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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 Abdominal Pain and Confusion: A Case Report of Abdominal Epilepsy(Kare Publ, 2015) Kuvandik, Guven; Karakus, Ali; Sahan, Mustafa; Ozcan, OguzhanAbdominal epilepsy is a recurrent and rare condition characterized by gastrointestinal symptoms such as abdominal pain, nausea, vomiting and neurological findings such as lethargy and convulsion. Although usually seen in childhood, it can also be seen in adults. After ruling out more common causes of abdominal pain, it is diagnosed with electroencephalography (EEG). The improvement of symptoms with antiepileptics is important in diagnosis. A 17-year-old woman was admitted to the emergency department with sudden loss of consciousness. On admission, general condition of the patient was moderate. The patient had confusion, and her other vital signs were as follows: Glasgow Coma Scale (GCS) at 11 (E: 2M: 5V: 4); arterial blood pressure, 100/60 mmHg; heart rate, 100 beats/min; respiration rate, 20 breaths/min and temperature, 37.2 degrees C. Other physical examination findings were normal. First serum glucose level was 85 mg/dL. Serum amylase, lipase and other laboratory test results were within normal limits. After two hours of monitoring, her consciousness was completely opened. For differential diagnosis of abdominal pain, control results were normal. There was not any abnormal findings in computed tomography (CT) scans of brain. In EEG recordings, moderately active epileptiform abnormalities were detected. Levetirasetam medication was initiated. There were no problems observed during the one-year treatment period. Abdominal epilepsy is a rare condition that should be considered in patients presented with abdominal pain and confusion. After the initial tests performed for differential diagnosis of abdominal pain, patients should be evaluated with EEG.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 The Analysis of Mean Platelet Volume and Platelet Distribution Width Levels in Appendicitis(Springer India, 2015) Aydogan, Akin; Akkucuk, Seckin; Arica, Secil; Motor, Sedat; Karakus, Ali; Ozkan, Orhan Veli; Yetim, IbrahimWe aimed to analyze the diagnostic value of mean platelet volume and platelet distribution width, which are also known as the markers of platelet count, in acute and perforated appendicitis. The data of 202 patients who applied to general surgery clinic in Mustafa Kemal University Hospital from 2007 to 2012 with acute appendicitis were analyzed retrospectively. The findings were separated to two groups due to the perforation status (perforated vs. non-perforated). Age, sex, leukocyte, hemoglobin, hematocrit, mean platelet volume, and platelet distribution width were examined. The mean age of the patients was 35.8. Twenty-one of all cases were perforated appendicitis (10.4 %), and the rest was acute appendicitis (non-perforated) (n=181, 89.6 %). The mean platelet volume value was 9.8 +/- 2.1 fL; mean thrombocyte count, 340.9x10(9)/L; and mean platelet distribution width value, 18.3 %. There were statistically significant differences between sex and age, hemoglobin, hematocrit, leukocyte, mean platelet volume, and platelet distribution width. There was a positive correlation between mean platelet volume, platelet distribution width, and platelet. Age, leukocyte, platelet, mean platelet volume, and platelet distribution width were higher in cases with perforation as a comparison with non-perforated cases. We think that mean platelet volume and platelet distribution width may be valuable markers to detect the risk of perforation in early periods of acute appendicitis.Öğe Asymptomatic Wolff-Parkinson-White pattern(Cukurova Univ, Fac Medicine, 2016) Karakus, Ali; Delice, Orhan[Abstract Not Available]Öğe Attention to compartment syndrome in snakebites!(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2015) Karakus, Ali[Abstract Not Available]Öğe Can venous blood gas be used instead of arterial blood gas in emergency department?