Awareness, attitude and experiences regarding public health ethics of public health professionals
Nergis Kayacan 1, Muzaffer Eskiocak 2, Necati Dedeoğlu 3, Esin Karlıkaya 3
1 Department of Occupational Diseases, Kayseri City Hospital, Kayseri, 2 Department of Public Health, Medicine, Sanko University, Gaziantep, 3 Department of Public Health, Trakya Unıversıty, Edirne, Turkey
DOI: 10.4328/ACAM.20884 Received: 2021-10-04 Accepted: 2021-10-25 Published Online: 2022-12-08 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):1-5
Corresponding Author: Nergis Kayacan, Department of Occupational Diseases, Kayseri City Hospital, Kayseri, Turkey. E-mail: firstname.lastname@example.org P: +90 532 062 93 62 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1922-5835
Aim: Healthcare ethics is closely related and similar to medical ethics; however, it is not limited to this. The basic distinction between healthcare ethics and traditional medical ethics is that public health specialists deal with the health problems of societies rather than health problems of individuals. Public health ethics is a current and important field that needs to be studied. The aim of this study is to question the experiences of public health practitioners in public health ethics and professional ethics for the purpose of strengthening the ethical dimension of staff, identifying their awareness and determining their attitudes and understanding on this topic.
Material and Methods: The study was conducted between 03.02.2016 and 15.03.2016 with public health professionals that were registered in the Communication Group of Halk Sağlığı Uzmanları Derneği (HASUDER).
Results: Two hundred ninety-nine people participated in our study. According to the results of our study, all of the H0 Hypotheses that were formed by us were rejected. There is a significant difference between the experience, awareness and attitudes of the public health professionals who participated in the study in terms of healthcare ethics. Only half of the staff had received public health training in their professional training.
Discussion: As indicated in the basic principles of public health ethics, public health should address the health of society in a manner that respects the rights of individuals. Since there are no studies in the literature on healthcare ethics conducted with public health professionals in our country, our study is one of the pioneering ones in this field. The training of public health professionals in healthcare ethics is not adequate, and they feel the need to receive training in this field.
Keywords: Healthcare, Ethics, Experience, Awareness, Attitude
Decision delivery interval in emergency cesarean sections and fetal and maternal outcomes: A prospective cohort study
Latifa Mochhoury 1, Aicha Yacoutı 1, Milouda Chebabe 1, Abdelmajid Lkoul 2, Amina Barkat 3
1 Laboratory of Health Sciences and Technologies, Higher institute of Health Sciences, Hassan First University of Settat, Settat, 2 Laboratory of Health Sciences Research, National School of Applied Sciences, Ibn Zohr University, Agadir, 3 Research Team in Maternal and Child Health and Nutrition, Faculty of Medicine and Pharmacy, Mohammed V. University, Rabat, Morocco
DOI: 10.4328/ACAM.21312 Received: 2022-07-12 Accepted: 2022-08-18 Published Online: 2022-08-30 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):6-11
Corresponding Author: Latifa Mochhoury, Laboratory of Health Sciences and Technologies, Higher institute of Health Sciences, Hassan First University of Settat, 26000, Settat, Morocco. E-mail: email@example.com P: +21 262 030 35 82 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5019-2296
Aim: The aim of this study is to evaluate the effect of this delay on fetal and -maternal outcomes and whether this delay causes adverse outcomes in significant proportions in a Moroccan population.
Material and Methods: A prospective observational cohort study was conducted from September 2021 to April 2022 in the Gynecology and Obstetrics service of the Provincial Hospital Hassan 2, Settat Morocco with 322 parturients who presented with an indication for an emergency caesarean section. Bivariate and multivariate logistic regression analyses were carried out to identify predictors. The multicollinearity diagnostic was performed based on the inﬂation of variance factor
Results: The average time to perform emergency caesareans was 68.95 ± 69.607 minutes (≈1 hour and 8 minutes) with extremes of 8 and 540 minutes. Over 78% of parturients had a Delivery Decision time Interval (DDI) of more than 30 minutes.
Unavailability of the уmergency kit (OR = 4.712, CI = 2.16-10.2), unavailability of the anesthetist team (OR = 3.239 CI = 1.532-6.847), patient’s hesitation (OR = 2.883, CI = 1.471-5.651), and unavailability of the preoperative assessment (OR= 0.613, CI= 0.357-1.051) were considered as significant factors associated with prolonged DDI.
Discussion: Through this study, we have concluded that the current recommendations regarding the interval between decision and delivery were not respected in Moroccan current practice. Raising the healthcare professional’s awareness regarding the importance of respecting the recommendations is crucial to improve the current situation and ultimately improve fetal and maternal outcome increase
Keywords: Cesarean Section, DDI (Decision to delivery interval), Feto-Maternal outcome
Comparison of patients who underwent video-assisted thoracoscopic surgery or thoracotomy
Muharrem Cakmak, Siyami Aydın
Department of Thoracic Surgery, Faculty of Medicine, Fırat University, Elazig, Turkey
DOI: 10.4328/ACAM.21324 Received: 2022-07-18 Accepted: 2022-08-18 Published Online: 2022-08-23 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):12-16
Corresponding Author: Muharrem Cakmak, Department of Thoracic Surgery, Faculty of Medicine, Fırat University, Elazig, Turkey. E-mail: firstname.lastname@example.org P: +90 424 233 35 55 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9504-2689
Aim: Thoracotomy is one of the surgical procedures used in thoracic surgery. The morbidities in this method are related to the size of the surgical incision. Video-assisted thoracoscopic surgeries (VATS) are operations performed to reduce surgical morbidity without sacrificing basic surgical principles. Smaller and fewer incisions are made in VATS compared to thoracotomy. In our study, we aimed to compare the advantages and disadvantages of patients who underwent video-assisted thoracoscopic surgery or thoracotomy.
