Tıp Fakültesi

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Ameloriate Effect of Glucose Monohydrate on Nicotine Sulfate-Induced Toxicity and Teratogenicity in Xenopus Embryos: an Experimental Study
(Middle Pomeranian Sci Soc Env Prot, 2023) Emre, Mustafa; Tunc, Erdal; Sertdemir, Yasar; Pekmezekmek, Ayper Boga
It is well documented that nicotine causes low birth weight, preterm birth, pregnancy difficulties, lower fertility, inhibition of spermatogenesis, and decreased steroidogenesis and potassium channels conductance of Xenopus oocytes. Lung cancer is the most well-known adverse impact of nicotine. This work used a 96-hour FETAX test to examine how concurrent administration of glucose monohydrate modifies the effects of exposure to nicotine, nicotine sulfate, and/or glucose on ion channels and membrane potential in Xenopus leavis embryos at an early stage of development. In-vitro fertilised embryos were treated with nicotine and glucose alone or in combination for this aim, and the effects of those treatments were then assessed for potential teratogenic effects. At the conclusion of the FETAX technique, the ratios of healthy, abnormal, and dead embryos were calculated, and the length of embryos in each treatment group was assessed. The ratios of abnormal and dead embryos were considerably higher with nicotine treatment alone compared to controls. Compared to the results of the nicotine-alone treatment group, the ratio of aberrant embryos was marginally reduced by concurrent glucose and nicotine therapy. In contrast, the ratio of normal embryos was raised. Additionally, treatments with glucose, nicotine, and Nic+Glu significantly altered the resting membrane potentials of fertilised oocytes (p < 0.001). Our findings indicated that the simultaneous treatment groups that also received glucose had a protective impact on embryos. Such structured, more sophisticated research is required to confirm these findings.
Could the Umbilical Cord Suggest the Method of Anesthesia?
(Galenos Publishing House, 2023)
Objective: We aimed to investigate changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), creatine kinase-myocardial band (CK-MB), and troponin I levels, which were biochemical parameters that gave an idea regarding clinical conditions such as tissue damage and asphyxia, according to the anesthesia type, to compare their levels in mothers who gave birth with normal spontaneous vaginal delivery (NSVD) and to investigate whether the type of anesthesia applied caused a change in biochemical parameters. Methods: Of the 90 patients included in the present study, 30 (33.3%) underwent general anesthesia, while 30 (33.3%) underwent spinal anesthesia, and 30 (33.3%) gave birth with NSVD. AST, ALT, LDH, CK-MB, and troponin I levels were measured in all pregnant women before they were taken to the operating room or delivery room. After the baby was delivered, a blood sample was taken from the umblical artery to measure AST, ALT, LDH, CKMB, and troponin I levels. The APGAR scores, the need for oxygen, positive pressure ventilation, and intubation after delivery of the newborns were recorded. Results: Statistically significant increases were found in AST, ALT, LDH, and troponin I levels in umblical artery in all groups when compared with their levels in pregnant women before delivery. Conclusion: An increase in umbilical artery CK-MB and ALT levels was observed in the NSVD group. Due to the increase in umbilical artery CK-MB and ALT levels in the NSVD group, it was found that it was not appropriate to evaluate the effects of anesthesia on the newborn with these markers
Citation - Scopus: 7
The effect of coronary slow flow on ventricular repolarization parameters
(ScienceDirect, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Güzel, Tuncay; Günlü, Serhat; Kılıç, Raif
Introduction: 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.
The effect of coronary slow flow on ventricular repolarization parameters
(ELSEVIER, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Güzel, Tuncay; Günlü, Serhat; Kılıç, Raif
Introduction: 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.
EFFECT OF METFORMIN ON MUSCLE ATROPHY IN EXPERIMENTAL DIABETIC RATS
(2023) Gökdemir.Gül Şahika; Keşim, Dilek Aygül; Gökdemir, Mehmet Tahir; Baylan,Mukadder
Background: Although first-line biguanide metformin is frequently administered to T2DM patients, the effects of long-term use on muscle are unknown. This study aimed to examine the effect of metformin-treated diabetes on muscle atrophy in experimental diabetic rats. Materials and methods: Twenty-one Wistar albino male rats in 3 groups were included in our research. Insulin resistance HOMA-IR, mTOR, and Myostatin levels and gastrocnemius weight were measured. Results: Myostatin level was significantly higher in the non-medicated diabetes group than in the healthy control group (p<0.001). Moreover, myostatin level was significantly lower in the metformin group (p=0.001). The weight of gastrocnemius was significantly lower in both the metformin-treated and non-metformin-treated diabetic groups compared to the control group (p<0.001 for both groups). Moreover, the gastrocnemius weight was significantly higher in the metformin group than in the non-medicated group (p=0.004). The HOME-IR level had a significantly negative correlation with the mTOR level (R=-0.783; P<0.001) and a positive correlation with the myostatin level (R=0.622; P=0.003). Conclusion: Our evidence and data support that metformin may be effective in preventing muscle wasting. To conclude, this study showed that metformin has anti-atrophic effects on muscles in diabetes and that metformin can prevent muscle mass loss.
