Acute nontraumatic torticollis in a patient with right lower quadrant pain: case report

Right lower quadrant pain is one of the most common symptoms of the emergency patients. For accurate diagnosis and treatment; the patients must be questioned and examined very well. Also accompanying conditions due to right lower quadrant pain may be noticed. In this case presantation, we discussed a patient who was presented with right lower quadrant pain and cervical dystonia. By limiting the usage of metoclopramide the patient was followed seamlessly. In this case presentation we want to accentuate that a patient who with abdominal pain may be presented with rare symptoms such of dystonia. In such conditions a detailed anamnesis and physical  examination are the first steps of the evaluation to prevent potential hazardous outcomes. Inparticular, a surgeon must be always carefully while taking history and examining the patient

Effects of dietary ascorbic acid on performance, carcass composition and bone characteristics of turkeys during high summer temperature

WOS: 000253878600019Heat stress is major welfare problem in the poultry industry. Huge economic losses occur every year because of mortality and decreased production due to high environmental temperatures. This experiment was conducted to determine the effects of level of inclusion of ascorbic acid supplementation to the diet on performance, carcass composition and bone characteristics of male turkeys during high summer temperature. A total of 120 day-old turkey chicks were wing banded at hatch and randomly distributed into 3 treatment groups. Three diets were formulated to provide a similar nutrient profile with the exception of using three graded levels of ascorbic acid, namely 0, 150 and 300 mg/kg of the diet. The experimental diets were used from 0 to 18 weeks of age. Body weights, feed intake and feed conversion ratio, slaughter weight, carcass yield, portions, composition and thigh and breast pigmentation of the turkeys were not affected by ascorbic acid (p>0.05). Also, shank and tibia bone characteristics were not affected by ascorbic (p>0.05)

Fournier's Gangrene Severity Index on the outcomes

Fournier's gangrene (FG) is a rare, rapidly progressive, fulminant form of necrotizing fasciitis of the genital, perianal and perineal regions. Several factors have been reported to contribute to the clinical outcomes. The primary aims of this study were to examine the clinical features of patients with FG and evaluate the predictivity of the Fournier's Gangrene Severity Index (FGSI) score on the outcomes. We carried out a collective retrospective chart review of patients diagnosed and treated for FG in three reference centers between January 1995 and July 2007. Seventy-two patients with FG with were included to the study. Data were collected on medical history, symptoms, physical examination findings, admission and final laboratory tests, timing and extent of surgical debridement and antibiotic therapy. Perianal and perirectal abscess, scrotal abscess and urethral stenosis were the leading etiological factors. Diabetes mellitus was the predominant risk factor. Etiological factors and risk factors did not significantly contribute to survival or mortality, and duration of the symptoms was significantly longer in the non-survivor's group (P < 0.05). The FGSI scores were higher in the non-survivor's group. Regression analysis showed a FGSIS score of 10.5 as the cut-off to the outcome. Based on these results, we conclude that a patient's metabolic status and the extent of disease at presentation are the most important factors determining the prognosis of FG. The FGSI score may be considered as an objective and simple tool to predict the outcome in the patient with FG and should be used in further studies of FG patient series for comparison purposes

The protective effects of dexmedetomidine on hepatic ischemia reperfusion injury

PubMed: 25428535Objective: The aim of this study was to evaluate the effect of dexmedetomidine (100 ?g/kg-ip) on liver ischemia and reperfusion (I/R) in rats. Methods: Twenty-four Wistar Albino rats were separated into three groups as control (C), ischemia-reperfusion injury (I/R) and dexmedetomidine group (I/R-D). Ischemia was induced with portal clampage for 45 minutes and reperfusion period was 45 minutes after declampage. Group I/R-D was received dexmedetomidine 100 ?g/ kg i.p. 30 min before portal clampage. Thiobarbutiric Acid-Reactive Substances (TBARS), glutathioneS-transferase (GST), superoxide dismutase (SOD), Catalase (CAT), and Paraoxonase 1 (PON-1) were investigated in blood samples. Also HSP60 and p53-positive hepatocytes were counted under ImageJ image analysis program. Results: All parameters, except GST levels, were significant between the groups (p < 0.05). Although HSP60 expression was significantly increased between I/R, I/R-D and C groups there were no significant differences between I/R-D and C (p = 0.443). On the other hand, p53 expression was also significantly increased between I/R, I/R-D and C groups At the same time, there were no significant differences between I/R-D and C groups (p = 0.354). Conclusion: All the results suggest that dexmedetomidine has beneficial effects on liver ischemia/reperfusion stress

Value of serial platelet indices measurements for the prediction of pulmonary embolism in&nbsp;patients&nbsp;with deep venous thrombosis

Utkan Sevuk,1 Mehmet Veysi Bahadir,2 Rojhat Altindag,3 Erkan Baysal,3 Baris Yaylak,3 Nurettin Ay,4 Firat Ayaz,1 Ertan Demirtas5 1Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey; 2Department of General Surgery, Dicle University, Diyarbakir, Turkey; 3Department of Cardiology, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey; 4Department of General Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey; 5Department of Cardiovascular Surgery, Liv Hospital, Ankara, Turkey Background: To date, no validated biomarkers with high sensitivity and specificity have been established for diagnosis of pulmonary embolism (PE) in patients with deep venous thrombosis (DVT). There is a need to develop simple and reliable noninvasive tests that can accurately identify patients with PE, even in small hospitals or clinics. The aim of this study was to investigate the value of mean platelet volume (MPV) and platelet distribution width (PDW) for predicting occurrence of PE in patients with DVT. Methods: Records of acute DVT patients were reviewed retrospectively. Group 1 consisted of 50 patients with acute DVT and group 2 consisted of 50 patients with acute DVT who developed PE during follow-up. The control group consisted of patients with uncomplicated primary varicose veins of the lower limbs. Venous peripheral blood samples for measurement of MPV, PDW, and platelet count were drawn on admission, before the treatment, and at the time of PE diagnosis. Results: MPV and PDW levels at the time of PE diagnosis were higher in group 2 than group&nbsp;1 (P&lt;0.001 and P=0.026, respectively). Receiver operating characteristics analysis revealed that a 5.2% increase in admission PDW during follow-up provided 70% sensitivity and 82% specificity (area under the curve, 0.80), and a 6.6% increase in admission MPV during follow-up provided 74% sensitivity and 83% specificity (area under the curve, 0.84) for prediction of PE occurrence in patients with DVT. PDW and MPV levels at the time of PE diagnosis were found to be independent risk factors for the occurrence of PE in patients with DVT. Conclusion: Serial measurements of MPV and PDW, and percent change in MPV and PDW appears to be a useful marker for predicting occurrence of acute PE in patients with a first episode of acute proximal DVT. Keywords: deep venous thrombosis, pulmonary embolism, platelet indices, mean platelet volume, platelet distribution widt

The protective effects of dexmedetomidine on hepatic ischemia reperfusion injury

Objective: The aim of this study was to evaluate the effect of dexmedetomidine (100 mu g/kg-ip) on liver ischemia and reperfusion (I/R) in rats