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Aim: Acute pancreatitis (AP) is a disease with inflammation, and patients present with severe acute upper abdominal pain in emergency departments. AP can result in higher mortality as its clinical severity increases. Therefore, in this study, we want to investigate the clinical utility of the systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII) in showing the severity of AP. Material and methods: Among the patients admitted to our emergency department between January 2020 and December 2022, 201 patients diagnosed with AP were included in the study. These patients were divided into two groups according to the severity of the disease as mild and severe AP (MAP and SAP). Demographic data and laboratory data of the patients (white blood cell count, such as SIRI, SII and C-reactive protein, SIRI, SII and C-reactive protein) were recorded. Differences between groups of AP patients divided according to disease severity were analyzed. Results: 165 (82.1%) patients had MAP and 36 (17.9%) patients had SAP. 52.8% of the patients were male. The mean of the SAP group was significantly higher than the SII MAP group (3165.71±3058.42 vs.1043.31±849.15; p Conclusion: High SII and SIRI are useful markers that can show the severity of AP. Key words: acute pancreatitis severity, SII, SIRI, biomarker

Aim: The use of the right to die in the center of the individual's own decision is called euthanasia. This decision, was evaluated from legal, religious, and medical perspectives. In different countries applied euthanasia, which can be performed actively or passively. In our study, we planned to investigate the perspectives of healthcare professionals working in the emergency department about euthanasia and their thoughts on diseases that can be applied to euthanasia. Material and methods: A survey was conducted from June to October 2022 on non-physician health workers working in the Emergency department. A questionnaire including demographic data, professional knowledge, and Attitude Scale towards Euthanasia, Death, and the Terminally Patient was administered to the healthcare professionals who agreed to participate in the study. The obtained data were analyzed. Results: In the study, the feedback of 60 participants, 37 of whom were women, was evaluated. The mean age of the entrants was found to be 39.07±10.11 years. 60% of the participants had received cardiopulmonary resuscitation training in the past year. 70% of the participants stated that they could be euthanized for coma, 38.33% for severe disability, and 36.67% for severe and incurable neurological diseases. Conclusion: In the process of euthanasia, which does not have a legal infrastructure in our country, different perspectives are seen from different departments of health services. Key words: emergency department, euthanasia, non-health workers

To report a probable interaction between meropenem and antiepileptic drugs that resulted in poor control of epileptic seizures. A previously healthy 21 years old woman admitted to emergency department with fever and stiff neck. Her Glasgow Coma Scale score was E3M5V4. Physical examination revealed conscious to tend to fall asleep, closed eyes and normal-sized and reactive pupils. Meropenem and vancomycin were initiated for the suspicion of menengitis. On the 3rd day of the antibiotic therapy generalized tonic clonic seizures were observed. Phenytoin and intravenous (IV) thiopental were initiated. The patient was intubated and mechanically ventilated. EEG revealed generalized epileptiform activity. In the following days, seizure activity continued. Levetirasetam, carbamazepine and VPA were added for treatment respectively, but seizures were continued. On the 20th day of meropenem therapy, interaction of carbapenems and anti-epileptic agents was suspected. Antibiotherapy was discontinued. Serum concentrations of VPA increased over the next days and achieved therapeutic levels. On day 21 she was extubated, no seizures occurred over the following 48 hours. She was discharged from the ICU, with blood anti epileptic concentrations within the therapeutic range. Carbapenems have a potential effect of inducing seizures and may also lower serum levels of antiepileptic drugs. Clinicians should be aware of this potential interaction that may be associated with serious adverse effects. Status epilepticus is one of the most important neurologic emergencies, and therapeutic control becomes more difficult as its duration becomes longer. Patients receiving antiepileptics and carbapenem group antibiotics concominantly should be closely monitored due to possible drug interaction between these agents.