Mevlana Tıp Bilimleri Dergisi Arşiv

ABSTRACT

Aim: In this study, we aimed to present the perioperative anaesthetic management in pediatric patients who underwent surgery for craniosynostosis which can progress with life-threatening complications.

Materials and Method: We retrospectively reviewed the file of all 26 craniosynostosis patients who were operated between January 2009-January 2021. The following were analyzed retrospectively: demographic data; anesthesia risks; duration of anesthesia and surgery; additional conditions of abnormality; airway and bleeding management; complications.

Results: Of the 26 patients included in the study, 16 had trigonocephaly, 4 scaphocephaly, 3 plagiocephaly, and 3 mixed types. Twenty (76.9%) of the patients were male, and 6 (23.1%) were female. Five out of the 26 patients (19.23%) had additional anomalies (1 Apert syndrome, 2 cardiac anomalies, and 2 hydrocephalus). The mean duration of surgery was 167.03 min, and duration of anesthesia was 179.92 min. CL scores were evaluated in direct laryngoscopy of the patients. CL I was found in 5 patients (19.2%), CL II in 13 patients (50.0%) and CL III in 8 patients (30.8%). Severe hypotension was observed in 5 patients (19.23%) in the intraoperative period. Noradrenaline at a dose of 0.03 mg/kg/min was administered to these patients with simultaneous blood and fluid infusion. A statistically significant difference was found between the preoperative and intraoperative hematocrit values of the patients whose mean preoperative hematocrit values were 35.99% and intraoperatively 26.85% (0.001).

Conclusions: We observed that pediatric patients with craniosynostosis had difficulty in airway management and risk of massive intraoperative bleeding. These patients require carefully planned anesthetic management.

Key words: Craniosynostosis, pediatric patients, anaesthetic management, bleeding management

ABSTRACT

Seljuks gave great importance to the treatment of diseases and medical education. While the Seljuk sultans were reconstructing the cities, they also made investments in the field of health. In the Seljuks, health services were generally provided in institutions such as dârü’ş-şifâs and caravanserai hospitals. They were careful about the health issue against the risk of epidemics, and applied the modern treatment methods of the period against diseases such as leprosy and plague. In the Seljuk lands, dârü’ş-şifâs, hospitals in the caravanserai and mobile hospitals were serving the patients. In the caravanserais, passengers were given free health care. Apart from the Seljuk rulers, statesmen and benefactors also had dârü’ş-şifâs built. In this study, the health structures and treatment methods in Konya before the establishment of modern medicine will be examined.

Key words: The Seljuk Hospitals, Medicine, Dârü’ş-şifâ, Konya

ABSTRACT

Aim: Oncogenic Human papillomavirus (HPV) types play an important role in the development of cervical cancer. The cervix is an easily accessible organ that significantly improves the prognosis with early diagnosis by screening tests, and subsequent early treatment planning. In our study, we wanted to investigate the importance and prevalence of HPV subtypes in cervical neoplastic lesions.

Materials and Methods: 296 women who applied to the gynecological oncology clinic in our hospital and underwent colposcopic biopsy based on HPV tests were evaluated retrospectively. Colposcopic biopsy samples were evaluated by histopathological examination and HPV samples were evaluated by polymerase chain reaction (PCR) and DNA typing was performed.

Results: Among the HPV types in our patients, the most common HPV type 16 was detected. Among the high-risk HPV types, the 5 most common types are 16,31,18,51, and 52, respectively. While the most common HPV types were 16,35,31 in high-grade squamous intraepithelial lesions (H-SIL), and 16,51,31 in low-grade squamous intraepithelial lesions (L-SIL). In our region, a cervical premalignant or malignant lesion was detected in 129 of 296 patients who had a colposcopic cervical biopsy. In 110 of these 129 patients, HPV was detected in etiology, and HPV was not detected in 19/129 of them.

Conclusion: The HPV virus is the most important risk factor in the etiology of cervical cancer. The content of vaccines planned to be developed against HPV is the most common and high-risk group subtypes and will be promising in preventing cervical cancer.

