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Halil Can Küçükyildiz, Salih Kürşat Şimşek, Burçak Söylemez, Giray Güneş, Fatih Koç, Ünal Özüm
Journal of Surgery and Medicine, Volume 6, pp 282-284; https://doi.org/10.28982/josam.1080889

Abstract:
Background/Aim: The Coronavirus-19 (COVID-19) pandemic disrupted all planned, elective surgical procedures and appointment-based health services due to the decreased capacity of hospitals, healthcare professionals' focus on fighting the pandemic and efforts to protect patients, society and healthcare workers from the pandemic. The purpose of this study was to ascertain the perspective of patients on elective surgery, who applied to neurosurgery outpatient clinics at two different centers as clean and non-clean hospitals. Methods: This cross-sectional prospective study was performed between March 2021 and July 2021, during the COVID-19 pandemic. 160 patients who were offered elective surgery for various indications in neurosurgery outpatient clinics were enrolled in the study. To this end, a questionnaire was administered to patients that included information about their demographics, pandemic processes and their anxiety levels during this process. Age, level of education, COVID -19 infection and vaccination status were all questioned in the survey. Univariate and multivariate analysis were used to determine the factors that might influence a patient's decision towards surgery. Results: In the univariate analysis of the factors, educational status, pandemic-induced anxiety and whether the hospital is a pandemic hospital or not were identified as statistically significant effective factors in patients' decision to accept surgery (P
Ahmed Ramiz Baykan, Serkan Cerrah, Levent Ogul, Ayetullah Temiz, Elmas Kasap
Journal of Surgery and Medicine, Volume 6, pp 674-678; https://doi.org/10.28982/josam.1115509

Abstract:
Background/Aim: Although cholecystectomy is recommended by many guidelines after endoscopic retrograde cholangiopancreatography (ERCP) for gallstones, the necessity of cholecystectomy in geriatric patients is a matter of debate. Here we compare the outcomes of new biliary events in cholecystectomized and non-cholecystectomized patients of geriatric age after ERCP for suspected choledocholithiasis. Methods: Non-cholecystectomized patients who underwent ERCP for choledocholithiasis from 2015 to 2017 were included in this retrospective cohort study. Patients with other biliary pathologies, incomplete clearance of common bile duct stones, and those who could not be reached at follow-up were excluded from the study. Biliary events (cholecystitis, cholangitis, pancreatitis, re-ERCP) were evaluated by considering age groups in patients with and without cholecystectomy in their follow-up after sphincterotomy. Results: A total of 284 patients were followed for an average of 69.77 (0.2) months. The cumulative incidence of biliary events in cholecystectomized patients was lower (16% vs. 21.5%; P < 0.001), and cholecystectomized patients had a longer time to the occurrence of events (mean 74.49 [0.27] months vs. 73.50 [0.33] months; P = 0.03). There was no significant difference in the frequency of biliary events between elderly patients with and without cholecystectomy (P = 0.81), and the cumulative incidence of biliary events in the in situ group was significantly lower than that in the geriatric group (17.5% vs 32.6%; P = 0.03) Conclusion: Although cholecystectomy significantly reduces subsequent biliary complications in young patients, it does not provide a statistically significant benefit in geriatric patients. We believe that there may be no need for routine prophylactic cholecystectomy after endoscopic sphincterotomy in geriatric patients.
Dila Şener, Atakan Aydın, Ekin Cücü, Taylan Adademir, Deniz Mukaddes Türet,
Journal of Surgery and Medicine, Volume 6, pp 689-692; https://doi.org/10.28982/josam.1017655

Abstract:
Background/Aim: Nowadays, many deaths are related to vessel injury-induced blood loss. Failure to control bleeding also increases the risk of death. This study aimed to investigate the hemostatic effects of the Algan Hemostatic Agent (AHA) foam application in a rat model in which severe femoral artery bleeding was induced. Methods: Fourteen rats were randomly assigned to two groups: (1) control (physiological saline) (n = 7) and (2) AHA foam (n = 7). The left femoral artery of the rats was incised and when the bleeding started, and the area was pressed with another sponge for 10 s in all rats. Afterwards, physiological saline solution impregnated gauze or AHA foam was placed over same area. A chronometer was started and area was checked after 2 min. If no bleeding occurred during the first 2 min of application, it was recorded as “successful”. If bleeding occurred, the same procedure was repeated up to three times. If hemostasis could not be achieved even after the third application, it was considered a failure, and “failed” was recorded. All animals were sacrificed under high anesthesia for least 10 min after the experiment. Results: Application of AHA resulted in complete (100%) control of bleeding in all rats within the first 2 min. In control group, hemostasis was achieved in 1 out of 7 (14.3%) rats by the third application. Failure was recorded for the remaining six rats. The hemostatic success rate of the AHA foam was significantly higher than the rates of control group (P = 0.005). Conclusion: AHA foam is a very effective hemostatic agent and can be applied easily on vascular trauma models. Further studies are needed to elucidate hemostatic features of AHA.
, Gulfem Ezgi Ozaltın, Dilan Demirtas Karaoba,
Journal of Surgery and Medicine, Volume 6, pp 615-618; https://doi.org/10.28982/josam.1000789

Abstract:
Background/Aim: There are conflicting results regarding the effect of motor and functional independence levels of disabled children on the burden of care. In addition, this burden, as well as musculoskeletal problems of pediatric caregivers, has not been examined in detail. The aim of this study is to examine the effects of motor and functional levels of the disabled child. Methods: The study was planned as a single-blind, multicenter, cross-sectional study. Children between ages 1-12 with physical disabilities from various problems, and 65 caregivers over the age of 18 who cared for them for at least 6 months, were included. Caregivers were divided into two groups, as per the BAKAS Caregiver Impact Scale score as high care burden (n = 33) or low care burden (n = 32). The motor level of the disabled child was determined by the Gross Motor Function Classification System, and the functional level of the Pediatric Functional Independence Measurement. The Nordic Musculoskeletal Questionnaire was used to evaluate musculoskeletal problems in caregivers. Results: There was no significant difference between the Gross Motor Function Classification System levels of children in groups (P > 0.05). The Pediatric Functional Independence Measurement scores of children in the high care burden group were significantly lower than those in the low care burden group (P < 0.05). According to a comparison of pain in parts of the body for 12 months, using the Nordic Musculoskeletal Questionnaire, the percentage of pain in the neck, shoulder, back, elbow, hand, hip, and foot regions of caregivers was significantly higher in the group with a high care burden (P < 0.05). There was no significant difference between percent of low back and knee pain in the last 12 months (P > 0.05). A weak positive correlation was found between the BAKAS Caregiver Impact scores and the Pediatric Functional Independence Measurement of children with disabilities (r = 0.26; P = 0.03). Conclusion: The lower functional level of the disabled child may cause an increase in caregiver burden of both the caregivers and musculoskeletal disorders.
, Nejla Canbulat Şahiner, Selda Ateş Beşirik, Mehmet Uysal
Journal of Surgery and Medicine, Volume 6, pp 610-614; https://doi.org/10.28982/josam.993190

Abstract:
Background/Aim: Circumcision is an invasive operation that male children undergo in our country and some others. During this process, the child can experience fear, anxiety, and pain simultaneously. As a randomized controlled VR study, this research was conducted to determine the effect of virtual reality (VR) glasses on reducing fear/anxiety and pain during circumcision in children. Methods: The study was conducted on 125 children (6-11 years old). The same healthcare team performed the circumcision of the children in both groups. The children were randomly split into VR and control groups. The children in the VR group, just before the circumcision, watched their preferred cartoon film via VR glasses. No additional procedure was applied to the children in the control group except for ordinary procedures in the hospital. The fear and pain status measured by Wong-Baker Faces Pain Rating Scale and Children Fair Scale of all the children were evaluated before and after the operation by the child, parents, and the observer. Descriptive statistics, chi-square, and t-tests analyzed the data. Results: There was no significant difference between the groups regarding demographic characteristics such as age, BMI, previous hospitalization, and anesthetic drug used before the procedure of the children included in the study. Preoperative (VR = 1.03 (0.18), control = 1.05 (0.22)) and pre-procedural (VR = 2.61 (1.02), control = 2.33 (1.22)) fear levels were also similar (P > 0.05). After the procedure, it was determined that the mean duration of the procedure (365.36 (64.73) sec), crying time (21.31 (41.74) sec), and fear scores (0.36 (0.68)) of the children in the VR group were lower (P < 0.001). However, pain mean scores were similar (P > 0.05). Conclusion: It is thought that watching a cartoon with VR glasses during the circumcision operation may be effective in reducing the child's fear level, crying, and operation time.
Fatih Yılmaz, , Evrim Yılmaz, Ulukan Inan
Journal of Surgery and Medicine, Volume 6, pp 643-646; https://doi.org/10.28982/josam.974748

