Cardiovascular etiology with report of 3 cases in differential diagnosis of epilepsy

Epilepsi çocukluk çağında %0.5-1 oranında görülen, tekrarlayıcı nöbetlerden oluşan klinik bir tablodur. Çocukluk çağında senkop görülme insidansı %15 olup, acil servise nöbetle başvuruların%3-5'ine senkop neden olmaktadır. Genel populasyonda senkopun epilepsiden daha yaygın görülmesine rağmen, bilinç kaybı ve nöbetle başvuran hastalarda genellikle akla ilk olarak epilepsi gelmektedir. Ayrıntılı tetkikler basta senkop ve diğer kardiyojenik kökenli hastalıklar olmak üzere diğer non-epileptik paroksizmal olayların da bilinç kaybının nedeni olduğunu gösterebilir. Bu yazıda çocuk acil servisi ve çocuk nörolojisi polikliniğine bilinç kaybıyla başvuran ve tetkiklerinde kardiyovasküler nedenler saptanan üç olgu sunularak, epilepsi ayırıcı tanısında kardiyojenik kökenli senkopların mutlaka hatırlanması gerektiği vurgulandı.Epilepsy is a disorder with an incidence of 0.5-1.0% in childhood and characterized by recurrent seizures. The incidence of syncope in childhood is 15% and it causes 3-5% of admissions to the emergency department. Although syncope is more frequent than epilepsy in general population, usually epilepsy is the first pre-diagnosis in patients with loss of consciousness and seizures. Detailed investigations may show other reasons like syncope and cardiologic diseases as the cause of loss of consciousness. In this paper,we present 3 patients admitted to the pediatric emergency department and pediatric neurology clinic with cardiovascular reasons in the etiology of loss of consciousness and pointed out that cardiac syncope should be remembered in the differential diagnosis of epilepsy

Increased oxidative stress is associated with insulin resistance and infertility in polycystic ovary syndrome

Objectives: The present study aims to investigate the role of oxidant-antioxidant status in young women with polycystic ovary syndrome (PCOS).Material and methods: Seventy-one women with PCOS and 53 healthy controls are compared in aspect of demographic characteristics, biochemical data, hormones, and oxidant-antioxidant status.Results: The PCOS group had significantly lower zinc, higher malondialdehyde and gluthathione peroxidase and lower serum catalase levels than the control group (p = 0.016, p < 0.001, p = 0.043 and p = 0.025 respectively). The PCOS patients with IR had significantly higher malondialdehyde, lower catalase and serum zinc levels than the PCOS patients without IR (p = 0.015, p = 0.010, p = 0.001 respectively). The infertile PCOS patients had significantly higher malondialdehyde, lower catalase and serum zinc levels than the fertile PCOS patients (p = 0.022, p = 0.045,p = 0.001 respectively). There was a statistically significant and positive correlation between HOMA-IR and malondialdehyde values (r = 0.523, p = 0.001), between HOMA-IR and glutathione peroxidase values (r = 0.468, p = 0.001) and between HOMA-IR and zinc values (r = 0.601, p = 0.001). There was a statistically significant and negative correlation between HOMA-IR and catalase values (r = –0.493, p = 0.001).Conclusions: The patients with PCOS are under oxidative stress and this oxidative stress seems to be the highest in patients with IR and with infertility. Despite the prominent increase in the oxidative stress, there was a variation in the antioxidant response

Spatial and temporal heterogeneity in human mobility patterns in Holocene Southwest Asia and the East Mediterranean

We present a spatiotemporal picture of human genetic diversity in Anatolia, Iran, Levant, South Caucasus, and the Aegean, a broad region that experienced the earliest Neolithic transition and the emergence of complex hierarchical societies. Combining 35 new ancient shotgun genomes with 382 ancient and 23 present-day published genomes, we found that genetic diversity within each region steadily increased through the Holocene. We further observed that the inferred sources of gene flow shifted in time. In the first half of the Holocene, Southwest Asian and the East Mediterranean populations homogenized among themselves. Starting with the Bronze Age, however, regional populations diverged from each other, most likely driven by gene flow from external sources, which we term “the expanding mobility model.” Interestingly, this increase in inter-regional divergence can be captured by outgroup-f$_3$-based genetic distances, but not by the commonly used F$_{ST}$ statistic, due to the sensitivity of F$_{ST}$, but not outgroup-f$_3$, to within-population diversity. Finally, we report a temporal trend of increasing male bias in admixture events through the Holocene

