ISSN 2415-1297 (Online)   ISSN 2415-1300 (Print)
Volume : 27 Issue : 2 Year : 2019
Med J Islamic World Acad Sci: 27 (2)
Volume: 27  Issue: 2 - 2019
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1.Sex-based differences in the morphometric parameters of distal of the femur: A magnetic resonance imaging study
Ali Haydar Baykan, Haci Bayram Tosun, Sibel Ateşoğlu Karabaş, Recep Aydın, İbrahim İnan, Şükrü Şahin
doi: 10.5505/ias.2019.00008  Pages 34 - 40
The morphology of the knee joint varies according to sex and ethnic groups. Full knowledge of these variable morphological data is important for achieving formal compatibility between the knee surface to be resected and the prosthesis when designing knee arthroplasty. This study aimed to perform morphometric measurements of distal femoral anatomy in healthy adults in terms of sex and age.
The magnetic resonance imaging (MRI) images of 180 patients aged 22 years or older were retrospectively examined in 2018. The anthropometric measurements of the distal femoral anatomy were performed using proton density spectral attenuated inversion recovery MRI sequences. The anatomic and surgical transepicondylar axis length, anterolateral and anteromedial condylar depth, posterior condylar length, epicondylar axis angle, intercondylar notch width and length, and medial and lateral condylar height were measured in all cases. The values obtained were recorded in millimeters and degrees and evaluated through comparisons by sex and age.
The distal femoral dimensions were significantly higher in males than in females in terms of all parameters measured independently of age (P < 0.05).
In this study, the normal reference values of distal femur measurements were determined using MRI in adult patients. These reference values can guide the knee surgery.

2.Does fixation of fibular fractures accompanying distal tibial fractures affect the ankle stability?
Fırat Fidan, İsmail Ayder Gülten, Cengiz Kazdal, Akif Kurtan, Abdülkadir Polat
doi: 10.5505/ias.2019.37929  Pages 40 - 43
This study aimed to evaluate radiologically whether fixing the fibula in the case of combined distal third tibial and fibular fractures resulted in ankle instability.
This retrospective study included 39 patients (23 male and 16 female) with combined distal tibial and fibular fractures. All fractures were treated with plate versus intramedullary nail without fibular fixation.The radiologic images of patients were reviewed, and the radiologic ankle stability was assessed. For radiologic ankle stability, medial distance, overlap distance of the tibia and fibula, and also tibiofibular gap distance during the ankle x-ray examination were measured. The American Orthopaedic Foot and Ankle Society (AOFAS) score was used for the clinical evaluation.
The mean age of patients was 41 (17–68) years. The fracture type according to the AO/OTA classification was detected as 42A1 in 18 patients, 42A2 in 12 patients, and 42A3 in 9 patients. None of the patients had radiological instability. The mean AOFAS score was 89.4 (60–100).
Fixing the fibular fracture in combined distal tibialand fibular fractures did not cause ankle instability radiologically regardless of the fixation method.

3.Conventional parathyroidectomy versus noninstrumental minimally invasive parathyroidectomy in parathyroid adenoma
Mustafa Alimoğulları, Hakan Buluş
doi: 10.5505/ias.2019.58826  Pages 44 - 49
In recent years, minimally invasive parathyroidectomy (MIP) is frequently preferred in treating primary hyperparathyroidism (PHPT). The aim of this study was to compare the results obtained using MIP with no instrument and those after conventional parathyroidectomy (CP) in patients with single parathyroid adenoma (SA).
Patients who underwent surgery with SA diagnosis between January 2010 and June 2017 were analyzed retrospectively. Patients with the preoperative multiglandular disease were not included in the study. The patients with SA diagnosis were divided into two groups according to the type of surgery they underwent: MIP and CP. Their demographic characteristics; duration of surgery; preoperative and postoperative parathormone (PTH), calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP) values; localization study results; and pathological diagnosis were compared.
A total of 74 patients were operated for SA. Further, 42 (56.7%) of the patients were operated with the MIP technique and 32 (43.2%) with the CP technique. The mean age of the patients was 52.0 ± 12 years for MIP and was 56.7 ± 12 years for CP. The mean operative time was 66.1 ± 27.3 min for MIP and 106.5 ± 44.6 min for CP. The success rate was 92.8% for MIP and 100% for CP. Neck ultrasonography (USG) and parathyroid scintigraphy (PS) were performed on all patients for preoperative diagnosis and localization. The accuracy rates were 66.2% for USG and 89.1% for PS. No significant difference was found between USG and PS sensitivity with regards to adenoma diameter. The mean follow-up period was 13.2 ± 9.7 months (range 3–32 months).
MIP is an appropriate surgical choice in SA treatment if preoperative localization studies are performed at a proper and adequate level. In MIP, the success rate of the surgery increases significantly in parallel with the increase in the performing team's experience.

