Kounis Syndrome is the development of acute coronary syndrome (ACS) because of allergic reactions; allergens, such as foods, insect venom, iodine contrast agent or drugs can cause this syndrome. Hirudotherapy (leech therapy) is increasingly used as a useful therapeutic option in a variety of medical and surgical procedures, and potential complications related to this therapy include Aeromonas species infections, bleeding, anemia and allergic reactions. Here, we present a patient diagnosed as Type 1 Kounis Syndrome after using hirudotherapy for her knee aches. 41-year-old woman admitted to emergency department with sudden onset of face edema, shortness of breath and chest pain complaints and diagnosed as an allergic reaction and anaphylaxis due to leech therapy. Kounis Syndrome should be considered in acute coronary syndrome patients who were admitted to emergency department with anaphylaxis clinic.

Objective: There is no study in the literature investigating ischemia-modified albumin (IMA) values and thiol disulfide homeostasis (TDH) parameters in acute urticaria patients. This study aimed assessment of TDH parameters and IMA in acute urticaria patients.Methods: The study included a total of 68 cases, with 35 acute urticaria patients and 33 healthy volunteers. Patients who presented to Ordu University Hospital and were diagnosed with acute urticaria between January 2019 and June 2019 and healthy individuals as the control group were included in the study. Serum albumin, IMA, native thiol, total thiol, and disulfide thiol levels were measured, and the results were compared between the groups.Results: IMA values of 0.93±0.09 in the study group were significantly high compared to 0.8±0.10 in the control group (p<0.01). Native thiol (SH) level was 353.66±87.5 in the study group, 393.62±47.7 in the control group (p:0.022), and total thiol (TSH) level was 385.46±86.6 in the study group and 433.53±56.06 in the control group (p:0.008). In the patient group there was a significant negative correlation between SH levels and IMA levels (r=-0.626, p<0.001).Conclusion: In acute urticaria, IMA increases while SH and TSH levels reduce. However, TDH does not change. The lack of change in the balance may be explained by acute urticaria being an acute event and not being a chronic inflammatory process.

Purpose: Novel coronavirus disease 2019 (COVID-19) is an infectious disease unknown before the 2019 outbreak in Wuhan. This study evaluated telomere length in COVID-19 (+) and (-) samples with clinical-demographic parameters. Materials and Methods: DNA was isolated from COVID-19 (+) (n=70) and (-) (n=70) patients. Telomere length was determined by real-time-PCR (RT-PCR). The 2–∆∆Ct method was used to analyze the telomere length of the samples. Results: There were significant differences in creatinine, LDH, ferritin, WBC, NEU and CRP in COVID-19 (+) patients compared to COVID-19 (-) patients. The NEU/LYM (or N/L) ratio was found higher in the patients with COVID-19 (+), than in COVID-19 (-). On the other hand, our COVID-19 (+) patients (mean±std:0.93±0.58) had significantly shorter telomere lengths than the COVID-19 (-) (mean±std:1.26±0.76). Moreover, COVID-19 (+) male patients (mean±std:1.06±0.50) had longer telomere length than female patients (mean±std:0.76±0.54). Telomere length was significantly shorter in patients with COVID-19 (+)with high blood urea nitrogen (BUN), high creatinine, high hematocrit, high NEU levels, normal platelets (PLT), and low WBC levels. Conclusions: Our findings suggest that telomere length and blood parameter levels influence the severity of COVID-19. Blood parameters differed in patients with COVID-19 (+) and COVID-19 (-). As a result, increasing the number of similar studies in the future can demonstrate the significance of our findings. Keywords: COVID-19, Telomere length, RT-PCR, NEU/LYM, blood

