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The evaluation of two different surgical approaches in total hip arthroplasty according to the patient satisfaction, plantar pressure distribution and trendelenburg sign

Original Article

The evaluation of two different surgical approaches in total hip arthroplasty according to the patient satisfaction, plantar pressure distribution and trendelenburg sign


Ahmet Yildirim, Tacettin Ayanoglu, Mustafa Ozer, Erdinc Esen, Ulunay Kanatli, Selcuk Bolukbasi.

   

Abstract
The aim of this prospective study was to analyze the results of two different surgical aproaches for total hip arthroplasty as Trendelenburg sign, plantar pressure distribution with the help of dynamic pedobarography and clinical results by Harris Hip Score. A total of 28 patients who underwent unilateral total hip arthroplasty using two different types of lateral approach as conventional lateral Hardinge approach and intermuscular Hardinge approach described by Pai were included in this study. Plantar pressures have maesured by EMED-SF pedobarography device and analysed by the help of a commercial software; that seperates the foot to the four different parts which are called masks. Trendelenburg’s sign has been estimated as grade 1 and grade 2 by the method which was described by Hardcastle and Nade. Clinical outcome was measured by comparing Harris Hip Scores pre-operatively and postoperatively at last clinic visit. In both groups after the two years from the surgery; total contact time has increased at the operation side when the results were compared before the surgery at the same side and at the other side after the surgery. Also when we looked at the first and second masks which show the significant part of the stance phase; contact areas have similarly increased and the changes at the peak pressures were similar as contact areas. In both groups Harris Hip score was increased significantly after the operation. This is the first study to compare two different lateral approaches by pedobarographic analysis, clinical evaluation and functional scoring. The fuctional and clinical early results are similar in both lateral hip approaches for total hip arthroplasty when superior gluteal nerve protection, conjuant tendon repair and postoperative rehabilitation have done well.

Key words: Total hip arthroplasty, pedobarography, Trendelenburg’s sign, Harris hip score, gait analyses

Med-Science. 2019; 8(1): 1-6

 

 
Medicine Science Vol:8 Issue:1 Year:2019 PP:1–259

Lower limb injuries secondary to hoeing machine accidents

Original Article

Lower limb injuries secondary to hoeing machine accidents


Ali Gulec, Fatih Durgut, Ali Ozdemir, Ahmet Yildirim, Bahattin Kerem Aydin.

   

Abstract
Agricultural accidents are important for Turkey as more than 20 million people are involved in agriculture. The aim of this study was to evaluate orthopaedic lower limp injuries related to hoeing machine from a trauma centre localized in Middle Anatolia Region. 15 patients who hospitalized for hoeing machine were included to study due to lower limp injuries between April 2012 and May 2017. All the medical records were scanned retrospectively to evaluate “the demographic, epidemiologic characteristics of patients, cause of accidents, type of injury, duration of hospital stay and also hospital costs were evaluated retrospectively “. According to database, fifteen patients were hospitalised for lower limp injuries (14 were male, 1 female). The mean age was 45.2 (19-64) years old. The most frequent injury was tibia fracture (64 %). The mean hospital stay time was 14 days (between 1and 53). The mean cost was 11.140,16 (500 and 27.115,08) Turkish Liras. The rate of knee dislocation was 26 %. Most prevalent injury was tibia fracture. Simple precautions can be effective for preventing this kind of injuries. Meticulous examination is important as the rate of knee dislocation is high in these types of traumas.

Key words: Hoeing machine, knee dislocation, agricultural injury, fracture

Med-Science. 2019; 8(1): 7-10

 
 

 

 

Correlation between homocysteine levels and stroke in patients with acute ischemic stroke

Original Article

Correlation between homocysteine levels and stroke in patients with acute ischemic stroke

Adnan Kirmit, Aysegul Akagunduz Ege, Ali Guctekin, Mustafa Kemal Basarili, Mujgan Ercan Karadag

   

Abstract
Ischemic strokes are mostly caused by atherosclerosis, and increased homocysteine levels are considered to play a role in atherosclerosis. The aim of this study was to investigate serum total homocysteine (tHcy) levels in the first 24 h of ischemic stroke patients and to analyze the correlation between tHcy levels and the clinical severity of ischemic stroke. The study included a total of 151 participants including a patient group of 83 patients diagnosed with acute ischemic stroke and a control group of 68 age- and gender-matched subjects with no history of ischemic vascular diseases between June 2006 and December 2007. Demographic characteristics of were recorded for each participant and stroke severity was assessed using the modified Rankin Scale (mRS) in each patient. Serum tHcy, vitamin B12, folic acid, and fibrinogen levels as well as platelet count and lipid profiles were measured for each participant. Serum tHcy levels were significantly higher and the folic acid levels were significantly lower in the patient group compared to the control group (p

Key words: Acute ischemic stroke, modified rankin coma scale, homocysteine, vascular risk factors

Med-Science. 2019; 8(1): 11-5

 

 

Is there any relationship of postoperative atrial fibrillation with the use of blood products and postoperative hemoglobin levels in patients undergoing coronary artery bypass grafting?

Original Article

Is there any relationship of postoperative atrial fibrillation with the use of blood products and postoperative hemoglobin levels in patients undergoing coronary artery bypass grafting?

Ahmet Yuksel, Yusuf Velioglu, Mehmet Ergun Tecimer, Irem Iris Kan, Murat Bicer, Orcun Gurbuz, Mustafa Tok, Bulent Ozdemir, Nofel Ahmet Binicier, Isik Senkaya Signak

   

Abstract
The goal of this study was to assess the relationship of postoperative atrial fibrillation (AF) with the use of blood products and postoperative hemoglobin levels following coronary artery bypass grafting (CABG). Eighty patients undergoing isolated CABG from June 2013 to December 2013 in our institution were included in this study, and divided into two groups that contain 40 patients according to their postoperative blood hemoglobin levels in this prospective study. In Group 1 and 2, there were patients that whose postoperative hemoglobin levels were below 10 g/dL and above 10 g/dL, respectively. Groups were compared with each other according to the use of blood products and occurrence of AF, then the relationship between use of blood products and occurrence of AF was analyzed. Moreover, patients that occur postoperative AF and patients that do not occur postoperative AF were compared with each other; thus, risk factor analysis for postoperative AF were performed. Postoperative AF was observed in 12 (30%) patients in Group 1 (mean age: 62.0±9.6 years, 24 male) and 7 (17.5%) in Group 2 (mean age: 60.3±9.0 years, 27 male), but this difference was not found to be statistically significant. When patients that occurred AF and did not occur AF were compared, according to the number of patients that had received blood products, the patients that had occurred AF had received more blood products than the patients whom had not occurred AF although again this difference was not statistically significant. In risk factor analysis; advanced age, low ejection fraction, obesity and the non-use of preoperative beta blocker were found to be risk factors associated with postoperative AF. In accordance with this study, the use of blood products and postoperative hemoglobin levels do not have an important impact on AF that occurs in patients undergoing isolated CABG. However, further studies with larger patient series are needed to elucidate this relationship.

Key words: Atrial fibrillation, blood transfusion, hemoglobin, coronary artery bypass grafting

Med-Science. 2019; 8(1): 16-20

 
 

 

 

Prevalence of frailty syndrome and related factors in older adults living in a nursing home

Original Article

Prevalence of frailty syndrome and related factors in older adults living in a nursing home


Semsinnur Gocer, Osman Gunay.

   

Abstract
In this study, it was aimed to determine prevalence of frailty syndrome in older adults living in a nursing home in Kayseri and to assess relationship of frailty with sociodemographic characteristics and health-related conditions. This cross-sectional study was conducted on older adults living in a nursing home in Kayseri in 2016. Data were collected by using a sociodemographic questionnaire, Katz Index of Independence of Daily Living Activities, Instrumental Activities of Daily Living Scale, Geriatric Depression Scale and Study of Osteoporotic Fracture Index. It was aimed to include 128 older adults living in the nursing home. A total of 105 people were included. Chi-square test was used for statistical analysis. Of subjects, 56.2% were men; 5.7% were married and 45.7% were literate, 92.4% had health insurance, and 70.5% had regular income. Mean age was 77.5±8.7 years. Prevalence rate of frailty syndrome was 31.4%. Prevalence rate was found to be higher in women and in those aged ≥85 years. It was found that walking difficulty and walking stick use were more prevalent, while general health perception and sleep quality were poorer in older adults with frailty syndrome. Frailty syndrome was detected in approximately one-third of the study group. Prevalence rate of frailty syndrome was found to be higher among women and it was found to be increased by advancing age. The frailty has negative influence on health perception, sleep quality and walking difficulty. It is important to assess older adults for frailty and risk factors and to raise awareness the caregivers on frailty syndrome..

