Publications by authors named "Abdullah Osman Koçak"

17 Publications

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Lidocaine versus dexketoprofen in treatment of tension-type headache: A double-blind randomized controlled trial.

Am J Emerg Med 2021 Mar 7;41:125-129. Epub 2021 Jan 7.

Department of Emergency Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

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http://dx.doi.org/10.1016/j.ajem.2020.12.057DOI Listing
March 2021

Evaluation of the relationship of serum vitamin D levels in COVID-19 patients with clinical course and prognosis.

Tuberk Toraks 2020 Sep;68(3):227-235

Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey.

Introduction: SARS-CoV-2 (COVID-19), which emerged in Wuhan, China in December 2019, infected more than six million people in a short time. In COVID-19, the relationship of many laboratory parameters to morbidity and mortality has been defined. In our study, we aimed to determine the relationship of serum vitamin D level to clinical course and prognosis.

Materials And Methods: This study included 108 patients; 88 patients who stayed in Ataturk University and Erzurum City Hospital between March 24, 2020 and May 15, 2020, who were identified as COVID-19 by real-time PCR method from the nasopharyngeal swab and 20 asymptomatic voluntary medical personnel who tested negative for real-time PCR after routine check-up in our hospital.

Result: In statistical analysis conducted between healthy control group and vitamin D levels of patients admitted due to COVID-19, it was observed that patients infected with COVID-19 had a lower level (p= 0.004). In 20 patients developing MAS, a lower level of vitamin D was observed (p= 0.004) compared to 68 patients who did not develop. In the comparison of vitamin D levels of the patients (n= 8) who developed exitus in their follow up due to COVID-19, it was observed that vitamin D levels were statistically significantly lower compared to the living (p= 0.009).

Conclusions: Due to COVID-19, pandemic, long-running quarantines caused insufficient use of sunlight and worsening of vitamin D deficiency. We wanted to draw attention again with our study to vitamin D which can be responsible for the heavy clinical course of COVID-19 and whose replacement is easy to apply.
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http://dx.doi.org/10.5578/tt.70027DOI Listing
September 2020

Comparison of ibuprofen and piroxicam gel in the treatment of trauma pain: A randomized double-blind trial of geriatric population.

Am J Emerg Med 2020 10 17;38(10):2110-2115. Epub 2020 Aug 17.

Department of Emergency Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Objective: This study aimed to compare the analgesic efficacy of topical ibuprofen and topical piroxicam for acute musculoskeletal injuries.

Methods: In this prospective, randomized, controlled, double-blinded study, geriatric patients were assigned to groups to receive either topical ibuprofen (n = 70) or topical piroxicam (n = 69). The first dose of gel was applied in the emergency department and the remaining doses were self-administered at home by the patients thrice daily for 72 h. For each patient, the initial baseline visual analog scale (VAS) score (V 0) was compared with the VAS scores at the 60 min (V1), 120 min (V2), 24 h (V3) and 72 h (V4) time points. The decreases in VAS scores, clinical effectiveness of the treatments, and incidence of adverse events were evaluated.

Results: In the topical ibuprofen group, the VAS scores were significantly lower at each measurement time point compared to baseline (p < .001). The results were as follows: V0 -V: 1.08, 95% CI: 0.56-1.61; V0 -V2: 1.09, 95% CI: 0.49-1.69; V0 -V3: 1.44, 95% CI: 0.81-2.07; V0 -V4: 1.59, 95% CI: 0.91-2.26. The mean percentage decrease in the VAS scores in the topical ibuprofen group was significantly higher than that in the topical piroxicam group (p < .001). The clinical effect of treatment was found to be significantly higher for the ibuprofen gel group (p < .001). There was no substantial difference in treatment-related adverse events between the groups (p > .05).

Conclusion: Ibuprofen gel, which is a safe treatment option for geriatric patients, is more clinically effective than piroxicam gel. Response to Reviewers.
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http://dx.doi.org/10.1016/j.ajem.2020.08.041DOI Listing
October 2020

Are Serum Interleukin 6 and Surfactant Protein D Levels Associated with the Clinical Course of COVID-19?

Lung 2020 10 12;198(5):777-784. Epub 2020 Sep 12.

Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Yakutiye, Turkey.

Purpose: SARS-CoV-2 (COVID-19) has infected more than 7 million people worldwide in the short time since it emerged in Wuhan, China in December 2019. The aim of this study was to investigate the relationship between serum interleukin 6 (IL-6) and surfactant protein D (SP-D) levels and the clinical course and prognosis of COVID-19.

