Does Septoplasty Affect Hemoglobin and Erythropoietin Levels in Patients With Nasal Septal Deviation?

AIM: To investigate the effect of septoplasty in patients with nasal septum deviation (NSD) on erythropoietin (EPO) and hemoglobin (Hgb) levels. METHODS: Between 2017 December and 2018 May, 47 patients with NSD who underwent septoplasty in Adiyaman University Medical Faculty Department of Otorhinolaryngology included in this prospective study. The changes in EPO and Hgb levels were studied before and 3 months after the surgery. RESULTS: The mean age of the patients studied was 30.7 ±â€Š9.9. 31 of the patients were male and 16 were female. Pre- and post-operative 3rd month mean EPO levels of the patients were 11.45 ±â€Š4.9 Mu/mL and 11.39 ±â€Š6.02 Mu/mL, respectively. When these values were analyzed, no statistically significant difference was found (P = .93). Pre- and post-operative 3rd month mean Hgb levels were 14.6 g/dL, and 14.6 g/dL, in turn. When these values were analyzed, no statistically significant difference was found (P = .68). CONCLUSION: According to these results, the author can say there is no statistically significant relationship between NSD and EPO or Hgb. Therefore, this issue will be enlightened with future studies including more patients and objective tests evaluating nasal patency.

Chemerin rs17173608 Gene Polymorphism is not Associated with Type 2 Diabetes Mellitus: a Cross-sectional Study.

BACKGROUND: Previous studies have shown that chemerin has important roles in the development of obesity, insulin resistance, metabolic syndrome, polycystic ovary syndrome (PCOS) and T2DM. The main goal of our study was to investigate the role of Chemerin rs17173608 gene polymorphism in T2DM (type 2 diabetes mellitus). MATERIALS AND METHODS: 100 patients with T2DM and 50 healthy volunteers were included in the present study. DNA isolation from blood samples was performed with K1820-02 DNA Mini Kit. Chemerin gene polymorphism was detected by Tetra- Amplification Refractory mutation system polymerase chain reaction (T-ARMS-PCR). At the end of T-ARMS-PCR, samples were run using gel electrophoresis. Some samples were validated by sequence analysis. RESULTS: In the genotype analysis, 18.0% of patients had TT genotype and 81.0% of TG genotype was detected. GG genotype was not detected in any patient. Genotype of 1 patient was unidentified. Genotype distribution of healthy control group was 12.0% TT genotype and 88.0% TG genotype. Similar to the T2DM group, the GG genotype was not detected in the control group. There was no statistically significant difference between T2DM group and healthy control group for TG and TT genotypes. CONCLUSION: To our knowledge, chemerin rs17173608 gene polymorphism has been investigated in T2DM for the first time herein. In the present study, the TT genotype ratios were higher in the T2DM subjects than in healthy subjects. G allele frequency in the T2DM group was lower than that in the control group. However, there was no statistically significant difference between the groups.

Sarcopenia in diabetic nephropathy: a cross-sectional study.

OBJECTIVE: To investigate the relationship between sarcopenia and diabetic nephropathy. METHODS: 56 diabetic patients without complications, 50 diabetic patients with nephropathy, 53 healthy controls included in this present study. Demographic characteristics such as sex, age, anthropometric measurements such as weight, body mass index [BMI], hip circumference, waist circumference and upper arm circumference were measured. Sarcopenia diagnosis was based on European Working Group on Sarcopenia in Older People [EWGSOP] criteria which consist of hand grip strength, 6-meter walking test and muscle mass. RESULTS: The frequency of sarcopenia increased gradually from 15.1% in healthy control group to 21.4% in the diabetes group, and 34% in diabetic nephropathy group (X2 for trend, p = 0.029). The frequency of sarcopenia was similar in diabetes and diabetic nephropathy group. However, the frequency of sarcopenia was higher in diabetic nephropathy than healthy controls (OR = 2.89, CI [1.11-7.51] in logistic regression). CONCLUSION: In the present study, the prevalence of sarcopenia was higher in patients with diabetic nephropathy compared to healthy controls.

Investigation of the vitamin B12 deficiency with peripheral neuropathy in patients with type 2 diabetes mellitus treated using metformin.

