Objective: In this study; we aimed to determine the identification and the antifungal susceptibility testing of yeasts from the samples of the patients that were sent from Anesthesia Intensive Care Unit of Yuzuncu Yil University Education and Research Hospital. Materials and Methods: The yeasts were identified by using germ tube test, cornmeal tween 80 media, BBL CHROMagar media and API 20C AUX yeast identification system. The antifungal susceptibility tests were performed for amphotericin B, flucytosine, fluconazole and itraconazole by using ATB FUNGUS 2 INT agar microdilution system. Results: 54.6% of the yeasts were identified as C.albicans which was the most common yeast followed by; C.parapsilosis (12%), C.tropicalis (10.6%), C.glabrata (9.3%), Trichosporon spp.(5.3%), C.famata (4%), C.utilis (1.4%), C.kefry (1.4%) and Rhodotorula glutinis (1.4%). According to the results of antifungal susceptibility tests, the resistance rate for fluconazole and itraconazole were 14.6% and 26.6% respectively. However no resistance was detected against amphotericin B and flucytosine. Conclusion: The results of this study show that C.albicans is the most common yeast isolated from the patients at intensive care unit in our hospital. Increase in the resistance of fluconazole and itraconazole which are frequently used for emprical treatment demonstrates the importance of antifungal susceptibility tests.

Objective: Patients with a diagnosis of Parkinson’s disease face an increased risk of bone fracture, especially fracture of the head of the femur. This increased risk has been attributed to the postural instability characteristic of the disease, to neurological damage or to a reduction in bone mineral density. Because of the increased frequency of falling and its complications, the link between Parkinson’s disease and osteoporosis demands attention. For this reason, we thought it of value to investigate the relationship between Parkinson’s disease and the incidence of osteoporosis in the Turkish population. Materials and Methods: We compared a group of 65 idiopathic Parkinson’s patients with a control group of 30 individuals, who were matched for age and sex, and who had no known systemic diseases, for bone mineral density. Individuals with electrolyte and metabolic diseases which might affect bone metabolism were excluded from the study. The stage of Parkinson’s disease was determined according to UPDRS and Hoehn and Yahr scores. Results: Results of the study showed a significant reduction in bone mineral density in Parkinson’s patients compared to the control group; also, as the stage of the disease advanced according to the Hoehn and Yahr score, and as immobility increased, so bone mineral density decreased (p: 0.037). Conclusion: In the light of these results, we emphasize that osteoporosis and its possible complications should be taken into account when planning primary and secondary care treatments for Parkinson’s patients.

Objective: Osteoarticular tuberculosis is often seen in the third frequency in the extrapulmonary tuberculosis cases. Tuberculose spondylodiscitis constitute approximately 1-5% of all TB patients. Lower thoracic and upper lumbar vertebrae are most affected vertebras. In this practice, we evaluated the tuberculosis spondylodiscitis cases who were admitted to our clinic. Material and Method: Twelve patients with tuberculosis spondylodiscitis, who were admitted to our clinic in May 2007 and December 2011, are evaluated. Results: Six male and six female patients were included to the study. The mean age of patients is 57±19. Complaints such as fever, night sweats and weight loss was observed in seven cases. We observed thoracic involvement in eight patients, lumbar involvement in three patients and cervical involvement in one patient. We observed spondylitis accompanied by discitis. Conclusion: A good history should be taken in patients who are suspected tuberculous spondylodiscitis. The diagnosis should be supported by clinical and laboratory findings. In these patients, appropriate radiological imaging method should be implemented without delay. Thus, the patients can receive early diagnosis, the treatment can be initiated earlier and morbidity rates can be reduced.

Objective: Yuzuncu Yil University of Medicine Department of Public Health made a survey and some primary schools of city of Van have between evaluated. After earthquake new buildings have been constructed instead of collapsed ones, the damaged buildings have been reinforced. This study aims to make a comparison between the current situation and the situation before earthquake. And also it aims to make an evaluation in terms of environmental health no matter related to earthquake or not. Materials and Methods: It is a descriptive study. It is a follow-up study of Van Yuzuncu Yil University of Medicine Department of Public Health and the study has been re-evaluated by going to 17 out of 18 schools again after the earthquake. Schools were evaluated in terms of environmental health by the using the Turkish Standards Institute (TSE)’s TS 9518 Elementary School-Physical Settlement-General Rules and TS 12014 Environmental Health-Schools standards and prepared a survey of 99 questions by literature scanning. Statistical analysis of the data was performed with the Statistical package for the social sciences 15.0 program. Results: The difference in the average number of students in classrooms, the number toilets for boys and toilets for girls, the number of toilets for male and female teachers and the number of seismic resistance reports were also significant (p<0.05). Conclusion: Deficiencies according with the earthquake and a significant portion of existing deficiencies before earthquake have not been removed.

