Factors affecting seizure recurrence in the emergency department.

Background: Information on Emergency Department (ED) follow-up of patients presenting with epileptic seizures is limited. Objectives: It was planned to investigate the factors affecting the recurrence of epileptic seizures in the follow-up of patients presenting to the ED with the complaint of epileptic seizures. Materials and methods: This prospective, observational, single-center study was carried out in an adult population presenting to the ED. The study included patients older than 18 years of age presenting to the ED with the complaint of epileptic seizures. Results: Of the 205 patients included in the study, 68 (33.2%) had seizure recurrence during the 6 h. In the univariable analysis, advanced age, prolonged post-ictal duration, increased seizure duration, generalized tonic clonic seizure, alcohol consumption within past 24 h, hypertension, coronary artery disease, Alzheimer's disease, prior ischemic cerebrovascular disease, low Glascow Coma Scale (GCS), high glucose, high C-Reactive Protein, high phosphorus, low potassium, high blood urea nitrogen, high lactate, increased anion gap, high osmolarity were statistically significant in predicting recurrent seizure recurrence within 6 h. According to the logistic regression, postictal duration, GCS score, and age were independent predictors in our model. The cut-off value of postictal duration in predicting seizure recurrence at the highest sensitivity (66.2%) and specificity (89.8%) was 22.5 min. Conclusion: A prolonged postictal state, low GCS score, advanced age may be an indication of seizure recurrence. Therefore, patients with a long postictal duration, low GCS score, advanced age should be followed up more carefully in terms of recurrent seizures in the ED.

Leech Application-related Upper Gastrointestinal Bleeding: A Case Report.

Leech therapy (Hirudotherapy) is a method used in the treatment of many diseases since ancient times. Although many complications have been reported following the use of this method, no systemic life-threatening bleeding has yet been described. A-43-year-old male patient was diagnosed with upper gastrointestinal bleeding following leech application that he had received for infertility one week earlier. The complications of hirudotherapy typically spontaneously improve due to the local effects of this treatment. The most frequently reported complications are local infections, and less commonly allergies and prolonged local bleeding can occur. However, in this case report, we describe a life-threatening upper gastrointestinal bleeding as a new complication. Gastrointestinal bleeding appearing a week after leech therapy does not necessarily mean that leeches caused gastrointestinal bleeding in this case. Nevertheless, considering the development time of gastrointestinal bleeding, it can be deduced that it was possibly due to hirudotherapy. Patients should be informed about alarming symptoms that can indicate complications following leech application.

Early predictors of mortality for moderate to severely ill patients with Covid-19.

BACKGROUND: Determining the factors affecting the mortality and clinical conditions of the patients with Covid-19 are indispensable needs in developing patient treatment algorithms. We aimed to determine the parameters that can predict the mortality of moderate to severely ill patients with laboratory confirmed Covid-19. METHODS: Moderate to severely ill, Covid-19 patients older than 18 years were included. Mild Covid-19 patients and the ones with negative polymerase chain reaction test results were excluded from the study. The primary outcome of the study was 30-day mortality rate and we aimed to determine the factors affecting mortality in moderate to severely ill Covid-19 patients. RESULTS: 168 patient results were analyzed. Median age of the patients was 59.5 (48.3 to 76) and 90 (53.6%) were male. According to multivariate regression analysis results, the presence of any comorbid disease (p = 0.027, HR = 26.11 (95%CI: 1.45 to 471.31)), elevated C-reactive protein levels (CRP) (p < 0.001, HR = 1.24 (95%CI: 1.11 to 1.38)) and presence of dyspnea (p = 0.026, HR = 4.26 ((95%CI: 1.19 to 15.28)) were found to significantly increase the mortality, while high pulse O 2 saturation level (p < 0.001, HR = 0.90 (95%CI: 0.82 to 0.99) was found to decrease. When receiver operating characteristic curve was created for laboratory tests, it was determined that white blood cell counts, neutrophil counts, CRP levels and neutrophil/lymphocyte ratio predicted mortality while Lymphocyte levels did not. CONCLUSION: Dyspnea, the presence of any comorbid disease, elevated CRP levels, and low pulse O 2 saturation levels predict mortality in moderate to severely ill Covid-19 patients.

Changes in flavonoid and phenolic acid contents in some Rosa species during ripening.

In this study, fruits of Rosa dumalis, R. canina, and R. villosa were cultivated and harvested at six different time points based on colour changes during the ripening period. Phenolic acid and flavonoid contents in fresh hypanthium were determined by HPLC-DAD. Derivatives of organic acid (gallic, caffeic, p-coumaric, and ferulic acids) and flavonoid (catechin, eriocitrin, rutin, apigenin, quercetin, apigenin-7-O-glucoside and kaempferol) were quantified using calibration curves. Phenolic acid contents of the Rosa species increased nonlinearly depending on the harvesting time. The highest amount of catechin was found at the fifth harvest time point (H-5) ranged from 323 to 472mgkg-1. The highest level of caffeic acid content was found in the R. dumalis ranged from 24 to 77mgkg-1. The total amount of flavonoid increased up to the fifth harvest time point (H-5), whereas the amount of total phenolic acid tended to decrease until the same harvest period.