Volume : 4 Suppl : 3 Year : 2025
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Kocaeli Medical Journal - Kocaeli Med J: 4 (3)
Volume: 4  Issue: 3 - 2015
ORIGINAL ARTICLE
1. The Findings of Echocardıography in Down syndrome Patients Who Applied to The Polyclinic of Pedıatrıc Cardiology
Onur Çağlar Acar, Abdurrahman Üner, İbrahim Ece, Serdar Epçaçan
Pages 1 - 3
INTRODUCTION: Down syndrome is the most common autosomal aneuploidy syndrome in human beings caused by the trisomy in chromosome 21. The congenital cardiac and major vascular abnormalities, caused especially by the unusual growth of endocardial cushions, is seen more commonly compared to the healthy societies in Down syndrome. In this study, the target is to define the rate of congenital cardiac disease in patients who were diagnosed with Down syndrome who applied to the Pediatric Cardiology Polyclinic of Medical Faculty of Yüzüncü Yıl University.
METHODS: This prospective research is performed in 198 cases whose Down syndrome diagnoses were made with the karyotype analyse and who were transferred to the Pediatric Cardiology Polyclinic for further examination in the dates between August 2010 - September 2012. All the patients are evaluated by echocardiography.
RESULTS: The rate of patient's age is between 1 month to 13 years. The rate of congenital cardiac disease in the patients with Down syndrome diagnoses is identified to be 54%. The atrioventricular septal defect is the most common congenital cardiac disease with the incidence rate of 49.9%. The atrioventricular septal defect is followed by; atrial septal defect (14.1%), ventricular septal defect (11.3%) and patent ductus arteriosus (8.5%).
DISCUSSION AND CONCLUSION: The rate of congenital cardiac disease in patients with Down syndrome in and around Van and the rate of atrioventricular septal defect is found consistent with the literature.

2. Extrapulmonary Tuberculosis: A Retrospective Review of 331 Cases at Kocaeli Tuberculosis Dispansary
Aysun Şengül, Nalan Ogan, Yusuf Aydemir
Pages 4 - 9
INTRODUCTION: We aimed to evaluate the demographics, localisation, diagnostic methods and treatment outcome of patients with extrapulmonary tuberculosis treated between 2005 and 2011 in Kocaeli Tuberculosis Dispansary, Turkey.
METHODS: We retrospectively reviewed medical charts of patients. We excluded patients who transferred to the other dispanseria or those medical records couldn’t be obtained.
RESULTS: A total of 331 extrapulmonary tuberculosis patients (52% female, 48% male ) with a mean age of 39,2 (±17,6) years were registered for treatment. Sites of extrapulmonary tuberculosis were lymph node in 119 (36%) patients, pleural in 112 (33,9%), bone and joint in 31 (9.4%), genital in 17 (5,1%), gastrointestinal in 15 (4.5%), skin in 9 (2.7%), urinary in 8 (2,4%), miliary in 6 (1.8%), central neural system in 6 (1.8%), pericardial in 6 (1,8%) breast in 2 (%0,6) and larynx in 1 (0,3%) patients. Pleural tuberculosis were common in male and young age, lymph node tuberculosis were common in female. Histopathological methods in 228 (68,9%), microbiological methods in 17 patients, both microbiological and histopathological methods in 4 patients (1,2%) and clinical, radiological and other methods were used in 82 (24,8%) patients for diagnosis. 311 patients (94%) had a successful treatment outcome. Of patients with unsuccessful outcome, 12 (3.6%) had defaulted, 8 (2.4%) had died.
DISCUSSION AND CONCLUSION: Altough tuberculosis can disseminate all tissues, lymph node and pleura are the most common sites of extrapulmonary tuberculosis. Fight with tuberculosis is continued in tuberculosis and objective diagnostic methods were common methods in diagnosis of extrapulmonary tuberculosis.

