Background: With recent technological advances, magnetic resonance imaging (MRI) has offered new ... more Background: With recent technological advances, magnetic resonance imaging (MRI) has offered new sequences that can evaluate the real-time motion of anatomic structures. This study aims to evaluate the interobserver agreement in the diagnosis of diaphragmatic dysfunctions using bi-parametric MRI, in which dynamic sequences for diaphragm movement and static sequences for soft tissue resolution are used together to provide a visualization of the diaphragm. Methodology: Twenty-nine cases that underwent a bi-parametric magnetic resonance examination which includes coronal T2 single-shot turbo spin echo and the coronal SENSE single-shot balanced turbo field echo real-time sequences were retrospectively evaluated. The images of the patients were assessed by two independent observers. Cohen's kappa coefficient was calculated to evaluate the interobserver agreement. Results: The mean age of the patients was 44.86 ± 17.57, ranging from 18 to 80 years. The kappa value was calculated as 0.889, indicating a strong agreement between the interobservers. Conclusions: Our experience suggests that bi-parametric MRI is a promising tool in the evaluation of diaphragmatic abnormalities.
AİBÜ İzzet Baysal tıp fakültesi dergisi, Aug 31, 2022
The aim of this study is to determine the accuracy and usefulness of fine needle aspiration biops... more The aim of this study is to determine the accuracy and usefulness of fine needle aspiration biopsy(FNAB) in the diagnosis of parotid masses. Materials and Methods: FNAB findings of 123 patients who were operated over a last ten years period were retrospectively analyzed and compared with histopathological findings. We examined the sensitivity, the specificity, the positive predictive value (PPV), the negative predictive value (NPV) of FNAB. Results: FNAB results of the patients who participated in the study are as follow; non-diagnostic for 7 patient (%5.7), atypia of undetermined significance for 7 patients (%5.7), bening neoplasm for 98 patients (79.7%) and malign cytology for 11 patients (%8.9). Histopathological results were maligned found in 1 out of 98 patients with benign neoplasm in cytology results in FNAB. The histopathological result was benign in 2 of 11 patients with malignant neoplasm in the cytology findings with FNAB. The specificity of FNAB in the diagnosis of parotid masses was found as 98% and the sensitivity was 90%. The positive predictive value (PPD) was detected as 86% and the negative predictive value was detected 98%. Conclusion: Since malignant masses of the parotid are rare and diverse, diagnosis with FNAB can be difficult. Another complicating factor is the similarity of low-grade malignant tumor and benign tumor. As a result, FNAB has high accuracy for benign parotid tumors, but low for malignant parotid tumors.
Aim: The aim of this study is to assess the correlation between the level of disc herniation and ... more Aim: The aim of this study is to assess the correlation between the level of disc herniation and pelvic and lumbar vertebral incidences in patients operated for lumbar disc herniation. Material and Method: This retrospective study included those patients whose file records were analyzed. The demographic data and clinical findings of 59 patients diagnosed with single level lumbar disc herniation and underwent unilateral microdiscectomy were recorded. In the analysis of the variables, SPSS 25.0 (IBM Corparation, Armonk, New York, United States) was used. Results: The patients involved 28 men and 31 women whose median age was found as 43.31±4.27 (38-54) years. With regard to location, it was determined that in 28 (47.5%) patients, the herniated discs were located on the right and in 31 patients (52.5%), they were located on the left. In terms of levels, in patients with herniated discs at level L5-S1, the median pelvic index and L4 index were found to be significantly lower than those of patients with herniated discs at levels L4-5 and L3-4 (p=0.002, p=0.001), whereas in patients with herniated discs at level L4-5, the median L5 incidence was found to be significantly high (p=0.001). Conclusion: In this study, the pelvic index and L4 and L5 indexes were found to be significantly low in patients with herniated discs at level L5-S1. It is considered that future prospective and multicentered studies with long-term follow-up are necessary.
Aim: The aim of this study is to assess the correlation between the level of disc herniation and ... more Aim: The aim of this study is to assess the correlation between the level of disc herniation and pelvic and lumbar vertebral incidences in patients operated for lumbar disc herniation. Material and Method: This retrospective study included those patients whose file records were analyzed. The demographic data and clinical findings of 59 patients diagnosed with single level lumbar disc herniation and underwent unilateral microdiscectomy were recorded. In the analysis of the variables, SPSS 25.0 (IBM Corparation, Armonk, New York, United States) was used. Results: The patients involved 28 men and 31 women whose median age was found as 43.31±4.27 (38-54) years. With regard to location, it was determined that in 28 (47.5%) patients, the herniated discs were located on the right and in 31 patients (52.5%), they were located on the left. In terms of levels, in patients with herniated discs at level L5-S1, the median pelvic index and L4 index were found to be significantly lower than those of patients with herniated discs at levels L4-5 and L3-4 (p=0.002, p=0.001), whereas in patients with herniated discs at level L4-5, the median L5 incidence was found to be significantly high (p=0.001). Conclusion: In this study, the pelvic index and L4 and L5 indexes were found to be significantly low in patients with herniated discs at level L5-S1. It is considered that future prospective and multicentered studies with long-term follow-up are necessary.
