Outcomes of the patients diagnosed incidentally appendicitis during cesarean section

Objectives: Appendicitis is the most common condition leading to an intraabdominal operation for a non obstetric problem in pregnancy and diagnosis of appendicitis is complicated by the physiologic and anatomic changes that occur during pregnancy. Although a surgical procedure carries the risk of fetal loss or preterm delivery, delay in diagnosis also increases the risk of complications in both mother and fetus. In this report we present our experience and analyze clinical characteristic and the pregnancy outcomes of appendicitis diagnosed incidentally during cesarean in the third trimester. Material and methods: The study population consisted of 23 pregnant women who were diagnosed incidentally with appendicitis during cesarean at Erzincan University Hospital between 2015 and 2016. Results: Appendectomy was performed on 23 patients during a caesarean section performed for any reason. The mean dia-meter of appendix was 7.82 ± 1.85 mm. The mean operation time was 67.39 ± 18.94 SD and antibiotic therapy was given to all patients. Postoperative complications were noted in 4 (17.4%) patients. Wound infection was seen in 4 (17.4%) patients, the other 19 patients revealed no postoperative complications. The mean of APGAR score of newborns in the postoperative period was 8.26 ± 0.86 SD and no complications were observed in both mothers and newborns. Histopathology of the specimen confirmed acute appendicitis in 23 (100%) cases. Conclusions: Acute appendicitis is a challenging diagnosis in the pregnant patient; however, early surgical intervention should be performed with any suspicion. The type of surgery depends on the surgeon’s preference and experience

Evaluation of Nail Findings in Patients with COVID-19 History and Wood's Lamp Examination

Introduction: Various skin findings due to coronavirus have been identified. There are a few case reports on nail findings after coronavirus (COVID-19) infection. We aimed to document the nail findings of the COVID-19 survivors and shed light on the interesting luminescence seen under the Wood's light. Methods: One hundred and seventy-four patients diagnosed with COVID-19 infection in the last 100 days were grouped in terms of the agents used in the treatment. Fifty-seven volunteers without a history of infection were included. Results: Patients treated with favipiravir had a significantly higher positivity of luminescence (p: 0.0001). The most common nail findings in patients were splinter hemorrhage (13%), followed by leukonychia (12%) and longitudinal ridges (7.9%). Discussion/Conclusions: The luminescence may be seen due to the accumulation of favipiravir or its excipients (titanium dioxide and yellow ferric oxide) on the nails. Wood's lamp examination of the plasma taken from a patient after favipiravir's first dose revealed the same luminescence as we saw on the nails. Accordingly, this accumulation may be seen in the vital organs. Although our knowledge about the virus increases day by day, the potentially hazardous effects of the virus and long-term complications of the treatment options are still being investigated

Efficacy of 2940 nm Multifractional Er: YAG Lasers in Self-inflicted Razor Blade Incision Scars

Background Deliberate self-harm (DSH) can be defined as self-inflicted injury without an intention to suicide, and it may result in scar formation with a particular shape. Aims There is no treatment algorithm for DSH scars, nor is there a gold standard for the treatment of hypertrophic scars. Therefore, we aimed to share our experience with Er: YAG laser treatment of self-inflicted razor blade incision scars. Patients/Methods The study involved 18 patients with DSH scars treated with fractional ablative Er: YAG laser (MCL 31 Asclepion laser Technologies) between 2017 and 2020, with the parameters of 40 J/cm(2), 300 mu s, and 4 Hz. The sessions were repeated by increasing 10 joules in every session with 4-week intervals until reaching a maximum of 80 joules. The patients were evaluated retrospectively by two different dermatologists in terms of scar improvement over digital photographs taken before and 4 weeks after the treatment. Evaluations have been made based on a 4-point score (0:no change, 1:1%-25% mild, 2:26%-50% moderate, 3:51%-75% well, and 4:76%-100% excellent improvement). Results After the third session, 90.9% of the patients showed a moderate improvement. After the fourth session, only 27.2% of the patients had a good, and 63.2% of the patients had a moderate improvement rate. Conclusions Er: YAG laser is a safe and effective treatment method for the hypertrophic scars induced by razor blades. Also, we believe that combined treatments with other treatment modalities will provide better results in DSH scars

Complication of lichen sclerosus [Liken sklerozus komplikasyonu]

