Selçuk Tıp Dergisi Arşiv

Aim:

The present study was undertaken to evaluate the prevalence, height and location of maxillary sinus septa in patients with a dentate and an edentulous maxilla using cone beam computed tomography imaging.

Patients and Methods:

This descriptive study was conducted on a retrospective evaluation of cone beam computed tomography images of 1322 maxillary sinus with 661 subjects from January 2016 to February 2018. The study consisted of 1322 maxillary sinuses: 1092 from patients with a dentate and 230 from patients with an edentulous maxilla.

Results:

The mean age of the 661 patients (373 women, 288 men) was 42.1 ± 18.2 years. A total of 468 (35.4%) septa was recorded in 1322 maxillary sinuses  with a mean height was 7.95 ± 4.03 mm. Of 468 sinus septa, the majority was located in the posterior region of the maxillary sinus. Of these, 121 (25.8%) were in the anterior, 140 (29.9%) were in the middle and 207 (44.2%) were in the posterior region.

Regarding the status of the dentition in the maxilla in relation to the distribution of sinus septa, septa were present in 387 (35.4%) dentate and in 81 (35.2%) edentulous regions.

Conclusion:

The prevalence of septa is high in all parts of the maxillary sinus. For this reason, comprehensive evaluation should be performed with an appropriate radiographic technique to prevent possible complications during sinus surgery.

Aim: Bites are an essential cause of injury since the world. Treatment of bites is made according to specific guides and principles. The study's purpose is to examine the demographic characteristics of patients hospitalized due to bite wounds and to be a guide for new studies and treatments by sharing surgical treatment experiences.

Material and Method: Patients who were bitten and required surgical treatment were included in the study. Demographic characteristics, tetanus, and rabies prophylaxis applications, infection agents isolated from the wound site, antibiotherapies applied, and surgical treatments were recorded.

Results: Of the patients, 43 were male and mean age (±SD) of 34.5±23.8years (range, 3-85 years). Bites were in the head and neck region in 13(65%) of patients under 15 years old and in 12(27.3%) of the patients over 15 years old. In extremities, the injury was present in 7(35%) patients under 15 and in 28(63.6%) patients over 15 years old. Of the injuries, 50(78.1%) were caused by dogs, 8(12.5%) by wild animals (7 pigs, one wolf), 4(6.3%) by other pet species (horse, donkey, cow), and 2(3.1%) by humans. The intervention was made to all the patients according to guide of rabies prophylaxis specified by the Ministry of Health, General Directorate of Public Health. Irrigation was applied to the wound site with plenty of pressurized and soapy water. Forty patients received tetanus prophylaxis, 62 patients received rabies prophylaxis, and rabies immunoglobulin was applied to patients considered as suitable. Prophylactic amoxicillin clavulanate treatment was started in 38 of the patients, crystalline penicillin-G in 12, sultamicillin in 6, the combination of sultamicillin and aminoglycoside in 6, and cefazolin treatment in 2. 12(18.8%) patient underwent an urgent operation for repair process without any microbiological examination on the date of arrival. Among the patients to whom repair was applied on the first day, 7 had primary saturation, 3 had a local flap, 1 underwent ear, and 1 underwent nasal replantation, one patient had femoral artery repair, and one patient had peroneal nerve repair. Among 52 patients who underwent late repair, primary suturation was applied to 35, skin graft to 4, local flap to 17, and paramedian forehead flap to 2. No complication was seen in any of the patients who underwent early and late repairs.

Conclusion: Bacterial burden of the wound can be reduced enough to allow urgent repair owing to the irrigation of the wound with plenty of pressurized and soapy water in bites. 

Aim: In childhood, infectious mononucleosis cases caused by Epstein-Barr virus (EBV) are seen with high frequency. The signs and symptoms of acute EBV infection can manifest with different clinical pictures. Care should be taken in differential diagnosis for correct treatment. In our study, it was aimed to examine the clinical presentation of acute EBV infections by age and high-risk age groups among children.

Patients and Methods: A total of 337 pediatric patients with infectious mononucleosis who applied to our tertiary hospital in 2013-2020 were included in the study. EBV VCA IgM and IgG antibodies were studied by ELISA method (quantitative microplate ELISA, Euroimmun®, Germany) in accordance with company recommendations. Patient information and results were evaluated retrospectively.

