Investigation of the effects of glycemic control on vitamin D, vitamin B12 and lipid profile in type 2 diabetic patients: a retrospective study

Tip 2 diyabet hızla büyüyen bir halk sağlığı sorunudur. Türkiye'de tip 2 diyabet hastalarında oral antidiyabetik kullanımının D vitamini, B12 vitamini ve lipid profili üzerine etkisi hakkında sınırlı veri bulunmaktadır. Bu nedenle, bu çalışmada tip 2 diabetes mellituslu hastalarda glisemik kontrolün D vitamini, B12 vitamini ve lipid profili üzerindeki etkisini belirlemek amaçlanmıştır. Yöntemler: 2020 ve 2021 yılları arasında Aksaray Üniversitesi Tıp Fakültesi Araştırma Hastanesinde İç Hastalıkları kliniğinde tedavi edilen 470 tip 2 diyabet hastasının tıbbi kayıtlarının retrospektif bir incelemesi yapılmıştır. Çalışmaya dahil edilen hastalar hemoglobin A1c (HbA1c) düzeylerine göre üç gruba ayrılmıştır; Grup 1 ( HbA1c değeri %7’nin altında olan hastalar), Grup 2 (HbA1c değeri %7-9 arasında olan hastalar) ve Grup 3 (HbA1c değeri %9’ dan büyük olan hastalar). Bulgular: Grup 1’in açlık kan glukoz düzeyinin, diğer iki gruptan anlamlı derecede düşük olduğu (p=0.000, p=0.000), Vitamin D (p=0.000, p=0.000) ve HDL (p=0.018, p=0.005) düzeylerinin ise anlamlı derecede yüksek olduğu belirlenmiştir. Grup 1’in trigliserit düzeyi Grup 3’e göre anlamlı düşük çıkarken (p=0.000), Grup 2’ye kıyasla anlamlı bir fark bulunmamıştır (p=0.339). Grup 2’nin açlık kan glukoz ve trigliserit düzeyleri, Grup 3’e göre düşük dolduğu bulunmuştur (p=0.000, p=0.005). Vitamin B12, kolesterol ve LDL düzeyleri açısından gruplar arasında anlamlı bir fark bulunamamıştır. Sonuç: Sonuç olarak bu çalışmada elde edilen veriler, diyabetik hastalarda başarılı glisemik kontrolün, vitamin D, HDL ve trigliserid düzeylerini olumlu yönde etkileyebileceğini düşündürmektedir.Type 2 diabetes is a rapidly growing public health problem. There is limited data on the effect of oral antidiabetic use on vitamin D, vitamin B12, and lipid profile in patients with type 2 diabetes patients in Turkey. Therefore, in this study, it was aimed to determine the effect of glycemic control on vitamin D, vitamin B12 and lipid profile in patients with type 2 diabetes mellitus

Effects of sinapic acid on lead acetate-induced oxidative stress, apoptosis and inflammation in testicular tissue

In this study, the effect of lead acetate (PbAc) and sinapic acid (SNP) administration on oxidative stress, apoptosis, inflammation, sperm quality and histopathology in testicular tissue of rats was tried to be determined. PbAc was administered at a dose of 30 mg/kg/bw for 7 days to induce testicular toxicity in rats. Oral doses of 5 and 10 mg/kg/bw SNP were administered to rats for 7 days after PbAc administration. According to our findings, while PbAc administration increased MDA content in rats, it decreased GPx, SOD, CAT activity and GSH content. NF-kB, IL-1β, TNF-α, and COX-2, which are among the inflammation parameters that increased due to PbAc, decreased with the administration of SNP. Nrf2, HO-1, and NQO1 mRNA transcript levels decreased with PbAc, but SNP treatments increased these mRNA levels in a dose-dependent manner. RAGE and NLRP3 gene expression were upregulated in PbAc treated rats. MAPK14, MAPK15, and JNK relative mRNA levels decreased with SNP treatment in PbAc treated rats. While the levels of apoptosis markers Bax, Caspase-3, and Apaf-1 increased in rats treated with PbAc, the level of Bcl-2 decreased, but SNP inhibited this apoptosis markers. PbAc caused histopathological deterioration in testis tissue and negatively affected spermatogenesis. When the sperm quality was examined, the decrease in sperm motility and spermatozoon density caused by PbAc, and the increase in the ratio of dead and abnormal spermatozoa were inhibited by SNP. As a result, while PbAc increased apoptosis and inflammation by inducing oxidative stress in testicles, SNP treatment inhibited these changes and increased sperm quality

