Search results for: Mücahit Ünal

Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

Abstract:

Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

Procedia PDF Downloads 267

Authors: Halil Bas, Unal Demiray, Sukru Dursun

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Water and ground water pollution at the most of the countries is important problem. Investigation of water pollution source must be carried out to save fresh water. Because fresh water sources are very limited and recent sources are not enough for increasing population of world. In this study, investigation was carried out on pollution factors effecting the quality of the groundwater in Çorum Stream Basin in Turkey. Effect of geological structure of the region and the interaction between the stream and groundwater was researched. For the investigation, stream and groundwater sampling were performed at rainy and dry seasons to see if there is a change on quality parameters. The results were evaluated by the computer programs and then graphics, distribution maps were prepared. Thus, degree of the quality and pollution were tried to understand. According to analysis results, because the results of streams and the ground waters are not so close to each other we can say that there is no interaction between the stream and the groundwater. As the irrigation water, the stream waters are generally in the range between C3S1 region and the ground waters are generally in the range between C3S1 and C4S2 regions according to US Salinity Laboratory Diagram. According to Wilcox diagram stream waters are generally good-permissible and ground waters are generally good permissible, doubtful to unsuitable and unsuitable type. Especially ground waters are doubtful to unsuitable and unsuitable types in dry season. It may be assumed that as the result of relative increase in concentration of salt minerals. Especially samples from groundwater wells bored close to gypsium bearing units have high hardness, electrical conductivity and salinity values. Thus for drinking and irrigation these waters are determined as unsuitable. As a result of these studies, it is understood that the groundwater especially was effected by the lithological contamination rather than the anthropogenic or the other types of pollution. Because the alluvium is covered by the silt and clay lithology it is not affected by the anthropogenic and the other foreign factors. The results of solid waste disposal site leachate indicate that this site would have a risk potential for pollution in the future. Although the parameters did not exceed the maximum dangerous values it does not mean that they will not be dangerous in the future, and this case must be taken into account.

Keywords: Çorum, environment, groundwater, hydrogeology, geology, pollution, quality, stream

Procedia PDF Downloads 501

Authors: Muge Unal, Cengiz Uslu, Mehmet Faruk Altunkasa

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Walkability relates to the ability of the places to connect people with varied destinations within a reasonable amount of time and effort, and to offer visual interest in journeys throughout the network. So, the good quality of the physical environment and arrangement of walkway and sidewalk appear to be more crucial in influencing the pedestrian route choice. Also, proximity, connectivity, and accessibility are significant factor for walkability in terms of an equal opportunity for using public spaces. As a result, there are two important points for walkability. Firstly, the place should have a well-planned street network for accessible and secondly facilitate the pedestrian need for comfort. In this respect, this study aims to examine the both physical and bioclimatic comfort levels of the current condition of pedestrian route with reference to design criteria of a street to access the urban green spaces. These aspects have been identified as the main indicators for walkable streets such as continuity, materials, slope, bioclimatic condition, walkway width, greenery, and surface. Additionally, the aim was to identify the factors that need to be considered in future guidelines and policies for planning and design in urban spaces especially streets. Adana city was chosen as a study area. Adana is a province of Turkey located in south-central Anatolia. This study workflow can be summarized in four stages: (1) environmental and physical data were collected by referred to literature and used in a weighted criteria method to determine the importance level of these data , (2) environmental characteristics of pedestrian routes gained from survey studies are evaluated to hierarchies these criteria of the collected information, (3) and then each pedestrian routes will have a score that provides comfortable access to the park, (4) finally, the comfortable routes to park will be mapped using GIS. It is hoped that this study will provide an insight into future development planning and design to create a friendly and more comfort street environment for the users.

Keywords: comfort level, geographical information system (GIS), walkability, weighted criteria method

Procedia PDF Downloads 311

Authors: Cansu Arslan Turan, Tuba Cimilli Ozturk, Ebru Unal Akoglu, Kemal Aygun, Ecem Deniz Kırkpantur, Ozge Ecmel Onur

