http://medicaljournal.gazi.edu.tr/index.php/GMJ/issue/feed Gazi Medical Journal 2019-10-01T08:23:11+03:00 Mehmet Ali ERGÜN aliergun@gazi.edu.tr Open Journal Systems Gazi University Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1645 Gastric Polyps: A Retrospective Analysis of Endoscopic Biopsies: A Single Center Study in Central Anatolia 2019-10-01T08:23:11+03:00 Hilal Erinanc hilalerinanc@yahoo.com Gulhan Kanat Ünler hilalerinanc@yahoo.com Hüseyin Savaş Göktürk hilalerinanc@yahoo.com Gulsum Teke Özgür hilalerinanc@yahoo.com <p><strong>Objective:&nbsp; </strong>Gastric polyps accounts for %6 of gastrointestinal endoscopy. Geographical differences occur in the prevalence of them. We aimed to determine the spectrum of&nbsp;gastric&nbsp;polyps .</p> <p><strong>Matherial and method: </strong>Data including demographics, medical history and histological characteristics of polyps and <em>Helicobacter pylori</em> were obtained retrospectively.</p> <p><strong>Results: </strong>Of the 24568 endoscopies performed, 184 patients were identified as having gastric polyps. The most frequently encountered&nbsp; were hyperplastic polyps (62%), followed by fundic gland polyps (19,3%) and adenomatous polyps (3, 8%).&nbsp; The corpus (36,4 % ) was the most common site and the antrum (25%) was the second. Female patients were more affected than male patients (64,7%). Majority of the polyps (88%) were smaller than 1 cm in diameter. The mean age was 62,10+13,4 (range:30-90) years. Fundic gland polyps were observed at younger age (mean age: 56,58) compared to other gastric polyps. Intestinal metaplasia was more frequently encountered in hyperplastic polyps than in fundic gland polyps.</p> <p><strong>Conclusion:</strong>&nbsp;&nbsp; In this study, hyperplastic polyps are the most common in our population however there was no association between the hyperplastic polyps and&nbsp; <em>H. pylori</em> infection.&nbsp; H.<em> pylori</em> infection ratio was similar in both hyperplastic polyps and fundic gland polyps however all of the patient have chronic gastritis. This findings suggest chronic gastritis also play role in hyperplastic polyps development.&nbsp; The study also showed that H. Pylori infection is still common in our country and further studies need to find efficacy of <em>H.pylori </em>treatment. &nbsp;</p> 2019-10-01T00:00:00+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1740 Nail Diseases: A Study of 1973 Cases 2019-10-01T08:17:31+03:00 Ahu Yorulmaz ahuyor@gmail.com Basak Yalcin ahuyor@gmail.com <p><strong>Background:</strong> The nail is a horny structure covering the tips of the digits. This semihard ectodermal skin appendage not only protects the distal phalanx, but also assists fine motor activities and enhances the sensitivity of the fingertips. Nail diseases continue to be one of the frequent causes of dermatology consultations. However, current literature on the prevalence of nail diseases in general populations is still limited.</p> <p><strong>Objective:</strong> To estimate the prevalence of nail diseases among outpatients of a dermatology clinic and to determine factors associated with nail diseases.</p> <p><strong>Methods:</strong> A total of 1973 patients [850 men and 1123 women; mean age, 42.1 ± 17.9 years (range: 18–100 years)] were prospectively enrolled. Following a thorough dermatological examination, nail findings of the patients were recorded. Mann-Whitney U and χ2 tests were used for statistical analysis, with a significance threshold of <em>p</em> &lt; 0.05.</p> <p><strong>Results:</strong> Nail abnormalities/diseases were observed in 560 of 1973 patients (28.4%). The most frequently observed nail abnormalities/diseases were onychomycosis (27.5%), leukonychia (8.6%) and splinter hemorrhages (7.9%). A Mann-Whitney U test showed that there was a significant relationship between age and prevalence of nail abnormalities/diseases (<em>p</em> &lt; 0.001). In addition, there was statistically significant relationship between gender and prevalence rates of nail abnormalities/diseases (<em>p</em> &lt; 0.001).</p> <p><strong>Conclusions:</strong> We have demonstrated positive associations between a number of factors and prevalence of nail diseases. Further studies are required to support these findings.</p> 2019-09-21T22:22:47+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1742 Dinamik Kontrastlı Manyetik Rezonans Görüntüleme, Benign ve Malign Kemik Tümörlerinin Ayrımında Katkı Sağlar mı? 2019-10-01T08:17:31+03:00 Halit Nahit Şendur hsendur@gmail.com Nil Tokgöz niltokgoz@yahoo.com Aylin Billur Şendur dr.billursendur@gmail.com Mahinur Cerit mahinurp@yahoo.com Emetullah Cindil emetiyildirim@yahoo.com Murat Uçar drucar@yahoo.com Aykın Şimşek ayk@gazi.edu.tr <p><strong>Amaç: </strong>Kemik tümörlerinde benign ve malign lezyon ayrımında dinamik kontrastlı manyetik rezonans görüntülemenin (DK MRG) etkinliğinin değerlendirilmesi.</p> <p><strong>Yöntem</strong>: Direkt grafide kemik tümörü bulunan 18 erkek ve 19 kadından oluşan 37 hasta (ort. yaş: 33,3; yaş aralığı:11-69) çalışmaya dahil edildi. Bir hastada iki farklı kemik tümörü olduğundan, toplam 38 lezyona (29 benign, 9 malign) DK MRG gerçekleştirildi. DK MRG’de sinyal intensitesi–zaman (SİZ) eğrilerine göre 2 kategori tanımlandı. SİZ eğrilerinde birinci dakikada göreceli kontrastlanma oranı (K1) ve eğrilerin eğimleri ölçüldü.