Browsing by Author "Dursun, Recep"

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Analysis of Burn Cases Observed After the 2011 Van Earthquake
(Turkish Assoc Trauma Emergency Surgery, 2013) Dursun, Recep; Karadas, Sevdegul; Gormeli, Gokay; Isik, Yasemin; Cakir, Cumhur; Gormeli, Cemile Ayse
Background The purpose of this study was to determine the epidemiological features of cases that were registered for burns and treated at a hospital after the Van earthquake to compare burn cases from the previous year and to determine the factors that influenced mortality. METHODS Patients who were admitted to the Van Region Training and Research Hospital within the 3-month period after the earthquake were categorized as group 1; patients who were admitted within the same time interval in the previous year were categorized as group 2. RESULTS There were 121 patients in Group 1 and 89 patients in Group 2. It was determined that there were 36% more burn cases in Group 1. Flame burns were observed 4.8 times more often in Group 1 compared to Group 1 (p=0.002). Exitus was observed in 25.4% of cases in Group 1 and in 7% of cases in Group 2 (p=0.0069). CONCLUSION It was determined that the number of burn cases registered after the earthquake, the number of flame burns, the percentage of burns and the rate of mortality were higher than the data before the earthquake.
A Clinical Analysis of Patients Undergoing Fasciotomy Who Experienced the 2011 Van Earthquake
(Turkish Joint Diseases Foundation, 2012) Gormeli, Gokay; Gormeli, Cemile Ayse; Guner, Savas; Ceylan, Mehmet Fethi; Dursun, Recep
Objectives: This study aims to investigate the clinical profile and prognosis of the patients with fasciotomy who were admitted to Van Training and Research Hospital following the 2011 Van earthquake. Patients and methods: Twenty-one patients (11 males, 10 females; mean age 38.3 years; range 18 to 60 years) who had urgent fasciotomy in our clinic following the earthquake were included. Medical records including demographic data, clinical characteristics and prognostic data of the patients were retrospectively analyzed. Results: Seven of 21 patients with fasciotomies underwent amputation. Fasciotomy incisions were closed with skingrafting in nine patients and with primary closure in three patients. Eight patients had full range of motion of the joint, while four patients had restricted range of motion of the joint and needed rehabilitation. Two patients had sensory loss. Conclusion: Compartment syndrome is one of the serious problems after the Van earthquake. The infection ratio was low, while the amputation ratio was high. The use of anticoagulants following compartment syndrome worsens the clinical presentation, increasing the intracompartmental pressure.
The Clinical Profile of Musculoskeletal Injuries Associated With the 2011 Van Earthquake in Turkey
(Turkish Joint Diseases Foundation, 2012) Gormeli, Gokay; Gormeli, Cemile Ayse; Guner, Savas; Ceylan, Mehmet Fethi; Dursun, Recep
Objectives: In this study, we aimed to evaluate the clinical profile of the patients with musculoskeletal injuries associated with the 2011 Van earthquake and treatment modalities applied. Patients and methods: Between 23.10.2012 and 28.10.2012, a total of 285 patients (151 males, 134 females; mean age 38.6, years; range 1 to 84 years) with musculoskeletal injuries associated with the earthquake who were admitted to Emergency Department of Van Training and Research Hospital were retrospectively analyzed. Medical records including the profile of injury, injury type, site of injury, treatment modalities applied and prognosis were evaluated. Results: Ninety-five of 285 patients had soft tissue damage, while 144 had fractures. Of these fractures, 81 required surgical treatment. Forty-six patients had crush injury, while 28 had compartment syndrome. Open and multiple fractures and fragmented fractures were common. The majority of the fractures involved limbs, indicating higher incidence of lower limb involvement rather than upper limb involvement. The incidence of infection was lower in the patients who experienced the earthquake. Conclusion: Orthopedic surgery is of utmost importance for the patients with musculoskeletal injuries associated with the earthquake. Appropriate triage should be performed and then the patients with open fractures and compartment syndrome should be given priority for surgery. In such cases, debridement, open reduction and internal fixation are the most common surgical treatments.
