Purpose: The aim of this study is to evaluate the perceptions of stigmatization regarding sexual and reproductive health and the associated factors among female students at Pamukkale University Faculty of Medicine.Materials and methods: This study is a cross-sectional research conducted at Pamukkale University Faculty of Medicine between February 17 and 27, 2025. The study population consisted of 850 female students enrolled in the 2024–2025 academic year, and based on the sample size calculation performed using the G*Power program, a minimum of 369 participants was determined. A convenience sampling method was employed. The dependent variable of the study was the Sexual and Reproductive Health Stigmatization Scale in Young Women. Data were collected through Google Forms. Higher total scores obtained from the scale indicate increased stigmatizing attitudes toward sexual and reproductive health. The minimum possible score on the scale is 0, while the maximum score is 20.Results: Female students scored 7.20±2.98 points on the scale. Approximately 25.2% (n=93) of the participants reported obtaining their basic knowledge on sexual matters from friends, while 26.6% (n=98) stated that their families exert pressure on their freedom of life and worldview. Within the family context, about 82.3% (n=304) indicated that sexual health issues were not discussed. The stigmatization score of those who obtained basic knowledge from their families (6.58±3.64) was significantly lower compared to those who obtained information from websites (7.75±2.78) (p=0.024); on the other hand, the stigmatization score of participants who perceived family pressure (8.13±2.61) was significantly higher (p<0.001).Conclusion: The sexual and reproductive health stigmatization scores of female students were below the moderate level. This finding indicates that even medical education does not completely eliminate stigmatization.
Purpose: To investigate tracheobronchial diameters and tracheobronchial bifurcation angles on computed tomography (CT) in patients with pneumomediastinum.Materials and methods: CT scans of 63 patients with pneumomediastinum (PP) and 63 patients with normal CT findings (PN) were retrospectively evaluated in the Radiology Archives of our hospital. In PP, the extent of mediastinal air on CT images was visually classified into three grades. Thoracic anteroposterior distance (TAPD) and transverse thoracic distance (TTD), anteroposterior (AP) diameters of the trachea and bronchi, tracheal length (TL), right main bronchus angle (RMBA), left main bronchus angle (LMBA), subcarinal angle (SCA), and interbronchial angle (IBA) were measured on CT images in all patients. All measurements were compared between patients with and without pneumomediastinum.Results: A significant sex-related difference was observed in thoracic AP diameter and left main bronchus diameter in the PN group. Among PP, 22.2% (n=14) were grade 1, 30.2% (n=19) were grade 2, and 47.6% (n=30) were grade 3.Tracheal length and left main bronchus diameter were higher in PN patients compared to PP patients. The mean SCA was 75.06±23.40° in the PP group and was significantly greater than in the PN group (p=0.001). LMBA was significantly higher in the PN group compared with the PP group (p=0.003).Conclusion: Individuals with a narrower LMBA, shorter tracheal length, larger thoracic AP diameter, and wider SCA may be at greater risk of developing pneumomediastinum in the setting of barotrauma.
Purpose: The aim of this study was to retrospectively examine the reasons for the health measures applied to children and adolescents who applied to the Child and Adolescent Psychiatry Outpatient Clinic, whether additional measures were applied, sociodemographic characteristics, diagnoses and treatments.Materials and methods: The files of 150 children and adolescents who applied to the outpatient clinic with a health measure decision between 01.01.2023 and 31.12.2024 were retrospectively reviewed.Results: The most common diagnosis was depressive disorder (35%), and antipsychotics (44%) and antidepressants (35%) were the most commonly used treatments. Sexual abuse was significantly higher in females and being a child dragged into crime was significantly higher in males (p=0.002). Substance abuse was significantly higher in children who did not continue their education (p=0.022). The diagnosis of ADHD and conduct disorder was significantly higher in males and depressive disorder was significantly higher in females (p<0.001; p=0.005; p<0.001). Intellectual disability was found to be significantly higher in children dragged into crime (p<0.001). A significant correlation was found between the diagnosis of anxiety disorder and regular outpatient follow-up, and substance use disorder and not attending regular follow-up (p=0.031; p=0.034).Conclusion: The study has allowed us to evaluate the sociodemographic and clinical characteristics of cases with health measures and better understand the importance and impact of mental health support and follow-up for children. More comprehensive and longitudinal studies in this field are important for strengthening the child protection system.
