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Öğe Cutaneous Leishmaniasis with Mucosal Involvement(Galenos Publishing House, 2021) Çabalak, Mehmet; Çulha, Gülnaz; Bal, Tayibe; Kaya, Tuğba; Çelik, EbruLeishmaniasis is a protozoan parasitic disease transmitted to humans by infected female sand flies. Turkey has received more than three million immigrants from Syria because of the civil war and political instability. This study reported cases of two patients, who were from Syria and lived in Hatay, with cutaneous leishmaniasis and mucosal involvement. Two patients presented to the infectious diseases clinic with a complaint of facial lesions and were subsequently referred to the parasitology department laboratory. Smears were prepared from the lesions, stained with Giemsa and examined under a microscope. Moreover, aspirates taken from the patients’ lesions were inoculated into the modified Novy-MacNeal-Nicolle medium. The diagnosis was made when amastigotes were detected in both smears. Proliferation of promastigotes was observed in one of the clinical specimens inoculated on the medium. By PZR-RFLP, Leishmania tropica were detected in the isolate. Both patients were treated with amphotericin B. One patient was treated again with a pentavalent antimony compound because of the recurrence of the lesion. © 2021 Turkish Society for Parasitology.Öğe Duodenal bölge tutulumu ile seyreden mortal nötropenik enterokolit olgusu(2022) Yaqoobi, Hasibullah; Bal, Tayibe; Çabalak, Mehmet; Önlen, Yusuf; Ocak, SabahattinNötropenik enterokolit çoğunlukla akut lösemili hastalar gibi mukozal hasarı indükleme potansiyeli yüksek hastalığı olanları ve yoğun kemoterapötik rejimleri alan hastaları etkilemektedir. Burada kemoterapi devamında ateş, karın ağrısı, bulantı, kusma, karında şişkinlik, ishal, ağız içinde yara şikayetleri ile başvuran, batın BT’ de diffüz duodenum duvar kalınlaşması saptanan 34 yaşında akut lenfoblastik lösemi tanılı nötropenik enterokolit olgusu sunulmuştur. Olgumuzu sunmaya değer kılan duodenal bölge tutulumu ile seyreden nötropenik enterokolit olmasıdır.Öğe Effect of hepatitis C infection and its clearance on the frequency of coronary artery disease in diabetics(Galenos Yayınevi, 2020) Bal, Tayibe; Kurtdere, Cuma; Önlen, Yusuf; Çabalak, MehmetObjectives: Chronic hepatitis C (CHC) infection considered to be associated with an increased risk of coronary artery disease (CAD). However, there is not enough data concerning this association in diabetics. Thus, this study investigated the effect of chronic HCV infection and its clearance on the CAD risk in diabetics. Materials and Methods: This was a retrospective case-control study conducted at the Mustafa Kemal University, Department of Infectious Diseases and Clinical Microbiology, Hatay, between January 2010 and January 2015. The presence of CAD and its main risk factors such as age, sex, hypertension (HT), hyperlipidaemia (HL), chronic obstructive pulmonary disease and chronic renal failure were compared between 100 HCV infected diabetic patients and 100 uninfected diabetic controls. The HCV-infected patients were further divided into a viral clearance group and a persistence group, and the CAD prevalence was also compared between these two groups. Results: Patients with CHC were predominantly male (55% vs 39%) and predominantly older than 60 years of age (68% vs 51%) in comparison with controls. The HCV-infected group had a significantly lower prevalence of CAD, HT and HL compared with controls (p<0.001). Furthermore, no significant differences were found between groups with viral clearance and persistent viremia for the prevalence of CAD (p=0.80). Conclusion: Our data suggested that chronic HCV infection might be a protective factor against CAD and successful HCV eradication may not increase the risk of CAD in diabetics. These findings indicate a need for additional studies to clarify the effects of HCV infection and its clearance on the risk of CAD in diabeticsÖğe Effectiveness of oral direct acting antivirals in elderly chronic hepatitis C patients: real-world data(Türk Geriatri Derneği, 2020) Çabalak, Mehmet; Bal, TayibeIntroduction: Objectives: Elderly cases have not been adequately representedin clinical trials with respect to chronic hepatitis C treatment. Extremely limited realworld data is available on new direct-acting antivirals in elderly patients. Herein, weaim to evaluate real-world data on new direct-acting antivirals used in the treatmentof chronic hepatitis C virus.Materials and Method: Medical records of 122 patients who started treatmentwith new direct-acting antivirals between January 2018 and December 2019 owingto chronic hepatitis C virus infection were analyzed retrospectively. Patients weredivided into two age groups: those younger than 65 years and those aged 65 andolder. Sustained virological response at 12 week rates were compared between thetwo groups. Sustained virological response at 12 week treatment efficacy analyseswere performed with both modified intention to tract and per protocol.Results: Sustained virological response in the 12th week post treatment wassimilar in both elderly patients and younger patients. Per protocol analysis was97.6% (42/43) vs. 100% (56/56) and modified intention to tract analysis was 91.3%(43/45) vs. 91.8% (56/61), respectively. The most common genotype of patientsaged 65 years and older were 1b 80%, and the most common genotype of patientsyounger than 65 years was 1b 57%.Conclusion: In the present study, Sustained virological response rates weresimilar in elderly patients compared to younger patients; however, very limitedinformation is available on the effectiveness and safety of new, recently approveddirect-acting antivirals in the elderly population.Öğe Evaluation of Four Adult Visceral Leishmaniasis Cases(Galenos Publishing House, 2023) Çabalak, Mehmet; Çulha, Gülnaz; Kaya, Tuğba; Gürsoy, Didar; İlhan, Gül; Özbilgin, AhmetLeishmania infantum is the species responsible for visceral leishmaniasis [(VL), kala-azar], which is observed sporadically mainly in pediatric age groups in the Aegean, Mediterranean and Central Anatolian regions of Türkiye. The aim of this study is to evaluate the diagnosis, clinic, laboratory results and treatments of four adult patients with VL who applied to our hospital. The patients were referred to our hospital to investigate hematological malignancy. In the study, the data of four patients (three men, one woman; age range: 30-40 years) who were diagnosed with VL and treated in the infectious diseases clinic of our hospital between January 2022 and April 2022 were evaluated retrospectively. The diagnosis of VL was made according to appropriate clinical and physical examination findings, biochemical and serological tests (indirect fluorescent antibody test and rK39 rapid antigen test) and polymerase chain reaction (PCR) results, as well as the presence of amastigote forms of the parasite in bone marrow samples. Serology positivity was found in all patients, and bone marrow positivity was found in two patients. According to the results of RT-PCR in all patients, it was determined that the species causing the disease was L. infantum/L. donovani. Initially, the most common symptoms were fever, fatigue, and abdominal distension. None of the patients had an