ISSN 2415-1297 (Online)   ISSN 2415-1300 (Print)
 
             
 
Volume : 25 Issue : 2 Year : 2017
 
Med J Islamic World Acad Sci: 24 (4)
Volume: 24  Issue: 4 - 2016
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ORIGINAL ARTICLE
1.Serum CA 125, Progesterone, and βHCG Levels in the Differential Diagnosis of Abortion and Ectopic Pregnancy
Sibel Mutlu, Ali R. Benli, Orhan Gelişen, Burcu Aykan
doi: 10.5505/ias.2016.82712  Pages 102 - 106 (386 accesses)
This study aimed to investigate the role of serum cancer antigen (CA) 125, progesterone, and beta-human chorionic gonadotropin (βHCG) levels in the differential diagnosis of intrauterine pregnancy, complete or incomplete abortion, and extrauterine pregnancy.
This study was carried out in a teaching and research hospital between 2007 and 2009. A total of 175 patients with abortion, tubal ectopic pregnancy, and healthy pregnancy were recruited into the study. Pre- and post-treatment blood levels were compared among the groups.
Serum βHCG levels were higher in cases of normal healthy pregnancy than in cases of abortion and ectopic pregnancy. No difference was observed between serum βHCG levels of abortion and ectopic pregnancy cases. The levels of serum CA 125 in abortions were found to be higher compared with the other two groups. The levels of serum progesterone in cases of ectopic pregnancy were found to be lower compared with the other two groups.
The utilization of the serum βHCG level in the differential diagnosis of normal/abnormal pregnancies and serum CA 125 and progesterone levels in the differential diagnosis of abortion and ectopic pregnancies are alternative parameters.

2.Topical 0.05% Cyclosporine A Eyedrops for Treating Moderate-to-Severe Vernal Keratoconjunctivitis
Kenan Çalışır, Taha Ayyıldız, Ümit Çallı
doi: 10.5505/ias.2016.83704  Pages 107 - 111 (329 accesses)
This study aimed to investigate the efficacy of topical cyclosporine A (CsA) 0.05% in patients with moderate-to-severe vernal keratoconjunctivitis (VKC).
This retrospective study included 37 patients who were admitted to the clinic between January 2015 and December 2015. All patients were diagnosed with moderate-to-severe VKC and treated with topical CsA 0.05% (Restasis Allergan, Inc. CA, USA). The VKC diagnosis was based on patient history and typical clinical signs and symptoms. Sign and symptom scores of each patient were obtained at pretreatment and during treatment (1, 3, and 6 months).
Of the 37 patients, 20 (54.1%) were male and 17 (45.9%) were female. The mean age of the patients was 11.83 ± 4.70 years (6–24 years). The symptom–sign and total scores of the patients were significantly reduced at 1, 3, and 6 months compared with baseline values. Symptom–sign scores also significantly reduced from 1 month to 3 months and from 3 months to 6 months (P < 0.05).
Topical CsA 0.05% is an effective formulation used for treating moderate-to-severe VKC. It may reduce the need for steroids.

3.Clinicopathological Compatibility Rates with Regard to Skin Punch Biopsies
Nuran Süngü, Hayriye T. Doğan, Aydan Kılıçarslan, Huban S. O. Yavuz, Seda Maralı, Merve Kıran, Akın Aktaş, Ahmet Metin
doi: 10.5505/ias.2016.46873  Pages 112 - 115 (251 accesses)
The aim of this study was to explore the compatibility of clinical prediagnosis and histopathological diagnosis of skin punch biopsies at the Pathology Department of Ankara Atatürk Training and Research Hospital, Yıldırım Beyazıt University, Turkey. Several factors may change the appearance of a typical lesion because the skin is open to the external environment, and clinical diagnoses may be difficult. As a result, the histopathological assessment of skin punch biopsies and the support given by clinicians to the pathologist are extremely important.
Whole punch biopsy diagnoses, which were evaluated at the department between the years 2006 and 2015, were grouped according to the inflammatory reaction patterns determined and described in Weedon’s Textbook of Dermatopathology. Subsequently, the compatibility rates of clinical prediagnosis were studied, focusing especially on the first three prediagnoses. A total of 2967 punch biopsies were evaluated at the department between the years 2006 and 2015; 93.09% were diagnosed with inflammatory dermatosis, and 6.9% with tumors. The compatibility rate between clinical prediagnosis and pathological diagnosis was 85.77%; 65.75% of the cases were compatible with the first three prediagnoses. The compatibility rate of inflammatory dermatosis was 93.09%.The most common compatibility with prediagnosis was seen in epidermal maturation and keratinization and elastic tissue lesions with a rate of 100%.
Although performing a skin biopsy is easy, histopathological evaluation of the skin has not been used commonly. In fact, it is recommended that skin biopsy should be performed in cases with possible neoplasia, bullous diseases, or dermatosis, which have not been clinically diagnosed. In these cases, clinicopathological correlation is important to reach a true diagnosis. This study aimed to determine mutual contributions of clinicians and pathologists by evaluating clinicopathological compatibility rates.

