Browsing by Author "Akelma, Hakan"

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Citation - WoS: 2
Citation - Scopus: 2
Association of Inflammatory and Metabolic Markers With Mortality in Patients With Postoperative Femur Fractures in the Intensive Care Unit
(Mdpi, 2025) Kilinc, Metin; Celik, Enes; Demir, Ibrahim; Aydemir, Semih; Akelma, Hakan; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background and Objectives: Postoperative femur fracture in elderly patients is associated with high morbidity and mortality, especially in the intensive care unit (ICU). Various factors, including demographic and laboratory parameters, may influence mortality in this population. The aim of this study was to evaluate the association of inflammatory and metabolic markers with mortality in ICU patients with postoperative femur fractures and to identify key predictors to enhance risk stratification and improve patient outcomes. Materials and Methods: In this retrospective single-center study, we analyzed 121 patients aged over 65 years with postoperative femur fractures who were admitted to the ICU between January 2023 and January 2024. Demographic and clinical data, including comorbidities, Charlson Comorbidity Index (CCI), and Acute Physiology and Chronic Health Evaluation (APACHE II) score, were collected. Laboratory parameters such as white blood cell count (WBC), albumin, C-reactive protein (CRP), D-dimer, Pan-Immune-Inflammation Value (PIV), CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and others were analyzed. Linear regression, logistic regression, and Receiver Operating Characteristic (ROC) analyses were performed to determine the predictive value of these markers for ICU mortality. Results: The mean age of the patients was 76.3 +/- 9.6 years, and 52.1% were female. The most common comorbidities were hypertension (67.8%) and diabetes (49.6%). ICU mortality occurred in 24 patients (20%). Significant predictors of mortality included higher CRP (>62.8 mg/L), NLR (>10.0), PIV (>450), and APACHE II scores (>23) (p < 0.001 for all). Lower albumin levels (<2.5 g/dL) were strongly associated with increased mortality (p < 0.001). ROC analysis demonstrated that the APACHE II score had the highest predictive accuracy for mortality (AUC = 0.83), followed by albumin (AUC = 0.79) and PIV (AUC = 0.76). Extended ICU stay (>10 days) was also significantly correlated with increased mortality (p < 0.001). Conclusions: This study successfully demonstrates the utility of combining traditional clinical markers, such as APACHE II score, with novel inflammatory markers, such as PIV, CAR, and NLR, in predicting mortality in ICU patients following femur fracture surgery. The integration of emerging biomarkers with well-established scoring systems offers enhanced predictive accuracy and provides valuable insights into patient management.
Comparison of AI Applications and Anesthesiologist's Anesthesia Method Choices
(BMC, 2025) Celik, Enes; Turgut, Mehmet Ali; Aydogan, Mesut; Kilinc, Metin; Toktas, Izzettin; Akelma, Hakan
Background in medicine, Artificial intelligence has begun to be utilized in nearly every domain, from medical devices to the interpretation of imaging studies. There is still a need for more experience and more studies related to the comprehensive use of AI in medicine. The aim of the present study is to evaluate the ability of AI to make decisions regarding anesthesia methods and to compare the most popular AI programs from this perspective. Methods the study included orthopedic patients over 18 years of age scheduled for limb surgery within a 1-month period. Patients classified as ASA I-III who were evaluated in the anesthesia clinic during the preoperative period were included in the study. The anesthesia method preferred by the anesthesiologist during the operation and the patient's demographic data, comorbidities, medications, and surgical history were recorded. The obtained patient data were discussed as if presenting a patient scenario using the free versions of the ChatGPT, Copilot, and Gemini applications by a different anesthesiologist who did not perform the operation.Results over the course of 1 month, a total of 72 patients were enrolled in the study. It was observed that both the anesthesia specialists and the Gemini application chose spinal anesthesia for the same patient in 68.5% of cases. This rate was higher compared to the other AI applications. For patients taking medication, it was observed that the Gemini application presented choices that were highly compatible (85.7%) with the anesthesiologists' preferences. Conclusion AI cannot fully master the guidelines and exceptional and specific cases that arrive in the course of medical treatment. Thus, we believe that AI can serve as a valuable assistant rather than replacing doctors.
Evaluation of the Satisfaction of Relatives of Patients Being Treated in the Intensive Care Unit
(2024) Kılınç, Metin; Çelik, Enes; Akelma, Hakan; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Aims: There has been no previous study on the satisfaction of relatives of patients receiving treatment in the intensive care unit of our hospital. Our study was conducted to improve quality and service in our intensive care unit. A survey was conducted to evaluate the satisfaction of the relatives of patients receiving treatment. Methods: The satisfaction of the relatives of the patients who were treated for at least 3 days in the 3rd Step general intensive care unit at Mardin Training and Research Hospital between 01. February 2023 and 01. June 2023 was evaluated in line with the surveys. A questionnaire was given to each patient’s relative by the attending physician to be filled out. Results: 114 patient relatives participated in the study. 12 patient relatives did not agree to fill out the survey. 102 patient relatives filled out the satisfaction survey. Conclusion: Waiting room in intensive care unit conditions need to be improved. In our study, we think that patient relatives have confidence in the treatments applied to their patients and are satisfied with the skills and abilities of doctors and nurses.