immunosuppressive condition. It was understood that all the patients lived in the rural area of Syria’s Idlib province. Hepatosplenomegaly, increased erythrocyte sedimentation rate, anemia, leukopenia and thrombocytopenia were found in all patients. The patients were treated with liposomal amphotericin-B (L-AMB). One patient did not come for follow-ups, the other three patients were found to have completely recovered in their follow-up. No recurrence was observed in any of the patients. In conclusion, VL should be considered in patients who apply to health institutions with complaints of fever, hepatosplenomegaly, increased erythrocyte sedimentation rate, anemia, leukopenia and thrombocytopenia. © Telif hakkı 2023 Türkiye Parazitoloji Derneği-Makale.Öğe Genotype distribution of Hepatitis C Virus in Hatay province of Turkey(Galenos Yayınevi, 2020) Çabalak, Mehmet; Bal, Tayibe; Demir, Mehmet; Ocak, Sabahattin; Önlen, YusufObjectives: The treatment duration and response of chronic hepatitis C (CHC) are closely related to the genotypes of hepatitis C virus (HCV). This study aimed to determine the genotype distributions among CHC patients in the Hatay province of Turkey. Materials and Methods: In this study, demographic data of 589 patients who received a therapy for CHC at the infectious diseases and gastroenterology clinics between June 2016 and May 2019 were retrieved from the hospital information system and medical charts of the patients and were retrospectively reviewed. Results: The most common HCV genotype in our study was genotype 1b (66.9%), followed by genotype 2 (10.5%), genotype 1a (7.3%), genotype 4 (7.1%), genotype 3 (7%), and mixed genotype (1.2%). Six of the mixed genotypes were identified as 1b+4, while one was 1a+3. There was a statistically significant difference between females and males with regards to the HCV genotypes (p<0.001). Patients with genotype 1b tended to be older, while patients with genotypes 3 and 4 tended to be younger. Conclusion: Genotype 1b is the most common HCV genotype in Hatay province, and it is followed by genotypes 2, 1a, 4 and 3. Compared to the studies conducted in previous years in Turkey, our study identified a lower rate for genotype 1b, along with an increase in the distribution rates of the other genotypes. Monitoring the changes in HCV genotype distribution is of vital importance to develop effective strategies in the treatment of HCVÖğe Hatay ilindeki importe sıtma olgularının retrospektif analizi : 10 yıl içerisinde 75 olgu(Türkiye Parazitoloji Derneği, 2019) Şahin, Selma İlkay; Çabalak, Mehmet; Bal, Tayibe; Ocak, Sabahattin; Önlen, Yusuf; Çulha, GülnazAmaç: Endemik olmayan ülkelerde görülen importe sıtma olguları gecikmiş tanı ve tedaviye sekonder artmış komplikasyon oranı ve mortalite riski taşımaktadır. Bu çalışma ile kliniğimizde son 10 yılda takip edilen importe sıtma olgularının insidansının ve klinik özelliklerinin irdelenmesi amaçlanmıştır. Yöntemler: Bu retrospektif çalışmaya Ocak 2008 - Aralık 2017 tarihleri arasında kliniğimizde importe sıtma tanısı ile takip edilmiş 75 olgu dahil edilmiştir. Olgulara ait epidemiyolojik, laboratuvar, tedavi ve klinik seyre ilişkin verilere sistem kayıtlarından ulaşılmıştır. Bulgular: Olguların 74’ü erkek, 1’i kadın olup ortanca yaş 51(23-64) olarak saptanmıştır. Olguların tamamı Sahra altı Afrika ülkelerine seyahat etmiş ve hiçbiri seyahat öncesinde kemoprofilaksi almamıştır. Tüm olgularda etkenin Plasmodium falciparum olduğu görülmüştür. İmporte sıtma olgu sayısı 2015 sonrasında düşme eğilimindeydi. En sık görülen bulgular sırasıyla ateş (%100), trombositopeni (%84) ve anemi (%72) olarak saptanmıştır. Olguların %8’i ciddi seyirli sıtma olgusu olmakla birlikte ölümle sonuçlanan olgu görülmemiştir. Sonuç: Son yıllarda ülkemizden bildirilen importe sıtma olgu sayısındaki artışa rağmen bölgemizde bu sayıda düşüş olduğu görülmektedir. Ülkemiz importe sıtma olgularının en sık görüldüğü ülkeler arasında yer aldığından, ateş yüksekliği ve trombositopeni ile başvuran olgularda sıtmanın endemik olduğu bir bölgeye seyahat öyküsü olup olmadığı sorgulanmalıdır.