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Öğe A fatal rabies case and experiences of a mass post exposure prophylaxis among healthcare workers(Akademiai Kiado ZRt., 2021) Şener, Alper; Akman, Canan; Akça, Anıl; Varışlı, BehcetWe aimed to monitor the adverse effects (AE) and efficacy of post exposure prophylaxis (PEP) in health care workers (HCWs) exposed to a rabies patient. In this study 109 HCWs and eight household contacts were PEP candidates. Contact persons without infection control precautions were in Group I (high risk-82 cases). HCWs indirectly exposed to environmental surfaces were classified in Group II (low risk-35 cases). PEP schedule was rabies vaccine (RBV) + equine rabies immunoglobulin (eRIG) in Group I and only RBV in Group II. Local and systemic AE were observed in all cases. Efficacy of post exposure prophylaxis (PEP) was determined by rabies development in a six month follow-up. 585 doses of RBV have been used in 117 cases and eRIG has been used in 82 cases. 32 Nurses (39%); 22 emergency medicine technicians (26.8%); 12 doctors (14%); six laboratory technicians (0.07%); six radiology technicians (0.07%); four cleaners (0.05%) were in Group I (82 cases), respectively. One doctor, laboratory technician, nurse and radiology technician (0.02%); two emergency medicine technicians (0.04%) and nine cleaners (25.7%) were in Group II (35 cases), respectively. Routes of transmission were blood in five (0.06%); saliva in 14 (17%); sweat in 50 (61%); CSF/serum in five (0.06%); sexual intercourse in one (0.01%); personal equipment in seven (0.09%) in Group I, respectively. Indirect contact was the only route in Group II. The most common local and systemic AE were seen in Group I; pain at injection side (19 cases) and fever (13 cases). Both of them showed statistically significant difference (P<0.05). Allergic rash has been seen at only one case. PEP failed in one case where the possible exposure way was sexual intercourse. PEP is the safest way to prevent rabies. Infection control precautions were still not enough applied. eRIGs are also safe and have rare AE.Öğe A RETROSPECTIVE ANALYSIS OF THE CAUSES OF SEVERE HYPONATREMIA IN THE PATIENTS AGED OVER 65 ADMITTED TO THE EMERGENCY DEPARTMENT(Gunes Kitabevi Ltd Sti, 2022) Akman, Canan; Cetin, MuratIntroduction: This study aimed to retrospectively analyze the data of patients older than 65 years and diagnosed with severe hyponatremia in the emergency department. Method: Patients >= 65 years and with severe hyponatremia (serum sodium levels <= 125 mEq/L) were included in the analyses. Results: Fifty-five patients were hypovolemic, 22 were normovolemic, and 23 were hypervolemic. 65.5% (n = 36), 59.1% (n = 13) and 60.9% (n = 14) of the groups were females (p > 0.05), and regarding comorbidities, 27.3%, 9.1%, and 4.3% of the groups were diagnosed with a malignancy, respectively (p = 0.031). Conclusions: Early diagnosis and treatment in the emergency department are critical considering the severity and prognosis of hyponatremia.Öğe Acil Servise Başvuran Hipertansiyon Hastalarının Klinik Özellikleri ve Acil Servise Başvuru Sıklığını Etkileyen Faktörlerin İncelenmesi(2020) Akman, Canan; Akşit, ErcanGiriş ve Amaç: Acil servis doktorları yüksek kan basıncı nedeniyle acil servise başvuran hastalar ile sık olarakkarşılaşmaktadır. Bu çalışmanın amacı, acil servise başvuran hipertansiyon hastalarının klinik özelliklerini ve acilservise başvuru sıklığını etkileyen faktörleri incelemektir.Gereç ve Yöntemler: Bu çalışmaya hastanemiz acil servisine başvuran daha önce hipertansiyon tanısı olan 100gönüllü hasta alınmıştır. Araştırmanın veri toplama aşamasında yüz yüze görüşülerek anket uygulanmıştır.Bulgular: Hastaların %52’sinde 10 yıldan fazladır hipertansiyon mevcuttu. Hastaların %81’ine yaşam tarzı değişikliğihakkında bilgilendirme yapılmıştır. Hastaların sadece %32’sine acil durumda kullanması için ilaç reçete edilmiştir.Takipte olduğu doktor tarafından, hipertansiyonun uç organlarına zarar verebileceği hastaların yalnız %40’ınaanlatılmıştır. Son bir yıl içinde hipertansiyon nedeni ile iki veya daha fazla sayıda acil servise başvuran hasta oranı%57’dir.Sonuç: Bu çalışma hipertansiyon tanısı ile bir yıl içinde iki veya üstü sayı ile acil servise başvurunun olduğunugöstermektedir. Hipertansiyon hastalarına hastalıkları hakkında ayrıntılı bilgilendirme yapmak hastaların acil servisebaşvuru sıklıklarını azaltabilir.