Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ Gazi University Medical Journal en-US Gazi Medical Journal 1300-056X <p>All opinions and reports within the articles that are published in the Gazi Medical Journal are the personal opinions of author(s). Gazi University, Editors and the publisher do not accept any responsibility for these articles. The journal is printed on acid-free paper.</p> The Effects of Memantine after Propofol Anaesthesia to Recovery on Cognitive Functions and Pain in Streptozotocin Induced Diabetic Rats http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1542 <p><strong>Objective:</strong> The aim of this study is to research the neurocognitive, neuroprotective and analgesic effects of the memantine in diabetic rats after anaesthesia.&nbsp; Postoperative cognitive dysfunction is a frequent complication after anaesthesia. Although the reason of this hasn’t been explained completely, there are numerous risk factors such as the increase of cognitive dysfunction during postoperative period. Being in older age, coexisting diseases, etc. are among these risk factors. Propofol, one of the anaesthetic agents, is an agent causing the postoperative cognitive dysfunction.Memantine has beneficial effects on memory deficits and learning process. Additionally, it is an agent which also has neuroprotective effects, and is used for the treatment of chronic pain syndromes. In this study, we aim to determine its effects on recovery, cognitive functions and pain of memantine after propofol anaesthesia.</p> <p><strong>Materials and Methods: </strong>Thirty Wistar rats were divided into 5 groups randomly. 0,9 % NaCl (1ml i.p.) were given to Group C on 31st day after normal nutrition period during 30 days. 0,9 % NaCl (1ml i.p.) was given to Group DC on 31st day after normal nutrition period during 30 days. 0,9 % NaCl (1ml i.p.) was given to Group DM on 31st day after oral memantine treatment (20 mg/kg/day) during 30 days. Propofol (150 mg/kg i.p.) was given to Group DP on 31th day after normal nutrition period during 30 days. Propofol (150 mg/kg i.p.) was given to Group DPM on 31th day after oral memantine treatment (20 mg/kg/day) during 30 days. Recovery, cognitive function and the pain level of the rats are evaluated with “tail pinch”, “Radial Arm Maze” and “hot-plate” respectively.</p> <p><strong>Results: </strong>Recovery durations of the rats in Group DMP were shorter than rats in Group DP (p&lt; 0,0001). Hot-plate values were significantly longer than control values in all groups, except for Group C, when compared in-group (p&lt;0,05).</p> <p><strong>Conclusion: </strong>In conclusion, this study showed that memantine has beneficial effects on recovery, cognitive functions and pain after propofol anaesthesia in diabetic rats. <strong>&nbsp;&nbsp;</strong></p> Erdal Çiçek Ömer Kurtipek Mustafa Arslan Yusuf Ünal Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Early Cardiovascular Evaluation after Methylphenidate in Children with Attention-Deficit Hyperactivity Disorder http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1599 <p><strong>Objective</strong>: Rare cardiovascular side effects may be observed in patients after treatment with methylphenidate for Attention Deficiency and Hyperactivity Disorder (ADHD). In this study, we aimed to evaluate the cardiac effects of methylphenidate before and after treatment in our center in children with ADHD.</p> <p><strong>Method</strong>: This study included 253 ADHD patients who underwent methylphenidate treatment and involved a retrospective comparison of their demographic data, heart rate, systolic, diastolic blood pressure, corrected QT (QTc) interval with electrocardiography and echocardiographic examinations from before and two weeks after treatment.</p> <p><strong>Results: </strong>The median age of the patients was 11.8 ± 3.3 years, palpitations were observed in 18 (7%) patients, and blood pressure elevation was observed in 5 (1.9%) patients after methylphenidate treatment. Sinus tachycardia was observed in all patients with palpitation symptoms, and echocardiography revealed an atrial septal defect in four patients, valvular pulmonary stenosis in two patients, ventricular septal defect and patent ductus arteriosus in one patient. No significant difference in heart rate, systolic and diastolic blood pressure values were identified after treatment. Although the QTc intervals recorded after treatment were significantly longer, these values did not exceed pathological levels.</p> <p><strong>Conclusion: </strong>The findings of evaluations of children with ADHD after methylphenidate treatment vary according to the characteristics of the patients. Patients with structural heart disease or with arterial hypertension should be monitored more carefully before the use of methylphenidate in the diagnosis of ADHD. Our findings suggests that both blood pressure measurement and electrocardiographic assessment appear to be useful and appropriate in the detection of side effects after methylphenidate treatment.</p> Erman Çilsal Eray Yurtçu Aygül Elataş Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Radyofrekansın Hipertansif ve Normal Sıçanlarda Duktus Epididimis Üzerine Etkileri http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1642 <p><strong>Amaç:</strong> Çalışmamızda 2100 MHz &nbsp;radyofrekans&nbsp; (RF)’ın hipertansif ve normotensif sıçanlarda ki androjen reseptör dağılımına etkilerinin histokimyasal ve immünohistokimyasal yöntemlerle belirlenmesi amaçlanmıştır.