Medical Science and Discovery https://medscidiscovery.com/index.php/msd <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 Health Sciences. </span></p> en-US <p><a href="https://creativecommons.org/licenses/by-nc/4.0/" target="_blank" rel="noopener">https://creativecommons.org/licenses/by-nc/4.0/</a></p> editor@medscidiscovery.com (Asghar Rajabzadeh) office@lycians.com (Elena Jalba) Wed, 28 Feb 2024 22:36:32 +0300 OJS 3.3.0.10 http://blogs.law.harvard.edu/tech/rss 60 Radionuclide Imaging Findings in Iatrogenic Stress in Cases with Reduced Left Ventricular Ejection Fraction https://medscidiscovery.com/index.php/msd/article/view/1113 <p><strong>Objective:</strong> This study aims to contribute to the existing literature by assisting in the selection of stress protocols for patients with reduced left ventricular ejection fraction (LVEF). We also aim to provide insights into patient follow-up based on changes in post-stress LVEF determined by echocardiography.</p> <p><strong>Methods: </strong>Our retrospective study encompassed 487 patients initially diagnosed with coronary artery disease. Left ventricular function was assessed using echocardiography and myocardial perfusion scintigraphy. Among them, 250 patients with LVEF values within normal limits constituted Group-1, while 237 patients with LVEF values below 50% formed Group-2. Exercise stress testing was performed using a treadmill according to the Bruce protocol. For vasodilator stress testing, intravenous adenosine infusion at a rate of 140 μg/kg/min was administered for 6 minutes. Tc-99m-sestamibi was intravenously administered (8-12 mCi) for stress imaging and (24-36 mCi) for rest imaging.</p> <p><strong>Results:</strong> The median age of all patients in the study was 64 (52-79) years, with 283 (58.1%) being male. Myocardial perfusion, assessed by myocardial perfusion scintigraphy, revealed a fixed perfusion defect in all patients. Reversible perfusion defects were observed in 172 (35.3%) patients. Among patients with reduced echo-LVEF values, those who underwent exercise stress testing showed significantly lower post-stress EF values compared to those who underwent vasodilator stress testing (35 (25-42) vs. 36 (30-47), p: 0.0005). Post-stress LVEF was notably lower in patients with reversible perfusion defects, indicating a higher rate of LVEF decrease due to stress (p: 0.0005).</p> <p><strong>Conclusion:</strong> Left ventricular ejection fraction (LVEF) serves as a valuable metric for assessing left ventricular function. The findings from this study support its utility in guiding the selection of a suitable stress protocol and monitoring patients during iatrogenic cardiac stress applications.</p> Sule Ceylan Copyright (c) 2024 Sule Ceylan https://creativecommons.org/licenses/by-nc/4.0/ https://medscidiscovery.com/index.php/msd/article/view/1113 Sun, 04 Feb 2024 00:00:00 +0300 Drug Resistance Tests for Mycobacterium Tuberculosis and Compatibility between Tests; From Past to Today https://medscidiscovery.com/index.php/msd/article/view/1127 <p><strong>Objective:</strong> The gold standard for pulmonary tuberculosis diagnosis is the demonstration of Mycobacterium tuberculosis bacilli. Drug susceptibility test results of the bacilli obtained are crucial in tuberculosis treatment management. The various tests used to determine drug susceptibility must yield the same result. In the present study, we aimed to evaluate the compatibility of drug susceptibility test results obtained by Löwenstein-Jensen (L-J) and BACTEC 460TB methods from the past to the present.</p> <p><strong>Material and Methods:</strong> Sputum results from 79 patients suspected of multidrug-resistant pulmonary tuberculosis (MDR-TB) clinically, radiologically, and bacteriologically were evaluated for isoniazid, rifampicin, ethambutol, and streptomycin between June 1997 and June 1998. Culture and drug sensitivity tests on the L-J medium were conducted at the Heybeliada Chest Diseases and Thoracic Surgery Center bacteriology laboratory, while culture and drug sensitivity tests with the BACTEC 460 TB system were performed at another center. The results were assessed for compatibility using the Kappa (κ) test, a tool for comparing two independent parameters.