Health Professionals of Emergency Service: an Evaluation of Disaster Medicine and Ethical Values
(Univ Bophuthatswana, 2015) Sevimli, Sukran; Dursun, Recep; Karadas, Sevdegul
Aim: To obtain the opinions of health professionals' who work in emergency medical services on the application of basic attitudes like triage, ethics, legal rules; to popularize problems they have encountered or may experience while giving health services after natural disasters; and to develop further suggestions. Material and method: In order to evaluate health service problems, laws, triage and ethics applications, a questionnaire tool was formulated. The poll that was taken included 133 emergency service workers, with and without earthquake experiences. Data were analyzed using descriptive statistics with statistical significance set at p<0.001. The frequency distributions taken into account and chi square test were applied to understand the difference between the employees who experienced an earthquake and the employees who did not. Findings: 57.7% of participants in the survey were males and 42.3% females. Their average age was 29.8 %. 16.8% of them worked in the university hospital, 77.4 % in a state hospital and 5.8% in private hospitals. 51.1% of the participants were doctors, 43.1% nurses and 5.8% emergency medical technicians. 48.2% of the participants had experienced earthquakes, 52.6% had not. 27% of them were consulted on triage, 37.2% on both triage and legal rules, 31.4% on triage, laws and ethics and 4.4% on triage and ethical principles. Conclusion: Results show that while ethical principles are less considered in medical services after natural disasters, triage and legal regulations play an essential role in resource allocation and medical service presentation. The results show that the inclusion of ethical training in natural disaster medicine education and its enhancement through regular rehearsals is essential.
Health Professionals of Emergency Service: Evaluation of Triage and Ethical Values in Disaster Medicine
(Emergency Medicine Physicians Assoc Turkey, 2015) Sevimli, Sukran; Dursun, Recep; Karadas, Sevdegul
Aim: To understand opinions of health professionals who work in emergency services about the application of basic concepts, such as triage, ethics, legal rules, to popularize problems they experience while they are providing health services after natural disasters, and to develop suggestions. Materials and Methods: In order to evaluate health service problems, a questionnaire tool was formulated regarding triage and ethics applications. The questionnaire was given to 133 emergency service workers with and without earthquake experiences. Data were analyzed using descriptive statistics with statistical significance set at p < 0.001. The frequency distributions were taken into account and chi square test was performed to understand the differences between employees who had experienced earthquakes and those who had not. Results: In the survey, 57.7% of participants were male and 42.3% were female. The mean age of the participants' was 29.8 years; 16.8% of them worked in the university hospital, 77.4% in the state hospital, and 5.8% in private hospitals. Of the participants, 51.1% were doctors, 43.1% were nurses, and 5.8% were emergency medical technicians; 48.2% of participants had experienced an earthquake and 52.6% had not. In addition, 27% of the participants had to consult regarding triage; 37.2% on triage and legal rules; 31.4% on triage, laws, and ethics; and 4.4% on triage and ethical principles. Conclusion: The results show that triage and legal regulations play an essential role in resource allocation and medical service presentation, while ethical principles are less considered in medical services after natural disasters. Inclusion of ethical training in natural disaster medicine education and its enhancement through regular rehearsals are essential.
The Investigation of the Impacts of Major Disasters, on the Basis of the Van Earthquake (October 23, 2011, Turkey), on the Profile of the Injuries Due To Occupational Accidents
(Elsevier Sci Ltd, 2015) Hekimoglu, Yavuz; Dursun, Recep; Karadas, Sevdegul; Asirdizer, Mahmut
The purpose of this study is to identify the impacts of major disasters, on the basis of the Van earthquake (October 23, 2011, Turkey), on the profile of the injuries due to occupational accidents. In this study, we evaluated 245 patients of occupational accidents who were admitted to emergency services of Van city hospitals in the 1-year periods including pre-earthquake and post-earthquake. We determined that there was a 63.4% (P < 0.05) increase in work-related accidents in the post-earthquake period compared to the pre-earthquake period. Also, injuries due to occupational accidents increased 211% (P < 0.05) in the construction industry, the rate of injuries due to falls from height increased 168% (P < 0.05), and the rate of traumas to the head and upper limbs increased 200% (P < 0.05) and 130% (P < 0.05), respectively, in the post-earthquake period compared to the pre-earthquake period. We determined that the ignoring of measures for occupational health and safety by employers and employees during conducted rapid construction activities and post-earthquake restoration works in order to remove the effects of the earthquake increased the number of work accidents. In this study, the impact of disasters such as earthquakes on the accidents at work was evaluated as we have not seen in literature. This study emphasizes that governments should make regulations and process relating to the post-disaster business before the emergence of disaster by taking into account factors that may increase their work-related accidents. (C) 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Mmp-1, Mmp-9, and Timp-1 Levels in Oral Lichen Planus Patients With Gingivitis or Periodontitis
