Pre-operative Serum CEA and CA19-9 Levels in Patients with Gastric Cancer: A Single-Center Experience

Introduction: To evaluate the preoperative CEA and CA19-9 levels and their association with clinicopathologic features and mortality. Methods: This retrospective study was conducted on patients who underwent gastric surgery due to gastric adenocarcinoma from 2008 to 2015. Preoperative serum CEA and CA19-9 levels were compared according to the TNM classification and survival data were compared. Results: A total of 335 patients were included in the study with the mean age of 66.1±11.0 years. CEA and CA19-0 positivity were 29.1% and 28.1%, respectively. According to the CEA groups, T stages of the cases were statistically significant (p = 0.013). The rates of T stage 1 in group 1 (CEA positive) were significantly higher than the group 2 (CEA negative) (p=0.007). According to the CA19-9 positivity; rate of stage 2 was significantly higher in the group 1 (CA19-9 positive) (p=0.001); however, rates of stage 2 and 3 were significantly higher in the group 2 (CA19-9 negative) (p=0.004 and p=0.007, respectively). Mortality information could be accessed for 309 cases and 108 deaths (36%) were observed. The mean survival time was 45.21±2.42 months. No significant difference was observed between the groups (p>0.05). Conclusion: Patients with higher levels of CEA and CA19-9 seem to have higher grades of gastric cancer. However, CEA and CA19-9 level does not seem to be in association in our study population

Serum uric acid level is associated with type 2 diabetes mellitus and diabetic regulation

Aim: Serum uric acid is a risk factor for cardiovascular and renal diseases. The role of uric acid as a renal and cardiac risk factor is more prominent in subjects with diabetes mellitus and hypertension. In present retrospective analyze, we aimed to compare serum uric acid levels of subjects with well and poorly controlled type 2 diabetes mellitus (T2DM) and healthy population. Methods: Patients with T2DM, who admitted to outpatient clinics of our institution between April 2017 and January 2018 were retrospectively analyzed. Diabetic subjects grouped into well or poorly regulated T2DM groups according to the HbA1c level (patients with an HbA1c lower than 7% were grouped as well regulated while others grouped as poorly regulated T2DM). Control subjects were healthy individuals whom asked for a routine check-up in our institution. Clinical and laboratory parameters of the study groups compared. Results: Serum uric acid levels of well-controlled T2DM, poorly controlled T2DM and control groups were 5.9±1, 6.7±1.8 and 4.3±1 mg/dL, respectively (p<0.001). Post Hoc analysis revealed that uric acid levels of well controlled diabetics were significantly lower than the uric acid levels of poorly controlled diabetics (p=0.04) and significantly higher than that of the control subjects (p<0.001). Conclusion: We suggest that elevated uric acid indicates a cellular level of damage and can be used as a prognostic indicator of pre-diabetes and T2DM. &nbsp

Serum Uric acid is correlated with HbA1c levels in type 2 diabetes mellitus

Aims: Uric acid is the product of purine metabolism and elevated serum uric acid levels are associated with many metabolic conditions. In present retrospective analysis, we aimed to compare serum uric acid levels of well controlled type 2 diabetic subjects to those of poorly controlled type 2 DM patients. Methods: Medical database of type 2 diabetic subjects whom admitted to outpatient clinics of our institution, between January 2017 and August 2017, were retrospectively analyzed. Patients with a HbA1c level lower than 7,5% were classified as well controlled and others were classified as poorly controlled type 2 DM group. Uric acid levels of the groups were compared. Results: Serum uric acid level of well controlled and poorly controlled diabetics were 4.1 (2,8-5,9) mg/dl and 5,9 (4-9,6) mg/dl, respectively. The difference was statistically significant (p<0.001). A Pearson’s correlation test was revealed that serum uric acid was strongly and positively correlated with HbA1c (r=0.81, p<0.001). Conclusion: Serum uric acid levels worsen in poorly controlled type 2 diabetic subjects. Since HbA1c levels reflects changes in 3 months period, variations in serum uric acid levels could be used as a predictor of diabetic control level in shorter time periods

Mean Platelet volume to platelet and red cell distribution width to platelet ratios in Irritable Bowel Syndrome

