A Novel Technique for the Management of Persistent Biliary Fistulas Developing After Liver Hydatid Cyst Surgeries: Drain Clamping Technique.

BACKGROUND: External biliary fistula, where the residual cyst is associated with the biliary tree, is one of the most common complications after liver hydatid cyst surgery. Surgical procedures become a consideration for patients in whom the biliary fistula persists despite all endoscopic procedures. However, reoperation for biliary fistula after hydatid cyst surgery leads to additional complications and increases morbidity and mortality. AIM: This study aims to treat persistent biliary fistulas that develop after liver hydatid cyst surgery using a simple noninvasive technique. MATERIALS AND METHODS: External drainage surgery was performed on 295 patients with liver hydatid cysts. Endoscopic treatment methods were used in patients who developed biliary fistula after surgery. Despite all endoscopic treatment methods, 14 patients developed persistent biliary fistulas. These patients were subsequently treated using the drain clamping technique. FINDINGS: All persistent fistulas occluded in 11.86 days (with a range of 8-20 days). No complications were observed in the one-year follow-up visits. CONCLUSION: Drain clamping, a novel approach to the treatment of persistent biliary fistulas developed despite all available endoscopic methods, can be safely used. This technique resulted in a complete recovery in patients without the need for surgical procedures.

Knowledge, attitudes and behaviors of primary health care nurses and midwives in breast cancer early diagnosis applications.

PURPOSE: The purpose of this research was to analyze the knowledge, attitudes and behaviors of the nurses and midwives about the early diagnosis of breast cancer. MATERIALS AND METHODS: This cross-sectional study was carried out at 9 family medical centers (FMCs) and 1 community health center (CHC) in Bingol; the population of this research consisted of 25 midwives and 38 nurses. The protocol for this study was approved by the regional ethics committee of Bingol University. The study was performed in accordance with the principles of the Declaration of Helsinki. The purpose of this study was explained to the nurses and midwives who participated, and their written and verbal permission was obtained; great care was taken to ensure that they understood participation was voluntary. A questionnaire of 41 questions was used for the data collection. RESULTS: When the age distribution of nurses and midwives was examined, it was found that 96.8% of them were aged ≤39 years. A total of 92.0% of midwives and 84.2% of nurses practiced breast self-examination (BSE). A total of 56% of the married women practiced family planning, and the most frequent method was using contraceptive pills. A total of 88.9% of the women had never had hormonal treatment for any reason. The BSE knowledge level of 65% of the women, who performed clinical breast examination, was complete. Among the women who had full knowledge of BSE, 38.5% of them performed examination once every 6 months, 23.0% of them once a year and 38.5% of them once every 3 years. CONCLUSION: This research showed that the deficiencies for nurses and midwives regarding the early diagnosis methods of breast cancer have been identified, and supporting these deficiencies with training is recommended.

Evaluation of anxiety condition among type 1 and type 2 diabetic patients.

PURPOSE: This study was conducted for the purpose of determining the relationship between type 1 and type 2 diabetic patients and anxiety. METHOD: This study was conducted between August and September 2015 at Bingol State Hospital. The study included 131 patients with diabetes mellitus (DM) followed up at the Internal Diseases Polyclinic of Bingol State Hospital. The questionnaire used in the study consisted of two parts. The first part of the questionnaire comprised a set of questions querying the sociodemographic characteristics and the second part comprised the Beck Anxiety Inventory. RESULTS: The incidence of Type 1 DM was found to be higher among female compared to male patients, whereas type 2 DM was found to be higher among male compared to female patients, and this difference was statistically significant. According to the results of Beck Anxiety Scale (BAS) applied to the patients to examine their psychological states, 94.2% of male and 96.8% of female patients were found to be in the severe anxiety group. Among both male and female patients, BAS scores of the type 2 DM patients were higher than those of type 1 DM patients. When the distribution of BAS scores among the patients was examined, it was found that males received 44.7±13.2 points and females received 47.0±13.0 as mean value, but no statistically significant difference was found between BAS scores by sex. Unlike female patients, the difference between duration of disease and BAS score was found to be statistically significant in male patients. CONCLUSION: In planning the treatment of patients with diabetes, evaluating them mentally will help to provide optimal treatment and care services.

Malignant rhabdoid tumour in the stomach.

In this case report, a rare tumoral morphology in the gastrointestinal system is introduced. Malignant rhabdoid features are rarely observed in the gastrointestinal system but this discrimination is important due to the tumor's poor prognosis, aggressive behavior and early metastasis.