Browsing by Author "Ustun, Mehmet"

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Factors Affecting Bilirubin Levels Following Drainage Proceduresin Obstructive Jaundice
(2019) Aydın, Cengiz; Çapar, Ahmet Ergin; Günay, Süleyman; Karaca, Avni Can; Ustun, Mehmet
Introduction: Measuring serum bilirubin levels is easy and readily available invirtually every healthcare facility. It is practically used by physicians for thefollow up of the patients with obstructive jaundice.Despite its common use as amarker for follow up, the literature lacks clear data about its interpretation as aclinical marker.We don’t have clearly set prognostic rules and cutoff pointsespecially about the rate of bilirubin decrease following biliary drainageprocedures.We conducted a retrospective study to determine the likely factorsthat affect bilirubin levels following the interventional relief of obstructivejaundice.Material-Method: We retrospectively analyzed data from 73 patients withobstructive jaundice who underwent interventional drainage procedures over atime period of 4 years in a tertiary healthcare center.Results: Decrease in the bilirubin levels was most rapid in the first 48hour following the drainage. From the analyzed variables, only age andselected type of the drainage procedure significantly affected the rateof bilirubin decrease in our patient group. We failed to establish cutoffpoints that can accurately predict the patients with slower bilirubindecrease.Conclusion: Serum bilirubin level is an important and commonly usedmarker predicting the success of treatment and the prognosis of thepatients with obstructive jaudince. Type of drainage and the ageproven to significantly affect the rate of bilirubin decrease regardless ofunderlying pathology
Prospective Comparison of the Efficacy of Two Common Appendicitis Scoring Systems: Is Combination a Solution?
(2020) Karaca, Avni Can; Akpınar, Göksever; Karaali, Cem; Ustun, Mehmet; Atıcı, Semra Demirli
Aim: The diagnosis of acute appendicitis mostly relies on history taking and physical examination findings supported by laboratory and imaging studies. A number of different diagnostic scoring systems have been developed to facilitate diagnosis, and their accuracies vary among patient populations. This prospective study aims to evaluate the accuracy of the two most frequently used scoring systems in the Turkish patient population and to analyse the possible diagnostic advantage of using these two systems in combination. Method: Patients admitted to the emergency department of a tertiary healthcare centre with acute abdominal pain who eventually underwent appendectomy between July 2018 and January 2019 were enrolled in the study. Alvarado and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scores, as well as other laboratory parameters, were recorded for each patient. Using histopathologic examination as the gold standard, the sensitivity, specificity and positive and negative predictive values of each scoring system were calculated and combined using McNemar’s x2 test. Results: Data from a total of 203 patients were analysed. The sensitivity of the RIPASA system (95%) was far superior to that of the Alvarado system (35.6%). However, the Alvarado scoring system had much higher diagnostic specificity than the RIPASA system (80% vs 33.3%). The combined sensitivity and specificity of the tests rose to 88% and 62.5%, respectively. Conclusion: The RIPASA system has high sensitivity; however, the Alvarado system has high specificity for the Turkish population. Both the Alvarado and RIPASA scoring systems are useful clinical tools with different strengths. Using these two systems in combination increases diagnostic power by combining the strongest aspects of both tests.
Citation - WoS: 9
Citation - Scopus: 9
The Relationship Between Thyroidectomy Complications and Body Mass Index
(Assoc Medica Brasileira, 2020) Ustun, Mehmet; Karaca, Avni Can; Birol, Ihsan; Uslu, Gulberk; Atici, Semra Demirli; Aydin, Cengiz
INTRODUCTION: Obesity is a growing public health problem associated with many comorbid diseases. The aim of this study was to evaluate the relationship between body mass index and complications of thyroidectomy. METHODS: Patients who underwent total thyroidectomy between January 2015 and December 2018 were enrolled. Patients were divided into two groups, i.e., BMI <25 (group A) and BMI >= 25 (group B). Demographics, operative time, and complications were retrospectively reviewed. RESULTS: The study included 145 patients (66 in Group A and 79 in Group B). There was no significant difference between the two groups in terms of age (p=0.330) and gender (p=0.055). No surgical site infection and bleeding complications were observed in any patients. The mean operative time was 148.4 minutes (90-235) in Group A and 153.4 minutes (85-285) in Group B (p=0.399). Transient hypocalcemia was observed in 25 (37.9%) patients in group A, and 23 (29.1%) patients in Group B (p = 0.291). Permanent hypocalcemia was not observed in any patient in group A, and in 2 patients in Group B (2.5%) (p = 0.501). Transient recurrent nerve palsy was observed in 1 (1.5%) patient in Group A and in 3 (3.8%) patients in Group B (p=0.626). None of the patients had permanent recurrent nerve palsy. Parathyroid autotransplantation was performed on 1 patient (1.5%) in group A and on 7 (8.9%) patients in Group B (p=0.055). CONCLUSION: We think there is no relationship between a high BMI and thyroidectomy complications, and surgery can also be performed safely in this patient group.