ISSN 1301 - 0883 | E-ISSN: 1309-3886
Eastern Journal Of Medicine - Eastern J Med: 7 (1)
Volume: 7  Issue: 1 - 2002
ORIJINAL MAKALE
1.The Effect of Dorzolamide on Intraocular Pressure and Ocular Pulse Amplitude: Adjunctive Therapy to Beta-Blockers as a Substitite for Pilocarpine or as a Second-Line Therapeutic Agent in Patients with Open-Angle Glaucoma
M. L. M.L, Ö. Benian
Pages 1 - 5
To evaluate the effect of dorzolamide on the intraocular pressure (IOP), ocular pulse amplitude (OPA), systemic blood pressure and pulse rate in openangle glaucoma patients using a beta-blocker and 2% pilocarpine combination and beta-blocker monotherapy. The secondary aim was to find out the effect of dorzolamide on IOP and OPA in patients using selective versus nonselective beta-blocker. Methods:Thirteen patients who had beta-blocker and pilocarpine combination (Group 1) and 15 patients who had beta-blocker monotherapy (Group 2) were enrollled. A randomly selected eye of bilaterally affected patients was included in the observer-blinded and parallel-group study. Baseline data consisted of 4 day-time IOP, OPA, systemic blood pressure and pulse rate measurements. Patients in Group 1 discontinued pilocarpine and used beta-blocker-dorzolamide combination and patients in Group 2 used dorzolamide as a second-line therapeutic agent with a beta-blocker. The same measurements were performed after 4 weeks and after 6 months in both groups. Results: In Group 1 the baseline IOP was 18.9±2.2 mmHg; after 4 weeks and 6 months no statistically significant change was observed (17.6±2.3 and 17.8±3.2 mmHg respectively, p>0.05). However in Group 2, a statistically significant IOP decrease from 22.5 ± 3.3 mmHg to 18.0 ± 2.0 mmHg after 4 weeks (p<0.05) and to 18.4 ± 1.8 mmHg after 6 months (p<0.05) occurred. There were no changes in OPA, systemic blood pressure and pulse rate in either groups during the follow-up period. The additive effect of dorzolamide with selective and nonselective beta-blockers was analyzed using a cross-sectional study design of the data obtained from 28 eyes. Twelve patients who used selective beta-blocker and dorzolamide showed an increase in IOP (from 18.4±2.3 to 19.3±1.9 mmHg, p>0.05) and a decrease in OPA (from 3.7±1.2 to 3.2±0.9 mmHg, p>0.05) after 5 months, although these changes were not statistically significant. The IOP was stable during the same period (17.3±2.0 and 17.2±2.6 mmHg, p>0.05) but the OPA showed a slight, but not significant increase (2.7±1.1 and 3.1± 1.5 mmHg, p>0.05) in sixteen patients using nonselective beta-blocker and dorzolamide. Conclusion: Dorzolamide is safe and effective when used with beta-blockers but its interaction with selective and nonselective beta-blockers needs further investigation.

2.Loss of Correction in Thoracolumbar Junction Fractures with Posterior Fusion
İ. Tuncay, F. Akpınar, N. Tosun, İslam C
Pages 6 - 10
A retrospective study evaluated clinical and radiological results of the patiens with thoracolumbar junction fractures who were operated with posterior instrumentation. Method: In this study, the loss of correction in 20 consecutive patients who underwent posterolateral spinal fusion with Alici instrumentation for unstable thoracolumbar junction fractures was investigated. According to the outcome of the operations, patients were divided into two groups. The first group comprised those patients (12 patients= 60 %) in whom screws were successfully and correctly inserted and the second included the ones (8 patients, 40 %) with incorrectly inserted screws. Radiological evaluation was done by measuring anterior height loss (AHL), kyphotic angle (KA) and sagittal index (SI) from conventional lateral radiography, also spinal canal occupation (SCO) from computerized tomography scans pre and postoperatively. Results: There was statistically significant difference between postoperative AHL values of group 1 and group 2 (early postoperative value p<0.05, late postoperative value p<0.01) and also between early and late postoperative values in both groups (p<0.0001). Although there was no difference between two groups’ early postoperative KA and SI values (p>0.05) late postoperative values (p<0.05) were different. On the other hand no statistically significant difference was demonstrated between two groups’ postoperative SCO values (p>0.05). All the patients except three, returned to their jobs following the operation. We have observed solid fusion both clinically and radiologically in all patients. Two patients have developed complications, one had a cerebrospinal fluid fistula, which later resolved spontanously and the other had serious infection and which required removal of the instrumentation. Conclusion: Posterolateral fusion is recommended to provide original sagittal contour. In long term, functional recovery of patients may favour the surgical option for the treatment of these fractures, despite significant statistical difference between two groups in respect of loss of correction.

