Evaluation and comparison of tick detachment techniques and technical mistakes made during tick removal

BACKGROUND: Tick is among the important ectoparasites of humans and animals. Ticks may transmit disease-causing pathogens to humans. Tick contact may be resulted in several viral and bacterial infections, including Crimean-Congo Hemorrhagic Fever. Timely removal of ticks with appropriate methods is important in prevention of disease transmission. There are many methods reported for tick detachment. In this study, we aimed to evaluate two of them, suture lassoing and freezing and to compare both methods and to examine technical mistakes with these techniques. METHODS: This study was designed as a prospective cross-sectional study, and included the ticks detached by healthcare professionals or directly by patients who presented to the emergency department due to tick contact. The ticks were recorded as larvae, nymphs, and adults according to their growth period. Ticks detachment types with surgical sutures and removal mistakes were recorded. RESULTS: The majority (77.4%) of the ticks were removed by healthcare professionals and a lower rate by patients themselves with hand (22.6%). No technical mistake was found in 72 (77.4%) patients, and the tick was detached as a whole, while detached broken in 15 (16.1%) patients, and the tick was detached as a whole, but the sutures were attached wrong in six (6.5%) patients. Tick broken off due to technical mistakes was most commonly seen in the ticks removed by the individuals themselves. CONCLUSION: The results of this study suggest that when appropriately and correctly used, both suture lassoing and tweezers are effective in tick removal. Public awareness-raising and training programs should be increased on this issue. © 2020, Turkish Association of Trauma and Emergency Surgery. All rights reserved

Serum amphiregulin and cerebellin 1 levels in primary hypertension patients

Background: Hypertension is a major risk factor for cardiovascular diseases, stroke, congestive heart disease and renal failure. Primary hypertension is a multi-factorial complex disease and its exact etiology still remains unknown. In this study we aimed to compare serum amphiregulin and cerebellin-1 levels of primary hypertension patients with healthy subjects. Material and methods: Forty-four hypertensive patients and 44 healthy people were included. Patients with systolic blood pressure measurements ≥ 140 mm Hg and diastolic blood pressure measurements ≥ 90 mm Hg were evaluated as hypertensive. Serum amphiregulin and cerebellin 1 levels were measured using ELISA method. Results: Mean amphiregulin level was 32.1 (10.2–72.5) pg/mL in hypertension group and 36.9 (15.9–109.5) pg/mL in control group (p = 0.002). Mean cerebellin 1 levels were comparable in both groups, 82.1 (23.9–286.1) pg/mL in hypertensive group and 95.1 (60.2–293) pg/mL in control group (p = 0.261). Serum amphiregulin to predict hypertension was found to be ≤ 23 pg/mL with specificity of 97% and sensitivity of 48.5% (AUC = 0.74; 95% CI, 0.62–0.86; p = 0.001). Conclusions: Hypertension is associated with lower serum amphiregulin concentrations

Zehirlenme nedeniyle acil servise başvuran hastaların klinik özellikler ve maliyet açısından değerlendirilmesi

Objective In this study, it is aimed to evaluate the demographic, etiologic and clinical characteristics of the poisoning cases admitted to emergency room along with their costs to Social Security Institution. ( Sakarya Med J 2019, 9(3):470-478 ).Materials and MethodsThis is a descriptive study. The data were obtained by retrieving the files of the patients who were registered for poisoning to a university hospital adult emergency service between October 2015 and October 2017 from the automation system.Results Of the patients, 60.3% were in the 18-24 age group, 30.6% were in the 25-34 age group and 60.0% were females. Of the admissions, 56.8% were due to suicide attempt. In the 18-24 age group and in women, poisonings were found more likely to be a suicide attempt. Of the patients, 50.6% admitted with drug poisoning. The second common cause of poisoning after drugs was carbon monoxide (CO) with 20.6%.Conclusion Poisoning is an important public health problem requiring urgent diagnosis and treatment. Most of the drug poisonings, which have a significant share in all poisonings, are suicide attempts. For this reason, the presence of psychiatric symptoms must be investigated in patients with drug poisoning. The second common cause of poisoning after drugs was found to be CO in our study. This situation should be taken into account especially for applications in winter period. Poisoning is also costly in terms of the health economy. It is important to raise public awareness of poisoning in order to prevent both health-related and financially adverse consequences.Amaç Bu çalışmada acil servise başvuran zehirlenme olgularının demografik, etiyolojik ve klinik özellikleri ile bunların sosyal güvenlik kurumuna olan maliyetlerinin değerlendirilmesi amaçlanmıştır. ( Sakarya Tıp Dergisi 2019, 9(3):470-478 ) Gereç ve Yöntemler Çalışmamız tanımlayıcı tiptedir. Veriler, Ekim 2015-Ekim 2017 tarihleri arasında bir üniversite hastanesi yetişkin acil servisine zehirlenme ön tanısıyla kaydı yapılan hastaların dosyalarının otomasyon sisteminden retrospektif olarak incelenmesi ile elde edilmiştir. Bulgular Hastaların %60,3’ü 18-24, %30,6’sı 25-34 yaş grubunda olup, %60,0’ı kadındır. Başvuruların %56,8’inde etkenle maruziyet, intihar amacıyla gerçekleşmiştir. 18-24 yaş grubunda ve kadınlarda zehirlenmelerin daha çok intihar amaçlı olarak gerçekleştiği bulunmuştur. Hastaların %50,6’sı ilaç nedenli zehirlenme ile başvurmuştur. İlaç dışı başvuruların en sık nedeni ise %20,6 ile karbonmonoksit (CO) zehirlenmesi olmuştur. Sonuç Zehirlenmeler, acil tanı ve tedaviyi gerektiren önemli bir halk sağlığı sorunudur. Tüm zehirlenmeler içinde önemli bir paya sahip olan ilaca bağlı zehirlenmelerin büyük bölümü intihar amaçlı alım sonucu gerçekleşmiştir. Bu nedenle ilaç zehirlenmesi ile gelen hastalarda psikiyatrik tabloların varlığı mutlaka araştırılmalıdır. Çalışmamızda ilaç dışı nedenlerle gerçekleşen zehirlenmelerin en büyük nedeni CO olarak bulunmuştur. Özellikle kış döneminde gelen başvurularda bu durum dikkate alınmalıdır. Zehirlenmeler, sağlık ekonomisi açısından da maliyetlidir. Zehirlenmelerin gerek sağlıkla ilgili, gerekse de mali açıdan yarattığı olumsuzlukların önlenmesi açısından toplumsal farkındalığın arttırılması önemlidir

