Goal: 16 - Barış, Adalet ve Güçlü Kurumlar
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Barış, Adalet ve Güçlü Kurumlar
Sürdürülebilir kalkınma için barışçıl ve kapsayıcı toplumlar tesis etmek, herkes için adalete erişimi sağlamak ve her düzeyde etkili, hesap verebilir ve kapsayıcı kurumlar oluşturmak.
Barış, istikrar, insan hakları ve hukukun üstünlüğüne dayalı etkin yönetim olmadan, sürdürülebilir kalkınma olmasını bekleyemeyiz. Gittikçe artan ölçüde bölünmüş bir dünyada yaşıyoruz. Bazı bölgelerde barış, güvenlik ve refah sürekli iken, diğer bazı bölgelerde ise bitmek bilmeyen çatışma ve şiddet sarmalı var. Ancak bu, hiçbir şekilde kaçınılmaz sonuç değildir ve mutlaka çözümlenmelidir.
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Publication Metadata only RELATIONSHIP BETWEEN SUICIDAL PATIENTS AND VITAMIN D(2019-04-25T00:00:00Z) Atik, Dilek; Taşlıdere, Bahadır; TAŞLIDERE, BAHADIRNTRODUCTION: When a person end their life consciously and intentionally, it is called suicide. Suicide is not a random and nonpurposeful movement, but it is a way of getting rid of the crisis or problem that cause a big trouble and can not be overcome (1,2).The person who committed suicide carries out this action with the thoughts of despair and the lack of people around to help. Suicide is related to ongoing stress factors and narrowing of options before the individual (1,2). The most commonly used method for suicide is multiple drug intake and suicide probability is high among people who have previously attempted suicide, people from families with suicidal individuals (3,4). One of the most investigated issues related to suicide is mental disorders. Numerous studies have reported high rates of mental disorders in individuals who attempt suicide or who die from suicide (5,6). In a study conducted on 100 people who had attempted suicide, 70% of them had depression, 15% had alcoholism, 3% had schizophrenia and 5% had other disorders (7). The most important of the sterols belonging to the vitamin D family is cholecalciferol (vitamin D3). Cholecalciferol is composed of 7- dehydrocholesterol in the skin with the effect of ultraviolet rays (8). The aim of this study was to investigate the vitamin D levels in patients admitted to our emergency department due to suicid intervention and to contribute to the treatment of clinical applications according to the results. METHOD: This study is conducted prospectively in patients presented with suicide in Istanbul Sağlık Bilimleri University Kanuni Sultan Suleyman Training and Research Hospital Emergency Medicine Clinic between 01.12.2018-01.02.2019 with the approval of Kanuni Sultan Süleyman Training and Research Hospital Ethics Committee by the protocol numbered 2018/11/47. The study included 59 individuals with suicidal attempt and 42 subjects with control group. Blood taken from the patients was taken as disposable 10 ml, vacuumed, nonanticoagulanted, in biochemistry tubes for 5-7 ml and centrifuged at 2500 rpm for 10 minutes and their serum was separated within half an hour. Separated serums were stored at -80°C until examined. Each serum was only dissolved once on the day of the study. All variables were tested for conformity to normal distribution, Kolmogorov Smirnov test and compliance with parametric test criteria. The data obtained by the study carried out within the scope of clinical research are statistically nonparametric. For this reason, Mann Whitney U tests were used for statistical evaluations based on categorical (nominal or ordinal) and binary variables. Spearman rank correlation in non-parametric data and Pearson correlation in parametric data were used as correlation methods. FINDINGS: A total of 59 patients and 42 control groups were included in our study. 70.3% (n = 71) of the participants were female and 29.7% (n = 30) were male. The mean age of the participants was 30.7 and the minimum and maximum ages were 18 and 53 years. When the final results of the patients were evaluated; 50.8% (n = 31) were discharged with health, 29.5% (n = 18) were hospitalized and 7.1% (n = 12) were admitted to intensive care unit. When the presence of psychiatric disease was evaluated inthe patients with suicidal attempt, 42.3% (n = 25) had psychiatric disease and 57.6% (n = 34) did not have a diagnosis of psychiatric disease. In patients with suicidal interventions, a positive, high level relationship was detected with the presence of psychiatric disease (r: 0.860, p=0.000). Hastaların The relationship between vitamin D levels and the presence of psychiatric disease was statistically significant (r: 0.276, p = 0.005). Laboratory parameters of vitamin D minimum 4.4 maximum 33 values were found, the effect of vitamin D on suicidal interference is negative, a significant relationship is found (z:-3.630, p=0.000). ). When the relationship between vitamin D levels and previous suicide attempts was found to be significant (z: -2.260, p = 0.024) DISCUSSION: It has been reported that vitamin D has an important role in the treatment of many chronic diseases in recent years (9,10). The risk of suicide is different in every