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    Can the Drain Fluid pH Predict Anastomotic Leakage after Sleeve Gastrectomy?
    (Zamensalamati Publ Co, 2022) Kutluer, Nizamettin; Dogan, Serhat; Aksu, Ali; Ayyildiz, Hakan; Kalayci, Mehmet; Karagoz, Zuhal Karaca; Ozkan, Zeynep
    Background: Laparoscopic Sleeve Gastrectomy is the most common type of surgical treatment for morbid obesity. One of the most important complications is leakage from the stapler line. Early detection of a leakage is important in preventing undesirable events. Objectives: The aim of this study was to evaluate the predictive value of postoperative drain fluid pH on early detection of leakage. Methods: This study was performed with 63 patients including 33 patients who underwent laparoscopic sleeve gastrectomy for morbid obesity (Group SG) and 30 patients who underwent laparoscopic cholecystectomy (Group LC), as the control group. Fluid sample was obtained after surgery with intra-abdominal drain. The pH value of this fluid was measured using a pH meter at the Ohaus device in the biochemistry laboratory of study hospital. Results: When the differences in the mean pH values of patients who underwent obesity surgery and gallbladder surgery were evaluated; no statistically significant difference was found between the mean pH value of patients (p: 0.808> 0.05). Conclusion: None of our patient had leakage and unable to demonstrate how would be the drain fluid pH value if there was a leak, we suggest that drain fluid pH would not be a suitable alarming sign for a leakage in the early period. Because we know that most of the leaks occur at the proximal part of the stomach and that there is more saliva drainage through the line of leakage. Although it is known that the acidic fluid of the stomach can be drained from the same leak in this condition, it is not unlikely that saliva can bring the pH to normal levels. Therefore, if the pH of the drain fluid is close to normal, it is meaning that there is no leakage from the site.
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    The importance of measuring the uncertainty of HbA1c analysis
    (2021) Ayyildiz, Hakan; Kalayci, Mehmet
    Aim: HbA1c, which reflects blood glucose levels in the last two to three months, has a significant role in the diagnosis, treatment and follow-up of diabetic patients. Measurement uncertainty is defined as the range of possible values, which comprises the measured level. This study aims at showing how to calculate the measurement uncertainty of HbA1c and informing clinicians on its significance for the efficient diagnosis, treatment and follow-up.Materials and Methods: The measurement uncertainty calculating model was used to determine the measurement uncertainty of HbA1c. This model comprises six steps and is constructed depending on European Accreditation Guidelines, described in Nordest Guidelines, Eurolab Technic Report, and ISO/DTS 21748 Guidebook. The HbA1c analysis was chromatographically studied with Trinity Biotech Premier Hb9210 analyzer. Besides internal and external quality control data of HbA1c tests done in Elazig City Hospital in the months between January 2019 and September 2019, data analyses were done to calculate the measurement uncertainty by using the HbA1c test results.Results: The measurement uncertainty of HbA1c was calculated as HbA1c±4.27% using a confidence interval of 95%. These results, were found to be lower than the total allowable error, determined by international organizations. Based on our results, the cut-off value of HbA1c of 6.5% had a measurement uncertainty between 6.2% and 6.8%.Conclusion: We consider that this study will guide the laboratory specialists, concerned with the suggestion that “medical laboratories are required to calculate the measurement uncertainty for quantitative results.” Furthermore, reporting the measurement uncertainty with test results will supply clinicians with information about measurement quality and contribute to creating awareness on this issue.