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

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

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

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

The Effect of Epinephrine Administration on Return of Spontaneous Circulation and One-Month Mortality with Cardiopulmonary Arrest Patients

Objective: The objective of this study is to determine the effect of epinephrine administration on the return of spontaneous circulation (ROSC) and one-month mortality in patients with cardiopulmonary arrest. Methods: We conducted this study between August 1, 2016 and May 31, 2017. Importantly, we included the witnessed cases (>= 18 years) of in-emergency department cardiopulmonary arrest (IEDCA) and out-of-hospital cardiopulmonary arrest (OHCA) in the study. We divided the patients into two groups: the adrenaline group (Group 1) and the non-adrenaline group (Group 2). Thereafter, we investigated ROSC and one-month mortality in them. Results: We included 183 patients (50.3% of males and 49.7% of females with a mean age of 64.2 +/- 16.8 years) in the study. The percentages of IEDCA and OHCA cases were 25.1% and 74.9%, respectively. Epinephrine was administered to 100 (54.6%) patients (Group 1). Among these patients, 15.9% (n=29) of the patients had shockable rhythms (ventricular fibrillation, pulseless ventricular tachycardia) and 84.1% (n=154) of them had non-shockable rhythms (asystole, pulseless electrical activity) as the initial rhythm. ROSC and one-month mortality rate of these patients were 24% (n=44) and 72.8% (n=36), respectively. The one-month mortality rates of Group 1 (30% of patients had IEDCA and 70% of patients had OHCA) and Group 2 were 43.8% and 56.2%, respectively (p=0.0231). The ROSC and one-month mortality rates of Group 1 and Group 2 cases, whose initial rhythm was a shockable rhythm, were 26.6% and 50% vs. 42.8% and 66.6%, respectively