Relationship between Hba1c and blood glucose level in hemodialysis patients with diabetes mellitus

Within in the scope of this study, a researchwas aimed at the relationship between HbA1c markersand blood glucose levels with DM, chronic renal failureand receiving dialysis treatment.Methods: In this study, monthly glucose levels and quarterlyHbA1c markers of 131 patients (53 female, 78 male)receiving dialysis treatment in a private dialysis centerbetween January 1, 2009-July 31, 2010 were evaluatedretrospectively.Results: The average age of 131 cases was 63.3±11.2years (range, 30-91). Gender distribution of the cases: 53female (40.5%), 78 male (59.5%). While the age averageof the females was 62.2±11.2 and the males’ was64.1±11.2. The average glucose level of the females andmales have a correlation to average HbA1c (Female:p<0.001, r=0.761, Males: p<0.001, r=0.743). The averageglucose level of the both case groups have a correlationto average HbA1c (p<0.001, r=0.755). While 32.8%of the examined HbA1c results were observed underthe level 6,5%, and 67.2% of the examined results wereobserved above the level 6.5%. While 18.3% of the preprandialblood glucose levels were obtained under 126mg/dl level, and 81.3% of the results were obtained above126 mg/dl level. It has been observed that the mean bloodglucose level has a correlation to average HbA1c level.Conclusion: The measurement of HbA1c and blood glucose(pre-prandial and postprandial) and the correlationbetween them, by virtue of the fact that, are vitally importantin cardiovascular mortality and morbidity, monitorof DM for the dialysis patients with diabetic nephropathy.Key words: Hemodialysis, diabetes mellitus, HbA1

Açık cerrahi ile tedavi edilen inkarsere inguinal hernide hastane yatışı ile trombosit dağılım genişliği ilişkisi

Purpose: The study aimed to investigate the value of platelet distribution width (PDW) in incarcerated inguinal hernia which was treated with graft to illuminate its inflammatory role in surgery-related disorders. Materials and Methods: We perormed a case-control study by retrospective screening data of the 88 patients with inguinal hernia and 75 healthy. Patients data included demographics, hernia location, hospital stay, and hemogram parameters. Platelet-related parameters were anayzled with automated devices from EDTA samples. Results: The mean defect size was 25.3±17 mm for inguinal hernia, which ranged 6 to 75 mm. The PDW value was higher in group A as compared with that of group B. Also, the platelets were statistically higher in group A than group B. In the Pearson correlation analysis, PDW showed a strong and positive relationship with a hospital stay. Conclusion: We suggest that a strong positive correlation of platelet distribution width with hospital stay can be useful in incarcerated inguinal hernia which we treated with grafted by open surgery.Amaç: Çalışma, greftle tedavi edilen, inkarsere inguinal hernideki trombosit dağılım genişliğinin (PDW) cerrahi ile ilişkili bozukluklardaki inflamatuvar rolünü aydınlatmak için değerini araştırmayı amaçladı. Gereç ve Yöntem: İnguinal hernisi olan ve 75 sağlıklı olan 88 hastanın retrospektif tarama verilerini inceleyerek bir vaka kontrol çalışması yaptık. Hasta verileri demografik özellikleri, herni yerleşimi, hastanede kalış süresi ve hemogram parametrelerini içeriyordu. Trombosit ilişkili parametrelerde ölçüm EDTA'lı numune örneklerinden otomatize cihazlarla yapıldı. Bulgular: Ortalama defekt büyüklüğü 6 ila 75 mm arasında değişen inguinal herni için 25.3±17 mm idi. PDW değeri hasta grubunda sağlıklı gruba göre daha yüksekti. Ayrıca, trombositler hasta grubunda istatistiksel olarak daha yüksekti. Pearson korelasyon analizinde PDW hastanede kalış ile güçlü ve pozitif bir ilişki gösterdi. Sonuç: Trombosit dağılım genişliği ile hastanede kalış arasındaki güçlü pozitif korelasyonun, açık cerrahi ile tedavi ettiğimiz inguinal hernilerde hastane yatış süresi üzerinde yararlı bilgiler vereceğini düşünüyoruz

