The effect of gender on pain, hip muscle strength, fatigue and functionality in adults patients with Guillain-Barre syndrome
Tuba Can Akman 1, Mehmet Duray 2, Aziz Dengız 1, Nilufer Cetisli Korkmaz 1
1 Department of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, 2 Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Süleyman Demirel University, Isparta, Turkey
DOI: 10.4328/ACAM.20601 Received: 2021-03-18 Accepted: 2021-06-16 Published Online: 2022-06-03 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):712-715
Corresponding Author: Tuba Can Akman, School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey. E-mail: firstname.lastname@example.org P: +90 258 2964259 F: +90 258 2964494 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5230-2009
Aim: Patients with Guillain-Barre Syndrome (GBS) commonly suffer motor, sensorial and functional problems. Gender may be the determining factor in the symptoms of these patients. The present study was planned to investigate the effect of gender on the severity of pain, muscle strength, fatigue, and loss of function in patients with GBS.
Material and Methods: Thirty-two adult patients with GBS (11 females, 21 male) were included in the study. Data on pain level, muscle strength, fatigue level, and functionality, which were assessed by using the Visual Analogue Scale (VAS), manual muscle testing, Fatigue Severity Scale and Functional Independence Measures, respectively, were obtained from patient files retrospectively.
Results: The mean age of the women was 55.90 ± 11.97 years, the mean age of the men was 63.14 ± 12.98 years. Bilateral hip extension strength of the women was significantly lower, while fatigue was significantly higher in men (p<0.05). No significant differences were detected in terms of other muscle strengths, pain level and functionality between the groups (p>0.05).
Discussion: It seems that women tend to have greater muscle weakness, while men show higher levels of fatigue in GBS. According to our results, more emphasis should be given to the strengthening of hip muscles in female patients with GBS, while energy conservation techniques should be prioritized in male patients with GBS during treatment.
Keywords: Guillain Barre Syndrome, Pain, Muscle Strength, Fatigue, Functional
IFN-γ, IL-10, ghrelin and nesfatin-1 levels in acute brucella patients
Department of Biochemistry, Health Science Faculty, Cankiri Karatekin University, Cankiri, Turkey
DOI: 10.4328/ACAM.21061 Received: 2022-01-14 Accepted: 2022-05-27 Published Online: 2022-06-13 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):716-720
Corresponding Author: Emrah Caylak, Department of Biochemistry, Health Science Faculty, Cankiri Karatekin University, Cankiri, Turkey. E-mail: email@example.com P: +90 544 613 49 99 F: +90 376 212 00 75 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0408-9690
Aim: This study aimed to investigate gamma interferon (IFN-γ), interleukin-10 (IL-10), ghrelin and nesfatin-1 levels in acute brucella patients and to evaluate the effect of combination of antimicrobial agents after therapy.
Material and Methods: Patients were assigned to the Brucella-infected group if they had confirmed laboratory findings. Sixty brucella-infected patients and thirty healthy individuals were included in the study. Doxycycline-streptomycin (DOX-STR) and doxycycline-rifampicin (DOX-RIF) were used in the treatment of brucellosis.
Results: Significantly increased IFN-γ, IL-10 and ghrelin levels and decreased nesfatin-1 levels were determined in brucella patients compared with healthy controls (p < 0.001). After therapy, IFN-γ, IL-10 and ghrelin levels were significantly lower, and nesfatin-1 levels were significantly higher compared to the pre-treatment group, especially in (DOX-STR) regimen (p < 0.001).
Discussion: It is thought that the rise of free oxygen radicals and the decrease in antioxidant capacity may play a role in the pathogenesis of brucellosis. In this study, the therapeutic power of antibiotic combinations was determined by monitoring inflammatory agents and ghrelin and nesfatin-1 levels measured before and after treatment in patients. Adding ghrelin and nesfatin-1 to effective treatment protocols for brucella will ameliorate their inflammatory status and antioxidant system.
Keywords: Brucellosis, Gamma Interferon (IFN-γ), Interleukin-10 (IL-10), Ghrelin, Nesfatin-1, Antibiotic treatment
Matrix Rhythm therapy in chronic neck pain: A pilot study
Ayşe Nur Oymak Soysal 1, Ummuhan Baş Aslan 2, Emine Aslan Telci 2, Erhan Ozfidan 3
1 Department of Therapy and Rehabilitation, Sarayköy Vocational High School, Pamukkale University, Denizli, 2 Department of Physiotherapy and Rehabilitation, School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, 3 Department of Physical Medicine and Rehabilitation, Private Tekden Hospital, Denizli, Turkey
DOI: 10.4328/ACAM.21063 Received: 2022-01-14 Accepted: 2022-06-09 Published Online: 2022-06-23 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):721-725
Corresponding Author: Ayşe Nur Oymak Soysal, Department of Therapy and Rehabilitation, Sarayköy Vocational High School, Pamukkale University, Sarayköy, Denizli, 20300, Turkey. E-mail: firstname.lastname@example.org P: +90 258 415 15 00 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5383-7937
Aim: The aim of this study was to determine the effects of Matrix Rhythm Therapy (MRT) with combined physiotherapy treatment on pain intensity, muscle spasm, disability level and depressive symptoms in chronic neck pain.
Material and Methods: A total of 26 participants with a mean age of 44,46 ± 9,98 years were randomly divided into two groups (intervention and control group). Each participant was treated with ten sessions of a combined physiotherapy program, including hot pack, transcutaneous electrical nerve stimulation, therapeutic ultrasound and conventional massage, exercises and patient education. Additionally, the intervention group received five sessions of MRT. Pain intensity, muscle spasm, disability level and depressive symptoms were assessed before and after the treatment program.
Results: There was a statistically significant improvement in pain, muscle spasm and disability levels after treatment in both groups (p<0.05), except for depression scores (p>0.05). The difference in change values in terms of activity pain and muscle spasms was found in favor of the intervention group (p<0.05), but there was no difference between the groups in terms of rest pain, disability level and depression scores (p>0.05).
Discussion: The findings of the study suggest that both the combined physiotherapy program and the MRT application in addition to the combined physiotherapy program have a positive effect on pain, muscle spasms and disability levels in patients with chronic neck pain. On the other hand, MRT increased the efficiency of the combined physiotherapy treatment in the terms of activity pain and muscle spasm in patients with chronic neck pain.
Keywords: Neck pain, Physiotherapy Modalities, Massage, Spasm
Pattern and microbiological features of diabetic foot ulcers
Gülşah Baycelebi 1, Hasan Ergenc 2, Zeynep Ergenc 2, Özlem Karaca Ocak 3, Kerim Güzel 4, Feyzi Gökosmanoğlu 5
1 Department of Internal Medicine, Atasam Hospital, Samsun, 2 Department of Internal Medicine, Ayancık Government Hospital, Sinop, 3 Department of General Surgeon, Medicana International Hospital, Samsun, 4 Department of General Surgeon, Faculty of Medicine, Biruni University, İstanbul, 5 Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Biruni University, İstanbul, Turkey
DOI: 10.4328/ACAM.21092 Received: 2022-01-31 Accepted: 2022-06-10 Published Online: 2022-06-21 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):726-730
Corresponding Author: Hasan Ergenc, Department of Internal Medicine, Ayancık Government Hospital, Sinop, Turkey. E-mail: email@example.com P: +90 368 613 10 27 F: +90 368 613 16 87 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0519-0264
Aim: Diabetic Foot Ulcers (DFUs) are a common complication of type-1 and type-2 diabetes and a significant cause of morbidity and mortality. About 10-15% of patients with diabetes develop foot ulcers. Due to insufficient diagnosis and treatment, amputations in patients occurs and treatment costs increase, which brings a serious financial burden to the patient and the country. This study aimed to evaluate the clinical and microbiological data on diabetic foot infections in our clinic.
