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American Journal of PharmTech Research    Follow    
  This is an Open Access Journal Open Access journal
     ISSN (Online) 2249-3387
     Published by ScopeMed Homepage  [75 journals]
  • Conversion Disorder; an unusual etiology of wrist drop: Report of a case
           and review of literature
    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Saeed Bin Ayaz, Atif Ahmed Khan, Sumeera Matee, Zaheer Ahmed Gill.
      Wrist drop is commonly a consequence of Radial Nerve injury and infrequently due to C7/C8 radiculopathy, brachial plexus lesion or central causes. We present here a rare case of wrist drop due to conversion disorder. He was a 31-year-old soldier who presented with left sided wrist drop and numbness over dorsal aspect of left hand following gunshot injury to the left forearm. His repeated electrophysiological evaluation revealed injury to the sensory branch of left Radial Nerve. Magnetic resonance imaging of brain, muscle enzymes and routine laboratory investigations were normal. After getting treatment as a case of radial nerve injury, focal dystonia and adjustment disorder he was finally diagnosed as a case of conversion disorder. Motor point blocks, orthotic support, electrical muscle stimulation, cognitive behavioral therapy and biofeedback were tried but did not prove effective. Patient ultimately landed up with the psychiatrist and is still under his treatment. Conversion disorder may be considered in a patient presenting with wrist drop when no organic cause can be found. Early opinion of a psychiatrist is needed to be sought in suspicious cases after providing relevant clinical findings and investigations.

      PubDate: Thu, 17 Apr 2014 10:54:51 GMT
       
  • Acute Complications of Diabetes Due to Schizophrenia and New Generation
           Antipsychotics: Relationship Between Egg-Chicken'
    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Erol Arslan, Mustafa Çakar, Şeref Demirbaş, Şirzat Yeşilkaya, Mehmet İnce, Salim Özenç, Ali Kılınç, Kenan Sağlam.
      A number of patients with schizophrenia have diabetes mellitus in higher rates than the general population due to some pathophysiologic and genetic mechanisms and effects of antipsychotic drugs. Hyperosmolar hyperglycemic state is an acute metabolic complication of diabetes and an important process up to coma. Here, we describe two cases who developed a mild hyperosmolar hyperglycemic state associated with the use of new-generation antipsychotic drugs, presented in emergency department and treated as inpatients.

      PubDate: Thu, 17 Apr 2014 10:51:57 GMT
       
  • The Relationship between Family Structure and Eating Attitudes of People
           Registered to the Family Mediciners
    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Salim Ozenc, Sirzat Yesilkaya, Dursun Karaman, Nuri Yildiran, Erdal Pan, Mehmet Ince, Erol Arslan.
      Introduction: There are many causes of eating behavior disorders. Family factor is also one of them. In this study, we aimed that to determine whether there is a relationship between family structure and eating attitudes by young people, who have registered to the family doctors, between the ages of 14 to 24 that is registered with their family doctors. Material and methods: People registered with to the family doctors, between the ages of 14 to 24, and who have applied to the family health center from June 2012 to October 2012 were included in the study. From the registered 180 people of 149 of them, who agreed to participate in the study and filled out the questionnaire completely, were evaluated. The semi-structured interview form for sociodemographic characteristics, Eating Attitudes Test (EAT), and the Family Assessment Scale (FAS) were used for data collection. Results: Between sexes, there were no statistically significant difference observed in terms of the sub-groups of FAS and the EAT scores (p> 0.05). There were no statistically significant correlation observed between the sub-groups of FAS scores and the EAT scores (p> 0.05). A statistically significant elevation in terms of contact points have been identified in women than in men (p = 0.040). Discussion: In our study, there was no relationship found between eating attitudes and family structures was not found within the people, who have registered to the family doctors, between the ages of 14 to 24. Corresponding to this, the results of our study is compatible with studies showing that there is no relationship between family functioning and eating attitudes. However, it is imperative to perform longitudinal studies analyzing possible causes and related effects of this issue.

      PubDate: Thu, 17 Apr 2014 10:51:19 GMT
       
  • BENEFITS OF HYPERBARIC OXYGEN THERAPY IN A PATIENT WITH MULTIFOCAL
           OSTEONECROSIS MIMICKING SEPTIC ARTHRITIS.
    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Şeref Demirbaş, Mehmet İnce, Erol Arslan, Kemal Şimşek, Salim Özenç, Seyit Ahmet Ay, Murat Karaman, Sebahattin Sarı, Bayram Koç.
      Osteonecrosis is a progressive disease characterized with bone damage. Glucocorticosteroids, which are used in treatment of many diseases, are believed to be the most important reason for development of non-traumatic osteonecrosis. Osteonecrosis(ON) generally does not affect multiple joints simultaneously and mimic septic arthritis. In this article, we reported a 48-year-old woman with osteonecrosis who received glucocorticosteroids due to autoimmune hepatitis. The onset of the osteonecrosis was mimicking septic arthritis with multiple joint involvements after corticosteroid therapy. Physical examination; there was mild erythema, effusion, warmth, and diffuse tenderness on palpation in bilateral ankles and knees. Significantly intensity changes were compatible with ON in the femur and the tibia, increased fluid in the knee joint and edema in muscle groups and fatty tissue that are around the knee joint were seen on MRI. Other tests were negative for artiritis.Hyperbaric oxygen treatment was used effectively for the treatment of the patient. Patient's complaint of pain was ceased acoording to Visual Analogue Scale and she did no need to much painkiller. The main purpose of the treatment of ON is intended to protect the patient's natural joint structure. HBO and other medical approaches were provided benefit to patients with ON. Because HBO restores tissue oxygenation, reduces oedema, and induces angioneogenesis. By reducing the intraosseous pressure, venous drainage is restored, and the microcirculation is improved.

      PubDate: Thu, 17 Apr 2014 10:50:15 GMT
       
  • Perforation of Ascending Colon Tumor Mimicking Acute Appendicitis: A case
           report
    • Abstract: Publication year: 2014
      Source:Balkan Military Medical Review
      Mehmet Ince, Erol Arslan, Ali Kılınç, Mustafa Cakar, Sebahattin Sari, Ali Osman Yildirim, Kenan Sağlam.
      Acute abdomen may result from several diseases such as infection, ischemia, obstruction, and perforation. Less frequently, diverticulitis, tumor perforation may be the reason. Ruling out acute appendicitis is mandatory in patients presenting with right lower quadrant abdominal pain. We report a 43-year-old male, suffering from right lower quadrant pain lasting for 2 days resembling acute appendicitis, which has been subsequently diagnosed perforation of ascending colon with tumor via advanced images modality that had been operated emergently. Histological findings revealed poorly differentiated adenocarcinomas for ascending colon mass and liver metastasis. If young patients with acute abdomen admitted to emergency service; appendicitis and other inflammatory diseases should be recognized as initial diagnosis. However, perforation or obstructions of malign colon tumors should be kept in mind.

