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Öğe Adaptation and psychological problems and suggestions for solution of foreign students studying at medical faculty(2021) Barzgarjalali, Elham; Elmarhum, Muhammed; Elseyhkuvedir, Muhammed; Rasuly, Abdul Jalal; Gamsızkan, Zerrin; Abdulal, Muhammed; Sungur, Mehmet AliAim: Students who change places due to social, economic, geographical, cultural, and war reasons are likely to experience difficulties while adapting to the new environment. The aim of this study is to identify adaptation and psychological problems experienced by foreign students and to present suggestions to faculty education commissions to improve the health and education conditions. Materials and Methods: The study was conducted between January and March 2020. The universe of the study consisted of all foreign students in the 2019-2020 academic year studying at the medical school. No sampling method was used in the study by aiming to reach the entire population. Foreign students studying at the Faculty of Medicine filled out a questionnaire including the educational problems experienced by the students and Beck’s Depression Inventory (BDI). Results: The most common problems of foreign students were as; language problems in 50 (49.0%) students, being away from family in 31 (30.4%) students, and financial problems in 21 (20.6%) students. It was found that 39.2% (n = 40) of the students had minor depression, 29.4% (n = 30) had mild depression, 26.5% (n = 27) had moderate depression and 4.5% (n = 5) had severe depression scores according to BDI. 69.5% of the students stated that they faced negative behaviors because they were foreigners. Conclusion: Supportive interventions can prevent the development of depression by providing academic and psychological relief to foreign students.Öğe Adolesan Çocuklarda Hepatit B Belirteçlerinin İncelenmesi-Düzce Üniversitesi Hastanesi 5 Yıllık Sonuçlar(2021) Kılıçaslan, Önder; Sav, Nadide Melike; Karaca, Seda Erişen; Sungur, Mehmet Ali; Öztürk, Cihadiye Elif; Kocabay, KenanAmaç: Hepatit B virüsü (HBV), akut ve kronik karaciğer hastalığının ve bunlara bağlı morbidite ve mortalitenin başlıca nedenidir. Ülkemizde 1998 yılında Hepatit B aşısı rutin aşı takvimine alındı. Bu çalışmada, ülkemizde Hepatit B aşısı uygulanmaya başlandıktan sonra doğan çocuklardaki Hepatit B belirteçlerinin değerlendirilmesini amaçladık.Gereç ve Yöntemler: Düzce Üniversitesi Tıp Fakültesi Çocuk Polikliniklerine başvurup HBV seroloji testleri yapılan, rutin aşı takviminde aksama olmayan ve yaşları 10-19 arasında olan 310 çocuğun Hepatit B belirteçleri değerlendirildi. Çocukların tam aşılı sayılabilmeleri için 1999 ve sonrası doğumlu olanlar çalışmaya dahil edildi. Aynı hastanın farklı zamanlarda yapılan değerlendirmeleri çalışma dışı bırakıldı.Bulgular: Çalışmaya 166 (%53,5) erkek ve 144 (%46,5) kız toplam 310 çocuk alındı. Çocukların 192’sinde anti-HBs pozitif (%61,9), 118’inde (%38,1) negatif saptandı. Cinsiyetler açısından anti-HBs ve HBsAg pozitifliği karşılaştırıldığında anlamlı fark bulunmadı. Sonuç: Hepatit B aşısı sonrası bireylerin seropozitiflik durumları üzerine günümüzde fazla araştırma yapılmıyor olsa da çalışmamızda saptanan anti-HBs pozitiflik oranları; geniş bir popülasyonda yeni bir çalışma planlanarak aşılama sonrası anti-HBs düzeyinin değerlendirilmesinin tekrar gündeme gelmesini, belki de kişiden kaynaklanan sigara içme, fazla kilo problemi veya aşıların uygulanması yönünden kaynaklanan aşı transportu, saklama ve uygulama problemleri gibi sorunların ortaya çıkmasını sağlayarak, toplumda saptanan pozitif anti-HBs yüzdesinin istenilen düzeye gelmesini sağlayacaktır.