20230914213328 20230914213328 Selçuk Tıp Dergisi sinandemircioglumd@gmail.com Prof. Dr. Sinan DEMİRCİOĞLU Selçuk Tıp Dergisi Selcuk Med J 2149-8059 1017-6616 9 14 2023 39 3 Emine Türen Demir Pembe OLTULU Mustafa Korkmaz 0000-0003-0926-6748 MEHMET ARTAÇ ALİ ACAR SITKI ÖZBİLGEÇ 0000-0002-4776-4791 Metastasis of lobular breast cancer to the reproductive organs is an extremely rare condition. The followup of internal genital metastases for patients who received tamoxifen and chemotherapy after breast cancer surgery has important clinical significance. Here, we introduce such a patient who applied to our hospital and received treatment. 9 14 2023 147 150 10.30733/std.2023.01673 https://selcukmedj.org/en-us/a-case-report-of-alveolar-lobular-breast-cancer-metastasized-to-the-whole-female-reproductive-system-en-7369/ https://app.selcukmedj.org/uploads/makale-pdf/2021-130-202978313.pdf Hamit Göksu Savaş Karpuz Levent Tekin HALİM YILMAZ Ramazan Yılmaz https://orcid.org/0000-0001-6295-7295 Background and objective: Ultrasound (USG)-guided caudal epidural steroid injections (CESI) have the advantage of being more easily applicable without radiation exposure. However, there is limited evidence regarding their use in the treatment of lumbar disc herniation, and no data is available regarding patient satisfaction. The aim of this study is to evaluate the effect of USG-guided CESI on axial or radicular low back pain. Methods: This study was designed as a retrospective case-control study conducted in an outpatient setting at a tertiary care hospital. Records of the 21 patients who underwent USG-guided CESI due to axial or radicular low back pain and had an assessment with a visual analog scale (VAS pain), degree of pain relief, patient satisfaction scale, sleep quality, and Roland Morris Disability Questionnaire (RMDQ) in the patient files or electronic database were included in the study between December 2022 and May 2023. Results: There was a significant difference in VAS pain scores between admission and the 2nd week and between admission and the 6th week (p<0.001). The frequency of meaningful pain reduction accepted as more than 50% pain relief was 57.1% and 38.1% at the 2nd and 6th weeks, respectively. A significant difference was found in RMDQ scores between admission and the 2nd week, between admission and the 6th week (p<0.001), and between the 2nd week and the 6th week (p = 0.447). While 71.4% of the patients described poor sleep at presentation, this ratio was 19.0% and 23.8% at the 2nd and 6th weeks, respectively. While 91.5% of the patients declared that they were better in the 2nd week, 71.4% reported that they were better in the 6th week. Conclusion: Ultrasonography-guided CESI is an effective treatment method for improving pain, sleep quality, and disability by ensuring high patient satisfaction in individuals with axial or radicular low back pain in a short-to-moderate-term follow-up. 9 14 2023 139 146 10.30733/std.2023.01641 https://selcukmedj.org/en-us/efficacy-of-ultrasound-guided-caudal-epidural-steroid-injection-for-axial-or-radicular-low-back-pain-a-retrospective-cross-section-en-7313/ https://app.selcukmedj.org/uploads/makale-pdf/1641-92990499.pdf selçuk alver 0000-0003-4739-6623 9 14 2023 114 121 10.30733/std.2023.01651 https://selcukmedj.org/en-us/the-efficacy-of-interfacial-plan-block-procedures-on-postoperative-satisfaction-of-surgeons-a-survey-study-en-7320/ https://app.selcukmedj.org/uploads/makale-pdf/1651-358004403.pdf Uğur Gülper İLKAY ÖZER 0000-0001-6170-0930 İBRAHİM KILINÇ 0000-0002-7729-7557 FAHRİYE KILINÇ 0000-0002-1202-8735 Objective: Direct immunofluorescence examination contributes to the correct and differential diagnosis and treatment management of immune-mediated dermatological diseases that can also affect the mucous membranes. In this study, it was aimed to compare skin/mucosa biopsies performed using direct immunofluorescence and histopathological examination, compliance with the preliminary diagnosis and to evaluate the diagnostic value of immunofluorescence examination. Patients and Methods: A total of 207 patients’ biopsies sent to the pathology laboratory between January 01, 2019 and December 31, 2019 were evaluated. Groups were formed according to the preliminary diagnosis (intraepithelial/subepithelial separation conditions, lupus erythematosus, lichen planus, vasculitis), and histological (intraepithelial/subepithelial separation, clasia, dermal mucin deposition) and direct immunofluorescence (immunoglobulin G, M, A, and C3 depositions, patterns) findings were recorded. SPSS 23.0 package software with Kappa statistics and the McNemar test were performed. P<0.05 was considered statistically significant. Results: Direct immunofluorescence results were negative in 115 patients, positive in 91 patients and could not be evaluated in one patient. Histological agreement was found in 19 of 44 (43.2%) patients with bullous pemphigoid, 10 of 18 (55.6%) with pemphigus, 26/51 (50.9%) with lupus erythematosus, 10/15 (66.7%) with lichen planus, 6/6 (100%) with Henoch Shönlein purpuras and 37/62 (59.7%) with other vasculitides. Direct immunofluorescence positivity was found as 19/19 for bullous pemphigoid, 10/10 for pemphigus, 11/26 for lupus erythematosus, 2/10 for lichen planus, 6/6 for Henoch Shönlein purpura, and 28/37 for other vasculitides (κ = 0.021). Conclusion: Direct immunofluorescence examination significantly supports clinical and histopathological findings in the diagnosis of immune mediated dermatologic diseases and in the differential diagnosis of vesiculobullous diseases. 