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Parasitic infections are more frequently observed in immunosuppressed cases, such as those infected with human immunodeficiency virus (HIV). Furthermore, compared to immunocompetent cases, a more severe clinical course is observed in the immunosuppressed patient group. HIV-positive individuals have increased pathogenicity of parasites and may exhibit a wide range of clinical symptoms of varying severity that may result in mortality. Visceral leishmaisis (VL) is a vector-borne disease and an important opportunistic infection seen in HIV/AIDS cases, most notably in Southern Europe and Africa, where both infections are endemic. Several parasites namely toxoplasmosis, cryptosporidiosis, isosporiasis, cyclosporiasis, amebiasis, giardiasis, plasmodium, and strongyloidiasis are infections posing significant risk factors for these patient groups. In this study, visceral leishmaniasis was investigated serologically in serum samples and parasitic infections were analyzed by conventional methods in fecal samples from HIV-positive cases. 5 of the 42 cases included in the study were female. The mean age of these cases was 38.7 years (19-66). Blastocystis spp was detected in 5 fecal samples obtained from HIV-positive cases. The rK39 dipstick test with serum samples yielded a very weak band in one case, while none of the other tests yielded a positive band. As a result, the regional prevalence of these latent infections, which can be subclinical in HIV-positive patients, is important to know. However, the literature lacks sufficient data on the situation in Turkey. In this study, the prevalence of enteric parasitic infections in people with HIV infection in our region was found to be low and VL was not detected.

Amaç: Doğum sürecinde ebelerle iletişiminin kadınların doğum deneyimine etkisini incelemektir. Gereçler ve Yöntem: Bu tanımlayıcı tipte kesitsel araştırmanın örneklemini, Mart 2016- Ekim 2016 tarihleri arasında İzmir’de Sağlık Bakanlığı’na bağlı bir devlet hastanesinde normal doğum yapmış 353 kadın oluşturmaktadır. Katılımcılarla yapılan yüzyüze görüşmelerde veri toplamak için "Lohusa Tanıtım Formu", "Doğumda Ebeyle İletişimi Değerlendirme Formu" ve “Wijma Doğum Beklentisi/Deneyimi Ölçeğinin B Versiyonu” kullanılmıştır. Bulguların analizinde SPSS istatistik programı aracılığıyla frekans, yüzde, ortalama, standart sapma hesaplanmış, ki kare ve korelasyon analizleri uygulanmıştır.Bulgular: Katılımcıların yaş ortalaması 26,72 ± 5,05 olup ortalama doğum sayısı 2,08±1,07’dir. Doğumların büyük çoğunluğu (%88,7) gebeyi takip eden ebe tarafından, %11,3’ü ise doğum sürecinde müdahale eden ebe ve doktor tarafından yaptırılmıştır. Katılımcıların, Doğumda Ebeyle İletişimi Değerlendirme Formu’ndan aldıkları puanların ortalaması 25,03±6,52; Wijma Doğum Beklentisi/Deneyimi Ölçeği’nin B Versiyonu’ndan aldıkları puan ortalaması ise 89,95±23,08’dir. Bulgular, kadınların ebelerin iletişim davranışlarını algılama düzeyi ile doğum beklentisi/deneyimi arasında negatif yönlü, orta düzeyde güçlü ve istatistiksel olarak anlamlı bir ilişki olduğunu göstermektedir (r= ­,36; p< 0,05). Sonuç: Ebelerin doğum eyleminde sergiledikleri olumlu ve etkili iletişim becerileri, kadınların doğum deneyimini olumlu yönde etkilemiştir., Aim: The aim of this study is to examine the relationship between the ability to communicate of midwives with the birth experience of women. Material and Methods: The sample of this cross-sectional descriptive research consists of 353 women who gave birth by vaginal delivery in a state hospital affiliated to the Health Ministry in İzmir between March 2016 and October 2016. In order to collect data in face-to-face interviews with the participants, “Puerperant Description Form”, “The Communication with Midwife Assessment Form in Childbirth” and “Wijma Scale, B Version of Expectation of Giving Birth /Experience” were used. In the analysis of the findings, frequency, percentage, mean, standard deviation were calculated, chi-square and correlation analysis were applied using the SPSS statistical program.Results: Average age of the women who participated in the research is 26,72 ± 5,05. Most of the births (88,7 %) of women were done by the midwife who followed the pregnancy, and 11,3 % of them by midwife and doctor who intervened during the birth process. Average point of the women who have got from Form of Assessment of Communication Perception of Women in the Childbearing Process was found as 25,03±6,52 (max: 33,00). The average score obtained by the participants from the Form for the Assessment of Perception of Communication with Midwives in Birth Process is 25.03 ± 6.52 (Max: 33.00; The average score they got from Version B of the Wijma Birth Expectancy / Experience Scale is 89.95 ± 23.08. The findings show that there is a negative, moderately strong, and statistically significant relationship between women's perception of the communication behaviors of midwives and their birth expectation/experience (r =, 36; p

