A rare complication of recurrent cerebrovascular infarct: Bilateral vocal cord paralysis

Bilateral vocal cord paralysis (BVCP) is usually the result of an iatrogenic injury especially secondary to thyroid and parathyroid surgery. However, BVCP that cause airway obstruction due to serebral cortical stroke very rarely has been reported. We, herein report a case of BVCP that resulted in respiratory arrest as a late and life threatening complication of recurrent cerebral infract. A 67 years old male patient admitted the emergency room with complaint of respiratory insufficiency. His complaint was progressed during last 3-4 months. He had two cerebral infractions attacks in a month approximately one year ago. On admission, physical examination revealed that, he had bilateral wheezing and stridor. He had right sided hemiplegia and had no history of heart failure or chronic obstructive lung disease. Endoscopic laryngoscopy was performed to evaluate upper airway obstruction. Laryngoscopy revealed that bilateral vocal cords were fixed and immobile at midline. Due to recurrent respiratory arrest, insufficient and fixed BVCP, open tracheostomy was perormed. After operation, he had no respiratory insufficiency or any complications. So he discharged from hospital with normal respiratory function

A Case of Hypogonadism Presented with Alopecia Universalis

WOS: 000324603300023PubMed: 25207137

Reversible Hepatotoxicity of Mirtazapine in a Patient with Major Depression

WOS: 000292729200014Mirtazapine is a noradrenergic and specific serotonergic antidepressant that is approved for use in the treatment of major depression. It is generally well tolerated with some mild side effects such as drowsiness, excessive sedation, increased appetite, weight gain, and dry mouth. We present a case of 23 years old female depressive patient who developed abdominal pain and elevation of liver enzymes during treatment with mirtazapine and returned to normal after stopping the mirtazapine use. (Archives of Neuropsychiatry 2011; 48: 162-3

Mortal bilateral psoas abscess caused by urogenital infection in geriatric age

Psoas apsesi nadir rastlanan, tanısı zor ve geç konulan bir durumdur. Primer ve sekonder olarak sınıflandırılır. Erişkin hastalarda üriner sistem enfeksiyonlarına sekonder psoas apsesi gelişmesi nadir bir durumdur. Olgumuz 79 yaşında erkek hasta, ürosepsis tanısıyla yatırıldı. Uygun antibiyotik tedavisine rağmen genel düşkünlük hali, hipotansiyon ve ateş kliniği devam etti. Çekilen batın bilgisayarlı tomografide bilateral iliopsoas kasında retroperitoneal alana kadar uzanım gösteren apseler izlendi. İliopsoas apselerine perkütan yolla drenaj kateteri yerleştirildi. Kontrol tomografide batın içinde yaygın kistik-apse odakları saptandı. Cerrahi drenaj için hazırlanırken gelişen ani kardiak arrest nedeniyle hasta exitus oldu. Psoas apsesi özgün olmayan klinik bulguları ve nadir görülen bir durum olması nedeniyle tanısı geciken, yanlış tanılar ile mortalite oranı yükselen ve apse drenajı yapılmayan vakalarda mortalite oranı %100'e ulaşan bir durumdur.Psoas abscess (PA) is a rare condition which is difficult to diagnose, so its diagnosis may be delayed. It is classified as primary and secondary psoas abscess. In adult patients, PA caused by urinary tract infections is a rare entity. Our case, a 79 year old male patient was hospitalized with a diagnosis of urosepsis. In his follow-up despite the appropriate antibiotic therapy the symptoms of fever, hypotension and general weakness persisted. Abdominal computed tomography, showed bilateral iliopsoas muscle abscesses extending to the retroperitoneal area. Percutaneous drainage catheters were inserted into iliopsoas abscesses. Control computed tomography revealed disseminated cystic-abscess centers in the abdomen. During preoperative management for surgical drainage of abscesses, the patient died due to a sudden cardiac arrest. Psoas abcesess is an entity, with delayed diagnosis because of its nonspecific clinical features and infrequency. Its mortality rate is high due to misdiagnosis and may even reach upto 100% in the absence of abscess drainage

