The Sufficiency of Assistant and Intern Doctors’ Knowledge About Basic and Advanced Life Support: A Survey Study

Objective:We aimed to evaluate the level of assistant and intern doctors’ knowledge about basic and advanced life support.Material and Methods: In this study, the current knowledge of 357 assistant and intern doctors at the hospital of Cumhuriyet University was reviewed via a questionnaire of 40 questions about basic and advanced life support. The participants' consent was received before administering the questionnaire. The findings were reported in figures and percentages. While the Kruskal-Wallis Variance analysis test was used for statistical calculations, the chi-square test was used for statistical comparisons. p<0.05 was accepted as significant. This study consists of questions prepared about the recent changes in the guide for cardiopulmonary resuscitation by the American Heart Association (AHA) released in 2010.Results: This study weights the answers from both of the participant groups equally even though the practical experience of assistant doctors is greater than the interns’. The ratio of right answers to the questions about general knowledge of basic and advanced life support is found to be low in this particular study. However, assistant doctors aged between 20-30 achieve a higher rate of true answers compared to the other participant doctors.Conclusions:This study has concluded that the knowledge level of assistant and intern doctors is insufficient and not up-to-date. It has also shown that insufficient knowledge may cause danger, given the fact that basic and advanced life support cannot be applied effectively without correct and accurate information

Evaluation of the Prevalence of Incidental HBV, HCV and HIV Infection Among Patients Presenting to the Emergency Department: A Prospective Cross-sectional Study

Aim: In this study, we randomized the patients without known hepatitis-B, hepatitis C and HIV infection who presented to the emergency department (ED). We measured the serum levels of HBsAg, Anti-HCV and Anti-HIV antibodies besides biochemical tests regarding the diagnostic process of the main complaint resulting in presentation to the ED. In this way, we aimed to determine the prevalence of occult chronic viral diseases among patients presenting to the ED and the risk of ED employees was evaluated. Materials and Methods: The study included 800 patients who had presented to the ED for any reason over two month and who had no history of infectious viral disease. Results: Four hundred and thirthy-four (54.2%) of the patients were male, 366 (45.8%) were female, and the mean age was 32.7 (+/- 16.9) years. The rate of presence of a person with an infectious viral disease at the patient's home was 1%, 0.5% and 0.0% for HBV, HCV, and HIV, respectively. The overall history of HBV vaccination was 15.5% in our study sample. HBsAg, anti-HCV and HIV-positivity were 2%, 0.8% and 0.0%, respectively. Conclusion: The prevalence of HBV- and HCV-positivity in patients admitted to the ED who did not have any known chronic viral disease was consistent with the general population prevalence. No significant change in the prevalence of HCV compared to previous years can be explained by the absence of a protective vaccine. The absence of HIV-positivity can be explained by the low rate of HIV-positivity in our country

The effects of desert dust storms, air pollution, and temperature on morbidity due to spontaneous abortions and toxemia of pregnancy: 5-year analysis

Epidemiological studies have suggested an association between particulate air pollution, increased temperatures, and morbidity related to pregnancy outcomes. However, the roles of desert dust storms and climatological factors have not been fully addressed. The objectives of the present study were to investigate the association between desert dust storms, particulate matter with a diameter <= 10 mu m (PM10), daily temperatures, and toxemia of pregnancy and spontaneous abortion in Gaziantep, South East Turkey. The study was conducted retrospectively at emergency department of two hospitals in Gaziantep city. Data from January 1, 2009, to March 31, 2014, were collected. Patients, who were diagnosed with toxemia of pregnancy and spontaneous abortion by radiological imaging modalities, were included in the study. Daily temperature ranges, mean temperature values, humidity, pressure, wind speed, daily PM10 levels, and records of dust storms were collected. A generalized additive regression model was designed to assess variable effects on toxemia of pregnancy and spontaneous abortion, while adjusting for possible confounding factors. Our findings demonstrated that presence of dust storms was positively associated with the toxemia of pregnancy both in outpatient admissions (OR=1.543 95% CI=1.186-2.009) and inpatient hospitalizations (OR=1.534; 95% CI=1.162-2.027). However, neither PM10 nor maximum temperature showed a marked association with spontaneous abortion or toxemia of pregnancy in our study population. Our findings suggest that desert dust storms may have an impact on the risk for adverse pregnancy outcomes such as toxemia of pregnancy. Health authorities should take necessary measures to protect pregnant women against detrimental effects of these storms

Impact of desert dust storms, PM10 levels and daily temperature on mortality and emergency department visits due to stroke

