ISSN 1301 - 0883 / E-ISSN 1309 - 3886

  Eastern J Med: 5 (1)
Volume: 5  Issue: 1 - 2000
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1. Is it effective to file medical malpractice litigations and the names of hospitals and physicians involved on the Internet or not?
R.J. Cleophas, T.J. Cleophas
Pages 3 - 6
It was recently debated in the media that filing names of hospitals and physicians involved in medical malpractice suits on the Internet may create incentives for hospitals and physicians to improve their quality of care. Also, with improved quality of care, it may curb the need for expensive litigations. Method: Different arguments pertinent to such a decision, in terms of effectiveness, efficacy, efficiency, and practicability, are considered. Results and conclusions: The litigation system has been documently more adequate to determine injury than negligence, and so, making malpractice data and the names of those involved available on the Internet is a hazardous plan. In terms of effectiveness, efficacy, efficiency, and practicability, there are too many counter-arguments to warrant implementing this plan.

2. Polymerase chain reaction in pulmonary tuberculosis
O. Okutan, Z. Kartaloğlu, A. İlvan, K. Cerrahoğlu, E. Kunter, R Aydilek
Pages 7 - 9
Early diagnosis is one of the most important steps in the management of tuberculosis, so the conventional diagnostic techniques need to be improved. In our study, the diagnostic value of polymerase chain reaction (PCR) in active pulmonary tuberculosis was investigated. Methods: We have examined 79 cases (61 patients and 18 healthy subjects) between 20-22 ages. In these cases Mycobacterium tuberculosis complex DNA specific IS6110 field has been investigated by PCR and the results were compared with the microbiological culture. Results: The sensitivity of PCR results were found to be 96.72% and the specificity was 100%. In 59 out of 61 cases with pulmonary tuberculosis, culture and PCR positivity were shown, PCR was negative for 2 of the culture (+) cases. All control cases were negative in terms of bacteriological culture, PCR, and sputum smear for acid fast bacillus (AFB). Conclusion: PCR is a rapid technique with high sensitivity and specificity. However, there is always a risk of contamination with other specimens and the amplification products. PCR is believed to be useful and time saving if we consider the time needed to wait for the results of microbiological culture, which in turn might cause delay in starting the treatment in time, especially in sputum smear negative cases.

3. Evaluation of a serological test for the diagnosis of tuberculosis using the 38kda antigen
A. M. Abdelnoor, G. Khaled, G.M. Matar, M.N. Khalil, F. Ramadan
Pages 10 - 12
To evaluate an enzyme immunoassay utilising the 38 KDa Mycobacterial antigen as a possible test for the laboratory diagnosis of tuberculosis. Method: The sera of 37 patients with confirmed tuberculosis, 37 tuberculin-negative, apparently healthy individuals and 27 tuberculin-positive, apparently healthy individuals were tested. Moreover, seropositive, apparently healthy individuals were tested by a peripheralblood- based PCR assay using a broad range bacterial primer and one that is specific for the M. tuberculosis complex. Results: Four of 37 patients with confirmed tuberculosis, 10 of 37 tuberculin-negative, apparently healthy individuals and none (0 of 27) of the tuberculin-positive, apparently healthy individuals were seropositive. All seropositive, apparently healthy individuals were negative by PCR. Conclusion: The sensitivity of the enzyme immunoassay utilising the 38 KDa antigen in this study was 10.8% and the specificity 84.4%. Thus, it appears that this test may not be used for the diagnosis of tuberculosis in the Lebanese.

4.Effects of education on knowledge and attitude of breast self examination among 25+ years old women
M. Öztürk, V.S. Engin, A.N. Kişioğlu, G. Yılmazer
Pages 13 - 17
To investigate effects of education on knowledge and attitude of breast self examination (BSE) among women. Method: Knowledge and performance of BSE among women residents at Gülistan district of Isparta were both evaluated by a preliminary study. After that, an educational program about BSE was carried out. Six months later, final situation was evaluated by constructing two groups: Study group (n=62) that consisted of women and the control group (n=63) assigned by randomized sampling. Results: The ratio of knowledge about BSE in the study group increased from 30.3% to 77.4% while it was 50.8% in the control group. Similary the ratio of subjects who regularly performed BSE in the study group was found to be increased from 19.0% to 61.3% while the same ratio was found 39.7% in the control group. The differences between two groups and in the same group before and after training were statistically significant. Knowledge of BSE was correlated with education and employment status among all respondents. Correct practice of BSE was found to be correlated with employment status among study group while it was found to be correlated with education, employment, age and prosperity in the control group. Conclusion: The results from this study suggest that an educational program can significantly improve BSE practice in women.