Brazilian Journal of Otorhinolaryngology, Jul 1, 2022
Introduction: Nasal septum deviation is the leading cause of upper airway obstruction. Chronic up... more Introduction: Nasal septum deviation is the leading cause of upper airway obstruction. Chronic upper airway obstruction may cause myocardial injury due to chronic hypoxia. Effects of sep-Q2 toplasty on left venticular diastolic and sistolic functions are not well known. The myocardial performance index is an easy-to-apply and reliable parameter that reflects systolic and diastolic cardiac functions. Objective: The present study aimed to investigate the effect of nasal septoplasty on the myocardial performance index in patients with nasal septal deviation. Methods: This prospective study consisted of 50 consecutive patients who underwent septoplasty due to symptomatic prominent C-or S-shaped nasal septal deviation. Transthoracic echocardiogarphy was performed in all patients before and 3 months after septoplasty. Calculated myocardial performance indices were compared. Results: Significantly higher left ventricular myocardial performance index (0.52 ± 0.06 vs. 0.41 ± 0.04, p < 0.001), longer isovolumic relaxation time (95.0 ± 12.5 vs. 78.0 ± 8.6 ms, p < 0.001), longer isovolumic contraction time (45.5 ± 7.8 vs. 39.5 ± 8.6 ms, p < 0.001), longer deceleration time (184.3 ± 32.5 vs. 163.6 ± 45.4 ms, p = 0.004), higher ratio of transmitral early to late peak velocities (E/A) (1.42 ± 0.4 vs. 1.16 ± 0.2, p = 0.006) and shorter ejection time (270.1 ± 18.3 vs. 286.5 ± 25.8 ms, p < 0.001) were observed before septoplasty when compared to values obtained 3 months after septoplasty. Left ventricular systolic ejection fraction was similar before and after septoplasty (63.8±2.8% vs. 64.6±3.2%, p = 0.224).
The goal of the study is to retrospectively assess cases of renal injuries. Material and Methods:... more The goal of the study is to retrospectively assess cases of renal injuries. Material and Methods: The cases of renal injury presenting at Adiyaman Training and Research Hospital between January 1st, 2013, and December 31st, 2017 were investigated in terms of age, gender, radiologic findings, grade of renal injury, and cause of injury. The degree of kidney injury determined by imaging methods was evaluated in terms of the American Association for the Surgery of Trauma (AAST). Results: Of the 123 patients with renal injury, 27 were female (21.95%) and 96 were male (78.05%), with an average age of 32.6 ± 16.7 years. In total, 59 cases (47.96%) were younger than 35 years. When the cases were examined according to age groups, 11 (8.94%) cases were under the age of 14 years, 23 (18.70%) cases were aged 15-24 years, and 25 (20.32%) cases were aged 25-34 years. The older age groups included 23 (% 18.70) cases aged 35-44 years, 19 (15.46%) aged 45-54 years, 9 (7.31%) aged 55-64 years, and 13 (10.57%) older than 65 years. Overall, 59(47.96%) injuries were from traffic accidents (p<0.005), 36 (28.96%) from falls, 12 (9.74%) from sharp and penetrating object injuries, seven (5.69%) from gunshot wounds, five (4.07%) from assaults, and four (3.25%) from work accidents. Conclusion: Renal traumas are life-threatening injuries. We have evaluated renal injuries in terms of radiological and forensic medicine, and we believe the findings contribute to the existing literature on this subject.
Adıyaman Üniversitesi sağlık bilimleri dergisi, Dec 15, 2016
Bu çalışmada amaç; balık tüketimi sıklığı ile osteoporoz (OP) arasındaki ilişkiyi değerlendirmekt... more Bu çalışmada amaç; balık tüketimi sıklığı ile osteoporoz (OP) arasındaki ilişkiyi değerlendirmektir. Materyal ve metot: Bu çalışmada 45 ile 75 yaş aralığında postmenapozal kadın hastaların kayıtları incelendi. Çalışma kriterlerine uyan 152 postmenapozal kadın hasta çalışmaya dahil edildi. Olgular, haftalık balık tüketim alışkanlığı 250 gram ve üzerinde olanlar Grup 1 ve balık tüketim alışkanlığı haftalık 250 gramın altında olanlar Grup 2 olarak sınıflandırılmıştır. Osteoporoz tanısında yaygın olarak Dual Enerji X Ray Absorbsiyometri (DEXA) yöntemi kullanıldığından, bu çalışmada da kemik mineral içeriğini (gram:g) iki enerji X-ray absorbsiyometri (DEXA) cihazı verilerine göre sınıflandırma yapıldı. Olguların tüm vücut ve total kalça taramaları aracılığıyla KMY (g/cm 2) değerleri elde edildi. KMY (tüm vücut ve total kalça değerleri incelendi; ancak L2-L4 esas alındı) ve T-SKOR ise L2-L4 değerlerine göre klinik tanılar; osteoporoz, osteopeni ve normal olarak sınıflandırıldı. Bulgular: Olguların 45'i (%29,60) Grup 1'de, 107'sinin ise (%70,40) Grup 2'de yer aldığı tespit edildi. Grup 1'deki olguların %19,73 (n:30) ve Grup 2'deki olguların %1,97 (n:3) KMY normal değerlerde tespit edildi. Bu değer balık tüketim alışkanlığı olmayan gruba göre karşılaştırıldığında istatistiksel olarak (p<0,05) anlamlı olarak bulundu. Osteoporoz tespit edilen olgular Grup 1'de %10,20 (n:5) ve Grup 2'de ise %89,79 (n:44), osteopeni Grup 1'deki olguların %14,28 (n:10) ve Grup 2'deki olguların %85,72'sinde (n:60) tespit edilmiştir. Bu değerler arasında fark olmakla birlikte balık tüketim alışkanlığı olmayan gruba göre karşılaştırıldığında istatistiksel olarak anlamlı (p>0,05) değildi. Ancak balık tüketim alışkanlığı olan Grup 1'deki sadece beş olguda osteoporoz ile uyumlu olduğu görüldü. Elde edilen değerler istatistiksel olarak anlamlı (p<0,05) olduğu tespit edildi. Sonuç: Bu çalışma verilerine göre; menopoz sonrası dönemdeki kadınlarda haftalık balık tüketiminin 250 gram ve üzerinde olan olgularda KMY üzerine olumlu etki yaptığı ve osteoporoz riskini azalttığı tespit edildi.