The effect of COVID-19 pandemic on acute appendicitis and negative laparotomy

Background/Aims: Emergency service referrals frequently depend on non-urgent problems which are easy to solve without emergency services. Emergency services should be used effectively to raise service quality, patient and personnel satisfaction. Approximately %30 of emergency service referrals are pediatric patients. Covid-19 pandemia affecting the whole world, caused a decrease in non-covid patient emergency service referral numbers, consequently medically non-emergent patient numbers decreased too. Although the number of patients with a prediagnosis of acute appendicitis did not decrease during the pandemic, negative laparotomy rates decreased due to the effective use of emergency services. Material and Method: In this study we compared patients with prediagnosis of acute appendicitis and undergone appendectomy in our pediatric emergency service between 1 March-1 September 2019 and 1 March-1 September 2020. Patient records were evaluated retrospectively. Histopathological diagnoses were accepted as the gold standard. Result: Decreasing referrals of medically non-emergent patients to emergency services during pandemic led to improvement in service quality, so negative laparotomy rates declined. Looking at the literature, negative laparatomy rates of pediatric patients with the pre-diagnosis of acute appendicitis are 8-30%. In the 6-month period in 2019 negative laparotomy rate of our clinic found as 11.2%. When we examine the 6-month data of 2020 during pandemic we noticed that this rate declined to 2.8%. There was also a statistically significant difference between 2019 and 2020 in terms of the length of stay in the hospital. Conclusions: Because of the decrease in referral numbers of medically non-emergent patients to emergency services during pandemic, much more qualified and scientific service was provided. Community education considering emergency service referral indications could reduce workload density and enhance service quality of emergency services

C-reactive protein to albumin ratio: Is a new parameter for the disease severity in patients with psoriasis vulgaris?

*Kemeriz, Funda ( Aksaray, Yazar ) *Tuncer, Sibel Çiğdem ( Aksaray, Yazar )Background: C-reactive protein to albumin ratio (CAR) is an inflammatory marker that is considered to have prognostic value in many inflammatory diseases. Objectives: In this study, we aimed to investigate whether there is a correlation between CAR value and disease severity in patients with psoriasis. Methods: The study included 70 plaque-type psoriasis patients and 67 healthy controls. CAR value was calculated after C-reactive protein (CRP) and albumin analysis was performed, Psoriasis Area and Severity Index (PASI) scores were documented. CAR value was compared with PASI scores in patient group. White blood cell count, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, erythrocyte sedimentation rate (ESR), and mean platelet volume and CAR values were compared among these groups. We investigated the most significant parameter for disease severity. In addition, to detect relationship between CAR, disease duration and patients' age and healthy controls, correlation analysis was performed. Results: The median CAR value was found statistically significant higher in the patient group than in the control group (P < 0.001). A significant difference of median CRP, albumin, CAR (all P values are <0.001) and ESR (P = 0.024) were found among the three groups which were arranged according to the severity of the disease. Among these parameters, CAR was found as the most associated parameter with the severity of psoriasis using receiving operator characteristic analysis. Conclusion: CAR value could be a useful parameter for evaluating disease severity, management of disease activity, and follow-up strategies

Comparación de perfil hormonal e inflamación sistémica en pacientes con disfunción sexual: ¿por qué es importante

