This study is a prospective observational clinical study. We used the Carragee classification that was done according to annulus integrity and the existence of extruded/ free disc fragments in lumbar disc herniations. Carragee’s groups (type I,II,III and IV) were evaluated as preoperatively and intraoperatively. In total, 62 single level lumbar disc herniation cases were treated with sequestrectomy or subtotal discectomy between 2008 and 2009. The average follow-up period was 14.12 months (12-18 months). We performed only sequestrectomy technique to Carragee’s type I cases, having small annular defect with free disc fragment. Subtotal lumbar discectomy was performed to other three groups. In this study we aimed to compare reherniation ratio and clinical results in each group treated with sequestrectomy or subtotal discectomy. Clinical results were evaluated using visual analog scale (VAS) and Oswestry (ODI) scores. Patients’ reherniation rates and clinical results were evaluated and recorded 3 and 12 months postoperatively.

Objectives: To investigate whether pneumatic tube system leads to hemolysis in blood samples. Materials and Methods: Blood samples from twenty patients were sent to the laboratory, being obtained both manually and with hospital pneumatic tube system. Parameters which affected hemolysis including aspartate aminotransferase, lactate dehydrogenase and serum potassium levels were measured. Results were expressed as mean and stantard deviation. The difference between the two groups were assessed by t test. Results: AST, LDH and K levels of manually transported samples were, 32,6±22,7 U/L, 302,6±162 U/L and 3,9±0,5 mmol/L respectively, whereas for PTS transported samples 33, 3±21,9 U/L, 328,3±22,7 and 3,9±0,6 mmol / L (p>0.05, for all). Conclusion: PTS, currently being used in our hospital, did not lead to hemolysis. We suggest each hospital should test their pneumatic tube system in terms of hemolysis.

Warfarin is the most commonly used oral anticoagulant around the world. The most important complication of warfarin is bleeding. This study was conducted to evaluate the patients admitted to our hospital with bleeding complications during the course of warfarin therapy. Sixty patients (27 female, 30 male) were enrolled into this retrospective study. The patients were evaluated according to their age, gender, duration of the therapy (months), the doses (mg/day), follow-up periods, co-administered drugs, bleeding localization, treatments, amount of blood transfusions, duration of bleeding, and PT, INR and aPTT. Mean duration of anticoagulant use was 21.8 ± 32.4 months (0.5–156), mean INR follow-up duration of was 37.7 ± 66.8 (3–390) days. The most common indication of warfarin was cardiac valve replacement. Mean warfarin dose was 5.1 mg/day. The most frequent bleeding localization was upper gastrointestinal tract. Twenty seven (44.5%) of the patients had major bleeding, and 32 (55%) had minor bleeding. Two patients (3.3%) died due to fatal bleeding. INR, Hb and Htc levels at the admission, types of treatment modalities and duration of bleeding were different among bleeding types (p<0.05). Forty five patients (75%) had been using at least one other drug in addition to warfarin. Thirty seven (61.7%) of the patients had their regular INR checks. In this study we found that the bleeding complications of warfarin were associated with the duration of treatment, high INR and concomitant drug use.

Aim: In this prospective clinical study the aim was to evaluate and compare the efficacy of TENS and elektroacupuncture in patients with lumbar discal herniation. Method: Sixty patients (30 males, 30 females) who have low back pain for three months or more and were diagnosed to have lumbar discal herniation allocated into two groups randomly. Age range of the patients was 20-50 years. TENS was applicated to 30 patients of the first group, and electroacupuncture applicated three times weekly to 30 patients of the second group, in a total 15 sessions, each session lasting 20 minutes. All patients were evaluated at admission, just after the treatment, and one month after the treatment by following parameters; HFF (Hand-Finger Floor Distance), SLR (Smooth Leg Raising), Tenderness of Valleix Points, VAS (Visual Analog Scale), Oswestry Pain Disability Form and Low Back Pain Result Scale. Results: Statistically significant differences were not found in HFF, SLR, Tenderness of Valleix Points, VAS, Oswestry Pan Disability Form and Low Back Pain Result Scale parameters between the two groups (p>0,05). There was statistically significant improvement in these parameters just after the treatment compared with admission in both groups (p<0,05). This significant improvement continued one month after the treatment (p<0,05). Conclusion: In conclusion; in short term both TENS and electroacupuncture were found efficient in the treatment of lumbar discal herniation. We suggested that both TENS and electroacupuncture which can be used either combined with other physical therapy modalities or alone are efficient in the treatment of patients with lumbar discal herniation.