Abstract:
Fibrocartilaginous dysplasia (fibrous dysplasia and massive cartilaginous differentiation or fibrochondroplasia, FCD) is a rare variant of fibrous dysplasia and a term used for cases of fibrous dysplasia with prominent cartilage tissue. A limited number of FCD cases have been reported in the literature, which can be seen in both clinical forms. A 16-year-old male patient, who had been followed for ten years with a diagnosis of polyostotic fibrous dysplasia in the left hip and cranium, presented with pain in the left leg after a fall. A subtrochanteric pathological fracture in the left femur was detected on exam, the lesion area was curetted, and osteotomy and fixation were applied. Microscopic assessment revealed a fibro-osseous lesion of benign spindle cell fibrous connective tissue with woven bone trabeculae, without osteoblastic rim or large areas of benign cartilage nodules. The final diagnosis was fibrocartilaginous dysplasia. In our literature review, 26 cases of FCD were reported so far. Age distribution of patients ranged from 4 to 53 years (mean 15.9) and the male / female ratio was 15/11 = 1.36. Eighteen cases were monostotic, and 8 were polyostotic. In cases with noted clinical and follow-up data, symptom duration ranged from 8 weeks to 18 years (mean 62.2 months), with no recurrence or malignant transformation in a mean follow-up of 21.71 (2-60) months post-treatment. In the cartilage component, there was increased cellularity, some nuclear atypia, binucleation, and myxoid degeneration. This situation simulates benign and malignant entities such as enchondroma, fibrocartilaginous mesenchymoma, well-differentiated intramedullary osteosarcoma, and chondrosarcoma with a differential diagnosis. FCD is a benign and very rare lesion with a prominent chondroid component, but may cause difficulty with differential diagnosis. Awareness of the histopathological and radiological features of FCD cases, their age range, and involvement areas provides an approach to distinguish them from lesions that may be confusing in a differential diagnosis.
, Yeliz Balca, , Tuğba Çobanoğlu
Journal of Surgery and Medicine, Volume 6, pp 605-609; https://doi.org/10.28982/josam.1109124

Abstract:
Background/Aim: The etiologies of childhood schizophrenia and bipolar disorder have not yet been clarified. In cases in which the symptoms of mood are not dominant and psychotic symptoms are more dominant, it may be difficult to distinguish between childhood schizophrenia and bipolar disorder diagnoses. Follow-up studies concerning this subject have indicated that approximately half of the adolescents diagnosed with bipolar disorder were first (and incorrectly) diagnosed with schizophrenia. Therefore, strong markers are still needed to be used in the differential diagnosis at the time of the first application. An increase in the number of studies on the neuroinflammatory process in pediatric schizophrenia and bipolar illness have started to appear in the literature. The neutrophil–lymphocyte, thrombocyte–lymphocyte, and thrombocyte–neutrophil ratio (NLR, TLR, and TNR, respectively) levels in patients with childhood schizophrenia and childhood bipolar disorder at the time of admission and five years later were evaluated to determine whether inflammatory markers changed over time. Methods: Twelve patients diagnosed with childhood schizophrenia and 14 patients diagnosed with childhood bipolar disorder were included in the study. Active infections, medical, neurological, endocrine, and metabolic illnesses, mental retardation, further concomitant psychiatric diagnoses, and intoxication were all exclusion factors. Hemograms from the same patients who satisfied the inclusion criteria when they originally applied and again at the fifth year follow-up were evaluated. Age, gender, neutrophil, lymphocyte, leukocyte, and thrombocyte values were recorded. NLR was calculated by dividing the neutrophil count by lymphocyte count. TLR value was calculated by dividing the thrombocyte count by lymphocyte count. TNR value was calculated by dividing the thrombocyte count by neutrophil count. Bipolar disorder and schizophrenia status were compared using NLR, TLR, and TNR parameters both at the time of initial diagnosis and at the fifth year of follow-up. Results: When the initial admission hemograms of patients with childhood schizophrenia or childhood bipolar disorder were examined, no statistically significant differences between the two groups in terms of NLR (P = 0.150) and TLR (P = 0.440) were found. TNR was significantly higher in childhood bipolar disorder patients than in childhood schizophrenia (P = 0.015). At the fifth year follow-up, the hemograms of individuals diagnosed with either childhood schizophrenia or childhood bipolar disorder were compared, and no statistically significant differences between the two groups in NLR, (P = 0.572),TLR (P = 0.758), and TNR (P = 0.328) were found. Conclusion: It was concluded that NLR and TLR levels did not change significantly over time in either disease and could not be used for the differential diagnosis of either disease. TNR may be considered for differential diagnoses in childhood schizophrenia and bipolar disease, particularly at the time of the first episode after confirmation of this study's findings with future studies.
Arzu Bilen, Filiz Mercantepe, Habib Bilen, İlyas Capoglu
Journal of Surgery and Medicine, Volume 6, pp 594-596; https://doi.org/10.28982/josam.993536

Abstract:
We present the case of a 70-year-old female patient with persistent hypoglycemia after total gastrectomy due to gastrointestinal stromal tumors. She was thought to have late dumping syndrome but was diagnosed with insulinoma after further examination. Dumping syndrome is mainly seen after stomach or esophageal surgery. It is divided into early dumping and late dumping syndrome. Late dumping syndrome is initially manifested by an exaggerated insulin response and reactive hypoglycemia after glucagon-like peptide-1 release. Diagnosis is based on clinical findings. Treatment mainly consists of reducing carbohydrate intake and not ingesting solid and liquid foods together. In cases where diet alone is not sufficient, acarbose, an α-glucosidase inhibitor that slows the digestion of carbohydrates, may be beneficial for late dumping. Octreotide can be used in resistant cases. However, the diagnosis of insulinoma, which leads to a similar clinical presentation in resistant dumping cases, should be kept in mind. Our patient who showed clinical signs of dumping syndrome after gastrectomy, and treatment-resistant hypoglycemia was diagnosed with insulinoma on the basis of further investigations. The patient’s symptoms resolved after surgery for insulinoma.
Fatma Nurgül Taşgöz, Nergis Kender
Journal of Surgery and Medicine, Volume 6, pp 557-560; https://doi.org/10.28982/josam.1071697

Abstract:
Background/Aim: Benign myometrial lesions are frequently found in pathologic specimens of hysterectomies. High rates of coexistence of these lesions with endometrial cancer have also been reported. Our aim was to evaluate the effect of myometrial lesions on the consistency of diagnoses between endometrial sampling results and final hysterectomy findings in patients with endometrial hyperplasia (EH) before hysterectomy. Methods: Two hundred seventeen patients who were diagnosed as having EH via endometrial sampling and underwent hysterectomy within three months were included in this retrospective cohort study. The patients’ preoperative and postoperative pathologic findings were compared, and discordant results were defined to be either overdiagnosed or underdiagnosed. Results: The overall diagnostic concordance between the endometrial sampling results and the final hysterectomy pathologic findings was 32.2%. The rate of concurrent endometrial carcinoma (EC) among all EH was 22.1%. The discordance between preoperative endometrial sampling and final hysterectomy specimen results was evaluated, and patients with underdiagnosis were older (60.5 years, P < 0.001), had a higher BMI (30.84 kg/m2, P < 0.001), were mostly postmenopausal (P < 0.001), had lower parity numbers (median = 2, P = 0.002), and had a lower rate of co-existing adenomyosis (P = 0.009). The rates of co-existing leiomyoma between the groups were not different. No effect of other demographic characteristics was observed in the multivariate regression analysis; however, the presence of adenomyosis was a significant independent risk factor affecting a 5.8-fold increase in overdiagnosis (-1.50; OR: 0.17 (0.05-0.50) P = 0.002) and 4.5-fold increase in underdiagnosis (-1.50; P = 0.005). Conclusion: Co-existing adenomyosis could lead to discordance of the pathologic findings in women with EH diagnoses before hysterectomy.
Filiz Banu Çetinkaya Ethemoğlu, Irem Gümüş Özcan
Journal of Surgery and Medicine, Volume 6, pp 591-593; https://doi.org/10.28982/josam.907090

Abstract:
Neurofibromatosis (NF) is a genetic and multisystemic disease with autosomal dominant transition. It can affect anesthesia applications by affecting more than one system. In the presence of neurofibromas in the airway, it can cause airway obstruction and difficulties in respiratory delivery during general anesthesia. The presence of tumors affecting the central nervous system makes spinal anesthesia risky. Anesthesiologists should act with awareness of each multisystemic complication when evaluating and managing patients. This case report aims to present our general anesthesia practice in an elective cesarean operation in a pregnant patient with neurofibromatosis type 1.
Buket Tuğan Yildiz, Deniz Tuncel, Nursel Yurttutan, Şerife Çöklü
Journal of Surgery and Medicine, Volume 6, pp 540-542; https://doi.org/10.28982/josam.955602

Abstract:
Anti-myelin oligodendrocyte (MOG)-positive cases have a variable clinical presentation. MOG autoantibodies are associated with acute disseminated encephalomyelitis, multiple sclerosis, clinically isolated syndrome, neuromyelitis optica, isolated optic neuritis, and transverse myelitis. Our patient had bilateral optic neuritis with acute tetraparesis. Cranial magnetic resonance imaging (MRI) showed leptomeningeal contrast involvement and contrast enhancement in all cranial nerve nuclei. Spinal MRI revealed leptomeningeal contrast enhancement, and a contrast-enhancing lesion was found in the cervical spinal cord. This case is worth presenting because spinal leptomeningeal involvement is rare in anti-MOG-positive patients.
Fadime Eda Gökalp Satici, Hamide Sayar
Journal of Surgery and Medicine, Volume 6, pp 537-539; https://doi.org/10.28982/josam.947348

Abstract:
A pseudoglandular schwannoma is a rare benign tumor. Controversy in the literature regarding the histogenesis of pseudoglandular schwannoma exists. Histological features of pseudoglandular schwannomas are different than those found in classical schwannomas. A patient with pseudoglandular schwannomas has a good prognosis, and no cases of recurrence have been reported in the literature.
S.M.N.S.M. Mallawarachchi, G.S.K. Dharmarathna
Journal of Surgery and Medicine, Volume 6, pp 494-497; https://doi.org/10.28982/josam.897752

