ScopeMed - RSShttp://www.scopemed.orgScopeMed RSSen-us Copyright © 2011 ScopeMed All rights reserved. ScopeMedhttp://www.scopemed.org/img/logo-scopemed-ttk.gifhttp://www.scopemed.org 2015-08-30T02-50-57Z Fetal demise despite successful medical conversion of supraventricular tachycardia causing hydrops and acceptable fetal cardiovascular profile score : case report http://www.scopemed.org/?mno=26379 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
yılmaz yozgat, Seçil Kurtulmuş, Cüneyt Eftal Taner, taliha öner, Önder Doksöz, Rahmi Özdemir, Timur Meşe.
Fetal tachyarrhythmia is the best describable reason for non-immune hydrops fetalis. However the most widespread tachyarrhythmia is supraventricular tachycardia. If supraventricular tachycardia (SVT) can not be cured, it can cause hydrops fetalis and fetal loss. The progonosis in fetus with developed hydrops secondary to supraventricular tachycardia depends on quick response to anti-arythmic treatment, the pregnany week of the fetus, the well being and its high cardiovascular profile score (CVPS). Here a fetus with 28 weeks of hydrops that developed secondarily to SVT was submitted as subject. In the first day of maternal antiarythmic treatment consisting of digoxin and sotalol applied on the subject, it was observed that fetal tachycardia turned successfully into sinus rhythm. The CVPS of the fetus was calculated as 7/10 compatible to life. (2 points loss from skin edema, 1 point loss from reverse arterial A wave in ductus venosus) However during the monitoring period the well being of fetus could not be maintained and hydrops fetalis became worse and fetal loss occurred in the 21st day of treatment. This subject was submitted to discuss CVPS and to indicate that CVPS may not be very reliable to show the prognosis in subjects with hydrops developing secondarily to SVT.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=26379
Huge left atrial appendix thrombus http://www.scopemed.org/?mno=26841 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Sait Demirkol, Şevket Balta, Uğur Küçük, Mustafa Kürklüoğlu, Turgay Çelik.
Atrial fibrillation is the most common chronic arrhythmia and is associated with increased left atrial thrombus. Its presence and location have important implications in deciding on the therapeutic approach. Echocardiography is essential in establishing the diagnosis in patients with cardiac masses. Because the source of left atrial thrombus is often appendage, it may not be identified by transthoracic echocardiography. We herein demonstrated a huge left atrial appendix thrombus that was identified by transthorasic echocardiography easily.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=26841
Prognostic Significance of Signet Ring Cell Component in Mucinous Colorectal Carcinomas http://www.scopemed.org/?mno=28063 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Önder Öngürü, Tolga Sentürk, Eyüp Duran, Yıldırım Karslıoğlu, Mustafa Öztürk, İsmail Hakkı Özerhan, Nail Ersöz, Ayhan Özcan, Şükrü Özaydın, Armağan Günal.
Introduction: Mucinous carcinomas which is frequently localizated in rectum and is approximately %10 of colorectal carcinomas is known to have poor prognosis than colorectal adenocarcinomas. Mucinous colorectal carcinoma with signet ring cell component is investigated the clinicopathological and prognostic features in this study. Material and Method: 741 patients underwent resection due to colorectal carcinoma in our university hospital between 1994 and 2008 years. Mucinous carcinoma were seen in 99 patients. All pathology slides of mucinous carcinoma patients were re-examined. Lymphatic invasion, necrosis and ulceration have been assessed. Results: Clinicopathologic features, survival times and statistical results were compared with mucinous carcinoma with signet ring cell component and without signet ring cell component in the study. Lymphatic invasion and lymph node metastasis were more frequent in mucinous carcinoma with signet ring cell component than mucinous carcinoma without signet ring cell component. (%32&%16 p=0.019) (p
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=28063
Massive Obstetric Hemorrhage Due to Placenta Increta During Second Trimester Pregnancy Termination : A Case Report http://www.scopemed.org/?mno=27418 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Mustafa ÖZTÜRK, Uğur KESKİN, Murat DEDE, Müfit Cemal YENEN.
Summary: In this case report, we aimed to inform about massive hemorrhage due to placenta increata during the abortion process and emphasize the importance of fast decision making in management. An eighteenth week pregnant woman was diagnosed with anhydramnios and absence of fetal heart pulse. Due to massive vaginal bleeding during pregnancy termination procedure, hysterotomy was decided and performed immediately. Hysterectomy was perfomed because of failure to control bleeding and detection of placenta increate. Placenta insertion anomalies should be thoroughly considered in the termination procedure of the second trimester pregnancy. Morbidity and mortality can be reduced by early diagnosis and fast decision making for management.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=27418
Pulmonary brucellosis: one case http://www.scopemed.org/?mno=28878 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Şafak Yıldız, Ahmet Ertuğrul, Ömer Deniz, Ergun Tozkoparan, Hayati Bilgiç.
Brucellosis is a serious, multisystemic zoonotic disease, which is continuing to be endemic in the certain religions of the world. Because the signs and symptoms of the disease is not specific, the disease usually causes delay in the diagnosis and treatment. Every system can be affected in the body, but the musculoskeletal and osteoarticular systems are the most affected. Pulmonary involvement is rare but a serious complication. In this article we report a brucellosis case with the literature data, which was clinically and radiographically presented only with pneumonia. The diagnose was made with hemoculture and serologic tests.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=28878
Incidentally diagnosed haemangiopericytoma of the hard palate http://www.scopemed.org/?mno=28366 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Gurkan Raşit BAYAR, Tamer ZERENER, Aydin GULSES, Omer GUNHAN.
Haemangiopericytoma is a soft tissue tumour derived from mesenchymal cells with pericytic differentiation. This tumor involves mostly the lower extremity and retro peritoneum and rarely the head and neck region. Surgery has been suggested the gold standard of the treatment with additional benefits if radiotherapy is taken. Here, we report the case of a Haemangiopericytoma in a 32- year old male patient. The tumour was discovered incidentally during the follow up clinical examination of his oro-nasal closure. Wide excision of the tumour was performed, and radiation theraphy was administered. At the end of the one year follow up, no recurrence was detected. Haemagiopericytoma is an uncommon vascular tumour with unpredictable behaviour, which necessitates a life-long follow up period. Due to the lack of data about this rare entity, further clinical reports and systematic reviews are essential.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=28366
KARTAGENER SYNDROME WITH INTERATRIAL SEPTAL ANEURSYM AND CONGENİTAL ATRİOVENTRICULAR BLOCK: TWO CASE REPORTS http://www.scopemed.org/?mno=31558 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Erkan Kahraman, Cengiz Öztürk.
The Kartagener syndrome is a rare autosomal recessive disorder characterized by bronchiectasis, sinusitis, situs inversus. Primary ciliary dyskinesia is condition with a prevalance of 1 in 20000 live births and fifty percent of primary ciliary dyskinesia is Kartagener’s Syndrome. Kartegener syndrome; may be accompanied with cardiac abnormalities such as ventricular septal defect (VSD) and atrial septal defect (ASD) in addition to dextrocardia. In this article, as addition to above-mentioned abnormalities, existence of two different cardiac problems together at the same time is reviewed with clinical, radiological and echocardiographyic characteristics by means of taking the literature into consideration.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=31558
The Jeune syndrome in an adult: A case report http://www.scopemed.org/?mno=29797 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Nurettin Yiyit, Akın Yıldızhan, Fatih Hikmet Candaş, Rauf Görür, Turgut Işıtmangil.
Jeune syndrome or asphyxiating thoracic dystrophy characterized by narrow rib cage and respiratory distress, accompanied by a multi-organ anomaly is a rare disease. Patients usually die due to complications of respiratory distress and in their first year. 25-year-old man was admitted to our clinic with the diagnosis of Jeune syndrome. We detected radiologically that patient's rib cage was small and narrow and transverse and sagittal diameter of the rib cage was short . It has been reported in a small number of adult patients with Jeune syndrome. The respiratory distress determines the prognosis of patients. The respiratory problems decrease with age. Over time, kidney and liver damage may occur. For this reason, intensive respiratory support for these patients from birth and the follow-up of liver and renal functions are important.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=29797
A case of dermatomyositis that cause respiratuar muscle weakness and interstitial pneumonia http://www.scopemed.org/?mno=31486 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Alper Gündoğan, Mehmet Aydoğan, Ufuk Turhan, Ergün Uçar, Sedat Yılmaz, Muhammet Çınar, Ergun Tozkoparan, Hayati Bilgiç.
