The Use of Cangrelor as Bridge Antiplatelet Therapy in a Patient with Recent Percutaneous Coronary Intervention for Acute Coronary Syndrome, Who Developed Esophageal Perforation After Transesophageal Echocardiography.

Dual antiplatelet therapy (DAPT) is a vital part of the pharmacological management in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). While early discontinuation of DAPT increases ischemic risk, some patients on DAPT may require urgent surgery, necessitating its interruption. Cangrelor, an intravenous P2Y12 antagonist, provides strong platelet inhibition within minutes and platelet activity normalizes within one hour after the cessation of the drug. Bridging antiplatelet therapy with cangrelor has been increasingly studied as an alternative option to ensure the continuation of platelet inhibition in CAD patients who require discontinuation of DAPT. The present patient, with a recent history of PCI for acute coronary syndrome, experienced a significant esophageal perforation following transesophageal echocardiography (TEE). This severe complication was effectively managed endoscopically, and as part of the recent PCI treatment, prolonged cangrelor infusion was successfully utilized with no thrombotic or bleeding events throughout the management of the complication.

The Bibliometric Analysis of the Postgraduate Theses Written on Medical Parasitology in Türkiye.

Objective: The aim of this study was to analyze the theses prepared in the field of medical parasitology in Türkiye and to reveal the importance given to the science of parasitology in the groves of academe and to raise awareness in this field. Methods: Council of Higher Education's National Thesis Center database has been analyzed postgraduate these documents conducted in the field of medical parasitology from January 1985 to September 2022. Results: As a result of the examining, 393 theses made in the field of medical parasitology were detected. It was determined that 52.9% of the theses prepared were master, 28% of PhD and 19.1% were the thesis of medical specialty thesis and 61.3% of the theses prepared were related to protozoa, 16.5% of helminths, 8.6% arthropods and 12.2% of intestinal parasites (helminth and protozoa). The top five types of parasites in the theses were Toxoplasma gondii, Leishmania spp., Echinococcus spp., Giardia intestinalis and Cryptosporidium spp. respectively. Conclusion: In conclusion, it was of the opinion that more importance should be given to the field of medical parasitology in Türkiye.

Investigation of Mitochondrial Cytb Gene Region of Both Echinococcus granulosus Eggs from Dogs and Cystic Echinococcosis Isolates Obtained from Sheep and Cattle by Molecular Methods.

Background: We aimed to determine the common Echinococcus granulosus genotypes in Agri, Türkiye and to obtain information on the transmission of this parasite. Methods: Cystic echinococcosis samples from 100 slaughtered cattle and 100 slaughtered sheep and faecal samples from 200 stray dogs were included in 2021. Collected cyst fluid samples and faces were examined microscopically. DNA was isolated from the germinal membrane of the cysts and from the parasite eggs in the stool samples. The mitochondrial cytb gene region of the parasite was amplified by PCR. Genotypes were determined using the Basic Local Alignment Search Tool (BLAST) after sequence analysis of PCR amplicons. Results: The highest percentage of cysts was found in the lungs of sheep and the liver of cattle. In addition, 75% of sheep cysts and 25.6% of cattle cysts were fertile. Taenia spp./Echinococcus spp. eggs were found in 6% of the faeces of 200 dogs examined microscopically. E. granulosus eggs were detected in 4 out of 50 stool samples analysed by PCR. All samples analysed by sequence analysis were identified as E. granulosus s.s. G1 genotype. Sequence comparison revealed revealed one or more-point mutations in different regions of the five samples. Conclusion: E. granulosus s.s. G1 genotype, known as sheep strain, is common in the Agri, Türkiye. The controlled slaughter of livestock, especially sheep, and the avoidance of feeding hydatid cyst organs to dogs, together with public education, were necessary to prevent the spread of the disease.

Dental plaque quantitation by light induced fluorescence technology in exclusive Electronic Nicotine Delivery Systems (ENDS) users.