Material and Methods: Patients (n;47) were divided into two groups as patients who underwent VATS (Group 1; 28) and open surgery (thoracotomy) (Group 2; 19). Age, gender, localization of the disease, diagnosis, surgeries, duration of surgery, pain scores, length of stay, complications, and mortality of the patients in each group were recorded. Values were recorded as numerical expressions ranging from zero (no pain) to 10 (very severe pain). The groups were compared statistically.
Results: When the groups were compared, there was no significant difference between the groups in terms of gender, localization, and mean age (p>0.05). However, it was seen that Group 1 had significantly lower scores compared to Group 2 in terms of duration of surgery, length of hospital stay, and pain. Moreover, it was observed that in Group 1 complication rates were significantly lower compared to Group 2.
Discussion: VATS is prominent as it is less invasive compared to thoracotomy and the postoperative period is more comfortable. It has much more advantages than the thoracotomy procedure. Therefore, we strongly suggest that VATS be preferred to thoracotomy when possible and be strictly applied.
Keywords: Advantages, Disadvantages, Thoracotomy, Video-assisted thoracoscopic surgeries
Intestinal perforation due to isolated blunt abdominal trauma from work accident: A single center experience
Nazım Güreş 1, Ömer Küçük 2, Ergin Erginöz 3, Server Sezgin Uludağ 4
1, 2 Department of General Surgery, Balikesir Atatürk City Hospital, Balikesir, 3, 4 Department of General Surgery, University of Istanbul-Cerrahpasa, Faculty of Medicine, Istanbul, Turkey
DOI: 10.4328/ACAM.21396 Received: 2022-09-18 Accepted: 2022-10-19 Published Online: 2022-10-21 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):17-20
Corresponding Author: Ergin Erginöz, Department of General Surgery, Istanbul University-Cerrahpasa, Faculty of Medicine, Cerrahpasa Tıp Fakultesi Yerleskesi, Kocamustafapasa Caddesi, No: 53, Cerrahpasa, Istanbul, Turkey. E-mail: email@example.com P: +90 536 879 97 71 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8349-3298
Aim: Isolated blunt abdominal trauma due to occupational accidents and related hollow organ injury is a very rare phenomenon. Therefore, their diagnosis can be difficult and delays in diagnosis can result in significant morbidity and mortality. In this study, we aimed to present cases of hollow organ injury caused by isolated abdominal blunt trauma due to work accidents.
Material and Methods: Five male patients with isolated blunt abdominal trauma due to a work accident who applied to our center between 2017 and 2022 were included. Isolated blunt abdominal trauma occurred in three patients as a result of hitting a log, plank, and ax handle, and in one as a result of hitting a sack, and in one as a result of cow horn damage.
Results: Ileal injury occurred in three patients, jejunal injury in one patient, and colonic injury in one patient. The average time for the onset of trauma to hospital admission varied between 3 to 60 hours. All patients developed acute abdominal signs, and abdominal CT showed abdominal free air, fluid, or a combination of both. One patient developed leukopenia, while other patients had significant leukocytosis. Primary repair was performed in two patients, loop ileostomy in two patients, and loop colostomy in one patient. Four patients were discharged and one patient died of sudden cardiac arrest.
Discussion: Hollow organ injury may occur due to isolated blunt abdominal trauma from work accidents, and the findings can be easily missed. Delays in diagnosis can lead to significant morbidity and mortality. Primary repair in the early period and ostomy creation in delayed perforations may be treatment options in these patients.
Keywords: Hollow Organ Perforation, Blunt Abdominal Trauma, Perforation, Work Accident
Diagnostic value of mid-regional pro-atrial natriuretic peptide (MR-proANP) level in patients with acute pulmonary embolism
Ertuğrul Altuğ 1, Hasan Kara 2, Ayşegül Bayır 2, Ahmet Ak 2, Seyit Ali Kayış 3, Ali Ünlü 4, Bülent Behlül Altunkeser 5, Mustafa Koplay 6, Abdullah Tunçez 5, Hüseyin Tezcan 7
1 Department of Emergency Medicine, Başaksehir Çam and Sakura State Hospital, Istanbul, 2 Department of Emergency Medicine, Faculty of Medicine, Selcuk University, Konya, 3 Department of Biostatistics and Medical Informatics, Faculty of Medicine, Bolu İzzet Baysal University, Bolu, 4 Department of Medical Biochemistry, Faculty of Medicine, Selcuk University, Konya, 5 Department of Cardiology, Faculty of Medicine, Selcuk University, Konya, 6 Department of Radiology, Faculty of Medicine, Selcuk University, Konya, 7 Department of Cardiology, Ministry of Health Konya City Hospital, Konya, Turkey
DOI: 10.4328/ACAM.21399 Received: 2022-09-19 Accepted: 2022-10-28 Published Online: 2022-10-29 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):21-24
Corresponding Author: Ertuğrul Altuğ, Department of Emergency Medicine, Başaksehir Çam and Sakura State Hospital, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 535 656 84 42 Corresponding Author ORCID ID: https://orcid.org/0000-0001-6807-643X
Aim: Right ventricular failure can develop in patients with pulmonary embolism (PE) and is associated with increased mortality. Mid-regional pro-atrial natriuretic peptide (MR-proANP), a natriuretic peptide, is secreted due to the increased atrial wall tension caused by right heart failure. In this study, we aimed to investigate the diagnostic value of MR-proANP in patients who presented to the emergency department with a pre-diagnosis of pulmonary embolism.
Material and Methods: Among patients with a preliminary diagnosis of PE, 100 patients who were confirmed to have PE by computed tomography pulmonary angiography (CTPA) were determined as the case group. As a control group, 50 patients were randomly identified, in whom the diagnosis of PE was excluded. Echocardiography was performed in all patients in the case group immediately after the diagnosis was confirmed, and the presence of right ventricular dysfunction was investigated. This study was designed as a prospective observational study.