Öğe Acil Servise Özkıyım Girişimi Nedeniyle Başvuran Vakaların Retrospektif İncelenmesi(2024) Akman, Canan; Öksüz, Merve AtaçAmaç: Dünyada ve ülkemizde önemli bir psikososyal sorun olan özkıyım girişimleri, acilen önlem alınması gereken bir sorun olarak karşımıza çıkmaktadır. Bu nedenle çalışmada, Çanakkale ilinde bulunan bir hastanenin acil servisine özkıyım girişimi nedeni ile başvuran hastaların sosyodemografik ve bazı klinik özelliklerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma, tek merkezli, gözlemsel ve retrospektif bir çalışmadır. Çalışmamızda 01.01.2013-31.12.2023 yılları arasında Çanakkale bulunan bir hastanenin yetişkin acil servis birimine özkıyım olgusuyla başvuran yetişkinlere ait veriler hastane otomasyon sistemi üzerinden taranarak geriye dönük olarak incelenmiştir. Bulgular: Acil servise 2013-2023 yılları arasında başvuran özkıyım girişiminde bulunan hastaların yaş ortalamasının 33.65 olduğu, %58.8’inin erkek, %52.4’ünün ise bekar olduğu görülmektedir. Başvuruda bulunan hastaların 69.4’üne konsültasyon istendiği, bu istemlerin ise en yüksek oranı %40.6 ile ruh sağlığı ve hastalıkları bölümüne ait olduğu belirlenmiştir. Başvuran hastaların %42.9’unun acil servise geliş saatinin 24:00-06:00 aralığında olduğu, %35.3’ü acil servise yaz ayları içerisinde başvurduğu görülmüştür. Acil servise özkıyım girişimi nedeniyle başvuran hastaların %24.7’si Keskin cisimle kendine zarar verme, %17.6’sı Kimyasallar ve zararlı maddelere maruz kalma ve kendine zarar verme tanısı ile başvurmuşlardır. Ayrıca hastaların geliş tanıları ile cinsiyetleri arasında anlamlı farklılık olduğu belirlenmiştir. Sonuç: Çalışmada özkıyım girişiminde bulunan hastalar arasında erkek cinsiyet oranı ve bekar olma oranın daha yüksek olduğu görülmüştür. Ayrıca çalışmada hastaların geliş tanıları ile cinsiyetleri arasında anlamlı farklılık olduğu belirlenmiştir.Öğe Acil Serviste Spontan Pnömotoraks Tanısı Alan Hastaların Demografik Verilerinin Retrospektif Olarak Değerlendirilmesi(2021) Akman, Canan; Çetin, MuratAmaç: Pnömotoraks, plevral boşlukta hava bulunmasıdır. Pnömotoraks tanılarının yarıdan fazlası herhangi bir travma durumu söz konusu olmadan ortaya çıkmaktadır. Bu durum spontan pnömotoraks (SP) adını almaktadır. Aynı zamanda pnömotoraks vakaları ile acil serviste sıkça karşılaşılmaktadır. Tanı ve tedavisinin anında hızlı olarak yapılması gereken ve önem taşıyan bir plevra hastalığı olarak karşımıza çıkmaktadır. Bu çalışmada acil servise başvuran SP hastalarının demografik özellikleri, risk faktörleri, klinik özellikleri, tanı ve tedavi yaklaşımlarının farkındalığının ortaya konulması amaçlanmıştır. Gereç ve Yöntemler: Ocak 2018-Haziran 2020 tarihleri arasında Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi acil servisine başvuran SP tanısı alan hastalar retrospektif olarak tek merkezli incelenmiştir. Hastalarda yaş, cinsiyet, acil servise geliş şekilleri, şikayetleri, alta yatan hastalık durumları, sigara öyküsü, daha önce pnömotoraks şikayeti varlığı, nüks ve sayısı, fizik muayene bulguları, eşlik eden durumlar, tansiyon pnömotoraks varlığı, tüp torakostomi tedavisi ve tedavinin sonuçları belirlenmiştir. Bulgular: Acil servise başvurup SP tanısı alan 53 hasta çalışmaya dahil edildi. Hastaların %92,5 (n=49) erkektir. %92,5’ine (n=49) tüp torakostomi işlemi uygulanmıştır. Bu hastaların %84,9’u (n=45) göğüs cerrahi servisine, %11,3’ü (n=6) yoğun bakıma ve %2’si (n=3,8) dış merkeze sevk edilmiştir. Tedavinin sonuçlarına bakıldığında ise %88,7’si (n=47) spontan pnömotoraks hastası şifa ile taburcu edilmiştir. Sonuç: Spontan pnömotoraks zamanında müdahale edilmediğinde hayati tehlike oluşturabilecek bir klinik durumudur.Öğe Akut böbrek hasarı olan hastalarda serum düzeltilmiş ve iyonize kalsiyum seviyelerinin karşılaştırılması(2021) Akman, Canan; Bakirdogen, Serkan; Daş, Murat; Balcı, Serdal; Aykan, Okyanus NecdetGiriş: Hastaneye yatırılan hastalarda akut böbrek hasarı (ABH) sık olarak görülmektedir (%1,92). ABH’lı hastalarda serum düzeltilmiş ve iyonize kalsiyum düzeylerinin acil hemodiyalizi öngörmedeki etkisi bilinmemektedir. Bu çalışmada acil serviste ABH tanısı alan hastalarda serum düzeltilmiş ve iyonize kalsiyum düzeylerini karşılaştırmayı amaçladık. Yöntem: Çalışmamız retrospektif olarak planlandı. Grup 1: En az bir kez acil hemodiyaliz seansı alan ABH hastaları. Grup 2: Hemodiyalize girmeyen AKIN evre 1-3 olan hastalar. Hastaların başvuru anında serum düzeltilmiş ve iyonize kalsiyum, kreatinin ve albümin değerleri incelendi. Çalışmanın tüm verileri SPSS 19.0 ile kaydedildi. İstatistiksel anlamlılık için p <0,050 kabul edildi. Bulgular: Serum düzeltilmiş kalsiyum düzeylerinin ortalaması grup 1'de grup 2'ye göre daha düşüktü ve fark istatistiksel olarak anlamlıydı (p <0,001). Kan gazındaki ortalama iyonize kalsiyum seviyeleri grup 1'de grup 2'ye göre daha düşüktü ve fark istatistiksel olarak anlamlıydı (p = 0,002).