Mehmet Yavuz Danışık, Habibe Selmin Özensoy, Fatih Ahmet Kahraman, Mehmet Güllüoğlu, Alp Şener, Y. K. Günaydın, Hakan Oğuztürk
Aims: In our study, we aimed to compare the codes white given by the emergency services of two tertiary hospitals in Ankara, to reveal the significant differences between them and to discuss the reasons that may lead to these differences. Methods: In our study, we compared the codes white data given from the Emergency Medicine Department of Bilkent Ankara City Hospital (ABCH) and Ankara Training and Research Hospital (ATRH) between 01.01.2021 and 31.12.2022. We classified the data according to the gender, occupation, working hours of the violence, the person who caused the violence, and the type of violence. For research analysis, we grouped the data using Windows-based Microsoft 365 Excel, and for statistical analysis, we used IBM SPSS version 26. Results: The gender that was exposed to violence more in ABCH was women, the most frequent perpetrators were the relatives of the patients, and the type of violence experienced was verbal violence. In ATRH, male health workers were the most frequently exposed to violence, while the most frequent perpetrator was the patient himself, and more cases of physical violence were reported. Conclusion: There are significant differences between the incidents of violence in the emergency departments of the two hospitals, which have different socio-cultural environments due to their location.
目的：我们的研究旨在比较安卡拉两家三级医院急诊科提供的白色代码，揭示它们之间的显著差异，并讨论可能导致这些差异的原因：在研究中，我们比较了比勒肯特安卡拉市医院（ABCH）和安卡拉培训与研究医院（ATRH）急诊科在 2021 年 1 月 1 日至 2022 年 12 月 31 日期间提供的白色代码数据。我们根据性别、职业、暴力发生的工作时间、施暴者和暴力类型对数据进行了分类。为了进行研究分析，我们使用基于 Windows 的 Microsoft 365 Excel 对数据进行了分组，并使用 IBM SPSS 26.0 版对数据进行了统计分析：结果：在 ABCH 中，遭受暴力较多的性别是女性，最常见的施暴者是患者的亲属，暴力类型是语言暴力。结论：在阿富汗儿童和青少年健康中心，男性医务人员最常遭受暴力，而最常施暴者是病人本人，报告的身体暴力事件也较多：结论：两家医院由于地理位置不同，社会文化环境也不尽相同，因此其急诊科发生的暴力事件存在明显差异。
{"title":"Comparative analysis of codes white given by the emergency departments of two different third level hospitals in Ankara","authors":"Mehmet Yavuz Danışık, Habibe Selmin Özensoy, Fatih Ahmet Kahraman, Mehmet Güllüoğlu, Alp Şener, Y. K. Günaydın, Hakan Oğuztürk","doi":"10.51271/icjem-0028","DOIUrl":"https://doi.org/10.51271/icjem-0028","url":null,"abstract":"Aims: In our study, we aimed to compare the codes white given by the emergency services of two tertiary hospitals in Ankara, to reveal the significant differences between them and to discuss the reasons that may lead to these differences.\u0000Methods: In our study, we compared the codes white data given from the Emergency Medicine Department of Bilkent Ankara City Hospital (ABCH) and Ankara Training and Research Hospital (ATRH) between 01.01.2021 and 31.12.2022. We classified the data according to the gender, occupation, working hours of the violence, the person who caused the violence, and the type of violence. For research analysis, we grouped the data using Windows-based Microsoft 365 Excel, and for statistical analysis, we used IBM SPSS version 26.\u0000Results: The gender that was exposed to violence more in ABCH was women, the most frequent perpetrators were the\u0000relatives of the patients, and the type of violence experienced was verbal violence. In ATRH, male health workers were the\u0000most frequently exposed to violence, while the most frequent perpetrator was the patient himself, and more cases of physical violence were reported.\u0000Conclusion: There are significant differences between the incidents of violence in the emergency departments of the two\u0000hospitals, which have different socio-cultural environments due to their location.","PeriodicalId":479890,"journal":{"name":"Intercontinental Journal of Emergency Medicine","volume":"156 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140235506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emine Kadıoğlu, Serhat Karaman, Demet Acar, Emine Doğan, Nazlı Karakus Kenan, Asiye Muminat Cap, Emin Fatih Vişneci, Yavuz Yılmaz
Aims: Acute myocardial infarction (AMI) remains one of the leading causes of cardiovascular mortality. However, the parameters used to predict short-term mortality are limited. Glucose-potassium ratio (GPR) is a new biomarker that has been recently used. This study aimed to investigate the usefulness of GPR in predicting short-term mortality in patients diagnosed with AMI in the emergency department. Methods: This retrospective cohort study was conducted between January 1, 2022, and June 30, 2022, and included patients registered in the hospital emergency health system with IRB (Institutional Review Board) approval. Patients were identified based on inclusion criteria, and their demographic data, laboratory findings, and outcomes were recorded in the hospital registration system. Data comparisons between deceased and non-deceased patients were performed using the Student's t-test. Correlation analysis was performed using Spearman's correlation coefficients. A binary logistic