Selçuk Tıp Dergisi Arşiv

To determine the seropositivity ratios of hepatitis-B and hepatitis-C in pregnant women living in Kocaeli region. Three thousand seven hundred and fifty-six pregnant women who applied to Izmit Women and Child Health Hospital for delivery (vaginal delivery, cesarean) were included in this retrospective study. HBsAg, AntiHBs, Anti-HCV and Anti-HIV were detected by macro ELISA system in all pregnant women. Data were analysed with the SPSS statistical programme. Seropositivity of HBs-Ag, Anti-HBs and Anti-HCV were detected 2.2%, 3.7% and 0.3% respectively in pregnant. There were no pregnant women who have seropositivity with Anti-HIV. The results detected for seropositivity of hepatitis-B and hepatitis-C in Kocaeli region are similar to those found in other regions of Turkey.

It is not possible to determine dysrhythmias at any time, because those may occur briefly and unpredictably throughout the day. Transtelephonic electrocardiography (TTE) allows arrival to the hospital by the phone line dysrhythmia at the time. The aim of this study was to evaluate the value of TTE in the diagnosis and treatment of dysrhythmias, especially seen intermittently, in pediatric patients. We retrospectively evaluated records of 121 children, followed-up in Pediatric Cardiology Unit between May 2003 and May 2006. The patients were age of between 4 months to 18 years (median age 12 ± 4.4 years). The most common presenting symptoms were palpitation (42.1%), chest pain (15.7%), palpitation together with chest pain (6.6%), syncope (5%), easy fatigability (5%) and also the research of drug efficiency (3.3%). The dysrhythmia findings were determined on TTE in 21 of 110 cases whose standard electrocardiographies were normal. On TTE, supraventricular tachycardia was observed in three of 25 patients with normal HM. The dysrhythmia was detected in 24% of TTE records (supraventricular extrasystoles, ventricular extrasystoles, sinusal tachycardia, supraventricular tachycardia, sinus bradycardia, sinus tachycardia, sinus pause, Mobitz type I atrioventricular block were detected in 11, 7, 4, 3, 2, 1 and 1 cases, respectively). Four patients were using drugs (verapamil in 3 and propranolol in 1) before TTE recordings. According to the TTE records, medical treatments were started in 10 patients with previously untreated (verapamil in 5, propranolol in 3, digoxin in 1 and also amiodarone in 1). Eventually, we suggest that HM is a usefull, reliable and non-invasive diagnostic method for the detection of dysrhythmias in patients with dysrhythmia suggestive symptoms and normal ECG. Additionally, TTE should be used in follow-up and treatment of the patients with some dysrhythmias, even undetectable with HM.

Atopic dermatitis (AD) is a chronically relapsing skin disease that begins most commonly during early childhood. The prevalence of AD is increasing because of the alteration lifestyle and the disease effects life quality indifferently. In this study, subjects were 30 patients who were admitted to Dermatology Clinic of Selçuk University Meram Medical Faculty with the diagnosis of AD. There were 20 healty subjects as a control group, without any atopy history and have no clinical symptoms. Skin prick tests, composed of 51 materials; house dust mites, tree polens, grass polens, insects and mold were performed both groups. In this test histamin solution was positive and serum salin were negatif controls. Pricks tests were reactive mostly for house dust mites, mold, grass pollens and the other pollens in the AD group. In the healty group, there were reactive results for house dust mite and candida only in one subject. Serum total IgE levels elevated in 17 of 30 patients (56.7%) in AD group , and 2 subjects in the healty group (10%). Statistical analyses showed that, in the AD group, serum total IgE levels are significantly higher than healty controls (p