Results: The mean age of the patients was 5.1 ± 3.4 years. 22.8% of the patients were in the group of 0-2, 43.0% of them were 3-5, 29.7% of them were 6-12, and 4.5% of them were 12 years old and above. The most common signs or symptoms in children diagnosed with acute EBV infection were lymphadenopathy (59.6%), lymphocytosis (45.1%), fever (40.9%), swelling in the throat (39.2%) and pharyngitis (30.0%). Fever complaints were significantly higher between the ages of 3-5 compared to other age groups. The seasonal distribution of the cases was similar. It was determined that the cases increased over the years and the most cases were seen in 2019 (23.4%). It was observed that the time between the start of complaints and the application to the hospital increased directly proportional to age groups.

Conclusion: In our study, it was concluded that there was no difference in acute EBV infection in childhood age groups in terms of signs and symptoms, and the number of cases increased slightly over the years, especially in children with lymphadenopathy, splenomegaly and hepatomegaly.

Aim: The aim of this study was to primarily investigate the effects of selected anesthesia method on anxiety, patient satisfaction and pain level in elective caesarean section, and secondarily obtain information about quality of service.

Materials and Methods: The study was carried out as a prospective questionnaire in the Department of Anaesthesiology and Reanimation the Meram Medical Faculty Hospital of Necmettin Erbakan University between June 2017 and August 2017, on 160 volunteers aged between 18 and 45 years for whom elective cesarean section under General Anesthesia (GA) or Spinal Anesthesia (SA) was planned. Demographic data of the patients such as age, place of residence, education level, number of children, and cesarean experiences were recorded. In the preoperative and postoperative period, anxiety levels were measured by State-Trait Anxiety Inventory (STAI-D), pain levels were measured by Visual Analog Scale (VAS) scores and satisfaction levels were evaluated at postoperative 6th and 24th hours by (Quality of Recovery: QoR 40 T) questionnaire.

Results: There was no statistically significant difference between the patients' preoperative and postoperative anxiety scores and demographic data (p> 0.05). Patients with previous cesarean experience had lower preoperative anxiety levels (p <0.05). The STAI-D scores and the numbers of patients with anxiety in the GA and SA groups were similar (p> 0.05).Postoperative anxiety levels were significantly lower in both groups than in the preoperative period (p <0.05). VAS values of the SA group at the 6th and 24th hours were significantly higher than the group treated with GA.(p<0.05). The 24th hour VAS values of the SA group were higher than the VAS values at the 6th hour (p <0.05). In the GA group, VAS values at 24th hour were lower than the VAS values at 6th hour (p <0.05). The satisfaction levels of general anesthesia and spinal anesthesia were similar in the postoperative period (p> 0.05). Complaint of headache was high in SA group while complaint of sore throat was high in GA group(p<0.05). While there was no correlation between anxiety level, VAS values and satisfaction level (p> 0.05), there was a negative correlation between VAS values and pain parameters, which are the subgroup of satisfaction questionnaire, in both groups (p <0.05).

Conclusion: It is concluded that the preferred anesthesia method in elective cesarean section has no effect on anxiety and satisfaction, and the patient satisfaction level and service quality will be improved by providing effective analgesia by reviewing our postoperative pain algorithm.

Background: The aim of this study was to develop a fructose- and iron-mediated model of steatohepatitis, which is similar to the human phenotype.

Methods: We randomly divided ninety 1.5 months old female Wistar-Albino rats into three groups. All three groups contained 30 rats in each group and 5 subgroups per group. While the control group was fed ad libitum, the fructose group’s feed consisted of 60% fructose in drinking water and that of the fructose-iron group consisted of 60% fructose in drinking water along with intraperitoneal administration of iron every 2 weeks. We performed laparotomies at 2-week intervals (at 2, 4, 6, 8, and 10 weeks) in all subgroups.

Results: None of the groups had hepatosteatosis or fibrosis at the end of the 10th week. Hepatocellular ballooning scores were significantly higher in the fructose-fed groups than in the control group (p<0.001). At 10th week serum ferritin levels in the fructose-iron group were significantly higher than those in the control and fructose groups (p<0.001). Iron accumulation in the rat liver was observed in the fructose-iron group histopathologically by the 4th week.