Eurasian journal of emergency medicine, Mar 26, 2020
Aim: The aim of this study was to evaluate the diagnostic performance of non-contrast rapid seque... more Aim: The aim of this study was to evaluate the diagnostic performance of non-contrast rapid sequences (RAMRI) visualization on cases who were clinically diagnosed as having acute abdominal pain (AAP). Materials and Methods: Forty-six patients were chosen from 2850 patients who were admitted to the emergency service between January 2016-January 2019 because of sudden onset abdominal pain and could not get a computerized tomography analysis. A 1.5 Tesla magnetic resonance (MR) device (GE Signa Hi-Speed, Milwaukee) was used for analysis. Coronal and axial T2-weighted single-shot fast spin-echo series were used as scan protocol. No intravenous, oral or rectal contrast material was used. The cases were identified as positive (+) or negative (-) by MRI. The cases who had symptoms related with AAP, were considered as positive (+), and the cases who did not have symptoms or had symptoms which were not related with AAP, were considered as negative (-). Results: Of the patients, 26 (56.5%), were female and 20 (43.5%) were male. The median age was 38.65 (18-86) years. The treatment methodology was surgery for 25 cases (54%) and conservative for 21 (46%) cases. The operative group (surgically treated) included 24 MR (+) and one MR (-) cases. There was a harmony between the clinic and MRI data of all members in non-surgical group. The accuracy of the study was calculated as 95.6% (44/46). The sensitivity of RAMRI was calculated as 96% for operative group and 100% for non-operative group. Conclusion: A successful diagnostic performance was achieved by non-contrast RAMRI in cases with AAP.
Background: Tinnitus is a common auditory symptom. Dysfunction in the autonomic nervous system (A... more Background: Tinnitus is a common auditory symptom. Dysfunction in the autonomic nervous system (ANS) is an essential part of the etiopathogenesis of tinnitus. ANS regulates heart rate and heart rhythm and can lead to ventricular repolarization changes, which can cause malignant ventricular arrhythmias. T wave peak-to-end T(p-e) interval and T(p-e)/QT ratio are known ventricular arrhythmia indexes, and the index of cardiac-electrophysiological balance (iCEB) is a novel index that can be used to predict the risk of malignant ventricular arrhythmia. The goal of the study was to investigate these ventricular arrhythmia indexes in patients with tinnitus. Methods: The study population consisted of 240 patients with tinnitus and 240 healthy subjects. A standard 12-channel surface electrocardiogram was applied to both groups. T(p-e) interval, QT interval and QRS duration were determined. Corrected QT (QTc) was determined via Bazett's formula. To predict ventricular arrhythmia, iCEB (QT/QRS), T(p-e)/QT, corrected iCEB (QTc/QRS) and T(p-e)/QTc values were determined and compared between groups. Results: Compared to the control group, QT (376.46 ± 36.54 vs 346.52 ± 24.51 ms), QTc (426.68 ± 24.68 vs 390.42 ± 24.04 ms), T(p-e) (75.86 ± 14.68 vs 62.42 ± 8.64 ms), T(p-e)/QT (0.201 ± 0.06 vs 0.180 ± 0.01) and T(p-e)/QTc (0.177 ± 0.06 vs 0.159 ± 0.02) were significantly higher in patients with tinnitus (p < 0.001 for all). QT/QRS (3.92 ± 0.68 vs 3.56 ± 0.32) and QTc/QRS (4.44 ± 1.03 vs 4.01 ± 0.64) were also significantly higher in patients with tinnitus (p = 0.018 and p = 0.008, respectively). In addition, significant positive correlations were found between T(p-e), T(p-e)/ QTc ratio and disease duration (r = 0.792, p < 0.001; r = 0.500, p < 0.001, respectively). Conclusion: As a result, patients with tinnitus may have an increased risk of malignant ventricular arrhythmia.
