Diagnostic performance of two ultrasound techniques for the detection of cleft palate without cleft lip: axial-transverse and equal sign.

OBJECTIVE: There is no study that compares the diagnostic performance of ATV and ESV techniques in detecting cleft palate. We aimed to evaluate the diagnostic accuracy of two ultrasound techniques: axial-transverse (ATV) and "equal sign" view (ESV), in detecting fetal cleft palate without cleft lip. PATIENTS AND METHODS: This prospective study was conducted from March 2019 to January 2022 in a tertiary referral hospital. Secondary palates were assessed with ATV and ESV by two experienced fetal medicine specialists who were blinded to each other's ultrasound findings. Final diagnosis was done according to postnatal physical examination. The sensitivity and specificity of the two techniques were calculated. RESULTS: A total of 311 pregnancies which met the study criteria were evaluated. Postnatal physical examination showed that 13 (0.4%) neonates had cleft palate only (CPO). According to final diagnosis the sensitivity, specificity, positive predictive value and negative predictive value for ATV were 100%, 98.7%, 76.4%, 100% and 100% for ESV were 76.9%, 97.8%, 58.9% and 99%, respectively. CONCLUSIONS: ATV in 2D ultrasound provides higher sensitivity and specificity than ESV in detecting CPO.

The comparison of del nido cardioplegia and crystalloid-based blood cardioplegia in adult isolated coronary bypass surgery: A randomized controlled trial.

Background and Aim: In our study, patients who underwent isolated coronary artery bypass surgery (CABG) using Del Nido cardioplegia (DNC) and crystalloid-based cold blood cardioplegia (CBC) were compared. Subject and Methods: In this study, two groups of patients who underwent isolated CABG using DNC (n = 106) and CBC (n = 107) were prospectively randomized. Groups were compared in terms of many results such as troponin T, returning spontaneous rhythm, and cardioplegia volume. Results and Conclusions: Median troponin T levels of the DNC and CBC groups were compared for the 0th hour (baseline), 12th, 36th, and 60th hours. There was no statistical difference between groups in troponin T levels of the baseline 0th hour (18[33] vs. 22[27] pg/ml; P = 0.724). Troponin T levels at the 12th hour were less in the DNC group than the CBC group but no statistical difference between the groups (790[735] vs. 826[820] pg/ml; P = 0.068), respectively. Troponin T levels at 36th and 60th hours were higher in the CBC group compared to the DNC group, and a statistical difference was observed (580[546] vs. 650[550] pg/ml; P = 0.030) and (359[395] vs. 421[400] pg/ml; P = 0.020), respectively. After X-clamping, the spontaneous rhythm rate was statistically higher in the DNC group than the CBC group (72.60% vs. 37.40%; P < 0.001). There was no statistical difference between the groups in terms of postoperative arrhythmia, hospital stay, and mortality rates (P > 0.05). Based on data we acquired from the study, we think that DNC is at least as safe and effective as CBC in adult CABG cases.

Comparison of patients with and without intellectual disability under general anesthesia: A retrospective study.

BACKGROUND AND PURPOSE: We analyzed and retrospectively compared patients with and without intellectual disability (ID) who underwent oral surgery under general anesthesia at Istanbul University, Faculty of Dentistry, Department of General Anesthesia, between October 2012 and June 2013 with regard to the following categories: Demographic features, American Society of Anesthesiologists (ASA) classification, Mallampati score, type of anesthetic drug used during the operation, type of intubation used, any difficulties with tracheal intubation, presence of systemic diseases, and recovery times after ending general anesthesia. MATERIALS AND METHODS: A total of 348 patients were selected from the Department of Maxillofacial Surgery and the Department of Pedodontics who underwent surgery with general anesthesia. Medical histories of all patients were taken, and their electrocardiography, chest X-rays, complete blood count, and blood clotting tests were checked during a preoperative assessment. Mallampati evaluations were also performed. Patients were grouped into ASA I, II, or III according to the ASA classification and were treated under general anesthesia. RESULTS: There was no significant difference between normal and intellectually disabled patients in terms of gender, Mallampati scores, intubation difficulties, mean anesthetic period, time to discharge, or postoperative nausea and vomiting. Epilepsy and genetic diseases in intellectually disabled patients were significantly more common than in non-ID (NID) patients. However, the frequency of diabetes and chronic obstructive pulmonary disease in NID patients was significantly higher than in the intellectually disabled patients. CONCLUSION: Dental treatment of intellectually disabled patients under general anesthesia can be performed just as safely as that with NID patients.

Predictive value of neutrophiltolymphocyte ratio in the severity of non-alcoholic fatty liver disease among type 2 diabetes patients.

