Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization

An investigation of saliva and plasma levels of urotensin 2 in recently diagnosed type 2 diabetes mellitus patients on metformin treatment

Introduction: Diabetes mellitus (DM) is a primary disease of the carbohydrate metabolism that is characterised by absolute or relative insulin deficiency, or insulin resistance. Although life expectancy is low for diabetic patients, the prognosis has been improved in recent decades. Metformin is an oral antidiabetic that reduces insulin resistance and plasma glucose levels by decreasing glucose production in the liver. It can be used as a standalone treatment or in combination with other antidiabetic medications or insulin. Urotensin 2 (U-II), which is one of the most effective known vasoconstrictor peptides, was observed to act as a vasoconstrictor in diseases such as hypertension and heart failure, and to induce vasodilation in healthy volunteers. Some studies have proposed that the activation of the U-II system could lead to metabolic syndrome. Certain studies have determined a link between DM and U-II. However, there exist no studies on the effects of U-II in recently diagnosed type 2 DM patients after metformin treatment. This study aims to investigate the plasma and saliva levels of U-II at diagnosis and after a three-month metformin treatment in recently diagnosed type 2 DM patients, and to compare these levels to those of healthy volunteers. Material and methods: Our study compared 30 recently diagnosed type 2 DM patients to their states after three-month metformin treatment and 30 healthy volunteers. Results: When compared with the control group, there was no significant increase in the plasma and saliva U-II levels of recently diagnosed type 2 DM patients. We determined a statistically significant increase in the plasma and saliva ureotensin-2 levels of recently diagnosed type 2 DM patients after a three-month metformin treatment (p < 0.05).Conclusions: It was concluded that the patients with type 2 DM have a multifactorial aetiopathogenesis and an increase in U-II levels after metformin treatment. Metformin has no known effect on the U-II metabolism; therefore, the findings need confirmation through more clinical and experimental studies with more participants

Does the sonography-scintigraphy correlation affect the success of minimally invasive parathyroid Surgery? Results from a single center

In patients with primary hyperparathyroidism, complete surgical resection of all hyperfunctioning parathyroid tissue is essential. The aim of this study was to evaluate the success rates of minimally invasive parathyroidectomies for primary hyperparathyroidism performed after localization studies with 99mTc-sestamibi (MIBI) scintigraphy and neck ultrasonography (USG). And also, we aimed to determine the factors affecting the success rate in surgery. Retrospective analysis of 58 consecutive patients with a diagnosis of primary hyperparathyroidism who underwent parathyroidectomy between January 2018 and December 2021 in our institution. The patients were evaluated according to Miami criteria and divided into two groups as successful or unsuccessful surgery. Demographic and clinical characteristics of the patients were obtained from hospital records. Surgical success was achieved in 50 (86.2%) of the 58 patients included in the study. In both groups, neck USG and MIBI scintigraphy showed the same localization for the lesion in a correlated manner. The clinical complaints of the patients, preoperative PTH, Ca and 24-hour urinary Ca levels were similar in both groups. In 10 (17.2%) patients, inconsistency in localization was found between USG and MIBI scintigraphy, and surgical failure was found in 4 (40%) of these patients. Surgical failure was statistically significant in patients with inconsistency in localization between USG and MIBI scintigraphy. The sono-scintigraphic scan concordance increases surgical success rates in cases where minimally invasive parathyroid surgery is planned. If there is an inconsistency between USG and MIBI, preoperative four dimentional computed tomography, intraoperative rapid PTH, gamma probe or frozen method can be used. It should be kept in mind that multiple gland pathologies may be more common in addition to solitary adenoma in lesions smaller than 1 cm in USG. In addition, in these cases, as the diagnostic value of scintigraphy is low, surgical success will also decrease. [Med-Science 2023; 12(3.000): 613-7

The association of metabolic syndrome components with anthropometric measurements