psychiatric disorder. Psychiatric disorder most commonly associated with increased risk of suicide is major depression (11,12,13). The identification of vitamin D receptors in brain regions affecting depression has strengthened the relationship between vitamin D and depression. In human and animal studies, vitamin D receptors and 1-α-hydroxylase enzyme are found in the brain and the role of vitamin D in central nervous system functions have been shown (14,15). According to the results of our study, vitamin D levels was detected low in cases with sucidal attempts. There is increasing evidence that there is a relationship between depressive symptoms and low serum/plasma 25 (OH) D levels. Cross-sectional studies and prospective data also support that low vitamin D levels are associated with an increased risk of depression (16,17). In a study showing that vitamin D deficiency and mood disorders were very common among the elderly, the quality of life of the elderly women with low vitamin D (<400 IU / day) was found to be lower than those with higher vitamin D. In order to improve the quality of life in the elderly, it was emphasized that the recommended daily intake of vitamin D (≥400 IU / day) is important (18). In our study, the relationship between the presence of psychiatric disease in patients with suicidal attempt is indirectly similar to other studies. Low vitamin D levels were found to be a factor in suicidal intervention. CONCLUSION: Suicidal intervention is a condition with high mortality and morbidity. According to the results of our study, considering the low level of vitamin D in patients with suicidal interventions and underlying psychiatric disorders, it was thought that D vitamin replacement can be taken into treatment protocols and suicidal interventions could be reduced.Publication Metadata only Tıp Fakültesi Son Sınıf Öğrencilerin Tıpta Uzmanlık Sınavında Tercihlerini Etkileyen Faktörler ve Acil Tıp Uzmanlığı Dalı Hakkında Tutumları(2021-03-01T00:00:00Z) Göksu, Muhammet Mert; Taşlıdere, Bahadır; TAŞLIDERE, BAHADIRAim: It is important to investigate the factors affecting the choice of the specialty area of medical students. Determining the factors that affect this selection reveals the priorities that students take into account. It is important to investigate the prejudices about not choosing emergency medicine and some surgical branches which are in a strategic position. Solution-oriented strategies should be developed in this regard. Material and Methods: This study includes 86 of the final year students of the Faculty of Medicine. The participation rate in the survey was 80.4% and all participants- approvals were received. The questionnaire developed by the researchers was used as a data collection tool in the study. The survey consisted of 40 questions. 10 of the questions were for socio-demographic information, 30 of them included the reasons for choosing the medical school, the reasons for taking the specialty examination in medicine, the desired and unwanted specialties. 27 of these were Likert type questions. Results: 46 of the participants were female (53.3%), 40 of them were male (46.5%). Among our students, it is seen that the main reason for choosing Medical Faculty is -willingness to help people- (75.6%) and -a promising profession- (69.8%). In addition, the family influence in this preference was found to be 55.8%. Our question -Would you consider Emergency Medicine Specialist as your first choice?- Was answered negatively at a rate of 72%. The most preferred reason for those who think to choose; were the advantages of working on a seizure in emergency medicine. The biggest negative thought about emergency medicine has been its physical and psychological severity, the high number of seizures, and the fear of being exposed to violence. Dermatology and cardiology were the most desired departments among the specialty branches, while gynecology and obstetrics, General surgery, and pediatry were among the undesirable departments. Conclusion: The biggest obstacle to emergency medicine choices was the exhausting seizures and the fear of exposure to violence. The future plans of the final year students of the Faculty of Medicine do not only concern themselves but also the future of the departments that are not preferred. It is necessary to determine the factors that affect the surgical branches and emergency medicine preferences of the students. In this way, studies should be carried out for factors that are perceived negatively and important strategic expertise branches for our future should be supported. Keywords: Emergency Medicine, Medical Students, Specialization ExamPublication Metadata only Bezmialem Vakıf Üniversitesi Hastanesi Acil Servisine Başvuran Adli Nitelikli Olguların ve Adli Raporların Değerlendirilmesi(2021-12-12T00:00:00Z) Kara, Kerem; Taşlıdere, Bahadır; TAŞLIDERE, BAHADIREvaluation of Forensic Cases and Forensic Reports Appealing to Bezmialem Vakıf University Emergency DepartmentIntroductionForensic cases are all events caused by intent, negligence, recklessness or carelessness that cause a person to be physically