Abant Izzet Baysal University Research Articles

Internet Addiction and Its Effect on Sleep Quality Among Medical Students

Aim: This study was carried out to determine the prevalence of internet addiction in medical school students, and to examine the relationship between internet addiction and sleep quality, sleepiness and psychological resilience. Method: The study was conducted with 213 participants studying at Bolu Abant Izzet Baysal University Faculty of Medicine. A sociodemographic questionnaire, Young Internet Addiction Test-Short Form, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Brief Psychological Resilience Scale were applied to all participants, and the results were statistically evaluated. Results: The average age of the participants was found as 21.25±2.00. 65.3% (n=139) of the participants were women and 27.2% (n=58) were first-year students. The average score of Young's internet addiction was 27.15±7.35; the average Pittsburgh Sleep Quality Index score was 5.49±2.47. 60% of them were evaluated as having poor sleep quality. Average Epworth Sleepiness Scale scores were 6.62±4.22; average scores of the Psychological Resilience Scale were 19.35±5.04. There was a positive and significant relationship between Young Internet Addiction and Pittsburgh Sleep Quality. As internet addiction increased, sleep quality decreased. A negative significant relationship was found between Young's Internet Addiction and the Brief Psychological Resilience Scale. As internet addiction increased, psychological resilience decreased. Conclusion: In our study, it was determined that as internet addiction increased, sleep quality and psychological resilience decreased, and daytime sleepiness increased. We can improve sleep quality by preventing internet addiction, and increase participation in daily activities and psychological resilience by reducing daytime sleepiness. Keywords: internet addiction disorder, sleeplessness, resiliency, psychological

IS THERE ANY EFFECT OF THE SEVERITY OF FLEXIBLE PES PLANUS ON THE BALANCE PERFORMANCE IN ELITE GYMNASTS?

Flexibility is an important component of athleticism in gymnasts' training, as its insufficient development can significantly complicate the process of formation of specific skills and movement coordination and limit the possibility of manifesting and increasing strength and speed abilities (Дейнеко & Біленька, 2021). The aim of this study was to analyse the impact of the severity of FPP on balance performance in different planes (frontal, sagittal and overall balance) in the Turkish national youth team. This study is a prospective and double-blinded cohort study conducted in the Department of Physiotherapy and Rehabilitation of Bolu Abant Izzet Baysal University. The evaluation protocol consists of two main phases: first, the measurement of joint positions or angles (subtalar joint position, subtalar joint angle, first metatarsophalangeal (MTP) extension angle and tibia-femoral angle measurement), second, the measurement of balance. 20 participants aged 13-18 years, male and female, from the Turkish national youth gymnastics team were included in this study. Linear regression analysis was performed to determine whether there is an effect of severity of FPP on balance performance. There is no clear effect of FPP severity on balance performance in youth gymnastics at the national level. However, some evaluations show significant associations in the frontal plane in relation to the mediolateral stability index. None of the assessments showed a significant association with the anteroposterior stability index.

Could serum uric acid to HDL cholesterol ratio predict sacroiliitis?

Recently, several inflammatory markers, including the uric acid to HDL cholesterol ratio (UHR), triglyceride/HDL cholesterol ratio (THR), systemic inflammatory index (SII), and C-reactive protein to albumin ratio (CAR), have been reported to be associated with inflammatory conditions. However, their collective role in sacroiliitis has not been extensively studied. This study aims to investigate the general characteristics and inflammatory markers in patients with and without sacroiliitis, and to observe any differences in these parameters in subjects with active and chronic sacroiliitis. Patient with sacroiliitis who showed up in the Radiology Department of Abant Izzet Baysal University Hospital were enrolled. Patients diagnosed with sacroiliitis based on clinical symptoms, physical examination, and conventional radiography or MRI findings were included in the sacroiliitis group. Patients without sacroiliitis who present with back pain or hip pain but have normal radiographic findings were included in the control group. General characteristics, including age, sex, body mass index (BMI), medical history, and disease duration, were collected from all participants. Blood samples were collected to measure inflammatory markers, including UHR, THR, SII, and CAR. The collected data were compared between sacroiliitis and control groups. Subgroup analysis was also performed to compare the inflammatory markers between subjects with active and chronic sacroiliitis. The median UHR of the sacroiliitis and control subjects were 11% (3-20%) and 7% (3-13%), respectively (p<0.001). Serum UHR was significantly and positively correlated with CRP (r: 0.4, p = 0.001) and ferritin (r: 0.17, p = 0.045) levels. In ROC analysis, a UHR level higher than 8% has an 81% sensitivity and 64% specificity in detecting sacroiliitis (AUC: 0.8, p<0.001, 95% CI: 0.72-0.84). In conclusion, we suggest that UHR could provide useful data as an additional diagnostic tool in patients with sacroiliitis.