Citation - WoS: 2
Citation - Scopus: 2
Examining the effect of COVID-19 vaccines on the menstrual cycle: A study from Turkey
(LWW, 2023) Toktaş, İzzettin; Akelma, Hakan; Araç, Eşref; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Concerns about a possible relationship between vaccination against Coronavirus Disease 2019 (COVID-19) and menstrual disorders have been raised in the media. In addition, different studies have shown that the COVID-19 vaccine may be associated with menstrual changes. This study was conducted to investigate the effects of COVID-19 vaccines on the menstrual cycle in women. This cross-sectional descriptive study was conducted between August 16 and September 17, 2021. Data were collected through a self-administered questionnaire via an online form sent to the participants through social media. Data of 586 women were included in this study. A total of 82.4% (n = 483) of the participants were aged between 31 and 50 years. The BioNTech vaccine (2 doses) was administered to 75.8% (n = 444), Sinovac (3 doses) to 9.0% (n = 53) of the participants. 53.1% (n = 311) of the women experienced changes in their menstrual cycles. The most common menstrual changes after vaccination were delayed menstruation (n = 176; 30.0%) and prolonged menstrual duration (n = 132; 22.5%). Menstrual delay, prolonged menstrual duration, heavy bleeding, and early menstruation were more common in women than prior to receiving the vaccine (P < .05). More than half of the women experienced menstrual cycle changes after receiving the COVID-19 vaccine. Women experienced significantly higher rates of menstruation delay, prolonged menstrual duration, heavy bleeding, and early bleeding compared to before vaccination.
Healthcare-Associated Infections in Patients with COVID-19: Is It Different from the Pre-Pandemic Period
(Journal of Infection in Developing Countries, 2024) Solmaz, İhsan; Kavak, Şeyhmus; Arac, Songul; Akelma, Hakan; Başgöz, Bahadir Bilgin; Koyun, Sedrettin; Kaya, Şafak
Introduction: Healthcare-associated infections (HAIs) are common in intensive care unit (ICU) patients and may cause devastating consequences. However, the prevalence of HAI and its effects on in-hospital mortality among critically ill COVID-19 patients is ambiguous. We determined the prevalence of HAI and the rate of mortality in critically ill COVID-19 patients and compared it with pre-pandemic ICU patients. Methodology: This retrospective study was conducted with adult ICU patients admitted to Gazi Yasargil Training and Research Hospital (Diyarbakir,Turkey) in April-November 2019 (defined as the pre-pandemic period) and in April-November 2020 (defined as the pandemic period). All patients in the pandemic period had COVID-19, while none in the pre-pandemic period did. Patients diagnosed with HAIs during the in-hospital follow-up period were recorded. Results: Of 4596 enrollees, 3386 (73.7%) were pandemic-period patients and 1210 (26.3%) were pre-pandemic-period patients. HAI prevalence was significantly higher at 5.9% (n = 71) in the pandemic-period patients and 2.7% (n = 91) in the pre-pandemic-period patients (p < 0.001). Comorbidities including hypertension (63.4% vs 14.2%, p < 0.001), diabetes mellitus (39.4% vs 8.8%, p < 0.001), and coronary artery disease (30.9% vs 10.9%, p = 0.002) were significantly more frequent in pandemic-period HAI-positive patients. The most common HAI was catheter-related bloodstream infection in both groups, with similar frequency (p = 0.652). In-hospital mortality rate was 85.9% versus 65.9% in pandemic- versus pre-pandemic-period HAI-positive patients (p < 0,05). Conclusions: The prevalence of HAI and the in-hospital mortality rate was significantly higher among pandemic-period patients. © 2024 Elsevier B.V., All rights reserved.
