Ismail Temel

The prevalence of nutritional anemia in pregnancy in an east Anatolian province, Turkey

BackgroundAnemia is considered a severe public health problem by World Health Organization when anemia prevalence is equal to or greater than 40% in the population. The purpose of this study was to determine the anemia prevalence with the associated factors in pregnant women and to determine the serum iron, folate and B12 vitamin status in anaemic pregnants in Malatya province.MethodsThis is a cross-sectional survey. A multi-sage stratified probability-proportional-to-size cluster sampling methodology was used. A total of 823 pregnant women from sixty clusters were studied. Women were administered a questionnaire related with the subject and blood samples were drawn. Total blood count was performed within four hours and serum iron, folate and B12 vitamin were studied after storing sera at -20 C for six months.ResultsAnemia prevalence was 27.1% (Hb < 11.0 gr/dl). Having four or more living children (OR = 2.2), being at the third trimester (OR = 2.3) and having a low family income (OR = 1.6) were determined as the independent predictors of anemia in pregnancy. Anemia was also associated with soil eating (PICA) in the univariate analysis (p < 0.05). Of anaemic women, 50.0% had a transferrin saturation less than 10% indicating iron deficiency, 34.5% were deficient in B12 vitamin and 71.7% were deficient in folate. Most of the anemias were normocytic-normochromic (56.5%) indicating mixed anemia.ConclusionsIn Malatya, for pregnant women anemia was a moderate public health problem. Coexisting of iron, folate and B vitamin deficiencies was observed among anaemics. To continue anemia control strategies with reasonable care and diligence was recommended.

The effects of ginkgo biloba extract on tissue adenosine deaminase, xanthine oxidase, myeloperoxidase, malondialdehyde, and nitric oxide in cisplatin-induced nephrotoxicity.

This study was carried out to determine if Ginkgo Biloba Extract (GBE or Egb 761) exerts a beneficial effect against cisplatin-induced renal failure in rats. Sprague Dawley rats were divided into four groups. The first group (control) received orally 1 mL/kg/day of 0.9% saline by an oral carrier vehicle on days 1 to 10. The second group was injected with 7 mg/kg cisplatin intraperitoneally (i.p.) on the fourth day, once only. The third group (vit E=cisplatin) was administered 10 mg/kg/day i.p. vit E on 1 to 10 days with one dose of i.p. cisplatin (7 mg/kg) injection on the fourth day. The fourth group (GBE=cisplatin) was given GBE orally at 100 mg/mL/kg started on the first day up to the tenth day with one dose of cisplatin (7 mg/kg) injection on the fourth day. Cisplatin was found to lead a statistically significant increase in plasma BUN and creatinine levels, as well as urine micro total protein (MTP) levels, leading to acute renal failure (ARF) in rats. Renal xanthine oxidase (XO) activities increased in all groups (statistically significant in cisplatin=GBE-treated rats; P≤0.001). Adenosine deaminase (AD) activities were increased in cisplatin-treated rats, and decreased in cisplatin=GBE-treated (PB≤0.041) and cisplatin=vit E-treated (PB≤0.005) rats, compared to controls. Malondialdehyde (MDA), nitric oxide (NO) levels and myeloperoxidase (MPO) activities were increased in the kidney tissue of cisplatin-treated rats. Vit E improved plasma creatinine and urine MTP levels, together with tissue MDA, NO levels, and MPO activities. But GBE had no statistically significant effect on those parameters. These results indicate that increased XO, AD and MPO activities, as well as MDA and NO levels play a critical role in cisplatin nephrotoxicity. GBE has been shown to protect against cisplatin-induced nephrotoxicity. Toxicology and Industrial Health 2006; 22: 125-130.

