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Aspirin for preventing hemodialysis-associated chronic hepatitis C infections
(Viral Hepatitle Savaşım Derneği, 2018) Bal, Tayibe; Önlen, Yusuf; Şahin, Selma İlkay; Turgut, Faruk Hilmi
Objectives: This study aimed to evaluate whether aspirin therapy is effective in protecting against hepatitis C virus (HCV) infection in maintenance hemodialysis patients, one of the high-risk groups for HCV infection. Materials and Methods: This retrospective cross-sectional study included 408 patients with end-stage renal failure who underwent maintenance hemodialysis for at least 3 months in four private hemodialysis units in Hatay, Turkey, in January 2017. The patients were classified into two groups according to their aspirin exposure status: non-users (n=228) and regular aspirin users (n=180). The proportion of patients with hemodialysis-related chronic hepatitis C (CHC) was compared between the groups. Irregular aspirin users, patients infected with HBV or diagnosed with CHC before initiation of hemodialysis therapy were excluded from the study. Results: The prevalence of hemodialysis-related CHC was 3.9% among the 408 patients. Hemodialysis-related CHC was not seen in any of the 180 regular aspirin users. Regular aspirin users showed a significantly lower prevalence of hemodialysis-related CHC than non-users (p<0.001). There was a significant (p<0.001), but weak (Cramer’s V=0.180) correlation between hemodialysis-related CHC and aspirin exposure status. Conclusion: These results indicated that regular use of aspirin might be linked to a lower risk of hemodialysis-related CHC. However, further prospective studies are required to confirm this association.
Beclin-1, an autophagy-related protein, is associated with the disease severity of COVID-19
(Pergamon-Elsevier Science Ltd, 2021) Okuyan, Hamza Malik; Dogan, Serdar; Bal, Tayibe; Cabalak, Mehmet
Aims: Coronavirus disease 2019 (COVID-19), which is a highly contagious disease, is an ongoing outbreak worldwide with high morbidity and mortality. The approaches targeting the autophagy processes might have promising diagnostic and therapeutic values against Coronavirus infection. Here, we aimed to investigate the relationship of Beclin-1 (BECN1), an autophagy-related protein, with blood parameters and the clinical severity in patients with COVID-19. Materials and methods: We enrolled 108 patients with COVID-19 and 21 healthy controls in this study, from September 2020 to January 2021 and divided all patients into two groups according to the severity of the disease: The non-severe group and the severe group. BECN1 levels and blood parameters were measured with Enzyme-Linked Absorbent Assay and routine techniques, respectively. Key findings: Serum BECN1 levels were increased in patients with COVID-19 compared to the healthy controls, and its concentrations were significantly higher in the severe group than in the non-severe group (p < 0.001). BECN1 levels showed a significantly positive correlation with coagulation markers such as D-dimer and Fibrinogen (FIB) and inflammation markers such as C-reactive protein (CRP), Procalcitonin (PCT), Ferritin and biochemical markers such as Blood urea nitrogen and Lactate dehydrogenase (p < 0.001). We detected that areas under the ROC curve for BECN1, D-dimer, FIB, PCT, CRP and Ferritin were 0.8662, 0.9110, 0.8278, 0.9996 and 0.9284, respectively (p < 0.0001). Significance: BECN1 may serve as a predictive biomarker in evaluating the disease severity of COVID-19. Our data suggest that BECN1 mediated-autophagy modulation might have a promising value in improving the clinical outcomes of COVID-19.
Can it be osteoarticular involvement in the brucellosis?
(Taylor & Francis Ltd, 2023) Gozdas, Hasan Tahsin; Bal, Tayibe
[Abstract Not Available]
A Case of Chemical Ventriculitis Due to Intraventricular Colistin Treatment
(Derman Medical Publ, 2014) Dorum, Bayram Ali; Bal, Tayibe; Ozer, Utku; Aygun, Fatma Deniz; Silfeler, Ibrahim
Nosocomial infections of central nervous system have high mortality, if they are due to Acinetobacter spp., the rate can be as high as 70%. Intraventricular treatment of ventriculitis, caused by Acinetobacter baumannii can be considered as current treatment choice, because of this high mortality. Here in, we report a case of ventriculitis, caused by A. baumannii related to ventriculoperitoneal shunt. We used to treat both with intravenous meropenem, colistin, rifampicin and intraventricular colistin and gentamcin because of persistent ventriculitis after removel of the shunt and multi drug resistant blood flow infection of A. baumannii. The culture of cerebrospinal fluid (CSF) became sterile with intraventricular treatment, but pleocytosis, fever and low glucose level of CSF persisted and chemical ventriculitis was considered to become. We continued the treatment with decreasing the dosage and increasing the interval of drug and were successful both in treatment of the infectious and chemical ventriculitis. The aim of this article is to report the successful treatment of ventriculitis caused by A. baumannii with intraventricular colistin in the fail of intravenous treatment, despite of reversible chemical ventriculitis.
