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Risk of Malignancy Index (RMI) in the Pre-Operative Evaluation of Patients with Adnexal Masses

Original Article

Risk of Malignancy Index (RMI) in the Pre-Operative Evaluation of Patients with Adnexal Masses

Rajat Kumar, Gunvant Vaishnav, Anjali Soni, Kalpana Dave

   

Abstract
The aim of this study is to evaluate use of RISK of MALIGNANCY INDEX (RMI) in primary evaluation of adnexal masses without clear evidence of malignancy, by combining serum CA 125 levels, USG score and menopausal status. It is a cross sectional study conducted at Department of gynaec- oncology, Gujarat Cancer and Research Institute, Ahmedabad. A total of 40 women aged 20 to 65 years with ultrasound diagnosed adnexal masses, and serum measurement of cancer-associated antigen CA-125 levels, were studied. They all had surgical exploration (laparotomy) between May 2005 to July 2007 .The RMI was based on menopausal status, ultrasound morphology of adnexal masses and absolute level of serum CA-125. RMI cut-off of 200 was chosen. The various testing methods were evaluated for sensitivity, specificity, positive and negative predictive values. The best performance was with a RMI at a cut-off of 200 with a sensitivity of 66.66%, specificity of 63.15%, positive predictive value of 66.66% and negative predictive value of 65.15% to diagnose malignancy. When RMI was used, it is better in detecting benign tumour and malignant tumour rather than individual component. RMI to be a valuable, reliable and applicable method in primary evaluation of patients with adnexal masses, and a usable method for referral of advanced neoplasia to a more complex healthcare unit.

Key words: Menopausal status, CA-125, ovarian cancer, risk of malignancy index

Med-Science. 2016; 5(1): 1-11

Medicine Science Vol:5 Issue:1 Year:2016 PP:1–350

Pattern and Physiotherapy Management of Shoulder Pain A 5-Year Retrospective Audit of a Nigerian Tertiary Hospital

Original Article

Pattern and Physiotherapy Management of Shoulder Pain A 5-Year Retrospective Audit of a Nigerian Tertiary Hospital

Olusola Ayanniyi, Olutade Joseph Dosumu, Chidozie E. Mbada

   

Abstract
Shoulder Pain (SP) is a common musculoskeletal problem and it constitutes a source of referral and workload for physiotherapy. This study investigated the pattern and management of SP in a physiotherapy department of a tertiary hospital. A five-year case chart review (January 2005 to December 2009) of patients with SP referred to the outpatient physiotherapy clinic of University College Hospital, Ibadan, Nigeria was conducted. Data were gleaned on patients’ age, gender, occupation, referring diagnosis, physiotherapist’s impression, side of affectation, functional limitation, associated co-morbidities and impairments, pattern of treatment and outcome assessment tools. A total of 4.316 case charts were reviewed over the time period, SP accounts for 2.8% with a female to male ratio of 6:4. The mean age of the patients was 50.6±26.2 years and the age group for peak prevalence (43.8%) was 41-60 years. There was higher preponderance of left SP (51.2%) than right in the ratio of 5:4. SP resulted mostly from fracture (19.6%), osteoarthritis (10.7%) and dislocation (6.6%). SP led to functional limitation in personal care (23.1%), work (14.0%) and sleep (9.0%). The most prevalent musculoskeletal condition associated with SP was elbow pain (8.3%), knee pain (6.6%) and neck pain (5.0%) while hypertension (16.5%), diabetes (6.6%) and sickle cell (2.5%) were co-morbid medical conditions with SP. Reduced range of motion (73.6%), muscle atrophy (28.1%) and muscle weakness (27.3%) were the most associated impairments resulting from SP. Mobilization technique (76.0%), reciprocal pulley (62.8%) and hydro collator pack (62.0%) were often employed in the management for SP. The mean treatment duration of patients was 5.2±2.4 weeks. Outcome assessments were documented in 82.6% of the cases. Goniometer (28.9%), oxford muscle grading (19.0%) and verbal rating scale (15.7%) were the most frequently used assessment tools. Shoulder pain is not an uncommon condition presenting for physiotherapy among Nigerian patients and it constitutes a small burden on the physiotherapy care at a tertiary hospital. The pattern and management of shoulder pain in this study is similar to findings from previous studies from around the world.

