Is histogram analysis useful in the diagnosis of COVID-19 patients?
Seda Nida Karaküçük 1, Murat Baykara 2, Kezban Tülay Yalçınkaya 3, Selçuk Nazik 4, Fatma Gümüşer 4, Kamil Doğan 1, Adil Doğan 1
1 Department of Radiology, Kahramanmaras Sutcu İmam University, School of Medicine, Kahramanmaraş, 2 Department of Radiology, Fırat University, School of Medicine, Elazığ, 3 Department of Molecular Microbiology, Kahramanmaras Sutcu İmam University, School of Medicine, Kahramanmaraş, 4 Department of Infectious Diseases and Clinical Microbiology, Kahramanmaras Sutcu İmam University, School of Medicine, Kahramanmaraş, Turkey
DOI: 10.4328/ACAM.20744 Received: 2021-06-11 Accepted: 2021-08-20 Published Online: 2022-07-27 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):831-835
Corresponding Author: Seda Nida Karaküçük, Department of Radiology, Kahramanmaras Sutcu İmam University School of Medicine, Avşar Mah. West Periphery Blv. No: 251, 46040 Onikişubat, Kahramanmaraş, Turkey. E-mail: firstname.lastname@example.org P: +90 506 380 36 93 Corresponding Author ORCID ID: https://orcid.org/0000-0002-3789-6571
Aim: In this study, we aimed to show the contribution of the chest computed tomography (CT)-based histogram analysis method, which will enable us to make quick decisions for patients who are clinically suspected of having COVID-19 infection and whose diagnoses cannot be confirmed by polymerase chain reaction (PCR) tests.
Material and Methods: A total of 84 patients, 40 in the PCR-positive group (age range: 17-90 years) and 44 in the PCR-negative group (age range: 15-75 years), were included in the study. A total of 154 lesions with ground-glass density, 78 in the PCR-positive group and 76 in the PCR-negative group, were detected in these patients’ thorax CT scans. The region of interest was placed on the ground-glass opacities from the images and numerical data were obtained by histogram analysis. Numerical data were uploaded to the MATLAB program.
Results: The localizations of ground-glass densities in the CT findings of patients with probable and definite COVID-19 diagnoses were similar; 74.7% of the ground-glass areas in both groups showed peripheral distribution. Lesions were frequently observed in right lungs and lower lobes. In histogram analysis, standard deviation, variance, size %L, size %M, and kurtosis values were higher in the PCR-positive than the PCR-negative group. When receiver operating characteristic curve analysis was performed for standard deviation values, the area under the curve was 0.640, and when the threshold value was selected as 123.4821, the two groups could be differentiated with 62.8% sensitivity and 61.8% specificity.
Discussion: The use of histogram-based tissue analysis, which is a subdivision of artificial intelligence, for clinically highly suspicious patients increases the diagnostic accuracy of CT. Therefore, performing CT analysis with the histogram method will significantly aid healthcare professionals, especially in clinics where rapid decisions are required, such as in emergency services.
Keywords: COVID-19, Histogram Analysis, Chest CT
Ghrelin and nesfatin-1 levels and relationship with fertility hormones in obese women
Department of Biochemistry, Health Science Faculty, Cankiri Karatekin University, Cankiri, Turkey
DOI: 10.4328/ACAM.21062 Received: 2022-01-14 Accepted: 2022-05-31 Published Online: 2022-06-03 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):836-840
Corresponding Author: Emrah Caylak, Aksu Mahallesi, Saglık Bilimleri Fakultesi, Karatekin University, Cankiri, 18200, Turkey. E-mail: email@example.com P: +90 544 613 49 99 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0408-9690
Aim: This study aimed to evaluate calorie intake, fertility hormones, ghrelin, and nesfatin-1 levels during the menstrual cycle (MC) in fertile women, and to determine possible the independent relationship between obesity and food intake, and the serum levels of fertility and adipokine hormones.
Material and Methods: Thirty normal weight and 30 obese women, all having apparently normal fertility, were studied. Calorie intake and serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone (fertility hormones), and ghrelin, nesfatin-1 were measured during the follicular (FP), midcycle (MP), and luteal (LP) phases of the MC.
Results: Calorie intakes were significantly higher in obese women compared with controls. Obese women showed lower FSH, LH, estradiol, ghrelin, and nesfatin-1 levels compared with normal women, whereas progesterone levels were similar between the two groups. The levels of ghrelin and nesfatin-1 increased gradually during the menstrual cycle, peaking at MP and declining gradually thereafter. With Spearman’s correlation analyses in obese women, ghrelin showed a negative correlation with calorie intake and a positive correlation with FSH/LH/estradiol, whereas nesfatin-1 maintained a positive association with calorie intake and FSH and LH showed a negative correlation with LH/estradiol.
Discussion: It is not known, whether the fertility hormones in MC are associated with the appetite-regulating hormones, and whether these hormones differ between phases of the MC between obese or non-obese women.
Keywords: Obesity, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, ghrelin, nesfatin-1, menstrual cycle
Serum AMH and 25 (OH) vitamin D levels in polycystic ovarian syndrome
Department of Obstetrics and Gynecology, Medicalpark Hospital, Samsun, Turkey
DOI: 10.4328/ACAM.21096 Received: 2022-02-02 Accepted: 2022-05-23 Published Online: 2022-06-27 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):841-844
Corresponding Author: Naziye Gurkan, Department of Obstetrics and Gynecology, Medicalpark Hospital, Samsun, Turkey. E-mail: firstname.lastname@example.org P: +90 505 790 79 49 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1088-018X
Aim: In this study, we aimed to investigate the possible relationship between serum 25(OH) vitamin D and AMH levels in patients diagnosed with polycystic ovarian syndrome.
Material and Methods: A total of 42 patients, including 21 patients diagnosed with PCOS and 21 control group patients who did not have clinical and laboratory findings of PCOS, were included. Women were diagnosed with PCOS based on the revised Rotterdam criteria. Patients in the control group were selected from patients with tubal, male factor, endometriosis, or unexplained infertility. All participants underwent venous blood sampling for the determination of AMH and 25-OH vitamin D levels. The primary outcome of the study was investigation of the relationship between 25(OH) vitamin D concentration and serum AMH levels.
Results: Serum LH, total testosterone, HOMA-IR, and fasting insulin levels in PCOS patients were significantly higher than in the control group. The mean age of the participants in both groups was similar (25.8±2.03 vs. 26.5±2.88, p<0.054). BMI values of PCOS patients were significantly higher than of those in the control group (28.02±5.11 kg/m2 vs 26.01±3.09 kg/m2, p<0.04). Serum AMH levels of PCOS patients (6.13±2.11 ng/mL) were significantly higher than in the control group (3.44±0.43 ng/mL, p<0.01). On the other hand, serum 25(OH)D levels of the patients in the PCOS (16.5±4.02 ng/mL) group were found to be significantly lower than in the control group (21.03±2.30 ng/mL, p<0.03). While serum AMH was positively correlated with total testosterone, it was negatively correlated with age in PCOS. Serum AMH levels were negatively correlated with BMI in PCOS. No significant correlation was observed between 25-OH Vitamin D and AMH levels in the PCOS group.
