Cutaneous Anthrax Outbreak in the Trakya Region of Turkey

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Tip 1 Diyabetes Mellituslu Çocuklarda Tanı Anındaki Klinik ve Laboratuvar Bulgularının Değerlendirilmesi

Objective: The aim of our study is to evaluation of clinical and laboratory findings at the time of diagnosis in children with Type 1 Diabetes Mellitus (T1DM). Methods: In this study, 142 children diagnosed with T1DM who were referred to Pediatric Endocrinology Policlinic and Emergency Policlinic of Dicle University Medical Faculty between 2013 and 2016 were evaluated. Retrospectively, the sociodemographic characteristics, symptoms and laboratory findings of the patients were recorded from the files. All the data obtained were evaluated statistically. Results: Sixty two (43.66%) of the patients were girls. The mean age was 10,10 ± 1,39 years. The blood glucose level at diagnosis was 425,85 ± 12,51 mg/dl and HbA1c was 13,57 ± 3,77. Anti-Glutamate Decarboxylase (anti-GAD) positivity was detected in 47.8% of the cases. 18.3% of the patients had a T1DM story in their family. Patients were diagnosed mostly in January (12.6%) and November (11.9%). 83.8% of cases had both polyuria and polydipsia, 41.5% had consciousness level change and 6.3% had coma. Ketoacidosis was present in 43% of the patients at the time of admission, ketosis in 48.5% and only hyperglycemia in 8.5%. Conclusion: Type 1 DM is mostly observed in adolescence. The most common symptoms of the disease are polyuria and polydipsia. For this reason the community needs to be educated that polyuria and polydipsia may have T1DM findings. Awareness of the community in this issue can reduce the frequency of diabetic ketoacidosis, the most important complication of diabetes

Triglyceride-glucose index levels in patients with congenital hypogonadotropic hypogonadism and the relationship with endothelial dysfunction and insulin resistance

Introduction: The risk of cardiometabolic diseases is increased in patients with hypogonadism. The triglyceride-glucose (TyG) index is a novel surrogate marker of insulin resistance and is associated with cardiovascular diseases. We investigated the TyG index levels and the relationship with endothelial dysfunction and insulin resistance in patients with congenital hypogonadotropic hypogonadism (CHH). Material and methods: A total of 98 patients with CHH (mean age 21.66 ± 1.99 years) and 98 healthy control subjects (mean age 21.69 ± 1.21 years) were enrolled. The demographic parameters, TyG index, asymmetric dimethylarginine (ADMA), high-sensitivity C-reactive protein (hs-CRP), and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured for all participants. Results: The patients had higher waist circumference (p < 0.001), triglycerides (p = 0.001), insulin (p = 0.003), HOMA-IR (p = 0.002), ADMA (p < 0.001), and TyG index (p < 0.001) levels and lower HDL-C (p = 0.044) and total testosterone (p < 0.001) levels compared to healthy control subjects. TyG index levels significantly correlated with the ADMA (r = 0.31, p = 0.003) and HOMA-IR (r = 0.32, p < 0.001) levels. TyG index was also determinant of HOMA-IR levels (ß = 0.20, p = 0.018). Conclusion: The results of the present study show that patients with CHH had increased TyG index levels. Also, the TyG index is independently associated with insulin resistance in patients with CHH. Long-term follow-up studies are warranted to find out the role of the TyG index in determining cardiometabolic risk in patients with hypogonadism.

Association of serum and follicular fluid leptin and ghrelin levels with in vitro fertilization success

 Objectives: The aim of this study was to evaluate the relationship between in vitro fertilization (IVF) cycle outcomes, serum and follicular fluid (FF) levels of leptin and ghrelin. Material and methods: Forty-four women who underwent intracytoplasmic sperm injection cycles (ICSI) were enrolled in the study. On the third day (D3) of the menstrual cycle, venous blood samples were drawn for serum measurements of leptin and ghrelin. The follicular fluid (FF) and the corresponding oocyte were obtained from a single dominant preovulatory follicle at the time of oocyte pick-up. The FF and D3 serum leptin and ghrelin concentrations were measured by enzyme-linked immunosorbent assay. The relationship between pregnancy rate and serum, follicular fluid levels of leptin and ghrelin were analyzed. Results: Of the 44 cases included, nineteen achieved clinical pregnancy (43.18%). Follicular fluid ghrelin levels were significantly lower in the pregnant group than non-pregnant group (p < 0.05) With respect to FF leptin, there was no statistically significant differences between the pregnant and non-pregnant women (p > 0.05). There was no statistically significant difference in D3 serum ghrelin between pregnant and non-pregnant groups (p > 0.05). However, D3 serum leptin levels were significantly lower in pregnant women than non-pregnant women (p < 0.05). Conclusions: Lower ghrelin levels in the follicular fluid were associated with higher pregnancy rates. Also, D3 serum leptin levels were inversely correlated with clinical pregnancy rates. These findings support the potential role of these molecules on IVF outcomes

