PubMed İndeksli Yayınlar Koleksiyonu
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Browsing PubMed İndeksli Yayınlar Koleksiyonu by Author "10. Faculty of Medicine / Tıp Fakültesi"
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Article Acute Cyanide Intoxication Due To Apricot Seed Ingestion(Soc Argentina Pediatria, 2024) Talay, Mehmet N.; Gungor, Emre; Orhan, Ozhan; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiIntroduction : Cyanide poisoning, whether it be accidental or intentional, remains a significant danger to adults and children, especially in societies where agriculture is a primary source of income. We examined the clinical follow-up, complications, and results of cyanide poisoning cases that occurred after eating the pits and seeds of plants containing cyanide glycosides, such as apricot kernels and almonds. Methods : Between 01/01/2017 and 01/08/2022, 14 children aged 1-18 years who were followed up with a prediagnosis of cyanide poisoning in our Paediatric Intensive Care Unit (PICU) were retrospectively analysed. Results : Eight of the patients followed with a preliminary diagnosis of cyanide poisoning were female and six were male. The most common admission month was July (42.8%) coinciding with the agricultural season. The most common symptoms at presentation were weakness and fatigue (n = 7). In the PICU, 4 patients presented lip cyanosis; 3, altered level of consciousness. Vomiting, seizure, headache, dizziness and palpitatons were less frequent. Four patients were treated with hydroxocobalamin (Cyanokit (R) ) as an antidote due to acidosis in their blood gases. All patients treated for cyanide poisoning were discharged. Conclusions : Cyanide poisoning should be considered in paediatric patients with suspicious findings, sudden loss of consciousness, increased anion gap acidosis and lactic acidosis. The history of eating the seeds of plants such as apricot and almonds should be investigated .Article Citation - WoS: 2Citation - Scopus: 2Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?(Springer, 2023) Güzel, Tuncay; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiBackground: In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥ 75 years) than in younger (< 75 years) patients. Methods: This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results: The overall sample included 1923 patients (1419 < 75 years and 504 aged ≥ 75 years). There was no difference between the groups in terms of cumulative events defined as primary outcome (3.5% vs. 4.4%, p = 0.393). Infection related to device system was significantly higher in the ≥ 75 age group (1.8% vs. 3.4%, p = 0.034). There was no significant difference between the groups in terms of clinically significant hematoma and pneumothorax (0.7% vs. 0.4%, p = 0.451, 1.4% vs. 1.0%, p = 0.477, respectively). In multivariate model analysis, no association was found between age ≥ 75 years and infection related to the device system. Conclusion: Infection rates were relatively higher in the patient group aged ≥ 75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.Article Citation - WoS: 4Citation - Scopus: 4Antibiotic Resistance and Mortality in Icu Patients: a Retrospective Analysis of First Culture Growth Results(Mdpi, 2025) Kilinc, Metin; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiObjectives: This study aimed to analyze the antibiotic resistance patterns of microorganisms isolated from intensive care unit (ICU) patients and evaluate their impact on mortality and length of ICU stay. Given the increasing prevalence of multidrug-resistant (MDR) pathogens in critically ill patients, understanding their resistance profiles is crucial for optimizing empirical antibiotic therapy and improving patient outcomes. Methods: This retrospective study included 237 ICU patients admitted between 1 July 2022, and 1 January 2024. The initial culture growth results from blood and urine samples were analyzed. Microorganism identification was performed using VITEK 2 Compact and conventional bacteriological methods, while antibiotic susceptibility testing followed CLSI 2022 and EUCAST 2022 guidelines. Results: A total of 237 ICU patients were included in this study. The most frequently isolated microorganisms were Escherichia coli (E. coli) (44.3%), Klebsiella pneumoniae (K. pneumoniae) (35.0%), and Pseudomonas aeruginosa (P. aeruginosa) (25.3%), with Acinetobacter baumannii (A. baumannii) (31.2%) being the most resistant pathogen. Among Gram-positive bacteria, methicillin-resistant Staphylococcus aureus (MRSA) (12.2%) and vancomycin-resistant enterococci (VRE) (21.5%) were the most frequently identified multidrug-resistant (MDR) pathogens. Regarding antimicrobial resistance, carbapenem resistance was highest in A. baumannii (55%), followed by P. aeruginosa (40%) and K. pneumoniae (30%). Additionally, ESBL-producing E. coli (43.2%) and K. pneumoniae (38.5%), as well as carbapenemase-producing K. pneumoniae (18.6%) and E. coli (9.2%), were identified as key resistance mechanisms impacting clinical outcomes. Patients with MDR infections had significantly longer ICU stays (p < 0.05) and higher mortality rates. The Kaplan-Meier survival analysis revealed that A. baumannii infections were associated with the highest mortality risk (HR: 4.6, p < 0.001), followed by MRSA (HR: 3.5, p = 0.005) and P. aeruginosa (HR: 2.8, p = 0.01). Among laboratory biomarkers, elevated procalcitonin (>= 2 ng/mL, OR: 2.8, p = 0.008) and CRP (>= 100 mg/L, OR: 2.2, p = 0.01) were significantly