Idiopathic inflammatory myopathies are a heterogeneous group of autoimmune disorders along with muscle weakness. Pulmonary involvement is one of the main causes of mortality and morbidity. Our case has been diagnosed as dermatomyositis. She was referred to our clinic with the complaint of dyspnea. Radiography, diffusion and pulmonary function tests were normal. Ground glass opacities were detected in High Resolution Computarise Tomography (HRCT) of patient but patient was in the early period of interstitial lung disease. With the complaint of air hunger, respiratory muscle weakness was considered and Maximal İnspiratuar Pressure (MIP), Maximal Exspiratuar Pressure (MEP) are planned and measured 34% and 39% respectively. Ciyclophospamide was added to patient’s steroid therapy. After two months of treatment, regression of ground glass opacities were detected and values of MIP and MEP were measured 92% and 94% respectively. It should be considered that respiratory function tests and chest radiographies could be insufficient in diagnosing respiratory muscle weakness and interstitial lung disease. In suspected cases HRCT should be taken and MIP, MEP should be measured. Measurement of MIP and MEP are parameters that can be used in diagnosis and response to treatment of respiratory muscle weakness.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=31486
Approach to Injuries Caused by Rabies Suspected Dog Bites: Three Cases http://www.scopemed.org/?mno=32457 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Abdül Kerim Yapıcı, Ümit Kaldırım, Ahmet Karakaş, İbrahim Arzıman, Salim Kemal Tuncer, Özcan Altınel.
Animal and human caused bites constitute 5% of total trauma cases admitted to emergency department. Seventy % of animal bites are caused by dogs. These bites are usually incised wounds. Repair timing of wounds due to animal bites are still in discussion. In recent studies, it is advised that primer repair must be carried out for cases who admitted within the first 24 hours with non-infected wounds particularly if wound is at head and neck region. Besides of wound repair, immunoglobulin application, vaccine program initiation and proper antibiotic treatment should be also considered, in order to prevent rabies and wound infection. In this study, we aimed to share our experiences of primer of repair animal (dog) bites admitted to emergency department.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=32457
A Case of Pneumonia and Bacteriamia Caused by Corynebacterium Striatum in a Immun Supressed Host http://www.scopemed.org/?mno=30795 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
mehmet burak selek, tuğba kula atik, bayhan bektöre,hakan erdem, orhan baylan, mustafa özyurt.
Corynebacterium striatum, is a gram positive bacterium that can cause opportunistic infections in immunocompromised host and it is among the members of the normal flora of skin and mucous membranes, In this case, a 88 years-old Non-Hodgkin lymphoma patient admitted to intensive care unit with pneumonia and bacteriemia due to C. striatum which was isolated from both blood and respiratory specimens sent simultaneously, is presented. Isolates are diagnosed as C. striatum with conventional biochemical tests and VITEK2 automated diagnostic system. Diagnosis is also confirmed by VITEK-MS. Isolate was susceptible to vancomycin, teicoplanin, linezolid, erythromycin and gentamicin; resistant to trimethoprim/sulfamethoxazole, ciprofloxacin, ceftriaxone, imipenem, meropenem, tetracycline and penicillin. Initial emperical meropenem treatment subsituted with linezolid and control samples, taken after a week period, were negative for C. striatum. Isolation of coryneform bacteria from clinical samples usually considered as contamination or colonization. In this case presentation, C. striatum, a member of coryneform bacteria, was isolated as causative agent in a patient with immunosupression, prolonged hospital stay and antibiotherapy. We believe effective coordination between laboratory and clinician is much more important in such cases.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=30795
Gardner Syndrome: Case Report http://www.scopemed.org/?mno=31476 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Hakan Demirci, Yusuf Serdar Sakin, Zülfikar Polat, Murat Kantarcıoğlu, Ahmet Uygun, Sait Bağcı.
Gardner Syndrome is a rare multi systemic, autosomal dominant inherited disorder characterized with poliposis, skin and soft tissue tumors. In this syndrome, if prophylactic total colectomy is not performed, malignant neoplasms may develop nearly in all patients. Half of the osteomas occur in head region. Gardner syndrome must be investigated in patients with three or more osteomas. Skin findings include epidermoid cyst, fibroid, lipoma, leiomyoma ve desmoid tumors. We present a case of a 21-year-old patient with polyposis coli and osteoma, which admitted to our hospital with abdominal pain and diarrhea.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=31476
Right atrial thrombus due to central venous catheter: a case report http://www.scopemed.org/?mno=32925 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Mustafa Gülgün, Kürşat Muzaffer Fidancı, Halil Demir, Vural Kesik, Sait Demirkol, Ayhan Kılıç.
Thrombus is one of the complications of central venous catheter used in cancer patients. Here, we present a case of 13 years-old girl who was diagnosed right atrial thrombus during routine echocardiographic screening in terms of anthracycline treatment which has been given to her because of hepatocellular carcinoma for six months. She had no complaint and her physical examination was normal. Electrocardiogram showed normal sinus rhythm. The presence of the 19x18 mm ovale and mobile mass in the free wall of right atrium with normal ejection fraction was shown by two dimensional transthorasic echocardiography (2DTTE) and three dimensional transthorasic echocardiography (3DTTE). There was no congenital thrombotic risk factor. She was administered tissue plasminogen activator and heparin infusion. Three monts later, mass dimensions were 6x5 mm with low-molecular-weight heparin. In conclusion, children with central venous catheter should be followed by echocardiyography routinely to avoid potential complications, even they have no symptom and 3DTTE can be used for more detailed examinations.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=32925
İsolated traumatic hip posterior dislocation: a case report http://www.scopemed.org/?mno=34478 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Faruk AKYILDIZ, Hasan TURĞUT, Selahattin ÖZYÜREK, Ömer ERŞEN, Şafak EKİNCİ, Serkan BİLGİÇ.
Traumatic hip dislocations are considered to be an orthopedic emergency and should be reduced as soon as possible. In this article we present a ketamine assisted reduction of isolated posterior hip dislocation in emergency conditions. Avascular necrosis did not occur in our case and we would like to draw attention to the issue that reduction should be done immediately.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=34478
Right Heart Thrombus Dissolved After Medical Management in a Patient with Behçet’s Disease http://www.scopemed.org/?mno=34359 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Ilknur Balta, Sevket Balta, Sait Demirkol, Murat Unlu.
Behçet’s disease is a chronic relapsing multisystem disease of unknown etiology. The manifestations of the disease are: recurrent aphthous stomatitis, genital ulcerations, other mucocutaneous lesions, ocular, articular, neurological, urogenital, cardiovascular, gastrointestinal and pulmonary manifestations. Vascular complications are a common component of this disease but cardiac involvement is a very rare and the sign of poor prognosis. A 48-year-old male patient presented with dyspnea, atypical chest pain, and haemoptysis. In his past history; he was unremarkable except for Behçet's disease. Further investigations revealed a free right atrial thrombus and pulmonary thromboembolism. We preferred medical management which consisted of immunosuppressive drugs and anticoagulation. On a follow-up period of three months we observed complete dissolution of the thrombus and dramatic improvement of clinical status.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=34359
ATYPICAL ULNAR ENTRAPMENT NEUROPATHY, ARCADE OF STRUTHERS: A CASE REPORT http://www.scopemed.org/?mno=36982 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
HALİT YASAR, HAKAN AKGUN, MUAMMER KORKMAZ, HAKAN TEKELI, CENK KILIC, BILAL BATTAL, OGUZHAN OZ, ZEKI ODABASI.
Ulnar nerve usually gets entrapped at cubital sulcus, but it may rarely occur at the wrist region and the most frequent reason is chronic pressure. Entrapment of the ulnar nerve at the arm region is very rare and only a few case reports have been published. Arcade of Struthers, which is found in the middle region of the arm, is an entrapment area for ulnar nerve. We aimed to underline the importance and presence of arcade of Struthers by presenting a 20 year old male patient with a clinical presentation of ulnar entrapment neuropathy and having electrophysiological findings of ulnar entrapment at the middle region of his arm.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=36982
Assessment of health promotion behavior of adolescents in a high school http://www.scopemed.org/?mno=43275 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Hatice Bebiş, Dercan Akpunar, Serpil Özdemir, Selim Kılıç.
