm, or epigastric pain, with or without shortness of breath and nausea/ vomiting. The heart attack severity can range from mild to severe, which may compromise heart function, causing heart failure, low blood pressure, and other organ dysfunction. During hospitalization, heart enzymes and electrocardiograms often show changes consistent with heart attacks. Some may even have abnormal heart rhythms, causing cardiac arrest that can be lethal. In this study, it is aimed to present a case of spontaneous coronary artery dissection that result in sudden death.

A death after scorpion envenoming: ARDS

Insect bites-snake insertions are encountered as non-natural deaths in a few cases per year. Insect bites include deaths due to scorpion envenoming. Death events caused by scorpion envenoming are a common public health problem in tropical and subtropical countries [1]. In our country, the species of poisonous scorpion, Androctonus crassicauda and Leiurus quinquestriatus, are common in southern and southeastern Anatolia regions [2]. Scorpion envenoming can lead to serious consequences ranging from simple reactions such as redness, itching, and pain to death due to respiratory and circulatory system effects [3]. Respiratory signs are a common problem, especially in children. Many patients lose their lives due to pulmonary edema [4]. We planned to present a 5-year-old male with ARDS after scorpion envenoming with histopathological findings.