Discussion: While serum AMH levels of PCOS patients increased, 25 (OH) vitamin D levels decreased. AMH and vitamin D levels did not correlate.
Keywords: PCOS, AMH, 25 (OH) Vitamin D, BMI, HOMA-IR
C-erb-b2 expression in luminal b breast cancer has higher axillary lymph node involvement ratio
Gürkan Değirmencioğlu 1, Mehmet Tolga Kafadar 2, Mehmet Kılıç 3
1 Kırıkhan State Hospital Clinic of General Surgery, Hatay 2 Department of General Surgery, School of Medicine, Dicle University, Diyarbakir 3 Department of General Surgery, School of Medicine, Osmangazi University, Eskisehir, Turkey
DOI: 10.4328/ACAM.21121 Received: 2022-02-20 Accepted: 2022-03-23 Published Online: 2022-04-06 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):845-849
Corresponding Author: Mehmet Tolga Kafadar, Department of General Surgery, School of Medicine, Dicle University, 21280, Diyarbakir, Turkey. E-mail: email@example.com P: +90 412 248 80 01 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9178-7843
Aim: In this study, the effect of c-erb-B-2 (HER-2/neu) expression on axillary lymph node involvement in Luminal- B breast cancer was examined.
Material and Methods: One hundred seven female patients were included in this study who were classified as Stage 1, Stage 2 and Stage 3 pathologically, with positive Estrogen (ER) and Progesterone Receptor (PR) and with the diagnosis of invasive ductal carcinoma with a single focal mass and not a synchronous tumour and received surgical therapy. The lymph node involvement ratio (LNIR) was divided into two groups as over and below 25%. These acquired data were compared with the groups with positive and negative c-erbB-2 gene expression, axillary LNI status, and LNIR separately.
Results: The data of 107 female patients aged between 27 and 87 years were evaluated in this study. The mean age of the patients was 55.69±12.68 years. LNIR was found to be less than 25% in 76.6% (n: 82) of the patients, and over 25% in 23.4% (n: 25) of the patients. The c-erbB-2 positivity was significantly different in the axilla with and without metastatic lymphadenopathy (p =0.026). There was no statistically significant relationship between tumour diameter and metastatic lymphadenopathy. Although axillary metastatic lymphadenopathy positivity was found to be significant in patients with lymphovascular invasion (p<0.001), it was also found to be significant, as in the group with LNIR>25 (p<0.001).
Discussion: This study demonstrated that high expression of c-erbB-2 is associated with poor prognosis of breast cancer by increasing axillary LNI. In hormone (Estrogen and Progesterone) positive patients, if c-erB-2 is also positive, there is greater number of axillary LNI.
Keywords: Breast Cancer, Axillary Lymph Node, Involvement
Cystic artery anatomies in laparoscopic cholecystectomy and literature review
Zeliha Turkyilmaz 1, Zeki Hoşcoşkun 1, Oğuz Taşkınalp 2
1 Department of General Surgery, Faculty of Medicine, Trakya University, 2 Department of Anatomy, Faculty of Medicine, Trakya University, Edirne, Turkey
DOI: 10.4328/ACAM.21133 Received: 2022-03-13 Accepted: 2022-05-26 Published Online: 2022-06-18 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):850-853
Corresponding Author: Zeliha Turkyilmaz, Department of General Surgery, Faculty of Medicine, Trakya University, 22030, Edirne, Turkey. E-mail: firstname.lastname@example.org P: +90 532 708 29 44 Corresponding Author ORCID ID: https://orcid.org/0000-0002-0012-2089
Aim: In laparoscopic surgery, knowing the anatomic variations helps to be ready for any possibilities. In this study, it was aimed to evaluate the cystic artery (CA) variations and frequency in patients who underwent laparoscopic cholecystectomy (LC).
Material and Methods: The study was carried out by reviewing retrospectively the reports and movies of 100 LC. The positions of the cystic artery and cystic duct relative to Calot’s triangle (CT) were determined and the frequency of variation was reviewed.
Results: In 82% of our cases, the cystic artery was monitored as a single branch in the CT, whereas two CA were clipped in 12% of cases. In 3 cases in this study, CA went through the caudal of and parallel with the cystic duct, and entered the gall bladder. In one case, the cystic duct passed through the curve formed by the CA. This pattern was named “spiral cystic artery”.
Discussion: The anatomy of the components, which make up a CT has so many diversifications that understanding these variations acts as a key role during LC.
Keywords: Laparoscopy, Cholecystectomy, Arteries
Clinicopathological characteristics and prognostic factors of gastrointestinal stromal tumors treated with curative surgery
Osman Erdogan 1, Alper Parlakgumus 2, Ugur Topal 3, Kemal Yener 4, Zeynel Abidin Tas 5, Oktay Irkorucu 6
1 Department of Surgical Oncology, Konya Numune Hospital, Konya, Turkey, 2 Department of Surgical Oncology, Adana City Training and Research Hospital, Adana, Turkey, 3 Department of Surgical Oncology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey, 4 Department of General Surgery, Adana City Training and Research Hospital, Adana, Turkey, 5 Department of Pathology, Adana City Training and Research Hospital, Adana, Turkey, 6 Department of Clinical Sciences, College of Medicine, Universty of Sharjah, Sharjah, United Arab Emirates
DOI: 10.4328/ACAM.21134 Received: 2022-03-07 Accepted: 2022-04-07 Published Online: 2022-04-08 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):854-859
Corresponding Author: Osman Erdogan, Department of Surgical Oncology, Konya Numune Hospital, Konya, Turkey. E-mail: email@example.com P: +90 332 235 45 00 F: +90 332 235 67 36 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9941-2704
Aim: In this study, we aimed to present our experience with Gastrointestinal Stromal Tumors (GIST).
Material and Methods: All GIST cases in the archived files of the pathology database of Adana City Hospital for the period between January 2010 and December 2019 were reviewed. Patients were grouped according to their mitotic index: Group1: ≤5 and, Group2: >5; the two groups were compared for clinical symptoms, preoperative tests, treatments, pathological characteristics and follow-up data; and univariate and multivariate survival analyses were performed.
Results: This study included 106 patients, who were divided in Group 1 (61 patients) and Group 2 (45 patients). The most common tumor location was the stomach (54.7%), the mean tumor size was 7.45 cm The tumor size was greater in Group 2 (5 vs. 8 cm, p<0.001), the margins were irregular in Group 2 (14.8% vs. 35.6%, p:0.013), the high-risk group according to NIH Guidelines was Group 2 (24.6% vs. 88.9%, p<0.001), and necrosis (p:0.002) and invasion (p<0.001) were more common in Group 2. Among the patients who developed recurrence, the time to recurrence was longer in Group 1 (61 vs. 48 months, p:0.037). The metastatic growth rate was higher in Group 2 (4.9% vs. 24.4%, p:0.003). While disease-free survival was shorter in Group 2 (126 vs. 98, p:0.020). Multivariate analyses showed that emergency operations, a Ki67 index of >5, presence of tumor necrosis, S100 positivity and recurrence at follow-up were all associated with reduced survival.
