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Introduction: Dystonia is anabnormal contraction due to primary and secondary causes of the muscles in the body. Case Report: In the literature, although many cases of congenital or edynsel with dystonia have been reported, a case as a result of a bee sting has not. Conclusion: We aimed to present a case with recurrent dystonia as a result of a bee sting.

Aim: 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.

Giris Degisik klinik ozelliklere sahip olan akrep sokmasi vakalari ulkemizde en sik Guneydogu Anadolu’da gorulmektedir. Akrep zehiri icerdigi cesitli enzimler nedeniyle farkli klinik tablolara neden olmakta ve ozellikle cocuklarda kalp etkilenimi nedeniyle olum gorulebilmektedir. Akrep sokmasi sonucu ventrikul yetersizligi, miyokart islev bozuklugu, sistemik hipertansiyon, pulmoner odem ve kardiyojenik sok gorulebilmektedir. Kalp etkilenimi gorulen olgularda pozitif inotrop destegi yaninda alfa blokor ilaclar da kullanilmakta prazosin ve doksazosin bu grupta yer almaktadir. Prazosin katekolamin artisi sonucu olusan kalp hasarini onleyerek etki gostermekte ve tasikardi, hipertansiyon, hipersalivasyon, terleme gibi sempatik bulgularin gelistigi olgularda kullanilabilmektedir. Prazosin yerine ayni etkili doksazosin de tedavide kullanilmakta, ancak etkinligi ve kullanimi konusunda literaturde yeterli veri bulunmamaktadir. Bu yazida, doksazosin kullandigimiz olgu sunuldu. Akrep Sokmalarinda Doksazosinin Etkinligi; Cocuk Olgu Sunumu Effectiveness of Doxazosin in Scorpion Stings; Child Case Report

Background: Diabetes mellitus affects the systolic and diastolic function of the left ventricle (LV). The aim of the present study was to evaluate the index of myocardial performance (IMP), a new Doppler index, in asymptomatic, normotensive patients with type 2 diabetes mellitus (T2DM). Methods: The study population consisted of 40 asymptomatic normotensive patients with T2DM (22 women, 18 men; mean [±SD] age 49 ± 7 years) and 20 healthy controls (13 women, seven men; mean age 45 ± 4 years). M-Mode and two-dimensional Doppler echocardiography was performed in all subjects to calculate IMP. Venous blood samples were collected for analysis and body mass index (BMI) was calculated. Results: In normotensive T2DM patients, the mitral E wave was decreased, whereas mitral A wave, mitral E/A ratio, and septal wall thickening were increased compared with values obtained for the control group. The IMP was higher in normotensive T2DM patients than in the control group (P = 0.004). There was a significant correlation between IMP and triglyceride (TG) levels (P

Summary Background: The aim of this study was to investigate the association between the aortic elastic properties and the left ventricular diastolic function measured by tissue Doppler echocardiography (TDE) in asymptomatic type 2 diabetes mellitus. Methods: Fifty-seven asymptomatic patients with type 2 diabetes (33 women, mean age: 49 ± 6 years) and 25 healthy control subjects (19 women, mean age: 46 ± 7 years) were included in the present study. Diastolic filling indices were measured by conventional (CE) and tissue Doppler echocardiography. The aortic elastic properties [Aortic stiffness index (ASI), aortic distensibility and strain] were measured as previous definition. Results: Compared with control subjects, the ratio of LV diastolic abnormalities measured by CE and TDE were found higher in patients with type 2 diabetes (36% and 73.6%, p = 0.001, respectively, and 52% and 89.4%, p

Background: A significant number of applications to emergency services consists of elderly patients. Elderly patients are at increased risk for abdominal aortic aneurysms. Therefore, we measured the diameter of the aorta in patients over the age of 65 and compared with the risk factors, Amaç:Acil servislere başvuruların önemli birkısmını oluşturan yaşlı hastalarda abdominal aortanevrizma riski fazladır. Bu sebeple 65 yaş ve üzerihastaların aort çapı ölçülerek risk faktörleri ilebirlikte değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem:65 yaş ve üzeri 150 hastaçalışmaya dahil edildi. Travma ile acil servisegelenler, vasküler olabilecek şikayet veya bulgu ilegelenler çalışmaya dahil edilmedi. Hastaların renalarter ayrım yerinden ve iliak bifurkasyo üzerindenolmak üzere iki yerden aort çapları ölçülmüştür veaort boylu boyunca taranarak diğer arada kalanalanlar da değerlendirildi. Veriler SPSS 20.0istatistik programı ile değerlendirilmiş ve t-test, kikaretestleri uygulandı.Bulgular:Abdominal aort anevrizması (AAA)tesbit edilen 3 hastanın 2’si kadın cinsiyette idi.Aort çapları sigara içen hastalarda içmeyenlere göredaha geniştir(p

