Acute appendicitis coexisting with acute pyelonephritis causing diagnostic dilemma: a case report

Background Acute appendicitis and acute pyelonephritis are the most common diseases admitted to emergency departments. Both conditions have common symptoms such as flank pain, abdominal pain, and fever. Patients' history, physical examination, laboratory evaluation, and imaging methods are used to differentiate these two conditions. Diverticulitis, colitis, gynecological pathologies, and ureteral stones that mimic acute appendicitis should be kept in mind as differential diagnoses. Cases of pyelonephritis mimicking acute appendicitis have been reported in the literature, but there has not been a reported case in which acute appendicitis occurs during management of acute pyelonephritis. In this article, a case report which can cause such a diagnostic dilemma has been presented. Case presentation A 42-year-old female patient presented with clinical features suggestive of acute appendicitis that developed after a diagnosis of acute pyelonephritis. She underwent laparoscopic appendectomy on account of acute appendicitis during medical treatment for acute pyelonephritis. Physical examination showed only right costovertebral tenderness without any rebound tenderness at McBurney's point at the first admission, but during treatment rebound tenderness at McBurney's point was also detected. The Alvarado score of the patient was 5 at the first admission and 7 when acute appendicitis was diagnosed. The patient fully recovered and was discharged after both diseases were completely treated. Conclusions As seen in this case, it should be remembered that both diseases can be seen together which causes a diagnostic dilemma. If clinical or biochemical progression is detected in a patient under treatment, imaging methods should be repeated and additional ones with higher resolutions should be used

Importance of Clinical Suspicion in Rapid Diagnostic Test Negativity in Malaria: Two Case Reports

Introduction: Malaria is a life-threatening disease caused by infection with Plasmodium parasites. Rapid diagnostic tests (RDTs) have been used for the diagnosis of malaria without special equipment by unskilled personnel over the last 15 years. The treatment should only be given after the clinical diagnosis confirmed by RDT or microscopy. RDTs' specificity and sensitivity have been reported as >95% by the World Health Organization - Foundation for Initiative New Diagnostics (WHO-FIND). Case report: A 30-years-old male and a 23-years-old female presented to our emergency department with fever and history of a visit to a malaria-endemic country. Plasmodium trophozoites were seen in the blood smear samples via light microscopy. However, RDTs were negative. The patients were treated according to their pathogens. Conclusion: Rarely, RDT might result in a false negative in the diagnosis of malaria. People travelling to endemic areas should be closely monitored. Emergency department physicians should not neglect microscopy which is the gold standard for diagnosis of malaria

Spor video oyunları oyuncu deneyimi ölçeğinin Türkçe uyarlaması

Bu araştırmada, spor video oyunlarında oyuncu deneyimini ölçmek amacıyla geliştirilen ölçeğin Türkçeye uyarlamasını yapmayı amaçlamaktadır. Ölçek spor video oyunlarında oyuncuların oyun deneyimini 6 alt boyut üzerinden incelemeyi amaçlamaktadır. Araştırmanın araştırma grubunu aktif olarak spor video oyunlarını oynayan bireyler oluşturmuştur. Bu doğrultuda araştırma grubu 244’ü erkek (%97,6) ve 6’sı kadın (%2,40) olmak üzere toplam 250 kişiden oluşmaktadır. Araştırma grubundan elde edilen verilerin istatistiki işlemlerinin uygulanmasında IBM SPSS 25.0 paket programı ile LİSREL programından faydalanılmıştır. Ölçeğin geçerlik ve güvenirliğinin test edilmesi için madde analizi, güvenirlik analizi, madde toplam korelasyon analizi, madde ayırt edicilik analizi ve açıklayıcı faktör analizi yapılmıştır. Ölçek ve alt boyutları için DFA yapılmış, uyum indeksleri, AVE-CR ve güvenirlik değerlerine bakılmıştır. Elde edilen bulgulara bakıldığında x2/df=2,101, CFI=0,99, GFI=0,93, AGFI=0,91, NNFI=0,99, NFI=0,98, RMR=0,063, SRMR=0,038 olarak tespit edilmiştir. Uyum indekslerinin ölçeğin Türkçe uyarlamasının kabul edilen sınırlar arasında olduğunu göstermektedir. Ölçeğin Türkçe formunda yer alan alt boyutların Cronbach’s Alpha ve CR değerleri 0,82 ile 0,96 arasında dağılım göstermektedir. Ayrıca AVE değerleri 0,63 ile 0,86 arasında dağılım gösterdiği tespit edilmiştir. Sonuç spor video oyunları oyuncu deneyimi ölçeğinin Türkçe formu 21 madde ve 6 alt boyuttan oluşturulmuş geçerli ve güvenilir bir ölçüm aracı olduğu tespit edilmiştir