      PubDate: Thu, 17 Apr 2014 10:49:26 GMT
       
  • 18th CONGRESS OF BALKAN MILITARY MEDICAL COMMITTEE
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      .
      18th CONGRESS OF BALKAN MILITARY MEDICAL COMMITTEE ISTANBUL, TURKEY May 22-26, 2013

      PubDate: Tue, 15 Apr 2014 09:51:23 GMT
       
  • Factors Associated with Chronic Post-Thoracotomy Pain
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Sara Eleni AMPRACHIM, Ioannis D. GKEGKES, Ioanna V. PAPATHANASIOU, Labrini KOURKOUTA.
      Thoracotomy is one of the surgical procedures that present with increased incidence of chronic postoperative pain and discomfort. The related pain after thoracotomy can provoke considerable peri-operative as well as long-term morbidity of notable intensity and duration. Post-thoracotomy pain is considered to be a result of the thoracic structure damage, including damage to ribs, muscles, peripheral nerves and pleura. The surgical incision, the rib retraction, the discontinuity of costal pleura, trocar placement and suturing are the possible pathogenic causes of chronic post-thoracotomy pain. Various techniques and prevention strategies have been proposed in order to offer satisfactory analgesia to postoperative thoracotomy pain. Nevertheless, both acute and chronic pain related to thoracotomy continue to represent a challenge for thoracic surgeons. Recommenda tions can only be established in this regard based on unique studies, with a higher or lower level of evidence depending on their design. Well designed randomized prospective studies are required to evaluate the diverse technical variation for the performance of thoracotomy and their association with post-thoracotomy pain.

      PubDate: Sun, 13 Apr 2014 03:36:28 GMT
       
  • Duties of the Head Nurse for the Organization of Prevention and Control of
           Nosocomial Infections in MHAT Hospital/Military Medical Academy, Sofia,
           Bulgaria
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Rositza DOYNOVSKA, Angel D. ANGELOV, Georgi POPOV.
      Prevention and control of medical-care related nosocomial infections are of the top priorities in every medical facility. The problem of nosocomial infections goes along with medical activities, posing health and financial consequences of various dimensions. Current regulations, orders and recommendations of the President of Military Medical Academy (MMA) define the methods and means of control, together with the personnel in charge. One of the basic duties of every Head Nurse in Multiprofile Hospital for Active Treatment (MHAT) Sofia, MMA, is the active participation in the prevention and control of the nosocomial infections while respecting hierarchy subordination, during onset, registration and taking of measures according to the current hospital program. Preventive measures ensure high level of protection for patients, staff and visitors. Training of nurses and hospital attendants is a basic duty of the Head Nurse. Due to the severity of the problem posed by the nosocomial infections, constant work is required in order to match administrative measures and personal responsibility of the hospital employees.

      PubDate: Sun, 13 Apr 2014 03:34:04 GMT
       
  • The Concept of Health in Ancient Greek Medicine
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Emmanouil MAGIORKINIS, Nikolaos PETROGIANNIS, Christos BISSIAS, Aristidis DIAMANTIS.
      The purpose of this article is to summarize the views on Health in Ancient Greek Medicine. We studied mainly the Hippocratic and Galenic Corpus as well as the views of contemporary scholars on the subject. Important aspects on human health include the “four humors theory”, the strict connection of human physiology with the laws of Nature and the interconnection between the functions of human body and the way of life and habits of the patient. The humoral theories provided the basis for treatment strategies in Hippocratic medicine which was strictly individualized and case restricted. Hippocrates, on the basis of those theories, also suggested a set of rules for everyday life in his “Regimen” suggesting a direct association between health and life style. In all aspects of human life, the golden mean is considered to be the optimum way, according to the writer of the Hippocratic texts, in order to restore the balance between opposing powers that tend to disturb the homeostasis of human health.

      PubDate: Sun, 13 Apr 2014 03:32:11 GMT
       
  • Professional Identity Statuses of First-year College Students in General
           Practice Nursing Programmes: the Case of Lithuania
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Ramute RIMKIEN&#;, Vilma &#;YD&#;I&#;NAIT&#;.
      Introduction: What is nowadays called “globalization” enforces social, economic and political changes which make collegial higher education institutions search for the best possible means to more effectively adapt to the fast changing environment and prepare competitive professionals for the market. Professional identity is the important factor, which increases competitiveness of a young specialist in the labor market. Person’s professional identity forms whilst training in a higher education institution– the development of person’s knowledge, abilities, skills, approaches, values and beliefs, which takes place during theoretical and practical studies. According to most scientists’ opinion, professional identity forms from the first year of study by acquiring deeper professional understanding, developing professional values and approaches. When analyzing the peculiarities of professional identity development, some scientists apply the concept of the Marcia identity research, which functions in the context of problem solution. Marcia distinguishes four statuses of identity according to alternative exploration level and decision-making crisis as well as the commitment to certain field: the lowest – Identity diffusion, higher – Foreclosure, still higher – Identity Moratorium, the highest – Identity Achievement. The article analyzes the levels of the professional identity statuses of first-year students’ in the General Practice Nursing programmes in Lithuanian colleges. The research was performed in March – April 2012 when the first-year students in the General Practice Nursing programme followed theoretical subjects and passed clinical practice work tasks. The research involved 251 first-year Nursing students, whose age was from 18 to 49 years. The research results have shown that half of the first-year students-respondents are in the ‘strong status’ level of the acquired professional identity; and the respondents-students in the group of over 20 years old are well aware of their professional goals, are more autonomous, have stronger commitment to their professional choice than the respondents-students of the 18-20-yearold group.

      PubDate: Sun, 13 Apr 2014 03:29:17 GMT
       
  • Experiences from Post-Graduate Courses organized by the NATO International
           Security and Assistance Force (ISAF) in Support of the Afghan Health
           System
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Murat DURUSU, Umit KALDIRIM, Ibrahim ARZIMAN, Engin Ilker CICEK, Mehmet ERYILMAZ, Oguz KILICKAYA, Yusuf Emrah EYI, Ali Osman YILDIRIM, Salim Kemal TUNCER, Selahattin OZYUREK, Ramazan AKYILDIZ.
      Introduction: This article aims to share the experience and ‘evaluations for the future’ gained from the "Emergency Care for Trauma" course on 14-15 April 2010 and "Emergency Care, echocardiography, anesthetical applica tions, blood bank management, and medical technician course" on 18-21 December 2010 performed with the attendance of Afghan medical personnel were to be shared. Method: The courses were evaluated retrospectively under the titles including; course curriculum, training instructors, participant characteristics, participant evaluations and course of events, preparation, execution and results. Results: 13 hours of theoretical training, 6 hours of practical stations with a total of 19 training hours of the course were scheduled for execution in two days. An organization committee composed including one president, two secretaries, six trainers and six assistant trainers. Moreover, three interpreters assisted for the simultaneous translation. A total of 24 and 25 medical personnel attended the two courses, respectively. Pre-test and post-test were administered to course participants before and after the course in order to evaluate the effectiveness of the first course. Darish simultaneous translation was done during all training sessions. At the end of each course, reviews from participants were discussed. Discussion and conclusion: The experience gained from the course and direction of the participants revealed that it needs to be repeated every six months. More time was decided to be offered for the practical part of the course. Educational training course has been planned after 4-5 periods of courses for the Afghan health workers. In this way, the course was planned to get integrated into the Afghan health system. Post-graduate courses are important components of modern health care systems. In many developed countries, these kind of courses have become compulsory and are performed regularly. However, standardized and regularly performed courses in developing countries are currently not ‘the norm’ and should be supported.

