Demonstration of the protective effect of ghrelin in the livers of rats with cisplatin toxicity

Despite the various and newly developed chemotherapeutic agents in recent years, cisplatin is still used very frequently as a chemotherapeutic agent, even though cisplatin has toxic effects on many organs. The aim of our study is to show whether ghrelin reduces the liver toxicity of cisplatin in the rat model. Twenty-eight male Sprague Dawley albino mature rats were chosen to be utilized in the study. Group 1 rats (n = 7) were taken as the control group, and no medication was given to them. Group 2 rats (n = 7) received 5 mg/kg/day cisplatin and 1 ml/kg/day of 0.9% NaCl, Group 3 rats (n = 7) received 5 mg/kg/day cisplatin and 10 ng/kg/day ghrelin, Group 4 rats (n = 7) received 5 mg/kg/day cisplatin and 20 ng/kg/day ghrelin for 3 days. Glutathione, malondialdehyde (MDA), superoxide dismutase (SOD), plasma alanine aminotransferase (ALT) levels, and liver biopsy results were measured in rats. It was determined that, especially in the high-dose group, the MDA, plasma ALT, and SOD levels increased less in the ghrelin group as compared to the cisplatin group, and the glutathione level decreased slightly with a low dose of ghrelin, while it increased with a higher dose. In histopathological examination, it was determined that the toxic effect of cisplatin on the liver was reduced with a low dose of ghrelin, and its histopathological appearance was similar to normal liver tissue when given a high dose of ghrelin. These findings show that ghrelin, especially in high doses, can be used to reduce the toxic effect of cisplatin

Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (<4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs

Evaluation of poisoning cases that admitted to the emergency department for suicidal ideation

Aim: In this study, we aimed to evaluate the effects of gender, age, time of admission to the emergency department, season, drug used, the time patients were admitted to the emergency department following the drugs administration, and psychiatric illness history on the clinical outcome of patients by examining the patients who admitted to our emer- gency department after taking suicidal drugs. Materials and Methods: The data of the study were obtained as a result of the retrospective examination of the cases who took drugs for suicidal purposes, who admitted to the emergency department of our hospital between January 2019-January 2020. We divided those who were discharged and admitted to the ward as good clinical outcome, and those who were admitted to the intensive care unit and those who died had poor clinical outcome. We statistically analyzed the effects of age, gender, the active substance used, the time of admission to the emergency department, the number of hours after which it was presented, a previous suicide attempt, and a history of psychiatric illness on clinical outcomes. Results: 295 patients were included in the study. 64.4% (190) of the cases were female and 35.6% (105) were male. The mean age of the patients is 32.9, and the majority of them are in the 25-34 age group (31.5%). The fact that the patients were male, admitted to the emergency room 4 hours after taking the drug, admitted to the emergency room between 00.00-07.59, committed suicide with psychiatric medication, had a previous sui- cide attempt and diagnosis of psychiatric illness, had a statistically poor clinical outcome (p<0.001). Conclusion: As a result, the history of the patients, the active substances they took, the hours and duration of their arrival to the emergency department can be used to predict the occurrence of serious clinical pictures in suicidal drug intake

The study of Zeynep Cemali's children books according to the basic i̇tems of the children literature

