Background/Aim: Sports injuries represent a significant public health concern, and their prevalence is on the rise due to the growing global population and increased participation in amateur and professional sports. Epidemiological studies on sports injuries are crucial in identifying priority areas for injury prevention efforts. While there is a wealth of research on musculoskeletal injuries specific to various sports, there is a scarcity of epidemiological studies focusing on patients seeking care at sports medicine outpatient clinics. This study aims to define and categorize the diagnoses of patients presenting to a sports medicine outpatient clinic for musculoskeletal injuries. Methods: This retrospective cohort study included all patient visits for musculoskeletal injuries at the sports medicine outpatient clinic between 1 July 2022 and 30 June 2023. Patients with complaints other than musculoskeletal injuries and those lacking sufficient data (diagnosis or injury type) in the data recording system were excluded. Data recorded for each participant included age, sex, symptoms, injured body region, and injury type. Diagnoses were categorized using the Orchard Sports Injury and Illness Classification System (OSIICS) v.13. Descriptive analyses provided a detailed overview of reported injuries, including counts and proportions within specific injury categories. Categorical variables are presented as ‘n’ and (%), while continuous variables are expressed as medians with interquartile ranges (IQRs). Results: Data from 1,203 patients (395 females and 808 males) were analyzed, with a mean age of 24 (2.2) years. A total of 1393 injuries were documented, with the knee being the most commonly injured body region (n=398, 30.7%). Among the OSIICS v.13 injury categories, muscle/tendon injuries constituted 33.7% (n=466) of all injuries, followed by cartilage/synovium/bursa injuries (n=432, 31.2%). Conclusion: This study revealed that the knee was the most frequently injured body region among patients seeking care at the sports medicine clinic for musculoskeletal injuries. Muscle/tendon injuries were the predominant type of injury observed.
{"title":"Musculoskeletal injuries profile of patients applying to a sports medicine outpatient clinic","authors":"Merve Demir Benli","doi":"10.28982/josam.7944","DOIUrl":"https://doi.org/10.28982/josam.7944","url":null,"abstract":"Background/Aim: Sports injuries represent a significant public health concern, and their prevalence is on the rise due to the growing global population and increased participation in amateur and professional sports. Epidemiological studies on sports injuries are crucial in identifying priority areas for injury prevention efforts. While there is a wealth of research on musculoskeletal injuries specific to various sports, there is a scarcity of epidemiological studies focusing on patients seeking care at sports medicine outpatient clinics. This study aims to define and categorize the diagnoses of patients presenting to a sports medicine outpatient clinic for musculoskeletal injuries. Methods: This retrospective cohort study included all patient visits for musculoskeletal injuries at the sports medicine outpatient clinic between 1 July 2022 and 30 June 2023. Patients with complaints other than musculoskeletal injuries and those lacking sufficient data (diagnosis or injury type) in the data recording system were excluded. Data recorded for each participant included age, sex, symptoms, injured body region, and injury type. Diagnoses were categorized using the Orchard Sports Injury and Illness Classification System (OSIICS) v.13. Descriptive analyses provided a detailed overview of reported injuries, including counts and proportions within specific injury categories. Categorical variables are presented as ‘n’ and (%), while continuous variables are expressed as medians with interquartile ranges (IQRs). Results: Data from 1,203 patients (395 females and 808 males) were analyzed, with a mean age of 24 (2.2) years. A total of 1393 injuries were documented, with the knee being the most commonly injured body region (n=398, 30.7%). Among the OSIICS v.13 injury categories, muscle/tendon injuries constituted 33.7% (n=466) of all injuries, followed by cartilage/synovium/bursa injuries (n=432, 31.2%). Conclusion: This study revealed that the knee was the most frequently injured body region among patients seeking care at the sports medicine clinic for musculoskeletal injuries. Muscle/tendon injuries were the predominant type of injury observed.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"2013 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Elevated troponin T (Tp) is an important indicator in the decision to catheterize. However, since COVID-19 infection may cause elevated Tp, different biomarkers are needed to make the decision for catheterization. We aimed to investigate the importance of fibrinogen-to-albumin ratio (FAR) and CRP-to-albumin ratio (CAR) values in predicting obstructive coronary artery disease (CAD) in patients hospitalized with COVID-19 pneumonia and catheterized with the suspicion of acute coronary syndrome (ACS). Methods: In this retrospective cohort study, clinical, laboratory, catheterization, and electrocardiography data of all patients were analyzed. Patients with obstructive CAD were defined as the MI group, and patients with normal coronary arteries were defined as the normal group. Results: The MI group consisted of 49 patients (66.2%), and the normal group consisted of 25 patients (33.8%). Both FAR and CAR were significantly higher in the MI group (P=0.007; P=0.009, respectively). FAR and CAR were found to be independent predictors of obstructive CAD (95% CI 0.06 [0.000-34.052], P=0.024; 95% CI 1.35 [0.803-2.255], P=0.025, retrospectively). A cut-off value of 0.64 for FAR has an 80% sensitivity and a 40% specificity, and a cut-off value of 0.65 for CAR has an 83% sensitivity and a 41% specificity in predicting obstructive CAD. Conclusion: A decision for ACS and catheterization in patients hospitalized with COVID-19 pneumonia in the ICU should not be based only on elevated Tp, as it is useful to evaluate FAR and CAR values in addition to Tp.
