Predicting complicated acute diverticulitis with the HALP score: A retrospective study.

OBJECTIVE: HALP score is a scoring system consisting of hemoglobin, albumin, lymphocyte and platelet. It is different from other prognostic markers because it provides information about both inflammation and immunonutrition status. This study aims to evaluate the severity of the disease and the level of prognosis in patients diagnosed with acute diverticulitis. MATERIAL METHODS: 190 patients diagnosed with acute diverticulitis between January 2017 and June 2023 were included in the study. The patients were divided into two separate groups according to the Hinchey classification. The prognostic effect of inflammatory markers and HALP score was examined. RESULT: The median values of C-reactive protein, white blood cell count, neutrophil count, HALP score, and hospitalization duration were significantly higher in patients diagnosed with complicated diverticulitis than in those diagnosed with uncomplicated diverticulitis. (p < 0.001, p = 0.045, p = 0.004, p < 0.001 and p < 0.001, respectively). The distinguishing feature of the HALP score in predicting the complexity of the diagnosis of diverticulitis was evaluated using ROC analysis. Area Under Curve (AUC) value was found to be 0.723 (p < 0.001). According to the ROC curve, the sensitivity and specificity for the cut-off value of HALP score ≤44.1 were 66.7 % and 75.0 %, respectively. CONCLUSION: HALP score is an inexpensive parameter that can be used safely to determine the severity and prognosis of acute diverticulitis.

The role of infectious parameters in the early prediction of complicated colonic diverticulitis.

BACKGROUND: Acute colonic diverticulitis has recently become a significant cause of hospital admissions. Complicated colonic diverticulitis, a severe form of the disease, necessitates medical and surgical intervention. Prompt diagnosis in these patients is crucial. This study aims to assess the role of infectious parameters in the early diagnosis of complicated colonic diverticulitis. METHODS: This retrospective study analyzed 82 adult patients diagnosed with acute diverticulitis. Recorded data included patient demographics, hospital stay duration, disease location, and surgical procedures. Infectious parameters such as white blood cell count (WBC), C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), percentage of immature granulocytes (IG%), and systemic immune-inflammatory index (SII) were calculated and noted. Patients underwent abdominal computed tomography upon admission, and based on these results, they were categorized into uncomplicated or complicated diverticulitis groups. Statistical analysis was performed to identify differences between these groups. RESULTS: CRP, NLR, and SII were significantly more predictive of complicated acute colonic diverticulitis. However, no statistical differences in WBC and IG% values were observed between the groups. CONCLUSION: The study found that the percentage of immature granulocytes, previously deemed a reliable marker in many studies, did not significantly predict complicated colonic diverticulitis. Further comprehensive studies are necessary to explore inflammatory markers in colonic diverticulitis more thoroughly.

Comparison of open and closed burn wound dressing applications with tissue culture sampling.

BACKGROUND: Secondary infections are the leading cause of death in burn patients. The purpose of this study is to evaluate the effects of open and closed burn dressings on the development of secondary infections. METHODS: Tissue cultures were obtained from the burn sites of 56 patients between the ages of 18 and 65 who were admitted to our burn unit between December 2022 and January 2023, on days 3 and 7. The impact of the demographic features of the patients, the characteristics of the burn wound, the dressing type, and the first intervention strategies given to the burn wound on the development of wound infection were evaluated. RESULTS: There was no statistically significant difference between the open- and closed-dressing groups in terms of cultural positiv-ity (P>0.05). A statistically significant difference (P=0.019) was found between the groups in terms of culture positivity among those whose wounds were cleansed with warm water as the initial intervention after a burn and those whose wounds were not. CONCLUSION: Even though the main impacts of the patient's variables on the development of a wound infection are recognized, it has been found that the appropriate and successful first intervention in a burn wound is also quite important.

An effective and reliable marker in grading the severity of acute cholecystitis: Increased immature granulocyte percentage.

