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Öğe Asemptomatik Tansiyon Yüksekliğine Acil Tıp Asistanlarının Yaklaşımının Değerlendirilmesi(Ümit Muhammet KOÇYİĞİT, 2021) Arıkan, Erhan; Arıkan, Nurcan; Aktaş, Ahmet; Ardahanlı, İsaAmaç: İstanbul ilindeki Acil Tıp asistanlarının, acil servise başvuran asemptomatik tansiyon yüksekliği olan hastalara yaklaşımlarınındeğerlendirilmesidir.Gereç ve Yöntem: 15 Şubat-15 Temmuz 2015 tarihleri arasında İstanbul ilindeki eğitim ve araştırma hastaneleri ve üniversitehastanelerindeki Acil Tıp kliniklerinde, Acil Tıp asistanı olarak çalışan 211 hekime anket çalışması yapılmıştır.Bulgular: Asistanların % 31.3’ü (n=66) asemptomatik tansiyon yüksekliğinde tedaviye başlayacağını ifade ederken, % 68.7’si (n=145)herhangi bir tedavi uygulamadıklarını ifade etmiştir. Tedaviye başlayacağını ifade edenlerin; tedaviye başlama sınırları sistolik kanbasıncı için 130 ile 200 mm-Hg arasında, diyastolik kan basıncı için 80 ile 120 mm-Hg arasında, ortalama arter basıncı için ise 70 ile150 mm-Hg arasında değişmektedir. Asistanların % 56.4’ü (n=119) asemptomatik tansiyon yüksekliği ile gelen hastalarda tetkik istemeeğilimindeyken, % 43.6’sı (n=92) tetkik istemeyeceğini ifade etmişlerdir. Tetkik isteyeceğini ifade edenlerin % 29.4’ü (n=35)Hemogram, % 79.0’u (n=94) böbrek fonksiyon testleri, karaciğer fonksiyon testleri, % 90.8’i (n=108) elektrokardiyografi, % 31.1’i(n=37) kardiyak markırlar, % 2.6’sı (n=15) ise beyin BT isteyeceğini ifade etmiştir.Sonuç: Asemptomatik tansiyon yüksekliği gibi tedavi ve takibi arada konuların standart ve doğru bir yaklaşım ile yönetilebilmesi için,bu konuyla ilgili eğitimlerin özellikle ilk yıllarda verilmesinin, asistanların yaklaşımlarını değiştirmekte önemli olacağını düşünmekteyiz.Öğe Can the Triglyceride/HDL Ratio in Chronic Kidney Disease bePredictive of Cardiac Risk?(2021) Aktaş, Ahmet; Gedikli, Mustafa Asım; Kara, Canan; Bakır, Muhammed RaşidObjective: Chronic Kidney Failure is one of the important causes of increased morbidity andmortality recently. Cardiovascular mortality is an important cause of mortality in patients withchronic kidney failure. It has been reported that triglyceride/high density lipoprotein ratio (TG/HDL) cholesterol ratio shows cardiac risk in previous studies. In our study, we aimed to show whetherthere is a relationship between TG/HDL cholesterol ratio and cardiovascular risk in patients withchronic renal failure receiving dialysis treatment and not. Materials and Methods: A single-center retrospective study. In our study, 40 healthy, 50 dialysedpatients with chronic renal failure and 50 patients without receiving dialysis (predialysis) whoapplied to internal medicine outpatient clinic were included. Patients' files were scannedretrospectively. TG/HDL ratios were recorded and calculated. Patients who use lipid-lowering drugs and patients with diabetes were not included in our study. Results: TG/HDL cholesterol ratio was found to be statistically significantly higher in predialysispatients and patients receiving dialysis due to chronic renal failure compared to healthy controls.TG/HDL cholesterol ratio was higher in patients with chronic renal failure that did not undergodialysis compared to patients with chronic renal failure that were dialysed, but it was not statisticallysignificant. Conclusion: As an indicator of cardiovascular mortality due to chronic kidney disease, theTG/HDL-C ratio can be an inexpensive, reproducible predictor. TG/HDL-C ratio was found to behigher in patients with chronic kidney disease that did not undergo dialysis, compared to chronickidney patients undergoing dialysis and the healthy control group.