Öğe Analysis of Emergency Department Presentations due to Injuries From Motor Vehicle Crashes and Pedestrian Strikes(Springernature, 2020) Akman, Canan; Kuru, TolgahanObjective The objective of this study was to analyze the causes and outcomes of presentations to the emergency department (ED) due to injuries from motor vehicle crashes and pedestrian strikes along several parameters. Methods Data from 798 patients who were injured due to motor vehicle crashes or pedestrian strikes that occurred in Canakkale Province were retrospectively analyzed. Patient demographic data such as age and gender, emergency service outcomes, and the consulted clinics were also recorded. Distributions of the crashes by weekdays or weekends, national and religious holidays, official holidays, and Ramadan month were comparatively analyzed. Results A total of 253 people injured in motor vehicle crashes and 395 people injured in pedestrian strikes were directly brought to the ED from the crash or strike scene. While 656 patients were discharged from the ED, 142 patients were referred to other clinics for surgery. A total of 538 crashes occurred on weekdays and 206 on weekends, and 54 crashes occurred during official and religious holidays. Most crashes occurred in summer, and the second most occurred in autumn. The rate of pedestrian strikes that occurred in summer and autumn was statistically significantly higher than the rate of injuries from motor vehicle crashes observed in the same seasons. The majority of the weekend crashes were caused by persons who had not consumed alcohol. Conclusion Traffic crashes occur more commonly among young men and in the summer season, while national, official, and religious holidays do not seem to play a role in the frequency of traffic crashes.Öğe Assessment of Awareness Levels About Anticoagulants in Patients With Atrial Fibrillation Presenting to Emergency Department(Springer, 2021) Akman, Canan; Kırılmaz, Bahadır; Balcı, Serdal; Akşit, Ercan; Yurtseven, Ersan; Duygu, AliAtrial fibrillation (AF) is a rhythm disorder observed mostly amongst adults. AF has been regarded as one of the most important medical problems because it leads to thromboembolism and paralysis risks. Although warfarin has been used in the past to cope with this health problem, new oral anticoagulant medicines have replaced it in the last few years. The new oral anticoagulants, namely, dabigatran etexilate, rivaroxaban, and apixaban, are currently being used in daily clinical practice and treatment guidelines. Since AF patients are supposed to receive long-term oral anticoagulant therapy, it is extremely important to provide them with accurate information and appropriate training regarding the treatment to decrease oncoming complications. This is a prospective study involving 168 patients who were admitted to the emergency department with AF and who were using oral anticoagulants. Findings indicate a lack of awareness in the patients regarding the effects and side effects of the drugs they take despite having been informed by the prescribing physician. We believe that informed action by patients with regard to the oral anticoagulants and their side effects will have an impact on the reduction in hospitalization observed. It will also make a substantial contribution to the quality of life of AF patients and to their use of medical services.