The prevalence of Giardia intestinalis and Entamoeba histolytica/dispar in Van Regional Training and Research Hospital: A four-year monitoring

Objective: The aim of this retrospective study was to determinethe frequency rates of Giardia and E.histolytica/E.dispar and their distribution by years as well as agegroups and gender distribution during a four-year period.Materials and methods: A total of 9911 stool samplessent to our laboratory between January 2008 and December2011 were tested for parasites. Native-Lugol and formolethyl acetate sedimentation methods were utilized formicroscopic identification of Entamoeba sp. and Giardiatrophozoites and cysts in fresh stool samples. Additionally,trichrome staining was performed in stool sampleswhere the distinctive diagnosis could not be confirmed.Results: From a total of 9911 stool samples analyzedduring the study, 4.7% were positive for Giardia and 6.2%were positive for Entemoeba histolytica/ Entemoeba dispar.Of Giardia-positive patients 57% were male and 43%female. Similarly, 56% of Entemoeba histolytica/ Entemoebadispar positive patients were male and 44% werefemale. Both parasites’ higher frequency rates seen inmale groups were found statistically significant (p<0.01).Conclusion: It is seen that intestinal protozoon infectionsare still present as an important public health problemin our region. In order to prevent this problem, personalhygiene and sanitation rules education for community aswell as infrastructure improvements are necessary.Key words: Giardia, Entemoeba histolytica/ Entemoeba dispar, prevalenc

Van depreminin su-kaynaklı bazı bulaşıcı hastalıklar üzerine etkisi

Objective: In this study, it was aimed to compare the isolation frequency of some water-borne disease causing microorganisms in pediatric patients before and after Van earthquake in order to determine the potential impact of earthquake on those selected infectious diseases. Methods: The laboratory test results of Adenovirus, Rotavirus, Hepatitis A virus (HAV), Giardia intestinalis and E.histolytica/dispar which were requested from 0-14 years old children, during six months before and six months after Van earthquake which took place on 23 October 2011, were retrospectively reviewed. Results: Adenovirus, Rotavirus, Anti HAV IgM and E.histolytica/dispar showed reduction in the isolation frequency rate during the six months period after the earthquake compared with the same period of previous year. The reduction rates in the isolation frequencies of Rotavirus and E.histolytica/dispar were found to be statistically significant (p<0.001). In contrast, Giardia intestinalis isolation frequency was significantly higher in the six months period after the earthquake (<0.001). Conclusion: Disaster management programme which was conducted after Van earthquake have been shown to be effective in preventing water-borne infectious diseases. Taking special precautions against Giardia spp. after earthquakes should be kept in mind

Antibiotics resistance of Stenotrophomonas maltophilia strains isolated from various clinical specimens

Background: A limited number of antibiotics are recommended for the therapy of Stenotrophomonas maltophilia infections due to therapy difficulties caused by its numerous mechanisms of resistance.Objectives: In this study conducted over a period of approximately 5 years we aimed to determine resistance rates of S. maltophilia based on drug classification recommended by Clinical and Laboratory Standards Institute.Methods: A total of 118 S. maltophilia strains isolated from various clinical specimens between January 2006 and June 2012 were included in the study. BD Phoenixautomated microbiology system (Becton Dickinson, USA) was utilized for species level identification and antibiotic susceptibility testing.Results: Sixty seven of S. maltophilia strains were isolated from tracheal aspirate isolates, 17 from blood, 10 from sputum, 10 from wound and 14 from other clinical specimens. Levofloxacin was found to be the most effective antibiotic against S. maltophilia strains with resistance rate of 7.6%. The resistance rates to other antibiotics were as follows: chloramphenicol 18.2%, trimethoprim-sulfamethoxazole 20.3% and ceftazidime 72%.Conclusion: The study revealed that S. maltophilia is resistant to many antibiotics. The treatment of infections caused by S. maltophilia should be preferred primarily as levofloxacin, chloramphenicol, and TMP-SXT, respectively.Keywords: Stenotrophomonas maltophilia, antibiotic, resistanc

