Showing papers by "Dicle University published in 1997"

Significantly increased complication risks with mass circumcisions.

Abstract: Objectives To present the most serious complications from circumcision and to compare the complications caused during mass and single circumcisions performed by medically trained or untrained operators. Patients and methods The study comprised both a retrospective and prospective analysis of 220 cases of complications from circumcisions occurring during the last decade and a comparison of the frequency and distribution of complications in mass (n=700) and single (n=600) circumcisions. Results Traditional (medically untrained) circumcisers were responsible for 85% of the complications and almost all the disastrous ones. The frequency of complications from mass circumcision was statistically significantly higher than that from circumcisions performed singly in operating room conditions (relative ratio 3.05 and P<0.001). Conclusion Circumcision can have serious life-threatening and prolonged complications. It should only be performed in medical institutions by suitably trained surgeons. Mass circumcisions organized for any purpose carry significantly greater risk and should be prevented.

Traumatic spinal cord injuries in Southeast Turkey: an epidemiological study

Abstract: In 1994, a retrospective study of new cases of traumatic Spinal Cord Injury (SCI) was conducted in all the hospitals in Southeast Turkey: 75 new traumatic SCI were identified. The estimated annual incidence was 16.9 per million population. The male/female ratio was 5.8/1. The mean age was 31.3, being 31.25 for male patients and 31.36 for female patients. 70.7% of all patients were under the age of 40. The major causes of SCI were falls (37.3%) and gunshot wounds (29.3%), followed by car accidents (25.3%), and stab wounds (1.3%). Thirty one patients (41.3%) were tetraplegic and 44 (58.7%) paraplegic. In tetraplegic patients the commonest level was C5, in those with paraplegia L1. The commonest associated injury was head trauma followed by fractures of the extremity(ies). Severe head trauma, being a major cause of death, may have obscured the actual incidence of SCI. Most of gunshot injured SCI patients were young soldiers fighting against the rebels. As there was no available data for the rebels with SCI, the actual incidence of SCI in Southeast (SE)Turkey should be higher than that found in this study.

Management of ileosigmoid knotting.

Abstract: Background Ileosigmoid knotting is a rare cause of intestinal obstruction. Methods The clinical records of 16 patients treated for ileosigmoid knotting were evaluated retrospectively. Results There were 11 men and five women. The mean age was 45 ycars. Thc mean duration of symptoms was 44 days. Plain abdominal radiographs showed multiple air-fluid levels in the colon and/or small bowel. At operation, ileum and/or sigmoid colon necrosis was obscrved in 13 patients, both ileum and total colon necrosis in two, while there was no necrosis in one patient. Rcsection of necrotic bowel was necessary in 15 patients. Intestinal continuity was restored by primary anastomosis in 12; three required a stoma. The patient without necrosis was treated by detorsion and mesosigmoplasty. Three of 16 (19 per cent) patients died; septic shock was the major cause of death. Conclusion Aggressive preoperative resuscitation, appropriate antibiotic therapy, effective surgery and postoperative metabolic support help minimizc morbidity and mortality rates.

Acute bacterial meningitis in adults: Analysis of 218 episodes

Abstract: A retrospective study was conducted to examine the laboratory, clinical features and outcome of 206 adult acute bacterial meningitis patients (218 episodes) during the years 1985–1996. Pneumonia (8.7 per cent), head trauma (7.8 per cent) and chronic otitis media (6.0 per cent) were identified as the main predisposing factors for acute bacterial meningitis. Aetiology was described only in 61 episodes (28.0 per cent). Streptococcus pneumonia was the most commonly identified pathogen overall, causing 33 of the 218 episodes (15.2 per cent). Antibiotic treatment before admission was given to 48.4 per cent of patients. On admission, the following symptoms of meningitis were predominant: 83 per cent had neck stiffness, 81 per cent had a headache and 73 per cent had fever. Case fatality rate was 27.1 per cent (59 patients). The important factors in mortality were as follows: old age, a long duration of symptoms before admission, a lack of neck stiffness, obtunded mental state on admission, low glucose levels in first CSF, low CSF/blood glucose ratio, and abnormality in computerised tomography scanning.

