Tip 2 Diyabetli Bir Hastada Linagliptine Bağlı Lokalize Ağrılı Döküntü

The number of patients with type 2 diabetes using dipeptidylpeptidase-4 (DPP-4) inhibitors is increasing across the world.Although this class of antidiabetic medications is generallysafe and associated with less side effects compared to otheroral antidiabetic medications, they could also cause some sideeffects such as skin rashes. Herein we report a case of type 2diabetes patient who developed a painful maculopapular rashinduced by linagliptin, a widely used DPP-4 inhibitor.A localized painful maculopapular rash developed on thepalmar faces of the patient’s hands almost 1 day after theinitiation of the drug. The patient was using intensive insulintherapy before linagliptin was started. There was no eruptionon the other body parts except the palmar faces of the hands.Following the discontinuation of the drug, the rash disappearedin about four days. The patient had no history of urticaria anddid not use an ACE inhibitor. As far as we know, this is the firstcase report of a skin rash induced by linagliptin in the Turkishliterature. This case report highlights a rare and lesser knownside effect of linagliptin, a new member of DPP-4 inhibitors.Dipeptidil peptidaz-4 (DPP-4) inhibitörleri kullanan tip 2 diyabet hastalarının sayısı dünya genelinde artmaktadır. Bu antidiyabetik ilaç sınıfı genelde güvenli olmakla birlikte diğer oral antidiyabetik ilaçlarla karşılaştırıldığında daha az yan etki ile ilişkili olsa da, deri döküntüleri gibi bazı yan etkilerle ilişkili olabilirler. Burada yaygın olarak kullanılan bir DPP-4 inhibitörü olan linagliptin ile indüklenen ağrılı makülopapüler döküntü gelişen tip 2 diyabetli bir hastayı sunuyoruz. Linagliptin başlandıktan 1 gün sonra hastamızın ellerinin palmar yüzünde lokalize ağrılı makülopapüler bir döküntü gelişti. Linagliptin başlanmadan önce hasta intensif insülin tedavisi altındaydı. Vücudun diğer bölgelerinde herhangi bir döküntü yoktu. Linagliptin kesildikten sonra 4 gün içerisinde döküntü kayboldu. Hastanın ürtiker öyküsü yoktu ve Anjiyotensin dönüştürücü enzim inhibitörü kullanmıyordu. Bildiğimiz kadarıyla bu, Türk literatüründe Linagliptine bağlı deri döküntüsü geliştirdiği rapor edilen ilk olgudur. Bu olgu sunumu, DPP-4 inhibitörlerinin nadir görülen ve daha az bilinen bir yan etkisini vurgulamaktadır

Oxidative stress of crystalline lens in rat menopausal model

Purpose: To evaluate lenticular oxidative stress in rat menopausal models. Methods: Forty Wistar female albino rats were included in this study. A total of thirty rats underwent oophorectomy to generate a menopausal model. Ten rats that did not undergo oophorectomy formed the control group (Group 1). From the rats that underwent oophorectomy, 10 formed the menopause control group (Group 2), 10 were administered a daily injection of methylprednisolone until the end of the study (Group 3), and the remaining 10 rats were administered intraperitoneal streptozocin to induce diabetes mellitus (Group 4). Total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) measurements of the crystalline lenses were analyzed. Results: The mean OSI was the lowest in group 1 and highest in group 4. Nevertheless, the difference between the groups was not statistically significant in terms of OSI (p > 0.05). The mean TOS values were similar between the groups (p > 0.05), whereas the mean TAC of group 1 was significantly higher than that of the other groups (p < 0.001). Conclusions: Our results indicate that menopause may not promote cataract formation

Post-operative Dressing for Paediatric Hypospadias Repair

The optimal dressing is still unclear, despite hypospadias being one of the most prevalent surgical operations. Children’s dressing for hypospadias surgery was searched on PubMed as “dressing for hypospadias,” “postoperative dressing for pediatric hypospadias,” and “dressing AND hypospadias.” Experimental studies, animal studies, reviews, letters, and repetitive publications were excluded from the study. By evaluating these reviewed publications, factors affecting hypospadias dressing, such as surgeon, country, dressing type, characteristics, and why it is preferred, will be revealed. As a result, 17 articles were examined, and the advantages of each were established by examining the results. The type of hypospadias, the surgeon’s choice, and its ease of removal stand out as the crucial factors in treating hypospadias in children, along with the degree of development of the nation

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

The possibilities of increasing estrous in the out of season by using exogen hormons at the private farm engaged awassi sheep breeding.

