Katip Celebi University Ataturk Training Research Articles

The effect of preoperative TSH levels on perioperative complications in patients undergoing pituitary surgery

IntroductionPituitary surgery involves special conditions for the anaesthetist due to the anatomical localisation and the role of the pituitary gland in hormonal balance. The aim of this study was to retrospectively investigate the effect of TSH levels on perioperative complication rates in patients undergoing pituitary surgery.MethodsIn this study, patients who underwent pituitary surgery at Izmir Katip Celebi University Ataturk Training and Research Hospital between January 2017 and November 2022 were retrospectively screened. Two patients out of the 137 were excluded from the study as they underwent simultaneous aneurysm surgery along with pituitary tumor surgery. A total of 135 patients meeting the criteria were analyzed. Patients were divided into three groups according to TSH levels. Perioperative complication rates and mortality rates were compared between the three groups.FindingsThe study included a total of 135 patients, with an age range of 16–76 years. Among the groups with low–normal–high TSH levels, there were no statistically significant difference observed, in postoperative complications, such as epistaxis, rhinorrhea, postoperative nausea/vomiting, seizures, hypertension, and hypotension. When looking at the incidence of postoperative diabetes insipidus, a significant difference was found between the groups. When examining the mortality rates on the 28th day, a significant difference was found between the groups, with a mortality rate of 25% in the high TSH group (p < 0.5).ConclusionsThe risk of perioperative mortality is higher in patients with TSH levels above normal.

3. Basamak Sağlık Hizmeti Veren Kuruma Başvuran Feokromasitoma Tanılı Hastaların Klinik, Biyokimyasal ve Radyolojik Bulgularının Retrospektif Olarak İncelenmesi

Objective: To bring the current data of pheochromocytoma, which has a poor clinical course when diagnosed late and incorrectly, to the literature. Material and Methods: According to the retrospectively evaluated data of patients diagnosed with pheochromocytoma biochemically and pathologically, 32 patients were examined in the study, meeting the eligibility criteria. Exclusion criteria: being pregnant, being under the age of 18, only having a biochemical diagnosis and not having regular endocrinological records. The patient’s name-surname, gender, age, presence of an additional disease, clinical findings, computerized tomography (CT), magnetic resonance (MR) images, normetanephrine and metanephrine values were recorded in detail, as stated in the ethics committee approval. The results were evaluated using the Wilcoxon - T test using SPSS Statistics 25.0. Results: According to the results of 32 patients, 28 women and 4 men, the most common finding was sweating (90.6%). Tachycardia (84.4%), hypertension (84.4%), skin rash (56.6%), fatigue (75%), shortness of breath (46.9%), headache (31.3%), anxiety (31.3%), fear of death (21.9%), tremor (18.8%), pale skin (18.8%), nausea (12.5%), vomiting (9.4%), visual impairment (6.3%) and weight loss (3.1%) were determined. Locally, 43.8% of the tumors were seen on the right and 36.3% on the left. A statistically significant difference was found between preoperative and postoperative metanephrine values (p&lt;0.05). Statistically significant difference was found between preoperative and postoperative normeta-nephrine values (p&lt;0.05). There was no statistically significant difference between preoperative and postoperative basal cortisol values. (p=0,816). Conclusion: The current data of patients diagnosed with pheochromocytoma who applied to Izmir Katip Celebi University Ataturk Training and Research Hospital were examined and it was seen that the symptoms of these patients were correlated with patients around the world. It was concluded that preoperative and postoperative metanephrine and normetanephrine decreased significantly (p&lt;0.05), but no significant change was observed in basal cortisol levels (p&gt;0.05).

Diagnostic Value of Neutrophil to Lymphocyte Ratio and Mean Platelet Volume on Early Onset Neonatal Sepsis on Term Neonate