Comparison of one and three initial monthly intravitreal ranibizumab injection in patients with macular edema secondary to branch retinal vein occlusion

AIM: To compare three initial monthly intravitreal ranibizumab (IVR) injections followed by pro re nata (PRN) dosing with one initial monthly IVR injections followed by PRN dosing for macular edema (ME) secondary to branch retinal vein occlusion (BRVO). METHODS: Forty-two eyes of 42 patients who had IVR injections for BRVO were retrospectively studied. Eighteen eyes received 1 initial IVR injection (1+PRN group) and 24 eyes received 3 monthly IVR injections (3+PRN). At 1, 3, 6 and 12mo; spectral-domain optical coherence tomography (SD-OCT) was performed. Central macular thickness (CMT), the integrity of the external limiting membrane (ELM), the presence of subretinal fluid, cyst size, the presence of inner segment/outer segment (IS/OS) defect were determined. RESULTS: At baseline the mean CMT was 521.3±153.2 µm in the 3+PRN group while it was 438.1±162.4 µm in 1+PRN group. At the final visit, mean CMT was 278.3±87.8 µm in the 3+PRN group and 285.2±74.2 µm in the 1+PRN group (P=0.079). The changes in CMT over the entire study period were also comparable in both groups (243±160 µm in the 3+PRN group, and 152.9±175.3 µm in the 1+PRN group; P=0.090). At baseline, best-corrected visual acuity (BCVA) was 0.92±0.60 logarithm of the minimal angle of resolution (logMAR) in the 3+PRN group, while it was 0.72±0.46 logMAR in the 1+PRN group. Final BCVA was 0.42±0.55 logMAR in the 3+PRN group and 0.38±0.50 logMAR in the 1+PRN group (P=0.979). Additionally, the BCVA changes from baseline to final visit were not significantly different (-0.50±0.45 logMAR in the 3+PRN group, and -0.33±0.39 logMAR in the 1+PRN group; P=0.255). CONCLUSION: No significant differences in the anatomical or functional results are found between 3+PRN and 1+PRN regimens in the patients receiving ranibizumab for ME secondary to BRVO. Intact IS/OS and baseline BCVA are good predictor of the visual gain, while baseline CMT is a good predictor of the anatomical gain

