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    Assessment of Risky Exposures to HBV and HCV in Health Care Workers and Cost Analysis
    (Galenos Yayincilik, 2005) Yildirim, Mustafa; Sencan, Irfan; Ozdemir, Davut; Yilmaz, Zeynep; Kucukbayrak, Abdulkadir; Cakir, Selma
    The aim of this study is to evaluate the reported situation of exposures to potentially infective biological material and its cost of intervention in health care workers (HCWs). Occupational Health Department (OHD) is composed of one infectious diseases specialist and one nurse at April 2001 and all HCWs have been asked for reporting biologically risky exposures to OHD. All of the reported risky exposures were assessed from the point of epidemiologic and cost analysis between 2002 and 2004. Forty-four risky exposures were reported that consisted of fourty sharp and four splah injuries. Risky exposures were reported most frequently in nurses and the hands were found the most injuried parts of the body. The HCWs were exposed by biological risky materials that belong to 10 patients with anti- HCV positivity, 10 patient HBsAg, 10 patient anti-HBs and three patient had not any marker positivity. Source of biological risky materials were not determined at 12 cases. Cost of serological investigation of the source patients and victims, victims that followed up and postexposure prophylaxy are calculated as 10.684 YTL according to current value of ministry of finance of Turkey. 4388 YTL was saved by owing to preexposure prophylaxis. In conclusion, sufficient protective barrier measure should be applied to decrease the level of occupational injuries and re-move medical wastes with proper methods. Careless of vaccination for the preventible diseases with vaccine should be assumed as a malpractice.
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    A Case of Giant Hepatic Hydatid Cyst Infected with Morganella morganii and the Literature Review
    (Hindawi Ltd, 2012) Hakyemez, Ismail Necati; Sit, Mustafa; Aktas, Gulali; Tas, Tekin; Mengeloglu, Firat Zafer; Kucukbayrak, Abdulkadir
    Hydatid cyst disease is a common worldwide zoonosis. Most of the cysts are located in the liver. Abscess formation due to infection of the cyst is an important complication. M. morganii, a Gram-negative Bacillus, is a quite rare cause of liver abscess. A 77-year-old woman was admitted to hospital with complaints of fever, chills, nausea, vomiting, loss of appetite, and abdominal pain located in the right-upper quadrant. Her history was positive for hepatic hydatid cyst disease ten years ago. Physical examination revealed a painful mass filling the right-upper quadrant and extending down to umbilicus. Indirect hemagglutinin test for hydatid cyst was positive at a titer of 1/320. Giant liver abscess due to infected hydatid cyst was found in computed tomography scan. Surgeons performed cystectomy and cholecystectomy. Cefazoline, cefuroxime, and metronidazole were administered empirically, but all the three agents were replaced with intravenous ceftriaxone after M. morganii was isolated from the cultures of the abscess material. Clinical signs of the patient resolved at the second week of treatment, and she was discharged.
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    Evaluation of psychiatric morbidity and quality of life in inactive HbsAg carriers
    (Academic Journals, 2011) Kucukbayrak, Abdulkadir; Canan, Fatih; Alcelik, Aytekin; Aktas, Gulali; Kocoglu, Esra; Tas, Tekin
    Hepatitis B virus (HBV) infection develops in forms from asymptomatic carrier to cirrhosis. There are several studies examining the quality of life of patients with HBV in literature. However, only two studies have investigated the psychiatric morbidity in hepatitis B patients. In this study, we evaluated psychiatric morbidity and quality of life in inactive HbsAg carriers. This case-controlled study was performed among 26 healthy volunteers as control group and 31 inactive HbsAg carriers. Seven (22.5%) of our Hepatitis B patients were found to have an Axis I psychiatric diagnosis. For the carriers, the diagnoses made were major depression (3 patients), major depression with conversion disorder (1 patient), moderate depressive disorder (1 patient), cyclothymic disorder (1 patient), and obsessive-compulsive disorder (1 patient). No significant difference was found between carriers and controls in terms of quality of life scores and anxiety and depression scores. According to these findings, the patients with hepatitis should undergo psychiatric evaluation by a specialist. Also, physicians should be aware that emotional and psychiatric support is not necessary for all of the patients with hepatitis B.
