ISSN 1301 - 0883 / E-ISSN 1309 - 3886

  Eastern J Med: 17 (2)
Volume: 17  Issue: 2 - 2012
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1.Stress assessment by anaesthesiologists and nurses working in paediatric intensive care units
Malgorzata Grzeskowiak, Alicja Bartkowska-Sniatkowska, Jowita Rosada-Kurasinska, Iwona Kielbasiewicz-Drozdowska, Piotr K. Janicki
Pages 59 - 66
Paediatric intensive care units (PICU) play a special role in the therapy of critically ill children. The physicians (anaesthesiologists) and nurses are at a particular risk of job-related stress because continuous work stress can lead to psychological and physical disturbances. The aim of the study was to assess the stress level among the anaesthesiologists and nurses in the PICU. The anaesthesiologists and nurses (104), recruited from five university hospital centres in Poland, participated in the study between 2005-2008. The participants were asked how they estimate the stress level at work, both in general and specific in relation to working in the PICU. Both tested groups estimated the stressfulness of their job in the PICU as high or very high. The most stressful factors for doctors were: decision on limitation of intensive therapy, giving information to parents about a child’s death and stressful attitude towards challenging clinical cases. For nurses, the stressful-factors included witnessing the parents’ reaction to critical state of their child and/or child’s death. The anaesthesiologists and nurses working in the PICU are very stressed and in their opinion work in intensive unit is much more stressful than other jobs. Even though the stress job-related factors are well known the methods to cope with them seem to be insufficient. Based on our research, we argue that the medical team in the PICU should develop and realize competences of stress management or psychological support.

2.Assessment of endometrial cavity of infertil patients with transvaginal sonography, hysterosalpingography, and hysterescopy
Banu Bingol, Faruk Abike, Herman Isci
Pages 67 - 71
To compare the accuracy of transvaginal sonography (TVS), hysterosalpingography (HSG) and hysteroscopy (HS) for uterine pathologies among infertile women. 168 women with diagnosis of infertility were enrolled in this study and assessed with TVS, HSG and HS. TVS, HSG and HS were carried out in all cases, in the 5th-8th days of follicular phase of the cycle. Operative hysteroscopy with directed biopsy was considered as the gold standard. HSG, TVS, and HS were conducted by specialized gynecologists, who were blinded to the results of the other examinations. Endometrial polyp (n=66, 39%), submucous myoma (n=46, 28%), endometrial hyperplasia (n=29, 17%) and suspect of intrauterine synechia (n=27, 16%) were detected with TVS. In the evaluation with HSG results, submucous myoma or polyp (n=42, 25%), irregular uterine contour (n=29, 17%), intrauterine synechia (n=24, 15%) were detected. 73 patients (43%) had normal HSG results. HS (with or without resection) results detected endometrial polyp (n=59, 35%), submucous myoma (n=47, 28%), endometrial hyperplasia (n=35, 21%) and intrauterine synechia (n=27, 16%). Endometrial biopsy revealed no atypical hyperplasia of the endometrium. TVS is the primary investigative method for evaluating every infertile couple by means of uterine cavity and ovaries. TVS seems to be additional and superior to HSG. It is a candidate to be an easy and useful method in the detection of uterine abnormalities among infertile women including polypoid lesions, endometrial hyperplasia and submucosal myoma with respect to hysteroscopy as the gold standard. It can be suggested that HSG should be replaced by the diagnostic hysteroscopy as a first-line investigation for intrauterine pathologies in infertile patients.

