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    The effect of gluten-free diet on mean platelet volume, neutrophil and neutrophil/lymphocyte ratio in children with celiac disease
    (2020) Agin, Mehmet; Kayar, Yusuf; Dertli, Ramazan; Konur, Sevki; Surmeli, Neslihan; Ozkahraman, Adnan
    Aim: Celiac Disease (CD) is a chronic, autoimmune and systemic disease. In the present study, the purpose was to investigate the effect of a gluten-free diet on Mean-Platelet-Volume (MPV), neutrophil and neutrophil/lymphocyte Ratio (NLR).Material and Methods: A total of 106 patients who were diagnosed with CD and who were followed-up by the Pediatric Gastroenterology Clinic of the Hospital, and 50 healthy children were included in the study. The demographic data of the patients and the neutrophil, lymphocyte, platelet, NLR were recorded before the diagnosis and one-year after gluten-free diet. The hematologic parameters of the patients were compared with the healthy control group at the diagnosis time. Following a one-year gluten-free diet, the hematologic parameters of the patients were compared with the parameters at the diagnosis time.Results: The mean age of the patients was 12.1±3.2 years (7-16 years), and the mean age of the control group was 14.5±4.1 years (12-16 years). A total of 48% (51/106) of the patients were female and 34% (17/50) of the control group was female. Hematological parameters of patients compared pre-dietary and post-dietary; lymphocyte and platelet ratios were significantly higher, whereas neutrophils, MPV and NLR were significantly lower. Neutropenia was detected in 15 patients before the diet. It was observed that neutrophil level reached the normal range after gluten-free diet in patients with neutropenia.Conclusions: The MPV, neutrophil and NLR values, that was low during the diagnosis, may be ameliorative with the gluten-free diet. In addition, CD should be considered in the differential diagnosis of neutropenic patients.
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    Inflammatory parameters and insulin resistance and cigarette smoking in type 2 diabetes mellitus
    (2018) Kayar, Yusuf; Agin, Mehmet; Unver, Nurcan
    Aim: Smoking remains a global problem and it is known as a cause of many diseases. Globally, tobacco use is the most important cause of preventable morbidity and mortality. The aim of this study is to evaluate the impact of smoking on insulin parameters and inflammatory markers, and the variation of these parameters according to the duration of smoking cessation in patients who quit smoking. Material and Methods: 612 patients aged 18-70 years (n = 612) who were undergoing treatment and follow-up for type 2 diabetes mellitus were included in this study. The patients were categorized into 3 groups (i.e., smokers, ex-smokers, and nonsmokers). Test results ofof hemoglobin A1c (HbA1c), cholesterol, triglyceride, high density lipoprotein (HDL) levels, low density lipoprotein, leukocyte count, C-reactive protein, fibrinogen, and ferritin levels were obtained. Body mass indexes (BMI) and blood pressure were also measured. Results: Smoking was significantly associated with the male gender, HbA1c, HDL level, BMI, waist circumference, the homeostatic model assessment-insulin resistance (HOMA-IR) core, and inflammatory markers. Current smokers who smoked ≥20 packs/year demonstrated poorer metabolic results compared to those who smoked 0-10 pack(s)/year. The metabolic parameters were worse in ex-smokers who quit smoking <1 year ago compared to ex-smokers who quit 1-5 years, 5-10 years, and >10 years ago. Conclusion: We demonstrated that smoking increased insulin resistance, metabolic syndrome, and inflammation. Smoking was also observed to worsen glycemic control by further increasing insulin resistance in diabetic patients.
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    The prevalence of Helicobacter Pylori and related conditions in Van province and its region
    (2019) Agin, Mehmet; Kayar, Yusuf
    Aim: The prevalence of Helicobacter Pylori (HP) is up to 90% in developing countries, whereas it is less than 40% in developed countries. This study aims to determine the prevalence of HP in Van city and its region and to investigate the relationship between the presence of HP and the clinical, endoscopic appearanceMaterial and Methods: A total of 367 cases that presented with the dyspeptic complaints to the Gastroenterology outpatient-clinic and underwent upper-gastrointestinal endoscopy and gastric biopsies between July/2017-March/2019 were included in the study. The patients included in the study were divided into three age-groups (1-5 years, 6-10 years, 11-18 years). The clinical complaints, endoscopic findings were recorded in all patients. The relationship between HP positivity and clinical complaints, the endoscopic appearance was analyzed.Results: The presence of HP was found in 234(63.8%) patients. However, the incidence of HP was 63.8% in all patients; it was found 34.6% between 1-5 years, 61.8% between 6-10 years, and 71.2% between 11-18 years, respectively. The duodenal ulcer was found in 8.5%(20/234) of HP positive cases, and 3.5%(5/133) of HP negative cases. In predicting the presence of HP, the ulcer specificity was determined 96%, the sensitivity was 8.5%, the positive predictive value was 80%, and the negative predictive value was found 37.4%Conclusion: HP should be considered in patients with recurrent and chronic abdominal pain. Endoscopic appearance of nodular antral gastritis and the ulcer should suggest HP infection. The high rate of activity and chronicity in HP positive cases indicates the importance of HP eradication therapy.
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    The relation between life quality and subtype of the disease in patients with irritable bowel syndrome
    (2019) Kayar, Yusuf; Agin, Mehmet; Unver, Nurcan; Dertli, Ramazan; Kirpinar, Ismet
    Aim: Irritable bowel syndrome (IBS) is not a life-threatening condition; however, people with IBS have a low quality of life (QOL) that might affect their education, social and professional achievements. Many studies have shown that patients who have IBS have lower QOL compared to the general population together with patients who have chronic diseases. The relation between IBS subtype and QOL is still not clear. For this reason, our study aims to evaluate the relationship between subtypes of the disease and QOL in patients who have IBS. Material and Methods: The 100 patients with IBS and 100 healthy individuals who were aged from 18 to 65 years, were included in our study. The relationship between disease subtype and quality of life in IBS patients were analyzed. Results: Regarding quality of life between the groups in the examination; the overall health scores were lower at a significant level in the patients who had IBS subtype as predominant-constipation than those who had IBS subtypes as predominant-diarrhea and mixed type (p=0.013;p=0.045;p<0.05,respectively).The vitality scores were higher at a significant level in patients whose IBS subtypes were predominant-diarrhea than those who had the IBS subtype as predominant-constipation (p=0.007;p<0.01). There were no statistically significant differences between the IBS subtypes and other parameters(p>0.05). Conclusion: It was shown that the QOL of IBS patients were significantly lower than the healthy population, but some differences were also found between the disease subtypes. QOL measurement as part of future therapeutic trials in IBS will help ensure optimal treatment.