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Öğe Bilateral Ureteral Stones Causing Anuria: A Case Report(Aves, 2015) Gur, Ali; Turtay, Muhammet Gokhan; Gurbuz, Sukru; Oguztruk, Hakan; Sarihan, M. Ediz; Oguz, Fatih; Derya, SerdarIntroduction: Bilateral ureteral stone is not known to frequently result in anuria during emergency. Case Report: An 18-year-old male patient was admitted to an emergency department with the complaint of sudden inability to urinate. He did not mention any additional complaints. On conducting a physical examination, we could not detect any pathological findings. From the patient's blood tests, potassium and creatinine levels were found to be 6.4 mmol/L and 9.81 mg/dL, respectively. Subsequently, we found bilateral ureteral stones on ultrasonography and non-contrast spiral computed tomography. Urology consultation was requested. The patient undergoing emergency surgery had ureterorenoscopy, bilateral endoscopic retrograde basket, and DJ stents procedures done by urology. During the follow-up, the patient was able to urinate, and his creatinine and potassium levels decreased. The patient was discharged. Conclusion: For patients admitted with complaint of anuria, we should keep in mind that the patient could have bilateral ureteral stones; therefore, he or she may have acute kidney failure and may subsequently require emergency surgery.Öğe Carotid Artery Dissection: A Case Report(Emergency Medicine Physicians Assoc Turkey, 2020) Ekmekyapar, Muhammed; Oguzturk, Hakan; Ekmekyapar, Tuba; Derya, Serdar; Gurbuz, SukruCarotid artery dissection, firstly described by Pratt-Thomas and Berger in 1947, typically begins in inner layer of artery wall, proceeds to the middle layer, and intramurally extends along length of the artery as a result of the pressure produced by blood stream. This study aims to report a case in which internal carotid artery dissection was diagnosed as secondary to trauma. A 24-year-old male patient was brought to the emergency room by 112 emergency service team after a motorcycle accident. Physical examination of the patient revealed a painful dermabrasion in his right neck region and other system examinations were normal. Carotid-vertebral color Doppler ultrasonography was performed on the patient because he had a right neck pain. Accordingly, an intimal flap appearance compatible with dissection was observed on the right internal carotid artery (ICA) proximal segment. Then, brain+cervical CT angiography was performed on the patient, and an appearance compatible with dissection was observed in the right ICA. Therefore, the patient was referred to neurology and neurosurgery consultation and accordingly admitted to neurosurgery intensive care unit. As a result, carotid artery dissection in addition to other intracranial pathologies should be considered among differential diagnoses for patients with head and/or neck pain complaints regardless of whether or not they have a trauma history.Öğe Chilaiditi Syndrome: A Rare Cause of Shortness of Breath and Abdominal Pain(Aves, 2018) Ekmekyapar, Muhammed; Turtay, Muhammet Gokhan; Yucel, Neslihan; Oguzturk, Hakan; Gurbuz, Sukru; Derya, SerdarIntroduction: Chilaiditi syndrome is a rare condition in which a segment of the small or large intestine is interposed in between the diaphragm and the liver. This case report presents a patient who was admitted to the Department of Emergency Medicine, Turgut Ozal Medical Center with complaints of respiratory distress and abdominal pain and then diagnosed with Chilaiditi syndrome. Case Report: An 81-year-old female patient was admitted to the emergency department with complaints of difficulty in breathing and abdominal pain. The patient's anamnesis indicated that difficulty of breathing increased when she had abdominal pain. There was no defense or rebound, but sensitivity was observed on abdominal examination. Other system examinations were normal. Abdominal ultrasonography performed on the patient was also normal. A dynamic thorax-abdominal tomography was obtained in terms of differential diagnosis of the patient who had abdominal pain. In the dynamic thorax-abdominal tomography of the patient, loops of the colon were visualized in the vicinity of the liver anterior segment, and these images indicated with Chiliaditi syndrome. Conclusion: As a result, when the causes of shortness of breath and abdominal pain are investigated, Chiliaditi syndrome should be considered as a differential diagnosis.