Purpose Pediculosis caused by human head louse, Pediculus humanus capitis De Geer (Anoplura: Pediculidae) is a public health problem with a high prevalence, especially among children in school age. Different chemical pediculicides (insecticides) are used against lice but the repeated application of these pediculicides for the treatment of P. humanus capitis infestation in the past decades has resulted in the development of resistance. The plant essential oils have been used as alternative sources of lice treatment agents. Pediculicidal activity of the essential oils of three Origanum species (O. onites, O. majorana and O. minutiflorum) against P. humanus capitis adults was examined in this study. Methods Essential oils from aerial parts of three Origanum species were obtained by hydrodistillation using a Clevenger-type apparatus. P. humanus capitis specimens used were obtained from infested children by combing method at primary schools. Adult lice were exposed to three dilutions (1%, 0.5% and 0.1% w/v) of tested oils for 5 min using the adult immersion test. Results According to the results, all Origanum essential oils at 1% concentration have been shown to significantly decrease the rate of limb, bowel and abdomen movements, producing more than 90% mortality after 12 h. Conclusion Our results indicated that Origanum essential oils can be used for the development of new pediculicides against head louse.

Aim: To examine attitudes to eating in multiple sclerosis (MS) patients. Material and Method: The study included 64 cases diagnosed with MS according to the 2017 McDonald criteria and a control group of 64 healthy volunteers of similar age, gender, and education level. All the study participants underwent a detailed neurological examination and were then administered the Eating Attitudes Test (EAT), the Beck Anxiety Inventory (BAI), and the Beck Depreession Inventory (BDI). Results: In the comparisons between the groups of the EAT results, a score of ≥30 was obtained by 24 (37.5%) MS patients and 14 (21.8%) of the control group. When the MS patients were compared in two groups according to the Expanded Disability Status Scale (EDSS) score of ≤3 and ≥4, an EAT score of ≥30 was obtained by 11 (25%) patients with EDSS score ≤ 3 and by 13 (68.5%) patients with EDSS ≥4. Conclusion:The study results demonstrated that the patients with MS had a worse attitude to eating than the control subjects. When it is considered that some foodstuffs are among MS triggers, the presence of eating disorders or poor eating behaviour becomes important.