The evaluation of vancomycin-resistant enterococci and carbapenamase producing Klebsiella colonization among ICU-Hospitalized Patients

Background: Multi-drug resistant organisms, especially Vancomycin-Resistant Enterococcus (VRE) and Carbapenam Resistant Klebsiella pneumoniae (KPC), are serious health threat. Early detection of resistant bacteria colonization amongpatients in intensive care units (ICUs) not only enables effective treatment but more importantly prevents disease and limits transmission. Therefore, we aimed to to assess the frequency of VRE and KPC colonization via rectal swab sampling. Methods: The study was carried out in ICUs of a tertiary hospital. Two rectal swab samples were collected within the first 24 hours of admission and another one was taken every subsequent 15 days to test for for VRE and KPC carriage. Results: A total 316 rectal swab samples taken from 230 patients. Forty-seven patients were screened at least 2 times. 183 patients were not further screened due to discharge, exitus or transfer to other wards. Thirty-six patients (16%) were determinedto be VRE (+). The most frequently isolated strain was E. faecium (80.5%) and its most common genotype was VanA (87.5%). Seven patients (3%) were identified as KPC (+). OXA-48 type crbapenamase was confirmed in all KPC isolates. Conclusion: This study shows that VRE and KPC colonization continues to be a serious threat in ICUs. Keywords: Carbapenam resistant klebsiella pneumoniae; vancomycin-resistant enterococci; intensive care units

ZONISAMIDE EXPERIENCE IN PATIENTS WITH REFRACTORY EPILEPSY

Amaç: Parsiyel epilepsisi bulunan, > 16 yaş hastalarda zonisamidin güvenilir ve etkin bir antiepileptik ilaç olduğu yapılan kontrollü çalışmalarla gösterilmiştir. Ancak literatürde zonisamidin çocuklarda kullanımı, etkinliği ve güvenilirliği ile ilgili yeterli sayıda çalışma bulunmamaktadır. Gereç ve yöntem: Ocak 2010-Aralık 2010 tarihleri arasında, diğer anti-epileptik ilaçlara yanıt alınamayan ve zonisamid tedavisi başlanan 10 dirençli epilepsi olgusunun tedavi sonuçları değerlendirilmiştir. Zonisamid, 2 mg/kg/gün ve 2 dozda başlanarak, haftalık 1-2 mg/kg/gün doz artışı yapılmış ve maksimum 12 mg/kg/gün dozunda kullanılmıştır. Bulgular: On hastanın (5 kız, 5 erkek) ortalama yaşı 9,7 yıl (min 4,7-max 17)'dir. 2/10 olgu idiyopatik, 3/10 olgu kriptojenik, 5/10 olgu semptomatik epilepsi olarak sınıflandırılmıştır. Tedavi süresi ortalama 6,9 aydır. Olguların 6/10'u jeneralize, 4/10'u parsiyel epilepsi hastasıdır. Jeneralize ve parsiyel epilepsi gruplarında birer olguda ≥ %50 tedavi yanıtı görüldü. Parsiyel epilepsi olarak sınıflandırılan 1 olgunun ise nöbetsiz olduğu tespit edilmiştir. Zonisamid tedavisi süresince sadece 1 olguda geçici iştahsızlık ve kilo kaybı görüldüğü saptanmıştır. Sonuç olarak, antiepileptik ilaçlara yanıt alınamayan, özellikle parsiyel epilepsisi bulunan olgularda zonisamid tedavisinin etkili ve güvenli bir tedavi seçeneği olduğunu düşünmekle beraber daha çok olguyu kapsayan çalışmalarla desteklenmesi gerektiği kanaatindeyiz. Objeçtive: It have shown with controlled studies that, zonisamide is a safe and effective antiepileptic drug in > 16 years of age patients with partial epilepsy. However, there is not enough study on the efficacy and safety of the use zonisamide with children, in literature. Material and method: The treatment results of 10 cases with refractory epilepsy, not responded to the other anti-epileptic drugs and zonisamide therapy was initiated, between January 2010-December 2010, were evaluated, The starting dose of zonisamide was 2 mg / kg / day, dose has been increased weekly by 1-2 mg / kg / day and a maximum of 12 mg / kg / day was used. Results: Ten patients (5 boys, 5 girls), mean age was 9.7 years (min 4.7-max 17 years). 2/ 10 of the cases idiopathic, 3 / 10 of the cases cryptogenic and 5 / 10 of the cases were classified as symptomatic epilepsy. The mean duration of treatment was 6.9 months. 6 / 10 of the cases were generalized and 4 / 10 of the cases were partial epilepsy patient. In each generalized and partial epilepsy groups, ≥ 50% treatment response was seen in one patients. One case who had been classified as partial epilepsy was found as seizure free. In only 1 case, temporary loss of appetite and weight loss was seen during zonisamide therapy. As a result, we thought that zonisamide is effective and safe treatment option, particularly in patients with partial epilepsy who did not respond to other antiepileptic drugs, but more studies are needed to support

