International Journal of Current Medical and Biological Sciences

The Cardiac Complications in Hemorrhagic Strokes: Insights from a Unique Bigeminy Rhythm Presentation

Alper Resit GUNDUZ — 2024-10-04

During the acute phase of subarachnoid hemorrhage, cardiac rhythm disturbances are frequently observed, affecting 50% to 100% of patients. Although benign arrhythmias like sinus tachycardia, sinus bradycardia, premature atrial contractions, and premature ventricular contractions are common, clinically significant arrhythmias such as ventricular tachycardia or atrial tachyarrhythmias manifest in only 1-4% of patients. This case report delves into the intricate connection between cardiac complications and neurological emergencies, using a distinctive bigeminy rhythm presentation in a 43-year-old male patient with aneurysmal subarachnoid hemorrhage.

Investigation of Care Burden and Burnout Levels of Elderly Care Providers Receiving Home Health Services

Büşra GÖKTEPE — 2024-10-03

Background: This study aimed to determine the care burden and burnout status of individuals caring for the elderly receiving home health care services and to reveal the needs to be addressed at the point of intervention for the caregiver for the identified situation.

Materials and Methods: This descriptive study was conducted between January 1 and April 1, 2022 with individuals who had been providing care to patients registered in the Home Health Services unit of XXXXXX University Training and Research Hospital for at least 1 month, who were not paid for their caregiving work, and who agreed to participate in the study.

Results: The burnout scale short form score of caregivers was 2.8±1.3 in women and 2.0±1.1 in men. This difference between both genders was statistically significant. (p<0.047) As the dependency level of the care recipients increased, the time-dependency burden subscale scores of the caregivers increased and this result was statistically significant. (p<0.001) In this study, a significant negative correlation was found between the caregivers burden inventory time-dependency burden subscale score of caregivers and the Katz Activities of Daily Living (ADL) scale of care recipients. (p<0.001) A statistically significant strong positive correlation was found between the total Caregivers Burden Inventory (CBI) score of caregivers and the burnout scale short form score. (p<0.001)

Conclusions: A statistically significant positive correlation was found between the total CBI score and the Burnout Scale-Short Form score of caregivers. Burnout may lead to negative outcomes such as low self-esteem, low motivation and low performance in caregivers.

The Determination of Foot Angles in Healthy Adult Turkish Population

Abdullah Ray — 2024-10-13

Background: It is well known that morphometric measurements taken from the foot are related to foot biomechanics. Radiographic angle and measurements of the certain parameters of the foot are reference sources in the treatment and surgical planning of foot and ankle deformities. This study has focused on measuring and evaluating the angular variables of the foot in terms of age and gender on foot radiographs of healthy adults.

Material and Method: A total of 300 individuals (150 females and 150 males) between the ages of 25 and 55 were grouped according to age and gender. Four angular variables were measured on lateral radiographs of the right foot taken with weight. The variables measured are as follows: Gissane Angle, Bohler Angle, Medial Arch Angle and Lateral Arch Angle. Statistical analyses were conducted with R (version 4.3.2 64-bit (2023-10-31 ucrt)) software.

Results: As a result of the analyses, the difference between genders was found to be statistically significant in the variables of Gissane Angle and Bohler Angle. While statistically significant difference was found only between the individuals in the third group in terms of Lateral Arch Angle variable, no significant result was found between the groups and the genders forming the groups for the variable of Medial Arch Angle.

Conclusion: The morphometric data acquired in this study with the use of the lateral radiographs of the foot can serve as a reference value for healthy Turkish population.

Comparison of the Effect of Transurethral and Suprapubic Catheterization on Transurethral Prostatectomy Results in Patients With Acute Urinary Retention Secondary to Benign Prostatic Hyperplasia

Adem Tunçekin — 2024-11-07

Background: We aimed to evaluate the impact of different catheterization methods on transurethral resection of the prostate outcomes in patients with benign prostatic hyperplasia related acute urinary retention.

