COVID-19 pandemic: Evaluating its psychological impact and individuals' depression, anxiety, and stress levels

Background: The COVID-19 pandemic is a global public health problem affecting mental health, and basic data are required for evidence-based mental health interventions. This study aimed to identify the prevalence of psychological impacts, anxiety, depression, stress, and any associated risk factors in individuals living in Turkey during the COVID-19 pandemic. Materials and methods: The population of this descriptive study consisted of individuals over the age of 18 living in Turkey. The data were collected between July–September 2020 using the snowball sampling method. The study was completed with 1733 participants. The data were collected using the Impact of Events Scale-Revised and the Depression Anxiety Stress Scale. Statistical analyses included percentage, mean, standard deviation, a Chi-square test, a Mann Whitney U test, Kruskal Wallis and Tamhane's T2 post hoc, and Spearman's correlation. P < 0.05 was considered statistically significant. Results: 45.1% had moderate or severe psychological effects; 42.7% had a moderate or severe depression, 31.7% had moderate or severe anxiety, and 28.5% had moderate or severe stress levels. Being a woman, being single, unemployment, smoking, the presence of chronic diseases, being young (<35), being a university graduate, having a household size of 5 or more, a low income, having poor health, and being underweight were significantly correlated with some psychological impact, depression, anxiety, and stress levels of people. Conclusion: During the pandemic period, almost half of the respondents were found to experience some psychological impact of the pandemic and have negative moderate to severe mental health levels. Risk groups for mental health were identified

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Helicobacter Pylori Eradikasyonunda Klasik 3'lü Tedavinin Etkinliği

Amaç: Helicobacter pylori H. pylori gastrik ülser, duodenal ülser ve atrofik gastrite neden olan bir mikroorganizmadır. Bu bakterinin eradikasyonu zordur ve eradike etmek için genellikle 14 günlük çoklu antibiyotik kullanımı gerekmektedir. Bu çalışmada amacımız H. Pylori eradikasyonunda klasik 3’lü tedavinin Tokat ili ve çevresindeki eradikasyon başarısını belirlemektir.Gereç ve Yöntem: Çalışmada Ocak 2012 - Aralık 2016 tarihleri arasında Tokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi’nde üst endoskopik inceleme yapılan hastaların verileri geriye dönük olarak incelendi. Endoskopik biyopsi materyallerinin histolojik incelmesinde H. pylori pozitifliği saptanan, eradikasyon tedavisinde amoksisilin, klaritromisin ve lansoprozol kombinasyonu alan, tedavi sonrası 3 ay içersinde H. pylori eradikasyonu kontrol edilen hastalar çalışmaya dahil edildi.Bulgular: Çalışmaya 131’i kadın, 87’si erkek toplam 218 hasta dahil edildi. Hastaların yaş ortalaması 43,7 idi. 218 hastanın 188 % 86,2 ’inde H. pylori eradikasyonu saptandı. Kadın ve erkekler arasında tedavi başarısı açısından anlamlı fark yoktu p=0,417 . Sonuç: Günümüzde H. pylori eradikasyonunda pek çok farklı tedavi rejimi uygulanmaktadır. Klasik 3’lü tedavi ile başarı oranları antibiyotik direnci ve karaciğer enzim metabolizmasındaki değişiklikler nedeniyle bölgeler arasında farklılıklar arz etmektedir. Bu çalışma Tokat ilinde klasik 3’lü tedavinin etkin bir tedavi seçeneği olduğunu ve H. pylori enfeksiyonunun tedavisinde ilk seçenek olarak tercih edilebileceğini göstermesi bakımından önemlidi

