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    The antimicrobial activity of ephedrine and admixture of ephedrine and propofol: an in vitro study
    (ELSEVIER SCIENCE INC, 2018) Tulgar, Serkan; Alasehir, Elcin Akduman; Selvi, Onur
    Introduction: Propofol and Ephedrine are commonly used during anesthesia maintenance, the former as a hypnotic agent and the later as a vasopressor. The addition of propofol to ephedrine or administration of ephedrine before propofol injection is useful for decreasing or preventing propofol related hemodynamic changes and vascular pain. This in vitro study evaluated the antibacterial effect on common hospital-acquired infection pathogens of ephedrine alone or combined with propofol. Material and method: The study was performed in two stages. In the first, the Minimum Inhibitory Concentration of propofol and ephedrine alone and combined was calculated for Escherichia coli, Enterococcus faecium, Staphylococcus aureus, Pseudomonas aeruginosa, and a clinical isolate of Acinetobacter spp. at 0, 6, 12 and 24 h, using the microdilution method. In the second stage, the same drugs and combination were used to determine their effect on bacterial growth. Bacterial solutions were prepared at 0.5 MacFarland in sterile 0.9% physiological saline and diluted at 1/100 concentration. Colony numbers were measured as colony forming units. mL(-1) at 0, 2, 4, 6, 8, 10 and 12th hours. Results: Ephedrine either alone or combined with propofol did not have an antimicrobial effect on Escherichia coli, Enterococcus faecium, or Pseudomonas aeruginosa and this was similar to propofol. However, ephedrine alone and combined with propofol was found to have an antimicrobial effect on Staphylococcus aureus and Acinetobacter species at 512 mcg. mL(-1) concentration and significantly decreased bacterial growth rate. Conclusion: Ephedrine has an antimicrobial activity on Staphylococcus aureus and Acinetobacter species which were frequently encountered pathogens as a cause of nosocomial infections. (C) 2017 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.
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    Are physicians aware of current HIV / AIDS diagnostic practices? A study from a tertiary centre in Turkey
    (J INFECTION DEVELOPING COUNTRIES, 2018) Alasehir, Elcin Akduman; Yesilbag, Zuhal; Karadeniz, Asli; Yaman, Gorkem
    Introduction: Early diagnosis of HIV infection is essential for the reduction of morbidity/mortality rates, health expenditures and the prevention of infection spread. In this study we aimed to test the knowledge of physicians regarding HIV risk groups, AIDS indicator diseases and their current practices about screening. Methodology: A questionnaire was used to collect data from physicians working in a multidisciplinary 170-bed tertiary university hospital in Istanbul, Turkey. The questionnaire measured physician knowledge of the above-mentioned points. Results: Ninety-six physicians replied to the questionnaire. "Preoperative screening" was found to be the most common (65.6%) indication for HIV testing. A large portion of physicians (72.9%) felt comfortable with an HIV test and 71.9% of the physicians had no impeding condition for HIV testing. Physicians were mostly (67.7%) unaware of the current guidelines for HIV testing. Conclusions: Teaching programs are essential to increase knowledge of HIV screening for physicians as this is an essential part of early diagnosis and therefore important for decreasing morbidity and mortality.
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    Can high volume pericapsular nerve group (PENG) block act as a lumbar plexus block?
    (ELSEVIER SCIENCE INC, 2020) Alasehir, Elcin Akduman; Ipek, Belkiz Ongen; Thomas, David Terence; Ercan, Tugba Erener; Sitar, Mustafa Erinc
    Can high volume pericapsular nerve group (PENG) block act as a lumbar plexus block?
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    Evaluation of Treatment Applications and Antibiotic Resistance Rates for Community Acquired Urinary Tract Infections in Turkey and a Review of the Literature
    (GALENOS YAYINCILIK, 2020) Eroglu, Askin; Alasehir, Elcin Akduman
    Objective: Increased extended-spectrum beta lactamase (ESBL) production is associated with higher rates of community-acquired strains in urinary tract infections (UTI) leading to an increase in the resistance rates, duration of treatment and costs. We aimed to investigate the resistance rates of ESBL-positive urine culture strains in our clinic, reviewed the literature and analysed antibiotics used in UTI treatment in outpatients in Turkiye. Materials and Methods: 2913 patients who were admitted to the outpatient clinics of Maltepe University Faculty of Medicine and Baskent University Faculty of Medicine were evaluated retrospectively. Data on prescribed antibiotics in outpatients with the diagnosis of UTI from all cities of Turkiye were collected through the Turkish Ministry of Health, Turkish Medicines and Medical Devices Agency. Results: Out of 563 ESBL-positive (19.3%) urine culture isolates, 450 (79.9%) were Escherichia coli and 89 (15.8%) were Klebsiella sp. Resistance rates were as follows: 98.8% to cefuroxime, 67.6% to ciprofloxacin, 12.5% to fosfomycin, 8.7% to amikacin, 1.4% to meropenem and 15% to nitrofurantoin. The most commonly prescribed antibiotics were ciprofloxacin (22.25%), fosfomycin (21.10%) and nitrofurantoin (12.82%). Conclusion: Our study suggests that the antibiotic resistance rates of most antibiotics prescribed for UTI in Turkiye are above the suggested rate of 10-20% to be used as empirical therapy. Updating and dissemination of guidelines for UTI in the light of antibiotic prescribing and resistance surveillance studies will contribute to the rational use of antibiotics in Turkiye.