Which inflammatory marker might be the best indicator for sacroiliitis?

AbstractThis study aimed to investigate the potential of inflammatory markers, including platelet‐to‐lymphocyte ratio (PLR), neutrophil‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), and C‐reactive protein‐to‐lymphocyte ratio (CLR), in identifying sacroiliitis. Present retrospective study was conducted at the Abant Izzet Baysal University Hospital, including patients diagnosed with sacroiliitis between August 2020 and March 2023. Control subjects with normal sacroiliac joints were also included. Sacroiliitis patients were further categorized into active and chronic sacroiliitis groups. Demographic data and laboratory characteristics, such as erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP), and various blood parameters, were recorded. Inflammatory markers were calculated, including PLR, NLR, LMR, and CLR. Statistical analyses were performed to compare the study groups and evaluate the diagnostic performance of these markers. A total of 226 subjects, including 132 sacroiliitis patients and 94 control subjects, were included in the study. Serum CRP levels were significantly higher in sacroiliitis patients compared to the control group. NLR, PLR, and CLR values were elevated in sacroiliitis patients, while LMR was decreased. There were significant correlations between these markers and established inflammatory markers. Receiver operating characteristic (ROC) analysis demonstrated moderate diagnostic performance for NLR, PLR, LMR and CLR in detecting sacroiliitis. Inflammatory markers, specifically NLR, PLR, LMR and CLR, showed significant differences between sacroiliitis patients and the control group. In addition PLR is useful in distinguishing active and chronic sacroiliitis. These markers, in conjunction with established inflammatory markers, may serve as supportive diagnostic tools for sacroiliitis.

Diyabetli Hastalarda Miyokard Perfüzyon Sintigrafisinde Miyokard İskemisini Öngörmede Ürik Asit-HDL Kolesterol Oranının Rolü

The Role of Uric Acid to HDL Cholesterol Ratio in Predicting Myocardial Ischemia in Myocardial Perfusion Scintigraphy in Diabetic Patients&#x0D; Abstract&#x0D; Objective: Diabetes Mellitus (DM) is a significant risk factor for cardiovascular diseases, particularly myocardial ischemia. Both diabetes mellitus type 2 and cardiovascular conditions are characterized by a high burden of inflammation. The uric Acid to High-Density Lipoprotein cholesterol ratio (UHR) has been suggested as a novel marker of metabolic and inflammatory diseases. Hence, this study investigated the predictive role of the Uric Acid to High-Density Lipoprotein cholesterol ratio (UHR) in myocardial ischemia detected by Myocardial Perfusion Scintigraphy (MPS) in diabetic patients.&#x0D; Materials and Methods: This study included patients who underwent MPS between January 2022 and March 2023 at the Nuclear Medicine Department of Abant Izzet Baysal University Hospital. Based on the MPS results, the participants were divided into normal perfusion and myocardial ischemia. Variables such as age, sex, leukocyte count, hemoglobin, hematocrit, platelet count, serum uric acid, urea, creatinine, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, transaminase, blood fasting glucose, C-reactive protein, and serum albumin were recorded and compared between the groups.&#x0D; Results: Among the 73 diabetic patients, 37 had myocardial ischemia, and 36 had normal MPS. Serum uric acid levels were higher in the ischemic group (6.3 ± 1.5 mg/dL) than in the normal group (5.1 ± 1.8 mg/dL) (p

Bacterial strains promote the growth of peach, sweet cherry and plum saplings in the regions with the short growing season

