Oral zinc sulphate in treatment of patients with thallium poisoning: A clinical therapeutic trial
Khalifa E. Sharquie, Khalil I. Al-Hamdi, Adil A. Noaimi, Ahmed A. Al-Mohammadi
J Clin Exp Invest 2011;2(2):133-137.
https://doi.org/10.5799/ahinjs.01.2011.02.0226
Research Article
[Abstract]
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ABSTRACT
Objectives: Thallium poisoning is usually associated with typical dermatological features simulating that of zinc deficiency. The aim of this study was to evaluate the role of oral zinc sulphate in the treatment of patients with thallium poisoning.
Materials and methods: This clinical therapeutic trial study was conducted in Departments of Dermatology of Baghdad and Basrah Teaching Hospitals from February 2008 - February 2010, where a total of 37 patients with thallium poisoning were enrolled.
A detailed history was taken from all patients and complete clinical examination was performed. All patients received zinc sulphate in a dose of 5 mg/kg three times a day few days before confirming the diagnosis of thallium poisoning. Thallium in urine had been measured using the colorimetric method and was positive in all patients. After confirming the diagnosis of thallium poisoning, thallium antidotes Prussian blue was given to 32 patients.
Results: Age range of 37 patients was 5-33 (mean, 24±5.3) years. The dermatological findings were mainly, anagen hair loss affected the scalp and limbs. Also, dusky ecchymotic red dermatitis like rash was observed on the face and dorsum of hands and legs. Neurologic manifestations, mainly of peripheral neuropathy, were reported in 21 (55%) patients. All patients but two responded promptly to a trial of zinc sulphate within few days.
Conclusion: Oral Zinc sulphate appears to be an effective and safe treatment for thallium poisoning particularly for skin and hair features and in reducing its lethal progression and complications.
Keywords: Thallium poisoning, oral zinc sulphate, treatment, Iraq
Effectiveness of sevoflurane or propofol combined with remifentanil for intubation without muscle relaxants
Dilek Karaaslan, Tülay T. Peker, Pakize Kırdemir, Esra Nayır, Özlem Özorak, Hüseyin Kosat
J Clin Exp Invest 2011;2(2):138-143.
https://doi.org/10.5799/ahinjs.01.2011.02.0227
Research Article
[Abstract]
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ABSTRACT
Objectives: We aimed to investigate the reliability of the hypothesis that whether sevoflurane-remifentanil could offer equivalent intubation conditions with propofol-remifentanil in the absence of muscle relaxants.
Materials and methods: Total of 80 patients of ASA grades I and II scheduled for elective surgery were randomly allocated into two groups. Patients in group I received an infusion of remifentanil 1 mcg/kg/min and inhalation of sevoflurane 8% until the Bispectral index (BIS) being less than 60. Patients in group II received a co-infusion of remifentanil and propofol 1 mg/kg/h until BIS is <60. Intubation was attempted when BIS is <60. Intubation conditions were assessed as optimal, good, marginal, and poor using vocal cord opening, jaw relaxation and patient's movements. The heart rate and mean arterial blood pressure (ABP) were recorded before and during the induction, and thereafter, 1, 2 and 5 minutes following intubation. The time for BIS to be <60 was recorded.
Results: Optimal intubation conditions were achieved more often in group II than in group I (90% versus 45%, p=0.002). The ratio of patients showing optimal or good intubating conditions was 80% in group I and 100% in group II (p=0.035). Time required for BIS was shorter in group II than in group I (47.1±27.2 sec vs. 111.9±60.6 sec, p<0.001). In both groups, there was a decrease in heart rate and mean ABP compared to baseline.
Conclusion: Under BIS monitorization, propofol-remifentanil combination offered better intubation conditions and shorter anesthesia induction period compared with sevoflurane-remifentanil.
Keywords: Intubating conditions, propofol, remifentanil, sevoflurane, comparison
The effect of extremely low frequency magnetic field on heart tissue iron density
Sevda Söker, Cemil Sert, Mustafa Deniz, Ercan Ayaz, Selçuk Tunik, Yusuf Nergiz
J Clin Exp Invest 2011;2(2):144-148.
https://doi.org/10.5799/ahinjs.01.2011.02.0228
Research Article
[Abstract]
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Objectives: The aim of this histological study was to investigate the effects of extremely low frequency, low intensity magnetic field on the heart muscle ıron density.
