Sigma metrics and quality goal index: A new road map in clinical chemistry
Yasemin Erdoğan Döventaş 1, Hatice Erdoğan 2
1 Medical Biochemistry, 2 Medical Microbiology, Ministry of Health University, Haseki Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.20677 Received: 2021-04-29 Accepted: 2021-07-11 Published Online: 2022-02-16 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):241-244
Corresponding Author: Yasemin Erdoğan Döventaş, Ministry of Health University, Haseki Training and Research Hospital, Medical Biochemistry, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 532 548 59 51 Corresponding Author ORCID ID: https://orcid.org/0000-0003-3166-841X
Aim: Sigma measurements are a standard tool for quality assessment of test performance in a laboratory. In this study, we aimed to calculate sigma metrics and quality goal index (QGI) for 28 biochemical parameters. Sigma values of each assay were calculated, based on the bias and coefficient of variation from internal quality control (IQC) and external quality assurance scheme (EQAS).
Material and Methods: External quality assessment (EQA) and internal quality control data for 28 parameters in a biochemical laboratory were collected from July 2019 to February 2020. The sigma values of each assay were calculated, based on the bias, total error allowable, and coefficient of variation, according to the quality goal index, the main causes of poor performance were determined to guide quality improvement. This study was conducted in the Haseki Training and Research Hospital Biochemistry Laboratory. Sigma metrics calculation was performed as (TEA − Bias)/CV for 28 biochemistry parameters analyzed with AU5800 [Beckman Coulter (BC), USA]. Total allowable errors were followed as per Clinical Laboratory Improvement Amendments (CLIA) guidelines.
Results: At IQC 1, eight of the 28 parameters (AST, ALT, LDH, CK, ALP, HDL, T. Bil
and D. Bil) showed world-class performance. At IQC 2, three of the 28 parameters (ALP, T.bil, and Crea) achieved 6 sigma (world-class performance), and three parameters (Amilase, K, Cl, and Lipase) showed world-class performance for EQC. The quality goal index (QGI) was calculated for items with analysis performance < 3 sigma, and the main causes of poor performance were determined to guide quality improvement.
Discussion: Sigma metric analysis provides a benchmark for the laboratory to design a protocol for IQC, address poor assay performance, and assess the efficiency of the existing laboratory process. Six Sigma methodology is an effective tool for evaluating the performance of biochemical analytes and conducive to quality assurance and improvement. The quality goal index is a calculation that complements this method.
Keywords: Internal quality control (IQC), External quality control (IQC), Quality goal index (QGI), Six sigma
Measuring depression and anxiety level and determining concerns regarded to pandemic in doctors and nurses working in operating room
Kadriye Acar 1, Hüseyin Acar 2, Erdinç Kamer 3, Gülay Oyur Çelik 4
1 Department of Surgery Room, Izmir Katip Çelebi University, Atatürk Training and Research Hospital, 2 Department of Emergency Medicine, Izmir Katip Çelebi University, Atatürk Training and Research Hospital, 3 Department of General Surgery, Izmir Katip Çelebi University, Atatürk Training and Research Hospital, 4 Department of Surgery Nursing, Faculty of Health Sciences, Izmir Katip Çelebi University, Izmir, Turkey
DOI: 10.4328/ACAM.20686 Received: 2021-05-03 Accepted: 2021-07-26 Published Online: 2022-02-21 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):245-249
Corresponding Author: Hüseyin Acar, Department of Emergency Medicine, Izmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey. E-mail: email@example.com P: +90 (532) 500 90 29 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1905-7133
Aim: One of the most important conditions for healthcare professionals to work efficiently during the pandemic is to ensure complete physical and mental well-being. This study was planned to measure the depression and anxiety levels of nurses and doctors working in the operating room during the COVID-19 pandemic, and to determine the causes of anxiety related to the pandemic.
Material and Methods: This study is a cross-sectional, descriptive and region-stratified survey study. This study was conducted with operating room nurses and doctors who volunteered to participate. Participants were administered a survey consisting of 13 questions that questioned the reasons for concern about COVID-19 in addition to the Beck Anxiety Scale and Beck Depression Scale.
Results: There was no difference between doctors and nurses regarding anxiety and depression symptoms. Anxiety level was higher in men. Depression and anxiety levels were high in those who worked for sixteen years and over, while depression and anxiety levels were significantly lower in the 18-35 age group. The most worrisome situation for healthcare professionals was the possibility of working in a unit where they had never worked before. The working area that the participants considered the most risky one in relation to COVID-19 was the emergency operating room.
Discussion: We observed that participants showed mild depression symptoms and moderate anxiety. Also, psychological conditions of the younger participants were better.
Keywords: Depression, Anxiety, COVID-19, Pandemic, Healthcare workers
The impact of COVID 19 pandemic on pattern of cancer mortality in Najran, Saudi Arabia: A single-cancer center experience
Ahmed M. Badheeb 1, Mohamed A. Badheeb 2, Hamdi Alhakimi 3
1 Departmant of Medical Oncology, Oncology Centre, King Khalid Hospital, Najran, Saudi Arabia, 2 Departmant of Medicine, King Khalid Hospital, Najran, Saudi Arabia, 3 Department of Public Health Sciences, Uttech university, Uttech, Netherlands, Holland
DOI: 10.4328/ACAM.20778 Received: 2021-07-09 Accepted: 2021-08-20 Published Online: 2022-02-05 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):250-252
Corresponding Author: Ahmed Mohamed Badheeb, Oncology Centre, King Khalid Hospital, 1120, Najran, Saudi Arabia. E-mail: Badheebdr@gmail.com P: +96 653 831 84 39 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9753-5583
Aim: To explore the association between mortality and Covid infection, age, sex, site of cancer, stage, and the interval between the last dose of chemotherapy given within the last 30 days before death.
Material and Methods: Adult cancer patients who died of cancer in King Khalid Hospital in Najran -Saudi Arabia , were included in this retrospective observational study. We compared mortality patterns in a period of 6 months in 2020 (March to August) with the corresponding period of 2019.
Results: 50 dead adult cancer patients were included, 24 in 2019 and 26 in 2020. Among them, 21% vs 42% were younger than 65 years of age; 61% vs 62% were males, for the years 2019 & 2020 respectively. The top three killers in 2019 were colorectal, gastro-esophageal cancers, and hepatocellular carcinoma, while in 2020 were colorectal, hepatocellular carcinoma, and lymphomas. About 16.7% of patients died within 30 days of receiving anti-cancer treatment in 2019 in comparison with 7.7% in 2020. The difference in the 30-days mortality after receiving anti-cancer treatment was not statistically significant between 2019 and 2020 (p=0.329).
Discussion: The Year 2020, the time of the COVID-19pandemic, was not associated with a significant increase in the short-term mortality among patients with malignancy in Najran, Saudi Arabia. Our results generally reflect the crucial role of strict preventive national measures in saving lives and warrants further exploration.