or mentally victimized (1, 2). Firearm injuries, stab injuries, traffic accidents, falls, beatings, work accidents, poisonings, burns, electric shocks, sexual assaults, all kinds of suicide attempts, torture allegations, suspicious or unexpected deaths can be considered as forensic cases. The first place where these cases are evaluated is usually the emergency departments. Therefore, physicians working in emergency departments have a great responsibility (3, 4). We retrospectively evaluated the forensic reports written in the emergency department of our hospital with this study, which we intend to do in order to write more accurate forensic reports. With this study, it is aimed to increase the awareness of newly graduated medical students and emergency physicians about forensic reports and thus to keep their knowledge about the subject up-to-date.MethodsOur study was carried out retrospectively in Bezmialem Vakıf University Faculty of Medicine Emergency Service after approval of the Ethics Committee. The study was completed by examining the forensic reports written between 01.09.2020 and 30.09.2020.ResultsThe ratio of forensic cases admitted to the total number of patients within a one-month period was approximately 2.6%. The decrease in the number of emergency services due to COVID-19 and other restrictive measures may have decreased the rate of forensic cases admitted (4, 5). In our study, 78.9% (157 people) of forensic cases were men and the mean age was 34.26 ± 11.89. The proportion of women was 21.1% and the mean age was 37.21 ± 12.54. Men are more present in traffic than women. They work in high-risk jobs and have higher rates of alcohol use and substance abuse. For this reason, men are more involved in forensic cases (6). Among the forensic case reasons, 32.2% (64 people) of traffic accidents were the first. In other studies examined, traffic accidents were in the first place as well (7). The second most common reason for men was abuse (19 people), and poisoning for women (10 people) (Table 1). The area with the most frequent injuries was the upper extremity with a rate of 56.3% (112 people), followed by lower extremity (33.2%- 66 people), head- neck (23.1%- 46 people), thorax- back (22.6%- 45 people), abdomen (10.1%- 20 people), pelvis (8.5%- 17 people) and genital area (0.5%- 1 person) (Table 2). 35.2% (70 people) of the reports were prepared due to work related accidents. 87.1% of these cases were men. While the most common cause of work related accidents in males was cuts (49%), it was blunt trauma in females (44%). Only 12.1% of the reports written in the emergency department were written as definitive reports. Temporary forensic reports were prepared for the remaining 175 cases. One of the common problems with forensic reports is that the physician gives a temporary report when he/she is able to give a definitive report (5). It was seen that 50.8% of the reports mentioned if the injury was life-threatening or not. It was stated at a rate of 60.3% whether the injury could be relieved by a simple medical intervention or not. These ratios show that information should be given about the reason for the preparation of the report and its legal dimension. In forensic reports, the answers that are generally expected from the emergency physician are whether the person is life-threatening and whether he/she will recover with simple medical intervention. The deficiencies observed in the preparation of the forensic report can be seen as a neglect of duty for the physician. Emergency physicians should know how to write a forensic report and what their responsibilities are in this regard. Forensic reports must be filled in carefully, detailed and accurately.Student: Kerem Kara 160101066Mentor: Dr.Öğr.Üyesi Bahadır TAŞLIDEREReferences1. Aktas N, Gulacti U, Lok U, Aydin İ, Borta T, Celik M. Characteristics of the Traumatic Forensic Cases Admitted To Emergency Department and Errors in the Forensic Report Writing. Bull Emerg Trauma. 2018 Jan;6(1):64-702 . Bozkurt S, Daraoğlu V, Okumuş M, Savrun A, Karanfil R, Gök AA. Acil Serviste Düzenlenen Adli Raporların Uygunluğunun Değerlendirilmesi ve Tespit Edilen Eksiklikler. Journal of Clinical and Analytical Medicine, 2015;6: 331-43. Küçük E, Günel C. Demographic characteristics of forensic ınvestigation in emergency service. Sakarya Medical Journal. 2016;6(2):100-105. 4. Kukul Güven FM, Bütün C, Yücel Beyaztaş F, Eren Ş, Korkmaz İ. Cumhuriyet üniversitesi tıp fakültesi hastanesine başvuran adli olguların değerlendirilmesi. ADÜ Tıp Fakültesi Dergisi. 2009;10(3):23-28. 5. Korkmaz T, Kahramansoy N, Erkol Z, Sarıçil F, Kılıç A. Evaluation of the forensic patients presenting to the emergency department and legal reports. Haseki Tip Bulteni. 2019;50:14-20.6. Crane CA, Godleski SA, Przybyla SM, Schlauch RC, Testa M. The Proximal Effects of Acute Alcohol Consumption on Male-to-Female Aggression: A Meta-Analytic Review of the Experimental Literature. Trauma Violence Abuse. 