BACKGROUND: Acute cholecystitis (AC) is an acute inflammatory disease of gallbladder and it is one of the most common causes of acute abdominal pain. Determining the severity of AC at hospital admission is extremely important to choose the most effective treatment method and predict vital prognosis. The aim of this study was to investigate the effectiveness of immature granulocyte percentage (IG%) in grading AC severity. METHODS: This retrospective study was carried out on 528 patients hospitalized due to AC diagnosis. Demographic data, white blood cell (WBC) count, neutrophil lymphocyte ratio (NLR), IG%, C-reactive protein (CRP) levels, and imaging results of patients were recorded. Furthermore, patients' length of hospital stay was determined. Tokyo Guidelines were used to grade AC severity. According to this grading, patients were classified into three groups as grade 1 (mild), grade 2 (moderate), and grade 3 (severe) AC. Differences among groups were analyzed statistically. RESULTS: There were 386 patients (73.1%) in the mild AC group, 102 patients (19.3%) in the moderate AC group, and 40 patients (7.6%) in the severe AC group. WBC, NLR, CRP and IG% were significant parameters in discriminating mild AC from moderate and severe AC. However, only IG% was a significant parameter in discriminating moderate AC from severe AC. Moreover, the power of IG% to discriminate between patients with mild and moderate AC and those with severe AC was dramatically higher than the other parameters. CONCLUSION: Increased IG% is seen as an effective and reliable predictor in the early determination of AC severity.

Assessment of Ankaferd Blood Stopper in experimental liver ischemia reperfusion injury

Background/aim: To investigate possible protective effects of Ankaferd Blood Stopper® (ABS) in an experimental liver ischemia reperfusion injury (IRI) model. Materials and methods: The study was carried out on 30 female rats separated into 3 groups as sham, control (IRI), and treatment (IRI + ABS) groups. In the IRI + ABS group, 0.5 mL/day ABS was given for 7 days before surgery. In the IRI and IRI + ABS groups, the hepatic pedicle was clamped for 30 min to apply ischemia. Then, after opening the clamp, 90-min reperfusion of the liver was provided. Blood and liver tissue samples were taken for biochemical and histopathological analyses. Results: Compared to the sham group, the IRI group had significantly higher levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total oxidant status (TOS), malondialdehyde (MDA), fluorescent oxidant products (FOP) and lower expression of albumin and total antioxidant status (TAS) (P < 0.05). Compared to the IRI group, the IRI+ABS group showed lower expression of AST, ALT, TOS, MDA and FOP and higher expression of albumin and TAS (P < 0.05). In the histopathological analysis, congestion scores were statistically significantly lower in the IRI + ABS group than in the IRI group. Conclusions: ABS has a strong hepatoprotective effect due to its antioxidant and antiinflammatory effects and could therefore be used as a potential therapeutic agent for IRI.

Role of increased immature granulocyte percentage in the early prediction of acute necrotizing pancreatitis.

BACKGROUND: Acute necrotizing pancreatitis (ANP) is the most severe form of acute pancreatitis (AP), and it has high mortality rates. Therefore, early diagnosis and treatment are of critical importance for the prognosis. The aim of this study was to investigate the effectiveness of immature granulocyte percentage (IG%) in the early prediction of ANP. METHODS: This retrospective study included 96 adult patients hospitalized with a diagnosis of AP. Demographic data of the patients were recorded. The white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), IG%, C-reactive protein (CRP), and amylase levels were determined. Furthermore, computed abdominal tomography was applied to the patients, and the length of hospital stay was recorded. Patients were divided into two groups as those with acute edematous pancreatitis and ANP, according to the tomography results. The differences between the groups were analyzed statistically. RESULTS: The WBC count, NLR, CRP, and IG% were significant markers in the prediction of ANP. However, IG% had higher values with regard to the sensitivity, specificity, AUROC, and negative and positive predictive values (100%, 95%, 0.982, 78.9%, and 100%, respectively). CONCLUSION: An increased IG% is a simple, fast, and effective marker in the early prediction of ANP. METHODS: This retrospective study was carried out on 96 adult patients who were hospitalized with a diagnosis of acute pancreatitis. Demographic data of the patients were recorded. White blood cell count, neutrophil/lymphocyte ratio, IG%, C-reactive protein and amylase levels were determined. Furthermore computed abdominal tomography was applied to the patients and the length of hospital stay was recorded. The patients were divided into two groups as acute edematous pancreatitis and acute necrotizing pancreatitis according to the tomography results. The differences between the groups were analyzed statistically. RESULTS: White blood cell count, neutrophil/lymphocyte ratio, C-reactive protein and IG% were significant markers in the prediction of acute necrotizing pancreatitis. However, IG% had higher values of sensitivity, specificity, AUROC, negative and positive predictive values ( 100%, 95%, 0.982, 78.9%, 100%,respectively). CONCLUSION: Increased IG% is a simple, fast, and effective marker in the early prediction of acute necrotizing pancreatitis.

