Does Ramadan fasting contribute to the increase of peptic ulcer perforations?

OBJECTIVE: Medical treatment has been widely used in peptic ulcer disease, however perforation is a severe complication. The rationale of this study was to evaluate the effect of Islamic Ramadan fasting on peptic ulcer perforation. PATIENTS AND METHODS: Patients (No. 2311) who were operated on due to peptic ulcer perforation in a teaching and reference Hospital of a State University from January 1979 to January 2016 were analyzed. Patients were divided into two groups. Group I (No. 1805) included patients who were operated during other periods of the years without Ramadan fasting (396 months), while Group II (No. 506) constituted of patients who were operated on during the fasting periods (36 months). RESULTS: There was no significant difference in the mean ages between the groups (38 vs. 42 years). The mean monthly number of surgical intervention rates was higher in Group II (14.05 vs. 4.55, p < 0.001). There was a statistically significant rise in the number of male patients during Ramadan months (p = 0.0073). While omentoplasty with upper midline laparotomy vs. other surgical methods was significantly more employed in Group II (p = 0.0024), mortality rates were similar as 2.27 and 2.56% in Group I and II, respectively (p > 0.05). We could not detect any seasonal differences, although hot summer days constituted the longest fasting durations (19 hours) in the country. CONCLUSIONS: This study suggested that the occurrence of peptic ulcer perforation was significantly high during Ramadan fasting months due to the long fasting periods especially with significant male predominance.

DID CHERNOBYL ACCIDENT CONTRIBUTE TO THE RISE OF THYROID CANCER IN TURKEY?

CONTEXT: Radioactivity has been known to be a causative factor for thyroid cancer. OBJECTIVE: To answer whether the Chernobyl nuclear accident had any harmful effect on the rate of thyroid cancers after a wait-and-see period. BACKGROUND: The Chernobyl accident in 1986 was chosen as a milestone because of its close proximity to the geographical area studied. DESIGN: The time periods chosen were: I. 1990-1996 (latent period), II. 1997-2003 (sensitive period), III. 2004-2015 (control period). SUBJECT AND METHODS: A retrospective study was conducted in a teaching and reference state hospital. The statistical analysis of the data of 4251 patients was made by chi-square and Fisher exact tests. RESULTS: A total of 4251 patients were operated on because of thyroid diseases between 1990-2015. The number of patients in regard to the three time periods were 817, 1141 and 2293, respectively. Statistically significant rise of thyroid cancer and significant geographic vulnerability among different parts of the country were detected between the first two periods, but not between the second and third. The rising rates of malignancy were 1.71% (14/817), 6.83% (78/1141) and 8.59%(197/2293). The mean ages of malignant cases were 51.07 years, 46.2 years and 41.8 years although the mean ages of benign cases were 47.91,60.2, and 61.3 years according to groups, respectively. CONCLUSION: The Chernobyl nuclear accident seemed to have harmful effect on the rate of thyroid cancer or at least contributed to its increase.

Bochdalek's hernia in an adult with colon necrosis.

The improper fusion of the posterolateral foramina of the diaphragm was first described by Bochdalek in 1848. The true incidence of this congenital anomaly ranges from 1/7,000 to 6%. Although it is a well-known neonatal disease, it can also be diagnosed incidentally in adult patients. Until now, a total of around 100 cases of occult asymptomatic Bochdalek's hernia have been reported. The symptomatic cases are encountered more rarely. Colon necrosis among the symptomatic cases was reported in some cases. We herein report a case of a 21-year-old man with a left-sided Bochdalek's hernia which led to total necrosis of the transverse colon. Following resection and colocolonic anastomosis, the defect on the diaphragm was repaired. After an uneventful recovery period, he was discharged from the hospital on the 10th postoperative day. Being aware of this rarely encountered disease and of the factors for early diagnosis is of utmost importance to decrease mortality and morbidity.

Primary hydatid cyst of vastus lateralis muscle.

Musculoskeletal system is rarely involved by hydatid cyst,the larval form of Echinococcus Granulosus. A 37-year old man was diagnosed as having a cystic mass within his left thigh musculature. Preoperative computerized tomography suggested an unusual location of echinococcus although serology could not confirm the diagnosis. During surgery, a white coloured cyst within left vastus lateralis muscle was enucleated. Pathological examination after removal of the mass revealed hydatid cyst of vastus lateralis muscle. This case emphasizes that hydatidosis should be included in differential diagnosis of any soft tissue mass especially in regions where it is endemic.

Hydatid disease in the breast: a case report.

A case of primary breast hydatid disease observed in a 42-year old female patient is reported. Physical examination, mammography and ultrasonography were the methods used for the diagnosis. The lesion was located in the upper outer quadrant of the right breast. The mass was surgically removed under local anaesthesia. No complications were observed postoperatively. We wanted to emphasize the importance of keeping in mind the possibility of hydatid disease in cystic breast lesions, particularly in endemic regions.

Irreducible inguinal hernia, bowel obstruction, and torsion of testis in a patient with testicular feminization syndrome.

Testicular feminization syndrome, irreducible inguinal hernia, bowel obstruction, and testicular torsion were diagnosed and treated in a 13-year-old girl. Diagnosis of this case in such a complex form in an emergency room is a rare occurrence. Through this case, we want to emphasize the coincidence of inguinal hernia and testicular feminization and the X-linked recessive transmission character of the disease.