背景/目的:肌钙蛋白T (Tp)升高是决定是否插管的重要指标。然而，由于COVID-19感染可能导致Tp升高，因此需要不同的生物标志物来决定是否插管。目的探讨纤维蛋白原-白蛋白比(FAR)和crp -白蛋白比(CAR)值在预测COVID-19肺炎住院疑似急性冠脉综合征(ACS)患者阻塞性冠状动脉病变(CAD)中的重要性。方法:在这项回顾性队列研究中，对所有患者的临床、实验室、导管和心电图资料进行分析。梗阻性CAD患者定义为心肌梗死组，冠状动脉正常患者定义为正常组。结果:心肌梗死组49例(66.2%)，正常组25例(33.8%)。心肌梗死组FAR和CAR均显著升高(P=0.007;分别为P = 0.009)。FAR和CAR是阻塞性CAD的独立预测因子(95% CI 0.06 [0.000-34.052]， P=0.024;95% CI 1.35 [0.803-2.255]， P=0.025，回顾性分析)。FAR的临界值为0.64，其敏感性为80%，特异性为40%;CAR的临界值为0.65，其预测阻塞性CAD的敏感性为83%，特异性为41%。结论:在ICU住院的COVID-19肺炎患者是否进行ACS和插管的决定不应仅基于Tp升高，因为除了Tp外，评估FAR和CAR值也很有用。
{"title":"Fibrinogen to albumin and C-reactive protein to albumin ratio can play an important role in catheterization decisions in COVID-19 pneumonia patients: A retrospective cohort study","authors":"Veysel Tosun, Ali Yaşar Kılınç","doi":"10.28982/josam.7860","DOIUrl":"https://doi.org/10.28982/josam.7860","url":null,"abstract":"Background/Aim: Elevated troponin T (Tp) is an important indicator in the decision to catheterize. However, since COVID-19 infection may cause elevated Tp, different biomarkers are needed to make the decision for catheterization. We aimed to investigate the importance of fibrinogen-to-albumin ratio (FAR) and CRP-to-albumin ratio (CAR) values in predicting obstructive coronary artery disease (CAD) in patients hospitalized with COVID-19 pneumonia and catheterized with the suspicion of acute coronary syndrome (ACS). Methods: In this retrospective cohort study, clinical, laboratory, catheterization, and electrocardiography data of all patients were analyzed. Patients with obstructive CAD were defined as the MI group, and patients with normal coronary arteries were defined as the normal group. Results: The MI group consisted of 49 patients (66.2%), and the normal group consisted of 25 patients (33.8%). Both FAR and CAR were significantly higher in the MI group (P=0.007; P=0.009, respectively). FAR and CAR were found to be independent predictors of obstructive CAD (95% CI 0.06 [0.000-34.052], P=0.024; 95% CI 1.35 [0.803-2.255], P=0.025, retrospectively). A cut-off value of 0.64 for FAR has an 80% sensitivity and a 40% specificity, and a cut-off value of 0.65 for CAR has an 83% sensitivity and a 41% specificity in predicting obstructive CAD. Conclusion: A decision for ACS and catheterization in patients hospitalized with COVID-19 pneumonia in the ICU should not be based only on elevated Tp, as it is useful to evaluate FAR and CAR values in addition to Tp.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"145 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: An estimated 300 million individuals worldwide live with hepatitis B virus (HBV) infection. Alanine aminotransferase (ALT) levels, which indicate liver damage when elevated, are among the crucial laboratory parameters frequently monitored in the follow-up of chronic hepatitis B patients. The primary objectives of antiviral treatment are to reduce liver inflammation and prevent the development of hepatocellular carcinoma or cirrhosis by inhibiting HBV replication. This study evaluated ALT responses and identified factors influencing patient responses following initiating entecavir (ETV) or tenofovir disoproxil fumarate (TDF) treatment. Methods: This retrospective cohort study collected data from treatment-naive and treatment-experienced patients with elevated ALT levels who received either ETV (0.5 or 1 mg per day) or TDF (245 mg per day) treatment between 2008 and 2018. Pregnant women and patients under 18 were excluded from the study. Elevated ALT levels were defined as greater than 35 IU/L for men and 25 IU/L for women. All patients underwent examinations for ALT, HBV DNA levels, HBeAg, and antiHBe at baseline and every 3–6 months. ALT levels of the patients were monitored for 60 months, and the presence of fatty liver was also documented. Results: Our study comprised 192 patients with a mean age of 53.7 (13.42) years. The majority of patients, 130 (67.7%), were male. Of these, 97 (50.5%) started ETV treatment, while 95 (49.5%) began TDF treatment. The median baseline ALT levels of the patients were 68 (44–133.5) IU/L, and the median ALT levels at the 60th month were 24 (18–32) IU/L. The median initial HBV DNA level was 114,282 (267.5–5,029,875) IU/mL, and the median HBV DNA levels from the 6th month onwards were 0 (0–0). ALT normalization was observed in 44.8% of men and 28.1% of women at 3 months, which was statistically significant (P=0.034). Normalization rates by gender remained consistent in all other months. No significant differences were noted in this regard. ALT normalization rates were 58.5% at the 6th month and 74.7% at the 24th month in the ETV group, significantly higher than in the TDF group (P=0.01, P=0.02, respectively). In patients with fatty liver, ALT normalization rates were significantly lower at 6, 12, 24, and 48 months than those without fatty liver (P=0.01, P=0.01, P=0.009, P=0.002, respectively). Conclusion: Although ALT responses to ETV treatment were more pronounced in specific months, both drugs demonstrated overall efficacy. ALT levels in patients with fatty liver remained elevated despite antiviral treatment. Therefore, patients with chronic hepatitis B and fatty liver may require additional support beyond antiviral therapy, including metabolic, nutritional, and lifestyle recommendations.