      PubDate: Sun, 13 Apr 2014 03:27:35 GMT
       
  • Adaptation of Temperament and Character Inventory (TCI) –
           Cloninger’s in a Specific Population - The Bulgarian Military Man
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Milena DIMITROVA, Toni DONCHEV.
      The author of the Temperament and Character Inventory (TCI) is Dr. C. Robert Cloninger, working at Washington University in St. Louis, USA. His questionnaire includes four temperament dimensions and three personality (character) dimensions. The Bulgarian version of the questionnaire was adapted in 2003-2004. TCI consists of 240 dichotomous items, completed independently. The questionnaire provi des information on temperament, character, adaptive capacity and emotional stability of the subjects, so it is especially important as a diagnostic and prognostic test method. Considered in the clinical aspect, Cloninger’s model can serve as a useful instrument for clinical diagnosis and prediction of personality disorders. From personality (character) traits depends on whether the person is abnormal at all, while temperament depends on the type of personality abnormality and vulnerability (susceptibility) to affective disorders

      PubDate: Sun, 13 Apr 2014 03:25:25 GMT
       
  • Cardiorespiratory Changes during Colonoscopy in Young Patients with no
           Known Diseases
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Ivaylo VAZHAROV, Yolanda ZAYAKOVA.
      Introduction: Like every invasive procedure colonoscopy carries risks for complications, mainly cardiorespiratory. Aim: The purpose of this study is to investigate cardiorespiratory changes during colonoscopy in young patients with no known diseases. Materials and Methods: Between March 2010 – March 2013, 41 young patients - 31 men and 10 women underwent colonoscopy (“Olympus”) by two experienced endoscopy specialists. The patients were free of signs and symptoms of any heart and pulmonary diseases. During endoscopic examination each patient was monitored with Holter (“Hewlett-Packard”) and pulse oximeter. The blood pressure was measured before, during and after the procedure. Results: During colonoscopy 17 patients (41.46%) manifested rhythm disorders. In 9 patients (21.95%) sinus tachycardia occurred. In 3 patients (7.32%) supraventricular extra systoles were observed and in 2 patients (4.87%) - ventricular extra systoles. No ST-T changes were found. The highest blood pressure values were measured before and during endoscopy, but they did not exceed 165/105 mmHg. In 5 patients (12.2%) a hypotensive reaction was observed, but the values were not lower than 80/50 mmHg. In 3 patients (7.32%) there was a short bradycardia with a heart frequency of 50-55 /min. Conclusions: Our results showed that the rhythm disorders during lower colonoscopy occur in almost half of the examined patients, there is an increase or decrease of the blood pressure in some patients, but that did not require physician’s aid and the examination could be carried out safely without monitoring.

      PubDate: Sun, 13 Apr 2014 03:23:29 GMT
       
  • Acute Barotitis Media in Flight: Pathophysiology, Symptoms, Prevention,
           Treatment
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Ourania FYNTANAKI, George ALEVITSOVITIS, Leonidas ANGELAKIS, Vasileios MOUTEVELIS.
      Acute barotitis media or aerotitis media is one of the most prevalent medical issues caused during flight. This is the reason that the incidence of aerotitis media increases not only among aviation crews but among common travelers due to the increasing airplane transportation. Its pathophysiology is completely explained by Βoyle’s law, since the gas volumes in our body and in the airplane cabin change during the flight. In fact, the problem is caused by the dysfunction of equilibrium between the air in the middle ear and the surrounding environment. The main symptoms are severe otic pain and partial hearing loss, mainly during the descent. There are many predisposing factors for this medical condition such as a concomitant upper respiratory infection. Many preventive measures can be used to avoid otic barotrauma, like the Valsalva maneuver. The treatment is generally symptomatic, but there are also ongoing relevant research projects.

      PubDate: Sun, 13 Apr 2014 03:20:02 GMT
       
  • Complex Segmental Fractures of the Radius and Ulna without Associated
           Dislocation or Ligamentous Injury: A Case Report
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Demetrios KAPOUTSIS, Miltiades ZIOGAS, Ioannis LACHANAS, Konstantinos GARTSIOUDIS, Ioannis ZAGAS, Konstantinos KARLIAFTIS.
      Isolated complex segmental fractures of the forearm bones are rare injuries that result from significant force and warrant challenging operative treatment. We present one such case where, despite the severity of the bone injury there were no associated dislocation or ligamentous injuries at the proximal or distal radioulnar joints. The patient was treated with open reduction and internal fixation with very satisfactory clinical and radiological outcome after a six-month follow-up.

      PubDate: Sun, 13 Apr 2014 03:18:11 GMT
       
  • Injury of Tank Personnel due to Kickback: A Case Report
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Yusuf Emrah EYI, Sukru ARDIC, Ibrahim ARZIMAN, Cengiz KAYA, Murat DURUSU, Mehmet ERYILMAZ.
      Kickback is the backward momentum of a gun when it is discharged. In this paper, it is aimed to share a case of splenic injury and mandibular fractu re due to a kickback during throwing of Leopard 2 tankball.

      PubDate: Sun, 13 Apr 2014 03:16:13 GMT
       
  • Symptomatic Hypocalcaemia in a Patient with Bone Metastatic Prostate
           Cancer
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Apostolos PAPPAS, Nikolaos KONTORAVDIS, Athanasios PANOUTSOPOULOS, Nikolaos KORONAKIS, Emmanouil LAGOUDIANAKIS, George KARANIKAS, George MIHALOPOULOS, George SIOZOS, George ANDRIANOPOULOS.
      Symptomatic hypocalcaemia has rarely been reported in bone metastatic prostate cancer patients. The use of bisphosphonates as part of palliative treatment in patients with concurrent medical conditions is among the most common causes of hypocalcaemia. We present the case of a patient with bone metastatic prostate cancer who experienced severe hypocalcaemia while being treated with zoledronic acid.

      PubDate: Sun, 13 Apr 2014 03:13:28 GMT
       
  • Patients’ Satisfaction with their Post-operative Pain Management in
           Armed Forces’ Hospitals of Athens, Greece
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Maria MITSIOU.
      The purpose of this study was to investigate patients’ satisfaction with their post-operative pain management, identify the characteristics of their pain and explore any possible gaps in postoperative pain management in Armed Forces’ Hospitals in Athens. A total of 150 consecutive patients on their 2nd post-operative day, selected from different wards of the surgical sector of the three tertiary care Armed Forces’ hospitals in Athens, Greece, were included in the study. Data was collected using “The American Pain Society/Patient Outcome Questionnaire” For the 2nd post-operative day, 26.7% of the patients reported the level of their pain as 5 in the 0-10 VAS (mean = 3.15 2.14). A 90.7% of the respondents were generally satisfied with the management of their post-operative pain, whereas 53.3% of them were very satisfied with the response of nurses and 45.3% were very satisfied with doctors’ response when they were complaining of pain. The time for administration of a medication on demand was

      PubDate: Sun, 13 Apr 2014 03:11:30 GMT
       
  • Diagnosing Personality Disorders in Temperament and Character Inventory
           (TCI), Cloninger’s Questionnaire
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Milena DIMITROVA, Toni DONCHEV.
      Personality disorders are very impor tant and quite often remain occult during the first psychological selection for military personnel. Personality disorders are difficult in their diagnosis even when the person has already demonstrated emotional and behavioral symptoms of disadaptation. We present our experience in diagnosing personality disorders with the adaptation of a psychological test for the Bulgarian population: Temperament and Chara cter Inventory (TCI), Cloninger’s. It is a new psychological test of good proven effectiveness, extremely useful when making the first psychological selection for entry in the military service, participation in military missions and training abroad and for objectification of military medical expertise. The study, conducted on 534 servicemen, suggests that determining the type of temperament allows the prediction of the occurrence of certain types of personality disorder. The features which invariably recur and are especially important for the formation of almost all types of abnormal personality peculiarities are: Coopera tiveness (C), Self-transcendence (ST) and Harm avoidance (HA). A chara cteristic with less importance is Selfdirectedness (S).