</p> <p><strong>Results:</strong> All drug sensitivity tests for isoniazid, rifampicin, ethambutol, and streptomycin were collectively evaluated. It was determined that 263 (83.3%) of 316 drug sensitivity tests yielded concordant results, while 53 (16.7%) produced discordant results. The drug sensitivity tests using L-J and BACTEC 460TB methods indicated compatibility only for streptomycin (κ = 0.715). In contrast, they yielded different results for isoniazid (κ = 0.585), ethambutol (κ = 0.552), and rifampicin (κ = 0.507). Streptomycin exhibited compatibility, while isoniazid, ethambutol, and rifampicin showed incompatibility between the L-J and BACTEC 460TB methods.</p> <p><strong>Conclusion:</strong> Drug sensitivity tests are pivotal in tuberculosis treatment management. While literature suggests compatibility between L-J and BACTEC 460TB methods, our study revealed incompatibility. Evaluation of drug sensitivities may lead to confusing results. Current practices involving studies in the same laboratory and genetic testing contribute to faster and more accurate outcomes in managing drug-resistant tuberculosis. Genetic tests and reference laboratories remain crucial for antituberculosis drug sensitivity, emphasizing their continued importance.</p> Metin Keren Copyright (c) 2024 Metin Keren https://creativecommons.org/licenses/by-nc/4.0/ https://medscidiscovery.com/index.php/msd/article/view/1127 Sat, 03 Feb 2024 00:00:00 +0300 Decadal Descriptive Analysis of Health Status, Hospitalization, Intensive Care Admissions, and Mortality Rates Among the Elderly Population in Turkey (2012-2022) https://medscidiscovery.com/index.php/msd/article/view/1125 <p><strong>Objective:</strong> This study aimed to analyse decadal changes in health status, hospitalisation, intensive care admissions, and mortality rates among the Turkish elderly population from 2012 to 2022, focusing on the impact of the COVID-19 pandemic.</p> <p><strong>Material and Methods:</strong> A retrospective study obtained data from the Turkish Statistical Institute (TÜİK) and Health Statistics Yearbooks. Descriptive statistics were used to elucidate healthcare utilisation patterns and mortality profiles among individuals aged ≥ 65 years.</p> <p><strong>Results:</strong> Analysis showed that self-reported "Very good/Good" health status peaked at 70.7% in 2012, decreased to 60.9% in 2019, and rebounded to 63.4% in 2022. The hospitalisation rates for the 65-74 age group increased from 17.5% in 2012 to 20.2% in 2021, with males (20.2%) having higher rates than females (16.0%) in 2021. ICU admission rates escalated during the pandemic, reaching 3.7% in 2021 for ages 65-74 and 4.7% for 75+ years, before declining in 2022 to 3.0% and 4.0%, respectively. The annual population growth rate has significantly decreased from 21.7 per thousand in 2012 to 5.5 per thousand in 2022, whereas the crude death rate has remained stable, dropping from 7.1 per thousand in 2012 to 5.1 per thousand in 2022.</p> <p><strong>Conclusion:</strong> This study highlights fluctuating health perceptions among the elderly exacerbated by the pandemic. The enduring gender disparities in health status and healthcare utilisation underscore the need for gender-sensitive policies. The consistent yet stable mortality rates amidst demographic shifts emphasise the resilience of Turkey's healthcare system. These findings provide critical insights into geriatric care policies and post-pandemic health care strategies.