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Öğe Acute Hepatitis C Infection Developing in the Offspring Born to an Anti-HCV- Positive Mother: A Case Report(Aves, 2009) Sirmatel, Fatma; Midikli, Durdane; Sirmatel, Ocal; Gursoy, Bensu; Duygu, FaziletAcute hepatitis C developed one month after delivery in a child whose mother was an inactive carrier of HCV and had given birth by normal vaginal delivery. Acute hepatitis C was diagnosed after one month in the child by serological, biochemical and ultrasonographic tests. Although the patient had high liver enzyme levels (ALT 245 IU/L, AST 123 IU/L), and positivity for both anti HCV (by ELISA) and HCV-RNA viral load (by PCR), the mother was an inactive HCV carrier. The patient was breasfed by the mother and showed spontaneous clearence without antiviral treatment after two years. Women should be examined for HCV before pregnancy in regions with medium HCV risk levels, and need to be enlightened regarding this issue. Also, considering that 20-25% of acute hepatitis C cases show spontanous clearance within 6-12 months on follow up, unnecessary treatment can be prevented.Öğe Analysis of Holo-Transcobalamin (Active Vitamin B12) in the Sera of Patients with Chronic Viral Hepatitis(Galenos Yayincilik, 2010) Sirmatel, Fatma; Sirmatel, Ocal; Bugdayci, Guler; Eris, Fatma Nur; Dincer, SevimIn chronic viral hepatitis, when early hepatic necrosis and viral replication are defined, progression of hepatic necroinflammation can be terminated and cirrhosis can be prevented by therapy. In chronic hepatic failure, an increase in the blood levels of vitamin B12 is observed as a result of vascular leakage. From this perspective, in cases with chronic viral hepatitis B (HBV) and chronic viral hepatitis C (HCV), the indicator of serum active vitamin B12, namely holo-transcobalamin II (Holo-TCII), is interpreted as an indicator of hepatocellular damage prior to treatment. The aim of this study is to evaluate the value of serum Holo-TCII in the diagnosis of hepatic failure and hepatocellulardamage in chronic viral hepatitis. In a university hospital, Holo-TCII, the best indicator of serum vitamin B12, was analyzed in the sera of 127 healthy blood donors and in 274 patients with chronic viral hepatitis (127 HBV patients and 17 HCV patients), who were clinically, serologically and histologically diagnosed. Age distribution of the patients ranged between 18 and 70 years. Serum samples of the patients with chronic viral hepatitis were collected before therapy and kept at -20 degrees C until use. When determining the study group, the patients with decompensated cirrhosis, any cardiac, metabolic, hematologic, gastrointestinal and autoimmune disorderswere excluded. As the control group, healthy blood donors without metabolic, cardiovascular, gastrointestinal and hematologic diseases were chosen; age and gender distributions were also considered to be parallel with the patient group. Analyses were performed with commercially available Holo-TCII kits according to the prospectus, using macro enzyme immunoassay method (EIA) method. Results were statistically compared between the groups. In our study, no difference was determined in terms of holo-TCII levels between chronic HBV (42.07 pmol/L) and HCV patients (42.8 pmol/L), whereas the results of the HBV and HCV patients were found to be significantly higher compared to the control group (25.7 pmol/L, p< 0.017). Holo-TCII can be used as the earliest symptom of cellular damage, particularly in patients with chronic viral hepatitis. Further studies on chronic hepatic failure and cellular damage may also provide information that Holo-TCII can be used as a diagnostic criterion.Öğe Brucellosis. An evaluation of 140 cases(Aves, 2008) Gursoy, Bensu; Tekin-Koruk, Suda; Sirmatel, Fatma; Karaagac, LemanBrucellosis is an important preventable disease for our country. In this study the epidemiological, clinical and laboratory findings of 140 patient with brucellosis followed in our department between January 2004-December 2007 were evaluated. Seventy of the patients were male, 70 were female. Mean age was 37.09 +/- 18.2 (ranges of 5-80) years. Rates of acute, subacute and chronic infection forms were 80.0, 14.3, 5.7%, respectively. The most common mode of transmission was consumption of unpasteurized milk products (62.1%). The main symptoms were fever, arthralgia, sweating and malaise. The frequent signs were fever (61.2%), lymphadenomegaly (11.4%), splenomegaly (10.7%), hepatomegaly (8.6%) and arthritis (5.7%). In 82 (59%) patients elevated C-reactive protein, in 39 (27.9%) patients elevated transaminase levels, in 36 (25.7%) patients anemia and in 22 (15.7%) patients leukocytosis were determined.