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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 Are the anticardiolipin antibodies a risk factor for coronary artery disease in chronic renal failure patients?(Taylor & Francis Ltd, 2008) Ucar, Edip; Kuvandik, Guven; Sert, Mehmet; Kuvandik, Ceren; Temizkan, Aysegul; Borazan, AliObjective. It has been proposed that anticardiolipin (aCL) antibodies are a risk factor for coronary artery disease (CAD) in recently studies. In this study, we aimed to investigate the existence of coronary artery disease in dialysis patients who were aCL positive and undergoing hemodialysis and peritoneal dialysis due to end stage renal failure and also to determine its relationship with risk factors in patients with coronary artery disease. Methods. This study has been conducted in the end stage renal failure in 140 hemodialysis patients, 18 peritoneal dialysis patients, and 38 healthy controls. The urea, creatinine, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, total protein, and albumin values are obtained. In all cases, aCL levels are investigated with ELISA method. Results. In the HD and CAPD patients, no significant relationship could be found between the age, gender, dialysis time, total cholesterol, HDL cholesterol, LDL cholesterol, total protein, and albumin values (p 0.05). HD and CAPD vs. controls (aCL), 9.2% (13/140), 11.1% (2/18) vs. 2.6% (1/38), p = 0.002. No significant difference was noted between aCL-positive and -negative patients in serum urea, creatinine, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, total protein, and albumin levels. The coronary artery disease was determined in three patients out of 16 patients with aCL positivity. Conclusion. The prevalence of aCL antibodies positivity in our study was similar to the prevalence of aCL positivity in other studies. Therefore, we do not think aCL antibodies positivity is a risk factor for coronary artery disease.Öğe Clinical presentation and laboratory findings of organic phosphorus poisoning(Springer, 2007) Ozer, Cahit; Kuvandik, Guven; Gokel, Yuksel; Duru, Mehmet; Helvaci, Mehmet RamiThis study was conducted to evaluate the demographic, causative, and biologic characteristics of patients with organophosphate (OP) poisoning who were admitted to tertiary teaching and research hospitals at 2 different universities. All patients admitted to the emergency departments of Cukurova University Hospital in Adana, Turkey, between 2001 and 2003 and the Hospital of Mustafa Kemal University in Hatay, Turkey, between 2004 and 2006 were included. The study group consisted of subjects with a mean age of 28.5 +/- 14.1 y (range, 14-80 y), and the maximum number of cases in the second decade of life; the female-to-male ratio was 2.2:1. In all, 27 of 43 females and 16 of 20 males were married. Most subjects (n=55) had graduated from primary school; 3 were illiterate and 5 were highly educated. A total of 36 (57.1%) subjects belonged to lower socioeconomic groups. Fifty-three patients intended to commit suicide, and 10 cases were accidental. Mean arrival time of subjects to the hospital after poisoning was 9.9 +/- 16.1 h (range, 1-96 h); mean Glasgow Coma Scale score was 10.2 +/- 2.9 (range, 3-15). A total of 19 subjects were intubated, and 4 died. A total of 59 patients recovered completely. The mortality rate (6.3%) depended on various factors such as OP compound consumed, amount ingested, time interval before hospitalization, and patients' general health. Chances for recovery were greater when the patient was hospitalized at the earliest indication. In conclusion, ON especially affected young single females, and most cases were due to attempted suicide. Because OP poisoning is an important cause of morbidity and mortality, therapy should be started immediately to avoid undesirable consequences.