Gazi Medical Journal http://medicaljournal.gazi.edu.tr/index.php/GMJ Gazi University Medical Journal en-US Gazi Medical Journal 1300-056X <p>All opinions and reports within the articles that are published in the Gazi Medical Journal are the personal opinions of author(s). Gazi University, Editors and the publisher do not accept any responsibility for these articles. The journal is printed on acid-free paper.</p> The Effect of Mitomycin C on the number of Keratocytes on the Posterior Wall of the Stroma of Cornea after Photorefractive Keratectomy http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1780 <p><strong>Introduction: </strong>We have decided to investigate its effect on a number of keratocytes on the posterior wall of the stroma of cornea, in which stromal removal depth has little effect on.</p> <p><strong>Methods: </strong>This is a cohort clinical trial. All patients with the required criteria for entering the study after filling the consent, they were first examined by the Confoscan III system and then the number of keratocytes on the posterior wall of the stroma of cornea was measured. At the end of the treatment, patients were followed up (end of month 3) with posterior keratocytes cells’ count.</p> <p><strong>Results: </strong>In this study, out of 13 patients (26 eyes) referring to the clinic, 8 (51.5%) were male and 5 (38.5%) were female. The mean refractive index before surgery was -3.6 ± 0.8 diopters. Also, the mean number of keratocytes on the posterior wall of the stroma of cornea after surgery was 714.7 ± 12.9, with the lowest of 697.5 and the highest of 726.3. There was no statistically significant difference between the number of keratocytes before and after surgery (P = 0.838).</p> <p><strong>Conclusion: </strong>The use of 0.02% mitomycin, topically, during keratorefractive surgery does not affect the number of keratocytes on the posterior wall of the stroma of cornea<strong>.</strong></p> Hanieh Ahmadi Majid Reza Sheikh Rezaei Mohammad Naeim AminiFard Hamed Jafarpour Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 HeLa Hücrelerinde Sisplatinin MTOR, AKT, CCND1 ve STAT3 mRNA İfadesi Üzerine Etkileri http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1798 <p>Objective: Cervical cancer is one of the most tumors seen in womans and second leading cause of cancer death in women. Cisplatin (CDDP), a platin based compound, is the most important chemotherapeutic agent and effectively used for the treatment of sarcomas and solid tumors. It binds to the DNA with crosslinks and leads inhibition of replication, causing DNA damage. As a result of this action, apoptotic pathways are induced and cell death occurs. Methods: In this study, HeLa cells were treated with different concentrations of CDDP at 24 and 48 hours. Cell viability was determined by XTT method. Moreover, after treatment with selected doses of cisplatin, quantitative mRNA expression of mTOR, AKT, CCND1 and STAT-3 genes was analyzed using Real-Time PCR. Results: IC50 concentration of CDDP was found to be about 60 µM for 24h and 8 µM for 48h treatment. Moreover, all analyzed genes’ expression was shown to diminish only after 24 h treatment. On the other hand, no statistically significant change was found after 48 h cisplatin exposure with respect to quantitative mRNA expression. Conclusion: In our study, different mRNA expression pattern was found after CDDP treatment regarding to exposure time. Our study has been contributed the literature in terms of detecting the effect of conventional chemotherapeutic CDDP on cell survival pathways.</p> Ebru Alp Akın Yılmaz Hacer İlke Önen Ece Konaç Abdullah Ekmekçi Emine Sevda Menevşe Adnan Menevşe Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Evaluating the Effect of Prebiotics in the Rehabilitation of Gut Microbiota After Antibiotic Therapy in Rats http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1805 <p>The present study evaluated the effect of galacto-oligosaccharides (GOS) on gut microbiota after antibiotic treatment given two times a day. Four groups were made having six rats in each group. G1 was a control group fed on a basal diet. While, the remaining were treated in groups given antibiotic and GOS separately and also in combination as in G2. The dose of antibiotic and GOS was calculated by HED (Human Equivalent Dose) formula. Fecal samples were analyzed at the interval of five days for bacterial population especially <em>Bifidobacterium</em> spp., <em>Lactobacillus</em> spp. and <em>Escherichia coli</em> and total plate count was achieved using selective media. The results indicated that the growth of <em>Bifidobacterium</em> spp. and <em>Lactobacillus</em> spp. depended on GOS and antibiotic dose. The combination of GOS-Cephalexin is mostly of interest because due to the antibiotic. The results of <em>Bifidobacterium</em> spp. and <em>Lactobacillus</em> spp. were decreased while on GOS consumption, the growth of such species is increased. The results of G3 showed that the number of colonies of <em>Bifidobacterium</em> spp. and<em> Lactobacillus</em> spp. was significantly higher than G2 on the 5<sup>th</sup> day. Furthermore, the recovery rate was faster as compared to other groups. This research suggested that intake of GOS during antibiotic treatment significantly strengthen the microbiota by increasing the population of <em>Bifidobacterium</em> spp. and <em>Lactobacillus</em> spp. as well as reducing the number of <em>E. coli</em> that shows resistance to many antibiotics.