Material and Methods: In this study, 62 diabetic foot patients who were followed up with the diagnosis of diabetic foot in our internal medicine clinic between 2016 and 2022 were retrospectively analyzed. Bacterial identification, antimicrobial therapy, and ulcer classification data, such as cultures and biopsies, were obtained from patient files and electronic records. Patients were divided into two groups: medical treatment and surgical treatment. Surgical interventions and amputations were made in line with the decisions of the diabetic foot council.
Results: A total of 62 patients, 40 (64,5%) male, and 22 (35,5%) female, were included in the study. Diabetic chronic microvascular complications were found in 49 patients and osteomyelitis in 43 patients. All of these 43 cases were amputated. The distribution of DFUs according to pathophysiological etiology was most frequently neurogenic (46.7%). Bacteria were isolated from 24 patients, and the most frequently isolated bacteria was Staph. Aureus. Other patients who did not detect growth in the culture received empirical antibiotic therapy. When patients in medical and surgical treatment groups were compared, hypertension, hyperlipidemia, bacterial growth in culture, gender, and oral antidiabetic drug or insulin use properties were statistically similar. The presence of peripheral vascular disease, poor glycemic control, osteomyelitis, sedimentation >70 mm/hr, and diabetic complications were statistically significantly higher in the surgical group.
Discussion: Poor glycemic control and diabetic chronic complications increase the risk of diabetic foot infections. It may be possible to protect patients from DFUs through glycemic control, prevention and early treatment of chronic complications.
Keywords: Diabetic Infections, Microbiological Data, Amputation
Evaluation of the effect of analgesic nociceptive monitorization in cases of urological surgery undergoing general anesthesia and spinal anesthesia
Mehmet Tepe 1, Hasan Hüsnü Yüce 2
1 Department of Anesthesiology and Reanimation, Faculty of Medicine, Adiyaman University Adiyaman, 2 Department of Anesthesiology and Reanimation, Private Meydan Hospital, Sanliurfa, Turkey
DOI: 10.4328/ACAM.21095 Received: 2022-02-02 Accepted: 2022-03-08 Published Online: 2022-06-07 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):731-735
Corresponding Author: Mehmet Tepe, Department of Anesthesiology and Reanimation, Medical School, Adiyaman University, 02100, Adiyaman, Turkey. E-mail: firstname.lastname@example.org P: +90 505 351 92 30 F: +90 416 223 16 93 Corresponding Author ORCID ID: https://orcid.org/0000-0002-2596-1284
Aim: In this study, it was aimed to identify and compare the effectiveness of spinal block and general anesthesia and to evaluate postoperative pain relations using the analgesic nociceptive index (ANI) monitoring in urologic surgery cases under general anesthesia and spinal anesthesia.
Material and Methods: Sixty patients were included in this study. The ANI palette was placed 2 cm below sternum xiphoid projection noninvasively, and ECG palette was placed to the V5 chest leads place, and ANI values after general anesthesia or spinal anesthesia and in set time intervals measurements were performed for each patient. In order to evaluate postoperative pain of patients, the visual analogue pain scale (VAS) and ANI values were recorded.
Results: Study groups were compared in terms of median ANI values at the intraoperative 0, 5, 10, 15, 20, 25, 30, 60, 90, and 120 Minutes, and there was no significant statistical difference between the two groups. Study groups were compared in terms of postoperative median ANI values. There was no significant statistical difference between the two groups. There was a low and negligible negative correlation between postoperative ANI values and postoperative VAS values. It was not statistically significant (P <0.05).
Discussion: When the study groups were compared, ANI values showed no significance in terms of intraoperative and postoperative measurements. The presence of a low and negligible negative correlation between postoperative ANI and VAS values measured in these groups is assumed to be insignificant.
Keywords: ANI, VAS, General Anesthesia, Spinal Anesthesia, Urologic Surgery
Intracranial lipomas: Clinical and radiological analysis of 153 cases and review of the literature
Ziya Asan 1, Aydan Koysuren 2, Hatice Duygu Ciftci Sivri 3
1 Department of Neurosurgery, Faculty of Medicine, Ahi Evran University, 2 Department of Neurology, Kirsehir Training and Research Hospital, 3 Department of Emergency Medicine, Kirsehir Training and Research Hospital, Kirsehir,Turkey
DOI: 10.4328/ACAM.21104 Received: 2022-02-12 Accepted: 2022-03-12 Published Online: 2022-03-13 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):736-740
Corresponding Author: Ziya Asan, Department of Neurosurgery, Faculty of Medicine, Ahi Evran University, 40100, Kirsehir, Turkey. E-mail: email@example.com P: +90 533 650 26 41 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8468-9156
Aim: It is aimed to describe the localization distribution of lipomas in cases diagnosed with intracranial lipoma, HU value measurements in CT examinations, and point value measurements in MRI and discuss them in the light of the literature.
Material and Methods: Cases diagnosed with intracranial lipoma were recorded retrospectively by scanning the radiology database and polyclinic records. The localization of the lipomas was recorded by measuring the HU value on CT imaging and spot value measurements on MRI T2 sequence imaging. The same data were recorded and compared in control radiological examinations.
Results: A total of 153 cases were diagnosed with intracranial lipoma, and falx lipoma (n:72) was the most common. Intra-calvarial lipoma, which was not defined in the literature, was detected in 21 cases. In CT examinations, the mean HU value at the time of initial diagnosis was -57.91 ± -12.81; In the examination of MRI T2 sequences, it was recorded as 1384.23 ± 101.62. In control radiological examinations, no statistically significant difference was detected between HU values in CT examinations and point values in MRI examinations.
Discussion: It was determined that intracranial lipomas did not differ in their quantitative radiological examinations. Epilepsy resistance to medical treatment is observed in almost all cortical lipomas. Association with central nervous system anomalies is seen only with callosal lipomas.
Keywords: Intracranial Lipoma, HU Value, Hounsfield Unit, Lipoma
Comparison of first admission hemogram parameters and chest computed tomography findings of pediatric COVID-19 patients
Eyüp Sarı 1, Ramiz Yazici 2, Bensu Bulut 3, Gülnur Çoban 4, Dilek Atik 5, Cengizhan Kilicaslan 6
1 Department of Pediatric, Faculty of Medicine, Health Sciences University Gülhane, Ankara, 2 Department of Emergency Medicine, Hitit University, Çorum Erol Olçok Education and Research Hospital, Çorum, 3 Department of Emergency Medicine, Faculty of Medicine, Medipol University, Istanbul, 4 Ankara Provincial Health Directorate Bilkent Public Hospitals Presidency, Ankara, 5 Department of Emergency Medicine, Faculty of Medicine, Karaman University, Karaman, 6 Department of Pediatrics, Medical School, Aksaray University, Aksaray, Turkey
DOI: 10.4328/ACAM.21106 Received: 2022-02-13 Accepted: 2022-05-10 Published Online: 2022-05-28 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):741-745
Corresponding Author: Cengizhan Kilicaslan, Department of Pediatrics, Medical School, Aksaray University, Aksaray, Turkey. E-mail: firstname.lastname@example.org P: +90 505 271 94 17 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6093-7132
Aim : We use computed tomography, which is one of the frequently used imaging tests, both as a disease diagnosis method and to follow the clinical course in COVID-19 patients. This also means radiation exposure. Radiation exposure, especially in pediatric patients, can cause life-threatening diseases. Is there a blood parameter that will reduce this undesirable event and allow estimation of computed tomography findings? Are hemogram analysis, one of the most commonly used blood tests, and tomography findings of the disease related? We designed this study based on the questions.
