A prospective medico-legal study of physical and sexual child abuse in Alexandria governorate, Egypt
Zahraa K. Sobh 1, Heba M. Menessi 2
1 Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, University of Alexandria, 2 Violence Against Women and Children Unit in the Medicolegal Department of Ministry of Justice at Alexandria, Ministry of Justice, Egypt
DOI: 10.4328/ACAM.20353 Received: 2020-09-24 Accepted: 2020-10-29 Published Online: 2020-11-10 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):592-597
Corresponding Author: Zahraa K. Sobh, Forensic Medicine and Clinical Toxicology, Faculty of Medicine, University of Alexandria, Champollion street, Al Attarin, Alexandria, Egypt. E-mail: firstname.lastname@example.org / email@example.com P: +2 01020744739 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7836-9639
Aim: Child maltreatment is one of the most prevailing violations of human rights. Limited knowledge is available regarding child abuse in Arab countries includ- ing Egypt. This article highlights the medicolegal aspects of physical and sexual abuse against children under the age of 12 years in Alexandria governorate, Egypt.
Material and Methods: This is a prospective cross-sectional study that included all children under 12 years of age with reported abuse in Alexandria over a six-month period. All children underwent a general examination followed by an examination of genital and anal regions using colposcopy.
Results: The study included a total of 67 children with suspected abuse; 18% physical abuse and 82% sexual abuse. Males constituted 71.64% of the children. All children with suspected intra-familial physical violence were proved to have non-accidental traumas. Delinquents had accidental and self-inflicted injuries. Anal, vaginal, and oral penetration represented 74.54% 12.72%.and 12.72% of children with suspected sexual assaults, respectively. Medicolegal evidence was present in 29% of the children with suspected sexual abuse and all children with positive medicolegal findings were sodomy victims.
Discussion: Reported child abuse in the Alexandria governorate is the tip of the ice burg. Children’s homes are the most dangerous places in which violence took place. Intra-familial physical abuse against young children is socially acceptable that is why only serious traumas were notified. Accidental and self-inflicted injuries were reported among delinquents. Medicolegal assessment of physical trauma usually yields firm medicolegal opinion. Sexual child abuse was more reported than physical abuse; however, sexual abuse is difficult to be proved.
Keywords: Physical abuse; Sexual abuse; Child maltreatment; Alexandria; Egypt
Misuse of inhaler devices and associated factors in chronic obstructive pulmonary disease patients
Serhat Seker, Suat Konuk, Emine Ozsari, Tuncer Tug
Department of Chest diseases, Bolu Abant İzzet Baysal University, Bolu, Turkey
DOI: 10.4328/ACAM.20354 Received: 2020-10-06 Accepted: 2020-12-09 Published Online: 2020-12-23 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):598-602
Corresponding Author: Suat Konuk, Department of Chest Diseases, Bolu Abant Izzet Baysal University, Bolu 14030, Turkey. E-mail: firstname.lastname@example.org P: +90 507 3410126 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8240-4775
Aim: Inhaler device misuse is a common problem in the management of Chronic Obstructive Pulmonary Disease (COPD). In this study, we aimed to evaluate the incorrect use of inhaler devices and associated factors in patients with COPD.
Material and Methods: A total of 75 patients with the diagnosis of COPD were randomized. Demographic characteristics, type of device used, satisfaction with the drug, whether they received any training, and the inhalation technique were evaluated. Disease duration, pulmonologist follow-up, and device type were compared with the frequency and type of errors.
Results: Among the patients, 85.3% received information from the pulmonologist, 9.3% from another healthcare professional, and 5.3% did not receive any information about drug use; 20% of the patients were on Diskus, 4% on Turbohaler, 33.3% on capsuled devices, 37.3% pMDI, and 5.3% were on Ellipta. In total, 49.3% of patients were using their devices correctly. In patients who had 3 or more pulmonology follow-ups per year, correct installation of the device, mouth washing, and total correct use scores were significantly higher (p <0.05). Capsuled device users had significantly higher rates of performing adequate inhalation and the total score of correct use compared to pMDI users (p <0.05).
Discussion: In COPD patients, frequent follow-up and the type of device used were found to be related to correct inhaler use. Applied inhaler device training should be given by a pulmonologist both initially and during follow-up, with particular attention to the technique of using the pMDI.
Keywords: COPD; Inhaler devices; Misuse; Patient education
Evaluation of vitamin D levels in pregnant women with familial mediterranean fever (FMF)
Harun Egemen Tolunay 1, Korkut Dağlar 2, Kudret Erkenekli 2, Dilek Şahin 1, Aykan Yücel 1
1 Etlik Zübeyde Hanım Maternity and Women’s Health Teaching and Research Hospital, 2 Dr. Zekai Tahir Burak Women’s Health Research and Education Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.20356 Received: 2020-09-27 Accepted: 2020-10-26 Published Online: 2020-11-12 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):603-606
Corresponding Author: Harun Egemen Tolunay, Etlik Zübeyde Hanım Maternity and Women’s Health Teaching and Research Hospital, Ankara, Turkey. E-mail: email@example.com P: +90 5557736303 F: +90 3125674019 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8922-4400
Aim: There is an essential role of D vitamin in the fetal birth weight and bone development of the fetus. The main goal of this paper is to compare the vitamin D levels of pregnant women with familial Mediterranean fever (FMF) and normal pregnant women.
Material and Methods: Medical records of pregnant women (n=46) diagnosed with FMF and control group pregnants (n =31) were evaluated retrospectively.
Results: The vitamin D levels of pregnant women with FMF and normal healthy pregnants were 11.59 ± 6.7 ng/mL and 17.42 ± 9.36 ng/mL, respectively (p = 0,002). The birth weight of fetuses in the control group was significantly higher than the average birth weight of pregnant women with FMF (p = 0,022). Besides, a statistical difference was detected between two groups for vitamin D levels
Discussion: Pregnancies complicated by FMF could have additional morbidities. The presence of FMF in pregnancy may change the course of the pregnancy. These pregnant women have low levels of vitamin D. Pregnant women with FMF could have low fetal birth weight. Low vitamin D levels may cause this situ- ation in the pregnancy.
Keywords: Vitamin D, Familial mediterranean fever, Pregnancy, Fetal birth weight, FMF
Reliability of the measurements of cross-sectional area and diameter of semitendinosus and gracilis tendons using 1.5 T magnetic resonance imaging
Volkan Kızılgöz 1, Ragıp Gökhan Ulusoy 2, Oğuzhan Özdemir 1
1 Department of Radiology, Kafkas University, Faculty of Medicine, 2 Department of Orthopaedics, Kafkas University, Faculty of Medicine, Kars, Turkey
DOI: 10.4328/ACAM.20357 Received: 2020-09-30 Accepted: 2020-10-29 Published Online: 2020-11-11 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):607-611
Corresponding Author: Volkan Kızılgöz, Kafkas University, Faculty of Medicine, Department of Radiology, Kars, Turkey. E-mail: firstname.lastname@example.org P: +90 5057994013 Corresponding Author ORCID ID: https://orcid.org/0000-0003-3450-711X
Aim: Hamstring tendons are widely used for anterior cruciate ligament (ACL) reconstruction. Preoperative magnetic resonance (MR) images have been used to measure the dimensions of hamstring tendons and to predict the graft size prior to ACL reconstruction. The aim of this study was to determine the reliability of measurements of the diameter and area of semitendinosus and gracilis muscle tendons using 1.5 Tesla magnetic resonance imaging (MRI).