Results: The median value of MR-proANP (645.8 (66.37-3313.08) pmol/L) in the case group was found to be significantly higher than median value of MR-proANP (442.9 (226.73-774.78) pmol/L) in the control group (p:0.003). MR-proANP was found to be significantly higher in the differential diagnosis of PE.
Discussion: In addition to clinical signs and symptoms, MR-proANP levels seem to be a useful variable that may improve diagnostic accuracy in patients with suspected pulmonary embolism in the emergency department.
Keywords: MR-proANP, Acute Pulmonary Embolism, Right Ventricular Failure, Biomarker
Evaluation of anxiety and pain levels in patients undergoing colonoscopy in the COVID-19 pandemic
Ayşe Neslihan Balkaya, Füsun Gözen
Department of Anesthesiology and Reanimation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Education Hospital, Bursa, Turkey
DOI: 10.4328/ACAM.21402 Received: 2022-09-21 Accepted: 2022-10-28 Published Online: 2022-11-10 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):25-29
Corresponding Author: Ayşe Neslihan Balkaya, Department of Anesthesiology and Reanimation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Education Hospital, Emniyet Street, No:35, 16290, Yıldırım, Bursa, Turkey. E-mail: email@example.com P: +90 544 871 53 43 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8031-6264
Aim: In this study, we aimed to evaluate factors affecting the anxiety and pain of patients undergoing colonoscopy during the COVID-19 period.
Material and Methods: Before the colonoscopy, patients aged 18-80 years were asked to fill out the Spielberger State-Trait Anxiety Inventory Scale (STAI), along with a personal data form in which demographic data and medical history were questioned, and their pain was questioned with the Visual Analogue Scale (VAS). The pain was questioned in patients who underwent colonoscopy under sedoanalgesia according to VAS after full recovery (Modified Aldrete Score ≥8).
Results: Three hundred and thirty patients (M/F=53/47) with a mean age of 53.41±14.75 years participated in the study. 22.7% of the patients had COVID-19 infection. COVID-19 vaccine was administered to 47.6% of the patients. 85.5% were concerned about COVID-19 transmission during colonoscopy. The mean STAI-S (STAI-State) was 47.49±8.86, and STAI-T (STAI-Trait) was 39.84±8.94 in the patients. The mean VAS score was 2 (0-10) before colonoscopy and 4 (0-10) after colonoscopy. There was no difference in STAI-S, STAI-T, pre and post-colonoscopy VAS scores between those who had COVID-19 and those who did not (p=0.134, p=0.155, p=0.891, p=0.953). There was no difference in STAI-S, STAI-T, and VAS scores between those vaccinated with the COVID-19 vaccine and those not vaccinated (p=0.127, p=0.527, p=0.932, p=0.983). Gender, educational status, STAI-S, STAI-T scores, and colonoscopy waiting time affected VAS scores.
Discussion: Being infected with COVID-19 and being vaccinated with COVID-19 vaccine are not among the factors affecting patients’ anxiety and pain.
Keywords: COVID-19, Colonoscopy, Anxiety, Pain, Vaccine
Trimethylamine N-Oxide levels increase in patients with severe and non-severe COVID-19
İbrahim Halil Yasak 1, Mustafa Yılmaz 2, Mehmet Resat Ceylan 3, İsmail Koyuncu 4, Eyyup Sabri Seyhanlı 5
1 Department of Emergency Medicine, Faculty of Medicine, Harran University, Şanlıurfa, 2 Department of Emergency Medicine, Faculty of Medicine, Fırat University, Elazığ, 3 Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Harran University Faculty of Medicine, Şanlıurfa, 4 Department of Medicinal Biochemistry, Faculty of Medicine, Harran University, Şanlıurfa, 5 Health Science University, Mehmet Akif İnan Research and Training Hospital, Emergency Department, Şanlıurfa, Turkey
DOI: 10.4328/ACAM.21403 Received: 2022-09-21 Accepted: 2022-10-28 Published Online: 2022-11-15 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):30-34
Corresponding Author: İbrahim Halil Yasak, Department of Emergency Medicine, Faculty of Medicine, Harran University, 63300, Şanlıurfa, Turkey. E-mail: firstname.lastname@example.org P: +90 414 344 44 44 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6399-7755
Aim: This study aimed to measure and evaluate serum trimethylamine N-oxide (TMAO) levels in patients with COVID-19.
Material and Methods: The patients were divided into three groups according to their polymerase chain reaction (PCR) results and the clinical picture of the disease: Group 1 (negative PCR result, n = 44), Group 2 (positive PCR result and non-severe disease, n = 38) and Group 3 (positive PCR result and severe disease, n = 45).
Results: TMAO levels were significantly different among the three patient groups. Post Hoc Dunn’s analysis revealed a significant difference between Group 1 and Group 2 (p = 0.006), Group 1 and Group 3 (p < 0.001) and Group 2 and Group 3 (p = 0.031). ROC analysis revealed that a cut-off value of 2.92 had a sensitivity of 74.70%, a specificity of 68.18%, a positive predictive value of 81.6% and a negative predictive value of 58.8%.
Discussion: The results of this study demonstrated that TMAO levels increased in the patients with COVID-19, and further TMAO levels increased as the severity of the disease progressed.
Keywords: Biomarkers, COVID-19, Peripheral Blood, Severe, Trimethylamine N-oxide
In the emergency department, the diameter of the inferior vena cava and aorta with ultrasonography in upper gi bleeding
Muhammed Saltuk Deniz 1, Fatih Tanrıverdi 2, Çağdaş Yıldırım 2, Gül Pamukçu Günaydın 2, Mehmet Ergin 2, Alper Gök 1, Fatih Kıvrakoğlu 3, Osman Ersoy 4
1 Department of Emergency Medicine, Ankara Research and Training Hospital, Ankara, 2 Department of Emergency Medicine, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, 3 Department of Internal Medicine, Osmaniye State Hospital, Osmaniye, 4 Department of Internal Medicine, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
DOI: 10.4328/ACAM.21405 Received: 2022-09-23 Accepted: 2022-10-29 Published Online: 2022-11-11 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):35-39
Corresponding Author: Fatih Tanrıverdi, Üniversiteler Mahallesi, No: 1, 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: It was aimed to to investigate the use of USG imaging of the inferior vena cava (vci) and aortic diameter in predicting hospitalization in patients diagnosed with upper gi bleeding.