Aim: Irritable Bowel syndrome (IBS) is a common gastrointestinal disease worldwide with a broad spectrum of symptoms. In present retrospective study, we aimed to compare mean platelet volume to platelet ratio (MPR) and red cell distribution width to platelet ratio (RPR) values of IBS patients to those of healthy subjects. Methods: Patients whom followed up in internal medicine clinic of our institution between 2014 January to 2018 January were enrolled to the study. IBS subjects divided into constipation dominant or diarrhea dominant IBS groups. Healthy individuals visited our outpatient clinics for a check-up were enrolled as control group. Results: Median MPR of the constipation IBS, diarrhea IS and control groups were 0,034 (0,02-0,06), 0,034 (0,02-0,06), and 0,028 (0,01-0,05), respectively. The difference between groups was statistically significant (p=0.004). Conclusion: We think that elevated MPR in a patient with typical symptoms of IBS could be helpful in the diagnosis of the disease. Therefore, we suggest automatic calculation of MPR in hemogram assays. &nbsp

Millennium pandemic: A review of coronavirus disease (COVID-19)

Coronaviruses, a large family of single-stranded RNA viruses, can infect humans and animals, and can cause neurological, gastrointestinal and hepatic diseases as well as causing various lung diseases, including pneumonia, with shortness of breath, cough and fever. At the end of December 2019, a group of health authorities reported unidentified cases of pneumonia in a seafood market in Wuhan, China. The World Health Organization (WHO) used term 2019 novel coronavirus (COVID-19) to refer to a coronavirus that affected the lower respiratory tract of patients with pneumonia in Wuhan, China on 29 December and the WHO announced that the official name of the 2019 novel coronavirus was coronavirus disease (COVID-19). COVID-19 is seen in many countries around the World and has been accepted as a pandemic by WHO. It is defined as a suspicious case with fever, sore throat, cough, and people with a history of traveling to China or some parts of the country, or someone who contact with a patient who has a history of travel in China or contact with a confirmed COVID-19 infection patient. Currently, there is no proven vaccine or antiviral therapy that can be used against animal or human coronavirus. To control the outbreak, the drugs must be developed as soon as possible. Various drugs have been used in the treatment of COVID-19 and the main ones are chloroquine, remdesivir, lopinavir/ritonavir, oseltamivir, favipiravir. Since the virus affects the whole World, vaccines and/or new curative antiviral drugs are needed to end the pandemic. For this purpose, large-scale observational studies are needed

A rare non-hemolytic case of ıdiopathic cold agglutinin disease

Background: Cold agglutinin disease is a very rare condition associated with agglutination of erythrocytes in cold environment usually due to IgM type antibodies. Other than hemolytic anemias, it may interfere with routine hemogram tests due to miscalculation of red blood cell count (RBC) and other hemogram parameters calculated with involvement of RBC. Awareness of the condition is important to overcome laboratory errors. Methods: We studied a peripheral blood smear and repeated the hemogram test at 37°C to establish the diagnosis of cold agglutinin disease. Results: Initial hemogram test results of the fifty-eight year-old man was as follows: RBC: 1.34 M/µL, hemoglobin (Hb): 12.4 g/dL, hematocrit (Htc): 11.8%, mean corpuscular hemoglobin (MCH): 92.4 pg, and mean corpuscular hemoglobin concentration (MCHC): 105 gr/dL. Despite the standard indirect Coombs test being negative, repeated tests at room temperature was 4+. We suspected cold agglutinin disease and repeated the hemogram test using the Bain-Marie method at 37°C and the test results showed RBC: 3.4 M/µL, hemoglobin: 12.6 g/dL, hematocrit: 30.2%, MCH: 31.7 pg, and MCHC: 41.8 g/dL. Conclusions: Inappropriate hemogram results may be a sign of underlying cold agglutinin disease. Hemolytic anemia not always accompanies the disease; however, cold exposure may trigger erythrocyte agglutination in vitro and may cause erratic laboratory results

Superior Vena Cava Syndrome and Multiple Venous Thrombosis in a Patient with B Cell Lymphoma