Purpose: To identify clinicopathological factors associated with pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in patients with triple-negative breast cancer (TNBC).Matherials and methods: A retrospective study of 51 women with stage I–III TNBC who received NAC between January 2019 and December 2024 at Antalya Training and Research Hospital. Binary logistic regression was used to determine independent predictors of pCR.Results: The median age was 49 years (range: 28-79), and 28 patients (54.9%) achieved pCR. Patients aged ≥60 were significantly less likely to achieve pCR (OR: 0.22; 95% CI: 0.05-0.98; p=0.048*). No significant associations were found for carboplatin or pembrolizumab use.Conclusion: This real-world cohort confirms that pCR rates are consistent with literature. Advanced age was a significant negative predictor, emphasizing the importance of personalized approaches in elderly patients.
Purpose: Psoriasis is a common chronic inflammatory skin disease characterized by recurrent, scaly plaques. IL-17 plays a central role in its pathogenesis, and Secukinumab—an anti-IL-17A monoclonal antibody—is widely used for treatment. Long non-coding RNAs (LncRNAs) regulate keratinocyte proliferation and immune responses, yet their response to IL-17 inhibition remains unclear. This study aimed to investigate the effect of Secukinumab on MEG3 and MSX2P1 lncRNA expression in a psoriasis cell culture model.Materials and methods: HaCaT cells were stimulated with lipopolysaccharide (LPS) to mimic inflammatory conditions, followed by treatment with various doses of secukinumab. Cell viability was assessed at 24, 48, and 72 hours using CCK-8, with 7.5 mg/ml determined as the LD₅₀ concentration. RNA was isolated, and gene expression levels were measured via qRT-PCR.Results: The results demonstrated an approximately 20-fold reduction in MEG3 expression and an approximately 190-fold reduction in MSX2P1 expression following secukinumab treatment compared to the control group. These findings suggest that IL-17 inhibition may influence keratinocyte function through the modulation of LncRNAs associated with proliferation and inflammation.Conclusion: Secukinumab appears to alter the expression patterns of key LncRNAs in keratinocytes. Further investigation is warranted to clarify the downstream molecular pathways involved and their relevance in the clinical management of psoriasis.
Purpose: This study aimed to investigate whether Prothrombin G20210A (Factor II) and PAI-1 4G/5G gene polymorphisms are associated with COVID-19 severity and clinical outcomes among patients admitted to the Emergency Department of Pamukkale University Hospital (Denizli, Türkiye) between June and December 2021.Materials and methods: In this prospective, cross-sectional, observational study, 150 PCR-confirmed COVID-19 patients and 300 healthy volunteers were genotyped for Prothrombin G20210A and PAI-1 4G/5G polymorphisms by PCR and DNA sequencing. Laboratory parameters, disease severity indices, intensive care unit (ICU) admission, and mortality were analyzed.Results: The genotype distribution among patients was GA 54.7% and GG 45.3% for Prothrombin G20210A, and 4G/4G 77.3% and 4G/5G 22.7% for PAI-1. There were no significant differences in Prothrombin G20210A variants except for lower lymphocyte counts in GA carriers (p=0.031). The PAI-1 4G/5G group showed a significantly higher monocyte count (p=0.012), while differences in urea and other biochemical parameters were not statistically significant (p>0.05). Patients carrying both PAI-1 and Prothrombin heterozygous variants (double heterozygotes, n=13) had lower hemoglobin (p=0.010) and lymphocyte counts (p=0.012), but higher monocyte (p=0.001) and ferritin levels (p=0.006). This subgroup also demonstrated lower oxygen saturation (p=0.049) and significantly higher intensive care unit admission (46.2% vs. 15.3%, p=0.005) and mortality (38.5% vs. 9.5%, p=0.002).Conclusion: Prothrombin G20210A and PAI-1 4G/5G polymorphisms particularly their coexistence were associated with hematologic and inflammatory alterations, as well as increased ICU admission and mortality rates. These variants may have potential value for risk stratification and should be evaluated in larger studies.