Comparison of microsuturing to the use of tissue adhesives in anastomosing sciatic nerve cuts in rats

Abstract: The purpose of this study was to investigate and to compare the effects of microsuturing to that of tissue adhesives (Tisseel) on the healing of anastomosing peripheral nerve incisions. Forty-five Wistar-Albino rats were placed in special cages and separated into three groups (n = 15). In the control group, biliteral sciatic nerves were explored but no incision was made. In the first experimental group, bilateral sciatic nerves were incised and end-to-end anastomosing was performed by microsuturing the epineurium. In the second experimental group, tissue adhesive (Tisseel) was used alone in anastomosing the sciatic nerve cuts. Assessments of the healing processes were demonstrated by 1.electromyography (EMG), 2. measuring the electrical responses of the anastomosed nerves after electrical stimuli, 3. histopathological examination. Statistical analysis of the EMG findings showed that the Tisseel group was the closest in the healing process to the control group. After applying electrical stimuli to the dissected nerves, the resistance value of the Tisseel group was nearest to those of the control group. The histopathological examinations showed highly degenerative nerve bundles and prominent foreign body granuloma at the anastomosed sites of the microsutured group. The granulomatous inflammation was observed to be much less in the Tisseel group. We conclude that the healing effect of Tisseel was found to be superior to that of microsuturing as demonstrated by the findings of EMG, electrical responses of the anastomosed nerves, and histopathological examination.

Traumatic oesophageal perforation.

Abstract: Sixteen patients were treated for traumatic oesophageal perforation (13 cervical, 3 thoracic) over a 16-year period. In 14 cases the trauma was penetrating. The median delay from injury to treatment was 32 hours and the mean period of hospitalization was 26 days. The treatment procedures were two-layer primary closure with or without drainage, drainage alone and near-total oesophageal exclusion with cervical T-tube oesophagostomy. Postoperative complications were cervical oesophageal leak in two patients and tracheo-oesophageal fistula and oesophageal stenosis, each in one case. Of the eight patients treated within 24 hours of perforation, two died, and of the eight treated later, four died (overall mortality 37.5%). The heightened mortality after delayed diagnosis illustrates the prognostic importance of a high index of suspicion. To prevent leakage, buttressing with viable tissue following primary closure can be useful, especially after delayed diagnosis. Because of the continuing controversy concerning management of late-diagnosed oesophageal perforation, individualized treatment is widely advocated.

Two cases of nephrotic syndrome and tertian malaria in south-eastern Anatolia.

Abstract: Tertian malaria is endemic in south-eastern Anatolia. As in Europe and America, in south-eastern Anatolia, an etiological agent is seldom identified in nephrotic syndrome. Two patients with Plasmodium vivax and nephrotic syndrome are described here. The possible relationship between Plasmodium vivax and nephrotic syndrome should be explored in children in endemic malarial regions.

The effect of alternate-day low dose prednisolone on bone age in children with steroid dependent nephrotic syndrome

Abstract: Radius, ulna, short bones (RUS), carpal (CARP) bone age (BA), tibial cortico-diaphyseal (C/D) ratio and trabecular aspect were assessed in 19 children with steroid dependent nephrotic syndrome and 15 age matched healthy children. Both RUS and CARP BA were significantly lower than in the controls. Trabecular aspect and tibial C/D ratio did not show any statistical significance. There was a positive correlation between HSDS and RUS BA delay (r = -0.476, p < 0.05); CARP BA delay and RUS BA delay (r = 0.563, p < 0.01) and RUS BA and CARP BA (r = 0.891, p < 0.001). In conclusion, RUS and CARP BA are both retarded and positively correlated in steroid dependent nephrotic children.