(2023) Erdogan, Yakup Kadri; Karakus, AliObjective: In our study, we aimed to evaluate the usability of venous blood gas (VBG) in substitution for arterial blood gas (ABG). Methods: In this study, 110 patients with respiratory complaints, who were brought intubated were evaluated prospectively. Arterial and venous blood gases were taken simultaneously shortly before the initiation of oxygen therapy in the emergency department. PH, pO2, pCO2, SaO2, HCO3, lactate (Lac) and BEecf values were recorded. Results: Of the 110 patients included in the study, 75 were male (68.2%), 35 were female (31.8%), and they had a mean age of 53.7 ± 23.1 years. A strong positive correlation between PH, PCO2, HCO3-, BEecf, Lac values (p=0.001) and positive correlation between PO2 and SaO2 values (p= 0.002) were detected. Conclusion: We can conclude that venous blood gas be used in substitution for arterial blood gas in patients who are presented to emergency service and it may reduce the need for arterial blood gas sampling.Öğe A case of acute hemorrhagic cystitis caused by salmonella paratyphi a in a pediatric patient(2012) Yula, Erkan; Deveci, Ozcan; Toka-Ozer, Turkan; Tekin, Alicem; Inci, Melek; Karakus, AliIt is a very rare medical condition that Urinary tract infection (UTI) caused by Salmonella species. Seven-year-old boy admitted to our hospital with complaint of lower abdominal pain, burning and pain during urination (dysuria), nausea and increased fever. The patient had normal vital signs but abdominal examination revealed bilateral suprapubic tenderness. In the laboratory, it was found the amount of hemoglobin 12.9 g/dL, red blood cell count 4.8 million/mm3, white blood cell count 11.800/mm3, platelet count 275.000/mm3, level of C-reactive protein 30.2 mg/L, serologically S. paratyphi A "O" antibody (1/160) and S. paratyphi A "H" antibody (1/320) positivity. Urine examination showed gross hematuria and leukocyte esterase was positive. Urine culture was performed and isolate obtained urine culture was identified with conventional methods. Result of urine culture was reported as Salmonella species and isolate was determined as Salmonella paratyphi A by using anti-sera during the advanced identification. Results of radiological imaging were found normal. The patient was diagnosed as acute hemorrhagic cystitis caused by S. paratyphi A and received ceftriaxone treatment for seven days and had a full recovery. We conclude that in case of acute hemorrhagic cystitis, S. paratyphi A should be considered as causative agent in endemic areas.Öğe Cases of organophosphate poisoning treated with high-dose of atropine in an intensive care unit and the novel treatment approaches(Sage Publications Inc, 2014) Karakus, Ali; Celik, Muhammet Murat; Karcioglu, Murat; Tuzcu, Kasim; Erden, Ersin Sukru; Zeren, CemOrganophosphate poisoning is a life-threatening condition, which is being responsible for the symptoms due to cholinergic effects. Clinical status and blood levels of cholinesterase are used its diagnosis. While atropine and pralidoxime (PAM) appear as essential medications, hemofiltration treatments and lipid solutions have been widely studied in recent years. In this study, the importance of high-dose atropine therapy and early intervention and novel treatment approaches are discussed. Records of a total of 25 patients treated for organophosphate poisoning in the intensive care unit (ICU) between April 2007 and December 2011 were evaluated retrospectively. Of the 25 patients, 14 (56%) were male and 11 (44%) were female with a mean age of 34.8 +/- 17.66 years (range: 14-77 years). The patients were most frequently admitted in June (n = 4) and July (n = 4) (16%). Of the 25 patients, 22 patients (88%) were poisoned by oral intake, two (8%) by inhalation, and one (4%) by dermal route. Of them, 20 patients (80%) took organophosphates intentionally for suicidal purposes, while five (20%) cases poisoned due to accidental exposure. The scores of Glasgow Coma Scale of nine patients (36%) were below 8 point upon admission to hospital. The highest dose of atropine given was 100 mg intravenously on admission and 100 mg/h/day during follow-up. The total dose given was 11.6 g/12 days. A total of 11 patients (44%) were on mechanical ventilation for a mean duration of 5.73 +/- 4.83 days. The mean duration of ICU stay was 6.52 +/- 4.80 days. Of all, 23 patients (92%) were discharged in good clinical condition and one patient (4%) was referred to another hospital. This study suggests that atropine can be administered until secretions disappear and intensive care should be exerted in follow-up of these patients. In addition, in case of necessity for high doses, sufficient amounts of atropine and PAM should be available in hospitals.