Purpose: Hepatitis A is a vaccine-preventable disease that may follow a more severe course and can lead to fulminant hepatitis in patients with chronic hepatitis. The aim of this study is to determine the seroprevalence of hepatitis A in patients with chronic hepatitis B and C, and to assess the need for hepatitis A vaccination.Materials and methods: A total of 885 adult patients with chronic hepatitis B and C, who had not previously received hepatitis A vaccination and in whom antiviral therapy was initiated between January 2008 and December 2020, were included in the study. Immunity against hepatitis A was assessed at the time of diagnosis by measuring Anti-HAV IgG using the Microparticle Enzyme Immunoassay (MEIA; AxSYM-HAVAB 2.0, ABBOTT) method.Results: The seroprevalence of hepatitis A was 92.7% among 789 patients with chronic hepatitis B and 96 patients with chronic hepatitis C; it was determined to be 94% in patients with chronic hepatitis B and 83% in patients with chronic hepatitis C. While 78% of anti-HAV IgG seronegativity was detected in individuals under 30 years of age, 90% of seronegative cases were under 40. Seropositivity approached 100% in those over 50 years of age; however, a 64-year-old man and a 68-year-old woman with chronic hepatitis C were not immune to hepatitis A.Conclusion: Since hepatitis A superinfection in patients with chronic hepatitis B and C may follow a severe course and lead to a fulminant course, it should be kept in mind that hepatitis A seroprevalence is low, particularly in patients under 30 years of age. However, although the rate decreases with age in adult patients, seronegativity may be detected at any age; therefore, Anti-HAV IgG should be evaluated at the time of diagnosis in all patients with chronic hepatitis, and those found to be negative should be vaccinated against hepatitis A.
Purpose: Scientists have discovered more information on ancient genes, migration patterns, and human population evolution by studying DNA extracted from old samples. This research aimed to synthesize current understanding of the relationship between MTHFR mutation and ancient DNA, exploring possible implications for our understanding of the evolutionary and genetic underpinnings of disorders.Materials and methods: Genomic DNA isolation from petrous bone and teeth samples was performed using the Ancient DNA extraction from bones and teeth kit. In the obtained genomic DNAs, the gene-specific region was amplified by PCR, and the polymorphic locus located in this region was observed on high-resolution agarose gel. The MTHFR mutation was examined by genotyping based on DNA sequence analysis.Results: MTHFR A1298C mutation was detected in three samples and MTHFR C1298C mutation was detected in one sample.Conclusion: Looking at MTHFR changes in ancient DNA helps scientists understand how these gene differences affected human survival.
Amaç: Kardiyovasküler hastalıklar, dünya genelinde önde gelen ölüm nedenlerinden biridir ve koroner arter hastalığı (KAH) en yaygın olanıdır. İzole koroner arter bypass grefti (CABG), çok damarlı KAH tedavisinde etkili bir yöntem olmaya devam etmektedir. Cerrahi sırasında aortik kros-klamp (ACC) süresi, postoperatif sonuçları etkileyebilir; ancak, acil servise CABG öyküsü ile başvuran hastalarda bu etkinin kapsamı henüz tam olarak araştırılmamıştır. Bu çalışma izole CABG öyküsü olan ve acil servise başvuran hastalarda aortik kros-klamp süresinin postoperatif klinik sonuçlar üzerindeki etkisini değerlendirmeyi amaçlamıştır.Gereç ve yöntem: Bu retrospektif gözlemsel çalışmaya, Ocak 2022 ile Ocak 2025 tarihleri arasında kardiyopulmoner bypass (CPB) altında elektif izole CABG yapılan 167 yetişkin hasta dahil edilmiştir. Hastalar, ACC süresinin medyanına (63 dakika) göre iki gruba ayrılmıştır: Grup I (≤63 dk, n=86) ve Grup II (>63 dk, n=81). Postoperatif sonuçlar arasında 24 saatlik drenaj, transfüzyon gereksinimleri, ekstübasyon süresi, atriyal fibrilasyon, serebrovasküler olaylar, düşük kardiyak output sendromu ve renal replasman tedavisi analiz