Aim: 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

Objective: The aim of this study was to investigate effect of loss weight on P wave dispersion in obese subjects. Research Methods and Procedures: After a 12-week weight loss program (diet and medical therapy), a total of 30 (24 women and six men) obese subjects who had lost at least 10% of their original weight were included in the present study. All subjects underwent a routine standard 12-lead surface electrocardiogram. Electrocardiograms were transferred to a personal computer by a scanner and then magnified 400 times by Adobe Photoshop software (Adobe Systems, Mountain View, CA). P wave dispersion, which is also defined as the difference between the maximum P wave duration and the minimum P wave duration, was also calculated. Results: After a 12-week weight loss program, BMI (p < 0.001), maximum P wave duration (p < 0.001), and P wave dispersion (p < 0.001) significantly decreased. The mean percentage of weight loss was 13% (10% to 20.3%). The decrease in the level of P wave dispersion (21 ± 10 and 7 ± 12 ms, p < 0.002) was more prominent in Group II (≥12% loss of their original weight) than Group I (

Familial Mediterranean fever (FMF) may pose a risk for cardiovascular diseases due to continuous inflammatory status observed during the course of the disease. Recently, the presence of fragmented QRS (fQRS) has been recognized as a predictor of myocardial fibrosis. In this study, we aim to investigate the frequency of fQRS and its relation to Doppler-based indices. This study consisted of 80 FMF patients and 30 healthy control subjects. fQRS pattern was defined as the presence of additional R waves or RSR’, evidenced by notched R or S wave on electrocardiography (ECG). The patient and the control groups underwent conventional echocardiography and tissue Doppler echocardiography. There was no significant difference between groups regarding age (29 ± 12 vs 29 ± 15). FMF patients exhibited a statistically higher frequency of fQRS (% 56 vs % 13) (p

İnsanlar tarafından atmosfere salınan gazların (karbondioksit, diazot monoksit, metan, su buharı, kloroflorokarbon) miktarlarının artması sonucunda dünya yüzeyinde sıcaklığın artması küresel ısınma olarak tanımlanmaktadır. Bunun sonucunda kışın sıcaklıklar artmakta, hayvanların göç dönemleri ve iklimler değişmekte ve değişikliklere dayanamayan bitki ve hayvan türleri de azalmaktadır. Sıcak bölgelerde yaşayan soğukkanlı hayvanlardan olan yılan gibi hayvanların da yaşam siklusu değişebilmektedir. Yılan ısırması vakaları ülkemizde özellikle yaz aylarında güney ve güneydoğu bölgesinde sıkça rastlanan vaka grubudur. Biz de yaz ayları dışında literatürde rastlanmayan böyle bir vakayı sunmayı amaçladık. The increase in the Earth's temperature due to the inctrease in the amount of gases (carbon dioxide, nitrous oxide, methane, water vapor, and chlor- ofluorocarbons) released into the atmosphere by humans is defined as global warming. Therefore, temperature increases in Winter, migration periods and climates change and thus species of fauna and animals which cannot tolerate such changes decrease. Life cycles of cold-blooded animals such as snakes living in warm areas vary. Cases of snake bites are frequently observed in the south and south-east of Turkey, especially in Summer. Therefore,we aimed to present a case which is not encountered in the literature except during Summer