Öğe The high rate of Candida parapsilosis candidemia among non-burn patients with polytrauma in the surgical intensive care units of a university hospital(İnönü Üniversitesi Tıp Fakültesi, 2020) Bal, Tayibe; Çabalak, Mehmet; Özer, Burçin; Çömez, Mehmet Selim; Önlen, YusufAim: Candidemia is a life-threatening infection that has been reported to be associated with poorer outcomes in trauma patients. The present study aimed to investigate the epidemiology of candidemia in non-burn patients with polytrauma. Material and Methods: We conducted a retrospective, single-center, observational study of polytrauma patients with candidemia admitted to the surgical intensive care units of a university hospital in Turkey between 2013 and 2017 on. Results: The incidence of candidemia was 127 episodes per 1000 intensive care unit admissions in polytrauma patients. Nonalbicans Candida species accounted for 75.5% of all candidemia episodes. C. parapsilosis (51.05%) was the predominant species, followed by C. albicans (24.52%) and C. tropicalis (12.21%). The highest crude mortality rate (72%) was observed in patients with C. parapsilosis candidemia. In multivariate analyses, who had undergone prior gastrointestinal surgery were 7.1 times more likely to have C. parapsilosis candidemia than those with other strains. Conclusion: Our study, remarkable, demonstrated a high incidence of Candidemia had in polytrauma patients, and non-albicans Candida species were the most frequently isolated candida species. According to our study findings, a prior history of gastrointestinal surgery may help predict C. parapsilosis, as the causative agent of candidemia in polytrauma patients. However, since our study was observational and limited to such a small number of patients, the results obtained should be applied with caution.Öğe Hıv pozitif olgularda viral hepatit ve sifiliz koinfeksiyonu seroprevalansının irdelenmesi(Bilimsel Tıp Yayınevi, Tuba Yıldırım, 2020) Çabalak, Mehmet; Bal, TayibeHIV pozitif olgularda beklenen yaşam süresinin uzaması ile viral hepatit ve sifiliz gibi cinsel yolla bulaşan infeksiyonların önemigörece artmıştır. Bu çalışma ile kliniğimizde izlenmiş olan HIV pozitif olgularda viral hepatit ve sifiliz koinfeksiyonu seroprevalansınınirdelenmesi amaçlanmıştır.Materyal ve Metod: Bu retrospektif, kesitsel, tek merkez çalışmaya kliniğimizde Ocak 2018-Kasım 2019 tarihleri arasında izlenmişolan HIV ile infekte 98 olgu dahil edildi. Olgulara ait demografik verilere, fizik muayene bulgularına, CD4 T lenfosit sayısı, HCV RNA,HBsAg, anti-HBc IgG, anti-HBs, anti-HCV, anti-HAV IgG, RPR ve TPHA test sonuçlarına hasta dosyalarından retrospektif olarak ulaşıldı.Bulgular: Olguların ortanca yaşı 33.5 (24-44) yıl olup 73’ü (%74.5) erkek, 13’ü (%13.3) yabancı uyruklu, 69’u (%70.4) tedavi naif,20’si (%20.4) erkeklerle seks yapan erkek (ESE) ve 5’i (%5.1) IV ilaç bağımlılığı öyküsü olan olgulardan oluşmaktaydı. En sık (%75.5)olası bulaş yolu heteroseksüel ilişki, medyan CD4 T lenfosit sayısı ise 249.5 hücre/mm3 (145-358) idi. Olguların 15’inde (%15.3) enaz bir koinfeksiyon mevcuttu. En sık görülen koinfeksiyonlar HIV/sifiliz ve HIV/HBV koinfeksiyonlarıydı [sırasıyla %13.3 (n= 13) ve %4.0(n= 4)]. Sadece