Objective: In this study, we aimed to determine the frequency of metallo-beta-lactamase (MBL) producing resistant Acinetobacter baumannii (A.baumannii) strains in our region that have spread quickly and caused a threat in our country as well as all over the world in recent years. Materials and Methods: 70 imipenem-resistant strains of A.baumannii identified between January 2009 and August 2010 were tested for MBL production with two different phenotypic methods; combined disk test and modified Hodge. Antibiotic susceptibility of A.baumannii strains were determined with the BD Phoenix automated microbiology system (Becton Dickinson, USA). Results: Clinical specimens that A.baumannii strains were isolated from included 38 tracheal aspirates, 17 blood, 13 wounds and 2 CSF specimens. Strains were tested with combined disk synergy and the modified Hodge methods for MBL production. While MBL production was detected in 79% with only combined disk test and in 97% with only modified Hodge test, 76% strains were found with both of the test methods. Conclusion: MBL production of A.baumannii strains were found to be remarkably high in our hospital, however exact frequency of MBL production could only be determined with confirmation of these results by molecular methods.

Aim: To evaluate the effectiveness of the ESWL treatment on clearance rate of the urinary system calculi according to the stone localization and size. Materials and methods: Two hundred and thirty-eight patients with urinary stone were treated with ESWL in our Urology Department between the years 2000 and 2005. Of these urinary stones, 97 stones were localized in the pelvis, 10 stones were localized in the lower calyx, 8 stones were localized in the middle calyx, 11 stones were localized in the upper calyx, 34 stones were localized at proximal ureter, 28 stones were localized at middle ureter and 50 stones were localized at distal ureter. The effectiveness of the treatment is evaluated according to size and localization of the stones. The period between ESWL treatment was in range of 5 and 20 days and patients were reevaluated by abdominal plain radiography after ESWL treatment between 7th to 14th days. Other treatment modalities were applied to patients who had 3 unseccusful ESWL sessions. Four mm and less of the calculi fragments were accepted as successful treatment after the 3 months. Results: Our success rate according to stone localization was 81.8% in the upper calyx, 75% in the middle calyx, 60% in the lower calyx, 86.6% in the pelvis, 91.2% at proximal ureter, 89.3% at middle ureter and 72% at distal ureter. Conclusion: Although our success rate could change according to stone localization and size, our results were found similar with the literature. Success rate is dependent on the stone size and localization as we found in our study.

Aim: Demographic features, clinical follow-up and therapeutical responses of 110 adult patients with ITP were evaluated. Method: One hundred and ten patients with idiopathic thrombocytopenic purpura and persistant thrombocytopenia for at least 6 months in Hematology Clinics, Medical School of Yuzuncu Yıl University between 1993 and 2009 were enrolled to the study. Thrombocyte count < 50 x 109 /L was described as unresponsiveness, partial and complete response were determined as 50 x 109 /L-150 x 109 /L and > 150 x 109 /L; respectively under therapy for last four weeks. Results: Eighty-three patients were male and 27 patients were female (M/F: 3/1). Initial thrombocyte counts were between 1x109/L and 100x109/L (mean thrombocyte count 20.84 x109/L). Eleven patients were followed up without therapy. Initial therapy for remaining 99 patients was 1 mg/kg methyl prednisolone. Complete response was achieved in 53 patients (53.5%). Recurrence was observed in 20 patients (37%) with complete remission in consequent 2-6 months and splenectomy was performed. Immunosuppressive therapy was initiated for 19 patients irresponsive to steroid therapy or splenectomy. Conclusion: Steroid therapy and splenectomy is generally effective as an initiative treatment, vincristine therapy is considered to be effective for patients with refractory ITP.

Aim: In this study, we aimed to define the prevalance of traditional CAD risk factors in patients with acute coronary syndrome (ACS) referring to our university hospital which is a tertiary center. Methods: We studied the clinical (hypertension, diabetes mellitus, dyslipidemia, smoking, and coronary arterial disease history) and laboratory characteristics of consequent 431 patients hospitalized in the Coronary Intensive Care Unit of Yuzuncu Yıl University, the Department of Cardiology with the diagnosis of ACS between the years 2006 and 2009. Findings: The frequency of smoking was 67.8% in men and 14.5% in women, diabetes was present in 16.6% of men, and 35% of women. Hipertension (HT) was present in 31.2% of the men and 68.4% of the women. Mean total cholesterol and LDL-cholesterol levels were 178.5±46.1 mg/dL, and 106.5±37.4 mg/dL. Among younger (<50 years old) patients the family history was significantly more prevalent than olders (%48.5 vs. %22.3, p<0.001). Results: In patients with ACS presented to our hospital, the most common cardiovascular risk factors among younger patients (<50 years old) were smoking and familial history whereas among older patients hypertension and smoking were more prevalent. Therefore smoking is a common problem in our region.

