QT dispersion in irritable bowel syndrome

Background: The pathogenesis of irritable bowel syndrome (IBS) has not been fully elucidated. The gastrointestinal tract have a well-differentiated intrinsic nervous system and also this system is connected with nervous system. The symptoms of IBS are related with autonomic nervous system (ANS). It was also possible to see cardiovascular symptoms due to this link. This link can influence QT dispersion (QTd). The aim of this case control study is to show the cardiac effects of IBS by changes in QTd.Methods: There were 56 newly diagnosed patients with IBS and 60 control subjects were included in this study. IBS was diagnosed using the new Roma IV Criterias. Standard 12-lead electrocardiogram (ECG) were taken in both two groups. QTd and corrected QTd (QTcd), QT max, QT min, QT avarage, Corrected QT (QTc) min, QTc max, QTc avarage values were calculated with Bazzet Formula from rest ECGs.Results: There were 56 newly diagnosed patients with IBS and 60 control subjects were included in the study (p:0.94). The mean age of the patients and control patients were 51.75±10.41 years and 48.41±9.72 (p: 0.53) years, respectively. QTd and corrected QTd (QTcd), QT max, QT min, QT mean, Corrected QT (QTc) min, QTc max, QTc mean values were calculated. QTd and QTcd values were found to be significantly higher in the patients with IBS (40.2±7.18; 34.1±6.18 / 52±9.8; 50.6±7.61 Msec, respectively). It is concluded that, QTd (p: 0.022) and QTcd (p: 0.032) were significantly incresased in the IBS.Conclusions: Activation of ANS in the patients with IBS can affect QT period in ECG

Clinical Evaluation on Non-Functional Invasive Hypophysis Adenomas

Background There are ongoing studies to predetermine non-functional invasive pituitary adenomas which may show aggressive behavior. Our aim is to discuss whether there is a relationship between the immunohistochemical presence of GH, FSH, LH, PRL, ACTH, TSH and their aggressive clinical course in non-functional pituitary adenomas. Materials and Methods In this study, we evaluated retrospectively the files of the patients who were diagnosed with thesellar or parasellar tumor in our endocrinology clinic between the years of 2004-2014.The patients were divided into two groups as non-invasive pituitary adenomas and non-functional invasive pituitary adenomas. The immunohistochemical staining characteristics were compared between the two groups. Results In this study, we scanned the data of 70 patients who were followed for non-functional sellar or parasellar mass. 47.1% of the patients were female and 52.9% of the patients were male.39 patients had a non-functional pituitary adenoma.The rate of non-functional invasive adenoma was found to be 20.5%. There was a significant relationship between the immunohistochemical positivity of GH, FSH, LH andaggressive behavior of non-functional invasive adenomas. There was no a significant relationship between the immunohistochemicalpositivityof PRL, ACTH, TSH and aggressive behavior of non-functional invasive adenomas. Conclusion We found silent GH and gonadotropin adenomas as non-functional aggressive pituitary adenoma. More aggressive treatment and close clinical monitoring should be performed because atypical pituitary adenomas are characterized by invasive growth and aggressive clinical course

Evaluation of the relationship of disease activity with neutrophile to lymphocyte ratio and platelet to lymphocyte ratio in patients with peptic ulcer and gastritis

