ISSN 1301 - 0883 / E-ISSN 1309 - 3886

  Eastern J Med: 19 (3)
Volume: 19  Issue: 3 - 2014
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1.Molecular epidemiology of influenza in Asia
Shuvra Kanti Dey, Shazeed- Ul-Karim, Rashidul Islam, Tahsina Islam, Shahidul Islam, Nahid Hasan
Pages 119 - 125
Influenza means ‘flu’, caused by RNA viruses of Orthomyxoviridae family which is an infectious agent of birds and mammals. It causes mild to severe symptoms including chills, fever, sore throat, muscle pains, headache, coughing, fatigue but about 33% of the cases with influenza are asymptomatic. Occasionally it leads to pneumonia in both healthy and immunosuppressive person. Influenza is transmitted through the air by coughing, sneezing or creating aerosols containing influenza. It can also be transmitted by direct contact with bird droppings or nasal secretions or through contact with contaminated surfaces. Influenza now spreads all over the world and it is also known as seasonal epidemics. Several reports depicted both emergence and pandemic potential of the virus in the perspective of earlier pandemic influenza viruses of 1918 (H1N1), 1957 (H2N2) and 1968 (H3N2) by comparison of the available genetic sequence data. An avian strain named H5N1 raised the concern of a new pandemic after it emerged in Asia in 1990s. After several years ‘swine flu’, also known as influenza A/ H1N1, emerged in Mexico, USA and several other nations. The principal objective of the present work is to investigate the evolutionary history of the viruses circulating in Asia and to understand the relationship between epidemiologic and evolutionary process within the affected human population.

2.The comparison of electrocautery and curettage of the nailbed for the treatment of ingrown toenail
Mustafa Isik, Oguz Cebesoy, Mehmet Subasi, Burcin Karsli, Duran Topak, Fethi Bilgin
Pages 126 - 129
The ingrown toenail is a condition of the active young population that often seriously impairs the patient’s comfort, causing distress to walk, which is seen in the second and the third decades. We aimed to compare two different treatment techniques for that disease. A total of 80 patients who underwent surgery, using the Winograd technique, due to an ingrown toenail were included. The mean age of the patients was 29 (21-44) years. There were 32 female (40.0%), and 48 male (60.0%) patients. The patients were divided into two groups: Group 1 (n=40) is consisted of patients in whom electrocautery was applied during the surgery, whereas curettage was done in Group II (n = 40). Recurrence and infection rates were compared. The statistical analysis revealed no significant difference between the two groups in terms of recurrence, and infection rates (p> 0.005). Our results showed that there is no superiority of one of these methods to the other in terms of the recurrence, and infection rates.

3.Orbital complications secondary to acute sinusitis– A 10 years retrospective review
Eyzawiah hassan, Balwant Singh Gendeh, Salina Husain, Mohd Zaki Faizah
Pages 130 - 136
Orbital complication may accompany acute sinusitis in all age, commonly preseptal or orbital cellulitis. To evaluate the clinical presentation, management, and outcome of orbital complications of sinusitis in patients treated at our institution. A case study of retrospective review of 10 patients with orbital complications secondary to acute sinusitis was conducted in our center over a 10-year period. The clinical presentation, relevant investigations, management and outcome were analysed. Most of the patients were children. The most common diagnosis was sub-periosteal abscess (SPOA) in five patients (50%), followed by two cases each of preseptal cellulitis, and orbital cellulitis and one of orbital abscess. CT scan plays a major role in diagnosis and disease monitoring. Surgical drainage is recommended in managing orbital abscesses, but we highlight a case of a small orbital abscess which was successfully managed conservatively. The clinical examination alone is not always helpful and therefore a CT scan is useful to diagnose and monitor the extent of the intraorbital infection. Rigorous medical treatment has an important role not only in preseptal and orbital cellulitis, but also in SPOA and small orbital abscess.

