Relationship between platelet indices in acute cholecystitis: A case-control study

INTRODUCTION AND AIMS

We aimed to investigate changes in initial platelet indices in patients arriving at the emergency department with acute cholecystitis.

MATERIAL AND METHODS

A retrospective case-control study was conducted at a tertiary care teaching hospital. Demographics, comorbidities, laboratory data, length of hospital stay, and mortality data for the acute cholecystitis group were retrospectively obtained from the hospital digital database. Platelet count, mean platelet volume, plateletcrit, platelet distribution width, and platelet mass index were collected.

RESULTS

A total of 553 patients with acute cholecystitis were the study cases, and 541 hospital employees were the study controls. According to the results of the multivariate analysis of the platelet indices studied, only mean platelet volume and platelet distribution width showed significant differences between the two groups (adjusted odds ratio: 2, 95% confidence interval: 1.4-2.7, p < 0.001 and adjusted odds ratio: 5.88, 95% confidence interval: 2.44-14.4, p < 0.001, respectively). The multivariate regression model created had an area under the curve of 0.969 in the prediction of acute cholecystitis (accuracy: 0.917, sensitivity: 89%, and specificity: 94.5%).

CONCLUSION

The study results indicate that the initial mean platelet volume and platelet distribution width were independent predictors of acute cholecystitis.

Biomechanical analysis of titanium fixation plates and screws in mandibular angle fractures

OBJECTIVE

The aim of this study was to evaluate the mechanical behavior of different rigid fixation methods in mandibular angle fractures.

MATERIALS AND METHODS

Three different three-dimensional finite element models of the mandible were developed to simulate the biomechanical responses of titanium plates and screws. The fracture lines were fixed with double 4-hole straight, 4-hole square, and 5-hole Y plates with monocortical screws. 150 N incisal occlusal loads were simulated on the models. The commercial ANSYS software was utilized to calculate the Von Mises stresses on fixative appliances.

RESULTS

The highest Von Mises stress values were observed in the Y plate, whereas the lowest stress values have been found in the square plate.

CONCLUSIONS

The use of square plate led to better stability and lower mechanical stresses than other techniques.

Effect of Erythropoietin on Microvascular Anastomosis in Rat

Purpose: To investigate the re-endothelialization potential of erythropoietin (EPO) following microvascular anastomosis in rat femoral artery.Methods: Ninety-six male Sprague-Dawley rats weighing between 300 g and 320 g were allocated randomly into two groups (control and EPO, n = 48). Left femoral artery microvascular anastomosis was performed in the rats. The control group was given 0.5 mL of 0.09 % NaCl subcutaneously 48 h  postoperatively while the EPO group was given 150 U/kg recombinant human erythropoietin  subcutaneously 48 h post-operatively. Tissue was harvested from each group after 1, 3, 5, and 7 days. All of the rats were sacrificed for morphometric analysis. Each arterial segment was analyzed morphometrically using Clemex Image Analysis software by a single examiner. The cross-sectional area of the media and neointima was measured and the intima/media ratio was calculated. Hematocrit  measurement was carried out for all the rats.Results: The I/M ratio differed significantly (p < 0.05) between the control and erythropoietin groups, at all time-points. The hematocrit was significantly (p < 0.05) lower in the control group than in the erythropoietin groups on day 7, but not on the other days.Conclusion: This study demonstrates that erythropoietin markedly inhibits neointima formation with accelerated re-endothelialization in rat femoral arteries following microvascular anastomosis.Keywords: Erythropoietin, Microvascular anastomosis, Re-endothelialization, Hematocrit, Neointima/media ratio

Surgical repair of the isolated incomplete median cleft lip

Median cleft lip refers to a vertical cleft on the midline of the upper lip. It is a rare congenital craniofacial anomaly brought about by a fusion failure in the medial nasal prominence. A novel surgical approach to median cleft lips and their repair is reported herein, with reference to a clinical case. The patient had a cleft in the lower half of the upper lip. There were no other craniofacial anomalies in this patient other than the cleft. Within the framework of the patient's surgical treatment, a functional and cosmetically satisfactory result was achieved by performing a V-Y advancement flap on the columella base, Z-plasty in the vermillion zone, and Z pattern muscular tissue repair, without having to resort to any tissue excisions.

The dome procedure: a new technique for the reconstruction of the umbilicus

PURPOSE

The absence of the umbilicus is, in essence, an aesthetic deformity of the abdominal wall. The goal of reconstructing the umbilicus is to obtain a natural, three-dimensional appearance. In this study, we present a new technique called the "dome procedure" for the reconstruction of the umbilicus.

METHODS

This procedure can be applied under local anaesthesia on an outpatient basis and the drawing of the design is simple. The technique was applied to six patients who presented with an absence of the umbilicus following repair of a large incisional and umbilical hernia.

RESULTS

No major or minor complications were encountered. Patient satisfaction was high after surgical intervention.

CONCLUSIONS

The dome procedure, which enables the umbilicus to have a natural appearance with sufficient depression and normal-appearing wrinkles, is simple, easy to perform, and safe.

The importance of education in diabetic foot care of patients with diabetic neuropathy

OBJECTIVE

Our aim is to research the effect of the knowledge and routine gained from the diabetic foot (DF) care education program given to patients with Type 2 Diabetes Mellitus (DM) with diabetic neuropathy.

MATERIALS AND METHOD

A total of 104 patients with Type 2 DM and diabetic neuropathy participated in a survey to evaluate standards of DF care, and knowledge of and behavior relating to personal care. The difference in knowledge and personal care between the group who had received education on diabetes and the group who had not was researched.

RESULTS

A total of 42.3% of patients reported receiving education about diabetes. The education for Type 2 DM patients increased the frequency of attending yearly check-ups (p:0.028), and helped develop the habit of having doctors check their feet (p:0.004). When comparing the daily practice of those who had received education about DF care with those who had not, positive effects of education were seen in all questions evaluating foot care, nail care and choice of shoe. The statistical analysis proved that the educated group were significantly better in terms of foot care such as using moisturizer (p:0.002) and using insoles (p:0.042).

CONCLUSION

Our study reveal that educating diabetic patients about foot care is an effective method to develop their knowledge. However we observed that this education is not provided to all diabetic patients. We believe that every diabetic patient should receive education from the moment of diagnosis and repeated education during check-ups by doctors will increase effectiveness.

A Case with Gaucher-Like Cells

Gaucher-like cells (GLC) are sometimes indistinguishable from real Gaucher cells. GLC can be detected in various diseases. We present a 4.5 year old boy with massive cervical lympadenopathy and an intraabdominal mass mimicking lymphoma. Many GLC were seen in the fine needle aspiration material of an enlarged lymph node. Ziehl-Neelsen stain of the aspirate revealed many acid-fast bacteria in the GLC. Fine needle aspiration might provide valuable information in the evaluation of enlarged lymph nodes.

A Case with Micromegakaryocytes

A boy with no previous history of bleeding presented with ecchymoses and splenomegaly. He was followed up for thrombocytopenia and micromegakaryocytes for 20 months till clinically malignancy was diagnosed. Micromegakaryocytes must always be treated with suspicion, as they may provide an important clue for dyshematopoesis.

KEY WORDS

Micromegakaryocytes, Leukemia, Dismegakaryopoesis.