THE PRESCHOOL AND PRIMARY SCHOOL EDUCATIONAL GAMES: A TEACHERS’ PERSPECTIVE

This paper examines preschool and primary school educational games from teachers’ perspective. Research group was composed by Amasya centre and related preschools and primary schools working teachers aged between 20 and 40, official and on payment (temporary). In total, 214 preschool and primary school teachers have been interviewed. The handouts have been delivered in the meeting “Preschool education games from teacher’s point of view evaluation questionnaire” and have been adapted to the topic under study. The handouts have been analysed as frequency and percentage from the delivered. After the evaluation of the handouts of preschool and primary school use of games as educational asset an average of 99.1% of teachers think that it is effective. An average 99.1% of teachers believe that teaching through games has been effective and durable and 88.7% of them proved it. As a result, learning through games offers the children an effective and durable input, proved crucial in the learning process.  Article visualizations

Efficacy of periarticular injection applied trough knee other than posterior capsule in simultaneous bilateral total knee arthroplasty

WOS: 000385436400008PubMed ID: 26566320Background: We aimed to evaluate periarticular multimodal drug injection (PMDI) in bilateral total knee arthroplasty. Methods: In 154 knees of 77 patients, PMDI was administered intraoperatively through the regions other than posterior capsule to one knee; other knee was control. Results: Drug-injected knees had lower visual analog scale scores and higher passive range of motion postoperatively (p < 0.05). The active straight leg raise was higher in drug-injected knees (47 [61%] vs 19 [24.7%], p < 0.001). Conclusions: PMDI is a safe and effective method of early postoperative pain management in total knee arthroplasty when applied through regions other than posterior capsule

Graft position in arthroscopic anterior cruciate ligament reconstruction: Anteromedial versus transtibial technique

Introduction: When treating anterior cruciate ligament (ACL) injuries, the position of the ACL graft plays a key role in regaining postoperative knee function and physiologic kinematics. In this study, we aimed to compare graft angle, graft position in tibial tunnel, and tibial and femoral tunnel positions in patients operated with anteromedial (AM) and transtibial (TT) methods to those of contralateral healthy knees. Materials and methods: Forty-eight patients who underwent arthroscopic ACL reconstruction with ipsilateral hamstring tendon autograft were included. Of these, 23 and 25 were treated by AM and TT techniques, respectively. MRI was performed at 18.4 and 19.7 months postoperatively in AM and TT groups. Graft angles, graft positions in the tibial tunnel and alignment of tibial and femoral tunnels were noted and compared in these two groups. The sagittal graft insertion tibia midpoint distance (SGON) has been used for evaluation of graft position in tunnel. Results: Sagittal ACL graft angles in operated and healthy knees of AM patients were 57.78° and 46.80° (p  0.05). Conclusions: Precise reconstruction on sagittal plane cannot be obtained with either AM or TT technique. However, AM technique is superior to TT technique in terms of anatomical graft positioning. Posterior-placed grafts in tibial tunnel prevent ACL reconstruction, although tibial tunnel is drilled on sagittal plane

Concomitantly intra-articular fracture of proximal condylar second and third proximal phalanges: A rare case report

AbstractIntroductionA rare case of proximal phalange fractures has been presented in this study.Presentation of caseA 29-year-old male patient from Turkey was admitted to the orthopedics and traumatology clinic with a complaint of left hand pain, which had persisted for 10days. He described a rotational trauma that had occurred right after hitting his hand on the wheel of a car as a result of an in-car traffic accident 10days ago. Radiological work-ups were requested. In the anteroposterior (AP) graph of the case in which the fracture line could not be observed in the oblique graph, unicondylar fractures in the proximal section of the second and third proximal phalanges have been observed. Surgical treatment was not planned because 10days had passed since the trauma. In the control graphs taken after 3 weeks, healing at the fracture site was observed, and he was referred to physiotherapy after the removal of the splint. A good result was observed after physiotherapy.DiscussionBecause of the extension of tendons is important over the bone, the goal of the treatment is not only to heal the fracture, but also to preserve the sliding mechanism of these tendons. Regarding to lack of soft tissue trauma, favored joint movements after the healing of the fracture can be achieved more easily with conservative treatment; however, the fracture must be closely followed up.ConclusionCondylar fractures of proximal phalanges those nondisplaced can be conservatively treated with closed methods

