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Öğe High dose oral furosemide with salt ingestion in the treatment of refractory ascites of liver cirrhosis(The Canadian Society for Clinical Investigation, 2016) Yakar, Tolga; Demir, Mehmet; Dogan, Ozlem; Parlakgumus, Alper; Ozer, Birol; Serin, EnderPurpose: We aimed to evaluate and compare the efficacy and safety of high-dose furosemide+salt orally by comparing HSS+ furosemide (i.v.) and repeated paracentesis in patients with RA. Methods: This was a prospective study of 78 cirrhotic patients with RA, randomized into three groups: Group A (n= 25) i.v. furosemide (200-300 mg bid) and 3% hypotonic saline solution (HSS) (once or twice a day); Group B (n= 26) oral furosemide tablets (360-520 mg bid) and salt (2.5 g bid); and, Group C (n= 27) repeated large-volume-paracentesis (RLVP) with albumin infusion. Patients without hyperkalemia were administrated 100 mg of spironolactone/day. During the follow-up; INR, creatinine, and total bilirubin levels were measured to determine the change in MELD (model of end stage liver disease) score. Results: Hepatic encephalopathy (HE), severe episodes of spontaneous bacterial peritonitis (SBP) and pleural effusions (PE) occurred more frequently in Group C. Improvement in Child-Pugh and MELD score was better in Group A and B than Group C. In Group B, improvements were seen in the Child-Pugh and MELD score, reduction in body weight, duration and number of hospitalization. In Groups A and B, remarkable increases in diuresis were observed (706±116 to 2425±633 mL and 691±111 to 2405±772 mL) and serum sodium levels also improved. HE and SBP were occurred more often in group C (p<0.002). Hospitalization decreased significantly in Group B (p<0.001). There was no significant difference in survival among groups. Conclusion: High dose oral furosemide with salt ingestion may be an alternative, effective, safe and well-tolerated method of therapy for RA. © 2016 CIM.Öğe Glomus tumor of the hip. An unusual location(2009) Hakverdi, Sibel; Kalacı, Aydıner; Yaldiz, Mehmet; Akansu, BülentGlomus tumors are usually benign neoplasms that occur in the dermis or subcutaneous tissues of the extremities. They occur very rarely in the hip. We report a patient with severe pain and tenderness in the left hip, especially on palpation, and in the sitting position. On physical examination, there was a soft palpable subcutaneous mass and severe tenderness in the left hip. Ultrasound revealed a hypervascular subdermal mass that was 1.2 cm in diameter, which was subsequent totally excised under local anesthesia. The histopathologic diagnosis was a 'glomus tumor'. The patient has been symptom-free for 3 months of follow-up.Öğe Inflammatory linear verrucous epidermal nevus with genital involvement(Pulse Marketing and Communications LLC, 2012) Balci, Didem Didar; Yenin, Jülide Zehra; Çelik, Ebru; Sarikaya, Gökhan; Atik, EsinAn 18-year-old woman was admitted to our clinic complaining of pruritic lesions on her inguinal and genital areas that had been present since birth. She had previously used topical steroids and a combination of topical steroids and calcipotriol for approximately 6 months; however, the treatment was unsuccessful. Her medical history was unremarkable. On dermatologic examination, mild erythematous, lichenified, and verrucous papules occurring in a linear pattern on the right inguinal area and on the region extending from the right labium majus to the perianal area were noted (Figure). Additionally, an erythematous area with central erosion surrounded by maceration was noted on the intergluteal area. Two separate punch biopsy samples were obtained from the erythematous, lichenified, verrucous, papular lesion on the inguinal area and from the erythematous, eroded, macerated lesion on the intergluteal area. Histopathological examination of both biopsy specimens revealed a thin orthokeratotic layer and scattered parakeratotic layers, as well as papillomatosis and acanthosis of the epidermis with a slight hyperpigmentation of the basal layer. A mild, perivascular, chronic inflammatory cell infiltration was noted in the dermis. Based on the clinical and histopathological findings, the patient was considered to have inflammatory linear verrucous epidermal nevus, and cryotherapy was initiated. At the 2-week follow-up after the first application, it was observed that the itching complaint decreased substantially and the eroded lesions in the intergluteal area were re-epithelialized. On clinical follow-up, no improvement was observed in the papular component of the lesion after 4 sessions of cryotherapy. The patient voluntarily discontinued the follow-up after 4 sessions of cryotherapy. © 2012 Pulse Marketing & Communications, LLC.