Öğe Comparison of Familial Mediterranean Fever patients by triglyceride/high-density lipoprotein ratio(2021) Aktaş, Ahmet; Gedikli, Mustafa Asım; Şahin, AliAim: In this study, we aimed to show whether there is a relationship between FMF disease and cardiovascular risk by comparing Triglyceride/HDL-Cholesterol ratios between FMF patients and the control group.Materials and Methods: A total of 300 patients, including 150 Familial Mediterranean Fever (FMF) patients and 150 control groups aged 18-65, were included in our study. Triglyceride/HDL-Cholesterol ratios of the patients were compared.Results: Triglyceride/HDL-Cholesterol ratio was statistically significantly higher in the FMF group than the control group (p=0.026).Conclusion: In FMF patients, the Triglyceride/HDL-Cholesterol ratio can be used as an inexpensive, reproducible predictor in showing a cardiac risk.Öğe Diabetes Mellitus Patients with Fibromyalgia have a Higher Risk of Cardiovascular Disease(2022) Polat, Musa; Aktaş, AhmetAim: The primary aim of this study is to investigate the effect of the presence of Fibromyalgia(FM) on cardiovascular risk and cardiopulmonary capacity in diabetes mellitus (DM) patients. In addition, the prevalence of FM in DM patients was investigated according to the American College of Rheumatology (ACR) 2016 criteria. Material and Methods: The study included 188 premenopausal female patients with Type 2 DM. The physical activity level of the study participants was assessed with the International Physical Activity Questionnaire - short form. The cardiopulmonary capacity was evaluated with the 6-minute Walk Test. The cardiovascular risks were evaluated with the Framingham risk score. Participants were examined for the presence of FM according to the ACR 2016 criteria. Results: 63 (33.5%) participants met the ACR 2016 FM diagnostic criteria. DM patients with FM have significantly lower physical activity levels (p=0.004) and cardiopulmonary capacity (p=0.009), and they also have significantly higher cardiovascular risks (p=0.02) than DM patients without FM. Conclusion: FM is seen in approximately one-third of DM patients, and the presence of FM reduces cardiopulmonary capacity and increases cardiovascular risk. In the management of patients diagnosed with DM, the presence of FM should be investigated, and treatment should be applied with pharmacological and non-pharmacological methods to reduce the contribution to cardiovascular risk.Öğe DİREKT ETKİLİ ANTİVİRAL TEDAVİ ALAN KRONİK HEPATİT C HASTALARINDA ALFA FETOPROTEİN SONUÇLARININ DEĞERLENDİRİLMESİ(2021) Aktaş, Ahmet; Altinkaya, EnginAmaç: Kronik hepatit C tanılı hastalarda doğrudan etkiliantiviral ilaç tedavisi sonrasında nekroinflamasyonun birgöstergesi olan alfa fetoprotein değerinde meydana gelendeğişimi saptamaktır.Gereç ve Yöntemler: Çalışmamızda Ocak 2015 ile Ocak2020 tarihleri arasında Cumhuriyet Üniversitesi Tıp FakültesiGastroenteroloji Bilim Dalı Polikliniğinde değerlendirilipkronik hepatit C tanısı ile direkt etkili antiviral tedavibaşlanan 294 hastanın verileri retrospektif olarakincelenmiştir. Aldıkları direkt etkili antiviral tedavilerinegöre; sofosbuvir/Ledipasvir ± ribavirin tedavisi alan hastalar1. grup (n=114), paritaprevir + ritonavir/ombitasvir ±dasabuvir ± ribavirin tedavisi alan hastalar 2. grup (n=180)olarak iki ana grupta değerlendirilmiştir.Bulgular: Hastaların tedavi öncesindeki ortalama alfafetoprotein değeri 8.25±10.82 ng/ml, tedavi bitimindekiortalama alfa fetoprotein değeri ise 5.14±10.80 ng/ml olaraksaptanmış ve bu değişim istatistiksel olarak anlamlıbulunmuştur (p<0.01). Birinci grupta tedavi bitimindeki alfafetoprotein değerinde tedavi öncesi değere göre anlamlıdüşme gözlenirken (p<0.01), 2. grupta hafif düşmegözlenmiş; ancak bu düşüş istatistiksel olarak anlamlıbulunmamıştır (p=0.175).Sonuç: Çalışmamızda kronik hepatit C tanılı hastalardagüncel antiviral tedaviler ile nekroinflamasyonun birgöstergesi olan alfa fetoprotein değerlerinde gerileme olduğusaptanmış ve direkt etkili antiviral ile tedavi sonrası erkendönemde fibroziste anlamlı iyileşme olduğu görülmüştür.