Öğe Closed lip schizencephaly: A case report(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2012) Arica, Vefik; Karakus, Ali; Silfeler, Ibrahim; Arica, Secil Gunher; Altas, Murat; Tutanc, Murat; Basarslan, FatmagulSchizencephaly, has been defined as an almost symmetrical bilateral cleft along the cerebral hemisphere. Clinical findings in patients with schizencephaly depends on the type of clefts (on of off type) and the amount of malformed parenchyma. Incidence of schizencephaly is unclear, while a population-based study performed in the United States reported its incidence as 1.54: 100000. These types of cortical developmental malformations had variable clinical signs depending on the function of the affected area which range widely from mental-motor retardation and epilepsy to focal neurological disorders. We also presented a very rare case with bilateral cleft palate aged 4 years who was referred with recurrent afebrile convulsive episodes and diagnosed as schizencephaly, subependimal heterotopia and temporal lobe epilepsy by cranial MRIÖğe DEMOGRAPHIC, CLINIC AND LABORATORY CHARACTERISTICS OF CASES PRESENTED TO EMERGENCY DEPARTMENT WITH SCORPION STING: 345 CASES OVER A 4-YEARS PERIOD(Carbone Editore, 2013) Duru, Mehmet; Karakus, Ali; Yengil, Erhan; Sahan, Mustafa; Zeren, Cem; Kekec, Zeynep; Yagiz, Abdullah ErmanIntroduction: In the scorpion stings, based on the involved system, clinical and laboratory changes may be seen in a wide spectrum from mild pain and flushing to death. The present study was aimed to assess patient demographics, clinical characteristics and outcomes. Methods:All patients presented to emergency department with scorpion sting between 2008 and 2011 were retrospectively evaluated by using electronic database. Results: Overall, 345 cases were included into the study, consisting of 160 male (46.4%) and 185 female (53.6%) with a mean age of 34.39 +/- 19.47 years. It was found that scorpion sting patients were most commonly stung at extremities (n=322; 93.3%). The most commonly observed complaint was pain (n=334; 96.8%).Localized flushing and edema were observed in 307 cases (89.0%). In the laboratory evaluation, it was found that mean values of complete blood counts, biochemistry assays and prothrombin time (PT). international normalized ratio (INR) and partial thromboplastin time (PTT) were within normal range. Of the cases, 99.4%(n=343) were discharged, while two children (0.6%) died due to cardiac and respiratory complications. Conclusions: Since complete blood count and coagulation assays may be normal, these assays aren't routinely needed in all cases with scorpion sting. Anti-serum therapy should be considered at early course of the disease in children and elderly patients due to complications and mortality; it should be intravenously administered V indicated, but it should not be used in all patients.Öğe Demographic, clinic and laboratory characteristics of cases presented to emergency department with scorpion sting: 345 cases over a 4-years period(Acta Medica Mediterranea, 2013) Duru, Mehmet; Karakus, Ali; Yengil, Erhan; Sahan, Mustafa; Zeren, Cem; Kekec, Zeynep; Yagiz, Abdullah ErmanIntroduction: In the scorpion stings, based on the involved system, clinical and laboratory changes may be seen in a wide spectrum from mild pain and flushing to death. The present study was aimed to assess patient demographics, clinical characteristics and outcomes. Methods:All patients presented to emergency department with scorpion sting between 2008 and 2011 were retrospectively evaluated by using electronic database. Results: Overall, 345 cases were included into the study, consisting of 160 male (46.4%) and 185 female (53.6%) with a mean age of 34.39±19.47 years. It was found that scorpion sting patients