SUMMARY Assessment of health promotion behavior of adolescents in a high school Adolescent period is the most brilliant period of health. This situation may be overlooked in adolescent health problems which may occur. In the literature, determining the factors that affect adolescent and risk behaviors, the appropriate age periods reported improved health strategies. The purpose of this research, assessment of health promotion behavior of adolescents in a high school. This study was conducted between February to May 2013 as a cross-sectional research. This research was carried out in a trade vocational school with 932 students between the ages of 13 to 19. Data collection form includes questions about the students’ socio-demographic characteristics and Adolescent Health Promotion Scale. In this study, Cronbach's α value of Adolescent Health Promotion Scale is found 0.90 and total scale score is 132.1 ± 24.6 (40-196). The 50.4% of girl students and the 52.7% of boy students were found to have high percentage of scale mean scores and A significant difference wasn’t found in groups at total scale scores (p>0.05). Percentege of nineth class students were found higher than high class students in nutrition and exercise (p0.05). A significant difference was found between participants’ fast-food consume status with take high scores status on health responsibilities sub-component and total scale scores (p
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=43275
The Effect of Ultrasound Guided Transversus Abdominis Plane Block for Cesarean Delivery on Postoperative Analgesic Consumption http://www.scopemed.org/?mno=49122 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Kadir Hakan Cansız, Ahmet Ertürk Yedekçi, Hüseyin Şen, Sezai Özkan, Güner Dağlı.
Backgraund and aim: In our study we evaluated the postoperative analgesic consumption and analgesic efficacy of ultrasound guided transversus abdominis plane (USG-TAP) block in patients undergoing caesarean section (CS). Methods: Seventy ASA I-II patients undergoing CS following spinal anaesthesia were included in our study. The patients were divided into two groups randomly: Group T (TAP Block group) (n:35) and Group C (Control group) (n:35). At the end of the surgery Group T patients received USG-TAP block using 20 ml of 0.25% levobubivacaine. All participants received standart analgesic regime of tramadol via intravenous patient controlled analgesia (IV-PCA). Patients were assessed at 1, 4, 6, 12, 18 and 24 h after TAP block for hemodynamic parameters, verbal numerical rating pain scores (VNRS) (pain at rest and coughing), total amount of IV-PCA tramadol demand and consumption, time to first rescue analgesia, total amount of rescue analgesic demands, sedation, nausea, vomitting and satisfaction by a blinded investigator. Results: The VRNS scores both at rest and coughing were found significantly lower in TAP block group with levobupivacaine compared to control group at all check points. Total amount of IV-PCA tramadol demand and consumption, number of rescue analgesic demands and consumption were significantly lower in TAP block group. Time to first rescue analgesia was longer in TAP group. Patient satisfaction was significantly higher in TAP group. Conclusions: In our study USG-TAP block provided effective postoperative analgesia and we consider this technique as a safe and effective method for postoperative pain control after Caesarean delivery.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=49122
EXTERNAL EAR CANAL RECONSTRUCTION IN PATIENTS WITH RADICAL MASTOİDECTOMY http://www.scopemed.org/?mno=47531 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Mehmet Aldemir, Salim Özenç, Duran Tok, Seher Altınel, Özcan Altınel, Ethem Poyrazoğlu.
Kolesteatomalı Kronik otitler günümüzde halen güncelliğini korumakta ve önemini sürdürmektedir. Kolesteatomalı KOM cerrahisinde başlıca kapalı, açık ve doldurulmuş kavite teknikleri kullanılmakta. Kapalı tekniklerde anatomi ve işitmenin korunmasına rağmen nüks kolesteatoma ve revizyon mastoidektomi ameliyat riski oldukça fazladır. Açık tekniklerde ise kavite bakım sorunları olması, işitmenin daha fazla etkilenmesine rağmen nüks kolesteatoma riski oldukça düşüktür. Son yıllarda kolesteatoma riski kadar işitmenin rekonstrüksiyonu ön plana çıkmıştır. Ancak işitme rekonstrüksiyonu ve postoperatif bakım sorunlarını ortadan kaldırmak için küçük, kuru ve mümkün olduğunca anatomisi restore edilmiş bir kavite gerekmektedir. Bu amaçla GATA Haydarpaşa Eğitim Hastanesi KBB servisinde 12 kolesteatomalı kronik otitis medialı hastaya radikal mastoidektomi+DKY rekonstrüksiyonu+mastoid kavite obliterasyonu ameliyatı uyguladık. Bu çalışmada amacımız olgularımızda kuru, küçük ve epitelize DKY olan bir kavite elde etmek idi. Bu hastaları postoperatif 15 ay süre ile takip ettik. Olgularımızda 1. ayın sonunda 3 olguda, 3. ayın sonunda 5 olguda, 6.ayın sonunda 9 olguda ve 12.ayın sonunda 11 olguda kuru ve epitelize intakt DKY elde ettik. Bir olguya, tedavi ile geçmeyen ve pis kokulu kulak akıntısı nedeni ile postoperatif 14. ayda revizyon mastoidektomi yaparak orta kulağı dolduran rekürren kolesteatoma tespit ettik. Aynı zamanda DKY kemik greftinin rezorbe olduğunu gözledik. Radikal mastoidektomilerde DKY’nun kortikal kemik grefti ile rekonstrükte edilmesi ve mastoid kavitenin temporal adale ile rekonstrüksiyonunun açık tekniklerdeki kavite problemlerinin giderilmesinde ve işitme rekonstrüksiyonunda etkili olduğu sonucuna vardık.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=47531
Bypassing The Cuffing Effect In Adult Hypospadias Surgery Diversion http://www.scopemed.org/?mno=48865 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
bilal fırat alp.
Introduction Urethral stents are frequently used for urinary diversion after hypospadias surgery. The foley catheter is not generally preferred, for the formation of a ‘cuff ’ on deflation of the balloon of all foley catheters that causes difficulty in removal (cuffing effect of balloon). In the literature, there is not comprehensive study on the usage of foley catheter for adult hypospadias surgery. We have recently been using the modified foley catheter that we designed in our patients. In this study, we aim to compare the results of no-balloon catheter (nelaton catheter) and modified foley catheter usage after TIPU operations in adults. Patients and methods The medical records of 53 adult patients who applied TIPU for subcoronal or midpenile hypospadias between November 2008 and September 2012 were evaluated retrospectively. Patients were evaluated in two groups based on the performed urinary diversion. Group 1 was composed of 29 patients to whom 16 F nelaton catheter was used for urinary diversion between November 2008-December 2010, whereas Group 2 consisted of 24 patients to whom 12 F foley catheter coated by 16 F nelaton catheter by half was used for urinary diversion between February 2011 – September 2012. Results There was no statistically significant difference between Group 1 and Group 2 in terms of age, the location of the mea, the number of secondary cases, the length of the neourethra, fistula and urethral stricture (p>0.05). Surgery success rate was 79.3% in Group 1 and 79.1% in Group 2 (p>0.05). At the 6th month follow-up, no statistically significant difference was found between two groups regarding fistula and urethral stricture. In terms of postoperative patient comfort, Group 2 were better than Group 1 (p
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=48865
USE AND ABANDONMENT RATES OF ASSISTIVE DEVICES/ORTHOSES IN PATIENTS WITH STROKE http://www.scopemed.org/?mno=152325 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
İsmail Safaz, Fatih Tok, İlknur Tuğcu, Hatice Türk, Evren Yaşar, Rıdvan Alaca.
Objective: Aim of this study was to examine the use of assistive devices/orthoses in patients with stroke. The rates of orthotic prescription and abandonment, and the reasons of abandonment were investigated. Materials and Methods: One hundred and seven stroke patients, who had been rehabilitated in our hospital, were visited by two social service specialists and a questionnaire was applied to all patients. Results: Mean elapsed time after stroke to evaluation time was 48.90±23.49 months. Among subjects, 57.0% were prescribed a tripod or a tetrapod, and 26.2% was given a wheelchair. Overall, 39.3% of patients declared that they were not using their tripod/tetrapod and 28.6% were not using their wheelchair. Concerning upper limb orthoses, 22.4% of patients were given an inhibitor hand splint and 16.8% were given a neutral wrist splint. The abandonment rates were 70.8% and 77.8%, respectively. More than half of those subjects stopped using their orthoses. Regarding lower limb orthoses, 43.0% of patients were prescribed an ankle foot orthosis and 54.3% of them stopped using it. Conclusion: Significant amount of stroke patients seem to stop using their assistive device/orthoses despite their need. Further studies are warranted for better understanding the relevant causes.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=152325
Determination of the attitudes of students from different department in the field of health on the discrimination against the elders http://www.scopemed.org/?mno=152591 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Gülşah Köse, Hatice Ayhan, Sevinç Taştan, Emine İyigün, Cengiz Han Açıkel, Sevgi Hatipoğlu.
