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Item The Diagnostic Value of Protein Carbonyl Levels in Acute Carbon Monoxide Intoxication(DUZCE UNIV, 2017-01-01) Gunaydin, Mucahit; Turkmen, Suha; Karaca, Yunus; Tatli, Ozgur; Yildirim, Furkan; Altinkaynak, Buket Akcan; Gunduz, AbdulkadirObjective: Carbon monoxide (CO) is the main cause of intoxication-related mortality and morbidity in developed countries. It is responsible for more than half of fatal intoxications in many countries. The purpose of this study was to determine the diagnostic value of protein carbonyl (PC), a good marker of oxidative stress, in association with oxidative stress resulting from hypoxia emerging in patients with acute CO intoxication. Methods: Thirty-four patients diagnosed with acute CO intoxication at the Emergency Department and 38 healthy volunteers were included in the study. Patients' PC levels at time of admission and after treatment were compared with those of a control group. Results: No statistically significant difference was observed among PC levels at time of admission in the patient and control groups (p = 0.305, patient group 0.025 +/- 0.01, control group 0.026 +/- 0.01). A significant decrease was determined in post-treatment PC levels in the patient group compared to those at time of admission (p = 0.006, admission 0.025 +/- 0.01, post-treatment 0.017 +/- 0.008). No significant correlation was determined between patients' carboxyhemoglobin (CO-Hb) levels and PC levels at time of admission (Correlation coefficient = -0.006, p= 0.971). Conclusions: We think that PC is not suitable for use as a biomarker in the acute period in patients with CO intoxication.Item Developing Cricothyroidotomy Skills Using a Biomaterial-Covered Model(ELSEVIER SCIENCE INC, 2020-01-01) Senuren, Cigdem Ozkaya; Yaylaci, Serpil; Kayayurt, Kamil; Aldinc, Hasan; Gun, Cem; Simsek, Perihan; Tatli, Ozgur; Turkmen, SuhaIntroduction-Cricothyroidotomy is an advanced and life-saving technique, but it is also a rare and a difficult procedure. The purpose of the present study was to produce a low-cost simulation model with realistic anatomic features to investigate its effectiveness in developing cricothyroidotomy skills. Methods-This study was performed at a university simulation center with 57 second-year student paramedics and a cricothyroidotomy simulation model. Total scores were assessed using a checklist. This consisted of 13 steps and was scored as misapplication/omission=0, correct performance and timing with hesitation=1, and correct performance and timing without hesitation=2. One of these steps, local anesthesia of the area if time is available, was not performed owing to time limitations. The highest possible score was 24. Data are presented as mean +/- SD with range, as appropriate. Normal distribution was evaluated using the Kolmogorov-Smirnov test, Student t test, and Mann-Whitney U test, and correlation analysis was used for statistical analysis. Results-Students completed the cricothyroidotomy procedure steps in 116 +/- 46 (55-238) s. At performance assessment, the score achieved was 12 +/- 5 (2-24). The highest total score of 24 was achieved by 3 students (5\%). Total scores exhibited negative and significant correlation with procedure time (r=-0.403, P=0.002). Conclusions-The model developed in this study is an inexpensive and effectivemethod that can be used in cricothyroidotomy training for student paramedics. We think that repeating the cricothyroidotomy procedure on the model will increase success levels.Item Ischemia-modified albumin and the IMA/albumin ratio in the dignosis and staging of hemorrhagic shock: A randomized controlled experimental study(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2020-01-01) Turedi, Suleyman; Sahin, Aynur; Akca, Metehan; Demir, Selim; Kose, Gokcen Derya Reis; Cekic, Arif Burak; Yildirim, Mehmet; Yulug, Ersin; Mentese, Ahmet; Turkmen, Suha; Acar, SamiBACKGROUND: To determine the value of ischemia-modified albumin (IMA) and IMA/albumin ratio (IMAR) in the diagnosis and staging of hemorrhagic shock (HS). METHODS: A pressure-targeted HS model was established in this study. The control and shock groups were monitored for 30 min and 60 min to simulate varying durations of exposure to HS. All subjects underwent invasive arterial monitoring during the experiment and were further divided into mild and severe shock groups based on decreases in mean arterial pressure (MAP). Biochemical and histologic comparisons were performed between the groups. RESULTS: Our results revealed higher IMA, IMAR, lactate, total oxidant status (TOS) and oxidative stress index (OSI) levels in both the 30- and 60-min shock groups compared to the control group. Concerning MAP-based shock staging, IMA, IMAR, lactate, TOS and OSI levels in the 30-min and 60-min mild and severe shock groups were higher than those of the controls. However, there was no significant difference between the mild and severe shock groups. A significant correlation was determined between all the biomarkers evaluated and HS-induced damage in various organs. This correlation was highest in lactate and IMAR levels. CONCLUSION: IMA and IMAR levels may be used in the early diagnosis of HS and also have the potential for use in determining the severity of HS. IMA and IMAR measurement may also be considered as an alternative or in addition to lactate measurement in the diagnosis of HS.Item A Comparison of the Effects of Grayanotoxin-Containing Honey (Mad Honey), Normal Honey, and Propolis on Fracture Healing(KARGER, 2018-01-01) Sahin, Aynur; Turkmen, Suha; Guzel, Nizamettin; Mentese, Ahmet; Turedi, Suleyman; Karahan, Suleyman Caner; Yulug, Esin; Demir, Selim; Aynaci, Osman; Deger, Orhan; Gunduz, AbdulkadirObjectives: Delayed healing and non-union of fractures have a significant effect upon patient morbidity. Studies have therefore largely concentrated on accelerating fracture healing. This study was intended to compare the effect of ``mad honey{''} and propolis on fracture healing using radiological and histopathological analysis. Subjects and Methods: Femur fracture was surgically performed on 48 rats, followed by fixation. Animals were then divided into 8 groups: 2 control groups (15-and 30-day) and 6 treatment groups (15-and 30-day normal honey, 15-and 30-day ``mad honey,{''} and 15-and 30-day propolis). Rats were sacrificed at the end of these periods, and radiological and histological examinations were performed. Results: Radiological healing in the propolis group after 15-day therapy was statistically better than in the control (p = 0.004) and normal honey (p = 0.006) groups. After 30-day therapy, healing in the propolis group (p = 0.005) and grayanotoxin-containing ``mad honey{''} group (p = 0.007) were significantly better than in the control group. Histologically, there was a statistically significant difference between the 15-day propolis group and the other groups (control, honey, mad honey: p = 0.003, p = 0.003, and p = 0.002, respectively). We also found a statistically significant difference when the 30-day propolis group (p = 0.005) and `` mad honey{''} group (p = 0.007) were compared to the control group. Conclusions: This study shows that grayanotoxin-containing `` mad honey{''} and propolis can accelerate fracture healing. (C) 2018 The Author(s) Published by S. Karger AG, Basel.Item Comparison of self versus expert-assisted feedback for cricothyroidotomy training: a randomized trial(BMC, 2022-01-01) Aldinc, Hasan; Gun, Cem; Yaylaci, Serpil; Senuren, Cigdem Ozkaya; Guven, Feray; Sahiner, Melike; Kayayurt, Kamil; Turkmen, SuhaBackground The self-video feedback method may have the potential to provide a low-cost alternative to physician-driven simulation-based training. This study aimed to assess the utility of two video feedback methods by comparing the improvement in performing cricothyroidotomy procedure following self video feedback (trainees review their performance by themselves) and expert-assisted video feedback (trainees review their performance while an emergency physician provides additional feedback). Methods This study was pretest-posttest and two-group designed research performed at a university simulation center with 89 final-year medical students and used a cricothyroidotomy simulation model. After seeing an educational presentation and a best practice video, trainees were randomized into two groupsItem Gallbladder volvulus(WILEY, 2022-01-01) Abdelrahman, Zeinab AbdelMohsen; Omar, Razana Mohd; Mirza, Salman; Turkmen, SuhaGallbladder volvulus is a rare entity. The condition results in rotation of the gallbladder on its mesentery along the axis of cystic duct and artery. Gallbladder volvulus is a condition in which the organ twists on its long axis to the point where its vascular supply is compromised.Item Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp(BMC, 