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Öğe Atrial fibrillation associated with carbon monoxide intoxication(Cukurova Univ, Fac Medicine, 2018) Yakar, Sule; Baykan, Necmi; Durukan, Polat; Salt, Omer[Abstract Not Available]Öğe Comparison of Different Suture Techniques(Derman Medical Publ, 2015) Kavalci, Cemil; Cevik, Yunsur; Durukan, Polat; Sayhan, Mustafa BurakAim: Traumas are frequent causes of presentation to emergency departments. Suturing is usually required in treatment of patients with scalp laceration. This study aimed to investigate different suture methods with respect of patient satisfaction, wound healing, and treatment cost in patients with scalp laceration. Material and Method: A total of 60 patients were included in the study. The patients were divided into 3 groups; traditional suturing (Group 1), stapling (Group 2), and the tissue adhesive (Group 3) groups. Chi-Square and Kruskal-Wallis tests were used for comparison of the groups. A p value less than 0.05 was considered statistically significant. Results: Two-thirds of the patients were male. The patient satisfaction was highest in the Group 3 (p<0.05). Tissue adhesive group had the lowest treatment cost (p<0.05). Discussion: In contrast to existing traditional belief, the alternative suture methods, i.e. tissue adhesives and staples are not expensive. The patient satisfaction was highest in the tissue adhesive group.Öğe Copeptin as a diagnostic PH marker in acute pulmonary embolism(Marmara Univ, Inst Health Sciences, 2022) Baykan, Necmi; Yakar, Sule; Ozkan, Seda; Sen, Ahmet; Salt, Omer; Durukan, PolatObjective: The present study aimed to investigate the effectiveness of copeptin levels in detecting increased pulmonary artery pressure and right ventricular dysfunction in patients with acute pulmonary embolism. Methods: A total of 116 patients who presented to the emergency department with chest pain or dyspnea and were diagnosed with acute pulmonary embolism and 30 healthy controls were included in the study. Plasma copeptin levels of patients and healthy control group were measured. Right ventricular functions and pulmonary artery pressures were evaluated in echocardiography of patients diagnosed with acute pulmonary embolism. Results: Copeptin levels were significantly higher in patients with right ventricular dysfunction than in those without right ventricular dysfunction [median 1.06(0.03-7.14) vs. 0.59(0.31-2.50), p= 0.01]. Conclusion: Copeptin can be used as a new biomarker in the diagnosis of acute pulmonary embolism and in predicting right ventricular dysfunction and increased pulmonary artery pressure in patients with acute pulmonary embolism.Öğe Edirne Basic Education Module: The Result and the Evaluation of Activity for Three Year(Emergency Medicine Physicians Assoc Turkey, 2009) Kavalci, Cemil; Guzel, Ahmet; Cevik, Yunsur; Durukan, PolatBACKGROUND: Physicians should be improved their knowledge and ability due to represent for equal and reliable health setting. We aimed to present the three-year evaluation results of the Basic Education Module, which is the first step of the certification program for physicians in Edirne. MATERIAL AND METHODS: All physicians were performed with test contained twenty questions before and after of course. The differences between the values before and after course were tested with depend and independent t test. A p value less than 0.05 was accepted as the level of significance. RESULTS: Two hundred seventy-seven physicians were included in this study. Differences in values of all physicians which admitted to education programs between before and after course in were statistically significant (p <0.001). Although differences in values of control groups between before and after course in were not statistically significant (p >0.05). CONCLUSION: Basic Education Module programs are necessary to represent for quality and