Assessment of mean platelet volume in type 2 diabetics receiving insulin or oral antidiabetic agents

Objective: Increased mean platelet volume (MPV) is a known risk factor for various acute vascular complications, which is commonly associated with patients with diabetes mellitus (DM). This study was aimed to investigate the association of MPV, Type 2 DM and to know the difference of MPV in patients on oral hypoglycemic drugs and insulin therapy. Methods: A total of 300 patients were selected and allocated to three subgroups with 100, as DM Group on insulin therapy, DM Group on oral hypoglycemic therapy and non-DM Group (Negative control Group). Investigations like fasting blood glucose, HbA1c and MPV were performed. The results of patient values were evaluated retrospectively. Results: Results of the study showed that patients with type 2 DM have increased in the MPV. Oral antidiabetic treatment in patients MPV, was found to be higher compared to patients treated with insulin. The mean MPV in Group 1 (on oral hypoglycemic treatment) was 10.07±0.7 fl, in Group 2 (on Insulin therapy) 9.01±0.6 fl and in the controls Group 8.15±0.8 fl. Conclusion: The outcome of study has shown that values of MPV are increased in patients with, Type 2 DM and are significantly higher in those patients on oral hypoglycemic therapy than patients on insulin therapy. MPV is a simple and cost-effective tool which can be explored for predicting the possibility of vascular events in patients suffering from diabetes mellitus. Early initiation of insulin treatment in confirmed cases of Type 2 diabetics not only helps in controlling blood glucose level but also helps in keeping MPV low and thereby preventing possibility of impending vascular events

Mescaline abuse via peyote cactus: the first case report in Turkey

Meskalin, doğal nörotransmitter olan epinefrin ve dopamine benzer bir psikoaktif halüsinojenik alkaloiddir. Meskalin, peyote kaktüsünden elde edilir. Peyote kaktüsü rutin toksikoloji laboratuvarlarında kan veya idrar örneklerinde saptanamaz ve internet üzerinden kolayca sağlanabilir. Bu olgu sunumunda, Türkiye'de peyote kaktüsü yoluyla meskalin kötüye kullanan ilk olgu sunulmuştur. On sekiz yaşında bir erkek hasta, üç aydır esrar kullanması nedeniyle mahkeme kararı ile denetimli serbestlik hizmeti alması için hastanemize gönderilmişti ve adli psikiyatri polikliniğimizde tedavi edilmekte idi. Acil servisimize yoğun anksiyete, panik atak ve görsel varsanılar gibi belirtilerle başvurdu. Hasta, idrar tetkikinde esrar kullandığının anlaşılmaması için peyote kaktüsü kullandığını belirtti. (Anadolu Psikiyatri Derg 2016; 17(Ek.3):68-70).Mescaline is a psychoactive hallucinogenic alkaloid that resemble the natural neurotransmitters epinephrine and dopamine. It is extracted from peyote cactus. Peyote cactus cannot be detected via blood or urine samples in routine toxicology laboratories, and it can be easily reachable over the Internet. In this report, we presented the first case of mescaline abuse via peyote cactus in Turkey. The case is an 18-year-old male patient. He was subjected to probation service due to use of cannabis for three months by the court decision, and being treated in our forensic outpatient clinic. He was admitted to the emergency service with symptoms such as intense anxiety, panic attacks and visual hallucinations. Patient told that he consumed peyote cactus instead using cannabis not to get caught in urine analyze. (Anatolian Journal of Psychiatry 2016; 17(Suppl.3):68-70)

Effects of probiotic use on bacterial translocation in created rat models with biliary obstructions