Key words: Shoulder pain, pattern, physiotherapy management

Med-Science. 2016; 5(1): 12-26

Associations Between PSA Levels and Erectile Dysfunction in the Patient with LUTS

Original Article

Associations Between PSA Levels and Erectile Dysfunction in the Patient with LUTS

Huseyin Celik, Ahmet Camtosun, Caner Ediz, Ramazan Altintas, Cemal Tasdemir

   

Abstract
Erectile dysfunction (ED) are common problem in males with lower urinary tract symptoms suggestive (LUTS).The aim of this study is to evaluate whether there is an association between PSA levels and ED or not. This study included total of 54 males aged 45-75 years old, who attended in department of urology. International Prostate Symptom Score (IPSS) was used for LUTS measurements. The International Index of Erectile Function questionnaire-5 (IIEF) was used ED measurements. We evaluate the relationship between PSA and ED or LUTS. Patients were divided into3 groups according to PSA level. Group 1: 0,1-1,3 ng/dl, group 2: 1,3-3,2ng/dl and group 3: 3,2-10 ng/dl. The IPSS score was 16,9 in group 1, 18,1 in group 2 and 21 in group 3. The IIEF score 16,4/14,1/13,8 respectively. The severity of ED or LUTS was associated with the PSA level. PSA showed a significant positive correlation with ED and LUTS. In group 1 patients having lowest PSA level, sexuel function was better. ED was positively correlated with LUTS. ED and LUTS were significantly and independently correlated with PSA level. PSA may be a predictor factor for ED. But, there was no significant difference between PSA level and ED. Nevertheless, multicenteric, controlled, long-term, randomized studies are needed.

Key words: PSA, Erectile dysfunction, LUTS, IPSS, IIEF

Med-Science. 2016; 5(1): 27-33

An Evaluation of the Efficacy of ESWT and Placebo-ESWT Treatment for Chronic Plantar Fasciitis

Original Article

An Evaluation of the Efficacy of ESWT and Placebo-ESWT Treatment for Chronic Plantar Fasciitis

Gulsen Aykol, Yuksel Ersoy

   

Abstract
The aim of this study was to evaluate the short-term effectiveness on heel pain and daily activities of extracorporeal shock wave therapy (ESWT) and placebo- ESWT in the treatment of chronic plantar fasciitis. A total of 42 patients diagnosed with chronic plantar fasciitis ongoing for at least 6 months were randomly separated into 2 groups. Group 1 (study group, n=21) were administered a total of 5 sessions of ESWT treatment at once a day for days with an EMS (Electro Medical System) Swiss DolorClast Master ESWT device at frequency 10-15 Hz, 2-3 bar pressure with 2000 shocks per session. Group 2 (control group, n=21) were administered placebo-ESWT. The pain levels were evaluated with a Visual Analog Scale (VAS) and the heel pain together with range of movement and activities with Roles-Maudsley (RM) scoring. Comparisons were made of the values pre-treatment and at 1 week and 5 weeks post-treatment. In the VAS values of the study group, a decrease was determined of 43.39% in post-treatment week 1 and of 70.37% in week 5 compared to pre-treatment values. The RM pain score reduced by 28.4% in week 1 and by 56.79% in week 5. In the control group, the VAS scores reduced by 17.13% and 16.03% and the RM scores by 8.86% and 11.4% respectively at weeks 1 and 5 post-treatment. The reductions in the treatment and control groups were found to be statistically significant and when the changes were compared between the two groups, the differences were found to be statistically significant. The treatment group was determined to have made statistically significantly more improvement than the control group. ESWT was seen to be a safe and effective treatment choice with short-term efficacy in the treatment of chronic plantar fasciitis.

Key words: ESWT, Placebo-ESWT, Chronic Plantar Fasciitis

Med-Science. 2016; 5(1): 34-45

Screening the Effect of Metformin on Serum Vitamin B12 and Blood Homocysteine Levels in Patients with Type 2 Diabetes Mellitus

Original Article

Screening the Effect of Metformin on Serum Vitamin B12 and Blood Homocysteine Levels in Patients with Type 2 Diabetes Mellitus

Hassna Osama, Hoda Abd Elbadie Hussein, Mohamed E. A. Abdelrahim, Heba F. Salem

   

