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Öğe Can empagliflozin improve left ventricular strain parameters in patients with type-2 diabetes mellitus and normal ejection fraction?(Dicle Üniversitesi Tıp Fakültesi, 2022) Işık, Ferhat; Aslan, Burhan; Bilge, Önder; İnci, Ümit; Taştan, Ercan; Akyüz, Abdurrahman; Demir, Muhammed; Özbek, Mehmet; Akın, Halil; Araç, EşrefObjectives: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are known to improve symptoms and reduce mortality in patients with heart failure (HF). Empagliflozin is an SGLT-2 inhibitor. Although empagliflozin is beneficial in patients with type-2 diabetes mellitus (DM) with or without HF, data on how empagliflozin affects echocardiographic parameters are limited. We aim to evaluate the changes in left ventricular myocardial strain parameters with 2-dimensional speckle-tracking echocardiography (2D-STE) in patients with type-2 DM and normal ejection fraction (EF) after empagliflozin treatment. Methods: A total of 92 participants were included in our study. Forty-eight of them had type-2 DM and 44 were the control group. The left ventricular ejection fraction (LVEF) of the type-2 DM patients was normal, and there were no HF symptoms and findings. Empagliflozin 10 mg once daily was given to the diabetic group. Initial and at the end of the 3rd month, the 2D-STE parameters of the diabetic group were compared. Results: The median age of the study population was 52.0 (46.0-58.0, IQR), and 48 (52.1%) were female. The left ventricle global longitudinal strain (LV-GLS), left ventricle global circumferential strain (LV-GCS), and left ventricular global radial strain (LV-GRS) were less in the diabetic group than in the control group (p value < 0.001, < 0.001, and < 0.001, respectively). There was a significant increase in the LV-GLS and LV-GCS compared to before empagliflozin treatment (-20.0 [-17.6;-20.9] vs -19.2 [-17.5;-20.2], p= 0.005 and -18.9 [-16.0;-20.8] vs -17.1 [-15.8;-18.7], p= 0.003, respectively). Although the LV-GRS increased compared to baseline, the change was not significant (37.0 [31.0-41.6] vs 36.3 [32.4-40.3], p= 0.776). Conclusion: In our study, after empagliflozin treatment left ventricular myocardial strain parameters such as LV-GLS and LV-GCS were improved in patients with type-2 DM and normal EF.Öğe Dicle Üniversitesi Tıp Fakültesi Hastanesi’nde bruselloz seroprevalansı: Rose Bengal Testi ve Brucella Coombs Test sonuçları(Dicle Üniversitesi Tıp Fakültesi, 2022) Temiz, Hakan; Özcan, Nida; Araç, Eşref; Özbek, ErdalAmaç: Bruselloz dünyanın birçok ülkesinde ve ülkemizde en yaygın görülen zoonotik hastalıklardan biridir. Bu çalışmada; 2021 yılı içerisinde hastanemiz mikrobiyoloji laboratuvarına çeşitli klinik ve polikliniklerden bruselloz şüphesi ile gönderilen hasta serum örneklerinde çalışılan RoseBengal Testi (RBT)ve BrucellaCoombs Testi (BCT) aglütinasyon titrelerinin, bölgemizdeki bruselloz seroprevalansını belirlemek için retrospektif olarak irdelenmesi amaçlanmıştır. Yöntemler: Hastalardan serolojik testlerde kullanılmak üzere kan örnekleri alındıktan sonra serumları ayrıldı. Tarama testi olarak RoseBengal lam aglütinasyon testi kullanılmıştır. Tarama testi pozitif bulunan hasta serumlarına, Brucella immuncapture aglütinasyon testleri uygulanmıştır. Çalışmamızda uygulanan testlerde, BCT yöntemiyle 1/320 ve üzeri bulunan titreler pozitif olarak değerlendirilmiştir. Bulgular: Çalışmada değerlendirilen 5.196 bruselloz şüpheli hasta örneğinden; RBT pozitif olan 336 (%6,5) hasta bulunmuştur. RBT pozitif olan serumların 257 tanesinin (%76,5) BCT titresi 1/320 ve üzerinde pozitif olarak saptanmıştır. BCT seropozitifliği %62,2 oranında en sık 20-50 yaş grubunda görülmüştür. BCTseropozitifliğinin hastanın başvurduğu kliniğe göre dağılımında ise en sık başvuru yapılan klinik %47,6 oranında enfeksiyon hastalıkları polikliniği idi. BCT seropozitif serumların 176’sı (%52,4) kadın, 160’ı (%47,6) ise erkek hastalara aitti. Sonuç: Bruselloz, fakültatif intrasellüler bakterilerle ortaya çıktığından birçok organ ve sistemi etkileyebilmektedir. Hastalığın tanısında kültür altın standart olmakla birlikte serolojik testler de sıklıkla kullanılmaktadır. Bu çalışma ile elde edilen retrospektif veriler doğrultusunda hastanemizde bruselloz seroprevalansı %5 olarak saptanmıştır. Bu çalışmada serolojik test sonuçlarını değerlendirerek bölgesel verilerin oluşturulmasında katkı yarattığımızı düşünmekteyiz.