Hospital Automation System Research Articles

Evaluation of patients with COVID-19 diagnosis for chronic diseases

AimCOVID-19 is one of the most consequential pandemic in world history. Chronic diseases, which are risk factors that increase the case fatality rates, have been the leading cause of death all over the world. This study was aimed at detecting coexisting chronic diseases in patients hospitalized with a diagnosis of COVID-19.Material and methodThe study was carried out with data from 229 patients in an intensive care unit, from June 1st through June 30th. 2020. The inclusion criteria of the study was as follows: (1) having a COVID-19 diagnosis confirmed by PCR test; (2) being hospitalized in the relevant intensive care unit within the dates of the study; and (3) having their data accessible through the hospital automation system. Through literature; chronic diseases of the patients and their effects on the COVID-19 process were evaluated. Statistical analyzes were performed using the Statistical Package for Social Sciences (SPSS) version 24.0 (IBM Corp.; Armonk, NY, USA).ResultsThe average age of the patients studied were 61.4 years. While the average symptom duration was 8.2 days; total hospitalization period was 13.1 days. The average length of stay of patients (n = 75) who were sent to intensive care unit was 10.1. The most common chronic disease among patients was hypertension with 47.2%. This was followed by diabetes mellitus (32.8%) and heart disease (27.5%), respectively. In the population studied, cough (59.4%), fever (58.5%) and shortness of breath (45.9%) were found to be the most common symptoms. Leukopenia, impairments in liver and muscle enzymes, abnormal C-reactive protein, ferritin and d-dimer levels were the important biochemical tests.ConclusionParticular attention should be paid to the elderly COVID-19 patients with chronic diseases, especially DM, HT and cancer.

Effectiveness of interventional procedures for post-laminectomy syndrome: A retrospective study.

In our study, we aimed to evaluate the change in numerical rating scale (NRS) score and interventional procedures performed on patients with post-laminectomy syndrome whose NRS score 7 and above according to the NRS. This study was carried out by examining the files of 107 patients, including 69 women and 38 men, aged 18 years and over who had applied between February 1, 2010, and February 1, 2015. Pain localization, post-operative periods, interventional procedures, and post-procedural pain status were determined using pain monitoring forms and hospital automation system in our clinic. Statistical significance of the obtained data was evaluated by Pearson Chi-square test, Kruskal-Wallis H test, Friedman test, and Mann-Whitney U-test. p>0.05 was not statistically significant, p<0.05 was considered statistically significant. With interventional procedures, 48.5% of patients had a reduction in pain of more than 50%. The success rate was 66.7% in patients with radicular pain. Pain palliation was achieved in 28.8% of patients who underwent transforaminal epidural steroid injection, whereas in patients undergoing dorsal root ganglion pulsed radiofrequency, this rate was 44.4%. When the pain scores of patients with permanent spinal cord stimulator (SCS) were compared with other patient groups, permanent SCS was found to be statistically and clinically significant (p<0.001). Post-laminectomy syndrome is not usually caused by a single pathology, and more than 1 intervention and recurrence are often needed. Post-laminectomy syndrome is a disease that requires a multidisciplinary approach and multiple treatment options must be decided according to the patient. More research is needed on treatment options.

How to score acute pancreatitis in the emergency setting: five systems against ED-SAS