Aim: In this descriptive study, it has been aimed to determine the attitudes of students, who studied in a military education and research hospital, concerning the discrimination against the elderly. Material and methods: The sample of this study was 227 students who agreed to participate the study. Personal info sheet and elder discrimination attitude scale were used for the collection of data. Results: The mean scale score of the students was 50.00 ± 5.95 and the students had negative attitudes in respect of elder discrimination. Their attitudes on elder discrimination changed according to their school and gender (respectively p=0.015; p=0.004). Moreover, the students did not want to work in the department of geriatrics and the students who did not work with the elder people had more negative attitudes against the elders. Discussion and conclusion: The results of this study showed that the students of our country, which had an aging population, have a negative attitude on the elder people and they do not want to work with them. These results suggest that the geriatrics should be made attractive for the students in our country.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=152591
Maternal Immunologic and Clinical Response to Antiretroviral Therapy Initiation Before or During Pregnancy in HIV-1 Infected Women and associated factors in Southwest Ethiopia http://www.scopemed.org/?mno=155305 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Girma Mamo Ijigu, Desta Hiko Gemeda, Mulugeta Tarekegn Angamo.
The aim of this study is to assess maternal treatment outcomes to antiretroviral therapy initiated before or during pregnancy in HIV-1 infected women and associated factors in southwest Ethiopia. Hospital based retrospective cohort study was conducted from January 1st 2008 to December 31st 2012.The data were processed using SPSS version 16 (Chicago: SPSS Inc., 2007). A p-value of < 0.05 was considered statistically significant. Among the 202 study participants, 169(83.6%) and 142(70.3%) had good immunological and clinical outcomes respectively. In adjusted logistic regression analysis, unknown HIV status prior to pregnancy (AOR=0.158, 95% CI=(0.041–0.602), P=0.007), Baseline CD4 count < 200 (AOR = 0.023, 95%CI= (0.003–0.190), P=0.000), baseline WHO clinical stage III (AOR=7.673, 95%CI=1.640–35.892, P=0.010), Highly Active Antiretroviral Therapy initiation during pregnancy (AOR=0.349,95% CI=0.157–0.776,P=0.010) were identified as independent predictors of maternal treatment outcomes. In conclusion, Women who started Highly Active Antiretroviral Therapy before pregnancy had good clinical outcome compared to those who started during pregnancy. The independent predictors of maternal outcomes were HIV status prior to pregnancy, baseline CD4 count before initiation of Highly Active Antiretroviral Therapy, time of Highly Active Antiretroviral Therapy initiation, world health organization clinical stage before initiation of Highly Active Antiretroviral Therapy and duration of treatment with Highly Active Antiretroviral Therapy.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=155305
Dental Anxiety and Associated Factors in Young Individuals http://www.scopemed.org/?mno=153609 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Yusuf Çetin Doğaner, Ümit Aydoğan, Hande Üçler Yeşil, Oktay Sarı, Bayram Koç.
Aim: Despite modern technological applications in dental treatment, dental practices still continue as one of the stressor concerns. In this study, dental anxiety (DA) levels and associated factors were investigated. Material and Methods: The study included 588 dental patients between 14-30 years old and applied to the dental health unit of primary care in March-September 2012. Participants were asked to fill out the questionnaire examining sociodemographic features, previous dental history and "Modified Dental Anxiety Scale" measuring dental anxiety. Results: Approximately seventy five percent of the study sample was comprised of 20-25 years old patients. When the state and frequency of going to dentist were queried 17.5% of patients had never gone, only 6.1% emphasized that they had visited every 6 months regularly. The ratio of individuals had high DA levels was detected as 14.3%. The statistically significant difference was detected in terms of educational levels (p=0.013), the frequency of dental visits (p=0.047), problematic dental history (p=0.005) and complications after dental treatment (p=0.017) among the high DA patients comparing to normal ones. Conclusion: It was ascertained that enhancing the educational level is one of the significant factors to prevent the DA development. Questioning of past dental history and execution of proper approach to mitigate the effects of bad experiences before oral and dental health practices will reduce the related anxiety levels. The compliance process of dental treatment will be helpful not just for dental health, but also to protect other systemic diseases.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=153609
School culture in health education institutions: Gulhane Military Medical Academy (GMMA), Health Noncommissioned Officer College Example http://www.scopemed.org/?mno=155836 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Yasin UZUNTARLA, Aykut GÖKSEL, Selim KILIÇ.
The aim of this study is to investigate the perception of school culture of the students and trainees of Health Noncommissioned Officer College (HNOC) in the GMMA. The population of the study consists of 126 HNOC college students studying in second class and 97 graduated trainee. The scale participation rate was 90,5% (n=202). The scale of Organizational Culture in Educational Institutions developed by Erdem and İşbaşı was used as data collection tool. Result of factor analysis, Organizational Culture surveyed for the five dimensions. The terms of the five dimensions, significant differences found between these groups. The NCOs have positive perception for the symbol dimension including ceremony and military training whereas the HNOC students have positive perception than the NCOs for the rest of the dimensions.In order to strengthen the culture of school, activities and projects enriching communication and cooperation between the students and the academic staff should be organized.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=155836
Determination of Whole Blood Reference İntervals from Patient Results Registered in Hospital Information System http://www.scopemed.org/?mno=167492 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Tuncer Çaycı, Yasemin Gülcan Kurt, Tevfik Honca, Ahmet Taş, Mehmet Ağıllı, Fevzi Nuri Aydın, İbrahim Aydın, Taner Özgürtaş.
Each laboratory must be determined the referrence intervals according to their own patient population. However, the reference interval studies are both costly and laborious. In recent years, the reference intervals was easily indirectly calculated from patient results registered in the hospital information systems. We aimed to determine reference intervals for some hematological test parameters from patient results in the hospital information systems by the percent estimation method of non-parametric and compare with the reference intervals that we use in our laboratory and recommended by the existing manufacturers. In this study, whole blood test results of 39,723 patients in the Hospital Information System were used. For detecting the high and low reference intervals was used the MedCalc non-parametric percent estimation statistical program. Reference intervals were calculated separately in gender and age subgroups. Our results were indicated separately using of reference intervals for all of the sub-parameters for both gender and in the 0-12 age group. In addition, for hematocrit and hemoglobine tests in men over the age of 65 must be used different reference intervals than other groups. The reference interval values that we have obtained at the end of our study were shown a significant differences from the values recommended by the manufacturer company and we use. Furthermore, Our reference interval values are more suitable for use in the our laboratory.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=167492
Evaluation of Hearing with Audiometry and Transient Evoked Otoacoustic Emission in Patients with Mild and Moderate Psoriasis http://www.scopemed.org/?mno=178662 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Ersin Aydın, Bilal Doğan, Özlem Karabudak Abuaf, Ercan Karabacak, Evren Erkul, Ömer Sağlam, Engin Dursun.
Psoriasis is a chronic inflammatory disease characterized by T-cell mediated hyperproliferation of keratinocytes. Sensorineural hearing loss may occur as a complication of autoimmune and inflammatuar diseases. The aim of this study was to demonstrate whether there is a relationship between sensorineural hearing loss and psoriasis. Forty-one psoriasis patients and control group composed of age 41 individuals were included in the study. Pure-tone audiometry and Transient Evoked Otoacoustic Emission (TEOAE) tests were performed to all the participants. The psoriasis activity was evaluated by Psoriasis Area and Severity Index (PASI). Hearing thresholds were higher in patients with psoriasis in Pure-tone audiometry but the differences were not significant (p>0.05). Also we compared reproducibility, response levels, and S/N ratios by TEOAE measurements between 2 groups. Reproducibility, response levels, and S/N ratios were lower in patients with psoriasis but the differences were not significant (p > 0.05). Consequently, we demonstrated that in patient with mild and moderate psoriasis haven’t hearing loss in our study. Large number studies in patients with severe psoriasis may be helpful to clarify the relationship between sensorineural hearing loss and psoriasis.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=178662
A Novel Platelet Concentrate For Guided Bone Regeneration: Titanium Prepared Platelet-Rich Fibrin (T-PRF) http://www.scopemed.org/?mno=173504 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Mustafa Tunalı, Hakan Özdemir, Zafer Küçükodacı, Şeref Ezirganlı, Emre Baris, Serhan Akman, Arzu Atay, Erhan Fıratlı.
