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    Drug intoxications in the emergency department: Our 1-year experience
    (Kare Publ, 2025) Oksuz, Ersoy; Demir, Bilgehan
    OBJECTIVE: Drug intoxication (DRI), which occurs due to accidental or suicidal use of high doses of drugs, has a high mortality and morbidity rate. emergency departments of hospitals are the units where these patients first come to the hospital, where the first interventions are performed and where the mortality rate is higher than other departments. therefore, DRI is a more important health problem for the emergency department (ED) than other departments of hospitals. In this study, we aimed to retrospectively investigate the demographic characteristics, drugs used and clinical course of patients admitted to the ED of our hospital with the diagnosis of DRI. METHODS: Patients admitted to the ED of Malatya Training and Research Hospital with the diagnosis of DRI were retrospectively screened from the hospital database. The patients' demographic characteristics, medications and clinical conditions were recorded. Patients over the age of 18 years who were diagnosed with DRI and whose medicationuse was identified were included in this study. Patients under the of 18 and those poisoned by other substances such as alcohol, illegal chemicals, or agricultural pesticides were excluded. RESULTS: Demographic characteristics, type of intoxication and clinical course of the patients included in the study are shown in Table 1. In 2023, 282 patients were admitted to the emergency department of our hospital with the diagnosis of DRI. Of these, 60% were women and 40% were men (n=170, n=112, respectively) and there was no statistically significant difference between the numbers of men and women (p=0.156). Fifteen percent of the women were over 50 years of age and 85% were under 50 years of age. this ratio was 55% to 45% in men. there was no statistically significant difference in the age distribution between men and women (p=0.246, p=0.260, respectively), (Table 1). 77% of the patients used overdose drugs for suicidal purposes and 23% accidentally (n=217, n=65, respectively). There was no statistically significant difference in the type of DRI, total number of males and females and age distribution (p=0.26). While 60% of the patients were hospitalized, 25% were admitted to intensive care unit and 35% to service (n=70, n=100, respectively). There were statistically significantly more patients admitted to service (p=0.03). CONCLUSION: The results of our study show that the number of female patients admitted to the ED of our hospital with the diagnosis of DRI, patients under 50 years of age and suicidal use are higher, the most commonly used drugs in these patients are NSAIDs, SSRIs and antipyschotics as a drug group and drugs used in psychiatric disorders. Our study has shown that frequently used and easily accessible drugs are more likely to be abused, and that questioning such drugs, especially in patients presenting to the emergency service with drug intoxication in this region, may be valuable for diagnosis and treatment.
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    Efficacy of preemptive intravenous ibuprofen and dexketoprofen on postoperative opioid consumption in laparoscopic cholecystectomy: Randomized controlled study
    (Public Library Science, 2025) Soyalp, Celaleddin; Yayik, Ahmet Murat; Oksuz, Ersoy; Yuzkat, Nureddin
    Background To compare the effects of preemptive single-dose intravenous (IV) ibuprofen and dexketoprofen on postoperative pain and opioid consumption in patients undergoing laparoscopic cholecystectomy (LCC).Methods The study included 90 patients aged 18-65 years with an ASA score of I or II who underwent LCC. Patients were equally divided into three groups: Control Group (Group P), 100 cc 0.9% NaCl was infused intravenously over 30 min, Dexketoprofen Group (Group D), 50 mg dexketoprofen in 100 cc 0.9% NaCl was infused intravenously over 30 min, and Ibuprofen Group (Group I), 800 mg ibuprofen in 100 cc 0.9% NaCl was administered intravenously over 30 min. Visual Analog Scale (VAS) scores and opioid requirement were recorded at 1, 2, 4, 6, 12 and 24 hours postoperatively.Results There was no significant difference between the Dexketoprofen and Ibuprofen groups with regard to VAS scores, whereas VAS scores were higher in the control group than other groups in the 1st, 2nd, 4th, 6th,12th, and 24th hours. In addition, fentanyl consumption was higher in the control group at 0-6 hours and at 24 hours compared to the other two groups.Conclusion Preemptive ibuprofen and dexketoprofen administration reduce pain scores and opioid consumption compared with the control group, however, they are non-inferiority to each other.
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    Efficacy of tocilizumab therapy in severe COVID-19 pneumonia patients and determination of the prognostic factors affecting 30 days mortality
    (Marmara Univ, Fac Medicine, 2022) Delen, Leman; Kasapoglu, Umut Sabri; Gok, Abdullah; Cagasar, Ozlem; Tetik, Bora; Oksuz, Ersoy
    Objective: In coronavirus disease - 19 (COVID-19) patients, cytokine storm develops due to the increase of pro-inflammatory cytokines. Tocilizumab (TU.), has been used in the treatment of COVID-19 patients and successful results have been obtained. The aim of this study was to determine the efficacy of TCZ and also investigate the prognostic factors affecting the success of treatment and mortality in COVID-19 patients treated with TCZ. Patients and Methods: Between March 2020 and August 2021, a total of 326 confirmed severe COVID-19 pneumonia patients, treated in the intensive care unit, were included in the study. Results: The mean age of the patients was 63.02 +/- 11.58 years, and 203 (62.3%) of the patients were male. Patients treated with TCZ had a longer survival time compared with the standard therapy (p=0.012). It was found that type of respiratory support (HR:2.19, CI:1.10-4.36, p=0.025) and hyperlactatemia on the day of TCZ therapy admission (HR:2.93 CI:1.53-5.64, p=0.001) were the significant and independent prognostic factors of survival in severe COVID-19 pneumonia patients treated with TCZ. Conclusion: Tocilizumab therapy improved 30-days survival in critically ill COVID-19 pneumonia patients. Also, among the patients with TCZ, types of respiratory support and hyperlactatemia on the day of TCZ admission were the independent prognostic factors.