Öğe Comparison of bacterial isolates cultured from hemodialysis patients and other patients with diabetic foot and their antimicrobial resistance(Taylor & Francis Ltd, 2007) Cetin, Meryem; Ocak, Sabahattin; Kuvandik, Guven; Aslan, BahadirThe aim of this study was to compare microbial findings and their resistance to antibiotics between hemodialysis patients and patients without end-stage renal failure with diabetic foot infections. An 18-month-long descriptive study analyzed bacterial isolates obtained from 32 hemodialysis (HD) patients with diabetic foot infection in an Antakya hemodialysis center and 65 patients with diabetic foot infection admitted to the Education and Research Hospital of Mustafa Kemal University, Turkey. No significant difference in the mean number of pathogens per patient was found between the dialysis patients and other patients (2.3 vs. 2.1, respectively) (p > 0.05). While the occurrence of gram-positive bacteria in the HD patients was found to be 59.0%, this rate in the other patients was 53.1% (p > 0.05). While most frequent bacterial species isolated in the HD patients were S. aureus (22.9%), followed by coagulase-negative Staphylococcus spp. (CNS) (19.7%), the microorganisms in the other patients were found as CNS (20.7%), followed S. aureus (18.0%). The data recommend that antibiotic therapy in HD patients with diabetic foot infection should be more closely guided by culture findings and antimicrobial susceptibility results.Öğe Coronary Artery Disease Risk Factors in Patients on Continuous Ambulatory Peritoneal Dialysis(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2008) Pocan, Bekir; Ucar, Edip; Kuvandik, Guven; Borazan, Ali; Guven, Oguz; Gursurer, Metin; Camizci, RaleAim: We aimed to investigate especially early stage non traditional cardiovascular risk factors in end stage renal failure patients who were in Continued Ambulatory Peritoneal Dialysis (CAPD) programme in our center. Methods: In this study 21 CAPD patients and 21 sex and age matched controls were enrolled. The clinical history and demographic parameters were obtained and than for physical evaluation blood samples were drawn for 12 hours fasting glucose, serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, apoA, apoB, total protein, albumin, calcium, phosphorus, parathormon (PTH), hemoglobin (Hb), Lp(a), C-reactive protein (CRP), homocysteine (tHcy), anticardiolipin antibody (ACLA), fibrinogen. Results: While age, sex, Body Mass Index (BMI), smoking status and hereditary factors were comparable between the groups, diabetes mellitus and hypertension were significantly higher in CAPD patients. There was no statistical significance between the groups considering mean serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, PTH, Lp(a), tHcy, ACLA Ig M and ACLA Ig G levels. In the present study mean apoA level was significantly lower in the study group, while apoB and phosphorus were higher (p=0.003). Also mean total protein, albumin, calcium, and Hb level were significantly lower, while mean CRP and fibrinogen were higher in the study group (p=0.0003). Conclusion: Because of the high rates of increased risk factors for coronary artery disease in CAPD patients at early stages, these patients should be closely followed for coronary artery disease.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 Effect of weight loss on P wave dispersion in obese subjects(Wiley, 2006) Duru, Mehmet; Seyfeli, Ergun; Kuvandik, Guven; Kaya, Hasan; Yalcin, FatihObjective: The aim of this study was to investigate effect of loss weight on P wave dispersion in obese subjects. Research Methods and Procedures: After a 12-week weight loss program (diet and medical therapy), a total of 30 (24 women and six men) obese subjects who had lost at least 10% of their original weight were included in the present study. All subjects underwent a routine standard 12-lead surface electrocardiogram. Electrocardiograms were transferred to a personal computer by a scanner and then magnified 400 times by Adobe PhotoShop software (Adobe Systems, Mountain View, CA). P wave dispersion, which is also defined as the difference between the maximum P wave duration and the minimum P wave duration, was also calculated. Results: After a 12-week weight loss program, BMI (p < 0.001), maximum P wave duration (p < 0.001), and P wave dispersion (p < 0.001) significantly decreased. The mean percentage of weight loss was 13% (10% to 20.3%). The decrease in the level of P wave dispersion (21 +/- 10 and 7 +/- 12 ins, p < 0.002) was more prominent in Group II (>= 12% loss of their original weight) than Group I (<12% loss of their original weight) after the weight loss program. A statistically significant correlation between decrease in the level of P wave dispersion and percentage of weight loss was found (r = 0.624, p < 0.001). Discussion: Substantial weight loss in obese subjects is associated with a decrease of P wave duration and dispersion. Therefore, these observations suggest that substantial weight loss is associated with improvement in atrial repolarization abnormalities in obese subjects.