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Aim: Massive methanol poisonings have occurred in the past decades, resulting in a large number of deaths. In this study, our aim is to retrospectively analyze methanol poisoning cases admitted to the emergency department between 2019-2021, to evaluate their demographic characteristics, causes of poisoning, clinical and laboratory findings, treatments applied and mortality, and to contribute to the poisoning data of our country. Material and Method: The cases of methanol poisoning who applied to the emergency department in a 3-year period were analyzed retrospectively. Medical files of patients aged 18 years and older were reviewed. Patients diagnosed with 'methanol poisoning' as a result of the examination were included in the study. Results: A total of 59 patients were included in the study. 88% (n=52) of the patients with a mean age of 53±10 were male. The presence of neurological symptoms and GCS were associated with mortality among the symptoms of patients presenting to the emergency department (p=0.017, p

Aim: Tube thoracostomy is an interventional procedure in which there is a high risk for the spread of COVID-19. In this study, we compare the tube thoracostomy procedures performed early on in the pandemic and those performed later after steps were taken in accordance with the new recommendations. Material and Method:It is a retrospective and single-center study. COVID-19 patients with spontaneous pneumothorax with indications for tube thoracostomy presented to our emergency department between March 10, 2020, and March 31, 2021. Based on the applied tube techniques, two groups were defined; group 1, patients who underwent classical tube thoracostomy, group 2, patients who underwent tube thoracostomy with the recommended preventive measures for COVID-19. The collected data were compared between the two groups.Results: 106 patients met the study criteria and were included in the study. The difference in the length of the tube duration time between the old or new technique was statistically significant (p < 0.05), no difference was identified in the duration of stay, intensive care unit admission, or mortality compared with the two techniques. Conclusions:In this study, the new measures recommended for tube thoracostomy were found to be effective for the treatment of patients.

We aimed to reveal the anti-convulsant effects sulfasalazine and its mechanism in pentylenetetrazole (PTZ)-induced seizures in rats. Forty-eight male Wistar albino rats (200-250 g) were randomly divided into two groups: 24 for electroencephalography (EEG) recording (group A) and 24 for behavioral studies (group B). About 70 mg/kg PTZ was used for behavioral studies after sulfasalazine administration and 35 mg/kg PTZ was used for EEG recording after sulfasalazine administration. Electrodes were implanted on the dura mater over the left frontal cortex and the reference electrode was implanted over the cerebellum for EEG recording. Racine’s convulsion scale, first myoclonic jerk onset time, spike percentages, brain malondialdehyde (MDA), superoxide dismutase (SOD), and prostaglandin F2α (PGF2α) levels were evaluated between the groups. First myoclonic jerk onset time was significantly shorter in the saline group than both 250 and 500 mg/kg sulfasalazine groups (P<0.05). Racine's convulsion scores were significantly lower in the 250 and 500 mg/kg sulfasalazine groups than the saline group (P<0.05, P<0.001). The two sulfasalazine groups had lower spike percentages than the saline group (P<0.05). Significantly lower MDA and PGF2α levels were observed in the 250 and 500 mg/kg sulfasalazine groups compared with the saline group (P<0.05, P<0.001, respectively). SOD increased significantly in both sulfasalazine groups compared with the PTZ+saline group (P<0.05). Our study demonstrated that sulfasalazine had protective effects on PTZ-induced convulsions by protecting against oxidative and inflammatory damage associated with PTZ.

Purpose: Liver damage caused by drugs and other chemicals accounts for about 5% of all cases. Methotrexate (MTX), a folic acid analogue, is a first-line synthetic antimetabolite agent routinely used in the treatment of rheumatoid arthritis and other autoimmune and chronic inflammatory diseases. Polyethylene glycol (PEG) has antioxidant activity. In this study, we evaluated biochemically and histopathologically the antifibrotic effect of PEG 3350 administered intraperitoneally to prevent methotrexate-induced liver damage in rats. Methods: A total of 30 male rats including 10 rats was given no drugs (normal group), and 20 rats received single-dose 20 mg/kg MTX for induced liver injury in this study. MTX was given to 20 rats, which were divided in two groups. Group 1 rats was given PEG 30 mg/kg/day (Merck) intraperitoneally, and Group 2 rats % 0.9 NaCl saline 1 mL/kg/day intraperitoneally daily for two weeks. Results:Transforming growth factor beta (TGF-β), plasma malondialdehyde (MDA), liver MDA, serum tumour necrosis factor alpha (TNF-α), alanine aminotransferase and plasma pentraxin-3 levels and, according to tissue histopathology, hepatocyte necrosis, fibrosis and cellular infiltration were significantly better in MTX+PEG group than in MTX+saline group. Conclusion: PEG 3350 is a hope for toxic hepatitis due to other causes, since liver damage occurs through oxidative stress and cell damage, similar to all toxic drugs.

Introduction: Non-thyroid disease syndrome (NTDS) is a common syndrome in critical diseases and is characterized by below-normal levels of free T3 (fT3) and free T4 (fT4) in the absence of primary thyroid gland pathology. Pneumonias are a group of respiratory system infections that are associated with a high incidence of mortality. Rapid biomarkers are needed to determine the diagnosis and prognosis in patients with pneumonia to optimize treatment potential. This study investigated the effect of changes in thyroid hormone and procalcitonin (PCT) levels on prognosis and mortality in patients with pneumonia. Method: This study was conducted as a retrospective observational study in a tertiary hospital. Between 2019 and 2020, 1118 patients with pneumonia were included in the study. For all participants, PSI scores were calculated and disease severity was determined according to these scores. Patient demographic and disease data were recorded. Discussion and Conclusion: Low fT3 hormone levels in patients diagnosed with pneumonia upon arrival at the emergency department had an important effect on prognosis. Our results indicated that fT3 levels had a reliable predictive effect on prognosis, disease severity, and mortality. In addition, we found that fT3 was superior to PCT in predicting mortality.

