COMPARISON OF CHANGES IN THE ANKLE AFTER UNICONDYLAR KNEE ARTHROPLASTY AND HIGH TIBIAL OSTEOTOMY

Objectives: We aimed to compare the changes in the coronal alignment of the ankle joints and their clinical effects after high tibial osteotomy (HTO) and unicondylar knee arthroplasty (UKA). Methods: 50 HTO and 54 UKA patients who were operated on for medial knee osteoarthritis between 2013 and 2018 were retrospectively evaluated. The hip-knee-ankle angle (HKA), the medial proximal tibial angle (MPTA), the tibial plafond inclination (TPI) and the talar inclination (TI) angles were measured before and after operation. Visual analog scale (VAS), short form 36 (SF-36), and ankle-hindfoot scale (AHS) scores of both groups were evaluated and recorded. Results: Angular changes in the HKA, MPTA, TPI and TI values showed significantly greater values in the HTO group (p<0.001). When asymptomatic and symptomatic cases were compared, it was found that changes in the HKA, TPI and TI values were significantly greater in symptomatic cases in the HTO group (p<0.05). A significant decline was observed in the VAS, SF-36 and AHS scores in the HTO group in the postoperative period (p<0.05). In intergroup evaluations, a significant decline was detected in pain and functional scores of the HTO group when compared to the UKA group (p<0.05). Conclusion: Unicondylar knee arthroplasty can be a good alternative to HTO in selected cases for postoperative ankle complaints.Level of Evidence III; Therapeutic Studies Investigating the Results of Treatment

The course of acute appendicitis disease i̇n the COVID-19 period

The COVID 19 outbreak has changed the course of diseases requiring emergency surgery. Our aim in this study is to reveal whether the COVID 19 pandemic complicates acute appendicitis (AA) disease or not. We retrospectively investigated the patients who were diagnosed with AA in our city (Rize, Turkey). Our study includes two patient groups over 16 years of age who were operated on for AA. Group 2 includes patients operated between 11 March 2020 and 31 December 2020, while Group 1 includes patients who were operated on during the same period in 2019. There were 298 patients (57%) in Group 1 and 226 patients (43%) in Group 2. In Group 2, midline or paramedian incisions were used significantly more than the classical Mc Burney incision: (%10 vs %20, p<0.003). Postoperative complications were significantly higher in Group 2: (%5 vs %12, p<0.004). White blood cells and CRP were significantly different in Group 2 in the admission blood tests (p<0.005, p<0.001, respectively). Operation time and hospitalization time were significantly different in Group 2 (p<0.001, p<0.014, respectively). During the COVID-19 pandemic, there was a serious decrease in the number of patients admitted to the emergency services. Because people were afraid of being infected, they preferred to stay home and with the increase in complaints, they applied to the hospital. AA disease has also become more complicated, as people delayed their admission to the hospital. Serious changes happened in the course of the disease

Effects of COVID-19 pandemic on colorectal cancer surgery

BACKGROUND: The coronavirus disease-19 (COVID-19) pandemic has changed the course of diseases that require emergency surgery. OBJECTIVE: To evaluate the effect of the COVID-19 pandemic on colorectal cancer disease stage. DESIGN AND SETTING: Retrospective analysis in the city of Rize, Turkey. METHODS: This was a comparative analysis on two groups of patients with various symptoms who underwent surgical colorectal cancer treatment. Group 1 comprised patients operated between March 11, 2019, and December 31, 2019; while group 2 comprised patients at the same time of the year during the COVID-19 pandemic. RESULTS: Groups 1 and 2 included 56 and 48 patients, respectively. The rate of presentation to the emergency service was higher in Group 2 (P < 0.02). The stage of the pathological lymph nodes and the rate of liver metastasis was higher in Group 2 (P < 0.004 and P < 0.041, respectively). The disease stage was found to be more advanced in Group 2 (P < 0.005). The rate of postoperative complications was higher in Group 2 (P < 0.014). CONCLUSION: The presentation of patients with suspicious findings to the hospital was delayed, due both to the fear of catching COVID-19 and to the pandemic precautions that were proposed and implemented by healthcare authorities worldwide. Among the patients who presented to the hospital with emergency complaints and in whom colorectal cancer was detected, their disease was at a more advanced stage and thus a higher number of emergency oncological surgical procedures were performed on those patients