Materials and Methods: In this retrospective study, three evaluators independently reviewed 74 knee MRI to determine the diameter and cross-sectional area of semitendinosus and gracilis tendons at three levels (medial femoral condyle, joint line and below the tibial plateau). Mean values were calculated for each reviewer and intraclass correlation coefficient (ICC) values were used to assess inter-rater agreement.
Results: There was an excellent inter-rater agreement with respect to measurements of the width and cross-sectional area of semitendinosus and gracilis tendons at all levels. The inter-rater agreement with respect to the thickness of semitendinosus and gracilis tendons ranged from good to excellent at the three levels.
Discussion: Using 1.5 T MR imaging for preoperative hamstring graft size prediction, authors found excellent inter-rater agreement with respect to the mea- sured cross-sectional area of semitendinosus and gracilis muscle tendons at three levels in this study. Even though the ICC values for tendon thickness of gracilis muscle were relatively low, the inter-rater agreement was rated as “good” in two axial planes, and “good to excellent” in one axial plane. More studies are needed to discover the exact inter-rater agreement levels for hamstring tendon measurements using 1,5 T MR images.
Keywords: Hamstring tendons; Autografts; Anterior cruciate ligament; Inter-observer variability; Magnetic resonance imaging
COVID-19 and the risk to health care workers: Is it possible to prevent nosocomial transmission?
Arzu Altunçekiç Yıldırım 1, Celali Kurt 1, Ali Aygün 2, Yeliz Çetinkol 3, Şükran Kaygısız 4, Hakan Timur 5
1 Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, 2 Department of Emergency Medicine, Faculty of Medicine, 3 Department of Medical Microbiology, Faculty of Medicine, 4 Department of Neurology, Faculty of Medicine, 5 Department of Obstetrics & Gynaecology, Faculty of Medicine, Ordu University, Ordu, Turkey
DOI: 10.4328/ACAM.20359 Received: 2020-10-05 Accepted: 2021-01-14 Published Online: 2021-01-23 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):612-616
Corresponding Author: Arzu Altunçekiç Yıldırım, Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ordu University, 52200, Ordu, Turkey. E-mail: email@example.com P: +90 452 225 01 86 GSM: +90 505 3745836 F: +90 452 225 01 90 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1141-9838
Aim: Health employees are the key point in the struggle against the disease and in-hospital transmission during the 2019 coronavirus disease (COVID-19) pandemic. Hospital contamination poses a serious risk for both healthcare personnel and social transmission. In our study, we aimed to evaluate the COVID-19 positivity and prevention strategies in healthcare personnel.
Materials and Methods: The SARS-CoV-2 PCR results examined among health employees for all reasons were retrospectively collected. Combined nasopha- ryngeal and oropharyngeal swab samples were used. Real-time PCR was used for testing. With the epidemic, the pandemic preparation process started in our hospital. All in-hospital organization was prepared in steps. Training programs and practical applications were put into practice.
Results: Among 1054 active health personnel, 682 underwent 876 tests. Only 2 people (0.3%) were identified as positive for SARS-CoV-2 on PCR tests. In the total number of tests, the positivity rate was identified as 0.22%. In this period, no health employee developed severe disease, and no personnel died due to COVID-19.
Discussion: Creating effective health strategies with a preparation process, together with in-hospital organization and training, and the use of appropriate and sufficient personal protective equipment, are highly effective in protecting healthcare personnel and preventing hospital-borne transmission.
Keywords: Coronavirus; Polymerase chain reaction; Healthcare workers
Comparison of the clinical and radiological results of posterior cruciate ligament-retaining and posterior cruciate ligament-stabilized knee arthroplasties
Sezgin Bahadır Tekin 1, Mehmet Ömer Arpacıoğlu 2
1 Department of Orthopedics, Dr. Ersin Arslan Education and Research Hospital, 2 Department ofOrthopedics, Gaziantep University/Retired, Gaziantep, Turkey
DOI: 10.4328/ACAM.20360 Received: 2020-10-02 Accepted: 2020-11-01 Published Online: 2020-11-15 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):617-620
Corresponding Author: Sezgin Bahadır Tekin,Department of Orthopedics, Dr. Ersin Arslan Education and Research Hospital, Gaziantep, Turkey. E-mail: firstname.lastname@example.org P: +90 5317916686 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4740-9949
Aim: Total knee arthroplasty (TKA) is one of the most successful orthopedic surgeries. To further improve these outcomes, researchers have developed vari- ous types of prosthetics. This study aims to compare the clinical and radiological results of the common posterior cruciate ligament (PCL)-retaining (CR) and PCL-stabilized (PS) knee arthroplasties.
Material and Methods: We retrospectively evaluated the data of patients that were diagnosed with gonarthrosis in our clinic and who underwent knee replace- ment. The patients were evaluated using the American Knee Society score (AKSS) and radiographic assessment.
Results: There were a total of 115 subjects. Fifty-nine knees of 54 patients and 80 knees of 61 patients were included in the study. Forty-six of the 54 patients in the ligament-retaining group were female (86%) and 8 were male (14%). Fifty-two of the 61 patients in the ligament-stabilized group were female (85%) and 8 were male (15%).
The mean age was 67.4 years (54-82) in the ligament-retaining group and 65.4 years (42-85) in the ligament-stabilized group. The mean follow-up time in both groups was 32.6 months (12-98).
Discussion: The comparison of PCL-retaining and PCL-stabilized knee arthroplasties revealed that the ligament-stabilized group was superior in terms of the range of motion. The radiological examination revealed a difference in component alignment. The two groups did not differ significantly regarding other parameters.
Keywords: Knee; Arthroplasty; Prosthesis; PCL; Cruciate
Can the novel inflammatory markers be used in the prediction of Gestational Diabetes Mellitus or to strengthen the screening test?
Deniz Simsek, Yasin Altekin
Department of Obstetrics and Gynecology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
DOI: 10.4328/ACAM.20362 Received: 2020-10-04 Accepted: 2020-11-03 Published Online: 2020-11-15 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):621-625
Corresponding Author: Deniz Simsek, Mimar Sinan Mah. Emniyet Cad. Polis Okulu Karşısı Yıldırım, Bursa, Turkey. E-mail: email@example.com P: +90 224 294 40 00 – 4037 F: +90 224 366 69 25 Corresponding Author ORCID ID: https://orcid.org/0000-0002-0975-9457
Aim: The pathophysiology of Gestational diabetes mellitus (GDM) has not been exposed properly, however, some clues designate the systematic inflamma- tion. New inflammatory markers such as mean platelet volume (MPV), neutrophil- to- lymphocyte ratio (NLR), platelet- to-lymphocyte ratio (PLR), and platelet distribution width (PDW) might play a crucial role in predicting or diagnosing GDM.
In this study, we aimed to evaluate the possible association between the CBC parameters (MPV, PDW, NLR, PLR values) which were sampled on the test day of the glucose challenge test and GDM.
Material and Methods: Pregnant women who underwent 50 gr GCT were evaluated. Among them, patients with an abnormal 100 g oral glucose tolerance test (OGTT), and normal OGTT results were recruited in groups 1 and 2, respectively.Women with normal GCT were included in Group 3 as controls. Patients who had complete hemogram count on the day of GCT or OGTT were reviewed.The MPV, NLR, PLR and PDW parameters were analyzed statistically between groups.