3. Seasonal Evaluation of the Skin Prick Test Results in Sakarya Region.
Yusuf Aydemir, Hikmet Çoban, Adil Can Güngen, Hasan Düzenli, Canatan Taşdemir
Pages 10 - 13
INTRODUCTION: The aim of this study; was to determine the spectrum and frequency of positive reactions to skin prick tests in patients with respiratory tract allergic symptoms, and was to identify common allergens in our region.
METHODS: In the study, we retrospectively evaluated skin prick test results of 1336 adults (mean age 35.7±14 years) with allergic diseases history who the skin prick tests performed between April 2012 to May 2014 in the East Marmara Region, Turkey
RESULTS: In 1014 of 1336 patients(76%) we obtained positivity to at least one of the allergens tested. The highest positive sensitivity of allergens in the skin prick tests were house dust mite (n=576, 43.1%)and tree pollens (n= 522, %39.1) have been found. The maximum number of tests and positivity was detected most frequently in June and July.
DISCUSSION AND CONCLUSION: Atopy in Sakarya is frequently seen. Geographic and seasonal features of the region are consistent with the distribution of allergens. We suggest these results will give some help to diagnose and manage of allergic diseases in patients of this region.

4. Hospitalization characteristics and physiciatric consultations status associated with post-discharge suicide reattempt; retrospective observational study
Onur Karakayalı, Gülhan Kurtoğlu Çelik, Ferhat Içme, Havva Şahin Kavaklı, Sevilay Vural, Alp Şener
Pages 14 - 20
INTRODUCTION: The aim of this study is to investigate effects of hospitalization status after the treatment and requesting emergency psychiatric consultation on recurrent suicide attempts of the patients who admitted to emergency department, during one year of follow up period
METHODS: This retrospective observational study is conducted in the emergency department of a Tertiary Research and Training hospital, on patients admitted due to suicide attempt, between January 1st and December 31-2010 after the ethics committee approval. Archival data were retrospectively screened for the study group and the file numbers of the patients were reached to communicate directly with them
RESULTS: : 278 patients, 0.28% of total admissions, were admitted to the study. 133 patients (57.8%) were consulted psychiatrically. In the patients with the need for a psychiatry consultation, lack of psychiatric consultation was found to be associated with the 5,21 times increased risk for repeated suicide attempts after admission. The rate of suicide reattempts in patients with a history of psychiatric disorder was significantly higher (p=0.014). The patients who were discharged from the intensive care unit and the emergency room with their own request have a higher rate of suisidal thinking than the other patients (p=0,007). The risk of suisidal reattempts was 3,96 times higher in patients discharged upon their own requests than the hospitalized patients, also the risk of suisidal reattempts was 0,96 times higher in patients discharged upon healing than the hospitalized patients.
Patients hospitalized in the intensive care unit had the risk of suisidal reattempts 4,64 times more than the patients hospitalized in other departments

DISCUSSION AND CONCLUSION: Psychiatric consultation before discharging from the emergency departments routinely, and more effective psychiatric follow up of the patients after discharge may decrease recurrent suicide attempts. Preventive algorithm must be defined in order to not allow the patients with own request discharge