In our previous studies, we developed a novel platelet-rich product that we called titanium-prepared platelet-rich fibrin (T-PRF). T-PRF is based on the hypothesis that titanium may be more effective at activating platelets than the silica activators used with glass tubes in Chouckroun's platelet-rich fibrin (PRF). This study aimed to assess the effects of T-PRF on bone augmentation in a rabbit calvaria model. Twenty-four adult male New Zealand rabbits were used in the study. T-PRF alone, anorganic bovine bone (ABB), and T-PRF + ABB were used in the experimental groups. No materials were used in the control group. Half of the animals were sacrificed after 1 month, and the remaining animals were sacrificed after 3 months. A histomorphometric evaluation was performed to compare new bone formation among the groups. More new bone areas were noted in the T-PRF group than other three groups. The ABB and T-PRF + ABB groups also had better new bone formation compared to the control group. Based on the results of this study, T-PRF membrane can be successfully used for bone augmentation.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=173504
The Investigation of Neuroprotective Effects of Aminoguanidin and N-Acetylcystein administration alone and combination in Spinal Cord Trauma model http://www.scopemed.org/?mno=183862 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Özkan Tehli, Nail Çağlar Temiz, Mehmet İlker Özer, Halil İbrahim Seçer, Engin Gönül, Serhat Pusat, Alparslan Kırık, Mehmet Kadri Daneyemez.
In this study the neuroprotective efficacy of N-Acetylcystein and Aminoguanidin administered after spinal cord injury was examined regarding clinical and laboratory outcome. Rats were divided into 5 groups: Control group, trauma group, Aminoguanidin group, N-Acetylcystein group, and Aminoguanidin+N-Acetylcystein group. Total laminectomy of thoracal 9th or 10th vertebra was performed on all rats. Spinal trauma was formed by weight drop model for all groups except the control group. 1 ml of %0.9 NaCl solution was administered twice daily to control group. 100mg/kg Aminoguanidin and N-Acetlysistein was given twice daily for 5 days to own group, Both drugs were administered to Aminoguanidin+N-Acetylcystein group in the same dose.Neurologic examination results were graded according to Tarlov’s chart and all the rats were clinically assesed by Rivlin and Tator’s inclined plane degrees. Treumatized spinal cord segments were obtained. Malondialdehyte, superoxidedismutase, glutathion peroxidase activity of these tissue specimens were measured. Results revealed an increase in the inclined plane degrees and neurological examination grading along with statistically significant decrease in Malondialdehyte level, superoxidedismutase and glutathion peroxidase activities in Aminoguanidin, N-Acetylcystein and Aminoguanidin+N-Acetylcystein groups as compared to control group. We propose, Aminoguanidin and N-Acetylcystein can show neuroprotection when used in combination or alone but there is no additive effect of combined use.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=183862
Increased Visceral Adiposity Index in Patients with Polycystic Ovary Syndrome; Relationship Between Inflammation, Insulin Reisistance and Hyperandrogenity http://www.scopemed.org/?mno=187088 2015-08-30T02-50-58Z
Source: Gulhane Medical Journal
Aydoğan Aydoğdu, Cem Haymana, Serkan Tapan, Abdullah Taşlıpınar, Mahmut Yazıcı, Yalçın Başaran, Mustafa Dinç, Alper Sönmez, Ömer Azal.
Polycystic ovary syndrome (PCOS) is characterized by insulin resistance, hyperandrogenism and subclinical inflammation. Visceral obesity is associated with proinflammatory activity, deterioration of insulin sensitivity, increased risk of developing diabetes, hypertension, atherosclerosis, and higher mortality rate. We searched if the patients with PCOS have increased visceral adiposity index (VAI) and along with its relation to the measures of inflammation, insulin sensitivity and hyperandrogenism. Thirty-nine patients with PCOS and forty-two age and body mass index (BMI) matched healthy controls were enrolled in the study. VAI was calculated by the Formula [Waist Circumference / (36.58 + (1.88XBMI))] x (Triglyceride/0.81) x (1.52/HDL Cholesterol). High sensitivity C reactive protein (hs-CRP) level was determined by Enzyme immunoassay (EIA). IR was calculated by the Homeostasis model assessment of IR (HOMA-IR) formula. Plasma triglyceride, LH/FSH ratio, testosterone, insulin, hs-CRP levels, HOMA-IR score, Dehydroepiandrosterone sulfate (DHEA-S) and VAI were significantly higher where as HDL-C level and sex hormone binding globulin (SHBG) levels were significantly lower in women with PCOS compared to healthy controls. VAI correlated positively with BMI, hs-CRP, waist-to-hip ratio, HOMA-IR and negatively with SHBG. Testosterone and LH/FSH did not significantly correlated with VAI. VAI is increased in patients with PCOS in concordance with insulin resistance and inflammation. We found also relationship between hyperandrogenism and VAI in PCOS patients.
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Sat, 29 Aug 2015 14:56:17 GMT -08:00 http://www.scopemed.org/?mno=187088
Toxicity Evaluation and Cytogenetic Screening of Process Water Using a Plant Bioassay http://www.scopemed.org/?mno=200367 2015-08-30T02-50-58Z
Source: Nigerian Journal of Basic and Applied Sciences
D.I. Olorunfemi, J.O. Olomukoro and O.A. Anani.
The effect of toxic substances on aquatic lives from a wastewater indiscriminately discharged into the environment during oil and gas exploration activities in Nigeria is the focus of this study. A plant bioassay, the Allium cepa test, was used for the cytogenotoxicity screening of process water on root growth inhibition and chromosome abnormalities in the meristematic roots of the plant. Results of the physicochemical analysis of the wastewater collected from Nigerian Agip Oil Company (NAOC) facility at Ogboinbiri in Bayelsa State at the point of discharge into the environment showed that it had an unpleasant odour, was slightly alkaline (pH 7.72) and had high electrical conductivity (2793.33 µS/cm). Lead, manganese, iron, chromium and nickel were present at amounts (0.13, 0.33, 4.47, 0.17 and 0.10 mg/l respectively) above national (NESREA) and international (USEPA) limits for effluent discharge. Macroscopic evaluation of A. cepa cultivated in the wastewater resulted in significant (p
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Sat, 29 Aug 2015 09:53:38 GMT -08:00 http://www.scopemed.org/?mno=200367
Role of International Fund for Agricultural Development/ Community Based Agricultural and Rural Development Programme (IFAD/CBARDP) in Improving the Livelihood of Rural Women: A Case Study of Aliero Local Government Area, Kebbi State, Nigeria http://www.scopemed.org/?mno=200362 2015-08-30T02-50-58Z
Source: Nigerian Journal of Basic and Applied Sciences
A.I. Illo, A.K, Ango, H. Usman, and Z. Aminu.
This study examined the role of IFAD/CBARDP on improving rural women’s livelihood in Kebbi State, Nigeria. Multistage sampling technique was adopted to select 80 IFAD participating women. Structured questionnaire was used in data collection. Descriptive statistics was used to present the data obtained. Majority of the women were married, and at active productive ages. Qur’anic education was the common educational status of the participants. The findings also reveal that all the IFAD participating women were provided with assistance based on needs and interest and the common assistance provided was the training on tailoring, knitting, soap and cream making and later the participants were provided with such machines. In addition, the participants were also provided cash loan. The programme has lead to improvement of the living standards of the participants after programme participation. Attitudinal dispositional test using 3 points Likert’s scale reveal that the participating women strongly agreed that the programme has improved their living standard, the loan was adequate, and all the assistance provided was based on their needs and interest. It is concluded that the participating women were involved in decision making, most especially on the assistance provided, and the management of the assistance. It’s recommended that effort should be geared towards increasing women participation in any intervention programme that could uplift the livelihood of the rural communities.
