Prevalence and etiologies of pulmonary hypertension at Somalia-Turkey Training and Research Hospital in Mogadishu

Introduction: pulmonary hypertension (PH) is one of the leading causes of mortality in the world. This study aimed to determine the ratio distribution and etiological characteristics of PH in Somalia-Turkey Training and Research Hospital. Methods: the study was designed as a hospital-based retrospective observational study and included 260 patients who were diagnosed with PH by transthoracic echocardiography (TTE) in the cardiology outpatient clinic in Somalia-Turkey Training and Research Hospital in Mogadishu. Sociodemographic and clinical characteristics and data on morbidity were retrieved from clinical records. Results: the echocardiographic prevalence of PH was found to be 18% (n=260). PH due to left heart disease was the most common form of PH (n=151, 58%), followed by PH due to lung disease (n=61, 23%), group 1 PH (n=38, 16%), group 5 PH (n=7, 2%), and chronic thromboembolic PH (CTEPH) (n=3, 1%). Conclusion: the present study showed that the prevalence of PH in Somalia is relatively higher than the rest of the world's average. The distribution characteristics of the disease could be related to the region-specific differences of the causative diseases. Further studies are needed to better capture the epidemiology of PH in Somalia

Comparison of some physical and physiological characteristics of the male sedentaries, male handball players and male wrestlers whose ages were between 13 and 1513- 15 yaş arasındaki güreşçiler hentbolcular ve sedanterlerin bazı fiziksel ve fizyolojik parametrelerinin karşılaştırılması

The study aimed at the comparison of some physical and physiological characteristics of the male sedentaries, male handball players and male wrestlers whose ages were between 13 and 15.77 male individuals (sedentaries=26, handball players=26 and wrestler=25) participated voluntarily. Height, weight and BMI values of the subjects were measured and tests for right and left hand grip strengths, leg and back strength, 20m sprint test, 30 sec sit-up, push-up, sit-reach (flexibility), respiratory function (FVC, VC, FEV1, PEF) and counter movement jump (anaerobic power)  were performed.As a result; it was found out that those who did sports in adolescent period had higher physical and physiological parameters than sedentaries. ÖzetBu çalışmanın amacı, 13-15 yaş erkek sedanter, hentbolcu ve güreşçilerin bazı fiziksel ve fizyolojik özelliklerinin karşılaştırılmasıdır.Araştırmaya 77 erkek sporcu ve öğrenci (sedanter=26, hentbolcu=26 ve güreşçi=25) gönüllü olarak katılmıştır. Çalışmaya katılan deneklerin boy, vücut ağırlığı, beden kitle indeksi (BKİ) ölçülmüş ve sağ ve sol el-pençe kuvvetleri, sırt-bacak kuvveti, 20 m. sürat, 30 sn. mekik, 30 sn. şınav, otur-uzan (esneklik), solunum fonksiyon (FVC, VC, FEV1, PEF) değerleri ve dikey sıçrama (anaerobik güç) testleri uygulanmıştır.Sonuç olarak; adölesan dönemdeki spor yapan bireylerin fiziksel ve fizyolojik parametrelerinin aynı yaştaki sedanter bireylerden daha yüksek olduğu tespit edilmiştir

The comparison of some physical and physiological characteristics of the male sedentaries, male handball players and male wrestlers whose ages were between 13 and 15