      PubDate: Sun, 13 Apr 2014 03:09:17 GMT
       
  • How Cost-worthy is the Hellenic AirForce’s Investment on Health
           Disorders Prevention: Policy Comparison between Flying-non Flying
           Personnel
    • Abstract: Publication year: 2013
      Source:Balkan Military Medical Review
      Georgios ALEVETSOVITIS, Ioanna KATSOU, Vasileios MOUTEVELIS, Ourania FYNTANAKI, Panagiotis PREZERAKOS.
      Introduction: The main interest of this study is focused on the level of interaction between the perceived health level and the degree of health prevention policy applied by the Hellenic AirForce which compels the flying personnel in an annual health examination, whereas the ground personnel attends a similar examination every two years. Objective: Statistical analysis of crosscorrelation between health status and the degree of prevention (by the means of health services consumption) in a sample of the Hellenic Air Force personnel. Materials – Methods: Calculation of cardiovascular risk score (Hellenic Score) and Body Mass Index in a sample of 190 individuals (92 pilots and 98 individuals from technical/maintenance – air traffic control sectors) from 120 Flight Training Wing and statistical analysis of the level of correlation between health status and the intensity of medical prevention policy. Results: The level of cardiovascular risk depends positively upon the BMI value (p=0.009). The BMI value-overweight and obese is in statistically significant relation to the type of profession (ground personnel p= 0.004). However, the cardiovascular risk score does not seem to depend strongly upon the type of profession. Conclusions: In general, Hellenic Air Force pilots seem to keep a higher level of quality Health status and the interpretation of this result lies upon the policy of Health Prevention measures.

      PubDate: Sun, 13 Apr 2014 03:07:02 GMT
       
  • Pregnancy after renal transplantation and management: a case report and
           review of the literature
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Gezginc K, Celik C, Karatayli R, Colakoglu MC.
      It is well known that conception rates in dialysis patients with chronic renal failure are low. However, renal transplantation restores fertility and increases conception rates in women at reproductive age. In those who have conceived, pregnancy cannot be anticipated without risks, and mother, fetus and allograft should be closely monitored. Here we report a pregnancy following renal transplantation and review the current literature in terms of proper management.

      PubDate: Sun, 13 Apr 2014 02:21:54 GMT
       
  • Percutaneous approach for extraction of a renal fragmented double-j stent:
           case report
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Ors AO, Zor M, Bedir S, Alan C, Tahmaz L, Peker AF.
      We report a 20-year old male with a fragmented Double-J (D-J) stent in the renal pelvis, and its surgical treatment modality (percutaneous removal of the D-J fragments). We suggest that percutaneous approach might be considered as a minimally invasive surgical procedure in such cases.

      PubDate: Sun, 13 Apr 2014 02:20:47 GMT
       
  • Motor neuron disease like syndrome with long term organophosphate
           exposure: case report
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Senol MG, Togrol RE, Saracoglu M.
      Pesticide exposure was shown to be associated with more than two-fold increase in amyotrophic lateral sclerosis (ALS) risk, with greater risk at higher levels of exposure. Most studies of moderate pesticide exposure have found increased prevalence of neurological symptoms. Here, we report a 63 yearold male patient with motor neuron disease (MND) like syndromes with a history of organophosphate (gestathion) exposure for at least twenty years.

      PubDate: Sun, 13 Apr 2014 02:19:19 GMT
       
  • Multiple basal cell carcinomas following irradiations for Hodgkin's
           disease
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Karadudak O, Dogan B.
      We present the case of a 63 year-old Caucasian man with 24 basal cell carcinomas (BCCs) overlying his back and upper chest, which was irradiated three times between 1972-1975 for Hodgkin􀂶s disease. These lesions had developed between 2000 and 2005. All the tumors were located within radiation fields. He had skin type II. He had no other known risk factor for cutaneous malignancy, in particular any history of excessive or intense burning with sun exposure. Other possible causes of basal cell carcinoma, such as arsenic intoxication, nevoid basal cell carcinoma syndrome (NBCCS), were excluded. There is no family history of skin cancer. We therefore postulate that his multiple basal cell carcinomas have arisen as a late adverse effect of irradiation.

      PubDate: Sun, 13 Apr 2014 02:18:01 GMT
       
  • Nursing involvement in extraordinary situations
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Oflaz F.
      Crisis situation has been defined as extraordinary indicating an unstable situation of extreme danger and difficulty. These are large-scale events that affect significant number of people at the same time and are beyond individual control. Thus, to be ready for the adverse effects and lessen these effects has become significant in the lives of people all over the world in this age of terrorism and violence. These kinds of events are dynamic events and have multiple stages causing extensive morbidity and mortality. Due to tremendous destruction and loss, local communities are unable to respond effectively to victims, and additional help is required from external sources. The burdens of health care delivery system of the affected community increase and cannot meet the needs of the society. Today's nurses are often the largest contingent of professionals on hand at the disaster, and they are full participants and key players in disaster response efforts. That is, nurses from all specialties recognized the need to become better prepared to respond to crisis situations. Today's nursing practice requires a conceptual model including an all hazards approach. This paper summaries the nursing involvement in extraordinary situations including the characteristics of the event and how to ready for being effective in these situations.

      PubDate: Sun, 13 Apr 2014 02:16:42 GMT
       
  • Nonconvulsive status epilepticus: different etiologies
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Senol MG, Togrol RE, Boyraz O, Saracoglu M.
      The clinical and electrophysiological manifestations of four patients diagnosed with nonconvulsive status epilepticus (NCSE) were assessed. The first patient (21-year old male) who suffered from headache, nausea and vomiting, blurry vision and speech problems was found to have a right parieto- occipital acute ischemia area associated with low plasma homocysteine and folate levels, developed generali􀀀ed tonic-clonic convulsive sei􀀀ures and was subsequently in an apathy-like mental status. The second patient (48-year old male) was followed up with a diagnosis of secondary progressive multiple sclerosis and was brought to our clinic after developing confusion, left internuclear opthalmoplegia, a rigid posture of the upper extremities and a general difficulty with communication. He was found to have large interconnected demyelinating plaques forming a conglomerate. The third patient (77-year old female) with a previous history of diabetes mellitus presented with having no relation with the surroundings, no reaction and not speaking. She was confused as well. The fourth patient (71-year old female) was followed up with a diagnosis of epilepsy for the last nine years. She had been using her medicines irregularly and had stopped taking them abruptly. All four were eventually diagnosed with non-convulsive status epilepticus. The features of these four interesting cases with NCSE are discussed.

      PubDate: Sun, 13 Apr 2014 02:14:43 GMT
       
  • The value of high resolution cervical ultrasonography and dual-phase
           Tc-99m sestamibi scintigraphy for the preoperative localization of
           parathyroid adenomas
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Arslanoglu A, Sabanci U, Arslan N, Yildirim N.
      The purpose of this study was to localize parathyroid adenomas preoperatively by using high resolution ultrasonography (USG) and dual-phase Tc-99m Sestamibi scintigraphy. Ten patients who had clinical signs and symptoms of hypercalcemia and blood chemistry suspicious for primary hyperparatyroidism were included into this study. All patients were evaluated with both USG and Sestamibi scan as well as serum calcium and parathormone (PTH) levels. Serum PTH levels were high in all patients, while serum calcium levels were high in 9 of 10 patients. Eight patients (80%) had a documented adenoma by US and 8 (80%) had so by Sestamibi scan. Both high resolution USG and Sestamibi scan were effective for localization of parathyroid adenomas. Since USG is easy to perform and inexpensive compared to Tc-99m Sestamibi scintigraphy, it should be the first diagnostic tool for the evaluation of hyperparathyroid patients suspected to have primary adenomas.