Lichen sclerosus (LS) is a chronic, inflammatory disease which is mostly located to genital region, usually in women. Etiology of the disease is not exactly understood. It can be asymptomatic or it may also cause itching, scarring or malignity development. Diagnosis of LS is clinical but in some cases, a biopsy may be necessary. The cases who have cellular atypia besides the expected usual findings in the biopsy are considered to be risky for squamous cell carcinoma (SCC) development. Here in this case, the biopsy result from a forty-nine-year-old female patient with a complaint of resistant genital itching and afterwards development of a small tumoral structure has shown SCC findings. We presented this case for taking attentions to the malignity risk on the basis of LS and promoting alertness and early diagnosis. [Med-Science 2017; 6(1.000): 128-30

Inguinal Papule with a Milky Secretion

Abstract Not Availabl

A new treatment option for poikiloderma of Civatte: 577 nm pro-yellow laser

Background Although many laser systems have been used in the treatment for Poikiloderma of Civatte (POC), there is no standard treatment guideline. Objectives We aimed to present our data on the efficacy and safety of single-session pro-yellow laser treatment for POC. Methods The study included 14 patients treated with pro-yellow laser (QuadroStarPRO YELLOW(R) Asclepion Laser Technologies, Germany) between 2017 and 2019. Treatment had been applied in two passes during the same session; a general pass with 22 j/cm(2) over the whole lesion, then, one more pass only on the telangiectatic lesions with 18 j/cm(2) fluence. They were evaluated based on their pictures taken before and 4 weeks after the treatment and scored by a 4-item scoring in terms of the improvement (0:no change, 1:1%-25% mild, 2:26%-50% moderate, 3:51%-75% well, and 4:76%-100% excellent improvement). Results The mean age of the patients (1 female, 13 males) was 59.64 +/- 8.16 years. Five patients had Fitzpatrick-2 and 9 patients had Fitzpatrick-3 skin types. Six patients had mild, 8 patients had moderate improvement, one of them has been illustrated in Figure 1. Sixty-minute mild erythema was the only adverse effect observed. Conclusions We think that pro-yellow laser is a good treatment option for POC treatment. Repeated sessions are required for the complete healing of the lesions, while one single session has proved to be deficient. We observed that it was a quite safe treatment option, especially for the neck region, which was inclined to scarring and atrophy development

A case with pyoderma gangrenosum, after an abdominal surgery

Pyoderma gangrenosum (PG) is a pathergy positive, ulcerative neutrophilic dermatosis. Pathergy phenomenon is described as a sterile pustule and an ulcer development after minor skin traumas like a bump or bruise, or needlestick injury. In the literature, there are PG cases associated with the pathergy phenomenon on the post-surgical scar tissue. It presents as a necrotic and an ulcerative lesion clinically and, debridement is performed mostly with wrong pre-diagnoses. Debridement makes the lesion get wider and the morbidity increase. There are some PG case reports in the literature which were ended up with amputation due to debridement of a lesion which was an overlooked PG. Herein, we present a case with a giant abdominal pyoderma gangrenosum developed after a surgery in the abdominal drainage site and has reached to 30 cm size after debridement. [Med-Science 2019; 8(2.000): 451-3

Genetic algorithm-driven surface-enhanced raman spectroscopy substrate optimization

Surface-enhanced Raman spectroscopy (SERS) is a highly sensitive and molecule-specific detection technique that uses surface plasmon resonances to enhance Raman scattering from analytes. In SERS system design, the substrates must have minimal or no background at the incident laser wavelength and large Raman signal enhancement via plasmonic confinement and grating modes over large areas (i.e., squared millimeters). These requirements impose many competing design constraints that make exhaustive parametric computational optimization of SERS substrates pro-hibitively time consuming. Here, we demonstrate a genetic-algorithm (GA)-based optimization method for SERS substrates to achieve strong electric field localization over wide areas for recon-figurable and programmable photonic SERS sensors. We analyzed the GA parameters and tuned them for SERS substrate optimization in detail. We experimentally validated the model results by fabricating the predicted nanostructures using electron beam lithography. The experimental Raman spectrum signal enhancements of the optimized SERS substrates validated the model predictions and enabled the generation of a detailed Raman profile of methylene blue fluorescence dye. The GA and its optimization shown here could pave the way for photonic chips and components with arbitrary design constraints, wavelength bands, and performance targets