Results: A total of 9819 patients were screened with 50gr GCT over a 3-year period. The distribution of patient numbers within the groups in groups 1, 2, and 3 was 167, 400, and 610 patients, respectively. There was no statistically significant difference between Group 1 and Group 2 for NLR, PLR, Platelet, MPV, PDW, neutrophil, lymphocyte, and hemoglobin (p>0.05). Healthy patients had higher MPV and lower PDW values than patients with GDM, which differed significant.
Discussion: Neither the novel inflammatory markers PLR, and NLR, nor the platelet parameters PDW, and MPV seemed to be beneficial to predict GDM or strengthen the 50g glucose challenge test during the routine screening period. These markers might be related with chronic circumstances, and the usefulness of novel inflammatory markers might be revealed in the near future.
Keywords: Inflammation marker; Neutrophil-to-lymphocyte ratio, Mean platelet volume; Gestational diabetes mellitus; Platelet-to-lymphocyte ratio; Platelet distribution width
Evaluation of “white code” notifications at the training and research hospital between 2015 and 2019
Mustafa Çalık 1, Melike Mercan Başpınar 2, Serpil Soyudoğru 1
1 Department of Emergency Medicine University Of Health Sciences Gaziosmanpasa Training And Research Hospital, 2 Department of Family Medicine University Of Health Sciences Gaziosmanpasa Training And Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.20364 Received: 2020-10-06 Accepted: 2020-11-07 Published Online: 2020-11-20 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):626-632
Corresponding Author: Mustafa Çalık, Department of Emergency Medicine, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, Osmanbey Street, 621 Street, 34255, Gaziosmanpaşa, İstanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 2129453000 Corresponding Author ORCID ID: http://orcid.org/0000-0002-3184-2943
Aim: This study has been carried out as part of the activities to define Workplace Violence (WPV) based on the white code system according to age, gender, types, sources, time-periods, and groups in health care professionals (HCPs). The white code notification is a government support system including a web ad- dress, a call center serving all day, and free legal support for HCPs.
Material and Methods: A retrospective data-based study was realized by including 316 white code notifications at Gaziosmanpaşa Training and Research Hospital in Istanbul, Turkey, between January 3, 2015 and January 1, 2019. The statistical significance level of tests was accepted as p<0.05 using statistical software SPSS version 22.
Results: Samples consisted of 316 (mean age=31 ±6.8 years) HCPs (49% male, 51% female) who were reported in white code applications for four years. WPV was distributed as doctors in 160/316 (50.6%), nurses in 65/316 (20.6%), security personal in 50/316 (15.8%), secretary in 29/316 (9.2%) cases respectively. Nurses and medical secretaries exposed to violence aged under 30 years had a significantly higher rate than those aged ≥30 years old (p=0.002). The highest prevalence of violence in the hospital was in polyclinic rooms (66.5%). Distribution of WPV based on departments was as follows: emergency medicine (36.4%), pediatrics (16.5%), and internal medicine (7.3%). In this study, the most common type of violence was insult plus verbal threat (39.6%) and the most common reason was the waiting-line problem (21.8%). WPV was highest in the summer season (30.4%), around 12:00-16:00 hours (28.2%), and peaked in September (10.8%) and December (10.8%). WPV was shown increased in 2018 (31.6%) than that of 2015 (19.9%), 2016 (24.1%), and 2017 (24.4%) especially in doctors (p=0.002) and female HCPs (p<0.001).
Discussion: The results of this research show the importance of increasing white code cases, especially the percentage of doctors and female HCPs. The impli- cations of this study are expected to provide feedback in describing increased WPV to health workers. Institutions should train staff to handle violence, provide a therapeutic environment, simplify the reporting process, and encourage reporting of all types of violence.
Keywords: White code; Health care professionals; Workplace violence
The effect of bilateral and unilateral knee arthroplasty under regional anesthesia on ischaemia-modified albumin and thiol/disulphide homeostasis
Seyda Efsun Ozgunay 1, Sermin Eminoglu 1, Nazan Cevik 2, Yasemin Ustundag 3, Mehmet Gamli 1, Zeynep Tabur 4, Umran Karaca 1, Derya Karasu 1, Canan Yilmaz 1, Ozcan Erel 5
1 Department of Anesthesiology and Reanimation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, 2 Department of Orthopedics and Traumatology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, 3 Department of Medical Biochemistry, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, 4 Department of Anesthesiology and Reanimation, Bursa City Hospital, Bursa, 5 Department of Medical Biochemistry Laboratory, University of Health Sciences Ankara Yıldırım Beyazıt Research and Education Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.20365 Received: 2020-10-06 Accepted: 2020-11-04 Published Online: 2021-02-09 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):633-637
Corresponding Author: Seyda Efsun Ozgunay, Department of Anesthesiology and Reanimation, Bursa Yuksek Ihtisas Training and Education Hospital, Mimar Sinan Street Yildirim, 16290, Bursa, Turkey. E-mail: email@example.com P: +90 5359723603 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1501-9292
Aim: Tourniquet application in extremity surgery causes ischemia-reperfusion injury. An increase in ischemia-modified albumin level is an early indicator of ischemia. The aim of this study is to investigate the effect of bilateral and unilateral total knee arthroplasty on the oxidation parameters and ischemia- modified albumin level, and thiol/disulfide homeostasis.
Material and Methods: A total of 57 patients who underwent knee arthroplasty were included in the study. Patients were divided into two groups: group 1 with unilateral knee arthroplasty (n=33) and group 2 with bilateral knee arthroplasty (n=24). Sociodemographic features, ischemia-modified albumin levels, and thiol/disulphide homeostasis were evaluated.
Results: Ischemia-modified albumin levels at the 5th minute and 24th hour were significantly higher in the bilateral arthroplasty group compared to its pre- operative level (p=0.001 and p=0.01, respectively). In the unilateral group, ischemia-modified albumin was significantly higher only in postoperative 24th hour compared to preoperative levels (p=0.012). In the intergroup comparison, only the ischemia modified albumin value at 5 minutes was high in the bilateral group (p=0.002). The hospital stay in Group 2 was significantly longer than that of patients in Group 1 (p=0.035).
Discussion: In cases of bilateral knee arthroplasty with spinal-epidural anesthesia, preoperative thiol/disulfide homeostasis parameters and ischemia-modified albumin values did not differ at the postoperative 24th hour.
Keywords: Regional anesthesia; Knee arthroplasty; Bilaterally; Modified albumin; Thiol
Investigation of the effect of smoking on depression and stress in healthcare workers during a pandemic
Öztürk Taşkın, Ufuk Demir, Veysel Garani Soylu
Department of Intensive Care Unıt, Kastamonu Training and Research Hospital, Kastamonu, Turkey
DOI: 10.4328/ACAM.20367 Received: 2020-10-09 Accepted: 2020-11-14 Published Online: 2020-11-25 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):638-641
Corresponding Author: Öztürk Taşkın, Kastamonu Training and Research Hospital Intensive Care Unıt, Centrum, 37150, Kastamonu, Turkey. E-mail: firstname.lastname@example.org P: +90 5076424188 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7328-9579
Aim: In the COVID-19 pandemic, healthcare workers suffer from significant stress and anxiety disorders. The importance of smoking in the mortality and mor- bidity of COVID-19 disease is obvious. In this study, we aimed to investigate the effects of smoking on depression and perceived stress in healthcare workers who served at the forefront during the pandemic period.
