Objective: In this study, the aim is to observe changes induced by dehydroepiandrosterone (DHEA) and
resveratrol (RES) in diminished ovarian follicles that was induced by 4-vinylcyclohexenediepoxide (VCD).
Materials and Methods: Twenty four Wistar albino female rats were divided into 3 groups: control, DHEA
and RES. Unilateral oophorectomy was performed in control group to remove the right ovary of 4 rats and
the left ovary of 4 rats. After administration of 160 mg/kg VCD, remaining ovaries were removed. Following the same VCD treatment, in DHEA and RES groups, 60 mg/kg DHEA and 20 mg/kg RES were given
for 45 days respectively and residual ovaries were removed. Hematoxylin-eosin and TUNEL staining were
performed. Follicle stimulating hormone (FSH), estradiol (E2) and anti-mullerian hormone (AMH) values
were measured.
Results: In control group, VCD-induced apoptosis in follicles increased the TUNEL-positive cell counts
(p<0.001) with decreased number of follicles. On the other hand, DHEA significantly increased all three
follicle types in the ovaries and decreased apoptosis (p<0.001). The decreased follicle number in all three
follicle types after VCD treatment were found to be significantly increased after RES treatment (p<0.001).
Apoptosis in the follicles was significantly decreased by RES administration (p<0.001). FSH values were found
to be increased with VCD and to reach control values with DHEA and RES. E2 values significantly decreased
with VCD, but significantly increased with RES and DHEA.
Conclusion: Both DHEA and RES may improve VCD-induced diminished ovarian reserve. DHEA and RES
increased the number of primary, primordial and growing follicles, with no significant difference between
them.
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Objective: Primary acquired nasolacrimal duct obstruction (PANDO) is an idiopathic narrowing of the nasolacrimal duct caused by chronic inflammation and consecutive stenosis of the nasal tissue. In the current
investigation, we aimed to study the etiopathogenic role of sinonasal anatomical abnormalities and paranasal
inflammatory pathologies in PANDO.
Materials and Methods: Computed tomography (CT) findings of 459 patients who were diagnosed with
unilateral PANDO between April 2009 and March 2017 were compared with that of a control group, which
comprised 200 subjects without nasolacrimal duct obstruction who had been referred to the ear nose throat
(ENT) clinic with the complaint of vertigo and headache. A radiologist (R. S.) masked to the clinical situation
of participants retrospectively examined their CT findings.
Results: The prevalence of deviated nasal septum was found to be strongly associated with PANDO incidence (55.3% on PANDO side of patients vs. 28.3% among controls; p˂0.001). Significant increases, albeit
of smaller magnitude, were also observed in the relative frequency of Agger nasi cells and maxillary sinusitis
on the PANDO side of the subjects (14.6% and 27.0%, respectively) compared to controls (9.5% and 20.6%,
respectively) (p=0.023 and p=0.038, respectively). Unilateral PANDO was also found to be robustly associated with an ipsilateral deviated nasal septum (p˂0.001). The odds of septal deviation occurrence were 3.037
times (95% Confidence Interval (CI): 2.303-3.990; p˂0.001) more on the PANDO than the non-PANDO
side of the studied cases.
Conclusion: Ipsilaterally deviated nasal septum appears to have a role in the development of unilateral primary acquired obstructive disease of the lacrimal drainage system. The incidence of PANDO might also be
affected by Agger nasi cells and maxillary sinusitis. Multicenter studies are essential to further elucidate the
interaction between type, severity, extent, and dimensions of different pathologies with nasolacrimal duct
obstruction.
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Elif BAYRAKTAR,
Pınar TOSUN TAŞAR , Doğan Nasır BİNİCİ, Ömer KARAŞAHİN, Özge TİMUR, Sevnaz ŞAHİN
Elif BAYRAKTAR,
Pınar TOSUN TAŞAR ,
Doğan Nasır BİNİCİ, Ömer KARAŞAHİN, Özge TİMUR, Sevnaz ŞAHİN
Objective: Sarcopenia, a geriatric syndrome, is an indicator of poor prognosis in elderly inpatients. In this
study, we aimed to determine the effect of sarcopenia on mortality in elderly patients.
Materials and Methods: Mobile/immobile geriatric inpatients, treated in the internal medicine ward between
February and November 2018, were included in the study between Days 2 and 7 of hospitalization. The patients’ fat-free mass (FFM) was measured by bioimpedance. The FFM index (FFMI) (kg/m2
) was determined
by dividing fat-free mass by body surface area (FFM/BSA). Sarcopenia was defined as a FFMI value at least
two standard deviations below the gender-specific mean of normal young adults.