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    Frequency of precore/core mutants in chronic Hepatitis B cases
    (Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2013) Akçalı, Sinem; Sanlidag, Tamer; Bicmen, Can; Özbakkaloğlu, Beril; Alasehir, Elcin Akduman
    Objective: In recent years, the presence of precore/core region mutations were uncovered by the examination of Hepatitis B Virus (HBV) deoxyribonucleic acid (DNA) that is isolated from patient samples with anti-HBe seroconversion without viral replication loss. In this study, the frequency of precore/core mutations were investigated on serum samples obtained from chronic hepatitis B patients. Methods: From a total of 100 samples 69 anti-HBe and HBV DNA positive, and 31 HBeAg and HBV DNA positive samples were analyzed in the study to determine the mutations with the INNO-LIPA method at the Serology laboratory. Statistical analyses were bone with, SPSS v11.5 and chi-square and variance analysis (ANOVA) tests were conducted. Results: The precore mutations were detected in 68, while the core promoter mutations were present in 57 samples. Mutations were detected at the precore region in 11 out of 31 HBeAg positive (35%), and 57 out of 69 anti-HBe positive samples (83%). Likewise, the core promoter region was affected in 10 of 31 HBeAg (32%), and 47 out of 69 anti-HBe positive samples (68%). Both precore and core promoter mutations were substantially higher in the anti-HBe positive group (p<0.05). Conclusion: As a result, since precore/core mutations were prevalent in samples obtained from the study group, it is our opinion that careful attention must be paid to such mutations during the diagnosis and treatment phases of chronic hepatitis B patients.
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    Idiopathic chylothorax in geriatrics: the oldest case report so far
    (WALTER DE GRUYTER GMBH, 2018) Ipek, Belkiz Ongen; Alasehir, Elcin Akduman; Sitar, Mustafa Erinc; Levent, Ender; Orki, Alpay
    Chylothorax is a rare condition characterized by accumulation of chylous fluid in the pleural space resulting in impaired ductus thoracic integrity. It can be an outcome of a traumatic process, although there are a few non-traumatic and/or idiopathic cases in current literature. In this article, we present the oldest case report so for, who is an 87-year-old woman complaining of acute respiratory distress symptoms with pleural effusion having no trauma history. The patient was analyzed for the disease etiology strenuously. Thoracentesis was performed together with imaging modalities and detailed systemic laboratory tests. Non-surgical treatment was successful as the outcome.
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    Seroepidemiology of hepatitis viruses, measles, mumps, rubella and varicella among healthcare workers and students: Should we screen before vaccination?
    (ELSEVIER SCIENCE LONDON, 2020) Karadeniz, Asli; Alasehir, Elcin Akduman
    Background: Health care workers (HCWs) and students are at increased risk for blood borne infections and vaccine preventable diseases (VPDs). The aim of this study was to determine the seroprevalence of antibodies against measles, rubella, mumps, varicella zoster virus (VZV), hepatitis A and B viruses among HCWs and students and to determine whether there are differences according to gender and age group. Methods: Information about characteristics of the 1053 participants, history of disease and vaccination status were collected using a structured questionnaire. Serum samples were tested for antibodies by commercial immunoenzymatic assays. Results: Seropositivity rates were 57.1% for measles, 74% for mumps, 96.3% for rubella, 93.7% for VZV, 33.9% for hepatitis A virus and 92.2% for hepatitis B virus. Susceptibility rates among participants 18-26, 27-38 and >38 years of age were statistically significant for measles (46%, 18.6% and 0%; p < 0.001) and mumps (27.1%, 12.9% and 21.4%; p < 0.05), respectively. Conclusion: Low seropositivity rates for measles, mumps and HAV are important findings. For other diseases other than VZV, it is thought that vaccination without pre-screening is more appropriate. Healthcare institutions should have policies for screening and vaccination of their staff and students. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences.