No abstract

Objective: The neutrophil to lymphocyte ratio (NLR) has been investigated as an indicator of mortality and/or morbidity in many clinical pathologies. However, these studies have mostly been conducted for specific diseases. We investigated whether there is a relationship between the NLR and hospitalization or discharge decisions in the emergency department (ED). Methods: We retrospectively reviewed the medical records of patients admitted to the ED. The NLR values of the patients were calculated, and their demographic characteristics (age and gender) and clinical outcomes were recorded. Results: Of the 1970 patients, 1400 (71.1%) were discharged from the ED, and 570 (28.9%) were hospitalized. The patients who were discharged were younger and had lower NLR values, and this group had a lower female gender ratio (p<0.001, p<0.001, and p<0.001, respectively). The NLR threshold for discharge was 4.8, with a sensitivity of 70% and a specificity of 60%. Of the 570 hospitalized patients, 478 (83.9%) were discharged from the hospital and 92 (16.1%) died. Deceased patients were statistically significantly older with higher NLR values (p<0.001 and p=0.001, respectively). The threshold value of NLR for predicting mortality was calculated as 11.5, with a sensitivity of 45% and a specificity of 77%. Conclusions: Our study reveals that the NLR is an important predictor of hospitalization and mortality in patients admitted to the ED regardless of diagnosis. ED physicians may consider to discharge patients with NLR values below 4.8 instead of spending additional time with advanced tests. In addition, clinicians should review the risk of mortality in patients with NLR values greater than 11.5 more thoroughly concerning mortality and should consider early aggressive treatment options.

Objective: Cup therapy has an important place in traditional and complementary medicine applications. The purpose of our study, this is the first time to investigate the protective effect of cup therapy in rats on experimentally generated epileptic seizures in new rat modeling created by different anatomic regions. Methods: In our study, 42 Wistar albino rats 3-4 months old (200-250 g) were used. Four other groups (n=7) except G3 and G4, 24 hours after cup therapy application, PTZ (35 mg/kg, sc., 0.2 cc) was injected, followed by behavioral epilepsy scoring. Results: In the 'Open Area' and 'Elevated Plus Maze' tests, there was no behavioral difference between the cup therapy group and the control group (p > 0.05). Given all the parameters, the G4 group significantly reduces the seizure compared to other groups (p < 0.05). There is a significant difference in G2, G5 and G6 groups compared to G3 in the phases parameter (p < 0.05). Conclusions: In this study, the new wet cup therapy (G2), which was applied for the first time, had a protective effect on seizures. G2, G5 and G6 groups are observed to suppress seizures compared to G3. Our findings are expected to contribute greatly to animal model analysis in the future.