Hasan Buyukaslan

Mean platelet volume and red cell distribution width levels in initial evaluation of panic disorder

Background As the relationship between psychological stress and platelet activation has been widely studied in recent years, activated platelets lead to certain biochemical changes, which occur in the brain in patients with mental disorders. However, data relating to the mean platelet volume (MPV) in patients with panic disorder (PD) are both limited and controversial. Herein, we aimed to evaluate, for the first time, the red cell distribution width (RDW) levels combined with MPV levels in patients with PD. Patients and methods Between January 2012 and June 2015, data of 30 treatment-naïve patients (16 females, 14 males; mean age: 37±10 years; range: 18–59 years) who were diagnosed with PD and 25 age- and sex-matched healthy volunteers (10 females, 15 males; mean age: 36±13 years; range: 18–59 years) (control group) were retrospectively analyzed. The white blood cell count (WBC), MPV, and RDW levels were measured in both groups. Results The mean WBC, MPV, and RDW levels were 9,173.03±2,400.31/mm3, 8.19±1.13 fl, and 12.47±1.14%, respectively, in the PD group. These values were found to be 7,090.24±1,032.61, 6.85±0.67, and 11.63±0.85, respectively, in the healthy controls. The WBC, MPV, and RDW levels were significantly higher in the patients with PD compared to the healthy controls (P=0.001, P=0.001, and P=0.003, respectively). However, there was no significant difference in the platelet number between the patients with PD and healthy controls (P>0.05). Conclusion Our study results are the first to demonstrate that the RDW levels combined with MPV levels significantly increase among patients with PD. We believe that increased RDW and MPV levels can be used as a novel marker for PD.

The effects of lycopene on intestinal injury due to methotrexate in rats

Objective: The aim of this study was to investigate the effects of lycopene (Lyc) on methotrexate (Mtx)-induced intestinal damage in rats. Method: Twenty-eight male Sprague Dawley rats were divided into four equal groups: control, Mtx, Lyc, and Mtx-L. Control group: Rats were given only the vehicle. Lyc group: Rats were given Lyc (10 mg/kg) with corn oil by oral gavage for 10 days. Mtx group: Rats were injected intraperitoneally with a single dose of 20 mg/kg of Mtx and given corn oil by oral gavage. Mtx-L group: Rats were treated with Lyc (10 mg/kg) for 10 days after a single dose of Mtx (20 mg/kg). All of the rats were euthanized using terminal anesthesia, and the intestinal tissues were removed for histological examination and for pro-inflammatory cytokine measurement (tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β)), total oxidative status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI). Results: Mtx administration increased histopathological damage and increased TNF-α, IL-1β, TOS, TAC, and OSI levels in the small intestine tissues. Lyc therapy applied to the Mtx-L group provided significant improvement in all parameters of histopathological damage to the small intestine and significantly reduced the levels of IL-1β, TOS, and OSI in the intestinal tissues. Conclusions: The results of this study indicate that Lyc might be useful for protecting intestinal damage induced by Mtx in rats by reducing the increased oxidative stress and pro-inflammatory cytokine (IL-1β) levels.