Objective: All over the world, shows a significant increase in obesity and diabetes. Intake of foods that contain fructose, glucose and starch-based sugar is a potential risk for metabolic syndrome. Obesity and diabetes are important effects of high fructose corn syrup (HFCS). We aimed to research, activity of Na+/K+-ATPase in addition to glucose transporter (GLUT) 2, resistin, adiponectin and other biochemical markers in rats fed glucose, fructose and starch-based sugars. Materials and Methods: Study was performed on rats and 3 groups were included in the study. Rats were fed with chows that were given either normal diet for control group (70% carbohydrate, 20% protein and 10% fat), high fructose (70% carbohydrate (87% fructose and 13% starch), 20% protein and 10% fat), or high sucrose (70% carbohydrate (87% sucrose and 13% starch), 20% protein and 10% fat). Rats were fed with chows for 8 weeks. In this process, the weight of the rats were followed. At the end of the experiment, blood is taken in all groups. Level of HbA1c, glucose, resistin and adiponectin were studied. GLUT2 and Na+/K+-ATPase activity were studied in the liver tissue. Results: A significant increase in adiponectin levels were determined in rats fed both HFCS and sucrose (p<0.001). A significant decrease in level of Na+/K+-ATPase activity were determined in rats fed both HFCS and sucrose (p<0.001). There was no significant differance level of HbA1c, glucose, resistin and GLUT2 in rats fed sucrose or HFCS (p>0.05). Conclusions: Fructose-rich diet has an effect on changes in the ATPase activity and is a major risk factor for obesity.

Objective: The aim of this study is to define the attitude of hand hygiene practices among healthcare providers in Emergency Clinic and to compare with previous studies and assess the effectiveness of studies made up to improve compliance to hand hygiene guidelines. Materials and Methods: The study was prospectively conducted in Emergency Clinic of Antalya Training and Research Hospital. The title of healthcare provider, type of contact, whether hand hygiene with soap or antiseptic solution applied or not and drying condition recorded on study forms. Chi-square test was used in statistical analysis and p<0.05 assumed significant. Results: 814 contacts observed during this study. 561 (%68.9) of them were classified as clean and 253 (%31.1) as dirty. Totally, hand washing rate was %14.7 in clean contact group and %30.0 in dirty. Hand washing in dirty contact group was significantly higher. When we checked the glove usage, only 298 (%36.6) contacts applied with gloves. Glove usage was significantly higher in nurses. On the other hand, 119 (%14.6) of total 814 contacts hand washing applied with soap, 40 (%4.9) was with antiseptic solution. Conclusion: As compared with previous studies, we could not find significant enhancement in hand washing rates despite encouraging applications in last years. Policies for hand hygiene practices should be questioned and revised.

Objective: There are many surgical techniques to treat hypospadias, which is a frequently seen congenital deformity caused by incompletely developed urethra. We aimed to share our experiences with the most prevalent of these surgical techniques, tubularised incised plate urethroplasty (TIPU). Material and Method: 20 distal hypospadias cases, treated with TIPU between 2013 and 2015, were evaluated retrospectively. The cases were analyzed in terms of age of the patient, mea localization, existence of cordee, operation time, removal time of the urethral catheter, hospitalization time and complication. Results: The average age of the patients was 13, 05 (1-25 ages). None of the cases had cordee. Mea localization of the patients was distributed as 5 coronal, 9 subcoronal and 6 distal penile. Average operation time was 60 min. (50 min.–70 min.), average hospitalization time was 3,8 days (2-10). Urethral catheters were removed on the 10th day during the control. As there were not any early complications with the cases, 3 patients developed fistula, 1 patient experienced total wound opening and 1 patient developed narrowness. Conclusion: TIPU operation is a safely practicable technique with low complication rates and good cosmetic results especially in distal hypospadias cases.

