Σάββατο, 26 Μαρτίου 2016

The Most Influential Scientist in the Development of Medical informatics (11): David B. Shires

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Izet Masic.



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MRI Verification of a Case of Huge Infantile Rhabdomyoma

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Naser Ramadani, Kreshnike Dedushi Kreshnike, Sefedin Muçaj, Serbeze Kabashi, Astrit Hoxhaj, Naim Jerliu, Ramush Bejiçi.
Introduction: Cardiac rhabdomyoma is type of benign myocardial tumor that is the most common fetal cardiac tumor. Cardiac rhabdomyomas are usually detected before birth or during the first year of life. They account for over 60% of all primary cardiac tumors. Case report: A 6 month old child with coughing and obstruction in breathing, was hospitalized in the Pediatric Clinic in UCCK, Pristine. The difficulty of breathing was heard and the pathological noise of the heart was noticed from the pediatrician. In the echo of the heart at the posterior and apico-lateral part of the left ventricle a tumoral mass was presented with the dimensions of 56 x 54 mm that forwarded the contractions of the left ventricle, the mass involved also the left ventricle wall and was not vascularized. The right ventricle was deformed and with the shifting of the SIV on the right the contractility was preserved. Aorta, the left arch and AP were normal with laminar circulation. The pericard was presented free. Radiography of thoracic organs was made; it resulted on cardiomegaly and significant bronchovascular drawing. It was completed with an MRI and it resulted on: Cardiomegaly due to large tumoral mass lesion (60x34 mm) involving lateral wall of left ventricle. It was isointense to the muscle on T1W images, markedly hyperintense on T2W images. There were a few septa or bant like hypointensities within lesion. On postcontrast study it showed avid enhancement. The left ventricle volume was decreased. Mild pericardial effusion was also noted. Surgical intervention was performed and it resulted on the histopathological aspect as a huge infantile rhadbomyoma. Conclusion: In most cases no treatment is required and these lesions regress spontaneously. Patients with left ventricular outflow tract obstruction or refractory arrhythmias respond well to surgical excision. Rhabdomyomas are frequently diagnosed by means of fetal echocardiography during the prenatal period.


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Hashimoto Thyroiditis and Nephrocalcinosis in a Child with Down Syndrome

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Lidvana Spahiu, Haki Jashari, Vjosa Mulliqi-Kotori, Blerta Elezi-Rugova, Besart Merovci.
Introduction: Hypothyroidism has been reported to affect renal function and structure. However, the association of hypothyroidism with distal renal tubular acidosis (dRTA) is rarely reported in children. Case Presentation: We present a 6-year-boy with Down syndrome admitted in our department due to vomiting, weakness, polyuria, polydipsia, irritability and weight loss in the last few weeks. Investigations revealed features of hypokalemia, metabolic acidosis and alkaline urine consistent with dTRA. Abdominal ultrasound found nephrocalcinosis. In addition, Antithyroid peroxidase antibodies were positive, suggesting an autoimmune background for the pathogenesis of the tubular dysfunction. Treatment for dRTA and hypothyroidism was started and symptomatic improve was noticed. Conclusion: dRTA should be excluded in children with autoimmune disorders who develop weakness, polyuria, polydipsia or growth failure. Early diagnosis would reduce long-term complications.


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Bariatric Surgery in University Clinic Center Tuzla - Results After 30 Operations

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Amir Ahmetasevic, Fuad Pasic, Miroslav Bekavac Beslin, Miroslav Ilic, Dzenita Ahmetasevic, Mirza Mesic.
Introduction: Project of Bariatric surgery in University clinic center (UCC) Tuzla has been initiated in 2009 as an idea of professor Deo Meić and soon after that Bariatric surgical team led by doctor Fuad Pasic has been created. Material and methods: Practical team education was realized in Croatia in hospital Sisters of Mercy under supervision of professor Miroslav-Bekavac Beslin. First bariatric operations in UCC Tuzla has been done in 2011 and it was biliopancreatic diversion (BPD) Scopinaro. Results and discussion: So far there has been done 30 operations and among them there have been used almost all operative modalities - restrictive, malabsorptive and combined (laparoscopic gastric banding-LAPGB, Roux-y mini gastric bypass,open and laparoscopic gastric sleeve resection, and over mentioned Scopinaros BPD). Beginning results are very promising according to the fact that almost all operated patients after one year stopped using antihypertensive, antidiabetic and antidepressant therapy, that average years weight loss is 35-100 kilograms and total satisfactions of patients after surgeries is obvious.


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Social Network Sites as Educational Factors

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Alireza Ebrahimpour, Farnaz Rajabali, Fatemeh Yazdanfar, Reza Azarbad, Majid Rezaei Nodeh, Hasan Siamian, Mohammad Vahedi.
Background: in this present era, the technology development has established certain type of communication. Nowadays education as the fundamental principle in transferring cognition to the learners has found various methods. Recently the concept that social networks could be effective tool in easing the achievement to the educational goals has been under attention. Therefore, this investigation is trying to find out whether, the social networks could play role on the process of education among students? Materials and Methods: This cross sectional descriptive study was performed on 1000 students from 7 medical universities in 2015. The data collection tool was questionnaire that was approved Cronbachs alpha was 0.85. Meanwhile its validity was confirmed too. The obtained data were analyzed by the descriptive statistic, ANOVA, Turkey and used X2 SPSS-19. Results: In this investigation, 940 subjects were under study. 85% used daily the social network. The highest usage was attributed to the Telegram. 52% preferred image suitable for transferring of information. Even though, 73% believed that these networks have significant effects on coordinating of students with in university charges. Conclusion: Considering the findings of the present study, it is proposed that the universities integrate the social networks in the education programs and recognize it as the awareness factor, therefore benefit it in the educational affairs.