Materials And Methods: The study included a total of 108 individuals: 88 patients who were diagnosed with COVID-19 by real-time PCR of nasopharyngeal swab samples and admitted to the Atatürk University Pulmonary Diseases and the Erzurum City Hospital Infectious Diseases department between March 24 and April 15, and 20 asymptomatic healthcare workers who had negative real-time PCR results during routine COVID-19 screening in our hospital.

Results: Patients who developed macrophage activation syndrome had significantly higher IL-6 and SP-D levels at the time of admission and on day 5 of treatment compared to the other patients (IL-6: p = 0.001 for both; SP-D: p = 0.02, p = 0.04). Patients who developed acute respiratory distress syndrome had significantly higher IL-6 and SP-D levels at both time points compared to those who did not (p = 0.001 for all). Both parameters at the time of admission were also significantly higher among nonsurvivors compared to survivors (IL-6: p = 0.001, SP-D: p = 0.03).

Conclusion: In addition to IL-6, which has an important role in predicting course and planning treatment in COVID-19, SP-D may be a novel pneumoprotein that can be used in the clinical course, follow-up, and possibly in future treatments.
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http://dx.doi.org/10.1007/s00408-020-00393-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486805PMC
October 2020

Comparison of topical capsaicin and topical piroxicam in the treatment of acute trauma-induced pain: A randomized double-blind trial.

Am J Emerg Med 2020 09 2;38(9):1767-1771. Epub 2020 Jun 2.

Department of Emergency Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Background: This study aimed to compare the analgesic efficacy of topical capsaicin and topical piroxicam in acute musculoskeletal injuries.

Methods: This is a prospective, randomized, controlled, double-blinded study. The data for the 67 patients in the piroxicam group and the 69 in the capsaicin group were examined. The initial visual analog scale (VAS) scores were compared with the 60th and 120th minute as well as the 24th and 72nd hour values. Differences between the VAS scores, clinical effectiveness of the treatment and side effects were evaluated.

Results: In the capsaicin group, the mean difference in the delta VAS scores was significantly higher at each measurement time. The mean of the percentage of reduction in the VAS scores of the topical capsaicin group was significantly higher than that in the topical piroxicam group. The highest difference in terms of both outcomes was determined at the 72nd hour VAS change. Mean differences were 1.53 (95% CI: 0.85-2.221) and 19.7 (95% CI: 12.4-27.2) respectively (p < 0.001). In the capsaicin group, the clinical effect of the treatment was found significantly higher (p < 0.01). The difference between the clinical effectiveness of the groups regarding the treatment outcomes was also statistically significant (p < 0.001). There was no significant difference between the patient groups regarding the presence of side effects.

Conclusion: Topical capsaicin can be used as an alternative to topical piroxicam initially and at follow-up in patients presenting to the emergency department with acute pain as there were no observable differences in side-effects between the two groups.
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http://dx.doi.org/10.1016/j.ajem.2020.05.104DOI Listing
September 2020

Intradermal injection for hiccup therapy in the Emergency Department.

Am J Emerg Med 2020 09 25;38(9):1935-1937. Epub 2020 Mar 25.

Department of Emergency Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Hiccup is a condition caused by involuntary contraction of inspiratory muscles, especially the diaphragm. Although it is generally considered as a physiological. response, if hiccup persists for a long time, it can lead to many undesirable conditions such as depression, weight loss, insomnia, and fatigue. A 35-year-old male patient was admitted to our emergency department with hiccup lasting for 15 h. He had a history of several hiccup attacks. Classical non-pharmacological and pharmacological therapies were used to treat the condition without any response. As an alternative method, an intradermal injection was applied. A mixture of thiocolchicoside and lidocaine was administered intradermally to a depth of 1-3 mm at the epigastric region and adjacent to the sternocleidomastoid muscle. The patient's hiccup ended after the intradermal injection procedure. During 48 h of follow-up the hiccup attack did not develop again. No complications related to the process were detected. This is the first case in the literature demonstrating the use of intradermal injection to terminate hiccups. The intradermal injection approach can be administered in cases of hiccups that do not respond to medical treatment.
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http://dx.doi.org/10.1016/j.ajem.2020.03.044DOI Listing
September 2020

Comparison of effectiveness coolant spray and placebo in patients with acute ankle trauma prospective randomized controlled trial.

Am J Emerg Med 2020 07 7;38(7):1458-1462. Epub 2020 Jan 7.