Discussion: This study provides information on the clinicopathological characteristics and epidemiology of GISTs. Patients with a high mitotic index are associated with poor histopathological and oncological outcomes.
Keywords: Gastrointestinal Stromal Tumors (GISTs), Prognostic Factors, Survival
Polyclonal outbreak of bacteremia caused by Burkholderia cepacia in the intensive care unit
Ilkay Bahceci 1, Feray Ferda Senol 2, Aziz Ramazan Dilek 3, Ilknur Esen Yildiz 4, Nuray Arslan 1, Ömer Faruk Duran 1
1 Department of Medical Microbiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, 2 Department of Medical Microbiology, Elazig Fethi Sekin State of Hospital, Elazig, 3 Department of Medical Microbiology, Faculty of Medicine, Karamanoglu Mehmet Bey University, Karaman, 4 Department of Infectious Diseases, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
DOI: 10.4328/ACAM.21136 Received: 2022-03-10 Accepted: 2022-04-11 Published Online: 2022-04-13 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):860-862
Corresponding Author: Ilkay Bahceci, Department of Medical Microbiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey. E-mail: firstname.lastname@example.org P: +90 505 713 18 65 Corresponding Author ORCID ID: https://orcid.org/0000-0003-3662-1629
Aim: Burkholderia cepacia is a multidrug-resistant, opportunistic pathogen of humans and outbreaks of infection in hospitals have been described. In this study, we aimed to report an outbreak in patients without cystic fibrosis or chronic granulomatous disease involving different species of Burkholderia cepacia.
Material and Methods: A small outbreak of nosocomial Burkholderia cepacia complex occurred in a 6-bed intensive care unit. We isolated Burkholderia cepacia from blood cultures of the patients admitted to our intensive care unit. All isolates from patients and the environment were identified by standard microbiological techniques and VITEK system. Antibiotic susceptibility testing was performed using Kirby Bauer’s disk diffusion method and the VITEK system
Results: All isolates exhibited identical patterns of antibiotic susceptibility and all isolates were sensitive to trimethoprim-sulfamethoxazole, ceftazidime and meropenem. The isolates were typed using pulsed-field gel electrophoresis using the restriction enzymes XbaI and SpeI. Accordingly, while 4 strains were similar, one was different.
Discussion: The experience from this outbreak reminded us of the importance of outbreak investigation in such small outbreaks and keeping the health care workers educated and constant attention on this issue. The results of this study emphasized once again the necessity to maintain our sensitivity to the basic principles of sanitation and to raise our awareness of such outbreaks.
Keywords: Burkholderia cepacia, Outbreak, Intensive Care Unit
Agreement between physiotherapists and mothers in the rehabilitation of children with down syndrome
Zeynep Rabia Sahin 1, Süleyman Gürsoy 2, Erdoğan Kavlak 3
1 Department of Therapy and Rehabilitation, Mehmet Akif Ersoy University, Burdur, 2 Department of Physiotherapy and Rehabilitation, School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, 3 Department of Neurological Rehabilitation, School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
DOI: 10.4328/ACAM.21138 Received: 2022-03-12 Accepted: 2022-05-17 Published Online: 2022-05-23 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):863-867
Corresponding Author: Erdoğan Kavlak, Department of Neurological Rehabilitation. School of Physical Therapy and Rehabilitation, Pamukkale University, 20160, Kinikli, Denizli, Turkey. E-mail: email@example.com P: +90 258 296 42 57 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6344-259X
Aim: The aim of this study was to examine the agreement between physiotherapists and mothers about the treatment of children with Down syndrome who received treatment in special education and rehabilitation centers.
Material and Methods: Mothers of 117 children with Down syndrome whose mean age was 26.24±12.94 months, and physiotherapists were included in this study. All participants were treated at special education centers in the province of Aydın. A questionnaire consisting of 6 open-ended questions was used to describe the expectations and views of the physiotherapists and mothers about the physiotherapy and rehabilitation programs for the children.
Results: The mean age of the mothers with a child with Down syndrome was 36.74±4.15 years, and the mean age of the physiotherapists was 34.03±9.32 years and their mean number of working years was 9.91±8.76. Statistically, a moderate agreement was found between the physiotherapists and the mothers in terms of additional treatment (K=0.225 and p=0.000) and the effectiveness of the physiotherapy program applied to DS children (K=0.204 and p=0.000).
When the agreement between the physiotherapists and the mothers about the appropriateness of the treatment applied to DS children was examined, a statistically good agreement was found (K=1.000 and p=0.000).
Discussion: We believe that the views and expectations of the mothers should be taken into account by the physiotherapists when preparing a treatment program for children with Down syndrome.
Keywords: Down Syndrome, Physiotherapist, Mother, Physiotherapy, Kappa
An alternative marker of inflammation in parenteral nutrition: IMA
Mustafa Timurkaan 1, Gulsum Altuntas 2, Mehmet Kalayci 3, Esra Suay Timurkaan 1, Hakan Ayyildiz 4, Semih Dalkilic 5
1 Department of Internal Medicine, Elazig Fethi Sekin City Hospital, Elazig, 2 Department of Intensive Care Unit, Elazig Fethi Sekin City Hospital, Elazig, 3 Department of Biochemistry, Akcakoca State Hospital, Duzce, 4 Department of Biochemistry, Elazig Fethi Sekin City Hospital, Elazig, 5 Department of Biology, Faculty of Science, Firat University, Elazig, Turkey
DOI: 10.4328/ACAM.21141 Received: 2022-03-12 Accepted: 2022-04-13 Published Online: 2022-04-18 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):868-872
Corresponding Author: Mustafa Timurkaan, Department of Internal Medicine, Elazig Fethi Sekin City Hospital, 23300, Elazig, Turkey. E-mail: firstname.lastname@example.org P: +90 505 889 31 50 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1950-0489
Aim: There is an increase in inflammation and metabolic complications in patients receiving PN. Because of inflammation and oxidative stress, an increase in IMA levels can be observed. We aimed to evaluate the effectiveness of detecting IMA and other inflammatory parameters in modulating nutritional therapy of critically ill patients.
Material and Methods: A total of 83 subjects were divided into two groups: 41 receiving PN (F:20, M:21) and 42 receiving EN (F:22, M:20). Patients over the age of 18 whose NRS 2002 score was <3, and who were followed up in the intensive care or palliative care units were included. CBC, glucose, protein, albumin, ferritin, CRP, electrolytes, and IMA levels were compared.
Results: There was a difference in CRP values in the group receiving PN compared to the group receiving EN (p=0.001). NLR and CRP/albumin were found to be higher in the PN group (p <0.05 and p <0.01). IMA levels were also found to be significantly higher in the PN group compared to the enteral group (p <0.01).
Discussion: Compared with EN, inflammation, metabolic and oxidative stress can occur in patients receiving PN. Increased inflammatory parameters and IMA levels are important in terms of additional treatment modalities to nutrition. This oxidant process can be prevented by using antioxidant support such as vitamins and minerals, emulsions containing olive oil, and omega-3 fatty acids. IMA and inflammatory parameters can be guiding as predictors of this process.