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Quality of Public Hospitals Websites: A Cross-Sectional Analytical Study in Iran

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Salarvand Shahin, Samadbeik Mahnaz, Tarahi Mohammad Javad, Salarvand Hamed.
Introduction: Nowadays, hospitals have turned increasingly towards the Internet and develop their own web presence. Hospital Websites could be operating as effective web resources of information and interactive communication mediums to enhance hospital services to the public. Aim: Therefore, the aim of this study was to assess the quality of websites in Tehrans public hospitals. Material and methods: This cross-sectional analysis involved all public hospitals in Irans capital city, Tehran, with a working website or subsites between April and June, 2014 (N=59). The websites were evaluated using three validated instruments: a localized checklist, Google page rank, and the Alexa traffic ranking. The mentioned checklist consisted of 112 items divided into five sections: technical characteristics, hospital information and facilities, medical services, interactive on-line services and external activities. Data were analyzed using descriptive and analytical statistics. Results: The mean website evaluation score was 45.7 out of 224 for selected public hospitals. All the studied websites were in the weak category based on the earned quality scores. There was no statistically significant association between the website evaluation score with Google page rank (P=0.092), Alexa global traffic rank and Alexa traffic rank in Iran (P>0.05). The hospital websites had a lower quality score in the interactive online services and external activities criteria in comparing to other criteria. Due to the low quality level of the studied websites and the importance of hospital portals in providing information and services on the Internet, the authorities should do precise planning for the appreciable improvement in the quality of hospital websites.


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Accreditation of Management Communication and Information Systems in Public Hospitals of Sabzevar City, Iran

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Fereshteh Farzianpour, Saeed Shojaei, Mohammad Arab, Abbas Rahimi Foroushani.
Objective: Information systems are computer systems that collect, store, process, retrieve, show, and provide timely information required in practice, education, management, and research. The purpose of these systems is to support hospital activities in practical, tactical, and strategic levels in order to provide better service to patients. This study aimed to evaluate the communication and information system (MCI) in public hospitals in Sabzevar city in 2014 from the perspective of human resources according to international standards of the Joint Commission Accreditation Hospital (JCAH). Methods: This study was a practical, descriptive, cross-sectional study. The study population consisted of Sabzevar nurses who used hospital information system. Sampling was done by classification method and in proportion to the number of nurses in each health care units in hospitals in 2014. The sample size was 200 and after referring to hospitals, 200 questionnaires were completed. Sample size was calculated by the formula n=Z2P (1-P)/d2 with P=0.5, α=0.05, d=0.05, and Z=1.96. Data collection tool was the questionnaire of assessment of hospital information systems of JCAH, which has 124 specific questions, including 6 areas. To assess the effect of demographic variables with MCI standards of two questionnaires (feasibility and implementation), the following steps were taken. 1. Kolmogorov-Smirnov test was used to determine whether responses were normal or not. 2. In case of normal data, t-test was used for dual groups and one-way ANOVA test for groups of three or more. 3. If not normal, Mann-Whitney test was used for dual groups and Kruskal-Wallis test for groups of three or more. Results: Research findings show the mean results of feasibility and implementation of all 6 areas of international standards MCI have feasibility in three hospitals in Sabzevar in 20 sections (H1=105.01±10.468), (H1=196.31±4.662), (H2=104.26±9.099), (H2=195.33±3.778) (H3=106.48±11.545) and (H3=197.57±4.943), respectively. Conclusion: The results showed that the mean feasibility and implementation of all six areas of MCI international standards is practical in three hospitals in Sabzevar in 20 wards. Also, 50% of users in clinical departments, physicians, and nurses agreed to appropriateness of the hospital information and communication systems for doing their duties.


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Conceptual Model of Clinical Governance Information System for Statistical Indicators by Using UML in Two Sample Hospitals

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Fatemeh Rangraz Jeddi, Mehrdad Farzandipoor, Masoud Arabfard, and Azam Haj Mohammad Hosseini.
Objective: The purpose of this study was investigating situation and presenting a conceptual model for clinical governance information system by using UML in two sample hospitals. Background: However, use of information is one of the fundamental components of clinical governance; but unfortunately, it does not pay much attention to information management. Material and Methods: A cross sectional study was conducted in October 2012- May 2013. Data were gathered through questionnaires and interviews in two sample hospitals. Face and content validity of the questionnaire has been confirmed by experts. Data were collected from a pilot hospital and reforms were carried out and Final questionnaire was prepared. Data were analyzed by descriptive statistics and SPSS 16 software. Results: With the scenario derived from questionnaires, UML diagrams are presented by using Rational Rose 7 software. The results showed that 32.14 percent Indicators of the hospitals were calculated. Database was not designed and 100 percent of the hospitals clinical governance was required to create a database. Conclusion: Clinical governance unit of hospitals to perform its mission, do not have access to all the needed indicators. Defining of Processes and drawing of models and creating of database are essential for designing of information systems.