Keywords: COVID 19, SARS-CoV-2, Mortality, Malignancy, Cancer
Comparison of dual-task performance in healthy geriatric individuals from different age groups
Yasemin Martin 1, Duygu Şahin 2, Filiz Altuğ 3, Hanifegül Taşkıran 4
1 Private Empathy Consulting Special Education and Rehabilitation Center, Denizli, 2 Department of Physiotherapy and Rehabilitation, Institute of Health Science, Hacettepe University, Ankara, 3 School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, 4 Department of Physiotherapy and Rehabilitation, Istanbul Aydin University, İstanbul, Turkey
DOI: 10.4328/ACAM.20868 Received: 2021-09-21 Accepted: 2021-10-21 Published Online: 2021-10-28 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):253-257
Corresponding Author: Duygu Şahin, Division of Physical Therapy and Rehabilitation, Institute of Health Science, Hacettepe University, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 553 524 40 74 Corresponding Author ORCID ID: https://orcid.org/0000-0002-2914-7976
Aim: The aim of this study was to compare the dual-task performance of healthy geriatric individuals in different age groups.
Material and Methods: One hundred and two healthy geriatric individuals were included in our study (Group 1: aged 65-75 years, Group 2: aged 75-84 years). In single-task, Montreal Cognitive Assessment Scale was used to evaluated cognitive performance; Timed Up and Go Test, 30 Seconds Sit-to-Stand Test and 10 Meter Walking Test were applied to evaluate motor performance. Dual-task performance was evaluated as motor-motor and motor-cognitive. The Dual-Task Questionnaire was applied to determine how difficult it was for the individuals during the dual-task.
Results: In single-task comparisons, a significant difference was found in favor of Group 1 in all assesments. While there was a significant difference in favor of Group 1 in motor-motor dual-task performance duration and motor-cognitive dual task performance duration (p= .000), there was no statistically significant difference in motor-motor dual-task performance (p=0.791) and motor-cognitive dual task performance (p=0.475) between groups. For Dual-Task Questionnaire, a significant difference was found between the two groups in favor of Group 1 (p= .000).
Discussion: Correspondingly with the decrease in physical and cognitive functions that occur with aging, a decrease in dual-task performance and performance durations were observed. Analyzing the studies conducted in the literature and more comprehensive studies on this subject will guide authors and clinicians.
Keywords: Aging, Cognition, Geriatrics, Rehabilitation
Comparison of glucose concentration stability in serum and plasma tubes
Nilgun Isiksacan 1,2, Pinar Kasapoglu 1, Alev Kural 1, Zeynep Levent Cirakli 1, Munevver Mert 1, Yuksel Gulen Cicek 1, Sehide Baz 1, Duygu Teksoz 1, Sebnem Tekin Neijmann 1
1 Department of Biochemistry, University of Health Sciences, Bakirköy Dr. Sadi Konuk Training and Research Hospital, 2 Department of Immunology, University of Health Sciences, Istanbul, Turkey
DOI: 10.4328/ACAM.20887 Received: 2021-10-07 Accepted: 2022-01-17 Published Online: 2022-01-25 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):258-262
Corresponding Author: Nilgun Isiksacan, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Zuhuratbaba Mah., Tevfik Saglam Cad., No:11, 34180, Bakirkoy, Istanbul. E-mail: email@example.com P: +90 532 494 49 95 Corresponding Author ORCID ID: https://orcid.org/0000-0002-0230-6500
Aim: The objective of this study is to research the stability of glucose in samples collected into serum and plasma tubes, according to centrifuging following different waiting periods, and to identify which glucose tube would be most suitable for accurate glucose measurement in laboratories.
Material and Methods: A total of 12 venous blood samples were collected from volunteers subjected to OGTT (n=20) after fasting and after administering 75g of glucose. Serum (VACUETTE®CAT Serum Separator Clot Activator) and plasma (VACUETTE®FC Mix Tube) tubes were used. Centrifugation was performed as follows: in the 1st group, immediately at hour 0, group 2, and 3 after having been kept at room temperature for respectively 2 hours, and 4 hours.
Results: No significant changes were identified among the fasting and postprandial blood glucose measurements in the plasma tubes at 0, 2, and 4 hours (p>0.05). Significant changes were identified among the fasting and postprandial blood glucose measurements in the serum group at 0, 2, and 4 hours (p=0.001; p<0.01).
Discussion: Our study demonstrated that the plasma tube was most effective in preventing a clinically significant change in glucose concentration at room temperature.
Keywords: Glucose, Pre-Analytical Phase, Stability
Characteristics of patients with acute coronary syndrome in the COVID-19 pandemic
Emine Altuntas, Kanber Ocal Karabay, Songül Usalp, Bayram Bagırtan, Ali Bayraktar, Filiz Celebi, Behzat Ozdemir, Sükrü Cetin
Department of Cardiology, Sancaktepe Sehit Professor Ilhan Varank Education and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.20894 Received: 2021-10-10 Accepted: 2021-11-02 Published Online: 2021-12-14 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):263-267
Corresponding Author: Emine Altuntas, Sancaktepe Sehit Professor Ilhan Varank Education and Research Hospital, Namık Kemal Street, No:7, Sarıgazi Emek, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 216 606 33 00 F: +90 216 606 33 97 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5887-5422
Aim: Coronavirus disease 2019 (COVID-19) has caused thrombotic disease. In this study, we aimed to determine the demographic and clinical characteristics of acute coronary syndrome (ACS) patients infected with COVID-19 and to investigate whether they differ from patients with ACS without COVID-19 in terms of these characteristics.
Material and Methods: The study was designed as a single-center retrospective study. Thirty- three COVID-19 infected ACS patients (Group 1) and 100 ACS patients without COVID-19 infection (Group 2) were included in the study.
Results: The groups were compared in terms of coronary angiographic data. Twenty-eight (84.8%) patients in Group 1 and 74 (74%) patients in Group 2 were presented as non-ST elevation myocardial infarctus. Patients were compared in terms of baseline Thrombolysis in Myocardial Infarctus (TIMI) flow, thrombus stage, myocardial blush (end), using of thrombus aspiration catheter, stent thrombosis, and TIMI flow after percutaneous coronary intervention, and it was observed that there was no statistical difference between the groups (p> 0.05).
Discussion: COVID-19 infection can cause plaque rupture, myocardial damage, coronary spasm and cytokine storm by triggering the coagulation and inflammation process. The fact is that we did not encounter an increased thrombus load in this study.
