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Objectives There is no reliable and valid biomarker to identify Irritable bowel syndrome (IBS) and its subtypes. The aim of this study is to explore potential serum biomarkers that may be associated with IBS subtypes, particularly in the vitamin D pathway. Methods The study population comprised 75 IBS patients and 79 controls. Patients divided into IBS subtypes. Routine biochemical parameters, 25-OH-vitamin D, vitamin D binding protein (VDBP) and vitamin D receptor (VDR) serum levels were compared between IBS subtypes and controls. Factors related to IBS subtypes were examined by multivariate logistic regression analysis. Results Vitamin D levels were lower; VDBP and VDR were higher in all IBS patients than in controls (p Conclusions Increased VDBP levels were associated with all IBS subtypes. Patients, especially in IBS-D, had higher serum levels of VDBP, CRP and ESR. Vitamin B12 deficiency, which we consider as a result of the disease, was more common in IBS-C.

Objectives: This study aims to evaluate cardiometabolic risk factors in ankylosing spondylitis (AS) patients and their relationship with epicardial fat thickness (EFT). Patients and methods: The study included 50 consecutive AS patients (29 males, 21 females; mean age 40.5±9.4 years; range 25 to 60 years) with a median disease duration of 8.3 years and 50 healthy controls (33 males, 17 females; mean age 39.8±6.4 years, range 24 to 58 years). All patients’ EFT was measured with echocardiography. Results: Both body mass index and waist circumference measurements were higher in AS patients than healthy controls (25.4±3.5. vs. 24.5±2.9 kg/m 2 , p=0.005; 96.2±10.8 vs. 86.7±12.6 cm, p

Aim: Our aim was to evaluate whether there was a relationship between mean platelet volume and myocardial perfusion defect in diabetic patients using myocardial perfusion imaging. Method: Forty-four diabetic patients with myocardial perfusion defect (group 1) and 44 diabetic patients without myocardial perfusion defect (group 2), matched for age and gender, were retrospectively examined. Levels of mean platelet volume (MPV) in the two groups were assessed. Results: MPV was higher in group 1 than group 2 patients (8.76 ± 0.76 and 8.25 ± 0.78 fl), respectively, p = 0.003). Levels of glucose, triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, haemoglobin (Hb) and glycosylated haemoglobin (HbA1c), and body mass index (BMI) in the two groups were not statistically significantly different. Multivariate logistic regression analyses showed that MPV was the only variable independently associated with myocardial perfusion defects (OR: 2.401, 95% CI: 1.298-4.440, p = 0.013). Conclusion: This study showed that higher MPV was associated with myocardial perfusion defects. Higher MPV in diabetic patients was independently related to myocardial perfusion defects and may be an indicator of myocardial ischaemia.

Data examining the association between vitamin D and diabetic peripheral neuropathy are limited. This study investigated the serum levels of vitamin D, vitamin D-binding protein (VDBP), and vitamin D receptor (VDR) in diabetics in the Yozgat region of Turkey, and assessed their relationships with diabetic peripheral neuropathy. 69 diabetic patients and 49 age- and sex-matched control subjects were enrolled in this clinical prospective study. All the diabetics underwent conventional sensory and motor nerve conduction studies, and diabetic peripheral neuropathy was confirmed or ruled out according to the electromyography findings and Douleur Neuropathique 4 questions. Serum vitamin D, VDBP and VDR levels were measured using commercial enzyme-linked immunosorbent assay kits. The serum vitamin D levels (p = 0.001) were significantly lower, while the VDR levels (p = 0.003) were higher, in diabetics than in controls. The serum VDBP levels were similar in both groups (p > 0.05). The serum vitamin D levels were significantly lower in diabetics with diabetic peripheral neuropathy than in those without (p = 0.032), whereas the serum VDBP and VDR levels were similar in these two groups (p > 0.05). The lower serum vitamin D levels in diabetics, especially in those with peripheral neuropathy, may suggest a neurotrophic effect of vitamin D.