reliable health setting by all physiciansÖğe Edirne temel eğitim modülü: Üç yıllık sonuç ve etkinlik değerlendirilmesi(2009) Kavalcı, Cemil; Güzel, Ahmet; Çevik, Yunsur; Durukan, PolatGİRİŞ VE AMAÇ: Sağlık hizmetlerinin eşit ve güvenilir olarak sunulabilmesi için hekimlerin mesleki bilgi ve becerilerini geliştirmeleri gerekmektedir. Bu çalışmada Edirne ilinde uygulanan Acil Hekimliği Sertifikasyon Programı’nın ilk basamağı olan Temel Eğitim Modülü’nün 3 yıllık değerlendirme sonuçlarını sunmayı amaçladık. MATERYAL METOD: Tüm hekimlere kurs öncesi ve sonrası 20 sorudan oluşan test uygulandı. Kurs öncesi ve sonrasında kursiyerlerin aldıkları puanların istatistiksel olarak karşılaştırılmasında Bağımlı Grupta t testi ve Bağımsız Gruplarda t testi kullanıldı. p < 0.05 değeri anlamlı olarak kabul edildi. BULGULAR: Kursa toplam 277 hekim katıldı. Eğitime katılan tüm hekim gruplarında ön test ve son test sonuçları arasında istatistiksel olarak anlamlı (p<0.001) bir fark bulunurken, kontrol grubunda istatistiksel olarak anlamlı bir fark bulunamamıştır (p >0.05). SONUÇ: Programı tamamlayan hekimlerin hastalara daha bilinçli ve güvenli acil sağlık hizmeti verebileceğine inanmaktayız.Öğe Emergency presentation of ophthalmic zona(Cukurova Univ, Fac Medicine, 2018) Durukan, Polat; Baykan, Necmi; Salt, Omer; Yakar, Sule; Tekin, Ismail; Kavalci, Cemil; Ozkan, Seda[Abstract Not Available]Öğe Evaluation of Patients with Ischemic Stroke Receiving iv t-PA in the Emergency Department(Aves, 2018) Salt, Omer; Baykan, Necmi; Kaymaz, Nesij Dogan; Yakar, Sule; Donmez, Halil; Koseoglu, Emel; Durukan, PolatAim: The aim of the present study was to determine the demographic characteristics, localization of emboli, imaging findings, National Institutes of Health Stroke Scale (NIHSS) scores, and complications of patients who received intravenous (iv) tissue plasminogen activator (t-PA) due to early period of ischemic cerebrovascular disease (CVD) during the 6-year period in a tertiary level emergency department of a university hospital. Materials and Methods: The study was retrospectively performed in 65 patients aged >= 18 years and who underwent iv t-PA with a diagnosis of ischemic CVD. Demographic data, such as age, gender, and smoking, were obtained by examining the medical records of the patients. The baseline Glasgow Coma Scale, NIHSS, start time of the event, time of admission to the hospital, and prognosis of the patients were recorded. Results: Intracranial hemorrhage was detected in 16.9% of the patients after treatment. On examination of the patients' outcome, a total of 32.3% (n=21) died after therapy. A significant correlation was observed between high NIHSS score and complications. Conclusion: In our study, a high NIHSS score at the time of admission has been found to increase both the risk of intracerebral hemorrhagic complication and mortality. We hypothesize that iv t-PA treatment gives successful results despite the complications, and emergency physicians should be more courageous in their application.Öğe Evaluation of Triage Tox Drug Kit in Intoxication Cases(Galenos Yayincilik, 2009) Kavalei, Cemil; Guzel, Ahmet; Cevik, Yunsur; Durukan, PolatPoisonings are important Causes of emergency room visits It especially very common among adolescents and women. in this study we airved to define the value of tox drug screen kit in the diagnosis and treatment of poisoning cases. Poisoning cases admitted to emergency department of Trakya University Hospital between january and June 2009 were evaluated prospectively. Demographic features of patients poisoning agents of intake of poisonous agent admission times treatment methods results of toxicologic screen durations of emergency department treatment and outcomes were recorded. Data were expressed as mean +/- standard deviation median and percentage. During the study period. 1.7% of emergency department visits were due to poisoning. 