Öğe Dicle Üniversitesi Tıp Fakültesi Hastanesi’nde HBsAg, Anti-HCV, Anti-HIV Seroprevalansı ve Hepatit B Bağışıklığının Değerlendirilmesi(2024) Temiz, Hakan; Özcan, Nida; Araç, Eşref; Akkoç, Hasan; Özbek, ErdalAmaç: Ülkemizde kronik karaciğer hastalığının en sık nedeni hepatit B virüs (HBV) ve hepatit C virüs (HCV) enfeksiyonlarına bağlı kronik viral hepatitlerdir. İnsan immünyetmezlik virüsü (HIV, Human Immunodeficiency Virus) enfeksiyonu, toplumun tüm kesimlerini etkileyebilmesi, sağlıklı yaşam süresini kısaltabilmesi ve kişiden kişiye bulaşarak yayılabilmesi nedeniyle önemli bir halk sağlığı sorunu olmaya devam etmektedir. Bu çalış- mada; 2021 yılı içerisinde hastanemiz mikrobiyoloji laboratuarına çeşitli klinik ve polikliniklerden gönderilen hasta serum örneklerinde çalışılan rutin hepatit ve HIV seroloji testleri sonuçlarının retrospektif olarak irdelenmesi sonucunda, test sonuçlarının değerlendirerek güncel bölgesel verilerin oluşturulmasında, korunma önlemlerinin alınmasında ve risk altında olan sağlık personellerinin bilinçlendirilmesinde katkı yaratmayı amaçladık. Gereç ve Yöntem: Hepatit B yüzey antijeni (HBsAg), HCV antikoru (Anti-HCV) ve HIV antikoru (Anti-HIV) ve Hepatit B yüzey antikoru (Anti- HBs) testleri; elektrokemiluminesans immünoassay yöntemi kullanılarak Cobas e601 cihazında (Roche Diagnostics, Almanya) çalışıldı. Anti-HIV testinde, sınır değer ve reaktif çıkan sonuçlar Ulusal HIV-AIDS Doğrulama Referans Merkezine gönderilerek doğrulama testi yapıldı. Bulgular: Çalışmada HBsAg için gönderilen 10.003 örneğin 533’ü (%5,3), Anti-HCV için değerlendirilen 9.996 örneğin105’i (%1,1) ve Anti-HBs test edilen 9.994 örneğin 4.260’ı (%42,6) seropozitifti. Anti-HIV için gönderilen 9.952 örneğin 133’ü (%1,3) reaktifti ve yapılan doğrulama testleri sonucunda 72 örnekte (%0,7) pozitiflik saptandı. Sonuç: HBV, HCV ve HIV enfeksiyonlarından korunmada toplumsal farkındalığın artırılması ile bu enfeksiyonların risk gruplarının taranmasının sürekliliği sağlanmalıdır.Öğe Effect of cardio-gastric interaction on atrial fibrillation in GERD patients(Dicle Üniversitesi Tıp Fakültesi, 2023) Günlü, Serhat; Araç, Eşref; Aktan, Adem; Kayan, Fethullah; Altıntaş, Bernas; Karahan, Mehmet ZülkifObjective: Atrial fibrillation (AF) and gastroesophageal reflux disease (GERD) are very common in daily clinical practice. Post-prandial AF episodes have been reported in GERD patients. Although it was reported in previous studies that it was caused by sympathovagal imbalance, there are no studies on cardiac conduction system involvement. In this study, we aimed to evaluate whether the risk of developing AF increases in untreated GERD patients with non-invasive electrophysiological tests. Methods: The research was prospectively performed. Endoscopy was performed on the individuals due to reflux complaints. ECG was recorded at 25mm/s and 10 mm/mV amplitude, and 24-hour Holter ECG (three-channel; V1, V2, and V5) was performed. ECG parameters were measured and Holter ECG results were analyzed. Results: A total of 120 individuals, 60 patients and 60 controls, were included. No significant statistically differences existed between groups for hypertension, diabetes, smoking, or dyslipidemia (p>0.05). In terms of heart rate, Pmax, Pmin, QTd, and QTcd, there were no significant differences across the two groups (p>0.05). P-wave dispersion (Pd) was substantially higher in the study group (p=0.014). Comparing the heart rate variabilities of 24-hour Holter ECG recordings across the groups, the standard deviation of R-R intervals (SDNN) was substantially higher in the study group (p<0.001). Low Frequency (LF) and LF/HF were significantly higher in the control group (p<0.001 and p=0.003, respectively). AF was detected in nine individuals on Holter ECG. Conclusion: Pd duration and risk of developing AF were higher in GERD patients.