Mevlana Tıp Bilimleri Archive

ABSTRACT

Gallbladder mucocele (GBM) is the development of a swollen gallbladder caused by the accumulating of semisolid immobile mucoid material in the gallbladder fundus for functional or mechanical reasons. This is also called gallbladder hydrops. Its incidence is about 3%. Decreased bile flow, decreased gallbladder movement, and altered water absorption in the gallbladder lumen cause biliary sludge and thus predispose to the development of mucocele. The first case was a 26-year-old female patient who presented to the clinic with complaints of nausea, vomiting, flatulence, indigestion and pain in the epigastric region and the right-upper quadrant. On abdominal USG, it was determined that the gallbladder wall was normal and there were stones and sludge with a diameter of 14 mm in the gallbladder lumen. The second case was of a 34-year-old female patient who applied to the clinic with complaints of stomach pain and nausea. The patient was taken to the operation without performing USG in the second case. Laparoscopic cholecystectomy was performed in both cases, and histopathological examination revealed mucoid material in the lumen, flattened epithelium, and inflammatory cell infiltration in the focal areas. The diagnosis of ‘Gallbladder Mucocele’ was given to the patients accompanied by these findings. In this article, is discussed the clinicopathological results of two cases diagnosed with gallbladder mucocele together with the literature.

Key words: Mucocele, Gallbladder, Cholecystectomy, Cholecystitis

ABSTRACT

Diabetic ketoacidosis (DKA) is one of the acute and serious metabolic complication of type 1 diabetes. It is a common condition in type 1 diabetes patients due to insulin deficiency and increased anti insulin hormones. Type 1 diabetes can present with diabetic ketoacidosis as well as during infection, metabolic balance and poor treatment management. DKA is one of the most important causes of diabetes-related mortality and morbidity in childhood and adolescence. In this article, a case of SARS-Coronavirus-2 (Covid 19) in severe diabetic ketoacidosis is presented.

Key words: Children, Covid 19, Diabetic ketoacidosis, Respiratory distress

ABSTRACT

Aim: In this study, it was aimed to evaluate the level of knowledge of university students studying in the field of health in sustainable nutrition and environment and their adherence with the Mediterranean diet.

Methods: This study was conducted in a cross-sectional type. It was conducted on 687 students studying at the Faculty of Medicine (n=413) and the Department of Nutrition and Dietetics (n=274) in AprilMay 2019. In the research, sociodemographic characteristics questionnaire form, sustainable nutrition and environmental relationship questionnaire form and Mediterranean diet adherence screener were used. In the analysis of the data, chi-square test, Mann Whitney-U test, Kruskall-Wallis test were used. p<0,05 was accepted significant.

Results: The rate of hearing of Nutrition and Dietetics students on the term of sustainable nutrition was higher than that of Medical students (p<0,001). It was determined that 95,2% of the participants did not receive education on sustainable nutrition. It was determined that students of both departments dealt with the concept of sustainable nutrition at least with its ecological dimension (Medicine: 27,8%; Nutrition and Dietetics: 25,5%). Adherence of Nutrition and Dietetics students with Mediterranean diet was found to be significantly higher than that of medical students (p<0,001).

Conclusion: It has been determined that more than half of the students had not heard of the concept of sustainable nutrition before. It was determined that the students dealt with sustainable nutrition with the environmental dimension at the lowest rate. It was found that the participants had a low adherence to the Mediterranean diet.

Key words: Mediterranean diet, Diet, Environment, Sustainability.

ABSTRACT

Purpose: To evaluate the changes of anterior chamber parameters determined by the Scheimpflug camera before and after laser peripheral iridotomy (LPI).

Materials and Methods: Thirty-one eyes of 20 patients with primary angle-closure suspect, primary angle closure, and primary angle-closure glaucoma were included in this study. Central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), and pupil diameter values were compared using the Pentacam Scheimpflug rotating camera system (Oculus Optikgeräte GmbH, Wetzlar, Germany) before and after LPI.

Results: At one month after LPI, it was noted that the mean IOP decreased from 19.78±8.74 mmHg to 16.4±3.57 mmHg (p<0.001). The average ACA increased from 24.1±6 degrees to 26.6±6.6 degrees (p<0.001). The average ACD increased from 2.11±0.4 mm3 to 2.14±0.4 mm3 (p=0.083). The mean ACV increased from 101.6±36 mm3 to 105.7±38 mm3 (p=0.439). The mean CCT increased from 540.9±45.9 μm to 555.4±42.8 μm (p=0.018). The mean pupil diameter decreased from 3.5±1.1 mm to 3.2 ±0.5 mm (p=0.828).

Conclusions: It has been determined that LPI has made some changes in the three-dimensional morphology of the AC.

Key words: Laser peripheral iridotomy, Anterior chamber, Primary angle closure, Scheimpflug camera

ABSTRACT

Purpose: Cadence is a value that can vary from person to person and is usually calculated as the number of steps per minute. Baropedometer, on the other hand, provides detailed analysis of foot dynamics by measuring the pressure distribution under the foot. In addition to cadence, it is also used in the evaluation and measurement of foot diseases in clinics and studies.

Methods: In our study, using 2014 model Diasu by Sani Corporate's baropedometer device; Separate cadence values (step/min) were calculated for the right and left feet. Demographic data such as age, weight and height of 101 individuals included in this study were recorded. The averages of the walks were taken into consideration from these recorded data. The obtained data were evaluated with Independent Samples Test in SPSS 25.0 package program.