</p> Rabia Omer Sanaullah Iqbal Bilal Sajid Mushtaq Muhammad Bilal Hussain Mustafa Nadhim Owaid Farhan Saeed Marwa Waheed Mohammad Ali Shariati Muhammad Usman Khan Toheed Ahmad Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Gilbert Sendromunun Hematolojik Parametreler Üzerine Etkisi var mı? http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1834 <p><strong>Amaç:</strong> Gilbert sendromu, artmış indirek bilirubin düzeyleri ile karakterize, tekrarlayan hafif sarılıklarla seyreden benign bir hastalıktır. Bu çalışmanın amacı, bilirubinin artmış seviyelerinin, kırmızı küre dağılım genişliği (RDW), ortalama trombosit hacmi (MPV), nötrofil/lenfosit oranı (NLR), platelet/lenfosit oranı (PLR) ve diğer hematolojik parametreler üzerindeki etkilerini araştırmaktır.</p> <p><strong>Yöntem:</strong> İşe giriş muayeneleri için başvuran 20-28 yaş arası toplam 1190 genç erkek birey çalışmaya alındı. İşe giriş muayeneleri kapsamında ayrıntılı anamnez alımı, detaylı fizik muayene, hematolojik ve biyokimyasal parametreleri, tüm abdominal ultrasonografileri yapıldı. Kriterleri karşılayan 774 hasta arasından indirekt bilirubin yüksekliği dışında patolojik neticesi olmayan 63 hastaya Gilbert sendromu tanısı kondu. Kontrol grubu olarak 70 hasta rastgele olarak 711 hasta arasından seçildi. İstatistiksel olarak karşılaştırma ve korelasyon analizleri yapıldı.</p> <p><strong>Bulgular:</strong> Gilbert sendromu grubunda RDW 12,0 ± 1,1; MPV 7,7 ± 0,7 fl; NLR 2,23±1,07; PLR 113,1±31,0 idi. Kontrol grubunun ise RDW değeri 11,8 ± 0,9 (p=0,153); MPV 8,2 ± 0,8 fl (p&lt;0,001); NLR 1,84 ± 0,78 (p=0,026); PLR 102,6 ± 28,1 (p=0,044) idi. Yapılan karşılaştırmalarda RDW’ de her iki grup arasında fark saptanmazken; Gilbert sendromlularda MPV kontrol grubuna göre istatistiksel olarak anlamlı düzeyde düşük, NLR ve PLR ise yüksek idi. Total bilirubin seviyeleri ile MPV ve lenfosit sayıları arasında anlamlı negatif korelasyon saptandı (p&lt;0,05).</p> <p><strong>Sonuç:</strong> Gilbert sendromunun kardiyoprotektif etkisinde, hematolojik parametrelerdeki değişiklikler rol oynayabilir.</p> Tolga Düzenli Başak Çakır Güney Alpaslan Tanoğlu Mustafa Kaplan Taner Akyol Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Determining White Blood Cell Count In Sterile Body Fluids: Cell Counting Chamber vs Sysmex UF-1000i http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1855 <p><strong>Background: </strong>Counting of cells in sterile body fluids other than blood and urine provides important diagnostic information. The aim of the study is to evaluate the performance of the body fluid module of Sysmex UF-1000i system in comparison with cell counting chamber results.</p> <p><strong>Methods: </strong>71 routinely collected sterile body fluid samples were evaluated. The samples were cerebrospinal fluid, peritoneal fluid, pleural fluid, synovial fluid, drain fluid and bile.&nbsp; Cell counts were simultaneously determined with both bright lined Neubauer Cell Counting Chamber® (Marienfeld, Germany) and Sysmex UF-1000i BF (Sysmex, Japan) according to the manufacturers’ recommendations. The results were evaluated statistically with interclass correlation coefficient (ICC) and related p- values were calculated.</p> <p><strong>Results:</strong> There were seven purulent samples. Outliers were seen between microscopic examination and Sysmex UF-1000i results with purulent samples. The difference between the cell counts of the two methods was 1979 cells (cells/ml) with outliers, and 69 cells (cells/ml) without outliers. The ICC with and without outliers were 0.128 and 0.963, respectively.&nbsp; With outliers, correlation between the two methods was not statistically significant (p=0.139). Without outliers, correlation between two methods was statistically significant (p&lt;0.001) and good agreement was observed.</p> <p><strong>Conclusions:</strong> our results showed that especially for macroscopically purulent samples, counting chambers would still be the best choice for WBC counting, however for macroscopically non-purulent samples Sysmex UF1000i is a good alternative instrument for rapid workflow especially in routine microbiology laboratory in sterile body fluids other than blood and urine.</p> Ebru Evren Ebru Us Zeynep Ceren Karahan Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Effects of Dental Extraction on Cognitive Functions in the Elderly http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1865 <p><strong>Objective: </strong>Dental extraction can be a cause of short-term cognitive decline in elderly patients. In this research, we aimed to evaluate cognitive functions using the Mini-Mental State Examination before and after tooth extraction in elderly patients who have undergone dental extraction with local anesthesia.