Annals of Medical Research

Hypocupremia-related anemia and neutropenia late after Roux-en-Y gastric bypass surgery

Ece Yigit — 2024-06-28

Roux-en Y gastric bypass (RYGB) is a type of surgery that is both restrictive in food intake and malabsorptive. The prevalence of copper deficiency (hypocupremia) has been reported as 10%-%20 after RYGB. Copper deficiency has started to appear more frequently due to bariatric surgical procedures, which are widely applied all over the world and in our country, but it is often not recognized. In order to raise awareness on the subject, we wanted to present a patient who developed copper deficiency and secondary anemia and neutropenia after RYGB.

Helicobacter pylori surveillance study in the Eastern Anatolia Region; single center

Aysun Yakut — 2024-06-28

Aim: The prevalence of Helicobacter pylori (H. pylori) varies among populations as well as among the world's populations. In this study, we aimed to investigate the frequency and effects of H. pylori in our patients living in the Eastern Anatolia Region.

Materials and Methods: This retrospective study was conducted with 2.062 patients living in the Eastern Anatolia Region between 2021 and 2022 and applying to the endoscopy unit for gastroscopy. The demographic characteristics, gastroscopy findings, and histopathological characteristics of the materials taken during the endoscopy of our patients who applied to us for various indications were recorded in the hospital database.

Results: The average age of the patients included in our study was 45.9±16.4 years. 1.100 of these patients were women and 962 were men. 308 of the patients had gastric mucosal atrophy, 224 had intestinal metaplasia, and 1.151 were H. pylori positive. Of the H. pylori positive patients, 214 had bulbar ulcers and 48 had stomach ulcers. Intestinal metaplasia and gastric mucosal atrophy were statistically significantly associated with the age of the patients.

Conclusion: H. pylori infection causes many changes in the stomach, both endoscopically and histopathologically. However, the main reason for this change is host genetics and the virulence of H. pylori.

Posterior superior alveolar artery thickness and intraoperative bleeding in maxillary sinus floor augmentation procedures

Sebiha Nihal Yilmaz — 2024-06-28

Aim: This study aimed to investigate the relationship between the thickness of the posterior superior alveolar artery (PSAA) and the intraoperative bleeding volume during maxillary sinus floor augmentation (MSFA) procedures.

Materials and Methods: This was a prospective observational study involving 24 consecutive participants who underwent MSFA at a university hospital in Turkey. The thickness of the PSAA was assessed using cone beam computed tomography (CBCT). Intraoperative data were collected to measure bleeding volume. The statistical analysis included Spearman correlation analysis to determine the relationship between PSAA thickness and bleeding volume.

Results: The present study revealed no significant correlation between the thickness of the PSAA and the volume of intraoperative bleeding. The mean PSAA thickness was 1.36 mm (SD: 0.40 mm), and the widest canal diameter was 2.40 mm. Univariate analysis revealed no significant associations between PSAA diameter and the assessed factors, with β values ranging from -10.510 to 6.814 and p values all above 0.2.

Conclusion: These findings suggest that the thickness of the PSAA, as determined by CBCT, may not be a predictive factor for intraoperative bleeding during MSFA procedures. This study contributes to the understanding of surgical risk management in MSFA patients and supports the continued use of CBCT for preoperative assessment.

Assessment of the correlation between arterial blood gas indices and duration of stay in the emergency department observation unit for pediatric patients aged 0-18 with rotavirus gastroenteritis

Semih Canpolat — 2024-06-28

Aim: Rotavirus (RV) is the predominant pathogen responsible for the onset of infectious acute gastroenteritis among children younger than five years of age, which is one of the critical public health concerns and one of the childhood gastroenteritis that can cause morbidity and mortality. Although definitive diagnostic methods are essential in such cases, these methods are not always easily accessible. That study aims to investigate the association between blood gas parameters in respondents who have tested positive for RV antigen and their subsequent observation time in the emergency department, as well as the length of their hospitalization.

