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Öğe A 5-year retrospective evaluation of snakebite cases in Hatay, Turkey(Sage Publications Inc, 2015) Karakus, Ali; Zeren, Cem; Celik, M. Murat; Arica, Secil; Ozden, Raif; Duru, Mehmet; Tasin, VeyisSnakebites are relatively rare medical emergency cases that might lead to serious consequences. This study aims to evaluate snakebite cases in terms of medical follow-up, antivenom therapy and antivenom reactions. Medical records of patients admitted to emergency department between January 1, 2006 and December 31, 2010 were retrospectively investigated. Snakebite-related cases of a total of 125 patients were included in the scope of the study. Of the total 125 cases, 54.4% were male and 45.6% were female. Most of cases (n: 65, 52%) were aged over 30years, while the mean age was 34.87 +/- 19.29years. Snakebite-related applications to the emergency department were mostly seen in June with 27 cases. Upon admitting, all patients were recorded to be conscious and showing good general conditions; however, they suffered from pain and edema at the site of bite. Of all, 25 patients only suffered from bite injury and ecchymosis due to snakebite. The site of bite was upper extremities in 66 patients (52.8%), whereas it was lower extremities in 58 (46.4%). Of all, antivenom was unnecessary in 25 (20%) patients, while four antivenoms were administered to each of the 23 (18.4%) patients. Furthermore, six (4.8%) patients needed nine antivenom administrations for each. Anaphylaxis (n: 2, 1.6%), compartment syndrome (n: 2, 1.6%) and serum sickness (n: 1, 0.8%) encountered in remaining cases. Of all, 86 (68.8%) patients were hospitalized in the emergency department, while 25 (20.0%) patients were followed up by observation in emergency service. Only one patient was treated and followed up in intensive care unit. Implementation of antivenom therapy is considered unnecessary for the treatment of all snakebite cases. Antivenom reactions and number of related cases might be reduced by continuous close monitoring, appropriate prophylaxis and controlled slow infusion administration of medications.Öğe Acute Atrial Fibrillation and Anaphylaxis due to Bee Sting: Case Report(Aves, 2014) Karakus, Ali; Akcay, A. Burak; Celik, M. Murat; Arica, Secil; Tasin, Veyis; Caliskan, KocaIntroduction: Reactions due to bee stings ranging from local reactions to anaphylactic shock may occur in clinical presentations. Cardiac side effects and death may occur as a result of bee stings. Case Report: This study described a 53-year-old man with no history of cardiac disorders or anaphylaxis whose lip was stung by a bee. The patient was brought to the emergency department with anaphylactic shock. There was acute atrial fibrillation shown on the electrocardiogram, and echocardiogram and biochemical markers were normal. Conclusion: In the literature, three patients developed atrial fibrillation and atrial flutter as a result of bee stings. We also aim to share the diagnosis and treatment of such a case.Öğe Association with Leptin Gene c.-2548 G>A Polymorphism, Serum Leptin Levels, and Body Mass Index in Turkish Obese Patients(Humana Press Inc, 2013) Sahin, Deniz Say; Tumer, Cemil; Demir, Cemil; Celik, M. Murat; Celik, Mustafa; Ucar, Edip; Gunesacar, RamazanLeptin is a protein hormone which plays a critical role in the regulation of both body-weight through reducing food intake and stimulating energy expenditure. Several polymorphisms in leptin gene (LEP), which encodes for leptin, have been described. However, its association with obesity is still controversial. Therefore, in the present study, we aimed to investigate whether LEP c.-2548 G > A polymorphism was associated with serum leptin levels, lipid parameters, and body mass index in Turkish obese patients. Forty-seven obese patients and 48 healthy individuals were included in the study. Blood samples were collected for DNA extraction. LEP c.-2548 G > A polymorphism were detected using polymerase chain reaction-restriction fragment length polymorphism technique. Serum leptin levels and lipid parameters were measured by ELISA and enzyme colorimetric assay techniques, respectively. GA or AA genotypes and A allele carrier frequencies of the c.-2548 G > A polymorphism in the LEP were higher in obese (38.3, 34.0 and 72.3 %) when compared with controls (14.6, 12.5, and 27.1 %; p = 0.011, 0.016, and 0.002, respectively). On the other hand, AA or AG genotypes were also related to increased serum leptin levels (p < 0.001) and body mass index (p < 0.0001). All these consequences showed that LEP -2548 AA or AG genotypes are important predictors for increased levels of leptin and BMI in Turkish obese patients and it may be a useful marker for obesity risk in our population.Öğe Detection of primary clarithromycin resistance of Helicobacter pylori and association between cagA+ status and clinical outcome(Springer, 2013) Yula, Erkan; Nagiyev, Togrul; Kaya, Ozlem Aycan; Inci, Melek; Celik, M. Murat; Koksal, FatihHelicobacter pylori was examined in 110 patients (82 (74.5) with gastritis, 18 (16.4) with duodenitis, six (5.5) with duodenal ulcer and gastroesophageal reflux, and four (3.6 %) with normal) with gastrointestinal problems living in rural area, no history of macrolide use, and detected by culture (71.8) or direct detection from gastric biopsies by PCR (82.7 %). Also, cagA gene was identified using PCR and was found positive in 68/91 (74.7 %) strains. The prevalence of clarithromycin-resistant H. pylori was investigated by two methods including PCR-RFLP (7.7 (A2142G 1.1 and A2143G 6.6 %)) and twofold agar dilution (8.9 %) to detect phenotypic and genotypic status simultaneously. Among all the H. pylori positive patients, eight (8.8 %) isolates were found to be resistant to clarithromycin by at least one of the AD and/or PCR-RFLP methods. H. pylori positive rates were significantly correlated with patients' sex, age, and endoscopic findings (p = 0.040, < 0.001 and < 0.001, respectively). There were no differences in gender or endoscopic findings related to cagA (+) and cagA (-) patients. The gene of cagA was not significantly helpful in predicting the clinical outcome of H. pylori infection alone. In conclusion, we revealed that there was a low prevalence of primer clarithromycin resistance in patients living in rural area with no history of macrolide use. The prevalence of mutant strains among the macrolide-resistant H. pylori varies even geographically between close provinces.