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CHA2DS2-VASC Score and this score components in predicting radial artery complications of among patients who underwent elective transradial coronary angiogram

ORIGINAL RESEARCH

CHA2DS2-VASC Score and this score components in predicting radial artery complications of among patients who underwent elective transradial coronary angiogram

Mehmet Timur Selcuk, Hatice Selcuk, Orhan Maden, Ozge Cakmak Karaaslan Muharrem Tola, Habibe Kafes, Elif Hande Cetin, Kevser Gulcihan Balci, Mustafa Mucahit Balci

   

Abstract

Transradial approach (TRA) has been more and more accepted for cardiovascular operations. TRA uncommonly leads to hemorrhagic and ascular complications. CHA2DS2-VASc score is utilized to estimation the risk of thrombosis in patients with atrial fibrillation. We intended to assess the relationship between the CHA2DS2-VASc score or components of this score and radial artery complications after transradial coronary ngiography. A total of 412 consecutive patients who underwent a TRA were evaluated in this study. Patients were divided into two groups as total complications (n= 73) and no-complications (n= 339) groups. The CHA2DS2-VASc score was higher in patients who had total complications group yet it was not statistically significant (p=.149). Total complication group were older compared to control group (p=.017). As the radial artery diameter decreased, and sheath/radial artery diameter increased, the risk of the total complication group higher significantly (for all; p<.001). Known coronary artery disease (OR: 2.230, 95% CI: 1.007- 4.975, p= .048) was independent risk factors for predictor of radial artery thrombosis, DM was an independent predictor of radial artery pseudoaneurysm (OR: 4.746, 95% CI: 1.269- 17.747, p= .021), age was an independent predictor of radial artery hematoma (OR: 1.054, 95% CI: 1.005- 1.106, p= .029) and radial artery total complications (OR: 1.047, 95% CI: 1.005- 1.087, p= .015). The CHA2DS2-VASc score alone is not connected with the risk of radial artery complications after transradial catheterization but CHA2DS2-VASc score components may help to predict complications the risk of in radial interventions.

Key words: CHA2DS2-VASC, radial artery complications, transradial coronary angiogram

Med-Science. 2021; 10(1): 1-6
 
Medicine Science Vol:10 Issue:1 Year:2021 PP:1–271

Therapeutic approaches to children with enuresis: A retrospective study

ORIGINAL RESEARCH

Therapeutic approaches to children with enuresis: A retrospective study

Ilknur Ucuz, Ayla Uzun Cicek

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Abstract

Enuresis is a common pediatric condition and there are different treatment options. This study aimed to evaluate treatment options for enuresis in a sample of the child and adolescent psychiatry clinic. The data and treatment results of 98 patients (mean age: 10.38±2.15 years, range=6-16 years) diagnosed with enuresis between 1 May 2015 and 1 October 2020 were retrospectively reviewed. We found that 57 of the patients had previously applied to the hospital for enuresis, and 14 of them have applied to child and adolescent psychiatry, 10 of them to pediatric surgery, 20 of them to other branches of pediatrics, and 13 of them to the urology clinic. In previous hospital applications, behavioral treatment only had been applied to 40.4% of the patients, and pharmacotherapy had been applied in 59.6% of the patients. On the other hand, in the child and ado-lescent psychiatry clinic, 26.5% of the patients received behavioral treatment only, and 73.5% used drugs along with behavioral treatment, and the most frequently preferred drugs were imipramine (oftenest) and desmopressin. Also, the rates of psychiatric comorbidity in those who received medical treatment were significantly higher than those who treated behavioral treatment only. In conclusion, this study revealed that different clinical branches apply different treatment approaches to enuresis. In child and adolescent psychiatry, imipramine was the most commonly used agent in medical treatment, and this has been attributed to the high rate of psychiatric comorbidity.

