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Öğe Apricot tree falls: a study from Malatya, Turkey(Allied Acad, 2016) Oguzturk, Hakan; Turgut, Kasim; Turtay, Muhammet Gokhan; Sarihan, M. Ediz; Gur, Ali; Beydilli, Inan; Gurbuz, SukruIntroduction: Falls from trees constitute an important and fatal form of injury. The present study aimed to assess the demographic and clinical features of apricot tree falls. Materials and methods: The patients who were admitted to the emergency department with a fall from an apricot tree between June 2015 and September 2015 were recorded prospectively. The age, gender, fall height, fall time, emergency department admission time, vital signs, injury types, treatments and outcomes, Glasgow coma score, and injury severity score, were studied for each patient. Results: There were 30 falls from apricot trees and all of them were male. The mean age was 29 +/- 18.9 years, and 33% of the patients were in the pediatric age group. The patients suffered from extremity (46.7%), spinal system (30%), chest (13.3%), abdomino-pelvic (6.7%), and head (3.3%) injuries. Arm and forearm fractures were ranked first among all the fractures. The majority of the patients (70%) were managed and discharged from emergency department. None of the patients died, and all of them recovered fully. Conclusion: Falls from apricot trees usually lead to only minor injuries. The emergency department has the most important role in the management of these injuries. A considerable amount of patients are children, therefore, clear and feasible rules regarding child workers will reduce falls from apricot trees.Öğe Atrial Fibrillation due to Blunt Cardiac Injury: Case Report(Aves, 2018) Turgut, Kasim; Yucel, Neslihan; Oguzturk, Hakan; Ulutas, Zeynep; Afsin, AbdulmecitIntroduction: Blunt cardiac injury secondary to chest trauma is an important cause of emergency department admissions. It can range from asymptomatic myocardial contusion to significant dysrhythmia, acute heart failure, valvular injury, or cardiac rupture. Case Report A 38-years-old patient was admitted to the emergency department with atrial fibrillation (AF) that occurred after a car accident. The patient had chest trauma caused by striking the steering wheel during the accident. The AF rhythm of the patient reverted to the normal sinus rhythm at the 3rd hour after trauma. Conclusion: Emergency medicine professionals should keep in mind arrhythmias due to blunt chest trauma and take electrocardiograms of patients to be able to provide treatment in time.Öğe COMPARISON OF PULMONARY FUNCTION TESTING AMONG NON-SMOKERS, HAND-ROLLED CIGARETTE SMOKERS AND FACTORY MADE CIGARETTE SMOKERS(Southeast Asian Ministers Educ Organization, 2018) Turgut, Kasim; Turtay, Muhammet Gokhan; Kilic, Talat; Oguzturk, Hakan; Gulacti, Umut; Gur, Ali; Guven, TanerTobacco use causes significant health problems. The aim of this study was to compare the following factors among factory-made cigarette (FMC) smokers, hand-rolled cigarette (HRC) smokers and non-smokers (NS): demographic characteristics, pulmonary function testing (PFT) and carboxyhemoglobin (COHb) levels. PFT included checking: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, forced expiratory flow from 25-75% of the vital capacity (FEF25-75) and peak expiratory flow (PEF). We wanted to determine the impact of smoking on pulmonary function testing and to determine any differences in PFTs and COHb levels between FMC and HRC smokers. A total of 182 participants (all males) were included in the study. The subjects in the study were randomly chosen from emergency service admissions which had complaints other than respiratory system. The mean age of study subjects was 40.8 (range: 22-92) years. Mean age of starting smoking among HRC smokers was not significantly different from FMC smokers (95% CI: -0.55-2.37, p=0.220). HRC smokers had significantly lower economic and education levels than FMC smokers (95% CI: 9.0-45.2, p<0.01). NS had highest economic and educational levels (95% CI: 35.9-66.6, p<0.01) of the 3 study groups. The mean [+/- standard deviation(SD)] FEV1/FVC was 76.66 (+/- 7.45) among FMC smokers (95% CI: 74.82-78.51), 77.36 (+/- 8.14) among HRC smokers (95% CI: 75.36-79.36) and 83.13 (+/- 5.08) among NS (95% CI: 81.70-84.56, p<0.01). The mean (+/- SD) FEV1 was 84.50 (+/- 17.80) among FMC smokers (95% CI: 80.12-88.92 ), 89.4 (+/- 15.8) among HRC smokers (95% CI: 85.56-93.32) and 95.30 (+/- 13.3) among NS (95% CI: 91.59-99.07, p<0.01). The mean (+/- SD) PEF was 81.90 (+/- 19.30) among HRC smokers (95% CI: 77.19-86.69), 78.10 (+/- 18.70) among FMC smokers (95% CI: 73.47-82.74) and 86.20 (+/- 16.0) among NS (95% CI: 81.70-90.69, p=0.06). The mean FVC, FEV1, FEV1/FVC, FEF25-75%, and PEF values among NS were significantly (p<0.05) higher for each variable than the mean of these values among FMC and HRC smokers. The mean COHb level among NS was significantly (p<0.05) lower than the mean COHb levels in the two smoking groups. There were no significant differences in PFT results or COHb levels between the two smoking groups (p>0.05). Cigarette smoking cause impairment of pulmonary function equally independent of the cigarette type (FMC, HRC) smoked.