Keywords: Thrombosis, Inflammation, Acute Coronary Syndrome, COVID-19
Impact of mechanical endometrial injury on clinical pregnancy rates in women with clomiphene-resistant polycystic ovary syndrome
Suat Suphan Ersahin 1, Aynur Ersahin 2
1 Department of Obstetrics and Gynecology, Altınbas University, 2 Department of Obstetrics and Gynecology, IVF-Center, Medical School, Bahcesehir University, Istanbul, Turkey
DOI: 10.4328/ACAM.20910 Received: 2021-10-18 Accepted: 2021-11-09 Published Online: 2021-11-15 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):268-271
Corresponding Author: Suat Suphan Ersahin, Department of Obstetrics and Gynecology, Altınbas University, Istanbul, Turkey. E-mail: email@example.com P: +90 533 341 75 66 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7180-7413
Aim: In this study, it was aimed to evaluate the effect of mechanical endometrial injury before letrozole treatment on clinical pregnancy rates in patients with clomiphene-resistant polycystic ovary syndrome (PCOS).
Material and Methods: Thirty women with PCOS who could not achieve ovulation despite 150 mg of clomiphene citrate (CC) daily were included in the study. Patients in the PCOS group were equally divided into two groups before letrozole treatment (n=15). Group 1: Endometrial injury was performed with a pipelle cannula in the midluteal phase, and letrozole treatment was started in the next cycle. Group 2: In this group of patients endometrial injury was not performed. Letrozole treatment was started in these patients in the next cycle. Twenty patients with unexplained infertility were taken as a control.
Results: Beta hCG was found positive in 4 of 15 patients with endometrial injury in the PCOS group (26.6%). Beta hCG was found positive in 3 of 15 CR-PCOS cases who did not undergo injury (20%). Although beta hCG positivity was higher in the injury group, the difference was not significant (p=0.34). Clinical pregnancy was detected in 3 cases (20%) in patients with injury in the PCOS group. Similarly, clinical pregnancy was detected in 3 of the patients without injury (20%). In the control group, beta hCG positivity and clinical pregnancy rate were detected in 2 out of 10 patients with mechanical endometrial injury (20%).
Discussion: Mechanical endometrial injury before letrozole treatment does not increase clinical pregnancy rates both in women with clomiphene-resistant PCOS and unexplained infertility.
Keywords: Clomiphene-Resistant, PCOS, Unexplained Infertility, Mechanical Endometrial Injury, Clinical Pregnancy
Chromatographic and hematological comparison of sickle cell carriers and hemoglobin D los angeles carriers
Süheyl Uçucu 1, Talha Karabıyık 2
1 Department of Medical Biochemistry, Muğla Public Health Care Laboratory, Muğla, 2 Department of Medical Biochemistry, Bursa City Hospital, Bursa, Turkey
DOI: 10.4328/ACAM.20914 Received: 2021-10-28 Accepted: 2021-12-06 Published Online: 2021-12-08 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):272-275
Corresponding Author: Süheyl Uçucu, Department of Medical Biochemistry, Muğla Public Health Care Laboratory, Muğla, Turkey. E-mail: firstname.lastname@example.org P: +90 555 306 28 74 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6320-2457
Aim: Sickle cell trait and Hb D-Los Angeles (β121Glu→Gln) variant have complete blood count (CBC) and chromatographic similarities. Therefore, the differential diagnosis of these hemoglobinopathies is problematic. The aim of this study was to differentiate hemogram results between patients diagnosed with Hb S carrier and Hb D Los Angeles carrier, to compare with HPLC thalassemia screening tests hematologically and chromatographically, and to discuss their distinctive features.
Material and Methods: The study included 128 Hemoglobin D Los Angeles and 110 Hemoglobin S carriers. Age, sex, RBC, Hb, HTC, MCV, MCH, RDW, serum iron, TIBC, ferritin, HbA2, HbF, HbA0, abnormal peak retention time (RT) and area under the peak were examined.
Results: A statistically significant difference was detected in serum RBC levels, abnormal hemoglobin, retention time, and Hb A2 levels (p=0.036, p<0.001, p<0.001, p<0.001, respectively) between Hb D Los Angeles and Hb S carriers, while levels of abnormal hemoglobin in Hb S and Hb D Los Angeles carriers were between 24.6% and 44.6% in Hb S carriers, it was between 32.2-43% in Hb D carriers. The average RT levels were 1.02 in HbS, and 0.96 in Hb D. Hb A2 levels were significantly higher in Hb S carriers.
Discussion: Although the Hb D-Los Angeles variant and the Hb S carrier profile have similar CBC and electrophoretogram, they can be distinguished from each other using RT, HbA2, and abnormal hemoglobin levels. RT and HbA2 levels seem to be the main discrimination factors, but it should not be forgotten that they do not always have sufficient discrimination power. Molecular diagnostic methods such as PCR or DNA sequencing should be used for definitive diagnosis.
Keywords: Hemoglobinopathies, Hb D-Los Angeles, Sickle Cell, Hb S, HPLC
Students’ perception of factors affecting learning
Muhammad Humayun 1, Ambreen Khalid 2, Asmara Syed 3, Ekramy Elmorsy 3, Iram Arshad 1, Syed Sajid Hussain Shah 3
1 Department Of Biochemistry, Central Park Medical College, Lahore, Pakistan, 2 Department Of Physiology, Shalamar Medical And Dental College, Lahore, Pakistan, 3 Department of Pathology, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
DOI: 10.4328/ACAM.20916 Received: 2021-10-23 Accepted: 2021-11-12 Published Online: 2021-11-19 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):276-278
Corresponding Author: Muhammad Humayun, Department Of Biochemistry, Central Park Medical College, Lahore, Pakistan. E-mail: email@example.com P: +92 332 841 01 80 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8128-6191
Aim: In this study, we aimed to evaluate the perception of medical students of external factors, which influence their learning process.
Material and Methods: The study was conducted in the Central Park Medical College Lahore in August – September 2021. The questionnaire was distributed to the medical students who wished to participate in this study. Two hundred and one completely filled proformas have been received, which were analyzed using computer software.
Results: The analysis of the two hundred and one completely filled proformas revealed that factors, which strongly influence the learning process include teaching by teachers with excellent teaching strategies/skills, having a separate room for study, 24/7 library availability, and revision of important component/topics in special revision sessions at the end of the course.
Discussion: The evaluation of the factors that influenced the learning process of the students from the students’ point of view is vital for teachers and administrators of the institution because improvements made in this regard will enhance the performance and academic achievements of the students. The most important factors that have an impact on the learning process of the students are teaching strategies and a comfortable environment.
Keywords: External Factors, Learning, Medical Students
The epidemiology of poisoning in emergency department in Turkey
Cüneyt Arıkan, Ejder Saylav Bora, Güner Yurtsever, Osman Sezer Çınaroğlu, Hüseyin Acar, Tutku Duman Şahan, Fatih Esad Topal
Department of Emergency Medicine, İzmir Katip Çelebi University, Atatürk Research And Training Hospital, İzmir, Turkey
DOI: 10.4328/ACAM.20917 Received: 2021-10-23 Accepted: 2021-11-11 Published Online: 2022-01-25 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):279-282
Corresponding Author: Ejder Saylav Bora, Emergency Medicine, İzmir Katip Çelebi University, Atatürk Research And Training Hospital, İzmir, Turkey. E-mail: firstname.lastname@example.org / email@example.com P: +90 532 450 78 55 Corresponding Author ORCID ID: https://orcid.org/0000-0002-2448-2337
Aim: Poisoning has a high potential mortality and morbidity. In order to prevent poisonings and reduce the risk of mortality and morbidity, it is necessary to determine the poisoning profile. Along with changes in medicine, technology and sociocultural life, the poisoning profile also changes over time. It is essential to keep up-to-date information on the subject in order to control poisoning.