OBJECTIVES: In comparison to conventional combustible cigarettes, Electronic Nicotine Delivery Systems (ENDS) including both e-cigarettes (ECs) and heated tobacco products (HTPs) significantly reduce exposure to toxic chemical emissions. However, their impact on dental plaque remains unclear. This study measures dental plaque in ENDS (ECs and HTPs) users using quantitative light-induced fluorescence (QLF) technology, comparing them with current, former, and never smokers. METHODS: This cross-sectional study compared dental plaque measurements using QLF technology (Q-ray cam™ Pro) among current smokers (≥10 cigarettes/day), former smokers (quit ≥6 months), never smokers, and exclusive ENDS users (quit ≥6 months). Dental plaque measurements were expressed as ΔR30 (total area of mature dental plaque) and ΔR120 (greater plaque thickness/maturation-calculus). The Simple Oral Hygiene (SOH) score was calculated by the QLF proprietary software. Statistical analyses including ANCOVA was performed by R version (4.2.3) with p < 0.05. RESULTS: A total 30 smokers, 24 former smokers, 29 never smokers, and 53 ENDS users were included. Current smokers had significantly higher ΔR30 and ΔR120 values compared to other groups (p < 0.001). ENDS users showed plaque levels similar to never and former smokers (p > 0.05) but significantly lower than current smokers (p < 0.01). Although ENDS users showed a lower SOH score than smokers, this difference was not statistically significant. Daily toothbrushing and mouthwash usage were significant covariates. CONCLUSION: ENDS users exhibited reduced accumulation of dental plaque and calculus compared with current smokers. CLINICAL SIGNIFICANCE: Exclusive ENDS use could less impact dental plaque accumulation compared to cigarette smoking. Further research is needed to confirm these findings and fully understand ENDS impact on dental plaque formation.

E-cigarettes and heated tobacco products impact on dental color parameters.

Objectives: Abstaining from tobacco smoking may not only improve general health, but also reduce teeth staining and restore teeth whiteness. Compared with conventional cigarettes, E-cigarettes (ECs) and heated tobacco products (HTPs) may offer substantial reduction in exposure to pigmented tar-like compounds of cigarette smoke. It is possible that improvements in dental color indices may be observed in those who have stopped smoking combustible cigarettes by switching to tar-free nicotine delivery products. Methods: This cross-sectional study evaluated and compared dental color parameters by digital spectrophotometry among five different groups: individuals who currently smoke ; individuals who used to smoke but have quit ; individuals who have never smoked ; exclusive users of electronic cigarettes (former smokers) ; and exclusive users of heated tobacco products (former smokers) . Results: Dental whiteness in current cigarette smokers was notably worse compared with never and former smokers, (13.38 Whiteness Index for Dentistry (WID) units vs. 19.96 and 16.79 WID units). Remarkably high WID values (i.e., whiter teeth) were also observed in ECs (16.72 WID units) and HTPs users (17.82 WID units). Compared to current smokers, difference in dental whiteness for ECs and HTPs users was visually noticeable (ΔWID difference being on average > 2.90 units). The colour differences measured as delta E*(ΔE*) were all visually detectable except for the comparison between ex-smokers and ECs users for which no perceptible color difference was observed (0.415). Conclusion: Exclusive use of ECs and HTPs is associated with better dental color measurements than current smoking, suggesting that tar-free nicotine delivery technologies are unlikely to have negative effects on dental appearance. Clinical significance: Use of alternative nicotine delivery systems may be associated with cosmetic benefits with important implications for those smokers perceiving dental aesthetics as a significant problem. For these an oral-based narrative may be a much more significant reason to refrain from smoking than the fear of developing smoking-related diseases in future.

Molecular Characterization of Giardia intestinalis and Cryptosporidium spp. Detected in Humans in Agri, Türkiye.

Background: We aimed to determine the prevalence of Giardia intestinalis and Cryptosporidium spp. in patients who admitted hospital with diarrhea and to gain information about the transmission of these parasites in Agri, Türkiye. Methods: This study included 184 patients who applied to Agri-Diyadin State Hospital, Türkiye in 2022. The immunochromatographic card test was used for detection of the G. intestinalis and Cryptosporidium spp. Nested PCR-RFLP analysis of the COWP gene and sequence analysis of the gp60 gene were used to genotype and subtype Cryptosporidium spp., whereas Nested PCR and sequence analyses of ß-giardin gene were used genotype G. intestinalis. Results: Of the 184 stool specimens examined, 12 (14.29%) and 7 (3.80%) were positive for G. intestinalis and Cryptosporidium spp., respectively. The Cryptosporidium species were identified as C. parvum belonging to the IId sub-type family. The G. intestinalis were identified assemblages A. Conclusion: Assemblage A, which is associated with diarrhea, is responsible for giardiasis and C. parvum IId subtype, often found in sheep, goats and cattle, is responsible for cryptosporidiosis in Agri, Türkiye.

