Clinical characteristics and short-term outcomes of adult patients with urolithiasis: first report from Somalia.

OBJECTIVE: This study aimed to investigate the data of adult patients admitted to the only tertiary care center in Somalia with the diagnosis of urolithiasis and to present the first report from this Sub-Saharan African country. PATIENTS AND METHODS: This study was designed as a retrospective single-center study conducted in Somalia Turkiye Training and Research Hospital. Adult patients who received the diagnosis of urolithiasis and who were admitted to the urology department constituted the target population. Reviewed data included demographic parameters, stone features, type of surgical procedure, intraoperative and early postoperative complications, and inpatient mortality. RESULTS: Overall, 3,680 patients were admitted during the study period. Among these, 620 (17%) patients were admitted due to urolithiasis. There was a significant male predominance with a male-to-female ratio of 3.4:1. Urinary bladder was the most common stone location (n=253, 40.8%), followed by the kidney (n=223, 35.9%). The mean stone diameter was 22.41 (5-64); most (39.4%) of the patients had a stone diameter between 20 and 30 mm, while 27.5% had stones with diameters between 10 and 20 mm. Minimally invasive procedures were the primary surgical modality in 52.6% (n=326) of our patients. However, 45.9% (n=285) of the patients underwent open surgery. CONCLUSIONS: The rate of adults with urolithiasis is relatively high in Somalia, as in many other African countries, with a significant male predominance. Although open surgery is rarely used for treating adult urolithiasis in industrialized countries, this approach is still commonly used in Somalia, similar to other parts of Africa.

The effects of a TNF-alpha inhibitor and HBO combination on the severity of pancreatitis and oxidative response in an experimental model of acute pancreatitis.

OBJECTIVES: We aimed to investigate the effects of infliximab and HBO (hyperbaric oxygen) used alone or in combination on oxidative stress and the severity of pancreatitis in an experimental model of AP (acute pancreatitis). MATERIAL AND METHODS: A total of 60 rats were randomly divided into five groups. Group 1 underwent laparotomy; Group 2 underwent experimental AP; Group 3 was given an infliximab infusion and underwent AP; Group 4 was subjected to HBO therapy after AP; and Group 5 was given infliximab infusion before AP and subjected to HBO therapy. Serum amylase, superoxide dismutase (SOD), malondialdehyde (MDA), and glutathione peroxidase (GPX) levels in the pancreas tissues were measured. The pancreatic tissue samples were scored. RESULTS: There were statistically significant differences in the histopathological scores and amylase levels between non-treated AP and all the three treatment groups. Group 5 had the closest histopathological scores to the sham group. MDA levels were significantly different between non-treated AP and all the three treatment groups, but the SOD levels and GPX values were not. CONCLUSIONS: Combination of HBO therapy and Infliximab showed a synergistic effect on the reduction of histopathological severity and mortality in acute pancreatitis. All treatment modalities reduced the pathological findings by decreasing lipid peroxidation and partly increasing the antioxidant capacity in early period (Tab. 1, Fig. 3, Ref. 28).

Combat application tourniquet (CAT) eradicates popliteal pulses effectively by correcting the windlass turn degrees: a trial on 145 participants.

INTRODUCTION: We aimed to define an ideal range of windlass turn degrees for 100 % success rates within the study population. METHODS: CAT was applied at mid-thigh level. Data included age, lower extremity circumference (LEC), body mass index (BMI), and mean arterial pressure (MAP). Windlass turn degrees were measured in failed and successful participants. The failed participants' windlass mechanisms were twisted until the popliteal artery was occluded. Failure to success and additional turn degrees to secure the windlass mechanism of CAT was determined. Doppler ultrasound was used to examine the popliteal artery blood flow. RESULTS: 145 servicemen have participated in the study. Initially, 70 % successfully applied CAT. There was no statistically significant difference in BMI and MAP values between successful and failed participants. The mean LEC for failed and successful applications were 57.5 ± 4 and 56.8 ± 4, respectively. The required turn degrees for success ranged between 45° and 270°. After correction, the cumulative success rate of 93 and 100 % was reached at 990° and 1170° overall turn degrees. DISCUSSION: In order to adequately stop limb hemorrhage, soldiers should be taught their optimal turn degrees.