3.Serum Zinc and Copper Levels in Amebic Dysentery
A. B. Erbağcı, M. Tarakçıoğlu, M. Namıduru, E. S. Namıduru, J. Özaslan, İ. Karaoğlan
Pages 11 - 14
It is suggested that zinc alters the functionality of Entamoeba histolytica in vitro as reflected by decrease in replication and adhesion and in vivo as manifested by inhibition of amebic pathogenicity. Suggesting a possible role in amebic intestinal disease copper significantly inhibits Entamoeba histolytica acid phosphatase activity. Methods: Thirty-one patients with Entamoeba histolytica rectocolitis and 26 age/gender matched healthy subjects were recruited for the study. Plasma zinc and copper levels were determined with 5-Br-PAPS and bathocuproin with deproteinization methods respectively. Results: Serum zinc concentration was (median; minmax) significantly lower in patients with amebic dysentery (9.9; 4.7-19.6 mmol/L) than the control group (12.4; 7.9-20.0mmol/L), (p<0.05). Serum copper concentrations of the patients (19.7; 7.27-54.3 mmol/ L) and the control group (12.2; 11.5-33.5 mmol/L) were not statistically different. Conclusion: Serum zinc concentrations decreased in patients with Entamoeba histolytica rectocolitis, but a significant difference was not observed for serum copper concentrations.

4.Erythrocyte glucose 6-phosphate dehydrogenase deficiency frequency in Gaziantep, Turkey
A. B. Erbağcı, N. Yılmaz
Pages 15 - 18
Glucose 6-phosphate dehydrogenase (G6PD) deficiency manifests genetic polymorphism and prevalence of its varying among geographic regions and ethnic groups. G6PD deficiency is important in Gaziantep, Turkey because high deficiency prevalence was observed in Adana and Antakya, the neighbouring Mediterranean cities. Methods: In this study, sera from 306 subjects (166 female, 140 male) between 1-80 years old were for erythrocyte G6PD activity with International Committee for Standardization in Hematology (ICSH) method. After excluding the outliers, 95 % interpercentile interval was accepted as reference limit. Results: In Gaziantep reference group erythrocyte G6PD activity limits for subjects over one year old are 6.4 - 13.2 U/ g Hb, 30ºC. Seven subjects with low enzyme activities indicate that G6PD deficiency frequency is approximately 2.3 ± 1% in Gaziantep. Conclusion: G6PD deficiency frequence is approximately 2.3 ± 1 % in Gaziantep which is higher than the mean prevalence in Turkey.

OLGU SUNUMU
5. Urorectal septum malformation sequence: a case report
M. Türkmen, G. İnan, N. Çulhacı, H. Yüksel, F. Sönmez, K. Temoçin
Pages 19 - 21
Abstract |Full Text PDF

6.Abdominal aortic aneurism operation in a high risk patient under combined spinal epidural anesthesia
L. Kılıçkan
Pages 22 - 23
Abstract |Full Text PDF

7. Primary venous aneurysm of the external jugular vein
H. Ekim, S. Özen
Pages 24 - 25
Abstract |Full Text PDF

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