Mallory-Weiss syndrome is characterized by a mucosa rupture on the gastroesophageal junction and usually associated with intense retching, cough, straining, or vomiting. Methanol intoxication is a cause for severe mortality and morbidity. We aimed to emphasize the lifesaving importance of history taking, rapid diagnosis, and treatment for Mallory-Weiss syndrome secondary to methanol intoxication in the present case. A 54-year old male patient admitted to the emergency service by ambulance with the complaint of bloody vomiting. The patient's overall condition was moderate, and he was confused. He was taken into the resuscitation room. The patient was admitted to urgent endoscopy because of active bleeding. It was detected that he had drunk the alcohol that he made at home and presented bloody vomiting when he woke up in the morning. The patient was diagnosed with methanol intoxication and upper gastrointestinal system (GIS) bleeding. After intravenous infusion of 10 mL/kg loading dose of 10% ethanol, infusion continued by 1.5 mL/kg/hour. Urgent hemodialysis was implemented after infusion of 1 mEq/kg NaHCO 3 into the patient presenting severe acidosis. The patient was admitted for further tests and treatment after hemodialysis; he was discharged by cure after nine days. Mallory-Weiss syndrome may develop in GIS bleeding cases triggered by vomiting and have mortal causes. The complaints that start with severe vomiting may be caused by fatal conditions such as methanol intoxication like in the present case. Therefore, a detailed patient history, as well as rapid diagnosis and treatment by emergency clinicians, have vital importance.

Objective: This study aimed to examine the effect of the pandemic on hospital mortality and patient admission in four months since March 2020 when the Ministry of Health announced the first confirmed COVID-19 case in Turkey and the first wave occurred. Material-Method: This research is a single-centre, retrospective, cross-sectional descriptive study. It covers the periods between March 01 and Jun 30 of 2018, 2019, and 2020. Results: Between 2018-2020, 897522, 972799, and 395438 patients were admitted to our Hospital, respectively. It was observed that the number of admissions decreased by 55-60% in 2020 compared to the previous years (p=0.001). Moreover, 205318 (22.9%) of the admissions in 2018, 229278 (23.6%) of the admissions in 2019, and 1127293 (32%) of the admissions in 2020 were emergency room (ER) admissions. Especially in 2020, there was a significant increase in the overall in-hospital (p=0.001) and ER (p=0.001 mortality rates compared to previous years. In-hospital mortality was found to be higher, especially in patients with suspected COVID-19 (p=0.001). It was found that the number of deaths due to respiratory causes was significantly increased in 2020 compared to the previous years (p=0.001). Conclusion: The COVID-19 pandemic has led to significant changes in mortality rates and causes of mortality compared to previous years. Although the pandemic has affected all healthcare systems, ER and intensive care units (ICU) are seriously affected.

Mallory-Weiss syndrome is characterized by a mucosa rupture on the gastroesophageal junction and usually associated with intense retching, cough, straining, or vomiting. Methanol intoxication is a cause for severe mortality and morbidity. We aimed to emphasize the lifesaving importance of history taking, rapid diagnosis, and treatment for Mallory-Weiss syndrome secondary to methanol intoxication in the present case. A 54-year old male patient admitted to the emergency service by ambulance with the complaint of bloody vomiting. The patient's overall condition was moderate, and he was confused. He was taken into the resuscitation room. The patient was admitted to urgent endoscopy because of active bleeding. It was detected that he had drunk the alcohol that he made at home and presented bloody vomiting when he woke up in the morning. The patient was diagnosed with methanol intoxication and upper gastrointestinal system (GIS) bleeding. After intravenous infusion of 10 mL/kg loading dose of 10% ethanol, infusion continued by 1.5 mL/kg/hour. Urgent hemodialysis was implemented after infusion of 1 mEq/kg NaHCO 3 into the patient presenting severe acidosis. The patient was admitted for further tests and treatment after hemodialysis; he was discharged by cure after nine days. Mallory-Weiss syndrome may develop in GIS bleeding cases triggered by vomiting and have mortal causes. The complaints that start with severe vomiting may be caused by fatal conditions such as methanol intoxication like in the present case. Therefore, a detailed patient history, as well as rapid diagnosis and treatment by emergency clinicians, have vital importance.

The frequency of use of many food supplements sold under the name of herbal products has increased today. As a result of easy access to the whole society with tools such as television, radio and especially the internet, many such products sold uncontrolled and outside the control of physicians can cause serious health problems. Our case reports a 65-year-old male patient who was admitted to the emergency service with a headache and left arm numbness. In the detailed history taken, it was learned that he used a herbal product without the recommendation and control of the physician in order to increase sexual power. It was learned that he did not have any known disease, operation, and medicine used under the control of a physician. It is known that such herbal products cause serious neurological events. The use of these products should be questioned, especially in patients who are admitted to the emergency department with acute neurological complaints and have no apparent medical history.

Amaç: İntihar, kişinin istemli olarak özbenliğine yönelmiş bir saldırganlık halidir. Her geçen gün mortalite ve morbitide oranları artan intihar vakaları önemli bir halk sağlığı sorunudur. Bu çalışmada, intihar girişimi nedeni ile başvuran hastaların demografik özellikleri, intihar girişimi yöntemlerinin değişken klinik faktörleri ile değerlendirilmesi ve sonuçlarla literatüre katkıda bulunulması amaçlanmıştır.

BACKGROUND: The aim of the present study was to detect the prognostic importance of lactate and other blood gas parameters for mortality prediction in patients with critical malignancies referring to the emergency service. The general condition of patients with malignancy who have referred to the emergency department should be evaluated and it should be shown that they are not in any oncological emergency. It is a highly significant predictor of mortality after sepsis and shock in hyperlactatemia accompanying metabolic acidosis. It is significantly used for treatment monitoring.METHODS: This study was planned prospective and observational study. The patients enrolled were divided into two groups including survivor and non-survivor depending on 30-day mortality. The primary outcome of the study was determined as following the mortality within 30 days.RESULTS: The mean lactate level was 1.9 (1.4-2.5) mmol/L in the survivor group, and 2.6 (1.9-4.4) mmol/L in the non-survivor group; a significant difference was obtained between both groups (p<0.001). When the cut-off value of the lactate was determined as >2.95 mmol/L in order to differentiate the survivors from nonsurvivors, the sensitivity and specificity were detected as 35.0% and 86.1%, respectively. It was detected by the multivariate regression analysis that lactate predicts the 30-day mortality with a higher significance level in patients with critical malignancies.CONCLUSIONS: It was concluded that lactate is a good predictor and may be used safely in predicting 30-day mortality in patients with any critical malignancy referring to the emergency department.