{"title":"Evaluation of alanine aminotransferase responses in chronic hepatitis B patients using entecavir or tenofovir disoproxil fumarate","authors":"Ufuk Sonmez, Özge Kaya, Derya Çağlayan, Alpay Arı","doi":"10.28982/josam.7899","DOIUrl":"https://doi.org/10.28982/josam.7899","url":null,"abstract":"Background/Aim: An estimated 300 million individuals worldwide live with hepatitis B virus (HBV) infection. Alanine aminotransferase (ALT) levels, which indicate liver damage when elevated, are among the crucial laboratory parameters frequently monitored in the follow-up of chronic hepatitis B patients. The primary objectives of antiviral treatment are to reduce liver inflammation and prevent the development of hepatocellular carcinoma or cirrhosis by inhibiting HBV replication. This study evaluated ALT responses and identified factors influencing patient responses following initiating entecavir (ETV) or tenofovir disoproxil fumarate (TDF) treatment. Methods: This retrospective cohort study collected data from treatment-naive and treatment-experienced patients with elevated ALT levels who received either ETV (0.5 or 1 mg per day) or TDF (245 mg per day) treatment between 2008 and 2018. Pregnant women and patients under 18 were excluded from the study. Elevated ALT levels were defined as greater than 35 IU/L for men and 25 IU/L for women. All patients underwent examinations for ALT, HBV DNA levels, HBeAg, and antiHBe at baseline and every 3–6 months. ALT levels of the patients were monitored for 60 months, and the presence of fatty liver was also documented. Results: Our study comprised 192 patients with a mean age of 53.7 (13.42) years. The majority of patients, 130 (67.7%), were male. Of these, 97 (50.5%) started ETV treatment, while 95 (49.5%) began TDF treatment. The median baseline ALT levels of the patients were 68 (44–133.5) IU/L, and the median ALT levels at the 60th month were 24 (18–32) IU/L. The median initial HBV DNA level was 114,282 (267.5–5,029,875) IU/mL, and the median HBV DNA levels from the 6th month onwards were 0 (0–0). ALT normalization was observed in 44.8% of men and 28.1% of women at 3 months, which was statistically significant (P=0.034). Normalization rates by gender remained consistent in all other months. No significant differences were noted in this regard. ALT normalization rates were 58.5% at the 6th month and 74.7% at the 24th month in the ETV group, significantly higher than in the TDF group (P=0.01, P=0.02, respectively). In patients with fatty liver, ALT normalization rates were significantly lower at 6, 12, 24, and 48 months than those without fatty liver (P=0.01, P=0.01, P=0.009, P=0.002, respectively). Conclusion: Although ALT responses to ETV treatment were more pronounced in specific months, both drugs demonstrated overall efficacy. ALT levels in patients with fatty liver remained elevated despite antiviral treatment. Therefore, patients with chronic hepatitis B and fatty liver may require additional support beyond antiviral therapy, including metabolic, nutritional, and lifestyle recommendations.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135734397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: There is no gold standard method in pilonidal sinus surgery, because each technique has a recurrence rate. This study aims to evaluate the outcomes of pilonidal sinus surgeries performed by a single surgeon using excision and primary closure technique in a state hospital. Methods: The study included 159 pilonidal sinus patients operated on by a single surgeon in the General Surgery Department between September 2014 and May 2022. The patients were investigated retrospectively, and age, gender, surgical technique, type of anesthesia administered, time needed to return to normal life, history of previous abscess drainage, long-term complaints in the incision area, number of intergluteal sinuses, postoperative complications and recurrence rates were recorded. Missing information was completed with polyclinic medical records and phone calls. Patients with incomplete data were excluded from the study. An excision and primary closure method was performed on all patients included in the study. Results: Sixty-seven (42.1%) of the patients were male and 92 (57.9%) were female. The mean age was 27.8 (8.97) years. Twenty-one (13.2%) patients were operated on under local anesthesia, whereas 138 (86.8%) received spinal anesthesia. The mean operative time was 28.87 (8.01) minutes (range: 14-47 minutes). The mean length of hospital stay was determined to be one day (range: 6-24 hours). Surgical-site infections developed in 4 (2.5%) patients and wound dehiscence developed in 14 (8.8%) patients during the postoperative period. Patients developing these conditions were followed up with dressing and antibiotic treatment. The mean postoperative follow-up period was 67 months (range: 1-105 months). Recurrence was detected in six patients during the follow-up period, representing a recurrence rate of 3.8%. Conclusion: Primary closure after asymmetrical excision of the pilonidal sinus is an easily performed technique with minimal postoperative pain and early wound healing. Additionally, this method has early return-to-work rates and low recurrence rates. We think that this method would be more applicable in pilonidal sinus surgery due to these advantages.