Abstract
Vitamin B12 deficiency is a side effect of metformin use in patientswith type 2 diabetes mellitus (T2DM) and associated with increase in plasma homocysteine levels.The aim of present work was to screen vitamin B12 and homocysteine levels in patients with T2DM on metformin therapy. Patients with T2DM collected from Fayoum University hospital outpatient clinics were screened and divided into three groups. Group 1 was thirty patients on metformin therapy for more than one year without vitamin B12 supplementation; group 2 was thirty patients on metformin therapy for more than one year on vitamin B12 supplementation and group 3 was patients not receiving metformin therapy (control group). All patients were subjected to complete history taking, including peripheral neuropathy and laboratory investigations. The mean±SD serum vitamin B12 level was significantly higher in the metformin and vitamin B12 supplementation users compared to metforminonly and non-metformin users (p

Key words: Metformin, Vitamin B12 deficiency, homocysteine, neuropathy, type 2 diabetes mellitus

Med-Science. 2016; 5(1): 46-56

The Effect of Hydroxychloroquine Treatment on Blood Sugar Level, Serum Lipid Profile and the Retina in Systemic Lupus Erythematosus Patients

Original Article

The Effect of Hydroxychloroquine Treatment on Blood Sugar Level, Serum Lipid Profile and the Retina in Systemic Lupus Erythematosus Patients

Rania M. Sarhan, Amira Shaban, Mohamed Nabil Abd El Hamid, Heba Farouk Salem

   

Abstract
The aim of this study was to evaluate the effect of hydroxychloroquine (HCQ) on blood sugar level, lipid profile and retina in newly diagnosed systemic lupus erythromatosus (SLE) patients. Fifty newly diagnosed SLE patients were collected from Immunology and Rheumatology outpatient clinics in Beni Suef University hospital. All patient’s questionnaire included name, age, sex, smoking status, the date of the diagnosis, drugs taken during the follow up period and present history of other diseases. Only HCQ was prescribed to the patients within one year follow-up. They were with a mean (SD, range) age 30 (7.07, 25, 35) years old. Their total lipid profile which included total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and fasting blood sugar (FBG) and postprandial blood glucose levels (PPBG) were analyzed in MASTER LAB in Beni suef before and after 6 months from the using of HCQ as well as our patients were converted to Ophthalmology Department in Beni Suef University hospital before and at the end of six months of HCQ therapy to undergo to complete eye examinations. The mean (SD) of TC, TG, LDL, FBG and PPBG were significantly decreased after HCQ than before using it while HDL was increased at p

Key words: Systemic lupus erythematosus, Hydroxychloroquine, blood sugar, lipid profile, retina

Med-Science. 2016; 5(1): 57-71

Information and Practices about Childrens’ Dental Health of the Mothers Have 2-4 Year Old and Who Applied Sıtmapınarı Family Health Center in the City of Malatya [Malatya Sıtmapınarı ASM ’ye Başvuran 2-4 Yaş Çocuğu Olan Annelerin Çocuklarının Diş Sağlığına Ait Bilgi Düzeyi ve Uygulamaları]

Original Article

Information and Practices about Childrens’ Dental Health of the Mothers Have 2-4 Year Old and Who Applied Sıtmapınarı Family Health Center in the City of Malatya [Malatya Sıtmapınarı ASM ’ye Başvuran 2-4 Yaş Çocuğu Olan Annelerin Çocuklarının Diş Sağlığına Ait Bilgi Düzeyi ve Uygulamaları]

Gulsen Gunes, Duygu Celik Seyitoglu, Selale Sahin

   