Öğe Comparıson of pulmonary functıon testıng among non-smokers, hand-rolledcıgarette smokers and factory made cıgarette smokers(Southeast asıan mınısters educ organızatıon, seameo-tropmed, 420-6 rajvıthı rd,, bangkok 10400, thaıland, 2018) Turgut, Kasim; Turtay, Muhammet Gokhan; Kilic, Talat; Oguzturk, Hakan; Gulacti, Umut; Gur, Ali; Guven, Taner; Colak, CemilTobacco use causes significant health problems. The aim of this study was to compare the following factors among factory-made cigarette (FMC) smokers, hand-rolled cigarette (HRC) smokers and non-smokers (NS): demographic characteristics, pulmonary function testing (PFT) and carboxyhemoglobin (COHb) levels. PFT included checking: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, forced expiratory flow from 25-75% of the vital capacity (FEF25-75) and peak expiratory flow (PEF). We wanted to determine the impact of smoking on pulmonary function testing and to determine any differences in PFTs and COHb levels between FMC and HRC smokers. A total of 182 participants (all males) were included in the study. The subjects in the study were randomly chosen from emergency service admissions which had complaints other than respiratory system. The mean age of study subjects was 40.8 (range: 22-92) years. Mean age of starting smoking among HRC smokers was not significantly different from FMC smokers (95% CI: -0.55-2.37, p=0.220). HRC smokers had significantly lower economic and education levels than FMC smokers (95% CI: 9.0-45.2, p<0.01). NS had highest economic and educational levels (95% CI: 35.9-66.6, p<0.01) of the 3 study groups. The mean [+/- standard deviation(SD)] FEV1/FVC was 76.66 (+/- 7.45) among FMC smokers (95% CI: 74.82-78.51), 77.36 (+/- 8.14) among HRC smokers (95% CI: 75.36-79.36) and 83.13 (+/- 5.08) among NS (95% CI: 81.70-84.56, p<0.01). The mean (+/- SD) FEV1 was 84.50 (+/- 17.80) among FMC smokers (95% CI: 80.12-88.92 ), 89.4 (+/- 15.8) among HRC smokers (95% CI: 85.56-93.32) and 95.30 (+/- 13.3) among NS (95% CI: 91.59-99.07, p<0.01). The mean (+/- SD) PEF was 81.90 (+/- 19.30) among HRC smokers (95% CI: 77.19-86.69), 78.10 (+/- 18.70) among FMC smokers (95% CI: 73.47-82.74) and 86.20 (+/- 16.0) among NS (95% CI: 81.70-90.69, p=0.06). The mean FVC, FEV1, FEV1/FVC, FEF25-75%, and PEF values among NS were significantly (p<0.05) higher for each variable than the mean of these values among FMC and HRC smokers. The mean COHb level among NS was significantly (p<0.05) lower than the mean COHb levels in the two smoking groups. There were no significant differences in PFT results or COHb levels between the two smoking groups (p>0.05). Cigarette smoking cause impairment of pulmonary function equally independent of the cigarette type (FMC, HRC) smoked.Öğe The effect of lactate levels on prognosis in patients with ST-segment elevation myocardial infarction(2020) Gur, Ali; Ulutas, Zeynep; Turgut, Kasim; Guven, Taner; Yucel, Neslihan; Ermis, NecipAim: The prognostic role of lactate for early mortality in patients with ST-segment elevation myocardial infarction (STEMI) submitted to primary percutaneous transluminal coronary angiography (PTCA) is not elucidated clearly. This study was conducted with patients that presented to the emergency department (ED) with STEMI and underwent PTCA to investigate whether the changes in lactate values from ED admission to 24 hours after PTCA affected mortality.Material and Methods: This prospective observational study on 143 patients with STEMI was conducted at emergency service and tertiary-level cardiology clinic in a public university hospital. The documentation for each patient included detailed information on demographics, type of myocardial infarction according to electrocardiography and PTCA results, duration of hospital stay, vital signs, laboratory findings on admission, lactate levels 24 hours after PTCA, and outcome (hospital discharge or death). Results: The lactate values are higher in non-surviving groups measured 24 hours after PTCA (P 0.001). The differences in the lactate levels from the time of admission to 24 hours after PTCA were significantly lower in the non-surviving group (P 0.001). Conclusion: Among patients presenting to the ED with STEMI, a high lactate level is associated with mortality. Also, the difference between lactate values of the patients after PTCA is associated with the risk of mortality. Therefore, we consider that first lactate levels in ED and last lactate levels after PTCA in patients with STEMI can provide physicians with an insight into the possibility of mortality.Öğe Evaluation of Factors Related to Mortality Caused by Firearm Injury: A Retrospective Analysis from Malatya, Turkey(Acad Medical Sciences I R Iran, 2019) Turgut, Kasim; Gur, Ali; Guven, Taner; Oguzturk, HakanBackground: Firearm related injuries continue to increase throughout the world and they become the first or second cause of mortality in worldwide. The present study aimed to determine the factors that affect mortality in firearm injuries. Methods: The patients which were admitted to emergency service between January 2011 and December 2015 due to firearm injuries, were reviewed from hospital records. The patients were evaluated in terms of their age, sex, event time, admission time, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), the reason of event, type of weapon, the region of the body that injured, department in which they were hospitalized, hospitalization duration and the relation between these parameters and mortality. Results: A total of 174 patients (86.8% male, 13.2% female) were identified. The mean age of patients was 35.2 years and 30 patients (17.2%) died. Among the cases, 137 were attempted homicide (78.7%), 23 were accidents and the remaining 14 were suicides. The suicidal cases had significantly higher mortality rate than other causes (P = 0.003). The most frequently used weapon was pistols (73.6%) and the events took place between 18.00 and 24.00 (36.2%) hours mainly. The injuries were mostly on extremities, however many of deaths were seen after head-neck injuries and the mortality rate of head and neck injuries was significantly higher than other regions (P < 0.001). The mean of hospitalization duration was 9.1 days and it was 10.2 +/- 11.7 days for survivors, 4 +/- 7.3 days for died subjects. The hospitalization duration of died patients was significantly shorter than survivors (P = 0.042). The GCS of died patients (4.4 +/- 1.7) was significantly lower than those of survivors (13.3 +/- 2.8) (P < 0.001). The ISS score of died patients (49.7 +/- 24.1) was significantly higher than those of survivors (13.6 +/- 10.6) (P < 0.001). Conclusion: It was determined that GCS, ISS, length of hospitalization, injuries due to suicide attempt, the department of hospitalization, injuries to head-neck regions affected mortality significantly.Öğe Falls from height: a retrospective analysis(Zhejıang unıv sch medıcıne, second affılıated hospıtal, 88 jıefang rd, hangzhou, 310009, peoples r chına, 2018) Turgut, Kasim; Sarihan, Mehmet Ediz; Colak, Cemil; Guven, T; Gur, A; Gurbuz, SBACKGROUND: Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality. METHODS: A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. RESULTS: The study comprised of 292 (63.5%) men and 168 (36.5%) women patients. The mean age of all patients was 27 +/- 24.99 years. Twenty-six (5.6%) patients died and the majority of them were in >= 62 years old group. The highest percentage of falls was at 0-5 years age group (28.3%). People fell mainly from 1.1-4 metres(m) level (46.1%). The causes of falls were ordered as unintentional (92.2%), workplace (8.1%) and suicidal (1.7%). Skin and soft tissue injuries (37.4%) were the main traumatic lesions. CONCLUSION: Age, fall height, fall place, lineer skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.Öğe Falls from height: A retrospective analysis(Zhejiang Univ Sch Medicine, 2018) Turgut, Kasim; Sarihan, Mehmet Ediz; Colak, Cemil; Guven, Taner; Gur, Ali; Gurbuz, SukruBACKGROUND: Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality. METHODS: A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. RESULTS: The study comprised of 292 (63.5%) men and 168 (36.5%) women patients. The mean age of all patients was 27 +/- 24.99 years. Twenty-six (5.6%) patients died and the majority of them were in >= 62 years old group. The highest percentage of falls was at 0-5 years age group (28.3%). People fell mainly from 1.1-4 metres(m) level (46.1%). The causes of falls were ordered as unintentional (92.2%), workplace (8.1%) and suicidal (1.7%). Skin and soft tissue injuries (37.4%) were the main traumatic lesions. CONCLUSION: Age, fall height, fall place, lineer skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.