Browsing by Author "Karadas, Sevdegul"

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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.
Analysis of Cases With Tuberculous Peritonitis: a Single-Center Experience
(Aves, 2014) Dulger, A. Cumhur; Karadas, Sevdegul; Mete, Rafet; Turkdogan, M. Kursat; Demirkiran, Davut; Gultepe, Bilge
Background/Aims: Tuberculous peritonitis (TP) is a rare form of tuberculosis and is caused by peritoneal involvement with Mycobacterium tuberculosis. A distinctive correlation exists between socioeconomic state and disease prevalence. We aimed to evaluate the clinical, laboratory, and radiological findings of patients with TP. Materials and Methods: We conducted a retrospective study in patients with peritoneal tuberculosis from January 2004 to October 2008 at Yuzuncu Yil University Medical School Education and Research Hospital. During this time, the data of 21 patients (17 females) with TP were reviewed. Results: Fever, abdominal pain, and anorexia were the most common symptoms. An analysis of ascites showed lymphocyte predominance and low albumin gradient in all patients. Patients with TP had a median ascites adenosine deaminase (ADA) level of 139 U/L (range, 25 to 303U/L). Peritoneal involvement (wet peritonitis) was seen in all the cases. Following 6-month administration of combined anti-TBC treatment, mean serum CA-125 levels were within the normal range among patients who had previously higher serum CA-125 level. Mortality rate in the total cases was 4.6%. Conclusion: Peritoneal tuberculosis should be considered in the differential diagnosis of exudative ascites in eastern Turkey. A high level of suspicion is required, especially in high-risk populations living in rural areas. ADA seems to be a sufficient, safe, and inexpensive method to perform the diagnosis of peritoneal tuberculosis. Serum CA-125 levels may play a key role to support the diagnosis as well as disease management of TP.
The Analysis of the Cases of Aspired Fuel Oil and Gasoline Through Siphonage Method
(Pakistan Medical Assoc, 2013) Gonullu, Hayriye; Karadas, Sevdegul; Oncu, Mehmet Resit; Dulger, A. Cumhur; Keskin, Siddik
Accidental aspiration of petroleum products in children can also be witnessed in adults working with petroleum products by siphonage or swallowing fire for demonstration purposes. Ten cases admitted to Yuzuncu Yil University Emergency Service due to fuel oil and gasoline aspiration in a three-year period were retrospectively analysed. All cases were males and their average age was determined as 32,4 +/- 7.83 years. Three of the patients aspirated gasoline and 7 fuel oil. Blood gas values in all patients were at normal levels and their average white blood cell values were 16590. The most frequent symptom for referral to our service was shortness of breath. Infiltration was confirmed in the chest X-ray of 2 patients with aspirated fuel oil and all cases of gasoline aspiration. All patients received methylprednisolone and IV proton-pump inhibitors for treatment. Eight patients were given antibiotics. All victims were discharged from the hospital after recovery. Aspiration of petroleum products which is normally rarely seen is witnessed more frequently in under developed countries. Since the findings determined by screening methods are often nonspecific, history is important for making a diagnosis.
Analyze of Ventilator Associated Pneumonia
(derman Medical Publ, 2015) Sunnetcioglu, Aysel; Karadas, Sevdegul; Cegin, M. Bilal; Sunnetcioglu, Mahmut; Kanter, Ahmet
Aim: Ventilator-associated pneumonia (VAP) is the infection that is an important cause of morbidity and mortality developed in patients whom the invasive mechanical ventilation (MV) were performed in intensive care units (ICU). In this study, the factors of VAP developing in patients whom the mechanical ventilation of ICU performed, antibiotic susceptibility to these factors and determining the risk factors were aimed. Material and Method: Between January 2009 and March 2013, 79 cases, followed with the mechanical ventilation for at least for 48 hours and developed VAP, were retrospectively reviewed at Anesthesiology and Intensive Care Unit of Reanimation at Faculty of Medicine at Yuzuncu Yil University, performing endotracheal intubation. The cases were evaluated in terms of microorganisms, antibiotic susceptibility and risk factors. Results: The rate of our VAP speed was calculated to be 19.68 on the day of 1000 ventilator. While a single microorganism could be isolated in 81.1% of the 74 VAP cases whose the active pathogen could be isolated, two or more than two microorganisms were isolated in 18.9% of them. While 83 of the strains (90.2%) were gram-negative bacteria, 7 of them (7.6%) were gram-positive bacteria. Acinetobacter spp. (40.2%) was most commonly isolated as a gram-negative factor, but methicillin-resistant S. aureus (4.3%) was isolated as a gram-positive factor. It was determined that the isolated factors in VAP cases were significantly resistant to the broad-spectrum antibiotics. Discussion: As a result, in patients with high-risk factors for the development of VAP, early and appropriate empirical antibiotic treatment should be started according to the results of the sensitivity of the unit and for the multi-drug-resistant microorganisms with common and high mortality.