Serum thiol levels and thiol/disulphide homeostasis in gunshot injuries

BackgroundGunshot injuries result in serious traumatic tissue damage due to high velocity of the bullet, deep penetration, and ballistic effect. Trauma is known to be related with oxidative stress. Serum thiol levels and disulphide/thiol homeostasis are novel oxidative stress biomarkers. In this study, we aimed to investigate serum thiol levels and disulphide/thiol homeostasis in injury patterns of patients admitted to the emergency department with a gunshot injury.MethodA total of 128 participants were included in the study. The participants were divided into two groups: the patient group (Group 1; n = 73) and healthy controls (Group 2; n = 55). Native thiol, total thiol, disulphide levels, disulphide/native thiol, disulphide/total thiol, and neutrophil-to-lymphocyte ratio (NLR) were measured. The Revised Trauma Scale (RTS) and Glasgow Coma Scale (GCS) scores were calculated.ResultsNative thiol, total thiol, and disulphide levels were significantly lower in Group 1 (p < 0.001). Disulphide/native thiol ratio, disulphide/total thiol ratio, and NLR were significantly higher in Group 1, compared to Group 2 (p < 0.05). There was a positive correlation between thiol levels and RTS and GCS scores and NLR. Stepwise linear regression analysis showed that native thiol was an independent indicator of RTS and GCS scores. The receiver operating characteristic curve (ROC) analysis revealed that serum native thiol levels of ≤ 342.9 could predict gunshot injury with a sensitivity of 82% and a specificity of 77% (area under the curve = 0.853; 95% confidence interval 0.783–0.924).ConclusionOur study results suggest that thiol–disulphide homeostasis is disrupted in patients sustaining gunshot injuries, and thiol levels decrease in correlation with the severity of trauma with a high sensitivity and specificity. As the level of native thiol is an independent predictor of the severity of trauma, reduced thiol levels may be of prognostic value in the early assessment of patients in the emergency room.

Evaluation of oxidant, antioxidant, and S100B levels in patients with conversion disorder

Introduction Various psychodynamic, neurobiological, genetic, and sociocultural factors are believed to be involved in the etiology of conversion disorder (CD). Oxidative metabolism has been shown to deteriorate in association with many health problems and psychiatric disorders. We evaluated oxidative metabolism and S100B levels in the context of this multifactorial disease. Methods Thirty-seven patients with CD (25 females and 12 males) and 42 healthy volunteers (21 females and 21 males), all matched for age and sex, were included in this study. The total oxidant status, total antioxidant status, oxidative stress index, and S100B levels were compared between the two groups. Results The total oxidant status, oxidative stress index, and S100B levels were significantly higher in patients with CD than in the control group, whereas the total antioxidant status was significantly lower. Conclusion CD is associated with deterioration of oxidative metabolism and increased neuronal damage.

Self Mutilation of Genitalia-Using Teeth

Genital self-mutilation (GSM) is an uncommon self-inflicted injury, and rarely do self-mutilations have a serious nature. GSM is not a single clinical entity, and it can occur in any psychiatric state or condition. The instruments that are used for self-mutilation can vary, and treatment of these injuries requires a detailed clinical evaluation and multi disciplinary approach. We report here a case report about a 22-year-old mentally retarded man who referred to our emergency service for bloody vomitting by his family members. To our knowledge this is the first such case reported in literature as of injury technique.

Posttraumatic persistent shoulder pain: Superior labrum anterior-posterior (SLAP) lesions

Patient: Male, 57 Final Diagnosis: Typ 2 Superior labrum anterior-posterior lesion Symptoms: Shoulder pain after trauma Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology • Emergency Medicine Objective: Rare disease Background: Due to the anatomical and biomechanical characteristics of the shoulder, traumatic soft-tissue lesions are more common than osseous lesions. Superior labrum anterior-posterior (SLAP) lesions are an uncommon a cause of shoulder pain. SLAP is injury or separation of the glenoid labrum superior where the long head of biceps adheres. SLAP lesions are usually not seen on plain direct radiographs. Shoulder MRI and magnetic resonance arthrography are useful for diagnosis. Case Report: A 57-year-old man was admitted to the emergency department due to a low fall on his shoulder. In physical examination, active and passive shoulder motion was normal except for painful extension. Anterior-posterior shoulder x-ray imaging was normal. The patient required orthopedics consultation in the emergency observation unit due to persistent shoulder pain. In shoulder MRI, performed for diagnosis, type II lesion SLAP was detected. The patient was referred to a tertiary hospital due to lack of arthroscopy in our hospital. Conclusions: Shoulder traumas are usually soft-tissue injuries with no findings in x-rays. SLAP lesion is an uncommon cause of traumatic shoulder pain. For this reason, we recommend orthopedic consultation in post-traumatic persistent shoulder pain.