The objective of this study is to investigate musculoskeletal complaints (MSCs) in healthcare workers (HCWs) in 3 community hospital–based departments [internal medicine (IM), general surgery (GS), and emergency department (ED)] and its effects on the quality of work life (QWL) of hospital HCW.This prospective cross-sectional study was performed in the 700-bed community training hospital. All HCW staffed in 3 departments (IM, GS, ED) of the hospital were asked to respond to items in the study data sheet. Enrolled personnel were inquired about their demographic data, work history and schedule, and medical history. The 16-item Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) Turkish version was applied to evaluate MSC. A total of 216 HCW constituted the study sample and demographic characteristics, history, and clinical findings were analyzed.Among all, 103 personnel (47.7%) were women (n = 42, 41.1% in physicians, n = 57, 87.6% in nurses and n = 4, 8% in other HCW) (P = .000). A total of 173 personnel (79.7%) reported MSC in some part of their bodies. Female personnel had MSC significantly more commonly than males (chi-square = 40.7, P = .000). Numbers and percentages of the personnel with MSC in 3 departments (IM, GS, ED) were 51/61, 52/65, and 70/90, respectively (P = .67). Total QWL score of those without MSC was significantly higher than others (74.7 + −12 vs 63.2 + −15, respectively; t test, P = .000). Total frequency score of MSC as elicited via CMDQ was significantly higher in those without MSC compared to the others (8.1 + −7.6 vs 0.1 + −0.6, respectively, t test, P = .000).Female sex, high-income, university graduation, being a nurse or a physician, and older age impose risk for HCW in hospital with respect to having MSC. Presence of MSC affects QWL negatively.

Objective: To analyze clinical and sociodemographic properties of the patients as measured by the “Hospital Anxiety and Depression Scale-HADS” including the subscale regarding anxiety (HAD-A) in emergency department (ED) and to detect the effect of a session of Benson relaxation method (BRM) on high anxiety level. Methods: Adult patients presented to the state hospital ED in seven days were recruited in this prospective study. Patients with high (≥8) scores were randomized to the treatment or control groups. They were asked to pursue BRM to alleviate anxiety. Results: Six hundred thirty-four patients were recruited (mean age 44.1 and 52% were female). Patients with acute exacerbation or with psychiatric illness, with a systemic disease and higher acuity level had higher HAD-A scores ( P < .05). BRM group had a mean score change higher than controls (7.2 ± 2.9 vs 3.4 ± 2.6, t test, P = .026). Conclusions: Patients who underwent BRM had larger decreases in HAD-A scores than others.

This article reports on two patients with unsuspected oesophageal foreign body ingestion, with chest pain as the main symptom. The patients had extensive cardiac evaluation to rule out myocardial ischaemia. Further evaluation showed an impacted oesophageal foreign body. Oesophageal foreign bodies should be considered as factors in chest pain. W e report on two patients presenting with chest pain as the main symptom, who had unsuspected foreign body ingestion. CASE REPORTSCase 1 A 41-year-old man had chest pain for 2-3-h. He had ingested alcohol 2-3 h before the pain began, and he had nausea that began simultaneously with chest pain. He had a history of gastro-oesophageal reflux disease and heavy alcohol use. He denied any specific event that may have given rise to these symptoms. On arrival, the patient's vital signs were normal. Results of cardiac evaluation were negative. Physical examination showed an epigastric tenderness, but was otherwise unremarkable. Initial electrocardiographic examination was normal. Laboratory data, such as creatine kinase isoenzyme MB and troponin I obtained on admission, were normal. The chest radiograph showed normal findings. After 12 h under observation, he continued to have symptoms, and came to the emergency department of Bayindir Hospital for further evaluation. Abdominal ultrasonography was normal. The patient underwent an oesophagogastroduodenoscopy (OGD), which showed a foreign body in the oesophagus, oesophagitis with linear exudates in the distal part of the oesophagus and pangastritis. A 4.5 cm61.5 cm CD Rom piece was in the middle of his oesophagus (fig 1). After the foreign body was removed from the oesophagus by OGD, the patient did well, with no reccurrence of chest pain. He was discharged home after 24 h on oral proton pump inhibitor treatment. Case 2A 57-year-old woman had chest pain and dysphasia for 1 week. A week before she was examined by her gynaecologist and was given some drugs for a gynocologic problem. The patient had a history of odynophagia and chest pain that began simultaneously after she took those drugs. She was able to swallow fluids, but was avoiding solids because of the severity of the associated odynophagia and chest pain.The patient's vital signs were normal. Results of cardiac evaluation were negative. Physical examination and initial electrocardiography were normal. Laboratory data such as creatine kinase isoenzyme MB and troponin I were normal. A chest radiograph showed normal findings. Abdominal ultrasonography was normal. Owing to continued symptoms, we performed an OGD, which showed a foreign body in the oesophagus-a pill blister was in the distal part of the oesophagus (fig 2). She had taken her medicine with the blister. After the foreign body was removed from the oesophagus by OGD, the patient was relieved of her symptoms Abbreviation: OGD, oesophagogastroduodenoscopy

Urinary stone disease (USD) alone can cause much morbidity, but when present in conjunction with urinary tract infection, complications and morbidity increase even more. This study investigated the clinical and laboratory findings in patients who had USD with and without infection and evaluated the most suitable diagnostic value for urinary tract infection parameters before urine culture results were available. In a prospective fashion, patients who presented to the emergency department with a complaint of colicky flank pain (with or without hematuria) and who were diagnosed as having urolithiasis with ultrasound were evaluated for 1 year. The gold standard for the diagnosis of urinary tract infection was urine culture. The most suitable diagnostic value for urinary tract infection parameters was determined by receiver operating characteristic (ROC) curves. Logistic regression was used to identify independent variables that predicted a positive urine culture. Of the 192 eligible patients, 177 agreed to participate in the study. Of the clinical and laboratory characteristics analyzed, urine WBC, blood WBC, and fever were significantly different between culture positive and negative patients (p < 0.001, p = 0.04 p = 0.012, respectively). Using ROC curve analysis, pyuria (over 10 WBCs per HPF), fever over 37.9°C, and leucocytosis over 11,300 were the best predictors of a positive culture result. The logistic regression model for leukocytosis >11,300 (OR 2.1), pyuria (OR 2.8), and temperature >37.9°C (OR 3.1) showed a significantly increased risk of having a positive urine culture (correct class 87.9%). While a single physical examination or laboratory finding cannot predict urinary tract infection in USD patients with complete reliability, the presence of pyruria, fever, and leukocytosis significantly increases the odds of a positive urine culture.

The aim of the study was to examine factors affecting pain during intravenous (IV) catheter placement in an emergency department. A cross-sectional, observational study was conducted at an academic emergency department. Nine hundred and twenty-five adult patients who had a 20-gauge IV catheter placed were enrolled in the study. Patients were excluded for the following conditions: more than one IV attempt, altered mental status, head trauma, lack of contact due to visual impairment, hearing or speech disorder, intoxication, distracting injury or physical abnormality at the IV site. The magnitude of pain in IV catheter placement was not related to age, sex, experience of the individual placing the IV catheter, site of IV catheter insertion and use of analgesic or antidepressant drugs (p > 0.05). Patients with a history of depression reported significantly higher pain than non-depressed patients (p = 0.001). Depressed patients reported higher severity of pain during IV catheter placement than non-depressed ones. This may influence the decision on whether or not to use local anaesthesia for catheter insertion.