Öğe Evaluation of Intoxication Cases Applying to the Emergency Department of Medical School Hospital(Aves, 2012) Zeren, Cem; Karakus, Ali; Celik, M. Murat; Arica, Vefik; Tutanc, Murat; Arslan, M. MustafaObjective: Poisoning has been an important human problem since ancient times. The definition of a poison as a substance drug whch was potentially fatal was first introduced by the British in 1230. In our study, we aimed to retrospectively evaluate the cases of poisoning admitted to the Mustafa Kemal University Hospital between January 1, 2006 and December 31, 2010. Material and Methods: Poisoning cases admitted to the emergency room were reviewed retrospectively. Age, gender, places of transportation, clinical status, types of poisoning, intoxication periods, locations and methods of treatment, length of stay and outcomes were evaluated. Results: A total of 134 cases of poisoning were studied, of whom 30.6% were male and 69.4% were female. The mean age was 27.87 +/- 12.97. The cases were referred to hospital, 53.7% were fully conscious, 35.1% were confused and 11.2% were unconscious Drugs that cause poisoning were classified as, multiple drug (47patients-35.1%), antidepressants (29 patients-21.6%) and pesticides (26 patients-19.4%), respectively. Poisoning is most commonly seen in December. One hundred and twenty-three (91.8%) patients were treated by gastric lavage, activated charcoal and antidote. Seventy-five patients (56%), in the emergency bed service, 21 out (15.6%) in intensive care and 38 patients (28.4%) under emergency observation were discharged following observation. Most of the cases (53 cases 39.6%) were (determined 3 days lies) kept under observation as inpatients for 3 days. The patients were evaluated according to the results of follow-up and treatment; 131 patients (97.8%) were discharged after treatment, 3 patients (2.2%) were transferred No death occurred in the cases of poisoning which were treated. Conclusion: Poisoning was most commonly seen following multiple drug intake, in suicide attempts in adults, and in children by accidental ingesting. Most of the patients can be kept under observation in emergency beds and discharged from the service, by experienced emergency physicians. In order to reduce the incidence of poisoning, the family and society should be educated cleaning agents kept in inaccessible places and advice given regarding not prescribing unnecessary drugs or selling drugs without prescription.Öğe An investigation of motivational factors affecting treatment process of patients with rheumatoid arthritis in Hatay province(Aves Press Ltd, 2013) Celik, M. Murat; Kalyoncu, Umut; Guzelsagaltici, HakanIn the present study, it was aimed to investigate factors of motivation concerning referral of the patient with rheumatoid arthritis (RA) to rheumatology department. Ninety-five consecutive patients with RA presented to Rheumatology Department of Hatay State Hospital between August, 2012 and October, 2012 were included to the study. The patients attended to one or more control visit within prior 6 months were considered as patients regularly attending control visits. Those attended to a control visit during study period but not within prior 6 months were considered as patients not regularly attending control visits. In the light of information obtained from patients, two distinct forms were designed including reasons for attending regularly or not regularly to control visits. The form designed for patients regularly attending control visits included 42 items, whereas the form designed for patients not regularly attending control visits included 56 items. Ninety-five patients (63 women) with RA were included to the study. Mean ages were 46.4 +/- 13.0 and 40.6 +/- 12.6 years. Of these patients, 81 (85.3%) were patients regularly attending control visits, whereas 14 (14.7%) were patients not regularly attending control visits. It was seen that, the educational levels was primary school or below in 47 (58%) of the 81 patients attending regularly to control visits vs. all 14 patients attending not regularly to control visits (p=0.002). While 37 (45.6%) of the patients attending regularly to control visits were on steroid therapy, 12 (85.7%) of the patients attending not regularly to control visits were on steroid therapy. The difference was statistically significant (p=0.006). The main factors motivating patient with RA are found to be related to clinicians and healthcare providers; thoughts, beliefs and expectations of the patients; conditions of hospital; working condition of the patients; economic arguments; and social interactions. Regular follow-up of the patients with rheumatoid arthritis can be affected by several factor originating from patient or clinician. It seems that socio-cultural level of the patients directly affect regular follow-up of these patients.Öğe A rare cause of oral papillomatous lesions: Cowden syndrome(Medknow Publications, 2012) Balci, Didem Didar; Celik, M. Murat; Celik, Ebru; Demir, Mehmet; Yaldiz, Mehmet[Abstract Not Available]
