A retrospective study on the pathologies in patients with coccydynia-lumbosacralgia and their treatment.

BACKGROUND: The aim of this study was to arrange the treatment according to the etiology following the differential diagnosis in patients who had presented to the Orthopedics and Traumatology and General Surgery outpatient departments, and to emphasize the post-treatment success. METHOD: The charts of 156 patients who had presented to the Orthopedics and Traumatology, General Surgery Departments of the Kafkas University Faculty of Medicine between July 2012 and June 2021 were retrospectively reviewed after permission was obtained from the ethics committee in this study. The demographic findings and Visual Analogue Scale (VAS) results for those with a symptom of pain as detected during the physical examination were recorded from the patient charts. RESULTS: A total of 156 patients who had presented with traumatic and non-traumatic conditions to the Orthopedics Clinic complaining of pain, burning, sensitivity, discharge and hyperemia at the coccyx region were included in the study. The reason for the lumbosacralgia was found to be traumatic as in heavy lifting or working physically difficult jobs in 62 of the 95 patients (65.26%) who presented with lumbosacralgia and pain referred to the coccyx. The mean VAS was 7.37 before treatment and 2.32 following conservative treatment. There was a history of falling on the coccyx region in 8 of the 14 patients with traumatic isolated coccydynia. The pre-treatment mean VAS was 8.64 in the patients with a diagnosis of coccydynia while the post-treatment mean VAS was 0 in 8 patients with full recovery, 4.33 in 3 patients with partial recovery, and 9.66 in 3 patients with no recovery. The pre-treatment mean VAS was 7.58 in the 29 patients with thrombosed hemorrhoids, decreasing to 0 after treatment. The pre-treatment mean VAS was 4.16 in the 18 patients with a pilonidal sinus, again decreasing to 0 after treatment. CONCLUSION: Possible underlying etiological factors should be taken into account when making a diagnosis in patients with coccydynia and the treatment should be determined in a multidisciplinary manner.

Retrospective Evaluation of Patients Diagnosed with Cystic Echinococcosis at Kafkas University Faculty of Medicine's Surgical Outpatients Unit.

OBJECTIVE: The aim of this study was to retrospectively evaluate the serological and radiological analysis and medical and surgical treatment results of patients diagnosed with cystic echinococcosis (CE). METHODS: Records belonging to a total of 67 patients diagnosed with CE who presented to the Kars Kafkas University Faculty of Medicine Research Hospital's Surgical Outpatient unit between January 2012 and December 2015 were retrospectively evaluated. RESULTS: Of 67 CE cases, 53 (79.1%) were females and 14 (20.9%) were males. The age ranged between 12 and 77 years, and the mean age was 47.37±17.81 years. The most common cyst location was the liver, in 60 patients (89.5%). Other localizations were found in 7 (10.5%) of the 67 cases. Open surgery was used to treat 32, and drainage accompanied by ultrasonography (USG) was used to treat 13 cystic cases. The remaining 22 patients were followed-up. Among the followed-up patients, the radiologic imaging findings of six patients were consistent with a hydatid cyst, but the indirect hemagglutination assay (IHA) results were negative. CONCLUSION: We concluded that CE is an important public health problem for the Kars region due to a low socioeconomic and educational level, where livestock breeding is also common. More comprehensive epidemiological studies should be undertaken and national control programs are required to keep the disease under control.

Myofibroblastoma.

Myofibroblastoma of the breast is a rare benign mesenchymal tumor. We report a 61-year-old male case who presented to the orthopedic clinic with right shoulder pain. The physical and clinical examination was normal and he was referred to our clinic. Excision was performed and there were no postoperative complications.

Effects of alpha lipoic acid on intra-abdominal adhesion: an experimental study in a rat model.

BACKGROUND: This study was performed to determine the effect of alpha lipoic acid, a powerful antioxidant, on intra-abdominal adhesion formation. METHODS: Twenty-four female Wistar Albino rats weighing 250-300 g were used in this study conducted on three groups consisting of the alpha lipoic acid group (Group I, n=8), control group (Group II, n=8), and sham group (Group III, n=8). After performing laparotomy with a midline incision under general anesthesia, the adhesion model was created on the antimesenteric side of the caecum in Group I and Group II. 50 mg/kg alpha-lipoic acid was administered intraperitoneally (IP) in Group I while the surgical procedure was performed but no drugs administered in Group II. Only laparotomy was performed in Group III. Rats were sacrificed at the end of the tenth day. RESULTS: Macroscopic scoring was performed, tissue samples were obtained and subjected to biochemical and histopathological evaluation. The degree of adhesion and malondialdehyde level decreased (p<0.01), and glutathione levels had increased (p<0.01) in Group I compared to Group II in macroscopic scoring. CONCLUSION: Alpha lipoic acid was found to significantly decrease (p<0.01) intra-abdominal adhesion when administered IP compared to the control group.

The comparison of the effects of ellagic acid and diclofenac sodium on intra-abdominal adhesion: an in vivo study in the rat model.

Peritoneal adhesions are seen frequently after abdominal surgery and can cause serious complications. We aimed to evaluate the effects of the oral use of diclofenac sodium and ellagic acid on formation of postoperative adhesions in rats Studies have shown that agents with anti-inflammatory properties and antioxidant substances can prevent adhesion by decreasing oxidative stress. We compared and evaluated the effects of ellagic acid that has strong antioxidant and anti-inflammatory properties and the nonsteroidal anti-inflammatory diclofenac sodium on peritoneal adhesion development in our experimental study. Laparotomy was performed with a midline incision under general anesthesia and an adhesion model was created on the antimesenteric side of the cecum in Groups I, II, and III. Group I received 85 mg/kg ellagic acid and Group II, 50 mg/kg diclofenac sodium through the nasogastric catheter while Group III received no medication. Only laparotomy was performed in Group IV. The rats were sacrificed at the end of the 14th day. Following macroscopic scoring, tissue samples were removed and subjected to biochemical and histopathologic evaluation. The degree of adhesion and the malondialdehyde level were decreased (P < 0.05), and glutathione level increased (P < 0.05) in Group I compared to Group II and Group III. The effects of ellagic acid on the prevention of peritoneal adhesion were found to be stronger than diclofenac sodium. This can be explained by the fact that ellagic acid is a strong antioxidant and decreases oxidative stress with anti-inflammatory and anti-angiogenic effects.