Mevlana Tıp Bilimleri Archive

Bochdalek hernisi konjenital diyafragma hernilerinin en sık görülen tipi olup yetişkinlerde görülme sıklığı oldukça nadirdir. Daha çok yenidoğanda görülür. Defektler büyük oranda sol taraftadır. Sağ tarafta ve bilateral olarak da görülebilirler. Genellikle nonspesifik solunum ve gastroinstestinal semptomlarla karşımıza çıktığı için erişkinlerde geç tanı alırlar. Literatür incelendiğinde yetişkin bireylerde bochdalek hernisi olgularının azlığı dikkat çekmektedir. Olgu sunumu sayısı sınırlıdır. Biz bu olgu sunumumuzda birkaç yıldır varolan nefeste daralma ve sırta vuran ağrı şikayetleriyle gelen ve yapılan incelemeler sonucunda sol diyafragma posteriorundaki defektten toraksa herniye kolon ansları ve intratorasik ektopik böbrek tespit edilen 54 yaş erkek hastayı nadir görülen bir vaka olması nedeni ile sunacağız.

Infantile hypertrophic pyloric stenosis (IHPS) is narrowing of the pyloric duct due to hyperplasia of pyloric smooth muscle fibers. It is the most common cause of gastric outlet stenosis during neonatal period. It usually presents with projectile nonbilious vomiting in an otherwise healthy infants at 3 to 6 weeks of age. Undiagnosed cases may have a course with dehydration, severely poor feeding, acid-base imbalance and apnea, which may lead to death when neglected (1,2). Previous studies have reported that it is 4-fold more common in boys than girls. Although history and physical examination is sufficient to make the diagnosis, it is detected by ultrasonography and contrast-enhanced passage x-rays. Treatment is surgical extramucosal pyloromyotomy. In this manuscript, we aimed to report a 37-day-old male case which was admitted with complaints of intermittent dysnpnea-apnea, somnolence, and difficulty feeding persisting for a week, and then diagnosed with IHPS.

Cellulitis is an acute bacterial infection of the skin's deeper layers. Clinical indicators such as redness, swelling, warmth, and tenderness manifest at the site of infection . If left untreated, cellulitis can lead to serious complications, necrosis, abscess, and osteomyelitis . The most frequently isolated bacteria are Streptococcus pyogenes and Staphylococcus aureus (S. aureus). These bacteria species often exploit breaches in the skin's integrity to gain entry to tissue. In rare cases, cellulitis may extend to contiguous
tissues, precipitating abscess formation or osteomyelitis. We present a case of cellulitis on the anterior left tibia, resulting from trauma, which progressed to abscess formation and surrounding tissue necrosis. A 17-year-old male with no prior medical history presented with swelling and redness 10 days after sustaining a fall down stairs. Despite initial cellulitis diagnosis, the infection worsened, yielding Staphylococcus aureus growth in wound culture and necessitating treatment for necrotic soft tissue infection. Our case was successfully treated without any complications. First-generation cephalosporins and antistaphylococcal penicillins are commonly the initial choices for treating skin and soft tissue infections. However, they may not effectively combat infections caused by methicillin-resistant S.aureus (MRSA). While antibiotic selection is paramount, supportive measures such as removing infected foreign bodies, surgically draining lesions like abscesses, and ensuring regular wound cleansing are crucial for achieving successful recovery. In conclusion, clinical evaluation remains crucial in managing skin and soft tissue infections because laboratory results may not fully reflect the patient's condition. Empirical antibiotic therapy should be initiated immediately, taking into account the severity of the lesion, clinical condition, and likely pathogens. Obtaining cultures from the affected area helps identify the pathogen and determine antibiotic resistance patterns, guiding the treatment plan accordingly.

Spatial Disorientation (SD) in aviation is the incorrect perception that a pilot has of the position or movement of the aircraft in relation to the Earth or other nearby air vehicle. A survey was conducted on 203 military pilots, with ages between 24-46. Helicopter pilots had the largest number of illusions caused by ‘NVG (Night Vision Goggle)- related illusions’ (93.8%) and ‘Brownout-whiteout illusion’ (93.8%), while transport aircraft pilots had the highest number of ‘SD during final approach and landing’ (82.6%), and jet pilots had the highest number of ‘Illusion of anti-collision light reflection from clouds/fog’ (92.7%) and ‘Leans illusion’ (92.7%). A significant difference in severity scores of 'Brownout- whiteout illusion' was found between utility helicopter pilots and attack helicopter pilots (p<0.001). There was also a significant difference in the frequency of ‘Star- ground light confusion illusion’ between those pilots (p=0.035).
Significant difference in the frequency of this illusion was also found among jet, helicopter and transport pilots (p<0.001). To cope with the ongoing problem of SD and its detrimental effects on flight safety, it is crucial to develop pilot-specific flight profiles and incorporate SD simulations particular to each aircraft model into the physiological trainings.

