Anthrax in Eastern Turkey, 1992–2004

We investigated animal and human anthrax cases during a 13-year period in eastern Turkey. From 1992 to 2004, a total of 464 animal and 503 human anthrax cases were detected. Most cases occurred in summer. Anthrax remains a health problem in eastern Turkey, and preventive measures should be taken

Medical students' knowledge of the disease, frequency of depression, anxiety, stress symptoms, and related factors in the COVID-19 pandemic: A web-based questionnaire

MakaleWOS:000926968200021Objective: In this study, it was aimed to determine the level of knowledge of medical students about coronavirus disease 2019 (COVID-19), to investigate the frequency of depression, anxiety, stress symptoms and related factors.Materials and Methods: The study is a cross-sectional study conducted with 904 volunteer medical students. Data were collected with an online questionnaire, including sociodemographic characteristics, knowledge about COVID-19, the Depression, Anxiety, and Stress Scale.Results: Mean age was 21.3 +/- 2.2 years, and 54% of them (n=488) were female. Fifty five percent (n=497) thought that their level of knowledge about COVID-19 was sufficient, and 94.6% (n=846) were concerned about the disruption of their education. Their knowledge level was found to be 15.09 +/- 2.43 points out of 23 points. The depression, anxiety and stress symptoms were found in 64.9%, 70.4% and 34.1% of participants, respectively. The risk of anxiety (OR=0.51, 95%CI=0.94, p=0.020) and depression (OR=0.95, 95%CI=1.15, p=0.025) were higher in women. Those with a high fear of transmitting the COVID-19 infection to their relatives had higher symptoms of depression, anxiety, and stress. (p<0.001).Conclusion: Medical students have a good knowledge level of COVID-19. However, they experience high levels of anxiety, stress and depression symptoms; and concerned about the disruption of their education

Antrax: Evaluation of 68 Cases

Sixty-eight anthrax cases admitted to our clinic, from June 1986 to June 1996, were evaluated in respect to clinical findings, therapy methods and prognosis. Patients were 15-63 years old, 31 of them were female and 37 were male. It was understood that from August to October, in three months, there was an increase in anthrax cases. A history of direct contact with animals was obtained in 46 (68%) cases. Incubation period of our cases was 1-9 (average : 3.8) days. The whole cases were cutaneous anthrax; 41 of them were malignant pustule, and 27 were malignant edema. Bacillus anthracis was seen on Gram stain smears in 20 cases (29%). Vesicular fluid culture was positive in 12 cases. Both the culture and Gram stain smear was positive in 9 of these cases. Procain penicillin was used for 7 days in the treatment of patients with malignant pustula. For the therapy of malignant edema patients penicillin G was started and then continued with procain penicillin with the addition of prednisolon for 10 days. The average time of hospitalization was 9.5 days and the mortality rate was 1.5%

Cutaneous Anthrax on Eyelid in a Pregnant Woman

Otuz iki yaşında ve 17 haftalık gebe olan hasta, göz kapağında yara ve tüm yüzünde şişlik şikâyetleri ile hastanemize sevk edildi. Hastanın hikâyesinden eşiyle hasta hayvan kesimine katıldığı, ete temas ettiği öğrenildi. Sağ göz alt kapağında kenarları hiperemik ortası nekroze görünümlü krutlu lezyon ve tüm yüzde boyuna kadar yayılan ödem saptandı. Antibiyotik kullanan hastanın kültürlerinde üreme olmadı. Şarbon tanısı, epidemiyolojik hikâyesi, fizik muayene bulgusu ve direkt preparatta Bacillus anthracis görülmesi ile konuldu. Hastanın tedavisi için on gün penisilin verildi. Bu olgu, hastanın gebe olması, ender bir yerleşim olan alt göz kapağına yerleşmesi, anne ve bebekte herhangi bir komplikasyon ve sekele neden olmaması nedeniyle sunulmaya değer bulunmuştur.A 32-year-old patient who was 17 weeks of pregnant referred to our hospital due to a lesion on the eyelid and swelling on her face. Patient's history revealed that she helped her husband for slaughtering of a sick animal and contacted with the meat. A scabby lesion was detected on the inferior eyelid with hyperaemia around, central necrotic appearance and swelling. The diagnosis of anthrax was performed based on her epidemiological data, physical examination findings, and Bacillus anthracis were seen on direct preparation. This case was considered worthy to present since she was pregnant, the disease was located on the inferior eyelid, which is a rare place for location, and caused no complication or sequel either in mother or in baby