Approach To Scorpion Stings During Pregnancy: Two Cases
(Galenos Yayincilik, 2011) Guler, Ayse; Karadas, Sevdegul; Kurdoglu, Zehra
Introduction: Although there are many studies in the literature about scorpion stings and scorpion venoms, data on maternal and fetal effects during gestation is very little. In this paper, we presented two pregnant cases who applied to our clinic because of scorpion sting and discussed the management of scorpion envenomation with literature. Cases: Two pregnant women at 32 and 24th gestational weeks admitted to the emergency department with the complaint of scorpion sting. Physical, ultrasonographic examinations and laboratory results were normal. Clinical staging of the scorpion sting was stage I in both patients. No gestational complications occured during follow of the patients who were offered hospitalisation and managed with supportive treatment. Both patients delivered healthy babies vaginally at term. Conclusion: In management of scorpion stings during pregnancy, observation and supportive treatment are sufficient when the patient is at stage I.
Brucellosis-Related Acute Pancreatitis: a Rare Complication of a Universal Disease
(Sage Publications Ltd, 2016) Suvak, Burak; Dulger, Ahmet Cumhur; Karadas, Sevdegul; Gonullu, Hayriye; Bayram, Yasemin; Gonullu, Edip; Guducuoglu, Huseyin
Objectives To determine the prevalence and determinants of acute pancreatitis in patients with acute brucellosis. Methods Adult patients with brucellosis were retrospectively recruited. Brucellosis and acute pancreatitis were diagnosed according to standard criteria. Laboratory analyses included Wright agglutination titre, serum biochemical parameters and blood count. Results Patients with acute pancreatitis (n=21) had significantly higher Wright agglutination titres, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, -glutamyl transpeptidase, amylase, lipase and serum glucose concentrations, and significantly lower haemoglobin concentrations and haematocrit than patients with brucellosis alone (n=326). Conclusions Hyperglycaemia, anaemia, and liver transaminase and cholestatic enzyme concentrations may represent new approaches for assessing disease severity in patients with brucellosis and acute pancreatitis.
Can D-Dimer Levels Predict the Treatment Outcome in a Patient With Tuberculosis
(Pakistan Medical Assoc, 2014) Dulger, Ahmet Cumhur; Karadas, Sevdegul; Gonullu, Hayriye; Beyazal, Mehmet; Bulut, Gulay; Gultepe, Bilge
Tuberculous peritonitis is a leading cause of mortality and morbidity particularly in the developing world. Delay in initiation of treatment distinctively increases mortality. Treatment response to anti-tuberculosis drugs is usually observed by regression of symptoms and clearance of ascites. With initiation of treatment, laboratory values including CA-125 levels generally return to normal levels in 3 months. However, there is still no consensus about treatment response during the follow-up period. Serum D-dimer level is used as an inflammation marker in some cases. A case with Tuberculous peritonitis successfully monitorised by serum D-dimer levels is presented.
A Case of Budd-Chiari Syndrome Associated With Alveolar Echinococcosis
(Pakistan Medical Assoc, 2014) Karadas, Sevdegul; Cumhur, Dulger Ahmet; Bilge, Gultepe; Mehmet, Beyazal; Mustafa, Kosem
Alveolar echinococcosis of the liver is caused by the tapeworm Echinococcus multilocularis. Budd-Chiari Syndrome (BCS) is a hepatic venous outflow tract obstruction and involves abdominal pain, hepatomegaly and high-gradient ascites. A low-gradient ascites in connection with the Syndrome rarely occurs in case of alveolar echinococcosis of the liver. Here we report a 20-year-old man with the syndrome and low-gradient ascites due to a huge liver mass. Further diagnostic examination revealed alveolar echinococcosis of the liver. Diuretic agents and albendazole were used as palliative therapy in the case.