Öğe Black Widow Spider Envenomation with Elevated Troponin I Levels(Aves, 2018) Das, Murat; Akdur, Okhan; Akman, Canan; Cetinkaya, YaseminIntroduction: The black widow spider is found worldwide. Alpha-latrotoxin is responsible for the toxic effects related to the spider bite. We report the case of a patient who presented at the emergency department after being bitten by a black widow spider that later developed increased cardiac enzymes. Case Report: The patient was a 24-year-old male who had been bitten by a black spider inside his shoe while he was working in the garden. The patient was referred to the emergency department of department of emergency medicine Canakkale Onsekiz Mart University Faculty of Training and Research Hospital with nausea, vomiting, and severe rigidity in the abdomen for the differential diagnosis of acute abdomen. With severe sweating, the patient had rales in the lower lung zones, and abdominal examination revealed diffuse abdominal guarding. Blood biochemistry revealed creatine kinase (CK): 1838 U/L, CKMb: 71.6 U/L, and troponin I: 0.14 ng/mL. In follow-ups, the troponin I levels increased to 3.01 ng/mL. Electrocardiography revealed normal sinus rhythm. He was followed with a bedside monitor for 3 days in the emergency department. When the patient's troponin I and CK levels decreased, at the end of the third day he was discharged.. Conclusion: Black widow envenomation should be followed for cardiac toxicity other than symptoms, such as muscle spasms, sweating, anxiety, and headache.Öğe Clinical, Demographic and Prognostic Evaluation of Patients Admitted the Emergency Department with Mushroom Poisoning(2023) Varışlı, Behçet; Yıldırım, Sinan; Akman, Canan; Ataç, Kenan; Çakır, OkanFungal intoxications can lead to a variety of conditions ranging from simple gastroenteritis to severe neurological manifestations, and even fatal liver and kidney failure. In this study, we aimed to evaluate the diagnosis, treatment, prognosis and demographic data of patients admitted to the emergency department due to fungal intoxication. The aim of this study was to conduct a retrospective evaluation of examination findings, laboratory investigations, duration of treatments, hospitalization rates, and mortality rates in patients admitted to our emergency department due to fungal intoxication between October 01, 2017 and October 01, 2018. Of the 40 patients included in the study, 25 (62.5%) were female, with a mean age of 44.83 ± 17.00 years and a range of 18 to 82 years. Nausea and vomiting had the highest frequency (28 patients) among the presenting complaints of the patients. Only 11 (27.5%) patients underwent gastric lavage and decontamination with activated charcoal, whereas 29 (72.5%) patients had no gastric decontamination. The highest frequency of admissions was recorded in November. The highest frequency of patient admissions was between 01:00 and 02:00. It was concluded that there was a low rate of the administration of gastric decontamination in patients admitted to the emergency department, especially those admitted to the ward. In our study, the majority of patients with fungal intoxication had early-onset mild symptoms. Particular attention should be paid to early diagnosis and adherence to appropriate treatment algorithms in emergency departments, particularly in patients presenting with late-onset symptoms that may result in mortality.Öğe Diagnostic and Prognostic Roles of Procalcitonin and Other Tools in Community-Acquired Pneumonia: A Narrative Review(Multidisciplinary Digital Publishing Institute (MDPI), 2023) Özbay, Sedat; Ayan, Mustafa; Özsoy, Orhan; Akman, Canan; Karcıoğlu, ÖzgürCommunity-acquired pneumonia (CAP) is among the most common causes of death and one of the leading healthcare concerns worldwide. It can evolve into sepsis and septic shock, which have a high mortality rate, especially in critical patients and comorbidities. The definitions of sepsis were revised in the last decade as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. Procalcitonin (PCT), C-reactive protein (CRP), and complete blood count, including white blood cells, are among the most commonly analyzed sepsis-specific biomarkers also used in pneumonia in a broad range of studies. It appears to be a reliable diagnostic tool to expedite care of these patients with severe infections in the acute setting. PCT was found to be superior to most other acute phase reactants and indicators, including CRP as a predictor of pneumonia, bacteremia, sepsis, and poor outcome, although conflicting results exist. In addition, PCT use is beneficial to judge timing for the cessation of antibiotic treatment in most severe infectious states. The clinicians should be aware of strengths and weaknesses of known and potential biomarkers in expedient recognition and management of severe infections. This manuscript is intended to present an overview of the definitions, complications, and outcomes of CAP and sepsis in adults, with special regard to PCT and other important markers.