ABSTRACT
Objectives: To test our hypothesis that a new modified VAS [mVAS] is superior and more objective than VAS in evaluating pain perception and treatment response between genders who have renal colic pain
Methods: The individuals in patient and control groups were first asked to mark the pain perceived during access of IV line [VAS[IV] score]. Then the patients with renal colic were asked to mark the pain they experienced before treatment [VAS[RC] score] and at 15 and 30 minutes after the administration of the first analgesic drug. The modified VAS scores [mVAS score] were obtained by subtracting the VASIV score from VAS[RC] score
Results: When VAS was used, the female patients had significantly higher level of pain at 0, 15, and 30th minutes than men [p = 0.012, p = 0.001, and p = 0.003, respectively]. However, there was not any significant difference at 0 and 30[th] min between sexes while female patients had significantly higher level of pain scores only at 15[th] minute according to mVAS scores [p = 0.027]
Conclusion: We think that the mVAS is superior and more objective than VAS in evaluating pain perception and abolished the difference in the perceived level of pain due to gender
Subject(s)
Humans , Male , Female , Middle Aged , Adult , Renal Colic , Pain , Analgesia , Prospective StudiesABSTRACT
Ultrasonography [USG] is widely used in emergency departments to assist in the diagnosis and treatment of patients. An increasing number of studies in the unconventional use of USG in thorax and lung examination have been conducted in recent years. Sliding lung sound [SLS] has been researched extensively during the last decade was accepted as a radiologic sign in 2008. However, determining SLS requires a certain degree of clinical experience since it is a subjective indicator. We have discovered the "pleural sliding sign [PSS]", which is as valuable as the SLS, but more objective sign. PSS is present at any time when SLS is present; furthermore, it can be used as a diagnostic sign even when the SLS is doubtful. In this study, we present our views on PSS and in particular wish to share this information with clinicians who are interested in performing emergency USG. We also aim to stimulate further research on this subject.
ABSTRACT
The eligibility for thrombolytic therapy for patients who present to the emergency department with Acute Ischaemic Stroke [AIS] has been researched in this study. Patients who had presented to the emergency department of our hospital between March 2008-2009 and diagnosed as AIS clinically and radiologically were included in the study prospectively. One hundred and twelve patients were included in the study. Forty nine [43.8%] were female and the mean age was 68.7 +/- 12.2 [median 71.5]. The mean time from the onset of symptom to hospital admission was 12.2 +/- 12.9 hours [median 6 hours]. Two [1.8%] patients did not have any contraindication for thrombolytic therapy. Arrival time at the hospital of three hours and higher was the single contraindication in 40 [35.7%] patients. The most common four contraindications were delayed admission, multilobar infarct or hypodensity of more than 1/3 of the hemisphere, hypertension and mild neurological symptoms respectively. Our data suggest that the primary barrier to the delivery of thrombolytic therapy for AIS is delayed arrival of the patient to a hospital, and up to 1/3 of our patients, the percentage arriving within 4 hours of the onset of stroke symptoms, might be eligible for attempted re-perfusion
ABSTRACT
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. 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. We studied acutely OP-poisoned patients admitted within 24 hours after OP exposure. 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]. 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