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Aim: In recent years, it has been observed that extrapulmonary tuberculosis cases have increased compared to pulmonary tuberculosis cases. In patients with pulmonary tuberculosis, extra pulmonary tuberculosis is asymptomatic, although the true incidence of intraabdominal and gastrointestinal tuberculosis is unknown, there are studies reporting that tuberculous peri- tonitis is rare. Radiology guides the diagnosis of this disease, which can be missed and has increased morbidity and mortality when early diagnosis is not made. In this study, we aimed to examine our patients with tuberculous peritonitis with epidemiological, clinical and laboratory findings and to emphasize that radiology is a guide in diagnosis.Methods: This is a retrospective study including epidemiological, clinical and laboratory data of 23 patients who were followed up with the diagnosis of tuberculous peritonitis in our hospital between January 2012 and February 2020. The data were obtained from patient files and hospital data recording system. The data obtained were evaluated using numbers and percentage calculation.Results: 8 (34.8%) of the patients were male, 15 (65.2%) were female, the mean age was 41.5 ± 22.1. Five (21.7%) patients had hypertension and 3 (13%) had diabetes mellitus. 20 (87%) of the patients had abdominal pain, 18 (78.3%) had fever, abdominal swelling and acid, 17 (73.9%) had night sweats, and 14 (60.9%) had anorexia. Computed tomography and ultrasonograp- hy were used as radiological methods in 16 (69.5%) patients, and only computed tomography was used in 7 (30.5%) patients. The diagnosis was made histopathologically in 17 (73.9%) of the patients, microbiological in 3 (13%), and both microbiological and histopathologically in 3 (13%) patients.Conclusion: Tuberculous peritonitis is a rare disease that can be easily overlooked because its signs and symptoms are nonspecific. Early diagnosis and treatment is important to prevent morbidity and mortality. The radiological findings are very helpful in diagnosis. Ultrasonography and computed tomography are very guiding both for the diagnosis of tuberculous peritonitis and for the examination of acid fluid and peritoneum., Amaç: Son yıllarda ekstrapulmoner tüberküloz olgularının arttığı gözlenmektedir. Tüberküloz peritonit nadir görülen ekstrapulmoner tüberküloz formudur. Bu çalışmada tüberküloz peritonit olgularını irdeledik.Yöntem: Bu çalışma, Ocak 2012-Şubat 2020 tarihleri arasında hastanemizde tüberküloz peritonit tanısıyla takip edilen toplam 23 hastanın verisini içeren retrospektif bir çalışmadır. Veriler hasta dosyalarından, hastane veri kayıt sisteminden elde edilmiştir. Bulgular: Hastaların 8 (%34.8)’i erkek, 15 (%65.2)’i kadın, yaş ortalaması 41,5±22.1 idi. Beş (%21.7) hastada hipertansiyon, 3 (%13)’ünde diyabetes mellitus mevcuttu. Hastaların 20 (%87)’sinde karın ağrısı, 18 (%78.3)’inde ateş, karında şişlik ve asit, 17 (%73.9)’sinde gece terlemesi, 14 (%60.9)’ünde iştahsızlık mevcuttu. Onaltı (%69.5) hastada radyolojik yöntem olarak bilgisayarlı tomografi ve ultrasonografi, 7 (%30.5) hastada sadece bilgisayarlı tomografi kullanıldı. Hastaların 17 (%73.9)’sinde tanı histopatolojik, 3 (%13)’ünde mikrobiyolojik, 3 (%13)’ünde ise hem mikrobiyolojik hem histopatolojik olarak konuldu. Sonuç: Tüberküloz peritonitte erken tedavi önemli olduğundan en kısa sürede tanıya gidilmelidir. Radyolojik bulgular nonspesifik olmakla beraber tanıda yardımcıdır. Hem düşündürücü bulgular olması hem de asit sıvısı ve periton incelemesi için ultrasonografi ve bilgisayarlı tomografi oldukça yol göstericidir.

Dear editor In a recent paper, Sevuk et al used the single-hospital-based database to investigate whether cobalamin (vitamin B12) deficiency increased the risk of postoperative delirium in patients aged >60 years undergoing cardiac surgery with cardiopulmonary bypass.1 In this retrospective study, the incidence of postoperative delirium in 100 patients with cobalamin deficiency was compared to 100 controls without cobalamin deficiency. Because the incidence of postoperative delirium in patients with cobalamin deficiency was significantly higher than that in the control group (P=0.017), the authors concluded that cobalamin deficiency may be associated with increased risk of delirium in elderly patients undergoing cardiac surgery. This article has drawn the attention of anesthesiologists who are involved in prevention and treatment of postoperative delirium. Apparently, the conclusion raises a plausible defect when all patients developing delirium were considered as one group. Delirium is a clinical diagnosis with a wide range of neuropsychiatric manifestations. The pathophysiology of delirium is not fully understood. Delirium is classified as hyperactive, hypoactive, or mixed forms.2 Etiologic diagnosis of the hyperactive and hypoactive subtypes of delirium may be different.3 Nutritional status has been suggested to play a role in predisposing or directly causing this acute cerebral dysfunction.4 A previous study reported that vitamin B12 supplementation for 40 weeks reduced delirium in demented patients aged over 60 years with low serum vitamin B12 (

