Open reduction and percutaneous pinning for medial condyle fractures of elbow in children: is it a risk for complications?

Background: There are limited cases of humerus medial condyle fracture in the literature treated by open reduction and percutaneous pinning. This study presents cases treated by open reduction and percutaneous pinning and discussed the problems reported in the literature.Methods: Nine cases were treated by open reduction and percutaneous pinning between 2006-2014. These cases were followed for nonunion, avascular necrosis, range of motion, nerve lesion and infection for 15.3 months (range 11 to 18 months).Results: No non-union, avascular necrosis, iatrogenic nerve lesion or infection developed in our cases. All patients gained full range of motion.Conclusions: This study presents that surgical technique and early timing of surgery prevents the complications

A biomechanical comparison of two cephalomedullary nails; one using a single lag screw with antirotator blade and a nail using two lag screws for unstable intertrochanteric fractures

Background: Implant choice for fixation of intertrochanteric fractures remains controversial despite being one of the most commonly performed operations. Although use of sliding hip screws is still considered a gold standard in treatment of these fractures, there is a wide tendency in using cephalomedullary nails because of their biomechanical superiority over sliding hip screws. This trial was initiated in order to compare the biomechanical properties of two different cephalomedullary nails, aPFN and the PROFIN under axial loading, based on the questions that can a single lag screw with an antirotator blade render better rotational stability? Is there a difference between one lag screw or two lag screws with respect to superior migration or cut-out of the screws? And do different nail designs cause different types of failure and what are the pros and cons of classical and new designs from the view point of biomechanical aspects?Methods: Ten pairs of third generation synthetic bone models simulating unstable intertrochanteric fracture were used for biomechanical testing.Results: No posterior displacement of screws was recorded in both groups suggesting rotational unstability.  There was not a significant difference between forces values loaded at the time of failure.Conclusions: Although there was no statistically significant difference between compressive strengths at the time of failure, aPFN may provide equal rigid fixation with less possible cut-out which may have an important consequences in real clinical applications

Foreign Bodies in Nasal Cavity: Our Experience over 1 Year [Nazal Kavitede Yabanci Cisim: 1 Yillik Sonuclarimiz]

The aim of this study is to determine some parameters such as the structure of foreign body, age of patient etc. in patients with foreign body in their nasal cavity. The patients who referred to our hospital with foreign body in their nasal cavity between November 2013 and November 2014 are included to study. Data were collected retrospectively from patients records. 80 patients had foreign body in their nasal cavity. 45(%56.25) of them have foreign body in right nasal cavity, while 35 have in left one (%43.75). 48 of the patients were male (%60), 32 of them were female (%40). The foreign bodies were more common in early ages. 28 of patients (%35) were between age 0-2, 32 of them (%40) were between age 2-4, 15 of them (%19) were between age 5-8 and 5 of them (%6) were older than 8 years old. The foreign bodies mostly consist of little plastic substances (18 patients, %22.5), beans (16 patients %20), paper particles (12 patients, %12) and sponge (7 patients, %8.75). Only 5 of patients had complication of epistaxis after removal of foreign body. Foreign bodies in nasal cavity are common disorders of pediatric population. Although it is generally easy to remove foreign bodies from nasal cavity, it must be also considered that, all foreign bodies of nasal cavity have potential risk to obstruct the airway. Because of this, the foreign body in the nasal cavity is an emergency situation. [Med-Science 2015; 4(1.000): 2065-72

Cochlear Mechanisms in Noise Induced Hearing Loss

One of the most common cause of hearing loss depends on noise overexposure. Noise is a stress factor that has auditory, psychological and physiological effects. Noise causes overproduction of stress hormones, sleep disturbances and impairment of cellular immunity. The effect of noise that inflicts organic damage on the human hearing system varies depending on intensity, and duration of the noise and individual susceptibility. There are several anatomical and physiologic abnormalities caused by noise overexposure. These abnormalities vary from the minimal loss of metabolic activities of hair cells and stiffness of stereocilia to total loss of organ of corti and the auditory nerve. The opportunity to treat and prevent noise induced hearing loss may increase with the clarification of the mechanism of cochlear damage in noise. Understanding of these mechanisms is important for development of new agents for treatment or prevention of noise induced hearing loss. In this report, we reviewed the pathological changes of the cochlea in noise induced hearing loss in the light of the literature. [Med-Science 2015; 4(4.000): 2967-74

Unilateral Choanal Atresia Diagnosed During Operation: Case Report [Peroperatif Tani Konulan Unilateral Koanal Atrezi: Olgu Sunumu]

