The link between cord blood IL-1β, TLR4, PGE2 and TAC values with neonatal diseases

Premature birth is an important cause of neonatal mortality and neonatal morbidity. Most premature births are known to be induced by cytokines released for different reasons. Inadequate congenital immune response in premature infants may contribute to increased susceptibility to infection. The aim of the study is to determine the IL-1β, TLR4, PGE2, and TAC profiles in cord blood with characteristics specific to pregnancy and the correlation with neonatal complications caused by premature birth. The study included 26 neonates, 11 girls and 15 boys, born from 24-42 weeks of gestation. Of these, 13 were term and 13 were preterm . For IL-β, PG-E2, TLR4 and TAC levels, 1 mL of cord blood sample was taken from preterm and term neonates. Data related to demographic data, clinical status of patients and outcomes were obtained from electronic medical records and files. Cytokine values obtained from premature neonates were statistically high in terms of TLR4, IL1 and PGE2 compared to term infants. The TRL4 and IL1 values for premature infants with necrotizing enterocolitis and retinopathy of prematurity were lower compared to those without NEC and ROP. In spite of negative correlations between TAC and the other three cytokines, a statistically significant correlation was not identified. TLR4, IL1 and PGE2 were negatively correlated with weight and gestational week, contrarily TAC measurements were positively correlated with weight and gestational week. Measurements of cytokine concentrations in cord blood are among important biomarkers showing degree of inflammation and may assist in predicting neonatal complications and play an effective role in development of specific treatments.

Evaluation of metabolic factors affecting the presence of hepatosteatosis and the effect of insulin like growth factor-1 level in overweight and obese children

Although previous studies related to non-alcoholic fatty liver disease (NAFLD) in childhood were predominantly ALT and uric acid level, the number of studies that have been handled in terms of insulin like growth factor-1 (IGF-1) level or IGF-1 standard deviation score (SDS) is limited. In this study, all factors that may affect NAFLD, including IGF-1 level and IGF-1 SDS, were evaluated in two groups of children who were not statistically different from each other in terms of age, gender, weight, height, body mass index and puberty. This study was a cross sectional study. 36 children with evidence of fatty liver disease on ultrasound imaging and 38 children without it were included in the study. Anthropometric data, laboratory measurements and radiological results of all participants were evaluated. All factors that could affect NAFLD were evaluated by binary logistic regression analysis. Weight, weight SDS, body mass index (BMI) SDS, homeostasis model assessment of insulin resistance (HOMA-IR), AST, ALT, GGT, uric acid, triglyceride, HDLcholesterol, IGF-1, IGF-1 SDS were evaluated in this model to predict NAFLD. In the statistical model, the percentage of predicting those with NAFLD, that is, the sensitivity, was 88.9%, while the detection rate of those without NAFLD, that is, the specificity, was 94.7%. IGF-1 level was found to be significantly lower in the group with NAFLD (p: 0.04), but there was no significant difference between the groups in terms of IGF-1 SDS (p: 0.10). There are conflicting results in studies examining the relationship between IGF-1 SDS and NAFLD. This may be due to ethnicity, regional differences, kit-specific laboratory reference ranges, or method of measurement. Laboratory measurements including appropriate parameters with a detailed physical examination can be used to predict the presence of NAFLD without the need for radiological examination.

Relationship between depression and socio-demographic and illness characteristics in arsenicosis population of Bangladesh

A community based cross-sectional study was carried out by a self-structured questionnaire on 168 participants aged between 18 and 60 years at two arsenic prone area of Bangladesh to determine the association between extent of depression and socio-demographic as well as illness characteristics in arsenicosis population. The mean age ± SD was 42 ± 10.15 years. Female respondents were almost twice (63.1%) than the males (36.9%) in this study. Most of the respondents (94.0%) were shallow tube well water user. Among them most (80.0%) of the respondents were detected as arsenic contaminated water consumer over more than six months. Study estimated that almost half (44.3%) of the participants had suffered from mild to moderate depression in the moderate arsenicosis group. Less than quarter (20.8%) participants suffered severe depression in severe arsenicosis group. Quarter (26.7%) had mild arsenicosis with no depression. This difference was not significant. Gender had significant influence on proportion of level of depression. Females significantly suffered more from depressive symptoms than males. More than two third of the female respondents suffered from some kind of depressive symptoms; where less than one third of the males were suffered from depressive symptoms. Age has no significant relation with depression. Respondents who were 48 years and above age group had highest percentages of severe depressive symptoms (35.8%). This age group also suffered from highest percentage of mild to moderate depression (37.1%). Though most of the respondent (85.1) had no diabetes and hypertension. Respondents with physical illness suffered more from some sorts of depression than those without illness, but the result is not statistically significant. We understood that depression has health challenges in adult arsenicosis patients. Therefore, physicians should take account depression in their treatment management when deal with arsenicosis patients.