Leishmaniasis is a protozoan parasitic disease transmitted to humans by infected female sand flies. Turkey has received more than three million immigrants from Syria because of the civil war and political instability. This study reported cases of two patients, who were from Syria and lived in Hatay, with cutaneous leishmaniasis and mucosal involvement. Two patients presented to the infectious diseases clinic with a complaint of facial lesions and were subsequently referred to the parasitology department laboratory. Smears were prepared from the lesions, stained with Giemsa and examined under a microscope. Moreover, aspirates taken from the patients' lesions were inoculated into the modified Novy-MacNeal-Nicolle medium. The diagnosis was made when amastigotes were detected in both smears. Proliferation of promastigotes was observed in one of the clinical specimens inoculated on the medium. By PZR-RFLP, Leishmania tropica were detected in the isolate. Both patients were treated with amphotericin B. One patient was treated again with a pentavalent antimony compound because of the recurrence of the lesion.Leishmaniasis, bir protozoon parazit olan Leishmania türlerinin sebep olduğu ve enfekte dişi kum sinekleri tarafından bulaştırılan bir hastalıklar grubudur. Türkiye, yakın sınır komşumuz olan Suriye’de meydana gelen iç savaş ve siyasi istikrarsızlık nedeniyle üç milyonu aşan sayıda göç almıştır. Bu çalışmada, Suriye’den göç ederek Hatay’da yaşayan, iki yurt dışı kaynaklı mukozal tutulumlu kutanöz leishmaniasis olgusu ve tedavileri sunulmaktadır. Enfeksiyon hastalıkları kliniğine yüzünde lezyon nedeniyle başvuran iki olgu, Parazitoloji Anabilim Dalı laboratuvarına yönlendirilmiştir. Olguların lezyonlarından yayma preparatlar hazırlanmış ve Giemsa ile boyanarak mikroskop altında incelenmiştir. Aynı zamanda olguların lezyonundan, aspirasyon sıvısı alınarak modifiye edilmiş Novy-MacNeal-Nicolle besiyerine inoküle edilmiştir. Üreme gözlenen örnekler, ITS-1 bölgesini hedefleyen LITSR ve L 5.8S primerleri kullanılarak PZR-RFLP yöntemi ile tiplendirilmiştir. Olguların lezyonlarından hazırlanan yayma preparatların ikisinde de amastigotlar görülerek tanı konmuştur. Besiyerine inoküle edilen klinik örneklerin, birinde promastigotların ürediği gözlenmiştir. PZR-RFLP ile izolat Leishmania tropica olarak tiplendirilmiştir. Olguların ikisi de amfoterisin B ile tedavi edilmiştir. Bir olgu lezyonun tekrar etmesi nedeniyle beş değerli Antimon bileşiği ile tekrar tedavi edilmiştir.

Amaç: Bu çalışmanın amacı akustik değerlendirme bataryalarından biri olan nazometre ölçüm parametreleriyle, Vücut Kütle İndeksi (VKİ) arasındaki ilişkinin incelenmesidir.Gereç ve Yöntem: 18-25 yaş arası sağlıklı sese sahip 94 kadın katılımcı, zayıf (n=20), normal (n=30), fazla kilolu (n=20) ve obez (n=24) olmak üzere 4 VKİ grubuna ayrılmıştır. Ölçümler NASOMETER-II Model 6400 ile gerçekleştirilmiş olup değerlendirme ve kayıt sırasında katılımcılara oral ve nazal metinler okutulmuştur. İncelenen parametreler ise sırasıyla; minimum, maksimum ve ortalama nazalans skordur. Bulgular: VKİ fark etmeksizin nazal cümledeki nazalans skorları, oral cümledekinden daha yüksektir (p0,05).Sonuç: Ölçüm sonucunda VKİ’nin iki uç değeri olan zayıf ve obez grubun, oral ve nazal cümleler sırasında nazometre değerlerinde anlamlı bir farklılık bulunamamıştır. Bunun nedeni olarak ise uç VKİ gruplarında nazalans skorlarındaki değişimi inhibe edecek bir fizyolojik kompansasyon mekanizmasının olduğu düşünülmektedir.

Within the scope of semi-occluded vocal tract exercises (SOVTEs), we aimed to examine the effects of four exercise combinations, which involved various fluid densities and tube submersion depths, on acoustic and electroglottographic (EGG) parameters.Four procedures (P) were applied consecutively to 30 female participants with normal voices using different tube submersion depths and fluid densities, including P1 (2 cm, water), P2 (2 cm, nectar), P3 (10 cm, water), and P4 (10 cm, nectar). Nasometric (Nasometer II model 6450) and EGG (Electroglottograph model 6103) measurements were taken before the procedures were initiated (pre-test) and at the end of each procedure. In addition, EGG measurements were taken for each procedure during the application.For all three velar positions (oral passage, oro-nasal passage, nasal passage), the only procedure that caused a significant change compared to the pre-test stage in regard to nasalance score was P2 (2 cm nectar) in common. All other procedures except P1 (2 cm water) significantly increased velar closure compared to pre-test levels. However, when the differences between the exercises were examined, the least velar closure, compared to the other procedures, was obtained after P4 (10 cm nectar). While there was no significant difference between the procedures in the EGG measurements during the exercise, a significantly higher tendency to contact was observed after the procedures with a denser consistency, and an increase in the fundamental frequency (fIn SOVTEs in which water phonation is performed with a tube, the use of a fluid with a consistency denser than water can be considered a particularly promising approach. In addition, exercises performed with increasing consistencies in 2 cm depth can provide more vocal cord and velopharyngeal port closure by increasing EGG-CQ and nasalance score values. However, more care should be taken while increasing the consistency at a submersion depth of 10 cm.

