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Öğe Benign nodules of the thyroid gland and 25-hydroxy-vitamin D levels in euthyroid patients(K Faisal Spec Hosp Res Centre, 2022) Bolat, Haci; Erdogan, AlirizaBACKGROUND: The presence of nodules in the thyroid gland is common in iodine-deficient areas of the world. Recently, vitamin D levels were found to be lower than normal and sometimes deficient in malignant nodules of the thyroid. OBJECTIVE: Evaluate the relationship between the serum vitamin D levels and benign thyroid nodules in euthyroid patients. DESIGN: Cross-sectional. SETTING: Tertiary care center in Turkey. PATIENTS AND METHODS: Patients referred to the general surgery outpatient clinic and diagnosed with thyroid nodules were the study group. The control group consisted of healthy individuals without thyroid nodules. Age, BMI, thyroid ultrasonography, serum 25-hydroxyvitamin D, free T3, free T4, thyroid stimulating hormone, calcium, magnesium, phosphorous, total protein, albumin, glucose, creatinine levels and glomerular filtration rate (GFR) were compared between groups. MAIN OUTCOME MEASURE: Serum 25-hydroxy-vitamin D levels and size of the thyroid nodules. SAMPLE SIZE AND CHARACTERISTICS: Of 849 individuals, 453 were patients with thyroid nodules and 396 were healthy individuals. RESULTS: The mean serum vitamin D levels of patients with thyroid nodules were significantly lower than controls (P<.001). Serum vitamin D levels along with serum total protein levels and eGFR were independent variables associated with the presence of a thyroid nodule (P<.001, p=.005 and P=.017, respectively). CONCLUSION: These findings suggest vitamin D deficiency might be one of the pathophysiologic factors in development of thyroid nodules.Öğe Case controlled study for determination of risk factors in abdominal wall endometriosis following a cesarean section(Sage Publications Ltd, 2022) Erdogan, Pinar; Erdogan, Aliriza; Bolat, Haci; Ozbey, CanerIntroduction: Abdominal wall endometriosis (AWE) is the presence of ectopic endometrial tissue in abdominal wall and is most frequently encountered in women with previous cesarean section (CS). The aim of this study is to evaluate the possible risk factors of AWE development. Methods: Women with previous CS and pathologically confirmed AWE were included into the study (n=33). Controls (n= 127) were randomly selected among women who had previous CS and absence of AWE were confirmed by physical examination. Clinical characteristics of the patient and the CS operation preceding AWE were recorded. Results: CS was performed before onset of labor in 87.9% in AWE and in 59.1 % of control group (p= 0.002). The antenatal BMI and weight gain during pregnancy were significantly higher in AWE patients (p < 0.0001; p = 0.002, respectively). In logistic regression model procedure duration (p= 0.039; OR= 1083), antenatal BMI (p =0.003; OR= 1254), weight gain (p=0.002; OR= 1171), and CS before spontaneous labor (p= 0.021; OR = 5169) were significant parameters for predicting AWE. Discussion: High antenatal BMI, weight gain during pregnancy, and longer duration of operation are all factors effecting subsequent AWE development. However, CS before spontaneous labor is by far the most powerful risk factor for AWE development.Öğe Case controlled study on diagnostic predictive value of inflammatory markers of complete blood count in pregnant women with acute appendicitis(Taylor & Francis Inc, 2022) Erdogan, Pinar; Erdogan, AlirizaThe aim of this study is to evaluate and compare the diagnostic ability of platelet-related parameters and white cell-based parameters in pregnant women with appendicitis. This is a retrospective case-controlled study. Women aged between 18 and 50-years-old who had undergone appendectomy between January 2010 and January 2021 were enrolled in the study. Age, pathological diagnosis and relevant laboratory parameters were recorded for each patient. Gestational characteristics were recorded for pregnant patients. There were 58 pregnant and 1171 non-pregnant women enrolled. Pregnant women with acute appendicitis were significantly younger (p < .0001, d= -0.532), had significantly lower PLT (p = .002, d= -0.428) and ALC (p = .033, d= -.304) levels but had significantly higher MPV (p = .004, d = .415) levels than non-pregnant counterparts. In pregnant women, only MPV was the independent predictor of acute appendicitis (OR: 1,952). MPV cut-off value of 9,6 fL provided 63,5% sensitivity, 67,7% specificity, 94,2% PPV and 17,3% NPV whereas 10 fL provided 55,8% sensitivity, 100% specificity, 100% PPV and 21,4% NPV for acute appendicitis in pregnant women. Therefore, MPV