{"title":"Primary closure method after asymmetrical excision of a pilonidal sinus treatment: A retrospective cohort study","authors":"Tuba Atak","doi":"10.28982/josam.7904","DOIUrl":"https://doi.org/10.28982/josam.7904","url":null,"abstract":"Background/Aim: There is no gold standard method in pilonidal sinus surgery, because each technique has a recurrence rate. This study aims to evaluate the outcomes of pilonidal sinus surgeries performed by a single surgeon using excision and primary closure technique in a state hospital. Methods: The study included 159 pilonidal sinus patients operated on by a single surgeon in the General Surgery Department between September 2014 and May 2022. The patients were investigated retrospectively, and age, gender, surgical technique, type of anesthesia administered, time needed to return to normal life, history of previous abscess drainage, long-term complaints in the incision area, number of intergluteal sinuses, postoperative complications and recurrence rates were recorded. Missing information was completed with polyclinic medical records and phone calls. Patients with incomplete data were excluded from the study. An excision and primary closure method was performed on all patients included in the study. Results: Sixty-seven (42.1%) of the patients were male and 92 (57.9%) were female. The mean age was 27.8 (8.97) years. Twenty-one (13.2%) patients were operated on under local anesthesia, whereas 138 (86.8%) received spinal anesthesia. The mean operative time was 28.87 (8.01) minutes (range: 14-47 minutes). The mean length of hospital stay was determined to be one day (range: 6-24 hours). Surgical-site infections developed in 4 (2.5%) patients and wound dehiscence developed in 14 (8.8%) patients during the postoperative period. Patients developing these conditions were followed up with dressing and antibiotic treatment. The mean postoperative follow-up period was 67 months (range: 1-105 months). Recurrence was detected in six patients during the follow-up period, representing a recurrence rate of 3.8%. Conclusion: Primary closure after asymmetrical excision of the pilonidal sinus is an easily performed technique with minimal postoperative pain and early wound healing. Additionally, this method has early return-to-work rates and low recurrence rates. We think that this method would be more applicable in pilonidal sinus surgery due to these advantages.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136024713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zeynep Tuncer, Nurcan Akbulut, Ural Can Ekmekçi, Gözde Gürsoy Çirkinoğlu, Vesile Öztürk, Yüksel Erkin
Background/Aim: Trigeminal neuralgia (TN) is a prevalent cranial nerve disorder. While inflammation has been implicated in neuropathic pain in numerous recent studies, its role in TN has remained uncertain. Given the increasing significance of neuroinflammation, this study aims to explore the association between inflammation and TN and to assess whether there are disparities in the monocyte to high-density lipoprotein ratio (MHR) and neutrophil to lymphocyte ratio (NLR) values between TN patients and healthy individuals. There is a dearth of literature concerning the link with MHR, a parameter extensively studied in cardiac research but unexplored in the context of TN. Methods: This retrospective cohort study encompassed 48 patients diagnosed with classical TN and 40 healthy controls treated at the neurology and pain clinic of Dokuz Eylül University. Demographic and clinical variables, such as age and gender, along with monocyte, neutrophil, lymphocyte, and high-density lipoprotein (HDL) levels, were retrospectively retrieved from medical records. Inflammation markers, namely MHR and NLR, were calculated. Nonparametric tests were employed to compare these markers between TN patients and healthy controls. Results: Regarding sociodemographic data, the average age of the patient group was 59.8, while that of the healthy group was 47.4. A significant age difference was observed between the patient and healthy groups (P<0.001). However, no significant differences between the groups regarding MHR or NLR values were detected. Conclusions: These findings may suggest the presence of an inflammatory process characterized by local neurogenic inflammation in the pathophysiology of TN. Further comprehensive studies are required to assess the utility of MHR as a readily applicable marker in neurological disorders with neuroinflammatory and neuropathic pain etiologies.
{"title":"Monocyte to high-density lipoprotein ratio and neutrophil to lymphocyte ratio in trigeminal neuralgia patients: A retrospective cohort study","authors":"Zeynep Tuncer, Nurcan Akbulut, Ural Can Ekmekçi, Gözde Gürsoy Çirkinoğlu, Vesile Öztürk, Yüksel Erkin","doi":"10.28982/josam.7884","DOIUrl":"https://doi.org/10.28982/josam.7884","url":null,"abstract":"Background/Aim: Trigeminal neuralgia (TN) is a prevalent cranial nerve disorder. While inflammation has been implicated in neuropathic pain in numerous recent studies, its role in TN has remained uncertain. Given the increasing significance of neuroinflammation, this study aims to explore the association between inflammation and TN and to assess whether there are disparities in the monocyte to high-density lipoprotein ratio (MHR) and neutrophil to lymphocyte ratio (NLR) values between TN patients and healthy individuals. There is a dearth of literature concerning the link with MHR, a parameter extensively studied in cardiac research but unexplored in the context of TN. Methods: This retrospective cohort study encompassed 48 patients diagnosed with classical TN and 40 healthy controls treated at the neurology and pain clinic of Dokuz Eylül University. Demographic and clinical variables, such as age and gender, along with monocyte, neutrophil, lymphocyte, and high-density lipoprotein (HDL) levels, were retrospectively retrieved from medical records. Inflammation markers, namely MHR and NLR, were calculated. Nonparametric tests were employed to compare these markers between TN patients and healthy controls. Results: Regarding sociodemographic data, the average age of the patient group was 59.8, while that of the healthy group was 47.4. A significant age difference was observed between the patient and healthy groups (P<0.001). However, no significant differences between the groups regarding MHR or NLR values were detected. Conclusions: These findings may suggest the presence of an inflammatory process characterized by local neurogenic inflammation in the pathophysiology of TN. Further comprehensive studies are required to assess the utility of MHR as a readily applicable marker in neurological disorders with neuroinflammatory and neuropathic pain etiologies.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136072592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: The increase in waist circumference and obesity are among the important human health problems at present. It cannot be denied that this problem, which has a negative effect on many body systems, may also cause negative effects on the respiratory system. Therefore, we aimed to investigate the effect of waist circumference and body mass index (WC and BMI, respectively) on spirometric parameters, such as the forced expiratory volume in 1 s and forced vital capacity (FEV1 and FVC, respectively). Methods: In this retrospective cohort study, patients who applied to the chest diseases outpatient clinic of our hospital between January 1 and December 31, 2022 and had existing abdominal computed tomography (CT) and pulmonary function test results recorded in the hospital system were included. The WC of the patients was measured using the abdominal CT results. The BMI of the patients was measured using their height and weight values. The correlation between the WC, BMI, and spirometric parameters (FEV1, FVC) was examined. Results: A statistically significant correlation between the WC and BMI values of the 90 patients included in the study and their FVC and FEV1 values was found. In the relationship between all evaluated parameters, the P-value was <0.001. Based on the Spearman's correlation test, it was concluded that WC showed a highly negative correlation with both FVC and FEV1 (−0.984 and −0.870, respectively). BMI also had a high negative correlation with FVC and FEV1 (−0.905 and −0.867, respectively). Conclusion: Weight gain, which leads to an increase in WC and BMI, appears to have a negative effect on the respiratory system. To maintain good respiratory function, it is recommended that patients adopt lifestyles that help them avoid gaining weight.
