ISSN 1301 - 0883 | E-ISSN: 1309-3886
Eastern Journal Of Medicine - Eastern J Med: 21 (3)
Volume: 21  Issue: 3 - 2016
ORIGINAL ARTICLE
1.Investigation of Brucella Seroprevalence in Human and Livestocks in Igdır, Turkey
Gülhan Bora, Yasemin Akkoyunlu, Mehmet Berköz, Güneş Açıkgöz, Mustafa Berktaş, Fikret Altındağ, Aydoğan Bora
doi: 10.5505/ejm.2016.02886  Pages 107 - 112
INTRODUCTION: Brucellosis is a zoonotic disease of worldwide and still remains endemic in some developing countries, especially in Turkey. Milk is the main food product serving as a vector for Brucella. In this study we aimed to investigate the seroprevalence of human and animal brucellosis.
METHODS: The study group consisted of 358 subjects who had high risk occupations of animal breeder and farmer. The test results were interpreted and titers equal or in excess of 1/40 were considered significant. 189 farm animals were incorporated to our research. Among these animals, 104 of them were sheep and goat and 85 of them were cattle. The Brucellosis Milk Ring Test (BRT) was used to test raw milk samples collected the selected herds in the study area.
RESULTS: The seroprevalence of human brucellosis was 6.7%. Seroprevalence of animal brucellosis was found as 22.75 % in livestocks. This study is important for being the first study in recent years that demonstrates the Brucella seropositivity rates in Iğdır Province
DISCUSSION AND CONCLUSION: This high seropositivity in our region may depend on the high rates of animal brucellosis; those of which were inadequate under control by veterinary and by vaccination and people who consuming the milk by without boiling.

2.Plasma cobalamin level as a considered tumor marker for hepatocellular Carcinoma
Ersoy Öksüz, Murat Öksüz, Türker Egesel, Gürsel Özgür, Gülşah Saydaoğlu
doi: 10.5505/ejm.2016.47966  Pages 113 - 118
INTRODUCTION: Hepatocellular carcinoma (HCC) is one of the most common cancer in men and women. There are many serological tumor markers for the diagnosis of HCC. These are alpha-fetoprotein (AFP), des-gamma-carboxyprothrombin, vitamin B12 binding protein and HCC associated alkaline phosphatase. The aim of this study was to evaluate the possibility of using vitamin B12 as a tumor marker for HCC.
METHODS: This cross sectional study was performed during a 2 year period, and serum samples were obtained from 38 HCC, 57 non-cancerous cirrhotic and 82 healthy control groups. Vitamin B12 levels were determined by using an automated chemiluminescence system test kit.
RESULTS: All HCC patients also had an underlying cirrhotic pattern. The period of the previous liver disease was 30.7±26.3 month in cirrhotic patients and 15.4±10 month in the HCC group. AFP and vitamin B12 levels in HCC patients were significantly higher (median AFP: 219 ng/ml, median B12: 1106 ng/ml) than cirhosis patients (median AFP: 9,7 ng/ml, median B12: 445 ng/ml) and control group (median B12: 442 ng/ml) (p<0,001). In the HCC group, there was a good positive correlation between level of vitamin B12 and AFP (p: 0.002) but this correlation was not appeared in cirhosis group. We also examined whether the correlation between the tumor size and vitamin B12 levels and AFP levels. We didn’t found any correlation between these parameters (p>0.05).
DISCUSSION AND CONCLUSION: Vitamin B12 levels can be useful as tumor marker in addition to other tumor markers and imaging modalities. Additional studies must be done related to this subject and the other liver masses without malignancies.

