Meltem Sertbas - Academia.edu (original) (raw)

Papers by Meltem Sertbas

Canadian Journal of Infectious Diseases & Medical Microbiology, Aug 24, 2022

Background Preliminary data suggest that patients with comorbidities are more susceptible to seve... more Background Preliminary data suggest that patients with comorbidities are more susceptible to severe COVID-19 infection. However, data regarding the presence of metabolic syndrome (MetS) in patients with COVID-19 are scarce. Aim In the present study, we aim to investigate the association between MetS components and disease severity in hospitalized COVID-19 patients. Methods We conducted a prospective observational study of 90 hospitalized patients with COVID-19 pneumonia at a tertiary hospital. The study population consisted of inpatients who tested positive by the reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. Patients with critical COVID-19 disease on admission were excluded. Adult Treatment Panel III of the National Cholesterol Education Program (NCEP-ATP III) criteria were used to define MetS. Laboratory analysis and thorax CT were performed on admission. Results 90 patients, 60 moderate and 30 severe COVID-19 patients, included in the study. The percentage of MetS cases was higher among severe COVID-19 patients (p=0.018). Of the MetS criteria fasting blood glucose (p=0.004), triglycerides (p=0.007) were significantly higher in patients with severe COVID-19 disease with no statistical significance found in waist circumference (WC) (p=0.348), systolic blood pressure (p=0.429), and HDL-C levels (p=0.263) between two groups. Body mass index (BMI) values were similar in both severe and moderate cases (p=0.854). In logistic regression analysis, serum triglycerides (p=0.024), HDL-C (p=0.006), and WC (p=0.004) were found as independent prognostic factor for severe COVID-19 infection. Conclusion Severe COVID-19 patients have higher rates of MetS. Serum triglycerides, HDL-C, and WC have an impact on disease severity in COVID-19.

Turkiye Klinikleri Family Medicine - Special Topics, 2021

Southern Clinics of Istanbul Eurasia, 2019

In several studies, chronic heart failure has shown to be associated with cortisol levels as incr... more In several studies, chronic heart failure has shown to be associated with cortisol levels as increasing morbidity and mortality. The present study aims to evaluate the relationship between serum cortisol levels measured at hospitalization and 48 hours after the first sample with the early and late mortality rate at follow up period in patients with chronic heart failure. Methods: Overall, 66 patients (36 female, 30 male) admitted with the diagnosis of heart failure were included in this study. First cortisol level measurement at the admission, and the second after 48 hours were made. Patients who died within the first sixty days were considered as early mortality and patients who died within 60-180 days as late mortality. Results: After six months of follow up, overall, 18 out of 66 patients died. First, cortisol levels were established to be higher in the mortality group than the patients survived (18.84±5.39 vs 15.47±4.95; p=0.028). The mortality rate was also found to be higher in the groups with NYHA class III-IV (p=0.033), in male sex (p=0.045), in the group with higher BMI (p=0.036), while it was found to be lower in the patients with hypertension group. In cox regression analysis with a model of gender, BMI, NYHA stage, Hypertension and cortisol levels, it was established that high NYHA stage 2.614 [1.017-6.717] (p=0.046), lack of HT 0.358 [0.139-0.921] (p=0.033) and high cortisol levels 5.091 [1.757-14.774] (p=0.003) were factors predicting mortality. Conclusion: In conclusion, a high level of serum cortisol is an independent predictor of early cause mortality risk in patients with chronic heart failure. Class III-IV NYHA and lack of HT were found to be other established factors influencing mortality rate of these patients.

Journal of Investigative Medicine

Carpal tunnel syndrome (CTS) is seen in 5% of the population and 14%–30% in diabetics. Although e... more Carpal tunnel syndrome (CTS) is seen in 5% of the population and 14%–30% in diabetics. Although electrophysiological tests are used as the gold standard method in the diagnosis, alternative methods are being studying. We aimed to investigate whether the measurement of median nerve cross-sectional area (CSA) by ultrasound is associated with the presence and severity of CTS. This prospective, cross-sectional observational study includes 128 randomly selected T2DM patients. Electrodiagnostic study was performed for all patients to diagnose CTS. Median nerve CSA were measured with ultrasound examination. The severity of the CTS was determined by Padua method. Among 128 diabetes mellitus (DM) patients, 54 (28%) had CTS and 53 (41%) had diabetic peripheral polyneuropathy. The mean duration of DM was 11.55 years. Median nerve CSAs of the patients were significantly higher in patients with CTS (CTS (−): 10.47 ± 2.67 vs CTS: (+) 12.37 ± 3.17; p < 0.001). Median nerve CSA cutoff value of &...

