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Öğe Duzce University Hospital in the Pandemic Process: From the Perspective of Chief Physician(Duzce Univ, 2020) Akcan, Fatih Alper; Onec, Kursad; Annakkaya, Ali Nihat; Pehlivan, Mevlut; Karaduman, Zekeriya Okan; Balbay, Oner Abidin; Ergun, Hacer AkWe aimed to compile the effects of the preparations on the new coronavirus outbreak (Covid-19) in the largest pandemic, which is still visible in the world. Pandemics have caused millions of people to become ill, disabled and death for centuries Thanks to past pandemics that deeply affect the society health, socially and economically, preparations have been made again against possible pandemics. Preparations may not go as planned. Desperation may occur for unforeseen situations. Despite these despair, the tool that can contribute in practice besides the basic principles in combating pandemics can be obtained from the past. Like every pandemic, the pandemic will end one day. Those applied and not implemented after the outbreak will be evaluated and will remain a lesson from the past for future outbreaks.Öğe The Effect of Treatment on Weight Gain in Iron Deficiency Anemia and Its Association with Ghrelin and Hepcidin Levels(Duzce Univ, Fac Medicine, 2023) Kilinc, Halil Cansun; Onec, Birgul; Onec, Kursad; Ankarali, HandanAim: Although loss of appetite in iron deficiency anemia (IDA) and weight gain during treatment are common complaints, there are very few studies in adults. This study aimed to determine the levels of ghrelin, one of the appetite-related hormones, and hepcidin, one of the main regulators of iron metabolism, in IDA, and to examine the effects of treatment on weight gain and the levels of these hormones. Material and Methods: Eighty-seven adult patients with IDA and a control group of 50 healthy volunteers were included in the study. Anthropometric measurements and blood samples were obtained from the patient and control groups before treatment, and repeated after treatment in the IDA group. Results: No significant difference was found in terms of weight, body mass index (BMI), and waist-to-hip ratio between groups but there was a significant increase in weight and BMI, in the patient group after treatment (both p<0.001). Pre-treatment hepcidin and ghrelin levels of the patient group were significantly lower than the control group (p<0.001, and p=0.026, respectively), and hepcidin levels increased significantly after treatment (p<0.001). The increase in ghrelin was not statistically significant but showed a positive weak correlation with both weight (r=0.254, p=0.018) and BMI (r=0.231, p=0.031) increase. Hepcidin levels were not correlated with weight and BMI changes. Conclusion: These findings revealed low levels of ghrelin and hepcidin in adults with IDA and an increase in weight and BMI with treatment. Hepcidin increased with treatment but was not correlated with weight gain, ghrelin was weakly correlated.Öğe An evaluation of suspected cases of Hantavirus infection admitted to a tertiary care university hospital in Duzce, Turkey, between 2012 and 2018(Tubitak Scientific & Technical Research Council Turkey, 2021) Ince, Nevin; Onec, Kursad; Sav, Tansu; Sungur, Mehmet Ali; Menemenlioglu, DilekBackground/aim: Hantavirus is a rodent borne zoonosis caused by the members of the virus family Bunyaviridae, genus Hantavirus. In this study, we aimed to determine the role of peripheral blood leukocyte ratio in differential diagnosis of Hantavirus disease. Materials and methods: The medical records of patients at the Duzce University Medical Faculty were examined retrospectively. A total of 20 patients diagnosed with hantavirus infection confirmed by serologic tests were included in the study (Group 1). The other group consisted of 30 patients suspected of hantavirus infection but found negative (Group 2). Demographic, clinical and laboratory characteristics, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte (LMR) ratios of both groups were compared. Results: As a result of the istatistics analysis, no difference was found between the groups' age, sex, and clinical complaints except lethargy-weakness (P = 0.004) and diarrhea (P < 0.001). Hemogram analysis showed a significant difference between the groups in terms of leukocyte, hemoglobin, hematocrit, platelet, mean platelet volume (P < 0.05) and PLR (P = 0.001) and LMR (P = 0.003) values from peripheral blood leukocyte ratios. Conclusion: In conclusion, NLR, PLR, and LMR ratios may be useful for clinicians in differential diagnosis of Hantavirus in patients presenting with similar symptoms of Hantavirus disease.