Does inguinal hernia repair affect uroflowmetric parameters? A prospective controlled clinical trial.

OBJECTIVE: The aim of this study was to determine the changes in uroflowmetric values of male patients following elective inguinal hernia repair. METHODS: The study group comprised patients treated with open or laparoscopic inguinal hernia repair. Patients who underwent surgery due to various diseases such as cataract, multinodular goiter, choledocholithiasis, thyroid and breast cancer, hydrocele, or spermatocele were recruited to the control group. Perioperative characteristics, including pain assessed using the visual analog scale (VAS), uroflowmetric values, and post-void residual urine volumes (PVR), were recorded preoperatively and on Postoperative Days (POD) 1 and 30. Uroflowmetry, VAS, and PVR values were also recorded for the control group on Study Days 1, 3, and 30. RESULTS: There were 103 subjects in this study (52 treated with elective inguinal hernia repair in the study group, 51 in the control group). Preoperative VAS, maximum and average flow rate, and PVR were similar in the 2 groups (P > .05 for all), whereas comparisons of these 3 factors on POD 1 revealed significant differences (P < .001 for all). Linear regression analysis demonstrated that preoperative maximum and POD 1 VAS values of patients who underwent elective inguinal hernia repair could significantly predict acute urinary retention or voiding dysfunction (P = .001 for all). CONCLUSION: Postoperative pain affect parameters and cause urinary retention after open or laparoscopic inguinal hernia repair.

The Effect of Calcium Dobesilate on Liver Damage in Experimental Obstructive Jaundice.

Purpose/Aim of the study: Inflammation and oxidative stress are two significant factors affecting the degree of liver damage in obstructive jaundice. The aim of this study was to evaluate the effect of calcium dobesilate (CaDob), an effective antioxidant and anti-inflammatory drug, on damage to liver caused by experimental obstructive jaundice. MATERIALS AND METHODS: 30 rats in total were randomly placed into three groups, each group consisting of 10 rats. The sham group (Group 1) only received solely laparotomy. In the control group (Group 2), ligation was applied to the biliary tract and no treatment was implemented. In the CaDob group (Group 3), following ligation of the biliary tract, 100 mg/kg/day CaDob was implemented via an orogastric tube for a 10-day period. Liver tissue and blood samples were taken for histopathological and biochemical examination. RESULTS: The CaDob group had significantly lower test values for serum liver functions when compared to the control group. Statistically lower levels of tissue malondialdehyde (MDA) and fluorescent oxidation products (FOP) were detected in the CaDob group, and the CaDob group had significantly higher levels of sulfydryl (SH) than the control group. Histopathological scores in the CaDob group were found out to be statistically less than the scores the control group received (p < 0.05). CONCLUSIONS: CaDob treatment repaired the histpatological changes induced by bile duct ligation. The hepatoprotective effects of CaDob can be associated with its antioxidant properties of the drug.

Assessment of the effect of calcium dobesilate in experimental liver ischemia-reperfusion injury.

