Comparison of two different anesthetic methods on pain perception in prostate biopsy
Engin Kolukcu 1, Sahin Kilic 2, Dogan Atılgan 3
1 Department of Urology, Tokat State Hospital, Tokat, 2 Department of Urology, Fethiye State Hospital, Fethiye, Mugla, 3 Department of Urology, Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey
DOI: 10.4328/JCAM.6028 Received: 23.09.2018 Accepted: 25.10.2018 Published Online: 30.10.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 121-4
Corresponding Author: Engin Kolukcu, Department of Urology, Tokat State Hospital, Tokat, Turkey. GSM: +905354002385 F.: +90 3562120258 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0003-3387-4428
Aim: In this study, we aimed to compare the efficiency of two different local anesthetic techniques in transrectal ultrasound (TRUS) guided prostate biopsy.Material and Method: The medical records of 798 patients who underwent 12 core transrectal ultrasound guided prostate biopsy were evaluated retrospec-tively. The patients were divided into 2 groups to receive two different kinds of anesthesia during the procedure as follows: Group 1, rectal application of 2% lidocaine gel and Group 2 periprostatic nerve block. The perception of pain during the insertion of the probe and during the biopsy procedure was scored for each group separately by using a visual analog scale (VAS). Results: The mean age, mean total PSA level and mean prostate volume of the patients in Group 1 were 67.67 ± 8.91 years, 12.57 ± 17.67 ng/ml and 51.41 ± 22.62 ml respectively. The mean age, mean total PSA level and mean prostate volume of the patients in Group 2 were 64.64 ± 7.63 years, 13 ± 18.02 ng/ml and 53.44 ± 44.01 ml respectively. The mean VAS scores of Group 1 and Group 2 during probe insertion were 4,87 ± 1,14 and 5,19 ± 1,16 respectively (p<0.001). The mean VAS scores during biopsy were 3,56 ± 1,43 for Group 1 and 2,5 ± 0,91 for Group 2. The difference between these scores was statistically significant (p<0.001). Discussion: Using of lidocaine gel for analgesia in TRUS-guided prostate biopsy significantly decreases the perception of pain experienced during the probe insertion procedure. On the other hand, PPNB is more effective than the using of lidocaine gel in pain control when the level of pain experienced during the biopsy is examined. Analgesia is substantially ensured by using PPNB, but analgesia combined with topical anesthetic agents could provide a more comfortable biopsy procedure.
Keywords: Cancer; Pain; Periprostatic Nerve Blockage; Prostate Biopsy.
Use of multiple artery grafts to ensure long-term graft patency in coronary bypass surgeries
Kenan Abdurrahman Kara
Cardiovascular Department, Yeditepe University Medicine School University Hospital, İstanbul, Turkey
DOI: 10.4328/JCAM.6001 Received:10.08.2018 Accepted: 07.10.2018 Published Online: 08.10.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 117-20
Corresponding Author: Kenan Abdurrahman Kara, Cardiovascular Department, Yeditepe University Medicine School University Hospital. İçerenköy Mah. Hastane Yolu Sok. 4,4/1 34718 Ataşehir, İstanbul, Turkey. ORCID ID: 0000-0003-1295-7689
Aim: When selecting a graft for coronary artery bypass surgery (CABG), it is necessary to consider the quality of life and life expectancy of the patient besides ensuring complete revascularization. Use of multiple artery grafts confers the advantage over venous grafts because of their longer patency rates. The aim of this study is to evaluate our experiences in the use of arterial grafts and draw attention to the use of multiple artery grafts. Accordingly, coronary bypass surgeries that we have performed by using multiple arterial grafts were reviewed in our study. Material and Method: Between January 2017 and December 2017, 10 patients (8 males average age: 52.75 2 females average age: 61) had undergone CABG surgery by using multiple arterial grafts. We used the left internal mammary artery (LIMA) and radial artery (RA) in 2 patients, LIMA and right internal mammary artery (RIMA) in 6 patients and LIMA-RIMA and radial artery in 2 patients. In 2 of these patients, a T-graft was constructed by anastomosing the proximal end of the free RIMA to the side of the attached LIMA. In all cases, the radial artery was proximally anastomosed to the aorta. All patients were followed up in the intensive care unit for 2 days. Patients were discharged from the hospital in 5-6 days on average. Results: Patients were evaluated in terms of operative mortality, cross clamp time, intensive care and hospitaliza-tion period, pain in the incision area, management of post-extubation saturation levels, postoperative complications, recurrent angina, myocardial infarction (MI) and reoperation. No complications were reported during the early period of our evaluations. Although low levels of saturation were detected during this time in patients for whom bilateral IMA was used, saturation increased in the following days with no complications. No sternal dehiscence or infections were observed in patients. Non-steroidal anti-inflammatory (NSAI) and paracetamol anti-analgesics were given to all patients. For measurement of incision area pain, a pain index test was implemented. Discussion: In patients, whose venous grafts are used following CABG, early period graft thromboses lead to repeti-tive interventional operations and increase in re-operations. Although the superiority of CABG operation versus stent operation is accepted for multiple vein patients, many cardiologists and patients carry objections against the repetitive interventional operations that may arise due to early graft failure and the consequent increase in early period mortality and morbidity risk. We believe that we can overcome these risks by use of multiple artery grafts which allow for a higher patency rate over the long term.
Keywords: Bilateral IMA; Radial Artery; Artery Graft; Graft Occlusion
Effectivity of local bupivacaine infusion in the prevention of postoperative ileus
Erol Kiliç 1, Bülent Koca 2
1 General Surgery, Mustafa Kemal Universty, Hatay, 2 Bafra State Hospital, Samsun, Turkey
DOI: 10.4328/JCAM.5980 Received: 09.08.2018 Accepted: 22.09.2018 Published Online: 25.09.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 109-12
Corresponding Author: Erol Kiliç, Departman of General Surgery, Tayfur Sökmen Medicine Faculty, Mustafa Kemal Universty, 31000, Hatay, Turkey. GSM: +905324067941 E-Mail: email@example.com ORCID ID: 0000-0002-0229-2911
Aim: Inflammation is the predominant factor in the development of gastrointestinal dysmotility or postoperative ileus although dissection and neurological and inflammatory factors secondary to intestinal manipulation have been blamed. In this study, we investigated the effectivity of local bupivacaine infusion for prevention of postoperative ileus. Material and Method: This retrospective study included patients that underwent median laparotomy and received conven-tional analgesia alone or conventional analgesia followed by local bupivacaine. Patients that received conventional analgesia (nonsteroidal anti-inflammatory drugs [NSAIDs] + opioids) followed by local bupivacaine infusion (15 mg/h during 48h) with Pain buster pump system were classified as Group 1 (n=30) and the patients that received conventional analgesia alone ( [NSAIDs] + opioids) were classified as Group 2 (n=31). Results: The groups were similar in terms of age, gender, preoperative ASA score, surgical technique, and operative time. The Visual Analog Scale (VAS) scores during the periods 8-24 and 24-48 h and the analgesic requirement during the periods 0-8, 8-24, and 24-48 h were significantly decreased in Group 1 compared to Group 2 (p<0.05). In Group 1, active postoperative bowel sounds started earlier (38 vs. 47 h) and mean time to first flatus/defecation was significantly lower than in Group 2 (64.13 ± 9.06 vs. 77.90 ± 10.25 h) (p<0.05). Discussion: Transfascial bupivacaine infusion appears to be an effective technique since it reduced early postoperative pain and postop-erative analgesic requirement and also provided favorable effects in the prevention of postoperative ileus, thereby leading to shorter intensive care unit stay.
Keywords: Postoperative Ileus; Postoperative Analgesia; Transfascial Bupivacaine Infusion
Does hepatic visualisation show residual/metastatic thyroid tissue in differentiated thyroid cancer?
