Pagophagia-Induced Hyponatremia: An Unusual Case

Hyponatremia occurs when the serum sodium level is below 135 mmol/L. The symptoms include nausea, vomiting, confusion, headache, cardiorespiratory symptoms, profound somnolence or coma, and seizures are observed. Iron deficiency anemia can also cause pagophagia, a Pica subspecies. Although it has been emphasized that electrolyte disturbance may develop due to pagophagia, only a dearth of cases was reported. A 59-year-old male patient was brought to the emergency department with complaints of incoherent speech that started at night, disorientated movements (such as fluttering and climbing), insomnia, restlessness, and confusion. In 2017, he experienced hyponatremia due to pagophagia and a salt-free diet. At the index episode of hyponatremia, he experienced confusion, drowsiness, and sleepiness. It was learned that the patient enjoyed these symptoms.For this purpose, the patient made a habit of eating a completely salt-free diet and consumed plenty of water. Although pagophagia is considered to cause hyponatremia because it causes excessive water intake, there are not enough cases reported. It is to be noted that people develop habits or addiction to things they like

Analysis of Injuries During Sacrifice in Feast of Sacrifice

Objective: This study included patients who applied to the Emergency Department of Gaziantep University hospital with injuries that occurred during the sacrifice in first day of the Feast of Sacrifice of 2017.Methods: Forty seven patients applied to our emergency department due to the injuries that occurred during animal slaughter and meat processing on the first day of in total of four-day feast in 2017.Results: Total of 25.5% of these patients were female (n=12) while 74.5% were male (n=35). The mean age was 37.7±12.5 for males, 40.3±12.6 for females 38.05±12.35 for overall group. None (except for one (2.1%) of the accident victims was animal slaughterer and all of the injuries were in form of self-injury. There was tendon laceration in 10.6% (n=5) of the patients and skin and subcutaneous tissue laceration in 42 patients (89.3%). Cephalic vein laceration was detected in only one patient (2.1%) as arteriovenous injury. In one patient (2.1%) the digital nerve was partially lacerated. Five of the patients (10.6%) were hospitalized and the others were discharged after their treatment in emergency department. No permanent disability or loss of function was observed in one month's follow-up.Conclusion:The injuries that may be encountered during sacrifice are preventable injuries. Accidental injuries caused by application of the sacrifice will be minimized when it’s performed by professionals

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

Diversity, biogeography, evolutionary relationships, and conservation of Eastern Mediterranean freshwater mussels (Bivalvia: Unionidae)

Located at the junction between Europe, Africa, and Asia, with distinct evolutionary origins and varied ecological and geographical settings, together with a marked history of changes in orogeny and configuration of the main river basins, turned the Eastern Mediterranean into a region of high diversity and endemism of freshwater taxa. Freshwater mussels (Bivalvia, Unionidae) from the Western Palearctic have been widely studied in their European range, but little attention has been dedicated to these taxa in the Eastern Mediterranean region and their diversity and phylogeography are still poorly understood. The present study aims to resolve the diversity, biogeography, and evolutionary relationships of the Eastern Mediterranean freshwater mussels. To that end, we performed multiple field surveys, phylogenetic analyses, and a thorough taxonomic revaluation. We reassessed the systematics of all Unionidae species in the region, including newly collected specimens across Turkey, Israel, and Iran, combining COI+16S+28S phylogenies with molecular species delineation methods. Phylogeographical patterns were characterized based on published molecular data, newly sequenced specimens, and species distribution data, as well as ancestral range estimations. We reveal that Unionidae species richness in the Eastern Mediterranean is over 70% higher than previously assumed, counting 19 species within two subfamilies, the Unioninae (14) and Gonideinae (5). We propose two new species, Anodonta seddoni sp. nov. and Leguminaia anatolica sp. nov. Six additional taxa, Unio delicatus stat. rev., Unio eucirrus stat. rev., Unio hueti stat. rev., Unio sesirmensis stat. rev., Unio terminalis stat. rev. removed from the synonymy of Unio tigridis, as well as Unio damascensis stat. rev. removed from the synonymy of Unio crassus, are re-described. The nominal taxa Unio rothi var. komarowi O. Boettger, 1880 and Unio armeniacus Kobelt, 1911 are proposed as new synonyms of Unio bruguierianus, and Anodonta cyrea Drouët, 1881 and Anodonta cilicica Kobelt & Rolle, 1895 as new synonyms of Anodonta anatina. Also, the presence of Unio tumidus in the Maritza River is confirmed. The phylogeographic patterns described here are interpreted concerning major past geological events. Conservation needs and implications are presented, together with populations and species conservation priorities

Experiences of Turkey's First National E-Congress of Emergency Medicine

Aim: In our study, by analyzing the first national emergency medicine e-congress organized during the pandemic process, it was investigated what differences it made to the emergency medicine field. Materials and Methods: The study was arranged by taking data from www.acilakademi.net website, which was published under the title of 1st National Emergency Medicine E-Congress of the Emergency Medicine Physicians Association of Turkey (ATUDER) between June 11 and June 13, 2020. Results: A total of 120 speakers and 545 listeners attended. 66.7% of the speakers were male, 45% verbally (oral presentation) presented, and 45.8% participated with the title of attending physicians. 13.3% of the topics presented by the speakers were critical care. The clothes 69.2% of them wore were in the style of daily clothes. The average speaking time of the invited speakers is 18.71 +/- 4.91 (13.3-31.19) minutes. While the average number of people watching the invited speakers was 46.65 +/- 43.86 (16-252), the number of those who watched the presentations until the end was calculated as 14.73 +/- 8.43 people. It was observed that the male gender was in a significant majority with oral presentations, invited speakers, and moderators (p=0.020). Conclusion: Organizing online congresses is advantageous for the participants as an alternative to the traditional congress and it can be made more effective with some arrangements