Bu çalışmanın amacı, 13-15 yaş erkek sedanter, hentbolcu ve güreşçilerin bazı fiziksel ve fizyolojik özelliklerinin karşılaştırılmasıdır. Araştırmaya yaş ortalamaları 13,95±0,81 yıl, boy ortalamaları 158,7±11 cm, vücut ağırlığı ortalamaları 52±12,32 kg ve beden kitle indeksi ortalamaları 20,33±2,9kg/m2, olan 77 erkek sporcu öğrenci(sedanter=26, hentbolcu=26 ve güreşçi=25) gönüllü olarak katılmıştır. Çalışmaya katılan deneklerin boy, vücut ağırlığı, beden kitle indeksi(BKİ) ölçülmüş ve el-pençe kuvveti, sırt-bacak kuvveti, 20 m. sürat, 30 sn. mekik, 30 sn. şınav, otur-uzan(esneklik), solunum fonksiyonu ve dikey sıçrama(anaerobik kapasite) testleri uygulanmıştır. Elde edilen verilerin SPSS 18.0 programı ile analiz edildiği araştırmada, örneklem gruplarında yer alan deneklerin demografik özellikleri ve ölçüm sonuçlarına ilişkin ortalama değerleri ve standart sapma değerlerinin tanımlayıcı istatistikleri hesaplanmıĢtır. Gruplar arası karşılaştırmalar tek yönlü varyans analizi (One way ANOVA) ile değerlendirilirken, gruplar arası farklılıkların hangi grup yada gruplardan kaynaklandığının tespiti için çoklu karşılaştırma testlerinden Tukey testi kullanılmıştır. Güven Aralığı %95 olarak belirlenmiş ve p<0,05‟in altındaki değerler istatistiksel açıdan anlamlı kabul edilmiştir. Çalışmaya katılan deneklerin; el-pençe kuvveti, sırt-bacak kuvveti, 20 m. sürat, 30 sn. mekik, 30 sn. şınav, otur-uzan(esneklik), FVC(zorlu vital kapasite), VC(vital kapasite) ve anaerobik güç değerlerinde istatistiksel açıdan anlamlı bir faklılık bulunurken (p<0,05), FEV1(1 saniyede çıkarılan maksimum hava miktarı), PEF(Zirve akım hızı), yaş, boy, kilo ve bki değerleri arasında istatistiksel açıdan anlamlı farklılık olmadığı tespit edilmiştir (p>0,05). Sonuç olarak; adölesan dönemdeki spor yapan bireylerin fiziksel ve fizyolojik parametrelerinin aynı yaştaki sedanter bireylerden daha yüksek olduğu tespit edilmiştir. Yine bu sonuca bağlı adölesan dönemde bireylerin branş gözetmeksizin spora yönlendirilerek fiziksel ve fizyolojik özelliklerinin geliştirilmesi gerekliliği ön plana çıkmıştır.The study aimed at the comparison of some physical and physiological characteristics of the male sedentaries, male handball players and male wrestlers whose ages were between 13 and 15. 77 male individuals (sedentaries=26, handball players=26 and wrestler=25) participated voluntarily in the study and their mean age was 13.95±0.81 years, mean height was 158.7±11 cm, mean weight was 52±12.32 kg and mean body mass index was 20.33±2.9kg/m2 . Height, weight and BMI values of the subjects were measured and tests for hand grip strength, leg and back strength, 20m sprint test, 30 sec sit-up, push-up, sit-reach, respiratory function and counter movement jump were performed. The data obtained were assessed using SPSS 18.0 program. Descriptive statistical values regarding arithmetic means and standard deviations of demographic characteristic and measurement results of the subjects were calculated. Intergroup comparisons were performed with Oneway ANOVA. Tukey test was employed to find out which group/s provided the intergroup differences. Confidence interval was 954%. Significance level was set p<0.05. There was statistically significant difference among the participants in terms of hand grip strength, 20m sprint test, 30 sec sit-up, push-up, sit-reach, FVC (forced vital capacity), VC (vital capacity) and anaerobic strength (p<0.05) values while no statistically significant difference existed in terms of FEV1 (forced expiratory volume in 1 second), PEF (peak expiratory flow), age, height, weight and BKI values (p>0.05). As a result; it was found out that those who did sports in adolescent period had higher physical and physiological parameters than sedentaries. Again; in light of the study results; it was recommended that individuals should be encouraged to do sports regardless of sportive branches and their physical and physiological characteristics should be improved

Myositis ossificans on the forearm in a 10-year-old girl

WOS: 000352078400009PubMed ID: 25647566Myositis ossificans is a rarely encountered benign lesion characterized by a non-neoplastic heterotopic bone formation in both soft tissue and skeletal muscle. Three subgroups of myositis ossificans are identified: myositis ossificans progressiva, which is hereditary; nontraumatic or pseudomalignant myositis ossificans, which is developed in the absence of any trauma; and myositis ossificans circumscripta, which is related to evident and direct trauma. In this case report, we present a girl with a swelling on the forearm who was finally diagnosed with nontraumatic myositis ossificans

Continuous ultrasound guided erector spinae plane block for the management of chronic pain

Neuropathic pain is a common chronic pain condition, whichcan develop due to a variety of etiologies such as surgery, trauma,herpes zoster, diabetes, and cancer[1]. It is usually difficult tomanage, and patients often show an insufficient response toanalgesic medications or experience intolerable adverse effects.Therefore, analgesic management is difficult, and the quality of lifeof the patient is adversely affected. Post-thoracotomy painsyndrome (PTPS) can be encountered in 25–47% of patientsundergoing either a thoracotomy or a video-assisted thoracoscopicsurgery (VATS). Initial management usually comprises NSAIDs,opioids and neuropathic agents[2].A variety of interventional procedures have been described fortreatment of thoracic refractory pain, including intercostal nerveblocks, thoracic epidural analgesia (TEA), thoracic paravertebralblocks (TPVB) and spinal cord stimulation. However, they can betechnically challenging to perform and are associated with asignificant failure rate (up to 15% in TEA) [3]. The erector spinae plane (ESP) block is a novel paraspinal planeblock first described for thoracic analgesia when performed at theT5 level[4]It has also been recently shown to be effective inproviding extensive somatic and visceral abdominal analgesiawhen performed at the T7-9 level[5]. ESP block is a goodalternative to other invasive techniques because the blockade canbe easily performed and has a low complication rate. An effectiveanalgesia can be provided and maintained by using continuous ESPblock. To illustrate this potential, we aimed to share our successfulexperience on using continuous ESP block in a patient with chronicpain in left thoracic and left axillary regions due to the malignmesenchymal tumour and Ewing’s sarcoma, which was unrespon-sive to the opioid mediation