An Evaluation of quantitative body composition on thoracic computed tomography and the effect on clinical severity in patients with chronic obstructive pulmonary disease

The aim of this study was to evaluate the effect on disease severity of the quantitative measurements of pectoral muscle area (PMA), pectoral muscle index (PMI), pectoral muscle density (PMD), subcutaneous adipose tissue (SAT) and mediastinal adipose tissue (MAT) taken on thoracic computed tomography (CT) of patients with chronic obstructive pulmonary disease (COPD), according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. A retrospective screening was made of patients diagnosed with COPD and applied with thoracic CT and respiratory function tests. For patients with obstructive findings, a record was made of height, weight, body mass index, and smoking history (packet/year). On thoracic axial CT images, the PMA, PMI, PMD, SAT, and MAT values at the aortic arch level were calculated quantitatively using OsiriX software (Pixmeo, Switzerland). The patients were grouped as A-B-C-D according to the GOLD 2018 guidelines. Then two groups were formed as mild-moderate COPD (GOLD A-B) and severe COPD (GOLD C-D). The relationship was evaluated between clinical severity and quantitative body composition values according to the GOLD classification. A total of 80 patients diagnosed with COPD were included in the study comprising 61 males and 19 females. The GOLD A-B group included 43 (53.75%) patients and the GOLD C-D group, 37 (46.25%) patients. No significant difference was determined between the two groups in respect of the PMA, PMI, and PMD values (p=0.001). A statistically significant difference was determined between the groups in respect of the SAT and MAT values (p=0.001, p=0.002, respectively). A cutoff value of <30.04 in PMD (0.964; 95%CI:0.928-1) showed the best performance in predicting the mild-moderate COPD patients (GOLD A-B) with 92% sensitivity and 93% specificity. The results of this study demonstrated that PMD showed the best quantitative body composition performance in the differentiation of mild-moderate and severe COPD disease.

Abu Al Qasim Al Zahrawi (Albucasis): The father of modern surgery

Known as the father of surgery, Al-Zahrawi (936-1013) made significant contributions to modern medicine and surgery. His greatest contribution to science was his work “Kitab al-Tasrif”, which he shared nearly fifty years of experience and medical education by writing and illustrating. In this study, he explained not only surgical interventions, but also methods and surgical instruments developed by him for the diagnosis and treatment of medicine. In the last chapter of Al-Tasrif consisting of 30 volumes, "On Surgery and Tools", he introduced many surgical instruments such as scalpels, forceps, retractors, curettes, pincers, specula, cauterization, and binding style instruments. This study aims to provide an overview of Al-Zahrawi's life whose contributions to science living in medieval Islamic geography are not limited to modern medicine and surgery.

Ganglion cell complex analysis in thalassemia major patients measured by optical coherence tomography

To analyze the changes in ganglion cell complex (GCC), peripapillary retinal nerve fiber layer (RNFL) thickness and central macular thickness (CMT) on spectral domain optical coherence tomography (OCT) in patients with thalassemia major. Forty one eyes of 41 patients with thalassemia major and 41 eyes of 41 healthy subjects were included in this prospective and comparative study. Peripapillary RNFL thickness, CMT and macular GCC thickness were evaluated with OCT (Cirrus HD-OCT 5000Carl Zeiss Meditec, Inc, Dublin, CA, USA) in all patients and healthy controls. Additionally, disease duration, serum ferritin level, hemoglobin concentration, the dosage and duration of chelation therapy, count of transfusion, patient’s weight were analyzed in thalassemia major group. RNFL thickness values were lower in the thalassemia patients but the difference was not statistically significant (except superior quadrant) and there was no significant differences in the mean CMT measurements. GCC thickness was thinner in all areas ( average, superior, inferior, superior-temporal, inferior-temporal, superior-nasal, inferior-nasal) but only the thinning in the inferior-temporal was statistically significant. GCC and RNFL thickness changes occur earlier than CMT changes in β-thalassemia major patients. GCC thickness measurements can be used for follow-up in combination with other diagnostic methods.