Smartphone evaluation of postero-anterior chest x-rays: An inter-observer study

Background: Posterior-anterior chest x-ray (PA-CXR) is among the most commonly used imaging methods in the diagnosis both in the emergency departments (ED) and the other clinics. The aim of the present study was to evaluate the diagnostic reliability of PA-CXRs sent via a smartphone. Methods: This study was conducted as an inter-observer study. PA-CXRs were photographed with a smartphone and they were sent to two separate participants (emergency medicine specialists one with 4 years experience and another with 3) via the WhatsApp application. And the participants evaluated to these images on their mobile phone. Results: A poor concordance was determined in a ratio of 3/8 and good concordance was detected in a ratio of 3/8 between the two participants (p < 0.05). It was observed that only the mediastinum assessments could be an alternative to the gold standard (p < 0.01). Conclusion: We may conclude that the assessments done via a smartphone (photographing and sharing) may not be reliable. (C) 2020 Elsevier Inc. All rights reserved.WOS:0006813086000152-s2.0-85095784686PubMed: 3317274

Applicability of 3.0 T MRI images in the estimation of full age based on shoulder joint ossification: Single-centre study

Skeletal maturity is evaluated by many radiological methods for forensic age estimation. Direct radiography and computed tomography lead to a rise in ethical concerns due to radiation exposure. Therefore, magnetic resonance imaging (MRI) has currently been used in recent studies. In this study, the ossification stage of the shoulder joint was determined retrospectively in 178 male and 109 female individuals in the age group 12 to 30 years using 3.0 T MRI. All the images were evaluated with T1-weighted turbo spin echo (T1 TSE) sequence and T1 fast low angle shot two-dimensional sequence (T1 FL2D). The combined staging method, which was defined by Kellinghaus et al. and Schmeling et al., was used. The infra- and inter-observer agreement levels were very good (kappa and kappa(w)). There were no significant age differences between males and females in all stages. In most of the stages, the ossification of the proximal humeral epiphyses occurred earlier in females than in males. Stage 4 did not occur in either of the sexes before the 18th birthday as the youngest patients in this stage was at 19 and 18 years of age in males and females, respectively. We concluded that evaluating the ossification of the proximal humeral epiphysis with MRI imaging for forensic age estimation may be beneficial. Evaluating the same anatomical structure with different MRI sequences may be useful for accurate staging diagnosis.WOS:0005798551000242-s2.0-85088640574PubMed: 3273616

Traumatic Injuries From Sheep Sacrifice During the Eid Al-Adha Holiday: A Prospective Multicentered Study

Objective: We sought to describe injuries related to the sacrificial slaughtering of animals during the Eid holiday. Methods: We conducted a centered prospective observational cohort study during the Eid (August 21-24, 2018) at 5 emergency departments in Gaziantep, Turkey. Descriptive statistics of injuries collected included the injury location, involvement of dominant or non-dominant hand, cause of injury (instrument vs animal), type of instrument causing injury, surgical interventions performed, and professional occupations of patients. Results: We included two hundred seventy-seven patients with injuries who fulfilled the criteria and excluded injuries not related to animal slaughter. Most injuries (91%) occurred in people who were not professional butchers (n=252) and simple laceration (not involving vessels or tendons) was the most common injury type (95.3%; n=265). Those who were injured and had no experience were mostly injured during the processing of the meat (butchering) and while helping others. Lacerations were most commonly observed in the upper extremity (83.4%; n=231), on the non-dominant side (67.5%; n=187), in the hand (78.7%, n=218), and specifically in the index finger (23.1%; n=64). A surgery was performed on 8 patients. Conclusion: The first day of Eid is associated with an increase in mostly non-dominant upper extremity injuries among inexperienced people slaughtering animals. Further education and safety measures may reduce such injuries. Emergency departments serving larger Muslim communities may benefit from anticipating an uptick in these injuries

Knowledge and Skills of the Senior Students of Paramedical, Nursing and Medical Faculties on Cardiopulmonary Arrest Recognition, Maintenance of Chest Compression and Ventilation

WOS: 000489681000004Aim: We believe that automatic external defibrillators are not common in our country and aimed to compare the knowledge and skills of senior students in paramedical, nursing and medical faculties on recognizing cardiopulmonary arrest (CPA) case, providing proper chest compression and maintenance of ventilation as well as evaluating cardiopulmonary resuscitation (CPR) cycle one month before starting profession. Materials and Methods: Fifty senior students from paramedic department, 50 senior students from nursing department and 50 senior students from medical school were included in the study. The participants were asked 10 theoretical questions to evaluate their basic resuscitation knowledge. Each participant was then asked to intervene in a suspicious CPA case using Prestan Adult CPR Manikin alone in a separate room. Results: The highest rate of correct answers given to theoretical questions related to CPR was in paramedic students with a mean score of 7.34 +/- 1.99 points among the students of these three departments (p=0.001). The mean scores of both theoretical and practical application of paramedic students were found to be significantly higher than the students of the nursing and medical faculties, when all three groups were compared with each other with regard to their mean success scores of theoretical and practical applications. Conclusion: In our study, the mean scores of both theoretical and practical application of paramedic students were found to be significantly higher than the other groups