Effects of Ramadan intermittent fasting on performance, physiological responses, and bioenergetic pathway contributions during repeated sprint exercise.

Introduction: This investigation aims to elucidate the impact of Ramadan intermittent fasting on performance, physiological responses, and bioenergetic pathway contributions during repeated sprints. Methods: Fourteen active male Muslim athletes (age = 22.4 ± 1.8 years, body weight = 69.5 ± 3.8 kg, height = 176 ± 5.1 cm) executed a repeated sprint protocol, consisting of ten 20-meter sprints with 15-s passive recovery intervals, during both fasting and non-fasting conditions. The fasting session was conducted after a 12-14 h fast following Sahur (the pre-dawn meal during Ramadan). In contrast, the non-fasting session occurred before the Ramadan fasting period began, during the same hours of the day, at a time when fasting was not yet required for the athletes. Bioenergetic pathway contributions during repeated sprints were quantified using the PCr-LA-O2 method. Results: The mean sprint time during fasting sessions was 3.4 ± 0.3 s compared to 3.3 ± 0.2 s in non-fasting sessions, indicating a trend approaching the threshold of significance for slower times in the fasted state (p = 0.052, effect size (ES) = 0.34). In terms of bioenergetic contributions, the total metabolic energy expenditure (TEE) was slightly lower during fasting sessions (236.5 ± 22 kJ) compared to non-fasting sessions (245.2 ± 21.7 kJ), but this difference was not statistically significant (p = 0.102, ES = 0.40). Similarly, metabolic energy expenditure per sprint was 23.7 ± 2.2 kJ in fasting conditions compared to 24.5 ± 2.2 kJ in non-fasting conditions (p = 0.106, ES = 0.35). The oxidative energy contribution did not differ significantly between fasting (34.2 ± 4.1 kJ) and non-fasting conditions (34.2 ± 4.1 vs. 35.5 ± 5.2 kJ; p = 0.238, ES = 0.28). Similarly, lactic (60.4 ± 7.6 vs. 59.2 ± 8.3 kJ; p = 0.484, ES = 0.15); and alactic (149.3 ± 19.9 vs. 143 ± 21.5 kJ; p = 0.137, ES = 0.30) energy contributions showed no significant differences between the fasting and non-fasting sessions. The percentage of performance decrement (Pdec) and the percentage contributions of oxidative, lactic, and alactic pathways to the total energy expenditure did not differ significantly between the fasting and non-fasting conditions, indicating a similar bioenergetic profile across both conditions. Conclusion: The present findings indicate no significant differences in performance metrics and metabolic outcomes between fasted and non-fasted states. Future assessments with longer duration and higher intensity protocols may provide further insights.

Effect of erector spinae plane block on postoperative intravenous morphine consumption in open subcostal nephrectomy: A prospective randomized clinical trial.

OBJECTIVES: We began with the hypothesis that the erector spinae plane block (ESPB) would decrease postoperative morphine consumption in patients scheduled for open subcostal nephrectomy. METHODS: After obtaining ethics committee approval and informed patient consent, American Society of Anesthesiologists I-II, 46 patients between the ages of 18 and 65 who were scheduled for elective nephrectomy with an anterior subcostal incision were included in this study. Patients were randomly divided into two groups, the ESPB and the control group, using the sealed envelope technique. In the ESPB group, ESPB was applied with 20 mL of 0.25% bupivacaine at the T10 level at the block corner before being taken to the operating room. Patient-controlled analgesia with intravenous morphine was applied to both the ESPB and the control groups. RESULTS: Intraoperative remifentanil consumption in the ESPB group was statistically significantly less than in the control group (1069.5±211.54 micrograms versus 1471.4±202.21 micrograms) (p<0.001). Postoperative morphine consumption of the patients was also lower in the ESPB group (16.8±4.13 milligrams versus 33.65±6.91 milligrams) (p<0.001). The numeric rating scales of the patients in the ESPB group were lower than in the control group (p<0.001). The additional analgesic requirements of patients were less in the ESPB group (35% vs 95%, p<0.001). Patient satisfaction was higher in the ESPB group compared to the control group (p=0.009). Nausea was lower in the ESPB group than in the control group (p=0.007). CONCLUSION: Preemptive administration of ESPB is a safe and beneficial analgesic method in patients undergoing open subcostal nephrectomy.

