Eurasian Journal of Medicine最新文献

Conduction blocks complicating ST(ST-segment)-elevation myocardial infarction are associated with increased morbidity and mortality. Research indicates that anterior and inferior wall myocardial infarction were the most encountered causes of blocks but with conflicting results. However, patterns of conduction blocks have not been widely established in our population. The aim was to study the various patterns of conduction blocks following ST-elevation myocardial infarction and their prognostic implications. Prospectively, 70 patients, aged > 18 years, diagnosed with ST segment elevation myocardial infarction were included in the study. Post intensive care unit admission, all patients were observed for conduction blocks using a standard 12-lead electrocardiogram and repeated the same every 48 h throughout the hospitalization stay. Statistical analysis was performed using software R version 3.6.0. Out of 70 patients, 70% were males. Mean age was 60.7 ± 13.4 years. The proportion of blocks was first-degree heart block (28.6%), Mobitz II heart block (20%), complete heart block (17.1%), Mobitz I heart block (11.4%), right bundle branch block (10%), left bundle branch block (10%), left anterior hemiblock (1.4%), and trifascicular block (1.4%). No significant diference was found between males and females with respect to various conduction heart blocks (P > .05). Mortality was observed only in patients with complete heart block (11.4%) and first-degree heart block (2.8%; P = .003). Statistically, no significant diference was observed between various conduction blocks with respect to cardiac enzymes, random blood sugar, and lipid levels (P > .05). High mortality rate has been found in the patients with complete heart block indicating that severity of conduction block is a predictor of poor outcome in the ST-elevation myocardial infarction patients.

The use of intravenous lipid emulsion (ILE) is thought to reverse the acute neurological and cardiac toxicities generated by local anesthetic and non-anesthetic drugs. The aim of this review is to provide an updated overview of ILE therapy in the management of the toxic efects of medications on humans. Indications, mechanisms of action, monitoring, dosing, lipid formulations, adverse efects, and contraindications related to ILE are highlighted. Although ILE therapy was initially utilized for local anesthetic toxicity, its use has been extended to patients with overdoses or poisoning induced by various non-local anesthetic drugs. It has been proposed that intravenous lipid droplets generate a discrete lipophilic phase in the bloodstream into which liposoluble drugs preferentially partition. This partitioning efect, known as the lipid sink phenomenon, is thought to decrease the quantity of drug content in tissues in vital organs. At the same time, other studies have also described several molecular mechanisms that may contribute to ILE efcacy. Potential adverse efects of ILE have also been identified, such as pulmonary toxicity, hypertriglyceridemia, acute pancreatitis, interference with laboratory measurements, fat overload syndrome, worsening of systemic absorption of toxin, and hepatic dysfunction. Intravenous lipid emulsion therapy is gaining wider acceptance in critical care units and emergency rooms as a possible treatment modality for liposoluble drug toxicity. Currently, recommendations on ILE administration in clinical toxicology are mainly based on published case reports and animal studies. Thus, further clinical studies are required to increase knowledge about ILE therapy.

This study covers Child Sexual Abuse (CSA) survivors who had never disclosed the abuse until their psychiatric interview. There is a clear lack of understanding of which factors contribute to delays in the disclosure of CSA. Thus, we aimed to examine the risk factors and sociodemographic variables that may inhibit CSA disclosures. We retrospectively analyzed the files of patients who presented to a child and adolescent psychiatry clinic with diferent complaints between 2010 and 2020 in a tertiary hospital. All of these sexual assaults were ofcially reported by a child and adolescent psychiatrist to the competent authorities. The mean period of time from abuse to disclosure was 28.4 ± 32.5 months. The time from abuse to disclosure was significantly negatively correlated with mothers' education years (r=-.430, P < .01) and with the age of onset of sexual abuse (r=-.589, P < .001). Results of multiple linear regression showed that female sex and the earlier age of onset of sexual abuse were significant predictors of increased duration from abuse to disclosure. Our results provide insights into several risks that may afect the time from abuse to disclosure for CSA survivors. Studies with larger samples are needed to understand the factors afecting the time from abuse to disclosure.