Keywords: Nutrition, Enteral, Parenteral, IMA, Hyperinflammation
Predictive role of SEC in mitral restenosis following successful percutaneous balloon mitral valvuloplasty (PBMV)
Omer Tasbulak 1, Mustafa Duran 2, Ahmet Anıl Şahin 3, Serkan Kahraman 1, Ali Riza Demir 1, Begum Uygur 1, Yalcin Avcı 1, Omer Celik 1, Ahmet Arif Yalcin 1, Mehmet Erturk 1
1 Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 2 Department of Cardiology, Konya Training and Research Hospital, Konya, 3 Department of Cardiology, Istinye University, Faculty of Medicine, Liv Hospital Bahcesehir, Istanbul, Turkey
DOI: 10.4328/ACAM.21143 Received: 2022-03-14 Accepted: 2022-04-14 Published Online: 2022-04-14 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):873-878
Corresponding Author: Omer Tasbulak, Istasyon Mahallesi, Turgut Ozal Bulvarı, No: 11, Küçükçekmece, Istanbul, Turkey. E-mail: email@example.com P: +90 507 293 61 70 F: +90 212 471 94 94 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6307-5136
Aim: The aim of this study was to investigate the predictive role of spontaneous echo contrast (SEC) in mitral restenosis after percutaneous balloon mitral valvuloplasty (PBMV).
Material and Methods: We retrospectively analyzed 341 consecutive patients who underwent PBMV at our hospital. Subjects who participated in the study were assigned to two groups: patients who had demonstrable SEC in the left atrial cavity and left atrial appendage and patients who did not have SEC in the left atrial cavity and left atrial appendage. For each group, the following variables were analyzed: demographic characteristics, past medical records, laboratory values, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) parameters.
Results: Compared to patients without SEC, patients with SEC were older, had a higher incidence of diabetes mellitus (DM), ischemic stroke and AF (p<0.05). With respect to TTE and TEE measurements, patients with SEC had lower estimated pre-procedural left ventricular ejection fraction (LVEF), a smaller calculated mitral valve area (MVA), a larger left atrial (LA) dimension and higher estimated preprocedural Wilkins score (p<0.05). In addition, the incidence of mitral restenosis following PBMV was significantly higher in patients with SEC compared to patients without SEC ( p <0.05), and this difference was more apparent in patients with grade 3-4 SEC compared to those with grade 1-2 SEC (p<0.05)
Discussion: Our data showed that there is a strong association between SEC formation in the left atrium and left atrial appendage and mitral restenosis following PBMV
Keywords: Percutaneous Balloon Mitral Valvuloplasty, Mitral Restenosis, Spontaneous Echo Contrast
Distribution of cervical epithelial lesions in a conventional Pap smear
Department of Obstetrics and Gynecology, Istanbul IVF-Center, Istanbul, Turkey
DOI: 10.4328/ACAM.21144 Received: 2022-03-15 Accepted: 2022-04-15 Published Online: 2022-04-15 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):879-881
Corresponding Author: Ramazan Ozyurt, Istanbul IVF-Center, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 532 748 34 90 Corresponding Author ORCID ID: https://orcid.org/0000-0001-6822-2222
Aim: In this study, we aimed to examine the distribution of cervical epithelial lesions in conventional pap smear screening.
Material and Methods: The smear results of 4500 patients aged 25-65 years who applied to the Istanbul training and research hospital between 2010 and 2011 for conventional smears were analyzed retrospectively. The smear results of the patients were recorded from their files. Smears taken from all patients using plastic brushes were evaluated according to the Bethesda system. The smears were classified by an experienced pathologist according to the following epithelial abnormalities: ASCUS: Atypical squamous cells of undetermined significance, AGUS: atypical glandular cells of undetermined significance, LGSIL: Low grade squamous intraepithelial lesion, HGSIL=High grade squamous intraepithelial lesion, Squamous cell carcinoma and other rare abnormalities. After the smear was stained with the Papanicolaou method, it was evaluated under light microscopy. ASCUS, AGUS, LGSIL and HGSIL are epithelial anomalies in cervical cells and are diagnosed using light microscopy.
Results: The normal smear rate was found to be 14%. The most common epithelial anomaly was recorded as chronic cervicitis with a rate of 60%. While the rate of smears containing atrophic cells was 9%, the rate of smears containing insufficient cells was 8%. A smear containing squamous cells was detected in 5.2% of the cases. Atypical squamous cells of undetermined significance were detected in 2% of cases, while atypical glandular cells of undetermined significance were found in 0.2%. While low-grade squamous intraepithelial lesion was 0.8%, high grade squamous intraepithelial lesion was found to be 0.3%. Cervical cancer was not detected in 4500 cases. Considering the number of patients who underwent smear screening, it can be considered normal not to detect cervical cancer.
Discussion: A large proportion of cervical epithelial lesions can be accurately detected with conventional pap smear screening.
Keywords: Pap Smear, Cervix, Epithelial Lesion, Screening
RT-PCR cycle threshold (Ct) values predicting COVID-19 patients’ outcome
Seyda Ignak 1, Demet Yalcin 2, Olida Cecen 3, Muhammed Mert Sonkaya 3, Isilsu Ezgi Uluisik 3, Ozlem Unay Demirel 4
1 Department of Medical Biology, School of Medicine, Bahcesehir University, 2 Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istinye University, 3 5th Year Medical Student, School of Medicine, Bahcesehir University, 4 Department of Biochemistry, School of Medicine, Bahcesehir University, Medical Park Goztepe Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21145 Received: 2022-05-18 Accepted: 2022-06-28 Published Online: 2022-06-30 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):882-886
Corresponding Author: Seyda Ignak, Department of Medical Biology, School of Medicine, Bahcesehir University, Sahrayıcedid Mah., Batman Sok., No:66, Kadıkoy, 34734, Istanbul, Turkey. E-mail: email@example.com P: +90 216 579 82 26 F: +90 216 468 40 84 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9382-8162
Aim: Clinical presentation of COVID-19 ranges from asymptomatic to fatal cases. Therefore, predictability of prognosis gains importance in managing the disease. The aim of this study is to investigate the relation between RT-PCR cycle threshold (Ct) values and the clinical severity of COVID-19 infection.
Material and Methods: A retrospective study was conducted among 1224 COVID-19 patients. A scoring system, which is designed by the World Health Organization was used to classify patients by means of their clinical status.
Results: The cut-off for Ct value in ROC curves was 21.52 at the point, when the COVID-19 patient clinic is shifting from ambulatory to hospitalized (79.7% sensitivity, 69% specificity). A significant weak positive correlation was found between age and WHO Score (r= .238 p<0.01) and a significant weak negative correlation was found between Ct value and WHO Score (r= -.068 p<0.05) in COVID-19 patients.
Discussion: Patients with lower RT-PCR Ct values were more likely to go through the disease more severely due to higher virulence. Reporting of numerical Ct values may help clinicians in terms of prognosis.