Cerebral Venous Sinus Thrombosis Presentation in Emergency Department in Van, Turkey
(Pakistan Medical Assoc, 2014) Karadas, Sevdegul; Milanlioglu, Aysel; Gonullu, Hayriye; Sayin, Refah; Aydin, Mehmet Nuri
Objective: To exmaine the distribution of age, gender, time between onset and presentation, clinical findings, predisposing factors, platelet distribution width, mean platelet volume values and neuroimaging findings, together with the treatment regime and the outcome for patients of cerebral venous sinus thrombosis. Methods: The retrospective, descriptive cross-sectional study was conducted at Yuzuncu Yil University, Medical Faculty Hospital in Van, Turkey, comprising 51 cases diagnosed with cerebral venous sinus thrombosis between January 2008 and September 2011. The diagnosis was based on the results of clinical evaluation, cranial magnetic resonance imaging and venography. SPSS 16 was used for statistical analysis. Results: Overall, 43 (84.3%) of the cases were female, and 8(15.7%) were male. The average age was 32 +/- 11.13 years. The most frequent symptom was headache in 41 (80.4%) cases. The postpartum period was one of the most observed predisposing factors in 17 (33.3%) patients. The magnetic resonance imaging was normal in 35 (68.6%) cases, but in all of the cases, magnetic resonance venography was abnormal. Topographically, the most frequent involvement was transverse sinus in 40 (78.4%) cases. Besides, 50 (98%) patients were discharged following full recovery or mild sequela and only 1 (2%) case had severe sequela. Conclusion: Patients presenting with headache should be examined carefully in the emergency department. Early diagnosis and treatment with clinical and neuroimaging techniques for such patients is recommended.
Clinical and Laboratory Features of Adult Measles Cases Detected in Van, Turkey
(Pakistan Medical Assoc, 2015) Sunnetcioglu, Mahmut; Sunnetcioglu, Aysel; Mentes, Osman; Baran, Ali Irfan; Karadas, Sevdegul; Aypak, Adalet
Objective: To evaluate adult measles patients with respect to their clinical and laboratory findings as well as complications. Methods: The retrospective study was conducted at YuzuncuYil University, Van, Turkey, between December 2012 and June 2013, and comprised cases diagnosed with measles. The diagnosis was based on clinical findings and all were serologically confirmed with the presence of Anti-measles Immunoglobulin M antibodies. Results: Of the 50 records studied, 41(84%) related to women. Overall mean age was 25.52+/-4.07 years. The most common symptoms were fever and rash 50(100%), malaise 49(98%), cough 48(96%), headache 44(88%) and sore throat 36(72%). The presence of Koplik spots, lymphadenopathy and hepatomegaly were observed in 3(6%), 6(12%) and 2(4%) patients respectively. Thrombocytopenia and elevated liver enzymes were detected in 26(52%) and 22(44%)patients. Pneumonia was the most common complication in 9(18%) patients. Other respiratory complications were bronchitis 5(10%) and laryngotracheitis 6(12%). Of the cases, 9(18%) exhibited otitis media. Premature delivery and spontaneous abortus occurred in 2(4%) and 3(6%) patients of the 15(30%) pregnant women. Conclusion: Measles continues to be an important health problem in Turkey and needs an effective elimination programme.
Coexistence of Hepatocelluler Carcinoma and Cyst Hydatid Disease of the Liver
(Pakistan Medical Assoc, 2014) Karadas, Sevdegul; Dulger, Ahmet Cumhur; Gonullu, Hayriye; Bulut, Gulay; Beyazal, Mehmet
The evidence suggests that both delta hepatitis-related hepatocellular carcinoma (HCC) and cyst hydatid disease (CHD) are frequently seen separately in people who live in the rural areas of Asia. However, there are still a few case reports about coexistence of these different diseases in the same liver. The current case illustrates a number of clinical problems that physicians face in the diagnosis of patients with basically different liver masses.
The Comparison of the Treatment Strategies Preferred in Patients With St Segment Elevated Myocardial Infarction (Thrombolytic Therapy for Life)
(Elsevier Science inc, 2013) Ozdemir, Mahmut; Yurtdas, Mustafa; Sahin, Musa; Aladag, Nesim; Karadas, Sevdegul; Babat, Naci; Gumrukcuoglu, Hasan Ali
Contact Dermatitis Due To Alternative Treatment Methods: Four Case Reports
(Emergency Medicine Physicians Assoc Turkey, 2012) Karadas, Sevdegul; Gonullu, Hayriye; Aydin, Irfan; Oncu, Mehmet Resit
Herbal medicines are commonly used in the eastern regions of Turkey, especially in the treatment of rheumatic complaints. In addition, the use of various foods and drinks for cosmetic purposes is increasing among Turkish people. Despite this extensive use of alternative treatment methods for medical and cosmetic purposes, comprehensive research is still required due to the severe local and systemic adverse effects of these treatments. Here, cases of phyto contact dermatitis due to "Ranunculus kotchy boiss" and "Urtica" and irritant contact dermatitis associated with butter are presented.