{"title":"Effect of waist circumference and body mass index on respiratory function","authors":"Gökhan Çoraplı, Mahmut Çoraplı","doi":"10.28982/josam.7892","DOIUrl":"https://doi.org/10.28982/josam.7892","url":null,"abstract":"Background/Aim: The increase in waist circumference and obesity are among the important human health problems at present. It cannot be denied that this problem, which has a negative effect on many body systems, may also cause negative effects on the respiratory system. Therefore, we aimed to investigate the effect of waist circumference and body mass index (WC and BMI, respectively) on spirometric parameters, such as the forced expiratory volume in 1 s and forced vital capacity (FEV1 and FVC, respectively). Methods: In this retrospective cohort study, patients who applied to the chest diseases outpatient clinic of our hospital between January 1 and December 31, 2022 and had existing abdominal computed tomography (CT) and pulmonary function test results recorded in the hospital system were included. The WC of the patients was measured using the abdominal CT results. The BMI of the patients was measured using their height and weight values. The correlation between the WC, BMI, and spirometric parameters (FEV1, FVC) was examined. Results: A statistically significant correlation between the WC and BMI values of the 90 patients included in the study and their FVC and FEV1 values was found. In the relationship between all evaluated parameters, the P-value was <0.001. Based on the Spearman's correlation test, it was concluded that WC showed a highly negative correlation with both FVC and FEV1 (−0.984 and −0.870, respectively). BMI also had a high negative correlation with FVC and FEV1 (−0.905 and −0.867, respectively). Conclusion: Weight gain, which leads to an increase in WC and BMI, appears to have a negative effect on the respiratory system. To maintain good respiratory function, it is recommended that patients adopt lifestyles that help them avoid gaining weight.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136072288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Post-operative nausea and vomiting (PONV) are defined as nausea and/or vomiting occurring within the first 24 h after surgery and are often observed in the first 2 h after surgery. Only a few previous studies on the use of low fresh gas flow that reduces inhaler agent consumption in laparoscopic cholecystectomy patients at high risk of PONV have been published. Our study aimed to determine the incidence of PONV in the first 30 min and again at 24 h in cases of laparoscopic cholecystectomy in which we applied low fresh gas flow (1 L/min). In addition, we wanted to predict whether the pre-operative neutrophil/lymphocyte ratio (NLR) ≥2 is a risk factor for PONV in our patients to whom we applied low fresh gas flow. Methods: For our prospective cohort study, 80 cases between the ages of 18 and 65, had American Society of Anesthesiologists (ASA) scores of I and II, and who had been scheduled to undergo elective laparoscopic cholecystectomy were included in the study. The NLR limit (calculated by dividing the neutrophil count obtained from the complete blood count before surgery by the lymphocyte count) calculated in the pre-operative period after a patient’s informed consent was obtained was accepted as 2 [5]. Patients were classified into two groups: (1) NLR-I with NLR <2 and (2) NLR-II with NLR ≥2. Premedication was not used in either group. Results: A total of 80 patients were included in the study. They were divided into two groups for classification purposes: (1) NLR-I (n=40) and (2) NLR-II (n=40). The characteristics of the patients in both groups, such as gender distribution, ASA scores, smoking status, mean age, and body mass index (BMI) values, were not different. Sevoflurane consumption in the groups was similar (P=0.169). The time required to complete surgery was longer in the NLR-II group (P=0.025). Nausea/vomiting and antiemetic use were similar in the NLR-I and NLR-II groups in which low fresh gas flow was applied in the first 30 min and 24 h (P=0.500). Although nausea/vomiting was more common in the female and non-smoking group in the first 30 min and 24 h, it was not statistically significantly different from males and smoking groups (P=0.325). However, nausea/vomiting was more common and significantly different in the ASA II versus the ASA I group (P=0.046). The time required to complete surgery was longer, and sevoflurane consumption was higher in patients with nausea and vomiting (P=0.001). Conclusions: Pre-operative NLR as classified by the two groups was not associated with an increase in the risk of PONV in patients to whom we applied low fresh gas flow. A decrease in sevoflurane consumption due to low fresh gas flow may lead to a reduction in the risk of PONV in at-risk patients.
