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    Anatolian propolis extracts enhance cisplatin efficacy in ovarian cancer through AKT/mTOR pathway modulation and demonstrate antibacterial and antibiofilm activities
    (Humana Press Inc, 2025) Erdogan, Esra; Ozdem, Berna; Cimentepe, Ozge Ozturk; Tekedereli, Ibrahim
    Propolis, a natural resinous substance rich in bioactive compounds, has been traditionally used for its therapeutic properties. This study investigates the cytotoxic and anticancer effects of Anatolian propolis on ovarian cancer cells, focusing on its modulation of the AKT/mTOR pathway and its ability to enhance cisplatin efficacy. Its antimicrobial and antibiofilm properties were also assessed, addressing infection risks in immunocompromised cancer patients. In epithelial ovarian cancer (A2780) cell line, apoptosis, cell cycle progression, and cell viability were evaluated using flow cytometric analysis, propidium iodide/annexin V staining, and MTS assay, respectively. The signaling pathways were analyzed using Western blotting. The IC50 value of propolis was determined as 0.342 +/- 0.180 mg/mL in the A2780 cell line and 1.11 +/- 0.31 mg/mL in the MCF-10A cell line. Apoptosis in the cells was evaluated using annexin V/PI staining and Caspase-3 expression via flow cytometry after treatment with varying concentrations of propolis and cisplatin. The combination of propolis at IC50 and cisplatin at IC25 demonstrated the highest apoptotic activity. Propolis treatment upregulated pro-apoptotic Bax while downregulating survival proteins (Bcl-2, mTOR/p-mTOR, and AKT/p-AKT) in A2780 cells, demonstrating AKT/mTOR pathway-mediated anticancer activity. Propolis exhibited potent antibacterial and antibiofilm activity against clinically relevant pathogens including MRSA and MDR E. coli, confirming its antimicrobial potential. Anatolian propolis demonstrates anticancer activity by modulating the AKT/mTOR pathway and enhancing cisplatin efficacy. Its antibacterial and antibiofilm properties further highlight its potential as a dual-function therapeutic agent, especially in cancer contexts where secondary infections are a common complication.
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    Bacteriological profile of diabetic foot ulcers and analysis of serum meteorin levels
    (Springer, 2025) Erdogan, Esra; Yetisgen, Azize; Keskin, Lezzan; Tanriverdi, Elif Seren; Ugur, Isilay Gokce Benk
    ObjectiveWith the increase in the incidence of diabetes mellitus (DM) in recent years, diabetic foot ulcers (DFU), which are common and serious chronic complications of diabetes, have also become widespread. DFU is highly associated with a significant deterioration in quality of life as well as increased morbidity and mortality. Meteorin is a potent neurotrophic growth factor and shows antiangiogenic, antihyperalgesic, antinociceptive and neuroprotective effects. This study aimed to determine the possible relationship between meteorin, diabetes and diabetic foot ulcer by comparing the serum meteorin levels of healthy control group, DM patients and patients with diabetic foot ulcers.MethodsOur study included a total of 62 diabetic patients, 31 of whom had DFU, and 29 healthy individuals as a control group. Meteorin levels of the participants were measured using ELISA method in serum samples. Other laboratory and epidemiological data of the patients were obtained from the hospital database.ResultsIn the wound cultures taken from patients with DFU, the most commonly isolated bacteria were Staphylococcus aureus and Pseudomonas aeruginosa. Serum meteorin levels were found to be statistically significantly higher in diabetic patients as compared to the healthy control group, and among diabetic patients, those with DFU had significantly higher levels compared to those without DFU. A positive significant correlation was found between meteorin level and age, HbA1c, WBC, urea, sedimentation, CRP and ferritin.ConclusionThe results of our study, aimed at better understanding the biological functions and potential clinical applications of meteorin, suggest that meteorin could potentially be used as a biomarker for the development of DFU.