Does neo-adjuvant chemotherapy improve the negative effect of lymphovascular invasion in survival after radical cystectomy?

PURPOSE: There is a lack of studies in the literature to evaluate the impact of the specific benefit of the use of neo-adjuvant chemotherapy (NAC) on the negative effect of lymphovascular invasion (LVI) on prognosis. We aimed to evaluate the survival differences of patients according to the presence of LVI with and without administration of NAC before radical cystectomy (RC). MATERIALS AND METHODS: We retrospectively evaluated data of the patients who underwent RC with pelvic lymphadenectomy and urinary diversion for bladder cancer recorded in the bladder cancer database of the Turkish Uro-oncology Association between 2007 and 2021. Patient demographics, follow-up time and overall survival (OS) were noted. RESULTS: A total of 633 subjects included in the analyses. Median follow-up time was 24 months (IQR 12-54). Five years OS of the whole cohort was 55.1%. This was 54.7% and 59.9% in NAC- and NAC+ groups (P = 0.683), respectively. It was also 35.7% and 65.7% in LVI+ and LVI- patients (P < 0.0001), respectively. There was a significant difference between LVI+ and LVI- patients (33.2% vs. 68.2%, P < 0.0001) in NAC- group, but similar 5-year OS was found (53.2% vs. 64.5%, P = 0.552) in NAC+ group. In multivariable analyses, female gender, pN stages, presence of variant histology and LVI were significant independent predictive factors for OS in the whole cohort and in the NAC- group. However, gender association, pN stages and LVI lost significance in NAC+ group. CONCLUSION: Presence of LVI significantly reduced OS, and the NAC treatment improved the negative effects of LVI on OS. Our findings encourage the use of NAC before RC.

Spread of Intestinal Parasites in Patients Presenting with Gastrointestinal Complaints.

Objective: The aim of this study is to determine the prevalence of intestinal parasites in patients admitted to University of Health Sciences Türkiye (UHS) Van Training and Research Hospital. Methods: A total of 300 patients between the ages of 18-90 who applied to UHS Van Training and Research Hospital with gastrointestinal complaints and were referred to the parasitology laboratory between September 2021 and December 2021, and 100 patients without any chronic disease and gastrointestinal complaints in the control group were included in the study. Stool samples taken from patients included in the study and individuals in the control group were analyzed by native-lugol and modified acid-fast staining methods. Results: In the study, intestinal parasites were detected in 41 (13.3%) of 300 patients in the patient group and in seven (7%) of 100 individuals in the control group. The highest rate of Blastocystis species (Blastocystis spp.) (5.7%) was found in the patient group. Entamoeba coli 3%, G. intestinalis 2.7% and Cryptosporidium species (Cryptosporidium spp). 2.3% were found among the other species detected. In addition, a statistically significant correlation was found between the incidence of parasites and abdominal pain (p=0.022) and nausea (p=0.029). Conclusion: As a result; it was concluded that intestinal parasites are still an important health problem in patients with gastrointestinal complaints and intestinal parasites should definitely be considered in this patient group.

The Significance of Opportunistic Parasitosis and Blastocystosis in Patients with Gastric Cancer: a Study with Control Group.

Objective: The aim of this study was to determine the prevalence of opportunistic parasites and Blastocystis spp. in patients with gastric cancer (CA) and to determine the significance of these parasite. Methods: The patient group and the control group were composed of 100 people each. The stool samples were examined under the microscope for intestinal parasites with the native-Lugol method. Then, samples were multiplied by formol-ethyl acetate method and stained with modified acid-fast method. Results: Intestinal parasite positivity was indicated in 14% of the gastric CA, and 2% of the healthy individuals (p=0.001). Blastocystis spp. (p=0.009) was identified in 11%, Cryptosporidium spp. was identified in 4%, G. intestinalis was identified in 2%, and C. cayetanensis was identified in 1% of the patient group. There were significant differences between the intestinal parasite positivity (p=0.012), abundant Blastocystis spp. positivity (p=0.041) and all Blastocystis spp. positivity (p=0.037) in patient and control groups. Most of the patients who were positive for parasites had diarrhea. Conclusion: Based findings, it was concluded that it would be beneficial to evaluate gastric CA patients, especially those with diarrhea, for intestinal parasites.