Material and Methods: In our study, participants were asked questions on the Depression Severity Scale (PHQ-9), the Perceived Stress Scale (PSS 14), and the Fagerström Test for Nicotine Dependence (FTND) using aquestionnaire method, and the results were evaluated.
Results: Depression and stress symptoms were most often found in the healthcare workers included in our study. However, there was no statistically significant difference in depression and perceived stress scale between smoking and non-smoking groups.
Discussion: Previous studies have demonstrated that smokers are more affected by COVID-19 and that their morbidity rate is higher. Because of this informa- tion, smoking healthcare professionals are more symptomatic in terms of mental health disorders, but no statistical difference was reported between smokers and non-smokers in this study in terms of being symptomatic. Although smoking was revealed as a comorbidity for COVID-19, there was no significant differ- ence between smoking and non-smoking healthcare professionals in terms of mental health disorders.
Keywords: Smoker; COVID-19; Depression; Stress; Healthcare workers
Effectiveness of aflibercept treatment after dexamethasone in macular edema caused by branch retinal vein occlusion: Case series
Department of Ophthalmology, Hitit University Medicine Faculty, Corum, Turkey
DOI: 10.4328/ACAM.20371 Received: 2020-10-11 Accepted: 2020-11-18 Published Online: 2020-11-26 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):642-646
Corresponding Author: Tayfun Şahin, Hitit University Medicine Faculty, Department Of Ophthalmology, 019030 Corum, Turkey. E-mail: email@example.com P: +90 506 328 4338 F: +90 364 713 0101 Corresponding Author ORCID ID: https://orcid.org/0000-0003-2319-0807
Aim: This study aims to assess the effectiveness of aflibercept in patients with macular edema caused by Branch Retinal Vein Occlusion following dexametha- sone implant treatment.
Material and Methods: This study included treatment-naive 20 eyes of 20 patients. At baseline and follow-ups, the patients’ Best Corrected Visual Acuity, the Central Macular Thickness and Central Macular Volume measures taken with Spectral-Domain Optical Coherence Tomography were recorded. The patients who had deterioration of visual acuity or macular thickness ≥ 300 were administered intraocular injection again. Recurrent cases following dexamethasone injection were administered aflibercept injection three times with an interval of one month.
Results: Compared to the baseline, the patients demonstrated an increase in visual acuity and a decrease in macular thickness and macular volume following the dexamethasone injection ( p=0.013, p=0.009, p=0.021, respectively). In an average of three and half months after the injection, there was a decrease in visual acuity (0.90 ± 0.44 logMAR), an increase in macular thickness (579 ± 107 μm) and macular volume (12.25 ± 1.55 mm3) (p>0.05 all). Three months after the the completion of three aflibercept injections, there was no deterioration in visual acuity (0.41 ± 0.23 logMAR) according to the recurrence time of macula edema (p=0.048). Macular thickness (288 ± 47 μm) and macular volume (8.59 ± 0.96 mm3) values demonstrated nonsignificant increases (p>0.05).
Discussion: Aflibercept treatment is effective in recurrence following the Dexamethasone treatment in macula edema caused by branch retinal vein occlusion.
Keywords: Aflibercept; Combination treatment; Dexamethasone; Macular edema; Vein occlusion
Investigation of the effect of surgical menopause on physical, psychosocial and cognitive functions in women
Rabia Oz 1, Nesrin Yagcı 2
1 Fizyo Vital Physical Therapy and Wellness Counseling Center, 2 Pamukkale University School of Physical Therapy and Rehabilitation, Denizli, Turkey
DOI: 10.4328/ACAM.20372 Received: 2020-10-12 Accepted: 2020-11-26 Published Online: 2020-12-07 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):647-652
Corresponding Author: Nesrin Yagci, Pamukkale University, School of Physical Therapy and Rehabilitation, Kinikli Campus, 20100 Denizli, Turkey. E-mail: firstname.lastname@example.org P: +90 258 2964266 F: +90 258 2964494 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5669-4932
Aim: This study was planned to examine the effects of surgical menopause on physical, psychosocial and cognitive functions.
Material and Methods: The study included 25 women aged 40-54 years. The participants consisted of healthy individuals who have not yet entered meno- pause, who have been diagnosed with surgical menopause and who were literate. Before surgical menopause, all participants were assessed using a form including demographic information for demographic data; 5 times sit to stand test, sit and reach test, half squat test, hand grip strength measurement test, Visual Analogue Scale for physical functions; Perceived Stress Scale, Center for Epidemiological Study Depression Scale, Hamilton Anxiety Rating Scale, Women’s Health Initiative Insomnia Scale for psychosocial functions; and Montreal Cognitive Assessment Scale for cognitive functions. All participants were reevaluated after 3 months of surgical menopause.
Results: The mean age of the participants was 45.96±4.26 years and the mean body mass index was 30.57±4.50 kg/cm2. In physical function tests, psychoso- cial functions, cognitive functions there was no statistically significant difference between the pre- and postoperative test results of the participants (p>0.05). The decrease in spinal pain intensity of the participants was statistically significant compared to the preoperative period (p<0.05). After surgery, the partici- pants’ scores on the CES-Depression Scale were decreased and the difference was statistically significant (p<0.05).
Discussion: After surgical menopause, participants’ depression levels and spinal pain improved. Surgical menopause did not affect the participants’ other physical, psychosocial and cognitive functions of.
Keywords: Pain, Cognitive dysfunction, Menopause
Results of surgical treatment with proximal femur nail in adult femur pertrochanteric fractures
Emre Ergen 1, Mustafa Karakaplan 1, Bünyamin Arı 2, Okan Aslantürk 3, Özgür Yılmaz 3, Erkay Nacar 4
1 Department of Orthopaedics and Traumatology, Inonu University Medical School, Malatya, 2 Department of Orthopaedics and Traumatology, Ankara Yenimahalle Training and Research Hospital, Ankara, 3 Department of Orthopaedics and Traumatology, Malatya Training and Research Hospital, Malatya, 4 Department of Public Health, Karabuk Provincial Directorate of Health, Karabük, Turkey
DOI: 10.4328/ACAM.20373 Received: 2020-10-15 Accepted: 2020-11-14 Published Online: 2020-11-24 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):653-657
Corresponding Author: Emre Ergen, Inonu University Medical School, Orthopaedics and Traumatology Department, Malatya, Turkey. E-mail: email@example.com P: +90 537 764 71 68 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6452-2401
Aim: Proximal femoral nails are widely used in the treatment of pertrochanteric fractures, as they can be applied in a shorter time and with less bleeding, with their more stable biomechanical properties during axial loading. In this retrospective study, conducted in our institution, we aimed to determine the effective- ness of PFN, especially in various osteoporotic conditions, mental health conditions, anesthesia risk, functional outcomes and mortality
Material and Methods: Functional and radiologic results of 109 consecutive patients with intertrochanteric femur fractures, who have undergone osteosynthe- sis with proximal femoral nail between October 2009 and January 2015, were examined retrospectively. In addition to demographic characteristics, the type of fracture, comorbidities, type of trauma, duration from the moment of fracture to surgery, surgery duration and complications, presence of union and position of the implant were evaluated clinically and radiologically. The American Society of Anesthesiologists (ASA) scale was used for surgical risk assessment. The Harris Hip Scoring System was used for functional evaluation.