3.Evaluation of antimalarial potential of aqueous stem bark extract of Bombax buonopozense P. Beauv. (Bombacaceae)
Tom Chinyere Iwuanyanwu, Godwin Christian Akuodor, AugustineDick Essien, Florence Chidume Nwinyi, Joseph Linus Akpan, Dorcas Okayo Okorafor
Pages 72 - 77
The treatment of malaria in Africa is becoming increasingly difficult due to rising prevalence of plasmodium falciparum resistant to antimalarial drugs. This study was undertaken to investigate the in vivo antiplasmodial effect of the aqueous stem bark extract of Bombax buonopozense in mice infected with chloroquine-sensitive plasmodium berghei NK65. The in vivo antiplasmodial effect against early infection and curative effect against established infection were studied. The extract at all doses (100, 200 and 400 mg/kg, p.o.) used, exhibited significant (P<0.05), dose-dependent activity against the parasite in suppressive and curative tests. These results show that the stem bark extract of Bombax buonopozense plant has significant antiplasmodial effect. The reduction in parasitemia levels in the two employed models suggest that a part of its antimalarial activity is mediated by direct plasmocidal effect on the parasite.

4.Seroprevalence of Immunoglobulin M/A/G antibodies against Bordetella pertussis and Bordetella parapertussis among asymptomatic children at 6-8 of age in Turkey
Atilla Ersen, Ferhan Karademir, Mustafa Özyurt, Selami Süleymanoğlu, Seçil Aydınöz, Cihan Meral, Gökhan Aydemir, İsmail Göçmen
Pages 78 - 82
Bordetella pertussis infection is a vaccine preventable disease, but immunity following the vaccination is not life-long. Moreover parapertussis may share similar clinical presentation with pertussis and mostly recognized in prolonged bronchitis. Although the serology of pertussis has been well studied, those of parapertussis have not. We herein investigated antipertussis and antiparapertussis serology in asymptomatic healthy children. We examined IgM, IgA and IgG antibodies against B. pertussis and B. parapertussis among 100 asymptomatic children aged from 6 to 8 years who got regular vaccination. The antibody titers were measured by indirect immunofluorescence test (IFA). 10% of them had IgA titers of > or = 100 EU/ml, 33% had IgM titers of > or = 320 EU/ml who could be considered as acute or recent pertussis infection and 89% had IgG titers > or = 100 EU/ml as a protective level of pertussis. Bordetella parapertussis antibody levels of IgG, IgA and IgM were detected in 33%, 17%, and 11% respectively. We suggest 2 explanations for the acquisition of pertussis and parapertussis antibodies in our children: (1) asymptomatic pertussis and parapertussis infections are common; (2) Although higher values of IgG observed, acute infection markers still persisted, and one problem in this regard may be waning immunity against pertussis. Of the strategies considered, the addition of a preschool booster is therefore a priority in Turkey.

5.Endovenous laser ablation (EVLA) versus high ligation and striping (HL/S): Two-years follow up
Halil Basel, Cemalettin Aydin, Yasin Ay, Bekir İnan, Hasan Ekim, Cemil Goya, Mehmet Bilgin
Pages 83 - 87
Endovenous laser ablation (EVLA) of the great saphenous vein (GSV) is thought to minimize postoperative morbidity and reduce work loss compared with high ligation and stripping (HL/S). However, the procedures have not previously been compared in a trial with parallel groups where both treatments were performed in tumescent anesthesia on an out-patient basis. Patients with varicose veins due to GSV insufficiency were randomized to either EVLA (980 nm) or HL/S in tumescent anesthesia. Miniphlebectomies were also performed. In our clinics, 87 varicosis patients were treated between September 2006 and December 2009. EVLA was applied in 90 cases and HL/S was applied in 84 cases. Clinical features and demographic characteristics of the patients were summarized. EVLA procedure was done by 980 nm diode laser (Ceralas D 980, Biolitec) at continues mode with 15 W energy. Patient visits were done at post-operative 10th day, 6th month, 1st year and 2nd year. Routine physical examination and Doppler USG assessments were performed at these visits. EVLA and HL/S procedures were done in complete success in all cases at both groups. All cases were invited for control visits. At post-operative 10th day all patients were evaluated, at 1st year control visit number of attended patients was 130 (EVLA: 68, HL/S: 62) and at 2nd year control, visit number of attended patients was 104 (EVLA: 56, HL/S: 48). When complications developed after procedures were evaluated; no infection, hematoma or paresthesis were observed in EVLA group. However in HL/S group; infections, hematomas and paresthesis were observed in 2, 6 and 24 cases respectively. In terms of treatment success there was not significant difference between EVLA procedure and HL/S methods. However, in terms of post-op complication, EVLA method was associated with significantly less paresthesis, hematoma and pain. EVLA method is a method as effective and safe as standard treatment. However, when a long term result of this method is shown completely, its effectiveness will be cleared and its clinical utility will be established.