Zekiye Hasbek 1, Serdar Savaş Gul 2, Esra Cıftcı 3, Seyit Ahmet Erturk 1, Ali Cakmakcılar 1, Gülhan Duman 4, Bülent Turgut 5
1 Department of Nuclear Medicine, Cumhuriyet University, School of Medicine, Sivas, 2 Department of Nuclear Medicine, Gaziosmanpaşa University, School of Medicine, Tokat, 3 Department of Nuclear Medicine, Sakarya University, School of Medicine, Sakarya, 4 Department of Endocrinology, Cumhuriyet University, School of Medicine, Sivas, 5 Department of Nuclear Medicine, Katip Çelebi University, School of Medicine, İzmir, Turkey
DOI: 10.4328/JCAM.5838 Received: 28.03.2018 Accepted: 27.04.2018 Published Online: 28.04.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 49-53
Corresponding Author: Zekiye Hasbek, Dept. of Nuclear Medicine, Cumhuriyet Univ. School of Medicine, Campus, 58140, Sivas, Turkey. T.: +90 3462580000/0253 GSM: +905336111750 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0002-8119-3363
Aim: Diffuse homogen hepatic uptake in whole-body scan (WBS) after radioiodine remnant ablation (RRA) suggests that there is occult or visible remnant thyroid tissue and/or tumor tissue. It is thought that the reason is hepatic metabolization of radioiodine (131I) marked thyroglobulin fragments which are secreted by remnant/tumor tissue. The aims of this study were to investigate whether the hepatic visualisation after radioiodine remnant ablation showed the presence of metastatic or residual disease in patients with differentiated thyroid cancer and also to investigate whether early or late WBS after RRA (RxWBS) had an effect on the physiological hepatic uptake. Material and Method: 201 DTC patients were evaluated (F/M: 152/49; mean age: 49.61±13 years (range: 18–85 years)) who referred for RRA. The therapeutic 131I dose ranged from 100mCi to 200mCi. RxWBS was performed earlier (in 1-4th-day after RRA) in 106 patients (Group 1) and was performed later (in 5-9th-day after RRA) in 95 patients (Group 2). Results: Diffuse hepatic uptake were seen only in three patients (2.8%) and was not seen in 103 patients (97.2%) in Group 1. However, in Group 2 diffuse hepatic uptake was seen in 93 patients (97.9%) (p<0.05) and not seen only in 2 patients (2.1%). There is not a statistically significant relationship between the hepatic uptake and serum Tg, LT4 and TSH level. There is a statisti-cally significant relationship between anti-Tg level and hepatic uptake. Discussion: Physiological diffuse hepatic uptake of radioiodine in WBS after RRA may not be seen during the early WBS. Thus, metastatic foci may be missed with early scanning. We conclude that RxWBS after RRA should be done in late period.
Keywords: Differentiated Thyroid Cancer; Radioiodine; Hepatic Uptake; Scintigraphy
The effects of kinesio tape and stretching on hamstring muscles flexibility
Erdem Demir 1, Nesrin Yağcı 2
1 Alanya Municipality Accessible Recreational Center, Antalya, 2 Pamukkale University, School of Physical Therapy and Rehabilitation, Denizli, Turkey
DOI: 10.4328/JCAM.5829 Received: 22.03.2018 Accepted: 09.05.2018 Published Online: 14.05.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 45-8
Corresponding Author: Nesrin Yağcı, Pamukkale University, School of Physical Therapy and Rehabilitation, Kınıklı Campus, 20070, Denizli, Turkey. T.: +90 2582964266 F.: +90 2582964494 E-Mail: email@example.com ORCID ID: 0000-0002-5669-4932
Aim: Kinesio Tape (KT) is a dynamic treatment approach which is used for pain relief, painless movement, soft tissue healing, and edema by increasing the circulation. The aim of this study is to investigate the effects of stretching exercises with KT on hamstring flexibility in young females. Material and Method: Thirty healthy young females participated in this study. The right leg hamstring muscles were stretched using PNF contract-relax technique and taped using KT (Group I; n=30), the left leg hamstring muscles were stretched by PNF contract-relax technique but they were not taped using KT (Group II; n=30). All the subjects were examined before and after the interventions (four weeks) with the active knee extension and modified sit and reach test. Results: Range of mo-tion (ROM) and flexibility increased in both groups. When we compared the two interventions, there were significant differences in terms of the active knee extension test scores. But there was no difference in results in a comparison of the modified sit and reach test scores (p>0.05). The improvements in Group I subjects were significantly greater compared to those of Group II (p=0.0001). Discussion: The results indicate that KT increased the effect of stretching exercises of hamstring muscles and improved ROM of the knee joint in healthy female subjects.
Keywords: Kinesio Tape; Hamstring Muscle; Flexibility
Evaluation of the normal tibial tubercle-trochlear groove distance with magnetic resonance imaging in a Turkish population
Hatice Kaplanoglu, Aynur Turan, Baki Hekimoğlu
Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye
DOI: 10.4328/JCAM.5796 Received: 03.07.2018 Accepted: 10.08.2018 Published Online: 27.08.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 31-4
Corresponding Author: Hatice Kaplanoglu, Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye. T.: +90 3125084443 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0003-1874-8167
Aim: Patellar instability is a common multifactorial knee pathology with a high recurrence rate. In this condition, the symptoms often continue and result in the patient becoming susceptible to chondromalacia and osteoarthritis. Tibial tuberosity–trochlear groove distance (TT-TG) is very important in the evaluation of patellofemoral joint instability. In this study, we investigated the normal value of TT-TG distance in men and women of different age groups and evaluated the reliability of magnetic resonance imaging (MRI) in TT-TG distance measurement. Material and Method: The study was carried out between January 2017 and December 2017 on 99 patients over the age of 18, all reporting knee pain but presenting with normal knee examination and MRI findings. The patients with abnormal findings on knee MRI or physical examination were excluded from the study. Results: The mean age of the patients was 41.1 ± 11.0 years with a median of 40 (18–68) years. The mean TT-TG distance in the whole population was 9.3 ± 3.3 mm, with a mean value of 9.9 ± 3.6 mm in men and 8.8 ± 3.0 mm in women. Within the male and female patient groups, the TT-TG distance did not significantly differ by age (p = 0.646 and p = 0.570, respectively). Discussion: In the present study, no significant difference was identified in the TT-TG distance measurement between males and females in different age groups. From the results of this study, it can be concluded that MRI is a reliable method for the evaluation of TT-TG distance.
Keywords: Knee; Magnetic Resonance Imaging; Tibial Tuberosity–Trochlear Groove
Your voice isn’t the only thing transmitted on your mobile phone! Germs are being transmitted too
Salman Sarfraz Khokhar 1, Jayakumar Subramaniam 1, Majed Gorayan Alrowaili 2, Mohamed Soliman 1, Amjed Naeem Alrawili 3, Sultan Theyab Mannaa Alshammri 3, Hind Hamd 3, Malek Ramadan Alenzi 3
1 Department of Microbiology, 2 Dean, 3 Sixth year Medical Student, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
DOI: 10.4328/JCAM.5926 Received: 08.06.2018 Accepted: 28.08.2018 Published Online: 04.09.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 89-92
Corresponding Author: Dr. Jayakumar. S, Department of Microbiology, Faculty of Medicine, Northern Borders University, Arar-91431, Kingdom of Saudi Arabia, P.O Box-1321. GSM: +966536687576 E-Mail: email@example.com ORCID ID: 0000-0002-1120-3407
Aim: Mobile phones and its usage are inevitable in this tech-savvy medical setup. Their use in the healthcare settings represents a potential source of spreading microorganisms that may contribute to hospital-acquired infections. In recent years much concern has been expressed over the frequent use of these devices by healthcare workers and clinical medical students even in washrooms that can serve as a vector for transmitting pathogens to the patients. Material and Method: This cross-sectional study identified microbiological contamination of mobile phones used by clinical medical students at Northern Border University (NBU), Arar, Saudi Arabia. Results: Out of 110 mobile phones screened, 99(90%) were contaminated. The most abundant isolates include coagulase-negativeStaphylococci 26 (24 %) followed by Staphylococcus aureus 20 (18%), Klebsiella pneumoniae 6 (5.4%) and Escherichia coli 2 (1.8%). Seventy-five (68%) of Gram-positive bacilli were isolated. Discussion: Our study indicates that mobile phones can serve as reservoirs of both pathogenic and non-pathogenic microorgan-isms. To reduce the risk of cross-contamination proper guidelines of hand hygiene; restricted use of mobile devices during clinical working hours and frequent decontamination of these devices and awareness of its usage should be promoted.