bir olguda HIV/HBV/sifiliz koinfeksiyonu tespit edilmiş, ancak HIV/HCV koinfeksiyonuna rastlanmamıştır. Etkin HBV aşılanma oranı %26.5, geçirilmiş HBV infeksiyonu %14.3, izole anti-HBc sıklığı %3.9 olarak bulundu. Viral hepatit veya sifiliz ile koiinfekteolgular sadece HIV ile infekte olgulara oranla daha yaşlıydı ancak gruplar arasında cinsiyet, antiretroviral tedavi (ART) deneyimi, CD4T lenfosit sayısı açısından anlamlı fark olmadığı görüldü (sırasıyla p= 0.013, p= 0.106, p= 0.542 ve p= 0.421). TPHA ve anti-HAV IgGseropozitifliği, ESE olgularında ESE olmayan olgulara göre anlamlı oranda daha yüksekti (sırasıyla, p< 0.001 ve p= 0.035).Sonuç: Kliniğimizde takip edilmekte olan HIV pozitif olgularda HBV, HCV ve HAV seroprevalansı genel popülasyondaki oranlara benzerbulunmuştur. Öte yandan HIV ile infekte ESE olgularının ESE olmayan olgulara oranla daha yüksek TPHA ve anti-HAV IgG seropozitifliğine sahip oldukları görülmüştürÖğe İmmünsüpresif tedavi alacak hastalarda hepatit serolojisi(Harran Üniversitesi Tıp Fakültesi Dekanlığı, 2020) Çabalak, Mehmet; Bal, Tayibe; Ocak, SabahattinAmaç: İmmünsupresif ilaç kullananlarda, hepatit B reaktivasyon riskine yönelik tarama yapılması önerilmektedir.Bu çalışmada immünsüpresif tedavi öncesi, Enfeksiyon hastalıkları kliniğine yönlendirilen hastalarda hepatit Bvirüsü (HBV), hepatit C virüsü (HCV) ve hepatit A virüsü (HAV) sonuçları retrospektif olarak irdelenmesiamaçlandı.Materyal ve Metod: Çalışmamızda Ocak 2018 - Aralık 2018 tarihleri arasında immünsüpresif tedavi öncesi,Enfeksiyon hastalıkları kliniğine yönlendirilen 148 hastanın hepatit B yüzey antijeni (HBsAg), hepatit B yüzeyantikoru (Anti-HBs), hepatit B core protein antikoru (Anti-HBc IgG), anti hepatit C virüs antikoru (Anti-HCV) ve antihepatit A virüs antikoru (Anti-HAV) hasta dosyalarından ve hastane otomasyon sisteminden retrospektif olarakincelendi.Bulgular: HBsAg pozitiflik oranı %4,1, Anti-HBs pozitiflik oranı %31,8, İzole Anti-HBc IgG pozitiflik oranı %1,4 veiki hastada ise Anti-HBs bakılmamıştı. Anti-HCV pozitifliği %1,4 tespit edildi. Hastaların %79,7 Anti-HAVbakılmamış, Anti-HAV pozitifliği %12,2 ve Anti-HAV negatifliği %8,1 olarak saptandı.Sonuç: İmmünsüpresif tedavi öncesi tarama yapılmasına rağmen bazı taramaların eksik yapıldığı tespit edildi.Bu nedenle bu hastaları takip eden hekimlere eğitim verilmesi ve özellikle HBV enfeksiyonu konusunda farkındalıkoluşturulmasını önermekteyiz.Öğe Intravenous drug use rates and results of direct-acting antiviral treatment in prisoner patients(Galenos Yayınevi, 2020) Çabalak, Mehmet; Bal, TayibeIntravenous drug use (IVDU) is more common inprisoner patients, and this is a global problem. Hepatitis C virus(HCV) infection is higher in prisoners than general population. Inour study, we aimed to examine the IVDU rates and direct-actingantiviral (DAA) treatment results of the prisoners who applied toHatay Mustafa Kemal University Clinic of Infectious Diseases.Materials and Methods: In our study, IVDU rates and HCVtreatment results of 85 prisoners who applied to Hatay MustafaKemal University Faculty of Medicine Clinic of Infectious Diseasesbetween January 2017 and December 2019 were retrospectivelyanalyzed. Treatment results were evaluated by performing modifiedintention to tract (mITT) and per protocol (PP) efficacy analysis,respectively.Results: The rate of IVDU was 37.7% in prisoners who werepositive for HCV. Although sustained virological response (SVR) ratewas 100% in PP analysis, SVR rate was determined as 80.5% inmITT analysis. Viral genotype 3 (41.6%) and genotype 4 (39%) werethe most common.Conclusion: However, data on HCV screening and treatment inprisons in Turkey is inadequate or too low. We think that with theuse of DAAs, patients’ compliance to treatment will increase, it is animportant step for HCV eradication and multicenter studies shouldbe conducted.