Archives of Current Medical Research <p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">E-ISSN:</span></span></strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> 2717-9788</span></span></p> <p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Please use Dergipark system for new submissions from link below.</span></span></strong></p> <p><a href=""><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"></span></span></strong></a></p> <p><span style="vertical-align: inherit;"><strong><span style="vertical-align: inherit;">Abstracting and Indexing:</span></strong><span style="vertical-align: inherit;"> EuroPub, Directory of Research Journal Indexing, Eurasian Scientific Journal Index, J-Gate, Scientific Indexing Services (SIS), CiteFactor, Asos İndeks, Türkiye Atıf Dizini, TurkMedline Google Scholar, Crossref</span></span></p> <p>Archives of Current Medical Research (ACMR) is an international, peer-reviewed, open-access scientific journal for publication of original medical, pre-clinical and clinical research, case reports, reviews and letters about all areas of medicine, dentistry and related medical disciplines. 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Key the references (double-spaced) at the end of the manuscript. EndNote users can access a direct download of the updated ACMR Publications style at </em></strong><a href=""><strong><em></em></strong></a></p> <p><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> <strong><a href=""><img src="" alt="" width="142" height="67" /></a> </strong> </span></span></span></span></p> en-US <p>Others can remix, tweak, and build upon your work non-commercially, and although their new works must also acknowledge you and be non-commercial, they don’t have to license their derivative works on the same terms.</p> <p> </p> (Hasan Serdar Öztürk, MD, PhD. Professor of Medical Biochemistry) (Mutluhan Alban) Mon, 27 Sep 2021 11:14:04 +0000 OJS 60 Roles of the Ratio of C-Reactive Protein to Serum and Pericardial Fluid Albumin Levels in Predicting in-Hospital Mortality in Patients Undergoing Pericardiocentesis <p><strong>Background: </strong>Pericardial effusions occur due to excessive fluid accumulation in the pericardial space. In effusions not responding to medical treatment, pericardiocentesis is an important method of treatment affecting prognosis. CRP/albumin ratios have been found to be associated with prognosis in conditions such as cardiac failure, sepsis, malignancy; and the routine available parameters used for the prognosis prediction of the patients who underwent pericardiocentesis are limited. In this study, we aimed to examine the usability of CRP/albumin and CRP/pericardial fluid albumin (CRP/pf-albumin) ratios as predictors for in-hospital mortality of patients who underwent pericardiocentesis.</p> <p><strong>Methods: </strong>This study included 54 patients (25 females and 29 males). All patients underwent pericardiocentesis.</p> <p><strong>Results: </strong>The average age was 67±14 years. When the groups were compared with each other, CRP, CRP/albumin ratio and CRP/pf-Albumin ratio were higher in the in-hospital mortality group compared to the group discharged with recovery [19 (14-25), 6.3 (1-30), p&lt;0.001; 4.27 (3.87-12.02), 1.9 (0.24-10.38), p&lt;0.001; 7 (6.25-13.59), 2.5 (0.28-12.22), p&lt;0.001, respectively]. In the univariate logistic regression analysis, CRP (odds ratio [OR]: 0.821, P: 0.004, 95.0% confidence interval [CI]: 0.918-1.049), CRP/albumin ratio (OR: 0.600, P: 0.011, 95.0% CI: 0.406-0.888) and CRP/pf-Albumin ratio (OR: 0.608, P: 0.004, 95.0% CI: 0.431-0.856) was found to be associated with in-hospital mortality in patients who underwent pericardiocentesis.</p> <p><strong>Conclusion: </strong>For the first time in the literature, we demonstrated that CRP/albumin and CRP/pf-Albumin ratios are associated with in-hospital mortalities in patients who underwent pericardiocentesis, irrespective of the etiology.</p> Uğur Küçük, Emine Gazi, Bahadır Kırılmaz Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Low Platelet Level May be a Predictor for Mortality in Adult Patients with Common Variable Immune Deficiency <p><strong>Introduction: </strong>Common variable immunodeficiency (CVID) is the most common symptomatic immunodeficiency in adults. We aimed to reveal mortality rates, causes of mortality in CVID patients as well as demographic and clinical characteristics and differences of survived and dead CVID patients, and the effect of platelet counts on mortality in these patients.