Materials and methods: In this study, 45 male Spraque Dawley rats were introduced and were divided into three groups as sham, control and experiment group. The experimental group was exposed to a 0.25 mT to Extremely Low Frequency Magnetic Field (ELF-MF) for 14 days, 3h a day in metacrylate boxes. The sham group was treated like the experimental group, except for ELF-MF exposure. For control, nothing applied to rats in this group and they completed their life cycle in the cage during the study period. After exposure period, the rats were sacrificed under ketalar an-esthesia (50 mg / kg, intramuscularly). Heart tissues were immediately fixed in 10% neutral formaldehyde and embed-ded in paraffin blocks. Histological sections from cardiac tissue stained by hematoxylin-eosin, Perls' Prussian blue for iron pigments. Histological slides were photographed under a Nikon DS-2MV photomicroscope.
Results: The architecture and histology of the control, sham and experimental group were observed as normal. No differences were observed between the control, sham and experimental rat groups in the iron stain of heart tissues.
Conclusion: As a result of our study, we did not observe differences between the control and ELF-MF (experimental) group. In this investigation we demonstrated that the exposure of cardiac tissue of rats to the ELF-MF did not change in the iron stain study.
Keywords: Extremely low frequency magnetic field, heart, iron
Does obturator nerve block always occur in 3-1 block?
Pakize Kirdemir, Ayhan Comert, Simel Kendir, İbrahim Tekdemir, Alaittin Elhan
J Clin Exp Invest 2011;2(2):149-151.
https://doi.org/10.5799/ahinjs.01.2011.02.0229
Research Article
[Abstract]
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ABSTRACT
Objective: In the femoral "3-in-1 block", obturator nerve block is routinely unsuccessful. Anatomical studies are not available to explain why blockade of obturator nerve or lumbar plexus does not occur. The aim of this study was to examine the effectiveness of femoral "3-in-1 block" obturator nerve block on a cadaver model.
Materials and methods: Totally, 12 mature adult human cadavers were selected. Methylene blue dye (30 ml) was in-jected under the fascia iliaca in eight cadavers and into the femoral nerve sheath in four cadavers. Careful bilateral dissections were performed following dye injections.
Results: It was seen that the dye did not spread to the medial part of the psoas major muscle and the obturator nerve was not stained with the dye in eight cadavers in whom dye was injected laterally into the femoral sheat. In four ca-davers in whom dye was injected into the femoral nerve sheat, metylene blue spread through fascial layers in the plane under the psoas muscle and stained the obturator nerve just before emerging medially from the fascia psoas. At this point, the obturator nerve pierced the psoas fascia and extended extrafascially in the medial and deep borders of the psoas muscle. In this area, the upper section of the obturator nerve was found also to be stained with the dye.
Conclusion: We concluded that the cause of an unsuccessful obturator nerve block might be the fascial anatomy of this region. The lateral cutaneous femoral nerve and the femoral nerve easily can be blocked in the fascia iliaca com-partment, but the obturator nerve block fails because of its being extrafascial in this region.
Keywords: Obturator nerve, femoral nerve, nerve sheath, anesthetic techniques
The comparison of free androgen index and serum free testosterone levels in women with hirsutism or polycystic ovary syndrome
Oya Güngör, Gönül Erden, Ceylan Bal, Nihal Uğuz, Sevilay Sezer, Şeyda Özdemir, H. Tuğrul Çelik, M. Metin Yıldırımkaya
J Clin Exp Invest 2011;2(2):152-156.
https://doi.org/10.5799/ahinjs.01.2011.02.0230
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Objectives: In many laboratories free testosterone can not be measured, so that free androgen index is suggested in-stead. The aim of this study was to compare free androgen index and serum free testosterone levels measured by ra-dioimmunoassay in women with hirsutism or polycystic ovary syndrome.
Materials and methods: Totally 94 women referred to the polyclinics of Ankara Numune Hospital were retrospectively included. Three patient groups were composed; 55 of hirsutism, 20 of polycystic ovary syndrome and 19 of both hirsutism and polycystic ovary syndrome. Total testosterone and sex hormone binding globuline levels were measured by chemiluminescence method and free testosterone levels were measured by radioimmunoassay. Free androgen index was calculated from total testosterone and sex hormone binding globuline.
Results: There was a significant positive correlation between free testosterone and free androgen index in patients with hirsutism, in patients with polycystic ovary syndrome, in patients with hirsutism and polycystic ovary syndrome, and in total patient group [r(hirsutism)=0,597, r(PCOS)=0,617, r(hirsutism and PCOS)=0,779, r(total patient group)=0,649, P<0,01].