</p> <p><strong>Yöntem:</strong> 24 Wistar albino cinsi erkek sıçan 4 gruba ayrıldı. Kontrol grubuna 1 ml/gün/1 ay çeşme suyu gavaj ile verildi. Deneysel hipertansiyon grubuna 60 mg/kg L-NAME (çeşme suyunda çözünmüş) gavaj ile 1 ay süresince uygulandı. RF grubu 2 ay süresince 60 dk/5 Gün/2100 MHz radyofrekans uygulandı. Deneysel hipertansiyon modeli oluşturulan ve radyofrekans uygulanan gruba ise 1 ay süre ile 60 mg/kg L-NAME gavaj ile verildi ve 2 ay süresince 60 dk/5 Gün/2100 MHz radyofrekans dalgaboyuna maruz bırakıldı. Deney bitiminde deneklerin duktus epididimis dokularına Masson’s Trikrom ve Androjen Reseptör (AR) boyamaları uygulandı.</p> <p><strong>Bulgular:</strong> Histokimyasal boyamalarda, hipertansiyon grubunda tübül epitel hücrelerinde stereosilyalarda silinme ve spermiyum miktarında azalma görülürken, radyasyon grubunda stereosilya yapılarının pinopod şeklinde düzenlenim gösterdiği tespit edildi. Her iki uygulamanın birlikte yapıldığı grupta ise tübül epitel hücrelerinde yoğun dejenerasyon ve baş/kuyruk anomalisi gösteren spermiyumlar izlendi. AR immünohistokimyasal boyamalarında hipertansif sıçanlarda tutulumun yoğun olduğu, buna karşılık her iki uygulamanın birlikte yapıldığı grupta tutulumun zayıfladığı görüldü.</p> <p><strong>Sonuç</strong>: Hipertansiyon ve 2100 MHz RF maruziyetinin sıçan duktus epididimisinde belirgin hasara neden olduğu ve AR dağılımını olumsuz etkilediği belirlendi</p> Gökçe Nur Arık Dilek Kuzay Cemile Merve Seymen Çiğdem Özer Tayfun Göktaş Bahriye Sirav Aral Fatih Şentürk Gülnur Take Kaplanoğlu Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Gestasyon Haftasına göre Düşük Doğum Ağırlığı olan Prematüre İnfantlarda Kantitatif Ultrasonografi ile Kemik Mineral Dansitesinin Değerlendirilmesi http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1710 <p><strong>Amaç:</strong> Gestasyon haftasına göre düşük doğum ağırlıklı (SGA) ve normal doğum ağırlıklı (AGA) preterm yenidoğanların kantitatif ultrasonografi ile seri olarak ölçülen tibial kemik ses hızı (SOS) değerlerinin karşılaştırılmasıdır.</p> <p><strong>Gereç ve Yöntemler:</strong> 24-35 gestasyon haftasında doğup, kemik mineral dansitesi postnatal 1. haftadan itibaren seri tibial SOS ölçümüyle değerlendirilen preterm yenidoğanların klinik ve laboratuvar verileri retrospektif olarak incelendi.</p> <p><strong>Bulgular:</strong> Postnatal 1 haftalıkken tibial SOS ölçümü yapılmış olan 44’ü AGA, 23’ü SGA olan toplam 67 preterm yenidoğan çalışmaya alındı. Çalışmaya alınan bu yenidoğanların 50’sinin üçüncü hafta, 31’inin altıncı hafta seri tibial SOS ölçümleri de mevcuttu. SGA ve AGA yenidoğanların doğum ağırlığı sırasıyla 1341±299 gr - 1359±457 gr (p = 0.59), gestasyon haftası 33.8±2.6 hafta – 29.8±3.1 hafta (p &lt;0.001) bulundu. SGA-AGA olma ve gestasyon haftasının tibial SOS değerlerine etkisi univariate analiz ile incelendi, SGA ve AGA gruplarda tibial SOS değerleri sırasıyla birinci hafta 3051±169 m/s - 2915±116 m/s (p = 0.09), üçüncü hafta 3017±180 m/s - 2906±124 m/s; (p = 0.57) ve altıncı hafta 2977±152 m/s - 2882±103 m/s (p = 0.38) bulundu.</p> <p><strong>Sonuç:</strong> Çalışmamızda postnatal birinci, üçüncü ve altıncı hafta tibial SOS değerleri&nbsp; AGA ve SGA preterm yenidoğanlarda benzer bulundu. Bu konuyla ilgili net bir sonuç çıkartabilmek için prospektif, örneklem sayısının uygun olduğu ve prenatal risk faktörlerinin eşleştirildiği preterm SGA ve AGA yenidoğanlarda seri tibial SOS ölçümlerinin&nbsp; değerlendirildiği çalışmalara ihtiyaç vardır.&nbsp;</p> Sabriye Korkut Ahmet Özdemir Levent Korkmaz Osman Baştuğ Hülya Halis Tamer Güneş Mehmet Adnan Öztürk Selim Kurtoğlu Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Effect of Dexmedetomidine on Lung Tissue Lower Extremity Ischemia Reperfusion Injury in Streptozotocin Induced Diabetic Rats http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1724 <p><strong>Objective: </strong>The aim of our study was to investigate the effects of dexmedetomidine on lung tissue in rat’s lower extremity after undergoing an ischemia reperfusion (I/R) injury.</p> <p><strong>Material and methods: </strong>After obtaining ethical committee approval, 24 Wistar albino rats (200-270 gr) were randomly divided into four groups: (Control (Group C), diabetes-control (Group DC), diabetes I/R (Group DIR), and diabetes-I/R-dexmedetomidine (Group DIRD). In diabetes groups, single-dose (55 mg/kg) streptozotocin was administered intraperitoneally. Rats with a blood glucose level above 250 mg/dl at the 72nd hour were accepted as diabetic. At the end of four weeks, laparotomy was performed in all rats. Nothing else was done in Group C and DC. In Group DIR, ischemia reperfusion was produced via two-hour periods of clamping and subsequent declamping of infra-renal abdominal aorta. In Group DIRD, 100 μg/kg of dexmedetomidine were administered intraperitoneally.</p> <p><strong>Results: </strong>When the groups’ lung tissue neutrophil infiltration/aggregation light microscopic findings were compared to each other, a significant difference was observed among the groups (p=0.003). When the groups’ lung tissue injury score light microscopic findings were compared, a significant difference was observed among the groups (p=0.001). When groups were compared to each other in terms of lung tissue MDA levels and SOD activities, a significant difference was observed (p=0.002, p=0.018, respectively).</p> <p><strong>Conclusion: </strong>Our results confirm that dexmedetomidine has protective effects against the lung damage resulting from IR in diabetic rats. However, future studies should be conducted to evaluate these effects.</p> Şaban Cem Sezen İlknur Aytekin Çelik Muhammed Enes Aydın Naciye Türk Özterlemez Mustafa Arslan Meral Erdal Erbatur Mustafa Kavutçu Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Vitamin D Deficiency and Its Correlation with Coronary Artery Ectasia http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1726 <p><strong>Objectives:</strong> Vitamin D plays a pivotal role in cardiovascular system and its deficiency is related to various of cardiovascular disorders. We investigated the association between serum vitamin D level and coronary artery ectasia formation.