Öğe Evaluation of Alpha Fetoprotein Results in Chronic Hepatitis C Patients Who Received Directly Acting Antivral Treatment(Kırıkkale Üniversitesi, 2021) Aktaş, Ahmet; Altinkaya, EnginObjective: It is to detect a change in the value of alpha fetoprotein, which is an indicator of necroinflammation after direct effective antiviral drug therapy in patients diagnosed with chronic hepatitis C.Material and Methods: In our study, the data of 294 patients who were evaluated in the Gastroenterology outpatient clinic of Cumhuriyet University Faculty of Medicine between January 2015 and January 2020, and who were diagnosed with chronic hepatitis C and started direct-acting antiviral treatment, were retrospectively analyzed. Patients were evaluated in 2 main groups according to the direct acting antiviral treatments they received. Patients who received sofosbuvir + ledipasvir ± Ribavirin treatment were the first group (n=114) and the patients who received paritaprevir + ritonavir/ Ombitasvir ± Dasabuvir ± Ribavirin treatment were the second group (n=180).Results: The mean alpha fetoprotein value of the patients before treatment was 8.25±10.82 ng/ml and the mean alpha fetoprotein value at the end of the treatment was 5.14±10.80 ng/ml and this change was statistically significant (p<0.01). In the first group, alpha fetoprotein values at the end of treatment decreased significantly compared to the pretreatment value (p<0.01), whereas in the second group a slight decrease was observed. However, this decrease was not statistically significant (p=0.175).Conclusion: In our study, it was determined that alpha-fetoprotein values, which is an indicator of necroinflammation, decreased with current antiviral treatments in patients with chronic hepatitis C, and a significant improvement in fibrosis was observed in the early period after treatment with direct-acting antiviral.Öğe Evaluation of the distribution of ABO and Rh blood groups in Sivas province(Sivas Cumhuriyet University, 2021) Aktaş, Ahmet; Ünlü, GamzeObjective: To determine the A, B, O, AB blood group distribution and Rhesus (Rh) positivity rate of Sivas province, and thus to know the distribution of blood groups in our region and to use it in a practical and scientific manner when necessary.Method: The blood group results of a total of 50,441 individuals over the age of 18 who applied to Sivas Cumhuriyet University Health Services Application and Research Hospital for various reasons between 2018 and 2020 were analyzed retrospectively. ABO and Rh blood groups were determined according to the data obtained from the Hitachi ElecSys 2010 Rack device. Various groupings were made according to blood type, gender and age, and the results were evaluated by percentage calculation.Results: 19.387 (38.4%) people A Rh (+), 14.045 (27.8%) people O Rh (+), 7.202 (14.2%) people B Rh (+), 3445 (6.8%) ) person AB Rh (+), 2781 (5.5%) person A Rh (-), 2060 (4.08%) person O Rh (-), 1027 (2.03%) person B Rh (-), 500 (0.9%) persons were identified as AB Rh (-). In terms of Rh blood group, it was seen that 44.076 (87.3%) people were Rh (+) and 6365 (12.6%) people were Rh (-).Conclusions: In summary Sivas province of Turkey reflects the demographic. Blood type distribution rates of Sivas province are similar to other provinces in our region and the general population of our country. However, we saw differences with some other regions. It is very important to know the blood type for blood supply and storage in our region. We hope that these up-to-date data on blood group distribution in Sivas will be useful for the practice and literature in terms of blood groups database.