(Pergamon-elsevier Science Ltd, 2013) Ertugrul, Abdullah Seckin; Dursun, Recep; Dundar, Niyazi; Avunduk, Mustafa Cihat; Hakki, Sema Sezgin
Objective: Oral lichen planus (OLP) is a chronic inflammatory disease of unknown aetiology. The aim of this study was to investigate matrix metalloproteinase (MMP)-1, MMP-9, and MMP inhibitor-1 (TIMP-1) levels in gingival crevicular fluid (GCF) by enzyme-linked immunosorbent assay and to investigate MMP-1, MMP-9, and TIMP-1 levels in gingival tissue by immunohistochemical staining of samples from patients with and without OLP. Design: Twenty-seven patients with OLP (gingivitis, OLPG; chronic periodontitis, OLPP) and thirty healthy non-OLP patients (gingivitis, HG; chronic periodontitis, HP) were included in this study. The MMP-1, MMP-9, and TIMP-1 levels in GCF were determined by enzyme-linked immunosorbent assay. The MMP-1, MMP-9, and TIMP-1 levels in gingival tissue were determined by immunohistochemical staining. Results: The mean levels of MMP-1 and MMP-9 in the GCF of OLPP patients were significantly higher and TIMP-1 was significantly lower than in HP patients; similarly, the mean levels of MMP-1 and MMP-9 were higher and TIMP-1 was significantly lower in OLPG patients than in HG patients. Our findings illustrate that tissue MMP-9 levels were statistically higher and TIMP-1 level were significantly lower in the OLPP group in comparison to the HP group, and the OLPG group in comparison to the HG group. The tissue MMP-1 level in the non-OLP group was found to be lower when compared with the OLP groups. But not statistically significant. Conclusions: Increased levels of MMP-1 and MMP-9 with decreased levels of TIMP-1 in GCF and increased MMP-1, MMP-9 levels and decreased TIMP-1 levels in the gingival tissue of OLP patients in combination with poor oral hygiene may cause increased tissue breakdown. The results of our study provide information about the effects of the periodontal status on the enzyme profiles in GCF and gingival tissue of OLP and non-OLP patients. (C) 2013 Elsevier Ltd. All rights reserved.
Myocardial Infarction Due To Lightning Strike
(Pakistan Medical Assoc, 2013) Karadas, Sevdegul; Vuruskan, Ertan; Dursun, Recep; Sincer, Isa; Gonullu, Hayriye; Akkaya, Emre
Cardiac events due to lightning strike and their severity vary according to the strength of the electric current and the duration of exposure. The electrophysiological effects of lightning on the heart can result in ventricular fibrillation, asystole, QT prolongation, supraventricular tachycardia, and non-specific ST-T wave changes. In this report, a case of a patient who suffered myocardial infarction due to lightning strike is presented, which is a rare complication
Neurosurgical Injuries Caused by the 2011 Van Earthquake: the Experience at the Van Regional Training and Research Hospital
(Elsevier Science inc, 2015) Aycan, Abdurrahman; Yener, Ulas; Aycan, Nur; Gonullu, Edip; Dursun, Recep; Gonullu, Hayriye
Background: On October 23, 2011, a devastating earthquake, magnitude 7.2 on the Richter Scale, jolted the province of Van in the east of Turkey and led to hundreds of casualties. Objectives: In this study, we aimed to present our clinical experience in the management of patients with cranial and spinal injuries who were admitted to the Van Regional Training and Research Hospital. Methods: The retrospective study included 44 (77.2%) patients who were referred to the neurosurgery department after being diagnosed with spinal and cranial injuries due to earthquake at the emergency department between October 23 and 27, 2011. Results: The patients comprised 32 male (72.7%) and 12 (27.3%) female patients with a mean age of 23.5 years. The injuries included scalp injury (n=16), burst fracture (n=7), compression fracture (n=3), epidural hematoma (n=9), subdural hematoma (n=3), contusion (n=1), traumatic subarachnoid hemorrhage (n=2), depressed skull fracture (n=3), linear fracture (n=9), cervical fracture (n=2), and pneumocephalus (n=1). Most of the patients (90.9%) had isolated injuries and the others (9.1%) presented with combined cranial and spinal injuries. At discharge, the 3 patients with spinal fractures were paraplegic, and of the 2 patients who were operatively treated due to subdural hematoma, 1 was hemiparesic and the other was hemiplegic. No mortality occurred in our patients. Conclusions: The results of this study demonstrated that, in the aftermath of a natural disaster, conducting correct triage procedures and performing a prompt intervention with appropriate and qualified equipment play key roles in reducing morbidity and mortality. (C) 2015 Elsevier Inc.