BACKGROUND: Non-alcoholic fatty liver disease is a progressive inflammatory disease that ultimately results in cirrhosis and liver failure. It is assosiciated with two step hit scenario; the first step is fat accumulationin liver and in the second step inflammation and fibrosis are the major compenents. The incidence of this disease is increasing worldwide, following rising incidences of obesity and diabetes mellitus. AIM: The aim of this study is to analyze the relationship between non-alcoholic fatty liver disease andseverity and neutrophil-to-lymphocyte ratio among the patients having type 2 diabetes mellitus. METHODS: This study involved 143 patients with type 2 diabetes who were placed into four groups (grade 0, 1, 2, 3) based on steatosis level due to blinded ultrasonographic evaluation. Biochemical parameters and counts of total white blood cells, neutrophils, and lymphocytes were determined. Neutrophil-to-lymphocyte ratio was compared across the four patient groups. RESULTS: Levels of hemoglobin A1c, creatinine, alanine aminotransferase, high-density lipoprotein cholesterol and triglycerides were significantly different between the four patient groups (ANOVA p-values: p <0.001, p=0.011, p=0.002, p=0.034, p=0.002, respectively). Counts of white blood cells, neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio significantly differed between the groups (p <0.001). Neutrophil-to-lymphocyte ratio was positively correlated with steatosis grade (p < 0.001). CONCLUSIONS: Neutrophil-to-lymphocyte ratio increases with increasing grade of non-alcoholic fatty liver disease in patients with type 2 diabetes, and may be a convenient marker to follow progression of non-alcoholic fatty liver disease. (Acta gastro-enterol. belg., 2016, 79, 295-300).

Neutrophil-to-lymphocyte ratio in patients with severe tinnitus: prospective, controlled clinical study.

OBJECTIVE: To determine the relationship between severe tinnitus and inflammation using the neutrophil-to-lymphocyte ratio as a marker of stress. METHODS: A total of 107 patients who had been suffering with severe tinnitus (tinnitus handicap inventory scale grades of 3-5) for at least 2 weeks were recruited. Patients underwent detailed ENT examinations and audiometric tests to exclude a relevant pathological cause of the tinnitus. Patients with systemic diseases, malignancy or inflammatory diseases that could alter neutrophil-to-lymphocyte ratio were excluded. A total of 107 age- and sex-matched healthy control participants were also recruited. Routine laboratory test results and neutrophil-to-lymphocyte ratio were compared between the patients and controls. RESULTS: Lipid profile, liver function, white blood cell count, haemoglobin level, mean corpuscular volume, and vitamin B12 and folate levels were similar among the patients and controls. However, mean neutrophil-to-lymphocyte ratio was significantly higher among the patients than the controls (p < 0.05). CONCLUSION: The findings of this novel study suggest that neutrophil-to-lymphocyte ratio should be considered during the evaluation of tinnitus patients as a potential clinical marker of tinnitus. Further studies are required to verify the findings.

Intermittent partial surface wetting and its effect on body-surface temperatures and egg production of white and brown domestic laying hens in Antalya (Turkey).

1. The effect of intermittent partial surface wetting on body and surface temperature were investigated at 62 and 20 weeks of age in domestic laying hens of ATABEY (white) and ATAK (brown) strains. 2. The number of control and treatment birds was 96, half of which were 62 weeks of age and the remainder 20-week-old birds. 3. Sprinkling was done on the head, head appendages, neck and dorsal surface by releasing 10 ml/bird in a sprinkling session. The control birds were not sprinkled at any time. 4. The first measurement was carried out immediately before sprinkling, the second just after sprinkling, and measurements were then repeated every 5 min until the end of the 20th min. 5. Partial surface sprinkle cooling had a positive effect in relieving the birds of heat stress. The treatment birds had lower core body, head and dorsal surface temperatures than the control birds. 6. The treatment effect on egg production was significant in young birds but not in the older ones.

Surface wetting and its effect on body and surface temperatures of domestic laying hens at different thermal conditions.