associated with ICU mortality. Additionally, patients who remained in the ICU for more than seven days had a 1.4-fold increased risk of mortality (p = 0.02), further emphasizing the impact of prolonged hospitalization on adverse outcomes. Conclusions: MDR pathogens, particularly A. baumannii, MRSA, P. aeruginosa, and K. pneumoniae, are associated with longer ICU stays and higher mortality rates. Carbapenem, cephalosporin, fluoroquinolone, and aminoglycoside resistance significantly impact clinical outcomes, emphasizing the urgent need for antimicrobial stewardship programs. ESBL, p-AmpC, and carbapenemase-producing Enterobacterales further worsen patient outcomes, highlighting the need for early infection control strategies and optimized empirical antibiotic selection. Biomarkers such as procalcitonin and CRP, alongside clinical severity scores, serve as valuable prognostic tools for ICU mortality.Article Antidepressant-Like Effects of Ashwagandha (Withania Somnifera) on Chronic Unpredictable Mild Stress-Induced Depression in Adolescent Rats(Springer, 2025) Gokdemir, Gul Sahika; Seker, Ugur; Baksi, Nazan; Baylan, Mukadder; Demirtas, Berjan; Gokdemir, Mehmet Tahir; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; Department of Basic Medical Sciences / Temel Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiRationaleAdolescent depression is often linked to biological changes associated with stress. However, new approaches and treatment strategies for early intervention and prevention of depression in children and adolescents are still limited. Ashwagandha is an Ayurvedic herb widely used in the management of anxiety and stress. However, there is no information in the current literature on its potential effect on adolescent depression.ObjectivesThis study aimed to investigate the effects of depression on proapoptotic proteins and neuroinflammation and the antidepressant effect of Ashwagandha on depression-like symptoms in adolescent rats exposed to the Chronic Unpredictable Mild Stress (CUMS) model.MethodsIn the study, CUMS model was used to induce depression in adolescent rats. Rats were treated with Ashwagandha or Sertraline. To evaluate the antidepressant effects, behavioral tests as well as biochemical and histological analyses were performed. Forced Swim Test (FST), Sucrose Test and Elevated Plus Maze Test were performed as behavioral tests. Brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were measured by the ELISA method in the fronto-parietal cortex. Proapoptotic proteins (Bax and Caspase-3) and inflammatory markers (TNF-alpha and IL-1 beta), as well as glial fibrillary acidic protein (GFAP), were evaluated immunohistochemically in the fronto-parietal cortex.ResultsProapoptotic proteins (Bax and Caspase-3) and inflammatory markers (TNF-alpha and IL-1 beta) were increased in the CUMS group. BDNF and GFAP levels were decreased. Ashwagandha treatment was more effective than Sertraline in reducing the levels of these proteins and markers. Additionally, Ashwagandha prevented weight loss.ConclusionsAshwagandha showed antidepressant-like effects in adolescent rats, reducing apoptosis, inflammation, and neuroinflammation, suggesting potential for treating adolescent depression.Article Citation - WoS: 1Citation - Scopus: 1Assessing the Prognostic Value of Halp Score in Peripheral Artery Disease: Correlation With Lesion Severity and Long-Term Mortality(Sage Publications Ltd, 2025) Evsen, Ali; Aktan, Adem; Kilic, Raif; Yalcin, Abdulaziz; Ozbek, Mehmet; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiIntroduction Peripheral artery disease (PAD) poses a growing clinical challenge due to an aging population, despite advances in treatment methods. Various scoring systems have emerged to predict high-risk patients, including the HALP (hemoglobin, albumin, lymphocyte, and platelet) score, known for predicting prognosis in cancers and stroke. This study assesses the HALP score's relation to lesion severity and long-term mortality in PAD patients. Methods We retrospectively analyzed 305 symptomatic PAD patients undergoing endovascular intervention. The following formula was used to calculate the HALP score: hemoglobin (g/L) x albumin (g/L) x lymphocyte count (/L) / platelet count (/L). Lesion severity was classified by TASC-II: TASC AB and TASC CD. Mortality data were obtained from hospital and social security records. Results The study involved 305 patients (mean age 64.4 +/- 11.8 years; 72.1% male), divided into survivors (208) and non-survivors (97). ROC analysis identified HALP score as the strongest predictor of long-term mortality (AUC: 0.736; 95% CI: 0.679-0.793; p < .001). HALP score (HR, 0.087; 95% CI, 0.025-1.300; p < .001), age (p < .001), DM (p = .007), and CRP (p = .013) independently predicted mortality. Kaplan-Meier analysis showed higher HALP scores linked to lower long-term mortality (Log-rank: 20.102, p < .001), with an average follow-up of 48 +/- 18 months. Conclusion The HALP score emerged as a robust predictor of PAD prognosis, surpassing individual components and other parameters. Lower HALP scores correlated with more severe lesions and reduced life expectancy.Article Citation - WoS: 1Citation - Scopus: 1Assessment of Iron Metabolism and Inflammation in Children With Cerebral Palsy(Mdpi, 2025) Orhan, Ozhan; Gokdemir, Gul Sahika; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; Department of Basic Medical Sciences / Temel Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiBackground/Objectives: Cerebral palsy (CP) is a motor disorder resulting from brain damage that is common in childhood. Iron is vital for the body's basic functions. Iron metabolism disorders and inflammation contribute to the neurological complications seen in CP. The purpose of this research was to ascertain the association and correlation between markers of inflammation and iron metabolism in children with CP. Methods: A total of 181 children diagnosed with CP and 111 typically developing children were retrospectively included in the study. Demographic data, blood parameters, C-reactive protein, iron, total iron binding capacity, and inflammation markers were evaluated. Results: C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and systemic immuno-inflammatory index (SII) levels of CP children were found to be statistically significantly higher than those of control group children (p < 0.05). Iron (Fe) and ferritin levels were lower in the CP group, while total iron binding capacity (TIBC) was higher. Spearman correlation analysis showed significant correlations between iron, ferritin and TIBC and SII. Conclusions: Iron deficiency and chronic inflammation are associated with the pathophysiology of CP in patients with CP, and therefore it is important to monitor markers of iron metabolism and inflammation in these patients.Article Citation - WoS: 1Citation - Scopus: 1Association Between the Triglyceride-Glucose Index and Contrast-Induced Nephropathy in Chronic Total Occlusion Patients Undergoing Percutaneous Coronary Intervention(Bmc, 2025) Soner, Serdar; Aktan, Adem; Kilic, Raif; Guzel, Hamdullah; Tastan, Ercan; Oksul, Metin; Guzel, Tuncay; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiObjective The triglyceride glucose (TyG) index is a biomarker of insulin resistance and is associated with an increased risk of cardiovascular events. Contrast-induced nephropathy (CIN) is an important complication that causes poor outcomes in patients undergoing percutaneous coronary intervention (PCI). In this study, we aimed to investigate the relationship between the TyG index and CIN and mortality in patients who underwent PCI due to chronic total coronary occlusion (CTO). Methods Two hundred eighteen individuals from three separate medical centers who underwent procedural PCI between February 2010 and April 2012 and had a CTO lesion in at least one coronary artery were recruited. According to the TyG index, patients were divided into two groups. Patients with a TyG index >= 8.65 were included in Group 1, and patients with a TyG index < 8.65 were included in Group 2. Patients were followed up for 96 months. The main outcome was the development of CIN and mortality. Results The mean age of the patients (65.8 +/- 10.94 vs. 61.68 +/- 11.4, P = 0.009), diabetes mellitus (60 [44.8%] vs. 11 [13.1%], P < 0.001), and dyslipidemia rates (52 [38.8%] vs. 21 [25%], P = 0.036) were higher in group 1. In multivariable logistic regression analysis, it was seen that age (OR = 1.04, 95% CI = 1.01-1.08, P = 0.020), chronic kidney disease (OR = 2.34, 95% CI = 1.02-5.33, P = 0.044), peripheral artery disease (OR = 5.66, 95% CI = 1.24-25.91, p = 0.026), LVEF (OR = 0.95, 95% CI = 0.92-0.99, P = 0.005), LDL cholesterol levels (OR = 1.00, 95%CI = 1.00-1.02, P = 0.024) and TyG index (OR = 2.17, 95% CI = 1.21-3.89, P = 0.009) were independent predictors of the development of CIN. Conclusion Our study demonstrates a correlation between the TyG index and the prevalence of CIN in patients with CTO undergoing PCI. Adding the TyG index to the routine clinical evaluation of patients with CTO undergoing PCI may help protect patients from the development of CIN.Article Citation - WoS: 6Citation - Scopus: 5The association of allergic rhinitis severity with neutrophil-lymphocyte and platelet-lymphocyte ratio in children(Northern Clinics of İstanbul, 2022) Cansever, Murat; Sarı, Neslihan; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiObjective: The aim of the study was to investigate the relationship between the severity of allergic rhinitis (AR) and neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in pediatric patients. Methods: This study is a retrospective, cross-sectional, and observational study including 200 AR patients and 160 healthy controls. Of the patients, 39% were boys with a mean age of 10.5 years. The study included children with persistent and intermittent AR. Of the controls, 50.6% were boys with a mean age of 10.3 years. We compared NLR and PLR from blood test between study and control groups. They were also compared according to AR severity within the patient group. Results: The NLR was 1.64±1.29 in the study group whereas 1.18±0.31 in the control group. The PLR was 102.72±31.20 in the study group whereas 79.36±11.72 in the control group. When NLR and PLR were compared between groups, we found statistically significant differences in both NLR and PLR (p=0.003, p=0.001, respectively). We found a statistically significant difference when comparing both NLR and PLR in patients with intermittent and persistent AR. These rates increased with disease severity (p=0.000, p=0.000, respectively). Conclusion: Both NLR and PLR are useful markers for the diagnosis and severity of AR. Clinicians can use these markers to assess disease severity in pediatric patients at the beginning of the diagnostic process.Article Citation - WoS: 2Citation - Scopus: 2Association of Inflammatory and Metabolic Markers With Mortality in Patients With Postoperative Femur Fractures in the Intensive