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Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics.

Dünya hayatında zaman zaman, hayatı zorlaştıran, insanların mutsuz olmasına ve maddi zarara yol açan, hatta ölümle sonuçlanan ve beşer gücü ile kontrol edilemeyen büyük toplumsal olaylar yaşanmaktadır. Türkçede belâ ve musibet olarak adlandırılan büyük toplumsal olaylarla ilgili insanların ortaya koydukları yaklaşımları ve tepkileri, sahip oldukları inanç ve dünya görüşüne göre şekillenir. Kur’ani öğretiye göre hayatın baştan sona bir sınav olduğunu bilen müslümanlar toplumsal olayları sabırla karşılarlar ve mevcut durumdan en az zararla çıkmak için bir takım tedbirler geliştirirler. 2020 yılında bütün dünyada etkili olan pandemiyi (Covid-19) kimileri komplo teorileriyle açıklarken müslümanlar bunu ilahi bir sınama ve ilahi kudretin karşısında kulun aciz kalması şeklinde yorumlamışlardır. Türkçede belâ kelimesi büyük sıkıntı anlamında, fitne kelimesi ise genellikle toplumsal kargaşa anlamında kullanılmaktadır. Sabır denilince de sıkıntı karşısında pasif bekleyiş anlaşılmaktadır. Biz bu makalede, hem insanların büyük toplumsal olaylar karşısında almaları gereken tavrın ne olması gerektiğini, hem de bu olaylarla ilgili Kur’an’ın anahtar kavramları olan belâ, fitne ve sabrın etimolojik ve semantik anlamlarını Kur’an ve tefsir kaynakları bağlamında açıklığa kavuşturmayı amaçladık. Yaptığımız araştırma, inceleme ve tahliller sonucunda Kur’ân’da belâ ve fitne kelimelerinin büyük olay, kargaşa anlamlarının yanı sıra daha çok, ilâhî sınama ve deneme anlamlarında kullanıldığı anlaşılmaktadır. Buna göre Allah bazılarına çok, bazılarına da az nimet vererek kullarını sınamaktadır. Aile fertleri, komşular, akrabalar ve iş arkadaşları bir biri için bir sınav vesilesidir. Geçici veya kronik hastalıklar, salgın hastalıklar, bedensel veya ruhsal engellilik durumu, yaşlılık ve beklenmedik ölümler de herkesin karşılaşabileceği ağır sınavlardandır. Bu çalışma ile ilâhî sınamanın ve sabrın mahiyetini biraz daha vuzuha kavuşturmayı umuyoruz.

The aim: The Japanese word “ikigai” indicates “something to live for” and “having a purpose in life”. Ikigai or well-being, has been associated with many positive outcomes in the physical and mental health of elderly people. In this study, the relationship between ikigai and level of physical activity and polypharmacy was examined in a Turkish population. Material and methods: Both telephonic interviews and face-to-face interviews were conducted with 307 participants (59.2 % women) who completed the Ikigai-9 Turkey Scale and provided demographic information. Results: Correlations between groups (polypharmacy vs. non-polypharmacy) were analyzed with an independent t-test and analysis of variance. The means of the ikigai scores were statistically significant in the polypharmacy (24.04±8.72) and non-polypharmacy 32.64±7.53) groups (p

