Selçuk Tıp Dergisi Arşiv

Aim: This study was undertaken to evaluate the electromyograpy (emg) and laboratory findings of amyloidosis related with dialysis in the patients treated with high flux (HF) and standart (STD) hemodialysis (HD). Method: This study included a total of 16 standart HD and 16 HF HD patients who were treated with dialysis for at least 3 years. Median nevre (motor and sensory), Unlar nevre (motor and sensory), Fibular motor, Posterior Tibial motor and Sural sensorial nerves were evaluated. Blood β2 mikroglobulin levels in these patients were investigated. Results: There was statistical significant difference in regard to blood β2 mikroglobulin levels between both groups (p=0.00). EMG findings of Carpal tunel syndrome (CTS) was observed in 20% and 25% of the patients treated with ST HD and HF HD (respectively). There was no statistical significant difference in terms of EMG findings between two groups (p=0.539). Conclusion: EMG is a useful method in the detection of neurological findings such as CTS. The initiation of HF TD appears to be reasonable before the findings of amyloidosis related with dialysis was started in susceptible cases.

Aim: Despite its high prevalence, pain induced by uremic neuropathy is usually underrecognized during diagnostic process and undertreated. In most of the patients, traditional drugs are ineffective. In this study, we investigated the effect of gabapentin on neuropathic pain along with quality of life (QOL) and depression in hemodialysis (HD) patients. Methods: Twenty two patients with chronic renal failure who were on HD were included in our study (10 males and 12 females, mean age 62±3.53). We administered 300 mg/day gabapentin for 8 weeks to patients in whom neuropathic pain was detected. We administered SF-36 Evaluation Test (Physical Component Score and Mental Component Score) for QOL, Beck s Depression Inventory (BDI) for depression and Short Form of McGill s Pain Questionnaire (SF-MPQ: VAS; Visual Analogue Score, PPI; Present Pain Intensity, total SF-MPQ) before and after the treatment. Results: With gabapentin treatment, we found a statistically significant decrease in pain scale scores. Total SF-MPQ decreased from 21.32±8.74 to 7.5±5.72, VAS scale decreased from 6.4±2.15 to 2.45±1.81, PPI decreased from 3.18±1.1 to 1.3±0.88. We also determined significant improvements in SF-36 and BDI scales (p

Aim: Intervertebral disc herniation is a very common neurosurgical pathology.A prospective, controlled cohort study was conducted to assess whether sleeping position is important or not in the formation of lumbar disc hernia in etiology. Because according to the sleeping position the rotational force applied to the lumbar region may differ. Method: This is a prospective study carried out between 2007-2008 in 84 patients to be operated with lumbar disc hernia at two different level. The patients were grouped into two groups according to their sleeping position habits before they get ill. Conclusion: We find that there was a statistically significant relations between cross leg position and occurance of disc herniation when compared to adjoined legs position.

Aim: This study had been planned to detect the factors affecting the cost of care in intensive care units. Methods :Between 01 August 2002 and 01 August 2003 patient who stayed more than 48 hours in the intensive care units were followed. Results :The median value of cost was (3668 $). Cost was considered to be ‘increased’ if it was more than 3668 $. In multivariate analysis factors associated with risk of increased cost were hospital acquired infections (OR 4.2621 95% confidence interval 1.688-10.735 p = 0.002), being admitted for post opertive care(OR 2.746 95% confidence interval 1.086-6.947 p=0.033) increased length of stay (OR 3.807 95% confidence interval 1.510-9.597 p= 0.005). The invasive interventions ,severity of ilness scores (SAPS II and APACHE II) and age (>65) were not detected to be independent risk factors for increased cost. Conclusion : Infections, admission for post operative care and increased length of stay were found to be associated with increased cost inpatients followed in intensive care units.

