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Aim: Acrylamide (ACR) is a water-soluble neurotoxic substance that has been widely researched in recent years. Boric acid (BA) is a component that does not have a toxic effect when taken at low concentrations and has a cystotoxic activity. Studies have reported that BA has antioxidant effects. In this study, we aimed to examine the protective efficacy of BA against the toxic damage that ACR may cause in the brain tissue. Material: In this study, 28 Wistar Albino male rats with an average weight of 320-400 grams were used. In our study, ACR was administered intraperitoneally (i.p.) at a dose of 50 mg/kg for 14 days, while BA was administered orally (p.o.) with a dose of 200 mg/kg for 14 days. Group 1 (n=7): It is the control group and no medication was administered for 14 days. Group 2 (n=7): ACR group, Group 3 (n=7): BA group and Group 4 (n=7): ACR + BA group. Results: The comparison between the groups in terms of serum Total Oxidant Status (TOS) and Malondialdehyde (MDA) analysis revealed that the highest MDA level was in the ACR group. The MDA and TOS levels of the ACR+BA group were significantly lower than the ACR group (p

Anadolu, birçok medeniyeti üzerinde misafir etmiş, vatan olmuş, bereketli ve kutsal toprakların adıdır. Köklü bir tarihe ve güçlü bir kültürel mirasa sahip Türkler, göçebe olarak yaşamlarını sürdürürken çadırdaki nemden, böceklerden, soğuktan korunabilmek için düz dokuma olarak da bilinen kilim dokuma yaygılarını örtü olarak kullanmışlardır. Anadolu’yu yurt edindikten ve yerleşik hayata geçtikten sonra da hayatlarının her aşamasında kilim dokuma yaygıları varlığını sürdürmüştür. Koyun veya keçi yününden elde ettikleri ve kök boya tekniğiyle renklendirdikleri yün iplikler ile “ıstar” denilen ağaç dokuma tezgâhlarında binbir emekle her bir motife anlam yükleyerek, duygularını katarak; acılarını, hayallerini, özlemlerini, aşklarını, korkularını rengârenk işleyerek kilim dokumalarını oluşturmuşlardır. Halen günümüzde kullanmakta olduğumuz kilim dokumaları ecdadımızın bize miras olarak bıraktığı, nesilden nesile aktarılarak günümüze kadar ulaşan ve geçmişimize de ışık tutan, uygulama aşamasındaki teknikleri ve güzellikleriyle hayranlık ve hatta şaşkınlık uyandıran kilim motiflerinden oluşmaktadır. Öyle ki 2003 yılında UNESCO tarafından, 2006 yılında da TBMM tarafından kabul edilen “Somut Olmayan Kültürel Miras” kavramı kapsamında sözleşmenin en önemli maddelerinden biri olan el sanatlarına dokumacılık ve telkâri de dahil edilmiştir. Anadolu’da 2500 yıllık kadim bir geçmişe sahip olan telkâri, ülkemizde özellikle Mardin ilinin Midyat ilçesinde Süryani ve Müslüman ustalar tarafından tamamen el işçiliği ile üretilmektedir. Telkâri; gümüş veya altından yapılmış farklı mikronlardaki teller ile istenilen modele uygun oluşturulan çatının şekline göre telkâri iç dolgu teknikleri kullanılarak tamamlanması, toz kaynak işlemi ile birbirine kaynaklanması ve sağlamlaştırılması sonucu ortaya çıkan sanat eseridir. Geleneksel Türk el sanatları olarak tarihimizde özel bir yere sahip 21. yüzyıla sağlam adımlar ile kendi öz kimliğini kaybetmeden ulaşan iki güçlü, kadim dost sanatımız olan kilim dokuma ve telkâri gümüş işlemeciliğinin kaybolmasını engellemek ve bizden sonraki nesillere mutlaka özüne bağlı kalarak, bozmadan aktarmak, sürdürülebilirliğini sağlamak amacıyla kilim dokuma ve telkâri gümüş işleme sanatını bir arada kullanarak daha önce yapılmamış farklı görsellikteki telkâri-kilim tasarımları uygulanmıştır. Telkâri ve kilim dokuma sanatı, uygulama aşamasında üretim teknikleri ve kullanılan malzemeler bakımından birbirinden farklı özelliklere sahiptir. Renkli yün, kilim iplikleriyle bir alt, bir üst dokuma tekniği uygulanarak üretilen kilim dokuma ve gümüş telin işlenmesiyle oluşan telkârinin bir arada kullanılmasıyla ortaya çıkan tasarımlarda bu birlikteliğin oluşturduğu uyum, teknik ve malzeme açısından özgün ve özgür eserlerin ortaya çıkmasını sağlamıştır.

This study was designed prospectively to investigate the demographic data of the patients who had blood and blood products in Dicle University Medical Faculty Research Hospital Emergency Service between 01 November 2014- 01 November 2015, also to investigate the indications for blood products used, the amount and the type of the products used. When we look at the diagnosis of patients who underwent transfusion in the emergency department; It was determined that 26.2% were transfused for malignancy, 32.6% for anemia, 18.3% for trauma, 12.5% for GIS bleeding, and 10.4% for other reasons. The patients who had blood product transfusion were 623; 53.8% were male and 46.2% were female. The mean age of the patients was determined 47.87±23.66. The percentage of transfused blood products were as following: 83.6% erythrocyte suspension (ES), 17.3% fresh frozen plasma (FFP), 17.3 % platelet suspension(PS), 0.6% whole blood(WB), %4.3 other blood components (OBC). As a result, we can say that in our study, a large number of transfusions were performed in the emergency department, a specific protocol was not adhered to in determining the indication, and transfusion was performed in support of patients who were mostly under outpatient follow-up. Emergency transfusion decisions should be performed with true emergency indication, follow-up with clinical response rather than laboratory response, and consciousness about the aim of transfusion.