regression model was created to determine the predictive parameters, and odds ratios and 95% confidence intervals (CI) were presented. Results: A total of 665 patients diagnosed with AMI were included in the study, with 75.9% of all patients being male and an average age of 62.14±11.62. A total of 6.6% of the patients included in the study died due to various causes during hospitalization. When laboratory values of deceased AMI patients were examined, statistically significant increases in glucose, urea, creatinine, WBC, neutrophil, lymphocyte, troponin, ckmb, and lactate levels were observed. The effects of GPR, NLR, PLR, lactate, and troponin levels on in-hospital mortality were analyzed using univariate logistic regression. GPR (95% CI 1.015-1.036, p=0.000), troponin (95% CI 1.001-1.001, p=0.000), and lactate (95% CI 1.437-1.908, p=0.000) were found to be the most important factors associated with mortality in patients with AMI. The ability to predict in-hospital mortality in AMI was compared, and GPR was found to have a higher predictive ability than troponin, a biomarker of myocardial damage (AUC: 0.729; P?=?0.000; Sensitivity:70%; Specificity:70%; Cut-off: 38.21). Conclusion: GPR, as a new and inexpensive biomarker, can be used to determine in-hospital mortality in patients with AMI. This index has a better predictive ability than troponin, NLR, and PLR, but is weaker than lactate.
目的：急性心肌梗死（AMI）仍是心血管疾病死亡的主要原因之一。然而，用于预测短期死亡率的参数却很有限。葡萄糖-钾比值（GPR）是最近使用的一种新生物标志物。本研究旨在探讨 GPR 在预测急诊科诊断为急性心肌梗死患者的短期死亡率方面的作用：这项回顾性队列研究在 2022 年 1 月 1 日至 2022 年 6 月 30 日期间进行，研究对象包括经 IRB（机构审查委员会）批准在医院急诊医疗系统登记的患者。根据纳入标准确定患者，并在医院登记系统中记录其人口统计学数据、实验室检查结果和预后。死亡和非死亡患者之间的数据比较采用学生 t 检验。相关性分析采用斯皮尔曼相关系数。建立了二元逻辑回归模型以确定预测参数，并给出了几率比和 95% 的置信区间 (CI)：研究共纳入了 665 名确诊为 AMI 的患者，其中 75.9% 为男性，平均年龄为（62.14±11.62）岁。共有 6.6% 的患者在住院期间因各种原因死亡。对已死亡的急性心肌梗死患者的化验值进行检查后发现，血糖、尿素、肌酐、白细胞、中性粒细胞、淋巴细胞、肌钙蛋白、ckmb 和乳酸盐水平均有统计学意义的显著增加。采用单变量逻辑回归分析了 GPR、NLR、PLR、乳酸和肌钙蛋白水平对院内死亡率的影响。结果发现，GPR（95% CI 1.015-1.036，p=0.000）、肌钙蛋白（95% CI 1.001-1.001，p=0.000）和乳酸盐（95% CI 1.437-1.908，p=0.000）是与急性心肌梗死患者死亡率相关的最重要因素。比较了预测急性心肌梗死患者院内死亡率的能力，发现 GPR 的预测能力高于心肌损伤的生物标志物肌钙蛋白（AUC：0.729；P=0.000；灵敏度：70%；特异度：70%；临界值：38.21）：结论：GPR作为一种新的、廉价的生物标志物，可用于确定AMI患者的院内死亡率。该指数的预测能力优于肌钙蛋白、NLR 和 PLR，但弱于乳酸。
{"title":"The new biomarker that predicts in-hospital mortality in myocardial infarction: glucose/potassium ratio","authors":"Emine Kadıoğlu, Serhat Karaman, Demet Acar, Emine Doğan, Nazlı Karakus Kenan, Asiye Muminat Cap, Emin Fatih Vişneci, Yavuz Yılmaz","doi":"10.51271/icjem-0027","DOIUrl":"https://doi.org/10.51271/icjem-0027","url":null,"abstract":"Aims: Acute myocardial infarction (AMI) remains one of the leading causes of cardiovascular mortality. However, the parameters used to predict short-term mortality are limited. Glucose-potassium ratio (GPR) is a new biomarker that has been recently used. This study aimed to investigate the usefulness of GPR in predicting short-term mortality in patients diagnosed with AMI in the emergency department.\u0000Methods: This retrospective cohort study was conducted between January 1, 2022, and June 30, 2022, and included patients registered in the hospital emergency health system with IRB (Institutional Review Board) approval. Patients were identified based on inclusion criteria, and their demographic data, laboratory findings, and outcomes were recorded in the hospital registration system. Data comparisons between deceased and non-deceased patients were performed using the Student's t-test. Correlation analysis was performed using Spearman's correlation coefficients. A binary logistic regression model was created to determine the predictive parameters, and odds ratios and 95% confidence intervals (CI) were presented.\u0000Results: A total of 665 patients diagnosed with AMI were included in the study, with 75.9% of all patients being male and an average age of 62.14±11.62. A total of 6.6% of the patients included in the study died due to various causes during hospitalization. When laboratory values of deceased AMI patients were examined, statistically significant increases in glucose, urea, creatinine, WBC, neutrophil, lymphocyte, troponin, ckmb, and lactate levels were observed. The effects of GPR, NLR, PLR, lactate, and troponin levels on in-hospital mortality were analyzed using univariate logistic regression. GPR (95% CI 1.015-1.036, p=0.000), troponin (95% CI 1.001-1.001, p=0.000), and lactate (95% CI 1.437-1.908, p=0.000) were found to be the most important factors associated with mortality in patients with AMI. The ability to predict in-hospital mortality in AMI was compared, and GPR was found to have a higher predictive ability than troponin, a biomarker of myocardial damage (AUC: 0.729; P?=?0.000; Sensitivity:70%; Specificity:70%; Cut-off: 38.21).