Evaluation of the radiocontrast nephropathy development due to the contrast-enhanced CT applications in emergency department
Gülçim Saraçoğlu 1, Sedat Yanturalı 2, Rıdvan Atilla 2, Başak Bayram 2, Pınar Yeşim Akyol 3
1 Department of Emergency, Muğla Sıtkı Koçman University, Research and Training Hospital, Muğla, 2 Emergency Department, Dokuz Eylül University, Izmir, 3 Emergency Department, Katip Çelebi University, Atatürk Research and Training Hospital, Izmir, Turkey
DOI: 10.4328/ACAM.20768 Received: 2021-07-26 Accepted: 2021-10-05 Published Online: 2022-08-24 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):947-951
Corresponding Author: Pınar Yeşim Akyol, Department of Emergency Medicine, Izmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey. E-mail: email@example.com P: +90 505 357 29 41 Corresponding Author ORCID ID: https://orcid.org/0000-0003-2477-1443
Aim: We aimed to determine the incidence of post-contrast acute kidney injury (PC-AKI), the demographic characteristics of patients, and the reasons that facilitate the development of PC-AKI in patients who were admitted to the emergency department and underwent computed tomography (CT) with intravascular contrast media.
Material and Methods: This study is a retrospective, cross-sectional and analytical study. Patients over the age of 18 who underwent CT with intravascular contrast media and were hospitalized for at least 48 hours were included in this study. The development of PC-AKI and the clinical and demographic characteristics of the patients were evaluated.
Results: A total of 816 patients were included in the study. Thirty-six (4.4%) patients developed PC-AKI. We found that the average length of hospital stay was 22.2 ± 41.7 days. Patients with a history of hypertension (HT) and diabetes mellitus (DM) and who had hypotension on admission to the emergency department were found to have a higher risk of developing PC-AKI (p<0.05 for all of them). The development of PC-AKI was significantly higher in patients receiving ACE inhibitors (p=0.004). When the clinical outcomes of the patients with PC-AKI were evaluated, it was observed that 47.2% (n=17) of them died. Mortality was statistically significantly higher in patients with PC-AKI than in the patients without PC-AKI (p<0.0001).
Discussion: PC-AKI led to an increase in the length of hospital stay of patients. The patients with PC-AKI had a higher mortality rate compared with the patients without PC-AKI.
Keywords: Contrast Material, Emergency Department, Nephropathy
Surgical removal of asymptomatic polyps detected on the day of egg collection increases fertility outcome
Department of Obstetrics and Gynecology, Istanbul IVF-Center, Istanbul, Turkey
DOI: 10.4328/ACAM.21014 Received: 2021-12-22 Accepted: 2022-08-11 Published Online: 2022-08-11 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):952-954
Corresponding Author: Ramazan Ozyurt, Department of Obstetrics and Gynecology, Istanbul IVF-Center, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 532 748 34 90 Corresponding Author ORCID ID: https://orcid.org/0000-0001-6822-2222
Aim: In this study, we aimed to determine the impact of surgical removal of polyps that were detected incidentally on the day of egg collection on the fertility outcome.
Material and Methods: Forty-five patients who were suspected of having polyps in the ultrasonographic examination performed during egg collection were included in the study. The patients were informed about the endometrial polyp and hysteroscopy was recommended. While 30 of 45 patients accepted hysteroscopy, 15 patients did not. Patients who did not undergo hysteroscopy continued their routine treatment and embryo transfer was performed. Polyps of different localizations and sizes were detected in 28 of 30 patients who underwent hysteroscopy and were surgically removed. No polyps were found in two patients. Frozen embryo transfer was performed to the patients after polypectomy. A single embryo was given to the patients in both groups. The primary outcome measures of the study were detection of serum beta-hCG levels, clinical pregnancy rate (CPR), live birth rate (LBR), and miscarriage rate.
Results: The mean size of the polyps was 15 mm (range 2 mm to 25 mm). Beta hCG values measured after 12 days in the polypectomy group were positive in 14 of 28 patients (50%). Beta hCG positivity was detected in 6 of 15 patients in the control group (40%). Beta hCG positivity was significantly higher in the polypectomy group than in the control group (p<0.02). Clinical pregnancy was detected in 13 of 14 patients in the polypectomy group (46.4%). In the control group, clinical pregnancy was detected in 5 patients (33.3%). A significant increase was found in the polypectomy group in terms of CPR rates (p<0.01). While 11 patients in the polypectomy group had a live birth (39.2%), 5 patients in the control group had a live birth (33.3%). There was no difference between the groups in terms of live birth and miscarriage rates (p<0.76 and p<0.40 respectively).
Discussion: Surgical removal of asymptomatic polyps detected on the day of egg collection leads to a significant increase in clinical pregnancy rates.
Keywords: Polypectomy, Egg Retrieval Day, Clinical Pregnancy, Live Birth, Miscarriage
Experiencing pregnancy: Joy or pain?
Department of Obstetrics and Gynecology, Health Science Undergraduate School, Trakya University, Edirne, Turkey
DOI: 10.4328/ACAM.21022 Received: 2021-12-23 Accepted: 2022-06-09 Published Online: 2022-08-05 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):955-958
Corresponding Author: Gulden Aynacı, Department of Obstetrics and Gynecology, Health Science Undergraduate School, Trakya University, Edirne, Turkey. E-mail: email@example.com P: +90 507 979 95 06 Corresponding Author ORCID ID: https://orcid.org/0000-0002-2112-8631
Aim: Pregnancy is a natural phenomenon and brings many psychological and social changes. Pregnancy is a unique life experience. The pregnancy period is expected to be a positive and satisfying time, bringing new life to the world; however, pregnant women may also experience some disorders. The aim of the study was to evaluate the quality of maternal well-being and the necessity of optimal care interventions in the follow-up of pregnant women.
Material and Methods: Our study was conducted from December 2020 to November 2021 with pregnant volunteers who presented to the Trakya University Hospital. The PES-Brief was administered.
Results: The study included 378 volunteers. There were positive correlations between uplifts frequency scores and motivation to breastfeed. Uplifts scores were lower among those who stated that pregnancy tired them. There was a statistically significant relationship between long-term breastfeeding plans and high hassles scores.
Discussion: Our study demonstrated that the PES-Brief can be used to identify women with less planned pregnancies who are at increased risk of possibly pregnancy negativity. Its application in routine pregnancy checks and maternity care will improve the identification of women.