Purpose Recent studies have shown that cytokines secreted from adipose tissues play a role in the pathogenesis of type 2 diabetes mellitus (T2DM). CTRP5 (C1q-TNF-related protein 5) is a novel adipokine that has been shown to be associated with glucose and lipid metabolism. Varying levels of CTRP5 have been reported in individuals with diabetes, obesity and coronary artery disease. The aim of this study was to examine serum levels of CTRP5 and to show the relationship with cardiometabolic parameters in T2DM patients. Method The study included 40 T2DM patients and 40 age- and sex-matched healthy control subjects. All the study participants were evaluated with respect to BMI, waist circumference, lipid profile, insulin resistance (HOMA-IR), serum CTRP5 levels, carotid intima-media thickness, and hs-CRP. Results No statistically significant differences were found between the control group and the diabetic group in terms of age, sex, or BMI. Serum CTRP5 levels (T2DM = 94.55 +/- 28.70 ng/ml, control = 76.02 +/- 27.22 ng/ml,P = 0.004*) were significantly higher in the group of newly diagnosed diabetic patients. A positive correlation was found between CTRP5 and the cardiometabolic parameters of carotid intima-media thickness (CIMT), hs-CRP, HOMA-IR and BMI. Regression analysis results showed that CTRP5 levels were independently correlated with insulin resistance estimated by HOMA-IR. Conclusion Serum CTRP5 levels were correlated with cardiometabolic parameters and could therefore be a promising indicator of metabolic status and a possible biomarker of insulin resistance. However, the contradictory results reported in different studies indicate the need for further research to assess the significance of CTRP5 for diagnosis and monitoring of treatment efficacy.

Background: As we know that close contact is the main reason of the contagious diseases, caregivers are at higher risk for diseases that we can prevent by vaccines. In present study, we aim at revealing an example of clinical inertia in geriatrics, which shows us the status of vaccination both in a group of older patients and their caregivers. Materials and Methods: Both the caregivers and their dependent geriatric patients were included, and the selection of the participants was designed on a random and volunteer basis. We performed the study with a phenomenological design and asked the participants their vaccination status. For the participants that were not vaccinated, the reasons were questioned with a demographic form. Correlations between parameters were analyzed with an independent t-test and analysis of variance. SPSS (IBM SPSS for Windows, ver.24) was used to analyze the data, which were saved in excel files. Results: A total of 144 caregivers with 21 men (14.6%) and 123 female (85.4%) were included in the study. A total of 111(77.1%) caregivers had never been vaccinated before, while 21 (14.6%) caregivers were vaccinated occasionally, and finally, 12 (8.3%) caregivers were vaccinated on a regular base. The vaccination status of the older adults was as follows: 42 patients (29.2%) had never been vaccinated before, 60 (41.7%) had been vaccinated occasionally, and 42 (29.2%) patients had been vaccinated regularly. Conclusion: The vaccination rates of caregivers and older patients were lower than we expected, so primary-care providers need to plan more vaccination awareness studies in social media and communities. Clinical inertia might be an essential reason in the lower vaccination rates of the caregivers and older adults’ population.

The aim: İkigai, or well-being, has been associated with many positive outcomes in the physical and mental health of elderly people. In the present study, we conducted a validity and reliability study of the İkigai-9 scale in Turkish society and outlined its associations with facets of well-being.Methods: A translation, re-translation method was used to create linguistic equivalence of the İkigai-9 scale in the Turkish language. The correlations between the İkigai-9 Turkish version with the Warwick Edinburgh Mental Well-being Scale Short Form and the Depression Anxiety Stress Scale (DASS-21) were studied. Face-to-face interviews were conducted with volunteers regarding the scale. Data were saved in excel files and analyzed with SPSS (IBM SPSS for Windows, ver.24).Results: The findings confirmed the validity and reliability of the İkigai-9 Turkish version using 382 participants. The total scores on the İkigai-9 Turkish version were correlated positively with mental well-being and negatively correlated with depression, anxiety, and depression (p0.05).Conclusions: İkigai and studies related to the concept of mental well-being should be widened and expanded across nations. These studies could be beneficial to healthcare providers to attenuate the impact of suffering from various diseases. We present the İkigai-9 Turkish version for further study in both in the national and international contexts that healthcare workers could compare their results in other countries.

While the value of preventive healthcare services comes up repeatedly, the healthcare professionals are now trying to find solutions for the expanding geriatric population's problems before they occur. The risk of drug-drug interactions may get preventively reduced in older patients with the selection of co-medications that are less likely to interact. The choice of drugs for older patients is crucial when commencing with potential incriminated agents together, such as, serotonin and norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, diuretics, proton pump inhibitors, nonsteroidal anti-inflammatory drugs, etc., which could interact with each other and cause hyponatremia in a short period of time. In this paper, a rare case of an older patient with venlafaxineinduced hyponatremia has been presented.

Carotid body tumors (CBTs) or chemodectomas are non-chromaffin paragangliomas. Carotid body tumors appear as painless, slowly expanding masses located in the upper part of the neck under the chin. On physical examination, it presents as a soft, non-tender mass in the lateral aspect of the neck that can move more freely in a horizontal plane than vertically, referred to as a positive Fontaine sign. The differential diagnosis of a lateral neck mass, rarely seen in adults, includes lymphadenopathy, branchial cleft cysts, salivary gland tumors, neurogenic tumors, and carotid artery aneurysms. A 62-year-old female patient presented with only neck swelling. CBTs are rarely detected in the etiology in cases of lymphadenomegaly. We wanted to present the case to the literature.

Background Neudesin is a protein that is secreted from adipose tissue and central nervous system and has a regulatory function on energy metabolism. Although the effect of this protein is shown in the experimental model of type-2 diabetes mellitus (Type-2DM), its effect in humans is not clearly known. In this study, we aimed to evaluate the relationship between serum neudesin level and metabolic, anthropometric and cardiovascular parameters in newly diagnosed Type-2 DM patients (Group 1). Methods Forty patients in each were included in our study for Group 1 and for the control group (Group 2), which consisted of age and sex-matched healthy subjects. Serum neudesin, hs-CRP, carotid intima media thickness (CIMT), body mass index (BMI) and insulin resistance (HOMA-IR) levels were compared prospectively. Results Serum neudesin levels were significantly higher in diabetic patients than in the control group (Type 2 DM = 64.69 ± 3.06 ng / ml, Control = 55.52 ± 5.48 ng / ml, P = 0.004 *). There was an independent relationship between serum neudesin and HOMA-IR and BMI. Although there is a correlation between serum neudesin and CIMT ; this feature disappeared in the regression analysis. Conclusions Serum neudesin increased in new diagnosis Type-2 DM patients. This increase seems to be related to obesity and insulin resistance. However, more extensive research is needed to clarify this issue.

Background and Objectives: With this study, for the first time among patients diagnosed with COVID-19, the neutro- phil-lymphocyte-ratios of men and women were compared. Materials and Methods: The study was conducted with 80 patients and the data was gained retrospectively on the electronic documents of the hospital. Results: The neutrophil-lymphocyte-ratio was statistically significant and higher in the male than the women for all ages and geriatric patients (p

Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome following acute stroke and it continues to be effective for many years. This consensus-based guideline is not only a good address to clinical questions in practice for the clinical management of dysphagia including management, diagnosis, follow-up, and rehabilitation methods, but also includes detailed algorithms for these topics. The recommendation paper has been written by a multidisciplinary team and offers 117 recommendations for stroke patients with dysphagia. While focusing on management principles, diagnosis, and follow-up in the 1st part (45 items), rehabilitation details were evaluated in the 2nd part (72 items).

Cennet, Allah’ın iman eden ve sâlih amel işleyen kullarına mükâfat olarak hazırladığı ebedî mutluluk yurdudur. Kur’ân’da ve hadis-i şeriflerde, cennetin mahiyeti, cennet nimetleri, yiyecekler, içecekler ve yaşanacak müreffeh bir hayata dair bilgiler yer almaktadır. Kur’ân’da cennet tasvirleri ve cennet nimetlerinin adı, temsilî bir anlatımla ifade edilmekte, dünyada insanlar tarafından bilinen nesnelerden hareketle bilinmeyen âlem (gayb) hakkında bilgi verilmektedir. Dünyadaki nesnelerle cennetteki nesneler arasında sadece isim benzerliği vardır. Mahiyeti ise insan tasavvurunu aşmaktadır. Kur’ân’da mekân olarak cennet ve cennet nimetleri, dünyadaki en güzel yerlere, dünya nimetlerinin en güzeline ve insanların en çok arzuladığı şeylere benzetilerek tarif edilmiştir. Müteşabihattan olan bu anlatımı, hakikatin, temsilî bir tasviri olarak görmek gerekir. Kur’ân’da cennetliklere, yaşıt eşler, yemyeşil bahçeler, ferahlatıcı gölgelikler, saraylar, her türlü lezzetli meyveler, sarhoş etmeyen içkiler vaat edilmektedir. Nebe Sûresi 33. âyete meallerde ve tefsir kaynaklarında çoğunlukla “göğsü tomurcuklanmış kız” anlamı verilmiştir. Bu da cennette erkeklere verilecek eşlerin yeni ergenlik çağındaki kızlar şeklinde anlaşılmasına yol açmıştır. Ancak âyette yer alan kevâiŅb kelimesinin güzel görünümlü, şerefli, etrâb kelimesinin de “yaşıt eşler” şeklindeki anlamı dikkate alındığında söz konusu âyeti “güzel görünümlü, şerefli, yaşıt eşler” şeklinde anlamlandırmak daha uygun düşmektedir.