      PubDate: Sun, 13 Apr 2014 02:13:20 GMT
       
  • Can we use the gland/smooth muscle ratio of the prostate to predict the
           outcome of alpha blockade in benign prostate hyperplasia'
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Kaplan O, Senkul T, Adayener C, Akyol I, Iseri C, Yildirim S.
      The predictive capability of the gland/smooth muscle ratio of the prostate gland regarding the outcome of medical treatment of benign prostatic hyperplasia (BPH) was evaluated. Thirty patients referred for lower urinary tract symptoms and with a negative prostate biopsy for a suspicious digital rectal examination or elevated serum PSA levels were included in the study. International Prostate Symptom Score (IPSS) was obtained and uroflowmetry were performed in each patient. All patients were administered 5 mg of tera- 􀀀osin once daily with dose titration for 6 weeks and then the IPSS and the uroflowmetry were repeated. The biopsy specimens were reviewed to find out the gland/smooth muscle ratio. A correlation between the gland/smooth muscle ratio of the prostate gland and the percent improvement in the IPSS and uroflowmetry was assessed. Mean age of the patients was 65.3. Mean pre-treatment values of IPSS, Qmax and Qave were 14.6±5.7, 10.6±2.9 mL/s and 5.2±1.7 mL/s; whereas, post-treatment measurements were 9.3±4.8, 12.9±3.8 mL/s and 6.3±2.2 mL/s, respectively. All of the differences between pre- and posttreatment measurements were statistically significant (p

      PubDate: Sun, 13 Apr 2014 02:11:29 GMT
       
  • The effect of temporary aneurysm clip and topical papaverine
           administration on the vasospastic rat femoral artery
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Dinc C, Iplikcioglu AC, Berkman Z, Bikmaz K.
      We evaluated the mechanical spasm induced by temporary aneurysm clip and the effect of topical papaverine administration on vasospastic rat femoral artery. Vasospasm was constituted in the right femoral arteries of 12 rats. Left femoral arteries were served as controls. Subsequently, each group was divided into two subgroups: temporary aneurysm clip plus topical papaverine administration; and temporary aneurysm clip plus topical saline administration. Thus, a total of 4 groups were created: 1a) vasospastic artery + temporary clip + papaverine; 1b) vasospastic artery + temporary clip + saline; 2a) non-vasospastic artery + temporary clip + papaverine; 2b) non-vasospastic artery + temporary clip + saline. Temporary aneurysm clips were applied for 5 minutes in each group. Subsequently, papaverine and saline were administrated topically. Pictures were taken to measure the diameters of vessels by macro system equip camera before and after applying temporary aneurysm clips; and also, the diameters of arteries were measured every 10 minutes for one hour after the drug administration. Difference between before and after the applying temporary aneurysm clips in every 4 groups were not statistically significant. The difference between the papaverine and saline administrated diameter of artery in both vasospastic and non-vasospastic groups was statistically significant. Papaverine provided maximum dilatation on vessels 10 minutes after the topical administration. Effects of topical papaverine administration in both vasospastic and non-vasospastic groups were similar. We could not detect any significant difference between the effect of topical papaverine administration following temporary aneurysm clip application in vasospastic and non-vasospastic groups.

      PubDate: Sun, 13 Apr 2014 02:09:12 GMT
       
  • Histological evaluation of the cystoscopic appearance of primary bladder
           tumors
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Senkul T, Adayener C, Iseri C, Karademir K, Akyol I.
      The histological evaluation of the cystoscopic appearance of the primary tumors and of the superficial tumors on follow-up has been previously studied. In the present study, we aimed to evaluate the correlation of the cystoscopic appearance and the histology of primary bladder tumors and to assess the benefits and the indications of such predictions in patients afflicted with these tumors. The grades and stages of 41 patients with primary bladder tumors were estimated as Ta grade 1, Ta grade 3, T1 grade 3 or muscle invasive. Then, the visual predictions on tumor stage and grade were correlated with the histopathological evaluation. The cystoscopy correlated with the histology in 88% of pTa grade 1, 57% of pTa grade 3, 60% of pT1 grade 3 and 86% of muscle invasive tumors. In primary bladder tumors, the grade and stage cannot be accurately determined by cystoscopic appearance.

      PubDate: Sun, 13 Apr 2014 02:06:59 GMT
       
  • Three-dimensional versus conventional digital subtraction angiography in
           the diagnosis of intracranial aneurysms: case report
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Asir A, Guven G, Tekin T, Kutlay M, Colak A, Simsek H, Demircan MN.
      Digital subtraction angiography (DSA) is considered the gold standard in the assessment of cerebral vasculature. Recently, three-dimensional (3D) reconstruction of intracranial vessels is of interest for evaluation of aneurysms. A 58-year-old female patient admitted with an acute-onset headache. Computed tomography (CT) scans of the brain revealed subarachnoidal hemorrhage, but repeated DSAs were not able to identify the source of bleeding. Later on, the patient was evaluated with 3D DSA which revealed an anterior cerebral artery aneurysm. Eventually, the aneurysm was treated with endovascular embolization. Superiority of the 3D DSA leads us to question the use of conventional DSA, which is still considered as a gold standard for the diagnosis of intracranial aneurysms.

      PubDate: Sun, 13 Apr 2014 02:05:15 GMT
       
  • A rare cause of abdominal pain: a case of renal infarct
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Zeybek N, Gorgulu S, Yildiz F, Ozturk E, Peker Y, Tufan T.
      We present here a patient who was admitted to the hospital with abdominal pain. The patient was complaining of abdominal pain radiating to right lower quadrant and right flank initially. During the follow up, to reduce of abdominal pain and development of hematuria several diagnostic studies were performed. Contrast enhanced computerized tomography and color Doppler ultrasound revealed a perfusion defect at the superior lobe of the right kidney. The patient was followed up non-operatively and discharged by recovery of the perfusion. Diagnosis of Renal infarction should be considered if symptoms such as hematuria develop accompanying uncertain abdominal pain in patients. Contrastenhanced CT may be helpful for the diagnosis.

      PubDate: Sun, 13 Apr 2014 02:03:38 GMT
       
  • Dyke-Davidoff-Masson Syndrome: report of two cases
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Togrol RE, Senol MG, Yasar H, Saracoglu M.
      Cerebral hemiatrophy or Dyke-Davidoff- Masson syndrome (DDMS) is a rare clinical picture, characterized by unilateral cerebral atrophy and facial asymmetry, hemiparesis, seizures and mental retardation. The clinical findings vary according to the extent of the brain damage. In this report, a 22 year-old patient with epileptic seizures, hemiatrophy and hemiparesis, associated with a cyst starting from the lateral ventricle stretching to the vertex and a 20 year-old patient with hemispheric atrophy will be discussed.