4.Intensive care unit family needs: Nurses' and families' perceptions
Turkan Ozbayir, Nurten Tasdemir, Esma Ozseker
Pages 137 - 140
The aim of this study was to compare intensive care nurses and patients’ relatives’ perceptions about intensive care family needs in Turkey. The study adopted a descriptive cross-sectional design. The Turkish version of Critical Care Family Needs Inventory was used to investigate the family members’ needs of a convenience sample of 70 family members of intensive care unit patients and the perceptions of the 70 intensive care unit nurses about these needs. The Critical Care Family Needs Inventory rankings of the two groups were similar. Eight of the ten most highly ranked needs were the same but the order was different. The most important need was “to be assured that the best care possible is being given to the patient” for relatives and “to receive information about the patient once a day” for nurses. There were statically significant differences in family members’ needs and nurses’ perceptions of these needs.

5.Effects of prostatectomy in patients with elevated serum prostate specific antigen levels and lower urinary tract symptoms: A prospective study
Şenol Adanur, Hasan Rıza Aydın, Tevfik Ziypak, Erdem Koç, Turgut Yapanoğlu, İsa Özbey, Özkan Polat
Pages 141 - 145
Our aim is to determine the impact of prostatectomy on serum prostate specific antigen levels in patients with Lower Urinary Tract symptoms (LUTS), but negative multicore prostate biopsy results and higher serum prostate specific antigen levels. 100 patients were referred to our clinics with lower urinary system symptoms without any evidence of suspect prostate carcinoma in digital rectal examination, and transurethral ultrasound (TRUS). Patients with histopathologically benign diagnoses in prostatic biopsy because of higher serum prostate specific antigen (PSA) levels (PSA>4ng/ml) were retrospectively evaluated. The association between preoperative and postoperative 3 and 6 month serum PSA levels were statistically evaluated in patients who had undergone transurethral resection of the prostate (TUR-P) or open prostatectomy resection with the diagnosis of benign prostatic hyperplasia (BPH), and also correlation between changes in serum PSA levels and histopathologic diagnosis was analysed. The preoperative mean total PSA (tPSA) and free PSA (fPSA) values were 16.89 ng/mL and 3.65ng/mL, respectively. Postoperative 3 month- mean tPSA and fPSA values were 1.34 and 0.4ng/mL, while postoperative 6 month mean tPSA and fPSA values were determined as 1.59 and 0.56ng/mL, respectively. Postoperative histopathologic evaluation of the surgical specimens of the patients revealed BPH in 84%, BPH + prostatitis in 12%, and prostate cancer 4% of the cases, respectively. BPH surgery can be performed safely on patients with symptomatic BPH and increased PSA levels without any evidence of prostate carcinoma. Favourable and comforting results can be achieved with BPH surgery, which improves symptoms and normalises PSA values.

6.Gastroesophageal reflux frequency of children in Hatay: A retrospective analysis
Füsun Aydoğan, Ebuzer Kalender, Erhan Yengil, Recep Dokuyucu, Murat Tutanc
Pages 146 - 149
Gastroesophageal reflux disease (GERD) refers to clinical symptoms caused by pathological escape of stomach contents to esophagus. Several diagnostic methods are used for the detection of GERD in children. In our study, gastroesophageal reflux scintigraphy cases performed in our clinic between April 2012 and September 2010, were retrospectively analyzed visually and quantitatively. It was aimed to evaluate the frequency of GERD according to age groups in the pediatric population of Hatay. A total of 122 patients aged between 2 months and 15 years with suspicion of GERD were included to our study retrospectively. Patients were divided into 4 groups according to their ages, and each group was divided into 2 groups as GERD positive and negative ones. Scintigraphic imaging was performed using Tc-99m DTPA. Images were evaluated visually and quantitatively. There were pathologic reflux in 36 of 122 patients (29.5%) according to gastroesophageal reflux scintigraphy. GERD was found higher in boys than in girls statistically (p= 0.008) and positivity rate in 0-2 age group was significantly higher than in other age groups (p=0.001). The index values were higher in 0-2 age group cases who had negative gastroesophagial reflux index and this was statistically significant (P=0.007) than other age groups. As a result, gastroesophagial reflux scintigraphy is a well-tolerated imaging modality that allows the diagnosis of the disease noninvasively in children by avoiding the invasive diagnostic tests.

