46,XX Karyotype in a Male with Ambigious Genitalia: A Case Report

40 days old case who were diagnosed with ambigious genitalia were sentto laboratory of cytogenetics. Mother was 26 years old and have to alivechildren and case were the second child and applied to Child SurgeryDepartment due to continiously vomiting and uneasy conditions. Sexualdevelopment were as male on physical examinations. Cell culture wasapplied for chromosomal analysis. Slides were stained with GiemsaBanding Staining (GTG) and 100 cells were totaly counted and karyotypingwere done with 15 metaphase. Chromosome with 46,XX karyotype. Casewere taken under consideration of congenital adrenel hyperplasia afterevalution of karyotype. Case were discussed according to by information ofpresents literatures

Organophosphate Poisoning in Pregnant Patients: A Case Report

Organofosfata maruz kalma veya zehirlenme kadınların tarım işçisi olarak çalıştığı gelişmekte olan ülkelerde yaygın olarak görülmektedir. Organofosfatların toksisitesi kolinesteraz aktivitesinin inhibisyonu ve reseptör bölgesindeki asetilkolin etkisinin uzaması ile kendini gösterir. Semptom ve bulgular nikotinik veya muskarinik reseptörler hangisinin daha çok etkilendiğine bağlıdır. Gebelikte organofosfat zehirlenme vakaları oldukça nadirdir. Bu olgu sunumunda iki saattir devam eden baş dönmesi, tekrarlayan bulantı kusma, hipersalivasyon ve görme keskinliğinde azalma şikayetleriyle hastanemize başvuran 26 yaşındaki hamile kadın hastayı bildirmeyi amaçladık. Alınan anamnezinde şikayetlerinin ilaçlanmış sebze yendikten sonra başladığı öğrenildi. Hastada organofosfat zehirlenmesinde sıklıkla karşılaşılan sekresyon artışı ve bilateral miyosiz mevcuttu. Organofosfat zehirlenmesi olduğu klinik ve laboratuvar olarak teyid edilen hastaya intravenöz atropin tedavisine başlandı ve oksim tedavisi uygulanmadı. Üç gün içerisinde kliniği düzelen hasta şifayla taburcu edildi ve beş hafta sonra normal vajinal doğum gerçekleşti. Bebekte organofosfat ve atropine maruz kalma belirti ve bulguları gözlenmedi. Gebe hastalarda organofosfata zehirlenmelerine bağlı oluşan spontan abortus vakaları bildirilmiştir. Gebelikte organofosfat zehirlenmelerine bağlı olarak hem annede hem fetüste ciddi etkilere neden olabilmektedir. Bununla birlikte, gebeliğin devamını sağlamak üzerine kesin bir strateji bulunmamaktadır. Gebelerde atropin ile tedavi organofosfat zehirlenmelerinin klinik etkilerini geri döndürmekte başarılı olabilmektedir.Organophosphate exposures and poisoning are common and generally under-reported in developing countries where women are mainly involved in agricultural work. Toxicity of organophosphates is due to inhibition cholinesterase activity and prolonging the effects of acetylcholine in the receptor site. Symptoms and findings depend on the equilibrium between the nicotinic and muscarinic receptors. Cases of organophosphate poisoning in pregnancy are rare. In this case report we reported that a 26-year-old pregnant woman who presented at the our hospital with two hour history of dizziness, recurrent vomiting, increased saliva and loss of visual acuity. These symptoms started after eating vegetable which sprayed with Organophosphate. Our patient's signs of organophosphate toxicity included increased secretion and bilateral miosis. After clinical and laboratory confirmation for organophosphate poisoning, the patient responded to intravenous doses of atropine; oximes were not applied. Although She recovered within 3 days and delivered a healthy baby 5 weeks later by spontaneous vaginal delivery after being discharged. The child showed no signs or symptoms of organophospate and atropine exposure. Organophosphate poisoning that occurs due to spontaneous abortion was reported in pregnant patients. Poisoning during pregnancy may result in serious adverse effects for both mother and the fetus or neonate. Nonetheless, no definite strategy focused on maintaining pregnancy. Maternal treatment with atropine was successful in reversing the organophosphate toxicity

The nasal carriage of Staphylococcus aureus among Kırıkkale University hospital staff and patients visitors