Effect of Smoking on Serum Concentrations of Total Homocysteine, Folate, Vitamin B12, and Nitric Oxide in Pregnancy: A Preliminary Study

Objective: Nitric oxide (NO) is a potent vasodilator released by endothelial cells that plays an important role in modulating maternal and fetal vascular tone in normal pregnancy. Lower plasma levels of vitamins may result in hyperhomocysteinemia, a known risk factor in pregnancy. The aim of this study was to investigate whether there are alterations in the serum levels of total homocysteine (tHcy), folate, vitamin B12, and total nitrite, as an index of NO, in smoking as compared with age-matched nonsmoking pregnant women. Methods: Thirty-three women (19 smoking and 14 nonsmoking) between 16 and 22 weeks of their gestation were included in this study. The serum tHcy levels were analyzed by using an enzyme-linked immunosorbent assay kit. Vitamin B12 and folate values were measured by means of DPC kits. Total nitrite was measured by Griess reaction as an index of endogenous NO production. Results: The serum tHcy concentrations were significantly increased in smoking as compared with nonsmoking pregnant women (p < 0.001). The folate and vitamin B12 concentrations were lower in smoking than in nonsmoking pregnant women, but only the differences in folate concentrations were statistically significant (p < 0.001). The tHcy concentrations showed a significant negative correlation with folate in the smoking pregnant women. The serum total nitrite concentrations were lower in smoking than in nonsmoking pregnant women (p < 0.05). In addition, the serum nitrite levels in smoking pregnant women had significant negative correlations with tHcy and positive correlations with folate and vitamin B12 levels. Conclusions: In the light of our findings, we propose that smoking might enhance the vasoconstrictor capacity in pregnant women by increased tHcy concentrations and by a simultaneous decrease in the production of NO which is a vasodilator compound.

The relationships between plasma and erythrocyte antioxidant enzymes and lipid peroxidation in patients with rheumatoid arthritis

Objective. The present study was undertaken to evaluate the activities of some key erythrocyte and plasma enzymes participating in free radical metabolism and the end product of lipid peroxidation in rheumatoid arthritis, and whether there are any differences for these parameters between newly diagnosed untreated patients and rheumatoid arthritis patients on drug therapy. Patients and methods. Superoxide dismutase and catalase activities, and malondialdehyde levels were determined in erythrocytes and plasma samples from 54 patients with rheumatoid arthritis (21 of whom without any treatment and 33 on classical therapy regimens) and from 33 healthy controls. Results. There were no statistically significant differences in mean values of activities of the erythrocyte enzymes between the patients and controls. Malondialdehyde levels were significantly increased in both newly diagnosed untreated patients and patients on drug therapy compared to control subjects. Malondialdehyde levels were lower in the treated group than the newly diagnosed untreated group (0.214 ± 0.111 μmol/L and 0.388 ± 0.075 μmol/L, respectively) (P < 0.0001). Mean plasma superoxide dismutase activity was lower in the group of newly diagnosed untreated patients compared to those of the treated and control groups (1.31 ± 0.69 U/mL, 1.79 ± 0.94 U/mL and 2.48 ± 0.95 U/mL, respectively) (P < 0.0001, untreated vs control groups). Conclusions. These results suggest sufficient antioxidant enzyme activities in erythrocytes in patients with rheumatoid arthritis and also increased lipid peroxidation end products in newly diagnosed untreated patients compared to control group and patients on drug therapy.

The effect of moxonidine on endothelial dysfunction in metabolic syndrome

BackgroundEndothelial dysfunction has been reported in patients with type 2 diabetes mellitus and even in healthy obese individuals with a normal metabolic profile. Sympathetic activity commonly is increased in obese hypertensive patients, and moxonidine is effective in lowering BP and improving insulin sensitivity.ObjectiveTo evaluate the effect of moxonidine on endothelial dysfunction in patients with metabolic syndrome.MethodsTwenty-six patients with mild hypertension were treated with moxonidine and a hypocaloric diet for 3 months, while a second normotensive group (n = 26) were followed-up with calorie restriction alone. Anthropometric (body mass index, waist and hip circumferences, and waist-to-hip ratio) and metabolic features (fasting plasma glucose and insulin, aminotransferases, γ-glutamyl transpeptidase, triglycerides, and cholesterol levels) and flow-mediated dilatation (FMD) were evaluated. Insulin resistance was calculated by using the homeostasis model assessment formula. Insulin sensitivity was calculated according to the quantitative insulin-sensitivity check index (QUICKI).ResultsSBP and DBP (both p < 0.001) and waist circumference (p = 0.02) were higher, and QUICKI (p = 0.043) and FMD (p = 0.01) were lower in the hypertensive group at baseline. After 3 months, nearly all the study parameters improved in both treatment groups. The decrease in BP, increase in FMD, and improvements in metabolic and anthropometric parameters were significantly greater in the moxonidine-treated group than in those treated with diet alone.ConclusionMoxonidine is proposed as a valuable option for treating mild-to-moderate hypertension in obese and insulin-resistant patients with metabolic syndrome as it appears to improve endothelial dysfunction in these patients.