Material And Methods: Forty-five patients over the age of 18 with upper gi bleeding who applied to the emergency department between 01/02/2019 and 01/10/2019, and 45 volunteers without hypovolemia as the control group were included in the study. VCI and aortic diameters of the patients were recorded prospectively using USG.
Results: While the mean age in the patient group was 67±19 years, it was calculated as 74±9 years for the control group. The mean values of VCI expiratory, inspiratory diameters and VCI collapse index in the control group and patient group were respectively 18.47±2.5 mm, 15.2±2.4 mm and 0.18±0.06; 15.56±3.6 mm, 13.2±3 mm and 0.15-0.12. The mean values of aortic suprarenal and infrarenal diameters in the control group and patient group were respectively 24.3±2.2 mm and 21.7±2.3 mm; 19.0±3.6 mm, 17.0±3.4 mm. When all these parameters were compared with the control group, statistically significantly lower values were recorded in the patient group (p<0.001).
Discussion: In our study, vci diameter, aortic diameter, and vci collapsibility index values were lower in patients with upper gi bleeding, and although they can be used as an aid in the diagnosis of the disease in the emergency department, these low values were not found to be associated with the hospitalization or discharge decision of the patients.
Keywords: Gastrointestinal Bleeding, VCI Diameter, Aortic Diameter, USG
The relationship between second-trimester amniotic fluid CRP levels and pregnancy outcomes
Fedi Ercan 1, Nefise Nazli Yenigul 2, Elif Yuce Bilgin 2, Murat Ustunel 3
1 Department of Gynecology and Obstetrics, Faculty of Medicine, Aydın Menderes University, İzmir, 2 Department of Gynecology and Obstetrics, Faculty of Medicine, Health Sciences University, Bursa Yuksek Ihtisas Research and Training Hospital, Bursa, 3 Department of Gynecology and Obstetrics, Faculty of Medicine, Health Sciences University, Şanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
DOI: 10.4328/ACAM.21409 Received: 2022-09-26 Accepted: 2022-12-10 Published Online: 2022-12-26 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):40-44
Corresponding Author: Nefise Nazli Yenigul, Department of Gynecology and Obstetrics, Faculty of Medicine, Health Sciences University, Bursa Yuksek Ihtisas Research and Training Hospital, Bursa, Turkey. E-mail: firstname.lastname@example.org P: +90 505 825 46 18 Corresponding Author ORCID ID: https://orcid.org/0000-0003-3365-8899
Aim: The aim of this study is to investigate the relationship between CRP levels studied in second-trimester amniotic fluid and pregnancy outcomes.
Material and Methods: Seventy-three single pregnant women who underwent amniocentesis for genetic purposes in our perinatology clinic between 16-22 weeks of gestation and gave birth in our hospital were included in the study. Pregnancies resulting in preterm birth (PTB), preeclampsia, preterm premature rupture of membranes (PPROM), gestational diabetes mellitus (GDM) and postterm pregnancies were defined as “composite outcomes” and these patients were evaluated as Group 1. In addition, patients in Group 1 were divided into five subgroups: PTB, preeclampsia, GDM, PEMR, postterm pregnancies. On the other hand, pregnant women with normal pregnancy outcomes were included in Group 2. All recorded data of these groups were compared.
Results: Amniotic fluid CRP level was 0.10 ± 0.18 mg / L in Group 1 and 0.07 ± 0.08 mg / L in Group 2 (p: 0.94). In Group 2, gestational age and fetal birth weight were higher. However, this difference was not significant. When CRP values in individual subgroups were compared in terms of composite results (preeclampsia, PTB, GDM, PPROM and postterm pregnancy), amniotic fluid CRP levels were higher than in the general population.
Discussion: Our study presented evidence that second-trimester amniotic fluid CRP level is not associated with PD, PPROM, preeclampsia, postterm pregnancy and GDM, which we consider as composite obstetric outcomes.
Keywords: Amniotic Fluid, CRP, Pregnancy, Composite Outcomes, Second Trimester
Percentage of immature granulocytes in subacute thyroiditis follow-up and differential diagnosis with Graves’ disease
Sevde Nur Fırat, Tülay Omma, Püren Gökbulut, Şerife Mehlika Kuşkonmaz, Cavit Çulha
Department of Endocrinology and Metabolism, University of Health Science, Ankara Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21410 Received: 2022-09-25 Accepted: 2022-11-18 Published Online: 2022-11-26 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):45-48
Corresponding Author: Sevde Nur Fırat, Department of Endocrinology and Metabolism, University of Health Science, Ankara Training and Research Hospital, Hacettepe Mah, Ulucanlar Cad, 06230, Altindag, Ankara, Turkey. E-mail: email@example.com P: +90 312 595 33 30 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9386-5879
Aim: Graves’ disease (GD) and subacute thyroiditis (SAT) are common causes of thyrotoxicosis. Although the presence of neck pain is helpful in the differential diagnosis of these two entities some cases of SAT may have an atypical painless presentation. In recent years, the number of patients with painless SAT has been increasing in the literature and sometimes this may cause difficulties in differential diagnosis. Thus, auxiliary parameters other than clinical findings are needed for the correct diagnosis. In our study, we aimed to evaluate the immature granulocyte percentage (IG%), which is a new marker of acute inflammation, in the differential diagnosis of SAT, which is an inflammatory condition, and GD.
Material and Methods: In this study, data from 59 patients diagnosed with GD and 59 patients with SAT in the Endocrinology and Metabolic Diseases Outpatient Clinic of a tertiary medical care center, between January 2017 and October 2021 were retrospectively analyzed. Pre-treatment clinical and laboratory data obtained from patients who were diagnosed with SAT or GD were analyzed, IG% were recorded. The IG% were re-evaluated in patients after treatment.
