MIDDLE BLACK SEA JOURNAL OF HEALTH SCIENCE

Published by Middle Black Sea Journal of Health Science
Online ISSN: 2149-7796
Publications
Article
Objective: This study has aimed to share the perioperative management practices and respective outcomes in patients; who underwent urgent thoracotomy due to traumatic hemothorax during the pandemic. Methods: In a single-center, 18 patients; who underwent urgent thoracotomy due to traumatic hemothorax in March 2020 to March 2021, were included in the study retrospectively. Patient data were retrieved from digital archive files. The initial evaluation was performed in the emergency room while wearing complete personal protective equipment. Patients were taken into the operating room under emergency conditions without waiting for the results of the nucleic acid tests performed on oropharyngeal and nasopharyngeal swabs. The operation was carried out by involving the minimum number of personnel. In the postoperative period, patients were followed up in a negative pressure intensive care room. Isolation measures were maintained until two novel coronavirus nucleic acid tests on oropharyngeal and nasopharyngeal swabs collected 48 hours apart were reported as negative. Results: During the one-year period in the COVID-19 pandemic, 18 patients were operated on with the indication of urgent thoracotomy. Of the patients, 14 were men (77.8%), and 4 were women (22.2%). Nucleic acid test results were negative in 17 patients (94.5%). The nucleic acid test result was reported positive in one patient (5.5%) for samples taken at the 48th hour. Nucleic acid tests were performed on the oropharyngeal and nasopharyngeal swabs obtained on the fifth and seventh days from the operation personnel. No novel coronavirus transmission occurred in the healthcare personnel. In the postoperative period, 15 patients (83.3%) were successfully treated and discharged from the hospital, but 3 patients (16.7%) died. No morbidity or mortality occurred due to COVID-19. Conclusion: Urgent thoracotomies can be successfully performed during the COVID-19 pandemic. Novel coronavirus transmissions can be avoided if relevant healthcare personel comply with isolation measures and use complete personnel protective equipment Anahtar Kelimeler COVID-19, Thoracotomy, Surgery
 
Article
Abstract Objective: COVID-19 was first discovered in Wuhan in December 2019 and spread all over the world. This study was conducted to evaluate the knowledge, attitudes and behaviours of people living in Northern Cyprus regarding COVID-19. Methods: This descriptive study designed to evaluate the level of knowledge, attitude and behaviour of participants who are Turkish Cypriots between 7-17 April 2020 after the first COVID-19 case diagnosed in our country. A twenty-nine-item questionnaire was prepared, distributed randomly to participants on social media and took 7-10 min to complete. Data were analyzed with a 95% confidence and p<0.05 significance level. Results: Of the 1192 respondents, 70.8% are between 20-29 years old, 69.8% are women, and 69.1% are university students. The average score in knowledge of all participants about COVID-19 was found to be 47.39, and the general precaution level average score of all participants was found to be 45.97. A statistically significance difference was determined in between the GPL average score and age (p=0.012), gender (p=0.000), marital status (p=0.000), being a university student (p=0.002), working status (p=0.000), and having a healthcare professional in the family Conclusion: Both the knowledge and precaution levels of the participants were determined to be at ‘good’ levels. It was shown that the participants had a high level of knowledge of COVID-19 and a high level of compliance with preventive measures.
 