Introduction: A country’s development level is measured with a quantitative parameter called the human development index (HDI). The present study researched the effects of HDI parameters (such as healthcare standards, income, and education level) on the incidence of tuberculosis. Methodology: HDI data of 36 provinces of Turkey and the tuberculosis surveillance data were obtained from the Ministry of Development and the Ministry of Health, respectively. The associations between the incidence of tuberculosis and other HDI parameters were analyzed. Results: Higher population density (n/km2) (CI = 0.05 to 0.40) and higher relapse rate of tuberculosis (CI = 0.36 to 1.48) were identified to be independent predicting factors that increased the incidence of tuberculosis, whereas higher gross national product (CI = -0.06 to 0.00), the population that holds a green Medicare card (CI=-0.58 to -0.04), increased general practitioners per 100,000 people (CI=-0.66 to -0.01), female population (CI = -0.70 to -0.06), married population (CI = -1.34 to -0.03), were found to be significant negative predicting factors that were relevant to the incidence (protective against tuberculosis). Conclusions: Tuberculosis is a disease that is affected by multiple factors, including the components of HDI. Improvement of income level, facilitation of access to health services via health insurance, urbanization with lower population density strategy, and provision of enough general practitioners may be useful in reducing the incidence of TB' in provinces of developing countries such as Turkey.

A disaster can be defined as a situation where the affected society cannot overcome its own resources. Our aim was to present the case of a fire disaster caused by a liquefied petroleum gas (LPG) tanker-based explosion on the Diyarbakir-Bingol road in Lice to determine the various kinds of challenges and patient groups that an emergency department faces and to discuss more effective interventions for similar disasters. This is a retrospective cross-sectional study. To find out the factors that affected mortality, we investigated the patient conditions presented at the time of admission. Among 69 patients included in the study, 62 were male (89.9%) and seven were female (10.1%). The average age of patients was 32.10±14.01 years, and the burn percentage was 51.1±32.2. One patient died during the first response, and a total of 34 patients (49.3%) died during the patient follow-up. Factors statistically related to mortality were determined to be inclusion in the severe burn group, presence of inhalation injuries, use of central venous catheter on patients, application of fasciotomy, presence of a tracheostomy opening, use of endotracheal intubation and sedoanalgesia, and transfer to centers outside the city (p-values

SUMMARY Objectives Natural disasters, which are defined as events causing great damage or loss of life, are events of natural origin unpreventable by human beings that occur in a short period of time and lead to loss of life and property. The aim of the study is to analyze which patient groups and problems at a university hospital after the earthquakes in Van. Methods For the purposes of this study, 169 patients who presented to our emergency room following the earthquakes that occurred on the 23rd of October, 2011 and the 9th of November, 2011 in Van and were treated as an outpatient or inpatient were enrolled. Patients were divided into two groups. Patient data including the clinical and demographic characteristics were analyzed. Results Among the 169 patients included in our study, 97 (57.4%) were male and 72 (42.6%) were female. The mean age was 26.95±16.44 years in Group 1 and 39.80±23.08 years in Group 2. In our study, the majority of the patients in Group 1 had orthopedic injuries, while internal problems were more common in Group 2. The need for intensive care was greater among the patients in Group 1 compared to Group 2 (p

Background: This study aimed to investigate the prevalence of malnutrition and explore the somatic, psychological, functional, and social or lifestyle characteristics linked to malnutrition in elderly people at a hospital in Turkey. Material/Methods: This study included 1030 patients older than 65 years of age who were seen at the internal medicine and geriatrics outpatient clinics of the study centers in Istanbul, Ankara, Duzce, Corum, Mardin, Malatya, and Diyarbakir provinces between January and December 2014. All patients underwent Mini Nutritional Assessment (MNA) and Geriatric Depression Scale (GDS) tests via one-on-one interview method. The demographic properties of the patients were also recorded during this interview. Results: Among 1030 patients included in this study, 196 (19%) had malnutrition and 300 (29.1%) had malnutrition risk. The malnutrition group and the other groups were significantly different with respect to mean GDS score, income status, educational status, the number of children, functional status (ADL, IADL), the number of patients with depression, and the number of comorbid disorders. According to the results of the logistic regression analysis, age (OR=95% CI: 1.007-1.056; p=0.012), BMI (OR=95% CI: 0.702-0.796; p

BACKGROUND The aim of this study was to investigate the protective effects of L-glutamine (GLN) against liver and kidney injury caused by acute toxicity of deltamethrin (DLM). MATERIAL AND METHODS Thirty-two rats were indiscriminately separated into 4 groups with 8 rats each: control group (distilled water; 10 ml/kg, perorally [p.o.]), DLM group (35 mg/kg p.o. one dose.), GLN group (1.5 gr/kg, p.o. single dose.) and DLM (35 mg/kg p.o. one dose.) + GLN group (1.5 gr/kg, p.o. one dose after 4 hours.). Testing for total antioxidant status (TAS), total oxidant status (TOS), interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) analyses were performed on tissue samples, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), urea, and creatinine were analyzed on serum samples. Liver and kidney samples were histopathologically analyzed. RESULTS The TOS level in liver was significantly higher in the DLM group than in the control group, and the level in DLM+GLN group was considerably lower than in the DLM group. The TAS level in the DLM+GLN group was considerably higher than in the control and DLM groups. The TAS level in kidney tissues was considerably lower in the DLM group than in controls, but was similar to other groups. Histopathological analyses of liver tissues established a significant difference between DLM and DLM+GLN groups in terms of grade 2 hepatic injury. However, no significant difference was found between DLM and DLM+GLN groups in terms of kidney injury. CONCLUSIONS Glutamine leads to significant improvement in deltamethrin-induced acute hepatotoxicity in terms of histopathologic results, tissue oxidative stress parameters, and serum liver function marker enzymes.

