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Öğe An investigation of cardiac effects in patients presenting to the pandemic clinic with suspected COVID-19(2022) Karslı, Aysun; Özsan, Sinan Oğuzhan; Comertpay, Ertan; Başkürkçü, Ahmet Faruk; Eroğlu, Oğuz; Deniz, TurgutAim: COVID-19 is a virus capable of causing cardiovascular complications. This study investigates whether any cardiac effect is present in patients presenting with suspected COVID-19 in the light of Electrocardiography (ECG) findings. Material and Method: This prospective study involved patients with chest pain presenting to the pandemic clinic with suspected COVID-19. Patients were divided into two groups based on their PCR results, PCR-positive and -negative. All participants’ demographic characteristics, presentation symptoms and the duration thereof, physical examination findings, laboratory results, and ECG findings were recorded. Patients with positive PCR results were invited for checks on the 15th day, when repeat ECG was performed. Results: A-50 patients with positive PCR results and 50 with negative PCR results were included in the study. The mean age of the entire patient group was 52.30±16.02 years, and 56% were women. No difference was determined between the positive and negative PCR result patients in terms of age or sex (p=0.116; 0.687, respectively). Presentation high sensitive cardiac Troponin (hs-cTn) levels were significantly higher in the patients with positive PCR results than in the PCR-negative patients (p<0.001). Rates of detection of ST-T change at presentation ECG were 38% in the patients with positive PCR results and 16% in those with negative PCR results (p=0.023). ST-T alteration persisted at 15th day ECG in 36% of the patients with positive PCR results. P-wave amplitude and mean heart rate were significantly higher at presentation ECG in the patients with positive PCR results than at ECG on day fifteen (p=0.038; <0.001 respectively). Conclusion: A cardiac effect does occur in patients with COVID-19, and this can be shown by means of ECG findings. The increase in P-wave amplitude at presentation ECG in patients with positive PCR results may represent a marker of COVID-19-related cardiac overload. ECG should be performed both at presentation and in the following days on COVID-19 patients presenting with chest pain, and care should be taken against potential ischemic ST-T alterations.Öğe Be Aware of Critical Drugs in Emergency Departments: An Extreme Iatrogenic Insulin Overdose via Subcutaneous and Intramuscular Routes(Emergency Medicine Physicians Assoc Turkey, 2021) Coşkun, Figen; Vural, Sevilay; Eroğlu, Oğuz; Cömertpay, Ertan; Durmaz, Senay ArıkanIntroduction: Insulin is a highly used parenteral medication in emergency departments. Although most severe insulin overdoses occur as suicide attempts, medication errors can be the reason. We aimed to highlight the potential medication errors in emergency departments due to the poor control of critical drugs like insulin and the similarities between the brand names of drugs, as we experienced during this case. Case Report: We present a 75-year-old diabetic woman with an extreme insulin overdose. A total of 3000 UI of insulin was administered by subcutaneous and intramuscular routes. She developed typical and atypical episodes of hypoglycemia requiring intravenous dextrose, a high-calorie diet, and glucagon administration. Almost all of the classic side effects of glucagon occurred during her intensive care unit follow-up. She recovered without any sequela or recurrence of hypoglycemia at the end of 5 days of admission. Conclusion: Insulin overdose can be a life-threatening condition by causing hypoglycemia. Albeit rare, insulin overdose can occur as a medication error in hospitals. To prevent such incidents for emergency departments, the medication errors should be objectively laid out, and proactive strategies should be integrated without adversely affecting acute care.Öğe Bir Çaydanlık Dolusu Datura: Hemoroidim Var Ama Umrumda Değil.