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The Effect of Trandolapril on Insulin Resistance is Determined by the Degree of Baseline Resistance Level

Original Article

The Effect of Trandolapril on Insulin Resistance is Determined by the Degree of Baseline Resistance Level

Canan Ersoy, Alparslan Ersoy, Gulsah Elbuken, Ercan Tuncel

   

Abstract
Insulin resistance (IR) is the core problem in type 2 diabetes mellitus that may lead to cardiovascular morbidity and mortality. Hypertension commonly accompanies type 2 diabetes. Antihypertensive agents improving IR may reduce the risk of cardiovascular diseases. This study was conducted to assess the effect of trandolapril on IR, glucose and lipid metabolisms in hypertensive subjects with different degrees of IR and investigate the importance of IR level in angiotensin converting enzyme inhibitor response. The subjects were nondiabetic and type 2 diabetic hypertensive patients treated with trandolapril for 12 weeks. Blood pressures (BP) and metabolic parameters were measured in all patients at baseline and after 12 weeks of trandolapril treatment and compared. Trandolapril reduced BP similarly in nondiabetic and diabetic patients. Homeostasis model assessment insulin resistance (HOMA-IR), serum glucose and hemoglobin A1C (A1C) in diabetic patients were higher than nondiabetics. HOMA-IR (from 9.0  1.0 to 6.6  0.7, p4.67 responded better. In conclusion, trandolapril improved insulin sensitivity better in type 2 diabetic hypertensive patients with higher degree of IR compared with the ones with low grade IR, being independent of its hemodynamic action.

Key words: Trandolapril, insulin resistance, type 2 diabetes mellitus, glucose, lipid

Med-Science. 2014; 3(2): 1140-54

Medicine Science Vol:3 Issue:2 Year:2014 PP:1140–1342

Frequency of Subclinic Hypothyroidism at the Patients That Are Using Valproic Acid

Original Article

Frequency of Subclinic Hypothyroidism at the Patients That Are Using Valproic Acid

Mehmet Ibrahim Turan, Atilla Cayir, Ibrahim Selcuk Esin, Yasemin Cayir, Huseyin Tan

   

Abstract
Valproic acid is one of the most commonly used anti-epileptics in the treatment of childhood epilepsy. The aim of this study was to determine the risk factors for and incidence of subclinical hypothyroidism (SH) in children with idiopathic epilepsy using valproic acid (VPA). Patients monitored with a diagnosis of idiopathic epilepsy, using valproic acid for longer than 12 months and who were seizure-free for at least 6 months were included in the study. Levels of free thyroxine, free triiodothyronine and thyrotropin were measured. The results were then compared with those of the control group. Rates of SH in patients using VPA and the control group were 18.5% and 6.2%, respectively. The difference was statistically significant (P0.01). In conclusion, SH is a common effect seen in children with epilepsy using VPA. It will be beneficial to measure thyroid functions at specific intervals.

Key words: Child, epilepsy, valproic acid, hypothyroidism

Med-Science. 2014; 3(2): 1155-61

Comparison Between Nitazoxanide and Metronidazole in the Treatment of Protozoal Diarrhea in Children

Original Article

Comparison Between Nitazoxanide and Metronidazole in the Treatment of Protozoal Diarrhea in Children

Asmaa A.E. Ali, Mohamed E.A. Abdelrahim, Neveen A. Elmoslamy, Amira S.A. Said, Mohamed H. Meabed

   

Abstract
Diarrheal disease is a leading cause of illness and death in children worldwide. Diarrhea is caused by a blend of bacterial, viral and parasitic pathogens. Enteric protozoal infections such as giardiasis, amebiasis and cryptosporidiosis are among the most common and most prevalent forms of gastrointestinal parasitic infections worldwide. Both nitazoxanide and metronidazole are used in treatment of protozoal diarrhea. Nitazoxanide was found to have a very broad spectrum of activity against many forms of parasites. Metronidazole also produces good results when it is used for treatment of parasitic infections. The aim in this study was to evaluate and compare the effect of nitazoxanide and metronidazole in treatment of protozoal diarrhea in children. This study was carried out on 160 diarrheic patients (83 males and 77 females), aged from 1-11 years old collected from the-clinics of pediatric department at Beni suef University Hospital. Patients were divided into two groups. Group A received Nitazoxanide 100 mg in 1-4 years aged patients and 200 mg in 4-11 years aged patients twice daily for 3 days respectively, Group B received Metronidazole 50 mg/Kg/body weight daily for 7 days. Patients were represented to full history taking, physical examination, laboratory investigations in the form of stool analysis, culture and complete blood count (CBC). There was a significant increase in the number of cases resolved by Nitazoxanide compared to Metronidazole group in both amebiasis and giardiasis (p-value < 0.05) with similar clinical improvement when using Nitazoxanide for 3 days and Metronidazole for 7 days.
This study confirms the efficacy and safety of nitazoxanide as a 3-day treatment of diarrhea due to giardiasis & amebiasis in children. A 3-day course of nitazoxanide could replace much longer regimens of metronidazole