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Sat, 29 Aug 2015 08:39:22 GMT -08:00 http://www.scopemed.org/?mno=200362
Sarcoidosis Presenting as Acute on Chronic Liver Failure–Report of the First Case http://www.scopemed.org/?mno=187843 2015-08-30T02-50-58Z
Source: Medicine Science | International Medical Journal
Cyriac Abby Philips, Chetan Ramesh Kalal, Awinash Kumar.
Sarcoidosis is a multi system disease with different clinical presentations. Asymptomatic presentation is the commonest, but others include jaundice with chronic cholestasis, cirrhosis, portal hypertension, hepatic venous outflow tract obstruction and extrahepatic biliary obstruction. Cirrhosis and portal hypertension are the rarest manifestation of hepatic sarcoid and represent less than 1% of all cases. Acute on chronic liver failure as a presentation of sarcoidosis has never been reported before. Here we present a patient of sarcoidosis presenting with acute on chronic liver failure, and in whom, steroid therapy improved liver failure with a good outcome.
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Sat, 29 Aug 2015 01:39:35 GMT -08:00 http://www.scopemed.org/?mno=187843
Risk Factors for Gestational Diabetes in Women with Polycystic Ovarian Syndrome http://www.scopemed.org/?mno=200161 2015-08-30T02-50-58Z
Source: Medicine Science | International Medical Journal
Senem Arda Duz, Ilgın Turkcuoglu.
We aimed to compare the pre-gestational metabolic states of the women who were previously diagnosed with policystic ovarian syndrome and had gestational diabetes mellitus in the subsequent pregnancy and who did not have gestational diabetes mellitus in subsequent pregnancy and to determine the independent variables that predict the gestational diabetes mellitus risk for policystic ovarian syndrome patients in the subsequent pregnancy. Between the dates 2007 and 2012, the patients who were diagnosed with policystic ovarian syndrome in our outpatient gynecology clinic were searched retrospectively. Then these patients were called for pregnancy states. All of these patients have pregnancy spontaneously. The patients’ pre-gestational mean age, body mass index, metabolic and hormonal profiles and pregnancy outcomes were compared between policystic ovarian syndrome cases who developed gestational diabetes mellitus or not. We found some differences in pregestational metabolic states between the policystic ovarian syndrome patients who developed gestational diabetes mellitus in pregnancy or not. The mean age, body mass index, very low density lipoprotein, triglyceride, fasting insulin, fasting c-peptide levels, 1st and 2nd hour glucose levels in 75 gr oral glucose tolerance test, homeostatsis model assessment –insulin resistance measures and neonates’ birth weights were higher in gestational diabetes mellitus group than non-gestational diabetes mellitus group. But high density lipoprotein was lower in gestational diabetes mellitus group than non- gestational diabetes mellitus group. There were no differences between the mean levels C- reactive protein, hormonal profile, mean fasting glucose, low density lipoprotein cholesterol, total cholesterol levels and mode of delivery. Glucose intolerance was significantly higher in the gestational diabetes mellitus group (%74,07 vs %6,66). With the multipl logistic regression analysis we found the body mass index as the strongest independent predictor of gestational diabetes mellitus in policystic ovarian syndrome patients (OR: 2,831, %95 CI: 1,234-6,495). The second independent predictor was the high 2nd hour glucose level in oral glucose tolerance test(OR: 1,119, %95 CI: 1,026-1,221). The pre-gestational metabolic variables including the age, body mass index, lipid profile, and glucose metabolism are significantly different in the gestational diabetes mellitus group than the non-gestational diabetes mellitus group. The obesity and glucose intolerance are the independent predictors of gestational diabetes mellitus in policystic ovarian syndrome cases.
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Sat, 29 Aug 2015 00:34:20 GMT -08:00 http://www.scopemed.org/?mno=200161
Re-Evaluating the Efficacy of the Aqueous Leaf Extract of Bridelia ferrugenia and its Potential Combination with Metformin in the Management of Diabetes Mellitus http://www.scopemed.org/?mno=198710 2015-08-30T02-50-58Z
Source: Journal of Medicinal Herbs and Ethnomedicine
Kwesi Prah Thomford, Dominic Adotei Edoh, Joseph A. Sarkodie, Ama Kyeraa Thomford, Kennedy Essuman, Derrick Owusu.
Herbal medicinal products play a significant role in the management of diabetes and other chronic diseases either as a monotherapy or in combination with allopathic treatments. The hypoglycaemic activity of a Ghanaian herbal antidiabetic product (Bridelia Tea) prepared from the dried leaves of Bridelia ferrugenia was re-evaluated in this study with the view of improving its activity and explore the possible benefit of using the product in combination with Metformin. Male and Female Sprague-Dawley Rats (210-220 g) were rendered hyperglycaemic by a single intraperitoneal administration of Streptozocin (STZ) (70 mg/ kg) after an overnight fast. Hyperglycaemic rats then received one of the following treatments [(Bridelia ferrugenia (BRD) 30 mg/kg or 300 mg/kg), (Metformin (MET) 250 mg/kg or 1000 mg/kg ), (MET 250 mg/kg and BRD 30 mg/kg), (MET 1000 mg/kg and BRD 300 mg/kg)]. The hypoglycaemic effect of B. ferrugenia, Metformin and the combination of the two (2) products were not significantly different during an initial 6 hrs of monitoring (p > 0.05). In the long-term study over 28 days, BRD 300 mg/kg had hypoglycaemic effects comparable to Metformin 1000 mg/kg p.o. and better than BDF 30mg/kg p.o. (p < 0.05). However, the combination of the two products B. ferrugenia and Metfomin at the two doses reduced their therapeutic effect compared to animals receiving either of the two treatments alone. Increasing the concentration of the product from the current 30 mg/kg to 300 mg/kg may improve its efficacy and there is the need to further study the nature of the herb-drug interaction between Bridelia ferrugenia and Metformin.
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Fri, 28 Aug 2015 13:33:18 GMT -08:00 http://www.scopemed.org/?mno=198710
Synchronous ten trigger finger: A case report http://www.scopemed.org/?mno=188340 2015-08-30T02-50-58Z
Source: Hand and Microsurgery
Gokce Yildiran, Muhammed Nebil Selimoglu, Osman Akdag, Mehtap Karamese, Zekeriya Tosun.
Trigger finger is a disorder that presents with a blocking feeling and pain during finger movements. This condition more commonly occurs in the 2nd finger with involvement of multiple digits being extremely rare. There are very few known cases in which trigger finger was developed in all ten fingers. Here, an unusual case of ten-digit finger trigger is presented. A 44-year-old female housewife visited our clinic with painful blocking feeling in her hand. Her examination was compatible with trigger finger. Her hands were operated on in different sessions and A1 pulleys of all fingers were released. After the operations, blocking feeling and pain during flexion disappeared and normal range of motion was obtained. On the occasion of this very rare case, the etiology and approach for multiple trigger fingers is discussed.
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Fri, 28 Aug 2015 07:17:01 GMT -08:00 http://www.scopemed.org/?mno=188340
A case of diaphragmatic mesothelial cyst with US and MRI findings http://www.scopemed.org/?mno=29743 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Fuat Ozkan, Mehmet Fatih Inci, Yakup Yesilkaya, Murvet Yuksel, Keramettin Ugur Ozkan.

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Fri, 28 Aug 2015 01:56:27 GMT -08:00 http://www.scopemed.org/?mno=29743
Unusual iatrogenic foreign body in a nose: A case report http://www.scopemed.org/?mno=31482 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Murat Salihoglu, Berkay Tolga Suer, Caglar Calli, Ercan Pinar, Onuralp Kurt.
Foreign bodies in the nose are common in children, but are rarely found in adults. In this case, a 34-year-old male was ad- mitted to our clinic with complaints of nasal obstruction, halitosis and foul-smelling purulent nasal discharge. History of the patient revealed a septoplasty procedure completed about one year ago. Anterior rhinoscopy and nasal endoscopic exami- nation of the patient revealed that both nasal cavities were filled with foreign bodies. After the removal of these materials, the foreign bodies were identified as rhinolith particles with 2x5cm X-ray film cut-out sheets embedded within. We thought the X-ray film sheets were used for nasal packing following the previous septoplasty. The X-ray film sheets had eventually become rhinoliths over time. It is not clear why the packing was retained for such a long duration. As demonstrated by this case report, postoperative follow-up after septoplasty is important, and iatrogenic foreign bodies should be considered in the differential diagnosis of an adult patient with rhinolithiasis.