Cutaneous anthrax on eyelid in a pregnant woman

ERTURK, AYSE/0000-0001-6413-9165WOS: 000383256800013PubMed: 27551179A 32-year-old patient who was 17 weeks of pregnant referred to our hospital due to a lesion on the eyelid and swelling on her face. Patient's history revealed that she helped her husband for slaughtering of a sick animal and contacted with the meat. A scabby lesion was detected on the inferior eyelid with hyperaemia around, central necrotic appearance and swelling. the diagnosis of anthrax was performed based on her epidemiological data, physical examination findings, and Bacillus anthracis were seen on direct preparation. This case was considered worthy to present since she was pregnant, the disease was located on the inferior eyelid, which is a rare place for location, and caused no complication or sequel either in mother or in baby

The Antibiotic Usage in a University Hospital and Necessity of an Antibiotic Policy

To determine the problems with inappropriate prescribing of antibiotics in hospitalized patients, a crosssectional study was carried out in Atatürk University, Medical School Hospital, the largest hospital in Eastern Anatolian Region of Turkey. Patients hospitalized between 03 May 2001 and 10 May 2001 were included in the study. Appropriateness of antibiotic use was evaluated using published recommendations for antibiotic prescription. Statistical analysis was made by chi-square test. A total of 717 patients were evaluated. Of the patients, 378 (52.7%) were receiving one or more antibiotics. Empirical use was more frequent (45.5%) than prophylactic (40.5%) and specific (based on culture result, 14.0%) use. Inappropriate use was found to be 44.4%, and it was 68.6%, 30.2% and 20.8% in prophylactic, empirical and specific administrations, respectively. The main problem in medical wards was unnecessary use of antibiotics while it was improper timing or duration of surgical prophylaxis in surgical wards. Appropriate usage rate of ampicillin-sulbactam, the most commonly used antibiotic, was 38.9%. This study emphasized a high proportion of misuse of antibiotics in the hospital. Our results are striking in respect of display of the need of antibiotic management policy in hospitals

Kırım-Kongo Hemorajik Ateşli Hastalarda Ortalama Trombosit Hacmi ve Nötrofil/Lenfosit Oranının Prognostik Değeri

Amaç: Kırım-Kongo Kanamalı Ateşi (KKHA) virüsü, Bunyaviridae ailesine üye Nairovirus olup insanlarda ciddi hastalığa neden olur. KKKA enfeksiyonunda pansitopeni, organ yetersizliği ve yaygın damar-içi pıhtılaşma ortaya çıkabilir. Bu çalışmanın amacı, ortalama trombosit hacmi (MPV), nötrofil-lenfosit oranı (NLR) ve trombosit-lenfosit oranı (PLR)'nda bir değişiklik olup olmadığını ve bu parametrelerin hastanede kalış süresi için prediktör olup olamayacağını belirlemektir.Yöntem: Toplam 50 KKHA hastalığı bulunan (27 M ve 23 F) ve benzer yaş grubunda toplam 47 (27 M ve 20 F) sağlıklı birey çalışmaya alındı. Hematolojik ve biyokimyasal testleri ile C-reaktif protein (CRP), hasta ve kontrollerde çalışıldı. Hastanede kalış süresi üzerinde bağımsız prediktörleri belirlemek amacıyla çok değişkenli lojistik regresyon analizi yapıldı.Bulgular: MPV, hastalarda kontrollerden daha yüksek [8.4 (min / maks 6,4-9,4) fL vs 7.0 (min/maks 6,0-8,7) fL, p <0.001] idi. NLR ve PLR her iki grupta benzerdi. Hastanede kalış süresi prediktörleri: düşük beyaz kan hücreleri (WBC) ve trombosit sayısı (p <0.001 ve p=0.002 sırasıyla), bunlar yanı sıra uzamış protrombin zamanı (PT) (p=0.013), yüksek kreatinin (p=0.033) ve glukoz (p=0.044) düzeyleri olarak saptandı.Sonuç: MPV hasta grubunda daha yüksek olup NLR ve PLR oranları kontrol grubu ile benzerdi. MPV, NLR ve PLR hastanede kalış uzunluğu belirleyicisi olarak tespit edilmedi. Ancak, azalmış lökosit ve trombosit sayımı ile birlikte uzamış PT, artmış kreatinin ve glukoz düzeyleri, hospitalizasyon süresini predikte ettiği bulunduObjective: Crimean-Congo hemorrhagic fever (CCHF) virus, a Nairovirus within the family Bunyaviridae, causes severe disease in humans. Pancytopenia, organ failures and disseminated intravascular coagulation may occur as a result of CCHF infection. The aim of this study was to determine whether there is a change in the mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), and whether these might be predictors for the duration of hospitalization.Methods: A total of 50 CCHF patients (27 M and 23 F) and a similar age group of 47 healthy individuals (27 M and 20 F) were included in the study. Hematologic and biochemical tests inclusive of C-reactive protein were conducted on patients and controls. To determine the independent predictors of the duration of hospitalization, a multivariate logistic regression analysis was performed.Results: The MPV was higher in patients than that of the controls [8.4 (min/max 6.4-9.4) fL vs. 7.0 (min/max 6.0-8.7) fL, p<0.001]. The NLR and PLR were similar in both groups. The predictors of the length of hospitalization included decreased white blood (WBC) cell and platelet counts (p<0.001 and p=0.002, respectively), together with elevated prothrombin time (PT) (p=0.013) creatinine (p=0.033) and glucose levels (p=0.044). Conclusion: The MPV was higher in patients but NLR and PLR were similar in both groups. The MPV, NLR and PLR did not serve as predictors of hospitalization length. However, elevation of PT, creatinine, glucose, along with decreased WBC and platelets counts were found to be predictors of hospitalization period. J Microbiol Infect Dis 2015;5(2): 51-5