The main objective of this study was to describe the characteristic imaging features of cerebral and spinal hydatid disease (HD) in magnetic resonance imaging (MRI) and computed tomography (CT) in order to provide more effective differential diagnoses in endemic regions. We also aimed to use MRI and CT to evaluate whether the World Health Organization's (WHO) new classification of hepatic cystic echinococcosis (CE) could be used in the classification of cerebral HD.We retrospectively reviewed the CT and MR images of 30 patients who were diagnosed with cerebral and spinal HD between 1990 and 2014. The imaging findings were noted. All hydatid cysts were classified according to the WHO classification of hepatic CE, consisting of six types.The study group consisted of 49 CEs in 27 patients with cerebral HD and 12 CEs in three patients with spinal HD. Of the cysts, 14 were type CL (cystic lesion), 29 were type CE1, 11 were type CE2 and seven were type CE3. In other words, 54 cysts were in the active group and seven were in the transition group. Most of the cysts were type CL and CE1.Even though characteristic imaging features could be used in the differential diagnosis of HD, sometimes the differentiation of HD from other cystic lesions may be difficult. The use of WHO classification will provide standardisation of uniform treatment modality, as the treatment of HD, according to the stage of the disease, may be surgical or medical.

Central venous catheterization, an effective method for intravenous therapy, is commonly used at emergency departments and intensive care units. In this study, we aimed to assess the complications of central venous catheterization procedure in pediatric patients at emergency department and to seek possible risk factors for complications. This study included a total of 64 patients (41 males (64.1%) and 23 females (35.9%)) who underwent central venous catheterization between January 1, 2011 and May 31, 2013. Personal records of the patients were retrospectively assessed using the hospital records system. A total of 64 catheters [53 (%82.8) femoral, 5 (%7.8) subclavian, and 6 (%9.4) jugular] were inserted in all cases. One arrhythmia episode, one pneumothorax, five arterial punctures, and 4 hematomas were observed, making up a total of 11 complications (17.2%). No statistically significant relationship was observed between development of complications and age, gender, indication for central venous catheterization, anatomical site preferred for catheter insertion, time of the day of performance of the procedure, and the level of training of the performing resident (p>0.05). Hypovolemic shock as an indication for the procedure and three or more attempts to access target vein during insertion were significantly correlated with complications (p=0.015 and p=0.025, respectively). Three or more attempts to access the target vein, as well as hypovolemic shock as an indication of the procedure, were risk factors for complications.J. Exp. Clin. Med., 2013; 30:345-348

A 28-year-old man was admitted with symptoms of heart failure. Echocardiography revealed severe left ventricular dysfunction, apical aneurysm, and a 40 × 11 mm sized mobile thrombus attached to apical septum with a narrow stalk. The patient had anterior myocardial infarction two years ago. Heparin infusion was started at 1000 IU/hour for 48 hours. There was no detected change on the size of the thrombus. Surgery recommended to the patient was refused by him because of the procedural risks. Tirofiban infusion was started. Repeat echocardiography showed significant reduction in thrombus size after 24 hours, and complete resolution of the thrombus after 48 hours. To our knowledge, this is the first case with left ventricular mobile thrombus treated successfully with tirofiban infusion.

Intestinal bacterial overgrowth (IBO) and increased mucosal permeability are suggested to increase bacterial translocation (BT) in liver injury. Rifaximin (RIF) is a minimally absorbed oral antimicrobial agent that restores gut microflora imbalance. The aim of the present study was to investigate the effects of RIF on BT frequency in thioacetamide (TAA)-induced liver injury. Group 1 was the control. In group 2 (TAA), rats received TAA daily for 3 days. In group 3 (TAA + RIF), RIF was commenced on the same day as the first dose of TAA. In group 4 (RIF), rats received only RIF. Ileal aspirate Escherichia coli counts were significantly lower in the TAA + RIF group than in TAA group. There was no difference in BT frequency between the TAA and TAA + RIF groups. Our results suggest that factors such as intestinal barrier dysfunction and impaired host immune shield, apart from IBO, play an important role in BT in this model.

Introduction: Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening idiosyncratic reaction during the use of antipsychotic drugs, usually beginning in the first 2 weeks of the treatment. NMS is generally manifested by muscle rigidity, hyperthermia, autonomic instability, altered mental status, tremors, elevated serum creatinine phosphokinase, and leukocytosis. Case Report: A 26-year-old male patient who had a ventriculoperitoneal (V-P) shunt was admitted to the emergency department with complaints of loss of consciousness, fever, respiratory distress, and palpitations. In his history, we learned that treatment of quetiapine 25 mg/day was initiated 6 months ago. After physical examination and laboratory results, the patient, who had a V-P shunt, was primarily considered shunt dysfunction or infection. But, with laboratory parameters and radiographic examinations, we moved away from this diagnosis. He was evaluated as NMS due to the history of antipsychotic drug using, fever, rigidity, tachycardia, tachypnea, confusion, and increase of creatine phosphokinase for the preliminary diagnosis. Since there was no any etiological factor that could explain the clinical process, he was admitted to the medical intensive care with a diagnosis of NMS.Conclusion: NMS is a disorder that can be life-threatening and must be recognized by clinicians