      PubDate: Sun, 13 Apr 2014 02:02:24 GMT
       
  • The results of damage control surgery in abdominal trauma
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Simsek A, Ozer MT, Eryilmaz M, Ozturk E, Ozerhan IH, Gorgulu S, Peker Y, Tufan CT.
      Damage control surgery has increased as a popular application in patients with a deteriorated general condition due to a severe trauma incident. The purpose of the study is to investigate the morbidity and mortality of such patients who were followed up at our hospital due to a damage control surgery. This research was scheduled as a retrospective study. Eleven patients who underwent damage control surgery during 2000-2006 were included in the study. Arterial blood pressures, amount of transfusions, body temperature during admission, blood pH and injury severity scores (ISS) of the patients were determined and recorded. The period of stay in the intensive care unit, duration of re-operation and number of re-operations were also recorded. The mean age of the study group was 27 + 8 years while average ISS values were 34 + 12. All patients suffered from penetrating abdominal injuries due to firearm weapons. Seven liver, 4 colon, 3 small intestine, 1 pancreas, 1 kidney, 3 spleen and 3 large vein injuries were observed. The duration of stay in the intensive care unit was 19 + 14 and 29 + 17 days, respectively. Patients were re-operated 24 times after damage control surgery. Six patients were rehospitalized after discharge due to late complications. One of the most frequent reasons for reoperation was incisional hernia (n=9), intraabdominal abscess (n=7), ostomy correction (n=4), entero-cutaneous fistula (n=3) and fistula development (n=2). One patient died of severe sepsis and multi-organ failure. The decision to perform a damage control surgery must be made quickly when the patient is in the operating room and after the decision is made, it is essential to immediately provide hemorrhage control and avoid bowel contamination. It is obvious that determining the importance of damage control surgery as re-operation may be extremely necessary in order to avoid morbidity.

      PubDate: Sun, 13 Apr 2014 01:57:15 GMT
       
  • Laparoscopic inguinal hernia repair results of a military hospital in
           Turkey
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Sabanci U, Ogun I, Candemir G.
      The purpose of this study is to demonstrate that the laparoscopic inguinal hernia repair is very safe and effective procedure for the patients with minimal postoperative pain, short hospital stay, and shorter time to return normal activities as compared to open procedures. Four hundred sixty-eight laparoscopic hernia repairs were performed in 391 patients between 1995 and 2002. Three hundred and fifty patients were operated by total extraperitoneal (TEP), and 41 patients by transabdominal preperitoneal (TAPP) technique. The mean operation times were 70.5 (± 20.3) and 55.4 (± 24.2) minutes for TAPP and TEP respectively. Postoperative pain was determined by visual analog scale (VAS). One patient had major complication (femoral nerve injury). Twenty four seromas (5.1%), and 10 (2.1%) hernia recurrences were observed. Laparoscopic hernia repair is a safe and effective technique with minimal postoperative pain and short hospital stay. Patients can return back to their normal activities in a short period compared to open hernia repair procedures.

      PubDate: Sun, 13 Apr 2014 01:54:36 GMT
       
  • The evaluation of the effects of cetrimide-clorhexidine and hypertonic
           sodium chloride combination on liver, lung, and biliary tract in hydatid
           disease
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Balkan M, Balkan A, Kilciler G, Mentes O, Aydin A, Oner K.
      The aim of this study was to evaluate whether combined use of cetrimide-chlorexidine and hypertonic sodium chloride as scholexidal agents leads to complications in liver, lung or biliary tract. Thirty Spregue-Dowley rats weighing 100􀀀10 gr were used in this study. Rats were divided into two groups. Fifteen rats in group I were injected with 10% hypertonic sodium chloride, whereas 15 rats ingroup II were injected 0.5% cetrimide - 0.05% chlorhexidine combination. After 5 cc blood aspiration by intracardiac punction, liver, choledoc canal and lungs were taken out en-bloc. Liver SOD, MDA, GSH-Px were studied at the department of pharmacology. Sixteen rats, which survived after the operation for 120 days, were put to sleep. The specimens from liver and lung parenchyma were evaluated. In this study, histopathological evaluation of liver tissue in group I was found to be sclerosing cholangitis, whereas in group II, moderate stress factors in liver tissue was noticed. In this experimental study, we found that the administration of 0.5% cetrimide - 0.05% chlorhexidine combination as a scholexidal agent into the biliary tract instead of a protoscoleces agent is a safe approach.

      PubDate: Sun, 13 Apr 2014 01:52:45 GMT
       
  • Visual prognosis and pars plana vitrectomy indication in preretinal
           hemorrhages
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Unal M, Ayata A, Sonmez M, Tatlipinar S, Ersanli D.
      The aim of this study is to determine the indications of primary pars plana vitrectomy and clinical and visual prognosis of preretinal hemorrhages. Primary pars plana vitrectomy was done to 14 diabetic retinopathy patients with preretinal hemorrhage during the laser photocoagulation and 8 patients with traumatic preretinal hemorrhages which were not resolved in 3 to 6 weeks period. The patients were interpreted by means of surgical and hemorrhagic complications, hematological diseases and visual prognosis postoperatively. Clear vitreous was obtained in all cases while macular edema in 12 cases, retinal ischemic places and neovascularization in 6 of 14 diabetic cases were seen. Laser photocoagulation was applied to all cases. Hematological disease was not seen in any traumatic cases. Preoperative visual acuities were between P+, P+ and 0.1 while 0.2 and 0.9 postoperatively. Primary pars plana vitrectomy is a good alternative in traumatic persistent preretinal hemorrhages to prevent blood toxicity and in diabetic retinopathies with preretinal hemorrhages to allow laser photocoagulation.

      PubDate: Sun, 13 Apr 2014 01:50:38 GMT
       
  • Surgical approaches for treatment of infected acute necrotizing
           pancreatitis
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Simsek A, Yagci G, Ozturk E, Ozer MT, Can MF, Kece C, Peker Y, Gorgulu S, Akdeniz A, Cetiner S, Tufan T.
      Necrotizing Acute Pancreatitis (NAP) complicated by infection is a very serious disease resulting in multi-organ failure. It is still associated with a very high mortality. The aim of our study was to evaluate of Infected Necrotizing Acute Pancreatitis (INAP) in patients treated with the various surgical approaches. We retrospectively reviewed twentythree patients with INAP, who were surgically treated, in order to assess the results of the surgical treatment between 1995 and 2005. Of the cases mentioned, 15 were male while the rest (8 cases) being female (average 52 years of age, range 44-78). The average APACHE II score for whole study group (after 48 h) was 12.8. Operative procedures consisted of external drainage (ED) in 11 cases (48%) and necrosectomy with continuous local lavage (NCL) in 12 cases (52%). The overall mortality rate was 21 percent (n=5). In the group with fatal outcome, first operation performed was ED in three cases and NCL in two cases. The reason for death was multi-organ failure in all patients. During a median follow-up of 20.4 months, 9 (39%) out of 23 patients had one or more late complications: pseudocyst in 5 (21%), pancreatic fistula in 2 (9%), delayed collection in 1 (4%) and incisional hernia in 1 (4%). In patients with infected necrosis who deteriorate during conservative treatment, NCL may be an option with acceptable morbidity, re-operation and mortality rates. We believe that complications during surgical therapy of acute infected necrotizing pancreatitis are carrying high risk factors, but their treatment is not hopeless.