The research was done to consider the regulating potential of 3 plants growth-promoting bacterial (PGPB) strains, including Burkholderia gladia BA7, Bacillus subtilus OSU142, and Bacillus megatorium M3 alone and their combinations on the growth of grafted peach, sweet cherry, and plum nursery plants in 2014, which had not sufficient growth after grafting in the first year (2013) at the Abant Izzet Baysal University, Bolu, Türkiye. The results found that the two combinations of isolates are more efficient than their three combinations or using them alone. The most efficient treatment was observed OSU142 + M3 in the case of peach, OSU142 + BA7 in the sweet cherry, and M3+BA7 in the plum. In conclusion, changes in climate situations and increasing in the world population need extraordinary attempts to increase plant materials in an organic and sustainable way. Bacterial strains are among the bioregulators that have emerged as promising, new, and environmentally friendly microorganisms to support the overall sustainability of production systems. Briefly, bacterial applications significantly affected many growth characteristics of peach, sweet cherry, plum, and other fruit crops. So, they would be advised for the organic production of saplings.

Bacterial strains effect on the nursery plants growth of ‘Granny Smith’ apple grafted on M-9, MM-106, and MM-111 rootstocks

Sapling treatment with plant growth promoting bacterial strains (PGPBs), is not spread on a wide scale for horticultural crops; basically, their application in fruit crops has not received much attention. For this reason, ‘Granny Smith’ apple was grafted on three clonal rootstocks using the chip budding method on 15 May 2013; at the end of the vegetative season, saplings with shoot lengths of 40 or less than 40 cm were selected as plant materials for the second year of research (2014) at the Abant Izzet Baysal University, Bolu, Türkiye to consider bacterial strains including Burkholderia gladia BA7, Bacillus subtilus OSU142 and Bacillus megatorium M3 in combination with different apple clonal rootstocks effectivity on the growth of saplings. Considering the results, the sapling weight at initially recorded between 8.6 and 36.0 g, the sapling weight at the end of the growing season 66.6–110.7 g, and the sapling weight increase rate between 181.7 and 789.1%. Root fresh and dry weight and root dry mater ratio obtained respectively 34.9–61.6 g, 15.3–34.1 g, and 44.8–57.8%. Sapling shoot length at the beginning was recorded between 15.1 and 35.6 cm, sapling shoot length at the end of the growing season ranged from 77.7 to 103.7 cm, sapling shoot length increase rate between 150.4 and 549.3%, and the number of lateral branches varied between 1.0 and 7.5 pcs. Briefly, bacterial strains application combined with the different apple rootstocks significantly affected all the evaluated characteristics of apple saplings. In light of the result findings, bacterial application in the nursery of apples as well as other fruit crops would be advised for better development and organically production of nursery plants.

Is the prognostic nutritional index a predictor of Covid-19 related hospitalizations and mortality?

Prognostic nutritional index (PNI) is a novel inflammation marker that useful in predicting prognosis of certain conditions. We aimed to study PNI of the outpatient and inpatient subjects with established Covid-19 and also aimed to compare PNI of deceased and survived Covid-19 patients. The patients with Covid-19 whom presented to outpatient or inpatient clinics of Abant Izzet Baysal University Hospital were enrolled to the study. PNI levels of the inpatients and outpatients, deceased and survived were compared. PNI values of deceased and survived in inpatients were also compared. Study population was consisted of 4419 subjects (2907 outpatients and 1512 inpatients). PNI of the inpatient (41.55 (36.42-47.1)) group was significantly lower than the PNI of the outpatient (51.95 (47.95-55.75)) subjects (p<0.001). The sensitivity and specificity of PNI (≤46.2 level) in determination of requirement inpatient treatment were 71.2% and 83.5%, respectively. PNI of the deceased patients (37(33.39-40.86)) was lower than the PNI of the survivors (50.45(45.6-54.65)), (p<0.001). The sensitivity and specificity of PNI at ≤44.55 level in determining mortality were 89.22% and 78.87%, respectively. We suggest that PNI could serve as a reliable prognostic index in covid-19 patients. Reduced level of PNI should alert physicians since it is associated with need for hospitalization and mortality in this population.