were most commonly stung at extremities (n=322; 93.3%).The most commonly observed complaint was pain (n=334; 96.8%).Localized flushing and edema were observed in 307 cases (89.0%). In the laboratory evaluation, it was found that mean values of complete blood counts, biochemistry assays and prothrombin time (PT), international normalized ratio (INR) and partial thromboplastin time (PTT) were within normal range. Of the cases, 99.4%(n=343) were discharged, while two children (0.6%) died due to cardiac and respiratory complications. Conclusions: Since complete blood count and coagulation assays may be normal, these assays aren't routinely needed in all cases with scorpion sting. Anti-serum therapy should be considered at early course of the disease in children and elderly patients due to complications and mortality; it should be intravenously administered if indicated, but it should not be used in all patients.Öğe A Demonstrative Carbon Monoxide Intoxication(Derman Medical Publ, 2014) Sahan, Mustafa; Yasaran, Iffet; Karakus, Ali[Abstract Not Available]Öğe Diabetic Foot Due to Anaphylactic Shock: A Case Report(Kashan Univ Medical Sciences, 2014) Karakus, Ali; Ozkan, Mustafa; Karcioglu, Murat; Ozden, Raif; Ustun, Ihsan; Caliskan, Koca; Gokce, CumaliIntroduction: Diabetic foot is a clinical disorder, which is commonly seen in patients with diabetes mellitus. It is also the major cause of below knee amputation in the world. There are many underlying causes such as neuropathic, ischemic, and infectious causes for diabetic foot. Local or systemic complications may develop after snake bite. Case Presentation: We reported a very rare case, involving a 78-year-old male admitted to the Emergency Department, who developed anaphylactic shock and diabetic foot after the snake bite. Conclusions: Reviewing the literature, this is the second reported case of snake bite associated with diabetic foot.Öğe Diagnosis of Dementia, Scale and Disability Report on Reflection(Derman Medical Publ, 2015) Karakus, Ali[Abstract Not Available]Öğe Differential Diagnosis of Sinus Tachycardia: A Case with Upper Gastrointestinal Bleeding(Cukurova Univ, Fac Medicine, 2015) Karakus, Ali[Abstract Not Available]Öğe Dystonia due to Bee Sting: A Case Report(Aves, 2014) Karakus, Ali; Caliskan, Koca; Duru, Mehmet; Kuvandik, Guven; Arslan, Gokhan; Erdogan, Yakup Kadri; Sahan, MustafaIntroduction: Dystonia is anabnormal contraction due to primary and secondary causes of the muscles in the body. Case Report: In the literature, although many cases of congenital or edynsel with dystonia have been reported, a case as a result of a bee sting has not. Conclusion: We aimed to present a case with recurrent dystonia as a result of a bee sting.Öğe Effects of intralipid and caffeic acid phenyl esther (CAPE) against hepatotoxicity and nephrotoxicity caused by glyphosate isopropylamine (GI)(Sage Publications Inc, 2016) Alp, Harun; Pinar, Neslihan; Dokuyucu, Recep; Kaplan, Ibrahim; Sahan, Mustafa; Senol, Serkan; Karakus, AliThis study was aimed to investigate the protective effects of caffeic acid phenyl esther (CAPE) and Intralipid (IL) against hepatotoxicity and nephrotoxicity caused by acute intoxication of glyphosate (N-phosphonomethyl) glycine) (GI) in rats. Forty-nine Wistar Albino rats were randomly divided into seven groups as: I, Control; II, Intralipid (IL) (18.6 mL/kg, orally); III, CAPE (10 mu mol/kg, intraperitoneally); IV, GI (4 mg/kg/day, intraperitoneally); V, GI + IL; VI, GI+CAPE; and VII, GI + IL + CAPE. Total antioxidant status (TAS) and total oxidant status (TOS) levels were measured in serum samples. Tissues were analyzed with hematoxylin and eosin (H&E) staining protocol. Bcl-2, Bax, and caspase-3 were evaluated by immunohistochemical method. The results revealed that, in hepatic tissues, the TAS levels were lower and the TOS levels were higher in the GI group compared to other groups. In renal tissues, the TAS levels were significantly lower in the GI group than in the control, IL, CAPE, and GI + IL + CAPE groups. The TOS levels were significantly higher in the GI group than in the control group. Moreover, histopathological analysis revealed severe hepatotoxicity in the GI group. In the GI + CAPE + IL group, hepatotoxicity recovered significantly. Nephrotoxicity was also observed in the GI group and moderately reduced in the GI + CAPE group. Biochemical results were confirmed by histopathologic examination. The results also revealed that CAPE and IL, due to their antioxidant effects, have a decreasing effect against both hepatotoxicity and nephrotoxicity caused by GI. Therefore, CAPE and IL may function as potential agents for supportive therapy since they decrease organ damage, or may facilitate the therapeutic effects of the routine treatment of patients with GI poisoning.