\u0000Conclusion: GPR, as a new and inexpensive biomarker, can be used to determine in-hospital mortality in patients with AMI. This index has a better predictive ability than troponin, NLR, and PLR, but is weaker than lactate.","PeriodicalId":479890,"journal":{"name":"Intercontinental Journal of Emergency Medicine","volume":"146 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140235525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic aortic dissection is a complex and potentially life-threatening condition characterised by separation of the aortic wall layers. It causes diagnostic difficulties especially in the emergency department (ED) setting due to its different presentations and critical need for rapid treatment. In this case report, we describe a 79-year-old man with a history of hypertension and oral anticoagulant use who presented to the ED with atypical chest pain, nausea and dyspnea. Initial complaints, medical history, clinical evaluation and imaging were suggestive of chronic aortic dissection. The patient's clinical course, diagnostic work-up in the emergency department, including computed tomography angiography (CTA), and management strategy are discussed. The diagnostic challenges and decision-making process in the emergency department are highlighted. The successful outcome in this case is to demonstrate the importance of a high index of suspicion and rapid imaging in the emergency department for patients presenting with atypical symptoms and risk factors for aortic dissection. This case report aims to highlight the critical role of emergency medicine in the early recognition and management of chronic aortic dissection. It emphasises the need for awareness and rapid action in the emergency department to improve patient outcomes in this potentially dangerous condition.
{"title":"Chronic aortic dissection in the emergency department: a case report","authors":"Melih Çamcı, Ş. Gökhan, Fatih Ahmet Kahraman","doi":"10.51271/icjem-0031","DOIUrl":"https://doi.org/10.51271/icjem-0031","url":null,"abstract":"Chronic aortic dissection is a complex and potentially life-threatening condition characterised by separation of the aortic wall layers. It causes diagnostic difficulties especially in the emergency department (ED) setting due to its different presentations and critical need for rapid treatment. In this case report, we describe a 79-year-old man with a history of hypertension and oral anticoagulant use who presented to the ED with atypical chest pain, nausea and dyspnea. Initial complaints, medical history, clinical evaluation and imaging were suggestive of chronic aortic dissection. The patient's clinical course, diagnostic work-up in the emergency department, including computed tomography angiography (CTA), and management strategy are discussed. The diagnostic challenges and decision-making process in the emergency department are highlighted. The successful outcome in this case is to demonstrate the importance of a high index of suspicion and rapid imaging in the emergency department for patients presenting with atypical symptoms and risk factors for aortic dissection. This case report aims to highlight the critical role of emergency medicine in the early recognition and management of chronic aortic dissection. It emphasises the need for awareness and rapid action in the emergency department to improve patient outcomes in this potentially dangerous condition.","PeriodicalId":479890,"journal":{"name":"Intercontinental Journal of Emergency Medicine","volume":"154 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140235753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
İnsaf Karaca Bent, Harika Köşlük Gürler, Osman Ekinci
Aims: Electroconvulsive therapy (ECT) is based on stimulation of brain tissue with an electrical current and the induction of generalized convulsions. The aim of this study was to compare the use of rocuronium as a muscle relaxant and sugammadex as an antidote during ECT with succinylcholine in terms of its effect on adequate anesthesia, hemodynamics, and recovery. Methods: This study was planned as a single-center prospectively collected and retrospectively analyzed observational cohort study. Patients were divided into two groups as group S (succinylcholine) and group R+S (rocuronium and sugammadex). Patients were premedicated with 0.5 mg of atropine I.M. half an hour before the procedure. Propofol 1mg/kg was administered as an induction agent in both groups, succinylcholine 1mg/kg in Group S, and rocuronium 0.4mg/kg in Group R+S. Sugammadex 2mg/kg was administered as a rocuronium antidote. Vital signs were monitored throughout the procedure with ECG, spo2, and blood pressure monitoring. Results: There was a statistically significant difference between the two groups (Group S and Group R+S) in the time to return for spontaneous respiration (p=0.002). The mean SSS value was 111.78 seconds in Group S and 88.82 seconds in Group R+S. There was a statistically significant difference between the spontaneous eye-opening times between Group S and Group R+S. (p=0.017) The mean SGA value was 211.42 seconds in Group S and 173.12 seconds in Group R+S. There was a statistically significant difference between Group S and Group R+S in the duration of modified Aldrete score 9 (p=0.000<0.05). The mean duration of MAS 9 was 542.60 seconds in Group S and 410.54 seconds in Group R+S. Conclusion: In conclusion, although the high cost of rocuronium sugammadex limits its routine use in ECT anesthesia, it can be used as an ideal alternative agent in cases where succinylcholine is contraindicated or anticholinesterases are not suitable because it shortens the recovery time and the time to return of spontaneous respiration compared to succinylcholine.