Care Unit(Mdpi, 2025) Kilinc, Metin; Celik, Enes; Demir, Ibrahim; Aydemir, Semih; Akelma, Hakan; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiBackground and Objectives: Postoperative femur fracture in elderly patients is associated with high morbidity and mortality, especially in the intensive care unit (ICU). Various factors, including demographic and laboratory parameters, may influence mortality in this population. The aim of this study was to evaluate the association of inflammatory and metabolic markers with mortality in ICU patients with postoperative femur fractures and to identify key predictors to enhance risk stratification and improve patient outcomes. Materials and Methods: In this retrospective single-center study, we analyzed 121 patients aged over 65 years with postoperative femur fractures who were admitted to the ICU between January 2023 and January 2024. Demographic and clinical data, including comorbidities, Charlson Comorbidity Index (CCI), and Acute Physiology and Chronic Health Evaluation (APACHE II) score, were collected. Laboratory parameters such as white blood cell count (WBC), albumin, C-reactive protein (CRP), D-dimer, Pan-Immune-Inflammation Value (PIV), CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and others were analyzed. Linear regression, logistic regression, and Receiver Operating Characteristic (ROC) analyses were performed to determine the predictive value of these markers for ICU mortality. Results: The mean age of the patients was 76.3 +/- 9.6 years, and 52.1% were female. The most common comorbidities were hypertension (67.8%) and diabetes (49.6%). ICU mortality occurred in 24 patients (20%). Significant predictors of mortality included higher CRP (>62.8 mg/L), NLR (>10.0), PIV (>450), and APACHE II scores (>23) (p < 0.001 for all). Lower albumin levels (<2.5 g/dL) were strongly associated with increased mortality (p < 0.001). ROC analysis demonstrated that the APACHE II score had the highest predictive accuracy for mortality (AUC = 0.83), followed by albumin (AUC = 0.79) and PIV (AUC = 0.76). Extended ICU stay (>10 days) was also significantly correlated with increased mortality (p < 0.001). Conclusions: This study successfully demonstrates the utility of combining traditional clinical markers, such as APACHE II score, with novel inflammatory markers, such as PIV, CAR, and NLR, in predicting mortality in ICU patients following femur fracture surgery. The integration of emerging biomarkers with well-established scoring systems offers enhanced predictive accuracy and provides valuable insights into patient management.Article Citation - WoS: 15Citation - Scopus: 13Clinical features of generalized lipodystrophy in Turkey: a cohort analysis(Wiley Online Library, 2023) Özbek, Mehmet Nuri; Yildirim Simsir, Ilgin; Tuysuz, Beyhan; Tanrikulu, Seher; Celik Guler, Merve; Akinci, Baris; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiAim: To describe the Turkish generalized lipodystrophy (GL) cohort with the frequency of each complication and the death rate during the period of the follow-up. Methods: This study reports on 72 patients with GL (47 families) registered at different centres in Turkey that cover all regions of the country. The mean ± SD follow-up was 86 ± 78 months. Results: The Kaplan-Meier estimate of the median time to diagnosis of diabetes and/or prediabetes was 16 years. Hyperglycaemia was not controlled in 37 of 45 patients (82.2%) with diabetes. Hypertriglyceridaemia developed in 65 patients (90.3%). The Kaplan-Meier estimate of the median time to diagnosis of hypertriglyceridaemia was 14 years. Hypertriglyceridaemia was severe (≥ 500 mg/dl) in 38 patients (52.8%). Seven (9.7%) patients suffered from pancreatitis. The Kaplan-Meier estimate of the median time to diagnosis of hepatic steatosis was 15 years. Liver disease progressed to cirrhosis in nine patients (12.5%). Liver disease was more severe in congenital lipodystrophy type 2 (CGL2). Proteinuric chronic kidney disease (CKD) developed in 32 patients (44.4%) and cardiac disease in 23 patients (31.9%). Kaplan-Meier estimates of the median time to diagnosis of CKD and cardiac disease were 25 and 45 years, respectively. Females appeared to have a more severe metabolic disease, with an earlier onset of metabolic abnormalities. Ten patients died during the follow-up period. Causes of death were end-stage renal disease, sepsis (because of recurrent intestinal perforations, coronavirus disease, diabetic foot infection and following coronary artery bypass graft surgery), myocardial infarction, heart failure because of dilated cardiomyopathy, stroke, liver complications and angiosarcoma. Conclusions: Standard treatment approaches have only a limited impact and do not prevent the development of severe metabolic abnormalities and early onset of organ complications in GL.Article Comparison of Different Fixatives Effects in Histochemical Stainings of Peripheral Nerve Tissue(Cellular and Molecular Biology Association, 2024) Dörtbudak, M.B.; Demircioğlu, M.; Şeker, U.; Demircioğlu, İ.; Department of Basic Medical Sciences / Temel Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiA pathological condition in the peripheral nerve tissue, which provides the connection between the organism and the external environment, negatively affects the standard of living. The nerve tissue histotechnology is of serious importance both for scientific studies and for clinical diagnosis. The fixation, which is one of the leading procedures for