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Öğe The prognostic value of the Glasgow coma scale, serum acetylcholinesterase and leukocyte levels in acute organophosphorus poisoning(K FAISAL SPEC HOSP RES CENTRE, 2011) Cander, Basar; Dur, Ali; Yildiz, Mesut; Koyuncu, Feridun; Girisgin, Abdullah Sadik; Gul, Mehmet; Okumus, MehmetBACKGROUND AND OBJECTIVES: Organophosphate poisoning (OP) is a serious clinical condition that may sometimes be fatal. The aim of this study was to determine whether the Glasgow coma scale (GCS), and serum acetylcholinesterase and leukocyte levels have prognostic value in acute OP poisoning. DESIGN AND SETTING: Retrospective review of records of patients admitted to the intensive care unit of Selcuk University, Meram Medical Faculty, Emergency Department, Konya, Turkey, between January 2006 and January 2009. METHODS: We studied acutely OP-poisoned patients admitted within 24 hours after OP exposure. RESULTS: The mean age of the 25 patients was 37 years (range, 20-80 years). Three (12%) of the 25 patients (male-female ratio, 12: 13) died. The mean GCS values of the patients who died were significantly lower compared to those of the group that survived (4 vs 11.7, respectively P <.05). While the mean serum acetylcholinesterase levels were lower in the patients who died, the difference in the mean serum acetylcholinesterase levels between the patients who died and the ones who survived was not statistically significant (3841 IU/L vs. 1768 IU/L, respectively). CONCLUSION: Although serum cholinesterase values can be used in the quick diagnosis, their efficiency at predicting outcome in patients with OP poisoning has not been established. It has also been determined that serum leukocyte values have no prognostic value in OP poisoning, but GCS values have been found to be effective in predicting the outcome.Öğe The role of optic nerve ultrasonography in the diagnosis of elevated intracranial pressure(B M J PUBLISHING GROUP, 2007) Girisgin, Abdullah Sadik; Kalkan, Erdal; Kocak, Sedat; Cander, Basar; Gul, Mehmet; Semiz, MustafaObjective: To evaluate the convenience and utility of optic nerve ultrasonography ( ONUS) in the evaluation of emergency patients with elevated intracranial pressure (EICP) due to traumatic or non-traumatic causes. Methods: This study was conducted between May 2005 and December 2005 in the emergency department of Meram Faculty of Medicine, Selcuk University. Patients with traumatic or non-traumatic EICP were included in the study. Among these, 28 patients with EICP determined on cranial computed tomography (CCT) and a control group of 26 patients with no disease had the vertical and horizontal diameters of the optic nerves (ONs) of both eyes measured by ultrasonography ( US). The measurements were done by wetting the closed eyelids and using a 7.5-MHz linear probe. Results: Horizontal and vertical diameters of both ONs of the 54 patients were measured and the averages calculated. The mean (SD) ON diameter for the group suspected of having EICP was found to be 6.4 (0.7) mm, and that for the control group to be 4.6 (0.3) mm. In the statistical analysis carried out between these two groups (t test), the difference was found to be significant at p< 0.001. Conclusions: In detection and follow-up of EICP cases, such as cerebrovascular accident and trauma, ONUS is a practical, risk-free, inexpensive, convenient and, if performed by experts, reliable method. As a result, although CCT may be more useful in diagnosis, ONUS may be more efficient in detecting EICP. In those cases where CCT and other conventional imaging methods are not available, ONUS can facilitate the diagnosis and help in treatment.