Öğe Management of Nephrology and Hemodialysis Patients in the Pandemic - Experiences of Duzce University(Duzce Univ, 2020) Onec, KursadIn the COVID-19 (SARS-CoV2) pandemic, which emerged in Wuhan, China, and influenced the whole world, the number of cases worldwide is approaching 7 million by June 2020 and number of deaths unfortunately reached around 400 thousand. The available data suggest that elderly people with chronic diseases such as chronic respiratory tract, diabetes, chronic kidney disease or cardiovascular disease are at higher risk for both in terms of disease and death. Hemodialysis patients are defined as a special subgroup for higher risk requiring different management approaches, partly because they are at more advanced age and they have to go to the hemodialysis unit and be in crowded environments. On the other hand, patients with COVID-19, especially who need intensive care, are at high risk of developing acute renal failure and their follow-up is also important. In this article, we wanted to share our experience as the nephrology clinic of Diizce University Medical Faculty, both in the management of our own nephrological patient population, especially in hemodialysis patients, and in the nephrological follow-up of COVID-19 patients.Öğe Serum seladin-1 levels in diabetes mellitus and Alzheimer's disease patients(Springer Heidelberg, 2020) Onmez, Attila; Alpay, Merve; Torun, Serkan; Sahin, I. Ethem; Onec, Kursad; Degirmenci, YildizBackground Diabetes mellitus (DM) has been shown to increase the risk of Alzheimer's disease (AD). Downregulation of selective Alzheimer's disease indicator-1 (seladin-1) occurs in the cerebral regions affected by AD. However, inconsistent results have been reported for the relationship between seladin-1 levels and AD. The effect of DM on serum seladin-1 levels in AD is unknown. The present study is aimed to investigate serum seladin-1 levels in diabetic and non-diabetic patients with AD. Methods Forty-six patients with AD and 25 healthy volunteers over 65 years of age were included in this study. The patients were divided into three groups-those with AD only, those with DM and AD, and control groups. Demographic characteristics and serum seladin-1 levels were compared among the groups. Results There was no statistically significant difference in seladin-1 levels in the AD only group compared to the control group (p = 0.376). However, seladin-1 levels were significantly lower in the DM and AD group compared to the AD only and control groups (p = 0.002, p = 0.001; respectively). Negative correlations were present between seladin-1 and fasting glucose, postprandial glucose, HbA1c, and insulin (p < 0.05; all). Conclusion Decreased serum seladin-1 values in the presence of DM and inverse correlations with diabetic parameters in patients with AD, together with a non-significant difference from the control group, suggests that seladin-1 may be altered only in the presence of DM in patients with AD. Lower serum seladin-1 levels may also play a role in the pathogenesis of AD in patients with DM.Öğe Type and Level of Anxiety Affects the Perception of Pain During Bone Marrow Biopsy(Duzce Univ, 2021) Onec, Birgul; Onec, Kursad; Esbah, Ali Umit; Esbah, OnurObjective: Bone marrow aspiration and biopsy (BMAB) is an essential tool for diagnosis of hematological disorders. The most frequent complaint after BMAB is pain but the severity of this pain is described very different among patients. We investigated factors predicting this pain focusing on the role of state and trait anxiety. Methods: One hundred and ten adult patients undergoing BMAB, were informed adequately and assessed with The State-Trait Anxiety Inventory (STAI) before the procedure. In this Likert-type inventory, State Anxiety Scale evaluates the current state of anxiety, asking how respondents feel at that moment. The Trait Anxiety Scale evaluates relatively stable aspects of anxiety proneness, including general states of confidence, calmness, and security. After the biopsy, pain was measured with visual analog scale. Results: Most of the patients (71.8%) described mild pain but moderate to severe pain were significantly more frequent in both high state and trait anxiety groups. Pain severity had a positive but weak correlation with trait anxiety but not with state anxiety. The described pain level was associated with older age but was not with indication of biopsy, performance status, comorbidities or previous BMAB experiences. Conclusions: Results of our study made us thought that a good communication with the patient and talking about possible outcomes days before procedure might play a role reducing his or her anxiety but because age and trait anxiety cannot be changed by using fast acting anxiolytic drugs, advantage of premedication with anxiolytics in order of reducing pain, would be limited.
