Spinal cord trauma represents a major cause of emergency department admissions, with high morbidity and mortality rates. It requires early and urgent treatment. This experimental study assessed the effectiveness of a combination of primrose and N-acetylcysteine (NAC) in managing spinal cord injury (SCI). We divided 46 adult male Wistar albino rats (6–8 months old, weighing 300–350 g) into five groups. Group 1 (n = 10) received only primrose; group 2 (n = 10) received only NAC; group 3 (n = 10) received a combination of NAC and primrose; group 4 (n = 10) received no intervention (first control group); group 5 (n = 10) underwent laminectomy only (second control group). Intergroup neurological and motor function were evaluated on days 1, 7, and 14. Oxidative biochemical markers, such as superoxide dismutase (SOD), glutathione peroxidase (GPX), and malondialdehyde (MDA), were measured. Significant differences were recorded in the GPX, SOD, and MDA values of groups 1, 2, 3, and 4 (p < 0.001, p = 0.005, and p = 0.097, respectively). Groupwise comparisons were conducted to identify the clinical significance of these markers. GPX and SOD levels were significantly higher in group 1 than in group 2; MDA levels were lower in group 1. GPX and SOD levels were significantly higher than in group 3 than in group 1; MDA levels were lower in group 3. Compared with group 5, group 1 demonstrated significantly higher GPX and SOD levels and lower MDA levels. Results in group 2 were similar to results in group 5. In group 3, GPX and SOD levels were significantly higher than in groups 2 and 5; MDA levels were significantly lower. Comparisons according to inclined plane angle level and motor function values revealed significant results on day 14, in favor of group 3 rats that had received the combined treatment. The combined administration of NAC and primrose for traumatic SCI was more effective than either treatment alone in terms of improving biochemical and neurological functions. These findings suggest that the combination of NAC and primrose can serve as an effective treatment option for traumatic SCI.

Introduction: Coronavirus disease 2019 (COVID-19) patients are predisposed to thrombotic events. COVID-19 coagulopathy can be associated with ADAMTS-13 (a disintegrin-like and metalloprotease with thrombospondin type I repeats 13) levels. ADAMTS-13, the cleaving protease of highly thrombogenic ultra-large von Willebrand Factor (vWF) multimers, was rarely investigated in COVID-19 patients and inconsistent results were obtained. We measured ADAMTS-13 levels of patients admitted to emergency department. Methodology: A prospective study was carried out with 180 individuals at the Emergency Department of Uşak Training and Research Hospital. The patients were divided into three groups: mild COVID-19 (group 2), severe COVID-19 with oxygen saturation below 94% (group 3), and control group (group 1). ADAMTS-13 levels were analyzed with an enzyme linked immunosorbent assay (ELISA) kit (SunRed, Shanghai, China). Demographic data, clinical findings, and routine laboratory test results (alanine aminotransferase (ALT), aspartate aminotransferase (AST), white blood cell, lymphocyte, platelet, C-reactive protein (CRP), lactate dehydrogenase (LDH), prothrombin time, international normalized ratio (INR), partial thromboplastin time, D-dimer, creatinine, urea) were evaluated. Results: ADAMTS-13 serum levels were slightly lower in groups 2 and 3 compared to the control group, with no significant difference between the ADAMTS-13 median values (p > 0.05). Groups 1 and 2 exhibited comparable outcomes. Group 3 demonstrated notably elevated levels of CRP, LDH, D-dimer, AST, ALT, creatinine; and decreased platelet counts and INR levels (p < 0.05). Conclusions: COVID-19-associated coagulopathy is still unclear. Based on our data, ADAMTS-13 levels cannot be used as a biomarker to help stratify patients’ risks at the time of admission.

Aims: Since strokes are an important cause of morbidity and mortality all over the world, early diagnosis and treatment are extremely important for sequela-free recovery. The best treatment option for an ischemic stroke is intravenous thrombolytic therapy with recombinant tissue plasminogen activator. In this study, we aimed to determine the factors affecting in-hospital mortality among patients who presented to the emergency department due to an ischemic stroke and received thrombolytic therapy. Methods: This cross-sectional study reviewed the medical records of patients who presented to the emergency department with stroke symptoms between January 2018 and August 2022, were diagnosed with ischemic stroke, received thrombolytic treatment within the first 4.5 hours of symptom onset, and were subsequently hospitalized. Results: After excluding patients who did not meet the inclusion criteria, 184 patients were included in the study. It was found that 42 (22.8%) of the patients had an exitus in the follow-up. We determined that the mortality rate was higher in patients admitted to the emergency department with emergency health services compared to outpatients (p

Tüm vücut bilgisayarlı tomografi (TVBT), multitravma hastalarının acil servislerde değerlendirilmesinde günümüzde temel tanısal yöntemlerden biri haline gelmiştir. Spiral ve çok kesitli BT teknolojilerinin gelişimiyle birlikte, özellikle yüksek enerjili ve künt travma olgularında çoklu organ yaralanmalarının erken ve doğru biçimde saptanması mümkün olmuştur. Travmanın genç erişkinlerde önde gelen mortalite nedenlerinden biri olduğu göz önünde bulundurulduğunda, TVBT’nin sağladığı hız ve tanısal doğruluk klinik açıdan kritik değer taşımaktadır. Endikasyonlar arasında majör ve politravma, şüpheli klinik muayene, hemodinamik olarak unstabil olgular ve yüksek riskli travma mekanizmaları öne çıkmaktadır. Literatürde retrospektif çalışmalar mortalitede %2–5 oranında azalma bildirse de, randomize kontrollü veriler bu üstünlüğü net biçimde ortaya koymamıştır. Ancak, tanısal sürecin hızlanması, komplikasyonların önlenmesi ve hastanede kalış süresinin kısalması yönünden belirgin faydalar sağlandığı kabul edilmektedir. Gelecekte yapay zekâ tabanlı otomatik algoritmalar, düşük doz protokoller ve teleradyoloji uygulamalarıyla birlikte TVBT’nin travma yönetimindeki etkinliğinin daha da artacağı öngörülmektedir.

Kalsiyum kanal blokerleri (KKB'ler) hipertansiyon, anjina pektoris, kardiyak aritmiler ve diğer bozuklukların tedavisinde kullanılır. Bu ilaçların hem hızlı salımlı hem de kontrollü salınımlıp preparatları mevcuttur(1). Bu ajanların potansiyel toksisitesi önemlidir ve hastalar tarafından çoğu zaman yeterince dikkat edilmemektedir. Örnek olarak, kasıtlı veya kasıtsız aşırı dozdan kaynaklanan 9500' den fazla KKB zehirlenmesi vakası, 2002 yılında Amerika Birleşik Devletleri'ndeki zehir danışma merkezlerine bildirilmiştir (2). Tüm kardiyovasküler ilaç maruziyetlerinin sadece yüzde 16'sı KKB'lere bağlı olmasına rağmen, bu sınıf ölümlerde yüzde 38'ini oluşturuyordu (2).