Hydrogel Burn Dressing Effectiveness in Burn Pain
(Elsevier Ltd, 2024) Celik, Enes; Akelma, Hakan
Severe burns are painful and dramatic injuries. Studies show that pain is underestimated and often not adequately treated. This study aims to evaluate the analgesic efficacy of hydrogel burn dressing and silver sulfadiazine, which are two agents commonly used in first-aid dressings for burn patients. This study, designed as a prospective, observational, and cross-sectional study. Study included 64 pediatric patients admitted to our burn center between 01.03.2020 and 01.09.2020 who were examined by our burn service after their first treatment in the emergency dressing room. Two groups of patients were included in the study. Pain level was assessed in the dressing room before and 10 min after the procedure using the Visual Analog Scale and FLACC (Face, Legs, Activity, Cry, Consolability) pain assessment scales.During the study period, Burnaid® was applied to 62.5% of patients (40 patients) and silver sulfadiazine to 37.5% (24 patients). In terms of pain scores, pre-dressing FLACC values were higher in Group B (p = 0.039); post-dressing VAS and FLACC values were significantly lower in group B (p 0.001; p 0.001). In terms of additional analgesia, we found more patients in Group S received analgesics (p 0.001).We believe that its effect on burn wound pain is superior to that of silver sulfadiazine. © 2024 Elsevier B.V., All rights reserved.
Ultrasound-Guided Regional Anesthesia in Permanent Pacemaker Implantation: an Observational Study
(MDPI, 2025) Akelma, Hakan; Celik, Enes; Ipek, Yusuf; Turgut, Mehmet Ali; Tanircan, Muhammed Rasit; Aktan, Adem; Karahan, Mehmet Zulkuf; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Background and Objectives: When pacemakers were first introduced, their indications and implantation techniques were quite limited. Over 400,000 permanent pacemakers are implanted annually worldwide, mostly under local anesthesia (LA), which is preferred for its hemodynamic stability. However, inadequate LA often leads to excessive use of local anesthetics or analgesics. This study evaluates the efficacy of combining interscalene brachial plexus block (ISB) and superficial cervical plexus block (SCPB) as regional anesthesia (RA) techniques during permanent pacemaker implantation compared to LA. Materials and Methods: A total of 42 patients were divided into RA and LA groups. The RA group underwent ISB and SCPB under ultrasound guidance, while the LA group received traditional local anesthetic methods. Results: The RA group exhibited superior pain control, reduced analgesic requirements, and higher satisfaction rates compared to the LA group. Ultrasound guidance enhanced block success rates and minimized complications. Conclusions: ISB and SCPB offer a superior alternative to LA for pacemaker implantation, especially in patients with anxiety or insufficient LA response.
Vatanından Uzakta Ölmek” Palyatif Bakım Kliniğinde Ölen 7 Suriye Uyruklu Hasta ve Ülkemizin Sığınmacıların Sağlık İhtiyaçlarını Karşılamadaki Rolü
(2022) Akelma, Hakan; Karahan, Mehmet Zülkif; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu Üniversitesi
Savaşlar, iç çatışmalar telafisi mümkün olmayan yıkımlara neden olup, en çok da sivilleri etkilemektedir. Yıkımın etkisi başta ikincil şahıslara ihtiyaç duyan çocuk, yaşlı ve kadınlar için daha belirgindir. Şu anda dünyadaki sığınmacıların yarısından fazlası Suriye’de hayatlarını kurtarmak için ülkelerinden ayrılmak zorunda kalan sığınmacılardan oluşmaktadır. Siyasal, sosyal, kültürel ve ekonomik açıdan toplumu ve bireyleri etkileyen yurdundan edilme durumu sağlık sorunlarını da beraberinde getirmektedir. Sığınmacılar zor yaşam koşulları, barınma, beslenme, şiddet ve psikolojik travmalar gibi birçok neden ile sağlık bakım sisteminde en kırılgan ve savunmasız gruplardandır. Kendi yaşam alanlarından zorunlu olarak ayrılan bireylerin yaşam konforlarının azalması ve yaşadıkları psikolojik yıkım, beraberinde bulaşıcı hastalıklar, kardiyovasküler hastalıklar, diyabet, kanser ve akciğer hastalıkları gibi kronik hastalıkların riskini artırmaktadır. Bu hastalıklara bağlı palyatif bakım ünitelerine yatışlar artmakta ve bu kliniklerde yaşam koşullarından daha iyi şartlarda sağlık hizmeti almakta ancak hastalıklarının şiddetine göre ölümler gerçekleşmektedir. Türkiye, sığınmacılara mümkün olan en iyi yaşam koşullarını ve kapsamlı insani yardımı sağlamaktadır. Sığınmacılar hem kamplarda hem de barındıkları iskânlarda tüm sağlık hizmetlerini sürdürmektedir. Bu sığınmacılar aynı şekilde gerekli durumlarda palyatif bakım hizmetlerinden faydalanmaktadır. Bu çalışmanın amacı palyatif bakım kliniklerde özellikle kanser, diyabet ve diğer kronik hastalıklar sonucu hayatını kaybeden sığınmacı hastaların değerlendirilmesi ve bunun yanında ülkemiz sağlık bakımındaki desteğini vurgulamaktır.