Prognostic factors and clinical features of rhino-orbital-mucormycosis cases: an update for patient and visual survivals

AIM: To determine the frequency of patients' vision survival and prognostic factors and evaluate clinical features in rhino-orbital mucormycosis. METHODS: Forty-three eyes of 43 patients followed up with orbital mucormycosis infections were included in the study. Demographic characteristics of the patients, symptoms at admission, ophthalmologic and non-ophthalmologic examination findings, clinical findings during follow-up, medical and surgical procedures, and complications were recorded. Patient survival was determined by assessing the incidence of mortality, and vision survival was defined as achieving a final visual acuity of at least light perception. RESULTS: Twenty-seven (62.8%) patients were male, and 16 (37.2%) were female. When the underlying disease status of the patients was examined, it was observed that all patients had an underlying disease and diabetes constituted the majority (65.2%). Periorbital swelling (69.8%) and ophthalmoplegia (53.5%) were the most common symptoms and findings at the admission of patients with mucormycosis infection. The disease resulted in death in 22 (51.2%) patients. The presence of fever and shorter duration of antifungal therapy were associated with lower patient survival. Exenteration surgery was not found to be associated with the survival of the patients. Frozen eye, loss of pupillary light reflex, and development of central retinal artery occlusion were associated with lower vision survival. CONCLUSION: This study presents one of the most extensive patient series in the literature on rhino-orbital mucormycosis. Knowing the patients' symptoms at the time of admission and the clinical findings during the infection process will increase awareness about the disease

Antibiotic resistance and extended spectrum beta-lactamase production in fecal Escherichia coli strains isolated from human and cattle

Son bir ay içinde antibiyotik kullanmamış insanların dışkılarından izole edilen herbiri farklı bireye ait 140 Escherichia coli susu ile sığırların rektum mukozasından izole edilen 114 E.coli susunun 10 antibiyotiğe duyarlılığı disk difüzyon yöntemi ile, bu suşlarda genişlemiş spektrumlu beta-laktamaz (GSBL) üretimi fenotipik doğrulama testi ile belirlenmiştir. İnsan suşlannda ampisilin, ampisilin-sulbaktam, amoksisilin-klavulanik asit, piperasilin-tazobaktam, sefotaksim, siprofloksasin, trimetoprim-sulfametoksazol direnci sığır suşlarındakinden, sığır suşlannda amikasin direnci insan suşlanndakinden anlamlı derecede daha yüksek bulunmuştur. Seftazidim ve gentamisin direnci insan suşlannda daha yüksek bulunmuşsa da fark anlamlı değildir. İki grup susta da en yüksek direnç ampisilin için bulunmuştur. İnsan suşlannda direnç cinsiyete göre fark göstermemiş, ancak 13 yaş ve altındaki çocuklara ait suşlarda büyüklerden izole edilenlere göre ampisilin, ampisilin-sulbaktam, seftazidim, gentamisin ve trimetoprim-sulfametoksazol direnci anlamlı derecede yüksek bulunmuştur. İnsan suşlannda GSBL üretimi % 3 olarak saptanmış, sığır suşlannda GSBL üretimine rastlanmamıştır.A hundred forty E.coli strains isolated from stools of humans who did not use antibiotics in the last one month and 114 E.coli strains isolated from cattle's rectal mucosa were enrolled in this study. Each strain was from different individuals. Susceptibility of these strains to ten antibiotics were determined by disk diffusion test and extended spectrum beta-lactamase (ESBL) production by phenotypic confirmation test. The resistance to ampicillin, ampicillin-sulbactam, amoxicilin-clavulanic asid, piperacillin-tazobactam, sefotaxime, ciprofloxacin and trimethoprim-sulfamethoxazole in human E. coli strains were found significantly higher than the resistance of cattle E. coli strains and the resistance to amikacin in cattle E. coli strains was found significantly higher than the resistance of human E. coli strains. Although the resistance to ceftazidime and gentamicin in human E.coli strains were found higher, the differences was not statistically significant. The highest resistance was for ampicillin in both cattle and human strains. The differences in antibiotic resistance of human strains were insignificant in two genders. But the antibiotic resistance were significantly higher in the strains from children under 13 age than the strains from adults for ampicillin, ampicillin-sulbactam, trimetoprim-sulfamethoxazole, gentamisin and ceftazidime. While ESBL production from human strains was 3 %, there was no production in cattle strains