To assess the effectiveness of a new scale known as “Emergency department SpO2 (peripheral capillary oxygen saturation), age, and SIRS (Systemic inflammatory response syndrome)” (ED-SAS) that can be used to predict prognosis within 24 hours following presentation compatible with acute pancreatitis in patients admitted to the emergency department. This research project was conducted as a single-center, retrospective, cohort study. The Acute Physiology and Chronic Health Evaluation II (APACHE II), SIRS, Bedside Index for Severity in Acute Pancreatitis (BISAP), ED-SAS, modified Glasgow Scale and Ranson criteria scoring of the patients were evaluated using their presentation data screened from the hospital automation system. Then, the efficiencies of these evaluation systems were compared using the receiving operating curve (ROC). The conformity of the data to the normal distribution was checked with the Kolmogorov-Smirnov test. The ROC analyses were employed to identify the cut-off values of the scoring systems in calculating death rates. The method developed by DeLong et al. was used to compare the ROC curves of the scoring systems. The study has been completed with 235 patients, 91 (38.7%) male and 144 (61.3%) female, with a mean age of 63.1 ± 17.7 years. In the ROC analysis of the ED-SAS evaluation tool to predict death rates, the area under the curve (AUC) value was found to be 0.85 (95% confidence interval: 0.79–0.89), and the Youden index was 0.62, with a p value of 0.001. Mortality prediction with ED-SAS significantly differed compared to the Ranson and SIRS scoring systems (P = 0.001 and P = 0.03, respectively). However, no statistically significant difference was found in the comparison of the ED-SAS score with the modified Glasgow and APACHE II scores (P = 0.12 and P = 0.54, respectively). It was concluded that the Baseband ED-SAS scores provided equally significant results in terms of AUC at the 95% confidence interval (P = 0.05). Statistical analyses revealed that the APACHE II, SIRS, BISAP, modified Glasgow and ED-SAS scores were found to be significantly higher among the dead in comparison to the survivors (P &lt; 0.05). ED-SAS constitutes a simple, fast, expedient and effective evaluation system that can be utilized to predict mortality in acute pancreatitis in the emergency setting.

Macro-CK in carbon monoxide poisoning: A guide for in-hospital mortality?

Carbon monoxide (CO) poisoning is common in developing countries and can be mortal. CO poisoning can present with various signs and symptoms. In addition, it has been observed that some people have increased cardiovascular diseases and are associated with high mortality. In this study, the usability of Macro creatine-kinase (Macro-CK) for in-hospital mortality detection in CO poisoning was investigated. This study is a retrospective and single-center study. Data of patients diagnosed with CO poisoning were accessed from the hospital automation system. Macro-CK was accepted for patients with CK-MB higher than total CK. The patients were divided into two groups according to the Macro-CK determination. Macro-CK detected patients were arranged as group-1, and the others as group-2. In-hospital mortality rates were determined in the groups and compared between groups and analyzed. 1100 patients were eligible for the study. Of these patients, Macro-CK was detected in 33 patients (0.03%). The mean age of the patients was 37.6 ± 16.9 and 43.2% were male. In-hospital mortality was 20 (60.6%) in group 1, and 50 (4.7%) in group 2 and was statistically significant (p

Evaluation of pulmonary embolism in the pace of covid-19

Background: To investigate the prevalence and clinical and laboratory characteristics of the cases with pulmonary embolism (PE) in the pace of coronavirus disease-2019 (COVID-19). Materials and methods: COVID-19 patients' records were retrospectively scanned from the hospital's automation system and recorded on patients' files. Results: Of 1452 COVID-19 patients, 17 (1.2%) were diagnosed with PE. Compared cases with PE with controls, it was seen that mean age was higher (p=0.036), male gender was prominent (p=0.016), patients presented with dyspnea symptoms further (p<0.001), while O2 saturation measured at room air on admission was lower (p=0.002). In PE patients, glucose (p=0.007), D-dimer (p<0.001), C-reactive protein (p<0.001) and ferritin levels (p=0.002) were higher than controls. In Receiver-Operator Characteristics analysis, the cut-off value of D-dimer in predicting PE was found to be 4211 ng/mL (p<0.001). COVID-19 patients were diagnosed with PE median five (min:max=0:36) days after hospitalization. Additionally, PE patients were found to have longer hospitalization time (p<0.001), the requirement for caring in the intensive care unit (p<0.001), and intubation (p=0.001), and non-invasive mechanical ventilation (p<0.001) in more patients, compared to controls. Mortality rates were similar in both groups, with three and 106 deaths in PE and control groups, respectively. Lower-extremity Doppler ultrasonography was performed in 196 patients, and thrombi were detected in the femoral vein in four patients, also presenting with PE. Conclusions: Even if there is no embolism without any obvious clinic of PE in all cases with COVID-19, such cases should be screened for PE in the presence of significant D-dimer elevation. © 2021 A. CARBONE Editore. All rights reserved.