Öğe Chilaiditi syndrome: a rare cause of shortness of breath and abdominal pain(Aves, buyukdere cad 105-9, mecıdıyekoy, sıslı, ıstanbul 34394, turkey, 2018) Ekmekyapar, Muhammed; Turtay, Muhammet Gokhan; Yucel, Neslihan; Oguzturk, Hakan; Gurbuz, Sukru; Derya, SerdarIntroduction: Chilaiditi syndrome is a rare condition in which a segment of the small or large intestine is interposed in between the diaphragm and the liver. This case report presents a patient who was admitted to the Department of Emergency Medicine, Turgut Ozal Medical Center with complaints of respiratory distress and abdominal pain and then diagnosed with Chilaiditi syndrome. Case Report: An 81-year-old female patient was admitted to the emergency department with complaints of difficulty in breathing and abdominal pain. The patient's anamnesis indicated that difficulty of breathing increased when she had abdominal pain. There was no defense or rebound, but sensitivity was observed on abdominal examination. Other system examinations were normal. Abdominal ultrasonography performed on the patient was also normal. A dynamic thorax-abdominal tomography was obtained in terms of differential diagnosis of the patient who had abdominal pain. In the dynamic thorax-abdominal tomography of the patient, loops of the colon were visualized in the vicinity of the liver anterior segment, and these images indicated with Chiliaditi syndrome. Conclusion: As a result, when the causes of shortness of breath and abdominal pain are investigated, Chiliaditi syndrome should be considered as a differential diagnosis.Öğe CT findings of a rare case of mesenteric injury due to blunt abdominal trauma(2017) Unlu, Serkan; Derya, SerdarÖğe CT findings of a rare case of mesenteric injury due to blunt abdominal trauma(Inonu University Faculty of Medicine Emergency Medicine Department, Malatya, Turkey, 2017) Unlu, Serkan; Derya, Serdar[Abstract Not Acailable]Öğe EFFECTS OF HYDROXYCHLOROQUINE PLUS FAVIPIRAVIR TREATMENT ON THE CLINICAL COURSE AND BIOMARKERS IN HOSPITALIZED COVID-19 PATIENTS WITH PNEUMONIA(Sestre Milosrdnice Univ Hospital, 2022) Delen, Leman Acun; Gok, Abdullah; Kasapoglu, Umut Sabri; Cagasar, Ozlem; Gok, Zarife; Berber, Nurcan; Derya, SerdarBackground: The novel coronavirus disease 2019 (COVID-19) has a broad spectrum of clin-ical manifestations, the most common serious clinical manifestation of the coronavirus infection being pneumo-nia. Unfortunately, the optimal treatment approach is still uncertain. However, many studies have been conducted on the effectiveness of several medications in the treatment of COVID-19 infection. The aim of this study was to evaluate the effectiveness of the hydroxychloroquine (HCQ) + favipiravir (FAV) treatment regimen and HCQ alone by comparing the patient's clinical response and laboratory results on the fifth day of treatment in patients hospitalized due to COVID-19 infection.Patients and methods: This retrospective cohort study was conducted in Malatya Training and Research Hospital between March 2020 and July 2020. The study included 69 patients with confirmed COVID-19 with pneumonia. The patients were divided into 2 groups, those receiving HCQ alone and those receiving the HCQ + FAV combination.Results: A total of 69 patients were included in the study, and the mean age was 60.09 +/- 15.56 years. A statisti-cally significant decrease was observed in C-reactive protein (CRP) levels, at the end of the fifth day, in patients who received HCQ + FAV treatment (p=0.002), whereas there was no decrease in CRP levels in patients who received HCQ treatment alone. In addition, an increase in lymphocyte count and a better fever response was observed at the end of the fifth day in patients who received HCQ + FAV (p=0.008). However, there was no statistical difference between both treatment regimens in terms of hospital stay and treatment results (p=0.008, p=0.744, p=0.517).Conclusion: Although the combination of HCQ + FAV treatment was observed to be effective on CRP levels and fever response in patients with COVID-19 pneumonia, there was no difference in terms of hospital stay and discharge.