Introduction: Adult-onset Still’s disease (ASD) is a systemic inflammatory disease of unknown etiology and pathogenesis. ASD, one of the most important causes of fever of unknown origin, is diagnosed after ruling out infection, malignancy, and rheumatologic diseases. It may also present with fever alone, without typical skin rash and articular manifestations. Case Report: There are no pathognomonic laboratory findings in ASD. In this paper, we report a case that presented to the emergency department with fever, malaise, and joint pain for 5 days and was subsequently diagnosed with ASD. Conclusion: In patients with prolonged fever combined with musculoskeletal symptoms and macular rash, the differential diagnosis should include ASD. Timely diagnosis and treatment of the disease can prevent complications and lead to a favorable prognosis, Introduction: Adult-onset Still’s disease (ASD) is a systemic inflammatory disease of unknown etiology and pathogenesis. ASD, one of the most important causes of fever of unknown origin, is diagnosed after ruling out infection, malignancy, and rheumatologic diseases. It may also present with fever alone, without typical skin rash and articular manifestations.Case Report: There are no pathognomonic laboratory findings in ASD. In this paper, we report a case that presented to the emergency department with fever, malaise, and joint pain for 5 days and was subsequently diagnosed with ASD. Conclusion: In patients with prolonged fever combined with musculoskeletal symptoms and macular rash, the differential diagnosis should include ASD. Timely diagnosis and treatment of the disease can prevent complications and lead to a favorable prognosis

Objective: In the present study, determination of symptoms, clinical characteristics, prevalence and recovery rates was aimed in patients who applied to the emergency service and diagnosed with hypernatremia.Methods: Patients who applied to Dicle University Medical School Emergency Service during January 2013-December 2014 and whose serum Na>148 mEq/L were included in the study. The study was conducted retrospectively.Results: Hypernatremia prevalence was determined as 0.21% in the cases who applied to the emergency service. The average age in all patients was 69±22 and the median age was 72 years. The average hospitalization period was 13.3±10.9 days. The mortality rate was 75.7% and male gender domination (56%) was determined in patients who developed mortality. When mortality and recovery groups were compared statistically; significant difference was determined (p, Amaç: Bu çalışmada acil servise başvuran ve hipernatremi tespit edilen hastalarda semptomlar, klinik özellikler, prevalans ve sağ-kalım oranlarının belirlenmesi amaçlanmıştır. Yöntemler: Çalışmaya, Ocak 2013-Aralık 2014 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi acil servisine başvuran, serum Na>148 mEq/L üzerinde olan hastalar dahil edildi. Çalışma retrospektif olarak gerçekleştirildi. Bulgular: Acil servise başvuran olgularda hipernatremi prevalansı %0,21 olarak tespit edildi. Tüm hastaların yaş ortalaması 69±22, median yaş 72 yıl idi. Ortalama hastanede kalma süresi 13,3±10,9 gün idi. Mortalite oranı %75,7 ve mortalite gelişen hastalarda erkek cinsiyet hakimiyeti (%56) tespit edildi. Mortalite ile şifa grubu istatistiksel olarak karşılaştırıldığında; hastanede kalma süresi, glukoz, üre, kreatinin ve kalsiyum ortalamaları açısından anlamlı fark tespit edildi (p< 0.05). Hastalarımızın acil servise başvuru yakınmaları sıklık sırasına göre bilinç değişikliği (%92,7), oral alım bozukluğu (%82,4), ateş (%48,6) idi. Eşlik eden komorbid durumlar ise sıklık sırasına göre serebrovasküler hastalık (%36,9), Demans/Alzheimer (%32,4), Hipertansiyon (%28,9) idi. Sonuç: Sonuç olarak hipernatremi yaşlı, oral alımı bozuk, serebrovasküler hastalığı ve demansı olanlarda daha sık görülebilen ve yüksek mortaliteyle seyreden bir sıvı-elektrolit bozukluğudur

To investigate the relationship between clinical and demographic characteristics and mortality in patients with organophosphate poisoning.The retrospective study was conducted at Dicle University,Diyarbakir,Turkey, and comprised data of patients who presented with organophosphate poisoning between April 2004 and April 2013. The records were assessed in two groups, with Group 1 having data related to recovery, and Group 2 having data related to mortality. SPSS 16 was used for statistical analysis.Of the 296 patients, 219(74%) were women. Mortality was the outcome in 41(13.9%) cases. In Group 2, mean age, marital status, rural origin, presence of psychiatric disease, being illiterate, presence of nicotinic symptoms, and late admission were significantly higher than Group 1 (p0.05 each). Logistic regression analysis indicated bradycardia as the most prominent independent predictor of mortality (p0.001). Other independent predictors were age, glucose level, lactate dehydrogenase, coma and acidosis (p0.05 each).Independent predictors of mortality in patients with organophosphate poisoning as bradycardia, age, glucose, lactate dehydrogenase level and acidosis.

