Introduction Acute pancreatitis (AP) is the leading cause of hospitalization among gastrointestinal disorders. The aim of our study is to compare the results between AP patients with and without COVID−19, and to reveal the effects of COVID−19 on the course, intensive care needs and mortality of AP patients. Material methods This was a single-center, retrospective and observational study. Patients over 18 years of age, who were diagnosed with AP during the current pandemic. According to the RT-PCR test result, patients were divided into two groups: COVID-19 positive and COVID-19 negative. Gender, age, laboratory parameters, intensive care unit admission, length of hospital stay, severity and mortality of AP were compared between these two groups. Results We reviewed 562 patients presenting to the emergency department who were diagnosed with acute pancreatitis between 10.03.2020 and 31.12.2020 and included 189 patients in our study. Positive patients need for intensive care (7.23%) were higher compared to negative patients (0.94%). 32.53% of positive patients and 14.15% of negative patients had severe AP ( p < 0.03). We established that being COVID-19 positive, CCI scores of ≥5, presence of COVID-19 compatible pneumonia on CT and BISAP scores had an effect on mortality ( p < 0,05). Conclusion The severity and mortality of AP increase in patients with both AP and COVID-19. This rate increases even more in the presence of COVID-19-associated pneumonia. We believe that new strategies should be developed for the follow-up and treatment of patients with both these conditions.

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.

Acute pancreatitis (AP) is the sudden inflammation of the pancreas, and it may be confined to the pancreas, or more life-threatening, affecting all organs and systems. AP is a common gastrointestinal condition Worldwide and is associated with cost to the health care system. It progresses mildly in 80% of patients and resolves with treatment, but in cases of severe AP, with mortality of around 30% recorded. In this section, we will discuss the first management of the AP in the emergency department. Because this is the period when management decisions can change the course of the disease and the length of stay in the hospital. In the management AP, approaches regarding the utility and timing of antibiotics, the timing and type of nutritional support, endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy approaches are constantly being updated. Treatment is mainly related to the severity of the disease. With early diagnosis and treatment, most of the patients can be discharged, and the development of complications and mortality can be reduced. Therefore, emergency management is important in acute pancreatitis.

Aim: End-tidal CO2 (ETCO2) levels are reflective of the ventilatory and metabolic/perfusion status of a patient, regardless of his/her SpO2 values. This study aimed to investigate the utility of ETCO2values in predicting the need for intubation, ICU admission, and mortality in hospitalized patients with COVID-19 pneumonia. Material and Method: A total of 108 hospitalized patients with COVID-19 pneumonia were included. Data on respiratory parameters (oxygen saturation, ETCO2, and respiratory rate [RR]- with and without O2 [w/wo O2]) and laboratory parameters were recorded. Results: The need forintensive care unit(ICU) admission was associated with significantly higher ETCO2 values (wO2:27.9 (4.6) vs. 18.6(8.4), p=0.040; woO2: 30.1(4.9) vs. 23.8(6.9), p=0.040). Mortality was associated with higher likelihood of higher RR (wO2:32.4(5.8) vs. 24.6(6.8), p=0.002) and lower oxygen saturation (wO2:92.9(3.8) vs. 95.5(4.2), p=0.025; woO2:87.1(5.7) vs. 91.8(6.6), p=0.013). Presence vs. lack of intubation need was associated with significantly increased likelihood of saturation (wO2:93.1(5.3) vs. 95.9(3.8), p=0.013; woO2:87.6(8.3) vs. 92.3(5.9), p=0.007). Hospital discharge vs. ICU stay was associated with significantly higher ETCO2 values (wO2:27.9 (4.6) vs. 18.6(8.4), p=0.040; woO2: 30.1(4.9) vs. 23.8(6.9), p=0.040) Conclusion: Our findings revealed the association of decreased ETCO2 (w/wo O2) values with a lower likelihood of hospital discharge and increased likelihood of ICU transfer. Low oxygen saturation levels related the increased risk of both intubation need and mortality in hospitalized COVID-19 patients.

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Patients and Methods: This single center, retrospective study involved patients presenting to a tertiary emergency department with foreign bodies in the airway or gastrointestinal system. Non-traumatic, non-pregnant patients aged 18 or over were scanned through the ICD-10 diagnostic code. Age and sex, reasons for ingestion/insert on (unintentional, for suicide, or for sexual gratification), the type of object, test data, treatment, complications and mortality were recorded. Results:The mean age of the 189 patients included was 36, and 59.2% were women. Ingest on was unintentional in 86.2%, for suicide in 10.6%, and for sexual gratification in 3.2%. Unintentional ingestion was more common in women, while ingestion for self-harm was unique to men. Fish bones, pins, garlic, and teeth were most frequently encountered in unintentional ingestions. The most commonly ingested objects for self-harm were sharp items such as razor blades and nails. Flexible laryngoscopy was employed in 40.7% of cases and endoscopic interventions in 57.6%. Foreign bodies were removed with flexible laryngoscopy or endoscopy in 61.3% of cases, and surgery was performed on 6.9%. Foreign bodies were most encountered in the larynx-pharynx, esophagus, and stomach.None of the patients died. No complications were detected. Conclusion:Foreign body ingestion is a widespread, global clinical problem. Our hospital receives many presentations involving foreign body ingestion, and the emergency and gastroenterology departments have considerable experience in this area. The endoscopic approach was the safest and most effective method due to its high success and low complication rates.

Backgrounds: Decreased RBC count and decreased Hb concentration in the blood is defined as anemia. Anemia can be caused by acute excessive bleeding, hemolysis or inadequate production. If the patient is symptomatic, an immediate blood transfusion is required. Methods:A retrospective, single-center study was performed between April 2019 and April 2021 with non-traumatic, non-pregnant patients over 18 years of age, who had erythrocyte transfusion in the emergency department. For the laboratory parameters Hb, Ca and K, the initial levels from the blood analysis performed at admission to the emergency department were recorded as Hb1, potassium K1, and calcium Ca1, and the blood levels after the transfusion as Hb2, K2, and Ca2. Mortality of patients was recorded.Results: A total of 458 patients were included in the study. 44.3% of patients were male. The mean age was 66.33 ± 17.51/year. Mortality developed in 6.55%. There was a statistically significant difference in laboratory values between non-surviving and surviving patients. The mortality rate increased in patients with Hb1 values below 5.05g/dl and Hb2 values below 7.75g/dl, and patients with Ca1-2 values below 6.85mg/dl. It was determined that this increase in mortality rate was 3 to 6 times on average. Conclusions:Our findings reveal that the transfusion procedures in our clinic are in accordance with the new transfusion guidelines. It is important to use blood and blood products, the only source of which is human, for the right indication, at the right time, and in the right amounts.