Keywords: PCR, Cycle Threshold, COVID-19, SARS CoV-2
Our experience with hospitalized children with pertussis
Özlem Üzüm 1, Tuba Tınastepe 1, Yavuz Demirçelik 1, Hacer Örsdemir Hortu 1, Gülberat İnce 1, Ali Kanık 2, Kayı Eliaçık 1, Mehmet Helvacı 1
1 Department of Pediatric Diseases, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, 2 Department of Pediatric Diseases, Katip Çelebi University Faculty of Medicine, Izmir, Turkey
DOI: 10.4328/ACAM.21146 Received: 2022-03-16 Accepted: 2022-04-16 Published Online: 2022-04-19 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):887-890
Corresponding Author: Özlem Üzüm, University of Health Sciences, Tepecik Training and Research Hospital, Department of Pediatric Diseases, Izmir, Turkey. E-mail: firstname.lastname@example.org P: +90 507 785 96 37 Corresponding Author ORCID ID: https://orcid.org/0000-0003-3297-7476
Aim: Pertussis is a lower respiratory tract infection caused by Bordetella pertussis, especially seen in children younger than six months, lasting more than fourteen days and developing with paroxysmal cough, inspiratory stridor and vomiting after coughing. In this study, it was aimed to present the demographic data and clinical characteristics of patients whose pertussis diagnosis was confirmed by clinical and Polymerase Chain Reaction tests in the infant service.
Material and Methods: Patients hospitalized with a diagnosis of pertussis between April 2014 and April 2019 were included in the study. Demographic data, symptoms, acute phase reactants, respiratory virus/bacterial sampling results, length of hospital stay and intensive care admissions were recorded.
Results: A total of 65 cases were included. Gender, age younger than or older than one year, low birth weight, and birth before 37 weeks were not associated with follow-up in the intensive care unit, whereas 5 of the 11 cases with other pathogens in addition to Bordetella pertussis were admitted to the intensive care unit. This rate was significantly higher than in cases where no additional pathogen was detected.
Discussion: As a result, it was thought that if there is a clinical suspicion in cases where the probable diagnostic criteria are not met, the diagnosis of pertussis should be confirmed by microbiological tests. In addition, it is thought that predictions can be made regarding the clinical course with the additional pathogen that can be detected using Polymerase Chain Reaction tests.
Keywords: Children, Polymerase Chain Reaction, Pertussis
The relationship of serum copper and zinc levels with oxidative stress markers and other laboratory parameters in COVID-19 patients
Ugur Fahri Yurekli 1, Umran Liste 2
1 Department of Medical Biochemistr, 2 Department of Medical Microbiology, Sanlıurfa Mehmet Akif Inan Education and Research Hospital, Sanliurfa, Turkey
DOI: 10.4328/ACAM.21147 Received: 2022-03-16 Accepted: 2022-04-18 Published Online: 2022-05-27 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):891-894
Corresponding Author: Ugur Fahri Yurekli, Department of Medical Biochemistr, Sanliurfa Mehmet Akif Inan Education and Research Hospital, Şanlıurfa, Turkey. E-mail: email@example.com P: +90 532 777 93 99 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7969-5196
Aim: Serum Copper (Cu) and Zinc (Zn) levels can be associated with novel coronavirus disease 2019 (COVID-19). However, the correlation of serum Cu and Zn levels with biochemistry, hormones, and coagulation parameters has not been fully revealed. This study aims to determine serum Cu and Zn levels and their relationships with other laboratory parameters in the acute phase of COVID-19.
Material and Methods: This retrospective observational study was conducted with patients who were diagnosed with COVID-19 in a tertiary hospital. The study was continued with the remaining 116 people: 53 healthy and 63 SARS-CoV-2-positives seriously ill. All laboratory data were retrospectively scanned from patient files at the hospital information system.
Results: It was found that serum Cu, G6PD and TAS levels decreased, Zn TOS and OSI levels increased when COVID-19 patients were compared with healthy individuals. There is a positive correlation between serum Cu level and AST in COVID-19 patients, and a negative correlation between total bilirubin and LDH. There is a negative correlation between serum Zn levels and direct bilirubin, CRP, and procalcitonin.
Discussion: Many studies have been reported showing that both Cu and Zn have antiviral effects against COVID-19. Although our data support these studies, it has been revealed that serum Cu and Zn levels were correlated with AST, direct/total bilirubin, LDH, CRP, and prolactin.
Keywords: COVID-19, Copper, Zinc, G6PD, OSI
Effects of migraine on anxiety, depression symptoms and quality of life: A hospital-based study
Cennet Buyukyoruk 1, Ruhusen Kutlu 1, Emine Genc 2
1 Department of Family Medicine, 2 Department of Neurology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
DOI: 10.4328/ACAM.21155 Received: 2022-03-21 Accepted: 2022-07-25 Published Online: 2022-07-29 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):895-899
Corresponding Author: Ruhusen Kutlu, Department of Family Medicine, Meram Medical Faculty, Konya Necmettin Erbakan University, 42080, Konya, Turkey. E-mail: firstname.lastname@example.org P: +90 332 223 66 01 F: + 90 332 223 61 81 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8502-0232
Aim: Migraine has a great detrimental effect on the daily life of the patient by making negative effects on socioeconomic functioning and quality of life. In this study, it was aimed to evaluate the symptoms of anxiety, depression and quality of life in patients with and without migraine and to determine the factors affecting them.
Material and Methods: This analytical typed case-control study was conducted on 402 people over the age of 18. 201 of whom had migraine and 201 did not have migraine. Hospital Anxiety and Depression Scale (HADS) and World Health Organization Quality of Life Scale Short Form (WHOQOL-BREF TR) were used to collect data about patients.
Results: In the present study, 90.5% (n=182) of patients with migraine were female, 80.1% were married, 58.2% had secondary school education, 21.9% were smokers. Among the factors that triggered the migraine attack, noise ranked first with a frequency of 78.1% (n=157). Anxiety and depression scores were significantly higher in those with migraine than in those without migraine (p<0.001). Quality of life parameters such as physical health, psychological health, social relations and environmental area scores were significantly higher in those without migraine than in those with migraine (p<0.001). General health and life satisfaction of the individuals without migraine were significantly higher (p<0.001).
Discussion: Migraine must be taken seriously since it has a negative impact on patients’ lives. Besides medical treatment, patients should be evaluated carefully for their quality of life and psychiatric conditions. As family physicians, we must approach our patients holistically.
Keywords: Anxiety, Depression, Migraine, Quality of Life
Characteristics and management of consultations requested from the emergency department and other outpatient clinics in a surgical oncology clinic
Şeref Dokcu 1, Mehmet Ali Çaparlar 2, Özhan Çetindağ 2, Musluh Hakseven 2, Salim Demirci 2
1 Department of Surgical Oncology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, 2 Department of Oncological Surgery, Faculty of Medicine, Ankara University, Ankara,Turkey
DOI: 10.4328/ACAM.21157 Received: 2022-03-22 Accepted: 2022-04-22 Published Online: 2022-05-16 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):900-904
Corresponding Author: Şeref Dokcu, Department of Surgical Oncology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Üçkuyu Mh., 21010, Kayapınar, Diyarbakır, Turkey. E-mail: email@example.com P: +90 533 443 43 33 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1807-8108
Aim: Interdepartmental collaboration is sought through consultations, which represent a common and important aspect of medical practice. Despite its importance, we have very little information due to the limited number of studies. In this study, we aimed to examine the differences between departments, as well as the characteristics and functioning of consultations requested from a surgical oncology clinic.