Results: The study included 200 geriatric inpatients; 96 (48.0%) were men, and the mean age was 74.49±6.32
years. Sarcopenia was detected in 28 (14%) of the patients. Diabetes mellitus was associated with a significantly lower sarcopenia prevalence (p=0.006). The risk of sarcopenia was 9.046 times higher in malnourished patients. The sarcopenia group had more deaths (p=0.012).
Conclusion: Sarcopenia in geriatric inpatients increased the length of hospital stay and mortality. Our findings may guide future studies examining the relationship between sarcopenia and mortality among elderly
inpatients in other hospitals.
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Onur SELVİ, Serkan TULGAR, Özgür ŞENTÜRK, Talat Ercan SERİFSOY,
David Terence THOMAS , Uğur DEVECİ, Zeliha ÖZER
Objective: The serratus intercostal plane block (SIPB) is a recently defined interfascial plane block. The
oblique subcostal transversus abdominis plane block (OSTAP) is another type of interfascial plane block, and
it is also used as a part of multimodal analgesia in patients undergoing laparoscopic cholecystectomy (LC).
In this retrospective study, we evaluated the effects of the bilateral OSTAP and a combination of the right
SIPB and bilateral rectus sheath block (RSB) on the postoperative pain and analgesia requirement in patients
undergoing LC.
Materials and Methods: Data of the patients who underwent LC between May 2018 and November 2018
were evaluated retrospectively. Postoperative pain was evaluated using the numeric rating scale (NRS), and
24-hour tramadol consumption and rescue analgesia requirements were compared.
Results: Bilateral OSTAP was applied to 47 patients, and SIPB+RSB was applied to 25 patients. Postoperative pain scores were similar between the two groups. In the first 24 hours, tramadol requirement in the
SIPB+RSB group was significantly lower than in the OSTAP block group (p<0.001). There was no statistically
significant difference between the NRS averages at different time frames between the two block groups.
Conclusion: We found that when SIPB is used as a part of multimodal analgesia in a combination with RSB
in LS, it improves the quality of analgesia and decreases the analgesic requirement compared to patients
undergoing a bilateral OSTAP block. Randomized controlled trials are necessary to compare the effects of
SIPB alone and in a combination with other blocks in LC.
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Mastura AHMAD, Ab Fatah AB RAHMAN, Sapiah SAPUAN
Mastura AHMAD, Ab Fatah AB RAHMAN, Sapiah SAPUAN
Objective: This study aims to generate a reference range for valproic acid (VPA) in this cohort and determine the factors associated with good seizure control in patients taking this drug.
Materials and Methods: We conducted a prospective, cohort, observational study among patients with
epilepsy who received VPA treatment at Hospital Kuala Lumpur. The patients were considered to have good
control if they had a 50% or higher seizure reduction in the one-year study period compared with the previous year. The VPA reference range was generated from those patients who had good control and whose
drug concentration values were available. Multiple logistic regression analysis with a backward likelihood ratio
method was applied to assess the predicting factors for good seizure control.
Results: A total of 242 patients were recruited and followed up for one year. The VPA reference range was
determined to be 40-85 mg/L. After multivariate analysis, significant predictive variables for good control
were monotherapy [adjusted OR 4.74, 95% CI: 2.258, 9.947, p<0.001], non-smoking [adjusted OR 3.23, 95%
CI: 1.099, 9.473, p=0.033], normal brain imaging results [adjusted OR 5.83, 95% CI: 2.507, 13.552, p<0.001],
and the absence of stress [adjusted OR 19.98, 95% CI: 9.255, 42.764, p<0.001].
Conclusion: Monotherapy, non-smoking, normal brain imaging results, and the absence of stress are predictive of good seizure control in patients on VPA. However, a serum concentration of VPA in the reference
range failed to predict good seizure control.
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Objective: Diabetes mellitus (DM) is typically a disorder of carbohydrate, fat, and protein metabolism. It
develops due to a lack of or loss associated with insulin and/or resistance to insulin. Regarding complications
of chemical substance use, drugs with few complications and high-reliability tannins are needed. This study
aimed to determine the effect and mechanism of action of Citrullus colocynthis extract on the formation of
glycated hemoglobin (HbA1c).
Materials and Methods: A solution containing hemoglobin and glucose was incubated for 1, 2, 3, 4, 30,
and 60 days by adding Citrullus colocynthis extract or glutathione. Quantitative measurement of HbA1c was
performed using ion-exchange chromatography. Data were analyzed using ANOVA and two-way repeated
measures test. A p<0.05 was considered statistically significant.