2021-01-01) Yaylaci, Serpil; Ulman, Yesim Isil; Vatansever, Kevser; Senyurek, Gamze; Turkmen, Suha; Aldinc, Hasan; Gun, CemBackground Integration of clinical skills, ethical decision-making, and reflection skills have emerged as cornerstones of clinical teaching in medical schools. This study aimed to detect whether a multimodal learning environment approach consisting of lectures, a drill, post-drill video debriefing, and written reflection in an emergency medicine rotation boot camp improves interns' patient management skills, ethical decision-making, and reflection skills. Methods A multimodal learning environment was created by the collaboration of emergency medicine, ethics, and medical education specialists. Multiple educational techniques involving lectures, case discussions, and role-playing a crisis scenario were applied. Pre-test and post-test, debriefing on performances on video records, video-recorded performance assessment, and reflective essays about their own and group's performances were used to assess various aspects of the student performances. Additionally, a meeting was organized with the presence of the authors to create qualitative data obtained through the program evaluation meeting conducted on three themes: influences of teaching methods, students' performances, and common achievements and mistakes of students. Results 133 students participated. Post-test multiple-choice question (MCQ) test scores were slightly higher than pre-test. A low and medium correlation was detected among pre-test and post-test patient management problem (PMP) and reflection scores, which was more prominent for female students. Multiple linear regression showed that pre-test and post-test PMP scores significantly contributed to reflection scores. These results might support that better patient management predicts more robust reflective practice. Teachers observed that students appreciated being inspired by well-performing peers, particularly noting the empathic needs of patients, companions, and other health professionals. However, students overlooked summoning forensic or social services and were inhibited by the pressure of the contextual traits of the drill. Conclusion The multimodal learning environment created by multidisciplinary collaboration contributed to the improvement of components of situational awareness of the interns: patient management skills, ethical decision-making, and reflective practice. During this research, we created a toolbox better to capture the richness and diversity of student interactions. Considering the scarcity of context-specific assessment methods and widespread use of MCQs or generic scales for higher-order thinking skills in medicine, this study might be regarded as a step forward in that context.Item Myocarditis following COVID-19 mRNA (mRNA-1273) vaccination(WILEY, 2022-01-01) Chellapandian, Suresh Babu; Turkmen, Suha; Salim, Imtiaz; Chinnakaruppan, Shanmugavel; Mohammad, JassimIn this case report, we presented a case of myocarditis as a rare complication that developed after Covid mRNA-1273 vaccine. Cases of post-vaccine myocarditis usually progress with mild symptoms. However, it should be a situation that healthcare workers should keep in mind, that myocarditis may develop after vaccination.Item A novel method for improving chest tube insertion skills among medical interns Using biomaterial-covered mannequin(SAUDI MED J, 2017-01-01) Tatli, Ozgur; Turkmen, Suha; Imamoglu, Melih; Karaca, Yunus; Cicek, Mustafa; Yadigaroglu, Metin; Bayrak, Selen T.; Asik, Olgun; Topbas, Murat; Turedi, SuleymanObjectives: To develop a low-cost biomaterial-covered chest tube simulation model and assess its possible usefulness for developing the chest tube insertion skills among medical interns. Methods: This mannequin-based interventional study was performed in a University hospital setting. We included 63 physicians performing emergency medicine internship at the Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey, between January 2015 and March 2015. A dummy was prepared for training simulation using a display mannequin. Medical interns received instruction concerning pneumothorax and the chest tube procedure. A total of 63 medical interns participating in this interventional study were asked to insert a chest tube in a biomaterial-covered mannequin. A senior trainee scored their performance using a check list and the mean of the total scores was calculated (21 items