(2017) Eroğlu, Oğuz; Çoşkun, Tijen; Kaya, Hatice Algan; Vural, Sevilay; Çoşkun, FigenDoğada sayısız çeşitte bitki bulunmaktadır. Bu bitkilerin bir kısmının insan hayatını tehdit edici özelliklere sahip olduğu bilinmekteyken, bir kısmının ise çiğnenerek, yutularak, içilerek, tüttürülerek veya sürülerek kullanılmasının bazı hastalıkları tedavi ettiğine inanılmaktadır. Çok eski zamanlardan beri devam eden bitkilerle tedavi etme alışkanlığı, bugün internet gibi kullanım ve ulaşım sahası sınırsız olan bir dünyada, her an gözümüze çarpmakta ve daha düne kadar halk arasında “kocakarı ilacı” olarak tarif edilen birtakım bitkiler, bilimsel formüllerle insanlara sunulmaktadır. Bitkisel tedavi kürü olarak sunulan bu formüller, hayatı tehdit edici zehirlenmelere neden olabilir. Bu yazıda internetten edinilen bir tarif sonrası, hemoroid tedavisi için kullanılan Datura Stramonium bitkisine bağlı zehirlenme olgusunun sunulması amaçlanmıştır.Öğe Cama Yumruk Atan Hastaların Demografik Özellikleri Ve Hava Koşulları İle İlişkisi(2017) Eroğlu, Oğuz; Koçak, Orhan Murat; Çoşkun, Figen; Deniz, TurgutGiriş: Eski çağlardan beri hava koşullarının insan davranışları üzerinde etkisi olduğuna inanılmaktadır. Yapılan çalışmalarda elde edilen farklı sonuçlardan dolayı, bu etki halen popülerliğini koruyan bir tartışma konusudur. Cama yumruk atma eylemi, ani gelişen, dürtüsel bir kendine zarar verme davranışıdır; hava koşullarının yanında altta yatan birçok sebeple ilişkilendirilebilir. Bu çalışma cama yumruk atma sebebiyle acil servise başvuran hastaların demografik özelliklerini ve hava koşullarından etkilenip etkilenmediğini araştırmak amacıyla yapılmıştır. Gereç ve Yöntem: Çalışmamız 01.Ocak.2013 ile 31.Aralık.2014 tarihleri arasında "Cama yumruk atma" eylemi sonucu acil servise başvuran hastalar üzerinde retrospektif olarak yapılmıştır. Hava koşullarına ait veriler Türkiye Cumhuriyeti Orman ve Su İşleri Bakanlığı Meteoroloji Genel Müdürlüğü'nden alınmıştır.Bulgular: Çalışmaya 69 hasta dahil edildi. Çalışma grubunun %82.6'sı (n=57) erkek, % 81.2'si (n=56) bekar, % 27.5'si (n=19) üniversite öğrencisi, % 15.9'u (n=11) işsiz, %73.9'unda (n=51) yaralanma dominant elde, %37.7'sinin (n=26) kan alkol testi pozitif, %14.5'inde (n=10) ise önceden tanısı konmuş psikiyatrikhastalık mevcut idi. Cama yumruk atma sebebiyle başvuran hastaların olay günü veya olaydan bir gün önceki hava koşullarından etkilenmediği ancak etiyolojik faktörlerin bir kısmının hava koşulları ile ilişkisi olduğu saptandı. Sonuç: Cama yumruk atma eylemi pek çok sebeple ilişkilidir. Bu eylemin gelişimi, yalnızca hava koşullarındaki değişikliklerle açıklanamaz; ancak bazı olguların hava koşullarındaki değişikliklerden etkilendiği, özellikle hava sıcaklığı veya basınç gibi değişkenlerin bu eylemi tetiklediği söylenebilir.Öğe DEMOGRAPHIC, ANATOMICAL AND CLINICAL FEATURES OF PATIENTS WITH GLASS-PUNCHING INJURIES(2018) Eroğlu, OğuzObjective: Glass-punching behavior may lead to simple injuries, or sometimes to permanent disabilities. The purpose of this study was to investigate the demographic, anatomical, and clinical features of patients presenting to the emergency department due to glass-punching, and to examine the relations between these factors. Material and Methods: This retrospective study was performed with patients presenting to the emergency department due to glass-punching. Patients’ demographic data, where the incident took place, its cause, patient’s alcohol and substance use, history of psychiatric disease, the scale of the resulting injury, its location, whether it occurred in the flexor or extensor zones, accompanying injuries, and treatments administered were recorded. The chi-square test was used for data comparisons. p values <0.05 were regarded as significant. Results: One hundred thirteen patents were included. Patients’ mean age was 25.39 ± 7.58 years and 88.5% were male. More than half of the patients (56.6%) were single, and 83.2% were injured on the right side. Alcohol consumption at time of injury was determined in 29.2%, and 12.4% of patients had a diagnosed psychiatric disease. The flexor zone 5 (33.6%) and zone 4 (18.6%), and the extensor aspect zone 5 (49.6%) and zone 6 (36.3%) were the most commonly injured regions. No correlation was determined between gender, marital status, or presence of psychiatric disease, and zone injuries (p>0.05). However, significant correlation was determined between extensor zone 4 injury and right-side injury, and alcohol use (p= 0.036; 0.014, respectively). Conclusion: Glass-punching behavior is commonly seen in males, in single subjects, and in the right hand. The most commonly affected regions in such injuries are extensor zones-5 and 6, and flexor zones-4 and 5. Extensor zone-4 injury is more common in right-handed subjects and those using alcohol.