Introduction: the coronavirus disease 2019 (COVID-19) pandemic led to a lockdown period. Confinement periods have been related to unhealthy lifestyle behaviors. Our study aimed to determine weight change, changes in eating and exercise habits, the presence of depression and anxiety, and diabetes mellitus (DM) status in a cohort of patients with obesity. Methods: the study was undertaken in nine centers of Collaborative Obesity Management (COM) of the European Association for the Study of Obesity (EASO) in Turkey. An e-survey about weight change, eating habits, physical activity status, DM status, depression, and anxiety was completed by patients. The International Physical Activity Questionnaire (IPAQ) score was used to determine physical activity in terms of metabolic equivalents (METs). A healthy nutrition coefficient was calculated from the different categories of food consumption. The Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) Questionnaire were used for determining depression and anxiety, respectively. Results: four hundred twenty-two patients (age 45 +/- 12.7 years, W/M = 350/72) were included. The healthy nutrition coefficient before the pandemic was 38.9 +/- 6.2 and decreased to 38.1 +/- 6.4 during the pandemic (p < 0.001). Two hundred twenty-nine (54.8%) patients gained weight, 54 (12.9%) were weight neutral, and 135 (32.3%) lost weight. Patients in the weight loss group had higher MET scores and higher healthy nutrition coefficients compared with the weight gain and weight-neutral groups (p < 0.001). The PHQ and GAD scores were not different between the groups. Percent weight loss was related to healthy nutrition coefficient (CI: 0.884 [0.821-0.951], p = 0.001) and MET categories (CI: 0.408 [0.222-0.748], p = 0.004). One hundred seventy patients had DM. Considering glycemic control, only 12 (8.4%) had fasting blood glucose, NA