OBJECTIVE: The relationship between vitamin B12 deficiency and peripheral neuropathy has been shown in a number of previous studies. Metformin is the indispensable first-line treatment for type 2 diabetes mellitus (DM) worldwide. One of the adverse effects of the use of metformin is vitamin B12 deficiency. In the present study, we investigated the relationship between vitamin B12 deficiency and peripheral neuropathy due to the use of metformin. METHODS: Patient's laboratory and electromyography (EMG) data were retrospectively reviewed. Patients with no EMG report and other necessary information were excluded from the study. RESULTS: Eighty-six patients with type 2 DM using metformin were included in the study. Of these patients, 26 were males and 60 were females. The mean age of the patients was 55.1±7.7 years. The mean body mass index of the patients was 29.1±9.01 kg/m2. The mean HbA1c level of the patients was 8.6%±2.1%. The mean duration of diabetes was 8.02±5.4 years. The incidence of vitamin B12 deficiency was 38.4%. Peripheral neuropathy was detected in 33.7% patients. There was no statistically significant difference in vitamin B12 levels between patients with peripheral neuropathy and those without peripheral neuropathy (p=0.64). CONCLUSION: Therefore, it can be concluded that the lack of vitamin B12 secondary to the use of metformin did not significantly increase the frequency of peripheral neuropathy.

The Role of Sleeve Gastrectomy on Preventing Type 2 Diabetes Mellitus.

AIM: To investigate the effect of bariatric surgery on HbA1c and serum cortisol levels in morbidly obese patients without type 2 diabetes mellitus. MATERIALS AND METHODS: Twenty-nine patients who underwent sleeve gastrectomy and whose body mass index was> 40 were included in the present study. Patients' files were reviewed retrospectively. Those with diabetes mellitus and those with age <18 were excluded from the study. Pre-operative and 1-year post operative data were documented. The obtained data were analysed by SPSS statistical program. RESULTS: The mean age of the patients was 27.4 ± 8.4. 5 of the patients were male, and 24 were female. The mean body mass index of the patients was 44 ± 2.3. 1 patient [3.4%] had hypertension. Four patients [13.7%] had gastroesophageal reflux disease. The number of smokers was 7 [24.1%], and the number of alcohol users was 3 [10.3%]. There was a statistically significant decrease in HbA1c, body mass index values after operation [p value <0.01], but cortisol was not different [p value = 0.72]. CONCLUSION: In this present study we found that bariatric surgery caused a significant decrease in HbA1c levels in non-diabetic patients, suggesting that bariatric surgery may prevent Type 2 Diabetes Mellitus in obese patients.

Lack of Variation in Inflammatory Hematological Parameters between Benign Nodular Goiter and Papillary Thyroid Cancer.

BACKGROUND: Inflammatory hematological parameters like the neutrophil/lymphocyte (N/L) ratio have been investigated in many cancer types and significant relationships found with prognosis, for example. The aim of this present study was to investigate the impact of hematological parameters notably on N/L ratio and mean platelet volume (MPV) in papillary thyroid cancer cases. MATERIALS AND METHODS: A total of 79 patients who underwent a thyroidectomy operation in Findikli, Goiter Research and Treatment Center during 2011- 2015 period were enrolled in the study, 41 with papillary thyroid cancer and 38 with benign goiter confirmed by pathological examination. We collected clinical and laboratory data for the patients from hospital records retrospectively. Blood samples taken at admission were assessed for parameters compared between the groups. RESULTS: No significant differences between papillary thyroid cancer and benign goiter groups were apparent in terms of age, the N/L ratio, MPV, white blood cell count (WBC), red blood cell count (RBC), hemoglobin, hematocrit, platelet, neutrophil, lymphocyte, red blood cell distribution width (RDW) and platelet crit (PCT) levels (>0.05). Only the level of platelet distribution width (PDW) significantly differed, being lower in the papillary cancer group (<0.05). CONCLUSIONS: No significant relationship between papillary thyroid cancer and inflammatory hematological parameters including in particular the N/L ratio and MPV. The relevance of the PDW values remains unclear.

Increased mean platelet volume in patients with idiopathic subjective tinnitus.

Tinnitus is the perception of sound with no external stimulus and idiopathic subjective tinnitus is the most common type in adults. Mean platelet volume (MPV) alterations were shown in some inflammatory diseases and were evaluated as a clinically useful marker. Our aim was to investigate MPV alterations in idiopathic subjective tinnitus patients. A total of 101 patients and 54 age- and sex-matched healthy control subjects were enrolled in the study. Patients included in the study had complaints of tinnitus for at least 3 months. All patients underwent detailed otolaryngologic examination, blood sampling, pure tone audiometry, magnetic resonance imaging of ear, and vertebrobasilar artery Doppler ultrasonography to make the differential diagnosis of tinnitus. Blood sampling consisted of renal-liver-thyroid function tests, lipid profile, and complete blood count. All tests and examinations except the imaging modalities were also performed for the control group. There were no differences in age and sex distribution of groups. Mean platelet volume values were significantly increased in tinnitus patients when compared with controls (p = 0.001). We think that MPV can be qualified as a useful marker in tinnitus patients.

