Balikli Rum Vakfi Hastanesi

Objectives: Fournier’s gangrene is an aggressive, rapidly progressing, and life-threatening necrotizing fasciitis of the perineal and genital regions. Various scoring systems have been developed for predicting survival and prognosis in Fournier’s gangrene. This retrospective study aimed to evaluate the effectiveness of the newly developed Fournier’s gangrene mortality index (FGMI) in predicting mortality associated with Fournier’s gangrene. Methods: The study included patients over the age of 18 years who were followed-up with a diagnosis of Fournier’s gangrene in the general surgery clinics of three different hospitals in Şanlıurfa province between 2014 and 2024. The patients included in this study were divided into two groups: deceased (n = 20) and surviving (n = 149). In FGMI, the parameters used were age, creatinine level, albumin level, lymphocyte percentage, and neutrophil-to-lymphocyte ratio. Based on the total score and risk assessment, <5 points were categorized as low-to-moderate mortality risk and ≥5 points as high mortality risk. Results: A total of 169 patients with a diagnosis of Fournier’s gangrene were included in the study; 87 were men (51.48%). The median age of all patients was 53 (40–63) years; 20 patients (11.8%) died. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score did not show a statistically significant difference between the deceased and surviving groups (p = 0.5). Compared to the survivors, the deceased had higher neutrophil counts, neutrophil percentages, neutrophil-to-lymphocyte ratios, platelet-to-lymphocyte ratios, and C-reactive protein-to-albumin ratios, whereas lymphocyte counts, lymphocyte percentages, eosinophil counts, eosinophil percentages, monocyte counts, and monocyte percentages were lower, and these differences were statistically significant. According to receiver operating characteristic (ROC) analysis, the ROC-area under the curve for predicting mortality based on an FGMI score of ≥5 was 0.88 (95% CI: 0.80–0.95) with a sensitivity of 90% and a specificity of 70% (p < 0.001). Univariate risk analysis was performed, and the odds ratio revealed that mortality risk in patients followed-up for Fournier’s gangrene with a FGMI score of ≥5 was 20 times higher (4.48–90.91) (p < 0.001). Conclusions: The results reveal that the FGMI score is a scoring system that can predict mortality at the initial clinical presentation of patients with Fournier’s gangrene. Another important finding of the present study is that the LRINEC score was not sufficiently effective in predicting mortality.

Kehadiran pelajar nakal di lingkungan sekolah telah menimbulkan berbagai permasalahan, termasuk mengancam perlindungan hukum bagi para guru. Studi ini bertujuan untuk menganalisis perlindungan hukum bagi guru akibat kenakalan pelajar dalam perspektif teori anomie. Penelitian ini menggunakan pendekatan kualitatif dengan wawancara mendalam terhadap guru-guru yang pernah mengalami kenakalan pelajar. Temuan utama menunjukkan bahwa ketidakpastian hukum, lemahnya dukungan institusi, dan minimnya sanksi bagi pelajar nakal menjadi faktor utama yang menghambat perlindungan hukum bagi guru. Melalui analisis berdasarkan teori anomie, penelitian ini memberikan pemahaman yang lebih mendalam tentang konflik norma sosial dan kebutuhan individu yang mendasari kenakalan pelajar. Implikasi praktis dari penelitian ini adalah perlunya peningkatan kerjasama antara sekolah, keluarga, dan lembaga hukum untuk meningkatkan perlindungan hukum bagi guru. Penelitian ini diharapkan dapat memberikan kontribusi dalam menjaga lingkungan belajar yang aman dan kondusif bagi semua pihak yang terlibat.