Receiver operating characteristics curves were drawn to assess the diagnostic power of parameters for all patient groups [For hirsutism (n=55) auROC (FT)=0,431 auROC (FAI)=0,485] [For PCOS (n=20) auROC (FT)=0,431 auROC (FAI)=0,359] [For hirsutism and PCOS (n=19) auROC (FT)=0,676 auROC (FAI)=0,669]. In our study, free testosterone and free androgen index were found useful to diagnose ‘hirsutism and polycystic ovary syndrome' but not others.
Conclusion: Free androgen index can be used instead of free testosterone in hirsutism and polycystic ovary syndrome for diagnosis.
Keywords: Free androgen index, free testosterone, hirsutism, polycystic ovary syndrome
The use of child safety seats: A survey on levels of knowledge and attitudes of university employees
Kursat Bora Carman, Yılmaz Palancı
J Clin Exp Invest 2011;2(2):157-160.
https://doi.org/10.5799/ahinjs.01.2011.02.0231
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ABSTRACT
Objectives: Child safety seats are the best practice for protecting child occupants. In western world, a significant re-duction of child deaths in motor vehicle crashes has occurred over the past years. However, the use of child safety seats will be obligatory in Turkey from 2010 onwards. We aimed to determine the prevalence of safety seat use and survey the opinions of parents about children safety seat use in traffic.
Materials and methods: A survey was conducted in Kars province of Turkey. A questionnaire was handed out to par-ents who were employees in a university. The first part of questionnaire was concerned with the personal properties of participants. The second part was designed to evaluate the level of parents' knowledge on child safety seat.
Results: Of the 600 questionnaires distributed, 516 (86%) were returned and included in the final analysis. This study showed that 266 participants were having children and automobile. The ownership of child safety seat was only 13.5% among them. The parents reported that the lack of knowledge about child safety seats was the main reason for not having safety seats. Majority of parents stated that they would be more careful in the future about child safety in traf-fic.
Conclusion: This study showed that most parents were uninformed about the necessity of child safety seats. The au-thorities have to develop new strategies to increase the rate of child safety seat use.
Keywords: Child, car accident, seat, safety
Association of a single nucleotide polymorphism in the SUR1 gene with type 2 diabetes and obesity in Turkish patients
Osman Evliyaoglu, Enver Sancaktar, Erkan Söğüt, Mustafa Kemal Başaralı, Nuriye Uzuncan, Baysal Karaca
J Clin Exp Invest 2011;2(2):161-167.
https://doi.org/10.5799/ahinjs.01.2011.02.0232
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[Abstract]
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Objectives: Sulfonylurea receptor 1 (SUR1) gene codes the SUR1 protein that plays a key role in glucose-induced in-sulin secretion. In this study, we have investigated the relationship between the polymorphism in exon 31 of the SUR1 gene and type 2 diabetes, and its association with obesity in Turkish diabetic patients.
Materials and methods: A total of 90 patients (45 males and 45 females, aged 43-70 years old) who were followed up in the diabetes outpatient clinic were enrolled in the study. Serum glucose, triglyceride, cholesterol and blood HbA1c levels were determined. The SNPs in exon 31 were examined by a polymerase chain reaction/restriction fragment length polymorphism (PCR-RFLP) method.
Results: A significant increase in the frequency of the A allele was observed in type 2 diabetic patients compared with that of the control group (41% vs. 24%, p<0.01), and this association was stronger in the subgroup of patients with obesity (A allele 44%, p<0.01). There was a significant difference in genotype distribution of exon 31 R1273R SNP be-tween the patients and controls (P=0.01), especially between the patients with obesity and the control group (P=0.007).
Conclusion: This study reports that the SNP in exon 31 of the SUR1 gene is strongly associated with type 2 diabetes mellitus in Turkish patients with concomitant obesity, suggesting interactions of SUR1 variants with type 2 diabetes and obesity.
Keywords: Type 2 diabetes, obesity, SUR1 gene polymorphism, RFLP
Treatment of tibial diaphysis fractures with reamed and locked intramedullary nailing
Abdullah Demirtaş, Mehmet Oğuz Durakbaşa, İbrahim Azboy, Atilla Polat, Bekir Yavuz Uçar, Yahya Coşar, Gürkan Gümüşsuyu
J Clin Exp Invest 2011;2(2):168-174.
https://doi.org/10.5799/ahinjs.01.2011.02.0233
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[Abstract]
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ABSTRACT
Objectives: The aim of this study was to evaluate the results of reamed and locked intramedullary nailing for tibial di-aphysis fractures.
Materials and methods: The study included 38 patients (26 males, 12 females) who were treated with reamed and locked intramedullary nailing for tibial diaphysis fractures. Fractures were classified according to Gustilo-Anderson classification and functional results were assessed using the Johner-Wrush criteria.