</p> <p><strong>Methods:</strong> Our study included 45 patients with coronary artery ectasia and 55 patients with normal coronary artery. Vitamin D and parathyroid hormone levels were obtained before coronary angiography.</p> <p><strong>Results:</strong> Baseline characteristic features were similar between groups. The Vitamin D levels and serum calcium levels were significantly lower in the coronary artery ectasia group compare to control group (respectively; 15.6 ng/ml vs. 12.0 ng/ml; p=0.002 and 9,52 vs. 9.0 ; p&lt; 0.001). PTH level of CEA patients were higher than the control group (44.0 pg/ml vs. 29.5 pg/ml; p=0.018).</p> <p><strong>Conclusion:</strong> Our results showed a significant inverse correlation between Vitamin D deficiency and coronary artery ectasia.<strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong></p> Burak Sezenöz Yakup Alsancak Emrullah Kızıltunc Selcuk Ozkan Atiye Cengel Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Dinoprostone Versus Double Balloon Catheter for Cervical Ripening in Patients with Isolated Oligohydramnios http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1752 <p><strong>Objective:</strong> To compare the labor characteristics and neonatal outcome of dinoprostone vaginal insert and double balloon catheter in pregnancies with isolated oligohydramnios at term.</p> <p><strong>Methods:</strong> All pregnant women with isolated oligohydramnios and immature cervix at term that underwent labor induction with either the dinoprostone vaginal insert or double balloon catheter between 08 September 2016 and 08 September 2017 at a tertiary centre were included in the study. Data regarding the characteristics of parturition, including the period of time from insertion of the ripening agent to vaginal delivery, caesarean section rate, distribution of caesarean indications, need for augmentation, change in haemoglobin, new-born birth weight, meconium-stained amniotic fluid, 5-minute Apgar score and neonatal intensive care unit admission, were extracted from medical records.</p> <p><strong>Results: </strong>The cesarean section rates were 29% versus 48.8% in the dinoprostone and balloon catheter groups, respectively (p = 0.03). The other intrapartum, postpartum characteristics and neonatal outcome were comparable between groups.</p> <p><strong>Conclusion: </strong>Dinoprostone vaginal insert is a more efficient way of cervical ripening compared to the double balloon catheter in patients with isolated oligohydramnios. Both agents are comparable for neonatal outcome.</p> Funda Akpinar Orhan Altınboğa Ertuğrul Karahanoğlu Tuğba Kınay Runa Özelçi Şafak Özdemirci Sertaç Esin Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Knowledge of Emergency Medicine Physicians about Local Anesthetic Toxicity and Intravenous Lipid Treatment http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1782 <p><strong>Objective:</strong> To evaluate the knowledge of emergency medicine doctors regarding local anesthetic systemic toxicity (LAST) and intravenous lipid emulsion (LE) used in treatment, and to raise awareness of this issue.</p> <p><strong>Materials and Methods:</strong> A questionnaire consisted of 17 questions about demographics, local anesthetic (LA) use, toxicity, and treatment methods was administered to emergency medicine doctors working at different hospitals.</p> <p><strong>Results:</strong> 181 doctors were included in this survey. Most of the (137 participants, 75.7%) participants were working in state hospitals. Professional experiences of the participants varied. The majority of participants (103 participants, 56.9%) stated that they had not received any training about the use of LAs during their education. Lidocaine was the most preferred local anesthetic agent (75.5%). Majority of the participants stated that their knowledge about the LAs they used was insufficient. Forty-one (22.7%) participants answered that they know the indications and route of LE administration. Nine (5%) participants reported that they have encountered LA toxicity and have used LE. One hundred eighteen participants (65.2%) stated that they do not have LE in their emergency department.</p> <p><strong>Conclusion:</strong> Knowledge about the&nbsp; LA toxicity&nbsp; and&nbsp;&nbsp; lipid &nbsp;emulsion&nbsp; usage&nbsp; in the treatment of LAST is insufficient among emergency doctors. More efforts must be made to improve this issue.</p> Özlem Güler Hakan Hakkoymaz Fatih Nazmi Yaman Evren Ekingen Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 A Method to Find out Perceptional Sound Composition of the Vowels in the Contemporary Turkey Turkish http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1808 <p><strong>Objective: </strong>The speech sounds are used in audiology and audio-verbal therapy. Perception of speech sounds is related with their acoustic properties and inner ear physiology. Therefore, a perceptional aspect of the acoustic content should not be overlooked. In this study, we evaluated linear and perceptional changes in the vowels’ sound content at and over the comfortable hearing level according to dBA-filter.</p> <p><strong>Methods:</strong> Recordings of 8 vowels (&lt;a, e, i, ı, o, ö, u, ü&gt;) of the contemporary Turkey Turkish were filtered by a dBA-filter. Then linear frequency data (Hz) of both original and dBA-filtered files were analyzed for fundamental frequency (F0) and formants (f1 to f5) by Praat; subsequently, the data were transferred to the perceptional range (Critical Bark Bands, CBB).</p> <p><strong>Results: </strong>Our data demonstrated that linear values of F0 and f4,5 did not reveal any relationship with vowels, while f1-3 presented phoneme-specific patterns. dBA-filtering did not affect linear data of f3,4 (&lt;u&gt; was the only exception) and f5. Linear f1values were increased by dBA-filter (particularly in &lt; ı,u,ü&gt;). f2 of &lt;ı, u&gt; presented major deviations. Vowels’ CBB-changes were evident in f1 (the only exception was &lt;e&gt;), and it was evident in only f2 of &lt;ı, u&gt;.