Öğe Effect of exposure to violence on the development of burnoutsyndrome in ambulance staff(2016) Deniz, Turgut; Saygun, Meral; Eroğlu, Oğuz; Ülger, Hüseyin; Azapoğlu, BurcuBackground/aim: The aim of this study is to determine the condition of ambulance staff (AS) who have been exposed to any kind of violence and to predict risk of development of burnout syndrome. Materials and methods: Our study was performed with 120 AS working for the Kırıkkale Ambulance Services. During the research, questionnaires collecting descriptive information and the extent of violence to which the AS were exposed were administered; participants were asked to fill out the questionnaire themselves. Results: It was found that 81 (67.5%) participants had been subjected to at least one type of violence (verbal or physical). Sixty-two percent were exposed to verbal abuse and 55.8% to verbal threats. Rates of physical threats and attacks were higher among male staff (P 0.036, P 0.022), while the rate of personal accomplishment was determined to be significantly lower in males (P 0.006). Emotional exhaustion and depersonalization scores were determined to be significantly higher in those who perceived less support from administrators (P 0.014, P 0.032). Conclusion: All kinds of negative situations exhaust an individual physically and mentally and lead to the development of burnout syndrome. AS are more prone to these kinds of situations.Öğe Evaluation of brain computed tomography results in pediatric traumas(2023) Cömertpay, Ertan; Özsan, Sinan Oğuzhan; Yeşilyurt, Ömer; Eroğlu, Oğuz; Vural, Sevilay; Coşkun, FigenAims: The use of brain computed tomography (CT) in the management of childhood head traumas is increasing every day. However, due to the more prominent harmful effects of radiation caused by CT in children and the increase in health expenditures, rules have been settled to determine brain CT indications, especially in children with mild head trauma. The aim of this study is to contribute to the literature by sharing the demographic characteristics, clinical findings and Brain CT results of pediatric patients who admitted to the emergency department (ED) with head trauma. Methods: The study was conducted retrospectively in children who admitted to Kırıkkale University Hospital ED with head trauma. The demographic characteristics of the patients, their complaints at admission, Glasgow coma score (GCS), examination findings, follow-up and treatment management in the ED, and brain CT results were recorded. Chi-square test was used to compare the data. A value of p<0.05 was considered statistically significant. Results: 234 children with head trauma were included in the study. Mean age of the study group was: 9.13±6.36 /years and 57.3% (n=134) were males. While 7.2% of the children were <2 years old, 92.8% of them were ?2 years old. Mean GCS was 14.92±0.79. Falling from a height was the most common cause of head trauma with 30.8%, followed by falling from the same level with 21.8% and in-vehicle traffic accident with 18.4%. Headache (37.2%), nausea-vomiting (36.8%) and loss of consciousness (13.7%) were the three most common admission symptoms after head trauma. Headache was found to be significantly higher in the ?2 age group and nausea-vomiting in the <2 age group compared to the other group (p=0.006; p<0.001, respectively). While 97.9% of brain CT results were normal, the most common pathological finding was linear fracture (2.1%). In terms of brain CT results, no difference was found between children <2 years and ?2 years of age (p=0.527). Conclusion: Majority of the pediatric patients we evaluated in our study had minor head trauma, and most of the brain CT results were normal. Headache, nausea, vomiting, and loss of consciousness were the three most common symptoms after head trauma. Nausea-vomiting was observed more frequently in children aged <2 years and headache was observed inchildren aged ?2 years after head trauma, compared to other age groups.