Öğe Hoeing machine accident: a case report(Australian Rural Health Educ Network, 2018) Turgut, Kasim; Gurbuz, SukruContext: Agricultural accidents are a prominent cause of mortality and morbidity in the literature despite few studies. The machines and equipments used in this sector frequently cause agricultural accidents. One of these, the hoeing machine, can cause tragic and severe injuries. Issue: We present a case of subtotal leg amputation that occurred after a hoeing machine accident in 2015 in Malatya, eastern Turkey. We monitored the patient and started initial therapies according to advanced trauma life support in the emergency service. However, his right leg was severely injured and had to be amputated. Lessons learned: Hoeing machine accidents lead to physical disabilities due to extreme injury and amputation.Öğe Hoeing machine accident: a case report(Australıan rural health educ network, po box 242, deakın west, act 2600, australıa, 2018) Turgut, Kasim; Gurbuz, SukruContext: Agricultural accidents are a prominent cause of mortality and morbidity in the literature despite few studies. The machines and equipments used in this sector frequently cause agricultural accidents. One of these, the hoeing machine, can cause tragic and severe injuries. Issue: We present a case of subtotal leg amputation that occurred after a hoeing machine accident in 2015 in Malatya, eastern Turkey. We monitored the patient and started initial therapies according to advanced trauma life support in the emergency service. However, his right leg was severely injured and had to be amputated. Lessons learned: Hoeing machine accidents lead to physical disabilities due to extreme injury and amputation.Öğe Investigation of the characteristics differentiating complicated and non-complicated appendicitis: A prospective analysis(2020) Ozdas, Sabri; Turgut, Kasim; Sirik, Mehmet; Aydin, IrfanAim: To investigate preoperative laboratory and clinical results and imaging methods in patients with complicated and non-complicated appendicitis.Materials and Methods: A total of 141 patients aged over 16 years, who underwent surgery with the diagnosis of acute appendicitis, were included in the study. In patients diagnosed with acute appendicitis based on physical examination and laboratory findings, abdominal contrast-enhanced tomography was performed for confirmation and differential diagnosis. Age, gender, body temperature, complaint, duration of complaint, number of white blood cells, the largest diameter of appendicitis measured on computed tomography (CT), Alvarado score, and recurrent admission to any health institution with the same complaint were recorded. Intraoperative findings and pathology reports were evaluated to determine whether the appendicitis was complicated, and the cases were divided into two groups as complicated and non-complicated. Results: Totally 141 patients were included in the study, 39 cases were classified as complicated and 102 cases as non-complicated appendicitis. There were more people with high fever in the complicated group (p=0.023). The median of largest appendicitis diameter measured on the CT was 8.5 (5.5-15) mm, and a significant difference was determined between the two groups in terms of diameter (p0.001). The median time from the onset of the complaints to the emergency department presentation was 12 hours, and this duration was significantly longer in the complicated group (p0.001). Analysis of receiver operating characteristic curves yielded the cutoff values of 8.35 mm for diameter (area under the curve [AUC]: 0.860; sensitivity: 87.2%; specificity: 63.7%), and 10.5 hours for time interval (AUC: 0.868; sensitivity: 97.4%; specificity: 64.7%) were found to be the best predictive values for the complicated acute appendicitis determination.Conclusion: In patients diagnosed with acute appendicitis, necessary interventions should be immediately undertaken, especially in the presence of fever, increased appendicitis diameter, and delayed presentation to hospital.