</p> <p><strong>Methods: </strong>A group of 40 randomly selected patients &gt;65 years old who underwent dental extraction were included. Mini-Mental State Examinations were performed before and after dental extraction.</p> <p><strong>Results: </strong>The patients’ total Mini-Mental State Examination scores after dental extraction were statistically significantly lower than the patients’ scores before extraction (p &lt; 0.0001).</p> <p><strong>Conclusion: </strong>The results of this study suggest that tooth extraction can be a cause of short-term cognitive decline in elderly patients. However, the possibility that loss of teeth is another contributing factor to long-term cognitive decline should be evaluated in further comprehensive clinical studies.</p> Sara Samur Ergüven Ayşe Hande Arpacı Mustafa Arslan Berrin Işık Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Neuroprotective effects of Onion (Allium cepa) Ethanolic Extract on Animal Model of Parkinson's Disease Induced by 6-hydroxydopamine: A Behavioral, Biochemical, and Histological Study http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1951 <p><strong>Objectives:</strong> Parkinson’s disease (PD), a progressive neurodegenerative disorder. Oxidative stress plays an important role in PD pathophysiology. Onion has antioxidant properties. In an experimental study, we have evaluated the effects of onion ethanolic extract (OEE) on animal models of Parkinson disease (PD) in male rats.<br><strong>Methods:</strong> Studied groups were sham group, Parkinson’s group (Parkinson rats without treatment), and three treatment groups including Parkinson rats that treated with OEE at 50, 100, and 200 mg/kg/day. Animal model of PD was induced by injection of 6-hydroxydopamine (6-OHDA) into the right substantia nigra. The administration of all the extracts were started 14 days before the surgery and continued daily for seven days after surgery. Learning and memory were evaluated by a Morris water maze. In addition, malondialdehyde (MDA) concentrations and histological parameters (density of neurons) were determined by thiobarbituric acid reactive substances (TBARS) and Nissl staining, respectively.<br><strong>Results:</strong> Our results showed that 6-OHDA led to cognitive dysfunction, increased MDA and neuronal damage compared sham group. However, the administration of OEE was improved cognitive dysfunction, decreased MDA and prevented neuronal damage in animal model of PD. <br><strong>Conclusion:</strong> The onion could be a new nutrition strategy and essential part of the food diet for preventing PD.</p> Mahmoud Salami Omid Reza Tamtaji Mojgan Mohammadifar Sayyed Alireza Talaei Abolfazl Azami Tameh Alireza Abed Shahriar Shirkhoda Ehsan Dadgostar Mohsen Taghizadeh Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Ghrelin Tedavisi Overleri Cerrahi Olarak Çıkarılmış Sıçanlarda Lipit Metabolizmasını ve Hepatik Dejenerasyonu Düzeltir http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1967 <p><strong>Amaç:</strong> Menopoz sonrası dönemde ortaya çıkan metabolik bozukluklar kadınlarda yağlı karaciğer hastalığı gelişme riskini arttırmaktadır. Bu çalışmanın amacı, ghrelinin overektomize (OVT) sıçanlarda metabolik biyobelirteçler ve hepatik morfoloji üzerindeki etkilerini değerlendirmektir.</p> <p><strong>Gereç Ve Yöntem:</strong> Ketamin-klorpromazin anestezisi altında (100 mg / kg, 0,75 mg / kg), Sprague-Dawley sıçanlarına (n = 12) çift taraflı OVT, kontrol grubunda taklit cerrahi uygulandı (n = 6). Ameliyattan dört hafta sonra, OVT sıçanlarının yarısı 4 hafta boyunca oral olarak ghrelin (1 mg / kg / hafta) ile tedavi edildi, diğerleri tedavi edilmedi. 8. hafta sonunda kardiyak ponksiyon ile ötenazi yapılarak serum glukoz, insülin, aspartat aminotransferaz (AST), yüksek yoğunluklu lipoprotein (HDL), düşük yoğunluklu lipoprotein (LDL), çok düşük yoğunluklu lipoprotein (VLDL), trigliseritler, östradiol ve progesteron, otomatik bir analizör ile ölçülmüştür.</p> <p><strong>Bulgular: </strong>2 ay sonunda OVT ile artan (p &lt;0,001) vücut ağırlıkları, ghrelin ile değişmedi. Serum östradiol ve progesteron seviyeleri değişmiş gonadal hormon durumu doğrulayacak şekilde azaldı (p &lt;0,05), ancak insülin ve glukoz düzeyleri değişmedi. Düşmüş HDL ve artmış LDL düzeyleri (p &lt;0,05), tedavi edilmemiş OVT sıçanlarında belirgindi, ghrelin tedavisi LDL düzeylerini düşürdü (p &lt;0,05), ancak HDL seviyelerini değiştirmedi. Bununla birlikte, OVT sıçanlarında ghrelin, trigliseritleri, VLDL ve AST seviyelerini anlamlı düzeyde düşürdü (p &lt;0,05). OVT grubunda ortaya çıkan sinüzoidal konjesyon, aktifleşmiş Kupffer hücreleri ve balonlaşma şeklinde hasarlanmış hepatositlerde ghrelin tedavisi ile düzelme görüldü.