{"title":"A comparison of the effects of succinylcholine and rocuronium on recovery time from anesthesia and vital signs in electroconvulsive therapy","authors":"İnsaf Karaca Bent, Harika Köşlük Gürler, Osman Ekinci","doi":"10.51271/icjem-0026","DOIUrl":"https://doi.org/10.51271/icjem-0026","url":null,"abstract":"Aims: Electroconvulsive therapy (ECT) is based on stimulation of brain tissue with an electrical current and the induction of generalized convulsions. The aim of this study was to compare the use of rocuronium as a muscle relaxant and sugammadex as an antidote during ECT with succinylcholine in terms of its effect on adequate anesthesia, hemodynamics, and recovery. \u0000Methods: This study was planned as a single-center prospectively collected and retrospectively analyzed observational cohort study. Patients were divided into two groups as group S (succinylcholine) and group R+S (rocuronium and sugammadex). Patients were premedicated with 0.5 mg of atropine I.M. half an hour before the procedure. Propofol 1mg/kg was administered as an induction agent in both groups, succinylcholine 1mg/kg in Group S, and rocuronium 0.4mg/kg in Group R+S. Sugammadex 2mg/kg was administered as a rocuronium antidote. Vital signs were monitored throughout the procedure with ECG, spo2, and blood pressure monitoring.\u0000Results: There was a statistically significant difference between the two groups (Group S and Group R+S) in the time to return for spontaneous respiration (p=0.002). The mean SSS value was 111.78 seconds in Group S and 88.82 seconds in Group R+S. There was a statistically significant difference between the spontaneous eye-opening times between Group S and Group R+S. (p=0.017) The mean SGA value was 211.42 seconds in Group S and 173.12 seconds in Group R+S. There was a statistically significant difference between Group S and Group R+S in the duration of modified Aldrete score 9 (p=0.000<0.05). The mean duration of MAS 9 was 542.60 seconds in Group S and 410.54 seconds in Group R+S.\u0000Conclusion: In conclusion, although the high cost of rocuronium sugammadex limits its routine use in ECT anesthesia, it can be used as an ideal alternative agent in cases where succinylcholine is contraindicated or anticholinesterases are not suitable because it shortens the recovery time and the time to return of spontaneous respiration compared to succinylcholine.","PeriodicalId":479890,"journal":{"name":"Intercontinental Journal of Emergency Medicine","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140235582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: The aim of this study is to investigate the reasons for presentation, diagnoses, and outcomes of patients with high fever in the emergency department. Methods: This research is a retrospective study planned by examining the files and data of patients who presented to the emergency department between 01.03.2021 and 01.03.2023, and whose body temperature was above 38 degrees Celsius. Patient data was analyzed from patient files and the Hospital Information Management System (HIMS). The demographic characteristics, vital signs at admission, reasons for presentation, diagnoses, and outcomes of patients with complete data from patient files and HIMS were investigated. Results: Of the 288 patients included in the study, 151 (52.4%) were male, and the mean age was 47.04 ± 18.75. When examining the reasons for patients' presentation to the emergency department, 79 (27.4%) patients presented with sore throat, and 44 (15.3%) patients presented with fever. When examining the final diagnoses of patients, acute tonsillopharyngitis was the most common diagnosis with 99 (34.4%) patients, followed by 30 (10.4%) patients with Covid-19. Regarding the outcomes of patients, 190 (66%) patients were discharged from the emergency department, 63 (21.9%) were admitted to the ward, and 26 (9%) were admitted to the intensive care unit. Conclusion: Cases with high fever in the emergency department encompass a wide range of conditions, ranging from mild viral upper respiratory tract infections to potentially fatal infections such as meningoencephalitis and myocarditis. Therefore, in febrile cases in the emergency department, serious infectious causes should be considered in terms of the focus of fever. Additionally, non-infectious causes should also be kept in mind as they can cause high fever.