</p> <p><strong>Bulgular: </strong>SİZ eğrilerine göre; 29 benign kemik tümöründen 24’ü (%82,8) kategori 1, 5’i (%17,2) kategori 2 ile uyumlu kontrastlanma gösterdi. Dokuz malign kemik tümörünün tamamı (%100) kategori 2 kontrastlanma ile uyumlu olarak değerlendirildi. Benign ve malign lezyonları ayırt etmede K1 için %85’lik eşik değerinin duyarlılığı %100, özgüllüğü %86,2 bulundu (p&lt;0,001). SİZ eğrilerinin eğiminde %84,1’lik eşik değerinin duyarlılığı %100, özgüllüğü %82,8 bulundu (p&lt;0,001).</p> <p><strong>Sonuç: </strong>DK MRG’de benign lezyonlarda daha yavaş ve daha az, malign lezyonlarda ise daha hızlı ve daha yüksek oranda kontrast tutulumu izlenmektedir. K1 değerleri ile SİZ eğri eğimleri tanısal doğruluk yönünden benzer sonuçlar vermekte olup, benign ve malign lezyonların ayrımında DK MRG’nin ilk dakikası en önemli verileri sağlamaktadır.</p> 2019-09-21T22:23:02+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1774 Şişirilebilir Penil Protez İmplantasyonu Tecrübemiz 2019-10-01T08:17:31+03:00 İyimser Üre iyimserure@yahoo.com <p><strong>Amaç:</strong> Şişirilebilir penil protez implantasyonu yapılan hastaların klinik ve cerrahi verilerini incelemek</p> <p><strong>Yöntem:</strong> 2013-2018 yılları arasında ED&nbsp; tedavisi amacıyla Eskisehir Osmangazi Üniversitesi Tıp Fakültesi Üroloji Departmanında şişirilebilir penil protez implantasyonu yapılan 58 hastanın verileri retrospektif olarak değerlendirildi. Hastaların etyolojik verileri, operasyon ile ilgili veriler ve komplikasyonlar kaydedildi. Hastalar, uygulanan protezin tipine göre sınıflandırılarak istatistiksel analiz yapıldı ve toplanan veriler açısından gruplar arasında fark olup olmadığı araştırıldı.</p> <p><strong>Bulgular:</strong> Hastaların ortalama yaşı 59,98 ±10,2 idi. 39 (%67,2) hastaya 2 parçalı (AMS Ambicor<sup>TM</sup>), 17 (%29,3) hastaya 3 parçalı (AMS 700<sup>TM </sup>CX) ve 2 (%3,4) hastaya da 3 parçalı (AMS 700<sup>TM </sup>LGX) şişirilebilir penil protez implantasyonu yapıldı. Ortalama takip süresi 20,4 ±13,1 ay idi. Ambicor protez uygulanan hastalarda ortalama operasyon süresi daha kısa idi (p:0,042). Yine bu grupta ortalama takip süresi daha uzundu (p:0,031). Diğer parametrelerde gruplar arasında fark saptanmadı.</p> <p><strong>Sonuç:</strong> Şişirilebilir penil protez implantasyonu, düşük komplikasyon oranı ve kısa hospitalizasyon süresi ile erektil disfonksiyon tedavisinde önemli yeri olan bir cerrahidir. Hangi tip protezin uygulanacağına hasta ve hekim beraber karar verebilir.</p> 2019-09-21T22:23:24+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1821 Analyzing Food Patterns and Preferences of Urban Population of Fasa (Phase I of Studying the Nutritional Healthy City in Fasa) 2019-10-01T08:17:31+03:00 Fatemeh Dogani moshaverchap@gmail.com Fateme Najjari moshaverchap@gmail.com Mohammad Mehdi Naghizadeh moshaverchap@gmail.com Azizallah Dehghan moshaverchap@gmail.com Ali Khani Jeihooni moshaverchap@gmail.com Alireza Askari moshaverchap@gmail.com Elham Ehrampouh moshaverchap@gmail.com Atefeh Alizadeh moshaverchap@gmail.com Reza Homayounfar moshaverchap@gmail.com <p><strong>Background</strong>: Proper and healthy eating is one of the key steps for developing a healthy population. The risk of disease and mortality decreases with a good nutrition. The access level, quality and choice of food consumed among people are affected by the economic, social, race and cultural status. It means that people with various culture and social system consume various types of food in various amounts.</p> <p><strong>Methods</strong>: In a cross-sectional study, 1000 adults living in the Fasa were selected by cluster sampling. Demographic, socioeconomic status, dietary habits, consumption of some important food items such as fruit and vegetables, oils, cereals, dairy, and salt were questioned in a 26 item questionnaire.</p> <p><strong>Results</strong>: The results show that there are significant problems in people lifestyle and dietary patterns in Fasa. A significant proportion of population had not regularly consumed breakfast and snack or significant consumption in fruits and vegetables. Hydrogenated vegetable oil and fried oil considerably used, and the most common method to prepare meat products was frying in oil. The refined grains are the major source of energy in people, and whole grains and cereals did not significantly used. Sugar and sweeteners were consumed significantly. Albeit, there were some positive points in the diet of region, including low consumption of carbonated beverages and processed foods, as well as high consumption of dairy products.</p> <p><strong>Conclusion</strong>: Significant drawbacks in the dietary pattern of the region exists that need to be planned to improve them to minimize the risk factors of noncommunicable diseases.</p> 2019-09-21T22:23:46+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1836 Knowledge of Medical Ethics Among Medical Undergraduate Students in a Medical College in South India 2019-10-01T08:17:31+03:00 Chandni Gupta chandnipalimar@gmail.com Vikram Palimar vpalimar@gmail.com Sneha Guruprasad Kalthur sneha.guruprasad@manipal.edu <p><strong>Introduction:</strong> All around the world medical training has become more and more commercialized and medical ethics has taken a backseat. Doctors should know medical ethics not only just to avoid blame of negligence but they should also respect the human morals principles. If we teach ethics to medical students it has shown significant influence on professionalism and moral qualities of medical professionals. The aim of this study is to assess the knowledge of bioethics in medical undergraduate students in a medical college in south India.