</p> <p><strong>Sonuç:</strong> Sonuç olarak menopoz sonrası erken dönemde hafif dislipidemi ve hepatik dejenerasyonun ghrelin tedavisi ile azaldığı ve çalışmanın daha fazla araştırma gerektirdiği görülmektedir.</p> Esra Bihter Gürler Dilek Özbeyli Özlem Tuğçe Çilingir Kaya Feriha Ercan Berrak Ç. Yeğen Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Postgastrectomy Changes in the Pancreatic Volume at Computed Tomography Examinations http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2065 <p><strong>Objective: </strong>We aim to determine the volume changes of the pancreas after gastrectomy by using volumetric computed tomography (CT) measurements.</p> <p><strong>Methods:</strong>Thirteen patients (8 men, 5 women, age range: 42 y – 76 y) who were diagnosed with gastric cancer and underwent gastrectomy (2 subtotal, 11 total) were included in this retrospective study. Pancreatic volumes were measured in preoperative (Pvol<sub>pre</sub>) and postoperative (3<sup>rd</sup> month (Pvol<sub>1stFU</sub>), 7-11<sup>th</sup> month (Pvol<sub>2ndFU</sub>), and 18-60<sup>th</sup> month (Pvol<sub>3rdFU</sub>) follow-up) contrast-enhanced CT examinations. To calculate the pancreatic volume, first, we manually drew the outermost margins of the pancreas and cut the volume, then we used a threshold method to exclude fat densities that infiltrated the pancreas. We used the Shapiro -Wilk test for normality, Levene test for homogeneity and one-way ANOVA test for comparing multiple groups.&nbsp; The significance level of 0.05 is used.</p> <p><strong>Results:</strong>Pancreatic volumes decreased significantly within the 3<sup>rd</sup> month after the surgery in all of the patients (Pvol<sub>pre</sub>: 87,6 cc, Pvol<sub>1stFU</sub>: 60,4 cc, p=0.044). The differences in the pancreas volumes between first, second and third follow-up examinations were not significant (p &gt; 0.05 for all).</p> <p><strong>Conclusion:</strong>This study demonstrated that pancreas volume significantly decreases after gastrectomy and the decrease could be well documented with volumetric CT.&nbsp; The decrease in the volume is more evident in the 3rd month follow up period. A radiologist should be aware of an expected decrease in the volume of the pancreas in the follow-up after gastrectomy.</p> Koray Kılıç Dilan Ece Geylan Durgun Melih Akyüz Gonca Erbaş Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Psikiyatride Sık Kullanılan İlaçların Kısa Ürün Bilgisinde ve Kullanma Talimatında Yazılı Araç Makine Kullanımı Uyarılarının İncelenmesi http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2092 <p><strong>Amaç:</strong> Bu çalışmada psikiyatride sıklıkla kullanılan ve santral sinir sistemine yönelik istenen ve istenmeyen etkileri bulunan belirli ilaçların kısa ürün bilgisi (KÜB) ve kullanma talimatında (KT) araç ve makine kullanımına dair uyarıların yer alma durumlarının incelenmesi amaçlandı.</p> <p><strong>Metot:</strong> Türkiye genelinde psikiyatride sık kullanıldığı bildirilen on ilacın güncel KÜB/KT’lerinin ayrıntıları incelendi. İlaçların KÜB’lerinde “Araç ve makine kullanımı üzerindeki etkiler”, KT’lerinde ise “Araç ve makine kullanımı” başlıkları altında yazılı bilgiler standart değerlendirme ölçütleri kullanılarak en az iki farklı zaman diliminde değerlendirildi.</p> <p><strong>Bulgular:</strong> Bu çalışmada toplam 409 jenerik müstahzarın KÜB/KT’si incelendi. Bu müstahzarların %80,2’sinde KÜB/KT’lerdeki ilgili uyarılar orijinallerindekiler ile tam benzerlik gösterirken, KÜB/KT’lerde sırasıyla %8,3 ve %8,1 oranında orijinallerine kıyasla “majör farklılık” bulundu. Bu “majör farklılığı” KÜB’ünde barındıran etkin maddelerin venlafaksin (%47,8), risperidon (%34,0), sertralin (%22,2) ve paroksetin (%5,6) olduğu, KT’sinde barındıranların ise paroksetin (%72,2), mirtazapin (%52,0), sertralin (%22,2) ve venlafaksin (%13,0) olduğu saptandı. KÜB’de yer alan uyarıların KT’ye ne ölçüde yansıtıldığına ilişkin yapılan incelemede, paroksetin dışında tüm etkin maddelere ait jeneriklerin her birinin KÜB/KT’lerinin kendi içinde uyumlu olduğu saptandı.</p> <p><strong>Sonuç:</strong> Araç ve makine kullanımı uyarıları bakımından her ne kadar KÜB ile KT arasında genel olarak uyum görülse de, incelenen azımsanmayacak oranda ilacın orijinalinin KÜB/KT’lerinde yazılı uyarı bilgilerinin bunların jenerik müstahzarlarının KÜB/KT’lerindekilerden farklılıklar gösterdiği dikkati çekmektedir. Çalışmada elde edilen tespitler, KÜB/KT'deki bilgi içeriklerinin standardizasyonu konusunda daha titiz bir yaklaşım ihtiyacına işaret etmektedir.</p> Dilara Bayram Volkan Aydın Ahmet Akıcı Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Effect of Refractive Error on Color Vision http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2126 <p><strong>Purpose: </strong>Prevalance of refractive error is increasing and without correct color perception everyday tasks such as matching or distinguishing color is a challenge. The aim is to determine the effect of refractive error on the color matching of red, green and blue appearing surfaces and how this color matching changes with refractive correction with glasses.