ISSN 1301 - 0883 | E-ISSN: 1309-3886
Eastern Journal Of Medicine - Eastern J Med: 21 (4)
Volume: 21  Issue: 4 - 2016
ORIGINAL ARTICLE
1.Examınatıon of Atypical Located Hydatıd Cyst Disease in Eastern Turkey
Gülhan Bora, Aysel Sünnetçioğlu, Mahmut Sünnetçioğlu, Aydın Bora, Özkan Yılmaz, Numan Çim, Ali İrfan Baran
doi: 10.5505/ejm.2016.58066  Pages 158 - 161
INTRODUCTION: The hydatid cyst disease is a zoonotic infection caused by Echinococcus granulos. It usually causes infection in the liver and lungs. To a lesser extent, it may cause infection in the spleen, heart, bones and central nervous system In this study, serological examination of hydatid cyst cases showing localization out of liver and lungs has been aimed.
METHODS: The clinical, radiological, and serological findings of a total 435 patients included to the examination between May 2010 and 2013, have been evaluated together. The indirect hemagglutination (IHA) test results were retrospectively scanned from hospital database of 288 patients among those who have received treatment because of hydatid cyst. The findings have been evaluated statistically through Chi-square trend analysis method according to ages and their localizations.
RESULTS: According to the data obtained, 12(7.2%) of 288 patients showing atypical localization in IHA results were positive and 13(9.6%) of them were found negative (p=3.393).
DISCUSSION AND CONCLUSION: The hydatid cyst is a disease that can be seen in every age range, besides, atypical localizations can also be seen in any age range. In terms of protecting public health, the public’s awareness should be raised and a greater emphasis on prevention methods are needed.


2.Which hemogram parameter is more cautionary in euthyroid patients with gestational diabetes mellitus
Saliha Yıldız, Rıfkı Üçler, Murat Alay, Emi&775;ne Bulut Ekici
doi: 10.5505/ejm.2016.66375  Pages 162 - 167
INTRODUCTION: The aim this study was to compare the various hemogram parameters in euthyroid patients with GDM and healthy pregnant controls and to determine wich parameter is more cautionary for Gestational diabetes mellitus diagnosis.
METHODS: Fifty three pregnant women clinically diagnosed as GDM were recruited from the Endocrinology Department between December 2014 and May 2015. The age, gestational age and body mass index (BMI)-matched thirty five healthy pregnant women as control group were recruited from the Obstetrics and Gynecology Department at same period. The serum samples were obtained after overnight fasting, at the time of OGTT for the analysis and analyzed within 1 h of collection.The level of significance was established by using the student t-test for normally distributed values and Mann Whitney U test for abnormally distributed values. Correlation analysis was determined by using Spearman's rank correlation coefficent. A receiver-operating characteristic (ROC) analysis was conducted to specify the best cut-off value to predict the outcome.
RESULTS: Statistically significant relationships with platelet count, platelet distribution width, lymphocyte count, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), red cell distribution width (RDW) and GDM disease were found (p; 0.000, 0.000,0.000, 0.000, 0.000, 0.007 respectively). Platelet distribution width had higher sensitivity and specificity than other parameters.
DISCUSSION AND CONCLUSION: In conclusion, our study states that in prediction of GDM, the parameters such as PLR, NLR and especillay PDW are more significant than the others and draws attention to the inflammation in the pathogenesis.