This study investigated the efficacy of surface wetting at different thermal conditions on core body, head, and dorsal surface temperatures in laying hens. Hens were sprinkled on the head and dorsal surface by releasing a sprinkling dosage of 10 mL.bird(-1). The first measurement was taken presprinkling, and the second was taken immediately postsprinkling and then repeated every 5 min for 20 min. The cooling water needs for intermittent partial surface wetting to relieve acute heat stress in the laying hens were quantified for 48 domestic laying hens under 4 experimental thermal conditions. The hens were kept at 4 thermal conditions at average dry-bulb temperatures of 31.30 +/- 0.03, 33.20 +/- 0.08, 36.01 +/- 0.12, and 40.24 +/- 0.08 degrees C; RH of 67.68 +/- 0.37, 51.78 +/- 1.98, 24.59 +/- 0.90, and 16.12 +/- 1.55%; and air velocities of 0.09 +/- 0.00, 0.07 +/- 0.00, 0.08 +/- 0.00, and 0.09 +/- 0.00 m.s(-1), respectively. The differences in core body, head, and dorsal surface temperatures among the 4 thermal groups were 0.15, 0.18, 0.23, and 0.22 degrees C for core body temperature; 1.63, 1.44, 2.51, and 0.97 degrees C for core head temperature; and 1.23, 1.37, 1.41, and 0.64 degrees C for core dorsal temperature at thermal conditions 1, 2, 3, and 4, respectively. There were significant differences in core body, head, and dorsal surface temperatures among the 4 thermal condition groups. It was concluded that the spraying interval was directly proportional to the product of the vapor pressure deficit and the thermal resistance of convective mass transfer of the wetted hens, because there were no significant differences in the air velocity among the 4 thermal condition groups and the air velocity was very low.

Early first trimester ultrasound examination. Is it really efficient in the clinical management of the pregnancy?

OBJECTIVE: This is a retrospective study accomplished to determine the efficiency of the first trimester ultrasound examination especially when performed on elective conditions. MATERIALS AND METHOD: The records of patients who had undergone early first trimester transvaginal ultrasound in Obstetrics and Gynecology Department of Cerrahpasa School of Medicine, Istanbul University between from January 1999 to December 2000 were reviewed. The records of 426 patients were eligible for the analysis. The age, parity, gestational week that the ultrasound performed, the complaint on appliance, the features visible on the ultrasound were noted. The patients were divided into two groups: patients without any complaint (Group 1) and patients applied with any complaint (Group 2). The prognosis of the pregnancy was determined through the follow-up. On the statistical analysis, chi-square test, student-t test, Pearson correlation analysis and multiple linear regression analysis were utilized. RESULTS: In group 1, 79% of examinations were normal whereas the rate of normal ultrasound was 50% in group 2. The difference between the groups was statistically significant (p=0.000). On group 1, 7 subsequent abortions, 7 missed abortions and one case of mole hydatiform were identified (7.6%). When the patient applied with a complaint, ultrasound examination revealed abnormal findings that enabled to reach an accurate diagnosis in 29.9% of these patients. 50 abortions (inevitable or incomplete), 13 missed abortions, 3 ectopic pregnancies and 2 mole hydatiform were diagnosed. The difference between the two groups according to ability to reach a diagnosis on the initial ultrasound was statistically significant (p=0.000). CONCLUSION: The value of ultrasound examination before the 10th weeks of pregnancy is not validated when the patient has no complaint even if it appears as the most powerful mean to assess the accurate gestational age and observing fetal cardiac activity is the best prognostic variable for the outcome of the fetus.

Enzymatically validated liquid chromatographic method for the determination of ascorbic and dehydroascorbic acids in fruit and vegetables.

A liquid chromatographic method has been described for the determination of total vitamin C, ascorbic acid (AA) and dehydroascorbic acid (DHAA) in fruits and vegetables. The complete separation of AA and DHAA could be achieved on a C18 column using 0.2 M KH2PO4 (pH adjusted to 2.4 with H3PO4) as the mobile phase at a flow-rate of 0.5 ml/min. Since the detection sensitivity was poor for DHAA even at 210 nm, it was estimated as the difference between the total AA after DHAA reduction and AA content of the original sample, using dithiothreitol (DTT) as the precolumn reductant. The reaction times for the complete conversion of DHAA to AA at room temperatures were 150, 120, 90 and 75 min for 1, 2, 4 and 8 mmol DTT per mmol of DHAA, respectively. The percentage recovery ranged from 81.7 to 105.9. AA contents of some selected fruits and vegetables were analyzed comparatively by liquid chromatography and enzymatic assay to validate the method.

Functional evaluation of renal transplants with scintigraphy.

A variety of techniques have been employed to assess renal function and its evolution after transplant surgery. Since initial perfusion studies are easy to perform, one may be tempted to rely on 99mTc-diethylenetriaminepentaacetic acid (DTPA) scanning alone. Some discrepancies have been observed between perfusion studies and clinical outcome of the renal transplant patients however. We therefore decided to evaluate both 99mTc-DTPA and 131I-hippuran renal scanning in 28 renal transplant patients. Sixty 99mTc-DTPA perfusion and 131I hippuran scintigraphies were performed using a same-day protocol. The examinations were repeated in 14 patients at weekly or monthly intervals to monitor the clinical trend of these patients. The results of this study indicate that, for early detection of the kidney problems, 131I-hippuran scintigraphy was superior to 99mTc-DTPA perfusion scans, but for the proper clinical management of renal transplant patients, both procedures should be utilized.