Chest CT in COVID-19 pneumonia: correlations of imaging findings in clinically suspected but repeatedly RT-PCR test-negative patients
(Springer, 2021) Korkmaz, Inan; Dikmen, Nursel; Keles, Fatma Ozturk; Bal, Tayibe
Background: To emphasize the importance of CT in the diagnosis of COVID-19 disease by comparing the thoracic CT findings of COVID-19 patients with positive RT-PCR results and patients with clinical suspicion of COVID-19 but with negative RT-PCR results. Results: In our study, COVID-19 patients with positive RT-PCR results (RT-PCR (+) group) and patients with clinical suspicion of COVID-19 but negative RT-PCR results (RT-PCR (-) group) were compared in terms of CT findings. In CT images, ground-glass opacity and ground-glass opacity + patchy consolidation were the most common lesion patterns in both groups. No statistically significant differences in the rates and types of lesion patterns were observed between the two groups. In both groups, lesion distributions and distribution patterns were similarly frequent in the bilateral, peripheral, and lower lobe distributions. Among the 39 patients who underwent follow-up CT imaging in the first or second month, a regression in lesion number and density was detected in 18 patients from both groups. Consolidations were completely resorbed in 16 of these patients, and five patients had newly developed fibrotic changes. The follow-up CT examination of 16 patients was normal. Conclusions: Due to the false-negative rate of RT-PCR tests caused by various reasons, clinically suspected COVID-19 patients with a contact history should be examined with CT scans, even if RT-PCR tests are negative. If the CT findings are positive, these patients should not be removed from isolation.
COVID-19 disease severity to predict persistent symptoms: a systematic review and meta-analysis
(Cambridge Univ Press, 2022) Dirican, Emre; Bal, Tayibe
Background: It is unclear, whether the initial disease severity may help to predict which COVID-19 patients at risk of developing persistent symptoms. Aim: The aim of this study was to examine whether the initial disease severity affects the risk of persistent symptoms in post-acute COVID-19 syndrome and long COVID. Methods: A systematic search was conducted using PUBMED, Google Scholar, EMBASE, and ProQuest databases to identify eligible articles published after January 2020 up to and including 30 August 2021. Pooled odds ratio (OR) and confidence intervals (CIs) were calculated using random effects meta-analysis. Findings: After searching a total of 7733 articles, 20 relevant observational studies with a total of 7840 patients were selected for meta-analysis. The pooled OR for persistent dyspnea in COVID-19 survivors with a severe versus nonsevere initial disease was 2.17 [95%CI 1.62 to 2.90], and it was 1.33 [95%CI 0.75 to 2.33] for persistent cough, 1.30 [95%CI 1.06 to 1.58] for persistent fatigue, 1.02 [95%CI 0.73 to 1.40] for persistent anosmia, 1.22 [95%CI 0.69 to 2.16] for persistent chest pain, and 1.30 [95%CI 0.93 to 1.81] for persistent palpitation. Conclusions: Contrary to expectations, we did not observe an association between the initial COVID-19 disease severity and common persistent symptoms except for dyspnea and fatigue. In addition, it was found that being in the acute or prolonged post-COVID phase did not affect the risk of symptoms. Primary care providers should be alert to potential most prevalent persistent symptoms in all COVID-19 survivors, which are not limited to patients with critical-severe initial disease.