ObjectiveIt is known that the inhalation of air pollutants adversely affects human health. These air pollutants originated from natural sources such as desert storms or human activities including traffic, power generating, domestic heating, etc. This study aimed to investigate the impacts of desert dust storms, particulate matter ≤10 μm (PM10) and daily maximum temperature (MT) on mortality and emergency department (ED) visits due to stroke in the city of Gaziantep, Southeast Turkey.MethodThe data on mortality and ED visits due to stroke were retrospectively recruited from January 1, 2009, to March 31, 2014, in Gaziantep City Centre.ResultsPM10 levels did not affect ED visits or mortality due to stroke; however, MT increased both ED visits [adjusted odds ratio (OR) = 1.002, 95% confidence interval (CI) = 1.001–1.003] and mortality (OR = 1.006, 95% CI = 0.997–1.014) due to stroke in women. The presence of desert storms increased ED visits due to stroke in the total population (OR = 1.219, 95% CI = 1.199–1.240), and all subgroups. It was observed that desert dust storms did not have an increasing effect on mortality.ConclusionOur findings suggest that MT and desert dust storms can induce morbidity and mortality due to stroke

The effects of oral Ginkgo biloba supplementation on radiation-induced oxidative injury in the lens of rat

Background: The aim of this study was to evaluate the antioxidant role of Ginkgo biloba (GB) against radiation-induced cataract in the rat lens after total cranial irradiation with a single 5 Gray (Gy) dose of gamma irradiation. Materials and Methods: Twenty-four Sprague-Dawley rats were used for the experiment. The rats were randomly divided into three equal groups. Group 1 did not receive GB or irradiation (control group) but received 1-ml saline orally plus sham-irradiation. Group 2 received total cranium 5 Gy of gamma irradiation as a single dose (IR group) plus 1-ml saline orally. Group 3 received total cranium irradiation plus 40 mg/kg/day GBE (IR plus GBE group). Biochemical parameters measured in murine lenses were carried out using spectrophotometric techniques. Results: Lens total (enzymatic plus non-enzymatic) superoxide scavenger activity (TSSA), non-enzymatic superoxide scavenger activity (NSSA), glutathione reductase (GRD), and glutathione-S- transferase (GST) activities significantly increased in the IR plus GBE groups when compared with the IR group. However, TSSA, GRD and GST activities were significantly lower in the IR group when compared with the control group. Lens xanthine oxidase (XO) activity in the IR group significantly increased compared to that of both the control and IR plus GBE groups. Conclusion: GBE has clear antioxidant properties and is likely to be a valuable drug for protection against gamma-irradiation and/or be used as an antioxidant against oxidative stress

Workplace violence in emergency departments in Turkey

Background Studies on workplace violence against physicians in emergency departments (EDs) in Turkey are lacking. Methods To describe the frequency and types of workplace violence, a 34-question online survey of the past 12 months was sent to physicians working in EDs in Turkey. Types of violence were categorized as verbal threats, physical assaults, confrontation, stalking, and sexual harassment. Results A total of 366 physicians completed the survey; 4 were excluded (minimum 20 hours/week). Sixty-two percent of respondents were men. Ninety-nine percent reported verbal abuse and 54% reported physical violence. Family members, not patients, were the most common perpetrators of every form of workplace violence. Hospitals limiting the number of visitors and loitering had 14% reduction in physical threats. Only 23% of respondents indicated that their hospital offered information about preventing and managing workplace violence even though 86% noted interest. Only 1% never had fear, even though 89% indicated they had security staff. Over 89% felt that hospital security was lacking in number and ability to protect. For 82%, workplace violence affected their ability to provide patient care. Ninety percent indicated that current laws do not adequately protect them. There was also no statistically significant difference in any type of workplace violence based on the timing or length of shifts, type of hospital, or number of hours worked. Of all types of violence reported, only stalking demonstrated a statistically significant difference between men and women. Conclusion Workplace violence is a real danger for physicians working in EDs in Turkey, similar to other countries, demonstrating that this problem transcends borders. Further studies should assess root causes of violent behaviors of patients and their visitors, as well as possible (administrative, social, and legal) mechanisms to minimize such violence. Hospitals that limited the number of visitors and empowered security officers were associated with decreased violence

Effects of Dust Storms and Climatological Factors on Mortality and Morbidity of Cardiovascular Diseases Admitted to ED

Objective. This study was designed to investigate the effects of Desert Dust Storms and Climatological Factors on Mortality and Morbidity of Cardiovascular Diseases admitted to emergency department in Gaziantep. Method. Hospital records, obtained between September 01, 2009 and January 31, 2014, from four state hospitals in Gaziantep, Turkey, were compared to meteorological and climatological data. Statistical analysis was performed by Statistical Package for the Social Science (SPSS) for windows version 24.0. Results. 168,467 patients were included in this study. 83% of the patients had chest pain and 17% of patients had cardiac failure (CF). An increase in inpatient hospitalization due to CF was observed and corresponded to the duration of dust storms measured by number of days. However, there was no significant increase in emergency department (ED) presentations. There was no significant association of cardiac related mortality and coinciding presence of a dust storm or higher recorded temperature. The association of increases in temperature levels and the presence of dust storms with “acute coronary syndrome- (ACS-) related emergency service presentations, inpatient hospitalization, and mortality” were statistically significant. The relationship between the increase in PM10 levels due to causes unrelated to dust storms and the outpatient application, admission, and mortality due to heart failure was not significant. The increase in particle matter 10 (PM) levels due to causes outside the dust storm caused a significant increase in outpatient application, hospitalization, and mortality originated from ACS. Conclusion. Increased number of dust storms resulted in a higher prevalence of mortality due to ACS while mortality due to heart failure remained unchanged. Admission, hospitalization, and mortality due to chest pain both dependent and independent of ACS were increased by the presence of dust storms, PM10 elevation, and maximum temperature

