Anatolian Clinic Journal of Medical Science / Anadolu Kliniği Tıp Bilimleri Dergisi

97-104

Authors: Süreyya Ekem, Nida Fatma Taşcılar, Esra Acıman Demirel, Banu Özen Barut, Handan Ankaralı, H. Tuğrul Atasoy

Aim: Typical antipsychotics and clozapine could cause EEG abnormalities and risk of epileptic seizures. Little is known about the effects of newer antipsychotics on EEG. The present study therefore examined the risk of EEG abnormalities associated with the use of atypical antipsychotics [clozapine, quetiapine, risperidone, olanzapine and new atypical antipsychotics (amisulpride, aripiprazole, paliperidone)] and of the typical antipsychotics (chlorpromazine, haloperidol, zuclopenthixol, pimozide). Materials and Methods: EEG patterns were prospectively investigated in 102 patients with schizophrenia or schizoaffective disorders. While 82 out of the 102 patients were under atypical [clozapine (n=16), risperidone (n=20), quetiapine (n=10), olanzapine (n=14), and new atypical antipsychotics (n=10)] and typical [haloperidol (n=5), chlorpromazine (n=2), zuclopenthixol (n=3), pimozide (n=2)] antipsychotic treatment, 20 of them were not under any treatment. These three groups were compared with a sex- and aged- matched control group of healthy volunteers (n=29). Results: No statistically significant difference regarding demographic characteristics was found between the groups. Both the patients who were not on any medication and the healthy volunteers had normal EEG’s. Epileptic activity was observed in 31.3% of the patients under clozapine treatment (p<0.05) and in 10% of the patients under quetiapine treatment (p>0.05). EEG abnormalities other than epileptic activity were observed in 58.3% of the patients under typical antipsychotics (p<0.01) and 35% of the patients under risperidone treatment (p<0.01). EEG was normal in 78–80% of the patients using quetiapine and new atypical antipsychotics, compared to 33.3% of the patients under typical antipsychotic treatment (p=0.012). Discussion and Conclusion: Herein, we found that clozapine was the most epileptogenic antipsychotic and that typical antipsychotics were making the worse EEG changes. Nevertheless, in the psychotic patients under clozapine treatment EEG is a must. Psychotic patients with consequential epilepsy could be given new atypical antipsychotics because it has the least unwanted effects on EEG. Moreover, it should also be emphasized that there is a need for further scientific research to clarify all aspects characterizing the complex link between seizure threshold and psychotropic drugs.

119-128

Authors: Nurten Elkin

Aim: In this study, we aimed to determine the preferred mode of delivery and the related factors in women aged 18–49 years who applied to a family health center. Materials and Methods: This is a descriptive study based on a questionnaire applied to the 307 women aged 18–49 years who applied to a family health center in the central Istanbul and had a history of pregnancy. The data were analyzed by the SPSS (Statistical Package for the Social Sciences) 16.0 software. Results: During the survey, 24.4% of the women were pregnant and 91.8% had a previous delivery, of whom 46.8% had a Cesarean section. 49.2% of those who had had a delivery reported that their doctors had decided on the mode of delivery. 54.4% of those who had a normal delivery the last time they gave birth reported that they preferred normal delivery because they thought it to be the natural way of giving birth. For 73.1% of those who had a delivery by Caesarean section, the operation was medically indicated. 81.4% of the women who were pregnant at the time of the survey reported that they were planning about the mode of delivery; and 68% of these reported that they were thinking of having a normal delivery. A statistically significant correlation was found between the preferred mode of delivery and the characteristics of the women including the level of education, the type of the settlement where they live, employment status, monthly income status and presence of problems experienced in previous pregnancies (p<0.05). 73.4% of the women who previously gave birth received information on the modes of delivery, and 61.8% of these received such information from their doctors. Discussion and Conclusion: Women’s lack of knowledge about the modes of delivery in pregnancy is one of the preventable factors that increase the frequency of delivery by Caesarean section. Therefore it is quite important that women be informed on the modes of delivery by primary care family doctors and family health workers.

135-138

Authors: Pınar Dervisoglu, Mehmet Karacan, Mustafa Kosecik

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a disorder which is attracting increased awareness in clinical practice. Despite being an uncommon disease, it is a frequent cause of unexpected death in young persons. Although the term ARVC used for this cardiomyopathy suggests that it involves the muscle of the right ventricle, in recent years there were cases reported in which the left ventricle was severely affected. The current study reports an ARVC-diagnosed fifteen-year-old male patient who had no clinical features previously and died from sudden congestive heart failure; he had two siblings with a history of sudden unexpected death. We would like to bring to mind once again the important role of early diagnosis for ARVC to avoid undesirable consequences of the disease.

143-148

Authors: Ahmet Salduz, Necmettin Turgut, Serkan Bayram, Murat Altan, Mehmet Chodza, Mehmet Ekinci, Turgut Akgül

Although pathogens causing osteomyelitis vary, relatively uncommon microorganisms can cause osteomyelitis in immunosuppressed patients. In this study we aimed to present the diagnosis and treatment of a patient with a rare case of osteomyelitis due to infection with a species of Fusobacterium. A 48-year-old female patient complaining of swelling and pain in her left thigh for the last three months was referred to our clinic with a prediagnosis of bone malignancy based on the MRI findings. The patient had a history of immunosuppressive drug use for scleroderma. The patient suffered a pathological femoral fracture two days after her first visit to us. Abscess drainage and debridement were performed to treat her osteomyelitis, and an osteosynthesis including antibiotic cement-coated intramedullary nail insertion was performed for the fracture. Fusobacterium necrophorum grew in the culture of the preoperative specimens. The patient for whom vacuum-assisted closure was used during her hospitalization was discharged after the acute phase reactants returned to normal and the IV antibiotic treatment was completed. It should be noted that bacteria from the genus Fusobacterium can cause osteomyelitis in immunosuppressed patients, and that while making the differential diagnosis of the lytic lesions of bones osteomyelitis is one of the possibilities.

153-161

Authors: Orhan Alimoglu, Julide Sagiroglu, Moaath Alsmadi, Tamador Shamaileh, Mutaz Albrezat, Mohammad Nayfeh, Neyaf Almajali, Sara Alsauod, Ali Abualhayja’a, Tunc Eren

General surgical diseases have been long treated via conventional (open) or laparoscopic operations. With the advances in technology, there is a paradigm shift from conventional laparoscopy. As a result, single incision laparoscopic surgery (SILS), natural orifice transluminal endoscopic surgery (NOTES), and robotic surgery have evolved as new treatment options for minimal invasive surgery. It has been shown in many series that a wide variety of procedures of general surgery can be managed safely and effectively by robot assisted laparoscopic surgery (RALS). In this review, current advances and practice in robotics in the most commonly applied gastrointestinal surgical procedures will be emphasized.