In the present scenario, the entire world is facing a crisis due to COVID-19 (Coronavirus disease of 2019) pandemic.It has affected severely and changed the normal course of development of almost every country in the world.The available health infrastructure of even developed countries has become inadequate to manage and control the pandemic.The knowledge of the tools and techniques applied to control and prevent the pandemic worldwide has been obtained from past experiences; almost all the adopted recommendations are based on the teaching of Greek-Arab physicians.It is the need of time to explore the bequest of medieval-age physicians.In this study, the authors reviewed the recommendations of a few famous medieval-age physicians to compile their application at the time of COVID-19.
Recent studies and meta-analyses have shown that orthogeriatric trauma units and orthogeriatric care improve patient outcomes in geriatric fractures.Orthogeriatric patients require a more complex treatment approach in trauma units than younger patients.Cognitive disorders, fragility, comorbidities, inadequacies in self-care, and mobility inadequacies are some of the main factors showing that these patients have complex approach needs.Orthogeriatric care should include orthopedic surgeons, geriatricians, physiotherapists, occupational therapists, and social assistants.This study aimed to review the effects of orthogeriatric trauma units and orthogeriatric care on patient outcomes in geriatric fractures.
This study aimed to compare the outcomes of Chevron osteotomy for hallux valgus fixation using a cannulated screw versus a Kirschner wire.This study included 20 feet of 23 patients with hallux valgus fixed with a cannulated screw (Group A) and 22 feet of 18 patients with hallux valgus fixed with a Kirschner wire (Group B) between 2015 and 2020.We excluded one patient who was infected and three patients who could not be contacted.We evaluated our patients retrospectively.No significant difference was found between the postoperative early-and late-stage hallux valgus angles in both groups (P > 0.05).Likewise, no significant intergroup difference was not found between the postoperative early-and late-stage intermetatarsal angle values (P > 0.05).Patients in Group B were followed up for an average of 18.2 months, whereas patients in Group A were followed up for an average of 17.4 months.No significant difference was observed between the two implants in terms of the union time of the osteotomy line (P > 0.05).The time to union was significantly longer in the male patient group than in the female patient group, regardless of the type of implant used.
Low back pain is one of the most common problems in society.Although it has many causes, degenerative back pathologies may be a key contributor.Low back pain may be a common symptom in patients with lumbar disk herniation, affecting the quality of life of most patients.Lower back and leg pain that do not respond to medical treatment and continue for a long time, accompanied by weakness in the legs, are surgical causes in herniated disk pathologies.Microendoscopic microdiscectomy and open surgery are the two different surgical treatment methods.The surgical approach is determined by the surgeon's experience, current technical capacity, and patient-related factors.The most preferred surgical method for many years has been the open surgery method.However, microendoscopic microdiscectomy is also becoming widespread due to recent research and the increasing experience of surgeons.This study compared the aforementioned surgical methods and found that they yielded similar results.The complication rates of microendoscopic discectomy may decrease with increasing surgical experience when widely used.The advantages of microendoscopic discectomy are as follows: a short operation time, a clear view of the operating field using a 30° telescope, shorter length of stay, earlier mobilization and return to work, and lower infection rates.
This study aimed to describe the isolated bilateral patella fracture and treatment management of a 27-year-old male patient brought to the emergency department of our hospital with pain and swelling in both knees after a motor vehicle accident.During the accident, the patient's both knees hit the dashboard.Radiographs revealed comminuted displaced patella fractures in both knees.On the same day, open reduction and internal fixation were performed for both patella fractures in the same session.On the first postoperative day, the patient was made to walk with the support of crutches and under the control of angle-adjustable knee braces, with full weight given to both sides.The complete union was observed in the postoperative sixth week.The patient had a painless full range of motion of the knee joint in the postoperative 18th month and was satisfied with his life.