Objective: In the pregnancy period, the incidence of suicide attempt is lower compared to other life-periods. However, according to the recent studies, suicide attempts may lead life-threatening consequences in high-risk pregnant women. The aim of this study is to compare pregnant patients admitted to the emergency department for suicide attempt in terms of their sociodemographic and clinical properties and suicide attempt methods.Methods: In this study, 56 patients admitted to the emergency department of university for suicide attempt between January 1, 2009, and December 31, 2014, were included and they were classified according to suicide attempt methods into 2 groups as violent ones. Group 1 included violent methods as hanging, jumping, shooting and Group 2 included non-violent method as drugs. The study was a retrospective cross-sectional study. The sociodemographic, psychiatric and clinical properties of the patients were identified by patient registry system and patient files, and inter-group differences were compared.Results: In this study, 15 (26.7%) patients in the violent suicide attempt group, and 41 (73.3%) patients in the non-violent suicide attempt group, totally 56 patients were included. In the non-violent suicide attempt group, cigarette smoking, suicide attempt due to boredom, and live birth was significantly higher as compared to violent group; hospitalization period and fetal death was lower (p=0.04; p=0.006; p=0.004; p=0.004, respectively).Conclusion: Most of our pregnant suicide attempt patients are in the non-violent group, however, violent suicide attempt increased hospitalization period and fetal mortality significantly. J Clin Exp Invest 2015; 6 (2): 115-120Key words: Emergency department, pregnant, suicide attempt, Giriş: Gebelik döneminde intihar girişimi hayatın diğer dönemlerine göre daha düşüktür. Ancak son yıllarda yapılan çalışmalarda özellikle yüksek risk grubunda olan gebe kadınlarda görülen intihar girişimi hem anneyi hem de fetüsün yaşamını tehdit ettiği için önemli sonuçları vardır. Çalışmamızın amacı acil servise intihar girişimi nedeniyle başvuran gebe hastaları sosyodemografik ve klinik özellikleri açısından değerlendirmek ve intihar girişimi yöntemlerine göre karşılaştırmaktır.Yöntemler: Bu çalışmada 1 Ocak 2009 ile 31 Aralık 2014 tarihleri arasında bir üniversite hastanesi acil servisine intihar girişimi nedeniyle başvuran 56 gebe hasta çalışmaya dahil edildi. Çalışmaya alınan hastalar intihar girişim yöntemlerine göre; Grup1; şiddet içeren (ası, yüksek yerden atlama, ateşli silah ile kendini vurma)ve Grup 2; şiddet içermeyen (ilaç alma) olarak iki gruba ayrıldı. Bu çalışma retrospektif kesitsel bir çalışma olarak planlandı. Hastaların sosyodemografik, klinik ve psikiyatrik özellikleri hasta kayıt sistemi ve dosyalar incelenerek tespit edildi ve gruplar arasındaki farklılıklar araştırıldı. Bulgular: Şiddet içeren intihar girişimi grubunda 15 (%26,7) hasta ve şiddet içermeyen intihar girişimi grubunda 41 (%73,3) olmak üzere toplam 56 hasta çalışmaya alındı. Şiddet içermeyen intihar girişim grubunda sigara kullanımı, can sıkıntısı sebebiyle intihar girişimde bulunma ve gebeliğin canlı doğum ile sonlanması şiddet içeren gruba göre anlamlı olarak yüksek iken hastanede yatış süresi ve gebeliğin fetal ölüm ile sonlanması düşük idi (sırasıyla: p=0.04; p=0.006; p=0.004; p=0.004). Sonuç: İntihar girişiminde bulunan gebe hastalarımızın çoğunluğu şiddet içermeyen grupta yer almasına rağmen şiddet içeren intihar girişiminde bulunan gebelerin hastanede yatış süresi ve fetal ölüm sayısında belirgin artışa sebep olduğu görülmüştür

Hypokalemic periodic paralysis (HPP) is a disorder that characterized by attacks of skeletal muscle paralysis depending on the changes in serum potassium levels, and can occur due to primary and secondary causes. One of the secondary causes of HPP is distal renal tubular acidosis (DRTA). DRTA is a disorder that characterized by hypokalemia or hyperkalemia hypercalciuria, metabolic acidosis and alkaline urine. DRTA's clinical symptoms are listed as constipation, nausea, vomiting, kidney and skeletal muscle complications, nephrocalcinosis, urolithiasis and severe hypokalemia crisis. In this case report, we reported a patient who admitted to emergency department with complains of nausea, vomiting, and periodic muscle weakness and was diagnosed with hypokalemic periodic paralysis due to DRTA was presented.

This study aims to investigate the acute protective effect of montelukast sodium in hepatic injury secondary to acetaminophen (APAP) intoxication. This study used 60 rats. The rats were grouped into 6 groups. The control group was administered oral distilled water 10 ml/kg, the APAP group oral APAP 1 g/kg, the montelukast sodium (MK) group oral MK 30 mg/kg, the acetaminophen+N-acetylcysteine (APAP+NAC) group oral APAP 1 g/kg, followed by a single dose of intraperitoneal NAC 1.5 g/kg three hours later, the acetaminophen+montelukast sodium (APAP+MK) group oral APAP 1 g/kg, followed by oral MK 30 mg/kg 3 h later, the acetaminophen+N-acetylcysteine+montelukast sodium (APAP+NAC+MK) group oral APAP 1 g/kg, followed by a single intraperitoneal NAC 1.5 g/kg plus oral MK 30 mg/kg 3 h later. Blood and liver tissue samples were taken 24h after drug administration. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin were studied from the blood samples. Liver tissue samples were used for histopathological examination. Compared with the control group, serum AST and ALT activities were higher in the APAP and APAP+NAC groups. APAP+NAC, APAP+MK, and APAP+NAC+MK groups had reduced serum ALT and AST activities than the group administered APAP alone. APAP+MK and APAP+NAC+MK groups had a lower serum ALP activity than the control group. Histopathologically, there was a difference between the group administered APAP alone and the APAP+MK and APAP+NAC+MK groups. MK is as protective as NAC in liver tissue in APAP intoxication in rats.

Congenital heart defects with right-to-left shunt are one of the hypoxia-related causes of acquired secondary polycythemia (SP). Tetralogy of Fallot (ToF) is the most common congenital cyanotic heart disease in children. Cases of uncorrected ToF in adult ages are rare. This paper reports a woman detected with elevated hemoglobin level during routine tests performed for infertility therapy and subsequently diagnosed SP with related ToF.