6.A huge pelvic mass in a 14-year-old adolescent with isolated fallopian tube torsion
Salim Bilici, Mehmet Göksu, Mehmet Melek, Cihangir Akgün, Burhan Beger, Veli Avci
Pages 88 - 90
Isolated fallopian tube torsion is seen rarely in sexually inactive early-adolescent girls. It can present with lower abdominal pain and pelvic mass. In this report, we aimed to draw attention to this rare clinical condition in childhood by presenting a 14-year-old girl. Isolated fallopian tube torsion should be considered in adolescent patients who have colic pain, especially unilateral pelvic localization with abrupt onset. Early diagnosis and prompt surgical intervention can save fallopian tubes in tubal torsion.

7.Lumbar dermoid cyst causing aseptic meningitis
Timur Yıldırım, Gıyas Ayberk, Mehmet Faik Ozveren, Berna Gokce
Pages 91 - 93
Dermoid cysts are rarely occurring intramedullary spinal cord tumors and they develop due to the inclusion of epithelial elements during closure of the neural tube. They may be detected in the medulla spinalis region extending from cervicomedullary junction to conus medullaris. Spontaneous and iatrogenic rupture of the dermoids causes recurrent meningitis by discharging their contents into subarachnoid space. The purpose of this report is to consider spinal dermoid cysts in the differential diagnosis of young patients with the findings of aseptic meningitis to avoid misdiagnosis and inadequate treatment.

8.Giant vulvar hematoma during pregnancy after sexual intercourse: A case report
Servet Hacivelioglu, Bulent Haydardedeoglu, Erhan Simsek, Tayfun Cok
Pages 94 - 96
Lower genital tract hematomas are rarely seen in clinical practice. Although one can frequently see vulvar hematomas when delivering a baby, there are few reports on vulvar hematomas in pregnant patients. Here the authors present a case on a giant vulvar hematoma in a pregnant patient that developed after usual sexual intercourse. Due to the enlarging hematoma and unbearable pain, an operation was offered to the patient. Under general anesthesia, a 5-cm vertical incision was made on the thinnest portion of the vaginal mucosa, and the hematoma was evacuated. As the case reported here is very uncommon, the usual recommendations about sexual intercourse during pregnancy should not change.

9.Leiomyoma of the vesicovaginal septum: A case report
Ismet Gun, Zafer Kucukodacı
Pages 97 - 101
Vaginal leiomyomas are very rare solid tumors of unknown exact etiology. These tumors are generally asymptomatic. Its can lead to preoperative misdiagnosis. The diagnosis of this tumors can only made by histopathology. The treatment of choice is surgical excision. Local recurrence and transformation into sarcoma are rare. In this article, we have reported a 39-year-old woman with an approximately 3x4 cm regular homogenous solid mass reaching to the hymenal ring in the area of the anterior wall of vesicovaginal septum.

10.The management of the congenital anterior urethral diverticula with calculi which is the cause of acute urinary retention (Globe vesicale): A case report
Necip Pirinççi, İlhan Geçit, Mustafa Güneş, Kerem Taken, Serhat Tanık, Kadir Ceylan
Pages 102 - 104
Congenital urethral diverticula with calculi has a low incidence as reported in the literature. Congenital diverticula have been seen % 10-20 in all urethral diverticula. The etiology of urethral stones are urethra and bladder stones, urethral diverticula, foreign matters, urethral stenosis and urethral trauma. Management of treatment urethral stones is surgery and endoscopy. Our case was a three years old boy who referred to our clinic due to globe vesicale. Diagnosis was performed with cystoscopy and the presence of a stone in the urethral diverticula.

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