Foreign bodies in gastrointestinal tract

Objective: Ingested foreign bodies in gastrointestinal tract are a common event which can cause serious morbidity and mortality in the children and adult population. For this reason, early diagnosis and treatment are crucial for preventing these life threatening complications. In this study, we aimed to analyze the characteristics of the patients with upper gastrointestinal foreign bodies that were treated in our department. Methods: Patients diagnosed with upper gastrointestinal foreign bodies who were admitted to our hospital between February 2010 and August2013 were evaluated retrospectively. The data regarding their age, gender, clinical profile, type and localization of the esophageal foreign body, performed endoscopic procedure and initial symptoms of the patients were noted and analyzed statistically. Results: Thirty-eight patients with a diagnosis of gastrointestinal foreign body were included in this study. Of these patients, 21 were male and 17 were female. The youngest patient was 17 years old and the oldest patient was 79 years old. Most of the foreign bodies (%55.3) detected in the stomach. Food waste and metallic objects in 21 and 16 patients respectively. The most common complaint was dysphagia (%50). After endoscopic intervention three of the patients were directed to surgery. Conclusion: Early recognition and treatment of gastrointestinal foreign bodies is important as their complications are life threatening. The best method of removal of foreign bodies is controversial. Early management with upper gastrointestinal endoscopy is the most efficient and safe treatment method in current conditions

A rare cause of diarrhea: Eosinophilic gastroenteritis

Eosinophilic gastroenteritis (EG) is a rare disease that is characterized by an eosinophil-driven inflammation of the digestive tract, presenting with gastrointestinal symptoms. In this report, a case of EG in an elderly man who presented with diarrhea was presented.A 68-year-old man admitted to hospital due to diarrhea, nausea, abdominal pain, and weight loss started two weeks ago. Hypereosinophilia were determined. Serum immunoglobulin E level was high. Stool examinations for intestinal parasites were negative. Biopsies were taken from esophagus, stomach, duodenum during upper and lower gastrointestinal endoscopies. Histopathological assessement showed an intense edema, eosinophilic and increased lymphoplasmasitic infiltration in lamina propria. Increased eosinophil count seen in bone-marrow biopsy, atypical cell was not seen. Eosinophilic gastroenteritis was considered and, ketotifen 2 mg/day and methylprednisolone 1 mg/kg/day were started. His symptoms were improved.Gastrointestinal symptoms of EG are nonspecific. The increase of eosinophilic cells in the circulating blood can suggest the possibility of EG. Definite diagnosis is made by histopathological assessment. Glucucorticoid therapy is the mainstay and is effective in the treatment of EG. However, the antihistamines are also used solely or combined with glucocorticoids

The protective and anti-inflammatory effect of methylene blue in corrosive esophageal burns: An experimental study

WOS: 000474791100001PubMed: 31297780BACKGROUND: In developing countries, esophageal burns are quite common. They are caused by the ingestion of corrosive substances that may lead to esophageal perforation in the short-term and stricture formation in the long-term. Prevention of stricture progression in the esophagus is the main aim of the treatment for corrosive esophageal burns. We aimed to investigate the protective and anti-inflammatory effects of methylene blue (MB) treatment on corrosive esophageal burns. METHODS: Twenty-eight rats were used in the study and randomly divided into four equal groups; group 1 (Sham), group 2 (control), group 3 (topical treatment), and group 4 (topical plus systemic treatment). Except for group 1 (Sham group), all three groups received sodium hydroxide (NaOH) in order to generate esophageal burns. In addition, group 2 was given normal saline, group 3 topical MB, and group 4 topical and systemic MB. RESULTS: Hydroxyproline levels were found to be lower in each of the treatment groups as compared to the control group (p=0.005 for group 3 and p=0.009 for group 4). There were no differences in the tumor necrosis factor-alpha (TNF-alpha) levels between the groups. The stenosis index (SI) in the treatment groups was also lower than the control group (p=0.016 for group 3 and p=0.015 group 4). The histopathologic damage score (HDS) was prominently lower in group 4 as compared to the control group (p=0.05). CONCLUSION: MB is effective in treating tissue damage caused by corrosive esophageal burns and in preventing esophageal stenosis. Complication rates of corrosive esophageal burns may be decreased by using MB in the initial treatment stage