© 2021, Eurasian Society of Family Medicine. All rights reserved.Aim: This study aims to research the association of metabolic syndrome components with anthropometric measurements like arm circumference, neck circumference, hip circumference, waist-hip ratio, and waist-to-height ratio, which are applied rarely. Methods: This cross-sectional study was conducted with 292 patients in November-December 2019. The arm circumference, neck circumference, waist circumference, hip circumference, waist-hip ratio, waist-to-height ratio, and body mass index measurements of the patients were made. Glucose, high-density lipoprotein, low-density lipoprotein, systolic, and diastolic blood pressure measurements were also recorded. The association between metabolic syndrome components and anthropometric measurements was analyzed. Results: Metabolic syndrome is diagnosed in 32.8% of the participants. According to body mass index, 18.6% of the patients were normal, 34.2% were overweight, and 47.2% were obese. There was a significant difference between the patients with and without metabolic syndrome in terms of laboratory parameters, blood pressure values, and anthropometric measurements. In the diagnosis of metabolic syndrome, optimal cut-off values for arm circumference, neck circumference, hip circumference, waist-hip ratio, and waist-to-height ratio were determined as 31.75 (AUC=0.703), 34.85 (AUC=0.763), 113.75 (AUC=0.757), 0.90 (AUC=0.701), 0.61 (AUC=0.769) for females while they were 35.75 (AUC=0.573), 39.75 (AUC=0.795), 111.5 (AUC=0.607), 0.96 (AUC=0.888), 0.61 (AUC=0.888) for males respectively. Conclusion: A significant correlation was detected between arm circumference, neck circumference, hip circumference, waist-hip ratio, and waist-to-height ratio, and metabolic syndrome components. However, low-density lipoprotein was not correlated with neck circumference and high-density lipoprotein with waist-to-height ratio

Yorulma testinin, üç farklı tam seramik yapım sistemi vertikal kırılma Direnci üzerine etkisi

<p><strong>Purpose: </strong>To investigate the effects of fatiguing test on the fracture strength of all-ceramic crowns (IPS Empress II, Conventional InCeram and Celay InCeram).</p> <p><strong>Material and Methods: </strong>Twenty crown; shapes 8mm in diameter and 7mm in height were fabricated for each all-ceramic system. For each ceramic system, 10 specimens were tested for fracture strength without fatiguing. A secondly, remaining specimens was submitted to a fatiguing and then fractured using a universal testing machine for each systems. The results were statically analyzed using a one way ANOVA and Student t test.</p> <p><strong>Results: </strong>When comparing the fracture strength of all-ceramic crowns with and without the fatiguing test, the strength was lower after fatiguing (p<0.05). The strength of conventional InCeram specimens was significantly affected after fatiguing test.</p> <p><strong>Conclusion: </strong>These results suggest that although the conventional In Ceram system has high fracture strength, it is more sensitive to fatiguing test within the three all ceramic systems.</p> <p><strong>ÖZET</strong></p> <p><strong>Amaç</strong>: Yorulma testinin tam seramiklerin (IPS Empress II, Geleneksel InCeram ve Celay InCeram) kırılma direnci üzerine etkisinin araştrılması.</p> <p><strong>Gereç ve Yöntem</strong>: Her seramik sistemi için 8 mm çapında 7 mm yüksekli'inde 20 adet master die hazırlandı. Her seramik sistemi için 10 adet örneğin kırılma direnci yorulma testi uygulanmadan test edildi. İkinci olarak, her gruba ait kalan örneklere yorulma testi uygulandı ve universal test cihazı kullanılarak kırılma testi yapıldı. Elde edilen sonuçlar tek yönlü ANOVA ve student t testi kullanılarak değerlendirildi.</p> <p><strong>Bulgular: </strong>Yorulma testi uygulanan ve uygulanmayan tam seramik kronlar karşılaştırıldığı zaman, yorulma testi sonrası bütün gruplarda kırılma direnci değerleri azaldı (p<0.05). Geleneksel InCeram sistemine ait örnekler yorulma testinden en fazla etkilendi (p<0.05).</p> <p><strong>Sonuç: </strong>Elde edilen sonuçlara göre, üç farklı tam seramik yapım sistemi arasında, geleneksel InCeram sistemi en yüksek kırılma direnci göstermesine rağmen yorulma testinden en fazla etkilenen sistem oldu (p<0.05).</p> <strong>Anahtar kelimeler</strong>: Tam seramikler, yorulma testi, vertikal diren

