Akut tonsillofarenjitli hastalardan izole edilen beta hemolitik streptokokların tiplendirilmesi

Streptokoksik tonsillofarenjit vakalarının büyük bir kısmından A grubu beta hemolitik streptokoklar(AGBHS) sorumludurlar.Ancak diğer serogruplarda,özellikle C ve G grubu BHS larda akut bakteriyel farenjitin nedeni olabilmektedirler. Selçuk üniversitesi tıp fakültesi klinik bakteriyoloji ve infeksiyon hastalıkları polikliniğine ateş,boğaz ağrısı gibi şikayetlerle başvuran ve akut tonsillofarenjit düşünülen 256 hastanın boğaz kültürleri değerlendirildi.BHS saptanan 113 örneğin streptokok serogruplan lateks aglütinasyon(LA) metodu ile yapıldı ve %84.1 Agrubu, %4.4 B grubu, %7.1 Cgrubu ve %4.4 G grubu olarak tiplendirildi. İzole edilen suşlarm çeşitli antibiyotiklere duyarlılıkları saptandı.AGBHS'lar penisilin ve sefuroksime en yüksek oranda (%97.89) duyarlı bulundular.Amoksisilin ve klaritromisin duyarlılığı %94,73,ampisilin ve sulbaktam-ampisilin duyarlılığı %91.57, sefaleksin duyarlılığı %89.47 veSMX duyarlılığı %82.1 idi. AGBHS' larda eritromisin direnci ise %6.32 olarak belirlendi.AGBHS ların tamamı basitrasine duyarlı bulundu. Nongrup A BHS ların,özellikle C ve G grubu,basitrasine duyarlı olabileceği düşünülmektedir.Bu da basitrasine duyarlı ve dirençli tüm suşlarm tiplendirilmesi gerektiğini göstermektedir. Sonuç olarak;akut tonsillofarenjitli hastalarda erken tanı ve uygun tedavi dikkate alındığında izole edilen BHS ların tiplendirilmesinde LA testi, kültürle beraber kullanıldığında hızlı ve güvenilir bir test olarak göz önüne alınmalı;ayrıca AGBHS ların tedavisinde penisilin birinci seçenek olarak düşünülmelidir.Klaritromisin,eritromisin ve sefuroksim de alternatif tedavide düşünülmelidirA Group beta hemolytic streptococci are responsible for majority of streptococcal tonsillopharyngitis cases.But also other serogroups,especially C and G group beta hemolytic streptococci,may cause acute bacterial pharyngitis 256 patients applying to the Selçuk Universty Faculty of Medicine, Clinical Bacteriology and Infectious Diseases Department with complaints of fever and sore throat were evaluated with throat cultures. S ero typing of BHS detected 1 1 3 samples were done by latex agglutination(LA) method and of which %84.1 were typed as group A, %4.4 as group B, %7.1 as group C, %4.4 as group G. Ratios of antibiotic susceptibility of strains were detected. A Group beta hemolytic streptococci had the highest sensitivity to penicillin and cefuroxime (%97.89). Sensitivitiy to amoxicillin and clarithromycin were %94.73 and these were %91.57 for ampicillin and sulbactam-ampicillin, %89.47 for cephalexin, %82.1 for SMX. Erithromycin resistance was found to be %6.32 in AGBHS. All AGBHS were sensitive to bacitracin. It is thought that non AGBHS, especially group C and G might be sensitive to bacitracin and this shows that all strains sensitive and resistant to bacitracin should be serotyped. Considering early diagnosis and suitable treatment of acute tonsillopharyngitis patients LA test, when was used with culture, should be accepted as a fast and reliable method for evaluating isolated BHS. Besides, penicillins still remains as distinguished modality for treatment of AGBHS. Erithromycine and the other macrolides,and cefuroxime should be considered as alternative treatment