7.Co-existence of pulmonary, tonsillar and laryngeal tuberculosis
Erkan Ceylan, Harun Soyalic, Imran San
Pages 150 - 153
A 56-year old male applied to otorhinolaryngology clinic with sore throat and dysphagia. During direct examination, ulcero-vegetative lesions were found in the left palatine tonsil and tonsil plicas. In the indirect laryngoscopy, ulcero-vegetative lesions were also observed in some regions of the larynx and epiglottis, Because of the suspicion of laryngeal carcinoma and metastasis, punch biopsy of the left palatine tonsil was performed. Chest X-ray and computerized tomography of the thorax revealed two adjacent cavitations in the apico-posterior segment of the left upper lobe. In the histopathologic examination of biopsies, granulomatous necrosis including caseification necrosis structures that proved tuberculosis was observed. In the fiberoptic bronchoscopic analysis, endobronchial lesion was not detected. Acid-fast bacilli were determined in sputum and bronchial lavage in microscopy and culture. The case of this middle aged male patient; with co-existence of tonsillar, laryngeal and pulmonary tuberculosis presents the clinical significance of upper airway tuberculosis in terms of its infectiousness and rare occurrence.

8.Magnetic resonance imaging findings of eosinophilic pleural effusion: A case report
Masashi Ohe, Satoshi Hashino, Mitsuru Sugiura
Pages 154 - 157
We report a case of idiopathic eosinophilic pleural effusion, the diagnosis of which was troublesome due to a considerable difference in properties between right and left pleural effusions. A 58-year-old woman was admitted with a 4-week history of right-sided chest pain. Bilateral pleural effusions were detected on computed tomography. EPE was not identified by initial aspiration from left-sided pleural effusion with scant eosinophils, but was diagnosed by secondary aspiration from right-sided pleural effusion rich in eosinophils. We searched for a means to distinguish between bilateral pleural effusions. As a result, diffusion-weighted imaging was found to distinguish right- from left-sided effusion. The patient was subsequently treated successfully with corticosteroid treatment.

9.Overlap of myasthenia gravis and graves’ disease
Aysel Milanlıoğlu, Vedat Çilingir, Mehmet Hamamcı, Temel Tombul
Pages 158 - 159
Both myasthenia gravis and graves’ disease are auto-immune diseases. Patients with myasthenia gravis may have evidence of coexisting auto-immune thyroid diseases like graves’ disease. The coexistence of two diseases is rarely observed but easily recognized if the association comes to mind. In this report, we present a case of 17-year-old female patient having myasthenia gravis with concomitant graves’ disease and is treated successfully with both pyridostigmine and propylthiouracil options. In conclusion, our case is a good example that the clinical features of autoimmune diseases can overlap and the presence of one auto-immune disease in a patient should require detailed investigations for other autoimmune diseases.

10.Acute respiratory failure in pulmonary congestion: Case report and review
Francesco Massoni, Emanuela Onofri, Serafino Ricci
Pages 160 - 163
Pulmonary Congestion (PC) is one of the most important causes of death in patients with heart failure which can be induced by a functional disorder no macroscopic appreciable in the examination of the heart. The authors present a case of edema and Respiratory Failure (RF) by PC in absence of clear and significant cardiac pathological elements in autopsy. Before the edema and then the PC act through an atelectasic mechanism that can be the cause of RF. The PC is often underestimated in the necropsy findings rather than being considered the main cause of death both in the case of objective cardiac injuries that in functional cardiac deaths.

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