Results: The mean age was 36 years (range 18-61). There were 21 AO/ASIF type A, 16 type B, and 1 type C fractures. Twenty-four fracture were closed (63.1%) and 14 (36.9%) were open fractures. According to the Gustilo-Anderson classification, 9 were grade I, 4 patients grade II, and one grade IIIA open fractures. Intramedullary nailing was per-formed following open reduction in 18 patients, and closed reduction in 20. The mean time to surgery was 9.4 days and the mean follow-up was 29 months. Union was achieved in all patients within a mean of 17.6 weeks. Anterior knee pain developed in 18 patients and infection developed in three patients. Angular deformity less than 10º was developed 12 patients (31.6%). There were screw breakacge and synostosis in four and two patients respectively. Ac-cording to the Johner-Wrush criteria, functional results were very good in 23 patients (60.5%), good in 12 patients (31.6%) and fair in 3 (7.9%) patients.
Conclusion: Treatment of tibial diaphysis fractures with reamed and locked intramedullary nailing gives satisfactory results. It should be considered as first choice in the treatment of these fractures.
Keywords: Tibia shaft fracture, closed-open surgery, intramedullary nail, reamed dynamisation, complication, locking screw
Effects of vitamin C supplementation on iron and iron binding capacity in sports players after training
Yüksel Koçyiğit, Mehmet Cüneyt Aksak, Yıldız Atamer, Ayfer Aktaş, Ersin Uysal
J Clin Exp Invest 2011;2(2):175-180.
https://doi.org/10.5799/ahinjs.01.2011.02.0234
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Objectives: The aim of this study was to investigate the effects of vitamin C (vit C) supplementation on blood iron (Fe++), total iron binding capacity (TIBC), blood glucose and insulin levels in footballers and basketball players follow-ing three weeks of training and vit C supplementation.
Materials and methods: Blood samples from a total of 20 male sportsmen consisting of amateur footballers and basketball players were taken before and after experiment included an exercise on a treadmill with 1% tilt at a speed of 10 km/h for 10 minutes. Then, they were taken into training camp and they received 1 gr/day vit C daily for three weeks. At the end of the three weeks, blood samples were taken from the experiment groups and the levels of Fe++, TIBC, glucose and insulin were measured. Also, they were asked to fill a questionnaire about previous scores in com-petitions, and their habits on vitamin intake or smoking. Results of the questionnaire have been reflected as ratios.
Results: Data were analyzed and it was found that in both groups blood Fe++ and glucose levels of before and after exercise were elevated (p<0.01; p<0.001) while TIBC and insulin levels decreased (p<0.05). After supplementation of vit C, the Fe++ and TIBC levels in basketball players showed more increase compared with the footballers (p<0.001).
Conclusion: Our findings showed that vit C supplementation increased Fe++ levels and decreased TIBC.
Keywords: Vitamin C, football, basketball, serum iron, iron binding capacity, glucose, insulin
Evaluation of the warm-up habits and knowledge levels in amateur athletes
Cengiz Arslan, İsmail Gökhan, Hasan Aykut Aysan
J Clin Exp Invest 2011;2(2):181-186.
https://doi.org/10.5799/ahinjs.01.2011.02.0235
Research Article
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ABSTRACT
Objectives: The aim of this study was to evaluate the warm-up habit and level of knowledge in the amateur athletes.
Materials and methods: A total of 510 amateur athletes aged between 17 and 30 years with the mean sport age of 6.2±3.4 years were included. There were 360 males (mean age 22.4±2.0 years) and 150 females (mean age 21.2±2.1 years). Warm-up habits of athletes were obtained using by the Likert-type survey questionnaire consisting of 20 ques-tions. The reliability coefficient of the survey had been calculated as cronbach alph=0.647, KMO=0.715, Bar-lett=1968.711 (p<0.05).
Results: It was observed that 56.3% of the athletes had sportive success in elite level and 25% of the male athletes and 32% of the female athletes had never injured before. Item of "warm-up has no effect on the performance of the athlete" was rejected with the mean score of 2.70±0.93, item of "warm-up lessens the risk of being injured for the ath-letes" was accepted by majority (83.9%). Of all athletes, 83.9% of them had been injured more than once. The warm-up habit was found to be performed in 47.8% at pre-training or pre-competition periods, however cool-down habit was found in 17.3% of athletes at the end of activity.
Conclusion: There was a common belief that warm-up had a positive effect on the performance of the athletes, re-duced the risk of injury, increased the movement angle of joints. But it can be said that habits of the amateurs was not at a sufficient level.
Keywords: Amateur athlete, warm-up, cool-down, injury, knowledge level
The relationship between level of anti-CCP, clinical activity and quality of life in patients with psoriatic arthritis
Remziye Akçalı, Mehtap Bozkurt, Kemal Nas, İbrahim Yardımeden, Demet Uçar
J Clin Exp Invest 2011;2(2):187-191.
https://doi.org/10.5799/ahinjs.01.2011.02.0236
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ABSTRACT
Objectives: Psoriatic arthritis (PsA) is an inflammatory joint disease. The aim of this study was to investigate the titers of Anti-syclic citrullinated protein (anti-CCP antibodies) in PsA and assess their associations with clinical characteristics and quality of life.
Materials and methods: Fourty two patients with PsA and 38 healthy control subjects were included. Demographic data and clinical characteristics including age, gender, disease duration, and erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anti-CCP antibodies and rheumatoid factor were assessed. Visual analog scale (VAS), Nottingham Health Profile (NHP) and short form-36 (SF-36) were used to evaluate QOL in both groups.
Results: The demographic data of the subjects were not different between the groups. Patients with PsA had higher anti-CCP levels compared to healthy controls (56.3±73.0 U vs. 0.9±0.5 U, respectively, p=0.01) Thirteen (33.3%) patients with PsA had positive anti-CCP, while no anti-CCP positivity was found in the control group (p<0.001). The scores of NHP social isolation, emotional reaction and pain subscales were significantly higher in PsA patients than in control subjects (p<0.05). The scores of physical domains of NHP were not statistically different between groups. There was no statistically significant correlation between the NHP or the SF-36 scores with ESR or CRP levels in PsA group. SF-36 and NHP were found to be significantly correlated with VAS and fatigue (p<0.05).
Conclusion: Anti-CCP antibody positivity was significantly higher in patients with PsA and anti-CCP titers were not related to quality of life measures.
Keywords: Psoriatic arthritis (PsA), Anti-syclic citrullinated protein (anti-CCP) antibodies, quality of life
The frequency and disribution of cancer cases in Hatay District in 2008
Seçil Arıca, Ersin Nazlıcan, Cahit Özer, Dilek Benk Şilfeler, Vefik Arıca, Tümay Özgür, Ümmahan Özaydın
J Clin Exp Invest 2011;2(2):192-195.
https://doi.org/10.5799/ahinjs.01.2011.02.0237
Research Article
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ABSTRACT
Objectives: The aim of this study was to evaluate all cancer cases reported in 2008 in Hatay district.
Materials and methods: Data of 465 cancer patients were collected by Hatay Cancer Early Diagnosis and Screening Centre between January 1-December 31, 2008 and evaluated.
Results: Totally 465 cancer cases were collected from centre of Hatay and districts. 48,8% of these cases (227 cases) were female patients, 51,2% (238 cases) were male. The most frequently encountered cancers were skin (27,7%) and breast cancers (14,7%) when evaluated in terms of the incidence of cases.
Conclusion: Due to cancer screening studies becoming widespread in the community, cases with cancer can be determined in the early stage, also studies intended for etiology and preventive medicine gradually increase. Skin and breast cancers are common in Hatay. Therefore, further studies on etiology and preventive measures for cancer are needed.
Keywords: Epidemiology, Hatay, cancer
Thyroid dysfunction during pregnancy and evaluation of its results
Mehmet Sühha Bostancı, Fatih Taşkesen
J Clin Exp Invest 2011;2(2):196-201.
https://doi.org/10.5799/ahinjs.01.2011.02.0238
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ABSTRACT
Objectives: In this study, we aim to evaluate obstetric outcomes of the women with thyroid dysfunction than the normal pregnant women.
Materials and methods: In our study, 633 women between the ages of 18 to 35 who admitted to Kovancılar State Hospital Obstetrics and Gynecology Clinic for pregnancy follow-up between January 2010 and January 2011 were evaluated. Serum thyroid - stimulating hormones (TSH), free tri-iyodotironin (T3), free thyroxine (T4) levels for all patients were studied. Antithyroidal peroxidase (anti-TPO) and Anti-thyroglobulin (anti-Tg) parameters were measured if they were necessary. The relationship between thyroid functions and complications such as eclampsia, preeclampsia, maternal anemia, postpartum hemorrhage, fetal anomalies, shoulder dystocia, neonatal hypoglycemia was examined.