Aim: We aimed to investigate the relationship between the presence of spondylolisthesis and Modic... more Aim: We aimed to investigate the relationship between the presence of spondylolisthesis and Modic changes (MCs) by using lumbar magnetic resonance imaging (MRI). Methods: The study included 139 adult patients aged 18-65 years with lumbar spondylolisthesis detected on lumbar MRI. Demographic characteristics such as age, gender, and levels and grades of spondylolisthesis, and presence of lumbar MCs/types were recorded. The findings were compared between two groups including grade 1 and grade 2 spondylolisthesis. Results: Grade 1 and 2 spondylolisthesis groups were similar for age (p=0.787), sex (p=0.076), listhesis' level (p=0.268) and direction (p=0.280). The presences of pars spondylolysis, disc space narrowing, and MCs were significantly higher in patients with grade 2 spondylolisthesis than those with grade 1 (94.4% vs 64.1%), (97.2% vs 83.5%), and (100% vs 83.5%), respectively (all p
Background: Sharp and penetrating object injuries (SPOIs) are seen frequently in forensic medicin... more Background: Sharp and penetrating object injuries (SPOIs) are seen frequently in forensic medicine practice. In this study, we aimed to retrospectively investigate cases with SPOIs. Materials and Methods: This study investigated the charts of patients treated at Adiyaman University Education and Research Hospital between January 1, 2013, and December 31, 2017. A total of 934 inpatients with sharp object injuries were included in the study. Data were assessed using a suitable computer-aided package program. Cases were examined in terms of age, gender, injury body site, suicide or homicide, radiologic findings, presence of vital danger, and severity of injury. Results: In this study, we examined the charts for 934 inpatients with stab wounds. It was stated that 124 (13.27%) of those injured were female and 810 (86.63%) male; the average age of the injured persons was 29.8 ± 18.2 years. It was found that 214 (22.91%) people were exposed to vital danger and that 720 (77.09%) suffered from soft tissue injuries (penetrating skin and muscle injuries). Also, 69.27% of the cases (n = 647) involved people less than 35 years of age. Conclusion: Considering that stab injuries are more frequent in the lower age groups, we believe that such injuries could be reduced by increasing training programs for young people.
GENEL BİLGİLER İsim ve Soyadı : Saliha KAFADAR Anabilim Dalı : İşletme Programı : Yönetim ve Orga... more GENEL BİLGİLER İsim ve Soyadı : Saliha KAFADAR Anabilim Dalı : İşletme Programı : Yönetim ve Organizasyon Tez Danışmanı : Yrd. Doç.Dr. Varol Günyaşar Tez türü ve Tarihi : Yüksek Lisans - Aralık 2004 Anahtar Kelimeler : Lojistik Sektörü, Türkiye, Toplam Kalite, Müşteri Memnuniyeti TÜRKİYEDE LOJİSTİK SEKTÖTÜNDE TOPLAM KALİTE YÖNETİMİ Dünya ticaretinin ana unsurlarından biri olan lojistik gelişmiş teknoloji ve uluslararası ticaret açısından gün geçtikçe önem kazanmaya başlamıştır.Seksenli, doksanlı yıllar arasında Turkiyede kara, hava ve deniz taşımacılığı olan lojistik sektörü doksanlı yılların ikinci yarısında teknolojik alt yapısını gelistirerek, dünya üzerindeki gelişmiş ülkelere ayak uydurmaya başlamıştır. Müşteri memnuniyeti ve bunun yaratılması, sürekliliği ve yüksek kaliteli servisin sürdürülebilirliği diğer ticari ve pazarlama aşamalarında olduğu gibi lojistik içinde önemli bir faktördür. Bununla birilikte kalite her kültür, her firma ve her çalışana göre görecelidir. Görünen odur ki, Türkiyede lojistik kelimesi bazı firmalar için kaliteyi artırma anlamına gelirken bazıları için kelimeden öteye geçmemiştir. Bununla birlikte ürün sınırlarını daraltıp serviste farklılık getirerek aynı ürün aynı pazara bir kaç firma tarafından sunulmaktadır. Bu koşullar altında en temel farklılık kalite, tecrübe, hız ve güleryüzlü hizmet ile sağlanır.Hazırlanan bu tezin amacı, herşeyden once, lojistiğin firma kültürü ile kalitenin kombinasyonu ve uygulaması konusunda bilgi vermesi içindir. Türkiyede lojistik sektörü açısından, sonuçlara bakılarak sektörün kalitesi nasıl artırılır konusu açıklanmış, firma açısından müşteri memnuniyetini geliştirmek için hangi servisler sunulmalı ve nasıl uygulanmalı hakkında sonuçlar bulunmuştur. GENERAL KNOWLEDGE Name and Surname : Saliha KAFADAR Field : Management Programme : Management and Organization Supervisor : Asst. Prof. Dr. Varol Günyaşar Degree Awarded and Date : Master - December 2004 Keywords : Logistics Sector, Turkey, Total Quality, Customer Satisfaction ABSTRACT TOTAL QUALITY MANAGEMENT AT LOGISTICS SECTOR IN TURKEY The logistics which considered as one of the world's trades main components, in advanced technology and international trading capacities have commenced to become more valuable, as the time goes by. The advanced logistics sector which became an integrated of developed countries in the world, also in Turkey between eighties and nineties in the fields of the transportations of inland, in air, in rail-road and combined transportations, formed its infrastructure and commenced to progress in the second half of nineteen-ninety. The clients' satisfaction and its creation are very important factors at logistics like in any other trading and marketing progress, continuously and high in quality service must be ensured, as well. Although the concept of quality is variable, according to every culture, different firm establishment and the comprehension of each worker. Apparently, the progression at logistics sector in Turkey, has been announced, either some of the firms to increase the quality or the others only increase the number of interests to open up. In such a manner that, the logistics hadn't go through further than a name of a firm. However, by reducing the limits of product and service differentiation concept, the same product or service which has been submitted to the same market by several firms, so that the basic differentiation would be provided by quality, experience, speed and nice treatment. The purpose of this prepared thesis, before all else, gives us the understanding the logistics by combination of the firms' culture with quality and its application. Also, it is to announced the explanation of what should be done to improve the quality of sector according to the receipt results, to evaluate the satisfaction of clients from the angle of firm which provides services and how applied to them under the circumstances of the logistics sector of Turkey
Background: With recent technological advances, magnetic resonance imaging (MRI) has offered new ... more Background: With recent technological advances, magnetic resonance imaging (MRI) has offered new sequences that can evaluate the real-time motion of anatomic structures. This study aims to evaluate the interobserver agreement in the diagnosis of diaphragmatic dysfunctions using bi-parametric MRI, in which dynamic sequences for diaphragm movement and static sequences for soft tissue resolution are used together to provide a visualization of the diaphragm. Methodology: Twenty-nine cases that underwent a bi-parametric magnetic resonance examination which includes coronal T2 single-shot turbo spin echo and the coronal SENSE single-shot balanced turbo field echo real-time sequences were retrospectively evaluated. The images of the patients were assessed by two independent observers. Cohen's kappa coefficient was calculated to evaluate the interobserver agreement. Results: The mean age of the patients was 44.86 ± 17.57, ranging from 18 to 80 years. The kappa value was calculated as 0.889, indicating a strong agreement between the interobservers. Conclusions: Our experience suggests that bi-parametric MRI is a promising tool in the evaluation of diaphragmatic abnormalities.