Key words: HPV subtypes, cervical intraepithelial neoplasia, cervix carcinoma

ABSTRACT

Background: The Mevlevi Sema ceremony is a Sufi ritual that includes meditation, exercise actions, and religious symbols. Sema is also a method of meditation. There are few whirling dervishes in the world. Positive effects of worship on stress and anxiety leads to a hypothesis that whirling dervishes have low stress levels, high sleep quality, and optimal neurotrophic factors.

Aim: Our aim in the present study is to determine the effect of stress levels of whirling dervishes on neurotrophic factors.

Materials And Methods: In this research, possible protective effect of Sema against stress was investigated. A total of 33 adult men comprising, 17 whirling dervishes, and 16 healthy volunteers were recruited. Neurotropic factors (VEGF, BDNF, GDNF), PNX-20, anxiety levels (BECK Anxiety Scale), and sleep quality (Richard-Campbel Sleep Scale) data were obtained from the participants.

Results: It was found that whirling dervishes have lower VEGF, BDNF, GDNF, Phoenixin levels, anxiety scores, and better sleep quality.

Conclusion: Many alternative meditation practices have being popularly utilised for stress management. Sema is a less-known type of meditation practice. Our results, revealed that Sema may be an effective tool in stress management.

Key words: Sema, whirling dervishes, neurotrophic factors, phoenixin-20, sleep, anxiety

ABSTRACT

Aim: In this study, it is aimed to determine the knowledge of the trainees in the Family Art and Education Center (ASEM), to raise awareness about reproductive health, and to determine the effectiveness of the training given in order to complete their knowledge deficiencies.

Methods: The study was conducted with 80 trainees who received training at ASEM between May 1 and June 30, 2018. Pre-test, interactive training and then post-test were administered to the volunteer participants. Statistical analysis of the data was made using the SPSS 27.0 package program. McNemar X2 test was used in the analysis of the data. p<0.05 was accepted as the cut-off value for statistical significance.

Results: Eighty trainees with a mean age of 41.33±9.54 years old participated in the study. In the pre-test, 20.0% of the participants and 53.8% in the post-test correctly knew all the cancers screened by national cancer screening programs. In addition, it was seen that 32.5% of women knew the right time to perform breast self-examination in the pre-test, while this rate increased to 85.0% in the post-training test. A statistically significant difference was found between the pre-test and post-test in all subjects given in the field of reproductive health (p<0.05).

Conclusion: It was found that the participants had a low level of knowledge about family planning, sexually transmitted infections and female cancers in the screening program, and the educational intervention provided was beneficial. However, it was determined that a sufficient increase could not be achieved with the education intervention. This shows that training programs targeting women and including issues in the field of reproductive health should be repeated with periodic and up-to-date content.

Key words: Education, women's health, reproductive health

ABSTRACT

Aim: Adolescence is a period in which lifestyles and behaviors are shaped. The behaviors acquired in this period continue their effects throughout life. Positive behaviors contribute to the protection and development of health, while negative behaviors cause an increase in mortality and morbidity. The concept of health literacy, which includes the processes of accessing health-related information, understanding, evaluating and applying processes, has an important place in the adolescence period. The aim of this study is to examine the relationship between health literacy and risky health behaviors in adolescents.

Materials and Methods: The cross-sectional study was conducted with 382 students from two high schools in Konya, between 2018 and 2019. The dependent variable of the study is risky health behaviors, and the main independent variable is health literacy level. Data were collected using the Turkish Health Literacy Scale, Risky Health Behaviors Scale, and sociodemographic characteristics questionnaire, which were distributed and collected by the researcher. T Test, One Way Anova Test, Mann Whitney-U Test, Kruskal-Wallis Test and Pearson Correlation Test were used in data analysis.

Results: In the study, the mean score of the Health Literacy Scale was found to be 34.3±8.7 and the mean score of the Risky Health Behaviors Scale was found to be 44.9±7.7. When risky health behaviors were examined according to students' health literacy levels, it was found that students with excellent and sufficient health literacy had significantly lower risk health behaviors (p<0.001).

Conclusion: As a result of the study, it is seen that students with high health literacy levels have lower risky health behaviors. It is recommended to increase the level of health literacy in order to reduce risky health behaviors observed in adolescents.

