May 2016

Original Article

A Study of Distal Sensory Nerves in Patients with Newly Diagnosed Asymptomatic Type 2 DM

Halil Ay1 , Yılmaz İnanç2 , Suna Sarıkaya Ay3 , Yaşar Altun4 , Bahar Pehlivan5 , Yusuf İnanç1

1 Nöroloji AD. Gaziantep Üniversitesi Tıp Fakültesi, Gaziantep, 2 Nöroloji AD. Sütçü İmam Üniversitesi Tıp Fakültesi, Kahramanmaraş, 3 Nöroloji AD. Harran Üniversitesi Tıp Fakültesi, Diyarbakır, 4 Nöroloji Kliniği, Adıyaman Devlet Hastanesi, Adıyaman, 5 Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye

DOI: 10.4328/AEMED.86

Abstract

Aim: This study aimed to determine the importance of Medial Plantar (MP), Dorsal Sural (DS) and Medial Dorsal Cutaneous (MDC) sensory nerve conduction studies in addition to the other routine electrophysiological studies performed in newly diagnosed Type II Diabetes Mellitus (DM) for diagnosing diabetic polyneuropathy (PNP) at an early stage. Material and Method: This study included a total of 35 patients aged less than 60 years with newly diagnosed, untreated Type II Diabetes, and 30 healthy volunteers who applied to the Outpatient Clinic of Internal Medicine and Endocrinology at Şanlıurfa Training and Research Hospital and Harran University Faculty of Medicine Research and Application Hospital between April 2014 and August 2014. Results: Our study enrolled a total of 35 Type II Diabetes patients (20 females, 15 males) with a mean age of 47.22±8.15 years, and 30 healthy controls (17 females and 13 males) with a mean age of 49.30±6.56 years. The two groups did not significantly differ with respect to age and sex (p>0.05). MP, MDC, and DS sensory nerve conduction studies, performed additionally to the standard PNP protocol, revealed that the amplitudes and conduction velocities of each of the three nerves were significantly lower than those of the control group (p<0.01). Discussion: It is possible to diagnose diabetic PNP at an early, asymptomatic stage by studying sensory nerves conduction properties of MP, MDC, and DS in addition to the standard electrophysiological PNP protocol. Detection of PNP by these methods at an early stage may help taking measures to prevent progression into symptomatic PNP.

Keywords

Diabetic Polyneuropathy; Medial Plantar Nerve; Medial Dorsal Cutaneous Nerve; Dorsal Sural Nerve

Corresponding Author: Halil Ay, Nöroloji AD. Gaziantep Üniversitesi Tıp Fakültesi, Gaziantep, Türkiye. GSM: +905306934206 E-Mail: ayhalil27@hotmail.com

How to cite this article: Ay H, İnanç Y, Ay SS, Altun Y, Pehlivan B, İnanç Y. A Study of Distal Sensory Nerves in Patients with Newly Diagnosed Asymptomatic Type 2 DM. J Ann Eu Med 2016;4(2): 35-8.

 

Computed Tomographic Based Determination with all Aspect of Spontaneous Passage of Ureteral Stone

 

Ibrahim Buldu1 , Mehmet Cetinkaya2 , Omer Kurt3 , Okan Istanbulluoglu1 , Türker Acar4 , Duran Efe4

1 Department of Urology, Faculty of Medicine, Mevlana University, Konya, 2 Department of Urology, Faculty of Medicine, Sıtkı Kocman University, Mugla, 3 Department of Urology, Faculty of Medicine, Namik Kemal University, Tekirdag, 4 Department of Radiology, Faculty of Medicine, Mevlana University, Konya, Turkey