Initial experience with laparoscopic gastrectomy in a low-volume center

Objective: Today, minimal invasive surgery has gained wide acceptance by general surgeons, even in complex oncological procedures. Despite the increased experience on laparoscopic distal gastrectomy, limited number of surgeons prefer laparoscopic total gastrectomy for proximal or middle-third gastric cancer, due to the concern of technical difficulties which can alter the quality of oncological outcomes. Methods: We retrospectively analyzed gastric cancer patients who underwent curative intent laparoscopic gastrectomy by single surgeon from October 2013 to April 2014. Five total gastrectomy + D2 (-No 10 and 11d) and 1 distal gastrectomy + D2 lymphadenectomy were analyzed for patient demographics, pathological characteristics, morbidity and in-hospital mortality. Results: The mean operating time was 255,8±37.2 minutes. The mean blood loss was 121.6±20.4 ml. In all patients, R0 resection were performed. The mean number of harvested lymph nodes were 22.6±7.3. The median number of metastatic lymph nodes was 16 (0-23). In one patient, less than 15 lymph nodes were retrieved. Complication rate was 33.3% (n=2). In one patient, who underwent laparoscopic distal gastrectomy, afferent loop syndrome developed. In another patient, who underwent total gastrectomy plus splenectomy a massive pulmoner embolism developed. The median hospital stay was 10 (6-18) days. Conclusion: With increased experience in advanced laparoscopic procedures, laparoscopic total gastrectomy may be considered as the first line treatment approach for gastric cancer patient even in a low-volume center

Ocena związku między wskaźnikiem oporu tętnic nerkowych a rozległością i złożonością choroby wieńcowej u pacjentów z ostrym zespołem wieńcowym