Background Growing evidence suggest that macrophage migration inhibitory factor (MIF) plays a vital role in glucose metabolism. We aimed to ascertain whether MIF levels are altered in subjects with prediabetes and also to determine the relationship between MIF and metabolic parameters as well as visceral fat mass. Material and Methods This cross-sectional study included 40 subjects with prediabetes and 40 age-, body mass index (BMI)- and sex-matched subjects with normal glucose tolerance. Circulating MIF levels were measured using enzyme-linked immunosorbent assay. Metabolic parameters of recruited subjects were evaluated. Visceral fat mass was measured using bioelectrical impedance method. Results Circulating MIF levels were found to be elevated in subjects with prediabetes compared to controls (26.46 ± 16.98 versus 17.44 ± 11.80 ng/mL, P = 0.007). MIF positively correlated with BMI, visceral fat mass and indirect indices of homeostasis model assessment of insulin resistance. In linear regression model, an independent association was found between MIF levels and metabolic parameters, including BMI, visceral fat mass and homeostasis model assessment of insulin resistance. Multivariate logistic regression analyses revealed that the odds ratio for prediabetes was higher in subjects in the highest quartile of MIF compared to those in the lowest quartile, after adjusting for potential confounders. Conclusions Increased MIF levels are associated with the elevation of prediabetic risk.

Ganodermalucidum (Lingzhi in Chinese and Reishi in Japanese) is a popular medicinalmushroom and has been used for about 2.000 years in Chinese medicine. In thelast 30 years, this fungi has been investigated by modern pharmacologists.Several studies showed that G. lucidum is effective in modulating immunefunctions and inhibiting tumor growth. Other than these effects, G. lucidum hasalso been demonstrated that it can be used in the treatment of hypertension,hyperlipidemia, diabetes mellitus, nephritis, asthma, arthritis, inflammatorybowel diseases and many other diseases. The certain mechanism of these effectsis still unclear. So, G. lucidum is not suggested as a therapeutic agent. It isutilized mostly as an immune enhancer and a health supplement. In these paper, we report a case with acute pancreatitispresenting with different clinical findings.Ganoderma lucidum ( Japoncada'da Reishi, Çince'de Lingzhi) popüler birtıbbi mantardır ve Çin tıbbında yaklaşık2.000 yıldır kullanılmaktadır Son 30yılda, bu mantarlar, modern farmakologlar tarafından incelenmiştir . Pek çokçalışma, G. lucidum'un immün fonksiyonları düzenlediği ve tümör büyümesinin engellenmesindeetkili olduğunu göstermiştir. Bu etkilerin dışında G. lucidum ayrıcahipertansiyon, hiperlipidemi, diyabet, nefrit, astım, arterit, iltihaplıbağırsak hastalıkları ve diğer hastalıkların tedavisinde de kullanılabilirolduğu gösterilmiştir. Bu etkilerin belli mekanizması hala belirsizdir. Bunedenle, G. lucidum bir terapötik madde olarak tavsiye edilmez. Çoğunlukla, birbağışıklık arttırıcı ve sağlık için ek gıda olarak kullanılır. Bu olgusunumunda, farklı klinik bulgularla kliniğimize başvuran akut pankreatitli birolgu sunulmuştur.&nbsp

[Abstract Not Available]

