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    Posterior fascicular ventricular tachycardia: A rare cause of tachycardia
    (College of Physicians and Surgeons Pakistan, 2022) Kurt, Erdem; Ak, Rohat; Bahadırlı, Suphi
    A 13-year male patient with a history of tachycardia attacks was diagnosed to have left posterior fascicular ventricular tachycardia (VT) according to the electrocardiogram (ECG) obtained at the emergency service. This diagnosis was confirmed with advanced electrophysiological studies and the case was diagnosed by genetic evaluation, which was performed to reveal the underlying cause, to have Brugada type 2 syndrome that might be associated with sudden cardiac death. Underlying causes should be evaluated, although idiopathic VTs generally have a good prognosis.
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    Predicting intensive care unit admissions for COVID-19 patients in the emergency department
    (Cambridge University Press, 2022) Bahadırlı, Suphi; Kurt, Erdem
    Objective: Determining the parameters that can predict the requirement of intensive care unit (ICU) admissions among the coronavirus disease 2019 (COVID-19) patients presented to the emergency departments (EDs). Methods: In adult consecutive patients admitted (March 15 - April 15, 2020) to the ED of a state hospital for COVID-19, we retrospectively analyzed demographic data, symptoms, laboratory tests, and chest computed tomography (CT) on arrival. Results: We included 458 patients [213 (46.5%) females, median age 48 y]. Body temperature, respiration rate, C-reactive protein (CRP), D-dimer, ferritin values, and the number of comorbidities were significantly higher in patients admitted to the ICU than others. Also, diffuse infiltration in chest CT is more common in patients who need ICU follow-up. As a result of the binary regression analysis, a statistically significant correlation was found between the presence of dyspnea (odds ratio [OR]: 12.55), tachypnea (relative risk [RR] >= 18) (OR: 14.54), multiple comorbidities (>= 2) (OR: 23.39), diffuse infiltration in CT (OR: 14.52), and CRP (>= 45 mg/L) (OR: 4.71); and the need for ICU admission. Conclusion: It has been concluded that the presence of dyspnea and tachypnea, elevated CRP, presence of multiple comorbidities, and diffuse infiltration in CT may predict the need for ICU admissions of the patients, who presented to the EDs.
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    The comparison of Ottawa Ankle Rules and Shetty test performances in foot-ankle trauma patients visited to the emergency department
    (Elsevier Science Ltd, 2022) Ak, Rohat; Kurt, Erdem; Bahadırlı, Suphi; Çakır, Mehmet Semih; Bilgu, Ali Selman; Eke Kurt, Şebnem Zeynep
    Background: The Ottawa Ankle Rules (OARs) and Shetty test (ST), are assessment guidelines intended to minimize radiographs in patients with ankle trauma. The aim of this study is to determine and compare the effectiveness of OARs and ST in patients admitted to the emergency department (ED) with foot and ankle trauma. Methods: This prospective cohort study was carried out in the ED of a tertiary care teaching hospital. OARs and ST were practiced by different doctors to patients, who were admitted with foot and ankle trauma. X-ray images were analyzed by a radiologist. Accuracy measures were covered such as sensitivity, specificity, positive predictive value, negative predictive value. Results: The study was completed a total of 207 patients, after achieving the inclusion and exclusion criteria. The mean age of the patients was 33.1 +/- 16.3, and 96 (46.4%) were female. For OARs, it was determined that as sensitivity 97.22%, specificity 48.89%, positive predictive value 50.36%, negative predictive value 97.06%, positive likelihood ratio 1.9 and negative likelihood ratio 0.06. If the OARs had been used, there would have been a 32.8% reduction in the ankle X-ray system. For the ST, it was determined that as sensitivity 51.39%, specificity 85.93%, positive predictive value 66.07%, negative predictive value 76.82%, positive likelihood ratio 3.65 and negative likelihood ratio 0.57. Discussion: The OARs can be used as a screening tool, due to causing the high sensitivity in foot and ankle traumas. The ST was found to be inefficient in this study. In addition, the significant reduction in the number of X-rays with the use of OARs is another major result of the study.