Keywords: Pregnancy Experience, Uplifts, Hasless, Maternal Well-Being
Post-vaccination COVID-19 positivity and clinical situation analysis in healthcare professionals
Ilkay Bahceci 1, Feray Ferda Senol 2
1 Department of Medical Microbiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, 2 Department of Medical Microbiology, Elazıg Fethi Sekin State of Hospital, Elazıg, Turkey
DOI: 10.4328/ACAM.21139 Received: 2022-03-11 Accepted: 2022-04-13 Published Online: 2022-08-03 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):959-962
Corresponding Author: Ilkay Bahceci, Department of Medical Microbiology, Faculty of Medicine, Recep Tayyip Erdoğan University, 53100, Merkez, Rize, Turkey. E-mail: firstname.lastname@example.org P: +90 464 223 61 26 Corresponding Author ORCID ID: https://orcid.org/0000-0003-3662-1629
Aim: Healthcare workers are an occupational group that is at the forefront of a pandemic process, where morbidity and mortality are intense. Deaths due to COVID-19 among workers in our country and in the world are reported mostly in healthcare workers. In this study, we aimed to analyze the rate of contracting COVID-19 among healthcare workers after vaccination and the clinical features of the disease.
Material and Methods: Between January 14, 2021 and June 29, 2021, the diagnosis of COVID-19 in healthcare workers who had clinical complaints after a single dose and two doses of vaccination was made as a result of the evaluation of the patients’ throat and nose swab samples by reverse transcriptase-polymerase chain reaction (RT-PCR). The disease table of the positive patients was grouped as home treatment and hospital treatment by accessing clinical and laboratory records from electronic medical records.
Results: At least one dose of vaccine was given to 11,540 (79.62%) of a total of 14,461 healthcare workers. COVID-19 positivity was detected in the PCR test performed on 51 single-dose vaccinated healthcare workers and 177 double-dose vaccinated healthcare workers with clinical complaints. While all patients vaccinated with a single dose were treated at home, 176 of the patients vaccinated with two doses were treated at home and 1 was treated in the hospital.
Discussion: It has been seen that if countermeasures against COVID-19 are not taken, it could be a great disaster for the whole world, that the most important defense against this pandemic is vaccination, and that those who have COVID-19 after vaccination have a mild illness even if they have the disease.
Keywords: COVID-19, Healthcare Workers, Vaccine
A potential therapeutic effect of miR-155 downregulation in an experimental model of demyelination
Ola Saed Elfetiany 1, Hala Abdelgawad 1, Nesrine M. El Azhary 1, Doaa Abdelmonsif 2, Samar El Achy 3, Maha A. Hegazy 1
1 Department of Medical Physiology, 2 Department of Medical Biochemistry, 3 Department of Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
DOI: 10.4328/ACAM.21203 Received: 2022-04-22 Accepted: 2022-06-19 Published Online: 2022-08-27 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):963-967
Corresponding Author: Ola Saed Elfetiany, Department of Medical Physiology, Faculty of Medicine, Dr. Fahmy Abdel Meguid Street, Mowssat Building El Shatby, Alexandria, 2156, Egypt. E-mail: O_elfetiany13@alexmed.edu.eg P: +20 100 264 06 55 Corresponding Author ORCID ID: https://orcid.org/0000-0001-6938-5760
Aim: The aim of this study was to investigate the possible effects of microRNA-155 inhibition in restoring remyelination after the establishment of lysolecithin- mediated demyelination in rats.
Material and Methods: Adult male albino rats were subjected to intrahippocampal injection of lysolecithin (LPC). LPC-treated rats received either antimicroRNA-155 NPs, blank NPs or phosphate buffer saline (PBS). One additional group was injected with PBS, acting as a negative control. After scarification of rats, histopathological examination of hippocampi, and quantitative PCR to detect mir-155 and myelin basic protein (MBP) were conducted.
Results: Our results showed that delayed treatment with antimicroRNA-155 nanoparticles was associated with histopathological improvement of demyelination score with no significant effect on biochemical markers.
Discussion: This study supports the promising therapeutic role of antimicroRNA-155-loaded nanoparticles in demyelinating disorders.
Keywords: Demyelination, miRNA 155, Multiple Sclerosis
Evaluation of factors associated with time to diabetic ketoacidosis resolution in children
Mehmet Öztekin 1, Capan Konca 1,2, Mehmet Tekin 3, Semih Bolu 1
1 Department of Pediatrics, School of Medicine, Adiyaman University, Adiyaman, 2 Department of Pediatric Intensive Care Unit, School of Medicine, Adiyaman University, Adiyaman, 3 Department of Pediatrics, School of Medicine, Inonu University, Malatya, Turkey
DOI: 10.4328/ACAM.21164 Received: 2022-03-28 Accepted: 2022-06-02 Published Online: 2022-08-01 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):968-972
Corresponding Author: Capan Konca, Department of Pediatrics, School of Medicine, Adiyaman University, Adiyaman, Turkey. E-mail: email@example.com P: +90 505 489 69 04 F: +90 416 225 26 60 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8625-9045
Aim: In this study, it was aimed to examine the relationship between clinical, demographic, and laboratory characteristics of patients at admission and time to diabetic ketoacidosis (DKA) resolution.
Material and Methods: The files of patients with the diagnosis of DKA between January 2013 and December 2018 were reviewed retrospectively.
Results: A total of 25 patients were included in the study. The mean age of the patients was 9.3 ± 3.41 years. In 19 patients (76%), diabetes mellitus (DM) was diagnosed simultaneously with DKA. The mean time to DKA resolution was found to be significantly longer among patients with a family history of DM, newly diagnosed DM, respiratory distress, odor of acetone on the breath, altered consciousness, and severe coma. There was a significant correlation between the time to DKA resolution and the Pediatric Risk of Mortality score and the length of stay. There was also a significant negative correlation between time to DKA resolution and both pH and HCO3 levels.
Discussion: DKA is an acute, severe, and life-threatening complication of type 1 DM in children. It is important to identify the factors affecting the prognosis and resolution time of comas in these patients in order to predict outcomes. Our findings show that the prognosis will be worse and the time to resolution will be longer among children with altered consciousness, newly diagnosed DM, respiratory distress, a high PRISM score, severe DKA coma, and severe acidosis at the time of admission.
Keywords: Children, Coma, Diabetic Ketoacidosis (DKA), Factors, Pediatric, Resolution Time
Beta-lactam antibiotic-induced thrombocytopenia: MYH9 & TUBB1 genes
Didem Özkan 1, Yasemin Ardıçoğlu Akışın 2, Dilara Fatma Akın Balı 3, Nejat Akar 4
1 Vocational School of Health Services, Istanbul Okan University, Istanbul, 2 Department of Biochemistry, Faculty of Medicine, TOBB Economy and Technology University, Ankara, 3 Department of Medical Biology, Faculty of Medicine, Niğde Omer Halisdemir University, Niğde, 4 Department of Pediatrics, Medical School,TOBB Economy and Technology University, Ankara, Turkey
DOI: 10.4328/ACAM.21174 Received: 2022-04-05 Accepted: 2022-06-05 Published Online: 2022-06-09 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):973-977
Corresponding Author: Didem Özkan, Vocational School of Health Service, Tuzla Campus, Istanbul Okan University, 34959, Akfırat, Tuzla, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 216 677 16 30 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4210-5073
Aim: Macrothrombocytopenia is a congenital autosomal-dominant blood disorder characterized by increased platelet size and a decreased number of circulating platelets. In this study, it was aimed to show the MYH9 and TUBB1 gene changes, which are the genes associated with the disease, in a patient with thrombocytopenia receiving beta-lactam antibiotic therapy.