Aim: The results of locked intramedullary nailing performed with tibial shaft fractures were evaluated. Methods: The results of locked intramedullary nailing, performed on 75 patients (51 men and 24 women) with tibial shaft fractures between April 2005 and April 2009 in Ministry of Health Ankara Atatürk Education and Research Hospital 1st Orthopaedics and Traumatology Clinic and Yüzüncü Yıl University Medical School Department of Orthopaedics and Traumatology were evaluated. The local ethics committe has was approved. The evaluation in the study was performed according to Johner and Wrush criteria. Reamed intramedullary nailing was performed on all patients. Only 12 of the patients were dynamised. Mean period for taking to surgery was 7.6 days and average discharge period was 4.8 days. Patients were mobilised with an average of 20 days. Results: Union was achieved in all patients and mean union period was 17.2 weeks. According to Johner and Wrush criteria; 53.3% of the patients had excellent, 26.6% good, 13.3% moderate and 6.7% had bad results. Conclusion: Reamed intramedullary nailing method should be the first preferred method of treatment in appropriate tibial fractures.

Aim: Detection of hospital infections and agents in Yuzuncu Yil University Medicine Faculty Research Hospital and definition of local data. Methods: A total of 3254 patients, hospitalized, followed and treated in Anesthesia and Reanimation, Pediatrics, and Pulmonary Intensive Care Units as well as Neurochirurgia, Orthopedics and Internal Medicine Clinics of Yuzuncu Yil University Medicine Faculty Research Hospital were monitored for hospital infections and the results were evaluated. Results: Hospital infection rate was detected as 3.5% in Yuzuncu Yil University Medicine Faculty Research Hospital. The most common hospital infections were pneumonia (48.2%), urinary tract infections (19.6%), surgical region infections (18.7%), and blood circulatory system infections (13.4%), respectively. Among the causative microorganisms; Acinetobacter baumanii (23.2%) was the most common followed by Klebsiella spp. (20.5%), E.coli (19.6%), and Pseudomonas (%11.6). Methicillin resistance of S.aureus and Coagulase-negative staphylococci (CoNS), which were detected as hospital infection agents, was detected as 100%. Additionally extended spectrum beta-lactamase (ESBL) rates of E.coli and Klebsiella spp. were detected as 81.8% and 91.3% respectively which were quite high. Although carbapenems were the most affective agents against isolated non-fermentative Gram negative bacteria in this study, the resistance rates were detected to be increased. Conclusion: Hospital infections are important problems in our hospital like they are globally. The main aspect to gain control of these infections is hospital infection surveillance studies. Control of hospital infections is possible through determination of hospital flora agents of each center, their resistance patterns, distribution of infections and generalizing the use of appropriate antibiotics.

Leptospirosis is a commonly encountered type of zoonosis throughout the world especially in tropical regions. Though leptospirosis presents with a non icteric form in nearly 90% of cases, it leads to Weil’s disease characterized by fever, jaundice, tendency to bleeding and fulminant hepatorenal failure in approximately 10% of infected persons. Herein we report a case of Weil's disease, presenting with fever, jaundice, acute renal failure and thrombocytopenia.

