Search

Background: Tularemia is a zoonotic disease (reservoir is usually rodents) caused by Francisella tularensis, especially seen in the northern hemisphere. Hunters are in the risk group for this disease. In this study, it was aimed to determine the seroprevalence of tularemia among hunters and determine the risk factors of tularemia in our country. Methods: The Turkish Republic of Northern Cyprus (TRNC) is divided into four regions (Nicosia, Kyrenia, Famagu­sta/Trikomo, and Morphou/Lefka) and 100 volunteer hunters randomly selected from these regions were included in our study. Tube agglutination test (TAT) and F. tularensis IgG and IgM (ELISA method) were applied in all sera. All hunt­ers were filled with a pre-prepared questionnaire to determine risk factors for tularemia. Results: TAT positivity was found in 11%. While F. tularensis ELISA IgG positivity was 17%, IgM positivity was not found in any hunters. Hunters with positive F. tularensis ELISA IgG test (17%) were accepted as seropositive in terms of tularemia. There was no statistically significant difference between the mean age of IgG-positive and negative hunt­ers (p= 0.915). Of the 86 hunters who kept at least one hunting dog in their garden, 15 (17.4%) were IgG-positive. There was no significant relationship between feeding hunting dogs and tularemia (p= 0.561). Conclusion: Our study showed that the seroprevalence of tularemia was high (17%) among hunters, who are consid­ered a risk group, in our country. We think that more epidemiological research should be done on tularemia infection and it should not be overlooked in the clinic.

Sıtma, Plasmodium parazitlerinin neden olduğu ve halen dünyayı etkileyen ciddi bir enfeksiyon hastalığıdır. Dünyada en sık görülen tür Plasmodium vivax (P. vivax)’tır. Vivax sıtması, karaciğerde latent kalıp, aylar hatta yıllar sonra relapslara neden olan hipnozoit formlar ile karakterizedir. Bunun yanında, P. vivax enfeksiyonunda uzamış inkübasyon sürelerinden bahsedilmektedir. Bu çalışmada, sekiz gün ara ile hastanemize başvuran ve P. vivax tanısı alan iki sıtma olgusu incelenmiştir. Hastalarımızdan biri en son 7 ay, diğeri ise 12 ay önce ülkeleri olan Pakistan’dan ülkemize gelmiş ve bu sürede bir daha yurt dışına çıkmamışlardı. İkisinin de daha önceden sıtma öyküsü bulunmamaktaydı. Ülkemizde, 1950 yılından itibaren Plasmodium parazitlerini bulaştıran Anofel cinsi sivrisineklerin adadan elimine edilmesi sonucu sıtma enfeksiyonu eradike edilmiş ve o tarihten günümüze kadar geçen sürede yerli sıtma vakasına rastlanmamıştır. Buna rağmen, son yıllarda değişen sivrisinek faunası ile birlikte yurt dışı kaynaklı vakaların artmasının, yeniden yerli sıtma olgularının görülmesi açısından risk teşkil ettiği düşünülmektedir. Sonuç olarak, güncel araştırmaların ve sürveyans çalışmalarının yapılması ile daha doğru ve kesin veriler elde edilebilecektir.

Cutaneous leishmaniasis (CL) is a common illness that causes skin lesions, principally ulcerations, on exposed regions of the body. Although neglected tropical diseases (NTDs) are typically found in tropical areas, they have recently become more common along Africa’s northern coast, particularly in Libya. The devastation of healthcare infrastructure during the 2011 war and the following conflicts, as well as governmental apathy, may be causal factors associated with this catastrophic event. The main objective of this study is to evaluate alternative diagnostic strategies for recognizing amastigotes of cutaneous leishmaniasis parasites at various stages using Convolutional Neural Networks (CNNs). The research is additionally aimed at testing different classification models employing a dataset of ultra-thin skin smear images of Leishmania parasite-infected people with cutaneous leishmaniasis. The pre-trained deep learning models including EfficientNetB0, DenseNet201, ResNet101, MobileNetv2, and Xception are used for the cutaneous leishmania parasite diagnosis task. To assess the models’ effectiveness, we employed a five-fold cross-validation approach to guarantee the consistency of the models’ outputs when applied to different portions of the full dataset. Following a thorough assessment and contrast of the various models, DenseNet-201 proved to be the most suitable choice. It attained a mean accuracy of 0.9914 along with outstanding results for sensitivity, specificity, positive predictive value, negative predictive value, F1-score, Matthew’s correlation coefficient, and Cohen’s Kappa coefficient. The DenseNet-201 model surpassed the other models based on a comprehensive evaluation of these key classification performance metrics.

