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    Acute renal injury due to rhabdomyolysis: A tertiary hospital experience
    (2021) Arac, Esref; Solmaz, Ihsan; Yuksel, Enver; Ekin, Nazim; Arac, Songul
    Aim: Rhabdomyolysis (RML) is a clinical and biochemical syndrome caused by acute necrosis of striated muscle fibers and the subsequent transportation of potentially toxic cellular contents into the systemic circulation. In this study, we present data from rhabdomyolysis patients that developed acute renal failure who were hospitalized and treated in our clinic in 2019. Materials and Methods: We reviewed all cases of RML treated in the tertiary hospital within a 12-month period, which was defined as serum creatinine kinase (CK) levels > five times the upper normal limit. The inclusion criteria were as follow: (a) being aged ≥ 18 years, (b) being treated for RML within the designated time period, (c) AKI development. The exclusion criteria are as follows: (a) being aged 5 time upper normal limit (UNL), 14 conformed to the inclusion criteria and were selected as subjects Results: A total of 14 patients were included in the study, 12 of which were male. The mean age of the patients was 48.1 (18–80). The etiologies were as follows: hypothyroidism, 3; prolonged exposure to sun, 2; electrolyte imbalance due to severe diarrhea, 1; viral upper respiratory tract infection (URTI), 3; intramuscular injection, 1; heavy exercise or falls.Conclusion: Rhabdomyolysis is an interdisciplinary clinical condition that can lead to life-threatening outcomes including AKI. Rapid diagnosis and treatment can be life-saving. AKI is a significant potential complication of RML and renal function should be evaluated irrespective of CK levels or the presence of myoglobinuria.
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    Importance of early debridement and sterilization in burn: Inspection of infections observed in our burn unit
    (2021) Akelma, Hakan; Karahan, Zeki Ayhan; Arac, Songul
    Aim: In this study, we aimed to investigate the infections that developed in our burn-unit between 2014-2018 and to retrospectively evaluate the patients who have developed in all wound cultures.Materials and Methods: The files of the patients who received inpatient treatment between 2014 and 2018 were evaluated at the Burn Treatment Unit. Nineteen patients who were reproductive in their culture were included in the study. Patients whose files could not be accessed or no records were excluded from the study.Results: The mean age of 19 patients with recorded reproduction by our infection control committee was 15.16 ± 14.63 years and 63.2% were male. All 19 patients have had reproduction. The most common causative agent was Staphylococcus aureus. Reproduction was not detected in any of the blood cultures. When we examined the burn scores of the patients 3 (15.8%) patients had first degree burn, 13 (68.4%) patients had second degree burn, and 3 (15.8%) patients had third degree burn. When we examined the types of Burns, 2 patients had electrical burns (10.5%), 16 patients had hot water burns (84.2%) and 1 patient had hot oil burns (5.3%)Conclusion: As a result of our study, we found the rate of infection, especially the wound infections, in our burn unit to be lower in other (blood, urine and catheter) infections. We consider early surgical excision of patients hospitalized in our department and extreme sensitivity to environmental sterilization and environmental cleanliness of our department may be the cause.
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    Measuring the knowledge and attitudes of physicians towards patients with HIV/AIDS: study of Anatolian group
    (Emerald Group Publishing Ltd, 2024) Kaya, Safak; Arac, Esref; Akgul, Fethiye; Comoglu, Senol; Kaya, Sehmuz; Arac, Songul; Yildiz, Yesim
    Purpose This paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked. Design/methodology/approach The survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title. Findings A total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively. Originality/value In this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease.
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    Use of vena cava inferior collapsibility index and perfusion index in volume status monitoring during intermittent fasting in the ramadan
    (2021) Arac, Songul; Ozel, Mehmet; Zengin, Sehmus; Kanbur, Incifer; Gokdemir, Mehmet Tahir
    Aim: This study aimed to evaluate the hemodynamic status of fasting emergency service professionals by measuring the inferior vena cava collapsibility index (IVCCI) using bedside ultrasonography and the perfusion index (PI) using a noninvasive method and examining the relationship between these two parameters.Materials and Methods: This was a prospective cross-sectional study. The IVCCI and PI were measured in emergency service professionals at 11:00 am, 07:00 pm, and 10:00 pm between May 16 and June 4, 2018, corresponding to the 11th and 20th days of Ramadan. IVCCI and PI levels at different times of fasting and after feeding were compared.Results: The IVCCI-2 value of the volunteers at the 16th hour of fasting was significantly higher than the IVCCI-1 value at the 8th hour of fasting (p 0.001). The IVCCI-3 value at the postprandial 2nd hour after eating was significantly lower than both the average IVCCI-1 at the 8th hour of fasting (p 0.001) and average IVCCI-2 at the 16th hour of fasting (p 0.001). The PI-2 value at the 16th hour of fasting was significantly lower than the PI-1 value at the 8th hour of fasting. The PI-3 value at the postprandial 2nd hour after eating was significantly higher than both the average PI-1 at the 8th hour of fasting (p = 0.001) and the average PI-2 at the 16th hour of fasting (p 0.001).Conclusion: The collapsibility increased at the longest time of fasting, and the collapsibility ratio decreased after eating. Similarly, PI was the lowest at the longest time of fasting, whereas PI increased after eating.