</p> <p><strong>Materials and methods: </strong>The study group included 50 patients [(Female: 23 (46%), Male: 27 (54%)] with CVID, who were followed-up at regular basis for a period of ten years (115.18 ± 80.74 months).</p> <p><strong>Results: </strong>Diagnostic delay was 84 (0-360) months and the mean follow-up time was 115.18 ± 80.74 months. The most common clinical presenting complaints were frequent and recurrent infections and pneumonia. Of the patients; 30% had lymphopenia, 56% splenomegaly, and 60% bronchiectasis. At diagnosis, serum IgG levels were 1.72 (0.33 – 6.90) g/L and switched memory B cell percentages 1.70 (0 – 52.0). The overall survival rate of the patients during the follow-up time was 88%. As a result of univariate Cox regression analysis, platelet count was determined to be an independent risk factor for mortality in CVID patients (Hazard ratio, HR: 0.990, 95% confidence interval, CI: 981-0.999, p: 0.025). As a result of multivariate Cox regression analysis; current age, BMI and neutrophil/lymphocyte ratio were not found to be independent predictors for mortality. When the patients were classified according to mean platelet counts, the mortality rate in the patient group with platelets &lt; 207770/mm<sup>3</sup> was determined to be statistically significantly higher compared to the patient group with platelets &gt; 207770/mm<sup>3</sup> (log-rank: 0.013). The most common causes of mortality were pneumonia and pneumonia-induced sepsis.</p> <p><strong>Conclusion: </strong>Clinicians dealing with this patient group should remember that immune dysregulation and low platelet count are independent risk factors for mortality and they should particularly follow-up patients with low platelet count closely.</p> Gokhan aytekin, Fatih Çölkesen; Eray Yıldız; Şevket Arslan, Ahmet Çalışkaner Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Depression, Occupational Anxiety, and Related Factors in Medical Students <p><strong>Abstract</strong></p> <p><strong><em>Background</em></strong><em>:</em> Depression occupies an important place in medical students’ psychiatric disorders, with a prevalence of approximately 20-40%. We aim to examine factors that might affect depression in medical students and investigate the relationship between occupational anxiety and depression severity.</p> <p><strong><em>Methods:</em></strong> Eighty-eight medical students who were diagnosed as having major depressive disorder were included in the study. A Sociodemographic Data Form, the Occupational Anxiety Questionnaire for Medical Students, Beck Depression Inventory, and Beck Anxiety Inventory were used.</p> <p><strong><em>Results:</em></strong> A statistically significant relationship was found between academic success, living with family, Occupational Anxiety Questionnaire for Medical Students and Beck Depression Inventory scores. The mean value of the occupational anxiety of the students was 35.87±9.82. The most anxious options for students in the Occupational Anxiety Questionnaire for Medical Students were the inability to prepare for and pass the Central Medical Specialty Exam.</p> <p><strong><em>Conclusions:</em></strong> It is necessary to focus on factors that may affect the severity of depression, which affect both the social and professional lives of medical students who are physician candidates. The issues about occupational anxiety should be taken into consideration when planning medical school education and postgraduate working conditions.</p> Meltem Gürü, Gül Ferda Cengiz Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Hyperthermic Intraperitoneal Chemotherapy After Cytoreductive Surgery; Experience and Short Term Outcomes <p><strong>Purpose: </strong>Cytoreductive surgery + hyperthermic intraperitoneal chemotherapy is an important treatment option in patients with primary diagnosis of colorectal cancer, ovarian cancer, appendix cancer, gastric cancer (selected cases), malignant peritoneal mesothelioma and peritoneal pseudomyxoma in the presence of peritoneal involvement and resectable lesions limited to the abdomen. In this study, it is aimed to discuss cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy(HIPEC) in the light of literature.</p> <p><strong>Patients and methods: </strong></p> <p>The data of patients who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy between June 2017 and September 2020 at Eskişehir Osmangazi University Medical Faculty Surgical Oncology and Gastroenterology Surgery Departments were analyzed. The study was designed retrospectively, and all patients who were discussed at the oncology council and decided on CRS + HIPEC were included in the study.