A comparative study was undertaken to evaluate the possible effects of time selection of irradiation on the healing of microvascular anastomoses. In this experimental study, 40 adult male Sprague-Dawley rats were divided into four groups, 10 animals in each. In Group 1, the rats were exposed to radiotherapy with a dose of 20 Gy in a single fraction at a 170,916 cby/min dose rate, at an 80-cm source to a skin distance from 3 to 4 cm in the right groin fields involving the femoral artery, using a Co60 megavoltage radiotherapy machine. The animals were operated on under general anesthesia 2 weeks later. During the operation, femoral microarterial anastomoses were performed. In Group 2, the rats were irradiated and operated on as in Group 1, on the same day. In Group 3, the rats were operated on and, 2 weeks later, irradiated, as in Group 1. In Group 4 (control group), the rats were operated on as in Group 1. No radiotherapy was performed. All rats were explored under general anesthesia after 1 month. Patency was evaluated, and the anastomotic sites were taken for histopathologic and electron microscopy studies. The authors found that there were no major differences in the healing of microvascular anastomoses in the early preoperative, immediate preoperative, and early postoperative irradiated groups. The patency rates of all radiotherapy groups were not statistically different from control arteries (p > 0.05).

Objective: To identify errors in forensic reports and to describe the characteristics of traumatic medico-legal cases presenting to the emergency department (ED) at a tertiary care hospital. Methods: This study is a retrospective cross-sectional study. The study includes cases resulting in a forensic report among all traumatic patients presenting to the ED of Adiyaman University Training and Research Hospital, Adiyaman, Turkey during a 1-year period. We recorded the demographic characteristics of all the cases, time of presentation to the ED, traumatic characteristics of medico-legal cases, forms of suicide attempt, suspected poisonous substance exposure, the result of follow-up and the type of forensic report. Results: A total of 4300 traumatic medico-legal cases were included in the study and 72% of these cases were male. Traumatic medico-legal cases occurred at the greatest frequency in July (10.1%) and 28.9% of all cases occurred in summer. The most frequent causes of traumatic medico-legal cases in the ED were traffic accidents (43.4%), violent crime (30.5%), and suicide attempt (7.2%). The most common method of attempted suicide was drug intake (86.4%). 12.3% of traumatic medico-legal cases were hospitalized and 24.2% of those hospitalized were admitted to the orthopedics service. The most common error in forensic reports was the incomplete recording of the patient's "cooperation" status (82.7%). Additionally, external traumatic lesions were not defined in 62.4% of forensic reports. Conclusion:The majority of traumatic medico-legal cases were male age 18-44 years, the most common source of trauma was traffic accidents and in the summer months. When writing a forensic report, emergency physicians made mistakes in noting physical examination findings and identifying external traumatic lesions. Physicians should make sure that the traumatic medico-legal patients they treat have adequate documentation for reference during legal proceedings. The legal duties and responsibilities of physicians should be emphasized with in-service training.

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Objective:The aim of this study is to investigate and analyse pregnant women who were admitted to our emergency service due to acute poisoning. Material and Methods:All cases were retrospectively collected from our computer records and emergency record book between 01. 01.2006 and 01.01.2010; the registration data on age, gravidity, gestational week, whether the poisoning was deliberate or accidental, causative agent, admission time, treatment results and mortality outcome were collected and analyzed.Results: Eighty eight women admitted with acute poisoning were known to be pregnant and the poisoning was accidental in 23% of the cases, while 77% were suicidal intoxications. 74% of patients were in the 21-34 age group. Accidental intoxications were due to carbon monoxide, foods and cleaning products. 75.4% of the suicidal poisonings were caused by medical drugs, with analgesics, multiple drugs and psychiatric drugs being the top culprits and accounted for 53%, 31% and 16% of drug poisonings respectively. In terms of gestational week, 47.4% of suicidal poisonings were within the first trimester and the relationship between suicidal attempt and gestational week was found to be statistically significant (p<0.015). However, the relationship between gravidity and the rate of suicidal attempts was not statistically significant (p=0.214). All patients were followed up and treated in the emergency service and no mortality was observed in the study. Bulgular: Acil servise akut zehirlenme ile ba vuran 88 gebe olgunun %77'si özk y m amaçl , %23'ü kazara olu an zehirlenmeler idi. Olgular n %74'ü 21-34 ya grubundayd . Kazara olan zehirlenmeler karbon monoksit, besin ve temizlik ürünlerine ba l yd . Özk y m amaçl zehirlenmelerin %75.4'ünde etken medikal ilaçlar olup s ras yla %53 analjezikler, %31 çoklu ilaçlar ve %16 oran nda da psikiyatrik ilaçlar saptand . Gebelik haftas na göre, özk y m amaçl zehirlenmelerin %47.4'ü 1. trimesterda olup gebelik haftas ile özk y m giri imi aras ndaki ili ki istatistiksel olarak anlaml bulundu (p<0.015). Ancak, gravida ile öz-k y ma te ebbüs etme aras ndaki ili ki istatistiksel olarak anlaml bulunmad (p=0.214). Olgular n tamam n n takip ve tedavisi acil serviste yap ld , çal mada ölüm vakas na rastlanmad . Conclusion:Sonuç: Gebelikteki akut zehirlenme vakalar n n ço u özk y m amaç-l d r. Gebeler özk y ma en fazla gebeli in ilk üç ay nda te ebbüs etmektedir. ntihar amac yla en s k kullan lan madde ise t bbi ilaçlard r. (J Turkish-German Gynecol Assoc 2011; 12: 199-203)

Introduction-After a scorpion sting, patients commonly present to hospitals with pain. Our study sought to compare the analgesic efficacy of IV paracetamol, IV dexketoprofen trometamol, topical lidocaine, and placebo in patients reporting pain after presenting with a history of scorpion sting.Methods-This double-blind, randomized, placebo-controlled study was conducted in the emergency department of a tertiary hospital. Adult patients who presented with the complaint of pain after a scorpion sting and did not have systemic findings were randomly assigned to 1 of the following 4 groups: IV paracetamol, IV dexketoprofen trometamol, topical lidocaine, and placebo. The visual analog scale scores were measured at the time of presentation to the emergency department and at 30 and 60 min to determine the pain intensity.Results-The study included 106 patients, of whom 30 were in the paracetamol group, 26 in the dexketoprofen trometamol group, 25 in the topical lidocaine group, and 25 in the placebo group. We did not find a different analgesic effect among the groups in the first 30 min (P=0.185). IV paracetamol, dexketoprofen trometamol, and topical lidocaine did not show different analgesic effects in the first 60 min (P>0.05). IV paracetamol and dexketoprofen trometamol were found to provide a more effective analgesia than the placebo at 60 min (P<0.05). The analgesic effects of topical lidocaine and placebo did not differ (P=0.330).Conclusions-IV paracetamol and IV dexketoprofen trometamol provided analgesia in the first 60 min, similar to topical lidocaine but superior to placebo.