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Fri, 28 Aug 2015 01:56:27 GMT -08:00 http://www.scopemed.org/?mno=31482
Oral and dental findings of griscelli syndrome type 3 http://www.scopemed.org/?mno=31687 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Ozlem Marti Akgun, Ceyhan Altun, Gunseli Guven Polat, Ceren Yildirim.
Griscelli syndrome (GS) is a rare autosomal recessive genetic disorder characterized by variable immunodeficiency, partial albinism, abnormal accumulation of melanosomes in melanocytes, pigmentary dilution of the skin, and shiny silver-gray hair. GS has three types, with the first and second types caused by mutations in two genes being located at band 15q21: RAB27A and MYO5A. The expression of the third form of GS is restricted to the characteristic hypopigmentation of GS, and results from mutation in the gene that encodes melanophilin MLPH. It has also been shown that an identical phenotype can result from the deletion of the MYO5A F-exon. The aim of this case report is the presentation of oral and dental features and SEM images of the hair of a 12-year-old girl with GS type 3.
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Fri, 28 Aug 2015 01:56:27 GMT -08:00 http://www.scopemed.org/?mno=31687
Fibrous dysplasia as a rare cause of nasolacrimal duct obstruction http://www.scopemed.org/?mno=34993 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Bahtiyar Polat, Burak Asik, Abdullah Durmaz, Yusuf Uysal.
Fibrous dysplasia of the paranasal sinuses is mostly asymptomatic, but sometimes may cause signs and symptoms de- pending on its location. We report two cases of maxillary fibrous dysplasia obstructing the lacrimal drainage system as a reason of chronic dacryocystitis, and reviewed the related literature. The first case underwent an endonasal endoscopic approach combined with external dacryocystorhinostomy. He had a patent lacrimal system at one-year follow-up. The le- sion was completely removed via an endonasal endoscopic approach in the second case, wherein the patient was asymp- tomatic of the six-month follow-up period.
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Fri, 28 Aug 2015 01:56:27 GMT -08:00 http://www.scopemed.org/?mno=34993
Low level termination of external carotid artery and its clinical significance: A case report http://www.scopemed.org/?mno=35814 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Surekha Devadasa Shetty, Satheesha Nayak Badagabettu, Naveen Kumar, Ashwini Aithal.
The external carotid arterial system is a complex vascular system providing nourishment to the territorial areas of the head and neck. The branches of the external carotid artery are the key landmarks for adequate exposure and appropriate placement of cross-clamps on the carotid arteries during carotid endarterectomy. Knowledge of anatomical variation of the external carotid artery is important in head and neck surgeries. Variations in the branching pattern of the external carotid artery are well known and documented. We report a rare case of low-level termination of the external carotid artery. It terminated by dividing into maxillary and superficial temporal arteries deep into the posterior belly of the digastric muscle, one inch below the angle of the mandible. The occipital and posterior auricular arteries arose from a common trunk given off by the external carotid artery.
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Fri, 28 Aug 2015 01:56:27 GMT -08:00 http://www.scopemed.org/?mno=35814
Multiple vascular anomalies involving renal, testicular and suprarenal arteries http://www.scopemed.org/?mno=38601 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Suresh Rao, Vincent Rodrigues, Mohandas Rao KG, Nikolai Ovchinnikov.
Knowledge of variations of blood vessels of the abdomen is important during operative, diagnostic and endovascular pro- cedures. During routine dissection of the abdominal cavity, we came across multiple vascular anomalies involving renal, suprarenal and testicular arteries. The left kidney was supplied by two renal arteries originating together from the abdomi- nal aorta, and the right kidney was supplied by two accessory renal arteries, one of which was arising from the right renal artery and the other one from the aorta (about 2 inches below the origin of the renal artery). Accessory renal veins were present on both sides. The right testicular artery was arising from the lower accessory renal artery. The left testicular artery was looping around the inferior tributary of the left renal vein, whereby forming a sharp kink. The left middle suprarenal artery was diving into three small branches; the upper two branches were supplying the left suprarenal gland, whereas the lower branch was supplying the left kidney. Furthermore, detailed literature and the clinical and surgical importance of the case are discussed.
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Fri, 28 Aug 2015 01:56:27 GMT -08:00 http://www.scopemed.org/?mno=38601
The motivation to pursue surgical subspecialty training is largely gender-neutral: A national survey in Switzerland http://www.scopemed.org/?mno=151568 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Reto M. Kaderli, Julia C. Seelandt, Franziska Tschan Semmer, Adrian P. Businger.
Objectives: Over the last years, an increasing proportion of general surgeons have opted for a surgical sub-specialization, possibly due to economic pressures. With regard to the increase in women physicians, the aim of the present study was to examine qualitatively and quantitatively gender differences and reasons for obtaining sub-specialization in surgery. Methods: Survey among board-certified surgeons and surgical residents in Switzerland. Content analyses were done by using Mayring’s content analysis. Results: A total of 455 arguments to pursue surgical subspecialty training were grouped in six different categories, namely: “Interest” (82/512, 16.0%), “demand for quality” (104/512, 20.3%), “future prospects” (142/512, 27.7%), “obligation to specialize” (48/512, 9.4%), “financial reasons” (10/512, 2.0%), and “prestige” (13/512, 2.5%). Men mentioned “demand for quality” (P = 0.01) significantly more often than women, but there were no other statistically significant differences between genres. Conclusions: Intrinsic arguments were more important, including a “demand for quality”, especially for men. However, the arguments in favor of surgical subspecialty training are largely gender-neutral.
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Fri, 28 Aug 2015 01:53:58 GMT -08:00 http://www.scopemed.org/?mno=151568
Principles of risk management in surgery departments http://www.scopemed.org/?mno=164199 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Fatemeh Rezaei, Mohammad H Yarmohammadian, Masoud Ferdosi, Abbas Haghshenas.
Objectives: Surgical procedures aim at preserving human life and improving life quality. However, there are many poten- tial risk sources that can cause serious harm to patients. For centuries, managers believed that the technical competence of the surgeon is the only key to a successful surgery. But over the past decade, risks have been considered in terms of process-based safety procedures, teamwork and inter departmental communication. This study aims to determine how the process-biased surgical risk management should be done in terms of project management tool named activity breakdown structure (ABC). Methods: This study was conducted in two stages. First, literature review and meeting with professors was done to de- termine principles and framework of surgical risk management. Responsible teams for surgical patient journey were then involved in subsequent meetings to develop the process-biased surgical risk management. This study is a qualitative research in which the inductive approach is used on focus groups. Sampling was performed to achieve representative- ness through intensity sampling biased on experience and seniority. Context analysis of interviews and consensus themes extracted from focus discussion group meetings discussion was the analysis tool. Results: We structured the patient journey process in five main phases, 24 activities and 108 tasks. Then, the responsible teams were involved, and the transposition and allocated places for performing were chosen. Because of their importance, some activities and task themes such as patient identification and records review were repeated in each phase. Conclusions: Risk management of surgical departments is significant as this is typically the hospital facility with the both the highest cost and revenue. Communication between the surgical team and other clinical teams outside the surgery department through process-biased perspective could improve the safety of patients.
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Fri, 28 Aug 2015 01:53:58 GMT -08:00 http://www.scopemed.org/?mno=164199
Primary mammary tuberculosis: Clinical diagnostic dilemma http://www.scopemed.org/?mno=164826 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Sunder Goyal, Anjali Solanki, Shveta Narang, Kartikeya Kashyap.
Background: Primary mammary tubercular swelling poses a clinical diagnostic dilemma owing to its atypical clinical pic- ture which may mimic breast malignancy or breast abscess. In all the three condition axillary lymph nodes are involved no doubt their consistency is variable. Keeping this in mind this study was carried out. Material and Methods: In our study, we report five patients with mammary tuberculosis who presented with painless mass during one year period. One patient was having involvement of ipsilateral axillary lymph nodes. Clinical diagnosis was confusing as all patients were in late twenties or late thirties. Fine-needle aspiration cytology proved the diagnosis. Results: Mainstay of treatment was Antitubercular drug therapy. In all the five patients lump resolved completely. None of our patient required surgical intervention. Conclusion: Breast Tuberculous is uncommon in countries where incidence of pulmonary and extrapulmonary tuberculosis is very high. It continues to pose a diagnostic challenge due to its rarity, atypical clinical features and non confirmatory radiological modalities. Unnecessary mastectomy can be avoided if we keep this rare but medically treatable condition on back of our mind.