By setting out from increased neutrophil count, decreased lymphocyte count, and increased mean platelet volume (MPV), which is a result of the effect of inflammation on blood cells, we aimed to investigate whether neutrophil to lymphocyte ratio (NLP) and MPV can be used as an auxiliary parameter for the diagnosis of early-onset neonatal sepsis (EOS). This study was conducted by analyzing term neonates with EOS and physiological jaundice who were admitted to the neonatal intensive care unit of Izmir Katip Celebi University Ataturk Training and Research Hospital. A total of 63 neonate files were examined to include 30 term neonates with EOS, and 77 neonate files were examined to include 30 term neonates with physiological jaundice as a control group. NLR had an area under the curve (AUC) of 0.891 for prediction of EOS. At a cut-off level of 1.42, NLR had a likelihood ratio (LR) of 5.5, sensitivity of 88%, a specificity of 84%, a positive predictive value (PPV) of 84.6%, and a negative predictive value (NPV) of 87.5%. MPV had an AUC of 0.666 for the prediction of EOS and at a cut-off level of 9.3 fL, MPV had an LR of 1.23, sensitivity of 84%, a specificity of 32%, a PPV of 55.2%, and an NPV of 66.6%. In conclusion, this study provides evidence that NLR and MPV can be used in addition to conventional parameters in the diagnosis of EOS.

Effect of diabetes mellitus on prognosis and development of hepatocellular carcinoma in patients with hepatitis C-related cirrhosis

Aim: Hepatitis C virus (HCV) infection and diabetes mellitus (DM) negatively affect each other. HCV patients diagnosed with DM have more complications than patients with HCV infection alone. In this study, we aimed to investigate the effect of DM on complication rate, hepatocellular cancer (HCC) development and mortality in HCV RNA (+) cirrhosis patients. Material and Methods: Patients admitted with Hepatitis C-related cirrhosis and followed up for at Izmir Katip Celebi University Ataturk Training and Research Hospital Gastroenterology and Internal Medicine Clinic for at least six months between 2005and 2014 were retrospectively evaluated. Results: A total of 146 patients with HCV-related cirrhosis were included in the study. Of these patients, 53 (36.3%) had diagnosis of DM. In 108 patients who did not develop hepatocellular carcinoma (HCC), the mean CHILD score at final admission (p=0.024), difference between mean CHILD scores at final and initial admission (p=0.011), and annual rate of increase in CHILD score (p=0.047) was significantly higher in the DM group. There was no significant difference between the DM and non-DM groups according to both overall survival (p=0.115) and time of HCC development (p=0.567). Conclusion: While HCC development and overall survival were similar in both groups, in the subgroup of patients who did not develop HCC, the annual increase in CHILD score and final CHILD score were significantly higher in DM patients.

Evaluation of the Olfactory Function With the "Sniffin' Sticks" Test After Endoscopic Transsphenoidal Pituitary Surgery.

The aim of this study was to evaluate the olfactory function of patients who had undergone endoscopic transsphenoidal pituitary surgery. In this prospective study, the "Sniffin' Sticks" test was performed between June 2016 and April 2017 at Izmir Katip Celebi University Ataturk Training and Research Hospital. Thirty patients who were scheduled to undergo endoscopic transsphenoidal pituitary surgery were evaluated preoperatively and 8 weeks postoperatively using the Sniffin' Sticks test battery for olfactory function, odor threshold, smell discrimination, and odor identification. The patients were evaluated preoperatively by an otolaryngologist. The patients' demographic data and olfactory functions were analyzed with a t test and Wilcoxon-labeled sequential test. The study group comprised 14 women (46.7%) and 16 men (53.3%) patients. The mean age of the patients was 37.50 ± 9.43 years (range: 16-53 years). We found a significant difference in the preoperative and postoperative values of the odor recognition test (P = 0.017); however, there was no significant difference between the preoperative and postoperative odor threshold values (P = 0.172) and odor discrimination values (P = 0.624). The threshold discrimination identification test scores were not significant (P = 0.110). The olfactory function of patients who were normosmic preoperatively was not affected postoperatively. This study shows that the endoscopic transsphenoidal technique for pituitary surgery without nasal flap has no negative effect on the olfactory function.

Prevalence of malnutrition / malnutrition risk in cancer patients: experince of an oncology outpatient clinic in Turkey

Introduction: The objective of this study is to determine the prevalence of malnutrition risk (MR)/malnutrition (MN) in cancer patients using MNA. Methods: This observational study was conducted with cancer patients in the Izmir Katip Celebi University Ataturk Training and Research Hospital Medical Oncology Outpatient Clinic. Demographic data, daily functional status according to the Eastern Cooperative Oncology Group (ECOG), nutritional status according to Mini Nutrition Assessments (MNA) and anthropometric measurements obtained with TANITA Body Composition Analyzer Model TBF-300 (TANITA) were used in the evaluation of patients. Results: The study enrolled 296 oncology patients. The mean age was 58.34 ± 11.60 years. Two hundred and eight (70.3%) of the patients were women. The most common three tumor types were breast tumors (43.2%; n=128); gastrointestinal tract tumors (33.1%; n=98), genitourinary tract tumors (10.8%: n=32). The mean BMI of the patients was 27.45 ± 5.75 m2/kg. According to MNA 118 of the patients were in normal nutritional status (39.9%). 130 of them were at the risk of malnutrition (43.9%), 48 of them were malnourished (16.2%). Conclusion: In cancer patients, the prevalence of malnutrition and malnutrition risk is significantly high, and this may alter the patient’s life quality and expectancy. Therefore, the nutritional status of every patient that is diagnosed with cancer should be assessed in early stages of the disease.