Öğe Assessment of Central Corneal Thickness, Intraocular Pressure and Retinal Nerve Fiber Layer Thickness at Women with Polycystic Ovary Syndrome(Duzce Univ, 2017) Teberik, Kuddusi; Sağlam, Hakan; Başbuğ, Alper; Karaaslan, Musa; Kaya, Murat; Sungur, Mehmet AliObjective: To compare intraocular pressure, central cornea thickness, anterior chamber depth, axial length and thickness of retina nerve fiber layer between women with polycystic ovary syndrome and healthy at the same age segment. Methods: Between August 2015-January 2016, 46 women who have polycystic ovary syndrome and 53 healthy women have been included to the study. After a complete ophthalmologic examination, intraocular pressure, central cornea thickness, anterior chamber depth, axial length and retinal nerve fiber layer thickness were investigated. In the statistical analysis of the data, Independent Samples t test was utilized to compare the groups. Results: While mean age was 23.4 +/- 4.5 (16-35) in the group with polycystic ovary syndrome, average age level was found as 24.0 +/- 6.1 (18-54) among the controls (P=0.549). Intraocular pressure values were measured and determined as 17.7 +/- 2.6 mmHg in the group with polycystic ovary syndrome, while the values were 15.2 +/- 2.4 mmHg in the controls (P <0,001). Although it was 79.4 +/- 10.2 mu m in the group with polycystic ovary syndrome, retinal nerve fiber layer thickness in the nasal quadrant was found to be 73.8 +/- 10.9 mu m among the controls (P <0.001). Conclusion: We found that the increased levels seen in intraocular pressure and retinal nerve fiber layer thickness in the nasal quadrants of the patients with polycystic ovary syndrome were statistically significance. Hence, we recommend that the patients with polycystic ovary syndrome should be specially analyzed as to eye assessment.Öğe The Association between Iron Deficiency and Otitis Media with Effusion(Aves, 2019) Akcan, Fatih Alper; Dündar, Yusuf; Akcan, Hümeyra Bayram; Cebeci, Derya; Sungur, Mehmet Ali; Ünlü, İlhanOBJECTIVES: The purpose of this trial is to examine the clinical role of iron metabolism on development of Otitis media with effusion. MATERIALS and METHODS: This prospective study was conducted in a tertiary referral center. The study group made up of children who had surgery for Otitis media with effusion (OME). Control group was comprised of children who had surgery by a pediatric surgeon for inguinal hernia repair or circumcision operations with normal ear nose throat examination. Each group was evaluated depending on the serum iron metabolism parameters. RESULTS: One-hundred-thirteen children with OME and 117 control patients were included to the study. Iron deficiency anemia was detected in 18 out of 113 patients (15.9%) in study group while there were 4 out of the 117 patients (3.4%) in control group (p:0.001). The mean hemoglobin level was 12.16 +/- 1.16 in OME group and 12.93 +/- 1.08 in control group (p<0.001). CONCLUSION: The current study shows the rate of iron deficiency anemia is higher in patients with OME than controls. Iron-deficiency anemia might be considered a potential risk factor for development of otitis media with effusion, and iron parameters should be evaluated in these children.Öğe A Basic Approach to Select the Appropriate Method in case of Extended Dominance(2019) Sungur, Mehmet Ali; Kanık, Emine Arzu; Ata, AlperObjective: In cost-effectiveness analysis, treatment methods are ranked by cost and effectiveness, and a method more costly but less effective, is dominated. In models that none of the methods is absolutely dominated but one of them is extendedly dominated, selecting cost-effective method is complicated. Aim of this study was to propose a classification for magnitude of incremental cost-effectiveness ratio of extendedly dominated method, which can use for deciding about cost-effectiveness of this treatment. Methods: Simulated data based on actual data, and simulated hypothetical data in accordance with actual data were used. All possibilities were tried to consider by generating different costs, effectiveness and response rates. Proportional magnitudes of incremental cost-effectiveness ratios of treatments extendedly dominated were investigated. Descriptive statistics for each model, and weighted means by response rates were calculated and change in percentage of extended dominance were compared. Results: Magnitude of