Upper GIS Endoscopic İnvestigation Results (Order Based on Percentage) 
Colonoscopic Investigation Results (Order Based on Percentage) 
Article
Objective: The aim of this study was to evaluate the upper gastrointestinal endoscopy and colonoscopy results in patients who presented with abdominal pain and received a diagnosis of nonspecific abdominal pain following the examination and tests. Methods: We included a total of 52 patients who presented at the emergency service between 01.01.2011 and 01.01.2012 with symptoms of abdominal pain and received a diagnosis of nonspecific abdominal pain following normal examination, routine blood and urine tests and ultrasound analysis. All patients underwent upper gastrointestinal endoscopy and colonoscopy on the same day. The results were evaluated and diagnoses made according to the endoscopy and pathology findings. Results: There were 23 (44.2%) males and 29 (55.8%) females. The mean age was 54.5 ± 15.3 (23-86) years. A pathology was present on upper endoscopy in 47 (90.4%) patients and lower endoscopy in 27 (51.9%) patients. Comparison of the pathology rates for upper endoscopy and colonoscopy showed a significantly higher rate for upper endoscopy. The most common findings were chronic gastritis with upper endoscopy 13 males (25%) and 17 (32.7%) females, hemorrhoids with colonoscopy 10 males (19.2%) and 12 (23.1%) females. A pathology was present on both examinations in 25 (48%) patients. Cancer was found in 7 (13.5%) patients (6 gastric, 1 colon cancer). Helicobacter pylori was (+) in 53.8% of the cases. Conclusion: Same day upper and lower endoscopy in patients with nonspecific abdominal pain provided important results. However, we feel upper endoscopy should have priority when it is not possible to perform both investigations.
 
Cytologic and Colposcopic Evaluation Results 
Article
Objective: We aimed to evaluate the efficacy of conventional cytology on detecting precancerous lesions in postmenopausal women by comparing the results of colposcopic biopsies of the pre and postmenopausal women with abnormal cervical cytologies. Methods: Between January 2010 -December 2014 we reviewed patients who underwent colposcopic examination in clinic of obstetrics and gynecology of Bakirkoy Dr Sadi Konuk Teaching and Research Hospital retrospectively. The women were evaluated according to menopausal status, abnormal cervical cytologies and colposcopic examination results. NCSS (Number Cruncher Statistical System) for statistical analysis was used. Results: Patient population (n=1658) was composed of 1289 premenopausal (77.7%) and 369 postmenopausal (22.3%) women. According to the results of cervical cytologies; benign Atypical squamous cells - unknown significance (ASCUS), Atypical squamous cells where a high-grade lesion cannot be eliminated (ASC-H) were not found statistically significant between two groups (p>0.05). Low-grade squamous intraepithelial lesion (LSIL); in premenopausal group, and high-grade squamous intraepithelial lesion (HSIL) in the postmenopausal group were found significantly higher (respectively p= 0.006; p = 0.002; p <0.01). When colposcopic results were evaluated; benign findings in postmenopausal women and cervical intraepithelial neoplasia (CIN) I in premenopausal women were found significantly higher (respectively, p = 0.001; p = 0.001; p <0.05). When postmenopausal patients with ASCUS cytology were evaluated, benign biopsy rate was significantly higher in colposcopy, on the other hand, CIN I ratio was significantly higher in premenopausal group with ASCUS cytology (p=0.007, p <0.01). When patients with LSIL were evaluated, benign biopsy rate in colposcopy was higher in postmenopausal patients, CIN I and CIN II-C III- Squamose cell carsinoma (SCC) rates were found in highly significant in premenopausal patients (p = 0.032; p <0.05). Conclusion: When compared with the premenopausal patients group, we have reached the conclusion that the conventional cytology has less efficiency in detecting the precancerous lesions in postmenopausal cases; therefore, colposcopic examination may be appropriate in postmenopausal women. Routine liquid based cytology and HPV screening can achieve clarity in this debate, screening programs should be implemented effectively especially in postmenopausal group and further large scale studies are needed.
 
Typical hourglass appearance of temporal space abscess is seen. Note that the buccal space was also been affected.  
CT scan demonstrated expanded facial space of buccal and temporal area compared to left side of her face.  
Resolved signs of odontogenic infection after treatment with moxifloxacin.  
Article
Temporal space infections are seen as a swelling of the superficial and/or deep temporal regions. They are sporadically reported and usually develop before or after extraction of infected maxillary molars. A 50-year-old woman had undergone extraction of her mandibular right second molar tooth in a different clinic, and after a month she visited our department because of the temporal and buccal space abscess which had not responded the antibiotic therapy. Painful swelling and trismus were diagnosed on her right temporal and buccal region with a general malaise. A CT scan revealed an inflammatory area into the temporal and buccal space. Treatment with surgical intervention and intramuscular penicillin G did not provide improvement. Antibiotic was switched on to moxifloxacin 400 mg in a day orally for 7 days. After this treatment, both temporal and facial swellings, trismus and her malaise were completely resolved.
 