Doktora Tezi. YÖK Tez No:407524Bu araştırma, son dönem çocuk edebiyatı yazarlarından Zeynep Cemali'nin roman ve öykülerini çocuk edebiyatının temel ögeleri olan biçim, içerik, dil anlatım ve ileti bakımından inceleyerek, yazarın eserlerinin değerini ortaya koymayı ve onun çocuk edebiyatımızdaki yerini belirlemeyi amaç edinerek hazırlanmıştır. Bu amaç kapsamında, yazarın bütün çocuk roman ve öykülerinin biçim çözümlemesinde kapak, resimleme, boyut, kâğıt, sayfa düzeni, harfler, yazım ve noktalama unsurlarına; içerik çözümlemesinde konu, ana düşünce, olay, kahramanlar, yer ve zaman, bakış açısı ve anlatıcı, ileti unsurlarına yer verilmiştir. Eserlerin dil ve anlatım özellikleri incelenirken atasözleri, deyimler ve ikilemeler tespit edilmiştir. Araştırmada kullanılan doküman incelemeye dayalı nitel bir çalışmayı içeren yöntem uyarınca elde edilen veriler, yazarın ele alınan tüm eserleri, çocuğa ve çocuk edebiyatına bakış açısı göz önünde bulundurularak yorumlanmıştır. Bu yorumlamada eserlerde değerlendirmeye alınan içerik, dil anlatım ve ileti özellikleri göz önünde tutulmuştur. Zeynep Cemali edebiyat yaşamı boyunca sadece çocuk edebiyatıyla ilgilenmiştir. Çocuk romanı ve öykülerinden başka türde eserler vermemiştir. Yazarın çocuk roman ve öyküleri ile ilgili yaptığımız bu çalışma; onun çocuklara ve çocuk edebiyatına bakış açısını göstermesi, eserlerinin değerini ortaya koyması bakımından önemlidir.This study was conducted in order to manifest the value of the works of Zeynep Cemali, one of the last era children's literature authors, and determine her place in Turkish children's literature by examining her novels and stories with regard to the key elements of children's literature which are style, content, language and expression and message. Within the scope of this purpose, in the style analysis the elements of cover page, limning, size, paper, page layout, letters, spelling and punctuation and in content analysis the elements of topic, main idea, plot, characters, time and setting, view point and narrator, messages were included in all of the author's children's novels and stories. While language and expression features of the works were being examined, proverbs, idioms and reduplications were determined. The data which was gathered in accordance with the method including a documan study based on the content analysis was interpreted by taking all the works of the author and her point of view about children and children's literature into consideration. Content, language and expression and message features which were evaluated in these works were taken into account in this interpretation. Zeynep Cemali was interested only in children's literature in all of her life. She never generated any other types of works rather than children's novels and stories. The study we did about the children's novels and stories of the author is significant in respect to the fact that it demonstrates her point of view about the children and children's literature and appreciates the value of her works

Association Between Type of Fracture and Mortality Rate in Hip and Femur Fractures

Aim: This study included patients who presented to the emergency department with hip and femur fractures. By investigating which fracture type carried the highest risk for mortality, we aimed to provide a basis for surgeons to help them prioritize patients. Material and Methods: This was a single-center retrospective study. A total of 336 patients who presented to the emergency department with traumatic, isolated hip or femur fractures were included. The same surgical team operated all patients within four days. The fractures were categorized according to the fracture types. Patients were followed up about mortality during 28 days. Results: A total of 336 patients were included in the study, and 51 patients died in 28 days follow-up. Patients were divided into three groups according to their ages as 18- 44, 45-64, and > 64. There was no significant difference between the fracture types and mortality according to age groups. When the patients included in the study were evaluated as a single group, intertrochanteric fracture types were significantly related to mortality (p0.010). Discussion: In this study, mortality rates were found to be higher in patients with intertrochanteric fractures among all patients

Evaluation of the prognostic role of NLR, LMR, PLR, and LCR ratio in COVID-19 patients

We aimed to find the most useful biomarker by examining the prognostic effect of neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), and lymphocyte-C reactive protein ratio (LCR) in patients with coronavirus disease 2019 (COVID-19). Three hundred and four patients diagnosed with COVID-19 infection in our hospital within 5 months (April-August 2020) were examined. Laboratory values and demographic findings of the patients were analyzed retrospectively. Thirty-six patients were diagnosed with severe cases. The ratio of NLR, LMR, PLR, and LCR of patients with severe and those with nonsevere clinical symptoms were statistically analyzed. The NLR and PLR ratios of those with severe clinical symptoms were significantly higher (p < 0.001), the LCR rate was significantly lower (p < 0.001), and there was no significant difference in the LMR rate (p = 0.199). When we examined other peripheral blood parameters, we found that CRP was high, lymphocyte and monocyte were low (p < 0.001), but neutrophil (p = 0.416) and platelet (p = 0.998) were not statistically different between the groups. According to the results, routine blood values are abnormal in patients with COVID-19. NLR, PLR, and LCR ratios can be used as more significant biomarkers than other values in predicting the prognosis of patients