Öğe Nasobiliary drainage for benign recurrent intrahepatic cholestasis in patients refractory to standard therapy(The Canadian Society for Clinical Investigation, 2016) Yakar, Tolga; Demir, Mehmet; Gokturk, Huseyin S.; Kanat, Ayse G. Unler; Parlakgumus, Alper; Ozer, Birol; Serin, EnderPurpose: Benign recurrent intrahepatic cholestasis (BRIC) is characterized by episodic cholestasis and pruritus without anatomical obstruction. The aim of this study was to evaluate the safety and efficacy of nasobiliary drainage (NBD) in patients with BRIC refractory to medical therapy and to determine whether the use of NBD prolongs the episode duration. Methods: This was a multicenter retrospective study consisting of 33 patients suffering from BRIC. All patients were administrated medical treatment and 16 patients who were refractory to standard medical therapies improved on treatment with temporary endoscopic NBD. Duration of treatment response and associated complications were analyzed. Results: Sixteen patients (43% females) underwent 25 NBD procedures. The median duration of NBD was 17 days. There were significant improvements in total and direct bilirubin and alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and gamma-glutamyl transpeptidase on the 3rd day of NBD. Longer clinical remission was monitored in the NBD group. Post-endoscopic retrograde cholangiopancreatography pancreatitis was observed in one of 16 cases. Conclusion: NBD effectively eliminates BRIC in all patients and improves biomarkers of cholestasis. It can be suggested that patients with attacks of BRIC can be treated with temporary endoscopic NBD; however, the results of this study should be confirmed by prospective studies in the future. © 2016 CIM.Öğe Fecal examination of Shami goats from Damascus with respiratory syndrome(2006) Yaman, Mehmet; Gökçen, Ahmet; Güzel, MuratThis study was carried out in order to determine the prevalence of helminth species and their relation to the respiratory syndrome in Damascus goats bred in Hatay, Turkey. Fecal samples obtained from 130 Shami goats with respiratory signs including coughing, growling respiration and mucopurulent discharge were examined using the Fulleborne's salt saturated flotation, Benedek sedimentation and Baerman Wetzel methods. Helminth invasions were commonly observed in the goats. Of these goats, 68.46% were found to be infected by various helminth species. Besides this, 30% of the goats were infected with Eimeria species. The percentage of lung nematodes causing respiratory syndrome in goats was found to be 18.46. In conclusion, the goats with respiratory syndrome should also be examined for lung nematodes.Öğe Strongyloides stercoralis in a patient complaining of chronic diarrhea(2006) Culha, Gülnaz; Savaş, Lütfü; Onlen, YusufIn this study, a case of Strongyloides stercoralis infection in a 38-year-old patient with complaints of chronic diarrhea and stomach ache is presented. His history showed that the patient who has been a mechanic for 25 years is a farmer as well. S. stercoralis larvae were found during the parasitological examination of the patient's stool samples taken 3 times. The patient was given Albendazol (400 mg a day) for fifteen days. After the patient started to take Albendazol, there was a reduction in the number of parasites in the stool examined on the fifth day. In the stool examinations made on the tenth day, fifteenth day and after the treatment ended, no parasites were seen. When the treatment was completed, all the complaints of the patient disappeared. It was found that no investigation of parasitic infection had been made previously and he had been given different treatments. For this reason, it is important to investigate the possibility of parasitic infection in patients with chronic diarrhea.Öğe Pain associated with heterotopic ossification: Does it have a neurogenic component as well?