Öğe Evaluation of extremity injuries presented to emergency department(Academy of Medical Sciences of I.R. Iran, 2017) Karakus, Ali; Kuvandik, Guven; Atalay, EzgiObjective: In this study, we aimed to review cases with firearms injury of extremities presented to our hospital. Methods: After approval by Institutional Board, electronic database was retrospectively screened for firearms injury of extremities between 2012 and 2015. Overall, 600 cases with firearms injury of extremities were included in the study. Cases were assessed fordemographicand clinical characteristics, Mangled extremity severity score (MESS), Glasgow Coma Scale (GCS), costs and outcomes. Results: Totally, 552 (92.0%) cases were men and 48 (8.0%) were women. Mean age was 29.97 ± 10.40 years (range: 5-64 years). A significant difference was detected in gender distribution. Of the cases, 96.6% (n = 580) were Syrian war casualties. Lower extremity injury was the most frequently seen injury (n = 312; 52.0%). Mean MESS score was 4.71 ±1.32 (range: 2-9). GCS score was <8 in 3 fatal cases (0.5%) whereas it was 15 in 597 cases (99.5%). It was found that 66 cases (11.0%) underwent amputation after they arrived in the hospital as a result of crush injury due to mine and blast. In cases who underwent amputation, a positive correlation was detected in MESS scores (P = 0.00). Mean cost was estimated to be 6,936 TL (280-32,232 TL). Conclusion: Young male and lower extremity injuries were most commonly encountered. Amputation was performed in the early period in cases with highest MESS scores. It was seen that amputation was common in crush injuries due to mine and blast. It was found that patient volume at emergency department and hospital and costs were increased due to war. © 2017, Academy of Medical Sciences of I.R. Iran. All rights reserved.Öğe Evaluation of Extremity Injuries Presented to Emergency Department(Acad Medical Sciences I R Iran, 2017) Karakus, Ali; Kuvandik, Guven; Atalay, EzgiObjective: In this study, we aimed to review cases with firearms injury of extremities presented to our hospital. Methods: After approval by Institutional Board, electronic database was retrospectively screened for firearms injury of extremities between 2012 and 2015. Overall, 600 cases with firearms injury of extremities were included in the study. Cases were assessed for demographic and clinical characteristics, Mangled extremity severity score (MESS), Glasgow Coma Scale (GCS), costs and outcomes. Results: Totally, 552 (92.0%) cases were men and 48 (8.0%) were women. Mean age was 29.97 +/- 10.40 years (range: 5-64 years). A significant difference was detected in gender distribution. Of the cases, 96.6% (n = 580) were Syrian war casualties. Lower extremity injury was the most frequently seen injury (n = 312; 52.0%). Mean MESS score was 4.71 +/- 1.32 (range: 2-9). GCS score was <8 in 3 fatal cases (0.5%) whereas it was 15 in 597 cases (99.5%). It was found that 66 cases (11.0%) underwent amputation after they arrived in the hospital as a result of crush injury due to mine and blast. In cases who underwent amputation, a positive correlation was detected in MESS scores (P = 0.00). Mean cost was estimated to be 6,936 TL (280-32,232 TL). Conclusion: Young male and lower extremity injuries were most commonly encountered. Amputation was performed in the early period in cases with highest MESS scores. It was seen that amputation was common in crush injuries due to mine and blast. It was found that patient volume at emergency department and hospital and costs were increased due to war.