Abstract
According to the Dental Association of Turkey, the prevalence of the preschool children having caries and bearing its consequences is over 80%. It is a common known fact that brushing teeth decreases the risk of caries in teeth at a meaningful level. Protection of dental health in early childhoodand giving the habits of keeping the teeth healthy to children are closely related with the knowledge and attitudes of mothers. Our purpose in this study is to determine the levels of information on dental and oral health of the mothers who applied to Sıtmapınarı Family Health Center in the city of Malatya with 2-4-year-old children. It is also aimed in this study that the applications and the factors that affect them are defined in this context as well. The study has the quality of being a definitive one, and has been conducted with the mothers having children between the ages 2-4 who applied to Sıtmapınarı Family Health Center. A questionnaire consisting of 21 questions was applied to 331 mothers. The questionnaire form included questions on the socio-demographic characteristics of the mothers as well as their information levels on the applications on oral and dental health.In the analyses of the data, the Chi-Square Test, Unpaired T Test and One Way Anova Tests were used. 40,5% of the children of the mothers who participated in our study brush their teeth. The rate of knowing that the toothpaste must include fluorine among the mothers has been determined as 24,8%; and the rate of knowing why the fluorine is added to the toothpastes has been determined as 28,2%. 33,2% of the mothers are inclined to check the food of their children with the same spoon their children are using during the meal, which makes it easier for caries to appear. The educational level, socio-economic status, working or not working of mother, brushing their own teeth or not influenced the brushing the teeth behavior of the children and the knowledge levels of the mothers on dental and oral health(p0,05). In conclusion, wrong applications that influence the oral and dental health in a bad way are very common, and must be fought against. Mothers must be informed on the reasons of the fluorine gel and polisher agents, and also on the importance of brushing teeth.

Key words: Dental health in children, protection from caries, information level, mothers

Med-Science. 2016; 5(1): 72-85

Effect of Subclinical Hypothyroidism on the Mean Platelet Volume of Pregnant Women

Original Article

Effect of Subclinical Hypothyroidism on the Mean Platelet Volume of Pregnant Women

Oktay Sari, Alpaslan Tanoglu, Onur Mahmutoglu, Umit Aydogan, Fatma Beyazit, Yasam Kemal Akpak, Ugur Keskin

   

Abstract
Subclinical hypothyroidism (SH) is a frequently seen clinical disorder, which needs to be managed strictly in the pregnant population. SH is closely related with newborn complications and also suggested to be risk factor for cardiovascular events. Mean platelet volume (MPV), a determinant of platelet function, is a newly emerging risk marker for cardiovascular events. The aim of this study was to evaluate how MPV values and other hematological parameters are influenced in pregnants with subclinical hypothyroidism. A total of 70 subclinical hypothyroidic pregnants and 40 euthyroid pregnant controls were enrolled in our study. Age, body mass index (BMI), erythrocyte and platelet parameters were all evaluated. Erytocyte parameters and thrombocyte parameters, including MPV, were not statistically significantly different between pregnants with SH and healthy pregnants (p>0.05). Mean free T3 and TSH levels of subclinical hypothyroidic pregnants were statistically significantly different from healthy pregnant (p=0.04 and p

Key words: Mean platelet volume, subclinical hypothyroidism, erytocyte parameters, platelet parameters

Med-Science. 2016; 5(1): 86-93

The Effect of Dexamethasone in Tramadol Induced Nausea and Vomiting

Original Article

The Effect of Dexamethasone in Tramadol Induced Nausea and Vomiting

Nurcin Gulhas, Mukadder Sanlı, Abdul Vahap Aslan, Ulku Ozgul, Murat Bıcakcıoglu, Mahmut Durmus

   

Abstract
We aimed to investigate the efficacy of a single dose bolus of dexamethasone on tramadol induced nausea and vomiting in our study. After approval was taken from ethics committee and patients, a total of 60 ASA I-II patients who were planned to undergo total abdominal hysterectomy (TAH) under general anesthesia were included in this study. A patient-controlled analgesia device was explained for the patients with preoperative visit. After the non-premedicated patients were taken in the operation room, the routine monitorization was performed. Induction was provided with 1μg/kg of fentanyl, 2 mg/kg propofol and 0.1 mg/kg vecuronium. 6-8% concentration of desflurane in a mixture of 50% air and 50% O2 was used for maintenance of anesthesia. When the incision was started to be closed, the patients were randomized into two groups by envelope method. 8 mg iv dexamethasone (2 mL) was given for Group D (n=30), iv Saline solution (2 mL) was given for Group K (n=30). After the incision was closed, a loading dose of intravenous tramadol 1 mg/kg was administered in both groups. The patients were taken in the postanesthesia care unit by extubating following the antagonism of muscle relaxant at the end of surgery. The patient-controlled analgesia device was scheduled to be as infusion: no, bolus: 12 mg, lock-out time: 10 min, 24 hour dosing limit: 400 mg. The pain and nausea and vomiting scores, additional analgesic and antiemetic requirements, the total amount of tramadol consumption were recorded at post-operative recovery and postoperative 2, 4, 6, 12 and 24 hours. Although the incidence of nausea and vomiting, and pain scores at 2 and 4 hours were not statistically significant, they were lower in Gorup D compared to Group K (p>0.05). 14 patients in Group K required additional antiemetics and 12 patients in Group D required additional antiemetics (p>0.05). Six patients in Group K required additional analgesics and 4 patients in Group D required additional analgesics. Although the total amount of tramadol consumption was not statistically significant, it was lower in Group D compared to Group K. It was concluded that a single bolus dose of dexamethasone 8 mg has not reduced tramadol induced nausea and vomiting in patients who were planned to undergo TAH.