(American Society of Interventional Pain Physicians, 2014) Ekiz, Timur; Yetisgin, Alparslan; Yildizgoren, Mustafa Turgut; Onat, Sule Sahin[No abstract available]Öğe The distribution of patients with intestinal parasites presenting at the parasitology laboratory of the Mustafa Kemal University medical faculty(2006) Culha, GülnazIn this study, fecal specimens of 3,679 patients presenting at the parasitology laboratory of the Medical Faculty of the Mustafa Kemal University between September and May 2005 were examined for intestinal parasites. A total 3,679 stool specimens from 1,260 (34.3%) males and 2,419 (65.7%) females for intestinal parasites using the native-Lugol method were examined. Intestinal parasites were found in 265 (34.23%) male and 509 (65.76%) females. One or more intestinal parasites were detected in 774 (21.03%) patients. A total of 1,720 cellophane tape specimens were examined (64 (38.60%) male and 1,056 (61.39% female). E. vermicularis was found in a total of 150 (8.72%) patients; of whom 65 (9.78%) were male patients and 85 (8.04%) female. The distribution of intestinal parasites detected in stool specimens were follows: (31.5%) Giardia intestinalis, (25.3%) Blastocystis hominis, (18.30%) Entamoeba coli, (13.40%) Entamoeba histolytica/dispar, (1.2%) Dicrocoelium dentriticum, (%1) Ascaris lumbricoides, (%2. 8) Iodamoeba bütschlii, (%1.20) Chilomastix mesnili, (1.4%) Hymenolepis nana, (1.8%) Trichomonas hominis, (0.2%) Strongyloides stercoralis and (0.7%) Taenia saginata.Öğe Detection of cutaneous leishmaniasis cases in Hatay and surrounding areas(2006) Culha, Gülnaz; Akçali, CenkLeishmaniasis; is a disease that is transmitted by infected sand flies when they suck the blood of mammals. Cutaneous leishmaniasis (CL), which is given such names as the Antep boil in Turkey, is mostly seen on the skin and sometimes on the mucosa and heals with a recessed scar. Between June 2003 and October 2005, 55 patients with skin lesions presented at the parasitology laboratory of the Mustafa Kemal University Medical Faculty for the detection of CL. Microscopic examination showed Leishmania amastigotes in 40 patients who were given a diagnosis of CL. Thirteen patients were men (32.5%) and 27, women (67.5%). The most frequent age range was 0-20 (57.0%). The lesions were mostly found on the face in 27 (67.5%) patients and on the hands and feet in 13 (32.5%). Fourteen patients (35.0%) had 2 or more lesions. The duration of the lesions was from a minimum of 1 month to a maximum of 3 years. The patients were mostly from Iskenderun/Kirikhan, Iskenderun/Arsus Serinyol, Altinözü, Samanda? Antakya, Harbiye and they were farmers. Cutaneous leishmaniasis was more often detected during the May-June period. Some patients came to our laboratory from regions that had not reported CL before. Therefore, we think that CL has been increasing in Hatay and its surroundings.Öğe Exercise-induced T wave normalization in a patient with stable angina pectoris(2008) Yalçin, Hülya; Küçukler, Nagehan; Gürbüz, Süleyman; Reyhan, Mehmet; Erol, Tansel; Atalay, Hakan; Yalçin, Fatih[No abstract available]Öğe The effectiveness of the Epley maneuver for the treatment of BPPV and the role of nystagmus direction as an early indicator of successful treatment(2007) Ako?lu, Ertap; Okuyucu, Semsettin; Okuyucu, Esra; Melek, Ismet Murat; Duman, Taşkin; Da?li, Ali SafakOBJECTIVES: We investigated the role of the direction of nystagmus that might occur during the Epley maneuver as an early indicator for treatment success in benign paroxysmal positional vertigo (BPPV). PATIENTS AND METHODS: The study included 47 patients (24 males, 23 females; mean age 46+/-12 years; range 29 to 70 years) who underwent the Epley maneuver for BPPV. The occurrence and the direction of nystagmus were observed. RESULTS: Nystagmus occurred in 16 patients during the maneuver, being ipsilateral in nine patients and contralateral in seven patients. The treatment was successful in seven patients (77.8%) with ipsilateral nystagmus, whereas none of the patients with contralateral nystagmus benefited from the maneuver. While there was no significant relationship between ipsilateral nystagmus and the success of the treatment (p=0.625), a significant correlation was found between contralateral nystagmus and treatment failure (p=0.000). CONCLUSION: The occurrence of contralateral nystagmus during the Epley maneuver may be a sign of an unsuccessful result.