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    Is the neutrophil to lymphocyte ratio associated with liver fibrosis in patients with chronic hepatitis B?
    (Baishideng Publishing Group Inc, 2015) Kekilli, Murat; Tanoğlu, Alpaslan; Sakin, Yusuf Serdar; Kurt, Mevlüt; Öcal, Serkan
    AIM: To determine the association between the neutrophil to lymphocyte (N/L) ratio and the degree of liver fibrosis in patients with chronic hepatitis B (CHB) infection. METHODS: Between December 2011 and February 2013, 129 consecutive CHB patients who were admitted to the study hospitals for histological evaluation of chronic hepatitis B-related liver fibrosis were included in this retrospective study. The patients were divided into two groups based on the fibrosis score: individuals with a fibrosis score of F0 or F1 were included in the "no/minimal liver fibrosis" group, whereas patients with a fibrosis score of F2, F3, or F4 were included in the "advanced liver fibrosis" group. The Statistical Package for Social Sciences 18.0 for Windows was used to analyze the data. A P value of < 0.05 was accepted as statistically significant. RESULTS: Three experienced and blinded pathologists evaluated the fibrotic status and inflammatory activity of 129 liver biopsy samples from the CHB patients. Following histopathological examination, the "no/minimal fibrosis" group included 79 individuals, while the "advanced fibrosis" group included 50 individuals. Mean (N/L) ratio levels were notably lower in patients with advanced fibrosis when compared with patients with no/minimal fibrosis. The mean value of the aspartate aminotransferase-platelet ratio index was markedly higher in cases with advanced fibrosis compared to those with no/minimal fibrosis. CONCLUSION: Reduced levels of the peripheral blood N/L ratio were found to give high sensitivity, specificity and predictive values in CHB patients with significant fibrosis. The prominent finding of our research suggests that the N/L ratio can be used as a novel noninvasive marker of fibrosis in patients with CHB.
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    Social stigmatization in Turkish patients with chronic hepatitis B and C
    (Ediciones Doyma, S.L., 2021) Yozgat, Ahmet; Can, Güray; Can, Hatice; Ekmen, Nergiz; Akyol, Taner; Kasapoğlu, Benan; Kekilli, Murat
    Background and aim: Viral hepatitis is the most important cause of chronic hepatitis worldwide. Stigmatization is defined as a feeling of rejection and isolation of patients by society due to illness. There are no studies on chronic viral hepatitis in the literature in English, which has its own religious and socio-cultural structure. In our study, we aimed to investigate the presence of social stigmatism and psychosocial effects on patients with different stages of chronic viral hepatitis B and C. Methods: Forty-five patients with chronic hepatitis C and 114 patients with chronic hepatitis B were enrolled in the study. Berger's scale was used for stigmatization, composed of 40 four-point Likert items that have four subscales: personalized stigma, disclosure, negative self-image, and public attitude. Stigma score ranges between one and four. Stigma is accepted as present if the overall score is above two. Results: Overall the mean stigma scores were 1.97 ± 0.58 and 2.14 ± 0.57 for chronic hepatitis B and C, respectively. There was stigma in 47.4% of the patients with chronic hepatitis B, and 60% of the patients with chronic hepatitis C. Being male was the risk factor on overall stigma, disclosure and public attitude in chronic hepatitis C. Living in an urban setting was the risk factor on negative self-image in chronic hepatitis C and on personalized stigma and disclosure in chronic hepatitis B. Conclusions: To the best of our knowledge, this is the first study that provides qualitative information about chronic hepatitis-related stigma. Stigmatization is a major problem in Turkey and worldwide. We believe that increasing the knowledge of the patients and society by teaching about the transmission routes of the disease and focusing on vaccination studies will prevent stigmatization.
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    Successful management of an esophageal foreign body with a rigid bronchoscopy
    (2015) Beyazıt, Yavuz; Tanoğlu, Alpaslan; Kekilli, Murat; Kurt, Mevlüt
    Ingestion of a sharp foreign object can lead to esophageal hemorrhage and perforation, which is related to high morbidity and mortality. To avoid such complications, early and adequate therapeutic management of these cases is crucial. Endoscopy procedures are frequently performed in these patients, and a high proportion of patients with foreign bodies require endoscopic intervention [1-4]. Most cases of foreign-body ingestion occur in the pediatric population, with a peak incidence at ages between 6 months and 6 years [5] Among adults, it occurs mainly in people with psychiatric disorders, mentally challenged individuals, or impairment caused by alcohol, pica, and those seeking some secondary gain with access to a medical facility.