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OBJECTIVES: There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes. MATERIALS AND METHODS: The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes. RESULTS: One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge. CONCLUSION: Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields.

Background: The success of battle against COVID 19 depends on public adherence towards infection control measures, which is greatly affected by their knowledge, attitude, and practices towards the COVID 19 pandemic. Objectives: Among the residents in the rural field practice area of a teaching hospital in Mangaluru:- 1) To assess knowledge, attitude, practice regarding preventive measures of COVID 19. 2) To assess stigma and risk perception of COVID 19. Methodology: A community based cross sectional study, by house-to-house visit was conducted among 323 participants residing in the rural field practice area of A.J. Institute of Medical Sciences & Research Centre, Mangaluru. Multistage sampling was adopted. Details regarding socio-demographic characteristics; knowledge, attitude, practice regarding preventive measures of COVID 19; risk perception and stigmatizing behavior was collected. Analysis was done using SPSS trial version 28. Results: 61% of participants were male; 27% had primary education and 33.1% were unemployed. Mass media was the most common source of COVID 19 related information. The knowledge of preventive measures of COVID 19 was good in 97.5% of the participants. 98.1% had positive attitude towards the preventive measures of COVID 19. The practice of preventive measures of COVID 19 good in 63.5%. 87.6% had taken two dose of COVID 19 vaccine. Low risk perception was seen in 96% and 83.6% had low stigmatizing behavior towards COVID 19. Gender was significant predictor of attitude scores. Age, gender, educational status, occupation status, type of family was the significant predictor of practices scores. Conclusion: Majority of the participants had good knowledge, positive attitude and good practice of preventive measures of COVID 19. As a result of effective IEC effort by different authorities is reaching rural part of India, people are aware of the preventive measures, has positive attitude about it and are practicing them.

In this article, we discuss the successful treatment of acute respiratory distress syndrome (ARDS), a rare complication of opioid overdose, through high-flow nasal cannula oxygen therapy (HFNCOT). A 32-year-old male patient was referred to the emergency department with an ambulance due to a state of confusion following intravenous opioid intake. On arrival, the patient had an arterial blood pressure of 100/60 mmHg, pulse of 112 beats/min, respiratory rate of 8 breaths/min, and oxygen saturation (SpO2) of 75%. On neurologic examination, he had miotic and isochoric pupils, and Glasgow Coma Score was 12 (E: 3 M: 5 V: 4). Cardiac examination showed that the heart was rhythmic and tachycardic. Chest examination revealed bibasilar crackles and wheezing. Naloxone was administered to the patient, and oxygen treatment was applied through a mask. Then, HFNCOT was commenced to the patient in whom the PaO2/FiO2 ratio in the blood gas was calculated as 141 following antidote treatment and whose chest radiograph showed bilateral infiltrations. The patient was discharged from the emergency critical care unit on the 3rd day of his hospitalization because infiltrations in his chest radiograph regressed. HFNCOT can recover the patient's hypoxemia and help reduce the necessity of mechanical ventilation in patients with mild or moderate ARDS.

Background: Obsessive-compulsive disorder (OCD) is a neuropsychiatric illness, develops in childhood, and can result in considerable impairment to an individual's lifespan. The persons suffer from OCD do not seek treatment in medical settings and remain undiagnosed or misdiagnosed, and consequently, the person faces persistent untreated symptoms over time leading to considerable disturbance in familial, academic, or social functioning. Therefore, careful assessment of OCD symptoms is seminal to clinical practice. OCD among clients attending the outpatient clinic of Azadi Teaching Hospital in Iraq was assessed in the current study. Methods: This cross-sectional study that consisted of 465 consecutive clients who visited an outpatient psychiatric clinic of Azadi Teaching Hospital in Iraq was designed, and face-to-face interview was performed using a translated Arabic version of Padua Inventory-Washington State University Revision in order to assess the OCD symptoms. Results: The study confirmed previously unrecognized symptoms of obsessions and compulsions in those who visited the psychiatric outpatients' clinic. In addition, it was shown that among total obsessions and compulsions, obsessions included contamination, thoughts of harm to self/others, impulses to harm self/others and compulsions included checking and dressing/grooming and washing which were more prevalent in males, those completed primary school education, completed higher education, and divorced/married clients. The study did not show any significant difference among different age group and employment aspects. Conclusion: The study confirmed that some individuals are unaware of their obsessions and compulsions and clinical screening would give us a golden opportunity to their issue recognition and immediate treatment commencement.

Objective: It was aimed to investigate whether neglected and abused pediatric patients are properly recognized and reported by emergency physicians in the emergency department (ED). Methods: This prospective study was conducted on patients between 0 and 6 years of age presenting with trauma to ED. Patients were examined again by an emergency medicine specialist independent from the physician who did the first intervention during clinical follow-up phase after notification of patients presenting with trauma to emergency physician. Asked radiological examinations and clinical follow-up were performed. The suspected abuse evaluation form, consisting 12 items, which was formed by considering the forms used in previous studies was used to examine the awareness of physicians in cases of abuse suspicion. Results: A total of 126 patients were included in our study. 54% of cases (n = 68) were male and mean age was determined to be 31.3 ± 18.9 months. It was found that no judicial records were written to 35.7% (n = 45) of our patients and that 11.1% (n = 5) of these patients were hospitalized. In 51.1% (n = 23) of patients without judicial records, multiple suspected abuse findings were identified. According to evaluation of first physician, it was found that 75.9% (n = 41) of discharged patients had no judicial records and was not considered as neglect and abuse. Conclusion: We conclude that detection rates of abuse can be increased by developing child abuse screening forms and ensuring the continuity of the necessary training programs. Keywords: Neglect, Abuse, Pediatric

Distant metastasis to the ureters is uncommon. Moreover, isolated ureteric metastasis from gastric cancer is extremely rare and only sporadically reported. It indicates an advanced stage and carrier a very poor prognosis. We describe a case of synchronous bilateral ureteric metastasis from stomach adenocarcinoma after gastrectomy and chemoradiation. To our knowledge, it is the first case published in the literature with such presentation.