      PubDate: Sun, 13 Apr 2014 01:48:45 GMT
       
  • Orthodontic treatment need and malocclusion prevalence in Turkish adult
           males
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Sari E, Kurtulmus H, Boyacioglu H.
      The purpose of this study is to assess the objective and subjective levels of orthodontic treatment needs and severity of malocclusion in Turkish male adults considering the effect of regional variation. A sample of 556 adult males (median age of 21 years) from 7 different regions of Turkey have been subject to this study. The Index of Orthodontic Treatment Need (IOTN) was used to evaluate the orthodontic treatment need. Questionnaires were used to evaluate the perception of malocclusions and the benefit of orthodontic treatment of subjects. Forty-seven percent of subjects had definite need of orthodontic treatment based on dental health component (DHC) of IOTN. Severe contact point displacement (4d-14%) was the most frequently encountered occlusal traits in the sample. 63.3% of subjects had no need of treatment according to the subjective esthetic component (EC) of the IOTN whereas, 59% of subjects had no need treatment based on objective EC of the IOTN. South East region had the highest proportion with no treatment need based on objective EC (p=0.036). It is found a good correlation between objective and subjective EC (p=0.614). Turkish male adult could evaluate the objective orthodontic treatment need. Most of the subjects (64%) did not demand the orthodontic treatment in this study. Class I (51%) was the most frequently seen malocclusion type in these subjects.

      PubDate: Sun, 13 Apr 2014 01:47:14 GMT
       
  • The effect of Suprogel - macromolecule polysaccharide - on the formation
           of postoperative abdominal adhesions
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Zeybek N, Kenar L, Yildiz F, Peker Y, Kurt B, Serdar M, Kusaslan R, Tufan T.
      Abdominal adhesion is one of the major causes of intestinal obstruction, primary and secondary female infertility, chronic pelvic pain, and inconveniences in the future operations. Postoperative adhesions develop after 90% of all laparotomies and they become mostly the reason for 54% to 74% of small bowel obstructions, which need additional surgical correction by the rate of 41% to 44%. The aim of this study is to evaluate the efficacy of Suprogel® - macromolecule polysaccharide - in the protection against formation of postsurgical adhesion in a standardized rat experimentally pathological model. Twenty rats with induced peritoneal adhesion were randomly divided into two groups. Rats in group 1 received no medication, while ingroup 2 rats Suprogel® was applied. Adhesions were evaluated blindly 21 days following the surgical operation. Adhesion tissue samples were microscopically evaluated. Tissue hydroxyproline and collagen concentrations were measured. The adhesion grading and histopathological adhesion score were significantly lower in Suprogel group, but peritoneal hydroxyproline levels did not differ significantly between the groups. Consequently, the present study suggested that intraperitoneal administration of Suprogel® might be effective to reduce the incidence of postoperative adhesions in this experimental model.

      PubDate: Sun, 13 Apr 2014 01:45:28 GMT
       
  • Surgical stabilization of multiple spine tumors (report of two cases)
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Asir A, Simsek H, Kutlay M, Colak A, Demircan MN, Cetinkal A, Secer HI, Kaya S.
      We present two cases of multiple spinal malign involvements both of whom underwent lumbar and cervical tumor resection and stabilization surgery. The first case was a 60-yearold male otherwise healthy, who had back pain. MRI studies revealed L2 vertebra body invasion which later found out to be originated from prostate adenocarcinoma. He underwent decompression, tumor resection and stabilization with fusion via anterolateral-retroperitoneal approach. One month later, C6 vertebra invasion had been detected and after decompression, anterior stabilization by autogenous bone graft and screw plate was performed. Second case was 78-year-old female who presented with back pain due to multiple myeloma. She underwent tumor resection and posterior fusion by allograft and transpedicular instrumentation. 3 years after first intervention, metastatic lesions in atlas and axis had been detected. Following the anterior corpectomy, stabilization and fusion was performed using fibular allograft. Sufficient fusion was confirmed for both patients in three months time. The patients have been followed-up for 4 years and 12 months respectively. The stabilization procedures provided durable pain relief and preservation of ambulatory status so far. Since the survival time of the patients with spinal malignancies has been superior to previous decades, combination of surgical and conservative treatments is necessary to promote encouraging outcomes.

      PubDate: Sat, 12 Apr 2014 17:08:03 GMT
       
  • Management of a recurrent sigmoid volvulus in a young patient. Report of a
           case
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Akyuz M, Mentes O, Gur S, Ozdemir Y, Kozak O, Tufan T..
      Bowel obstruction after large bowel volvulus is a rare cause of acute abdomen. Volvulus of the sigmoid colon occurs more commonly in older, psychiatric or senile patients in prolonged bed rest, but chronic constipation, congenital abnormalities, drug addiction, and surgery also play a role in the etiology. We described a rare case of 21 years-old man who admitted to our hospital with severe abdominal pain, distension and inability to discharge stools. Abdominal computed tomography (CT) revealed a dilated colon with an air-fluid level and the “whirl sign”. On his previous history, he described same attack one year ago which he underwent urgent operation of sigmoidopexy. Our diagnosis was volvulus of the sigmoid and we performed urgent primary resection and anostomosis. Accurate diagnosis and early surgical intervention are essentials for optimal management in sigmoid volvulus. In young and medically fit patients resection and primary anastomosis should be the first choice.

      PubDate: Sat, 12 Apr 2014 17:04:50 GMT
       
  • Management of a recurrent sigmoid volvulus in a young patient. Report of a
           case
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Akyuz M, Mentes O, Gur S, Ozdemir Y, Kozak O, Tufan T..
      Bowel obstruction after large bowel volvulus is a rare cause of acute abdomen. Volvulus of the sigmoid colon occurs more commonly in older, psychiatric or senile patients in prolonged bed rest, but chronic constipation, congenital abnormalities, drug addiction, and surgery also play a role in the etiology. We described a rare case of 21 years-old man who admitted to our hospital with severe abdominal pain, distension and inability to discharge stools. Abdominal computed tomography (CT) revealed a dilated colon with an air-fluid level and the “whirl sign”. On his previous history, he described same attack one year ago which he underwent urgent operation of sigmoidopexy. Our diagnosis was volvulus of the sigmoid and we performed urgent primary resection and anostomosis. Accurate diagnosis and early surgical intervention are essentials for optimal management in sigmoid volvulus. In young and medically fit patients resection and primary anastomosis should be the first choice.

      PubDate: Sat, 12 Apr 2014 17:04:47 GMT
       
  • Prenatal diagnosis of campomelic dysplasia at the first trimester: case
           report
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Goktolga U, Keskin U, Gezginc K, Karasahin KE, Ergun A, Gul D, Baser I.
      A case diagnosed as camphomelic dysplasia with the clue of increased nuchal translucency was demonstrated. This was the second pregnancy of 30 year old patient, and her first pregnancy was known to be terminated with 8 weeks old complete miscarriage. Genetic investigation was lacking fort he abort material. There was no known marriage with a relative among couples. Patient was first detected with present fetal cardiac activity and CRL of 11.9mm size at 7th week of gestation at routine pregnancy follow-up. TORCH tests were negative. At 12th week of gestation, CRL 56.1mm, nuchal translucency 8.1 mm and generalized skin edema was detected. CVS procedure was carried out for cytogenetic investigation. While have been waiting for culture result, at 14th week of gestation, at ultrasound, short femur length (10th percentile), normal biparietal diameter and increased transverse abdominal diameter was detected, chest wall was narrow and seemed bell-shaped. Ultrasound findings were correlated with campomelic dysplasia. Fetal caryotype was reported as normal. 14th week of pregnancy, pregnancy was terminated after taking informed consents from parents. Postnatal inspection confirmed prenatal ultrasound findings. If nuchal translucency increases, osteochondrodysplasia and campomelic dysplasia should keep in mind.