{"title":"Infectious causes and outcomes of patients with high fever in the emergency department","authors":"M. I. Şaşmaz, Bülent Demir","doi":"10.51271/icjem-0029","DOIUrl":"https://doi.org/10.51271/icjem-0029","url":null,"abstract":"Aims: The aim of this study is to investigate the reasons for presentation, diagnoses, and outcomes of patients with high fever in the emergency department. \u0000Methods: This research is a retrospective study planned by examining the files and data of patients who presented to the emergency department between 01.03.2021 and 01.03.2023, and whose body temperature was above 38 degrees Celsius. Patient data was analyzed from patient files and the Hospital Information Management System (HIMS). The demographic characteristics, vital signs at admission, reasons for presentation, diagnoses, and outcomes of patients with complete data from patient files and HIMS were investigated.\u0000Results: Of the 288 patients included in the study, 151 (52.4%) were male, and the mean age was 47.04 ± 18.75. When examining the reasons for patients' presentation to the emergency department, 79 (27.4%) patients presented with sore throat, and 44 (15.3%) patients presented with fever. When examining the final diagnoses of patients, acute tonsillopharyngitis was the most common diagnosis with 99 (34.4%) patients, followed by 30 (10.4%) patients with Covid-19. Regarding the outcomes of patients, 190 (66%) patients were discharged from the emergency department, 63 (21.9%) were admitted to the ward, and 26 (9%) were admitted to the intensive care unit.\u0000Conclusion: Cases with high fever in the emergency department encompass a wide range of conditions, ranging from mild viral upper respiratory tract infections to potentially fatal infections such as meningoencephalitis and myocarditis. Therefore, in febrile cases in the emergency department, serious infectious causes should be considered in terms of the focus of fever. Additionally, non-infectious causes should also be kept in mind as they can cause high fever.","PeriodicalId":479890,"journal":{"name":"Intercontinental Journal of Emergency Medicine","volume":"186 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140235772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prurigo Nodularis is a skin disease, secondary to a chronic scratching behavior. As multiple etiologies were said to be the cause of this condition, no clear pathophysiology has been described, and treatment is still not readily available. An elderly patient presented to the Emergency Department for confusion was found to have multiple excoriating lesions on the abdomen, back and extremities. Multiple treatment regimens were tried to manage this skin disease prior to this admission, with no improvements. This patient was eventually diagnosed with Prurigo Nodularis and treatment was initiated. In this case report we discussed the etiologies, presentation and management of Prurigo Nodularis, while focusing on the case in hand.
{"title":"Psychogenic pruritis as a cause of prurigo nodularis: a case report","authors":"Cima Hamieh, Mahmoud El Hussein, Eric Revue","doi":"10.51271/icjem-0014","DOIUrl":"https://doi.org/10.51271/icjem-0014","url":null,"abstract":"Prurigo Nodularis is a skin disease, secondary to a chronic scratching behavior. As multiple etiologies were said to be the cause of this condition, no clear pathophysiology has been described, and treatment is still not readily available. An elderly patient presented to the Emergency Department for confusion was found to have multiple excoriating lesions on the abdomen, back and extremities. Multiple treatment regimens were tried to manage this skin disease prior to this admission, with no improvements. This patient was eventually diagnosed with Prurigo Nodularis and treatment was initiated. In this case report we discussed the etiologies, presentation and management of Prurigo Nodularis, while focusing on the case in hand.","PeriodicalId":479890,"journal":{"name":"Intercontinental Journal of Emergency Medicine","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135037913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: The aim of this study is to evaluate the clinical laboratory and demographic characteristics of children aged 0-18 with Type 1 Diabetes who applied to Kırıkkale University Hospital. Methods: Patients who applied to Kırıkkale University Medical Faculty Hospital between January 2011 and January 2021 and were diagnosed with Type 1 diabetes mellitus were included in the study. From file information; age at admission, age at diagnosis and laboratory values at admission were recorded. Results: Of the children, 48 (48.5%) were boys and 51 (51.5%) were girls. The mean age of all patients was 14.4±2.1 years. It was observed that its frequency increased during the adolescence period. It appeared that patients frequently increased in the autumn and winter months. Vitamin D was low in 74.4% of the patients. Statistical significance was found between HbA1c of those who applied to the hospital with a diagnosis of diabetic ketoacidosis. Conclusion: It is instructive to investigate the regional characteristics of the disease in terms of genetic and environmental factors that have an important place in the etiology. The findings of our study were consistent with similar studies and literature.