Frequency of osteoporosis in postmenopausal women is rising depending on various factors. This study is aimed at to analyse the risk factors that cause osteoporosis for women living in Kütahya. The assessment of bone mineral density (BMD) of Lumbar vertebral bone (L1-L4) via dual energy X-ray absorptiometry (DEXA) machine in a-p position was carried out on 103 women, aged between 40- 82 who had already been in menopause and applied to Kütahya Devlet Hastanesi (Kütahya State Hospital) department of DEXA for assessment of bone mineral density. Study data were achieved from survey results. Experimental group was evaluated according to World Health Organisation (WHO)’s Osteoporosis Classifications via DEXA assessments as T score -1,0 SD> normal, T score -1,0 SD and -2,5 SD is osteopeni and T score <-2,5 SD is osteoporosis. It was observed that all the respondents are housewifes, primary school educated and have a low activity level. It was observed again that the responders who are osteoporosis and osteopenia are older,shorter; particularly, osteoporosis group is 3 cm shorter and have less weight than normal group of people. The group of people who are osteoporosis and osteopenia have a lower age of first and last menstruation than normal people. Yet, they have a higher breast-feeding duration. It was detected that the patients have a lower T scores who had used cortisone for a long time and had bone fracture than who didn’t have any. It was detected again that the scores fell down depending on tested people’s decreasing in come, however, they rose depending on tested people’s rising education status. It was detected that the T scores of people who are leading a rural life was lower than who are leading a urban life. As a result of our study it was noticed that risk of osteoporosis rises depending on age, life style, characteristics of sociodemographic are effective on falling of bone mineral density.

We carried out a retrospective and prospective study of 47 patients who had sustained injuries over the last three years from the hand passing through or striking glass. The demographic data, severity of injury, history of psychiatric illness and outcomes of the patients were evaluated. The preoperative examination of these injuries significantly underestimated the amount of damage. A simple and small laceration has the potential to conceal an underlying deep injury. For this reason, if glass is implicated as a causative agent, careful preoperative evaluation and surgical management should be considered.

To determine the distribution and association with demographic variables of breast complaints of women in Early Diagnosis-Scanning and Education Centers (KETEM). Electronically kept data in Konya KETEM was analyzed by omitting personal information via SPSS package software in 2011. Dependent and independent variables were demographic features and breast complaints. Descriptive statistics were used, and logistic regression analysis was performed step by step to define the correlations. Mean age of women applying to KETEM between 2007 and 2010 was 44±12 years, and 92% were of social security. Median age of first menstrual cycle was 13 years, median number of living births was 3, and median total duration of breastfeeding was 36 m. The rates of OKS use, smokers, obesity and vegetative life style were 9%, 7%, 33% and 2%, respectively. The rates of mammography and self-checked breast examination were 32% and 18%, respectively. 44% had any kind of breast complaints, and 8% had a history of experienced breast disease. While the existence of complaints was associated with age, height, number of living births, total breastfeeding duration and type of nutrition, experienced breast disease was related to height and smoking (at least, p

Identification of patients who will deliver prematurely is extremely important to decrease neonatal and maternal morbidity and mortality. The aim of this study was to evaluate the value of cervical length (CL) measurement in predicting preterm birth (PTB) in asymptomatic low risk women. A total of 200 consecutive asymptomatic patients between 16-22 gestational age who had no history of PTB previously were included in this prospective study. CL was measured by transvaginal ultrasonography and the predictive value of CL for PTB was evaluated in this low risk population. The incidence of PTB was 4.5% (9/200). The mean age (±S.D.) of the preterm and term groups was 27.7±6.98 and 24.9±4.47 years, respectively (p=0.222). The CLs at 16-22 weeks were not statistically different between the term group (35.0±4.57 mm) and the preterm group (36.5±6.93 mm) (p=0.887). Cesarean delivery rate was significantly higher in preterm group (p=0.04). Ultrasonographic CL measurement alone has limited value in prediction of preterm delivery in a low risk asymptomatic population. Also there is insufficient evidence to recommend routine CL screening in this subpopulation. Further larger prospective studies are needed to identify patients that may benefit most from such screening.