incremental cost-effectiveness ratio of the method extendedly dominated is a quite important factor to decide about it, when response rates of alternative methods are similar or same. Slight changes were observed as the response rates differ from each other, but there was not an extreme impact on proportions of extended dominance. Conclusions: A very simple and practical classification which can be used to assess the proportional magnitude of the incremental cost-effectiveness ratio of extendedly dominated treatment method and be valid regardless of whether response rates of treatments in model are same or different was suggested.Öğe Batı Karadeniz Bölgesinde Bir Üniversite Hastanesine Başvuran Hasta ve Hasta Yakınlarının Akılcı İlaç Kullanımına Yönelik Bilgi ve Davranışlarının Değerlendirilmesi(2021) Coşkun, Nuri Cenk; Sungur, Mehmet Ali; Aydın, Meryem; Solmaz, Cahide İrem; Turhan, Elif Çağla; Dizman, Büşra; Yıldırım, İremAmaç: Bu araştırma; toplumda Akılcı İlaç Kullanımı farkındalık düzeyinin belirlenmesi için planlanmıştır. Gereç ve Yöntemler: Tanımlayıcı kesitsel tipte planlanmış olan bu araştırmaya Düzce ilinde 121’i erkek, 65’i kadın olmak üzere 186 kişi katılmış olup, yüz-yüze görüşmeler ile anket uygulanmıştır. İstatiksel verilerin değerlendirilmesinde Pearson ki-kare, Fisher kesin olasılık testi ve Fisher-Freeman-Halton testleri kullanılmıştır.Bulgular: Araştırmamızda; katılımcıların %72’sinin ilaçsız tedaviyi tercih ettiği, %98,9’unun hekiminin tavsiyesi ile ilaç kullandığı, %83,3’ünün Akılcı İlaç Kullanımını hakkında daha önce bilgi sahibi olmadıklarını, %61,3’ünün evinde kullanılmayan ilaç olduğunu, %36,8’inin bitkisel ilaç kullandığını, %73,5’inin ilaçlarını çöpe atarak imha ettikleri bilgisine ulaşılmıştır. Ayrıca araştırmamızda anlamlı olarak; kadınların erkeklere oranla daha fazla başkasına ilaç tavsiye ettikleri, 65 yaş üstü katılımcıların antibiyotiği ateş düşürücü olarak bildikleri ve üniversite mezunu katılımcıların diğer gruplara göre daha fazla Akılcı İlaç Kullanımı hakkında farkındalıklarının olduğunu tespit edilmiştir. Sonuç: Araştırma sonucunda Akılcı İlaç Kullanımı farkındalığı %3,8 gibi çok düşük bir oran olarak tespit edilmiştir. Bu sebeple halkı akılcı olmayan ilaç uygulamalarından ve yanlış ilaç bilgilerinden kurtarmak için Akılcı İlaç Kullanımı farkındalık çalışmalarının daha fazla güçlendirilerek tüm bölge halkına ulaştırılması gerektiği sonucu çıkarılabilir. Gelecekte yapılacak çalışmalarda Akılcı İlaç Kullanımı hakkında farkındalığın artırılması için neler yapılabileceği konusunun araştırılması hedeflenmektedir.Öğe Biomonitoring of bisphenol A, 4-nonylphenol, and 4-t-octylphenol in Turkish population: exposure and risk assessment(Springer Heidelberg, 2022) Şüküroğlu, Ayça Aktaş; Battal, Dilek; Kocadal, Kumsal; Sungur, Mehmet Ali; Çok, İsmet; Ünlüsayın, İrfanBiomonitoring studies are important tools to understand the effects of endocrine-disrupting compounds on human health. Up to now, there have been no biomonitoring and risk assessment studies conducted in Turkish population in which urinary bisphenol A (BPA), 4-nonylphenol (4-NP), and 4-t-octylphenol (4-t-OP) levels were measured simultaneously. The aim of this study is to measure urinary BPA, 4-NP, and 4-t-OP on Turkish population and conduct a risk assessment using urinary levels of chemicals of interest. During the study, liquid chromatography with tandem mass spectrometry (LC-MS/MS) was used to measure urinary levels of above-mentioned chemicals, and human biomonitoring was used as a risk assessment tool in 103 volunteers, living in Mersin Region, Turkey. Urinary BPA, 4-NP, and 4-t-OP were founded as 0.0079 mu g/g creatinine, 0.0177 mu g/g creatinine, and 0.0114 mu g/g creatinine, respectively. The obtained estimated daily intakes (EDIs) were calculated as 0.095 mu g/kg bw/day, 0.041 mu g/kg bw/day, and 0.091 mu g/kg bw/day, for BPA, 4-NP, and 4-t-OP, respectively. In conclusion, although no potential health risk due to BPA and 4-NP exposure was observed, there might be health risks associated with 4-t-OP exposure in the Turkish population.