Keywords: Hospital Acquired Infections; Mobile Phones; Microbial Contamination; Microbial Resistance; Hand Hygiene; Medical Students; Saudi Arabia.
Optic coherence tomography evaluation of macula after external beam radiotherapy
Neslihan Kurtul 1, Gökhan Özdemir 2, Necla Gürdal 1, Ayşegül Çömez 2
1 Department of Radiation Oncology, 2 Department of Ophthalmology, Faculty of Medicine, Sutcu Imam University, Kahramanmaraş, Turkey
DOI: 10.4328/JCAM.6002 Received: 11.08.2018 Accepted: 12.09.2018 Published Online: 17.09.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 113-6
Corresponding Author: Neslihan Kurtul, Department of Radiation Oncology, Sutcu Imam University Faculty of Medicine, Avsar Campus, Kahramanmaras, Turkey. GSM: +905067872841 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0001-9173-6280
Aim: In this study, we aimed to investigate the optic coherence tomography findings in patients who received external beam radiotherapy. Material and Meth-od: All consecutive subjects applied to the radiation oncology department due to head, neck or brain tumors were enrolled prospectively into the study. Macula radiation dose and eye dose were calculated from dose-volume histogram plot curve. Eyes were evaluated with regard to macular thickness with optical coher-ence tomography at the baseline and 6th month after the radiotherapy. Results: A total of 32 eyes of 16 patients were included in the study. The mean macula dose was 1780 ± 1403 cGy, maximum macula dose was 2059 ± 1479 cGy and the mean eye dose was 1015 ± 784 cGy. Among 16 patients, macular edema was developed in one patient (%6,25) 18 weeks after the radiotherapy. Apart from this patient, no other patient developed any kind of retinal complication regarding the radiotherapy during 6 months follow up. The retina showed no change with regard to the studied parameters during the study period (p<0.05).Discussion: OCT is an effective way to determine early changes in patients undergoing radiotherapy and it enables prompt diagnosis of early clinical macular edema. This study is of significance in that our patients didn’t get direct retinal radiation therapy during 6-months follow-up. Long-term studies with a larger cohort group will yield more suggestive data on this clinical entity.
Keywords: Macula; Optical Coherence Tomography; Radiotherapy
Evaluation of analytical quality of cardiac biomarkers in the emergency laboratory by sigma metrics
Fatma Ceyla Eraldemir
Department of Biochemistry, Kocaeli University School of Medicine, Kocaeli, Turkey
DOI: 10.4328/JCAM.6003 Received: 13.08.2018 Accepted: 28.08.2018 Published Online: 04.09.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 35-40
Corresponding Author: Fatma Ceyla Eraldemir, Department of Biochemistry, Kocaeli University Facultyof Medicine, Kocaeli, Turkey. T.: +90 2623037256 E-Mail: email@example.com ORCID ID: 0000-0001-9410-8554
Aim: The analytic quality of cardiac biomarkers were investigated consecutive six months by sigma metric method in our emergency laboratory. Total allowable error ratio (TEa%)’s of AAB, BV, RCPA, Ricos, and Rilibak were used for calculation. Sigma levels are compared and used to decide which TEa% is appropriate for our laboratory for more accurate results. Material and Method: Sigma levels were calculated for cardiac biomarkers which include Troponin I (cTnI), Troponin T (cTnT), CKMB mass, Myoglobin (Mb) and NT-proBNP in our emergency laboratory department between December 2017 and May 2018. The internal quality control (IQC) and external quality control (EQC) assessment results and TEa%’s of AAB, BV, RCPA, Ricos, and Rilibak were used to calculate sigma metrics. The sigma metrics for tests were calculated by “Sigma = (TEa% − Bias%) / CV%” formula. Results: Considering different TEa% ‘s, it is evaluated that CKMB mass sigma level is at the “world-class quality”. On the contrary, cTnT sigma level is found to be at the level of “poor quality”. For AAB, BV, RCPA, Ricos and Rilibak, different sigma levels are observed. Discussion: Due to using different TEa%’s for each test, different sigma levels were determined. On the other hand, because of the “poor quality” level of cTnT sigma value, decision is taken for the improvement of cTnT in our laboratory. In addition, it is observed that there is no specified TEa% for whole blood samples. Therefore, it is concluded that, for more accurate and consistent evaluations, specified matrix of TEa% values are required for whole blood samples.
Keywords: Six Sigma; Analytical Quality Management; Emergency Units; Laboratory Markers; Cardiac Biomarkers
Brucella infection in children: Evaluation of 148 pediatric patients
Özlem Özgür Gündeşlioğlu
Deparment of Pediatric Division of Pediatric Infectious Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey
DOI: 10.4328/JCAM.5956 Received: 28.06.2018 Accepted: 28.07.2018 Published Online: 29.07.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 99-103
Corresponding Author: Özlem Özgür Gündeşlioğlu, Deparment of Pediatric Division of Pediatric Infectious Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey. GSM: +905055677801 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0003-2202-7645
Aim: Brucellosis a worldwide infectious zoonotic disease. This study was aimed to evaluate the clinical, demographic characteristics, complications, treatment and follow-up results of pediatric patients diagnosed with brucellosis. Material and Method: The medical records of 148 pediatric patients who were diagnosed with brucellosis were studied retrospectively. Results: Sixty-one female (41.2%), 87 male (58.8%), in total 148 pediatric patients who were diagnosed with brucellosis were included in the study. Among the patients, 64.1% had a history of consuming fresh cheese, 4.1% had a history of consuming raw milk and 16.9% had a history of keeping a Brucella diagnosed animal at home. Brucella history rate in the family members of the patients was determined as 39.2%; and 12.8% of the patients included in the study were asymptomatic. The most common complaint of the patients who were symptomatic was fever (59.5%) followed by arthralgias (41.2%) and leg pain (38.5%). All patients were subjected to standard tube agglutination test and blood culture was taken from 93 patients. B. melitensis in blood culture was positive in 72% of the patients. Osteoarticular involvement developed in 12.1% of the patients; and 1.3% of the patients developed relapses after the end of the treatment. Discussion: Brucellosis is still an endemic disease in Turkey. Brucella can infect all organs and tis-sues and is a major cause of morbidity. The use of more than one antibiotic in the treatment and long treatment duration reduces patient compliance; thus, close follow-up of the patients is important.
Keywords: Brucella; Osteoarticular Involvement; Pediatric; Treatment
A possible interaction of TIMP-1 and TSP-1 with familial mediterranean fever
Malik Ejder Yıldırım 1, Hande Küçük Kurtulgan 1, Hasan Kılıçgün 2, Deniz Bakır 3, Sepil Erşan 3
1 Department of Medical Genetics, Faculty of Medicine, Cumhuriyet University, Sivas, 2 Deparment of Nutrition and Dietetics, Faculty of Health Sciences, Erzincan University, Erzincan, 3 Department of Biochemistry, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
DOI: 10.4328/JCAM.5959 Received: 02.07.2018 Accepted: 27.08.2018 Published Online: 05.09.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 104-8
Corresponding Author: Malik Ejder Yıldırım, Department of Medical Genetics, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey. T.: +90 3462191156 F.: +90 3462191155 E-Mail: email@example.com ORCID ID: 0000-0003-4386-1583
Aim: Matrix metalloproteinases (MMPs) may influence many biological and pathological processes including inflammatory responses. Thrombospondins (TSP) are a glycoprotein group of the extracellular matrix. In this study, we aimed to investigate a possible association of TIMP-1 (an inhibitor of metalloproteinases) and TSP-1 (an adhesive protein involved in cell-matrix interactions) with familial Mediterranean fever. Material and Method: Thirty FMF patients who had compound heterozygous or homozygous MEFV mutations and thirty healthy controls were included in this study. The patients were selected after screening by reverse hybridization procedure. TIMP-1 and TSP-1 levels of the patients and controls were measured by ELIZA. Results: TIMP-1 and TSP-1 levels of the patients who had homozygous or compound heterozygous MEFV mutation were compared with 30 healthy controls. The levels of TIMP-1 in the patients were statistically higher than those in the control group (p < 0.001). There was no significant difference between the patients and controls in terms of TSP-1 levels (p = 0.84). Discussion: IL-1β has an important role in FMF disease and it may stimulate expression of TIMP-1. TIMP-1 levels are increased in FMF patients on the basis of inflammation and higher TIMP-1 levels in patients may be associated with the self-limited nature of FMF. TSP-1 level can be modulated by proin-flammatory cytokines but there was no any significant difference between TSP-1 levels of FMF patients and the control group in our study. It can be thought that there is no interaction between TSP-1 and the pathogenesis of FMF.
