Acute appendicitis is the most common cause of acute abdominal pain, requiring emergency surgery. Approximately one third of cases have pain unexcepted location due to its various anatomical location. Acute appendicitis is a very rare cause of left lower quadrant pain; if it occurs, a few congenital anomalies should be considered such as Situs Inversus totalis and Midgut Malrotation (MM). MM is a rare congenital anomaly; it occurs due to error in process of rotation or fixation of intestines around the superior mesenteric vessels and it refers to nonrotation or incomplete rotation of intestines. Here we report a case who presented with left lower abdominal pain and was diagnosed with acute perforated appendicitis with intestinal nonrotation. Clinicians should be aware that intestinal nonrotation may be presented with left lower quadrant pain and complicated by acute appendicitis.
Core–shell quantum dot ZnS/CdSe screen-printed electrodes were used to electrochemically measure human blood plasma levels of exogenous adrenaline administered to cardiac arrest patients. The electrochemical behavior of adrenaline on the modified electrode surface was investigated using differential pulse voltammetry (DPV), cyclic voltammetry, and electrochemical impedance spectroscopy (EIS). Under optimal conditions, the linear working ranges of the modified electrode were 0.001–3 μM (DPV) and 0.001–300 μM (EIS). The best limit of detection for this concentration range was 2.79 × 10–8 μM (DPV). The modified electrodes showed good reproducibility, stability, and sensitivity and successfully detected adrenaline levels.
Aim: Spontaneous rupture of an arachnoid cyst resulting in a subdural hygroma is an infrequent event. We report an adult patient who had no previous neuroimaging and had acute onset headache, dizziness, and nausea unrelated to trauma.Case: A 67-year-old male patient was brought to the emergency service complaints of sudden onset of dizziness, headache, and vomiting while working in the garden. He described ongoing nausea and headache localized to the frontal region. Brain CT imaging was planned for the patient whose nausea and dizziness worsened while his symptomatic treatment continued. In the brain CT, a large hypodense extracerebral collection was detected in the area starting from the middle fossa in the right cerebral hemisphere and extending to the convexity level in the frontoparietal region. The patient was consulted in the neurosurgery unit. Surgical intervention was not considered, and the patient was admitted to the neurosurgery service for treatment. Due to the asymptomatic course in the service follow-ups, he was discharged with outpatient clinic control recommendations.Conclusion: This case illustrates the importance of recognizing the possibility of spontaneous rupture of an arachnoid cyst. This phenomenon should be considered as a differential diagnosis in patients without head trauma. Although it is rare, being aware of such a case is helpful in preventing possible bad outcomes.
Objective: Due to the high mortality levels associated with the novel coronavirus, reliable predictors for determining disease mortality and severity are needed to permit the careful allocation of health services and for earlier clinical intervention and follow-up. The purpose of this study was to determine the predictive value of the C-reactive protein (CRP)/albumin ratio (CAR) and the fibrinogen/albumin ratio (FAR) in determining mortality and evaluate correlations between these values and thoracic computed tomography (CT) findings. Material and Methods: COVID-19 patients aged over 65 presenting to the emergency department of a tertiary training and research hospital between Oct 15, 2021, and Jan 15, 2022, were examined in this single-center, retrospective study. The study population was established based on inclusion and exclusion criteria. The patients’ mortality status and pulmonary involvement percentages were compared with their laboratory parameters. Results: The relationships between patients’ CAR and FAR values and mortality and disease severity were investigated. Cut-off points of 3.0 for CAR (AUC 0.767, sensitivity 76.5% and specificity 70.1%) and 14.4 for FAR (AUC 0.731, sensitivity 75.0% and specificity 69.0%) were determined for the prediction of mortality. In terms of prediction of disease severity, cut-off points were 4.2 for CAR (AUC 0.786, sensitivity 73.7%, and specificity 75.2%) and 15.2 for FAR (AUC 0.789, sensitivity 84.2%, and specificity 69.6%). Conclusion: Based on our study findings, CAR and FAR values may be useful in the early differentiation of mortality and pulmonary parenchymal involvement in elderly COVID-19 patients.
Aortic dissection is a fatal cardiovascular health problem. Chest and back pain are among the common complaints of the patients, and they may also apply with atypical clinics. It is very difficult to diagnose with examination and anamnesis, especially in patients who present with poor consciousness and stroke symptoms. In this study, we wanted to present a 62-year-old female patient who had syncope at home and was unconscious for about 1 hour, has stroke symptoms, and aortic dissection was detected in her examinations. When no hemorrhage was detected in non-contrast brain CT, neck and brain contrast-enhanced CT angiography imaging was performed. Aortic dissection flap extending to the right carotid communis was detected in the imaging. Clinicians should pay attention to detailed examination and be alert for further examinations in order not to harm the patient in terms of underlying causes, especially in unconscious patients who have a stroke clinic and cannot express their complaints in a healthy way.
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