Öğe Investigations of structural, spectral (IR, 1H?, 9F?, 11B?, 13C?, 15 N?, 17O?NMR) and anticancer properties of 5FU@B12N12 complexes(2021) Aktaş, Ahmet; Nassif, Wassim; Sayın, KorayB12N12 nanocage was selected as a drug carrier for 5-fluorouracil (5FU). Both compounds were optimized B3LYP/6– 31 + G(d) level in the water. Electrophilic/nucleophilic attack regions and the appropriate interaction sites were determined by molecular electrostatic potential (MEP) maps. The possible interaction structure between 5FU and B12N12 nanocage was determined. Additionally, it was determined that five pieces of 5FU were coordinated to BN nanocage step by step. Each compound is characterized as structurally. IR, 1H-, 9F-, 11B-, 13C-, 15 N-, 17O-NMR spectra are calculated and compared with published data. The interaction energies and deformation energies were calculated for each BN-5FU complex. As for the biological application, 5FU and B12N12 nanocage were interacted with vascular endothelial growth factor receptor 2 (VEGFR2), which PDB ID is 2OH4. The possible structure of drugs at pH = 7 ± 1 was determined. Molecular docking analyses of each drug and its possible structures were performed with 2OH4. It was found that studied compounds interacted with 2OH4. This result implies that the studied compounds can be used as an anti-cancer drug.Öğe New anti-viral drugs for the treatment of COVID-19 instead of favipiravir(2021) Aktaş, Ahmet; Tüzün, Burak; Aslan, Rukiye; Sayın, Koray; Ataseven, HilmiThe SARS-CoV-2 virus is a major problem in the world right now. Currently, all the attention of research centers and governments globally are focused on the investigation of vaccination studies and the discovery of small molecules that inhibit the SARS-CoV-2 virus in the treatment of patients. The goal of this study was to locate small molecules to be used against COVID19 instead of favipiravir. Favipiravir analogues were selected as drug candidates from the PubChem web tool. The RNA dependent RNA polymerase (RdRp) protein was selected as the target protein as favipiravir inhibits this protein in the human body. Initially, the inhibition activity of the studied compounds against RdRp of different virus types was investigated. Then, the inhibition properties of selected drug candidates and favipiravir were examined in detail against SARS-CoV-2 RdRp proteins. It was found that 2- oxo-1H-pyrazine-3-carboxamide performed better than favipiravir in the results of molecular docking, molecular mechanics Poisson-Boltzmann surface area (MM-PSBA) calculations, and ADME analyses.Öğe Relationship Between HbA1c Level and Triglyceride/HDL Cholesterol Ratio and Triglyceride Glucose Index in Diabetes Patients(2022) Gedikli, Mustafa Asım; Kalın, Betül Sarı; Aktaş, AhmetObjective: To compare HbA1c level with triglyceride/HDL cholesterol (TG/HDL-C) ratio and triglyceride glucose (TyG) Index and to show its relationship with HbA1c level. Method: Our study was carried out retrospectively on patients who applied to the Department of General Internal Medicine, Sivas Cumhuriyet University Hospital, Turkey, between January 1, 2015 and January 1, 2020. The study is a retrospective review of 2,938 patients. HbA1c, triglyceride, and glucose values of the patients were recorded. TyG index and TG/ HDL-C) ratio were found by calculating. Patients were grouped according to their HbA1c levels, TyG index and triglyceride/HDL cholesterol ratios. Results: We found that the TG/HDL-C ratio and the TyG index were statistically significantly lower as the HbA1c level decreased. When we grouped the patients according to their gender, we found that male patients had higher HbA1c, higher TyG index and TG/HDL-C ratio than female patients. Conclusion: We found a positive correlation between HbA1c levels and TG/HDL-C ratio and TyG index. Considering other studies in the literature, according to the results of our study, we predict an increased risk of coronary artery disease and cerebrovascular disease in patients with poor glycemic control.