Material and Methods: In this study, coagulation parameters and platelet aggregation tests were performed after ingestion of a beta-lactam antibiotic in an 8-year-old boy with thrombocytopenia, the MYH9 and TUBB1 genes were scanned by PCR and DNA sequencing, and the results were subsequently analyzed using bioinformatics tools.
Results: We found previously described TUBB1 polymorphisms, p.R307H , p.Q43P, p.T178T and the novel mutation p.K64A in the MYH9 gene in a boy and his mother. Changes in genes important for thrombocytopenia in a boy after taking beta-lactam antibiotics prompted us to study the same genes in the mother, since her mother had macrothrombocytopenia, and we found a new mutation in her mother
Discussion: Determination of gene changes after beta-lactam antibiotic use in bleeding patients is important in terms of helping the clinic in the treatment.
Keywords: Platelets, Macrothrombocytopenia, MYH9
Assessment of thiol disulfide homeostasis in isolated head injury
Fatih Tanrıverdi 1, Ozcan Erel 2
1 Department of Emergency Medicine, 2 Department of Biochemistry, School of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
DOI: 10.4328/ACAM.21177 Received: 2022-04-06 Accepted: 2022-05-31 Published Online: 2022-08-04 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):978-982
Corresponding Author: Fatih Tanrıverdi, Department of Emergency Medicine, School of Medicine, Yıldırım Beyazıt University, Üniversiteler Mahallesi, 06800, Çankaya, Ankara, Turkey. E-mail: email@example.com P: +90 312 552 60 00 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9959-5769
Aim: This study aimed to differentiate traumatic brain injury (TBI) and non-traumatic brain injury (NTBI) among patients presenting to the emergency department with isolated head trauma. For this purpose, we investigated whether the combined use of the parameters of thiol/disulfide homeostasis, an oxidative stress marker, and IMA (Ischemia Modified Albumin) was useful in differentiating the two conditions.
Material and Methods: This study was prospectively conducted on 92 patients who presented to the emergency department between 01.06.2018 and 01.01.2019, and 40 healthy subjects as controls. Thiol/disulfide homeostasis parameters (Thiol, disulfide), are the oxidative stress markers measured by a novel method developed by Erel and Neşelioğlu, and IMA were studied in the patient and control groups.
Results: NT and TT values were significantly lower in the TBI group than in the NTBI group (p <0.001, <0.001, respectively). Disulphide, IMA, and index1 and index 2 values were significantly higher in the TBI group compared to the NTBI and the control groups (p =0.019, <0.001, < 0.001, and < 0.001, respectively).
Discussion: The results of the present study suggest that these easy-to-perform, cheap, and automated biomarkers may help make a differential diagnosis between the two conditions.
Keywords: Isolated Head Trauma, Traumatic Brain Injury, Thiol/Disulfide Homeostasis
Sex estimation using palmprint measurements among a sample of adult Egyptians
Eman Adel Seif, Wafaa Mohamed Elsehly, Magda Hassan Mabrouk Soffar, Maii Farag Henaidy
Department of Medicine and Clinical Toxicology, Faculty of Medicine, Alexandria University, Egypt
DOI: 10.4328/ACAM.21178 Received: 2022-04-07 Accepted: 2022-06-05 Published Online: 2022-06-23 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):983-988
Corresponding Author: Magda Hassan Mabrouk Soffar, Department of Medicine and Clinical Toxicology, Faculty of Medicine, Champollion Street, Alexandria, Egypt. E-mail: firstname.lastname@example.org P: +20 121 070 15 52 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6230-8591
Aim: Sex estimation is crucial in the forensic field. Palmprints are unique prints that are commonly recovered from crime scenes. A tri-radius ‘delta’ is a meeting point of three groups of ridges. Five tri-radii are identified on the palm, four at the base of Index (a), Middle (b), Ring (c) and little finger (d), and one axial tri-radius (t) near the wrist. This study assessed the validity of distance between palmar tri-radii (abcd-t) as a sex predictor in a sample of Egyptians.
Material and Methods: The study was conducted on 100 adult Egyptians (50 females and 50 males). Palmprints were obtained using fingerprint inked strips (6 x 10 inches). Palmprints were scanned and the distances between the axial tri-radius ‘t’ and other tri-radii (a, b, c, and d) were measured using Software. Also, combined abcd-t distance (sum of four distances) was calculated.
Results: Means of palmar tri-radii distances from (abcd) to axial t were significantly higher in males. ROC curve analysis was done for all palmar tri-radii distances. Male could be predicted on the right side when (d-t) distance >7.11cm or combined abcd-t distance > 32.17 cm with accuracy (88%). On the left side, male could be predicted when (b-t) distance> 8.65 cm or combined abcd-t distance>32.37 cm with accuracy (87%).
Discussion: Palmar tri-radii distances are significantly longer in Egyptian males. Subsequently, these measurements could predict sex with reasonable accuracies among adult Egyptians. Similar studies on other populations are recommended.
Keywords: Sex Estimation, Palmprint Measurements, Palmar Tri-Radii Distances, Egyptians
Is the heart of premature babies born as a result of IVF pregnancy different?
Fatma Hilal Yılmaz 1, Mehmet Burhan Oflaz 2, Hüseyin Altunhan 3, Nuriye Emiroğlu 3, Emin Ünal 2, Nazlı Dilay Gültekin 4
1 Department of Neonatology, Dr. Ali Kemal Belviranli Hospital for Obstetrics and Pediatrics, Konya, 2 Department of Pediatric cardiology, Necmettin Erbakan University Meram Medical Faculty, Konya, 3 Department of Neonatology, Necmettin Erbakan University Meram Medical Faculty, Konya, 4 Department of Neonatology, LÖSANTE Child and Adult Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21183 Received: 2022-04-12 Accepted: 2022-06-29 Published Online: 2022-06-30 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):989-992
Corresponding Author: Fatma Hilal Yılmaz, Department of Neonatology, Dr. Ali Kemal Belviranli Hospital for Obstetrics and Pediatrics, Konya, Turkey. E-mail: email@example.com P: +90 505 928 23 45 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1152-9773
Aim: This prospective study aims to reveal whether preterm births with ART-induced pregnancies are at greater risk of structural and functional cardiac pathologies compared to the control group of preterm births from spontaneous pregnancy.
Material and Methods: Between October 2017 and January 2020, 25 premature babies born by means of assisted reproductive techniques (AC) and 25 babies born from spontaneous pregnancy (SC) were included in the study. All babies recruited for the study were born at or below 34 weeks of gestational age. The groups were evaluated in terms of anatomical, m-mode and tissue Doppler systolic and diastolic functions using transthoracic echocardiography (ECHO).
Results: The groups were found to be similar in terms of anatomical, m-mode and tissue doppler systolic and diastolic functions by transthoracic ECHO (p=0.156).
Discussion: Early diagnosis of possible cardiac diseases is vital for pre- and post-natal management and ultimately for the survival of the infant. Studies should be focused on understanding and eliminating the pathophysiologies increasing the risk of CHD during ever-increasing ART practices.
Keywords: Assisted Reproductive Technology, Heart Defect, Prematurity
Anti-inflammatory therapy in patients with severe COVID-19 pneumonia: A single-center observational study
Gülnur Kul 1, Gürkan Değirmencioğlu 2
1 Department of Infectious Diseases and Clinical Microbiology, 2 Department of Infectious Diseases and Clinical Microbiology, Kırıkhan State Hospital, Hatay, Turkey
DOI: 10.4328/ACAM.21185 Received: 2022-04-13 Accepted: 2022-05-31 Published Online: 2022-06-24 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):993-998
Corresponding Author: Gülnur Kul, Mimarsinan Mahallesi, İsmail Turan Bulvarı, No:40, Hatay, Kırıkhan, 31440, Turkey. E-mail: firstname.lastname@example.org P: +90 505 301 05 45 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7317-3461
Aim: In our study, the effects of methylprednisolone and anakinra drugs in the treatment of hyperinflammation in severe COVID-19 patients were investigated.
Material and Methods: In this single-center retrospective study, severe COVID-19 patients followed up with signs of hyperinflammation were examined. The patients were examined in the Sequential Treatment Group receiving high-dose methylprednisolone followed by Anakinra, and the concomitant treatment group receiving both at the same time. Inflammatory parameters, imaging findings, and way of leaving the intensive care unit of the patients were compared.
Results: A total of 87 patients were included in the present study. In both treatment groups, an increase in lymphocyte levels and a decrease in CRP, lactate dehydrogenase (LDH) and ferritin levels were detected at the end of treatment values compared to the initial treatment values. (p<0.001 and p<0.001). Also, LDH values after the treatment were significantly lower in the concomitant treatment group than in the sequential treatment group (p=0.049). In the present study, 53 of the patients were discharged with good recovery and 34 died. The mortality rate was 31% in the concomitant treatment group and 43% in the sequential treatment group. In terms of mortality, numerical findings in favor of the concurrent treatment group were determined.
Discussion: In addition to the studies in the literature, it was found that the concomitant use of Methylprednisolone and Anakinra can be an effective treatment option that reduces mortality and improves inflammatory parameters.
Keywords: Anakinra, Methylprednisolone, Mortality
Anxiety levels of healthcare personnel in different stages of COVID-19 pandemic: A nationwide study from Turkey
Edip Bayrak 1, Ahmet Riza Sahin 1, Akkan Avci 2, Hilmi Erdem Sumbul 3, Erhan Kaya 4, Alperen Kilic 5, Mehmet Bugrahan Gurcan 6, Bekir Aktura 7, Celaleddin Turgut 8, Ramazan Azim Okyay 9
1 Department of Infectious Disease, Health Science University, Adana City Research and Training Hospital, Adana, 2 Department of Emergency Medicine, Health Science University, Adana City Research and Training Hospital, Adana, 3 Department of Internal Medicine, Health Science University, Adana City Research and Training Hospital, Adana, 4 Department of Public Health, Public Health Directorate of Osmaniye, Osmaniye, 5 Department of Psychiatry, Faculty of Medicine, Istanbul Medipol University, Istanbul, 6 Department of Psychiatry, Faculty of Medicine, Kocaeli University, Kocaeli, 7 Istanbul University, Institute of Health Sciences, Istanbul, 8 Department of Psychiatry, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaras, 9 Health Science University, Adana City Research and Training Hospital, Deputy Chief Physician, Adana, Turkey
DOI: 10.4328/ACAM.21186 Received: 2022-04-13 Accepted: 2022-06-18 Published Online: 2022-06-20 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):999-1003
Corresponding Author: Edip Bayrak, Dr. Mithat Özsan Bulvarı, Kışla Mah., 4522 Sok. No: 1, Yüreğir, Adana, Turkey. E-mail: email@example.com P: +90 532 394 61 69 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8641-122X
Aim: SARS CoV-2 transmission in healthcare personnel was first reported on January 20, 2020. The aim of this study was to evaluate the anxiety levels experienced by healthcare personnel in Turkey during the COVID-19 pandemic and the factors affecting these levels.
Material and Methods: A survey investigating sociodemographic features and examining anxiety levels was conducted among approximately 1000 healthcare personnel who were expected to take active roles in the pandemic across Turkey. The survey was conducted in three stages: before the pandemic spread to Turkey, at the beginning of the pandemic and when the pandemic became prominent. A logistic regression analysis was performed to determine the factors affecting anxiety and predictors of anxiety levels.
Results: In the first survey, always (odds ratio, 15.781; p<0.01) and often (odds ratio, 5.365; p<0.05) media use, in the second survey media use (p<0.05) and profession (odds ratio, 0.021; p<0.05) and in the third survey, marital status (odds ratio, 17.716; p<0.01) and gender (odds ratio, 4.431; p<0.05) were determined as the predictors of anxiety related to COVID-19.
Discussion: As a result of this study, healthcare personnel groups were defined (women, nurses, married people) who need special intervention and support to provide spiritual comfort when working on the front line in the fight against COVID-19. Further comprehensive studies are needed of the extent of psychological support required by healthcare personnel and to whom and how this support should be provided.
Keywords: COVID-19, SARS CoV, Anxiety, Healthcare Personnel
Impact of the lockdown in the pandemic period on admissions due to non-COVID-19 pneumonia: A retrospective, cohort study
Melahat Uzel Şener, Ayperi Öztürk, Zeynep Tilbe Saymaz, Aydın Yılmaz
Department of Chest Disease, University of Health Sciences, Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21187 Received: 2022-04-14 Accepted: 2022-06-18 Published Online: 2022-06-21 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1004-1007
Corresponding Author: Melahat Uzel Şener, Department of Chest Disease, Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Keçiören, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 505 649 74 38 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8309-9517
Aim: The pandemic period has led to social and individual behavioral changes all over the world. In this study, the differences in the admissions of non-coronavirus disease 2019 (non-COVID-19) community-acquired pneumonia cases during the pandemic lockdown period in Turkey were analyzed.
Material and Methods: Patients with suspected COVID-19 and under the age of 18 were excluded, and non-COVID-19, hospitalized community-acquired pneumonia cases were included in this retrospective, cohort study. The analyzes were carried out by creating two groups as before the pandemic (March-May 2019) and the lockdown period of the pandemic (March-May 2020). The number of admissions and mortality rates were taken into consideration as primary outcomes.