</p> <p><strong>Conclusion:</strong> It is apparent that speech sound content at and over the comfortable hearing level stimulates higher frequency bands than found in original voice. Only &lt;e&gt; presented no perceptional change while major changes were particularly seen in &lt;ı, u&gt;. Thus, we could pronounce that perceptional aspect by dBA-filter would provide us with a new perspective for understanding the results of speech tests.</p> Yusuf Kemal Kemaloğlu Güven Mengü Çağıl Gökdoğan Alper Kutalmış Türkcan Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Could We Reduce Unnecessary Colposcopic Examinations? http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1838 <p><strong>Objective:</strong> We assessed outcomes of biopsies due to colposcopic examination because of abnormal pap smear or positive HPV test and we reviewed our approach to cervical intraepithelial lesions in the light of the literature.</p> <p><strong>Methods:</strong> This was a retrospective study involving 115 women who underwent colposcopy with positive HPV test or abnormal pap smear results in Amasya University gynecology policlinic from January 2017 to June 2018. Demographic data, colposcopy indications, HPV genotypes, cytology and biopsy results were assessed. All data were calculated with SPSS (Version 22.0, SPSS Inc., Chicago, IL, USA) for statistical analysis. Relationships between categorical variables were assessed by Fisher's Chi-square test (Fisher's Exact test). Statistical significance was accepted as p &lt;0.05.&nbsp;</p> <p><strong>Results:</strong> The median age of the colposcopy performed population was 45 (30-65 years). The rates of high risk HPV genotypes 16, 18, 16/18 and non-16/18-HPV were found to be 28.7%, 15.6%, 10.4% and 48.7%, respectively. The rates of pap-smear cytology; ASC-US, LG-SIL and HG-SIL were found to be 30.4%, 9.6% and 6.1%, respectively. The rates of colposcopic biopsy results LG-SIL and HG-SIL were found to be 20% and 9.6%. There was no relationship between the groups of HPV genotypes and pap-smear results (p&gt;0.05). HG-SIL histopathology was frequently detected with HPV-16 genotypes. When the number of punch biopsies increased, high-grade lesions were identified greatly (p=0.01).</p> <p><strong>Conclusion:</strong> The number of unnecessary colposcopic examinations and colposcopy induced biopsies could be reduced without fear of kidnapping the diagnosis of cervical cancer.</p> Banuhan Şahin Pervin Karlı Osman Fadıl Kara Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 The Prevalence and Predicting Factors of Female Child Marriage in North-West of Iran: A Case-Control Multi-Center Study http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1851 <p><strong>Objective</strong><strong>:</strong> Child marriage which violates the human rights is still a prevalent problem in South Asia where more than half of the teenage marriages occur. It is estimated that in developing countries one in three girls marries before the age of 18 and one in seven marries before 15. In this study we aimed to determine the prevalence of child marriage and identify potential factors predicting its occurrence.</p> <p><strong>Methods: </strong>This case-control study was carried out at the premarital counseling centers in Tabriz city. The participants consisted of 1532 subjects (766 couples) with 140 couples as the case group. Univariate and multivariate logistic regression models were used to calculate the odds ratios (OR) and 95% confidence intervals (CI).</p> <p><strong>Results: </strong>In one year period the prevalence of child marriage (before the age of 18) was 18.2% while in 8.12% of all marriages the age of bride was under 16 (fifteen years old or younger). We found that lower education and level of knowledge about the impacts of child marriage were independent predictors of early marriage. In consanguineous marriages the risk of child marriage was 95% higher compared to the control group (OR: 1.95; 95% CI: 1.23-3.09).</p> <p><strong>Conclusion: </strong>It seems necessary to implement targeted preventive interventions, including educational programs to increase the public awareness about the social, physical, and fiscal consequences of early marriage, delivering skills to empower girls in deciding for their lives, and developing educational and occupational opportunities for young girls.</p> Fariba Heidari Saeed Dastgiri Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Hipertansif, Pre-Hipertansif ve Kontrol Grupları Arasında Epikardiyal Yağ, Karotis ve Femoral İntima-Media Kalınlıklarının Karşılaştırılması http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2168 <p><strong>Giriş: </strong>Bu çalışmanın amacı pre-hipertansiyonun kardiyovasküler risk oluşturup oluşturmadığını değerlendirmekdir. Bu amaçla birer ateroskleroz ve kardiyak risk göstergesi olan epikardiyal yağ kalınlığı (EYK), karotis intima-media kalınlığı (KIMK) ve femoral intima-media kalınlığı (FIMK) hipertansif, pre-hipertansif ve sağlıklı populasyonda&nbsp; ölçülerek karşılaştırılmıştır.</p> <p><strong>Yöntem:&nbsp; </strong>Çalışma kesitsel olarak planlandı. Sistolik kan basıncının (SKB) 120-140 ve diyastolik kan basıncının (DKB) 80-90 mmHg arasında olması pre-hipertansiyon, SKB&gt;140 ve/veya DKB&gt;90 mmHg olması ise hipertansiyon olarak tanımlandı. Sağlıklı gönüllüler 1.gruba (57 birey), pre-hipertansiyonu olanlar 2. gruba (58 hasta), hipertansiyonu olanlar ise 3. gruba (56 hasta) alındı. EYK, KIMK ve FIMK her 3 grupta ölçülerek aralarında istatistiksel anlamlı fark olup olmadığı araştırıldı.