Öğe Control of phlebotomine sandflies and the latest development in this field(2008) Yaman, MehmetPhlebotomine sandflies make people uncomfortable because of biting and because they transmit various diseases. Especially, leishmaniasis is a serious public health problem in a number of countries, and requires control management. No effective control methods have been found for immature sandflies. On the contrary, the studies on destruction and modification of their habitats have found to be suitable for mature sandflies. Barrier spraying method recommended for exophilic sandflies are generally unsustainable and uneconomical. Although residual insecticide spraying of dwellings is successful in urban areas with high concentrations of endophilic sandflies, it may be both impractical and ineffective in rural areas where dwellings are more dispersed and surrounded by a large, untargeted reservoir of sandflies. Therefore, insecticide impregnated bed nets and curtains may be the best choice in rural areas. However, these applications do not replace other methods. Control of zoonotic cutaneous leishmaniasis would be control with insecticide-impregnated dog collars. In addition, alternative control methods such as avermectin or microbial agents spraying of the sandflies' sugar supplying vegetation and the use of pheromone baits are still under investigation. Moreover, antibodies produced by the host against the salivary glands of sandflies shown promise in the development of vaccination in the control of both sandflies and leishmaniasis.Öğe Sudden die-off of honeybee colonies(2008) Muz, Mustafa NApis mellifera is used for honeybee keeping all over Turkey. Recently, honeybees have been suddenly disappearing for no apparent reason. It is presumed that some viral and parasitic honeybee pathogens are responsible for this. No medical research has been conducted to determine the pathologic causes of the sudden die-off of the honeybee colonies in Turkey as yet. This is of urgent importance for future of the honeybee industry.Öğe A case of Diplotriaena monticola (Yamaguty, 1935) in the white-spectacled bulbul (Pycnonotus xanthopygos)(2007) Yaman, Mehmet; Ayaz, ErolIn Hatay, 13 nematodes (8 [female symbol] and 5 [male symbol]) were observed in the thoracic cavity of a white-spectacled bulbul (Pycnonotus xanthopygos). The parasites were cleared with lactophenol and then investigated under the light microscopy and important morphological parts of parasites were measured. The parasites were identified as Diplotriaena monticola Yamaguty, 1935 (Fam.: Filariidae) under the subfamily of Diplotriaeninae. It is important because this case is the first report of this infection in a white-spectacled bulbul in Turkey.Öğe Investigation of helminth infections of cats and dogs in the Hatay province(2006) Yaman, Mehmet; Ayaz, Erol; Gül, Abdurrahman; Muz, Mustafa NecatiIn this study autopsies and fecal examinations of 8 cats and 6 dogs were performed. The helminth infection rate was founded to be 50.0% in cats and dogs after the fecal examinations. Trichuris sp. eggs were found in feces of one dog, and Ancylostoma sp. eggs in feces of one cat and one dog. Seven (87.5%) cats and 2 (33.4%) dogs were found to be infected with various helminths according to the results of the autopsies. The helminth species and their rates were Toxocara cati (62.5%), Joyeuxiella pasqualei (50.0%), Hydatigera taeniaformis (25.0%), Mesocestoides sp. (12.5%) and Dipylidium caninum (12.5%) in cats; T. canis (16.7%) and D. caninum (16.7%) in dogs during the autopsies. Numerous tetrathyridium larvae of the Mesocestoides sp. were found in the abdominal cavity of one cat. In conclusion, the high prevalence of ascarid infections in cats and dogs may be important for human health.Öğe Investigation of the prevalence of Trichomonas vaginalis in women with complaints of vaginal discharge and itching(2006) Culha, Gülnaz; Hakverdi, Ali Ulvi; Zetero?lu, Sahin; Duran, NizamTrichomonas vaginalis (T. vaginalis) is the most common pathogen that is sexually spread in women. In this study, the presence of Trichomonas vaginalis was investigated in patients with vaginal discharge and itching who presented at the polyclinic of the Mustafa Kemal University Medical Faculty Department of Gynecology. These women were between 20-40 years of age. During gynecologic examination of patients, vaginal fluid samples were collected with swaps from the speculum and fornics to two tubes that contained sterile saline. One of the vaginal discharges collected with swaps was used for direct microscopic examination and Giemsa staining. The other one was used for culturing for T. vaginalis in Trichomonas medium that contained horse serum and antibiotics. While the fre-quency of T. vaginalis was found to be 1.81% (5 of the 275 samples) by the direct microscopic examination and Giemsa stain, this ratio was 2.18% (6 of the 275 samples) by the culture method. In conclusion, it was decided to use the culture method in diagnosis of T. vaginalis in addition to direct microscopic examination. This was the first study of T. vaginalis infection in our region and it was compared with other studies carried out in other regions of Turkey. Our results were somewhat lower than those in other regions.