{"title":"Is the reduced risk of post-operative nausea and vomiting in low flow anesthesia applications associated with pre-operative neutrophil/lymphocyte ratio values?","authors":"Sevgi Kutlusoy, Ahmet Aydın, Erdinç Koca","doi":"10.28982/josam.7889","DOIUrl":"https://doi.org/10.28982/josam.7889","url":null,"abstract":"Background/Aim: Post-operative nausea and vomiting (PONV) are defined as nausea and/or vomiting occurring within the first 24 h after surgery and are often observed in the first 2 h after surgery. Only a few previous studies on the use of low fresh gas flow that reduces inhaler agent consumption in laparoscopic cholecystectomy patients at high risk of PONV have been published. Our study aimed to determine the incidence of PONV in the first 30 min and again at 24 h in cases of laparoscopic cholecystectomy in which we applied low fresh gas flow (1 L/min). In addition, we wanted to predict whether the pre-operative neutrophil/lymphocyte ratio (NLR) ≥2 is a risk factor for PONV in our patients to whom we applied low fresh gas flow. Methods: For our prospective cohort study, 80 cases between the ages of 18 and 65, had American Society of Anesthesiologists (ASA) scores of I and II, and who had been scheduled to undergo elective laparoscopic cholecystectomy were included in the study. The NLR limit (calculated by dividing the neutrophil count obtained from the complete blood count before surgery by the lymphocyte count) calculated in the pre-operative period after a patient’s informed consent was obtained was accepted as 2 [5]. Patients were classified into two groups: (1) NLR-I with NLR <2 and (2) NLR-II with NLR ≥2. Premedication was not used in either group. Results: A total of 80 patients were included in the study. They were divided into two groups for classification purposes: (1) NLR-I (n=40) and (2) NLR-II (n=40). The characteristics of the patients in both groups, such as gender distribution, ASA scores, smoking status, mean age, and body mass index (BMI) values, were not different. Sevoflurane consumption in the groups was similar (P=0.169). The time required to complete surgery was longer in the NLR-II group (P=0.025). Nausea/vomiting and antiemetic use were similar in the NLR-I and NLR-II groups in which low fresh gas flow was applied in the first 30 min and 24 h (P=0.500). Although nausea/vomiting was more common in the female and non-smoking group in the first 30 min and 24 h, it was not statistically significantly different from males and smoking groups (P=0.325). However, nausea/vomiting was more common and significantly different in the ASA II versus the ASA I group (P=0.046). The time required to complete surgery was longer, and sevoflurane consumption was higher in patients with nausea and vomiting (P=0.001). Conclusions: Pre-operative NLR as classified by the two groups was not associated with an increase in the risk of PONV in patients to whom we applied low fresh gas flow. A decrease in sevoflurane consumption due to low fresh gas flow may lead to a reduction in the risk of PONV in at-risk patients.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136073387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Abnormal uterine bleeding (AUB) in women can often be attributed to a range of underlying factors, including endometrial premalignant and malignant lesions. However, despite the prevalence and potential severity of these lesions, the specific risk factors contributing to their development have not been fully explained. This study aims to explore the risk factors linked to these lesions and to elucidate the corresponding management strategies, filling a crucial gap in our understanding of the underlying causes of AUB. Methods: This retrospective cohort study was conducted among women presenting with AUB and undergoing endometrial biopsy at a gynecology clinic between July 2018 and January 2022. We recorded patients' demographic and clinical characteristics, ultrasonographic findings, and histopathological results of endometrial biopsies. Excluded from the study were patients under 30 years old, pregnant women, those with biopsy results from another center, individuals diagnosed with cancers other than endometrial cancer, cases of insufficient endometrial biopsies, and patients with missing data. The included patients were categorized into two groups: benign and premalignant/malignant, based on histopathological results, and subsequently compared using clinicodemographic findings. Logistic regression analysis was conducted to identify significant risk factors for premalignant/malignant endometrial lesions. We assessed the predictive capacity of endometrial thickness (ET) for premalignant/malignant lesions through receiver operating characteristic (ROC) analysis. Results: A total of 391 patients were analyzed, with a mean age of 50.9 (7.7) years. Among these patients, 89.3% (n=349) were classified as benign, while 10.7% (n=42) exhibited premalignant/malignant lesions. The premalignant/malignant group displayed higher age and BMI compared to the benign group (55.83 [10.55] vs 50.3 [7.6], P<0.001 and 29.17 [3.40] vs 27.73 [3.67], P=0.018, respectively). Logistic regression analysis identified age, BMI, and ET as significant risk factors associated with premalignant/malignant endometrial lesions. ROC analysis for predicting premalignant/malignant lesions using ET yielded cut-off values of 10.5 mm for premenopausal women (sensitivity 62.5%, specificity 58.7%, AUC [95% CI]: 0.688 [0.56-0.80], P =0.012) and 8.5 mm for postmenopausal women (sensitivity 88.5%, specificity 70.2%, AUC [95% CI]: 0.854 [0.78-0.92]; P<0.001). Conclusion: In summary, our findings shed light on the pivotal role of age, BMI, ET, and menopausal status in tailoring management strategies for patients with AUB, underscoring the importance of individualized approaches in enhancing patient care. However, definitive conclusions warrant multi-center prospective investigations to validate these findings in a larger population.
