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Öğe Effects of different measurements of foot angle on vital activities of hemodialysis patients(2023) Özbay, Zeynep; PEKMEZ, HIDIR; İnceoğlu, Feyza; Arpacı, Muhammed; aydın, merve; Pembegul, Irem; Aladag, MuratAim: Individuals who receive hemodialysis treatment due to chronic renal failure have limitations in their daily lives and a decrease in physical activity and walking speed. In this study, we have investigated the effectiveness of various measurements of ankle angles of hemodialysis performed on patients on balance, falling risk, and daily life activities. Materials and Methods: 114 volunteer hemodialysis patients with a mean age of 30-94 have measured at the position of plantar flexion, inversion, and eversion by a 1-degree sensitivity manual goniometer. The Time Up and Go test (TUG), Lawton and Brody Instrumental Activities of Daily Living (IADL) Scale and Barthel Index (BI) were applied to the patients. Statistical analyses were made with the SPSS 25 program. Results: 55 male and 59 female participants were accompanied in the study. The average age was 62.8 ± 15.29, the average hemodialysis duration was 5.59 ± 3.92, the average body mass index was 5.08 ± 5.1 and he average number of falls was 5.59 ± 3.92. A low positive significant correlation was observed between plantar flexion and inversion foot angle measurements with The Lawton and Brody IADL scale (p<0,05). A low-level significant positive correlation was observed between the BI score and the plantar flexion angle measurements (p<0.05). A highly significant positive correlation was observed between plantar flexion angle measurement and inversion angle measurement. In contrast, a moderately significant positive correlation was observed between plantar flexion angle measurement and eversion angle measurement (p<0.05). Conclusion: We observed a decrease in daily life activities and a walking speed increase in falling risk in the diagnosis of chronic renal failure in hemodialysis patients.Öğe Frequency of gallstones in female healthcare workers of childbearing age in Malatya region(2023) ALADAĞ, HÜLYA; Aladag, MuratAim: Gallstones are seen more frequently in women and in both sexes in the society, causing serious health problems and reducing the quality of life. In this study, we aimed to evaluate and present the frequency of gallstones among female healthcare professionals of reproductive age in the Malatya region. This is the first study in our country in the field of gallbladder stone frequency among female healthcare professionals of childbearing age. Materials and Methods: We included all female employees of childbearing age working in our hospital, and the frequency of gallstones was found by retrospectively evaluating the routine records of healthcare professionals in the hospital. The frequency of gallstones in the patients was obtained from routine abdominal ultrasonography records made during health checks and abdominal tomography records when necessary. Frequency of data was used as number and percentage for statistical evaluation of data, and Fisher’s chi-square test was used for evaluation of non-numerical data. Results: The average age of female employees of childbearing age is 30.02 ± 5.42 years and the age range is 19-50 years. Of 1224 healthcare workers, 65 (5.3%) had gallbladder stones and 1.6% had polyps, and 35 (2.8%) had a history of cholecystectomy. Only the difference between gallstone rates according to body weight was statistically significant (p<0.01). There was no statistically significant difference between birth, number of miscarriages and height between those with and without gallstones (p>0.05). In our cases, it was determined that gallstones increased in parallel with age and weight. Conclusion: As a result, the frequency of gallstones among female healthcare workers of reproductive age was statistically significantly proportional to body weight. The incidence of gallstones was directly proportional to weight, patient age, and working time in the hospital.