Purpose: The aim of this study is to see oxidative DNA damage (8-OHdG), its relationship with inflammatory mediators (IL6 and TNFA), and its reflections on laboratory findings in patients who had COVID-19 infection at different intensities. Materials and Methods: Serum interleukin-6 (IL6), tumor necrosis factor-alpha (TNFA), and 8-hydroxy-2′-deoxyguanosine (8-OHdG) levels were measured using kits based on the enzyme-linked immunosorbent assay (ELISA) principle. Results: In COVID-19 positive patients treated in intensive care 8-OHdG marker level is at the highest level and statistically significant. In patients receiving inpatient treatment in the hospitalized, the 8-OHdG marker level is higher than the control and outpatient groups. IL6 values were at the highest level in the patient group treated in the intensive care unit and were higher than the outpatient and control groups. There was no statistically significant difference between the control and patient groups in terms of TNFA values. Neutrophil-to-lymphocyte ratio (NLR) was lower in the control group than in all patient groups. C-reactive protein (CRP) is higher in hospitalized patients than in the control group. Lactate dehydrogenase (LDH) was found to be statistically significantly higher in hospitalized patients than outpatients. Conclusion: As the severity of COVID-19 increases, serum 8-OHdG and IL6 levels also increase. These parameters can guide the diagnosis of COVID-19 patients in the early stages of the disease course.

Many biomarkers are used in addition to radiologic examinations to determine the severity of COVID-19. This study aims to determine WBC, neutrophil, lymphocyte, platelet, D-dimer, CRP, AST, ALT, LDH, PT, APTT, INR, urea, creatinine, lactate, and ferritin levels in COVID-19 patients and the effect of their changes on mortality rate. The study was conducted between 11 March 2020 and 31 August 2020 (during the COVID-19 pandemic). A total of 502 patients older than 18 years who presented with suspected COVID-19 were included in the study. Of these 502 patients who applied to the hospital, 229(45.6%) were male and 273(54%) were female. 301(60%) patients were diagnosed with COVID-19 through computed tomography and PCR tests. 201(40%) patients with negative test results constituted the control group. Patients with positive test results 48.2% (n=145) were men, and 51.8% (n=156) were women. The median age of the patients was 51±25 years. The patients tested positive for COVID-19 were divided into three groups as outpatients (26.9%), inpatients (68.8%), and intensive care unit patients (4.3%). The mortality rate of the patients followed via the patient follow-up system after 30 days was determined as 2.7%. The biomarker values of patients examined in this study tested negative and positive for COVID-19 were compared. In the study, D-dimer, ferritin, Lactate, AST, ALT, LDH, Urea, Creatinine, APTT, and INR levels were found to be higher in the positive tested patients than the negative ones. In the study, it was concluded that neutrophil, lymphocyte, CRP, and ferritin ratios should also be followed in the follow-up phase of the disease. It is important that additional measures should be taken in cases when these biomarkers increase by following the values of the patients who started taking treatment. Also, the ratio of biomarkers is crucial in determining whether the treatment has been effective or not.

Objective: This study aimed to determine the change in forensic cases admitted to an emergency department after the COVID-19 pandemic, due to its adverse effect on all people around the world in various ways. Methods: This study was conducted retrospectively in a single center. The sample size included 1645 forensic cases over the age of 18 years admitted to an emergency department between 1 January 2019 and 31 December 2020. Ethical approval before the study was obtained from a Local Clinical Research Ethics Committee. The period between 11 March 2020 and 31 December 2020 was considered the COVID-19 pandemic (DP), while the pre-DP period was named BP. The distribution rates of forensic cases in BP versus DP were compared. Results: Both traffic and work accidents were higher in males than females, whereas suicide attempts were higher in females than males (p <0.001). Suicide attempts by both women (BP: 14.9%, DP: 17.4%) and men (BP: 3.7%, DP: 4.9%) showed an increase for DP (p < 0.01). Work accidents were lower in women (BP: 22.3%, DP: 13.4%) and men (BP: 22.5%, DP: 21.1%) in DP than BP (p <0.01). Conclusion: The COVID-19 pandemic has increased suicide rates in both women and men but reduced work accident rates. Suicide rates were higher in women than men. The COVID-19 pandemic has negatively affected people in many ways, including forensic, employment, economic, and psychological aspects.