Results: There were 178 cases in the 2019 group and 63 cases in the 2020 group. Gender and age distribution were similar in these two groups. While the rate of intensive care hospitalization was high in the 2020 group, mortality was low (14.3% vs 19.1%); but these differences were not statistically significant. In addition, bilateral infiltration rates were significantly higher in the 2019 group (80.9% vs. 22.2%; p<0.001).
Discussion: The low number of admissions during the lockdown period shows that there is awareness of the pandemic in society. Again, it can be said that this closure process plays a role in reducing the transmission of infectious diseases such as pneumonia.
Keywords: Pandemic, Lockdown, Isolation, Admission, Pneumonia
Calcium Channel Blockers Increase Sunitinib Effectiveness in Metastatic Renal Cell Carcinoma Treatment
Celal Alandağ 1, Elif Yüce 2, Feyyaz Özdemir 2
1 Department of Medical Oncology, Sivas Numune Hospital, Sivas, 2 Department of Medical Oncology, Karadeniz Technical University, Trabzon, Turkey
DOI: 10.4328/ACAM.21190 Received: 2022-04-15 Accepted: 2022-06-16 Published Online: 2022-06-20 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1008-1012
Corresponding Author: Celal Alandağ, Department of Medical Oncology, Sivas Numune Hospital, Sivas, Turkey. E-mail: email@example.com P: +90 506 912 83 19 Corresponding Author ORCID ID: https://orcid.org/0000-0002-2589-8174
Aim: Repurposing non-cancer drugs may be a new hope for cancer treatment. It has many advantages. Sunitinib is a tyrosine kinase inhibitor that inhibits vascular epithelial growth factor receptors. It is used for metastatic renal cell carcinoma (mRCC) treatment. We planned to investigate the effects of noncancer drugs like calcium channel blockers (CCBs) and others on sunitinib in mRCC patients.
Material and Methods: We retrospectively scanned the files of mRCC patients applied to our center between January 2013 and April 2019 and used sunitinib. We analyzed some parameters of these patients and their effects on overall survival (OS) and progression-free survival (PFS). A χ2 or Fisher’s exact test, Kaplan-Meier and Cox regressions were used in the statistical analysis.
Results: Thirty-five patients were examined, 15 of them were taking CCB for arterial hypertension and sunitinib for RCC, simultaneously. The 36-Months OS rates of CCB users and non-users were 61.1 and 38.9%, respectively (OR:5.1, 95% CI: 1.17-22.1, P=.041). The 24-Months PFS rates of CCB users and non-user were 68.8 and 31.3%, respectively (OR:8.25, 95% CI: 1.79-38.01, P=.007).
Discussion: It is a new idea to combine the targeted cancer drugs and non-cancer drugs for better anticancer outcomes. There were 36-months OS and 24-months PFS advantages with simultaneously taking CCBs and sunitinib. Sunitinib and CCBs combination should be studied in preclinical studies and their additive effect mechanisms should be clarified.
Keywords: Calcium Channel Blocker, Renal Cell Carcinoma, Repurposing, Sunitinib
Has anything changed in the last decade in the long-term outcome of patients with antenatal hydronephrosis?
İsa Yılmaz 1, Harun Peru 1, Metin Gündüz 2
1 Department of Pediatric Nephrology, 2 Department of Pediatric Surgery, Faculty of Medicine, Selcuk University, Konya, Turkey
DOI: 10.4328/ACAM.21193 Received: 2022-04-15 Accepted: 2022-06-16 Published Online: 2022-06-20 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1013-1016
Corresponding Author: İsa Yılmaz, Department of Pediatric Nephrology, Faculty of Medicine, Selcuk University, Konya, Turkey. E-mail: firstname.lastname@example.org P: +90 332 235 42 05 F: +90 332 237 60 25 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8654-9173
Aim: We tried to determine the etiological causes of antenatal hydronephrosis (AH) patients in their postnatal follow-ups in order to stress the importance of vesicoureteral reflux (VUR), to reveal the frequency of urinary tract infection (UTI) and scarred kidney in patients with hydroureteronephrosis or obstructive hydronephrosis with (VUR), and its effect on prognosis according to the degree of hydronephrosis.
Material and Methods: In this retrospective study, 251 patients diagnosed with AH were evaluated between January 2011 and January 2021. According to the renal pelvis antero-posterior (AP) diameter measurement, patients were classified into 3 groups as mild (group-1 with 121 cases, 48.2%), moderate (group-2 with 84 cases, 33.5%) and heavy (group-3 with 46 cases, 18.3%) grades. The groups were compared in terms of demographic data, laboratory results, imaging findings and prognosis.
Results: There was a significant difference in the frequency of UTI, bilateral hydronephrosis and hydroureteronephrosis between the groups (p<0.001, p=0.003, p=0.006, respectively). The incidence of pathological causes of hydronephrosis was higher in patients with bilateral hydronephrosis (p=0.040). Urinary tract infection was found to be higher in patients with hydroureteronephrosis, obstructive hydronephrosis and VUR (p=0.012, p=0.001, p=0.006, respectively). The incidence of renal scar was found to be higher in patients with hydroureteronephrosis, VUR and UTI (p=0.001, p<0.001, p<0.001). A significant difference was detected in the incidence of VUR, obstructive hydronephrosis and renal scar between the groups (p=0.002, p<0.001, p=0.006). Expectedly, the rate of surgical operation was higher in group-3 than in group-1 and 2 (p<0,001).
Discussion: In addition to the degree of antenatal hydronephrosis, the presence and bilaterality of hydroureteronephrosis are determining factors for the diagnostic imaging method and prognosis. Mild AH tends to improve spontaneously more compared to the other two groups. Patients with moderate to severe AH should be followed up for a long time with a more established approach.
Keywords: Antenatal Hydronephrosis, Long-Term Outcomes, Childhood
Applicability of the ROX index in decision-making for hospitalization in COVID-19 patients
Umut Sabri Kasapoglu 1, Engin Burak Selcuk 2, Murat Yalcınsoy 3, Kadir Uckac 2, Abdullah Fahri Sahın 4, Recep Bentlı 5
1 Department of Pulmonary and Critical Care Medicine, Malatya Training and Research Hospital, 2 Department of Family Medicine, Inonu University School of Medicine, 3 Department of Chest Diseases, Inonu University School of Medicine, 4 Department of Pathology, Turgut Ozal University School of Medicine, 5 Department of Internal Medicine, Inonu University School of Medicine, Malatya, Turkey
DOI: 10.4328/ACAM.21196 Received: 2022-04-17 Accepted: 2022-06-18 Published Online: 2022-06-20 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1017-1021
Corresponding Author: Engin Burak Selcuk, Department of Family Medicine, Inonu University School of Medicine, Turgut Ozal Medical Center, 44280, Battalgazi, Malatya, Turkey. E-mail: email@example.com P: +90 532 488 20 43 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8484-0223
Aim: Data on the outpatient follow-up of COVID-19 cases is still scarce. Also, the significance of the ROX index in decision-making for hospitalization in the ambulatory COVID-19 cases remains unknown. The aim of this study is to determine the general characteristics of COVID -19 patients treated as outpatients and to investigate whether the ROX index is applicable in hospitalization decisions.