Öğe Effects of Erdosteine on Acetaminophen-induced Hepatotoxicity in Rats(Sage Publications Inc, 2008) Kuvandik, Guven; Duru, Mehmet; Nacar, Ahmet; Yonden, Zafer; Helvaci, Rami; Koc, Ahmet; Kozlu, TolunayWe investigated the effects of erdosteine on acetaminophen (APAP)-induced hepatotoxicity in rats. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), AST (aspartate aminotransferase), and ALT (alanine transaminase) activities, and malonyldialdehyde (MDA) and nitric oxide levels as oxidant/antioxidant biochemical parameters were investigated with light microscopic evaluation in adult female Wistar Albino rats. APAP administration produced a decrease in hepatic SOD, CAT, and GSH-Px activities, and coadministration of erdosteine (150 and 300 mg/kg) resulted in increases in the activities. MDA and NO levels increased in the APAP group, and erdosteine treatments prevented these increases. Significant elevations in serum AST and ALT levels were observed in the APAP group, and when erdosteine and APAP were coadministered, their serum levels were close to those in the control group. Light microscopic evaluation of livers showed that there were remarkable centrilobular (zone III) hepatic necrosis and mild to moderate sinusoidal congestion in the APAP group, whereas in the erdosteine group, cellular necrosis was minimal and the hepatocytes maintained a better morphology when compared to the APAP group. Erdosteine prevented APAP-induced liver injury and toxic side effects probably through the antioxidant and radical scavenging effects of erdosteine.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.Öğe Evaluation of patients with snakebite who presented to the emergency department: 132 cases(Turkish Assoc Trauma Emergency Surgery, 2016) Sahan, Mustafa; Tasin, Veyis; Karakus, Ali; Ozcan, Oguzhan; Eryigit, Umut; Kuvandik, GuvenBACKGROUND: The present objective was to evaluate clinical stages, complications, treatment modalities, and termination of treatment in patients who presented to the emergency department with snakebite. METHODS: A total of 132 snakebite cases were retrospectively examined using emergency department records. RESULTS: The majority of patients, 42.9% (n=57), had grade 0 snakebite. The local complication most frequently observed was pain (42.4%, n=56); the most common systemic complication was prolonged international normalized ratio (INR) level (5.3%, n=7). Local complications were observed in patients at all stages, while systemic complications were observed only in patients at advanced stages. Antivenom was administered in 46.4% (n=61) of patients, 52.2% (n=69) of patients were hospitalized, and 47.7% (n=63) of patients were discharged after 6-12 hours of monitoring. No negative outcome was observed during 6-month or year-long follow-up. CONCLUSION: Complications should be evaluated based on type of toxin, and appropriate treatment should be initiated efficiently, according to clinical stage. This approach reduces or prevents the development of complications.Öğe Hepatitis C virus infection is probably associated with autoimmune disorders and malignancies but not with autoimmune thyroiditis(Asian Network for Scientific Information, 2007) Kuvandik, Guven; Helvaci, Mehmet Rami; Ozer, Cahit; Altintas, Engin; Kaya, Hasan; Duru, MehmetIn this study initially consecutive patients with Autoimmune Thyroiditis (AT) were taken in the Endocrinology Polyclinics. Beside that age and sex-matched patients with HCV infection and control cases were randomly studied in the Gastroenterology and Internal Medicine Polyclinics, respectively. One hundred and seventy-two patients with AT, 62 with HCV infection and 110 control cases were studied. AT was diagnosed in eight (12.9%) cases of the HCV infecteds' group and this ratio was 11.8% (13 cases) in the control group (p>0.05). Similarly, HCV infection was detected in one (0.5%) case of AT group and this ratio was 0.9% (one case) in the control group (p>0.05). Parallel to these results, prevalences of antithyroid peroxidase and/or antithyroglobulin antibodies were detected as 29.0% (18 cases) and 32.7% (36 cases) in the HCV infecteds' and control groups, respectively (p>0.05). As another face of the results, it was detected one case of monoclonal gammopathy of undetermined significance and one case of lichen planus in the HCV infecteds' group. As a conclusion, HCV infection may be associated with autoimmune disorders and malignancies but not with AT.