Article
Objective: Acanthamoeba species are the ubiquities free-living amoebae and can infect humans, causing diseases such as keratitis and encephalitis. Acanthamoeba species are often grown on non-nutrient agar spread with Escherichia coli or peptone-yeast extract-glucose. We investigated the amount of growth of Acanthamoeba in different axenic and monoxenic media. Methods: The non-nutrient agar with Pseudomonas aeuroginosa, Enterobacter aerogenes, Staphylococcus aeurous, Escherichia coli, and Klebsiella pneumoniae were used as monoxenic media. The encystation, mycological peptone-maltose, peptone yeast extract glucose, roswell park memorial institute 1640 and trypticase beef hemoglobine media were used as axenic media. Results: We compared the growth of Acanthamoeba species in different axenic and monoxenic media in this study. In relation to the growth rate, the non-nutrient agar with Pseudomonas aeuroginosa had the highest values achieved among monoxenic media and roswell park memorial institute 1640 media was the highest value among axenic media. Conclusion: In view of the results, we can affirm that these monoxenic media are adequate to grow of Acanthamoeba species. In addition, a classic and basic medium that supports the growth of Acanthamoeba species consists of peptone yeast extract glucose. However, the roswell park memorial institute 1640 media was an excellent commercially available media for the growth of Acanthamoeba and it was able to keep Acanthamoeba by long periods of time.
 
Incision of the modified Iselin's method: Skin incision and subcutaneous dissection. PSIS: Posteior Superior Iliac Spine G.max: Gluteus Maximus T. Major: Trochanter Major
Clinico-radiological workup of patients with acetabular fractures
Radiological and functional outcome of patients at final follow-up
Article
Objective: The main purpose of the surgical treatment of posterior acetabular fracture is to achieve anatomical reduction to attain a functional and stable hip joint without pain. Although Kocher-Langenbeck (K-L) approach is the most commonly used surgical exposure, various modified approaches have been described in the literature. The aim of this study to determine the early surgical results of the acetabulum posterior fractures surgery via Iselin's modified K-L approach. Methods: We reviewed the hospital records of patients who were operated for acetabulum posterior wall fractures via Iselin's modified approach between 2016 and 2018. All patients had detailed radiological, clinical evaluation and fractures were classified by AO/ASIF classification. All patients had radiological and clinical evaluation at the end of the postoperative 1st year. Results: There were 16 men and 4 women with an average age of 42.8±18.0 (range 18-77) years. The average follow-up was 14.8±6.1 (range 6-28) months. The right hip was involved in 12 (60%) patients and the left in 8 (40%) patients. The average operative time was 78.6±16.7 (range, 54–115) minutes. Average blood loss during the operation was 179.22±51.9 (range, 100–260) ml. The postoperative reduction was graded as anatomic (0–1 mm of displacement) for 17 hips and imperfect (2–3 mm of displacement) for 3 patients. No patient had a deep infection, implant loosening, recurrent dislocation, deep venous thrombosis (DVT), pulmonary embolism (PE) or revision fixation. Conclusion: The modified approach of Iselin is a successful approach with its ease in the surgery of displaced fractures that extending proximally and early radiological and functional results.
 
Top-cited authors
Nülüfer Erbil
  • Ordu Üniversitesi
Mehtap Gümüşay
  • İstanbul University-Cerrahpaşa
Mehmet Melih Ömezli
  • Ordu Üniversitesi
Gülşah Evyapan
  • Cukurova University
Fadime Eroglu
  • Cukurova University