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Determination of Minimum Data Set (MSD) in Echocardiography Reporting System to Exchange with Iran’s Electronic Health Record (EHR) System

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Zahra Mahmoudvand, Mehran Kamkar, Leila Shahmoradi, Ahmadreza Farzaneh Nejad.
Background: Determination of minimum data set (MDS) in echocardiography reports is necessary for documentation and putting information in a standard way, and leads to the enhancement of electrocardiographic studies through having access to precise and perfect reports and also to the development of a standard database for electrocardiographic reports. Aim: to determine the minimum data set of echocardiography reporting system to exchange with Irans electronic health record (EHR) system. Methods: First, a list of minimum data set was prepared after reviewing texts and studying cardiac patients records. Then, to determine the content validity of the prepared MDS, the expert views of 10 cardiologists and 10 health information management (HIM) specialists were obtained; to estimate the reliability of the set, test-retest method was employed. Finally, the data were analyzed using SPSS software. Results: The highest degree of consensus was found for the following MDSs: patients name and family name (5), accepting doctors name and family name, familial death records due to cardiac disorders, the image identification code, mitral valve, aortic valve, tricuspid valve, pulmonary valve, left ventricle, hole, atrium valve, Doppler examination of ventricular and atrial movement models and diagnoses with an average of. Conclusions: To prepare a model of echocardiography reporting system to exchange with EHR system, creation a standard data set is the vital point. Therefore, based on the research findings, the minimum reporting system data to exchange with Irans electronic health record system include information on entity, management, medical record, carried-out acts, and the main content of the echocardiography report, which the planners of reporting system should consider.


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Design and Development of a Clinical Risk Management Tool Using Radio Frequency Identification (RFID)

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Faramarz Pourasghar, Jafar Sadegh Tabrizi, Khadijeh Yarifard.
Background: Patient safety is one of the most important elements of quality of healthcare. It means preventing any harm to the patients during medical care process. Objective: This paper introduces a cost-effective tool in which the Radio Frequency Identification (RFID) technology is used to identify medical errors in hospital. Methods: The proposed clinical error management system (CEMS) is consisted of a reader device, a transfer/receiver device, a database and managing software. The reader device works using radio waves and is wireless. The reader sends and receives data to/from the database via the transfer/receiver device which is connected to the computer via USB port. The database contains data about patients medication orders. Results: The CEMS has the ability to identify the clinical errors before they occur and then warns the care-giver with voice and visual messages to prevent the error. This device reduces the errors and thus improves the patient safety. Conclusion: A new tool including software and hardware was developed in this study. Application of this tool in clinical settings can help the nurses prevent medical errors. It can also be a useful tool for clinical risk management. Using this device can improve the patient safety to a considerable extent and thus improve the quality of healthcare.


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The Diagnostic Value of MRI in Brucella Spondylitis With Comparison to Clinical and Laboratory Findings

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Ali Baradaran Bagheri, Koorosh Ahmadi, Niaz Mohamad Jafari Chokan, Bita Abbasi, Reza Akhavan, Ehsan Bolvardi, Somayeh Soroureddin.
Background: Brucellosis is an endemic zoonotic disease, especially in the Middle East and Mediterranean regions and can involve many organs and tissue. Osteoarticular involvement is the most common complication. Spondylitis is its most prevalent clinical form in adults, and there may be difficult in diagnosis and treatment. In present study, we aimed to assess these diagnostic value of MRI, in patients with spondylitis due to brucella, comparing with clinical and laboratory findings. Method: Patients with low back pain who were admitted to Sheikhol-raees MRI center were included in this study. None of these patients had any documented infectious disease. Diagnosis of brucellosis was made, based on MRI findings, which would be approved by serology. After confirmation with serology, the group with positive serology were compared with the negative group, in sex, age, MRI findings level of vertebral involvements, signal intensity in T1 weighted and T2 weighted. Results: Among 53 patients with diagnosis of brucella spondylitis, 33 underwent serology study, 20 were positive and 13 were negative and the others consider out of study. From these 20, 3 had tuberculosis spondylitis, whose mean age was 56 and the 67% of them were male. Mean age in the positive brucella spondylitis were 46 and 67% of them were male. In negative group mean age was 55, and of whom 57% were male. There was no statistically significant difference in MRI findings such as changes in signal intensity, disk space narrowing, Intracanalicular mass, Abscess formation. Level of invlovment in vertebrae. Conclusion: The results of this study shows that although MRI is Modality of choice in diagnosis of spondylitis, it is not enough specific to diagnosis the reasons of spondylitis.


