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Evaluation of Neuroimaging and Electroencephalography Findings in Patients with Status Epilepticus [Status Epileptikus Tanısıyla İzlenen Hastaların Nörogörüntüleme ve EEG Bulgularının Değerlendirilmesi]

Original Article

Evaluation of Neuroimaging and Electroencephalography Findings in Patients with Status Epilepticus [Status Epileptikus Tanısıyla İzlenen Hastaların Nörogörüntüleme ve EEG Bulgularının Değerlendirilmesi]

Berrak Bilginer Gurbuz, Fatih Gurbuz, Atilla Cayir, Irfan Oguz Sahin, Deniz Okdemir, Alev Guven, Aydan Degerliyurt, Gulsen Kose

   

Abstract
Status epilepticus (SE) is one of the most important pediatric emergent conditions because of major cause of morbidity and mortality. SE should be diagnosed and treated emergently, because it is one of the diseases that may lead to serious sequalea. The aim of the study is to evaluate neuroimaging methods and electroencephalography (EEG) findings of patients with SE, who were under follow up at our hospital. 162 patients (age range, 0-18 years) with SE treated and followed at our hospital between December 2006 and May 2009 were enrolled in our study. Patient’s age, sex, MRI- CT imaging and EEG findings were recorded from patient’s files. Patient’s age and sex were similar. CT was available in 41 patients and MRI was available in 36 patients. CT results of 28 patients were normal, but some pathologies were found in 13 patients. MRI results of 14 patients were normal, but some alterations were detected in 22 patients. EEG was present in 97 patients. EEG results of 49 patients (%50.5) were normal. Consequently, there is no enough data regarding the necessity of the use of neuroimaging methods in case of previous etiology-confirmed SE. However, neuroimaging methods may be considered useful to determinate etiology of SE, response to treatment, and effects on long-term prognosis. Moreover, we can highlight that the early period EEG may be important in determining prognosis.

Key words: Status epilepticus, children, neuroimaging, EEG

Med-Science. 2015; 4(3): 2356-63

Medicine Science Vol:4 Issue:3 Year:2015 PP:2356-2699

Comparison of Conventional Inflammatory Parameters with Tumor Necrosis Factor- α Levels in Different Stages of Diabetic Retinopathy and Non-Diabetic Controls

Original Article

Comparison of Conventional Inflammatory Parameters with Tumor Necrosis Factor- α Levels in Different Stages of Diabetic Retinopathy and Non-Diabetic Controls

Metin Guclu, Berkant Kaderli, Canan Ersoy

   

Abstract
Aim of this study was to identify the risk factors associated with diabetic retinopathy in patients with Type 2 diabetes mellitus(DM), and to compare the levels of erythrocyte sedimentation rate (ESR), high sensitive CRP(hs-CRP) and tumor necrosis factor-α (TNF-α), in patients with every stage of diabetic retinopathy and non-diabetic healthy controls. A total of 79 individuals, 64 diabetic and 25 healthy controls were included in the study. Patients were divided into three groups. Group 1 consisted of those without diabetic retinopathy (DR) (n=26), group 2 with non-proliferative (NPDR) (n=19), and group 3 with proliferative diabetic retinopathy (PDR) (n=19). Even though the similar age distribution, disease duration were different as 6.9 ± 6.5, 10.3 ± 5.4, and 12.7 ± 5.1 years in Group 1, Group 2 and Group 3, respectively (p>0.001). The majority of the patients with PDR were male, had high levels of albuminuria and high percents of receiving insulin treatment (p

Key words: Diabetic retinopathy, inflammation, hs-CRP, TNF-α, postprandial blood glucose

Med-Science. 2015; 4(3): 2364-78

The Change of Neutrophil Lymphocyte Ratio in Acute Appendicitis

Original Article

The Change of Neutrophil Lymphocyte Ratio in Acute Appendicitis

Egemen Kucuk

   