5. The Efficiency of Vacuum Assisted Closure Method for Treatment of Deep Sternal Infections Following Open Cardiac Surgery
Hüseyin Şaşkın, Çağrı Düzyol, Kazım Serhan Özcan, Hüseyin Maçika, Mustafa İdiz
Pages 21 - 29
INTRODUCTION: In this study, we aimed to compare the conventional treatment methods with vacuum assisted closure treatment technique for mortality, re-infection and duration of hospitalization in patients who had deep sternal wound infection after cardiac surgery.
METHODS: Seventy two patients who had deep sternal infection after open heart surgery between November 2006-June 2014 were enrolled in the study. The data were collected retrospectively. The patients who were treated with conventional wound care were enrolled in group 1(n=38), the patients who were treated with vacuum assisted closure were enrolled in group 2 (n=34).
RESULTS: Twenty five of the patients were female and the mean age of the patients were 65,3±7,8 years. The mean values of C-reactive protein(p=0.02), leukocyte counts(p=0.01) and erythrocyte sedimentation rate (p=0.005) were significantly different between the groups. The incubation of sternal and mediastinal swap at 10 days were positive in 26 patients in group 1(68,4%), and positive in 5 patients in group 2(14,7%)(p=0.0001). The 90-days mortality; no mortality was observed in group 1, and 6 of patients(%15,8) died in group 2 (p=0.03). The duration of hospitalization in survived patients were 23,3±5,5 days in group 1 and were 17,3±3,4 days in group 2 (p=0.0001).
DISCUSSION AND CONCLUSION: The patients who were treated with vacuum assisted closure when compared to conventional wound care, for deep sternal wound infection after cardiac surgery, were associated with shortened hospital stay, accelerate in wound healing and eradication of microorganisms.

6. Percutaneous Treatment Of Peripheral Artery Disease: A Single Center Experience
Burak Turan
Pages 30 - 36
INTRODUCTION: Interventional procedures for peripheral arterial disease have increasing popularity. Percutaneous interventions have become the first line therapy in many vascular territories. Aim of the present study is to evaluate the procedural results of percutaneous interventions for peripheral arterial disease in our single center.
METHODS: Angiographic procedures performed between July 2011 and October 2015 were retrospectively evaluated. Interventional procedural data and in-hospital adverse events were acquired from hospital records.
RESULTS: A total of 11224 angiographic procedures were screened. Of these, 1144 procedures were performed for the diagnosis of peripheral arterial disease. A total of 167 interventional procedures (mean age 62±10, 82% male) were detected. The most common procedure was lower extremity intervention (n=101), which was followed by cranial (n=43), upper extremity (n=19) and visceral (n=4) interventions. Overall procedural success rate was 95%. Intravascular stents were used in 82% (n=135) of patients. Among in-hospital adverse events, death was observed in 1 (0.6%), cerebrovascular events in 2 (1.2%), bleeding requiring transfusion in 1 (0.6%), dialysis requirement in 1 (0.6%) patient(s). Post-procedural amputation or myocardial infarction was not observed. Majority of patients (89%) were discharged from hospital the next day. Cerebrovascular event rate in carotid artery intervention was 4.7% (n=2). Iliac, femoral/popliteal and subclavian/brachial artery interventions had a procedural success rate of 97, 92 and 90%, respectively. Procedural success was 100% in carotid/vertebral and renal artery interventions.
DISCUSSION AND CONCLUSION: Percutaneous interventions for the management of peripheral arterial disease can be performed with high procedural success and acceptable adverse event rates in our center.

7. Comparison of the Effect of Trabeculectomy and Phacotrabeculectomy on Macular Thickness in Primary Open-Angle Glaucoma
Dilara Pirhan, Nurşen Yüksel, Ruken Çinik, Berna Özkan
Pages 37 - 42
INTRODUCTION: The comparison of the effects of trabeculectomy and phaco-trabeculectomy on central macular thickness (CMT)
METHODS: 22 eyes of 22 patients with primary open angle glaucoma (POAG) which had undergone trabeculectomy surgery, 20 eyes of 20 patients who had been diagnosed POAG with concurrent cataract which had undergone phacotrabeculectomy surgery and 25 eyes of 25 patients with only cataract serving as controls were included. CMT measurements was performed before surgery, at postoperative 1 week, 1 month and 3 months after surgery by using optic coherens tomography (OCT).
RESULTS: Increase in CMT of phacoemulsification and phacotrabeculectomy groups was observed at postoperative 1 week while that of was not observed in trabeculectomy surgery. The difference between trabeculectomy and phacotrabeculectomy group was statistically significant (p=0.03). Postoperative CMT were increased in all groups in the first month, however mean CMT change was statistically significant between trabeculectomy and phacotrabeculectomy group (p=0.01). By 3. month the mean CMT levels were close to the preoperative value in all three groups and the difference between the groups was not statistically significant.
DISCUSSION AND CONCLUSION: When increase in CMT in phacotrabeculectomy group at postoperative first week and first month compared to that of trabeculectomy group, finding out statistically difference may be related to is more manipulation during surgery and longer duration.