Material and Methods: This retrospective cohort study was conducted in confirmed adult COVID-19 cases between 15 October 2020 and 01 March 2021. A total of 5240 confirmed COVID-19 patients were included in the present study. Factors affecting hospitalization were investigated.
Results: The study population was divided into two groups as those who require hospitalization (n=672) and those who did not (n=4568). The number of male patients and the mean age of the patients were significantly higher in hospitalized patients group (p=0.046, p<0.001). ROX index that was calculated at the home visit on the third day of disease was found significantly lower in the group of hospitalized patients (p<0.001). There was a significant correlation between ROX index and inflammatory biomarkers in the present study (p<0.001). The ROX index was found the most accurate parameter for decision-making for hospitalization in ambulatory COVID-19 patients (AUC=0.794 CI=0.773-0.814, p<0.001).
Discussion: The ROX index can be a useful and objective clinical tool for decision making for hospitalization in the ambulatory COVID-19 cases.
Keywords: COVID-19, Ambulatory, Hospitalization, Predictors, ROX Index
Evaluation of scoring methods in trauma patients with rib fractures
Department of Thoracic Surgery, Faculty of Medicine, Fırat University, Elazig, Turkey
DOI: 10.4328/ACAM.21197 Received: 2022-04-18 Accepted: 2022-06-17 Published Online: 2022-06-18 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1022-1025
Corresponding Author: Muharrem Cakmak, Department of Thoracic Surgery, Faculty of Medicine, Fırat University, Elazig, Turkey. E-mail: firstname.lastname@example.org P: +90 533 301 68 97 F: +90 424 233 35 55 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9504-2689
Aim: In thoracic traumas, it is very important to provide accurate treatment after determining the severity of the trauma. Therefore, scoring systems are used to determine morbidity and mortality rates. These scoring methods include the Rib Fracture Score (RFS), Chest Wall Injury Score (CWIS), Chest Trauma Score (CTS), Thoracic Trauma Severity Score (TTSS), and Injury Severity Score (ISS). In our study, we aimed to evaluate the scoring systems in patients with post-traumatic rib fractures and accompanying pathologies, and to determine the trauma severity, mortality and morbidity rates with these scorings.
Material and Methods: The records of 482 patients followed up and treated for post-traumatic rib fractures. The patients were divided into two groups as survivors (n: 418) and those who died (n: 64). The mean number of fractures, RFS, CWIS, CTS, TTSS, ISS values, and mortality and morbidity rates were recorded.
Results: The mean number of fractures was 3.02±2.92, RFS; 4.84±4.71, CWIS; 1.68±0.79, CTS; 5.01±1.46, TTSS; 6.58±2.20, ISS; 7.90±8.64. When surviving and deceased patients were compared in terms of the mean number of fractures, RFS, CWIS, CIS, TTS, and ISS, the number of deceased patients was statistically significant compared to the surviving patients (p<0.05).
Discussion: It was observed that mortality rates increased in trauma patients as the number of rib fractures increased with concomitant pathologies such as pneumomediastinum, hemothorax, pneumothorax, contusion, and flail chest as well as concomitant organ injuries such as spleen, kidney and liver. These pathologies and the presence of concomitant injuries were significant in mortality and morbidity.
Keywords: Fractures, Ribs, Scoring, Trauma
Evaluation of dental anxiety: Nyala Region, Sudan
Elif Esra Ozmen 1, Metin Ocak 2
1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ahmet Keleşoglu University, Karaman, 2 Department of Emergency, Gazi State Hospital, Samsun, Turkey
DOI: 10.4328/ACAM.21198 Received: 2022-04-20 Accepted: 2022-06-19 Published Online: 2022-06-21 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1026-1030
Corresponding Author: Elif Esra Ozmen, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ahmet Keleşoglu University, Karaman, Turkey. E-mail: email@example.com P: +90 507 152 42 13 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1920-4655
Aim: Dentists may commonly meet fear and anxiety during dental procedures. Patients may be frightened due to the expectation of pain, and this may cause them to delay their dental treatment. Physicians should be able to plan treatment by noticing anxiety and fear situations. Numerous scales were developed for this purpose. The Dental Anxiety Scale (DAS) and Modified Dental Anxiety Scale (MDAS) are the most commonly used scales. The aim of the present study was to evaluate the dental anxiety of a group of adult individuals in the Nyala region of Sudan.
Material and Methods: The study was conducted on adults who have been referred to the Nyala Training and Research Hospital. The present study included 104 individuals, including 43 (41.35%) males and 61 (58.65%) females with ages ranging between 20 and 57 years. The participants were asked to fill in the prepared questionnaire. Dental anxiety level was determined through the Dental Anxiety Scale (DAS) and Modified Dental Anxiety Scale (MDAS).
Results: In this study, which examined levels of dental anxiety, it was concluded that there was no difference in anxiety level between the genders (p>0.05). It was observed that the use of aerators in dentistry practices increases anxiety (p<0.05). It was concluded that the heads of the dental scaler used during scaling also increased the level of anxiety (p<0.05). However, it was detected that they do not have a fear of local anesthesia (p>0.05).
Discussion: Considering the results of the study reveals that it has not been determined under what conditions the emerging anxiety can develop. However, it was observed that anxiety level differs among nations.
Keywords: Dental Anxiety, Dental Procedures, Dental Anesthesia
Glucose-to-potassium ratio: A novel index associated with the clinical status in acute coronary syndrome patients
Ferit Boyuk 1, Serhat Caliskan 2, Rumeysa Yigen 3
1 Department of Cardiology, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, 2 Department of Cardiology, Bahçelievler State Hospital, 3 Depertmant of Emergency Medicine, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21200 Received: 2022-04-21 Accepted: 2022-06-18 Published Online: 2022-07-02 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1031-1035
Corresponding Author: Ferit Boyuk, Belgrad Kapı Yolu Caddesi, Kazlisesme Mahallesi, No: 1, Zeytinburnu, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 212 409 02 00 F: +90 212 409 22 10 Corresponding Author ORCID ID: https://orcid.org/0000-0003-2313-1495
Aim: Acute coronary syndrome is the foremost cause of death in the world. Hyperglycemia and hypokalemia have been found to be associated with poor prognosis in ACS. In this study, we aimed to assess the diagnostic value of GPR in ACS.
