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    Analysis of Childhood Physical Violence Cases Presented to the Emergency Department
    (2021) Akpinar, Gulseren
    Aim: To examine the demographic and epidemiological characteristics of children who were exposed to physical violence.Materials and Methods: Data of patients younger than 18 years admitted due to physical violence exposure to the Emergency Medicine Clinic in a tertiary university hospital were retrospectively reviewed.Results: A total of 120 cases met the study criteria. The median age of patients was 15 (4-18) years and 70.8% of them were male. The female/male (F/M) ratio was 35/85. Emergency admissions due to physical exposure were made most frequently in July (n=16, 13.3%), where in 57.5% were made between 16:00 and 23:59. The most common injury site was the head (n=39, 32.5%) followed by the extremities (n=21, 17.5%). Moreover, 87.5% of patients had minor injuries according to Injury Severity Score levels.Conclusion: Most of pediatric forensic cases were male adolescents. Education about a safe environment should be provided by taking protective measures to reduce the incidence of these cases. In addition, awareness activities in which parents and children can participate effectively should be supported and expanded by social institutions.
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    Effect of the Seasonal Changes on Renal Function in Patients with Acute Ischemic Stroke
    (2020) Akpinar, Gulseren; Boğan, Mustafa; Yusufoğlu, Kaan; Korkmaz, Miray; Baldane, Emine Gül; Çevik, Erdem
    Objective: This study aimed to define seasonality trends of acute renal dysfunction in the patients with ischemic stroke.Method: This study was conducted retrospectively. Data were obtained from digital records of Şişli Hamidiye Etfal Training and Research Emergency Medicine Clinical Statistic Office.Results: One hundred ninety-nine patients with ischemic stroke were included in the study. Patients were divided into two groups according to their renal functions. Group 1 (patients with abnormal renal function) included 70 patients. In this group, the mean urea value was 67.3±26.9 mg/dL, the mean creatinine value was 1.4±1.1 mg/dL, the mean age was 77.0±6.5 years, 34 patients were male (48.6%). Group 2 (patients with normal renal function) included 129 patients. In this group, the mean urea value was 37.9±9.9 mg/dL, the mean creatinine value was 0.9±0.2 mg/dL, the mean age was 76.6±7.3 years, 74 patients were male (57.4%). Season distribution, age and gender distribution, affected area of the brain, and platelet count did not show significant differences between the groups (p>0.05).Conclusion: There is not a significant relationship between seasonal changes and renal dysfunction in the patients with ischemic stroke.
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    Evaluation of trailer attached-two wheel tractor (Pat- pat) accident - related pediatric injuries in Turkey's western black sea region
    (2021) Akpinar, Gulseren; Demir, Mehmet Cihat
    Traumatic injuries related to agricultural production can lead to serious illness, disability, and even death. Pediatric injuries due to trailer attached-two wheel tractor (Patpat)accidents occupy a scarce place in the literature. To contribute to the literature, we aimed to evaluate the demographic characteristics and analysis of pediatric injuriesdue to a Pat-pat accident admitted to our emergency department in the last decade. The study data were obtained by retrospectively examining patients younger than 18years of age admitted to the Emergency Medicine Clinic between 01/01/2010 and 31/12/2019 with injuries due to Pat-pat accident. Demographic characteristics, injurysites, injury types, hospitalization status, length of hospital stay, injury severity score (ISS), and mortality status were recorded. Due to the Pat-pat accident, 32 childrenapplied to the hospital. The male/Female ratio was 25/7. The median age of pediatric patients ranging from 9 to 18 years was 17 years. When evaluated according to theinjury areas, extremity injuries were the most common. Admissions were most frequently in the summer season (n=21, 65.6%) and in July (n=13, 40.6%). These caseswere admitted mostly on Tuesday (n=8, 25.0%) and between 16:00 and 23:59 (n=22, 68.8%). According to the ISS, 20 of the patients had a mild injury (ISS?3), 3 had amoderate injury (4? ISS ?8), and 9 had a severe injury (ISS?9). To prevent accidents, the public should be made aware of this issue, and the authorities should be morecareful in making the necessary administrative decisions and in implementation. For young agricultural workers, it should be an obligation to ensure proper education andjob security. Pat-pat, which is not well known but often used in rural agricultural areas of the Western Black Sea region, can have dangerous consequences for children.Children should be kept away from such unsafe vehicles.
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    ntravenous Diltiazem or Metoprolol Administration in the Emergency Department for Acute Rate Control of Atrial Fibrillation Patients with Rapid Ventricular Response with Unknown Ejection Fraction
    (2021) Demir, Mehmet Cihat; Doğan, Muharrem; Polat, Esra; Akpinar, Gulseren
    im: Atrial fibrillation (AF) is the most widespread persistent cardiac arrhythmia in adults.There is no standard procedure applied in AF patients with rapid ventricular response withunknown ejection fraction (EF) in the emergency department. This study aimed to comparethe effectiveness and side effects of diltiazem and metoprolol treatments without knowing theEF in AF patients with rapid ventricular response in the emergency department.Material and Methods: Patients with a ventricular response ?110/min were selected as havingAF with rapid ventricular response. The patients first received 25 mg intravenous diltiazem asa rate control drug were compared with those first received 5 mg metoprolol. A total of 50patients whose EF were not registered before the admission date and was measured after beingconsulted for cardiology following acute rate control in emergency department were includedin this study.Results: For the first drug treatment, diltiazem was given to 56% (n=28) of the patients andmetoprolol to 44% (n=22). Moreover, 44% (n=22) of the patients needed a second druginfusion. The proportion of patients received diltiazem in those with preserved EF wassignificantly higher than those with reduced EF (p=0.032). No statistically significantdifference was found between the rates of needing a second administration based on the EF(p=0.157).Conclusion: Diltiazem was found to reduce heart rate earlier than metoprolol. While updatingthe guidelines for drug selection in acute rate control of AF with rapid ventricular response,rural emergency departments, where EF measurement cannot be achieved, should also beconsidered.