Investigation of hepatitis E virus seroprevalence and risk factors in hemodialysis patients

BackgroundHemodialysis patients are at increased risk for hepatitis E virus (HEV) infection due to their immunocompromised status and frequent exposure to invasive medical procedures. HEV can lead to chronic infections and severe complications, particularly in high-risk populations. This study aimed to determine HEV-IgG seroprevalence among hemodialysis patients in Ankara, Turkey, and evaluate associated risk factors.MethodsA total of 160 hemodialysis patients from three private dialysis centers in Ankara were included in this prospective, cross-sectional study. Anti-HEV-IgG antibodies were detected using the ELISA method. Demographic characteristics and potential risk factors, including dialysis duration, comorbidities, blood transfusion history, drinking water source, dietary habits, and involvement in animal husbandry, were assessed via structured surveys. Statistical analyses were conducted using SPSS Version 22.0, with Pearson’s chi-square and Fisher’s exact tests applied to categorical variables. Logistic regression analysis was performed to identify independent risk factors for HEV seropositivity.ResultsHEV-IgG seropositivity was detected in 42 patients (26.25%). Seroprevalence increased significantly with age, rising from 6.7% in patients under 55 years to 47.4% in those over 65 years (p < 0.001). Extended dialysis duration (>5 years) was also significantly associated with HEV seropositivity (p = 0.02). However, no significant associations were found between HEV seropositivity and gender, blood transfusion history, source of drinking water, consumption of raw meat, or involvement in animal husbandry (p > 0.05).ConclusionThe HEV-IgG seroprevalence among hemodialysis patients in Ankara was higher than previously reported rates in Turkey. Age and prolonged dialysis duration emerged as significant risk factors, underscoring the importance of screening and preventive strategies in this vulnerable population. Further multi-regional studies are needed to better understand HEV transmission dynamics and improve management strategies in hemodialysis patients

Impact of laboratory test use strategies in a Turkish hospital

Objectives: Eliminating unnecessary laboratory tests is a good way to reduce costs while maintain patient safety. The aim of this study was to define and process strategies to rationalize laboratory use in Ankara Numune Training and Research Hospital (ANH) and calculate potential savings in costs. Methods: A collaborative plan was defined by hospital managers; joint meetings with ANHTA and laboratory professors were set; the joint committee invited relevant staff for input, and a laboratory efficiency committee was created. Literature was reviewed systematically to identify strategies used to improve laboratory efficiency. Strategies that would be applicable in local settings were identified for implementation, processed, and the impact on clinical use and costs assessed for 12 months. Results: Laboratory use in ANH differed enormously among clinics. Major use was identified in internal medicine. The mean number of tests per patient was 15.8. Unnecessary testing for chloride, folic acid, free prostate specific antigen, hepatitis and HIV testing were observed. Test panel use was pinpointed as the main cause of overuse of the laboratory and the Hospital Information System test ordering page was reorganized. A significant decrease (between 12.6-85.0%) was observed for the tests that were taken to an alternative page on the computer screen. The one year study saving was equivalent to 371,183 US dollars. Conclusion: Hospital-based committees including laboratory professionals and clinicians can define hospital based problems and led to a standardized approach to test use that can help clinicians reduce laboratory costs through appropriate use of laboratory test

Lattice Cell Assisted Topology Optimization of an Extendable Wing for Munition

This study focuses on developing a structural concept for an extendable wing for munitions using a lattice-cell-assisted approach. The process involves topology optimization followed by size optimization of the strut-based lattice cell radii. Initially, the topology optimization of the wing structure's design space is conducted using the Solid Isotropic Material with Penalization (SIMP) method to minimize compliance while adhering to a volume fraction constraint. Based on the resulting relative density distribution, the topology-optimized regions are populated with strut-based lattice structures. Subsequently, size optimizations for the lattice cell radii are performed using both single-objective and multi-objective functions. The optimized wing structures are then compared in terms of mechanical performance and weight. Results demonstrate that incorporating lattice cell structures enhances the mechanical performance of the wing. Furthermore, size optimizations using single and multi-objective approaches reveal comparable mechanical performances, leading to an overall weight reduction of approximately 17.5% through the two-level optimization process. Additionally, increasing the number of design variables during size optimization further improves the results, achieving a 36% reduction in the maximum stress in the wing structure with lattice cells

