Mustafa Şahan

Ateşli Silah Yaralanmasında Gözden Kaçan İncebarsak Yaralanması: Olgu Sunumu

Yuksek kinetik enerjili atesli silahlarla meydana gelen abdominal yaralanmalarda ilk laparatomide gozden kacan yaralanmalar ozellikle savas bolgelerinde sik karsilasilan bir durumdur. En onemli sebebi yetersiz cerrahi eksplorasyon ve cerrahin deneyimsiz olmasidir. Cok erken tespit edilerek tedavi edilenler disinda mortalite orani yuksektir. Onlenmesi icin yaralilarin degerlendirilmesi ve eksplorasyonu sistematik bir sekilde yapilmalidir. Hemodinamik olarak instabil olan yaralilarda hasar kontrol cerrahisi prensipleri uygulanmalidir. Bu yazida yuksek kinetik enerjili atesli silahla abdominal bolgeden yaralanma sonrasi laparotomi yapilan, ancak peritonit gelismesi uzerine hastanemize gonderilen ve relaparatomide incebarsakta gozden kacan yaralanma tespit edilen 21 yasindaki erkek hastayi sunduk. Anahtar kelimeler: Gozden kacan yaralanma, Atesli silah yaralanmasi, Hasar kontrol cerrahisi

Role of Inflammatory Mediators in the Prediction Angiographic Thrombus in Patients with Acute Coronary Syndrome

Aim: Inflammatory mechanisms had played a major role in the formation and prognosis of acute myocardial infarction. Inflammatory mediators was assci ated with negative consequences of acute myocardial infarction. This study tested the hypothesis that in the acute phase of acute coronary syndrome, leukocyte count, neutrophil count, neutrophil lymphocyte ratio, and high sensitivity C reactive protein (hsCRP) are predictive of angiographic thrombus formation in the infarct related artery. Material and Method: This prospective study included 150 consecutive patients with acute coronary syndrome. Patients were assigned to a thrombus formation group (n=65) and a non thrombus formation group (n=85). Blood samples for measurement of hsCRP and for routine blood laboratory studies were collected before to coronary angiography. Numerical data were expressed as mean ± Standard deviation. Nominal data were expressed as the number and percentage. Comparisons between groups, chi-square test was used for nominal variables. Comparisons between groups, t-test was used for numerical data. All statistical analyzes, p <0.05 was considered significant. Results: The levels of hsCRP , total leukocyte counts, neutrophil counts, and neutrophil/ lymphocyte ratios were substantially higher in the thrombus formation group than in the non thrombus formation group patients (for each, P < 0.05). T-test analyses identified hsCRP , leukocyte count, neutrophil count, and neutrophil/lymphocyte ratio as independent predictors of thrombus formation in the infarct-related artery (for each, P < 0.05). Discussion: In patients with acute coronary syndrome, higher leukocyte conut, neutrophil count, neutrophil / lymphocyte ratio and level of hsCRP are predictors to indicate thrombus formation.

A Sample of Crisis Management in the Emergency Department and Evaluation of Patients; Reyhanlı-Hatay-Turkey Experience

1 Ali Karakuş1, Mustafa Şahan1, Mehmet Duru1, Güven Kuvandık1, Koca Çalışkan1, Gökhan Arslan1, Veyis Taşın1, Oğuzhan Özcan2 1Acil Tıp AD., 2Tıbbi Biyokimya AD., Mustafa Kemal Üniversitesi Tıp Fakültesi, Hatay, Türkiye Acil Servis Kriz Yönetimi Örneği / A Sample of Crisis Management in the Emergency Department A Sample of Crisis Management in the Emergency Department and Evaluation of Patients; Reyhanlı-Hatay-Turkey Experience

Snake Envenomation to the Face of a Child--Rare Case.

Snakebites are seen in summer season in the southern part of Turkey, including Hatay province. In average of 40 patients with snakebites are admitted to our hospital every year. Viper is the most common venomous snakes in our region. Their hemotoxins and necrotoxins lead to local or systemic tissue damage and is responsible for the mortality and morbidity. In this report, we described a rare pediatric case, a six-year-old boy having been bitten on the left side of his face when he was looking around from their homes balcony. The patient was orotracheally intubated and mechanically ventilated because of airway obstruction due to severe edema. 12 flacon of anti-snake venom, mannitol infusion, fresh frozen plasma, erythrocytes suspension and antibiotherapy were administered to the patient. Seven days after the admission, clinical and laboratory findings were improved and the patient was discharged in a good condition. Snakebites inflicted on face and neck areas may cause rapidly progressive edema in respiratory tract and lead to life-threatening conditions. Therefore early orotracheal intubation is very important to prevent mortality.

ACİL SERVİSE BAŞVURAN 65 YAŞ ÜSTÜ HASTALARDA ABDOMİNAL AORT ANEVRİZMA TARAMASI VE RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ

Background: A significant number of applications to emergency services consists of elderly patients. Elderly patients are at increased risk for abdominal aortic aneurysms. Therefore, we measured the diameter of the aorta in patients over the age of 65 and compared with the risk factors