Keywords: TIMP-1; TSP-1; FMF; Mutation
Prevalence of trigeminal neuralgia patients in the community: A retrospective study
Ayse Ozcan Kucuk 1, Aydin Keskinruzgar 2
1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mersin University, Mersin, 2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adiyaman University, Adiyaman, Turkey
DOI: 10.4328/JCAM.5982 Received: 29.07.2018 Accepted: 03.09.2018 Published Online: 05.09.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 16-9
Corresponding Author: Aydin Keskinruzgar, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adıyaman University, 02000, Adiyaman, Turkey. GSM: +905416795521 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0001-5735-6890
Aim: The aim of this study is to evaluate the prevalence of trigeminal neuralgia (TN) in Adıyaman and its surrounding populations. Material and Method: The study population consisted of 154.969 patients admitted to the Adıyaman University, Department of Oral and Maxillofacial Surgery between 2015 and 2018. Clinical records of 41 patients diagnosed with TN were retrospectively reviewed. Demographic data and clinical characteristics of the patients were recorded. Localization, age and sex distribution and the prevalence of TN were determined. Results: Among the 41 cases with TN, 27 were female and 14 were male. The mean age of the patients was 58.59 ± 16.38 years. Thirty-nine patients (95.1%) had unilateral and 2 patients (4.9%) had bilateral TN. While the mandibular branch (V3) involvement of the trigeminal nerve was observed in 16 patients, 5 patients showed maxillary branch (V2) involvement, and 3 patients exhibited ophthalmic branch (V1) involvement. In addition, V1+V2 involvement was observed in 1 patient, V2+V3 involvement was observed in 5 patients and V1+V2+V3 involvement was described in 11 patients. Overall, the prevalence of TN was found to be approximately 0.03% (26/100.000). Discussion: TN is a rare disease, estimation of its prevalence is difficult, hence, the literature on the prevalence and of TN is limited. The prevalence rate is about 4.5-29.5 per 100.000 individu-als in other studies. The present study revealed that the prevalence of TN in Adıyaman and its surroundings was 26/100.000. This study may be the first one in Turkey to investigate the prevalence of TN.
Keywords: Trigeminal Neuralgia; Prevalence; Epidemiology
Evaluation of performance of orient gene strep a rapid antigen test in tonsillopharyngitis
Sibel Gumus 1, Betil Ozhak Baysan 1, Ozlem Koyuncu Ozyurt 1, Hatice Yazisiz 2, Gozde Ongut 1, Kubra Yildirim 3, Aynur Inan 4, Nilgun Erkek 5, Dilara Ogunc 1
1 Department of Microbiology, Faculty of Medicine, University of Akdeniz, 2 Microbiology Laboratory, Antalya Education and Research Hospital, 3 Central Laboratory, Akdeniz University Hospital, 4 Medical Student, Akdeniz University, Faculty of Medicine, 5 Department of Pediatri, Faculty of Medicine, University of Akdeniz, Antalya, Turkey
DOI: 10.4328/JCAM.5783 Received: 17.07.2018 Accepted: 16.08.2018 Published Online: 27.08.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 41-4
Corresponding Author: O. Koyuncu Ozyurt, Department of Microbiology, University of Akdeniz, Faculty of Medicine, 07070 Antalya, Turkey. T.: +90 2422496393 F.: +90 2422496906 E-Mail: email@example.com ORCID ID: 0000-0003-1260-0671
Aim: The aim of this study is to investigate the performance of Orient Gene Strep A rapid test kit (Zhuhai Encode Medical, China), which detects the presence of Lancefield Group A antigen of S. pyogenes in throat swab specimens by lateral flow immunoassay, in comparison with throat culture. Material and Method: A total of 250 throat swabs obtained from pediatric patients who were admitted to Akdeniz University Hospital between January 20, 2015 and March 4, 2016 for acute tonsillopharyngitis were included in the study. Throat swab specimens were placed on the transport medium (Copan, Italy) and plated on Columbia blood agar plates (BBL, BD, US). Plates were incubated for 24-48 hours at 35-37 °C under aerobic conditions. S. pyogenes isolates were identified by colony morphology, beta hemolysis formation, L-pyrrolidonyl-naphthylamide (PYR, Remel, USA) hydrolysis, Lancefield group typing kit (Plasmatec, UK) and MALDI-TOF MS (Bruker Daltonik, GmBH, Germany). Results: S. pyogenes growth was observed in 54 (21.6%) of the 250 samples that were being worked on. Rapid antigen test was positive in 46 (85.2%) of those 54 culture positive cases and negative in the remaining 8 (14.8%) cases. Moreover, strep-A rapid diagnostic test was positive in 4 cases with negative culture. The sensitivity and specificity of Orient Gene Strep A compared with culture were 85.2% and 98%, respectively.Discussion: Orient Gene Strep A rapid test is inexpensive and provides rapid results with considerable sensitivity and specificity so is suitable for using together with culture for the diagnosis of streptococcal pharyngitis.
Keywords: Streptococcus Pyogenes; Throat Culture; Orient Gene Strep A Rapid Test
Should we use remifentanil in every dose and every case?
Naldan Muhammet Emin 1, Ali Taghizadehghalehjoughi 2
1 Department of Anesthesiology and Reanimation, Erzurum Regional Training and Research Hospital, 2 Department of Pharmacology and Toxicology, Faculty of Veterinary Science, Atatürk University, Erzurum, Turkey
DOI: 10.4328/JCAM.5942 Received: 21.06.2018 Accepted: 25.07.2018 Published Online: 29.07.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 26-30
Corresponding Author: Naldan Muhammet Emin, Department of Anesthesiology and Reanimation, Erzurum Regional Training and Research Hospital, 2500, Yakutiye, Erzurum, Turkey. GSM: +905063803300 F.: +90 4422325025 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0002-7492-1975
Aim: We widely use remifentanil as a pain killer in all cases that need surgery such as: broken bone, intestine, brain disease, organ transplantation. But we need to apply any of opioid analgesics according to the surgery type. The aim of the study is to determine neurotoxic or neuroprotective effects of differ-ent remifentanil doses in glutamate induced toxicity model in cerebellum cell culture. Material and Method: Cerebellum neurons were obtained from pupil of newborn Sprague dawley rat. Glutamate (10-5 mM) was added to all culture dishes except negative control group. Remifentanil was added in three different doses for 24 hours, and then evaluation was done by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), Total Antioxidant Capacity (TAC), Total Oxidant Status (TOS) and Flow cytometry (Annexin V- apoptosis marker). Results: Our data shows the highest and the lowest viability obtained from low and high remifentanil dose around %91 and %75 respectively. TAC and TOS results have correlation with MTT results. TAC capacity in remifentanil 0,2 mM group shows nearest to control group value. Discussion: According to our result, remifentanil has potential to decrease toxicity level of glutamate and increases cell viability ratio.