Citation - WoS: 1
Citation - Scopus: 1
Effectiveness of Valproic Acid in the Treatment of Sydenham's Chorea and a Literature Review
(Sage Publications inc, 2024) Ozgun, Nezir; Akdeniz, Osman
There is still no evidence-based guideline and consensus on the treatment Sydenham's Chorea (SC). The first-line medication preference of specialists depends on personal experience and is variable. In this study, we evaluate the treatment results of pediatric patients who were treated with valproic acid (VPA). The medical records of 17 patients diagnosed with SC were reviewed retrospectively. The mean time to clinical improvement was found as approximately 5 days, the mean duration of remission as 13.60 & PLUSMN; 3.94 weeks and the mean duration of medication use was found as 17.96 & PLUSMN; 3.81 weeks. No side effects were observed in any of the patients and relapse occurred in 2 patients. A positive correlation was found between the initial C-reactive protein (CRP) level and the duration of medication use. Until evidence-based guidelines are established, VPA can be used as an effective, safe, and inexpensive first-line treatment option, especially in pediatric patients.
Citation - Scopus: 1
Investigation of the effect of comorbid psychopathologies on glycemic control in children and adolescents with type 1 diabetes mellitus
(Turkish J Clinical Psychiatry, 2022) Kardaş, Burcu; Kardaş, Ömer; Demiral, Meliha; Özbek, Mehmet Nuri
Objective: The presence of comorbid psychiatric conditions in chronic diseases makes the management of the disease difficult. Our study, we aimed to examine the relationship between psychiatric comorbid conditions and glycemic control in children and adolescents with Type 1 Diabetes. Method: In our study, depending on the number of patients, good and moderate controls were evaluated as a single group, and HbA1c levels of 8.5 and below were included in this group. Children for Depression Inventory (CDI), Screen for Child Anxiety-Related Emotional Disorders (SCARED), Turgay Child and Adolescent Behavioral Disorders Based on DSM-IV Screening and Evaluation Scale were applied. The case and parents were evaluated with K-SADS-PL.Among 778 diabetic patients who were followed up in the pediatric endocrinology clinic, 73 cases between the ages of 8 and 17 who were followed up regularly, who did not have any comorbidities and who accepted to participate in the study were evaluated psychiatrically. Results: Of the 73 cases included in the study, 29 were accepted as the patients with good glycemic control (HbA1c <= 8.5 mg / dl), and 44 as with poor glycemic control (HbA1c>8.5mg / dl). In cases with poor glycemic control, parents' education level and income level were significantly lower, while the rate of attention deficit and hyperactivity disorder, major depressive disorder, social anxiety disorder and psychopathology was significantly higher. Discussion: The findings of this study revealed that there are many factors affecting glycemic control and there is a strong relationship between glycemic control and psychopathologies.