{"title":"Exploring risk factors and management strategies for endometrial premalignant/malignant lesions in women with abnormal uterine bleeding: A retrospective cohort study","authors":"Anıl Erturk","doi":"10.28982/josam.7934","DOIUrl":"https://doi.org/10.28982/josam.7934","url":null,"abstract":"Background/Aim: Abnormal uterine bleeding (AUB) in women can often be attributed to a range of underlying factors, including endometrial premalignant and malignant lesions. However, despite the prevalence and potential severity of these lesions, the specific risk factors contributing to their development have not been fully explained. This study aims to explore the risk factors linked to these lesions and to elucidate the corresponding management strategies, filling a crucial gap in our understanding of the underlying causes of AUB.\u0000Methods: This retrospective cohort study was conducted among women presenting with AUB and undergoing endometrial biopsy at a gynecology clinic between July 2018 and January 2022. We recorded patients' demographic and clinical characteristics, ultrasonographic findings, and histopathological results of endometrial biopsies. Excluded from the study were patients under 30 years old, pregnant women, those with biopsy results from another center, individuals diagnosed with cancers other than endometrial cancer, cases of insufficient endometrial biopsies, and patients with missing data. The included patients were categorized into two groups: benign and premalignant/malignant, based on histopathological results, and subsequently compared using clinicodemographic findings. Logistic regression analysis was conducted to identify significant risk factors for premalignant/malignant endometrial lesions. We assessed the predictive capacity of endometrial thickness (ET) for premalignant/malignant lesions through receiver operating characteristic (ROC) analysis.\u0000Results: A total of 391 patients were analyzed, with a mean age of 50.9 (7.7) years. Among these patients, 89.3% (n=349) were classified as benign, while 10.7% (n=42) exhibited premalignant/malignant lesions. The premalignant/malignant group displayed higher age and BMI compared to the benign group (55.83 [10.55] vs 50.3 [7.6], P<0.001 and 29.17 [3.40] vs 27.73 [3.67], P=0.018, respectively). Logistic regression analysis identified age, BMI, and ET as significant risk factors associated with premalignant/malignant endometrial lesions. ROC analysis for predicting premalignant/malignant lesions using ET yielded cut-off values of 10.5 mm for premenopausal women (sensitivity 62.5%, specificity 58.7%, AUC [95% CI]: 0.688 [0.56-0.80], P =0.012) and 8.5 mm for postmenopausal women (sensitivity 88.5%, specificity 70.2%, AUC [95% CI]: 0.854 [0.78-0.92]; P<0.001).\u0000Conclusion: In summary, our findings shed light on the pivotal role of age, BMI, ET, and menopausal status in tailoring management strategies for patients with AUB, underscoring the importance of individualized approaches in enhancing patient care. However, definitive conclusions warrant multi-center prospective investigations to validate these findings in a larger population.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90905607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Özlem Erdede, Kübra Alkan, Erdal Sarı, Serpil Değrmenci, R. G. Sezer Yamanel
Background/Aim: Prolonged fever in children presents a diagnostic challenge due to its diverse underlying causes. While infectious diseases historically played a primary role, recent shifts in disease patterns and the emergence of conditions such as multisystem inflammatory syndrome in children (MIS-C) have added complexity. Understanding factors contributing to prolonged fever, particularly the rise in MIS-C and Kawasaki Disease (KD), is vital for accurate diagnosis and timely intervention. This study aimed to identify the etiologies causing prolonged fever in children with temperatures exceeding 38°C for a minimum of 5 days and to examine its relationship with conditions like MIS-C and KD following the coronavirus disease 2019 (COVID-19) pandemic. Methods: We conducted a retrospective cohort study at a pediatric hospital in Istanbul, Turkey, involving 243 children aged 3 months to 17 years with prolonged fever (>38°C for ≥5 days) between April 2020 and October 2022. We collected data on patient demographics, clinical characteristics, laboratory results, and final diagnoses. The study categorized patients into Group 1 (KD and MIS-C) and Group 2 (other causes). We performed logistic regression analysis to identify factors associated with KD and MIS-C, using hospitalization days and levels of C-reactive protein (CRP), ferritin, and D-dimer. We calculated sensitivity, specificity, and likelihood ratio values and generated ROC (Receiver operating characteristic) curves. The threshold for statistical significance was set at P<0.05. Results: This study encompassed 243 patients with prolonged fever. The primary causes of admission included infection-related illnesses (60.91%, n=148), MIS-C (18.52%, n=45), and KD (10.70%, n=26). Significant differences were observed in lymphocyte count (P<0.001), CRP level (P<0.001), ferritin level (P<0.001), D-dimer level (P<0.001), hospitalization days (P<0.001), and echocardiographic findings (P<0.001) between the groups. Logistic regression analysis revealed noteworthy associations between the presence of KD and MIS-C and hospitalization days (P=0.001), elevated CRP levels (P=0.018), elevated ferritin levels (P=0.009), and elevated D-dimer levels (P=0.001). Ferritin exhibited an AUC (Area under curve) of 0.737 (P<0.001), and D-dimer demonstrated an AUC of 0.782 (P<0.001) in differentiating between the presence of KD and MIS-C. Conclusion: The prevalence of infectious and inflammatory conditions remains high in cases of prolonged fever, with a noticeable increase in the occurrence of KD and MIS-C since the onset of the COVID-19 pandemic. Notably, ferritin, CRP, and D-dimer levels are valuable indicators for identifying children at elevated risk of developing KD and MIS-C. While data were collected during the epidemic, additional data collection beyond this period would be necessary.
{"title":"Factors linked to Kawasaki disease and MIS-C in children with prolonged fever: A retrospective cohort study","authors":"Özlem Erdede, Kübra Alkan, Erdal Sarı, Serpil Değrmenci, R. G. Sezer Yamanel","doi":"10.28982/josam.7928","DOIUrl":"https://doi.org/10.28982/josam.7928","url":null,"abstract":"Background/Aim: Prolonged fever in children presents a diagnostic challenge due to its diverse underlying causes. While infectious diseases historically played a primary role, recent shifts in disease patterns and the emergence of conditions such as multisystem inflammatory syndrome in children (MIS-C) have added complexity. Understanding factors contributing to prolonged fever, particularly the rise in MIS-C and Kawasaki Disease (KD), is vital for accurate diagnosis and timely intervention. This study aimed to identify the etiologies causing prolonged fever in children with temperatures exceeding 38°C for a minimum of 5 days and to examine its relationship with conditions like MIS-C and KD following the coronavirus disease 2019 (COVID-19) pandemic.\u0000Methods: We conducted a retrospective cohort study at a pediatric hospital in Istanbul, Turkey, involving 243 children aged 3 months to 17 years with prolonged fever (>38°C for ≥5 days) between April 2020 and October 2022. We collected data on patient demographics, clinical characteristics, laboratory results, and final diagnoses. The study categorized patients into Group 1 (KD and MIS-C) and Group 2 (other causes). We performed logistic regression analysis to identify factors associated with KD and MIS-C, using hospitalization days and levels of C-reactive protein (CRP), ferritin, and D-dimer. We calculated sensitivity, specificity, and likelihood ratio values and generated ROC (Receiver operating characteristic) curves. The threshold for statistical significance was set at P<0.05.