BACKGROUND: This study investigates the protective effect of calcium dobesilate (CaDob), an effective antioxidant and anti-inflammatory drug, on experimental liver ischemia-reperfusion injury (IRI). METHODS: Forty rats were divided into four groups. In Group 1, (sham), only hepatic pedicle was induced. In Group 2 (control), hepatic pedicle was reperfused for 90 min after being clamped for 60 min. No treatment was given in Group 1 and 2. In Group 3 (perioperative CaDob), 100 mg/kg CaDob was given 2 hours prior to the operation in which hepatic pedicle was reperfused for 90 min following a 60-min clamp. In Group 4 (preoperative CaDob), after 100 mg/kg/day CaDob was given for 10 days before the operation, hepatic pedicle was clamped for 60 min and reperfused for 90 minutes. At the end of these procedures, blood and liver tissue samples were collected for biochemical and histopathological assessment. RESULTS: Liver function tests and tissue oxidative stress parameters were significantly lower in the preoperative and perioperative treatment groups than the control group. Furthermore, it was observed that histopathological injury in the control group significantly decreased in both perioperative and preoperative treatment groups. CONCLUSION: Calcium dobesilate demonstrated a significant hepatoprotective effect in terms of its antioxidant and anti-inflammatory effects.

A new and early marker in the diagnosis of acute complicated appendicitis: immature granulocytes.

BACKGROUND: The aim of this study was to investigate the effectiveness of the immature granulocyte (IG) count (IGC) and percentage (IG%) in both diagnosing acute appendicitis (AA) and discriminating between simple appendicitis (SA) and complicated appendicitis (CA). METHODS: This study was carried out using the data of 438 adult patients who underwent an appendectomy. Demographic details, the preoperative white blood cell (WBC) count, neutrophil/lymphocyte ratio (NLR), IGC and IG%, operation findings, and pathology results were assessed retrospectively. The patients were grouped as AA and normal appendix (NA) according to the pathology reports, and the AA cases were subdivided into SA and CA groups according to the intraoperative findings. RESULTS: WBC, NLR, IGC, and IG% were significant parameters in the diagnosis of AA. The area under the receiver operating characteristic curve (AUROC: 0.795), sensitivity (55.5%) and specificity (96.1%) values of IGC were higher than the other parameters. All of the parameters were also significant for a CA diagnosis; however, the value of IG% in a CA diagnosis was stronger than the other parameters (IG% AUROC: 0.979, sensitivity: 94.4%, specificity: 97.9%). CONCLUSION: The IG value is a fast, easily available, and reliable parameter in both diagnosing AA and discriminating between SA and CA.

Rectal application of argan oil improves healing of colorectal anastomosis in rats1.

PURPOSE: To investigate the possible effects of argan oil on the healing of colorectal anastomoses. METHODS: n Group 1 (sham), laparotomy was performed and the colon was mobilized. In the control (Group 2) and argan oil (Group 3) groups, colonic resection and anastomosis were applied. To the control and sham groups, 2 mL of 0.9% NaCl was administred rectally, and in the argan oil group, 2 mL/day argan oil was applied rectally for 7 days. RESULTS: The mean bursting pressures of the argan oil and sham groups were significantly higher than the values in the control group. A significant difference was determined between the tissue hydroxyproline and prolidase levels of control group and other groups. Histopathologically, argan oil showed significant beneficial effects on colonic wound healing. In the argan oil and sham groups, the tissue malondialdehyde and fluorescent oxidation product levels were found to be lower and total sulfhydryl levels were higher than the control group. CONCLUSIONS: The rectally administered argan oil was observed to have significantly ameliorated wound healing parameters and exerted a significant antioxidant effect. This is the first study in the literature about the beneficial effects of argan oil on colorectal anastomoses.