Department of Emergency Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Introduction: Coolant spray application in musculoskeletal injuries is an effective and harmless method to treat pain and reduce functional limitation. This study assessed the clinical value of coolant spray application on patient comfort before and during the radiographic imaging process along with its early analgesic and anti-edema effects.

Methods: A total of 155 patients, admitted to the emergency department between April 1, 2019, and June 31, 2019, were included in this study. The patients were randomly assigned to either a coolant spray or a saline spray (placebo) group. To the coolant spray group patients, Cryos ®Spray (Phyto Performance, Italy) was applied. To the placebo group patients, a normal saline solution in a bottle covered with white opaque paper and refrigerated at 4 °C was sprayed. Radiographic images of the patients were scored for appropriateness of the standard imaging characteristics.

Results: The mean scores were 8.13 ± 1.8 and 6.58 ± 2.2 for the coolant spray and normal saline spray groups, respectively; the differences were statistically significant between the two groups (mean difference: -1.56, 95% CI:-2.20 to -0.92; p = .000). Patients with fractures on their radiographs and treated with coolant spray received higher scores than similar patients treated with normal saline spray (mean difference:-1.92, 95% CI:-3.28 to -0.55; p = .009). The proportion of patients requesting analgesic treatment before discharge was statistically lower in the coolant spray group compared to the normal saline group (p = .025).

Conclusions: The radiographic images taken after coolant spray intervention in patients with acute ankle trauma were more successful in showing the target structures.
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http://dx.doi.org/10.1016/j.ajem.2019.12.054DOI Listing
July 2020

Comparison of intradermal mesotherapy with systemic therapy in the treatment of low back pain: A prospective randomized study.

Am J Emerg Med 2020 07 9;38(7):1431-1435. Epub 2019 Dec 9.

Department of Emergency Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Introduction: Musculoskeletal pain such as low back pain (LBP) are routinely encountered in the ED and contribute to ED overcrowding. The aim of our study was to compare the efficiency of mesotherapy with systemic therapy in pain control in patients with lumbar disk herniation.

Methods: We conducted this prospective parallel randomized controlled trial with the patients admitted to the emergency department with low back pain related to herniated lumbar disk. Mesotherapy was performed to one group, while intravenous dexketoprofen was administered to the control group. Changes in pain intensity at 15th minute, 30th minute, 60th minute and 24th hours after treatment using Visual Analogue Scale (VAS), need to use analgesic drug within 24 h after treatment, and adverse effect of the treatment methods were compared between groups.

Results: The decreases in pain intensity were statistically significantly higher in mesotherapy group for all time intervals. The need to use analgesics was statistically significantly three fold higher in the systemic therapy group. There was no statistically significant difference in having any adverse effect between study groups during one-week follow-up period.

Conclusions: Changes in medical practices, from the systemic administration of NSAIDs to the minimally invasive techniques such as mesotherapy with potent efficacy and minimal side effects, may enhance the ability of EDs to meet the waiting time targets and improve patient's satisfaction.
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http://dx.doi.org/10.1016/j.ajem.2019.11.044DOI Listing
July 2020

Comparison of two scores of short term serious outcome in COPD patients.

Am J Emerg Med 2020 06 27;38(6):1086-1091. Epub 2019 Jul 27.

Department of Emergency Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Introduction: Chronic Obstructive Pulmonary Disease (COPD) related visits to the emergency department have increased substantially during the past decade. An important challenge facing emergency physicians when treating COPD patients is deciding on disposition. The aim of this study was to evaluate Integrated Pulmonary Index scoring to guide the disposition decisions of emergency physicians by comparing its compatibility with Ottawa COPD Risk Score.

Methods: This is a prospective methodological study, in which we compared the accuracies of the Integrated Pulmonary Index and Ottawa COPD Risk Score in predicting of the short-term serious outcomes in patients admitted to the emergency department with COPD exacerbation. Patients who admitted to our emergency department between 01.01.2019-31.03.2019 were evaluated.

The Results: Among the 208 patients, there were 154 (74.0%) short-term serious outcomes. The AUCs were 0.915 and 0.943 for Integrated Pulmonary Index and Ottawa COPD Risk Score, respectively. The difference between AUCs for two scores was not statistically significant. The best cut-off point for Integrated Pulmonary Index and Ottawa COPD Risk Score were ≤3 and >4, respectively. For these best cut-off points, the sensitivity and specificity of Integrated Pulmonary Index were 92.9 and 87.1, respectively. The sensitivity and specificity of Ottawa COPD Risk Score were 99.3 and 85.2, respectively. Besides, the accuracy of Integrated Pulmonary Index was 91.3, and the accuracy of Ottawa COPD Risk Score was 95.7.