Özofagus korozif yanıklarında erken dönem striktürün engellenmesinde N-asetil kullanımının etkinliğini araştırmaktır. Gereç ve Yöntemler: Özofagusun yakıcı maddeler nedeniyle gelişen darlıkları, sıvı veya katı nitelikteki yakıcı maddelerin ağız yoluyla alınması sonucu ortaya çıkmaktadır. Bulgular: Konvansitonel+N-Asetil sistein kullanılan grupta 1 hastada, konvansiyonel tedavi uygulanan grupta 7 hastada darlık gelişti. Sonuç: Tek başına konvansiyonel tedavi ve konvansiyonel tedavi + N-asetil sisteinin birlikte kullanım etkinliğini değerlendirmek için randomize prospektif bir çalışma yapıldı. Evre 2b ve evre 3 yanıklı 50 hasta incelendi. Yoğun n-asetil sistein tedavisi ileri evre korozif özofajiti bulunan hastalarda striktür gelişim sıklığını azaltabilir. Daha fazla sayıda hasta içeren gruplar veya deneysel çalışmalarla bulgularımızın destekleneceğini umuyoruz. (JAEM 2011; 10: 73-5), Esophageal stricture early corrosive burns to investigate the eff ectiveness in preventing the use of N-acetyl-cysteine. Strictures of the esophagus due to caustic substances occur with the ingestion of solid or liquid corrosive materials. Materials and Methods: A prospective randomized study was performed to evaluate the eff ectiveness of conventional therapy alone and conventional therapy + N-acetyl cysteine. Fifty patients with grade 2b and grade 3 burnt were analyzed. Intensive n-acetyl cysteine therapy can reduce the incidence of stricture development in patients with advanced grade corrosive esophagitis. Results: N-acetyl cysteine group+ Konvansitonel used in 1 patient, stenosis developed in 7 patients in the group with conventional treatment. Conclusion: We believe that our fi ndings will be better supported with the groups including larger number of patients or with the experimental studies. (JAEM 2011; 10: 73-5)

Objectives: To investigate the protective role of thymoquinone (TQ) on unilateral testicular ischemia-reperfusion (I/R) injury in mice. Materials and Methods: Experiments were performed on male C57BL/6 mice (8 weeks old, 20–25 g). The animals were divided into 3 groups including 6 mice in each group: control (sham), torsion/detorsion (TD) and TD+TQ. Mice, except the sham-operated group, were subjected to left unilateral torsion (720° rotation in the clockwise direction). The experiments were finished after sham operation time for controls, 120 min torsion and 240 min detorsion for the other groups. In the TD+TQ group 10 mg TQ was injected intraperitoneally 30 min before detorsion. Results: In the TD group total oxidative stress (TOS), oxidative stress index (OSI) and malondialdehyde (MDA) levels were higher than in the controls. TQ treatment decreased MDA, TOS and OSI values, but did not affect the total antioxidant capacity and myeloperoxidase activity in the TD+TQ group. Upon histological examination, mice in the TD group displayed moderate-to-severe disruption of the seminiferous epithelium. Treatment with TQ resulted in significantly reduced histological damage associated with I/R injury. Conclusion: Our results suggested that TQ treatment may have a protective effect on testicular I/R injury.

We investigated the effects of erdosteine on acetaminophen (APAP)-induced hepatotoxicity in rats. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), AST (aspartate aminotransferase), and ALT (alanine transaminase) activities, and malonyldialdehyde (MDA) and nitric oxide levels as oxidant/antioxidant biochemical parameters were investigated with light microscopic evaluation in adult female Wistar Albino rats. APAP administration produced a decrease in hepatic SOD, CAT, and GSH-Px activities, and coadministration of erdosteine (150 and 300 mg/kg) resulted in increases in the activities. MDA and NO levels increased in the APAP group, and erdosteine treatments prevented these increases. Significant elevations in serum AST and ALT levels were observed in the APAP group, and when erdosteine and APAP were coadministered, their serum levels were close to those in the control group. Light microscopic evaluation of livers showed that there were remarkable centrilobular (zone III) hepatic necrosis and mild to moderate sinusoidal congestion in the APAP group, whereas in the erdosteine group, cellular necrosis was minimal and the hepatocytes maintained a better morphology when compared to the APAP group. Erdosteine prevented APAP-induced liver injury and toxic side effects probably through the antioxidant and radical scavenging effects of erdosteine.

Cyclosporine A (CsA) is used for the treatment of autoimmune and inflammatory disorders. However, CsA-induced nephrotoxicity remains an important clinical problem, and oxidative stress has been implicated as a possible responsible mechanism. We assessed the protective ability of N-acetylcysteine (NAC), an antioxidant, against CsA-induced nephrotoxicity.Wistar albino rats were randomly assigned into four groups. Group 1 rats were treated with sodium chloride as control, group 2 with CsA, group 3 with CsA and NAC, and group 4 with NAC alone. Animals were sacrificed and blood samples were analyzed for blood urea nitrogen (BUN), serum creatinine (Cr), malondialdehyde (MDA) and nitric oxide (NO) levels, and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities. Kidney sections were analyzed for MDA and NO levels and SOD and GSH-Px activities, as well as histopathological changes.Overall, the treatment of rats with CsA alone produced significant increases in NO and MDA levels and significant decreases in SOD and GSH-Px activities in serum and renal samples. Morphological changes, including tubular epithelial atrophy, vacuolizations, and cellular desquamations, were clearly observed in the rats treated with CsA alone. Concurrent NAC administration with CsA improved renal function, as indicated by lower BUN and Cr values. Moreover, NAC significantly reduced MAD and NO levels and increased SOD and GSH-Px activities in serum and renal tissue, as well as provided a histologically proven protection against CsA-induced nephrotoxicity.These results indicate that NAC produces a protective mechanism against CsA-induced nephrotoxicity and suggest a role for oxidative stress in pathogenesis.