</p> <p><strong>Materials and methods:</strong> The study is conducted on 108 undergraduate students who were studying at KMC, Manipal. A preformed proforma containing few questions regarding medical ethics will be given them to fill. The results are analyzed using simple statistics methods.</p> <p><strong>Results:</strong> Our study showed that 86.11% of students have knowledge of ethics. 57.4% of the students think that knowledge of ethics is very important in medical curriculum.</p> <p><strong>Conclusion:</strong> The study will help us to find the knowledge of medical ethics among the undergraduate medical student in a medical college in south India. It will also reflect the student view about the importance of knowledge of ethics in Medical curriculum.</p> 2019-09-21T22:24:17+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1964 Array-CGH Analizlerinde Saptanan De Novo Değişimlere Klinik Genetik Yaklaşım 2019-10-01T08:17:31+03:00 Gökçe Kumbasar gokcekumbasar@gmail.com Güven Toksoy toksoyg@gmail.com Seher Başaran basarans@istanbul.edu.tr Birsen Karaman bkaraman@istanbul.edu.tr <p><strong>Amaç: </strong>Bu çalışmada, mikrodizin tabanlı karşılaştırmalı genomik hibridizasyon (a-CGH) incelemesinde saptanan genomik dengesizliklerin ikinci bir yöntemle, örneğin floresan <em>in situ</em> hibridizasyon (FISH), gerçek zamanlı kantitatif polimeraz zincir reaksiyonu (Real-Time qPCR) ya da bir başka array platformu gibi, çalışılarak doğrulanması, klinik açıdan anlamının irdelenmesi ve genotip-fenotip ilişkisinin kurularak ailelere özgün genetik danışma verilmesi amaçlandı.</p> <p><strong>Gereç ve Yöntem:</strong> Postnatal dönemde multiple konjenital anomali/mental retardasyon (MKA/MR) ve prenatal dönemde fetal ultrasonda birden fazla patolojik bulgular nedeniyle, İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Tıbbi Genetik Anabilim Dalı'nda kromozom analizi tamamlanmış, normal karyotipe sahip ancak yapılan a-CGH incelemesinde değişim saptanmış, parental çalışmalarla <em>de novo</em> olduğu belirlenmiş 10 olguda a-CGH çalışmasında saptanan değişimlerin, değişimin tipine göre uygun tekniklerin kullanımı ile doğrulama çalışmaları yapıldı.</p> <p><strong>Bulgular:</strong> Çalışmada; 8 olgunun değişimi doğrulanarak fenotiple ilişkilendirildi, 2 olguda ise değişimin tekniğe bağlı hibridizasyon hatalarından kaynaklandığı sonucuna varıldı.</p> <p><strong>Sonuç:</strong> Elde ettiğimiz bulgular, a-CGH tekniği ile saptanan değişimlerin doğrulama çalışmaları tamamlanmadan raporlandırılmaması ve her değişimin tek tek değerlendirilerek en uygun, hızlı ve ekonomik teknikle doğrulanması gerektiğini ortaya koymuştur.</p> 2019-09-21T22:25:02+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1994 The Miniaturization of Instruments and Laser Lithotripsy have Improved Urolithiasis Treatment without Requiring Fluoroscopic Control in Preschool Children 2019-10-01T08:17:31+03:00 Fazlı Polat dr.fpolat@mynet.com Zafer Turkyilmaz zafertrk@yahoo.com Ramazan Karabulut ramazank@gazi.edu.tr Suleyman Yesil syesil2003@yahoo.com Kaan Sonmez kamez@yahoo.com <p><strong>Aim:</strong> To present the outcomes of&nbsp; retrograde intrarenal surgery (RIRS)&nbsp; and laser lithotripsy for the treatment of calculi&nbsp; of preschool age children.</p> <p><strong>Patients and Methods: </strong>The records of 28 patients ≤6&nbsp;years old who underwent endoscopic procedures for treatment of stones at the our hospital&nbsp; from 2013 to 2016 were reviewed retrospectively. In the treatment of renal and upper ureteral stones, laser lithotripsy was used with flexible ureterorenoscope (URS) without ureteral dilatation. The information recorded included patient demographics, stone size and location, operative technique and postoperative outcomes. &nbsp;</p> <p><strong>Results:</strong> A total of 32&nbsp; lithotripsy procedures to treat 34 stones were performed in 28 children 18 (&nbsp;64%) males and 10 (36&nbsp;%) females;&nbsp; 22 (78.5%) single and 6(21.5%) multiple stones; median age, 45,8±9,36 months (10-72). Stones were located in the kidney in 21 cases (75%), the upper ureter in 7(25%). Mean stone size was 12,07-+1,74(9-15)&nbsp;mm. Four (14.2%) of these patients also had bladder stone accompanying it. The stones of these patients were also fragmented using&nbsp; laser with flexible URS. Anesthesia duration was 26-105&nbsp;min (mean, 59,64±22,39).&nbsp; In fourteen patients with narrow ureteral orifices urethral JJ stents were placed firstly and flexible URS were done easily after 2 weeks. We did not use fluoroscopy; thus &nbsp;radiation free treatment was reached &nbsp;all patients. Follow-up ranged from 2 months to 3 years (mean, 24 months). Complete stone clearance was achieved at the end of the procedure in 26 (92.8%) patients. No major complications were encountered during or after the procedure, although 2 minor complications (&nbsp;7.1%) occurred. The mean duration of hospitalization was 2,21±0,87&nbsp;days (range, 1-4 days).