Abstract:
Background/Aim: Patient safety is an integral component of health care. Adverse event reporting plays a key role in ensuring patients’ safety. The Sri Lankan Ministry of Health has introduced guidelines and a system of adverse event reporting. Here we assess the pattern of adverse event reporting in selected 46-line ministry hospitals. Methods: The adverse events reported in the year 2019 were analyzed. The frequency of reporting of each event was assessed. The issues in relation to adverse event reporting and root causes were assessed through focus group discussions with selected hospital administrators. Results: Most reported events were “patient falls”, contributing to 30.46% of the total. Availability of guidelines, well-established quality management units, and a non-punitive non-fault-finding approach to adverse event reporting and analysis process were identified as strengths of the system. But lengthy paper-based documentation process was recognized as a major weakness. Conclusion: Although the state health sector of Sri Lanka has an established system of adverse event reporting, it is mostly limited to non-clinical events such as falls. Fear of blame and shame among staff and the lengthy paper-based reporting system have negatively affected the process.
Bharath B, G. Sagar Reddy, John Francis
Journal of Surgery and Medicine, Volume 6, pp 527-529; https://doi.org/10.28982/josam.917282

Abstract:
Lipomas are the most typically diagnosed soft tissue tumors. A lipoma is composed of adipose tissue, may vary in size, and is usually seen in the subcutaneous region, most commonly over the extremities followed by trunk and neck. In this case report, a rare case of giant lipoma that was found in the preperitoneal space arising from the parietal peritoneum measuring 40 x 36 x 5 cm and weighing 3.7 kg is described. This lipoma was successfully excised without any immediate or late post-operative complications and no recurrence for 24 months post-operatively.
Betul Guzelyuz, Halit Eren Taşkin, Rahşan KEMERDERE, Yağmur Özge Turaç KÖSEM, Burak Tahmazoğlu, Semih Can Çetintaş
Journal of Surgery and Medicine, Volume 6, pp 533-534; https://doi.org/10.28982/josam.982170

Abstract:
Iatrogenic perforation can cause gastric perforation; among the complications of lumboperitoneal shunt placement, intestinal perforation is extremely rare vs. infectious complications; perforation may occur in the ascending colon with projection of the incision site. This case involves a 41-year-old patient, with gastric perforation from pseudotumor cerebri during incision in the abdominal right quadrant to insert a lumboperitoneal shunt.
Fettah Eren, Bengü Özkan Bakdik, Aysegul Demir
Journal of Surgery and Medicine, Volume 6, pp 488-493; https://doi.org/10.28982/josam.983605

Abstract:
Background/Aim: It is known that sleep disorders and headaches are related. However, there are only very few studies examining this correlation in chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the association between sleep disorders, headaches, and hypoxia in COPD patients. Methods: This study was designed as a prospective case-control study with 120 COPD and 83 controls patients of similar age/gender. International classification of headache disorders - version 3 (ICHD III) was used for the diagnosis of headache. Pain intensity was calculated using the visual analog scale (VAS). For the effect of headache, headache activities of daily living index (HADLI) questionnaire was applied. Pulmonary function tests were performed with a PC-based spirometry device. Blood pressure and blood oxygen saturation were measured by fingertip pulse oximetry. Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Dyspnea severity was graded according to the modified medical research council (mMRC) scale. Results: Headache was detected in 54 patients (45%) with COPD. The most common type of headache was tension type (66.7%). Patients with headache had higher diastolic blood pressure, severity of dyspnea score, and lower forced expiratory volüme-1 (FEV1), forced vital capacity (FVC) (P = 0.037, P = 0.001, P = 0.001, P = 0.001 respectively). Sleep disturbance was quite common in COPD patients (79.2%). PSQI score was higher in patients with headache (P = 0.006). Patients with poor sleep quality had higher pain severity (P = 0.006). Female gender, high diastolic blood pressure and low forced expiratory volume-1 second (FEV1) increased the risk of headache (P = 0.004, P = 0.02, P = 0.032, respectively). Conclusion: Headache is a complex symptom in patients with COPD and associated with higher diastolic blood pressure and pulmonary dysfunction. These parameters should be evaluated in COPD patients with headache.
Melda Soysal Tomruk, Murat Tomruk, Ismail Çalik
Journal of Surgery and Medicine, Volume 6, pp 460-464; https://doi.org/10.28982/josam.935905

Abstract:
Background/Aim: The worldwide spread of COVID-19 caused changes in daily routines. During the lockdown, parks and gyms were closed and access to outdoor areas was limited. After reopening, many restrictions were removed. Since this process may have altered physical activity and well-being levels, this study aimed to explore how physical activity (PA) levels and well-being of Turkish citizens were affected by the initial COVID-19 lockdown and the reopening. Methods: In this prospective, cross-sectional study, participants were asked to complete an online survey twice: first in May 2020 (when initial strictest partial lockdown procedures were applied) and second in July 2020 (after most restrictions had been removed). The online survey consisted of questions related to demographics, PA levels, and well-being. Categorical questions (expressed as either day per week or min per day) were used to assess vigorous and moderate PA, time spent sitting, etc. The WHO-5 Well-Being Index was used to assess well-being. Results: The mean age and the body mass indexes of 94 individuals (52 females, 42 males) were 36.16 (10.04) years and 25.14 (3.82) kg/m2, respectively. During both lockdown and after reopening, low levels of PA and well-being levels above the low mood limit (< 50) were identified. No significant change was found in either any of the PA-related variables or the well-being of participants between the initial and final assessments (P > 0.05). Conclusion: Our results showed that PA levels and well-being of Turkish citizens remained unchanged after the reopening process when compared to the initial lockdown due to COVID-19. These findings may also suggest that reopening was not a sufficient stimulant factor to alter physical activity and well-being. Despite all the negative effects brought on by the pandemic, it is essential to adopt approaches to keep PA levels and well-being high.
Sheikh Ali, Mohammed Khurram, Mohd Yaseen
Journal of Surgery and Medicine, Volume 6, pp 455-459; https://doi.org/10.28982/josam.953637

Abstract:
Background/Aim: Abdominal wall defects may result from trauma, burn, necrotizing soft tissue infection or complications of abdominal surgeries. Reconstruction poses a great challenge for the surgeon in cases of large abdominal wall defects with lack of surrounding tissue. Abdominal wall defects lack a good functional and aesthetic impact and early reconstruction is prudent for better outcomes. This study evaluates the results of Vacuum assisted wound closure (VAC) therapy in patients with large anterior abdominal wall tissue defect which could not be closed primarily otherwise. Methods: This case series included 20 patients with partial thickness, anterior abdominal wall tissue defects. All patients had suffered an acute trauma. Wound debridement was done and VAC therapy dressing was applied in systematic manner. Dressing was changed every 3 or 4 days and continued up to 9-14 days. Results: Twenty patients underwent VAC therapy with an average age of 32 years (range, 25-52 years). Indications comprised tissue loss after acute trauma due to road traffic accident, burn and other trauma leading to anterior abdominal wall soft tissue defect. VAC was used for an average of 12 days, with an average negative pressure of 125 mm Hg. Healthy granulation tissue was formed in all patients. Subsequently split thickness skin grafts were applied in these patients. This results in early recovery as well as decreased morbidity in all patients. Conclusions: All patients had good tolerance to Vacuum-assisted closure. It offers many benefits comprising fewer dressing changes and an earlier return to daily activities. Patients with large abdominal defects can benefit from this procedure.
Nihan Aydin Güzey, Havva Esra Uyar Türkyilmaz
Journal of Surgery and Medicine, Volume 6, pp 445-448; https://doi.org/10.28982/josam.1072866

Abstract:
Background/Aim: Fluid warming is a useful method to prevent maternal and neonatal hypothermia. Because colloids stay in the intravascular space longer than crystalloids, their protective effect against hypothermia may be more emphasized. The aim of this study is to compare the effects of using warmed colloids or crystalloids on maternal and neonatal core temperatures, neonatal blood gas values, and maternal thermal comfort scores. Methods: After ethical approval, 220 ASA I or II pregnant women, scheduled for cesarean section with spinal anesthesia were enrolled in the study. Patients were assigned to receive hydroxyethyl starch (group HES) or Ringer’s lactate solution (group RL) throughout the intraoperative study period. Once the patient entered the room, fluids were actively warmed with fluid warmer to 41 °C in both groups. Measurement of maternal core temperature (MT) and thermal comfort score (TCS) were performed before starting intravenous fluid administration (control), at the time of delivery of the neonate (delivery), 15th, 30th minutes, and at the end of the surgery. Tympanic temperature of the neonates was measured 1 minute after delivery. Blood gas samples from the umbilical artery of the neonates at the 1st minute and Apgar scores at 1st and 5th minutes after delivery were evaluated. Results: Maternal tympanic temperatures, maternal thermal comfort scores were higher at all measurement values other than control measurement in group HES. Neonatal tympanic temperatures (P=0.051), neonatal umbilical artery cord pH (P
Musa Silahli, Mehmet Tekin, Burak Bilgin, Servet Özkiraz
Journal of Surgery and Medicine, Volume 6, pp 413-418; https://doi.org/10.28982/josam.954325