Öğe Determination of Basal Metabolic Rate and Body Composition With Bioelectrical Impedance Method in Children With Cerebral Palsy(Sage Publications Inc, 2009) Sert, Cemil; Altindag, Oezlem; Sirmatel, FatmaThis study uses the bioelectrical impedance method to assess the body composition, basal metabolic rate, and some other physical properties of children with cerebral palsy. In this study, 41 children with spastic cerebral palsy were assessed, and 56 normally developed children were included as control. Parameters such as body compositions, basal metabolic rate, body resistance, liquid compartment, and capacitance of patients and control group were measured and analyzed statistically. Basal metabolic rate, body mass index, extracellular liquid, intracellular liquid, body capacitance, and resistance differed significantly compared to the control group (P < .01), whereas extracellular mass, lean body mass, body cell mass, and fat mass did not differ significantly compared to the control group (P > .05). Parameters such as basal metabolic rate, body composition, and body resistance can be determined using the bioelectrical impedance method in children with cerebral palsy.Öğe Evaluation of Cases with Acute Viral Hepatitis(Galenos Yayincilik, 2006) Koruk, Suda Tekin; Gursoy, Bensu; Koruk, Ibrahim; Zeyrek, Fadile Yildiz; Unutmaz, Gokhan; Karaagac, Leman; Sirmatel, FatmaAcute viral hepatitis is a worldwide health problem. Sixty-eight patients with acute viral hepatitis admitted to Harran University Hospital between March 2004 and March 2007 were included in this study. These patients were evaluated according to their age, gender, complaints, clinical findings, laboratory results and prognosis. Thirty-three (48.5%) of the cases were diagnosed as acute hepatitis A virus (HAV) infection, 22 (32.3%) as hepatitis B virus (HBV) infection, 9 (13.2%) as hepatitis C virus (HCV) infection, 2 (2.9%) as HBV and hepatitis D virus (HDV) co infection and 2 (2.9%) as HBV and HAV co infection. Mean age was 28.24 +/- 16.48 years and 34 (50%) of them were male. Two patients with acute HBV infection were pregnant at their 20 and 22nd weeks. The symptoms and signs of the patients at the hospital course were weakness (95.6%), jaundice (90.9%), dark urine (86.2%), anorexia (79.4%), nausea (64.7%), icterus (92.6%), hepatomegaly (38.2%), fever (35.3%) and splenomegaly (14.6%). The mean ALT level was 1418.4 +/- 999.7 U/L, AST level was 993.7 +/- 927.4 U/L and total bilirubin was 7.51 +/- 6.94 mg/dL. atypical clinical course was seen in three of the hepatitis a cases (9%); in one of them fulminan hepatic failure was developed and she has died. In 3 (13.6%) of the acute B cases HBsAg carrier stage was observed, all of the other cases showed seroconversion during follow up. In conclusion acute viral hepatitis infection is a global health problem associated with morbidity and mortality. Prevention of viral hepatitis relies on improvements in sanitation and vaccination for HAV and HBV infection.Öğe Evaluation of the Patients Applying to the Hospital for a Tick Bite(Aves, 2011) Korkmaz, Tanzer; Sirmatel, Fatma; Boztas, GuledalObjective: Cases of tick bite require careful assessment because Crimean-Congo haemorrhagic fever (CCHF) is an increasingly important tick-borne disease in Turkey. The aim of this study is to analyse the patients who applied to the hospital for a tick bite and to determine the prevalence of tick bites in the Bolu Province according to the records of the Provincial Directorate of Health. Methods: The charts of the patients admitted to the Emergency Department between 1 January 2007 and 31 July 2010 were reviewed. The locations where the tick attached to the patient, site of the tick bite on the body, dates of tick bite and removal of the tick as well as the demographic characteristics were recorded. Moreover, data of the Provincial Directorate of Health on total number of tick bites, confirmed CCHF cases and deaths due to CCHF in the Bolu Province during the study period were evaluated. Results: A total of 451 