Mevlana Tıp Bilimleri Archive

Orbital cellulitis is defined as infection of the soft tissue surrounding the eye. Orbital complications can be seen in children affected by acute sinusitis. Herein we report a twelve year old child admitted to our clinic with complaints of redness, swalling, pain and burning of the right upper eyelid after acute sinusitis. Frontal, maxillary and ethmoidal sinusitis, frontal bone destruction, osteomyelitis and subperiosteal abscess were observed in the orbital magnetic resonance imaging of the patient, whose clinical conditon did not improve despite appropriate antibiotic therapy. In the follow up; limitation of upward and lateral gaze began in the right eye then surgical abscess drainage was performed. Staphylococcus aureus growth was observed in the patient's blood and abscess drainage culture. The patient recovered without sequelae after surgical and medical treatment. It is important to consider a sinusitis complication in a patient who presents with eyelid swelling, proptosis, pain and limitation of movement and evaluate it in terms of appropriate medical treatment and early surgical intervention in order to prevent permanent damage.

In this case report, we present a four-year-old girl who was referred to our center after experiencing resistant tachycardia while being treated at another facility for fever and cough. The patient's electrocardiogram showed long RP interval supraventricular tachycardia, with negative P waves in leads D2, D3, and aVF. After transthoracic echocardiography revealed a decrease in ejection fraction, the patient was diagnosed with Permanent Junctional Reciprocal Tachycardia (PJRT). The patient did not respond to the promptly administered adenosine therapy. She was also resistant to amiodarone treatment, but was successfully treated with catheter ablation. Supraventricular tachycardia is a common condition in pediatric emergency practice and can lead to tachycardiomyopathy if diagnosis is delayed. In this case report, we emphasize the importance of carefully reassessing the ECG in cases of tachycardia that do not respond to adenosine before moving on to broad-spectrum antiarrhythmic drugs. We also highlight that PJRT should be considered in cases of resistant tachycardia and, given that it is often resistant to medication and can lead to tachycardiomyopathy, patients should be promptly referred for catheter ablation without delay.

Purpose: The aim of this study was to evaluate the relationship between dietary habits and sociodemographic variables, tobacco-alcohol use, body mass index, waist and hip circumference measurements.
Materials and Methods: A total of 293 patients who applied to a family medicine outpatient clinic between 01.12.2021 - 28.02.2021 and volunteered to fill out a questionnaire including sociodemographic information form and three-factor nutrition scale were evaluated. Participants were classified as normal or overweight/obese according to body mass index, and their educational status was divided into two groups as primary school or lower level education and high school or higher level education and compared with each other.
Results: The consciously restricting eating sub-dimension score of the Three-Factor Nutrition Scale was higher in women than in men (p=0.011). The uncontrolled eating subscale score of overweight/obese participants was higher than that of normal individuals (p=0.047). Uncontrolled eating, emotional eating, hunger sensitivity score and total score of the three-factor nutrition factor were significantly higher in participants with primary education or lower than in participants with high school or higher education (p=0.002; p=0.002 p<0.001; p<0.001 respectively). No significant relationship was found between the total score and sub-dimension scores of the three-factor nutrition questionnaire and marital status, occupation and income, smoking/alcohol use status and history of chronic disease (p>0.05).
Conclusion: A strong positive correlation was found between the results of the three-factor nutrition questionnaire and body mass index. A stronger correlation was found between uncontrolled eating behaviour, one of the sub-dimensions of the three-factor eating questionnaire, and increased body mass index than the other sub-dimensions. Knowing that uncontrolled eating behaviour increases in obese patients may be a guide in the reorganisation of eating habits in the treatment and prevention of obesity.

Purpose: The transsphenoidal approach is one of the most commonly used methods in the surgical treatment of pituitary tumors. Although this method allows for faster postoperative recovery, it carries the risk of intraoperative complications due to the close vascular and nerve neighborhood. The aim of this study was to investigate the angle range of the Sella Turcica (ST) in the transsphenoidal approach and how this varies according to age and gender.
Methods: CT images of 47 males and 53 females with an age range of 18-75 years who presented to the neurosurgery outpatient clinic and underwent head tomography were included. On the radiologic images included in the study, the angles formed between the horizontal line connecting the anterior and posterior spina nasalis and the anterior and posterior borders of the fossa hypophysialis were measured in accordance with the transsphenoidal surgical procedure. dbc angle was calculated from the difference of these two angles. Micro Dicom Viewers software program was used for the measurements.
Results: It was observed that dbc angle was higher in men than in women. It was also found that dbc angle decreased with increasing age, that is, there was a negative correlation between age and dbc angle. However, these parameters were not statistically significant (p=0.105, p=0.337, respectively).
Conclusions: This is the first study to demonstrate the values of the entry angle that can be used in transsphenoidal surgical approach, which is widely used in pituitary gland surgery, and the relationship between this angle and both gender and age. It is thought that surgeons who want to reach the pituitary gland through nose will reach the exact position of the pituitary gland and cause fewer complications when they advance it within the safe angle range we recommend during surgery.