To determine the contribution of imaging techniques for diagnosis and therapy planning of patients with parotid masses. 16 patients (10 female, 6 male; between 13-75 age; mean age 41.12±16.97 years) were evaluated retrospectively. Age, gender, clinical characteristics of patients, imaging studies which were performed preoperatively, location and characteristics of masses and invasion to the surrounding tissue, histopathologic examination of surgery specimens were evaluated in the current study. Histopathologic examinations of specimens revealed that all cases were benign. Histopathologic findings revealed no malignancy. Histopathologically, lesion was diagnosed as pleomorphic adenoma in 11 patients (%68.75) and Warthin tumor in 5 patients (%31.25). The mass was located in left parotid gland in 8 (%50) patients and in right parotid gland in 8 (%50) patients. Preoperative, ultrasound (US) was performed in 7 patients; computed tomography (CT) was performed in 9 patients; magnetic resonance imaging (MRI) was performed in 5 patients. US should be the initial investigation of choice for patients with parotid masses because of superficial location. US is effective, inexpensive, nonradiation, non-invasive, practical and does not require sedation in diagnosis parotid masses. Deeply located tumors and malign tumors should be evaluated with CT or MRI. CT or MRI alone is sufficient for evaluation.

Time management and making a correct diagnosis are very important for survival of patients with altered state of consciousness. In our study, we aimed to determine the value of the infrascanner device, which is a non-invasive and a fast method in detection of intracranial hemorrhage. A total of 38 patients who had been admitted to the emergency department of our hospital with the complaint of altered state of consciousness were included in the study. The patients underwent investigations with regard to hemorrhage immediately after admission using the infrascanner device by trained residents of emergency medicine. 20 (52.6%) of the patients were male. The mean age was 51.8 years and the Glasgow Coma Scale was 10.6 (15-3). While hemorrhage was detected on cerebral CT in 22 (57.9%) patients, it was not detected in 16 (42.1%). In the infrascanner device examination, negative results were detected in 24 (63.2%) patients and positive results were detected in 14 (36.8%) patients. The sensitivity of the infrascanner device was found to be 63.6%, specifity was found as 100%, the positive predictive value was found as 100%, and the negative predictive value was found as 66.7%. The results obtained from the study indicate that the infrascanner device provided beneficial clinical data in addition to symptoms and neurological examination in patients who required further imaging procedures. The high specificity puts forth that patients in whom hemorrhages are detected using the infrascanner device, should definitely be evaluated with further tests.

Admitted to our clinic with stab wounds treatment of cervical tracheal injuries conservatively. Our clinic between the ages of 25-40 due to penetrating injury to the cervical trachea under 2 cm and 6 cases were evaluated retrospectively. Generally, in patients presenting with cervical subcutaneous emphysema, respiratory distress and tracheal input-output occured . broad-spectrum antibiotic were taken and cervical anteseptikli spançlarla tightly closing, and continuous nasal oxygen, There were not accompanied organ injuries like esophagus and other organ .1 weeks after the spontaneous tracheal incisions were closed, and decreased subcutaneous emphysema were discharged. Tracheobronchial injuries due to stab injury to the cervical trachea is almost always, while the bullet wounds of firearms in any area that fits.Our cases injuries at around 80% of cervical trachea was noted in the literature. Cervical tracheal injury in patients with stridor, subcutaneous emphysema, severe respiratory distress, hemoptysis, hoarseness is the most common findings. if it is less than 2 cm and the tracheal anterior cervical injuries, if any organ injury, such as closing trakeastomi thought were more appropriate to remain conservative

Colorectal cancer remains a significant health problem today. In parallel to the developments in the field of surgery, improvements in adjuvant and neoadjuvant treatment modalities lead to increase in both local control and overall survival times. The main purpose of this review is to discuss the current treatment options of rectal cancer with literature data. Surgery is an essential treatment option for rectal cancer. Treatment success for rectal cancer has been increasing by the help of neoadjuvant (preoperative) or adjuvant (postoperative) modalities. According to the recent studies, preoperative (chemo) radiation therapy is superior to postoperative treatment in terms of local control and sphincter preservation. However, there is not enough data regarding to the difference between the efficacy of shortterm preoperative radiotherapy and long-term chemoradiotherapy. Today, for the treatment of rectum cancer, preoperative (chemo) radiotherapy is superior to postoperative (chemo) radiotherapy in terms of overall survival and local control. However, new prospective randomized trials should be designed to compare the short term and long term preoperative (chemo) radiotherapy.

Stroke related monoparesia is rare clinical condition and predominantly arose from small bleeding or lacuner infarcts secondary to small vascular disease. In this case we present monoparesia characterized by isolated motor defesit without sensorial deficit due to infarction of left precentral gyrus.

