Medical Science and Discovery <p><span style="font-family: Arial; font-size: small;"><strong>Medical Science and Discovery</strong> (ISSN: 2148-6832) is an international open access, peer-reviewed scientific research journal that provides rapid evaluation of articles in all disciplines of Medical Sciences.&nbsp;</span></p> en-US (Asghar Rajabzadeh) (Elena Jalba) Mon, 30 Sep 2019 00:00:00 +0300 OJS 60 Serum AMH levels are not associated with adverse perinatal outcomes in women undergoing IVF treatment due to diminished ovarian reserve <p><strong>Objective: </strong>Anti-Mullerian hormone (AMH) is used as a biomarker for the estimation of fertility related parameters such as quality and quantity of oocytes in in vitro fertilization (IVF) procedures. High oocyte quality may also be associated with healthy trophoblastic invasion and lower complication rates during pregnancy. The aim of this study is to evaluate the relationship between AMH values and perinatal complications in infertile women with poor ovarian reserve (POR).</p> <p><strong>Material and Methods:</strong> A total of 68 women undergoing IVF treatment were included in the study. Thirty six of them constituted the study group (POR) and 32 pregnant women constituted the control group (Tubal factor). All women in the study were chosen from patients who have undergone to their first IVF cycle. Serum AMH levels were analyzed with an ELISA kit in all patients.</p> <p><strong>Results:</strong> AMH level was 5.4 times higher in the control group compared to that of the study group (p&lt;0.05). No significant differences were observed between the groups with regard to preterm birth rate, gestational age at birth, birth weight, 1st and 5th minute Apgar scores, and neonatal intensive care unit admission rates (all, p&gt;0.05).</p> <p><strong>Conclusion:</strong> We found that AMH did not predict adverse perinatal outcomes in women with POR.</p> Coşkun Şimşir, Tolga Ecemiş, Aynur Adeviye Erşahin, Gürhan Güney, Buğra Çoşkun, Bora Çoşkun, Sevtap Handemir Kılıç Copyright (c) 2019 Medical Science and Discovery Tue, 03 Sep 2019 00:00:00 +0300 The Impact of Serum C-peptide Level on Bone Mineral Density in Postmenopausal Type 2 Diabetic Women. <p><strong>Objective: </strong>Recent studies suggested that c-peptide had biological activity on bone metabolism. We aimed to evaluate the impact of c-peptide level on bone mineral density (BMD) in postmenopausal type 2 diabetic women.</p> <p><strong>Methods: </strong>Thirty-five insulin naïve type 2 diabetic postmenopausal women were included in our prospective cohort study. Fasting and random c-peptide, parathyroid hormone (PTH), vitamin D, insulin, alkaline phosphatase level (ALP) levels and BMD were evaluated.</p> <p><strong>Results: </strong>The mean age of patients was 61.8±8.56 years. The mean fasting c-peptide, random c-peptide and insulin levels were 3.0±1.24, 7.7±3.7 and 13.9±11.2 µIU/ml, respectively. The mean femoral neck (FN-BMD) and total lumbar spine bone mineral density (L-BMD) were 0.787±0.127 and 0.919±0.122 g/cm<sup>2</sup>, respectively. C-peptide level was associated with total hip BMD (p&lt;0.05) but this relation disappeared after regression analysis adjusted for confounders. A negative correlation between PTH level and FN-BMD was found (p=0.01). Total hip BMD and L-BMD were negatively correlated with age (p=0.01 and p=0.02, respectively). A positive association between DPP4 inhibitor treatment and total hip BMD was observed (p=0.03).</p> <p><strong>Conclusions: </strong>We observed a positive association between total hip BMD and serum c-peptide level. However, this relationship disappeared in multiple linear regression analysis. Further studies are necessary to evaluate the impact of c-peptide level on the risk of osteoporosis in T2DM.</p> Berna İmge Aydoğan, Adile Begüm Bahçecioğlu Mutlu, Çağlar Keskin, Funda Seher Özalp Ateş, Sevim Güllü Copyright (c) 2019 Medical Science and Discovery Mon, 09 Sep 2019 00:00:00 +0300 Analysis of breast true-cut biopsies by applying immunohistochemical study of myoepithelial markers <p><strong>Objective: </strong>Breast pathologies are very common in women. Breast cancer is the most common and most frequent cause of death in women. The most common type of breast cancer is invasive ductal carcinoma. Histopathological examination of the tissue taken with a fine needle aspiration biopsy or true-cut biopsy is the main diagnostic method when clinical examination of breast and/ or radiological mass is detected. The definitive diagnosis of benign and malignant lesions of the breast is important in the form of treatment. The most important features in the diagnosis of breast cancer are atypical cellular features such as invasion, desmoplasia, pleomorphism, hyperchromasia, nuclear irregularity, prominent nucleoli, high mitosis count. Loss of myoepithelial layer in the malignant cases is a very important feature in the diagnosis. Aim of this study is to evaluate the benign and malignant breast pathologies with the immunohistochemical panel.