The aim of the present study was to investigate the hepatoprotective and antioxidant effects of Lycium barbarum (LB) extract against paracetamol-induced acute oxidative stress and hepatotoxicity in rats. The subjects were divided into 6 groups of 8 rats each. The rats in the LB group were administered a dose of 100 mg/kg LB extract dissolved in saline via the intraperitoneal route for 7 days. Subsequently, after last dose of LB, PCT was given in a single dose of 1 g/kg diluted in saline via the oral route. Twenty-four hours later, blood samples were drawn from all of the subjects for serum Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Total antioxidant status (TAS) and Total oxidant status (TOS) tests, and liver tissue samples were obtained for histopathological evaluation. The mean TAS level of the group that was subjected to PCT intoxication was significantly lower than those of the other groups. Additionally, the mean TOS, Oxidative stress index (OSI), ALT and AST values were significantly higher in this group. Though the mean TAS level in the PCT + LB group was significantly higher than that of the PCT group, the TOS, OSI, ALT, and AST levels were significantly lower. When the PCT + LB group and the PCT only group were compared in terms of liver damage during the histopathological evaluation, a statistically significant difference was observed in Grade I and Grade III damage (P=0.013 and P=0.038, respectively). We conclude that Lycium barbarum extract leads to a significant improvement in PCT-induced acute hepatotoxicity in terms of the histopathological results, serum oxidative stress parameters, and serum liver function marker enzymes.

Toxic epidermal necrolysis (TEN) is a rare, life-threatening condition that is usually associated with medication use and characterized by separation of epidermis and dermis and a scalded skin appearance. A 71-year-old man presented to emergency department with fever, malaise, and hyperemic skin eruptions and bullae. Skin lesions covered more than 70% of total body surface area. Nikolsky sign was positive. He had been begun ceftriaxone for pneumonia before. TEN was considered as the initial diagnosis; the medication he used was stopped, appropriate supportive treatment was begun, and the patient was admitted to intensive care unit. He was discharged on 8th day after skin epithelization occurred. Toxic epidermal necrolysis is a highly fatal syndrome, in which early diagnosis, stopping the offensive drug, and administering appropriate supportive treatment are important components of the management. Toksik epidermal nekrolizis (TEN) nadir görülen, hayatı tehdit eden, ciltte epidermis dermis ayrışması yapan ve haşlanmış deri görünümü veren, genellikle ilaç kullanımı ile ilişkili bir klinik durumdur. Acil servise 71 yaşında erkek hasta ateş, halsizlik, ciltte hiperemik erüpsiyonlar ve büller ile başvurdu. Cilt lezyonları total vücut alanının %70’inden fazlaydı. Nikolsky bulgusu pozitifti. Hastaya 3 gün önce pnömoni tanısıyla seftriakson başlanmıştı. Hastada TEN düşünüldü. Kullandığı ilaç kesildi. Uygun destek tedavisi başlandı. Yoğun bakım ünitesine yatırıldı. Hasta 8. günde ciltte epitelizasyon gelişince tabucu edildi. TEN mortalitesi yüksek bir sendrom olup acil serviste erken tanı, sebep olan ilacın erken kesilmesi ve uygun destek tedavisinin verilmesi önemlidir.

This study investigated whether goji berry extract (GBE), a known antioxidant, reduces ischemic reperfusion injury when administered to rats exposed to experimental testis torsion. A total of 32 Sprague-Dawley male rats were randomized into 4 groups, including the control (sham), goji, torsion, and torsion-goji groups. The treatment groups received intraperitoneal GBE prior to torsion. The left testes of the animals were subjected to torsion via 5 hours of ischemia and 6 hours of reperfusion. TAC (total antioxidant capacity), TOS (total oxidant status) and OSI (oxidative stress index) levels were calculated. Approximately 5-μm-thick sections were stained with hematoxylin-eosin (H&E) and examined under a light microscope. Statistical analyses were performed with the SPSS 15 software package. The mean serum TAC level was significantly increased in Groups 2 and 4 compared with Groups 1 and 3 in biochemical analyses (for both P < 0.001). The mean serum TOS level was significantly increased in Group 3 compared with Groups 1, 2, and 4 (P < 0.001, P < 0.001, and P = 0.003, respectively). Comparison of the groups with regard to histopathological examination revealed that Group 4 exhibited a significantly higher rate of hemorrhage and congestion compared with Groups 1 and 2 (P = 0.038). The groups did not differ significantly with respect to degeneration. Ischemic reperfusion injury associated with testis torsion was reduced by the antioxidant effect of GBE. Further experimental and clinical studies are needed to confirm the agent’s efficacy for this indication.