Effectiveness of the preventive administration of vasoactive amines in counterbalancing significant patient blood pressure drops following nimodipine administration during mechanical thrombectomy procedures.

BACKGROUND: Focal vasospasm (FV) of the occluded vessel can occur during the endovascular treatment of acute ischemic stroke (AIS). Nimodipine is commonly used to treat vasospasm and can play a role in distinguishing it from artery narrowing due to iatrogenic dissection or residual clot. However, nimodipine administration can result in arterial hypotension and subsequent enlargement of the ischemic core. OBJECTIVE: To assess the efficacy of preventive and continuous vasoactive amine infusion to counterbalance nimodipine-induced hypotension. METHODS: We reviewed data from a prospective registry of patients treated for AIS between January 2019 and January 2022 who were administered nimodipine. All patients were equipped with an arterial cannula for invasive blood pressure measurement and given vasoactive amines preemptively before general anesthesia and throughout the procedure. Data obtained from invasive monitoring of mean arterial blood pressure (MABP) in a time-lapse of 25 min before and after nimodipine administration were analyzed. RESULTS: MABP significantly decreased after nimodipine administration but remained within the recommended range (81.79 ± 0.49 mmHg). Nimodipine was effective in reducing FV caused by stent retriever passage in 76.3% of cases. Furthermore, it proved valuable in diagnosing iatrogenic dissection (9.2%), residual clot (10.5%), or intracranial stenosis (4%). CONCLUSIONS: Infusion of vasoactive amines effectively counteracted the intraarterial nimodipine effect, thus avoiding frank arterial hypotension during endovascular treatment. Nimodipine has been useful in differentiating the diagnosis of FV resulting from mechanical thrombectomy and other potential causes, such as iatrogenic dissection or residual clot.

Evaluation of Cortical Thicknesses and Bone Density Values of Mandibular Canal Borders and Coronal Site of Alveolar Crest.

Objectives: The objectives of this retrospective study are to measure the amount of the alveolar crest cortication and cortication around the mandibular canal, and to evaluate bone density values of alveolar crest, cortication around mandibular canal, and possible implant placement area for edentulous sites. Material and Methods: Six hundred forty-two cone-beam computed tomography scans from 642 subjects were evaluated in four centers. Cortical thicknesses of alveolar crest and mandibular canal cortical borders (buccal, lingual, apical, and coronal) in each mandibular posterior teeth region were measured. Bone density of alveolar crest and mandibular canal cortical borders (buccal, lingual, apical, and coronal) in each mandibular posterior teeth region were recorded. The correlations between numeric variables were investigated using Pearson's correlation test. Results: The largest cortical border of the canal was measured 1.1 (SD 0.71) mm at the left second molar area and in coronal side of the mandibular canal (MC). Left and right first premolar regions showed higher bone density values compared to the other sites in all bone density values evaluations. The buccal side of the canal at the right first premolar region showed the highest bone density values (832.32 [SD 350.01]) while the coronal side of the canal at the left second molar region showed the lowest (508.75 [SD 225.47]). The bone density of possible implant placement area at the both left (692.25 [SD 238.25]) and right (604.43 [SD 240.92]) edentulous first premolar showed the highest values. Positive correlations between the bone density values of alveolar crest and the coronal side of MC were found in molar and left second premolar regions (P < 0.05). Conclusions: Results may provide information about the amount of cortication and bone densities tooth by tooth for posterior mandible to surgeons for planning the treatment precisely.

Prevalence of Fascioliasis in Slaughtered Cattle in Agri Province.