WITHDRAWN: Comparison of vacuum-assisted closure therapy and debridement with primer surgical closure for fournier's gangrene treatment: 10 years' experience of a single centre.

The International Brazilian Journal of Urology will retract this article because the authors were not authorized to publish the data according to the Department of Urology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey, where the paper was done.

Assessment of &lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt; resistance profiles in intensive care units: Five-year outcomes

Aim: Pseudomonas aeruginosa is a non-fermentative Gram-negative bacilli which infections in hospitals have high morbidity and mortality rates. The aim of this study is to determine the antimicrobial susceptibility profiles of P.aeruginosa strains isolated in Izmir Katip Celebi University Ataturk Training and Research Hospital between January 2011 and October 2015. Materials and Methods: In our hospital, between January 2011- October 2015, 1056 P.aeruginosa strains isolated from various clinical specimens of patients who have been in intensive care units were included in the study. The strains were isolated and identified by the BD Phoenix™ Automated Microbiology System (Becton-Dickinson, USA) system. Antibiotic susceptibilities were established by disk diffusion and were evaluated according to the Clinical Laboratory Standards Institute (CLSI) criteria in 2011-2014 and EUCAST criteria in 2015. Results: The highest antibiotic resistance rates were found for cefoperazone/sulbactam, aztreonam, ceftazidime, piperacillin/ tazobactam and cefepime. Conclusion: In our hospital, resistance rates of P. aeruginosa strains isolated from intensive care unit were higher consistent with data reported in our country. The results of this study will help the establishment of more appropriate treatment protocols against P.aeruginosa infections and will aid in preventing the development of a high number of resistant strains.

Lymph Node Density in Node‐Positive Laryngeal Carcinoma

We investigated the value of lymph node density (LND) as a predictor of survival in patients with laryngeal squamous cell carcinoma (SCC) and positive neck node (pN+) after laryngectomy. Case series with chart review. Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey. We reviewed the records of 289 patients with newly diagnosed primary laryngeal carcinomas who underwent partial or total laryngectomy and combined neck dissection at a tertiary referral center between June 2006 and December 2014. Patients with pN+ laryngeal SCC (n = 101) were included in the study. Overall survival (OS) and disease-free survival (DFS) were used to evaluate the prognostic significance of LND. In 101 patients with pN+ laryngeal SCC, LND ≥0.09 and number of metastatic lymph nodes >4 were significantly associated with OS and DFS but not the overall tumor, node, and metastasis stage. Forward stepwise Cox regression analysis revealed that LND ≥0.09 was the only independent predictor of both DFS and OS. Furthermore, the odds ratio of LND ≥0.09 was 10 times higher in patients with regional recurrence when compared patients without regional recurrence. LND was the only independent prognostic predictor of OS and DFS in patients with pN+ laryngeal SCC. Moreover, patients with LND ≥0.09 were significantly associated with high risk of regional recurrence. Thus, patients with LND ≥0.09 are at high risk of regional recurrence and death and may be considered for adjuvant chemoradiation.

Is inhaled colistin beneficial in ventilator associated pneumonia or nosocomial pneumonia caused by Acinetobacter baumannii?