Objective: The aim of this study is to assess the complication rates of percutaneous nephrolithotomy (PCNL) by using the modified Clavien grading system. Materials and Methods: We performed a retrospective chart review of 35 patients who underwent PCNL by 1 experienced surgeon over a 2-year period (2012-2015). All stones were evaluated with CT preoperatively. Patients’ age, gender and stone burden per renal unit were recorded. Complications were recorded and classified by using the modified Clavien classification system. Results: The average age of the 35 patient was 53 (15-85) years. The mean stone burden per renal unit was 2.5 (1– 5.0) cm. The overall complication rate was 77%. The most common low-grade complication was fever. There were low rates of Grade III complications. There were no Grade IV or V complications. Conclusion: PCNL carries a low-grade complication rate when the modified Clavien system is used for the classification of complications. The most important consideration for achieving consistently successful outcomes in PNL with minimal major complications is the correct selection of patients. A well-standardized technique and postoperative follow-up are mandatory for early detection of complications.

Objective: This study was conducted to determine job satisfaction levels of nurses and midwives working in hospitals and family health centers in Van. Material and Method: This survey was conducted on a total of 596 nurses and midwives working in hospitals and family health centers in Van. A questionnaire of 27 questions was guestionered to participants with face-to-face interview method in order to identify their socio-demographic properties and job satisfaction levels. The data was analyzed by SPSS (ver: 15) statistics software with ratio test and chi square test. Results: In the study, 278 of the 596 nurses and midwives (46.6%) were found to be satisfied with their jobs, while 161 (27%) were found to be partially satisfied and 157 (26.3%) to be unsatisfied. Conclusion: A significant amount of nurses and midwives were found to be unsatisfied with their jobs. Based on the findings, it was concluded that excessive workloads were acting as sources of stress, causing a drop in life standards and having a negative effect on productivity; and as such, a reduction on working hours and an increase in number of nurses and midwives on every medical unit was necessary.

Objective: The aim of this study is to determine the levels of serum homocysteine, folate, vitamin B6 and vitamin B12 and their relations with each other in volunteers without deep venous thrombosis. Materials and Methods: Seventy apparently volunteers without deep venous thrombosis were included in the study. For biochemical analyses, homocysteine, folic acid, vitamin B12, and vitamin B6 levels were measured by EIA method (USCNlife-EİAab, China). The absorbance values obtained from the device were substituted into the calibration chart to prepare the results of samples. Results: There were 35 male and 35 female patients ranging in age from 17 to 78 years, with a mean age of 48.9±13.35 years old. Twenty five volunteers had hyperhomocysteinemia. In hyperhomocysteinemia group, 6 volunteers had low folic acid level, 4 had low vitamin B12 level, and 3 had low vitamin B6 level. Mean Homocysteine levels were 14.54±6.90 µmol/L in females and 16.13±10.01 µmol/L in males. The difference was significant (p<0.05). Among the 25 participants with hyperhomocysteinemia, 6 had a combination of heterozygous methylenetetrahydrofolate reductase (MTHFR) 677 and heterozygous MTHFR 1298 mutations. Ten (40%) individuals with hyperhomocysteinemia had hypertension, while only 7 (15.5%) of the remaining 45 patients with normal homocysteinemia level had hypertension (p<0.05). Conclusion: The data from this study suggest that increased homocysteinemia levels are not rare in Turkish people and are associated with an increased risk for hypertension. In Turkish individuals with hyperhomocysteinemia, there may be a high rate of MTHFR 677 polymorphism, as seen in this study. Therefore hyperhomocysteinemic patients should be screened for this mutation.

16-year-old female patient refered to our polyclinic with difficulty in wearing shoe, foot pain, misformation of fifth toe and cosmetic complaints. After examination, left foot polydactyly is diagnosed and the patient has not got any other systemic pathologies and family history. The case presented here differs from frequently seen cases of polydactyly in that the anomaly was postaxial polydactyly (both Y-shaped metatarsal and proximal phalanx duplication). Lateral ectopic toe amputation is generally accepted procedure for the polydactyly surgery. In this case we performed amputation and reconstruction surgery procedure. With the different surgical technique applied in this unusual case, we aimed to achieve successful cosmetic and functional results.

Foreign body ingestion is a significant problem that causes morbidity and mortality in childhood. Ingested foreign bodies could be detected in stomach (60%), esophagus (20%), intestines (11%) and oropharynx (9%). In almost 80% of the cases, the ingested material passes uneventfully through the gastrointestinal tract. Endoscopy is applied in 10-20% and surgery is applied to 1-14% of the cases. Here we report a 8-year-old child who has undergone laparotomy for ileal obstruction due to polyurethane foam ingestion.

