No abstract

In this study, the analgesic effects of dexketoprofen trometamol and meperidine hydrochloride were compared in patients diagnosed with renal colic. This study was a prospective, randomized, double-blind study. Fifty-two patients, between the ages of 18 and 70 years who were diagnosed with renal colic, were enrolled in the study after obtaining ethics committee approval. Before drug injection, dexketoprofen trometamol and meperidine hydrochloride were placed in closed envelopes, and the patients were randomly given a single dose of intravenous infusion for 20 minutes. Severity of pain and symptoms was evaluated with the numerical rating scale and renal colic symptom score for each patient immediately before administration of drugs and 30 minutes after the end of the application. At the same time, systolic arterial blood pressure, diastolic arterial pressure, respiratory rate, heart rate, nausea, vomiting, and reactions due to drug administration were recorded before and after drug administration. In statistical methods, t test, analysis of variance, and repeated measure analysis were used for the analysis of normally distributed continuous variables and the Mann-Whitney U, Kruskal-Wallis and Friedman tests were used for analysis of not-normally distributed continuous variables. In the analysis of discrete variables, the χ test was used. In both groups, a significant decrease was found in numerical rating scale values measured 30 minutes after drug administration, but the decline in dexketoprofen trometamol group (P = 0.02) was found to be more. Although a significant decrease was found in the renal colic symptom score (P < 0.001) values measured after drug administration in the dexketoprofen trometamol group, no significant decrease was found in the meperidine HCl (P = 0.058) group. After drug administration, a statistically significant decrease was found in the systolic arterial blood pressure, heart rate, and respiratory rate in both groups. Also, a statistically significant decrease was found in the diastolic arterial pressure in the meperidine group. But these changes in vital findings were not serious enough to disrupt patients' clinical status. With this study, we concluded that dexketoprofen trometamol, from the nonsteroidal anti-inflammatory drug group, can be within the primary treatment options for renal colic because of better analgesic efficacy, being well tolerated by patients compared with meperidine hydrochloride.

Background:This study aims to compare the poisoned patients who could not be administered activated charcoal because of its unavailability with the poisoned patients who were administered charcoal in the later period and to reveal the results about its effectiveness.Study Question:Is the use of activated charcoal effective against poisoning caused by oral medication?Study Design:This retrospective cohort study with historical control was planned at a tertiary hospital. Patients older than 18 years were admitted to the emergency department because of oral drug poisoning during the study periods. A total of 1159 patients who were not given activated charcoal and 877 patients who were given activated charcoal were included in this study.Measures and Outcomes:The frequency of clinical findings secondary to the drug taken, the frequency of antidote use, the frequency of intubation, and the hospitalization length were determined as clinical outcome parameters.Results:There was no statistically significant difference in the development of central nervous system findings, cardiovascular system findings, frequency of intubation, and blood gas disorders, as well as the length of hospitalization periods according to the activated charcoal application. Hepatobiliary system findings and electrolyte disturbances were found to be less common in patients given activated charcoal. The frequency of tachycardia, speech impairment, coma, and respiratory acidosis was found to be statistically higher in patients who were administered activated charcoal. The hospitalization period of the patients who were given activated charcoal was longer in patients with drug findings; however, there was no difference in the hospitalization periods of the patients who were given an antidote.Conclusions:The use of activated charcoal in poisoned patients may not provide sufficient clinical benefits. However, clinical studies with strong evidence levels are needed to determine activated charcoal's clinical efficacy, which is still used as a universal antidote.