Key words: Enuresis, child/adolescent, pharmacotherapy, behavioral therapy, treatment

Med-Science. 2021; 10(1): 7-12
 

Assessment of tongue depressor-related tongue swelling in pediatric patients with ultrasonography: A prospective, case-controlled observational study

ORIGINAL RESEARCH

Assessment of tongue depressor-related tongue swelling in pediatric patients with ultrasonography: A prospective, case-controlled observational study

Merih Onal

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Abstract

Adenoidectomy is one of the most common surgeries performed in children. The tongue depressor is being routinely used during adenoidectomy exerts high mechanical pressure on the tongue. We aimed to discover tongue swelling created by the compression of tongue depressor by using ultrasonography (USG) in pediatric patients who were undertaken adenoidectomy. Thirty-four patients who were undertaken adenoidectomy were involved in the study group. In the control group, 33 patients who were undertaken pediatric surgery were involved. The tongue surface area (TSA) measurement was achieved for two times. In the study group, TSA1 was performed immediately following intubation, prior to the installment of the tongue depressor, TSA2 was performed following the removal of the tongue depressor however prior to extubation. In the control group, TSA1 was performed immediately following intubation, TSA2 was performed prior to extubation. An important correlation was noticed among the severity of tongue swelling (defined as TSA2 – TSA1 ) (P = 0.000) and tongue depressor. Tongue depressor may provoke tongue swelling in adenoidectomy procedures that can be shown with USG. This tongue swelling seems to be a result of the pressure applied by the tongue depressor. Tongue depressor related tongue swelling may cause respiratory complications in patients with already restricted airway passage even if the patients are fully awake. The tongue swelling in pediatric patients under adenoidectomy surgeries was demonstrated for the first time in the literature by USG.

Key words: Adenoidectomy, children, complications, tongue disease, ultrasonography

Med-Science. 2021; 10(1): 13-7
 

ADME predictions and molecular docking study of some compounds and drugs as potential inhibitors of COVID-19 main protease: A virtual study as comparison of computational results

ORIGINAL RESEARCH

ADME predictions and molecular docking study of some compounds and drugs as potential inhibitors of COVID-19 main protease: A virtual study as comparison of computational results

Harun Uslu, Pelin Koparir, Kamuran Sarac, Arzu Karatepe

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Abstract

There is an urgent need for a drug to be used against COVID-19, which negatively affects human life worldwide and causes pandemic leading to the death of many people. Although some drugs are included in the treatment protocols of health institutions, there are currently no specific drugs against COVID-19 or are unknown, and effective treatment options remain very limited. Since designing a novel drug and testing its pharmacological properties may take long years, here we used a faster virtual study approach for some of our compounds with different chemical structures against COVID-19. Moreover, we included some drugs in this study and compared in silico results obtained. The activity potentials of these compounds were further evaluated through molecular docking studies with AutoDock4 and AutoDock Vina software. Among all the compounds studied, compounds 1a, 1b, and 1c demonstrate significant activity like other prodrugs, particularly against COVID-19. The most promising compound 1a has appropriate ADME prediction values and high binding affinity as a potential inhibitor of COVID-19 main protease.

Key words: COVID-19, molecular docking, ADME Predictions, favipiravir, remdesivir, hydroxychloroquine

Med-Science. 2021; 10(1): 18-30
 

The effects of comorbidity factors on the prognosis in geriatric sepsis patients in the intensive care unit

ORIGINAL RESEARCH

The effects of comorbidity factors on the prognosis in geriatric sepsis patients in the intensive care unit

Ozkan Gorgulu, Mehmet Nuri Kosar

   

Abstract

Mortality rates in geriatric sepsis patients are very high in the intensive care unit. The aim of our study is to evaluate the prognosis of geriatric patients diagnosed with sepsis according to age groups in the intensive care unit. The data of 189 geriatric patients were reviewed retrospectively. Elixhauser Comorbidity index was calculated. The patients were divided into three different age groups young-old (65-74 years), middle-old (75-84 years) and oldest-old (85 years and above). The prognosis was evaluated in patients with Elixhauser Comorbidity index score ≥ 10. The mean length of ICU stays of those aged over 85 years (21.10±23.75) and 75-84 years (17.45±20.59) was compared with that of 65-74-year-old patients (10.23±12.19). Young elderly patients had shorter length of ICU stay than other groups (95% confidence interval) (p=0.01 p0.05). Oldest-old and middle-old patients’ length of stay in the intensive care unit was longer period than young-old patients. Mortality rate in geriatric sepsis patients with Elixhauser Comorbidity Index was greater than 10 is over 70%, but ICU stay did not affect 30-day mortality.