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Although the mechanism of action is not well known, Intravenous Lipid Emulsion (ILE) has been shown to be effective in the treatment of lipophilic drug intoxications. It is thought that ILE probably separate the lipophilic drugs from target tissue by creating a lipid-rich compartment in the plasma. The second theory is that ILE provides energy to myocardium with high dose free fatty acids activating the voltage gated calcium channels in the myocytes. In this study, the effects of ILE treatment on digoxin overdose which are frequently observed in emergency departments was searched in an animal model in terms of cardiac side effects and survival. The study was carried out at Yeditepe University, Faculty of Medicine-Experimental Animals Research Center Labs in December 2015. 40 Sprague-Dawley rats weighing 300-400 g were divided into 5 groups randomly. As the pre-treatment, the first group received saline, the second group received lipid, the third group received DigiFab, and the fourth group received DigiFab and lipid. Following that, digoxin was infused to all groups until death except the control group. First arrhythmia and cardiac arrest occurrence times were recorded. As no medication causing arrhythmia was infused, Group 5 was excluded from the statistical analysis performed for the comparisons of first arrhythmia and death time. According to the results although there was no significant difference in the statistical analysis comparing the four groups, as the rats, only exposed to digoxin intoxication were compared with the rats pre-treated with ILE in terms of first arrhythmia time and cardiac arrest occurrence times, significant difference was observed between the groups. According to our results, using DigiFab treatment, intralipid treatment, intralipid and DigiFab treatment for the rats exposed to digoxin intoxication makes no significant difference in terms of the first arrhythmia and death occurrence time. However, it is not possible to say that at the doses we use in the study, ILE treatment might be successful at least as a known antidote. The fact that the statistical significance between the two groups is not observed in the inter-comparisons of all the groups, the study should be repeated in the larger groups.

Keywords: arrhytmia, cardiac arrest, DigiFab, digoxin intoxication

Procedia PDF Downloads 234

Authors: Gizem Kodak, Alper Unal, Birsen Koldemir, Tayfun Acarer

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Turkish Straits System which consists of Istanbul Strait (Bosphorus), Canakkale Strait (Dardanelles) and the Marmara Sea has a strategical location on international maritime as it is a unique waterway between the Mediterranean Sea, Black Sea and the Aegean Sea. Thus, this area has great importance since it is the only waterway between Black Sea countries and the rest of the World. Turkish Straits System has dangerous environmental factors hosts more vessel every day through developing World trade and this situation results in expanding accident risks day by day. Today, a lot of precautions have been taken to ensure safe navigation and to prevent maritime accidents, and international standards are followed to avoid maritime accidents. Despite this, the environmental factors that affect this area, trigger the maritime accidents and threaten the vessels with new accidents risks in different months with different hazards. This descriptive study consists of temporal and spatial analyses of environmental factors causing maritime accidents. This study also aims at contributing to safety navigation including monthly and regionally characteristics of variables. In this context, two different data sets are created consisting of environmental factors and accidents. This descriptive study on the accidents between 2001 and 2017 the mentioned region also studies the months and places of the accidents with environmental factor variables. Environmental factor variables are categorized as dynamic and static factors. Dynamic factors are appointed as meteorological and oceanographical while static factors are appointed as geological factors that threaten safety navigation with geometrical restricts. The variables that form dynamic factors are approached meteorological as wind direction, wind speed, wave altitude and visibility. The circulations and properties of the water mass on the system are studied as oceanographical properties. At the end of the study, the efficient meteorological and oceanographical parameters on the region are presented monthly and regionally. By this way, we acquired the monthly, seasonal and regional distributions of the accidents. Upon the analyses that are done; The Turkish Straits System that connects the Black Sea countries with the other countries and which is one of the most important parts of the world trade; is analyzed on temporal and spatial dimensions on the reasons of the accidents and have been presented as environmental factor dynamics causing maritime accidents.

Keywords: descriptive study, environmental factors, maritime accidents, statistics

Procedia PDF Downloads 202

Authors: F. Nur Baran Aksakal, Özge Dinç, H. Tanju Besler, Begüm Mutuş, Özlem Üliç Çatar, Orhan Aydoğdu, Serhat Ünal