TEZ9145Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 2013.Kaynakça (s. 55-62) var.xi, 63 s. : res. (bzs. rnk.), tablo ; 29 cm.Bu çalışma, Adana İli Çukurova ilçesi Salbaş Beldesinde özel bir koyunculuk işletmesinde yürütülmüştür. Denemede, yetiştiriciliği yapılan 45 baş ivesi ırkı şişek koyun kullanılmıştır. Araştırma, asezonal dönemde koyunların kızgınlığa gelmesini sağlamak, doğum oranını ve çoğuzluğu olumlu yönde arttırmak amacıyla yapılmıştır. Denemede kızgınlığı sağlamak amacıyla iki farklı progesteron uygulaması (MAP ve CIDR) yapılmış ve bir de kontrol grubu oluşturulmuştur. Her grupta 15 baş koyun kullanılmıştır. Deneme, istatistiki olarak Oranların Farkına Ait Hipotez Testi kullanılarak analiz edilmiştir. Yapılan istatistik analiz sonucunda; kızgınlık oranı, MAP ve CIDR uygulamalarında % 100,0 yani iki gruptaki 15’er koyunun hepsi kızgınlığa ulaşmış ancak kontrol grubundaki koyunların hiçbirinde kızgınlık görülmemiştir. Gruplarındaki doğum oranı sırası ile MAP % 33,33 ve CIDR % 40,00 olarak bulunmuştur. istatiksel olarak doğum oranları üzerine bir farkın olmadığı ancak CIDR’ın etkisinin daha fazla olduğu belirlenmiştir. Gruplardaki çoğuz doğum oranları ise MAP % 40,00 ve CIDR % 16,66 olarak bulunmuştur. İstatistiksel analiz sonucuna göre çoğuz doğum oranı üzerine MAP’ın etkisinin daha fazla olduğu tespit edilmiştir (p<0.05). Sonuç olarak asezonal dönemde İvesi koyunlarına eksogen hormon uygulamasının kızgınlık, doğum ve çoğuzluk üzerine olumlu etkilerinin olduğu tespit edilmiştir.This study was carried out in a private sheep breeding farm in Salbaş Town of Çukurova District of Adana City. A total of 45 Awassi ewes were used. In the trial the aim of the study was to provide the estrous out of season, to increase the birth rate and multiple births. Two different types of progesteron applications (MAP and CIDR) were applied to provide estrous and a control group was created. 15 Awassi ewes were used in each group. This trial statistically analyzed by using Hypotesis Test of Rates Differences. According to results of statistical analyses; estrous rates were % 100,0 observed in MAP and CIDR groups, this means all 15 ewes have showed estrous in each groups but none of the ewes have showed estrous in control group. The birth rates of MAP and CIDR applied groups were found; % 33,33 and % 40,00 respectively. Statistically CIDR’s effect on birth rate is detected higher. In MAP and CIDR groups multiple births were observed as ; % 40,00 and % 16,66 respectively. As a result of statistical analyse, MAP’s effect on multiple birth rate wasfound higher (p<0.05). Consequently; the application of exogen hormone has positive effects on increasing of estrous out of season, birthrate and multiple births

Effect of Splenectomy to Short Bowel Syndrome in Rats.

The aim of this study was to determine the effect of splenectomy in the short bowel syndrome. Twenty-four Wistar-albino rats weighing between 210 and 375 g were used. They were divided into three groups. In group A, short bowel syndrome (SBS) was created by 75 % bowel resection. In group B, SBS and splenectomy was performed. In group C, after transecting the bowel, it was anastomosed. Before and 45 days after the procedures, all rats were weighed. In all three groups, the first and final weight of the rats, the final bowel weight and length, the ileal and jejunal crypt depths, the villus height, the luminal diameter, the bowel wall thickness, and the number of apoptotic cells and mitosis per 100 crypt cell were compared. Periportal fibrosis, infiltration, bile stasis, and bile duct proliferation were detected in liver samples. The rat intestinal length and weight was the least in group B while the jejunal crypt depth was higher in group B than in group A and it was exactly the opposite for the jejunal and ileal villus heights. The ileal and jejunal luminal diameter, the ileal bowel wall thickness, the jejunal and ileal apoptotic cell number, the jejunal mitosis, and the periportal fibrosis were highest in group B. Adding splenectomy to an SBS model has a negative impact on bowel adaptation