Endocan is a proteoglycan secreted mainly from endothelial cells. It has been implicated that there is a link between endocan and endothelial dysfunction. Polycystic ovary syndrome (PCOS) is a reproductive and metabolic disease associated with increased risk of cardiovascular events. The aims of this study were to ascertain whether circulating endocan levels are altered in women with PCOS, and whether there is an association between endocan and carotid intima media thickness (cIMT).This cross-sectional study included 80 women with PCOS and 80 age- and BMI-matched controls without PCOS. Circulating endocan levels were measured using ELISA. Metabolic, hormonal parameters and cIMT were determined. 2-h oral glucose tolerance test (2-h OGTT) was performed on all women.Circulating endocan levels were significantly elevated in women with PCOS compared with controls (5.99 ± 2.37 vs. 3.66 ± 1.79 ng/ml, P0.001). Endocan levels positively correlated with BMI, homeostasis model assessment of insulin resistance (HOMA-IR), free androgen index (FAI), high-sensitivity C-reactive protein (hs-CRP), and cIMT in both PCOS and control groups. Endocan levels did not correlate with fasting blood glucose, 2-h OGTT, A1Circulating endocan levels are significantly higher in women with PCOS and endocan is independently associated with cIMT. Elevated endocan levels can be a predictor of increased cardiovascular risk in PCOS subjects.

Aim Swallowing is a vital activity. the difficulty while swallowing, referred to as swallowing disorder, is strongly associated with serious health problems in the elderly. the aim of this study is to enable early recognition of the swallowing function developing as an asymptomatic condition. Method Our study was conducted on elderly populations aged 65 years and over who met the exclusion criteria. Firstly, to be able to reach the number of sampling, "EAT-10 questionnaire", which also has a Turkish validation, was used to eliminate those with symptomatic swallowing disorders. the number of patients we reached was 320, but 7 dropped out of the study and therefore the study was carried out with a total of 313 [reached as 97.8% (up 95% G-power)]. Result We used validated sEMG test in the quantitative (objective) detection of asymptomatic swallowing disorder. in this method, asymptomatic swallowing disorder was detected in 39 cases (12.4%). Conclusion Swallowing disorder without symptoms is frequent and the sEMG test is useful in detecting it in the elderly population.

With this case report, we want to assess the synergistic effect of both a diuretic and an SGLT-2 inhibitor on the fall event of a patient who is 65 years old and has a history of repeated falls before. After we modified the medications appropriately, she has never experienced a fall event again. So as we know, older adults do not take fall events as a pathological condition instead of a normal physiological aging process. So primary-care physicians should question the fall history of an older patient before starting a drug such as SGLT-2 inhibitors, which is known as an agent that has side effects including falls, dehydration, etc.

BACKGROUND Kallistatin is a secreted protein that acts as a tissue kallikrein inhibitor. It has anti-inflammatory, antioxidant and vasoprotective properties. Polycystic ovary syndrome (PCOS) is a reproductive and metabolic disease associated with low-grade chronic inflammation and multiple risk factors for cardiovascular diseases. The aims of this study were to ascertain whether circulating kallistatin levels are altered in women with PCOS, and whether there is an association between kallistatin and carotid intima-media thickness (cIMT) as well as inflammatory markers high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α). METHODS This cross-sectional study included 75 women with PCOS and 75 age- and BMI-matched controls without PCOS. Circulating kallistatin and TNF-α levels were measured using ELISA. Metabolic and hormonal parameters, hs-CRP levels and cIMT were also determined. All subjects underwent the 2-hour oral glucose tolerance test (2-h OGTT). RESULTS Circulating kallistatin levels were significantly elevated in women with PCOS compared to controls (6.31±2.09 vs. 4.79±2.26 ng/mL, P