Purpose: The aim of this study is to retrospectively compare the relationship between female obesity and embryo quality and pregnancy outcome.Materials and methods: In this retrospective study, which received approval by the ethical committee, data of in vitro fertilization (IVF) patients (n:542) between January 2019 and August 2021 were examined. The patients were divided into four groups: Group 1, Body Mass Index (BMI) <18.50 kg/m2 (n:16); Group 2, BMI 18.50-24.99 kg/m2 (n:263); Group 3, BMI 25.00-29.99 kg/m2 (n:156); Group 4, BMI ≥30 kg/m2 (n:107). Demographic characteristics of patients, baseline hormone levels, treatment protocols employed, counts of collected oocytes, day of embryo transfer, transferred embryo quality, a positive pregnancy test, and live births were collected, and statistical analysis was performed.Results: There were no significant differences between the groups in terms of age, collected oocyte count, number of mature oocytes, maturation rate (p>0.05). Group 4 showed a statistically significant decrease in the number of 2PN (p=0.014) and fertilised oocyte count (p=0.006) compared to Group 2. When comparing pregnancy outcomes based on BMI groups, it was found that obesity did not significantly affect positive/negative pregnancy rates, live birth rates, miscarriage rates, biochemical pregnancy rates among the groups (p>0.05). Logistic regression analysis indicated a decrease in embryo quality with increasing age. Multiple regression analysis (MRA) results showed that a good quality of the transferred embryo had a positive impact on achieving a positive pregnancy outcome. The presence of pregnancy was negatively affected by increasing age. In Group 1 and Group 2, there were significantly more Day-5 transfers than in Group 4 (p=0.008).Conclusion: This study showed that obese patients had a lower rate of Day 5 embryos compared to non-obese patients. However, no difference was found between BMI and pregnancy rates. The development of good quality embryos had a favourable effect on pregnancy outcomes, whereas increasing age had a negative effect. The present data suggest that further studies evaluating the mechanism underlying the effect of obesity on embryo development are warranted.
Purpose: This study aimed to evaluate the data of foreign national cases who underwent forensic autopsy andapplied to Forensic Medicine Units in Denizli province in the light of political, geographical, and socioeconomicaspects, to contribute to domestic and foreign studies in this field, and to determine the preventable causes ofdeaths.Materials and methods: We retrospectively analyzed the medicolegal reports of foreign nationals who appliedto the Directorate of Forensic Medicine Council and Pamukkale University Department of Forensic Medicine andforeign nationals who were autopsied in the Pamukkale University.Results: It was observed that the number of autopsies performed on foreign nationals constituted 2.38% of allautopsies. The most common country of origin of foreign national death cases was Syria with 25.6%. Amongthe foreign national death cases, 29.1% (25) were tourists. The most common cause of death among foreigndeaths was natural origin (43%).In the case of foreign nationals, 316 reports were issued for 271 cases. The most common country of origin ofthe applicants was Iran with 33.2%. Of the applicants, 48.3% applied for reports on intentional injury.Conclusions: Strict pregnancy follow-up, improving living conditions, and providing counseling services tofamilies on child care, neglect, and education are among the measures that can be taken to reduce mortality inthe 0-10 age group.Considering that children are the future of society, it is of great importance that children who are dragged intocrime are supported at the earliest possible time.