DOI: 10.4328/AEMED.87

Abstract

Aim: The objective of this study is to determine tomographic measurement parametres that are effective on spontaneous passage (SP) of ureteral stones in patients who will undergo unenhanced multidetector computed tomographic examinations (MDCT). Material and Method: The patients who presented with complaints of renal colic to our clinic during 2013-2015 were retrospectively evaluated. The medical files of 813 patients were reviewed and the medical records of 331 cases who had undergone CT were examined. A total of 217 patients whose stone size was less than 10 mm were included in the study. The patients whose stones passed were included in Group 1, and those whose stones did not pass spontaneously were included in Group 2. Data about age and gender of the patients, location, laterality, history of spontaneous stone passage from the ipsilateral side, ureteroscopy, shock wave lithotripsy (SWL), anteroposterior (AP) diameter of the renal pelvis, diameter of the stone as measured on coronal and axial planes, stone volume, and average thickness of the renal parenchyma were evaluated. Parametres effecting passage of the stone were statistically analysed. Results: The mean age of the patients (female, n=152, and male, n=65) was 42.3 years. The patients had upper (n=73) and lower (n=144) ureteral stones. The median diameter of the renal pelvis (17.2 mm), stone diameter on the coronal plane (6.1 mm) and the axial plane (4.6 mm), and thickness of the renal parenchyma (20 mm) were measured. Statistical analysis revealed that the location, volume, diameter of the stone on the coronal and axial planes were influential factors on spontaneous stone passage. In logistic regression analysis, only the location of the stone and its diameter on the coronal plane were found to be independent effective factors on spontaneous stone passage. Discussion: In our study based on data retrieved from MDCT, the location and size of the stone were found to be independent factors affecting spontaneous stone passage. However, a surprising result is that the AP diameter of renal pelvis and renal parenchymal thickness, both of which are factors important for urologists, were not effective on SP.

Keywords

Ureteral Stone; Unenhanced Multidetector Computed Tomography; Spontaneous Passage

Corresponding Author: Ibrahim Buldu, Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey. GSM: +905054553123 F.: +90 3322411111 E-Mail: ibrahimbuldu@yahoo.com

How to cite this article: Buldu İ, Cetinkaya M, Kurt Ö, Istanbulluoglu O, Acar T, Efe D. Computed Tomographic Based Determination with all Aspect of Spontaneous Passage of Ureteral Stone. J Ann Eu Med 2016;4(2): 39-42.

The Endothelial Nitric Oxide Synthase Gene Variant rs2070744 in Turkish Elite Athletes

Abdullah Cenikli1 , Ayşe Feyda Nursal2 , Akin Tekcan3 , Funda Demirtürk4 , Serbülent Yiğit5

1 Department of Couching, Gaziosmanpasa University, School of Physical Education and Sports, Tokat, 2 Department of Medical Genetic, Giresun University, Faculty of Medicine, Giresun, 3 Ahi Evran University, School of Health, Kirsehir, 4 Department of Physiotherapy and Rehabilitation, Gaziosmanpasa University, Tokat School of Health, Tokat, 5 Department of Medical Biology, Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey

DOI: 10.4328/AEMED.85

Abstract

Aim: Genetic variations have been associated with physical performance. The Endothelial Nitric Oxide Synthase (eNOS) gene variants have been widely studied in this context. The aim of the present study is to compare the T786C variant of the eNOS gene in Turkish elite athletes and control groups. Material and Method: DNA samples were obtained from 52 elite athletes (45 male, 7 female) and 60 control subjects (49 male, 11 female). The T-786C variant of the eNOS gene was genotyped by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) method. Results: TT, TC, CC genotypes of the T-786C variant of eNOS gene were observed in 40.0%, 48.3%, and 11.6% of control subjects and in 55.7%, 30.7% and 13.4% of elite athletes, respectively. There was not any statistically significant difference in genotype and allele frequencies of T-786C of the eNOS between the elite athlete and the control groups (p>0.05). Discussion: The present study demonstrated that the T-786C variant of the eNOS gene is not associated with study population but larger sample analyses are needed in different groups of elite athletes in order to substantiate these findings.

Keywords

Nitric Oxide Synthase; the T-786C; Variant; Elite Athletes

Corresponding Author: Akin Tekcan, Ahi Evran University, School of Health, Kirsehir, Turkey. GSM: +905055719646 E-Mail: akintekcan@hotmail.com

How to cite this article: Cenikli A, Nursal AF, Tekcan A, Demirtürk F, Yiğit S. The Endothelial Nitric Oxide Synthase Gene Variant rs2070744 in Turkish Elite Athletes. J Ann Eu Med 2016;4(2): 31-4.

