Can malignant lymphadenopathies be predicted? Analysis of clinical, ultrasonographic and laboratory data
Anar Aslanov, Burak Uçaner, Mehmet Sabri Çiftçi, Mehmet Zeki Buldanlı
Department of General Surgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21513 Received: 2022-11-22 Accepted: 2022-12-24 Published Online: 2022-12-30 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):768-771
Corresponding Author: Mehmet Zeki Buldanlı, Department of General Surgery, Gülhane Training and Research Hospital, General Dr. Tevfik Sağlam Street, No:1, 06010, Etlik, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 312 304 51 50 F: +90 312 304 27 00 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6491-7630
This study was approved by the Ethics Committee of Gulhane Training and Research Hospital (Date: 2022-07-01, No: 2022/103)
Aim: Lymphadenopathy may be result from an infectious disease or manifest an underlying hematologic disease, a metastasis of an as-yet undiagnosed malignancy, or a primary malignancy. This study aimed to investigate whether there is predictive value in malignancy by examining data from patients who underwent excisional biopsy for lymphadenopathy.
Material and Methods: Clinical data from patients who had undergone excisional lymph node biopsy at a single-center approximately six years were retrospectively reviewed. Based on the results of the histopathology report, patients were divided into two separate groups that are malignant and benign histopathology groups. Then, the malignant histopathological group was further divided into two subgroups: primary lymph node malignancy and lymph node metastatic malignancy.
Results: The mean age of patients included in the study was 47.5±17.0 years (19-87 years). It was observed that the CRP levels were higher in primary lymph node malignancies than in metastatic malignancies in lymph nodes (p=0.027). When histopathology results were accepted as a reference, the sensitivity of ultrasonography in detecting malignant lymph nodes was 77.2%, specificity was 48.1%. For malignant lymph nodes, only lymph node diameter proved to be a determinant (p=0.026). Lymph node diameter >25 mm was predictive of malignant histopathology with a sensitivity of 54.5% and a specificity of 66.7%.
Discussion: While ultrasonography is a significant predictor of lymphadenopathy, CRP levels may be important in differential diagnosis of primary lymph node malignancies from metastatic malignancies in the lymph nodes.
Keywords: Lymphadenopathy, Lymphoma, Malignant Lymph Node, Metastatic Lymph Node, Benign Lymph Node
The role of platelet distribution width in the diagnosis of ischemic and hemorrhagic stroke
Mustafa Enes Demirel, Sinan Özel
Department of Emergency, Faculty of Medicine, Bolu Abant İzzet Baysal University, Bolu, Turkiye
DOI: 10.4328/ACAM.21573 Received: 2023-01-03 Accepted: 2023-03-02 Published Online: 2023-08-30 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):772-776
Corresponding Author: Mustafa Enes Demirel, Department of Emergency, Faculty of Medicine, Bolu Abant İzzet Baysal University, 14030, Bolu, Turkiye. E-mail: email@example.com P: +90 505 391 09 03 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5187-5737
This study was approved by the Clinical Researches Ethics Committee of Bolu Abant İzzet Baysal University (Date: 2022-02-22, No: 2022/29)
Aim: Current efforts to find diagnoses using simple and widely used indices of platelet activation have focused on the platelet activation caused by morphological changes, including both pseudopodia formation and spherical shape. The aim of this study was to evaluate the effect of PDW in differentiating ischemic and hemorrhagic stroke.
Material and Methods: The study included a total of 333 patients, of which 269 had ischemic stroke and 64 had hemorrhagic stroke. Demographic data of the patients such as gender and age, National Institutes of Health Stroke Scale (NIHSS), Glasgow Coma Scale (GCS) and the modified Rankin score (mRs) were recorded. Complete blood count parameters were also recorded and compared between the patients with ischemic and hemorrhagic stroke.
Results: The mean age of the patients was found to be 72.3±12.71 years in the ischemic stroke group and 69.27±14.39 years in the hemorrhagic group. The median neutrophil count was statistically significantly higher in the hemorrhagic stroke group (p=0.041). The median level of albumin was statistically significantly higher in the patients with hemorrhagic stroke (p=0.010). The median PDW value was determined to be statistically significantly higher at 14.9 (11.9-17.8) in the ischemic stroke group compared to 12.85 (11.33-17.03) in the hemorrhagic stroke group (p=0.009).
Discussion: As the PDW level was statistically significantly lower in patients with hemorrhagic stroke than in patients with ischemic stroke, it may be of value in distinguishing these two forms of stroke. However, further comprehensive, multi-center studies are needed to better understand the role of PDW in ischemic and hemorrhagic stroke.
Keywords: Cerebral Hemorrhage, Cerebrovascular Disorders, Platelet, Stroke
Evaluation of attitudes and knowledge of anesthesiologists about regional anesthesia methods in ophthalmic surgery: A national survey study
Birzat Emre Gölboyu 1, Bahadir Ciftci 2
1 Department of Anesthesiology and Reanimation, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, 2 Department of Anesthesiology and Reanimation, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
DOI: 10.4328/ACAM.21647 Received: 2023-05-13 Accepted: 2023-07-03 Published Online: 2023-07-15 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):777-781
Corresponding Author: Birzat Emre Gölboyu, Department of Anesthesiology and Reanimation, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey. E-mail: firstname.lastname@example.org P: +90 506 734 50 82 Corresponding Author ORCID ID: https://orcid.org/0000-0002-2011-2574
This study was approved by the Ethics Committee of Istanbul Medipol University (Date: 2020-12-10, No: 886)
Aim: The use of regional techniques in ophthalmic surgery is becoming increasingly important. Worldwide, these techniques are usually performed by ophthalmologists, while the perioperative care of patients is provided by anesthesiologists. Therefore, good communication between the surgeon and the anesthesiologist is necessary for the careful management of all techniques used in ophthalmic surgery. In this study, the willingness of anesthesiologists to assume responsibility in the use of regional techniques and their knowledge of ophthalmic nerve blocks were assessed in a national survey.