A Patient Care Predictive Model using Logistic Regression

Medical treatments and operations in hospitals are divided into in-patient and out-patient procedures. It is critical for patients to know and understand the differentiation between these two forms of treatment since it will affect the time of a patient's stay in a hospital or a medical institution as well as the cost of a treatment. In today's era of information, a person's talents and expertise may be put to good use by automating activities wherever possible. A medical service will be termed inpatient care if a doctor issues an order and the patient is admitted to the hospital on that order whereas a patient seeking outpatient care do not need to spend the night in a hospital. Choosing between in-patient and out-patient care is usually a matter of how involved the doctor wants to be with the patient's treatment. With the aid of numerous data points regarding the patients, their illnesses, and lab tests, our main objective is to develop a system as part of the hospital automation system that predicts and estimates whether the patient should be given an in-patient care or an out-patient care. The main idea of the paper is to understand and develop a logistic regression model to predict whether a patient needs to be treated as an in-patient or an out-patient depending on the results of laboratory tests. Furthermore, this study also focuses on how logistic regression performs for this dataset. In addition, research on how logistic regression performs for this dataset was also not done. From the study, the results show that logistic regression gives an accuracy of 75%, F1-score of 73%, precision of 74% and recall of 74%.

EVALUATION OF RDW, MPV, PLATELET LABORATORY PARAMETERS IN PROSTATE CANCER PATIENTS ADMITTING TO EMERGENCY DEPARTMENT WITH HEMATURIA

Abstract:Prostate Cancer (PCA) is the most common among urological malignant tumors. Prostate cancer patients may be unable to urinate, and may have hospital admissions with symptoms like erectile dysfunction or hematuria. Although hematuria is a highly common clinical manifestation in the society, the frequency of it is not known in prostate cancer patients, which is one of the urological malignancies. The purpose of this study was to investigate the relation of RDW (distribution width of the red blood cells), MPV (mean platelet volüme) and Platelet Blood Parameters with hematuria in prostate cancer patients admitting to the emergency clinic with hematuria. The present study was conducted retrospectively by examining the hospital automation system and patient files of prostate cancer patients admitting with hematuria between 01.01.2018-01.01.2020 to Yozgat Bozok University Emergency Medical Clinic. A total of 60 patients with full files and that matched study criteria were included in the study. For the purpose of comparing blood parameters for the purpose of comparing blood parameters, 45 patients with prostate cancer, nonspecific complaints and non-additional diseases were evaluated as the control group. MPV (mean platelet volume), RDW-CV (red blood cells distribution width) blood parameters of patients with prostate cancer hematuria were found to be significantly higher in the control group. Platelet value of the patient group was found to be significantly lower than the control group. However, the platelet blood parameter values were significantly lower in patients with major hematuria than in patients with minor hematuria (&amp;lt;0.05). According to the results of the present study, we believe that all the three parameters (RDW, MPV and Platelet levels), which can be measured in full blood count in the prostate cancer patient group in particular, can guide clinicians that the finding of hematuria can develop, and will be beneficial in follow-up and treatment. However, unlike RDW and MPV laboratory parameters, we think the Platelet parameter is an important parameter in predicting the type of hematuria that can develop.

Evaluation of patients receiving hemodialysis in an emergency service

Aim: Acute kidney injury (ARH) is an important emergency with high mortality and morbidity depending on patient characteristics, comorbidity and clinical situation. Rapid recognition of acute renal failure (ARF) and initiation of renal replacement therapy (RRT) is one of the most important factors determining the survival of these patients. The initiation of RTT in the emergency department depends on the correct indications in the critical patient, the correct use of resources and effective nephrological follow-up. This study aims to determine the hemodialysis indications of patients undergoing hemodialysis for the first time in the emergency service and to investigate the effect of this application on routine hemodialysis and survival. Methods: We carried out a retrospective cohort study with patients who underwent hemodialysis for the first time by central venous catheterization in the emergency service between January 01, 2019 and December 31, 2019. Age, gender, presence of chronic disease, symptoms and laboratory values of the patients were recorded from the patient files in the hospital automation system. Data regarding the hospitalization or discharge of the patients after emergency hemodialysis were collected. Patient follow-up was carried out from the patient records, and the nephrology follow-ups were examined for 3 months after emergency hemodialysis. Their routine hemodialysis and 28-day mortality were evaluated. Results: A total of 185 patients were included in the study. 55.1% of the patients (n=102) were male and the mean age was 65.63 (15.92) years. While 49.2% (n=91) of the patients were included in the routine hemodialysis program, mortality developed in 22.7% (n=42) on the 28th day. No statistically significant relationship was found between the current systemic diseases, hemodialysis indications and undergoing routine hemodialysis program (P=0.327, P=0.45). Conclusion: Although there was no statistically significant relationship between the dialysis indications of the patients and their inclusion in the routine dialysis program, emergency hemodialysis is an important procedure. The clinical condition and laboratory values of the patients should be evaluated synchronously. Physicians should not be late in initiating hemodialysis in the follow-up and treatment of electrolyte disorders and intoxications; the treatment of the patient should be decided as quickly as possible.