Perspectives of Young Adult Men Regarding Violence against Women: A Cross-sectional Study from Turkey

Women are often victims of male-to-female intimate partner violence. The sample in this study consisted of 637 participants who were conscripted soldiers at Gulhane Military Medical Academy in Ankara, Turkey. This research examined the perspectives and perceptions of young adult men toward violence against women and identified potential risk factors for violence. In this study, 8.8 % of the participants reported perpetrating violence against women. Multivariate analysis indicated young adult males whose father acted violently against their mother were 3.5 times more likely to commit violence against women than young men without violent fathers. It is suggested public health nurses could effectively prevent violence by providing health education

Otitis media with effusion:diagnosis and treatment

Otitis media with effusion (serous otitis media) is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. Serous otitis media is the most common cause of hearing loss in children in the developed world. Hearing loss may be affected speech, cognitive, and psychological development of the childeren. In addition, otitis media with effusion is not only seen in children, this sign may present with signs of nasopharyngeal diseases. For this reason, especially in childhood otitis media with effusion should be treated by early diagnosis. [Archives Medical Review Journal 2013; 22(2.000): 194-208

Facial Nerve Paralysis seen in Pseudomonas sepsis with ecthyma gangrenosum

Ecthyma gangrenosum is a skin lesion which is created by pseudomonas auriginosa. Peripheral facial paralysis and mastoiditis as a rare complication of otitis media induced by pseudomonas auriginosa.In this study, 4 months child who has ecthyma gangrenosum and facial nerve paralysis was reported. [Cukurova Med J 2013; 38(1.000): 126-130

Carbon Dioxide Laser Endoscopic Posterior Cordotomy Technique for Bilateral Abductor Vocal Cord Paralysis A 15-Year Experience

WOS: 000320855300012PubMed ID: 23519722Importance: Treatment of bilateral vocal cord paralysis is a considerable challenge for otolaryngologists. Many surgical techniques have been developed for the management of this entity to eliminate the need for tracheotomy. Objective: To evaluate the success of the unilateral carbon dioxide laser endoscopic posterior cordotomy technique for bilateral abductor vocal cord paralysis. Design: A retrospective study. Setting: A university department of otolaryngology-head and neck surgery. Participants: Sixty-six patients (58 women and 8 men) diagnosed as having bilateral abductor vocal cord paralysis. Intervention: Endoscopic posterior cordotomy with the carbon dioxide laser. Main Outcome Measures: Decannulation and postoperative voice quality and exercise tolerance. Results: The most common etiologic factor was recurrent laryngeal nerve paralysis after thyroidectomy, observed in 61 patients (92%); an unknown cause was observed in 5 (8%). Unilateral cordotomy sufficed in 58 patients (88%). We performed revision procedures for vocal cord granuloma in 4 patients (6%). Bilateral cordotomy was required for 4 patients (6%) with an insufficient airway. Postoperative tracheotomy was needed for only 4 patients owing to the edema in the operation site. These patients underwent decannulation within a mean period of 7 days. No patient had poor postoperative exercise tolerance. We found no statistically significant difference between the preoperative and postoperative voice quality using the 10-item Turkish version of the Voice Handicap Index. Conclusions and Relevance: Carbon dioxide laser endoscopic posterior cordotomy is a safe, minimally invasive, effective technique with a short operation time. A bilateral approach or a revision procedure is rarely required. Bilateral cordotomy should be reserved for patients with insufficient airway passage with unilateral cordotomy