Serdar Olt

Reply to the letter to the editor by Beyan concerning: Increased mean platelet volume in patients with idiopathic subjective tinnitus

We appreciated the comment of Beyan on our paper which investigating the relationship between mean platelet volume (MPV) and idiopathic subjective tinnitus [1]. At first, there is a comment about platelet function and MPV, and claim that MPV is linked with platelet production, not function. In our study, we did not focus on platelet function and we did not use MPV as a platelet function indicator. On the other hand, there are numerous studies in literature which stated that MPV values were related with platelet function [2–6]. We think that this relation can be explained in an indirect way. Larger platelets have more granules and aggregate more rapidly. In addition, increased MPV was found associated with shortened bleeding time [6]. Second, there is a comment about MPV measurement method. As we mentioned in our study, MPV can be affected by several parameters such as age, hyperlipidemia, and smoking. Because of this reason, we created homogenous groups. In addition, some other factors can be responsible for wrong measurement such as used anticoagulant, storage temperature, analysis time and counters [7]. When used ethylenediamine tetraacetic acid (EDTA) as an anticoagulant, there are different statements about time interval for optimal MPV measurement. Dastjerdi et al. reported that if the measurements were performed within 1 h time, accurate measurements could be performed with using EDTA anticoagulant [2]. Lancé et al. propose measurements 120 min after sampling to perform appropriate measurements when using EDTA [8]. We were not standardized time interval in our study but MPV measurements were performed in all individuals in the same way. All the subjects and controls’ MPV values were measured similarly in both groups, and we found statistically significant alterations. Therefore, we think that our findings are very important and we believe that MPV can be qualified as a useful marker in tinnitus patients.

Sarcopenia in diabetic nephropathy: a cross-sectional study

Abstract Objective. To investigate the relationship between sarcopenia and diabetic nephropathy. Methods. 56 diabetic patients without complications, 50 diabetic patients with nephropathy, 53 healthy controls included in this present study. Demographic characteristics such as sex, age, anthropometric measurements such as weight, body mass index [BMI], hip circumference, waist circumference and upper arm circumference were measured. Sarcopenia diagnosis was based on European Working Group on Sarcopenia in Older People [EWGSOP] criteria which consist of hand grip strength, 6-meter walking test and muscle mass. Results. The frequency of sarcopenia increased gradually from 15.1% in healthy control group to 21.4% in the diabetes group, and 34% in diabetic nephropathy group (X2 for trend, p = 0.029). The frequency of sarcopenia was similar in diabetes and diabetic nephropathy group. However, the frequency of sarcopenia was higher in diabetic nephropathy than healthy controls (OR = 2.89, CI [1.11-7.51] in logistic regression). Conclusion: In the present study, the prevalence of sarcopenia was higher in patients with diabetic nephropathy compared to healthy controls.

The Role of Sleeve Gastrectomy on Preventing Type 2 Diabetes Mellitus

AIM: To investigate the effect of bariatric surgery on HbA1c and serum cortisol levels in morbidly obese patients without type 2 diabetes mellitus. MATERIALS AND METHODS: Twenty-nine patients who underwent sleeve gastrectomy and whose body mass index was> 40 were included in the present study. Patients’ files were reviewed retrospectively. Those with diabetes mellitus and those with age <18 were excluded from the study. Pre-operative and 1-year post operative data were documented. The obtained data were analysed by SPSS statistical program. RESULTS: The mean age of the patients was 27.4 ± 8.4. 5 of the patients were male, and 24 were female. The mean body mass index of the patients was 44 ± 2.3. 1 patient [3.4%] had hypertension. Four patients [13.7%] had gastroesophageal reflux disease. The number of smokers was 7 [24.1%], and the number of alcohol users was 3 [10.3%]. There was a statistically significant decrease in HbA1c, body mass index values after operation [p value <0.01], but cortisol was not different [p value = 0.72]. CONCLUSION: In this present study we found that bariatric surgery caused a significant decrease in HbA1c levels in non-diabetic patients, suggesting that bariatric surgery may prevent Type 2 Diabetes Mellitus in obese patients.

TSH secreting adenoma: a rare cause of severe headache

31 years old male patient admitted to the emergency department because of recurrent severe head aches which continued for two years. The patient has been consulted our clinic of internal medicine because of thyroid function abnormalities. Laboratory investigations revealed elevated serum TSH of 8,6 mU/L (normal range (N); 0.34-5,6), free T4 (fT4) of 1,73 (N;0,61-1,12ng/dl), and free T3(fT3) of 5,48 (N; 2,5-3,9pg/mL). Other laboratory parameters were normal. Physical examination revealed stage 3 goiter. The other system examinations were normal. We have learned that two years ago brain computed tomography scan was performed due to headache and result was reported as normal. Considering secondary hyper thyroidism pituitary MR was performed. Pituitary MR revealed a 13x18 mm macroadenoma. The patient under went transphenoidal surgery. Final diagnosis wasTSH secreting adenoma after pathological examination. After surgery headache and hyperthyroidism were recovered.