ISSN: 2149-2247 | E-ISSN: 2149-2549

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Erciyes Med J: 37 (1)

Volume: 37  Issue: 1 - 2015

REVIEW
1.Diagnosis and Treatment of Bicuspid Aortic Valve Disease
Mehmet Akif Çakar, Ercan Aydın
doi: 10.5152/etd.2015.7582  Pages 1 - 5
Bicuspid aortic valve disease is the most common congenital cardiac anomaly. The prevalence in the general population is between 0.46% and 1.37%. There is significantly high cardiac morbidity associated with bicuspid aortic valve disease, predominantly due to progressive valve dysfunction (stenosis or regurgitation) that requires surgical intervention for symptom relief or prevention of left ventricular dysfunction, or less commonly, for complications of endocarditis. Bicuspid aortic valve disease is clinically important not only because of valve disease but also because of its association with many vascular abnormalities, such as aortic dilatation and aortic coarctation.

ORIGINAL ARTICLE
2.Sleep Quality and Factors Affecting It in Patients with Chronic Psychiatric Disorders
Birgül Özkan, Sibel Arguvanlı Çoban, Bayise Saraç, Kadriye Melike
doi: 10.5152/etd.2015.7837  Pages 6 - 10
Objective: The study aimed to determine sleep quality and factors affecting it in patients with chronic psychological disorders.
Materials and Methods: The research was conducted at Gevher Nesibe Medical Faculty Hospital of Erciyes University between March 10th, 2009 and April 10th, 2009. In total, 132 patients with psychiatric disorders were included, and all the patients were asked to fill the Pittsburgh Sleep Quality Index (PSQI) and Personal Information Forms.
Results: According to the data obtained, the mean scores of PSQI were as follows: sleep duration, 1.17±1.09 h; sleep efficacy, 1.23±0.97; daytime dysfunction, 1.40±1.01; sleep disorder, 1.16±0.83; sleep latency, 2.80±1.58; sleeping pills, 1.35±0.76; and global PSQI, 9.13±2.37. In total, 93.2% of the patients were found to have a bad sleeping quality. As the global PSQI scores increased, sleeping time, sleeping pill use, sleeping quality, sleeping activity, sleep latency, and daytime dysfunction scores also increased (p<0.05). In addition, there was a positive correlation among them. The correlation between the global PSQI scores and marital status and between the place of residence and occupational-professional status was found to be significant (p<0.05).
Conclusion: As patients with chronic psychiatric disorders have frequent sleep problems, planning interventions for the sleep problems of patients can be recommended.

3.Frequency of Lung Disease in Patients Diagnosed with Uveitis
Hatice Kılıç, Asiye Kanbay, Ayşegül Şentürk, Canan H Hasanoğlu, Ayşegül Karalezli, Fatma Yülek, Can Ateş
doi: 10.5152/etd.2015.8488  Pages 11 - 15
Objective: To identify the etiologic and demographic features of uveitis cases admitted to the Ankara Ataturk Education and Research Hospital in Turkey and to determine the frequency of lung disease in these cases.
Materials and Methods: The records of 140 uveitis cases followed up in our hospital were retrospectively examined. The patients underwent systemic and complete ophthalmologic examinations. Laboratory and radiological examinations were performed for the etiology of uveitis. The age and sex of the patients, anatomic localization, and the etiology of uveitis were evaluated.
Results: The mean age±standard deviation of 140 patients included in the study was 39.6±14.9 years. The proportion of female/ male was 61 (43.6%)/79 (56.4%). The cases were put into 4 groups according to their anatomical localizations: anterior uveitis (48.6%; n=68), posterior uveitis (28.6%; n=40), panuveitis (31.1%; n=31), and intermediate uveitis (0.7%; n=1). Idiopathic uveitis accounted for the majority of all cases (n=69, 49.3%). Behcet’s disease was the second most common diagnosis (n=41, 29.3%), followed by uveitis associated with sarcoidosis (n=8, 5.7%). Anterior uveitis was the most common anatomical localization (n=68, 48.6%) and posterior uveitis followed it (n=40, 28.6%).
Conclusion: The etiologic distribution of uveitis varies with the geographical location. The most frequently seen form of uveitis in our clinic is idiopathic. Among diseases leading to uveitis and primarily affecting the lung, Behcet’s disease comes first and it is followed by sarcoidosis.