Öğe Markers of inflammation as determinants of mortality in intensive care unit patients(Springer, 2007) Kuvandik, Guven; Ucar, Edip; Borazan, Ali; Aydemir, Selim; Ilikhan, Sevil; Sekitmez, Nedred; Duru, MehmetIn this study, the investigators explored the relationship between mortality rate and serum levels of C-reactive protein (CRP), erythrocyte sedimentation ratio (ESR), albumin, and hemoglobin, leukocyte, and platelet counts of patients at the time of first admission to the intensive care unit (ICU). A total of 123 patients were admitted to 2 different ICUs. In the emergency departments, serum levels of CRP, ESR, and albumin and hematologic parameters of 81 patients who died and were 42 patients who survived were compared. Student t test and the chi(2) test were used for statistical analyses. Mean CRP and ESR levels and leukocyte counts were higher in nonsurvivor than in survivor groups (P<.001 for all). Additionally, serum CRP and ESR elevations and leukocyte counts were determined to be individually related to mortality (P<.001, P<.05, and P<.05, respectively). The investigators concluded that initial serum levels of CRP and ESR and leukocyte counts can be used as determinants of mortality in ICU patients.Öğe Morganella morganii-associated arthritis in a diabetic patient(Springer, 2008) Cetin, Meryem; Ocak, Sabahattin; Kuvandik, Guven; Aslan, Bahadir; Temiz, Muhyittin; Aslan, AhmetThis case report involves a 60-year-old diabetic man who developed septic arthritis as a result of the pathogen Morganella morganii. The patient had complaints of elevated body temperature, malaise, rigors and pain in the left knee, despite no history of trauma. On examination of the knee, erythema, warmth, tenderness and swelling was observed. Arthrocentesis performed on his left knee indicated the presence of straw-coloured, cloudy fluid without crystals. Bacterial identification based on biochemical and automated methods indicated the growth of M morganii. M morganii was also isolated from the exudate of a diabetic ulcer in the left foot, with antibiotic susceptibilities identical to those from the knee effusion. This case indicates that M morganii may be considered as a possible cause of septic arthritis in diabetic patients, especially those with diabetic foot infections.Öğe A Physiologic Events' Cascade, Irritable Bowel Syndrome, is Significantly Associated with Chronic Gastritis, Hemorrhoid, Urolithiasis, and Depression(Elsevier Science Bv, 2007) Duru, Mehmet; Kuvandik, Guven; Ozkan, Orhan Veli; Helvaci, Mehmet Rami; Kaya, HasanObjectives: About one third of people report recurrent upper abdominal discomfort, and irritable bowel syndrome (IBS) is probably associated with most of the underlying pathologies. Materials and Methods: We took consecutive patients admitted to the Emergency Department because of upper abdominal discomfort. IBS is diagnosed according to Rome II criteria in the absence of red flag symptoms, which are not typical for IBS. Other underlying causes of upper abdominal discomfort were detected and results were compaired between the cases with and without IBS. Results: One hundred and twenty patients with IBS and 138 patients without were studied. Although 61.6% (n=74) of the IBS cases were female, this ratio was 42.0% (n=58) in patients without IBS (p<0.001). On the other hand, chronic gastritis (CG) was detected in 72.5% (87) of cases with IBS, whereas this ratio was 36.2% (50) in patients without (p<0.001). Similarly, although the prevalence of hemorrhoid was 33.3% (40) in the IBS cases, it was 15.2% (21) in the other group (p<0.001). Beside that, urolithiasis was detected in 17.5% (21) of the cases with IBS and in 11.5% (16) of the cases without (p<0.05). Additionally, the prevalence of depression was higher in the IBS group (p<0.001). Conclusion: Relationships between IBS and CG, hemorrhoid, urolithiasis, and depression are significant, and IBS is a cascade of many physiologic events, being initiated with psychological disturbances-like many stresses and eventually terminating with gut dysfunction. Keeping in mind these associations will be helpful for physicians during prevention, treatment, and follow up of these patients.