Ülkü Karaman

Malondialdehyde, Glutathione, and Nitric Oxide Levels in Toxoplasma gondii Seropositive Patients

The aim of this study was to investigate the difference in the serum malondialdehyde (MDA), glutathione (GSH), and nitric oxide (NO) levels between normal and T. gondii-infected patients. To this end, MDA, GSH, and NO levels in the sera of 37 seropositive patients and 40 participants in the control group were evaluated. In Toxoplasma ELISA, IgG results of the patient group were 1,013.0 +/- 543.8 in optical density (mean +/- SD). A statistically significant difference was found between patients and the control group in terms of MDA, GSH, and NO levels. A decrease in GSH activity was detected, while MDA and NO levels increased significantly. Consequently, it is suggested that the use of antioxidant vitamins in addition to a parasite treatment shall prove useful. The high infection vs control ratio of MDA and NO levels probably suggests the occurrence as a mechanism of tissue damage in cases of chronic toxoplasmosis. Moreover, it is recommended that the patient levels of MDA, GSH, and NO should be evaluated in toxoplasmosis.

The incidence of Demodex species in skin biopsy specimens diagnosed as actinic keratosis and nonmelanoma skin cancer

Background: The most common types of skin cancers include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), which are grouped as non-melanoma skin cancers. Actinic keratosis (AK) is a precancerous lesion that may develop into SCC. The pilosebaceous follicle mites, Demodex folliculorum and Demodex brevis, inhabit most commonly and densely certain facial skin areas where BCC and SCC also develops most frequently. Objective: Determine the prevalence of Demodex species in skin biopsy specimens diagnosed as SCC, BCC, and AK. Method: Specimens of the patients whose reports were available were studied in terms of Demodex. The specimens were stained using Hematoxylin and Eosin, and evaluated for Demodex species positivity. Results: There were Demodex species in seven (38.9%) out of 18 AK cases, 12 (31.6%) out of 38 SCC cases, and 26 (44.8%) out of 58 BCC cases of this study. The rate of Demodex species in patients diagnosed SCC, BCC, and AK was found to be rather high. Conclusion: Demodex species should also be evaluated in the follow-up of the treatment of patients in SCC, BCC, and AK group.

Epidemiology of Cyclospora Species in Humans in Malatya Province in Turkey

Background: Cyclospora species are rare among other Coccidia parasites and can cause recurrent gastroenteritis. Cyclospora spp. can infect reptiles, insects, rodents, and mammals. Objectives: The present study aimed to determine the epidemiology of Cyclospora spp. in Malatya province and its neighboring provinces. Patients and Methods: Totally, 2281 stool samples taken from patients with digestive system complaints who referred to the polyclinics affiliated with Inonu University, Faculty of Medicine in Malatya Province and its neighboring provinces, in 2006, and whose stool specimens were submitted to the parasitology department were examined. A questionnaire was developed to determine the epidemiology of Cyclospora spp. in the patients as the dependent variable of the study. All the participants signed an informed written consent. The samples were coated with Entellan™ after staining via acid-fast staining and were examined on an immersion microscope objective. The data are presented as mean, standard deviation, or number/percentage. The chi-square test was used for the statistical analyses. Statistically, a P value < 0.05 was accepted as meaningful. Results: The stool samples were examined via direct microscopic examination and acid-fast staining. Positivity was determined in 129 (5.7%) cases. In the overall assessment of the patients with respect to general body itching, rectal itching, allergy, immunosuppression plus cancer, shortness of breath, ulcerative colitis, diarrhea, abdominal pain, salivation, constipation, nausea, vomiting, growth retardation, and anemia, there was no significant relationship. However, in the statistical evaluations among the positive cases, the difference was found to be significant. Conclusions: The study was conducted in Malatya Province, but patients from the neighboring provinces were also included in the evaluation during the study. Of all the positive cases, 5.6% were those from Malatya Province and its surrounding areas. Additionally, Cyclospora spp. were observed among the patients referring to the polyclinics with digestive system complaints in 8.1% of those from the Adiyaman province and in 6.9% of those from the Kahramanmaraş region. The incidence of Cyclospora cayetanensis may be higher in these regions if an epidemiological study is performed. Consequently, we suggest that Cyclospora spp. be investigated in digestive system disorders, especially in immunosuppressed patients.

