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  • Küçük Resim
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    Diagnostic utility of neutrophil lymphocyte ratio in acute complicated cholecystitis
    (2019) Ay, Serden; Tanrikulu, Ceren Sen
    Aim: To investigate whether the neutrophil lymphocyte ratio is a determining factor in the detection of complicated acute calculous cholecystitis. Material and Methods: The study was planned as retrospective and multi-centered. One hundred and twenty patients were divided into 3 groups equally. Group1; patients with symptomatic gall stones having undergone elective cholecystectomy. Group 2; patients having undergone cholecystectomy with acute cholecystitis.Group 3: patients having undergone cholecystectomy with acute complicated cholecystitis. Blood glucose, C-reactive protein, leukocyte, neutrophil, and lymphocyte ratio were recorded from the hospital records in the final laboratory parameters of patients before surgery. ROC nalysis, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), cut-off and AUC values for NLR were calculated. Results: There was a significant difference between the gangrenous cholecystitis group and other groups in terms of white blood cell count values (p = 0.002 and p <0.001).There was a significant difference between the gangrenous cholecystitis group and other groups in terms of CRP values (p <0.001).There was a difference between gangrenous cholecystitis group and normal cholecystectomy group according to the mean glucose values (p = 0.006)According to ROC analysis, sensitivity, specificity, cut-off and AUC values for NLR in terms of gangrenous cholecystitis and acute cholecystitis were,77.50%,67.5%,80.9%,73.8%,6.56 and 0.736, respectively. For gangrenous cholecystitis group and normal cholecystectomy group; these values were 85%, 77.5%, 94%, 87.9%, 4.43% and 0.878%, respectively. Conclusion: The increase in the acute cholecystitis N / L ratio appears to be a simple inflammatory marker that indicates that the condition has become complicated, that is easily detectable and does not add additional cost.
  • Küçük Resim
    Öğe
    Zinc oxide, lidocaine, hot water, and lateral internal sphincterotomy for fissure-in-ano: Randomized controlled study
    (2019) Ay, Serden; Eryilmaz, Mehmet Ali; Oku, Ahmet; Karahan, Omer
    Aim: Aim of this study is to compare the effect of zinc oxide pomade, lidocaine pomade, hot water sitting bath and lateral internal sphincterotomy for treatment of chronic anal fissure in terms of healing and complications. Material and Methods: One hundred and forty five patients who were diagnosed with chronic anal fissure between May 2011 and September 2012 at our clinic were enrolled for this prospective randomized trial. All cases were randomized into four groups. Group 1: The patients would apply 15% of zinc oxide pomade twice a day after the 10 minutes of hot water sitting bath. Group 2: The patients would apply 5% of lidocaine pomade twice a day after the 10 minutes of hot water sitting bath. Group 3: The patients would make only 10 minutes of hot water sitting bath twice a day.Group 4: Lateral internal sphincterotomy was performed to the patients. Healing rates, recurrences,changes in symptoms after the treatment and complications were recorded. Results: There were not any difference within the groups in terms of age and gender. The healing in the Sphincterotomy group significantly much more when compared to the other groups at both the third and the sixth weeks(p<0,001).The other groups were similar with the each other(p>0,05). Conclusion: LIS is superior to zinc oxide, lidocaine or hot water applications. There was no difference between the non-operative treatments.