Results: Fifty-nine patients were male and 50 were female. The mean age was 77,69 (17 -102) years. The mean follow-up time was 32,9 (12-61) months. The etiology was as follows: a simple fall in %89.9 of cases, a fall from height in %7,3 of cases and motor vehicle accidents in %1,8. Operative procedures were performed within an average of 3,54 days after admission to our hospital (range 0-17 days). The average length of hospital stay was 7,76 days (range 2-56 days). Nine patients had complications related to the fracture. The mean score on the Harris scale at the last follow-up was 79,6 (48-100). The mortality rate in the first year was %29,6. A high ASA score and age over 80 years were found to generate a statistically significant increase in the risk of mortality and poor functional outcome.
Discussion: Pertrochanteric fractures are usually diagnosed in elderly patients due to low energy traumas. The first choice of treatment must be surgical for an early return to pre-fracture activity levels. The proximal femoral nail is a reliable, safe and effective treatment method for pertrochanteric fractures due to its advantages such as application with closed reduction, providing anatomic and biological fixation, short surgical time, low blood loss and complication rate, and the possibility of early weight-bearing.
Keywords: Intertrochanteric fractures; Proximal femoral nail; Harris hip score
Investigation of factors affecting musculoskeletal pain and quality of life in university students
Fatih Tekin, Feride Yarar
School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
DOI: 10.4328/ACAM.20374 Received: 2020-10-15 Accepted: 2020-11-14 Published Online: 2020-11-26 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):658-662
Corresponding Author: Fatih Tekin, Pamukkale University, School Of Physical Therapy And Rehabilitation, Denizli, Turkey. E-mail: firstname.lastname@example.org P: +90 258 296 4264 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7829-7957
Aim: In this study, we aimed to examine the factors affecting musculoskeletal pain and quality of life in university students experiencing musculoskeletal pain.
Material and Methods: Two hundred-eighteen (F:120; M:98) (X=21.22±1.9) university students studying at Pamukkale University School of Physical Therapy and Rehabilitation were included in the study. Due to the Covid-19 pandemic, the study was conducted over the phone and online. The correlation between the Cornell Musculoskeletal Discomfort Scale and the Nottingham Health Profile with gender, age, BMI, smoking habit, exercise habit, and time spent in front of a desk-computer-TV was examined.
Results: Age parameter was correlated with back musculoskeletal pain in the trunk region (p<0.05). Body Mass Index parameter was correlated with back, lower back and shoulder musculoskeletal pain (p<0.05). Smoking habit was found to be correlated with musculoskeletal pain in the right hand and wrist (p<0.05). Exercise habits were found to be correlated with musculoskeletal pain in all regions except both hands and wrists and both lower legs (p<0.05). There was a correlation between time spent sitting at the desk-computer-TV and musculoskeletal system pains in the neck, back, low back, shoulder and hip (p<0.05). Qual- ity of life was moderately correlated with smoking habits (p<0.05) and was positively correlated with exercise habits (p<0.05). Significant correlations were found between the duration of sitting at the desk-computer-TV and the quality of life parameters (p<0.05).
Discussion: University students suffer from musculoskeletal pain due to a relatively intense training program based on practice and some harmful habits, and their quality of life is negatively affected by this situation. Students should take precautions to protect their musculoskeletal systems and gain regular exercise habits.
Keywords: College students; Musculoskeletal pain; Quality of life
The effects of intravitreally injected dexamethasone implant and anti-VEGF on macular edema due to retinal vein occlusion
Aydin Yıldız, Sedat Arıkan
Department of Ophthalmology, Onsekiz Mart University, Canakkale, Turkey
DOI: 10.4328/ACAM.20378 Received: 2020-10-23 Accepted: 2020-11-23 Published Online: 2020-12-01 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):663-666
Corresponding Author: Aydin Yildiz, Department of Ophthalmology, School of Medicine, Canakkale Onsekiz Mart University, Barbaros Street, 17100, Canakkale, Turkey. E-mail: email@example.com P: +90 533 559 5252 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0396-5900
Aim: In this study, we aimed to investigate the efficacy of intravitreal treatment modalities for macular edema secondary to central retinal vein occlusion (CRVO) and branchial retinal vein occlusion (BRVO).
Material and Methods: A total 58 patients with macular edema secondary to CRVO and BRVO were included in this retrospective study. The patients followed up between 2012 and 2018 were subjected to either intravitreal dexamethasone (DEX) implant injection (Group 1), or intravitreal anti-vascular endothelial growth factor (anti-VEGF) containing ranibizumab injection (Group 2). Additionally, the patients who received the combination of intravitreal DEX and anti- VEGF treatment (Group 3) were also assessed in this study. The degree of central macular thickness (CMT) using optical coherence tomography, and best -corrected visual acuity (BCVA) levels were evaluated in all groups before and after treatment.
Results: CRVO and BRVO were present in 12 and 46 patients, respectively, and the mean follow- up time was 38 months. The mean CMT values measured in pretreatment vs. posttreatment period in Group 1, Group 2 and Group 3 were 448±41.3μm vs.217.7±15.9μm (p<0.05), 492±38.5μm vs.249.3±13.8μm (p<0.05), and 562.5±85.7μm vs.330.3±55.9μm (p<0.05), respectively. Regarding the comparison of BCVA levels measured in the pretreatment vs. postreatment period, there was a statistically significant increase in all groups as follows: 0.8±0.08 logMAR vs. 0.4±0.08 logMAR (p<0.05) in Group 1, 0.9±0.1 logMAR vs. 0.3±0.05 logMAR ( p<0.05) in Group 2, and 1.6±0.3 logMAR vs. 0.5±0.1 logMAR( p<0.05) in Group 3.
Discussion: The intravitreal injection treatments with either dexamethasone implant or anti-VEGFs can have a potential effects on the resolution of macular edema secondary to BRVO. Moreover, their combination can be beneficial for the persistent macular edema arising from CRVO.
Keywords: Retinal vein occlusion; Intravitreal injections; Dexamethasone implant; Aflibercept; Ranibizumab
Imatinib Mesylate induces apoptosis in chronic myeloid leukemia cells by triggering nitric oxide production
Aynur Karadağ Gürel 1, Tülin Özkan 2, Buket Altınok Güneş 3, Asuman Sunguroğlu 2, Fügen Aktan 4
1 Department of Medical Biology, School of Medicine, Usak University, Usak, 2 Department of Medical Biology, School of Medicine, Ankara University, Ankara, 3 Medical Laboratory Techniques, Vocational School of Health Services, Ankara University, Ankara, 4 Department of Biochemistry, Faculty of Pharmacy, Ankara University, Ankara, Turkey
DOI: 10.4328/ACAM.20379 Received: 2020-11-02 Accepted: 2020-11-30 Published Online: 2020-12-12 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):667-671
Corresponding Author: Aynur Karadağ Gürel, Usak University, Faculty of Medicine Dean’s Office 4th Floor, 64200, Usak, Turkey. E-mail: firstname.lastname@example.org P: +90 276 221 21 21-6240 GSM: +90 5326821113 F:+90 276 221 22 34 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5499-5168
Aim: Chronic Myeloid Leukemia (CML) is a myeloproliferative disease characterized by abnormal clonal proliferation of hematopoietic stem cells. The over- production of nitric oxide (NO) causes reactive oxygen species and subsequent oxidative stress to cell toxicity. The production of factors such as nitric oxide (NO) and reactive oxygen species (ROS) in the cell and/or tissue environment affects the behavior of normal cells and cancer cells. In this study, we aimed to investigate the effects of nitric oxide formed as a result of Imatinib Mesylate (STI571, Gleevec®) metabolism on cell death.