Background: Early prediction of disease severity in acute pancreatitis (AP) is crucial. The aim of this study was to investigate the body-mass index (BMI), plasma leptin, nesfatin-1 and ghrelin levels as potential markers predicting peripancreatic necrosis and severity in acute pancreatitis. Methods: In the study period, 97 consecutive patients with AP were prospectively analysed. Severe AP was defined according to the Atlanta Criteria. BMI was also calculated. To measure plasma Leptin, Nesfatin-1 and Ghrelin concentrations, the blood samples were obtained from patients within 24 hours of admission. Results: Out of 97 patients, 92(70 females, 22 males) were considered eligible for analysis. Of the 92 patients, 30 patients (32.6%) were assessed as severe pancreatitis. BMI and leptin levels were significantly higher in patients with severe pancreatitis. The pooled sensitivity and specificity of BMI as a predictor for the development of pancreatic necrosis were 0.90(95%CI = 0.56–0.99) and 0.70(95%CI = 0.58–0.79), respectively; with an overall area under curve value of 0.78.The pooled sensitivity and specificity of leptin levels as a predictor for development of pancreatic necrosis were 1(95%CI = 0.69–1) and 0.73(95%CI = 0.62–0.82),respectively; with an overall area under curve value of 0.82.Nesfatin-1 and ghrelin levels showed no significant difference in patients with mild pancreatitis (6.97 ± 0.84 ng/ml and 2.3(1.0–9.9);respectively) and severe pancreatitis (6.74 ± 0.65 ng/ml and 2.0(1.9–9.9); respectively) (p = 0.1923 and 0.8531;respectively). Conclusion: BMI and plasma leptin levels both were correlated with the severity of pancreatitis. Leptin levels showed better area under the curve, sensitivity and specificity values compared to BMI in prediction of pancreatic necrosis.Nesfatin-1 and ghrelin levels were not found to be predictors of the severity of disease.

Giriş: Sülük enfestasyonu epistaksis, üst solunum yolu obstrüksiyonu, hemoptizi ve nefes darlığı gibi semptomlara sebep olabilir. Sülükler genellikle su içerken veya yıkanırken ağız ve burundan girebilir. Olgu Sunumu: Bu olguda aralıklı burun kanaması, burun tıkanıklığı, boğaz ağrısı ve nefes darlığı şikayetleri ile acil servise başvuran mental retarde bir hasta sunulmuştur. Sonuç: Bu belirtilerin orofarinks bölgesine tutunan sülükten kaynaklandığı anlaşılmıştır., Introduction: Leech infestations can lead to many symptoms, such as epistaxis, shortness of breath, obstruction of the upper respiratory tract, and hemoptysis. Leeches can often enter the body with drinking water or washing the mouth and nose.Case Report: In this case report, we presented a patient who was mentally retarded and admitted to emergency medicine with complaints, such as intermittent epistaxis, nasal congestion, sore throat, and shortness of breath.Conclusion: Finally, we understood that these symptoms were related to an oropharyngeal leech

Gallstone ileus is a rare but serious complication of cholelithiasis. It is a rare cause of small bowel obstruction but it accounts up to 25% of non-strangulated small bowel obstructions in elderly. Obstruction usually occurs in the terminal ileum. Although the most frequent mechanism of gallstone ileus is migration of the gallstone through a gallbladder-duodenal fistula, there have been cases of bowel obstruction caused by gallstones without any findings of bilio-enteric fistula during the operation. The diagnosis is usually delayed due to nonspecific clinical signs and symptoms. Abdominal computerized tomography (CT) scan is the optimal way to diagnose the gallstone ileus. It can identify the site and nature of the obstruction. The optimal surgical approach is a matter of debate. Enterolithotomy is the most performed operation. One stage operation should be performed in selected low risk patients. In this study, we report a 55 years old male patient who underwent surgical intervention due to gallstone ileus. During the operation, we observed that two individual gallstones lead to obstruction in anastomotic stricture which was due to the patient's prior small bowel resection. Also, no fistula was found during the operation between the gall bladder and the gastrointestinal tract of patient. The gallstones were removed by enterolithotomy. Because there was no gallstone in the gallbladder, we did not perform cholecystectomy. J Clin Exp Invest 2015; 6 (1): 72-74. Safra taşı ileusu, kolelitiazis'in nadir ama ciddi bir komplikasyonudur. İnce barsak tıkanıklıklarının nadir bir nedeni olmasına rağmen, yaşlılarda strangulasyon'a bağlı olmayan ince barsak tıkanıklıklarının %25'inin sebebidir. Tıkanıklık, genellikle terminal ileum'da gerçekleşir. Safra taşı ileusu'nun en sık oluş mekanizması safra kesesi duodenum arasındaki bir fistülden safra taşının migrasyonu olsa da, ameliyat sırasında bilio-enterik fistül saptanamayan vakalar da rapor edilmiştir. Hastalığın tanısı, nonspesifik belirti ve bulgular nedeniyle genellikle gecikir. Safra taşı ileusu tanısını koymada abdominal bilgisayarlı tomografi ideal olan bir yöntemdir. Tıkanıklığın yerini ve özelliğini gösterebilir. En uygun cerrahi yöntem ise tartışmalıdır. Enterolitotomi en sık uygulanan yöntemdir. Tek aşamalı ameliyat ise, sadece seçilmiş düşük riskli hastalarda yapılmalıdır. Bu çalışmamızda, safra taşı ileusu nedeniyle ameliyat ettiğimiz 55 yaşındaki erkek bir hastayı sunuyoruz. Ameliyatta, 2 adet safra taşının hastanın daha önce geçirdiği ince barsak rezeksiyonundan sonra oluşan anastomoz darlığında tıkanıklığa neden olduğu saptandı. Ayrıca, hastanın safra kesesi ile gastrointestinal kanalı arasında fistülün olmadığı da saptandı. Enterolitotomi ile safra taşları çıkartıldı. Safra kesesinde taş saptanmadığı için, kolesistektomi yapılmadı.

Paragangliomas are considerably rare and usually benign chromaffin cell tumors originating from sympathetic ganglia outside adrenal medulla. They are usually asymptomatic and detected incidentally. Tumor spread is through both lymphatic and hematogenous route. However, they may cause symptoms when excessively grown. They can be successfully treated with surgery even if they reach a gigantic size when they are diagnosed at an early period and lack metastases. From this perspective, early diagnosis and treatment of them is of great importance. In this study we present a patient presenting to emergency department with dyspnea and diagnosed with a giant paraganglioma in the anterior mediastinum.