Assessment of patients with Hepatitis D

Amaç: Hepatit delta virüsü (HDV), insanları enfekte ettiği bilinen en küçük virüstür. Aynı zamanda hepatit B hastalarında karaciğer ilişkili mortalitenin en önemli nedenidir. HDV defektif bir ribo nükleik asit (RNA) virüsüdür. Dünyada 15-20 milyon insanın delta ile enfekte olduğu tahmin edilmektedir. Delta hepatitli olgularımızın epidemiyolojik ve klinik yansımalarını belirlediğimiz çalışmamızda bu hastaların klinik, laboratuvar verilerini, tedavilerini, serolojilerini ve biyopsi sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntemler: Atatürk Üniversitesi Tıp Fakültesi Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji servisine 2008-2013 tarihleri arasında başvuran delta hepatit hasta dosyaları retrospektif olarak incelendi. Antijen ve antikor sonuçları enzyme-linked immunosorbent assay (ELISA) (Dia. Pro Diagnostic Bioprobes Srl, Milan, Italy) yöntemi ile araştırıldı. HBV-DNA'nın ve HDV RNA'nın (Qiagen©, Germany) belirlenmesi polimeraz zincir reaksiyonu, yöntemleri ile yapıldı. Olgulara karaciğer biopsisi uygulandı. Patolojileri Knodell ile değerlendirildi.Bulgular: Çalışmaya 2540 HBsAg pozitif hasta dahil edildi. Yüz üç (%4,05) anti HDV pozitif bulundu. Bu 103 hastanın yaşları 19-70 (ortalama 49 yıl) arasında olup, 35'i kadın (%34), 68'i (%66) erkek idi. Hastalardan 10'unda (%9,7) siroz gelişti. Anti-HBe pozitif 60 (%58,3) hasta varken 34 (%33) hastada HBeAg ve anti HBe negatif bulundu. Sonuç: Hepatit B'li hastalarda siroza, hepatosellüler karsinomaya (HK) gidişi ve mortaliteyi arttırdığı için delta virüsü mutlaka araştırılmalıdır. Ülkemiz ve özellikle bölgemiz için önemli bir sorundur. Delta hepatitine karşı korunmak için hepatit B aşı programlarına uyulmalı ve kan örnekleri taranmalıdır

Naturally Occurring Cutaneous Anthrax: Antibiotic Treatment and Outcome

Objectives: Cutaneous anthrax (CA) is the most common clinical presentation in human anthrax, but the duration of antibiotic therapy in naturally occurring CA is controversial. The aim of this study was to compare the clinical outcomes of patients receiving antibiotic treatment for either 3-5 days (group 1) or 7-10 days (group 2) in uncomplicated CA. Methods: A total of 66 patients were enrolled; 29 (44%) in group 1 and 37 (56%) in group 2. Infections were classified as mild (n = 22, 33%) or severe (n = 44, 67%) CA. Results: There were no significant differences between the groups in symptom resolution time, fever clearance time, healing of lesions, development and healing of eschars, requirement for surgical intervention or the development of complications. Both edema resolution time and duration of hospital stay were longer in group 2. There were no therapeutic failures, relapses or deaths in either group. Steroid therapy was used in 32% of patients with severe CA, but a beneficial effect on resolution of edema was not demonstrated. Conclusions: These results suggest that short-course antibiotic therapy is as effective as standard-duration therapy in uncomplicated CA and that steroid therapy may not be effective. Copyright (C) 2012 S. Karger AG, Base