Sarcopenia and Balance in Community-dwelling Women with Postmenopausal Osteoporosis

Objective:Sarcopenia and osteoporosis share common risk factors and biological pathways. In the present study, patients with postmenopausal osteoporosis were screened for sarcopenia using the algorithm proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) and balance impairment was investigated in sarcopenic patients.Method:Fifty three postmenopausal osteoporotic patients were evaluated for sarcopenia as per the algorithm proposed by the EWGSOP. Among the parameters included in the algorithm, gait speed was assessed using the timed up&go test (TUG), Jamar hand dynamometer was used to measure grip strength and calf circumference (an anthropometric method) was used for the measurement of muscle mass. Balance was assessed using the Berg balance scale and functional abilities using the TUG.Results:Fifty three postmenopausal patients with osteoporosis with a mean age of 65.48±9.12 years (range 47-84) were enrolled in the study. Sixteen patients (30.2%) reported a fall within the previous year, 22 patients (41.5%) had a history of fracture and 17 patients (32.1%) had maternal history of hip fracture. Sarcopenia was present in 8 (15.1%) patients. There was no significant difference between balance measurements of sarcopenic and non-sarcopenic patients (p>0.05). Only muscle mass showed a positive weak correlation and a significant association with balance (r=0.28, p<0.05).Conclusion:Despite low rate of balance impairment, most of our patients had a history of fracture. Balance is not the only risk factor for falls in postmenopausal patients. The use of anthropometry as a screening tool and usage of more objective methods for definitive diagnosis provide more accurate data for the measurement of muscle mass

Meaning in life, religious coping, and loneliness during the coronavirus health crisis in Turkey

Since December 2019, the COVID-19 pandemic has caused serious mental health challenges and consequently the Turkish population has been adversely affected by the virus. The present study examined how meaning in life related to loneliness and the degree to which religious coping strategies mediated these relations. Participants were a sample of 872 adults (242 males and 360 females) drawn from general public in Turkey. Data were collected using Meaning in Life Questionnaire, UCLA Loneliness Scale, and the Religious Coping Measure. Meaning in life was associated with more positive religious coping and less negative religious coping and loneliness. Positive religious coping was associated with less loneliness, while negative religious coping was associated with more loneliness. Religious coping strategies mediated the impact of meaning in life on loneliness. These findings suggest that greater meaning in life may link with lesser loneliness due to, in part, an increased level of positive religious coping strategies and a decreased level of negative coping strategies.Ataturk University SBA-2020-859

IS ROLANDIC EPILEPSY ALWAYS A BENIGN DISEASE?