</p> <p><strong>Method:</strong> In this interventional single center study, 127 medical students from Bahcesehir University were enrolled. In a well-lit room (4794 lumen), an A4 paper sized color was placed on a tripod 4 meters away from the participant. They were asked to match the shown color to the scale. The scale consisted of five shades of three main colors (red, green, blue). Answers were categorized as correct or false. Categorical independent data were analyzed with Chi-square tests and for categorical paired data, McNemar tests were used.</p> <p><strong>Results:</strong> 127 students consisted of sixty-four males (Mean: 19.70 ± 1.136) and sixty-three (Mean: 19.49 ± 0.965) females. 60 participants had refractive error and 67 participants had healthy vision. When emmetropes were compared to participants with refractive error, for only red color, emmetropes had significantly lower error rates (9%) compared to participants with refractive error (25%) (p=0.015). 60 participants with refractive error had lowered error rates in red (14%), green (10%) and blue (20%) color after correction. The decreases in error rates were not significant except blue was insignificant on the edge. P values for red, green and blue respectively are p=0.096, p=0.286 and p=0.050.</p> <p><strong>Conclusion:</strong> The study found that refractive error negatively effects color perception and correcting the underlying health problem decreases the error rate in color perception.</p> Esin Arslan Umut Diremsizoglu Cagatay Barut Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Retrospectif Analysis of 1545 Patients: Neuroimaging in Headache http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2152 <p><strong>Objective:</strong> Neuroradiological imaging is also used to differentiate between primary and secondary headaches. The aim of this study was to evaluate retrospectively the significant abnormal neuroradiological imaging results and rates in the primary headache group. In addition, it was also planned to analysis the results of all headaches with imaging and discuss the imaging in the headache with the literature.</p> <p><strong>Methods:</strong> Medical records of headache patients of the neurology outpatient clinic at the tertiary care center were reviewed. Patients who required brain imaging and did not have any disease that could cause pathology in imaging were included. Neuroradiological images were grouped as brain computed tomography (CT), brain magnetic resonance imaging (MRI) and others. Results were normal, significant abnormal findings and others.</p> <p><strong>Results:</strong> Total 1545 patients were included. Primary headache 992, secondary headache 91, painful cranial neuropathies and other headaches were observed in 462 patients. Significant abnormal radiological findings were found to be 4.3% in primary headache, 14.3% in secondary headache, and 6.6% in painful cranial neuropathy and other headaches. Significant findings in primary headache were Arnold Chiari Malformation, sinus thrombosis, intracranial mass, choroid plexus xanthogranuloma, hydrocephalus, vascular malformation.</p> <p><strong>Conclusion:</strong> In this series, the rate of significant findings in neuroradiological imaging in primary headache is low. Secondary headaches require neuroimaging because of the presence of underlying life-threatening causes, although the rate of abnormal neuroradiological imaging is low. History, examination, and red flags in headache may lead to imaging, but patient and physician concerns may also increase imaging rates.</p> Bahar Say Ufuk Ergün Mehmet Tunç Murat Alpua Adil Doğan Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Evaluation of Clinical Outcome and Mixed Chimerism Follow-up after Allogeneic Hematopoietic Stem Cell Transplantation in Hematological Malignancies http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2231 <p><strong>Objective:</strong> The level of donor-recipient chimerism is an established method to document donor engraftment. Allogeneic stem cell transplantation(ASCT) may result in mixed hematopoietic chimerism (MC), especially after reduced intensity conditioning regimens. Increasing MC levels in the post ASCT period may indicate disease relapse, graft failure, or rejection. In this study we aimed to study clinical outcome of mixed chimerism after ASCT in patients with hematological diseases.<strong>&nbsp;</strong></p> <h1><strong>Methods:</strong> The data of 335 patients whose ASCT were performed at our center between 2009 and 2019 and survived more than three months after transplantation were analyzed retrospectively.</h1> <p><strong>Results:</strong> During follow up period 127 (43%) of 293 patients in full chimeric (FC) group and 11 (26.1%) of 42 patients in MC group died.&nbsp; 11 patients received donor lymphocyte infusions (DLI) after MC detected, 4 of them converted into FC. 10 mix chimeric patients converted into FC spontaneously. In 3 patients no donor cell was observed in time (0%). 