Material and Methods: 32D (Control) and 32DP210 Cells were treated with 10um of Imatinib Mesylate for 24, 48 and 72 hours. Methyl tetrazolium assay (MTT) was used for cell viability. Griess assay and capillary electrophoresis were used to measure Imatinib Mesylate -mediated NO production. The number of cells leading to apoptosis was calculated by counting 1000 cells and compared with the amount of NO. Statistical analysis of the obtained data was done with SPSS for Windows statistical package program.
Results: The presence of NO is important for increased cell death in the cell culture medium. Imatinib mesylate concentrations administered to healthy and CML groups increased intra cell NO levels by a significant amount in Bcr-Abl+ CML cell lines. The production of NO per apoptotic body is decreased during the apoptosis, and analysis of NO production using CE in these cells has rapid and efficient separation ability.
Discussion: As a result, knowing the molecules and effects regulating NO activity better appears to be a target point to remove many irregularities of these molecules. Sensitive detection of these metabolic products is important as variations in NO levels in many diseases provide information about development of diseases and treatment.
Keywords: Chronic myeloid leukemia; Imatinib mesylate (STI571, Gleevec); Nitric oxide; Capillary electrophoresis; Apoptosis
Evaluation of the effect of COVID-19 disease on ventricular density using computer tomography
Pinar Gundogan Bozdag 1, Gulden Eser Karlıdag 2
1 Clinic of Radiology, Fethi Sekin City Hospital, 2 Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Fethi Sekin City Hospital, Elazig, Turkey
DOI: 10.4328/ACAM.20381 Received: 2020-10-24 Accepted: 2020-11-23 Published Online: 2020-12-03 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):672-675
Corresponding Author: Pınar Gundogan Bozdag, Fethi Sekin City Hospital, Clinic of Radiology, Elazig,Turkey. E-mail: Pbozdag23@gmail.com P: +90 532 137 7622 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7303-5832
Aim: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a novel coronavirus identified at the end of 2019. Radiological examinations, espe- cially thorax Computed Tomography (CT), play an important role in the fight against this infectious disease. In this study, we aimed to analyze the effect of COVID-19 disease on the cardiac ventricles by measuring density on CT.
Materials and Methods: Patients who underwent thorax CT with a pre-diagnosis of COVID-19 and whose Polymerase Chain Reaction (PCR) test was positive, and patients who underwent CT for any reason were included in the study. Among 270 patients included in the study, 147 were men, 123 were women, and the mean age was 45.5 (29.2-62) years. The patients with a positive PCR test were divided into three groups. The control group and the three groups were compared with each other in terms of age, gender, CTR, right and left ventricular density.
Results: In both studies, a significant difference was found between the groups in terms of age (p<0.005). There was no significant difference between Group 1 and Group 3 in terms of age, right and left ventricular density, and CTR (p>0.005).
Discussion: In patients with COVID-19, cardiovascular comorbidities are common. Therefore, early diagnosis will boost the effectiveness of treatment. Consid- ering the severity of the disease and the primary focus on managing infection and respiratory failure, not all patients have complete cardiac data and imaging results are not available. Ventricular density and CTR measurements on CT did not yield significant results in COVID-19 patients. However, we think that more patients and appropriate imaging will yield important results, as previous studies have shown the impact of COVID-19 disease on the cardiovascular system.
Keywords: COVID19; Tomography; Cardiomyopathies; Cardiac ventricles
Reasons for transition to open surgery in laparoscopic cholecystectomy
Mustafa Şentürk, Murat Çakır, Mehmet Biçer, Mehmet Aykut Yıldırım
Department of General Surgery, Necmettin Erbakan University Meram faculty of medicine, Konya, Turkey
DOI: 10.4328/ACAM.20382 Received: 2020-10-24 Accepted: 2020-11-25 Published Online: 2020-12-07 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):676-679
Corresponding Author: Mustafa Şentürk, Department of General Surgery, Necmettin Erbakan University Meram Medicine Faculty, Konya, Turkey. E-mail: email@example.com P: +90 5362029499 Corresponding Author ORCID ID: https://orcid.org/0000-0002-3230-1743
Aim: Laparoscopic cholecystectomy is a minimally invasive surgical technique that has become widespread since the 1980s. Many factors are effective in the conversion to open surgery. This study aimed to investigate the rates and reasons for the conversion to open in laparoscopic cholecystectomy surgeries in our hospital.
Material and Methods: This study aimed to examine 3263 cholecystectomy cases with the conversion to open during surgery between June 2014 and June 2019. Patients were examined in terms of age, sex, comorbidities, acute cholecystitis attack status, previous surgery, adhesion, gallbladder wall thickness, revealing surgical anatomical structure, surgical complications, length of hospital stay, and mortality. The results were evaluated statistically.
Results: Data of 70 patients, who were performed laparoscopic cholecystectomy with the conversion to open surgery during the procedure, were reviewed. The conversion rate was 2.3%. Among the patients, 28 were female and 42 were male. Sixty-two of the patients had an episode of acute cholecystitis. The most common reason for the conversion was that the anatomy could not be revealed.
Discussion: It should be kept in mind that laparoscopic cholecystectomy surgery, which is interpreted as a simple surgical procedure, can always be converted to an open surgery and there may be vital complications.
Keywords: Laparoscopic cholecystectomy; Complication; Conversion to open
The effect of body composition on prognosis in critically ill COVID-19 patients
Ismail Beypinar 1, Murat Bayav 2, Anil Ucan 3, Serdar Efe 4
1 Department of Medical Oncology, Eskişehir City Hospital, 2 Department of Radiology, Eskişehir City Hospital, 3 Department of Internal Medicine, Eskişehir City Hospital, 4 Department of Intensive Care, Eskişehir City Hospital, Eskişehir, Turkey
DOI: 10.4328/ACAM.20383 Received: 2020-10-25 Accepted: 2020-11-24 Published Online: 2020-12-05 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):680-684
Corresponding Author: Murat Bayav, Eskişehir City Hospital, Department of Radiology, Eskişehir, 26080, Turkey. E-mail: firstname.lastname@example.org P: +90 5356171747 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8210-4182
Aim: Although limited risk factors were observed with the accumulated evidence during the SARS-CoV-2 (COVID-19) pandemic, there is still a lack of evidence for markers distinguishing asymptomatic-mild disease from severe disease. In this study, we aimed to evaluate the prognostic impact of sarcopenia and vis- ceral adipose tissue in ICU patients treated for COVID-19.
Material and Methods: The study designed as a retrospective cross-sectional study for evaluating the effect of prognostic radiologic features in COVID-19 infected patients. The patient characteristics, intubation status and dates, transfer to ICU, and last control or death dates were recorded. Axial CT images, including all abdominal muscles, total skeletal muscle area, were calculated. The total and psoas sarcopenia index (PSI) was calculated by dividing the square of the patient’s height by the square meter (cm2/m2). Also, axial CT images of the body fat subcutaneous adipose and visceral adipose tissue distribution areas were calculated in cm2 using threshold values of -30 to -190 for adipose tissue.