Objectives:This study aims to demonstrate on a manikin the effects of performing compression in cardiac arrest cases on the floor or stretcher on performer tiredness and basic life support. Materials and methods:The study included 40 healthcare personnel comprising physicians, paramedics and emergency medicine technicians employed at our hospital's emergency medicine clinic and competent in current cardiopulmonary resuscitation (CPR) application. The performers were asked to perform compression as advised in American Heart Association guidelines for five turns of two minutes each on an adult CPR application manikin placed on a stretcher with a trauma board underneath and with compression hardness setting adjusted to high level. The performers were allowed to rest between each turn for two minutes. Data related to the number and depth of compressions were obtained from computer environment separately for each turn of two minutes. At least one day after the application, the same performers were asked to perform compression for five turns of two minutes each on the adult CPR application manikin placed on the floor on a flat surface with a trauma board underneath and with compression hardness setting adjusted to high level. Data related to the application were obtained while the application was performed by means of the used manikin's embedded computer program. Results: Mean difference between the number of compression values for five turns of compressions performed on stretcher or floor was 0.9 compression/minute without a statistically significant difference (p=0.602). Difference between depth of compression values for compressions performed on stretcher or floor was 0.14 mm without a statistically significant difference (p=0.898). A statistically significant difference was observed between compressions performed on stretcher or floor in terms of mean tiredness score (p<0.001). Conclusion: Compression in CPR is a tiresome procedure. Even if performers take two-minute turns, compression efficiency may decrease in prolonged CPR. Compression performed on stretcher was more tiresome in prolonged CPR. Compression may be more efficient when performed on the floor outside the hospital in prolonged CPR since performers will feel less tired. However, compression performed on stretcher inside the hospital may be more efficient with more than two healthcare workers since it is more tiresome.Keywords: Basic life support; cardiopulmonary resuscitation; manikin; on floor; on stretcher.Comparison of the efficiency of cardiopulmonary resuscitation performed at emergency department on stretcher or floor on a manikin ÖZ Amaç: Bu çalışmada kardiyak arrest olgularında kompresyonun yerde veya sedye üzerinde yapılmasının uygulayıcı yorgunluğuna ve temel yaşam desteğine etkileri manken üzerinde gösterildi. Gereç ve yöntemler: Çalışmaya hastanemizin acil tıp kliniğinde çalışan ve güncel kardiyopulmoner resüsitasyon (KPR) uygulamasını bilen doktor, paramedik ve acil tıp teknisyenlerinden oluşan 40 sağlık personeli alındı. Uygulay...

Amaç: Antitrombotik ilaçlar ağır COVID-19 hastalarının tedavisinde kendine rutin bir yer edinmiş olmasına rağmen, enfeksiyona maruz kalmadan önce herhangi bir sebeple antitrombotik ilaç kullanımının hastalığın prognozuna ve klinik seyrine bir etkisi olup olmadığı henüz bilinmemektedir. Bu çalışmanın amacı SARS COV-2’ye maruz kalmadan önce antitrombotik ilaç kullanımının hastalığın klinik seyri ve mortalitesi üzerine etkisi olup olmadığını belirlemektir. Gereç ve Yöntemler: Hastanemiz COVID-19 polikliniğine başvuran COVID-19 tanısı yapılan RT-qPCR test sonucu ile doğrulanan ve bir akciğer görüntülemesi ile COVID-19 pnömonisi tanısı alan tüm hastalar çalışmaya dahil edilmiştir. Covid-19 pnömonisi olan hastaların anamnez bilgileri, hastanede ve yoğun bakımda yatış süreleri hastane kayıt sisteminden elde edildi ve kayıt altına alındı. Tüm hastaların klinik sonlanımları; sağkalım veya exitus olarak sınıflandırılarak kayıt altına alındı. Bulgular: PCR testi pozitif olup aynı zamanda viral pnömonisi olan hasta sayısı toplam 415 idi. Hastaların yaş ortalaması 53±19 ve 234’ü (56%) erkek idi. 415 hastanın 168’i (40%) en az bir çeşit antitrombotik ilaç kullanmakta iken 247’si (60%) herhangi bir antitrombotik ilaç kullanmıyordu. COVID-19 öncesi antitrombotik ilaç kullanan 168 hastada mortalite oranı %4,5 iken, antitrombotik kullanmayan 247 hastada mortalite oranı %12,5 olarak bulundu (p=0.008). Antitrombotik ilaç kullanan 168 hastada yoğun bakıma yatış oranı %10,1 iken, antitrombotik kullanmayan 247 hastada yoğun bakıma yatış oranı %13,7 olarak (p=0.31). Sonuç: Erken hastalıkta, özellikle ayaktan hastalarda antitrombotik tedavi, koagülopatiyi ve endotelyal ilişkili hastalığı önleyebilir, ancak trombo-inflamatuar faz sırasında çok geç bir antitrombotik tedavi uygulaması gerekli koruyucu etkiyi sağlamayabilir. Bu hipotezin uygun prospektif randomize çalışmalarda test edilmesi gerekmektedir.