4.Serum and Urine Levels of Magnesium in Adult Males with Type 2 Diabetes Mellitus in Jeddah, Saudi Arabia
Syed M. Farid
doi: 10.5505/ias.2016.27147  Pages 116 - 122 (366 accesses)
The present study aimed to investigate the association of serum and urine magnesium (Mg) levels of the patients living in Jeddah, Saudi Arabia, with type 2 diabetes mellitus (T2 DM) without complications. The effect of Mg deficiency on the prevalence of DM and its related complications has received great attention. Serum and urine Mg, fasting serum glucose (FSG), glycated hemoglobin (HbA1c), and urine creatinine (Creat) levels were determined in 68 diabetic subjects and 62 age-matched nondiabetic subjects (controls) using auto-analyzer and atomic absorption spectrometer. Body mass indices (BMI) of the subjects were also determined. The serum Mg levels in the patients with T2 DM were significantly lower than that in controls. BMI and the levels of FSG, HbA1c, and urine Mg were significantly higher and urine Creat level lower in diabetic subjects compared with nondiabetic subjects. Significantly lower serum Mg and significantly higher urinary Mg levels were observed in diabetic subjects with poor glycemic control (HbA1c >7%) compared with the nondiabetic population. The present correlation study revealed a highly significant correlation between FSG and HbA1c (r = 0.846, P = 0.000). Aging and increasing duration of DM alter the metabolism of Mg by decreasing its serum concentration and increasing its urinary excretion. This study also showed a significant negative association between serum Mg and FSG (r = –0.408, P = 0.039 and HbA1c (r = –0.478, P = 0.043). Also, a significant negative association was observed between serum Mg and age of both patients with T2 DM (r = –0.787, P = 0.044) and controls (r = –0.798, P = 0.041). Again, a significant negative correlation (r = –0.452, P = 0.018) was observed between serum Mg and urine Mg levels of the diabetic population of the study. DM and poor glycemic control alter the metabolism of Mg by increasing its urinary excretion and lowering its serum levels. Its clinical implications were discussed in this study.

CASE REPORT
5.Occipital Aneurysmal Bone Cysts in an Adult Patient: A Rare Case and Review of Literature
Oktay Gürcan, Atilla Kazancı, Ahmet G. Gürçay, Halil C. Küçükyıldız, İsmail Bozkurt, Ömer F. Türkoğlu, Murad Bavbek
doi: 10.5505/ias.2016.34711  Pages 123 - 126 (253 accesses)
This study aimed to report a rare case of occipital aneurysmal bone cysts (ABCs) in an adult patient. ABCs account for 1% of primary bone tumors. They are usually seen in pediatric age and rare in adults. They are benign fibro-osseous lesions, but they also tend to double in size rapidly and destruct the morphology of the bone. They have a tendency to extend to the long bones and vertebral column. The calvarial ABCs are 3%–6% of ABC. They usually affect the frontal and temporal bones of the skull, and cranial nerve findings are frequently seen. In the adulthood, occipital ABCs are extremely rare. Sixteen cases of occipital ABC, average age 15 years, have been reported in the literature. A 50-year-old female patient was admitted to the clinic with the history of an occipital mass lesion, which had been growing for 6 months. Magnetic resonance imaging and computed tomography of the cranium revealed an irregular-shaped destructive lesion of 55 × 18 × 28 mm3 in the diploe part of the occipital bone. The mass with an approximately 6 cm radius, and 1 cm normal bone edge was completely excised. Because of total resection, no adjuvant therapy was performed. Neither recurrence nor residual lesion was observed in the postoperative 24 months.

6.Stabilization of Distal Tibia Metaphysis Extra-Articular Fracture Accompanying Soft Tissue Defect in the Medial Supramalleolar Area and Wound Management: A Case Report
Erdem Y. Uymur, Levent Demir, Ahmet Köse, Şafak Aktar, Orhan Karsan
doi: 10.5505/ias.2016.98470  Pages 127 - 129 (277 accesses)
This study aimed to present the case of a patient with distal tibia metaphysis extra-articular fracture accompanying soft tissue defect.
A 19-year-old patient who fell from a horse 3 h ago was evaluated in the emergency department of a tertiary trauma hospital. He had left tibia distal metaphysis extra-articular fracture with a wound of 5 × 3.5 cm2on the medial side of the supramalleolar region. The wound was mechanically cleansed and covered with sterile dressings. A long leg splint
was applied. Medical treatment including antibiotic therapy and tetanus prophylaxis was immediately started. Distally wedged tibial nailing fixation and interlocking using distal supportive bolt locking screw of the nailing system were performed. The screw surface was covered with available soft tissues of the wound. The treatment was continued using
the vacuum-assisted closure system. Next, soft tissue reconstruction was done using the Yin-Yang flap. Two months later, a dynamization procedure was performed on the patient, whose soft tissue defect was resolved. His fracture healed in the postoperative fifth month. The wound was stable in the postoperative 13th month. All inserted implants were removed on the patient’s request, and treatment was successfully completed.
Distal supportive bolt locking screw was inserted most distally and covered with available soft tissue to stabilize distal tibial metaphyseal extra-articular fracture accompanying soft tissue defect in the supramalleolar region. Possible infections due to the exposure of distal interlocking screws of standard nailing fixation were prevented. A powerful fixation was
achieved using the aforementioned nailing system. This fixation system not only created quite stable fixation to restore osseous pathology, but also could create a suitable environment to resolve soft tissue defect via proper treatment options and strategies.



 











 
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