ISSN 1301 - 0883 / E-ISSN 1309 - 3886

  Eastern J Med: 22 (3)
Volume: 22  Issue: 3 - 2017
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1.Investigation of the effects of diclofenac sodium in rat ovary on the number of preantral follicles by stereological methods in prenatal period
Neşe Çölçimen, Murat Çetin Rağbetli, Mikail Kara, Okan Arıhan, Veysel Akyol
doi: 10.5505/ejm.2017.77486  Pages 80 - 84
INTRODUCTION: Pregnancy is a period in which maximum amount of attention is required for healthy future generations. In this period, choice, duration and dosage of medication as well as the changing physiology of the mother should be taken into account. Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of drugs that have analgesic, anti-pyretic and anti-inflammatory effects. This group of drugs can be used in the treatment of the ongoing rheumatic diseases or which occur during the pregnancy period and the complications that occur due to pregnancy. We aimed to show how it affects the number of over preantral follicles of newborn fetus on rats by using Diclofenac Sodium which belongs to this drug family group.
METHODS: Diclofenac Sodium (1 mg / kg, IM) was injected for 15 days from the 5th day of pregnancy to pregnant rats in Diclofenac Sodium group and saline (1 ml / kg, IM) was injected to the pregnant rats of the sham group at the same time period. In the 4th week after birth, ovarian tissue preparates of rat pups were stained with hematoxylin-eosin and ovarian total tissue volumes and preantral follicle counts were evaluated under light microscope.
RESULTS: There was no statistically significant difference between groups for ovarium total tissue volumes and preantral follicle numbers (p>0.05). Lowest value of follicular intensity was observed in Diclofenac sodium group among study groups however no statistically important difference was found (p>0.05).
DISCUSSION AND CONCLUSION: Results obtained in our study may be related with administration of drug in not use high dose (1mg/kg). Further studies may be performed with higher doses.

2.Assessment of Melanoma Risk in Acquired Melanocytic Nevi Using Digital Dermoscopic and 3-Point Checklist Score
Göknur Özaydın Yavuz, Necmettin Akdeniz, İbrahim Halil Yavuz, Ömer Çalka, Serap Güneş Bilgili
doi: 10.5505/ejm.2017.53215  Pages 85 - 90
INTRODUCTION: Among skin cancers if not diagnosed early the highest death rate is for malign melanoma. Many studies has showed that multipl nevi lead to an increased risk of melanoma. It is a good option to take photos of patients in periodic intervals. In our study, we calculated the risk of melanoma in patients with acquired melanocytic nevi with 3-point checklist and digital dermoscopy and we aimed to compare the results and their advantages to each other
METHODS: We enrolled 300 patients with acquired melanocytic nevi in our study. Cases we enrolled in our study were recorded in the pre-prepared patient follow-up form. In this study Fotofinder HD (Germany) digital dermoscopy instruments was used. Lesions that were regarded as malign by 3-point scoring method were excised and histopathologically evaluated. In statistical calculations significance level of 5% was used and calculations were made by SPSS (ver: 13) statistical package program.
RESULTS: Of our patients 157 were male (52.3%) and 143 (47.7%) were female. Sensitivity of digital dermoscopy was determined as 86% according to the 3-point checklist. Of the 300 patients 6 were diagnosed as malign melanoma. Sensitivity of the 3-point checklist was determined as 97%.
DISCUSSION AND CONCLUSION: In our study, the results of 3-point checklist were detected higher than previous studies. Since digital dermoscopy is easy to use, this method is conenient especially for inexperienced physicians in the diagnosis of malignancy. But dermoscopic algorithms remain as the first choice for specialist physicians.