Airway inflammatory markers in chronic obstructive pulmonary disease patients and healthy smokers

BACKGROUND Cigarette smoke with its toxic ingredients leads to chronic inflammations in the airways. OBJECTIVES In this study, the effect of cigarette smoke on the levels of inflammatory markers, interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-α) in induced sputum was investigated. MATERIALS AND METHODS Twenty patients with chronic obstructive pulmonary disease (COPD) (group I), 20 healthy smokers (group II), and 20 healthy nonsmokers (group III) were included in the study. The levels of IL-6, IL-8, and TNF-α in induced sputum were measured in these groups, and comparison analysis between the groups and correlation analysis for smoking load (pack-years) and spirometric parameters were performed. RESULTS Mean age of the patients in groups I, II, and III were 61.2 ± 1.7, 58.2 ± 1.6, and 59.1 ± 5.4 years, respectively (P > 0.05). Smoking loads of group I and group II were 38.6 ± 2.1 and 29.5 ± 2.3 pack-years, respectively (P < 0.05). All cytokine levels were significantly higher in group I than groups II and III (P < 0.05). In addition to this, mean cytokines levels were significantly higher in group II than group III (P < 0.05). Smoking load of group II subjects was positively correlated with IL-6, IL-8, and TNF-α in induced sputum (P < 0.05). CONCLUSIONS We found that inflammatory marker levels in induced sputum were significantly higher in COPD patients and smokers than nonsmokers. Moreover, there was a moderate positive correlation between IL-6, IL-8, and TNF-α levels and smoking load in the healthy smokers. We think that further studies are needed to determine whether higher levels of cytokine levels in sputum might be helpful in predicting the healthy smokers who will develop COPD in future.

The role of fecal calprotectin and lactoferrin in the diagnosis of necrotizing enterocolitis.

Background: Early detection of necrotizing enterocolitis can improve the prognosis, however, there is not a reliable laboratory test to detect either newborns at risk for necrotizing enterocolitis development or those at early stages of the disease. Since fecal lactoferrin and fecal calprotectin are inflammatory markers of gastrointestinal diseases, it was hypothesized that both these biomarkers could be successfully used in the diagnosis of necrotizing enterocolitis. Methods: In a prospective study, fecal lactoferrin and fecal calprotectin concentrations of 14 newborns with necrotizing enterocolitis and consecutively admitted 40 healthy preterm, and 23 healthy full-term newborns were measured with enzyme-linked immunosorbent assay technique. Results: Mean fecal lactoferrin and fecal calprotectin were not different between preterm and full-term newborns (p = .235 and p = .845, respectively), or those who were diagnosed with necrotizing enterocolitis or not (p = .545 and p = .968, respectively). Prevalence of necrotizing enterocolitis was 1.51% (14 of 2734). Stage of the disease did not have a statistical effect on mean levels (p = .694 and p = .267, respectively). Mean fecal lactoferrin and fecal calprotectin levels were not different in the case of breastfeeding (p = .623 and p = .792, respectively). Conclusion: Neither fecal lactoferrin nor fecal calprotectin has a role in the identification of necrotizing enterocolitis, especially in early stages of the disease. Further studies on wider necrotizing enterocolitis series are needed for a more definite conclusion.