Abstract
Acute appendicitis is the most common indication for emergency abdominal surgery, although it remains difficult to diagnose. Aim of this study is to investigate the supporting role of neutrophil/lymphocyte ratio in diagnosis of acute appendicitis. The medical records of 241 patients who had undergone appendectomy between June 2013 and March 2014 were investigated retrospectively. Sixty patients who had undergone at least one complete blood count during preoperative hospital admission and who had no other active inflammatory conditions at the time the sample was taken were included in the study. Neutrophil/lymphocyte ratio and leukocyte count values were determined in each patient at hospital admission and during active acute appendicitis. Age, sex, neutrophil/lymphocyte ratio and leukocyte counts were recorded for each patient. The mean age of the patients was 33.15±10.94 years, male to female ratio was 1.5:1. Mean leukocyte count was significantly higher in acute appendicitis group (13.14±2.99×103/mm3) than control group (7.42±2.12×103/mm3) (p=0.01). The best cutoff point for leukocyte count was 10.10×103/mm3, with sensitivity of 94% and a specificity of 75%. Mean neutrophil/lymphocyte ratio was significantly higher in acute appendicitis group (5.47±3.24) than control group (1.99±1.11) (p=0.02). The best cutoff point for neutrophil/lymphocyte ratio was 1.73, with sensitivity of 97% and a specificity of 87%. Area under receiver operating characteristic curve was 0.67 for leukocyte count and 0.60 for neutrophil/lymphocyte ratio. Neutrophil/lymphocyte ratio was significantly higher in acute appendicitis and can be used as a supportive diagnostic parameter in the diagnosis of acute appendicitis.

Key words: Acute appendicitis, Neutrophil/lymphocyte ratio, Diagnosis.

Med-Science. 2015; 4(3): 2379-87

Comparative Study of Orotracheal Intubation through Air Q Laryngeal Mask Airway: Blind Versus Fiberoptic Guided During General Anesthesia

Original Article

Comparative Study of Orotracheal Intubation through Air Q Laryngeal Mask Airway: Blind Versus Fiberoptic Guided During General Anesthesia

Mahmoud M. Amer, Doaa A. Rashwan, Reham M. Essawy

   

Abstract
This study was designed to compare the hemodynamic and arousal responses to blind orotracheal intubation through Air Q laryngeal mask airway versus flexible fiberoptic guided. 100 adult patients ASA I and II undergoing elective surgeries under general anesthesia with orotracheal intubation were divided into two groups according to the technique of intubation through Air-Q ILA Group І (n= 50) patients intubated blindly through Air-Q ILA Group ІІ (n=50) patients intubated through Air-Q ILA guided by flexible fiberoptic bronchoscope. The following parameters were recorded: heart rate, systolic, diastolic and mean arterial blood pressure and Bispectral Index (BIS) values: preinduction, after induction of anesthesia, then at 1 and 5 minutes after intubation, arterial oxygen saturation (SpO2): before, during and after intubation, time of insertion(in seconds) and number of attempts of insertion of the endotracheal tube and airway complications; injury to the gums or teeth damage, hoarseness of the voice, bleeding, sore throat. Systolic and mean arterial blood pressures were statistically significant lower in the fiberoptic group than the blind group. There was no statistically significant difference between the two groups in the heart rate and diastolic blood pressure.There was statistically significant lower time of intubation and less number of attempts in fiberoptic group than in blind group, the success rate of intubation in the fiberoptic group was 100% compared to 76% in blind group. There was statistically significant lower BIS value in the fiberoptic group 1 minute after intubation than in the blind group. Endotracheal intubation through the Air-Q ILA guided by flexible fiberoptic bronchoscope is associated with less hemodynamic and arousal responses than blind endotracheal intubation through the Air-Q ILA, the number of attempt and time of successful intubation were statistically significantly lower in the fiberoptic group than the blind group.

Key words: Air Q Laryngeal Mask Airway, fiberoptic bronchoscope, pressor response, arousable response

Med-Science. 2015; 4(3): 2388-400

Pre-opereative Parathormone Levels are Correlated with Mean Diameter of Parathyroid Adenoma and Pre-operatıve Serum Calcium and Alkaline Phosphatase Levels

Original Article

Pre-opereative Parathormone Levels are Correlated with Mean Diameter of Parathyroid Adenoma and Pre-operatıve Serum Calcium and Alkaline Phosphatase Levels

Gulsah Elbuken, Recep Aktimur, Kadir Yildirim, Sude Hatun Aktimur, Mehmet Derya Demirag, Aysu Basak Ozbalci, Mustafa Bakirtas, Banu Kirtiloglu, Nuraydın Ozlem

   