We report here an instrument designed by Dr Hasan Börekci that provides support to the knot to facilitate knot tying in laparoscopic procedures. We call the device the 'Börekci knot-supporting instrument' and the technique 'Börekci's knot technique'. Materials and methods: To evaluate the efficacy of this instrument, 17 surgeons performing laparoscopic surgery tied 3 knots using the classical intracorporeal method and then using the intracorporeal knot-supporting instrument. The times required to tie each knot were recorded and compared statistically. Results: Comparing the 2 knotting methods, the time spent tying the knots was shorter with the knot-supporting instrument in all 3 trials and the difference was significant (P = 0.026) in the third trial. Conclusion: This alternative technique can be used for all knots in laparoscopic surgery when classical intracorporeal knotting is difficult.

Rivaroxaban is one of the new anti-coagulants that inhibit Factor Xa and rarely cause rectus sheath hematoma and retroperitoneal haemorrhage which are uncommon, life-threatening complications. Here is a case of an elderly patient on rivaroxaban therapy for the stroke prevention in non-valvular atrial fibrillation who developed rectus sheath hematoma and retroperitoneal bleeding.Keywords: Rectus sheath hematoma, retroperitoneal bleeding, rivaroxaban.

Aim: Bone disorders such as osteopenia or osteoporosis are the most common clinical manifestations seen in sickle cell disease (SCD) with a high of morbidity. There are many reasons, including vitamin D deficiency for the appearance of bone problems. In the present study we aimed to evaluate osteopathy in patients with SCD using bone mineral densitometry (BMD) and biochemical indices. Material and Method: 61 patients (29 female, 32 male) were included in the study. The age, gender, and biochemical parameters with BMD were evaluated using dual energy X-ray absorptiometry from lumbar vertebrae. According to Z scores, [-2] was considered as osteoporosis. Multivariate analysis was performed to determine the factors influencing BMD. Results: There were a total of 61 SCD patients. The average age was 21.06±5.06 (15-27) years and the mean BMI was 19.15±2.98 kg/m2. 23 patients were osteopenic (11 female, 12 male) (37.7%) and 26 were osteoporotic (12 female, 13 male) (44.3%). Twelve patients (6 female and 6 male) (18%) had normal Z scores. Vitamin D was found severely deficient (

Aim: Health anxiety (HA) in patients consist of incorrect reference to normal bodily sensations as a signs of a serious disease. The aim of this study is to investigate the HA in patients admitted to internal medicine outpatient clinic for several times within one year. Material and Method: 60 patients who admitted more than one time to internal medicine outpatient clinic within one year and the control group consisted of 60 people were enrolled in this study. Short-form of health anxiety inventory (SAE-KF) was given to these groups, The results were compared statistically. Results: SAE-KF scores were significantly higher in the patient group (11.17 ± 6.07) than the control group (10.71±4.44) (Z=-5.96, P

Evidence suggests that migraine is associated with metabolic syndrome, which is also implicated in non-alcoholic fatty liver disease (NAFLD). Reported for the first time, we aimed to investigate the relationship between migraine and NAFLD in patients with migraine. A total of 90 consecutive migraine patients were enrolled in this cross-sectional study. The diagnosis of migraine was determined according to the International Classification of Headache Disorders-II diagnostic criteria. The diagnosis of NAFLD was based on abdominal ultrasonography findings. Anthropometric indices and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated, and serum insulin level measurements and other biochemical analyses were performed for each subject. The measurements of body mass index and waist circumference were significantly higher in migraine patients with NAFLD than in those without NAFLD (p0.001). Regarding the laboratory results, insulin (p = 0.024), alanine aminotransferase (p = 0.027), and triglyceride levels (p = 0.001) and the HOMA-IR (p = 0.039) were higher in migraineurs with NAFLD than in those without NAFLD. Among the headache characteristics, the presence of aura was higher, and disease and attack durations were significantly longer in migraineurs with NAFLD than in those without NAFLD (p = 0.005, p = 0.024, and p = 0.023; respectively). However, the headache characteristics did not correlate with either the hepatosteatosis grade or HOMA-IR in migraine patients (p0.05). Our results show that NAFLD may present in migraine patients with higher frequency of auras and longer disease and attack durations.