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    Knowledge, attitudes, and behaviors toward antibiotic use among pharmacy students in southeastern Türkiye: A cross-sectional study from Harran University
    (Lippincott Williams & Wilkins, 2026) Erdogan, Esra; Yasar, Seyma
    Antimicrobial resistance (AMR) has emerged as a critical global health threat, driven largely by the irrational and excessive use of antibiotics in both human and veterinary medicine. T & uuml;rkiye consistently ranks among the highest antibiotic-consuming countries worldwide. As future healthcare professionals, pharmacy students play a pivotal role in promoting rational antibiotic use and antimicrobial stewardship (AMS). This study aimed to assess the knowledge, attitudes, and practices (KAP) of pharmacy students regarding rational antibiotic use and AMR, and to identify educational gaps for curriculum improvement. A cross-sectional study was conducted among first-, second-, and third-year students (n = 141) enrolled at Harran University Faculty of Pharmacy, T & uuml;rkiye. Data were collected using a structured, self-administered questionnaire developed from the literature and validated by experts. The survey assessed students' sociodemographic characteristics, antibiotic use history, knowledge of antibiotic effectiveness and resistance mechanisms, and attitudes and behaviors toward rational use. Data were analyzed using IBM SPSS Statistics version 26.0, with descriptive and inferential statistics; significance was set at P < .05. Most students (82.3%) correctly identified bacteria as the target of antibiotics, yet 17.7% held misconceptions - mainly believing antibiotics treat all microorganisms or viral infections. While awareness of AMR as a global issue was high, notable misconceptions persisted, such as antibiotics strengthening immunity or requiring avoidance with probiotics. The majority (85.8%) reported non-antibiotic strategies (e.g., rest, fluids, herbal remedies) as their first-line management for illness. Nearly all students (97.2%) opposed prescribing on patient demand and recognized irrational use as the main driver of resistance. However, knowledge gaps were evident regarding diagnostic testing prior to antibiotic prescription - only 56% correctly identified antibiogram testing. Overall, attitudes and practices were generally responsible, though incomplete understanding of key AMR concepts remains. Pharmacy students at Harran University demonstrated good awareness and responsible behaviors toward antibiotic use, yet persistent misconceptions underscore the need for targeted educational interventions. Integrating AMS and clinical microbiology modules early in pharmacy curricula may enhance future pharmacists' competence in combating AMR and promoting rational antibiotic use.
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    Multidrug-resistant uropathogens in pediatric urinary tract ınfections: a multicenter retrospective trend analysis (2020-2024)
    (Springer, 2026) Erdogan, Esra; Yetisgen, Azize; Dogan, Serpil; Sinanoglu, Muhammed Selcuk; Kilic, Fedli Emre; Kurt, Osman
    Large-scale public health disruptions, including pandemics and natural disasters, may influence healthcare delivery, pathogen distribution, and antimicrobial resistance (AMR). This retrospective multicenter study evaluated uropathogen profiles and temporal trends in antibacterial resistance among hospitalized pediatric patients with urinary tract infections (UTIs) across periods corresponding to the COVID-19 pandemic, the February 6, 2023 Kahramanmara & scedil; earthquakes, and the post-earthquake phase in heavily affected regions of T & uuml;rkiye. Hospitalized pediatric patients (0-18 years) with culture-confirmed UTIs admitted between January 2020 and December 2024 to three tertiary care hospitals were included. Pathogen identification and antibacterial susceptibility testing were performed using standard microbiological methods in accordance with EUCAST criteria. Uropathogen distribution and resistance patterns were compared across predefined study periods. A total of 1131 pediatric patients were analyzed, of whom 54.29% were female. Gram-negative bacteria predominated (89.57%), with Escherichia coli (59.86%) and Klebsiella spp. (18.92%) being the most frequently isolated pathogens. Across the study periods, E. coli demonstrated significant increases in resistance to ampicillin (63.26% to 81.90%), ceftriaxone (41.99% to 53.76%), ceftazidime (39.46% to 63.10%), and trimethoprim-sulfamethoxazole (32.27% to 40.34%) (all p < 0.01). Among Klebsiella spp., a significant temporal increase was observed only for imipenem resistance, which rose from 18.64% during the COVID-19 period to 37.50% during the earthquake period before declining to 13.21% in the post-earthquake period (p = 0.021). Multidrug-resistant (MDR) phenotypes were predominantly detected among Gram-negative organisms, with the highest proportions observed in Serratia spp., Citrobacter spp., Enterobacter spp., and Pseudomonas spp., while MDR prevalence in E. coli was comparatively lower. Temporal variations in antibacterial resistance were observed among pediatric UTI pathogens during periods of major public health disruption. These findings highlight the importance of sustained regional surveillance and context-aware empiric treatment strategies in settings exposed to systemic healthcare stressors.