Öğe Diagnostic utility of microhematuria in renal colic patients in emergency medicine: correlation with findings from multidetector computed tomography(2019) Daş, Murat; Bardakçı, Okan; Yurtseven, Ersan; Akman, Canan; Beyazit, Yavuz; Akdur, OkhanAlthough urine analysis is a simple and inexpensive method for the initial evaluation of renal colic patients presenting in emergency departments, it is regarded as unreliable for an exact diagnosis of urinary system stones. The aim of the present study is to assess the association between clinical demographics, and stone size and location, with the combined utility of urinalysis and unenhanced multidetector computed tomography (MDCT) in the emergency department. After gaining local Ethics Committee approval, a retrospective study was conducted with data from 186 patients who presented at our emergency service with flank pain and documented urolithiasis. Stone location and size was determined by MDCT, and the presence of microhematuria confirmed by urinalysis. The presence of hydronephrosis and clinical complaints were also recorded. A total of 186 patients were included in the present study, in which an absence of microhematuria was recorded in 24.7% patients. Urine density was found to be elevated in the microhematuria group (p=0.001). Upper urinary tract stones and hydronephrosis were found to be associated with the presence of microhematuria. Although statistically insignificant, an increased trend of microhematuria was observed with stones over 5 mm in size. Urinary stone size and location are directly associated with the incidence of microhematuria. Absence of microhematuria does not preclude MDCT imaging, however, especially in cases where stones are suspected in patients with renal colic.Öğe Efficacy and Safety Analysis of Botox Application and Iatrogenic Botulism: Panacea or Peril?(Bentham Science Publ Ltd, 2024) Karcioglu, Ozgur; Akman, Canan; Atnis, IlknurClostridium botulinum toxin-A (BoNT-A) creates temporary paralysis in the muscles by acting on the muscle-nerve junction. It is injected into the mimic muscles when a decrease in the movements of the mimic muscles is desired. Despite many favorable applications, the use of BoNT-A is not without drawbacks. Although there is no expected serious side effect on health in BoNT-A treatments, various problems can be encountered in patients treated for aesthetic purposes. Botulism is a rare but potentially life-threatening syndrome, which is caused by the toxin produced by the bacterium Clostridium botulinum, which acts on the nervous system, vegetative forms of C. botulinum can only survive in anaerobic conditions, while spore forms are common in nature and can withstand harsh conditions. Botulism can stem from bacterial spores which release toxin in the body; in the form of enteric botulism, and wound botulism. The cases that develop 'iatrogenic botulism' after such procedures are usually those receiving high-dose toxin for therapeutic purposes. The treatment of botulism mainly consists of anti-toxin therapy and, if necessary, intensive care to prevent organ failures, including respiratory support. This article aims to cover all these issues related to botulism and other adverse outcomes related to BoNT-A injection in light of the most recent literature.Öğe Evaluation of patients admitted to the emergency department with headache and undergoing neuroimaging(Bayrakol Medical Publishing, 2021) Akman, Canan; Erbil, Bülent; Topçuoglu, Mehmet Akif; Karaca, Mehmet Ali; Akpınar, Erhan; Özmen, Mehmet MahirAim: It is of great importance to differentiate the primary or secondary causes of headaches in the intensity of emergency services. The underlying causes of secondary headaches can be caused by neurological causes and may have a mortal course. In this study, it was aimed to determine red flags in neuroimaging for life-threatening secondary causes of patients who applied to the emergency department with headache complaints and underwent brain imaging.Material and Methods: Our study was planned retrospectively and