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    Evaluation of novel ventricular repolarization parameters in patients with acromegaly
    (2023) Eren, Hayati; Genc, Selin; Evren, Bahri; Şahin, İbrahim
    Objectives: T wave’s peak and end interval (Tp-e), Tp-e/QT ratio and Tp-e/QTc ratio are novel markers of ventricular repolarization and are associated with ventricular arrhythmias. Increased ventricular arrhythmia incidence is reported in patients with acromegaly. The purpose of this study is to evaluate ventricular repolarization using the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio in patients with acromegaly. Methods: Thirty-five patients with acromegaly were included in the study. The control group was consisted of forty-one subjects without acromegaly that having similar age, sex ratio and comorbidities. The Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio, and other ventricular repolarization parameters of all patients were evaluated using electrocardiography. Results: Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio were significantly prolonged in patients with acromegaly compared to the control group. Furthermore, Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio showed a significant correlation with plasma GH levels and LVMI values. Conclusions: Our study revealed that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio are prolonged in patients with acromegaly. We believe that the Tp-e interval, Tp-e/QT ratio, and Tpe/QTc ratio can be used in the evaluation of increased cardiovascular risk in patients with acromegaly.
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    An unusual cause of hypoglycemia; the case of a male patient with Munchausen's Syndrome
    (2021) Genc, Selin; Evren, Bahri; Slocum, Ayshe; Bozbay, Abdulkadir; Sener Aydin, Emine; Sahi?n, Ibrahim
    Munchausen's Syndrome is a psychiatric illness in which patients create potentially life-threatening symptoms for the purpose of admission to a hospital or other primary gains. A 23-year-old male patient was admitted to the Inonu University, Turgut Ozal Medical Center Endocrinology Inpatient Unit with hypoglycemic attacks. The patient had hypoglycemia that required intensive dextrose infusion. Studies conducted after his hospitalization revealed that the patient intentionally injected himself with high doses of insulin in order to be hospitalized. A diagnosis of factitious hypoglycemia and Munchausen Syndrome (MS) was made. The patient was followed up with recommendations from the psychiatry department. Factitious hypoglycemia, resulting from deliberate usage of blood glucose-lowering medications in the absence of hyperglycemia, is characterized by frequent episodes of hypoglycemia and recurrent hospitalizations and causes a variety of severe symptoms. Typical signs include low blood glucose levels, suppressed c-peptide and pro-insulin levels, and inappropriately high insulin levels. The purpose behind the current case report is to emphasize the significance of considering MS in the differential diagnosis of patients presenting with hypoglycemia and, although it is more prevalent among females, to demonstrate