Minimally invasive methods for treating renal stones are increasingly preferred.Retrograde intrarenal surgery (RIRS) is a minimally invasive procedure used for renal stones smaller than 20 mm, which is currently preferred by some surgeons for patients with a larger stone burden (1).RIRS is favored over percutaneous nephrolithotomy (PNL) due to lower morbidity, less postoperative pain, and shorter hospital stay, and over extracorporeal shock wave therapy (ESWL) due to higher stone-free rates (2).RIRS is usually performed with general anesthesia (GA) to reduce respiratory-induced kidney movements.However, applying GA results in increased morbidity in patients with cardiac and pulmonary comorbidities.Thus, patients and surgeons may have reservations about using even minimally invasive pro-cedures, such as RIRS, due to the requirement of GA.The quality of a minimally invasive surgical procedure can be improved using a minimally invasive anesthesia method.A regional anesthesia approach is more reliable in elderly patients with high comorbidities and is therefore preferred by anesthesiologists and patients.Among these applications, spinal anesthesia (SA) is more frequently used due to its low postoperative pain, short hospital stay, and less anesthetic use (3).Another advantage of SA is that it costs much less than GA.Our experience in ureterorenoscopy using SA has led us to consider that successful operations using flexible instruments can be undertaken efficiently and reliably using RIRS in cases of proximal ureteral stone migration into the kidney.
In ancient times, fire was considered an effective treatment for various diseases such as warts, wounds, infections, bleeding, fatigue, stress disorders, gastrointestinal diseases, musculoskeletal pain, and skin cancer.Its first reference could be found in surgical papyrus (1550 BC) in Egyptian society.Cautery was considered a cure for religious beliefs.It became more known in the world in the late 1800-1900 AD.Hippocrates recommended its applications in many diseases such as hemorrhoids and sciatica (1-3).Cautery is called "Kaiy" in Arabic, which is derived from the Greek word "Kaiein," meaning "burning."Amal-Kaiyy is a method in which caustic soda, electric current, fire, hot metal rods, and so forth are used to burn a specific part of the body, dry excess fluid, remove flesh, and prevent bleeding, as reported by Alam et al. (4,3).Burning was used for treating patients with psychotic problems.The complications of burning included infection at the site, and 45.5% of patients needed antibiotic therapy.Cautery is an invasive technique performed by traditional healers who believed in its effectiveness in treating many diseases.In a study on mice, burning reduced the phagocytic activity of neutrophils in the nonspecific immune system, which resulted in heat damage from burning, leading to sensory nerve dysfunction and hyperthermia.Pain from burning (e.g., from several places where cautery is used) can act as a distraction and lead to a transient improvement in some patients with psychiatric problems.Various Greek scholars, for example Razi, Majsi, Zahrawi, Baghdadi, Jorjani, and Masihi, shared their experiences with Amal Kaiyy in the relevant writings.Ibn Hubal Al-Baghdadi proposed this method for the surgical removal of pus from a liver abscess (5-7).According to Ibn Sina, burning is a very useful treatment method because it prevents the spread of infectious lesions and inhibits blood flow.Bukhari quoted Prophet Muhammad (PBUH: Peace Be Upon Him)
Autologous hematopoietic stem cell transplantation (ASCT) is indicated as a consolidative treatment after induction and/or salvage therapy of various hematologic malignancies, including multiple myeloma and other plasma cell disorders, Hodgkin lymphoma, and non-Hodgkin lymphomas [1].Coronavirus disease 2019 (COVID-19), caused by a single-stranded RNA b coronavirus, named as 2019 novel coronavirus (2019-nCoV), forced the World Health Organization to declare it a pandemic on March 11, 2020.It has led to serious chaos all over the world and has been a significant cause of morbid-ity and mortality [2].ASCT processes were also adversely affected during this difficult and exhausting period.Some candidate patients lost their chance of ASCT due to COVID-19-related mortality (CRM) and morbidities.The disruptions in treatment schedules due to the emergence of COVID-19 during pre-and post-transplant periods caused additional morbidity and mortality.The cancellation of hospital visits to decrease the risk of transmission, temporary reductions in the number of health personnel, and so forth also ended up with disruptions in medical care and follow-up [3].