&nbsp; Recurrence of urolithiasis was a long-term complication in two patients; These cases were subsequently treated smilarly with flexible URS. No other long-term complications were revealed by ultrasonography.</p> <p><strong>Conclusions:</strong> Our results suggest that flexible URS is a safe and effective minimally invasive treatment modality for&nbsp;renal stones in preschool children.</p> 2019-09-21T22:25:18+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2022 MELD-XI Score in Hospitalized Heart Failure Patients with Cardiac Electronic Devices 2019-10-01T08:17:32+03:00 Orçun Çiftci orucun@yahoo.com Caşit Olgun Çelik drolgunclk09@gmail.com Kerem Can Yılmaz keremcny@hotmail.com Emir Karaçağlar dremirkaracaglar@hotmail.com Burak Sezenöz drburaksezenoz@gmail.com Bülent Özin bozin1@gmail.com İbrahim Haldun Müderrisoğlu haldunm@baskent.edu.tr <p><strong>Objective</strong>: MELD-XI (Model for End-Stage Liver Disease Excluding INR) score predicts mortality in patients with heart failure. Herein, we assessed the role of MELD-XI score in predicting in-hospital mortality among heart failure patients having intracardiac cardioverter defibrillator&nbsp; (ICD) or cardiac resynchronization therapy with defibrillator backup (CRT-D) who presented with appropriate device shock or acute decompensated heart failure.</p> <p><strong>Methods</strong>: We reviewed the medical records of patients with implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator backup admitted to coronary care unit with acute decompensated heart failure or appropriate implantable device shocks between 01 January 2013 and 01 November 2018. MELD-XI score was compared between the deceased and surviving patients. The correlation of MELD-XI score with in-hospital mortality was sought.</p> <p><strong>Results</strong>: There were 106 coronary care unit admissions of 67 patients (52 (77.6%) males and 15 (22.4%) females), who had a mean age of 64.8 (range 19-93) years. Eighty-eight (83.0%) admissions were for acute decompensated heart failure and 18 (17.0%) for appropriate device shock and/or electrical storm. A total of 16 (15.1%) patients died at hospital. The median MELD-XI score of the patients who died at hospital was significantly greater than that of the survivors (11.80 (0.59-28.98) vs 15.24 (9.11-24.64); p&lt;0.05). A binary logistic regression analysis showed that MELD-XI score was a significant independent predictor of in-hospital mortality (X<sup>2</sup>=1.229 (%95 CI 1.06-1.43); p&lt;0.05).</p> <p><strong>Conclusion</strong>: MELD-XI score successfully predicts in-hospital mortality among patients with ICD or CRT-D admitted with acute decompensated heart failure or appropriate implantable electronic device shocks.</p> 2019-09-21T22:25:48+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2041 Effect of Fullerenol C60 on Erythrocyte Deformability During Ischaemia-Reperfusion Injury of Lower Extremity in Diabetic Rats 2019-10-01T08:17:32+03:00 Gülay Kip gulaykip@yahoo.com Hakan Kartal hakhankartal@gmail.com Faruk Metin Çomu fmc_68@yahoo.com Yücel Polat dr.yucelpolat@hotmail.com Mustafa Arslan mustarslan@gmail.com Ayşegül Küçük kucukaysegul@hotmail.com <p><strong>Background:</strong> Fullerenol, a water-soluble C60-fullerene derivative synthesized by Chiang et al, has been demonstrated to be able to scavenge free radicals in vitro and in vivo. Although its protective effects have been already studied and shown in ischemia reperfusion (IR) injury, additional investigation is necessary for its effect on erythrocyte deformability. The purpose of our study was to look into the effects of fullerenol C60 on erythrocyte deformability in rat lower extremity ischemia reperfusion injury model.</p> <p><strong>Materials and Methods: </strong>After approval of the Ethics Committee,&nbsp; 30 Wistar Albino rat were divided into 5 groups (n:6) as; Control (C), Diabetes (group D), diabetes+ fullerenol C60 group (DF), diabetes+ IR (group DIR) and diabetes IR+ fullerenol C60 (DIRF). 55 mg/kg streptozotocin was administered to the rats for diabetes. After the period of 72 hour, &nbsp;blood glucose concentration was mesured, 250 mg/dl and above were considered as diabetic rat. Four week after the formation of diabetes, rats were subjected to 2 hour ischemia and 2 hour reperfusion. Erythrocyte packs&nbsp; were prepared from heparinized blood samples and deformability measurements were performed.</p> <p><strong>Results: </strong>The deformability index was significantly increased in diabetic rats; however, it was similar in group D, DF and DIRF. It was significantly increased in group DIR when compared to group C, D, DF and DIRF. The relative resistance was increased in I/R models.</p> <p><strong>Conclusion:</strong> This study aimed to investigate the effects of IR on erythrocyte deformability which may lead to disturbance in blood flow and hence tissue perfusion in infrarenal rat aorta. We found that fullerenol C60 had beneficial effects by reversing undesirable effects of IR. In our opinion, further studies with larger volume are required to support our promising results.