Abstract:
Background/Aim: Retinopathy of prematurity (ROP) is important morbidity in premature infants and is the most common preventable cause of blindness in childhood. Carnitine is a key molecule in energy metabolism and in oxidation of fatty acids, which are the main structural component of phospholipid membrane of the brain and retinal cells. Premature babies are born with insufficient carnitine pools. This study aimed to evaluate the effect of carnitine replacement on ROP in premature infants aged < 34 gestational weeks. Methods: Premature infant records between 2014 and 2019 were retrospectively examined. All premature infants at gestational ages < 34 weeks were included. Data from the two groups who received/did not receive carnitine supplementation in total parenteral nutrition (TPN) over two consecutive time periods and whose ROP examination was complete were recorded retrospectively. Fifty-eight out of 125 infants were in the carnitine group, and 67 formed the non-carnitine group (CG and NCG, respectively). The morbidity data from subjects, especially those with ROP, who received (CG) and did not receive carnitine (NCG), were compared. Results: Of the 125 infants enrolled, no significant differences in gestational age (P = 0.323) or birth weight (P = 0.597) between the groups was found. The Cox regression analysis revealed that carnitine replacement in the premature infant was a protective factor for ROP (P=0.045, B= −0.933, hazard ratio 0.393, 95% confidence interval 0.158–0.978). Conclusion: Carnitine supplementation may offer protection from developing ROP during exposure to oxygen in premature infants.
Ufuk Öztürk, Emine Gazi, Öztürk Özdemir
Journal of Surgery and Medicine, Volume 6, pp 432-435; https://doi.org/10.28982/josam.913769

Abstract:
Background/Aim: Atherosclerotic cardiovascular disease is one of the most common causes of morbidity and mortality in developed countries. Genetic and environmental factors are associated with atherosclerosis development. Some single nucleotide polymorphisms have also been directly related to atherosclerosis, for example, polymorphisms that reduce nitric oxide (NO) levels and/or activity have been linked to atherosclerotic diseases. However, the multidrug resistance gene 1 (MDR-1) polymorphism is related to repeated cardiovascular events. This study aimed to investigate the relationship between MDR-1 and endothelial NO synthase (e-NOS) polymorphism and severe coronary artery disease (CAD). Methods: In total, 90 patients presenting with acute coronary syndrome were included in this cross-sectional study. Patients with at least > 70% stenosis in ≥ 2 coronary vessels were defined as severe CAD (Group 1), while those with this same level of involvement in < 2 vessels were diagnosed with single-vessel disease (Group 2). MDR 3435C-T and eNOS T-786C were determined by polymerase chain reaction (PCR) amplification. Comparison of parametric and nonparametric values between the two groups was performed using the Student’s t- or Mann–Whitney U test. Categorical variables were analyzed using the χ2 test. Risk estimations for the association of severe CAD with the polymorphisms were calculated using odds ratio (OR) and 95% confidence intervals by comparing the genotypic combinations. Results: Baseline demographic parameters were similar in both groups, except for the presence of DM and glucose level. T allele of MDR was 42% and 40% in groups 1 and 2, respectively (OR = 1.12). The C allele of eNOS was 34% and 30% in groups 1 and 2, respectively (OR = 1.16). Fourteen and 15 patients (40% and 27%, respectively) had both T and C alleles in patients in groups 1 and 2, respectively (OR = 1.77). All P-values were > 0.05. Conclusion: This study is the first one that shows that MDR1 and e-NOS polymorphisms are frequent in patients with ≥ 2 vessel disease and may be associated with severe CAD.
Alaa Mohammad, Deniz Mihçioğlu, Filiz Gerçeker, Başar AKSOY
Journal of Surgery and Medicine, Volume 6, pp 436-439; https://doi.org/10.28982/josam.930690

Abstract:
Background/Aim: Obesity is a global public health problem seen worldwide, with an increasing prevalence over time. Obesity is a multifactorial disease affected by both genetic and environmental factors. It is accompanied by many other diseases, the most important of which are immune system disorders. Induction of suppression of HLA-G molecule T and B lymphocytes is associated with natural killer cells and antigen-presenting cells. The HLA-G gene shows functional polymorphisms in regulatory regions. The HLA-G gene is slightly more conserved compared to other HLA genes, both in the same population and among different populations. The aim of this research is to determine the association of HLA-G gene polymorphisms (14 bp insertion/deletion 3 'UTR (rs66554220), rs41557518, and rs1063320) with obesity. Methods: Fifty normal (BMI ≤30) individuals having no obesity-related chronic disorder, and 50 obese (BMI≥ 30) individuals were included in the study. After DNA isolation, PCR and PCR-RFLP methods were used for genotyping. Results: The genotype frequencies of HLA-G polymorphisms (rs66554220, rs41557518, and rs1063320) in the normal and obese groups were compared, and as a result, no significant difference was found (P>0.05). Conclusion: No significant association was found between rs66554220, rs41557518, and rs1063320 polymorphisms and obesity.
Turgut Anuk, Hasan Çantay
Journal of Surgery and Medicine, Volume 6, pp 373-376; https://doi.org/10.28982/josam.982615

Abstract:
Background/Aim: In Turkey, women between 40–69 years of age are routinely subjected to mammography screening for breast cancer. Despite this, the mammography rate is only 28.9% in women aged 15 years and above. This is an indication that women in Turkey are not sufficiently interested in mammography screenings. This study aimed to determine the factors that affect the decision to not have mammography screening for women aged 40 and above. Methods: The study was designed as a hospital-focused cross-sectional study. The population of the study comprised 7,239 women aged 40 years and above. The sample size that would represent the population was calculated as 365 women with 50% prevalence, 95% confidence interval, and 5% deviation in the Epi Info program. A Chi-square test used in the binary analysis (P
Hasan Aydin, Ahmet Türk, Abdullah Karadağ
Journal of Surgery and Medicine, Volume 6, pp 382-385; https://doi.org/10.28982/josam.961385

Abstract:
Background/Aim: Thyrotoxicosis is a hypermetabolic disease, common in people with iodine deficiency. Cardiac pathologies can be seen in untreated cases. Vitamin D is a supportive therapy for thyrotoxicosis and its deficiency also plays an important role in pathologies including cardiac diseases. Adropin is a peptide hormone regulating the energy homeostasis, and its levels in blood change in cardiac pathologies. Our purpose is to reveal the effects of vitamin D treatment on the heart tissue of rats with thyrotoxicosis and on the adropin levels. Methods: Our study was designed as 25 days. 28 Sprague-Dawley female rats were divided into 4 groups; Control (3ml of distilled water), Thyrotoxicosis (100μg/day L-thyroxine) Treatment (100μg/day L-thyroxine+200IU /day Vit. D), Vit D (200IU/day Vit. D). Firstly, heart tissues were stained with Masson trichrome method. The preparations were examined under the microscope and evaluated semi-quantitatively. After that, serum adropin levels were measured with ELISA method. Malondialdehyde level of heart tissue was evaluated by spectrophotometry. Heart tissue was evaluated in aspects of fibrosis, congestion, edema and impairment of tissue integrity. Results: All of the evaluation parameters of the heart tissue were found highly significantly increased in thyrotoxicosis group, in contrast to the control and vitamin D group. Despite a decrease in the treatment group, there was no significant difference in the thyrotoxicosis group (P
Aslıhan UZUN, Asena Keleş Şahin
Journal of Surgery and Medicine, Volume 6, pp 364-368; https://doi.org/10.28982/josam.1058713

Abstract:
Background/Aim: Muscle trauma, vascular injury, and compensatory vasoconstriction during strabismus surgery may cause changes in the choroidal circulation in the early postoperative period. This study aims to evaluate the effect of extraocular muscle surgery on posterior ocular parameters, including central subfield thickness (CST), average retinal thickness (ART), choroidal thickness (CT), and macular volume (MV). Methods: This prospective cohort study included 26 eyes of 26 strabismic patients who underwent single medial or lateral rectus recession surgery using a fornix-based conjunctival incision. All participants underwent detailed ophthalmologic evaluation, including axial length (AL) and spherical equivalent (SE), uncorrected (UCVA), and best-corrected visual acuity (BCVA). Retinal and choroidal images were obtained using spectral-domain optical coherence tomography (OCT). All measurements were performed preoperatively and repeated 1 week and 1 month after surgery. Results: All patients received satisfactory results in terms of deviation. None of the patients showed changes in AL, SE, UCVA, and BCVA. No significant differences were noted in CST and MV values (P=0.472 and P=0.182, respectively). Although subfoveal CT and ART showed statistically significant decreases 1 week after surgery (P=0.012 and P=0.046, respectively), no significant differences in these values were observed 1 month after surgery (P>0.05). No significant differences exist in the measurements between the preoperative, postoperative first week, and first month in nasal and temporal CT (P>0.05). Conclusion: Extraocular muscle surgery performed with the fornix-based conjunctival incision is a safe procedure for posterior ocular parameters, including CST, ART, CT, and MV.
Suna Koç, Ilke Küpeli
Journal of Surgery and Medicine, Volume 6, pp 360-363; https://doi.org/10.28982/josam.1058849

Abstract:
Background/Aim: Given the increasing incidence and mortality caused by coronavirus 2019 ( COVID-19) worldwide, beneficial and effective treatment for patients in the early pulmonary phase is still of great importance. Fifteen-day continuous hemodynamic, laboratory, and clinical courses of patients with acute respiratory distress syndrome (ARDS) due to COVID-19 who received short-term high-dose and long-term low-dose systemic methylprednisolone were compared. Methods: Two hundred and two patients were reported to have ARDS due to COVID-19 in the intensive care unit between June 1, 2020 and February 1, 2021. The patients were divided into two groups: (1) short-term high-dose and (2) long-term low-dose systemic methylprednisolone. Age, gender, Acute Physiology and Chronic Health Evaluation (APACHE II) scores, steroid treatment protocol, intubation duration, length of stay (LOS), Neutrophil/Lymphocyte Ratio, C-reactive protein (CRP), procalcitonin, lactate levels, cytokine filter requirements, the prognosis, and total costs were obtained from their records. Results: It was determined that elderly patients tended to be given low doses of steroids. No significant differences between the two treatment protocols in terms of other parameters were found. It was determined that high doses of steroids affected only CRP levels (P
Fatma Tuba Engindeniz, Deniz Simsek, Burcu Dinçgez
Journal of Surgery and Medicine, Volume 6, pp 295-299; https://doi.org/10.28982/josam.1029878