Effect of desert dust storms and meteorological factors on respiratory diseases

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Wartość prognostyczna płynu w opłucnej oraz stężenia antygenu CA-125 i NT-proBNP u pacjentów z ostrą dekompensacją niewydolności serca

Background: Acute decompensated heart failure (HF) is a serious complication associated with significant morbidity and mortality. The CA-125 and NT-proBNP levels have been shown in some studies to predict the outcome, however, the prognostic value of other simple clinical parameters such as pleural effusion has not been established yet. Aim: To assess the prognostic value of pleural effusion regarding in-hospital and 6-month follow-up outcome in patients with acute decompensated HF and the relationship between pleural effusion and CA-125 and NT-proBNP levels. Methods and results: The CA-125 and NT-proBNP levels were measured at baseline and the presence of pleural effusion was examined on chest radiograms. One hundred patients were prospectively followed until the occurrence of cardiac death, defined as death from worsening HF or sudden cardiac death, or completion of follow-up period. There were 27 deaths over the course of 6 months of follow-up. An insignificant trend towards higher values of CA-125 was found in patients with pleural effusion. Univariate Cox regression analysis showed that there was no relationship between pleural effusion and in-hospital outcome as well as mortality during 6-month follow-up. The CA-125 and NT-proBNP levels predicted mortality. Multivariate Cox regression analysis showed that only CA-125 was an independent predictor of the 6-month outcome (RR: 1.2; 1.04-1.4; p = 0.001). Conclusions: In patients with acute decompensated HF, accompanying pleural effusion did not predict mortality or rehospitalisation during the 6-month follow-up. The increased CA-125 level was found to be an independent predictor of poor outcome, irrespective of pleural effusion. Kardiol Pol 2010; 68, 7: 771-778Wstęp: Ostra dekompensacja niewydolności serca jest poważnym powikłaniem związanym z istotną chorobowością i śmiertelnością. W niektórych badaniach wykazano, że stężenia antygenu CA-125 i N-końcowego fragmentu propeptydu peptydu natriuretycznego typu B (NT-proBNP) pozwalają przewidywać rokowanie, ale dotychczas nie ustalono wartości prognostycznej innych prostych parametrów klinicznych, takich jak płyn w opłucnej. Cel: Celem pracy była ocena wartości prognostycznej płynu w opłucnej w odniesieniu do wewnątrzszpitalnych i 6-miesięcznych wyników leczenia u pacjentów z ostrą dekompensacją niewydolności serca, a także zależności między obecnością płynu w opłucnej a stężeniem antygenu CA-125 i NT-proBNP. Metody i wyniki: Stężenia antygenu CA-125 i NT-proBNP oznaczano na początku obserwacji, a obecność płynu w opłucnej oceniano na zdjęciu rentgenowskim klatki piersiowej. Obserwowano prospektywnie 100 pacjentów aż do wystąpienia zgonu z przyczyn sercowych, zdefiniowanego jako zgon z powodu nasilenia niewydolności serca bądź nagły zgon sercowy, lub do zakończenia okresu obserwacji. W trakcie 6-miesięcznej obserwacji wystąpiło 27 zgonów. Wśród pacjentów z płynem w opłucnej stwierdzono nieistotną statystycznie tendencję w kierunku większych wartości stężenia antygenu CA-125. W jednozmiennej analizie regresji Coxa nie wykazano zależności między obecnością płynu w opłucnej a wewnątrzszpitalnymi wynikami leczenia oraz umieralnością w 6-miesięcznej obserwacji. Stężenia antygenu CA-125 i NT-proBNP pozwalały przewidywać umieralność. W wielozmiennej analizie regresji Coxa wykazano, że niezależnym wskaźnikiem predykcyjnym wyników leczenia po 6 miesiącach było tylko stężenie antygenu CA-125 (ryzyko względne 1,2; przedział ufności 1,04-1,4; p = 0,001). Wnioski: U pacjentów z ostrą dekompensacją niewydolności serca współistnienie płynu w opłucnej nie pozwalało przewidywać umieralności oraz ryzyka ponownej hospitalizacji w ciągu 6-miesięcznej obserwacji. Stwierdzono, że zwiększone stężenie antygenu CA-125 było niezależnym wskaźnikiem predykcyjnym niekorzystnego rokowania, którego wartość prognostyczna nie wykazywała związku z obecnością płynu w opłucnej. Kardiol Pol 2010; 68, 7: 771-77