Datura Stramonium Intoxication: Report of a Case With Psychiatric Symptoms
(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2011) Karadas, Sevdegul; Selvi, Yavuz; Sahin, Mustafa; Selvi, Fatih; Oncu, Resit; Ozgokce, Fevzi
Delirium is a common neuropsychiatric syndrome and is often caused by metabolic, systemic disorders and drug or poison intoxication. Though hallucinations, delusions and agitation are sometimes present, the symptoms of delirium are clinically distinct from those induced by other psychiatric disorders. Datura stramonium is a hallucinogenic plant which is a member of belladona alkaloids. The toxic effects of Datura stramonium most often include visual and auditory hallucinations, confusion and agitation. We report a patient who was poisoned with Datura stramonium and presented to the emergency department with psychiatric symptoms.
Delayed Traumatic Intracerebral Hemorrhage: for How Many Hours Should Patients With Mild Head Trauma Be Observed
(derman Medical Publ, 2015) Karadas, Sevdegul; Gonullu, Hayriye; Gulsen, Ismail; Baltacioglu, Huseyin
Delayed traumatic intracerebral hematoma is a rare complication of head injury. The etiopatogenesis of DTIH is not precisely known. We herein report a case of delayed traumatic intracerebral hematoma, with mild HT. This 25-year-old male fell down while playing in a footbal match. He had headache and vertigo. He was kept under observation for about 12 hours at the emergency department. At the 26th hour after the HT incident, he presented to our hospital again with the complaints of nausea, vomiting and headache. A control brain computed tomography was performed and a traumatic intracerebral hematoma was determined in the frontal region. As a result, DTIH may be fatal. Close observation and repeat CBT scanning may reduce complications and mortality.
Effectivity of One Session Charcoal Hemoperfusion Treatment in Severe Carbamazepine Poisoning
(Kowsar Publ, 2013) Isik, Yasemin; Soyoral, Lokman; Karadas, Sevdegul; Emre, Habib; Cegin, Muhammed Bilal; Goktas, Ugur
A carbamazepine intoxication with suicide attempt is a relatively common clinical problem that presenting with coma, respiratory depression, arrhythmia, hemodynamic instability and even death. We report a case of severe carbamazepine poisoning that was successfully treated with one session charcoal hemoperfusion. On admission, the patient was comatose and required ventilator support. Hemoperfusion with coated activated charcoal successfully decreased the serum carbamazepine concentration from 45 mu g mL(-1) to 21 mu g mL(-1) within 2 h, with subsequent clinical improvement.
The Effects on Complications and Myopathy of Different Voltages in Electrical Injuries
(Turkish Assoc Trauma Emergency Surgery, 2011) Karadas, Sevdegul; Gonullu, Hayriye; Oncu, Mehmet Resit; Isik, Daghan; Canbaz, Yasin
BACKGROUND The purpose of this study was to investigate the demographic and clinical characteristics of electrical injuries, laboratory findings, complications, and mortality and morbidity rates of these injuries. METHODS Patients with electrical injuries admitted to the emergency department between January 2006-2010 were retrospectively analyzed. The cases were evaluated by age, gender, source of electrical power (low-high voltage), seasonal distribution, ECG changes, laboratory findings, clinical care units, complications, and mortality rate. RESULTS Eighty-four (57.1%) of the cases were exposed to low-voltage electricity (Group I), while 63 (42.9%) of the cases were exposed to high-voltage electricity (Group II). The majority of cases with electrical injuries were aged 26-45 years. Thirty of the women (85.7%) were wounded by low-voltage while 58 of the men (51.8%) were wounded by high-voltage electricity. Alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine kinase, and CK-MB levels were higher and the level of calcium was lower in Group II. Complications (pathologies due to fall from high levels, cardiac dysrhythmias, compartment syndrome) and the mortality rate were higher in Group II. CONCLUSION In cases with high-voltage electrical injuries, cardiac complications, complications due to fall from high levels and the mortality rate increase in conjunction with the degree of the muscle damage.
