Meaning of Headache at the Emergency Department

AIM: We investigated the meaning of headache in the emergency room, as a precursor symptom of structural or systemic disorders, especially life-threatening neurological disorders, or as one of the other headaches unrelated to structural disorders in patients who applied to the emergency department with headache complaints. The causes of primary and secondary headaches should be carefully differentiated from each other at the emergency situations.METHODS: Patients aged 18 years and older, who applied to the Emergency Department of the Faculty of Medicine of 19 Mayis University, with a complaint of headache were included in the study. Primary headaches were divided into subtypes according to the IHS (International Headache Society) classification. Secondary headaches were divided into two subgroups as neurological and nonneurological.RESULTS: 200 patients, 112 women and 88 men, who applied to the emergency department with the complaint of headache, were included in the study. Migraine was found in 48 patients, tension-type headache in 29 patients, cerebrovascular disease in 52 patients, CNS infection in 4 patients, intracranial mass in 11 patients, traumatic bleeding in 6 patients, psychiatric disorders in 8 patients, sinusitis in 9 patients, and metabolic disease in 22 patients. Cranial CT was normal in 10 patients with primary headache, cerebral hemorrhage in one patient and cerebral edema was found in one patient. Cranial CT was normal in 18 patients with secondary headache, SAH in 40 patients, intracerebral hemorrhage in 4 patients, intracranial mass in 10 patients, subdural hematoma in 4 patients, cerebral edema and ischemia in 6 patients, and epidural hematoma were found in 1patient.CONCLUSION: The causes of patients presenting to the emergency department with headache were cerebrovascular disease, migraine, and tension-type headache. In our study, the most common cause was cerebrovascular disease. The prevalence of migraine varies between 3.4-6.1% in men and 12.9-17.7% in women. In our study, the incidence of migraine was 23%, and it was seen 3 times more in women than in men

A case of acute hepatitis following mad honey ingestion

Acute hepatitis is characterized by liver inflammation and liver cell necrosis. The most frequently observed underlying cause thereof is viruses, but various other causes, such as alcohol, medication, or toxins may also lead thereto.In this paper, a case of acute hepatitis presenting with bradycardia, hypotension, and a prominent increase in liver enzymes following mad honey ingestion is discussed. Since there are only few cases of acute hepatitis following mad honey ingestion in the literature, we want to present this subject matter. Keywords: Mad honey poisoning, Mad honey intoxication, Bradycardia, Hypotension, Acute hepatiti

The Analysis of Poisoning Cases Presented to the Emergency Department within a One-Year Period

SUMMARY: Objectives: Intoxication is the emergence of unwanted signs and symptoms in an organism after exposure to potentially harmful chemical, physical or organic materials. In our study, we evaluated demographic and etiological factors of adult patients admitted to the emergency department with suicidal or accidental poisoning. Methods: This study was conducted retrospectively by using data from the forensics books, protocol notebooks and patient files. Patients over the age of 14 years that were admitted to the Goztepe Training and Research Hospital during a 1-year period (September 2011-September 2012) with poisoning were included in the study. Results: A total of 430 patients were included in the study and 278 of those patients were females (64.7%). The male/female (F/M) ratio was 1.82/1 and the mean age of the patients was 27.4±11.75 years. The analyses showed that in 348 patients (80.93%) the cause of poisoning was medicine, in 39 patients (9.06%) alcohol and drugs, in 37 patients (8.6%) rat poison, in 4 patients (0.93%) a caustic substance and organophosphates in 2 patients (0.46%). The highest rate of admittance due to poisoning was seen in July, followed by August and September. When the frequency of admittance was evaluated in terms of seasons: summer had the highest frequency with 35.6%, then autumn with 29.1%, spring with 19.8% and winter with 15.6%. Conclusions: The results of our studies are similar to previously reported studies in Turkey. Poisoning cases are more common in women and the most common way of poisoning is by medication. Unlike previous reports from the literature, we found that poisoning was most frequent in the summer. ÖZET: Amaç: Zehirlenme potansiyel olarak zarar verebilen herhangi bir kimyasal, fiziksel veya organik maddeye maruziyet sonrası organizmada bazı istenmeyen belirti ve bulguların ortaya çıkmasıdır. Biz bu çalışmamızda intihar amaçlı veya kazara zehirlenme nedeniyle acil servisimize başvuran erişkin hastaların demografik ve etiyolojik faktörlerini araştırdık. Gereç ve Yöntem: Çalışma geriye dönük bir çalışma olup veriler adli defter, protokol defteri ve hasta dosyalarından elde edilmiştir. Bir yıllık süre içerisinde (Eylül 2011-Eylül 2012) Göztepe Eğitim ve Araştırma Hastanesi'ne zehirlenme ile başvuran 14 yaş üstü hastalar çalışmaya dahil edildi. Bulgular: Çalışmaya toplam 430 hasta dahil edildi. Olguların 278'i kadın (%64.7), 152'si erkekti (%35.3). Kadın/erkek (K/E) oranı 1.82/1, yaş ortalaması 27.4±11.75 idi. Zehirlenme nedeni incelendiğinde; 348'inin (%80.93) ilaç, 39'unun (%9.06) alkol ve ilaç, 37'sinin (%8.6) fare zehiri, dördünün (%0.93) kostik madde, ikisinin (%0.46) organofosfat olduğu görüldü. En yüksek başvurunun sırasıyla temmuz, ağustos, eylül aylarında olduğu görüldü. Mevsimlere göre başvuru sıklığına bakıldığında %35.6 yaz, %29.1 sonbahar, %19.8 ilkbahar ve %15.6 kışın başvuru olduğu tespit edildi. Sonuç: Çalışmamızın sonuçları literatürde Türkiye'de daha önce yapılan çalışmalarla benzerlik göstermektedir. Zehirlenme olguları kadınlarda daha sık olup en sık ilaç alımı yolu ile olmaktadır. Literatürden farklı olarak en sık yaz mevsiminde zehirlenme tespit edildi. Key words: Emergency services, poisoning, suicide, Anahtar sözcükler: Acil servis, zehirlenme, intiha