European Journal of Gastroenterology & Hepatology

Background While the relation of mean platelet volume (MPV) with inflammatory diseases is obvious... more Background While the relation of mean platelet volume (MPV) with inflammatory diseases is obvious, its role in nonalcoholic fatty liver disease (NAFLD) without cardiovascular comorbidities, obesity and diabetes mellitus is not clear. Methods A total of 249 patients (nonobese, nondiabetic and not having cardiac diseases) who underwent an abdominal ultrasonography assessment were enrolled. They were divided according to the absence (group 1) or presence (group 2) of hepatic steatosis. The patients with steatosis were further divided according to the severity of steatosis as group 2a (grade 1), 2b (grade 2) and 2c (grade 3). The demographic and laboratory features were compared between groups. Results Hepatic steatosis was absent in 120 patients and detected in 129 patients (grade 1, 2, 3 hepatic steatosis in 75, 49 and 5 patients, respectively). BMI, aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio and serum AST, ALT, triglyceride levels were significantly higher in group 2 than in group 1 (P < 0.001, P < 0.001, P < 0.001, P = 0.005, P < 0.001, respectively). BMI, serum AST and triglyceride levels were significant factors for NAFLD (P < 0.001, P = 0.018, P = 0.001). MPV was neither different between groups (P > 0.05) nor a predictor factor for NAFLD (P > 0.05). Conclusion MPV is a useless parameter to detect NAFLD without cardiovascular comorbidities, obesity and diabetes mellitus.

Journal of the Pakistan Medical Association

Introduction: To evaluate whether normalisation of serum thyroid-stimulating hormonelevels with l... more Introduction: To evaluate whether normalisation of serum thyroid-stimulating hormonelevels with levothyroxine is related with metabolic parameters and psychologic wellbeing. Method: The observational, case-control study was conducted from to May to July 2019 in the outpatient thyroid clinics of Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey, and compried hypothyroid patients in the euthyroid state with levothyroxine treatment and euthyroid controls. Psychological wellbeing was assessed using the General Health Questionnaire-12, and metabolic parameters with lipid levels and body composition were analysed for both the groups. Data was analysed using SPSS 25. Results: Of the 159 subjects, 110(69%) were case with a mean age of 50.1±11.7 years, and 49(31%) were controls with a mean age of 47.3±15.2 years. There was no significant difference related to thyroid-stimulating hormonel levels between the groups (p=0.191). Free throxine levels were significantly higher i...

Medicina dello Sport, 2021

Northern Clinics of Istanbul, 2021

T he novel coronavirus-19 disease (COVID-19) due to the severe acute respiratory syndrome coronav... more T he novel coronavirus-19 disease (COVID-19) due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus was first reported in Wuhan, China, in December 2019 [1]. Since then, it has spread throughout the World with significant morbidity and mortality. In March 2020, the World Health Organization (WHO) reported COVID-19 as a pandemic and, over time, reported 110749023 confirmed cases of infection and 2455131 deaths until February 22, 2021 [2]. Due to the high morbidity and mortality associated with ABSTRACT OBJECTIVE: We aimed to compare the effects of blood groups and Rh factor on the development of coronavirus-19 disease (COVID-19) with all aspects such as clinical course, inflammatory parameters, and organ-specific biochemical parameters with a significant number of patients. METHODS: This multicenter study was carried out retrospectively on 3551 patients hospitalized with the diagnosis of COVID-19 and whose blood groups were recorded during the time of hospitalization. As control groups, 22133 individuals' medical data who were admitted to the blood bank affiliated with our hospitals during the last year was used. The differences between the blood groups and clinical characteristics were analyzed. RESULTS: Of the 3551 patients, A Rh (+) blood group was found to be in a higher ratio in the case group than controls, with increased risk to be infected (case: 41.3% vs. control: 38.8%), (OR 1.113; 95% CI: 1.036-1.197; p=0.003). Meanwhile O Rh (+) blood group ratios were significantly lower in the case group than in the control group (case: 26% vs. control: 28.3%) (OR 0.862; 95% CI: 0.823-0.966; p=0.005). There was no significant difference between blood groups in terms of admission to the intensive care units and mortality, it was observed that patients with AB Rh (+) blood group have a greater risk for intubation than others (OR: 1.467; 95% CI: 1.040-2.071; p=0.028). CONCLUSION: We demonstrated that people with blood group A Rh (+) more susceptible to COVID-19, whereas blood group 0 Rh (+) have a protective effect against the infection. Once a person has been infected with severe acute respiratory syndrome coronavirus 2, we should be mindful that patients with blood group AB Rh (+) would be prone to intubation more than other blood groups.