Results: Pre-treatment IG% was found to be significantly higher in the SAT group when compared GD group. There was a significant decrease in IG% after treatment in SAT. In addition, steroid need was higher in patients with high IG% in the SAT group.
Discussion: Our study showed that IG% may be a helpful parameter in the differential diagnosis of GD and SAT and in predicting the need for steroids in SAT patients early.
Keywords: Immature Granulocyte Percentage, Subacute Thyroiditis, Graves’ Disease
Approaches of patients to health care before and during the COVID-19 pandemic
Tamer Sekmenli 1, Cansu Onur 2, Duygu Bağışladı 2, Zeynep Gülsüm Şeker 2, Osman Sarıteke 2, Selin Gül Etlik 2, Eminegül Karasu 2, Aslı Buse Sarıkaya 2 Mustafa Mert Kayim 2, Kevser Nur Aytekin 2, Fatma Kurt 2, Birsen Aksoy 2, Rahman Oktay 2
1 Department of Pediatric Surgery, 2 Student of Medical, Faculty of Medicine, Selcuk University, Konya, Turkey
DOI: 10.4328/ACAM.21411 Received: 2022-09-26 Accepted: 2022-11-18 Published Online: 2022-12-08 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):49-54
Corresponding Author: Tamer Sekmenli, Department of Pediatric Surgery, Faculty of Medicine, Selcuk University, Konya, Turkey. E-mail: firstname.lastname@example.org P: +90 332 241 21 81 F: +90 332 241 21 84 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8867-1383
Aim: In the present study, the aim is to determine the approaches of patients to healthcare services before and during the pandemic by comparing the rates of outpatient admissions and hospitalizations to Selçuk University Medical Faculty Hospital throughout the present study.
Material and Methods: The present study is a retrospective, descriptive study. Patients diagnosed with COVID were admitted to Selçuk University Medical Faculty Hospital on March 5, 2020. During the pandemic, no patients diagnosed with COVID were admitted to the adult cardiology, neurology, internal medicine, psychiatry, emergency, general surgery and pediatric emergency, pediatric psychiatry, pediatrics and pediatric surgery polyclinics and services. Hence, these clinics were included in the study. In the study, patients’ data who applied to the relevant clinics of Selçuk University Medical Faculty Hospital or were hospitalized in the relevant clinics, including the years 2019, 2020 and 2021, were examined as pre-pandemic (2019) and pandemic period (2020, 2021) quarterly. The parameters of the present study were the pre-pandemic and pandemic period. The data obtained in the study were evaluated with descriptive statistics (as frequency and percentage).
Results: In the first year of the pandemic, it was determined that both the number of outpatient clinic referrals and hospitalizations to the relevant clinics decreased significantly. Although the impact of epidemic diseases, emerging throughout human history has decreased, the risk they carry is systematically exaggerated, and the fears of the public fueled constantly by the media.
Discussion: Unfortunately, this fear in society was also reflected in hospital admissions. Therefore, to manage medical services correctly during pandemics, planned and organized psychosocial support services are needed to preserve the mental health of the community as well as to enable appropriate medical interventions.
Keywords: Covid-19, Hospitalization Procedures, Impact of patients, Hospital Management
Investigation of oxidative stress and Interleukin 33 (IL33) level in pericardial fluid of patients with coronary artery bypass surgery
Ömer Göç 1, Mustafa Göz 2, Reşat Dikme 1, Mahmut Padak 1
1 Department of Perfusion Techniques, Vocational School of Health Services, Harran University, Şanlıurfa, 2 Department of Cardiovascular Surgery, Private Anadolu Hospital, Bursa, Turkey
DOI: 10.4328/ACAM.21417 Received: 2022-09-28 Accepted: 2022-11-11 Published Online: 2022-11-15 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):55-59
Corresponding Author: Reşat Dikme, Department of Perfusion Techniques, Vocational School of Health Services, Harran University, Yenişehir Campus, Haliliye, 63300, Şanlıurfa, Turkey. E-mail: email@example.com P: +90 535 458 78 44 F: +90 414 318 32 09 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9157-7830
Aim: Pericardial fluid composition changes in coronary artery disease. This study aims to investigate interleukin 33 (IL 33), total antioxidant status (TAS), total oxidative stress (TOS), and oxidative stress index (OSI) levels in the pericardial fluid and blood plasma of patients who have undergone coronary artery bypass surgery and contribute to the understanding of the pathophysiology of the disease.
Material and Methods: In the study, IL 33, TAS, TOS, and OSI levels were determined in the pericardial fluid and blood plasma of 40 patients who had undergone coronary artery bypass surgery, and the relationship between these parameters was investigated.
Results: IL 33 level in pericardial fluid (51.44 pq/mL) was found to be higher than Plasma IL 33 level (32.31 pq/mL). A significant positive correlation was found between OSI and TOS in pericardial fluid and plasma (p<0.01). A significant negative correlation was found between OSI and TAS in pericardial fluid (p<0.01).
Discussion: IL 33 level was found to be low in patients with coronary artery disease. A higher IL 33 level in pericardial fluid indicates that IL 33 is specific to the heart tissue and passes from the heart tissue to the pericardial space. TOS caused by cellular stress during the inflammation of the coronary arteries directly triggered OSI. IL 33 level may be increased to prevent damage to cells due to TOS and OSI. This study shows us that pericardial fluid can reflect physiological and biochemical changes in the heart, and therefore pericardial fluid can be used for diagnostic and therapeutic purposes.