Amaç: Geleneksel ve tamamlayıcı Tıp (GETAT) uygulamaları, ilgili alanda sertifikası bulunan hekim ve/veya diş hekimi sorumluluğunda ve Sağlık bakanlığınca yetkilendirilmiş merkezlerde yapılması gerekmektedir. Eğitimler esnasında standart enfeksiyon kontrol önlemleri/hijyen ve enfeksiyonlarla alakalı temas bilgisi verilmekte birlikte yetersiz olabileceği düşünülmektedir. Bu çalışmada GETAT uygulayan hekimlere klinikte enfeksiyon kontrol önlemleri/hijyen kurallarının önemini hatırlatma ve vurgulama amacıyla onların bilgi, tutum ve davranışlarının belirlenmesi amaçlanmıştır. Yöntem: Çalışma, demografik bilgiler ve literatürden destek alınarak hazırlanan GETAT kliniğinde hijyen uygulamalarını sorgulayan dijital anket ile hekimlere ulaşılmış, onların konu ile alakalı bilgi tutum ve davranışları belirlenmeye çalışılmıştır. Edinilen veriler istatistiksel olarak irdelenmiştir.Bulgular: Toplam 103 katılımcının % 54.4 erkek, % 46.6 Pratisyen hekim, % 9.7 aile hekimi olup %38.8’sinin hekimlik tecrübesi 20 yıl ve üzerindedir. Hekimlerim %95.0’i en az bir GETAT sertifikasına sahip olup en çok alınan sertifika %64.3 oranında hacamat(kupa), %45.9 akupunktur, %34.7 ozon tedavisi, %33.7 sülük tedavisi olarak belirlenmiştir. Katılımcıların %92.8’si hepatit B aşısı, %49.5’u tetanoz aşısı, %22.7’u da grip aşılarını yaptırmış olup %54.5’inin AntiHBs titresi 10 IU’nun üzerindedir. Hekimlerin % 65.7'ü Kesici delici aletleri özel atık torbalarında, %11.8'u ise kırmızı renkli tıbbi atık poşetlerinde biriktirmekte ya da zararsız hale getirmektedir. Katılımcıların %57.0’sı “delici kesici olmayan aletleri” kırmızı renkli tıbbi atık poşetlerine, %28.0 tüm atıklarla aynı poşete atmaktadır. Hekimlerin %72.5’ü GETAT uygulamalarında enfeksiyon kontrol önlemleri/hijyen konusundaki bilgi düzeyini yeterli bildirmiş, %86.2’si GETAT’ta yeterli hijyen kuralları uygulanmazsa Hepatit, HIV’in bulaşmasına neden olabileceğini düşünmektedir. GETAT uygulamalarından önce hastaların Hepatit B, C ve HIV test durumlarını soranlar %65.6 iken, %71,6’ü Hepatit B, C yada HIV (+) bir hastaya GETAT uygulamasında yaklaşımının değişebileceğini ifade etmiştir. Hastaya temas eden tüm malzemelerin tek kullanımlık olduğunu belirtenlerin oranı %73 iken %37.6’sının enfeksiyon hastalıklarına karşı sürekli koruyucu ekipman kullandıklarını; %61.3’ü ise klinikte eldivensiz çalışmadığını belirtmişlerdir. Hekimlerin %21’i GETAT uygulamalarının enfektif komplikasyonları olabileceğini ifade etmiş, %50.5’i delici kesici alet yaralanmalarında uygulanacak bir enfeksiyon kontrol prosedürü varlığını bildirirken, %35.6’sı son 5 yılda klinik içinde delici kesici alet yaralanmasına(iğne batması vs.) 1-3 kere maruz kaldığını bildirmiştir. Katılımcıların yarısından fazlası(%54.5) “GETAT uygulamaları ve hijyen” konusunda, ek bir eğitime gereksinim duyduklarını belirtmiştir.Sonuç: Hijyen, tıbbi atık ve kan yolu ile bulaşan enfeksiyonlardan korunmada ilave eğitimin anlamlı olacağı belirlenmiştir.