histological examination of tissues, aims to preserve tissue morphology. Another essential part of the histological examination is staining process. This study, it was aimed to determine the fixative that provides optimal histological appearance in peripheral nerve tissue. Therefore, various histochemical stainings of tissues fixed with some fixatives used in practice were compared. Sciatic nerves from each rat (n=7) used in the study were fixed with different fixatives and histochemical staining was performed. In histological examination, cellular (nucleus-cytoplasm) and intercellular morphological details, staining intensity and distribution were evaluated. At the end of the study, formaldehyde was found to be the most ideal fixing agent for all stains. Although Bouin and Carnoy fixatives differed according to the staining type, their fixation quality was similar in general. Glutaraldehyde did not give as good results as other fixatives in all stainings. This study is an important technical reference for clinical and experimental studies. © 2024 Cellular and Molecular Biology Association. All rights reserved.Article Comparison of Orexigenic and Anorexigenic Neuropeptide Levels in Hyperemesis Gravidarum Patients With Normal Pregnant Women: a Prospective Cohort Study(Lippincott Williams & Wilkins, 2024) Yilmaz, Mehmet; Aksin, Serif; Balsak, Deniz; Aboalhasan, Yasmin; Batmaz, Ibrahim; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiBackground: The aim of this study was to determine whether orexigenic neuropeptides, orexin and galanin, and anorexigenic neuropeptides, alpha-melanocyte-stimulating hormone (alpha-MSH) and cocaine- and amphetamine-regulated transcript (CART), are implicated in hyperemesis gravidarum (HG). Methods: Fifty pregnant women who had been diagnosed with HG between April 2022 and February 2023 at the Siirt University Faculty of Medicine Training and Research Hospital (tertiary center) were recruited for this study. An equal number of pregnant women without an HG diagnosis were included in the study as the control group. Participants' age, pregnancy history, medical history, thyroid function test results, complete blood count results, and electrolyte levels were recorded, and their orexin, galanin, alpha-MSH, and CART serum levels were analyzed using an enzyme-linked immunosorbent assay. Results: No statistically significant differences in orexigenic neuropeptides (orexin and galanin) were observed between the HG and control groups. A statistical difference was found between an anorexigenic neuropeptide (alpha-MSH) and the control group (P = .012). Based on a receiver operating characteristic analysis, the alpha-MSH parameter was statistically significant for distinguishing between participants with an HG diagnosis and those without, with a sensitivity of 63.6%, specificity of 65.9%, and cutoff value of 11769.3 pg/mL (P = .012, area under curve: 0.655). Based on the severity classification of ketonuria (ketonuria levels of +1 or +2 were classified as mild, whereas levels of +3 or +4 were classified as moderate to severe), the anorexigenic CART neuropeptide was found to be a statistically significant diagnostic indicator of severe ketonuria (P = .020). Conclusion: alpha-MSH and CART levels were found to be related in HG patients and in HG patients with severe ketonuria.Article Citation - WoS: 1Citation - Scopus: 1Comparison of Pde-5 Inhibitors Used in Erectile Dysfunction With Some Candidate Molecules: a Study Involving Molecular Docking, Admet, Dft, Biological Target, and Activity(Bmc, 2025) Sagir, Suleyman; Unsal, Velid; Oner, Erkan; Yildiz, Resit; Mert, Basak Dogru; 09.03. Department of Nutrition and Dietetics/ Beslenme ve Diyetetik Bölümü; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 9. Faculty of Health Sciences / Sağlık Bilimleri Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiErectile dysfunction (ED) is a urological condition defined as the inability of a man to achieve or maintain an erection. This condition negatively affects his sexual performance and the performance of his partner. Phosphodiesterase type 5 (PDE5) inhibitors are commonly used to treat ED. Arginase II plays an important role in regulating L-arginine to NO synthase in the smooth muscle of the human corpus cavernosum of the penis. NO is a molecule essential for regulating a variety of functions, including arterial blood pressure, penile erection, and energy balance. Substances such as vardenafil, alprostadil, papaverine, and resveratrol increase NO production, thereby supporting sexual function and vascular health. Additionally, NO donors such as L-arginine, L-citrulline, and alpha-lipoic acid provide effective alternatives when used in combination with PDE5 inhibitors. Medications used in the treatment of ED include vardenafil, alprostadil, and papaverine. In addition, although molecules such as L-arginine, citrulline, resveratrol, alpha-lipoic acid, and rutin are thought to play a role in ED, their pharmacological and molecular effects have not been sufficiently elucidated. The aim of this study was to investigate the effects of these molecules in the treatment of ED by computer-based calculations, to obtain new information about them and to inspire new treatment strategies for ED. The physicochemical, molecular and pharmacokinetic properties of the compounds were determined by SwissADME software, and ADMET (absorption, distribution, metabolism, excretion and toxicity) data were determined by ADMETlab 3.0 software. Biological