Anterior glenohumeral instability: Classification of pathologies of anteroinferior labroligamentous structures using MR arthrography

We examined labroligamentous structures in unstable anteroinferior glenohumeral joints using MR arthrography (MRA) to demonstrate that not all instabilities are Bankart lesions. We aimed to show that other surgical protocols besides classic Bankart repair are appropriate for labroligamentous lesions. The study included 35 patients (33 males and 2 females; mean age: 30.2; range: 18 to 57 years). MRA was performed in all patients. The lesions underlying patients’ instability such as Bankart, anterior labral periosteal sleeve avulsion (ALPSA), and Perthes lesions were diagnosed by two radiologists. MRA yielded 16 diagnoses of Bankart lesions, 5 of ALPSA lesions, and 14 of Perthes lesions. Albeit invasive, MRA seems to be a more reliable and accurate diagnostic imaging modality for the classification and treatment of instabilities compared to standard MRI

Evaluating the features of interdigital neuroma using 3-Tesla magnetic resonance imaging

Interdigital neuroma is an entrapment neurop-athy of the interdigital nerve. Previously, studies on interdigital neuroma were done with 1 Tesla Magnetic Resonance Imaging and more often 1.5 Tesla Magnetic Resonance Imaging. We used 3 Tesla Magnetic Resonance Imaging in our study and we did not encounter as much as we know about the study with 3 Tesla Magnetic Resonance Imaging in the literature. Between 2013 and 2019, the 3 Tesla Magnetic Resonance Imaging results of 39 consecutive surgically-confirmed interdigi- tal neuromas and patients' files were retrospec- tively evaluated. The soft tissue surrounding the prominent interdigital nerve "target sign" were assessed. Spearman's rho, Pearson's correlation tests, and Mann-Whitney U-tests were used. Of the 39 cases (mean transverse dimension = 4.64 mm), 35 (89.7%) were hypointense on T1-weight - ed sequencing, 34 were intermediate (87.1%) on short tau inversion recovery sequencing, and 29 (74.3%) had slightly-moderately enhanced neuro-mas on post-contrast spectral presaturation with inversion recovery sequences. A statistically sig-nificant negative relationship was found between contrast enhancement and disease duration (p = 0.020). On short tau inversion recovery or spec-tral presaturation with inversion recovery series, the intralesional nerve view "target sign" was ob-served in 23 (58.98 %) of 39 neuromas. This is the first study in the literature with 3 Tesla Magnetic Resonance Imaging that shows the visual charac-teristics of interdigital neuroma and its possible contribution to the diagnosis of the disease

The treatment of acute myocardial infarction due to the occlusion of the left main coronary disease

Acute myocardial infarction (AMI) due to the occlusion of the left main coronary artery (LMCA) is a rare but serious condition in the era of percutaneus coronary intervention (PCI). Even more rare is AMI involved with both LMCA and its branches like trifurcartion or bifurcation: this is challenging for interventional cardiologists, because it involves the extension of the myocardium complicated by cardiogenic shock and its technical difficulties. Trifurcating coronary artery disease is a complex atherosclerotic process involving the origin of one or more of three side branches arising from a left main coronary vessel or trunk, with or without the involvement of LMCA itself. There is no classification or standardized methodology to treat LMCA disease in elective percutaneous intervention procedures. Furthermore, acute myocardial infarction presenting with left main coronary artery trifurcation lesion seems to be more troublesome, especially in young patients. Few series of PCI on significant lesions of the left main trifurcations have been described. Herein, we describe a patient who successfully underwent PCI and was supported by post intravascular ultrasound sonography and multislice computed angiography (MSCA), and after an uneventful follow-up with MSCA is now on the ninth month. (Cardiol J 2011; 18, 1: 77-82

Evaluation of Antibiotic Alternatives Used in Orthopedic Departments of 2 Hospitals According to Rational Use of Antibiotics