</p> <p><strong>Material and Methods: </strong>52 breast true-cut biopsy materials in the archives of Department of Pathology at Faculty of Medicine, Erzincan Binali Yıldırım University between 2015-2017 were re-examined with the immunohistochemical panel. The immunohistochemical staining markers such as estrogen, progesterone, cerb-B2, E-cadherin, P63, CD10, calponin, CK5/6 have been applied in all cases.</p> <p><strong>Results: </strong>23 cases were a benign disease such as fibroadenoma, adenosis, fibrosis, fibrocystic changes, and intraductal papilloma. 29 cases were a malignant epithelial tumor.</p> <p><strong>Conclusion:</strong> In the diagnosis of breast cancers, mainly cellular properties are determinative. The evaluation with the immunohistochemical panel will reduce the risk of diagnostic error when the cases that difficultly diagnosed with cellular properties.</p> Mecdi Gürhan Balcı, Mahir Tayfur Copyright (c) 2019 Medical Science and Discovery Mon, 09 Sep 2019 22:01:20 +0300 An evaluation of type 2 diabetes mellitus patients on different oral antidiabetic medications with regard to glycemic control and diabetic complications <p><strong>Objective:</strong> &nbsp;Diabetes Mellitus is a chronic and progressive disease that significantly impairs the workforce and economy due to its complications. This study aims to evaluate patients diagnosed with type 2 diabetes mellitus who use different oral antidiabetic medications with regard to glycemic control and diabetic complications.</p> <p><strong>Materials and Methods:</strong> This study included 200 patients who were being followed-up for a diagnosis of Type 2 DM.</p> <p><strong>Results:</strong> Of the 200 patients included in the study, 131 were on metformin monotherapy and 69 were on metformin and gliclazide combination therapy. HbA1c value of Metformin monotherapy prescribed patients was7,6%±1,5, metformin+gliclazide prescribed patients was 8,2%±1,9. There was a statistically significant difference between the two groups in terms of blood glucose levels (p&lt;0.05). There was no significant difference between the two groups with regard to microvascular complications and body mass index.</p> <p><strong>Conclusion:</strong> Our study determined that the level of glycemic control manifested by Type 2 DM patients was suboptimal despite using different types of oral antidiabetics and that their body mass indices were high. We reached the conclusion that the present situation is linked to factors such as incorrect dietary habits, inadequate exercise and walking, failure to comply with the medical treatment suggested by the physician, and lack of awareness about the severity of the disease.</p> Erhan Önalan, Nevzat Gozel, Burkay Yakar Copyright (c) 2019 Medical Science and Discovery Tue, 10 Sep 2019 09:46:10 +0300 The Effects of vitamin B12 and folic acid deficiency on hemogram parameters in children <p><strong>Objective:</strong> According to numerous studies, bicytopenia, pancytopenia, or isolated thrombocytopenia and anemia patients have folic acid (folate) and vitamin B12 (B12) deficiency. The purpose of this study is to analyze the effects of folate and B12 deficiency in childhood on several haemogram parameters such as platelet (PLT), mean platelet volume (MPV), hematocrit (HCT), mean corpuscular volume (MCV), and white blood cell (WBC) count.</p> <p><strong>Materials and Methods:</strong> The retrospective study included children who had applied to the pediatric outpatient clinic between 2015 and 2017. Patients were divided into 3 groups according to serum B12 and folate status.&nbsp; The results were evaluated by statistical methods.</p> <p><strong>Results:</strong> PLT and WBC levels of the folate and B12 deficiency group were found to be lower than the control group (p=0.015, p&lt;0.001 respectively), and their MPV and HCT levels were higher (p: 0.015, p&lt;0.001 respectively). MCV levels, however, were not different (p&gt;0.05). No effect of PLT and MCV on folate levels was seen. Similarly, any effects of MPV, PLT and MCV independent variables on B12 levels were not observed. Although platelet and leukocyte count was decreased in folate and B12 deficiency, thrombocytopenia and leukopenia were observed only three patients.</p> <p><strong>Conclusion:</strong> Although peripheral blood cell lines are not always seen low during folate and B12 deficiency, and there is not obvious anemia and MCV highness at a patient with neurological and psychological symptoms, folate and B12 deficiency should be thought if there are leukocyte and thrombocyte levels lower than mean reference values.