Association of total serum antioxidant capacity with the Tei index in echocardiography in patients with microvascular angina

Objectives Cardiac syndrome X (CSX) is a conditioncharacterized by exercise-induced chest pain that occursconsidering a normal coronary angiogram. We aimed toinvestigate the total serum antioxidant capacity (TAC) andbiventricular global functions using echocardiography inpatients with CSX.Patients and methods The study population included 55patients with typical anginal symptoms and a positiveexercise stress test, or ischemia in myocardial perfusionscintigraphy and normal coronary arteries detectedangiographically, and 49 healthy volunteers with atypicalchest pain and a negative stress test. TAC was assessedfrom blood samples. Transthoracic echocardiography wasperformed for the entire study population. The Tei index wascalculated using the formula IVCT+IVRT/ET.Results TAC was found to be significantly lower in the CSXgroup compared with the control group (0.70 ± 0.37 vs.1.5± 0.30, respectively, P1.77 mmol/l), it was found that the Tei indexwas higher in the decreased TAC group compared with theother groups (0.66 ± 0.18 vs. 0.49 ± 0.10 and0.46± 0.13 mmol/l, P<0.001, respectively).Conclusion Our study suggested that TAC wassignificantly decreased in CSX patients and decreasedantioxidant levels were related to impaired Tei index inechocardiography in patients with microvascularangina. Coron Artery Dis 26:620–625 Copyright © 2015Wolters Kluwer Health, Inc. All rights reserved

Expectations of pregnant women for antenatal care services and factors affecting anxiety severity during the COVID-19 pandemic

Objectives: We aimed to evaluate the difficulties pregnant women encountered while receiving health care, their demands for antenatal care, and their mental state during the COVID-19 pandemic. Material and methods: A total of 447 pregnant women were included in this cross-sectional study. The data were collected through a face-to-face questionnaire, which assessed participants’ demographic, individual, and obstetric characteristics, their opinions regarding the COVID-19 pandemic, expectations from their antenatal care services, and their Beck Anxiety Inventory (BAI) scores. Results: During the COVID-19 pandemic, it was determined that 17.2% of the pregnant women participating in our study could not go to antenatal follow-ups and almost half (45.9%) demanded that their follow-ups be reduced due to the risk of coronavirus transmission. The BAI scores were found to be significantly higher in participants with low-income levels, chronic diseases, those in the third trimester, those with high-risk pregnancy either previous or current, and those who got pregnant unintentionally. Young age, unintentional conception, advanced pregnancy week, previous high-risk pregnancy, and failure to receive regular antenatal care were independent variables that predicted moderate-severe anxiety in logistic regression analysis. Conclusions: In order to minimize the adverse effects of the COVID-19 pandemic on the mental health of pregnant women, it is important to develop support programs that contribute to the well-being of the mother and fetus by recognizing the pregnant women at risk in the antenatal period

Multilane traffic density estimation and tracking

As the number of vehicles in roads increases, information of traffic density becomes crucial to municipalities for making better decisions about road management and to the environment for reduced carbon emission. Here, the problem of traffic density estimation is addressed when there is continuous influx of vehicle data. First the traffic density is modeled by the clusters of the speed groups that are centered after Kernel Density Estimation technique is implemented for the probability density function of the speed data. Then, empirical cumulative distribution function of data is found by Kolmogorov-Smirnov Test. A peak detection algorithm is used to estimate speed centers of the clusters. Since the estimation model has linear and non-linear components, the estimation of variance values and kernel weights are found by a nonlinear Least Square approach with separation of parameters property. Finally, the tracking of former and latter estimations of a road is calculated by using Scalar Kalman Filtering with scalar state - scalar observation generality level. For all example data sets, the minimum mean square error of kernel weights is found to be less than 0.002 while error of mean values is found to be less than 0.26