Background: Despite advances in cardiovascular medicine, acute coronary syndrome (ACS) is still a major cause of morbidity and mortality worldwide. Synergy between percutaneous coronary intervention with TAXUS™ and Cardiac Surgery (SYNTAX) score is used to determine the extent and complexity of coronary artery disease (CAD). Renal resistive index (RRI), a renal Doppler ultrasound parameter, is used to detect renal haemodynamics. Although some risk factors for CAD, including hypertension and diabetes mellitus, were demonstrated to have an association with RRI; a direct relationship between the presence, extent, and complexity of CAD and RRI has not been investigated yet. Aim: In this study, we evaluated the relationship between RRI and SYNTAX score in patients with ACS. Methods: This cross-sectional study enrolled 235 patients who were diagnosed with ACS and underwent coronary angiography at our tertiary clinic between February 2016 and August 2016. Regarding clinical presentation, 112 patients were diagnosed with non-ST-segment elevation ACS (NSTE-ACS) and 123 patients were diagnosed with ST-segment elevation ACS (STE-ACS). The patients’ demographic, clinical, laboratory, echocardiographic data, SYNTAX scores and measurements of renal Doppler ultrasound parameters, including RRI, renal pulsatility index (RPI) and acceleration time (AT) were recorded. Results: Among 235 patients, 112 (47.7%) were diagnosed with NSTE-ACS and 123 (52.3%) were diagnosed with STE-ACS. Mean SYNTAX score and RRI of patients with NSTE-ACS and STE-ACS were 15.4 and 0.69, 21.1 and 0.67, respectively. The SYNTAX score was associated with gender, height, plasma uric acid level, left atrial diameter, left ventricular (LV) end-systolic and end-diastolic diameter, RPI, and RRI in patients with NSTE-ACS, as well as with low-density lipoprotein-cholesterol, total cholesterol, ejection fraction, and LV end-systolic diameter in patients with STE-ACS (p &lt; 0.05 for each variable). RRI was significantly associated with age, haemoglobin level, left atrial diameter, SYNTAX score, AT, and RPI in patients with NSTE-ACS, as well as with weight, body mass index, interventricular septum thickness at diastole, LV posterior wall thickness at diastole, LV ejection fraction, and RRI in patients with STE-ACS. Multivariate logistic regression analysis demonstrated that LV end-systolic diameter (β = 0.385, 95% CI 1.065–2.029, p = 0.019), RRI (β = 32.230, 95% CI 5343.15–2.E+24, p = 0.008), and RPI (β = –7.439, 95% CI 0.000–0.231, p = 0.015) were independent predictors of moderate to high SYNTAX score in patients with NSTE-ACS. Conclusions: Non-invasively detected RRI is closely associated with the extent and complexity of CAD in patients with NSTE-ACS. However, there is a need for randomised, controlled studies involving wider populations.  Wstęp: Mimo postępu w zakresie leczenia chorób sercowo-naczyniowych ostry zespół wieńcowy (ACS) jest nadal główną przyczyną chorób i zgonów na całym świecie. Zbieżność między przezskórną interwencją wieńcową z wszczepieniem stentu uwalniającego tacrolimus TAXUS™ a wskaźnikiem SYNTAX stosuje się do oceny rozległości i złożoności choroby wieńcowej (CAD). Wskaźnik oporu tętnic nerkowych (RRI), parametr określany za pomocą ultrasonografii doplerowskiej, pozwala wykryć istotne hemodynamicznie zwężenia tętnic nerkowych. Chociaż wykazano, że niektóre czynniki ryzyka CAD, w tym nadciśnienie tętnicze i cukrzyca, są powiązane z RRI, bezpośrednia zależność między rozległością i złożonością CAD a wskaźnikiem RRI nie została dotychczas zbadana. Cel: Celem niniejszej pracy była ocena związku między wskaźnikami RRI i SYNTAX u pacjentów z ACS. Metody: Do tego przekrojowego badania włączono 235 chorych z rozpoznaniem ACS, u których wykonano koronarografię w ośrodku specjalistycznym autorów w okresie od lutego do sierpnia 2016 r. Na podstawie obrazu klinicznego można wyróżnić dwie grupy chorych: u 112 osób rozpoznano ACS bez uniesienia odcinka ST (NSTE-ACS), a u 123 osób — ACS z uniesieniem odcinka ST (STE-ACS). Odnotowano następujące informacje o uczestnikach: dane demograficzne, parametry kliniczne i laboratoryjne, wyniki badań echokardiograficznych, wskaźnik SYNTAX i parametry uzyskane w badaniu nerek metodą ultrasonografii doplerowskiej, w tym wskaźnik RRI, wskaźnik pulsacyjności (RPI) oraz czas akceleracji (AT). Wyniki: Spośród 235 uczestników badania u 112 (47,7%) rozpoznano NSTE-ACS, a u 123 (52,3%) — STE-ACS. Średnia wartości wskaźników SYNTAX i RRI u chorych z NSTE-ACS oraz STE-ACS wynosiły odpowiednio 15,4 i 0,69 oraz 21,1 i 0,67. Wskaźnik SYNTAX był związany z płcią, wzrostem, stężeniem kwasu moczowego w osoczu, wymiarem lewego przedsionka, wymiarami końcowoskurczowym i końcoworozkurczowym lewej komory, wskaźnikami RPI i RRI u pacjentów z NSTE-ACS, a także ze stężeniem cholesterolu całkowitego i frakcji LDL, frakcją wyrzutową oraz wymiarem późnoskurczowym lewej komory u chorych ze STE-ACS (p &lt; 0,05 dla wszystkich zmiennych). Wskaźnik RRI wiązał się istotnie z wiekiem, stężeniem hemoglobiny, wymiarem lewego przedsionka, wartością wskaźnika SYNTAX, AT i wskaźnikiem RPI u chorych z NSTE-ACS oraz z masą ciała, wskaźnikiem masy ciała, grubością przegrody międzykomorowej w rozkurczu, grubością tylnej ściany lewej komory w rozkurczu, frakcją wyrzutową lewej komory i wskaźnikiem RRI u chorych ze STE-ACS. W wielozmianowej analizie regresji logistycznej wykazano, że wymiar późnoskurczowy lewej komory (β = 0,385; 95% CI 1,065–2,029; p = 0,019),wskaźnik RRI (β = 32,230; 95% CI 5343,15–2.E+24; p = 0,008) i wskaźnik RPI (β = –7,439; 95% CI 0,000–0,231; p = 0,015) były niezależnymi czynnikami predykcyjnymi średniej lub wysokiej wartości wskaźnika SYNTAX u pacjentów z NSTE-ACS. Wnioski: Wskaźnik RRI w badaniu nieinwazyjnym jest ściśle związany z rozległością i złożonością CAD u chorych z NSTE-ACS. Jednak potrzebne są randomizowane badania z grupą kontrolną obejmujące szerszą populację.