9 14 2023 104 113 10.30733/std.2023.01638 https://selcukmedj.org/en-us/an-overview-of-the-results-of-direct-immunofluorescence-in-mucocutaneous-biopsies-single-center-experience-en-7349/ https://app.selcukmedj.org/uploads/makale-pdf/1638-384082936.pdf ZELİHA YARAR HATİCE ÇALIŞKAN BURGUCU HASAN HÜSEYİN KIR https://orcid.org/0000-0001-5496-7397 MUSTAFA KULAKSIZOĞLU MUSTAFA ALTAŞ Introduction: Migraine is a neurovascular disease that is common worldwide. In a few studies, a relationship was found between vitamin D levels and headache severity and types. In this study, we primarily investigated whether there was a difference in vitamin D levels between migraine patients and healthy controls, and secondarily, whether there was a relationship between types and severity of migraine and vitamin D levels.   Patients and Methods: This case-control study was carried out between January 2021 - July 2022 at ***** University ***** Faculty of Medicine, Department of Neurology. 204 patients over the age of 18 who were diagnosed with migraine and 204 healthy volunteers without headache were included in our study. The diagnosis of migraine was made by a neurologist according to the International Headache Society 3 criteria.   Results: The mean vitamin D level was 15.30±9.93 ng/dl in the migraine group and 14.62±7.93 ng/dl in the control group. There was no statistically significant difference between the two groups (p=0.976). There was no difference between migraine patients and the control group in terms of vitamin D deficiency and insufficiency (p=0.365).   Conclusion: According to the results of our study, we did not find any difference in vitamin D levels between migraine patients and the normal population. There was no statistical difference in vitamin D levels among migraine subtypes. In addition, no relationship was found between severity and frequency of migraine attacks and vitamin D levels. According to the results of our study, the high prevalence of vitamin D deficiency appears to be a common problem in both migraine patients and the healthy population, and randomized clinical studies with large sample numbers are needed on this subject. 9 14 2023 122 127 10.30733/std.2023.01633 https://selcukmedj.org/en-us/is-vitamin-d-associated-with-the-presence-type-and-severity-of-migraine-en-7356/ https://app.selcukmedj.org/uploads/makale-pdf/1633-850595456.pdf MUSTAFA AYDIN Osman Gurdal FUAT USLUSOY Ömer Dilek SELMAN HAKKI ALTUNTAŞ 0000-0002-9577-7052 ABSTRACT Introduction: Most of the large defects in the hand are required vascularized skin coverage because they exposed tendons and bones. A pedicled groin flap has been offered as a standard flap for this indication. But immobilization of the upper extremity can be a disadvantage. Raising the groin flap is also possible as a free flap. The disadvantage of free flap is a time-consuming microsurgical procedure. We aimed to compare the pedicled and free groin flap reconstructions in patients with large hand defects based on patient-reported outcomes. Materials and Methods: Sixteen patients who had groin flaps pedicled or free for the large defects of their hands were included in this study between 2013-2020. This study was performed retrospectively clinical survey work. Patients were divided into two groups: the pedicled groin flap group (n=8) and the free groin flap group (n=8). Patients were followed for 2 years. The patients were subjected to DASH and SF-36 tests after a postoperative period. Pre- and postoperative pain were evaluated with the Visual Analogue Scale. On which day they could walk and sit in the toilet without pain and not needed a second person for daily work, the patients were asked. Results: Half of the patients with pedicled flaps had serious elbow and shoulder pain and required physical therapy. The wound healing was completed significantly earlier in the free groin flap group (p<0.05). The mean hospital stay in the pedicled group was longer than the free flap group (21 days and 13 days, respectively), which was statistically insignificant. The DASH scores were found to be 92 and 72 in the subacute and chronic stages in the pedicled flap group, whereas 52 and 24 were found in the free flap group, respectively (p = 0.012 and 0.002). According to SF-36 scores, physical functions were impaired significantly in the pedicled flap group (p < 0.001). The number of days needed by the second person for daily work was 79 in the pedicled group and 24 in the free flap group (p = 0.041). Sitting in the toilet without pain was started on the 63rd day in the pedicled group and on the 15th day in the free flap group (p = 0.036). Conclusions: By transferring the groin flap as a free flap, the problems related to shoulder and elbow joints have disappeared, hand rehabilitation could be started earlier, and the time to return to daily work was shortened. So, if the groin flap is preferred, free style should be considered first. 