Amaç: Evre 2 kolon kanserinde, adjuvan kemoterapinin katkısı ve fluorourasil içeren rejimlere oxaliplatin eklenmesinin rolü tartışmalı iken, evre 3 hastalarda, ikili kombinasyon kemoterapileri tercih edilmekte olup tedavi süresi tartışılmaktadır. Biz de kliniğimizde takip ettiğimiz evre 2 ve evre 3 kolon kanseri hastalarında adjuvan kemoterapi rejimlerini, sürelerini, etki ve yan etki oranlarını ortaya koymayı amaçladık.&#x0D; Gereç ve Yöntemler: Tıbbi Onkoloji Kliniğinde Ocak 2016 – Ocak 2022 tarihleri arasında takip ve tedavisi devam eden opere edilmiş evre 2 ve 3 kolon kanseri tanılı 236 hasta çalışmaya dahil edildi. Hastaların arşiv dosyalarından aldığı tedavi rejimleri ve süreleri, hastalıksız sağ kalım(HSK), genel sağ kalım (GS) arasındaki ilişki retrospektif olarak analiz edildi. &#x0D; Bulgular: Hastaların 109’u (%46,2) evre 2 olarak, 127’si (%53,8) evre 3 olarak tanı almışlardı. Kemoterapi süresi ve hastalıksız sağ kalım(HSK) açısından bakıldığında, evre 3 hastalarda hesaplanan HSK, kemoterapi alınmadığında 22,8 ±3,3 ay, üç ay kemoterapi alındığında 43,8 ± 6,8, altı ay kemoterapi alındığında 80,5 ± 13,5 ay olarak gösterilmiş olup bu fark istatistiksel olarak anlamlıdır (p=0,047). evre 2 hastalarda ise kemoterapi süresi ve adjuvan kemoterapi almaması HSK istatistiksel olarak anlamlı fark oluşturmamıştır (p= 0,099). Ayrıca Evre 3 hastalarda Folfox(Folinik asit + Fluorourasil + Oksaliplatin) kemoterapisi verilenlerin HSK’sı diğer rejimlere göre anlamlı olarak düşük bulunmuştur (p=0.007).&#x0D; Sonuçlar: Evre 2 hastalarda adjuvan tedavinin katkısı ve kemoterapi rejimleri arasında fark gösterilemezken, evre 3 hastalarda kemoterapi almayan ve 3 ay kemoterapi alan hastaların HSK süresi düşük bulunmuştur.

Aim: To investigate the adequacy of the CHOKAI score in the prediction of ureteral stones in patients presenting to the emergency department with renal colic. Material and Method: The data of all patients aged over 18 years, who presented to the emergency department with the complaint of renal colic and were diagnosed with ureteral stones during the study period were retrospectively analyzed using the electronic-based hospital information system. The area under the receiver operating characteristic curve and the area under the curve were used to assess for each patient to determine the cut-off value of the CHOKAI score in the prediction of ureteral stones. Results: The study was completed with 219 patients, of whom 146 were men, and the mean age was 39.4±16.1 years. When the cut-off value of the CHOKAI score was &gt;6, its sensitivity was 84.1%, specificity was 96.7%, positive likelihood ratio was 25.2, negative likelihood ratio was 0.2, positive predictive value was 99.4%, and negative predictive value was 49.2%. Conclusion: In this study, it was concluded that the CHOKAI score had high accuracy in terms of diagnostic power in detecting ureteral stones. However, further studies are needed to demonstrate the broader applicability of the score.

ABO ve Rh kan gruplarının kronik otitis media’lı hastalarda kolesteatom gelişimi ve hastalık ciddiyeti ile ilişkisinin incelenmesiç Kliniğimizde 2013-2020 yılları arasında kronik otit nedeniyle ameliyat edilen 149 hastanın ve normal toplumla karşılaştırılması amacıyla kronik otit öyküsü olmayan 200 hastanın dosyaları retrospektif olarak incelendi. Hastalar grup 1: kolesteatomlu kronik otit, grup 2: kolesteatomsuz kronik otit ve grup 3: kontrol grubu olarak sınıflandırıldı. Her hasta için yaş, cinsiyet, kan grubu verileri incelenerek karşılaştırıldı. Kolesteatom tespit edilen hastaların orta kulak risk indeksleri (OKRİ) ve kolesteatom evrelemeleri (KE) kaydedildi ve bu değerler ile kan grupları arasındaki ilişki incelendi. Grup 1’de 68 grup 2’de 81 hasta ve grup 3’ de 200 hasta vardı. Gruplar arasında yaş ortalamaları açısından fark yoktu. Grup 1’de bayan hasta oranı grup 2 ve kontrol grubuna göre daha düşüktü (p:0,021). Grup 1’de O kan grubu, grup 2’ye ve kontrol grubuna göre anlamlı derecede düşük, A kan grubu anlamlı derecede yüksekti (p:0,047). Diğer kan grupları açısından gruplar arasında anlamlı fark görülmedi (p>0,05). Kolesteatomlu hastalarda, OKRİ skorları ve KE açısından kan grupları arasında anlamlı fark görülmedi (sırasıyla p:0,149, p:0,157). Kan grupları farklılıklarının birçok hastalık gelişiminde risk faktörü olabileceğine yönelik çalışmalar yapılmıştır. Biz de yaptığımız çalışmada, kolesteatom gelişimi açısından O kan grubuna sahip bireylerin daha az risk, A kan grubuna sahip bireylerin ise daha yüksek risk taşıdıklarını tespit ettik. Bu sonuçlar ışığında kronik otitli hastalarda kolesteatom gelişimi açısından kan grupları farklılıklarının, hastaların takiplerinde bir risk faktörü olarak göz önünde tutulmasının faydalı olabileceğini düşünmekteyiz.