Epidemiological Research for Who has Ischemic Diseases While Using Effective Oral Anticoagulant Drug

Objective: Many complications can occur while treating the ischemic diseases, also while under treatment some patients have recurrent ischemic diseases. In our study we aimed that to investigate dermographic characteristics, risk factors, and causes for patients, who has ischemic disease while under treatment of oral anticoagulant therapy for any reason and INR levels between 2-3. Method: The files of patients diagnosed with myocardial infarction, ischemic cerebro vascular disease and pulmonary embolism who applied to the emergency department between 01.01.2014 and 31.12.2015 were analyzed retrospectively. The data of patients with an INR value of 2-3 and using oral anticoagulants were found from the hospital automation system. The data obtained were evaluated with the SPSS 17 Statistical analysis program. Results: The INR value was determined in 2-3 of 452 pulmonary embolus patients, 24 of 1442 ischemic cerebrovascular patients, and 55 of 1263 myocardial infarction patients. 6 people from 55 patients with myocardial infarction, 3 people from 24 patients with pulmonary embolism and 3 people from 24 patients with stroke had the same disease before. The patients who diagnosed with pulmonary embolism, were seen less frequently received high Wells scores and big vessels embolism in the group with INR levels in treatment range. The patients diagnosed with stroke whose INR levels in treatment range, had atrial fibrillation more frequently. Congestive heart failure, atrial fibrillation and pulmonary embolism were found to be high risk factors in myocardial infarction patients with an INR value of 2-3. Conclusion: As a result, we believe that patients who is under oral anticoagulant therapy, always carrying a risk of ischemic diseases and in this patient group risk factors are different from well known risk factors, so there will be a need for more work on this issue.

HASTANEDE ÇALIŞAN HEMŞİRELERİN HEMŞİRELİK DIŞI GÖREVLERİ VE NEDENLERİNİN İNCELENMESİ

Amaç: Çalışma; hemşirelerin hemşirelik dışı yaptıkları görevleri ve bu görevleri yapma nedenlerini belirlemek amacıyla gerçekleştirildi.Yöntem: Araştırmada Malatya il merkezindeki devlet ve üç özel hastanede çalışan toplam 1750 hemşireye dijital ortamda anket gönderilmiş, araştırmaya katılmayı kabul eden ve cevap veren toplam 824 (%47.08) hemşire ile araştırma tamamlanmıştır. Araştırmada evrenin tümüne ulaşılmaya çalışılmış, anketi cevaplamaya gönüllü olanlar araştırma kapsamına alınmıştır. Veriler, demografik özelliklerle ilgili yedi soru, görev yaptığı birimlerde hemşirelik dışı yaptıkları görevler ve bu görevleri yapma nedenlerini içeren çoktan seçmeli ve açık uçlu altı sorudan oluşan anket formu ile toplanmıştır. Verilerin değerlendirilmesinde sayı ve yüzdelik hesaplama kullanılmıştır.Bulgular: Çalışmada hemşirelerin hemşirelik dışı görevleri kayıt ve dokümantasyon hizmetleri açısından değerlendirildiğinde, %68.7’sinin laboratuvar istemi yaptığı, klinik destekler açısından değerlendirildiğinde %36.8’inin ise dikiş attığı tespit edilmiştir. Çalışmada hemşirelik dışı görevleri yapma nedenleri ve bu görevlerin yapılmadığında neler olabileceği sorgulandığında ise; hemşirelerin %41.9'unun mobinge maruz kalma korkusu yaşadığı saptanmıştır.Sonuç: Hemşirelerin büyük çoğunluğunun görev, yetki ve sorumluluklarını bilmelerine rağmen yönetici ve doktorlar tarafından mobinge maruz kalma korkusuyla kendi görevleri dışında çoğunlukla order yazdıkları, hastane otomasyon sisteminden doktor istemleri ve laboratuvar istemleri yaptıkları tespit edilmiştir.