</p> Kamil Şahin, Murat Elevli, Cihan Coşkun, Macit Koldaş Copyright (c) 2019 Medical Science and Discovery Thu, 12 Sep 2019 13:18:33 +0300 The bacterial profile and sensitivity patterns of isolates from medical equipment and surfaces in the Children’s emergency room of a Nigerian hospital <p><strong>Objective:</strong> &nbsp;Nosocomial infections are those acquired in hospitals or healthcare service units that first appear 48 hours or more after admission or within 30 days after discharge following in-patient care. Knowledge of the bacterial profile and sensitivity patterns of any hospital environment is a key factor in infection control and good antibiotic stewardship.</p> <p><strong>Material and Methods:</strong> This hospital-based cross-sectional study was conducted in the Children’s Emergency Room (CHER) of Enugu State University Teaching Hospital, Enugu, Nigeria.&nbsp; Samples for culture were collected from equipment and hospital surfaces. Antimicrobial susceptibility testing was determined for each isolate by the Agar diffusion method using Standard Nutrient Agar 1 discs.</p> <p><strong>Results:</strong> Bacterial growth was observed in 83 (70.3%) specimens. <em>Staphylococcus aureus</em> (53.4%) was the most common isolate cultured followed by Coagulase-negative <em>Staphylococcus</em> (18.8%), then <em>Escherichia coli</em> (13.9%). Among <em>Staphylococcus aureus</em> isolates, 25.9% were MRSA. Ampicillin resistance of the gram negatives was high. All the Gram-negative isolates were susceptible to Ciprofloxacin and Ceftriaxone.</p> <p><strong>Conclusion:</strong> <em>Staphylococcus aureus</em>, Coagulase-negative <em>Staphylococcus</em>, and <em>Escherichia coli</em> were the commonest isolates. More efforts are needed to ensure improved hygiene standards in order to reduce the burden of nosocomial infections.</p> Ikenna Kingsley Ndu, Isaac Nwabueze Asinobi, Uchenna Ekwochi, Obinna Chukwuebuka Nduagubam, Ogechukwu Francesca Amadi, Ifeyinwa Bernadette Okeke, Chukwunonso Chigozie Iheji, Ngozi Nancy Onu Copyright (c) 2019 Medical Science and Discovery Thu, 12 Sep 2019 13:53:03 +0300 Dynamic thiol/disulfide homeostasis in gestational diabetes mellitus: Is it related with adverse perinatal outcomes? <p><strong>Objective</strong><strong>:</strong> Aims of the study is to specify the significance of thiol/disulfide homeostasis in the aspect of gestational diabetes mellitus (GDM) and GDM-related complications.</p> <p><strong>Material and Methods:</strong> This study is a prospective review of the data of 61 healthy and non-pregnant women, 58 healthy pregnant women, and 62 pregnant women with GDM.</p> <p><strong>Results:</strong> The patients with gestational diabetes mellitus had significantly higher disulfide/native thiol and disulfide/total thiol concentrations than non-pregnant patients (p&lt;0.001 for both) and healthy pregnant patients (p: 0.015 and p: 0.018, respectively). Besides, in GDM group had significantly lower native thiol/total thiol concentrations than non-pregnant patients and healthy pregnant patients (p&lt;0.001 and p: 0.016, respectively). There were positive and significant correlations between disulfide levels and HbA1c concentrations (r=0.26, p: 0.042), and between disulfide and oral glucose tolerance test first hour concentrations (r=0.26, p: 0.039). The receiver operating characteristic curve analyses for native thiol, total thiol, and disulfide were unable to predict adverse perinatal outcomes in this cohort.</p> <p><strong>Conclusion:</strong> The significantly higher concentrations of disulfide/native thiol and disulfide/total thiol in women with GDM could be considered as the presence of increased oxidative stress.&nbsp; However, these markers failed to predict adverse perinatal outcomes.</p> <p><strong>Keywords: </strong>gestational diabetes mellitus; oxidative stress; perinatal outcome; pregnancy; thiol/disulfide homeostasis</p> Beril Gürlek, Murat Alan, Sabri Çolak, Özgür Önal, Özcan Erel, Cemile Biçer Copyright (c) 2019 Medical Science and Discovery Sat, 14 Sep 2019 12:28:10 +0300 The Evaluation of Benign Acute Childhood Myositis by Ultrasound Elastography <p><strong>Objective:</strong> &nbsp;&nbsp;Herein, we aimed to determine the diagnostic contribution of ultrasound elastography (UE) technique to the assessment of muscle stiffness in pediatric patients with myositis.</p> <p><strong>Material and Methods:</strong> This study enrolled 16 patients who presented to our hospital’s Pediatric Neurology Outpatient Clinic with the complaint of inability to walk and who had a clinical presentation of benign acute childhood myositis (BACM). The patients were referred to the Radiology Department to undergo muscle ultrasonography (USG), where they underwent UE of the gastrocnemius muscle (GCM).