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Comparison of the effects of general anesthesia and combined femoral popliteal nerve block on postoperatıve pain in patients with diabetic underwent transtibial amputations

Original Article

Comparison of the effects of general anesthesia and combined femoral popliteal nerve block on postoperatıve pain in patients with diabetic underwent transtibial amputations

Faruk Cicekci, Ahmet Yildirim, Ozkan Onal, Omer Faruk Erkocak, Inci Kara

   

Abstract
To compare the postoperative pain effects of ultrasound-guided combined femoral-popliteal nerve block and general anesthesia in patients with diabetes mellitus (DM) underwent unilateral transtibial amputations. The study was planned as a retrospective study. Sixty-four patients who underwent unilateral transtibial amputations operations between July 2016 and July 2017, with either general anesthesia (GA, n=28) or ultrasound-guided combined femoral-popliteal nerve block (CFPNB, n=36) were included in the study. Postoperative visual analogue (VAS) pain scores at 2, 6, 12, 24, and 48th hours, total amount of consumed pethidine and the first analgesia requirement time were evaluated. The demographic characteristics of the patients were similar (p>0.05). The VAS scores and total amount of consumed pethidine were lower, and longer the first opioid analgesia requirement time in the CFPNB group in the first 48 hours than in the GA group (p

Key words: Diabetes mellitus, transtibial amputation, general anesthesia, femoral nerve block, popliteal nerve block, ultrasonography, visual analogue score

Med-Science. 2019; 8(3): 496-9

 

Medicine Science Vol:8 Issue:3 Year:2019 PP:489-773

Prevalence of hypouricemia, possible causes and clinical outcome

Original Article

Prevalence of hypouricemia, possible causes and clinical outcome

Can Huzmeli

   

Abstract
Hypouricemia is usually defined as serum uric acid level <2,0 mg/dL. Hypouricemia has no symptoms and usually does not require treatment. But it can lead to nephrolithiasis clinically and acute kidney damage after exercise. There are many possible causes of hypouricemia, such as malignancy and diabetes mellitus. In this study, we aimed to investigate the prevalence and possible causes of hypouricemia and clinical outcomes. Patients who applied to the Kahramanmaras Necip Fazıl City Hospital between January 2016 and December 2017 and patients with serum uric acid levels were included in the study. Individuals with serum uric acid levels <2 mg/dl were screened and their diagnoses and treatments were noted. Renal ultrasonography was also evaluated for nephrolithiasis in patients with hypouricemia. A total of 59755 patients were included in the study. The prevalence of hypouricemia was determined as 0.88% (531/59755). The prevalence of hypouricemia was determined as 0.74% (365/49286) in the outpatient and 1.58% (166/10469) in the hospitalized patients. Of the patients diagnosed with hypouricemia, 77.9% were female and 22.0% were male. The prevalence of hypouricemia among female patients was found to be 1.06% (414/38701) and 0.55% (117/21054) among male patients. Possible causes include malignancy, diabetes mellitus, hypertension, pregnancy, intracranial pathology, burns and drugs. Clinically, acute renal failure, hyponatremia, chronic kidney disease and nephrolithiasis were detected. There were no illnesses or drug use stories in 114 cases. As a result, the prevalence of hypouricemia was found to be 0.88%. It was found higher in hospitalized patients and women.

Key words: Hypouricemia, malignancy, nephrolithiasis

Med-Science. 2019; 8(3): 500-2

Characterization of biosynthesized silver nanoparticles using Hypericum perforatum leaf and determination of their antibacterial activity

Original Article

Characterization of biosynthesized silver nanoparticles using Hypericum perforatum leaf and determination of their antibacterial activity

Arzu Ozgen, Erdi Bilgic, Sinem Gurkan Aydin, Mustafa Nizamlıoglu

   