The Evaluation of Bone Mineral Density in Patients with Thalassemia Major

 

Esra Akyüz Özkan1 , Zeynep Tuba Özdemir2 , Ayşe Neslin Akkoca3 1 Department of Pediatrics, Medical Faculty, Bozok University, Yozgat, 2 Department of Internal Medicine, Medical Faculty, Bozok University, Yozgat, 3 İskenderun State Hospital, Hereditary Blood Disease Center, Hatay, Turkey

DOI: 10.4328/AEMED.82

Abstract

Aim: We aim to evaluate osteopathy in patients with thalassemia major (TM) by performing bone mineral densitometry (BMD) and biochemical indices and to emphasize preventive measures and the importance of early diagnosis of osteoporosis. Material and Method: 37 TM patients (18 female, 19 male) were included in the study. The age, gender, biochemical parameters were recorded. BMD was determined using dual energy X-ray absorptiometry from lumbar vertebrae. Z scores were calculated automatically by the device. According to Z scores; <-1 was normal, -1-2 was osteopenia, >-2 was considered as osteoporosis. Results: 9 patients’ Z scores (24.3%) were normal, 5 patients were osteopenic (13.5%), and 23 patients were osteoporotic (62.2%). In the osteoporotic group, parathyroid hormone (PTH) was low in 2 patients (5.4%) and vitamin D was deficient in 12 (32.4%) patients. Lumbar BMD was positively correlated with age (r=0.625, P=0.000), height (r = 0.759, P =0.000), weight (r=0.830, P=0.000), and BMI (r=0.730, P=0.000), and was negatively correlated with ALP (r=-0.422, P=0.010). In the osteopenic group, vitamin D was deficient in 2 patients (5.4%); all other biochemical parameters were within normal limits. Lumbar BMD was positively correlated with age (r=0.625, P=0.000), height (r=0.759, P=0.000), weight (r=0.830, P=0.000), and body mass index (BMI) (r=0.730, P= 0.000), and was negatively correlated with alkaline phosphatase (ALP) (r= -0.422, P= 0.010). Discussion: Despite regular transfusions, osteopathy may occur at high rates in patients with thalassemia.

Keywords

Bone Mineral Density; Osteoporosis; Thalassemia Major

Corresponding Author: Esra Akyüz Özkan, Department of Pediatrics, Medical Faculty, Bozok University, Yozgat, Turkey. GSM: +905067026694 F.: +90 3542140612 E-Mail: uzdresra@gmail.com

How to cite this article: Özkan EA, Özdemir ZT, Akkoca AN. The Evaluation of Bone Mineral Density in Patients with Thalassemia Major. J Ann Eu Med 2016;4(2): 26-30.

 

Result of the Fixation of Tibial Shaft Fractures by the Inflatable Intramedullary Nail

 

Kürşat Gençer, Fırat Ozan, Kaan Gürbüz, Erdal Uzun, Mustafa Özyalçın, Eyyüp Sabri Öncel, Fuat Duygulu

Department of Orthopedics and Traumatology, Kayseri Training and Research Hospital, Kayseri, Turkey

DOI: 10.4328/AEMED.79

Abstract

The treatment strategy for tibial fractures differs with fracture location, displacement, soft tissue condition and comminution. Intramedullary nailing is considered the gold standard treatment for tibial fractures. In this study, the functional and radiographic results of tibial shaft fractures repaired with the inflatable intramedullary nail method were evaluated. From 2013 to 2015, 17 patients (10 males, 7 females; 8 right, 9 left; mean age 40.7 years) with closed tibial fractures repaired with inflatable intramedullary nails were assessed. The time from injury to surgery was an average of 2 days (range, 0–6 days). The mean time of hospital stay was 6 days (range, 2–19 days). The mean follow-up time was 15.4 months (range, 9–25 months). The mean time for patients to return to normal daily activities was 4.5 months (range, 4–6 months). The mean operation time was 47.5 min (range, 35–80 min). None of the patients had major perioperative or postoperative complications such as deep vein thrombosis, fat embolism, infection, or neurovascular complications except for the occurrence of delayed union in one patient. Only 4 patients had anterior knee pain and ankle pain during the early postoperative period. Inflatable intramedullary nails seem to be safe and effective in the treatment of tibial AO/OTA type A and B midshaft fractures.