Conclusions: Integrated Pulmonary Index was a potential candidate for evaluating respiratory status and prediction of short-term severe events in patients with acute COPD exacerbation in emergency departments.
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http://dx.doi.org/10.1016/j.ajem.2019.158376DOI Listing
June 2020

Assessment of the Accuracy of Cardiopulmonary Resuscitation Videos in English on YouTube according to the 2015 AHA Resuscitation Guidelines.

Emerg Med Int 2019 2;2019:1272897. Epub 2019 May 2.

Department of Biostatistics, Ataturk University Faculty of Medicine, Erzurum, Turkey.

Over the last decade, YouTube has become one of the largest online resources for medical information. However, uploaded videos are published without any peer review or quality control, so incorrect and incomplete information can be easily disseminated via the virtual platform and can be perceived as correct. The YouTube website was searched for videos in English uploaded between 15 October 2015 and 21 October 2016 using the following keywords: "CPR," "cardiopulmonary resuscitation," and "basic life support." This study had a cross-sectional analytical design. In the first evaluation, the accuracy of the videos was checked according to the information contained in the basic cardiac life support algorithm. In the second evaluation, we assessed whether advanced-level, innovative medical information was included in these videos; when included, the accuracy of such information was checked. Of 774 videos evaluated, 92 videos were included in the study after application of the exclusion criteria. The videos were scored on a scale ranging from 0 to 20 points. The mean total score, based on all criteria, was 4.79 ± 2.88. The highest mean total score was achieved by videos uploaded by official medical organizations (6.43 ± 3.57), followed by those uploaded by health professionals and organizations (4.25 ± 2.49), and those uploaded by unidentified sources. YouTube videos are insufficient in providing information about the basic life support algorithm and advanced-level information according to the 2015 AHA resuscitation guidelines for health professionals. The educational material published by health institutions that are constantly working in the area is a more reliable source of information on subjects that directly affect human life, such as cardiopulmonary resuscitation.
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http://dx.doi.org/10.1155/2019/1272897DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521518PMC
May 2019

Intradermal mesotherapy versus systemic therapy in the treatment of musculoskeletal pain: A prospective randomized study.

Am J Emerg Med 2019 11 28;37(11):2061-2065. Epub 2019 Feb 28.

Department of Emergency Medicine, Faculty of Medicine, Ataturk University, 25240 Erzurum, Turkey. Electronic address:

Introduction: Acute musculoskeletal injuries are one of the most common painful presentation when admission to the emergency department. The aim of the study is to compare the tenoxicam mesotherapy with intravenous dexketoprofen in pain control in patients with acute musculoskeletal injury.

Methods: This parallel randomized controlled trial was conducted with the patients admitted to the emergency department with musculoskeletal injury. Intravenous dexketoprofen was administered to the control group, and mesotherapy treatment was performed to the other group. Differences between 10th, 30th, 60th and 120th minutes VAS scores and on the admission VAS score, clinically meaningful change in pain intensity, and adverse effect of the procedures were compared among groups.

The Results: The differences in VAS scores and the presence of clinically meaningful change in pain intensity were statistically significantly higher in mesotherapy group than the systemic therapy group in all time periods. During one-week follow-up period, there was no reported adverse effect neither in mesotherapy group nor in the systemic therapy group.

Conclusions: The mesotherapy treatment may be superior than the systemic therapy for pain relief in musculoskeletal injury in short term follow-up in emergency department settings.
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http://dx.doi.org/10.1016/j.ajem.2019.02.042DOI Listing
November 2019

Comparison of intravenous NSAIDs and trigger point injection for low back pain in ED: A prospective randomized study.

Am J Emerg Med 2019 10 15;37(10):1927-1931. Epub 2019 Jan 15.

Bingol State Hospital, Department of Emergency Medicine, Bıngol, Turkey.

Introduction: Low back pain (LBP) is a common complaint originating from muscles Myofascial pain syndrome (MPS) is mainly associated with trigger points (TrP) in the muscle tissue. We compared the intravenously administered non-steroidal anti-inflammatory drug (NSAID) and trigger point injection (TPI) in the treatment of LBP patients admitted to the emergency department due to pain caused by TrPs.