Material and Methods: A total of 23 questions were asked to assess attitudes and knowledge about regional anesthesia procedures in ophthalmic surgery, and participants had three weeks to complete the Web-based questionnaire. Complete responses from 126 physicians were analyzed.
Results: 60% of participants work in university hospitals as faculty members. Although 54.8% of participants had worked in ophthalmic surgery for 3 months or more, and 76% reported that they had not attended any lectures or seminars on regional block use in ophthalmic surgery. When asked who applied blocks in ophthalmic surgery, 95% of the participants answered the surgical team.
Discussion: The lack of theoretical and practical knowledge about ophthalmic nerve blocks is striking even among the group of physicians who practice regional anesthesia. Even if regional techniques are performed by the surgeon himself, the anesthesiologist’s responsibility in perioperative patient care cannot be ignored. For this reason, the level of knowledge of anesthesiologists on this topic should be increased through various continuing education courses.
Keywords: Multimodal Pain Management, Ophthalmic Surgery, Regional Anesthesia, Retrobulbar Block, Ophthalmic Block
Relationship of chronotype and sleep quality with crime in schizophrenia patients in the high-security forensic psychiatry clinic
Burcu Sırlıer Emir 1, Aslı Kazgan Kılıçaslan 2, Sevler Yıldız 3, Osman Kurt 4
1 Department of Psychiatry, Elazığ Fethi Sekin City Hospital, Elazığ, 2 Department of Psychiatry, Bozok University, Yozgat, 3 Department of Psychiatry, Binali Yıldırım University, Erzincan, 4 Department of Public Health, Adıyaman Provincial Health Directorate, Adıyaman, Turkey
DOI: 10.4328/ACAM.21729 Received: 2023-04-15 Accepted: 2023-05-30 Published Online: 2023-06-09 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):782-787
Corresponding Author: Burcu Sırlıer Emir, Department of Psychiatry, Elazığ Fethi Sekin City Hospital, 23100, Elazığ, Turkey. E-mail: email@example.com P: +90 424 606 60 00 F: +90 424 238 76 58 Corresponding Author ORCID ID: https://orcid.org/0000-0002-3389-5790
This study was approved by the Clinical Research Ethics Committee of Firat University (Date: 2021-12-16, No: 2021/13-20)
Aim: It has been reported that schizophrenia (SZ) patients had poor sleep quality and displayed evening chronotype, and certain behavioral differences had been observed between chronotypes. In this study, we aimed to compare chronotype and sleep quality in criminal SZ patients and to examine the correlation of chronotype with crime types.
Material and Methods: Ninety-one criminal SZ patients and 91 healthy controls were included. Participants were administered the Positive and Negative Syndrome Scale (PANSS), Pittsburgh Sleep Quality Index (PSQI), and the Morningness – Eveningness Questionnaire (MEQ).
Results: While 28.6 % of the patient group were evening-, 36.3 % were intermediate- and 35.2% waere morning-type, it was seen that 8.8% of the control group were evening-, 31.9% were intermediate- and 59.3% were morning-type, and a significant difference was observed between them (p<0.001). The sleep quality in the patient group was significantly lower than in the control group (p<0.001). In the patient group, the crime rate between 24:00 and 06:00 was found to be significantly higher among evening types compared to other types (p<0.001).
Discussion: Criminal schizophrenia patients are of the evening type compared to the control group and have poor sleep quality. Corrective interventions for sleep and chronotype in SZ patients may change the rates and nature of crimes.
Keywords: Sleep, Schizophrenia, Chronotype, Circadian Rhythms, Crime
Electrophysiological severity of carpal tunnel syndrome and body composition measurement
Nuray Can Usta 1, Gökhan Peker 2
1 Department of Neurology, 2 Department of Orthopedia, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
DOI: 10.4328/ACAM.21748 Received: 2023-05-07 Accepted: 2023-06-12 Published Online: 2023-07-08 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):788-792
Corresponding Author: Nuray Can Usta, Department of Neurology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, 61040, Trabzon, Turkey. E-mail: firstname.lastname@example.org P: +90 505 886 06 08 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9238-1194
This study was approved by the Clinical Research Ethics Committee of Health Sciences University Kanuni Training and Research Hospital (Date: 2022-01-31, No: 2022/16)
Aim: In this study, it was aimed to determine the relationship between electrophysiological severity findings and body composition measurement (BCM) in patients with carpal tunnel syndrome (CTS).
Material and Methods: In this retrospective study, electromyography (EMG)-diagnosed CTS patients who had BCM were evaluated. In addition to general demographic data, total fat mass (TFM), total lean mass (TLM), total muscle mass (TMM), arm fat mass (AFM), arm lean mass (ALM) and arm muscle mass (AMM) data were recorded. According to their electrophysiological results, CTS patients were divided into three groups: mild, moderate, and severe.
Results: The study group consisted of 186 hands of 100 CTS patients. A significant association was detected between the increase in TFM (p<0.01), AFM (p<0.01), ALM (p=0.041), and AMM (p=0.029) among the BCM data and disease severity. There was a difference between CTS patient groups in terms of TFM, AFM, ALM and AMM values (p<0.001). A significant but weak negative correlation was found between TFM and AFM and the median nerve EMG study (p<0.05).
