ISSN 2415-1297 (Online)   ISSN 2415-1300 (Print)
Volume : 27 Issue : 3 Year : 2019
Med J Islamic World Acad Sci: 26 (4)
Volume: 26  Issue: 4 - 2018
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1.Gold standard treatment of the patients with total knee arthroplasty infection
Kaan Yüksel, Kasım Kılıçarslan, Mahmut Nedim Aytekin, Mahmut Uğurlu, Nihat Tosun
doi: 10.5505/ias.2018.46244  Pages 80 - 86
This study aimed to evaluate and compare early and mid-term results of the two-stage revision method used for diagnosing infections and giving treatment to patients who underwent total knee arthroplasty in Ankara Atatürk Research and Training Hospital, Turkey, between October 2013 and October 2015. Patient files were examined retrospectively, and patients were called for the last examination. Further, 23 patients were included in the study. The first and second stages of the two-stage revision were performed for all these patients. However, in 2 of these 23 patients, the process ended with arthrodesis and amputation. Infections were diagnosed based on the clinical examination of the knee, erythrocyte sedimentation rate, C-reactive protein, white blood cell counts, and intraoperative culture results. Laboratory parameters were also used for monitoring infection. Patients were evaluated preoperatively and postoperatively according to the American Knee Society clinical and functional scoring system. The mean age of the patients was 66.8 years. Also, 18 of the patients were female and 5 male. Early infection was detected in 4, delayed infection in 7, and late infection in 12 patients. The average follow-up time was 12.6 months. The American Knee Society clinical score was 35.0 (median score) preoperatively and 75.4 (median score) postoperatively. The functional score was 38.8 (median score) preoperatively and 77.3 (median score) postoperatively. In conclusion, early and mid-term results of patients with infected total knee prosthesis, who underwent the two-stage revision, were found to be consistent with the published results in terms of infection eradication success, radiological findings, and postoperative clinical and functional scores. It is possible to increase the success rate by approaching the cases in a standardized and systematic way.

2.A comparative study on C-reactive protein and gamma-glutamyl transferase as novel inflammatory markers of type 2 diabetes mellitus
Tushar Kanti Bandyopadhyay
doi: 10.5505/ias.2018.22309  Pages 87 - 91
Studies in the last few years have linked oxidative stress and inflammation to beta-cell function resulting from chronic exposure to hyperglycemia. Recent prospective trials have suggested that an elevated level of C-reactive protein and gamma-glutamyl transferase enzyme is associated with subsequent development of diabetes. The present study aimed to examine the relationship between gamma-glutamyl transferase and the marker of inflammation C-reactive protein in patients with diabetes. The study was conducted on 300 patients, including 100 healthy controls and 200 patients with type 2 diabetes. Plasma glucose levels (fasting and postprandial), serum levels of high-sensitivity C-reactive protein, levels of glycosylated hemoglobin, and serum gamma-glutamyl transferase hepatic enzyme levels were measured. The mean high-sensitivity C-reactive protein and gamma-glutamyl transferase levels in patients with type 2 diabetes mellitus were significantly higher than the values in controls (P < 0.0010). Further, a significant positive correlation was observed between gamma-glutamyl transferase levels and high-sensitivity C-reactive protein levels in patients with type 2 diabetics (r = 0.312, P = 0.001). The increase in the levels of high-sensitivity C-reactive protein and gamma-glutamyl transferase in patients with diabetes and their significant association might be a result of inflammati on and oxidative stress in diabetes mellitus.

3.Investigation of selenium levels in patients with fibrocystic breast disease
Servet Kocaöz, Ömer Parlak
doi: 10.5505/ias.2018.57984  Pages 92 - 95
The present study was conducted to compare serum selenium levels in patients with breast pain. Patients with fibrocystic disease (FCD) and other breast pathologies were divided into two groups. Biochemical analysis and some habits of patients admitted to the general surgery outpatient clinic with breast pain were reviewed retrospectively. The serum selenium levels were found to be lower in patients with FCD than in those with other breast pathologies (P < 0.00001). At the same time, tea and cigarette consumption was higher in patients with FCD having breast pain (P = 0.026 and P = 0.034, respectively). The serum selenium level was lower in patients with FCD who had breast pain than in patients with other benign breast pathologies. Tea and cigarette consumption was higher in these patients than in other patients. Further studies should monitor serum selenium levels indicating whether selenium supplementation is effective in patients with FCD.

