Introduction. As did many other nations, the Turkish government implemented precautions and lockdown measures in response to the rapid spread of the COVID-19 viral infection. The pandemic has caused millions of deaths globally, resulted in the development of comorbidities, and negatively affected national health care systems. The increased workload at hospitals and spread of the virus among health care professionals have resulted in delays in health care services delivery. The fear of COVID-19 transmission has resulted in people mostly staying at home. Objective. The aim of this study is to present the effects of the pandemic on the behavior of patients with diabetic foot ulcers (DFUs). Materials and Methods. Patients with DFU were categorized into 2 groups: patients hospitalized during the COVID-19 pandemic and patients hospitalized during the same period in 2019 (prepandemic). Demographic data, length of hospital stay, place of residence, Wagner grade of DFU, comorbidities, laboratory parameters, wound duration, duration of diabetes, and treatments applied were recorded. Results. During the pandemic, the length of hospital stay decreased, and patient referrals from other cities significantly decreased (P <.001). Hemoglobin A1c level was higher and Wagner grade was more advanced during the pandemic period (P =.014 and P =.033, respectively). The number of patients undergoing debridement alone decreased during the pandemic period, while those requiring amputation increased (P =.008 and P =.005, respectively). Conclusions. Patients with DFU delayed seeking timely proper medical advice during the pandemic. This resulted in a significantly higher amputation rate, with physical, psychosocial, and economic consequences. Virtual techniques (eg, video consultation) can be used to identify patients who require hospitalization. Close follow-up can be provided via home nursing care and by supplying advanced wound care products for in-home use. Patients with DFU should be encouraged to seek proper medical advice and take recommended precautions.
Objectives: To investigate the influence of the metastatic lymph node/total lymph node ratio (N-ratio) on survival and prognosis in surgically treated gastric carcinomas. Methods:A retrospective review of 73 patients who underwent curative resection at the Department of General Surgery, Hitit University Faculty of Medicine, Turkey. Receiver operating characteristic analysis was used to calculate the cut-off value for the N-ratio of the patients. The N-ratio cut-off value was determined to be 0.32. Patients were divided into 2 groups: below 0.32 (Group 1) and 0.32 and above 0.32 (Group 2). Original ArticleResults: Group 2 patients had a total lymph node mean of 25.10±13.64 while Group 1 patients had a total lymph node mean of 18.77±9.36 (p=0.04). In Group 2, the mean of metastatic lymph node was 15.97±10.30 (p<0.001). The mortality rate of Group 1 was 18% while Group 2 was 51.7%, and were statistically significant (p=0.0039). The estimated survival duration of Group 2 was 24.22 months, and Group 1 was 48.01 months (p=0.001). The mean estimated survival time for the entire group was 40.92 months. We differentiated patients from the development of mortality cut-off value in ROC analysis with 65.2% sensitivity and 72% specificity. This ratio was found to be 0.32, which was statistically significant (p=0.003). Ratios greater than 0.32 raised the risk of mortality by 4.8 times, which was statistically significant (p=0.003). Conclusion:The N-ratio could be a new metric to evaluate prognosis following curative gastrectomy and improve the existing tumor lymph node metastasis staging system.
Introduction: COVID-19 has spread all over the world and caused significant changes in healthcare practices. This is why many expert associations have published new guidelines on COVID-19 management. This study aims to investigate whether the COVID-19 pandemic has an effect on Inguinal hernia (IH) emergencies. Material and Method: A total of 63 patients diagnosed with strangulated/incarcerated inguinal hernia who presented to the emergency surgery department of our hospital between April 2020 and January 2021 during the pandemic (DP) and between April 2019 and January 2020 before the pandemic (BP) were retrospectively analyzed and compared. Results:There was no statistically significant difference between both groups in terms of demographic characteristics. The comparison of the number of admissions, admission time, anesthesia type, hospital stay, postoperative complications, ASA score, hernia, WBC, and CRP averages showed no statistically significant difference between the groups. Moreover, there was no statistically significant difference between the two groups in terms of distributions of hernia types, hernia repair types, mesh use, and additional resection requirement. The comparison of the patients who underwent organ resection by admission time in both groups showed no statistically significant difference. It was observed that the number of patients who required small bowel resection were especially high on the 4th day. In DP, small bowel resection was performed on 4 (66.7%) patients and omentectomy was performed in 2 (33.3%) patients. In BP, only one right hemicolectomy was performed. The comparison of the patients with an admission time of 4th day revealed a statistically significant difference (p=0.03). Conclusion: We observed that morbidity increased as the admission time was delayed. Anticipating that the fear of COVID-19 infection will hold back the emergency response during the pandemic period, patients should be informed not to delay early diagnosis and treatment.
Objective: To evaluate the risk factors for developing rectus sheath hematoma (RSH).
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