Material and Methods: Two hundred eighty-seven consecutive consultations requested by the emergency department and other departments were included in the study. The patients were categorized according to the characteristics of the consultations. The relationship between categorical variables was analyzed with the chi-square (χ2 test) test or Fisher’s exact test.
Results: Most consultations were requested during working hours (85%) and on weekdays (90%). Only 65% of the request forms contained sufficient information. The most common consultation request was from the emergency department (42%), the most common diagnosis was gastric cancer (24%), and the most common reasons for the request were surgical evaluation (30%) and bowel obstruction (29%). Only one interview was conducted with 56% of patients to end the consultation. Patients with a high Charlson comorbidity index were more likely to undergo major surgery (p = .004). Emergency department consultations were associated with early admission (p=0.00). Inadequate request forms were also associated with emergency department consultations (p=0.00).
Discussion: It should be noted that the inadequacy of the consultation text, which can be considered a communication failure during the consultation process, is not uncommon.
Keywords: Consultation, Emergency Medicine, Emergency Service, Medical Interconsultation, Patient Management
Is really posterior approach better than anterior in recurrent inguinal hernia?
Ersin Turan 1, Kemal Arslan 1, Barış Ayhan 2, Serap Melek Doğan 3, Osman Doğru 1
1 Department of General Surgery, Konya City Hospital, Konya, 2 Department of General Surgery, Karapınar State Hospital , Konya, 3 Department of General Surgery, Kepez State Hospital, Antalya, Turkey
DOI: 10.4328/ACAM.21158 Received: 2022-04-06 Accepted: 2022-06-11 Published Online: 2022-06-20 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):905-909
Corresponding Author: Ersin Turan, Department of General Surgery, Konya City Hospital, Konya, Turkey. E-mail: firstname.lastname@example.org P: +90 530 326 85 75 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6413-6949
Aim: In inguinal hernia operations, patient comfort is as important as postoperative recurrence in the success of surgery. The aim of this study is to compare the effects of minimally invasive preperitoneal single-layer mesh (MIP) and Lichtenstein repair (LR) on patient comfort in patients with recurrent inguinal hernia (RIH).
Material and Methods: The files of 107 patients with RIH were retrospectively reviewed. 48(%44.8)patients had MIP and 59(%55.2) patients had LR. Sheffield Pain Scale(SPS) and Verbal Pain Scale (VPS) were used for the evaluation of pain scores. Patients were questioned during preoperative period, postoperative 1st month and 1st, 3rd, 6th, 9th years regarding SPS, VPS and ability to perform daily activities.
Results: The mean time to return to work was 10 days shorter in the MIP group. There was no significant difference between the groups in terms of preoperative SPS scores, ability to perform daily activities and VPS scores. Both early postoperative pain scores as the SPS (1.24 vs 1.68, respectively, p = 0.01) and VPS scores (3.67 vs 4.68, respectively, p = 0.02) and late postoperative SPS scores (1.10 vs 1.30, respectively, p = 0.02) and VPS scores (2.46 vs 3.61, respectively, p = 0.04) were lower in the MIP group when compared with the LR group. The patient comfort parameters were significantly improved in the MIP group.
Discussion:The number of studies investigating patient comfort in recurrent hernias is very low in the literature. According to our study, MIP seems to be a better technic for recurrent inguinal hernias.
Keywords: Recurrent Inguinal Hernia, Lichtenstein Repair, Minimally Invasive Preperitoneal Repair, Patient Comfort
Treatment of ganglion cysts on the wrist: Why and how?
Numan Duman 1, Numan Atilgan 2, Tahsin Sami Colak 3, Mehmet Demiryurek 3
1 Department of Orthopedics and Traumatology, Faculty of Medicine, Uskudar University, Istanbul, 2 Department of Orthopedics and Traumatology, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, 3 Department of Orthopedics and Traumatology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
DOI: 10.4328/ACAM.21160 Received: 2022-03-23 Accepted: 2022-05-24 Published Online: 2022-05-27 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):910-913
Corresponding Author: Numan Atilgan, Department of Orthopedics and Traumatology, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey. E-mail: email@example.com P: +90 507 221 19 45 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7184-978X
Aim: Our study aimed at comparing the results of surgical treatment and additional cortisone application to ganglion cysts aspiration formed on the wrist, and to evaluate the reasons that lead patients to treatment.
Material and Methods: Patients who applied to our clinic between 2012 and 2019 were diagnosed with ganglion cysts were divided into two groups. Group A consisted of 91 patients who underwent surgical excision, and Group B consisted of 33 patients who underwent cyst aspiration with 1 ml of betamethasone administration. A total of 124 patients were evaluated regarding the cyst side, age, gender, complications after treatment modalities, preoperative and postoperative pain, and function scores.
Discussion: Pain was the leading complaint in 63 (50.8%) patients in our study. Considering the current literature, the most common complaint among symptomatic patients is pain. Also, the cyst size of the group that chose surgical treatment was larger than in the group that underwent aspiration with injection.
Results: In our study, it was observed that wrist ganglion cysts were more common in women than in men, they were more common on the dorsal side than on the volar side, and the first reason for choosing surgical treatment was cosmetic concerns and suspicion of the tumoral lesion after pain occurrence. The incidence of recurrence was 11.5 times higher in the patient group treated with aspiration and betamethasone injection compared to the patient group treated with surgical treatment.
Keywords: Cyst, Ganglion, Wrist, Aspiration
The effect of light and noise reduction on the sleep state of preterm infants
Müjde Çalıkuşu İncekar 1, Duygu Gözen 2, Ayhan Taştekin 3
1 Department of Pediatric Nursing, Faculty of Health Sciences, Yuksek Ihtisas University, Ankara, 2 Department of Pediatric Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpaşa, Istanbul, 3 Department of Neonatology, Medical Faculty, Medipol University, Istanbul, Turkey
DOI: 10.4328/ACAM.21162 Received: 2022-03-26 Accepted: 2022-06-03 Published Online: 2022-06-09 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):914-918
Corresponding Author: Müjde Çalıkuşu İncekar, Department of Pediatric Nursing, Faculty of Health Sciences, Yuksek Ihtisas University, Ankara, Turkey. E-mail: firstname.lastname@example.org Corresponding Author ORCID ID: https://orcid.org/0000-0002-4472-2406
Aim: The aim of this study was to determine the effect of reducing light and noise on the sleep of preterm infants.
Material and Methods: This randomized controlled trial study was conducted on 80 preterm infants. Infants in the study group were observed under a coated oxygen hood to reduce light and noise, and the infants in the control group were observed under a standard oxygen hood, for two hours.