Key words: Gastroenteritis, diarrhea, metronidazole, nitazoxanide

Med-Science. 2014; 3(2): 1162-73

The Effect of Gentamicin on the Action of Atracurium in Adult Patients

Original Article

The Effect of Gentamicin on the Action of Atracurium in Adult Patients

Walid A.A. Abdeltawab, Mohamed E.A. Abdelrahim, Amira S.A. Said, Ahmed A. Ahmed, Mahmoud A. Nassef

   

Abstract
The aim of the trial was to study the effect of Gentamicin as an aminoglycoside on Atracurium as a neuromuscular blocker. Forty patients (20-60 years old) who had minor surgical procedures were enrolled in the study. All the patients were with the American Society of Anaesthesiologists (ASA) physical status I-II with elective surgery in supine position. Patients were represented to full history, clinical examination and laboratory tests at Beni suef University Hospital to be sure that they met the criteria. Patients were divided into two equal groups. Group I (Atracurium-Gentamicin) and Group II (Atracurium alone). Group I received Gentamicin at dose of 2 mg/kg 5 minutes before starting the general anesthesia. The degree of muscle relaxation was monitored by using peripheral nerve stimulator with recording of Train of Four (TOF) ratio every 10 minutes. Clinical duration, onset time, time to spontaneous recovery T4/T1 ratio and occurrence of recurrence of the neuromuscular blockade were assessed. At the end of anesthesia it was noticed that there was no significant difference according to onset time, clinical duration or time to spontaneous recovery. Hence, there was no effect of using Gentamicin preoperatively on the action of the Atracurium.

Key words: Gentamicin, atracutium, neuromuscular blocker

Med-Science. 2014; 3(2): 1174-82

Perception Differences in Violence against Child

Original Article

Perception Differences in Violence against Child

Ahsen Kaya, Ekin O Aktas

   

Abstract
Objectives: Mostly, people who apply violence do not realize the effects of it, especially child victims give strong emotional responses to violence. Behaviors without any intention of abuse or neglect can mostly be seen among the people, who are dealing with children intensely like teachers and parents. Aim of this work is to determine the perception differences of parents, teachers and children in violence.
Methods: Revised form of Childhood Trauma Questionnaire and also 17 parameters related to violence were applied to children, parents and teachers and then their answers were compared with each other.
Results: Questionnaires were responded by 411 children, 135 parents and 85 teachers. In each three groups, it was noticed that the ratio of perception of violence in parameters related to physical violence was higher than in parameters related to emotional violence. While the teachers had the highest perception of violence, children had the lowest perception of violence.
Conclusions: Sensitiveness in perception of violence and education on this subject are not enough to stop violence. It must be prevented to apply violence in society for an aim of discipline and education and violence must not be seen as a way of teaching good manners. It also must not be applied as a tool for solving problems, gaining power and control. The rights of violence victims, especially children’s rights must be protected and there must be intimidating sanctions for people who practice violence on the others.

Key words: Child Abuse, behavior, neglect, victim.

Med-Science. 2014; 3(2): 1183-97

Perception Differences in Punishment Methods against Child

Original Article

Perception Differences in Punishment Methods against Child

Ahsen Kaya, Ekin O Aktas

   

Abstract
Potentially, all children have the risk of encountering with the ill-treatment of adults. In Turkey, discipline oriented punishment behaviors are social problems because of their traditional acceptability. In this study, the comparison of punishment methods both physical and emotional, which parents and teachers state to apply on their children/students and which the children state, assessment of perception differences were presented. By using randomized cluster sampling, it was chosen 4 schools from 27 elementary schools in Cigli, Turkey. The questionnaires about punishment methods were applied to students, parents and teachers. Answers of 411 students, 135 parents and 85 teachers are evaluated by SPSS program (version 13.0). Statistically significant difference is detected in perception of physical punishment methods among parents (2.6%) and their children (11.4%), and in perception of both physical (respectively 4.9% – 13.7%) and emotional (respectively 65.6%-35.7%) punishment methods among teachers and their students. A statistically significant difference has not been detected among the emotional and economical punishment methods stated by parents and their children. Emotional punishment methods are detected to be specified to a greater amount by teachers as compared to both children and parents. The physical punishment methods are still applied methods at home and at school in Turkey. Emotional punishment methods are more acceptable by parents and children than teachers. In Turkey, necessary precautions and consciousness raising programs should be applied for especially the physical punishment methods not to be seen as an acceptable behavior both at home and school.