Subject criticism in political philosophy: A Lacanian perspective

Siyaset Felsefesinde Özne Eleştirisi: Lacancı Bir Perspektif isimli tezimiz 3 ana başlıktan oluşmaktadır. Modern anlamda özne mefhumunun tam olarak kavranması adına sübjektivite kavramı son derece büyük önem taşır. Modern insan tasavvuruna vücut veren bu düşünüştür. Temeli, öznenin bütünlüğü, tamlığı, monadlığı ve muktedirliği olan bu düşünüş tamamı ile hümanist karakter ile çevrelenmiştir. Modern sübjektivitenin çok farklı epistemolojik yaklaşımlar ile eleştirileri olmuştur. Bu eleştiriler genel olarak, Tarihselliğin yadsınması, öznenin yetkinliği gibi başlıklar altına indirilebilir. Ancak hangi başlık altında ele alınırlarsa alınsınlar bu eleştiriler hiçbir zaman son durak olmamışlardır. Lacancı özne kavrayışı da tam olarak modern özne anlayışının karşı kutbunda yer alır. Bir şeyin kavranması, tek başında sadece onunla bağlantılı ya da benzer unsurların idrak edilmesi ile değil onun tam karşısında yer alan unsurlarında etkili biçimde kavranması ile olur. Bu bağlamda da Lacancı özne anlayışı ile modern sübjektivite arasındaki bağ açıktır. Bu bağın akabinde Lacan, Psikanaliz ve siyaset felsefesi arasındaki ilişkiyi değerlendirmek çalışmamızın bir diğer önemli amacını yansıtmaktadır.Criticism of the subject in Political Philosophy: A Lacanian perspective is our thesis consists of 3 main categories. The concept of subjectivity in the name of the subject to grasp the full meaning of the modern notion of extremely great importance. İt was thought that the body of modern human imagination. Basically, the subject of integrity, completeness, monads and omnipotence, which is surrounded by humanist character with all this thinking. Modern subjectivity has been criticism with many different epistemological approaches. These criticisms generally, deductible under headings such as the subject‟s competence and the denial of historicity. However, this criticism is taken no matter what title they have never been dealt with under the terminus. The realization of a thing is not only the recognition of the beginning or similar elements associated with it but also with the understanding of the elements in its opposite and then it becomes effective. In this context, it is clear ties between the Lacanian concept of subject and modern subjectivity. After that this tie, to assess the relationship between Lacan, psychoanalysis and political philosophy reflects another important goal of our work

The migration phenomenon in Zygmunt Bauman’s thought: A philosophical-sociological approach

Göç olgusu; sosyoloji, ekonomi, politika, hukuk, felsefe, uluslararası ilişkiler gibi birçok disiplinin çalışma alanına giren, farklı disiplinlerin onun farklı veçhelerini açıklamaya çalıştığı çok boyutlu bir kavramdır. Biz de çalışmamızın kapsam ve sınırlılıkları doğrultusunda, göç olgusuna ilişkin çeşitli meseleleri çalışmamızı üzerine bina ettiğimiz Zygmunt Bauman üzerinden aktarmaya çalışacağız. Bu çalışma, Baumancı düşünde göç olgusuna yönelik önemli imkânlar yattığı temel iddasına dayanarak, günümüzde göç/göçmenlik durumlarının karşı karşıya bulunduğu temel meselelerin neler olabileceği temel araştırma sorusu üzerine bina edilmiştir. Çalışma, felsefi-sosyolojik bir yaklaşımla bu soruşturmayı yürütmeyi gayret ederken, teorik arka plan olarak odağına, Baumancı sosyolojiyi ve onun düşünce sahasına giren temel meseleleri, düşünürleri almaktadır. Çalışma bu teorik rota ve düşünsel arka plan doğrultusunda, kapasitesinin sınırlarına ulaşmış; göçmen, mülteci, sığınmacı gibi ‘yabancı’larla karşılaşmanın kaçınılmaz olduğu bir dünyada ‘yabancı’lığa alerji duymadan bir arada yaşamanın hayati bir önemi bulunduğu sonucuna ulaşmıştır. Bize göre, bu yalnızca ahlaki bir sorumluluk ya da dayanışma meselesi değil pratik bir ihtiyaç ve gerekliliktir.The migration phenomenon is a multidimensional concept that enters the study fields of many disciplines like sociology, economics, politics, law, philosophy, and international relations. These different disciplines try to explain its different aspects. Within its scope and specific limitations, this study tries to convey various related issues of migration phenomenon through Zygmunt Bauman’s works, on which we have built our study. Based on the claim that there are significant possibilities for the migration phenomenon in the Baumanian thought, this study is founded on the research question, “What are the main issues facing immigration/immigration situations today?” While investigating with a philosophical-sociological approach, this study focuses on Baumanian sociology, its main issues and thinkers within its scope as a theoretical background. In line with this theoretical route and intellectual background, the study concluded that in a world that has reached the limits of its capacity, where it is inevitable to encounter ‘strangers’ like immigrants, refugees and asylum seekers, it is vitally important for living together, without the allergy to ‘strangers’. In our opinion, it is not just a moral responsibility or solidarity, but a practical need and a necessity