The Role of Hemogram Parameters in Predicting Sentinel Lymph Node Metastasis in Breast Cancer

Abstract: Background: Breast cancer remains the second most common cancer in the world after lung cancer. Breast cancer rate in Turkey was 40-50 / 100.000 in the west, and was 20 / 100.000 in the east. Objective: In our study, we aimed to investigate the prediction of hemogram parameters in showing sentinel lymph node metastasis. Materials &amp; Methods: Patients undergoing sentinel lymph node biopsy (SLNB) with the diagnosis of breast cancer between January 2015 and August 2019 in General Surgery Department of Abant Izzet Baysal University were retrospectively analyzed in present descriptive study. The patients were divided into two groups, SLNB positive and negative. The measured hemogram parameters were compared between these two groups. Analysis of the data was held with a statistical software (SPSS 18.0 for Windows, IBM Inc., Chicago, IL, USA). Results: A total of 93 patients were included in the study. The average age of SLNB positive and negative patients were 55 (30-81) years 59 (35-88) years respectively. In detecting SLNB positivity, sensitivities and specificities of Tumor diameter&gt; 0.9 cm were 72% sensitivity, 56% specificity, of CRP&gt; 0.65 mg/dL were 76% sensitivity, 51% specificity, of RMR&gt; 1.85 were 72% sensitivity, 46% specificity, of RDW&gt; 15.45% were 75% sensitivity,% 42 specificity, of PLR&gt; 106.5 were 72% sensitivity, 56% specificity. Conclusion: Since auxiliary metastasis is one of the most important points for the prognosis of breast cancer, we suggest PLR, RDW, RMR could serve as prognostic factors in determining lymph node metastasis along with CRP and tumor size in breast cancer.

Is Low-risk Prostate Cancer Really Low-risk? Consider Factors Affecting Biochemical Recurrence and Tumour Upgrade.

To evaluate the demographics, preoperative or pathological factors, and findings of magnetic resonance imaging (MRI) to predict the factors affecting biochemical recurrence and tumour upgrade in low-risk prostate cancer. A descriptive study. Department of Urology, Bolu Abant Izzet Baysal University, Bolu, Turkey, from January 2017 to December 2021. The data of 135 patients, who underwent radical prostatectomy for low-risk prostate cancer according to prostate-specific antigen (PSA) level, biopsy result and clinical stage, were analysed. Preoperative clinicopathological factors, MRI findings, and the final pathological results were analysed. Prognostic factors affecting the biochemical recurrence in the follow-up and tumour upgrade in the final pathology according to the International Society of Urological Pathology (ISUP) were evaluated. Mean age and preoperative PSA level were 61.37 ± 5.53 (46-74) years and 6.74 ± 1.97 (range 1.88-9.9) ng/dL, respectively. Multivariate analysis showed that the prostate volume and diameter of lesions were statistically significant in the patients with ISUP upgrade (p=0.006, p=0.025, respectively), and surgical margin positivity in the final pathology specimen was statistically significant for biochemical recurrence (p=0.016). Logistic regression analysis revealed that prostate volume and diameter of the lesion in MRI were independent predictors of ISUP score upgrade. Receiver operating characteristic (ROC) curve analysis showed that tumour size on the MRI had 49.4% sensitivity and 77.8% specificity at 10 mm (AUC:0.634, p=0.009 for predicting). Lower prostate volume, higher diameter of lesions in multiparametric MRI and surgical margin positivity were associated factors affecting the ISUP score upgrade and biochemical recurrence. Therefore, patients should be evaluated preoperatively and patient-based factors should be considered in the choice of a treatment plan. Prostate cancer, Cancer upgrade, Tumour size.

The prevalence of temporomandibular disorders among medical students

Aim: This study aimed to evaluate the frequency of temporomandibular disorders (TMD) among students at the Abant Izzet Baysal University Medical Faculty in Turkey.Methods: Two hundred eleven medical students aged between 18 and 30 were included in the study. The presence and severity of TMD were evaluated using the Fonseca Anamnestic Index (FAI). Parafunctional habits, bruxism, and orthodontic treatments potentially associated with TMD were investigated.Results: No TMD was determined in 87 (41.2%) of the participants, mild TMD in 82 (38.9%), moderate TMD in 37 (17.5%), and severe TMD in five (2.4%) in the evaluations performed using the FAI. The frequency of TMD was significantly higher in women compared to men (p

