Prevalence of Helicobacter pylori in symptomatic patients and detection of clarithromycin resistance using melting curve analysis

AbstractBackground:Clarithromycin is often a component of combination therapies for Helicobacter pylori eradication; however, increases in resistance rates have decreased the success of the treatment.Objective:This study was designed to determine the prevalence of H pylori infection in symptomatic patients and to detect clarithromycin resistance rates using melting curve analysis.Methods:Patients scheduled for upper endoscopy at the Endoscopy Unit of the Department of Gastroenterology, Duzce University, Medical Faculty Hospital, Konuralp/Duzce, Turkey, were assessed for enrollment in the study. Two pairs of gastric biopsy specimens (antrum and corpus) were obtained from each study patient. Histopathologic examination, rapid urease test, culture, and polymerase chain reaction (PCR) of the specimens were used to identify H pylori infection. Clarithromycin resistance was detected using melting curve analysis.Results:Seventy-five patients (41 women, 34 men; mean [SD]age, 42.6 [14.5] years [range, 17–70 years]) were included in the study. Using histopathology and rapid urease test, H pylori was detected in 40 (53.3%) of the 75 specimens. H pylori was detected using PCR in 40 (53.3%) specimens and by culture in 10 (13.3%) specimens. The specificity and sensitivity of PCR and culture were interpreted by comparing them with the results of histopathologic examination and urease tests. The specificity and sensitivity of PCR were 68.6% and 72.5%, respectively, and the specificity and sensitivity of culture were 97.1% and 22.5%, respectively. Of the 40 isolates, 21 (52.5%) were susceptible to clarithromycin, 12 (30.0%) were resistant, and a mixed susceptibility pattern was detected in 7 (17.5%) specimens. H pylori isolates from 19 (79.2%) of the 24 patients who had formerly used clarithromycin showed clarithromycin resistance.Conclusions:The prevalence of H pylori infection was 53.3% for the symptomatic patients in this study, and 47.5% of the isolates showed clarithromycin resistance using melting curve analysis. The PCR-based system used in this study was accurate for the detection of H pylori infection as well as clarithromycin susceptibility testing directly in biopsy specimens

The Effects of Nasal Septum Deviation on Ocular Examination Findings: Does Deviated Nasal Septum Cause Impaired Vision?

Aim: Nasal obstruction due to nasal septum deviation is associated with systemic diseases such as cardiopulmonary disease, neurological and vascular problems. But the effect of pure nasal deviation on the ocular system has not been precisely investigated. The aim of this study was to analyze the association of nasal septal deviation with ocular examination findings. Material and Methods: Twenty-seven adult patients underwent septoplasty and 31 controls were included in the study. The study group was conducted on patients with pure nasal septum deviation which is significantly obstructing the nasal airway (>50%). In ophthalmological examination; peripapillary retinal nerve fiber layer, macular and choroidal thickness measurements were obtained. The examination findings were compared between the study and control groups. Results: The mean macular thicknesses at nasal-500μm were 305.89±32.79 and 287.87±25.00 in the study and control groups, respectively (p=0.021). The mean macular thicknesses at nasal-1000μm were 353.04±21.28 and 341.16±17.97 in the study and control groups, respectively (p=0.025). The mean thickness of choroid was statistically significantly different at central (p=0.036) and peripheral measurements; nasal-500μm (p=0.020); nasal-1000μm (p=0.001); nasal-1500μm (p<0.001); temporal-500μm (p=0.023) and temporal-1000μm (p=0.045). No statistically significant difference was found between the two groups according to ocular tension, thickness of cornea, keratometry, anterior chamber depth, axial length of cornea, and retinal nerve fiber layer thickness. Conclusion: This is one of the pioneer studies evaluating the ocular examination findings in patients with nasal septum deviation. Our results indicate the increased thickness of both macula and choroid in patients with nasal septum deviation

Posterior pillar mucosal suspension technique for posttonsillectomy pain and wound healing: a prospective, randomized, controlled trial

WOS: 000447934800034PubMed: 30255204Objectives/hypothesisTo investigate the efficacy of a simple and feasible suturing technique on posttonsillectomy pain control and wound healing.MethodsA prospective, randomized, controlled trial was conducted on a sample of 121 children between 3 and 10years of age. Group A comprised children undergoing surgery with bipolar cautery and the posterior pillar mucosal suspension technique. Bipolar alone (Group B) and cold dissection tonsillectomy (Group C) were used as control groups. Pain was assessed at 1, 3, 5, 7, and 10days postoperatively via visual analog scale scores. Peritonsillar edema, erythema, and granulation tissue in the tonsillar fossa were evaluated by direct visual examination for wound healing on days 1, 3, 5, 7, and 10.ResultsThere were consecutive 121 patients which were included, with mean ages being 6.22.5, 6.1 +/- 2.4, and 6.1 +/- 2.6 in groups A, B, and C, respectively. Postoperative pain scores on days 1 and 3 were significantly lower in Group A than Group B and C (P<.001) and scores were 0.87 +/- 1.1, 3.83 +/- 2.29, and 4.29 +/- 2.48 on day 1 and 0.38 +/- 0.88, 2.25 +/- 2.13, and 2.76 +/- 2.12 on day 3 respectively. The wound-healing scores on postoperative 1st, 3rd, 5th, and 7th days were significantly lower in Group A than control groups (P<.001). The wound-healing score on postoperative day 10 was only different than Group C (P=.020).Conclusions p id=Par4 The posterior pillar mucosal suspension technique is an effective and comparable method in terms of wound healing, maintains the preoperative anatomical structures, and enables a better pain control with reduced analgesic/opioid usage

Cerrahi Teknik Post Tonsillektomi Hemoraji Oranını Anlamlı Olarak Değiştirir mi?