Key words: Older adult, nursing home, frailty syndrome, daily living activities

Med-Science. 2019; 8(1): 21-6

 

 

Relation of homeostasis model of insulin resistance and body mass index with cardiac repolarization inhomogeneity in overweight and obese patients

Original Article

Relation of homeostasis model of insulin resistance and body mass index with cardiac repolarization inhomogeneity in overweight and obese patients

Fatih Kuzu

   

Abstract
In obese individuals, asymptomatic minimal myocardial dysfunction can be encountered even in the absence of structural of functional cardiac alterations. Novel electrocardiographic (ECG) parameters are used to predict arrhythmias related to this situation. We aimed to evaluate body mass index (BMI) and homeostasis model of insulin resistance (HOMA-IR) levels and investigate their relationship with the novel ECG parameters. The study was conducted with 250 individuals in five groups (normoweight, overweight, class I obese, class II obese, and class III obese) each including 50 subjects. The ECGs of the individuals were retrospectively reviewed. Corrected QT (QTc), QTc dispersion (QTcd), Tpeak-Tend (Tp-e) interval, Tp-e dispersion (Tp-ed), and Tp-e/QT and Tp-e/QTc ratios were calculated and their relationship with BMI and HOMA-IR was investigated. ECG parameters indicating ventricular repolarization inhomogeneity were significantly different in overweight individuals compared with the normoweight individuals. Comparing overweight and obese subjects, it was determined that QTc, QTcd and Tp-ed parameters were significantly associated with obesity and showed positive correlations with BMI and HOMA-IR. There was a positive relationship of BMI and HOMA-IR with the novel parameters indicating ventricular repolarization abnormality. Novel and simple ECG parameters including QTc, QTcd, and Tp-ed might be beneficial in monitoring of such patients for critical cardiac events, such as ventricular tachycardia or sudden cardiac death.

Key words: Obesity, electrocardiography, QTc dispersion, Tp-e dispersion

Med-Science. 2019; 8(1): 27-31

 
 

 

 

The effect of measurement uncertainty for HOMA-IR in assessment of insulin resistance

Original Article

The effect of measurement uncertainty for HOMA-IR in assessment of insulin resistance

Mujgan Ercan, Aysen Caniklioglu, Esra Firat Oguz, Cigdem Yucel, Mehmet Ozcan, Fatma Meric Yilmaz, Sedat Abusoglu, Canan Topcuoglu, Yusuf Bayrakceken

   

Abstract
In this study, it is aimed to estimate not just the uncertainty measurement for the parameters of glucose and insulin having role when calculating HOMA-IR, but also true positiveness and negativeness in terms of cut-off values. The evaluation of the acceptability of the uncertainty value was also among the goals of the study. The uncertainty measurement for glucose and insulin is calculated as uncertainty measurement of HOMA-IR based on Eurochem/CITAC Guide CG 4. The uncertainty measurement for glucose and insulin was estimated as 3.83% and 4.16%, respectively. The measurement uncertainty for the calculated test HOMA-IR was calculated with cut-off values as 27% (0.27). Based on the cut-off value for HOMA-IR of 2.5%, IR(+) and IR(-) patients were 155 and 265, respectively. If the uncertainty measurement for HOMA-IR was added to its calculation, the cut-off value was detected as 2.23-2.77%. We reported the measurement uncertainty of the calculated test HOMA-IR at 95 % CI as 0.27 between 2.23 – 2.77. Especially for the tests used for screening; determination of cut-off values as a range including measurement uncertainty instead of a single value will be more suitable. No data is found in the literature for the calculated test HOMA-IR up to date.