</p> <p><strong>Bulgular: </strong>EYK 3 grup arasında karşılaştırıldığında arada istatiksel anlamlı fark olduğu görüldü (p&lt;0,001). Ayrıca, 2. ile 1. gruplar arasında ve 3. ile 2. gruplar arasında da istatistiksel anlamlı fark vardı (p&lt;0,001, her iki değerlendirme için). KIMK yönünden 3 grup arasında istatistiksel anlamlı fark bulundu (p&lt;0,001). Benzer olarak 2. ile 1. gruplar arasında, ve 3. ile 2. gruplar arasında da istatistiksel anlamlı fark vardı (p&lt;0,001, her iki değerlendirme için). FIMK her 3 grup arasında istatistiksel anlamlı olarak farklıydı (p&lt;0,001). 2. ile 1. gruplar arasında anlamlı fark bulunamazken, 3.ile 2. gruplar arasında anlamlı fark vardı (p=0,773 ve p=0,001, sırasıyla)</p> <p><strong>Sonuç:</strong> Bu sonuçlar bize indirekt olarak pre-hipertansif hastalarda subklinik ateroskleroz ve kardiyovasküler risklerin artmış olabileceğini düşündürebilir. Bununla beraber karotis arterlerdeki ateroskleroz femoral arterlerdeki ateroskleroza göre kan basıncından daha düşük değerlerde etkileniyor olabilir.</p> Aylin Güneşli Mustafa Yılmaz Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 The Relationship between Pain and ABO Blood Type During Saphenous Vein Ablation using N-Butyl Cyanoacrylate http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2275 <p><strong>Aim: </strong>The aim of this study was to investigate whether there is a relation between ABO blood groups and pain levels during venoblock procedure to vena saphena magna using N-butyl cyanoacrylate (NBCA), as well as need of analgesics in the postoperative period in patients with venous insufficiency.</p> <p><strong>Materials and Methods: </strong>Fifty patients from each of the A, B, AB and O blood groups were included in the study. The severity of pain during ablation with NBCA was measured using the Visual Analogue Scale (VAS) score. In addition, all patients were asked how many days they used analgesics after the procedure at the fifth day visit. VAS scores and postoperative analgesic requirements were evaluated according to ABO blood groups.</p> <p><strong>Results: </strong>Both VAS scores and the days of analgesics need after procedure in the B and AB blood groups were significantly higher than in the A and O blood groups (p &lt;0.001), however, were not different between B and AB blood groups. They were significantly higher in blood group 0 were than in blood group A (p &lt;0.001) but were significantly lower thanB and AB blood groups (p &lt;0.001). The VAS scores and days of analgesics need of patients with A blood group were the lowest among all blood groups (p &lt;0.001).</p> <p><strong>Conclusion: </strong>We demonstrated that pain levels occurred during venablock procedure and postoperative analgesic need were related to ABO blood group. Accordingly, the relationship between pain and blood group may contribute to pain management for both diagnostic and therapeutic purposes.</p> Mehmet Kirişci Gökçe Gişi Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 İzole Off-Pump Koroner Arter Bypass Sonrası Yeni Başlangıçlı Atrial Fibrilasyon Gelişiminde Preoperatif D Vitaminin Etkisi var mıdır? http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2337 <p><strong>Introduction:</strong> The aim of our study is to determine whether there is a relationship between preoperatively measured vitamin D, postoperative development of AF and early adverse events and vitamin D in patients with isolated off-pump coronary artery bypass.<br><strong>Method:</strong> Fifty five consecutive patients who underwent off-pump coronary bypass in our hospital were included prospectively. Patients were divided into two groups group 1 (n = 44) as patients who developed AF at any time within the first five days after the operation.and group 2 non-AF (n = 11). Two groups were examined in terms of preoperative blood vitamin D levels, postoperative AF and postoperative complications.<br><strong>Results:</strong> There was no significant difference between the two groups in terms of preoperative vitamin D values ​​(P = 0.850). In terms of postoperative complications, there was no difference between respiratory problem, pleural effusion, wound infection, stroke, dialysis due to kidney failure and mortality (p&gt; 0.05). In addition, no difference was found between vitamin D and postoperative complications.<br><strong>Conclusion:</strong> In our study for the first time in the literature, it was examined whether there was a relationship between preoperative vitamin D levels and AF development after off-pump coronary bypass. In our study, which was about 1 year and involving all seasons, there was no significant relationship between vitamin D and postoperative AF.</p> Murat Gunday Kazım Körez Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Neurofibromatosis Type 1 Molecular Diagnosis in Turkish Patients http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2430 <p>Neurofibromatosis type 1 (NF1) is a rare autosomal dominant, hereditary tumor-predisposition disorder.&nbsp; NF1 is characterized by multiple cafe-au-lait spots, multiple cutaneous neurofibromas, freckling in the axilla and inguinal area and iris Lish nodules. The prevalence is approximately 1 in 3000 individuals worldwide. In the present study, we aimed to detect the NF1 gene alterations in Turkish NF1 patients using next-generation sequencing (NGS). We analyzed 47 patients for mutations and all of them were unrelated. 27 NF1 mutations were identified. In total, 25 of the 27 mutations were likely pathogenic or pathogenic according to the ACMG criteria. Five of the pathogenic or likely pathogenic variants were novel. This is one of the large NF1 genetic&nbsp; studies in Turkey. We did not determine a genotype-phenotype correlation in this study because of the highly variable expressivity of the NF1 gene. According to our findings each population may have several exon regions that contain recurrent mutations. We suggest that genetic analysis with next-generation tools are more useful and helpful to provide early diagnosis and genetic counseling.