target and activity data were obtained by MolPredictX and PASS Online software. While the Gaussian 09 program was used for DFT calculations, PyMOL, AutodockTools 4.2.6, AutoDock Vina, and Biovia Discovery programs were used for molecular docking studies. It was found that L-arginine, citrulline, resveratrol and alpha-lipoic acid were well absorbed from the intestine, while rutin showed limited absorption. When their metabolic risks were evaluated, L-arginine and citrulline were found to have lower toxicity. Molecular docking results of rutin and resveratrol were remarkable. The electronic properties of the compounds were explained by DFT calculations. L-arginine and citrulline were found to have low toxicity and positive therapeutic effects. L-arginine and citrulline stand out as promising candidates for future research. Although resveratrol data are promising, unfortunately their potential toxicity and metabolic interactions require further investigation. It is important to learn more about these compounds or conduct research to improve their therapeutic efficacy. Although computer-based calculations play an important role in toxicity predictions, drug interactions, pharmacokinetics and toxicity properties should be carefully evaluated.Article Confounding Factors in the Tear Break-Up Time Test. Influence of Sequential Measurements(Taylor & Francis Ltd, 2025) Acet, Yakup; Dag, Yasar; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiClinical relevance The tear break-up time (BUT) test is important in diagnosing and monitoring tear film stability, and understanding potential changes in tear film dynamics during repeated measurements could improve the accuracy and reliability of the test in clinical practice. Background The study aimed to examine the changes in BUT value caused by subsequent measurements made in BUT test. Methods A total of 120 female participants were divided into groups (30 individuals each). Participants were divided into four groups based on the interval between two non-invasive tear break-up time (NI-BUT) tests: Group 1 (1-minute interval), Group 5 (5-minute interval), Group 10 (10-minute interval), and Group 15 (15-minute interval). The first NI-BUT test was called Initial NI-BUT (NI-BUT(I)), and the second test was called Subsequent NI-BUT (NI-BUT(S)). The first BUTvalue (BUT1st), the second BUT value (BUT2nd), the third BUT value (BUT3rd), the fourth BUT value (BUT4th), the fifth BUT value (BUT5th), and the average value of the first three BUTs (BUTA3) were compared between the NI-BUT(1) and NI-BUT(S) tests. Results Participant ages ranged from 18 to 36 years, with a mean of 25.1 +/- 3.2 years. The mean values of BUT1st, BUT2(nd), BUT3(rd), BUT4(th), BUT5(th), and BUTA3 in the NI-BUT(I) test were statistically significantly shorter than those in the NI-BUT(S) test for all groups (p < 0.05). The changes in the parameters were statistically significantly greater in Group 1 compared to the other groups (p < 0.05). Conclusions Subsequent measurements cause increased BUT values. The longer the interval between two measurements, the smaller the differences between the subsequent measurements. When performing the BUT test, a single measurement should be preferred if possible. If the clinician finds the results of a single measurement unsatisfactory and wishes to consider the average of multiple measurements, the interval between tests should be longer than 15 minutes.Article Citation - WoS: 1Citation - Scopus: 1The distribution and the antimicrobial susceptibility features of microorganisms isolated from the burn wounds; a ten-year retrospective analysis(Oxford University Press, 2023) Özkaçmaz, Ayşe; Dicle, Yalçın; Bayram, Yasemin; Parlak, Mehmet; Akış, Feride; Çallı, İskan; Department of Basic Medical Sciences / Temel Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiIn this study we aimed to evaluate the distribution features and antimicrobial susceptibility test results of the microorganisms isolated from the wounds of pediatric and adult burn patients. The culture and susceptibility test results of the microorganisms isolated from the wound swabs of the patients hospitalised in a tertiary burn care center in 10-years period, were retrospectively screened on the microbiology department databases. Their distribution of isolated microorganisms regarding species and susceptibility test results were compared with previous studies. A total of 367 microorganisms isolated from the burn wounds of 293 patients (13± 18.9 years, F/M: 0.93) (73 adult and 220 pediatric patients), were included in this study. A solitary agent was isolated in 239 (81.6%) patients, while two were isolated in 43 (14.7%) and three or more agents in 11 (3.8%). From these, 33% of the isolated microorganisms were gram positive cocci, 61% were gram negative bacteria and 6% were Candida spp. The most common isolated microorganisms were Staphylococcus aureus (18.5%), Pseudomonas spp. (16.9) and Escherichia coli (%11.2), while the least common was Streptococcus spp. (2.5%). Methicillin resistance was 15% among the S. aureus strains. No resistance was observed against levofloxacin, vancomycin, teicoplanin, linezolid, daptomycin, fusidic acid and tigecycline in S. aureus strains. The highest resistance rates were observed against levofloxacin (64%), tobramycin (64%), pip/tazobactam (63%), imipenem (63%), and the lowest against colistin (5%) and ceftazidime (29%), among Pseudomonas spp. The most common causative agents in burn wound infections and their