Abstract
The aim of the present study was to determine the relationship between biochemical parameters, mean diameter of parathyroid adenoma (MDPA) and parathyroid hormone (PTH) levels in patients who underwent parathyroid surgery.Materials and Methods: Data were collected retrospectively from patients with hyperparathyroidism who were operated and followed in our hospital between September 2011 and April 2014. Twenty-nine (male/female = 8/21) patients with a mean age of 58.31 ± 12.59 years were enrolled into the study. The mean pre-operative serum calcium and intact PTH (iPTH) levels were 11.98±1.23 mg/dl and 386.52±374.96 pg/ml, respectively. Serum pre-operative calcium levels were found to be significantly higher in patients who had nephrolithiasis than those who did not, whereas pre-operative serum phosphate levels were lower. Pre-operative iPTH levels were found to be correlated with pre-operative calcium, alkaline phosphatase and MDPA but not with pre-operative serum phosphate. Also, pre-operative calcium levels were found to be significantly correlated with MDPA.Conclusion: Presence of nephrolithiasis is associated with higher pre-operative calcium and lower phosphate levels. Pre-operative iPTH and calcium levels were also found to be significantly correlated with MDPA; this suggests that serum iPTH and calcium levels can be useful in predicting MDPA.

Key words: Hypercalcemia, primary hyperparathyroidism, parathyroid adenoma, parathormone, calcium

Med-Science. 2015; 4(3): 2401-13

Effectiveness of Natural Killer (NK) Cells in Peripheral Blood Stem-Cell towards Expression of EZH2, Ki-67, and Apoptosis in Retinoblastoma (RB) Cells Culture

Original Article

Effectiveness of Natural Killer (NK) Cells in Peripheral Blood Stem-Cell towards Expression of EZH2, Ki-67, and Apoptosis in Retinoblastoma (RB) Cells Culture

Hendrian Dwikoloso Soebagjo, Susy Fatmariyanti, Delfitri Lutfi

   

Abstract
A natural killer (NK) cell is a large granular lymphocyte having a cytotoxic activity against malignant tumor cells in the cellular immune response. NK cells play an important role to inhibit the metastasis of tumor and express glikoprotein molecule antigen (IgG) and variable cytotoxic factors like perforin, granzyme, cytolysin such as TNF-α against retinoblastoma cells. The aim of the study was to investigate the role of Natural Killer Cells (NK cells) as an alternative therapy, especially in cases of retinoblastoma. It is highly expected that the study can be used as a starting point in determining the strategic therapy, e.g. the cell targeted therapy to inhibit EZH2 and retinoblastoma cell proliferation. There were 2 groups of retinoblastoma cell cultures in this study, the groups of control (n=10) and exposure (n=10). The control group was a group of retinoblastoma cell cultures that did not get any therapy, while the exposure group was a group of retinoblastoma cell cultures with NK Cell exposure in vitro for 3 days. The data obtained were analyzed using the T- test and Pearson Correlation. In T-test, the results of the two groups indicated a significant difference in the positive expression of cell count of EZH2, Ki-67 and Apoptotic cells. The Pearson Correlation test showed that the expression of EZH2 was statistically negative significant (α: -0.930; p

Key words: NK cells, retinoblastoma, EZH2, proliferation, apoptosis

Med-Science. 2015; 4(3): 2414-30

Investigation of Extended-Spectrum Beta-Lactamase (Esbl) in Nosocomial Gram-Negative Bacterial Isolates by Different Test Methods

Original Article

Investigation of Extended-Spectrum Beta-Lactamase (Esbl) in Nosocomial Gram-Negative Bacterial Isolates by Different Test Methods

Filiz Orak, Akgun Yaman, Gulsah Seydaoglu

   

Abstract
The aim of this study is to investigate the existence of extended-spectrum beta-lactamase (ESBL) in nosocomial Gram-negative bacteria isolates and to compare different test methods that detecting ESBL. The strains producing the largest quantities of these enzymes are Klebsiella pneumoniae (K. pneumoniae), Klebsiella spp., and Escherichia coli (E. coli).

Key words: Extendet spectrum beta-lactamase, gram-negative bacteria, nosocomial infection

Med-Science. 2015; 4(3): 2431-40

Evaluation of the Practice of Antibiotic Prophylaxis in a State Hospital

Original Article

Evaluation of the Practice of Antibiotic Prophylaxis in a State Hospital

Yavuz Orak, Sultan Akkus, Filiz Orak, Aynur Suner

   

