Medeniyet medical journal最新文献

Objective: A recent spurt in incidence of meralgia paresthetica to 0.1-81% due to minimally invasive anterior approach to hip joint has resulted in reinterest in anatomy of lateral femoral cutaneous nerve (LFCN). Familiarity with variations in the course of LFCN will reduce the morbidity associated with orthopedic procedures around the anterior superior iliac spine (ASIS) and inguinal ligament (IL).

Methods: Twenty five adult human formalin embalmed cadavers were dissected. Course and relations of nerve to ASIS, IL and sartorius muscle was noted, distance of nerve from ASIS at IL was measured and statistically analyzed.

Results: Mean distance of LFCN from ASIS at IL was 1.73±1.15 cm. Differences between two sides and sexes was statistically not significant (p=0.51 and p=0.96 respectively). Inferomedial to ASIS, 94% of LFCNs crossed IL with 92% of them present within 4 cm medial to ASIS. Majority of LFCNs (90%) exited pelvis and entered thigh posterior to IL. Out of these nerves 48% were single trunks on entry into thigh, then bifurcated into anterior and posterior branches. Remaining LFCNs bifurcated proximal to IL or at level of IL. Trifurcations were seen in 6% while a rare case of pentafication was observed. In 66% main trunk/branches were present in intermuscular cleft between sartorius muscle and tensor fascia lata.

Conclusions: Care should be exercised by surgeons while dissecting around IL as more than half of nerves are liable to be injured during operative procedures. This would help in better anticipation of problem, acceptance and reducing litigation.

Objective: Neuroblastoma is one of the common tumors of childhood. The demonstration of new factors such as isocitrate dehydrogenase 1 (IDH1) and isocitrate dehydrogenase 2 (IDH2) mutations will be important in the diagnosis and treatment. IDH1 and IDH2 mutations have been found in many types of cancer, such as malignant gliomas, acute myeloid leukemias, chondrosarcoma, and thyroid carcinoma. This study aimed to investigate the presence of IDH1 or IDH2 mutations in patients with neuroblastoma and to determine whether these mutations were different in terms of age, clinical findings, and response to treatment.

Methods: Biopsy specimens of 25 patients with pediatric neuroblastoma patients were evaluated for IDH mutations. The clinical and laboratory features of the patients with/without mutation were retrospectively analyzed from a hospital database.

Results: A total of 25 patients for whom genetic analysis could be performed were included in the study (60% male, n=15). The mean age was 32.2±25.9 months (3 days-96 months). IDH1 mutation was detected in 8 (32%) and IDH2 mutations in 5 (20%) patients. These mutations showed no statistically significant relationship with age, tumor localization, laboratory results, stage, and prognosis. However, in the case of IDH mutation, patients were diagnosed at the advanced stage.

Conclusions: This study demonstrated the relationship between neuroblastoma and IDH mutation for the first time. Because to the fact that the mutation is very heterogeneous, it would be appropriate to conduct a larger series of patients in terms of the impact of the clinical significance of each mutation on the diagnosis and prognosis.

Objective: The preferred therapy for staghorn stones and large kidney stones is percutaneous nephrolithotomy (PCNL). Ultrasound-guided PCNL has definite advantages over fluoroscopy-guided PCNL. Preoperative characteristics are essential to assess better surgical outcomes. The goal of this study was to analyze the correlation of hydronephrosis with surgical outcomes after ultrasound-guided supine PCNL.

Methods: A retrospective study was conducted at Doris Sylvanus General Hospital. Data of the patients was obtained from hospital records. Hundred and five patients underwent ultrasound-guided PCNL in the supine position from August 2020 to August 2022. Data were analyzed using SPSS 16.0.

Results: The presence of hydronephrosis was 85 (80.95%), which consisted of Grade I 15 (14.30%), Grade II 25 (23.80%), Grade III 28 (26.70%), and Grade IV 17 (16.20%). In our study analysis, complications occurred in 16 patients (15.23%). Grade I complications of the Clavien-Dindo classification was of in 4 cases, 11 cases of grade 2 complications, and 1 patient died. The statistical result was the relationship between grade hydronephrosis and the grade of complication using the modified Clavien-Dindo system. We found a p-value of 0.207 (>0.05), and there is no statistically significant relationship p=0.382 and r=-0.086 was a negative correlation. There is also no statistically significant relationship between hydronephrosis and stone clearance with p=0.310.

Conclusions: The use of ultrasonographic guidance PCNL has been reported as a safe and effective procedure for the management of large renal stones. In this study, there was no correlation or signification between hydronephrosis and surgical outcome after ultrasound-guided supine PCNL.

Objective: To evaluate the macula, retinal nerve fiber layer (RNFL), retinal layers, and choroidal thickness (CT) using spectral domain optical coherence tomography (SD-OCT) in patients with alopecia areata (AA).

