Selçuk Tıp Dergisi Arşiv

in this study, the risks of emergency surgical procedures in elderly patients and the effect of surgery on the morbidity and mortality were investigated. The records of 884 patients, those who were 65 years old or elder, and who were operated on in the Department of Surgery, University of Selçuk beetwen May 1991 and April 1997 were analyzed, retrospectively. One hundred eighty three patients (20.7%) were operated on urgently and 701 patients (79.3%) were elective. The ratio of male ifemale was 1.9 (120M/63F) and the mean age was 72.3 (range 65-95) in the emergency operations. Most frequent reason for the emergency operations were intestinal obstruction (49 cases), acute mesenteric ischemia (24 cases) and pepic ulcer perforation (23 cases). Mean hospital stay was 10.8 days (3-51 days) in the emergency and 7.2 days (1-41 days) in the elective operation (p<0.0001). The mor-tality was 18.6% in the emergency and 3.4% in the elective operations (p<0.0001). There was no correlation bet-ween mortality rates in different age groups (p>0.05). The highest mortality was observed in intraabdominal abs-cess and in perforated gallbladder disease. Intestinal resection and anastomosis was performed in 55.9% of expired cases. The majority of the patients (70.6%), who had died, had coexisting cardiopulmonary diseases. The main causes of death in alt patients were sepsis and cordio-pulmonary diseases. The main causes of death in all patients were sepsis and cardio-pulmonary failure. In conclusion, age is not a contraindication for an emergency operation and does not affect mortality which appears to be directly related to the severity and nature of the di-sease and to the coexisting cordio-pulmonary diseases. For this reason, timing is very important in the operations of elderly patients, and it is wise to perform the most conservative operation in some severe surgical conditions.

Preoperative clinical evaluation remains the basis in determination of an appropriate surgical procedure for the patient with otologic disease. Sometimes, howereri after a most complete clinical and radiogical work-up, the clinician will be in doubt about the correct diagnosis. Explarotary tympanotomy provides a unique and helpful, safe and minor surgical procedure that allows direct visualization of contents of the middle ear. In this article, thirteen patients who had exploratory tympanotomy for hearing loss and contemporary indications for exploratory tympanotomy were discussed.

In this study, thirty cases af laringeal carcinoma which diagnosed in our clinic between November-1994 June-1996 are compared by preoperative CT, laryngoscopy and postoperative speciemen findings. By laryngoscopy one could evaluate the status the mucosal lining and vocale cord motility. Lımitations of the cord vocale motility is attributed to deep invasion of the tumour but, the exact dimensions of the tumour could not be estimated. The conventional radiologic examination methods da not add any useful knowledge to the laryngoscopy. The com-puted tomograpic examination is useful to determine the precise anatomic localization and spread of the tumour which is very useful ta surgeon to choose the surgical treatment method. We concluded that CT is valuable di-agnostic method in evaluating the preepiglottic area, paraglottic area, subglottic area and the inferior areas of the larynx which is obstructed by the large laryngeal masses and the cartilage invasion which could not be evaluated by laryngoscopy and other conventional radiological methods. Also we concluded that there may be wrong de-cisions about the cartilage invasion due to the irreguler calcifications and microinvasions by CT examination. In the evaluation of the small mucosal lesions CT could yield false negative results and these lesions could be more accurately determined by laryngoscopy. CT evaluation of the laryngeal carcinoma patient prior to surgical in-tervantion is an additional diagnostic tool to the laryngoscopy and very useful for the determination of the best conservative surgical method.

Normotensive (group l) (n-21) and pharmacologically normotensive (group Il) (n=13) patients with benign prostate hypertrophy (BPH) are included in a survey for efficacy of doxazosin, which is a selective alpha-1 bloc-ker. The effects of doxazosin on urinary flow rates, International Prostate Symptom Score (IPSS), residual urine volume and blood pressure are evaluated. Doxazosin was giyen 4 mg for 12 weeks after a titration period of 3 weeks. Differences were found statistically significant in all parameters. In both groups, doxazosin caused a sta-tistically significant reduction in diastolic blood pressure but this was clinically unimportant. Side effects were to-lerated well by the patients. When medical treatment is indicated in normotensive and pharmacologically nor-motensive BPH patients, doxazosin can be used without significant blood pressure reduction.