Methemoglobinemia and acute ıntravascular hemolysis after naphthalene poisoning in a pediatric patient
(SciELO Argentina, 2023) Orhan, Özhan; Talay, Mehmet Nur
Poisoning by naphthalene is uncommon in children. It is a type of poisoning brought on by ingesting, inhaling, or coming into touch with naphthalene-containing substances on the skin. Patients typically present with an initial onset of dark brown urine, watery diarrhea, and bile vomit. The signs include fever, tachycardia, hypotension, and low pulse oximetry readings even with oxygen support. Hemolytic anemia, methemoglobinemia, renal failure, and hyperbilirubinemia are all detected in blood tests. Erythrocyte transfusion, ascorbic acid, methylene blue, and N-acetylcysteine (NAC) therapies are provided to inpatients in addition to symptomatic treatment. We present a 23-month-old male patient who developed methemoglobinemia and acute ıntravascular hemolysis, who was followed up in the intensive care unit for five days due to naphthalene intoxication. Although naphthalene poisoning is very rare, it should be known that it has fatal consequences, and more care should be taken in its use and sale
Our Treatment Experience in Poisoning With Calcium Channel Blockers: a Series of Twelve Cases
(Briefland, 2024) Talay, Mehmet Nur; Orhan, Ozhan; Ozbek, Mehmet Nuri; Kangin, Murat; Turanli, Ese Eda
Background: Intoxications with cardiovascular system drugs constitute a small percentage of all poisoning cases. Calcium Channel Blockers (CCBs) are the most common drug poisoning in this group. Objectives: We aimed to evaluate the effectiveness of treatments for CCB poisoning and add to the current body of literature by outlining the clinical treatments we employ for bradyarrhythmia, hypotension, and resistant vasodilation resulting from CCB poisoning, as well as sharing our clinical insights in this field. Methods: Twelve patients, ranging in age from 1 month to 18 years, were admitted to the Tertiary Paediatric Intensive Care Unit (PICU) for treatment of medication poisoning related to the CCB group. Patients who ingested several drugs that caused CCB were not allowed to participate in the trial. Results: Twelve patients were followed up in the PICU due to poisoning with CCB group drugs. Of the patients, 7 were male and 5 were female. Five of the patients had taken CCB medication with the purpose of committing suicide, and 7 of them accidentally. All of the patients who received CCB to commit suicide had taken verapamil. Five patients whose hypotension and bradycardia continued were administered inotropes. In addition to PI, calcium gluconate, intravenous lipid, glucagon, insulin, bicarbonate, and methylene blue were given as therapy to our symptomatic patients. Plasmapheresis was applied to a patient who was hospitalized in the PICU due to a sudden loss of consciousness. Conclusions: In the management of patients with CCB poisoning, the use of hyperinsulinemia euglycemia, intravenous lipid emulsion treatment, glucagon treatments, and treatments including methylene blue and extracorporeal life support should be considered in cases of resistant hypotension, bradycardia, and coma in the early period.
Citation - WoS: 1
Citation - Scopus: 1
Oxidative Stress Enzyme NOX1 Is a New and Important Biomarker for Childhood Appendicitis?
(SpringerLink, 2023) Avcı, Veli; Ayengin, Kemal; Huyut, Zubeyir; Huyut, Mehmet Tahir; Soysal, Lokman; Bilici, Salim
Delayed appendicitis diagnosis may result in perforation and an increased risk of mortality. This study aimed to assess the diagnostic value of ischemia-modifed albumin, nicotinamide adenine dinucleotide phosphate oxidase 1, 2, and 4 levels in the diagnosis of non-complicated and complicated appendicitis. The study included 60 pediatric patients who presented to our clinic with a complaint of abdominal pain and underwent surgery with a diagnosis of appendicitis between November 2020 and December 2021 and also included 30 controls. Cases were divided into three groups: (i) non-complicated appendicitis (n = 30), (ii) complicated appendicitis (n = 30), and (iii) control (n = 30). The nicotinamide adenine dinucleotide phosphate oxidase 1 and 4 and ischemia-modifed albumin levels were higher in non-complicated and complicated appendicitis compared to the control (p < 0.001). In addition, considering the odds ratio values, the most efective biomarkers in the diagnosis were nicotinamide adenine dinucleotide phosphate oxidase 1 and 2, and procalcitonin, while the most efective biomarkers in the prognosis were nicotinamide adenine dinucleotide phosphate oxidase 1 and 2, and neotrophil/lymphocyte ratios. The data suggested that since the most successful biomarker nicotinamide adenine dinucleotide phosphate oxidase 1, with a value of 0.98- area under the curve, is the most successful biomarker in both diagnosis and prognosis of the disease, it can be used as an important biomarker in childhood appendicitis.