</p> <p><strong>Results: </strong>31 patients were included in the study. Primary diagnoses of the patients were colorectal cancer in 15 (48%), ovarian cancer in 9 (29%), stomach cancer in 3 (10%), mesothelioma in 2 (7%), appendix cancer in 1 (3%), and also peritoneal pseudomyxoma in 1 (3%). Therapeutic HIPEC was performed in 30 patients, prophylactic HIPEC was performed in 1 patient. Cytoreduction score was 0 in all patients. The median peritoneal cancer index was 15 (7-29). the median number of resected organs was 3(1-6). Stoma formation was performed in 14 patients (45%). During the postoperative 30 days, mortality was observed in 1 patient (3%) and morbidity in 5 patients (16%).</p> <p><strong>Conclusion: </strong>The early postoperative mortality and morbidity results which were reported in our study are compatible to those in the literature.</p> Ümit Özdemir, Ahmet Karayiğit, Dursun Burak Özdemir, İhsan Burak Karakaya, Hayrettin Dizen, İlter Özer, Bülent Ünal, Murat Ulaş Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Comparison of Lateral Pinning and Cross Pinning Results in Pediatric Distal Humerus Supracondylar Gartland Type 3 Fractures <p><strong>Background:</strong> In this study, we aimed to evaluate the functional outcomes and complications of Gartland type 3 patients treated with lateral pinning and cross pinning in children aged between five and ten years.</p> <p><strong>Methods:</strong> 74 fractures participated in the study and the data were analyzed. Patients in the lateral pinning group (n = 41) were treated with the lateral entry pin alone, and patients in the cross pinning group (n = 33) were treated with a combination of 2 lateral entry pins and 1 medial entry pin. Age, gender, fractured side, Vong Baker pain scale score, duration of surgery, postoperative complications, surgical approach, direction of pin application (lateral or cross), and Modified Flynn grading system grade were noted.</p> <p><strong>Results: </strong>No statistically significant difference was found between Lateral pinning and Cross pinning groups in terms of the grade of the Modified Flynn grading system and complications (iatrogenic ulnar nerve damage, loss of reduction and superficial infection) (respectively, p: 0.138 and p: 0.991).</p> <p><strong>Conclusion: </strong>When both techniques applied carefully, they give successful clinical results. If the surgeon detects intraoperative instability, s/he should not hesitate to pin the medial K-wire in order to increase stability.</p> Muhammet Salih Ayas, Kerim Öner Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Abduction Orthosis in Treatment of Primary Acetabular Dysplasia: Results of Three Years Follow-up <p><strong>Background:</strong> Acetabular dysplasia (AD) may appear after six months old despite normal previous physical and ultrasonographic examination, and management remains unclear. The purpose of current study was to evaluate success of abduction orthosis in treatment of primary AD patients.</p> <p><strong>Methods: </strong>Patients presented with AD between 2010-2017 were retrospectively reviewed. AD patients, who had stable hip joints on previous phsycial examination and Graf type1 on ultrasonography when younger than six months, were included study. AD was diagnosed according to the age-related acetabular index(AI) values. Abduction orthoses were applied full-time for five months plus part-time for three months. AI was re-measured at sixth months, at the end of first and third year. AI change was compared between dysplastic and nondysplastic hips.</p> <p><strong>Results: </strong>We evaluated 60 hips of 39 patients with AD treated with abduction orthosis at median age of 6 months. The mean AI was 31,4(29-35)°±2,1° in dysplastic hips. AI decreased to 26,5°±2,2°, 24,5°±2°, 21°±2,1° at sixth months, first and third years after treatment; respectively. The mean AI of nondysplastic hips was 25,3°(22-28)±2,1°; and decreased to 22,6°±2,4°, 21,1°±2°, 17,9°±1,8° at sixth months, first and third years follow-ups, respectively. At the end of the first 6 months, dysplastic hips had significantly better improvement in AI(4,9±2,1°) compared to non-dysplastic hips(2,7°±0,8°)(P&lt;0.001). There was no significantly difference in AI impovement after six months.</p> <p><strong>Conclusion: </strong>Primary acetabular dysplasia should not be ignored despite normal previous physical and ultrasonographic examination. Abduction orthosis may be used safely in treatment of children with primary AD older than six months.