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    Are using neutrophil‐to‐lymphocyte ratio and platelet parameters useful in predicting Short Bowel Syndrome in patients with mesenteric ischemia?
    (Sivas Cumhuriyet University, 2021) Koç, Süleyman; Soylu, Sinan
    Objective: Acute mesenteric ischemia (AMI) is a potentially life-threatening medical condition that results in bowel infarction and gangrene. It usually occurs over the age of 60 and is seen in both sexes at similar rates. Early diagnosis and treatment are the cornerstones in the treatment of AMI. Although different biochemical markers for AMI are used clinically, no specific laboratory test has been proven to identify the presence of ischemic or necrotic bowel. In this study, we aimed to evaluate Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLT/LYM), NLR/PLT, mean platelet volume-PLT ratio (MPV)/PLT, and MPV*NLR/PLT could be a useful tool for early prediction of the severity of AMI.Method: We analyzed retrospectively records of 105 patients diagnosed with acute AMI who were operated on at our clinic. We investigated patient demographics, clinical symptoms, concomitant diseases, blood test results, and data regarding the surgical procedure performed and the resection's width. The patients were divided into two groups as short bowel syndrome (SBS) developing and non-developing.Results: We enrolled a total of 105 AMI patients in this study. There was no significant difference between the rates of non-SBS and SBS in terms of age, gender, diabetes mellitus, and smoking status. WBC, NEU, LYM, and MPV were higher, and PLT was lower in the SBS group. There were no statistically significant differences in MPV/PLT between the two groups. The combined values of NLR, PLT, and MPV were also compared between non-SBS and SBS groups. According to our results, the means of NLR, PLT/LYM, NLR/PLT, MPV/NLR, and MPV*NLR/PLT variables were statistically significantly different between the two groups.Conclusions: Our findings showed that NLR, NLR/PLT, MPV/PLT, MPV*NLR, and MPV*NLR/PLT could be a relatively better tool for early prediction of the severity of AMI and SBS. Further studies have to be carried out to investigate the best parameter for predicting the severity or prognosis of AMI.
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    Clinical features and outcomes of gastrointestinal symptoms in patients with COVID-19
    (2021) Koç, Süleyman; Bulur, Oktay
    COVID-19 infected patients clinically can be asymptomatic or symptomatic. Clinical course in symptomatic patients may be present with mild, moderate, or severe symp- toms. The coronavirus can affect multi-organ systems. The respiratory system is the most frequent target for the virus. Besides, gastrointestinal involvement may occur in occasional patients. We aimed to determine the clinical features and outcomes of gastrointestinal symptoms in patients with COVID-19. We retrospectively investigated 188 COVID-19 patients—patients clinical and demographic information obtained from the hospital database. Patients were categorized according to the clinical manage- ment guide released by the Republic of Turkey Ministry of Health. The mean age of the patients was 55.95 years (±17.62). 118 (62.8%) of the patients were men, and 70 (37.2%) of women. 118 (62.8%) patients were symptomatic, and 70 (37.2%) patients were asymptomatic. Among symptomatic patients, 56(47.4%) patients have isolated non-gastrointestinal symptoms, 52 (44.06%) patients have both (non-gastrointestinal, and gastrointestinal) symptoms, and 10 (8.4%) patients have isolated gastrointestinal symptoms. The distribution of the symptoms in 118 symptomatic patients was: 61 (32.5 %) patients have a fever, 84 (44.7 %) patients have a cough, 72 (38.3%) patients have dyspnea. The spectrum of gastrointestinal symptoms was as follows: 11 (5.9%) patients have diarrhea, 18 (9.6% ) patients have abdominal pain, 24 (12.8%) patients have nausea, 14 (7.5%) patients have vomiting, 38 (18.7%) patients have anorexia, 2 (2.1%) patients have constipation. However, COVID-19 infection present commonly with respiratory and musculoskeletal symptoms; it is important to be aware of the varied clinical presentations in COVID-19, including isolated gastrointestinal symptoms. This will allow increasing the timely detectability of infected patients and more effective contact control measures.
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    Comparison of APACHE II and Modified Charlson Index in Mortality Prediction in Patients at Medical Intensive Care Unit
    (2022) Bulur, Oktay; Efe, Fatma Kaplan; Iynem, Hatice Kevser; Koç, Süleyman; Beyan, Esin
    Acute Physiology and Chronic Health Evaluation II (APACHE II) and Modified Charlson Index (MCI) are used to predict the fatality in intensive care units (ICU). We aimed to investigate the difference between these scores in the prediction of fatality in the medical intensive care unit. Our study is important because in our literature overview, this study is one of the rare studies that compares these scoring systems. 108 ICU patients included. In all subjects APACHE II and MCI performed. Procalcitonin, C-reactive protein(CRP) levels of patients were recorded. Patients were then grouped according to mechanically ventilated or not; mortality happened or not. Statistically significance found in age(p<0.045), mechanical ventilation, procalcitonin, CRP and MCI (p<0.001) about mortality . MCI sensitivity and specifity were higher than APACHE II in %95 confidance interval. Area under curve in ROC analysis was CRP (0.728), Procalcitonin (0.719), MCI (0.686), APACHE II (0.665) respectively. Our study demonstrates that the Modified Charlson Index combined with procalcitonin and CRP can be used for predicting mortality in medical ICU as well as APACHE II 
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    Mitochondrial Homeostasis and Mast Cells in Experimental Hepatic Ischemia-Reperfusion Injury of Rats
    (TURKISH JOURNAL OF GASTROENTEROLOGY, 2022-10-22) Koç, Süleyman; Doğan, Halef Okan; Karataş, Özhan; Erdoğan, Mehmet Mustafa; Polat, Vural
    Background: Ischemia-reperfusion injury is a histopathological event and is an important cause of morbidity and mortality after hepatobiliary surgery. We aimed to investigate the protective effect of uridine on hepatic ischemia-reperfusion injury in rats. Methods: The animals were divided into 4 groups (n = 8): group I (control), group II: ischemia-reperfusion (30 minutes ischemia and 120 minutes reperfusion), group III: ischemia-reperfusion+uridine (at the beginning of reperfusion), and group IV: ischemia-reperfusion+uridine (5 minutes before ischemia-reperfusion). Uridine was administered a single dose of 30 mg/kg IV. The 3 elements of the hepatoduodenal ligament (hepatic artery, portal vein, and biliary tract) were obliterated for 30 minutes. Then hepatic reperfusion was achieved for 120 minutes. Results: In the ischemia-reperfusion group, both liver tissues and serum chymase activity and high-temperature requirement A2 levels were higher. Severe central vein dilatation and congestion, widening sinusoidal range, diffuse necrotic hepatocytes and dense erythrocyte accumulation in sinusoids, and strongly inducible nitric oxide synthase expression were seen in the ischemia-reperfusion group. A clear improvement was seen in both uridine co-administration and pretreatment groups. Conclusion: Our results revealed that uridine limits the development of liver damage under conditions of ischemia-reperfusion, thus contributing to an increase in hepatocyte viability