Key words: Tramadol, nausea, vomiting, dexamethasone

Med-Science. 2016; 5(1): 94-101

Determining the Attitudes of the Students of Inonu University, Faculty of Medicine, on Social Gender Roles [İnönü Üniversitesi Tıp Fakültesi Öğrencilerinin Toplumsal Cinsiyet Rollerine İlişkin Tutumlarının Belirlenmesi]

Original Article

Determining the Attitudes of the Students of Inonu University, Faculty of Medicine, on Social Gender Roles [İnönü Üniversitesi Tıp Fakültesi Öğrencilerinin Toplumsal Cinsiyet Rollerine İlişkin Tutumlarının Belirlenmesi]

Duygu Celik Seyitoglu, Gulsen Gunes, Ayse Baran

   

Abstract
Social gender tells about the personality traits, roles and responsibilities defined socially for women and men in the society. Social gender roles, on the other hand, tell about the roles that are considered to be related with men and women in a traditional way. Social gender role includes the personality traits and behaviors that are considered to be proper for men and women in a cultural manner. The aim of this study is to determine the attitudes of the students at Inonu University, Faculty of Medicine, on social gender roles, and examine the factors that are effective on these attitudes. The study was designed as a cross-sectional study, and was conducted at Inonu University, Faculty of Medicine between the dates December 2014 – March 2015. Written approval was received from Malatya Clinical Researches Ethics Board and Inonu University, Faculty of Medicine in order to conduct the study. The minimum sampling size formula was calculated for the 1298 students studying at Inonu University, Faculty of Medicine. The minimum sampling size was found as 328. Half of the students were selected randomly from the class lists at the beginning of the study. 684 students were included in the study. The questionnaire form which included the “Attitude Scale on Social Gender Roles” (ASGR), whose first part was developed by the socio-demographic properties of the participants, and the second part developed by the researcher, was used as the data collection tool. This scale consists of 38 Items. The highest points that may be received from the scale is 190 and the lowest is 38. Receiving high points means having an egalitarian attitude. There are five sub-dimensions of the scale and they are; egalitarian gender, woman gender, gender at marriage, traditional gender and male gender roles. In statistical analyses of the data for the independent variables, the Man Whitney U and Kruskal Wallis Test (Post Hoc Bonferroni) were used. The mean age of the participant students was 22±2,23. 40, 8% of the participants were male, and 59,2% were female. The average of the total points of the students received from the Attitude Scale on Social Gender Roles was found as 139 (min 53-max 185). It was determined that female students had meaningfully more egalitarian attitude with 146 median points (p=0.001). While the median points received in the 17-19 age group was 143, it was 135 in people over 25 years of age 135 (p=0,027). The median points of the students whose mothers worked was found to be 146, and of those whose mothers did not work was found as 137 (p=0,001). When the median points of the students received from the scale in terms of their families were compared, it was determined that it was 127 in students who lived in a wide family, and 140 in those who lived in an elementary family (p=0.004). When the median points of the ASGR were considered according to the educational status of the mothers, it was determined that the median points of those students whose mothers were not educated was 133; and the median points of those whose mothers were university graduates was found as 145 (p=0,010). When the points received from the social gender roles sub-dimensions were considered, it was observed that female students had meaningfully more egalitarian attitudes when compared with the male students (p=0,001). In this study, which was conducted to determine the attitudes of the students of faculty of medicine on social gender roles, it was determined that the students showed a more egalitarian attitudes when compared with other employees. Female students, younger students, those living in elementary families, those whose mothers are working and have higher educational status show more egalitarian attitudes. It may be recommended that classes on social gender may be added to the curriculum in medicine faculties, and peer trainings may be organized with the participation of especially male students.

Key words: Social gender, gender roles, students from faculty of medicine

Med-Science. 2016; 5(1): 102-16