Keywords: Remifentanil; Cerebellum; Glutamate; Neurotoxicity; Total Oxidant Status
Information about bottom of iceberg of ammonia measurements in human plasma: Evaluation of uncertainty
Fatma Ceyla Eraldemir
Department of Biochemistry, Kocaeli University, Kocaeli, Turkey
DOI: 10.4328/JCAM.5949 Received: 26.06.2018 Accepted: 10.07.2018 Published Online: 11.07.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 93-8
Corresponding Author: Fatma Ceyla Eraldemir, Department of Biochemistry, Kocaeli University, Kocaeli, Turkey. T.: +90 2623037256 E-Mail:email@example.com ORCID ID: 0000-0001-9410-8554
Aim: Uncertainty of measurement (UM) defines the distribution of quantity values attributed to a measurand. The clinician assesses how much of the reported test result reflects its true value. UM for plasma ammonia was estimated according to the International Organization for Standardizairton (IOS ISO is actually the same organization as IOS. 15189) requirements in our laboratory. Material and Method: Plasma Ammonia of UM was calculated in accordance with The Guide to The Expression of Uncertainty of Measurement (GUM) and European Analytical Chemistry (EURACHEM) principles. Laboratory reproducibility was estimated with internal quality control (IQC), while external quality assessment (EQA) results were used to estimate bias and bias uncertainty. Uncertainity of reagents and calibrators was similarly determined. Using this data, including standard uncertainty, is combined with expanded uncertainty, and was also determined for ammonia. Results: The expanded uncertainty (k = 2) of ammonia was determined as 14.72 % (95% confidence interval). Discussions: Ammonia is a sensitive test which can be easily affected by preanalytcal errors; thus, it is important that the report is comprised of all analytical uncertainity factors for ammonia. Reporting UM for ammonia answered some questions (e.g., ‘How effective are the analytical sources in the analysis of ammonia?’ and ‘What is the true value of blood ammonia?’). This study may be a prime UM example of ammonia’s function in terms of the literature.
Keywords: Plasma Ammonia; Uncertainty; Internal Quality Control; External Quality Control; Within-Laboratory Reproducibility
Effects of ramadan lifestyle on lipid profile and oxidative stress markers in adult males
Kübranur Ünal 1, Canan Topçuoğlu 2, Çiğdem Yücel 2, Turan Turhan 2, Salim Neşelioğlu 3, Özcan Erel 3
1 Department of Biochemistry, Polatlı Public Hospital, 2 Department of Biochemistry, Ankara Numune Training and Research Hospital, 3 Department of Biochemistry, Ankara Yıldırım Beyazit University, Ankara, Turkey
DOI: 10.4328/JCAM.5943 Received: 21.06.2018 Accepted: 17.07.2018 Published Online: 17.07.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 5-9
Corresponding Author: Kübranur Ünal, Department of Biochemistry, Ankara Polatlı Public Hospital, Ankara, Turkey. E-Mail: firstname.lastname@example.org ORCID ID: 0000-0001-7940-4590
Aim: In most Muslim societies the daily routine and lifestyle change markedly during the month of Ramadan because of fasting during daylight hours and the altered day and night rituals. These changes could potentially have significant metabolic effects. The aim of this study was to explore the effects of Ramadan fasting and the resultant lifestyle changes on the biochemical profile and oxidative stress markers in healthy adult males. Material and Method: Forty-two healthy male volunteers following their usual Ramadan fasting routine were included in the study. The following serum variables were measured at the beginning and at the end of the month: triglycerides, total cholesterol, HDL cholesterol, non-HDL cholesterol, albumin, total protein, CRP, uric acid, ischemia-modified albumin (IMA), albumin adjusted-IMA (AAIMA), and thiol/disulfide homeostasis. Results: Triglycerides, total cholesterol, non-HDL cholesterol, IMA and AAIMA levels were significantly higher on the last day of Ramadan compared to the first day (p<0.05). HDL cholesterol levels were statistically lower on the last day of Ramadan than the first day (p<0.05). However, there were no significant changes in the remaining variables (total albumin, uric acid, CRP, and thiol/disulfide homeostasis parameters). Discussion: Lifestyle, nutritional, and diurnal rhythm changes during the month of Ramadan may be associated with hormonal and biorhythm alterations which could be responsible for the observed elevations in serum IMA, AAIMA and non–HDL cholesterol levels. However, further studies are required to ascertain the direct causes of these changes.
Keywords: Ramadan Fasting; Oxidative Stress; Ischemia Modified Albumin; Thiol/disulfide Homeostasis; Non-HDL Cholesterol
The effect of induced legal abortions on anxiety levels before and after the procedure
Sule Ozel 1, Yaprak Engin-Ustun 1, Rifat Taner Aksoy 1, Hatice Kansu-Celik 1, Rabia Nazik Yuksel 2, Bugra Coskun 1, Salim Erkaya 1
1 Obstetrics and Gynecology, Zekai Tahir Burak Woman’s Health, Education and Research Hospital, 2 Psychiatry Department, Ankara Numune Education and Research Hospital, Ankara, Turkey.
DOI: 10.4328/JCAM.5800 Received: 06.03.2018 Accepted: 17.05.2018 Published Online: 22.05.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 10-5
Corresponding Author: Hatice Kansu-Celik, Obstetrics and Gynecology, Zekai Tahir Burak Woman’s Health, Education and Research Hospital, 06230, Ankara, Turkey. T.: +90 3123065000 F.: +90 3123124931 E-Mail: email@example.com
Aim: The aim of this study was to investigate the effect of abortion procedure on psychological status of women. Material and Method: A total of 193 women seeking an elective abortion in legal 10 weeks gestational age interval were included in this prospective study. State-Trait Anxiety Inventory Scale (STAI) was performed twice; one is half an hour before the induced abortion and the other 10 days after the abortion. State anxiety (S-Anxiety) can be determined as discomfort, fear etc. Trait anxiety (T-anxiety) can be determined as a tendency to feel worried and discomfort. Results: S and T-Anxiety scores of cases showed statistical significant decrease after abortion (p = 0.000, p = 0.037 respectively). 65.3% of women had post-abortion T-anxiety scale score above 43 points (cut off for severe anxiety). Higher education levels are associated with lower pre and post-abortion T- Anxiety levels (p=0.000, p=0.003). Higher educated women were less likely to be at the risk of preabortion trait anxiety score above 43 points (OR 0.55, CI=0,5–1.14) and women with higher income were more likely to be at the risk of post-abortion State Anxiety Score above 43 point (OR 2.5, CI=0.94-0.42). Discussion: Anxiety scores are altered after induced legal abortions. Women who are admitted to gynecology clinics for an induced abortion should be monitored closely for psychological symptoms, and education about contraception should be given to all of the women in reproductive ages.
Keywords: Induced Abortion; Anxiety Disorders; Contraception; Family Planning
The relationship between hemoglobin variability and oxidative stress and inflammation in CKD
Tulay Kus 1, Ozlem Tiryaki Usalan 2, Celalettin Usalan 2
1 Departmen of Medical Oncology, Adıyaman University, Training and Research Hospital, Adıyaman, 2 Department of Nephrology, Gaziantep University School of Medicine, Gaziantep, Turkey
DOI: 10.4328/JCAM.5912 Received: 26.05.2018 Accepted: 09.06.2018 Published Online: 10.06.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 20-5
Corresponding Author: Tulay Kus, Department of Medical Oncology, Adıyaman University, Training and Research Hospital, TR-02040, Adıyaman, Turkey. T.: +90 4162161015 F.: +90 4162161014 E-Mail: firstname.lastname@example.org
Aim: Hemoglobin (Hg) variability, which is frequently seen in patients with chronic kidney disease (CKD) who undergo dialysis, has been shown to be associated with increased mortality and cardiovascular disease (CVD) , but its mechanism remains unclear. Increased oxidative stress and inflammation with uremia lead to the development of anemia. In this context, we aimed to investigate the relationship between Hb variability and oxidative stress and inflammation. Material and Method: The data of 114 patients followed by dialysis service of Gaziantep University were included in this study retrospectively. Myeloperoxidase (MPO), nitrotyrosine (NTY), total antioxidant capacity (TAC), interleukin-6 (IL-6), Hs-CRP, and plasminogen activator inhibitor-1(PAI-1) levels of the patients whom we divided into 6 groups according to their Hg variability were measured. A control group (n = 30) was also formed demographically and clinically appropriate to this group. Results: The mean MPO, NTY, IL-6, Hs-CRP, and PAI-1 levels were higher in the dialysis patients than in the control group, whereas TAC levels were lower. Prooxidant, inflammation and procoagulant activity levels were lower in the Group 6 (Hg>12) and the Group 3 (stable, Hg=11-12 gr/dl) but higher in wide Hg variable group (Group 5) and Group 1 (Hg <12 gr/dl). Discussion: Oxidative stress, inflammation, and procoagulant activity, which are associated with higher CVD and mortality were found to be high in wide Hg variable and anemic groups in patients who underwent dialysis. The present study has a valuable finding in terms of elucidating the possible mechanism of increased mortality in patients with wide variable Hg course.