Material and Methods: Among the patients under the age of 18 who applied to the emergency department, those with a positive reverse transcription-polymerase chain reaction (RT-PCR) and chest CT and hemogram were included in the study. Chest CT findings were classified according to the CO-RADS classification. We compared the CO-RADS classification with hemogram parameters and the ratios of these parameters.
Results: Platelet-to-lymphocyte ratio (PLR) rates were found to be significantly lower as imaging findings became more severe (<0.05). The ratio of MedianPlatelet Volume and Platelet (MPV/Plt) was found to be significantly higher as the imaging findings worsened (p<0.05). When the relationship between laboratory parameters according to imaging groups in our study was evaluated, there was a moderate negative correlation between lymphocyte and platelet levels and imaging findings (p<0.05). A moderate positive correlation with the monocyte level was found (p<0.05).
Discussion: For the CO-RADS classification, it can be said that the patient was established to classify possible COVİD-19 patients only according to chest CT. There is no study in the literature on the classification of pediatric patients with RT-PCR positive definite COVID-19 according to chest CT scans and the comparison of laboratory findings of patients with this classification. The combination of laboratory parameters and CO-RADS classification will guide clinicians in pediatric COVID-19 patient management.
Keywords: Pediatric COVID-19, CO-RADS, Emergency Department, Hemogram Parameters
Evaluation of intraductal breast papilloma based on immunohistochemical analysis of p16, p53 and ki-67
Osman Erdogan 1, Alper Parlakgumus 2, Ugur Topal 3, Tugba Toyran 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 Pathology, Faculty of Medicine, Cukurova University, Adana, Turkey, 5 Department of Pathology, Adana City Training and Research Hospital, Adana, Turkey, 6 Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
DOI: 10.4328/ACAM.21107 Received: 2022-02-13 Accepted: 2022-03-17 Published Online: 2022-03-18 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):746-749
Corresponding Author: Osman Erdogan, Department of Surgical Oncology, Konya Numune Hospital, Konya, Turkey. E-mail: email@example.com P: +90 507 763 01 21 / :+90 332 235 45 00 F: +90 332 235 67 36 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9941-2704
Aim: This study aimed to evaluate preoperative features, postoperative outcomes, and the positivity rates of immunohistochemical staining with p16, p53 and Ki-67 in patients undergoing surgery for intraductal papilloma.
Material and Methods: The study included 33 patients aged >18 years, diagnosed with intraductal papilloma between 2011 and 2020. Data about demographic features (age and gender), clinical picture, results of pathological examinations (if present), type of surgery, and immunohistochemical staining with p16, p53 and Ki-67 were obtained. In addition, the patients were divided into 2 groups: <50 years (Group1), ≥50 years (Group2). These 2 groups were compared in terms of the abovementioned parameters.
Results: All patients were female, with a mean age of 49.75 years. Papilloma rates were equal in right and left breasts. Discovery of a mass was the most common cause for presentation (72.7%). P16 and p53 were positive in Group1 and Group 2, with rates of 90.9% and 81.8%, respectively, and the mean Ki-67 index was 2.7. All patients aged <50 years were stained with p16. The distribution of p53staining was similar in both groups (p=0.817). The mean Ki-67 index was higher in women aged >50 years (2.1 vs 3.8) (p=0.018).
Discussion: This study showed high rates of p16 and p53 positivity in patients with intraductal papilloma. Although there was no difference in the distributions of p16 and p53 between the groups, the Ki-67 index was higher in patients aged >50 years. Multicentre studies with long-term follow-ups are needed to reveal the prognostic importance of tumor-suppressing genes such as p16 and p53.
Keywords: Papilloma, p16, p53, Ki-67, Breast
The effect of the COVID-19 pandemic period on the prevalence of metabolic syndrome in patients with schizophrenia and bipolar disorder
Emine Nur Çorum 1, Emrullah Dündar 2
1 Department of Occupational Therapy, 2 Department of Psychiatry, Fatih Community Mental Health Center, Haseki Education and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21108 Received: 2022-02-13 Accepted: 2022-03-18 Published Online: 2022-03-21 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):750-753
Corresponding Author: Emine Nur Çorum, Fatih Community Mental Health Center, Haseki Education Research Hospital, 34091, İstanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 212 531 51 04 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9661-4423
Aim: This study aimed at investigating the impact of COVID-19 lockdown on metabolic profile in bipolar disorder and schizophrenia patients at the time of COVID-19.
Material and Method: This study was completed with 190 individuals diagnosed with schizophrenia (116) and bipolar disorder (74). Waist circumference and blood pressure measurements were taken on the same date as triglyceride, glucose and HDL data in the electronic recording system of the participants. Initial assessment data are measurements within 3 months prior to the publication of the first case in Turkey. The second evaluation data, on the other hand, is the data obtained within 3 months after the date of removal or relaxation of the restrictions, which is defined as the normalization period.
Results: A significant increase was observed in the incidence of metabolic syndrome in the participants after the COVID-19 lockdown. In addition, a significant increase in glucose, triglyceride and diastolic blood pressure values, and a significant decrease in HDL values were detected. There was no significant change in systolic blood pressure and waist circumference values.
Discussion: It has been shown that the COVID-19 lockdown increases the incidence of metabolic syndrome in patients with schizophrenia and bipolar disorder and causes irregularities in metabolic syndrome parameters.
Keywords: Metabolic Syndrome, Schizophrenia, Bipolar Disorder, COVID-19 Lockdown
The importance of inflammatory parameters in the management of adhesive small bowel obstructions
Gökhan Yılmaz 1, Yusuf Tanrıkulu 2, Süleyman Kargın 2, Ceren Şen Tanrıkulu 3, Beslen Göksoy 4
1 Department of General Surgery, Faculty of Medicine, Medipol University, Istanbul, 2 Department of General Surgery, Faculty of Medicine, KTO Karatay University, Konya, 3 Department of Emergency Medicine, Health Sciences University, Konya City Hospital, Konya, 4 Department of General Surgery, Sancaktepe Şehit Prof. Dr. Ilhan Varank Research and Education Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21109 Received: 2022-02-14 Accepted: 2022-03-17 Published Online: 2022-03-18 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):754-758
Corresponding Author: Gökhan Yilmaz, Department of General Surgery, Faculty of Medicine, Medipol University, Istanbul, Türkey. E-mail: email@example.com P: +90 505 682 12 87 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0889-9586
Aim: In the present study, we aimed to examine the role of the Neutrophil-lymphocyte ratio (NLR) and Platelet-Lymphocyte ratio (PLR), which are cheap and easy-to-calculate markers, in surgical treatment decisions for patients with ASBO.
