ISSN 1301 - 0883 / E-ISSN 1309 - 3886


Eastern J Med: 22 (1)
Volume: 22  Issue: 1 - 2017
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1.Evaluatıon of Patıents Operatıvely Treated with a Dıagnosıs of Lumbar Dısk Hernıa: An Epıdemıologıcal Investigatıon
Abdurrahman Aycan, İsmail Gülşen, Mehmet Arslan, Fetullah Kuyumcu, Mehmet Edip Akyol
doi: 10.5505/ejm.2017.57966  Pages 1 - 4
INTRODUCTION: Lower back and leg pain is a common condition in the community which leads to loss of work and restricts daily life activities. About 2-3% of all painful lower back syndromes are caused by lumbar disc herniation (LDH). Surgery is performed in patients with sensory and motor deficits and the patients not responding to physical and medical treatment. In this study, we retrospectively evaluated the LDH patients that were operatively treated in our clinic through the review of the literature and the study was aimed to provide contribution to epidemiological studies.
METHODS: The retrospective study included 190 patients who were operatively treated between January 2013 and December 2015. Age, gender, level of herniation, neurological examination findings, presence of trauma, length of hospital stay, profession, recurrence, and surgical outcome were evaluated in all patients.
RESULTS: The 190 patients included 108(56.8%) males and 82(43.2 %) females with a mean age of 45 years. The level of herniation was L4-5 (%51.6), L5-S1(%32.1) with a rate of %83.7.Preoperative foot drop was found in %2.1 of the patients. Of these, %50 of them were improved and %50 of them sustained foot drop following the surgery.
DISCUSSION AND CONCLUSION: Lumbar disc herniation is one of the most common spine surgeries performed. Appropriate surgical procedure with an accurate diagnosis leads to good success rates and high patient satisfaction. Following the surgery, 122 patients were graded as “excellent”, 50 patients as “good”, 15 patients as “moderate”, and 3 patients as “poor”. These findings were consistent with the findings of the literature.

2.Mean platelet volume, red cell distribution width, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in the diagnosis acute appendicitis
Osman Toktaş, Mehmet Aslan
doi: 10.5505/ejm.2017.85570  Pages 5 - 9
INTRODUCTION: Mean platelet volume (MPV), red cell distribution width (RDW), platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) have been seperately reported to be a laboratory markers in several inflammatory diseases, including acute appendicitis. However, the results of these studies are conflicting. The aim of this study was to simultaneously investigate MPV, RDW, platelet to lymphocyte ratio (PLR) and NLR have a diagnostic role in the diagnosis of acute appendicitis and also the relationship between these systemic inflammation marker and leukocyte count.
METHODS: Thirty patients with acute appendicitis and 30 age-matched healthy subjects. RDW, MPV, neutrophils, lymphocytes and platelet counts were evaluated with complete blood count. The NLR and PLR were calculated as the ratios of the neutrophils and platelets to the lymphocytes.
RESULTS: NLR and leukocyte count were significantly higher in the acute appendicitis patients compared to controls (both p<0.01), while RDW levels were significantly lower (p=0.041). There were no statistically significant differences regarding platelet numbers, MPV levels and PLR between acute appendicitis and healthy subjects (p>0.05). There was a significant correlation between leukocyte count and NLR (p<0.01, r=0.365). However, leukocyte count was not correlated with RDW and MPV levels (p>0.05).
DISCUSSION AND CONCLUSION: The current study is the first to investigate MPV, RDW, PLR and NLR in acute appendicitis patients. We found significantly increased NLR and leukocyte count in acute appendicitis patients compared to healthy subjects. Combined use of NLR and RDW values along with leukocyte count and other clinical assessment could help the diagnostic process of acute appendicitis.

3.Comparison of ulltrasound guided brachial plexus blockage with general anesthesia and cost analysıs
Abdullah Kahraman, Nureddin Yüzkat, Muhammed Bilal Cegin, Volkan Baydi
doi: 10.5505/ejm.2017.74936  Pages 10 - 14
INTRODUCTION: In this study, we aimed to determine which method was superior; general anaesthesia versus brachial plexus block anaesthesia in patients undergoing upper extremity surgery in terms of anaesthesia quality, postoperative complications, patient comfort, patient satisfaction, and cost as in the contemporary world where economical use of resources have become more and more important.
METHODS: This study was taken up after local ethics committee approval (12.11.2014 date and No. 2). Among the cases scheduled for upper extremity surgery, 60 patients who are in ASA I-II groups according to the classifications of the American Society of Anaesthetists (ASA), between the ages of 18-65, for whom emergency or elective, single-sided hand, forearm or arm surgery with brachial plexus blockade or general aesthesia planned were included in the study. Two cases were separated into two groups by application order. USG guided peripheral nerve block was done in the first group (BPB group). The other group underwent general anaesthesia (GA group).
RESULTS: When the two groups were compared in terms of cost, BPB group was found to be significantly lower than GA Group.
DISCUSSION AND CONCLUSION: in upper extremity surgery, because brachial plexus blockage provides higher patient satisfaction, better VAS values in acute post-operative period, observation of lesser nausea and vomiting and is more economic compared to general anaesthesia, we believe, regional blocks must be used more often by being included in the routine practices.