Keywords: Hemoglobin Variability; Cardiovascular Disease; Oxidative Stress; Inflammation; PAI-1 Activity; Chronic Kidney Disease
Clinical and radiologic results of open reduction and fixation with locked plate screws in proximal humerus fracture–dislocation
Orhan Değnek 1, Ramazan Atiç 2, Celil Alemdar 2, Abdulkadir Aydın 2, Azad Yıldırım 3, Emin Özkul 2
1 From the Department of Orthopedics and Traumatology, Selahaddin Eyyubi State Hospital, Diyarbakır, 2 From the Department of Orthopaedics and Traumatology, Dicle University Medical Faculty, Diyarbakir, 3 From the Department of Orthopaedics and Traumatology, Private Muş Healing Hospital, Muş, Turkey
DOI: 10.4328/JCAM.5859 Received: 05.04.2018 Accepted: 02.05.2018 Published Online: 02.05.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 83-8
Corresponding Author: Ramazan Atıç, Dicle University Medical Faculty, 21280, Diyarbakir, Turkey. T.: +905321728629 F.: 00904122488440 E-mail: email@example.com
Aim: Proximal fracture dislocations of the humerus are rarely seen in society compared to other fractures. In our study, we evaluated the clinical and radio-logical results of patients who underwent open reduction and locked plate–screw fixation with proximal humerus fracture–dislocation. Material and Method: Between January 2009 and January 2016, 17 patients were treated with open reduction and locking plate screws in the Department of Orthopedics and Trau-matology at the Faculty of Medicine, Dicle University. Patients were divided into two groups according to age. Group 1 consisted of 6 patients over 65 years of age and the mean age was 77.5 (69-87). Group 2 consisted of 11 patients under 65 years of age and the mean age was 41.6 (24-60). Group 1 consisted of all female patients and Group 2 consisted of all male patients. Patient fractures were classified according to the Neer classification. Oxford Shoulder Scale, DASH Score, and Constant Murley Score were used in the clinical evaluation of the patients. Avascular necrosis phase was performed according to Cruess phase. Results: The mean follow-up period of the patients was 13.8 months (range 10-38). The mean duration of surgery was 1.11 days (range 0-4). According to the Neer classification, 11.8% of the cases were two-part fracture dislocation, 64.7% were three-part fracture dislocation, and 23.5% were four-part fracture dis-location. There was a statistically significant difference between Oxford and DASH scores in the clinical outcome according to age groups (p = 0.001, p=0.049). Avascular necrosis was observed in 14 of 17 (82.3%) patients. Additional complications such as wound infection, nonunion were not observed. Discussion: In proximal humerus fracture–dislocations, the first surgical choice should be open reduction and internal fixation in young patients, whereas internal fixation in addition to arthroplasty should be considered in elderly patients.
Keywords: Humerus; Fracture; Avascular Necrosis; Open Reduction; Plate
Effect of anti-inflammatory treatment on Sever’s disease management
Şafak Sayar 1, Hasan Hüseyin Ceylan 2, Barış Çaypınar 3
1 Ortopedi ve Travmatoloji Bölümü, Op. Dr. Medipol Üniversitesi Esenler Uygulama ve Araştırma Hastanesi, 2 Ortopedi ve Travmatoloji Kliniği, Op. Dr. Lütfiye Nuri Burat Devlet Hastanesi, 3 Fizyoterapi ve Rehabilitasyon Bölümü, Yrd. Doç. Dr. Gelişim Üniversitesi, Sağlık Meslek Yüksekokulu, İstanbul, Türkiye
DOI: 10.4328/JCAM.5839 Received: 26.03.2018 Accepted: 08.05.2018 Published Online: 14.05.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 54-7
Corresponding Author: Şafak Sayar, Medipol Üniversitesi Esenler Hastanesi, Birlik Mah. Bahçeler Cad. No:5 34230, Esenler, İstanbul, Türkiye. Tel: +90 2124401000 GSM: +905306966045 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0003-1293-4436
Aim: Sever’s disease is a calcaneal apophysitis condition and common childhood problem. Despite various treatment methods, there is not a gold standard treatment. In this study, we aimed to report the efficacy of anti-inflammatory treatment on Sever’s disease during a four-year period. Material and Meth-od: The study includes the pediatric patients, between 6-17 years old, who presented to the outpatient clinic with heel pain and had a Sever’s disease diagnosis between 2014 and 2017. Demographics and treatment records of patients were reviewed. Results: Of the 74 children who had a diagnosis of Sever’s disease, 59 were boys. Mean age was 10.77 (6.87-15.73) years at the time of diagnosis. Mean age was 11.14 (8.04-15.73) and 9.28 (6.87-13.20) years for boys and girls, respectively. Complaints were bilateral in 46 (62.16%) of 74 children. Mean symptomatic period between pain and diagnosis was 12.7 (range 2-108) weeks. Except for one patient, all of the 69 (93.2%) patients’ pain was resolved. Two weeks of ibuprofen usage was found to be sufficient for Sever’s disease treatment in 68 (91.89%) of our overall patient cohort. Discussion: Non-steroidal anti-inflammatory medication seems to be sufficient to treat most Sever’s disease patients. Simple anti-inflammatory treatment is enough for most primary cases; there is no evidence of the positive effect of expensive heel insoles or orthoses.
Keywords: Sever’s Disease; Calcaneal Apophysitis; Heel Pain; Ibuprofen
Effects of the use of conventional versus computer-aided design/computer-aided manufacturing sockets on clinical characteristics and quality of life of transfemoral amputees
Abdulkadir Aydın 1, Ramazan Atiç 2, Zekiye Sevinç Aydın 3, Celil Alemdar 2, Mehmet Karakoç 4, Kemal Nas 4, Serda Em 4
1 Dicle University Medical School Prosthetics and Orthotics Department, 2 Dicle University Medical School Orthopedics and Traumatology Department, 3 Dicle University Ataturk Health Services Vocational High School, 4 Dicle University Medical School Physical Medicine and Rehabilitation Department, Diyarbakır, Turkey
DOI: 10.4328/JCAM.5845 Received: 28.03.2018 Accepted: 26.04.2018 Published Online: 28.04.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 67-71
Corresponding Author: Abdulkadir Aydın, Prosthetics and Orthotics Department, Dicle University Medical School, 21280, Diyarbakır, Turkey. T.: +90 4122488001-14 (4522) GSM: +905327114752 E-Mail: email@example.com, firstname.lastname@example.org ORCID ID: 0000-0002-9316-448X
Aim: Amputee mobilisation requires prosthetic device use regardless of the amputation level and type. The socket is the most important part of the prosthesis and is manufactured by conventional methods worldwide. Recently, computer-aided design/computer-aided manufacturing systems have been frequently used in Europe and the United States for socket design. Use of the computer-aided design/computer-aided manufacturing method for socket production is increasing day by day. Are the sockets produced by this method advantageous or disadvantageous for amputees compared to the sockets produced by the conventional method? These results will provide guidance for units and centres that produce both above-knee and below-knee prostheses. For this purpose, we investigated whether there are differences between amputees fitted with conventional sockets and those fitted with computer-aided design/computer-aided manufacturing sockets in terms of their clinical characteristics and quality of life. Material and Method: In total, 56 patients, 28 fitted with a conventional socket (CS group) and 28 fitted with a computer-aided design/computer-aided manufacturing socket (CAD/CAM group), were included in the study. The dura-tion of daily prosthetic use, walking time with the prosthesis, walking distance with the prosthesis, walking time with the prosthesis without pain, time of adaptation to the prosthesis, causes of amputation, and manufacturing and fitting time of the prosthesis were investigated. Quality of life was evaluated using the 36-item Short-Form Health Survey (SF-36) and Turkish version of the Trinity Amputation and Prosthesis Experience Scales (TAPES). Pain was evaluated using the visual analogue scale (VAS). Results: General and mental health statuses were somewhat better in the CAD/CAM group. Results were more favour-able in the CAD/CAM group for the other items of the Short-Form 36 (SF-36) questionnaire (p > 0.05). The CAD/CAM group performed better in restriction of activity subscale (p = 0.012). There were no statistically significant differences between the groups regarding other parameters of TAPES (p > 0.05). The daily walking time with the prosthesis was higher in the CAD/CAM group than in the CS group (statistically significant; p = 0.020). The manufacturing and fitting time of the prosthesis was significantly different between the CAD/CAM and CS groups (p = 0.017). The VAS pain score was significantly lower in the CAD/CAM group (p < 0001). Discussion: Prosthetic sockets manufactured for above-knee amputees using the CAD/CAM method yielded some better outcomes than those manufactured with conventional methods in terms of quality of life.