Key words: Adolescence, health literacy, risky behaviors, healthy behavior

ABSTRACT

Thymomas and thymic carcinomas are rare tumors of thymus origin, usually located in the anterior mediastinum. The stage at the time of first diagnosis and complete surgical removal of the thymic tumor are the most important prognostic factors. According to the stage of the patients, treatment strategies including neoadjuvant/adjuvant chemotherapy and radiotherapy should be planned in multidisciplinary tumor boards. However, despite local treatments, a small number of patients may develop recurrence over time or metastasis can be detected at the first diagnosis. Combination chemotherapy regimens with platinum and doxorubicin are the standard firstlline therapy in patients who are not suitable for local treatments. There is no definitively accepted treatment recommendation in secondary care. The results of studies with tyrosine kinase inhibitors targeting vascular endothelial growth factor and immunotherapies in patients with progression after first-line therapy have been recently reported. In this review, I analyzed the overall treatment management of patients with thymoma and thymic carcinoma, the results of targeted therapies and immunotherapy studies, and their potential implications for current practice.

Key words: Targeted treatments, immunotherapy, thymic carcinoma, thymom

ABSTRACT

In particular, the recovery period of the coronavirus disease-2019 (COVID-19) patients with chronic disease may be prolonged, and the clinical course of the disease may be severe. The patient with prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Polymerase Chain Reaction (PCR) positivity and recurrent COVID-19 detected cytomegalovirus (CMV) pneumonia and deep lymphopenia was detected, and the patient was consulted to the immunology clinic. Human immunodeficiency virus (HIV) tests were performed when the CD4 level was 1% (27-57) in the peripheral lymphocyte subgroup analysis evaluated. HIV tests were performed and HIV RNA was positive. The patient was referred to the infectious diseases department. Viral causes of immunodeficiency, such as HIV, should also be considered in patients with recurrent COVID-19 and prolonged SARS-CoV-2 PCR positivity.

Key words: COVID-19, CMV, HIV, immune deficiency

Introduction: Oncocytic papillary cystadenoma is a very rarely seen epithelial tumor of the salivary gland. It is mostly located in the minor salivary glands. It usually occurs at the age of over 40 and is more commonly seen in women than in men. Studies have shown no link between cigarette smoking and the formation of oncocytic papillary cystadenoma. In microscopic evaluation, it can be confused with Warthin tumor, which is seen very often in the parotid gland and which also has oncocytic epithelial cells. However, the absence of lymphoid stroma is the most important diagnostic finding that differentiates oncocytic papillary cystadenoma from Warthin tumor.

Case: A 62-year-old male patient was admitted to the clinic with the complaint of neck swelling. He had no history of cigarette smoking. In the ultrasonography of the patient, a homogeneous, parotid-located, anechoic cystic lesion without a solid component was observed. In the excised material, a cystic tumoral lesion, the cross-sectional surface of which was dirty white and yellow in color, was observed. The case was reported as papillary oncocytic cystadenoma by microscopic examination of the sections taken.

Conclusion: Our case, which is rarely seen and is located in the parotid gland, is presented so that it may be kept in mind when a Warthin tumor-like lesion without lymphoid stroma is observed and so that it may be taken into consideration in the differential diagnosis.

Key words: Salivary gland, cyst, tumor

ABSTRACT

Tracheal stenosis is a rare condition that can be asymptomatic in children, or it can present with life-threatening severe respiratory failure. Acquired and congenital causes are included in the etiology. A good history, physical examination and flexible bronchoscoi are important in the diagnosis. Tracheal stenosis should be included in the differential diagnosis, especially in children presenting with wheezing. In this article, a case of tracheal stenosis with wheezing is presented.

Key words: Tracheal stenosis, wheezing, child, respiratory failure

ABSTRACT

Tularemia, caused by the Francisella tularensis, which is Gram negative small coccobacillus, is a zoonotic, bacterial, granulomatous infectious disease. It is widespread in the world. It is endemically and sporadically found in many regions throughout Turkey. Konya and its neighborhood is one of the regions, where the disease is endemically found. In Turkey, tularemia should be considered in definitive diagnosis in patients, who apply with fever and cervical lymphadenopathy and do not respond to beta- lactam antibiotics. In this article, we present a case of a 28-years-old patient with oropharyngeal tularemia, acute tonsillitis and cervical lymphadenopathy, which does not respond to non-specific antibiotics after consumption of a rabbit meat.

Key words: Francisella tularensis, tularemia, rabbit