Skin injuries, such as burns, can result in an open wound that can lead to the deterioration of the skin, which acts as a protective barrier against external agents, and can cause serious health problems. Pectin, a plant-derived polysaccharide, is a suitable candidate for wound care due to its gel-forming ability and biocompatibility. Pectin absorbs wound exudates to form a soft gel and is known for its strong anti-inflammatory efects. Pectin-based hydrogel systems promote wound healing by promoting fibroblast proliferation and keratinocyte migration. In the study, 60 male Wistar albino rats were used, and 6 diferent treatment groups were formed: Healthy control, burn control, silver sulfadiazine, pectin-based hydrogel system, pectin-based hydrogel system+iodine, pectin-based hydrogel system+plant extract. Rats with burn wounds were treated for 21 days, and the wound healing process was evaluated by macroscopic, biochemical, and histopathological analysis. The results showed that the pectin-based hydrogel system, iodine, and plant extracts promoted healing in burn wounds. Especially in the groups treated with silver sulfadiazine and plant extracts, the development of granulation tissue and regeneration of collagen fibers showed significant improvement. Furthermore, the pectin-based hydrogel system is thought to contribute to wound healing by maintaining skin moisturization. Vascular endothelial growth factor (VEGF) and transforming growth factor-β (TGF-β) levels decreased in the treatment groups compared to the burn group, and it was determined that these factors play an important role in wound healing. This study shows that pectin-based hydrogel systems can be an efective alternative in burn treatment, and their healing efects can be enhanced by the addition of iodine and plant extracts.

This study aimed to identify the health-related behaviors and associated factors among research assistants and final-year students at a Faculty of Medicine. In this cross-sectional study, a total of 712 assistant physicians and final-year medical students participated. Data collection involved using a survey form to inquire about participants' sociodemographic characteristics and the "Healthy Lifestyle Behavior Scale II (HPLP II)." Descriptive statistics, t-test, ANOVA, Kruskal-Wallis, and Mann-Whitney U tests with Bonferroni correction were employed for data analysis. Among the participants, 52.5% were assistant physicians, 47.5% were final-year students, and 50.4% were women. Physicians scored an average of 120.0 ± 16.5 on the HPLP II, with the lowest in the physical activity subscale and the highest score in the spiritual development subscale. Healthy lifestyles were more prevalent in those aged 23-28, in those not married and who are childless, women, non-shift workers, nonsmokers, those with chronic conditions, and those perceiving their health as good or fair. Factors influencing healthy lifestyle behaviors include age, marital status, parenthood, smoking and alcohol habits, work unit, health perception, and chronic diseases. Analyzing and conducting studies on modifiable characteristics are recommended to enhance health.

Hashimoto's thyroiditis (HT) is the most common cause of goiter and acquired hypothyroidism in children after iodine deficiency. In this study, clinical and laboratory findings and follow-up results of children diagnosed with HT are presented. The data of cases diagnosed with HT between 2004 and 2022 in 2 centers in Erzurum were evaluated retrospectively. Of the 81 children with HT whose ages ranged from 3 to 18 years (11.24 ± 3.72), 67 (82.7%) were girls and 14 (17.3%) were boys. The most common symptoms were neck swelling (37%), fatigue (23.5%), and hair loss (23.5%). There was a family history of HT in 12 cases (9.9%). Fifty-one (63%) of the cases were in the pubertal period and 30 (37%) were in the prepubertal period. There was no goiter in 36 (44.4%) of the patients, second degree goiter in 24 (29.6%), first degree goiter in 14 (17.3%), and third degree goiter in 7 (8.7%). Twenty-two (27.2%) of the cases were euthyroid, 27 (33.3%) were subclinical hypothyroidism, 23 (28.4%) were hypothyroidism, and 9 (11.1%) were hyperthyroidism. While 18 (22.2%) of the cases were followed up without medication, 59 (72.8%) were given levothyroxine and 4 (5%) were given methimazole. The mean follow-up time was 32.1 ± 33.7 months. The study's findings suggest that HT is more common in girls and occurs more frequently after puberty. A personal or family history of an autoimmune disease may be a warning sign for HT. Additionally, HT should be kept in mind in the diferential diagnosis of children presenting with complaints of neck swelling, fatigue, and hair loss.