: To evaluate clinical features, laboratory findings, and complications of typhoid fever cases in our hospital. Method: Twenty-one cases who were followed up with the diagnosis of typhoid fever in our clinic were investigated in respect of their histories, clinical and laboratory findings, treatment outcomes and prognosis. Results: Fifteen of the cases were female (71.4%), and 6 of them male (28.6%), with a mean age of 26 ±11.3 and age range of 12-63 years. All the cases had symptoms of fever, fatigue, loss of appetite and headache and CRP elevation as laboratory finding. Salmonella typhi was grown in 2 of the 12 cases (16.7%) who were previously initiated antibiotic treatment, and in 7 of the cases (77.8%) who were not administered antibiotic. In laboratory findings, 7 cases (33.3%) had leukopenia, 6 (28.6%) had anemia, 9 (42.9%) had thrombocytopenia, and 11 (52.4%) had ALT elevation. The response of the fever to treatment was found in an average of 3.5 ± 1.8 days. Complications were seen in 3 cases (%14.3) as following: acute pancreatitis, temporary hearing loss and sacroiliitis (each 4.8%). Conclusion: Typhoid fever is an endemic infectious disease which may sometimes show epidemics. Early diagnosis and treatment decreases complications and mortality rate, and the most important factor impeding diagnosis is antibiotic initiation before making a diagnosis.

Splenik rüptür ve hemoperitonium ile komplike olmuş bir splenik bruselloz olgusunu sunuyoruz. 37 yaşında bayan hasta hastaneye karın ağrısı, karında şişkinlik, baş dönmesi ve geceleri olan ateş nedeniyle başvurdu. Acil Servisteki muayenesinde arteriyel kan basıncı 60/40 mmHg, nabız dakikada 110 idi. Ortostatik vital bulgular orta derecede postural değişiklikler gösteriyordu. Sol üst kadranda ele gelen hassas kitle saptandı. Hastaya intravenöz sıvı ve norepinefrin uygulandı. Batın bilgisayarlı tomografisinde (BT) dalakta belirgin büyüme, splenik rüptür ve intraabdominal sıvı saptandı. Peritoneal lavaj kateteri ile batına girildi ve yaklaşık 1000 mL kan boşaltıldı. Kültür ve serolojik incelemeler için kanlar alındı. Hastaya dört ünite eritrosit süspansiyonu verildi. Brusella aglütinasyon testi 1: 1240 olarak pozitifti. Operasyon sonrasında 6 haftalık kombine bruselloz tedavisi verildi. Rifampin ve doksisiklinden oluşan konservatif tedaviyi tamamladıktan sonra hastanın sorunu olmadı ve karın ağrısı tekrarlamadı.

Bronchiechtasis is defined as an abnormal irreversible enlargement in one or more bronchi. It is common in developing countries. The omost common etiological agents are infections. Its treatment is surgical resection. It is a chronic suppurative disease. We aimed to present our case who was undergone upper and lower lobe resection of the lung resulting in compensatory hypertrophy of the middle lobe.

Noroviruses are the most common cause of acute nonbacterial gastroenteritis worldwide. Noroviruses, belonging to the family caliciviridae, are very contagious and cause clinical signs of nausea, vomiting, and diarrhea by spreading easily via contaminated water and food or directly from person to person. They cause outbreaks in hospitals, homes and schools where sufficient hygiene measures are not put into practice. Outbreaks of norovirus that threaten public health can be prevented by hand hygiene, disinfection of environmental surfaces, and with methods of wide sanitation.

Despite the fact that the etiology of Melkersson Rosenthal syndrome (MRS) is not fully known, factors like infections, genetic susceptibility, food intolerance and stress have been attributed to the etiopathogenesis. Its classical triad includes recurring facial edema, facial paralysis and plica linguata (fissured tongue, scrotal tongue). Observation of the classical triad is very rare and usually monosymptomatic involvement is observed. Edema is usually on the orofacial area and in rare cases on the eyelid. Facial paralysis is usualy unilateral. A fourteen year-old female patient was admitted a second time with the complaint of facial paralysis. On the physical examination, she could not shut her right eyelid completely. The right nasolabial sulcus was obliterated. The rim of the mouth was deviated when talking. The right side of the face was edematous. The papillae of the tongue were prominent. The case was evaluated as MRS. The clinical findings recovered totally with oral prednisolone treatment. It was aimed to emphasize that MRS should be considered for patients with recurring facial paralysis with this case report.