Prediction of Low Factor V Levels in Patients with Herbal Medicine Related Acute Liver Injury

  Background: Prior epidemiologic studies predicted a rapid rise in herbal medicine-related acute liver injury (HILI) and liver transplantation (LT) as trading of traditional herbal medicine drugs is expanded. HILI is the leading cause of liver transplantation in the world. The indication for LT was defined as acute liver failure (ALF) with the factor V (FV) level below 35%. Objective: To explore the possible impact of herbal medicine-related to the liver failure on the laboratory parameters and to determine if simple laboratory values play a role in determining lower FV levels. Materials and methods: Totally, 38 HILI cases who were admitted to a tertiary care hospital between May 2016 and May 2018 were scanned, retrospectively. Need for LT was assessed by the determination of FV levels. Results: The mean age of participants was 37±13 years where 27 (71%) were female while the rest were male and 81% of the total population were farmers. Total 78% patients were reportedly consuming herbal medicine pills, and 22% reported consuming traditional Turkish herbs. Among 38 cases with HILI in critical care, 2 (5.2%) have died, 3 (7.8%) underwent LT and 33 (87%) were recovered and discharged. Results of 38 patients with available data also showed that factor V levels were positively correlated with the hemoglobin and platelet levels (p<0.05) and negatively correlated with prothrombin time (p<0.05). Conclusion: These findings suggest that detecting anemia and thrombocytopenia could be an important, economically feasible strategy for improving outcomes in HILI

Prevalence of Non Alcoholic Fatty Liver Disease in patients with Parkinson Disease

INTRODUCTION[|]Non alcoholic fatty liver disease (NAFLD) has presented as the most common cause of chronic liver disease in the Western world. Parkinson disease (PD) is the second most common non-demyelinizan neurologic disase and its incidence is steadily increasing in the world. Our study aims to analyze the prevalence of ultrasonography-proven NAFLD among the PD patients. [¤]METHODS[|]A retrospective chart review was performed to identify PD patients who had at least two visits in the Liver Clinic from January 2017 to May 2018. Thus, 124 consecutive patients (the mean age 74,2+-11,9years; 65 female) with PD was longitudinally screened for NAFLD which were diagnosed according to ultrasonographic criteria. Control subjects (65 subjects, mean age was 68+-3.4 years; 35 female) were selected from age-matched eldely subjects. Demographic and laboratory data, concurrent statin use and results of hepatobiliary ultrasonography were collected. Patients with history of chronic liver disase, liver transplant, past alcohol use or not enough data to stage NAFLD were excluded. Data analyzed using Pearson's chi-squared test with the Stata software.[¤]RESULTS[|]Nonalcoholic fatty liver disease prevalence was significantly lower in the PD group than in the age -matched control group (21% vs. 36%, P<0.05). In multiple logistic regression analyses using baseline factors, statin use (P=0.04) and elevated Hb A 1 C (P<0.001), baseline fasting glucose below than 100 mg/dL (P=0.03), and elevated ALT levels (P<0.001) were independently associated with NAFLD.[¤]DISCUSSION AND CONCLUSION[|]While additional studies in large populations are needed to investigate the correlation between PD and NAFLD, further exploration of PD -related metabolic liver disease clinically appears warranted.[¤

SCREENING FOR HEPATITIS B AND C SEROPREVALENCE AND PREVALENCE OF HIV INFECTION AMONG AFGHAN REFUGEES NEWLY ARRIVED IN COASTAL REGION TURKEY IN 2018: A SYSTEMATIC SINGLE-CENTRE ANALYSIS

Introduction: Previous studies showed that refugee status have been associated with various deteriorated effects on human health including higher prevalence of hepatitis B, C and HIV infections. In this study we aim to bridge the gap between Afghan immigrants and naive Turkish population by identifying HBV, HCV and HIV profiles. In addition, a large number of laboratory parameters was collected for all participants, including hematologic and biochemical test results. Materials and Methods: We performed a retrospective review of laboratory records at a tertiary center in Northern Turkey from January 1, 2018, to April 15, 2018. Our population based study comprising hospital data of 403 Afghan refugees and 400 naive Turkish citizens. Results: Afghan refugees had higher anti-HIV seropositivity than Turkish citizens.(p<0.05).There were no difference between the two groups according to HbsAg and anti-HCV seropositivity. Also Afghan refugees had statistically lower ALT levels, higher hemoglobin levels and higher mean TSH level (p<0.05). Mean T4 level did not show significant difference between the two groups. Conclusion: We need further investigations to find out the risk of infections that originated from immigration

Attitudes and Behaviors Regarding Smoking in Friends and Relatives of Patients in Emergency Room: A New Frontier in the Fight against Tobacco

Background: Emergency rooms (ERs) are usually crowded with friends and relatives (F&Rs) of the patients. This experience may result in changes in smoking behaviors and create opportunities for smoking cessation interventions. The study aims to investigate these changes and offers a new frontier in the fight against smoking.Methods: This cross-sectional study was conducted in the ERs of two universities in different cities. A questionnaire consisting of 18 questions was applied to F&Rs of the emergency patients. Statistical analysis was performed using Jamovi program.Findings: A total of 603 respondents were included in the study. Of them, 71.3% were first-degree relatives, 51.7% waited 5 or more times in ER before, and 68.6% spent 0-2 hours in a day around the ER. Upon witnessing patients in the ERs, 53.4% of the F&Rs had the idea of quitting smoking and 42.9% wanted to have smoking cessation therapy during their wait in the hospital. While 76.1% of the participants were not using different brands of cigarettes when offered in normal life, this rate was lower around the ERs (64.6%) (P < 0.001). Participants smoked 0.82 ± 0.34 cigarette per hour in normal life excluding sleeping time; this number raised almost 6 folds during the wait (4.85 ± 2.11) (P < 0.001).Conclusion: F&Rs smoked more during waiting around ERs. However, they also expressed desire to quit smoking and receive smoking cessation intervention during the wait. Providing smoking cessation counseling to F&Rs in the ER may be a valuable intervention

Smoking behavior and attitudes of patient’s relatives in the pediatric emergency rooms- a multi-center study

It was aimed to investigate the smoking behavior and attitudes of the relatives of the children in the ERs to determine whether current experience had any impact on the desire to quit. This study conducted with 300 patient relatives who applied to the pediatric ER of three hospitals in different cities between June 2019 and June 2020. Apart from the demographic data, a questionnaire consists of 18 questions were applied regarding participants’ past and current ER experiences and smoking behaviors. All data were analyzed using SPSS version 20.0 (IBM, USA) software package. It was determined that many (47.3%) spent more than 4 hours in the vicinity of ERs. Most of the individuals (58.0%) had waited 3 or more times in the ER previously. Besides, 59.3% had the idea of quitting smoking as they saw the patients in the ER, and while in the hospital, 44.0% wanted to have smoking cessation treatment. The average number of cigarettes smoked per hour in daily life was 0.61 ± 0.52 (excluding sleep time), but during the waiting period, this figures went up considerably to 4.32 ± 5.28/ hour (p <0.001). The rate of those who consumed more than 20 cigarettes was higher in those who waited 5 or more times in the ERs previously (p = 0.025). Patient relatives who were interviewed in the pediatric ER smoked more frequently. There is a need for smoking cessation clinics that can be integrated into the ER