Bilgin, Yasin; Akkuş, Şeyma; Işık, Bahar; Sari, Fatih Mehmet

While drug trafficking is a major problem worldwide, body packing involving the storage of narcotic drugs in the human body represents an emergency because of the risk of deadly narcotic toxicity, intestinal obstruction and visceral perforation. We presented the evaluation of body packer cases, which have not been seen before in this region, in the emergency clinic. This study analyzes the medical records of body packers from January to July 2023. Hematological and biochemical tests, abdominal radiographs and tomographies, and removed packages were evaluated in all cases. Nine body packer cases carrying narcotic substances were observed in this study. The mean age was 33 ± 6.3, 2 (22%) were female and 7 (78%) were male. None of the patients required emergency surgery. One patient had acute narcotic intoxication. In this patient, whose packages were observed to be intact, drug intoxication was associated with substance use. Abdominal radiography diagnosed all cases and all were recovered and discharged. It is very important for public safety to diagnose body packing cases and prevent the transport of packages. In this issue, emergency physicians should have radiography and CT imaging features in asymptomatic body packing cases.

Deveci, Serol; Dinc, Kemal

Aim: Cesarean section rates have increased, and although various measures such as an- tenatal education programs have been introduced to correct this, these could not be per- formed face-to-face due to the COVID-19 pandemic and were largely carried out online. The aim of this study was to find out what effect traditional education during pregnancy and its online replacement have on the rate of cesarean births and how the pregnancy turns out in unusual situations. Materials and Methods: The research was designed as a retrospective cross-sectional study. Fifty women undergoing childbirth in our hospital who received online antenatal education (Group 1), 101 women who received classic education (Group 2), and 77 women receiving no education (Group 3) took part in the study. Patient data were retrieved from the hospital information system and patient records. Results: This study involved 228 pregnant women. Fifty pregnant women (22%) re- ceiving antenatal online education were assigned to Group 1, 101 women (44%) receiving classic face-to-face education to Group 2, and 77 women (34%) receiving no education to Group 3. Forty percent of Group 1, given online education, and 62.4% of Group 2, given classic education, were able to give birth via the normal vaginal route, and the difference was statistically significant (0.001). Cesarean delivery rates were significantly higher in Group 1 (60%) than in Group 2 (37.6%) (0.001). Statistically similar results were deter- mined in all three groups in terms of birth weight, birth length, and low birth weight. No significant difference was also observed between the three groups in terms of premature birth (37 weeks) (p=0.67). Conclusion: Online antenatal education does not reduce cesarean delivery rates com- pared to classic education. However, neonatal outcomes are similar.

Ergül, Emine Esra; Ergül, Cetin; Gundogdu, Mehmet

Aim: A critical health problem that affects people all around the world is vitamin D deficiency. Fundamentally, obesity and vitamin D deficiency are acknowledged as major global public health problem. In this study, we examined the connection between low vita min D levels and Body Mass Index (BMI), as well as the association between demographic factors and vitamin D. Materials and Methods: 207 participants who were 18 years old or older and had ever been diagnosed with a chronic disease were included in the study. The participants filled out a questionnaire to analyze their demographic characteristics and physical activity levels. As well as evaluating the body mass index, serum vitamin D levels were tested. Results: It was reported that among the study participants, there was a substantial positive association between levels of physical activity and vitamin D levels. Vitamin D levels were found to be significantly negatively correlated with participant weight and BMI. Increasing weight and BMI lead to a reduction in vitamin D levels. It was demonstrated that gender, body mass index, physical activity level, marital status, vitamin D-containing food consumption state and consumption amount, vitamin D supplementation state, ways of going to work, daily exposure to sunlight, seasonal exposure to sunlight affects vitamin D levels. Conclusion: The study group was found to have very high levels of vitamin D insuffi ciency and deficiency, and there was a strong association between 25-hydroxy vitamin D3 (25(OH)D3) serum level and physical activity level and BMI.

Ozdemir, Gokhan; Demirdöğen, Filiz; Akcay, Guven; Admış, Özlem

Aim: The neurons are the cells most susceptible to ischemic events. The exact mech anisms of cellular damage due to hypoxia and ischemia and the role of cytochrome c in this case have not been fully explained in detail. The aim of this study was to investigate cytochrome c in patients with acute ischemic stroke. Materials and Methods: The cytochrome c levels in venous blood received from 56 pa tients with acute ischemic stroke admitted to our hospital neurology clinic and 30 healthy volunteers have been studied. Infarct volume and arrival of patients with acute ischemic stroke were also recorded in the NIHSS. Results: There was no significant difference between the two groups. In addition, there was no statistical association between cytochrome c levels and infarct volume and arrival NIHSS in patients with acute ischemic stroke. Conclusion: Cytochrome c plays a very important role in complex cascades in the process leading to neuronal death from acute brain vascular occlusion. Brain ischemia; endoge nous neuroprotective mechanisms are activated, and cytochrome c is removed from the environment and kept within normal limits. In addition, blood cytochrome c levels in patients with acute ischemic stroke are not a biochemical marker for the diagnosis and the severity of disease.