Sebaceous carcinoma (SC) of the salivary gland is a very rare tumor occurring more in the parotid gland. It is extremely rare in the submandibular gland. Only four cases of submandibular gland SC have been reported worldwide in English literature. We present the first case of submandibular gland SC in our environment and the fifth to be reported in English literature. A 55-year-old male farmer presented to our facility with a 10-year history of progressive, painless left submandibular mass, which worsened 4 months before presentation, associated with dysphagia to solid, muffled voice, weight loss, and upper airway obstruction. He had emergency tracheostomy and biopsy of the left submandibular mass. Histopathological examination of the mass confirmed SC. He was referred for radiotherapy but said to have died few weeks later while still preparing to travel for the radiation therapy. The rarity of these cases made the clinicopathologic pattern to be poorly understood thus making the choice of treatment option difficult. More cases need to be reported in other to develop the best treatment modalities.
Most anthropologists and historians indicate that marriage was, and is still, a natural duty or an individual strategic event that is being practiced since the early existence of modern humans.This practice reflects the socioeconomic, ethnic, cultural, and religious needs of humankind (1).In 2008, Adam Kuper (2) of Brunel University reported what Charles Darwin, the greatest naturalist of the age, stated in 1868 that "the existence of a great law of nature is almost proved; namely, that the crossing of animals and plants which are not closely related to each other is highly beneficial or even necessary, and that interbreeding prolonged during many generations is highly injurious."Kuper added that "Darwin thought this was probably true of human beings."In this context, Claude Levi-Strauss, who was one of the greatest anthropologists of the 20th century, published a study "The elementary structures of kinship," in which he argued that "all the pre-modern societies of the world were on the basis of cross-cousin."However, the argument had an issue and the statement was criticized because Claude Levi-Strauss assumed that social structures progressed from a primitive to a civilized form.The term consanguinity came from the Latin words: con meaning shared and sanguis meaning blood.Thus, "blood relation," derived from the Latin word consanguinitas, is the property of being from the same kinship as another.Thus, consanguineous marriage is a contract between blood relatives who have at least one common ancestor no more remote than a great-great grandparent.The famous people who married their cousins included Charles Darwin, Albert Einstein, Queen Victoria, Franklin Roosevelt, and so forth (3).
Constrained acetabular liners were developed as a solution to recurrent hip instability in primary and revision hip replacement surgeries.The mechanism of these implants involves holding the femoral head captive in a socket.Hip movements have a shorter range of motion (ROM) in these implants compared with that in a conventional hip prosthesis.These implants are available in different designs, different head and offset sizes, and different ROM ratios (1-4).Complications of the constrained acetabular liners include conventional lower-extremity surgery complications such as infection and deep vein thrombosis.Another group of complications includes the complications directly related to the unique characteristics of constrained implants, such as the hip joint dislocation, separation of the head from the stem, liner dissociation, fracture of the metal ring, and development of impingement.Moreover, complications such as osteolysis, periprosthetic fracture, and loosening can be observed due to the less movement in these implants (1,2,5).In this study, a patient with intellectual disability and constrained ring fracture was presented.During the follow-up examinations, it was observed that the insert was fractured.
Supraglottic airway devices (SGA) were first used in 1988 to provide an easy airway method in resuscitation and difficult intubation (1).Subsequently, they were widely used in daily applications of general anesthesia.The classic laryngeal mask airway (LMA) was among the first to come into use and was preferred more than the face mask or endotracheal intubation because it made the airway method easier when applying anesthesia (2,3).Over time, LMA devices in different forms were developed to increase clinical performance and patient comfort.In each new design, targets were observed such as achieving rapid and easy placement, minimizing the aspiration risk, being able to provide ventilation at high pressure, and reducing the incidence of sideeffects and hemodynamic response (4, 5).The classic types of these devices have an air cushion inflated with an injector to provide a complete fit to the glottis.In the I-Gel model, which was developed later, a gel cushion was adopted instead of the air cushion, and when this gel reached body temperature, it provided complete fit to the glottis.In the recently developed Baska Mask LMA (Fig. 1), the rim of the tubeless tire mimick the fit principle (Fig. 2) and hence it is possible to aspirate the esophagus while providing effective ventilation and spontaneous fit of the LMA to the glottis with the air given to the patient.