Material and Methods: The study was designed as a retrospective cross-sectional clinical cohort study of patients with ACS. A total of 169 participants were enrolled in the research and divided into two groups: ACS (n:88) and Control (n:81). GPR was calculated by dividing serum glucose by potassium levels and its results were compared with Troponin, WBC, and NEU.
Results: Troponin was measured as 2261.76±3629.42 in the ACS group and found to be higher than in the Control group (4.8±3.11) (p=0.001). WBC (100±83,5 to 30,9±42,7mg/L; p=0,0001) and Neutrophil (49,5±11,9 to 34,8±7,3 mm Hg; p=0,0001) were found to be increased in the ACS group. GPR strongly increased in the ACS group compared to controls (25.61 to 24.15; p=0.001). GPR showed stronger diagnostic value (AUC: 0.97; p=0.001; Sensitivity: %92; Specificity: %86; Cut-off: 24.09).
Discussion: GPR as a novel and cheap marker, which can be useful for the diagnostic differentiation of ACS, but weaker than troponin and better than WBC and Neutrophil count.
Keywords: Acute Coronary Syndrome, Glucose-to-Potassium Ratio, WBC, Neutrophils
Relationship between plasma omentin-1 levels and newly diagnosed Stage I hypertension
Mehmet Ozyasar 1, Alim Erdem 2
1 Department of Cardiology, Konya City Hospital, Konya, 2 Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
DOI: 10.4328/ACAM.21201 Received: 2022-04-21 Accepted: 2022-06-17 Published Online: 2022-06-18 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1036-1039
Corresponding Author: Mehmet Ozyasar, Department of Cardiology, Konya City Hospital, Konya, Turkey. E-mail: email@example.com P: +90 332 310 50 00 / +90 505 732 85 62 F: +90 332 310 50 50 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5227-1716
Aim: Omentin-1 is an adipose tissue-derived cytokine with unknown biological function. The impact of omentin-1 on hypertension has been questioned due to its relation to obesity. This study is aimed to investigate omentin-1 levels in hypertensive patients.
Material and Methods: A prospective, case-control study evaluated patients admitted to outpatient cardiology clinics between January 2012 and December 2013. We designed two groups: the patient group comprised hypertensive patients with newly diagnosed stage-1 hypertension, and the control group comprised normotensive patients. The demographic and anthropometric characteristics and laboratory parameters of the patients in both groups were recorded. Plasma levels of omentin-1 were the primary outcome in this study.
Results: Patient group consisted of 52 hypertensive patients, whereas the control group consisted of 36 patients without hypertension. There was no significant difference between the groups in terms of demographic and clinical characteristics (p>0.05). The median omentin-1 level of the patient group was higher than that of the control group (756.2 ng/mL vs. 664.4 ng/mL); however, the difference was insignificant (p=0.161).
Discussion: The findings of this study did not suggest a significant relationship between the plasma omentin-1 levels and the newly diagnosed Stage I hypertension.
Keywords: Hypertension, Adipokines, Omentin
Retrospective evaluation of hemicolectomies in obstructive colon tumors: A single center experience
Metin Yalcin 1, Serdar Oter 2
1 Department of General Surgery, Antalya Training and Research Hospital, Antalya, 2 Department of Gastroenterological Surgery, Manisa City Hospital, Manisa, Turkey
DOI: 10.4328/ACAM.21205 Received: 2022-04-23 Accepted: 2022-06-21 Published Online: 2022-06-22 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1040-1042
Corresponding Author: Metin Yalcin, Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey. E-mail: firstname.lastname@example.org P: +90 535 585 61 63 Corresponding Author ORCID ID: https://orcid.org/0000-0003-2843-3556
Aim: The most common complications of colon cancer requiring emergency surgery are perforation and obstruction; 15-40% of patients with colon cancer initially show these conditions. The aim of this study is to evaluate clinical findings and perioperative outcomes of colon cancer patients who were emergently operated for obstruction in our center.
Material and Methods: After obtaining local ethical committee’s approval, a retrospective study was designed. Patients who underwent emergent surgery for obstructive colon cancer in our clinic were evaluated between February 2009 and February 2020.
Results: A total of 79 patients were included in the study. Forty (50.63%) of these patients, were male, 39 (49.37%) were female, and the mean age was 54.55 ±17.95 years (min-max: 17-87 years). In the postoperative period, according to the Clavien-Dindo classification, 12 (15.18%) complications were grade 1-2 and 9 (11.39%) were grade 3 and above. Postoperative wound infection was observed in 10 patients. Anastomotic leak was detected in only 2 patients. Totally 5 patients (6.32%) died during the first 30 days. The cause of mortality was sepsis in the early postoperative period in two patients, massive pulmonary embolism in two patients and myocardial infarction in one patient.
Discussion: Obstructive colon cancers requiring emergency surgery constitute a more challenging group than the elective surgery patient group. Our study showed that good results can be achieved in this group in terms of postoperative complications and early mortality.
Single-stage resection and anastomosis surgery can be safely preferred instead of the Hartman procedure in the selected patient group with left colon tumors.
Keywords: Hemicolectomy, Obstructive Colon Tumors, Early Mortality, Results
How should we enter peritoneum in vaginal hysterectomy?
Emine Türen Demir, Hasan Energin
Department of Obstetrics and Gynecology, Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye
DOI: 10.4328/ACAM.21206 Received: 2022-04-25 Accepted: 2022-06-20 Published Online: 2022-06-21 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1043-1046
Corresponding Author: Emine Türen Demir, Abdulhamid Han Caddesi, Hocacihan Mahallesi, No: 3, 42080, Konya, Türkiye. E-mail: email@example.com P: +90 332 323 64 15 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5510-4411
Aim: Anterior and posterior entrances to the peritoneal cavity are essential steps in vaginal hysterectomy. The objective of this study was to compare surgical techniques and results in women who had primarily anterior colpotomy or primarily posterior colpotomy to enter the peritoneum in vaginal hysterectomy.
Material and Methods: We analyzed the data of 90 women who underwent vaginal hysterectomy by the same surgical team in a university hospital between 2017 and 2021. The patients have divided into two groups: primarily anterior colpotomy or primarily posterior colpotomy. Operation time, amount of bleeding, and complication rates were compared between the two groups.
Results: First anterior colpotomy was performed in 44 patients, and the first colpotomy posterior was performed in 46 patients. Patient characteristics were similar in both groups. The mean age of the patients was 63.6±8.6 years, and the mean number of pregnancies was 3.07±1.05. The mean preoperative and postoperative hemoglobin difference was 1.5±0.6 g/dl. The mean uterine length was 9.33±2.07 cm, and the mean uterine weight was calculated as 118.1±42.2 g. The operation time was significantly shorter in the first colpotomy posterior group (67.5±7.7 min vs. 78.1±12.6 min p<0.05). While no significant complications were observed in the first posterior colpotomy group, one bladder injury was observed in the first anterior colpotomy group.