Öğe The efficacy and safety of vildagliptin treatment for nonalcoholic fatty liver disease in type 2 diabetes mellitus(Sivas Cumhuriyet University, 2020) Aktaş, Ahmet; Ozan, ZeynepObjective: Effects of dipeptidyl peptidase-4 inhibitors on liver function and glucose metabolism in nonalcoholic fatty liver disease (NAFLD) have not been well determined. The aim of this study was to evaluate the effect of vildagliptin on liver functions and hepatic steatosis and also to evaluate efficacy and safety of vildagliptin in NAFLD patients with type 2 diabetes mellitus (DM).Method: Fifty-four patients with type 2 DM, complicated with ultrasonography (USG) diagnosed NAFLD were prospectively enrolled in the study from June 2014 to June 2015 in Bozok University Hospital. All patients were subjected to lifestyle intervention of diet and physical exercise after the diagnosis of type 2 DM. Vildaliptin treatment was given 100mg per day. Liver non-invasive assessment tools such as, Fatty Liver Index (FLI), FIB-4 index, APRI Score, and other laboratory parameters were also evaluated before, 3 and 6 months after the initiation of treatment. Results: HbA1c was reduced from 9.22% (8.07-10.35) to 7.26% (6.27-8.10) (P < 0.001). During vildagliptin treatment, ALT levels improved from 30.91 ± 26.48 to 25.94 ± 14.8 IU/L (P < 0.05). The serum levels of TG and LDL decreased with statistical significance (P < 0.05). WC and BMI were also decreased (P < 0.001). FLI and APRI scores improved at 6 months after the initiation of vildagliptin (P < 0.05). Patients showed improvement for fatty liver severity by USG after vildagliptin treatment (P < 0.001). All the patients took vildagliptin of 100mg/day without reduction necessitated by related side-effects.Conclusions: Our preliminary study results showed that vildagliptin treatment have positive effect on blood sugar regulation, body composition, ALT, liver fibrosis and steatosis indexes in type 2 DM complicated with NAFLD. Vildagliptin seems to be effective and safe in NAFLD patients with type 2 DM.Öğe The relationship between chronic viral hepatitis and erectile dysfunction in male patients more than 65 years old(Sivas Cumhuriyet University, 2020) Taştemur, Sedat; Aktaş, AhmetObjective: Erectile dysfunction is defined as the incomplete failure of penile erection for satisfying sexual intercourse. Its incidence is quite high in male patients over 65 years of age. Many diseases, such as Diabetes Mellitus, obesity, and psychiatric diseases, affect erectile dysfunction. In our study, we aimed to show the relationship between chronic viral hepatitis and erectile dysfunction in male patients over 65 years of age. Method: A single-center retrospective study. Sixty-five male patients over 65 years old, 35 chronic viral hepatitis, 30 healthy controls were included in our study. Patients with comorbidities facilitating erectile dysfunction such as diabetes mellitus, obesity, and psychiatric disease were excluded from our study. Results: Erectile dysfunction was found in 49 of the 65 patients included in our study. There was no significant difference between HDL, Triglyceride, AST, ALT, GGT, LDH, Total Protein, and Albumin levels in the control group with hepatitis (p> 0.05). On the other hand, age and erectile dysfunction were found statistically significantly higher in the group with hepatitis (p <0.001, p = 0.002, respectively). IIEF, Total cholesterol and LDL were statistically significantly higher in the Control group (p <0.001, p = 0.01 and p = 0.02, respectively). Conclusions: The incidence of erectile dysfunction was higher in male patients over 65 years of age with chronic viral hepatitis compared to the control group. There was a significant relationship between erectile dysfunction and chronic viral hepatitis and advanced age.