BACKGROUND: To evaluate the macrophage migration inhibitory factor and E-selectin levels in patients with acute coronary syndrome. MATERIALS/METHODS: We examined the plasma migration inhibitory factor and E-selectin levels in 87 patients who presented with chest pain at our hospital. The patients were classified into two groups according to their cardiac status. Sixty-five patients had acute myocardial infarction, and 22 patients had non-cardiac chest pain (non-coronary disease). We designated the latter group of patients as the control group. The patients who presented with acute myocardial infarction were further divided into two subgroups: ST-elevated myocardial infarction (n = 30) and non-ST elevated myocardial infarction (n = 35). RESULTS: We found higher plasma migration inhibitory factor levels in both acute myocardial infarction subgroups than in the control group. However, the E-selectin levels were similar between the acute myocardial infarction and control patients. In addition, we did not find a significant difference in the plasma migration inhibitory factor levels between the ST elevated myocardial infarction and NST-elevated myocardial infarction subgroups. DISCUSSION: The circulating concentrations of migration inhibitory factor were significantly increased in acute myocardial infarction patients, whereas the soluble E-selectin levels were similar between acute myocardial infarction patients and control subjects. Our results suggest that migration inhibitory factor may play a role in the atherosclerotic process.

Background Receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPN) are soluble members of the tumor necrosis factor superfamily. Growing evidence suggest that there is link between inflammation, insulin resistance and OPG, soluble RANKL (sRANKL). We aimed to ascertain whether OPG and sRANKL levels are altered in prediabetic subjects and there is association between OPG/sRANKL and metabolic parameters. Methods Forty prediabetic subjects and 40 age- and BMI-matched controls were recruited for this cross-sectional study. Circulating OPG, sRANKL were measured using ELISA. Anthropometric and metabolic parameters were also determined. Results Circulating sRANKL (97.74±17.67 vs. 55.00±11.19 pg/mL, P=0.010) and OPG (261.54±74.55 vs. 159.23±52.91 pg/mL, P=0.020) levels were found to be significantly higher in diabetic subjects compared with control subjects. There was a positive correlation between sRANKL and OPG. sRANKL also positively correlated with BMI, insulin resistance marker HOMA-IR, inflammatory marker hs-CRP. Logistic regression analyses revealed that the odds ratio was increased for prediabetes in subjects with having elevated sRANKL levels. Conclusions Increased sRANKL and OPG levels were associated with prediabetic subjects. sRANKL and OPG may play a role in the pathogenesis of diabetes as well as metabolic disturbance.

Background: High levels of adhesion molecules are known to result in inflammation of the vascular cells through endothelial dysfunction and thus atherogenesis. To this end, this trial was performed to investigate whether a cause of the accelerated atherogenesis in cases with non-alcholic fatty liver disease (NAFLD) was the increase in the levels of the adhesion molecules. Material and Methods: 53 cases with NAFLD diagnosed using ultrasonography and biopsy and 46 control cases were enrolled in the trial. Soluble intercellular adhesion molecule (sICAM-1), Vascular adhesion molecule (sVCAM) and sE-selectinconcentrations were determined by using an enzyme linked immunosorbent assay (ELISA) kit from Biosource (Bender MedSystems GmbH, Vienna Austria) according to the manufacturer’s instructions. Results: The levels of these adhesion molecules in patients with NAFLD were higher than those in the control subjects but only a significant difference in sE-selectin levels between the NAFLD and control groups was observed (p 0.05). Conclusions: The high levels of adhesion molecules and particularly of the sE-selectin statistically suggest that endothelial dysfunction and inflammation occur, which may represent a major factor in accelerating the atherogenesis process. We believe that detection of a high sE-selectin level would be leading the way when developing new therapeutical modalities for cases with NAFLD.

Thrombotic thrombocytopenic purpura (TTP) is a syndrome with numerous neurological manifestations including altered mental status and seizures. However, status epilepticus (SE) has rarely been reported in this condition. Signs may be transient or fluctuate; however, permanent deficits do occur. Its prognosis was once considered uniformly poor, with a high mortality rate. Since the introduction of plasma infusions and exchanges, the prognosis of the disease has improved dramatically; remissions now occur in 80-90% of patients. Altered mental status in TTP often resolves with plasmapheresis. Likewise, we successfully treated a patient with thrombotic thrombocytopenic purpura (TTP) with pronounced clinical effects of status epilepticus with plasmapheresis and steroid treatment.