Amaç: Tonsillektomi pediatrik populasyonda en sık uygulanan cerrahi girişimlerden biridir ve KBB eğitiminde ilk öğrenilen işlemlerdendir. Bu çalışma, tonsillektomi sonrası kanamada cerrahi tekniğin etkili olup olmadığını değerlendirmeyi amaçlamıştır.Gereç ve Yöntemler: Bu prospektif planlı klinik çalışma, Mayıs 2012 ile Nisan 2015 arasında bir üçüncü basamak sağlık merkezinde gerçekleştirildi. Çalışma süresince, aynı cerrah tarafından 3 farklı teknikle toplam 608 hasta ameliyat edildi. Grup 1'de soğuk diseksiyon ile ameliyat edilen çocuklar, Grup 2'de bipolar koter ile opere edilen çocuklar, Grup 3’de ise posterior pillar mukozal sütür tekniği ile opere edilen çocuklar yer aldı.Bulgular: Soğuk diseksiyon (n=165), bipolar koter (n=274) ve posterior pillar mukozal sütür (n=169) tekniklerine toplam 608 hasta dahil edildi. Yaş ortancası 5 (2-14) idi. Beş hastada (%0,82) ameliyat sonrası kanama oldu. Bu hastalardan sadece birinde primer hemoraji gözlenmiş olup, hasta soğuk diseksiyon grubunda yer almaktaydı. Beş hastanın dördünde sekonder kanama gözlendi ve bu hastalar bipolar koter grubu ve posterior pillar mukozal sütür gruplarındaydı. Postoperatif hemoraji oranları gruplar için sırasıyla %0.61, %0,73 ve %1,18 olarak tespit edildi (p=0,861). Kanamayı kontrol etmek için ameliyat odasına sadece beş hastadan biri transfer edildi.Sonuç: Çalışmamızın bulguları, cerrahi tekniğin tonsillektomi sonrası kanama oranını etkilemediğini desteklemektedir. Farklı cerrahi teknikler arasında primer ve sekonder kanamada oranları açısından anlamlı fark olmadığı görüldü

Large pedinculated antral hyperplastic gastric polyp traversed the bulbus causing outlet obstruction and iron deficiency anemia: endoscopic removal

alper, murat/0000-0001-7069-0623WOS: 000181745400055PubMed: 12632536We present here a large (3 cm) hyperplastic gastric polyp prolapsed into duodenum and caused outlet obstruction and iron deficiency anemia in 60 years old male patient. Endoscopic removal was performed successfully

Time series analysis models for estimation of greenhouse gas emitted by different sectors in Turkey

WOS: 000424938100016Due to the increasing global warming in the world, analyzing greenhouse gas emissions is a crucial issue. This study has examined greenhouse gas emissions in Turkey according to energy sector, industrial processes sector, agriculture sector and waste sector. Then, time series analysis models are used to estimate greenhouse gas emissions based on sectors. Models' performances are tested using mean error, mean absolute error and root mean square error. The results show that forecasting models have a good potential to estimate the national greenhouse gas emissions for different sector within a reasonable error. The study results will help organize and estimate the national greenhouse gas emissions inventory

The Histopathological Findings of Adenoid Tissue After Topical Mometasone Furoate Implementation

WOS: 000441304600013Objective: Pediatric sleep disordered breathing (SDB) is a common childhood disease with a potential risk of several comorbidities. The most common cause of SDB in childhood is upper airway obstruction due to adenotonsillar hypertrophy and the classical treatment is adenotonsillectomy. However, it carries a risk of many complications and persistent apnea. Topical nasal steroid treatment may be an alternative to surgery in the treatment of pediatric SDB. However, histopathological effects of topical nasal steroids are mostly understudied. Methods: A retrospective controlled clinical study in an academic tertiary referral center. A total of 110 children were involved in the study who underwent adenoidectomy for the treatment of SDB. The study group (51-children) was treated with topical nasal mometasone furoate monohydrate 100 mcg/day. The control group (59-children) was selected randomly and all had no history of topical nasal steroid pre-operatively. Post-operative adenoidectomy specimens were reviewed according to acute/chronic inflammation findings, follicular hyperplasia, goblet cell hyperplasia, squamous metaplasia, fibrosis, atrophy, ulcer and hemorrhage. The findings were scored semiquantitatively for statistical analysis. Results: Chronic inflammation findings, follicular hyperplasia and goblet cell hyperplasia were significantly decreased in the study group in addition fibrosis, atrophy and ulcer findings were significantly increased in the study group. However, there was no statistical difference between the groups according to acute inflammation and hemorrhage. Conclusions: Topical nasal corticosteroids significantly suppress the nasopharyngeal inflammatory process in SDB. This treatment may be an alternative to surgery at least in patients with mild and moderate disease