Results: Hypothyroidism was found 18 of cases and hyperthyroidism was found 4 of them. The mean age of patients in the study was 26.42 (± 8.42). The mean values were 1.86 ± 0.19 μIU/mL for TSH, 1.15 ± 0.29 ng/mL for free T4 and 2.90 ± 0.31 pg/mL for free T3 respectively. Hashimoto's thyroiditis (9 cases, 50 %) was the most frequent etiology for patients with hypothyroidism. Other etiologic factors for hypothyroidism were found to be for 4 cases as (22.2%), iatrogenic (previously undergone thyroidectomy) and 5 cases as (37.8%) a lack of iodine. Maternal anemia was observed in 5 (27.78%) cases with hypothyroidism. Preeclampsia was observed 16.67% in patients with hypothyroidism.
Conclusion: Observed thyroid dysfunction in pregnant women may cause serious maternal and fetal complications. For disorders of thyroid function during pregnancy, to provide the necessary treatment at the appropriate time is important to prevent complications of mother and fetus.
Keywords: Pregnancy, hyperthyroidism, hypothyroidism, pregnancy complications
Serum oxidative stress status in CagA positive Helicobacter pylori infection
Zeliha Asiltürk, Yaşar Nazlıgül, Mehmet Yıldız, Metin Küçükazman, Oktay Bulur, Ayla Tezer, Zeynep Çizmeci, Kadir Okhan Akın
J Clin Exp Invest 2011;2(2):202-206.
https://doi.org/10.5799/ahinjs.01.2011.02.0239
Research Article
[Abstract]
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ABSTRACT
Objectives: Previous studies have suggested that CagA positive Helicobacter pylori (H.pylori) infection may cause the various oxidative damages. The objective of this study was to investigate serum oxidative status in infectetion with CagA positive H.pylori strains.
Materials and methods: Forty-two H.pylori CagA positive subjects and 39 H.pylori CagA negative subjects were enrolled. H.pylori infection was diagnosed by the histopathological assessment of gastric mucosa. CagA status was detected by enzyme immuno assay in a micro ELISA machine. Total antioxidant status (TAS) and total oxidant status (TOS) were measured autoanalyzer using commercially available kits. Serum oxidative stress index (OSI) was calculated using TAS and TOS measurements.
Results: The levels TAS and TOS of CagA positive subjects were found to be 1.48 ± 0.18 mmol/L, 36.88 ± 19.84 mmol/L. Those of CagA negative group were measured to be 1.43 ± 0.19 mmol/L and 38.44 ± 14.72 mmol/L respectively. The values of serum OSI were similar (25.28 ± 15.85 and 26.48 ± 10.02) in CagA positive and negative groups.
Conclusions: The measurements of serum oxidative status did not show any sigficant difference between the patients infected with CagA positive and CagA negative H.pilori strains.
Keywords: Helicobacter pylori, CagA, oxidative status, total antioxidant status, total oxidant status, oxidative stress index
Evaluation of patients with upper gastrointestinal bleeding in chronic renal failure
Fatma Paksoy, Turgay Ulaş, Adile Çakır, Taner Baştürk, Mehmet Sinan Dal, Fatih Borlu
J Clin Exp Invest 2011;2(2):207-213.
https://doi.org/10.5799/ahinjs.01.2011.02.0240
Research Article
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ABSTRACT
Objectives: Incidence of gastrointestinal complications especially gastric bleeding increased in patients with chronic renal failure (CRF). The aim of this study was to comparatively investigate upper gastrointestinal bleeding (UGB) in patients with non-hemodialysis CRF and the patients without CRF.
Materials and methods: Seventy-six patients (55 men and 21 women) with and without CRF and UGB was included. The first group who had CRF consisted of 23 patients and the control group 53. All patients were evaluated in the view point of age, gender, smoking status, other illnesses, medicine usage, laboratory parameters, endoscopic evidence and endoscopic intervention (scleroteraphy).
Results: Calcium levels of patients with a history of previous UGB was significantly lower compared with those bleeding for the first time (p<0.05). The mean parathormon level was higher in patients with CRF (171.24 ± 141.96 pg/ml) (p<0.05). Serum albumin level was negatively correlated with urea and creatinine (p<0.001), and positively correlated with hemoglobin and hematocrit levels (p=0.003 and p=0.005). The patients undergoing sclerotherapy more frequently needed transfusions (p<0.05). The hospitalization time found to be shortening with increasing hemoglobin, hematocrit, calcium and albumin levels; and lengthens with increased urea and creatinine.
Conclusion: The history of previous gastrointestinal bleeding and detection of pathological findings in endoscopy were more frequent in patients with CRF. Gastrointestinal bleeding risk did not reduce using by gastric protection against acetylsalicylic acid and other non-steroidal antiinflammatory drugs. Also, low albumin levels and secondary hiperparathyroidism in these patients may be risky for gastrointestinal bleeding.
