Aim: In this study was designed to investigate causative agents in patients with community-acquired pneumonia by use of culture and immunofluorescence antibodies. Methods: According to this purpose in 50 patients with clinically diagnosed pneumonia, blood cultures using BACTEC 9120 system (Beckton Dickinson - USA), sputum cultures with conventional methods were performed and isolated agents were identified with Sceptor panels (Becton Dickinson - USA). Also from the serums of the patients, using indirect fluorescence antibody methods (Pneumo Slide test-Poligono Industrial Dos De Octubre) IgM antibody against 9 pneumonia agents were investigated. Results: From a total of 50 patients the diagnosis was determined in 13 (26 %) with blood culture, in 6 (12 %) with sputum culture and in 26 (56 %) with indirect fluorescence antibody methods. In the end of the three study, rates of isolation of specific pathogens responsible for community-acquired pneumonia in our region were as follows: Streptococcus pneumoniae, 18 %, Legionella pneumophilia, 12 %, Mycoplasma pneumoniae 12 %, Influenza A 10 %, Haemophilus influenzae 8 %, Staphylococcus aureus 6 %, Adenovirus 6 %, Klebsiella pneumoniae 4 %, Parainfluenza 4 %, Respiratory syncytial virus 2 %, Influenza B 2 %, Coxiella burnetii 2 %, Chlamydia pneumoniae 2 %, Staphylococcus epidermis 2 %. With those methods couldn’t have been identified specific pathogen in 10 % of patients. Conclusion: In pneumoniae, which is an important health problem with high mortality and morbidity rates, it is necessary to diagnose with multiple methods for correct and early diagnosis of the disease.

Antibiotics are the most frequently used drugs, in our country as in the world, having been wrongly used most of the times. In this study, we aimed to evaluate tendency of antibiotic usage by the means of point prevelance method on three different days of three pursuing weeks in patients hospitalized in all wards of Yüzüncü Yıl University Medical Faculty Research Hospital. Our antibiotic usage rates in our hospital on the days the study was performed were overall 49.7%, 48.1%, 45.8% respectively. The departments that antibiotic usage rates were higher were Anesthesiology Intensive Care Unit (100%) among surgical departments and departments of Pediatrics (65.9%) among internal medical departments. Antibiotics used for treatment mostly were ampicillin-sulbactam, ciprofloxacin, metronidazole and ceftriaxon. Cefazolin, ampicillin-sulbactam, metronidazole and cefotaxim were the most used antibiotics for prophylactic purposes. According to general antibiotic usage criteria, it was established that approximately 42.1% of antibiotics were used inappropriately in our hospitalized patients, and the most important cause of the this usage was unnecessary and long-standing prophylaxis habits of surgical departments. In conclusion, inappropriate antibiotic usage rates in our hospital are high. Especially for preventing inappropriate antibiotic usage for surgical prophylaxis, cooperation with surgical units is necessary and a protocol for surgical prophylaxis should be prepared. Besides, pre and post-graduation education programs which will be held also during the specialty period concerning this topic should be emphasized.

In this study, Staphylococcus aureus which is the second cause of nosocomial infections were investigated for nasal carriage rates in our hospital staff and antimicrobial susceptibilities for meticillin and other several antibiotics were studied. From 326 personnel’s (nurse, doctor, nurse’s aide, health technician, kitchen staff) working in Yuzuncu Yil University hospital, nose front cavity swab samples were taken using cotton swabs soaked into serum physiologic. Single colony inoculation were performed on 5% sheep blood agar (SBA).l (nurse, doctor, nurses aide, technician, kitchen workers) with cotton swabs that were by sterile serum physiologic. The samples were incubated at 37oC for 24 hours. After this time of incubation, the colonies which were like staphylococci colonies were stained by Gram staining. Catalase and coagulase tests were performed on strains which showed Gram positive coccus morphology. S. aureus strains were determined and straightened with Sceptor (Becton Dickinson - USA) system. Antimicrobial susceptibilities of all S.aureus strains were evaluated by disc diffusion method for oxacillin and several other antibiotics (erythromycin, teicoplanin, vancomycin, gentamicin, ciprofloxacin, clindamycin and mupirocin). Nasal carriage rate of S. aureus, in our hospital was found as 20.8% (19.7% doctors, 15.7% nurses, 25.3% nurse’s aides, 26.9% health technicians, 22.7% kitchen staff) and MRSA rate was 5.9%. This rate level was considered as a risk factor for nosocomial infections.

Hepatic vein obstruction is associated to a clinical and pathological presentation named the Budd-Chiari syndrome, including hepatic sinusoidal dilatation and congestion, ascites and abdominal pain, as a result of hepatic outflow block. Echinococcal disease is caused by infection with the metacestode stage of the tapeworm Echinococcus. The most common presenting symptoms include malaise, weight loss, and right upper quadrant discomfort due to hepatomegaly. Hepatic vein invasion, typically associated to Echinococcus multilocularis has rarely been described .We provide here a detailed observation of a acute Budd-Chiari syndrome due to Echinococcus multilocularis infection. Detection of Budd-Chiari syndrome in case of Echinococcus multilocularis infection is important for the appropriate treatment.

Aim: In our study, cuff damage to the endotracheal tube was compared with the aid of Magill forceps and a simple device during nasotracheal intubation. Methods: All insertions were performed by nasotracheal intubation with Magill forceps or a simple device on a human model. The tube cuffs were lubricated with lidocaine spray. In the control group, intubation was performed using Magill forceps during direct laryngoscopy and in the study group with the aid of a hook shaped device which designed completely by us. Tube cuffs were examined in aspect of damage level, described as pinholes or major ruptures. Results: Although the rate of minor damage was found in the same ratio (2%) (p>0.05) in both groups, major ruptures were observed at a lower rate in the study group compared with the control group (8%vs 16% respectively) (p<0.05). No diffuculty was experienced related using the newly designed device. Conclusion: We concluded that the new device may help to minimize the incidence of cuff damage of the endotracheal tube, therefore could be a safe alternative to Magill forceps in nasotracheal intubation.

Aim: The aim is to explain the difference between standard deviation and standard error of the mean and to discuss which one should be used with the arithmetic mean when writing an academic paper. Result: When data of the experimental groups describes group parameters “mean ± standard deviation” should be used. “Mean ± standard error of the mean” should be used when comparing data from two or more groups to find a difference between the groups.