Objectives: Fournier’s gangrene is an aggressive, rapidly progressing, and life-threatening necrotizing fasciitis of the perineal and genital regions. Various scoring systems have been developed for predicting survival and prognosis in Fournier’s gangrene. This retrospective study aimed to evaluate the effectiveness of the newly developed Fournier’s gangrene mortality index (FGMI) in predicting mortality associated with Fournier’s gangrene. Methods: The study included patients over the age of 18 years who were followed-up with a diagnosis of Fournier’s gangrene in the general surgery clinics of three different hospitals in Şanlıurfa province between 2014 and 2024. The patients included in this study were divided into two groups: deceased (n = 20) and surviving (n = 149). In FGMI, the parameters used were age, creatinine level, albumin level, lymphocyte percentage, and neutrophil-to-lymphocyte ratio. Based on the total score and risk assessment, <5 points were categorized as low-to-moderate mortality risk and ≥5 points as high mortality risk. Results: A total of 169 patients with a diagnosis of Fournier’s gangrene were included in the study; 87 were men (51.48%). The median age of all patients was 53 (40–63) years; 20 patients (11.8%) died. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score did not show a statistically significant difference between the deceased and surviving groups (p = 0.5). Compared to the survivors, the deceased had higher neutrophil counts, neutrophil percentages, neutrophil-to-lymphocyte ratios, platelet-to-lymphocyte ratios, and C-reactive protein-to-albumin ratios, whereas lymphocyte counts, lymphocyte percentages, eosinophil counts, eosinophil percentages, monocyte counts, and monocyte percentages were lower, and these differences were statistically significant. According to receiver operating characteristic (ROC) analysis, the ROC-area under the curve for predicting mortality based on an FGMI score of ≥5 was 0.88 (95% CI: 0.80–0.95) with a sensitivity of 90% and a specificity of 70% (p < 0.001). Univariate risk analysis was performed, and the odds ratio revealed that mortality risk in patients followed-up for Fournier’s gangrene with a FGMI score of ≥5 was 20 times higher (4.48–90.91) (p < 0.001). Conclusions: The results reveal that the FGMI score is a scoring system that can predict mortality at the initial clinical presentation of patients with Fournier’s gangrene. Another important finding of the present study is that the LRINEC score was not sufficiently effective in predicting mortality.

Purpose: Systemic immune inflammation index (SII) has been used to evaluate the prognosis of various diseases in recent years. This study aimed to investigate the efficacy of SII in the preoperative diagnosis of complicated acute appendicitis (CAA). Materials and method: The data of patients who underwent surgery for acute appendicitis (AA) between January 2021 and December 2023 at our clinic were retrospectively analyzed. These patients had undergone surgical operations for AA and had available pathology results. Cases with histopathologic findings of gangrenous appendicitis, phlegmonous appendicitis, perforated appendicitis, and periappendicular abscesses were considered CAA. Cases without these manifestations and reported as appendicitis upon histopathological analysis were considered as noncomplicated acute appendicitis(NCAA). Data recorded and evaluated for the study included age, sex, preoperative C-reactive protein (CRP) levels, white blood cell (WBC) count, neutrophil count, lymphocyte count, platelet count, neutrophil-to-lymphocyte ratio (NLR), Alvarado score (AS), SII, and histopathologic examination results. Results: A total of 441 patients were included in the study. The mean age of the patients was 34.58 ± 11.70 years. There were 200 women (45.35%) and 241 men (54.65%). The number of noncomplicated and complicated cases was 332 (75.28%) and 109 (24.72%), respectively. SII, AS, NLR, and CRP values were significantly higher in the complicated group (p < 0.001, p < 0.001, p < 0.001, p = 0.001, respectively). The sensitivity and specificity of SII in detecting CAAs were 0.624 and 0.607, respectively, with a cutoff value of 1445. Conclusion: The sensitivity of SII in detecting CAA was 0.624, with specificity and cutoff values of 0.607 and 1445, respectively. SII can be used as an effective parameter for preoperatively predicting whether an AA case is complicated or not.

Background and Objectives: The aim of this study was to compare percutaneous aspiration injection reaspiration (PAIR), open surgery (OS), and laparoscopic surgery (LS) in the treatment of liver hydatid cysts in terms of effectiveness, complications, and recurrence rates. Materials and Methods: This retrospective cross-sectional study included 383 patients who were treated with a diagnosis of liver hydatid cyst at Harran University Faculty of Medicine between May 2014 and May 2024. Patients were divided into three groups based on the treatment method: PAIR, OS, and LS. The groups were analyzed in terms of demographic and clinical characteristics such as age, sex, number of cysts, cyst location, and cyst diameter. Various factors such as complications, recurrence rates, and biliary fistula development were compared. Statistical analyses were performed using Jamovi and JASP software, and p ≤ 0.05 was considered significant. Results: The risk of biliary fistula development was found to be significantly lower in patients treated using PAIR than in those in the surgical groups (p < 0.001). While the recurrence rate was higher in the PAIR group, the recurrence rates were similar in the OS and LS groups (p = 0.043). The risk of biliary fistula development and catheter removal time were found to be higher in patients with large cysts (p < 0.001). A strong and statistically significant correlation was observed between the length of hospital stay and the duration until catheter removal (p < 0.001). The maximum diameter of the cyst demonstrated a significant positive correlation with both the length of hospital stay (r = 0.363, p < 0.001) and the duration until catheter removal (p < 0.001). Conclusions: This study demonstrates that the PAIR method is effective in reducing biliary fistula development, but the recurrence rates are higher than OS and LS. OS and LS show similar outcomes in terms of recurrence.