Öğe Investigation of Sensitivity of Rapid Diagnosis Tests in Patients with Suspected Malaria(2024) Çulha, Gülnaz; Önlen, Yusuf; Çabalak, Mehmet; Kaya, Tuğba; Küçükeser, BurcuObjective: Malaria has been eradicated in Türkiye as of 2010, but there are imported cases. In this study, we aimed to compare the diagnostic value of two rapid tests; SD Bioline Malaria Ag Pf/Pan (SD-Pf/Pan) and SD Bioline Malaria Ag Pf/Pv (SD-Pf/Pv) with microscopy and real time-polymerase chain reaction (RT-PCR). Methods: Blood samples were taken from all participants. Thick drop smears were prepared. Thick drop smears were examined for malaria positive/negative distinction under the light microscopy. Then, two rapid diagnostic tests (SD-Pf/Pan and SD-Pf/Pv) were performed. After DNA extraction from blood samples, RT-PCR was typed. The data were evaluated with SPSS 21 program of statistics. Results: A total of 30 cases out of 66 suspected malaria cases were detected as positive with microscopy and RT-PCR. Twenty- seven patients were found positive with both SD-Pf/Pan and SD-Pf/Pv tests. Based on the microscopic results as a reference method, SD-Pf/Pan and SD-Pf/Pv rapid diagnostic tests had a 90% sensitivity, 100% specificity, 100% positive predictive value (PPV), and 92.86% negative predictive value (NPV). Based on the RT-PCR results as a reference method, for detection of P. falciparum, both tests had a 95.65% sensitivity, 100% specificity, 100% PPV, and 88.89% NPV. Moreover, while SD-Pf/Pv had a sensitivity, specificity, PPV, and NPV of 100% in detection of P. vivax; SD-Pf/Pan has a 77.78% sensitivity of, 61.90% specificity of, 46.67% PPV, and 86.67% NPV SD-Pf/Pan for detection of PAN. Conclusion: As a result, high sensitivity and specificity were detected in both kits in the diagnosis of malaria infections caused by P. falciparum and P. vivax. Rapid diagnostic tests can be used safely in diagnosis however the diagnosis should be supported by microscopy and RT-PCR methods when they are applicable.Öğe Investigation of Sensitivity of Rapid Diagnosis Tests in Patients with Suspected Malaria(Galenos Publishing House, 2024) Çulha, Gülnaz; Önlen, Yusuf; Çabalak, Mehmet; Kaya, Tuğba; Küçükeser, BurcuObjective: Malaria has been eradicated in Türkiye as of 2010, but there are imported cases. In this study, we aimed to compare the diagnostic value of two rapid tests; SD Bioline Malaria Ag Pf/Pan (SD-Pf/Pan) and SD Bioline Malaria Ag Pf/Pv (SD-Pf/Pv) with microscopy and real time-polymerase chain reaction (RT-PCR). Methods: Blood samples were taken from all participants. Thick drop smears were prepared. Thick drop smears were examined for malaria positive/negative distinction under the light microscopy. Then, two rapid diagnostic tests (SD-Pf/Pan and SD-Pf/Pv) were performed. After DNA extraction from blood samples, RT-PCR was typed. The data were evaluated with SPSS 21 program of statistics. Results: A total of 30 cases out of 66 suspected malaria cases were detected as positive with microscopy and RT-PCR. Twenty-seven patients were found positive with both SD-Pf/Pan and SD-Pf/Pv tests. Based on the microscopic results as a reference method, SD-Pf/Pan and SD-Pf/Pv rapid diagnostic tests had a 90% sensitivity, 100% specificity, 100% positive predictive value (PPV), and 92.86% negative predictive value (NPV). Based on the RT-PCR results as a reference method, for detection of P. falciparum, both tests had a 95.65% sensitivity, 