AİBÜ İzzet Baysal tıp fakültesi dergisi, Aug 31, 2022
The aim of this study is to determine the accuracy and usefulness of fine needle aspiration biops... more The aim of this study is to determine the accuracy and usefulness of fine needle aspiration biopsy(FNAB) in the diagnosis of parotid masses. Materials and Methods: FNAB findings of 123 patients who were operated over a last ten years period were retrospectively analyzed and compared with histopathological findings. We examined the sensitivity, the specificity, the positive predictive value (PPV), the negative predictive value (NPV) of FNAB. Results: FNAB results of the patients who participated in the study are as follow; non-diagnostic for 7 patient (%5.7), atypia of undetermined significance for 7 patients (%5.7), bening neoplasm for 98 patients (79.7%) and malign cytology for 11 patients (%8.9). Histopathological results were maligned found in 1 out of 98 patients with benign neoplasm in cytology results in FNAB. The histopathological result was benign in 2 of 11 patients with malignant neoplasm in the cytology findings with FNAB. The specificity of FNAB in the diagnosis of parotid masses was found as 98% and the sensitivity was 90%. The positive predictive value (PPD) was detected as 86% and the negative predictive value was detected 98%. Conclusion: Since malignant masses of the parotid are rare and diverse, diagnosis with FNAB can be difficult. Another complicating factor is the similarity of low-grade malignant tumor and benign tumor. As a result, FNAB has high accuracy for benign parotid tumors, but low for malignant parotid tumors.
Aim: The aim of this study is to assess the correlation between the level of disc herniation and ... more Aim: The aim of this study is to assess the correlation between the level of disc herniation and pelvic and lumbar vertebral incidences in patients operated for lumbar disc herniation. Material and Method: This retrospective study included those patients whose file records were analyzed. The demographic data and clinical findings of 59 patients diagnosed with single level lumbar disc herniation and underwent unilateral microdiscectomy were recorded. In the analysis of the variables, SPSS 25.0 (IBM Corparation, Armonk, New York, United States) was used. Results: The patients involved 28 men and 31 women whose median age was found as 43.31±4.27 (38-54) years. With regard to location, it was determined that in 28 (47.5%) patients, the herniated discs were located on the right and in 31 patients (52.5%), they were located on the left. In terms of levels, in patients with herniated discs at level L5-S1, the median pelvic index and L4 index were found to be significantly lower than those of patients with herniated discs at levels L4-5 and L3-4 (p=0.002, p=0.001), whereas in patients with herniated discs at level L4-5, the median L5 incidence was found to be significantly high (p=0.001). Conclusion: In this study, the pelvic index and L4 and L5 indexes were found to be significantly low in patients with herniated discs at level L5-S1. It is considered that future prospective and multicentered studies with long-term follow-up are necessary.
Aim: The aim of this study is to assess the correlation between the level of disc herniation and ... more Aim: The aim of this study is to assess the correlation between the level of disc herniation and pelvic and lumbar vertebral incidences in patients operated for lumbar disc herniation. Material and Method: This retrospective study included those patients whose file records were analyzed. The demographic data and clinical findings of 59 patients diagnosed with single level lumbar disc herniation and underwent unilateral microdiscectomy were recorded. In the analysis of the variables, SPSS 25.0 (IBM Corparation, Armonk, New York, United States) was used. Results: The patients involved 28 men and 31 women whose median age was found as 43.31±4.27 (38-54) years. With regard to location, it was determined that in 28 (47.5%) patients, the herniated discs were located on the right and in 31 patients (52.5%), they were located on the left. In terms of levels, in patients with herniated discs at level L5-S1, the median pelvic index and L4 index were found to be significantly lower than those of patients with herniated discs at levels L4-5 and L3-4 (p=0.002, p=0.001), whereas in patients with herniated discs at level L4-5, the median L5 incidence was found to be significantly high (p=0.001). Conclusion: In this study, the pelvic index and L4 and L5 indexes were found to be significantly low in patients with herniated discs at level L5-S1. It is considered that future prospective and multicentered studies with long-term follow-up are necessary.