2 of them are still in remission. 25 patients remained mix chimeric during follow up period. 66 patients received reduced intensity conditioning (RIC) regimen and 10 (15.1%) of them had MC during follow up period. 269 patients received myeloablative conditioning (MAC) &nbsp;regimen and 32 (11.8%) of them had MC during follow up period.</p> <p><strong>Conclusion:</strong> ASCT may result in MC especially after RIC regimens. MC does not always related with relapse risk and mix chimeric patients with malignant or benign hematological diseases can stay in remission for a long time.&nbsp;</p> Taha Bahsi Tuğçe Nur Yiğenoğlu Haktan Bağış Erdem Merih Kızıl Çakar Mehmet Sinan Dal Fevzi Altuntaş Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Cigarette Smoking: The Only Risk Factor of a Case with Chronic Mesenteric Ischemia http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1954 <p>Chronic mesenteric ischemia (CMI) is a rare condition and ıt could be mis-diagnosed becouse lack of specific signs. Patients with chronic mesenteric ischemia (CMI) typically present with a history of the chronic intermittent abdominal pain, fear of eating and weight loss. The etiology of chronic mesenteric ischemia is multifactorial which includes atherosclerosis risk factors such as diabetes, hypertension, hyperlipidemia, smoking and obesity. Herein, we present a case whose only risk factor was smoking and presented with subacute abdominal pain. A 74-year-old woman was admitted to outpatient clinic with continuous abdominal pain, vomiting and diarrhea for 2 weeks. She had no other symptoms and chronic diseases. She is an active smoker for 58 pacs/year. Her physical examination revealed that diffuse abdominal pain without peritoneal signs. Laboratory results demonstrated an inflammatory condition however, abdominal ultrasound and endoscopic examination were in normal limits. Contrast enhanced abdominal CT revealed acute exacerbation of CMI.&nbsp; The patients treated with endovascular stent implantation and all symptoms were resolved. Chronic mesenteric ischemia could seen with atypical presentations, solely due to smoking without multiple risk factors in older patients. Therefore, it should be remembered that the diseases may be encountered in atypical presentations in older patients . Moreover, smoking habits should be questioned and patients should be reminded about smoking cessation.</p> Cemile Özsürekci Hatice Çalışkan Gözde Şengül Ayçiçek Rana Tuna Doğrul Cafer Balcı Fatih Sümer Barbaros Çil Burcu Balam Yavuz Mustafa Cankurtaran Meltem Gülhan Halil Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Jehovah’s Witness Patient Undergoing Major Surgery: Methods to Minimize Blood Loss http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1965 <p>Jehovah's Witnesses are a group of people who refuses to get blood transfusions and blood products due to their faith. Due to this, Jehovah's Witness patients who are planned for major surgical procedures are always a challenge for both surgeons and anaesthetist. Surgical and anaesthetic techniques must be aimed at minimising blood loss. We are reporting a peri-operative management for a Jehovah's Witness patient scheduled for a major surgery. This article emphasizes the techniques to minimize blood lose, in order to avoid blood transfusion.</p> T Kumaravadivel Dharmalingam Constance Liew Sat Lin Rajesh Kumar Muniandy Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Pitfalls of Double Lumen Endotracheal Tube in Prone Position During a Thoracoscopic and Laparoscopic Assisted Esophagectomy (TLAE) : A Sabah Experience http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1969 <p>This case report is about a young gentleman who was diagnosed with advanced achalasia cardia with mega-esophagus and underwent an elective thoracoscopic and laparoscopic assisted esophagectomy (TLAE) in prone position. We highlight the challenges of maintaining correct placement of double lumen tube (DLT) while positioning the patient into prone position, as well as the use of fiberoptic bronchoscope (FOB) in troubleshooting dislodgement of DLT while pronated.</p> Ming Kai Tan Tat Boon Yeap Shanmuganathan Sakuntala Dewi Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Magnusiomyces Capitatus : A Rare Cause of Pneumonia http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1998 <p>Introduction Pneumonia is an important cause of morbidity and mortality in elderly patients. Magnusiomyces should be kept in mind as a rare cause of pneumonia, because of high mortality rates (&gt;%50). Case Presentation A 93-year-old male patient was admitted with cough, sputum, confusion and elevated inflamatuar markers and diagnosed with pneumonia. Magnusiomyces capitatus was detected in tracheal aspirate culture and detection of galactomannan antigen in tracheal aspirate fluid supported the diagnosis. After 10 days of intravenous Amphotericin B therapy pneumonia was improved. Conclusion Although it has been previously reported in the pleural fluid, we found it in tracheal aspirate culture. Because of its high mortality rates we recommend that clinicians should take this agent into account.