Background: Slow Coronary Flow Syndrome (SCFS) is an angiographic observation characterized by angiographically normal or near-normal coronary arteries with the delayed progression of contrast dye injected into the coronary tree. Previous studies suggested that these patients had autonomic dysfunction. Life threatening arrhythmias and sudden cardiac death have also been reported in these patients. Aim: Our aim was to assess autonomic function in slow coronary patients using heart rate variability and heart rate turbulence. Method: We selected 40 slow coronary patients and 30 healthy individuals with normal coronary. 24 hours ambulatory holter ECG recordings were obtained from all patients. Turbulence onset (TO), Turbulence slope (TS), Time domain HRV (SDNN, Mean RR, RMSSD, Pnn50 and triangular index (TI) were analysed and compared between two groups. Results: There were no difference in Mean RR (ms), RMSSD (ms) and Total Snn50 between groups. But SDNN (ms) and Triangular index (TI) were different between groups.( 128.52 ± 9.32 vs 174.25 ± 73 p

Evidence suggests that peripheral nerve injury occurs during the early stages of disease with mild glycemic dysregulation. Two proteins, neuron-specific enolase (NSE) and neurofilament light chain (NFL), have been examined previously as possible markers of neuronal damage in the pathophysiology of neuropathies. Herein, we aimed to determine the potential value of circulatory NSE and NFL mRNA levels in prediabetic patients and in those with peripheral neuropathy. This prospective clinical study included 45 prediabetic patients and 30 age- and sex-matched controls. All prediabetic patients were assessed with respect to diabetes-related microvascular complications, such as peripheral neuropathy, retinopathy and nephropathy. mRNA levels of NSE and NFL were determined in the blood by real-time polymerase chain reaction. NSE mRNA levels were similar between prediabetic and control groups (p0.05), whereas NFL mRNA levels were significantly higher in prediabetics than in controls (p0.001). NSE mRNA levels did not significantly differ between prediabetic patients with and without peripheral neuropathy (p0.05), while NFL mRNA levels were significantly higher in prediabetics with peripheral neuropathy than in those without (p = 0.038). According to correlation analysis, NFL mRNA levels were positively correlated with the Douleur Neuropathique 4 questionnaire score in prediabetic patients (r = 0.302, p = 0.044). This is the first study to suggest blood NFL mRNA as a surrogate marker for early prediction of prediabetic peripheral neuropathy, while NSE mRNA levels may be of no diagnostic value in prediabetic patients.

BACKGROUND: Blood neutrophil‐to‐lymphocyte (N/L) ratio is an indicator of the overall inflammatory status of the body, and an alteration in N/L ratio may be found in patients with familial Mediterranean fever (FMF). The aim of this study was to investigate the interrelationship between N/L ratio and FMF. METHODS: One hundred and fifteen patients and controls were enrolled in the study. The cases in the study were categorized as FMF with attack, FMF with attack‐free period, and controls. The neutrophil and lymphocyte counts were recorded, and the N/L ratio was calculated from these parameters. All patients were diagnosed according to Tel Hashomer criteria. RESULTS: A total of 79 FMF patients were included in the study and all subjects were receiving colchicine treatment at the time. The serum N/L ratios of active patients were significantly higher than those of attack‐free FMF patients and controls (P < 0.001). The optimum N/L ratio cut‐off point for active FMF was 2.63 with sensitivity, specificity, positive predictive value, and negative predictive value of 0.62 (0.41–0.80), 0.85 (0.72–0.93), 0.67 (0.44–0.85), and 0.82 (0.69–0.91), respectively. The overall accuracy of the N/L ratio in determination of FMF patients during attack was 71%. CONCLUSION: Our results demonstrate that N/L ratio is higher in patients with active FMF compared with FMF patients in remission and controls, and a cut‐off value of 2.63 can be used to identify patients with active FMF.