Material and Methods: A total of 103 patients with ileus or similar diagnosis in system records and who underwent bridectomy due to brid ileus, as stated in the surgery notes, were included. The age of patients at the time of application, gender, previous abdominal surgeries, whether they had previous surgery due to ileus, and duration of hospitalization were recorded. NLR and PLR ratios were obtained using a simple calculation model.
Results: According to the data obtained, the sensitivity and specificity values of WBC at 11.10 cut-off value were found to be 72.34% and 85.71%, while the sensitivity and specificity values of CRP at 2.13 were found to be 59.57% and 85.71%. The same values were found to be 82.98% and 85.71%, and 61.70% and 100% for NLR and PLR, respectively. The Youden Index was used to compare the accuracy rates, and NLR with a value of 0.68 was found to be the best parameter.
Discussion: In conclusion, various studies examining the estimation of the need for surgical treatment in patients with ASBO and emphasizing mostly radiological results have been published. Although the present study was not designed to evaluate all radiological, biochemical, and clinical parameters regarding the decision of surgical treatment for the patients, it provides evidence that NLR can be a critical indicator in this matter.
Keywords: Bowel Obstruction, Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio, Inflammatory Markers, CRP, Blood Count
A comparison of miRNAs with proinflammatory cytokines and procalcitonin of sepsis in the intensive care unit
Semiha Orhan 1, Kemal Yetiş Gülsoy 2, Esra Örenlili Yaylagül 3, Halit Bugra Koca 4, Lütfi Yavuz 5, Celal Ulger 6
1 Department of Intensive Care Unit, Afyonkarahisar University of Health Sciences, Afyonkarahisar, 2 Department of Intensive Care Unit, Burdur Public Hospital, Burdur, 3 Nutrition and Dietetics, Faculty of Health Sciences, Adnan Menderes University, Aydin, 4 Department of Biochemistry, Afyonkarahisar University of Health SciencesAfyonkarahisar, 5 Department of Anaesthesiology and Reanimation, Antalya University of Health Sciences Training and Research Hospital, Antalya, 6 Department of Biology, Art and Science Faculty, Adnan Menderes University, Aydin, Turkey
DOI: 10.4328/ACAM.21110 Received: 2022-02-14 Accepted: 2022-03-18 Published Online: 2022-03-24 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):759-764
Corresponding Author: Semiha Orhan, Department of Intensive Care Unit, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Turkey. E-mail: firstname.lastname@example.org P: +90 532 728 19 79 Corresponding Author ORCID ID: https://orcid.org/0000000326176197
Aim: The development of sepsis, the low efficacy of antibiotics used, long-term antibiotic use, and the development of resistance to antibiotics are significant problems in patients in intensive care units. The use of biological markers is promising for the diagnosis and treatment of sepsis. In this study, proinflammatory cytokines, procalcitonin and four miRNA expressions were analyzed in a time-dependent manner in a patient group and control group, and the correlations between them were examined.
Material and Methods: The study included 30 patients in the intensive care unit who were diagnosed with sepsis and applied with SOFA and APACHE-2 scoring and 30 control subjects. Serum samples were taken at 24 hours, 72 hours, and on the 7th day. Analyses according to time were made for interleukin-1 beta, interleukin-6, interleukin-10, TNF-alpha, procalcitonin and four miRNAs (miR-122, miR-146a, miR-150, and miR-223) in the collected samples and comparisons were made between the patients and the control group.
Results: At 24 hours, there was a decrease in the miRNA-146a, miRNA-150, and miRNA-122 values and an increase in the miRNA-223 values in the sepsis group compared to the control group. At 72 hours, a decrease was observed in the miRNA-146a, miRNA-150, miRNA-122, and miRNA-223 values in the sepsis group compared to the control group.
Discussion: When procalcitonin and inflammatory cytokines were compared with selected miRNAs in the diagnosis, treatment follow-up, and prognosis of sepsis in the intensive care unit, a correlation between procalcitonin levels, proinflammatory cytokines and miRNA-150, miRNA-146a, and miRNA-223 was found.
Keywords: Gene Expression, miRNA, Procalcitonin, Sepsis, qRT-PCR
Effect of korean red ginseng on colon anastomotic healing: A randomised controlled experimental study
Ufuk Tali 1, Mehmet Tolga Kafadar 2, Mustafa Cömert 3
1 Department of General Surgery, Mehmet Akif Ersoy State Hospital, Çanakkale, 2 Department of General Surgery, School of Medicine, Dicle University Diyarbakır, 3 Department of General Surgery, School of Medicine, Bülent Ecevit University, Zonguldak, Turkey
DOI: 10.4328/ACAM.21112 Received: 2022-02-15 Accepted: 2022-03-19 Published Online: 2022-03-28 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):765-769
Corresponding Author: Mehmet Tolga Kafadar, Dicle University School of Medicine Department of General Surgery, Diyarbakır, Turkey. E-mail: email@example.com P: +90 412 248 80 01 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9178-7843
Aim: Although vegetable medicinal products are used worldwide, their beneficial and harmful effects have not been well documented. The aim of this study was to assess the effect of Korean red ginseng (KRG) on the healing of experimental colonic anastomosis in a rat model.
Material and Methods: Forty rats were randomized into four groups as follows: control groups (A and B) and KRG groups (C and D). Surgical procedure consisted of a transection and handsewn anastomosis of the ascending colon. Animals daily received either KRG (50ml/kg) or an equal volume of water by gavages 5 days before operation and then the surgery was done. Rats in Groups A and C were sacrificed on postoperative day (POD) 3, rats in Groups B and D were sacrificed on POD 7. Anastomotic complications and anastomotic bursting pressure measurements were recorded. Following these measurements, the anastomotic segment was resected for hydroxyproline (HPO) and histopathological evaluation.
Results: No significant differences were found in anastomotic complications. The colonic bursting pressures in the KRG groups were statistically significantly better than in the control groups. The hydroxyproline content was also significantly higher in Group C than in Group A. Histological examination confirmed that KRG treatment significantly increased neovascularization, fibroblastic activity and collagen content compared with controls on POD 7.
Discussion: Peri-operative administration of the KRG has a positive influence on the healing of colonic anastomosis in rats.
Keywords: Korean Red Ginseng, Colon, Anastomosis
Evaluation of risk factors that play roles in retinopathy of prematurity
Seda Gümüştekin 1, Şahin Takçı 2
1 Department of Pediatrics, Erciyes University, Kayseri, 2 Department of Pediatrics, Ondokuz Mayıs University, Samsun, Turkey
DOI: 10.4328/ACAM.21113 Received: 2022-02-22 Accepted: 2022-04-12 Published Online: 2022-04-14 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):770-774
Corresponding Author: Seda Gümüştekin, Department of Pediatrics, Erciyes University, Kayseri, Turkey. E-mail: firstname.lastname@example.org P: +90 554 206 60 04 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0738-4265
Aim: Increasing survival rates of preterm babies have made it necessary to focus on complications of prematurity, such as retinopathy of prematurity (ROP). The present study aimed to investigate factors that may be involved in the development of ROP.
Material and Methods: Between February 2011 and March 2018, the medical records of babies born at 32 weeks of gestation or earlier and examined for ROP at Gaziosmanpaşa University, Neonatal Intensive Care Unit (NICU) were analyzed retrospectively. Risk factors that may be associated with the development of ROP in infants were determined.