Abstract:
Background/Aim: Cervical cancer is a preventable disease by appropriate screening programs, treatment of pre-invasive lesions, and vaccination. Thus, the knowledge of healthcare providers about this issue is crucial. The purpose of this study was to evaluate the knowledge of nurses and midwives who were working in the obstetrics and gynecology department about cervical cancer, screening programs, and human papillomavirus vaccination. Methods: The questionnaire comprising 17 questions about cervical cancer, screening programs, and the human papillomavirus that was created by the authors, was applied to midwives and nurses working in Bursa online. All participants were informed about the answers, cervical cancer and HPV vaccines adequately after finishing the questionnaire. Results: The number of participants volunteering to answer the survey was 510. Of these, the rate of participants claiming that cervical cancer is a preventable disease was 97.4%. Approximately 74% of them answered that the reason for cancer was a virus, and 97.8% said that it is screened with a cervical smear. Sixty percent of the participants answered the onset age of the cervical cancer screening program wrongly. There is a great lack of knowledge about the type of vaccines, administration age, and the population vaccinated. Only 2% of the participants had been vaccinated and 34% had offered the vaccination to someone. Conclusion: Midwives and nurses of the obstetrics and gynecology department working in Bursa have sufficient knowledge about cervical cancer, whereas they have a lack of knowledge about screening programmes and human papillomavirus vaccination. It is crucial to make everyone know that cervical cancer is preventable and that eradication is possible by vaccination. Community-based information about the cervical cancer screening program and HPV vaccines is essential.
Derya Argun, Pelin Basim
Journal of Surgery and Medicine, Volume 6, pp 300-305; https://doi.org/10.28982/josam.1036253

Abstract:
Background/Aim: Social media has great potential for easy access to medical information especially in underdeveloped countries. We aimed to analyze the content, reliability and quality of the most viewed YouTube videos, targeting patients intending to use this social media platform as a source of information about the esophagogastroduodenoscopy (EGD) procedure. Methods: Using the keywords “esophagogastroduodenoscopy” and “upper gastrointestinal endoscopy”, we assessed the publicly visible English-language videos available on YouTube. EGD Data Quality Score (EGD-DQS), Global Quality Score (GQS) and a modified DISCERN scale were used to assess the quality, flow and ease of use of the information and the reliability of the EGD videos. Results: Universities/health-care professional group was the most common source of video upload (36%). The reliability score of the videos presented by physicians was significantly higher compared to all other lecturer groups (P=0.044). The reliability score, EGD-DQS and GQS score were also found to be statistically higher in the universities/health-care professional group compared to the health information websites, advertisement and patient groups (P
Emine Yildirim, Eren Ozan Yildiz, Iklil Eryilmaz, Muzaffer Er, Sibel Bektaş
Journal of Surgery and Medicine, Volume 6, pp 273-277; https://doi.org/10.28982/josam.1049330

Abstract:
Background/Aim: One of the purposes of using neoadjuvant chemotherapy (NAC) is to evaluate the patients according to tumor-to-gland ratio, save them from mastectomy by reducing tumor dimension, and get more beautiful results cosmetically with less volume excision during breast-conserving surgery (BCS). Is it possible to achieve the goal of less volume excision after NAC? We aimed to compare the excised volume with BCS, margin positiveness and re-excision rates between the patients who received NAC and the ones who didn’t receive NAC in patients with breast cancer and to calculate the increase in BCS performability with NAC. Methods: Among 306 patients diagnosed with breast cancer between 2013 and 2021 at Gaziosmanpasa Training and Research Hospital, 105 patients who underwent BCS were included in this retrospective cohort study. Excised breast volume, surgical margin positiveness, re-excision and mastectomy rates were retrospectively compared in breast cancer patients underwent BCS with and without NAC. The patients who received BCS following NAC were named the primary chemotherapy (PC), and the patients whose treatment was initiated with BCS were named the primary surgery (PS) groups. Results: BCS was performed to 105 breast cancer patients, of which 28 (26.7%) received NAC, and 77(73.7%) started the treatment with surgery. There were no significant differences between the PC and PS groups with respect to excision volume (755.86 (725.69) and 709 (637.36), P=0.822). Re-excision was more common in PS than in the PC group (39.0% vs 10.7%, P=0.008). Fourteen patients who were candidates for mastectomy at the beginning, became eligible for BCS by receiving NAC, which caused a 15.38% increase in BCS applicability. Surgical margin positivity was seen in only 3 patients, which is why a statistical comparison wasn’t made. Conclusions: Although the tumor size was higher in the PC group, the excised breast volume did not show a significant difference between the two groups. PC decreased the re-excision rates in the chemotherapy candidate group. This data shows that patients who are candidates for adjuvant chemotherapy might be considered for PC to increase BCS success with lower re-excision rates and equivalent excised breast volume.
Veysel Barış TURHAN, Kürşat Dikmen, Mustafa Kerem
Journal of Surgery and Medicine, Volume 6, pp 263-267; https://doi.org/10.28982/josam.1076643

Abstract:
Background/Aim: Since the first pancreaticoduodenectomy (PD) surgeries, mortality, morbidity and length of hospital stay decreased, in return, the number of uncomplicated cases and dissected lymph nodes increased over the years. The aim of our study was to determine the effect of hospital volume on survival, postoperative hospital stay, fistula rate, morbidity rate and the number of lymph nodes dissected. Methods: In this retrospective cohort study, 213 patients who were operated with the diagnosis of periampullary tumor between January 2008 and January 2016 were included in the study. The patients were divided into four groups according to the years of surgery: Group A (n=31, 2008-2009), Group B (n=46, 2010-2011), Group C (n=50, 2012-2013) and Group D (n=86, 2014-2016). The groups were compared with each other in terms of the following factors; Pancreatic fistula rates, postoperative hospital stay, mortality rates, morbidity rates, number of dissected lymph nodes. Results: It has been observed that there is a relation between pancreatic tissue quality and duct size with fistulas (P=0.0016 and P=0.017, respectively). It is seen that as the amount of number lymph nodules increases, the quality of staging improves (P=0.009). Rates of mortality and morbidity are decreased, as the hospital volume increased (P=0.037), The same effect of hospital volume is observed in length of hospital stay and fistula rates, both improved (P=0.017 and P
Seniyye Zengin, Meliha Orhon Ergün
Journal of Surgery and Medicine, Volume 6, pp 258-262; https://doi.org/10.28982/josam.1083644

Abstract:
Background/Aim: Today, obesity is a rapidly growing health problem. Healthcare professionals have been encountering both obese adult and adolescent patients in the operating room more and more frequently. Morbid obesity affects all body systems, thus necessitating greater care in anesthesia management. Studies conducted in recent years have failed to find clear evidence for the most appropriate anesthesia technique with minimal effect on post-operative complications. Therefore, this study was designed to compare the effects of inhalation anesthesia and total intravenous anesthesia (TIVA) on post-operative complications in morbidly obese patients who underwent bariatric surgery. Methods: After receiving approval from the University Ethics Committee, the files of 304 patients who underwent laparoscopic gastric bypass and sleeve gastrectomy between January 2018 and December 2021 were screened. Patients with unexpectedly difficult airways, who underwent open surgery, in whom the anesthesia technique had to be changed intra-operatively for any reason, those scheduled for intensive care as decided during surgical planning, and those with liver or kidney failure were excluded from the study. A total of 278 patients were included in the study. Patients were divided into two groups according to the method of anesthesia used: (1) TIVA (Group T) and (2) inhalation anesthesia (Group I). Results: The study was performed with 278 patients of whom 213 were women, and 65 were men. Patient demographics were similar between the two groups. Comparison of the clinical characteristics of the study groups showed that the rate of admission to the intensive care unit (P=0.032), average duration of surgery (P
Didem Gülcü Taşkin, Faruk Beser, Ibrahim Adaletli, Fugen Cullu, Tufan Kutlu, Tulay Erkan
Journal of Surgery and Medicine, Volume 6, pp 399-401; https://doi.org/10.28982/josam.969588

Abstract:
Spontaneous choledochoduodenal fistula (CDF) is a rare form of biliary enteric fistula. A child with CDF who had a motor vehicle collision as a pedestrian at the age of 2 years is presented in this article. Since the accident, recurrent abdominal pain and black-colored stools were noted thrice a year. As a 13- year-old, the patient was admitted with vomiting of blood and melena. He was hospitalized with gastrointestinal bleeding. Endoscopy is performed because of bleeding and a fistula was detected incidentally. Barium swallow series and magnetic resonance cholangiopancreatography showed a fistula tract. Endoscopic retrograde cholangiopancreatography (ERCP) confirmed the definitive diagnosis and guided treatment. In our case, we emphasize the importance of ERCP in facilitating the diagnosis of CDF. Barium swallow radiography detects the passage of barium to the biliary system in only half of the CDF patients diagnosed via ERCP. In summary, we reported the youngest case of CDF with a large fistula orifice managed by endoscopic sphincterotomy.
Bilinc Dogruoz Karatekin, Afitap Icagasioglu
Published: 1 February 2022
Journal of Surgery and Medicine, Volume 6, pp 191-195; https://doi.org/10.28982/josam.1061762