OBJECTIVE: In this study, it was aimed to reveal the frequency of fascioliasis in cattle slaughtered in the slaughterhouses of Agri province. METHODS: The study was carried out on 230 cattle. The presence of Fasciola hepatica eggs in stool and bile fluid samples taken from each cattle was investigated by sedimentation-zinc sulfate flotation method, and the presence of adult parasites in the liver and bile ducts by postmortem examination. RESULTS: The study was conducted on 230 cattle samples. Fasciola spp. eggs were observed in 43 (18.7%) of the stools examined. As a result of the postmortem examination of the liver and gall bladder, F. hepatica adults were found in 52 (22.6%) cattle. All cattle positive in stool examination were also positive in liver and gallbladder examination. Fasciola gigantica adults were not detected in any of the cattle, and there was no statistically significant difference in terms of gender and race. CONCLUSION: In this study conducted on cattle in the Agri region, F. hepatica was found to be significantly common. The data obtained show that in order to prevent economic losses in animal husbandry, which is an important source of livelihood of the local people, effective prevention and control programs should be planned and implemented, and both sheep and cattle breeders should be made aware of the prevention of this infection.

Immediately repaired penile fractures: age is the only predictor of postoperative long-term functional outcomes.

Background: Penile fractures can lead to many functional complications, especially erectile dysfunction (ED). Few studies have evaluated the factors that predict late complications of an immediately repaired penile fracture. Aim: To identify the potential predictors of long-term poor functional outcomes following immediate surgical intervention for penile fractures. Methods: Sixty-eight consecutive patients with suspected penile fracture between 2003 and 2022 were retrospectively reviewed. Functional outcomes, postoperative complications, and follow-up duration were obtained from the records of follow-up visits. Age at presentation, location and length of the tunical tear, the presence of urethral rupture, and time to surgery were all analyzed as potential risk factors for postoperative functional outcomes. Outcomes: Postoperative erectile function and intercourse satisfaction were measured by the IIEF-5 (the 5-item version of the International Index of Erectile Function). Penile curvature, a palpable nodule, and paresthesia/numbness were detected by physical examination. Uroflowmetry was used to assess urinary flow in patients who underwent urethral repair. Results: Fifty-eight patients were analyzed. The mean ± SD age was 38.1 ± 10.4 years; the median follow-up was 79.0 months (range, 13-180); the median time to surgery was 9.8 hours (4-30); and the median tunical tear length was 15.5 mm (4-40). Urethral rupture was observed in 8 patients (13.8%). In univariable analyses, urethral rupture was associated with postoperative complications (P = .034). In addition, age at presentation and tunical tear size were significantly associated with postoperative complications and ED (P < .05). However, in multivariable analyses, only age at presentation significantly predicted postoperative complications and ED (P = .004 and P = .037). Clinical Implications: Age at presentation is the most important factor determining the prognosis of immediate surgical repair of the penile fracture, which aids in predicting potential complications and discussing them with patients prior to surgical intervention and during the follow-up period. Strengths and Limitations: The study's retrospective design is an important limitation. Furthermore, there were no data on an IIEF-5 outcome measuring preoperative erectile function. Conclusion: These results revealed an association between (1) urethral rupture, longer tunical tears, and older age and (2) the development of late complications. The remarkable finding of this study was that age at presentation was the only significant predictor of functional complications based on multivariable analyses. This relationship also remained robust in tests evaluating the covariance of the effects of aging on ED.

Investigation of Parasites in Food Handlers in Turkey.

Increasing world population parallelly also brings an increase in food production and consumption. As food consumption increases, so do foodborne infections. In cases where adequate food safety and hygiene is not provided in places such as restaurants, dormitories, prisons, hospitals where mass feeding is made outside the home, many parasitic agents can be transmitted to people through food. People working in the food processing and distribution sector and who are in the position of porters play an important role in the spread of parasites, as they can transmit parasitic agents to food through fingernails and hands. Parasites such as Enterobius vermicularis, Entamoeba histolytica, and Giardia intestinalis can be transmitted to food and then to patients through nails and hands. This study was planned to investigate the presence of parasites in hospital food production and distribution workers, such as cooks and waiters, using various methods. Stool and serum samples were taken from 100 food production and distribution workers. Stool samples were examined by native-Lugol, concentration, trichrome, acid-fast staining, and cellophane tape methods. E. histolytica antigen in stool and Toxoplasma and Taenia antibodies in serum were searched by enzyme-linked immunosorbent assay. Parasites were detected in 59% people, and 41 were evaluated as negative. This positivity was 71.9% (23/32) in the 45-61 age range. Blastocystis sp. (27%), Toxoplasma (25%), E. histolytica (10%), Taenia spp. (7%), E. vermicularis (7%), Entamoeba coli (7%), G. intestinalis (5%), Chilomastix mesnili (1%), and I. butschlii (1%) were detected in food handlers. High Toxoplasma antibody positivity (25%) suggests the possibility of transmission to kitchen workers through ways, such as infected raw meat. However, the detection of E. histolytica, Taenia spp., E. vermicularis, G. intestinalis parasites in workers at significant levels poses a significant risk for society consuming these foods. As a result, it is important to investigate the presence of parasites in the employee dealing with food production and distribution to protect patients from parasitic infections especially in hospitals where the people are immunocompromised and more susceptible, and where mass meals are eaten.