Journal of Surgery and Medicine, 2021

All procedures in this study involving human participants were performed in accordance with the 1... more All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments.

JPMA. The Journal of the Pakistan Medical Association, 2016

Metformin-associated lactic acidosis (MALA) is one of the most important drug toxicities with a h... more Metformin-associated lactic acidosis (MALA) is one of the most important drug toxicities with a high morbidity and mortality rate. We report herein a case of suicide attempt with metformin presenting as MALA and acute renal failure on admission to emergency department and acute myocardial injury later on hospitalisation. An obvious improvement of metabolic parameters was seen in our patient provided by anti-ischaemic treatment together with bicarbonate infusion and haemodialysis. Although myocardial injury due to MALA is not a common disorder, we must be aware that metformin overdose with lack of tissue oxygenation, hypoperfusion, and arrhythmias may cause myocardial ischaemia.

European Journal of Rheumatology, 2015

The association of rheumatoid arthritis (RA) and immune thrombocytopenic purpura (ITP) has been r... more The association of rheumatoid arthritis (RA) and immune thrombocytopenic purpura (ITP) has been reported rarely. Methotrexate, which is used for RA treatment, causes thrombocytopenia. Therefore, in medical practice, physicians avoid using methotrexate for RA in patients who have both RA and ITP. Here, we report an RA case that also had ITP, which did not decrease in platelet count after methotrexate therapy. A 50-year-old woman was diagnosed with diabetes mellitus in 1990, RA in 1995, and ITP in 2000. She had received hydroxychloroquine for more than 5 years. She was treated with prednisolone 16 mg/daily between 2006 and 2007, but she discontinued this therapy because of weight gain. Laboratory findings were not remarkable, except for thrombocytopenia. We started methotrexate therapy 10 mg per week for treatment of RA, and hydroxychloroquine therapy was stopped due to nonresponse. The methotrexate dose was increased up to 15 mg/week. Her complete blood cell count was monitored frequently. We did not observe any decrease in platelet count, while active arthritis symptoms of the patient were relieved. This case shows that methotrexate may be used in patients diagnosed with RA that is associated with ITP under strict monitoring.

West Indian Medical Journal, 2012

Aim: To determine the psychiatric symptom assesment of patients seeking treatment for irritable b... more Aim: To determine the psychiatric symptom assesment of patients seeking treatment for irritable bowel syndrome (IBS) and to demonstrate the presence of more complicated psychiatric disorders. Subjects and Method: The participants were recruited from patients who were attending internal medicine and gastroenterology clinics and who fullfilled the Rome III criteria for IBS. Fifty patients with IBS (IBS group) and 50 patients with complaints other than gastrointestinal symptoms (control group) were randomly selected. All participants were screened by the Structured Clinical Interview for DSM-IV (SCID-I), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Check list-90 (Revised) [SCL-90-R]. Results: Seventeen patients (34%) and three control subjects (6%) had at least one psychiatric diagnosis (p = 0.001). Global severity index (GSI) total scores and SCL-90-R items were significantly higher in the IBS group than the control group (0.92 ± 0.46 vs 0.358 ± 0.19, p < 0.001). Beck anxiety inventory and BDI scores were higher in the IBS group than the control group (p < 0.001). Axis-I psychiatric disorders diagnosed with SCID-I were significantly higher in the IBS group (34% vs 6%) [p = 0.001]. Among the Axis-I disorders, somatoform and anxiety disorders were higher in the patient group than in the control subjects (p = 0.002 and p = 0.0057) whereas there was no difference for mood disorders (p = 0.204). Seven (14%) of the patients and two (4%) of the control subjects had at least one Axis-II psychiatric disorder diagnosed with SCID-II without any significance (p = 0.159). Conclusion: These findings suggest that except for mood and personality disorders, almost all psychiatric symptoms and disease co-morbities with IBS are higher than in the sample without IBS. We can easily use SCL-90-R, BAI and BDI in internal medicine and gastroenterology clinics to detect psychiatric symptom levels and then to refer patients to a psychiatrist for further evaluation and treatment.