Results: In the study population, there were nine deaths that occurred among male patients. In univariate analysis, chronic obstructive pulmonary disease and PSI were found to be related to prognosis. The median survival was 14 days in PSI low group. The prognostic effect of the PSI was still valid in the male population. Other factors had no relationship with survival in univariate analysis. In multivariate analysis, the prognostic effect of TSI and PSI was related to prognosis, while COPD lost its prognostic effect.
Discussion: In this study, we found a new prognostic factor in critically ill COVID-19 patients, which may be a new area of interest. In contrast to other studies, we found no effect of BMI and visceral adipose tissue on mortality in COVID-19 patients treated in ICU. This feasible method needs further evaluation and validation with prospective studies in a large patient population.
Keywords: COVID-19; Mortality; Sarcopenia; Visceral adipose tissue; Prognosis; Critically ill patients
Angiogenic factors and evaluation of vascular status in preeclampsia
Şerif Aksin 1, Numan Çim 2, Hanım Güler Şahin 3, Deniz Balsak 4
1 Department of Obstetrics and Gynecology, Siirt University Faculty of Medicine, Siirt, 2 Department of Obstetrics and Gynecology, Istanbul Bilim University Faculty of Medicine, Istanbul, 3 Department of Obstetrics and Gynecology, Yuzuncu Yıl University Faculty of Medicine, Van, 4 Department of Obstetrics and Gynecology, Batı Hospital, Diyarbakır, Turkey
DOI: 10.4328/ACAM.20577 Received: 2021-03-09 Accepted: 2021-05-12 Published Online:2021-05-27 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):685-689
Corresponding Author: Şerif Aksin, Department of Obstetrics and Gynecology, Siirt University Faculty of Medicine, Siirt, Turkey. E-mail: email@example.com P: +90 5052774937 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1301-2508
Aim: The aim of this study was to measure serum levels of the angiogenic factors nitric oxide (NO), soluble endoglin (s Eng), soluble fms-like tyrosine kinase-1 (s Flt-1), placental-derived growth factor (PIGF) and vascular endothelial growth factor (VEGF) and to measure uterine and umbilical arterial blood flow using Doppler ultrasonography to investigate the physiopathology of preeclampsia and endovascular dysfunction by comparing brachial artery dilatation and the thickness of the carotid artery with normal pregnant women.
Material and Methods: Forty pregnant women with preeclampsia and 40 healthy pregnant women (control group) were recruited for the study in April 2011 and October 2011 at Van Yuzuncu Yil University. Systolic and diastolic blood pressure, urinary protein in spot urine samples, complete blood counts, aspartate transaminase (AST), alanine aminotransferase (ALT) levels of sEng, sFlt-1, VEGF, PIGF and NO, and APGAR scores at one and five minutes after birth were recorded and compared in all patients. Intima-media thickness of the carotid artery, brachial artery dilatation and umbilical artery Doppler parameters of all pregnant women were assessed and recorded.
Results: When compared to the control group, systolic and diastolic blood pressures urinary protein in spot and 24-hour urine collection, levels of AST, ALT and sFlt-1, and uterine artery Doppler parameters were significantly higher, whereas VEGF, platelet count and APGAR scores at one and five minutes after birth were lower in the preeclampsia group (p<0.001). Brachial artery dilatation before obstruction was found to be insignificant in both groups, while post- obstructive dilatation was found to be significantly higher in the control group.
Discussion: Uterine artery Doppler evaluation, assessment of brachial artery dilatation and measurement of VEGF and sFlt-1 levels seem to be useful in pre- eclampsia.
Keywords: Angiogenic; Preeclampsia; Vascular; Brachial Artery; Nitric Oxide
Beta-catenin or Pax 2. Which one is more useful in endometrial cancer?
Department of Pathology, TOBB Economics and Technology University School Of Medicine, Ankara, Turkey
DOI: 10.4328/ACAM.20691 Received: 2021-05-05 Accepted: 2021-05-27 Published Online: 2021-05-31 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):690-693
Corresponding Author: Devrim Kahraman, TOBB economics and technology university school of medicine, Department of Pathology, TOBB Hospital Ankara Yasam caddesi no:5 pk:06510 Söğutozu/Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 5055250295 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9858-9252
Aim : Pax 2 is a nuclear transcription factor. It is essential for the embryonic development of Müllerian organs and is suppressed through at later stages of embryonic development, but is reactivated during carcinogenesis. Beta- catenin is a protein that is translocated from membrane to cytoplasm and nucleus in WNT activation as a signaling pathway. Endometrioid carcinoma is associated with beta- catenin mutations. This study aimed to evaluate PAX2 and Beta- catenin expressions in benign and precancerous endometrial hyperplasias.
Material and Methods: The study was performed on 40 endometrial curettage materials, including benign endometrial hyperplasia (n: 20), precancerous en- dometrial hyperplasia (n: 10), and endometrioid carcinoma (n: 20) as study groups. For immunohistochemical evaluation, one representative paraffin block for each case was selected.
Results: Pax 2 nuclear staining was detected in all endometrial tissues. The mean percentage was % 70 in benign hyperplasia and % 90 in precancerous endo- metrial hyperplasia and endometrioid carcinoma. Beta- catenin membranous-cytoplasmic staining was detected in only precancerous endometrial hyperplasia with a percentage of % 80 and endometrioid carcinoma with a percentage of % 90.
Discussion: Pax 2 is expressed in benign endometrial hyperplastic, precancerous endometrial hyperplasia and carcinoma, but beta catenin is expressed in only precancerous endometrial hyperplasia and carcinoma. These findings suggest that both the WNT signaling pathway and PAX 2 transcription factor may contribute to the development of endometrial cancer.
Keywords: Cancer Precursor; Endometrial Hyperplasia; Endometrioid Carcinoma; Cancer Biomarkers
The association between dietary protein intake and depression among university students
Gokce Cakmak Kafadar, Selma Fırat, Suheyla Tekın, Selin Esen
Department of Nutrition and Dietetics, Kırklareli University School of Health, Kırklareli, Turkey
DOI: 10.4328/ACAM.20704 Received: 2021-05-12 Accepted: 2021-05-24 Published Online: 2021-06-02 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):694-698
Corresponding Author: Gokce Cakmak Kafadar, Kırklareli University School of Health, Department of Nutrition and Dietetics, 39060, Kırklareli / Turkey. E-mail: email@example.com P: +90 288-214-55-47 F: +90 288- 214-70-86 Corresponding Author ORCID ID: https://orcid.org/0000-0002-0364-1546
Aim: Depression, a chronic disease, affects approximately 322 million people worldwide. The results of studies examining the relationship between depression and consumption of milk and dairy products and protein are unclear. The aim of this study was to examine the relationship between healthy university students’ milk and milk products and protein intake and depression.
Material and Methods: This cross-sectional study was conducted with 1444 healthy university students aged 18-39 in Kırklareli in 2019. The data consisting of the Food Frequency Questionnaire (FFQ), Beck Depression Inventory, and anthropometric measurements were collected by dietitians.
Results: According to the results of the study, the daily dietary protein intake (g) and the energy from protein (%) differed significantly between participants with and without symptoms of depression (p <0.01). Depression scores and protein intake of participants, and energy from dietary protein (%) are inversely correlated (p<0.05, p<0.001, respectively). According to the regression analysis results, a negative association was found between the Beck depression score and the dietary protein percentage (p <0.001).