Urinoma occurs as a result of as severe urinary obstruction, trauma or endourology interventions. It commonly occurs because of traumas or urinary obstruction. Percutaneous drainage was applied to patients with post-traumatic urinoma. Double J stent of 3.8 Fr was sent to the renal pelvis under fluoroscopy. When the drainage was decreased at the Postop 3rd day, percutaneous catheter was removed and the patient was discharged. In the 3-month follow-up the patient had no clinical complaints of urinary, USG was normal except mild hydronephrosis. Urinoma must be always kept in mind in the follow-up, because urinoma may be seen in the late period in patients with renal trauma. Percutaneous drainage treatment and using Double J stent is sufficient in the patient with urinoma.

Bartter syndrome is a rare syndrome characterized by urinary loss of sodium, potassium, and chloride. This autosomal recessive syndrome encompasses a group of renal tubular diseases. These cases are characterized by hypokalemic metabolic alkalosis, high renin and aldosterone plasma levels, and high levels of prostaglandins in blood and urine. Peripheral block is one of the safest methods of anesthesia. The increasing use of ultrasound has further reduced the doses of drugs used. In addition, peripheral blocks have become more reliable since vascular structures have been more visible. In this paper, peripheral block applications in a 33 years-old case with a preoperative diagnosis of Bartter syndrome is presented.

Epidural block is a well-known and frequently referenced regional anesthesia technique in the field of anesthesia, and has positive effects on the cardiovascular and respiratory systems. While reducing the need for analgesics in patients, there are also negative effects such as hypotension, bradycardia, and cardiac arrest. Epidural anesthesia-induced cardiac arrest rate is stated as approximately 0.01%. The volume decrease in the pre-load of the heart causing secondary vagal response has great effect on cardiac arrest. In this paper a case of cardiac arrest encountered after epidural anesthesia in a very advanced age patient with a low cardiac reserve, and perioperative anesthesia management are presented.

Acute transient postictal blindness is a rare complication of seizures which generally appears in pediatric age group. Normal pupillary reactions and fundoscopic examination are found in postictal cortical blindness. It has been reported as a specific kind of Todd’s paralysis however, Todd’s paralysis most commonly appears in patients suffering from focal seizures. On the other hand, postictal blindness follows generalized seizures. We report a case of the development of transient cortical blindness after febrile convulsion which occurs rarely. We report a pediatric patient who suffered from postictal blindness. Postictal blindness can also occur after febrile convulsions which is very rare.

Urinary tract infections are one of the most common bacterial infections. In terms of gender, women spend more frequent urinary tract infections than men. Although bacterial pathogens in urinary tract infections are more common, fungal infections have begun to increase in recent years. In recent years, increasing fungal infections and increasingly widespread use of antifungal agents caused the emergence of resistant fungi strain and the increasing rate of resistance. Two cases of urinary tract infections that connected to candida strains will be presented to draw attention to this phenomenon gradually increasing frequency.

To present an old patient with Crohn’s disease and hidradenitis suppurativa presented with multifocal abscesses. An 81-year-old female presented with complaints of weight loss, cough, and multiple painful swellings with foul-smelling pus discharge in the groin area. Computed tomography demonstrated multifocal entire the whole gastrointestinal tract. It is of great importance to be aware of this association and the entire gastrointestinal tract should be investigated carefully, because a lack of awareness may lead to insufficient treatment.

Hemoglobin F is the major haemoglobin during intrauterine life because of its oxygen af?nity is higher than that of haemoglobin A and this facilitates oxygen transfer from the mother to the fetus. The level of hemoglobin F in adult life is determined by age, sex and a number of inherited characteristics. Genetic factors are related to the several genes in different chromosomes both linked and unlinked to the ß globin gene cluster. In this review, we focus on hereditary persistence of fetal hemoglobin and the other clinical conditions which are related with elevated fetal hemoglobin.

Diabetes mellitus is a chronic metabolic disease characterized by disturbance of the carbonhydrate and lipid metabolism. Foot ulcer is a serious complication of diabetes mellitus. Peripheral neuropathy in combination with unperceived trauma is the primary causative factor of the diabetic foot ulcer. Prevalence of foot ulcer ranges from 4-10% in patients with diabetes mellitus. The rate of amputation can be reduced by 50% with evidence-based treatment by a multidisciplinary approach in this high-risk group of patients. Diabetic foot ulcers predispose to infection and subsequent amputation even in the absence of critical peripheral vascular disease. Therefore, prophylactic measures and early management should be required to avoid its severe complications.