100 patients were included in the study. Mean age of the patients was 24.3 +/- 9.2 years. 32 of the patients were male (32%) and 68 were female (68%). Mean admission time to the hospital was 187.6 +/- 146.8 minutes. It was detected that 30% of the patients were poisoned with a single agent. The most common poisoning agents were tablets (94%). 52% of the patients were discharged from the hospital, 48% were hospitaliceed. No deaths were observed. We suggest the tox drug screen Kit is useful in the diagnosis and treatment of poisoning.Öğe Fournier's gangrene(Springer-Verlag Italia Srl, 2009) Kavalci, Cemil; Cevik, Yunsur; Durukan, Polat; Temizoz, Osman[Abstract Not Available]Öğe Importance of Neutrophil Gelatinase-Associated Lipocalin in Differential Diagnosis of Acute and Chronic Renal Failure(Kowsar Publ, 2014) Ozkan, Seda; Durukan, Polat; Kavalci, Cemil; Duman, Ali; Sayhan, Mustafa Burak; Salt, Omer; Ipekci, AfsinBackground: Neutrophil Gelatinase-associated Lipocalin (NGAL) protein is easily detected in the blood and urine soon after acute renal injury NGAL gains features of an early, sensitive and noninvasive biomarker for acute renal injury Recent evidences suggest that its expression is also increased in CRF reflecting the severity of disease. Objectives: In the present study, we aimed to investigate whether blood NGAL level plays a role in the differential diagnosis of acute and chronic renal failure. Patients and Methods: This was a prospective case-control study. Fifty patients presented to emergency department with acute renal failure (ARF), 30 with chronic renal failure (CRF) and 20 healthy individuals as control group were included in this study Blood pH, HCO3(-), BUN, creatinine and potassium values were evaluated in all patients. Blood NGAL values were evaluated in all groups. BUN, serum creatinine and NGAL values were statistically compared between patients and controls. Results: Median NGAL levels in patients was 304.50 (29), and 60 (0) in control, which was statistically significant between the two groups (Z = -6.477, P < 0.001). The median NGAL values were 261.50 +/- 291 in ARF group and 428.50 +/- 294 in CRF group. There was a significant difference in NGAL level between ARF and CRF groups (Z = -2.52, P = 0.012). Median BUN values were 153.46 +/- 82.47 in ARE group and 169.40 +/- 93.94 in CRF group. There was no significant difference in BUN value between ARF and CRF groups (P > 0.05). Median creatinine values were 2.84 +/- 2.95 in ARF group and 4.78 +/- 4.32 in CRF group. In serum creatinine values, a significant difference was found between ARF and CRE groups (P <0.05). Conclusions: Serum NGAL levels of ARE and CRF patients were significantly higher than healthy individuals. In addition, NGAL values of patients with CRF were significantly higher than those of ARE. Serum NGAL values can be used to detect renal injury and differentiate ARE and CREÖğe Intrahospital critical patient transport from the emergency department(Termedia Publishing House Ltd, 2020) Salt, Omer; Akpinar, Metin; Sayhan, Mustafa Burak; Ors, Fatma Betul; Durukan, Polat; Baykan, Necmi; Kavalci, CemilIntroduction: Although intrahospital transportation of critical patients from the emergency department (ED) is inevitable, it could also result in life-threatening situations. These situations, referred to as unwanted or unexpected events, mainly happen during the transportation of patients for diagnostic imaging or invasive procedures and result in a wide spectrum from vital condition changes, mental condition changes to cardiopulmonary arrest and death. Emergency departments have a high risk of facing such situations because these units are the first admission door of critical patients. Material and methods: This cross-sectional study was conducted prospectively, after interviewing the doctors who work in the ED actively, and by filling out the forms which were already prepared by the participants. Statistical analysis was performed according to the data received, and results were compared to the literature. Results: Three hundred and forty-seven doctors from 52 hospitals were included in the study. 