current antimicrobial susceptibility features should be well identified, in order for prevention of serious complications and optimal management the condition to occur.Article Citation - WoS: 4Citation - Scopus: 3Early puberty paradox: an investigation of anxiety levels of mothers and children, children's quality of life, and psychiatric diagnoses(SpringerLink, 2023) Kardaş, Burcu; Kardaş, Ömer; Demiral, Meliha; Özbek, Mehmet Nuri; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiEarly puberty signs lead to an increase in anxiety levels of parents and children. The aim of this study was to investigate the quality of life and anxiety levels of girls and their mothers who were admitted to a pediatric endocrinology clinic with concerns about early puberty. Girls and their mothers who were admitted to endocrinology outpatient clinic with concerns about early puberty were compared to healthy control group. Screen for Child Anxiety Related Emotional Disorders (SCARED) parent form, Quality of Life for Children Scale (PedsQL) parent form, and Beck Anxiety Inventory (BAI) were administered to the mothers. Children were evaluated with the Schedule for Afective Disorders and Schizophrenia for School-Age Children (Kiddie-SADS Lifetime Version) (K-SADS-PL). The study sample consisted of 92 girls and 62 of them were administered to clinic with concerns about early puberty. There were 30 girls in early puberty group (group 1), 32 girls were in the normal development group (group 2), and 30 were in the healthy control group (group 3). The anxiety level of group 1 and group 2 was signifcantly higher, and their quality of life was signifcantly lower when compared to group 3 (p<0.001). Mother’s anxiety level was found signifcantly higher in group 2 (p<0.001). It has shown that anxiety level and quality of life of children were associated with anxiety level of mothers and the current Tanner stage (r=0.302, p<0.005). Conclusion: Mothers and children who have concerns about early puberty are negatively afected when early puberty is a possibility. For this reason, educating parents will prevent negative impacts of this situation on children. At the same time, it will decrease health burden.Article Citation - WoS: 1Citation - Scopus: 1The effect of body mass index on complications in cardiac implantable electronic device surgery(WILEY, 2023) Güzel, Tuncay; Demir, Muhammed; Aktan, Adem; Kılıç, Raif; Arslan, Bayram; Günlü, Serhat; Altıntaş, Bernas; Karahan, Mehmet Zülkif; Özbek, Mehmet; Aslan, Burhan; Arpa, Abdulkadir; Coşkun, Mehmet Sait; Altunbaş, Mahsum; Tüzün, Rohat; Akgümüş, Alkame; Karadeniz, Muhammed; Aydın, Saadet; Güzel, Hamdullah; Aslan, Selen Filiz; Söner, Serdar; Taş, Ahmet; Ertaş, Faruk; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiBackground: Cardiac implantable electronic device (CIED) procedures are prone to complications. In our study, we investigated the effect of body mass index (BMI) on CIED-related complications. Methods: 1676 patients who had undergone CIED surgery (de novo implantation, system upgrade, generator change, pocket revision or lead replacement) at two heart centers in Turkey and met the study criteria were included in our study. For analysis of primary and secondary endpoints, patients were classified as non-obese (BMI < 25 kg/m2), overweight (25 ≤ BMI < 30 kg/m2), and obese (BMI ≥ 30 kg/m2). The primary endpoint was accepted as cumulative events, including the composite ofclinically significant hematoma (CSH), pericardial effusion or tamponade, pneumoth- orax, and infection related to the device system. Secondary outcomes included each component of cumulative events. Results: The rate of cumulative events, defined as primary outcome, was higher in the obese patient group, and we found a significant difference between the groups (3.0%, 4.3%, 8.9%, p = .001). CSH and pneumothorax rates were significantly higher in the obese patient group (0.3%, 0.9%, 1.9%, p = .04; 1.0%, 1.4%, 3.3%, p = .04, respectively). According to our multivariate model analysis; gender (OR:1.882, 95%CI:1.156–3.064, p = .01), hypertension (OR:4.768, 95%CI:2.470–9.204, p < .001), BMI (OR:1.069, 95%CI:1.012–1.129, p = .01) were independent predictors of cumulative events rates. Conclusions: Periprocedural complications associated with CIED (especially hematoma and pneumothorax) are more common in the group with high BMI.Article Citation - Scopus: 7The effect of coronary slow flow on ventricular repolarization parameters(ScienceDirect, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Güzel, Tuncay; Günlü, Serhat; Kılıç, Raif; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiIntroduction: Ischemia due to microvascular dysfunction may be responsible for the heterogeneity of ventricular repolarization in coronary slow flow. To our knowledge, there is no study in which QT interval, Tp-Te interval, index of cardiac-electrophysiological balance (iCEB), and frontal QRS-T angle were evaluated together in patients with CSF. In this study, we examined for the first time the relationship between all these myocardial repolarization parameters and CSF. Materials and methods: The study group included 178 patients (99 female, mean age: 50.6 ± 8.6 years) with isolated CSF without stenotic lesions and with angiographically proven normal coronary arteries. The control group included 120 patients (71 female, mean age: 49.3 ± 9.4 years) with normal coronary angiography. QRS duration, QT interval, QTc interval, Tp-Te interval, Tp-Te/QT, Tp- Te/QTc, iCEB score, and