Aim: Various types of haemorrhage can cause hypovolemic shock. Volume replacement for prevention of hypovolemic shock results with reperfusion. The aim of this study was to determine the hepatic tissue MDA, XO, SOD and AOA levels after reperfusion following ischemia with duration of 30 minutes. Method: Twenty four female Spraque-Dawley rats were divided into four groups of six rats in each. Group A was the control group and B, C, and D groups were ischemia-reperfusion groups which were reperfused for 1 hour, 3 hours and 24 hours after 30 minutes hemorrhagic ischemia, respectively. In the ischemia-reperfusion groups at the end of the reperfusion periods, rats were sacrified and the liver tissue samples were collected. In group A rats were only anesthetized for one hour and then they were sacrified and the liver tissue samples were collected. MDA, XO, SOD and AOA analyses were performed in liver tissues. Results: MDA and XO levels were significantly increased in the ischemia- reperfusion groups when compared with the control group (p<0,05). These changes were most obvious in the first hour. Conclusion: Our findings showed that volume replacement therapy after hypovolemic shock was lead to reperfusion injury. Because MDA, XO, SOD ve AOA changes were more significant in the first hour of the reperfusion than the 3th and 24th hours; we suggest maintenance of antioxidant suplements with replacement theraphy to decrease the reperfusion injury. For the supplemental management antioxidants such as alpha tocopherol, ascorbic acid and melathonin can be prefered in the first hour of reperfusion especially.

Retinopathy of prematurity (ROP) is a potentially blinding disease. ROP continues to be a leading cause of blindness of newborn in areas of the world that provide neonatal intensive care services to premature newborns. The aim of this review is to evaluate the new technical improvements and treatment modalities under current data. Increased number of Newborn Intensive Care Units leads to survive of incerased number of immature babies which in turn leads to increased number of premature infants to be screened and eyes to be treated. Although the current gold standart of screening method is examination by an experienced opthalmolog with binocular indirect ophthalmoscopy, a new debate arose that claims digital retinal photographs may be taken and evaluated in the remote reading centers by experienced ophthalmologists. On the other hand intravitreal injection of single dose of anti-VEGF may replace the more destructive cryotherapy and laser at the treatment aspect. Recent technical and medical improvements may induce major changes at the screening and treatment protocols of PR.

Oro-facio-digital syndrome, a group of congenital anomalies, is characterized by malformations of the oral cavity (cleft palate and tongue, abnormal dentition, high arched palate, tongue lobulation, hamartomata on the tongue), face (frontal bossing, facial asymmetry, hypertelorism, facial milia), and digits (syndactyly, brachydactyly, clinodactyly, polydactyly. This syndrome has nine different types. Oro-facio-digital syndrome type I (OFDS1) is the most common type, which identified by French dentists Papillon Leage and Psaume Jean, in 1954. OFDS 1 is an X-linked dominant condition that is lethal for males. OFDS 1 is a rare syndrome, occurring in approximately 1/250,000 live births. Approximately 75% of cases are sporadic. There is no specific therapy for OFDS 1 other than surgical correction of the dysmorphic features. Being a rare entity, this paper presents a case of OFDS 1 in a newborn.

Intrauterine devices (IUDs) are the most commonly used method of contraception, worldwide, especially in developing countries. Uterine perforation by an IUD is a rare but an important complication of IUD insertion. In this case report; we present, a patient who had “a neglected lost IUD”, in whom string of IUD was not seen in her follow up examination. The patient was told that in spite of the absence of the string; it will reserve its contraceptive effect. The patient had uneventful pregnancy and delivered at term. Thirty eight years old patient who had gravida 4, parity 4 was referred to our clinic because of lost IUD. In her history she had normal vaginal delivery before 2 years, after 6 weeks IUD was introduced in a health centre. She had pelvic pain and consulted the same health centre where she was told that the string was not seen but it will reserve its contraceptive effect. The patient got pregnant and delivered a full term baby. She had normal gynecological examination uterus and adnexa were normal in ultrasonographic examination but an echo of IUD was seen in Douglas. The IUD was extracted laparoscopically. We think that uterine perforation occurred during insertion of the IUD and it passed to Douglas pouch. For patients who have IUDs with lost string we should determine the location of the IUD. Uterine perforation should be thought of when empty uterine cavity is seen.

In this study, it was aimed to rise a notice of gastric obstruction, a rare complication of multidose activated charcoal treatment of organophosphate poisoning, because of a case. Clinical signs that thought to be an intestinal obstruction was recognized in a 65 aged male patient who was treated with multi-dose activated charcoal because of organophosphate poisoning. Some solid images could be related to activated charcoal determined by the computerized tomography. These congromelates were emptied by endoscopy since the gastric lavage was insufficient. A gastrointestinal obstruction may develope during the multi-dose activated charcoal treatment. In this case it is important to being aware of this complication and managing it in the appropirate time.