COVID-19 hastalarında çinko düzeylerinin incelenmesi
(2022) Doğan, Serdar; Bal, Tayibe
Amaç: Çinko (Zn), immün yanıtı güçlendirici etkisinin yanı sıra viral enfeksiyonlara karşı savunmada da rol oynadığı bilinen önemli bir eser elementtir. Bu çalışma ile kliniğimizde izlenen COVID-19 olgularında Zn düzeylerinin belirlenerek, rutin laboratuvar parametreleri ve hastalık şiddeti ile olan ilişkisinin irdelenmesi amaçlanmıştır.\rYöntem: Çalışmaya 135 COVID-19 hastası ile 26 sağlıklı birey dahil edilmiştir. Serum Zn, düzeyleri kolorimetrik yöntem ile ölçülmüştür. Ayrıca kreatinin, ALT, AST CK, LDH, ferritin, CRP, D-dimer ve fibrinojen düzeyleri değerlendirilmiştir.\rBulgular: Serum Zn düzeyleri tüm hasta gruplarında kontrol grubuna kıyasla; orta, ağır ve kritik hasta gruplarında ise hafif hasta grubuna kıyasla istatistiksel olarak anlamlı düzeyde düşük bulunmuştur. Ayrıca Zn düzeyleri kreatinin, ALT, AST, CK, lökosit düzeyleri ile zayıf negatif ve anlamlı bir korelasyon gösterirken, yaş, CRP, ferritin, D-dimer ve fibrinojen düzeyleri ile anlamlı, orta derecede ve negatif yönde bir korelasyon göstermiştir.\rSonuç: Serum Zn düzeyleri COVID-19 hastalarında sağlıklı bireylere göre istatistiksel olarak anlamlı oranda daha düşüktür. COVID-19 olgularında hastalık şiddeti ile serum Zn düzeyleri arasında net bir ilişki bulunamamış olsa da hastalık şiddeti ile ilişkili biyokimyasal ve inflamatuar markırlar ile serum Zn düzeyleri arasında anlamlı bir ilişki olduğu görülmüştür.
Cutaneous Leishmaniasis with Mucosal Involvement
(Galenos Publishing House, 2021) Çabalak, Mehmet; Çulha, Gülnaz; Bal, Tayibe; Kaya, Tuğba; Çelik, Ebru
Leishmaniasis 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.
Direct-acting antiviral therapy may help restore HCV-induced impaired redox balance and liver fibrosis process
(Walter De Gruyter Gmbh, 2023) Bal, Tayibe; Dogan, Serdar; Ozcan, Oguzhan; Cabalak, Mehmet; Cirkin, Berfin
Objectives: The aim of this study was to investigate the changes in thiol/disulfide balance, pro-fibrotic mediators (transforming growth factor-beta [TGF-beta] and periostin) and a potential biomarker for the prediction of HCV-induced HCC (3 beta-hydroxysterol Delta 24-reductase [DHCR24]) during direct-acting antiviral (DAA) therapy in chronic hepatitis C (CHC) patients. Methods: This prospective cohort study included 56 non-cirrhotic, treatment-naive CHC patients who were treated with DAAs between January and June 2020. Laboratory tests, including serum total/native thiol, TGF-beta, periostin, DHCR24, total bilirubin and albumin levels were measured and disulfide levels were calculated at baseline, then at 1 month and at the end of therapy (EOT). Results: Of the 56 patients, all achieved a sustained virological response after DAA therapy. There was a significant decrease in serum levels of disulfide and TGF-beta, (p=0.020 and p<0.001, respectively) and a significant increase in serum levels of native thiol compared with baseline levels (p=0.010). There was no significant change in levels of total thiol, DHCR24 and periostin levels. Serum TGF-beta levels were found to be positively correlated with total bilirubin levels (r(s)=0.470, p=0.001) and negatively with albumin levels (r(s)=-0.483, p<0.001). Asignificant moderate positive correlation was determined between baseline serum DHRC24 and disulfide levels (r(s)=0.356, p=0.007). Conclusions: The study results suggest that the DAA therapy may help to restore the impaired thiol/disulfide balance and reduce the pro-fibrotic process in CHC patients by markedly decreasing serum levels of TGF-beta, a key player in HCV-induced liver fibrosis.
Duodenal bölge tutulumu ile seyreden mortal nötropenik enterokolit olgusu
(2022) Yaqoobi, Hasibullah; Bal, Tayibe; Çabalak, Mehmet; Önlen, Yusuf; Ocak, Sabahattin
Nötropenik 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.
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, Mehmet
Objectives: 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 diabetics
Effectiveness of oral direct acting antivirals in elderly chronic hepatitis C patients: real-world data
(Türk Geriatri Derneği, 2020) Çabalak, Mehmet; Bal, Tayibe
Introduction: 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.