100% specificity, 100% PPV, and 88.89% NPV. Moreover, while SD-Pf/Pv had a sensitivity, specificity, PPV, and NPV of 100% in detection of P. vivax; SD-Pf/Pan has a 77.78% sensitivity of, 61.90% specificity of, 46.67% PPV, and 86.67% NPV SD-Pf/Pan for detection of PAN. Conclusion: As a result, high sensitivity and specificity were detected in both kits in the diagnosis of malaria infections caused by P. falciparum and P. vivax. Rapid diagnostic tests can be used safely in diagnosis however the diagnosis should be supported by microscopy and RT-PCR methods when they are applicable. © 2024 Turkish Society for Parasitology-Available online at www.turkiyeparazitolderg.org.Öğe Mukozal Tutulumlu Kutanöz Leishmaniasis(2021) Çabalak, Mehmet; Çulha, Gülnaz; Bal, Tayibe; Kaya, Tuğba; Celık, EbruLeishmaniasis, bir protozoon parazit olan Leishmania türlerinin sebep olduğu ve enfekte dişi kum sinekleri tarafından bulaştırılan bir hastalıklar grubudur. Türkiye, yakın sınır komşumuz olan Suriye’de meydana gelen iç savaş ve siyasi istikrarsızlık nedeniyle üç milyonu aşan sayıda göç almıştır. Bu çalışmada, Suriye’den göç ederek Hatay’da yaşayan, iki yurt dışı kaynaklı mukozal tutulumlu kutanöz leishmaniasis olgusu ve tedavileri sunulmaktadır. Enfeksiyon hastalıkları kliniğine yüzünde lezyon nedeniyle başvuran iki olgu, Parazitoloji Anabilim Dalı laboratuvarına yönlendirilmiştir. Olguların lezyonlarından yayma preparatlar hazırlanmış ve Giemsa ile boyanarak mikroskop altında incelenmiştir. Aynı zamanda olguların lezyonundan, aspirasyon sıvısı alınarak modifiye edilmiş Novy-MacNeal-Nicolle besiyerine inoküle edilmiştir. Üreme gözlenen örnekler, ITS-1 bölgesini hedefleyen LITSR ve L 5.8S primerleri kullanılarak PZR-RFLP yöntemi ile tiplendirilmiştir. Olguların lezyonlarından hazırlanan yayma preparatların ikisinde de amastigotlar görülerek tanı konmuştur. Besiyerine inoküle edilen klinik örneklerin, birinde promastigotların ürediği gözlenmiştir. PZR-RFLP ile izolat Leishmania tropica olarak tiplendirilmiştir. Olguların ikisi de amfoterisin B ile tedavi edilmiştir. Bir olgu lezyonun tekrar etmesi nedeniyle beş değerli Antimon bileşiği ile tekrar tedavi edilmiştir.Öğe Relationship of Semaphorin Proteins with Blood Markers in Patients with COVID-19(2023) Okuyan, Hamza Malik; Doğan, Serdar; Bal, Tayibe; Çabalak, MehmetAim: The COVID outbreak is a serious health problem affecting socio-economic life and healthcare systems worldwide. Although the role of Semaphorins in some diseases is relatively known, the association of these molecules with the pathogenesis of COVID-19 remains unclear. Therefore, we aimed to investigate the relationship of Semaphorins (Sema3A, Sema4A, Sema4D and Sema7A) with biochemical and inflammatory alterations and their roles in predicting the presence of disease and disease severity in COVID-19 patients. Material and Method: A total of 144 COVID-19 patients and 20 healthy individuals were enrolled in the current study. Serum Semaphorins were analyzed using Enzyme-linked Immunosorbent Assay. Other laboratory parameters were measured using routine laboratory techniques. Results: Sema3A concentrations were elevated in both patients with severe and non-severe COVID-19 groups compared with healthy controls (p<0.0001). Sema4A levels were significantly decreased in patients with the severe COVID-19 group (p=0.002). Sema3A was negatively correlated with routine hematological markers such as EOS, RBC, HGB, HCT and MCV. Further, Sema3A was positively correlated with coagulation markers such as D-dimer and fibrinogen and the inflammatory markers, such as ESR, CRP, PCT and ferritin and biochemical markers such as ALT, AST, BUN, CK and LDH. Sema4A was negatively correlated with WBC, while it was positively correlated with LYM and HCT. Sema3A levels over 3.03 ng/mL and Sema4A concentrations of less than 11.8 ng/mL may predict the presence of COVID-19 (p<0.0001, p=0.02, respectively). Conclusion: Our data presented here suggest that Sema3A and Sema4A could be diagnostic markers for COVID-19 and may have importance in the clinical management of the disease.