Aims: Our study was undertaken to examine the laboratory and clinical features of pernicious anemia patients presenting initially at the Turgut Ozal Medical Center, which serves as an important tertiary health center in Eastern Anatolia. Study Design: Among patients evaluated for etiology of anemia, we analysed the clinicopathological characteristics of 300 (158 females and 142 males) patients with pernicious anemia retrospectively. Place and Duration of Study: Department of Internal Medicine and Division of Hematology, Inonu University School of Medicine, between 1996 and July 2011. Methodology: Full blood counts, thyroid hormone levels, liver function tests and LDH levels Original Research Article British Journal of Medicine & Medical Research, 4(3): 807-815, 2014 808 were reviewed for 300 patients with pernicious anemia retrospectively. Peripheral blood smears and bone marrow biopsies were reviewed by a hematologist. Endoscopic examination and ultrasonographic inspection were performed for atrophic gastritis, gallbladder stones and hepatosplenomegaly for all patients. Laboratory values, ages, signs and symptoms of patients at the time of diagnosis were compared between genders. Results: The mean age of the female patients was 50.56 ± 17.75 years (17–84), while that of the male patients was 57.24 ± 15.78 (20–95) years. At the time of diagnosis, the male patients were older than the females (p = 0.002). LDH levels were significantly higher for females (p = 0.043). The incidence of gallstones was significantly higher in females (25.4%) than in males (10.7%) (p = 0,001). Pancytopenia was defined as a hemoglobin level lower than 10 gr/dl, leukocytes lower than 1.500/μL and platelets lower than 150.000/μL and the incidence of pancytopenia was 41.3% (n = 65) and 50.7% (n = 71) in the female and male patients, respectively, and the difference was not statistically significant. There was no statistically significant difference for frequency of thyroid disease or symptoms and signs at the time of diagnosis between genders. Conclusions: Pernicious anemia is not a disease of only elderly women; it can be seen in both men and women of younger ages. It is seen nearly as often in women as in men. Gallstones and abnormal thyroid activity can be observed at these patients at the time of diagnosis; therefore, these findings should be considered.

Aim: To investigate the relationship between mean platelet volume (MPV) and in-hospital deep venous thrombosis (DVT). Material and methods: 147 patients with the diagnosis of DVT and 149 control participants were included in the study. For all participants, clinical risk factors, smoking status, and other demographic data were recorded from hospital registries. The data of patients with DVT were compared with the control participants. Results: Mean MPV was significantly higher in patients with DVT than the control group (8.91 ± 1.86 vs 7.86 ± 0.9; P < .001). Body mass index, smoking frequency, hematocrit, and platelet count were significantly correlated with MPV. Independent predictors of in-hospital DVT were MPV (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.2-1.87; P ≤ .001), body mass index (OR = 1.17; 95% CI = 1.04-1.34; P = .012), and smoking (OR = 1.83; 95% CI = 1.09-3.08; P = .023). Conclusion: Mean platelet volume was significantly higher in patients with DVT, and it is an independent predictor of in-hospital DVT.

Background. Data on the relationship between homocysteine, plasminogen activator inhibitor 1, hs-CRP, fibrinogen, and carotid intima media thickness (CA-IMT) is plenty but contradicting and the majority of the studies investigated this issue in only specific thyroidism groups. The aim of this paper was to investigate these relations in patients with subclinical and clinical hypo- and hyperthyroidism. Methods. In this cross-sectional study, 16 patients from each thyroidism group and 20 healthy cases were enrolled. Fibrinogen levels and plasminogen activator inhibitor 1 (PAI-1) activity were assessed. CA-IMT was determined by gray-scale high-resolution color Doppler ultrasound. Results. Serum homocysteine levels were higher in hypothyroidic patients compared to the control ( 𝑃 = 0 . 0 0 3 ). Fibrinogen levels were higher in patients with subclinical hypothyroidism compared to other groups ( 𝑃 < 0 . 0 5 ). There was no difference between groups regarding PAI-1. Whereas total cholesterol, homocysteine, and LDL were correlated with CAIMT, hs-CRP, PAI-1, and fibrinogen were not. In the clinical hypothyroidism group, the correlation of homocysteine with CA-IMT was derived from the correlation between CA-IMT and homocysteine. Conclusions. Homocysteine and fibrinogen levels are higher in patients with clinical and subclinical hypothyroidism, respectively. Homocysteine level is associated with CA-IMTonly in patients with clinical hypothyroidism.

Paraoxonase-1, a high-density lipoprotein linked enzyme complex, was shown to be decreased in several cardiovascular diseases. We aimed to explore whether serum paraoxonase and arylesterase activities differ in dipper and non-dipper prehypertensive subjects compared to healthy controls. Sixty prehypertensive subjects and 30 controls were enrolled. All subjects underwent echocardiographic assessment and 24-hour ambulatory blood pressure monitoring (ABPM). According to the blood pressure (BP) course on ABPM, prehypertensive subjects were categorized into two: non-dipper prehypertensive (NDPH) and dipper prehypertensive (DPH) groups. Serum paraoxonase and arylesterase activities were detected spectrophotometrically. Paraoxonase and arylesterase activities were significantly lower in patients with NDPH compared to both DPH and control groups. Both paraoxonase and arylesterase activities showed significant negative correlations with BP and left ventricular mass index. We have demonstrated that NDPH subjects have lower paraoxonase and arylesterase activities compared to DPH subjects and normotensives. Further prospective studies are needed to clarify the role of paraoxonase and arylesterase activities in the development of overt hypertension in prehypertensive subjects.