2016 Dec;17(5):520-531 7. Serinken M, Turkcuer İ, Acar K, Ozen M. Evaluation of medicolegal reports written by physicians in the emergency unit with regard to deficiencies and mistakes. Ulus Travma Acil Cerrahi Derg 2011;17:23-8.Publication Metadata only Evaluation of Forensic Cases and Forensic Reports Appealing to Bezmialem Vakif University Emergency Department. Citation metadata(2021-04-01T00:00:00Z) Kara, Kerem; Taşlıdere, Bahadır; TAŞLIDERE, BAHADIRIntroduction: Forensic reports requested by the judicial authorities and determining the medical condition of the person are frequently written in the emergency services of hospitals. In our study, we evaluated the forensic reports retrospectively. Thus, we aimed to increase the awareness of physicians working in the emergency department about forensic reports. Method: Our study was conducted by retrospectively evaluating the forensic reports written between 01.09.2020 and 30.09.2020. A form containing all the parameters that should be in forensic reports was used in the study. Results: A total of 199 forensic reports were examined. The rate of men was 78.9% and their mean age was 34.26[+ or -]11.89 years. The rate of women was 21.1% and their average age was 37.21[+ or -]12.54 years. Traffic accidents were in the first place among the forensic case reasons with a rate of 32.2%. Other reasons were cuts (19.6%), assaults (12.1%), blunt traumas (10.1%), falls (9.5%), poisonings (6.5%), stab injuries (4.5%), burns (2.5%), and gunshot wounds (2%). The most frequently injured body part was the upper extremity with a rate of 56.3%. Applications were made most frequently between 06:00 a.m. and 11:59 a.m. 35.2% of the reports were prepared due to work-related accidents. Only 12.1% of the reports were written as definitive reports. Conclusion: Physicians working in emergency services need to know how to write a forensic report. There were some deficiencies that we encountered when we examined the forensic reports during our study; incident time, general condition and consciousness of the patient, physical examination findings, detailed description of the lesions were not available. In addition, in some of these reports, the existence of a life-threatening condition and the presence of a condition requiring simple medical intervention were not specified. Physicians should be constantly informed about the issue of forensic reports, both before and after graduation, and their legal responsibilities should be explained.Publication Metadata only INVESTIGATION OF PERSONAL PROTECTION KNOWLEDGE LEVEL OF PERSONNEL WORKING IN RISKY UNITS OF THE HOSPITAL AGAINST CBRN HAZARD(2021-07-04T00:00:00Z) Taşlıdere, Bahadır; TAŞLIDERE, BAHADIRIn this study, it was aimed to determine the use of personal protective equipment and the level of knowledge of healthcare professionals working in hospitals, especially in risky areas, in a possible chemical, biological, radiological, or nuclear incident. In this way, it is aimed to ensure that the healthcare personnel who intervene in the CBRN incident are ready consciously and effectively. A total of 270 people, 150 women, and 120 men, participated in the study. In the study, it was observed that whether the participants were male or female, their knowledge level of protection against CBRN danger did not significantly affect. 40 of these participants (14.8%) are healthcare technicians, 161 (59.6%) are nurses and 69 (25.6%) are doctors. Considering the occupational difference, the knowledge level of the participants who are nurses against CBRN danger was found to be significantly lower than the participants who were healthcare technicians and doctors. Considering the geopolitical position of our country, it is essential to know CBRN issues well and to intervene appropriately. Health personnel who will perform such an important intervention must first ensure their safety. In the study, it was found that the knowledge levels of the participants who knew the expansion of the CBRN expression were significantly higher than the participants who did not know the expression of CBRN against the risk of CBRN. The spectrum of CBRN threats is wide. There may be deaths, injuries, psychosocial impacts, damage to economic assets, environmental damage, and submissive and threatening approaches to political issues. To be protected against various threats such as chemical threats, bacteria that cause disease, viruses that cause pandemics, radiological threats, nuclear weapons, radiation spreading around, it is necessary to obtain detailed information about the subject first. In the study, it was determined that the protection knowledge level of the participants who received CBRN training against CBRN danger was significantly higher than the participants who did not receive CBRN training. First things to do in a CBRN event; to protect oneself and the injured from the harmful effects of CBRN agents, to be able to perform appropriate triage, to apply first aid and decontamination methods, to identify and diagnose the agent used, to carry out advanced diagnosis and treatment procedures. Comprehensive knowledge of CBRN agents is required to be prepared against CBRN agents at all times and to be able to manage the situation correctly when the event occurs.