Epidemiology of Tuberculosis with comparison of the efficacy of culture, real-time PCR and direct microscopy in the diagnosis of tuberculosis

Aim: Despite the developments every passing year, tuberculosis is still a major public health problem in Turkey and in the world. Early and correct diagnosis is important for the control of the disease. The aim of this study is to investigate the diagnostic efficiency of the culture (Lowenstein Jensen), real-time PCR (Abbott m2000rt, Bosphore MTBC Detection Kit) and direct microscopic examination of acid-resistant bacillus stained with Ehrlich-Ziehl-Neelsen (EZN), and the study was performed by evaluating the samples coming to our laboratory retrospectively over a 4-year period. Material and Methods: The samples sent to our mycobacteriology laboratory between January 2016 and December 2019 were evaluated retrospectively. The effects of direct microscopy and real-time PCR method were compared based on culture as a reference method. Results: Sensitivity, specificity, positive predictive value and negative predictive value of direct microscopy were calculated as 45%, 99.9%, 96.4%, 96.9%, respectively, in pulmonary samples and as 21.7%, 100%, 98.8%, 98.8%, respectively, in extrapulmonary samples. Sensitivity, specificity, positive predictive value and negative predictive value of real-time PCR were calculated as 80%, 98.3%, 98.8%, 97.3%, respectively, in pulmonary samples and as 62.5%, 99.2%, 50%, 99.5%, respectively, in extrapulmonary samples. Discussion: Although direct microscopic examination method is a cheap, simple, fast and highly specific test, its sensitivity is low. Therefore, patients with suspected tuberculosis should be evaluated together with culture, besides direct microscopy. It was observed that the sensitivity of direct microscopy was lower in extrapulmonary samples compared to pulmonary samples. The real-time PCR method has high sensitivity and specificity, and also gives fast results

Investigation of irisin levels in patients with major depressive disorder

Objective: Major depressive disorder (MDD) is a common psychiatric disorder. Irisin, produced by proteolysis of FNDC5, is thought to be an exercise -induced hormone that may play a critical role in inducing antidepressant -like effects. Our study aimed to investigate the relationship between irisin and newly diagnosed MDD patients. Methods: This cross-sectional study included 85 first-time diagnosed MDD patients and 81 healthy controls. Patients were diagnosed with MDD using the Structured Clinical Interview Questionnaire for DSM-IV Axis I and II Disorders (SCID-I, II) and the Hamilton Depression Scale (HAM -D). After an overnight fast, 5 ml of peripheral blood was drawn and serum irisin levels were measured. Results: When the effects of age and gender variables were controlled, no statistically significant difference in irisin levels was found between the groups. (F=1.832, p=0.178). When the effects of age, gender and body mass index variables were controlled and a partial correlation was made between irisin and HAMD scores, a significant negative correlation was found between irisin and HAMD scores (p<0.001, r=-0.523). The correlation analysis showed a statistically significant negative relationship between age and irisin levels (p=0.008, r=-0.205). However, when the effects of other variables were controlled and a partial correlation was made, no statistically significant relationship was found (p=0.610, r=-0.207). Conclusion: Our results indicate that irisin levels are associated with the severity of depression. Further studies are needed on the use of irisin as a potential biomarker for predicting clinical course and treatment response in patients with severe MDD

Correlation of suicidal thoughts and toxoplasmosis in patients with depression

Objective We investigated the correlation between serum anti-Toxplasma gondii IgG and suicidal thoughts in depressive patients. Methods Depressive patients with (n = 100) and without (n = 100) suicidal thoughts along with 100 healthy control subjects were recruited for this study. In all three groups, a semi-structured clinical interview form called Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) Axis-I Disorder (SCID-I), Hamilton Depression Rating Scale (HAMD), suicidal behavior scale, and a sociodemographic data form were completed. Sera from all participants were taken, and anti-toxoplasma IgG was measured by Enzyme Linked Immunosorbent Assay (ELISA)-Chemiluminescent Microparticle Immunoassay. Statistical analysis of the data was performed. Results The serum anti-toxoplasma IgG levels of patients with suicidal thoughts were significantly higher than those without suicidal thoughts and the controls, which were 80.04 +/- 40.66, 78 +/- 14.82, and 19.98 +/- 14.65, respectively, p < 0.001. There was no correlation between toxoplasma IgG and HAMD score in patients lacking suicidal thoughts (r = -0.112, p = 0.463). Conclusion This study shows a correlation between seropositivity for anti-Toxoplasma gondii IgG and depression with suicidal thoughts

Investigation of the relationship between hemogram parameters and procalcitonin levels in patients with psychiatric diseases