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    The Risk Factors Affecting Length of Stay and Mortality in Covid 19 Patients: Laboratory Parameters, Comorbidities, and Demographic Characteristics
    (Duzce Univ, Fac Medicine, 2021) Delen, Leman Acun; Erdogan, Esra; Yasar, Seyma
    Objective: Covid 19 can cause fatal pneumonia and serious complications. In the course of the disease the levels of different biochemical parameters increased and these parameters provide important information about the prognosis of the disease. The aim of this study was to investigate the relationship between biochemical parameters and length of stay and mortality in Covid 19 patients. Methods: In this retrospective study, a total of 767 Covid 19 patients hospitalized in our hospital were included. The demographic characteristics, length of stay, comorbid diseases and biochemical parameters of the patients were scanned from the hospital's database and patient files and recorded. Patients were grouped according to the length of stay; 1st Group: 7 days and less, 2nd Group: 8-10 days, 3rd Group: 11-13 days, and 4th Group: 14 days and more. Results: The mean CRP level was significantly higher in group 4 compared to group 1 (p = 0.002). The mean levels of LDH, PRO_BNP, and procalcitonin were significantly higher in group 4 compared to group 1 and group 2 (p <0.001, p = 0.026, p = 0.007, respectively). The mean level of fibrinogen was significantly higher in group 4 compared to group 2 (p = 0.011). Presence of DM and HT as comorbidities (p = 0.022, p = 0.006) and high levels of LDH and ferritin (p <0.001, p = 0.041) significantly increased the risk of death. Conclusions: The results of our study show that positive correlation between the levels of CRP, LDH, PCT, PROBNP, and fibrinogen the prolongation of hospitalization in Covid 19 patients and these parameters can be associated with the severity disease. These results show that increased levels of LDH and ferritin, age, prolongation of hospitalization, and the presence of HT and DM increase mortality rate and can be specific parameters in terms of prognosis.
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    The diagnostic potential of Asprosin and Meteorin-like proteins in basal and squamous cell carcinomas
    (Springer, 2025) Erdogan, Mehmet Mustafa; Erdogan, Esra; Kocaman, Nevin; Yasar, Seyma; Kavak, Songul Yerlikaya
    Non-melanoma skin cancer (NMSC) is the most prevalent malignancy worldwide, encompassing primarily BCC and SCC. Differentiating between these two carcinomas and distinguishing them from normal skin tissue can pose diagnostic challenges in certain cases. Adipokines, as regulators of various biological processes, have garnered attention for their potential roles in tumorigenesis. Asprosin (Asp) and Meteorin-like (Metrnl) are newly identified proteins implicated in several diseases, including cancer. Their potential contribution to the pathogenesis of skin cancers such as BCC and SCC remains underexplored. This study aimed to evaluate the expression profiles of Asp and Metrnl in BCC and SCC and to assess their potential utility as diagnostic biomarkers. The expression of Asp and Metrnl proteins was examined by immunohistochemical staining in biopsy samples from 60 control, 60 BCC, and 60 SCC cases obtained from the archive of the Pathology Laboratory of Malatya Turgut Ozal University Training and Research Hospital. Asp immunoreactivity was higher in BCC tissues compared to the other two groups, and it was statistically higher in SCC tissues compared to healthy control tissues. Metrnl immunoreactivity was also higher in BCC tissues compared to the other two groups, and statistically significant in SCC tissues when compared to healthy control tissues. The findings suggest that Asp and Metrnl proteins may serve as valuable biomarkers for distinguishing between BCC and SCC, the two most common non-melanoma skin cancers encountered in routine dermatopathology practice. These adipokines may also provide insights into the underlying pathophysiology of these malignancies, offering potential avenues for diagnostic and therapeutic advancements.