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Healthy eating habits are associated not only with the newborn, child, and maternal health but also with longer life expectancy by acting as a protective factor against non-communicable diseases such as obesity, diabetes, cardiovascular diseases, and cancer. The role of nutrition in medical education is to provide information about the relationship between healthy nutrition and malnutrition as well as diet-related non-communicable diseases. Considering the information pollution experienced in the field of nutrition and health in the society, it is seen that more than half of the population receives information from family physicians as the closest counseling unit. However, postgraduate nutrition education programs for physicians and other health professionals who wish to improve their current knowledge of the role of nutrition communication in the prevention and management of chronic diseases are limited worldwide. However, nutrition courses are either not included in the undergraduate medical education curriculum of physicians or they are insufficient. Based on this need, the main aim of the study group was to develop a "Nutrition and Nutrition Communication Training for Physicians" program that would be conducted in cooperation with the Sabri Ülker Foundation and the Federation of Family Physicians Associations (AHEF). This program is the first online nutrition and nutrition communication information platform for physicians in Turkey. This program aims to present the concept of adequate and balanced nutrition to physicians, the importance of nutrition in diseases with scientific data, and to gain communication skills that may be necessary while transferring scientific information to the public. A needs assessment questionnaire was applied to identify pre-program training needs. A study plan was made to allow the participation of all family physicians in the population, and a complete inventory was targeted. In other words, we aimed to reach the whole source without taking a section of the population. Participation in the training is based on volunteerism. The needs assessment study is conducted using 25,102 family physicians for whom email addresses are available. The online questionnaire was sent to all the family physicians with a reminder email one week after the first one, and 1308 responded. Considering the topics determined, a training program was prepared for family physicians under eight online training titles, starting in March 2022, and conducted once every two weeks. The number of audience members present at each session was between 1217 and 1673, and a minimum of 17 and a maximum of 53 questions were received in each session. We strongly believe that to prevent individuals' health problems and to have better control over chronic diseases, the information level of physicians should be increased via these kinds of interventions, and better collaboration between family physicians and dieticians should be established.

Keywords: nutrition communication, nutrition training, communication, nutrition

Procedia PDF Downloads 99

Authors: Demet Devrimsel Dogan, Ecem Deniz Kirkpantur, Muharrem Dogan, Ahmet Aykut, Ebru Unal Akoglu, Ozge Ecmel Onur

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Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain due to external compression of the celiac trunk by a fibrous arch that unites diaphragmatic crura on each side of the aortic hiatus. While 10-24% of the population may suffer from compression of celiac trunk, it rarely causes patients to develop symptoms. The typical clinical triad of symptoms includes postprandial epigastric pain, weight loss and vomiting. The diagnosis can be made using thin section multi-detector computed tomography (CT) scans which delineate the ligament and the compressed vessel. The treatment of MALS is aimed at relieving the compression of the celiac artery to restore adequate blood flow through the vessel and neurolysis to address chronic pain. Case: A 68-year-old male presented to our clinic with acute postprandial epigastric pain. This was patients’ first attack, and the pain was the worst pain of his life. The patient did not have any other symptoms like nausea, vomiting, chest pain or dyspnea. In his medical history, the patient has had an ischemic cerebrovascular stroke 5 years ago which he recovered with no sequel, and he was using 75 mg clopidogrel and 100 mg acetylsalicylic acid. He was not using any other medication and did not have a story of cardiovascular disease. His vital signs were stable (BP:113/72 mmHg, Spo2:97, temperature:36.3°C, HR:90/bpm). In his electrocardiogram, there was ST depression in leads II, III and AVF. In his physical examination, there was only epigastric tenderness, other system examinations were normal. Physical examination through his upper gastrointestinal system showed no bleeding. His laboratory results were as follows: creatinine:1.26 mg/dL, AST:42 U/L, ALT:17 U/L, amylase:78 U/L, lipase:26 U/L, troponin:10.3 pg/ml, WBC:28.9 K/uL, Hgb:12.7 gr/dL, Plt:335 K/uL. His serial high-sensitive troponin levels were also within normal limits, his echocardiography showed no segmental wall motion abnormalities, an acute myocardial infarction was excluded. In his abdominal ultrasound, no pathology was founded. Contrast-enhanced abdominal CT and CT angiography reported ‘thickened diaphragmatic cruras are compressing and stenosing truncus celiacus superior, this is likely compatible with MALS’. The patient was consulted to general surgery, and they admitted the patient for laparoscopic ligament release. Results: MALS is a syndrome that causes postprandial pain, nausea and vomiting as its most common symptoms. Affected patients are normally young, slim women between the ages of 30 and 50 who have undergone extensive examinations to find the source of their symptoms. To diagnose MALS, other underlying pathologies should initially be excluded. The gold standard is aortic angiography. Although diagnosis and treatment of MALS are unclear, symptom resolution has been achieved with multiple surgical modalities, including open, laparoscopic or robotic ligament release as well as celiac ganglionectomy, which often requires celiac artery revascularisation.

Keywords: differential diagnosis, epigastric pain, median arcuate ligament syndrome, celiac trunk

Procedia PDF Downloads 261