Keywords: Cardiopulmonary Bypass, Coronary Artery Disease, Interleukin 33, Oxidative Stress, Pericardial Fluid
Evaluation of the success of conservative treatment in spondylodiscitis patients with relevant laboratory findings
Mustafa Abdullah Özdemir 1, Serkan Bayram 2, Seniha Başaran 3, Şahin Karalar 2, Murat Korkmaz 2, Turgut Akgül 2, Ömer Haluk Eraksoy 3
1 Department of Orthopaedics and Traumatology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, 2 Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul University, Istanbul, 3 Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
DOI: 10.4328/ACAM.21433 Received: 2022-10-06 Accepted: 2022-12-02 Published Online: 2022-12-13 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):60-64
Corresponding Author: Serkan Bayram, Department of Orthopedics and Traumatology, Faculty of Medicine, Istanbul University, 34093, Fatih, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 212 414 20 00 F: +90 212 410 15 00 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7651-1200
Aim: In this study, we aimed to investigate the success of conservative treatment in patients with relevant laboratory findings and early-stage spondylodiscitis.
Material and Methods: A total of 79 patients (conservative group 38 patients and 41 patients in the surgery group) with early stage spondylodiscitis were included in this study. These patients were divided into two groups as follows: the conservative treatment group included patients in whom conservative treatment was successful, and the surgical treatment group, consisting of patients who underwent surgery due to refractory pain and poor laboratory findings that did not improve despite conservative treatment. Patients underwent laboratory tests twice: first at their initial presentation (initial); then, after antibiotic treatment (end-of-treatment). Laboratory parameters used were C-reactive protein (CRP), white blood count (WBC), platelet count (PLT), erythrocyte sedimentation rate (ESR), neutrophil count, lymphocyte count, monocyte count, NLR, PLR, and MLR ratios.
Results: No significant differences were noted between groups in terms of gender, age, and stage. The initial CRP, WBC, neutrophil count, monocyte and platelet were significantly higher in conservative group than in the surgical group. However, there were no significant differences between the groups in the initial ESR, lymphocyte count, NLR, PLR and MLR. The end-of -treatment ESR, WBC, platelet, monocyte, PLR and MLR were significantly higher in the surgical group than in the conservative group. However, there was no significant difference between the groups in the end-of-treatment CRP, neutrophil count, lymphocyte count, NLR.
Discussion: Surgery may be considered in patients with spondylodiscitis, when ESR, WBC, platelet, monocyte, PLR, and MLR do not improve with conservative treatment.
Keywords: Inflammatory Parameters, Spondylodiscitis, Conservative Method, Debridement
Effects of basic body awareness therapy on pain, sleep, quality of life during COVID-19 pandemic –a randomized controlled study
Seval Kutlutürk Yıkılmaz, Selen Güloglu, Öznur Özek, Melisa Demirtaş, Gizem Nur Aras
Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
DOI: 10.4328/ACAM.21435 Received: 2022-10-08 Accepted: 2022-11-09 Published Online: 2022-11-15 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):65-69
Corresponding Author: Seval Kutlutürk Yıkılmaz, Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey. E-mail: email@example.com P: +90 505 935 84 38 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9120-7071
Aim: In this study, we aimed to investigate the effects of the telerehabilitation-based BBAT (Basic Body Awareness Therapy) approach on body awareness, musculoskeletal pain, sleep, and quality of life (QoL) in university students during the COVID-19 social isolation and home quarantine period.
Material and Methods: The study was designed as a randomized controlled trial. A total of 40 university students participated in the study. Patients were divided into two groups: the treatment group who received the BBAT (n=20) and the control group who refused to receive treatment (n=20). BBAT was applied to the treatment group on an online platform for three days a week (60 minutes per session) for six weeks. Pre- and post-treatment self-reported questionnaire data were used. Pain severity was assessed using the McGill Pain Questionnaire (MPQ), sleep quality using the Pittsburg Sleep Quality Index (PSQI), body awareness using the Body Awareness Questionnaire (BAQ), and QoL using the World Health Organization Quality of Life (WHOQoL) questionnaire.
Results: In the treatment group, there was a statistically significant difference between the participants’ pre-treatment and post-treatment scores in MPQ, PSQI and BAQ, as well as in the psychological health, social relationships and environment domains and general health facet of the WHOQoL questionnaire (p<0.05). In the control group, no statistically significant difference was observed between the participants’ pre-treatment and post-treatment scores in MPQ, PSQI, BAQ and the psychological health, social relationships and environment domains of the WHOQoL questionnaire (p>0.05).
Discussion: The telerehabilitation-based BBAT approach is effective for university students’ body awareness, musculoskeletal pain, sleep, and quality of life during the ongoing COVID-19 pandemic period.
Keywords: Body Awareness, COVID-19, Pain, Pandemic, Sleep Quality
Effects of atropine on blood gas parameters and pulmonary shunt fraction
Erkan Bayram 1, Ecder Ozenc 2
1 Department of Anesthesia and Reanimation, Faculty of Medicine, Istinye University, Medical Park Gaziosmanpasa Hospital, 2 Department of Anesthesia and Reanimation, Haseki Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21445 Received: 2022-10-13 Accepted: 2022-11-14 Published Online: 2022-11-17 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):70-74
Corresponding Author: Erkan Bayram, Çukurçeşme Street, No:57, Gaziosmanpaşa, 34250, İstanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 533 658 76 86 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8527-8321
Aim: Atropine has been used for a long time in anesthesia management to inhibit salivary and bronchial secretions and laryngospasm before administration of an anesthetic agent. The objective of this study was to investigate the effects of atropine blood gas parameters and pulmonary shunt fraction for the first time in the literature.
Material and Methods: A total of 24 patients aged 20-75 years, hospitalized in the intensive care unit under mechanical ventilation were included in the study. 0.01 mg/kg atropine was administered intravenously and arterial and venous blood gas samples were taken at 15, 45 and 90 minutes, and the shunts were calculated. pH, PO2, PCO2, H+, HCO3 and SO2 values were measured and recorded. In addition, pulmonary shunt (QS/QT) fraction was calculated at 0, 15, 45 and 90 minutes.