Correlation of bicarbonate values measured with direct enzymatic method and blood gas analysis devices

Ankarali, Handan Camdeviren/0000-0002-3613-0523WOS: 000300974400013Introduction: In this study, we investigated to whether there is a relationship between bicarbonate levels simultaneously measured with the mathematical calculation of blood gas analysis device derived pH and pCO(2) and direct enzymatic method. Materials and methods: Arterial blood samples were taken from 90 patients hospitalized in the intensive care unit. Bicarbonate level was simultaneously measured in the ABL 800 blood gas analyzer with the method of mathematical calculation from the pH and pCO2 and in the Roche Diagnostics Cobas c501 with the enzymatic method. The results were compared. Results: Pearson correlation coefficient between the two measurements was r=0.944 showing a significant positive relationship. Also value of the ICC calculation which was 0.963 showed that there was a significant agreement between the two measurement methods (p=0.0001). None of the 90 values were not out of the agreement limits, as shown in Bland-Altman graphic. Conclusion: The present study showed that bicarbonate measurements with the blood gas analyzers which give quick results are reliable and acceptable when compared with the results of the direct enzymatic method. Conflict of interests: Authors have no conflict of interest

Tip 2 diyabet hastalarında tıkınırcasına yeme bozuklu?u ve glisemik kontrol arasındaki i?lişki

Objective: Our aim was to assess the prevalence of binge eating disorder (BED) in individuals with type 2 diabetes and to investigate whether a comorbidity with BED would affect glycemic control in these patients. Materials and Methods: Eighty-two type 2 diabetic patients were enrolled. The participants were assessed for eating disorders by a psychiatrist. Blood samples were drawn and HbA1c and other biochemical parameters were measured. Results: Of the 82 subjects, 27 (34.1%) met the criteria for BED. No other types of eating disorders were detected. HbA1c was significantly higher in individuals with BED (p<0.05). Conclusion: Our findings reveal that BED is highly prevalent among type 2 diabetic patients and it impairs glycemic control. Thus, patients with type 2 diabetes should be assessed carefully for eating disorders

Farklı Antihipertansif İlaçlara Bağlı Nadir Akut Pankreatit Olguları: Dört Olgu

Akut pankreatitin (AP) en önemli nedenleri benign safra yolu hastalıkları, metabolik hastalıklar ve alkolizmdir. Bazı ilaçlar (sülfonamidler, tiazidler, lizinopril, kaptopril, östrojen ve tetrasiklinler) da APyi indükleyebilirler. Burada farklı ilaçlar kullanmış olan hastalara ait dört AP olgusu sunulmuştur. İlk olgu 4 haftadır zofenopril kullanan 73 yaşındaki bir erkek hasta, ikinci olgu ise gebelik sonrası furosemid kullanan 24 yaşındaki bir kadın hastaydı. Üçüncü olgu bir ay valsartan kulanmıştı. Dördüncü hasta altı hafta süresince liziopril kullanmış ve AP olmuştu. Hastalardan hiçbiri pankreatit için bilinen risk faktörlerine sahip değildi. İlaçların kesilmesinin ardından dört hasta birkaç gün içinde herhangi bir komplikasyon olmadan iyileşti. Zofenoprile bağlı AP literatürde ilk kez bu çalışma ile sunulmuştur.The most important reasons of acute pancreatitis (AP) are benign biliary tract diseases, metabolic diseases and alcoholism. Some drugs also (sulfonamides, thiazides, lysinopril, captopril, estrogens and tetracyclines) can induce AP. We herein report four cases of AP patients who were using different drugs. The first case was 73 years old male patient who has been using zofenopril for 4 weeks and the second patient was 24 years old female who was using furosemide after her pregnancy. Third one was using valsartan for one month. Fourth patient was using lysinopril for six weeks and resulted in AP. All patients had no known risk factors for pancreatitis. After cessation of the drugs, four patients recovered in a few days without any complications. AP due to zofenopril was firstly reported in our manuscript in the literature