Methods: The right eyes of 42 AA patients (17 women, 25 men) and 42 controls (18 women, 24 men) were included in the study. Each subject underwent thorough ophthalmic examination and SD-OCT (Heidelberg Engineering) measurements. Central macular thickness (CMT), RNFL, the average thicknesses of the ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), inner retinal layers (IRL), photoreceptor layers (PRL) as well as subfoveal, temporal and nasal CT were measured.

Results: In all sectors, no significant difference was observed between the AA group and the control group with regard to the mean values for CMT and RNFL (p>0.05, for all). There was not a significant difference between the AA group and the control group with regard to the thickness of the GCL, IPL, INL, OPL, ONL, RPE, IRL, and PRL (p>0.05 for all). CT at the subfoveal, temporal, and nasal regions was significantly thicker in the AA group than in the control group (p<0.05 for all).

Conclusions: Along with T-lymphocyte-mediated hair follicle damage, choroidal melanocyte damage and inflammation can also be observed in AA patients. CT may increase secondary to melanocyte inflammation in AA patients.

Objective: Currently, multiple classification systems exist for the assessment of facial nerve paralysis. This study was designed to choose the most practical system for use in a clinical setting depending on the clinician need. We compared the responsiveness of the 3 facial nerve grading systems, i.e., House-Brackmann, Sydney, and Sunnybrook, as the subjective method and compared the outcomes with the objective method, i.e., the nerve conduction study. The correlation between the subjective and objective assessments was determined.

Methods: A total of 22 consented participants with facial palsy was assessed with photos and videography recordings where they performed 10 standard facial expressions. The severity of facial paralysis was evaluated with the House-Brackmann, Sydney, and Sunnybrook grading scales subjectively and with the facial nerve conduction study objectively. The assessments were repeated after 3 months.

Results: A Wilcoxon signed-rank test showed that there were statistically significant change in all three gradings after 3-month of assessment. The responsiveness of the nerve conduction study was significant for the nasalis and orbicularis oris muscles. It was not significant for the orbicularis oculi muscle. The nasalis and orbicularis oculi showed statistically significant correlation with the three classification systems except for the orbicularis oculi muscle.

Conclusions: All three grading systems, House-Brackmann, Sydney, and Sunnybrook, showed statistically significant responsiveness after 3 months of evaluation. The nasalis and orbicularis oculi muscle can be used to predict facial palsy recovery because they showed strong positive and negative correlations with the extent of facial nerve degeneration from the nerve conduction study.

Objective: The Nijmegen Cochlear Implant questionnaire (NCIQ) was used to gauge the quality of life (QOL) improvement among cochlear implant (CI) users who suffered from post-lingual deafness. This study aimed to determine the consistency and reliability of the Malay version of the Nijmegen Cochlear Implant questionnaire (NCIQ-M) and to report the QOL of patients using NCIQ-M.

Methods: This study has two phases: Phase I involves the translation of the NCIQ from English to Malay, followed by internal consistency and test-retest reliability assessment of the final version of NCIQ-M. Phase II involves QOL assessment of post-lingual deafness using NCIQ-M.

Results: Twenty CI users and 20 non-CI users answered the NCIQ-M. Test-retest reliability analysis of the NCIQ-M was performed using an intraclass correlation coefficient, achieving scores of more than 0.85. Internal consistency was analysed with Cronbach α of more than 0.70 in all subdomains. Scores between the two groups of subjects were analyzed using an independent sample t-test. Good internal consistency, intraclass correlation, and test-retest reliability were obtained. Scores in all six subdomains of the NCIQ-M are significantly higher in the CI user group than in the non-CI user group.

Conclusions: The NCIQ-M is a consistent and reliable subjective questionnaire to determine the QOL of CI users concerning physical, psychological, and social functioning.

Objective: Tuberculosis (TB) is an old disease and it has infected millions of people worldwide. Since it is a highly infectious disease, many people became TB contact due to prolonged exposure to a person with TB infection. This group of people is at a higher risk of getting latent and active TB infection, hence a vulnerable group for active TB screening. This study explored the factors that determined the attitude score, the level of knowledge, attitude, and stigma (KAS) regarding TB disease among TB contact.

Methods: This cross-sectional study used a validated KAS questionnaire, performed among 338 TB contacts from 5 health clinics in Kedah, Malaysia. The respondents were selected via convenience sampling. Simple and multiple linear regressions were used to analyze the data.

Results: The mean KAS scores of participants are 73.5% [standard deviation (SD)=17.06], 83.0% (SD=10.33), and 67.0% (SD=16.72), respectively. Higher income (p=0.001), better knowledge score (p<0.001), and higher stigma score (p=0.003) are the significant associated factors for the attitude score.

Conclusions: This study revealed that most of the TB contacts have good knowledge and constructive attitude toward TB prevention and screening, but their level of stigma on TB is high. The implementation of TB education and intervention programs among TB contacts are required especially among low-income groups.