Background: Superior vena cava syndrome (SVCS) develops due to external mechanical pressure of superior vena cava (SVC) by a mass lesion or by an enlarged lymph node, tumor invasion of the vessel wall, or venous thrombosis resulting in intraluminal obstruction. Approximately 3,9% of lymphomas are complicated with SVCS. This rate reaches to 7% in diffuse large B cell lymphoma. The objective of this article was to describe a case report of  a young woman with a diffuse large B cell lymphoma, complicated with pericardial-pleural effusion and SVCS. Methods: A 25 year old woman referred to the Internal Medicine Clinic of Abant Izzet Baysal University Hospital with complaints of bloating in the neck and both arms. She had chest pain, dyspnea, cough, and epigastric discomfort for 10 days. A thoracic magnetic resonance imaging (MRI) test and pathological assessment were carried out. Results: A mediastinal mass 64x112x82 mm in size, displaced the heart and main mediastinal structures to posterior, was detected by thoracic magnetic resonance imaging (MRI) test. The result of the pathological assessment of the biopsy specimen revealed large B cell lymphoma, stained strongly and diffusely with CD20 and bcl-2. She was referred to the hematology unit and doing well after a chemotherapy. Conclusions: Diagnosis of SVCS requires high level of clinical suspicion, detailed and complete physical examination. Moreover,  SVCS should be kept in mind in the differential diagnosis of patients  presented with edema in the neck and upper extremities

Neutrophil to lymphocyte ratio as an indicative of diabetic control level in type 2 diabetes mellitus

Background: Type 2 diabetes mellitus is associated with chronic low grade inflammation. One of the novel inflammatory markers is hemogram derived neutrophil to lymphocyte ratio (NLR). Objective: We aimed to compare NLR levels of diabetic subjects and healthy controls and to observe possible correlation between NLR and HbA1c. Methods: Medical data of type 2 diabetic subjects admitted to out-patient clinics of our institution between April to July in 2017 were obtained from database and retrospectively analyzed. Control group was chosen from healthy subjects who visited our institution for a routine check-up. Anthropometric measures, laboratory data, including, HbA1c, NLR were recorded. Results: Median NLR of the type 2 DM group 2.44 (1.9) was significantly elevated when compared to healthy controls (1.5 (0.9), (p<0.001). In addition, a Pearson\u2019s correlation test revealed that NLR was strongly correlated with age (r=0.26, p=0.008), fasting plasma glucose (r=0.38, p<0.001), and HbA1c (r=0.49, p<0.001). Conclusion: Elevated NLR in otherwise healthy subjects may be indicative of underlying impaired glucose metabolism and moreover, NLR should be used as a marker of diabetic control level in addition to HbA1c in type 2 diabetic subjects. DOI: https://dx.doi.org/10.4314/ahs.v19i1.35 Cite as: Duman TT, Aktas G, Atak BM, Kocak MZ, Erkus E, H S. Neutrophil to lymphocyte ratio as an indicative of diabetic control level in type 2 diabetes mellitus. Afri Health Sci. 2019;19(1). 1602-1606. https://dx.doi.org/10.4314/ahs.v19i1.3

A rare cause of acute abdomen: The omental torsion

WOS: 000364167800007Omental torsiyon nadir görülen bir akut karın nedeni olup klinik olarak birçok hastalığı taklit edebilmektedir. Tanı ve tedavisinde laparoskopi son derece yararlı bir yöntemdir. Bu yazıda, diagnostik laparoskopide omentumun torsiyonu tespit edilen ve laparoskopik olarak nekroze omentum dokusunun rezeke edildiği bir olgu sunulmaktadır.Omental torsion is a rare cause of acute abdominal pain and can mimic clinically many diseases. Laparoscopy is a useful method in the diagnosis and treatment of the omental torsion. In this article, a case with omental torsion which was detected during diagnostic laparoscopy and the necrosed omental tissue resection was done laparoscopically has been presented

Prevelance of anemia types and etiology in patients with anemia

In this study, we aimed to determine the frequency and etiologic causes of anemia types in a university clinic who were diagnosed with anemia, whether there were differences in anemia types by gender difference, and the relation of anemia types according to age and comorbidity. A total of 250 patients were included in the study. Iron deficiency anemia alone in 151, B12 deficiency anemia alone in 18, folate deficiency anemia alone in 2, anemia of chronic diseases in 11 and mixed anemia in 65 cases were detected. Underlying etiology of the anemia cases were diagnosed in 173 (69%) of the patients, however, the etiology of the anemia remained unclear in 77 (31%) cases. Iron deficiency was more frequent in women than in men (p [Med-Science 2018; 7(4.000): 919-22