Acceptable radiation leakage of microwave ovens on pregnant and newborn rat brains.

Abstract: The present article was intended to investigate the possible effects of the acceptable radiation leakage of microwave ovens on pregnant and new-born rat brains. Twenty-seven pregnant Wistar-albino rats were separated into three groups (n = 9), a control group (sham-exposed) and two experimental groups. The experimental gravid rats were confined in Plexiglas cages and placed next to the closed door of a microwave oven (power-output: 550 W). The NIR 15 (NIR: non-ionising radiation) group of gravid rats were exposed to the leakage of microwave ovens daily for 15 minutes whereas the NIR 30 group was exposed daily for 30 minutes during their pregnancies. The most striking changes were observed in the NIR 30 group of rats. Congestive vessels, edema and degenerative neurones were noticed in all experimental dams. Chronic inflammatory cell infiltrate, and focal necrosis of neurones were seen only in the NIR 30 group of dams. Progressive edema and conspicuous congestive vessels were seen in the offspring of both experimental groups. Chronic inflammatory cell infiltrate, haemorrhage, necrotic neural tissues, and degenerative neurones with a reactive glial proliferation were observed only in the offspring of the NIR 30 groups.

Effects of nimodipine on the cerebrovascular and neuronal changes during pneumococcal meningitis in the rat.

Abstract: It was investigated whether treatment with the calcium channels blocker Nimodipine, a 1,4-dihydropyridine derivative, influences vasculopathy and neuronal injury in experimental pneumococcal meningitis. Rats were randomly assigned to one of three experimental groups. The first group (Control group, n = 20) was given saline (0.4 ml/day) intraperitoneally (i.p.), whereas the second group (group C, n = 22) was treated only with ceftriaxone in a dosage of 30 mg/day/i.p.. The third group (group C-N, n = 22) was treated with the combination of ceftriaxone 30 mg/day/i.p., and nimodipine 0.6 mg/day/i.p.. Treatment was begun at the time of inoculation in all three groups. The control group was compared clinically and histopathologically with groups C and C-N at 24 h, three and six days after inoculation. Six rats in the control group and eight rats in group C and group C-N were sacrificed at 24 hours and seven rats in each group were sacrificed on the third and sixth day after inoculation. Clinically, there were no significant differences between group C and group C-N (p>0.05). There were significant differences between group C and group C-N for vasculopathy and neuronal injury (p < 0.0001 and p < 0.005, respectively).

Omeprazole, nitrendipine, famotidine and stress-induced ulcers.

Abstract: Background : Omeprazole inhibits gastric acid secretion by blocking the proton pump of the gastric parietal cell. Nitrendipine is a derivative of the dihydropyridine group of calcium channel blockers and administrated for angina and hypertension. Famotidine is one of the newer histamine H 2 -receptor antagonists and heals gastric and duodenal ulcers by reducing gastric acid output. Objectives : The healing effects of omeprazole. nitrendipine and famotidine on stress-induced gastric ulcers were investigated in rats. Methods : Forty male Wistar-albino rats were separated into five groups (n = 8), a control (non-stress) and four experimental (stress) groups. Experimental rats were treated with omeprazole, nitrendipine, famotidine or a placebo after the stresses of starvation and cold-restraint. Result : Macroscopically, the mean area of the affected lesional mucosa was 1/4 of the total gastric mucosa in the famotidine treated group and 1/5 of the total gastric mucosa in the nitrendipine treated group. A considerably decrease was observed in the omeprazole treated group in which the mean area of the lesional mucosa was only in 1/8 of the total gastric mucosa. On microscopic examination, congestive vessels and chronic inflammatory cell infiltrates were significantly reduced in the omeprazole treated group. Tissue regeneration was more prominent in the omeprazole group than the other groups. Conclusion : Omeprazole was found to be superior in terms of the effect on the healing process to nitrendipine and famotidine. Although therapeutic effects of nitrendipine and famotidine were observed, those were less than omeprazole.