Key words: Child abuse, punishment, parent, teacher, violence

Med-Science. 2014; 3(2): 1198-208

The Challenges in Autopsy Cases Exposed to Animal Attack

Original Article

The Challenges in Autopsy Cases Exposed to Animal Attack

Murat Bulent Tokdemir, Gursel Cetin, Bulent Sam, Erdal Ozer, Ali Yildirim, Celal Butun

   

Abstract
Discrimination between antemortem and postmortem lesions inflicted by animals from other traumas, and contribution of these injuries to the cause of death which is often encountered in forensic autopsies may cause some difficulties. Detailed identification, and, evaluation of bite marks which has the depth and shape of the teeth and jaw of the animal interfering to the cadaver, tissue losses, paw and tooth marks nd vital signs must be performed during autopsy. Current autopsy reports filed in the Morgue Department of Council of Forensic Medicine between the years of 1996 and 2001 had been retrospectively screened and various cases inflicted by animals during antemortem, perimortem and postmortem periods had been included in the study in order to determine emerging problems in autopsy cases with signs of animal attack and develop recommendations for points to be considered in these cases. Location of animal attack, severity of injury, typical wound characteristics, differential diagnosis among other lesions, the cause of death and effects on identification of the victim and consequences in terms of forensic medicine were evaluated based on autopsy reports of 130 cases. Postmortem (n=129 cases) and antemortem (n=1) signs of animal attack were detected. Lesions were commonly caused by marine animals, and observed on the head region. The identity of the victims, and cause of death couldn’t be determined in 22, and 48 % of the cases, respectively. When we consider the problems encountered during phases of determination of the cause and type of death and identification of the signs of postmortem animal scavening, the importance of forensic medicine approach in crime scene investigation on antemortem and/or postmortem animal attacks, identifying the profile of the offending animal and the challenging autopsy procedure becomes much more clear.

Key words: Autopsy, animal intervention, postmortem, bite

Med-Science. 2014; 3(2): 1209-23

The Usage of Ocular Trauma Scoring in the Visual Prognostic Evaluation of Traumatic Eye Injury

Original Article

The Usage of Ocular Trauma Scoring in the Visual Prognostic Evaluation of Traumatic Eye Injury

Burak Turgut, Sabiha Gungor Kobat, Rumeysa Tanyıldızı

   

Abstract
Aim of this study was to investigate the visual prognostic value of ocular trauma score (OTS) in traumatic eye injuries. A hundred and fourteen patients with the ocular trauma, which were underwent surgery between January 2008 and January 2012 at Firat University Hospital Clinic of Ophthalmology, were included in the study. The medical records of the patients were reviewed retrospectively. Similarly to the OTS study group, patients were divided into five groups based on their visual acuity (no light perception (NLP), light perception / hand movements (LP/HM), 1/200-19/200, 20/200-20/50, 20/40 and up) at the presentation. Ocular trauma classification was made according to the Birmingham Eye Trauma Terminology (BETT). The variables used in ocular trauma score (initial and final visual acuity, rupture, endophthalmitis, perforation, retinal detachment, afferent pupillary defect) were evaluated for each patient individually. A numerical value (raw number) was assigned to each of these variables. Numerical values related to the OTS variables were converted into OTS categories and the possible or expected visual outcome and prognosis were obtained. The percentages of the eyes in each category in the OTS study were compared with those of the eyes in our study. The average follow–up duration of patients was 10 months (range 5-12 months). The average age of patients was 24,7± 21,3 (1-86) years. Of the 27 (24%) were females and 87 (76%) were males. When we compared the table of distribution of final visual acuities in all OTS categories, in our group, NLP ratios were significantly lower in category 1 and 2 (p=0.0017, p=0.00009, respectively), whereas LP/HM ratios in categories 1, 2 and 3were significantly higher in our group than in the OTS study (p=0.00002, p=0.001, p=0.000001, respectively). When we compared final visual acuities in each categories of our study and the OTS study, in our study, 20/200 to 20/50 and 20/40 and over ratios in categories 2 and 3 were significantly lower than those in the OTS study, (p=0.00003, p=0.003, p=0.000001, respectively). 20/200 to 20/50 ratio in category 4 in our group was significantly higher than that in the OTS group (p=0.000001), whereas 20/40 and over ratio in category 4 in our study group was significantly lower than that in the OTS group, (p=0.000001, respectively). Ocular trauma scoring might provide information about visual outcomes of injury and categorical evaluation of traumatic ocular injuries at initial examination.