Results: A total of 193 infants were included in the study. Mean gestational age at birth and birth weight were 30.1 ± 1.9 weeks and 1487 ± 395 grams, respectively. ROP was detected in 61 (34%) of the infants, and 11 (18.1%) of those required treatment. Comparison of the characteristics of infants with and without ROP showed that gestational age at birth, birth weight, need for positive pressure ventilation in the delivery room, need and number of blood transfusions, Patent Ductus Arteriosus (PDA), Intraventricular Hemorrhage (IVH), presence of Bronchopulmonary Dysplasia (BPD), hyperglycemia, hemoglobin and hematocrit levels at discharge, period of oxygen support, time to achieve full enteral nutrition, and length of hospital stay were significant factors related to the development of ROP. In multivariate logistic regression analyses, birth weight, gestational age at birth, and period of oxygen support were the only independent risk factors.
Discussion: It is extremely important to identify risk factors for ROP and to take timely preventive and therapeutic measures for better premature outcomes.
Keywords: Prematurity, Retinopathy of Prematurity, Risk Factors
Results of treatment for acute and chronic extensor pollicis longus tendon ruptures
Numan Atılgan 1, Numan Duman 2, Tahsin Sami Colak 3, Mehmet Demiryurek 3
1 Department of Orthopedics and Traumatology, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, 2 Department of Orthopedics and Traumatology, Faculty of Medicine, Uskudar University, Istanbul, 3 Department of Orthopedics and Traumatology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
DOI: 10.4328/ACAM.21115 Received: 2022-02-20 Accepted: 2022-03-21 Published Online: 2022-03-22 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):775-778
Corresponding Author: Numan Duman, Department of Orthopaedics and Traumatology, Faculty of Medicine, Uskudar University, Istanbul, Turkey. E-mail: email@example.com P: +90 507 657 15 42 Corresponding Author ORCID ID: https://orcid.org/0000-0002-0183-4520
Aim: In this study, we aimed to observe the results of primary tendon repair in acute EPL tendon ruptures and the results of EIP tendon transfer for chronic EPL tendon ruptures.
Material and Methods: The study included patients diagnosed and operated for EPL tendon rupture and followed-up in our clinic between January 2012 and December 2020. Patients were separated into two groups according to the surgical procedure. Group A consisted of 13 patients who had EIP tendon transfer, and group B consisted of 18 patients who underwent primary EPL tendon repair. Preoperative and postoperative functional results of the groups were compared.
Results: Group A had EIP tendon transfer surgery; ten patients were male (76.9%), and three were female (23.1%). The injury was on the right side in 69.2% of the patients and on the left side in 30.8% of the patients. All patients in group B had primary tendon repair. In group B, 14 patients (77.8%) were males, and four were female (22.2%). The mean q DASH score was 66.53±10.99 for group A and 55.66±7.78 for group B. Postoperative q DASH score was 22.76 for group A, and 11.10 for group B. The joint range of motion was similar in both groups.
Discussion: In acute EPL tendon ruptures, primary tendon repair is the first treatment to be chosen, while in chronic EPL tendon ruptures, EIP tendon transfer may be the first treatment option given our clinical results.
Keywords: Tendon transfer, Rupture, Thumb
An assesment of relationship between serum preptin levels and anti-mullerian hormone in infertile womens with polycystic ovary syndrome
Mehmet Ak, Mustafa Bertan Demir
Department of Obstetrics and Gynecology, Kayseri City Education and Research Hospital, Kayseri, Turkey
DOI: 10.4328/ACAM.21117 Received: 2022-02-19 Accepted: 2022-03-22 Published Online: 2022-03-28 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):779-782
Corresponding Author: Mehmet Ak, Department of Obstetrics and Gynecology, Kayseri City Education and Research Hospital, 38072, Kayseri, Turkey. E-mail: firstname.lastname@example.org P: +90 506 684 90 49 F: +90 352 315 77 00 Corresponding Author ORCID ID: https://orcid.org/0000-0003-3384-0586
Aim: Despite the clear relationship between AMH, insulin and androgen levels, the relationship between preptin and AMH levels is not known. The close metabolic similarity between preptin and insulin suggests that there may be a relationship between this peptide and AMH. This study was planned to reveal the relationship between serum preptin, AMH, insulin and other metabolic parameters in infertile women with polycystic ovary syndrome (PCOS).
Material and Methods: Thirty infertile women with PCOS and 30 age- and BMI- matched control patients who did not have clinical and laboratory findings of PCOS were included in the study. In addition to serum preptin and AMH levels, other hormonal parameters such as insulin, androgens and HOMA-IR were measured on the third day of the cycle. Human preptin ELISA kit was used for preptin measurement. AMH Gen II ELISA kit was used for AMH measurement. The correlation between AMH, preptin, HOMA-IR and other endocrine and demographic parameters were evaluated.
Results: Serum total testosterone, insulin, LH levels and HOMA-IR of patients in the PCOS group were significantly higher than in the non-PCOS control group. FSH levels were similar in both groups. Median AMH levels in the PCOS groups were 8.44 (3.40–18.34) ng/mL. Median AMH levels in the non-PCOS control group were 3.50 (1.80–8.13) ng/mL. AMH values in the PCOS group were found to be significantly higher than in the control group (p<0.001). Serum preptin levels in the PCOS group were approximately six times higher than in the control group (244.13 (27-367) pg/mL vs. 42.22 (13-56) pg/mL, p <0.002). A positive and significant correlation was found between serum preptin levels and AMH (r=0.76, p <.05) and HOMA-IR (r=0.69, p <.02) values. A positive and significant correlation was found between AMH levels and both serum LH (r=0.70, p <.05) and testosterone levels (r=0.88, p <.01).
Discussion: This clinical study showed for the first time a positive relationship between serum preptin levels and AMH values in PCOS patients.When our study and the literature were reviewed together, it was observed that serum preptin levels increased in PCOS patients with a clinical picture similar to metabolic syndrome. Preptin’s relationship with other endocrine and demographic parameters is similar to insulin. In our study, the only point different from other studies is the positive correlation between preptin and serum AMH values. Despite the small number of our cases, this study has clinical significance as it is the first study to examine the relationship between preptin and AMH and insulin levels. We will be able to make clearer comments on this issue thanks to studies investigating serum and intra-follicular AMH and preptin values in PCOS cases simultaneously.
Keywords: PCOS, HOMA-IR, Preptin, AMH, Insulin
Predictors of hospitalization and short-term mortality among lung cancer patients in the emergency department
Yasemin Söyler, Pınar Akın Kabalak, Feza Uğurman
Department of Chest Diseases, Ankara Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21119 Received: 2022-02-20 Accepted: 2022-03-23 Published Online: 2022-03-28 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):783-787
Corresponding Author: Yasemin Söyler, Kuşcağız Mahallesi, Sanatoryum Cad., 06280, Keçiören, Ankara, Turkey. E-mail: email@example.com P: +90 535 843 07 36 Corresponding Author ORCID ID: https://orcid.org/0000-0002-0507-0767
Aim: Lung cancer is one of the leading reasons for emergency department (ED) visits. In this study, we aimed to determine the reasons for ED visits and to identify predictive factors for hospitalization and short-term mortality (30-days mortality).
Material and Methods: We conducted a retrospective, observational study on lung cancer patients admitted to ED of a tertiary hospital between 01 January 2018 and 01 January 2020. Patients’ demographic data, main symptoms on admission, laboratory parameters, and radiological findings were recorded. Logistic regression analysis was employed to identify the predictive factors for hospitalization and short-term mortality.