Öğe Retrospective Analysis of Cases with Imported Malaria in Hatay Province of Turkey: Seventy-Five Cases in Ten Years(Galenos Publishing House, 2019) Şahin, Selma İlkay; Çabalak, Mehmet; Bal, Tayibe; Ocak, Sabahattin; Önlen, Yusuf; Çulha, GülnazObjective: Cases with imported malaria have increased complication and mortality rates because of delayed diagnosis and treatment in non-endemic countries. This study aimed to investigate the incidence and clinical features of imported malaria in our clinic during the past 10 years. Methods: This retrospective study included 75 cases diagnosed as having imported malaria in our clinic between January 2008 and December 2017. The epidemiological data, laboratory findings, treatment data and clinical course of the cases were obtained from system records. Results: Patients were predominantly male (%98.6) with a median age of 51 (23-64) years. All cases were infected with Plasmodium falciparum, had a recent travel history to Sub-Saharan African countries and none had received chemoprophylaxis before travel. The incidence of imported malaria showed a declining trend after 2015. The most common findings were fever (100%), thrombocytopenia (84%) and anemia (72%). Although 8% of patients had presented with severe malaria, none of them died. Conclusion: Despite increasing incidence of imported malaria in our country in recent years, there is a decrease in this number in our region. Since Turkey is one of the countries with the highest prevalence of imported malaria in the world, patients with fever and thrombocytopenia should be questioned whether or not they had a history of travel to malaria-endemic area. © 2019 Turkish Society for Parasitology.Öğe Sofosbuvir and Ribavirin in Turkish non-cirrhotic chronic hepatitis C patients infected with genotype 2 or 3(2020) Bal, Tayibe; Çabalak, MehmetAim: Few studies have evaluated real-world clinical experience with sofosbuvir (SOF) plus ribavirin (RBV) in hepatitis C virus (HCV)genotypes 2 and 3 infections from Turkey. Thus, this study aimed to investigate the results of sofosbuvir plus ribavirin therapy ingenotype 2 and 3 cases followed in an infectious disease clinic at a university hospital in Hatay, southern Turkey.Material and Methods: In this single-centre, retrospective, observational study, 58 eligible patients treated with SOF/RBV (400 mgof SOF plus weight-based RBV) therapy between October 2016 and February 2019 were examined. Forty-three patients who hadcompleted the duration of treatment and had known virological response status were evaluated for treatment outcomes.Results: SOF/RBV achieves a sustained virological response (SVR) rate of 96.3% and 100% in the HCV genotype 2 and 3 groups,respectively, with treatment duration of 12-24 weeks. No patient experienced a virologic breakthrough while only one experiencedvirologic relapse after the completion of therapy. The incidence of adverse events was 25.5% (11/43) while the most common(11.6%) adverse event was ribavirin-related hemolytic anemia.Conclusion: The current study revealed that the SOF/RBV therapy achieved excellent response rates with a good safety profile innon-cirrhotic Turkish patients infected with HCV genotype 2 or 3.