3.Comparison of plaque and Distally-Wedged Tibial Nail in the treatment of extraarticular distal tibia fractures
Cihan Adanaş, Erdem Yunus Uymur, Sezai Özkan, Şehmuz Kaya, Mehmet Ünlü, Sinan Yılmaz, Levent Demir
doi: 10.5505/ejm.2017.49369  Pages 91 - 96
INTRODUCTION: Tibial fractures are encountered in many age-groups. Depending on fracture type and pattern, many types of treatment options including plate fixation, intramedullary fixation, circular external fixation are widely used. Depending on implant design, surgical approach could be various and be jeopardised.In this study, we wish to evaluate the benefits and negative sides between plate and distally-wedged tibial nail fixation.
METHODS: Between 2013 and 2016 (in Van Regional, Education and Research Hospital, Türkiye) 38 patients (25 male, 13 female patients: ages range 18 to 61 years, mean age is 41) treated surgically using distally-wedged tibial nail fixation (amount: 16) and plate fixation (amount: 22). The patients were evaluated by AOFAS score (documentated 1.5 and 6 months postoperatively), postop hospitalisation days, perop fluouruscopy imaging (scopy shooting) times and union time (months). Average follow-up time was 11 months (range: 9 to 28 months).
RESULTS: There was a shorter recovery period in the nail group and the hospital stay was shorter. (P <0.001)
The AOFAS score was higher at 1.5 months postoperatively and the number of scopies was higher at 1.5 months olds (p <0.001) No sigficiant difference were found in postoperative 6th month AOFAS score between plate and nailing groups.
DISCUSSION AND CONCLUSION: We have found and concluded that DSBLS(Distal Supportive Bolt Locking Screw) screw of this tibial nailing fixation system could provide distal interlocking strong enough especially when fracture is quite close to the distal tibial articular face,using distally wedged tibial nails and componenet.

4.Multislice Computed Tomography Imaging Of Gastrointestinal Stromal Tumors
Nadir Sezer, Muhammed Akif Deniz, Zelal Taş Deniz, Cemil Göya, Eşref Araç, Mehmet Emin Adin
doi: 10.5505/ejm.2017.08370  Pages 97 - 102
INTRODUCTION: Gastrointestinal stromal tumors (GIST) are mesenchymal tumors that constitute 1-3% of primary gastrointestinal tumors and approximately 5% of all sarcomas of the gastrointestinal tract. Multislice Computed Tomography (MSCT) is a highly sensitive imaging technique for detecting GISTs.
METHODS: We retrospectively evaluated findings of 56 consecutive subjects that were examined at Dicle University, School of Medicine, between 2008-2015 and diagnosed with GİST. Lesions were divided into two clinically distinct entities as recurrent and primary lesions. Densities of lesions in comparison to liver, origins of and spreading of the lesions, dimensions of the lesions, behavior pattern, and factors such as contour properties, invasion, and calcification which could potentially indicate malign behavior were also evaluated.

RESULTS: Age span of included subjects were between 28 and 81. The most common tumor location for hollow organs was found to be stomach (n=19, 32%). In extra-luminal, regions the most common tumor location was found to be mesentery (n=4). Hansfield Unit densities of tumoral lesions in comparison to liver density were hypodens (n=32, 71%), isodens (n=9, 20%) and hyperdens (n=4, %9) in a descending order. The tumor invasion was found to be effecting liver, peritoneum, and bladder, in a descending order. In 11(24%) subjects, distant metastasis to the liver was evident. In 4(9%) subjects peritoneum, in 3(7%) subjects adrenal gland and in 1(%2) subject bone metastasis was evident.
DISCUSSION AND CONCLUSION: MSCT is an important and indispensable modality for the detection, localization and identification of GISTs that can be seen in different parts of the gastrointestinal tract.

5.Hospitalization Timeliness of Patients with Myocardial Infarction
Tengiz Verulava, Tamar Maglakelidze, Revaz Jorbenadze
doi: 10.5505/ejm.2017.36854  Pages 103 - 109
INTRODUCTION: Timely self-help measures and management of acute myocardial infarction (AMI) improve the disease outcomes. AMI is most beneficial if applied within two hours from the onset of symptoms. However, many patients with AMI do not benefit because of seeking medical care late. The aim of research was to study to study timeliness of pre-hospital phase of treatment and investigate the causes of postponement in seeking treatment among patients with AMI
METHODS: Within the framework of the quantitative research, the beneficiaries were interviewed with a structured questionnaire
RESULTS: The majority of patients did not have necessary pre-hospital self-help measures, and called to the doctor when it was already late. Only 51% of patients appeal to self-help measures and 28% arrived at hospital within 2 hours after the onset of symptoms. 65% of the patients misunderstand the nature of pain. 28% of patients had pain resistance behavior.
DISCUSSION AND CONCLUSION: There is low awareness among the patients about the main symptoms of the disease and importance of call for an emergency in timely manner. Consequently, only a small part has been hospitalized in the first hours. Low development of the primary health care system in Georgia has negative impact on the quality of medical surveillance of the patient. It is recommended to improve institute of the family physician on the country scale, which will help to conduct continuous surveillance of the population, to increase patient awareness regarding basic symptoms of the disease.