This stuy was performed mainly in 3 villages of Kulu, Konya. All of the wives living in 5 avenues of the villages which were chosen randomly were included in the study. They were divided into two groups first, group was con-sisted of 79 spouses whose husbands were working in the abroad and the second was consisted of 90 women whose husbands were working in Turkey. Both groups were compared in terms of some demographic and psychologic symton-ıs_ First group had a significantly high ratio of psychologic symptoms compared to those of se-cond group. No relation between sociodemographic features and psychologic symptoms was determined. Results suggest that "being abroad" is an enough reason for wives to exhibit psychologic symptoms. This means that se-parated famllies have to be united as soon as possible fn order to solve these problems.

This study included 126 Down syndrome cases (81 males and 45 females) who had regular trisomy 21 in 120 cases, chromosome 21q trisomy in 5 and a mosaic karyotype in one case. The ratio of males to females was found to be 2:1 in regular trisomy 21 and 1:4 in chromosome 21q trisomy. The study implicated that trans-locations that were found were mostly matemal in origin. it is alsa noteworthy that the frequency of consanguinity among the parents having children with Down syndrome (21.6%) was not different from the population fre-quency in Konya (23.2%). Moreover, the mean age of ~her having children with Down syndrome was de-termined to be 30.7

Objective: This paper was aimed ta identify job satisfaction and its sources among health staffs (general practitioners, midwife, nurse, health functionary) working at public health centers. Materials and methods: In 1997, a self-administered questionnaire (Short form of Minnesota Satisfaction Questionnaire) was used for 153 health staffs who were working at 21 public health centers selected with cluster sampling in Konya province. Glo-bal satisfaction score was calculated generally and according ta demographic features. For each item which is constituted job satisfaction the ratio of health staff isafisfied' was calculated. Results: The percentage of health staff satistied was 59.5% and the average of global satisfaction score was 3.75. There was no relation between global satisfaction score and person's age, Bender, marital status, location of practice and job duration. The mid-wifes were less dissatisfied than the others. The working environrrıent and income were the most important fac-fors of dissatisfaction. Conclusion: According to the results health staffs working at public health center have low satisfaction score. The working condition and income salaries should be improved and the other matters which originates dissatisfaction must be considered.

Skin test and the determination of total lgE level in serum are the methods often used in the diagnosis of allergy. A prospective analysis was performed on 399 clinically atopic patients with bronchial asthma, rhinitis and conjunctivitis between May 1996- July 1998. This study was designed to investigate the allergens and the corelation between the serum total lgE and skin test reactions. Skin test reactions were positive in 207 patients. We found 73.91% positive skin test reactions for mixture of cereals, 59.42% for tree pollen extracts, 47.83% for grass pollen extracts, 27.05 for weed mixture and 23.67% for house dust mites. Skin test reactions were positive in 31%, 74%, 42%, 71%, 60% in brochial asthma, rhinitis, rhinitis+asthma, rhinitis+conjunctivitis, rhinitis+conjunkctivitis+asthma, respectively. 71% of patients with bronchial asthma and 33% of patients with rhinitis had high total lgE levels. We didn't determine positive correlation between the skin test positivity and high serum total lgE levels.

Labor pain, which causes intolerable pain in some mothers, is one of the most severe and difficult to control pains known. Despite the false belief that this pain is natural and that every mother should suffer from this pain, labor pain should definitely be controlled. Because, like other acute pains, the respiratory system has negative effects on the cardiovascular system, neuroendocrine and limbic systems. It is an event that exhausts the mother, causes stress and anxiety, and increases the need for oxygen by hyperventilation.