Laryngeal Tuberculosis: A Report of Two Cases

Laryngeal tuberculosis is rarely seen nowadays. Diagnostic delays are common in laryngeal tuberculosis because it might be confused with other diseases. It is usually accompanied by pulmonary tuberculosis and has a high risk of transmission. Therefore, it poses a serious problem in terms of public health. In this report, two cases of laryngeal tuberculosis are presented, a 25-year-old female and a 78-year-old male prediagnosed as gastroesophageal reflux and laryngeal cancer, respectively. Their diagnoses were delayed, and they have pulmonary tuberculosis as well. Both cases diagnosed by chest radiography and microbiological examination of sputum. In both cases, full recovery was achieved with a 6-month antituberculous treatment

Adenovirus Pneumonia Developed in a Military Barrack: A Case Report

Adenovirus often causes respiratory system infection in children, and it rarely leads to pneumonia in immunocompetant adults. Sometimes, outbreaks of adenovirus pneumonia occur in military barracks. In this report, a 28-year-old non-immunocompromised male contracted a severe adenovirus pneumonia during his military service was presented

Neuroleptic Malignant Syndrome During the use of Extended Release Quetiapine: A Case Report

Neuroleptic malignant syndrome during the use of extended release quetiapine: a case repor

A rare case of paraneoplastic limbic encephalitis leading to epileptic seizure in a patient with ovarian carcinoma

Paraneoplastic limbic encephalitis (PLE), a rare and diagnostically-challenging encephalopathy, is frequently associated with an underlying malign neoplastic tumor. Epileptic symptoms are uncommon but can be the first sign of the disease. We present a patient admitted to our intensive care unit (ICU) unit with epileptic seizure and a Glasgow Coma Scale (GCS) of six. All tests and investigations that had been utilized for this patient's diagnosis, including blood tests, serological analyses, magnetic resonance imaging (MRI), electroencephalogram (EEG) and cerebrospinal fluid (CSF) test results were evaluated. The patient had been diagnosed with ovarian carcinoma within the last year. The patient's cancer history, her most recent complaints and MRI results were strongly suspicious for paraneoplastic limbic encephalitis. Her neurological condition improved rapidly in a few days with steroid therapy. This case showed that any neurological deterioration based on an ovarian oncologic disease can bring PLE to mind. The possibility of PLE must be taken into consideration in patients presenting with epileptic seizures after neoplastic diagnoses

Risk factors for occupational brucellosis among veterinary personnel in Turkey

WOS: 000346883000006PubMed ID: 25132061Veterinarians and veterinary technicians are at risk for occupational brucellosis. We described the risk factors of occupational brucellosis among veterinary personnel in Turkey. A multicenter retrospective survey was performed among veterinary personnel who were actively working in the field. Of 712 veterinary personnel, 84(11.8%) had occupational brucellosis. The median number of years since graduation was 7 (interquartile ranges [IQR], 4-11) years in the occupational brucellosis group, whereas this number was 9 (IQR, 4-16) years in the non-brucellosis group (p < 0.001). In multivariable analysis, working in the private sector (odds ratio [OR], 2.8; 95% confidence interval [95% CI], 1.55-5.28, p = 0.001), being male (OR, 4.5; 95% CI, 1.05-18.84, p = 0.041), number of performed deliveries (OR, 1.01; 95% CI, 1.002-1.02, p = 0.014), and injury during Brucella vaccine administration (OR, 5.4; 95% CI, 3.16-9.3, p < 0.001) were found to be risk factors for occupational brucellosis. We suggest that all veterinary personnel should be trained on brucellosis and the importance of using personal protective equipment in order to avoid this infection. (C) 2014 Elsevier B.V. All rights reserved