Results: A total of 200 lung cancer patients (174 males, 36 females, mean age 64± 9.5 years) were included in the study. Respiratory symptoms (44.5%), clinical deterioration (23%), and pain (10.5%) were the most common main symptoms; 25% of patients had pneumonia on admission; 53% of patients were hospitalized and 4% of patients died in ED. Among the hospitalized patients, the length of stay in the hospital was 9.5 (1-56) days, during which 48 deaths (41.4%) were recorded. Among all patients, 41% died within 30 days after ED visits. In multivariate logistic regression, the presence of pneumonia was found to be a statistically significant predictive factor in both hospitalization (OR=5.420; 95%CI, 2.114 – 13.898; p < 0.001) and short-term mortality. (OR=0.241; 95%CI, 0.109 – 0.534; p < 0.001).
Discussion: The presence of pneumonia on admission is an important risk factor for hospitalization and short-term mortality. These relationships should be kept in mind for the careful management of lung cancer patients in ED.
Keywords: Emergency Department, Hospitalization, Lung Cancer, Pneumonia, Short-Term Mortality
Evaluation of disease spectrum diagnosed with bone marrow biopsy at a tertiary healthcare center in Turkey
Ahmet Seyhanlı 1, Yazgulu Cansu Ozkan 2, Sermin Ozkal 3, Guner Hayri Ozsan 4, Fatih Demırkan 4, Inci Alacacıoglu 4
1 Department of Hematology, Sivas Numune Hospital, Sivas, 2 Department of Internal Medicine, Dokuz Eylül University Faculty of Medicine, Izmir, 3 Department of Pathology, Dokuz Eylül University Faculty of Medicine, Izmir, 4 Department of Hematology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
DOI: 10.4328/ACAM.21122 Received: 2022-02-21 Accepted: 2022-03-21 Published Online: 2022-03-22 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):788-791
Corresponding Author: Ahmet Seyhanlı, Department of Hematology, Sivas Numune Hospital, Sivas, Turkey. E-mail: firstname.lastname@example.org P: +90 555 395 72 31 Corresponding Author ORCID ID: https://orcid.org/0000-0001-6082-2995
Aim: Bone marrow examination (BME) is commonly implemented to diagnose hemato-oncological diseases. There are only a few reports on diseases diagnosed via the BME and diagnostic yield in patients who applied to the hematology department. This study aimed to identify the primary indications and diagnoses of BME in patients who underwent bone marrow biopsy at Dokuz Eylul University in Turkey.
Material and Methods: We retrospectively reviewed demographic and laboratory data of 505 patients from January 2014 to September 2021. The cases under the age of 18 years were excluded. The patients were also stratified according to demographic data and diagnoses.
Results: Among the 505 bone marrow biopsies (BMB) studied, 386 (76.4%) procedures were performed to evaluate suspected malignancy and 119 (23.6%) for non-malignant indications. The primary indications for BME were: cytopenia (117, 23.2%), plasma cell neoplasm (PCN) (94, 18.6%), and myeloproliferative neoplasms (93, 18.4%). The most common diagnoses among all patients were PCN (110, 21.8%). Non-malignant outcomes comprised 3.2% of the total outcomes with 16 cases, of which thrombocytopenia due to peripheral destruction (immune thrombocytopenia) was the most common with eight (1.6%) patients. The majority of patients diagnosed with myelodysplastic syndrome and CLL were seen in patients aged 65 years and older.
Discussion: There is little published literature on the bone marrow profile, especially in geriatric patients. The higher incidence of hematological diseases in patients under 65 years of age can be attributed to more common BME procedures, which leads to earlier diagnosis.
Keywords: Hematologic Diseases, Trephine Biopsy, Bone Marrow
Organic or psychosomatic? A cross-sectional study
Süleyman Dönmezdil 1, Eşref Araç 2, Mahir Yeşildal 3, Mehmet Diyadin Güleken 4, Abidin Tüzün 5
1 Department of Experimental Psychology, Artuklu University, Mardin, 2 Department of Internal Medicine, Dicle University Faculty of Medicine, Diyarbakır, 3 Department of Psychiatry, Faculty of Medicine, Üsküdar University, İstanbul, 4 Department of Psychiatry, Gazi Yaşargil Training and Research Hospital, Diyarbakır, 5 Department of General Surgery, University of Health Sciences, Diyarbakır, Turkey
DOI: 10.4328/ACAM.21123 Received: 2022-02-22 Accepted: 2022-05-23 Published Online: 2022-05-27 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):792-796
Corresponding Author: Süleyman Dönmezdil, Department of Psychology, Artuklu University, Mardin, Turkey. E-mail: email@example.com P: +90 507 796 57 00 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7171-1374
Aim: Symptomatic treatments of psychosomatic symptoms are not successful because they cannot solve true etiological causes. To resolve the disorder, it is first necessary to investigate and diagnose the underlying cause and persuade the patient to use the appropriate drugs. In this study, it was aimed to make suggestions in order to identify patients who may have psychiatric symptoms and to prevent unnecessary invasive procedures by scanning psychosomatic symptoms prior to endoscopy indication.
Material and Methods: The Cornell index, Beck depression and Anxiety scales, and the Somatization scale were applied to 140 patients whose EGD procedure was planned. The patients were divided into three groups as normal endoscopic examination, antral gastritis, and other disease diagnoses (erosive gastritis, gastric ulcer, etc.). Beck Depression and Beck Anxiety Inventory scores were statistically lower in other diagnostic groups than in normal endoscopic findings and antral gastritis groups. Also, scores on the somatization scale were significantly higher in normal endoscopic findings and antral gastritis groups compared to other diagnostic groups.
Results: In patients who underwent EGD, the process was found to be more likely to cause normal endoscopic examination as the age decreased. In addition, somatization, Cornell index, anxiety and depression scores were higher at a young age.
The Cornell Medical Index showed a significantly higher sub-score of the strong neurotic structure in the antral gastritis group compared to the other groups. Similarly, there were significantly higher scores for the subscales of depression, irritability-anxiety, fear-startle, psychosomatic symptoms, hypochondriasis, and gastrointestinal disorders in the antral gastritis group compared to other diagnostic groups
Discussion: Our results show that applying the somatization scale or an equivalent screening scale to screen psychiatric symptoms before seeking endoscopic examination, especially in the young population, can provide early treatment and prevent increased treatment costs.
Keywords: Psychosomatic, Esophagogastroduodenoscopy, Somatization, Anxiety, Depression, Gastritis
Evaluation of D-dimer and fibrinogen levels in COVID-19 patients
Şeyma Aras, Emine Emektar, Şeref Kerem Çorbacıoğlu, Yunsur Çevik
Department of Emergency Medicine, Ankara Sanatoryum Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21126 Received: 2022-02-24 Accepted: 2022-03-29 Published Online: 2022-03-30 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):797-801
Corresponding Author: Emine Emektar, Ardahan Sokak, Sanatoryum Caddesi, No:25, 06280, Keçiören, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 505 556 26 75 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6056-4401
Aim: The aim of this study is to determine D-dimer and fibrinogen levels in COVID-19 patients and to evaluate their correlation with in-hospital mortality.
Material and Methods: Patients aged 18 years and older who applied to the emergency and/or pandemic outpatient clinic of our hospital and were hospitalized and whose COVID-19 PCR test was positive were included. Demographic data, vital and physical examination findings, laboratory values including D-dimer and fibrinogen levels were recorded. P <0.05 was considered statistically significant.