Distribution of Toxocara vitulorum in Cattle of Agri Region

OBJECTIVE: Parasitizing in the small intestines of cattle, buffalo and bison, Toxocara vitulorum is seen in countries with humid tropical and subtropical climates, including Türkiye. Adult parasites can cause digestive disorders such as loss of appetite, weakness, diarrhea or constipation, and sometimes death, especially in calves. This study was planned to investigate the distribution of T. vitulorum in cattle of the Agri region. METHODS: In this study, stool samples of the size of a walnut were taken from the rectum of 200 calves 0-6 months old and 200 cattle older than 1 year in the province of Agri and its districts, and the preparations were prepared using the saturated zinc sulfate flotation method and the preparations were examined under a light microscope. RESULTS: T. vitulorum eggs were detected in 70 (35%) of 200 calves aged 0-6 months and 21 (10.5%) of 200 cattle over one year old. The difference in positivity between cattle over one year old and calves was statistically significant (p=0.001). With fecal examination in 22 of the calves (11%), Trichostrongylidae spp. eggs were detected. CONCLUSION: It was determined that the prevalence of T. vitulorum in calves was high in Diyadin, Eleskirt, Dogubayazit, Hamur, Tasliçay, Tutak and Patnos districts of Agri province. We believe that larger-scale studies should be conducted on the spread of this parasite, which causes significant low yields in cattle breeding.

Endovascular treatment strategies for simultaneous bilateral anterior circulation occlusions in acute ischemic stroke: A single-center experience and systematic review of the literature.

BACKGROUND: Bilateral and simultaneous occlusion of the anterior circulation is a rare event in patients with acute ischemic stroke. Although endovascular treatment is feasible and safe, the endovascular strategy to be used remains a subject of debate. OBJECTIVE: To assess the different endovascular strategies proposed for the treatment of a bilateral, simultaneous anterior circulation occlusion following acute ischemic stroke. METHODS: We present a retrospective study of the clinical and radiological records of all patients with a bilateral, simultaneous anterior circulation occlusion treated at our center between January 2019 and December 2022. Following the PRISMA guidelines, we also conducted a systematic review of the literature. RESULTS: Two patients with a bilateral and simultaneous middle cerebral artery occlusion were treated at our center during the study period. A TICI score ≥2b was obtained in 4 out of 4 occlusions. Modified Rankin Scale (mRS) at 90 days was 0 and 4, respectively. The literature review retrieved reports on 22 patients. The most frequent bilateral occlusion sites were internal carotid artery-middle cerebral artery. The clinical presentation was severe in most patients. A combined thrombectomy technique proved to have the highest number of first-pass recanalization. A TICI ≥2b was obtained in 95% of patients and an mRS ≤2 was found in 31.8% of patients. CONCLUSIONS: In patients with bilateral and simultaneous occlusion of the anterior circulation, endovascular treatment using a combined technique appears to be rapid and effective. The clinical evolution of this patient population strongly depends on the severity of the onset symptoms.

Investigation of Anti-Toxoplasma gondii Antibodies in the Hemodialysis Patients with ELISA Method

