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Öğe The effectiveness of various doses of octreotide for sulfonylurea-induced hypoglycemia after overdose(HEALTH COMMUNICATIONS INC, 2006) Gul, Mehmet; Candler, Basar; Girisgin, Sadik; Ayan, Murat; Kocak, Sedat; Unlu, AliThis study was conducted to investigate the effectiveness of various doses of octreotide in reducing hypoglycemic attacks and the need for dextrose in patients with refractory and recurrent hypoglycemia related to sulfonylurea toxicity. This study was carried out at the Center of Experimental Research of Selcuk University Merann School of Medicine in Konya, Turkey. A total of 40 New Zealand rabbits of both sexes, weighing between 2500 and 3000 g, were used in this experiment. Rabbits were randomly divided into 4 groups, each of which consisted of 10 animals. All animals were given oral glidazide 100 mg. For the treatment of hypoglycemic attacks in group 1, only 15 mL of 50% dextrose (7.5 g) was given intravenously; in groups II, III, and IV, octreotide was given in doses of 25 mu g, 50 mu g, and 100 mu g, respectively. Octreotide was given to groups II, III, and IV at the 8th hour (when hypoglycemic attacks were induced), along with an intravenous infusion of an additional 15 mL of 50% dextrose (7.5 g) for each hypoglycemic attack that occurred. After the toxic dose was given, the rabbits were given the amount of dextrose used before and after octreotide administration, and the numbers of hypoglycemic attacks were recorded. The values of blood glucose for all animals were read every hour on the hour from the beginning of the study, and the study ended at the 24th hour, when hypoglycemic attacks stopped. A significant difference was observed between groups I, II, and IV in numbers of hypoglycemic attacks that occurred and dextrose doses given between 9 and 24 h (P=.001). The findings of this study suggest that a single dose of octreotide 100 mu g may be used to reduce the number of refractory and recurrent hypoglycemic attacks that occur because of sulfonylurea overdose; large prospective studies are needed to validate these findings.Öğe The effects of mannitol and melatonin on MRI findings in an animal model of traumatic brain edema(SPRINGER HEIDELBERG, 2008) Bayir, Ayseguel; Kiresi, Demet Aydogdu; Kara, Hasan; Cengiz, Sahika Liva; Kocak, Sedat; Oezdinc, Serife; Ak, AhmetObjectives: The aim of this study was to compare the effects of mannitol and melatonin on brain edema secondary to trauma using magnetic resonance imaging (MRI). Methods : A mild traumatic brain injury with the Feeney method was performed upon twelve New Zealand rabbits. Three hours after the trauma was inflicted, MRI images were obtained, then the subjects were divided into two groups : a mannitol group and a melatonin group. The mannitol group (n = 6) was given 2 gr/kg of 20% mannitol IV over 10 minutes and the melatonin group (n = 6) received 100 mg/kg of melatonin IV over 30 minutes. Thirty-three hours after the first MRI, MRI was repeated. The 3-hour and 36-hour post-trauma MRI images in both groups were scored regarding signs of edema and extent of brain tissue protrusion in a blinded fashion by a staff radiologist. Intragroup and intergroup comparisons were made using the Fisher exact test and chi square test. Comparison of brain tissue protrusion measurements was done using the Mann Whitney U test. Results : Signs of raised intraventricular pressure, contusion and parenchymal edema were more prevelant, and parenchymal protrusion was more prominent on the 36-hour MRI in both mannitol and melatonin groups. No significant difference was,found between the melatonin and mannitol groups in any parameter in the MRI images performed 3 and 36 hours after the head trauma. Conclusions : In this animal model, melatonin and mannitol had similar effects on brain edema, as demonstrated on MRI 3 and 36 hours after head trauma.Öğe Efficacy of aprotinin treatment on bilateral blunt chest trauma created in rabbits(PAKISTAN MEDICAL ASSOC, 2013) Kaya, Halil; Kafali, Mehmet Ertugrul; Aydin, Kemal; Kocak, Sedat; Sahin, Mustafa; Duran, Arif; Gul, MehmetObjectives: To investigate the effects of aprotinin, on blood gasses, oxidant-antioxidant status, and lung histopathology in an experimental bilateral blunt chest trauma model. Methods: Conducted at the Experimental Animal Laboratory of Meram Medical School at Selcuk University, Konya, Turkey, the study comprised 21 New Zealand female albino rabbits who were divided into three groups. Trauma was applied on the sham and aprotinin groups, which was administered intravenous Aprotinin 20.000 U/kg. Arterial blood samples were obtained from all rabbits at hours 0, 3, 24, and 96. At hour 96 after trauma, all rabbits were sacrificed using the decapitation method, and then blood and lung tissue samples were obtained. Blood nitric oxide, malondialdehyde and blood gas measurements were made. Histopathological changes in the lung were examined with a light microscope. Results: While no positive effect of aprotinin was observed on nitric oxide malondialdehyde and partial pressure of carbon dioxide values, it was seen to have an increasing effect on partial oxygen pressure level. Aprotinin had a partial effect on lung histopathology. Conclusion: Aprotinin was determined to have a positive effect on PO2 levels. We could not find any positive effects especially on alveolar haemorrhage.