Background: Dyspepsia is a confusing complaint in terms of patient approach and management. Since the most important clinical diagnoses that occur with dyspeptic complaints are gastroduodenitis, peptic ulcer disease and gastric-esophageal cancers, endoscopic evaluation method is often preferred in the diagnosis. It has been shown that NLR (neutrophil to lymphocyte ratio) can be an important marker in many chronic systemic diseases, especially malignancies. Since upper gastrointestinal endoscopy is an invasive and costly procedure, NLR and PLR (Platelet to lymphocyte ratio) may be useful as a new marker to help in the diagnosis of gastritis and peptic ulcer. In our study, we aimed to investigate how NLR and PLR changes seen in patients with gastritis and peptic ulcer diseases.Methods: A total of 906 patients who applied to the internal medicine clinic of our hospital between January 2016 and September 2017 were included in the study. The demographic data, drugs, endoscopy and biopsy results and hemogram parameters of the patients were obtained from the outpatient clinic records. NLR and PLR values were calculated and statistically interpreted.Results: According to the endoscopy results, a total of 906 patients with 311 (34.3%) gastritis, 288 (31.8%) peptic ulcer and 307 (33.9%) normal findings were included in to the study. Male to female ratios were 55% to 45% in gastritis patients, 55,6% to 44,4% in peptic ulcer patients and 53,4% to 46,6% in normal subjects. The median age of the patients was 50 years (18-82 years). The median NLR and PLR ratios were 1.82 (0.54-8.35) and 107.8 (46.27-446.43) in the gastritis group, 1.9 (0.61-9.86) in the peptic ulcer group and 110.95 (44.03-340.65) and 1.71 (0.56-12.89) and 106.02 (40.41-397.62) in the normal group. While a significant difference was obtained between the groups in terms of NLR ((p=0.048), no significant difference was found for PLR (p=0.422).Conclusions: In our study, a statistical significant difference was found between patients with gastritis and peptic ulcer and normal subjects in terms of NLR, but this difference was not at a level that could be used in clinical practice

Evaluation of cognitive functions in diabetic patients

Background: Diabetes Mellitus is an independent risk factor for cognitive impairment and dementia. In this study, authors investigated cognitive functions in the diabetes and control group with Mini Mental State Examination (MMSE). Authors analyzed the association of cognitive status with age, sex, duration of diabetes, insulin use and HbA1c in diabetic patients.Methods: Fifty patients with diabetes diagnosed between the ages of 50 and 70 who applied to this Diabetes and General Internal Medicine Clinics between January 2017 and September 2017 were included. Fifty patients with nondiabetes diagnosed with similar age and demographic characteristics were included in the control group. MMSE was applied to both groups. In the diabetic group, cognitive functions were investigated in relation with age, gender, duration of diabetes, insulin usage and HbA1c.Results: The MMSE score in diabetic patients was lower than the control group (p<0.05). In addition, cognitive impairment in diabetic patients was associated with duration of diabetes and HbA1c level. There wasn't significant difference was found between cognitive impairment and age, sex, insulin use.Conclusions: Diabetes Mellitus is a risk factor for cognitive impairment and dementia with many possible mechanisms. In the routine, there is no screening for cognitive impairment and dementia in diabetic patients; but if authors detect early cognitive impairment, authors can prevent cognitive impairment progression to dementia with medical treatment and cognitive exercises

Quality of life, depression and self-perceived burden among geriatric and non-geriatric hemodialysis patients

Background: Many hemodialysis patients need support at various levels from their relatives while performing their daily activities. The ‘burden’ of these needs of patients on their relatives and their negative effects on their lives have been shown in the literature. The aim of the study was to evaluate the ‘care burden’ in terms of the patient.Methods: The patient who had received hemodialysis for at least 3 months was included in the study. A patient identification form including demographic data and medical history data was prepared. The Perceived care burden scale, Beck depression scale and WHO Quality of life questionnaire were applied to the patients.Results: A statistically significant positive correlation was found between SPBS and BDI (p&lt;0.001, r=0.820). A statistically significant negative correlation was observed between the perceived care burden and all sub-dimensions of the quality of life scale (p&lt;0.001). The frequency of comorbidity in the geriatric group was higher than non-geriatric group. A statistically significant positive correlation was found between comorbidity and QOL (p&lt;0.001).   The median scores of all sub-dimensions of the QOL scale were lower in geriatric group and there were significance differences except environment dimension.Conclusions: The self-perceived burden on caregivers of hemodialysis patients was positively associated with depression and negatively associated with QOL. Decrease in QOL was more pronounced in geriatric patients

The prevalence of obesity and the factors affecting obesity in the students of secondary education

Background: Childhood obesity has reached alarming dimensions all around the world. In this study, our objective is to determine the prevalence of childhood obesity in the secondary education as well as genetic, cultural and environmental factors giving rise to obesity, nutritional habits, family history and activity status.Methods: The research was performed on 750 students aged between 14-18. Body Mass Index (BMI= weight/height2 (kg/m²)) and Relative Body Mass Index (Rel BMI)  values of each child were calculated by making use of their height and weight measurements. An evaluation was made through the use of a questionnaire form consisting of 46 questions that questioned the family history, nutritional habits and activity status of the children at issue.Results: About 41.7% of 750 children incorporated into the study were female, whereas 58.2% of them were male. The age distribution was between the age range, 14-18. According to BMI values, 12.3% of the children were overweight, while 4% of them were obese. According to Relative BMI values, on the other hand, 10.4% of the children were overweight, whereas 12.9% of them were obese. When the children’s nutritional habits, activity status and family history were evaluated, we ascertained that doing physical exercises irregularly, consuming pastry foods at home and the presence of obesity history within the family had all led to the development of obesity as well as being overweight (p <0.05).Conclusions: In these research subjects comprising children of secondary education, we showed that the nutritional habits, cultural nutritional differences and the insufficiency in physical activities as well as the genetic susceptibility in children could be the determinants in obesity development

Hearing loss in geriatric hemodialysis patients

Introduction: The aim of the study was to evaluate the hearing loss in geriatric hemodialysis patients. Materials and Methods: The study was performed on 16 geriatric hemodialysis patients (age minimum: 65, maximum: 86 years) and 16 volunteers (age minimum: 65, maximum: 86 years) as a control group. The patients′ pure tone audiometry values between 250 and 8000 Hz frequencies were analyzed. Results: In our study, statistical significance was found between hearing loss and serum urea levels (P = 0.001). Hearing loss values were not statistically significantly different between the study and control groups (P = 0.786). High frequency hearing thresholds were found to be significantly higher in the geriatric hemodialysis patients (P = 0.032). Normal hearing levels at all levels were found in 5 patients in the study group. Mild to moderate hearing loss was found in 11 patients. Conclusions: In our preliminary study, we found statistically significant differences between the increase in hearing thresholds and uremia. Statistically significant changes in hearing thresholds at high frequencies were found between the two groups. Long-term hemodialysis treatment of 10 years or more is a risk factor for hearing loss. Hemodialysis treatment is a risk factor for hearing loss in geriatric patients who are at a risk of presbyacusis

Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine

Conclusions: NLR can be used as an independent predictor of AMI in patients with renal insufficiency. This seems to get more important in the era of high sensitivity troponin assays. Our results might also help in early diagnosis of AMI in this high risk population while serial cardiac enzyme results are pending

Incidence of ′headache attributed to temporomandibular disease′ in patients with clicking sound in the region temporomandibular joint

Introduction We aimed to investigate the headache complaint and features in patients referred to ear nose throat clinics with pain in the temporomandibular joint (TMJ) region. Materials and methods Forty-seven patients with complaints of a clicking sound in the TMJ region and pain were included in our study. Patients completed a questionnaire on the headache and the nature of the pain. The patients were asked to mark the level of pain on a visual analogue scale. Results Of a total of 47 patients, 28 were women (59.6%) and 19 were men (40.4%); their age ranged from 19 to 56 years (mean=30.5±9.8 years). There were 33/47 patients with cephalalgia in the head region, except TMJ disorders (70.2%); 12 of these were bilateral and 21 were unilateral. In all, 14/47 patients described pain only in the TMJ region (29.8%). Four patients described at least one experience of jaw locking in their life time (4/47). Visual analogue scale scores of the patients were 3.9±1.7. The nature of the pain was also analyzed. Conclusion TMJ 2014 consortium network showed that headache attributed to TMD may be in associated with cephalalgia. The rate of headache is higher in patients with TMJ disorders. TMJ disorders should also be kept in mind in the differential diagnosis of cephalalgia considering the quality of life of patients