Key words: Geriatrics; sepsis; intensive care units; mortality; comorbidity

Med-Science. 2021; 10(1): 31-5
 

Effect of montelukast treatment on adenoid hypertrophy and sleep quality in pediatric patients

ORIGINAL RESEARCH

Effect of montelukast treatment on adenoid hypertrophy and sleep quality in pediatric patients

Isil Cakmak Karaer, Ayla Cimen

   

Abstract

Adenoid vegetation is part of lymphoid tissue located in the upper respiratory tract. When adenoid tissue becomes hypertrophied, it may cause narrowing of the respiratory tract and complications. Generally, treatment of adenoid hypertrophy is surgical; however, currently reducing the size of adenoid hypertrophy with the leukotriene receptor blocker of montelukast is evaluated among treatment choices apart from surgery. The aim of the study was to assess whether montelukast treatment is an alternative to surgical treatment or not. The study included a total of 50 pediatric patients. Adenoid tissue size was evaluated endoscopically and radiographically. Patients were divided into two groups based on closure of the nasopharynx by adenoid tissue. Group 1 comprised adenoid hypertrophy cases with the choana blocked by less than 50%, with Group 2 comprising children with adenoid hypertrophy and more than 50% closure of the choana. All patients began 5 mg montelukast treatment for 12 weeks. Patients had the pediatric sleep questionnaire applied before and after treatment. Tests and radiographic results were compared. In both groups, it was identified that montelukast treatment had no effect on adenoid tissue size (p=0.286, 0.304, respectively). Contrary to this, patients in Group 1 were identified to have statistically significant improvement in sleep quality with montelukast treatment (p=0.006). In Group 2 patients, there was no such improvement in sleep quality identified (p=0.91). Montelukast treatment increased sleep quality in children with less than 50% obstruction of the choana.

Key words: Adenoid hypertrophy, children, montelukast, sleep quality

Med-Science. 2021; 10(1): 36-9

Being a medical pathology expert in the COVID-19 pandemic

ORIGINAL RESEARCH

Being a medical pathology expert in the COVID-19 pandemic

Havva Erdem, Muruvvet Akcay Celik

   

Abstract

The aim of the study is to reveal the risk of COVID-19 among pathologists and to examine their views, concerns along with measures to be taken in dealing with COVID-19. The research was carried out in Turkey with online survey method, on 176 participants. According to the findings of the study, participants who served oneon-one to a COVID-19 patient was 47.16%. Number of participants assigned in the polyclinic and clinical processes of coronavirus patients; 63.6%. 24 participant (13.6%) stated that their frozen cases decreased. Substantially, there was a use of protective equipment (88.6%). Cytological specimens were seen to continue 93.7%. There was a competence of 88.6% in terms of protective equipment. It was determined that the anxiety levels of the participants did not change according to age groups, according to the hospital type, working pandemic outpatient clinic and gender variables (p> 0.05). As a result, medical pathologists actively continue their routine services during the pandemic process and also support their other colleagues by working actively in the COVID-19 outpatient clinic. As always, solidarity with our colleagues continues.

Key words: COVID 19, pathologist, pathology laboratory, protection

Med-Science. 2021; 10(1): 40-45
 

Factors affecting glycemic control in patients with type 2 diabetes mellitus using oral antidiabetics: A single-center experience

ORIGINAL RESEARCH

Factors affecting glycemic control in patients with type 2 diabetes mellitus using oral antidiabetics: A single-center experience

Aysegul Sakin, Murat Alay

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Abstract

In this retrospective study, we aimed to investigate the factors affecting glycemic control in patients with type 2 diabetes mellitus (DM) treated with oral antidiabetic drugs (OADs). From 2019 to 2020, type 2 DM patients treated with OADs were included in this study. Patients less than 18 years old and those treated with insulin were excluded from the study. The patients were divided into two groups according to HbA1C levels as follows: good glycemic control (GGC) (<7%) or poor glycemic control (PGC) (≥7). Of the 505 type 2 DM patients, 270 (53.5%) were female. There were 194 (38.4%) patients in the GGC group and 311 (61.6%) in the PGC group. The rate of marriage and employment were higher in the GGC group than those in the PGC group. Likewise, education level and, and high-density lipoprotein were higher in the GGC group than those in the PGC group. In the multivariate analysis, being married (odds ratio [OR], 0.39), duration of DM (OR, 1.12), having a high-school graduate (OR, 0.43), triglyceride level (OR, 1.001), and high-density lipoprotein level (OR, 0.979) were the factors affecting glycemic control. In this study, we found that being married and having a higher education level and high-density lipoprotein level were associated with GGC in type 2 DM patients treated with OADs.