Öğe Bir Aile Hekimliği Polikliniğinde 5-18 yaş arası Çocuklarda Anti Hbs Antikor Düzeyleri- Kesitsel Bir Çalışma(2021) Sungur, Mehmet Ali; Çekirge, Ersen; Gamsızkan, ZerrinAmaç: Bu çalışma; aile hekimliği polikliniğine başvuran 5-18 yaş arası çocuklarda serum Anti-Hbs antikor düzeyleri ile hepatit B aşılanma durumlarını araştırmak için yapılmıştır. Materyal ve Metod: Çalışma tanımlayıcı- kesitsel bir çalışmadır. Çalışmaya bir Aile Sağlığı Merkezine periyodik muayene ve okul sağlık taramaları için başvuran 5-18 yaş arası 84 çocuk dahil edilmiştir. Çalışmaya dahil edilen çocukların ailesinden çocuğun aşılanma durumu, kronik hastalık varlığı, anne baba eğitim ve meslek bilgisini içeren kısa bir form doldurması istendi. Bu yanıtlarla çocukların cinsiyet, yaş ve Anti-Hbs düzeyi arasındaki ilişki sorgulandı. Düzce Halk sağlığı laboratuarında Mikro-ELİSA yöntemi ile bakılan Anti-HBs düzeyi 10 mIU/ml’nin üzerinde olan antikor değerleri seropozitif olarak kabul edildi.Bulgular: Çalışmamıza alınan çocukların 45’i (%53,6) erkek, 39’u (%46,4) kız çocuk idi. Çalışmamızdaki çocukların yaş ortalaması 12,13±2,73 olarak tespit edildi. Çalışmamızda yaş artışı ile birlikte Anti HBs antikor titresinde anlamlı bir düşüş saptanmadı(p=0,571). Cinsiyete göre anti-HBs seropozitifliği arasında anlamlı fark bulunmamıştır. Çalışmamızda çocukların yaşı arttıkça aşı yapılmamış olma durumu daha küçük yaştakilere göre anlamlı olarak yüksek bulundu (p<0,001). Aşılı olduğu anamnezi alınan 62 çocuğun %46,77(n=29)’sinde Anti-HBs seronegatif olarak tespit edilmiştir. Sonuç: Çalışma sonuçlarımıza göre çocukların yaşı azaldıkça HBV aşısı olma durumu anlamlı olarak artmaktadır. HBV enfeksiyonunun yol açtığı hastalık sonuçlarının ciddi olması ve aşı ile etkin bir şekilde önlenebiliyor olması bakımından avantajı düşünüldüğünde bağışıklama hizmetlerinin takibi önemlidir.Öğe Blood Analysis Requests of Patients’ and Clinical Reflections in Primary Care(2020) Gamsızkan, Zerrin; Sungur, Mehmet Ali; Çayır, YaseminAim: The aim of the study is to determine the factors that may affect the demands of patients who come with the request to have a blood test without any chronic disease or a planned examination check.Methods: The data of this descriptive, cross-sectional study, were collected with a questionnaire that was prepared to examine the opinions of the patients who claim to have a blood test by coming to the family health center without any complaints. Patients over 18 years of age, who did not have any chronic disease and had no scheduled examination appointments were included in the study.Results: A total of 278 patients who wanted to have a blood test within the 6-months period were included in the study. Female patients who wanted to have a blood test were significantly more than male patients. When we look at the causes of patients who wanted to have a blood test; 61.2% (n=170) patients stated that they are concerned about their health and 6.1% (n=17) stated that they were affectedby media warnings. There was no significant relationship between the frequency of blood test requests of patients and their age, gender, education, and general health status.Conclusion: Patients with high expectations and anxiety may be more willing to perform blood tests at inappropriate intervals. Family physicians, whose primary role is preventive medicine, have consultancy and information duties in order to protect their patients from the risk of over-examination and diagnosisÖğe BRAF mutation, TERT promoter mutation, and HER2 amplification in sporadic or neurofibromatosis-related neurofibromas and malignant peripheral nerve sheath tumors: do these molecules have a signature in malignant transformation?