Predictive contribution of neutrophil/lymphocyte ratio in diagnosis of brucellosis.

Here we wanted to investigate predictive value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in the diagnosis of brucellosis. Thirty-two brucellosis patients diagnosed with positive serum agglutination test and thirty-two randomized healthy subjects were enrolled in this study retrospectively. Result with ROC analyzes the baseline NLR and hemoglobin values were found to be significantly associated with brucellosis (P = 0.01, P = 0.01, resp.). Herein we demonstrated for the first time that NLR values were significantly associated with brucellosis. This situation can help clinicians during diagnosis of brucellosis.

Relationship between vitamin D and glycemic control in patients with type 2 diabetes mellitus.

Herein I investigated the impact of vitamin D on glycemic control in patients with type 2 diabetes mellitus. 128 patients with type 2 diabetes mellitus were enrolled in this study (mean (S.D) age: 57.7±10 years, 26.6% were female). It was collected clinical and laboratory characteristics of patients from hospital records retrospectively. Patients were divided into two groups according to the HBA1c values: good glycemic control (HbA1c≤7%) and poor glycemic control (HbA1c>7%). It was compared 25 hydroxyvitamin (OH) D and other collected laboratory parameters between the two groups. The vitamin D deficiency rate was 98.3%. In the result with ROC curve analyzes and Mann Whitney U test vitamin D was'nt significantly associated with glycemic control (P value >0.05). Among other parameters result with ROC curve analyzes and student t test RDW-CV was found to be significantly associated with glycemic control (P value <0.05). Although high level of vitamin D deficiency, present study indicated that vitamin D was'nt significantly related to glycemic control in type 2 diyabetes mellitus. Even so RDW-CV was significantly related to glycemic control.

Which Factors are Predictive for Mortality among Hospitalized Patients with Cirrhosis?

BACKGROUND/AIMS: Cirrhotic patients admitted to the hospital have a high mortality rate. The aim of this study was to evaluate predictors of mortality in patients hospitalized for specific complications of cirrhosis. METHODOLOGY: All patients admitted to the gastroenterology service with cirrhosis during a 2-year period were retrospectively identified. We compared the clinical characteristics of patients who died and those who survived. Multivariable analysis was performed to determine predictors of mortality. RESULTS: A total of 84 patients were included in the study. In hospital mortality rate was 35%. Hepatorenal syndrome development (41% vs 4%, p < 0.001), MELD score (17 vs 12, p = 0.003), Child Pugh score (11 vs 8, p < 0.001), serum creatinine (p < 0.001) and serum potassium values (p = 0.01) were significantly higher in patients who died. Stepwise logistic regression analysis revealed that the best model in prediction of death included serum potassium levels (OR = 2.182; 95% Cl: 1.189-4.006; p < 0.001) and Child Pugh score (OR = 2.140; 95% CI: 1.507-3,038; p = 0.012). CONCLUSIONS: The mortality of cirrhotic patients admitted to hospital is significantly high. Prevention of acute kidney injury will be an appropriate approach for improving the survival in hospitalized patients with cirrhosis.

Demodex spp. Infestation in a breast-cancer patient: A case report.

Demodex folliculorum and Demodex brevis are obligatory parasites that live in sebaceous glands and follicles. When immune system becomes suppressed by any reason, patients become vulnerable to obligatory parasites like D. folliculorum and D. brevis. Immune system becomes suppressed in cancer patients who undergo chemotherapy, and as a result these patients become vulnerable to infestations. In our case, a 45 year-old female has been admitted to oncology clinic for a medical treatment of breast cancer. Her systematic physical examination was normal, except redness on her cheeks and forehead. There was no abnormality in biochemical and haematological laboratory values. We have decided to apply chemotherapy of Adriamycin, cyclophosphamide and 5-fluorouracil. Due to the itchy redness on her cheeks and forehead, we had performed an examination for demodex before chemotherapy; and we have identified 20 mites/cm(2) on her right and left cheeks, and 15 mites/cm(2) on her forehead. When our patient had came our clinic with increasing complaint of itchy rash, after the first course of chemotherapy we have reexamined demodex. The result of microscopic examination revealed large amount of demodex of 50 mites/cm(2) on her right and left cheeks and 30 mites/cm(2) on her forehead, which were nearly 2.5-times higher than the previous examination. This increase probably was associated with immune suppression of chemotherapy.