Periodontopathogen Profile of Healthy and Oral Lichen Planus Patients With Gingivitis or Periodontitis
(Nature Publishing Group, 2013) Ertugrul, Abdullah Seckin; Arslan, Ugur; Dursun, Recep; Hakki, Sema Sezgin
Oral lichen planus (OLP) is a chronic inflammatory disease that is frequently detected in oral tissues. The aim of our study was to identify the prevalence of the detection of periodontopathogenic microorganisms (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola in OLP patients and to compare with this prevalence of periodontopathogenic microorganisms in healthy non-OLP patients. Our study included 27 (18 chronic periodontitis (OLPP) and 9 gingivitis (OLPG)) patients diagnosed with OLP along with 26 (13 chronic periodontitis (HP) and 13 gingivitis (HG)) healthy non-OLP patients. The multiplex polymerase chain reaction (PCR) with subsequent reverse hybridization method (micro-I Dent) was used for identifying periodontopathogenic microorganisms present in subgingival plaque samples. The percentages of detection for A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia and T. denticola in subgingival plaque samples taken from OLP patients (OLPG and OLPP) were 18.5%, 85.1%, 81.4%, 88.8% and 74%, respectively. Meanwhile, in the non-OLP patients (HG and HP), these values were 7.6%, 50%, 46.1%, 73% and 57.7%, respectively. Thus, comparing the non-OLP groups with the OLP groups, the periodontopathogens' percentages of detection in the OLP groups were higher than those in the non-OLP groups. According to our study results, OLP patients have higher levels of infection with A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia and T. denticola than non-OLP patients. We argue that the high percentages in patients with OLP may help identify the importance of periodontopathogenic microorganisms in the progress of periodontal diseases of OLP.
Review of Van Earthquakes Form an Orthopaedic Perspective: a Multicentre Retrospective Study
(Springer, 2013) Guner, Savas; Guner, Sukriye Ilkay; Isik, Yasemin; Gormeli, Gokay; Kalender, Ali Murat; Turktas, Ugur; Dursun, Recep
This is a descriptive analysis, of victims of Turkey's October 23, 2011 and November 21, 2011 Van earthquakes. The goal of this study is investigated the injury profile of the both earthquakes in relation to musculoskeletal trauma. We retrospectively reviewed medical records of 3,965 patients admitted to in seven hospitals. A large share of these injuries were soft tissue injuries, followed by fractures, crush injuries, crush syndromes, nerve injuries, vascular injuries, compartment syndrome and joint dislocations. A total of 73 crush injuries were diagnosed and 31 of them were developed compartment syndrome. The patients with closed undisplaced fractures were treated with casting braces. For closed unstable fractures with good skin and soft-tissue conditions, open reduction and internal fixation was performed. All patients with open fracture had an external fixator applied after adequate debridement. Thirty one of 40 patients with compartment syndrome were treated by fasciotomy. For twelve of them, amputation was necessary. The most common procedure performed was debridement, followed by open reduction and internal fixation and closed reduction-casting, respectively. The results of this study may provide the basis for future development of strategy to optimise attempts at rescue and plan treatment of survivors with musculoskeletal injuries after earthquakes.