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The Significance of MRI Evaluation of the Uterine Junctional Zone in the Early Diagnosis of Adenomyosis

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Amela Sofic, Azra Husic-Selimovic, Aladin Carovac, Elma Jahic, Velda Smailbegovic, Jana Kupusovic.
Goal: The aim of the study is to define the MRI appearance of disorder in the Junctional zone (JZ) in women with adenomyosis compared to those without it, given the importance of the JZ in the regulation of various reproductive events. Materials and methods: This was a prospective, comparative and open study. Patients with adenomyosis have been sorted in target group, n = 82, while the control group consisted of patients without adenomyosis, n = 82. All patients, from both groups have undergone a magnetic resonance imaging of the pelvis. Using a software tool for measurement, the thickness of the JZ was measured in T2w sag sequences in all patients from both groups (target and control) n = 164. Patients in the target group type adenomyosis were assessed and categorized either as: diffuse, focal, or Adenomyoma and the results were compared. The presence of endometriosis and myomas in both groups was evaluated and its coexistence with adenomyosis was analyzed as well. Results: Of the 82 patients in the target group, 81.7% of the patients had diffuse adenomyosis, while 18.3% had focal type with statistically significant difference (p


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Advantages of Combined PET-CT in Mediastinal Staging in Patients with Non-small Cell Lung Carcinoma

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Nermina Beslic, Amera Sadija, Renata Milardovic, Timur Ceric, Sejla Ceric, Adnan Beganovic, Spomenka Kristic, Semra Cavaljuga.
Introduction: Precise mediastinal lymph node staging in patients with non-small cell lung carcinoma (NSCLC) provides important prognostic information and it is obligatory in treatment strategy planning. 18Fluoro-deoxy-glucose (18F-FDG) positron emission tomography - computerized tomography (PET-CT) based on detection of metabolic activity showed superiority in preoperative staging of lung carcinoma. Materials and Methods: Total number of 26 patients diagnosed with NSCLC were included in this retrospective, cross-sectional study. Status of mediastinal lymph nodes was assessed in all patients comparing contrast enhanced CT and 18F-FDG PET-CT findings. Discussion: We found in our study that 50% of patients had different N stage on contrast enhanced CT comparing to 18F-FDG PET-CT findings. Among the total number of patients which had different nodal status on PET-CT comparing to CT alone, we found in our study that 54% of patients had change in further therapy protocol after PET-CT change of nodal stage. Conclusion: Combined PET-CT which offers advantages of both modalities is excellent method for nodal (N) staging, so it is recommended in initial staging in patients with NSCLC. PET-CT used preopratively for mediastinal nodal staging has significant impact on further therapy planning and also has an consequential impact on health system savings.


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Evaluation of Diagnostic Methods in the Differentiation of Heart Murmurs in Children

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Zijo Begic, Senad Pesto, Senka Mesihovic Dinarevic, Edin Begic, Amra Dobraca, Izet Masic.
Introduction: The most common clinical sign in pediatric cardiology is a heart murmur (organic and inorganic). Organic are sign of heart disease, while inorganic (basically divided into accidental and functional) murmurs occur on anatomically healthy heart.. Aim: To determine the justification of the application of the methods of cardiac treatment. Patients and methods: Study included 116 children aged from 1 to 15 years, who were referred due to cardiac treatment to Pediatric Clinic, of Sarajevo University Clinical Center. Results: The first group consisted of children with innocent heart murmur, 97 (53 males). The second group consisted of patients with organic murmur, 19 (13 males). The average age of the first group was 7.69 (1.0115.01) years old, and of the second group 3.15 (1.01- 8.06) years old, and there is a significant difference between these two groups (p


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Use of Databases for Early Recognition of Risk of Diabetic Complication by Analysis of Liver Enzymes in Type 2 Diabetes Mellitus

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Maja Malenica, Besim Prnjavorac, Adlija Causevic, Tanja Dujic, Tamer Bego, Sabina Semiz.
Introduction: Because of increasing prevalence of T2MD worldwide, its very important to recognize risk factors for diabetic complications, as soon as possible. Symptoms of complications appear a few or many years after tissue damage. So, its imperative to establish surveillance of diabetics with laboratory and other diagnostic procedures for early recognition of diabetic complications. Follow up of clinical curs of diabetes, by using databases of patients, provide possibility for permanent analysis of important laboratory parameters and any changes could be registered. Although an emerging evidence suggests a strong association of ALT (alanine aminotransferase) and γGT (gamma glutamyl transferase) activity with type 2 diabetes mellitus (T2DM), only a limited number of studies have analyzed the association of AST (aspartate aminotransferase), ALT, γGT, and ALP (alkaline phosphatase) activities in controlled T2DM. Material and Methods: Gender differences are of special interest in trying to follow diabetes progression and development of its complications. Here the activities of ALT, AST, γGT, ALP were analyzed as well as levels of glycosylated hemoglobin (HbA1c) and fasting plasma glucose (FPG) in 40 T2DM patients and 40 age-matched healthy subjects. Blood samples were collected from all participants in regular 3-months intervals up to 6 months period. Standard IFCC enzyme protocols were used to determine enzyme activities. Results and discussion: In first measured interval, significantly higher activities of ALT (p= 0,050) and glucose levels (p=0,045) were shown in male. A significant correlation was shown between ALT and AST activity with FPG and HbA1c levels in first and third measured interval. ALT activity was much higher in the group of patients with poor glycemia control. Average levels of activities of enzymes stay nearly in normal limits, but changes of enzymes activities should be recognized as soon as possible, earlier than tissue changes and diabetic complications become irreversible.