Rolandik epilepsi, çocukluk çağının sık görülen parsiyel epilepsisidir. Genellikle uykuda gelişen fokal ya da sekonder jeneralize nöbetler görülür. Elektroensefalografide, tek taraflı ya da bilateral sentro-temporal diken dalga deşarjlarının varlığı karakteristiktir. Olguların çoğunda, adolesan dönemde elektroensefalografik ve klinik bulguların normale dönmesi nedeniyle iyi seyirli olarak kabul edilmektedir. Nöbetlerin seyrek olarak görülmesi ve iyi prognozu nedeniyle anti-epileptik tedavi başlanması tartışmalıdır. Bu makalede Rolandik epilepsi bulguları ile izlenen, takipte uykunun elektriksel status epileptikusu, dil, ince motor ve kişisel sosyal alanlarda baskılanma bulguları gelişen bir olgu Rolandik epilepsi seyrinin her zaman iyi huylu olmayabileceğine dikkat çekmek amacıyla sunulmuştur Rolandic epilepsy is a common childhood partial epilepsy. Focal or secondary generalized seizures during sleep are usually developed. On electroencephalography, unilateral or bilateral presence of the centro-temporal spike-wave discharges are characteristic. In most cases, electroencephalographic and clinical findings are return to normal in adolescent period and is considered as a good prognosis. Due to the rare seizures and good prognosis treat with anti-epileptic therapy is controversial. In this study, we presented a patient with Rolandic epilepsy, who developed electrical status epilepticus during sleep, suppression of language, fine motor, and personal social areas to keep attention to the course of Rolandic epilepsy may not be always good-nature

Increased P-wave dispersion in patients with newly diagnosed lichen planus

OBJECTIVE: Lichen planus is a chronic inflammatory autoimmune mucocutaneous disease. Recent research has emphasized the strong association between inflammation and both P-wave dispersion and dyslipidemia. The difference between the maximum and minimum P-wave durations on an electrocardiogram is defined as P-wave dispersion. The prolongation of P-wave dispersion has been demonstrated to be an independent risk factor for developing atrial fibrillation. The aim of this study was to investigate P-wave dispersion in patients with lichen planus. METHODS: Fifty-eight patients with lichen planus and 37 age- and gender-matched healthy controls were included in this study. We obtained electrocardiographic recordings from all participants and used them to calculate the P-wave variables. We also assessed the levels of highly sensitive C-reactive protein, which is an inflammatory marker, and the lipid levels for each group. The results were reported as the means ± standard deviations and percentages. RESULTS: The P-wave dispersion was significantly higher in lichen planus patients than in the control group. Additionally, highly sensitive C-reactive protein, LDL cholesterol, and triglyceride levels were significantly higher in lichen planus patients compared to the controls. There was a significant positive correlation between highly sensitive C-reactive protein and P-wave dispersion (r = 0.549,

TAY-SACHS HASTALIĞI BULUNAN BİR ERKEK ÇOCUĞUNDA MANYETİK REZONANS GÖRÜNTÜLEME BULGULARI

Tay-Sachs is a neurodegenerative lysosomal storage disease that is caused by the mutations in the HEXA gene. Decreased ß-hexosaminidase A activity leads to the accumulation of the GM2 gangliosides in neuron cytoplasms and causes progressive neurologic dysfunction. Magnetic resonance imaging findings drastically change during the progression of the disease. At the early stage of the disease T2 weighted images demonstrate hyperintense lesions in basal ganglia or non-specific findings. In the late phase of the disease cerebral and cerebellar atrophy, and basal ganglia and white matter T2 hyperintensities can be seen. In this paper, we reported a 17 month-old boy with Tay-Sachs disease whose clinical and magnetic resonance imaging findings progressed in 5 months period. Tay-Sachs HEXA genindeki mutasyonların neden olduğu nörodejeneratif bir lizozomal depo hastalığıdır. ß-heksosaminidaz A aktivitesinin düşüklüğü nedeniyle nöron sitoplazmalarında GM2 gangliozid birikimi ve bunun sonucunda da ilerleyici nörolojik disfonksiyon gelişir. Hastalığın progresyonu ile birlikte beyin manyetik rezonans görüntüleme bulguları da dramatik olarak değişir. Hastalığın erken dönemlerinde bazal ganglionlarda T2 ağırlıklı görüntülerde belirgin hiperintens lezyonlar ya da spesifik olmayan bulgular görülebilir. Hastalığı geç dönemlerinde ise serebral ve serebellar atrofi, bazal ganglion ve beyaz cevherde T2 hiperintens lezyonlar görülebilir. Bu makalede 5 aylık bir sürede klinik ve manyetik rezonans görüntüleme bulguları ilerleyen 17 aylık bir TAY-Sachs hastalığı olgusu sunulmuştu