Amaç: Birbirine yakın ve aynı bölgede yer alan iki farklı hastanenin ortopedi ve travmatoloji servislerinde yatan hastalarda, etkeni saptanan enfeksiyon olgularında antibiyotik kullanımının, akılcı ilaç tedavi rehberleri ve kültür antibiyogram sonuçlarına göre uygunluğunun araştırılması amaçlandı.Gereç ve Yöntem: Bu araştırma projesi T.C. Sağlık Bakanlığı Genel Sekreterlik İzni doğrultusunda 01 Ocak 2014 ile 31 Aralık 2014 tarihleri arasında, iki hastanenin ortopedi ve travmatoloji servislerinde enfeksiyon tanısına sahip olguların verileri üzerinden gerçekleştirildi. Malignitesi olan veya başka bir servise taburcu edilen olgular çalışmadan dışlandı. Standart bir form oluşturuldu. Bu form içerisine, olguların demografik verilerine ek olarak, kültür antibiyogram sonuçları, enfeksiyon patojen etkeni, kültür materyalinin nereden alındığı, kullanılan antibiyotiklerin pozolojisi, süresi ve uygunluğu ile olguların yatış süreleri raporlandı. Maliyetlerin hesaplanmasında, Sağlık Bakanlığı ve Maliye Bakanlığı 2014 yılı fiyat listeleri temel alındı. Birim fiyat üzerinden hasta başına kullanılan antibiyotik maliyetleri hesaplandı.Bulgular: Saptanan enfeksiyon etkeni için her zaman uygun antibiyotiğin seçilmediği belirlendi. Antibiyogram sonuçlarına göre etkili, daha düşük maliyetli antibiyotikler kullanılabilinmesine rağmen sıklıkla daha pahalı ve toplam maliyeti yükselten antibiyotikler seçilmiştir.Sonuç: Kanıta dayalı tıp ve akılcı antibiyotik kullanımı kapsamında enfeksiyon tedavisinde kültür antibiyogram sonuçlarına göre uygun antibiyotik seçilmesi gerekliliği tartışılmaz bir bilimsel gerçektir. Ortopedi ve travmatoloji servislerinde enfeksiyon tedavisinde enfeksiyon hastalıkları ve farmakoloji uzmanlarını da sürece katarak multi-disipliner yaklaşılarak kanıta dayalı rehberlerin kullanımının artışı sağlanmalıdırBackground: The present study is an analysis of appropriateness of antibiotics use for patients in whom infectious agent was detected. Data from patients in orthopedics and traumatology department of 2 hospitals in the same district were evaluated according to rational antibiotic drug use guidelines and culture antibiogram results.Methods: Data of patients diagnosed with infection between January 1, 2014 and December 31, 2015 in orthopedics and traumatology department of 2 different hospitals were analyzed. Patients diagnosed with malignancy or who were discharged from other departments were excluded. A standard form was used to collect demographic data, culture antibiogram results, details of infectious agent, source of culture material, posology of antibiotic used, duration and appropriateness of use, and length of hospital stay. Costs were estimated based on number of units used and price per unit according to 2014 Ministry of Health price list. Mean price of antibiotics used per patient was calculated and descriptive analyses were also completed.Results: It was determined that appropriate antibiotics for detected infectious agent were not always selected. Though there were effective, less expensive antibiotics that could have been used according to antibiogram results, more expensive antibiotics were often chosen, resulting in greater total cost.Conclusion: Multidisciplinary approach in patient care and use of evidence-based guidelines should be increased. Teams should be formed and led by infectious disease and pharmacology specialists. New strategies should be developed immediately in health economics and new pharmacoeconomic models should be initiated in orthopedics and traumatology department

An alternative malpractice system suggestion for Turkey: Patient compensation system

2015 Data Compression Conference, DCC 2015 -- 7 April 2015 through 9 April 2015 -- 113401Cocaine use has been related to the occurrence of myocardial infarction in young patients without other coronary risk factors. Acute myocardial infarction (AMI) secondary to the occlusion of the left main coronary artery (LMCA) in a cocaine user is infrequent, with sudden death being the most common form of presentation

Giant lipoma of the back affecting quality of life

Lipomas are benign tumours composed of adipose tissue. They may be localized in almost all body parts and may be in a giant form. Some of these giant lipomas may transform malignity and cause problems in daily living and detoriate quality of life. Mass localization also restrict body functions. In the present study, a 72-year-old man who presented with a mass enlarged in a time period of two years and because of this could not lie in the supine position, sit in an erect position and dress easily, go outside because of his physical appearance. With surgical treatment a 38 × 22 × 21 cm mass weighing 3575 g was successfully resected. Postoperative early phase complications did not occur. During 48 months of postoperative period, any recurrence was not detected and the patient was free of all his complaints. Cosmetic and functional results of the surgery and patient satisfaction were excellent. After surgery patient's quality of life was improved and restriction of body function was disappeared