{"title":"Evaluation of children with type 1 diabetes in Kırıkkale","authors":"Erkan Karahan, Ayşegül Alpcan, Yaşar Kandur, Serkan Tursun, Ayça Törel Ergür, Serap Yörübulut","doi":"10.51271/icjem-0011","DOIUrl":"https://doi.org/10.51271/icjem-0011","url":null,"abstract":"Aims: The aim of this study is to evaluate the clinical laboratory and demographic characteristics of children aged 0-18 with Type 1 Diabetes who applied to Kırıkkale University Hospital.\u0000Methods: Patients who applied to Kırıkkale University Medical Faculty Hospital between January 2011 and January 2021 and were diagnosed with Type 1 diabetes mellitus were included in the study. From file information; age at admission, age at diagnosis and laboratory values at admission were recorded.\u0000Results: Of the children, 48 (48.5%) were boys and 51 (51.5%) were girls. The mean age of all patients was 14.4±2.1 years. It was observed that its frequency increased during the adolescence period. It appeared that patients frequently increased in the autumn and winter months. Vitamin D was low in 74.4% of the patients. Statistical significance was found between HbA1c of those who applied to the hospital with a diagnosis of diabetic ketoacidosis.\u0000Conclusion: It is instructive to investigate the regional characteristics of the disease in terms of genetic and environmental factors that have an important place in the etiology. The findings of our study were consistent with similar studies and literature.","PeriodicalId":479890,"journal":{"name":"Intercontinental Journal of Emergency Medicine","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135037916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mert Kan, Ertan Cömertpay, Buğra İlhan, Oğuz Eroğlu, Turgut Deniz
Aims: The numbers of two-wheeled vehicle (TWV) accidents are rising continually. Social isolation caused by the Covid-19 pandemic affected the frequency of such accidents. This study was conducted in order to examine the general characteristics of victims presenting to the emergency department due to TWV accidents and to investigate the effect of the pandemic on such incidents. Methods: This retrospective study involved patients involved in TWV accidents. Presentations made prior to 11 March, 2020, were classified as the pre-pandemic period and those made subsequently as the pandemic period. The type of TWV, the accident mechanism, victims’ demographic characteristics, possession of a driver’s license, crash helmet use, injuries observed in victims, trauma severity scores (Glasgow Coma Scale [GCS]; injury severity score [ISS]; and revised trauma score [RTS]), laboratory test and imaging results, victims’ clinical outcomes (discharge, admission, or exitus), and the daily numbers of presentations to the emergency department due to TWV accidents before and after the pandemic were recorded. Results: A-349 patients were included in the study, 77.3% involved in motorcycle accidents and 22.7% in bicycle accidents. The mean age of the entire victim group was 24.48±13.52 years, and 93.1% were male. Riders comprised 93.7% of the victims and passengers 6.3%. Driver’s licenses were possessed by 16.6% of the victims, and 9.5% wore crash helmets. Motorcycle accidents were most frequently due to ‘falls associated with loss of balance,’ and bicycle accidents as a results of ‘collision with another vehicle or object.’ The three most commonly injured regions were the extremities, head, and thorax. RTS levels were 10.13±3.51 before the pandemic and 11.98±0.20 during it(p=0.046). ISS levels were 16.07±21.27 before the pandemic and 13.29±17.28 during it(p=0.259). The pre-pandemic mortality rate was 3.9%, while no fatal accidents occurred during the pandemic(p=0.068). Daily numbers of presentations to the emergency department due to TWV accidents were 0.09 before the pandemic and 0.17 during it. Conclusion: TWV accidents are frequently observed among young/middle-aged men. The great majority do not hold driver’s licenses, and crash helmet use is low. The extremities are the most frequently injured regions in such accidents. The number of accident victims presenting to the emergency department due to TWV accidents during the pandemic was almost twice as high as in the pre-pandemic period. The trauma energy of accidents occurring during the pandemic was lower than that in the pre-pandemic period, victims suffered less harm from trauma, and mortality decreased.
