Needle sticks and injuries due to surgical instruments in health care providers

Objective: Health caregivers are facing various risks andhazards in their working environment. In this study theevaluation and examination of measures to be taken wasaimed among occupational injuries in our hospital in thelast three years.Methods: This study was performed as a retrospectiveinvestigation of 40 records of injury for health care providersthat detected by infection control committee of atertiary care university hospital between May 2010 andApril 2013.Results: Forty health care providers mean aged 28.5±7.8years submission were included. There were 21 male and19 female subjects. Most cases were the nurses (16/40).The majority of the injuries occurred in the surgical wards.Among the submissions, only 3 were working in the emergencyservice. The type of injuries were needle stick in 36cases and injuries due to surgical instruments in 2 casesand mucosal exposure in 2 cases. Following injury, 39cases confirmed that they cleaned the injured area. Inone case, the injured area was exsanguinated by squeezing.The cause of injury was known by 25 cases; however,15 cases did not know the causative material. In one casehepatitis B developed after injury. This case did not applyto the infection committee early stage but referred afterthe development of signs of active hepatitis.Conclusions: Health care providers should be educatedabout the risks of occupational body fluids and blood exposuresand after exposure to blood or blood productsthey should apply to the infection control committee withoutdelay.Key words: Hepatitis B, needle stick, health care provider

Impact of the COVID-19 pandemic on diabetic ketoacidosis management in the pediatric intensive care unit

Background Diabetic ketoacidosis (DKA) is a common endocrine emergency in pediatric patients. Early presentation to health facilities, diagnosis, and good management in the pediatric intensive care unit (PICU) are crucial for better outcomes in children with DKA. Methods This was a single-center, retrospective cohort study conducted between February 2015 and January 2022. Patients with DKA were divided into two groups according to pandemic status and diabetes diagnosis. Results The study enrolled 59 patients, and their mean age was 11±5 years. Forty (68%) had newly diagnosed type 1 diabetes mellitus (T1DM), and 61% received follow-up in the pre-pandemic period. Blood glucose, blood ketone, potassium, phosphorus, and creatinine levels were significantly higher in the new-onset T1DM group compared with the previously diagnosed group (P=0.01, P=0.02, P<0.001, P=0.01, and P=0.08, respectively). In patients with newly diagnosed T1DM, length of PICU stays were longer than in those with previously diagnosed T1DM (28.5±8.9 vs. 17.3±6.7 hours, p<0.001). The pandemic group was compared with pre-pandemic group, there was a statistically significant difference in laboratory parameters of pH, HCO3, and lactate and also Pediatric Risk of Mortality (PRISM) III score. All patients survived, and there were no neurologic sequelae. Conclusion Patients admitted during the pandemic period were admitted with more severe DKA and had higher PRISM III scores. During the pandemic period, there was an increase in the incidence of DKA in the participating center compared to that before the pandemic

Neurobrucellosis

In 5-10% of cases of brucellosis may lead to central nervous system manifestation presenting most often as a meningitis or meningoencephalitis. We report three neurobrucellosis who have different presentation. First patient; a 49-year-old-woman who developed diffuse cerebral white matter lesions as leukoencephalopathy associated with neurobrucellosis, presented with gait disturbance, behavior change and seizure. Second patient; 44-year-old man was admitted to our hospital with a complaint of progressive motor weakness in his bilateral legs for four months and headache for one year. The patient’s symptoms may be explained with myeloradiculopathy and meningoencephalitis but the clinical picture didn’t correlate with imaging findings. Third patient; 23-year-old man was admitted to our hospital with a complaint of transient numbness attacks in his left of face and hand and headache for twenty days. He presented as meningitis which is the most clinical presentation of neurobrucellosis and meningovascular complications. Conclusively, brucellosis is still endemic in Turkey and thus neurobrucellosis should be considered in the unexplained neurological symptoms such as cognitive dysfunction, young transient ischemic attacks, paraparesis and psychiatric symptoms

Efficacy of vitamin E in children with immunotolerant-phase chronic hepatitis B infection