descriptively. Patients who presented to the 3rd step emergency department with headache within 10 years were included. Demographic characteristics, disease history and information, imaging information and results of the patients were recorded.Results: In this study, the mean age of 704 patients was 48.9 (17-92) years, 62.8% of whom were female, and 99.6% of the patients presented to the de-partment within the first 24 hours after headache. Their cranial CT scans identified intracranial pathologies in 19.2% (n=139) of the patients. Intracranial pathologies were detected in 27.5% who experienced the most severe headache in their life, in 31.7% who had a sudden headache, in 52.9% who had focal neurological deficits, in 23.8% who were older than 50 years old, and in other headache reasons.Discussion: In the study on the elimination of secondary headaches in the emergency room, we concluded that having the most severe headache ever, sudden onset, neurological deficit, and being over 50 years of age are warning criteria. Although brain CT scans are generally used in clinically suspicious situations, MRI should also be used for mortality and morbidity in these patients.Öğe Evaluation of the factors predicting the need for intensive care of patients with COVID-19 aged above 65 years: data from an emergency department in Turkey(Associacao Medica Brasileira, 2021) Akman, Canan; Daş, Murat; Bardakcı, Okan; Akdur, Gökhan; Akdur, OkhanOBJECTIVE: Individuals aged ≥65 years are more susceptible to COVID-19 disease and admission to intensive care is most notable. The scoring systems (national early warning score, quick sequential organ failure assessment, shock index) are recommended for rapid assessment of patients in emergency room conditions. The goal of our study is to evaluate scoring systems in conjunction with predictive factors of need for admission to intensive care of patients ≥65 years old with a diagnosis of COVID-19 who applied to the emergency room. METHODS: Patients were divided into two groups according to evolution in the emergency room, being those who needed or not intensive care. National Early Warning Score, quick sequential organ failure assessment, shock index scores and serum biochemistry, blood count and blood gas values were evaluated from hospital information management system records. RESULTS: Of the patients included in the study, 80.8% were admitted to the ward and 14.5% to the unit of intensive care. Lymphocyte count, base deficit and bicarbonate levels were lower, and the levels of C-reactive protein, lactate, D-dimer, urea and lactate dehydrogenase were higher in patients who needed intensive care. Quick sequential organ failure assessment and shock index were considered significant in the group admitted to the intensive care unit. CONCLUSIONS: We recommend that quick sequential organ failure assessment and shock index be used quickly, practically and easily in predicting the need for intensive care unit in patients aged ≥65 years in emergency department diagnosed with COVID-19.Öğe Haemogram indices are as reliable as CURB-65 to assess 30-day mortality in Covid-19 pneumonia(Scientific Scholar Llc, 2022) Bardakci, Okan; Das, Murat; Akdur, Gokhan; Akman, Canan; Siddikoglu, Duygu; Beyazit, Yavuz; Akdur, OkhanBackground. Mortality due to Covid-19 and severe community-acquired pneumonia (CAP) remains high, despite progress in critical care management. We compared the precision of CURB-65 score with monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio ( NLR), platelet-to-lymphocyte ratio (PLR) in prediction of mortality among patients with Covid-19 and CAP presenting to the emergency department. Methods. We retrospectively analysed two cohorts of patients admitted to the emergency department of Canakkale University Hospital, namely (i) Covid-19 patients with severe acute respiratory symptoms presenting between 23 March 2020 and 31 October 2020, and (ii) all patients with CAP either from bacterial or viral infection within the 36 months preceding the Covid-19 pandemic. Mortality was defined as in-hospital death or death occurring within 30 days after discharge. Results. The first study group consisted of 324 Covid-19 patients and the second group of 257 CAP patients. The non-survivor Covid-19 group had significantly higher MLR, NLR and PLR values. In univariate analysis, in Covid-19 