No abstract

Introduction and aim. This study aimed to compare the hospitalization rate, mortality rate and morbidity status of patients hospitalized with stroke and diabetic ketoacidosis (DKA) before and during the COVID-19 pandemic. Material and methods. The data of 2522 patients who applied to the emergency department (ED) before and during the pandemic were evaluated. A Poisson regression analysis was used to examine the number of presentations between two different periods. Results. Stroke cases during the pandemic era were compared to those during the pre-pandemic period, and it was shown that the mortality rate for stroke patients during the pandemic period was much higher. Treatment-related ED presentations decreased significantly during the pandemic period, particularly among patients aged 75–84 years. Rates of ED presentation decreased by 84 percent (IRR: 0.14, 95 percent CI: 0.03-0.59) in those with DKA and by 37 percent (IRR: 0.67, 95 percent CI: 0.53- 0.75) in those with stroke during the pandemic period. Conclusion. Conclusion: Stroke and DKA admissions decreased during the pandemic, but the rate of stroke mortality increased statistically 3.375 times. Getting emergency medical care increases their chances of survival. Even in a COVID-19 outbreak, treatment is critical.

OBJECTIVE:While abdominal pain is one of the most prevalent reasons for seeking medical attention, diagnosing elderly adults with acute appendicitis (AA) may be difficult. In this study, Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Alvarado ratings were evaluated for diagnostic accuracy in patients who reported to the emergency department complaining of abdominal pain and received surgery for AA . METHODS: The data of patients over the age of 65 years who reported to the ER and had appendectomy after being diagnosed with AA were evaluated in this retrospective cohort study. For each patient, the diagnostic accuracy of the Alvarado and RIPASA scores was determined individually. RESULTS: A total of 86 patients were included in the research. The average patient was 71.2 years old, with a male preponderance of 46.5%. Alvarado's score was found to have an area under the curve (AUC) of 0.799, the Youden's index of 0.549, and a p-value of 0.001 after a receiver operating characteristic (ROC) study of the Alvarado score in identifying the diagnosis of AA. The AUC was 0.886 (95%CI 0.799-0.944), the Youden's index was 0.642, and a p-value of 0.001 was found in the ROC analysis of the RIPASA score in identifying the diagnosis of AA. CONCLUSIONS: When comparing the two scores used to diagnose AA, we found no statistically significant difference between the RIPASA and Alvarado scores (p=0.09), although the Youden's index for the RIPASA score was higher.

Background/Aim: Diabetic ketoacidosis (DKA) is an endocrinological emergency frequently seen in emergency departments (ED). It can result in mortality if not treated appropriately. The aim of this study was to examine the relationship between baseline lactate levels and patient outcomes in DKA patients admitted to the emergency department (ED). Methods: This retrospective cohort study was carried out in the ED of a tertiary hospital between May 2022 and November 2022 using the data of patients diagnosed with DKA. Patients with missing data, patients transferred from another hospital, patients with a diagnosis other than DKA, and patients who could not be followed up were excluded from the study. The primary outcome of the study was admission to the intensive care unit (ICU) and/or in-hospital mortality. The area under the curve (AUC) was calculated by receiver operating characteristic (ROC) regression analyses to predict critically ill patients with lactate levels. Results: The study was completed with 95 patients. The mean age of the patients was 53.1 years and n = 46 were female. Twenty (21.1%) of these patients were admitted to the intensive care unit and 22 (23.2%) died. The statistical analysis showed that lactate levels were statistically significant in predicting critically ill patients (P < 0.001). ROC analysis showed that a lactate level of 2.6 mmol/dL could predict critically ill patients. The area under the curve was 0.823 (95% confidence interval: 0.731-0.894, sensitivity: 71.4, Specificity: 69.8), the Youden index was 0.476, and the P-value was 0.001. Conclusion: According to the results of this study, there is a significant relationship between the initial lactate levels in DKA patients and patients who will require critical care. Therefore, lactate can be used as an appropriate follow-up tool in the management of DKA patients.

ÖzBu çalışmada, Batı Karadeniz Bölgesi'nin önemli bir sahili olan Karasu Sahilinin 1990-2021 yılları arasındaki kıyı çizgisi değişiminin izlenmesi amaçlanmıştır. Bu kapsamda, bir uzaktan algılama yöntemi olan CoastSat açık kaynaklı yazılım araç takımı kullanılmış ve Karasu Limanı'nın doğusundaki yaklaşık 6,3 km'lik sahilin kıyı çizgisi değişimi incelenmiştir. Karasu Sahilinin 1990 ve 2021 yılları arasındaki uydu görüntüleri ve kıyı şeridi zaman serisi ile birlikte belirlenen 14 kesitteki değişimler CoastSat aracılığıyla elde edilmiştir. Bu veriler, ücretsiz açık kaynaklı bir coğrafi bilgi sistemi (CBS) yazılımı olan QGIS uygulamasında 2021 yılına ait uydu görüntüsü üzerinde açılarak görselleştirilmiş ve belirlenen 14 kesitteki farklı yıllara ait kıyı çizgileri arasındaki farklar hesaplanmıştır. Elde edilen bulgular, sahilde bazı kesitlerde önemli miktarlarda erozyonların meydana geldiğini, en fazla erozyonun 1990 yılına göre kıyaslama yapıldığında 2010 yılında yaklaşık 77 metre ile 5. kesitte meydana geldiğini göstermiştir. Öte yandan, 7. kesitten sonraki kesitlerde 1990 yılına göre zaman içerisinde kıyıda kum birikimi olduğu ve 7. kesitten önceki kesitlerde ise erozyon oluştuğu gözlemlenmiştir.