The prognostic significance of white coat hypertension (WCH) remains controversial. Consecutive patients (955 cases, 566 females) aged between 15 and 70 years were divided into 3 groups, those with sustained normotension (NT), WCH, and hypertension (HT), and the prevalences of obesity, impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM), coronary heart disease (CHD), and dyslipidemia were compared among the groups. Although the prevalences of all of the disorders showed significant progression from the sustained NT group towards the WCH and HT groups, the prevalence of dyslipidemia was significantly higher in the WCH group (P < 0.05 for all). Due to the gradually increased prevalences of obesity, IGT or DM, and CHD from the sustained NT group towards the WCH and HT groups and the highest prevalence of dyslipidemia in the WCH group, WCH should preferentially be accepted as an alarming sign of a deterioration in health rather than being a predisposing factor of HT or atherosclerosis alone. The significantly higher prevalence of dyslipidemia in the WCH group than in the HT group may be explained by the increased amount of adipose tissue in the HT cases, since the prevalence of obesity was the highest in the HT group. Thus, the high prevalence of WCH even in early decades may represent increased susceptibility to future weight gain, and dyslipidemia in patients with WCH may be a preliminary sign of obesity. Therefore, the management of WCH should focus on the prevention of dyslipidemia and excess weight gain.

The clinical symptoms of migraine are widely accepted to be related to the involvement of the autonomic nervous system, and especially to dysfunction in the regulation of the circulatory system and autonomic balance. Disturbance of the autonomic nervous system is a primary characteristic of migraine Therefore, patients with migraine have a variety of symptoms, such as vasodilatation (flushing), pilo-erection, nausea, vomiting, diarrhea, cutaneous vasoconstriction (pallor), and diaphoresis. The electrocardiographic changes seen during a migraine attack compared with the pain-free period could be secondary to reversible disturbances of the state of autonomic innervation of the heart and coronary arteries. Dysfunction of ANS may affect atrial and ventricular repolarization. For instance, increased sympathetic activity causes sinus tachycardia, but increased parasympathetic activity causes sinus bradycardia, atrioventricular block, and ST-segment and T-wave abnormalities. Comprehensive electrocardiographic analyses have been providing more details in terms of the detection of abnormalities in atrial and ventricular repolarization which potentially may result in arrhythmias in patients with migraine. However, there is no information in literature reporting the frequency of cardiac arrhythmias in migraine patients who had cardiac repolarization abnormalities. In this review, detailed electrocardiographic findings and their relation with the autonomic nervous system, including recent observations, have been evaluated. However, further studies are needed to investigate the association between autonomic dysregulation and cardiac repolarization abnormalities in patients with migraine.

Background Onychomycosis has a high prevalance among immunocompromised patients such as diabetics and hemodialysis patients. In the present study, we aimed to investigate the prevalence of onychomycosis among hemodialysis patients with and without diabetes mellitus, and to find out the factors likely to be associated with the development of onychomycosis among hemodialysis patients. Methods One hundred and nine hemodialysis patients were enrolled. Fifty-seven of hemodialysis patients had the diagnosis of diabetes mellitus. Nail scrapings were obtained from 76 patients who had dystrophic nail changes. Samples were examined with 20% potassium hydroxide solution and all of the samples were inoculated on Saboraud's dextrose agar, potateus dextrose agar and mycobiotic agar. Diagnosis of onychomycosis was based on the presence of both positive clinical signs and positive potassium hydroxide test. Results Onychomycosis was diagnosed in 26.6% of hemodialysis patients. Diabetes mellitus was present in 68.9% of patients with onychomycosis. Toenail scraping cultures were reported to be positive in 19.7% of patients with dystrophic nail changes. Logistic regression analysis revealed that the presence of diabetes mellitus and the mean duration of hemodialysis were the significant predictors associated with the development of onychomycosis. Conclusion The prevalence of dystrophic nail changes and onychomycosis is increased among hemodialysis patients. The dialysis duration and the presence of diabetes mellitus are the independent risk factors associated with the development of onychomycosis in uraemic patients.