Sagsoz, Mustafa Erdem; Hacimuftuoglu, Ahmet; Çıçek, Betül; Danışman, Betül; Ertugrul, Muhammed Sait

Aim: Parkinson’s disease (PD) is a progressive, neurodegenerative disease characterized by the loss of dopaminergic neurons. Multiple possible mechanisms such as oxidative stress, mitochondrial dysfunction or excitotoxicity caused by glutamate are thought to mediate neuronal loss in PD. It is stated that transcranial direct current stimulation (tDCS) has positive effects on PD, but underlying mechanisms are still largely undefined. So, in this study, the effects of tDCS on PD and the relationship of these effects with glutamate and NMDA levels were investigated. Materials and Methods: To induce the PD model, 6-OHDA (200 µM) was administered to SH-SY5Y cells for 24 hours. Electrical stimulation was applied to the SH-SY5Y cells at 20 minutes and 7 hours after 24 hours. The effect of tDCS on cell viability was measured by MTT 3-(4, 5-Dimethylthiazol-2-yl) method. Glutamate and NMDA receptor levels were measured using commercial kit. Results: 6-OHDA increases cell death in SH-SY5Y cells, while electrical stimulation reverses this effect. While 6-OHDA increased the glutamate level, tDCS therapy reversed this effect. There is no significant difference between the groups in NMDA levels. Conclusion: Our findings suggest that tDCS can be a functional therapy on PD by reducing glutamate toxicity.

Bakan, Nuri; Kurt, Nezahat; Türkeri, Özge Nur

Aim: HELLP syndrome is a possibly fatal complication of severe preeclampsia that occurs throughout pregnancy. Biochemical abnormalities are one of the hypotheses proposed to explain the disease’s physiopathological symptoms. According to studies, different congenital illnesses are caused by a lack of nutrients such as zinc, copper, iron, manganese, and folic acid, the demand for which increases during pregnancy. The objective of this study was to compare serum zinc and copper levels in healthy women and pregnant women with HELLP, as well as to investigate if there was a relationship between the two. Materials and Methods: The serum zinc and copper levels of 20 healthy pregnant women and 20 pregnant women with HELLP were measured using an Atomic Absorption Spectrophotometer. Results: Serum Zn levels in HELLP syndrome patients were significantly higher than in healthy pregnant women (p<0.05). Furthermore, a negative connection was found between Zn levels and PLT, and a positive correlation between LDH (r:-0.322, p<0.05; r:0.384, p<0.05 respectively). Conclusion: In conclusion, high serum zinc levels in HELLP syndrome can be evaluated in the laboratory.

Albayrak, Akif; Misir, Abdulhamit; Sevencan, Ahmet; Gür, Volkan; Yapici, Furkan; Özkan, Bilge; Akıncı, Şuayip

Aim: The tension of the spinal cord may pose a risk in terms of neurological damage during deformity correction of spine surgeries. Conus medullaris level can provide information\rabout the tension of the spinal cord. However there is lack of information in the literature\rabout the conus medullaris level in idiopathic scoliosis patients. This study aimed to compare conus medullaris levels and spinopelvic parameters among patients with adolescent\ridiopathic scoliosis (AIS), tethered cord syndrome with AIS, and healthy controls.\rMaterials and Methods: We retrospectively recruited fifty patients with AIS (mean\rage 14.3±2.0 years), forty-two patients with tethered cord syndrome with AIS (mean age\r13.6±4.8 years), and fifty patients with no spinal abnormality (mean age 14.5±2.4 years).\rFor the evaluation of and comparison of the patients, Risser stage, spinopelvic parameters\r(Cobb angle, lumbar lordosis angle, thoracal kyphosis angle, lumbosacral angle, thoracal\rtilt, T1-pelvis angle, sacral slope, sagittal and coronal balance, lumbar tilt, pelvic obliquity,\rpelvic tilt, and pelvic incidence), and conus medullaris levels were used. Conus medullaris\rlevels were measured on sagittal magnetic resonance imaging (MRI) T2-weighted sections,\rand spinopelvic parameters were measured on lateral whole-spine radiographs.\rResults: Conus medullaris termination levels were significantly lower in the tethered cord\rsyndrome with AIS group (p < 0.001) and were not significantly different between the\rAIS group and healthy individuals (p = 0.680). No significant differences were observed\rin the Risser stage, Cobb angle, lumbar lordosis, thoracal kyphosis, lumbosacral angle,\rthoracal tilt, T1-pelvis angle, sacral slope, sagittal balance, and coronal balance between\rthe tethered cord with AIS and AIS groups (all p > 0.05). Lumbar tilt, pelvic obliquity,\rpelvic tilt, and pelvic incidence parameters were significantly higher in the tethered cord\rwith AIS group (all p < 0.05 ).\rConclusion: This study demonstrated that the distribution of the conus locations in AIS\rpatients was similar to that in the healthy control group. Lumbar tilt, pelvic obliquity,\rpelvic tilt, and pelvic incidence parameters were significantly higher in the tethered cord\rsyndrome with AIS group.\r