Materials and Methods: This retrospective analysis encompassed 237 individuals ranging from 0 to 18 years old who sought medical attention at the outpatient clinic or emergency department of Adıyaman University Faculty of Medicine Training and Research Hospital and were found to have a positive RV antigen test. Respondents were segregated into cohorts according to age, gender, blood gas parameters, hemogram, biochemical parameters, duration of stay in the emergency observation room, and duration of stay in the pediatric ward. The respondents were categorized based on various criteria, including age, sex, blood gas readings, complete blood count, biochemical markers, duration of stay in the emergency observation area, and hospitalization period in the pediatric unit. Comprehensive demographic, blood gas, hematologic, and biochemical data were compiled and analyzed employing SPSS version 22.0.

Results: The study identified significant differences in the participants' pH, pO2, and HCO3 levels, along with the mean platelet volume (MPV). Notably, a significant correlation was established between the pH levels of blood gases in the emergency room observation space and the observation span for respondents testing positive for RV. In contrast, no significant link was observed between blood gas values and the duration of hospital stay.

Conclusion: The findings suggest that while blood gas analysis outcomes may not predict hospitalization length in cases of Rotavirus gastroenteritis, respondents presenting with lower blood pH levels tend to spend less time in the emergency observation unit. Therefore, it is recommended that blood gas analysis be conducted routinely for respondents presenting with symptoms of Rotavirus gastroenteritis upon their arrival at the emergency medical services.

Post-surgical efficacy of early motion on intra-articular distal radius fracture and the effect of osteoporosis on outcomes

Betul Basar — 2024-06-28

Aim: Post-surgical rehabilitation of intra-articular distal radius fractures in osteoporotic patients is still controversial. The aim of our study is to compare the effectiveness of early and late motion in intra-articular distal radius fractures in osteoporotic and non-osteoporotic patients.

Materials and Methods: Eighty patients were included in our study. The patients were divided into two groups according to osteoporosis (OP), (OP +, OP -). Each group was also divided into 2 groups according to initiation of motion ((Early motion subgroup (E-MOT), Late motion subgroup (L-MOT)). Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH), Patient-Rated Wrist Evaluation (PRWE) scores, Range of Motion (ROM) and grip strength were evaluated at final follow-up.

Results: No significant difference was found among the groups in terms of age, gender ratio, right hand–left hand ratio, hand dominance, follow-up duration, or fracture classification. Contrary, the range of motion and functional results of OP+,E-MOT group were found to be more successful than the OP+,L-MOT group, there was no significant difference between the OP-,EMOT group and the OP-,L-MOT group.

Conclusion: Early motion has a positive effect on the results in osteoporotic patients compared to late motion, while it does not significantly affect outcomes in non-osteoporotic patients. Early motion after surgery for intra-articular distal radius fractures is crucial for osteoporotic patients, but less so for non-osteoporotic patients.

The importance of forensic medicine education: A questionnaire survey

Ismail Altin — 2024-06-28

Aim: Forensic medicine is one of the basic areas of duty and responsibility of physicians just like the preventative, diagnostic, and treatment services of medicine. The aim of this study was to emphasise the importance of practice-based theoretical forensic medicine education by evaluating students who had taken and not taken forensic medicine internship.

Materials and Methods: Two groups were formed of students who had taken and not taken practice-based forensic medicine internship. A questionnaire of 24 items was administered to the students to evaluate their level of knowledge related to forensic medicine and expertise. The data obtained were analyzed statistically using SPSS vn. 24 software (IBM SPSS, Somers, NY, USA).

Results: There were seen to be statistically significant differences between the groups in the responses to many of the questions. Students who had not taken a forensic medicine internship felt that their knowledge was lacking on subjects related to forensic medicine, and the results showed deficiencies in these subjects.

Conclusion: Consistent with findings in literature, students who had not taken a forensic medicine internship felt inadequate in areas related to forensic medicine services and it was seen that their knowledge related to these subjects was lacking. Forensic medicine education should be an integral part of the medical faculty syllabus.

Inhibitory effects of mefenamic acid on rat urinary bladder contractions in vitro

Emine Kacar — 2024-06-28

Aim: In this study, the effect of mefenamic acid, a nonsteroidal anti-inflammatory drug, on the unconstrained contractile movement of the bladder muscle of female Spraque Dawley rats in diestrus was investigated. Since the effect of mefenamic acid on bladder smooth muscle is not known and its use for other conditions may cause possible side effects on the bladder, its effect was investigated for the possibility of using it as an active substance in the treatment of bladder problems.