</p> Sinan Yüksel, Serhan Ünlü, Önder Ersan, Mehmet Faruk Çatma, Yenel Gürkan Bilgetekin, Kürşat Reşat Demir Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Outcomes of Consultations to Burn Units from Emergency Service <p>Background: In addition to being painful, burns cause aesthetic anxiety, causing patients to apply to the emergencies as soon as it occurs, and their first interventions are made in the emergency. In this study, the compliance with the guidelines in the consultations requested from the burn center and the referral of the patients to the center was evaluated.</p> <p>Methods: Burn etiology, TBSA, burn depth, and area of adult patients were recorded, applied to our hospital’s emergency with burns in 2019 and 2020, and were asked for consultation from the burn center.</p> <p>Results: Within two years, consultation was requested from the burn center for a total of 288 patients. Of the consulted patients, 73 (25.3%) were admitted to the center. When the evaluation was made between the patients who were hospitalized and not, the burn depth, etiology, and the percentage of TBSA were statistically significant.</p> <p>Conclusions: Indications for referral and hospitalization to burn centers have been determined with specific clinical guidelines. A significant result that stands out in this study is that 215 out of 288 consultations requested from the burn center didn’t have an indication for hospitalization. With this study, the necessity of reconsidering the tendency to ask for a consultation has emerged. Emergency medicine physicians should be well-equipped with minor burn dressings as well as having knowledge about first response, referral decision and management. In this regard, if there is a burn unit/center in university hospitals or education<br />hospitals, rotation of emergency medicine residents to burn treatment units should be discussed.</p> Merve Akın, Ahmet Çınar Yastı Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Analyzing Electrocardiography Abnormalities in COVID-19 Patients Admitting to Emergency Department <p>Covid-19 pandemic, which appeared at the end of 2019 as a result of the SARS-CoV-2 virus in Wuhan, China, still remains as a very important global public healthcare problem. The disease can progress severely in people with advanced age and comorbid disease.</p> <p>In our study, the mean age of 502 patients detected to be COVID-19 positive admitted to Emergency Department was 50.45±19.14 years. The male population was 57.17% in the present study, and the most common symptoms were weakness 51.00%, cough 50.60%, and fever 42.03%, respectively. The three most common comorbidities were Hypertension 127 (25.30%), cardiovascular disease 112 (22.31%), Diabetes Mellitus 109 (21.71%). Electrocardiogram (ECG) performed in the Emergency Department yielded most sinus tachycardia 30.08%, Left Ventricular Hypertrophy (LVH) 5.38%, Ventricular Extra Systole (VES) 4.18%, and 1 of our 3 ST-elevated MI patients died in the emergency department.</p> <p>Considering the intense distribution of ACE2, which is the connecting point of SARS-CoV-2, in cardiomyocytes, Emergency Medicine employees should be able to monitor the changes in ECG and see the problems by evaluating other diagnostic procedures when necessary. As a result, we believe that our initial ECG recommendation is that cardiac monitoring will play an important role in treatment planning.</p> Miray Tümer, Ahmet Burak Erdem, Hakan Oğuztürk, Selahattin Gürü, Gülhan Kurtoğlu Çelik, Afşin Kayipmaz Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Effect of the Immunoglobulin G-A-M Treatment on Hepatic Functions and Mortality rates in Patients with Septic Shock <p><strong>Introduction and aim</strong>: In this study, we aimed to explore the effects of conventional sepsis treatment, including classical antibiotherapy and IgG-A-M combinations, on liver function tests in patients with severe sepsis.</p> <p><strong>Methods:</strong> All patients diagnosed with severe sepsis and treated with IgG- A- M combinations in the Adult Intensive Care Unit of Süleyman Demirel University Practice and Research Hospital between 2005-2013 were retrospectively examined. Demographic properties, age, gender, intensive care treatment duration, general exitus day, the death rate in the first 28 days, rate of the general death-survival period, 28th-day death rate, general death rate, diagnoses of cases were recorded.