</p> Remzi Bahşi Ebru Evren Deniz Mut Sürmeli Tuğba Turgut Hande Selvi Öztorun Ebru Us Zeynep Ceren Karahan Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Progressive Enlarging Blind Spot in a Young Asian Lady: A Case Report on Acute Zonal Occult Outer Retinopathy http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2008 <p>Acute Zonal Occult Outer Retinopathy (AZOOR) is a very rare retinal disease that predominantly affect the Caucasians. It is usually present in a young myopic woman with an acute onset of photopsia and enlarging blind spots. Here, we report a young Asian lady who presented with a typical presentation of AZOOR and later confirmed by electrophysiological test of the retina. She was wrongly diagnosed as retrobulbar optic neuritis due to low index of suspicion for AZOOR among the treating physicians in the hospital. Fortunately, she responded to systemic corticosteroid that was given as a treatment of optic neuritis. AZOOR was only diagnosed later by a visiting European neuro-ophthalmologist in a neighbouring country. The objective of this case report is to remind the reader that the condition exists in Asian population and should be kept as a differential diagnosis in a young lady who presented with progressive visual field defect.</p> Alvin Oliver Payus Ang Wen Jeat Liew Sat Lin Malehah Mohd Noh Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Amyloidoma of the Bladder Mimicking a Bladder Tumor http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2108 <p>Primary amyloidosis of the bladder is a rare disease reported in about 200 cases in the literature (1). Generally, this patients are admitted to the hospital with painless gross hematuria and lower urinary tract symptoms. Especially, symptomatic, radiological and cystoscopic findings of bladder amylodidosis and bladder cancer are similar. Neoplasia, hemorragic cystitis and lyphoma should be considered in differential diagnosis. Pathological diagnosis is imperative for the definitive diagnosis. Its pathophysiology is unknown, the prognosis is usually good and there is no specific treatment. Herein, we present the diagnosis and treatment of bladder amyloidosis, which is rare and mimics bladder cancer.</p> Hikmat Jabrayilov Murat Yavuz Koparal Ipek Gonul Isik Cengiz Kara Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Follow-Up Study of Follicular Lymphoma (FL) Treated Using Clarithromycin: Intravenous Erythromycin Combined with Prednisolone Treatment is Effective for Refractory FL Accompanied with an Ocular Lesion http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2153 <p>A 44-year-old man who presented lymphadenopathy was diagnosed with follicular lymphoma (FL). He was treated with rituximab, cyclophosphamide (CPM), doxorubicin, vincristine, and prednisolone (PSL), which resulted in a stable disease. The patient’s subsequent clinical course included partial remission and stable disease, each of which was treated by chemotherapy. At the third regrowth of the tumor, however, the patient was diagnosed with leukocytopenia and could not undergo further chemotherapy. Regression of his lymphadenopathy occurred following treatment with clarithromycin (CAM), which has anti-lymphoproliferative effects. CAM was continued with good outcome and then CAM was tentatively discontinued. Invasion of the lymphoma cells into the thoracic vertebrae occurred and was successfully treated by radiotherapy. Thereafter, he was successfully treated with CAM combined with PSL and CPM. At 57 years of age, he developed pancytopenia owing to therapy-related myelodysplastic syndrome; consequently, CPM was discontinued. Treatment with CAM combined with PSL was continued successfully. However, 15 months later, he complained of exophthalmos. Magnetic resonance imaging revealed a right orbital lesion. As an alternative to CAM combined with PSL, treatment with intravenous EM combined with PSL was used successfully. This case shows that treatment with intravenous EM combined with PSL may be effective in some cases of refractory FL.</p> Masashi Ohe Haruki Shida Yoshihiro Kusunoki Satoshi Jodo Ken Furuya Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Epidermolizis Büllozalı Hastada Anestezi Yönetimi http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2203 <p>ABSTRACT:</p> <p>&nbsp;</p> <p>Epidermolysis bullosa (EB) is a rare genetic disease that is associated with severe bullae formation in the body due to an increase in cutaneous and mucosal fragility. This bulla formation in mucocutaneous areas can ocur spontaneously, as well as by trauma, heat exposure or minimal mechanical trauma. Anesthesia applications in patients may have difficulties in airway management due to orofarengeal mucosa and skin involment and in skin integrity. In this case report, we aimed to discuss anesthesia management in a 21 year old male patient with epidermolysis bullosa who will undergo dental extraction under general anesthesia.