(Wiley, 2020) Coskun, Sinem; Gamsizkan, Mehmet; Yilmaz, Ismail; Yalcinkaya, Ulviye; Sungur, Mehmet Ali; Buyucek, Seyma; Onal, BinnurPeripheral nerve sheath tumors may occur sporadically or related to neurofibromatosis (NF). Unless the mechanisms of tumorigenesis in NF related malignant peripheral nerve sheath tumors (MPNST) are better understood, it remained unclear in sporadic cases. We aimed to investigate the genetic route for malignancy in both individuals with NF-1 and sporadic ones to open a way for targeted therapies in the future. We investigated the role of HER2 with Dual ISH DNA Probe Cocktail test, BRAF mutation (exon 15) and TERT promoter mutation frequency with Sanger sequencing method in respectively 25 sporadic neurofibromas, 25 NF-1 related neurofibromas and 25 MPNST cases from two institutes. Categorical data were analyzed and summarized as frequency and percentage. Statistical analysis was done with SPSS v.22 statistical package, and the statistical significance level was considered as 0.05. We identified TERT promoter mutation only in one sporadic MPNST (4%) and no BRAF mutation in any case. HER2 amplification is found in 10/25 (40%) MPNST cases. No mutations or gene amplification detected in neurofibromas (p < 0.001). MPNSTs are sarcomas with poor prognosis and limited treatment options. TERT promoter mutations and HER2 amplification may play a putative role in therapeutic purposes.Öğe Breiman Algoritması Kullanılarak Homojen Alt Grupların Belirlenmesi: Bir Uygulama(2014) Akşehirli, Özge; Ankaralı, Handan; Cangür, Şengül; Sungur, Mehmet AliBreiman, birçok verinin birbirine yakın olarak toplandığı "yüksek yoğunluklu" alanları bularak verilerin kümelenebileceğini söylemiştir. Bu çalışmada, Breiman'ın kümeleme algoritmasının işleyiş adımları tanıtılarak bir veri seti üzerinde uygulama adımlarının gösterilmesi ve sonuçlarının yorumlanması amaçlanmıştır. Uygulama bölümünde, hastaneye gece yeme sendromu şikâyetiyle başvuran 433 kişiye ilişkin sosyo-demografik ve klinik özellikler kullanılmıştır. Veri setinde olabilecek kümelerin ortaya konmasında, CART algoritmasından yararlanılmıştır. Elde edilen optimum ağaçta toplam 31 karar noktası bulunmuş ancak bunların 14' ünde yer alan deneklerin kendi içinde kümelenme gösterdiği belirlenmiştir. Çalışmaya alınan kişilerin 350'si oluşturulan 14 küme içine girmiş ve bunların 273 (%78)'ü klinik olarak gece yeme alışkanlığı yoktur tanısı almıştır. Elde edilen 14 kümenin 12'sinde yer alan kişilerin ağırlıklı olarak gece yeme alışkanlığı yok tanısı alanlardan oluştuğu ve bu sonuca göre, bu veri setinden elde edilen kümelerin, genel olarak gece yeme alışkanlığı olmayan bireyleri ayırt edebildiği söylenebilir. Sonuç olarak, hedef veya bağımlı değişkenin bilinmediği durumlarda, veri setinde var olan homojen alt grupların belirlenmesinde, danışmansız öğrenme yöntemlerinden biri olan kümeleme analizinin uygulanması için değişkenlerin dağılım şekli ve tipinden etkilenmeyen Breiman algoritması etkin bir şekilde kullanılabilirÖğe Burden of Chronic Migraine in Tertiary Headache Outpatient Clinics: Experience of 10 years a Multicenter Study(Sage Publications Ltd, 2017) Yalın, Osman Özgür; Uludüz, Derya; Sungur, Mehmet Ali; Özge, Aynur…Öğe Can Numeric Maturation Value Be Used as a Prognostic Indicator and Diagnostic Tool in Cutaneous Melanomas? A Morphometric Study(Sci Printers & Publ Inc, 2019) Gamsızkan, Mehmet; Büyücek, Şeyma; Coşkun, Sinem Kantarcıoğlu; Sungur, Mehmet Ali; Özlü, Emin; Bahçıvan, Atike; Önal, BinnurOBJECTIVE: Some melanocytic lesions can be difficult to diagnose because of ambiguous histological and immunohistochemical features. Morphometric features of melanocytes in the upper and lower parts of a challenging lesion may help to facilitate an accurate diagnosis. STUDY DESIGN: We studied 32 cases of invasive cutaneous melanoma, 35 cases of mild or moderate dysplastic nevus, and 31 cases of benign melanocytic nevus. All cases were immunostained with Sox10. The nuclear areas of 30 melanocytes were measured on each papillary (upper al1) dermis and reticular dermis/subcutaneous tissue (lower ILI) in all cases by using the Image J analysis program. Then, a maturation index (U/L) was calculated for each case. Also, cutaneous melanomas were categorized into 2 groups that displayed pseudo-maturation or the lack of it. RESULTS: Mean maturation index was 1.04 +/- 0.29 in melanomas, 1.23 +/- 0.28 in dysplastic nevi, and 1.52 +/- 0.33 in benign melanocytic nevi, respectively. There were statistically significant differences between melanoma and dysplastic nevus (p = 0.012) and between melanoma and benign melanocytic nevus (p < 0.001) for the maturation index. Although pseudo-maturation was associated with low mitotic activity and thin Breslow thickness, there was no significant difference between survival distributions of 2 melanoma groups. CONCLUSION: Calculation of the maturation index can be used as a supporting tool for the differential diagnosis of challenging cases. However, it may possess limitation for evaluation of nevoid melanoma, melanoma in situ, or clonal nevus.Öğe Can numeric maturation value be used as prognostic indicator and diagnostic tool in cutaneous melanomas (a morphometric study)?(Springer, 2018) Gamsızkan, Mehmet; Büyücek, Şeyma; Coşkun, Sinem Kantarcıoğlu; Sungur, Mehmet Ali; Özlü, Emin; Bahçıvan, Atike; Önal, Binnur…Öğe Can Peripheral MicroRNA Expression Data Serve as Epigenomic (Upstream) Biomarkers of Alzheimer's Disease?(Mary Ann Liebert, Inc, 2016) Yılmaz, Şenay Görücü; Erdal, Mehmet Emin; Özge, Aynur Avcı; Sungur, Mehmet AliAlzheimer's disease (AD) is a progressive neurodegenerative disorder and the most common form of dementia. However, biomarkers that require testing in the brain tissue pose a formidable practical barrier to AD diagnostic innovation. MicroRNAs (miRNAs) are responsible for control of gene expression at the posttranscriptional level and are essential for the function of neuronal networks and neuronal survival. miRNA expression can impact the regulation of APP (amyloid beta A4 precursor protein), PSEN1 (presenilin 1), PSEN2 (presenilin 2), and BACE1 (beta-secretase 1) genes in the brain that were previously implicated in AD pathophysiology. Little is known, however, on the extent to which peripheral tissue (e.g., whole blood) miRNA variation might offer clinical predictive value for AD. Moreover, few studies have examined multiple peripheral miRNA expression data at the same time. We report here, to the best of our knowledge, the first whole-blood-based and parallel study of seven miRNAs (hsa-miR-9-5p, hsa-miR-29a-3p, hsa-miR-106a-5p, hsa-miR-106b-5p, hsa-miR-107, hsa-miR-125a-3p, and hsa-miR-125b5p) in relation to AD susceptibility. Notably, these miRNAs are situated "upstream" to the genes implicated in AD. We measured the whole-blood miRNA expression by a real-time polymerase chain reaction in a large study sample (n = 281), comprising patients with AD (n = 172) and healthy controls (n = 109). A reduction in whole-blood expression of hsa-miR-9-5p, hsa-miR-106a-5p, hsa-miR-106b-5p, and hsa-miR-107 was significantly associated with an increased risk of AD (p < 0.05). Notably, after receiver operating characteristics curve analyses, hsa-miR-106a-5p displayed, as a predictor variable, 93% specificity and 68% sensitivity. On the other hand, the expression of hsa-miR29a-3p, hsa-miR-125a-3p, and hsa-miR-125b-5p was not significantly different between patients and controls (p > 0.05). In conclusion, these observations warrant replication in larger samples while making a contribution to translational research, precision medicine, and biomarker literatures, by expanding the current efforts for AD diagnostic innovation to the realm of epigenomic pathways such as miRNA expression variation among patients.Öğe Characteristics of Isolated Headache patients in Cerebral Venous Sinus Thrombosis (CVST): The Results of VENOST - national survey(Springeropen, 2018) Uludüz, Derya; Yalın, Osman Özgür; Duman, Taşkın; Domaç, Füsun Mayda; Öztürk, Şerefnur; Yayla, Vildan; Sungur, Mehmet Ali…Öğe Clinical Picture at Attendance and Response to Flexible Family-Based Low-Carb Life Style Change in Children With Obesity(Lifescience Global, 2021) Cakmak, Hatice Mine; Arslanoglu, Ilknur; Sungur, Mehmet Ali; Bolu, SemihAim: The study aims 1) to determine the clinical status of obese children at the admittance to the pediatric endocrinology referral center 2) to investigate the efficiency and compliance of the low-carb diet in a pediatric population with or without exercise, metformin Material and Methods: All subjects with the complaint of obesity and BMI percentile >95 were recruited from January 2012-August 2014. We evaluated basal retrospectively, recommended low carbohydrate family-wide eating practice and exercise to all, and metformin to selected cases, and recorded Self- reported adherence at first, third, sixth, and twelfth months. Results: Thirty-six subjects used metformin with a higher ratio of weight loss (90.0%, p=0.010) without a difference in the number of lost kilograms. In 160 cases without metformin; diet only, exercise only, and both diet and exercise groups lost weight significantly according to neither diet nor exercise group (OR:12.08, 95% CI 3.93-41.66, p<0.001; OR:3.04, 95% CI 1.18-7.84, p=0.022 and OR:32.80, 95% CI 7.14-150.77, p<0.001 respectively). Exercise plus diet (95.3%, p=0,002) and only diet (88.9%, p=0,023) were even more efficient than exercise alone (65.5%). In the twelfth month, 13.8% were on follow-up. Conclusion: Obesity gives rise to metabolic complications in the very early stages. A low carbohydrate diet proved to be acceptable and useful. Long-term consistency remains a challenge.Öğe Clinical role of vitamin D in prognosis of otitis media with effusion(Elsevier Ireland Ltd, 2018) Akcan, Fatih Alper; Dündar, Yusuf; Akcan, Hümeyra Bayram; Uluat, Ahmet; Cebeci, Derya; Sungur, Mehmet Ali; Ünlü, İlhanObjective: To investigate the clinical role of Vitamin D in prognosis of Otitis media with effusion. Methods: This prospective-controlled study was conducted at otolaryngology department in Duzce University, Turkey. The study group comprised children who were diagnosed with Otitis media with effusion between September 2016 and February 2017. Control group was conducted with children underwent circumcision or inguinal hernia repair operations that confirmed with ENT examination they do not have any sign of otitis media. After 3 months of follow-up without any treatment, unresolved cases who were accepted as chronic otitis media with effusion were operated under general anesthesia for ventilation tube application. Study and control groups were assessed depending on the serum 25(OH)Vitamin D levels at the end of 3 months; <15 ng/mL was accepted as vitamin D deficiency. The results were compared with the control group in terms of vitamin D levels. Also, subgroup analysis was performed addressing to the complete recovery otitis media with effusion and chronic otitis media with effusion. Results: One-hundred-seventy-four children with otitis media with effusion and 80 control patients were included to the study. One-hundred-eight (62%) out of 174 patients with otitis media with effusion was completely recovered after a 3-months follow up. Of those 66 out of 174 children, they had persistent diseases, underwent ventilation tube insertion after a 3-months follow-up. The mean 25(OH)Vitamin D level was 18.98 +/- 10.60 in otitis media with effusion group and 28.07 +/- 14.10 in control group and the difference was statistically significant between the study and control group (p < 0.001). Vitamin D deficiency was observed in 33 out of 66 patients (50.0%) in chronic otitis media with effusion group whilst 35 out of 108 patients (32.4%) in complete recovery otitis media with effusion group (p = 0.021). The rate of 25(OH)Vitamin D deficiency was 25% in control group which was statistically different from chronic otitis media with effusion and recovery chronic otitis media with effusion groups (p = 0.006). Conclusions: This study not only shows the relationship between Vitamin D and otitis media with effusion development, but also demonstrates the effects of Vitamin D on otitis media with effusion prognosis. There is a significant association between 25(OH)Vitamin D deficiency and follow-up outcomes of otitis media with effusion.