Amaç: Farklı beden kitle indeksine (BKİ) göre gruplandırılmış kadınların BKİ ile Çok Boyutlu Ses Programı – Multi-Dimensional Voice Program (MDVP) ve Elektroglottograf-Electroglottograph (EGG) ölçüm sonuçlarını incelemektir.Gereç ve Yöntemler: Çalışma grubunu 18-25 yaş arası 96 kadın katılımcı oluşturmaktadır. Katılımcılar zayıf (n=20), normal (n=29), fazla kilolu (n=22) ve obez (n=21) olarak dört BKİ grubuna ayrılmıştır. Akustik ölçümler KAY-PENTAX CSL model 4500 ve KAYPENTAX EGG model 6103 ile gerçekleştirilmiş olup kayıtlar, /ʌ/ fonasyonu üzerinden alınmıştır. Kayıt sonunda toplanan veriler analiz edilmiş ve gruplar arası karşılaştırmalar yapılmıştır.Bulgular: Dört BKİ grubuna ait MDVP parametreleri arasında anlamlı bir fark tespit edilmemiştir (p>0,05). Ayrıca BKİ’ye göre EGG frekans ölçüm parametrelerinden sadece ortalama jitter anlamlı farklılık gösterirken (p=0,016), bu farkın post-hoc testleri sonucunda obez ve normal grup arasında olduğu belirlenmiştir. Medyan değerler incelendiğinde bu fark, obez bireylerde 0,49 (0,27-1,03), normal bireylere 0,37 (0,24-0,6) göre daha yüksek bulunmuştur. Temel frekans (F0) değerleri ile BKİ grupları arasında ise anlamlı farklılıkgözlenmemiştir (p>0,05).Sonuç: Kadın olgularda BKİ gruplarına göre EGG kapanma fazlarına bakıldığında, obez grubun glottal kapanış ve kapanma fazlarının yalnızca ortalama değer olarak, obez olmayan BKİ gruplarına göre daha yüksek olduğu bulunmuştur. Ek olarak glottal açılış ve açıklık fazlarının yalnızca ortalama değer olarak, obez olmayan BKİ gruplarına göre daha düşük olduğu saptanmıştır. Ayrıca EGG-frekans ölçümlerinden jitter değerinin obez grupta normal gruba göre daha yüksek çıkması, bu grupta disfoni patolojisi riskinin daha fazla olabileceğini düşündürmektedir., Aim: The aim of this study is to examine the relationships between Multi-Dimensional Voice Program (MDVP) and Electroglottograph (EGG) measurement results of female individuals that are grouped according to their body mass index (BMI).Material and Methods: 96 women who are at the ages between 18-25 have participated.Participants were divided into 4 BMI groups; weak (n=20), normal (n=29), overweight (n=22) and obese (n=21). Acoustic measurements were performed with KAY-PENTAX CSL model 4500 and KAY-PENTAX EGG model 6103. During the measurements, the participants were asked to pronounce/ʌ/ phonation.Results: There was no significant difference between any MDVP parameters obtained from 4 BMI groups (p>0.05). Average-jitter, as one of the EGG frequency measurement parameter, has shown a significant difference (p=0.016), which was obtained from post-hoc datests of obese and normal group.According to the median value analysis, the difference was higher in obese individuals0.49 (0.27-1.03), than in normal individuals 0.37 (0.24-0.6). F0 values, obtained from MDVP and EGG, have no significant difference across any BMI group (p>0.05).Conclusion: When the EGG closure phases examined across BMI groups, it was founded that the obese group had higher glottal closing and closing phases compared to other BMI groups, while the glottal opening and opening phases were lower than the other BMI groups. In addition, the fact that the jitter value of the EGG-frequency measurements was higher in the obese group compared to the normalgroup. That suggests that the risk of dysphonia pathology may be higher in this group.

Background: Clinically, cutaneous leishmaniasis (CL) can be confused with granulomatous diseases and skin cancers, and it may lead to erroneous diagnosis and treatment. Diagnosis based and histopathology can have some difficulties due to low number of parasites, especially in chronic CL cases. We aimed to emphasize the necessity of considering CL in the differential diagnosis for cases of granulomatous diseases and basal cell carcinoma, particularly in areas where CL is endemic. Methods: One hundred and seven paraffin-embedded tissue biopsy specimens were selected from the archive, as of 2002, of Pathology Department, School of Medicine, University of Hatay Mustafa Kemal in Hatay, Turkey. After DNA isolation, performed with the samples were used for PCR analysis with specific 13A, 13B primers targeting kinetoplastid DNA (kDNA) found in all Leishmania species. Another PCR was performed with LITSR and L5.8S primers targeting ITS-1 internal-transcribed-spacer-1 (ITS-1) region to subtype positive samples. Then these samples were further analyzed for subtyping with PCR-RFLP using HaeIII enzyme (BsuRI). Results: Ten out of 107 tissue specimens were positive via kDNA-PCR. Lupus vulgaris, sarcoidosis, skin lymphoma and Leishmania cutis appeared in 9 out of 10 positive specimens. One of the cases presented with a mass on the cheek and was pre-diagnosed with hemangioma, but leishmaniasis did not appear. All of 10 specimens were diagnosed as granulomatous dermatitis. Two out of 10 samples, found positive with kDNA-PCR, were analyzed with ITS-1-PCR and identified as L. infantum/donovani after RFLP. Conclusion: Molecular methods should be utilized in the differential diagnosis of CL to eliminate false diagnoses of granulomatous diseases and skin cancers.