</p> Suna Kara Görmüş Copyright (c) 2024 Suna Kara Görmüş https://creativecommons.org/licenses/by-nc/4.0/ https://medscidiscovery.com/index.php/msd/article/view/1125 Mon, 05 Feb 2024 00:00:00 +0300 Investigation of Oxidative Stress and Antioxidant Pathways in Nasal Polyp Tissue: Peroxynitrite and Malondialdehyde Compared to NF-E2-related factor 2, Kelch-like ECH-associated protein one and Glycogen Synthase Kinase-3ß https://medscidiscovery.com/index.php/msd/article/view/1128 <p><strong>Objective:</strong> Nasal polyps are benign mucosal lesions with multifactorial causes that grow into the nasal cavity and are associated with inflammation. This study aims to investigate whether Nrf2, Keap1, GSK-3ß, Peroxynitrite, and malondialdehyde may be used as biochemical markers to determine the relationship between oxidative stress and nasal polyps. The goal is to explore the etiology of nasal polyps and contribute to the literature for a better understanding of the inflammatory pathophysiology of nasal polyps, ultimately leading to the development of new therapeutic approaches.</p> <p><strong>Materials and Methods:</strong> A total of 94 patients aged between 12 and 65 years who underwent a surgical operation for polyps (n = 49, case group) and septoplasty (n=45, controls) between February and September 2022 at the Department of Otorhinolaryngology, Faculty of Medicine, Gaziantep University were included in the study. Tissues taken from the polyp and the inferior turbinate in the case and control groups, respectively, were homogenized at the biochemistry laboratory and investigated using the ELISA method to compare the Nrf-2, Keap1, GSK-3ß, malondialdehyde, and peroxynitrite levels.</p> <p><strong>Results:</strong> Consistent with the study hypothesis, Nrf2 levels were lower, and Keap1 levels were higher in the case group, although the difference was not statistically significant. Although studies have reported increased levels of GSK-3β in chronic rhinosinusitis, they were statistically lower in polyps. This may be associated with the complexity of the GSK-3β network or the adequacy of Keap1 alone for Nrf2 inhibition. Peroxynitrite and malondialdehyde (MDA) levels are indicators of oxidative stress.</p> <p><strong>Conclusion:</strong> Nrf2, Keap1, GSK-3ß, MDA, and Peroxynitritetrite may be involved in the aetiology of nasal polyps based on the study's results. Keap1 and GSK-3ß, Nrf2 and Nrf2 module, actors which regulate oxidative stress, played a role in the pathophysiology of nasal polyps in combination with Peroxynitritetrite and malondialdehyde, according to the study findings. Potential treatments for nasal polyps are better understood through more extensive and well-matched studies.</p> Hasan İnco, Lütfi Semih Mumbuç , Seyithan Taysi Copyright (c) 2024 Hasan İnco, Lütfi Semih Mumbuç , Seyithan Taysi https://creativecommons.org/licenses/by-nc/4.0/ https://medscidiscovery.com/index.php/msd/article/view/1128 Mon, 05 Feb 2024 00:00:00 +0300 Symptom assessment in cancer patients using the Memorial Symptom Assessment Scale https://medscidiscovery.com/index.php/msd/article/view/1124 <p><strong>Objective:</strong> Cancer is a chronic disease characterized by the unregulated proliferation and abnormal spread of cells. Symptoms that occur after chemotherapy treatment, which is the most commonly used treatment in cancer, negatively affect morbidity, effectiveness of treatment and quality of life. This study aimed to determine symptoms in cancer patients undergoing chemotherapy using the Memorial Symptom Assessment Scale (MSAS)</p> <p><strong>Material and Methods:</strong> A total of 273 cancer patients who applied to Ümraniye Training and Research Hospital emergency department as outpatients and were hospitalized in the internal medicine department were included in the study between 5/1/2014 and 6/4/2014. The study was conducted prospectively. Of the 273 participants, 41.3% were female (N = 112) and 58.7% were male (N = 159). The mean age of the participants was 62.46 ± 12.913 years (range, 32-92 years). Participants were divided into 6 groups based on diagnosis: Lung cancers, gastrointestinal cancers, cancers of the reproductive system, hematologic cancers, cancers of the urinary system and others. Each participant used the Memorial Symptom Assessment Scale (MSAS) containing 32 symptoms to rate whether they had experienced each symptom during the past week. Of these 32 items, 24 provide information on the intensity and frequency of symptoms, while 8 provide information on severity and distress.