Management of Poisonous Snake Bites: Analysis of 29 Cases
Ayhan Akoz, Vahit Yildiz, Serhat Orun, Kenan Ahmet Turkdogan, Ali Duman
J Clin Exp Invest 2018;9(4):140-144.
https://doi.org/10.5799/jcei/3998
Research Article
[Abstract]
[PDF]
[References]
ABSTRACT
Objectives: The objective of this retrospective study is to provide contribution for management of the poisonous snake bites by comparison results of this study with the literature data.
Patients and Methods: This study retrospectively analyzed the demographic and epidemiologic characteristics of 40 patients who presented due to snake bites. 29 patients were included in this study. Patients’ age, sex, month of admission, duration of follow-up in the emergency room, laboratory outcomes, the regions of snake bite, number of the bites, local and systemic symptoms, and treatment received were assessed. Patients aged under 18 years were excluded from the study. Also patients were excluded if the snakes were not seen after the patients were bitten or if they developed no local or systemic symptoms within four hours after the bite. In addition, patients in whom adequate data could not be obtained were also excluded from the study.
Results: Out of the 29 patients included in this study, 15 (51.7%) were females. When the patients were examined according to local and systemic findings; local symptoms were observed in 18 patients (62.1%) and systemic symptoms in 11 patients (37.9%). There was a positive correlation between elevated ALP and diffuse edema in the bite area and hypotension findings. When durations of hospitalization were analyzed, the mean duration of hospitalization was 2.3±1.5 days.
Conclusion: We believe that, symptomatic and supportive treatment could be sufficient in majority of the patients with snake bites in our region, and a low dose antiserum therapy would be reasonable when antiserum is needed.
Keywords: snake bite, antivenom, treatment
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High Volume Adrenalin Solution Infiltration for Surgical Treatment of Gynaecomastia
Erkan Orhan
J Clin Exp Invest 2018;9(4):145-149.
https://doi.org/10.5799/jcei/4001
Research Article
[Abstract]
[PDF]
[References]
ABSTRACT
Objectives: Bleeding is an important problem in the surgical treatment of gynecomastia. The most implemented method to decrease the amount of bleeding is adrenaline infiltration, but adrenalin is mostly infiltrated with the fluid in the volume less than 250 cc in the clinic. It is expected that adrenaline will accumulate more in the tissue and thus, exhibit more bleeding-reducing effect by increasing the fluid volume used in the infiltration. In this study, the aim is to reveal the effect of increasing the amount of adrenaline in tissues by infiltrating a higher-volume solution without increasing the adrenaline concentration in patients who have received gynecomastia treatment by an open surgery on the postoperative blood loss and surgical complications in patients.
Materials and Methods: Patients who had undergone open gynecomastia surgery between 2011 and 2017 were retrospectively examined. Patients not subjected to infiltration were described as Group 1 (n:9), patients infiltrated with adrenalin 100 cc were described as Group 2 (n:13), and patients infiltrated with adrenalin 500 cc were described as Group 3 (n:23).
Results: The average decrease in the hemoglobin level (bleeding) after the operation was calculated to be 2.00±0.37 in Group 1, 1.5±0.4 in Group 2, 0.7±0.30 in Group 3 and the differences between groups were statistically significant (p<0.001).
Conclusion: The infiltration of adrenaline in the same concentration with a fluid of a higher volume decreases blood loss after the gynecomastia surgery operation.
Keywords: gynecomastia, blood loss, infitration
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Scrotal Calcinosis: Analysis of 5 Cases
Asuman Kilitci, Zeliha Kaya, Emine Müge Acar, Ömer Faruk Elmas
J Clin Exp Invest 2018;9(4):150-153.
https://doi.org/10.5799/jcei/4002
Brief Report
[Abstract]
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[References]
ABSTRACT
Idiopathic scrotal calcinosis (ISC) is an uncommon benign process, characterized by solitary or multiple, painless, strict scrotal nodules in the lack of systemic metabolic disorder. Its nature and reason have remained unknown and theories of origin contain idiopathic calcification arising within normal scrotal collagen, dystrophic calcification of inflamed scrotal epidermoid cysts, eccrine duct milia or dartoic muscle, and secondary to minor trauma. A total of 5 cases were found for ISC in our department of pathology. All patients underwent surgical excision of the lesions with overlying skin. Age range was from 25 to 49 years with a mean age of 31.4 years. Three of the patients with multiple lesions (3/5). The common appearance of the masses were hard, slowly growing, semi-mobile, lobulated, and well-circumscribed subcutaneous nodules. Diameter of the lesions ranged 0.7cm to 3cm. Grossly, there were firm, white with chalky and gritty areas. H&E stains revealed basophilic masses in dermis with foreign body giant cell reaction in 4 cases. No recurrences were noted. ISC is a rare, benign, disease of the scrotal skin that is characterized by calcium depositions of various sizes surrounded by a granulomatous reaction. In spite of the debate about the origin of this entity, surgery still seems to be the treatment of option and provides a good clinical outcome.
Keywords: idiopathic, scrotum, calcinosis, dermis, histopathology
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