Öğe Positive correlation of CRP and fibrinogen levels as cardiovascular risk factors in early stage of continuous ambulatory peritoneal dialysis patients(Taylor & Francis Ltd, 2008) Tekin, Ishak Ozel; Pocan, Bekir; Borazan, Ali; Ucar, Edip; Kuvandik, Guven; Ilikhan, Sevil; Demircan, NejatWe aimed to study the relationship between the C-reactive protein (CRP), albumin, and fibrinogen as cardiovascular risk factors in continuous ambulatory peritoneal dialysis (CAPD) patients, in the early stage of their therapy. The study included 21 CAPD patients as the study group (SG) and age- and sex-matched 21 healthy patients as the control group (CG). History and physical exam data were obtained for all cases, and demographic baseline characteristics were taken. Twelve-hour fasting serum levels of glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, total protein, albumin, hemoglobin, CRP, and fibrinogen were obtained. There was no statistically significant difference between the SG and CG in baseline characteristics, including age, sex, body mass index (BMI), smoking, and family history of cardiovascular disease. However, diabetes mellitus (DM) and hypertension (HTN) were significantly more common among the study group. The average total protein, albumin, and hemoglobin levels were significantly lower, and the CRP and fibrinogen levels were significantly higher (p < 0.001) in the SG. A positive correlation was seen (r = 0.443, p < 0.05) among CRP and fibrinogen levels in SG. There was no correlation among the other parameters in SG. For CG, there was no correlation seen for any studied parameters. When patients with and without cardiovascular disease (CVD) were compared, no correlation was seen between CRP and other parameters. A positive correlation of CRP and fibrinogen levels as cardiovascular risk factors was shown in early stage of CAPD patients. The CAPD patients with elevated levels of CRP and fibrinogen should receive close follow-up for cardiovascular disease prevention.Öğe Prevalence of white coat hypertension in underweight and overweight subjects(Int Heart Journal Assoc, 2007) Helvaci, Mehmet Rami; Kaya, Hasan; Yalcin, Atilla; Kuvandik, GuvenThe aim of the present study was to determine if there is any association between white coat hypertension (WCH) and body mass index. The study was performed in two phases. In the first phase, we studied consecutive underweight patients, while in the second phase, age-matched consecutive normal weight, overweight, and obese cases were studied. Although we detected 61 cases in the underweight group with a mean age of 24.1 years, we could only detect 12 age-matched cases in the obesity group, and thus the obesity group was not used for comparison. When we looked at the prevalences of sustained normotension (NT), WCH, and HT in the groups, there were gradual and significant increases in the prevalences of WCH in addition to the gradual, and significant decreases in the sustained NT from the underweight towards the normal weight and overweight groups. Eventually, only 31.5% of the overweight group had sustained NT, even though the mean age of the cases was very young. Due to the gradually increased prevalence of WCH from the underweight towards the normal weight and overweight groups, parallel to the already known increasing prevalences of HT, type 2 diabetes mellitus, hyperbetalipoproteinemia, dyslipidemia, and coronary heart disease and the very low prevalence of sustained NT among the overweight cases even in the early decades here, WCH should preferentially be accepted as an alarming sign of excess weight and many associated disorders in the future, rather than just being considered a predisposing factor of HT or atherosclerosis alone.