Mean platelet volume in diagnosis of acute appendicitis in children

Background

The clinical diagnosis of acute appendicitis (AA) in children is still problematic in status.

Objectives

To investigate the diagnostic value of mean platelet volume (MPV) in acute AA at childhood.

Methods

One hundred patients diagnosed as AA patients and 100 healthy individuals. Laboratory tests were studied in the hematology laboratory of the hospital.

Results

The MPV was found to be lower than normal in 48 cases in the AA group, and it was normal or higher than normal in 52 cases. In the control group, while MPV was found to be lower than normal in 13 cases, it was normal or higher than normal in 87 cases. The MPV was significantly lower in the AA group compared to the control group (p<0.001).

Conclusion

Our study indicated that MPV significantly decreased in pediatric AA patients. Hence, we believe that taking the MPV decrease into consideration along with the White Blood Cell Count elevation would be beneficial in patients with suspicion of AA.     

MTA apical plugs in the treatment of traumatized immature teeth with large periapical lesions

Abstract – This case report describes the management of a late‐referral case of periapically involved, traumatized immature permanent incisors by endodontic treatment and the use of mineral trioxide aggregate (MTA) apical plugs. A 10‐year‐old boy was referred to the clinic with a chief complaint of pain in his maxillary central incisors, which had experienced subluxation trauma 2 years earlier. Periapical radiograph of the teeth showed incomplete root development with wide‐open apices and large periradicular lesions. The canals were gently debrided using K‐files in conjunction with 2.5% NaOCl irrigation and 2% chlorhexidine for final flush. The root canals became asymptomatic after employing the same endodontic regimen for three visits. MTA plugs were placed in the apical area of the root canals, and the rest of the canal space was obturated by warm compaction of gutta‐percha and AH Plus sealer. Resolution of the large periapical lesions was observed 2 months after treatment. At 18 months, the periapical areas revealed radiographic evidence of bone healing. Following successful removal of the toxic content of the root canal, placement of MTA plugs resulted in both healing of the periradicular radiolucency and regeneration of the periapical tissue.     

Widespread maculopapular rash due to intramuscular interferon beta-1a during the treatment of multiple sclerosis

We describe a 41-year-old woman with multiple sclerosis, who presented erythematous maculopapular rash on the trunk and extremities after the second injection of interferon beta-1a. Histopathologic examination of the lesion revealed lymphocytic exocytosis and perivascular lymphocytic infiltrate in the dermis. Oral antihistamine and topical corticosteroid was started. After improvement of the lesions, the third injection was performed. However, the same reaction occurred. A prick test, which was performed 6 weeks after the eruption, also revealed positive reaction. Although injection-site reactions have been observed with interferon beta-1a, to our knowledge there have been no previous reports of interferon beta-1a-induced widespread cutaneous reaction.     

Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and functionality of the Turkish version of the Boston Questionnaire

OBJECTIVES: The aim of this study was to develop a Turkish version of the Boston Questionnaire and assess its reliability and validity. METHODS: Sixty-seven patients with idiopathic carpal tunnel syndrome were included in the study. The Turkish version of Boston Questionnaire was obtained after translation process, and was then administered to subjects twice within seven days. Reliability was assessed by internal consistency (Cronbach's alpha and item-total correlation), and reproducibility. Validity was examined by correlating the Boston Questionnaire scores to general health status (Short Form-36), pain severity (Visual Analogue Scale) and pinch and grip strength measures. RESULTS: Reliability of the Turkish version was very good, with high internal consistency (Cronbach's alpha 0.82 for symptom severity scale, and 0.88 for functional status scale), and reproducibility (Pearson correlation coefficient 0.60 for symptom severity scale, and 0.77 for functional status scale). The Boston Questionnaire scores were correlated with Visual Analogue Scale, physical functioning, physical role, bodily pain and emotional role subscales of Short Form-36, pinch and grip strength scores to obtain coefficients for external construct validity. CONCLUSION: Adaptation of the Boston Questionnaire for use in Turkey was successful. Our results seem to support previous finding of the English version, indicating that it is valid and reliable.     

Effects of ACE inhibition on the expression of type IV collagen and laminin in renal glomeruli in experimental diabetes

In the present study, we examined electron microscopically and immunohistochemically the effects of perindopril, an angiotensin-converting enzyme inhibitor, on renal microangiopathy in streptozotocin-induced diabetes in rats. To investigate changes in glomerular basement membrane (GBM) and tubular basement membrane components, we immunohistochemically localized type IV collagen and laminin. Animals have been divided into three groups of eight adult male rats each. The first group was the non-diabetic control group. The second group consisted of untreated diabetic rats. The third group consisted of diabetic rats that were treated with perindopril for 6 weeks. Blood glucose levels and body weight were measured. Morphometric analysis of kidney tissue was performed using light and electron microscopy to quantify glomerular size and thickness of the GBM. Blood glucose levels in diabetic rats were significantly increased when compared with non-diabetic controls. Blood glucose levels were not affected by perindopril treatment. Untreated diabetic rats showed increased glomerular size, thickening of the GBM and an increase in mesangial matrix as compared with controls. Treatment with perindopril prevented effectively glomerular hypertrophy and thickening of the GBM. Significant increase in type IV collagen and laminin was found in thickened GBM and mesangial matrix in kidneys of untreated diabetic rats. In perindopril-treated diabetic rats, staining of type IV collagen and laminin was less strong when compared with untreated diabetic rats. In conclusion, our data suggest that perindopril treatment is effective in preventing renal lesions possibly by ameliorating the diabetes-induced increase in expression of type IV collagen and laminin.