Materials and Methods: In the experimental study, 1.5 cm long smooth muscle strips from seven female Sprague Dawley rats were prepared and suspended in an isolated organ bath system containing Krebs solution under 1.5 g tension. The system was gassed continuously with oxygen/carbon dioxide mixture (95%:5%) and isometric contractions were recorded. At a dose of 300 µM, the contraction/relaxation effects of mefenamic acid concentration on bladder smooth muscle were investigated. The area under the curve (AUC) and amplitude values of bladder contractions were analyzed before and after mefenamic acid administration. With the data obtained from the analysis, the effect of mefenamic acid on bladder contractions was evaluated using paired t-tests in SPSS Statistical Software.

Results: The decrease in area and amplitude values was statistically significant (p<0.05). Mefenamic acid had an inhibitory effect on bladder contractions.

Conclusion: The present findings demonstrate the relaxant effect of mefenamic acid on the rat bladder and if similar effects are observed in human studies, mefenamic acid may be effective in the treatment of voiding problems such as bladder incontinence.

The effect of different forms of intravitreal ranibizumab administration on pain

Mehmet Coskun — 2024-06-28

Aim: To examine the effect of using the prefilled syringe formulation of intravitreal ranibizumab (ivr) on pain.

Materials and Methods: 30 patients received bilateral IVR injection due to diabetic retinopathy and macular edema and 30 eyes of these patients that received ready-to-use (PFS) IVR were considered as group 1, and the 30 eyes that received conventional IVR by withdrawing from the vial were considered as group 2. Patients who had previously received intravitreal injection, had intraocular surgery, used any eye drops, and were unable to cooperate with the assesment were excluded from the study. Pain experienced during the injection was assessed by using the numerical rating scale (NRS) and the verbal rating scale (VRS).

Results: The mean age of 30 female patients evaluated was 60.3±7.94 years. While the NRS was 3.70±0.79 in Group 1, it was 4.23±0.77 in Group 2, the difference was statistically significant (p=0.02). While the VRS was 2.13±0.34 in Group 1, it was found to be 3.0±0.58 in Group 2, the difference was statistically significant (p=0.02).

Conclusion: IVR application in ready-to-use formulation causes less pain during intravitreal injection.

Pain, health literacy, and related factors in patients with migraine

Tulin Gesoglu Demir — 2024-06-28

Aim: Migraine affects activities of daily living by decreasing individuals’ productivity and therefore imposes an economic burden on societies. In our study, considering health literacy’s (HL) close relationship with self-management, hospitalization rates, and health care costs, we aimed to determine the HL of patients with migraine and the relationship between demographic, clinical, and social factors affecting it.

Materials and Methods: The sample included 211 patients at least 18 years old who applied to the neurology outpatient clinic between July and December 2023 and had been diagnosed with migraine for at least 6 months. Data were collected using a sociodemographic information form regarding clinical features, the Visual Analog Scale (VAS), and the Health Literacy Scale (HLS-14) with established validity and reliability.

Results: On average, patients were 34.24 years old (SD = 12.23) and scored 47.54 points (SD = 12.60) on the HLS-14 and 7.53 points (SD = 1.88) on the VAS. Statistically significant (p ≤ .05) differences emerged between the patients in terms of age, marital status, level of education, income, disease duration, and HLS-14 scores, along with a negative correlation between VAS and HLS-14 scores (r = −.140, p = .042).

Conclusion: For individuals to participate more actively in making decisions about their health and benefit from better-quality health services, their HL has to be increased. Health care professionals should therefore identify patient groups with historically low HL and provide especially accessible information to such patients.

Evaluation of in-hospital and long-term outcomes of patients undergoing pericardiocentesis: A retrospective analysis

Mehmet Altunova — 2024-06-28

Aim: Pericardiocentesis is a critical invasive procedure for the diagnosis and treatment of patients with pericardial effusion, regardless of the etiological cause. We aimed to evaluate the in-hospital and long-term outcomes of patients undergoing pericardiocentesis due to pericardial effusion at a tertiary referral center.