Short-term efficacy of paraffin therapy and home-based exercise programs in the treatment of symptomatic hand osteoarthritis

Objectives: This study aims to investigate the effects of a home-based exercise program in combination with paraffin therapy on pain, functional status, grip strength, and quality of life (QoL) and to compare the outcomes of these two treatment modalities. Patients and methods: This prospective, single-blind, randomized-controlled study included a total of 61 patients (8 males, 53 females, mean age 59.22 years; range, 35 to 78 years) who were diagnosed with hand osteoarthritis (HOA) according to the American College of Rheumatology criteria between November 2016 and February 2017. The first group (group 1) (n=31) received paraffin therapy + home-based exercise program and the second group (group 2) (n=30) received home-based exercise program alone. All patients were assessed using the Visual Analog Scale (VAS), Australian/Canadian (AUSCAN) Osteoarthritis Hand Index, Health Assessment Questionnaire (HAQ), Hand Grip Strength (HGS), and Finger Pinch Strength (FPS) at baseline and at two and six weeks after the intervention. Results: In group 1, there were statistically significant improvements in all parameters at two and six weeks (p<0.05). Statistically significant differences were observed in the HGS and AUSCAN Osteoarthritis Hand Index scores in group 2 at two and six weeks (p<0.05). Inter-group analysis showed statistically significant differences in favor of group 1 in the VAS, HAQ, AUSCAN Osteoarthritis Hand Index, HGS, and FPS scores at two and six weeks compared to baseline scores (p<0.05). Conclusion: Paraffin therapy combined with home-based exercise program in patients with symptomatic HOA provides effective pain control and is effective in improving functional status, HGS, FPS, and QoL in short term

Microbiological evaluation of the burn wound infections

Yanık yaralarında enfeksiyon en önemli komplikasyon enfeksiyondur ve ölüm vakalarının %75'inin yanık yarası sonrası enfeksiyonlarına bağlı olduğu tahmin edilmektedir. Yaralarda kolontasyon sıklıkla birden fazla mikroorganizma ile olmaktadır. Derinin ilk görevi deri yüzeyinde yaşayan mikroorganizma gruplarını kontrol etmek ve patojen mikroorganizmaların deri altındaki dokuyu istila edip orada kolonize olmalarını önlemektir. Deride meydana gelen yanıklarda genellikle aerob ve anaerob mikroorganizmalar hakimdir. Yara iyileşmesinde mikroorganizmaların rolü ve önemi yıllardır tartışılmaktadır. Laboratuarda birden fazla mikroorganizma iiremiş kültürlerin uygun olup olmadığını ve bir veya birden fazla mikroorganizmanın identifikasyonunun anlamlı olup olmadığım iyi değerlendirmek gereklidir. Bu makalede yanık enfeksiyonlarının başarılı tedavisi için yanık yaralarının mikrobiyolojik açıdan değerlendirilmesindeki görüşler ortaya konmak istenmiştir. Ayrıca yanık yarası tedavisinde mikrobiyologun ve mikrobiyoloji laboratuarının önemli rolü bulunmaktadır.Infection is a major complication in burn wounds, and it is estimated that up to 75% of deaths following burn injury are related to infection. The wound colonization is most frequently polymicrobial. The skin's primary function is to control microbial populations that live on the skin surface and to prevent underlying tissue from becoming colonized and invaded by potential pathogens. In skins burn wound: generally aerobic and çnaerobic microorganisms found dominant. The role and significance of microorganisms in wound healing has been debated for many years. In the laboratory, consideration must be given to the relevance of culturing polymicrobial specimens, the value in identifying one or more microorganisms. This review has attempted to evaluate aspects in microbiological management in burn wounds for successful treatment of microorganisms. The role of the microbiologist and the microbiology laboratory in burn wound management is very important