patients, a 1-unit increase in NLR and PLR was associated with increased mortality, and in multivariate analysis for Covid-19 patients, age and NLR remained significant in the final step of the model. According to this model, we found that in the Covid-19 group an increase in 1-unit in NLR would result in an increase by 5% and 7% in the probability of mortality, respectively. According to pairwise analysis, NLR and PLR are as reliable as CURB-65 in predicting mortality in Covid-19. Conclusions. Our study indicates that NLR and PLR may serve as reliable predictive factors as CURB-65 in Covid-19 pneumonia, which could easily be used to triage and manage severe patients in the emergency department.Öğe In a Cerebral Palsy Patient During Finger Amputation Given the Nitrous Oxide After Occuring Pneumocephalus(Derman Medical Publ, 2014) Akman, Tarik; Guven, Mustafa; Aras, Adem Bozkurt; Akman, Canan; Cosar, MuratRanked among the causes of the cranial cavity Pneumocephalus defined as the presence of air trauma, tumors, infections, congenital anomalies cranium, iatrogenic factors, lumbar puncture, post operative cranial or spinal surgery, also can develop after epidural or spinal anesthesia such as Nitrous oxide anesthesia. In this present case because of the headaches in patients with Cerebral Palsy control cranial CT shot after we aim to provide incidentally captured rarely ethiology in pneumocephalus.Öğe Kardiyorenal Sendrom(2024) Akman, CananSon zamanlarda kalp ve böbrek hastalıklarının birlikte görülme sıklığı artmaktadır. Kardiyo-renal sendrom (KRS), kalp ve böbreğin akut ve kronik fonksiyon bozukluğu sonucu çift yönlü akut ve kronik işlev bozukluklarının görüldüğü bir klinik tablodur. Patofizyolojisinde nörohormonal ve hemodinamik mekanizmalar yer almaktadır. Beş alt tipi bulunmaktadır. KRS’nin yönetimi tibbi tedavideki ilerlemelere rağmen halen zorlu olabilmektedir.Öğe No Sedation, No Traction, and No Need for Assistance: Analysis of New Prakash's Method of Shoulder Reduction(Hindawi Ltd, 2020) Kuru, Tolgahan; Olcar, Haci Ali; Bilge, Ali; Nusran, Gurdal; Ozkilic, Recai; Akman, Canan; Prakash, LakshmananBackground and Objective. Shoulder dislocations, which often occur anterior, account for about half of all dislocations. There are numerous reduction methods reported for the conservative treatment of acute anterior dislocations. However, there is still an ongoing search for an optimal method given the procedure time, possible complications, success rates, and need for sedation/analgesia in existing methods. This study seeks to explore the effectiveness and safety of Prakash's method in the treatment of acute shoulder dislocations, which is a novel method in the treatment of anterior shoulder dislocations. Materials and Methods. A total of 19 patients who were admitted to the emergency department with the diagnosis of anterior shoulder dislocation participated in this study. The diagnosis of shoulder dislocation was established in the emergency department with physical examination and anteroposterior shoulder radiography. The method was applied only once to the patients in the sitting position by the same physician without using any help, traction, anesthesia, analgesia, and myorelaxant. Results. The mean age of the patients was 37.3 +/- 13.1 years. Among them, 36.8% n=4 of the patients. The success rate of the method was 94.7% n=18. No complication was noted in the patients. The mean procedure time was 243 +/- 38 seconds. Conclusion. Prakash's method is a safe method for anterior shoulder dislocations that can be quickly performed with no need for sedation, assistance, and traction and has a high success rate.Öğe Patients with Chiari Malformation Type 2 in VP Shunt Rare Complication(Derman Medical Publ, 2014) Akman, Tarik; Guven, Mustafa; Aras, Adem Bozkurt; Cikman, Oztekin; Safak, Ozbey; Karaaslan, Oznur; Akman, CananSpontaneous perforation of the bowel caused by VP shunt is a very rare complication, and if unnoticed will be fatal. Two years previously our case with Chiari malformation type 2 had revision of the distal end of the VP shunt and also myelomeningocele ends on at the end of the infant period. The case was examined laparoscopically and found to have rare spontaneous intestinal perforation at the transverse colon splenic flexure level, followed by anal prolapse of the peritoneal catheter.