Materials and Methods: Between 2019 and 2023, a retrospective examination was conducted on patients experiencing acute urinary retention secondary to benign prostatic hyperplasia. The study encompassed 89 patients who underwent transurethral resection of the prostate. The patients' demographic data, preoperative uroflowmetry results, pathology reports and the data obtained during their follow-up up to the 12th month were recorded. The patients' data were divided into two groups based on catheterization status: percutaneous cystostomy and Foley catheter, and compared.

Results: The study included 76 patients with a transurethral Foley catheter and 13 with a percutaneous suprapubic cystostomy. No significant differences were observed in preoperative parameters or postoperative complications and pathology results between the groups. Uroflowmetry showed a significant decrease in postoperative postvoiding residual urine volume in the suprapubic catheter group but no significant difference in maximum flow rate. In the Foley catheter group both maximum flow rate and postvoiding residual urine volume showed significant changes postoperatively. However, when comparing uroflowmetry results between groups no significant differences were observed.

Conclusions: Catheterization methods are utilized in the emergency management of acute urinary retention caused by benign prostate enlargement. Advantages and disadvantages should be carefully considered when selecting the appropriate method. Our study has shed light on this aspect. We believe that conducting more comprehensive prospective studies could yield more reliable results.

Assessing Colistin Resistance Among Clinical Isolates: A Comparative Study of BD Phoenix System versus Broth Microdilution Method

Nida Özcan — 2024-11-25

Background: This study aims to compare the colistin susceptibility detected by the BD Phoenix automated system among multidrug-resistant bacteria with the results of the broth microdilution (BMD) method.

Materials and Methods: The study included 236 isolates (92 A. baumannii, 68 K. pneumoniae, 55 P. aeruginosa, and 21 E. coli) which were isolated from clinical samples submitted to the bacteriology laboratory of XXXX Hospital. The BD Phoenix 100 automated system was evaluated using BMD as a reference method. Categorical agreement (CA, the number of concordant results), major errors (ME, results falsely categorized as resistant by the automated system despite being sensitive by the reference method), and very major errors (VME, results falsely categorized as sensitive by the automated system despite being resistant by the reference method) were calculated.

Results: Of the 236 isolates, colistin resistance was found in 34 (14.4%) isolates, with A. baumannii, K. pneumoniae, P. aeruginosa, and E. coli exhibiting resistance rates of 15.2%, 20.6%, 1.8%, and 23.8%, respectively. A. baumannii showed 89.1% CA between the two methods, with 10.8% VME. K. pneumoniae had an 83.8% CA with a 14.7% VME rate. P. aeruginosa exhibited a 98.1% CA with a 1.8% VME rate, while E. coli showed an 80.9% CA with a 19% VME rate. The BD Phoenix 100 automated system had a 10.5% VME rate compared to BMD. The automated system identified 9 out of 34 isolates as susceptible, contrary to the reference method which reported them as resistant.

Conclusions: Categorical agreement rates of the automated system varied according to bacterial isolates.The high VME rate of the BD Phoenix 100 system demonstrated the need to confirm colistin results reported as susceptible with SMD.

Socıodemographıc and Clınıcal Characterıstıcs of Patıents Hospıtalızed For Suıcıde In An Intensıve Care Unıt in Turkey: A Retrospectıve Study

Özlem Kaçkin — 2024-11-28

Background:Increasing suicide rates, mental health problems and the need for intensive care have become an important health problem. Therefore, analyzing the sociodemographic and clinical characteristics of patients hospitalized in intensive care for suicide attempts is critical for developing effective intervention and prevention strategies. This study aims to analyze the sociodemographic characteristics and mental health of individuals who attempted suicide.

Materials and Methods: In this retrospective descriptive study, suicide cases in the adult intensive care unit of a university hospital between 01.11.2017 and 01.11.2023 were analyzed through the hospital automation system.