\u0000Results: This study encompassed 243 patients with prolonged fever. The primary causes of admission included infection-related illnesses (60.91%, n=148), MIS-C (18.52%, n=45), and KD (10.70%, n=26). Significant differences were observed in lymphocyte count (P<0.001), CRP level (P<0.001), ferritin level (P<0.001), D-dimer level (P<0.001), hospitalization days (P<0.001), and echocardiographic findings (P<0.001) between the groups. Logistic regression analysis revealed noteworthy associations between the presence of KD and MIS-C and hospitalization days (P=0.001), elevated CRP levels (P=0.018), elevated ferritin levels (P=0.009), and elevated D-dimer levels (P=0.001). Ferritin exhibited an AUC (Area under curve) of 0.737 (P<0.001), and D-dimer demonstrated an AUC of 0.782 (P<0.001) in differentiating between the presence of KD and MIS-C.\u0000Conclusion: The prevalence of infectious and inflammatory conditions remains high in cases of prolonged fever, with a noticeable increase in the occurrence of KD and MIS-C since the onset of the COVID-19 pandemic. Notably, ferritin, CRP, and D-dimer levels are valuable indicators for identifying children at elevated risk of developing KD and MIS-C. While data were collected during the epidemic, additional data collection beyond this period would be necessary.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75838981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Aim: Clubfoot is the most common congenital foot deformity. Although the etiology and pathoanatomy of clubfoot are not fully understood, dysplasia is present in all musculoskeletal structures below the knee at varying rates. The aim of any treatment regimen is to obtain a pain-free, properly positioned foot that has functional use. The objective of this investigation was to evaluate difficulties in the follow-up and treatment of patients with clubfoot treated in our clinic after the 2023 Kahramanmaras earthquake. Methods: Data from patients with clubfoot treated with the Ponseti method at the Orthopedics and Traumatology Outpatient Clinic of Gaziantep Metropolitan Municipality Inayet Topcuoglu Hospital in Turkey between December 2022 and July 2023 were obtained from the hospital's electronic registry system. Patient demographics, the number of plaster casts made before the earthquake, the total number of plaster casts made, time delays in treatment due to the earthquake, and costs were all analyzed. The Dimeglio score was used for the morphological classification of clubfoot. We analyzed patient data from three time periods: the time of the initial treatment, the period before the earthquake, and the period after the earthquake. Results: The study included 31 feet (16 left and 15 right) of 20 patients (11 males, 9 females). The mean age of the cohort was 3.5 months (standard deviation: 1.6 months). The median and minimum/maximum Dimeglio scores were 11 (9, 13), 6 (4, 8), and 9 (7, 11) at first admission, before the earthquake, and after the earthquake, respectively (P<0.001). The number of casts before the earthquake was 4.32 (0.32), and the total number of casts was 9.39 (1.38). The average time delay until retreatment after the earthquake was 12 weeks (range: 8–15 weeks). There was a significant positive correlation between the duration of the delay and the Dimeglio score measured after the earthquake (r=0.392, P=0.029). The additional cost per patient due to the delay was calculated to be 8290.8 ± 5033.761 TRY (308.78 ± 187.43 USD). Conclusion: The 2023 Kahramanmaras earthquake had a significant impact on the management of clubfoot and other elective procedures. Dealing with the consequences of an unprecedented natural disaster is certainly challenging. However, by adopting carefully designed protocols and therapeutic approaches that are based on the unique characteristics of an illness, we can successfully alleviate the repercussions of such events.
{"title":"The impact of the 2023 Kahramanmaras (Turkey) earthquake on clubfoot management: A retrospective, observational study","authors":"Nevzat Gönder, Oguz Kaya, Ibrahim Halil Demir","doi":"10.28982/josam.7921","DOIUrl":"https://doi.org/10.28982/josam.7921","url":null,"abstract":"Background/Aim: Clubfoot is the most common congenital foot deformity. Although the etiology and pathoanatomy of clubfoot are not fully understood, dysplasia is present in all musculoskeletal structures below the knee at varying rates. The aim of any treatment regimen is to obtain a pain-free, properly positioned foot that has functional use. The objective of this investigation was to evaluate difficulties in the follow-up and treatment of patients with clubfoot treated in our clinic after the 2023 Kahramanmaras earthquake. Methods: Data from patients with clubfoot treated with the Ponseti method at the Orthopedics and Traumatology Outpatient Clinic of Gaziantep Metropolitan Municipality Inayet Topcuoglu Hospital in Turkey between December 2022 and July 2023 were obtained from the hospital's electronic registry system. Patient demographics, the number of plaster casts made before the earthquake, the total number of plaster casts made, time delays in treatment due to the earthquake, and costs were all analyzed. The Dimeglio score was used for the morphological classification of clubfoot. We analyzed patient data from three time periods: the time of the initial treatment, the period before the earthquake, and the period after the earthquake. Results: The study included 31 feet (16 left and 15 right) of 20 patients (11 males, 9 females). The mean age of the cohort was 3.5 months (standard deviation: 1.6 months). The median and minimum/maximum Dimeglio scores were 11 (9, 13), 6 (4, 8), and 9 (7, 11) at first admission, before the earthquake, and after the earthquake, respectively (P<0.001). The number of casts before the earthquake was 4.32 (0.32), and the total number of casts was 9.39 (1.38). The average time delay until retreatment after the earthquake was 12 weeks (range: 8–15 weeks). There was a significant positive correlation between the duration of the delay and the Dimeglio score measured after the earthquake (r=0.392, P=0.029). The additional cost per patient due to the delay was calculated to be 8290.8 ± 5033.761 TRY (308.78 ± 187.43 USD). Conclusion: The 2023 Kahramanmaras earthquake had a significant impact on the management of clubfoot and other elective procedures. Dealing with the consequences of an unprecedented natural disaster is certainly challenging. However, by adopting carefully designed protocols and therapeutic approaches that are based on the unique characteristics of an illness, we can successfully alleviate the repercussions of such events.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135452593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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