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Review of the Journal Acta Informatica Medica During Eight Year Period: 2008-2015

2016-03-26T19-34-37Z
Source: Acta Informatica Medica
Izet Masic, Edin Begic, Lejla Zunic.
Introduction: Acta Informatica Medica is official journal of the Academy for Medical Sciences of Bosnia and Herzegovina (from 2014 Acta Inform Med is published bimonthly). Aim: To evaluate journal Acta Informatica Medica in 2015 and compare findings to previous years. Material and methods: The study has retrospective and descriptive character, and included the period 2008-2015 (included 36 issues of journal). Results: A total of 83 (average 13,8 articles per journal) articles were published in Acta Informatica Medica during 2015. Analyzing the type of articles, original articles are present in majority during 2015 (68,6%) (by analyzing last eight years, 310 (67,3%) were original). During 2015, 27,7% of articles were related to the applied of Health informatics in field of clinical medicine, 63,8% preclinical medicine and 8,5% to public health. Collaboration rate in 2015 was 0,84. Most often the time required for decision on acceptance of article in 2015 is between 50 and 60 days. Articles came from 16 countries. According to scimagojr.com for 2014, Acta Informatica Medica has SCImago Journal Rank 0,166, while Cites / Doc. (2years) parameter (widely used as impact index) is 0,70. According to GoogleScholar, h5 index is 11 and h5 median is 19. We analyzed the Acta Informatica Medica by Publish or Perish software - H index was 14, g index was 19 and e-index was 10.39. Conclusion: Year after year the highest number of original articles are published. Although the period of revision of articles is acceptable, the period up to two months is certainly not long, the goal is to reduce this period. Although the magazine in mentioned field found its place, although it is indexed in numerous bases, including: PubMed, PubMed Central, SCOPUS, EMBASE, EBSCO, etc. The main goal for next year is that the magazine becomes part of the Web of Science. Imperative is further internationalization of the magazine.


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Evaluation of analgesic and antipyretic activity of Nigella sativa: an experimental study

2016-03-26T06-34-15Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Harshal N Pise, Sushma S Jadhav.
Background: Drugs commonly used in modern medicine for suppression of pain and fever provide only symptomatic relief, and long-term use of these drugs is associated with serious adverse effects. Recently, some evidences suggest that Nigella sativa inhibit eicosanoid generation in leukocytes and lipid peroxidation. They are reported to inhibit both cyclooxygenase and 5-lipooxygenase pathways of arachidonic acid metabolism (Houghton et al. Planta Med 1995;61:336). Aims and Objectives: To investigate the analgesic and antipyretic activity of N. sativa seed fixed oil and compare it with control and aspirin. Materials and Methods: Albino Wistar rats of either sex weighing 180200 g and Swiss mice weighing 2530 g were used. The study was conducted after approval from the Institutional Animal Ethics Committee. The tail flick method in rats described by DAmour and Smith and acetic acid-induced writhing in mice were used for evaluation of analgesic activity and bakers yeast-induced pyrexia method was used to evaluate antipyretic activity. Result: In tail flick method of analgesia, N. sativa showed analgesic activity, which was comparable with aspirin. In acetic acid-induced writhing model of analgesia, the action of N. sativa was significantly greater than the control group, and it was comparable with aspirin. In bakers yeast-induced pyrexia method, N. sativa group did not show any significant reduction in the rectal temperature at any hour interval. The changes in the rectal temperature in N. sativa group were comparable with control group (p > 0.05). Conclusion: Nigella sativa fixed oil has significant analgesic activity in both tail flick and acetic acid-induced method of analgesia. But, it does not have any significant antipyretic activity in bakers yeast-induced pyrexia method.


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Anti-inflammatory and analgesic activity of aqueous extracts of dried leaves of Murraya koenigii Linn.

2016-03-26T06-34-15Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Ateendra Singh, Anamika Singh, Omi Chouhan, Gyan Prakash Tandi, Mitali Dua, Anusuya Gehlot.
Background: Murraya koenigii, commonly known as karipatta or curry leaf, is analgesic and can be used effectively against inflammation and itching. The various pharmacological activities such as vasodilation, antimicrobial, antidiabetic, antiulcer, analgesic, phagocytic, and antioxidant activities of this plant have also been reported. Aims and Objectives: To evaluate the anti-inflammatory and analgesic activity of aqueous extract of dried leaves of M. koenigii Linn. in male Wistar rats. Materials and Methods: Adult male Wistar rats (100150 g body weight) were used in this study. Aqueous extract of M. koenigii Linn. was used to evaluate acute anti-inflammatory and analgesic activity by plethysmometer and hot plate method by oral administration at doses of 100, 300, and 500 mg/kg body weight in healthy albino rats. Result: In acute studies, the aqueous extract showed anti-inflammatory activity by significant reduction in the paw edema volume, in a dose-dependent manner when compared with the control and standard drug. Aqueous extract of M. koenigii Linn. significantly and dose-dependently reduced the number of acetic acid-induced writhing and significantly increased the latency of paw licking in hot plate method. Statistical analysis was carried out by one-way ANOVA, followed by Turkey's test. Conclusion: Aqueous extract of M. koenigii Linn. possesses both anti-inflammatory and analgesic activity in a dose-dependent manner.