</p> Taha Bahsi Hanife Saat Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Behavioral Disorders in Children: An Example of Primary Health Care http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2503 <p><strong>Background-aim</strong>: In this study; it is aimed to evaluate the destructive behavioral disorders in children between the age of 6-18 years old&nbsp; who applied to various family health centers in Ankara.</p> <p><strong>Method:</strong> The study was conducted as a cross-sectional study including 674 children and 337 parents who applied to family health centers in 4 different districts in Ankara. It is organized according to STROBE criteria. <strong>Results:</strong> 54.4% of the children were boys and 45.6% were girls. In children, attention deficit -hyperactivity disorder was found to be 9.9%, oppositional defiant disorder was 9.9% and behaviour disorder was 3.0%. Compared to married couples, attention deficit hyperactivity disorder was significantly more prevalent in children of divorced parents. Behaviour disorder was found to be significantly higher in families with low income.&nbsp; Diagnosis of attention deficit-hyperactivity was higher in boys than girls. Children with chronic illnesses and history&nbsp; of major accident ,poisoning or severe febrile disease had a significantly higher incidence of oppositional defiant disorder than healthy children and children who do not have any history.</p> <p><strong>Conclusion:</strong> Primary health care institutions have a strategic position in recognizing childhood mental/ behavioral disorders, it is important to increase the number of studies related to the subject in terms of protecting the social mental health.</p> Asiye Dikmen Cemal Koçak İrem Ekmekçi Ertek Seçil Özkan Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 İnsidental PET-CT ile Saptanan Senkron Farklı Histolojik Özellikte Bilateral Senkron Meme Kanseri; Olgu Sunumu http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1610 <p>Bilateral senkron meme kanseri meme kanserleri içerisinde nadir izlenen bir durumdur. Ancak meme görüntüleme tekniklerindeki gelişmelere bağlı olarak senkronbilateral meme kanseri insidansı artmaktadır. Genellikle her iki tümörün histopatolojik tipleri genellikle aynıdır. Günümüzde bilateralsenkron meme kanseri her iki tümör ayrı primer kabul edilerek tedavi edilmekte ve en sık uygulanan cerrahi prosedür bilateralmodifiye radikal mastektomidir.Olgumuzda 39 yaşında sağ memede invazivlobülerkarsinom tanısı konulan hastada evreleme ve uzak metastaz taraması amaçıyla yapılan PET-CT’de sol memede insidentalmalinite şüpheli lezyon saptanan ve bu lezyondan alınan biyopsi invazivduktalkarsinom olarak raporlanan hastaya sağ modifiye radikal mastektomi, sol memeye meme koruyucu cerrahi ve sol aksillersentineal lenf nodu örneklemesi uygulandı.</p> Kazım Çağlar Özçelik Hüseyin Pülat İsmail Zihni Huseyin Eken Oktay Karaköse Hasan Erol Eroğlu Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Pilomatricoma of the Neck Misdiagnosed as Sebaceous Cyst http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1999 <p>Pillomatricoma is a benign skin lesion originating from the hair follicle matrix. Most cases are usually only diagnosed post-operatively through histopathological examination (HPE) mainly because of the nature and presentation that resemble benign and superficial skin lesion, hence, the misdiagnosis prior to surgery. In this case report, we would like to highlight this condition and its important characteristics which appear to be under-reported due to lack of awareness among clinicians.</p> Boon Chye Gan Faridah Mohd Taib Jamal Sazly Haslinda Md Taha Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Is Recurrent Myopericarditis Recurrent Viral Myopericarditis? http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2045 <p>Myopericarditis is an illness with normally favorable prognosis and mostly seen in young adults. It is known that myopericarditis can be recurrent. However, it cannot be clarified why it is recurrent. We are presenting two cases including a 16-year-old and a17-year-old patients gone through myopericarditis for 3 times. We did a detailed research to introduce etiological reasons in two patients. We studied infectious reasons, autoimmune diseases, immunological and rheumatic diseases including mainly viral pathogens. During the myopericarditis&nbsp; attacks of patients, no pathological finding was identified other than being monocytosis in full blood counts, moderate sedimentation, CRP&nbsp; increase and raised troponin in laboratory data. We determined all viral pathogens known as agent as negative in both patients of ours. We think that patients particularly with more than one recurrent myopericarditis should be evaluated with a different perspective.</p> Semiha Terlemez Fatma Canbeyli Vildan Atasayan Serdar Kula Ayşe Deniz Oğuz Fatma Sedef Tunaoğlu Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Aneurysm of an Aberrant Right Subclavian Artery (Kommerell)- A Rare Phenomenon http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2078 <p>The aberrant right subclavian artery (ARSA) is a rare congenital variant of the aortic arch. When there is present of this aberrant anatomy, the brachiocephalic trunk is usually absent and the right subclavian artery arises as the fourth large arteries from the arch of the aorta. When the ARSA arises from a diverticulum of the distal aortic arch or descending aorta, it is termed as Kommerell aneurysm . Herein, we present a 51 years old man presented with neck pain due to cervical spondylosis. Pre-operative chest x-ray revealed a widened mediastinum. Further computed tomography (CT) of the thorax revealed Kommerell aneurysm of 2.5cm in diameter which does not resulted in any symptoms. We discussed the clinical implications and management of this rare entity in the report.