</p> <p><strong>Results:</strong> Children with myositis and healthy children are similar age (7.06 ± 1.52 year (5–11) vs. 7.00 ± 1.59 year (5–11) year) (P: 0.908) and body mass index (BMI) (20.04 ± 1.58 (18.6–24.2) vs. 22.08 ± 1.43 (19.9–24.4) (P: 0.946). The mean serum creatine kinase (CK) was measured as 1520.3 ± 1163.6 U/L (min: 456,&nbsp; max:4100) in children with myositis. In the children with myositis, the thickness of the medial and lateral GCM increased compared with that in control group (medial; 18.15 ± 3.02 mm vs 13.10 ± 2.26 mm, p&lt;0.001, lateral; 13.51 ± 3.07 mm vs 9.34 ± 1.86 mm, p&lt;0.001). The medial and lateral GCM ratio in group 1 was slight bigger than that in group 2 (medial; 1.10 ± 0.37 vs 1.00 ± 0.34, p: 0.274, lateral; 1.22 ± 0.44 vs 1.10 ± 0.29, p: 0.243). GCM strain values were mildly elevated in patients with myositis compared to controls.</p> <p><strong>Conclusion:</strong> In the children with myositis, the thickness of the medial and lateral GCM increased compared with that in control group. GCM strain ratio values were slightly higher in myositis patients compared to the control group. We think that the increase in muscle thickness values is mainly secondary to the edema seen in myositis. In addition, UE is a clinically applicable quantitative analysis for changes in myositis.</p> Gülay Güngör, Olcay Güngör Copyright (c) 2019 Medical Science and Discovery Tue, 24 Sep 2019 11:26:06 +0300 Colistin-induced nephrotoxicity and risk factors in intensive care unit: estimating from the routine laboratory findings <p><strong>Objective:</strong> In this study we aimed to evaluate the patients treated with colistin in an intensive care unit (ICU) and risk factors emergence of acute renal failure (ARF) after colistine treatment.</p> <p><strong>Materials and Methods:</strong> Patients treated with colistine in the ICU between June 2016 and September 2018 were reviewed in this retrospective study. The 37 patients who were received colistine more than 3 days due to detection of Acinetobacter baumannii in culture of tracheal aspirate specimen were included in this study. Sociodemographic and clinical data and also biochemical parameters, glomerular filtration rates (GFR), APACHE-II, RIFLE and AKIN scores were examined. Patients were divided into two groups as ARF-developing and non-ARF-developing. Follow - up parameters were compared between these two groups.</p> <p><strong>Results:</strong> The patient group consisted of 26 males and 11 females. The mean age of the patients was 61.0 ± 19.33 years and %45 of the patients developed ARF. Mean APACHE-II score was 20.7±5.6. Mean age was significantly older in ARF patients. Onset day of colistine was significantly lower in patients with ARF. Significant relationships were found with the creatinine, albumin, AST, ALT and BUN parameters between ARF.</p> <p><strong>Conclusion:</strong> Older age and early initiation of colistin treatment in the ICU should be considered to be risky for ARF development. Before colistin treatment BUN, creatinine, CRP, albumin and AST levels should be considered to be risky for ARF development. After colistin treatment ALT, BUN, creatinine, urine output, platelet, AST, arterial blood gas base excess levels, urine pH, and protein amount in urine should be followed carefully.</p> Ahmet Ziya Şahin, Betül Kocamer Şimşek Copyright (c) 2019 Medical Science and Discovery Fri, 27 Sep 2019 20:19:29 +0300 Homozygous SCN2A gene mutation causing early infantile epileptic encephalopathy: The second case in literature <p><strong>Objective:</strong> Early infantile epileptic encephalopathy type11 (EIEE) generally known as an autosomal dominant inherited disease caused by the voltage-gated sodium channel neuronal type 2 alpha subunit (Navα1.2) encoded by the SCN2A gene mutations. The clinic of the disease is variable. Herein we report the second case with a homozygous missense mutation of the SCN2A gene (c.1588 G&gt;T).</p> <p><strong>Material and methods:</strong> NGS gene panel including the SCN2A gene from genomic DNA extracted from peripheral blood using a commercially available kit and quantified using standard methods. Illumina miseq analysis platform was used for this purpose, we performed analysis of coding regions and exon-intron boundaries and the data was analyzed by IGV.</p> <p><strong>Results:</strong> The results confirmed by sanger sequencing show us an SCN2A (NM_001040142) c.1588 G&gt;T homozygote mutation.</p> <p><strong>Conclusion:</strong> This shows us more clinical and molecular studies need for SCN2A associated disease pathogenesis</p> Hale Önder Yılmaz Copyright (c) 2019 Medical Science and Discovery Fri, 27 Sep 2019 20:19:54 +0300