The Effects of Antivirals for Human Immunodeficiency Virus Treatment on Renal Functions
(Galenos Publ House, 2022) Cabalak, Mehmet; Bal, Tayibe; Turgut, Faruk Hilmi
Objective: Turkey is among the countries with a low incidence of the human immunodeficiency virus (HIV) infections. When HIV cases are decreasing worldwide, our country is among the countries where the number of patients is rapidly increasing. Tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF), and abacavir are the drugs used for HIV treatment in Turkey. The estimated glomerular filtration rate (eGFR) is widely used as a kidney function indicator. This study aimed to investigate the effects of TDF and TAF-based regimens on renal function. Materials and Methods: During the study period, 104 patients who are HIV-positive underwent treatment with an antiretroviral therapy (ART) regimen, of whom 60 fulfilled the inclusion criteria and were included in the study. This study retrospectively examined the effects of TAF and TDF-based regimens on eGFR and other routine parameters. Results: Patients receiving TDF-based regimens revealed significantly increased serum creatinine and decreased eGFR levels compared to pretreatment levels. Conversely, patients receiving a TAF-based regimen did not show significant changes in eGFR or serum creatinine levels. Conclusion: Our data indicate that eGFR levels decrease with a TDF-based regimen. Thus, with TDF as a component of the ART regimen, eGFR levels should be carefully monitored. TDF-free regimens should be used in patients who are predicted to have impaired renal function and those with renal function changes during treatment.
Efficacy and Safety of Direct-Acting Antivirals in Elderly Patients with Chronic Hepatitis C: A Nationwide Real-Life, Observational, Multicenter Study from Turkey
(Aves, 2022) Onlen, Yusuf; Bal, Tayibe; Cabalak, Mehmet; Oztoprak, Nefise Cuvalci; Sari, Nagehan Didem; Kurtaran, Behice; Senates, Ebubekir
Background: The number and proportion of elderly patients living with chronic hepatitis C are expected to increase in the coming years. We aimed to compare the real-world efficacy and safety of direct-acting antiviral treatment in elderly and younger Turkish adults infected with chronic hepatitis C. Methods: In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (>= 65 years) and younger adults (<65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups. Results: The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P =.879, P =.508 for modified evaluable population and P =.058, P =.788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir + ribavirin had a significantly lower sustained virological response 12 rates (P <.001, P =.047, P =.013, and P =.025, respectively). Conclusion: Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults.
Efficacy of ultrasound-guided percutaneous drainage in the treatment of psoas abscess
(Bayrakol Medical Publisher, 2022) Kayali, Alperen; Beyazit, Selen; Keles, Fatma Ozturk; Bal, Tayibe; Seyfettin, Ayca; Ugur, Mustafa
Aim: In this study, we aimed to evaluate the efficacy of ultrasound-guided percutaneous drainage applied to cases determined with psoas abscess, and to investigate predisposing factors and micro-organisms causing the disease.Material and Methods: Twenty-eight patients were examined, including 15 males and 13 females, aged 22-87 years, who underwent ultrasound-guided percutaneous drainage. Predisposing factors for the development of psoas abscess, the need for an additional surgical procedure after percutaneous abscess drainage, length of stay in hospital after the procedure, complications, and agent micro-organisms were evaluated. The efficacy of percutaneous drainage in the treatment was investigated.Results: The most common agents were determined to be Staphylococcus aereus, Escherichia coli, and Mycobacterium tuberculosis. Primary psoas abscess was determined in 6 (21.4%) patients and secondary psoas abscess in 22 patients. In cases with secondary psoas abscess, skeletal origin predisposing factors (spondylodiscitis, history of abdominal or vertebral surgery) were seen to most often play a role in the etiology. In 20 of the 22 (78.5%) patients with secondary psoas abscess, effective treatment was applied with antibiotherapy and percutaneous drainage. The mortality rate was 10.7%.Discussion: Low morbidity and mortality rates are the greatest advantages of percutaneous drainage. Although CT has emerged as a better diagnostic method for psoas abscess, ultrasound-guided percutaneous drainage has the advantages of easy availability, low cost, and it does not contain radiation. Ultrasound -guided percutaneous drainage is an effective and reliable method in the treatment of psoas abscess.
Electrocardiographic findings and cardiac safety of hydroxychloroquine+azithromycin in hospitalized patients with COVID-19
(Cukurova Univ, Fac Medicine, 2021) Akkus, Oguz; Bal, Tayibe; Yagoobi, Hasibullah; Bekler, Ozkan; Akkus, Gamze; Cabalak, Mehmet
Purpose: The aim of this study was to determine the novel arrhythmia markers (Tpe, cTpe, cTpe/cQT) in addition to standard evaluation of 12-derived electrocardiography (ECG) and effects of therapy in patients with COVID-19. Materials and Methods: We evaluated 12-derived ECG in 51 patients with COVID-19 at the pre-treatment stage and on the 2nd and 5th days of the treatment, retrospectively. Patients were treated by either hydroxychloroquine (HCQ) + azithromycin or HCQ alone. Severe COVID-19 patients were defined with the presence of clinical signs and symptoms of pneumonia plus SpO2<90%, or respiratory rate > 30 breathe/minute. Results: While 68.6% of patients received HCQ + azithromycin combination therapy, 31.4% of patients received HCQ monotherapy. On the 2nd day of the treatment, heart rate was the only statistically significant variable either on the treatment of HCQ + azithromycin or HCQ alone. On the 5th day of treatment, in addition to the heart rate, Tpe and cTpe levels were also statistically significant among the whole treatment regimens. Although Tpe statistically significantly increased in both treatment strategies during treatment, increasing relative Tpe ratios were similar between both of the treatment strategies. Conclusion: The results of our study suggests that those off-label drugs (HCQ/azithromycin) have an acceptable cardiac safety profile in COVID-19 disease during short hospitalization.
Examination of the Reasons for Change in Treatment in Patients Infected with Human Immunodeficiency Virus
(Galenos Publ House, 2023) Cabalak, Mehmet; Bal, Tayibe; Polat, Eda Selin; Ocak, Sabahattin; Onlen, Yusuf
Introduction: Highly active antiretroviral therapy (HAART) has significantly reduced morbidity and mortality in patients infected with Human immunodeficiency virus (HIV). Despite this success, the sustainability of the initial treatment regimen has become difficult as patients continue the treatment for life. Highly active antiretroviral therapy regimen change may often be necessary due to intolerance/toxicity, pregnancy, comorbidities, difficulty in patient compliance and failure to achieve virological suppression. In this study, it was aimed to examine the reasons for HAART change in patients followed up for HIV/AIDS in Hatay Mustafa Kemal University, Tayfur Ata Sokmen Faculty of Medicine Hospital. Materials and Methods: In this retrospective, cross-sectional, single-center study, 151 patients followed up at Hatay Mustafa Kemal University, Tayfur Ata Sokmen Medical Faculty Hospital for HIV between January 2018 and December 2020 were included in the study. Results: One hundred-seventeen (77.5%) of the cases were male and 34 (22.5%) were female. The mean age was 39.08 +/- 14.2 years (20-83). Treatment changes were made in 35 (23.2%) of the cases. The most common reason for treatment change was intolerance/toxicity (19) in 12.6% of cases. Other reasons for change; pregnancy was six (4%), treatment non-compliance was four (2.6%), patient request was three (2%), and physician decision was three (2%). No drug changes were detected in the cases due to virological failure. Conclusion: There is generally little data available in Turkey on the reasons for regime change in HIV patients using HAART. Therefore, the data we will obtain in this study can help draw a long-term plan for HAART drug management.
Frequency of Hepatitis B Virus Screening in Patients with Systemic Lupus Erythematosus
(Galenos Yayincilik, 2020) Cabalak, Mehmet; Kimyon, Gezmis; Bal, Tayibe
Introduction: Immunosuppressive drug use is common in the treatment of systemic lupus erythematosus (SLE). In cases receiving immunosuppressive therapy, screening for hepatitis B reactivation risk is also recommended. In this study, we aimed to investigate the frequency of hepatitis B screening in cases diagnosed as having SLE, who were followed up in the Rheumatology Clinic of Hatay Mustafa Kemal University. Materials and Methods: We included 93 patients who were followed-up in the Rheumatology Clinic of Hatay Mustafa Kemal University with the diagnosis of SLE between July 2017-December 2019 in our study. The screening rates of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core protein antibody (anti-HBc IgG) of the cases and the immunosuppressive drugs used by them were analyzed retrospectively. Results: The mean age of the cases was 38 years (minimum-maximum: 18-79), and 91.4% were women. Of the cases, 43 (46.2%) were determined to be never screened for hepatitis B, 34 (36.6%) screened inadequately, and only 16 (17.2%) screened fully. In 22 cases receiving high-risk immunosuppressive therapy, the rate of full screening of hepatitis B was 27.3%. Conclusion: In patients with SLE, even those who used high-risk immunosuppressive therapy, screening rates were found low. We think that awareness should be increased in this regard by performing joint training with clinics that start immunosuppressive therapy, a periodic repetition of these trainings should be done, and also multi-center studies should be conducted.
Genotype distribution of Hepatitis C Virus in Hatay province of Turkey
(Galenos Yayınevi, 2020) Çabalak, Mehmet; Bal, Tayibe; Demir, Mehmet; Ocak, Sabahattin; Önlen, Yusuf
Objectives: 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 HCV
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, Gülnaz
Amaç: 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.

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