Analgesic use for carbon monoxide poisoning induced headache: A randomized, controlled, double-blind, clinical trial

Purpose: To compare the effectiveness of three analgesics versus placebo in the relief of carbon monoxide (CO)-induced headache in patients with CO intoxication. Methods: This study was a prospective, randomized, double-blind and placebo-controlled trial. Patients diagnosed with CO intoxication and who had headaches were included in the study. They were divided into four groups. Patients in group 1 received 50 mg dexketoprofen i.v. in 100 mL of saline, while those in group 2 received 800 mg ibuprofen i.v. Patients in group 3 were given I g paracetamol i.v. Group 4 patients received placebo (100 mL of physiological saline. Visual analogue scale (VAS) values were recorded at onset of treatment, and subsequently at 30th, 60th, 90th and 240th min. Patients who scored 3 and below in VAS 240 were considered to have responded to treatment. Results: A total of 168 patients completed the study. Two analgesics and placebo significantly reduced VAS 240 score (p < 0.05). However, VAS 30, VAS 60 and VAS 240 values decreased significantly in the ibuprofen group, when compared to other groups (p < 0.05). Evaluation of response to treatment revealed no significant differences amongst the groups (p = 0.313). Conclusion: These results suggest that analgesics are not superior to oxygen therapy in the treatment of headaches caused by CO poisoning. However, ibuprofen + oxygen treatment may be applied in people who cannot tolerate headaches for a long time

Clinical utility of EDACS-ADP in patients admitted with chest pain to an emergency department

BACKGROUND: Acute coronary syndrome (ACS) is a common cause of mortality and morbidity. An ACS diagnosis can be made with electrocardiogram (ECG) and cardiac markers. However, despite medical advances, 2–5% of ACS patients are undiagnosed and discharged from emergency departments (EDs) because clinicians often find it difficult not only to diagnose and treat high-risk patients but also to define nonemergency diseases or safely discharge healthy patients. Risk stratification can be prevented, and inappropriate diagnosis and treatment protocols can be identified. The ED Assessment of Chest Pain Score-Accelerated Diagnostic Protocol (EDACS-ADP) scoring system, developed to identify patients with chest pain but at low risk for a major adverse cardiac event (MACE), is the first score based on clinical data from emergency medicine.   OBJECTIVES: This study investigates the usability of EDACS-ADP in Turkey.   MATERIALS AND METHODS: This is a prospective observational study of 392 patients. The primary outcome was a major adverse cardiovascular event (MACE) within thirty days.   RESULTS: A total of 116 MACEs occurred in 65 (16,6%) patients during a one-month follow-up. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+ LR), and negative likelihood ratio (–LR) values of the EDACS-ADP score for the evaluation of 30-day MACE rate in patients who admitted with chest pain for two months were as follows: 96.9%, 64.5%, 35.2%, 99.1%, + LR: 2.73, and –LR: 0.05.   CONCLUSION: Most of these patients were classified by the EDACS-ADP as low risk and suitable for discharge. The 30-day MACE rate of development was significantly low (0.9%) and acceptable in patients grouped as low risk

Effect of the Ecological Methods on the Surface Modification of the Kenaf Fibers

Kenaf is a biodegradable and environmental friendly bast fibre. The most rapidly expanding application field for kenaf fibre is composites as reinforcing material. In this study four different chemical treatments were applied to kenaf fibre by using conventional, ultrasonic and microwave methods. Weight loss, tensile strength, elongation properties, morphological characteristics (SEM) and FTIR analysis of the treated kenaf fibre were carried out. Valuable results were obtained from formic acid and acetic acid treatments of kenaf fibre by ultrasonic and microwave methods. The reasons for the ultrasonic and microwave processes to be successful are the strength achieved by sonication and microwave

Knowledge, Attitudes, and Behaviors of Pregnant Women Regarding Smoking Who Were Admitted to the Obstetrics Clinic of the Bulent Ecevit University Hospital

WOS: 000421135200001Objective: Smoking in pregnancy and postpartum period causes serious healthy risks for fetuses, newborns, and children. The purpose of this study was to determine the prevalence of smoking and associated socio-demographic factors and knowledge, attitude levels, and behaviors of pregnant smokers. Methods: A descriptive study was performed on 335 pregnant women who were admitted to our clinic between March 1 and April 30, 2014. A questionnaire prepared by researchers comprising 24 questions was applied to eligible women. Statistical analysis was performed using SPSS 19 software program. Descriptive statistical data are presented as frequencies, and measurements are presented as mean +/- standard deviation. Chi-square test was used for comparison between categorical variables. Mann-Whitney U test and Kruskal-Wallis analysis of variance were used for comparisons between paired groups. Results: A total of 20.5% of pregnant women smoked throughout pregnancy. Education and income status of pregnant women did not have a significant association with smoking during pregnancy (p=0.172 and p=0.203, respectively). Smoking status was compared with pregnancy, breastfeeding, and total knowledge scores. While a significant difference did not exist between pregnancy and total knowledge scores (p=0.126, p=0.051), knowledge scores of breastfeeding was significantly lower in smoking women (p=0.031). Education status and knowledge scores were compared. Each of the three knowledge scores was higher in women with higher education levels (p=0.003, p=0.000, and p=0.001). Conclusion: Smoking during pregnancy is a major health problem. Control frequency should be increased for pregnant smokers and for their babies as well as to aid in the early diagnosis of potential problems. Doctors, nurses, and midwives should remind patients who quit smoking during pregnancy that they should take professional help to not start smoking again in the postpartum period