Objective: The purpose of this study is to determine the prognosis of the demographic characteristics, etiology, morbidity and mortality rates of the pediatric trauma patients admitted to the emergency department of a training and research hospital. Material and Methods: Pediatric patients who have been brought to the emergency department of a training and research hospital between 1 st January-31 th December 2010 due to trauma have been included to this study. The demographic data of the patients, distribution by seasons and months, the etiologic factors that cause trauma, the way that patients have been admitted to the emergency department, conclusion figures of the patients in the emergency department, and data of the units where patients have been hospitalized, treatments, average hospitalization time, conclusion figures of the clinics where they have been hospitalized have been analyzed statistically. Results: Of the 18936 patients, 12096 boys and 6840 girls have been included to this study. The mean was as 8.11±5.19 in boys and 6.89±5.04 in girls. The most common age for trauma was 7-14 (36.15%) and it has been stated that the pediatric trauma cases have been mostly admitted in Spring and Summer months. Extremity injuries (42.40%) and falls (40.67%) were stated as the most etiologic causes. 815 of the patients have been hospitalized. 353 cases (43.31%) received surgical invention while 462 (56.69%) cases received only medical treatment. The causes of death in pediatric trauma patients were: 10 (47.62%) o due to traffic accidents, 5 (23.81%) due to falls, 5 (23.81%) due to burns and 1 (4.76%) due to drowning. It has been stated that 13 (61.90%) cases were male and 8 (38.10%) patients were girls of a total 21 cases resulting in death. Conclusion: Most of the pediatric traumas occur due to falls or simple extremity injuries. Traumas are mostly seen between the 7-14 age range during the primary school period. The most common etiological factors in hospital admissions are falls. The most common etiological cause of death in pediatric trauma is traffic accidents. (JAEM 2013; 12: 8-12) Özet Amaç: Bu çalışmanın amacı bir eğitim ve araştırma hastanesi acil tıp kliniğine başvuran pediatrik travma olgularının demografik özelliklerini, etiyolojisini, morbidite ve mortalite oranlarını, prognozlarını belirlemektir. Gereç ve Yöntemler: Retrospektif yapılan bu çalışmaya 1 Ocak-31 Aralık 2010 tarihleri arasında çocuk acil servisine travma nedeniyle getirilen, 0-18 yaşları arasındaki hastalar dahil edildi. Hastaların demografik verileri, mevsimlere, aylara göre dağılımı, travmaya neden olan etiyolojik faktörleri, hastaların acil servise nasıl başvurdukları, hastaların acil serviste sonuçlanma şekli, hastaneye yatan hastaların yattığı birim, aldığı tedavi, ortalama yatış süreleri, yattığı klinikte sonuçlanma şekli ile ilgili veriler istatistiksel olarak analiz edildi. Bulgular: Çalışmaya 18936 hasta (12096 erkek, 6840 kız) alındı. Erkek/kız oranı 1.7 idi. Olguların yaş ortalaması erkek çocuklarda 8.11±5.19, kız çocuklarda 6...

Objective: In this study, we aimed to analyze the demographic features and mortality rates of pediatric patients admitted to the emergency department and diagnosed with intoxication. Material and Methods: Patients admitted to the pediatric emergency department and diagnosed with intoxication between December 01, 2009 and December 31, 2010 were included in the study. Patients were evaluated through the examination of registration forms and hospitalization files. The characteristics, including age, sex, admission type to the emergency department, treatment before admission, time passed before admission, consciousness level at the time of admission, cause of poisoning, toxic agent, treatment administered after admission, outcome, and mortality rates, were recorded. Results: In our study, 1029 cases were included; 66.47% of the patients were female, and the female/male ratio was found to be 1.98/1. Poisoning was most frequently seen in the group of 13-18-year-old patients (56.17%). Patients were admitted mostly in the spring. The most frequent cause of poisoning was administration of drugs (81.8%), among which paracetamol was the most common and antidepressants were the second most common drugs. Suicide rate was 56.07%, and 54 patients (5.2%) had attempted suicide for the second time. Also, 85.71% of the patients were admitted to the emergency room within the first 2 hours. Conclusion: In order to minimize the rate of poisoning cases, preventive measures, education of the family, more secure storage of drugs, more prudent production of drugs in boxes by pharmaceutical companies, and prevention of childhood poisoning by regional epidemiological studies should be promoted.

Background/aim: The aims of this study were to investigate the significance of oxidative stress parameters in the pathogenesis of ischemic stroke and hemorrhagic stroke and to investigate their effects on stroke severity using the National Institutes of Health Stroke Scale (NIHSS).Materials and methods: A total of 92 patients, including 74 with ischemic stroke and 18 with hemorrhagic stroke, and 75 volunteers were enrolled in the study. Total oxidant status (TOS), total antioxidant status (TAS), paraoxonase, stimulating paraoxonase, arylesterase, and thiol levels were measured in both the patient and volunteer groups. NIHSS and oxidative stress index (OSI) scores were calculated.Results: TOS and OSI levels were significantly higher in the ischemia and hemorrhagic stroke groups than in the control group (P < 0.05). Arylesterase and thiol levels were significantly lower in the ischemia group than the control group (P < 0.05). No significant correlation was found between NIHSS score and TAS, TOS, OSI, paraoxonase, arylesterase, stimulated paraoxonase, and thiol levels (P > 0.05). Conclusion:Oxidative stress may play a role in the pathogenesis of both ischemic stroke and hemorrhagic stroke in terms of oxidants. We do not think that oxidative stress has any effect in determining stroke severity in either type of stroke.

No abstract

No abstract