Discussion: Our results revealed that the relationship between CTS disease severity and BMI increased not only with total adiposity in the body, but also with lean and muscle mass in the arm, especially in the arm fat mass. An increase in AFM value may help as a follow-up or predictive metric for the CTS.
Keywords: Carpal Tunnel Syndrome, Body Composition Measurements, Electromyography, Obesity
Toilet mastectomy: 12 year-experience of a high-volume breast surgery center
Murat Kartal 1, Tolga Kalaycı 2, Vefa Atış 1, Fuat Şentürk 3, Erdem Karadeniz 1, Müfide Nuran Akçay 1
1 Department of General Surgery, Faculty of Medicine, Atatürk University, Erzurum, 2 Department of General Surgery, Faculty of Medicine, Ağrı İbrahim Çeçen University, Ağrı, 3 Department of Surgical Oncology, Faculty of Medicine, Atatürk University Erzurum, Turkey
DOI: 10.4328/ACAM.21777 Received: 2023-06-04 Accepted: 2023-07-10 Published Online: 2023-08-30 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):793-796
Corresponding Author: Murat Kartal, Department of General Surgery, Faculty of Medicine, Atatürk University, Erzurum, Turkey. E-mail: email@example.com P: +90 507 191 96 09 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1396-5365
This study was approved by the Clinical Research Ethics Committee of Atatürk University Faculty of Medicine (Date: 2023-05-02, No: B.30.2.ATA.0.01.00/356)
Aim: Breast cancer is a global public health problem, and the life-saving effect of early diagnosis and treatment is evident. This study aimed to present the clinicopathological features of patients who underwent toilet mastectomy for metastatic breast cancer.
Material and Methods: Files of patients who underwent toilet mastectomy for metastatic breast cancer in a high-volume breast surgery center between January 2011 and January 2023 were retrospectively reviewed. Clinicopathological data of the patients were gathered and presented.
Results: Of the 32 patients who met the study criteria, 31 (96.9%) were female, and the mean age was 60 (33-85) years. There was involvement in the left breast in 19 (59.3%) patients and in the right breast in 13 (40.7%). Indications for surgery were ulceration in 13 (40.6%) patients, infection in 11 (34.4%) patients, and bleeding in 8 (25%) patients. Twenty-four (75%) of the defects were closed primarily, 6 (18.8%) with a skin graft and 2 (6.2%) with an advancement flap. Morbidity and mortality rates of the study were 37.5% (n=12) and 3.2% (n=1), respectively, and the most common postoperative complication was bleeding at the surgical site (n=5; 15.6%).
Discussion: In the presence of an overgrowth of tumor tissue, chest wall invasion, ulceration of the breast skin, discharge or bleeding, toilet mastectomy performed without adhering to oncological principles is aimed at reducing the tumor burden and increasing the quality of breast cancer.
Keywords: Bleeding, Mastectomies, Morbidities
Comparison of the effectiveness of transverse friction massage and thiele massage in female patients with chronic pelvic pain
Sena Öndeş, Aybüke Ersin
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Atlas University, Istanbul, Turkey
DOI: 10.4328/ACAM.21780 Received: 2023-06-06 Accepted: 2023-07-31 Published Online: 2023-08-10 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):797-802
Corresponding Author: Sena Öndeş, Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Atlas University, 34408, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 538 709 45 35 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9715-3083
This study was approved by the Non-Interventional Scientific Research Ethics Committee of Istanbul Atlas University (Date: 2022-06-21, No: E-22686390-050.01.04-17613)
Aim: This study aimed to investigate and compare the effectiveness of transverse friction massage and Thiele massage applied to the pelvic floor muscles in female patients with chronic pelvic pain.
Material and Methods: Twenty patients were divided into two groups of 10 people each: the transverse friction group and the Thiele massage group. Patients received transverse friction massage or Thiele Massage 2 days a week for 4 weeks. Measured parameters were pain, quality of life, sexual functions, and lower urinary tract symptoms. Visual Analog Scale and Mcgill Melzack Pain Questionnaire, Nottingham Health Profile, Female Sexual Function Index, and Bristol Female Lower Urinary Tract Symptoms Questionnaire were used to evaluate parameters, respectively.
Results: Statistically significant improvements were observed in all parameters in the transverse friction massage group (p<0.05) and all parameters except sexual functions improved significantly in the Thiele group compared to pre-treatment (p<0.05). When the two groups were compared with each other, no statistically significant difference was found in any of the parameters between the groups (p>0.05).
Discussion: Transverse friction massage and Thiele massage applied to the pelvic floor muscles in patients with chronic pelvic pain are easily applicable noninvasive treatment methods that can reduce the symptoms of the disease and increase the quality of life.
Keywords: Chronic Pelvic Pain, Pelvic Floor Muscles, Transverse Friction Massage, Thiele Massage
Do preoperative hemoglobin and hematocrit levels predict postoperative nausea and vomiting in orthognathic surgery patients? A retrospective case-control study
Seher Orbay Yasli, Dilek Gunay Canpolat, Fatma Dogruel, Canay Yılmaz Asan, Emrah Soylu, Ahmet Emin Demirbas
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
DOI: 10.4328/ACAM.21786 Received: 2023-06-09 Accepted: 2023-07-10 Published Online: 2023-07-22 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):803-807
Corresponding Author: Seher Orbay Yaşli, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Melikgazi, Kayseri, Turkey. E-mail: email@example.com P: +90 352 207 66 66 F: +90 352 438 06 57 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5163-3893
This study was approved by the Ethics Committee of Erciyes University Faculty of Medicine (Date: 2023-05-31, No: 2023/366)
Aim: Postoperative nausea and vomiting (PONV) is a common and distressing complication following orthognathic surgery. This retrospective study aimed to investigate the relationship between hemoglobin (Hgb) and hematocrit (HCT) levels and PONV occurrence in orthognathic surgery patients.