Introduction: This study aimed to evaluate the relationship between the hemogram parameters and the levels of procalcitonin, serum C-reactive protein, and inflammation in inpatients with psychiatric disorders. Material and methods: The study population consisted of 549 inpatients treated between January 2018 and December 2020. Data were obtained retrospectively from computer records and inpatient files. Only the first hospitalization of each patient was evaluated, and 199 patients were included in the study. The researchers examined the parameters including platelet activation, neutrophil lymphocyte ratio, monocyte lymphocyte ratio, platelet count, mean platelet volume, platelet distribution width, platelet lymphocyte ratio, and procalcitonin levels in patients and compared them with findings obtained from a control group. Results: Increased levels of C-reactive protein and decreased levels of platelets were observed in patients with schizophrenia, bipolar disorder, depressive disorder, and anxiety disorder. Increased platelet distribution width, platelet lymphocyte ratio, and neutrophil lymphocyte ratio were observed in patients with schizophrenia. The patients with bipolar disorder had increased mean platelet volume while patients with depressive disorder had an increased monocyte lymphocyte ratio. Procalcitonin levels increased in patients with anxiety disorder and depressive disorder. Discussion: Platelet activity can be an important criterion to investigate the etiopathogenesis underlying the inflammatory process in schizophrenia, bipolar disorder, depressive disorder, and anxiety disorders. To our knowledge, this is the first study to describe a positive correlation between increased monocyte lymphocyte ratio and procalcitonin levels in depressive disorder, and a positive correlation between increased procalcitonin levels and anxiety disorder and depressive disorder

Post-vaccination COVID-19 positivity and clinical situation analysis in healthcare professionals

Aim: Healthcare workers are an occupational group that is at the forefront of a pandemic process, where morbidity and mortality are intense. Deaths due to COVID-19 among workers in our country and in the world are reported mostly in healthcare workers. In this study, we aimed to analyze the rate of contracting COVID-19 among healthcare workers after vaccination and the clinical features of the disease.Material and Methods: Between January 14, 2021 and June 29, 2021, the diagnosis of COVID-19 in healthcare workers who had clinical complaints after a single dose and two doses of vaccination was made as a result of the evaluation of the patients' throat and nose swab samples by reverse transcriptase-polymerase chain reaction (RT-PCR). The disease table of the positive patients was grouped as home treatment and hospital treatment by accessing clinical and laboratory records from electronic medical records.Results: At least one dose of vaccine was given to 11,540 (79.62%) of a total of 14,461 healthcare workers. COVID-19 positivity was detected in the PCR test performed on 51 single-dose vaccinated healthcare workers and 177 double-dose vaccinated healthcare workers with clinical complaints. While all patients vaccinated with a single dose were treated at home, 176 of the patients vaccinated with two doses were treated at home and 1 was treated in the hospital.Discussion: It has been seen that if countermeasures against COVID-19 are not taken, it could be a great disaster for the whole world, that the most important defense against this pandemic is vaccination, and that those who have COVID-19 after vaccination have a mild illness even if they have the disease

Comparison of Er:YAG modalities (PIPS-SWEEPS) onEliminating of enterococcus faecalis populations