Keywords: CAD/CAM Socket; Conventional Socket; Transfemoral Amputation; Quality of Life; TAPES; SF-36
Mullerian anomalies and value of diagnosis with 2D ultrasonography
Cagdas Sahin, Ismet Hortu, Teksin Cirpan
Department of Obstetrics and Gynecology, Ege University Medicine Faculty, Izmir, Turkey.
DOI: 10.4328/JCAM.5846 Received: 29.03.2018 Accepted: 19.04.2018 Published Online: 26.04.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 72-5
Corresponding Author: Cagdas Sahin, Ege Universitesi Hastanesi Kadın Hast. ve Dogum Klinigi, 35040, Bornova, Izmir, Turkey. T.: +90 2323901700 F.: +90 2323430711 E-Mail: email@example.com ORCID ID: 0000-0001-7346-3987
Aim: Mullerian anomalies may accompany some gynecologic, reproductive, or obstetrical problems. They should be kept in mind as a factor for infertility and poor obstetrical results. Conventionally, 2D ultrasonography has been used for diagnosing mullerian anomalies. We evaluated mullerian anomalies diagnosed in our clinic and investigated the prediction of them by 2D ultrasonography. Material and Method: In this study, 82 patients were included who had mullerian duct anomalies. We evaluated all the patients through their medical records and interventions such as 2D ultrasonography, laparoscopy, and hysteroscopy. Results: Out of 82 patients, 53 suffered from infertility. Of the infertile patients, 67.9% (36/53) had uterus septus. The mean duration of infertility of the cases was 2.76 years (±SD 3.27). When we compared ultrasonography against laparoscopy findings, the sensitivity of ultrasonography was 96% and specificity was 15%. Also, comparing ultrasonography against hysteroscopy in diagnosis, the sensitivity and positive predictive value of ultrasonography were both 90%. But specificity was 33%. Discussion: The results of this study suggest that, laparoscopy and hysteroscopy is the gold standard for the diagnosis of mullerian anomalies when compared to 2D ultrasonography, as specificity is low with ultrasonography.
Keywords: Mullerian Anomalies; Ultrasonography; Laparoscopy; Hysteroscopy.
Understanding of birth control methods behaviors within the Syrian refugee population in Turkey
Tayfur Cıft 1, Muzaffer Temur 1, Engin Korkmazer 1, Burcu Dıncgoz Cakmak 1, Betul Dundar 1, Beril Senkutlu Kuyucu 1, Orhan Sahın 2, Emin Ustunyurt 1
1 Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Obstetrics and Gynecology, Bursa, 2 Health Science University, Okmeydani Training and Research Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey
DOI: 10.4328/JCAM.5842 Received: 27.03.2018 Accepted: 26.04.2018 Published Online: 28.04.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 58-61
Corresponding Author: Tayfur Cıft, Department of Obstetrics and Gynecology, Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey. E-Mail:firstname.lastname@example.org ORCID ID: 0000-0003-4025-9343
Aim: The majority of Syrian women refugees fall in between the reproductive ages of 15-49 years old. This migration has sparked a trend in studying various topics surrounding birth control, family planning and gynecological needs of this growing population. We aimed to learn the possible reasons for the increased birth rate within the Syrian refugee population and how different factors are contributing to the high number of birth rates. Material and Method: This study was conducted at the Obstetrics and Gynecology Department of the Bursa Yuksek Ihtisas Research and Training Hospital. The questionnaire was administered to 845 patients. Results: The mean age of the participants was 24.05 ± 6.2 and the mean number of children per woman born in Turkey was 1.02. 59.5% (n=491) of our study population did not use any contraception. 48% of the study population wanted to become pregnant again, 40% of them refused to use birth control based on their religious beliefs and 31% of the participants’ husbands wanted another child. Discussion: We hope that with our survey results, future studies can be conducted to help the medical community understand more about pregnancy rates within the Syrian refugee population and the reasons for not utilizing birth control methods.
Keywords: Syrian Refugees; Contraception; Birth Planning
May cystatin-c be associated with post-myocardial infarction complications?
Mustafa Begenc Tascanov 1, Ozcan Yılmaz 2
1 Tokat Medicalprk Hospital, Tokat, 2 Ondokuz Mayıs University, Samsun, Turkey
DOI: 10.4328/JCAM.5853 Received: 03.04.2018 Accepted: 27.04.2018 Published Online: 28.04.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 76-82
Corresponding Author: Mustafa Begenc Tascanov, Tokat Medicalprk Hospital, Tokat, Turkey. GSM: +905557860033 E-Mail:email@example.com ORCID ID: 0000-0002-9008-6631
Aim: Decreased cystatin C increases proteolytic effects of cathepsin contributing to plaque rupture. We aimed to investigate the association of cystatin C levels with in-hospital and post-discharge cardiac events in patients with acute myocardial infarction (AMI). Material and Method: We included 85 patients with AMI. Patients with cancer, systemic diseases, increased creatinine, active infection or aortic aneurysm were excluded. Demographic data, laboratory and echocar-diographic parameters were analyzed. Serum cystatin C levels were measured in before coronary angiography. Results: Non-ST elevation myocardial infarction was determined in 32.94% of the patients. There were no differences between the normal and high cystatin C groups in terms of gender, diagnosis, obesity, hypertension, hyperlipidemia, cigarette smoking, Killip classification, preference of primary percutaneous coronary intervention or thrombolytic therapy, fre-quencies of culprit coronary arteries or the number of obstructed arteries. Diabetes mellitus was more frequent in the high cystatin C group. Complication rates after AMI were similar in both the normal and high cystatin C groups on the 5th day and the 12th month. Mean age was higher in the high cystatin C group.ESR, low density lipoprotein (LDL) and total cholesterol were found to be significantly higher in the high cystatin C group. The optimum cut-off values for ESR, LDL and total cholesterol were 11, 88.6, and 161.5, respectively; diagnostic accuracies were adequate. Discussion: The results of the study showed that ESR, LDL and total cholesterol were higher in high cystatin C group, but complications were similar in both groups. We concluded that cystatin C was not a predictor for post-AMI complications at 12th month.