Conclusion: Chemically and histopathologically, a model of steatohepatitis can not be developed in young and female rats with 60% concentrated fructose feeding and administration of iron for 10 weeks. To develop a model of steatohepatitis resembling the human phenotype, it is more advisable and feasible to use adult male rats fed meals combined with fructose in order to maintain adequate hydration and nutrition for at least 16 weeks.

ANTEGRAD URETERAL STENTING; INDICATIONS - METHODS - COMPLICATIONS AND RADIOLOGICAL APPROACH TO  COMPLICATIONS

Abstract:

Objectives

The aim of this study is to evaluate the indications, success rate, complications, technical success enhancing method, methods of antegrad ureteral stenting and the radiological management of complications due to retrograde and antegrade ureteral stenting in the treatment of ureteral obstructions and ureteral leaks caused by malignant and benign etiologies.

Materials and Methods

In this retrospective study, fluoroscopy and US-guided antegrade ureteral stenting procedures between January 2016 and December 2018 were examined. The study included 110 antegrade ureteral stenting and percutaneous nephrostomy in a total of 78 patients with 25 female patients (32.05 %), a mean age of 65.87 (20-90) and 53 male patients (67.94%) with a mean age of 68.73 (30-90).  Demographic data, antegrade ureteral stenting indications, procedure results and complications were evaluated for each patient.

Results

Antegrade ureteral stenting is a good alternative for patients with retrograde ureteral stent placement and already with percutaneous nephrostomy catheters. It has a high technical success rate and low complication risk. The use of the equipment used in other radiological procedures in antegrade ureteral stenting increases the technical success. Malposition,  perforation, hemorrhage, urinoma, abscess complications such as retrograde or antegrade ureteral stenting can be managed by radiological methods.

Key Words: Double J Ureteral stent, Ureteral obstruction, Percutaneous, Antegrade, Hydronephrosis,

Aim: The aim of this study was to determine pressure ulcer prevention knowledge and attitudes among nurses who cared for surgical patients that were exposed to pressure ulcer risk factors such as immobilization and nutritional problems.

Materials and Method: This descriptive study was carried out with 150 nurses who were working in the surgical clinics and surgical intensive care units of a medical faculty hospital in XXXX and who had at least one year’s professional experience. Necessary permissions were obtained from the ethics committee and the institution prior to the research. Data were collected with a patient information form, the Pressure Ulcer Prevention Knowledge Assessment Instrument (PUPKAI) and the Attitude towards Pressure ulcer Prevention instrument (APuP) between October 1, 2018 and February 1, 2019.  Data were analyzed with the independent-samples t-test, the Mann-Whitney U test, the Kruskal-Wallis test, the correlation analysis and the multiple regression analysis.

Results: The mean age of the nurses was 29.91±6.48 years, 65.3% were female and half of them had undergraduate degrees. According to the PUPKAI total mean score (<60%), the pressure ulcer prevention knowledge of the nurses was inadequate and only 24% had a knowledge score ≥60%. Regression analysis results showed that, nurses' professional experience duration, working style, number of patients per shift and the experiences of giving care to patients with pressure ulcers were found to have a significant effect on the PUPKAI total mean score (p<0.05). According to the APuP total mean score (≥75%), the nurses had positive attitudes towards pressure ulcer prevention. It was also determined that the descriptive characteristics of the nurses did not significantly affect the APuP total mean score (p>0.05). There was no significant relationship between the total mean scores of the PUPKAI and APuP (p>0.05).

Conclusion: This study revealed that the surgical nurses had positive attitudes towards pressure ulcer prevention but they had inadequate knowledge about it. These findings highlight the need for institutional arrangements to ensure that nurses have access to evidence-based knowledge about pressure ulcer prevention.

Aim: It is important to identify allergens in reducing disease-related symptoms and improving quality of life in the allergic diseases. Therefore, we aimed to evaluate the frequency of aeroallergens in allergic patients in our region.

Method: 1078 patients (2-18 years) who applied to the pediatric allergy immunology outpatient clinic between September 2017- March 2018 were included to the study. The demographic and clinical characteristics of 642 patients with at least one allergic sensitization in the skin prick test were evaluated retrospectively. Total IgE levels, peripheral eosinophil counts in the blood, aeroallergen sensitivities in skin prick test were evaulated from the patient’s files. The study was approved by the Ethics Committee of the Alanya Alaaddin Keykubat Medical Faculty.