</p> <p><strong>Results:</strong> The most common types of symptoms based on the Memorial Symptom Rating Scale were lack of energy (72.9%), pain (71.1%) and difficulty concentrating (60.8%), while the least common symptoms were feeling “I don’t look like myself” (4.4%), swelling of arms and legs and changes in skin (7.3%) and constipation (8.4%). </p> <p><strong>Conclusion:</strong> Cancer patients have a lower quality of life due to the side effects of the treatments they receive or the impact of the cancer itself. The most common symptoms in the patients screened in this study were lack of energy and pain. In light of these data, determining the factors affecting the quality of life in cancer patients may be guiding in determining the symptomatic treatment for these patients and facilitating patient care.</p> Seda Kumbasar, Sema Basat Copyright (c) 2024 Seda Kumbasar, Sema Basat https://creativecommons.org/licenses/by-nc/4.0/ https://medscidiscovery.com/index.php/msd/article/view/1124 Sat, 24 Feb 2024 00:00:00 +0300 Frequency of Gastroesophageal Reflux in Diabetic Patients without Gastrointestinal Symptoms https://medscidiscovery.com/index.php/msd/article/view/1132 <p><strong>Objective:</strong> Diabetes Mellitus (DM) represents a complex metabolic disorder characterized by chronic hyperglycemia resulting from insulin dysfunction. Numerous studies have underscored the prevalence of gastrointestinal complications in individuals with DM. gastrointestinal complications in DM patients primarily stem from changes in gastrointestinal motility patterns. This study aimed to investigate the prevalence of asymptomatic Gastroesophageal Reflux Disease (GERD) in patients with DM due to the frequent occurrence of gastrointestinal (GI) complications in DM patients, which are often underdiagnosed owing to their asymptomatic nature. We further aimed to elucidate the potential correlations between GERD and peripheral neuropathy in DM patients.</p> <p><strong>Materials and Methods:</strong> Within this prospective study, 20 patients diagnosed with DM and without symptoms of GERD were selected from the Internal Medicine and Gastroenterology outpatient clinics. Patients were diagnosed with the primary method of GERD detection 24-hour ambulatory pH monitoring. Patients, devoid of any GERD symptoms and dyspepsia, were assessed through a dyspepsia questionnaire, followed by determining fasting glucose levels, HbA1c values, and Body Mass Index (BMI) calculations. Subsequent evaluations involved esophageal manometry and 24-hour ambulatory.</p> <p><strong>Results:</strong> The evaluation of results using 24-hour ambulatory pH meter testing revealed a 40% prevalence of GERD in asymptomatic DM patients (8 out of 20 patients). A comparative analysis between DM patients with and without GERD, based on age, sex, BMI, HbA1c values, and fasting blood glucose levels, demonstrated no statistically significant differences. However, the frequency of GERD was significantly elevated in asymptomatic DM patients compared to the general population in our country (p&lt;0.05).</p> <p><strong>Conclusion:</strong> The findings indicate that 40% of DM patients exhibit GERD even in the absence of symptoms, highlighting the ubiquity of GI symptoms and complications in DM patients. This underscores the critical need for enhanced vigilance and proactive measures for GERD complications in this demographic. Implementing precise dietary plans, lifestyle modifications, and appropriate pharmacologic interventions can substantially ameliorate the quality of life and thwart GERD-related complications, even in DM patients not manifesting overt GERD symptoms.</p> Nermin Mutlu Bilgiç, Ahmet Melih Özel, Oya Uygur Bayramiçli, Atilla Bulur Copyright (c) 2024 Nermin Mutlu Bilgiç, Ahmet Melih Özel, Oya Uygur Bayramiçli, Atilla Bulur https://creativecommons.org/licenses/by-nc/4.0/ https://medscidiscovery.com/index.php/msd/article/view/1132 Mon, 26 Feb 2024 00:00:00 +0300