BackgroundIn the present study, our objective was to evaluate and compare the clinical and microbiological results in patients receiving systemic and systemic plus inhaled colistin therapy due to nosocomial pneumonia (NP) or ventilator associated pneumonia (VAP) caused by Acinetobacter baumannii.MethodsA retrospective matched case–control study was performed at the ICUs at Izmir Katip Celebi University Ataturk Training and Research Hospital from January 2013 to December 2014. Eighty patients who received only systemic colistin were matched 43 patients who received systemic colistin combined with inhaled therapy.ResultsIn 97.6 % of the patients colistin was co-administered with at least one additional antibiotic. The most frequently co-administered antibiotics were carbapenems (79.7 %). The patient groups did not differ significantly in terms of the non-colistin antibiotics used for treatment (p > 0.05). Acute renal injury was observed in 53.8 % and 48.8 % of the patients who received parenteral colistin or parenteral plus inhaler colistin, respectively (p = 0.603). There were no significant differences between the groups in terms of clinical success (p = 0.974), clinical failure (p = 0.291), or recurrence (p = 0.094). Only, a significantly higher partial clinical improvement rate was observed in the systemic colistin group (p = 0.009). No significant differences between the two groups in terms of eradication (p = 0.712), persistence (p = 0.470), or recurrence (p = 0.356) rates was observed. One-month mortality rate was similar in systemic (47.5 %) and systemic plus inhaled (53.5 %) treatment groups (p = 0.526).ConclusionsOur results suggest that combination of inhaled colistin with intravenous colistin had no additional therapeutic benefit in terms of clinical or microbiological outcomes.

Oral Lichenoid Lesions Related to Drugs: Review of Clinicopathological Features and Differantional Diagnosis

Izmir, Turkey; Department of Internal Medicine, Clinic of Rheumatology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey Objective: Sjogren’s Syndrome (SS) is a systemic, multi-organ, autoimmune disease with an incidence of 4/ 100.000, predominantly affecting women. Minor salivary gland biopsy has been long considered as the gold standard of diagnosis. More than one focus (a cluster of >1⁄450 lymphocytes) within a 4mm area of glandular tissue is supportive for SS. Our study aims to demonstrate whether there is a significant difference between histologic focus score (FS)1⁄41 and FS>1. Study Design: Biopsies of 99 patients who were evaluated according to the American-European Consensus Group 2002 criteria (AECGC) at our instution’s Rheumatology clinic between 2010 and 2012 were reviewed retrospectively. Results: 91.9% of our patients were women. Two patients had inadequate samples for focus scoring. Out of 97 patients, 5 (5,15%) had FS1⁄41 and 32 (32.98%) FS>1. Chi-Square analyses showed a significant correlation between FS>1⁄41 and clinical presence of SS (p<0.004). Conclusions: FS1⁄41 was accepted, followed and treated as SS depending on AECGC.

PP-132 Eversion and Conventional Carotid Endarterectomy Techniques in Terms of a Comparison of Hypertension

Peripheral Interventions: Imaging in Diagnosis (Abstract nos. PP-132 w PP-142) The American Journal of Cardiology MARCH 26e29, 2015 11 IN AND C PP-132 Eversion and Conventional Carotid Endarterectomy Techniques in Terms of a Comparison of Hypertension. Haydar Yasa, Muhammed Akyuz, Barcin Ozcem, Mehmet Bademci, Nihan Karakas, Banu Akdag Lafci, Tayfun Goktogan, Ali Gurbuz. Bati Anadolu Central Hospital; Ege University; Katip Celebi University Ataturk Training And Research Hospital; Near East University Faculty Of Medicine. Background: The role of carotid endarterectomy for the treatment of carotid bifurcation atherosclerosis is now well established. The operative procedures for carotid stenosis, the eversion techniques require an oblique circumferential incision of the internal carotid artery (ICA) at the carotid bulb and transection of the carotid sinus nerve fibers. In this study, the incidence of postoperative hypertension (HTN) after eversion carotid endarterectomy (E-CEA) was compared with conventional carotid endarterectomy (C-CEA) in the shortand mid-term follow-up periods. Methods: Baseline blood pressures were recorded in all patients 1-2 weeks before the CEA. Systolic blood pressure values and diastolic blood pressure values were 1⁄4.078). The number of patients that had continued administeration of antihypertensive agents were, 4 (5.2%) and 3(3.4%) in the E-CEA group and C-CEA group, respectively. Normalization of arterial blood pressure was achieved in the other patients. No significant postoperative neurological, surgical, or cardiac complications developed in any patient in either group. Conclusion: As a result, the researchers suggest that there is no difference between the two groups after E-CEA control of hypertension at the early and middle periods.