Öğe Medical students' knowledge of ultrasonography: effects of a simulation-based ultrasound training program(African Field Epidemiology Network-Afenet, 2018) Eroğlu, Oğuz; Coşkun, FigenIntroduction: The use of simulation devices in medical education is becoming more prevalent with each passing day. The present study aimed to teach medical students to perform ultrasonography via a simulation-based ultrasound training program. Methods: The study was prospectively conducted on final year medical students who had not received previous ultrasound training and who came to the Emergency Department of the Kirikkale University Faculty of Medicine between July 2015 and July 2016. Ultrasound training was provided by two emergency department specialists who are qualified in this field. The training time was determined to be 20h (4h for theoretical lessons, 16h for hands-on). The students were evaluated by a theory test and practical application exam both before and after training. Results: Obtained were compared using the paired sample t-test, and p < 0.05 was considered to be significant. Results: Ninety-six final year medical students were included. Their mean age was 24.1 +/- 2.1 years. The mean test score obtained in the theoretical exam before training was 7.9 +/- 2.2, while that after training was 17.1 +/- 1.6 (p < 0.0001). The mean score obtained in the practical application exam before training was 1.1 +/- 0.9 points and that after training was 10.9 +/- 0.2 points (p < 0.0001). Conclusion: Medical students can learn to use an ultrasound device within a short period of time via simulation-based training programs. New studies must be conducted for the inclusion of ultrasound training programs in the medical education curriculum.Öğe METANOL ZEHİRLENMESİ NEDENİYLE ACİL SERVİSE BAŞVURAN HASTALARIN RETROSPEKTİF ANALİZİ(2021) Cömertpay, Ertan; Eroğlu, Oğuz; Deniz, TurgutAmaç: Metanol zehirlenmesi ülkemizde son zamanlarda sıkça karşılaşılan bir zehirlenme türüdür. Zehirlenme durumunda vakaların hızla tanınıp tedavi altına alınması sayesinde mortalite ve morbidite oranları azaltılabilir.Bu çalışmanın amacı, acil servise başvuran metanol zehirlenmesi hastalarının demografik özellikleri, fizik muayene bulguları ve laboratuvar sonuçları ile sağ kalım arasındaki ilişkiyi araştırmaktır.Gereç ve Yöntemler: Hastalar metanol zehirlenmesi sonrası eksitus olanlar ve hayatta kalanlar olmak üzere 2 farklı gruba ayrıldı. Tüm hastaların demografik özellikleri, başvuru şikayetleri, fizik muayene bulguları ve laboratuvar sonuçları ve klinik sonlanımları kaydedildi. Grupların karşılaştırılmasında Chi-square, Student t-test ve Mann-Whitney U testi kullanıldı. p<0.05 değeri istatistiksel olarak anlamlı kabul edildi.Bulgular: Çalışmaya metanol zehirlenmesi sonrası eksitus olan (n=5) ve hayatta kalanlar (n=12) olmak üzere toplam 17 hasta dahil edildi. Metanol zehirlenmesi sonrası en sık başvuru şikâyeti görme bozukluğu (%70.6) iken, bunu nefes darlığı (%35.3) ve bulantı-kusma (%35.3) takip ediyordu. Gruplar arasında başvuru şikâyeti bakımından farklılık saptanmadı. Her iki grupta da başta solunum sayısı (hiperventilasyon) olmak üzere vital bulguların ortalama değeri, normal değerinin üstündeydi. Ancak, vital bulgular bakımından gruplar arasında farklılık saptanmadı. Eksitus olan hasta grubundaki kreatinin düzeyi ve baz açığı seviyesi hayatta kalan gruptakilere göre anlamlı olarak artmışken, bikarbonat ve pH düzeyi ise anlamlı oranda azalmış olarak tespit edildi (sırasıyla p=0.015; 0.002, 0.020; 0.002).Sonuç: Metanol zehirlenmesi sonrası ölen hastalarda, kreatinin değerindeki ve baz defisitindeki artış, derinleşen asidoz ve azalmış bikarbonat düzeyi kötü klinik sonlanımla uyumludur. Görme bozukluğuna eşlik eden hiperventilasyon ve bilinç kaybı durumlarında metanol zehirlenmesi akla gelmeli ve bir an önce uygun tedavi prosedürlerine başlanmalıdır.Öğe Osborn wave in hypothermia and relation to mortality(W B Saunders Co-Elsevier Inc, 2019) Eroğlu, Oğuz; Serbest, Sancar; Küfeciler, Tarkan; Kalkan, AsımBackground & aim: The aim of this study was to compare hypothermia patients with and without an Osborn wave (OW) in terms of physical examination findings, laboratory results, and clinical survival. Methods: The study was carried out retrospectively on hypothermic patients. The hypothermic patients were divided into two groups. Group 1 comprised patients with OW on electrocardiogram (ECG), and Group 2 comprised patients without OW on ECG. The Mann-Whitney U test was used to compare the two groups, and the relationships between the variables and the presence of OW and mortality were analyzed with ANOVA. A value of p < 0.05 was considered statistically significant. Results: OW was detected on ECG of 41.9% of the patients (Group 1). The mean body temperature was 30.8 +/- 4.1 degrees C in Group 1 and 33.3 +/- 1.6 degrees C in Group 2 (p = 0.106). The mean creatinine level was 1.01 +/- 0.6 mg/dl in Group 1 and 0.73 +/- 0.5 mg/dl in Group 2 (p = 0.046). The mean bicarbonate level was 15.9 +/- 3.8 mmol/l in Group 1 and 18.6 +/- 3.5 mmol/l in Group 2 (p = 0.038). A relationship was determined between the presence of OW and pH, bicarbonate, and creatinine levels (p = 0.026; 0.013; 0.042, respectively). The mortality rate was 69.2% in Group 1 and 77.8% in Group 2 (p = 0.689). Conclusion: Although there is a relationship between the decrease in bicarbonate levels, changes in kidney functions that cause acidosis, and the presence of OW, it has no effect on mortality. The presence of OW in hypothermic patients is insufficient to make a decision regarding mortality. (C) 2018 Elsevier Inc. All rights reserved.