Material and Methods: Poisoning cases admitted to the emergency department between 2016 and 2020 were retrospectively reviewed. Patients aged 18 years and older were included in the study. Patients younger than 18 years of age and those with missing data were excluded from the study. Demographic, etiological and clinical features of poisonings were analyzed.
Results: A total of 774 subjects with a mean age of 39.1±15.4 were included in the study. Of these subjects, 472 (61%) were male. The most common mechanism of poisoning was intentional exposures (n=418, 54%). It was known which substance 737 (95.2%) patients were exposed to, and a total of 1030 substances that caused poisoning were identified. Medications (n=579, 56.2%) were the first among the exposed substances, and antidepressants (n=152, %26.3) were the first among the medications. Poisoning with alcohol and its derivatives (n=282, 27.4%) was in the second place. The rate of hospitalization in the inpatient service was 50.8% (n=393), intensive care unit was 13.8% (n=107) and the mortality rate was 4.4% (n=34). The statistical significance between unintentional poisonings, the subjects who used antidote and the subjects who underwent hemodialysis and mortality was high (p values, respectively: p<0.001, p<0.001, p<0.001).
Discussion: This study is one of the that contain up-to-date information in large case series in the field of toxicology. Poisonings were most often caused by intentional exposure. Among the substances that cause poisoning, medications, alcohol and its derivatives are in the first two places. Hospitalization, ICU admission and mortality rates are high in poisonings, which creates a serious economic and social burden for the health system.
Keywords: Poisoning, Intoxication, Emergency Department, Antidote
Acute rheumatic fever: Presentation with early arthritis in adults
İsmail Dogan 1, Osman Nuri Koyun 2 , Hakan Apaydın 3
1 Department of Rheumatology and Internal Medicine, Medicine Faculty, Ankara Yıldırım Beyazıt University, Ankara, 2 Department of Internal Medicine, Medicine Faculty, Hitit University, Corum, 3 Rheumatology Clinic, Ankara City Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.20919 Received: 2021-10-23 Accepted: 2021-11-09 Published Online: 2021-11-14 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):283-285
Corresponding Author: İsmail Doğan, Rheumatology Clinic, Ankara City Hospital, Bilkent, Çankaya, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 505 477 01 36 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7603-9484
Aim: Acute rheumatic fever (ARF) is a common disease in Turkey, most common between the ages of 6 and 20 years. It is rare in adults, and its clinical course differs from that in children. The aim of the study was to determine the clinical course of ARF in adults.
Material and Methods: Five patients who were admitted to our rheumatology outpatient clinic in a tertiary medical center located in Çorum province, with early-onset arthritis between 2017 and 2020 were diagnosed with ARF-associated arthritis. Acute rheumatic fever-associated arthritis was diagnosed according to Jones’s criteria.
Results: The age of the cases was between 35 and 56 (mean age 45.6 years), two of them were men and three were women. One patient had atrial fibrillation and one had coronary artery disease as comorbidities. Arthritis developed in all patients after a history of tonsillitis in the last 15-21 days, and morphological changes suggesting valve involvement were detected in the echocardiogram. Two of the patients had a previous history of ARF.
Discussion: Acute rheumatic fever should be considered in the differential diagnosis of arthritis that develops after an upper respiratory tract infection in adults with post-streptococcal reactive arthritis.
Keywords: Acute Rheumatic Fever, Arthritis, Carditis
Comparison of the short term outcomes between transobturator tape (TOT) and tension free vaginal tape (TVT) procedures in the treatment of urinary incontinence
Department of Obstetrics and Gynecology, TC Ministry of Health Health Sciences University, Gazi Yasargil Diyarbakır Training and Research Hospital, Diyarbakir, Turkey
DOI: 10.4328/ACAM.20936 Received: 2021-11-03 Accepted: 2021-12-12 Published Online: 2021-12-15 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):286-290
Corresponding Author: Cengiz Andan, Elazig Road, 10. Km, Üçkuyular Locality, 21070, Kayapınar, Diyarbakır, Turkey. E-mail: email@example.com P: +90 532 610 08 52 / +90 412 258 00 60 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6609-3284
Aim: In this study we aimed to compare effectiveness transobturator tape (TOT) and tension free vaginal tape (TVT) procedures that we performed in our gynecology clinics in female patients with SUI and MUI.
Meterial and Methods: In this study, a total of 194 patients who presented to the gynecology clinic of our hospital with the complaint of urinary leakage, who were diagnosed with SUI/MUI, and operated using TOT and TVT were retrospectively evaluated. Patients’ demographic data, examination findings, urodynamic test, stress test, Q-tip test, pad test, ultrasonography and operational outcomes were compared between the two groups.
Results: Of all patients, 128 were in the TOT and 66 in the TVT group. No statistically significant difference was found between both groups in terms of age, BMI, parity and duration of incontinence. The mean operation time was 20.3±5.9 minutes in the TOT group and 30.4±6.7 minutes in the TVT group, and the mean operation time was statistically significantly shorter in the TOT group. Postoperative residue values were significantly higher in the TVT group compared to the TOT group. The most common complication in both groups was pain in the postoperative 1st week, and it was found in 21 (16%) patients in the TOT group and 6 (9%) patients in the TVT group.
Discussion: There is no significant difference between the two procedure types in terms of continence and quality of life, although TOT procedure gave better results in terms of operation time, length of stay in the hospital and complication rates.
Keywords: Urinary incontinence, TOT, TVT, complications, QoL
Effects of the pathological characteristics on the presence of multicentric thyroid tumors in the contralateral lobe
Muhammet Pamukcu 1, Emine Demir 1, Mehmet Akif Aydin 2
1 Department of Otorhinolaryngology, 2 Department of General Surgery, Altinbas University, Medical Park Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.20952 Received: 2021-11-15 Accepted: 2021-12-17 Published Online: 2021-12-20 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):291-294
Corresponding Author: Mehmet Akif Aydin, Department of General Surgery, Altinbas University, Bahcelievler Medical Park Hospital, 34160, Bahçelievler, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 212 484 14 84 Corresponding Author ORCID ID: https://orcid.org/0000-0002-3324-1412
Aim: In this study, we aimed to investigate the effects of pathological tumor characteristics on the presence of a multicentric tumor in the contralateral lobe in papillary thyroid carcinoma (PTC).