Aim: The aim of this research is to determine the frequency of food addiction and the factors affecting this frequency in adults who consulted to healthy nutrition counsultancy in Trabzon/Ortahisar.
Methods: The study was cross-sectional. 181 adults were included in the study. Demographic charecteristics form and Yale Food Addiction Scale were used to collect study data. When the p value was below 0.05, it was considered as significant.
Results: 79.6% of the applicants were women and 69.1% were married. The mean age was 37.16±11.7 years and the mean body mass index was 31.44±6.09 kg/m2. Food addiction was determined in 21.7% of the applicants. A significant relationship was found between food addiction and interview with a psychologist/ psychiatrist, smoking status, body mass index, and eating speed according to applicant's statement (p=0.001, 0.032, 0.005, 0.045 respectively.). No significant relationship was found between food addiction
and other variables.
Conclusion: As a result of the study, the frequency of food addiction was determined to be 21.7%. This frequency is high and is consistent with national and international studies in the literature. This important public health issue requires realistic practices and interventions, including healthy nutrition consultancy, nutrition clinics, family health centres and schools.

Objective: Language impairment is a neurodevelopmental disorder characterized by reduced vocabulary, limited sentence structure and speech impairment. Emotion regulation refers to the cognitive and behavioral processes an individual uses to change the strength and timing of the expression of emotions. Healthy communication is closely related to the capacity to regulate emotions. In this study, it is aimed to investigate emotion regulation, problematic behaviors and their relationship with each other in preschool children diagnosed with language impairment.
Method: A patient group was formed with 46 participants aged 2-6 years with a diagnosis of language disorder according to the Diagnostic and Statistical Manual of Mental Disorders-5 and a control group was formed with 40 healthy participants aged 2-6 years without any psychiatric diagnosis. A sociodemographic data form was completed by the clinician, and the emotion regulation scale and preschool behavior scale were completed by the parents of the participants.
Results: No significant difference was found between the groups in terms of gender and age distribution. Emotion regulation scale total score (p=0.002) and resilience/negativity subscale (p=0.021) were significantly lower in the language disorder group compared to the control group. Preschool behavior scale total score was significantly higher in the language impairment group compared to the control group (p=0.01). No correlation was found between the total and subscale scores.
Conclusion: The results of our study show that children diagnosed with language impairment have weaker emotion regulation skills and more behavioral problems compared to their peers. We think that early emotional and behavioral follow-up of children with language disorder, improvement of emotion regulation skills and prevention of behavioral problems may be important for the mental health of these children.

Aim: In this study, we aimed to evaluate the demographic characteristics and maternal and perinatal outcomes of placenta previa and PAS cases in our clinic over a three period.
Methods: The sociodemographic characteristics and laboratory results of 94 participants (control = group 1; n=30, placenta previa = group 2; n=44, and PAS = group 3; n=20) were documented and compared between the groups.
Results: Gravity, parity, previous cesarean sections, symptoms on admission, signs of invasion at ultrasonography, gestational age at delivery, birthweight, neonatal intensive care unit admission rate, hysterectomy rate, length of hospital stay, blood transfusion, and atony differed significantly between the groups (p<0.05). Additionally, postoperative hemoglobin (groups 1 vs 2, 10.96+1.78 vs 9.66+1.22; p<0.001 and groups 1 vs 3, 10.96+1.78 vs 9.37+1.20; p<0.001) and Htc (groups 1 vs 2, 32.23±2.84 vs 28.83±3.97; p=0.001 and groups 1 vs 3, 32.23±2.84 vs 28.36±3.49; p<0.001) levels differed between them.
Conclusions: Invasion status and timing of delivery should be determined by means of ultrasonography in cases of placenta previa and PAS. A multidisciplinary approach to pregnant women with PAS in tertiary centers and involving an experienced team is very important in reducing maternal morbidity and mortality rates.