      PubDate: Sat, 12 Apr 2014 17:02:07 GMT
       
  • First trimester bleeding and pain
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Gezginc K, Goktolga U, Ergun A.
      The most common gynecologic emergency is vaginal bleeding and pain in patients who admit to emergency departments. Early pregnancy bleedings are observed in 20% of pregnancies. Immediate and appropriate management and proper treatment of pregnant that admit emergency unit with anxiety of bleeding is important. Doctor in emergency unit should evaluate and take the rapid history of the patient and apply laboratory tests, ultrasonography and multidisciplinary consultations. In pregnant that admit emergency unit with first trimester bleeding and pain, first of all ectopic pregnancy and incomplete abortus should be differentiated. After taking medical history and performing physical examination carefully, β-hCG level together with ultrasonography is more effective in evaluation of vaginal bleeding and pain at early pregnancy period. Appropriate management could be done later according to the differential diagnosis.

      PubDate: Sat, 12 Apr 2014 16:59:09 GMT
       
  • Work load-induced autonomic dysfunction - pathophysiological precursor of
           cardiovascular diseases
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Nikolova RI, Aleksiev LS, Vukov MI.
      Asymptomatic early-stage detection and prevention of Cardiovascular Diseases (CVD) ensure not only optimal health condition of military pilots but also flying safety, and mission performance. The aim of the present study was to examine the autonomic cardiovascular control pattern, and health risk studied by heart rate variability (HRV) in military pilots with different level of work load, and to determine whether the disturbed autonomic cardiovascular control might be associated with cardiovascular pre – morbidity in pilots with increased level of work load. Variability of heart rhythm, systolic and diastolic blood pressure was examined in 66 military pilots. Work load discriminated the whole group into following subgroups: with low (first sub-group), and increased (second sub-group) level of work load. HRV decreased significantly in second compared to first sub-group indicating a pattern of dysfunctional autonomic cardiovascular control. In the first subgroup health risk (HR) was in the range: 25-45 %, determining pre-abnormal cardiovascular control whereas in the second sub-group HR is above 65 % indicating dysfunctional control. Discriminating variables that distinguished sub-groups were mental and physical stress, sympathetic and parasympathetic modulation of cardiovascular function. Results of our study showed that dysfunctional autonomic cardiovascular control might be considered as a precursor of cardiovascular morbidity.

      PubDate: Sat, 12 Apr 2014 16:57:32 GMT
       
  • One-staged and multi-staged image–guided polymetastasectomies in
           patients with multiple parenchymal brain metastases
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Eftimov T, Petkov A, Ivanov I, Hadjiangelov I.
      The increasing number of patients with multiple parenchymal brain metastases demands the analyses of the use of newly introduced hightechnology methods for neurosurgical treatment. Thirty-eight patients with newly diagnosed and recurrent multiple parenchymal brain metastases were operated at the Neurosurgical Department of Military Medical Academy-Sofia over the period from January 2004 until June 2006. Fifty-three image-guided craniotomies with excision of 76 metastatic brain lesions were done. Patients were analyzed by: prognostic criteria of the RTOG, number and type of metastases, clinical symptoms, neurosurgical treatment and achieved results (early and late complications). The perioperative mortality was 6.25%. The results of neurosurgical treatment were objectified through early neuroimaging studies (CT/MRI). The postoperative complications were divided into: systemic, neurological and surgical. The functional status of the patients after the intervention was defined according to the Karnofsky Performing Scale and the quality of life - according to QL-index of Spitzer. The mean survival was found to be around 6 months. One-staged and multi-staged image–guided excisions of all lesions in patients with multiple parenchymal brain oligometastases (no more then 3) ensures better control of the neurooncological disease with low perioperative morbidity and mortality. On the other hand, quality of life is preserved and survival of patients with good control of the primary tumor disease is prolonged.

      PubDate: Sat, 12 Apr 2014 16:25:13 GMT
       
  • Approach for the overuse patello-femoral pain syndrome in recruits
           undergoing military training
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Derincek A, Arslanoglu A, Colak M.
      The aim of this study is to find different approaches and to define the place of treatment and to prevent the overuse patello-femoral pain (PFP) syndrome in recruits undergoing military training. We analyzed retrospectively the patients who admitted to Orthopedics and Traumatology department between June 15 and December 15, 2005 in Van Military Hospital. Total of 336 (8.6%) out of 3986 patients had knee pain. 126 (37.5%) of 336 patients with knee pain diagnosed as overuse PFP syndrome with clinical examination. 116 of the cases were males and 10 were females. Mean age was 24.7. 21 of 126 patients with overuse PFP syndrome had bilateral knee pain. Four patients had meniscopathy, 6 patients had plica hypertrophy, 6 patients had lateral prepatellar tightness, and 1 patient had patella alta. Majority of the patients stated that their symptoms and complaints aggregated with military training, and reduced with less activity and rest. Overuse PFP syndrome is frequently seen among recruits undergoing military training. Because the cause is largely unknown and the main treatment is less activity, patients are usually accused of being malingerers. Thus it makes difficult for medical staff and military superiors to deal with the problem. We recommend the reinforcement of quadriceps muscle strength and proper stretching before exercising during basic military training and this would be useful in treatment and prevention of overuse PFP syndrome.

      PubDate: Sat, 12 Apr 2014 16:22:52 GMT
       
  • Amyloid neuropathy: a clinicopathological study of 9 cases
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Kararizou E, Davaki P, Markou I, Gkiatas K, Vassilopoulos D.
      The purpose of this study is to investigate the clinical, electrophysiological and pathological features of amyloid neuropathy in order to establish the clinical and histological manifestations and to promote the earlier diagnosis of the syndrome. Biopsies were selected from over 700 sural nerve biopsies performed at the Section of Neuropathology. The diagnosis of amyloidosis was based on established clinico-pathological criteria. Other causes of peripheral neuropathy were excluded. Complete laboratory, clinical, electrophysiological and pathological studies were performed in all cases. Nerve biopsies of 9 patients were diagnosed as amyloidosis. The pathological features were amyloid deposition in epineurium, perineurium and endoneurium and predominant axonal degeneration with a varying pattern of myelinated fiber loss. Amyloid masses can been seen focally in the vessel wall and Congo red staining in 5- 10 μm thick sections best demonstrates the classic apple-green yellow birefringence The distal sensorymotor neuropathy was the most frequent neuropathic manifestation, followed by mononeuritis. Autonomic abnormalities were common. We discuss characteristic pathological features of neuropathy in primary and secondary or other forms of amyloidosis. It is still unclear the pathophysiology of the nerves involvement, but it is estimated the existence of a common immune mechanism

      PubDate: Sat, 12 Apr 2014 16:17:49 GMT
       
  • Evaluation of taking order and risk of facing with medical errors for
           nurses in a military hospital in Turkey
    • Abstract: Publication year: 2007
      Source:Balkan Military Medical Review
      Tosun N, Yildiz D, Dal U, Hatipoglu S.
      This is a descriptive study designed to determine the order taking process and probable risks of medical errors of nurses. The questionnaire form used in research was applied to 180 nurses with personal interviews. Percentages and the chi-square test were used for the analysis of the data. The percentage of orders written on daily basis (63.3%) in medical clinics, signing ratio of nurses after taking the physician order (65.6%) and taking order by phone (78.3%) are found high for risk as a medical error in our study. 96.7 % of the nurses has stated that if they notice a mistake at the order, they reconsult with the doctor to repeat the order. As a result of a probable medical error after a verbal order, the ratio of “I have no idea” (38.8%) answer may indicate that the nurses could be legally responsible. This study showed that nurses have had knowledge and performance deficiency in taking orders. Developing a multidisciplinary orientation and training program is necessary for preventing medical errors.

      PubDate: Sat, 12 Apr 2014 16:14:38 GMT
       
 
 
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