Selçuk Tıp Dergisi Arşiv

We aimed to compare the effects of 20 % mannitol, 3 % or 7 % hypertonic saline on hemodynamic parameters, intracranial pressure and electroencephalography in experimental head trauma. Bilateral craniotomy were carried out in the parietal region and standart head trauma was applied for all rabbits. The rabbits were randomly divided into four groups. In group I rabbits were only observed. In group II: 20 % mannitol, in group III: 3 % hypertonic saline and in group IV: 7 % hypertonic saline was administered intravenously to achieve similar osmolar load. Electroencephalography, mean arterial pressure, heart rate, intracranial pressure were recorded before trauma and 5 and 60 minutes after trauma. Increased intracranial pressure was significantly decreased by mannitol, 3 % and 7 % hypertonic saline solutions at the end of study (p0.05). The mean arterial pressure and heart rates increased after trauma in all groups (p

The aim of this study is to evaluate the indications, results and complications of amniocentesis that we performed in our clinic. Between January 2008 and January 2009 at the Department of Obstetrics and Gynecology Clinic of Selcuk University Meram Medicine Faculty, 617 amniocentesis procedure were performed for many indications in their 16-22nd weeks of gestations. The outcomes were analyzed. The mean age of mother was 32.43±6.66 (18-44) and the mean age of father was 35.79±7.42 (19-61). The mean gestational week was 17.68±2.82 and mean gravidity was 3.03±3.76 (1-12). The biggest amniocentesis indication group was high risk at prenatal screening test with 272 (44.1%) cases. Followed by the advanced maternal age with 203 (32.9%). Chromosomal abnormality was found in 30 (4.94%) cases after the result of karyotype analyses, 18 (60%) of these abnormalities were found in the group of >35 years old. In 15 patients Trisomy-21, in 3 cases Trisomy-18, in 2 cases Turner, in one case mosaicism (46XX/XY), in 4 cases translocation and in 5 cases inversion type chromosomal abnormality was detected. Of the 617 amniocenteses, 3 (0.48%) had fetal losses. The cause of abortion was early membrane rupture in two cases and cramps and vaginal bleeding in one case. Amniocentesis is the most commonly preferred and reliable invasive prenatal test for prenatal diagnosis of genetic disease with minimal complications. Amniocentesis is an important prenatal diagnostic method which must be used when there is accurate indication.

Retrospectively evaluated patient with thoracic trauma who were hospitalized and treated at chest surgery clinic from january 2005-july 2009 A total of 255 patient(220 male-35 female mean age 38.2) with thoracic trauma were evaluated with respect to etiology¬ thoracic pathologies assosiated injuries and treatment methods. Blunt and penetrating thoracic injuries were found in 167 and 88 patients .Respectively the most common cause were traffic accidents (%78) and stab wounds, (%92) for blunt and penetrating thoracic injurıes.The most frequent thoracic pathologies were soft injurıes(%35) followed by pneumothorax(%24), multpl rib fractures ,(%21) hemopneumothorax(%20) and hemothorax(%17).Extrathoracic injurıes were seen in 60(%23.5) patients .The most common being cranial(%45) ,extremity injuries(%38) and abdominal (%18.3). Treatment was conservative 53 patient (%20.78) tube thoracostomy (n- 167 %67.49)diapragmatic repair or bleeding control with thoracotomy (n-35 %13.7). Mortality occured in 3 patients (%1.17) It is important that thoracic trauma patients with increased risk of mortality and morbidity should recieve immidiate and systematic treatment