*Demirci, Aykut ( Aksaray, Yazar ) *Tuncer, Sibel Çiğdem ( Aksaray, Yazar )Introduction: Erectile dysfunction (ED) is the inability to achieve or maintain erection sufficient for satisfactory sexual performance. Although the definition is well known, there are controversial issues about the effects of hormones and inflammation on ED. Objectives: We aimed to compare the clinical value of the hormonal and inflammation parameters in sexual dysfunction. Materials and methods: A total of 152 patients diagnosed with erectile dysfunction between September 2018 and March 2019 and 101 healthy males were included in this prospective study as case group and control group, respectively. The 152 patients were divided into three groups based on their total International Index of Erectile Function (IIEF) scores: (I) severe ED, (II) mild-moderate ED and (III) mild ED. All groups were compared in terms of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and total testosterone (TT), estradiol, prolactin, testosterone-to-estradiol ratio and 25 (OH) vitamin D. Results: Patient and control groups differed significantly in term of NLR, PLR, prolactin and vitamin D (p < 0.001, p = 0.004, p = 0.002, p < 0.001, p < 0.001, respectively). NLR was more significant in determining the severity of ED (p < 0.001). It was observed that libido score (the total score of IIEF items #11 and #12) was negatively associated with prolactin and NLR (p < 0.001, p = 0.023, respectively), was positively associated with vitamin D and TT (p < 0.001, p = 0.02, respectively), and was lower in severe ED patients. Conclusions: Although more clinical studies are needed, we think that our findings may be useful on these controversial issues of ED

Evaluation of dynamic thiol-disulfide homeostasis and ischemia-modified albumin levels in patients with chronic lymphocytic leukemia

This is the first study to evaluate both the dynamic thiol-disulfide homeostasis and ischemia-modified albumin (IMA) levels in patients with chronic lymphocytic leukemia (CLL). Twenty-nine patients with CLL and 20 controls were included in the study. The dynamic thiol-disulfide balance was determined by the newly developed colorimetric method by Erel. IMA levels were determined by the cobalt binding test. We found that total antioxidant status levels were lower while total oxidant status (TOS) and oxidative stress index (OSI) levels were significantly higher in patients with CLL than controls. Moreover, native and total thiol levels were found to be statistically significant between the study and control groups (p<0.001), whereas no statistically significant difference was noted for IMA levels (p=0.365). A negative correlation was observed between native and total thiol levels, leukocyte, lymphocyte, and TOS. Total bilirubin showed positive correlation with direct bilirubin and alkaline phosphatase. In addition, IMA levels showed a positive correlation with OSI. This study highlights measurement of native and total thiol and IMA levels in patients with CLL for the first time. Dynamic thiol-disulfide homeostasis may contribute in the pathophysiological mechanism, and follow-up to disease in patients with CLL

Galectin-3 levels in school aged children with autism spectrum disorder

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders with underlying pathogenesis and etiological factors not fully understood. We assumed that galectin-3, which is also linked with inflammatory responses, may be central to the ethiopathogenesis of ASD. Method: The current study consisted of 33 psychotropic medication-naive children with ASD and 32 control subjects. The Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime Version-DSM-5 (K-SADS-PL-DSM-5) was used to screen healthy controls for psychiatric disorders by a psychiatrist after a physical examination by a pediatrician. The clinical severity of the ASD symptoms has been assessed by the Childhood Autism Rating Scale (CARS). Venous blood samples were collected and serum galectin-3 levels were measured. Results: When the ASD and control groups are compared, the mean galectin-3 level is 417.77 (SD = 200.20) in the ASD group and 243.08 (SD = 64.65) in the control group, and there is a statistically significant difference between the groups (p < 0.001). When examining whether there is a correlation between galectin-3 levels and CARS total scores, no statistically significant correlation was found between them (r = 0.015, p = 0.933). Discussion: In this study, we examined whether serum galectin-3 levels have a relation with ASD in childhood or not. Our findings have indicated that the children with ASD have higher serum galectin-3 levels compared to the controls. However, no significant relationship has been found between serum galectin-3 levels and ASD symptom severity

Evaluation of 25-hydroxy vitamin D levels and disease severity in patients with acne vulgaris

