Traumatic asphyxia is a rare syndrome in which the thoracoabdominal region is exposed to pressure and it presents with cervicofacial cyanosis and oedema, subconjunctival haemorrhage, and petechial haemorrhage in the face, neck and upper part of chest. In this report we present a 28 year old male patient whose whole body except the head and neck stayed under soil for about 30 minutes as an example case in order to review traumatic asphyxia syndrome.

Introduction: Sexual activity-related headache (SARH) is a benign cause of activity-related headaches, related to increasing intraabdominal pressure and arterial blood pressures. But, the pathophysiology is still unclear. More common in male patients with an average age of 40, its prevalence is 1% in the community. In this article, we presented a 24-year-old male who was diagnosed subarachnoid hemorrhage (SAH) after SARH.

Dexketoprofen trometamol (DT), a nonsteroidal anti-inflammatory drug, is a highly water-soluble salt and active enantiomer of rac-ketoprofen. Its parenteral form is commonly used for acute pain management in emergency departments of our country. Side effects such as diarrhea, indigestion, nausea, stomach pain, and vomiting may be seen after the use of DT. Anaphylactic shock (AS) secondary to infusion of DT is very rare and, to our knowledge, it is the first case report describing this side effect. This case report was presented to emphasize that AS may be seen after the use of DT.

SUMMARY Objective:The purpose of our study was to investigate the relationship between the pulmonary artery obstruction index (PAOI) assessed with helical computed tomography (CT) and impairment in blood gases in patients with acute pulmonary embolism (PE). Method: This retrospective study design was carried out in the Tertiary Training and Research Hospital Emergency Clinic over a 6-month period with patients in whom PE was detected. The Alveolar-arterial (A-a) oxygen gradient for oxygen was calculated according to the formula 150 -1.25 (PaCO2 -PaO2), and the PAOI for each patient was measured with the Qanadli score at the mediastinal window using chest CT angiography (CTA). Results: There were 113 patients included in the study; their mean age was 61.40 (±16.082) years and 51.4% of the patients were female. The mean Alveolar-arterial (A-a) oxygen gradient value was 65.13(±18.78) in massive embolism group. The mean PAOI was determined as 34.027 (min:7.5, max:83.7). The relationship between the radiologically measured PAOI and the Alveolararterial (A-a) oxygen gradient were compared, and an increase in the index was detected as the Alveolar-arterial (A-a) oxygen gradient level increased; this difference was found to be statistically significant (r=0.400; p<0.001).Conclusions: This retrospective observational study found a weak but positive correlation between the PAOI and the Alveolar-arterial (A-a) oxygen gradient. Our study showed that consideration of the Alveolar-arterial (A-a) oxygen gradient increases the sensitivity of blood gas analysis in documented pulmonary embolism.All data showed that the Alveolar-arterial (A-a) oxygen gradient values may be clinically beneficial, as such testing is easy to perform and cost-effective.Moreover, it can be performed at the bedside to detect which patients should be treated with thrombolytics.

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