This study aimed to determine the correlation of pathological features with cytopathological and histopathological findings in patients who underwent FNAB or surgery due to the detection of nodules with ABSTRACT Thyroid nodules are pathologies that are frequently encountered in general population and sometimes difficult to manage for patients and physicians.The most appropriate method for the management of these nodules is follow-up with ultrasonography (US) and fine-needle aspiration.This study investigated the correlation of suspicious nodules detected on US with cytopathological and histopathological results.Nodule size, nature, echo structure and blood supply, presence of peripheral halo, and presence of microcalcification in the nodule were compared in terms of malignancy and follicular patterns in a total of 55 patients.Statistically significant results were not found; however, we found similar rates to the literature in terms of the pathological diagnoses of malignancy and follicular pattern in patients suspected to have follicular neoplasia, which may be due to our hospital being an experienced center.We also think that further studies conducted with a higher number of patients and data on this subject can greatly contribute to the treatment and follow-up of thyroid cancer.
Thyroid fine-needle aspiration biopsy (FNAB) is the most valuable, accurate, and inexpensive method for patients with thyroid nodules (1-3).Most biopsies are adequate for cytological diagnosis.However, 2%-18% of these biopsies are reported as nondiagnostic, and of these nondiagnostic biopsies, 1%-4% include the risk of malignancy (4).The American Thyroid Association and Bethesda System for Reporting Thyroid Cytopathology suggest performing an ultrasoundguided repeat FNAB.However, the second FNAB may also yield an inadequate result.Thus, the management of these cases is essentially determined according to the malignancy risks they include (5,6).The aim of this study was to investigate the risk of malignancy in patients whose FNAB results were interpreted as nondiagnostic two times or more and who had undergone a surgical treatment. MATERIAL AND METHODSData obtained from digital records and patient files of 171 patients who had previously undergone a surgical treatment were included in this retrospective study.Thyroid nodules from these patients were initially evaluated using an Esaote color Dopler ultrasound (USG) (model: 796FDII; MAG Technology Co, Ltd, Yung-ho City, Taipei, Taiwan) and a superficial probe (model no: LA523 13-4, 5.5-12.5 Mhz).For repeat FNAB, a General Electric Logiq Pro 200 (model no: 2270968; GE Healthcare Korea, Seongnam-si, Gyeonggi-do, Korea) and a 5.5-to 7.5-MHz probe were used.Biopsy was performed using a 25G needle attached to a 10-mL syringe.All statistical analyses in this study were performed using SPSS (Windows 15,0) statistical package program.A chi-square test was used for categorical variables.P values were compared with 0.05 value and examined with the 95% confidence level.Independent samples were analyzed using the t test.
Intra-abdominal adhesions are a dynamic, fibroproliferative, and inflammatory defense mechanism created by the peritoneum against damage (1).Fibrous adhesions occur 10 days after peritoneal injury and reach maximum levels in 2-3 weeks.The most important natural protection mechanism preventing the formation of adhesions is the fibrinolytic system.The balance between plasminogen activators and inhibitors is crucial in determining the formation of normal healing or adhesion formation.Therefore, plasminogen activator inhibitor-1 (PAI-1) is considered to be the most important factor in the development of adhesions, and a high concentration of PAI-1 is found in the peritoneal tissue of patients with accompanies large adhesions (2).Postoperative adhesions constitute an important problem for surgeons in terms of reoperations (3).Propolis is a honey bee product containing plant tissue resin (4).Mouse and rabbit studies have shown that the hydroalcoholic solution of propolis has an anti-inflammatory effect after its topical application, injection, or oral administration ( 5).This study aimed to evaluate the antiinflammatory and anti-oxidant properties of propolis and its effect on the fibrinolytic system in postoperative adhesions. MATERIAL AND METHODSThis study was conducted experimentally at Baskent University Laboratory of Experimental Animals.Prior to the study, the ethical committee approval (project number DA 13/58) was obtained.Thirty male young Sprague-Dawley rats (aged 6-9 months) weighing between 284 and 405 g (mean 342 g) were used in the study.The rats were kept at room temperature at 21-23°C during the study, provided standard food and water, and monitored for 21 days.Before the surgery, fasting was not performed to prevent stress factors in the animals.All surgical