Öğe Frequency of GERD in women of childbearing age in Malatya region(2023) ALADAĞ, HÜLYA; Aladag, MuratGastroesophageal reflux disease (GERD) is frequently seen not only in our country but also all over the world. GERD not only impairs health and quality of life, but also causes serious financial losses in the working population. In this study, our aim is to determine the frequency of gastroesophageal reflux disease among female healthcare professionals of childbearing age in our region. Questions were asked about demographic data such as weight, age, height, BMI, medical history, and gastroesophageal reflux of female healthcare workers, whose data were generated by us. The answers to the questionnaires were collected and evaluated retrospective. All participants in the study were women. This study was carried out on 1224 female healthcare workers of reproductive age working in Malatya Turgut Özal University training and research hospital. Approximately 1150 of the employees who were distributed questionnaires filled out the questionnaires. The mean age of the female healthcare workers of childbearing age was 30.01±5.38 years, between 19-50. The mean height of the healthcare workers was 1.64±7.8 meters, the average weight was 68.05±13.2 kg, and their body mass index (BMI) was 27.4±3.6 kg/m². The frequency of GERD in the study group was found to be positive in 24%. 38.5% of the healthcare workers had previously gone to the doctor with complaints of pyrosis and/or regurgitation. A significant relationship was found between GERD and stress, fizzy drinks, lying down after meals, and family history of GERD. There was no significant relationship between the smoking and coffee use and age of the participants in the study in terms of the presence of GERD.We think that gastroesophageal reflux symptoms are common due to stress, unbalanced diet, irregular sleep and lifestyle habits due to the COVID pandemic in the last two years due to the fact that the participants in the study were healthcare professionals. Among our healthcare professionals, both pyrosis and other GERD symptoms were found to be higher than some of the previous studies, similar to those in our country. We think that the reason for this is that the extremely stressful work of health workers in the last 2 years has contributed to this. As it is known, health workers have worked very hard in the last 2 years, they did not even use their annual leaves, even those who wanted to retire could not retire. We think that this stress environment may also contribute to GERD symptoms.Öğe Nine healthy deliveries in four pregnant women with enzyme replacement therapy in Gaucher disease(2023) ALADAĞ, HÜLYA; Aladag, MuratAim: Our aim is to present the pregnancy and delivery cases that occurred with success- ful enzyme replacement therapy (ERT) in our female Gaucher patients, whom we have followed and treated for years. Materials and Methods: We tried to retrospectively evaluate and present 9 pregnancy and delivery events that occurred with successful ERT in 4 of our 32 Gaucher patients, whom we have been following up and treated for years in our clinic. Patient monitoring parameters include regular clinical, biological, and radiological evaluations. We checked our Gaucher’s disease (GD) patients regularly at regular intervals before and during preg- nancy for their hemoglobin, platelet, leukocyte, ferritin, blood sugar and creatinine levels. Results: 4 of the 32 cases were children, age range (4-16 years), 16 women age range (22- 68 years), 12 men age range (34-72 years). Four of our cases have not received treatment yet. 12 of the female cases are receiving regular ERT (3 months-14 years). Of the male cases, 9 were receiving ERT (3-9) and 3 were not taking medication. One of our cases gave birth to a total of 4 children, first twins and then two single children with an interval of 3 years. Two of our patients had two deliveries and one of our patients with both Gaucher and SLE disease gave birth. Pregnant patients came to check-ups more frequently during pregnancy and were followed up and treated with a multidisciplinary approach each time they came. The ERT treatments of the patients were increased during pregnancy as the patient gained weight, and the symptoms that increased during pregnancy were relieved by increasing the dose. Conclusion: As a result, in our study, we observed that there was a healthy and successful pregnancy and delivery with ERT, which was started at the appropriate time and given at the appropriate dose. Comprehensive studies involving more cases are required in this regard.