Selman Çelebi

The Levels of Ghrelin, Leptin, TNF-α, and IL-6 in Liver Cirrhosis and Hepatocellular Carcinoma due to HBV and HDV Infection

Background/Aim. Malnutrition, a common problem in liver cirrhosis and HCC, may readily deteriorate the clinical functions with resultant poor prognosis. Beside the hyper catabolic state frequently encountered in chronic liver disease and HCC, anorexia and reduced food intake also worsen the malnutrition. The recently discovered peptide hormone ghrelin acts as a counterpart of leptin in regulation of food intake and fat utilization. The aim of the present study was to investigate the ghrelin and leptin levels in cirrhosis and HCC due to hepatitis B and D viruses, and the association of ghrelin and leptin with TNF-α, IL-6 and the severity of the disease. Materials and methods. We measured serum ghrelin, leptin, TNF-α, and IL-6 levels using specific immunoassay in 45 patients (23 cirrhosis, 22 HCC) with HBV and/or HDV and in 25 control subjects. Results. In comparison to controls, serum ghrelin, TNF-α, and IL-6 levels were significantly higher in cirrhosis and HCC (P < .05), whereas serum leptin levels were found decreased (P < .05). There was a positive correlation between ghrelin and TNF-α, and a negative correlation between leptin and TNF-α (P < .05). Conclusion. In cirrhosis and HCC due to HBV or HDV, serum ghrelin levels were increased with a corresponding decrease in serum leptin concentrations, acting as a physiological counterpart of ghrelin. The increasing of ghrelin is more prominent in Child C cirrhosis and the level was correlated with TNF-α. The presence of nutritional and metabolic abnormalities, including malnutrition, in cirrhosis and HCC may, at least partly, elucidate high ghrelin and low leptin levels.

Epidemiological features of irritable bowel syndrome in a Turkish urban society.

Background and Aim:  Irritable bowel syndrome (IBS) is a widespread functional bowel disorder and its prevalence in Western societies ranges from 3‐20%. The present study aimed to determine the prevalence of IBS in eastern Turkey, particularly in urban parts of Elazig where 250 000 people live.

Preventive role of genistein in an experimental non-alcoholic steatohepatitis model.

Background and Aim:  The aim of the present study was to evaluate the preventive role of genistein, a phytoestrogen with a wide variety of pharmacological effects, in an experimental non‐alcoholic steatohepatitis (NASH) model.

Prevalence and Consultation Behavior of Self-Reported Rectal Bleeding by Face-to-Face Interview in an Asian Community

Background and Aim: Although rectal bleeding is a common gastrointestinal symptom, there are very few community-based studies, and all of these studies were conducted in the West. So far the epidemiologic characteristics of rectal bleeding have not been defined in an Asian country. We aimed to characterize self-reported rectal bleeding and its association with functional bowel disorders in Turkey. Factors affecting healthcare-seeking behavior were reviewed as well. Subjects and Methods: In this study, 760 subjects were chosen randomly. Questionnaires were completed by nurses during face-to-face interviews with each participant. Results: Of the 707 (93%) subjects included in this study, 9.5% had functional dyspepsia, 8.6% had irritable bowel syndrome (IBS), 24.5% had functional constipation, and 13.8% had functional abdominal bloating. The prevalence of rectal bleeding in the previous year was 14.7%. The recent onset of rectal bleeding was 2.7%. Rectal bleeding was more common among subjects younger than 45 years. Subjects who had functional constipation or constipation-dominant IBS reported rectal bleeding more frequently than others. The rate of consultation was only 41.3% among the subjects with rectal bleeding. Subjects aged ≧45 years and who had marked bleeding or bleeding more than twice a day or fear of cancer sought healthcare more frequently than others. Conclusion: Rectal bleeding is as common a symptom in Turkey as in Western countries. Advanced age and fear of cancer were independent predictors of consultation behavior in this group.

Portal hypertension due to Echinococcus alveolaris: a case report.

Infection of the liver with Echinococcus alveolaris (EA) contemplates with a fatal course though it is a rare condition. We present herein a patient with upper gastrointestinal bleeding due to portal hypertension caused by the involvement of the liver with EA.

Case study on drug-related adverse effects of hepatitis C therapy

The case of a 46-year-old woman with chronic hepatitis C who was prescribed subcutaneous pegylated interferon once a week and oral ribavirin once a day is presented. Within 24 h after the first injection to her left arm, the patient developed pruritus and erythematous papules at the injection site and painful papules on her hands. After immediate administration of antihistamines, the pruritus and papules remitted. One wk later, after injection in the right arm, skin lesions and pruritus were seen. After the third injection to the abdomen, the patient developed a rash, and after the fourth and fifth injections to other areas of the abdomen, injection-site papules were seen. The patient had no skin reactions for the next 12 mo, with the exception of injection-site papules. Hepatitis C virus RNA was negative after 12 mo of treatment. Clearly, patience is important during hepatitis C therapy in order to avoid unnecessary examinations and to promote successful outcomes.