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    First case of continuous ambulatory peritoneal dialysis peritonitis due to Candida sake
    (2009) Guclu, Ertugrul; Soypacaci, Zeki; Yildirim, Mustafa; Kucukbayrak, Abdulkadir; Ozdemir, Davut
    Fungal peritonitis is a relatively uncommon complication of peritoneal dialysis that contributes significantly to morbidity, drop out from the continuous ambulatory peritoneal dialysis (CAPD) program, and mortality. Candida sake infections were rarely published in literature. We present the first case of peritonitis due to C. sake. A 41-year-old man was admitted to our hospital with abdominal pain, nausea, vomiting, fever, weakness. Abdominal ultrasonography demonstrated a fistula tract, which has an opening at inferolateral of the umbilicus extending 5 cm from the skin into the abdominal cavity with a foreign body (11 × 10 mm length) inside the fistula. The foreign body was removed by surgery being apparently a part of a previously inserted peritoneal catheter. Postoperative specimens revealed polymorph leucocytes and yeast cells in Gram stain, and culture on Sabouraud dextrose agar (SDA) yielded a growth of a fungus, subsequently identified as C. sake with Api ID 32C. Fluconazole (200 mg/day) therapy was started. He recovered after two weeks of therapy. In conclusion, C. sake, a rare type of Candida species, should be considered as a probable peritoneal pathogen in patients with multiple episodes of bacterial peritonitis, previous broad-spectrum antibiotic therapy and diabetes mellitus. © 2008 Blackwell Publishing Ltd.
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    Problems Encountered by Volunteers Assisting the Relief Efforts in Van, Turkey and the Surrounding Earthquake Area
    (Aves, 2013) Ocak, Tarik; Duran, Arif; Ozdes, Taskin; Hocagil, Cuneyt; Kucukbayrak, Abdulkadir
    Objective: In this study, we aimed to identify the difficulties encountered by the health teams and personnel working as volunteers or on assignment in the earthquake area, and to identify their experiences and recommendations regarding the disaster. Material and Methods: This study was conducted in October and November 2011 in Van, Turkey and the surrounding region with individuals, mainly health personnel, who arrived in the city as volunteers or on assignment to assist the relief efforts. The study was conducted as these individuals carried out their duties. Face-to-face interviews were conducted with volunteers and personnel who agreed to complete the questionnaires as required. Results: A total of 168 persons were included in the study. The mean age of these individuals was calculated as 31 +/- 8 (age range 17 to 56). Of the participants, 74 (44%) arrived in the city or the surrounding area as part of their official assignment, and 94 (56%) arrived as volunteers. During the study, 77 (46%) of the individuals experienced a health problem on at least one occasion. A job definition could be identified for 74% of the participants. Conclusion: The job definitions and required materials should be pre-determined and work hours rotated according to a shift system. We believe that this would allow relief efforts to be conducted more effectively.
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    A Rare Cause of Pneumonia: Shewanella putrefaciens
    (Ankara Microbiology Soc, 2012) Tas, Tekin; Kucukbayrak, Abdulkadir
    We read with interestingly the paper named A Rare Cause of Pneumonia: Shewanella putrefaciens presented by Durdu et al. published in Mikrobiyol Bul 2012; 46(1): 117-21. S.putrefaciens is a gram-negative, facultative anaerobic and non-fermentative rod that rarely causes infections in humans. First, the authors reported that antibotic sensitivity tests of S.putrefaciens in the presented case were performed by Kirby-Bauer disc diffusion method. However, there is no recommendation about the antibiotic susceptibility testing by disc diffusion test for this bacteria in Clinical and Laboratory Standards Institute (CLSI), European Committee on Antimicrobial Susceptibility Testing (EUCAST), and British Society for Antimicrobial Chemotherapy (BSAC) guidelines. According to CLSI criteria, antibiotic susceptibility tests for S.putrefaciens should be done by a method which detects minimal inhibitory concentration. Second, this paper reported that S.putrefaciens was sensitive to third generation cephalosporins and penicillins. Besides, the authors suggested that susceptibility of these bacteria to these antibiotics was helpful for the differential diagnosis of Pseudomonas aeruginosa and S.putrefaciens. However, in the literature, S.putrefaciens had been reported as resistant to penicillin. We thought that these additional information would be helpful in the future studies related to S.putrefaciens.