Results: The mean age of patients hospitalized in the intensive care unit in the last 10 years was 27.06 ± 10.15 years and 61% were female. 79.6% of the patients were admitted with a prediagnosis of suicide and 17.7% with alcohol or substance intoxication. Family pressure (32.7%), economic problems (17.7%) and psychiatric problems (15%) were the main reasons for suicide. The most common methods of suicide were drug abuse (67%), insecticide use (26%) and hanging (4%). Seventy per cent of the patients were discharged with nausea and vomiting, 92 per cent were discharged, and 8 per cent died. Suicide cases occurred mostly in July (15%) in 2017 (21%) and 2022 (18%). Suicides were frequently observed at night, especially at 23:00 (14.6%).

Conclusions: This study investigated the sociodemographic and clinical characteristics of patients admitted to an intensive care unit in Turkey for suicide attempts. Results showed that most patients were young females who often attempted suicide by drug ingestion. Key contributing factors included family pressure, economic challenges, and psychiatric issues, with suicide cases peaking in the summer. These findings may aid in developing targeted prevention and intervention strategies by identifying high-risk groups and periods.

Diagnosis and Treatment Approaches in Gallstone Ileus: A Case Series from a High-Volume Clinic

Hasan Elkan — 2024-12-07

Abstract

Background: The aim of this study is to present the patients who were operated for gallstone ileus in our clinic in the light of literature information.

Materials and Methods: Data of patients who were operated on due to gallstone ileus in our clinic between January 2016 and January 2024. Demographic data, preoperative symptoms, comorbidities, diagnostic method, surgical method, location of Stones causing ileus and postoperative findings were recorded.

Results: It was observed that 8 patients were operated due to gallstone ileus in our clinic on the specified dates. The average age of the patients was 64.1(55-81) years. All patients had complaints of nausea, vomiting and abdominal pain. Six of our patients had comorbidities. While the diagnosis was made by Computed Tomography in 6 of the patients, it was made during surgery in 2 patients. Only enterolithotomy was performed in 7 of the patients, one of our patients underwent enterolithotomy, fistula repair and cholecystectomy. Considering the location of the Stones causing ileus, they were located in the ileum in 5 patients and in the jejunum in 3 patients. No postoperative mortality was observed in our patients.

Conclusion: Gallstone ileus is a diagnosis that should be kept in mind when patients who erderly, have comorbidities and have no previous history of abdominal surgery present whit ileus. Although enterolithotomy will be considered as a priority for treatment, we believe thet cholecystectomy and fistula repair can also be performed in a single session in patients whose general condition is not critical.

Key Words: Gallstone, Ileus, Diagnosis and Treatment

The Association of Demographic Data and Hematological Parameters with Causes of Death in Patients Following Cardiopulmonary Resuscitation in the Emergency Department

Yunus Esen — 2024-12-12

Background: Cardiopulmonary arrest, marked by the cessation of breathing and circulation, has high mortality rates. Cardiopulmonary resuscitation (CPR) outcomes are influenced by factors like arrest duration and underlying conditions. Inflammatory markers such as platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and red cell distribution width (RDW) may predict mortality.

Materials and Methods: This retrospective study analyzed 142 patients who died after CPR in the Emergency Department of Harran University Training and Research Hospital (between January 1, 2018, and December 31, 2020) and 150 healthy controls. Hematological indices (WBC, PLR, LMR, RDW) and clinical data were compared using statistical tests, including ROC analysis.

Results: The patient group had a mean age of 58.99 ± 19.28 years. Heart failure (7.5%) and acute myocardial infarction (6.8%) were the leading causes of death. WBC, LMR, and RDW were significantly higher in the patient group, while PLR and platelet counts were lower (p<0.05). ROC analysis identified RDW (AUC: 0.670) and LMR (AUC: 0.707) as significant prognostic markers.

Conclusions: Elevated LMR and RDW values and reduced PLR and platelet counts may predict mortality in CPR patients.

Keywords: Cardiopulmonary Resuscitation, Mortality Inflammatory Markers, Lymphocyte-Monocyte Ratio, Red Cell Distribution Width