Öğe [Ruptured pulmonary hydatid cyst: a case report].(2012) Çelik, Tanju; Akçora, Bülent; Tutanç, Murat; Yetim, Tülin Durgun; Karazincir, Sinem; Akin, Mehmet Mustafa; Çelikkaya, Mehmet EminHydatid cyst (HD), a very common disease in the world, is often transmitted to humans through dog feces. HD is especially common in countries where agriculture and animal husbandry is prevalent. HD is caused by Echinococcus granulosus. The clinic course of HD usually features settling in the liver and lungs. Lung involvement with chest pain, cough, shortness of breath can cause non specific symptoms such as fever and hemoptysis. Diagnostic interventions for HD include chest X-ray tomography, and physical examination. Although the treatment options of HD vary according to the clinical findings of the patients, the primary treatment may be considered as surgery. The most frequently applied methods of surgical treatment are cystectomy and capitonnage. Medical treatment is usually warranted for complicated cases, including the patients with multiple and unresectable lesions, patients who refuse surgery and the patients who cannot tolerate surgery. Treatment with albendazole and its derivatives are used. In this case report, we present a child with primary complaints of cough, chest pain, dyspnea, fatigue and fever who was latterly diagnosed with lung HD.Öğe Problem of cystic echinococcoss in Hatay(2008) Hakverdi, Sibel; Culha, Gülnaz; Canda, M Serefettin; Yaldiz, Mehmet; Altintaş, SüleymanEchinococcosis is a zoonotic infection caused by Echinococcus granulosus and E. multilocularis. It continues to be a serious public health problem in many countries including Turkey. In Hatay, no previous study has been carried out; therefore, in this study, in order to determine its prevalence and to attract scientific attention to this issue, we have retrospectively evaluated cases of cystic echinococcosis in human patients presenting at the pathology laboratory of the Mustafa Kemal University, Faculty of Medicine, Research Hospital, as well as Antakya and Iskenderun State Hospitals. We have identified a total of 26 cases, of which 18 were in female patients (69.23%) and 8 in male patients (30.76%). The highest rate of cystic echinococcosis was found in the liver (57.6%), and lungs (19.23%). It was also found in the peritoneal region, spleen, cervical region, muscle, and an incision scar. In addition, the presence of cystic echinococcosis was investigated in 35,812 cattle slaughtered in Antakya slaughterhouse and 5,448 (3.23%) were found to have cystic echinococcosis.Öğe Falciparum malaria originating in foreign country: four cases(2007) Onlen, Yusuf; Culha, Gülnaz; Ocak, Sabahattin; Savaş, Lütfü; Güllü, MuratMalaria has been commonly determined in tropical and subtropical regions and the Plasmadium (P.) vivax generally occurs in our country, Turkey. However, in the people who have been travelling abroad from Turkey P. falciparum and P. malaria were also detected. The diagnosis was confirmed by microscopy of Giemsa stained thin and thick blood slides in four cases, at a magnification of 1000. The diagnosis of four cases was made by seeing the gametocytes of P.falciparum in thin blood films. The cases were found in Hatay region and the patients are those working abroad. The cases are presented in order to emphasize on the necessity of giving education on public health and taking the precautions for the prevention of the disease and in order to draw attention to malaria diseases caused by different species from abroad and to the fact that it can be seen in local cases as well.Öğe Unusual localization of echinococcosis in Cukurova (134 cases)(2009) Hakverdi, Sibel; Sayar, Hamide; Yaldiz, Mehmet; Erdo?an, Seyda; Akansu, Bülent; Canda, M SerefettinEchinococcosis is a parasitic disease frequently occurring in societies where agriculture and raising animals are common. In Turkey, it is more commonly observed in eastern and middle Anatolia and in Marmara and Trakya regions. While there is a high rate of occurrence in the liver and lungs, Echinococcosis can occasionally be present in other tissues and organs. In this study which was carried out in the Cukurova region, we found 962 echinococcosis cases in a ten year period. Of these, 134 (13.9%) were located outside the liver and the lung. Our aim was to determine the rate of unusual location of echinococcosis cases in our region and draw attention to the issue.