Results: pAO2 values were statistically significantly higher at the 15th minute (109.63±7.95) compared to the 0th minute (107.00±5.99) (p=0.006) and 90th minutes (107.55±8.28) (p=0.022). CaO2 values were statistically significantly lower at the 45th minute (13.70±1.43) compared to the 0th minute (14.70±1.66) (p=0.013) and 90th minute (14.40±1.59) (p=0.008). Shunt (Qs/Qt) values were statistically significantly lower at the 45th minute (0.12±0.17) compared to the 0th minute (0.04±0.04) (p=0.040) and 90th minutes (0.07±0.10) (p=0.007).
Discussion: Administration of atropine significantly increased the pulmonary shunt, regardless of the current pathology, mechanical ventilation and treatment applied. Atropine increased the shunt at the maximum level, especially at the 45th minute. In this study, the shunt emerged as the gold standard in determining the treatment modality.
Keywords: Anesthesia, Atropine, Blood Gas, Pulmonary Shunt, QS/QT Fraction
Comparison of clinical categories, blood biomarkers and cycle threshold value in COVID-19
Oktay Yapıcı 1, Muhhamet Öksüzoğlu 1, Ayşe Yılmaz 1, Ezgi Çamlık 2, Mehmet Ünlü 3
1 Department of Infectious Diseases and Clinical Microbiology, 2 Department of Public Health, 3 Department of Microbyology, Faculty of Medicine, Balıkesır University, Balıkesir, Turkey
DOI: 10.4328/ACAM.21450 Received: 2022-10-17 Accepted: 2022-11-18 Published Online: 2022-11-26 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):75-77
Corresponding Author: Oktay Yapıcı, Department of Infectious Diseases and Clinical Microbiology, Balikesir University Hospital, Çağış Campus, 10145, Bigadiç, Balikesir, Turkey. E-mail: email@example.com P: +90 546 542 07 21 / +90 266 612 10 10 F: +90 266 612 10 10 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5472-9919
Aim: The aim of this study is to investigate whether the viral load of SARS-CoV-2 is an important factor in predicting disease severity and its relationship with clinical and biochemical parameters.
Material and Methods: In this cross-sectional retrospective study, 85 patients who were found to be positive for SARS-CoV-2 PCR at Balıkesir University Health Practice and Research Hospital were evaluated. RT-PCR (CT) values, laboratory values and demographic and clinical data of the patients at the first admission to the hospital were obtained from the electronic environment and compared.
Results: In our study, no significant relationship was found between baseline values and severity of clinical stages in adults with COVID-19. No correlation was found between the gender, vital status, hospitalization or admission to the intensive care unit, presence of comorbidity, degree of disease according to the thorax CT image and mean CT values of the participants included in the study (p>0.05).
Discussion: More prospective studies and additional data are needed to determine whether CT values can benefit clinicians in clinical and patient management decisions.
Keywords: Cycle Threshold, COVID-19
Tumor localization and other factors affecting prognosis in elderly patients with colon cancer
Elif Tugba Tuncel 1, Serkan Menekse 2
1 Department of Gastroenterology, 2 Department of Medical Oncology, Manisa State Hospital, Manisa, Turkey
DOI: 10.4328/ACAM.21471 Received: 2022-10-31 Accepted: 2022-12-10 Published Online: 2022-12-19 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):78-82
Corresponding Author: Elif Tugba Tuncel, Department of Gastroenterology, Manisa State Hospital, Manisa, Turkey. E-mail: firstname.lastname@example.org P: +90 506 743 43 37 Corresponding Author ORCID ID: https://orcid.org/0000 0002 0908 1949
Aim: In this study, we aimed to evaluate tumor localization, clinicopathological features, and response to treatment in elderly patients with colon cancer and determine their prognostic significance and effect on overall survival (OS).
Material and Methods: Data were retrospectively collected by screening the files of 84 elderly (>75 years old) patients with colon cancer followed up in our hospital between 2010 and 2022. According to tumor localization, the cases were divided into the right colon and left colon cancer groups. The patients’ demographic data (age, gender), clinicopathological features, tumor type, grade, size, and localization, and the presence of metastases were evaluated. The presence of K-RAS and BRAF, tumor stage, histology, tumor localization, and whether chemotherapy was applied were evaluated using multivariate and univariate analyses to determine their relationship with OS and prognosis.
Results: The study included a total of 84 patients, of whom 42 (50%) were male and 42 (50%) were female. The tumor was located in the right colon in 28 (33.3%) patients and in the left colon in 56 (66.7%) patients. The median mean age was 81 (77-91) years. Thirty-two (38.1%) patients were found to have the K-RAS mutant type, and 52 (61.9%) patients had the K-RAS wild-type. Five (6%) patients had the BRAF mutant type. OS and prognosis were worse in right colon tumors, in patients with RAS mutants, in those not receiving chemotherapy, and in those with advanced-stage tumors.
Discussion: Among the elderly patients with colon cancer, tumor localization in the right colon, the presence of RAS mutants, not having received chemotherapy, and the presence of advanced tumors were evaluated as poor prognostic factors. In the geriatric population, patient-tailored treatment should be planned with a multidisciplinary approach by considering the individual requirement of each patient.
Keywords: Elderly Patient, Colon Cancer, Tumor Localization, Prognosis
Serum zinc levels in patients with hirsutism
Fehmi Unal, Berna Sermin Kılıc
Department of Obstetrics and Gynaecology, Istanbul Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21491 Received: 2022-11-12 Accepted: 2022-12-10 Published Online: 2022-12-30 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):83-86
Corresponding Author: Fehmi Unal, Department of Obstetrics and Gynaecology, Istanbul Teaching and Research Hospital, 34098, Istanbul, Turkey. E-mail: email@example.com P: +90 212 459 60 00 F: +90 212 459 62 30 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8182-2051
Aim : Hirsutism is the overgrowth of male-pattern terminal hair in women. Polycystic ovarian syndrome is the most detected endocrinopathy among women, and there are many reports of its association with metabolic syndrome. Zinc is the second most abundant trace element in the human body and integral part of many enzymes. There are several studies about serum zinc levels in polycystic ovarian syndrome, but zinc has not been adequately studied in idiopathic causes of hirsutism. Our study aims to investigate Zinc levels in hirsutism patients.