patients were admitted to the Emergency Department, and 52.5% were female. The mean age was 41.7 years. The cases were predominantly observed in June and July, and were mostly from the city center (n=216) and the majority of them (n=338) were found to take place in the patients' primary living area. For patients in some professional groups such as labourers, officials and retired persons, the difference between male and female patients was statistically significant in terms of incurring a tick bite. According to the records of the whole province during the study period, 10 979 patients had a tick bite, 72 were diagnosed as CCHF, and 6 patients had a fatal outcome. Conclusions: Contact with a tick is a hazardous condition and precautions such as development of public awareness, preventive measures and education of the healthcare staff is crucial.Öğe Evaluation of Total Oxidative Level and Total Antioxidant Capacity in Cases with Chronic Viral Hepatitis(Aves, 2009) Sirmatel, Fatma; Duygu, Fazilet; Celik, Hakim; Selek, Sahabettin; Sirmatel, Ocal; Gursoy, Bensu; Eris, Fatma NurObjective: Oxidative stress is described as an instability between production of free radicals from cells and antioxidant defence of the body. The aim of the study was to investigate the correlation of total antioxidant capacity (TAC) and total oxidative level (TOL) with the severity of the disease and reliability of these parameters in the follow up of response to treatment in cases with chronic viral hepatitis (CVH). Methods: Between January 2004-March 2006, 73 cases with CVH were included in the study. The ages of the patients ranged from 15 to 70 years. Diagnosis of CVH was confirmed by clinical serological, and biochemical markers. The cases were divided into two groups: Group 1 as HBsAg-positive or anti-HCV-positive but HBV DNA or HCV RNA-negative and Group 2 as proven CVH. TAC, lipid hydroperoxide (LOOH), and TOL of the sera were studied according to Erel method, and statistically evaluated by 2 test in all the cases. Results: TAC, LOOH and TOL were found statistically significantly different between two groups. Average values of TAC were 1.8 +/- 0.5 mmol Trolox-Eqv./L and 1.0 +/- 0.15 mmol Trolox-Eqv./L in Group 1 and Group 2 (p=0.0001) respectively. Average values of LOOH were 5.3 +/- 2.8 mu mol H2O2 in Group 1 and 10.6 +/- 10.1 mu mol H2O2 in Group 2 (p=0.002). Average values of TOL were 10.2 +/- 5.9 mu mol H2O2 Eqv./L in Group 1 and 18.5 +/- 16.6 mu mol H2O2 Eqv./L in Group 2 (p=0.004). Conclusions: TAC was found higher, and TOL and LOOH were found lower in Group 1 than Group 2. The evaluation of plasma TAC, TOS ve LOOH levels may be important activation markers for the follow up of CVH.Öğe Investigation of a healthcare-associated candida infections in a Turkish intensive care unit: risk factors, therapy and clinical outcome(2021) Avcioğlu, Fatma; Sirmatel, Fatma; Behcet, Mustafa; Ozarslan, Oğulcan; Gözdaş, Hasan TahsinAim: Candida infections develop especially in intensive care unit (ICU) patients and increase the mortality rates. So, early and accurate diagnosis of Candida infections and determination of risk factors are very important. We aimed to retrospectively investigate Candida infections in terms of species and risk factors for candidemia caused by fungi. Methods: Candida infections in critically ill patients hospitalized in the Intensive Care Unit of Bolu Abant Izzet Baysal University Training and Research Hospital between January 2014 and December 2018 were retrospectively analyzed. The isolated Candida species were evaluated according to the sample types. The cases were investigated in terms of mortality due to candidiasis, previously used antibiotics and isolated Candida species. Results: 34 Candida species isolated from fungal cultures in ICUs were included in the study. Candida albicans (73.5%) was the most prevalent species isolated (NAC 26.5%). Patients with Candida isolated in their urine samples (76%) had a higher mortality rate than patients with Candida from other regions. Conclusion: The results of our study suggest that the highest rate of candidiasis (88%) is in patients who received beta-lactam antibiotic treatment. In addition, we think that when Candida species are detected in the urine samples of critically ill patients in the ICU, care should be taken in terms of candidiasis.