Results: In 642 of the patients (59.5%), a positive response was observed against at least one aeroallergen. Among patients, 34.8% had asthma, 73.7% had allergic rhinitis, 12.6% had atopic dermatitis, and 3% had chronic urticaria. 24.8% of the patients (159) had more than one allergic disease. When the evaulation of the patients with positive skin prick test, 57.3% were male and 42.7% were female. The mean age was 8.49 +/- 4.15 years. The sensitivity of house dust mites was the most common (76.1%). In the second and third frequency, molds (51.8% Alternaria alternata, 41.7% Claudosporum herbarum) and grass and cereal pollen (39.8%) sensitivity were observed. Other determined aeroallergen sensitivity frequencies were; weed pollen mixture (24.6%), trees pollen mixture (21.7%), cockroach (17.8%), cat hair (31.2%), olive tree (20%). The mean serum total IgE level was 215.6 IU/ml and the mean eosinophil count was 410.63/mm³.

Conclusion: Detection of responsible allergens is important to control symptoms and to give the chance the course of the disease with immunotherapy in the selected cases.

Ani işitme kaybı, hiperbarik oksijen tedavisi, prognostik faktörler

Foreign body aspiration (FBA) is a serious problem especially in pediatric age group. Delay in diagnosis and intervention can lead to a life-threatening condition. Young children are more concerned with the environment and neuromuscular mechanisms do not develop sufficiently. Factors such as lack of molar teeth and failure to perform chewing are the main causes of high FBA in children under 3 years of age. It is of vital importance that the patient is referred to a hospital where a rigid bronchoscopy can be performed quickly after the diagnosis. We retrospectively evaluated 47 patients who were treated in our clinic such as clinical symptoms, age, gender, foreign body (FB), location, positive radiological findings, and duration of stay.

47 patients; 29 male (63%), 18 female (37%), age ranging from 3 months to 8 years. The age of the 37 patients (80%) was below the age of 3 years. The main complaint at the time of admission was cough (80%) in 37 patients, wheezing in 23 patients (50%), shortness of breath in 15 patients (32.6%), infection in 5 patients (10.8%), high in 2 patients. there was fever (4.3%). In 37 patients (78%), the foreign body was of organic origin (such as inside or outside the shell, peanuts, hazelnut pieces) while in 10 patients (22%), an inorganic foreign object was found (such as a pen tip, a toy part, plastic parts, etc.). FB was located in the right main bronchus in 18 patients (39%), in the left main bronchus in 25 patients (51%) and in the trachea in 4 patients (8.7). There were no radiological findings in 18 patients (39%). Although 11 patients (23.9%) were anamnesis, their findings were normal. Twenty-three patients applied to our clinic within the first 24 hours after the event, and 24 patients were admitted to our clinic 24 hours after the event.

Although the results were generally consistent with the literature, the left main bronchus was 51% in terms of the localization of FB.

Context: Alcohol dependence syndrome is a major problem affecting both individuals and their family. Children of alcohol dependent parents are vulnerable to a host of behavioural problems. Studies in the west have shown both internalizing and externalizing symptoms in these children.

Aims: To assess the psychological functioning in offspring of alcohol dependent parents and its association with severity of alcohol dependence.

Settings and Design: This study was conducted at the Department of Psychiatry of a Tertiary hospital in Bangalore spanning a period of one year. Eighty children aged 11 years - 18 years, along with their alcohol dependent fathers were included.

Methods and Material: Socio demographic details of the parent and the child were collected by a semi structured Performa along with informed consent. Alcohol dependence was diagnosed based on ICD 10 criteria. Severity of Alcohol dependence was assessed using Severity of Alcohol Dependence Questionnaire (SADQ). Psychological functioning of the children was assessed using Youth Self Report Scale (YSR).

Statistical analysis used: descriptive statistics, and Chi-square test

Results: Among 80 children assessed 41 were males and 39 were females. 47.5% of them showed significant internalizing symptoms and 48.7% significant externalizing symptoms. Internalizing scores had higher correlation with girls (P – 0.004) and externalizing symptoms in boys (P – 0.008). However no correlation was found with severity of dependence in the father.