9 14 2023 128 134 10.30733/std.2023.01652 https://selcukmedj.org/en-us/the-use-of-groin-flap-for-hand-defects-which-should-be-prior-free-or-pedicled-based-on-patient-reported-outcomes-en-7362/ https://app.selcukmedj.org/uploads/makale-pdf/1652-572276291.pdf Sevda Şener Cömert Benan Çağlayan Selin Gamze Sümen 0000-0002-9845-1306 Aim: In this study, we aimed to evaluate the repetitive effects of hyperbaric oxygen treatment on patients’ pulmonary functions and diaphragmatic movement. Patients and Methods: The study group consisted of 22 patients diagnosed with various diseases who were administered hyperbaric oxygen treatment between June 2019 and December 2019. Respiratory functions such as dynamic and static lung volumes, diffusion capacity, and maximum inspiratory and expiratory pressures were evaluated before the start and end of the treatment sessions. Besides, the diaphragm thickness and the diaphragm movements during tidal volume and deep inspiration were measured with thoracic ultrasonography. Results: Twenty-two patients (16 male;6 female) with a mean age of 53.3±10.0 years were included. At the end of hyperbaric oxygen therapy total lung capacity, vital capacity, and residual volume were significantly increased (p<0.05). The other static lung volumes, maximum inspiratory and expiratory pressures, and diffusing capacity of the lungs for carbon monoxide did not change. The thickness of the diaphragm and diaphragmatic movement during tidal volume and vital capacity were also increased (p<0.05). Conclusion: In our study, we evaluated the effect of hyperbaric oxygen therapy on diaphragmatic and respiratory functions by using, diffusing capacity, as well as spirometry and diaphragmatic imaging techniques. As a result, hyperbaric oxygen treatment led to a significant change in pulmonary and diaphragmatic functions. Keywords: Diaphragm, Diffusing capacity, Hyperbaric oxygen, Lung, Toxicity 9 14 2023 97 103 10.30733/std.2023.01634 https://selcukmedj.org/en-us/how-can-hyperbaric-oxygen-therapy-affect-the-diaphragm-and-respiratory-functions-of-patients-en-7365/ https://app.selcukmedj.org/uploads/makale-pdf/1634-139045433.pdf İLKER UYAR M. EMİN YILDIRIM Background: Facelift surgery is a frequently preferred aesthetic surgery procedure to reduce the signs of aging and achieve a more youthful appearance. The incidence of complications such as hematoma is quite high among patients undergoing facelift surgery. This study aims to compare the efficacy of TXA and hemostatic net technique in terms of preventing hematoma formation in facelift surgery patients. Patients and Method: The study included 65 patients (56 F, 9 M) who underwent deep plan facelift and face and neck lift between October 2019 and February 2023. Patients were evaluated in four different groups: TXA given, those applied hemostatic net, those applied both, and the control group applied neither. Demographic information, follow-up findings, any hematoma or other complications in the postoperative period were recorded. Differences between the groups were evaluated statistically. Results: The mean age of the patients was 54 years. The patient group using only TXA consisted of 17 patients, the group hemostatic net applied consisted of 9 patients, the group applied both consisted of 21 patients, and the control group consisted of 18 patients. Hematoma was observed in 6 patients in total. Although a numerical decrease in the incidence of haematoma was observed in patients in whom only haemostatic net was used and in patients in whom only TXA was used, it was not statistically significant (p>0.05). The incidence of haematoma decreased that is statistically significant in patients in whom TXA and haemostatic net were used together (p<0.05). Conclusion: Tranexamic Acid and hemostatic net both together showed to be effective in reducing the incidence of hematoma. It is thought that these measures may improve surgical outcomes and accelerate the recovery process of patients. 9 14 2023 135 138 10.30733/std.2023.01654 https://selcukmedj.org/en-us/comparison-of-tranexamic-acid-and-haemostatic-net-in-reducing-the-risk-of-hematoma-in-facelift-surgery-en-7366/ https://app.selcukmedj.org/uploads/makale-pdf/1654-568375134.pdf