The Antioxidant Effects of Sesamol on Bleomycin-Induced Oral Submucous Fibrosis

Objective: Oral submucous fibrosis (OSF) is a disease characterized by abnormal collagen deposition that causes inflammation and malignancy in oral mucosal tissue. Fibroblasts and myofibroblasts, are the cells that show significant activation in the development of OSF. Bleomycin (BL) is a chemotherapeutic agent commonly used in cancer treatment that also causes inflammatory changes in the oral mucosa, initiating fibrosis in the oral submucosal tissue. Sesamol (SE) has antioxidative and anti-inflammatory properties which are abundant in sesame seeds and sesame oil, and SE has a beneficial effect on the mucosal layer. This experimental study aimed to investigate SE’s effects on BL-induced OSF. Materials and Methods: The study obtained 18 healthy adult male albino rats aged 3-4 months and weighing 200-250g from Bolu Abant Izzet Baysal University’s Experimental Animal Application and Research Center. The rats were divided randomly into control, BL, and BL + SE groups (n = 6 in each group). A model of OSF was established in the rats by administering 0.5 mg/mL of BL and 50 mg\kg of SE to the BL+SE group each day. The hematoxylin and eosin stain and Masson’s trichrome stain were used to assess histopathological changes in the oral mucosa. Results: The results revealed SE&nbsp;to have beneficial effects on BL-induced OSF through its antioxidant and anti-inflammatory properties. Histopathological evaluations and biochemical analysis of oral submucosal tissue samples also revealed SE to provide statistically significant protection against fibrosis in the oral mucosa (p &lt; 0.01). Conclusion: This study has demonstrated oral submucous fibrosis that develops due to BL as well as SE to have an antioxidant effect on OSF regarding BL-induced reactive oxygen species (ROS) activation and collagen synthesis.

C-reactive protein-to-lymphocyte ratio is a reliable marker in patients with COVID-19 infection: the CLEAR COVID study.

COVID-19 infection is characterized with elevation of inflammatory markers in bloodstream. A novel inflammatory marker, C-reactive protein (CRP)-to-lymphocyte ratio (CLR), is suggested to be associated with inflammation. We aimed to compare the CLR values of the deceased COVID-19 patients to the CLR of survived subjects. The patients with COVID-19 whom presented to outpatient or inpatient clinics of AbantIzzet Baysal University Hospital were enrolled to the present retrospective study. Subjects were grouped as either deceased or survived. CLR values of the groups were compared. Study cohort was consisted of 568 subjects in deceased and 4753 patients in survived group. Median CLR of the deceased and survived groups were 90 (0.2-1679)% and 11 (0.2-1062)%, respectively (p < 0.001). The sensitivity (75%) and specificity (70%) of CLR (> 23.4% level) in detecting mortality were higher than those of CRP and ferritin (AUC 0.80, p < 0.001, 95% CI 0.78-0.82). We suggest that elevated CLR levels in COVID-19 patients on admission should alert physicians for poor outcome.

Hemogram Parametreleri SARS CoV-2 Enfeksiyonunda Geniş Pulmoner Tutulumu Öngörebilir mi?

Aim: Since the start of the pandemic, the novel coronavirus infection SARS CoV-2 has caused huge morbidity and mortality, as well as a significant economic cost. We aimed to compare clinical and laboratory findings of the SARS CoV-2 patients with mild pulmonary involvement to those in subjects with advanced pulmonary involvement.&#x0D; Material and Methods: In this study, the relationship between hemogram indices and pulmonary involvement in patients hospitalized for SARS CoV-2 infection at Bolu Abant Izzet Baysal University Hospital was investigated. We analyzed the thorax CT images of the subjects with SARS CoV-2 in present retrospective study. Radiological pattern of disease-related in the lungs, percentage of lung involvement, hemogram parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), aspartate and alanine transaminases (AST and ALT), lactate dehydrogenase (LDH), D-dimer, ferritin, total bilirubin, albumin, creatinine kinase, serum creatinine in patients with advanced and mild pulmonary involvement were compared. &#x0D; Results: Advanced pulmonary involvement (greater than 50%) was positively and significantly correlated with ESR, (r=0.32, p

Views of the Students Learning Turkish as a Foreign Language on Distance Education during the COVID-19 Pandemic