Case report: amyand hernia

Herni, batın içindeki herhangi bir organın içinde bulunduğu kavitenin duvarındaki bir açıklıktan dışarı çıkması olarak tanımlanır. Amyand herni, inguinal herni kesesi içinde normal veya enflame apendiksin bulunduğu nadir bir durumdur. Kasık fıtığı olgularının yaklaşık %1’ inde görülür. İnguinal herni kesesi içerisinde apendiks varlığı ilk kez 1735 yılında Claudius Amyand tarafından tanımlanmış olup o tarihten bu yana onun ismine hitaben Amyand herni olarak adlandırılmaktadır. Amyand herni tanısı genellikle intraoperatif olarak konulmaktadır. Bu olguda sağ kasık fıtığı tanısı ile ameliyat edilen ve kese içinde apendiks vermiformisin gözlenip Amyand herni tanısı konulan 62 yaşında erkek hasta ve literatür bilgileri sunulmaktadır.Hernia is defined as the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. Amyand hernia is a rare form of inguinal hernia which occurs when the normal or inflamed appendix is included in the hernial sac. It is seen in approximately 1% of inguinal hernia cases. Apendix in inguinal hernia sac was first defined by Claudius Amyand in 1735 and has been named Amyand hernia in honour of him. Amyand hernia is generally diagnosed intraoperatively. In this case, a 62 year-old male patient who was diagnosed with having Amyand hernia since there was apendix vermiform in the sac and literature data are presented

Mus musculus karaciğerinin farklı loblarındaki glukoz-6-fosfat dehidrogenaz aktivitesi ile glutatyon düzeyi

Amaç: Oksidatif strese karşı hücresel yanıtta önemli rol oynayan antioksidan sistemler Glukoz-6-fosfat dehidrogenaz (G6PDH) ve glutatyon (GSH)’dur. İnsan ve fare G6PDH enziminin homoloji göstermesinden dolayı, farelerin farklı karaciğer loblarında G6PDH aktivitesi ve GSH düzeyleri araştırıldı. Gereç ve Yöntemler: Yirmi erkek Mus musculus albino fare çalışmada kullanıldı. Karaciğer loblarında G6PDH aktivitesi ve GSH düzeyi Beutler yöntemi ile ölçüldü. Bulgular: Farklı karaciğer loblarında G6PDH aktivitesi ve GSH düzeyinin ortalama ve standart sapması sırasıyla: Orta lob; 3.30 ± 1.44 Ü/g karaciğer, 1.84 ± 0.030 µmol/g karaciğer; sağ lob; 1.56 ± 0.93 Ü/g karaciğer, 0.57 ± 0.25 µmol/g karaciğer, sol lob; 2.43 ± 1.42 Ü/g karaciğer, 1.06 ± 0.21 µmol/g karaciğer, kaudat lob; 0.41 ± 0.17 Ü/g karaciğer, 0.05 ± 0.02 µmol/g karaciğer. Maksimum G6PDH aktivitesi ve GSH düzeyi medyan ve sol lobda bulunmuştur. Bunun yanı sıra, G6PDH aktivitesi ve GSH düzeyinin loblar arasında anlamlı farklılıklar gösterdiği saptanmıştır (p< 0.05). Sonuç: G6PDH aktivitesi ve GSH düzeyi erkek fare karaciğer loblarında heterojen dağılım göstermektedir.Objective: Glucose-6-phosphate dehydrogenase (G6PDH) and glutathione (GSH) are two antioxidant systems that play important roles in the cellular response to oxidative stress. G6PDH activity and GSH levels in different liver lobes of mice lend themselves particularly to comparative investigation due to the similar homology of human and mouse G6PDH and GSH enzymes. Material and Methods: Twenty males of Mus musculus albino mice were included in the experiments. The activity of G6PDH and GSH levels in liver were measured with the aid of the Beutler method. Results: Mean and standard deviation per g liver for lobular G6PDH activity and GSH levels were found to be as follows: 3.30 ± 1.44 U/g and 1.84 ± 0.030 mmol/g for the median lobe; 1.56 ± 0.93 U/g and 0.57 ± 0.25 mmol/g for the right lobe; 2.43 ± 1.42 U/g, 1.06 ± 0.21 mmol/g for the left lobe; and 0.41 ± 0.17 U/g, 0.05 ± 0.02 mmol/g for the caudate lobe. The highest G6PDH activity and GSHs level were found in the median and left lobes. Moreover, significant differences in G6PDH activity and GSH levels were recorded among lobes (<0.05). Conclusion: G6PDH activity and GSH levels were seen to have a heterogeneous distribution in the liver lobes of male mice

Spontaneous Regression of Lumbar Disc Herniations

Objective: Lower back and back pain are among the most common disease symptoms. on the other hand, herniated nucleus pulposus (HNP) is a common condition that triggers radiculopathy or myelopathy. If radiculopathy affecting the foot occurs concurrently with back pain, the patient is very likely to have lumbar disc herniation. Medical treatment, bed rest and physical therapy are primarily recommended to patients with radicular pain. This study aimed to describe the factors associated with spontaneous disc regression. Materials and Methods: Patients who were admitted to the outpatient clinic with lower back and leg pain were closely followed-up. After magnetic resonance imaging (MRI) scans revealed lumbar (HNP), a conservative medical treatment was recommended. When the patients’ radicular pain disappeared or neurological exams became normal, control MRI scans were done. Then, we retrospectively reviewed these patients. Results: We detected a total of 12 patients with lumbar disc regression, including six males and six females, in the last 3 years of follow-up. the mean age of the patients was 41.83±6.83. LHNP was present at the L4-5 space in five patients and at the L5-S1 space in seven patients. Eight (62.5%) of the patients had sequestrated disc herniation, while four had subligamentous disc herniation. Four of the sequestrated discs were upmigrated, and four of them were down-migrated. the mean time to pain disappearance of the patients was 2.33±1.23 months. Conclusion: A conservative treatment and bedrest are primarily recommended to patients with lumbar disc herniation and pain complaints. Time should be given for the body to regress the lumbar disc herniation with an inflammatory response. Surgery is inevitable in cases of unbearable pain and emergency conditions