Regionally to determine cigarette smoking level and affecting factors in a population is an important part of fighting with cigarette smoking. In this study we aimed to evaluate the smoking rates, the factors effecting on smoking and to learn the knowledges about quiting in patients who applied Iğdır Government Hospital Chest Diseaes Department. 721 patient , 426 male ( 59,1 %) and 295 female ( 40,9 %) were enrolled in the study who applied to our hospital between 1 December 2008- 2 February 2009. All patients filled the questionnaire by acting face to face. Demographic characteristics and smoking condition were asked in questionnaire forms. 102 (% 14.1) of the patients were never smoking, 514 (%71.3) of them were still smoking and 105 ( % 14.6) of them were quited. Smoking rates were increasing with education level in females (p

Hellp Syndrome (Hemolysis-Elevated Liver enzymes-Low Platelets)is characterized by hemolysis, elevated liver enzymes and low platelet count, and related with an increased with an increased foetal and maternal mortality. We aimed in this study to evaluate the morbidity and mortality of 15 Hellp syndrome patients who have been admitted to our intensive care unit, between 2005 and 2009 years retrospectively. Patients ICU admission indications, demographic, clinical and obstetric data was noted down; hemoglobin, serum albumin level, prothrombine time ve active partial thromboplastin time, fibrinogen level, thrombocyte number, total bilirubine ve creatinine levels, AST, ALT, lactate dehidroginase (LDH) levels were analysed. Intensive care unit(ICU)admission of Hellp sydrome patients were convulsion, loss of consciousness, airway control, invasive hemodinamic monitorisation, ARDS, intracerebral hemorrhage and respiration insufficiency During 4 day intensive care unit following of our patients, thrombocyte numbers began to increase from third day of admission. But this increament was statistically significant between admission day to ICU and fourth day. Again similarly AST, ALT, LDH, ürea ve creatinine levels began to decreased at third day and decreament was statistically significant as from fourth day(P

Our surgical results have been reported after repair of complete atrioventricular septal defects (CAVSD). Between 2001 and 2009, 29 patients with CAVSD underwent operation at our institution. Double patch repair of CAVSD were performed in all patients. All attempts to close the cleft of the left atrioventricular valve (LAVV) were conducted as completely as possible. Early mortality occurred in three cases (% 10.3) after repair. Twenty patients could be followed-up for a mean of 3.5 years. Reoperation wasn’t needed for LAVV insufficiency, residual atrial septal defect or ventricular septal defect. Repair for CAVSD can be performed in early infancy. The double - patch repair in a safe surgical method that can achieve low mortality and good midterm outcomes.

In this study, we aimed to compare the different delivery speeds of alow dose combined solution of levobupivacaine and fentanyl on haemodynamia, sensorial and motor blockade. 60 ASA I-III patients for spinal anesthesia undergoing transuretral resection were randomly assigned into two groups by using the combined solution of 7.5 mg levobupivacaine and 25 µg fentanyl in four seconds in group I and 40 seconds in group II with 22 G spinal needle for spinal anesthesia. Heart rate, noninvasive blood pressure, sensorial and motor blockade status were evaluated both before and after injections on regular intervals. When the sensorial block level reached to T10 dermatome, the operation began. There was no statistically significant difference between patients demographic data, operation time, ASA status. There were difference was noticed between hemodynamic status of the patients between two groups (p>0.05). Changes in sensorial blockade levels were similar in both groups (p>0.05), but motor blockade level was one in Group I, while it was noticed two in Group II and it was statistically significant (p 0.05). In this study it was shown that both of the injection rates of combination of levobupivacaine and fentanyl prove stable hemodynamia, but it was shown that motor blockade regression time was longer in rapid injection group.

To inform the doctors and nurses working in intensive care units about the pain in newborns, its effects on neonatal development, and the use of nonpharmacological methods for effective pain management. Newborns are challenged by several painful stimuli because of diagnostic and therapeutic preoperative invasive procedures, surgical trauma, and postoperative invasive procedures in the neonatal intensive care units. These babies face physiologic, psychological, and metabolic consequences because of pain. Pharmacologic and nonpharmacological methods are regarded as complementary in effective pain management. Studies showed that nonpharmacologic methods themselves are not only effective in management of pain resulting from invasive procedures but they also increase the effectiveness of medical therapy when used in combination.