Material and Methods: A total of 52 patients who underwent orthognathic surgery were included in this retrospective analysis. Patients were divided into two groups: 26 patients who experienced PONV and 26 patients who did not. Demographic and clinical characteristics, including age, sex, American Society of Anesthesiologists (ASA) class, body mass index (BMI), operation time, and visual analog scale (VAS) scores for pain were compared between the groups. Hemoglobin and hematocrit levels were also compared, and receiver operating characteristic (ROC) analysis was performed to identify the optimal cut-off values for PONV prediction.
Results: No significant differences in age, sex, ASA class, or operation time were observed between the two groups. However, patients in the PONV group had significantly lower Hgb (12.9 ± 1.0 g/dL) and HCT (39.1 ± 3.0%) levels compared to those in the non-PONV group (14.2 ± 1.5 g/dL and 43.05 ± 3.5%, respectively; p < 0.001). The ROC analysis revealed that the optimal cut-off values for PONV prediction were Hgb ≤ 13.3 g/dL (AUC = 0.778, sensitivity = 73.08%, specificity = 69.23%, p < 0.001) and HCT ≤ 39.3% (AUC = 0.808, sensitivity = 65.38%, specificity = 88.46%, p < 0.001).
Discussion: Lower preoperative Hgb and HCT levels were significantly associated with the occurrence of PONV in orthognathic surgery patients. These findings suggest that Hgb and HCT levels may be useful predictive factors for PONV and can potentially assist in developing targeted preventive strategies to improve patient outcomes.
Keywords: Hematocrit, Hemoglobin, Orthognathic Surgery, Postoperative Nausea And Vomiting
Etiologic and demographic characteristics of patients with anisocoria
Gamze Yıldırım Biçer 1, Dilek İşcan 2
1 Department of Ophthalmology, 2 Department of Neurology, Faculty of Medicine, Niğde Ömer Halisdemir University, Nigde, Turkey
DOI: 10.4328/ACAM.21792 Received: 2023-06-13 Accepted: 2023-07-17 Published Online: 2023-08-08 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):808-811
Corresponding Author: Gamze Yıldırım Biçer, Department of Ophthalmology, Faculty of Medicine, Niğde Ömer Halisdemir University, Bor Yolu, Nigde, Turkey. E-mail: firstname.lastname@example.org P: +90 505 353 28 32 F: +90 388 212 14 11 Corresponding Author ORCID ID: https://orcid.org/0000-0003-3058-6308
This study was approved by the Non-Invasive Clinical Research Ethics Committee of Niğde Ömer Halisdemir University Faculty of Medicine (Date: 2023-01-26, No: 7/2023)
Aim: In this study, we aimed to present the etiological causes and clinical features of the patients followed for anisocoria and to determine the most common causes according to age groups.
Material and Methods: The medical records of the patients aged 18 years and over who were followed up for anisocoria between June 2017 and December 2022 were retrospectively reviewed. Two groups were formed including patients aged 18-45 as Group 1 and patients over 45 years old as Group 2. The etiological causes were divided into 4 groups as physiological anisocoria, pharmacological anisocoria, ocular pathologies and nervous system pathologies. It was examined whether there was a difference between the two groups in terms of four main etiological reasons.
Results: A total of 99 patients followed for anisocoria between January 2017 and December 2022 were included in the study analysis. The most common cause of anisocoria was found to be due to ocular pathologies (64 eyes, 64.6%). The second most common etiologic cause was found to be physiological anisocoria (20 eyes, 20.2%). Anisocoria was observed in 12 (12.1%) patients due to neurogenic dysfunction and in 3 (3%) patients due to pharmacological effects. There was no statistically significant difference between groups 1 and 2 according to etiological causes (p=0.089).
Discussion: The ocular pathologies were found to be the most common cause of anisocoria. The most common ocular causes detected also varied in parallel to demographic changes. There is a need for descriptive studies of the etiology of anisocoria with a higher number of participants.
Keywords: Anisocoria, Parasympathetic System, Pupil Diameter, Sympathetic System, 3rd Cranial Nerve
COVID-19 patients with chronic disease symptoms at a Tertiary Care Hospital in Turkey
Department Of Emergency, Sultanbeyli State Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21795 Received: 2023-06-17 Accepted: 2023-07-31 Published Online: 2023-08-10 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):812-815
Corresponding Author: Semih Eriten, Department Of Emergency, Sultanbeyli State Hospital, 34935, Istanbul, Turkey. E-mail: email@example.com P: +90 533 614 32 00 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8516-372X
This study was approved by the Ethics Committee of Malatya Training and Research Hospital (Date: 2020-08-06, No: 23536505-000-13874)
Aim: The aim of this study is to evaluate the treatment of chronic diseases, which have a significant place in the course and mortality from COVID-19, taking into account the experience of a tertiary hospital.
Material and Methods: The study included a group of 407 patients with chronic disease symptoms who were followed up at the COVID-19 Polyclinic of Malatya Training and Research Hospital between August 1, 2020 and December 31, 2020. The research data were examined by the researcher using archive materials of COVID-19 Polyclinic according to the parameters determined by the researcher. The researcher gathered information about these study sample parameters from patient files and saved it in a Microsoft Office Excel file.