The epidemiology of demodex mites at the college students living in dormitories in the city of Ordu

OBJECTIVE Demodex folliculorum and Demodex brevis can cause different skin and eye symptoms. There are indications showing that the prevalence of these parasites is higher in public places. In this direction, the study was aimed to determine the prevalence of demodex in university students, inhabiting in dormitories. METHODS The study consisted of 300 men and women, college students who were staying in the dormitories in the city of Ordu. Random sampling method was used in the sample selection. Each participating student had to sign a patients consent form, before samples were taken using standard superficial skin biopsies from the faces of the patients. The samples were embedded in Entellan mounting solution and examined under the light microscope. RESULTS Samples were taken from 300 college students (170 males and 130 females) aged between 18-30 years, and in 110 (37%) of them, demodex mites were found. No significant differences were found between gender, age, type of skin or skin care, and Demodex incidence. CONCLUSION Demodex mites are very prevalent in college students studying in Ordu.

Mikrosporidialar ve Mikrosporidiyozis

All microsporidia are obligate parasites and have no active stages outside their host cells. Microsporidia lack some typical eukaryotic characteristics. There are now over 1200 species identified in 144 genera. The most familiar stage of microsporidia is the small, highly resistant spore, the size of which differs according to the species and is often 1-10 μm. The general life cycle pattern of the microsporidia can be divided into three phases: the infective or environmental phase, the proliferative phase, and the sporogony or spore-forming phase. There are several methods for diagnosing microsporidia: light microscopic, transmission electron microscopy (TEM), immunofluorescence assays (IFA) and molecular methods. The clinical course of microsporidiosis depends on the immune status of the host and site of infection. Microsporidia can cause infections such as diarrhoea, keratitis, myositis, bronchitis and brochiolitis. Human microsporidiosis represents an important and rapidly emerging opportunistic disease, occurring mainly, but not exclusively, in severely immunocompromised patients with AIDS. The treatment of microsporidiosis is generally achieved with medications and supportive care. Depending on the site of infection and the microsporidia species involved, different medications are utilized. The most commonly used medications for microsporidiosis include albendazole and fumagillin.