Keywords

Inflatable Intramedullary Nail; Tibial Fractures; Expandable Nail; Surgery

Corresponding Author: Fırat Ozan, Department of Orthopedics and Traumatology, Kayseri Training and Research Hospital, Kocasinan, Kayseri 38010, Turkey. T.: +90 3523368884 F.: +90 3523207313 E-Mail: firatozan9@gmail.com

How to cite this article: Gençer K, Ozan F, Gürbüz K, Uzun E, Özyalçın M, Öncel ES, Duygulu F. Result of the Fixation of Tibial Shaft Fractures by the Inflatable Intramedullary Nail. J Ann Eu Med 2016;4(2): 22-5.

Evaluation of Case Reports for Contacts with Risk of Rabies-Samsun Sample

 

Onur Ozturk1 , Eylem Isik Uyar2

1 Department of Family Medicine, Atakum Community Health Center, 2 Department of Publich Health, Atakum Community Health Center, Samsun, Turkey

DOI: 10.4328/AEMED.78

Abstract

Aim: Turkey is an endemic area for rabies infection. The number of contact cases at risk of rabies has not decreased as quickly as expected. We investigated the one-year at-risk contacts observed in Samsun between January 1 and December 31, 2014. Material and Method: This is a retrospective, cross sectional study. Data were taken from at-risk contact report forms collected in public health institutions. Analyses were made on June 2015 using the SPSS 20.0 package software. Results: We analyzed 2892 cases, of whom 69.9% were male. The difference in median age by gender (m:27, f:32) is significant (p=0.000). More patients were found in the 10-19 age group (21.1%) than in any other group. 75.5% of the animals causing an at-risk contact were dogs; however, in Atakum, injuries were caused by cats at nearly two times the rate of other towns (p=0.000). At-risk contacts were observed most commonly in the spring (31.8%). Rate of females who take medication or have a diagnosed disease is nearly two times the rate in males (p=0.000). There was an extremity injury in 95.4% of the cases. Discussion: Stray dogs are a public health problem that must be addressed. Rabies infection can be prevented by vaccination and antiserum. Public health services should work in constant collaboration with other disciplines.

Keywords

Rabies; At-Risk Contacts; Turkey; Samsun; Dog

Corresponding Author: Onur Ozturk, Esenevler Mah. 319 Nolu Sokak No: 4/4 Atakum, Samsun, Türkiye. GSM: +905547536566 E-Mail: dr.onurozturk@yahoo.com

How to cite this article: Ozturk O, Uyar EI. Evaluation of Case Reports for Contacts with Risk of RabiesSamsun Sample. J Ann Eu Med 2016;4(2): 17-21. 

Case Report

Stabbing Injury of the Forearm: A Case Report

Kaan Gürbüz, Erdal Uzun, Alper Çıraklı, Fırat Ozan, Fuat Duygulu

Department of Orthopedics and Traumatology, Kayseri Training and Research Hospital, Kayseri, Turkey

DOI: 10.4328/AEMED.83

Abstract

Foreign body injuries are common injuries and foreign body penetrations may occur in almost any part of the body. In the literature there are many reports including different kinds of piercing or penetrating injuries of the extremities. In this paper we report the case of a 19-year-old man who presented with a knife retained in the forearm and our treatment strategy for removing the knife. We informed our patient and took the consent form before the submission for publication.

Keywords

Penetrating Injuries; Stab Wound; Extremity

Corresponding Author: Erdal Uzun, Ortopedi ve Travmatoloji Kliniği, Kayseri Eğitim ve Araştırma Hastanesi, Kayseri, Türkiye. GSM: +905072117999 E-Mail: nuzuladre@gmail.com

How to cite this article: Gürbüz K, Uzun E, Çıraklı A, Ozan F, Duygulu F. Stabbing Injury of the Forearm: A Case Report. J Ann Eu Med 2016;4(2): 50-2.