Objectives: There are studies that show that double J stenting (DJS) increase BK nephropathy (BKN) 4 fold. DJS may cause vesicoureteral reflux (VUR) with normal bladder contraction. The aim of this study is to comparison risk of BKN, urinary tract infections (UTI) and postoperative urologic complications with the use DJS with anti-reflux device (ARD-DJS) and standart double J stent (St-DJS). Matherial and methods: Ninety patients (male/female: 50/40) that had undergone kidney transplantations in Diyarbakır Training and Research Hospital and Dicle University, Faculty of Medicine Hospital between January 2012 and April 2015 were enrolled in the study. Demographic data, immunosuppression protocols, presence of rejection, graft loss, postoperative urologic complications, UTI, plasma BK levels of the patients were evaluated retrospectively. Results: Median and IQR follow up time for ARD-DJS and St-DJS patients were 14 (12-18) months and 25 (16-30) months respectively. Five cases (5.5%) had BK viremia (P=0.025). All 5 cases with BK viremia were St-DJS users. Conclusion: As a result for postoperative UTI and postoperative urinary complication risk there were no statistically significant difference between ARD-DJS use and St-DJS use during ureteral anastomosis. BKN univariate analysis were significantly less than those st-DJS used. Risc factors were evaluated. But results were not statistically significant in the logistic regression analysis. We think that to demonstrate this benefit, we need randomized controlled studies with more patients and longer follow up.

Amaç: Travmatik kolorektal yaralanmalar halen önemli bir cerrahi sorun olmayadevam etmektedir. Bu çalışmada travmatik kolorektal yaralanmalarda morbidite vemortaliteye etkili risk faktörleri incelendi.Materyal ve metod: Ocak 2005- Aralık 2010 tarihleri arasında travmatik kolorektalyaralanma nedeniyle tedavisi yapılmış ve çalışmaya dahil edilen 194 hastanındosyaları retrospektif olarak incelendi. Hastalarda yaş, cinsiyet, yaralanmamekanizması, eşlik eden organ yaralanmaları, Flint yaralanma derecesi, tedavi şekli,travmadan tedaviye kadar geçen süre, hastanede yatış süresi, morbidite ve mortaliteverileri kaydedildi. Her hasta için, ISS, RTS ve TRISS hesaplandı.Bulgular: Hastaların 172' si (% 88,7) erkek, 22' si (% 11,3) kadındı ve yaşortalamaları 29,15 ± 12,39 (15- 89) idi. Yaralanmaların 179' u (%92,3) penetran ve15' i (% 7,7) künt yaralanmalardı. Künt yaralanmalarda morbidite ve mortaliteanlamlı olarak yüksekti. Postoperatif 62 hastada (% 32) komplikasyon gelişti. En sıkyara yeri infeksiyonu (21 hasta) ve akciğer komplikasyonları (21 hasta) gelişti (%10,8). Hastaların 24' ünde (% 12,3) mortalite gelişti. En sık mortalite sebebihipovolemik şoktu. Bu çalışmada univariate analizde, yaralanmanın cinsi (künt),yaralanma derecesi (Flint 3), tedavi şekli (stoma), ISS, RTS, TRISS ile hem mortalitehem morbidite arasında anlamlı ilişki saptandı. Cinsiyet ile mortalite ve TTI ilemorbidite arasında anlamlı ilişki saptandı. Multivariate lojistik regresyon analizde iseyaralanma mekanizması (künt), RTS ve ISS mortalite için; Flint yaralanma derecesive TTI morbidite için bağımsız risk faktörü olarak bulundu.Sonuç: Batın travmasıyla başvuran hastalarda, yaralanma mekanizmasının bilinmesi,erken tanı ve tedavi (TTI) ve skorlama sistemlerinin (ISS, RTS, TRISS) kullanılmasıönemlidir.Anahtar kelimeler: Travma, kolon, rektum, morbidite, mortalite, başvuru süresi,TRISS Aim: Traumatic colorectal injuries, continuous to be a major surgical challenge.This study examined risk factors of morbidity and mortality in traumatic colorectalinjuries.Materials and method: 194 patients were included in the study. The patients wereretrospectively analyzed from archive data, who; they were treatment of traumaticinjury to colon and rectum, made between January 2005 - December 2010. The age,gender, mechanism of injury, associated organ injury, degree of injury, therapy,trauma treatment interval, length of hospital stay, morbidity and mortality data wererecorded. For each patient, ISS, RTS, and TRISS was calculated.Results: 172 petients (88.7%) were male and 22 (11.3%) were female and themean age was 29.15 ± 12.39 (15-89). Postoperatively developed complications in 62patients (32%). There was 179 (92,3%) penetrating and 15 (7,7%) blunt injuries.Significantly higher morbidity and mortality in blunt trauma victims. Woundinfection and pulmonary complications were improved (10.8%) the most commoncomplications. Total mortality were occurred in 24 (% 12,3) patients. Hypovolemicshock was cause of mortality, the most common. Univariate analysis were included,type of injury, gender, degree of injury, therapy, ISS, RTS, TRISS; what weresignificantly correlated with mortality. There were a significant relationship betweenmorbidity with TTI, type of injury, degree of injury, therapy, ISS, RTS and TRISS. Inmultivariate logistic regression analysis, Flint grade and TTI was found to be anindependent risk factor for morbidity; mechanism of injury, RTS and ISS was foundto be an independent risk factor for mortality.Conclusion: Knowledge mechanism of the injury, early diagnosis and treatment andusing scoring systems are important.Keywords: Trauma, colon, rectum, morbidity, mortality, admission time, TRISS 56