Material and Methods: A total of 46 patients aged over 18 years who underwent total thyroidectomy due to PTC in our clinic were retrospectively evaluated. Patients’ demographic data such as age and gender, preoperative USG findings, postoperative pathological findings, lobe localization, and the presence of nodules in the contralateral lobe were recorded. In addition, tumor size, presence of nuclear atypia, mitotic activity, vascular invasion and extrathyroidal spread of the tumor and the presence of lymph node metastasis were obtained from pathological reports. Patients were divided into two groups as multicentric and non-multicentric, and the data were compared between these groups.
Results: The mean age of the patients was 44.9±12.3 years. Twenty-three patients had papillary thyroid microcarcinoma and 23 patients had papillary thyroid carcinoma. Postoperative pathological examination revealed multicentric PTCs in 15 patients . No statistically significant difference was found between patients with and without multicentric contralateral lobe tumors in terms of primary tumor diameter, nuclear atypia, mitotic activity, tumor necrosis, vascular invasion, extrathyroidal spread and lymph node metastasis (for all p>0.05).
Discussion: The pathology of the tumor in the contralateral lobe of the primary nodule can be seen with preoperative USG in the majority of patients with PTC. The presence of a multicentric tumor in the contralateral lobe is not correlated with tumor size and pathological characteristics of the tumor.
Keywords: Papillary Thyroid Carcinoma, Microcarcinoma, Multifocal, Multicentric, Tumor Size, Metastasis
Effectiveness of D-dimer, CRP, procalcitonin and white blood cell count in non-traumatic acute abdomen
Omer Yalkin 1, Fatih Altintoprak 1, Mustafa Yener Uzunoglu 1, Taner Kıvılcım 1, Ihsan Hakki Ciftci 2 , Fehmi Celebi 1
1 Department of General Surgery, 2 Department of Microbiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
DOI: 10.4328/ACAM.20966 Received: 2021-11-22 Accepted: 2021-12-22 Published Online: 2021-12-23 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):295-299
Corresponding Author: Omer Yalkin, Department of General Surgery, Faculty of Medicine, Sakarya University, Sakarya, 54100, Turkey. E-mail: email@example.com P: +90 506 976 65 55 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0311-5885
Aim: This prospective study investigates the effects of changes in leukocyte, CRP, D-dimer and procalcitonin levels during the treatment process of patients admitted to hospital with pre-diagnosis of non-traumatic acute abdominal pain on the decision about the treatment method.
Material and Methods: Patients included in the study were divided into 3 groups: those who underwent surgical treatment within the first 24 hours (Group-1), those who underwent surgical treatment within 24-48 hours (Group-2), and those who were discharged without surgical treatment after at least 48 hours of follow-up (Group-3). At the end of the treatment process, the change in the levels of leukocytes, CRP, D-Dimer and PCT values were examined in each group.
Results: A total of 141 patients (Group-1: 41 patients, Group – 2: 33 patients and Group – 3: 67 patients) were included in the study. The level of WBC tended to decrease in Group – 3 patients (p=0.001). The level of CRP tended to increase in Group – 2 patients (p=0.001) and decrease in Group – 3 patients (p=0.067) compared to the levels at the time of admission. The level of PCT was lower in Group-3 patients from the time of admission (p=0.005). D-dimer level in Group-3 patients tended to decrease compared to the level at the time of admission (p=0.096).
Discussion: Changes in these laboratory values add valuable information for clinicians and may prevent unnecessary surgical intervention in some patients.
Keywords: Abdominal Pain, Acute Abdomen, Emergency Surgery
Impact of a supervised pulmonary rehabilitation program on postoperative dyspnea in patients undergoing cardiac surgery
Osman Esen 1, Hatice Dilek Özcanoğlu 2
1 Department of Anesthesiology and Reanimation, Vocational School of Health, İstinye University, 2 Department of Anesthesiology and Reanimation, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
DOI: 10.4328/ACAM.20969 Received: 2021-11-22 Accepted: 2021-12-22 Published Online: 2022-01-01 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):300-303
Corresponding Author: Osman Esen, Zümrütevler Mah., Handegül Sokak, No:98/16, Maltepe, İstanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 505 677 13 85 F: +90 216 457 38 00 Corresponding Author ORCID ID: https://orcid.org/0000-0001-6280-5064
Aim: This prospective study aimed to analyze the impact of postoperative in-hospital pulmonary rehabilitation on pulmonary outcomes in patients who underwent cardiovascular surgery.
Material and Methods: This study was carried out on subjects who underwent cardiovascular surgery and were scheduled for a supervised pulmonary rehabilitation program following the cardiac surgery in our institute. The BORG scale of perceived exertion, a 100 points VAS scale for the severity of perceived dyspnea, and Respiratory Distress Assessment Instrument (RDAI) score were applied before and after completion of pulmonary rehabilitation program. Dyspnea, orthopnea, tachypnea, anxiety, cough and presence of sputum were also recorded prior to and subsequent to pulmonary rehabilitation. Blood gas analysis was also carried out before and after pulmonary rehabilitation.
Results: BORG scale score (1.89±0.07 vs. 1.21±0.05, p=0.001), VAS scale scores for dyspnea (5.7±0.4 vs. 8.5±0.8, p<0.001), and RDAI scores (4.2±0.5 vs. 7.8±1.2, p<0.001) improved significantly following pulmonary rehabilitation. The prevalence of dyspnea and tachypnea also reduced following pulmonary rehabilitation. No significant change was observed in blood gas analysis results.
Discussion: Application of a supervised pulmonary rehabilitation program including removal of bronchial secretions, postural drainage, percussion, vibration and aspiration and patients positioning improves self-reported dyspnea in patients who underwent cardiac surgery.
Keywords: Pulmonary Rehabilitation, Dyspnea, Cardiac Surgery
Evaluation of the clinical characteristic of psychiatric patients who are among the risk groups in the COVID-19 pandemic
Pınar Mutlu 1, Demet Gulec Oyekcin 2, Arzu Mirici 1, Uğur Gönlügür 1
1 Department of of Chest Diseases, 2 Department of Psychiatry, Çanakkale 18 Mart University , Çanakkale, Turkey
DOI: 10.4328/ACAM.20970 Received: 2021-11-26 Accepted: 2022-01-13 Published Online: 2022-02-23 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):304-308
Corresponding Author: Pınar Mutlu, Kepez Hamidiye Mah., Rauf Denktaş Cad., Konakkale Sitesi, A1, D:15, Merkez, Çanakkale, Turkey. E-mail: email@example.com P: +90 505 262 95 29 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7496-0026
Aim: The pandemic caused by COVID-19 has been a major concern for public health worldwide. Traditional medical practices need to be adapted quickly to meet the needs of vulnerable patients due to the COVID-19 outbreak. One of these patient groups is the mentally ill. Although COVID-19 itself affects mental health, this study aimed to investigate the clinical characteristics of COVID-19 patients who were previously diagnosed with mental illness.