Pregnancy is a period in a woman's life during which she experiences physiological, psychological, and social changes. These changes can lead to various mental illnesses, including postpartum depression (PPD), which is common during the perinatal period. Postpartum depression is a significant cause of morbidity and mortality for both the mother and baby. A peripartum-onset major depressive episode is defined as PPD when it occurs during pregnancy or up to 4 weeks postpartum. The frequency of this condition is extremely high. Its etiology is influenced by biological, psychological, and sociocultural factors. Depressed mood, anhedonia, feelings of guilt, irritability, lack of concentration, psychomotor agitation or retardation, sleep disturbance, and changes in appetite and weight can all be symptoms of PPD. There are various treatment options available, many of which are adapted from those used for major depression. Selective serotonin reuptake inhibitors, serotonin-noradrenaline reuptake inhibitors, tricyclic antidepressants, estradiol, progesterone, psychotherapies, electroconvulsive therapy, and brexanolone can be used to treat PPD. In addition, the newest drug approved by the FDA (Food and Drug Administration) for this condition is oral zuranolone. This review aims to analyze recent developments on zuranolone, the latest drug approved by the FDA for PPD, based on current studies.

The stroke center approach provides an efective solution for acute stroke management. Our study aims to systematically analyze our stroke center records to identify factors that afect acute stroke time-sensitive quality metrics. Data were prospectively collected from 524 acute stroke patients at the Comprehensive Stroke Center of Atatürk UniversityMedical Faculty Hospital between January 1, 2021, and September 30, 2021. Data collected included sociodemographic, clinical, admission type, initial National Institutes of Health Stroke Scale (NIHSS), treatment modality, and time-sensitive metrics and were statistically analyzed based on stroke quality metrics. Patients with mild NIHSS scores (0-7) had longer onset-to-door (OTD) time, door-to-computed tomography (CT)/neurologist, and hospitalization times (P < .001). The OTD, door-to-CT/neurologist, and hospitalization times varied depending on the treatment methods used (P < .005). The OTD time was influenced by the patient's level of education (P=.004), admission type (P < .001), and geographical location (P=.002). A moderate negative correlation was found between patients' OTD time and baseline NIHSS (r=-0.270; P < 0.001). The results emphasize the significance of several factors, such as admission type, geographical location, and treatment methods, in shaping the time-sensitive quality metrics of stroke care. Additionally, the initial NIHSS score of patients plays a crucial role in both prehospital and in-hospital aspects of acute stroke management.

Familial Mediterranean Fever (FMF) is an inherited autosomal recessive disorder resulting from the inheritance of MEFV gene mutations. Patients with FMF are at increased risk of secondary amyloidosis, namely type AA. In some Mediterranean populations, the α genotype was associated with the development of renal amyloidosis, a finding not reproduced in other populations. Our study aimed to assess the association of SAA1 genotypes with renal involvement. This is a retrospective analysis of FMF patients which were followed at our institute between January 2016 and August 2022. Familial Mediterranean Fever screening was performed using polymerase chain reaction and reverse hybridization techniques. Statistical analysis was performed using bivariate logistic regression. MEFV analysis of the studied patients (n=427) identified 52 patients with a homozygous genotype (12.1%) and 374 with a heterozygous genotype (87.5%). The heterozygous group were mostly heterozygous carriers of a single FMF variant (81%), while 19% were compound heterozygous. Renal involvement was revealed in 95 patients (22.2%), which were manifested as proteinuria (21.3%) and/or renal impairment in 4 patients (3%). The clinical diagnosis of amyloidosis was suspected in 6 patients only (1.4%). Analysis for SAA1 gene genotype-phenotype correlation showed that patients with the SAA1.1/1.1 (OR=0.54, P=.452) was not statistically associated with renal involvement. Pearson Chi-square was performed to examine the association between FMF homozygosity and each SAA1 genotype, which showed a significant association between FMF gene homozygosity with SAA1.1/1.1 genotype (χ2 = 8.06, P=.018). In our Jordanian FMF population, we report low rates of renal involvement with a high rate of the β haplotype (SAA1.5). Neither the α/α nor the β/β genotypes were associated with evidence of renal involvement.