Öğe Iliac Artery Dissection: A Case Report(Emergency Medicine Physicians Assoc Turkey, 2020) Ekmekyapar, Mohammed; Oguzturk, Hakan; Ekmekyapar, Tuba; Gurbuz, Sukru; Derya, SerdarIntroduction: Iliac artery aneurisms are generally observed associated with abdominal aortic aneurisms. Iliac artery dissection happens to be one of the rarely encountered cases and very few cases have been reported in literature. We aimed to present a patient with both iliac artery aneurisms associated with left iliac artery dissection in this study. Case: A male, 34-years old patient applied to emergency service with complaints of abdominal pain and paresthesia in his left leg. There was no pain or loss of strength in the left leg of the patient, but there existed a numbness described by himself. The brain computed tomography (CT) of the patient was considered as normal but his abdominal ultrasonography was reported as an aneurismal dilatation in both iliac artery at bifurcation level on a nearly 3 cm-segment, reaching up to 3 cm at the widest section and a mural thrombus reaching up to 70 % stenosis within the vein lumen were observed. Thereon, the patient went through a CT-angiogram and as a result dissection was observed in the left iliac artery together with aneurismal dilatation and mural thrombus in both iliac arteries The patient was hospitalized in the intensive care unit of cardiovascular surgery clinic. Conclusion: In regards to the patients who apply to emergency services with complaints of abdominal pain, numbness in extremities, acute abdomen or neurologic symptoms atypically seen like loss of strength; we should also keep in mind aortic dissection and/or iliac artery dissection among our preliminary diagnoses.Öğe INVESTIGATION OF THE EFFECT OF SIMULATOR USAGE ON ADVANCED LIFE SUPPORT AND LABOR HELP QUALIFICATIONS, AND SELF-EFFICACY OF PARAMEDIC STUDENTS(2022) Gürbüz, Perihan; Derya, Serdar; Yetiş, Gülsüm; Kolaç, Turgay; Çırak, Zehra DenizProfessional self-competence and self-efficacy of paramedics who first interfere to emergency events are important. An important ratio of deaths in emergency intervention are due to emergencies that require cardiopulmonary resuscitation (CPR), and also emergency labor is frequently seen in rural areas. In this research, CPR and labor simulation training’s effect on professional self-competence and relevance of self-efficacy in paramedic students has been investigated. The pre-test and post-test experimental research was carried out with 68 pregraduate paramedic students. Following the pre-questionnaire, all students were given simulation training about CPR and labor, and students were evaluated two times with a weak interval by making one-to-one simulation applications. Afterwards a post-questionnaire was applied, Sherer’s General Self-Efficacy Scale (SGSES) was used to determine self-efficacy levels. Professional self-competence perception level and evaluation scores of the students increased significantly in pre and post-questionnaire comparison. The statistically significant difference between professional self-competence perception and graduated high-school in pre-questionnaire was not obtained in post-questionnaire. While SGSES scores were higher in the students who felt more professional self-competence, SGSES scores and professional self-competence scores did not statistically differ among pre and post-questionnaires. Simulation trainings in the education process of paramedic students has significant impact on professional self-competence.Öğe Investigation of the relationship between type 2 diabetes risk and night eating behavior(2020) Derya, Serdar; Kayhan Tetik, Burcu; Mete, BurakAbstract: The aim of this study is to determine the prevalence of night-eating behavior and risk of undiagnosed type 2 diabetes in the community and to investigate a relationship between them. The study was carried out on 1381 individuals, aged 18-80 years, and living in Malatya province, between February-March 2018. The questionnaire consisting of socio-demographic characteristics, FINDRISK scale and Night Eating Scale was applied by face-to-face interview technique. The data were evaluated by using the SPSS 22.0 program. Significance level was accepted as p <0.05. The mean score of 1381 individuals on the FINDRISK scale was 11.17 and the mean score on the night eating scale was 26.93. We found that males, those who do not do exercise and do not have breakfast regularly, those who consumed 2 liters or less water daily, and smokers had a higher risk of developing diabetes mellitus within 10-years. The risk of developing diabetes within 10 years is different in those with and without night eating behavior (p=0.010). As a result we couldn’t find any relationship between night eating behavior and risk of diabetes determined by the FINDISK scale. Further research is needed on this subject.