Materials and Methods: A retrospective analysis of 204 patients who underwent pericardiocentesis between 2017 and 2022 was conducted. Patients were divided into two groups based on the development of mortality during long-term follow-up.

Results: The mean follow-up duration was 42.5 ± 22.7 months. The most commonly identified etiology was idiopathic, accounting for 44.1%, followed by neoplastic (33.3%) and infectious (10.8%) causes. In-hospital mortality occurred in 21 (10.2%) patients, while recurrence developed in 41 (20.1%) patients. During the follow-up period, 74 out of 204 participants experienced mortality. Multivariable Cox regression analysis identified left ventricular ejection fraction (LVEF) (p=0.013), malignancy (p<0.001), and hemodynamic instability (p<0.001) as independent determinants of long-term mortality.

Conclusion: Although pericardiocentesis has a low complication rate, mortality rates remain high in these patients due to additional comorbidities. LVEF, malignancy, and hemodynamic instability determine mortality. Careful management of this group can reduce further events.

Potentilla fulgens root extract's effect on breast cancer (MCF-7) and osteosarcoma (U2OS) cells proliferation and migration

Polat Ipek — 2024-06-28

Aim: This study evaluates the cytotoxic effect of Potentilla fulgens root extract on MCF-7, U2OS, and RPE-1 cell lines and investigates its impact on cell migration.

Material and Methods: The effect of Potentilla fulgens root extract on the cell viability of MCF-7, U2OS, and RPE-1 cells was analyzed using an MTT assay. The effect of the compounds on cell migration was evaluated at 24 and 48 hours using the wound healing assay. A wound-healing assay was used to measure the metastatic ability of cells in vitro.

Results: MTT assay showed that PRE had a cytotoxic effect on all three cell lines, depending on dose and time, and this effect was statistically significant. The wound healing assay results showed that PRE slowed the migration of live MCF-7 and U2OS cancer cells, and these effects increased over time.

Conclusion: As a result, this study indicates that PRE may be very useful in treating human osteosarcoma and breast cancer.

The effects of subchorionic hematomas on the future of pregnancies with threatened miscarriage

Zeynep Seyhanli — 2024-06-28

Aim: The clinical significance of first trimester subchorionic hematoma, which is worrisome to pregnant women in terms of the outcome of the pregnancy, still remains unclear. The objective of this study is to examine the association between subchorionic hematomas in patients with threatened miscarriage and adverse pregnancy outcomes.

Materials and Methods: The retrospective cohort study was conducted in a tertiary center from September 2022 to January 2024. 200 patients who were hospitalized with threatened miscarriage during the sixth to fourteenth week of a singleton pregnancy were included. The individuals that satisfy the established criteria for the study were categorized into two groups with threatened miscarriage based on the ultrasound examination: the study group, which included patients with subchorionic hematoma and the control group, which included patients without subchorionic hematoma. Demographic information, maternal and neonatal outcomes were compared for both groups.

Results: Maternal age, BMI, parity, gestational age at diagnosis, history of abortus were similar for both groups (p > 0.05). Miscarriage rates were higher in the group with SCH than without SCH (28% vs. 25%, p= 0.631), but no statistical significance was observed. The frequencies of intrauterine death, gestational age at delivery, preterm delivery, mode of delivery, hypertensive disorders of pregnancy, placenta previa-placenta accreta spectrum, gestational diabetes mellitus, intrauterine growth restriction were not statistically significant (p > 0.05) between groups. The hematoma sizes did not show any statistically significant difference between those whose pregnancies led to miscarriage and those whose pregnancies did not (29.6±14.30 mm vs. 27.1±14.58 mm, respectively; p = 0.367). The subchorionic hematoma diameters did not show any correlation with the gestational age at delivery, birth weight, APGAR scores at 1st and 5th minute.

Conclusion: Our study suggests that detection of threatened miscarriage with subchorionic hematoma did not result in an elevation in miscarriage rates, maternal and neonatal complications.