Bir Devlet hastanesi çalısanlarında bağırsak parazitlerinin görülme sıklığı

Objectives: Hepatitis C and interferon may trigger autoimmunity. We aimed to investigate the effects of combination treatment of peginterferon alpha (peg-IFN) + ribavirin in patients with chronic hepatitis C (CHC) on thyroid function tests and thyroid auto antibodies. Materials and Methods: The study included 45 outpatients with proven CHC having normal thyroid functions and previously not treated. The patients received combination of Peg-IFN+ribavirin. Values of fT3, fT4, TSH, antitiroglobulin (Anti-Tg) and thyroid peroxidase antibody (Anti-TPO) were measured at initial, fi rst, third and sixth months of treatment. Frequency of thyroid dysfunction was evaluated according to age and gender of patients. Results: Thyroid dysfunction emerged in 15 (%33.3) of 45 patients at the end of the six month of antiviral treatment. Symptomatic thyroid disease was confi rmed in 2 patients.Subclinical hyperthyroidism was determined in four patients (%8.9), and subclinical hypothyroidism in 3 patients (%6.7) at the end of third month.At the end of sixth month; symptomatic hyperthyroidism was observed in one patient (%2.2), subclinical hyperthyroidism in six (%13.3) and subclinical hypothyroidism in 7 patients (%15.6), and symptomatic hypothyroidism was determined in one patient (%2.2).At the end of the sixth month of antiviral treatment; Anti-Tg antibodies were positive in 12 patients (%26.7) and antiTPO in 11 patients (4 male and 7 female) (%24.5). No sig- nifi cant relationship was found between thyroid dysfunction and age, gender and ALT levels of patients (p>0.05). Conclusion: Periodic follow-up examinations should be done for thyroid autoimmunity and thyroid functions in CHC patients receiving combination treatment of PegINF+ribavirin.In adults, urethral foreign body is commonly observed with mental disorder, psychiatric or sexual behavior distursbance. In this paper, we reported a case which electrical cable wire was inserted into the urethra by the husband.Objectives: Dietary high fructose consumption which is closely associated with endothelial dysfunction via insulin resistance has recently increased in developed countries.Insulin resistance has a promoter effect on many meta-bolic disorders such as syndrome X, polycystic ovary syn-drome, Type 2 diabetes mellitus etc. Our aim in this study is to understand the impact of increased fructose intake on metabolisms of glucose, insulin and endothelial dys-function by measuring nitric oxide (NO) and endothelin-1(ET-1) levels in hepatic tissue which is crucial in fructose metabolism. Materials and Methods: We designed an animal study to understand increased fructose intake on hepatic en-dothelium. Twenty adult male albino rats were divided into two groups; the study group (group 1, n=10) received isocaloric fructose enriched diet (fructose-fed rats, con-taining 18.3% protein, 60.3% fructose and 5.2% fat) while the control group received purifi ed regular chow (group 2,n=10) for 2 weeks. After feeding period, blood and hepatictissue samples were collected and glucose, insulin, NO and ET-1 levels were analysed. Results: We found increased fasting glucose and insulin levels and impaired glucose tolerance in fructose fed rats. Higher NO and lower ETn1 levels were also detected in hepatic tissue samples of the group 1. Conclusion: Increased fructose consumption has delete- rious effects on glucose tolerance, insulin resistance and may cause to endothelial dysfunction. Key words: Fructose consumption, endothelial dysfunc-tion, nitric oxide, endothelin-1, liver.Oral squamous cell papilloma is a cutaneus lesions occurring due to human papilloma virus infections. These lesions spread locally and tend to have a high recurrence rate. Cases usually have a slow progression rather than acute symptoms. The course of disease is mostly subclinical. Although there are various treatment modalities which are recommended for the treatment of the disease, there is no particular and effective treatment modality that was proven. Limited surgical excisions result in frequent recurrences due to the presence of HPV in latent form around the lesions. Therefore, surgical excisions are combined with the other treatments such as systemically used interferons. We aimed to present a case of squmous cell papilloma with locally extensive lesions in the oral mucosa. Our patient was managed by the surgical excision and systemically given interferon treatment.

The Prevalence of Demodex Species and Its Relationship With the Metabolic Syndrome in Women of Malatya Province, Turkey.

Background: Demodex species are ectoparasites living in the hair follicles and sebaceous glands in human. Only two species, Demodex folliculorum and D. brevis were identified in human. While the D. folliculorum is settling in infundibular part of the hair follicles mostly, D. brevis settles into the sebaceous glands and ducts, which are deeper. These parasites live preferentially in hair follicles on the face and in the sebaceous glands, although they have also been reported to reside in seborrheic parts of the human body. The Demodex species have the highest rate on the face which has thesignificant number of sebaceous glands and sebum production in the skin. However, the rate of infestation increases with age in healthy skin. Objectives: The aim of this study was to determine the prevalence of Demodex species in healthy women and the relationship between the incidence of Demodex and metabolic syndrome (MetS). Patients and Methods: This study consisted of 151,498 women aged ≥ 20 years who reside in the central district of Malatya province, Turkey. In 5% confidence interval of sample size, while the design effect was 1.5 it was calculated as 552 individuals and while the design effect was 2 it was calculated as 736 individuals. The World Health Organization 30 cluster sampling method was used to select the samples. Women aged ≥ 20 years who were not pregnant or lactating were included in the study. From a total of 669 subjects included in this study, 90.89% of the largest sample was accessed. Results: Parasites were detected in 263 (39.3%) of 669 subjects and 3 of them were D. brevis. In chi-square analysis, nosignificant relationship was found between the incidence of the parasite, age, education level, occupation, marital status, family type, and MetS. However, a significant relationship was found between the diastolic pressure and those who fed with fatty foods and the incidence of parasite’s occurrence. Conclusions: According to the results of this study, MetS has no effect on the frequency of occurrence of the parasite; however, weight, fatty foods, and high diastolic pressure are effective in the frequency of occurrence of the parasite. The effects of these factors on the incidence of parasites should be supported by further study designs.