Öğe Role of Inflammatory Mediators in the Prediction Angiographic Thrombus in Patients with Acute Coronary Syndrome(Derman Medical Publ, 2015) Tasin, Veyis; Kuvandik, Guven; Karakus, Ali; Sahan, Mustafa; Duru, Mehmet; Kurt, Mustafa; Ozer, CahitAim: Inflammatory mechanisms had played a major role in the formation and prognosis of acute myocardial infarction. Inflammatory mediators was assciated 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.Öğe A Sample of Crisis Management in the Emergency Department and Evaluation of Patients; Reyhanli-Hatay-Turkey Experience(Derman Medical Publ, 2014) Karakus, Ali; Sahan, Mustafa; Duru, Mehmet; Kuvandik, Guven; Caliskan, Koca; Arslan, Gokhan; Tasin, VeyisAim: Natural disasters, terrorist bombings, transportation and industrial accidents can lead to many deaths and injuries. The number of deaths and injuries in these situations are closely related to cooperation among police, fire fighters, ambulances and hospital staff. Practice and organized positioning can improve such cooperation and experiences. In this study, we aimed to investigate the medical situation of the patients admitted to our hospital emergency service after the terrorist bombing attack occurred on Saturday May 11th, 2013 at about 14: 00 pm in the Reyhanli province and to evaluate our hospital applications. Material and Method: Data including gender, age, Glascow Coma Scale score, Injury Severity Score-ISS, K-Revise Trauma Score(RTS), type of transportation and injury, duration of treatment and prognosis of the patients injured after the explosion were collected retrospectively from the hospital records. Results: The terrorist bombing attack was the bloodiest event in the history of the Republic of Turkey. After the explosion, 51 people died. 27 of the 146 injured patients were admitted to our hospital. 20 of them were male and 7 were female. The mean age of the patients was 31,85 (1-63). Glascow Coma Scale scores were 3-8 for 3 patients, 9-13 for 6 patients and 14-15 for 18 patients. The most frequent injuries were observed in the extremities and soft tissues. 15 patients were discharged after their treatment and 9 patients were hospitalized by different services related to their medical conditions. Three patients died in the emergency department. The size of the event and the number of injured patients were evaluated by the doctors in charge in emergency service and the 112 paramedics. Then, other relevant doctors, administrative officers and health care staffs were instructed and called to the hospital. Appropriately triaged, monitored and treated patients were resulted after evaluating their conditions. Discussion: The soft tissue injuries were the most common case group in relation to the size of the event. The relationship was determined between trauma score values and mortality. Therefore, emergency services should be prepared to the cumulative injuries such as bombing events.Öğe SCREENING FOR ABDOMINAL AORTIC ANEURYSM IN GERIATRIC POPULATION(Derman Medical Publ, 2017) Karakus, Ali; Tasin, Veyis; Kartal, Ismail; Kuvandik, GuvenAim: An abdominal aortic aneurysm (AAA) is uncommon in people. Male gender and smoking are the most important risk factors. AAA is a condition that may be fatal when diagnosis is delayed This study aimed to emphasize the necessity for screening due to four fatal cases with abdominal aortic aneurysm in a genatric population. Material and Method The study included 320 patients from a nursing home and an emergency department The diameters of abdominal aortas were measured and assessed far risk factors. Results: Of the patients, 232 (72.5% were male and the mean age was 75.65 +/- 7.76 (range: 62-95 years). Hypertension was the most frequent risk factor determined. Mean aortic diameter was found as 18.87 +/- 2.74 mm (range 15-26 mm) No significant associations were detected among risk factors, age groups, and aortic diameter Four cases with abdominal aortic aneurysm died. Discussion AM is the most frequently seen aneurysm among true aneurysms. Major risk factors for AAA include male gender. smoking history. and age >65 years. In advanced ages, particularly in men, screening for AAA reduced deaths caused by rupture. The patients should be assessed for surgical intervention by Taking risk factors into consideration. Large-scale screening studies can reduce risk for mortality.