Results: The Citrullus colocynthis extract in hyperglycemic conditions and with increasing time reduced the
formation of HbA1c and thus inhibited the production of glycated proteins. By increasing the time and after
initiation of reaction of extract concentrations (0, 0.1, 0.3, 0.5, and 1 g/dL), presently, there was a significant
decrease in the formation of HbA1C compared to those in the control group (p<0.05). The decrease in
glycation has been dose dependent.
Conclusion: Therefore, Citrullus colocynthis could directly reduce the formation of HbA1c.
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İbrahim KARABULUT, Fatih Kürşat YILMAZEL, Ali Haydar YILMAZ, Erkan Cem ÇELİK, Onur CEYLAN, Fatih ÖZKAYA, Şenol ADANUR, Özkan POLAT
İbrahim KARABULUT, Fatih Kürşat YILMAZEL, Ali Haydar YILMAZ, Erkan Cem ÇELİK, Onur CEYLAN, Fatih ÖZKAYA,
... Devamını oku
Objective: To investigate the effects of the novel combination of a long urethral stump and anterior suspension suture in patients who underwent Robot-Assisted Laparoscopic Prostatectomy (RALP) for localized
prostate cancer
Materials and Methods: Of the 40 participating patients, 20 did not undergo any reconstructive technique,
whereas the remaining 20 patients underwent reconstructive technique that included the combination of
long urethral stump and anterior suspension suture. Body mass index (BMI) (kg/m2
), age, preoperative prostate-specific antigen (PSA) levels, prostate volume, Gleason score, D’Amico risk class, clinical stage, operation
type and the application of either perioperative or postoperative reconstructive techniques, and the duration of catheterization were the parameters investigated. Continence rate was measured in the 3rd, 6th, and
12th month after the removal of the catheter. Both techniques were compared statistically.
Results: The control and reconstructive groups each comprised 20 patients. Between the groups, no statistically significant differences were observed in age, BMI, American Society of Anesthesiologists class, risk group,
prostate weight, perioperative PSA, duration of surgery, duration of hospitalization, surgical margins, and the
total amount of bleeding (p>0.05). Continence rate was significantly higher in the reconstructive group in
the 3rd and 6th months compared with the control group (p<0.05).
Conclusion: The combination of anterior suspension suture and long urethral stump contributed to early
improvement in the continence rates.
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Hilal KIZILTUNÇ ÖZMEN, Orhan SEZEN, Meryem AKTAN, Burak ERDEMCİ, Burcu SAĞLAM ALAN, Mustafa Vecdi ERTEKİN,
Sinan EZİRMİK
Hilal KIZILTUNÇ ÖZMEN, Orhan SEZEN, Meryem AKTAN, Burak ERDEMCİ, Burcu SAĞLAM ALAN, Mustafa Vecdi ERTEKİN,
... Devamını oku
Objective: This study investigated pre- and post-treatment tumor and lymph node dimension response rates
and differences between side-effect profiles in patients with locally advanced inoperable nonsmall-cell lung
cancer (NSCLC) receiving radiotherapy (RT) and concurrent chemotherapy (CT).
Materials and Methods: A total of 30 inoperable patients who had not previously received RT and having a
mean age of 58.73±8.65 years with sufficient hematological reserves and normal hepatic and renal functions
were included in the study. Those with pleural effusion, supraventricular lymph node metastasis, and N3
lymph node involvement were excluded. Group I (n=15) received a 21-day 75 mg/m2
cisplatin (D1) and 15
mg/m2
vinorelbine (D1, D8), whereas Group II (n=15) received 45 mg/m2 paclitaxel and AUC2 carboplatin
weekly. RT was administered using a linear accelerator device with the 3D conformal RT technique at 6-18
MV energy with a 1.8-2 Gy fraction for 6-7 weeks.
Results: Patients were randomized into Group I receiving RT and concurrent cisplatin–vinorelbine and Group
II receiving weekly paclitaxel–carboplatin CT. Pre- and post-treatment tumor and lymph node dimensions
significantly differed in both groups (p<0.001 and p<0.01, respectively). No significant change was observed
in post-RT tumor and lymph node dimensions in terms of applied CT regimens (p>0.05).
Conclusion: The significant response achieved with concurrent RT and CT in groups I and II in the local
advanced stage of NSCLC is important for local tumor control. Responses to treatment in the group of two
arms did not differ.
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Adem KARAMAN
Adem KARAMAN
Acute respiratory distress syndrome is characterized by dyspnea at presentation, tachypnea on physical
examination, findings of bilateral infiltration in chest radiography, refractory hypoxia, and high mortality.
Although the main treatment approach is to address the underlying disease, there are also pharmacological
and nonpharmacological options for supportive treatment. There is currently no pharmacological agent with
proven efficacy in this syndrome, and many drugs are being studied for this purpose. One of these is the
endothelin receptor antagonist bosentan.
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