Öğe Effects of treatment with hydroxychloroquine and azithromycin on the index of cardiac electrophysiological balance in patients with COVID-19: A retrospective cohort study(Selçuk BAŞAK, 2021) Araç, Songül; Karahan, Mehmet Zülkif; Özel, Mehmet; Yiğit, Ramazan; Akkoç, Hasan; Araç, EşrefBackground/Aim: The common cardiac toxicities of hydroxychloroquine (HCQ) and azithromycin (AZ) are not well defined in COVID-19 patients. Index of cardiac electrophysiological balance (iCEB) is used as a novel risk marker for drug-induced arrhythmias. The purpose of this study was to evaluate ventricular repolarization using iCEB and other conventional ECG parameters such as the end of electrocardiographic T wave (Tp-e) interval, Tp-e/QT ratio, and Tp-e/ heart rate-corrected QT (QTc) ratio in COVID-19 patients treated with HCQ and AZ. Methods: This retrospective study enrolled 164 patients diagnosed with COVID-19 pneumonia in the Emergency Department (ED) and then transferred to the ward or the intensive care unit in April 2020. Results: A total of 164 patients with a mean age of 47 (18) years (range: 18-97 years) included 83 (50.6%) females. There were 38 and 126 patients in Groups HTQ and HTQ+AZ, respectively. On the 5th day of hospitalization, all patients’ heart rates were significantly lower (PÖğe Evaluation of catalase, myeloperoxidase and ferroxidase values in pregnant women with hyperemesis gravidarum(Via Medica, 2019) Ege, Serhat; Bademkıran, Muhammed Hanifi; Peker, Nurullah; Erdem, Selami; Bağlı, İhsan; Köçeroǧlu, Ruşen; Kahveci, Bekir; Yıldızhan, Recep; Erel, Özcan; Araç, EşrefObjectives: To investigate maternal serum catalase, myeloperoxidase and ferroxidase levels in pregnant women with Hyperemesis Gravidarum and to compare the results with healthy pregnancies. Material and methods: In this study, 60 female patients admitted to the Health Sciences University, Gazi Yasargil Training and Research Hospital, Gynecology and Obstetrics Department were evaluated. The patients were divided into two groups: Group 1 included 30 pregnant women with hyperemesis gravidarum; Group 2 included 30 healthy pregnant women. Pregnancies over 14 weeks were excluded from the study. Results: The laboratory and laboratory characteristics of both groups are shown in Table 1. No significant differences were found between the groups in terms of the maternal age, gestational age, gravidity, parity, fasting glucose level, and BMI. The maternal blood CAT levels were significantly higher in the HG group (219.6 ± 111.3 kU/L) when compared to the control group (71.5 ± 52.5 kU/L) (p < 0.001). The maternal blood MPO levels were lower in the control group (121.5 ± 36.3 U/L) than in the study group (90.9 ± 56.4 U/L) (p = 0.016). However, the ferroxidase levels were similar between the two groups. The independent variables BMI, age, parity, gravidity and gestational week effects were adjusted according to the logistic regression method with groups. Significant differences were observed between the two groups in the levels of CAT (0.001), MPO (0.005) values. Conclusions: This study suggests that antioxidants in response to oxidative stress gave different reactions with different mechanisms; Also, we believe that insufficient food intake suppresses the immune system and this has an important role on antioxidants.Öğe Examining the effect of COVID-19 vaccines on the menstrual cycle: A study from Turkey(Lippincott Williams and Wilkins, 2023) Toktaş, İzzettin; Akelma, Hakan; Araç, EşrefConcerns about a possible relationship between vaccination against Coronavirus Disease 2019 (COVID-19) and menstrual disorders have been raised in the media. In addition, different studies have shown that the COVID-19 vaccine may be associated with menstrual changes. This study was conducted to investigate the effects of COVID-19 vaccines on the menstrual cycle in women. This cross-sectional descriptive study was conducted between August 16 and September 17, 2021. Data were collected through a self-administered questionnaire via an online form sent to the participants through social media. Data of 586 women were included in this study. A total of 82.4% (n = 483) of the participants were aged between 31 and 50 years. The BioNTech vaccine (2 doses) was administered to 75.8% (n = 444), Sinovac (3 doses) to 9.0% (n = 53) of the participants. 