E-ÖĞRENME OYUNLARINDA ALGILANAN HAZ VE BİLGİ GELİŞİMİNİN DEĞERLENDİRİLMESİ: EGAMEFLOW ÖLÇEĞİNİN TÜRKÇE’YE UYARLANMASI

The basic understanding of e-learning games is to enable the student to reach both his / her participation and learning objectives with a correct flow design. At this point, the existence of a scale that effectively measures the perceived flow created by e-learning games and the knowledge improvement is very important. Thus, game designers can further integrate knowledge improvement factors with the game through the student perspective, while educators can successfully test the quality of the game's knowledge improvement. However, since the scales used for e-learning games are generally developed on the basis of commercial games, they cannot fully explain the pleasure and knowledge improvement in games-oriented games. The aim of this study is to adapt the EGameFlow Scale, which responds to the quality of the students' perceived enjoyment and knowledge improvement in e-learning games, and to test its validity and reliability. Explanatory Factor Analysis and Confirmatory Factor Analysis were applied for the construct validity, and the correlation of EGameFlow Scale and Achievement Goals Orientation Scale were calculated for compatibility validity. EGameFlow Scale reliability was determined by internal consistency, test split, and test-retest. As a result of Explanatory Factor Analysis conducted, a total of 21 items were extracted from the scale and all items were collected under 2 factors. The resulting new 2-factor construct explained 48.72% of the total variance. According to research findings, the Turkish form of EGameFlow Scale is an adequate tool for measuring the perceived enjoyment and the knowledge improvement of e-learning games.E-öğrenme oyunlarındaki temel anlayış, doğru bir akış tasarımıyla öğrencinin hem katılımını hem de öğrenme hedeflerine ulaşmasını sağlamaktır. Bu noktada e-öğrenme oyunlarının yarattığı akışı ve bilgi gelişimini etkin şekilde ölçen bir ölçeğin varlığı oldukça önemlidir. Oyun tasarımcıları, öğrenci bakış açısı ile bilgi gelişimi faktörlerini daha fazla bütünleştirebilir ve eğitimciler ise oyunun eğitimsel başarısını test edebilir. Fakat e-öğrenme oyunları için kullanılan ölçekler genellikle ticari oyunlar temelinde geliştirildiği için eğitim odaklı hazırlanan oyunlardaki haz ve bilgi gelişimini tam olarak açıklayamamaktadır. Bu çalışmanın amacı, eöğrenme oyunlarında öğrencilerin algıladıkları haz ve bilgi gelişimi başarısına cevap veren EGameFlow Ölçeğinin Türkçe uyarlamasını yapmak, geçerlik ve güvenirliliğini test etmektir. Ölçeğin yapı geçerliği için Açımlayıcı Faktör Analizi ve Doğrulayıcı Faktör Analizi, uyum geçerliğinde ise Başarı Yönelimleri Ölçeği ile korelasyonu hesaplanmıştır. Ölçeğin güvenirliği ise iç tutarlılık, test yarılama ve test tekrar test ile belirlenmiştir. Ölçeğin yapı geçerliği öncesi veri setinin faktör analizine uygun olup olmadığı denetlenmiştir. Yapılan Açımlayıcı Faktör Analizi sonucunda toplam 21 madde ölçekten çıkarılmış olup tüm maddeler iki faktör altında toplanmıştır. Ortaya çıkan yeni iki faktörlü yapı toplam varyansın %48.72’sini açıklamıştır. Ayrıca Doğrulayıcı Faktör Analizi sonucu elde edilen iki faktörlü modele ilişkin faktör yükleri, standart hata, kritik oran, hata varyansı ve R2 değerleri tüm maddeler için anlamlı görülmektedir. Ölçeğin uyum geçerliğinin test edilmesi için Başarı Yönelimleri Ölçeği ile arasında korelasyon kurulmuştur. Araştırma bulgularına göre, EGameFlow ölçeğinin Türkçe formu e-öğrenme oyunlarında algılanan akış hazzının ve bilgi gelişiminin ölçümlenmesinde yeterli bir araçtır