4.Does Cochlear Nerve Size Differ Among Societies?
Hakan Imamoğlu, Mustafa Fatih Erkoç, Mansur Doğan, Kasım Durmuş, Ertuğrul Mavili, Ümit Erkan Vurdem, Eylem Itır Aydemir
doi: 10.5152/etd.2015.9046  Pages 16 - 18
Objective: Cochlear nerve size is a prognostic factor for successful cochlear implantation. Reports about the cochlear nerve size in normal-hearing patients and differences among societies in the cochlear nerve size are not satisfactory. The purpose of this study was to determine the average cochlear nerve size in normal-hearing adults and to investigate whether there is a difference among societies on the basis of literature data.
Materials and Methods: This retrospective study included 21 patients (38 ears) who underwent Magnetic Resonance Imaging (MRI) because of either vertigo and/or tinnitus complaints. Measurements were conducted on parasagittal constructive interference in steady state (CISS) sequence MRI. Vertical and horizontal diameters and cross-sectional area (CSA) were evaluated at the fundus of the internal auditory canal. Differences in the cochlear nerve size between the right and left ears and gender were evaluated. The difference in the cochlear nerve size among societies was compared with a z-test using data from literature.
Results: The average vertical diameter, horizontal diameter, and CSA were 1.11 mm, 1.10 mm, and 0.96 mm2, respectively. No difference was found between the right and left ears and gender and among societies.
Conclusion: This study shows that the mean normal size of the cochlear nerve does not change between right and left ears and gender and among societies.

5.Sexual Health Services among Primary Healthcare Units in İstanbul
Asya Banu Babaoğlu, Selma Karabey, Ahmet Topuzoğlu
doi: 10.5152/etd.2015.6436  Pages 19 - 25
Objective: To evaluate factors that influence the frequency and quality of sexual health examinations performed by physicians working in Istanbul primary healthcare units and to develop auxiliary strategies based on these factors that would improve sexual healthcare.
Materials and Methods: In this cross-sectional study, a postal questionnaire was administered to a representative group of physicians working in primary healthcare units (i.e., family health centers) in Istanbul between January and February 2007.
Results: The response rate was 84.9%. While 84% of the physicians questioned the history of sexual health in their patients in case of a presence of a sexual health problem, only 8% questioned even if their patients reported any sexual health problems. Major barriers in obtaining a patient’s sexual health history included language and comprehension problems, lack of time, presence of the patient’s mother or other relatives during the evaluation, low level of patient education, and strong religious beliefs. Forty-two percent of the responding physicians shared the opinion that their pre-graduate training provided inadequate preparation for sexual health counseling, and 55.1% did not perform such counseling.
Conclusion: Major advancements toward the prevention of sexual disease and improvement of the population’s sexual health can be made by emphasizing the importance of sexual health in both pre- and post-graduate medical training, encouraging physicians to routinely ask their patients about their sexual health during examinations, and providing qualified consultancy services in primary healthcare units.

6.Assessment of Knowledge and Behavior on Hand Hygiene in Health Care Workers
Şafak Kaya, Zehra Kaçmaz, Necla Çetinkaya, Şehmuz Kaya, Hakan Temiz, Mansur Inalcan
doi: 10.5152/etd.2015.8707  Pages 26 - 30
Objective: Hand hygiene is a basic measure for the control of hospital-acquired infections. However, sustained compliance with hand hygiene in health care workers is poor. The purpose of this study was to investigate the practices and knowledge level about hand hygiene among health care workers in our hospital.
Materials and Methods: This study was performed in Diyarbakir Training and Research Hospital in May 2013. A total of 179 health care workers (HCWs) were included in the study. A questionnaire was administered to HCWs to assess their knowledge and practices on hand hygiene. Statistical Package for the Social Sciences (SPSS) 16.0 program was used for the evaluation of data.
Results: Of 179 patients in the study, 123 (68.7%) were male and 56 (31.3%) were female. The mean age was 28.7 years (18-56 years). A hundred and thirty-three (74.3%) of HCWs had received training on hand hygiene. However, it was determined that the knowledge levels and practices of HCWs on hand hygiene were inadequate.
Conclusion: It is important that health care workers should be educated about hand hygiene. In addition, it is necessary to improve the physical conditions of our hospital.