Objective: The aim of this study was to determine the seroprevalence of Toxoplasma gondii in hemodialysis (HD) patients and to reveal the importance of toxoplasmosis as a risk factor in these patients. Methods: The study was carried out between 26.12.2013 and 01.01.2016 at Van Yüzüncü University Dursun Odabas the Medical Center on patients with chronic renal failure who entered HD. As the patient group in the study, 150 patients with chronic renal failure who underwent HD; as the control group, 50 people without any known chronic disease and who did not receive any immunosuppressive therapy were included. The ELISA method was used to determine anti-T. gondii IgG and IgM antibody levels. A questionnaire including risk factors that may cause the transmission of T. gondii was applied to the patient and control groups. Results: In the study, 89 out of total 150 HD patients (59.3%) were found anti-T. gondii IgG antibody seropositive and 4 were (2.7%) anti-T. gondii IgM antibody seropositive. Fourteen of 50 healthy individuals in the group (28%) were anti-T. gondii IgG antibody positive, while none in this group was anti-T. gondii IgM antibody positive. Statistical analysis demonstrated there were separate significant correlations between both anti-T. gondii IgG (p<0.01) and anti-T. gondii IgM antibody (p<0.05) frequencies with chronic renal failure. While there were no statistically significant differences in the prevalence of anti-T. gondii IgG antibody identification based on gender and age groups, there were significant differences between the prevalence of anti-T. gondii IgM antibody based on both gender (p<0.05) and age groups (p<0.05). Some living conditions and habits of the patient group were evaluated statistically, and a significant correlation (p<0.05) was found between eating only raw meatballs and toxoplasmosis seropositivity. Conclusion: As a result, it was understood that the physicians who monitor of HD patients should assess toxoplasmosis among the risk factors.

The Importance of Antioxidant Enzymes and Oxidative Stress in Human Fascioliasis

Objective: The aim of this study was to determine the levels of superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT), and malondialdehyde (MDA) in the patients infected with Fasciola hepatica and establish whether these parameters differ among the patients with fascioliasis. Methods: The patient group consisted of 140 individuals with F. hepatica seropositive; the control group consisted of 140 healthy individuals who tested negative for this parasite and had no other diseases. The patient group consisted of individuals with no chronic diseases other than fascioliasis; in both the patient and the control groups, the subjects had no unhealthy habits such as smoking and alcohol consumption, etc. The blood samples taken to diagnose fascioliasis were evaluated by the ELISA method. The samples were studied according to the kit procedures for SOD, CAT, GPx and MDA markers. Results: In this study, 43.6% of 140 individuals in the patient group infected with F. hepatica had CAT (p=0.001), 35% had GPx (p=0.001), 12.9% had SOD (p=0.002), 90.7% had MDA (p=0.001). There was found a statistically significant difference between the patient and the control group in terms of the positivity of these four parameters. Conclusion: As a result, a statistically significant relationship was found between the increase in the SOD, GPx, CAT, and MDA levels and fascioliasis. The high rate of MDA revealed that oxidative stress occurred in patients with fascioliasis, resulting in an increased activity of SOD, GPx, and CAT. Amaç: Bu çalismanin amaci, Fasciola hepatica ile enfekte hastalarda süperoksit dismutaz (SOD), glutatyon peroksidaz (GPx), katalaz (CAT) ve malondialdehit (MDA) düzeylerini belirlemek ve fascioliasisli hastalarda bu parametrelerde farklilik meydana gelip gelmedigini ortaya koymaktir. Yöntemler: Hasta grubu, F. hepatica pozitif olan 140 hastadan; kontrol grubu ise bu parazit yönünden negatif bulunan ve baska herhangi bir hastaligi bulunmayan 140 saglikli kisiden olusturuldu. Hasta grubuna fascioliasis disinda herhangi bir kronik hastaligi olmayan ve hem hasta hem de kontrol grubuna sigara, alkol kullanimi olmayan kisiler dahil edildi. Hastalarda fascioliasis pozitifligini belirlemek için alinan kan örnekleri ELISA yöntemi ile çalisildi. Serum SOD, CAT, GPx ve MDA düzeyleri ELISA yöntemi ile degerlendirildi. Bulgular: Bu çalismada F. hepatica ile enfekte hasta grubundaki 140 kisinin %43,6'sinda CAT (p=0,001), %35'inde GPx (p=0,001), %12,9'unda SOD (p=0,002) ve %90,7 MDA pozitifligi saptandi. Bu dört parametrenin pozitifligi açisindan hasta ve kontrol grubu arasinda istatistiksel olarak anlamli fark bulundu (p=0,001). Sonuç: Sonuç olarak SOD, GPx, CAT ve MDA düzeyindeki artis ile fascioliasis arasinda istatistik olarak anlamli bir iliski saptanmistir. Çalismamizda MDA'nin yüksek oranda saptanmis olmasi fascioliasisli hastalarda oksidatif stres olustugunu ve SOD, GPx ve CAT aktivitelerinde artis oldugunu ortaya koymustur.