Hastane enfeksiyonlarının önemli bir, etkeni olan S. auerus suşlarının kaynaklarından birisi de hastane personelidir. Metisiline dirençli S. auerus (MRSA) kökenlerinin giderek artması tedavisi zor enfeksiyonlara neden olmaktadır. Bu çalışmada hastane personeli ile hasta ziyaretçileri arasında burunda S.aureus taşıyıcılık oranı bakımından fark olup olmadığının ve taşıyıcılığa etkili olası faktörlerle ilişkisinin araştırılması amaçlandı. Kırıkkale Üniversitesi Tıp Fakültesi Hastanesinde görevli 219 sağlık personelinin 34'ünde (%İ5) nazal S.aureus taşıyıcılığı saptanırken (29 MSSA (Metisilin sensitif S. Auerus), 5 MRSA'); bu oran 100 hasta yakınının 10'unda (%10) (5 MSSA, 5 MRSA) tespit edildi. Hastane personelinde S. aureus taşıyıcılığı hasta yakınlarına göre anlamlı oranda yüksek bulundu (p0.044). Taşıyıcılığı etkileyen risk faktörleri (hâlen damar içi antibiötik kullanımı, son 6 ayda hastanede yatış, son 6 ayda cerrahi operasyon geçirme ve kronik hastalık öyküsü) ile taşıyıcılık arasında anlamlı bir ilişki saptanmadı (p0.05). Erkeklerde S. aureus (MSSA açısından) taşıma sıklığı karşı cinse göre anlamlı olarak yüksek saptandı (p0,028). Taşıyıcılık oranı yüksek saptanan hastane personeli bu fırsatçı patojen bakterilerin bulaşmasında rol oynayabileceğinden; nozokomial enfeksiyonların önemli bir etkeni olan S. aureus taşıyıcılığinı önleyebilmek amacıyla hastane personelinin periyodik olarak izlenmesi ve gerekirse tedavisinin yapılması düşünülebilir.Health Staff is one of the sources of S. auerus strains which is an' important cause of hospital infections. The expansion of metisiline resistant S. auerus (MRŞA) roots cause the increase of infections which are difficult to treat. The aim of this study to investigate was the difference between hospital staff and patient visitors in terms of S.aureus carriage and the factors affecting carriage. While, nasal S.aureus carrieship was diagnosed on 34 staff (15%) (29 MSSA, 5 MRSA) out of 219 working at Kırıkkale University School of Medicine Hospital, this ratio was foun to be 10 out of 100 patient relatives (10%) (5 MSSA, 5 MRSA). S. aureus carriage was found to be significantly higher among hospital staff than that on patient relatives (p0,.044). No significant correlation was found between risk factors (current intravenous antibiotic use, hospitalization within last 6 months, surgical operation within last 6 months and chronic, illness history) and carriage rates (p>0.05). Carriage among males (in terms MSSA) was found to be significantly higher than that of females (p0.028). Since hospital staff with higher carrieship ratio can play a significant role in spread of these bacterie, periodic inspection and treatment of hospital staff when it is needed can be planned to avoid S. Aureus carriage which is an important cause of nozocomial infections

Risk factors for occupational brucellosis among veterinary personnel in Turkey

WOS: 000346883000006PubMed ID: 25132061Veterinarians and veterinary technicians are at risk for occupational brucellosis. We described the risk factors of occupational brucellosis among veterinary personnel in Turkey. A multicenter retrospective survey was performed among veterinary personnel who were actively working in the field. Of 712 veterinary personnel, 84(11.8%) had occupational brucellosis. The median number of years since graduation was 7 (interquartile ranges [IQR], 4-11) years in the occupational brucellosis group, whereas this number was 9 (IQR, 4-16) years in the non-brucellosis group (p < 0.001). In multivariable analysis, working in the private sector (odds ratio [OR], 2.8; 95% confidence interval [95% CI], 1.55-5.28, p = 0.001), being male (OR, 4.5; 95% CI, 1.05-18.84, p = 0.041), number of performed deliveries (OR, 1.01; 95% CI, 1.002-1.02, p = 0.014), and injury during Brucella vaccine administration (OR, 5.4; 95% CI, 3.16-9.3, p < 0.001) were found to be risk factors for occupational brucellosis. We suggest that all veterinary personnel should be trained on brucellosis and the importance of using personal protective equipment in order to avoid this infection. (C) 2014 Elsevier B.V. All rights reserved

Mortality-associated factors of candidemia: a multi-center prospective cohort in Turkey

Candidemia may present as severe and life-threatening infections and is associated with a high mortality rate. This study aimed to evaluate the risk factors associated with 30-day mortality in patients with candidemia. A multi-center prospective observational study was conducted in seven university hospitals in six provinces in the western part of Turkey. Patient data were collected with a structured form between January 2018 and April 2019. In total, 425 episodes of candidemia were observed during the study period. Two hundred forty-one patients died within 30 days, and the 30-day crude mortality rate was 56.7%. Multivariable analysis found that SOFA score (OR: 1.28, CI: 1.154-1.420, p < 0.001), parenteral nutrition (OR: 3.9, CI: 1.752-8.810, p = 0.001), previous antibacterial treatment (OR: 9.32, CI: 1.634-53.744,p = 0.012), newly developed renal failure after candidemia (OR: 2.7, CI: 1.079-6.761, p=0.034), and newly developed thrombocytopenia after candidemia (OR: 2.6, CI: 1. 057-6.439, p =0.038) were significantly associated with 30-day mortality. Central venous catheter removal was the only factor protective against mortality (OR: 0.34, CI:0.147-0.768, p = 0.010) in multivariable analysis. Candidemia mortality is high in patients with high SOFA scores, those receiving TPN therapy, and those who previously received antibacterial therapy. Renal failure and thrombocytopenia developing after candidemia should be followed carefully in patients. Antifungal therapy and removing the central venous catheter are essential in the management of candidemia