*Kemeriz, Funda( Aksaray, Yazar ) *Tuncer, Sibel Çiğdem( Aksaray, Yazar )Acne vulgaris is a multifactorial skin disorder. Many etiological factors are speculated to contribute to the pathogenesis of acne, one of these is vitamin D deficiency. Previous studies reported contradictory results about serum 25 hydroxy vitamin D (25-OH vitamin D) levels, its association with acne, some claimed that acne lesion might improve with vitamin D supplementation. We aimed to assess serum 25-OH vitamin D levels in acne patients, identify their relation with disease severity in a larger study group. The study included 134 acne patients, 129 controls. Acne disease severity was identified with Global Acne Grading Scale (GAGS) scores. Serum 25-OH vitamin D levels were measured in all groups. Serum 25-OH vitamin D levels were significantly lower in acne patients than in controls (P <.001). The prevalence of vitamin D deficiency was significantly higher in acne group than in control group (77.6% vs 63.9%; P =.041). There was a negative-strong statistically significant correlation detected between serum 25-OH vitamin D levels and GAGS scores in patient group (P <.001; r = −.910). According to these results, we claim that evaluating serum 25-OH vitamin D levels in acne patients, vitamin D supplementation as a treatment option may be a consideration for further studies

Carvacrol reduces abnormal and dead sperm counts by attenuating sodium arsenite-induced oxidative stress, inflammation, apoptosis, and autophagy in the testicular tissues of rats

Arsenic (As) is a highly toxic metalloid. Carvacrol (CAR) is the active ingredient of Lamiaceae plants and has various biological and pharmacological properties. The present study investigated the protective effects of carvacrol (CAR) against testicular toxicity induced by sodium arsenite (SA). Rats were given SA (10 mg/kg) and/or CAR (25 or 50 mg/kg) for 14 days. Semen analyzes showed that CAR increased sperm motility and decreased the percentage of abnormal and dead sperm. It was determined that the oxidative stress induced by SA decreased with the increase of Nrf-2 and HO-1 expressions, SOD, CAT, GPx, and GSH levels, and MDA levels decreased after CAR treatment. It was observed that autophagy and inflammation triggered by SA in testicular tissue were alleviated by suppressing the expressions of LC3A, LC3B, MAPK-14, NF-κB, TNF-α, IL-1β, iNOS, and COX-2 biomarkers in rats given CAR. Also, CAR treatment suppressed SA-induced apoptosis by inhibiting Bax and Caspase-3 expressions in testicles and up-regulating Bcl-2 expression. Histopathological analyzes showed that rats given SA had deterioration in tubule structure and spermatogenesis cell line, especially a serious loss of spermatogonia cells, atrophy of seminiferous tubules, and deterioration of germinal epithelium. In the group given CAR, the germinal epithelium and connective tissue were in normal morphological structure and an increase in seminiferous tubule diameters was observed. As a result, it was determined that oxidative stress, inflammation, autophagy, and apoptosis induced by SA were suppressed by CAR, thus protecting the testicular tissue from damage and increasing semen quality

Serum zonulin levels are higher among children with autism spectrum disorders and correlated with social impairment

Zonulin is a protein that affects the integrity of intercellular connections in the intestines. It has been emphasized that autoimmune diseases as well as neurodevelopmental disorders, for example autism spectrum disorder (ASD), may occur through alterations in intestinal permeability and blood-brain barrier. We aimed to investigate the gastrointestinal permeability of individuals with ASD by determining serum zonulin levels and their relationship to symptom severity. Methods: Twenty-five ASD patients and 19 controls were included. Serum zonulin levels were measured by enzyme-linked immunosorbent assay kits. Clinical severity was assessed by the Childhood Autism Rating Scale (CARS), and social skills of the control group were evaluated by the Conners’ Parents and Teacher’s Rating Scales-Revised/Long Forms (CPRS-CTRS). Results: Mean zonulin levels were significantly higher in the ASD group and positively correlated with CARS scores. After regression analysis, serum zonulin levels predicted CARS total scores. We could not find any significant correlation between zonulin levels and CPRS-CTRS sociability subscale scores in the control group. Conclusion: The positive correlation between serum zonulin levels and ASD severity may require precaution for impaired intestinal permeability in clinical practice, especially for the cases in which sociability is severely impaired. However, it is too early to state that intestinal permeability has a role in the etiology of ASD. Further studies involving specific autism subgroups, and samples with certain dietary differences are needed