59.4% (n = 206) of them were working at EDs which had more than 500 patients admitted. 51.9% (n = 180) of doctors stated that they performed 10 or more critical patients' transport every day from their ED. 86.7% (n = 301) of the participants stated that usage of control checklists would decrease the rate of unwanted situations and stated that they wanted to use them. Conclusions: Intrahospital transportation of critical patients from the emergency room is a subject that should require attention by emergency room doctors, and using educated personnel, proper equipment, standardized protocols and control checklists will decrease the frequency of unwanted situations effectively.Öğe Investigation of acute effects of diclofenac sodium on rat kidney with unilateral ureteral obstruction(Elsevier Science Bv, 2008) Yildiz, Mustafa; Pekdemir, Murat; Akpolat, Nusret; Durukan, Polat; Seckin, Dilara; Celiker, Huseyin; Kavalci, CemilObjectives: Obstruction of urine passage in anywhere from kidney to urinary bladder is named as obstructive uropathy. It is seen in renal colic patients in emergency departments. Diclofenac sodium, a non-steroidal anti-inflammatory drug, is frequently used in the treatment. This study was designed to investigate acute effects of diclofenac sodium on the kidney with unilateral ureteral obstruction. Materials and Methods: The study was performed in Experimental Investigation Centre of Firat University Faculty of Medicine. Wistar type female rats were categorized as control (I), sham (II), diclofenac (DS) (III), unilateral uretheral obstruction (UUO) (IV) and UUO+DS (V) groups. Rats were anesthesized by ketamin (5 mg/kg) and xylazine (5 mg/kg). In the IInd, IVth and Vth groups, midline abdominal incision was performed and in the IVth and Vth groups urethers were binded unilaterally. One mg of DS was given to IIIrd, IVth and Vth groups. Kidneys were sacrified in all groups. Blood and tissue samples were taken for biochemical and pathological analysis. Results: There was significant difference between the groups in pathological evaluation regarding neutrophyl, lymphocyte, and macrophage infiltration and proximal tubular dilatation (p<0.01 for all). It was found that infiltration was particularly increased in UUO group but decreased in UUO+DS group. In the biochemical analysis, there was a significant difference between the groups in respect to plasma levels of PGE(2) (p<0.01) and TXA(2) (p<0.01). When control and UUO+DS groups were compared, plasma PGE(2) (p<0.01) and TXA(2) (p<0.01) levels were found to be significanlty decreased in UUO+DS group. Conclusion: As a result, in UUO rat group in the first 5 hour, DS decreased the inflammation and tubular dilatation; but neither positive nor negative tissue level effect was determined.Öğe Isolated triquetrum fracture after trauma(Cukurova Univ, Fac Medicine, 2018) Durukan, Polat; Baykan, Necmi; Taslidere, Bahadir; Salt, Omer; Yakar, Sule; Ozkan, Seda; Kavalci, Cemil[Abstract Not Available]Öğe Kronik Böbrek Yetmezliği Olan Hipertansif Hastada Posterior Reversible Ensefalopati Sendromu: Olgu Sunumu(2018) Durukan, Polat; Baykan, Necmi; Salt, Ömer; Özkan, SedaPosterior reversibl ensefalopati sendromu klinik nöroradyolojik bir sendrom olup, T2 ağırlıklı manyetikrezonans görüntülemede bilateral pariyetooksipital loblarda simetrik yüksek sinyal yoğunluğulezyonları ile karakterizedir. Bizim olgumuzda ani görme kaybı şikayeti ile başvuran hipertansiyonve kronik böbrek yetmezliği olan periton diyalizi tedavisi alan ve posterior reversibl ensefalopatisendromu (PRES) gelişen 36 yaşında kadın hasta sunulmuştur. Acil hekimleri hipertansiyon ile ilişkilinörolojik semptomları olan özellikle kronik böbrek yetmezliği hastalarında hipertansif acil durumlarhakkında dikkatli olmalı ve eşlik edebilecek uç organ hasarlarını akılda bulundurmalıdır.