Brazilian Journal of Otorhinolaryngology, Jul 1, 2022
Introduction: Nasal septum deviation is the leading cause of upper airway obstruction. Chronic up... more Introduction: Nasal septum deviation is the leading cause of upper airway obstruction. Chronic upper airway obstruction may cause myocardial injury due to chronic hypoxia. Effects of sep-Q2 toplasty on left venticular diastolic and sistolic functions are not well known. The myocardial performance index is an easy-to-apply and reliable parameter that reflects systolic and diastolic cardiac functions. Objective: The present study aimed to investigate the effect of nasal septoplasty on the myocardial performance index in patients with nasal septal deviation. Methods: This prospective study consisted of 50 consecutive patients who underwent septoplasty due to symptomatic prominent C-or S-shaped nasal septal deviation. Transthoracic echocardiogarphy was performed in all patients before and 3 months after septoplasty. Calculated myocardial performance indices were compared. Results: Significantly higher left ventricular myocardial performance index (0.52 ± 0.06 vs. 0.41 ± 0.04, p < 0.001), longer isovolumic relaxation time (95.0 ± 12.5 vs. 78.0 ± 8.6 ms, p < 0.001), longer isovolumic contraction time (45.5 ± 7.8 vs. 39.5 ± 8.6 ms, p < 0.001), longer deceleration time (184.3 ± 32.5 vs. 163.6 ± 45.4 ms, p = 0.004), higher ratio of transmitral early to late peak velocities (E/A) (1.42 ± 0.4 vs. 1.16 ± 0.2, p = 0.006) and shorter ejection time (270.1 ± 18.3 vs. 286.5 ± 25.8 ms, p < 0.001) were observed before septoplasty when compared to values obtained 3 months after septoplasty. Left ventricular systolic ejection fraction was similar before and after septoplasty (63.8±2.8% vs. 64.6±3.2%, p = 0.224).
The goal of the study is to retrospectively assess cases of renal injuries. Material and Methods:... more The goal of the study is to retrospectively assess cases of renal injuries. Material and Methods: The cases of renal injury presenting at Adiyaman Training and Research Hospital between January 1st, 2013, and December 31st, 2017 were investigated in terms of age, gender, radiologic findings, grade of renal injury, and cause of injury. The degree of kidney injury determined by imaging methods was evaluated in terms of the American Association for the Surgery of Trauma (AAST). Results: Of the 123 patients with renal injury, 27 were female (21.95%) and 96 were male (78.05%), with an average age of 32.6 ± 16.7 years. In total, 59 cases (47.96%) were younger than 35 years. When the cases were examined according to age groups, 11 (8.94%) cases were under the age of 14 years, 23 (18.70%) cases were aged 15-24 years, and 25 (20.32%) cases were aged 25-34 years. The older age groups included 23 (% 18.70) cases aged 35-44 years, 19 (15.46%) aged 45-54 years, 9 (7.31%) aged 55-64 years, and 13 (10.57%) older than 65 years. Overall, 59(47.96%) injuries were from traffic accidents (p<0.005), 36 (28.96%) from falls, 12 (9.74%) from sharp and penetrating object injuries, seven (5.69%) from gunshot wounds, five (4.07%) from assaults, and four (3.25%) from work accidents. Conclusion: Renal traumas are life-threatening injuries. We have evaluated renal injuries in terms of radiological and forensic medicine, and we believe the findings contribute to the existing literature on this subject.
Adıyaman Üniversitesi sağlık bilimleri dergisi, Dec 15, 2016
Bu çalışmada amaç; balık tüketimi sıklığı ile osteoporoz (OP) arasındaki ilişkiyi değerlendirmekt... more Bu çalışmada amaç; balık tüketimi sıklığı ile osteoporoz (OP) arasındaki ilişkiyi değerlendirmektir. Materyal ve metot: Bu çalışmada 45 ile 75 yaş aralığında postmenapozal kadın hastaların kayıtları incelendi. Çalışma kriterlerine uyan 152 postmenapozal kadın hasta çalışmaya dahil edildi. Olgular, haftalık balık tüketim alışkanlığı 250 gram ve üzerinde olanlar Grup 1 ve balık tüketim alışkanlığı haftalık 250 gramın altında olanlar Grup 2 olarak sınıflandırılmıştır. Osteoporoz tanısında yaygın olarak Dual Enerji X Ray Absorbsiyometri (DEXA) yöntemi kullanıldığından, bu çalışmada da kemik mineral içeriğini (gram:g) iki enerji X-ray absorbsiyometri (DEXA) cihazı verilerine göre sınıflandırma yapıldı. Olguların tüm vücut ve total kalça taramaları aracılığıyla KMY (g/cm 2) değerleri elde edildi. KMY (tüm vücut ve total kalça değerleri incelendi; ancak L2-L4 esas alındı) ve T-SKOR ise L2-L4 değerlerine göre klinik tanılar; osteoporoz, osteopeni ve normal olarak sınıflandırıldı. Bulgular: Olguların 45'i (%29,60) Grup 1'de, 107'sinin ise (%70,40) Grup 2'de yer aldığı tespit edildi. Grup 1'deki olguların %19,73 (n:30) ve Grup 2'deki olguların %1,97 (n:3) KMY normal değerlerde tespit edildi. Bu değer balık tüketim alışkanlığı olmayan gruba göre karşılaştırıldığında istatistiksel olarak (p<0,05) anlamlı olarak bulundu. Osteoporoz tespit edilen olgular Grup 1'de %10,20 (n:5) ve Grup 2'de ise %89,79 (n:44), osteopeni Grup 1'deki olguların %14,28 (n:10) ve Grup 2'deki olguların %85,72'sinde (n:60) tespit edilmiştir. Bu değerler arasında fark olmakla birlikte balık tüketim alışkanlığı olmayan gruba göre karşılaştırıldığında istatistiksel olarak anlamlı (p>0,05) değildi. Ancak balık tüketim alışkanlığı olan Grup 1'deki sadece beş olguda osteoporoz ile uyumlu olduğu görüldü. Elde edilen değerler istatistiksel olarak anlamlı (p<0,05) olduğu tespit edildi. Sonuç: Bu çalışma verilerine göre; menopoz sonrası dönemdeki kadınlarda haftalık balık tüketiminin 250 gram ve üzerinde olan olgularda KMY üzerine olumlu etki yaptığı ve osteoporoz riskini azalttığı tespit edildi.