The clinics of HHV-6 infection in COVID-19 pandemic: Pityriasis rosea and Kawasaki disease.

A new type of coronavirus family (SARS‐CoV‐2), which can be found in humans and animals, with many varieties and clinical symptoms, was first seen in Wuhan, China in late 2019, under the name novel Coronavirus Disease 2019 (COVID‐19). In the literature, cutaneous symptoms related to the disease are generally emphasized. However, it is not yet known whether this new SARS‐CoV‐2 virus, which has entered our lives, plays a role in the etiopathogenesis of dermatological diseases. The patients who were admitted to the dermatology outpatient clinic between 1 April and 15 May 2019, and on 1 April and 15 May 2020 were retrospectively analyzed by searching the hospital automation system and patient files. The reason for the same months to be included in the study was to exclude seasonal effects on the diseases. After pandemic, the number of patients with Pityriasis rosea and Kawasaki disease increased significantly in patients who applied to the dermatology outpatient clinic. Our study is the first study showing Pityriasis rosea increase during the pandemic period. We think that this increase is related to HHV‐6 reactivation. Herein, we wanted to draw attention to two diseases in which Human Herpes 6 (HHV‐6) was accused in etiopathogenesis: Kawasaki disease and Pityriasis rosea.

Analysis of Demographic Characteristics of Patients Admitted to the Emergency Department with Rabies Risk

Amaç: Bu üç yıllık çalışmamızda acil servisimize başvuran kuduz riskli temas olgularının demografik özelliklerini değerlendirmeyi amaçladık.Gereç ve Yöntem: 2012-2014 yılları arasında kuduz riskli temas nedeniyle acil servisimize başvuran hastaların demografik özellikleri hastane otomasyon sistemi, acil hasta bakı kartları ve kuduz bildirim defterinden geriye dönük olarak incelendi. Elde edilen verilerin istatistiksel analizinde SPSS 21.0 paket programı kullanıldı.Bulgular: Çalışmaya 2732 hasta dâhil edildi. Hastaların %70,4’ü (n:1923) erkek, %29,6’sı (n:809) kadın ve ortalama yaşı 23,65 yıl (min: 0, maks: 87 yıl) idi. Hastaların %15,7’sinin 2012 yılında, %39,3’ünün 2013 yılında, %44,9’unun ise 2014 yılı içinde acil servise başvurduğu belirlendi. Başvurular en sık mayıs, haziran ve temmuz aylarında idi. En sık kuduz şüphesi olan hastalarda köpeklerle (%61,6) ve ısırılma yoluyla (%71,8) temas öyküsü mevcuttu. Hastaların %95,5’ine yara bakımı ve tetanoz profilaksisi uygulanmıştır. Hastaların %99,9’una 1 doz, %85,6’sına 2 doz, %51,5’ine 3 doz, %9,9’una 4 doz ve %6,2’sine 5 doz aşı, %7,9’una kuduz aşısıyla birlikte HRIG yapıldığı saptandı. Hayvanların %99,7’sinin takip süresince yaşadığı, %0,3’ünün ise öldüğü tespit edildi. Hiçbir hastamızda kuduz hastalığı belirtileri ve ölüm görülmedi.Sonuç: Bu çalışma ile kuduz şüpheli hayvanla temasın her geçen yıl artış gösterdiği ve ilimiz için halen ciddi bir halk sağlığı sorunu olduğu belirlendi. Belediyelerce yürütülen sahipsiz hayvan toplama, kontrol ve ıslah hizmetlerine daha fazla önem verilmesi, hayvan barınaklarının kapasite ve sayılarının arttırılması, toplumun kuduz hastalığı açısından bilgilendirilmesi gerekmektedir.

Comparison of the diagnostic accuracy of X-ray and computed tomography in patients with wrist injury

