effects of Ramadan fasting on the number of renal colic visits to the emergency department

Objective: The effects of fluid and diet restriction strictly during the long hours in Ramadan on the number of colic visits and biochemical factors of stone formation are controversial in the literature. The aim of this study was to assess the effects of Ramadan fasting on the number of renal colic visits and laboratory results of patients with renal colic

Methods: This was a prospective observational study, which was conducted with patients who were admitted to our emergency department with renal colic. The study period was divided into two parts: Before Ramadan and Ramadan. All laboratory results of patients and daily air temperature values were recorded. p<0.05 was considered statistically significant for all tests

Results: Total 176 patients [n:89 in before Ramadan, n:87 in Ramadan] with renal colic were enrolled into the study. During Ramadan, 49 [73.1%] of 67 patients were admitted in the first half of the month and 20 patients [26.9%] were admitted in the second half of the month. Only urine density and white blood cell values in Ramadan and non-Ramadan period were significantly different [p=0.004 and p=0.001]. Hemoglobin, general crystal, and triple phosphate crystal values in the first and the second half of Ramadan were significantly different [p=0.04, p=0.03, and p=0.03]

Conclusion: This study has shown that fasting in Ramadan does not change the number of renal colic visits. In addition, although fasting causes some changes in urinary metabolites, there is not enough evidence that these changes increase urinary calculus formation

Hair tourniquet syndrome

The hair tourniquet syndrome is a rare disorder. This syndrome has been described as involving the fingers, the toes and even the genitals. We report a case of hair tourniquet syndrome affecting multiple toes of an infant. After the hair fiber was removed there was a fast healing period and no signs of tissue necrosis were seen. The prompt diagnosis and treatment of the condition is vital to attain a good outcome and prevent further harm to the child

Diagnostic value of lactate levels in acute appendicitis

To assess the value of lactate measurements in addition to standard diagnostic measurement of white blood cell count [WBC] and C-reactive protein [CRP] in the accuracy of preoperative acute appendicitis [AA] diagnosis. A total of thirty-six consecutive patients with histopathologically confirmed acute appendicitis were retrospectively included in the study. Fifteen volunteers were included as control group. Patient characteristics, preoperative ultrasonography [US] and laboratory assessment including WBC, C-reactive protein [CRP] and lactate values were collected. Receiver Operator Characterstics [ROC] curves for discriminant values and sensitivity, specificity, positive and negative predictive values [PPV.NPV] were calculated. The male/female ratio of groups 1 and 2 were 25/11 and 9/6 respectively. Mean age: 34.13 +/- 9.6 years. Area under ROC values for lactate were found significant and discriminant value was found to be 8 mg/dl. Specificity, sensitivity, PPV and NPV calculated for lactate were as follows: 53%, 80%, 77% and 57%. Increased lactate levels as well as other inflammatory parameters should be considered as a diagnostic parameter in diagnosis of AA