Keywords: Acute Myocardial Infarction; Cystatin C; Complication
Acute effects of exercise on choroidal thickness and ocular pulse amplitude
Mehmet Serdar Dervişoğulları 1, Yüksel Totan 2, Ali Ender Kulak 3, Emre Güler 4
1 Ophthalmology Department, Başkent University, Adana, 2 Maya Göz Hastanesi, Ankara, 3 Kırşehir Ahi Evran Eğitim Araştırma Hastanesi, Kırşehir, 4 Medipol University, Istanbul, Turkey
DOI: 10.4328/JCAM.5844 Received: 28.03.2018 Accepted: 27.04.2018 Published Online: 28.04.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 62-6
Corresponding Author: Mehmet Serdar Dervisogullari, Ophthalmology Department, Başkent University Medical School, Adana Dr. Turgut Noyan Clinic and Research Center, Yüreğir, Adana, Turkey. T.: +90 3223272727 F.: +90 3223271274 GSM: +905327720616 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0003-2006-2906
Aim: To explore ocular changes in healthy people after exercise. Material and Method: Twenty participants underwent exercise for 15 minutes on a treadmill. Measurements of choroidal thickness, intraocular pressure (IOP), ocular pulse amplitude (OPA), and blood pressure were taken before and after exercise. En-hanced Depth, Imaging optical coherence tomography (EDI-OCT) was used to measure choroidal thickness at the fovea and at the areas 1500μm nasal and 1500μm temporal to the fovea; IOP and OPA were measured by the dynamic contour tonometer (DCT; Swiss Micro technology AG, Port, Switzerland). Blood pressure was measured concurrently with the acquisition of the scans. Results: Twenty participants (20 eyes) with a mean age of 22.65±0.98 years were measured. There was a significant increase in systolic and diastolic pressure after exercise (p<0.05). There was a significant decrease in IOP and OPA after exercise (p<0.05). There was no significant difference in the subfoveal, nasal or temporal choroidal thickness measurements after exercise (p>0.05). Discus-sion: In our study, there was no significant change in the thickness of the choroid after exercise. IOP and OPA significantly decreased, and systolic and diastolic blood pressure significantly increased, after exercise. This indicates an adaptation of vascular resistance due to vasoconstriction. The IOP and OPA decreases do not seem to be related with the changes in choroid thickness.
Keywords: Exercise; Choroid; Ocular Pulse Amplitude
The importance of evaluating measurement uncertainty for troponin I
Kübranur Ünal 1, Gökçe Filiz Atikeler 2
1 Department of Biochemistry, Polatlı Public Hospital, Ankara, 2 Department of Biochemistry, SU Hospital, İzmir, Turkey
DOI: 10.4328/JCAM.5835 Received: 22.03.2018 Accepted: 26.04.2018 Published Online: 26.04.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 1-4
Corresponding Author: Kübranur Ünal, Department of Biochemistry, Ankara Polatlı Public Hospital, Ankara, Turkey. E-Mail: email@example.com ORCID ID: 0000-0001-7940-4590
Aim: Myocardial infarction can be life threatening and the early diagnosis of acute myocardial infarction is highly important. The measurement of cardiac tro-ponin is the preferred way to establish the diagnosis of acute myocardial infarction. Measurement uncertainty provides quantitative estimates of the level of confidence that a laboratory has in its analytical precision of test results. The aim of this study is to present the importance of reporting hs-troponin I analysis results with measurement uncertainty estimation. Material and Method: The results of 16679 patients (8060 males and 8619 females) whose hs-troponin I results were analyzed in our laboratory in 2016 were retrospectively reviewed. The uncertainty of measurement was calculated according to Eurachem/CITAC Guide CG. The hs-troponin I analysis results were re-evaluated by estimation of measurement uncertainty. Results: Measurement uncertainty for hs-troponin I is estimated to be ± 19.60 %. In this study, 346 hs-troponin I analysis results (206 females and 140 males) which are above manufacturer recommended cutoff values might be below cutoff values if they were assessed based on measurement uncertainty. Also, 260 Troponin I analysis results (155 females and 105 males) which are below manufacturer recommended cutoff values cutoff values might be above cutoff values if they were assessed based on measure-ment uncertainty. The results of 606 out of 16679 patients (3.63%) were affected by uncertainty values. Discussion: Medical laboratories should calculate uncertainty of troponin tests and report this in conjunction with troponin results to help clinicians. A test result is not powerful enough without an assessment of its reliability. Therefore, hs-troponin I results which are close to cutoff values should be evaluated with uncertainty of measurement.
Keywords: Measurement Uncertainty; High-Sensitivity Troponin I; Myocardial Infarction
MR findings of retropharyngeal lipoma causing obstructive sleep apnea syndrome
Zülfü Birkan, Erhan Kaymaz
Radyoloji, Silivri Devlet Hastanesi, İstanbul, Türkiye
DOI: 10.4328/JCAM.5793 Received: 27.02.2018 Accepted: 13.05.2018 Publihed Online: 14.05.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 125-7
Corresponding Author: Zülfü Birkan, Radyoloji, Silivri Devlet Hastanesi, İstanbul, Türkiye. E-Mail: Dr.firstname.lastname@example.org ORCID ID: 0000-0001-6404-5265
Lipomas are the most common benign mesenchymal tumors of the body. Compared to other locations, lipomas localized in the head-neck region are much more rare, with those located within the retropharyngeal and parapharyngeal spaces are among the rarest forms. Surgical treatment of lipomas is mainly due to cosmetic reasons. Moreover, since a lipoma might cause serious health problems due to its pressure causing effect by mass as well as its localization, these would also require surgical intervention. With this case presentation, we have aimed to report a 22- year old case with symptoms of obstructive sleep apnea, diagnosed as retropharyngeal lipoma following MRI of the cervical region, along with data from a relevant literature.
Keywords: Lipoma; MRI; CT
Incest by grandmother with dementia: a case report
Nilfer Şahin, Damla Balkan
Department of Child and Adolescent Psychiatry, Faculty of Medicine, Muğla Sıtkı Kocman University, Muğla, Turkey
DOI: 10.4328/JCAM.5957 Received: 28.06.2018 Accepted: 09.08.2018 Publihed Online: 05.09.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 131-3
Corresponding Author: Nilfer Şahin, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Muğla Sıtkı Kocman University, Muğla, Turkey. T.: +90 2522115177 E-Mail: email@example.com ORCID ID: 0000-0001-7120-1561
Incest sexual abuse is defined as any sexual behavior applied to a child by close relatives. Incest is often between biological or stepfather and child or between siblings, less frequently between other family members. Victims are often girls. But sometimes boys can be victims of incest as well. Dementia is a disease that causes loss of intellectual function. It is usually permanent and progressive, and it increases the risk of elderly abuse and neglect. This case report presents incest sexual abuse of a boy by his grandmother.
Keywords: Child; Dementia; Incest
Pulmonary vein thrombosis associated with metastatic ovarian cancer
Vermi Degerli, Arife Erdogan
Department of Emergency Medicine, Izmir Bozyaka Education and Research Hospital, Bozyaka, Izmir, Turkey
DOI: 10.4328/JCAM.5880 Received: 28.04.2018 Accepted: 01.06.2018 Publihed Online: 05.06.2018 Printed: 01.01.2019 J Clin Anal Med 2019;10(1): 128-30
Corresponding Author: Vermi Degerli, Department of Emergency Medicine, Izmir Bozyaka Education and Research Hospital, 35170, Bozyaka, Izmir, Turkey. GSM: +905072334186 F.: +90 2322277201 E-Mail: firstname.lastname@example.org ORCID ID: 0000-0002-8556-1305
Pulmonary vein thrombosis (PVT) is a rare, life-threatening, and difficult-to-diagnose condition. Most of the literature on PVT consists of case reports, and its actual inci-dence is unknown. It occurs especially as a complication of malignancy or pulmonary surgery. We present a case of PVT detected incidentally in a 25-year-old female who presented with dyspnea and left flank pain and underwent computed tomography pulmonary angiography with a preliminary diagnosis of pulmonary artery embolism. Further investigation revealed that the PVT was associated with the lung metastasis of ovarian cancer. The patient died one month after diagnosis due to malignancy-related complications. Because of its nonspecific symptoms and findings, PVT may easily be missed or misdiagnosed. An emergency physician should consider not only pulmonary artery embolism but also PVT when considering a thromboembolic event in the differential diagnosis regardless of etiology and use appropriate imaging modalities to confirm this diagnosis.
Keywords: Pulmonary Vein; Thrombosis; Rare Disease