Results: In our study, patients with positive PCR test results had 30.9% asthma, 23.6% arrhythmia, 16.4% HT, 10.9% heart failure and 9.1% DM. Among patients with negative PCR results, 20.5% had HT, 17.6% had DM, 16.2% had asthma, 16.2% had arrhythmia and 11% had COPD.
Discussion: Based on the results of the study, it can be concluded that there is a significant association between chronic diseases and PCR test results. This suggests that individuals with pre-existing chronic conditions may be more prone to contracting the virus and testing positive for COVID-19.
Keywords: Chronic Diseases, Course Of COVID-19, COVID-19, Viral Infection, Patient Management
Evaluation of the use of three ports in total laparoscopic hysterectomies
Aylin Önder Dirican
Department of Gynecology and Obstetrics, Konya Başkent Universty, Konya, Turkey
DOI: 10.4328/ACAM.21796 Received: 2023-06-20 Accepted: 2023-08-30 Published Online: 2023-08-30 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):816-820
Corresponding Author: Aylin Önder Dirican, Department of Gynecology and Obstetrics, Başkent Universty, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 505 937 31 08 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5121-6317
This study was approved by the Clinical Research Ethics Committee of Karatay University Faculty of Medicine (Date: 2023-05-25, No: 2023/029)
Aim: The aim of this study is to evaluate the patient profile in which fewer ports can be used in laparoscopic hysterectomy.
Material and Methods: The study is based on cases performed by a team experienced in laparoscopic hysterectomy in a tertiary education and research hospital. Variables of patients were collected retrospectively from hospital electronic medical databases and analyzed. The use of 4 ports and 3 ports in laparoscopic hysterectomy was compared in terms of uterine weights, blood parameters and complications.
Results: Of a total of 201 patients, 28% (56) were operated using 4 ports (port-4 group), 72% (145) using 3 ports (port-3 group). The mean age of the patients was 49.03 (±4.53) years. Mean gravida, parity, and history of abdominal surgery were similar in both groups. Preoperative and postoperative hematocrit and hemoglobin values were similar in both groups. Although the need for blood transfusion was higher in the port-4 group (13%) than in the port-3 group (6.9%), no significant difference (p=0.26) was observed. Mean uterine weight (gr) was found to be significantly (p<0.001) lower in the port-3 group (193.03±45.60) than in the port-4 group (237.25±57.16). Total operation time (min) was significantly shorter (p<0.001) in the port-3 group (68.52±14.94) compared to the port-4 group (91.91±23.96). Postoperative complication rates were similar in both groups.
Discussion: Laparoscopic hysterectomies may be associated with a reduced number of ports, shorter operation time and less need for blood transfusion in patients with a smaller uterus.
Keywords: Laparoscopy, Hysterectomy, 3-Port
Comparison of vacuum assisted closure (VAC) application with conventional treatment after surgical intervention in patients with Fournier’s gangrene
Doğan Öztürk, Bülent Öztürk, Sibel Özkara
Department of General Surgery, Atatürk Sanatoryum Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21797 Received: 2023-06-17 Accepted: 2023-07-31 Published Online: 2023-08-03 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):821-824
Corresponding Author: Doğan Öztürk, Department of General Surgery, Atatürk Sanatoryum Training and Research Hospital, Ankara, Turkey. E-mail: email@example.com P: +90 537 295 03 22 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1754-9246
This study was approved by the Ethics Committee of Atatürk Sanatoryum Training and Research Hospital (Date: 2023-06-21, No: 2012-KAEK-15/2734)
Aim: This study aims to evaluate the etiology and predisposing factors of patients with Fournier’s gangrene and to compare the results and effectiveness of vacuum-assisted wound closure (VAC) and traditional dressing and debridement methods on wound healing after surgical intervention.
Material and Methods: This retrospective study was conducted by collecting the data of 65 patients with Fournier’s gangrene who applied to our hospital between March 1, 2016 and March 1, 2023. In this study, we divided our patients into two groups: those who were treated with VAC and those who were treated with conventional treatment. We evaluated these two groups according to certain parameters, for example, DM and obesity. The study was approved by the Ethics Committee on 21 June, 2023.
Results: A total of 65 patients were included in the study. Of these, 50 (87%) were male and 15 (13%) were female. The mean age of the patients was 52.6 ±10.45 years. Thirty-one patients were followed up with VAC, while conventional treatment was used in 34. However, in the comparison made without considering the predisposing factors, no significant difference was found between the two groups in terms of length of hospital stay. In addition, it has been statistically proven that VAC treatment is ahead of the traditional treatment method in terms of hospital stay in cases with obesity and DM. Considering their comorbid diseases, it was seen that they were effective on the length of hospital stay.
Discussion: Many methods have been tried in the care and follow-up of the wound in Fournier’s gangrene. Although they do not have clear advantages over each other, an appropriate patient-based method is used. The importance of other factors such as having similar effects, cost analysis, and length of hospital stay come to the fore.