Eurasian journal of emergency medicine, Mar 26, 2020
Aim: The aim of this study was to evaluate the diagnostic performance of non-contrast rapid seque... more Aim: The aim of this study was to evaluate the diagnostic performance of non-contrast rapid sequences (RAMRI) visualization on cases who were clinically diagnosed as having acute abdominal pain (AAP). Materials and Methods: Forty-six patients were chosen from 2850 patients who were admitted to the emergency service between January 2016-January 2019 because of sudden onset abdominal pain and could not get a computerized tomography analysis. A 1.5 Tesla magnetic resonance (MR) device (GE Signa Hi-Speed, Milwaukee) was used for analysis. Coronal and axial T2-weighted single-shot fast spin-echo series were used as scan protocol. No intravenous, oral or rectal contrast material was used. The cases were identified as positive (+) or negative (-) by MRI. The cases who had symptoms related with AAP, were considered as positive (+), and the cases who did not have symptoms or had symptoms which were not related with AAP, were considered as negative (-). Results: Of the patients, 26 (56.5%), were female and 20 (43.5%) were male. The median age was 38.65 (18-86) years. The treatment methodology was surgery for 25 cases (54%) and conservative for 21 (46%) cases. The operative group (surgically treated) included 24 MR (+) and one MR (-) cases. There was a harmony between the clinic and MRI data of all members in non-surgical group. The accuracy of the study was calculated as 95.6% (44/46). The sensitivity of RAMRI was calculated as 96% for operative group and 100% for non-operative group. Conclusion: A successful diagnostic performance was achieved by non-contrast RAMRI in cases with AAP.
Background: Tinnitus is a common auditory symptom. Dysfunction in the autonomic nervous system (A... more Background: Tinnitus is a common auditory symptom. Dysfunction in the autonomic nervous system (ANS) is an essential part of the etiopathogenesis of tinnitus. ANS regulates heart rate and heart rhythm and can lead to ventricular repolarization changes, which can cause malignant ventricular arrhythmias. T wave peak-to-end T(p-e) interval and T(p-e)/QT ratio are known ventricular arrhythmia indexes, and the index of cardiac-electrophysiological balance (iCEB) is a novel index that can be used to predict the risk of malignant ventricular arrhythmia. The goal of the study was to investigate these ventricular arrhythmia indexes in patients with tinnitus. Methods: The study population consisted of 240 patients with tinnitus and 240 healthy subjects. A standard 12-channel surface electrocardiogram was applied to both groups. T(p-e) interval, QT interval and QRS duration were determined. Corrected QT (QTc) was determined via Bazett's formula. To predict ventricular arrhythmia, iCEB (QT/QRS), T(p-e)/QT, corrected iCEB (QTc/QRS) and T(p-e)/QTc values were determined and compared between groups. Results: Compared to the control group, QT (376.46 ± 36.54 vs 346.52 ± 24.51 ms), QTc (426.68 ± 24.68 vs 390.42 ± 24.04 ms), T(p-e) (75.86 ± 14.68 vs 62.42 ± 8.64 ms), T(p-e)/QT (0.201 ± 0.06 vs 0.180 ± 0.01) and T(p-e)/QTc (0.177 ± 0.06 vs 0.159 ± 0.02) were significantly higher in patients with tinnitus (p < 0.001 for all). QT/QRS (3.92 ± 0.68 vs 3.56 ± 0.32) and QTc/QRS (4.44 ± 1.03 vs 4.01 ± 0.64) were also significantly higher in patients with tinnitus (p = 0.018 and p = 0.008, respectively). In addition, significant positive correlations were found between T(p-e), T(p-e)/ QTc ratio and disease duration (r = 0.792, p < 0.001; r = 0.500, p < 0.001, respectively). Conclusion: As a result, patients with tinnitus may have an increased risk of malignant ventricular arrhythmia.