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Negative pressure pulmonary edema during laryngeal mask use: a case report

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Aysun Postacı, Özlem Saçan, Ayfer N Yılmaz, Dilşen Örnek, Gülçin H Alay, Nermin Göğüş.
Negative pressure pulmonary edema (NPPE), a non-cardiogenic pulmonary edema, develops due to airway obstruction. Young, healthy, male patients, who have a lot of muscle mass that can lead to produce high negative intra-pleural pressure (athletes pulmonary edema syndrome, APS), are under the risk of developing NPPE. Usually, NPPE develops after extubation in patients who undergo endotracheal intubation however; there are some case reports showing that it can develop after laryngeal mask application (LMA) even in a less manner. The most possible reasons lead to airway obstruction during LMA use are biting of laryngeal mask tube, misplacement of tube, and laryngospasm. This case report presents a patient who undergoes LMA and develops NPPE due to laryngospasm during recovery from anesthesia.


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The revised conflict tactics scales (CTS2): validity and reliability study

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Yılda Arzu Aba, Özen Kulakaç.
Objective: The aim of this dissertation was to evaluate the validity and reliability factors of the Turkish version of CTS 2 Scale (The Revised Conflict Tactics) which was developed by Straus, Hamby, Boney-McCoy, & Sugarman in 1972 and renewed in 1996. Material and Methods: The sample of this research involved 624 female and male who were students of the faculties and colleges of Akdeniz (Mediterranean) University. The research data was collected by CTS 2 Scale that is consisted of 78 items in February-May 2007. For evaluation, Kendall W Analyis, Up and Down Average, Test and Retest methods; Cronbach Alpha Analysis and Pearson Moments Product Correlation methods were used. Results: As for the CTS 2s language validity analysis, the questionnaire was firstly translated into Turkish after then was translated back into English. Results: The content validity was performed by 6 specialists and it was found that there was not any differences among them (W = 0.247, p>0.05). The scale and its subdivisions test and retest reliability coefficients were 0.97-1.00 (p=0.00), and inner consistent coefficients were from 0.76 to 0.89. In addition, it was found that 27% of the scales up and down groups average was totally meaningful and corrected total item coefficients were enumerated 0.17 and 0.68. Since the 9 item whose value was under 0.20 did not affect the whole reliability of the scale, it was decided not to take them out of the scale. Conclusion: The Revised Conflict Tactics Scales Turkish translation was determined as reliable and valid meant to measure the dating violence among Turkish university students. As for the new researches, it was recommended to apply the CTS 2 on different groups that carry different socio-demographic features and analysis of the validity and reliability of the Turkish version of CTS 2.


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The predictive and prognostic value evaluation of serum extracellular matrix proteins levels in patients with pancreas adenocarcinoma

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Senem Karabulut, Mehmet Karabulut, Halil Alış, Nergiz Dağoğlu, Makbule Tambaş, Selin Kapan, Ebru Oran, Hilal Oğuz, Faruk Taş.
Objective: Fibronectin (FN),vitronectin (VTN), and tip IV kollagen (Kol IV) are the important components of the extracellular matrix (ECM) proteins. The objective of this study was to determine the clinical significance of serum levels of these molecules in pancreas adenocarcinoma (PA) patients. Material and Methods: A total of 33 patients with a pathologically confirmed diagnosis of PA and age- and sex-matched 30 healthy controls were enrolled into this study. Serum FN, VTN, and Kol IV concentrations were determined by the enzyme-linked immuno-sorbent assay (ELISA) method. Results: The median age at diagnosis was 59 years, range 32 to 84 years where 61% of the patients were male. Majority of the patients (70%) had good performance status (0-1). The most common tumor localization was head of pancreas (68%). Of the 9 patients who undergone surgical intervention, 5 patients (15%) had pancreaticoduodenectomy, while palliative surgery was performed in the remaining 4 (12%) patients. The baseline serum FN, VTN, and Kol IV levels were significantly higher in patients with PA than in the healthy control group (p=0.001, p=0.007 and p


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A practical approach in difficult intubation: use of gum elastic bougie on 10 cases

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Uğur Altınışık, Mesut Erbaş, Hasan Ali Kiraz, Tuncer Şimşek, Hatice Betül Altınışık, Fatoş İpek Türk, Hüseyin Toman, Hasan Şahin.
Objective: When faced with unexpected difficult intubation, despite all the technological advances, there is still a need of equipments that are easy to use and very reachable. In this study,we offer our experiences in use of gum elastic bougie in 10 cases with unexpected difficult intubation in our operation rooms. Material and Methods: In Çanakkale 18 March University Medical Facultys Operating Rooms and between the years 2013-2014, all the encountered unexpected difficult intubation cases are classified and the patients who has Mallampati score I-II and having any airway pathology evaluated for the use of Gum elastic bougie (GEB). Auxiliary equipments used in intubation, number of intubation attempts, number of anesthesiologists who tried for intubation, the number of trials with GEB and the complications due to the use of GEB were recorded. Results: A total of 10 cases with unexpected difficult intubation were included in the study. All of the cases were male and intubation was attempted with size 4 blades. Stylet in 6 cases, fast trach laryngeal mask in 1 case were used after unsuccessful intubation attempts. However the use of this equipments patients couldnt be intubated and after at least 3 three attempts GEB used this time for intubation. An experienced anesthesiologist with the help of GEB intubated all the patients at once. There were no complications related to the use of GEB. Conclusion: GEB is widely used in European countries for unexpected difficult intubation. In our patients, despite the absence of any complications, due to the blind insertion of bougie trauma cases have been reported. GEB when performed by an experienced anesthesiologist is a good alternative airway equipment in unexpected difficult airway management, because its inexpensive, easy to use and portable.