</p> 2019-09-21T22:26:31+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2107 The Cognitive Effect of Uric Acid in Idiopathic Parkinson’s Patients 2019-10-01T08:17:32+03:00 Osman Korucu tubersulf@yahoo.com <p><strong>Objective:</strong>High serum uric acid level (sUA) has been associated with decreased Parkinson's disease risk, slow disease progression, good cognitive performance and low dementia risk. In this study, the relation of dementia and uric acid levels was investigated in idiopathic Parkinson's patients that are known to be associated with low sUA.</p> <p><strong>Methods:</strong>Patients files of patients, who were diagnosed with idiopathic Parkinson's disease and have applied between dates 01.01.2009-31.01.2019, have been scanned retrospectively. Their age, gender, marital status, uric acid level and the presence of dementia were recorded. A total of 126 patients between ages 18-90 with creatinine levels below 1.25 mg/dl and no diagnosis of gout have been included in the study.</p> <p><strong>Results:</strong>Among 126 patients included in the study, 68 (54%) were male, 93 (73.81%) were married, and 37 (29.37%) patients were diagnosed with dementia. There was a statistically significant difference between groups with or without dementia diagnosis with regard to age (p:0.006) and marital status (p:0.007). Mean uric acid level was determined to be 4.6 mg/dl for the patients. There was no statistically significant difference between the two groups when this value was taken as reference (p:0.328). However, the number of patients diagnosed with dementia was relatively lower in the group with higher uric acid level.</p> <p><strong>Conclusion:</strong>The fact that median uric acid levels of our patients were within the interval recognized to be normal and the patients had relatively higher sUA levels in non-dementia group suggests that high sUA levels within normal interval may be protective.</p> 2019-09-21T00:00:00+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2140 Spinal Muscular Atrophy Results and Comparison of Commonly Used Methods 2019-10-01T08:17:32+03:00 Altug Koç draltug@gmail.com Elcin Bora elcinbora@gmail.com Uluc Yiş ulyis@yahoo.com Ozlem Giray Bozkaya ozlemgirayy@gmail.com Ayfer Ulgenalp ayferulg@gmail.com <p><strong>Aim:</strong> We aimed to share our genetic test results for SMA since 2001, and compare the commonly used screening and diagnostic methods for SMA.</p> <p><strong>Materials and Methods:</strong> The subjects consist of 222 individuals including SMA cases and their relatives, who referred our center for the investigation of SMA between the years 2001-2019. The results of Restriction Fragment Length Polymorphism (RFLP) between 2001-2015 years and Multiplex Ligation-dependent Probe Amplification (MLPA) between 2015-2019 years are investigated. RFLP is also used for selected cases after 2015.</p> <p><strong>Results:</strong> There is no prominent difference in diagnosis of SMA cases between methods. About 18% of the samples have homozygous <em>SMN1</em> exon 7-8 deletion. MLPA is better in determining the variants owing to <em>SMN2</em> gene.</p> <p><strong>Conclusion: </strong>There is no evident difference between the methods in the diagnosis of SMA. But, because of its ability in screening heterozygous SMA carriers and superiority in determining the <em>SMN2</em> copy number, the MLPA is markedly more successful. RFLP is kept as second method for special cases and used when confirmation is needed. In addition to these widely used techniques, there is a need for commonly used tests that able to detect <em>SMN1</em> point mutations (2-5% of SMA cases) and identify if 2 <em>SMN1</em> copies which are present on the same chromosome; the situation has a frequency of 3.6% in population.</p> 2019-09-21T22:28:02+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1970 Mucoepidermoid Resembling Squamous Cell Carcinoma in the Premaxilla: A Diagnostic Challenge 2019-10-01T08:17:32+03:00 Tuang Geng Ju erictgj@gmail.com Jeyasakthy Saniasiaya shakthy_18@yahoo.com Masaany Mansor shakthy_18@yahoo.com Zainal Azmi Zainal Abidin zaza@moh.gov.my <p>Salivary gland malignancy represents a rare yet diverse entity that covers a heterogenous spectrum of neoplasm of various clinical behavior, ranging from protracted, indolent to aggressive, life-threatening manner. Accurate histopathological diagnosis is imperative in terms of prognostication and further management planning. Herein, we report a case of an intermediate grade mucoepidermoid carcinoma of premaxilla masquerading as squamous cell carcinoma. Despite repeated biopsies, histological examinations failed to establish an accurate diagnosis. The patient eventually underwent wide surgical excision of the primary lesion with simultaneous bilateral supra - omohyoid neck dissection. Diagnosis dilemma encountered along with subsequent management are further discussed.