Results: The gestational age of preterm infants in the study group was 32.92±1.17 and in the control group- 33.31±0.90 weeks. There was a significant difference between the study and control groups in terms of the sleep state and activity count (p< 0.05).
Discussion: It was concluded that the preterm infants slept longer and the activity count was lower by reducing the light and noise.
Keywords: Infant, Light, Neonatal Intensive Care Unit, Noise, Premature
Evaluation of glycated hemoglobin (HbA1C) as a predictor of dyslipidemia in type 2 diabetic patients
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Northern Border University, Arar, Kingdom of Saudi Arabia
DOI: 10.4328/ACAM.21166 Received: 2022-03-30 Accepted: 2022-06-03 Published Online: 2022-06-05 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):919-922
Corresponding Author: Nida Suhail, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Northern Border University, Arar, Kingdom of Saudi Arabia E-mail: email@example.com P: +90 +96 650 922 32 95 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1314-5041
Aim: Patients with type 2 diabetes mellitus have an increased prevalence of dyslipidemia and are easy targets for cardiovascular diseases. This retrospective study investigated the serum lipid profile of patients with type 2 diabetes mellitus and assessed the relationship between HbA1c levels, lipid profile, and BMI to evaluate the importance of HbA1c as a predictor of dyslipidemia.
Material and Methods: The study was conducted at the Diabetes Center of the Tertiary Care Hospital in Arar, Saudi Arabia. Demographic and biochemical data of 100 patients with type 2 diabetes were collected from electronic records of the hospital. Correlation analysis was performed to analyze the association between HbA1c, lipid profile and BMI.
Results: The results revealed an increase in the levels of fasting blood glucose, blood urea nitrogen, total protein and HbA1C levels, accompanied by a decrease in albumin levels among both male and female patients with no significant difference among the genders. The study also demonstrated an alteration in the lipid profile of the patients with elevated levels of total cholesterol, TAGs and LDL-C with a concomitant reduction in HDL-C levels. Correlation analysis demonstrated a significant (p<0.05) positive correlation between HbA1C and different lipids (total cholesterol, Triglyceride and LDL-C) and BMI. A significant (p<0.05) negative correlation was found between HbA1C and HDL-C levels.
Discussion: The results indicate that in addition to as a biomarker for glycemic control, HbA1c can also be used in predicting dyslipidemia associated with type 2 diabetes to prevent the development of cardiovascular diseases.
Keywords: Type 2 Diabetes Mellitus, Dyslipidemia, Glycated Hemoglobin, Cardiovascular Diseases
Analysis of the nervus vagus effect on gastric adenocarcinoma development
Salih Kara 1, Esra Dişçi 1, Mehmet Dumlu Aydın 2, Betul Gündoğdu 3, Mehmet İlhan Yıldırgan 1, Nurhak Aksungur 1, Rıfat Peksöz 1
1 Department of General Surgery, 2 Department of Neurosurgery, 3 Department of Pathology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
DOI: 10.4328/ACAM.21167 Received: 2022-03-31 Accepted: 2022-06-17 Published Online: 2022-06-21 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):923-926
Corresponding Author: Salih Kara, Department of General Surgery, Faculty of Medicine, Atatürk University, 25240, Erzurum, Turkey. E-mail: firstname.lastname@example.org P: +90 442 344 79 46 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7877-9064
Aim: In this study, we aimed to investigate whether there was an association between a change in the histological composition of the neuroelectrical activity of the vagal nerves and the gastric tumor.
Material and Methods: The pathological materials of patients who were operated on in our hospital with the diagnosis of gastric adenocarcinoma were analyzed retrospectively. Tumor cells, vagal nerve and tumor-invading nerve cells were photographed in successive sections at 4x, 10x, 20x and 40x magnifications for stereotypic counts. During the course of the vagal nerve, axon density per square millimeter and neuronal densities were counted. Statistical analysis was performed between the number of degenerated axons, VSI, axon thickness, and tumor stage by scoring according to the tumor size stage (Tumor 1-2-3-4:10).
Results: Twelve (44.4%) patients were female and 15 (55.6%) were male, with a mean age of 62.9 ± 7.7 years. As the tumor grade increased, the difference between the normal axon numbers was found to be significant. Likewise, as the tumor stage increased, there were significant differences between the number of degenerated axons and tumor stage, also there were significant differences between VSI and tumor stage, similarly. Tumor size and axon thickness differences were found to be significant.
Discussion: Increased electrical potentials lead to a decrease in apoptosis and an increase in tumorogenesis. In this context, vagal hyperactivity may cause gastric adenocarcinoma. Vagal nerves may become more degenerate in high-grade malignant tumors. Thus, it is concluded that vagal nerve weakness may contribute to the progression of tumors.
Keywords: Gastric Adenocarcinoma, Tumorogenesis, Vagal Nerve, Axon Density, Vasospasm Index
Wells score and prediction of pulmonary embolism in patients with coronavirus disease 2019 in Morocco
Mohamed Amine Baba 1, 2, 4, Ahmed Kharbach 4, 5, Bouchra El Mourchid 4, Khadija Sabiri 4, Yassmine Maatoubi 4, Soukaina Wakrim 2, 3
1 Department of Health Sciences, Laboratory of Health Sciences Research, Ibn Zohr University, Agadir, 2 Faculty of Medicine and Pharmacy of Agadir, Ibn Zohr University, Agadir, 3 Department of Radiology, University Hospital of Souss Massa, Ibn Zohr Agadir University, Agadir, 4 High Institute of Nursing Professions and Health Technics of Agadir, Agadir, 5 Department of Public Health, Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco
DOI: 10.4328/ACAM.21173 Received: 2022-04-04 Accepted: 2022-06-18 Published Online: 2022-06-28 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):927-931
Corresponding Author: Mohamed Amine Baba, Department of Public Health, Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, 10100, Rabat, Morocco. E-mail: email@example.com P: +21 263 344 25 54 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6660-9527
Aim: This study aimed to evaluate the performance of the WELLS score for the diagnosis of pulmonary embolism in patients with COVID-19 in Souss-Massa Regional Hospital Center. This article reviewed the diagnostic accuracy of the WELLS score associated with the dosage of D-dimer biomarkers.
Material and Methods: This retrospective observational descriptive and transversal study was conducted at Souss-Massa Regional Hospital Center, from March 15, 2021 to June 26, 2021.
Results: The study included 77 patients who underwent chest CT angiography due to oxygen desaturation associated with the values of the biological marker D – dimers. The most responsive antecedents were type II diabetes (41.00%), hypertension (17.9%), and heart disease (15.4%). The mean age of 47 patients with pulmonary embolism had an average age of 62.09 years (±13.31), including 40 men (85.1%) and 7 women (14.9%); 9 patients died, with no medical history available. Comorbidity factors presented in 80.85% (38/47 cases) of patients, the most frequent being type II diabetes 44.73% (17/38 cases), arterial hypertension 28.94% (11/38), heart disease 5.26% (2/38), chronic respiratory failure 2.63% (1/38), smoking history 10.52% (4/38), asthma patients were 5.26% (2/38), and tuberculosis patients were 2.63% (1 /38). Among these patients 38.29% died. The combination of the Wells score with the value of D-dimers can be useful to guide the appropriate care for his patients.