</p> Krishna Kumar Katheraveloo Lenny Suryani Safri Jih Huei Tan Henry Chor Lip Tan Mohamad Azim Md Idris Hanafiah Harunarashid Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Sitoredüktif Cerrahi ile Hipertermik İntraabdominal Kemoterapi Uygulanan Hastada Anestezi Yönetimi http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2233 <p>Cytoreductive surgeries (CRS) are the common management modality for advanced cancers. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy offer survival advantages in well selected patients with peritoneal tumors. These procedures are technically challenging with potential for high perioperative morbidity and mortality. The complexity of CRS/HIPEC requires surgical specialization. In this case report, we wanted to dicuss anesthesia management in a 73 year old woman with ovarian cancer who underwent CRS/HIPEC under general anesthesia.</p> Nazan Has Selmi Necmiye Şengel Kamuran Koçyiğit Özer Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Migrating Foreign Body in the Spenoid Sinus http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2252 <p>Foreign body in paranasal sinus is relatively uncommon in adults unlike in pediatrics cases. Majority of foreign bodies in the paranasal sinus are reported to be identified from maxillary sinus (75%), followed by frontal sinuses (18%), finally sphenoid and ethmoidal sinuses. A 34-year-old gentleman with 1-year-history of accidental dislodged screw during a dental surgery presented with unilateral nasal symptoms. To our surprise, computed tomography paranasal sinus revealed opacity in the right sphenoid sinus when the initial screw was missing from the left side. Albeit a rare entity, awareness amongst physician on migration of foreign body is crucial as it may ascribe to devastating consequences.</p> Komalar Ponnuvelu Jeyasakthy Saniasiaya Norhaslinda Abdul Gani Khairul Azlan Shahril Abu Dahari Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Trapped Penis: Report of Two Cases http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2286 <p>Trapped penis(TP) is a rare disease, most commonly seen after neonatal&nbsp; circumcision. It rarely occurs in adults. This disease requires medical or surgical treatment. In this case report, we present two cases (one child and one adult) who developed TP after circumcision.&nbsp;</p> Serhat Çetin Fırat Çağlar Budak Özdemir Serhat Gürocak Mustafa Özgür Tan Rafet Turgut Alkibay Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Pure Epidural metastases of renal cell carcinoma: A case report http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2289 <p>Metastases is the most common cause of spinal tumors. Secondary tumors of the spine most frequently originate from cancers of breast, lung, and prostate carcinomas. Isolated epidural metastases are extremely rare. We present a 52-year-old patient with lumbar epidural metastasis of renal cell carcinoma. The patient was operated and histopathological examination revealed the renal cell carcinoma metastases.</p> Serhat Comert Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Pyogenic Granuloma of Ventral Surface of Tongue – A Rare Presentation http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2331 <p>Oral pyogenic granuloma is a common benign lesion of oral cavity. It is a type of reactive hyperplasia of oral cavity apart from peripheral ossifying fibroma, peripheral giant cell granuloma and fibrous hyperplasia. Various etiopathogenesis have been proposed like infection, trauma and hormone. The presentation may varies depending on site of lesion, etiology factors and patient’s activities. The common presentation is usually related to repeated trauma and chronic irritation to oral cavity subsites particularly to gingiva, lip, tongue and buccal mucosa. We present a case of pyogenic granuloma of ventral surface of tongue in young male adult football player with unusual presentation. Excision is still the treatment of choice in most of the centers, although other alternatives like cryosurgery and laser have been reported.</p> Vshakri Ehdam Ramiza Ramza Ramli Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Hereditary Hyperferritinemia Cataract Syndrome: Case Report http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2347 <p>Hereditary Hyperferritinemia-Cataract Syndrome (HHCS) is a rare disease characterized by cataract and hyperferritinemia. Herein, we present a pediatric patient diagnosed with HHCS.</p> Zeliha Guzelkucuk Hasan Fatih Çakmaklı Mehmet Onen Antonello Pietrangelo Nese Yaralı Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Acral Metastasis: A Very Rare Metastatic Site from Basaloid Squamous Cell Carcinoma of the Tonsil http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2364 <p>Basaloid squamous cell carcinoma (BSCC) is a variant of squamous cell carcinoma occuring in the tonsils. To the best of our knowledge, this represents the first report of acral metastasis from BSCC of the tonsil. We report a 46- year-old male with BSCC of the tonsil, with initial T2N0M0 treated with surgery and adjuvant chemo-radiation. Post treatment surveillance clinical examination, endoscopy and computed tomography scan did not reveal any signs of loco-regional recurrence. Three years later, he presented with pain and swelling of the distal phalanx of the left middle finger. Palliative Ray amputation of the distal phalanx of left middle finger was performed with histopathological evidence of metastatic basaloid squamous cell carcinoma. Scrutiny of the distal phalanx specimen and the initial tumour in the tonsil showed morphologically similar tumour concluding metastatic BSCC of the left middle phalanx. Acral metastasis is rare in squamous cell carcinoma of the tonsil but can occur years after completion of treatment.