Aim: We aimed to investigate the relationship between the presence of spondylolisthesis and Modic... more Aim: We aimed to investigate the relationship between the presence of spondylolisthesis and Modic changes (MCs) by using lumbar magnetic resonance imaging (MRI). Methods: The study included 139 adult patients aged 18-65 years with lumbar spondylolisthesis detected on lumbar MRI. Demographic characteristics such as age, gender, and levels and grades of spondylolisthesis, and presence of lumbar MCs/types were recorded. The findings were compared between two groups including grade 1 and grade 2 spondylolisthesis. Results: Grade 1 and 2 spondylolisthesis groups were similar for age (p=0.787), sex (p=0.076), listhesis' level (p=0.268) and direction (p=0.280). The presences of pars spondylolysis, disc space narrowing, and MCs were significantly higher in patients with grade 2 spondylolisthesis than those with grade 1 (94.4% vs 64.1%), (97.2% vs 83.5%), and (100% vs 83.5%), respectively (all p
Background: Sharp and penetrating object injuries (SPOIs) are seen frequently in forensic medicin... more Background: Sharp and penetrating object injuries (SPOIs) are seen frequently in forensic medicine practice. In this study, we aimed to retrospectively investigate cases with SPOIs. Materials and Methods: This study investigated the charts of patients treated at Adiyaman University Education and Research Hospital between January 1, 2013, and December 31, 2017. A total of 934 inpatients with sharp object injuries were included in the study. Data were assessed using a suitable computer-aided package program. Cases were examined in terms of age, gender, injury body site, suicide or homicide, radiologic findings, presence of vital danger, and severity of injury. Results: In this study, we examined the charts for 934 inpatients with stab wounds. It was stated that 124 (13.27%) of those injured were female and 810 (86.63%) male; the average age of the injured persons was 29.8 ± 18.2 years. It was found that 214 (22.91%) people were exposed to vital danger and that 720 (77.09%) suffered from soft tissue injuries (penetrating skin and muscle injuries). Also, 69.27% of the cases (n = 647) involved people less than 35 years of age. Conclusion: Considering that stab injuries are more frequent in the lower age groups, we believe that such injuries could be reduced by increasing training programs for young people.
GENEL BİLGİLER İsim ve Soyadı : Saliha KAFADAR Anabilim Dalı : İşletme Programı : Yönetim ve Orga... more GENEL BİLGİLER İsim ve Soyadı : Saliha KAFADAR Anabilim Dalı : İşletme Programı : Yönetim ve Organizasyon Tez Danışmanı : Yrd. Doç.Dr. Varol Günyaşar Tez türü ve Tarihi : Yüksek Lisans - Aralık 2004 Anahtar Kelimeler : Lojistik Sektörü, Türkiye, Toplam Kalite, Müşteri Memnuniyeti TÜRKİYEDE LOJİSTİK SEKTÖTÜNDE TOPLAM KALİTE YÖNETİMİ Dünya ticaretinin ana unsurlarından biri olan lojistik gelişmiş teknoloji ve uluslararası ticaret açısından gün geçtikçe önem kazanmaya başlamıştır.Seksenli, doksanlı yıllar arasında Turkiyede kara, hava ve deniz taşımacılığı olan lojistik sektörü doksanlı yılların ikinci yarısında teknolojik alt yapısını gelistirerek, dünya üzerindeki gelişmiş ülkelere ayak uydurmaya başlamıştır. Müşteri memnuniyeti ve bunun yaratılması, sürekliliği ve yüksek kaliteli servisin sürdürülebilirliği diğer ticari ve pazarlama aşamalarında olduğu gibi lojistik içinde önemli bir faktördür. Bununla birilikte kalite her kültür, her firma ve her çalışana göre görecelidir. Görünen odur ki, Türkiyede lojistik kelimesi bazı firmalar için kaliteyi artırma anlamına gelirken bazıları için kelimeden öteye geçmemiştir. Bununla birlikte ürün sınırlarını daraltıp serviste farklılık getirerek aynı ürün aynı pazara bir kaç firma tarafından sunulmaktadır. Bu koşullar altında en temel farklılık kalite, tecrübe, hız ve güleryüzlü hizmet ile sağlanır.Hazırlanan bu tezin amacı, herşeyden once, lojistiğin firma kültürü ile kalitenin kombinasyonu ve uygulaması konusunda bilgi vermesi içindir. Türkiyede lojistik sektörü açısından, sonuçlara bakılarak sektörün kalitesi nasıl artırılır konusu açıklanmış, firma açısından müşteri memnuniyetini geliştirmek için hangi servisler sunulmalı ve nasıl uygulanmalı hakkında sonuçlar bulunmuştur. GENERAL KNOWLEDGE Name and Surname : Saliha KAFADAR Field : Management Programme : Management and Organization Supervisor : Asst. Prof. Dr. Varol Günyaşar Degree Awarded and Date : Master - December 2004 Keywords : Logistics Sector, Turkey, Total Quality, Customer Satisfaction ABSTRACT TOTAL QUALITY MANAGEMENT AT LOGISTICS SECTOR IN TURKEY The logistics which considered as one of the world's trades main components, in advanced technology and international trading capacities have commenced to become more valuable, as the time goes by. The advanced logistics sector which became an integrated of developed countries in the world, also in Turkey between eighties and nineties in the fields of the transportations of inland, in air, in rail-road and combined transportations, formed its infrastructure and commenced to progress in the second half of nineteen-ninety. The clients' satisfaction and its creation are very important factors at logistics like in any other trading and marketing progress, continuously and high in quality service must be ensured, as well. Although the concept of quality is variable, according to every culture, different firm establishment and the comprehension of each worker. Apparently, the progression at logistics sector in Turkey, has been announced, either some of the firms to increase the quality or the others only increase the number of interests to open up. In such a manner that, the logistics hadn't go through further than a name of a firm. However, by reducing the limits of product and service differentiation concept, the same product or service which has been submitted to the same market by several firms, so that the basic differentiation would be provided by quality, experience, speed and nice treatment. The purpose of this prepared thesis, before all else, gives us the understanding the logistics by combination of the firms' culture with quality and its application. Also, it is to announced the explanation of what should be done to improve the quality of sector according to the receipt results, to evaluate the satisfaction of clients from the angle of firm which provides services and how applied to them under the circumstances of the logistics sector of Turkey
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