Mahmut Tas

Review of techniques for the removal of trapped rings on fingers with a proposed new algorithm

Various removal techniques for rings trapped on the finger have been described in the current literature. However, despite this being a frequently encountered situation in emergency departments, there is no comprehensive algorithm to manage and follow these patients in the current literature. The purposes of this study were to describe the most commonly used ring removal techniques and to establish an algorithm for the removal of rings trapped on fingers. We performed a comprehensive literature search in several databases to identify all articles, case reports, letters, and book chapters that focus on ring removal techniques in English language from 1960 to the present. There are 2 methods of removal: (1) noncutting techniques in which the rings can be removed without breaking the integrity of the ring and (2) various ring-cutting equipments and tools. All these techniques are classified into distinct groups and described in detail with illustrations. Furthermore, an algorithm for handling such patients is established according to case-based patient care. Following an algorithm for the removal of trapped rings on the finger will be useful for patients and emergency physicians. It will also prevent possible complications and will save time.

A case of neuroleptic malignant syndrome induced by olanzapine in postpartum period

Neuroleptic malignant syndrome (NMS) is a life-threatening medical complication that occurs as a result of dopaminergic receptor blockage in nigrostriatal pathways. This syndrome is mainly accepted to be an idiosyncratic reaction for antipsychotic medications. Incidence of NMS induced by olanzapine - an atypical antipsychotic - is extremely rare. However, there has been contradiction on postpartum period as a risk factor for NMS. This case is of interest due to the fact that it happens on postpartum period and is induced by olanzapine. We aimed in this study to evaluate the successfully cured case of neuroleptic malignant syndrome induced by olanzapine in postpartum period with the literature view.

Suicide By an Elderly Patient with Ischemic Heart Disease: Case Report

SUMMARY Older people are generally more successful than younger adults in committing suicide. Successful treatment of depression and chronic illness reduces the incidence of suicidal behavior in the elderly population. We present a case of successful suicide case by a patient who underwent coronary artery bypass graft surgery after an acute myocardial infarction.

The association between mean platelet volume and inflammation in geriatric patients with emergency hypertension

Objectives We aimed to investigate the role of inflammation parameters and platelet activation in geriatric patients with hypertension. Therefore, we compared the levels of those parameters in patients with hypertensive urgency and emergency. We also investigated the potential relationship between those parameters. Methods Ninety-six hypertensive (HT) patients (aged > 60) were included in the study in two groups: HT emergency (N = 48, group 1) and HT urgency (N = 48, group 2). Mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and high-sensitive C reactive protein (hs-CRP) were compared between those groups. Optimum cut-off levels of each parameter were determined by the use of Receiver operating characteristic (ROC) curve analysis. Pearson correlation test was used to examine the relationship between variables. Results The mean MPV and hs-CRP levels were significantly higher in patients with HT emergencies (both P < 0.001). Mean NLR was also significantly different between the two groups (P = 0.011). Pearson correlation analysis revealed a positive but weak correlation between the MPV and NLR (r = 0.245, P = 0.016), the hs-CRP level (r = 0.394, P < 0.001), and the WBC count (r = 0.362, P < 0.001). Conclusion Increased platelet activity and inflammation are associated with the end organ failure. Levels of MPV and other inflammatory parameters may be useful in the management of geriatric patients with HT.