3.Protective Effects Of Melatonin On Doxorubicin Induced Cardiotoxicity In Isolated Rat Heart
Zeynep Erdoğmuş Özgen, Meral Erdinç, Hasan Akkoç, İlker Kelle
doi: 10.5505/ejm.2016.19483  Pages 119 - 124
INTRODUCTION: Doxorubicin is a highly effective cancer chemotherapeutic agent and its clinical use is limited by its serious cardiotoxicity. Oxidative damage is suggested to play a major role in its cardiotoxicity. In this study we aimed to research the protective effects of melatonin-which is a free radical scavenger and antioxidant-on Doxorubicin-induced cardiotoxicity in isolated perfused rat heart.
METHODS: Male wistar albino rats were divided into four groups: 1.group: control (1ml (i.p) sterile saline), 2.group: Doxorubicin (Dox) (one dose, 10mg/kg (i.p)), 3.group: Dox (one dose, 10 mg/kg (i.p)) + Melatonin (Mel) for 7 days once a day 10 mg/kg (i.p)), 4.group: Melatonin (for 7 days once a day 10 mg/kg (i.p) ). After 7 days, the hearts were isolated and perfused by Langendorff system. Heart rate, coronary perfusion pressure, Left ventricular developed pressure (LVDP), LV(dP/dt)max and LV( dP/dt)min which shows max and min pressures during systole and diastole per time were recorded.
RESULTS: As a result; a significant increase in coronary perfusion pressure and LV(dP/dt)min and also a significant decrease in LVDP, LV(dP/dt)max and heart rates in the Dox group according to control group showed altered cardiac functions induced by Dox.Versus the Dox group, in the Dox+Mel group the coronary perfusion pressure and LV(dP/dt)min significantly decreased and LVDP and LV(dP/dt)max significantly increased.
DISCUSSION AND CONCLUSION: It is concluded that melatonin has protective effects on doxorubicin induced cardiotoxicity with altered heart contractility and hemodynamics.

4.Attitude and Behaviour of Hospital Workers on Healthy Diet and Lifestyle in Eastern Turkey
Dilek Kusaslan Avci, Huseyin Avni Sahin, Hatice Tuba Akbayram
doi: 10.5505/ejm.2016.24633  Pages 125 - 130
INTRODUCTION: This research was conducted for the purpose of determining the healthy lifestyle behaviors of physicians, nurses and other hospital employees in Medical School of Yuzuncu Yil University, Van, Eastern Turkey.
METHODS: A total of 430 physicians, nurses and other hospital employees working in the University Hospital were invited to participate. Research data in this descriptive study were collected with a questionnaire covering; nutrition consuming frequency, nutrition consuming behaviour, general health condition, body height and weight, blood pressure, alcohol and cigarette consumption, exercise, socio demographic characteristics.
RESULTS: Smoking more than 10 cigarettes a day in smokers among physicians, nurses, and other employees were 83.3 %, 76.7 % and 46.9 % respectively (p: 0.004). The highest rates of obesity were seen in physician(20.9%)(p=0.000). The highest rates of hypertension were seen in other employees (24.3%)(p=0.000). Eating fast food daily among physicians, nurses, and other employees were 10.5 %, 7.4 % and 0% respectively (p: 0.000). 11 % of females and 17.1 % of male were doing regular exercise. Starting the day without having breakfast among female and male were 37.2 %, 43.8 % respectively.
DISCUSSION AND CONCLUSION: As they are the role model for the rest of the population more time and care should be given to understand the reasons, so they may improve their attitudes regarding healthy diet and lifestyle.

5.The Determination of Health School Students' Knowledge, Attitudes and Behaviors on the Matter of Sexual Health in Eastern Turkey
Dilek Kuşaslan Avcı, Hüseyin Avni Sahin, Gulnihal Guvendi
doi: 10.5505/ejm.2016.98608  Pages 131 - 137
INTRODUCTION: This study aims to determine health school students’ level of sexual knowledge, sources of information, attitudes and behaviors on the matter of sexuality.
METHODS: The research was carried out among the students of Yuzuncu Yil University School of Health, Van, Eastern Turkey. The research was descriptive and cross-sectional. The survey form used for data collection includes questions on socio-demographic features, knowledge, attitudes and behaviors of students on sexual health. Statistical analyses were performed using SPSS v.18
RESULTS: It was found that 8% of girls, 35.1% of boys had sexual activity and 10.6% of the girls, 24.7% of the boys had incomplete sexual activity. Analysis reveal that there were significant differences between men and women about their report premarital sexuality, premarital sexual activity of boys and girls (in the past), know the meaning of masturbation,thoughts and feelings about masturbation, beliefs realted with the obligatory obediance of the sexual demands and expectation of virginity from spouse when married.
DISCUSSION AND CONCLUSION: We have concluded that health school students’ sexual knowledge is insufficient, their behaviors and attitudes are influenced by traditional approaches and understanding of sexuality differs between two genders.