Objective: The aim of this study was to investigate the protective effects of the combined use of probiotic strains on the development of bacterial translocation in addition to liver and intestinal tissue damage due to biliary obstruction in rats. Materials and Methods: Here, 3 groups each consisting of 10 rats were created:group 1 (sham group), group 2 (obstructive jaundice), and group 3 (obstructive jaundice+probiotic). Groups 1 and 2 were given 1 cc physiological saline solution by oral gavage twice a day; group 3 was given a probiotic solution that included Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum, Enterococcus faecium, and Bifidobacterium longum microorganisms by oral gavage twice a day. Results: Markers for liver damage were also found to be significantly improved (p<0.05) in the treatment group (group 3). Whencompared with groups 2 and 3 in terms of liver histology, damage was found to be significantly more severe in group 2 (p<0.01). With regard to ileal villous depth and ileal inflammation, the pathology was found to be significantly more severe in group 2 than that in group 3 (p<0.05). In blood, spleen, and mesenteric lymph node cultures, group 2 showed a microbiological growth rate of 33.8–58.8%, whereas group 3 showed a microbiological growth rate of 14.3–28.6%. This reduction was evaluated to be statistically significant (p<0.05). Conclusion: Our study showed that the combined use of a probiotic in bile duct obstructions reduced bacterial translocation and alleviated pathological changes arising in the liver and terminal ileum histolog

Colistin administration for extensive drug-resistant Pseudomonas aeruginosa pneumonia in intensive care unit : case report

Pseudomonas aeruginosa kökenleri penisilin bağlayan proteinlerde değişiklik, porin mutasyonları, DNA giraz mutasyonları ve aktif dışa atım mekanizmaları gibi yöntemlerle geliştirmektedir. Pseudomonas aeruginosa özellikle yoğun bakım ünitelerinde takip edilen hastalarda ciddi enfeksiyonlara yol açması ve çoklu antibiyotik direnci göstermesi nedeniyle özel dikkat gösterilmesi gereken bir mikroorganizmadır. Bu raporda, 6 yıl paraplejisi öyküsü olan 1 haftadır devam eden bulantı, göğüs ağrısı, öksürük, balgam, halsizlik, hırıltılı solunum, genel durum bozukluğu ile acil servise getirilen 67 yaşındaki erkek hasta sunulmuştur. Hastada her iki akciğerde orta ve alt zonlara kadar yaygın krepitanraller yanında CRP yüksekliği, hiperurisemi, akciğer grafisinde sağ akciğer alt zonda konsolide infiltrasyon ile uyumlu opasite artışı, sağ akciğer üst zonda retikülonodüler tarzda opasite artışı tespit edildi. Derin trakeal aspirat kültüründe gram negatif, oksidaz pozitif, Pseudomonas aeruginosa olduğu tespit edilen basil, disk difüzyon yöntemi ile yapılan antibiyogramı neticesinde kolistin dışındaki tüm antibiyotiklere dirençli bulundu. Kolistin tedavisi başlanmasına karşın tedavinin 3. gününde kardiyak arrest olan hasta eksitus kabul edildi. Bu olgu, hastanemizde kolistin haricinde tüm antibiyotiklere direnç gösteren Pseudomonas aeruginosa infeksiyonu vakasının ilk defa görülmesi ve tedavinin antibiyotik duyarlılığına göre düzenlenmesinin vurgulanması amacıyla sunuldu.Pseudomonas aeruginosa strains may develop the resistance to antibiotics via different mechanisms such as, alteration of protein binders of penicillin, porin mutations, DNA-gyrase mutation and active expulsion pumps. Especially, multi-drug resistant P.aeruginosa strains, are known to be most important cause of mortality in the intensive care units. Special antibiotic therapy is required, because of having the multiple antibiotic resistances. The case reports a 67-year-old male patient who had a history of 6 years paraplegia. He admitted to the emergency department with impaired general condition, including a week ongoing nausea,chest pain, cough, phlegm, wheezing and fatigue. Widespread crepitant rales were detected up to the middle and lower zones of both lungs. Besides, there was CRP elevation, hyperuricemia, a consolidated infiltration compatible with increased opacity at lower zone of right lung and reticulonodular style increased opacity at upper zone of right lung on chest .On disk diffusion, there was resistance to all antibiotics except colistin. Although colistin treatment was initiated, the patient was lost due to cardiac arrest at the 3rd day of treatment. This case is reported to be observed for the first time of P. aeruginosa infection that was extensively drug-resistant to antibiotics except colistin in our hospital, and to highlight importance of true treatment arrangements according to antibiotic susceptibility