[Frequency of intestinal parasites among administrators and workers in sanitary and non-sanitary institutions].

OBJECTIVE Transmission of parasites generally occurs through fecal-oral means directly from human to human or through receiving eggs and cysts by means of nourishment. The aim of the study was to investigate the frequency of intestinal parasites among administrators and workers in sanitary and non-sanitary institutions. METHODS Stool specimens were examined using native-lugol, Trichrome and acid-fast stains methods. RESULTS 23.7% of the 2443 fecal specimens were found to be positive. The frequencies of parasites were found to be 9.8% for Entamoeba coli, 7.2% for Blastocystis hominis, 7.2% for Iodamoeba butschlii, 3.4% for Giardia intestinalis, 0.9% for Dientamoeba fragilis, 0.13% for Entamoeba histolytica, 0.08% for Chilomastix mesnilii, 0.04% for Trichomonas intestinalis, 0.04% for Entamoeba hartmanni, 0.04% for Hymenolepis nana, 0.04% for Taenia spp. and 0.04% for Enterobius vermicularis. CONCLUSION This rate of parasite positivity among healthy subjects visiting hospital for porter examination suggests that intestinal parasites still constitute a public health problem in the region. Moreover, it can be considered that one important factor in the frequency of the parasite can be both the nature of the jobs of administrators and workers in sanitary and non-sanitary institutions and their interaction with people during sales.

Epidemiology of Blastocystis spp. in primary school students at a central village of Ordu province

Blastocystis spp. is one of the most common intestinal parasites in humans and its pathogenicity is still controversial. The epidemiology of this parasite varies depending on the socio-cultural, socio-economic and geographic circumstances. In this study, Blastocystis spp. was investigated in stool samples of a Primary School students’ in a Central Village in Ordu province who did not have any intestinal complaints. Before starting work, we were granted permission from National Education Directorate and the School Board. Blastocystis spp. was investigated in Primary School Students’ stool samples by direct microscopy and Trichrome staining. The stool samples which showed any form of Blastocystis spp. were evaluated as “microscopically positive” regardless of the number per microscope field. Eighty and 85 of the 165 students participating in working were male and female, respectively. As a result of the microscopic investigation, 45 (27.3%) students were identified as positive. Eighteen of the positive students (40%) were male and 27 (60%) were female. Direct microscopic inspection, sedimentation and permanent staining are routine methods used in diagnosis of Blastocystis spp. This study also evaluated trichrome staining for each stool samples. In our research, this parasite was identified in 27.3% of asymptomatic Primary School students’ stool samples. This suggests the parasite is relatively common in the region. Blastocystis spp. infects via the fecal-oral route. As a result, we presented recommendations for the enhancing personal hygiene, social education and the provision of water treatment for the students to protect themselves from infection with Blastocystis spp.

Presence of Parasites in Environmental Waters in Samsun and Its Districts

OBJECTIVE The aim of this study was to detect the presence of parasites in environmental waters in Samsun and its districts. METHODS At the center of Samsun, 13 stations were determined. The research was performed between March 2012 and February 2013, and every month, water samples were collected on the dates stated. The samples were stained with Kinyoun acid-fast, modified trichrome, and trichrome dyes after examining with the direct bond. The preparations were evaluated in terms of parasitologic under a light microscope. RESULTS Totally, 180 of 228 water samples analyzed were from streams; of these, 48 were drinking water samples. The following were found: 142 Giardia spp., 132 Cryptosporidium spp., 56 Cyclospora spp., 38 microsporidia, 47 Blastocystis spp., 38 Entamoeba coli cysts, 18 Dientamoeba, 9 Chilomastix, 9 Strongyloides spp., and 6 hookworms. CONCLUSION The widespread use of animal husbandry and agriculture in the region and the use of stream surroundings as a grazing area increase the presence of some determined protozoa during a certain period. Parasitological studies in humans and animals in the region should be conducted, and control programs should be applied.