Proton pump inhibitors, are potent inhibitors of gastric acid secretion which are widely used in treatment of acid related disorders. They are believed to have minimal side effect profile. Although hipersensitivity reactions are rare, anaphylaxia have been reported. Clinicians should be kept in mind that anaphylactic reactions with these drugs might be seen. In this case report we aimed to discuss treatment modalities of anaphylaxia after taking oral lansoprazole.

Arthrogryposis Multiplex Congenita is a congenital disorder characterized by joint contractures. This is often due to contractures of joints in patients undergoing orthopedic procedures is required. Short neck, micrognathia and joint contractures, causing the neck and jaw movement limitations may cause difficulty in intubation. In this presentation anesthesia management in a case of Arthrogryposis multiplex congenita were evaluated because of recurrent operations

Breast cancer is the most frequently diagnosed cancer in women and second cancer leading death among cancer deaths in women (after lung cancer). Simultaneous bilateral breast cancer is seen 1-2% and metachronous 5-8%. Bilateral breast cancer has worse prognosis than unilateral breast cancer. Locoregional recurrences after mastectomy is often occure in bone, muscle, skin or subcutaneous tissue of the chest wall, and that was seen approximately until 2 years. In skin metastases; asymmetric nodules, eritematose rash, itching, bleeding, ulceration, symptoms and signs such as necrotic exuda can be seen. Breast cancer treatment should be made by a multidisciplinary team. Radiotherapy in these patients are curative or palliative. In this case, we aimed to show the effectiveness of the electron beam in modern radiotherapy.

Single ventricle is a rare congenital heart disease. The number of patients who reach to adult age without surgical operation due to poor prognosis are rare. There are publications that report cases reached to 5 to 6 decades in the literature. What makes the present case interesting is that it is the single ventricule that reaches the oldest age without operation reported in our country.

Foreign body aspirations (FBA), which have high mortality and morbidity rate, are common pediatric emergency issues occured in childhood. FBA is seen more frequently among children under 3 years old. If there is no history of sudden-onset choking and cough, it can be ignored and the patient may come with recurrent pulmonary infections and its related complications. In this report, 10-monthold boy patient who was brought with complaints of sudden-onset of cough, vomiting and wheezing after eating a kind of broad bean ( termiye) was presented. Diagnosis was established on the history, physical examination, the chest X-ray and bronchoscopy. The foreign body (termiye) was located in the right inferior bronchus and removed. This case emphasizes that the presence of a foreign body aspiration must be kept in mind in childhood. Because foreign body aspiration is a serious problem that may lead to complications or even to death.

Split hand-foot malformation is a congenital limb malformation, characterized by a deep median cleft of the hand and/or foot due to the absence of the central rays. Split hand-foot malformation can occur as isolated anomalies or as one component of multisystem syndromes. The majority of the familial cases are inherited in an autosomal dominant manner. Some patients with split handfoot malformation have been found to have mental retardation, ectodermal and craniofacial findings. We presented a split handfoot malformation case with liver and cutaneous hemangioma by the literature. According to our investigations, this is the first case of split hand-foot malformation with existence liver and cutaneous hemangioma.

Myocardial bridge(MB) is common congenital anomaly of coronary arteries. Altough MB is generally asymptomatic, it can manifest as angina pectoris, acute myocard infarction, very rarely fatal cardiac arrhythmias and even sudden death. 44 years old man admitted to our cardiology clinic with typical chest pain and signs of anterior ischemia at electrocardiography, coronary angiography was performed and a myocardial bridge which cause total occlusion at mid-segment of left anterior descending artery detected. In this case report we aimed to discuss mechanism of symptoms, medical and invasive theraphy options and long term follow outcomes in MB.

Primary immunoglobulin A (IgA) nephritis associated with dominantly IgA deposition in glomerular mezengium. Macroscopic or microscopic hematuria are seen and proteinuria may be associated with hematuria. Acute renal failure (ARF) rarely occurs in the course of IgA nephritis. In here, a male case 15 years old with IgA nephritis had been presented with ARF and rapidly resolving renal failure.