Keywords: Renal insufficiency, chronic, gastrointestinal hemorrhage, risk assessment
The efficiency of valproic acid in a child with trichotillomania
Aysel Milanlıoğlu, Sultan Kılıç
J Clin Exp Invest 2011;2(2):214-215.
https://doi.org/10.5799/ahinjs.01.2011.02.0241
Case Report
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ABSTRACT
Trichotillomania is a relatively rare impulse control disorder that causes patients to pull out own hair. Studies regarding the pharmacological treatment in children or adults are scarce, and there is a lack of consensus on drug treatment. The current trend is to use mood stabilizers for reducing repetitive behaviors.
We present the case of 9-years-old child whose symptoms showed remarkable improvement after the administration of valproic acid. Our case is the second case in the literature that effectively treated with valproic acid. Additionally, this report indicates that this drug is potentially effective in reducing and also terminating complaints of trichotillomania. Further studies are needed to understand course of this disorder and considering the best treatment options.
Keywords: Trichotillomania, valproic acid, impulse control disorder
Mad-Honey intoxication leading to severe arrhythmia
Davut Baltacı, Serkan Öztürk, Kayıhan Karaman, Hayati Kandiş, Ayhan Sarıtaş
J Clin Exp Invest 2011;2(2):216-218.
https://doi.org/10.5799/ahinjs.01.2011.02.0242
Case Report
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ABSTRACT
Mad honey intoxication is rarely and locally seen, and it can cause cardiac arrhythmias from mild to life threatening health problems. A 52 year-old female patient admitted to our emergency room with dizziness and fatigue after ingestion of bitter honey. On examination in emergency room, her blood pressure was 70/40 mmHg and pulse value was 45/min. Atrial fibrillation and AV complete block rhythm was detected on her Electrocardiography (ECG) recording. She had no history of known-cardiac disease and use of medicine. On follow-up, her general health status got back to normal. The patient was discharged after her medical status was improved. In conclusion bitter honey intoxication can be life-threatening arrhythmias in people after ingestion of it. It is not restricted health problem to only that region of Turkey, but also to worldwide due to increase in people movement and international nutrition transport.
Keywords: Mad-honey, intoxication, arrhythmias, grayanotoxin
Rupture of a rudimentary horn at 16 weeks of gestation
İlhan Bahri Delibaş, Ünal İsaoğlu, Mehmet Yılmaz, Sedat Kadanalı
J Clin Exp Invest 2011;2(2):219-221.
https://doi.org/10.5799/ahinjs.01.2011.02.0243
Case Report
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ABSTRACT
A patient with acute abdomen at 16th week of gestation underwent an emergency laparotomy. At laparotomy two litres of fibrinated and free blood and a dead fetus with placenta was detected intraabdominally. The right ovary and tube was normal and the uterus was normal in size. There was a ruptured and actively bleeding uterine horn on the left side of the uterus. The ruptured uterine horn was excised with the left tube by preserving the left ovary. The patient recovered without any complications
Keywords: Rudimentary horn, pregnancy, rupture
Three cases with papillon-lefevre syndrome
Derya Uçmak, Yavuz Yeşilova, Mehmet Nurullah Er, Tuba Dal
J Clin Exp Invest 2011;2(2):222-224.
https://doi.org/10.5799/ahinjs.01.2011.02.0244
Case Report
[Abstract]
[PDF]
ABSTRACT
Papillon-Lefevre Syndrome is an extremely rare genetic disorder that typically effects infants of approximately one to 5 years of age. Papillon-Lefevre Syndrome is characterized by the development of palmar-plantar hyperkeratosis and early loss of the primary (deciduous) and permanent teeth due to rapidly progressive periodontopathy. The primary (deciduous) teeth frequently become loose and fall out by about five years of age. In the general population, the disorder occurs in approximately one to 4 individuals per 1.000.000. Here we present a Papillon- Lefevre Syndrome case, which is rarely seen, with a review of the literature.
Keywords: Periodontitis Juvenile, Papillon-Lefevre Disease, Keratoderma Palmoplantar
Anomali of left main coronary artery arising from the right sinus of valsalva
Hakkı Şimşek, Musa Şahin, Mesut İşlek, Salih Paker, Hasan Ali Gümrükçüoğlu
J Clin Exp Invest 2011;2(2):225-227.
https://doi.org/10.5799/ahinjs.01.2011.02.0245
Case Report
[Abstract]
[PDF]
ABSTRACT
Anomalous left main coronary artery arising from the right sinus of valsalva is a very rare congenital anomaly. It is important to recognize because it can lead to dangerous clinical situations such as sudden death. In this report, we present a case of single coronary artery in which left main coronary artery originating from the right sinus of valsalva and crossing aorta posteriorly.
