Browsing by Author "Toktas, O."

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Management of Gastric Cancer With Liver Metastasis in a Pregnant Woman
(Yuzuncu Yil Universitesi Tip Fakultesi, 2017) Cim, N.; Karaman, E.; Toktas, O.; Gunes, G.; Elci, E.; Andıc, E.; Yildizhan, R.
The complaints and symptoms of gastric cancer are non-specific and many of these symptoms are frequently masked by factors related to normal pregnancy. A 38 year-old woman with G10P8A1 and at 31 weeks of pregnancy was admitted to a maternity outpatients’ clinic complaining of nausea, vomiting and constipation during the previous 4 days. On palpation a solid lesion of 1.5 cm was palpable in the subxiphoid region. A solid nodule with largest diameter of 5 cm was observed on the liver and suspected to indicate metastasis. Under endoscopic examination, ulcerovegetan, fragile and malignant mass that surrounded and narrowed the gastric antrum and extended to an angular notch was seen. The biopsy that was taken from lesion was revealed to be the result of a malignant epithelial tumor of poorly differentiated adenocarcinoma. During the explorative laparotomy, a tumoral mass with multiple peripheral lymphadenopathies was observed in the posterior gastric antrum, pancreas and colon median entry-invasive artery. Multiple metastases were present in the omentum and liver with a large amount of acid in the abdomen. The patient was considered inoperable due to the gastric cancer being in a terminal stage and adjuvant chemotherapy was planned. Early diagnosis and treatment is important for the prognosis of gastric cancer. The complaints and symptoms of gastric cancer are non-specific and many of these symptoms are similar to those seen during a normal pregnancy. If the same symptoms recur during pregnancy or there is a failure to respond to therapy, the gastrointestinal system should be evaluated endoscopically. © 2017, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Mean Platelet Volume, Red Cell Distribution Width, Neutrophil To Lymphocyte Ratio and Platelet To Lymphocyte Ratio in the Diagnosis of Acute Appendicitis
(Yuzuncu Yil Universitesi Tip Fakultesi, 2017) Toktas, O.; Aslan, M.
Mean platelet volume (MPV), red cell distribution width (RDW), platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) have been seperately reported to be laboratory markers in several inflammatory diseases, including acute appendicitis. However, the results of these studies are conflicting. The aim of this study was to simultaneously investigate if MPV, RDW, PLR and NLR have a diagnostic role in the diagnosis of acute appendicitis and also the relationship between these systemic inflammation marker and leukocyte count. Thirty patients with acute appendicitis and 30 age-matched healthy subjects. RDW, MPV, neutrophils, lymphocytes and platelet counts were evaluated with complete blood count. The NLR and PLR were calculated as the ratios of the neutrophils and platelets to the lymphocytes. NLR and leukocyte count were significantly higher in the acute appendicitis patients compared to controls (both p<0.001), while RDW levels were significantly lower (p=0.041). There were no statistically significant differences regarding platelet numbers, MPV levels and PLR between acute appendicitis and healthy subjects (All; p>0.05). There was a significant correlation between leukocyte count and NLR (p<0.01, r=0.365). However, leukocyte count was not correlated with RDW and MPV levels (all; p>0.05). The current study is the first to investigate MPV, RDW, PLR and NLR in acute appendicitis patients. We found significantly increased NLR and leukocyte count in acute appendicitis patients compared to healthy subjects. Combined use of NLR and RDW values along with leukocyte count and other clinical assessment could help the diagnostic process of acute appendicitis. © 2017, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.