Results: Patients with increased D-dimer value were found to have higher age, higher rate of chronic kidney disease, higher fever and pulse values, lower saturation measurements, longer duration of the complaint, more severe pneumonia, longer hospital stay, greater requirement for mechanical ventilation and intensive care (p<0.05 for all values).
It was observed that the patients with increased fibrinogen were older and the duration of complaints was longer. When the laboratory values of the patients with and without fibrinogen increase were compared, it was determined that neutrophil, CRP and sedimentation values of the patients with increased fibrinogen were lower (p<0.05 for all values).
Discussion: In our study, we demonstrated that D-dimer levels measured at admission and during follow-up were higher in the deceased patients than in the surviving ones. We did not detect any clinical association between admission and follow-up fibrinogen levels and mortality in the deceased patients as compared with the surviving ones.
Keywords: COVID-19, D-dimer, Fibrinogen
The effect of rehabilitation in patients with facioscapulohumeral muscular dystrophy: A prospective clinical study
Department of Physical Therapy and Rehabilitation, Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey
DOI: 10.4328/ACAM.21129 Received: 2022-03-01 Accepted: 2022-04-04 Published Online: 2022-04-05 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):802-806
Corresponding Author: Askeri Turken, Elazig Yolu, 10. Km, Uckuyular Mevkii, 21070, Kayapinar, Diyarbakir, Turkey. E-mail: email@example.com P: +90 412 258 00 60 F: +90 412 258 00 50 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0638-8918
Aim: Facioscapulohumeral muscular dystrophy (FSHD) is a rare and slowly progressive disease that causes physical limitations. In our study, it was aimed to reveal the effects of rehabilitation and treatment programs applied in FSHMD patients on activities of daily living and walking.
Material and Methods: A clinical intervention trial was conducted. Data of 33 of the 38 patients diagnosed with FSHD were analyzed. A 20-weeks rehabilitation program composed of exercises (muscle-strengthening, stretching, range of motion, balance, coordination, walking, posture, and breathing), patient and family education, and neuromuscular electrical stimulation. Functional assessments were performed with the Barthel-Index (BI), the functional categories of ambulation (FAC) test, and the Oxford muscle strength grading scale before and after the rehabilitation.
Results: Average age of the participants (±SD) was 30.88±11.43 years, and 81.8% (n=27) were males. All patients had periscapular weakness and wing scapula. There was no prominent difference between flexion and extension and abduction of the two upper limb extremities (p> 0.05). There was a substantial increase in Barthel scores of the patients after rehabilitation (Z= 3,535; p<0.001).
Discussion: The implementation of the rehabilitation program causes an increase in BI scores. It is recommended that training of the society and health personnel will be beneficial. Further studies are needed to provide information about the frequency of this disease in the Turkish population.
Keywords: Rehabilitation, Muscular Dystrophy, Activities of Daily Living, Disability Studies, Genetic Disorders
Nasogastric tube placement verification with ultrasound by emergency nurses
Birdal Güllüpınar 1, Caner Sağlam 1, Arif Karagöz 2, Shikha Tandon 3, Erden Erol Ünlüer 4
1 Department of Emergency Medicine, Izmir Bozyaka Training and Resarch Hospital, Izmir, Turkey, 2 Department of Emergency Medicine, Izmir Çiğli Training Hospital, Izmir, Turkey, 3 Department of Emergency Medicine, Fortis Hospital, Mohali, India, 4 Department of Emergency Medicine, University of Medical Sciences, Izmir Bozyaka Training and Resarch Hospital, İzmir, Turkey
DOI: 10.4328/ACAM.21180 Received: 2022-04-10 Accepted: 2022-06-07 Published Online: 2022-06-07 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):807-811
Corresponding Author: Birdal Güllüpınar, Department of Emergency Medicine, Izmir Bozyaka Training and Resarch Hospital, Izmir, Turkey. E-mail: firstname.lastname@example.org P: +90 232 250 50 50 / +90 541 940 03 69 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6657-5654
Aim: Nasogastric tube placement is a common procedure. Its insertion can lead to pulmonary complications, perforation, and even death. It is imperative to confirm the placement of the nasogastric tube. Ultrasound is a diagnostic method which can be used to confirm nasogastric tube placement. It has been used successfully not only by physicians but by nurses as well. We aimed to determine the skills of emergency nurses to use the ultrasound for the confirmation of nasogastric tube placement after ultrasound training.
Material and Methods: This study is a single-center, prospective and single-blind study. The study was performed to evaluate the ability of emergency nurses to confirm correct nasogastric tube placement. Six emergency nurses were given theoretical education and hands-on training about ultrasound. They confirmed the location of the nasogastric tube using ultrasound.
Results: A total of 84 patients were included in the study. According to the radiograph, the tube was not in the stomach in two out of 84 patients. While ultrasound verified that the tube was not in the stomach for 5 patients, it detected these two patients. The sensitivity and specificity of ultrasound performed by nurses were 96.34% and 100%, respectively. The area under the curve calculated for the predictive power of the nurses’ ultrasound findings according to the radiography results was found to be 0.982 and statistically significant (p<,0.0001).
Discussion: Ultrasound can be performed by nurses the confirmation of correct nasogastric tube placement. Additionally, ultrasound may not be able to eliminate but significantly reduce the need for radiography.
Keywords: Nasogastric Tube, Enteral Nutrition, Emergency Nurse, Emergency Department, Point-of-care Ultrasound
Relationships between pain severity and sleep quality in people with neck pain
Department of Physical Medicine and Rehabilitation, Diyarbakır Dağkapı State Hospital, Diyarbakır, Turkey
DOI: 10.4328/ACAM.21191 Received: 2022-04-19 Accepted: 2022-06-19 Published Online: 2022-06-27 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):812-815
Corresponding Author: Özkan Yükselmiş, Dr. Şeref İnalöz Sokak, 21100, Yenişehir, Diyarbakır. E-mail: email@example.com P: +90 0531 525 39 66 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1996-7030
Aim: Studies have shown that individuals with neck pain experience a severe deterioration in sleep quality, individuals with low sleep quality receive less benefit when they receive neck pain treatment, and decrease in sleep quality increases the symptoms of depression in individuals with severe neck pain.
In the literature, studies on pain and sleep quality in individuals with neck pain have been conducted. However, studies that include all of these factors and determine the relationship between each other are not included. In this context, the aim of our study was to determine the relationship between pain severity and sleep quality in individuals with neck pain.
Material and Methods The study included 89 volunteers aged 18-65 years with complaints of neck pain with a score of 4 and above according to the Neck Disability Index (BDI). The pain intensity of the individuals participating in the study was evaluated with the Visual Analog Scale (VAS), their sleep quality was evaluated with the Pittsburg Sleep Quality Index (PUKI), and their personal information was evaluated with the Personal Information Form.
Results: In our study, it was observed that there was a moderate positive relationship between PUKI and BDI. In our study, a moderate positive correlation was determined between the increase in pain intensity and the deterioration in sleep quality.
Discussion: It was determined that impaired sleep quality could lead to neck disability.