{"title":"Injuries as a result of two-wheeler accidents and its relationship with the COVID-19 pandemic","authors":"Mert Kan, Ertan Cömertpay, Buğra İlhan, Oğuz Eroğlu, Turgut Deniz","doi":"10.51271/icjem-0013","DOIUrl":"https://doi.org/10.51271/icjem-0013","url":null,"abstract":"Aims: The numbers of two-wheeled vehicle (TWV) accidents are rising continually. Social isolation caused by the Covid-19 pandemic affected the frequency of such accidents. This study was conducted in order to examine the general characteristics of victims presenting to the emergency department due to TWV accidents and to investigate the effect of the pandemic on such incidents. Methods: This retrospective study involved patients involved in TWV accidents. Presentations made prior to 11 March, 2020, were classified as the pre-pandemic period and those made subsequently as the pandemic period. The type of TWV, the accident mechanism, victims’ demographic characteristics, possession of a driver’s license, crash helmet use, injuries observed in victims, trauma severity scores (Glasgow Coma Scale [GCS]; injury severity score [ISS]; and revised trauma score [RTS]), laboratory test and imaging results, victims’ clinical outcomes (discharge, admission, or exitus), and the daily numbers of presentations to the emergency department due to TWV accidents before and after the pandemic were recorded. Results: A-349 patients were included in the study, 77.3% involved in motorcycle accidents and 22.7% in bicycle accidents. The mean age of the entire victim group was 24.48±13.52 years, and 93.1% were male. Riders comprised 93.7% of the victims and passengers 6.3%. Driver’s licenses were possessed by 16.6% of the victims, and 9.5% wore crash helmets. Motorcycle accidents were most frequently due to ‘falls associated with loss of balance,’ and bicycle accidents as a results of ‘collision with another vehicle or object.’ The three most commonly injured regions were the extremities, head, and thorax. RTS levels were 10.13±3.51 before the pandemic and 11.98±0.20 during it(p=0.046). ISS levels were 16.07±21.27 before the pandemic and 13.29±17.28 during it(p=0.259). The pre-pandemic mortality rate was 3.9%, while no fatal accidents occurred during the pandemic(p=0.068). Daily numbers of presentations to the emergency department due to TWV accidents were 0.09 before the pandemic and 0.17 during it. Conclusion: TWV accidents are frequently observed among young/middle-aged men. The great majority do not hold driver’s licenses, and crash helmet use is low. The extremities are the most frequently injured regions in such accidents. The number of accident victims presenting to the emergency department due to TWV accidents during the pandemic was almost twice as high as in the pre-pandemic period. The trauma energy of accidents occurring during the pandemic was lower than that in the pre-pandemic period, victims suffered less harm from trauma, and mortality decreased.","PeriodicalId":479890,"journal":{"name":"Intercontinental Journal of Emergency Medicine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135037917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Umut Ocak, Fatih Arıcılar, Recep Sami Özay, Melih Yüksel, Mehmet Oğuzhan Ay, Halil Kaya
Meningoencephalitis, a potentially fatal condition marked by inflammation of the brain and medulla spinalis, can exhibit a wide range of symptoms. Streptococcus pneumonia, a gram-positive bacterium, is a common bacterial factor for this condition which can be challenging to diagnose due to its ability to resemble other diseases. Here, we report a case of a 48-years-old female with pneumococcal meningoencephalitis who presented with the symptoms of rhinitis, which is inflammation of the nasal passages and acute stroke treated with intravenous antibiotics and eventually admitted to the hospital. In this case report we would like to highlight that early diagnosis and proper treatment of meningoencephalitis are essential to improve patient outcomes, and physicians must recognize the central nervous system infections mimicking other diseases along with appropriate diagnostic approaches and management strategies.