Keywords: Coronary anomaly, coronary angiography, single coronary artery
A very rare case with neglected hip dislocation coexisted with posterior acetabular lip fracture
Vedat Uruç, Samet Karabulut
J Clin Exp Invest 2011;2(2):228-231.
https://doi.org/10.5799/ahinjs.01.2011.02.0246
Case Report
[Abstract]
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ABSTRACT
Neglected hip dislocation is a rare situation among children. The coexistence of acetabulum fracture is less common. The result of treatment depends on the time of diagnosis. Early treatment is mandatory in such cases. Seven years old female brought to our outpatient clinic with the complaints of right hip pain and walking difficulty. Her parents said that she had fallen from a horse one month ago. X-ray and CT showed a posterior dislocation of her right hip and a fracture on her right posterior acetabular lip. We performed an open reduction via posterior approach. Because the hip was unstable we fixed the femoral head to the acetabulum by a Kirshner wire. Pelvipedal cast was applied after the operation for 6 weeks. After 6 months avascular necrosis (AVN) developed on her right femoral head, the range of motion (ROM) of the hip was restricted and she had minimal pain on her right hip.
Keywords: Neglect, children, traumatic hip dislocation
A case with catecholaminergic polymorphic ventricular tachycardia
Hüseyin Uğur Yazıcı, Kadir Uğur Mert, Muharrem Nafisov, Ahmet Ünalır, Bülent Görenek
J Clin Exp Invest 2011;2(2):232-234.
https://doi.org/10.5799/ahinjs.01.2011.02.0247
Case Report
[Abstract]
[PDF]
ABSTRACT
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare type of polymorphic ventricular tachycardias in individuals without structural cardiac abnormalities. It typically has been induced by exercise or emotional stres. It generally is seen in childhood and adolescent period but rarely is seen in elderly. It usually ends by spontaneus, but rarely cause hemodynamic collapse. In here, we present a case with CPVT of successful treatment with a beta blocker therapy.
Keywords: Catecholaminergic, ventricular tachycardia
Cytomegalovirus pneumonia as cause of persistently wheezing in an infant with cystic fibrosis
Çiğdem Aliosmanoğlu, Zehra Şule Haskaloğlu, Ömer Cevit
J Clin Exp Invest 2011;2(2):235-237.
https://doi.org/10.5799/ahinjs.01.2011.02.0248
Case Report
[Abstract]
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ABSTRACT
Cystic fibrosis, presenting in childhood, is a hereditary disease that proceeds with the dysfunction of all exocrine glands. Two months infant who was born premature admitted with respiratory distress. The infant's oxygen saturation was 80% and white sphere was 23.000/mm3. Clor levels were found as 88 mEq/l and 103 mEq/l by sweat chloride test. Cystic fibrosis was diagnosed. The patient not responded to treatment and was positive CMV-DNA was detected. The patient responded well to ganciclovir treatment. When a case with cystic fibrosis does not respond to treatment, another underlying causes should be considered.
Keywords: Cystic fibrosis, CMV pneumonia, ganciclovir
Parathyroid scintigraphy in preoperative detection of parathyroid adenomas and use of gama probe in minimal invasive surgery
Reyhan Köroğlu, Mustafa Köroğlu
J Clin Exp Invest 2011;2(2):238-243.
https://doi.org/10.5799/ahinjs.01.2011.02.0249
Review
[Abstract]
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ABSTRACT
Clinical or subclinical hyperparathyroidism is one of the most common endocrine disorders. Excessive secretion of parathyroid hormone is most frequently caused by an adenoma of a parathyroid gland or glands. The conventional surgical approach is bilateral neck exploration, whereas minimally invasive parathyroidectomy has been made possible by the introduction of 99mTc-sestamibi scintigraphy for preoperative localization of parathyroid adenomas. Especially in ectopic localizations of parathyroid gland and its lesions preoperative localization have undeniable value. In minimally invasive technique the incision is small, dissection is minimal, postoperative pain is less, and hospital stay is shorter. Minimally invasive technique is easy, safe, with a low morbidity rate and has better cosmetic results lower overall cost than conventional bilateral neck exploration. In this technique greatly aided by intraoperative guidence with a gamma probe, based on in vivo radioactivity counting after administrating 99mTc-MIBI. In pres¬ent article, we reviewed actual literature on the preoperative localization of parathyroid adenomas and radioguided minimal invasive surgery.
Keywords: Paratyhroid adenoma, minimal invasive, surgery, parathyroid scintigraphy, gamma probe