Case Reports in Hepatology

A 73-year-old female patient with a history of type 2 DM for seven years was admitted to our out-... more A 73-year-old female patient with a history of type 2 DM for seven years was admitted to our out-patient clinic with a complaint of frequent hypoglycemic episodes. She was receiving basal- bolus insulin treatment. She underwent liver transplantation 20 months ago due to end stage liver disease caused by HCV infection genotype 1b. While she was still on tacrolimus for liver transplantation, she received direct acting antiviral agents including fix dose ledipasvir-sofosbuvir with ribavirin. Biochemical analysis showed fasting plasma glucose of 105 mg/dl and postprandial glucose of 200 mg/dl, glycosylated hemoglobin A1c of 4.8%, and c-peptide of 3.17 ng/ml. After achieving successfully virologic response with antiviral therapy, the patient stayed euglycemic and was no longer in need to any medication including insulin and the patient was followed only by dietary regulation. Achievement of the virological response in treatment of HCV infection can improve not only the liver status, but ...

Frontiers in Public Health

Aim: Early identification and treatment of infections in patients using domiciliary noninvasive m... more Aim: Early identification and treatment of infections in patients using domiciliary noninvasive mechanical ventilation (NIMV) due to chronic respiratory failure (CRF) can reduce hospital admissions. We assessed C-reactive protein (CRP), procalcitonin, and neutrophil lymphocyte ratio (NLR) as indicators of infection/inflammation. Methods: The study was designed as a retrospective, observational, cross-sectional study, and was performed in 2016 in an intensive care unit outpatient clinic in patients using NIMV. Patients who came to the outpatient clinic with dyspnea, increased sputum, increased prothrombin, and who had hemogram, procalcitonin, and serum CRP, NLR, and PLT/MPV levels assessed, were enrolled into the study. Demographic characteristics, co-morbid diseases, respiratory symptoms, hemogram, biochemistry, CRP, and procalcitonin values in stable and acute attack patients were recorded from patient files. The descriptive statistics and CRP, NLR, and procalcitonin values were assessed. Results: During the study period, 49 patients (24 female) with chronic obstructive pulmonary disease (COPD, n = 24), obesity hypoventilation syndrome (OHS, n = 15), or interstitial lung disease, n = 10), and having had three inflammatory markers assessed, were included in the study. Their mean age was 67 (SD ± 12). Stable patients vs. those who had an acute attack was 41 vs. eight, and within 7 days of outpatient admission four patients were hospitalized. CRP, NLR, and PLT/MPV values were similar in patients' who had sputum purulence, and an increase in dyspnea and sputum, but procalcitonin was significantly higher in patients who had an acute attack. Procalcitonin was not correlated with CRP, NLR, and PLT/MPV. Conclusions: Patients with CRF had similar levels of CRP and NLR during a stable and acute attack state. Procalcitonin may be a better marker for therapeutic decisions in advanced chronic inflammatory diseases.

Endokrynologia Polska

Insulin autoimmune syndrome is characterised by spontaneous hypoglycaemia, and excessive serum in... more Insulin autoimmune syndrome is characterised by spontaneous hypoglycaemia, and excessive serum insulin levels and insulin autoantibodies, which occur in the absence of exogenous insulin. It is seen especially with drugs containing the sulfhydryl group. Alpha lipoic acid is a sulfhydryl-containing antioxidant used in the treatment of diabetic neuropathy. As well as for diabetic neuropathy, it is frequently used in many countries for non-neuropathic pain, antiageing, and diet supplementation. Although insulin autoimmune syndrome is frequently reported in the Asian population due to their genetic predisposition, it is rarely seen in the Caucasian race, as in Turkey. Herein, we report a case diagnosed with insulin autoimmune syndrome after alpha lipoic acid usage in combination with vitamin B due to pain.

Gynecological Endocrinology

Northern Clinics of Istanbul