Cerebral Malaria: Case Report

Cerebral malaria is a rare complication caused by Plasmodium infection. Capillary blockage caused by infected erythrocytes, microglia activation and apoptosis of astrocytes as a result of cytokine leakage to the parenchyma are cited in the pathogenesis. Recently, a concept has evolved that metabolic changes in the brain in malaria infection may also be responsible for the epilepsy and encephalopathy pathogenesis. A 25-year-old male was admitted to our clinic for seizures and encephalopathy. The patient, diagnosed with cerebral malaria, recovered with antiedema, antiepileptic and antimalarial therapy. The pathophysiology and clinical and laboratory findings are discussed in light of the literature

Shigella flexneri Bacteremia in a Patient with Behcet’s Disease and Receiving Immunosuppressive Treatment: A Case Report

Shigella bacteremia usually causes gastrointestinal infections and has a table of disease accompanied by abdominal pain, bloody diarrhoea and fever. Bacteremia is not a common case but develops in the children under two years age and in malnourished children. Shigella bacteremia has a high rate of mortality and is a rare complication in adults which usually occurs in the presence of predisposing factors as diabetes and steroid use. In this study we presented a case, who had Behçet’s disease and received immunosuppressive treatment, developed S. flexneri bacteremia at the age of 56

Toksik Multinodüler Guatrda Çok Uzun Süreli Propiltiourasil Kullanımına Bağlı Nötropeni

Tirotoksikoz çeşitli yollarla hemtopoezi etkiler ve tionamidlerle birlikte miyelosupresyona neden olabilir. Toksik multinodüer guatra bağlı 20 yıl gibi uzun bir süre propiltiourasil kullanan ve febril nötropeni nedeniyle hastaneye yatışı yapılan hipertirodili bir hasta sunduk. Total tiroidektomi olduktan sonra hasta ötiroid iken nötropenisi düzeldi. Postoperatif patoloji ise mikropapiller tiroid karsinomu olarak değerlendirildi.Thyrotoxicosis affects hematopoiesis in several ways and thioamides may cause myelosuppression. We report a case of febrile neutropenia in a patient with hyperthyroidism who was using propylthiouracil for nearly 20 years for the treatment of toxic multinodular goitre. After surgery, the patient was euthyroid and neutropenia resolved. Postoperative pathology was evaluated as micropapillary thyroid carcinoma