4.The effect of super-oxidized water on the tissues of uterus and ovary: An experimental rat study
Abbas Aras, Erbil Karaman, Numan Çim, Serkan Yıldırım, Remzi Kızıltan, Özkan Yılmaz
doi: 10.5505/ejm.2017.42714  Pages 15 - 19
INTRODUCTION: Super-oxidized solutions are known to be potent disinfectants for external surfaces and also for wound care. There are limited data about the use of superoxidized water in the intraperitoneal organs. The aim of the present study was to evalaute its effect on the uterus and ovary when applied via intraperitoneal infusion in a rat model.
METHODS: Thirty Wistar-Albino rats weighing 250-300 g were randomly divided into three groups (10 rats/group). Group1(control group) rats received single dose of 10 mg/kg saline solution intraperitoneally.Group 2(single dose group) rats received single dose of 10 mg/kg pH-neutral SOW intraperitoneally. Group 3(multiple doses group) rats received multiple doses of 10 mg/kg pH-neutral SOW intraperitoneall at first, third and fifth days. All animals were sacrificed at one week after infusion. The macrıo- and microscopic histopathological examinations were performed for each rat.
RESULTS: All rats remained healthy during follow up of one week. The macroscopic examinations of the three groups showed no significant differences. No toxicity findings were found in three groups. The microscopic examinations revealed active endometial glandular structures in uterus and functional follicules at different stages of maturation in ovary. There was no significant differences with regards to the micrsocopic findings between three groups.
DISCUSSION AND CONCLUSION: Intraperitoneal infusion of pH-neutral SOW does not result in any significant toxicity and complications on the tissues of uterus and ovary.

5.Rare angiosarcoma of inferior turbinate; A case report and literature review
Mohd Eksan Sairin, Noorizan Yahya, Chew Yok Kuan, Mohamad Khir Abdullah, Salina Husain
doi: 10.5505/ejm.2017.92400  Pages 20 - 22
Angiosarcoma is a rare soft-tissue sarcoma. It is an aggressive, malignant endothelial cell tumour of vascular or lymphatic in origin. Angiosarcoma accounts for 2% of all sarcomas and over half of it occurred in head and neck region. Its treatment is challenging with a poor prognosis. We presented a case of angiosarcoma of inferior turbinate occurring in a 73 year-old man.

6.Congestive cardiac failure as a presentation of neonatal Graves in twin
Somosri Ray, Rakesh Mondal, Tapas Sabui, Rupa Biswas
doi: 10.5505/ejm.2017.57441  Pages 23 - 25
Neonatal Graves is a rare entity and neonatal thyroid storm is even rarer. Graves disease is an autoimmune disorder with production of thyroid stimulating immunoglobuline (TSI) resulting in diffuse toxic goiter. Neonatal thyrotoxicosis presents with hyper-excitability, poor weight gain, tachycardia. We report a case of congestive cardiac failure with paroxysmal supraventricular tachycardia as a presentation of neonatal Graves in twin babies.

7.Two novel associations in a case with Walker Warburg syndrome; Enophthalmia, interhemispheric cyst and cerebral hematoma
Sultan Kaba, Murat Doğan, Mehmet Deniz Bulut, Keziban Bulan, Nihat Demir, Lokman Üstyol, Zeyneb Ümit Bozdoğan, Nesrin Ceylan
doi: 10.5505/ejm.2017.18480  Pages 26 - 29
There were severe brain malformations, hydrocephaly, myopathy and congenital cataract in a 5-month old girl presented with seizure. Walker Warburg syndrome is the most severe form of congenital muscular dystrophy accompanied by brain and eye anomalies. The findings in this case fulfilling diagnostic criteria of Walker Warburg syndrome other than type 2 lissencephaly suggest an intermediate form between Walker Warburg syndrome and muscle-eye-brain disease. In this manuscript, we intended to present this case presenting features (enophthalmia, interhemispheric cyst and cerebral hematoma) not reported previously in the spectrum of congenital muscular dystrophy-dystroglycanopathy with brain and eye anomalies.

8.A different approach in removal of proximal Wharton's duct stone: Case report
Mahfuz Turan, Huseyin Ozkan, Mehmet Fatih Garca, Hakan Cankaya, Koray Avcı, Nazım Bozan, Ahmet Faruk Kıroglu
doi: 10.5505/ejm.2017.41736  Pages 30 - 33
We aimed to approach with a different surgical technique to stone excision far from orifice in Wharton duct. A 51-year-old female patient admitted to our clinic with the complaints of pain and swelling at the right of mouth floor and especially swelling during nutrition at the inferior of right jaw. In the intra oral examination; a large, sensitive with palpation, sides are erythematous solid mass in the right submandibular canal region was detected. In the ultrasonography examination, left submandibular gland was found significantly heterogeneous and 1 cm in diameter hyperechoic posterior shade showing stone at approximately 10 mm distance to Wharton duct was visualized. Sialolithiasis treatment varies according to the localization of the stone, duration of the symptoms, frequency of repetition and size of the stone. Either conservative or surgical techniques can be used for treatment. Surgically, either intraoral or extraoral approaches can be used. In our case, after removing the stone from the distal part of Wharton duct, original orifice of the duct was deactivated and distal part of the duct was marsupialised to mouth floor. Saliva discharge was seen from the new orifice inside the mouth at the postoperative 3rd week of the case. More clinical studies with increased numbers of cases are needed for accurate results of the treatment method.

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