Results: Male right and left cadence values were 58,07±23,77 steps/min, 58,18±24,67 steps/min, respectively. while in female individuals, these values were 55,87±22,89 steps/min on the right; on the left 56,75±21,52 steps/ min. As a result of the statistical analysis, no significant difference was found between cadence and measurement data (p>0.05).

Conclusion: When the literature is examined, cadence examines the changes in disease and aging along with other gait parameters. The insignificance of cadence change in healthy individuals due to demographic information made us think that cadence can only change in healthy individuals when they are diagnosed with the disease. Considering the studies stating that the change in cadence depends on walking speed and stride distance, it was thought that these parameters of gait should also be evaluated in future studies. There are studies in the literature reporting that cadence increases with age. However, no study has been found in the literature that directly correlates sole pressure with cadence. We think that our study will be a guide for other studies that reveal the factors affecting cadence.

Key words: Baropedometer, Cadence, Walk

ABSTRACT

Purpose: Primary thyroid disease accounts for over 95 percent of cases of hypothyroidism. It is aimed that patients with primary hypothyroidism become euthyroid by reaching the target thyroid stimulating hormone (TSH) level with levothyroxine sodium (LT4) replacement therapy. In this study, it was aimed to evaluate the patients who could not be treated optimally and to determine the frequency of patients treated with overdose or underdose. 

Methods: This retrospective study was carried out on 500 patients diagnosed with primary hypothyroidism who were followed up at Necmettin Erbakan University Meram Faculty of Medicine hospital, are over 18 years of age, without thyroid malignancy, and who had been receiving fixed dose LT4 replacement therapy for the last 6 months between January 2015 and December 2016. Serum TSH, free triiodothyronine (fT3) and free thyroxine (fT4) levels were used to determine the thyroid hormone status of the patients. Body mass index (BMI) of all patients were evaluated. Low density lipoprotein (LDL), high density lipoprotein ( HDL), very low density lipoprotein (VLDL), triglyceride and total cholesterol data of the patients were included in the analysis. 

Results: TSH levels were not within the desired target range in 66.8% (n=334) of patients under LT4 replacement therapy. While TSH level was higher than the desired target range in 50.8% of the patients (treatment with underdose), 16.0% of the patients had TSH levels below the desired target range (treatment with overdose). Only 20.6% of the patients had normal body weight. The prevalence of dyslipidemia was 69.2% in men and 68.9% in women and there was no significant difference between the genders (p = 0.968). 

Conclusion: In our study, it was observed that most patients under LT4 replacement therapy were not in the desired TSH range. When serum TSH levels cannot be normalized with LT4 therapy, an interdisciplinary diagnostic approach and careful history should be taken. 

Key words: Primary hypothyroidism, Target TSH, Overdose, Underdose, Dyslipidemia

ABSTRACT

Aim: Detection of bone marrow involvement in patients with lymphoma is an important step in clinical staging, treatment and follow-up. In this study, it was aimed to evaluate the relationship between lymphoma subtypes and bone marrow infiltration patterns.

Methods: Biopsy samples of 102 lymphoma cases evaluated histopathologically and diagnosed with bone marrow infiltration in Necmettin Erbakan University Meram Faculty of Medicine Medical Pathology Laboratory between 2016 – 2021 were reviewed. Sections were re-evaluated by 3 observers for infiltration patterns, lymphoma subtypes and infiltration patterns were recorded.

Results: The most common lymphoma subtypes were diffuse large B cell lymphoma (22.3%) and mantle cell lymphoma (22.3%), followed by T cell lymphoma (15.5%), follicular lymphoma (9.7%), chronic lymphocytic leukemia/small lymphocytic lymphoma (4.8%), Hodgkin lymphoma (4.8%), lymphoblastic lymphoma (1.9%), Burkitt lymphoma, MALT lymphoma, marginal zone lymphoma (0.94%), lymphoma of undetermined subtype (9.7%). Involvement patterns encountered were diffuse, paratrabecular, interstitial, nodular and mixed infiltration. In all cases the mixed type infiltration pattern was the most common with 29.1%. Mixed pattern, on the other hand, mostly included nodular and interstitial involvement together. The most common pattern as a single type was the diffuse pattern. The involvement patterns in diffuse large B cell lymphoma and mantle cell lymphoma, where the most common involvement was detected: 34.7% diffuse, 26% nodular, 17.4% mixed, 17.4% interstitial, 4.4% paratrabecular in diffuse large B cell lymphoma; 47.8% mixed, 21.7% diffuse, 17.4% paratrabecular, 13% nodular infiltration patterns in mantle cell lymphoma.

Conclusion: The mixed infiltration pattern was most common in mantle cell lymphoma, but was not specific as it was also seen in other lymphomas. In follicular lymphoma in which the paratrabecular pattern is prominent, other involvement patterns were also encountered. Based on the infiltration pattern, it is not possible to say definitively which lymphoma subtype the involvement observed in the bone marrow is associated with. For this, it is essential to refer to ancillary tests in determining the lymphoma type.

Key words: Bone marrow, Lymphoma, Infiltration, Pattern

ABSTRACT

It is crucial to distinguish bradikinin-mediated angioedema from mast cell-mediated angioedema. Bradykinin mediated angioedema often presents with severe or even life-threatening swelling. Bradykinin-mediated angioedema does not respond to standard treatments used for mast cell-mediated angioedema. Nowadays, the development of new drugs has made it possible to treat bradykinin-mediated angioedema-related attacks and to prevent morbidity and mortality. In this article, the known and unknown aspects of bradykinin-related angioedema, its pathophysiology, diagnosis and differential diagnosis, and treatment modalities are discussed.

Key words: Bradykinin-mediated angioedema, Hereditary angioedema