{"title":"Streptococcus pneumonia-induced meningoencephalitis presenting as rhinitis and acute stroke!","authors":"Umut Ocak, Fatih Arıcılar, Recep Sami Özay, Melih Yüksel, Mehmet Oğuzhan Ay, Halil Kaya","doi":"10.51271/icjem-0015","DOIUrl":"https://doi.org/10.51271/icjem-0015","url":null,"abstract":"Meningoencephalitis, a potentially fatal condition marked by inflammation of the brain and medulla spinalis, can exhibit a wide range of symptoms. Streptococcus pneumonia, a gram-positive bacterium, is a common bacterial factor for this condition which can be challenging to diagnose due to its ability to resemble other diseases. Here, we report a case of a 48-years-old female with pneumococcal meningoencephalitis who presented with the symptoms of rhinitis, which is inflammation of the nasal passages and acute stroke treated with intravenous antibiotics and eventually admitted to the hospital. In this case report we would like to highlight that early diagnosis and proper treatment of meningoencephalitis are essential to improve patient outcomes, and physicians must recognize the central nervous system infections mimicking other diseases along with appropriate diagnostic approaches and management strategies.","PeriodicalId":479890,"journal":{"name":"Intercontinental Journal of Emergency Medicine","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135037914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
İsmail Tekin, Mustafa Alpaslan, Necmi Baykan, Şule Yakar, Ömer Salt
Aims: To perform a retrospective analysis of patients who applied to the covid emergency department of a pandemic hospital within one year. Methods: Patients who applied to the hospital-wide and covid emergency unit between 01.01.2021 and 31.12.2021 in a pandemic hospital were evaluated retrospectively through hospital electronic data. The time of admission, age range, tomography scan rate, and hospitalization rates were evaluated. In the statistical analysis, descriptive analyzes were performed using the Statistical Package for Social Sciences for Windows 21.0 (SPSS 21.0) program. Results: 0.9% of hospital admissions were made from the covid emergency area. 96.3% of the cases were citizens of the Republic of Türkiye. The female patient admission rate was 52.4%, which was higher than that of males. The highest number of applicants was between the ages of 18-65 (79.5%). While the highest number of applications in terms of months was in September (17.1%), the highest number of applications was between 08.00-16.00 (58.5%) in terms of hours. The tomography rate was 9.1%. 2% of hospitalizations were made to the ward and 0.4% to the intensive care unit. Conclusion: During the epidemic period, the way of patient management and patient’s application rates may vary in hospitals and emergency services. During the epidemic, the number of patients ?uctuates in the process and there may be di?erences in age groups. In all kinds of epidemics, it is thought that the data obtained in the past epidemics can guide the reorganization of hospital emergency services.
目的:对某大流行医院新冠肺炎急诊科一年内就诊的患者进行回顾性分析。方法:通过医院电子数据对某大流行医院2021年1月1日至2021年12月31日期间申请全院和急诊的患者进行回顾性评估。评估入院时间、年龄范围、断层扫描率和住院率。在统计分析中，使用SPSS 21.0 (statistical Package for Social Sciences for Windows 21.0)程序进行描述性分析。结果:0.9%的住院患者来自新冠肺炎急诊区。96.3%的病例是基耶共和国公民。女性住院率为52.4%，高于男性。其中，18 ~ 65岁的人最多(79.5%)。按月份计算，申请人数最多的是9月份(17.1%)，按小时计算，申请人数最多的是8.00-16.00(58.5%)。断层扫描率为9.1%。2%的住院是在病房，0.4%的住院是在重症监护病房。结论:在疫情期间，医院和急诊部门的患者管理方式和患者应用率可能存在差异。在疫情期间，患者人数会不断变化，可能会出现死亡。各年龄组的参考资料。在各类疫情中，认为以往疫情中获得的数据可以指导医院急诊业务的重组。
{"title":"Analysis of the patients who applied to the covid emergency polyclinic in the Cappadocia region","authors":"İsmail Tekin, Mustafa Alpaslan, Necmi Baykan, Şule Yakar, Ömer Salt","doi":"10.51271/icjem-0012","DOIUrl":"https://doi.org/10.51271/icjem-0012","url":null,"abstract":"Aims: To perform a retrospective analysis of patients who applied to the covid emergency department of a pandemic hospital within one year. Methods: Patients who applied to the hospital-wide and covid emergency unit between 01.01.2021 and 31.12.2021 in a pandemic hospital were evaluated retrospectively through hospital electronic data. The time of admission, age range, tomography scan rate, and hospitalization rates were evaluated. In the statistical analysis, descriptive analyzes were performed using the Statistical Package for Social Sciences for Windows 21.0 (SPSS 21.0) program. Results: 0.9% of hospital admissions were made from the covid emergency area. 96.3% of the cases were citizens of the Republic of Türkiye. The female patient admission rate was 52.4%, which was higher than that of males. The highest number of applicants was between the ages of 18-65 (79.5%). While the highest number of applications in terms of months was in September (17.1%), the highest number of applications was between 08.00-16.00 (58.5%) in terms of hours. The tomography rate was 9.1%. 2% of hospitalizations were made to the ward and 0.4% to the intensive care unit. Conclusion: During the epidemic period, the way of patient management and patient’s application rates may vary in hospitals and emergency services. During the epidemic, the number of patients ?uctuates in the process and there may be di?erences in age groups. In all kinds of epidemics, it is thought that the data obtained in the past epidemics can guide the reorganization of hospital emergency services.","PeriodicalId":479890,"journal":{"name":"Intercontinental Journal of Emergency Medicine","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135037915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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