Abstract:
Background/Aim: Psychological status and quality of life of caregivers with children with cerebral palsy are lower than the population. The functional status of the child is one of the factors affecting the caregiver's quality of life. However, the relationship between gross motor and hand functions, communication, oromotor skills, oropharyngeal functions and the caregiver's quality of life remains unclear. The aim of the study is to examine the effects of the functional levels of children with cerebral palsy on the quality of life of their caregivers. Methods: Two hundred and seventeen children with cerebral palsy and their caregivers were included in this cross-sectional study. Inclusion criteria were; (i) Children aged 0-18, diagnosed with cerebral palsy (CP), followed in the pediatric rehabilitation outpatient clinic of the university, (ii) individuals who care for children with CP and volunteer to participate in the study, (iii) individuals who have a literacy level of understanding the purpose of the study and the forms to be filled in. Children's demographic information (age, gender), cerebral palsy types were recorded and detailed functional evaluation was made. The identity of the caregiver was recorded and quality of life was evaluated with the Short Form-12 (SF-12). Functional classification of the children were evaluated with Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS) and Eating and Drinking Ability Classification System (EDACS). The relationship between the child's functional level in each scale and the caregiver's SF-12 score was investigated. Results: Of the 117 children with a mean age of 7.62 (4.08), 52.5% were male (n=114) and 47.5% (n=103) female. According to CP types, 89.3% were spastic (n=191) (78.1% of them bilateral, 21.9% unilateral), 5.6% ataxic (n=12) and 5.1% dyskinetic (n=11). Median SF-12 PCS and MCS were 51.69 (25.76-62.92) and 55.36 (26.64-60.69), respectively. When the SF-12 scores were evaluated according to the functional levels of the children, both SF-12 PCS and SF-12 MCS scores differed significantly according to the GMFCS, MACS, CFCS and EDACS levels (P
Abdilkerim Oyman, Selver Işik, Seda Eröz, Melike Özçelik, Ibrahim Cil, Ozkan Alan, Mustafa Başak
Published: 1 February 2022
Journal of Surgery and Medicine, Volume 6, pp 177-180; https://doi.org/10.28982/josam.1049310

Abstract:
Background/Aim: Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor subtype with a poor prognosis despite various treatments. Some prognostic markers on survival (such as age, Eastern Cooperative Oncology Group Performance Score (ECOG-PS), isocitrated hydrogenase (IDH) status, alpha thalassemia/mental retardation syndrome X-linked (ATRX) mutation status, possibility of extensive surgery) have been defined. Prognostic Nutritional Index (PNI) has been evaluated in various cancers (such as lung, esophagus, and pancreas), and patients with a low PNI score have been associated with a poor prognosis for overall survival (OS). Our study aimed to examine the effectiveness of molecular and demographic characteristics and preoperative PNI score that may affect OS in GBM patients. Methods: In this retrospective cohort study, GBM diagnosed patients who were 18 years old or older, were included in the study. We measured their pretreatment PNI score and performed multivariate Cox regression analyses of OS in GBM patients. Results: A total of 107 patients were included in the study. Median age was 58 (range, 32-83) years. 72 patients (67.3%) were male and 35 patients (32.7%) were female. The mean preoperative PNI level was calculated as 50.5. The median overall-survival (mOS) was 19.7 months and the median time to progression (mTTP) was 8.1 months. There was no statistically significant result on overall survival in the univariate analysis of patients with PNI>50.5 (P=0.121). In multivariate analysis, being 70 years or older (P=0.012), IDH-1 wild and ATRX mutant patients (P=0.016), IDH-1 mutant and ATRX wild patients (P=0.037), and TTP 12 months and older (P
Ahmet Kağan AS, Mustafa Abanoz, Ahmet Ozyazicioglu
Published: 1 February 2022
Journal of Surgery and Medicine, Volume 6, pp 149-153; https://doi.org/10.28982/josam.1055846

Abstract:
Background/Aim: Recent studies have shown that various inflammatory parameters obtained from routine blood tests can be used in the diagnosis and follow-up of cardiovascular diseases. Stroke is the second most common cause of death in the world. In this study, we aimed to investigate the role of systemic immune inflammation index (SII) value in predicting symptom development in patients with moderate to severe carotid artery stenosis (CAS). Methods: Patients between the ages of 41 and 94 with moderate to severe CAS who were followed up and treated electively in our clinic between October 01, 2016 and October 31, 2021 were included in this retrospective observational cohort study. A total of 314 consecutive patients were included in the study. The patients were divided into two groups as asymptomatic (Group 1) and symptomatic group (Group 2). Results: There were 245 and 69 patients in Groups 1 and 2, respectively. The median ages of patients in Groups 1 and 2 were 62 (41-86) years and 69 (49-94) years, respectively (P
Emine Türkkan, Murat Doğan, Hüseyin Dağ
Published: 1 February 2022
Journal of Surgery and Medicine, Volume 6, pp 131-134; https://doi.org/10.28982/josam.1033655

Abstract:
Background/Aim: Although leukemia is thought to be triggered or initiated by viral infections, it is not clear which viruses are the causative agents for which stage of the disease. Previous studies have shown that the MxA protein is expressed from blood mononuclear cells in reply to inducement of type I interferons in viral infections. Viral infections may trigger childhood B-cell acute lymphoblastic leukemia (B-ALL), and the hypothesis of this study was the detection of the presence of viral infection by measuring MxA expression in blood mononuclear cells of recently diagnosed pediatric B-ALL patients as a surrogate viral marker. Methods: This study consisted two groups; the study group consisted of 30 newly diagnosed B-ALL and the control group consisted of 29 healthy asymptomatic children of similar age. Proven bacterial infection and COVID-19 PCR positivity were exclusion criteria. Bacterial culture of peripheral blood, complete blood count, plasma CRP levels and whole blood MxA levels detected by ELISA (Enzyme-Linked ImmunoSorbent Assay) method were taken. Results: The patients’ mean age was 7.42 years in the leukemia group (previously mentioned as study group) and 7.25 years in the control group. Routine serologic studies for newly diagnosed leukemia patients (CMV, EBV VCA and Hepatitis B IgM, anti-HCV and anti-HIV) were negative in all patients without any bacterial infection detected. The MxA levels were found significantly higher in children with B-ALL than in control group (5.84 (2.18-199.38) and 2.45 (1.17-88.65) ngr/ml, respectively, with P
Zeliha Coşgun, Emine Özsari, Emine Dağistan, Mehmet Coşgun
Published: 1 February 2022
Journal of Surgery and Medicine, Volume 6, pp 106-109; https://doi.org/10.28982/josam.994203

Abstract:
Background/Aim: Venous thromboembolism is a pathological process that is among the leading causes of hospital mortality, and many studies showed that vitamin D receptors have a role in thrombosis. This study aimed to investigate the effect of 25(OH)D deficiency on pulmonary thromboembolism and evaluate the pulmonary embolism severity index (PESI). Methods: Eighty-one patients over 18 years of age who underwent CT angiography with a pre-diagnosis of pulmonary embolism were included in this case-control study. Groups 1 and 2 consisted of 45 patients with pulmonary embolism (PE), and 36 patients without pulmonary embolism, respectively. The PE patients were divided into five groups in terms of age, gender, fever, systolic blood pressure, heart rate, respiratory rate, oxygen saturation, history of chronic lung disease and heart failure, mental status, and malignancy to calculate the PESI score. Classes 1 and 2 were classified as low-risk, and Classes 3, 4, and 5 as high-risk. The CT obstruction index (CTOI) was calculated in patients with pulmonary embolism. Vitamin D levels were noted. Results: No significant difference was observed between the groups in terms of age, gender, and body mass index values (P>0.05). 25(OH)D level was significantly lower in the pulmonary embolism group (7.2(3.3) vs. 8.7(7.0), P=0.028). The CTOI was significantly higher in the high-risk patient group (P=0.019). Conclusions: The evaluation of 25(OH)D levels may be beneficial in determining the risk of thromboembolism.
Mehmet Emre Yeğin, Ersin Gur, Yiğit Özer TİFTİKCİOĞLU, Meltem Songür Kodik
Published: 1 February 2022
Journal of Surgery and Medicine, Volume 6, pp 110-114; https://doi.org/10.28982/josam.1019323

Abstract:
Background/Aim: Maxillofacial trauma management has also undergone a change starting from December 2019 due to the emergence of a new viral infection, later called COVID-19, and then a pandemic mandating new medical protocols. This retrospective cohort study aimed to explain the changes in medical costs and underlying causes of cases with maxillofacial bone fractures during the COVID-19 period, based on the lack of focus on cost analyses on this subject in previous studies. Methods: Patients who were operated on for maxillofacial trauma in our clinic before and during the COVID-19 outbreak were retrospectively analyzed in terms of sex, age, etiology, personal protective equipment (PPE) usage, treatment methods, and total costs. Statistical analyses were carried out for any significant changes. Results: A total of 78 patients of which 38 were operated on before whereas 40 were operated on during the COVID-19 outbreak, were included in this study. Accordingly, 24 patients of the pre-COVID-19 group and 37 patients of the post-COVID-19 group were admitted from Emergency Department (ED), which included all the first wave patients (n=21). In the pre-COVID-19 group, a total of 220 screws and 58 plates were used for 22 IRFs. The total LoH of the patients was 180 days. In the post-COVID-19 group, 274 screws and 70 plates were used for 24 IRFs. The total LoH of the patients was 185 days. A total of 156 PPE including N95 masks and extra operation shirts were used. The pre-COVID-19 group’s treatment costs were calculated as USD 320.3 per patient. Post-COVID-19 group’s treatment costs were calculated as USD 496.68 per patient. Conclusion: The statistical evaluations revealed that the COVID-19 pandemic resulted in differences due to the introduction of PCR tests applied for each patient and the PPE used for the precautions taken for the COVID-19 infections. On the other hand, there were no changes in the number of the use of plates, screws, and in the length of hospitalization. It can be argued that this outcome has led to no necessary changes in the treatment protocols in terms of costs.
Abdilkerim Oyman, Ibrahim Cil, Melike Özçelik, Deniz Tataroğlu Özyükseler, Mustafa Başak, Ali Gökyer, Ilker Nihat Ökten
Published: 1 February 2022
Journal of Surgery and Medicine, Volume 6, pp 115-119; https://doi.org/10.28982/josam.990665