Lack of Correlations among Histopathological Parameters, Ki-67 Proliferation Index and Prognosis in Pheochromocytoma Patients

In this study prognostic correlations of histopathologic parameters and the Ki-67 proliferation index and as well as the diagnostic value of immunohistochemical markers in pheochromocytomas were evaluated. A total of 22 patients diagnosed with a pheochromocytoma between 2000-2010 in Izmir Katip Celebi University Ataturk Training and Research Hospital were included. Diagnostic value of the PASS scoring system, and prognostic correlations of histopathologic parameters and Ki-67 proliferation index were investigated. SPSS for Windows 17.0 software was used for statistical analysis. There was no statistically significant correlation between recurrence and clinicopathologic parameters or the PASS score (PASS>4). In addition, there were no statistically significant correlations between PASS score and clinicopathologic parameters, such as diameter (5 cm), weight (>100g), gender (female/male ratio) and age (25-45/45-55/>55). Besides, there were no significant correlation between diameter and clinicopathological parameters and also recurrence. However, there was a statistically significant correlation between Ki-67 proliferation index and capsule invasion (p=0.047). Some but not most of the findings in our study were concordant with the literature. To clarify relationships, investigations with standard scoring systems which are not affected by subjective factors and feature appropriate histopathological criteria should be made on larger study groups.

Management and Results of Ectopic Pregnancy Adapted by Clinical Guidelines: Two Years Experience of University Hospital in Turkey

Ectopic pregnancy is defined as the fertilized ovum implants in a location outside the endometrial cavity, remains to be an important cause of maternal morbidity and mortality worldwide and is a health problem with incidence ranges between 0.25% and 2% of all pregnancies. In our study, in Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Obstetrics and Gynecology from 2011 to 2013, 96 cases with diagnosis of ectopic pregnancy managed by the adapted RCOG’s Guide were analyzed retrospectively. The data were analyzed as follows: age, the history of operation, smoking, the presence of intrauterine device, blood groups, hemoglobin, platelets, values of B-hCG, the diagnostic interval, intra-abdominal free fluid and/or acute abdomen, the method of treatment and the success of treatment.

An imported cutaneous leishmaniasis case treated with glucantime

Cutaneous Leishmaniasis (CL) is an endemic disease in 98 countries that causes long-term noduloulcerative scars on the skin by Leishmania spp. one of the protozoa parasites. The disease is very common especially in Sanliurfa and Southeast provinces in our country. In recent years, the migration from neighbor countries because of the wars has led to an increase in cases. In this study, a CL case of 14-years old female patient with CL-associated ulcerative lesion on her right axillary cavity region, migrated from Syria and applied to Izmir Katip Celebi University Ataturk Training and Research Hospital is discussed. It was determined that the causative agent was Leishmania tropica subspecies by real-time PCR after diagnosis by aspiration material smear from lesion and NNN cultural method. It is aimed to create awareness among physicians working in non-endemic regions for the patients from CL endemic areas.

Therapeutic Efficacy of the Combination of Intratympanic Methylprednisolone and Oral Steroid for Idiopathic Sudden Deafness

The purpose of this study was to compare the efficacy of systemic steroid alone and combined with intratympanic methylprednisolone in the treatment of patients with idiopathic sudden sensorineural hearing loss. Prospective, randomized controlled trial. Settings Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey. Seventy-nine patients who met the inclusion criteria for idiopathic sudden sensorineural hearing loss were included in this study. Patients were randomly divided into 2 groups according to treatment: group A received combination therapy (intratympanic methylprednisolone + oral steroid) and group B received oral steroid alone. Of the 79 patients included, 6 patients missed the 1-month follow-up visit. Overall, 73 patients (37 combination group, 36 oral steroid group) who completed the 1-month follow-up and study intervention were included in the per-protocol analysis. Both the relationship between certain prognostic factors and the clinical outcome after treatment were analyzed. Combination therapy showed significant hearing improvement and speech discrimination scores compared with the use of systemic steroids alone (P < .05). In hearing outcomes in patients with severe hearing loss, combination therapy had statistically significant hearing improvement compared with oral steroid alone (P < .05). We recommend that combination therapy can be considered as initial treatment especially for patients with severe hearing loss.

Endometrial spiral artery Doppler parameters in unexplained infertility patients: is endometrial perfusion an important factor in the etiopathogenesis?