İtibar yönetimi bağlamında sosyal reklam kavramına yönelik bir araştırma

Kurumlar günümüz global rekabet ortamında varlıklarını korumak, marka değerlerini ve imajlarını pozitif yönde arttrabilmek için sosyal reklamlar aracılığıyla kitlesel yayın organlarında görünür olmaya çok önem vermişlerdir. Kurumların sosyal reklamlar vasıtasıyla medyadaki görünürlükleri itibar yönetimi bağlamında incelendiğinde, sosyal sorumluluk kampanyalarının toplumun sorunlarına ve kaygılarına duyarlı bir şekilde çözüm üretecek nitelikte olup hedef kitlelenin ve paydaşların hem duygusal hem de rasyonel beklentilerinin karşılanması yönünde hareket etmelerinin gerektiği görülmektedir. İtibar kavramının önemli bileşini ve kriteri olan sosyal sorumluluk ve buna bağlı olarak yapılan sosyal reklam kampanyaları kurumun itibarını korumak ve arttırmak amacıyla yapılmaktadır. Sosyal sorumluluk kampanyalarının geniş kitlelere ulaştırılması aracılığıyla yapılan sosyal reklamlar bu çalışmanın temel konusudur.Sosyal reklamların itibar yönetimi açısından değerlendirilmesi için örnek proje olarak seçmiş olduğumuz Samsung “Duyan Eller” reklam kampanyası, dijital ve görsel medyada “Yılın En Duygusal Sürprizi” olarak nitelendirilerek küresel çapta başarı elde eden bir sosyal sorumluluk kampanyası olmuştur. Söz konusu reklam kampanyasının örnek proje olarak tercih edilmesinin en geçerli nedeni de dünya çapında elde ettiği bu başarısıdır. “Duyan Eller” sosyal reklam kampanyası nitel araştırma yöntemlerinden olan odak grup ve reklam çözümlemesi yöntemi ile iki aşamalı olarak incelenmiştir. İlk aşamada sosyal reklam içerik analizi yöntemine göre incelenmiştir. İçerik analizinde “Duyan Eller” reklamı: Görsel ve dilsel ileti kullanımı, sembol kullanımı, ritüeller, kahramanlar ve değerlerin kullanımı açısından analiz edilmiştir. Araştırmamızın ikinci aşamasında ise işitme engelli altı kişinin katılımı ile odak grup çalışması yapılmıştır. Odak grup çalışmasının sonucunda elde edilen bulgular; içerik ve betimsel analiz yöntemi ile analiz edilmiştir.Araştırmamızın temel varsayımı olan sosyal reklamların itibara olumlu etkisini destekler nitelikte sonuç elde edilmiştir. Bu tezden elde edilen bulgular alana katkı sağlayacak ve bu alanda çalışacak diğer araştırmacılara da temel niteliğinde olacaktır.--------------------In today's global competitive environment, the corporates have placed great importance on being visible in mass media through social ıssue advertising, in order to protect their assets and to increase their brand value and image positively. When the visibility in the media through social ıssue advertisements is examined in the context of reputation management, it is seen that social responsibility campaigns need to respond to the problems and concerns of the society in a sensitive manner and to act towards meeting the emotional and rational expectations of the target groups and stakeholders. The social responsibility and social ıssue advertising campaigns, which are the important components and criteria of the concept of trust, are carried out in order to maintain and increase the reputation of the organization. Social ıssue advertising through the dissemination of social responsibility campaigns to the broad masses is the main subject of this studyThe Samsung “Hearing Hands” advertising campaign, which we chose as a sample of these thesis for the evaluation of social ads in terms of reputation management, has been a social responsibility campaign that has achieved success on a global scale by being called “The Emotional Surprise of the Year” in digital and visual media. The most valid reason for choosing this advertising campaign as a sample is its worldwide success.The “Hearing Hands” social advertising campaign was examined in two stages of the qualitative research methods which are the focus group and advertisement analysis method. In the first stage, social advertising was analyzed according to content analysis method. The use of visual and linguistic messages in advertising was analyzed in terms of symbol usage, rituals, heroes and the use of values. In the second phase of our study, focus group study was conducted with the participation of six people with hearing impairment. The results obtained from the focus group study with content and descriptive analysis.The findings of this research proved our assumption on “Social ıssue advertising, has a positive effect on reputation”. Also the findings obtained from this thesis will contribute to the field and will be the basis for other researchers who will work in this field

Betonarme düzlem çerçevelerin armoni tarama yöntemi ile optimum tasarımı.

In this thesis, the optimum design algorithm is presented for reinforced concrete special moment frames. The objective function is considered as the total cost of reinforced concrete frame which includes the cost of concrete, formwork and reinforcing steel bars. The cost of any component is inclusive of material, fabrication and labor. The design variables in beams are selected as the width and the depth of beams in each span, the diameter and the number of longitudinal reinforcement bars along the span and supports. In columns the width and the depth of the column section, the number and the diameter of bars in x and y directions are selected as design variables. The column section database is prepared which includes the width and height of column section, the diameter and the number of reinforcing bars in the column section is constructed. This database is used by the design algorithm to select appropriate sections for the columns of the frame under consideration. The design constraints are implemented from ACI 318-05 which covers the flexural and shear strength, serviceability, the minimum and maximum steel percentage for flexural and shear reinforcement, the spacing requirements for the reinforcing bars and the upper and lower bound requirements for the concrete sections. The optimum design problem formulated according to ACI 318-05 provisions with the design variables mentioned above turns out to be a combinatorial optimization problem. The solution of the design problem is obtained by using the harmony search algorithm (HS) which is one of the recent additions to meta-heuristic optimization techniques which are widely used in obtaining the solution of combinatorial optimization problems. The HS algorithm is quite simple and has few parameters to initialize and consists of simple steps which make it easy to implement. Number of design examples is presented to demonstrate the efficiency and robustness of the optimum design algorithm developed.Ph.D. - Doctoral Progra

Poli(vinil alkol)-kalsiyum aljinat, poli(n-izopropilakrilamit)-kalsiyum aljinat hidrojel kürelerine lakkaz immobilizasyonu

Tez (Yüksek Lisans) -- Kırıkkale Üniversitesi78504