frontal QRS-T angle were calculated from 12‑lead ECGs. Results: There was no significant difference in demographic parameters between the two groups. Compared with the control group, patients with CSF had significantly longer QTmax duration, QT dispersion, Tp-Te interval, and higher iCEB score, wider frontal QRS-T angle. Conclusion: In our study, we found that many of the ventricular repolarization parameters were adversely affected in patients with CSF. Impaired parameters may be associated with the risk of malignant ventricular arrhythmias.Article Citation - WoS: 4Citation - Scopus: 6The Effectiveness of Halp Score in Predicting Mortality in Non-St Myocardial Infarction Patients(Lippincott Williams & Wilkins, 2025) Kilic, Raif; Guzel, Tuncay; Aktan, Adem; Guzel, Hamdullah; Kaya, Ahmet Ferhat; Cankaya, Yusuf; Department of Internal Medical Sciences / Dahili Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiBackground:The HALP score, measured based on hemoglobin, albumin, lymphocyte, and platelet levels, is regarded as a novel scoring system that indicates the status of systemic inflammation and nutritional health. Our study aimed to evaluate the relationship between HALP score and prognosis in non-ST-elevation myocardial infarction (NSTEMI) patients. Methods Between 1 January 2020 and 1 January 2022, 568 consecutive patients diagnosed with NSTEMI from a single center were included in the study retrospectively. The patients were divided into two equal groups according to the median HALP cutoff value of 44.05. Patients were followed for at least 1 year from the date of admission. Results The average age of the patients was 62.3 +/- 10.6 years and 43.7% were female. In-hospital and 1-year mortality were found to be significantly higher in the group with low HALP scores (6.0 vs. 2.1%, P = 0.019 and 22.5 vs. 9.9%, P < 0.001, respectively). In receiver operating characteristic curve analysis, a cutoff level of 34.6 of the HALP score predicted 1-year mortality with 71% sensitivity and 65% specificity (area under the curve: 0.707, 95% confidence interval: 0.651-0.762, P < 0.001). In Kaplan-Meier analysis, higher mortality rates were observed over time in the group with lower HALP scores (log-rank test=16.767, P < 0.001). In Cox regression analysis, the HALP score was found to be an independent predictor of 1-year mortality (odds ratio: 0.969, 95% confidence interval: 0.958-0.981, P < 0.001). Conclusion We found that a low HALP score could predict in-hospital and 1-year mortality in patients admitted to the hospital with a diagnosis of NSTEMI.Article Citation - WoS: 3Citation - Scopus: 3Elevated Urotensin-Ii and Tgf-Β Levels in Copd: Biomarkers of Fibrosis and Airway Remodeling in Smokers(Mdpi, 2024) Kilinc, Metin; Demir, Ibrahim; Aydemir, Semih; Gul, Rauf; Dokuyucu, Recep; Department of Surgical Medical Sciences / Cerrahi Tıp Bilimleri Bölümü; 10. Faculty of Medicine / Tıp Fakültesi; 01. Mardin Artuklu University / Mardin Artuklu ÜniversitesiBackground and Objectives: Small airway fibrosis plays a critical role in the progression of chronic obstructive pulmonary disease (COPD). Previous research has suggested that Urotensin-II (U-II) and transforming growth factor-beta (TGF-beta) may contribute to pathological fibrosis in various organs, including the cardiovascular system, lungs, and liver. However, their specific relationship with airway fibrosis in COPD has not yet been thoroughly investigated. This study aims to evaluate the concentrations of U-II and TGF-beta in individuals with COPD, as well as in healthy smokers and non-smokers, to explore their potential roles in COPD-related fibrosis. Materials and Methods: The study included three distinct groups: a healthy non-smoker control group (n = 98), a healthy smoker group (n = 78), and a COPD group (n = 80). All participants in the COPD group had a smoking history of at least 10 pack-years. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, with only patients classified as GOLD stage 2 or higher being included in the study. Urotensin-II (U-II) and transforming growth factor-beta (TGF-beta) levels were measured using a commercially available ELISA kit. Results: COPD patients had a significantly lower FEV1 (58 +/- 15.4%) compared to smokers (79 +/- 4.5%) and non-smokers (92 +/- 3.7%) (p < 0.001). Similarly, COPD patients had a lower FEV1/FVC ratio (55 +/- 9.4%) compared to smokers (72 +/- 4.2%) and non-smokers (85 +/- 3.6%) (p < 0.01 and p < 0.05, respectively). SaO(2) was significantly lower in COPD patients (87%) compared to smokers (96.5%) and non-smokers (98%) (COPD vs. smokers: p < 0.05 and smokers vs. non-smokers: p > 0.05). U-II levels were significantly higher in COPD patients (175.10 +/- 62.40 pg/mL) compared to smokers (118.50 +/- 45.51 pg/mL) and non-smokers (85.29 +/- 35.87 pg/mL) (p < 0.001 and p < 0.05, respectively). COPD patients also had significantly higher levels of TGF-beta (284.60 +/- 60.50 pg/mL) compared to smokers (160.00 +/- 41.80 pg/mL) and non-smokers (92.00 +/- 25.00 pg/mL) (p < 0.001 and p < 0.05, respectively). Conclusions: Our study supports the growing body of evidence that U-II and TGF-beta play central roles in the development and progression of fibrosis in COPD. The negative correlation between these markers and lung function parameters such as FEV1 and FEV1/FVC indicates that they may be key drivers of airway remodeling and obstruction. These biomarkers could serve as early indicators of fibrotic changes in smokers, even before the onset of COPD.