The importance of procalcitonin in the diagnosis and prognosis of patients with dyspnea in the emergency department Is procalcitonin gold standart in pneumonia?

Aim: Dyspnea is a common problem in emergency services worldwide. Bacterial pneumonia is a common etiology in patients with acute dyspnea causing mor-bidity and mortality. Early initiation of appropriate antibiotic therapy reduces mortality. However, it is difficult to diagnose pneumonia with symptoms similar to acute heart failure and acute exacerbation of chronic obstructive pulmonary disease, and without definitive diagnostic testing. For this, it is thought that the use of a biomarker that can diagnose pneumonia at the time of admission to the hospital would be clinically useful. Material and Methods: Patients who came to the emergency department with shortness of breath were analyzed retrospectively. Three hundred patients were examined. Serum procalcitonin values of patients diagnosed with pneumonia by chest radiography or thorax CT were compared with other patients. Patients discharged from the emergency department or hospitalized were classified as a good clinical outcome group, patients who were intubated, in need of intensive care, or who died were classified as a poor clinical outcome group, and procalcitonin values were compared. The data were evaluated using the SPSS Statistics Standard statistical package program. A p <0.001 value was considered statistically significant. Results: In patients presenting with dyspnea, pneumonia (150), COPD exacerbation (30), lower respiratory tract infection (LRTI) (18), acute coronary syndrome (ACS) (27), and acute heart failure (AHF) (76) were diagnosed. The PCT values of the patients diagnosed with pneumonia were significantly higher than the other groups (p <0.001). In terms of white blood cell (WBC) values, there was no significant difference between pneumonia patients and other patients. When the neutrophil-lymphocyte ratio (NLR) was examined, it was found to be significantly higher in pneumonia patients (p <0.001). When we examined the progno-sis of pneumonia patients, the PCT values of the patients with a poor prognosis were found to be significantly higher (p <0.001). Discussion: We have seen that PCT has an important role in the diagnosis and prognosis of pneumonia in patients admitted to the emergency department with shortness of breath

Travmatik Olarak İntrüze Olan Maksiller Sürekli Kesici Dişlere Tedavi Yaklaşımı: İki Olgu Sunumu

Dentoalveolar travma çocuklarda çok yaygın bir durumdur. Çocukların anterior dişlerindeki dental travma acil tedavi gerektirir. İntrüzyon, travmaya bağlı olarak dişin alveolar kemik içersinde apikal olarak yer değiştirmesidir. Bu tip yaralanmalar genellikle maksiller dişlerde görülür ve ciddi pulpal ve periodontal hasarla ilişkilidir. Travmatik olarak intrüze olmuş dişlerin tedavisi ve prognozu hastanın yaşı, dentisyonun tipi, kök gelişimine ve travmanın ciddiyetine bağlı olarak değişebilmektedir. Bu olgu sunumlarında, travmaya bağlı olarak meydana gelen maksiller kesici dişleri tamamen intrüze olan 6 ve 10 yaşlarında olan iki erkek çocuğuna uygulanan iki farklı tedavi yaklaşımı sunulmuştur. Sonuç olarak, intrüze olan dişlerin tedavi planlaması multidisipliner olmalıdır ve konservatif tedavi seçeneği öncelikli olarak düşünülmelidir