53.1% (n = 311) of the women experienced changes in their menstrual cycles. The most common menstrual changes after vaccination were delayed menstruation (n = 176; 30.0%) and prolonged menstrual duration (n = 132; 22.5%). Menstrual delay, prolonged menstrual duration, heavy bleeding, and early menstruation were more common in women than prior to receiving the vaccine (P < .05). More than half of the women experienced menstrual cycle changes after receiving the COVID-19 vaccine. Women experienced significantly higher rates of menstruation delay, prolonged menstrual duration, heavy bleeding, and early bleeding compared to before vaccination.Öğe Independent predictors of mortality in ICU patients with COVID-19(Dicle Üniversitesi Tıp Fakültesi, 2023) Özel, Mehmet; Araç, Songül; Akkoç, Hasan; Araç, EşrefObjective: Early identification of Coronavirus disease 2019 (COVID-19) patients at high mortality risk can improve patient care and prevent deaths. To identify prognostic predictors that increase COVID-19 patient mortality risk in the Intensive Care Unit (ICU). Methods: Retrospective analysis of clinical characteristics and serological biomarkers of ICU-COVID-19 patients was performed in a tertiary hospital from 24 March 2020 to 20 December 2020. Analysis was conducted on two groups of study participants: survivors and deceased. Multivariate logistic regression was used to determine mortality risk. In order to determine prognostic predictors, the ANOVA test was used to compare the data of serological biomarkers on the day of patients' admission to the ICU and on the 5th day of follow-up. Results: A total of 335 patients (54.65%) were in the deceased group, and 278 (45.35%) were in the survivors group. A statistically significant difference was found between the deceased and survivor groups regarding mean age (p<0.001). According to multivariate analyses of patients' data, age, oxygen saturation, direct bilirubin, and ionized calcium were independent predictors of mortality (p <0.05). According to this analysis, age (OR=1.035, p=0.002, 95%CI 1.013-1.058), peripheral capillary oxygen saturation (SpO2) (OR=0.912, p<0.001, 95%CI 0,873-0.953), direct bilirubin (OR=6.821, p=0.024, 95%CI 0.282-36.285), ionized calcium (OR=30.524, p=0.035, 95%CI 1.262-738.34) was found that it increased the risk of mortality. In the multivariate logistic regression analysis, it was found that gender, age, and comorbidities had the highest odds ratios in terms of mortality. Conclusion: The study revealed that advanced age, low SpO2, high direct bilirubin, and elevated ionized calcium levels were independent predictors of mortality for COVID-19 patients in the ICU.Öğe Measuring the knowledge and attitudes of physicians towards patients with HIV/AIDS: study of Anatolian group(Emerald Group Publishing, 2021) Kaya, Şafak; Araç, Eşref; Akgül, Fethiye; Çomoğlu, Şenol; Kaya, Şehmuz; Araç, Songül; Yıldız, Yeşim; Büyüktuna, Seyit Ali; Kayaaslan, Bircan; Parlak, Emine; Baysal, Birol; Karakeçili, Faruk; Balık, Elif Zelal; Akkoç, Ali; Özdemir, Kevser; Kavak, Şeyhmus; Doğan, Suat Ali; Günay, Emrah; Karabela, Şemsi Nur; Cabalak, Mehmet; Çağ, Yasemin; Avcı, Veli; Durdu, Yasemin; Kaya, Zehra; Kılıç, Damla; Yerlikaya, Halis; Tarakçı, Hüseyin; Menteş, Osman; Tartar, Ayşe Sağmak; Köse, Adem; Alakuş, Ömer Faruk; Aktaş, Ulaş; Kömek, Halil; Aksöz, SelçukThis paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked. Design/methodology/approach The survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title. Findings A total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively. Originality/value In this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease.Öğe Multislice computed tomography imaging of gastrointestinal stromal tumors(2017) Araç, Eşref; Emin, Mehmet; Deniz, Muhammed Akif; Sezer, Nadir; Taş, Zelal Deniz; Göya, CemilGastrointestinal stromal tumors (GIST) are mesenchymal tumors that constitute 1-3% of primary gastrointestinal tumors and approximately 5% of all sarcomas of the gastrointestinal tract. Multislice Computed Tomography (MSCT) is a highly sensitive imaging technique for detecting GISTs. We retrospectively evaluated findings of 56 consecutive subjects that were examined at Dicle University, School of Medicine, between 2008-2015 and diagnosed with GIST. Lesions were divided into two clinically distinct entities as recurrent and primary lesions. Densities of lesions in comparison to liver, origins of and spreading of the lesions, dimensions of the lesions, behavior pattern, and