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    Evaluation of brain oxygenation by near infrared spectroscopy in healthcare professionals using surgical and ffp2/n95 masks
    (2022) Bozan, Öner; Atıs, Seref Emre; Çekmen, Bora; Karakısa, Halit; Karaaslan, Edip Burak; Ferhatlar, Mehmet Esat; İslam, Mehmet Muzaffer
    Aim: The present study aimed to detect changes in brain oxygenation associated with the use of surgical and FFP2/N95 masks using the near infrared spectroscopy (NIRS) method. Material and Methods: Volunteers wearing surgical masks were asked to sit upright for 30 minutes. Cerebral oxygen saturation values were measured at the 1st, 5th, and 30th minutes (group 1). The mask wearers were requested to return at the same time on the day following this procedure. In group 2, serial cerebral oxygen saturation values (SpO2) were obtained at the same time intervals as in group 1, but while the subjects were wearing FFP2/N95 masks. Results: A statistically significant difference was found between the groups in the comparison of the values measured using NIRS at the 1st, 5th, and 30th minutes in group 1. According to the post-hoc analysis, this difference was due to discrepancies in NIRS measurements at the 1st minute and 30th minute and at the 5th minute and 30th minute. No statistically significant difference was found between the groups in the comparison of the values measured using NIRS at the 1st, 5th, and 30th minutes in group 2. Conclusion: Neither surgical nor FFP2/N95 masks caused a clinically significant negative difference in brain oxygenation.
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    Evaluation of routine coagulation testing requirements in patients with severe epistaxis
    (2021) Çekmen, Bora; Bozan, Öner; Atıs, Seref Emre; Ünver, Sevilay Sema; Kokulu, Kamil; Kalkan, Asim
    Aim: There are studies about coagulation parameters are not required in the management of epistaxis. The aim of the present study was to investigate whether or not coagulation tests are required and its relationship with medications in severe epistaxis cases that require intervention. Material and Method: The patients above 16 years who had presented to emergency department due to epistaxis, who had undergone anterior/posterior nasal packing or electro-cautery to the nasal mucosa were included the study. The demographic characteristics, blood count, coagulation test, anti-platelet and anti-coagulant medications, the procedures carried out for stopping bleeding, whether reversal treatment or blood transfusion was needed were recorded. Results: A total of 469 patients, it was found that coagulation parameters had been tested in 141(30.2%). While PT, aPTT and INR values of the anti-coagulant using patients were significantly higher(p<0.001, p=0.003, p<0.001, respectively), the platelet and hemoglobin values were not found to be associated with anti-platelet drug and anti-coagulant use(p=0.304, p=0.098, respectively). The patients were allocated to two groups as those any parameter of whom was impaired or not. While a significant difference was found between the groups with regard to hemoglobin values(p=0.006), no patients were determined to need reversal treatment or hemoglobin replacement.Conclusion: Routine coagulation testing is not required for patients who have epistaxis that cannot be stopped with conservative methods and who are using anti-platelet drugs as it does not lead to a difference in treatment. Coagulation tests may not be performed in patients who use anti-coagulants based on the results.
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    Relationship of the crp/albumin ratio and the systemic immune-inflammation index with forrest classification in patients with gastrointestinal bleeding
    (2022) Bozan, Öner; Atis, Seref Emre
    Aim: The present study aimed to investigate CRP/albumin ratio and the systemic immune-inflammation index (SII) and Forrest classification in patients who presented to the emergency department with acute upper gastrointestinal (GI) bleeding. Materials and Method: Patients over 18 years of age who presented to the emergency department of our hospital with melena, hematemesis, and hematochezia and were diagnosed with upper GI bleeding via esophagoduodenoscopy were included in the study. Esophagoduodenoscopy results, and accordingly, the Forrest classifications, together with complete blood count, including hemoglobin, platelet, and neutrophil values, as well as demographic characteristics were recorded. SII (calculated by multiplying the platelet count with neutrophil count and dividing the value obtained by the lymphocyte count [platelet (P)×neutrophil (N)/lymphocyte (L)]) and CRP/albumin ratio was calculated. Results: No statistically significant difference was observed among the Forrest classification groups in terms of the median SII values as well as median CRP/albumin ratios. However, a statistically significant difference in median CRP/albumin ratios was observed among the dichotomized Forrest classification groups. Conclusion: The SII is not a reliable parameter either predicts GI bleeding or the Forrest classification in patients with upper GI bleeding. The CRP/albumin ratio might be a poor predictor of bleeding; however, it can not predict the Forrest classification.