Material and Methods: This prospective case-control study involved 48 women with hirsutism. The hirsutism group consisted of 26 PCOS and 22 idiopathic hirsutism patients. Forty healthy, BMI and age-matched non-hirsute women were included as the control group.
Results: Statistically significant differences were found in Zn levels between non-hirsute and hirsute women (112.1 µg/dL versus 98.2 µg/dL, respectively), (p < 0.001). Total Cholesterol, LDL and AMH levels were also statistically significantly higher in hirsute patients.
Discussion: Our findings conclude that both idiopathic hirsutism and PCOS hirsutism patients have an increased metabolic syndrome risk. Both dyslipidemia and hyperandrogenemia contribute to the development of future metabolic syndrome. Low zinc levels in hirsute patients may provide insight into the pathogenesis of the disease, thus helping to reduce the risk of associated complications.
Keywords: Polycystic Ovary Syndrome, Zinc, Idiopathic Hirsutism
Is Upper Extremity Pain An Important Cause Of Sleep Problems In Patients With Multiple Sclerosis?
Ayla Fil Balkan 1, Yeliz Salcı 1, Aslı Tuncer 2
1 Department of Neurological Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, 2 Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
DOI: 10.4328/ACAM.21494 Received: 2022-11-06 Accepted: 2022-12-11 Published Online: 2022-12-11 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):87-91
Corresponding Author: Ayla Fil Balkan, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Adnan Saygun Street, 06100, Samanpazari, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 312 305 15 72 / +90 535 454 90 27 Corresponding Author ORCID ID: https://orcid.org/0000-0002-2721-0222
Aim: In this study, we aimed to examine the localization of pain in multiple sclerosis (MS) patients and to determine the relationship of pain localization with quality of life, sleep and depression level.
Material and Methods: Eighty-six MS patients (19 males, 67 females, age: 18-65 years, Expanded Disability Status Scale (EDSS) Level 1-8) were included in the study. The pain was evaluated with the Short Form Mc-Gill Pain Questionnaire (SF-MPQ), quality of life (QoL) with the Nottingham Health Profile (NHP), sleep quality with the Pittsburg Sleep Quality Index (PSQI) and mood of depression with the Beck Depression Inventory (BDI).
Results: The percentage of patients with pain was 55.8. Patients complained of the neck (4.2%), upper extremity (25%), headache (14.5%), low back pain (47.9%), upper back pain (5%) and lower extremity pain (58.3%). NHP scores (total: p=0.033, pain: p=0.001, sleep: p=0.0033) and sleep quality (p=0.014) were better in patients without pain. In addition, there was a weak to moderate correlation between several PSQI scores (sleep quality: rho=0.498, p=0.001, sleep latency: rho=0.440, p=0.002, sleep efficiency: rho=0.343, p=0.017 and total: rho=0.379, p=0.008) and upper extremity pain.
Discussion: Upper extremity pain affects sleep quality and therefore QoL in patients with MS. For this reason, when examining the pain of MS patients with sleep problems, especially questioning this region and adding modalities to the program to relieve upper extremity pain may contribute to the sleep quality that it affects. Thus, the quality of life can be positively affected in many ways. Further studies are required to obtain exact conclusions.
Keywords: Multiple Sclerosis, Pain, Localization Sleep.
Reasons for prolonged hospital stay and clinical management in our surgical oncology clinic
Salim İlksen Başçeken, Ferit Aydın, Salim Demirci
Department of Surgical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
DOI: 10.4328/ACAM.21523 Received: 2022-11-28 Accepted: 2022-12-30 Published Online: 2022-12-30 Printed: 2023-01-01 Ann Clin Anal Med 2023;14(1):92-95
Corresponding Author: Salim İlksen Başçeken, Department of Surgical Oncology, Faculty of Medicine, Ankara University, Tıp fakültesi Cd., No:1-4, 06620, Mamak, Ankara, Turkey. E-mail: email@example.com P: +90 0506 277 68 21 Corresponding Author ORCID ID: https://orcid.org/ https://orcid.org/0000-0002-0918-3208
Aim: From a healthcare provider’s perspective, the optimal hospital stay is the minimum length of time required to safely discharge the patient home. Length of stay (LOS) is a surrogate indicator of a patient’s recovery. In this study, in light of the current literature, the causes of postoperative LOS in patients operated on for gastrointestinal malignancy in a surgical oncology clinic were discussed.
Material and Methods: This retrospective study includes data on baseline demographic characteristics, surgical characteristics, inflammatory markers, and perioperative characteristics of 383 consecutive patients hospitalized for more than 7 days at our surgical oncology clinic between January 2018 and May 2021. Categorical variables were analyzed with the Pearson chi-square test or Fisher’s exact test, and continuous variables were analyzed with the Mann-Whitney U test and Kruskal-Wallis test. Results were considered statistically significant at P<0.05.
Results: The patients consisted of 136 (35.5%) females and 247 (65.5%) males. The mean age was 60.9 ± 12.9 years. Complications were observed in approximately half of the patients (48.5%). Complications (p=0.00), re-intervention (p=0.008), diagnosis (p=0.00), and ICU admission (p=0.018) were significantly different from prolonged postoperative LOS in statistical analysis. We found that prolonged postoperative LOS was associated with a high CRP/ALB ratio (p=0.01) and procalcitonin levels (p=0.001). Readmitted patients mostly had increased ICU admission (p=0.018) and prolonged LOS (p=0.000).
Discussion: We believe that strict follow-up of patients with inflammatory markers to minimize postoperative complications will reduce prolonged postoperative LOS and result in reproducible improvement.
Keywords: Complication, Length of stay, Patient Readmission, Surgical Oncology