CASE REPORT
7.Severe Hemorrhagic Diathesis in a Patient with Prostat Adenocarsinoma and Diagnostic Approach
Oğuzhan Sıtkı Dizdar, Vildan Özkocaman, Mustafa Şahbazlar, Ercan Pesen, Ender Kurt, Fahir Özkalemkaş, Rıdvan Ali, Ahmet Tunalı
doi: 10.5152/etd.2015.5076  Pages 31 - 33
Disseminated intravascular coagulation, acquired hemophilia, and hyperfibrinolysis induced by prostate adenocarcinoma were first considered in the differential diagnosis of a patient who had been diagnosed with prostate adenocarcinoma and complicated with hemorrhage. Clinical progression and lack of response to other treatments directed us toward the diagnosis of hyperfibrinolysis and tranexamic acid therapy was initiated. Clinical and laboratory findings resulted in a partial improvement, but the response was insufficient. This situation was associated with metastasis and not initiating the treatment for the primary disease. This case was presented to emphasize the importance of treatment arrangement on the basis of differential diagnosis for hemorrhagic diathesis occurring in the clinical course of prostate adenocarcinoma.

8.A Case of a Placenta Percreta Presenting with Severe Vaginal Bleeding Following Early Second Trimester Pregnancy Termination
Mehmet Serdar Kütük, Mehmet Dolanbay, Fatma Özdemir, Semih Uludağ, Mahmut Tuncay Özgün
doi: 10.5152/etd.2015.7115  Pages 34 - 35
A 14-week pregnant woman was admitted to the hospital for pregnancy termination because of early rupture of membranes. Dilatation and curettage were performed because the placenta did not separate spontaneously after fetus evacuation. The placenta could not be extracted and severe vaginal bleeding occurred. The patient’s condition deteriorated. Placenta percreta was detected intraoperatively. Emergency hysterectomy was performed. Because of the high risk of maternal morbidity and mortality, it is important to consider placenta percreta in the presence of prolonged first and second trimester pregnancy termination, especially in those patients with a history of uterine surgery.

9.Type 1 Giant Coronary Aneurysm
Tahir Durmaz, Cemal Köseoğlu, Hüseyin Ayhan, Telat Keleş, Engin Bozkurt
doi: 10.5152/etd.2015.7343  Pages 36 - 38
Coronary artery aneurysm is a rare anomaly and is defined as the expansion of the diameters of normal coronary arteries by ≥1.5 times. Aneurysms reaching 4 times the normal size or 8 mm in diameter are defined as giant coronary aneurysms. Giant aneurysms involved in all of the left main coronary artery (LMCA), left anterior descending artery (LAD), and right coronary artery (RCA) are very rare. Here we report a case of a 47-year-old man presenting with non-ST elevation myocardial infarction and LMCA, RCA, and LAD coronary giant aneurysm as well as spontaneous dissection of the distal LAD.

10.Primary Cystic Echinococcosis in Psoas Muscle
Ibrahim Karaman, Ibrahim Halil Kafadar, Murat Kahraman, Mehmet Halıcı
doi: 10.5152/etd.2015.7832  Pages 39 - 42
Cystic echinococcosis (CE) caused by Echinococcus granulosus has been endemic in many parts of the world and involvement of the liver is the most frequently seen form. However, primary musculoskeletal involvement is rare. The radical treatment is surgical resection followed by anthelmintic medical therapy. In this study, a case of a 38-year-old woman with rare localization of CE in the psoas muscle at the proximal thigh is presented.

LETTER TO THE EDITOR
11.Anesthetic Management of Cornelia de Lange Syndrome: A Case Report
Ahmet Şen, Ahmet Salih Calapoğlu, Habibe Şen
doi: 10.5152/etd.2015.8302  Pages 43 - 44
Abstract | Full Text PDF

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