Citation - WoS: 7
Citation - Scopus: 5
Sağlam çocuk polikliniğine başvuran 0-1 yaş bebeği olan annelerde depresyon taraması ve depresyonda etkili risk faktörlerini belirleme
(2012) Battaloğlu İnanç, Betül; Aydemir, Nurcihan; Hatipoğlu, Sami
Sağlam çocuk polikliniğine başvuran 0-1 yaş bebeği olan annelerde Edinburgh Postnatal Depresyon Skalası (EPDS) ölçeğini kullanarak, depresyon oranlarını saptamayı ve etkili olan sosyodemografik faktörleri belirleyerek, elde edilen sonuçların diğer çalışmalarla korelasyonunu değerlendirmeyi amaçladık. Gereç ve Yöntem: 20 Temmuz- 20 Eylül 2007 tarihleri arasında, 0-1 yaş arası bebeği olan anneler çalışmaya dâhil edildi. 211 anne çalışmaya katıldı, postpartum sosyodemografik veri formu ile EPDS kullanıldı. Çalışmaya katılmayı kabul etmeyen 28 annenin, 7’sinde EPDS puanlaması depresyon için anlamlı değerlerde idi. Toplam 183 annenin verileri değerlendirmeye alındı. Annelerin sosyodemografik özelliklerini belirlemek için toplam 51 sorudan oluşan postpartum sosyodemografik veri formu kullanıldı. Depresyon yaygınlığını saptamak amacıyla annelere 10 sorudan oluşan EPDS ölçeği uygulandı. Değerlendirme 30 puan üzerinden yapıldı ve kesme puanı 13 ve üzeri ( ?13) olarak alındı. Bulgular: EPDS kesme puanı ?13 alınarak hesaplanan depresyon semptomatoloji skoru %30.6’dır. Çalışmaya katılan kadınların yaş ortalaması 27.5±5.45, yaş dağılımı 18 ile 43 arasında değişmektedir. EPDS puanı yüksek olanlarda evlilikten memnuniyet düzeyinin iyi olma oranı anlamlı düzeyde düşük; evlilikten memnuniyetleri orta ve kötü düzeyde olanlarda, psikiyatrik özgeçmişi olan annelerde ise EPDS puanları anlamlı düzeyde yüksek olarak saptanmıştır (p<0.01). Eşi çalışmayan, planlanmamış gebeliği olan, doğumda annede sağlık sorunu olan,gece doğum yapan annelerde EPDS puanlaması yüksek olarak görülmektedir (p<0.05). Bebekte sağlık sorunu olduğunu belirten, bebek bakımını güç olarak tarifleyenlerde, bebeğini emzirmeyen kadınlarda EPDS puanlaması istatistiksel olarak anlamlı düzeyde yüksek olarak saptanmıştır (p<0.01). Sonuç: Doğum sonrası depresyon birçok anneyi ve bebeği olumsuz etkileyen ciddi bir sorundur. Etkin bir tedavinin mümkün olmasına rağmen, olguların yarısından azı fark edilebilmektedir. Kitlelerin taranması, antenatal dönem, doğum sonrası erken dönem ve normal sağlam çocuk izlemleri döneminde, doğum sonrası depresyon tanısı koyabilme imkanını mümkündür. Toplumu temsil eden, büyük kitlelere yapılacak topluma dayalı çalışmalar ile geçerli, etkin bir doğum sonrası depresyon taramasının tanımlanmasına ve bu tip bir taramanın klinik olarak anne -bebek açısından hizmetin artırılmasına, olan etkisinin belirlenmesine gereksinim vardır.
Thirteen-Year Surveillance Results of Acute Flaccid Paralysis Cases in Southeast Turkey and the Effect of Refugee Movements on Surveillance Results
(Natl Inst Public Health, 2024) Turan, Birgul; Ozgun, Mert; Toktas, Izzettin; Korukluoglu, Gulay; Ozgun, Nezir; Kubat, Gulnaz
Objective: Acute flaccid paralysis (AFP) is a major neurological problem. Turkey has accepted over 4 million refugees since 2011 due to the wars in neighbouring countries. In the long term, refugees can have adverse effects on the limited resources of health, sanitation, water supply, foodstuff, and shelter services of host countries, precipitating the transmission and spread of enteroviruses causing AFP. This study examines the 13-year surveillance and incidence of AFP cases in southeast Turkey, and questions possible impact of refugee movements on these parameters, comparing the periods before (2007-2010) and after (2011-2019) 2011, when the refugee movements emerged. Methods: The records of cases reported from southeast part of Turkey with suspected AFP between January 2007 and December 2019 were reviewed retrospectively. Results: Of the patients, 121 (58.5%) were male. Mean age was 80.36 +/- 46.67 months. Eighty-five (41.1%) were aged 60 months or younger. The number of patients under 60 months increased significantly after 2011. Mean incidence was calculated as 0.88 cases/100,000 person years versus 1.58 cases/100,000 person years in the period before and after 2011, respectively. Guillain-Barr & eacute; syndrome (GBS) was the most common cause of AFP in both periods. As of 2011, however, the incidence of acute transverse myelitis increased approximately 4 times and GBS decreased proportionally. Non-polio enteroviruses were the most frequent isolates, detected from 9.1% of stool samples. Conclusion: Although refugee movements appear to may have adverse effects on AFP incidence and surveillance outcomes, larger studies involving the whole country, particularly at places where no refugees settled, are needed to achieve more conclusive evidence.

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