Öğe Nicotine addiction in pre-hospital emergency care workers in Turkey: a cross-sectional study(Taylor & Francis Inc, 2024) Karakas, Nese; citlik Saritas, Seyhan; Bentli, Recep; Derya, Serdar; Kartal, MertObjectiveThis study aims to determine the smoking prevalence and nicotine addiction in pre-hospital emergency care workers.MethodsThe study, conducted between March-April 2022 with the participation of 318 pre-hospital care workers, is cross-sectional. To determine the participants' nicotine addiction levels, the participants the Fagerstrom Nicotine Addiction Test (FNAT) was used. For statistical analyses, correlation, chi-square, student's t-test, and analysis of variance (ANOVA) were used. The statistical significance level was accepted as p < .05.ResultsWhile 53.0% Of The Study Group Used To Smoke, 9.1% Thought That Smoking Was Not harmful to health. The mean FNAT score of the smoking group was 5.04 +/- 2.92. Men's FNAT scores (p < .05) were higher for those over the age of 40 than for those under 40 than women (p < .05). In the comparison made according to the participants' occupations, the most smoking group was physicians (p < .05). The group with the highest addiction score among smokers was nurses (p < .05). A positive correlation was found between the years of employment in the sector and the FNAT scores of smokers (r = 0.146, p < .05).ConclusionPre-hospital emergency care workers had a much higher smoking prevalence and nicotine addiction than the medical staff in other units.Öğe Post-Covid pain frequency and affecting factors(2021) Teti?k, Bora; Demi?r, Gulsum Hilal; Kurt, Osman; Derya, SerdarCovid-19 disease was believed to be a short-term disease. However, as the disease was continuing to spread, it was understood that, it can continue for a long time. The aim of this study is to determine the symptoms of individuals with Coronavirus disease 2019 (Covid-19) and those who recovered from the disease and whether they have ongoing symptoms after recovery and the factors affecting of their pain complaints. This descriptive study included 152 patients who admitted to our hospital and diagnosed with Covid-19 and those recovered. The patients were interviewed by telephone and were questioned about their symptoms and conditions when they had Covid-19 and after recovering from Covid-19, by questions based on the literature as well as sociodemographic characteristics. The mean age of the patients was 44.9±13 (min=20, maks=83) and 66 (43.4%) were female and 86 (56.6%) were male. It was determined that 43 patients (28.3%) had and recovered from Covid-19, 1-2 months ago, 60 (39.5%) 2-3 months ago, 36 (23.7%) 3-4 months ago, and 13 (8.8%) 4-5 months ago. During the Covid-19 disease period, pain conditions were listed as 112 had body pain, 94 had headache, 36 had back pain, 35 had joint pain and 13 had lumbar pain. Post-Covid pain was detected in 12 people (7.9%). Body pain was reported in 5 people, headache in 2 people, lumbar pain in 4 people, and both body and joint pain in 1 person. It was observed that as the age group increased, the incidence of post- Covid pain increased. It was determined that the post-Covid pain rate was 7.9% and the patients experienced long-term body, head, lumbar and joint pain. Post-covid pain syndrome was more common in older ages. We suggest that a follow-up algorithm for post-recovery period should be developed.