Background and Objectives: This study aimed to investigate the weight loss, changes in eating habits, and satisfaction with the intragastric balloon (IGB) procedure in patients undergoing treatment for obesity, with follow-up until 6 months after IGB removal. Materials and Methods: This study included patients who underwent the IGB procedure between January 2020 and September 2024 at our clinic and were followed-up for 6 months after IGB removal. Patient records were retrieved from the endoscopy database. Parameters before IGB and during IGB removal were obtained from these records. Upon obtaining verbal consent from patients contacted via their registered phone numbers, their self-reported weights 6 months after IGB removal were recorded, and their body mass index (BMI) was calculated. During the same interview, patients were asked about their eating habits before IGB and 6 months after IGB removal, as well as their satisfaction with the procedure, based on questionnaires used in previous studies. The data collected included patients’ age, sex, weight, BMI, percentages of weight and BMI loss at IGB removal and 6 months after IGB removal, duration of IGB placement, maximum weight lost during IGB placement, time to achieve maximum weight lost, changes in eating habits, and satisfaction levels. Results: The mean age of the 62 patients who were included in this study was 33.24 ± 8.71 years, with 37 (59.67%) women and 25 (40.32%) men. The mean weight of the patients before IGB was 91.58 ± 7.04 kg, and the mean BMI was 32.00 ± 4.25 kg/m². The mean duration of IGB placement was 5.83 ± 0.41 months, with a mean maximum weight loss of 14.22 ± 4.70 kg and a mean time to achieve weight loss of 3.91 ± 0.91 months. There was a statistically significant difference between the weight before the IGB and the weight at IGB removal (p < 0.001). A significant difference was also noted in the weight before the IGB and 6 months after IGB removal (p < 0.001). The comparison of satisfaction levels showed no statistically significant difference in eating habits before the IGB (p = 0.384), whereas a significant difference was found in eating habits 6 months after IGB removal (p < 0.001). The weight loss differences between the satisfied and dissatisfied patients were significant at IGB removal and 6 months after, although no statistical difference was found in the pre-IGB weights between the satisfied and dissatisfied patients (p < 0.001). Conclusions: Patients undergoing the IGB procedure for obesity should correct their poor eating habits to maintain successful mid-term weight loss results.

Background and Objective: This study aimed to investigate the relationship between tramadol use and cardio electrophysiological imbalance (iCEB/iCEBc) in general surgery patients with complaints of acute postoperative pain (APP). Materials and Methods: In this prospective cross-sectional study, a total of 218 consecutive patients over the age of 18, who underwent surgical procedures in our clinic (postoperative), were included. For analgesic effect, tramadol was administered with an initial total max dose not exceeding 2 mg/kg. A single max dose (100 mg) was given intravenously, infused in 100 cc of saline over 60 min. In all patients requiring analgesia, electrocardiography (ECG) was performed in the supine position with 12 leads at 25 mm/s and 10 mm/mV, immediately before and after tramadol administration. iCEB was calculated as QT/QRS and iCEBc as QTc/QRS. Results: A total of 218 patients were included in this study, with 98 of them being male (45%) and the average age being 46.20 ± 17.19 years. The average tramadol dose for analgesic effect was 98.21 ± 7.62 mg. The QT interval (339.17 ± 36.27 vs. 349.88 ± 30.86, p = 0.001), QTc interval (407.07 ± 26.36 vs. 419.64 ± 31.78, p < 0.001), QRS duration (80.82 ± 11.39 vs. 78.57 ± 9.80, p = 0.018), iCEB (4.26 ± 0.69 vs. 4.52 ± 0.70, p < 0.001), and iCEBc (5.14 ± 0.86 vs. 5.42 ± 0.79, p = 0.001) values significantly increased compared to the baseline immediately after drug administration. Furthermore, the drug dose was identified as an independent predictor that increased iCEBc (β = 0.201, p = 0.003). Conclusions: Even at single and therapeutic doses, tramadol increases iCEB and iCEBc. Additionally, the drug dose is an independent predictor of increased iCEBc.

Evaluation of Educational Quality and Reliability of Laparoscopic Hydatid Cyst Surgery Videos on YouTube - Bezmialem Science