Secondary Infection and Co-infection in COVID-19 Patients Receiving Tocilizumab

Objective: Tocilizumab (TCZ) is a recombinant humanized anti-interleukin-6 receptor monoclonal antibody that is beneficial in critically ill coronavirus disease-2019 (COVID-19) patients. However, the clinical efficacy and safety of immunosuppressants (including TCZ, sarilumab and anakinra) in COVID-19 patients are not yet known. These treatments may predispose patients to infection. The aim of this study was to find any connection between the use of TCZ and increased secondary bacterial infections. Materials and Methods: In this study, we conducted retrospective analyses of secondary bacterial infections in COVID-19 patients in the intensive care unit (ICU). This study included patients with laboratory-confirmed COVID-19 infection or clinically and radiologically confirmed COVID-19 infections who were admitted to the university hospital adult ICUs between March 2020 and January 2022. Demographic data, recent exposure and travel history, clinical symptoms or signs, laboratory findings, and comorbidities were recorded. Microbial cultures from tracheal aspirates, blood, and urine were obtained at admission and throughout the hospital stay. The patients who received TCZ treatment noted and analyzed for seconder infections. Blood cultures were taken at least 48 hours after the first dose of TCZ. Results: We found that 80 patients (%37) had positive culture samples at admission, and most of these cases were admitted to the ICU from various hospital wards. The analyzed data showed that the TCZ group had a higher incidence of positive culture samples (75% vs. 35%, p=0.0001). The results showed that culture of TCZ taken patients had more incidence with methicillin resistance Staphylococcus aureus, Klebsiella spp., and Acinetobacter spp. (p=0.0001). Infection and mortality rates were much higher than those in the usual care group. Conclusion: Secondary infections and sepsis are major risk factors for mortality. The pathogens detected were drug resistant and had a lower chance of treatment. The benefit of TCZ treatment was lost in these patients because of secondary infections. Future studies are needed to help determine the risks of TCZ treatments

Dermatologic Diseases Presenting with Pigmentation Disorders in Children: A Single Center Experience

Background: To determine the incidence and demographic characteristics of skin diseases presenting with hyperpigmentation in children applying to the dermatology department. Methods: A total of 2815 children between the ages of 0 to 16 who applied to the dermatology clinic with the complaints of hyperpigmentation disorders were evaluated. The age, gender, socioeconomic status, place of residence and demographic characteristics of children with abnormal pigmentation skin lesions were investigated. Results: A total of 2815 children applied to the dermatology clinic during the study period. Of these patients 1491 were female (53%) and 1324 were male (47%). Of these 266 (9.4%) were diagnosed with skin disorders presenting with hyperpigmention. The causes of hyperpigmentation in these patients were was follows; pityriasis alba (2.6%), melanocytic nevus (2.1%), vitiligo (1.8%) postinflammatory hyperpigmentation (0.5%), and postinflammatory hypopigmentation (0.5%). According to the gender, p.alba, vitiligo, Becker nevus, acanthosis nigricans, tuberosclerosis and albinism were seen more in boys and nevus depigmentosus ephelis, postinflammatory hyperpigmentation/hypopigmentation and melanocytic nevus were seen more in the girls. Pitriyazis versicolor was seen equally in both genders. According to age groups, melanocytis nevus were found to be more frequent between the ages of 0-2 and 12-16, whereas pityrsasis versicolor was more frequent in ages 12-16 and P. alba in the 3-11 age group. Conclusions: There are quite a substantial number of pigmentation diseases occurring in children. Early diagnosis and treatment are important because although these diseases mainly cause cosmetic problems, they can decrease the quality of life. Here, we attempted to define the demographic characteristics of diseases presenting with disorders in pigmentation in children

A broadband microwave amplifier design by means of immittance based data modelling tool

In this paper a practical broadband microwave amplifier design algorithm is introduced utilizing the immittance data-modelling tool. In the course of design, first, the optimum input and output terminations for the active device are produced employing the real frequency technique. Then, these terminations are modelled utilizing the new immittance-modelling tool to synthesize the front-end and back-end matching networks. An example is included to exhibit the implementation of the proposed design algorithm to construct a single stage BJT amplifier over a wide frequency band. It is expected that the proposed design algorithm will find applications to realize wideband microwave amplifiers put on MMIC for mobile communication.Publisher's Versio