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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 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 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.