6.Ileosigmoid knot which is a cause of acute abdomen at 28 week of pregnancy: A rare case report
Osman Toktaş, Numan Çim
doi: 10.5505/ejm.2017.35220  Pages 110 - 113
Ileosigmoid knot (ISK) is an unusual surgical emergency. ISK, which is also known as compound volvulus or double volvulus is a rare case leading to intestinal obstruction. ISK is an unusual phenomenon in the West, but is relatively common in some African, Asian and Middle Eastern nations. This condition is serious, usually progressing rapidly to gangrene. Awareness of the condition is vital for early diagnosis and optimal management. ISK has to be considered in differential diagnosis of patients who present with ileus. We present a rare case in a 41 year-old, 28 weeks pregnant woman for whom ISK was identified in the operation.

7.CT and MRI Findings of Anthrax Meningoencephalitis; Case Report
Sercan Özkaçmaz
doi: 10.5505/ejm.2017.54264  Pages 114 - 117
Anthrax meningoencephalitis is a rare but mortal condition of anthrax. Primary focus of infection may be skin, respiratory and gastrointestinal anthrax. It has a poor prognosis with fatal outcome despite agresssive combined antibioterapy. Radiological findings demonstrate a haemorhagic encephalitis pattern with cerebral edema. We present an anthrax meningoencephalitis case with CT, MRI and DWI findings from an endemic region.

8.Bilateral infraclavicular block with ultrasonography in pediatric patient
Abdullah Kahraman
doi: 10.5505/ejm.2017.18209  Pages 118 - 119
Bilateral brachial plexus block is not frequently applied due to the risk of local anesthesia toxicity development. Therefore, general anesthesia is often the first choice in patients undergoing bilateral upper extremity surgery. A 14 years old female patient, weighing 42 kg was scheduled for surgery due to post-traumatic bilateral forearm fractures. Anesthesia methods were explained in detail to patient relatives and to the patient. Due to its high quality post-operative analgesia and long duration of effect, bilateral infraclavicular block was agreed to be used. A 15 ml mixture of 0.5% levobupivacaine and 1% lidocaine, under the guidance of ultrasound was injected to each side with lateral sagittal infraclavicular approach using a 22G injection needle. No operational or intra-operative complication was observed and no additional analgesic consumption was required during the 60 minutes operation and until the post-operative 10th hour. As a result, we believe that, ultrasound-guided upper extremity block, even bilateral block can be applied safely in appropriate pediatric cases.

9.Light microscopic determination of tissue
Fadime Kahyaoğlu, Alpaslan Gökçimen
doi: 10.5505/ejm.2017.24008  Pages 120 - 124
Tissues to be examined under a light microscope, must pass through certain stages. These are; detection(fixation), washing, dewatering (dehydration), polishing or transparent, absorption, recession or blocking, cutting, coloring and closing the lamella. At the end of this phase examination of the tissues with a light microscope takes place. Mistakes at any stage, may lead to irreparable consequences. For this purpose, the researcher during the examination of biological materials should properly fulfill tissue tracking methods. It is aimed to review the existing information about the first phase of tissue detection and to review and compile new publications. It was aimed to review present knowledge and recent literature on the fixation step which is the first step in tissue determination.

10.Irritable Bowel Syndrome, Depression and Anxiety
Cafer Alhan, Aslıhan Okan
doi: 10.5505/ejm.2017.08208  Pages 125 - 129
The relationship between psychiatric disorders and irritable bowel syndrome has been known for a long time. Although Irritable bowel syndrome (IBS) is a very common functional bowel disease associated with psychiatric disorders, its pathophysiology is not fully elucidated. Brain and bowel set up a bidirectional communication over the autonomic nervous system (ANS) and hypothalamic - pituitary - adrenal (HPA) axis. In a significant number of patients diagnosed with major depressive disorder (MDD) and anxiety disorders meet IBS criteria.

11.Clinically mild encephalitis/encephalopathy with a reversible splenial lesion associated with aseptic meningoencephalitis
Masayuki Higashino, Masashi Ohe, Ken Furuya, Yoichi Sanefuji, Norie Ito, Naoya Hattori
doi: 10.5505/ejm.2017.99609  Pages 130 - 132
Becaus this manuscript is Letter to Editor, there is no abstract.

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