Purpose: This study aimed to adapt the "Multidimensional Hope in Counseling and Psychotherapy Scale" (MHCPS), originally developed in Canada, for use among Turkish speakers.Materials and methods: Data were collected in two phases from a total of 460 individuals (303 in the first phase and 157 in the second phase). As part of the scale adaptation process into Turkish, language validity procedures were conducted at the initial stage. Subsequently, reliability analysis was assessed by calculating Cronbach’s alpha (α). The scale's structure was identified through Exploratory Factor Analysis (EFA) and confirmed using Guttman Split-Half, Spearman-Brown, semi-test, and confirmatory factor analyses (CFA). Criterion validity was evaluated using the Beck Hopelessness Scale (BHS).Results: In the original 34-item 5-point Likert MHCPS, five items with Cronbach’s alphas below 0.30 were removed. The remaining items exhibited alpha values ranging from 0.318 to 0.774, indicating acceptable reliability. The Kaiser-Meyer-Olkin measure (KMO=0.916) and Bartlett’s test (χ²=3691.735; p=0.001; N=406) confirmed sample adequacy for EFA. The EFA eliminated five additional overlapping items, resulting in a 24-item, four-factor structure with eigenvalues exceeding 1, accounting for 55% of the total variance, and factor loadings ranging from 0.428 to 0.777. Reliability was further supported by the Guttman Split-Half (0.861), Spearman-Brown (0.861), semi-test results (0.864, 0.823), and CFA indices (χ²/df=1.94, RMSEA:0.056, CFI:0.921, IFI:0.922, and GFI:0.886). A significant negative correlation with the BHS (r=−0.334, p<0.01) confirmed criterion validity.Conclusion: Validity and reliability analyses indicate that the MHCPS is suitable for use as a Turkish-language assessment tool.
Purpose: This study aimed to investigate the associations between nutritional status, functional capacity, frailty, and depression in older adults, and to evaluate how these parameters relate to body mass index.Materials and methods: A cross-sectional retrospective study was conducted by reviewing the records of patients who applied between January 01, 2024, and January 31, 2025, and included 417 older adults (mean age: 74.2±6.5 years; 61.1% female). Nutritional status was assessed using the Mini Nutritional Assessment, functional capacity with the Katz Index of Independence in Activities of Daily Living and Lawton-Brody Instrumental Activities of Daily Living Scale, frailty with the Clinical Frailty Scale. Physical performance was evaluated using the Timed Up and Go and Sit-to-Stand tests. Spearman's correlation coefficients and Kruskal-Wallis tests were used for statistical analysis.Results: Mini Nutritional Assessment scores were positively correlated with both basic (Katz, ρ=0.35; p<0.001) and instrumental (Lawton-Brody, ρ=0.32; p<0.001) activities of daily living. A significant negative correlation was observed between Mini Nutritional Assessment and Clinical Frailty Scale (ρ=-0.30; p<0.001). Mini Nutritional Assessment also showed weak but significant positive correlations with physical performance tests. A positive correlation was found between Body Mass İndex and Mini Nutritional Assessment (ρ=0.38; p<0.001); lower Body Mass İndex was associated with increased frailty (ρ=-0.21; p<0.001) and decreased performance in basic daily activities (Katz, ρ=0.16; p=0.001). However, the correlation between Mini Nutritional Assessment scores and Geriatric Depression Scale was weak and not statistically significant (ρ=-0.04, p=0.210).Conclusion: This study highlights the critical role of adequate nutrition in maintaining functional independence, reducing frailty, and supporting physical performance in older adults. Moreover, the relationship between nutritional status and depressive symptoms was found to be weak and did not reach statistical significance. Nutritional status should be a core component of geriatric assessments and addressed through multidisciplinary interventions.
I read with great interest the valuable study by Durmaz and Özen, published in the latest issue of Pamukkale Medical Journal, which investigated the relationship between preoperative HbA1c levels and postoperative complications in patients undergoing isolated coronary artery bypass grafting (CABG). The study's emphasis on HbA1c's role in predicting complications such as sternal wound infection and atrial fibrillation is clinically relevant. However, i believe there are several methodological and interpretative points that warrant further discussion.
Anaphylaxis is a severe, life-threatening allergic reaction that can present with a variety of systemic manifestations. Neurological symptoms such as seizures or seizure-like activity are uncommon in anaphylaxis. We present the case of a healthy young male with no history of seizures who experienced anaphylaxis following a hornet sting, manifested by urticarial rashes, facial flushing, and generalized pruritus. Interestingly, he developed seizure-like activity, characterized by focal jerky movement of the left upper limb with impaired consciousness as reported by eyewitnesses. This case highlights the atypical presentation of neurological manifestations of anaphylaxis, discusses its potential pathophysiological mechanisms, and reflecting individualized management approach in relation to established guidelines.