Introduction: Anal fistula is a benign anorectal disease. Infection of Hermann and Desfosses anal glands is responsible for the formation of abscesses and/or fistulas. The main treatment is surgery but recurrence and sometimes incontinence are frequently observed. So to choose surgical methods of anal fistula treatment is very important. Aim: The aim of this retrospective study was to evaluate the reliability and feasibility of Video-assisted anal fistula treatment (VAAFT) at the anal fistula surgery. Materials and Methods: A retrospective analysis was performed on data collected during a 11-year period (2008-2019) from 52 patients who underwent fistulotomy with loose seton technique. The male to female ratio was 3:1 and the mean patient age was 48.34 years. Results: Mortality, recurrence, complications rate were 0%. Though the patients were scheduled as day-surgery cases, the average duration of hospital stay was 1.18 days. Quality of life index (QOLI) for these patients were often be improved by treating their fistula. Conclusion: The appropriate treatment for anal fistula is dependent upon the anatomy and the location of the fistula tract. Detection of the inner mouth is the touchstone in the treatment of anal fistula. It could be determined location of inner mouth of the anal fistula easily with transparent anoscope guideline. VAAFT seems to be a safe and effective technique for treating perianal fistula without recurrence and anal incontinence.

Madde kullanm bozukluu ve dikkat eksiklii ve hiperaktivite bozukluu olan ergenlerdeki travmatik yaantlar ve sosyal destek algs asndan farkllklar Differences in the perception of social support and traumatic experiences in adolescents with substance use disorder and attention deficit and hyperactivity disorder

Bawang tiwai ( Eleutherine americana ) have antibacterial effect to Sthapylococus epidermis. This study was conducted to formulate an ethanolic extract of bawang tiwai into antiacne cream preparations, thus Dayak community empirically considered use this as an antiacne and boils. Formula (F) was made by varying the concentration of the ethanolic extract namely: F1 (1%), F2 (2%) and F3 (4%). Anti acne cream formulation tested with phytochemical screening, organoleptic (smell, color, homogenity), type of cream, cream dispersive test, and antibacterial activity test against Staphylococcus epidermidis . Phytochemical screening result shows that its contains alkaloids, flavonoids and saponins, organoleptic test showed stability in F3, antiacne cream has a pH value = 6. Dispersive cream generated meets the requirements with a range of 5-7 cm. Cream type is type O / W (oil in water). Test result by using agar diffusion method with Mueller Hinton Agar (MHA) medium, inhibition zone obtained in the negative control (0), F1 (0), F2 (5.17 ± 0,19mm) and F3 (6 ± 0,17mm), LSD oneway ANOVA showed 95% (p <0.05) compared F3 all treatments. This study antiacne cream of F3 (concentration of the ethanolic extract of bawang tiwai 4%) is the best formula with the greatest potential in the medium category against Staphylococcus epidermidis .

Eleven early maize (Zea mays) genotypes were evaluated for their yield and yield attributing traits at the research block of Regional Agriculture Research Station (RARS) Lumle, Kaski, Nepal during kharif season of 2016.

Objective: There isn't a widely accepted reference method to measure the cardiovascular disease (CVD) risk in human immunodeficiency virus (HIV)-infected patients. In our study, we aimed to investigate the presence of a parameter that would provide insight into CVD risk in HIV-positive individuals and can be conveniently used in their follow-up. Methods: This retrospective observational […]