ECE, AYDIN/0000-0001-9130-2431; dikici, bunyamin/0000-0001-7572-6525; Ece, Aydin/0000-0001-6764-8336WOS: 000249493400011PubMed: 17875084Background: The purpose of the present paper was to investigate the efficacy of vitamin E in children with immunotolerant-phase chronic hepatitis B virus (CHB) infection. Methods: Fifty-eight immunotolerant children were prospectively and randomly recruited into two groups. Group 1 (study group) included 30 patients who received vitamin E at a dose of 100 mg/day throughout 3 months; group 2 (control group) contained 28 patients who did not receive any medication. Comparison of serological, virologic, and biochemical response ratios were done at the end of the therapy and after 6 months of vitamin E discontinuation. Results: Mean alanine transaminase (ALT) values in group 1 at the beginning of the therapy, 3 months after the therapy initiation and 6 months after discontinuation were 30.4 +/- 7.3 IU/L, 31.3 +/- 7.8 IU/L and 32.1 +/- 8.5 IU/L, respectively. The mean hepatitis B virus (HBV)-DNA load of group 1 at onset, and at the third and ninth months of the treatment were 3106 +/- 718 pg/mL, 3530 +/- 137 pg/mL and 3364 +/- 1246 pg/mL, respectively. These changes in both ALT and HBV-DNA values did not reach significant levels (P > 0.05). In group 2, mean ALT values at the beginning of therapy, and at the third and ninth months were 28.0 +/- 1.8 IU/L, 34.6 +/- 8.1 IU/L, and 34.1 +/- 7.0 IU/L, respectively (P > 0.05), and mean viral load of HBV-DNA was 4227 +/- 1435 pg/mL, 3368 +/- 2673 pg/mL, and 3018 +/- 2814 pg/mL, respectively (P > 0.05). There was no statistically significant difference between group 1 and group 2 at the third and ninth months in the mean ALT values and viral load of HBV-DNA (P > 0.05). Hepatitis B s antigen and hepatitis B e antigen clearance or hepatitis B s antibody and hepatitis B e antibody seroconversion were not observed in either group. Conclusion: As a first study investigating the effect of vitamin E in children with immunotolerant CHB infection, no beneficial effect could be demonstrated. Different immunomodulator protocols should be considered for future investigations

Negative Pressure Wound Therapy and Skin Graft in Madura Foot Treatment

Madura foot is a rare, loca, chronic granulomatous skin infection which commonly affects the adult male foot. Medical treatment reduces the size of the lesion but surgical excision is necessary for radical treatment. We present a case of a 59 year old male farmer diagnosed as actinomadura of the right foot treated with medical treatment, total excision, negative pressure wound therapy and split thickness skin graft

Oxidative Stress Biomarkers in Urine of Patients with Hepatitis B and C

Objective: The aim of our study is to determine the role of oxidative stress biomarkers in hepatic damage in hepatitis B virus (HBV) and hepatitis C virus (HCV)-infected patients. Materials and Methods: Forty-eight patients with chronic hepatitis B, 15 patients with chronic hepatitis C and 30 healthy individuals as a control group were included in this study. Serum alanine-aminotransferase (ALT) and aspartate aminotransferase (AST) levels, urine oxidative stress biomarkers such as malondialdehyde (MDA) levels, superoxide dismutase (SOD-1) and catalase (CAT) activities were measured. Results: Urine MDA levels increased in patients with HBV and HCV compared to the control group. It was higher in HCV patients than HBV patients (p<0.001). Besides, while CAT and SOD-1 activities were decreased in the urine of patients with HCV, they increased in the urine of patients with HBV compared to controls (p<0.05). Furthermore, urine CAT ve SOD-1 activities in patients with HBV were statistically significantly higher than those of the HCV patients (p<0.001). Conclusion: Increase in urine MDA levels in hepatitis forms may be valuable in monitoring in viral hepatitis cases. Also, we thought that insufficiency of antioxidant barrier in patients with HCV may cause oxidative damage, so antioxidant treatment may useful and should be added to the combined therapy for these patients