CASE REPORT
8. Every ulcer may not be related to inflammatory bowel disease
Züleyha Akkan Çetinkaya, Mesut Sezikli, Göktuğ Şirin, Sevda Soydan, Fatih Güzelbulut
Pages 43 - 46
İleal ulcers are detected commonly in our clinical practice. Howewer they are always not be result of inflammatory bowel disease. İt is important to differentiate them other etiologies from inflammatory bowel disease. We herein report a case of ileal ulcer.

9. Isolated axillary nerve lesion occuring spontaneously
Ramazan Gündüz, İsmail Boyraz
Pages 47 - 50
68-year-old patient who is lawyer admitted to our clinic because of occuring weakness and pain on the left shoulder 3 months ago. His abductor muscle strength of left shoulder was 0/5 in the first examination. The strenght of other muscles and neurological examinations were normal. He did not describe any trauma and repetitive sport activities in the anamnesis. EMG was reported as severe axonal damage of the left axillary nerve and mild to moderate carpal tunnel syndrome.
Isolated axillary nerve palsy should be kept in mind in patients with acute severe shoulder pain and weakness Neuralgic amyotrophy,vasculitis, localized neuritis should be considered in the differential diagnosis in patients who dont describe any trauma.

10. Management of Giant Frontal Mucocele; Report of three cases.
Yakup Yegin, Mustafa Çelik, Kamil Hakan Kaya, Burak Olgun, Selçuk Güneş, Ayşe Pelin Yiğider, Mustafa Suphi Elbistanlı, Fatma Tülin Kayhan
Pages 51 - 55
Frontal sinus mucoceles are slow-growing and locally aggressive lesion of the frontal sinuses. A gradually enlarging lesion results in destruction of the wall of the sinus and extends to the encircling anatomic structures. Treatment of mucocele is surgical. There are different surgical approaches in frontal mucocele. Hereby we reported the diagnosis, treatment and follow-up of three cases of giant frontal mucocele and reviewed the relevant literature.

11. sunct syndrome: report of two cases
Çetin Kürşad Akpınar, Dursun Aygün, Hakan Doğru, Sedat Şen
Pages 56 - 58
Short lasting Unilateral Neuralgiform headache with Conjunctival injection and Tearing (SUNCT) syndrome, the etiology of which is not known for sure, is a rare trigeminal autonomic cephalgia. In its distinction paroxysmal groups of pain with low-moderate intensity which is generally unilateral and confined to the ophthalmic nerve region accompanied with autonomic symptoms is important. The usual duration ranges from 5 to 240 seconds. The etiology has not been exactly defined yet, but there are several studies going on over this subject. Various agents are used in the treatment of SUNCT syndrome which is a very rare condition. this paper presents two cases below and over the age range reported in the literature who were treated with carbamazepin (400 mg/day) and lamotrigine (150 mg/day).

12. Huge Bilateral Spermatocele Mimicking Testicular Neoplasia
Mücahit Kart, Mustafa Melih Çulha
Pages 59 - 61
We describe a case of bilateral spermatocele mimicking testicular neoplasia, diagnosed at scrotal ultrasound with surgical correlation. A 58 years of man was admitted to our clinic suffering from right scrotal swelling. After physical examination, not only right sided but also left sided scrotal swelling was detected. Scrotal ultrasound revealed cystic fluid masses which are monoloculer on right side and multiloculer on left side. Surgical exploration was arranged and total excision of spermatoceles which are both located near the body of epididymis, was performed without perforation. The patient recovered well and discharged on the second day. No complication was observed in the follow up after one month.