Purpose: This study aims to examine the effect of anxiety on gastric precancerous lesions by revealing the relationship of anxiety level with helicobacter pylori (H. pylori), gastric metaplasia and other gastric lesions.Materials and methods: Patients, who underwent endoscopy due to stomach complaints in the general surgery clinic and whose anxiety levels were measured simultaneously with the Beck Anxiety Inventory, were included in the study. Anxiety levels of the participants were categorized as normal, mild, moderate and severe. Endoscopically, whether there were peptic ulcus (PU), loose gastroesophageal sphincter (GES), gastritis, gastric ulcer, stomach mass, polyp, reflux and hiatal hernia were investigated. In pathological samples, the existence of H. pylori, gastric metaplasia (G. metaplasia), gastric dysplasia (G. dysplasia), gastritis, gastric atrophy, lymphoid aggregate and malignancy were examined. The relationship of anxiety level with endoscopic and pathological diagnoses was evaluated.Results: The study included 120 patients undergoing endoscopy and completing the Beck Anxiety Scale. The mean age of the patients was 49.09 years, while 56.7% of them were female. While no statistically significant relationship was found between anxiety level and antral gastritis (AG), gastric ulcer (GU), pangastritis, reflux esophagitis (RE), hiatal hernia (HH), gastric polyp (GP), alkaline gastritis (AG), a significant relationship was observed between anxiety level and loose GES (r:0.252, p:0.004), P. ulcus (r:-0.177, p:0.047), H. pylori (r:-0.141, p:0.034), intestinal metaplasia (r:-0.120, p:0.048) and malignancy (r:0.199, p:0.025).Conclusion: This study revealed that high anxiety level may cause P. ulcus, GES looseness and H. pylori positivity in addition to gastric metaplasia and gastric malign lesions.
Purpose: Stroke is the second leading cause of death and the third leading cause of disability worldwide. The highest recurrence rates are observed in subtypes such as large artery atherosclerosis (LAA) and cardioembolic (CE) stroke. Atrial fibrillation (AF) is a common cause of CE. However, the role of increased left atrial (LA) size as a potential risk factor for ischemic stroke remains controversial. This study aimed to evaluate whether LA size is associated with the long-term risk of stroke recurrence in patients with non-valvular atrial fibrillation.Materials and methods: This retrospective study included 191 patients diagnosed with ischemic stroke by a specialist neurologist at Afyonkarahisar University of Health Sciences between January 1, 2024, and June 1, 2024. Patients aged >18 years with acute ischemic stroke were included. Patients with a history of ischemic stroke who had not undergone transthoracic echocardiography were excluded. The etiological subtype of ischemic stroke was determined according to the TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria.Results: A total of 191 patients were included. Of these, 155 (81.2%) had non-recurrent stroke, while 36 (18.8%) experienced recurrent stroke. Smoking was significantly more common in patients with recurrent ischemic stroke (30.6% vs. 16.1%; p=0.046). The prevalence of AF was also higher in the recurrent stroke group (33.3% vs. 12.9%; p=0.003). Moreover, LA diameter was significantly greater in patients with recurrent ischemic stroke (median [interquartile range]: 43 [35.75-47] vs. 35 [33-37]; p<0.001).Conclusion: This study demonstrates that increased LA diameter, smoking, and AF are associated with a higher risk of recurrent ischemic stroke. Notably, larger LA diameter may contribute to blood stasis and thrombus formation in the left atrium, thereby elevating the risk of CE events. Further research is warranted to confirm these associations and strengthen the current evidence base.
Purpose: Detection of anti-HLA antibodies is crucial in pre-transplant immunological assessment to evaluate donor-recipient compatibility and prevent hyperacute rejection. This study aimed to evaluate lymphocyte crossmatch (XM) test results performed before kidney transplantation.Materials and methods: Lymphocyte crossmatch tests conducted at the Tissue Typing Laboratory of Pamukkale University Hospital between February 2020 and February 2024 were retrospectively analyzed. CDCXM (Complement-Dependent Cytotoxicity Crossmatch) and flow cytometric crossmatch (FCXM) tests were performed. For CDCXM, T and B lymphocytes were separated and tested individually, with serial dilution and DTT treatment applied. FCXM used anti-CD3 for T lymphocytes, anti-CD19 and anti-IgG for B lymphocytes, analyzed on a 10-color, 3-laser flow cytometer (Navios EX-Beckman Coulter, Inc. USA).Results: A total of 225 CDCXM test results, 105 of which were alive and 120 of which were cadaver, were included in the study. CDCXM T and FCXM T were negative in living donors, while CDCXM B and FCXM B positivity were 4.8% and 2.6%, respectively. CDCXM T and B positivity in cadaveric donors were 3.3% and 7.5%, respectively, and FCXM T and B positivity were 3.3% and 8.8%, respectively.Conclusion: Lymphocyte crossmatch remains a reliable and classical method for pre-transplant immunological evaluation. It effectively detects donor-specific anti-HLA antibodies and contributes to the prevention of hyperacute rejection in kidney transplantation.