</p> 2019-09-21T22:30:06+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2004 A Rare Reason in Acute Hepatitis: Brucella 2019-10-01T08:17:32+03:00 Ayşegül Bükülmez aysegulbukulmez@yahoo.com Pelin Balıkoğlu aysegulbukulmez@yahoo.com Ayşe Tolunay Oflu aysegulbukulmez@yahoo.com <p>Brucellosis is a zoonosis caused by the genus Brucella. It is the most common zoonosis especially in underdeveloped and developing countries. Brucellosis is a systemic disease may involve multisystem or any organs. Clinical manifestations and symptoms have variable characteristics. For this reason, it is known as a ‘great imitator’ in the medical literature. Reticuloendothelial system involvement is one of the most important features of brucella infection. The liver is the largest organ of the reticuloendothelial system. Therefore, the most frequently affected organ is the liver. The patients may have mild elevation of transaminases. Acute hepatitis is a rare manifestation of brucellosis. Two sisters diagnosed with acute hepatitis due to brucellosis are presented in this case report. The aim of the case report is to emphasize the importance that brucellosis is kept in mind for the differential diagnosis of acute hepatitis in regions where the brucellosis is endemic.</p> 2019-09-21T22:30:42+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2012 Foot Squamous Cell Carcinoma: Grieve Lessons from Diabetic Foot Ulcer Misdiagnosis 2019-10-01T08:17:32+03:00 Fatimah Ahmedy fatimahmedy@ums.edu.my Kean Hooi Teoh khteoh@ummc.edu.my Nornazirah Azizan nazirah@ums.edu.my Nik Amin Sahid Nik Lah nike_opo@ums.edu.my Tze Yang Chung chungty@ummc.edu.my <p>Foot squamous cell carcinoma (SCC) is rare and preponderance towards DFU misdiagnosis is very likely given the high risk of developing DFU among diabetics. This case highlights the needs to identify atypical features observed in any given DFU to avoid misdiagnosis and late detection of malignant changes. A 63-year-old gentleman with diabetes presented with non-healing right DFU for more than two years. The ulcer was hypergranulating over medial surface of mid-foot, had minimal slough and irregular edges but no callosities. Treatments include debridement, dressing and strict offloading of right foot, but the ulcer remained unchanged. Skin biopsy confirmed the diagnosis of SCC and surgical resection was done but complicated with bone metastases at 4 months post-surgery. The patient died secondary to bilateral pulmonary embolism in less than a year since the diagnosis of SCC. Atypical features that triggered the possibility of DFU misdiagnosis are: 1) prolonged non-healing DFU despite appropriate ulcer management and addressing factors affecting wound healing, 2) foot ulcer pain with no callosities typically observed in DFU, and 3) hypergranulating ulcer in a well-controlled diabetes. Reported cases of foot SCC were primarily over the heel, an area with high contact and pressure load during walking. In this case, the absence of great toe (acquired from old trauma) had possibly altered pressure distribution of the foot leading to atypical ulcer’s location. Prolonged non-healing DFU despite appropriate ulcer management and addressing factors affecting wound healing, with atypical clinical features should raise caveat of DFU misdiagnosis.</p> 2019-09-21T22:31:10+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2028 Sinonasal Carcinoma Mimicking Invasive Fungal Sinusitis: A Diagnostic Dilemma of an Extensive Paranasal Sinus Mass, a Case Report 2019-10-01T08:17:32+03:00 Nur Asma Binti Sapiai asmahannif@gmail.com Jeyasakthy Saniasiaya asmahannif@gmail.com Hilma Hazmi asmahannif@gmail.com Juhara Haron asmahannif@gmail.com Baharudin Abdullah asmahannif@gmail.com Faezatul Arbaeyah Hussain asmahannif@gmail.com <p>Tumors of the paranasal sinuses are rare. Usually, patient’s presents at an advanced stage of the disease as the initial symptoms are nonspecific and the tumour remains indolent from any months or even years, leading to not only delay in diagnosis but a conundrum in diagnosing this entity. Herein we are reporting a case of sinonasal carcinoma in a gentleman which was initially diagnosed as invasive fungal sinusitis. Patient’s initial presentation as well as the radiological investigation led towards the diagnosis of chronic invasive fungal sinusitis. The histopathological examination of the lesion was suggestive of sinonasal carcinoma. We would like to highlight the challenge in diagnosis as well as the management of this entity.</p> 2019-09-21T22:31:44+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2088 Successful Treatment of Infection-Triggered Acute Exacerbation of Idiopathic Pulmonary Fibrosis with Corticosteroids Combined with Macrolides 2019-10-01T08:17:32+03:00 Masashi Ohe oektsp1218@sweet.ocn.ne.jp Katsura Nagai katnagai@kme.biglobe.ne.jp Ken Furuya k-furuya@phoenix-c.or.jp Houman Goudarzi houman@pop.med.hokudai.ac.jp Satoshi Hashino shashino@med.hokudai.ac.jp Mitsuru Munakata munakata@fmu.ac.jp <p>Idiopathic pulmonary fibrosis (IPF) is a chronic progressive interstitial pneumonia (IP) with poor prognosis. Acute exacerbation (AE) of IPF (AE-IPF) has a substantial and sometimes fatal impact on prognosis. An effective pharmaceutical treatment for AE-IPF is lacking. Macrolides (MACs) have an anti-bacterial activity and anti-inflammatory effects, and IPF treatment with these agents has been recently reported. This report describes a case of infection-triggered AE-IPF treated with corticosteroids (CSs) combined with MACs. A 61-year-old male patient suffering from IPF previously treated with methyl-prednisolone (mPSL) (8 mg/day) was admitted because of fever, dry cough, and dyspnea. Reticular opacities (RO) on chest roentgenogram and ground-glass opacities (GGO) on high-resolution computed tomography (HRCT) exacerbated. The patient was diagnosed with influenza A and influenza A-triggered AE-IPF and was treated with peramivir and mPSL (1 g/day) for 3 days. RO on chest roentgenogram further exacerbated, prompting the addition of erythromycin (EM), in consideration of its anti-inflammatory effects. Thereafter, the patient was successfully treated with mPSL or PSL combined with EM. During the clinical course, he experienced cytomegalovirus (CMV)-induced IP and/or CMV-triggered AE-IPF, being successfully treated with ganciclovir and mPSL or PSL combined with EM. Thereafter, the patient was treated with CSs combined with EM or clarithromycin. Approximately 3 months after initiating EM, RO on chest roentgenogram and GGO on HRCT considerably improved. This case shows that treatment with CSs combined with MACs may be effective in some cases of infection-triggered AE-IPF.</p> 2019-09-21T22:32:13+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2117 Nadir Bir Koroner Arter Anomalisi: Sağ Sinüs Valsalva Çıkımlı Tek Koroner Arter 2019-10-01T08:17:32+03:00 Koray Kılıç koraykilic@yahoo.com Oğuzhan Türksayar oguzhanturksayar@gmail.com Gonca Erbaş gerbas@yahoo.com Burak Sezenöz drburaksezenoz@gmail.com <p>Koroner arter anomalileri konjenital kalp hastalıklarının nadir formlarındandır. Koroner anjiyografi yapılan popülasyonda %1-2 oranında görülmekte olup pek çok alt grubu tanımlanmıştır. Alt gruplar çeşitli araştırmacılar tarafından farklı şekillerde sınıflandırılmıştır. Koroner BT anjiografi, koroner arter anomalilerini saptamada oldukça etkin bir yöntemdir. Bu olgu bildiriminde sağ sinüs Valsalvadan çıkan sol koroner arterde seyir anomalisi olan bir hastanın koroner BT anjiografi bulguları sunulmaktadır.</p> 2019-09-21T00:00:00+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2148 Follow-Up Study of Follicular Lymphoma (FL) Treated Using Clarithromycin: Intravenous Erythromycin Combined with Prednisolone Treatment is Effective for Refractory FL Accompanied with an Ocular Lesion 2019-10-01T08:17:32+03:00 Masashi Ohe oektsp1218@sweet.ocn.ne.jp Haruki Shida hshida@med.hokudai.ac.jp Yoshihiro Kusunoki y.kusu@med.hokudai.ac.jp Satoshi Jodo jfamily@dia-net.ne.jp Ken Furuya k-furuya@phoenix-c.or.jp <p>A 44-year-old man who presented lymphadenopathy was diagnosed with follicular lymphoma (FL). He was treated with rituximab, cyclophosphamide (CPM), doxorubicin, vincristine, and prednisolone (PSL), which resulted in a stable disease. The patient’s subsequent clinical course included partial remission and stable disease, each of which was treated by chemotherapy. At the third regrowth of the tumor, however, the patient was diagnosed with leukocytopenia and could not undergo further chemotherapy. Regression of his lymphadenopathy occurred following treatment with clarithromycin (CAM), which has anti-lymphoproliferative effects. CAM was continued with good outcome and then CAM was tentatively discontinued. Invasion of the lymphoma cells into the thoracic vertebrae occurred and was successfully treated by radiotherapy. Thereafter, he was successfully treated with CAM combined with PSL and CPM. At 57 years of age, he developed pancytopenia owing to therapy-related myelodysplastic syndrome; consequently, CPM was discontinued. Treatment with CAM combined with PSL was continued successfully. However, 15 months later, he complained of exophthalmos. Magnetic resonance imaging revealed a right orbital lesion. As an alternative to CAM combined with PSL, treatment with intravenous EM combined with PSL was used successfully. This case shows that treatment with intravenous EM combined with PSL may be effective in some cases of refractory FL.</p> 2019-09-21T22:33:31+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2053 Comments on ‘A Lesson to Learn in an Iatrogenic Perforation of Sigmoid Volvulus after Endoscopic Derotation’ 2019-10-01T08:17:33+03:00 Sabri Selcuk Atamanalp ssa@atauni.edu.tr <p>Sigmoid volvulus is the wrapping of the sigmoid colon around itself causing an intestinal obstruction. The initial treatment of the disease is endoscopic derotation in uncomplicated and non-gangrenous patients. To prevent a recurrence in successfully derotated cases, some practitioners apply an anal tube, which may cause some complications including bowel perforation. I comment about a paper, which presented a case of a successful endoscopic derotation of sigmoid volvulus with iatrogenic bowel perforation due to anal tube.</p> 2019-09-21T22:39:49+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2010 Partial Sternotomy Technique Allows Use of Intraoperative Flexible Bronchoscope for Tracheomalacia Diagnosis 2019-10-01T08:17:33+03:00 Zafer Turkyilmaz zafertrk@yahoo.com Ramazan Karabulut ramazank@gazi.edu.tr Ebru Ergenekon ebruergenekon@gmail.com Gokcen Emmez gokcenemmez@yahoo.com Berrin Isik berrinisik@gazi.edu.tr Ibrahim Hirfanoglu imhirfanoglu@yahoo.com Teymursah Muradi timur_muradi@hotmail.com Melda Tas tasmelda@gmail.com Aysegul Simsek aisegul.simsek@hotmail.com Kaan Sonmez kamez@yahoo.com <p>Tracheomalacia(TM) &nbsp;is a structural abnormality of the tracheal cartilage causing collapse of its walls and airway obstruction.&nbsp; We describe herein a &nbsp;4 month–old case of TM associated with &nbsp;operated esophageal atresia with tracheoesophageal fistula. Intraoperative flexible&nbsp; bronchoscope was performed&nbsp; for&nbsp; diagnosis for TM&nbsp;&nbsp;&nbsp;&nbsp; during aortopexy operation &nbsp;via partial sternotomy .