Öğe Potential Risk Factors for In-Hospital Mortality in Patients with Moderate-to-Severe Blunt Multiple Trauma Who Survive Initial Resuscitation(Hindawi Ltd, 2018) Yucel, Neslihan; Demir, Tuba Ozturk; Derya, Serdar; Oguzturk, Hakan; Bicakcioglu, Murat; Yetkin, FundaIntroduction. The aim was to identify risk factors that influence in-hospital mortality for patients with moderate-to-severe blunt multiple trauma (BMT) who survive initial resuscitation. Methods. The prospective study involved 195 adult patients with BMT who were admitted to a referral hospital's emergency department (ED) betweenMay 1, 2015, and May 31, 2016. Results. Forty-three (22%) of the 195 patients died in hospital. Multivariate analysis identified low blood pH (odds ratio [OR] 6.580, 95% confidence interval [CI] 1.12-38.51), high serumlactate level (OR 1.041, 95% CI 1.01-1.07), high ISS (OR 1.109, 95% CI 1.06-1.16), high APACHE II score (OR 1.189, 95% CI 1.07-1.33), traumatic brain injury (TBI) (OR 4.358, 95% CI 0.76-24.86), severe hemorrhage (OR 5.314, 95% CI 1.07-26.49), and coagulopathy (OR 5.916, 95% CI 1.17-29.90) as useful predictors of acute in-hospital mortality. High ISS (OR 1.047, 95% CI 1.02-1.08), TBI (OR 8.922, 95% CI 2.57-31.00), sepsis (OR 4.956, 95% CI 1.99-12.36), acute respiratory distress syndrome (ARDS) (OR 8.036, 95% CI 1.85-34.84), respiratory failure (OR 9.630, 95% CI 2.64-35.14), renal failure (OR 74.803, 95% CI 11.34-493.43), and multiple organ failure [MOF] (OR 10.415, 95% CI 4.48-24.24) were risk factors for late in-hospital mortality. High Glasgow Coma Scale (GCS) was a good predictor for survival at 2, 7, and 28 or more days of hospitalization (OR 0.708 and 95% CI 0.56-0.09; OR 0.835 and 95% CI 0.73-0.95; OR 0.798 and 95% CI 0.71-0.90, resp.). Conclusion. Several factors signal poor short-term outcome for patients who present to the ED with moderate-to-severe BMT: low blood pH, high serum lactate level, presence of TBI, severe hemorrhage, coagulopathy, organ failure (respiratory, renal, and MOF), and ARDS. For this patient group, ISS and APACHE II scores might be helpful for stratifying by mortality risk, and GCS might be a good predictor for survival.Öğe Potential risk factors for ın-hospital mortality in patients with moderate-to-severe blunt multipletrauma who survive ınitial resuscitation(Hındawı ltd, adam house, 3rd flr, 1 fıtzroy sq, london, w1t 5hf, england, 2018) Yucel, Neslihan; Demir, Tuba Ozturk; Derya, Serdar; Oguzturk, Hakan; Bicakcioglu, Murat; Yetkin, FundaIntroduction. The aim was to identify risk factors that influence in-hospital mortality for patients with moderate-to-severe blunt multiple trauma (BMT) who survive initial resuscitation. Methods. The prospective study involved 195 adult patients with BMT who were admitted to a referral hospital's emergency department (ED) betweenMay 1, 2015, and May 31, 2016. Results. Forty-three (22%) of the 195 patients died in hospital. Multivariate analysis identified low blood pH (odds ratio [OR] 6.580, 95% confidence interval [CI] 1.12-38.51), high serumlactate level (OR 1.041, 95% CI 1.01-1.07), high ISS (OR 1.109, 95% CI 1.06-1.16), high APACHE II score (OR 1.189, 95% CI 1.07-1.33), traumatic brain injury (TBI) (OR 4.358, 95% CI 0.76-24.86), severe hemorrhage (OR 5.314, 95% CI 1.07-26.49), and coagulopathy (OR 5.916, 95% CI 1.17-29.90) as useful predictors of acute in-hospital mortality. High ISS (OR 1.047, 95% CI 1.02-1.08), TBI (OR 8.922, 95% CI 2.57-31.00), sepsis (OR 4.956, 95% CI 1.99-12.36), acute respiratory distress syndrome (ARDS) (OR 8.036, 95% CI 1.85-34.84), respiratory failure (OR 9.630, 95% CI 2.64-35.14), renal failure (OR 74.803, 95% CI 11.34-493.43), and multiple organ failure [MOF] (OR 10.415, 95% CI 4.48-24.24) were risk factors for late in-hospital mortality. High Glasgow Coma Scale (GCS) was a good predictor for survival at 2, 7, and 28 or more days of hospitalization (OR 0.708 and 95% CI 0.56-0.09; OR 0.835 and 95% CI 0.73-0.95; OR 0.798 and 95% CI 0.71-0.90, resp.). Conclusion. Several factors signal poor short-term outcome for patients who present to the ED with moderate-to-severe BMT: low blood pH, high serum lactate level, presence of TBI, severe hemorrhage, coagulopathy, organ failure (respiratory, renal, and MOF), and ARDS. For this patient group, ISS and APACHE II scores might be helpful for stratifying by mortality risk, and GCS might be a good predictor for survival.