Analysis of Feldstein - Horioka Hypothesis with Regards to Public and Private Saving - Investment Balance in Turkey

Investments, which are the prerequisite of economic growth and development, are financed by savings. For this reason, determination of the conversion rate of savings into investment has a considerable importance in terms of determining the economic policies. In this study, in Turkey, private saving-investment relationship and public saving-investment relationship are examined and analyzed separately. In this respect, the relationship between savings and investments in Turkey is examined in the framework of the Feldstein-Horioka Hypothesis for the period 1975-2014. As a result of the study, there has been no cointegration between private savings and investments in Turkey. In terms of public savings and investments, the rate of conversion of public savings into investments is low

EFFECT OF MECHANICAL ALLOYING DURATION ON TRANSVERSE RUPTURE STREGTH OF Al+10% Al2O3 COMPOSITES

Bu çalışma, Al+%10Al2O3 kompozitlerin mekanik alaşımlama (MA) yöntemi ile üretilerek eğme dayanım (TRS) özelliklerinin belirlenmesini içermektedir. Bu amaçla, Al ve Al2O3 tozları 2, 4, 6, 8 ve 10 saat süreyle mekanik alaşımlama işlemine tabi tutulmuş ve MA sonrası tozların tane boyut ölçümü ve SEM analizi yapılmıştır. Tozlar tek eksenli preste 700 MPa basınçla sıkıştırılarak blok numuneler haline getirilmiştir. Blok haline getirilen numuneler 600 °C sıcaklıkta 1 saat süreyle sinterlenmiştir. Ardından numunelerin sertlik değerleri, yoğunluk değerleri ve TRS dayanımları belirlenmiştir. Yapılan deneysel çalışmalar sonucunda, mekanik alaşımlama süresinin artmasıyla toz tane boyutlarında ve yoğunlukta azalma, sertlik ve eğme dayanımlarında artış meydana geldiği tespit edilmiştir.In this study, Al +% 10Al2O3 composites produced by mechanical alloying (MA) method, transverse rupture strengths (TRS) includes determination of the characteristics. For this purpose, Al and Al2O3 powders was carried out to mechanical alloying process for 2, 4, 6, 8 and 10 hours. Size of the powder and SEM analyses of particles were done. Powders were pressed under 700 MPa pressure in one direction. The samples were sintered at 600 &deg;C in flowing Ar atmosphere for one hour. Then, hardness, density, porosity and transverse rupture strengths (TRS) of sintered composites were determined. As a result of the experimental studies, it was determined that powder dimension was decreased with increased the duration of MA. It has also been determined that mechanical alloyed samples had lower density but also high hardness and TR

Kamu harcamaları ve vergi gelirlerinin ekonomik konjonktür üzerindeki etkisi: Türkiye üzerine bir uygulama

WOS:000440670700003The aim of this study is to test the effect of fiscal policy on economic activity in Turkey with Markov regime switching vector autoregressive model (MS-VAR). From this point of view, the effects of changes in fiscal policy on GDP during the economic expansion and contraction and the changes in fiscal policy multipliers over time are examined. In addition, the effectiveness of fiscal policy instruments, which consist of public expenditures and tax revenues, is determined by different regimes. The policy recommendations are developed according to the results.Bu çalışmanın amacı Türkiye’de maliye politikasının ekonomik faaliyetler üzerindeki etkisini Markov rejim değişim vektör otoregresif (MS-VAR) yöntemiyle test etmektir. Buradan hareketle ekonominin genişleme ve daralma dönemlerinde maliye politikasındaki değişimlerin milli gelir üzerindeki etkisi ve maliye politikası çarpanlarının zaman içindeki değişimi incelenmektedir. Ayrıca kamu harcamaları ve vergi gelirlerinden oluşan maliye politikası araçlarının konjonktürle mücadeledeki etkinliği farklı rejimler itibariyle belirlenmiştir. Elde edilen bulgulardan hareketle de politika önerileri geliştirilmiştir