Influence of aluminum salts on COVID-19 infected patients

Background/aim: Based on the antiviral and antibacterial properties of aluminum salts, we aimed to find out the influence of aluminum salts on COVID-19 infected patients. Materials and methods: We performed an observational retrospective cohort study which includes the patients diagnosed as COVID-19 and received aluminum salts in addition to actual treatments during hospitalization as the treatment group (Alum Group). Patients who received standard COVID-19 treatment protocols in the Infectious Diseases Clinics were included as the Control Group. Clinical findings, laboratory parameters, length of stay, survival, radiological follow-up, intensive care and mechanical ventilation needs, the presence of comorbidity, polymerase chain reaction (PCR) tests, symptoms, symptom recovery times, hospital stay times, treatment protocols, and clinical presence of pneumonia were examined in all patients. Advanced chemical composition analyzes of existing aluminum salts were also performed. Results: A total of 109 patients, 54 in the alum group and 55 in the control group, were included in the study. None of the patients in the aluminum group developed side effects due to the intake of aluminum salt. Survival status was significantly different between the two groups as there were 5 loss in the Control Group and none in the Alum Group (P = 0.023). The symptom recovery time was significantly shorter in the Alum Group; 2 (1-3) vs. 1 (1-2) days, P= 0.003. According to the paired samples analyses of the comparison between hospitalization and discharge, CRP levels significantly drops in the Alum Group (from 54.09 to 27, P = 0.001) but not in the Control Group. The drop was significantly same for the lactate dehydrogenase (LDH) and procalcitonin levels with P = 0.001. Conclusion: It has been observed that aluminum salts have beneficial effects in COVID-19 infected cases. Considering the low systemic toxicity of intermittent oral intake of aluminum salts as food supplements and the fact that pandemic control is still not achieved, the use of aluminum salts is promising

Association of Tumor Necrosis Factor Alpha -238G/A and -308G/A Promotor Polymorphisms with Clearance of Hepatitis B Virus Infection in Turkish Population

Objectives: Acute viral hepatitis B may lead to chronic hepatitis in 6% of adultpopulation. We compared the frequency of Tumor necrosis factor alpha promotor polymorphisms in chronic hepatitis B patients and people with natural immunity against hepatitis B.Materials and Methods: Chronic hepatitis B patients and age matched control cases with natural immunity to hepatitis B virus were recruited 1:1 in this study. Tumornecrosis factor alpha -238G/A and -308G/A polymorphisms were studied withPCR-RFLP. ?2 test was performed in statistical analysis.Results: A total of 101 volunteers enrolled in two study groups. Thirty-eight menand 12 women constituted the chronic hepatitis B patient group and 40 men and11 women recruited in natural immunity group. Frequency of -238G allele was87.5% and 97% in chronic hepatitis B and natural immunity groups, respectively.Frequency of -308G allel was 93% and 92.1% in chronic hepatitis B and natural im-munity groups, respectively. Frequencies of polymorphisms at positions -238 and-308 in the promotor of tumor necrosis factor alpha gene were not different be-tween chronic hepatitis B and natural immunity groups.Discussion: Tumor necrosis factor alpha promoter polymorphisms at -238 and-308 positions do not effect the outcome hepatitis B infection in Turkish population. Clearance of hepatitis B virus infection is multifactorial. Thus, further studiesneeded to identify genetic predisposition to chronic hepatitis B infection

Galectin-3: A biochemical marker to detect paroxysmal atrial fibrillation?

Purpose: Atrial fibrillation (AF) is the most common form of arrhythmia. AF leads to electrical remodelling and fibrosis of the atria; however, the mechanism(s) remain poorly understood. Galectin-3 is a potential mediator of cardiac fibrosis. The present study aimed to examine the relationship between serum galectin-3 levels and paroxysmal AF. Methods: Forty-six patients with paroxysmal AF and preserved left ventricular systolic function, and 38 age- and gender-matched control subjects, were involved in the study. Serum galectin-3 levels were analyzed with an enzyme-linked immunosorbent assay (ELISA). Results: Serum galectin-3 levels (median 1.38 ng/mL; 1.21 ng/mL-1.87 ng/mL; p< 0.001) were significantly elevated in patients with paroxysmal AF compared with the control. Left atrial diameter was significantly higher in patients with paroxysmal AF (41.2±3.0 mm vs. 39.6±3.3 mm). Left atrial diameter was found to be significantly correlated with serum galectin-3 levels in patients with paroxysmal AF (r= 0.378, p= 0.001). Conclusion: Serum galectin-3 levels are significantly elevated and significantly correlated with left atrial diameter in patients with paroxysmal AF