Rectal application of argan oil improves healing of colorectal anastomosis in rats

Abstract Purpose: To investigate the possible effects of argan oil on the healing of colorectal anastomoses. Methods: I n Group 1 (sham), laparotomy was performed and the colon was mobilized. In the control (Group 2) and argan oil (Group 3) groups, colonic resection and anastomosis were applied. To the control and sham groups, 2 mL of 0.9% NaCl was administred rectally, and in the argan oil group, 2 mL/day argan oil was applied rectally for 7 days. Results: The mean bursting pressures of the argan oil and sham groups were significantly higher than the values in the control group. A significant difference was determined between the tissue hydroxyproline and prolidase levels of control group and other groups. Histopathologically, argan oil showed significant beneficial effects on colonic wound healing. In the argan oil and sham groups, the tissue malondialdehyde and fluorescent oxidation product levels were found to be lower and total sulfhydryl levels were higher than the control group. Conclusions: The rectally administered argan oil was observed to have significantly ameliorated wound healing parameters and exerted a significant antioxidant effect. This is the first study in the literature about the beneficial effects of argan oil on colorectal anastomoses.

Percutaneous treatment of a superior mesenteric artery pseudoaneurysm and arteriovenous fistula with coil embolization: a case report.

Visceral artery pseudoaneurysm and arteriovenous fistula following penetrating abdominal injuries is a rarely observed complication. Presently described is the case of a 44-year-old male admitted to the hospital after having previously experienced penetrating abdominal trauma. The patient had developed a pseudoaneurysm in the superior mesenteric artery and an arteriovenous fistula between the superior mesenteric artery and vein following surgery. The patient underwent successful coil embolization procedure and he was discharged 1 day after intervention.

[Investigation of the presence of Francisella tularensis by culture, serology and molecular methods in mice of Thrace Region, Turkey]. / Trakya Bölgesi'nde farelerde kültür, seroloji ve moleküler yöntemlerle Francisella tularensis varliginin aranmasi

Tularemia is a disease that has been reported in Turkey since 1936. Although mice are considered to have a role in the transmission of Francisella tularensis to man, this has not been exactly confirmed yet. The aim of this study was to investigate the presence of F. tularensis in mice by using culture, serology and molecular methods. For this purpose, four villages (Edirne-Demirkoy, Kirklareli-Kaynarca, Tekirdag-Muzruplu, Tekirdag-Sinanli) were selected in Thrace Region of Turkey where tularemia cases had been reported previously. A total of 126 live-catch mouse traps were established in warehouses, barns, areas near wells, water tanks and creeks in the villages in December 2012. Traps were kept overnight and the next day the animals collected were identified at species-level. The live-captured mice were anesthetized and their heart blood samples were obtained. Subsequently, liver and spleen tissues were removed from every mouse under aseptic conditions in the class-2 safety cabinet. These tissues were cultivated in Francis medium containing 5% sheep blood, 0.1% cystein, 1% glucose and incubated for seven days in both normal atmosphere and 5% carbondioxide incubator at 37°C. Tularemia microagglutination test was performed by using the sera which were obtained from live-captured mice. Finally, DNAs were isolated from both liver and spleen tissues of mice, and real-time polymerase chain reaction (Tularemia RT-PCR; Public Health Agency of Turkey, Ankara) were performed. In our study, a total of 19 mice were captured and of these 11 were alive. Ten mice were identified as Apodemus flavicollis, seven were Mus macedonicus and two were Mus musculus. There were no Francisella tularensis isolation in the cultures of mice liver and spleen tissues. Serological tests yielded negative results for 10 mice whose serum samples could be obtained. In RT-PCR, positivity were detected in spleen tissues of two mice which were captured from Kaynarca where first tularemia cases in Turkey in 1936 were reported but has no report from then on. One of them was a live female Mus macedonicus, and the other was a dead male Apodemus flavicollis. In quantitative evaluation, number of microorganism per organ were calculated as 4 x 103 cfu/spleen in Mus macedonicus and 4 x 104 cfu/spleen in Apodemus flavicollis. This is the first study in Turkey indicating that the mice in natural environment harbored F.tularensis. In conclusion, the results of this study indicated that the agent of tularemia has been retained since 1936 in Kaynarca region and this persistence might present a potential risk for tularemia epidemics.