Kara, İlknur Sürücü

Aim: The most common seizure type in childhood is febrile convulsion, which is likely to recur due to many risk factors. This studyaimed to evaluate serum sodium and glucose levels in patients who had a febrile convulsion and investigate the relationship betweenthese values and recurrent seizures. Materials and Methods: The medical records of patients presenting to our hospital with the diagnosis of febrile convulsion between2013 and 2018 were investigated.Patients with high-risk factors for recurrence were excluded. According to the reference ranges of our laboratory, for glucose, 101- 149 mg/dl as mild-to-moderate stress hyperglycemia, above 150 mg/dl as severe stress hyperglycemia; for sodium, below 134mmol/L as hyponatremic. Results: Of the 90 patients, 51 were boys, and 39 were girls. Without recurrent convulsions with recurrent convulsions (first-last):The mean age was 27.2±12.7 months / 27.4 ± 11.3 months-30.5±12.4; the mean serum glucose level was 129.1±37 mg/dl/130 ±37.5mg/dl-124 ± 34 mg/dl; the mean serum sodium level was 134.07±3.05 mmol/L 134.4 ± 2.6 mmol/L-133.8 ± 2.9mmol/L. The glucoselevel was 60-100 mg/dl in 14/5 cases, 101-149 mg/dl in 39/10 cases, and above 150 mg/dl in 16/6 cases; the sodium level was135-150 mmol/L in 29/10 cases, < 135 mmol/L in 40/11 cases. Conclusion: Febrile convulsion is in most cases present with hyponatremia and hyperglycemia, but this cannot be a predictivemarker of seizure recurrence.

Arslan, Yusuf Kemal; Düzgün, Eren; Tanoglu, Ceyda; Baday-Keskin, Dilek

Aim: Distal symmetric polyneuropathy is a common complication causing foot ulcers and amputations in diabetic patients. TheMichigan Neuropathy Screening Instrument (MNSI) is one of the screening methods of diabetic neuropathy, which also providesa comprehensive foot evaluation. The aim of this study was to evaluate the validation, cross-cultural adaptation, and reliability ofTurkish Version of the MNSI in the Eastern Anatolia region of Turkey.Materials and Methods: One hundred twenty-six patients with diabetes mellitus were randomly assigned to the study. Thequestionnaire section of the MNSI was completed by the patients, and the physical examination section was evaluated by healthprofessionals. Nerve conduction studies were performed to 123 patients as the gold standard for diabetic neuropathy. All nerveconduction studies and patients were evaluated by a neurologist.Results: The inter-rater agreement of questionnaire section [ICC: 0.957 (95% CI: 0.940-0.969), p<0.001] and physical examinationsection [ICC: 0.917 (95% CI: 0.884-0.941), p<0.001] were excellent. The intra-rater agreement of the questionnaire section [ICC: 0.880(95% CI: 0.833-0.914), p<0.001] and physical examination section [ICC: 0.920 (95% Cl: 0.889-0.943), p<0.001] showed a high stability.The area under curve (AUC) for the questionnaire section and physical examination section of the MNSI were 0.588 (p=0.205) and0.880 (p<0.001), respectively. The optimum cut-off value of the physical examination section determined using both Youden’s indexand Index of Union as >3, with the sensitivity of 76.2%, specificity of 91.2%, positive predictive value of 64%, negative predictive valueof 94.9%. Conclusion: The physical examination section of Turkish version of the MNSI is valid and reliable.

Dabanlıoğlu, Bülent; Sener, Ebru; Ozcicek, Adalet; Aktaş, Mehmet; Akyüz, Sümeyye; Suleyman, Halis; Kocaturk, Hüseyin; Bedir, Fevzi; Karahan, Sevil

Aim: It has been reported that nephrotoxicity is observed in 5-25% of patients during vancomycin use. The part oxidative stress plays in the pathogenesis of vancomycin-induced nephrotoxicity has been demonstrated. Lutein shows antioxidant activity. The purpose of the present study was to evaluate effects experienced by lutein on oxidative kidney damage induced by vancomycin in rats biochemically an histopathologically. Materials and Methods: Oral administration of lutein at a rate of 1mg per kg was performed for the lutein plus vancomycin group (L+VAN) (n=6), whereas saline was administered to the vancomycin (VAN) (n=6) and healthy control (C) (n=6) groups. Sixty minutes after administration of lutein and solvent, 200 mg/kg vancomycin was intraperitoneally injected twice a day to L+VAN and VAN groups. This procedure was repeated for 7 days. Then malondialdehyde (MDA), total glutathione (tGSH), total oxidant system (TOS) and total antioxidant system (TAS) levels have been assessed in kidney tissues; in addition, creatinine and BUN were measured in blood samples. Kidney tissues were also evaluated histopathologically. Results: Significant histopathological damage could be seen in the kidney tissue of the VAN group that increasing MDA and TOS and creatinine and BUN. Histopathological damage was not very significant in the L+VAN group that decreasing MDA, TOS, BUN and creatinine levels. Conclusion: This suggests that lutein may be effective for the treatment of the treatment of vancomycin-associated oxidative kidney damage.