4.Incidental thyroid malignancies in patients operated for hyperthyroidism
Hakan Ataş, Narin Nasiroglu Imga, Dilek Berker, Bülent Çomçalı, Buket Altun Özdemir, Gökhan Akkurt
doi: 10.5505/ias.2019.65047  Pages 50 - 54
This study aimed to investigate the frequency of incidental thyroid cancer in patients undergoing thyroidectomy due to different forms of hyperthyroidism and also explore the behavioral pattern of cancer in malignant cases.
A total of 1210 patients operated in the clinic between March 2014 and August 2018 were screened consecutively. Of these, 347 were thyrotoxic; 68.9% were female, and 31.1% were male. Further, 43.8% (n = 152) had Graves’ disease (GD), 4% (n = 14) had toxic nodular goiter (TNG), and 52.2% (n = 181) had toxic multinodular goiter (TMNG). Patients with hyperthyroidism were classified into two groups (Group 1: Benign; Group 2: Malignant). Data including age, sex, presence of GD, body mass index (BMI), thyroid volume, thyroid-stimulating hormone value at the time of diagnosis, TR-Ab, anti-TPO-Ab, and follow-up of hyperthyroidism were compared between the groups.
Thirty-eight (11%) of all thyrotoxic patients had thyroid carcinoma. Sixteen (10.52%) patients with GD, 2 (14.3%) with TNG, and 20 (11%) with TMNG had thyroid carcinoma. The histopathological examination revealed 35 papillary (21 microscopic), 1 follicular, and 2 cases of medullary thyroid carcinoma. The incidence of malignancy increased in patients with high BMI. Anti-TR-Ab and anti-TPO antibodies were found to be significantly higher in the malignant group.
The risk of developing thyroid cancer in different forms of hyperthyroidism is similar. Even in thyrotoxic patients, high BMI correlates with the development of thyroid cancer. It is believed that the cancer rate of 11% should not be underestimated. It is strongly recommended that toxic patients, especially patients with TNG, be closely monitored with USG and FNAC for possible malignancy development.

5.Effect of dental caries and the consequential variation in blood parameters on the anaerobic performance of rowing athletes
Osman Hamamcılar, Tuğba Kocahan, Bihter Akınoğlu, Adnan Hasanoğlu
doi: 10.5505/ias.2019.78466  Pages 55 - 60
This study aimed to investigate the effect of dental caries and the subsequent poor oral health on the blood parameters and anaerobic performance of athletes. The study was conducted on 30 elite rowing athletes (18 male and 12 female) who had a DMF-T index value of 3.9 after an oral check-up. The athletes were split into two groups: the study group, which consisted of athletes having four or more infected tooth; and the control group with athletes having one or no infected tooth. The study group consisted of 15 athletes (9 male and 6 female) with infected tooth number ≥4, DMF-T value of 7, and a mean age of 18.73 ± 1.05 years, whereas the control group consisted of also 15 athletes (9 male and 6 female) with DMF-T value of 0.9 and a mean age of 18.26 ± 2.01 years. The anaerobic capacity of athletes was measured using the Wingate test (WanT). The two demographically similar groups had no difference in their blood parameters and urine density values (P > 0.05). Also, no statistically significant difference in the WanT results was observed between the two groups, and WanT performances were similar in both groups (P > 0.05). Further, the superficial decay at the enamel and dentine levels did not negatively impact the anaerobic performance of athletes. On the contrary, it was suggested that studies should be conducted on the effect of severe dental caries at the pulpal level on athletic performance, which may also cause chronic inflammation.

6.Relationship between body mass index and a novel oxidative stress marker thiol/disulfide homeostasis
Gökhan Akkurt, Mustafa Alimoğulları, Burcu Bulut, Sevgi Bilmez Altay, Didem Sunay, Murat Alışık
doi: 10.5505/ias.2019.87513  Pages 61 - 64
This study aimed to investigate the relationship between body mass index (BMI) and thiol/disulfide homeostasis, which is used as a novel marker of oxidative stress.
A total of 328 patients admitted to the Family Medicine Polyclinic of Karabük University were included in the study. The demographic characteristics, additional diseases, smoking history, and BMI measurements of the patients were evaluated. Patients with chronic diseases and active malignancy were excluded from the study. The native thiol (sh), total thiol (tt), disulfide (ss), disulfide/native thiol (ss/sh), disulfide/total thiol (ss/tt), and native/total thiol (sh/tt) values of patient’s blood samples were analyzed using thiol/disulfide homeostasis kit at the biochemistry laboratory of Yıldırım Beyazıt University. The patients were divided into four groups according to BMI measurements as follows: BMI <18.5, BMI 18.5–24.9, BMI 25–29.9, and BMI ≥30. The relationship of patient’s thiol values with the BMI and smoking status was statistically analyzed.
A negative correlation was found between BMI and both sh and tt values. However, a positive correlation was observed between ss, ss/sh, ss/tt, and sh/tt values and the increase in the BMI. Further, the BMI was found to be an independent variable and statistically significant in all thiol levels except disulfide in the analysis using the general linear model.
It is predicted that thiol/disulfide homeostasis measurements can be widely used in diagnosis because they are cheap and easily applicable and accessible.


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