Epidemiology of pemphigus in Turkey: One-year prospective study of 220 cases

Pemphigus is a group of rare and life-threatening autoimmune blistering diseases of the skin and mucous membranes. Although they occur worldwide, their incidence shows wide geographical variation, and prospective data on the epidemiology of pemphigus are very limited. Objective of this work is to evaluate the incidence and epidemiological and clinical features of patients with pemphigus in Turkey. All patients newly diagnosed with pemphigus between June 2013 and June 2014 were prospectively enrolled in 33 dermatology departments in 20 different provinces from all seven regions of Turkey. Disease parameters including demography and clinical findings were recorded. A total of 220 patients were diagnosed with pemphigus during the 1-year period, with an annual incidence of 4.7 per million people in Turkey. Patients were predominantly women, with a male to female ratio of 1:1.41. The mean age at onset was 48.9 years. Pemphigus vulgaris (PV) was the commonest clinical subtype (n=192; 87.3%), followed by pemphigus foliaceus (n=21; 9.6%). The most common clinical subtype of PV was the mucocutaneous type (n=83; 43.2%). The mean Pemphigus Disease Area Index was 28.14±22.21 (mean ± Standard Deviation).  The incidence rate of pemphigus in Turkey is similar to the countries of South-East Europe, higher than those reported for the Central and Northern European countries and lower than the countries around the Mediterranean Sea and Iran. Pemphigus is more frequent in middle-aged people and is more common in women. The most frequent subtype was PV, with a 9-fold higher incidence than pemphigus foliaceus.   </p

Effect of using simulation on the teaching ofresistance reading with color codes on learning and students’ opinions

Bu araştırmada renk kodları ile direnç okumanın öğretiminde simülasyon kullanımının öğrenme üzerindeki etkisi ve öğrencilerin görüşleri incelenmiştir. Araştırmaya Fen Bilgisi Eğitimi Anabilim Dalı birinci sınıfta öğrenim gören 60 öğrenci katılmıştır. Araştırmada tek örneklem son test desen kullanılmıştır. 10 sorudan oluşan başarı testi ve başarı testine ilave edilen 2 açık uçlu soru kullanılarak veriler toplanmıştır. Araştırma sonucunda renk kodları ile direnç okumanın öğretiminde simülasyon kullanımının öğrenme üzerinde etkili olduğu saptanmıştır. Fen bilgisi öğrencilerinin simülasyon kullanımına yönelik görüşlerinin genel olarak olumlu olduğu belirlenmiştir. Öğrencilerin simülasyon kullanımının avantajlarına yönelik görüşlerinin “akılda kalıcılık, pratik yapma, görsel, eğlenceli, kolay ve anlamlı öğrenme, hızlı öğrenme, zamandan tasarruf sağlama, pratik kullanım, direnç okumada kolaylık sağlama”; dezavantajlarına yönelik görüşlerinin ise “kafa karıştırması, gerçeğini görme isteği, ezber gerektirmesi, uğraştırıcı olması ve uzun zaman alması” kodlarında yoğunlaştığı belirlenmiştir.In this study, effect of using simulation on the teaching of resistance reading with color codes on learning, and students’ opinions were examined. The study was conducted with the participation of 60 first-year students attending the Science Education Department. One sample post-test design was used in the study. Data was collected by using achievement test including 10 questions and 2 open-ended questions added to achievement test. As a result of this study, it was reached that using simulation on the teaching of resistance reading with color codes is effective on learning. It was determined that students’ opinions on using simulation are positive in general. It was determined that students’ opinions on advantages of using simulation centered on codes of “memorable, practical, visual, enjoyable, easy and meaningful learning, time saving, practical usage, making resistance reading easier” and that students’ opinions on disadvantages of using simulation mainly focused on codes of “being confusing, desire to see the real one, requiring memorization, being challenging and taking long time

Medicine Science 2013;2(3):701-8 Copeptin and Insulin Theraphy Original Investigation Copeptin: May It Be a Novel Biomarker for Insulin Theraphy in Subjects with Diabetes?

Abstract Copeptin is a marker about prognosis of acute illnesses, generally. It may be also an indicato

Niacin: Does It affect 8-hydroxy-2-deoxyguanosine levels of the patients having low HDL cholesterol levels?

We aimed to determine whether niacin improve plasma HDL-cholesterol levels by decreasing 8-Hydroxydeoxyguanosine (8-OHdG) as a biomarker of oxidative DNA damage or not. Patients (n=32) with low HDL-cholesterol levels (&#8804; 40 mg/dl) were included in the study. Lipoprotein profiles (total cholesterol, HDL-C, and total triglycerides) were measured in all patients. LDL-C was calculated as described by Friedewald et al. Before and after 16 week of niacin therapy serum 8-OHdG was measured. There were significant difference between pre and post treatment plasma HDL-C and 8-OHdG levels. We concluded that niacin may raise HDL-C levels. The improvement of plasma HDL-C levels may have a protective effect on endothelial dysfunction. By reducing the level of 8-OHdG, niacin may decrease DNA damage. Thus, niacin therapy may be consider as an alternative to statins or fibrates in patients in whom fail to sufficiently correct low HDL-C levels. [Med-Science 2013; 2(2.000): 618-23