Discussion: In our study, it was concluded that increasing the amount of protein in the diet can reduce the risk of depression in healthy university students. It is necessary to pay attention to the energy of the diet from protein in places that provide food service systems (canteen, university cafeteria, dormitory cafeteria, etc.) where university students eat.
Keywords: Depression; Dietary Intake; Protein; Milk; Dairy Products
Comparison of the clinical results of closed intramedullary nailing in femoral shaft fractures between 1997-1999 and 2015-2019
Bedrettin Akar, Mucahid Osman Yücel
Department of Orthopedics and Traumatology, Sakarya Yenikent State Hospital, Kocaeli, Turkey
DOI: 10.4328/ACAM.20712 Received: 2021-05-22 Accepted: 2021-05-27 Published Online: 2021-06-02 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):699-703
Corresponding Author: Bedrettin Akar, Department of Orthopedics and Traumatology, Sakarya Yenikent State Hospital, 41000, Yenidoğan, İzmit Kocaeli, Turkey. E-mail: firstname.lastname@example.org P: +90 532 2089652 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7461-1777
Aim: In this study, we aimed to show the changes in treatment principles and factors affecting healing by comparing the previous clinical results of the ante- grade closed intramedullary nail (AСIMN) application with the current clinical results in the treatment of Femoral Shaft Fractures (FSF).
Material and Methods: Patients who underwent AСIMN due to FSF were named Group A (years 1997-1999) and Group B (years 2015-2019). Group A consisted of 25 patients, with a mean age of 41 years, and a mean follow-up of 29.1 months. Group B consisted of 17 patients, with a mean age of 51 years, and a mean follow-up of 22.3 months. Patients with pathological fractures, polio sequelae, cerebral palsy and pelvic fractures were excluded from the study. The clinical length of stay and operation processes of the groups were followed. Evaluations were made according to Thoresen criteria.
Results: In Group A, it was observed that union was sufficient in the clinical and radiological examinations of 17 patients who came for control. In Group B, of the 15 patients, 13 had complete union and 2 patients had delayed union. The mean between operation and trauma (days) in Group A was found to be significantly higher than in Group B (p = 0.0001). The mean operation time (min) in Group A was found to be significantly lower than Group B (p = 0.0001). No significant difference was observed between the Thoresen criteria distributions of both groups (p = 0.52).
Discussion: The AСIMN technique continues to be the preferred method in FSF. While there were no significant changes in etiology, frequency and treatment principles, improvements were observed in the structure, design and locking methods of implant materials. Significant improvements were observed in the preoperative waiting periods and operation times of the patients. We can attribute these developments to improved clinical conditions and increased surgical experience. Despite all the developments, there was no significant difference in the basic principles of the surgical technique and clinical results. We think that more comprehensive studies using different treatment modalities and more patient numbers are needed in the future.
Keywords: Femoral Fractures; Nailing; Intramedullary Nailing; Osteosynthesis
Spontaneous extensor pollicis longus (EPL) tendon rupture after ironing
Serdar Karaman 1, Muhammed Köroğlu 2, Zeynep Maraş Özdemir 3, Kadir Ertem 1
1 Department of Orthopedics and Traumatology, Medicine Faculty of İnönü University, Malatya, 2 Kilis State Hospital, Kilis, 3 Department of Radiology, Medicine Faculty of İnönü University, Malatya, Turkey
DOI: 10.4328/ACAM.20386 Received: 2020-10-29 Accepted: 2020-12-01 Published Online: 2020-12-11 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):704-707
Corresponding Author: Serdar Karaman, Department of Orthopedics and Traumatology, Medicine Faculty of İnönü University, 44280, Battalgazi, Malatya, Turkey. E-mail: email@example.com P: +90 5373040091 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5546-3649
Spontaneous tendon ruptures can occur rarely. Distal radius fractures, steroid applications and systemic diseases are mostly attributed to its etiology. In the treatment of spontaneous tendon ruptures, primary repair is not possible and tendon transfer is often required. The EPL tendon is the main extensor of the thumb. This muscle originates from the interosseous membrane, especially the dorsal part of the ulna. The EPL passes from the third dorsal extensor compart- ment ulnar to the Lister’s tubercle before returning to the thumb. Since spontaneous tendon ruptures often occur due to degeneration, the defect is large in the area of the rupture. Therefore, spontaneous tendon ruptures are treated with tendon transfer rather than end-to-end repair. In this case report, we aimed to present a case of extensor indicis proprius (EIP) tendon transfer to our 64-year-old female housewife who was admitted to our clinic with a spontaneous rupture of the EPL tendon a resulting from excessive ironing in a short term. As a result of the examination and radiological evaluation of the patient who ap- plied to our clinic with the complaint of inability to extend the thumb extension, a spontaneous EPL tendon rupture was diagnosed and surgical treatment was decided. While making a diagnosis of spontaneous tendon rupture, it was learned that the patient had no trauma and rheumatologic disease in her anamnesis. Ultrasound and magnetic resonance imaging (MRI) were used to confirm the diagnosis radiologically. The spontaneous EPL tendon rupture treatment was successfully provided by the transfer of the extensor indicis proprius (EIP) tendon. At the six month of follow-up after the surgical treatment, it was observed that the finger regained its former function. In elderly patients, repetitive, forceful finger movements for a long time may cause spontaneous tendon rupture. Long-term coercive thumb movement is a risk factor for EPL spontaneous tendon rupture.
Keywords: Spontaneous tendon rupture; Extensor pollicis longus (EPL); Tendon transfer
Endoscopically detected multicentric squamous cell carcinoma of the esophagus; Case presentation and literature review
Serkan Yalaki 1, Hüseyin Pülat 2, Oktay Karaköse 3, Serdar Şenol 4
1 Department of Gastroenterology, Mersin City Training and Research Hospital Mersin, 2 Department of Surgical Oncology, Mersin City Training and Research Hospital Mersin, 3 Department of Surgical Oncology, Samsun Training and Research Hospital Samsun, 4 Department of Gastroenterological Surgery, Samsun Training and Research Hospital Samsun, Turkey
DOI: 10.4328/ACAM.20387 Received: 2020-10-29 Accepted: 2020-12-14 Published Online: 2020-12-23 Printed: 2021-06-01 Ann Clin Anal Med 2021;12(6):708-710
Corresponding Author: Oktay Karaköse, Surgical Oncology Department of Samsun Training and Research Hospital Samsun, Turkey. E-mail: firstname.lastname@example.org P: +90 5065348909 Corresponding Author ORCID ID: https://orcid.org/0000-0002-2429-3915
Esophageal cancer is the 8th most common cancer worldwide and the 6th most common cause of cancer-related deaths. In general, the majority of esopha- geal cancer cases are more common in underdeveloped regions and are more common in males than females. Esophageal squamous cell carcinoma (ESCC) tends to occur in the proximal and middle esophagus and is the dominant sub-type worldwide, accounting for approximately 90% of all esophageal cancers. In a single patient, the simultaneous detection of an esophageal tumor endoscopically at multiple sites is very rare. Here, we aimed to discuss the case and literature in which endoscopic examination revealed all foci to be ESCC on biopsy.
Keywords: Endoscopy; Carcinoma; Squamous cell