Abstract:
Background/Aim: There is an unmet need for effective prognostic models in small cell lung cancer. Lung immune prognostic index (LIPI) and Modified Glasgow Prognostic Score (mGPS) markers are prognostic in various cancers. We aimed to examine LIPI and GPS markers' prognostic effects on overall survival (OS) in extensive-stage small-cell lung cancer (SCLC) patients. Methods: Patients who were 18 years of age or older, diagnosed with extensive-stage small cell lung carcinoma who received platinum-based chemotherapy as first-line treatment were included in this retrospective observational study. Having concurrent or sequential radiotherapy to the thorax and receiving non-platinum-based chemotherapy as first-line treatment were the criteria for exclusion. We measured their pretreatment LIPI and mGPS markers and performed multivariate Cox regression analyses of progression-free survival (PFS) or OS in extensive stage-SCLC patients. Results: A total of 129 patients were included in the study. Twenty-eight patients (21.7%) were mGPS 0, 65 patients (50.4%) were mGPS 1, and 36 (27.9%) were mGPS 2. Fourteen percent of the patients were LIPI 0 (n=18), %38 were LIPI 1 (n=49), and %48 were LIPI 2 (n=62). The OS of the mGPS 0, mGPS 1, and mGPS 2 patients were 19.0 months (95% CI, 16.3-21.7), 8.4 months (95% CI, 7.1-9.8), and 6.4 months (95% CI, 3.1-9.6) respectively, and those of LIPI 0, LIPI 1, and LIPI 2 patients were 18.3 months (95% CI, 9.9-26.7), 11.7 months (95% CI, 5.3-18.1), and eight months (95% CI, 6.6-9.5), respectively. In the multivariate analysis, ECOG PS 0-1 and LIPI score 0-1 were associated with better PFS (P=0.035 and P=0.03 respectively) and OS (P=0.003 and P=0.036 respectively). Conclusions: LIPI score predicted an unfavorable prognosis, whereas mGPS was not associated with survival. It would be better to consider the use of the LIPI score when managing extensive-stage small cell lung cancer.
Tuğba ONUR, Ümran Karaca, Korgün Ökmen, Serkan Terkanlioğlu, Anıl ONUR
Published: 1 February 2022
Journal of Surgery and Medicine, Volume 6, pp 120-124; https://doi.org/10.28982/josam.891954

Abstract:
Background/Aim: Post-surgical pain is a major factor affecting the quality of life of patients. This study aims to investigate the effectiveness of ilioinguinal block on acute and chronic neuropathic pain after inguinal hernia surgery with spinal anesthesia. Methods: This prospective cohort study included sixty ASA I-III patients aged 18-65 years, who underwent a unilateral inguinal hernia operation. The patients were divided into two groups: Those who received spinal block only (Group 1, n=30), and those who received spinal and ultrasound-guided ilioinguinal nerve block (Group 2, n=30). The perioperative and postoperative complications, Visual Analogue Scale (VAS) scores on rest and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scores at the postoperative 2nd, 6th, 12th, and 24th hours, and in the 3rd and 6th months were noted. Results: No significant difference was observed in the time of first analgesic administration among the groups, but tramadol use significantly reduced in Group 2 (P=0.019). Time until mobilization and discharge was significantly shorter among the Group 2 patients (P
Bünyamin Çildir, Suna Tokgoz-Yilmaz
Published: 1 January 2022
Journal of Surgery and Medicine, Volume 6, pp 59-63; https://doi.org/10.28982/josam.997222

Abstract:
Background/Aim: Hearing aids, cochlear implants, and guidance are highly effective in improving communication skills and the quality of life of individuals with hearing loss. During the Covid-19 pandemic, patients with hearing loss, especially those living far from city centers, faced insufficient device use due to their inability to go to the hospitals and device centers. This study aimed to evaluate the effects of remote monitorization of sound amplification in adults using cochlear implants and/or hearing aids during the lockdown period. Methods: In this cross-sectional study, we recruited 98 individuals with post-lingual cochlear implants (n=38) and hearing aids (n=60). Patients on hearing aids followed before the Covid-19 pandemic were guided with a remote computer connection during the pandemic. All participants filled out the Spatial Hearing Questionnaire (SHQ), the short version of Speech Spatial Quality of Questionnaire (SSQ12), Short Form-36 quality of life questionnaires (SF-36), Satisfaction with Amplification in Daily Life Questionnaire (SADL), and the Coronavirus 19 Phobia Scale (C19P-S) via google questionnaire. Results: During the lockdown period, there were significant increases in the spatial perception scores (SSQ12) of cochlear implant and hearing aid users (P
Serdar Özdemir
Published: 1 January 2022
Journal of Surgery and Medicine, Volume 6, pp 82-83; https://doi.org/10.28982/josam.953596

Abstract:
We have read the article titled “A case of acute renal failure requiring emergency hemodialysis due to hypothermia-associated rhabdomyolysis” published by Vural et al. with great interest. Acute renal failure is an uncommon diagnosis in patients presenting to the emergency department, and rhabdomyolysis is a relatively rare cause. The etiologic factors for rhabdomyolysis may be classified as hereditary and acquired (traumatic, and non-traumatic) causes. We thank the authors for this informative and successful case presentation. In this letter we also would like to mention a few important points and present an interesting phenomenon that we encountered.
Atilla Yalçin, Abdulkadir Polat
Published: 1 January 2022
Journal of Surgery and Medicine, Volume 6, pp 36-42; https://doi.org/10.28982/josam.938799

Abstract:
Background/Aim: Wrist parameters measured on direct radiography are essential in diagnosing distal radius fractures and many specific wrist disorders and determining prognosis after treatment. Previous studies have shown the intercommunity variability of these parameters in the literature. To our knowledge, no study in the literature reflects the normal values in the Turkish population. This study aimed to determine the distribution and normal limits of parameters measured in posteroanterior (PA) and direct lateral radiographs of the wrist in our population between age and gender groups. Methods: In this retrospective cohort study, patients who presented to 2 centers in our clinic between 2014-2020 and had PA and lateral wrist radiographs were retrospectively reviewed. Images from patients who had no significant osseous pathology and had not undergone wrist surgery were randomly selected, and 320 (201 female, 119 male) digital images were retrospectively analyzed. The mean age was 40.45 (13.71). The sample was divided into three groups (18-30, 31-50, over 51) according to age and into two groups according to gender. Radial inclination (RI), lunate fossa inclination (LFA), cord of radiocarpal arch (cord RC), radial shift (Radsh), radial height (RadH), ulnar variance (UV), third metacarpal height (3rd MH), carpal height (CH), capitate height (CapH), lunate transverse length (LL), lunate uncovering length (LUL), scapholunate joint distance (SLD), distal radioulnar joint distance (RUD), volar tilt on lateral radiographs (VT), scapholunate angle (SLA) were measured. The lunate uncovering ratio (LUR) was measured in proportion to the lunate uncovering length (LUL) / lunate transverse length (LL); carpal height ratio (CHR) by proportioning carpal height (CH) / third metacarpal height (3rd MH); revised carpal height ratio (rCHR) was calculated by proportioning the carpal height (CH) / capitate height (CapH). Results: Although the RI and SL values of angular parameters were similar between the gender groups, the LFI and VT values were significantly higher in the female group (P=0.014 and P=0.004, respectively). All metric parameters were significantly superior in the male group (P
Mahir Tayfur, Mecdi Balci
Published: 1 January 2022
Journal of Surgery and Medicine, Volume 6, pp 80-81; https://doi.org/10.28982/josam.885593

Abstract:
Giant hydronephrosis is a rare entity that most often develops due to obstruction at the ureteropelvic junction. The other etiologic factors include bladder and ureter tumors. Giant hydronephrosis can cause long-term complications such as hypertension, renal failure, rupture of the kidney, and malignant change if left undiagnosed or diagnosed late. A 73-year-old male patient was admitted to the hospital with complaints of difficulty in urination and brown colored urine. The patient's hemoglobin and hematocrit levels were low. Radiologically, there was widespread cystic development in the right kidney, a giant hydronephrosis, and a mass in the bladder. In the surgical material sent after the diagnosis of urothelial carcinoma by bladder biopsy, there was urothelial carcinoma in the bladder and right ureter. Since hydronephrosis may develop due to bladder and ureter tumors, which may result in nephrectomy, the early diagnosis of these tumors will reduce such serious complications. The early diagnosis and treatment of a giant hydronephrosis will increase the patient's quality of life by minimizing complications such as hypertension, kidney failure, and kidney rupture.
Eda Sünnetçi Silistre, Halil Uğur Hatipoğlu, Osman Yeşilbaş, Filiz Şükrü Gürbüz, Erdogan Ozturk, Ahmet Yalçinkaya
Published: 1 January 2022
Journal of Surgery and Medicine, Volume 6, pp 29-35; https://doi.org/10.28982/josam.1037054