Serum nitrite and nitrate levels in epileptic children using valproic acid or carbamazepine

In experimental epilepsy studies, nitric oxide was found to act as both proconvulsant and anticonvulsant. The objective of this study was to investigate the effects of valproic acid and carbamazepine on serum levels of nitrite and nitrate, which are the metabolites of nitric oxide. To achieve this goal, serum nitrite and nitrate levels were determined in active epileptic 34 children using valproic acid and 23 children using carbamazepine and in non-active epileptic 38 children (control group) not using any antiepileptic drug. In the valproic acid group serum nitrite and nitrate levels were 2.66 +/- 2.11 micromol/l and 69.35 +/- 23.20 micromol/l, 1.89 +/- 1.01 micromol/l and 49.39 +/- 10.61 micromol/l in the carbamazepine group, and 1.22 +/- 0.55 micromol/l, 29.53 +/- 10.05 micromol in the control group, respectively. Nitrite and nitrate levels were significantly high in both valproic acid and carbamazepine groups compared to the control group (P < 0.01). When valproic acid and carbamazepine groups were compared to each other, level of nitrate was found statistically higher in the valproic acid group in relation to the carbamazepine group (P < 0.01), however, there was no statistically significant difference in the levels of nitrite (P > 0.05). No relation could be found between serum drug levels and nitrite and nitrate levels. According to these results, it can be suggested that valproic acid and carbamazepine might have antiepileptic effects through nitric oxide.

Protective effects of Gingko biloba on thioacetamide-induced fulminant hepatic failure in rats.

Gingko biloba (GB) has antioxidant and platelet-activating factor (PAF) antagonistic effects. We investigated the protective effects of GB on thioacetamide (TAA)induced fulminant hepatic failure in rats. Fulminant hepatic failure was induced in treatment groups by three intraperitoneal (ip) injections of TAA (350 mg/kg) at 24-hour intervals. Treatments with GB (100 mg/kg per day, orally) and N-acetylcysteine (20 mg/kg twice daily, sc) were initiated 48 hours prior to TAA administration. The liver was removed for histopathological examinations. Serum and liver thiobarbituric acid-reactive substance (TBARS) levels were measured for assessment of oxidative stress. Liver necrosis and inflammation scores and serum and liver TBARS levels were significantly higher in the TAA group compared to the control group (P <0.001,<0.001, 0.001,<0.001, respectively). Liver necrosis and inflammation scores and liver TBARS levels were significantly lower in the GB group compared to the TAA group (P <0.001,<0.001 and 0.01, respectively). GB ameliorated hepatic damage in TAA-induced fulminant hepatic failure. This may be due to the free radical-scavenging effects of GB.

The effect of resveratrol on prevention of the development of postoperative adhesions in a rat model

Objective. Our aim was to investigate the anti-adhesion potential of resveratrol, a phytoestrogen naturally found in wine, in a rat uterine horn model. Methods. Lesions were created by laparotomy in the uterine horn of 70 rats, randomized before the operation into seven groups consisting of ten animals each: (1) control group, no adjuvant therapy; (2) intraperitoneal (IP) application of the resveratrol dilution vehicle, 10 mg/kg, before closing the laparotomy; (3) subcutaneous (SC) injection of dilution vehicle, 10 mg/kg, 30 min before the operation; (4) IP application of resveratrol, 10 mg/kg, before closing the laparotomy; (5) SC injection of resveratrol, 10 mg/kg, 30 min before the operation; (6) IP application of resveratrol, 10 mg/kg, before closing the laparotomy and continued SC daily for 5 days; and (7) SC injection of resveratrol, 10 mg/kg, 30 min before the operation and continued SC daily for 5 days. On the 14th postoperative day adhesion scores were determined. Levels of thiobarbituric acid-reactive substances and total antioxidant capacity (TAC) were also measured. Results. In animals treated with repeated SC resveratrol, adhesions were graded as significantly less severe than in the vehicle control group or the groups treated with resveratrol IP or IP plus SC. TAC of control group rats was significantly lower than that of animals treated with repeated SC resveratrol. Conclusion. Repeated SC resveratrol significantly reduces adhesion formation.