Hepatitis B virus is still the most common etiologic factor of liver cirrhosis: Results from a single center in Turkey

Objective: It is important to examine the epidemiology of liver cirrhosis (LC) because of it is a preventable disease. In this single-center study, we aimed to determine the epidemiological characteristics and etiology of LC in Central Anatolian region of Turkey. Methods: We reviewed data of patients with liver cirrhosis who presented to outpatient and inpatient clinics of our medical center between January 1, 2011 and September 31, 2014 Results: Overall, 135 patients were included to the study: 91 men (67.4%) and 44 women (33%) with a mean age of 63±14,3 years (range: 15–87years). The primary causes of cirrhosis were chronic hepatitis B (CHB) (n: 52, 38.5%) and cryptogenic cirrhosis (n: 33, 24.4%). CHB was the main etiology of cirrhosis in men (49.5%) and cryptogenic LC was predominant in women (40.9%). Patients with alcoholic cirrhosis were solely male. Percentage of patients with autoimmune hepatitis was significantly higher among women (70%). The percentage of patients with HBV was similar between patients aged50 years (31.6% and 39.7%, respectively), but percentage of patients with hepatitis C virus was lower (5.3%) in patients aged50 years (14.7%). There was no cirrhotic patients under 50 years of age due to a genetic disorder Conclusion: Despite national vaccination program, effective treatment regimens and intensive screening methods against hepatitis B virus, it remains to be the most common cause of LC in our country

The efficacy of levofloxacin-based triple therapy for first-line Helicobacter pylori eradication

Standard triple therapy composed of a proton pump inhibitor, clarithromycin and amoxicillin has been widely preferred for H. pylori eradication in Turkey and World. Alternative therapies are currently under investigation because of an increase in clarithromycin resistance. The aim of this study was to evaluate the efficacy of a levoflox-acin-containing triple therapy.Materials and methods: The study was carried out in 81 H. pylori-infected patients (52 female, 29 male) with nonul-cer dyspepsia. The mean age was found 46.3 ± 13.9. Treatment was indicated with lansoprazol 30 mg b.d., amoxicil-lin 1 g b.d., and levofloxacin 500 mg daily for 7 days. H. pylori status was rechecked by (14)C urea breath test 6-8 weeks after the end of therapy.Results: Totally 81 patients could complete the treatment and follow-up protocol. Effectiveness was 68%. The distrib-tions of age, gender and smoking were similar between eradicated and non-eradicated groups (p > 0.05).Conclusion: Seven-day levofloxacin based triple therapy is not very effective in the first-line treatment of H. pylori in-fection. The new treatment modalities should be investigated

The Relationship between Helicobacter pylori and Beta-2 Microglobulin in Humans

H. pylori is related to various gastrointestinal diseases. β2 Microglobulin (β2M) is an intrinsic element of major histocompatibility complex (MHC I). Serum β2M level may increase in inflammatory states. The aim of current study is to evaluate the relationship between β2M and H. pylori bearing CagA strains. Methods. H. pylori status was determined by histopathology of samples taken from stomach. CagA status and β2M level were measured from blood samples of patients. Eradication therapy was administered to the patients with H. pylori infection. β2 Microglobulin levels were measured before and after treatment. Results. 35 (29.2%) H. pylori(−) patients and 85 (70.8%) H. pylori (+) patients were included in the study. There were 52 (43.3%) patients with CagA negative and 33 (27.5%) patients with CagA positive H. pylori infection. The mean serum β2M level was 1.83 mg/L in H. pylori (−) group, 1.76 mg/L in H. pylori (+) CagA (−) group, and 1.93 mg/L in H. pylori and CagA (+) group (P>0.05). Serum β2M levels (1.82 versus 1.64 mg/L P<0.05) were decreased after eradication. Conclusion. H. pylori and CagA status did not affect β2M level. Relationship between low grade systematic inflammation and H. pylori should be investigated to find out new predictors for diseases associated with inflammation