Discussion: In a vaginal hysterectomy, when posterior colpotomy is performed first, Entrance into the peritoneal cavity is safer and quicker. Thus, surgeons feel more comfortable and secure while performing a vaginal hysterectomy and return to abdominal procedures minimally.
Keywords: Vaginal Hysterectomy, Anterior Colpotomy, Posterior Colpotomy, Peritoneal Reflection
Infantile Esotropia: Clinical features and surgical outcomes
Sule Bahadir Coskun, Nazife Sefi Yurdakul, Ahmet Maden
Department of Ophthalmology, Izmir Ataturk Training and Research Hospital, Izmir, Turkey
DOI: 10.4328/ACAM.21207 Received: 2022-04-25 Accepted: 2022-06-20 Published Online: 2022-06-21 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1047-1051
Corresponding Author: Sule Bahadir Coskun, Basın Sitesi, Atatürk Eğitim ve Araştırma Hastanesi, 35360 Karabağlar, İzmir, Türkiye. E-mail: firstname.lastname@example.org P: +90 232 243 43 43 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1713-899X
Aim: The objective of this study was to investigate clinical features and surgical outcomes of Infantile esotropia (IET) patients and to evaluate the effect of surgery age on binocular function.
Material and Methods: A total of 28 patients who underwent surgery were enrolled. Medical history of the patients was received, and the age of IET onset, prenatal history, family history and ocular therapies performed (closure therapy, using eyeglasses) were recorded. After cover-uncover test, patients’ deviation angles were determined utilizing prism cover test using an accommodative target for far/near. Visual acuity was evaluated according to the optotypes, objects or fixation on the Snellen chart depending on the cooperation of the patients. Bilateral medial rectus recession was applied in all patients.
Results: The mean age of IET onset was determined as 2.11±2.18 months. Patients’ age of surgery differed between 10 months and 25 years with a mean age of 5.3±6.1 years. In all patients, the preoperative amount of the far deviation was 48.39±1.06 PD (25-80 PD) and preoperative amount of near deviation was 48.57±12.97 PD (25-80 PD). Twenty-six patients first underwent bilateral medial rectus recession (maximum: 6.5 mm). When pre- and postoperative deviation angles were compared, postoperative deviation angles were significantly improved (p<0.05).
Discussion: The most appropriate time for surgery in IET cases should be taken as the earliest time when the amount of deviation can be accurately determined, refractive errors should be determined before and after surgery in all cases, treatment of amblyopia and early completion of surgical correction should be aimed at gaining binocular functions.
Keywords: Infantile Esotropia, Visual Acuity, Strabismus, Binocularity, Amblyopia
Predictive power of blood urea nitrogen and albumin ratio for mortality in acute ischemic stroke
Mazlum Kılıç 1, Davut Tekyol 2
1 Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, 2 Department of Emergency Medicine, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21328 Received: 2022-07-23 Accepted: 2022-08-25 Published Online: 2022-08-26 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1052-1055
Corresponding Author: Davut Tekyol, Selimiye, Tıbbiye Cd, No:23, 34668, Üsküdar, İstanbul, Türkiye. E-mail: email@example.com P: +90 530 233 08 82 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9353-6063
Aim: Globally, acute ischemic stroke (AIS) is one of the leading causes of death and permanent disability. The ratio of blood urea nitrogen to serum albumin (BAR) is a prognostic biomarker that combines two important determinants and has excellent predictive potential for mortality in critically sick patients. This study investigated the relationship between BAR and in-hospital mortality in AIS patients diagnosed in the emergency department (ED).
Material and Methods: A retrospective analysis of data of AIS patients aged 18 and older who presented to our emergency department during the study period was performed. Data were acquired from the hospital’s computerized information system. Each discriminant mortality cut-off value was evaluated using the receiver operating characteristic (ROC) curve and area under the curve (AUC).
Results: The study included a total of 300 patients with a mean age of 67.1±14.4 years; 156 (52%) of them were male. The mean length of stay in the hospital was found to be 7 days, and 67 patients were transferred to the intensive care units. Fifteen patients (5%) died during their follow-up in the hospital. As a result of the ROC analysis of BAR to predict the presence of in-hospital mortality, the AUC value was determined as 0.756 (95% confidence interval: 0.704-0.804), the Youden index as 0.47, and the p-value as 0.001. At a cut-off value of >4.21, BAR had a sensitivity of 93.3%, specificity of 54.4%, positive predictive value of 9.7, and negative predictive value of 99.4 in determining the presence of in-hospital mortality.
Discussion: BAR is a simple and useful in-hospital mortality predictor in patients with AIS.
Keywords: Stroke, Albumin, Blood Urea Nitrogen, Mortality
Comparison of intra-abdominal pressure in open surgery and endovascular aortic repair procedures
Sefer Usta 1, Gönül Erkan 2
1 Department of Cardiovasculary Surgery, 2 Department of Anesthesiology and Reanimation, Health Sciences University, Ahi Evren Training and Research Hospital, Trabzon, Turkey
DOI: 10.4328/ACAM.21331 Received: 2022-07-27 Accepted: 2022-08-27 Published Online: 2022-08-29 Printed: 2022-09-01 Ann Clin Anal Med 2022;13(9):1056-1060
Corresponding Author: Sefer Usta, Department of Cardiovasculary Surgery, Health Sciences University, Ahi Evren Training and Research Hospital, Trabzon, Turkey. E-mail: firstname.lastname@example.org P: +90 532 252 64 75 F: +90 462 231 04 83 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4988-3978
Aim: Surgery and endovascular aortic repair (EVAR) procedures performed in abdominal aortic aneurysm (AAA) disease can lead to increased intra-abdominal pressure (IAP). In this study, we aimed to determine IAP values in intact infrarenal AAA patients who underwent surgery and the EVAR procedure, and to contribute to the literature with our results.
Material and Methods: Thirty-six patients who underwent open surgery and EVAR treatment for infrarenal AAA between June 2018 and September 2021 were retrospectively analyzed.
The patients were divided into three groups. Group 1: Patients treated with open surgery and no drains; Group 2: Patients treated with open surgery in whom a drain was placed; Group 3: Patients treated with EVAR.
Results: Demographic data and comorbidities of the groups were similar. IAP values were lower in the EVAR procedure group (Group 3) compared to the other groups at each measurement period. This difference was statistically significant, especially at the postoperative 12th, 18th, and 24th hours (p<0.05). Among the groups that underwent open surgery, the postoperative IAP values in Group 2 were lower compared to Group 1.
Discussion: We found that placing a drain in patients undergoing open surgery is more beneficial to prevent IAP increase. However, endovascular surgery was much more effective than open surgical repair in preventing IAP increase.
Keywords: Abdominal Aortic Aneurysm, Intraabdominal Pressure, Endovascular Aortic Repair, Surgery