Abstract
In terms of antibiotic prophylaxis in surgical patients, incorrect application in hospitals is still one of the most frequently made errors in the medical practice. Surgical site infections, with a rate of 15%-18%, are seen as the second most prevalent of all nosocomial infections.The aim of our study was to investigate the use of antibiotics implemented in surgical prophylaxis. The study was conducted on 180 patients on whom elective surgery was performed in Mardin State Hospital between the dates of September 1 and December 31, 2013. Drug distribution was made according to age, gender, risk factors for surgical site infection; ASA (American Society of Anesthesiologists) score, the name of the prophylactic antibiotics used, clinics distribution, and wound classification. Our study determined that in 71.7% of the cases, prophylaxis was given in incorrect doses; that it was continued for too long a period in 56.2%; and that an inappropriate antibiotic had been selected in 51.7%. It has become more important for the infection control committee to not only create a guide, but also to periodically update training in coordination with anesthesiologists and surgical specialists and take necessary measures. The contribution of the clinical pharmacy practice to the solution of this problem must be discussed.

Key words: antibiotics, surgery, clinical pharmacy, prophylaxis

Med-Science. 2015; 4(3): 2441-9

Comparative Study of two Doses of Intrathecal Dexmedetomidine Versus Fentanyl as Adjuvant to Hyperbaric Bupivacaine Spinal Anesthesia

Original Article

Comparative Study of two Doses of Intrathecal Dexmedetomidine Versus Fentanyl as Adjuvant to Hyperbaric Bupivacaine Spinal Anesthesia

Mahmoud M Amer, Doaa A Rashwan, Maha A Shaker

   

Abstract
The aim of this study was to evaluate the effect of addition two different doses of dexmedetomidine or fentanyl to intrathecal hyperbaric bupivacaine on spinal block characteristics, intraoperative hemodynamics, the blood glucose level and postoperative pain. 100 patients ASA I and II, ages 20 -60 years old undergoing elective surgeries below the umbilicus under spinal anesthesia were divided into four groups (n=25 each): Patients were randomly allocated into four equal groups (n= 25, each): Group I: received 3 mL of 0.5% hyperbaric bupivacaine +0.5ml normal saline. Group II: received 3 mL of 0.5% hyperbaric bupivacaine plus 3 μg dexmedetomidine (diluted in 0.5ml of normal saline) intrathecal. Group III: received 3 mL of 0.5% hyperbaric bupivacaine plus 5 μg dexmedetomidine (diluted in 0.5ml of normal saline) intrathecal. Group IV: received 3 mL of 0.5% hyperbaric bupivacaine plus 25 μg fentanyl (0.5ml) intrathecal. intraoperative heart rate and mean arterial blood pressure showed no statistical significant differences between the study groups, patients in group II, III and IV had significantly longer sensory and motor block times than patients in group I. The time of first request of postoperative analgesia was statistically significantly shorter in group I compared to the other groups. Pain scores were higher in group I compared to the other groups. Postoperative blood glucose level was only statistically significantly higher in group II compared to the other groups. Both intrathecal dexmedetomidine and fentanyl are associated with prolongation of sensory and motor block, with stable hemodynamics, minimal effect on blood glucose level, and better postoperative analgesia, compared to intrathecal bupivacaine alone.

Key words: Spinal anesthesia, bupivacaine, dexmedetomidine, fentanyl

Med-Science. 2015; 4(3): 2450-64

Drug Prescribing Pattern in Dermatophytosis at the Medical Outpatient Clinic of a Tertiary Healthcare in Karnataka, India

Original Article

Drug Prescribing Pattern in Dermatophytosis at the Medical Outpatient Clinic of a Tertiary Healthcare in Karnataka, India

Vishal Prakash Giri, Om P Giri

   

Abstract
Aim of this study is to ascertain the drug prescribing pattern of the patients with Tinea infections attending a tertiary care teaching centre. This retrospective study conducted at a tertiary care teaching hospital in the Dakshina Kannada district, Karnataka for a period of one year. 158 prescriptions were audited to find generic/ brand names of drugs, number of drugs, dosage, forms, frequency, and duration of treatment. The age and sex distributions of patients and disease distribution were also studied. 72 (45.57%) patients were males and 86 (54.43%) were females. Terbinafine, Ketoconazole, Sertaconazole were prescribed as topical monotherapy .Clobetasone butyrate, Sertaconazole and Miconazole were prescribed as topical polytherapy. Terbinafine, Fluconazole and anti histaminics were prescribed as systemic monotherapy and polytherapy. Statistical analysis revealed p-value was > 0.05. Prescription patterns were in consensus with the general guidelines.

Key words: Dermatophytoses, medical audit, tertiary healthcare

Med-Science. 2015; 4(3): 2465-72