Rates and Risk Factors of Diabetic Foot Reamputations

SUMMARY Aim: The aim of this study is to determine the reamputation rate in patients who had amputation surgery in our hospital with the diagnosis of diabetic foot and to analyze the comorbid factors. Material and Method: Of 131 patients with detailed information in their files 66 patients who had amputation surgery are included in the study. Age, gender, smoking habits, comorbid diseases, number, level, side and time period of amputation surgeries experienced, presence of infection, wound culture growth of microbes, presence of leukocytosis and method of treatment are recorded. Diabetic foot ulcers of the patients are graded with Wagner-Meggit classification depending on the depth of the wound. Wounds are also evaluated in three different pathophysiological groups as neuropathic, neuropathic-ischemic and ischemic. Levels of amputation were digital, ray, transmetatarsal, below-knee transtibial and above-knee transfemoral. Ipsilateral or contralateral reamputations in previosly amputated patients were investigated. Results: Of the 66 patients who experienced amputation or reamputation surgery 45 were males and 21 were females. Mean age was 63,2 ( 26-88 ). 11 patients had reamputation surgery. 7 patients had ipsilateral reamputations at a more proximal level, 2 patients had contralateral side amputations and ipsilateral more proximal level reampuations and 2 patients had contralateral side amputations. Wagner-Meggit classification of the wounds in amputated patients yielded 4 Grade3, 40 Grade4, 11 Grade5 wounds where as 7 Grade4, 4 Grade5 wounds in reampuatated patients. Pathophysiological classification yielded 6 neuropathic, 21 neuroischemic and 28 ischemic wounds in amputation group where as 4 neuroischemic and 7 ischemic wounds in reamputation group. Discussion: Evaluation of diabetes dependent and nondependent comorbid risk factors as well as the physiological capacity of the patients are important as much as selecting accurate level of amputation level with the aid of new diagnostic techniques in decreasing reamputation risk and rates. [Med-Science 2012; 1(4.000): 283-91

A Retrospective Analysis of Amputation Rates and Comorbidity in Patients with Diabetic Foot Ulcer

Abstract Diabetic foot ulcers cause elongated hospitalisations with high treatment costs and high rates of lower extremity amputations resulting with increased morbidity and decreased quality of life. The aim of this study was to determine amputation rate in patients admitted to our hospital with the diagnosis of diabetic foot and the most common risk factors in patients with diabetic foot ulcers. 131 patients admitted to outpatient clinics of Izmir Katip Celebi University Ataturk Training and Research Hospital between January 2011 and December 2011 with the diagnosis of diabetic foot ulcer were retrospectively analyzed. Of these 96 were males and 35 were females. Age, gender, smoking and alcohol habits, comorbid diseases, presence of infection, growth of microorganism in medium, presence of leukocytes, hypertension, method of treatment and regimes of antibiotics are recorded. Mean age was 61,1 ( 26-90). Patients are divided into two groups according to treatment protocols, first group was consist of debriated and medicaly treated patients, while the second group covered amputated patients. 66 were amputated and the rest 65 had debridement-wound care and antibiotherapy after they were evaluated in the diabetic foot council of our hospital. Rate of amputation was 50 %. 36 of the amputated patients had major and the others had minor amputations. Most common comorbidities that related and nonrelated to diabetes were peripheral arterial disease ( 102 out of 131; 77% ) and hypertension ( 50 out of 131; 38% ); respectively. Grading of diabetic ulcers according to Wagner-Meggit classification yielded that most commonly seen wounds were grade 4 in the amputation group and grade 2 in the debridement group. According to pathophysiological classification most common cause were ischemic wounds in both groups. Compared to the literature, our amputation rates are higher. This issue can be attributed to high rates of comorbid factors, higher age and irregular follow-up. Key words: diabetic foot, amputation, comorbidity [Med-Science 2012; 1(4.000): 331-40

Copeptin: May it be a novel biomarker for insulin theraphy in diabetes? An animal study.

Copeptin is a marker about prognosis of acute illnesses, generally. It may be also an indicator associated with treatment of chronic diseases. We aimed to evaluate copeptin levels in rat models with stress, diabetes, diabetes+insulin. Healthy male Wistar rats, about 3 months old, weighing 200 250 g, were obtained from University Animal House. They were housed in small cages at standard conditions (24 ± 2&#xb0;C and 50 ± 5% humidity) with a 12 h light/dark cycle and were fed ad libitum with standard rat chow and tap water. Rats were divided into 4 groups: 8 control (C), 8 diabetic (D), 8 diabetic+insulin (DI) and 8 stress (S) rats. Quantitative measurement of Copeptin was performed using the ELISA method (Uscn Life Sciences, USA), according to the manufactur ers instructions. Copeptin level was statistically significant decreased in D+I groups. There was no difference in copeptin level between the S, D, and C groups. Copeptin may be considered as a new tool for the comparison of the efficiencies of new therapeutic modalities in diabetes. [Med-Science 2013; 2(3.000): 701-8