Comparison of Er:YAG Modalities (PIPS-SWEEPS) on Eliminating of Enterococcus Faecalis Populations Background: To determine the effectiveness of novel two Er:YAG lasers modalities, photon-initiated photoacoustic streaming (PIPS\SSP) and shock wave-enhanced emission photoacoustic streaming (SWEEPS\AutoSWEEPS) in terms of removal Enterococcus faecalis (E. faecalis) with or without antimicrobial agents [Sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX)]. Methods: Forty-two extracted single-rooted mandibular premolars were prepared, sterilized, and then inoculated with E. faecalis for 4 weeks, and randomly divided into to two main and three subgroups (n= 7). Group Ia ( PIPS + distilled water), Group Ib (PIPS + 5% NaOCl), Group Ic (PIPS + CHX), and Group IIa (SWEEPS + distilled water), Group IIb (SWEEPS + 5% NaOCl), and Group IIc (SWEEPS + CHX). Following incubation for 48 hours at 37°C, the colony forming units (CFU) were counted. Results: NaOCl and CHX activated with PIPS\SSP or SWEEPS\AutoSWEEPS modalities showed significantly higher reduction rates than distilled water activated with both laseractivated methods (p<0.05), but no significant differences were detected between the NaOCl and CHX groups. Besides, in all groups, no significant difference was detected between PIPS\SSP and SWEEPS\AutoSWEEPS performances in the reduction of CFU counts (p>0.05). Conclusion: Even novel laser activation methods or modalities are not sufficient alone to adequately reduce bacterial load and using antimicrobial agents with laser activation is necessary for the best reduction for microbial elimination. Novel SWEEPS\AutoSWEEPS modalıty with the conical 600μm tip showed no increased efficacy compared with PIPS\SSP mode. Besides, smaller fiber tip may increase the success of applications for minimally invasive access cavities and preparationEnterococcus Faecalis Biyofilmlerinin Ortadan Kaldırılmasında Er: YAG Yöntemlerinin (PIPS-SWEEPS) Karşılaştırılması Amaç: İki yeni Er: YAG lazer modalitesi olan foton-indüklü fotoakustik dalgalanma (PIPS \ SSP) ve şok dalgası ile geliştirilmiş emisyon fotoakustik akımının (SWEEPS \ AutoSWEEP) antimikrobiyal ajanlar (NaOCl ve klorheksidin glukonat) kullanılarak veya kullanılmadan E. faecalis uzaklaştırmadaki etkinliğinin belirlenmesidir. Gereç ve Yöntemler: Kırk iki ekstrakte tek köklü mandibular premolar hazırlandı, sterilize edildi ve daha sonra 4 hafta boyunca E. faecalis ekimi yapıldı ve rastgele iki ana ve üç alt gruba (n = 7) ayrıldı. Grup Ia (PIPS + distile su), Grup Ib (PIPS +% 5 NaOCl), Grup Ic (PIPS + CHX) ve Grup IIa (SWEEPS +distile su), Grup IIb (SWEEPS +% 5 NaOCl) ve Grup IIc (SWEEPS + CHX). 37 ° C'de 48 saat süreyle inkübasyonun ardından, oluşan koloniler (CFU) sayıldı. Bulgular: PIPS \ SSP veya SWEEPS \ AutoSWEEPS yöntemleri ile aktive edilen NaOCl ve CHX, her iki lazer aktivasyon metodu ile aktive edilen distile sudan anlamlı şekilde daha yüksek indirgeme oranları gösterdi (p <0.05), ancak NaOCl ve CHX grupları arasında anlamlı bir fark bulunmadı. Ayrıca, tüm gruplarda, CFU sayılarının azaltılmasında PIPS \ SSP ve SWEEPS \ AutoSWEEPS performansları arasında anlamlı bir fark saptanmamıştır (p> 0.05). Sonuç: Yeni lazer aktivasyon metod veya modülleri bile bakteri yükünü yeterince azaltmak için tek başına yeterli değildir. En etkili mikrobiyal eliminasyon için lazer aktivasyonun antimikrobiyal ajanlar ile birlikte kullanılması gerekmektedir. Konik 600μm uçla uygulanan yeni SWEEPS \ AutoSWEEPS modalitesi, PIPS \ SSP’e kıyasla artan bir etkinlik göstermedi. Daha küçük fiber uç kullanımı, minimal invaziv giriş kavitesi ve preperasyonlarda uygulamaların başarısını artırabilir

The relationship between laboratory findings and mortality in COVID-19 patients requiring intensive care

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shows a wide clinical manifestation from asymptomatic infection to life-threatening respiratory failure. This study aimed to determine the relationship between the survival and demographic data, comorbidity status, and laboratory parameters of coronavirus disease 2019 (COVID-19) patients requiring intensive care. Material and methods: We retrospectively analyzed 236 patients requiring intensive care whose diagnosis was confirmed by the SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test. The patients were divided into two groups in terms of survival. Demographic data; procalcitonin and C-reactive protein (CRP) levels; leukocyte, lymphocyte, and neutrophil counts in hemogram and neutrophil-tolymphocyte ratio (NLR) levels; and lower respiratory and blood cultures were examined, and the relationships between these parameters and survival were evaluated with hypothesis testing. Results: In the study, 156 (66.1%) males and 80 (33.9%) females, a total of 236 patients, were included. Sixty-seven (28.3%) surviving patients were determined as Group 1, and 169 (71.7%) deceased patients were determined as Group 2. A statistically significant difference was found between the groups in terms of mean age (p<0.001) and gender distribution (p=0.011). In laboratory parameters, a significant difference was observed between the groups in lymphocyte count (p=0.001), NLR (p<0.001), and procalcitonin levels (p<0.001). Although leukocyte (p=0.075), neutrophil (p=0.031), and CRP (p=0.112) levels were higher in Group 2, there was no statistical difference. Mortality was found to be higher in patients with comorbidity (p=0.012) or co-infection (p=0.002). Conclusion: High levels of neutrophil count, NLR, and procalcitonin; low lymphocyte count; the presence of comorbidity; and secondary bacterial infection were found to be associated with mortality in COVID-19 patients in the intensive care unit