Son Sınıf Ebe Öğrencilerin Klinik Rehber (Mentor) İle İlgili Değerlendirmeleri

Giriş: &Ouml;ğrenci, eğitimi sırasında, yoğun bir &ouml;ğrenme ve bireysel değişim s&uuml;reci i&ccedil;indedir. Bu s&uuml;re&ccedil; i&ccedil;inde &ouml;ğrencinin, kendisine yol g&ouml;sterecek bir rehbere ihtiyacı vardır. &Ouml;zellikle beceride yeterliliğin sağlanabilmesi i&ccedil;in uygulama alanında &ouml;ğrencinin bir rehber tarafından desteklenmesi gerekir. Ama&ccedil;: Araştırma; &ouml;ğrencilerin klinik uygulamaları sırasında eğitimleri i&ccedil;in yardım ve destek aldıkları mentor ebeler hakkındaki duygu ve d&uuml;ş&uuml;ncelerinin belirlenmesi amacı ile yapıldı. Y&ouml;ntem: Tanımlayıcı, kesitsel araştırma olarak yapılan bu &ccedil;alışma İstanbul ilinde bir &uuml;niversitenin ebelik b&ouml;l&uuml;m&uuml;nde yapıldı. Araştırmanın &ouml;rneklemini araştırmaya katılmayı kabul eden, soru formunu tam olarak dolduran ve klinik uygulamada mentor ile &ccedil;alışmış 52 &ouml;ğrenci oluşturdu. Veriler araştırmacıların hazırladığı soru formları ile toplandı. Verilerin değerlendirilmesinde y&uuml;zdelik dağılımı kullanıldı. Bulgular: &Ouml;ğrencilerin %67.3&rsquo;&uuml;n&uuml;n 22-23 yaşlarında olduğu, %55.8&rsquo;inin mentor&uuml;n&uuml;n servis ebe / hemşiresinin olduğu belirlendi. &Ouml;ğrencilerin %50&rsquo;den fazlası mentorlerinin kişilerarası ilişki becerisinin iyi olduğunu, %46&rsquo;dan fazlası &ouml;ğretme yeterliliğinin iyi olduğunu belirtti. &Ouml;ğrencilerin %70&rsquo;den fazlası mentorunun mesleki bilgisini iyi bulurken ancak %32.7&rsquo;si kendisine yeni mesleki bakış a&ccedil;ısı kazandırdığını belirtti. &Ouml;ğrencilerin %42.3&rsquo;&uuml; mentorlerinin &ouml;ğrenciyi savunucu tutum sergilediğini belirtirken, sadece %32&rsquo;sinden daha azı servis ortamına ilişkin iyi d&uuml;zeyde değerlendirme yapmıştır. &Ouml;ğrencinin &ouml;ğrenmesini olumlu etkileyen mentore ait &ouml;zellikler sorulduğunda ise samimi davranma, bilgili olma, saygı duyma, işini sevme, anlayışlı olma, sabırlı olma, g&uuml;venme, sorulara cevap verme, &ouml;ğretici ve geliştirici olma cevabı verenlerin sayısı %10&rsquo;dan daha azdır. &Ouml;ğrencinin &ouml;ğrenmesini olumsuz etkileyen klinik ortama ait &ouml;zellikler sorulduğunda ise &ouml;ğrencilerin %90&rsquo;dan fazlası malzeme yetersizliği, hasta odalarına ulaşımın zor olması, iş b&ouml;l&uuml;m&uuml; yapılmaması, doğum sayısını az olması, hekimin eğitime destek olmaması, meslek &uuml;yelerinin profesyonel davranış g&ouml;stermemesi ve soyunma odalarının olmaması gibi olumsuzlukları ifade etmiştir. Sonu&ccedil;: &Ouml;ğrenciler klinik uygulama s&uuml;resince mentorlerinden bilgili olma, kendilerine saygı duyma, anlayışlı ve sabırlı olma, &ouml;ğretici / geliştirici olma gibi &ouml;zellikler aramakla birlikte, mentorlerin &ccedil;ok azının bu &ouml;zelliği sahip olduğunu belirtti