Öğe Rupture of testicle accompanying multiple traumas: A case report(2020) Ekmekyapar, Muhammed; Turtay, Muhammed Gökhan; Gürbüz, Şükrü; Derya, Serdar; Gökçe, Hasan; Solgun, Ömer FarukIn this case report, we aimed to present an 18-year-old male patient who had ruptured testicle after severe testicular trauma that developed due to a motorcycle accident. An eighteen-year-old male patient was brought to the emergency service after a motorcycle accident. There were open fractures in the left arm and left leg. The scrotum was ruptured, both testicles were outside, and the right testicle was ruptured. The patient was underwent emergency surgery for intraabdominal hemorrhage and liver laceration by general surgery. Also urology joined the operation. Urology carried out right orchiectomy and left testicular fixation on the patient. Although rupture of testicles is a rare condition, it may accompany the diagnosis in patients with multiple traumas. Early urology consultation should be sought to be able to save testicles and minimize complications.Öğe Rupture of testicle accompanying multiple traumas: A case report(2020) Ekmekyapar, Muhammed; Turtay, Muhammed; Gurbuz, Sukru; Derya, Serdar; Gokce, HasanÖğe Secret Carbon Monoxide Intoxication Assessments of the Patients Who Presented to Emergency(2022) Derya, Serdar; Gürbüz, Şükrü; Oğuztürk, Hakan; Yücel, Neslihan; Turtay, Muhammet Gökhan; Ekmekyapar, Muhammed; Uyanık, ÖmürAim: The primary aim of this study is to evaluate patients who present to the emergency department with atypical symptoms in terms of occult Carbon monoxide (CO) poisoning, and the secondary aim is to compare the invasive and non-invasive values of Carboxyhemglobin (COHb) levels in patients with high CO levels. Material and Method: This prospective and descriptive study was conducted on 2775 adult patients who visited the Emergency Department (ED) between January 1 and March 31, 2015. The COHb levels of the individuals who applied to the emergency department with non-specific complaints were measured with a non-invasive multiwave pulse oximeter device and the date of application, age, gender, complaint, smoking history, pregnancy status, pulse COHb, blood COHb and blood metHb parameters were recorded in the preformed form. Values under 10% in smokers and under 6.6% in non-smokers were recorded as secret COHb intoxication. Results: 52.8% of the patients were male and 34.4% were smokers. The rate of pregnant women among female patients was 13.4%. The first three complaints were shortness of breath, chest pain and stomach ache. It was determined that the mean COHb of the patients was 1.44±1.65 in arterial blood gas and 1.75±1.63 in finger measurement. A highly significant positive correlation was found between the two averages. The COHb value measured by both techniques was higher in male patients and in smokers and non-pregnant patients. The rate of latent COHb intoxication was determined as 1% in smokers and 0.1% in non-smokers. Conclusion: We came to the conclusion that non-invasive COHb measurement can make positive contributions to the diagnosis of secret carbonmonoxyde intoxications.Öğe A Story of Extraordinary Abdominally Perforation(Emergency Medicine Physicians Assoc Turkey, 2020) Ekmekyapar, Muhammed; Gurbuz, Sukru; Derya, Serdar; Oguzturk, Hakan; Yucel, Neslihan; Turtay, Muhammet Gokhan; Ercan, AbdullahPneumoperitoneum is the result of a gastrointestinal (GI) tract perforation in more than 90% of cases. Perforation of the stomach or duodenum caused by peptic ulcer is considered the most common cause of pneumoperitoneum. In this article, we present a case of pneumoperitoneum associated with sigmoid colon perforation, which is the result of the patient trying to create a laxative effect by inserting the hose attached to the wash basin into his rectum and opening the water afterwards. An 89 years old male patient was brought to the emergency department with complaints of abdominal pain starting about 2 hours ago. The patient's abdominal ultrasonography showed free fluid up to 10 cm in the lower abdomen. Posterior anterior chest X-ray and direct standing abdominal X-ray of the patient had subdiaphragmatic free air and images with free fluid, pneumoperitoneum and perforation were obtained in contrast enhanced abdominal tomography. As a result of surgery performed by general surgery it was seen approximately 30 cm proximal from the rectumthat there was a 4 cm perforation in the sigmoid colon. We must consider pneumoperitoneum, which is the result of colon perforation especially in elderly patients with acute abdominal pain, to be definitely among our differential diagnoses.