Aim: This study aimed to determine the diagnostic value of pan immune-inflammation value, systemic immune-inflammatory index, and systemic inflammation response index in differentiating testicular torsion and epididymo-orchitis in patients with acute scrotum.
Methods: This retrospective observational study was conducted among male patients aged 18 and older who presented to the emergency department with testicular pain. The patients were divided into two groups: the operated testicular torsion group (n=93); epididymo-orchitis group treated for epididymoorchitis (n=125).
Results: A total of 218 patients (testicular torsion:93, epididymo-orchitis:125) were included in the study. Neutrophil/lymphocyte ratio, systemic immune-inflammatory index and systemic inflammation response index were found to have acceptable diagnostic power in testicular torsion detection (The Area Under the Curve:0.75, 0.77, and 0.78, respectively). Pan immune-inflammation value had an excellent diagnostic power in detecting testicular torsion, with >980.93 cut-off determined (The Area Under the Curve:0.81, %95Confidence interval:0.76-0.86,<0.001).
Conclusion: In the emergency department, it can be recommended to utilize pan immune-inflammation value, systemic immune-inflammatory index, and systemic inflammation response index, which are inexpensive, easily accessible, and produce quick results in the differentiation of testicular torsion and epididymo-orchitis. Pan immune-inflammation value is a superior index in predicting testicular torsion compared to other indexes.

Aim: The study was aimed to determine the changes in nurses' compliance levels with isolation precautions during the pandemic process and the affecting factors.
Material and Methods: The study was conducted with 274 nurses involved in the treatment and care of COVID-19 patients in a university hospital, it was examined the change in nurses' compliance levels with isolation precautions (self-controlled) and descriptive and relationship design to determine the influencing factors. The data were collected from nurses using the “Questionnaire Form” and the "Scale of Compliance with Isolation Precautions” (SCIP) using a sealed envelope method. The data were analyzed using t-tests and ANOVA to explore relationships between the variables. Ethical approval, institutional permission, and informed consent from the participants were obtained before the study.
Results: According to the nurses' self-assessments, while the pre-pandemic SCIP mean scores 66.43±7.04, the post-pandemic scores increased significantly to 70.44±5.59. Age, gender, education level, experience, clinical setting, shift type, and overtime status were found to have significant effects on adherence to isolation precautions (p<0.05). 86.5% of the nurses received training on isolation precautions in pandemic, and 58.4% reported experiencing problems with compliance.
Conclusion: It was determined that nurses' compliance with isolation precautions increased in pandemic. It is recommended that the results be taken into account to be prepared for similar emergencies.

Aim: Joint cracking behavior can become habitual due to the immediate release of joint tension and increased joint range of motion. Accordingly, this study aimed to evaluate the self-knuckle cracking habits of students studying at a university's Vocational School of Health Services.
Methods: The population of this descriptive cross-sectional study consisted of 203 volunteer students from a university's Vocational School of Health Services. Study data were collected with a survey form and descriptive statistics and Chi-square test were used to analyze the data.
Results: 72.9% of the students in the study group are female and the average age is 20.21±2.16 years. 68.5% of them describe the sound coming from the joint as cracking, and they mostly crack the finger joints (44.3%) and neck joints (26.6%). 52.5% of women and 19.5% of men stated that they cracked their neck joints 3 or more times a day, and the difference was found to be statistically significant (p<0.001). 77% of women and 92.7% of men stated that they were not afraid of cracking their joints (p<0.05). 50% of those who were afraid of cracking their finger joints and 87.9% of those who were not afraid stated that they cracked their finger joints 3 or more times a day (p<0.001). Of the students who were afraid of cracking their knuckles, 55.6% described the feeling of the sound after cracking their knuckles as bad, and 57.1% described the feeling of cracking someone else's knuckles as bad (respectively; p<0.001, p<0.001).
Conclusion: In our study, unlike the literature, the effect of fear of cracking joints on the individual's feeling of the sound of cracking his own joints and the feeling of cracking someone else's joints was examined and it was seen that it was effective on both.