Objective:This study aimed to investigate the distribution of three-year carbapenem resistance of Acinetobacter baumannii complex (ABC) in hospital infections isolated from the intensive care unit in the last three years.Materials and Methods:The patients who had ABC infection in the Intensive Care Unit of Near East University Hospital between 2016-2018 were included in this study. The data of the patients were investigated retrospectively from the digital records and the Infection Control Committee data. The initial infection report of the patients who had multiple ABC infections was included in the study. SPSS Statistics 23.0 program was used for statistical analysis.Results:A total of 92 patients were diagnosed with ABC infection during the study period, including 22 (23.9%) in 2016, 31 (33.7%) in 2017 and 39 (42.4%) in 2018. Fifty-six patients (60.9%) were male and 36 (39.1%) were female. The mean age of the patients was 61.61±17.43 years (range, 22-89 years). The most common isolates were from tracheal aspirate (28.3%, 26 patients), sputum 27.2%, 25 patients) and urine samples (23.9%, 22 patients). Carbapenem-resistant ABC infection was detected in 65 patients (70.7%) and carbapenemsensitive ABC infection was found in 27 patients (29.3%). There was a statistically significant increase in carbapenem-resistant ABC strains over the years (p

Objective:Intestinal parasitic infections (IPI) are considered as one of the most important public health problems that cause morbidity and mortality. For this reason, to determine their prevalence it is critical for prevention. This study aimed to determine the prevalence of intestinal parasites.Methods:In our study, a total of 4.957 patients registered to our hospital with gastrointestinal symptoms between January 2016 and December 2019 were retrospectively analysed. Their stool samples were examined macroscopically and microscopically. In the microscopy, native-lugol and formol ethyl acetate concentration methods were used. Crypto-Giardia-Entamoeba antigen test was applied. All cases were evaluated in terms of age, gender, year and season.Results:In our study group, 239 (4.8%) patients were detected as positive for intestinal parasites. Among these patients, 129 (54%) were male and 110 (46%) were female. No statistically significant difference was found between IPI and gender (p=0.228). Blastocystis hominis (76.2%) and Giardia intestinalis (12.1%) were the most common parasites. According to age groups, most intestinal parasites are found in 16-45 years old and least in 0-15-years-old (p=0.0001). A significant increase was found in positive intestinal parasite cases especially after 2018 (p=0.0001). Our study determined that intestinal parasites were observed most frequently in autumn (p=0.033).Conclusion:The prevalence of IPI in our country is low. However, due to the increasing trend of IPI since 2018, necessary measures must be implemented to prevent further increase in the number of cases. In addition, reasons behind the rising cases of intestinal parasites during the autumn months in which rainfall begins require further investigation.

Objective:In present times, malaria remains an infectious disease with a high mortality rate in some regions of the world. It is predicted to preserve its importance as a disease in the future because of the traveling human populations from malaria-endemic African countries into the regions where malaria has been eradicated. The objective of this study is to evaluate the increasing imported malaria cases in the Turkish Republic of Northern Cyprus.Methods:In this study, we investigated 13 patients who were diagnosed with malaria between 2016 and 2019. We clinically evaluated all the cases. More importantly, we made the diagnosis of these patients by Giemsa-stained thin and thick blood smears, rapid malaria antigen tests, and genotyping (only for five patients) by real-time polymerase chain reaction. Additionally, we evaluated patients with malaria in terms of age, gender, and seasons.Results:In the diagnosed malaria cases, 11 (84.4%) of them were male and 2 (15.6%) were female. There was no significance between malaria infection and gender (p=0.358). Plasmodium falciparum, Plasmodium vivax, and Plasmodium ovale infection were detected in ten patients (76.9%), two (15.4%) patients, and one (7.7%) patient, respectively. There was a significant increase (p=0.003) in the malaria cases in 2019 (n=9). The seasonal comparison revealed that malaria infections are most common in autumn (8/13, 61.5%).Conclusion:Despite the eradication of malaria in Turkish Republic of Northern Cyprus, the rising number of recently imported cases increases the risk of emerging local cases. Malaria infection should be immediately suspected, particularly, in foreign patients who travel from the malaria-endemic region and present with symptoms such as fever and shivering if the laboratory findings especially detect thrombocytopenia.