Material and Methods: Patients older than 18 years of age with COVID-19 pneumonia, PCR positive or negative, thoracic CT compatible with COVID-19 pneumonia, and who also had been diagnosed with psychiatric disease between 1 April – 1 October 2020 were included in the study. Psychiatric diagnoses of the patients, drugs they used, places they lived, PCR results, CT results, comorbidities, the treatment of COVID-19, and the final status of the patients were evaluated.
Results: Between the specified dates, the number of patients with COVID-19 with psychiatric disease was 37 (28.24%) out of 131. The average age of patients with COVID-19 was 56.63±11.25 years, and the average length of stay in the hospital was 5.57±1.52 days. There were 35 (94.6%) patients living in a nursing home. There were 26 patients (70.3%) with a previous history of psychiatric illness, and 23 of them (62.2%) had psychotic disorders. During the treatment period, 27 (73.0%) of the patients received multiple pharmacotherapies, and atypical antipsychotic drugs (51.4%) were mostly prescribed.
Discussion: As a result, in our study, we determined that living in nursing homes, having a psychiatric disorder, and taking multiple pharmacotherapies due to this psychiatric disorder increase the possibility of getting COVID-19.
Keywords: COVID-19, Psychiatric Disorder, Nursing Home, Antipsychotic
Assessment and management of the SARS-CoV-2 infection: A secondary center experience
Ahmet Cem Yardımcı 1, Erdem Ergen 2, Elif Ergene 3, Yasemin Seckın Guner 3, Muzaffer Karnap 3, Hatice Ballı 1, Duygu Demırbas Keskın 4, Hulya Yuksel 4, Fusun Bocutoglu 5, Veysel Celal Akbel 2, Serkan Yıldız 6, Derya Kalyoncu 7
1 Department of Infectious Diseases and Clinical Microbiology, 2 Depatment of Ophthalmology, 3 Department of Internal Medicine, 4 Department of Otorhinolaryngology, 5 Department of Obstetrics and Gynecology, 6 Department of Urology, 7 Department of Pediatrics, Istinye State Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21009 Received: 2021-12-18 Accepted: 2022-02-04 Published Online: 2022-02-07 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):309-313
Corresponding Author: Ahmet Cem Yardimcı, Istinye State Hospital, Istinye Street, No:98, 34465, Sariyer, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 212 323 44 44 / +90 506 336 98 71 F: +90 212 323 44 44 Corresponding Author ORCID ID: https://orcid.org/0000-0002-4727-3239
Aim: The aim of the study was to evaluate the management and outcomes of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a secondary hospital.
Material and Methods: This study included 699 hospitalized patients who had positive rRT-PCR for SARS-CoV-2 and/or typical findings of COVID-19 on chest computed tomography (CT). Demographics, comorbidities, initial laboratory tests on admission, treatment modalities, complications and outcomes were evaluated retrospectively.
Results: The mean age was 57.0±15.6 (range:16-94 years), and male to female ratio was 1.24; 58.7% of the patients had at least one underlying comorbidity, the most common was hypertension; 18.1% of the patients had lymphopenia, 35.7% hyperferritinemia, 58.3% had increased lactate dehydrogenase, and 58.5% had increased D-dimer. Chest CT revealed moderate and severe stages in 57.9% of the patients. Hydroxychloroquine was given to 37.2% and favipiravir to 67.1% of the patients. No significant difference was observed between treatment groups in terms of mortality (P=0.487); 5.8% of the patients were transferred to the ICU, 75.6% of whom needed non-invasive and 36.5% invasive mechanical ventilation. The overall case-fatality rate was 0.9.
Discussion: Older age, male gender, low lymphocyte count, CT findings, including bilateral involvement and severe stage were significantly associated with poor prognosis and mortality.
Keywords: Adults, COVID-19, Outcome, SARS-CoV-2, Treatment
Comparison of pre-pandemic normal period and COVID-19 pandemic period births: Quantitative outlook
Besim Haluk Bacanakgil, Işık Kaban
Department of Obstetrics and Gynecology, Istanbul Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21026 Received: 2021-12-25 Accepted: 2022-02-07 Published Online: 2022-02-09 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):314-316
Corresponding Author: Besim Haluk Bacanakgil, Department of Obstetrics and Gynecology, Istanbul Training and Research Hospital, 34103, Istanbul, Turkey. E-mail: email@example.com P: +90 532 237 07 24 Corresponding Author ORCID ID: https://orcid.org/0000-0002-4723-7297
Aim: In this study, we aimed to determine whether the COVID-19 pandemic has a negative effect on quantitative birth data by comparing it with the pre-pandemic normal period.
Material and Methods: In our tertiary center, 4743 births in the March 2019-February 2020 pre-pandemic normal period were quantitatively compared and analyzed with 4522 births in the March 2020- February 2021 pandemic period.
Results: In the pandemic period, the number of births decreased by 4.66% compared to the normal period. The mean gestational week was prolonged during the pandemic period. In pre-pandemic and pandemic periods, there was no statistically significant difference between the mode of delivery, cesarean section type, preterm birth, stillbirth, newborn birth weight and Apgar score (≤7).
Discussion: When we evaluated the annual quantitative data of the normal and pandemic periods, it was seen that the COVID-19 pandemic did not have a significant negative effect on births, except for a slight decrease in the birth rate. However, this does not mean that COVID-19 protection and hygiene measures will be abandoned until the pandemic process is over.
Keywords: COVID-19, Pandemia, Birth, Newborn
Clinical outcome of multidisciplinary patients hospitalized with the decision of emergency physicians
Özcan Yavaşi, Mehmet Altuntaş
Department of Emergency Medicine, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
DOI: 10.4328/ACAM.21027 Received: 2021-12-25 Accepted: 2022-02-01 Published Online: 2022-02-02 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):317-320
Corresponding Author: Özcan Yavaşi, Department of Emergency Medicine, Recep Tayyip Erdoğan University Research and Training Hospital, 53020, Rize, Turkey. E-mail: firstname.lastname@example.org P: +90 464 213 04 91 / +90 505 237 53 68 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8641-7031
Aim: In this study, we aimed to compare clinical outcomes of multidisciplinary patients who were admitted by the decision of emergency physicians (EPs) with that of patients, who were admitted after the consensus decision of consultant physicians in terms of number of consultation, emergency department (ED) and hospital length of stay (LOS), need for intensive care unit (ICU), transfer status after hospitalization and outcome.
Material and Methods: This was a retrospective observational study. The multidisciplinary medical patients who were above 18 years of age and need hospitalization were included. The patients were divided into two groups: Group I consisted of those who were hospitalized by the decision of EPs, and Group II consisted of patients who were hospitalized after a consensus reached between consulting physicians. Mann-Whitney U test and Chi-square tests were used for comparisons.
Results: Of the 1143 hospitalized patients, 204 (17.85%) were in Group I and 939 (82.15%) were in Group II. Group I patients needed more consultations in the ED, had higher ED-LOS, need more ICU, and were more commonly transferred to other departments after hospitalization. As the number of consultations increases, the ED-LOS increases accordingly in both groups. Although Group I patients seem to be more commonly transferred (p = 0.001), overall hospital-LOS between the two groups was similar (p = 0.143). The transferred patients in Group I had a higher hospital-LOS compared to non-transferred patients (p = 0.001).