Abstract
The silver nanoparticles of 1-100 nm size have the potential to be used in many medical fields, such as medical devices, therapies and molecular diagnostics, due to their antimicrobial properties. The biosynthesis of nanoparticles with numerous important advantages over chemical and physical methods has attracted attention today. In this study, the biosynthesis of the silver nanoparticles was performed using the Hypericum perforatum leaf extract to enhance the antibacterial effect of the silver nanoparticles. The morphological characteristic of the obtained mixture was determined using Transmission Electron Microscopy (TEM). Also the formation of the mixture was identified using UV-Vis spectrophotometer. The antibacterial activity of the synthesized Ag NPs using H. perforatum leaf extract was carried out in Gram (+) bacteria (Staphylococcus aureus ATCC 29213, Staphylococcus aureus ATCC 95923, Staphylococcus epidermidis ATCC 12228) and Gram (-) bacteria (Klebsiella pneumonia ATCC 700603, Escherichia coli ATCC 25922, Proteus mirabilis ATCC 27853, Shigella, Acinetobacter baumannii ATCC BAA 747) by disc diffusion method on solid media. The biosynthesized silver nanoparticles using the H. perforatum leaf showed higher antibacterial activity than the antibiotics.

Key words: Biosynthesized, silver nanoparticles, antibacterial activity, hypericum perforatum

Med-Science. 2019; 8(3): 503-7

 

Our laparoscopic gynecological surgery experience through a single incision

Original Article

Our laparoscopic gynecological surgery experience through a single incision

Gorker Sel

   

Abstract
Laparoscopic surgery has special importance for patients with cosmetic concerns. This cosmetic concern also reflects the willingness to take surgical approach as few incisions as possible. The aim of this study is to report the results of bilateral tubal ligation and salpingectomy with an incision of approximately 1 cm from the umbilicus and to introduce this simple and aesthetic technique. Between January 2018 and November 2018, 7 women were admitted to Zonguldak Bülent Ecevit University Faculty of Medicine, Department of Obstetrics and Gynecology with a request for permanent contraception. Under general anesthesia, under sterile conditions, 1 mm infraumbilikal skin incision with a 5mm guide blade removed trocar was entered into the abdomen, insufflation of the abdominal cavity with 15 mm Hg pressure was inflated with carbon dioxide, pneumoperitoneum was provided. 5 mm, 30 degrees optical (Storz ®) trocar was entered into the abdomen. After removal of optic, bluntly penetrated from the same 1 cm skin incision, just next to the 5 mm trocar, if it does not penetrated the fascia, this procedure was performed by expanding the fascial entry with blunt and sharp dissection, followed by 5 mm laparoscopic LigaSure (Covidien ®) was entered into the abdomen through 5-mm trocar. In 7 cases; bilateral tubal ligation and, if necessary, salpingectomy were performed. The mean duration of the cases was 20 (+/- 5) and the time to enter the abdomen was 3 (+/- 1) minutes. Blood loss was negligible since the cases were short-duration minimally invasive cases. In our series of 7 cases, two patients underwent bilateral salpingectomy, in which single incision was not compelling to perform salpingectomy. As aesthetic concerns and the need to reduce the length of hospital stay with less incision and the need for cost-effectiveness increase, these new methods will be developed, further.

Key words: Single incision, laparoscopy, gynecologic surgery, tubal ligation, salpingectomy

Med-Science. 2019; 8(3): 508-11

 
 

Fatty acid profile in patients with seborrheic dermatitis

Original Article

Fatty acid profile in patients with seborrheic dermatitis

Hulya Nazik, Aydin Sukru Bengu, Mehmet Kamil Mulayim, Perihan Ozturk

   

Abstract
Background: Seborrheic dermatitis is characterized by chronic inflammation affecting seborrheic areas. Many factors are responsible for the etiology of disease. Fatty acids play a role in protecting skin structural integrity and functionality. Essential fatty acids and unsaturated fatty acids have a regulatory effect on inflammation.Objectives: In this study, it was aimed to evaluate fatty acid profile in patients with seborrheic dermatitis in the active phase of disease. Thirty seborrheic dermatitis patients with active lesions and 30 healthy controls were included in study. Fatty acid analysis was performed on the serum using 7890/5970c gas chromatography-mass spectrometry (GC/MS) instrument (Agilent, Santa Clara, USA). The percentage of myristic acid, palmitic acid, stearic acid, palmitoleic acid, oleic acid, linoleic acid, linolenic acid and arachidonic acid levels in general fatty acids was determined. In patients with seborrheic dermatitis, essential and unsaturated fatty acids were found to be significantly lower than healthy controls (p