Escherichia hermannii is a microorganism very rarely isolated from clinical specimens, since its first identification in 1982. So far, there are around 17 human cases reported in medical sources. This small number of isolated case, eventually leads to a lack of information about the pathology and pathogenesis of infections caused by this microorganism. In the present article, we report a diabetic foot co-infection due to Escherichia hermannii and Enterobacter aerogenes. The treatment of the patient was started with a combination of empiric piperacillin/tazobactam and teicoplanin therapy. Later, based on the microbiology test results, this medication was converted to meropenem. When the patient’s septic condition improved, coronary artery bypass and transtibial amputation operations were performed. The patient recovered completely and was discharged without further issues. To the best of our knowledge, this is the first E. hermannii infection report from Cyprus and the Middle East.

Background: Before the introduction of direct-acting antivirals in the treatment of chronic hepatitis C patients, the combination of peginterferon alpha and ribavirin was the standard therapy. Observational studies that investigated sustained virological response (SVR) rates by these drugs yielded different outcomes. Aims: The goal of the study was to demonstrate real life data concerning SVR rate achieved by peginterferon alpha plus ribavirin in patients who were treatment-naïve. Study Design: A multicenter, retrospective observational study. Methods: The study was conducted retrospectively on 1214 treatment naïve-patients, being treated with peginterferon alpha-2a or 2b plus ribavirin in respect of the current guidelines between 2005 and 2013. The patients’ data were collected from 22 centers via a standard form, which has been prepared for this study. The data included demographic and clinical characteristics (gender, age, body weight, initial Hepatitis C virus RNA (HCV RNA) level, disease staging) as well as course of treatment (duration of treatment, outcomes, discontinuations and adverse events). Renal insufficiency, decompensated liver disease, history of transplantation, immunosuppressive therapy or autoimmune liver disease were exclusion criteria for the study. Treatment efficacy was assessed according to the patient’s demographic characteristics, baseline viral load, genotype, and fibrosis scores. Results: The mean age of the patients was 50.74 (±0.64) years. Most of them were infected with genotype 1 (91.8%). SVR was achieved in 761 (62.7%) patients. SVR rate was 59.1% in genotype 1, 89.4% in genotype 2, 93.8% in genotype 3, and 33.3% in genotype 4 patients. Patients with lower viral load yielded higher SVR (65.8% vs. 58.4%, p=0.09). SVR rates according to histologic severity were found to be 69.3%, 66.3%, 59.9%, 47.3%, and 45.5% in patients with fibrosis stage 0, 1, 2, 3 and 4, respectively. The predictors of SVR were male gender, genotype 2/3, age less than 45 years, low fibrosis stage, low baseline viral load and presence of early virological response. SVR rates to each peginterferon were found to be similar in genotype 1/4 although SVR rates were found to be higher for peginterferon alpha-2b in patients with genotype 2/3. The number of patients who failed to complete treatment due to adverse effects was 33 (2.7%). The number of patients failed to complete treatment due to adverse effects was 33 (2.7%). Conclusion: Our findings showed that the rate of SVR to dual therapy was higher in treatment-naïve Turkish patients than that reported in randomized controlled trials. Also peginterferon alpha-2a and alpha-2b were found to be similar in terms of SVR in genotype 1 patients.

Breast cancer is the most common cancer among women and in order to create alternative treatments different types of in vivo and in vitro studies have used various plant-based therapeutic agents. Humic acid (HA) induces apoptosis and has various pharmacological properties including anti-inflammatory and anti-proliferative effects. In our study, we examined the cytotoxic effects of HA at concentrations of 5, 10, 20, 50 and 100 μg/mL in human breast adenocarcinoma MCF-7 cell line for 24 and 48 h. By using MTT method, it has been found out that HA 100 g/mL had cytotoxic effect on human breast adenocarcinoma MCF-7 cell line at both 24 and 48 h; also found out that the effective dose of HA at the same time (24 and 48 h) was 50 μg/mL. The results of our study will shed light on the development of alternative therapeutic approaches in the treatment of cancer by evaluating the cytotoxic effect of HA.