Öğe Comparison of Hematological and Biochemical Parameters and Cardiovascular Risk Scores in Patients Applying to the Obesity Outpatient Clinic(Duzce Univ, Fac Medicine, 2022) Kaya, Nursel; Gamsizkan, Zerrin; Sungur, Mehmet AliObjective: The aim of this study was to compare hematological and biochemical parameters and cardiovascular risk scoring in patients admitted to the obesity outpatient clinic.Methods: In this descriptive cross-sectional study, data of the patients who admitted to the Obesity Outpatient Clinic of Duzce University Research and Application Hospital between 2017 and 2018 were evaluated retrospectively. Age, gender, smoking status, presence of Diabetes Mellitus (DM), and body mass index (BMI) were recorded and the cardiovascular risk of the patients was calculated by using the scoring system of the European Society of Cardiology (ESC) and Turkish Society of Cardiology (TSC).Results: A total of 631 participants were included in the study. The mean age was 38.9 +/- 12.1 (min=21, max=65) and 75.1% of the patients were female and 24.9% were male. It was observed that 19.2% of the patients were smokers, 4.6% had DM and 36.9% had insulin resistance. When the patients were evaluated according to the BMI scores, it was found that 3.3% of them were underweight, 7.3% were normal weight, 22.5% were overweight and 66.9% were obese. According to TSC risk scoring system, 51.4% of the patients were in low risk, 20.5% were in medium risk and 28.1% were in high risk category. According to the ESC risk scoring system, 83.5% of the patients were in low risk, 10.9% were in medium risk and 5.5% were in high risk category. According to both risk scoring systems, there were significant differences between the risk groups in terms of age, gender, BMI, and presence of DM (p<0.001). When evaluated according to the TSC risk score, it was seen that the patients in the high-risk category had a lower platelet/lymphocyte ratio and a higher total cholesterol/HDL ratio. According to both risk scoring systems, no correlation was found between cardiovascular risk and RDW, MPV, leukocyte count, and NLR(Neutrophil-Lymphocyte ratio). Conclusions: Conducting a cardiovascular risk assessment for patients who admit to primary health care services for obesity counseling is important. A cardiovascular risk assessment conducted at admission may help some precautions to be taken earlier. There is a need for more studies to determine easily accessible parameters that can predict cardiovascular risk.Öğe Comparison of histopathological and biomechanical changes of ligamentum mucosum in patients with anterior cruciate ligament rupture(Turkish Joint Diseases Foundation, 2024) Turhan, Yalcin; Arican, Mehmet; Karaduman, Zekeriya Okan; Sungur, Mehmet Ali; Gamsizkan, MehmetObjectives: The aim of this study was to identify the biomechanical and histopathological changes of ligamentum mucosum (LM) in patients with intact versus ruptured anterior cruciate ligament (ACL). Patients and methods: A total of 67 patients (45 males, 22 females; mean age: 33.2 +/- 7.9 years; range, 18 to 45 years) who underwent arthroscopic knee surgery for intraarticular pathologies between July 2022 and January 2023 were prospectively analyzed. The patients with LM were divided into two groups as the ACL intact group (n=31) and ACL ruptured group (n=36). Biomechanical tests and histopathological examinations were performed in all LM patients. Results: Age and body mass index distributions were similar between the groups (p>0.05). Peak force values of the LM in the ACL ruptured group were significantly higher than the ACL intact group (p=0.037). No significant difference was found between the groups in terms of collagen index (p=0.103) and fibroblast count (p=0.821). Conclusion: The peak force values of the LM were significantly higher in the ACL ruptured group as compared to the ACL intact group, which is probably due to the adaptation of LM in patients with ACL rupture against increased deforming forces to maintain knee stability.