Bilgi ve iletişim teknolojilerinin gelişmesi, internette yer alan servisler ve ürünler hakkında müşterinin bakış açısı, yorumları ve oy değerlerinin paylaşılmasına ve toplanmasına imkân sağlamıştır. Müşteriler, bu değerlendirmeleri çoklu kriterlere dayanarak gerçekleştirmektedir. Bu çalışmada, havayolu firmalarının performans analizi için Skytrax’ da yer alan veriler kullanılmıştır. Çok kriterli karar verme teknikleri kullanılarak yapılan bu çalışmada, Promethee II için gerekli olan ağırlık değerleri, bir yapay sinir ağları modeli olan Çok Katmanlı Algılayıcı (MLP) ile elde edilmiştir. Elde edilen sonuçlarda ANA havayolu firmasının yıllar içerisinde gelişmeler gösterip üst sıralara taşınırken, United havayolu firmasının iki yıl içerisindeki sıralamasında herhangi bir değişiklik gözlenmemiştir. Bu makalede kullanılan tekniklerin detayları verilirken, elde edilen sonuçlarda havayolu firmaları için rekabette sağladığı avantajlar vurgulanmıştır., The development of information and communication technologies offers the possibility of collecting and sharing customer views, comments and ratings about products and services over the Internet. Customers generally make these evaluations based on multiple criteria. This study uses such data recorded on Skytrax to analyse the performance of leading airlines. It does so using the a multicriteria decision making technique (Promethee II), and the criteria weight values required for the Promethee II method are obtained from a Multi-Layer Perceptron (MLP), an artificial neural network method. According to the results obtained, ANA airline has shown improvements in the years and moved up to the top, while the ranking of United airline within two years has not changed. The paper provides details of the technique and graphically presents results to highlight where airlines possess advantages over their competitors.

Objective This study aims to determine the optimum liquid medium for the reproduction of Trypanosoma cruzi strains and provide cryopreservation. Methods The reproduction density of T. cruzi strain was evaluated in the following five different commercial liquid culture media: RPMI 1640, Medium 199 (M199), Schneider's Insect Medium (SIM), Nutrient Broth (NB), Brain Heart Infusion Broth (BHIB). Cultures were monitored on every other day for a period of 24 days. Cryopreservation of T. cruzi was also performed and viability was tested after six months. Results Epimastigotes of T. cruzi were not found to be produced in NB and BHIB media. Significant difference was not observed among the reproduction potential of RPMI-1640, M199, and SIM after evaluating the data for the first 10 days. Between days 12 and 24, RPMI-1640 was found to be the best reproduction medium. From the 18th day onwards, parasites transformed amastigotes. On the 24th day, the highest level of amastigote amount was observed, and reproduction was determined to have stopped. As a result of cryopreservation, it was determined that the survival of T.cruzi continued after six months.. Conclusion Thus, the selection of RPMI-1640 medium, followed by M199 and SIM media would be appropriate when studying T. cruzi epimastigotes. Studies using epimastigotes should be planned for up to 18 days and for those using amastigotes, it would be appropriate to plan the studies after the 18th day. Moreover, T. cruzi can be cryopreserved with 15% DMSO and stored for a long time in liquid nitrogen.

Leishmaniasis, seen in tropical and subtropical regions, is an infectious disease caused by the protozoan parasite Leishmania species. There are three main forms of leishmaniasis: cutaneous, mucocutaneous and visceral leishmaniasis. Cutaneous leishmaniasis (CL) has become an increasing problem as the number of travels around the world increases and people go to work in endemic areas. Turkey has received great numbers of immigrants in recent years, from its neighboring countries like Iraq, Islamic Republic of Iran, Afghanistan, Turkmenistan and the Syrian Arab Republic because of the political instabilities in these countries as well as the job opportunities caused by large-scale development projects undertaken by Turkey. In this report, imported CL cases detected in five truck drivers transporting from Hatay to Turkmenistan, Syria, Saudi Arabia, Iran and Georgia, Uzbekistan and Azarbaijan countries were presented. The patients admitted to Mustafa Kemal University, Faculty of Medicine Dermatology Policlinic, with wound complaints on their bodies were directed to the Department of Parasitology to obtain smear samples from their wounds. The age range of the patients were 38 to 43 years. Patients with wound trail for a period ranging from one month to one year had a number of lesions varying between 2-7 and in all cases, a smear preparation was prepared from the lesions for diagnostic purposes. Clinical material obtained from five patients with pre-diagnosis of CL was firstly examined with Giemsa stain. Samples taken from the patients were inoculated into modified NNN (Novy-MacNeal-Nicolle) medium for the evaluation of the presence of the promastigotes. Promastigotes obtained from the inoculated medium were also genotyped using the ITS1 region. In all of the slides prepared from the clinical material taken from the patients amastigotes were determined. The growth of promastigotes were observed in only three of the clinical specimen inoculated media. The genotyped three species were Leishmania tropica, Leishmania infantum/donovani and Leishmania major. In this study, the importance of support for the diagnosis of different microbiological methods used in the diagnosis of leishmaniasis infection which occurred during the outbreaks of the disease has been put forward. In addition, it was aimed to draw attention to the importance of imported CL cases in our country diagnosed in five truck drivers making transportation from Hatay to Turkmenistan, Syria, Saudi Arabia, Iran, Georgia, Uzbekistan and Azerbaijan.