BackgroundThis study aimed to compare CT and XR images of patients admitted to the emergency department due to wrist injuries and to evaluate the accuracy of XR in the diagnosis of fractures. MethodsPatients; who admitted to ED with injuries due to wrist trauma and who underwent XR imaging and CT scans in the period from 1 January 2017 to 1 January 2018, were included in the study. CT scan image interpretation reports recorded in the hospital automation system were considered eligible to be included in the study. XR images were interpreted by an orthopedics and traumatology specialist. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and Kappa (κ) coefficient of XR were calculated according to CT. Inter-rater agreement was graded according to κ values. ResultsA total of 274 patients were included in the study. Fractures were identified in the XR images in 180 (66%) patients and in the CT images in 196 (72%) patients. Compared to CT, the Sn, Sp, PPV, NPV and κ coefficient of XR were 89%, 92%, 97%, 77% and 0.764 respectively. Compared to CT, the highest sensitivity of XR was measured to detecting radius (Sn: 95%, κ: 0.896) and 5th metacarpal fractures (Sn: 77%, κ: 0.859), the lowest sensitivity of XR was calculated in detecting scaphoid, capitate, pisiform, trapezium hamate, and triquetrum fractures (Sn: 59–14%, κ: 0.619–0.240). The sensitivity and κ coefficient of XR were calculated 54% and 0.530 in the adjacent bone fracture, 83% and 0.830 in joint dislocation, 75% and 0.661 in the fractures extending to the joint space. ConclusionsXR is the first-choice imaging modality in the evaluation of wrist injuries, but CT imaging should be preferred when fractures extending to the joint space, adjacent bone fracture and carpal bone fracture are being considered.

PCR positivity and D-dimer levels in pregnant women with COVID-19

Background: Every day brings us new data on COVID-19, which has come to affect all the dynamics of the society, and increasingly more scientific literature becomes available on the topic. However, research information about its effects on particular groups, e.g., pregnant women, is still very limited. Aims: This study was aimed to investigate D-dimer levels in pregnant women admitted to the hospital with suspected COVID-19. Study Design: This descriptive cross-sectional study was carried out among pregnant women admitted to our hospital between 1 April 2020 and 31 May 2020 with suspected COVID-19. The data about patients was obtained from patient records and the hospital automation system. Methods: The primary outcome variable of the study was the D-dimer levels. Secondary outcome variables were the presence/absence of cough, shortness of breath, headache, fever, weakness, proteinuria, diarrhoea, haematuria, loss of taste, hypertension, and gestational diabetes mellitus. Results: Data for 64 pregnant women were analyzed. Thirty-three (51.5%) of them had a positive polymerase chain reaction (PCR) results, and thirty-one (48.5%) had negative ones. The mean age of the participants was 26.33 ± 5.15 years. Of the pregnant women, 51.6% (n = 33) were PCR (+) for COVID-19, and 48.5% (n = 31) were PCR (-). The mean age of the participants was 26.33 ± 5.15 years. Headache occurred significantly more often in PCR (+) pregnant women than in PCR (-) ones (χ2 = 4.201, p = 0.040). A statistically significant difference was found when the groups were compared in regard to the presence of the fever symptom (χ2 = 5.036, p = 0.025). When PCR (+) and PCR (-) pregnant women were compared, a statistically significant difference was found in the D-dimer levels (Z = 2.896, p = 0.004). A logistic regression model with PCR positivity as the dependent variables and headache, fever, and D-dimer levels as independent ones revealed a Nagelkerke R2 of 26.8%, and relatively high sensitivity (87.9%) and specificity (59.1%) values in predicting PCR positivity. Conclusion: This research is the first study to have suggested a model for predicting PCR positivity in women suspected of having the COVID-19 disease, which can speed up decision-making in regard to pregnant women with COVID-19.

Evaluation of seasonal variation of vitamin D levels according to demographic criteria

Aim: Although vitamin D can be taken with nutrients, it is substantially synthesized in the skin tissue under the influence of the ultraviolet ray which comes from the sunlight. Therefore, the increase in the expression of vitamin D in the body during periods of increased sunlight can be expected. In this study, it was aimed to determine whether the change in the serum vitamin D levels of the patients who applied to Usak Training and Research Hospital were significant according to age, gender and months of the year. Material and Methods: The serum vitamin D test results of the patients aged 0-80 who applied to the outpatient clinics of the hospital between 1 January and 31 December 2018 were retrospectively obtained from the hospital automation system. Data were analyzed using SPSS 21 software. p0.05 was considered significant.Results: The largest population of 62.253 vitamin D requests is 18-65 age groups. Serum vitamin D levels were found to be 16.18±10.39 ng/ml in the whole population: 15.85±10.49 ng/ml in women and 17.18±10.03 ng/ml in men. The mean value for women was statistically lower than men (p 0.05). There was a statistically significant difference between vitamin D averages in months, the lowest mean value in January (10.74±8.58 ng / ml), the highest value in July (23.29 ±10.6 ng / ml).Conclusion: In this study, the mean levels of vitamin D were found to be insufficient even in the summer months when sunlight was the most effective. This may be due to the fact that the population may benefit from less sunlight or structural variations of the vitamin D-binding proteins in the body may affect the use of vitamin D. Therefore, extensive research is needed to determine the level of clinical effects of vitamin D deficiency.

