Metanol, metabolitleri tarafından toksik olan ve ahşabın damıtılmasıyla elde edilen renksiz, kokusuz bir alkol türüdür.Olgu: 64 yaşında kadın hasta, son bir aydır çift görme, denge kaybı ve 2 hafta boyunca beslenme kaybı, başvuru günü ise uyuşukluk ile ilgili soruları cevaplamada güçlük şikayetleri ile acil servisimize başvurdu. Ekstremitelerinde pembe-mor hiperemi vardı ve her iki dizde de yaygın dermatit düşünüldü. Hikâyede diz ağrısı için odun alkolünün topikal olarak uygulandıktan sonra dizlerde dermatit geliştiği öğrenildi ve hastaya metanol zehirlenmesi teşhisi kondu. Bilincin bozulması üzerine entübasyon kararı verildi ve hastanemizin anestezi ve reanimasyon ünitesinde entübe olarak hemodiyaliz yapıldı. Yoğun bakım ünitesine yatışından 3 gün sonra kardiyak arrest gelişti ve hasta ex oldu.Tartışma: Anyon boşluğu artmış metabolik asidoz vakalarında, nedeni açıklanamayan, metanol toksisitesinin ihmal edilmemesi ve bu durumun ölümcül olabilmesini hatırlatmayı amaçladık.

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We aimed to investigate the use and superiority of AIMS65 (Albumin, INR, Alteration in mental status, Systolic blood pressure, age) and Glasgow-Blatchford scores (GBS) in predicting hospital health costs in patients admitted to emergency department with upper gastrointestinal bleeding. Patients above the age of 18 who were admitted to the Emergency Department of Ümraniye Training and Research Hospital between 01.06.2018 and 31.05.2019, who were diagnosed with upper gastrointestinal bleeding were included in the study. Patients’ calculations of AIMS65 and GBS were recorded. Pearson’s Chi-square test was used, and statistical significance was assessed. A total of 151 patients included in the study, 109 (72.2%) were male. Of the patients 2(1.3%) were discharged from the emergency department and 7 (4.6%) were exitus. According to AIMS65 risk scoring, costs of emergency department and inpatient clinics and total clinical costs were higher in high risk group compared to the low risk group (p=0.007, p=0.007 and p=0.003 respectively). The costs of emergency department and inpatient clinic and total costs were found statistically significantly different between GBS groups (p<0.001, p=0.019, and p=0.001 respectively). AIMS65 risk score and GBS have been revealed to be useful in predicting the costs of emergency department and inpatient clinics and total clinical costs for patients with upper gastrointestinal bleeding.

The measurement of optic nerve sheath diameter (ONSD) is a reliable tool for the estimation of increased intracranial pressure (ICP). However, it is known that racial changes can occur in human anatomy. In the present study we aimed to determine the normal values of ONSD in Turkish adult population. This retrospective study involved the collection of data between June 1, 2015, and May 31, 2019, and was conducted on 291 adults known to have no increased cranial/intraocular pressure. The ONSD was measured at 3 mm posterior to the globe on MR images. 291 subjects were enrolled, 63.6% of whom were female. The total median ONSD was 4.40mm (4.20- 4.70). The median ONSD of the male participants was 4.50mm (4.25-4.75), of the female participants was 4.35mm (4.15-4.50) and the difference was statistically significant (p = 0.001). According to statistical analysis, it was found that only the presence of chronic renal failure altered the median of ONSD among the comorbid diseases (p = 0.042). Monitoring and treating increased ICP is crucial. Thanks to an ONSD with a known normal value, recognition and emergency management of this pathology would be easier. We think our study is noteworthy because it is the first study investigating the normal ONSD value in Turkish adult population.