</p> <p><strong>Results:</strong> AST- ALT- Albumin values of cases before and after Ig G- A- M combination treatments were also recorded. In statistical comparisons, p&lt; 0,05 was assumed to be significant. In this study, it was observed that IgG- A- M combination (Pentaglobin®) treatment had no statistically significant impact on AST- ALT- Albumin values.</p> <p> </p> <p><strong>Conclusion</strong>: Sepsis is a clinical condition that continues to have a high mortality rate despite advances in treatment modalities. Although anti-infective And anti-inflammatory treatments are used, there is no clear data on their efficacy.However, early diagnosis of sepsis, early initiation of antibiothearpy, early source control and timely initiation of appropriate fluid therapy play a key role in succsess of sepsis treatment. For this purpose, as emphasized in the sepsis 3 guideline, we think that raising awareness by physicians and practitioners in early diagnosis of sepsis is the Most important step in the treatment of this clinical condition.</p> <p><strong> </strong></p> Ahmet Bindal, Lütfi Sözen Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Emergency Major Surgery in Thoracic Trauma: Timing and Decision Process <p>Background: Surgery is required in 10-15% of patients with thoracic injuries. Surgery performed within the first few hours of the<br>injury is considered as an emergency surgery. The aim of study is to share our experiences with emergency surgical approaches<br>in thoracic trauma.</p> <p>Methods: Our study was carried out between June 2012-June 2020, by retrospective analysis of cases who were evaluated for<br>thoracic trauma in the emergency department and who underwent emergency surgery.</p> <p>Results: There were 5784 patients who requested for thoracic surgery consultation due to thoracic trauma. Of these cases, 1317<br>(22.8%) were patients who were evaluated in the emergency service due to isolated thoracic trauma. There were 18 patients (1.3%) who underwent emergency surgery for isolated thoracic trauma. Glasgow score was higher in the group that was discharged after recovery among all groups; and this was statistically significant (p= 0.045). It was statistically significant that intubation and low modified trauma scores were a poor prognostic factor (respectively p= 0.035, p=0,025).</p> <p>Conclusions: Tube thoracostomy is sufficient for most of the thoracic traumas. After emergency evaluation, fast and correct<br>decision in the appropriate surgical indication significantly reduces mortality.</p> Kubilay İnan, Eray Çınar, Özgür Ömer Yıldız Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Non-Surgical Treatment Options for Peyronie’s Disease <p>Peyronie's disease, which occurs with the formation of a fibrous plaque in the tunica albuginea; is a disease that causes some physical problems such as bending and shortening of the penis. There are surgical treatment methods of this disease as well as non-surgical treatment methods. Non-surgical treatment methods, which are grouped under six headings: oral treatments, topical treatments, traction and vacuum treatments, shock wave therapy, intraplate injection treatments, and experimental treatments, can be preferred in cases where the symptoms are not very advanced because they provide advantages in terms of ease of application, accessibility and cost.&nbsp; Although the only non-surgical treatment method approved by the FDA (U.S. Food and Drug Administration) yet is clostridium collagenase histolikum, which is used in intraplaque injection, studies have shown that other methods also reduce curvature, pain and plaque volume.</p> Damla Cinar, Sedanur Sari, Huseyin Alkan, Kubra Buket Ay, Enes Borcaktepe, Ahmet Yigit Duyum, Sude Sevcan Filikci, Eren Gencer, Cagla Senem, Serhat Soylu, Seyma Tuna, Rabia Tuncer, Mehmet Emin Yazici, Emre Altintas, Murat Gul Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000 Ideal Surgery Time in COVID-19 Process: A Case Report of Pulmonary Hydatid Cyst in Covid Patient <p>In order to reduce the risk of postoperative mortality and pulmonary/thromboembolic complications during the COVID process, surgery is recommended 4-7 weeks after the diagnosis of COVID in elective cases. We are sharing a case of a patient with a parasitic disease such as hydatid cyst, which was detected incidentally with the diagnosis of COVID-19, who was operated 8 weeks after the diagnosis of COVID-19 and experienced postoperative pulmonary complications.</p> Mehmet Çetin Copyright (c) 2021 Archives of Current Medical Research Mon, 27 Sep 2021 00:00:00 +0000