Abstract The number of Methicillin-resistant Staphylococcus aureus (MRSA) cases in communities and hospitals is on the rise worldwide. In this work, a nonlinear deterministic model for the dynamics of MRSA infection in society was developed to visualize the significance of awareness in interventions that could be applied in the prevention of transmission with and without optimal control. Positivity and uniqueness were verified for the proposed corruption model to identify the level of resolution of infection factors in society. Furthermore, how various parameters affect the reproductive number $${R}_{0}$$ R 0 and sensitivity analysis of the proposed model was explored through mathematical techniques and figures. The global stability of model equilibria analysis was established by using Lyapunov functions with the first derivative test. A total of seven years of data gathered from a private hospital consisting of inpatients and outpatients of MRSA were used in this model for numerical simulations and for observing the dynamics of infection by using a non-standard finite difference (NSFD) scheme. When optimal control was applied as a second model, it was determined that increasing awareness of hand hygiene and wearing a mask were the key controlling measures to prevent the spread of community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA). Lastly, it was concluded that both CA-MRSA and HA-MRSA cases are on the rise in the community, and increasing awareness concerning transmission is extremely significant in preventing further spread.

West Nile Virus (WNV) infection represents a major global public health challenge. Even though most of the patients are asymptomatic, some cases progress to critical condition which may be fatal. Diagnosis traditionally relies on serological methods, but their limitations, including cross-reactivity, highlight the need for alternative approaches. Here, we present the development and validation of a novel RT-qPCR assay for precise and rapid detection of WNV RNA in urine, emerging as a promising specimen due to its noninvasive collection and high viral load. The assay demonstrates high efficiency and sensitivity, with a detection limit comparable to commercially available kits. This study highlights the importance of in-house kit design as a diagnostic tool in regions affected by emerging tropical infections, such as WNV, exemplified Cyprus. It emphasizes the critical role of low-cost, early detection with high sensitivity and specificity in infection control and surveillance efforts.

Fitness centers offer an opportunity for investigating the indirect transmission of pathogens. Many people with varying levels of personal hygiene share sports equipment where direct surface-to-skin contact occurs. This study aimed to investigate the bacterial load and fungal and methicillin-resistant Staphylococcus aureus (MRSA) contamination on predetermined sports equipment in fitness centers in Northern Cyprus. Additionally, volunteer personal trainers and gym members were screened to detect whether they were carriers of MRSA. Samples were collected from six fitness centers on sports equipment. MRSA carrier status was investigated for personal trainers (n=10) and gym members (n=100). The study used culture-dependent techniques and used SPSS 20 software for statistical analysis. There was no statistically significant difference between fungal growth on the sports equipment, and Aspergillus spp. were predominant. However, one of the fitness centers had a statistically significant difference in fungal growth compared to the others (p

A coronavirus disease 2019 (COVID-19) disease, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created significant concern since December 2019 worldwide. The virus is known to be highly transmissible. Heterogenic clinical features even vary more among SARS-CoV-2 variants from asymptomatic forms to severe symptoms. Previous studies revealed an association between COVID-19 and vitamin D deficiency resulting from its low levels in COVID-19 patients. To our knowledge, there is no scientific investigation that evaluates the direct association between SARS-CoV-2 variants of concern and vitamin D receptor (VDR) gene markers in Cyprus. Thus, the present study aimed to identify the putative impact of VDR gene polymorphisms on SARS-CoV-2 infection among different variants. The nasopharyngeal swabs were taken from a total number of 600 patients who were admitted to Near East University Hospital COVID-19 Polymerase Chain Reaction (PCR) Diagnosis Laboratory for routine SARS-CoV-2 real-time quantitative reverse transcription PCR (RT-qPCR) test. The RT-qPCR negative resulting samples were taken as control samples (n = 300). On the contrary, the case group consisted of patients who were SARS-CoV-2 RT-qPCR positive, infected with either SARS-CoV-2 Alpha (n = 100), Delta (n = 100), or Omicron (n = 100) variants. Two VDR gene polymorphisms, TaqI-rs731236 T > C and FokI-rs10735810 C > T, were genotyped by polymerase chain reaction-restriction fragment length polymorphism. The mean age of the COVID-19 patient's ± standard deviation was 46.12 ± 12.36 and 45.25 ± 12.71 years old for the control group (p > 0.05). The gender distribution of the patient group was 48.3% female and 51.7% male and for the control group 43% female and 57% male (p > 0.05). Significant differences were observed in genotype frequencies of FokI and TaqI variants between SARS-CoV-2 patients compared to the control group (p

