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Öğe Comparison of surgery and surgery plus corticosteroid therapy in idiopathic granulomatous mastitis, prospective randomized study(2019) Akcan, Alper Celal; Patmano, Mehmet; Oz, Abdullah Bahadir; Arikan, Turkmen Bahadir; Gun, Iskender; Dogan, Serap; Sozuer, ErdoganAim: To compare therapeutic effectiveness of surgery alone with surgery plus corticosteroid in patients with granulomatous mastitis.Material and Methods: The study included 30 patients aged 23-60 years. The patients were randomly assigned into two groups by lot. In-group 1, the patients received 375 mg ampicillin-sulbactam (twice daily, p.o.) for a week; than 32 mg prednisolone was started which was gradually tapered (biweekly by 8 mg) over 8 weeks. Surgery was performed 2 weeks after tapering. In-group 2, the patients received 375 mg ampicillin-sulbactam (twice daily, p.o.) for a week and underwent surgery. During 2-years follow-up, all patients were assessed for etiological factors and recurrence.Results: No significant differences was found in demographic characteristics, smoking habits, oral contraceptive use, presenting complaints, physical examination findings, localization and diagnostic tools used between groups. During follow-up, recurrence was seen in one patient (6.7%) in surgery group and in 3 patients (20%) in steroid group but no significant difference was detected between groups (p>0.05). Conclusion: In patients with granulomatous mastitis, systemic steroid therapy is an effective modality in patients unresponsive to antibiotic therapy after ruling out tuberculosis.Öğe Management of acute cholecystitis in elderly (?65 years old) patients: A retrospective study comparing early versus delayed cholecystectomy(2023) Barut, Bora; Bağ, Yusuf Murat; Patmano, Mehmet; Gündoğan, Ersin; Tuncer, Adem; Dalda, Yasin; Gönültaş, FatihAim: Acute cholecystitis is the most common causes of acute abdomen in elderly popula tion. This study aimed to present the early postoperative period (? 30 days) outcomes of elderly patients (? 65 years old) with acute cholecystitis who underwent early or delayed cholecystectomy. Materials and Methods: Between January 2016 and December 2020, 74 patients aged 65 and over underwent cholecystectomy for acute cholecystitis were included in the study. The patients were divided into two groups as early (time between diagnosis and chole cystectomy 7 days or less, n= 43, 58.1%) or delayed (time between diagnosis and chole cystectomy over 7 days, n= 31, 41.9%) cholecystectomy. Demographic characteristics, preoperative laboratory and radiological findings, and perioperative data of patients were evaluated, and the groups were compared. Results: The median age of patients was 73 (65-90) years, and 39 (52.7%) were male. Sixty-one (82.4%) patients underwent laparoscopic, 8 open (10.8%) and 5 (6.8%) conver sion cholecystectomy. The rate of laparoscopic cholecystectomy was higher in the delayed group (n= 29, 93.5%) than in the early group (n= 32, 74.4%), but no statistically signifi cant difference was detected (p=.06). The rate of open cholecystectomy was statistically significantly higher in the early group (n=8, 18.6%) than in the delayed group (n=0) (P=.017), the conversion rate was similar between the groups (p=1). There was no signif icant difference between the groups in terms of intraoperative complications (p=1). The length of hospital stay was statistically significantly longer in the early compared to the delayed group (5 (1-21) days and 2 (1-12) days, respectively, p< .001). Conclusion: There was no statistical difference regarding intraoperative complications in patients underwent early or delayed cholecystectomy. We believe that the patient’s clinical presentation and early or delayed cholecystectomy experience of the team are vital in determining the timing of cholecystectomy, as well as the severity of acute cholecystitis.Öğe A rare foreign body during colonoscopy: Headpiece of enema kit(2018) Patmano, Mehmet; Cetin, Durmus Ali; Gumus, Tufan; Yildirim, Sumeyra