3.The Protective Role Of Resveratrol On Serum Total Sialic Acid And Lipid-Bound Sialic Acid In Female Rats With Chronic Fluorosis
Gökhan Oto, Suat Ekin, Hulya Özdemir, Mehmet Bulduk, Hasan Uyar, Ersoy Öksüz
doi: 10.5505/ejm.2016.69775  Pages 168 - 172
INTRODUCTION: In the present study, the effect of resveratrol on serum total sialic acid (TSA) and lipid bound sialic acid (LSA) was investigated in the rats exposed to chronic fluoride.
METHODS: The study was administered using 32 female Sprague Dawley rats weighing 200-250 g. Rats were divided into four groups (n=8/group). Group I comprised the control group, group II was treated with sodium fluoride (NaF) (10 mg/lt/day), group III was treated resveratrol (50 mg/lt/day) and group IV was treated NaF+resveratrol for 90 days period. Total sialic acid (TSA) and lipid-bound sialic acid (LSA) were determined in serum samples.
RESULTS: Statistical analysis showed that the NaF group was significantly higher than the control group with regards to LSA (17.59±2.734 mg/dL, 12.61±2.013 mg/dL) and TSA (87.86± 8.34 mg/dL, 71.47± 8.57 mg/dL) levels (p<0.01 and p<0.05 respectively). Whereas the Resveratrol group was also significantly lower than the NaF group regarding LSA (13.21±2.848 mg/dL, 17.59±2.734 mg/dL) and TSA (72.44± 10.43 mg/dL, 87.86± 8.34 mg/dL) levels (p<0.05 and p<0.05 respectively), Moreover, no significant differences in LSA (14.62±1.85 mg/dL, 12.61±2.013 mg/dL) and TSA (81.19 ±10.24 mg/dL, 71.47± 8.57 mg/dL) levels were observed in the Resveratrol + NaF groups, as compared to the control group (p>0.05).
DISCUSSION AND CONCLUSION: The present study demonstrated slight positive and beneficial effect of resveratrol on the concentration levels of LSA and TSA in serum..

4.Effect of safran, safranal and crocin which are active ingredients of Saffron (Crocus) on erythrocyte fragility and hematological parameters in carbon tetrachloride intoxicated rats
Okan Arıhan, Gokhan Oto, İbrahim Aras, İrfan Bayram
doi: 10.5505/ejm.2016.04127  Pages 173 - 177
INTRODUCTION: Carbon tetrachloride is a toxic chemical and well known for its carcinogenic property. Intoxication with carbon tetrachloride causes serious liver injury and it is used as an experimental model for triggering liver related diseases. Saffron (Crocus) species are well known bulbous ornamental and aromatic plants. Many of the saffron species are used in ethnomedicinal practices. In addition both saffron species and their ingredients are also subject to scientific research.
METHODS: In this study 72 rats were divided into 9 groups (n=8 in each group). Groups were set as control, olive oil, carbon tetrachloride, safran, safranal, crocin, carbon tetrachloride + safranal, carbon tetrachloride + crocin. Administrations were conducted for 7 days. Erythrocyte osmotic fragility and some selected hematological parameters were assessed.
RESULTS: Results state significant increase in erythrocyte fragility due to carbon tetrachloride and amelioration due to active ingredients of saffron. Among hematocrit, hemoglobin and red blood cell count parameters only significant alteration was observed in safran with an increase in red blood cell count.
DISCUSSION AND CONCLUSION: Different administration schemes can be evaluated in future studies in order to assess detailed impact of saffron constituents on hematological parameters and erythrocyte integrity.

5.Assessment of vitamin D levels in patients with acute coronary syndrome
Hakkı Simsek, Naci Babat
doi: 10.5505/ejm.2016.33042  Pages 178 - 182
INTRODUCTION: In recent studies, vitamin D is claimed to have positive effects for acute coronary syndrome (ACS) by decreasing states that are accepted as important risk factors for ACS development such as endothelial damage, high blood pressure, insulin resistance, diabetes development and vascular inflammation.
METHODS: We have investigated the relation between ACS and plasma vitamin D levels in this study.
RESULTS: The study was conducted with a total number of 90 patients diagnosed with ACS and 50 individuals with normal coronary artery angiography. No significantly different plasma vitamin D levels of control group was detected compared to the patients with ACS (Mean=15,2±4,8 versus 15,3±6,3ng/ml, p>0.05). Significant difference related to smoking prevalence was detected between the two groups (52.8% versus 20%, p<0.01).
DISCUSSION AND CONCLUSION: We have concluded that Vitamin D insufficiency does not increase the risk for development of ACS significantly, after the corrections related to blood cholesterol elevation, smoking, diabetes, high blood pressure, family history. According to these results, there was no association between plasma level of vitamin D and the risk of development of ACS

