Prediction of Low Factor V Levels in Patients with Herbal Medicine Related Acute Liver Injury

  Background: Prior epidemiologic studies predicted a rapid rise in herbal medicine-related acute liver injury (HILI) and liver transplantation (LT) as trading of traditional herbal medicine drugs is expanded. HILI is the leading cause of liver transplantation in the world. The indication for LT was defined as acute liver failure (ALF) with the factor V (FV) level below 35%. Objective: To explore the possible impact of herbal medicine-related to the liver failure on the laboratory parameters and to determine if simple laboratory values play a role in determining lower FV levels. Materials and methods: Totally, 38 HILI cases who were admitted to a tertiary care hospital between May 2016 and May 2018 were scanned, retrospectively. Need for LT was assessed by the determination of FV levels. Results: The mean age of participants was 37±13 years where 27 (71%) were female while the rest were male and 81% of the total population were farmers. Total 78% patients were reportedly consuming herbal medicine pills, and 22% reported consuming traditional Turkish herbs. Among 38 cases with HILI in critical care, 2 (5.2%) have died, 3 (7.8%) underwent LT and 33 (87%) were recovered and discharged. Results of 38 patients with available data also showed that factor V levels were positively correlated with the hemoglobin and platelet levels (p<0.05) and negatively correlated with prothrombin time (p<0.05). Conclusion: These findings suggest that detecting anemia and thrombocytopenia could be an important, economically feasible strategy for improving outcomes in HILI

Prevalence of Non Alcoholic Fatty Liver Disease in patients with Parkinson Disease

INTRODUCTION[|]Non alcoholic fatty liver disease (NAFLD) has presented as the most common cause of chronic liver disease in the Western world. Parkinson disease (PD) is the second most common non-demyelinizan neurologic disase and its incidence is steadily increasing in the world. Our study aims to analyze the prevalence of ultrasonography-proven NAFLD among the PD patients. [¤]METHODS[|]A retrospective chart review was performed to identify PD patients who had at least two visits in the Liver Clinic from January 2017 to May 2018. Thus, 124 consecutive patients (the mean age 74,2+-11,9years; 65 female) with PD was longitudinally screened for NAFLD which were diagnosed according to ultrasonographic criteria. Control subjects (65 subjects, mean age was 68+-3.4 years; 35 female) were selected from age-matched eldely subjects. Demographic and laboratory data, concurrent statin use and results of hepatobiliary ultrasonography were collected. Patients with history of chronic liver disase, liver transplant, past alcohol use or not enough data to stage NAFLD were excluded. Data analyzed using Pearson's chi-squared test with the Stata software.[¤]RESULTS[|]Nonalcoholic fatty liver disease prevalence was significantly lower in the PD group than in the age -matched control group (21% vs. 36%, P<0.05). In multiple logistic regression analyses using baseline factors, statin use (P=0.04) and elevated Hb A 1 C (P<0.001), baseline fasting glucose below than 100 mg/dL (P=0.03), and elevated ALT levels (P<0.001) were independently associated with NAFLD.[¤]DISCUSSION AND CONCLUSION[|]While additional studies in large populations are needed to investigate the correlation between PD and NAFLD, further exploration of PD -related metabolic liver disease clinically appears warranted.[¤

An interesting journey of an ingested needle: a case report and review of the literature on extra-abdominal migration of ingested Foreign bodies

Swallowed foreign bodies encounter a major problem especially in children, but fortunately they mostly do not cause any related complication and are easily passed with the stool. In this paper, an interesting journey of a needle is presented. A 20-year old female admitted to our emergency service after she had swallowed a sewing machine needle, which is initially observed in the stomach in the plain abdominal radiography. During the follow-up period, the needle traveled through bowels, and surprisingly was observed in the left lung on 10th day of the follow-up. It was removed with a thoracotomy and pneumotomy under the fluoroscopic guidance. The postoperative period was uneventful and the patient was discharged from the hospital on the day 5. We also review the literature on interesting extra-abdominal migrations of swallowing foreign bodies

The importance of electrocardiography in the clinical course of electric injuries

WOS: 000354772200010PubMed: 26033656BACKGROUND: The aim of the present study was to investigate the demographic and clinical characteristics of electrical injuries, type of electrical current and the importance of electrocardiography in clinical course. METHODS: Fifty-three patients (50 males [94.3%], 3 females [5.7%]; mean age 34.5 +/- 9.6; range 19 to 61 years) with electrical injuries treated in the burn center between 2011 and 2012 were retrospectively analyzed. The patients were evaluated for demographic and clinical characteristics, electrocardiographic findings and clinical outcomes. RESULTS: The electrocardiography findings of the patients were as follows: twenty-seven normal, twelve sinus tachycardia, three atrial fibrillation, seven right bundle brunch block, and four ventricular extra-systole. There was no mortality among patients with electrocardiographic findings of normal, right bundle brunch block, and ventricular extra-systole. Four patients with sinus tachycardia and one patient with atrial fibrillation died. Electrocardiographic findings of the patients wounded by high-voltage electricity were: two normal, two sinus tachycardia, and one atrial fibrillation. DISCUSSION: Mortality was higher in patients with sinus tachycardia and atrial fibrillation in the electrocardiography at the time of admission. These ECG findings were more often in patients wounded by high-voltage electricity. Therefore, electrocardiographic findings and type of the electrical current may provide prognostic value in the clinical course of patients