</p> <p>&nbsp;</p> <p>Key Words: Epidermolysis bullosa, general anesthesia, dental extraction</p> Necmiye Şengel Nazan Has Selmi İrem Barış Akbaş Metin Alkan Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Jejunal Divertikül Perforasyonu: Bilgisayarlı Tomografi Bulguları http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2263 <p>Jejunal diverticulosis and associated complication of diverticulitis and perforation of the diverticulum are extremely rare and are among the causes of acute abdomen especially in the elderly. Computed tomography is very important in the diagnosis of the disease, differential diagnosis of other acute abdominal causes, determination of complications and patient management. We present a case of jejunal diverticulitis who presented with acute abdomen and was operated in accordance with radiological imaging</p> Merve Yazol Halil Özer Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Osseous Tongue Mass http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1976 <p>Osseous choristoma is a benign osseous lesion found on the dorsum of tongue which is commonly discovered in the 3rd and 4th decade of life. The lesions mostly presents as an asymptomatic mass and is found incidentally during dental procedure or oral cavity examination. Having said that, globus sensation, dysphagia and even airway obstruction have been reported.</p> Jeyasakthy Saniasiaya Azwarizan Abdul Halim Norhaslinda Abdul Gani Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 The Relation between Childhood Obesity and MC4R Gene and Near MC4R Polymorphisms http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/1952 <p>Childhood obesity, especially in the developed countries including all over the world&nbsp;has an increasing prevalence.&nbsp;Regarding the major impact on public health perspective,&nbsp;childhood obesity should be monitored closely.&nbsp;Many researchers reported MC4R&nbsp;gene and near MC4R region polymorphisms to predispose monogenic obesity both in children and adults. In this study we investigated the relation between childhood obesity and Ser58Cys, Val50Met, Ile102Ser, Val103Ile, Asn274Ser,&nbsp; rs17782313 and rs17700633 polymorphisms in MC4R gene and near MC4R region in the Turkish population.&nbsp; It is very important to detect single gene disorders that may cause childhood obesity in order to screen children for the predisposition of obesity, as to protect them from environmental factors that may cause weight gain.</p> Ozgur Erkal Mehmet Ali Ergün Mehmet Boyraz Aysun Bideci Peyami Cinaz Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Dermatolojide Topikal Tazaroten Kullanımı: Güncel Bilgiler http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2185 <p>Tazarotene is a synthetic retinoid that regulates gene transcription by binding to high affinity retinoid acid receptor β and γ. Tazarotene has cream, gel and foam forms. Tazarotene is a well tolerated drug with low systemic absorption when administered topically. Tazarotene is mainly used in the treatment of acne vulgaris and psoriasis. However, tazarotene is recommended more frequently in the treatment of skin diseases. Within this study, skin disease treated with tazarotene have been reviewed in the light of recent literature.</p> Funda Tamer Esra Adışen Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Health Policies of Turkey and Neighboring Countries for Syrian Asylum Seekers http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2196 <p>Turkey is a transit and final destination for many asylum seekers, refugees and immigrants because of its geographical location, cultural issues and hospitality.&nbsp; The following article is aimed to present the health policies applied to Syrian citizens who escaped the Syrian Crisis in 2011. To evaluate the topic in detail, legal basis of health policies of Turkey and the neighboring countries who accept Syrians as asylum seekers or refugees were evaluated. As the right of human access to health is vital and it is thought that this study will help the researchers and policy makers to understand the results of their efforts and compare the health care needs and access to health care of Syrian asylum seekers.</p> Mohammad İsmail Farook Mustafa Necmi İlhan Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-21 2019-12-21 31 1 Türk Farmakoloji Derneği (TFD) 25. Ulusal Farmakoloji Kongresi Klinik Farmakoloji Çalışma Grubu (KFÇG) Sempozyumu 4 Kasım 2019, Kuşadası, Türkiye http://medicaljournal.gazi.edu.tr/index.php/GMJ/article/view/2280 <p><strong>Türk Farmakoloji Derneği (TFD) 25. Ulusal Farmakoloji Kongresi Klinik</strong></p> <p><strong>Farmakoloji Çalışma Grubu (KFÇG) Sempozyumu 4 Kasım 2019, Kuşadası, Türkiye</strong></p> . . Copyright (c) 2020 Gazi Medical Journal https://creativecommons.org/licenses/by/4.0 2019-12-22 2019-12-22 31 1