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Fri, 28 Aug 2015 01:53:58 GMT -08:00 http://www.scopemed.org/?mno=164826
Presentation and diagnostic accuracy of fine-needle aspiration cytology and ultrasonography in detecting breast cancer in tribal females of rural West Bengal http://www.scopemed.org/?mno=165567 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Sanhita Mukherjee, Sunanda De, Sarbari Swaika, Diptakanti Mukhopadhyay.
Background: The present study tried to have a comparative analysis of the sensitivity, specificity and positive predictive value (PPV) of ultrasonography (USG) and fine needle aspiration cytology (FNAC) in the detection of breast cancer among a tribal population. Materials and Methods: Ninety two tribal females attending surgical outdoor with breast lumps were included in the study. Their demographic parameters, the mode of presentation, time lapse since first noticed, presence and absence of well- known breast cancer risk factors were studied. All patients were subjected to FNAC and USG and the findings of these two investigations were compared with the histopathology reports when the patients came for a follow-up. Data were analyzed using the statistical package for social sciences software version 17 for Windows. Percentage, sensitivity, specificity, and positive predictive values (PPV) were calculated. Results: Among 92 patients 68 (74%) were diagnosed to have benign breast disease and 24 (26%) had carcinoma breast. Although the age of presentation of these patients did not differ from that of the western population, the time lapse since first noticed and the prevalence of well-known risk factors of breast cancer such as, parity and the usage of oral contracep- tive pills differed markedly in the study group. The sensitivity, specificity and PPV of ultrasonography were 91.67%, 91.18% and 78.58% respectively and that of FNAC was found as 95.83%, 97% and 92%. Conclusion: The study observed a late presentation of breast lump in tribal rural women of Bankura, West Bengal. Nev- ertheless, the accuracy of the screening procedures like USG and FNAC are comparable with that of the Western World.
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Fri, 28 Aug 2015 01:53:58 GMT -08:00 http://www.scopemed.org/?mno=165567
Effects of bile on arterial anastomosis in a rat model http://www.scopemed.org/?mno=170494 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Kamil Kilic, Gokhan Temiz, Murat Zeytunlu, Murat Kilic, Mehmet Alper.
Objective: Liver transplantation has been one of the areas in which microvascular surgery is frequently practiced. With the use of microsurgical techniques in hepatic artery anastomosis, the incidence of hepatic artery thrombosis has been signifi- cantly reduced. Hepatic artery anastomosis is realized after the anastomoses of the hepatic vessel and portal vessel are completed, and clamps are removed; in other words, after hepatic circulation starts. During hepatic artery anastomosis, bile runs towards the hepatic artery anastomosis line. This study aimed to investigate effects of bile on arterial anastomosis. Materials and Methods: Forty male Sprague Dawley rats were randomly divided into 2 groups. Femoral artery anasto- mosis was performed in rats of the control group (n = 20) through heparinized serum (10 U/ml) irrigation. In the rats of the study group (n = 20), however, femoral artery anastomosis was performed through heparinized serum (10 U/ml)+0.5 cc bile irrigation. After the 1st week, anastomosis patency was evaluated with color duplex ultrasonography. A 1 cm segment of the femoral artery involving the anastomosis line was removed for histopathological evaluation. Results: In the control group, no flow to the distal was observed in one anastomosis. All the anastomoses in the study group were patent. Histopathologically, perivascular polymorphonuclear leucocyte infiltration was observed in the study group. No statistically significant differences were observed for endothelial continuity and intimal thickening, and no statisti- cally significant differences were observed for anastomosis patency. Conclusions: In the light of these findings, it was determined that bile contamination did not have any negative or positive effects on artery anastomosis.
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Fri, 28 Aug 2015 01:53:58 GMT -08:00 http://www.scopemed.org/?mno=170494
Central corneal thickness in children with type 1 diabetes mellitus and the effect of metabolic control on corneal thickness http://www.scopemed.org/?mno=1161 2015-08-30T02-50-58Z
Source: Archives of Clinical and Experimental Surgery (ACES)
Emine Cinici.
Objective: To research whether central corneal thickness (CCT) of children with Type 1 diabetes mellitus (T1D) is different from healthy children at same age group and whether metabolic control has an effect on corneal thickness. Materials and methods: The children with T1D who applied to our outpatient department with the aim of controlling for possible diabetes complications and who had no diabetic retinopathy were prospectively evaluated. The healthy children from the same age group who applied to our outpatient setting for eye control and who had no systemic or eye disease were included in the control group. The CCT of all children was measured with ultrasonic pachymeter with topical anesthesia. Findings: While the corneal thickness for healthy children was 554.25±42.85 (500 – 678 µ), the average corneal thickness for diabetic children was 567.38±33.28 (487 – 628 µ). A significant difference was detected for average corneal thickness (Z=-2.040 p=0.041). No relation was detected between the central cornea thickness and the duration of diabetes (t=1.418 p=0.168), average HbA1C level (t=1.261p=0.218), hyperglycemia (t=0.228 p=0.821) and hypoglycemia attack number (t=-0.332 p=0.743). Result: CCT is increased in the patients compared to the control group even before diabetes mellitus (DM) has developed a retinopathy. A relation of this increase with period of diabetes, HbA1C level and hypoglycemia attack number could not be detected.
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Fri, 28 Aug 2015 01:53:58 GMT -08:00 http://www.scopemed.org/?mno=1161
Congenital ichthyosis in a very low birth weight infant http://www.scopemed.org/?mno=164971 2015-08-30T02-50-58Z
Source: Journal of Contemporary Medicine
Şahin Takcı, Deniz Anuk-İnce, Rüveyda Gümüşer, Serap Bilge, Zennure Takcı, Helin Deniz-Demir.
The ichthyoses are clinically and etiologically heterogeneous group of hereditary keratinization disorders. They are characterized by generalized scaling and dryness of the skin, occasionally by erythroderma and histopathologically by hyperkeratosis. Ichthyosis vulgaris and X-linked ichthyosis are the most common types of ichthyosis. Congenital ichthyoses are rare, which include lamellar ichthyosis, congenital ichthyosiform erythroderma, and harlequin ichthyosis. Lameller ichthyoses are usually present at birth or present soon after birth. The affected infants are born with a parchment paper like transparent membrane (collodion membrane). Prevention of the complications such as dehydration, sepsis, electrolyte imbalance and pneumonia is important for survival. The main goal of the treatment is to prevention of fluid loss, emollition of the skin and providing the softness of stratum corneum. In our case very low birth weight premature infant with the diagnosis of lamellar ichthyosis based on clinically findings was treated successfully only with topical agents. Hereby, we reviewed the care of premature infants with congenital ichthyosis in neonatal intensive care unit.
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Fri, 28 Aug 2015 01:52:34 GMT -08:00 http://www.scopemed.org/?mno=164971
NEUROGENIC PULMONARY EDEMA DEVELOPING AFTER CESAREAN SECTION http://www.scopemed.org/?mno=164946 2015-08-30T02-50-58Z
Source: Journal of Contemporary Medicine
Handan Güleç, Münire Babayigit, Aysun Kurtay, Zehra Tutal, Necla Dereli, Saziye Sahin, Eyup Horasanli.
Neurogenic pulmonary edema (NPE) is a pathogenesis of pulmonary edema which occurs often in the early period following the acute neurologic changes affecting the central nervous system and proceeds with respiratory failure. It causes respiratory problems requiring intubation in the patient. When evaluated in general terms, the pathophysiology of NPE includes cardiopulmonary dysfunction caused by catecholamines that are secreted rapidly and abundantly. This case study will examine the respiratory failure of a 35-year-old pregnant (for 37 weeks), which developed after an emergency cesarean section, and her later being diagnosed with Arteriovenous Malformation (AVM).
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Fri, 28 Aug 2015 01:52:34 GMT -08:00 http://www.scopemed.org/?mno=164946