Keywords: Fournier Gangrene, Vacuum-Assisted Wound Closure (Vac), Hospitalization, Wound Care
Comparison of opioid and opioid-free anesthesia in bariatric surgery
Şükrü Ümit Yaşar 1, Aslı Mete Yıldız 2
1 Department of Anesthesiology and Reanimation, Special Odak Hospital, 2 Department of Anesthesiology and Reanimation, Pamukkale University, Denizli, Turkey
DOI: 10.4328/ACAM.21801 Received: 2023-06-22 Accepted: 2023-08-23 Published Online: 2023-08-25 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):825-829
Corresponding Author: Aslı Mete Yıldız, Department of Anesthesiology and Reanimation, Faculty of Medicine, Denizli, Turkey. E-mail: firstname.lastname@example.org P: +90 530 932 23 34 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5621-7407
This study was approved by the Non-Interventional Clinical Research Ethics Committee of Pamukkale University (Date: 2019-12-11, No: 60116787-020/88341)
Aim: Opioids are widely used in anesthesia. Postoperative nausea and vomiting (PONV) is known to have side effects such as tremors and urinary retention and so on. Several studies have been conducted in recent years indicating that multimodal analgesia reduces opioid consumption. There are very few studies comparing opioid-free anesthesia with Laparoscopic Sleeve Gastrectomy (LSG). The aim of this study is to evaluate the effects of opioid-free anesthesia on pain scores and healing process in patients with LSG surgery.
Material and Method: This study was conducted on 64 cases between the ages of 18-65 prospectively in the general surgical operating room of Pamukkale University Hospital. Patients were randomly selected and grouped according to anesthesia method at the beginning of the surgery. Remifentanil as an opioid was administered for analgesia in Group I. Iv paracetamol, ibuprofen, ketamine and magnesium sulfate were administered in Group II. NRS was used as a pain score. Patients included in the study were followed from the beginning of the operation to the end of the postoperative 24 hours. The obtained data were analyzed using the SPSS 25 software.
Results: The body mass index (BMI) of the patients included in the study was 40 and above. In the study, women in both groups were in the majority (≥75%). In both groups, cesarean section was in the majority of patients in the history of a previous surgery. Patients in Group I were significantly higher when hypotension was examined. There was no significant difference in SpO2<94%, obstructive respiration, nausea, vomiting, chills, tramadol use, antiemetic need and mean TOF values in postoperative recovery unit. There was no significant difference in NRS score between groups at postoperative 1, 6, 12 and 24 hours. There were partially more complications in postoperative Group I.
Discussion: There was no significant difference between non-opioid anesthesia and opioid anesthesia, but the non-opioid anesthesia protocol can be safely used in LSG.
Keywords: Opioid-Free Anesthesia, Bariatric Surgery, NRS Score, Laparoscopic Sleeve Gastrectomy
Targeting one-carbon metabolism by methyl donors for prevention of
non-alcoholic fatty liver in rats
Huda Abdulaziz Al Doghaither
Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
DOI: 10.4328/ACAM.21802 Received: 2023-06-22 Accepted: 2023-07-31 Published Online: 2023-08-10 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):830-834
Corresponding Author: Huda Abdulaziz Al Doghaither, Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia. E-mail: email@example.com P: +966 50562 56 33 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6192-8326
This study was approved by the Ethics Committee of King Fahd Medical Research Center (KFMRC), King Abdulaziz University (Date: 2022-04-01, No: 315-22)
Aim: The purpose of the current work was to demonstrate and compare the impacts of folate, methionine, and choline as methyl donors in the prevention of NAFLD induced by a high-fructose diet (HFrD).
Material and Methods: Sixty adult male albino rats were divided into five groups: G1 had a control-fed basal diet; in G2, the rats were fed an HFrD containing 45% fructose (HFrD); in G3, G4, and G5, the rats were fed an HFrD supplemented with folic acid, L-methionine, and choline chloride, respectively. The present study’s findings showed a close connection between methyl donors and lipid metabolism.
Results: The findings indicated that the folic acid supplemented diet (HFrD+ folate) exhibited the most substantial improvement in hepatic total lipids (TP), triacylglycerol (TG), phospholipid (PL), serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), free fatty acid (FFA), albumin (ALB), total bile acid (TBA), fasting blood glucose (FBG), proinflammatory cytokines levels, and enzyme activities of alanine transaminase (ALT), aspartate transaminase (AST), fatty acid synthase (FAS), and acetyl coenzyme A carboxylase (ACC). In the same context, L-methionine had the most significant improvement in oxidative stress biomarker (glutathione [GSH], superoxide dismutase [SOD], 4-hydroxynonenal [4-HNE]) levels, followed by folic acid and choline.
Discussion: Methyl donors such as folic acid, methionine, and choline are essential for maintaining OCM and can prevent animals with NAFLD from developing liver lipid accumulation.
Keywords: One-Carbon Metabolism, L-Methionine, Choline, Folic Acid, Methyl Donors
In silico investigation of the antiemetic effect of cannabidiolic acid (CBDA), the phytocannabinoid of Cannabis sativa, by molecular docking method
Meryem Albayrak 1, Sultan Mehtap Büyüker 2
1 Department of Biotechnology, 2 Department of Pharmacy Services, Üsküdar University, Istanbul, Turkey
DOI: 10.4328/ACAM.21806 Received: 2023-06-27 Accepted: 2023-08-28 Published Online: 2023-08-30 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):835-839
Corresponding Author: Sultan Mehtap Büyüker, Department of Pharmacy Services, Üsküdar University, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 532 324 21 53 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1344-540X
Aim: Cannabis sativa has essential secondary metabolites in the treatment of diseases. The effects of the phytocannabinoids of Cannabis sativa on emesis continue to be investigated. In this study, we aimed to investigate the antiemetic effect of cannabidiol acid, one of the phytocannabinoids of the Cannabis sativa plant, by in silico methods.