Key words: HOMA-IR, insulin resistance, cut-off

Med-Science. 2019; 8(1): 32-6

 

 

Traumatic cataract study: Surgical outcomes of blunt versus penetrating ocular injuries

Original Article

Traumatic cataract study: Surgical outcomes of blunt versus penetrating ocular injuries

Cetin Akpolat, Ferhat Evliyaoglu, Muhammed Mustafa Kurt, Aylin Karadas, Mehmet Necdet Cinhuseyinoglu, Mustafa Nuri Elcioglu

   

Abstract
The aim of the present study is to evaluate the results of traumatic cataract surgery with regard to the type of trauma, mainly in the assessment of visual acuity. Forty-four patients who had been diagnosed with traumatic cataracts were included in this retrospectively designed study. The patients were divided into blunt and penetrating groups according to the type of trauma. Pre- and postoperative ocular findings of the cases were evaluated. Visual acuity, intraocular pressure, intra- and postoperative complications, associated injuries, and surgical approaches were analyzed. Thirty-three of the cases were male (75%) and 11 (25%) were female. There were 23 patients (52.27%) in the blunt group and 21 (47.72%) in the penetrating group. The pre-operative mean vision of the subjects included in the blunt and penetrating groups was 0.82 and 0.96 logMAR, respectively. Ten (22.72%) eyes were hypotonic (

Key words: Traumatic cataract, blunt injury, penetrating injury, phacoemulsification

Med-Science. 2019; 8(1): 37-41

 

 

 

Reliability of multi-vessel off-pump coronary artery by-pass surgery in patients who have low risk profile

Original Article

Reliability of multi-vessel off-pump coronary artery by-pass surgery in patients who have low risk profile

Hakan Fotbolcu, Erhan Kaya

   

Abstract
We investigated the reliability of multi-vessel off-pump coronary artery by-pass surgery in patients who have low risk profile. This study included 53 patients who undergone off-pump coronary artery by-pass surgery. Patients have been allocated two groups in terms of graft count. 1 and 2 vessel patients were defined as Group A and 3,4,5 vessel patients as Group B. Baseline and serial post-operative CK-MB values were obtained. Ejection fraction (LVEF), mitral-myocardial systolic velocities (lateral S’ and septal S’), mean E’, left ventricle filling pressure index (E/E’ ratio) and tricuspid-S’ were calculated at pre and postoperative period. Intensive care unit stay time was moderately correlated with pre mean E’ (r = -0.32, p=0.020) and pre E/E’ ratio (r = 0.34, p=0.013). ∆ CK-MB values were similar between two groups (p=0.263). There are no differences between groups in terms of ∆ LVEF, ∆ mean E’, ∆ lateral S’ and ∆ tricuspid S’. ∆ E/ E’ ratio was mildly in favour of group A patients (-2.31 ± 2.70 vs. -0.29 ± 2.89, p=0.007). Furthermore, ∆ septal S’ was slightly in favour of group A patients (0.71 ± 2.39 cm/s vs. -0.66 ± 1.73 cm/s, p=0.017). Multi-vessel off-pump coronary artery by-pass surgery seems as safe as 1 and 2 vessels despite small differences in terms of cardiac function alterations in patients who have low risk profile.

Key words: Multi-vessel off-pump coronary artery surgery, reliability, low risk profile

Med-Science. 2019; 8(1): 42-7

 

Is cerebral edema effective in idiopathic intracranial hypertension pathogenesis?: Diffusion weighted MR imaging study

Original Article

Is cerebral edema effective in idiopathic intracranial hypertension pathogenesis?: Diffusion weighted MR imaging study

Kerim Aslan

   

Abstract
The aim of this study is to research whether cerebral edema is effective in the pathogenesis of patients with idiopathic intracranial hypertension (IIH) by using diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurements. Was changed into thirty-six IHH patients who received DWI and 36 age- and sex-matched healthy control group were assessed retrospectively. ADCmin, ADCmean, and ADCmax values were measured from different regions of the brain for both IHH patients and the control group. The Student’s t-test was used to compare the ADCmin, ADCmax, ADCmean values acquired from distinct parts of the brain parenchyma of IIH patients with the values of control group. No significant difference was found between ADCmin, ADCmax, and ADCmean values of IIH and control group in bilateral frontal, parietal temporal and occipital lobe cortical and subcortical white matter, caudate nucleus head, putamen, thalamus, corpus callosum splenium and genu (P>0.05). This study showed that cerebral edema cannot be a significant mechanism in the pathogenesis of IIH.

Key words: Diffusion-weighted imaging, apparent diffusion coefficient, idiopathic intracranial hypertension, cerebral edema

Med-Science. 2019; 8(1): 48-52