Uterine perfusion, particularly the endometrial blood flow, may have an important role in endometrial receptivity. In order to assess the contribution of sub endometrial blood flow in the etiopathogenesis of unexplained infertility mid luteal- peri-implantation period spiral artery transvaginal color Doppler parameters were measured and compared with fertile controls. Forty-two consecutive patients admitted to Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Obstetric and Gynecology with the diagnosis of unexplained infertility after standard diagnostic work up constituted the study group and they were compared with a fertile control group admitted to hospital with non specific gynecological complaints or for check-up in the same period. Mid luteal transvaginal color Doppler ultrasonography was applied to each patient by the same radiologist who was blind to the diagnosis of the particular patient and, RI (resistance index) and PI (pulsatility index) values were calculated. There were no significant differences between the two groups, in respect to age, body mass index, basal hormonal and mid luteal progesterone levels (p>0.05). For the fertile control group, mid luteal-peri-implantation phase endometrial spiral artery mean RI values were calculated as 0.48±0.08 SD and mean PI values as 0.65±0.18 SD. For the study group, mean RI values were calculated as 0.54±0.07 SD, PI values were calculated as 0.80±0.16 SD. The differences for RI (p=0.009) and PI (p=0.004) were statistically significant. According to Doppler parameters, unexplained infertility patients have high impedance blood flow in spiral arteries which means that peri-implantation blood flow in these patient is lower than fertile controls. These findings suggest that endometrial perfusion may have an important contribution to etiopathogenesis of unexplained infertility.

Supracricoid Partial Laryngectomy

The aim of this study was to analyze the functional and oncologic results of supracricoid partial laryngectomy. Case series with chart review. Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey. The medical records of 56 patients, who underwent supracricoid partial laryngectomy between March 2002 and December 2010, were reviewed in this study. Forty-three patients underwent supracricoid partial laryngectomy with cricohyoidopexy, and 13 patients underwent cricohyoidoepiglottopexy. The overall and disease-specific survival, local control rates, and the mean time of decannulation and nasogastric tube removal were evaluated. Association of type of surgery with the functional and oncologic outcomes was evaluated and statistically compared. The median follow-up period was 58 months. The 1-, 3-, and 5-year overall survival rates were 100%, 96.4%, and 82.1%, respectively. The 1-, 3-, and 5-year local control rates were 100%, 96.1%, and 92.5%, respectively. Type of surgery did not show any significant difference in survival and local control rates (P = .546, P = .455). The mean (SD) decannulation and nasogastric feeding tube removal time was 11.43 (2.03) and 16.79 (3.51) days, respectively. The mean time of decannulation and nasogastric tube removal was significantly longer in patients who underwent cricohyoidopexy when compared with those who underwent cricohyoidoepiglottopexy (P = .002, P = .000). Although delaying deglutition functions could be termed a disadvantage of supracricoid laryngectomy, especially with cricohyoidopexy, supracricoid laryngectomy has reliable oncologic and functional results for locally advanced laryngeal cancers while maintaining laryngeal functions.

A Retrospective Analysis of Amputation Rates and Comorbidity in Patients with Diabetic Foot Ulcer

Abstract Diabetic foot ulcers cause elongated hospitalisations with high treatment costs and high rates of lower extremity amputations resulting with increased morbidity and decreased quality of life. The aim of this study was to determine amputation rate in patients admitted to our hospital with the diagnosis of diabetic foot and the most common risk factors in patients with diabetic foot ulcers. 131 patients admitted to outpatient clinics of Izmir Katip Celebi University Ataturk Training and Research Hospital between January 2011 and December 2011 with the diagnosis of diabetic foot ulcer were retrospectively analyzed. Of these 96 were males and 35 were females. Age, gender, smoking and alcohol habits, comorbid diseases, presence of infection, growth of microorganism in medium, presence of leukocytes, hypertension, method of treatment and regimes of antibiotics are recorded. Mean age was 61,1 ( 26-90). Patients are divided into two groups according to treatment protocols, first group was consist of debriated and medicaly treated patients, while the second group covered amputated patients. 66 were amputated and the rest 65 had debridement-wound care and antibiotherapy after they were evaluated in the diabetic foot council of our hospital. Rate of amputation was 50 %. 36 of the amputated patients had major and the others had minor amputations. Most common comorbidities that related and nonrelated to diabetes were peripheral arterial disease ( 102 out of 131; 77% ) and hypertension ( 50 out of 131; 38% ); respectively. Grading of diabetic ulcers according to Wagner-Meggit classification yielded that most commonly seen wounds were grade 4 in the amputation group and grade 2 in the debridement group. According to pathophysiological classification most common cause were ischemic wounds in both groups. Compared to the literature, our amputation rates are higher. This issue can be attributed to high rates of comorbid factors, higher age and irregular follow-up. Key words: diabetic foot, amputation, comorbidity