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

66-67

Authors: Savaş Karpuz

This letter contains a brief comment about the "The Knowledge Level of Turkish Rheumatoid Arthritis Patients about Their Diseases " that presented by Bozbas and Gurer. In this trial authors attracts the attention of the readers on patient education in a chronic disease. Study aimed to assess the level of disease specific knowledge of the patients with Rheumatoid Arthritis. Patients with Rheumatoid arthritis (RA) were evaluated about the awareness level of patients, and the “Patient Knowledge Questionnaire in Rheumatoid Arthritis (PKQ-RA)” was used in this high-quality study. Firstly, studied internal consistency of the Turkish version of PKQ-RA was high with Cronbach’s alpha of 0.71. and according to the results most of the patients (86.7%) reported that they had gained the information about RA from their physicians. Age, education, socioeconomic status, and family history of disease were associated with the Patients’ knowledge levels. But in conclusion authors unnoticed a previous study titled as “The assessment of knowledge level about their disease in patients with rheumatoid arthritis” and published by Karahan et al. In this earlier study authors firstly used the Turkish version of the PKQ-RA to evaluate the level of knowledge about the disease of patients with RA. Also, authors reported the very low level of knowledge. These two papers gain important contribution about the needs of the patient education. Patient education is important step of the treatment in the chronic disease and more clinical studies need especially from developed countries such as Turkey.

73-78

Authors: Abdulhalim Şenyiğit, Timur Orhanoğlu, Bülent Yaprak

Aim: In this study, we aimed to investigate the related biochemical markers and their correlations in non-alcoholic fatty liver (NAFL) disease. Materials and Methods: Patient files of individuals who came to our hospital for routine controls without any complaints were reviewed retrospectively. One hundred and forty-eight individuals (94 females; 54 males) whose ultrasonographic examination revealed varying degrees of NAFL disease constituted the patients group and 149 individuals (76 females; 73 males) whose results were clear the healthy controls group. We reviewed the ultrasonographically determined NAFL disease grades and fasting blood glucose, insulin, HOMA-IR, uric acid, C-reactive protein (CRP), triglyceride, LDL, HDL, TSH, vitamin D, AST, ALT, GGT and ALP values of a total of 297 patients. Results: With respect to sex, NAFL prevalence was significantly higher in the patients group than in the healthy controls for males (p=0.029). Similarly, fasting blood glucose, insulin, HOMA-IR, uric acid, triglyceride, HDL, ALT, AST, GGT and CRP levels were also significantly higher in the patients group. No effect of low HDL and vitamin D levels on NAFL disease grade was observed. Analyses based on NAFL disease grade showed statistically significant difference between the subgroups of disease grade of the patients group in terms of fasting blood glucose, HOMA-IR, ALT, AST and GGT mean values. When the analyses were repeated after the grade 2 and 3 subgroups were combined, there was statistically significant difference between the new grade 1 and 2 subgroups in terms of fasting blood glucose, insulin, HOMA-IR, ALT and GGT mean values. This time there was statistically significant difference in terms of mean insulin levels also, while the difference between the AST levels decreased. Discussion and Conclusion: Our study suggests that apparently healthy individuals also be examined for presence of NAFL disease because timely diagnosis and appropriate management could significantly help prevent complications such as cirrhosis and hepatocellular carcinoma.

84-87

Authors: Orhan Alimoğlu, Metin Leblebici, Tuba Atak, Jülide Sağıroğlu, Yadigar Yılmaz, Ercüment Tombalak, Elif Demirci, M. İhsan Karaman

Introduction: Ketamine can be used in high doses for general anesthesia and in low doses for analgesia. In this study, we aimed to present 49 patients operated under ketalar anesthesia. Materials and Methods: This study reports the results of 49 patients who were operated by Doctors Worldwide’s voluntary surgical team in the Port Loko Goverment Hospital, Sierra Leone, between 10 and 16 March 2014. The demographic characteristics of all patients and the surgical procedures performed were recorded. All patients were operated under ketamine and midazolam anesthesia. Results: 5 female and 44 male patients whose mean age was 36.8+17.8 were operated. 1 patient had umbilical, 1 had epigastric, and 35 had giant inguinal hernia. Umbilical and epigastric hernias underwent primary repair. Inguinal hernias were right-sided in 19 patients, and left-sided in 16. Twenty-eight patients had indirect hernia, while 6 had direct and 1 had bilateral hernia. No obstruction or strangulation was observed in any of the patients. Four pediatric patients with hernia underwent high ligation. In the adult age group, 28 patients underwent darn repair and 3 Bassini repair. Of the 8 patients with giant hydroceles, 4 had it on the right side and 4 on the left, and all of them were operated by Winkelmann’s technique. One patient underwent orchiectomy for a right-sided testicular mass; 1 excision of an inguinal tumor; 1 excision of a lipoma in the neck, and 1 excision of a solid mass in the left labium majus. No anesthesia-related complication developed in any of the patients. Conclusion: Safe and effective sedation achievable by intravenous administration of low-dose ketamine and midazolam is particularly useful for surgical procedures to be performed in field conditions where general anesthesia is not applicable.

93-96

Authors: Sedat Akbaş, Ahmet Selim Özkan, Muharrem Uçar, Ökkeş Hakan Miniksar, Mahmut Durmuş

Fusion of vertebral bones in ankylosing spondylitis causes flexibility loss in the neck and back. In advanced stages of the disease, airway management can be difficult due to the ankylosis of the cervical, thoracic, and lumbar vertebrae. In this paper, we report the awake fiber–optic nasotracheal intubation of a patient with expected difficult airway due to ankylosing spondylitis, whose extremely limited mouth opening and neck mobility required an urgent tracheostomy, causing respiratory distress.

102-107

Authors: Zeki Taşdemir, Güven Bulut, Engin Eceviz, Nurzat Elmalı

Pressure by a ganglion cyst in the posterior glenohumeral joint on the suprascapular nerve is a rare cause of shoulder pain. In this paper, we aimed to discuss in light of the literature the applicability of various treatment modalities for ganglion cysts compressing the suprascapular nerve. In magnetic resonance (MR) imaging, we observed cystic structures compatible with a ganglion cyst behind the right glenohumeral joint in three patients who had been complaining of shoulder pain with no history of trauma. Conservative and surgical methods have been suggested in the literature to treat ganglion cysts that cause pain and weakness in the glenohumeral joint. It has been observed that arthroscopic repair or removal of the cause of the cyst is successful in decompressing the suprascapular nerve in patients unresponsive to medical treatment. Arthroscopic technique is more advantageous than open surgery, providing less morbidity, faster restoration of functionality, and easier detection and treatment of intraarticular pathologies.

111-120

Authors: Maide Barış, İlhan İlkılıç

Prenatal testing and diagnostic procedures are a variety of intervention that aim to provide and do provide in utero information about the health of the fetus. These procedures are supported and argued for on grounds that they are beneficent occasionally for the pregnant woman or the society. This study presents a normative analysis on the possible effects of prenatal testing on women, the disabled, and the society, subsequently followed by an inquiry as to whose interests or rights provide the justificatory basis for such intervention.