Choanal atresia is the unilateral or bilateral obstruction of the passage between nasal cavity and nasopharynx. Transnasal surgery of choanal atresia in a patient with unilateral choanal atresia diagnosed accidentally during operation of septorinoplasti for septal deviation and external nasal deformity in Plastic Surgery Clinic is presented. A 25-year-old female referred to plastic surgery clinic with external nasal deformity and difficulty in breathing through nose. Although concha bullosa at middle concha and polipoid degeneration at lower concha are observed in computerized tomography of paranasal sinus, the patient referred to our clinic. In physical examination, due to advanced septal deviation, endoscopic examination of left nasal cavity could not be established. It was planned to examine the left nasal cavity in operating room after septoplasty. In the endoscopic examination after septoplasty, choanal atresia at left nasal cavity observed. Atresia was repaired with transnasal approach. At follow-up period, the choanal opening was intact. Unilateral choanal atresia is a disorder which can reach at the adolesant ages without diagnosis. Although the symptoms of the disease can be interfere in lots of diseases, the diagnosis is simple with nasal endoscopic examination. If nasal endoscopic examination is difficult because of nasal septal deviation, it must be performed in operating room before ending the operation to reveal the additional disorders. [Med-Science 2015; 4(1.000): 2073-9

Evaluation of the effects on nasal mucociliary clearance of various nasal solutions applied topically in patients with sinusitis

Mucociliary clearance (MC) is one of the main defense mechanisms of the nasal respiratory mucosa. The purpose of this study was to determine changes occurring nasal MC in patients with sinusitis, and how medical treatment affects changes in MC, and to identify an appropriate topical solution with positive effects on MC for use in the treatment of sinusitis by examining the effects of various topical solutions on MC. 60 patients diagnosed with rhinosinusitis at the ear, nose and throat clinic were included in this prospective study. Patients were randomly assigned into groups. Group 1 (n:10) received no topical treatment. Group 2 (n:10) was administered with fluticasone propionate, Group 3 (n:10) received mometasone furoate and Group 4 (n:10) received oxymetazoline. Group 5 (n:10) received isotonic sea water for nasal irrigation, while Group 6 (n:10) received isotonic Ringers solution for nasal irrigation. Group 7 represented the control group (non-sinusitis). The saccharin test was used to determine nasal mucociliary clearance times. The saccharin test was performed before and on the 2nd week of treatment in all groups. Basal MCT and 2nd week MCT values were compared in all groups. When measurements performed 20 min and 14 days after administration of topical agents were compared with basal values, mean MCT values at 20 min. and 14 days were shorter in all groups compared to mean basal MCT values. However, the difference between 20-min, 14th day and basal MCT values was only statistically significant in the oxymetazoline and isotonic Ringers solution groups (p [Med-Science 2018; 7(1.000): 1-4

An Unusual Orthopaedic Disease: Sarcoidosis-A Case Report

Sarcoidosis is an idiopathic, noncaseating granulomatous disorder with wide systemic involvement. It is encountered widely around the world and it affects both sexes, all the races in all age groups. Lungs, eyes, and skin are the organs most commonly affected. Constitutional features such as weight loss, fatigue, and myalgia are the most common symptoms. Bone involvement, which is very rare, was reported as present in 3 to 13% of effected cases, and it is most commonly seen in hands and feet, compared with long bone involvement, which is extremely rare. We hereby present a case with a diagnosis of sarcoidosis and multiple bone involvement emphasizing the importance of differential diagnosis

Arising Prevalence Of Oxa-48 Producer Escherichia Coli And Oxa-48 With Ndm Co-Producer Klebsiella Pneumoniae Strains

Background/aim: This prospective study aimed to determine the presence of the most common carbapenemase genes, blaOXA-48, blaKPC, blaIMP, blaVIM and blaNDM on carbapenem resistant clinical K.pneumoniae and E.coli isolates. Materials and methods: Isolates were selected according to EUCAST guideline; gradient test and disc diffusion with both meropenem and ertapenem discs. Resistance rates of these isolates to other antimicrobial agents were also examined by disc diffusion method. Carbapenem resistance gene were investigated by using Real-Time PCR. Results: A total of 3845 E. coli and 1689 K. pneumoniae isolates from clinical samples between January 2015 and April 2017 were evaluated. The 419 isolates were found as carbapenem resistant but only the first resistant isolate (n=155; 126 K. pneumoniae and 29 E.coli) of each patient were included. Carbapenem resistant isolates were most frequently isolated from intensive care units (48.8%). Colistin was the most effective antibiotic (91.0%). The 121 (78.1%) of the tested isolates were positive for OXA-48 (103 K. pneumoniae and 18 E. coli) and 9 K. pneumoniae carrying blaNDM were also positive for blaOXA-48. VIM, IMP and KPC type carbapenemases were not detected in any isolates. Conclusion: Carbapenem-resistant pathogens have been shown to be able to develop resistance mechanisms with more than one carbapenemase encoding gene.Wo

A case of schwannoma of the common peroneal nerve in the knee

Schwannomas are benign neurogenic tumors of peripheral nerves that originate from neural sheath. The aim of this case report is to bring to mind the schwannoma in the patient with knee pain. A 39-year-old woman presented with a complaint of knee pain of three months history. After surgical intervention, the patient’s complaints completely disappeared in the post-operative period. This should come to mind in the differential diagnosis of knee pain