Material and Methods: In this study, the molecular properties of cannabidiolic acid obtained from the PubChem database were investigated using the SwissADME database. To examine the effects of cannabidiolic acid on vomiting, the serotonin receptor was determined as the target protein. The target protein was obtained from the protein database, and molecular insertion was performed using AutoDock Vina. The docking process was visualized using Discovery Studio Visualizer and LigPlot imaging programs.
Results: According to our clamping study, the excellent hydrogen and hydrophobic interactions shown by CBDA on the 5HT3A receptor appear to be more effective than the reference drugs used.
Discussion: The examination found that cannabidiolic acid complies with Lipinski’s rules and has better binding energy, so it is a suitable candidate for the treatment of emesis.
Keywords: In-Silico, Cannabidiolic Acid (CBDA), Molecular Docking, Emesis, Antiemetic, Cannabis Sativa
Is there a relationship between systemic immune-inflammatory indices and asthma?
Fatma Esra Gunaydin 1, Huseyin Erdal 2
1 Department of Immunology and Allergy, Ordu University Training and Research Hospital, Ordu, 2 Department of Medical Genetics, Faculty of Medicine, Aksaray University, Aksaray, Turkey
DOI: 10.4328/ACAM.21807 Received: 2023-06-28 Accepted: 2023-08-07 Published Online: 2023-08-12 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):840-843
Corresponding Author: Huseyin Erdal, Department of Medical Genetics, Faculty of Medicine, Aksaray University, Aksaray, Turkey. E-mail: email@example.com P: +90 543 414 08 15 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0786-5077
This study was approved by the Ethics Committee of Ordu University (Date: 2023-03-31, No: 2023/87)
Aim: Immune inflammatory response plays an important role in patients with asthma. The goal of the current study is to determine whether pan-immune inflammation value (PIV) and systemic inflammatory response index (SIRI) are effective in predicting asthma.
Material and Methods: This retrospective study included 55 patients and 55 healthy controls followed in the Allergy and Immunology Clinics of Ordu University Training and Research Hospital.
Results: Neutrophil, Monocyte, MPV and PDW were statistically significant between the groups (p<0.05). A statistically significant difference was found between SIRI, PIV and dNLR, indices between the groups (p<0.05). No statistically significant difference was detected between SII, NLR, PLR and LMR compared to the controls (p>0.05).
Discussion: We concluded that SIRI and PIV could be novel and cost-effective inflammatory indices in patients with asthma.
Keywords: Asthma, Inflammation, Systemic Inflammatory Response Index, Pan-Immune-Inflammation Value
Development of the corpus callosum during normal growth
Duygu Baykal 1, Yaprak Çevirme 2, Gökhan Ocakoğlu 3, Mevlüt Özgur Taskapılıoğlu 2
1 Department of Neurosurgery, Bursa State Hospital, 2 Department of Neurosurgery, Faculty of Medicine, Uludag University, 3 Department of Biostatistics, Faculty of Medicine, Uludag University, Bursa, Turkey
DOI: 10.4328/ACAM.21812 Received: 2023-07-07 Accepted: 2023-08-14 Published Online: 2023-08-18 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):844-848
Corresponding Author: Mevlüt Özgür Taşkapılıoğlu, Department of Biostatistics, Faculty of Medicine, Uludag University, 16059, Gorukle, Bursa, Turkey. E-mail: firstname.lastname@example.org P: +90 224 295 27 40 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5472-9065
This study was approved by the Ethics Committee of Bursa Uludag University (Date: 2019-12-25, No: 2019-21/17)
Aim: Corpus callosum is the main structure communicating between the two brain hemispheres. This study aimed to investigate the differences in the corpus callosum’s and cranium’s shape during growth and assess their potential clinical implications.
Material and Methods: Cranium and corpus callosum shape data were collected from two-dimensional digital images. Generalized Procrustes analysis was used to obtain mean shapes between consecutive age groups. Shape deformation of the corpus callosum between successive age groups was evaluated using the thin-plate spline method.
Results: There were significant age-based differences were in the corpus callosum and cranium shape. The most prominent deformation was seen in the posterior midbody (a corpus callosum region), while the cranium deformation was observed in the biparietal area. There were significant differences in corpus callosum shape between 1- and 2-year age groups. The diameter of the cranium increased up to the age of 4 years; however, this increase was not uniform, especially in the biparietal areas.
Discussion: The skull’s growth and the corpus callosum’s development are not similar. The development of the corpus callosum may be a better indicator of neural development than skull enlargement.
Keywords: Corpus Callosum, Cognition, Development, Shape Analyses, Skull
Assessment of the patients referred to the pediatric cardiology clinic due to murmur
Ajda Mutlu Mıhçıoğlu
Department of Pediatrics, Unıversity of Health Sciences, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21831 Received: 2023-07-24 Accepted: 2023-08-25 Published Online: 2023-08-29 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):849-853
Corresponding Author: Ajda Mutlu Mıhçıoğlu, Department of Pediatrics, Unıversity of Health Sciences, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, 34147, Bakırköy, Istanbul, Turkey. E-mail: email@example.com P: +90 505 648 64 68 F: +90 212 414 69 94 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0143-4188
This study was approved by the Ethics Committee of Health Sciences University, Bakırköy Dr. Sadi Konuk Training and Research Hospital (Date: 2023-03-20, No: 2023-06-13)
Aim: Heart murmur is one of the most common reasons for evaluation in the pediatric cardiology clinic. The aim of this study is to evaluate the physical examination and echocardiographic findings of patients referred due to murmur.
Material and Methods: Patients admitted to the pediatric cardiology clinic due to murmur were evaluated retrospectively. The intensity of the murmurs was graded as 1-2/6, 3/6, and >3/6. The type of murmur was classified as innocent or pathological. Echocardiographic findings were classified as normal, normal for age, or pathological.