The efficacy of hemogram parameters in the differential diagnosis of renal colic and acute appendicitis in the emergency department.

To investigate the efficacy of WBC, PLR and NLR for use in the differential diagnosis of acute appendicitis and renal colic in the emergency department. This study was conducted after consent was received from the Cukurova University Medicine Faculty Noninvasive Clinical Research Ethics Committee. In this study, 440 patients for whom file data could be accessed in the hospital automation and archive system who were admitted to the hospital with abdominal pain were included. Of the 440 patients included in this study, 59.5% were male and 40.5% were female. The average age of the patients was 37.74±13.39 years. According to the pathological diagnosis, 207 patients were diagnosed with acute appendicitis. When the efficacy of differential diagnosis using hematological parameters was examined with ROC analysis, the neutrophil/lymphocyte ratio (NLR) value had the strongest predictive ability (AUC, 0.716, SS=0.024, 95% GA 0.668-0.764). After NLR, the platelet/lymphocyte ratio (PLR) value was the second-best concerning predictive ability for differential diagnosis (AUC, 0.608 SS=0.027, 95%, GA 0.555-0.661). Patients with acute appendicitis and renal colic often present to the emergency department with abdominal pain. While patients with acute appendicitis are usually treated with surgical methods, medical treatment is used for renal colic in the acute period. The differential diagnosis of these two patient groups is important. We believe that the PLR and NLR values can be used when an exact differential diagnosis cannot be made.

EVALUATION OF RADIOLOGICAL FINDINGS IN TERMS OF PHYSICAL ABUSE IN CHILDREN UNDER 4 YEARS OF AGE ADMITTED TO EMERGENCY DEPARTMENT

Physical abuse is defined as non-accidental injury. For 0-3 years of age children, evaluated in the emergency department, the possibility of physical abuse should be considered. The purpose of this study is to discuss the role of radiological findings in the assessment of physical abuse suspicion. Children in 0-3 years of age, admitted with fall to the emergency department of a university hospital in 2018, were retrospectively evaluated on hospital automation system. Data was obtained from electronic health records. The cases were examined in terms of age, gender, falling features, physical and radiological findings related to trauma and suspicion of abuse. Data was analyzed in SPSS program. In 100 cases, 52 (52.0%) were male and the mean age was 28.7±10.6 months. The clinical diagnoses of the cases were 51 (51.0%) falling from the same level, 11 (11.0%) falling from one level to another, and 38 (38.0%) ‘only’ falling. Posttraumatic radiological findings were as follows: 19 (19.0%) cases had soft tissue injury with bone fracture and/or joint dislocation; 17 (17.0%) cases had isolated soft tissue injury and 1 (1.0%) had temporal bone fracture and intracranial traumatic changes. In 11 (11.0%) cases had long bone fractures, 9 (9.0%) were diaphyseal fractures. Two (2.0%) cases had hand-finger, 1 (1.0%) clavicle, 1 (1.0%) calvarial and 1 (1.0%) facial bone fractures. The case with clavicle fracture could not be evaluated in terms of physical abuse suspicion, because of unknown condition of walking. The suspicion of physical abuse was considered in 1 (1.0%) case due to delay in hospital admission. Long bone diaphyseal fractures were most common in children aged 0-3 years. Since this finding showed low specificity to physical abuse, no suspicion of physical abuse was radiologically considered. The delay in hospital admission reveals the importance of evaluating cases from a multidisciplinary point of view in terms of suspicion of physical abuse.

Evaluation of the Mastoid Emissary Canals with Computerized Tomography in Patients with Chronic Otitis Media.