Öğe Investigation of Intrafamilial Transmission in Hepatitis B Surface Antigen (HBsAg) Positive Cases in Harran University Hospital(Ortadogu Ad Pres & Publ Co, 2009) Yengil, Erhan; Kurcer, Mehmet Ali; Sirmatel, FatmaObjective: Hepatitis B virus (HBV) is a public health problemowing to communicable and widespreant. In addition to It is important issue because of preventable and prevent to people from contaminated persons. Transmission of HBV may be connected to transmission carrecteristics such as horizontal, vertical, sexual and blood, priority. Aim of this study is to determine the possible route of HBV transmission throughout a family setting. Material and Methods: 173 members (29 spouses, 82 offspring, 11 mothers, 11 fathers and 40 siblings) of 40 index cases (HBsAg carriers and chronic active hepatitis cases) attending the Harran University Medical Faculty Hospital between Augst 2006 and March 2007 were screened prospectively for markers of HBV by using an ELISA. The chi-squared and Logistic regression analyses were used for statistical analysis. Results: Index cases was 18.8% of all family members, while HBsAg prevalence is 15.0% among family members except index cases. Among family members, the highest prevalences of antiHBc were in the mothers (54.5%) and sisters (45.5%), brothers (33.3%), sons (32.6%)and wifes (31.3%), the least prevalences of antiHBc were husbands (7.7%), fathers (18.2%), and doughters (22.2%) of all index cases. Transmission of HBV to both the mothers and sisters were positive was high, Transmission of HBV to fathers was low in all families. There was significant difference in cases where only the mother and husbands of index cases for HBV transmission (p=0.012). In the logistic regression model; living with chronic hepatitis B index case (OR=1.92; CI=1.03-3.57), to be illiterate (OR=6.81 CI=1.27-22.13), born at home with traditional methods (OR=3.70; CI=1.15-11.87) and born at home with the help of midwife (OR=3.44; CI=1.47-7.91) were higher risk for hepatitits B transmision. Conclusion: The family members of index cases with inactive HBV carriers, particularly in the case of chronic active hepatitis have a high risk of transmission.Öğe Seroprevalance of Hepatitis B Virus, Hepatitis C Virus and Hepatitis D Virus in Healthy Blood Donors(Galenos Publ House, 2012) Sirmatel, Fatma; Yetkin, Gulay; Eris, Fatma Nur; Koruk, Suda Tekin; Duygu, Fazilet; Karaagac, Leman; Dincer, SevimObjective: Training and research Hospital in the two different region, healthy volunteer blood donors were admitted to Blood Bank which serological markers to chronic viral hepatitis HBV, HCV and HDV seroprevalance was investigated by EIA. The aim of this study is to determine seropositivity indicating chronic hepatitis through west and southeast regions and to debate the difference between two regions according to literature. Materials and Methods: This study was performed in two groups. First group was enrolled in Sanliurfa between 2004-2006 years, whereas second group was programmed in Bolu between 2007-2009 years. Both of them were taken University Hospital Blood Bank. Healthy blood donors were chosen on a voluntary basis. The serological markers of donors HBV and HCV were studied by macro EIA (Abbott Axsym UK), whereas HDV markers in the sera of patients with HBsAg positive by micro EIA (Abbott UK). All the patients' ages, professions, birth places and history of transmission were questioned in detail. Results: In the first group; 565 (2.9%) HBsAg and 104 (0.5%) anti-HCV positive cases were found in a total of 19.250 healthy blood donors. Only 194 HBsAg positive cases were followed and monitories in which 5 (2.5%) ones of all were found to be anti-HDV positive. In the second group including 2012 blood donors, HBsAg and anti-HCV positivity were found respectively 24 (1.19%) and 5 (0.24%) besides no anti-HDV positivity. All subjects' mean age was 33.9(between 18-71 years). Conclusion: When comparing population of both Southeast and West cities in aspect of chronic viral hepatitis markers, it is found to be significantly less in West. Previously chronic viral hepatitis seroprevalance is higher in the Southeast region to show decline in recent years and especially in the western region has a remarkable absence of and anti-HDV positivity. We assume that the decrease in the rate seropositivity of chronic viral hepatitis is due to routine immunization and education programs.