Epidemiological Analysis of Poisoning Cases in Van, Turkey
(Pakistan Medical Assoc, 2014) Aydin, Irfan; Karadas, Sevdegul; Gonullu, Hayriye; Dulger, Ahmet Cumhur
Objective: To investigate the etiological and demographical characteristics of acute adult poisoning cases in eastern Turkey. Methods: The retrospective study was conducted at the Emergency Department of Yuzuncu Yil University, School of Medicine, and comprised data related to the period between 2007 and 2009. The data obtained included age, gender, referrals, manner of poisoning, manner of application, the department which followed up on the patients, duration of hospital stay. All data was noted on proforma. SPSS 15 was used for statistical analysis. Results: Of the total cases visiting the Emergency Department, 1207 (1.1%) related to poisoning. Of them, 880 (72.9%) had attempted suicide; 858 (71.1%) were female; 349 (29%) were male. The average age of the females was 25.4 +/- 8.5 years, and that of the males 28.3 +/- 14.3 years. Single-medicine was noted in poisoning 544(45.1%) patients. Other poisoning types were multidrugs 373 (30.9%); rat poisoning, insecticide and pesticides, 145 (12%); corrosives 38 (3.1%); and weed, mushroomang; food 47 (3.8%). Oral poisoning was noted in 1141(94.5%) cases. A total of 1019 (84.4%) patients received treatment and were followed up in the Emergency Department. Six (0.6%) patients died. Conclusion: There is a need to generate more awareness about the hazards of domestic cleaning products and to keep it away at some distinct place to minimised chances of confusion.
Esophagitis Due To Dexketoprofen Trometamol: a Rare Case Report
(Springer Wien, 2015) Olmez, Sehmus; Donmez, Salim; Aslan, Mehmet; Karadas, Sevdegul; Yavuz, Alpaslan
Various drugs are known to cause pill esophagitis. Antimicrobial drugs and nonsteroidal anti-inflammatory drugs are the most common causes of pill-induced esophagitis. Most patients suffer only self-limiting pain, but serious complications can occur. A 21-year-old man was admitted to our outpatient clinic with retrosternal chest pain, dysphagia, and odynophagia complaints, which occurred within 2 weeks after starting dexketoprofen trometamol. An upper endoscopy system examination revealed three well-demarcated ulcers in the esophagus at 35 cm from the incisors. Dexketoprofen trometamol may cause esophageal lesions. This rare disorder should be considered in patients presenting with sudden-onset retrosternal pain in addition to dysphagia and odynophagia.
The Evaluation of Clinical and Laboratory Findings of 63 Inpatient With Cutaneous Anthrax: Characteristics of Cutaneous Anthrax in Turkey
(deri Zuhrevi Hastaliklar dernegi, 2014) Ozkol, Hatice Uce; Karadas, Sevdegul; Sunnetcioglu, Mahmut; Ceylan, Mehmet Resat; Calka, Omer; Guducuoglu, Huseyin
Background and Design: Despite a very uncommon disease in developed countries, cutaneous anthrax (CA) is currently endemic in our countries. In this study, we aimed to bring out characteristic of anthrax of Turkey by comparing our results and the other CA reports in Turkey. Materials and Methods: Sixty three inpatients with CA between October 2009 and December 2012 were investigated retrospectively. All patients were diagnosed CA by clinical finding and/or microbiological examination. The demographic characteristics patient, routine tests, wound culture and gram staining results were recorded. Results were recorded on statistical program of SPSS 13.0 and were written using percent (%). Results: There were 63 inpatients (41 female (65.1%), 22 male (34.9%), mean age 35.9 years range10-83). Forty nine patients (77.8%) had a history of contact with animals or animal product. Thirty-eight (60.3%) and twenty-one (33.3%) patients were found in the summer and fall season, respectively. Gram staining and culture were performed in 51 patients. Gram-positive bacilli were detected in 17 patients (33.3%) by gram smear. Bacillus anthracis bacilli were produced in 11 patients (21.5%) in cultures test. The lesions were mostly seen on the left hand (30.2%). Penicillin was most frequently preferred in treatment of CA (87.3%). Conclusion: CA is still endemic in Eastern Anatolia and continues to increase in recent years. Women living in the villages in which income is obtained from buying and selling of animals constitute the most important risk group. Preventive actions such as training of the risky society, vaccination of animals, and obstructing of illegal animal entries across the border, will reduce the incidence of CA.