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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.

In the treatment of chronic anal fissure, both surgical and topical treatment methods are used. The purpose of this study was to research a combined topical treatment that we prepared and to compare the effectiveness of lateral internal sphincterotomy in chronic anal fissure with this topical treatment. A total of 183 patients with chronic anal fissure were divided into two groups. One hundred and four patients had topical medical treatment (group 1) and seventy-nine patients underwent lateral internal sphincterotomy (group 2). In the first group, a topical combination of ointments consisting of bacitracin-neomycin sulfate, dexpanthenol, and diltiazem was applied to the anal area. Four weeks after treatment, pain and bleeding during defecation, gas/fecal incontinence, treatment-related adverse events and recovery rates were evaluated in both groups. Also, patients were examined for recurrence between the 8th and 10th weeks. There was no significant difference in recovery rates between the groups. In group 1, recovery rate was 82.7%, while in Group 2 it was 92.4% (p = 0.054). In both groups, gas/fecal incontinence ratio was significantly different, supporting the medical treatment (p = 0.02). The severity of pain and bleeding during defecation were compared between the groups. Only the severe pain was significantly higher in the medical treatment group (p = 0.018). The recurrence rate was 5.8% in the medical treatment group, but no recurrence was detected in the surgical group. Due to possible complications of surgical treatment and similar recovery rates, medical treatment of patients with chronic anal fissure can be tried before surgical treatment. © 2020, Association of Surgeons of India.

Purpose: One of the most widespread surgical conditions is acute appendicitis in industrialized countries. Nevertheless, diagnosis of borderline cases is mostly troublesome and needs subsequent researches. For this reason, we aimed to investigate new parameters to improve estimation of acute appendicitis. Lymphoid hyperplasia, impacted stool, faecolith, caecal or appendiceal tumors have been accepted as causes of appendicitis formation, but anatomic variations of diameter of ileocecal lipomatosis and ileocecal angle have been never discussed before. The aim of this study was to assess the relationship between appendicitis and diameter of ileocecal lipomatosis and ileocecal angle. Materials and methods: 96 Patients (51 women, 45 men) who were found to have acute appendicitis during exploration and 67 patients (32 women, 35 men) who were not pre-diagnosed with acute appendicitis were enrolled in the study. The diameter of ileocecal lipomatosis and also ileocecal angle values were obtained via computed tomography (CT) scans. Results: There were no significant differences between two groups in the mean of ileocecal angle (p > 0.05) but diameter of ileocecal lipomatosis values was significantly higher in the appendicitis-positive group compared with the appendicitis-negative group (p: 0.001). Conclusions: There is a relationship between increase in diameter of ileocecal lipomatosis and appendicitis formation. © 2019, Springer-Verlag France SAS, part of Springer Nature.

The enoxaparin is a low molecular weight heparin with antithrombotic effect . Increasing use of enoxaparin in the therapy and prophylaxis of thromboembolic disorders causes an increase in the incidence of these potential anticoagulant-related complications . Retroperitoneal bleeding is one of those complications. This is a rare case report of spontaneous retroperitoneal hematoma as a result of ischemic stroke due to the use of enoxaparin. [J Contemp Med 2016; 6(4.000): 348-351]

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

Crimean-Congo Haemorrhagic Fever (CCHF) disease is a viral haemorrhagic fever syndrome present in Turkey since 2002 [1]. CCHF is transmitted by ticks and can be fatal. Thrombocytopenia and coagulopathy can develop and, because of severe bleeding in the gastrointestinal tract, the prognosis is poor. After 3-7 days of incubation, fever, headache, fatigue, generalised muscle pain, nausea, vomiting, and skin and mucosal haemorrhages can occur [2]. J Microbiol Infect Dis 2016;6(1): 38-39 Key words: CCHF, endoscopy, gastrointestinal bleeding

WOS:000335444500041 PubMed: 26060490 Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of stroke and death. Patients with hypertensive have an increased risk of developing atrial fibrillation. RDW (Red blood cell distribution width) levels are elevated in cardiovascular disorders including heart failure, stable coronary disease, acute coronary syndrome, slow coronary flow and stroke. Objective: We aimed to investigate the relation between RDW and AF in patients with hypertensive Method: We retrospectively examined 126 consecutive hypertensive patients (63 hypertensive patients with AF and 63 hypertensive patients without AF matched with age and sex Results: The mean age of the study population was 71,09 +/- 8,50 (af group) and 70,97 +/- 8,24 (non-af group) years. RDW level was different among patients with atrial fibrillation and without atrial fibrillation.(15,13 +/- 1,58 and 14,05 +/- 1,15 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.

Objective. Recent studies have demonstrated that enteric glial cells (EGC) participate in the homeostasis of the gastrointestinal tract. This study investigated whether enteroglial markers, including S100B protein and glial fibrillary acidic protein (GFAP), can serve as noninvasive indicators of EGC activation and disease activity in UC patients.Methods. This clinical prospective study included 35 patients with UC and 40 age- and sex-matched controls. The diagnosis of UC was based on standard clinical, radiological, endoscopic, and histological criteria. Clinical disease activity was evaluated using the Modified Truelove-Witts Severity Index. Serum samples were analyzed for human GFAP and S100B using commercial enzyme-linked immunosorbent assay kits.Results. GFAP was not detected in the serum of either UC patients or controls (P>0.05). However, we found a significant (P<0.001) decrease in the serum S100B levels in the UC patients. No correlation between the serum S100B level and the disease activity or duration was observed (P>0.05). The serum S100B levels did not differ between UC patients with active disease (24 patients, 68.6%) or in remission (11 patients, 31.4%) (P>0.05).Conclusions. Ulcerative colitis patients had significantly lower serum S100B levels, while GFAP was of no diagnostic value in UC patients.

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.

Background/aim: The possibility of adverse effects of the oral glucose tolerance test (OGTT) carried out for the screening of gestational diabetes among pregnant women and fetuses is a frequently discussed topic. The purpose of this study was to investigate the effects of the hyperglycemia peak during OGTT on the levels of oxidants and antioxidants in the body.Materials and methods: Eighty individuals who applied to the Outpatient Clinic with suspected diabetes and OGTT indication were included in the study. Glucose, total oxidant capacity status (TOS), total antioxidant capacity (TAS), superoxide dismutase (SOD), and lipid hydroperoxide (LOOH) levels were tested on blood samples collected from these individuals at 0, 60, and 120 min during the OGTT carried out with 75 g of glucose. Oxidative stress index (OSI) was calculated as the ratio of TOS to TAS.Results: While the oxidative parameters TOS and LOOH were significantly increased at 60. min of OGTT, only LOOH was significantly increased at 120. min of OGTT. Significant decreases in antioxidative parameters (TAS, SOD) were observed at 60. and 120. min of the OGTT and OSI was significantly increased at 60. and 120. min of the OGTT.Conclusion: Oxidative stress parameters were increased and antioxidative parameters were decreased during the OGTT. However, more extended studies are required to determine the effects of the increased oxidative stress on pregnant women and fetuses.