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Relationship between vitamin B12, homocysteine and oxidative stress in juvenile idiopathic arthritis

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Nihan Çakır Biçer, Emine Aksoydan, Çiğdem Aktuğlu Zeybek, Kenan Barut, Özgür Kasapçopur.
Juvenile idiopathic arthritis (JIA), which is one of the rheumatic diseases, is a systemic inflammatory disease characterized by chronic and erosive synovitis that involves peripheral joints. In patients who had been diagnosed with JIA, increasing proinflammatory cytokines, metabolic abnormalities associated with systemic inflammation, may provoke vascular endothelial damage which can cause atherosclerosis. Homocysteine is another metabolite among the factors causing endothelial dysfunction. Homocysteine is an intermediate metabolite which is formed during the conversion of methionine to cysteine and high levels of homocysteine in blood can lead to vascular damage. Dietary folate and vitamin B12 deficiency can cause an increase in blood homocysteine levels. Vitamin B12 is essential for the transfer of methyl group and cell division in humans, but it is also important for the proliferation, maturation and regeneration of the nerve cells. In addition, functional vitamin B12 deficiency in which blood vitamin B12 level is in the normal range and without severe clinical symptoms like anemia has also been reported. Studies have showed that vitamin B12 deficiency can lead to oxidative stress without causing significant increase in homocysteine levels by its effects on cytokines, growth factors, nitric oxide metabolism, antioxidant enzymes and producing reactive oxygen species.


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Differences between adolescent and adult cases of suicidal drug intoxication

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Halil Dogan, Lokman Adıgüzel, Emin Uysal, Sezgin Sarıkaya, Dogac Niyazi Ozucelik, Yıldız Okuturlar, Tufan Akın Gıray, Afşin Emre Kayıpmaz, Mustafa Yazıcıoglu, Cem Sisek.
Objective: Drug intoxications are among the major causes of emergency department admissions. There is a limited number of studies exploring the differences between adolescent and adult cases of intoxication. We aimed to compare adolescent and adult cases of drug intoxication to determine demographic and clinical properties of intoxications and necessary measures that have to be taken in both age groups. Material and Methods: Adolescent (9-19 years of age) and adult (19 years or older) cases of drug intoxication that presented to our Emergency Department between 1 June 2009 and 30 June 2010 were retrospectiely reviewed. Age, sex, purpose of drug intake, whether or not an antidote was used, single- or multi-drug intake, the group of the offending drug, duration of hospital stay, and clinical outcomes were recorded. Results: This study included a total of 278 patients, of which 39.2% (n=109) were adolescent and 60.8% (n=169) were adult. Among adolescents, 15.6% (n=17) were male and 84.4% (n=92) were female while %20.1 (n=34) of adults were male and 79.9% (n=139) were female. The mean age was 16.68±1.774 years in the adolescents and 27.87±7.264 in the adults. An antidote was used in 30% (n=3) of the adolescents and 70% (n=7) of the adults. Suicidal drug intake formed 39.2% (n=109) of the cases in the adolescents and 60.8% (n=169) in the adults. Multi-drug intake had a rate of 51.9% (n=42) in the adolescents and 48.1% (n=39) in the adults. Paracetamol was the offending agent in 46.9% (n=23) of the adolescents, while antidepressnats were responsible for 65.2% (n=30) of the drug intoxications in the adults. Duration of hospital stay was 1.19±0.775 hours in the adolescents and 1.15±0.617 hours in the adult cases. None of the patients in both groups died. Conclusion: Acute intoxications are an important medical problem for emergency departments. The most common suicide method is drug intake. Drug intoxications were more prevalent in women in both adolescent and adult age groups. Suicidal drug intoxications were more common in the adults compared to the adolescents. Paracetamol was the most commonly taken drug in the adolescents while antidepressants were the most common drugs in the adults. Multi-drug intake was more common in the adolescents than the adults. It is possible to reduce the number of drug intoxications by determining risk factors, taking necessary measures, and planning appropriate population-based educational activities.


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Retroperitoneal extra-adrenal paraganglioma: case report

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Ebubekir Gündeş, Faruk Aksoy, Halil İbrahim Taşcı, Osman Yılmaz.
Paraganglioma (PG), also known as extra-adrenal pheochromocytoma, is a rare neuroectodermal tumor. The incidence of extra-adrenal paraganglioma is between 00.1-0.1%. Paragangliomas originating from the retroperitoneum are generally functional. 40-50% of them are malignant and they generally have a slow progression. Surgical resection and radiotherapy are the preferred methods for the local treatment of these tumors. A case with a tumor localized in the retroperitoneal space that was totally resected by surgical method was evaluated.


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Atypical spinal tuberculosis: posterior paravertebral spread

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Erkam Kömürcü, Betül Kızıldağ, Şule Koşar, Tarık Akman.
Spinal tuberculosis phenomenon that is an extra pulmonary form of tuberculosis infection, the prognosis of which changes dramatically by early diagnosis and treatment, is still a significant health problem. While early diagnosis and treatment of typical spinal tuberculosis progressing typically is performed without any problems, incorrect treatment of spinal tuberculosis cases presenting atypical findings can lead to dramatic results despite the improvement in modern imaging techniques. In our study we aimed to present an atypical spinal tuberculosis case, for which a correct diagnosis based on abscess and fistula on the thigh that is unique in literature with accompanying pseudomonas co-infection presenting as an undefined atypical spread.