4.Pediatric arrest cases intervened by ambulance service of the Ankara province (Ankara, 2017)
İshak Şan
doi: 10.5505/ias.2018.78872  Pages 96 - 101
The out-of-hospital cardiac arrest incidence is 7.5–11.2/100,000 people/year. A multicenter study in North America found that the incidence of out-of-hospital cardiac arrest was higher in children and adolescents than in adults. This study aimed to determine the status of ambulance service of Ankara province in terms of child arrest cases. A total of 415,874 cases were assigned an ambulance by the Provincial Ambulance Service between January 01, 2017, and December 31, 2017. Cases with R09 (respiratory arrest) and I46 (cardiac arrest) ICD-10 code were identified among these cases. Further, 1.3% of these cases had cardiac arrest (n = 5530). Cases aged less than 18 years (2.2%; n = 124) were included in the study. The final status of the detected cases was confirmed by asking the hospitals where they were transferred. Moreover, 62.9% (n = 78) of the cases were men, and 91.9% (n = 114) of the emergency calls were from urban areas. The age range distribution was as follows: 25.0% (n = 31) were 0 year old, 20.2% (n = 25) were 1 year old, and 10.5% (n = 13) were 17 years old. Also, 6.4% (n = 8) of the cases died at the scene. To complete the cardiopulmonary resuscitation chain, prehospital records should be strengthened and the effectiveness of the interventions should be monitored. Wider series results are needed to determine the standards for prehospital medical practices for pediatric arrest cases.

5.Lower- versus upper-extremity surgery: effect on serum albumin levels
İrfan Aydın, İsmail Ağır
doi: 10.5505/ias.2018.82160  Pages 102 - 107
Hypoalbuminemia is one of the markers of trauma and major surgery. No study has reported on the comparison between upper- and lower-extremity surgery patients in terms of albumin levels. Therefore, the present study aimed to investigate the preoperative and postoperative serum albumin levels in patients who underwent extremity surgery and compare the changes in albumin levels after upper-extremity surgery with those after lower-extremity surgery. Sixty patients who presented to the emergency department of a tertiary care hospital due to trauma were included in the study. All the patients underwent either upper- or lower-extremity surgery by orthopedists and were consecutively selected regardless of their ages. Their serum albumin levels at the time of admission and on the third day after the surgery were obtained from the hospital patient records. A statistically significant difference in the preoperative and postoperative serum albumin levels was found in both groups (P < 0.05). Moreover, the mean difference between preoperative and postoperative serum albumin levels was found to be significantly higher in the lower-extremity group (1.52 ± 0.32 g/dL) than in the upper-extremity group (0.95 ± 0.39 g/dL) (P < 0.05). This study revealed that both upper- and lower-extremity surgeries caused hypoalbuminemia. This study was novel in finding that lower-extremity surgery caused more severe hypoalbuminemia in the patients compared with upper-extremity surgery. The reason for this significant difference was the longer duration of lower-extremity surgeries, requiring more fluid support during the surgery.

6.Can different fatty acid contents in propofol formulations change bacterial growth?
İbrahim Halil Ertaş, İbrahim Andan, Mihriban Yücel, Türkay Çakan, Hülya Teltik Başar
doi: 10.5505/ias.2018.98704  Pages 108 - 113
This study aimed to investigate how Propofol-Lipuro changed the quantity of bacterial growth compared with propofol after changing the lipid content of Propofol-Lipuro. Seven microorganisms (methicillin-resistant Staphylococcus aureus, methicillin-sensitive Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and Serratia marcescens), representing different groups that cause hospital-acquired infections and have been already investigated in previous studies, were selected. Each microorganism used in the study was incubated in 5% sheep blood agar at 36°C, and reproduction was enabled after 24 h. Three different groups were generated from each microorganism by inoculating the microorganism suspension with10-mL physiological serum (PS), propofol (P), and Propofol-Lipuro (PL). The quantitative growth levels were evaluated by repeated procedures at 36°C after 4, 8, 24, and 48 h. Although a statistically significant difference in terms of quantity of bacterial growth was detected in both propofol formulations (group P and group PL) compared with the control group (PS), no statistically significant difference was detected between the P and PL groups. No difference was detected in terms of bacterial growth in different lipid contents. In conclusion, this study suggested the use of aseptic methods and administration in accordance with the updated recommendations in the literature while using propofol formulations.

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