Öğe Nargile İçimi Sonrası Gelişen Karbon Monoksit İntoksikasyonu: İki Vaka Sunumu(2017) Durukan, Polat; Baykan, Necmi; Salt, Ömer; Yakar, Şule; Özkan, SedaNargile son 400 yılda özellikle yaşlılar tarafından, 1980'lerden sonra da gençler tarafından yaygın olarak kullanılmıştır. Nargile içicilerinde karbonmonoksit (CO) intoksikasyonu nadir izlenir. Bu sunumda, 21 ve 20 yaşlarında olan ve nargile içimi sonrasında CO intoksikasyonu sonucu bayılma ile gelen iki kadın hasta irdelenmiştir. Acil servise baygın halde getirilen hastaların karboksihemoglobin seviyeleri sırasıyla 26.5 ve 21,4 olarak ölçülmüştür. Nargile kullanımı son yıllarda, özellikle genç popülasyonda artmıştır. Bu artışa bağlı olarak, halsizlik, yorgunluk, bayılma gibi nonspesifik şikayetler ile CO intoksikasyonu oranı da artmaktadır. Acil servise başvuran nonspesifik şikayetleri olan özellikle genç hastalarda nargile kullanımı/maruziyeti derinlemesine sorgulanmalı ve bu konuda uyanık olunmalıdır.Öğe Organophosphate Poisoning Due to a Wheat Bagel(Japan Soc Internal Medicine, 2009) Kavalci, Cemil; Durukan, Polat; Ozer, Mehmet; Cevik, Yunsur; Kavalci, GuelsuemObjective Organophosphate compounds are possibly the most widely-used insecticides worldwide. Organophosphate compounds cause poisoning, inhibiting acetylcholinesterase at the cholinergic synapses. Civilian casualties resulted from a terrorist attack with sarin in a Tokyo subway. Recent terrorist activities have also raised concerns that organophosphate or nerve agents may be used as a weapon of terror or mass destruction. Methods In this study, an extraordinary type of mass poisoning was evaluated. Especially by focusing on the way of poisoning, the demographic features and clinical findings of patients were analyzed. Results After eating a wheat bagel, 13 patients with organophosphate poisoning were admitted to our emergency department. Seven were males and 6 were females. The mean age of the patients was 26 +/- 13.9. The mean serum acetylcholinesterase level was 2945.1 +/- 2648.9 U/L. Nine patients who had supportive treatment and who were given atropine and pralidoxime were hospitalized approximately 6.8 +/- 6.5 days. All of the patients recovered after the treatment and no deaths occurred. Conclusion If organophosphate poisoning is not diagnosed and treated in time, it may be fatal. When cases of food poisoning are admitted to the hospital, attention must be taken especially if it is a mass poisoning.Öğe Patient With Post Traumatic interhemispheric Subdural Hematoma: A Case Report(Gazi Univ, Fac Med, 2018) Baykan, Necmi; Durukan, Polat; Salt, Omer; Yakar, Sule; Kaymaz, Nesij Dogan; Kavalci, CemilTraumatic interhemispheric subdural hematoma is rarely seen important condition. It account about 6% of all patient with traumatic ISH. In our case we presented a trafic accident of 48 years old, male who was a brought to our ED. Norological examination there was neither patologic symptom nor increased intracranial pressure symptoms. In the cranial tomography at the level of anterior falx, about 13 mm width hyperdens area (subdural hemorrhage) was seen. without any patologic symptom in the norological examination of traumatic patient, even if there is no any risk to cause bleeding, intracranial bleeding can ocur. According to this reason we do suggest to do cranial scan for the patients with trauma history.