CASE REPORT
6.Ethylmalonic encephalopathy associated with respiratory failure
Halil Köse, Mehmet Hamdi Şahan, Halil İbrahim Aydin
doi: 10.5505/ejm.2016.69885  Pages 183 - 186
Ethylmalonic encephalopathy (EE) is a rarely encountered metabolic disease with autosomal recessive inheritance and is characterized by development retardation, acrocyanosis, petechiae and chronic diarrhea. In the literature, EE has usually presented itself with neurological disorders, developmental retardation, acrocyanosis and skin lesions. We encountered no case in the literature accompanied by respiratory failure. EE should be considered in the patients with severe respiratory failure, exanthematous skin lesion, acidosis, chronic diarrhea, neurological symptoms and pathological signal increment in the basal ganglia on MRI together with the history of sibling death and consanguineous marriage. Herein, a 2.5-year-old boy case, who presented with exanthematous lesions over the body and respiratory failure and had lactic acidemia, increase in serum C4 and C5 acylcarnitine derivatives, excretion of ethylmalonic acid, methyl succinic acid, isovalerylglycine and isobutyrylglycine in the urine, pathological signal increment in the basal ganglia on CT and MRI, and firstly defined homozygote deletion in the ETHE1 gene in genetic analysis. In conclusion, we intended to emphasize consider underlying EE metabolic disease in the cases with frequent lower respiratory tract infection and respiratory failure in the presence of hypotonia and neuromotor developmental retardation.

7.The efficiency of hemodialysis in transfusion-related acute lung injury (TRALI): A case report
Uğur Göktaş, Nureddin Yuzkat, Lokman Soyoral, M. Bilal Cegin, Abdullah Kahraman
doi: 10.5505/ejm.2016.30974  Pages 187 - 190
Transfusion-Related Acute Lung Injury (TRALI) is an important life-threatening complication that is related with blood transfusion. The frequency is reported as 1/5.000. It is generally characterized with hypoxia that appears at the 2-6th hours after the blood transfusion, bilateral infiltration in the chest radiography, and non-cardiogenic pulmonary edema. Acute respiratory distress, hypotension, tachycardia and fever accompany the clinical picture. Past surgery, blood transfusion, and sepsis are among the factors that trigger the disease. In this study, the efficiency of the hemodialysis applied in the right time in the treatment of a heavy TRALI case developed after a blood transfusion has been presented.

8.Cardiac hypertrophy and heart failure: From the case to review of literature
Francesco Massoni, Lidia Ricci, Claudio Simeone, Emanuela Onofri, Serafino Ricci
doi: 10.5505/ejm.2016.27247  Pages 191 - 196
In response to an increased workload due to physiological or pathological stimuli, the heart may undergo a process of growth with increased muscle mass called cardiac hypertrophy. It is a particular mechanism of long term compensation used by the heart to adapt permanently to a greater workload. Although, through its peculiar structural, molecular and metabolic characteristics, in early stage the hypertrophy allows to maintain an adequate cardiac function, after a variable period of time, the same characteristics promote the evolution to contractile dysfunction and heart failure. The latter represents an important cause of death and so the cardiac hypertrophy increases the cardiovascular morbidity and mortality. In this paper we report a rare case of extremely high degree of concentric cardiac hypertrophy, with a heart weight of 1050 g and longitudinal diameter of 16.5 cm, transverse diameter of 16 cm and antero-posterior diameter of 9 cm. The thickness of the left ventricle free wall was 4.2 cm, of the septum 4.3 cm and at the apex level 3.5 cm. These data, compared with those described in scientific literature, indicate the exceptional nature of our necropsy finding of a huge cardiac hypertrophy. The analysis of the pathogenetic mechanisms, which may determinate the fatal event in case of cardiac hypertrophy, shows that in the described case the death cause can be the onset of heart failure in presence of cardiomegaly.

9.Combined sciatic-psoas compartment nerve block in a patient with multiple myeloma
Orhan Binici, Fethi Akyol
doi: 10.5505/ejm.2016.09719  Pages 197 - 199
New techniques for the regional administration of anesthesia are being developed every day. Peripheral nerve blocks affect only minimally a patient’s hemodynamics, and may be the ideal choice in high-risk patients who may be intolerant to even a minor decrease in hemodynamic response. In this case report, the use of a combined sciatic-psoas compartment nerve block for a lower extremity surgery in a high-risk patient with multiple myeloma, acute renal failure and ASA III risk is addressed.

LETTER TO EDITOR
10.Large sphenoorbital meningioma with extension into the cavernous sinus
Nitin K Sethi, Tomoko Ikuine, Nicolle Steiner
doi: 10.5505/ejm.2016.70288  Pages 200 - 201
Abstract |Full Text PDF

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