Epidemiologic and clinical evaluation of the acute intoxication in pediatric patients

Acute poisoning is a critical and emergent public health problem worldwide among pediatric age group. The common epidemiological observation is required to understand the characteristics of the pediatric intoxication for each location and important for management the poisoning cases. This retrospective study researched the epidemiology of poisoning among children. This study represented the epidemiology of poisonings of children admitted to the pediatric intensive care unit at Afyonkarahisar Health Science University Faculty of Medicine between February 2020 and May 2021. Fifty one pediatric patients were reffered to the PICU due to acute intoxication. 58.9% of the analyzed patients were male and 41.1% were female. The mean age of all patients was 8.57±7.6. The majority of cases were due to drug-related poisonings. The average age of cases of suicidal poisoning was higher than accidental intoxication cases. Paracetamol was the most prevalent cause of drug-related intoxication and more common in children under 5 years of age and selective serotonin reuptake inhibitors were more frequent in adolescent group. All patients survived. Almost all of the patients were discharged from hospital within 3 days. Poisonings are still a serious reason for morbidity and mortality in developing countries among children. Early awareness of poisoning and appropriate management appeared to be effective and to decrease the mortality rate.

Ethical View of Telemedicine Practices

Telemedicine—the utilization of clinical data and innovation to progress distanced clinical care can change the patient-centered approach. Telemedicine can coordinate distance monitoring and diagnostic instruments with computerized cooperation and suggestions to better interact with patients when they are not in a hospital. Despite these preferences, there is still some doubt as to how telemedicine applications may affect care. Guaranteeing that telemedicine is ethically admissible requires projection and consideration of four potential issues: the disruption of the patient-physician relationship, jeopardizing patient privacy, impelling one-size-fits-all applications, and the impulse to expect that innovation should be efficient

Long-term Effect of Intravenous Iron Carboxymaltose Treatment on Oxidative Stress in Women with Iron Deficiency Anemia

Objective: This study aims to clarify the effects of intravenous iron supplementation on biomarkers for oxidative stress in women with iron deficiency anemia. Methods: This is a cross-sectional review of 40 healthy women and 40 women who underwent intravenous iron treatment due to anemia. Biochemical markers for oxidative stress were determined for both healthy controls and anemic patients. These markers were also evaluated at hour 1 and day 30 of intravenous iron treatment. Results: The patients with anemia had significantly higher catalase activity and total oxidant status (TOS) but significantly lower nitrate and total anti-oxidant status (TAS) than the healthy controls (p=0.0245, p<0.0001, p=0.0437 and p<0.0001 respectively). At hour 1 of intravenous iron treatment, nitrate, nitrite, nitric oxide, total thiol and TAS values were significantly lower and TOS values were significantly higher than those before the administration of treatment (p=0.0322, p=0.0003, p=0.0005, p<0.0001, p<0.0001 and p=0.004). At day 30 of intravenous iron treatment, catalase activity, nitrate, total thiol and TOS values were significantly lower than those before the administration of treatment (p=0.0332, p=0.0015, p=0.0391 and p<0.0001 respectively) and at hour 1 of treatment (p=0.0498, p<0.0001, p=0.0004 and p<0.0001 respectively). At day 30 of intravenous iron treatment, nitric oxide and TAS values were significantly higher than those before the administration of treatment (p=0.0480 and p=0.001 respectively) and at hour 1 of treatment (p<0.0001 for both). Conclusion: Intravenous iron replacement prompts oxidative stress at hour 1 of infusion in adults with anemia but this increase resolves partially in the following 30 days.