Key words: Glycemic control, oral antidiabetic drugs, marital status, body mass index

Med-Science. 2021; 10(1): 46-50
 

Determination of metabolic syndrome and insulin resistance rate among adults with ultrasound diagnosed non-alcoholic fatty liver disease

ORIGINAL RESEARCH

Determination of metabolic syndrome and insulin resistance rate among adults with ultrasound diagnosed non-alcoholic fatty liver disease

Filiz Araz, Murat Sert

   

Abstract

Metabolic syndrome (MS) has close association with nonalcoholic fatty liver disease (NAFLD) and is characterized by insulin insensitivity, central obesity, dyslipidemia, hypertension and high glucose levels. This study aimed to define the prevalence of MS, insulin resistance and diabetes among subjects with NAFLD.
Patients and method: In a tertiary center, patients diagnosed to have fatty liver disease by ultrasound were included. Cases with drug and/or alcohol use and liver diseases were excluded. Anthropometric measures were applied. Fasting glucose, insulin, c-peptide and transaminase levels were measured. Oral glucose tolerance test was applied to all cases. Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index was calculated. Insulin resistance was defined as HOMA-IR ≥2.7. ATP III criteria were applied for diagnosis of MS. 230 patients were enrolled. 141 patients (61.3%) were female. Mean age was 50.3±10 (18-95) years. Mean body-mass index (BMI) was 30.5±10.6 (18-50). Mean HOMA index was 3.3±2.6 (0.5-26.5). Impaired fasting glycemia was diagnosed in 78 (33.9%) patients, while impaired glucose tolerance and type 2 diabetes were diagnosed in 65 (28.3%) and 51 (22.1%) patients, respectively. MS prevalence among patients with NAFLD was 56.5%. MS was present in 73.2% of patients with HOMA index ≥ 2.7. Independently from BMI, insulin resistance is high in patients with NAFLD. Transaminase levels did not change with MS among NAFLD patients. NAFLD is associated with increased prevalence rate for metabolic syndrome, insulin resistance and type 2 diabetes.

Key words: Nonalcoholic fatty liver disease, metabolic syndrome, insulin resistance, HOMA

Med-Science. 2021; 10(1): 51-5
 

Comparison of single-use flexible URS and re-usable flexible URS: Effectiveness, reliability, cost-efficiency analysis

ORIGINAL RESEARCH

Comparison of single-use flexible URS and re-usable flexible URS: Effectiveness, reliability, cost-efficiency analysis

Mustafa Erkoc, Huseyin Besiroglu

   

Abstract

Comparison of Single-use Flexible Ureterorenoscopy (SF-URS) with Reusable Fiberoptic Flexible Ureterorenoscopy (RF-URS) is one of the most popular subject in Endourology. Flexible Ureterorenoscopy (F-URS) is the gold standard method used in the treatment of kidney and ureteral stones smaller than 2 cm and together with ESWL.SF-URS has been widely used along with RF-URS. Our study aims to analyze retrospectively RF-URS and SF-URS in terms of effectiveness, reliability and cost. 200 patients who underwent F-URS due to renal stones were included in our study. Patients were divided into 2 groups: 100 patients who underwent SF-URS and 100 patients who underwent RF-URS. Mean age of the two groups was 49.58, 50.24 in the RF-URS and SF-URS groups, respectively. The presence of hypertension and diabetes, Body Mass-Index (BMI), and stone characteristics were recorded, and postoperative stone-free rates, duration of hospital stay, duration of operation, postoperative hemoglobin loss, postoperative urosepsis, and auxiliary procedures were evaluated. A cost effective analysis was carried out. The demographic data and stone characteristics of both groups were similar and there was no statistically significant difference (p> 0.05). The SF-URS group was found to be more advantageous in terms of the duration of operation (p<0.05). Other operational data were similar to each other and no statistically significant difference was found (p>0.05). The RF-URS group was found to be more advantageous after a cost-effective analysis (p<0.05). SF-URS has an advantage over RF-URS in terms of image quality, ease of use and duration of operation. RF-URS was found to be more advantageous in a cost-effective analysis. In terms of other operational data, both procedures were similar. Well-designed prospective randomized controlled trials are needed.

Key words: Flexible URS, kidney stone, RIRS, stone

Med-Science. 2021; 10(1): 56-9