Öğe MUSHROOMS: THE VELVETY POISON(Carbone Editore, 2015) Gurbuz, Sukru; Oguzturk, Hakan; Turgut, Kasim; Turtay, Muhammet Gokhan; Guven, TanerIntroduction: Mushroom poisoning, a frequent health condition worldwide, documented since ancient times, can occur when an amateur mushroom hunter misidentifies a mushroom due to the close resemblance between toxic and edible species. In the majority of cases, mistakenly ingested mushrooms cause only gastrointestinal irritation, but certain toxic species, such as Amanita phalloides, can cause multiorgan failure and death. This study investigated the demographic and clinical characteristics of 79 mushroom poisoning cases, together with the treatments applied and their outcomes. Materials and methods: A total of 79 adult patients who were admitted to the emergency ward of the medical faculty of Inonu University between 2011 and 2014 were evaluated retrospectively. Results: The 79 patients ranged in age from 18 to 85 years; 44 (55.7%) were female and 35 (44.3%) were male. A total of 62 (78.4%) of the poisoning cases occurred during the spring and autumn seasons, which in Turkey are characterized by the highest levels of rainfall. At admission, nausea was observed in 76 (96.2%) cases, vomiting in 63 (79.7%), abdominal pain in 18 (22.8%), and diarrhea in 3 (3.8%). In 35 (44.3%) cases, toxicity symptoms onset within 6 hours of ingestion and later in 45 (64.5%) patients. A total of 73 patients recovered fully following medical treatment and were therefore discharged; three others received a liver transplant, one of whom survived. The remaining three patients, in whom no transplantations were performed, died; therefore a total of five patients did not survive. Conclusion: Mushroom poisoning can cause serious, potentially fatal illness. Rapid toxin analysis, prompt treatment and liver transplantation decrease the likelihood of mortality.Öğe Retrospective evaluation of patients who ingested drugs to commit suicide(2021) Yavuz, Erdal; Turgut, KasimAim: To analyze patients presenting to our hospital after ingesting drugs for suicide purposes. Materials and Methods: Adult patients that attempted suicide by ingesting drugs or other substances were retrospectively reviewed over a two-year period. The population of the study was determined among the patients diagnosed with the ICD-10 codes of X.40-X49 in hospital records. The patients were divided into two groups as hospitalized and discharged, and evaluated in terms of age, gender, substances ingested, number of different types of drugs ingested, the statement of life threatening status in forensic reports, whether gastric lavage or activated charcoal was applied, history of previous suicide attempts, presence of psychiatric diagnoses, and leukocyte count. Then, we investigated any statistical differences between the two groups. Results: A total of 216 adult patients with a mean age of 27.65 ± 9.45 years were included in the study. The hospitalization rate was 49.1%. Taking two or more different types of drugs, a high leukocyte count, application of gastric lavage and active charcoal, and the presence of life-threatening status in forensic report were found to be higher in the hospitalized group(p <0.05). It was observed that a history of previous suicide attempts or previous psychiatric diagnoses did not affect the hospitalization rate (p> 0.05). In addition, it was determined that for suicide purposes, psychiatric drugs were mostly taken by the patients with previous psychiatric diagnoses while those without these diagnoses mostly used analgesics to attempt suicide (p <0.001). Conclusion: Multiple drug type ingestion, leukocyte count, the presence of a life-threatening status in the forensic report, and gastric lavage and activated charcoal applications were determined as factors affecting the decision of emergency physicians to hospitalize patients that attempted suicide by ingesting drugs.Öğe Unexpected lumbar abscess due to scarification wet cupping: A case report(Churchill Livingstone, 2014) Turtay, Muhammet Gokhan; Turgut, Kasim; Oguzturk, HakanObjective: This case presents a rare cause of lumbar abscess. Methods: A 51-year-old male patient was admitted to the emergency department with a complaint of lumbar pain. Spinal magnetic resonance imaging revealed a lumbar abscess. Results: The abscess was treated with drainage of the abscess and antibiotic. Conclusion: Scarification wet cupping therapy should be taken into consideration as a rare cause of lumbar abscesses in patients who present with skin findings indicative of scarification. Scarification wet cupping therapy practitioners must pay attention to hygienic measures. (C) 2014 Elsevier Ltd. All rights reserved.
