ISSN 2415-1297 (Online)   ISSN 2415-1300 (Print)
Volume : 27 Issue : 3 Year : 2019
Med J Islamic World Acad Sci: 28 (2)
Volume: 28  Issue: 2 - 2020
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1.Should Portal Vein Resection Be Done in Patients with Locally Advanced Pancreas Cancer?
Mustafa Özsoy, İbrahim Kılınç
doi: 10.5505/ias.2020.80688  Pages 32 - 39
The main factor affecting resection in pancreatic adenocarcinoma is the involvement of the portal vein due to the anatomical location of the pancreas. This study aimed to investigate the effect of portal vein resection on postoperative morbidity and mortality.
Patients diagnosed with pancreatic cancer who underwent pancreaticoduodenectomy and portal vein resection between January 2014 and December 2018 were included in the study retrospectively. Besides, the demographic data of the patients, postoperative morbidity, and mortality rates were documented.
Seventeen patients [mean age 62.4 years; 11 (65%) were male, and 6 (35%) were female] were included in the study. Endoscopic retrograde cholangiopancreatography was applied to 10 patients (58%) with cholangitis at presentation. CA 19-9 elevation was found in all patients, and its mean was found to be 1497 U/L. Total pancreaticoduodenectomy was applied to 2 (11.7%) of 17 patients. In one patient (5.8%), hepatic artery resection, besides portal vein resection, was performed. The mean operation time was 2350 min, while the average blood loss was 820 mL. The most common TNM stage was T2N1M0 with 11 patients (64%). The pancreatic fistula was diagnosed in 3 (20%) of 15 patients. One patient with Grade C fistula died on the 27th postoperative day due to sepsis and multiorgan failure. Postoperative morbidity was encountered in 10 patients (58.8%). The average hospital stay of the patients was 12.4 days.
Portal vein resection increases the pool of patients who benefit from surgery in pancreatic cancer. However, it can be performed safely with morbidity and mortality rates similar to those of conventional pancreatectomies in experienced hands.

2.Are women aware of the importance of mammography in breast cancer diagnosis and screening?
Serap Ulusoy, İbrahim Kılınç, Burcu Akkurt, Ömer Parlak
doi: 10.5505/ias.2020.54871  Pages 40 - 48
This study aimed to reveal the experience and knowledge of women concerning mammography and raise awareness of mammography and breast cancer.
A mammography awareness survey was administered to 500 women aged between 40 and 69 years. A total of 434 women knew mammography, while the remaining 66 women were not aware of mammography. Of all respondents, 341 had previously undergone mammography, mostly with the recommendation of their doctors, while 159 participants had not undergone this procedure, mostly stating that they did not consider it necessary. In the group with a history of mammography, difficulties during scanning were reported by 196 women, of whom 187 reported having pain. Of all respondents, 407 stated that they would have mammography in the future whereas 93 denied it.
Education level and willingness to undergo mammography in the future were significantly higher in those with a history of mammography compared with the non-mammography group (P < 0.05 for both). The education status was also significantly higher in women who planned to undergo mammography compared with the women who denied it in the future (P < 0.05). The rate of fear of radiation exposure during scanning was significantly higher among the women without a history of mammography, who also did not plan to undergo this procedure in the future, compared with those who were willing to undergo this procedure (P < 0.05). However, other reasons for not undergoing mammography did not differ significantly between the two groups (P > 0.05). Increasing the awareness in society on breast cancer and mammography may facilitate the detection and treatment of breast cancer. Mammography is the most effective imaging method in detecting breast cancer. Understanding the perspective of women aged 40–69 years concerning this procedure and conducting appropriate studies in this direction may increase the rate of mammography in society and contribute to the early detection of breast cancer.