Discussion: The authorization of EPs to hospitalize multidisciplinary patients to the most related department seems to be feasible because overall hospital-LOS does not change.
Keywords: Emergency Department, Consultation, Multidisciplinary Patient, Hospitalization
Edible lactarius mushrooms poisoning: An emergency department experience
Department of Emergency Medicine, Faculty of Medicine, Karabuk University, Karabuk, Turkey
DOI: 10.4328/ACAM.21029 Received: 2021-12-28 Accepted: 2022-02-01 Published Online: 2022-02-02 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):321-324
Corresponding Author: Bora Cekmen, Alparslan Cd., No:1, Şirinevler, 78200, Karabük Merkez, Karabük, Turkey. E-mail: email@example.com P: +90 541 681 77 98 Corresponding Author ORCID ID: https://orcid.org/0000-0003-3348-8375
Aim: We aimed to examine the reasons for applying to the emergency department after eating Lactarius species mushrooms, which are consumed quite frequently in our region, and the relationship between the clinical outcomes of the patients and their laboratory values.
Material and Methods: This was a cross-sectional study. Patients older than 18 years of age who presented to the emergency department with various signs and symptoms after eating mushrooms were included in the study. The patient’s age, gender, comorbidities, and laboratory data were recorded from the hospital information system. Complaints of the patients at the time of admission, the treatment, which was given in the emergency department, the presence and duration of hospitalization were recorded.
Results: The number of patients included in the study was 34, 19 (55.9%) of whom were women and 17 (50%) of the patients were hospitalized. The most common comorbidity was diabetes (38.2%), and the most common symptom was nausea (61.8%). The CRP value of the inpatients was 7.60 [4.30-14.80], the potassium value was 4.57 (±0.43), and the aPTT value was 29.30 [27.10-33.70], which was statistically higher than in the patients who were not hospitalized (p-values were 0.022, 0.042, and 0.030 respectively).
Discussion: Lactarius mushrooms are edible mushroom species that are benign but can cause gastrointestinal symptoms. CRP can be a useful laboratory value to predict gastrointestinal symptoms and to determine the decision to hospitalization.
Keywords: Mushroom, Poisoning, Nausea, Emergency, Hospitalization
Pre-Endoscopic viral screening of children during the Covid-19 pandemic
Erkan Dogan 1, Eylem Sevinc 2, Nergiz Sevinc 3, Erhan Basar 4
1 Department of Pediatric, 2 Department of Pediatric Gastroenterology and Hepatology, 3 Department of Public Health, 4 Department of Microbiology, School of Medicine, University of Karabuk, Karabuk, Turkey
DOI: 10.4328/ACAM.21037 Received: 2021-12-31 Accepted: 2022-02-08 Published Online: 2022-02-09 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):325-329
Corresponding Author: Erkan Dogan, Department of Pediatric, School of Medicine, University of Karabuk, Karabuk, Turkey. E-mail: firstname.lastname@example.org P: +90 542 357 67 15 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1620-4123
Aim: Transmission of SARS-CoV-2 infection can easily occur through direct or close contact with infected people, just as with other infectious diseases. Therefore, it is important to detect it prior to the intervention for protecting the health of both the healthcare worker and the patient. In the study, it was aimed to determine the seropositivity rates of acute respiratory syndrome coronavirus 2, hepatitis A, hepatitis B, hepatitis C virus and human immune deficiency virus infections among children who underwent gastrointestinal endoscopy.
Material and Methods: The study was conducted at the Department of Pediatric Gastroenterology of the Karabuk University in Turkey from December 2020 to December of 2021. A total of 175 children were included in the study. The study was divided into three age groups as follows: 1-6 years old, 7-12 years old and 13-18 years old. All children were screened for acute respiratory syndrome coronavirus 2, hepatitis A, hepatitis B, hepatitis C virus and human immune deficiency virus infections.
Results: The median age was 12.5 years (1-18). The seroprevalence of acute respiratory syndrome coronavirus 2, Anti-HAV IgM, Anti-HAV IgG, HBsAg, Anti-HBs, Anti-HCV, Anti-HIV and were detected 0.57%, 0.57%, 42.8%, 0%, 58.8%, 1.1% and 0 % respectively. The seroprevalence of Anti-HAV IgG was significantly higher in children aged 1-6 years than in the group aged 13-18 years (95.7 vs 25.2: χ2=48.1, p=0.001).
Discussion: Although seroprevalence rates prior to endoscopy were low in this study, viral screening, except for hepatitis A infection, is essential for the safety of both patients and healthcare.
Keywords: Endoscopy, Hepatitis, HIV; SARS-CoV-2, Screening
Clinical results of closed intramedullary nailing in femoral diaphysis fractures
Bedrettin Akar 1, Mehmet Bülent Balioğlu 2
1 Department of Orthopedics and Traumatology, Sakarya Yenikent State Hospital, Sakarya, 2 Department of Orthopedics and Traumatology, Basaksehir Cam Sakura City Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21053 Received: 2022-01-11 Accepted: 2022-02-14 Published Online: 2022-02-19 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):330-334
Corresponding Author: Bedrettin Akar, Yenidoğan Mahallesi, Arslanağzı Sokak, No: 4, Yenidoğan, İzmit, 41000, Kocaeli, Turkey. E-mail: email@example.com P: +90 532 208 96 52 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7461-1777
Aim: Although there are many methods in the surgical treatment of femoral diaphyseal fractures (FDF), the preferred methodnowadays is Anterograde closed intramedullary nail (AKIMN) application. While giving the clinical results of our operations and AIMN applications due to FDF, at the same time, in this study, we aimed to present the most accurate options to the orthopedic researchers who are looking for indications by mentioning other treatment methods.
Material and Methods: In our retrospective study, in 25 patients with a mean age of 33.5 years who were urgently admitted to the Istanbul Training Hospital Orthopedics and Traumatology clinic due to FSF between 1997 and 1999, different models (Orthofix, Russel Tailor, Ünku type 1) and different locking types (Static and Dynamic) of AIMN were applied. During the mean follow-up period of 24.5 months, radiological and clinical examinations of the patients were performed. Evaluation of the results was done according to Thoresen criteria .
Results: Seventeen patients came to control visits. Nonunion and malunion were not seen in those who came to the control. In clinical and functional examination, it was observed that hip and knee joint movements were comfortable and functional loss did not develop. According to Thoresen criteria, 14 patients were evaluated as very good, one patient was good due to pain in the tuberositas region, one patient was evaluated as moderate due to 5-degree valgus deformity, and one patient was evaluated as bad due to post-op infection.