Öğe Fibrinolytic markers and neurologic outcome in traumatic brain injury(NEUROL SOC INDIA, 2006) Bayir, Aysegul; Kalkan, Erdal; Kocak, Sedat; Ak, Ahmet; Cander, Basar; Bodur, SaidAims: To determine the usefulness of fibrinolytic markers as early prognostic indicators in patients with isolated head trauma. Materials and Methods: Sixty-two consecutive patients (26 women and 36 men; mean age 61 years, range 2-76 years) with isolated head trauma seen within the first three hours of the trauma were included in the study. The Glasgow Coma score (GCS), platelet counts (Plt), prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen, fibrin degradation products (FDP) and D-dimer levels were measured. Head computerized tomography (CT) findings were categorized as brain edema, linear fracture, depressed fracture, contusion and bleeding. Plt counts, PT, PTT, fibrinogen, FDP, D-dimer levels and CT findings were compared with both GCS and mortality in the first week. Statistical significance was accepted at P <= 0.05. Results: A marked negative relationship was found between GCS and PT, PTT, FDP and D-climer levels (P < 0.001). Plt levels did not correlate with GCS. Mortality was most strongly related to GCS, PT, FDP and D-dimer levels (P < 0.001, P < 0.001, P < 0.001 and P < 0.001, respectively). We found no relationship between mortality and CT findings, nor was there any significant relationship between Plt, PTT and fibrinogen levels. Conclusion: GCS and fibrinolytic markers measured within the first three hours were useful in determining the prognosis of patients with isolated head trauma.Öğe The prognostic value of trauma scoring systems for gunshot injuries(PROFESSIONAL MEDICAL PUBLICATIONS, 2011) Bozdemir, Mehmet Nuri; Cander, Basar; Dur, Ali; Kocak, Sedat; Dundar, Defne Zerrin; Uyar, Mehmet; Girisgin, SadikObjective: We aimed to evaluate the trauma scoring systems on gunshot injured patients to predict trauma severity. Methodology: All patients with gunshot injury admitted to the emergency department (ED) from January 2007 through January 2009 were enrolled in the study. The demographic characteristics of patients such as age, gender, cause of the injury, type of the weapon used, the injured body parts, Glasgow Coma Scale (GCS), Shock Index (SI), the length of stay in the hospital and mortality were recorded from the patient charts. Injury Severity Score (ISS), Revised Trauma Score (RTS) and Trauma and Injury Severity Score (TRISS) have been calculated. The differences between the groups for these parameters were compared using the Mann-Whitney U test. Results: The mean age of patients was 33.2 +/- 16.1 and 79 of 87 patients were mate. The causes of GSIs were homicidal in 73.6% and bullet cartridge in 51.7%. Calculated GCS, ISS, RTS, TRISS and SI were 13.8 +/- 2.9, 13.0 +/- 9.3, 7.38 +/- 1.1, 93.9 +/- 14.9% and 1.9 +/- 0.9 respectively. GCS, RTS and TRISS scores for survivors were significantly higher than non-survivors (p<0.001). ISS score and SI for survivors were significantly lower than non-survivors (p<0.001). There were no statistically significant differences between the groups in terms of the length of stay in hospital (p>0.05). There was no statistically significant correlation of the length of stay in hospital with GCS, RTS and TRISS (p>0.05). The length of stay in hospital was found to correlate with ISS and SI positively (p<0.001). Conclusion: It is concluded that Gun Shot Injury (GSI) is much more likely in young males than the other types of trauma in the population. We recommend that trauma scoring systems should be used to show trauma severity and mortality.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.Öğe Stevens-Johnson syndrome due to concomitant use of lamotrigine and valproic acid(ADIS INT LTD, 2007) Kocak, Sedat; Girisgin, Sadik A.; Gul, Mehmet; Cander, Basar; Kaya, Halil; Kaya, EsengulStevens-Johnson syndrome (SJS) is a rare but life-threatening acute mucocutaneous hypersensitivity reaction, usually related to drugs. Severe cutaneous adverse effects such as SJS and toxic epidermal necrolysis can arise during treatment with antiepileptic drugs (AEDs). A 23-year-old female patient with idiopathic epilepsy was referred to the emergency service with fever, oral and genital mucosal lesions, generalized rash, and weakness. She had been taking carbamazepine, valproic acid, and lamotrigine until 1 week prior to referral. Following consultations with a range of clinicians, the patient was diagnosed with SJS related to lamotrigine on the basis of her history and physical findings, and on consideration of current consensus definitions of this condition. The patient was followed up and treated in the emergency intensive care unit with intravenous fluids, antibacterial therapy, and methylprednisolone. After 18 days, the patient was considered to have made a sufficient recovery and was discharged. Patients who undergo therapy with AEDs, particularly new users of these agents, should be informed of and monitored for possible systemic and cutaneous adverse effects of AEDs. Polytherapy should be avoided for as long as possible as this increases the frequency of adverse effects, and treatment should be discontinued if any rash appears.Öğe Succesful treatment of prolonged sulfonylurea-induced hypoglycemia with octreotide in a patient with chronic renal failure: Case report(ORTADOGU AD PRES & PUBL CO, 2008) Guel, Mehmet; Cander, Basar; Ahmet, A. K.; Girisgin, A. Sadik; Bayir, Ayseguel; Kocak, SedatPatients who present to the emergency department after ingestion of excessive amounts of suflonylurea medications have hypoglycemia refractory to dextrose administration. Recently, the use of octreotide was described as an alternative treatment in such patients. A diabetic patient with chronic renal failure who ingested excessive amounts of sulfonylurea medications causing refractory hypoglycemia resistant to treatment with large doses of intravenous dextrose was presented here. Octreotide administration rapidly reversed hypoglycemia allowing the patient's stabilization and eventual discharge without any significant adverse events. We believe that octreotide may be an effective therapy in refractory sulfonylurea-induced hypoglycemia.