Key words: Dermatitis, seborrheic; fatty acids, essential; fatty acids, unsaturated

Med-Science. 2019; 8(3): 512-5

 

Milk expression and maternity leave as determinants of breastfeeding among mothers employed in a baby friendly hospital

Original Article

Milk expression and maternity leave as determinants of breastfeeding among mothers employed in a baby friendly hospital

Meltem Gunes, Mualla Aykut, Neslihan Oner, Arda Borlu

   

Abstract
This study aimed to evaluate breastfeeding behaviors among healthcare professional mothers employed in a hospital which support Baby Friendly Hospital (BFH) Initiative program. Methods: This cross-sectional and descriptive study was performed in Erciyes University Hospital between August 2011 and June 2012. 175 healthcare professional mothers who had 1-5 years old children recruited for the study. Data was collected via a questionnaire which contains 51 questions. The rate of exclusive breastfeeding (EB) was 33.1% among healthcare professional mothers employed in a BFH. The mean of total breastfeeding duration was 13.02±7.53 months. The rates of cesarean delivery and initiation breastfeeding in an hour were 77.7% and 61.7% respectively of the study group. Vaginal delivered mothers’ breastfeeding rates in first one hour (79.5%) were significantly higher than caesarean delivered mothers’ (56.6%) (p

Key words: Breastfeeding, healthcare, lactation, mother

Med-Science. 2019; 8(3): 516-9

 

Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy

Original Article

Diffusion weighted magnetic resonance imaging in differentiation of small focal liver lesions (≤ 10 mm) detected in patients with extrahepatic primary malignancy

Ahmet Soyucok, Kerim Aslan, Murat Danaci, Ilkay Camlidag

   

Abstract
The purpose of the study is to assess the advantages of diffusion weighted resonance imaging (DWI) prospectively in the metastasis and benign differentiation of small (≤ 10 mm) focal liver lesions (FLL) detected in routine ultrasonography and/or computed tomography screening of patients with extrahepatic primary malignancy. A total of 77 small FLLs (33 metastasis, 27 cyst, 17 hemangioma) of 53 patients who received DWI in addition to conventional magnetic resonance imaging were assessed by 2 independent readers prospectively. Apparent diffusion coefficient (ADC) values were measured for each FLL. T-test was used to assess the statistically significant difference between average ADC values in differentiating between metastasis and benign FLLs. In the metastasis and benign differentiation of small FLLs, optimum cutoff values of ADC values were found by using receiver operating characteristic (ROC) analysis. Average ADC values of small focal liver metastases were statistically significantly lower than those of benign FLL (p < 0.001). Small focal liver metastases were differentiated from benign FLL with 100% sensitivity and 97.1% specificity by using 1.44 x 10-3 s/mm2 cutoff ADC value. This study shows that DWI can be useful in differentiating whether incidentally found small FLL is metastasis in patients who have extrahepatic primary malignancy.

Key words: Diffusion-weighted imaging, apparent diffusion coefficient, small focal liver lesions

Med-Science. 2019; 8(3): 520-5

 
 

Evaluation of left ventricular functions in patients with retinal vein occlusion

Original Article

Evaluation of left ventricular functions in patients with retinal vein occlusion

Batur Gonenc Kanar, Hatice Selen Kanar, Halil Atas

   

Abstract
The aim of this study was to evaluate cardiac functions in patients with retinal vein occlusion (RVO) by both conventional and speckle tracking echocardiography (STE). We included 54 consecutive RVO patients, 47 patients with systemic arterial hypertension (SAH), and 52 healthy controls. Two-dimensional echocardiography (2DE) and STE were performed to all patients and healthy subjects in order to assess left ventricle (LV) systolic and diastolic functions. There was no statistically significant differences among-group in clinical data. RVO and hypertensive patients had LV diastolic dysfunction in conventional echocardiographic measurements. The RVO patients had lower LV global longitudinal, radial, circumferential strain measurements than hypertensive patients and healthy controls. LV subclinical dysfunction might be determined by STE in patients with RVO, independent of whether or not they have SAH.

