Prophylactic oral calcium supplementation therapy to prevent early post thyroidectomy hypocalcemia and evaluation of postoperative parathyroid hormone levels to detect hypocalcemia: A prospective randomized study.

BACKGROUND: Postoperative hypocalcemia is the most common complication after total thyroidectomy. Postoperative parathyroid hormone (PTH) measurement is one of the methods to detect or prevent postoperative hypocalcemia. Prophylactic oral calcium supplementation is another method to prevent early postoperative hypocalcemia. The aim of this study is to detect the accurate timing of PTH and evaluate efficacy of routine oral calcium supplementation for postoperative hypocalcemia. METHODS: A total of 106 patients were performed total thyroidectomy. Rotuine oral calcium supplementation was given to group 1 and no treatment to group 2 according to randomization. Serum calcium and PTH level of patients in group 2 at postoperative 6, 12 and 24 h and patients in both groups at postoperative day 7 were evaluated. Patients were compared according to age, sex, operation findings, serum calcium and PTH levels and symptomatic hypocalcemia. RESULTS: Half of the patients (50%) were in group 1. Most of the patients were female (83%). The most common etiology of thyroid disease was multinodular goiter (64.1%). Oral calcium supplementation was given to 18 (33.9%) patients in group 2. Symptomatic hypocalcemia for group 1 and 2 was found to be 1.9 and 33.9% respectively (p < 0.05). No statistical difference can be observed regarding the timing of serum biomarkers. CONCLUSION: Serum PTH levels at postoperative 12 and 24 h can predict early post-thyroidectomy hypocalcemia. Prophylactic oral calcium supplementation therapy can prevent early post-thyroidectomy hypocalcemia with advantages of being cost effective and safe.

Evaluation of Demographic and Clinical Characteristics of Patients who Attempted Suicide by Self-Inflicted Burn Using Catalyzer.

Our aim was to assess demographic and clinical characteristics of patients treated at our units who attempted suicide by self-incineration, and to compare the results of burns with or without catalyzer use. Twenty patients who attempted suicide by self-incineration were examined in terms of clinical and demographic characteristics. Average age of the study population was 35 years (range 13-85 years). Average percentage of total body surface area burn was 53% (9%-100%). Six (30%) patients used gasoline and 5 (25%) used paint thinner in order to catalyze burning. Of these 11 patients who used a catalyzer, 5 (45.4%) had inhalation injury and 7 (63.6%) died. Among 9 patients who did not use any catalyzer, 1 (11.1%) had inhalation injury and 4 (44.4%) died. In general, inhalation injury was diagnosed in 6 patients (30%) while 11 (55%) patients died. A high morbidity and mortality rate was found in patients who used a catalyzer.

Parasitic infections of the appendix as a cause of appendectomy in adult patients.

OBJECTIVE: Assessment of frequency and clinical findings of parasitic infections for etiology of acute appendicitis. METHODS: Data of 1452 patients who were carried out appendectomy between January 1999 and December 2012 were analyzed retrospectively. Appendectomy was performed in 1159 of the patients with a pre diagnosis of acute appendicitis. Demographics, physical findings, radiologic and laboratory studies, operative findings, pathological results, presence and type of parasitosis were investigated. RESULTS: Among the 1159 patients done appendectomy with a pre diagnosis of acute appendicitis, 719 (62%) were males and 440 (38%) were females. Parasitic infection was demonstrated in 17 (1.4%) of them. Mean average age of these patients was 36.6 ± 20.1 years. Enterobius vermicularis was present in 15 (88.2%) and Entamoeba histolytica in 2 (11.8%) of the patients. Of the pathology specimens of appendix consisting Enterobius vermicularis, 12 (80%) were normal appendix tissues, 1 (6.6%) was acute uncomplicated appendicitis and 2 (13.3%) were perforated appendicitis. One (50%) of the two specimens consisting Entamoeba histolytica was normal appendix and the other (50%) was acute appendicitis. CONCLUSION: Differential diagnosis of parasitic infections in etiology of acute appendicitis should be made properly. It must be remembered that this attention can save patients from a negative laparotomy and morbidity and mortality of it.

Evaluation of burn injuries related to liquefied petroleum gas.

Liquefied petroleum gas (LPG) is a fuel that is widely used for domestic, agricultural, and industrial purposes. LPG is also commonly used in restaurants, industries, and cars; however, the home continues to be the main site for accidents. In Turkey, the increased usage of LPG as a cooking or heating fuel has resulted in many burn injuries from LPG mishaps. Between January 2000 and June 2011, 56 LPG-burned patients were compared with 112 flame-burned patients. There were no significant differences with respect to the mean age, sex, hospitalization time, and mortality in both groups. In the LPG-caused burn cases, 41 burns (73.2%) occurred at home, seven (12.5) were work-related mishaps, and eight (14.3) were associated with car accidents. The majority of the LPG burns (82%, 46 patients) resulted from a gas leak, and 18% of them were related to the failure to close LPG tubes in the patients' kitchens (10 patients). Burns to the face and neck (82 vs 67%, P = .039) and upper (62 vs 23%, P = .000) and lower (70 vs 45%, P = .002) extremities were significantly higher in LPG-caused burn cases than flame-burned cases. General awareness regarding the risk of LPG and first aid for burns appears to be lacking. The LPG delivery system should be standardized throughout countries that widely use LPG.

Effect of dexamethazone on hepatic vascular response in experimental sepsis.

BACKGROUND: The aim of the present study was to evaluate the effect of dexamethasone-pretreatment on the hepatic artery and portal vein of septic rats, which were generated by lipopolisaccarides (LPS) intraperitoneal injection. METHOD: Thirty-six albino Wistar rats were used and constructed as LPS (n = 12), control (n = 12), dexamethazone-pretreatment (n = 6) and dexamethazone-control (n = 6) groups. Hepatic artery and portal vein rings were excised and placed in Krebs-Henseleit solution. Vessel rings were contracted with phenylephrine adding to the organ chamber in cumulative doses. Then the contraction-response curves were drawn. RESULTS: In the LPS group, phenylephrine evoked contractions were reduced in both hepatic artery and portal vein rings in comparison to the control group. In the dexamethasone-control group, phenylephrine-evoked contractions were increased but not significantly. Dexamethasone-pretreatment increased the phenylephrine-evoked contractions close to the values of control group for both types of rings. CONCLUSIONS: Dexamethasone pretreatment corrected the vascular hyporeactivity to phenyleprine in isolated portal vein and hepatic artery rings prepared from the LPS treated rats in experimental sepsis. This might have occurred as a result of inhibition of inducible nitric oxide synthase expression.