Aim: Our aim was retrospectively to evaluate the complications applying to our hospital after circumcision. Method: Referring to Bingol State Hospital between 2006 and 2010 in the early period due to a complication of circumcision,or the complications of late circumcision, identified during routine examination without a complaint were retrospectively reviewed. Findings: The mean age of these patients was 6.2 years (1-25 years). 55 of totally 62 patients (89%) were circumcised in the campaign of mass circumcision or by traditional circumcisers as an individual, but 7 of them (11%) had been circumcised by doctors. Regardless of early and late period, the complication rates of 62 patients who had the complications after the circumcision were as follows; bleeding at 25 patients (40%), infection at 13 patients (20%), missing cutting of the foreskin at 7 patients (11%), penile hematoma at 5 patients (8%), penile skin bridges at 5 patients (8%), more cutting of the foreskin at 2 patients (3%), poor wound healing (scar) at 2 patients (3%), urinary retention at 1 patient (2%), ischemia- necrosis in penis skin at 1 patient (% 2), acquired hypospadias at 1 patient (2%) and partial amputation in the glans penis at 1 patient ( % 2) were respectively observed. Result We think that there will be a serious reduction in the rates of complication in case the process of circumcision is carried out by experts in health centers and in appropriate sterile conditions.

Aim: Phocomelia is a rare congenital disease characterized by the lack or complete absence of one or more of the long bones together with the attachment of the hands and feet (or similar structures) directly to the trunk of the body. In this report, we aimed to present a case of phocomelia diagnosed by ultrasonography at the 17 weeks of gestation. Case: On the routine antenatal ultrasonographic examination of the fifteen years old, G1P0 pregnant patient, bilateral fetal bones of humerus, radius, ulna, femur, tibia and fibula were not detected and biparietal diameter (BPD) was measured as compatible with a 17 weeks of gestation. The termination of pregnancy was offered to the family but they did not accept it and decided to continue the routine follow-up. The patient did not come to her visits regularly and after 4 months, BPD and abdominal circumference (AC) were measured as compatible with 32 and 25 weeks of gestation. A cleft lip and palate anomaly was also detected in the fetus. On the thirty-sixth week of gestation, the patient was hospitalized with a diagnosis of placental abruption and intrauterine ex fetus, and delivered a 2000 g ex male fetus, vaginally. No complication was seen in the postpartum period and the patient was discharged 24 hours after the delivery. Discussion: The prenatal diagnosis of phocomelia is easy by ultrasonography. On the ultrasonographic examination, the cleft lip and palate anomalies may also be detected together with the extremity defects. These rare congenital anomalies may be detected easily at the early weeks of gestation, if the pregnant women come to their antenatal visits regularly.

Intra-scrotal lithiasis associated with hydrocele is a rare condition. In this paper, a intra-scrotal lithiasis with hidrocele case, a 41 year-old man has been reported. Our case was diagnosed with ultrasonography. On the scrotum a mass above the right testicle was observed. He was operated on as a patient with the hidrocele. The aim of our study was to examine the etiopathogenesis of scrotal calculi, which were detected incidentally in various age groups, with reference to the medical literature.

Despite the fact that atherosclerotic extracranial carotid artery lesions are encountered very often the aneurysms are less common. The aneurysms are usually located in the main carotid artery especially at the bifurcation, thereafter it is seen in the internal carotid artery. In our case we report an aneurysm located in the extracranial segment of the internal carotid artery which was explorated under general anesthesia. After resection the arterial patency was established with end to end anostomosis.

Primary obstructive megaureter (POM) is described as dilatation of ureter due to a functional obstruction at distal ureter. It is seen commonly in pediatric age group and uncommonly in adults. Although it is known as a nonhereditary anomaly, some familial cases have also been reported. Most of the cases are asymptomatic and detected incidentally. The diagnosis is important for symptomatic patients. We aim in this study to present the ultrasonography and intravenous urography findings of POM in an adult patient who admitted with urinary system complaint.