Evaluation of occupational accidents in a tertiary emergency department introduction

Aim: Our study aimed to determine the characteristics of occupational accident cases admitted to an emergency department and evaluate these accidents in terms of emergency service cost.Materials and Methods: This descriptive study evaluated the age and gender of the patients, admission time, reason for admission and the sector in which the patient works. Trauma to the body area and the patients' cost covered by Social Security Institution were also evaluated according to the hazard classification for business organisations.Results: The study included a total of 410 patients admitted to the emergency department due to occupational accidents. Of these, 95.9% were male, of which 30.0% were working in construction sectors. The maximum number of admissions was between 800 and 1200 hours at a frequency of 34.6%. Furthermore, the costs of occupational accidents that the workers were exposed to in very dangerous sectors were the highest (p=0.012).Conclusion: Occupational accidents result in the highest number of deaths after traffic and home accidents. They have a significantly negative impact on both the workers' health and national economy. In particular, in work places classified as dangerous and very dangerous, the employees are at a risk of accidents that may cause permanent injury and/or death

Evaluation of Nursing Home Residents Applying to the Emergency Service

Background: Emergency deparment (ED) has an important role at the care of nursing home residents and acts facilitator role at the acute care, admission to the hospital, unexpected injuries and hospitals. Our research is aiming the evaluation of the demographic and clinical features of the nursing home patients applying to ED. Materials and methods: The nursing home residents who are aged 18 and over 18 applying to ED at the date between 15.04.2014-15.05.2015 are included to this respective study. In the study, demographic information of the patients and diagnosis and treatment information in the emergency room were evaluated. Results: 51 (52%) of the patients are male. The average age of them is 73. The most frequent disease observed in their medical history is Alzheimer’s disease. The physical examinations of the patients resulted that they have cachexia and dehydration. The oftenest diagnosises detected are lung disease (23.5%), infection (22.4%) and malnutrition (22.4%). It has been also detected that 45% of them admitted to hospital and 3.1% of them are to die. The rate of intensive care admission is 64% while the service admission rate is 36%. Conclusion: The rate of the admission of the nursing home residents to ER and especially to intensive care units is quite high. To ameliorate this condition, training and supervision of the nursing home workers should be made more carefully and often. Since we do not have sociodemographic and clinical data about the nursing home residents applying to ED, more study must be made about this area

Evaluation of the demographic, etiological & the costs of drug intoxication

Cases of intoxication are among the common medical emergencies. Cases of suicidal drug intoxication are more common among young people. Based on this information, our study aimed to identify the demographic and etiological characteristics of cases of drug intoxication and their costs to the social security institution. The files of patients diagnosed with drug intoxication in the adult emergency department of Kahramanmaraş Sutcu Imam University Medical Faculty Hospital between 01.01.2022 and 31.12.2022 were reviewed retrospectively from the automation system. In our study, the data of 110 patients admitted to the emergency department with a clinical picture of drug-related intoxication were evaluated. 75.5% of the patients were female and 40% of them were in the 18-24 age group. It was determined that 92.7% of the patients took the drug that caused intoxication for suicidal purposes and that psychiatric agents constituted a significant part of the drugs taken. Treatment costs increased significantly in cases of suicidal drug intake and multiple drug intake. The length of hospital stay and the cost of treatment increased as the time between the time of drug intake and the hospital arrival time increased. Most of the drug-related intoxications occurred due to suicidal intake. Most of the drugs used for this purpose were analgesics and psychiatric drugs. Emergency departments are the first places where patients with drug intoxication are evaluated, and all physicians working in the emergency department should know the approach to intoxication very well. [Med-Science 2023; 12(2.000): 462-5