</p> Mawaddah Azman Tey Kai Jun Mohd Shawal Firdaus Mohamad Tan Geok Chin Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Multiple and Huge Axillary and Neck Lymph Nodes http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2404 <p>We wanted to discuss our 3-year-old patient, who first started with small lymph nodes in the axillary region and then appeared on the neck, and these swellings gradually grew and were not accompanied by pain.</p> Abdullah Can Basaklar Zafer Turkyilmaz Ramazan Karabulut Kaan Sonmez Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Aktivin-Follistatin Sistemi : Böbrek Hasarına Yeni Bir Yaklaşım http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2379 <p>Activities are cytokines that are members of the transforming growth factor beta (TGF-β) superfamily. Activins have a number of effects in the body that regulate various growth and differentiation events such as embryogenesis, immune response regulation, wound healing in various systems in the body. The most important factor regulating the functions of activins in the body is the follistatin, also known as ‘activin binding protein’. Follistatin was first described as a protein in the follicle fluid that regulates the release of follicle-stimulating hormone (FSH) from the pituitary. Nowadays, it is known that follistatin is widely synthesized and secreted from many tissues in the body and has many reproductive and non-reproductive functions. Follistatin achieves these effects by binding to activin due to its affinity to activin and inhibiting it.</p> <p>Activin-follistatin system has important roles in renal development and regeneration. It has been shown in many studies that the activins inhibit the development of tubules in the embryological development process of the kidneys. Follistatin inhibits the actions of activins and contributes to the healthy progress of the renal organogenesis process. The role of the activin-follistatin system in renal tissue repair and regeneration was investigated in the ischemia reperfusion model in rats and in the ureteral obstruction-induced fibrosis model. These limited number of studies indicate that exogenous follistatin administration in renal injury may be a new therapeutic approach in renal tubule regeneration. This review summarizes how the activin-follistatin system acts in the process of renal development and recovery of renal damage.</p> Ebru Köken Eser Öz Oyar Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Pediatrik Ürolojide Alfa-1 Reseptör Bloker Kullanım Alanları http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2408 <p>The ares of usage of alpha-1 receptor blocker drugs in pediatric urology practice are dysfunctional micturation and urinary stone disease. In the light of current information, it may be said that alpha-1 receptor blocker drugs are beneficial in some of the children with both dysfunctional micturation and ureter stones of 5-10 mm in size.</p> Ali Atan Fazlı Polat Zafer Turkyilmaz Kaan Sonmez Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Aberrant Expression of Forkhead Box Proteins in Prostate Cancer Development http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2435 <p>Prostate cancer is one of the most common types of cancer in men. The evolutionarily-conserved Forkhead-box (FOX) family proteins are able to bind to promoters and enhancers in a sequence-specific way to regulate gene expression. FOX proteins participate in the most diverse range of biological functions from genetic diseases to cancers. Recent studies over the past few years demonstrated the dysregularity of the FOX family proteins which lead to prostate cancer pathogenesis and their role as an oncogene or tumor suppressor in prostate cancer. In addition, experimental studies have shown that the dysregulation of FOX proteins is associated with cancer initiation, proliferation, migration, invasion, metastasis and survival. In this review, we summarized the roles of FOX proteins in the pathogenesis of prostate cancer and evaluated their potential as targets for therapeutic intervention.</p> Cigdem Donmez Ece Konac Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 Respiratory Tract Safe Sampling and Quarantine Cabinet Development and Application Results http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2518 <p>The Safe Sampling Cabinet will be used to safely take the respiratory tract samples of patients who have the possibility of being infected due to Covid19 Pandemic or similar reasons; to take samples from a cabinet in positive pressure by filtering and ventilating in the operating theater hygiene class without transmitting the infection to health care professionals and to keep the areas with potential patients in the negative pressure and prevent infection. By filtering and discharging the air exhausted from the negative pressure division where the patient is present; it is aimed to prevent infection in open or closed areas. Furthermore, the units in the form of mobile cabinets have been designed and implemented to keep / quarantine the patients; who have positive test results or those waiting for the test results in crowded areas such as airports, shopping malls; in clean cabinets with negative atmospheric pressure.&nbsp;</p> Mehmet Renan Gökyay Semih Fahri Pertin Mustafa Necmi İlhan, MD, PhD Murat Kanber Serhat Ünlü Muzaffer Alta Zaim Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3 V. International Participated Erciyes Medical Genetics Days Congress http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2584 <p>.</p> Mehmet Ali Ergün, MD, PhD Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2020-06-11 2020-06-11 31 3