Öğe Noninvasive Tests to Assess Liver Stiffness in Patients with Chronic Hepatitis B: APRI, FIB-4, and FIB-5 Scores(Wiley, 2024) Yakut, Aysun; Aladag, MuratBackground. Invasive percutaneous liver parenchymal biopsy is the best test used to evaluate liver stiffness and fibrosis in the follow-up and treatment of chronic hepatitis B (CHB) patients. In this study, we aimed to indirectly evaluate the severity of liver parenchymal fibrosis with tests used in the laboratory. Methods. This retrospective study was conducted with 201 patients diagnosed with CHB who underwent liver biopsy between 2021 and 2022. Preprocedural examination information, laboratory tests, and histopathological data of the patients were taken from the hospital database and examined. Aspartate aminotransferase (AST)-platelet ratio index (APRI), 4 factor-based fibrosis index (FIB-4) score, and 5 factor-based fibrosis index (FIB-5) score were calculated and compared with liver histopathological features. Results. Of the 201 CHB patients, 76 were females and 125 were males. The average age of the patients was 38.05 +/- 12.63 years. A weak, statistically significant correlation was observed between FIB-4 and APRI scores. The patients' significant fibrosis scores were 31.3% and 33.8%, respectively (r = 0.313; r = 0.338; p=0.001; p<0.01). The very weak negative correlation of 17.4% between the patients' FIB-5 score and fibrosis score was statistically significant (r = -0.174; p=0.014; p<0.05). Conclusions. According to the data we obtained in our study, while the APRI score and FIB-4 score can be used safely, more comprehensive studies are needed for the reliability of the FIB-5 score.Öğe Successful ERCP application in pregnant women with cholestasis(2023) ALADAĞ, HÜLYA; Aladag, MuratWe aimed to present successful endoscopic retrograde cholangiopancreatography (ERCP) applications and results in our pregnant cases. A retrospective analysis was performed on the data of 14 successful ERCP procedures performed on our pregnant patients between 2016 and 2022. The ERCP operation was carried out on the patients while they were in the left decubitus position by endoscopists skilled in biliary endoscopy. Methods to lessen prenatal radiation exposure were used during the fluoroscopy procedure. Throughout the process, short-term fluoroscopies were employed. The duration of each fluoroscopy on the patient was noted. 14 pregnant women who presented with cholestasis results had ERCP and sphincterotomy. Two of the procedures were completed on full patients during the appropriate trimesters. Our pregnant women had a mean gestational age of 17.8 weeks and a mean mother age of 24.85.6 (19-38). The fluoroscopy took 0.16 minutes (0-35sec). Ten pregnant women (10 sec) had very little fetal radiation exposure, while four other pregnant women (4 sec to 14 sec) had some. The two women's combined prenatal radiation exposure was reportedly between 30 and 35 seconds. One mild bleeding after sphincterotomy, two hyperamylasemia following ERCP, and one case of acute respiratory distress syndrome were procedure-related complications. Two days after an ERCP, cholecystitis manifested in one pregnant woman. When measures are taken as directed by a multidisciplinary team, ERCP can be used during pregnancy without risk and produce positive outcomes.Öğe Viral respiratory tract infection in Gaucher disease, a rare disease: A case study of 24 patients in Malatya, Türkiye(2023) YAPRAK, BÜLENT; ALADAĞ, HÜLYA; Aladag, MuratAim: People with chronic diseases have a higher rate of morbidity and mortality from SARS-CoV-2 infection. Unknown is how SARS-CoV-2 affects rare disease populations like Gaucher disease. The purpose of this research was to investigate the effects of SARS- CoV-2 infection has on Gaucher patients. The only study conducted in Turkey so far is this one. Materials and Methods: Patients with Gaucher disease were included in the study between August 2020 and September 2022. Patients diagnosed with Gaucher disease were questioned one-on-one to determine if they had come into contact with another person who had COVID-19 symptoms or another patient who had COVID-19. The patients were questioned and their answers were recorded regarding their GBA genotype, previous splenectomy history, whether or not they received treatment, and whether or not they had a SARS-CoV-2 test. Results: Eight of our patients reported having contact with someone who had COVID-19 infection or was suspected of having the infection, and in three of these cases (37.5%) the patient reported having at least one symptom of infection. Out of the 18 patients who were tested, 4 (22.2%) had a positive result. Positive test results were associated with more symptoms in patients (3.8 vs 0.3, p0.001) than negative test results. In Gaucher patients, symptoms or positive test results were not correlated with age, gender, BMI, comorbidity, genotype, previous splenectomy, or enzyme replacement therapy. All of our patients only received supportive care; none of them required intensive care or specialized treatment. Conclusion: Our research revealed that there was a low risk of serious side effects in other chronic patients following SARS-CoV-2 infection in Gaucher patients. In this regard, studies with larger case series are required