might be useful for diagnosing acute appendicitis in pregnant women.Impact statement What is already known on this subject? In pregnant women, counts and percentages of white blood cells and neutrophils are known to be independent predictors of acute appendicitis. Meanwhile, physiologic leukocytosis of gestation is a challenge for interpretation of these parameters. Platelets and related markers are, as well, predictive for inflammatory processes in the human body. What do the results of this study add? The role of platelet-related markers in the diagnosis of acute appendicitis in pregnant women has not been studied previously. The results of the present study indicate that in pregnant women, changes in mean platelet volume might be an independent predictor of acute appendicitis. What are the implications of these findings for clinical practice and/or further research? Further similar large-scale case-controlled or cohort studies are required to validate the present results. In pregnant women with abdominal pain, the use of mean platelet volume as a biomarker could reduce negative laparotomy rates. A mean platelet volume is a useful tool for diagnosing acute appendicitis in pregnant women and provides helpful guidance for clinicians dealing with these patients in the emergency room.Öğe Comparison of spinal anaesthesia and erector spinae plane block in unilateral inguinal hernia: Randomised clinical trial(Wolters Kluwer Medknow Publications, 2024) Kacmaz, Mustafa; Bolat, Haci; Erdogan, AlirizaIntroduction:The objective of our study was to compare erector spinae plane block (ESP) with spinal anaesthesia (SA) for inguinal hernia repair with respect to anaesthetic efficacy, post-operative analgesia, mobilisation, discharge, complication and side effects. Patients and Methods:The study included 52 patients over 50 years of age, with the American Society of Anaesthesia physical status Class I-III. Group ESP (n = 26) was applied 30 ml of mixed local anaesthetic mixture applied at the L1 level to the plane of the erector spinae and 10 ml of tumescent when necessary, while Group SA (n = 26) was applied 3 ml of 0.5% bupivacaine at the L3-L4/L2-L3 level. Results:Intraoperative Visual Analogue Scale (VAS) value was lower in Group S, whereas the 6th-h VAS value was lower in Group ESP (P < 0.05). There was no significant difference between the VAS values at hour 12 and 24 (P > 0.05). Reaching post-anaesthesia discharge criteria 9 and time to mobilisation and oral feeding was shorter in Group ESP, whereas post-procedure waiting time was shorter in Group S (P < 0.05). While the need for post-operative analgesics was higher in Group S (P < 0.05), there was a high level of patient satisfaction in Group ESP (P = 0.05). Intraoperative midazolam requirement was lower in Group S, post-operative diclofenac requirement was lower in Group ESP (P < 0.05), post-operative urinary retention and tremor were higher in Group S (P = 0.05). Conclusion:ESP block provides adequate surgical anaesthesia compared to SA (non-inferiority) for inguinal hernia repair. It is associated with less analgesic requirement, low post-operative pain, less complication rate and high patient satisfaction in the post-operative period.Öğe Relationship of blood 25-hydroxy vitamin D level with fibrocystic breast disease and breast density(Cukurova Univ, Fac Medicine, 2022) Bolat, Haci; Erdogan, AlirizaPurpose: The aim of this study is to evaluate the association of blood 25-hydroxy vitamin D levels with fibrocystic breast masses and breast patterns. Materials and Methods: The study included 612 patients who presented with breast complaints or referred for routine screening between 2018-2021 and were requested to have breast ultrasonography (USG) and mammography (MG) examinations. Patients were divided into two groups; group 1 consisted of women with fibrocystic mass (BI-RADS 2-3) and group 2 consisted of women without breast mass (BI-RADS 1). These two groups were compared by age, breast USG, MG results, and blood 25-hydroxy vitamin D levels. Results: Of the 612 patients, 310 (51%) had fibrocystic mass in their breasts, while 302 (49%) had normal breasts. The mean age of both groups was similar. Those with fibrocystic mass in the breast had lower vitamin D levels and higher breast density than the control group. The group with higher breast density had lower vitamin D levels, and there was a negative correlation between vitamin D level and breast density Conclusion: Our study revealed that women with fibrocystic masses in their breasts (BI- RADS2 and BI-RADS3) had higher breast density and lower vitamin D levels than women without breast mass.