Öğe Significance of thiol/disulphide homeostasis and ischemia modified albumin levels in chronic obstructive pulmonary disease(2019) Eroğlu, Oğuz; Badem, Nermin Dindar; Baccıoğlu, Ayşe; Cömertpay, Ertan; Neselioglu, Salim; Erel, ÖzcanObjectives: The severity of inflammation occurring during chronic obstructive pulmonary disease (COPD) isclosely associated with oxidative stress. The aim of this study was to investigate the diagnostic value ofThiol/disulphide homeostasis (TDH) and ischemia modified albumin (IMA) levels in evaluating oxidativestress in COPD patients.Methods: This prospective study was performed with COPD patients presenting to the Kırıkkale UniversityHospital and with healthy volunteers. Subjects’ demographic data (age, sex, body mass index, and smokingstatus), native thiol (NT), total thiol (TT), disulphide (Ds), IMA levels and Ds/NT, Ds/TT and NT/TT ratioswere recorded. Statistical analysis was performed with SPSS 21.0 software.Results: One hundred ninety subjects were enrolled in the study, 141 COPD patients and 49 healthy volunteers.No difference was determined between the patient and control groups in terms of age, sex or body mass index.The antioxidant markers; NT and TT levels and NT/TT ratio were significantly lower in the patient groupcompared to the control group (p < 0.001, p < 0.001, and p < 0.003, respectively). The oxidant markers; IMAlevels and Ds/NT and Ds/TT ratios were significantly higher in the patient group (p = 0.006, p = 0.003, and p= 0.003, respectively). Significant negative correlation was determined between antioxidant and oxidantparameters. Sensitivity values were NT: 87.2%, TT: 83.3%, Ds/NT ratio: 68.1%, Ds/TT ratio: 68.1%, and IMA:77.8%.Conclusions: TDH was impaired in favor oxidants in COPD patients. TDH parameters and IMA can be usedto monitor oxidative stress emerging in COPD.Öğe The relation between performance and oral health in male athletes(2019) Yapıcı, Hakan; Eroğlu, Oğuz; Ayan, Sinan; Bağlar, Serdar; Memiş, Uğur Altay; Doğan, Ali AhmetObjectives: .Oral health is as important to an athlete’s sporting successas regular exercise and adequatenutrition. The aim of this study was to investigate the relation between oral health and sporting performance.Methods: This prospective study was carried out with male athletes. Athletes' demographic characteristics,dental care habits, number of decayed, missing or filled teeth, and sporting performance data were recorded.The Decayed Missing Filled Teeth (DMFT) index, Significant Caries index (SCI) and Plaque index (PI) wereused to assess oral health. The T-Drill, Zig-Zag, Lateral Change of Direction (LCD) and 505 tests to assessagility, and 10-, 20- and 30-m short sprint tests were used to assess speed. The results were analyzed on SPSSsoftware, and p values < 0.05 were regarded as significant.Results: Ninety-six athletes were included in the study. Active caries was determined in 70.8%. The meanDMFT index value was 3.9 ± 3.7, mean SCI 10.2, and mean PI 0.9 ± 0.4. DMFT was ? 4 in 45.8% of athletesand < 4 in 57.2%. No difference was determined between subjects with DMFT < 4 and DMFT ? 4 in terms ofage, height, body weight, or years engaged in sports. Agility and speed tests results were superior in subjectswith DMFT<4 than in those with DMFT ? 4, and times to completion of performance tests were shorter (p <0.05). Pearson correlation analysis revealed that DMFT was positively correlated with agility tests [T-Drill test(r = 0.428), Zig-Zag test (r = 0.428), LCD test (r = 0.286) and 505 test (r = 0.529)], and speed tests [shortsprint, 10-m (r = 0.309), 20-m (r = 0.336), 30-m (r = 0.449)] (p < 0.05).Conclusion: Impairment of oral health has an adverse effect on sporting performance, and this can lead topoorer results in performance tests such as agility and speed.