This study examines the views of international students learning Turkish as a foreign language (TFL)through distance education during the COVID-19 pandemic. The study is qualitative by nature and employed the case study method. The study group consisted of 31 nationals from different countries who had to take preparatory TFL courses in order to qualify as undergraduate students at the faculty of Engineering of the Bolu Abant Izzet Baysal University during the 2019-2020 academic year. A semi-structured interview form was used to determine the views of the participating foreign students on distance education during the pandemic. The results showed a decline in the expected language levels of the students due to technology and education-related problems they experienced during their distance learning process. While the students expressed the positive aspects of distance education as protection from the virus, recording of the classes which allowed repeated viewing, gaining experience, and saving time; the negative aspects expressed by the students were lack of previous experience in distance education, feelings of isolation, and having trouble asking for clarification when a teaching point was not understood during classes. More than half of the students stated that their motivation had increased during distance education and that they reported improvement in all their language skills but speaking. While the TFL students expressed positive opinions about online exams stating that they experienced less exam stress and did not have to go to school to take them, they also mentioned negative aspects of those exams such as technical problems they experienced while taking the exams and a high likelihood of cheating. Suggestions were made by the researcher based on the findings.

Trends of the last 20 years of Postgraduate Theses in the Field of Science Education related to Biotechnological concepts in Turkey: A Content Analysis

This study made for concepts related to biotechnology research trends between the years 2000-2020 graduate thesis in the field of science in Turkey, offers a descriptive content analysis. Within the aim of the study, a total of 65 postgraduate theses were examined by scanning the database of the YOK National Thesis Center. In this study, in which document analysis, one of the qualitative research designs, was used, theses were analyzed according to years, universities, study subjects, concepts, methods, data collection tools, sampling and sample size. According to the results obtained from the findings, it has been observed that the theses are predominantly master's theses, the postgraduate theses made in the field of science education related to biotechnological concepts were carried out in a total of 27 universities and the theses were mainly done in Gazi University, İnönü University and Bolu Abant Izzet Baysal University. According to the subject distribution, it has been observed that the theses are predominantly focused on learning, attitude/perception/interest and teaching. In addition, it has been concluded that quantitative studies are mostly used in the examined theses, and empirical designs among quantitative research methods are preferred more than non-experimental designs. As data collection tools, mostly skill, attitude, perception, personality, etc. tests, achievement tests, Likert type questionnaires and semi-structured interviews were used and it was observed that the most preferred sample group was university and high school students and the sample size was mostly between 101-300, 31-100. Based on the results of the study, researchers can focus on more detailed analysis in biotechnology education through meta-analysis.

Neutrophil to Lymphocyte ratio is significantly reduced after Sodium glucose cotransporter-2 inhibitor treatment in patients with type 2 diabetes mellitus

Background. Sodium glucose cotransporter-2 inhibitors (SGLT2i) are novel therapeutic agents that became available in the treatment of type 2 diabetes mellitus (T2DM). This group of antidiabetic agents are associated with reduced glycated hemoglobin (HbA1c), fasting glucose, body weight and body mass index (BMI) in diabetic patients. All those beneficial effects may also be associated with a reduction in inflammatory burden. The purpose of the study is to compare neutrophil to lymphocyte ratio (NLR), a novel inflammatory marker derived from hemogram, before and 6 months after SGLT2i treatment in diabetic subjects. We also aimed to compare fasting glucose, HbA1c and other metabolic parameters as well as anthropometric measures (weight, BMI) before and 6 month after initiation of SGLT2i therapy. Materials and methods. The subjects with type T2DM that show up in internal medicine outpatient clinics of Abant Izzet Baysal University Hospital between January 2021 and December 2021 were enrolled to the study. Pretreatment and posttreatment NLR and other parameters were compared. We also obtained pretreatment and posttreatment laboratory data including urea, creatinine, fasting glucose, HbA1c, glomerular filtration rate, aspartate and alanine transaminases, plasma sodium and potassium. Results. Fasting glucose was reduced from 195±72 mg/dl in pretreatment period to 146±53 mg/dl in posttreatment period (p&lt;0.001). HbA1c was reduced from 9.1±1.7% in pretreatment period to 7.7±1.7% in posttreatment period (p&lt;0.001). The NLR before treatment was 2.6±1.2% before SGLT2i treatment and was reduced to 2.2±0.6% in 6th month of SGLT2i therapy. NLR was significantly decreased after treatment (p=0.003). Conclusions. We suggest that NLR levels could be a marker of reduced inflammatory burden in T2DM subjects receiving SGLT2i treatment.