Öğe Plasma copeptin levels in the patients with gastrointestinal bleeding(W B Saunders Co-Elsevier Inc, 2017) Salt, Omer; Durukan, Polat; Ozkan, S.; Saraymen, R.; Sen, A.; Yurci, M. A.Introduction: Gastrointestinal bleeding is a significant cause of morbidity andmortality worldwide. In addition, it constitutes an important part of health expenditures. In this study, we aimed to determine whether there is a relationship between plasma copeptin levels and the etiology, location and severity of gastrointestinal bleeding. Materials and methods: This study was performed prospectively in 104 consecutive patients who were admitted to anemergency department with complaints of bloody vomiting or bloody or black stool. To evaluate the level of biochemical parameters such as Full Blood Count (FBC), serumbiochemistry, bleeding parameters and copeptin, blood samples were obtained at admission. For the copeptin levels, 2 more blood samples were obtained at the 12th and 24th hours after admission. The values obtained were compared using statistical methods. Results: In terms of the etiology of bleeding, the copeptin levels in the patients with peptic ulcer were higher than the levels in patients with other gastrointestinal bleeding. However, the difference was not statistically significant. There were no significant differences among all groups' 0th, 12th and 24th hour levels of copeptin. Discussion: We conclude that copeptin cannot be effectively used as a biochemical parameter in an emergency department to determine the etiology and location of gastrointestinal bleeding. It can, however, be used to make decisions on endoscopy and the hospitalization of patients with suspected gastrointestinal bleeding. (C) 2017 Elsevier Inc. All rights reserved.Öğe Pnömomediastinum: Olgu Sunumu(2017) Durukan, Polat; Tekin, İsmail; Yakar, Şule; Salt, Ömer; Baykan, Necmi; Özkan, SedaSpontan pnömomediastinum, herhangi bir tetikleyici sebep olmaksızın mediasten içinde hava bulunmasıdır. Oldukça nadir görülen, iyi huylu ve genellikle kendisini sınırlayan bir durumdur. Acil servise boğazda takılma hissi ve nefes darlığı şikayetleri ile başvuran ve spontan pnömomediastinum tanısı alan bir olgu sunulmuştur. Olgu konservatif tedavi ile sorunsuz iyileşmiştir. Spontan pnömomediastinum şüphesi olan olguların tanısı için dikkatli bir fizik muayene ve radyolojik değerlendirme çok önemlidir. Hastaların olası komplikasyonlar açısından yakın takibi gerekirÖğe Poisoning severity score, Glasgow coma scale, corrected QT interval in acute organophosphate poisoning(Sage Publications Ltd, 2010) Akdur, Okhan; Durukan, Polat; Ozkan, Seda; Avsarogullari, Levent; Vardar, Alper; Kavalci, Cemil; Ikizceli, IbrahimThe aim of this study was to investigate effectiveness of the poisoning severity score (PSS), Glasgow coma scale (GCS), and corrected QT (QTc) interval in predicting outcomes in acute organophosphates (OP) poisoning. Over a period of 2 years, 62 patients with OP poisoning were admitted to emergency department (ED) of Erciyes University Medical School Hospital. The age, sex, cause of contact, compound involved, time elapsed between exposure and admission to the ED, duration of hospital stay, and cardiac manifestations at the time of presentation were recorded. GCS and poisoning severity score (PSS) was calculated for each patient. Electrocardiogram (ECG) analysis included the rate, rhythm, ST-T abnormalities, conduction defects, and measurement of PR and QT intervals. Sixty-two patients with OP poisoning presented to our ED from January 2007 to December 2008 from which 54 patients were included in the study. The mean age was 34.1 +/- 14.8 years. Of the cases, 53.7% were female. Twenty-six patients had a prolonged QTc interval. Mean PSS of men and women was 1.8 +/- 1.0. No statistically significant correlation was found between the PSS and QTc intervals of the cases. A significant correlation was determined between the GCS and PSS of grade 3 and grade 4 cases. GCS is a parameter that helps clinician to identify advanced grade OP poisoning patients in the initial assessment in the ED. However, ECG findings, such as prolonged QTc interval, are not effective in determination of short-term prognosis and show no relationship with PSS.