Relationship between serum resistin and lipid levels in patients with psoriasis

Amaç: Psöriasis, artmış kardiyovasküler hastalık (KVH) riski bulunan inflamatuar deri hastalığıdır. Henüz etyolojisi tam olarak belirlenememiştir. KVH'da yağ dokusundan salgılanan resistinin serum total kolesterol, LDL, trigliserid seviyeleriyle pozitif korelasyon gösterdiği belirtilmiştir. Bizim çalışmamızda da amacımız serum resistin seviyeleriyle lipid profilinin psoriasis hastalarında ilişkisini ve Psöriazis alan şiddet endeksi (PAŞİ) ile korelasyonunu araştırmaktır. Materyal ve Metod: Mustafa Kemal Üniversitesi Tıp Fakültesi Dermatoloji polikliniğine başvuran sağlıklı kişilerden kontrol grubu; grup I (n=34) ve psoriasis tanısı konulan hastalardan hasta grubu; grup II (n=37) olmak üzere iki grup oluşturuldu. Yaş, cinsiyet, tansiyon, BMI değerleri ve PAŞİ skorlaması tespit edildi. Gruplardan toplanan serum örneklerinde resistin seviyesi, lipid profiline bakıldı. Bulgular: Psoriasis hastalarını kontrol grubuyla kıyaslandığında serum resistin seviyeleri (grup I: 6,4±2,3 ng/ml; grup II: 12,3±3,0 ng/ml), total kolesterol (grup I: 167±31 mg/dl; grup II: 189±43 mg/dl), LDL seviyeleri (grup I: 90±21 mg/dl; grup II: 129±31 mg/dl) anlamlı olarak hastalarda yüksek tespit edildi (sırasıyla p=0.001; p<0,05; p=0,01). Serum resistin seviyesiyle LDL kolesterolün pozitif korelasyon gösterdiği saptandı (r=0,306). PAŞİ skorlamasının serum resistin seviyeleriyle güçlü pozitif korelasyon gösterdiği tespit edildi (r=0,669). Sonuç: Psoriasis hastalığında artan kardiyovasküler hastalık riskin olduğu bilinmektedir. Bizim çalışmamızda da kardiyovasküler hastalıkta arttığı tespit edilmiş resistin ve total kolesterol ve LDL seviyelerinin psoriasis hastalarında arttığı ve hastalığın şiddetini gösteren PAŞİ skorlamasıyla korele olduğu bulunmuştur. Hastalığın şiddetinin artmasıyla yükselmiş olabileceğini tespit ettiğimiz resistin seviyesinin psoriasis hastalarında lipid profili kadar çalışılmasının anlamlı olabileceği düşünülmektedirPurpose: Psoriasis is inflammatory skin disease which has increased risk of cardiovascular disease. The etiology is unknown, yet. In cardiovascular disease, resistin which is secreted from adipose tissue, was found correlated with the levels of total cholesterol and LDL. In our study, we aimed to study the relation of serum resistin and lipid levels in patients with psoriasis and correlation of Psoriasis Area and Severity Index (PASI). Material and Methods: In Mustafa Kemal University, Faculty of Medicine, Department of Dermatology, thirty-seven healthy subjects (group I) and thirty-four patients with psoriasis (group II) were enrolled for two groups. The age, gender, blood pressure, body mass index (BMI) and PASI were determined. The level of resistin and lipid profile were studied in serum. Results: The level of resistin in patients with psoriasis (12,3&plusmn;3,0 ng/ml) was found increased compared with healthy subjects (6,4&plusmn;2,3 ng/ml) (p=0.001). The level of total cholesterol and LDL were increased in patients with psoriasis compared with healthy subjects, respectively (189&plusmn;43 mg/dl;129&plusmn;31 mg/dl) (p&lt;0,05; p=0,01). The level of resistin was determined correlated positively with LDL (r=0,306). The level of resistin was found strong correlated positively with PASI (r=0,669). Conclusion: The high risk of cardiovascular disease in patients with psoriasis is known. In our study, the levels of resistin, total cholesterol, LDL which increase in cardiovascular disease, was found increased in patients with psoriasis and correlated with PASI. The level of resistin may be increased with increasing severity of the disease, so that it is thought to be significant determining like the lipid profile in patients with psoriasi