Keywords: Neck Pain, Sleep Quality, Pain Severity
Assessment of inflammatory markers in ulcerative colitis and association with the disease
Ahmed Ramiz Baykan 1, Serkan Cerrah 1, Büşra Karahan 2, Sedat Çiftel 1, Ayetullah Temiz 3, Elmas Kasap 4
1 Gastroenterology, Erzurum Regional Training and Research Hospital, Erzurum, 2 Department of Internal Medicine, Erzurum Regional Training and Research Hospital, Erzurum, 3 Department of General surgery, Regional Training and Research Hospital, Erzurum, 4 Department of Gastroenterology, Celal Bayar University, Manisa, Turkey
DOI: 10.4328/ACAM.21202 Received: 2022-04-21 Accepted: 2022-06-16 Published Online: 2022-06-19 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):816-820
Corresponding Author: Ahmed Ramiz Baykan, Gastroenterology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey. E-mail: firstname.lastname@example.org P: +90 555 506 18 78 Corresponding Author ORCID ID: https://orcid.org/0000-0001-6798-0240
Aim: In daily routine practice, non-invasive tests are needed in addition to symptoms to determine activation in patients with ulcerative colitis (UC). In this study, it was aimed to compare the results of non-invasive tests used frequently at the time of diagnosis of patients diagnosed with UC with endoscopic severity.
Material and Methods: This retrospective cohort study was carried out on 202 patients between 2018 and 2022. The white blood count (WBC), mean platelet volume (MPV), hemoglobin (HB), hematocrit (Hct), C-reactive protein (CRP), albumin, neutrophil-lymphocyte ratio (NLR), CRP-albumin ratio (CAR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) of the patients were calculated at the time of diagnosis. The severity of UC was assessed via colonoscopy using the Mayo Endoscopic Subscore (Mayo Score). In addition, patients with active UC were re-evaluated during remission to calculate the predictive values of tests in UC activation and severity.
Results: There was a significant correlation between the Mayo Subscore and CRP (r: 0.34, P < 0.01), WBC (r: 0.23, P = 0.01), HB (r: –0.23, P = 0.01), NLR (r: 0.49, P < 0.01), CAR (r: 0.51, P < 0.01), PLR (r: 0.32, P < 0.01), and LMR (r: –0.34, P < 0.01). The sub-assessment, taking colon involvement into consideration, showed a correlation between the Mayo Subscore and NLR and CAR with pancolitis, left colon involvement, and distal colitis. The highest area under the curve (AUC) value, found in the tests, was with the CAR (0.919). When the CAR cut-off value was taken as 0.11, the sensitivity was 80.2%, and the specificity was 94.4%, indicating UC activation.
Discussion: Inflammatory markers in UC have adequate sensitivity in indicating activation, and they also aid in the identification of severity of involvement in patients.
Keywords: Ulcerative Colitis, CRP-Albumin Ratio, Neutrophil-Lymphocyte Ratio
Inferior vena cava and pulmonary artery diameters for prognosis of Coronavirus disease
Mehmet Altuntaş 1, Mümin Murat Yazıcı 1, Ali Çelik 1, Kemal Panç 2, Nur Hürsoy 2
1 Department of Emergency Medicine, 2 Department of Radiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
DOI: 10.4328/ACAM.21220 Received: 2022-05-05 Accepted: 2022-06-11 Published Online: 2022-06-22 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):821-825
Corresponding Author: Mehmet Altuntaş, Department of Emergency Medicine, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey. E-mail: email@example.com P: +90 506 416 14 04 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5624-968X
Aim: In this study, we aimed to analyze the relationship between pulmonary artery (PA) and inferior vena cava (IVC) diameters in non-contrast chest computerized tomography (CT) images of patients with coronavirus disease 2019 (COVID-19) and overall survival.
Material and Methods: This retrospective study consisted of 404 consecutive patients who underwent chest CT after admission to the emergency department between May 1 and June 31, 2021. CT measurements were performed by two radiologists. The prognostic value of PA and IVC diameters, the computerized tomography severity score (CT-SS), quick sequential organ failure assessment (qSOFA), and confusion, urea, respiratory rate, blood pressure, and age ≥65 years (CURB-65) score on overall survival were examined.
Results: The median age of the participants was 62 years (49-72), and 196 (48.5%) were male. Of the 404 patients, 61 died after admission. While main-PA, left-PA, right-PA (p < 0.001) and IVC-transverse (IVC-Tr) (p = 0.045) diameters were larger and statistically significant in the patients who died (AUC; 0.686, 0.722, 0.746, and 0.581, respectively), a statistically significant difference was not detected in terms of IVC anteroposterior diameter (IVC-AP) (p = 0.053) and the IVC-Tr/AP (p = 0.754) ratio. There was a statistical difference in mortality in qSOFA, CURB-65, and CT-SS values (AUC; 0.727, 0.798, and 0.708 p < 0.001, respectively).
Discussion: PA diameters measured from chest CT images at admission (main-PA ≥ 26.5 mm, right-PA ≥ 22.9 mm, and left-PA ≥ 21.6 mm) and the IVC-Tr diameter (≥34.5 mm) can be used as mortality predictors for COVID-19, along with other prognostic scores.
Keywords: Emergency Department, COVID-19, Pulmonary Artery, Inferior Vena Cava, Prognosis
Treatment of hydatid liver cyst: Comparison of open and laparoscopic surgery
Ercan Korkut 1, Nurhak Aksungur 1, Necip Altundaş 1, Salih Kara 1, Rıfat Peksöz 1, Mesud Fakirullahoğlu 2, Gürkan Öztürk 1
1 Department of General Surgery, Faculty of Medicine, Atatürk University, 2 Department of General Surgery, Erzurum City Hospital, Erzurum, Turkey
DOI: 10.4328/ACAM.21254 Received: 2022-05-31 Accepted: 2022-06-30 Published Online: 2022-06-30 Printed: 2022-07-01 Ann Clin Anal Med 2022;13(7):826-830
Corresponding Author: Ercan Korkut, Department of General Surgery, Faculty of Medicine, Atatürk University, Erzurum, Turkey. E-mail: firstname.lastname@example.org P: +90 505 562 27 89 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8543-7778
Aim: The aim of this study was to compare parameters that influence patient selection, cyst features, treatment outcomes, morbidity, and death rates in hepatic hydatid disease open versus laparoscopic surgery.
Material and Methods: A total of 660 patients were assessed between 2010 and 2020 who had surgery for a hepatic hydatid cyst diagnosis. The decision for open or laparoscopic surgery was made according to the stage, localization, number, size, and complication features of the cysts observed in the Computerized Tomography (CT) images and the characteristics of patients. The patients were divided into two groups: Open Surgery (Group A; n=607) and Laparoscopic Surgery (Group B; n=53). In terms of morbidity and mortality, characteristics of the cysts, patients, operation type, and treatment outcomes in both groups were compared.
Results: The demographic characteristics of the groups were similar. A total of 1020 cysts were determined in 660 patients. In Groups A and B, the mean number of cysts was 1.59 and 1.03, respectively. The mean duration of surgery in Group A and B was 110 ± 22 minutes and 70±18 minutes, respectively (p> 0.05). The mean hospitalization time in Group A and B was 9.3± 6.5 days and 6.5±1.1 days, respectively (p<0,05). The rate of biliary fistula in Group A and B was 35.5%, and 13.2%, respectively (p<0.05). The rate of other complications was 11.5% in Group A and 3.7% in Group B (p<0.05).
Discussion: Laparoscopic surgery is an effective and safe intervention for cysts in the accessible peripheral segments of the liver.
Keywords: Liver Hydatid Cyst, Laparoscopic Surgery, Open Surgery, Morbidity, Mortality