Aim: It is known that the half-life of pregabalin increases with age. This may be related to the decline in kidney function with age. In this study, it was aimed to investigate the neurotoxicity and renal toxicity that pregabalin may cause.
Materials and Methods: 100 patients followed up in the Department of Neurology between 2019-2020 were included for the study.It was planned to scan the hospital files of the adult patient group using pregabalin. The data obtained as a result of possible changes in serum electrolyte levels and kidney functions of patients with pregabalin indication were evaluated. Peripheral blood urea, uric acid, creatinine, serum electrolyte levels of the patients were determined and glomerular filtration rate (GFR) was analyzed twice, in six months for possible changes in kidney functions.
Results: Arithmetic mean values and changes were examined in patients who were measured twice in a six-month period. The effect of pregabalin use on urea and uric acid values, which are markers of renal function, was found to be statistically significant (p<0.05). There was no statistically significant effect on GFR, creatinine, Na+, Cl–, K+, Ca+2, Mg+2 and P+3 parameters (p>0.05).
Conclusion: This study may be useful to investigate the effects of pregabalin on other organs. The data obtained may contribute to the provision of information that may be useful to drug research and development institutions and to increase drug safety.

Amaç: Mesane kanseri sadece fiziksel hasara neden olmakla kalmayıp, aynı zamanda psikolojik sıkıntıları da beraberinde getiren önemli bir malignitedir. Depresyon, mesane kanseri hastalarında en sık görülen ruhsal hastalıklardan olup hastalık ve ilişkili faktörlere bağlanmaktadır. Çalışmamızda mesane kanseri tanısı konulmuş olan hastalarda depresif semptomların şiddeti tümör özelliklerinin karşılaştırılması ve aralarındaki ilişkinin belirlenmesi amaçlanmıştır.
Yöntemler: Üroloji Kliniği’ne başvurup USG ile mesane kanseri tanısı alan 30 hasta çalışmaya dahil edildi. Hastaların 21 soruluk Beck Depresyon Envanteri(BDE)’ni doldurması istendi. Hastaların yaş, cinsiyet, tümör boyutu ve BT görüntülemelerine göre yapılan klinik TNM evreleri kaydedildi. Daha sonra veriler hastaların tümör özellikleriyle birlikte değerlendirilerek sonuçlar SPSS ile değerlendirildi.
Bulgular: Hastaların ortalama BDE skoru 9,43±7,93 olarak ölçüldü. 17 hasta BDE’ye göre Minimal, 9 hasta Hafif, 2 hasta Orta, 2 hasta Şiddetli depresyon sınıfına dahil olduğu görüldü. Tümör boyutu ve BDE arasında yapılan ROK kurv analizine göre tümör boyutunu 1,75 cm cutoff değer kabul edersek bu değerin üzerinde BDE’nin anlamlı olarak yüksek olduğu görülmüştür.(p:0,016)(Resim 1)
Ayrıca yapılan korelasyon analizinde BDE skoru ile tümör boyutunun pozitif korele olduğu bulunmuştur. (p:0,002)
Sonuç: Mesane kanseri depresif semptomlara sebep olabilen önemli bir hastalıktır. Çalışmamızda tümör boyutunun semptom düzeyine etkisi araştırılmış olup büyük tümöre sahip hastalarda semptomların daha şiddetli olduğu sonucuna varılmıştır. Mesane kanseri olan hastalarda hastalık tanısı ve takibi sırasında depresif semptomları olan hastalarda psikiyatri görüşü alınmalıdır.

Aim: Present study analyzes kinesiophobia level in FMS patients and investigates the possible relationship between kinesiophobia and pain, disease activity, fatique, physical activity level, functional mobility and core muscle endurance (CME) times.
Materials and Methods: Forty-one female patients were participated in present study. Patients were assessed performing Tampa Scale for Kinesiophobia for kinesiophobia, a visual analog scale for pain level, the Fibromyalgia Impact Questionnaire for disease activity, the International Physical Activity Questionnaire- Short Form for physical activity (PA) level and Fatigue Severity Scale for fatigue. Core muscle endurance and physical fitness tests were applied. For statistical analysis were performed Spearman correlation coefficients and Mann-Whitney U test.
Results: Of the patients, disease duration was 3 (2/10) years and 25 (60.9%) had a high level of kinesiophobia. Significant relationships were detected between kinesiophobia and pain level (p<0.001), PA level, fatique, physical fitness tests and trunk flexor endurance time (p<0.05). However, kinesiophobia were not related to disease activity and other CME tests (p>0.05). Pain (p<0.001), fatique amd PA level, physical fitness tests, CME tests except trunk extensor test differed between high- kinesiophobia and low-kinesiophobia groups (p<0.05). However, disease activity was similar between high- kinesiophobia and low- kinesiophobia groups (>0.05).
Conclusions: Kinesiophobia seems to be associated with pain, PA level, fatigue, trunk flexor endurance and functional mobility. Evaluating kinesiophobia and associated factors in FMS patients may help in creating rehabilitation program.