Aim: Burns are one of the most difficult physical and psychological traumas that people face. Generally, protection and prevention strategies from burns are practiced. The young and the elderly are most likely to be affected tragically. The aim of the present study is to investigate the effect of Hypericum perforatum methanol extractcontaining gel on the healing of burn wounds. Materials and Methods: Forty male rats of the Sprague-Dawley strain were divided into four groups after a 4x4 area of their back was shaved, and an experimental burn was created with the direct contact of an aluminum metal stamp heated in boiling water for 15 seconds. There was no implementation on or treatment of the control group (Group 1). Burn wounds were irrigated with saline solution (Saline group, Group 2), and silver sulphadiazine 1% (Silverdin®) cream (Group 3), Hypericum perforatum methanol extract-containing gel (Group 4), and a placebo gel (Group 5) were applied topically 4 times a day after the contact burn. Histopathological analyses of the burned area were made at 4, 8, and 24 hours. Results: The topical use of Hypericum perforatum methanol extract-containing gel in the experimental contact burns, histologically; resulted in the reduction of collagen discoloration, vascular damage and hair follicle and glandula sebaceous damage while preserving total number of hair follicles, number of vessels and epidermal thickness compared to Silver Sulphadiazine 1% (Silverdin®) cream treatment. Conclusion: Positive effects of topical Hypericum perforatum gel were detected on experimental burns and its use might have beneficial effects on acute burn wounds.
Introduction Firearm injuries are a significant cause of mortality and morbidity. Our study aims to evaluate the injury patterns, results of imaging studies, treatment methods, outcomes, and mortality rates of patients who were admitted to the emergency department with firearm injuries. Methods Our study was designed as a retrospective descriptive study. To this end, adult patients who were admitted to our hospital with gunshot wounds between January 1, 2017, and July 31, 2021, were screened. The files of 527 patients who were admitted with gunshot wounds were analyzed. A total of 30 patients were excluded from the study due to missing data. Statistical analyses were performed using the data of a total of 497 patients. Independent variables of the study included sex, age, systolic blood pressure (SBD), diastolic blood pressure (DBD), pulse, respiratory rate, Glasgow Coma Scale (GCS) score, range of shot, injury site, X-ray, cranial CT, thorax CT, abdominal CT, and extremity CT angiography findings, and the need for treatment and referral. Mortality was the dependent variable of the study. A logistic regression model was created to predict factors affecting the survival of the patients who were admitted to the emergency department with gunshot wounds and to identify the independent variables affecting survival. A p-value of <0.05 was considered sufficient for significance. Results The majority of patients who were admitted to the emergency department due to gunshot wounds were male and the median age of the patients was 32 years (18-70 years). The comparison of the descriptive characteristics with respect to survival revealed that the systolic and diastolic blood pressures and GCS scores of the deceased patients were significantly lower than those of the survivors. The rate of shooting at short range was significantly higher in the deceased patients when compared to that of the survivors. In addition, the rate of the need for surgical intervention and the incidence of pneumocephaly in cranial CT were higher in the deceased patients than in the survivors. Significantly higher rates of deceased patients required referral to neurosurgery and thoracic surgery clinics than survivors. The patients who were referred to the thoracic surgery clinic had an increased death rate by 29-fold and the patients who were referred to the thoracic surgery clinic had an increased death rate by about nine-fold. On the other hand, the probability of death was reduced by about half when the GCS scores of the patients were higher. Discussion We evaluated GCS in our patient group and determined a significantly lower score in the patients who did not survive, which agrees with the findings of other studies. Patients with higher SBD and DBD showed a higher probability of survival, which agrees with the results in other studies. Most patients were shot from their extremities and none had died while the death rate was significantly higher in the patients who suf...
Covid 19 pandemisi direkt ve indirekt olarak sosyal hayatta önemli değişiklikler oluşturdu. Bu çalışmada acil sağlık hizmetleri açısından önemli bir yer tutan hastane dışı kardiyak arrest (HDKA) vakaları değerlendirildi. Pandemi öncesi dönem ile; demografik, etiyolojik ve acil sağlık hizmetlerinin sunumu açısından herhangi bir farklılık olup olmadığının araştırılması amaçlandı.
ObjectiveThis study aimed to analyze factors associated with patient mortality in COVID-19 patients hospitalized in the intensive care unit (ICU) and provide data to help prioritize the most critical patients.DesignRetrospective cohort studySetting and participantsData for 289 patients were analyzed by the XXX hospital’s IT department.MethodsA clinical retrospective cohort study was conducted in a tertiary hospital. Patients (n=289) with negative reverse transcription-polymerase chain reaction (RT-PCR) and positive chest computed tomography (CT) scan indicating COVID-19 were included in the research. Demographics, clinical characteristics, treatment modalities, and length of hospital stay were analyzed in relation to 30-day survival outcomes.ResultsThe mean age of the patients was 69.04±15.10 years (range 19-100), and 41.2% (n=119) were female. The mortality rate was 48.1% (n=139). There were statistically significant differences in laboratory findings, such as hemoglobin (p=0.021), lymphocyte counts (p=0.046), d-dimer (p=0.009), and lactate (<0.001) regarding one-month survival. Additionally, those hospitalized for more than 5 days had higher one-month survival rates (hazard ratio (HR)= 0.003, CI= 10.264-155.972). Moreover, intubated patients had a higher mortality risk during this period (HR=4.15, CI=1.53-11.20).Conclusions and implicationsThe first five days of patients hospitalized in intensive care units due to COVID-19 pneumonia are critical. Besides, the need for intubation was another factor independently affecting survival. Clinicians should be alerted about the significance of these factors.
Backround: High rates in trauma-related mortality pose a major health problem and increase every day. Early diagnosis and treatment can be lifesavers for this patient group in the emergency departments, which serve as the first place to admit trauma patients in a hospital. Objectives: We aim to determine high-risk criteria to indicate trauma patients getting the most use from whole-body tomography in patients with multiple traumas and reduce unnecessary computed tomography. Methods: We examined retrospectively all electronic files and computed tomography results of patients, who had been admitted to emergency department due to trauma, and who had undergone whole-body computed tomography. Results: We found that possibility of multiple injuries increased by 5.9 times in patients requiring mechanical ventilation. Possibility of multiple injuries in patients with free fluid in the Focused Assessment with Sonography for Trauma increased by 5.6 times. We also observed that possibility of multiple injuries in patients with Glasgow Coma Score < 13 increased by 4.3 times. Possibility of multiple injuries in hypoxic patients increased by 3.2 times. Possibility of multiple injuries in patients with a pulse ≥ 120/min increased by 1.8 times. Possibility of multiple injuries in patients with shock index ≥ 0.9 increased by 1.7 times. Conclusion: High-risk group in terms of multiple traumas involves mechanical ventilation need in trauma patients, positive Focused Assessment with Sonography for Trauma, Glasgow Coma Score being under 13, hypoxia, tachycardia, positive shock index, and extravehicular traffic accidents. Whole-body computed tomography should be performed in this patient group.
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