Key words: Retinal vein occlusion, left ventricle, speckle tracking echocardiography

Med-Science. 2019; 8(3): 526-30

 

The correlation between spiritual well-being and psychological resilience in patients with liver transplant

Original Article

The correlation between spiritual well-being and psychological resilience in patients with liver transplant

Abdurrezzak Gultekin, Funda Kavak, Aysel Ozdemir

   

Abstract
This study was conducted to determine the correlation between spiritual well-being and psychological resilience in patients with liver transplant. 127 patients determined via power analysis participated in the correlational descriptive study. The study was conducted at a liver transplant hospital in the east of Turkey between October 2017 and October 2018. Introductory Characteristics Form which was prepared by the researcher as well as Spiritual Well-Being Scale and Brief Resilience Scale were used in order to collect the data. It was determined that the patients’ spiritual well-being was 34.85±6.70 and their psychological resilience was 19.96±3.54. In the study, it was determined that there was a statistically positive correlation between the patients’ spiritual well-being and psychological resilience (pË‚0.05). In the study, it was determined that the patients who went through liver transplant had a higher spiritual well-being and psychological resilience and as their spiritual well-being increased, their psychological resilience increased. It is required for healthcare professionals to examine the well-being and psychological status of patients at certain intervals and develop skills of establishing a therapeutic relationship with patients and patient relatives.

Key words: Patient, liver transplant, spiritual well-being, psychological resilience

Med-Science. 2019; 8(3): 531-6

 
 

Arginine, symmetric and asymmetric dimethylarginine levels in the molsidomine treatment of experimental ischemia-reperfusion retinopathy

Original Article

Arginine, symmetric and asymmetric dimethylarginine levels in the molsidomine treatment of experimental ischemia-reperfusion retinopathy

Nihat Polat, Murat Atabey Ozer, Hakan Parlakpinar, Zeynep Aksungur, Onural Ozhan, Yusuf Turkoz

   

Abstract
This study aimed to evaluate the mean changes in Arginine, Asymmetric Dimethylarginine (ADMA) and Symmetric Dimethylarginine (SDMA) levels in the ischemia/reperfusion (I/R) retinopathy and efficacy of treatment with molsidomine by these levels. Experiments were performed on the New Zealand white rabbits each weighing approximately 2.5 kg. 28 rabbits were assigned to the following 4 groups, group 1 consisted sham, group 2 consisted I/R, group 3 consisted I/R+ treatment with molsidomine, group 4 consisted prophylaxis with molsidomine +I/R. In the group 2, 3 and 4, ischemia was induced by raising the intraocular pressure to 150 mmHg for 60 minutes. After 60 min, the IOP was returned to normal pressure. 4 mg/kg/day molsidomine was administered intraperitoneally four days after I/R in group 3, one day before I/R and three days after I/R in group 4. Arginine, ADMA and SDMA levels were measured on the aqueous humor. The mean arginine levels were 12.3±4.8 µmol/L in group 1, 12.4±1.4 µmol/L in group 2, 13.2±2.4 µmol/L in group 3 and 13.7±4.3 µmol/L in group 4. No difference was present between the groups (p=0.807). The mean ADMA levels were 2.6±0.8 µmol/L, 7.3±2.7 µmol/L, 0.5±0.5 µmol/L and 2.5±1.0 µmol/L respectively. Significant increase was present in the group 2 and significant decrease was present in the group 3 (p=0.001). The mean SDMA levels were 1.0±0.3 µmol/L, 1.8±0.2 µmol/L, 0.3±0.3 µmol/L and 1.0±0.4 µmol/L respectively. Significant increase was present in the group 2 and significant decrease was present in the group 3 (p=0.001). L-Arginine levels were kept steady, ADMA and SDMA values decreased with molsidomine. Four days treatment with molsidomine after I/R may be beneficial more than prophylaxis and three days treatment.

Key words: Aqueous humor, arginine, asymmetric dimethylarginine, ischemia-reperfusion retinopathy, molsidomine, symmetric dimethylarginine

Med-Science. 2019; 8(3): 537-40