Serum Levels of Trace Elements and Heavy Metals in Patients With Acute Hemorrhagic Stroke
(Springer, 2014) Karadas, Sevdegul; Sayin, Refah; Aslan, Mehmet; Gonullu, Hayriye; Kati, Celal; Dursun, Recep; Demir, Halit
Trace elements are essential components of biological structures, but alternatively, they can be toxic at concentrations beyond those necessary for their biological functions. Changes in the concentration of essential trace elements and heavy metals may affect acute hemorrhagic stroke. The aim of this study was to measure serum levels of essential trace elements [iron (Fe), zinc (Zn), manganese (Mn), copper (Cu), and magnesium (Mg)] and heavy metals [cobalt (Co), cadmium (Cd), and lead (Pb)] in patients with acute hemorrhagic stroke. Twenty-six patients with acute hemorrhagic stroke and 29 healthy controls were enrolled. Atomic absorption spectrophotometry (UNICAM-929) was used to measure serum Fe, Cu, Pb, Cd, Zn, Co, Mn and Mg concentrations. Serum Cd, Pb and Fe levels were significantly higher in patients with acute hemorrhagic stroke than controls (p < 0.001), while serum Cu, Zn, Mg and Mn levels were significantly lower (all p < 0.001). However, there was no significant difference between the groups with respect to serum Co levels (p > 0.05). We first demonstrate increased Cd, Pb, and Fe levels; and decreased Cu, Zn, Mg, and Mn levels in patients with acute hemorrhagic stroke. These findings may have diagnostic and prognostic value for acute hemorrhagic stroke. Further studies are required to elucidate the roles of trace elements and heavy metals in patients with acute hemorrhagic stroke.
Treatment of Intracranial Foreign Body
(Pakistan Medical Assoc, 2014) Karadas, Sevdegul; Dursun, Recep; Kiymaz, Nejmi
Craniospinal penetrating foreign body (FB) injuries are interesting, but rarely observed, cases. They are important in terms of the complications that they may cause. The etiologies of craniospinal penetrating injuries and intracranial FB are also different. Though a sewing needle is more rarely seen in an intracranial FB, it may occur as atttempted infanticide or as a result of an accident especially in early childhood before the closure of fontanels. We detected an intracranial sewing needle in the head radiograph of a case admitted to the emergency department for another reason. We present this case since this is a rare injury and the etiologies of craniospinal penetrating foreign body have different characteristics.
Türkiye’nin Dört Büyük İlinde Trafik Kazalarına Karışan veya Alkol Şüphesi Bulunan Sürücülerin Yol Kenarı Kontrollerinde Kandaki Alkol Konsantrasyonlarının Değerlendirilmesi
(2022) Karabağ, Gökmen; Duran, Latif; Sever, Demet; Asirdizer, Mahmut; Can, Hale Nur; Dursun, Recep; Arıca, Enes
Amaç: Önceki çalışmalar, alkollü araç kullanma ve/veya uyuşturucu etkisi altında araç kullanma (AUAK) ile trafik kazalarında artan ölüm ve yaralanma riski arasında bir ilişki olduğunu ortaya koymuştur. Bu çalışmanın amacı, Türkiye’nin dört büyük şehrinde trafik kazası geçirdikten sonra veya yol kenarı trafik kontrolünde alkollü olduğu şüphesi bulunan sürücülerin kanlarındaki alkol konsantrasyonlarının (BAC) araştırılmasıdır. Yöntem: Bu çalışmada, Türkiye’nin dört büyük ilindeki (Van, Manisa, Diyarbakır ve Samsun) üniversite hastanelerinde sürücülerin beş yıllık (1 Ocak 2015 - 31 Aralık 2019 tarihleri arasında) BAC için laboratuar kayıtlarını geriye dönük olarak inceledik. Bulgular: Üç yüz kırk iki olguda (%7,1) BAC’ler eşik değerin (0,01 g/100 mL) üzerindeydi. Alkol tayini için gönderilen olguların %11,3’ü kadın, %88,7’si erkek olup, yaş ortalaması 35,3±13,1’dir. Üç yüz kırk iki alkol pozitif olguda, olguların %58,8’inde BAC’ler %0,101’in üzerindeydi. Olguların BAC pozitifliği Manisa’da %9,4, Van’da %6,3, Samsun’da %5,3 ve Diyarbakır’da %5 idi. Kadınların %4,4’ünde (n=24) ve erkeklerin %7,4’ünde (n=318) BAC pozitif bulundu (p<0,05). Sonuç: Bu çalışma, bu alandaki sınırlı sayıdaki çok merkezli çalışmalardan biridir; çalışmada trafikte alkollü araç kullanmaya sıfır tolerans gösterilmesi, cezaların caydırıcılığının artırılması ve yol kenarı tarama testlerinin daha yaygın olarak kullanılması gerektiği sonucuna varılmıştır.
Türkiyedeki Van Depreminde Mobil Sağlık Hizmetleri
(2015) Dursun, Recep; Gönüllü, Hayriye; Güner, Savaş; Sevimli, Sukran; Çetinkaya, Orhan; Bilvanisi, Sevdegül Karadaş