Maxillary sinus lipoma: an unanticipated diagnosis

Subcutaneous tissue gives rise to numerous lesions such as lipoma, the most common benign soft tissue tumors. Lipoma is seen only extremely rarely in osseous units. In addition, craniofacial involvement of intraosseous lipoma may be misdiagnosed as a fibroosseous tumour such as fibrous dysplasia. Here, we present a case of an intraosseous lipoma obviously destroying and invading the maxillary bone.     

Acute kidney injury in hospitalized COVID-19 patients

International Urology and Nephrology - Acute kidney injury (AKI) in COVID-19 patients is associated with poor prognosis. However, the incidence, risk factors and potential outcomes of AKI in...     

Melatonin prevents deterioration of erectile function in streptozotocin-induced diabetic rats via sirtuin-1 expression

A review of the literature indicated that sirtuin-1 expression, a regulator of nitric oxide bioavailability in erectile dysfunction (ED) after melatonin therapy, has not yet been investigated. The objective of this study was to evaluate the protective effects of melatonin for erectile function with sirtuin-1 protein expression in type 1 diabetic rat models. Fifty male Sprague Dawley rats were placed into five groups. Except for those in the control group (C), each animal received a single dose (60 mg/kg) of streptozotocin to induce diabetes. The animals were placed into the diabetes (D) group, insulin (I) group (6 U/kg/day), melatonin (Mel) group (10 mg kg⁻¹ day⁻¹) and combined treatment (I + Mel) group. Ten weeks later, the serum testosterone levels, intracavernosal pressure (ICP), mean arterial pressure (MAP), malondialdehyde (MDA), cyclic guanosine monophosphate (c-GMP), 8-hydroxydeoxyguanosine (8-OHdG), nitric oxide synthase (NOS), caspase-3 activity, sirtuin-1 and endothelial nitric oxide synthase (eNOS) protein expression and histological findings were assessed. The mean ICP/MAP ratio for the D group was lower than the mean ratios for the other groups. The treatment groups, particularly the I + Mel group, exhibited lower 8-OHdG and MDA levels and caspase-3 activity than the D group. The sirtuin-1 and eNOS expression and cavernosal tissue (CT) histology seemed to have been preserved by the melatonin and/or insulin therapy. These results were indicative of a profound protective effect of melatonin by the activation of sirtuin-1 protein expression against hyperglycemia-induced oxidative CT injury.     

Are Fibrinogen and Complete Blood Count Parameters Predictive in Incarcerated Abdominal Hernia Repair?

Therapeutic delays in cases of external incarcerated hernias typically result in increasing morbidity, mortality, and health expenditures. We investigated the diagnostic role of blood fibrinogen level, white blood count (WBC), mean platelet volume (MPV), and platelet distribution width (PDW) in patients with incarcerated hernia. Two groups, each containing 100 patients, were studied. Group A underwent elective, and group B underwent incarcerated and urgent external hernia repair. We observed high fibrinogen and WBC levels but low MPV and PDW values for patients in group B. Contrary to our expectations, we found lower MPV and PDW values in the complicated group than in the elective group. The morbidity rate and cost burden were higher in group B, and the results were statistically significant. Early operation should be recommended for patients with incarcerated external hernias if their fibrinogen and WBC levels are high.Key words: Incarcerated external hernia, Fibrinogen, Complete blood countExternal strangulated hernia is one of the most common causes of intestinal obstruction especially in the elderly. Delay in treatment may be dangerous.¹ Andrews found that the need of bowel resection rate was 27% and the mortality rate was 21% when diagnosis was delayed more than 48 hours; whereas these rates were 7% and 1.4% when diagnosis was obtained in the first 24 hours.² In addition to increased morbidity and mortality rates, a delay in the treatment of strangulated external hernias is associated with extended hospital stays and an increased need for intensive care, thereby resulting in increased health costs. Of course, clinical signs and symptoms are the most important evidences in diagnosis of incarcerated hernias. In order to make correct diagnosis, we also have powerful weapons such as radiologic imaging methods. However, these clinical and radiologic evidences show complications, especially intestinal perforation due to incarceration. Awareness of probable complications is essential. In this regard, we sometimes need simple methods to alert us. The white blood count (WBC), mean platelet volume (MPV), platelet distribution width (PDW), and blood fibrinogen level have been shown to be valuable predictive parameters for ischemic events in different parts of the body.^3–9 There are probable ischemic tissues and organs in incarcerated hernia sac. So, in this study, we aimed to investigate the effectiveness of these simple blood tests in diagnosis. Generally, there is no problem in diagnosis, but sometimes the delay in treatment results in additional morbidity such as a need for bowel resection.