Effects of nimodipine and ofloxacin on staphylococcal brain abscesses in rats.

Abstract: The therapeutic effects of nimodipine (CAS 66085-59-4) and ofloxacin (CAS 82419-36-1) were investigated against experimental brain abscess formation in rats. Nimodipine, a 1,4-dihydropyridine derivative, is chemically related to nifedipine but the smooth muscle relaxant effect preferentially acts on cerebral arteries. Ofloxacin is a member of 4-Quinolone broad spectrum antibiotics. Ninety-six male Sprague-Dawley rats were inoculated intracortically with Staphylococcus aureus and then different groups were treated with either saline, ofloxacin or the combination of ofloxacin and nimodipine. The rate of brain abscess formation and mortality were considerably decreased by nimodipine and ofloxacin therapy. Combination therapy was found histologically to be considerably more effective than ofloxacin alone against brain abscess formation in rats.

Postpartum subcutaneous emphysema with pneumomediastinum.

Abstract: Spontaneous subcutaneous emphysema with pneumomediastinum occurs rarely in the setting of labour and delivery. We report the following occurrence in a 17 year old woman following delivery. Signs, symptoms, and pathophysiology are reviewed and treatment is discussed.

Urinary system stone disease is endemic in Southeastern Anatolia

Abstract: The \tucly of van den Boom on nutritional composition of home-prepared baby meals for Spanish infants in Madrid ( 1 ). containing veal. shows a low energy density ( S O 2 1 1 kcal/l00 g) and a high protein content (9.1 -C 2.8 g/100 kcal). In Spain, many mothers still consider home-made baby meals superior in quality to their commercial equivalents. As paediatricians, we have to give guidelines on the making of homemade baby foods, advising the addition of higher quantities of olive oil and carbohydrates (potatoes, etc.) in order to achieve a better energy balance. Nevertheless, it is necessary to be aware of the composition of nutrients contained in hospital-prepared baby meals. The new hospital cuisine has to undergo important changes to achieve adequate baby meals. The ESPGAN Guidelines (2) for complete meals advises an energy density of at least 70kca1/100g, far from that achieved in the home-prepared meals of Spanish children.

The effect of metabolic acidosis on serum apolipoprotein A I and apolipoprotein B levels in children with chronic renal failure.

Abstract: In this report serum apolipoprotein A I (Apo A I) and apolipoprotein B (Apo B) levels were determined in children with chronic renal disease (CRD) during metabolic acidosis, after the correction of metabolic acidosis and in healthy children to look for the effect of metabolic acidosis on Apo A I and B levels. It was found that Apo A I levels were significantly decreased during metabolic acidosis (p 0.05) although it was significantly different from those in the controls (p<0.01).

Histopathological changes in the vagina of rats treated neonatally with clomiphene citrate.

Abstract: Clomiphene citrate is a nonsteroid antiestrogen which is widely used in the therapy of receptor-positive estrogen for the induction of ovulation. Clomiphene citrate was given subcutaneously to newly born rats with daily injections of 100 mg/kg for 5 days. Changes caused by the clomiphene citrate in vaginas of female rats were investigated at 28 and 35 days. Depending upon the effect of the clomiphene citrate, histopathological changes such as papillary development at keratinization, increase in vaginal epithelium, and observation of polygonal shaped nodular cells in stroma were considered as important findings. It should be emphasised that clomiphene citrate used for induction of ovulation caused these abnormalities in the vagina of rats.

The importance of visual erotic stimulation in the differential diagnosis of erectile impotence.

Abstract: In this study we aimed to determine the importance of visual erotic stimulation (VES) alone, and in combination with intracavernosal papaverine injection (ICPE) in the differential diagnosis of erectile impotence Sixty-four patients with erection porblems were investigated betwen June 1992 and January 1994