Aim: The earthquakes centered in Kahramanmaraş on February 6, 2023, resulted in many citizens being rescued from the rubble with injuries. Initial treatments were provided in nearby hospitals, and patients were then referred to hospitals across Turkey. Hyperbaric oxygen therapy (HBO2) centers played a crucial role in the treatment of many patients. The Akyurt Hyperbaric Clinic, located 40 km from Ankara, began receiving patients on February 8, and the patient flow continued for three months. This study presents the experience of Akyurt Hyperbaric Clinic in managing earthquake victims.
Methods: The records of patients treated at the Akyurt Hyperbaric Clinic were retrospectively reviewed. Patient demographics and session statistics were compiled. Various challenges faced during patient management and the solutions implemented were documented.
Results: A total of 99 patients were treated. Treatments began 67 hours after the first earthquake. The mean duration of stay under the rubble was 34.5 hours. From February 11 onwards, treatment sessions were dedicated exclusively to earthquake victims. A total of 163 sessions were held. Most patients were treated on stretchers. Patients were transported to the clinic by emergency services. Session lists were planned daily based on patient conditions and logistics.
Conclusion: In light of the challenges experienced by patients in need of hyperbaric oxygen therapy following the disasters, the necessity for hyperbaric oxygen therapy centers in tertiary hospitals, particularly in major cities, has once again become evident.

Objective: Coronary heart disease (CHD) is a common health problem worldwide and coronary bypass grafting (CABG) is an important alternative treatment modality. The vena saphena magna (VSM) graft can be prepared with the classical method and multiple minimal skin incisions. We aimed to investigate the early results of patients undergoing coronary bypass grafting with the classical method and multiple minimal skin incisions during VSM graft preparation.
Methods: Between 2023 and 2024, 80 patients who underwent elective CABG were included in the study. Patients were divided into two groups: classical VSM preparation method (n=40) and multiple minimal skin incision method (n=40). Demographic data, comorbidities, intraoperative cardiopulmonary bypass (CPB) time, cross clamp (X clamp) time, wound site infection, postoperative intensive care unit (ICU) and total hospitalization time were evaluated in both groups.
Results: There was no significant difference between the two groups in terms of age, gender, comorbidities, cardiopulmonary bypass and cross clamp time. Wound infection rates were observed at 12.5% in the conventional method group and 5% in the multiple minimal incision group, though this difference was not statistically significant (p=0.235). Furthermore, there were no notable differences in the lengths of stay in the intensive care unit or the total hospital stay (p=0.625, p=0.129).
Conclusion: The early outcomes of VSM preparation with the classical technique compared to multiple minimal skin incisions indicated a lower rate of wound infections with the latter method; however, this difference did not achieve statistical significance.

Purpose: Urinary tract infections are a significant public health issue and the most common cause is E. coli. The compiled articles aim to investigate increasing antibiotic resistance and create awareness and provide an effective treatment path.
Method: Studies on E. coli and antibiotic resistance in the last 5 years were scanned in the Tr Index. Among the open access articles published in 2018 and later, written in Turkish, 13 articles discussing E. coli and antibiotic resistance together were examined.
Results: In all studies, the most common cause of urinary tract infections in both genders and all age groups is E. coli” and its frequency was reported as between 50% and 75%. Considering the antibiotic resistances, it was determined that Ampicillin, Sulfamethoxazole-trimethoprim, Ciprofloxacin, Amoxicillin-Clavulanic acid were the antibiotics with the highest resistance; Meropenem, Imipenem, Amikacin, Fosfomycin, Nitrofurantoin were found to be the antibiotics with the lowest resistance.
Conclusions: It is important to provide effective treatment for urinary tract infections, which are among the most common infections in our country and in the world, and E. coli, which is the most common cause of urinary tract infections. Resistance rates for E. coli may vary by region and may vary from year to year. Due to the development of high resistance to sulfamethoxazole-trimethoprim, ciprofloxacin and beta-lactam group antibiotics, which are frequently used in current treatments, and the increase in this resistance over time, especially revising empirical treatments with antibiotics with low resistance rates, studying antibiograms for treatment, and informing about conscious antibiotic consumption will increase the success of the treatment. It is expected to increase and prevent the increasing antibiotic resistance.