Abstract:
Background/Aim: The disease caused by the SARS-CoV-2 virus, COVID-19, has become the first viral disease outbreak defined as a pandemic in the 21st century. Experience with previous endemics shows that critical care workers disproportionately suffer from depression and anxiety after facing such outbreaks; however, data are limited regarding the early phase of spread. Our aim was to investigate depression and anxiety in healthcare workers employed in ICUs during the initial phase of COVID-19 spread in Istanbul, Turkey, and possible relationships with various characteristics of healthcare workers. Methods: This cross-sectional study evaluated descriptive and demographic characteristics, professions, COVID-19-related perceptions, depression and anxiety in healthcare workers from the 12 ICUs of six hospitals located in Istanbul, Turkey. The Beck Depression (Beck-D) and Anxiety (Beck-A) Inventories and the State-Trait Anxiety Inventory (STAI) TX-I and TX-II were used to assess depression and anxiety. Employees that worked in ICUs were included, regardless of profession, ICU type (neonatal/pediatric or adult), age, education and working status. We compared recorded data among employees with regard groups based on ICU type, sex, education status, profession, marital status, children, cohabiting status, and whether they were residing at their home. Additionally, multivariable regression analyses were performed to identify factors that were independently associated with scores obtained from the depression and anxiety scales. Results: A third of the studied population were found to have moderate-to-severe levels of depression and anxiety according to the Beck-D and Beck-A scales. The STAI TX-I scores were similar in all comparison groups except for significantly higher scores in participants living with their family/friends (P=0.027). STAI TX-II scores were higher in pediatric/neonatal ICU workers (P=0.001), nurses (P=0.002), employees without children (P=0.046), and those residing in their home (P=0.031). Beck-D scores were higher in nurses (P=0.001), those with lower education (P=0.025), subjects without children (P=0.008) and individuals living with their family/friends (P=0.002). Beck-A scores were higher in participants with lower education (P=0.001), nurses (P
Murat Serkan Songur, Eyüp Erkan, Seray Aslan, Hasan Ali Bayhan
Journal of Surgery and Medicine, Volume 5, pp 679-682; https://doi.org/10.28982/josam.953641

Abstract:
Background/Aim: Corneal endothelial morphology may be corrupted due to pterygium progression. To the best of our knowledge, no study in the literature investigates this. We aimed to evaluate corneal endothelial morphology using specular microscopy (SM) in patients with pterygium. Methods: In this case-control study, we included thirty-three Type 1 pterygium, thirty-one Type 2 pterygium, thirty Type 3 pterygium patients, and thirty healthy controls. The corneal endothelia of all patients were evaluated by SM, and cell density (CD), hexagonal cell ratio (HEX), corneal thickness (CT), and coefficient of variation (CV) were noted. Results: While there was no significant difference in corneal thickness (P=0.480) and coefficient of variation (P=0.068) between the groups in SM images, both corneal endothelial cell count (P=0.003) and hexagonal cell ratio (P=0.002) were significantly lower in Type 2 and Type 3 pterygium patients compared to Type 1 and control groups. Discussion: Corneal endothelial morphology was severely affected in type 2 and 3 pterygium. We think that type 2 and type 3 pterygium patients should be operated on as soon as they are diagnosed to prevent deterioration in corneal endothelial parameters.
Hande Gazeteci Tekin, Özgür Olukman
Published: 1 January 2022
Journal of Surgery and Medicine, Volume 6, pp 5-8; https://doi.org/10.28982/josam.1011145

Abstract:
Background/Aim: Obstetric brachial plexus injury (OBPI) is caused by traction to the brachial plexus during labor. Traction injury may vary from neurapraxia or axonotmesis to neurotmesis and can cause edema, avulsion, or rupture of the nerve. Improvement in the first two weeks after birth is a good indicator of outcome. The disability varies according to the location and severity of the effect in the plexus. However, most injuries are transient, with a total return of function in many cases. This study aimed to obtain clues for the prevention and follow-up of obstetric brachial plexus injuries by revealing the outcome and clinical features. Methods: In this retrospective cohort study, hospital records of patients with brachial plexus injury due to delivery were reviewed between January 2017 and September 2021. Injury levels, birth weights, other injuries at birth, maternal age, gravidity, gestation time, and treatment response were recorded. Brachial plexus injuries of the patients were classified per the NARAKAS classification. The Spearman correlation and Pearson correlation tests were used for correlation analyses. The variables were evaluated with the Chi-Square and Student's t-tests. The normality of the distribution was assessed with the Kolmogorov-Smirnov test. A value of P
Feyza Bayram, Süleyman Serkan Karaşin
Published: 1 December 2021
Journal of Surgery and Medicine, Volume 5, pp 1202-1205; https://doi.org/10.28982/josam.1008359

Abstract:
Background/Aim: Previous studies declared the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and other routine complete blood count (CBC) components as sensitive preeclampsia biomarkers. We speculated that the same associations existed with eclampsia and HELLP syndrome. Methods: This retrospective case-control study was conducted on 120 pregnant women between the ages of 18 and 40 years. Forty-nine patients with HELLP syndrome, 40 patients with eclampsia/preeclampsia, and 40 healthy pregnant women were included in the study. All groups were evaluated in terms of clinical characteristics and first-trimester hematological parameters. The primary outcomes were neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and the secondary results were hemoglobin, red blood distribution width, mean platelet volume, platelet count, neutrophil count, and lymphocyte count. Results: The median gestational age was 34 weeks (ranging between 23 and 41), with a median birth weight of 2300 grams. The median NLR was 3.9 (1.3-25.1), and the median PLR was 113.6 (20.7-693). The NLR and PLR values were significantly different between the three groups (P=0.014, P=0.002, respectively). NLR was different between normotensive and eclamptic pregnant women. PLR values were higher in normotensive pregnant women than in pregnant women with a history of HELLP. The median red cell distribution width was 44.6 in normotensive women, 41.5 in women with eclampsia, and 44.3 in women with a history of HELLP (P=0.017). Conclusion: TLR value was higher in pregnant women who had eclampsia. Platelet count and MPV were significantly lower in the HELLP group.
Buğra SUBAŞI, Fatih Oğhan, Hamdi Taşli, Nesibe Esra Karaman, Seçkin Akbal
Published: 1 December 2021
Journal of Surgery and Medicine, Volume 5, pp 1198-1201; https://doi.org/10.28982/josam.957229

Abstract:
Background/Aim: Tonsillectomy is one of the widely performed surgical procedures by otolaryngologists. Today, many new surgical instruments are used in tonsil surgery to reduce postoperative morbidity. This study aimed to compare intraoperative blood loss, operating time, postoperative pain, and bleeding between harmonic scalpel tonsillectomy, coblation tonsillectomy, bipolar tonsillectomy, and cold dissection tonsillectomy in adult patients. Methods: This prospective cohort study population comprised 96 adult patients aged 18-60 years (mean age: 34.9 (10.7) years) who were operated on for chronic tonsillitis. The amount of bleeding and the operation time were calculated intraoperatively. Postoperative pain level was evaluated using a Visual Analogue Scale (VAS) at the sixth postoperative hour and on postoperative days 1, 2, 3, and 7. Results: In the harmonic scalpel group, the mean volume of intraoperative bleeding (2.7 (1.5) ml) and the mean operation time (8.8 (3.0) min) were significantly lower compared to the other groups (P<0.001, P<0.001 respectively). Secondary bleeding was detected in 10 patients but there was no significant difference in the post-tonsillectomy bleeding rates between the four groups (P=0.86). Pain scores at the sixth postoperative hour were similar and significantly lower in the harmonic scalpel, coblation, and bipolar groups compared with the cold dissection group (P<0.001). The postoperative pain scores were significantly higher in the harmonic scalpel group compared to the cold dissection group on postoperative days 3 and 7 (P=0.03, P=0.02 respectively). Conclusion: Less bleeding during surgery, shorter operation time, and less pain in the early postoperative period are the advantages of Harmonic scalpel tonsillectomy. Also, it does not increase the rate of secondary bleeding but its benefit for late period pain is lower compared to the cold knife method. The harmonic scalpel is a practical and reliable method in adult tonsil surgery.
Zeynep Nilüfer Tekin, Canan Satir Özel
Published: 1 December 2021
Journal of Surgery and Medicine, Volume 5, pp 1174-1178; https://doi.org/10.28982/josam.1023148

Abstract:
Background/Aim: Since YouTube videos do not have accuracy filters, there are concerns about the information content. There are no studies specifically addressing the link between “Covid-19" and "radiology" in terms of content, reliability, and efficacy. The study aims to analyze videos posted on YouTube concerning Covid-19 and imaging in English. Methods: The parameters of 120 most viewed videos on YouTube were recorded with the search of keywords "Covid-19 radiology" and "Covid-19 imaging". Quality Criteria for Consumer Health Information (DISCERN) and medical information and content index (MICI) scores were used to assess the reliability and medical content quality, respectively. The content was evaluated by types of radiological modalities and the patient groups included. Efficacy classification was conducted to assess "informative," "misleading," "individual experience" and "news update" groups. Video sources and target audience were analyzed. Results: After the exclusion criteria, 55 videos were examined. The informative group (n=49) had a higher MICI score (MICI=8) when compared to the other groups (individual experience: 1 (n=3), news update: 1 (n=3), P<0.001). Among the informative ones, 25 videos (51%) were from radiology-related YouTube channels (YC). The MICI and DISCERN scores of the videos, where “radiologists” and “clinicians” make explanations, were significantly higher compared to the “others” group (P=0.001, and P=0.005, respectively). Computed tomography (CT) was the most frequently mentioned radiologic modality (n=49.84%). Pediatric and pregnant population videos were comparatively rarely offered (n=4.7% and n=3.4%). Conclusion: The most viewed videos on YouTube about Covid-19 and radiology are reliable and informative videos narrated by radiologists and published by radiology-related channels and radiology societies. Accurate and scientific evidence-based information sharing is important on online social and scientific platforms.
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