Browsing by Author "Cemil, Kavalci"

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Adequacy of Physicians Knowledge Level of Cardiopulmonary Resuscitation to Current Guidelines
(2015) Gulsum, Kocalar Ummu; Deniz, Arslan Engin; Cemil, Kavalci; Kayipmaz, Afsin Emre; Gulsum, Kavalci; Sukru, Yorulmaz; Akin, Giray Tufan
Aim: The purpose of this study is to test the level of information on CPR and suitability to current application of the phsicians practicing in hospital ANEAH. Material and Method: The form of a test of 20 questions fort his purpose has been prepared in accordance with the 2010 AHA-ERC CPR guidelines. This form distributed to volunteer physicians to fill in. A total of 173 physicians agreed to participate in he study. The results were analyzed statistically and tried to determine the factors affecting the level of information. Results:According to the results of the study physicians gender, age and the total duration of physicians and medical asistance doesn't affect the level of information. The number of CPR within I month positively affect the level of knowledge. The number of theoretical and practical training in medical school, have taken the positive impact the level of knowledge of physicians. The training period after graduation, significantly increased the level of physicians information, The order of these training sessions with the asistant courses, congress, seminars and lessions on the sempozims are effective. Discussion: CPR trainig programs for physicians should be standardized, updated and expanded. Recurent in-service trainig should be provided to increase phsicians knowledge on skills.
NEUTROPHIL LYMPHOCYTE RATIO IN PREDICTING SEVERITY OF INJURY, COMPLICATIONS AND MORTALITY IN CAUSTIC INGESTION CASES
(2020) Rezan, Karaali; Firdevs, Topal; Umut, Payza; Yesim, Akyol Pinar; Cemil, Kavalci; Zeynep, Karakaya; Esad, Topal Fatih
Background: Caustic ingestion is still alife-threatening condition. In this study, we investigated the significance of the neutrophil lymphocyte ratio (NLR) in predicting the severity of the injury, complications and mortality at an early stage in the emergency department. Material and methods: 133 patients included in the study. Endoscopic findings and Complete Blood Count (CBC) parameters were retrieved from hospital files. The data were divided into two groups Zargar grade 0, land 2A as Group1, 2B, 3A and 3B as Group 2. The Zargar scores and the laboratory values were evaluated with Spearman's Correlation. Results: We found that NLR and White Blood Cells ( WBC) values of Group 1 cases were statistically significant and lower than NLR and WBC values of Group 2 cases (p<0,05). Values in Group 2 patients showed that AUC value for the 6.99 cut-off value of the NLR WaS 0.913 sensitivity 100% and specificity was 78,3% (p <0.05). The 0,801 AUC for the 11.9 value of the WBC, sensitivity 66,7 and specificity 84.4 were found to be statistically significant (p <0,05). NLR> 7,33 AUC 0,915 (p<0.05) and AUC value for WBC> 11,9 was found to be 0,870 (p <0.05 ) for the patients with late complications. Interns of mortality no statistical relationship was found (p> 0,05). Conclusion: Endoscopy (EGD) is the valid gold standard method to determine the injury. In the literature, which patient groups should undergo endoscopy is also unclear. In addition, performing endoscopy in each patient will increase both the cost and the possibility of endoscopy-related complications. In our study NLR was statistically significant in predicting the severity of injury and possibility of complications in corrosive ingestion. Moreover, it can be obtain through affordable and routine blood count.
Scoring systems in prediciting mortality rate of patients applying emergency department
(2018) Cemil, Kavalci; Rezan, Tahtaci; Deniz, Arslan Engin
Objective: To compare the scoring systems used in intensive care units in terms of predicting the mortality in emergency patients and to determine the most appropriate scoring system for urgent care. Methods: This study was carried out by retrospectively reviewing the files of patients admitted to Ankara Numune Training and Research Hospital emergency medicine clinic between October 1, 2010 and October 31, 2010 for non-traumatic reasons and admitted to any service of the hospital. This study calculated automatically with the data obtained from the patients files and records, and Acute Physiology and Chronic Health Evaluation (APACHE.), Simplified Acute Physiology Score (SAPS.), Modified Early Warning Score (MEW) and Sequential Organ Failure Assessment (SOFA) scores via internet. Patient files were reviewed and their outcomes (hospitalization, discharge, referral and mortality) were recorded. The obtained data were entered in SPSS 18 and compared with the scores of APACHE., SAPS., MEW and SOFA. Results: Based on area under the curve analysis, APACE. (0.799; 95% CI: 0.746 to 0.845) showed the biggest area under the curve in terms of predicting the patients mortality. However, there was no difference between four scoring system in terms of predicting the mortality. Age (P<0.001, odd's ratio 1.055) pulse (P<0.007, odd's ratio 1.025) and SO2 (P<0.003, odd's ratio 0.952) variables were found to be independent risk factors for mortality. Conclusions: Scores such as APACHE., SAPS., and SOFA, can not be used to make an urgent decision on the first encounter with the patient even though they are successful in predicting mortality. In this case, MEW could be recommended as the most useful system. As a result, the use of scoring systems in emergency departments is useful and necessary. But, multi-centered and large patient group studies are needed.
The Value of Serum NGAL in Determination of Dialysis Indication
(2014) Cemil, Kavalci; Elif, Celikel; Serkan, Muhittin; Fevzi, Yilmaz; Deniz, Arslan Engin; Tamer, Durdu; Polat, Durukan; https://orcid.org/0000-0003-2529-2946; 25255577; AGG-1308-2022
Objective: To investigate if Neutrophil Gelatinase-associated Lipocalin can be used or not as a biochemical marker to determine the indications for emergency dialysis treatment. Methods: The study was conducted at the Emergency Department of Numune Taraining and Research Hospital, Ankara, Turkey, in 2012, and comprised 60 patients who had uraemic symptoms and abnormal laboratory tests, including elevated potassium, blood urea nitrogen, and creatinine level or lowered pH and bicarbonate. They were divided in to 2 equal groups as those having indication for dialysis (Group 1) and those not having such indications (Group 2). Relevant values, including that of Neutrophil Gelatinase-associated Lipocalin, were compared between the two groups. To assess the utility of Neutrophil Gelatinase-associated Lipocalin measurements at varying cut-off values to predict indications for dialysis, a conventional receiver operating characteristic curve was generated and the area under the curve was calculated. P<0.05 was considered statistically significant. Results: The mean age of the 30 patients in Group 1 was 68.29 +/- 16.9 years, while in Group 2 it was 66.47 +/- 14.2 years (p<0.65). The mean Neutrophil Gelatinase-associated Lipocalin level was 817.65 +/- 334.76ng/mL in Group 1 and 398.97 +/- 202.42ng/mL in Group 2 (p<0.001). The best cut-off level for Neutrophil Gelatinase-associated Lipocalin to predict emergency haemodialysis indication was 615ng/mL with a sensitivity of 82% and a specificity of 80%, and the areas under curve was 0.84. Conclusion: Serum Neutrophil Gelatinase-associated Lipocalin level may be a determining parameter for indication of emergency haemodialysis.