</p> 2019-09-21T22:33:59+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2047 Impact of Sleep, Sleep Loss and Recovery Sleep on Immunity 2019-10-01T08:17:33+03:00 Fathia Hussien Mohamed kozomoahmed121@gmail.com Cigdem Ozer ozercigdem@yahoo.co.uk <p>Sleep is a naturally, restorative process, characterized by altered consciousness. Normal sleep and circadian system act as important physiological regulator on immune functions, these regulation&nbsp;&nbsp; mediated by neurotransmitters, hormones and cytokines signals which support relation between the immune system and central nervous system. Various immune parameters in peripheral circulation show Diurnal changes over the day, these changes under effect of the 2 main stress systems, the sympathetic nervous system(SNS) and the hypothalamo pituitary adrenal (HPA) axis, changes occurring in immune parameters over the 24‐h during the sleep–wake cycle categorized to nocturnal Proinflammatory and daytime anti-inflammatory activity. In addition to its effects on cognitive function, compelling evidence links sleep loss to alterations in the neuroendocrine, immune and inflammatory systems. sleep deprivation&nbsp; either in partial sleep deprivation or total sleep deprivation as a stressful status enhances the adrenergic tons that affects innate and adaptive immunity, with increasing susceptibility to infections and immune-related diseases. Several studies have shown negative effects of sleep deprivation on all functions of the body and its effect on the immune system this review aims to explain the changes occurring in immune parameters and inflammatory cytokines over the 24‐h during the normal sleep–wake cycle and during sleep disturbance and benefit of sleep recovery(napping) to recede these physiological changes that resulting from sleep deprivation.</p> 2019-09-21T22:40:25+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2114 Principles, Domains and Processes of HIT Governance Frameworks: A Systematic Review 2019-10-01T08:17:33+03:00 Farahnaz Sadoughi FarahnazSadoughi@gmail.com Nasrin Davaridolatabadi FarahnazSadoughi@gmail.com Maryam Ahmadi FarahnazSadoughi@gmail.com Mehraban Shahi FarahnazSadoughi@gmail.com <p><strong>Introduction</strong>: IT governance points out how to manage IT and align the decisions related to IT with processes, resources, and responsibilities within the organization. This study was conducted aimed at a review of studies on the principles, domains, and processes of IT governance framework.</p> <p><strong>Method: </strong>This is an applied study that was carried out in the qualitative method of systematic review. The study population consisted of all English articles indexed in scientific databases and electronic journals available. 36 eligible articles from among the articles reviewed entered the study and the data desired were collected through data extraction form and search strategy and analyzed using content analysis.</p> <p><strong>Results</strong>: Results showed that among 36 articles, four of the articles dealt with principles, 33 articles with domains, and 24 articles with processes of IT governance frameworks. These principles are related to IT frameworks of ISO 38500, ITIL V3, TOGAF, Prince 2, COBIT, Val IT. The domains included frameworks of CMMI, ITIL, PMBOK, COBIT, ISO 27001, COSO, Val IT, P2CMM. The processes also referred to the frameworks of Val IT, P2CMM, COBIT, ISO 27001 and 27000, ITIL, PMBOK and CMMI<strong>.</strong></p> <p><strong>Conclusion: </strong>Based on this information and an overview of the principles, domains, and processes of the frameworks obtained in this study, the managers and officials of <u>hospitals'</u> IT units can specify an appropriate governance framework for IT Service Management, method improvement of processes, probable risks management and project management.</p> 2019-09-21T22:40:51+03:00 Copyright (c) 2019 Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2147 Rewarding Conversation Between Oocyte and Cumulus Cells Directs the Process of Folliculogenesis 2019-10-01T08:17:33+03:00 Duygu Dayanır duygudayanir@yahoo.com.tr Halil Ruso halil.ruso1@gmail.com Ziya Kalem ziyakalem@hotmail.com Timur Gürgan tgurgan@gurganclinic.com.tr Candan Özoğul ozogulcandan@gmail.com <p>The process of folliculogenesis needs a balanced environment to create a mature oocyte that is expected to have characteristics in order to form the ability of a healthy fertilisation. Previous studies have been focused on endocrine effects of hypothalamic–pituitary system on ovarian functions. Influences of this system have been studied for many years. Besides of extra-ovarian factors, recent studies have focused on intraovarian factors which forms the relationship between oocyte and cumulus cells. It has been shown that even the maturity of antral follicule and oocyte has been effected from this communication. These factors which takes part at process of folliculogenesis, were shown to be efficient even at the success of assisted reproductive technologies. We studied general lines of this conversation based on main research articles that continue to be relevant at this topic.</p> 2019-09-21T22:41:18+03:00 Copyright (c) 2019 Gazi Medical Journal