Results: Two hundred patients were included in the study. Murmur was graded 1-2/6 in 72.5% of patients, 3/6 in 7%, and>3/6 in 1%. Innocent murmur was detected in 54.5%, pathological murmur in 26% of the patients. Echocardiographic findings were normal in 54% of the presenting cases, normal for age in 15.5%, and pathological in 30.5%. Patients without murmur had normal echocardiographic findings in 64.1%, pathologic findings in 7.69%. Echocardiography was normal in the majority of the patients with a grade of 1-2/6, but was pathological in those with a grade of ≥3/6. Echocardiography was pathological in 7.69% of the patients without murmur, in 10.09% with an innocent murmur, and in 90.38% with a pathological murmur. The intensity of murmur was observed as significant (p=0.001), but the characteristics of the murmur was not observed as significant determinant in distinguishing echocardiographic findings (p=0.115).
Discussion: Echocardiographic findings are not always related to physical examination findings of murmur, therefore we suggest that auscultation alone may not be sufficient in the evaluation, and a detailed assessment with echocardiography may be more appropriate.
Keywords: Child, Echocardiography, Auscultation, Murmur
Validation of the Japan score in patients with upper gastrointestinal system bleeding and comparison with other scores
Abuzer Özkan 1, Kadir Özsivri 1, Serdar Özdemir 2, Abuzer Coşkun 1
1 Department of Emergency Medicine, University of Health Sciences Bağcılar Training and Research Hospital, 2 Department of Emergency Medicine, Health of Sciences University, Ümraniye Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21834 Received: 2023-07-27 Accepted: 2023-08-28 Published Online: 2023-08-30 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):854-858
Corresponding Author: Abuzer Özkan, Department of Emergency Medicine, Health of Sciences University, Bağcılar Training and Research Hospital, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 505 615 55 50 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4284-0086
This study was approved by the Ethics Committee of Umraniye Training and Research Hospital (Date: 2022-08-11, No: 258)
Aim: Upper gastrointestinal bleeding is a life-threatening emergency. Endoscopic intervention facilities are not available in all hospitals, and the number of personnel performing this procedure is insufficient to provide 24-hour service. Scales are being developed to predict endoscopic intervention in AUGB. Japan score is one of them.
Material and Methods: The study was designed prospectively. It was performed between 02-02-2023 and 02-06-2023. The study was carried out on patients who were admitted to the emergency department with the suspicion of upper gastrointestinal bleeding and were diagnosed with non-variceal upper GI bleeding after endoscopic examination.
Results: A total of 65 patients were included in the study. The median age was 61.0 years (44.0, 78.0); 46 were men (71%). Among the scores, Japan Score was the strongest predictor of the need for Endoscopic intervention (AUC 0.750).
Discussion: The Japan score, which is simpler to use and has a stronger predictive ability, can be used in this patient group compared to the relatively older scorings used to predict endoscopic intervention in UGIB.
Keywords: Upper Gastrointestinal Bleeding, Scores, Japan Score, Endoscopy, Glasgow Blatchford Score
Factors affecting mortality in patients with tuberculosis and the impact of the pandemic on patient follow-up
Derya Korkmaz 1, Pınar Ersoy 2
1 Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Afyonkarahisar Health Science University, 2 Department of Public Health, Provincial Directorate of Health, Afyonkarahisar, Turkey
DOI: 10.4328/ACAM.21835 Received: 2023-07-30 Accepted: 2023-08-30 Published Online: 2023-08-30 Printed: 2023-09-01 Ann Clin Anal Med 2023;14(9):859-863
Corresponding Author: Derya Korkmaz, Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Afyonkarahisar Health Science University, 03200, Afyonkarahisar, Turkey. E-mail: email@example.com P: +90 506 278 84 68 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7236-2164
This study was approved by the Clinical Research Ethics Committee of Health Sciences University (Date: 2022-08-05, No: 2022/394)
Aim: Tuberculosis (TB) remains one of the leading causes of mortality worldwide. In this study, we aimed to evaluate the patients who were followed up with a diagnosis of TB in the last five years, examine the factors associated with mortality in these patients, and investigate the effect of the pandemic on patient follow-up.
Material and Methods: The data of the patients who were followed up at the Tuberculosis Dispensary between June 1, 2017, and June 1, 2022, with a diagnosis of TB were retrospectively analyzed.
Results: The study included 395 patients with a mean age of 49.6±20.2 years who were followed up with a diagnosis of TB for five years. Of the patients, 208 (52.7%) were male and 187 (47.3%) were female. Pulmonary involvement was found in 160 (40.5%) and non-pulmonary involvement in 212 (53.7%) patients. Follow-up of 11.1% of patients resulted in death. The mean age of the deceased (65.1±16.9) was significantly higher (p<0.001), and there was no significant difference in mortality between both sexes (p=0.957). While the number of patients diagnosed before the pandemic was 219 (55.4%), it was 176 (44.6%) during the pandemic period and there was no difference between the two periods in terms of mortality.
Discussion: Patients over 61 years of age and those with pulmonary + non-pulmonary or pulmonary involvement had significantly higher mortality; therefore, a great deal of care should be taken to avoid delays in diagnosis and treatment, particularly for elderly patients. During the pandemic, the number of patients diagnosed has decreased due to disruptions in health services, so the number of cases and deaths due to TB may increase in the coming years. It is of great importance to take effective measures for disease control and to raise awareness on this issue.
Keywords: Tuberculosis, Pandemic, Mortality, Treatment