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Spontaneous perforation of pyometra; a rare cause of acute abdomen: report of a case

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Süleyman Bozkurt, Tuba Atak, Halil Coşkun.
Pyometra is defined as pooling of purulent material in the uterine cavity. We report a perforated pyometra presented with acute abdomen who was initially diagnosed as gastrointestinal perforation. A 68 year old woman was admitted as an emergency having developed sudden lower abdominal pain. Plain abdominal X-ray revealed free air in the peritoneal cavity. At laparotomy, enlarged perforated uterus of 12x7x4 cm in size was revealed. Hysterectomy and bilateral salpingooophorectomy was performed. Postoperative period was uneventful. Patient was discharged at thirteenth day. Although rare, perforation of pyometra should be considered in the differential diagnosis in an elderly woman with an acute abdomen.


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Plasma calprotectin values in acute pancreatitis

2016-03-26T00-59-29Z
Source: Bakırköy Tıp Dergisi
Murat Çikot, Asuman Gedikbaşı, Osman Köneş, Mehmet Karabulut, Ali Kocataş, Cevher Akarsu, Kaplan Baha Temizgönül, Selin Kapan, Halil Alış.
Objective: To investigate the usefulness of the plasma calprotectin values for diagnosis of acute pancreatitis. Material and Methods: 84 patients who have been diagnosed as acute pancreatitis (AP) were included in this prospective study. Control group (CG) included 30 patients with elective surgery for inguinal hernia or pilonidal sinus. Male to female ratio was 36/48 with a mean age of 44 (19-81) for AP group and male to female ratio was 20/10 with a mean age of 31 (21-56) for control group. Blood samples were taken to EDTA coated tube and then aliquots of serum were stored at -80°C for assaying. Serum Cal was determined using Cal ELISA Kit. Results: Cal values were significantly higher in AP cases than in control group (p=0.001), value range from 32 to 490 ng/ml. There was a statistically positive significant relationship between cal and WBC values (r=0.423 p=0.0001), between cal and CRP values (r=0.282 p=0.012), between cal and amylase values (r=0.675 p=0.0001), between cal and lipase values (r=0.595 p=0.0001). Conclusions: Plasma calprotectin levels increase nonspecifically with AP. Further studies are needed with larger number of patients who were classified according to the severity of AP.


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A cross sectional study of alcohol consumption among tribals and non-tribals adults of Narayanganj block in Mandla district of Madhya Pradesh, India

2016-03-26T00-13-53Z
Source: International Journal of Community Medicine and Public Health
Rahul Kewal Kumar, Rajesh Tiwari.
Background: Alcohol consumption is widely prevalent habit among tribal & non-tribal. Awareness about its hazardous effects is important to reduce the number of alcohol users and its dependency in them. A main objective of the study is to find out the magnitude of alcohol consumption among tribal & non-tribal & its association with hypertension. Methods: A cross sectional study using Multi stage sampling method with house to house visits. Sample size came out 300 each from the tribal & non-tribal adults. Study was conducted in Narayanganj block of Mandla district. Results: Among tribal study subjects about 29.3% of the subjects consumed alcohol whereas in non-tribal this was 14.3% & this difference was found to be statistically significant (P


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A cross sectional study to assess the client’s satisfaction with services provided at integrated counselling and testing centers for HIV/AIDS in selected districts of Madhya Pradesh

2016-03-26T00-13-53Z
Source: International Journal of Community Medicine and Public Health
Sanjay Kumar Chourasiya, Satish Saroshe, Sanjay Dixit, Shiv Shankar Swami, Salil Sakalle.
Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is one of the global pandemic that continues to spread at an alarming rate with over 6,000 new infections per day. The purpose of this work was to ascertain the satisfaction of the clients by the services provided at the ICTCs centers. Methods: A cross sectional study was conducted among clients attending Integrated Counselling and Testing Centers (ICTC) centers located at district hospitals of Indore division. The study was conducted keeping in consideration the original guidelines issued by the National AIDS Control Organization (NACO) and Madhya Pradesh State AIDS prevention and Control Society (MPSACS) during the inception of the integrated counselling and testing centers. The clients were clients served by selected ICTCs. Sample size was calculated by using OpenEpi software, version 2. Results: The present study highlights the fact that among the clients interviewed, male contribute (66.56%) while female clients comprised 34.45%. According to the study 90.8% of clients were aged between 18-50 years (the most sexually active age group). The study found that nearly one quarter (21.85%) of the clients were of direct walk in type, which is lower than a study conducted integrated counseling and testing centre (ICTC) of a tertiary care hospital (27%). There was low intention to share the test results with partners only 55.8% (N=86) this may be due to poor communication between partners due to traditional beliefs in our society, difficulty in discussing sensitive subjects such as sex, among the clients who received their test result. Conclusions: Majority of the clients were satisfied with the services provided at the ICTC. Illiterate clients were more satisfied as compared to the literate clients. More female clients were share the test result with their partner compared to male clients.


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