Neurocysticercosis is the most common parasitic infection of the human central nervous system, caused by the larval stage of Taenia solium. Its clinical manifestations vary widely, ranging from asymptomatic cases to seizures, focal neurological deficits, and increased intracranial pressure. The postpartum period involves significant immunological, hormonal, and metabolic changes that may influence the onset, progression, or presentation of infectious diseases. This report presents a rare case of neurocysticercosis presenting as a subdural hematoma during the postpartum period. A twenty-one-year-old woman with no previous medical history was admitted thirty-five days after cesarean section due to severe headache and speech impairment. Cranial computed tomography revealed a left-sided subdural hematoma measuring fifteen millimeters in thickness, associated with a seven-millimeter midline shift. The patient underwent emergency craniotomy to evacuate the hematoma. Histopathological examination of the surgical specimen confirmed the presence of the larval form of Taenia solium, thereby establishing the diagnosis of neurocysticercosis. Following surgery, the patient experienced seizures, which required intensified antiepileptic medication. Antiparasitic treatment consisting of albendazole and corticosteroids was initiated. Further radiological evaluations, including cranial and spinal magnetic resonance imaging, did not identify any additional cystic lesions. The patient responded well to treatment and was discharged on hospital day twenty-three with mild speech impairment. At the one-month follow-up visit, her neurological examination was entirely normal. This case highlights an unusual presentation of neurocysticercosis in the postpartum period and underscores the importance of considering this diagnosis in patients presenting with seizures or subdural hematoma in endemic regions.
Purpose: Asthma-COPD overlap (ACO) is a disease similar to Chronic Obstructive Pulmonary Disease (COPD) with some features of asthma. In the Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, it is defined as “asthma and COPD symptoms accompanying each other at similar rates in cases with persistent airflow limitation (postbronchodilator FEV1/FVC<70%)”. We aimed to investigate the frequency of patients with ACO according to GINA and GOLD criteria among those we followed with the diagnosis of COPD and to compare their clinical features and laboratory findings. We evaluated prostaglandin D2 (PGD2) levels in these patients and investigated whether it could be used as a parameter in the differential diagnosis of ACO.Materials and methods: Patients with COPD who applied to the chest diseases outpatient clinics of 3 hospitals in Denizli were examined between October 2021 and May 2022. Patients aged 40 years and older, who were followed up and treated with COPD by a pulmonologist for at least one year and who gave consent were included in the study. The presence of reversibility was investigated by pulmonary function test (PFT) in all patients. If the postbronchodilator FEV1/FVC was <70% in the patients included in the study and the reversibility was positive, it was considered as ACO. Patients divided into two groups as COPD and ACO were compared in terms of clinical, laboratory, PFT and hospital admissions.Results: A total of 166 COPD patients were included in the study. 158 of the patients were male and 8 were female, and their mean age was 61.48 (40-84). 30 (18.07%) patients included in the study with the diagnosis of COPD were diagnosed with ACO. While the mean blood eosinophil percentage in ACO patients was higher than in COPD patients, the mean blood neutrophil counts and percentages were lower than in COPD patients (p=0.02, p=0.02, and p=0.03, respectively). Total IgE level of the COPD group was higher than the ACO group (p=0.006).Conclusion: In our study, PGD2 was ineffective in differentiating ACO patients from COPD patients; mean blood eosinophil percentages and mean blood neutrophil percentages were useful but insufficient.