Are We Aware of the Neurological Manifestations of Cytomegalovirus Infection in Immunocompetent Individuals?

While cytomegalovirus (CMV) infection usually causes disease in immunosuppressed individuals, it mostly progresses as an asymptomatic infection in healthy adults. However, very rarely, immunocompetent individuals may also suffer from encephalitis and stroke. Nine patients who were admitted to the Neurology Clinic of Abant Izzet Baysal University Faculty of Medicine from 2016 to 2020 who had various neurological symptoms and were diagnosed with CMV infection were retrospectively analyzed. Symptoms, examination findings, laboratory results, radiologic imaging, and treatments were recorded and evaluated. Although severe infections because of CMV generally occur in newborns and immunosuppressed adults, it is estimated that the disease is more common in immunocompetent adults than known. This may be associated with unrecognized risks, in part because of immune dysfunction or comorbidities such as renal failure or diabetes mellitus. Also, CMV replication in arterial endothelial cells can restrict blood flow, inducing an atherosclerotic environment and causing stroke. Diagnosis is based on clinical suspicion and serology. Ganciclovir is administered for treatment. CMV infection should be considered in the differential diagnosis of patients presenting with neurological symptoms, even among immunocompetent individuals, because of the high possibility that patients can greatly benefit from antiviral treatment at the early stage.

The prognostic importance of PD-L1, PTEN, PHH3, and KI-67 expressions in invasive breast carcinoma.

The aim of this study was to investigate the relationship of PD-L1, PTEN, PHH3, and Ki-67 immunohistochemical stain expressions with prognostic clinicopathological parameters in breast cancer. Lumpectomy and mastectomy materials from 85 patients operated at the Department of Pathology, Bolu Abant Izzet Baysal University, Faculty of Medicine between 2014 and 2019 were retrospectively reviewed. PD-L1, PTEN, PHH3, and Ki-67 expressions were examined. Immunohistochemical staining results were compared with clinicopathological parameters and found to be associated with prognosis. A statistically significant correlation was found between PD-L1 and large tumor size, high histological grade, multifocality, and lymphovascular invasion. A statistically significant correlation was found between the loss of PTEN and large tumor size and histological grade. There was a statistically significant correlation between PHH3 and advanced age, large tumor size, and high histological grade. A statistically significant correlation was found between Ki-67 and large tumor size, high histological grade, and lymphovascular invasion. PD-L1, PTEN, PHH3, and Ki-67 are regarded as potential biomarkers that can be used to predict the prognosis of breast cancer and to develop targeted therapies.

Hypothyroidism is Strongly Correlated with Mean Platelet Volume and Red Cell Distribution Width

Abstract: Objective: Hypothyroidism is characterized with insufficient production and release of thyroid hormones, and cause a variety symptoms including cold intolerance, constipation, deceleration in movement, and hair loss. It is associated with increased inflammatory burden. Therefore, we aimed to observe red cell distribution width (RDW) and mean platelet volume (MPV) levels, novel predictors of inflammation, in patients with hypothyroidism and to compare to those in healthy subjects. Materials and Methods: The subjects with hypothyroidism that show up in internal medicine outpatient clinics of Abant Izzet Baysal University Hospital between January 2020 and January 2021 were enrolled to the retrospective study. Healthy volunteers were enrolled as control subjects. MPV and RDW of the study groups were compared. Results: The median RDW level of hypothyroid and control groups were 13.3 (10-20.7) % and 15.3 (11.8-21.3) %, respectively (p&lt;0.001). The median MPV level of hypothyroid and control groups were 10.2 (6.4-12.4) fL and 8.1 (5.4-11.5) fL, respectively (p&lt;0.001). MPV levels greater than 9.47 fL have 80% sensitivity and 72% specificity in predicting hypothyroidism (AUC: 0.66 [95% CI: 0.58-0.74]; p&lt;0.001). RDW levels greater than 13.4% have 80% sensitivity and 50% specificity in predicting hypothyroidism (AUC: 0.67 [0.82 [95% CI: 0.59-0.75]; p&lt;0.001). Conclusion: We suggest that elevated MPV and reduced RDW levels should alert physicians for hypothyroidism in otherwise healthy subjects. Keywords: Hypothyroidism, Red cell distribution width, Mean platelet volume, Inflammation, Thyroid hormones, Predictor, Retrospective study.