Material And Method: After randomization, NSAID was administered intravenously in group 1 and TPIs were performed as specified by Travell and Simons in group 2. The TrPs were identified with the anamnesis and physical examination Demographic characteristics and vital signs of the patients were recorded. Pain scores were measured with the Visual Analogue Scale (VAS) at admission; and in minutes 5, 10, 15, 30, and 60.

Results: There were 32 patients in group 1 and 22 patients in group 2. The demographics, vital signs, and pain scores at admission were not statistically significantly different between the groups. The pain scores decreased significantly in the TPI group. During the 60 min' follow-up period, the mean VAS pain score decreased by 0.41 ± 1.30 in the TPI group and by 2.59 ± 2.37 in the NSAID group (p < 0.001). Respond the treatment was significantly higher group TPI than Group NSAID (21/22 vs 20/32 respectively, p = 0.008).

Conclusion: In this small randomized study with several methodological limitations, TPI was superior to the intravenous NSAIDs in the treatment of acute LBP due to TrPs. TPI can be used in the emergency departments for the acute treatment of LBP in selected patients.
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http://dx.doi.org/10.1016/j.ajem.2019.01.015DOI Listing
October 2019

Erector spinae plane block for bilateral lumbar transverse process fracture in emergency department: A new indication.

Am J Emerg Med 2018 10 30;36(10):1927.e3-1927.e4. Epub 2018 Jun 30.

Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.

Plane blocks have become very popular in recent years with the introduction of ultrasonography into the regional anesthesia and algology practice. Ultrasound guided erector spinae plane (ESP) block was first described in 2016. ESP block involves injection of local anesthetics between erector spinae muscles and transverse process of thoracic or lumbar vertebrae and can block the dorsal and ventral rami of thoracolumbar spinal nerves. ESP block has been successfully reported to relieve the pain of multiple rib fracture in the emergency department (ED). Here we first report a novel indication for ESP block in ED; transverse process fracture of lumbar vertebra.
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http://dx.doi.org/10.1016/j.ajem.2018.06.072DOI Listing
October 2018

Ischemic stroke due to carbon monoxide intoxication: Two case reports.

World J Emerg Med 2018 ;9(1):73-75

Department of Emergency Medicine, Faculty of Medicine, University of Ataturk, Erzurum, Turkey.

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http://dx.doi.org/10.5847/wjem.j.1920-8642.2018.01.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5717382PMC
January 2018

Dual-energy CT shows brain ischemia and hyperbaric oxygen therapy efficacy in acute CO intoxication.

Am J Emerg Med 2016 Jul 17;34(7):1327.e3-4. Epub 2015 Dec 17.

Department of Emergency Medicine, Faculty of Medicine, University of Ataturk, Erzurum, Turkey.

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http://dx.doi.org/10.1016/j.ajem.2015.12.031DOI Listing
July 2016

Spontaneous reduction of ileoileal adult intussusception after blunt abdominal injury.

Am J Emerg Med 2015 Oct 29;33(10):1542.e3-5. Epub 2015 Jul 29.

Department of General Surgery, Faculty of Medicine, University of Ataturk, Erzurum, Turkey. Electronic address:

This is the first case report of an adult who had spontaneous reduction of ileoileal intussusception occurred after punching to the abdomen. A 40-year-old man was brought to our emergency department by ground ambulance due to pounding and punching a few hours ago. Physical examination showed multiple dermabrasions on his face, abdomen, and lower extremities. All other examinations were unremarkable except that of mild abdominal pain. Laboratory results gave no clues. On abdominal x-ray, paucity of intestinal gas, pseudomass and surrounding gas appearances were visible. No nausea or vomiting occurred during observation. His abdominal pain resolved gradually. On the 24th hour after admission, control computed tomography showed that the findings of intussusception disappeared. He was discharged after 1 day of observation. Outpatient follow-up did not show any abnormality. We suggest that, in patients with mild to moderate trauma, even if the patient has mild abdominal pain, physicians should rule out invagination. Computed tomography is the suggested imaging modality. These patients should be kept in close follow-up. If symptoms resolve and intussusception findings disappear in computed tomography, no further treatment is required.
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http://dx.doi.org/10.1016/j.ajem.2015.07.053DOI Listing
October 2015

Reversible left bundle-branch block due to carbon monoxide poisoning: a case report.

Am J Emerg Med 2016 Feb 19;34(2):342.e1-3. Epub 2015 Jun 19.

Emergency Department of Medical Faculty, Ataturk University, Erzurum Turkey.

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http://dx.doi.org/10.1016/j.ajem.2015.06.034DOI Listing
February 2016