Browsing by Author "Yapici, Kubilay"

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A Familial Outbreak of Fascioliasis in Eastern Anatolia: A Report With Review of Literature
(Elsevier, 2011) Karahocagil, Mustafa Kasim; Akdenin, Hayrettin; Sunnetcioglu, Mahmut; Cicek, Muttalip; Mete, Rafet; Akman, Nevzat; Yapici, Kubilay
Aim: To present the results of a cross-sectional epidemiological analysis of a familial outbreak of fascioliasis in Eastern Anatolia and to discuss the clinical, diagnostic and therapeutic properties of the patients. Materials and methods: A screening group consisting of 92 individuals from the same family with a history of watercress ingestion and a control group consisting of 30 individuals from neighboring families were included in the study. In both groups, full blood count, erythrocyte sedimentation rate, liver function tests and total IgE levels were assessed. Stool analysis was performed on three consecutive days with native, lugol and sedimentation methods. The diagnosis was based on the detection of parasite ova in the stool or alternatively based on consistent clinical, laboratory, and radiological findings or positive clinical findings in combination with a positive ELISA test. Abdominal ultrasonography and computerized tomography scans were performed on all patients. Results: 24 patients (21 women and 3 men) were diagnosed with fascioliasis. The mean age was 24.5 +/- 18.6 years (range, 5-64 years). All cases had a history of watercress ingestion, malaise, fatigue, lack of appetite, and abdominal pain. Clinical features included: weight loss was present in 18 cases (75%). dyspepsia in 12 (50%), headache in 11(45.8%), sweating in 10 (41.7%), fever and dyspnea each in 8 (33.3%), nausea and vomiting in 6 (25%), and itching in 4 (16.75). The most common laboratory abnormalities were total IgE elevation in 19 cases (79.2%) and eosinophilia in 17 (70.8%). The eosinophilia was >20% in 14 cases (58.3%) and the total IgE was >500 IU/ml in 15 cases (62.5%). Stool examination for ova was positive in 11 cases. 10 patients had positive clinical, laboratory and radiological findings. A further three patients were diagnosed based on their clinical findings and their ELISA results. All cases had positive ELISA results. All patients, except one pregnant woman, were treated with 10 mg/kg triclabendazole. Two patients required a second treatment course of triclabendazole 20 mg/kg in two divided doses due to persistence of ova in the stool. One patient who developed acute urticaria as a side effect of the drug was given three additional courses of 10 mg/kg triclabendazole in combination with prednisolone and antihistamines. The pregnant woman initially received four courses of 25 mg/kg praziquantel treatment for 1 week. As ova were still detected in her stool following delivery, she was subsequently treated with triclabendazole. Conclusions: One case of fascioliasis may indicate a familial outbreak. In the acute stage radiological investigations can assist in confirming the diagnosis. ELISA testing is a reliable and sensitive method for the diagnosis of fascioliasis during any stage of the disease and may also be useful during follow-up. (C) 2008 Elsevier B.V. All rights reserved.
Severe Thrombocytopenia and Hemorrhagic Diathesis Due To Brucellosis
(Acad Medical Sciences I R Iran, 2012) Karsen, Hasan; Duygu, Fazilet; Yapici, Kubilay; Baran, Ali Irfan; Taskiran, Huseyin; Binici, Irfan
Background: We aimed to examine cases of brucellosis that presented with severe thrombocytopenia and hemorrhagic diathesis. Methods: A total of 10 brucellosis cases with severe thrombocytopenia were included in this case-series study. Patients' files were reviewed for their clinical and laboratory findings, as well as clinical outcomes and complications. Platelet counts of < 20000/mm(3) were diagnosed as severe thrombocytopenia. Results: The lowest thrombocyte count was 3000/mm(3) while the highest was 19000/mm(3) (mean: 12000/mm(3)). Patients had the following symptoms: epistaxis (7 cases), petechia with epistaxis (4 cases), bleeding gums (3 cases), ecchymosis with epistaxis (2 cases), melena and renal failure (2 cases), and hematuria (1 case). Patients were given rifampicin and doxycycline along with supportive hematological therapy. All were treated successfully with no evidence of recurrence at follow-up visits. Conclusion: Since brucellosis is endemic in developing countries, it must be considered in the differential diagnosis of cases that present with severe thrombocytopenia and hemorrhagic diathesis.
Weil's Disease. a Case Report
(Doc design informatics Co Ltd, 2008) Karsen, Hasan; Karahocagil, M. Kasim; Sunnetcioglu, Mahmut; Yapici, Kubilay; Ekin, Selami
A 40-year old male patient with hepatitis, acute renal failure and confusion was admitted to our clinic. The patient was diagnosed as Weil's disease based on his clinical and laboratory findings, and he completely recovered with medical treatment.