Pulmonary embolism(PE) is a serious disease which is one of the most important reason of cardiovascular mortality. In spite of the fact that electrocardography(ECG) has a limited effect on the diagnosis and determination of the prognosis of PE, it is an essential method for clinically differentiating PE from other diseases that might be confused with PE, such as myocardial infarction(MI) .The aim of this case report presentation is to discuss whether this stuation might be a marker on determination of the prognosis.and the fact that PE could mimic the ECG findings of ST elevation myocardial infarction even though it is rare. Fifty six years old patient with acute renal failure and disorder of liver dysfunction, who had been treating in intensive care unit of internal medicine department, complained about chest pain and shortness of breath occuring on second day of his admission to the hospital. The patient was taken from cardiology department with anteroseptal MI prediagnosis after evaulation of the ECG demonstrating about 4 mm ST elevation in V1-V4 precordial derivations. Coronary angiography was performed to the patient being thought to whom primary percutaneous coronary intervention might be neccessary and there was not any lesion determined in epicardial coronary arteries. The parameters obtained from transthoracic echocardiographic evaulation of the patient was corcordant with the diagnosis of PE. It was understood from the imaging reports performed previously that trombus in vena cava inferior had been detected. The patient had cardiac arrest and died while he was being prepared for the pulmonary embolectomy operation after diagnosing of PE. The aspect which made our case report more attractive is that there were only various case reports published about PE in literature, which indicateST elevationmimicing anterior myocardial infartion. It is thought that this situation might be observed in PE and might guide for determination of the prognosis as well when this case report is evaulated together with the other ones.

Primary ciliary dyskinesia is an autosomal recessive, with abnormalities in ciliary structure and function in an outgoing and 20,000 live birth, is a rare disease. Kartagener’s syndrome is characterized by the combination of primary ciliary dyskinesia and situs inversus, and occurs in approximately half of patients with ciliary dyskinesia. It presented here a 12-year-old male patient had a history of recurrent respiratory tract infections and pneumonia.

Acute fatty liver of pregnancy is a rare disease that may lead to serious maternal and fetal complications. It is mostly seen in the third trimester and rarely seen in the postpartum period. The etiopathogenesis is not known. Multifactorial and genetic factors are thought to be responsible. The differential diagnosis include: preeclampsia, cholestatic jaundice and viral hepatitis. Treatment is supportive care following delivery. We presented a case of 21 years old, primigravida patient in her 34th week of pregnancy who had elevated liver enzymes, all other laboratory tests were normal on admission. Laboratory tests of the patient deteriorated within short period and acute fatty liver of pregnancy developed.

Congenital Leukemia is rare disease seen at birth or in the first 4 weeks of life . The incidence of Congenital Leukemia is 1 over 4.7 million live births. Most of the cases are myeloblastic leukemia. Usually symptoms like leukocytosis, petechia, echymosis, cutaneous nodules, hepatosplenomegaly and central nervous system involvement are seen. Two newborns with Down syndrome which were septic at application and diagnosed as congenital leukemia are presented in this article. The early recognition of such cases and finding opportunity to treat before the appearance of secondary complications such as sepsis play an essential role for saving life.

The purpose of the study is to discuss an atrial myxoma case, rarely thought for the differential diagnosis of dizziness, with the help of literature. A 65 year old woman patient was admitted to neurology clinic with complaint of dizziness that started four months ago. No neurological cause was defined as the result of the examinations and the patient was referred to cardiology clinic. After a detailed physical examinaiton, a huge myxoma that lead to obstruction on the left entrance and exit ways in left atrium was defined. The patient was recommended to have a surgical operation, yet she refused to do so. Dizziness is a frequently encountered clinical complaint. Since it may cause rare but serious clinical results, atrial myxoma should definetely be taken into consideration in differential diagnosis.