3.Mid-Term Results of the Metal-on-Metal Total Hip Arthroplasty
Vedat Biçici, İzzet Bingöl, Kasım Kılıçarslan
doi: 10.5505/ias.2020.32309  Pages 49 - 54
When it came into use, meta-metal surfaces, which received immense attention due to their varied advantages, were successfully applied for a while. However, over time, their use decreased because they were associated with some complications that developed due to metal wear. This study aimed to analyze the findings on metal-on-metal surfaces. Metal-on-metal total hip replacement prosthesis applied in our clinic between 2004 and 2008 was retrospectively screened. A total of 90 hips of 77 patients included in the study were evaluated. The average Haris hip score in the mid-term controls was 89.8 ( ±10.9). A revision was performed in six hips for different reasons (6.6%), and the total prosthesis survival rate was 93.3%. Symptomatically, only 2 (2.2 ) patients had pseudotumor and 28 patients (31.1% ) developed stress shielding due to prosthetic design. Similar success was achieved with other surface alternatives in terms of functional results and prosthetic survival in metal-on-metal surfaces in the medium term.

4.Comparison of short-term clinical outcomes of manipulation under anesthesia and arthroscopic capsular release in treating frozen shoulder
Enes Uluyardımcı, Durmuş Ali Öçgüder
doi: 10.5505/ias.2020.76736  Pages 55 - 60
Manipulation under anesthesia (MUA) and arthroscopic capsular release (ACR) are the two most common treatment options in the surgical treatment of refractory frozen shoulder (FS).
This study aimed to compare the short-term clinical outcomes of MUA and ACR in refractory FS treatment. This retrospective study included 17 patients who received MUA and 15 patients who received ACR due to refractory FS. The patients were evaluated clinically and functionally with the range of motion (ROM), American Shoulder and Elbow Surgeons (ASES) score, and visual analogue scale (VAS) pain score.
The mean follow-up time was 17.3 ± 9.8 months and 16.9 ± 9.1 months in the MUA and ACR groups, respectively, with no statistically significant difference between the two groups (P = 0.882). The mean age was 56.1 ± 6.8 and 55.7 ± 7.2 in the MUA and ACR groups, respectively, with no statistically significant difference between the two groups (P = 0.882). The two groups were found to be similar in terms of sex, affected side, duration of symptoms, presence of diabetes, and presence of thyroid disease (P > 0.970). In both groups, forward flexion, external rotation, and internal rotation improved significantly compared with preoperative values (P < 0.001). No significant difference was found between the two groups in terms of ROM, ASES score, and VAS pain score at the last follow-ups (P > 0.576).
Successful clinical and functional outcomes can be obtained with both MUA and ACR in the surgical treatment of refractory FS without major serious complications. In the present study, no significant difference was found between the MUA and ACR groups.

5.Complications of Infectious Mononucleosis in Children
Mesut Koçak, Deniz Güven
doi: 10.5505/ias.2020.83702  Pages 61 - 71
Infectious mononucleosis (IM) is detected more in preschool and infant children, with differences in clinical features. This study aimed to analyze and compare the demographic, clinical, and laboratory characteristics and complications of IM in Turkey and other nonindustrial countries.
The study was performed to retrospectively analyze the etiology of fever and lymphadenopathy in Keçiören Training and Research Hospital Pediatric Clinic between 2014 and 2018. Twenty-six patients clinically suspected of having IM and positive for Epstein-Barr virus (EBV) viral capsid antigen immunoglobulin M (IgM) antibody were included in the study.
The files of 26 (13%) patients diagnosed with IM were analyzed for EBV viral capsid antigen (VCA) IgM antibody. Twelve (46%) of the patients were male, and 14 (54%) were female; 21 (80.7%) were aged less than 3 years, and the average age was 26 months. The age of onset peaked between 0–12 months (34.6%) and 25–36 months (30.7%). Fever, lymphadenopathy, and hepatosplenomegaly were observed in all patients (n = 26). The fever lasted for an average of 5 days. Tonsillopharyngitis (80%), skin rash (69%), conjunctivitis (65%), anemia (12%), leukocytosis (54%), and high liver function (65%) were the most common laboratory findings. The average hospital stay was 7.5 days. Patients with prolonged fever, lymphadenopathy, and hepatomegaly were more prominent, and patients with elevated liver enzymes stayed longer in the hospital.
This study showed that exposure to EBV at an early age in Turkey, like other nonindustrial countries, developed into IM; therefore, the incidence rates of hepatosplenomegaly, lymphadenopathy, and hospitalization were high. It aimed to emphasize the importance of preventing exposure at a growing age because it also led to the development of chronic diseases in advanced ages.

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