CASE REPORT
6.Concurrence of prenatally diagnosed Cantrell pentalogy and short and tight umbilical cord: A possible case of hexalogy
Abdussamet Batur, Cemil Goya, Alpaslan Yavuz, Cihad Hamidi, Mehmet Guli Cetincakmak
doi: 10.5505/ejm.2016.92332  Pages 138 - 140
Cantrell pentalogy is a rather rare syndrome characterised by complete or partial ectopia cordis; together with omphalocele, congenital heart diseases, and defects in the pericardium, lower sternum and anterior diaphragm. In this article, our aim is to present the ultrasonographic evidence of the concurrence of a short umbilical cord and the Cantrell syndrome, which we believe will contribute to the literature.

7.Laparoscopic totally transhiatal diverticulectomy of giant epiphrenic oesophageal diverticulum
Nik Ritza Kosai, Hardip Singh Gendeh, Jing Liang Ho, Yi Rong Chiew, Mustafa Mohamed Taher, Paul Anthony Sutton
doi: 10.5505/ejm.2016.15863  Pages 141 - 144
Epiphrenic diverticulum is a rare form of oesophageal diverticulum involving the distal part of the oesophagus. We report the case of a 51 year-old lady who initially presented with nocturnal coughing and volume reflux. Clinical examination was unremarkable as were initial routine blood investigations. A plain chest radiograph, barium swallow, and computed tomography were performed which demonstrated features of a large oesophageal diverticulum. Oesophagogastroduodenoscopy revealed a wide neck, single diverticulum within the lower third of the oesophagus. Oesophageal manometry undertaken revealed normal oesophageal peristalsis and lower oesophageal sphincter pressure. An elective total transhiatal laparoscopic diverticulectomy with Heller’s cardiomyotomy and fundoplication was performed with good symptomatic improvement. The patient made an uneventful recovery and remains symptom free two years post-operatively.

8.Aggressive osteoblastoma of the maxilla-a diagnostic conundrum
Chetana Bhat, Kaveri Hallikeri, Punnya Angadi
doi: 10.5505/ejm.2016.65882  Pages 145 - 149
Osteoblastomas are biologically benign tumors with limited growth potential and may show a wide range of clinical, radiographic and histopathological findings. Osteoblastomas of the jaw may resemble other gnathic lesions including osteoid osteoma, cementoblastoma, cement-ossifying fibroma, cemento-osseous dysplasia and osteosarcoma, offering a unique diagnostic conundrum. Aggressive osteoblastoma, a rare variant of osteoblastoma characterized by the presence of atypical histopathological features like epithelioid osteoblasts and exhibiting locally aggressive behavior is rarely reported in the jaw bones. The accurate diagnosis and delineation of this entity from malignant bone tumors sometimes may be a challenge. The case report emphasizes this entity, which has to be differentiated from low- grade osteosarcoma and highlights the gravity of clinico-pathologic correlation in such lesions.

9.Spontaneous pseudomeningocele of sphenoid sinus or sphenoid mucocele?: A diagnosis dilemma
Noor Azrin Md Anuar, Narizan Ariffin, Teoh Jian Woei, Balwant Singh Gendeh
doi: 10.5505/ejm.2016.78973  Pages 150 - 153
A pseudomeningocele is an abnormal collection of cerebrospinal fluid (CSF) that communicates with the CSF space around the brain or spinal cord. We describe a rare case of spontaneous non-traumatic pseudomeningocele in a 28 year-old gentleman who presented with delayed puberty associated with headache. Computed tomography revealed an expansile mass over bilateral sphenoid sinuses. Magnetic resonance imaging supported the diagnosis of sphenoid mucocele. A transnasal transphenoidal endoscopic sphenoidotomy was performed. Intraoperatively, despite an anatomical puncture through the sphenoid ostium, alarmingly, the opening leaked out CSF. A dehiscent was identified with a dural opening. This was repaired with multilayer technique. Clinical improvement was observed post-operatively. The case reported here is unusual as they presented on imaging as a fluid collection in sphenoid sinus simulating a mucocoele, but were filled with CSF and represent pseudomeningocele. Surgeons should be alert to the presence of pseudomeningocele as they can mimic a mucocele or nasal polyp.

REVIEW ARTICLE
10.Should antenatal corticosteroids be done after 34 weeks of gestation? Review article
Sunullah Soysal, Begüm Yıldızhan
doi: 10.5505/ejm.2016.12269  Pages 154 - 157
Late preterm infants constitute the majority of preterm labors. The neonatal morbidity and mortality among late preterm infants are serious problems of obstetrical practice. This arises the question of antenatal corticosteroid administration beyond 34 week of gestation. In this review, need for antenatal corticosteroids after 34 weeks of gestation is studied.

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