Discussion: The combination of the Wells score with the value of D-dimers can be useful to guide the appropriate care for his patients.
Keywords: WELLS Score, Pulmonary Embolism, Patients, COVID-19
Ultrasound-guided erector spinae plane block versus rhomboid intercostal block for postoperative analgesia following thoracotomy
Tahsin Şimek 1, Fatih Doğu Geyik 1, Aynur Kaynar Şimşek 2, Yücel Yüce 1, Kemal Tolga Saraçoğlu 1, Recep Demirhan 3
1 Department of Anesthesiology and Reanimation, Health Sciences University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, 2 Department of Nursing, Faculty of Health Sciences, Marmara University, 3 Department of Thoracic Surgery, Health Sciences University, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21189 Received: 2022-04-14 Accepted: 2022-06-11 Published Online: 2022-06-21 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):932-936
Corresponding Author: Tahsin Şimşek, Health Sciences University, Kartal Dr. Lütfi Kirdar Training and Research Hospital, Cevizli Mh., Semsi Denizer Cd., E-5 Karayolu Cevizli Mevkii, 34890, Kartal, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 216 441 39 00 Corresponding Author ORCID ID: https://orcid.org/0000-0002-3068-4998
Aim: For the thoracotomy pain relief, opioids, thoracic paravertebral and epidural interventions are frequently used practices. In recent years, interfascial blocks such as the erector spinae plan block (ESPB) and rhomboid intercostal block (RIB) have started to be used for analgesia. We aimed to compare the postoperative analgesic effect of ESPB, RIB, and a control (C) group in pain management after open thoracotomy.
Material and Methods: This is a single-centered randomized controlled trial. A total of 75 patients were included in the study in three groups as the ESPB, RIB and control (C) groups. Under general anesthesia, in block groups, blockage was performed with 20 ml 0.25% bupivacaine. In Group C, no procedures other than the standard postoperative analgesia protocol were performed. The amount of postoperative analgesic consumption by the patients, and visual analogue scale (VAS) values were recorded.
Results: In group ESPB and RIB, the mean 24-hour tramadol consumption was 124±29.08 mg and 116±28.65 mg, respectively (p>0.05). In Group C, the consumption was 204±44.06 mg, significantly higher than in group ESPB and group RIB (p=0.004). The VAS values (p<0.05) and the numbers of patients needing rescue analgesic (p=0.048) were lower in groups ESPB and RIB than in group C. There was no significant difference between group ESPB and group RIB in any of these parameters
Discussion: ESPB and RIB were similar and they are more effective than the control group, whereas the former did not have superiority over each other.
Keywords: Analgesia, Block, Thoracotomy
Evaluation of vaginal culture results in patients with threatened preterm labor
Fehmi Unal 1, Nursu Kara 2
1 Department of Obstetrics and Gynaecology, 2 Department of Neonatology, Istanbul Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21278 Received: 2022-06-17 Accepted: 2022-07-25 Published Online: 2022-07-27 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):937-941
Corresponding Author: Fehmi Ünal, Department of Obstetrics and Gynaecology, Istanbul Training and Research Hospital, 34098, Istanbul, Turkey. E-mail: email@example.com P: +90 212 459 60 00 F: +90 212 459 62 30 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8182-2051
Aim: In this study, we aimed to investigate the effects of certain infections on preterm birth by examining cervicovaginal cultures from patients with and without premature rupture of membranes (PROM) who were diagnosed with threatened preterm labor.
Material and Methods: Records of 85 patients diagnosed and treated for threatened preterm labor were retrospectively reviewed. Cervicovaginal cultures and laboratory results were analyzed. Preterm labor was diagnosed based on the Creasy-Herron criteria. Medical and obstetric histories, ultrasound examinations, vaginal examinations, and information on non-stress tests were recorded for all patients. The latency period was determined by subtracting the week of gestation at hospital admission from that at birth.
Results: A total of 74 patients who met the inclusion criteria were included in the study. Staphylococcus haemolyticus (n=7, 20.5%) was the most common microorganism detected in the cervicovaginal cultures. Births occurred before 37 weeks of gestation in 23 (67.6%) of the 34 patients who tested positive for microbial growth. No difference was observed between the rates of cervicovaginal culture positivity in threatened preterm labor patients with and without PROM (p=0.57). Of the 29 babies born in our hospital, thirteen (54.5%) of the 23 preterm babies were admitted to our hospital’s neonatal intensive care unit. There were no positive indicators of infection or growth in the blood cultures of these infants.
Discussion: Cervicovaginal and urine cultures provide important information that may prevent severe mortality and morbidity during follow-up of patients with threatened preterm labor.
Keywords: Threatened Preterm Labor, Vaginal Culture, PROM
Evaluation of amplitude-integrated EEG use in the neonatal intensive care unit
Sadrettin Ekmen, Yusuf Deniz
Department of Pediatrics, Faculty of Medicine, Karabuk University, Karabuk, Turkey
DOI: 10.4328/ACAM.21284 Received: 2022-06-21 Accepted: 2022-07-28 Published Online: 2022-07-29 Printed: 2022-08-01 Ann Clin Anal Med 2022;13(8):942-946
Corresponding Author: Sadrettin Ekmen, Faculty of Medicine, Karabuk University, Karabuk, Turkey. E-mail: firstname.lastname@example.org P: +90 505 374 70 80 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9031-6361
Aim: Amplitude-integrated electroencephalogram (aEEG) is widely used in neonatal intensive care units (NICU), as it is easier to interpret than conventional EEG and does not prevent invasive procedures in infants. Although it is frequently used in the diagnosis and follow-up of Hypoxic Ischemic Encephalopathy (HIE) and neonatal convulsions developing after perinatal asphyxia, the relationship between neurological examination, aEEG and conventional EEG (cEEG) is still not fully understood.
Material and Methods: This study was carried out by retrospective evaluation of the patient’s files and aEEG records of 59 infants who were followed up with aEEG in the Neonatal Intensive Care Unit of Karabuk University Training and Research Hospital between January 1, 2020 and January 31, 2022. One infant who was beyond the neonatal period was not included in the analysis. The data of 38 infants with perinatal asphyxia and 20 infants who were prediagnosed with convulsions were evaluated.
Results: aEEG results of the infants diagnosed with perinatal asphyxia were found to be highly consistent with neurological examination in the early and late periods (84.2%). However, convulsion was detected in aEEG only in 20% of 20 infants with abnormal movements clinically suggestive of convulsions.
Discussion: Our study revealed that the use of aEEG is beneficial in infants who develop HIE after perinatal asphyxia but its benefit in the diagnosis and follow-up of neonatal seizures is not clear. We believe that the use of multi-channel aEEG and/or the use of aEEG together with conventional EEG in neonatal convulsion follow-up will provide more useful information.
Keywords: Hypoxia-Ischemia, Seizures, Newborn, Hypothermia, Electroencephalography