The Charlson Comorbidity Index: predicting readmission and severity in emergency departments

Introduction. The Charlson Comorbidity Index (CCI) is a comorbidity scale used widely throughout the world. Despite its widespread use, its relationship with patient readmission to the Emergency departments (ED) has not been evaluated previously. Aim. To show whether there is a correlation between the CCI score and the number of repeated admissions to ED and that the CCI score can be used as a predicted factor for the serious patients. Material and methods. This was a prospective observational cross-sectional study. Age, gender, vital signs of the patients who agreed to participate in the study was recorded. Numbers of ED readmissions of patients within six months after discharge and CCI scores have been recorded. Results. The study was completed with 1420 patients. The admission rates of patients in the ED in the six months were significantly higher in the CCI 5+ group than in other groups (p0). Conclusion. We believe that the CCI scoring system can be used by ED clinicians to predict the risk of readmission of patients after discharge from ED

Topical lidocaine anesthesia for nasopharyngeal sampling – a double-blind randomized placebo-controlled trial

Introduction and aim. The aim of this study is to evaluate the effects of topical lidocaine application for nasopharyngeal sampling, on pain perception, the comfort of the patients, and the application difficulty for healthcare staff. Material and methods. This study conducted with 100 healthy volunteers (50 participants in Lidocaine group and 50 participants in Placebo group). Two ml of a solution containing 10 mg/ml of lidocaine was applied to each nostril of the participants in the Lidocaine group, and the same dose of 0.9% NaCl to the Placebo group. We compared the changes in pain intensity and discomfort intensity using two numerical rating scales, the frequency of undesirable reactions, and the judgment of the practitioner staff. Results. There were statistically significant decreases in pain and discomfort scores in the Lidocaine group. Similarly, there were statistically significant decreases in the frequency of all undesirable reactions except “grimace”, in the second sampling in the Lidocaine group, however, there was a statistically significant decrease only in “holding staff’s hand” in second sampling in the Placebo group. Conclusion. Intranasal lidocaine application reduces the pain that occurs during nasopharyngeal sampling and makes the procedure easier for the patient and the healthcare worker

Effect of Nasal Corticosteroid on Secretory Immunoglobulin A Measured in Rat Nasal Lavage: Experimental Study

Objective In this study, we aimed to experimentally investigate the effects of nasal corticosteroids on the levels of secretory immunoglobulin A (sIgA) in nasal mucosa in rats

The Impact of ‘Stay At Home’ Orders on Emergency Room Admissions

Introduction. The 2019-novel-coronavirus (2019-nCoV) outbreak has become a common problem for the whole world. Aim. To investigate the impact of the 2019-nCoV pandemic period in our country on emergency room admissions. Materials and methods. The study was designed as a retrospective cohort. The first case of pneumonia infected with nCoV in our country was diagnosed on March 11, 2020. Considering the date of March 11, 2020, emergency room admissions for two periods of 7 days were investigated, pre-COVID-19 and COVID19. Demographic data, admission diagnosis, vital findings, stay times in emergency room, terminations and emergency department mortality examined. A group of ‘geriatric’ patient populations were created to examine the admission characteristics of patients aged-65 and over. Results. The 3466 patients included in the study. The average number of daily admissions was significantly higher in the pre-COVID-19 period (350.4 ± 54.5), compared to the COVID-19 period (144.7 ± 20.2, p=0001). While the proportion of cardiac-caused admissions increased during the COVID period, the proportion of gastrointestinal-induced admissions decreased (p<0001). Hospitalization rates for both adult and geriatric patients increased during the COVID period (p<0001). Conclusion. Despite all the negativity caused by the outbreak, this period has been one in which the public is aware of unnecessary emergency room which has been subsequently lessened

Clinical utility of EDACS-ADP in patients admitted with chest pain to an emergency department

Introduction: Acute coronary syndrome (ACS) is a common cause of mortality and morbidity. An ACS diagnosis can be made with electrocardiogram (ECG) and cardiac markers. However, despite medical advances, 2-5% of ACS patients are undiagnosed and discharged from emergency departments (EDs) because clinicians often find it difficult not only to diagnose and treat high-risk patients but also to define nonemergency diseases or safely discharge healthy patients. Risk stratification can be prevented, and inappropriate diagnosis and treatment protocols can be identified. The ED Assessment of Chest Pain Score-Accelerated Diagnostic Protocol (EDACS-ADP) scoring system, developed to identify patients with chest pain but at low risk for a major adverse cardiac event (MACE), is the first score based on clinical data from emergency medicine. Aim: This study investigates the usability of EDACS-ADP in Turkey. Material and Methods: This is a prospective observational study of 392 patients. The primary outcome was a major adverse cardiovascular event (MACE) within thirty days. Results: A total of 116 MACEs occurred in 65 (16,6%) patients during a one-month follow-up. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+ LR), and negative likelihood ratio (-LR) values of the EDACS-ADP score for the evaluation of 30-day MACE rate in patients who admitted with chest pain for two months were as follows: 96.9%, 64.5%, 35.2%, 99.1%, + LR: 2.73, and -LR: 0.05. Conclusions: Most of these patients were classified by the EDACS-ADP as low risk and suitable for discharge. The 30-day MACE rate of development was significantly low (0.9%) and acceptable in patients grouped as low risk