5.Random amplified polymorphic DNA typing of enterococcus faecalis isolated from Lebanese individuals
H.S. Harakeh, M. Uwaydah, G.M. Matar
Pages 18 - 20
In this study we assessed the utility of random amplified polymorphic DNA in the subtyping of 38 isolates of Enterococcus faecalis. Method: Twenty of 38 subtypes were recovered from urinary tract infections and 18 from rectal swabs of hospitalized patients with no enterococcal infections. All isolates were initially identified by conventional bacteriological methods and the API 20 Streptococcus system. Biotyping was done on the basis of hippurate hydrolysis (HH) test using API 20S. Susceptibility of the isolates to vancomycin, teicoplanin, ampicillin and gentamicin was performed by the disk diffusion and the agar dilution methods. Antimicrobials were selected based on treatment regimen adopted by clinicians. DNA was extracted from all isolates using the PureGene kit and Random Amplified Polymorphic DNA Typing (RAPD) was done using a 10 mer and 22 mer primers reflecting the GC content of the genome. Results: Our data have shown that 38 tested isolates were E. faecalis. Thirteen of 38 were of fecal origin and 6/38 were of urine origin. All 19 isolates were of biotype I (HH positive). The remaining 5 of fecal origin and 14 of urine origin were of biotype II (HH negative). All isolates were susceptible to vancomycin, teicoplanin and ampicillin except 3 urine and 1 fecal isolates that showed resistance to ampicillin. All urine isolates were resistant to gentamicin while 3 of 18 fecal isolates were susceptible to this antimicrobial agent. RAPD data have shown that 2/19 biotype I isolates, showed one RAPD pattern and were susceptible to teichoplanin and vancomycin; and 2/19 showed a different pattern and were susceptible to all tested antimicrobials except gentamicin. All 4 isolates were of urine origin. The remaining 15 biotype I isolates had different patterns. In addition, of 19 biotype II isolates, 2 showed one pattern and the remaining 17 different patterns. Two isolates were of urine origin and resistant to gentamicin. The RAPD patterns were reproducible. Conclusion: These observations suggest that RAPD is efficient for subtyping E. faecalis and may be useful as a tool in epidemiologic investigations.

6.Hemoptysis: bronchoscopic-computed tomographic correlation in ninety eight cases
H. Ekim, İ. Sanisoğlu, H. Akar
Pages 21 - 25
To retrospectively evaluate the efficiency of the fiberoptic bronchoscopy (FOB) examination compared to computed tomography (CT) in the evaluation of patients with hemoptysis. Methods: We retrospectively reviewed 98 patients who underwent FOB and CT for hemoptysis. There were 78 male and 20 female. The mean age was 46 years with a range from 18 to 80 years Results: Hemoptysis was attributed bronchiectasis in 19 (19.4%) cases, bronchogenic carcinoma in 18 (18.3%) cases, bronchitis in 23 (23.4%) cases, tuberculosis in 7 (7%) cases, cryptogenic causes in 28 (28.5) cases and miscellanous causes in 3 (3%) cases (a perforated hydatid cyst, a mitral stenosis and an intrabronchial foreign body). Endobronchial abnormalities were seen on CT but not at FOB in 4 of the 18 patients with malignancy. In contrast endobronchial abnormalities were identified at FOB but not seen by CT in 3 patients. CT and FOB agreed on only 11 of these 18 patients. Conclusion: FOB can be used for patients with hemoptysis with reduced cost compared to CT and frequently may lead to a precise histologic diagnosis and subsequent early surgical management. But both FOB and CT should be used for a complete diagnosis and appropriate therapy planning in most patients with hemoptysis.

7.Cervicothoracic pin migration following open reduction and pinning of a clavicular fracture (a case report)
J. Abdelnoor, J. Mantoura, A. Nahas
Pages 26 - 28
Abstract | Full Text PDF

8.Wilson’s disease presenting with severe hemolytic anemia (case report)
E.A. Özer, E. Kasırga, E. Özer, B. Atabay, I. Yaprak
Pages 29 - 30
Abstract | Full Text PDF

9.Hepatic schistosomiasis (report of a case accompanying a metastatic tumor in the liver)
Ö. Sağol, E. Özen, İ. Şimşek, E. Ellidokuz
Pages 31 - 32
Abstract | Full Text PDF

10.Urethral diverticulum and giant urethral stones occurring after scrotal flap urethroplasty
Z. Bayraktar, A.İ. Taşçı, T. Çaşkurlu, M. Çek, G. Sevin
Pages 33 - 34
Abstract | Full Text PDF

11.Squamous cell carcinoma of the kidney
Ö. Odabaş, M. Karakök, Y. Yılmaz, M.K Atilla, E. Akman, S. Aydın
Pages 35 - 36
Abstract | Full Text PDF

12.Crossed renal ectopy associated with tuberous sclerosis
Y. Yılmaz, Ö. Odabaş, İ. Demirtaş, M.K. Atilla, H. Dilek, H. Bayraklı
Pages 37 - 38
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13. Peptic ulcer or inflammatory gastric disease?
S. Kapıcıoğlu
Page 39
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