Discussion: AIMN is the first preferred method in the treatment of femoral diaphysis fractures caused by high-energy traumas. Since the fracture line is not opened, the amount of bleeding and the risk of infection decrease, the mobilization start time is shortened, and union is accelerated.Static locking should be preferred in order to prevent shortening and rotation in segmental fractures. Reamerization of the medulla accelerates the union and shortens the healing process.
Keywords: Femoral Fractures, Intramedullary Nailing, Orthopedic Surgery, Secondary Injury, Osteosynthesis, Fracture
Protective effects of quercetin against sepsis-induced oxidative damage on rat kidneys
Mehmet Duran 1, Murat Bıçakçıoğlu 2, Nezir Yılmaz 1,Bilge Aydın Türk 3, Mevlüt Doğukan 1, Hamza Nakır1, Zümrüt Doğan 4
1 Department of Anesthesiology and Reanimation, Faculty of Medicine, Adıyaman University, Adıyaman, 2 Department of Anesthesiology and Reanimation, Faculty of Medicine, İnönü University, Malatya, 3 Department of Pathology, Faculty of Medicine, Adiyaman University, Adiyaman, 4 Department of Anatomy, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
DOI: 10.4328/ACAM.21057 Received: 2022-01-14 Accepted: 2022-02-19 Published Online: 2022-02-22 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):335-339
Corresponding Author: Mehmet Duran, Department of Anesthesiology and Reanimation, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey. E-mail: firstname.lastname@example.org P: +90 505 689 54 04 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7568-3537
Aim: Sepsis is a clinical pathology, characterized by a severe and exaggerated inflammatory response. One of the most frequently damaged organs in sepsis is the kidney. Quercetin has anti-inflammatory, anti-proliferative, and antioxidant effects. In this study, it was aimed to examine the protective effects of quercetin on the kidneys.
Material and Methods: In the scope of this study, 31 rats were planned to be used in the experiments. The groups and number of animals were as follows: Group 1: 1.5 ml saline, Group 2: 1.5 ml olive oil, Group 3: intestinal ligation and puncture procedure was used to create experimental sepsis method. Group 4: 20 mg/kg quercetin was administrated by gavage. Group 5: quercetin was administered in intragastrically at doses of 20 mg/kg. In biochemical analyzes of kidney tissue samples, BUN, creatinine, MDA and GSH values were checked. Cell damage, inflammation and fibrosis were evaluated histopathologically.
Results: As a result of this study, tissue GSH levels were significantly different between groups 3 and 4 (p= 0.001). In terms of BUN value, it was found to be significantly higher in group 3 (p= 0.002). In tissue histology, glomerulitis (p= 0.001), tubular cell necrosis (p= 0.001) and mesenchymal matrix increase (p= 0.001) were different between groups 3 and 4. Finally, no fibrosis was observed in any group (p> 0.05).
Discussion: Quercetin has protective effects on kidney tissue against organ damage caused by sepsis.
Keywords: Quercetin, Sepsis, Antioxidant, Cecal Ligation
Relationship between the beliefs on social appearance, anxiety, and intolerance of uncertainty in rhinoplasty patients
Fatih Yığman 1, Serhat İnan 2
1 Department of Psychiatry, Faculty of Medicine, Ufuk University, 2 Department of Otorhinolaryngology, Faculty of Medicine, Başkent University, Ankara, Turkey
DOI: 10.4328/ACAM.21071 Received: 2022-01-21 Accepted: 2022-02-21 Published Online: 2022-02-21 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):340-344
Corresponding Author: Fatih Yığman, Department of Psychiatry, Faculty of Medicine, Ufuk University, Ufuk University Street, No:2, 06510 Çankaya, Ankara, Turkey. E-mail: email@example.com P: +90 535 695 81 26 Corresponding Author ORCID ID: https://orcid.org/0000-0001-6052-7662
Aim: Rhinoplasty is a surgical procedure performed for functional and/or cosmetic purposes. The purpose of the study is to evaluate the psychological factors that determine patient satisfaction in rhinoplasty surgery.
Material and Methods: A total of 121 patients (85 women, 36 men) participated in the study. Sociodemographic data form, social appearance anxiety scale (SAAS), beliefs about appearance scale (BAAS), short form of intolerance of uncertainty (IUS) scale and rhinoplasty outcomes evaluation questionnaire (ROEQ) were applied to the participants before and at the 3rd- month control after rhinoplasty.
Results: Before and after the operation, patients were divided into two groups, according to their SAAS scores. Preoperative BAAS, preoperative SAAS and postoperative REOQ scores were significantly higher in the group of patients whose SAAS scores decreased after the operation. It was determined that the change in ROEQ scores could be predicted by the change in SAAS scores (β=-0.454, p<0.005).
Discussion: Psychological factors such as appearance anxiety can act as a bridge between patient satisfaction and rhinoplasty outcomes. This study indicates a complex cognitive process and suggests that multidisciplinary approaches may be important to improve patient satisfaction after rhinoplasty.
Keywords: Rhinoplasty, Physical Appearance, Patient Reported Outcomes, Cognitive Psychology
Do complications of pancreatic cancer surgical treatment change in the aging world?
Orhan Aras 1, Rıdvan Yavuz 1, Hüseyin Çiyiltepe 1, İsmail Gömceli 2
1 Department of Gastroenterology Surgery, University of Health Science, Antalya Training and Research Hospital, 2 Department of General Surgery, Antalya Bilim University, Antalya, Turkey
DOI: 10.4328/ACAM.21078 Received: 2022-01-22 Accepted: 2022-02-22 Published Online: 2022-02-23 Printed: 2022-03-01 Ann Clin Anal Med 2022;13(3):345-349
Corresponding Author: Orhan Aras, Department of Gastroenterology Surgery, Antalya Training and Research Hospital, Varlık Mahllesi, Kazım Karabekir Cd., D Blok, Muratpaşa, 07050 Antalya, Turkey. E-mail: firstname.lastname@example.org P: +90 505 397 10 77 F: +90 242 249 44 62 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6390-116X
Aim: The elderly population in the community population is increasing day by day. Pancreatic malignancies have poor survival and high mortality and morbidity rates. In our study, we aimed to evaluate the effect of age on pancreaticoduodenectomy surgery.
Material and Methods: Patients who underwent pancreaticoduodenectomy between 2012 and 2020 were divided into 3 groups according to their age (60 years and younger group 1, 60-80 years old group 2, 80 years and older group 3). Early mortality and morbidity outcomes between the groups were compared.
Results: Parallel to the increase in age, a statistically significant increase was found in the ASA score (p:0.000), length of stay in the intensive care unit (p:0.021), mortality (p:0.003) and morbidity (p:0.021) rates between the groups.
Discussion: Considering the increasing elderly population in the world, we found that surgical intervention such as pancreaticoduodenectomy with high comorbidity can be performed with higher mortality and morbidity risks compared to younger patients.
Keywords: Pancreas Cancer, Pancreaticoduodenectomy, Mortality, Morbidity, Age