G6PD Deficiency in Neonatal Jaundice

INTRODUCTION: Neonatal jaundice is one of the important problems encountered by the newborn in the first week after birth, the etiology of which is very diverse and sometimes no cause can be detected. It can result in death if the patients differ in their clinics and are not diagnosed early. Glucose-6-phosphate dehydrogenase (G6PD) deficiency, which is one of the etiological causes of neonatal jaundice, is among the causes of neonatal jaundice in our country. In this study, it was aimed to examine the effect of G6PD enzyme on jaundice in newborns followed up in our hospital for jaundice. METHODS: The study group consisted of 100 icteric babies who were followed-up XXXXX Hospital City Neonatology Department with the diagnosis of jaundice. RESULTS: In our study, the most common causes of jaundice in 100 babies diagnosed with jaundice were ABO incompatibility in 31(31%), jaundice due to G6PD deficiency in 10(10%) babies. It was observed that total bilirubin levels in babies with G6PD deficiency decreased significantly over a longer period of time compared to babies without enzyme deficiency. No significant difference was found in the other parameters of the patients. Of the babies with G6PD deficiency, 52(52%) were boys and 48(48%) were girls. No statistically significant difference was DISCUSSION AND CONCLUSION: While investigating the etiology of jaundice in newborns, it would be appropriate to check the G6PD levels in babies, and it should be considered that jaundice may improve in a long time in babies with low G6PD levels, and the necessary treatment should be planned in this way

Hepatit B enfeksiyonu olan hastalarda yaşanılan zorlukların değerlendirilmesi

Objectives: Although stigma is well defined in people with a chronic disease or condition, it has not been studied much in individuals infected with hepatitis B virus (HBV). The study is one of the first descriptive individual studies conducted on this subject in our country. Our aim in this study was to evaluate the stigma experiences and concerns of individuals living with HBV, their sharing of their illness with the environment, and the state of being affected by their social relationships. Materials and Methods: Patients with hepatitis B surface antigen positivity who were admitted to the infectious diseases outpatient clinic were surveyed through face-to-face interviews. Epidemiological data, stigma experiences and anxiety states, people with whom they shared their illness, the reasons for not sharing, the impairment of social relations were questioned. Results: It was found that 19.5% of 390 individuals infected with HBV who participated in our study were "exposed" to stigma in various ways, and 27.4% were "worried" about experiencing this condition. In research, 19.9% of women, 41.4% of university graduates, and 34.8% of divorced or widowers were found to experience higher stigma (p=0.002, p=0.02 and p<0.001, respectively). It was determined that 56.7% of the participants did not share their illnesses, and this need increased with stigma experiences and anxiety. It was found that individuals mostly shared their disease status with their first-degree relatives (p<0.001). Conclusion: The fact that individuals infected with HBV experience different forms of stigma or experience anxiety suggests that there is a need to investigate these conditions and develop treatment interventions

Is liver biopsy necessary in patients with chronic hepatitis B with normal alanine aminotransferase level?

Objectives: If not treated early, morbidity and mortality will remain high in hepatitis B virus infection. In this study, it was aimed to analyze the liver biopsy results of patients with chronic hepatitis B with normal alanine aminotransferase (ALT) levels. Materials and Methods: The study was conducted retrospectively. The patients who were admitted in the infectious diseases and clinical microbiology outpatient clinic, had liver biopsy and received treatment between 01.09.2019 and 01.12.2019, were included. Results: A total of 169 patients were included in the study. Of the individuals, 95 (56.2%) were female, with a mean age of 42.4 +/- 11.15 years. The rates of having an histological activity index (HAI) score of 6/18 and above and a fibrosis stage of 2/6 or more (90%, 100%, respectively) in patients with ALT level above upper limit of normal (ULN) were higher than in patients with ALT level below ULN (63.6% and 79.1%, respectively) (p=0.001 and p=0.002, respectively). When 129 patients with ALT level below ULN were evaluated in subgroup analyses. HAI score was 6 or higher in 59 (58.4%) of the hepatitis B e antigen (HBeAg) negative patients, and fibrosis stage was 2 or higher in 76 (75.2%) patients. In patients with ALT below ULN and HBeAg positivity, the rates of HAI score of 6 and above and fibrosis stage of 2 and above were found to be statistically significantly higher than in HBeAg negative patients. Conclusion: Liver fibrosis and necroinflammation may develop in patients with normal ALT levels. In making the biopsy decision, ALT level should be considered together with other factors that may affect liver damage