Case Report; Late Congenital Diaphragmatic Hernia

Deniz Erdem1 , Pakize Özçiftci Yılmaz1 , Belgin Akan1 , Özgür Karakurt2 , Işıl Özkoçak Turan1

1 Yoğun Bakım Kliniği, 2 Göğüs Cerrahisi Kliniği, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Türkiye

DOI: 10.4328/AEMED.65

Abstract

Congenital diaphragmatic hernia is a progression into chest of abdominal organs depends on diaphragmatic defect during fetal development. Prevalence is 1 / 2500-3000 of live births. The most common seen hernia is Bochdalek (90%). In this presentation, late congenital diaphragmatic hernia is described in a patient treatment and follow-up process. Congenital diaphragmatic hernia is a congenital malformation manifested by diaphragmatic hernia, pulmonary hypoplasia and abdominal organ changes. The most common accepted theory of etiology is a problem in the closure of pleuroperitoneal canal. Left-sided hernias which are seen after puberty is rare. Our case is one of them. In conclusion, although the frequency of late congenital diaphragmatic hernia is 0.17–12 %, it is a clinical situation that may be encountered in intensive care practice. It must therefore be kept in mind.

Keywords

Diaphragmatic Hernia; Congenital; Bochdalek

Corresponding Author: Pakize Özçiftci Yılmaz, Yoğun Bakım Kliniği, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Türkiye. GSM: +905063006761 E-Mail: drpakize@gmail.com

How to cite this article: Erdem D, Yılmaz PÖ, Akan B, Karakurt Ö, Turan IÖ. Case Report; Late Congenital Diaphragmatic Hernia. J Ann Eu Med 2016;4(2): 46-9.

Placenta Previa Percreta with Bladder Invasion: Ultrasound and MRI Findings

Burcak Cakir Pekoz, Zafer Koc, Gurcan Erbay, Elif Karadeli Department of Radiology, Faculty of Medicine, Baskent University, Adana, Turkey

DOI: 10.4328/AEMED.64

Abstract

Placenta previa percreta is an abnormal placental implantation due to decidual deficiency. Placenta previa percreta with invasion of the urinary bladder is an uncommon and serious condition if not recognized before delivery. We report color Doppler ultrasound (CDUS) and magnetic resonance imaging (MRI) findings in two cases of placenta previa percreta with bladder invasion. Both cases presented with sudden painless vaginal bleeding and had previous cesarean delivery. CDUS and MRI findings are helpful for the prenatal diagnosis of plasenta previa percreta with invasion of the urinary bladder to prevent perinatal complications with this condition.

Keywords

Color Doppler Ultrasound; Bladder Invasion; Magnetic Resonance Imaging; Placenta Percreta

Corresponding Author: Elif Karadeli, Baskent Universitesi Adana Uyg. ve Araşt. Merkezi, Dadaloglu Mah. 2591 Sok. No: 4/A 01250 Yüregir, Adana, Turkey. T.: +90 3223272727-1025 F.: +90 3223271270 E-Mail: elifkaradeli@gmail.com

How to cite this article: Pekoz BC, Koc Z, Erbay G, Karadeli E. Placenta Previa Percreta with Bladder Invasion: Ultrasound and MRI Findings. J Ann Eu Med 2016;4(2): 43-5.

Review Article

An Overview of Pulmonary Manifestations in Sickle Cell Disease

Ramazan Öcal

Department of Hematology, Gazi University Medical Faculty, Ankara, Turkey

DOI: 10.4328/AEMED.84

Abstract

The increased survival of patients with sickle cell disease (SCD) into adulthood leads an increased incidence of multiorgan dysfunction. The lung is one of the most common organs that may be involved in SCD. The pulmonary manifestations of SCD are the leading cause of morbidity and mortality in these patients. Although pulmonary manifestations of SCD are very common, they remain underdiagnosed by clinicians. The main pulmonary manifestations of SCD are acute chest syndrome, chronic dyspnea, asthma, sleep-disordered breathing, acute and chronic venous thromboembolic disease, pulmonary hypertension, and pulmonary fibrosis. Herein, the current knowledge of the pathophysiology, diagnosis, and treatment of pulmonary manifestations of SCD are reviewed.

Keywords

Sickle Cell Disease; Pulmonary Manifestation; Acute Chest Syndrome

Corresponding Author: Ramazan Öcal, Department of Hematology, Gazi University Medical Faculty, Ankara, Turkey. GSM: +905534061356 E-Mail: drocal@gmail.com

How to cite this article: Öcal R. An Overview of Pulmonary Manifestations in Sickle Cell Disease. J Ann Eu Med 2016;4(2): 53-6.