Conclusions: It was found that there was high prevalence of psychiatric morbidity in terms of externalizing and internalizing behaviours in children of alcohol dependent fathers. Thus early detection of these problems and intervention would ensure improved functioning in this group.

OBJECTIVE: Studies have demonstrated that regular aerobic exercise improves several aspects of cognition such as attention, executive functions, memory and processing speed.  However, it is not clear how elite-level strength training affects cognitive function during adolescence. The aim of this study was to determine how a single session of strength training affects cognition in highly trained adolescents.

METHODS: Motor functions, ability of sustaining attention and executive functions of 25 elite female weightlifters were evaluated through finger tapping performance, simple visual reaction time (S- VRT), complex visual reaction time (C-VRT), simple recognition visual reaction time (SR-VRT) and complex recognition visual reaction time (CR-VRT) tests. Weightlifters were tested before and after a training session. 

RESULTS: There was a significant increase in mean CR-VRT of weightlifters after training (p<.01). In SR-VRT and CR-VRT tests, rate of false answers increased significantly after training (p<.05). Total number of taps and mean inter-tap intervals did not show any difference among weightlifters before and after training (p>.05). 

CONCLUSION: Adolescent weightlifters’ executive functions are deteriorated following a training session. In future studies, the duration of this deteriorating effect of strength training can be investigated.

Towards the end of 2019, new coronavirus causing acute respiratory distress syndrome in patients was detected in Wuhan Province, China . This virus was called serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the International Virus Taxonomy Committee. The disease caused by this new coronavirus was called coronavirus disease-2019 (COVID-19) by the World Health Organization. This virus was found to be in the subclass of Betakoronavirus caused by bats. The role of viral proteins such as envelopes, membranes, nucleocapsids and spike proteins responsible for viral infectivity in immunopathogenesis is being investigated in studies. It has been emphasized in studies in which multiple organ failure develops due to the development of cytokine storm, especially in the advanced stages of the disease. An effective host immune response, including natural and adaptive immunity to SARS-Cov-2, is essential for controlling and treating viral infection. Although there is no effective treatment for the disease today, the benefits of various immunosuppressive and immunomodulatory drugs have been shown in studies. In this article, the immunopathogenesis of SARS-CoV-2 and the treatment models that can be effective on immunopathogenesis are reviewed in the light of current literature.

Platelet-rich plasma has become increasingly popular in recent years, and it is a plasma component that contains a high concentration of platelets, which is obtained by centrifugation of blood. It was first used in 1987 to reduce the transfusion of homologous blood products following open heart surgery. In recent years, in addition to dermatology, the use of Platelet-rich plasma has been increasing in many medical branches such as orthopedics, physical therapy, plastic surgery, cardiovascular surgery, maxillofacial surgery, urology and ophthalmology. Dermatology are still increasingly being used in many different indications. The results obtained in the studies give hope and indicate a new indication every day. However, in studies, the lack of application stand and the low number of patients are seen as limiting effects. Before determining the exact indications of the Platelet-rich plasma, standardization of applications and controlled studies on large patient populations are needed.

Sustainability is satisfying the needs of present generation by pro tecting presence and quality of resources that future generations will need. A sustainable nutrition system refers to a diet with low environmental impacts which contribute to food and nutrition security for healthy life for present and future generations. Nutrition systems has changed as a result of growing global population, developing the technology, urbanization and industrialization. This situation result in environmental problems as water resources and land uses and increasing greenhouse gases emissions in addition to several health problems notably increasing cronic diseases incidence. Environmental changes and nutrition systems are interrelated. A nutrition model which is containing animal based food enough and plant based can supply sustainability of health and environment.

Systemic Lupus Erythematous, autoimmune character, is a inflammative disease holding many systems. The disease can sometimes follow insidiously with symptoms of fever, asthenia and prostration for years. Central nervous system is common. It is the clinical variable and may be very mild or very severe. In most patients, the age of onset is between 16-55 years old and is found in cases diagnosed in advanced age. Here, it is presented an elderly patient developed dizziness and right side prostration when she was 80 and diagnosed lupus when she was 85. We thought as worth for presenting because of that both the patient is elder and that the lesions have similar features with demyelinating plaques. The lupus should not be forgotten in the central nervous system involvement in advanced age cases and separator diagnosis.