factors such as contour properties, invasion, and calcification which could potentially indicate malign behavior were also evaluated. Age span of included subjects were between 28 and 81. The most common tumor location for hollow organs was found to be stomach (n=19, 32%). In extra-luminal, regions the most common tumor location was found to be mesentery (n=4). Hansfield Unit densities of tumoral lesions in comparison to liver density were hypodens (n=32, 71%), isodens (n=9, 20%) and hyperdens (n=4, %9) in a descending order. The tumor invasion was found to be effecting liver, peritoneum, and bladder, in a descending order. In 11(24%) subjects, distant metastasis to the liver was evident. In 4(9%) subjects peritoneum, in 3(7%) subjects adrenal gland and in 1(2%) subject bone metastasis was evident. MSCT is an important and indispensable modality for the detection, localization and identification of GISTs that can be seen in different parts of the gastrointestinal tract.Öğe The Effect of Aromatherapy Application on the Vital Signs of Intensive Care Patients(Düzce Üniversitesi, 2021) Büyükbayram, Zeliha; Aydın, Leyla Zengin; Araç, EşrefObjective: This study aims to examine the effect of aromatherapy application on vital signs in intensive care patients. Material-Method: This study was carried out as a nonrandomized controlled experimental trial. The population consisted of inpatients in the internal medicine intensive care unit of a research and training hospital located in southeastern Turkey. The sample of the study consisted of 100 patients. The data were collected between July 2018 and February 2019 using patient identification and monitoring forms. Descriptive statistics, t-test, chi-squared test, analysis of variance and post-hoc test were used in the analysis of the data.Results: The mean age of the experimental group patients was 66.84±20.53, 54.0% of them were female, 92.0% were married, 28.0% were literate, 78.0% were unemployed, and 74.0% had not been subjected to aromatherapy before; The mean age of the control group patients was 61.30±22.67, 52.0% of them were female, 82.0% were married, 30.0% were highschool graduates, 66.0% were unemployed, and 64.0% had not been subjected to aromatherapy before. It was found that the mean respiratory rate of the patients in the experimental group decreased significantly (p<0.05).Conclusion: It was determined that aromatherapy applied on the intensive care patients was not effective on their pulse rate, systolic blood pressure, diastolic blood pressure or partial oxygen pressure, but it was effective in reducing their respiratory rate.Öğe The relationship between monocyte/HDL cholesterol ratio and chronic kidney disease stages, single center study(DAHUDER, 2023) Solmaz, İhsan; Alakuş, Ömer Faruk; Yakut, Yusuf; Tekin, Yunus; Koyun, Sedrettin; Araç, EşrefObjectives: Chronic kidney disease (CKD) is an increasing public health problem. It is very important to know the definition of CKD, its risk factors and to predict the progression of its stages. Recently, the monocyte/HDL ratio (MHR) has been thought to be a new marker of inflammation and oxidative stress. In this study, it was aimed to investigate the relationship between stages and MHR in patients with stage 3A, stage 3B and stage 4 CKD. Methods: A total of 632 patients with CKD, aged 18 years and older, with stage 3A, stage 3B and stage 4 (eGFR) according to CKD stage were included in our study. Our study is retrospective and the data of the patients were obtained from the hospital system. Kruskal-Wallis and post hoc Tukey HSD tests were used for statistics. p < 0.05 was considered statistically significant. Results: The mean age of the patients included in the study was 63.4 ± 14.91(min:18max:98), and 305 (48.25%) of these patients were male and 327 (51.75%) were female. According to eGFR, 155 (24.5%) of the patients were stage 3A, 150 (23.8%) were stage 3B, and 327 (51.7%) were stage 4. In the statistical study of the groups divided into CKD stages with MHR, there was no significant difference between the groups (p: 0.245), while there was statistical significance for gender and hypertension (p: 0.004 and p: 0.044, respectively). Conclusion: As a result of this study, we concluded that MHR is not affected by CKD stages.