Background The mastoid emissary veins (MEVs) pass through the mastoid emissary canal-mastoid foramen (MEC-MF) in the mastoid region of the skull. MEVs can give rise to complications during surgical procedures. The purpose of our study was to investigate the morphological and morphometric characteristics of MECs of patients with clinical chronic otitis media (COM) using high-resolution computed tomography (HRCT). Methods Patients diagnosed with COM and undergoing temporal HRCT were identified by retrospectively scanning our hospital's automation system. Patients undergoing temporal HRCT for reasons other than COM, infection or tinnitus were identified for the control group by scanning the PACS archive. Sixty-two mastoid regions were examined in 38 unilateral and 12 bilateral COM patients, and 100 mastoid regions in the 50 patients in the control group. The presence of an accessory MEC-MF and MEC-MF diameters was evaluated in both groups. Results Main MEC diameters on the side of the ear with COM were 1.6 mm, and total accessory and main MEC diameters were 1.8 mm, both values being significantly higher than in the control group. Presence of accessory MEC on the side of the ear with COM was determined at 61.8%, significantly higher than in the control group. Conclusion Preoperative awareness of cranial venous drainage abnormalities is important to reduce surgical complications. Our study shows that MECs may be wider in diameter in patients with COM. MECs in COM patients must be identified before surgery to the mastoid region.

Evaluation of Trauma Scores, Clinical Outcomes and Hospital Costs of Patients Presenting with Traffic Accidents

Background: Traffic accidents have been a bleeding wound due to developing technology and increasing number of vehicles. Improvement in socio-economic level has led to an increase in number of vehicles and traffic accidents with injury and death increase accordingly. High costs appear by tests and treatments as well as further health problems and loss of labour power in traffic accidents. The aim of this study was to evaluate the trauma scores, clinical outcomes and hospital cost of patients presenting to the emergency department with road traffic accidents.&#x0D; Methods: Patients information; hospital automation system, forensic records and patient files were recorded. Cost information was received in hospital automation system. Hospital costs include examinations and treatments that have been performed since the first visit of the patients. According to the data obtained from the patients files, GCS (Glasgow Coma Scale), AIS(Abbreviated Injury Scale) and ISS(Injury Severity Score) scores of each patient were calculated separately. All variables were tested for conformity to normal distribution, Kolmogorov Smirnov test and compliance with parametric test criteria. The data obtained by the study carried out within the scope of clinical research are statistically nonparametric. For this reason, Kruskal-Wallis H tests were used for statistical evaluation of associated variables according to dependency status. Spearman rank correlation in non-parametric data and Pearson correlation in parametric data were used as correlation methods. The results were evaluated for a significance level of P &lt; .05.&#x0D; Results: The average cost of traffic accidents was found to be 247.38 Turkish Lira.The average cost of motor vehicle accidents was 246.53 Turkish Lira.The average cost of extra vehicular traffic accident was 235.3 Turkish Lira. Cost average was 265.9 Turkish Lira.The effect of clinical outcomes on the cost was found statistically significant. There was a statistically significant effect of GCS, AIS, ISS trauma scores on the cost. AIS and ISS and the cost was moderately significant and a positive correlation was found.&#x0D; Conclusion: Frequency of the traffic accidents, higher hospitalization rates and higher medical expenses have made the traffic accidents a significant public health problem economically We believe that community education should be increased in order to reduce traffic accidents in terms of health as well as the national economy.

EVALUATION OF SYSTEMIC INFLAMMATORY PARAMETERS IN CARBON MONOXIDE POISONING

Objective: The objective of this study is to examine systemic inflammatory blood parameters measured in complete blood count of patients with carbon monoxide (CO) poisoning and to evaluate the relation between the parameters and the severity of poisoning.Material and Methods: Our study is a retrospective case control study. Data was obtained through hospital automation system. Patients who were detected to have 10% and above carboxyhemoglobin levels were included in the study. Patients' complete blood count parameters, red cell distribution width (RDW), neutrophil/lymphocyte ratios (NLR), platelet/lymphocyte ratios (PLR) and treatments were recorded.Results: When the control group was compared to patient group, WBC, leukocyte, neutrophil, platelet, NLR and PLR values were higher in the patient group and these differences were statistically significant (p &amp;lt;0.05). Patients were split into two groups in accordance with the severity of their poisoning. No significant differences were observed in terms of laboratory results (p &amp;gt;0.05).Conclusion: In patients with CO poisoning, values of NLO, PLO and RDW indicate inflammation. We consider that these values do not assume a role in determination of poisoning severity and in shaping of the treatment to be administered.