Comparison of Albumin and Fresh Frozen Plasma as Colloid Therapy in Patients With Major Burns

Background: Burn injuries are one of the main causes of morbidity and mortality throughout the world, and burn patients have higher chances of recovery if they are treated with effective fluid and colloid management. Fresh frozen plasma (FFP) and albumin suspension used as a colloid treatment agent are very useful for the treatment of severe burns.Methods: This retrospective clinical trial was conducted at the Numune Education and Research Hospital Burn Center, Ankara, Turkey. Two hundred and nine patients who had severe burns that involved more than 30% of their total body surface area (TBSA) were studied. After the first 24 hours, 13 patients were deceased, leaving 196 patients remaining in the study, including 139 patients in the fresh frozen plasma group and 57 patients in the albumin group. Both the fresh frozen plasma and albumin groups received the standard therapy of the burn center, which was based on a standard protocol. Then, these patients were compared according to their clinical findings and mortality.Results: There were no significant differences between the groups with respect to age, gender, and comorbidities. The laboratory findings, blood, urine, and wound culture results were also similar between groups. The mortality rate was higher in the group receiving albumin than in the group receiving fresh frozen plasma (78.9% and 33.8%, respectively; p=0.0007).Conclusions: According to this study, there was a significant relationship between the improvement in mortality and the mode of colloid treatment in patients with major burns

Synergistic effect of multiple predisposing risk factors on the development of bezoars

AIM: To describe the clinical characteristics of patients with gastric or intestinal bezoars recently treated in our hospital

Our gynecological pathology rates in negative appendectomy cases

Jinekolojik organ patolojileri akut apandisit tanısında bizi yanıltmaktadır. Biz bu çalışmada, akut apandisit ön tanısıyla ameliyat edilen ve normal apendiks tespit edilen kadın hastalardaki tespit ettiğimiz jinekolojik patolojilerin tedavi yaklaşımlarını ve oranlarını sunmayı amaçladık. Kliniğimize 1997-2003 yılları arasında başvuran ve akut apandisit ön tanısıyla opere edilen 834 hasta retrospektif olarak incelendi. Peroperatif apandisit ve jinekolojik patoloji tanısı makroskobik olarak kondu. Sekiz yüz otuz dört hastanın 502’si (%60,8) erkek, 332’si (39.2) kadındı. Tüm hastaların 53 (%6,4)’ünde ameliyat esnasında normal apendiks ile karşılaşılmıştır. Negatif apenektomi saptanan 53 hastanın 38 i kadındı. Negatif apendektomiler kadınlarda erkeklere göre istatistiksel olarak anlamlı bir şekilde daha sık gözlenmiştir (χ² =8.34 p<0.01). Normal apendiks tespit edilen 38 hastanın 21 (%55,2) başka bir patoloji ile karşılaşılmamıştır. On yedi olguda (%44,8) ise jinekolojik patoloji ile karşılaşılmıştır. Bu hastaların 6’sında (%35) korpus hemorajikum kist rüptürü, 6’sında (%35) over kisti, 2’sinde (%12) pelvik inflamatuar hastalık, 2’sinde (%12) over torsiyonu, 1 (%6) tanesinde de ektopik gebelik sol tuba rüptürü tespit edilmiştir. Literatür incelendiğinde birçok çalışmada bu sonucu desteklemektedir. Karın ağrısı olan kadın hastalarda jinekolojik patoloji olasılığı da düşünülmeli; bu nedenle jinekolojik anamnez alınmalı ve jinekolojik muayene yapılmalıdır.Gynecological pathologies mislead us in diagnosis of acute appendicitis. In this study, we aimed to present the rates and the treatment of gynecological pathologies in women who were operated with diagnosis of acute appendicitis but having normal appendix. Between 1997- 2003, we retrospectively evaluated 834 patients who were operated with the preoperative diagnosis of acute appendicitis. The diagnosis of acute appendicitis and gynecological pathology were made during the operation by macroscopic axamination. There were 834 patients being 502 (%60.8) male and 332 (%39.2) female. There were normal appendices in 53 (%6.4) patients peroperaitvely. In 53 negative appendectomy cases there were 38 females. Negative appendectomy rates were more common in females than in males and that was found to be statistically significant (χ2= 8.34, p<0.01). Of the 38 females with negative appendectomies 17 (%44.8) had gynecological pathologies and 21 (%55.2) had no other pathologies. The gynecological pathologies were corpus hemorrhagicum cyst rupture (n=6, %35), ovarian cyst rupture (n=6, %35), pelvic inflammatory disease (n=2, %12), ovarian torsion (n=2, %12) and ectopic pregnancy rupture on the left ovarian tube (n=1, %6). In female patients with abdominal pain, we should also think the probability gyncological pathologies, that’s why gynecological history should be taken and gynecological examination should be made

Laparoscopic and Conventional Resections for Low Rectal Cancers: A Retrospective Analysis on Perioperative Outcomes, Sphincter Preservation, and Oncological Results

Background: This study aims to compare the results of laparoscopic and conventional techniques in patients with low rectal cancers