Key words: Visual acuity, ocular trauma score, prognosis, ocular trauma

Med-Science. 2014; 3(2): 1224-33

HBV, HCV and HIV Seroprevalence in Soldiers Tested for Carriership

Original Article

HBV, HCV and HIV Seroprevalence in Soldiers Tested for Carriership

Ozcan Deveci, Cem Uysal, Recep Tekin, Ali Cem Tekin, Muzeyyen Ay, Fatma Bozkurt, Saim Dayan

   

Abstract
Individuals employed or recruited to work in tourism, cleaning and food sectors and the men performing their military service in the food and cleaning services in the military are requested to undergo scans for the hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency (HIV) viruses as part of the carrier testing. The aim of the present study is to evaluate the seroprevalence of HBV, HCV and HIV in the soldiers scanned in terms of carriership. The study was conducted in the Kiziltepe State Hospital through the retrospective evaluation of the records of the soldiers who presented to the infectious diseases clinic between March 2010 and December 2012 for carriership scans. The HBV, HCV, and HIV tests were carried out in the central laboratory of the Kiziltepe State Hospital through the microparticle enzyme immunoassay (MEIA) method using the Axsym Plus Immunoessay Autoanalyzer (Abbott Laboratories, Abbott Park, Illinois, USA). The records of 367 soldiers between the ages of 20-22 were included in the study. Among these, 5 (1.36%) were HBsAg and 2 (0.55%) were anti-HCV positive, while none of them were positive for HIV. In order to reduce the risk of HBV, HCV and HIV infections, which are mainly transmitted through blood and sexual intercourse, preventive measures should be taken, education should be given and awareness should be increased. Especially individuals who are employed in sectors where the transmission risk is high should be periodically scanned and monitored for infection and diseases caused by these viruses.

Key words: HBV, HCV, HIV, seroprevalence, risk groups, troops

Med-Science.2014; 3(2): 1234-40

Nasolacrimal Duct Orifice: A Cadaveric Study in Relation to Important Anatomical Landmarks

Original Article

Nasolacrimal Duct Orifice: A Cadaveric Study in Relation to Important Anatomical Landmarks

Vrinda Ankolekar, Mamatha Hosapatna, Aswin Das, Supriya Padmashali, Anne D Souza, Antony Sylvan D Souza

   

Abstract
The nasolacrimal apparatus is intimately associated with the lateral nasal wall and may be approached using an endoscopic technique. This study was undertaken to describe in detail the gross anatomy of the nasolacrimal duct orifice in relation to various landmarks of the lateral nasal wall to improve the safety and efficiency of endoscopic surgical procedures. The study was conducted on 25 sagittal sections of adult cadavers in the Department of Anatomy, Kasturba Medical College, Manipal. The parameters measured were the distance from nasolacrimal duct orifice (NO) to the anterior end of middle concha (MC), distance from NO to the anterior nasal spine (ANS), distance from NO to the nasal floor (NF), distance from NO to anterior end of the inferior concha (AIC), and distance from NO to posterior end of the inferior concha (PIC). The shape of the NO was also observed and classified as oval, round and slit. The distance from NO to ANS was 2.73± 0.26 cm, the distance from NO to NF was 1.19± 0.34 cm, the distance between NO to MC, NO to AIC and PIC were 2.55 ±0.28 cm, 1.85±0.3 cm and 3.4±0.36 cm respectively. We also observed 3 types of shapes of NO, majority were slit like followed by oval and round. Knowledge of the anatomy of the nasolacrimal apparatus is essential for the surgeon during the performance of endonasal cystorhinostomies and maxillary osteotomies.

Key words: Nasolacrimal duct orifice, anterior nasal spine, middle concha, inferior concha

Med-Science. 2014; 3(2): 1241-8