ABSTRACT: Objectives: Antibiotic therapy for Pseudomonas infections is becoming increasingly difficult. In this study, the transposons from two multidrug-resistant (MDR) clinical Pseudomonas strains containing related transposons responsible for giving rise to resistance determinants were characterised.Methods: Two MDR clinical Pseudomonas isolates were obtained from a medical facility in Cyprus. The strains were identified as Pseudomonas putida C54 and Pseudomonas aeruginosa C69. DNA was extracted from both strains and was sequenced. Transposons were identified, annotated and compared with DNA sequences in GenBank.Results: Two related nested transposons, here named Tn6608 (from P. putida C54) and Tn6609 (from P. aeruginosa C69), were characterised. The transposons are built on an ancestral Tn1403 base element (here named Tn1403A) that contains only the transposition module (tnpA and tnpR) and the associated cargo gene module (orfA, orfB, orfC and orfD) flanked by a 38-bp inverted repeat. The nested transposons identified in this study have evolved via acquisition of multiple transposons, adding multiple resistance genes to an ancestral transposon that originally lacked any resistance determinants.Conclusion: Transposons related to Tn6608 and Tn6609 have evolved and are globally disseminated. Of particular interest is that most of these nested transposons are located within the same site in a genomic island, providing alternative avenues for dissemination.

A reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) is regarded as the most sensitive method available and is being used for screening procedure for all incoming passengers to Northern Cyprus for SARS-CoV-2. This study investigated the compatibility of two different RT-qPCR methodologies Diagnovital® and Bio-Speedy® by re-analyzing the previously confirmed positive samples. A total of 43 previously confirmed positive samples were re-analyzed by two different commercially available SARS-CoV-2 RT-qPCR kits. Only 23.5% of positive samples detected by Diagnovital® RT-qPCR kit were detected by Bio-Speedy® detection kit.

Abstract Background Antibiotic-resistant Enterobacteriaceae in the gastrointestinal flora can lead to infections with limited therapeutic options. Also, the resistant bacteria can be transferred from colonized persons to others. The present study was conducted to search the fecal carriage rates of (i) Enterobacteriaceae that produce extended-spectrum β-lactamase (ESBL-E) and/or (ii) plasmid-mediated AmpC β-lactamase (pAmpC-E), (iii) ciprofloxacin-resistant Enterobacteriaceae (CIP-RE), and (iv) carbapenem-intermediate or -resistant Enterobacteriaceae (CIRE) in Northern Cyprus. Methods A total of 500 community-dwellers were recruited from consecutive admissions to the clinical laboratories of four hospitals. One rectal swab or stool sample was collected from each participant. A questionnaire was applied to evaluate possible risk factors associated with intestinal colonization of resistant bacteria. The samples were cultured on antibiotic containing media to screen for resistant bacteria colonization. The bacterial colonies that grew on the plates were subjected to further phenotypic tests to confirm the resistance. Results Of 500 volunteers, ESBL-E, pAmpC-E, CIP-RE and CIRE carriage were detected in 107 (21.4%), 15 (3.0%), 51 (10.2%) and six (1.2%) participants, respectively. Escherichia coli was the most commonly recovered species among Enterobacteriaceae isolates. A significant proportion of ESBL-producing E. coli isolates (n = 22/107; 20.6%) was found to be co-resistant to CIP (p = 0.000, OR 3.21, 95% CI 1.76–5.87). In this study, higher socioeconomic status (CIP-RE: p = 0.024, OR 1.96, 95% CI 1.09–3.53), presence of gastrointestinal symptoms (CIRE: p = 0.033; OR 6.79, 95% CI 1.34–34.39), antibiotic use (ESBL-E: p = 0.031; OR 1.67, 95% CI 1.04–2.67; and CIRE: p = 0.033; OR 6.40, 95% CI 1.16–35.39), and travelling abroad (pAmpC-E: p = 0.010; OR 4.12, 95% CI 1.45–11.66) were indentified as risk factors. Conclusion The study indicates that resistant Enterobacteriaceae isolates are carried by humans in the community. To prevent further spread of resistance, rational use of antibiotics should be encouraged, and antibiotic resistance should be carefully monitored in Northern Cyprus.

Technologies and devices for cosmetic procedures are developing with each passing day. However, increased and unauthorized use of such emerging technologies may also lead to increases in unexpected results and complications as well. Here, we report a case of facial cellulitis after a “beauty parlor” session of skin cleaning with jet stream peeling device in 19-year old female patient for the first time. Complications due to improper and unauthorized use of jet stream peeling devices may also cause doubts about the safety and impair the reputation of the technology as well. In order to avoid irreversible complications, local authorities should follow the technology and update the regulations where the dermatologists should take an active role.