Objective The Wolrd Health Organization (WHO) encourages all countries to investigate antimalarial drug substances derived from herbal sources with the slogan "Hunt of the Next Artemisinin" due to the emergence of resistant strains of Plasmodium species to artemisinin. In the broad and simple sense, it was planned to help guide the young researchers set in-vitro and in-vivo models of malaria in order to be used in drug research and active ingredient studies. Methods In-vitro study, young Plasmodium berghei trophozoites were removed from the liquid nitrogen tank and resuspended in appropriate conditions, followed by incubation with chloroquine and tetracycline at concentrations of 0.1, 0.4, 0.8, 1.6, 6.4, 12.8 μg/mL for 24 hours at +37°C in a shaking incubator. In-vivo studies, Tetracycline group (TG) and Chloroquine group (KG) were administered 50 mg/kg of tetracycline and chloroquine by intragastric lavage and untreated control group (TACG) were administered the same amount of saline via the same route. The suppression of parasitemia in mice was followed for 24 days. Results In our in-vitro study it was observed that 0.8 μg/mL of chloroquine and 1.6 μg/mL of tetracycline was enough to suppress parasitemia. In our in-vivo drug study, all of the mice in the TG group died at day 24, and all of the mice in the TAKG group died at day 12, with no parasitemia observed in the mice in the KG group. Conclusion Our study suggests that if tetracycline therapy is administered when the induction of chloroquine therapy is delayed, the exacerbation of the parasitemia may be prevented and when chloroquine is obtained chloroquine therapy can be commenced thus preventing the loss of the patient.

Amaç: HIV (HumanImmunodeficiency Virus) (+) gebe yönetiminde, tarama testleri ve viral yükincelemeleri, etkili antiretroviral tedavi, sezaryen ile doğum ve emzirmedenkaçınma en güncel konulardır. Bu çalışmada kadın hastalıkları ve doğum (KD)hekimlerinin HIV (+) gebe yönetimi konusundaki bilgi, tutum ve davranışlarınınincelenmesi amaçlanmıştır.Gereç veYöntemler: Demografikbilgiler ve literatürden destek alınarak HIV (+) gebe yönetimine yönelikhazırlanan online/dijital anket ile KD hekimlerine ulaşılarak konu ile alakalıbilgi, tutum ve davranışları belirlenmeye çalışıldı. Bulgular: Toplam 125katılımcının 52’si (%41,6) erkek, 86’sı (%68,8) uzman hekim, 13’ü (%10,4)araştırma görevlisi, 34’ü (%27,2) 20 yıl ve üzeri mesleki deneyime sahip, 115’i(%92) gebelerden düzenli olarak Anti-HIV testi istemekte olup 77’sinin (%61,6)en az bir kez Anti-HIV pozitif gebe hastası olmuş, 49’u (%39,2) bugüne kadarAnti-HIV pozitif gebe takibi yapmış, 51’i (%40,8) ise Anti-HIV pozitif en azbir gebeye doğum yaptırmıştı. Hekimlerin 121’i (%96,8) Anti-HIV pozitifgebeleri doğrulama testlerine yönlendirirken 19’u (%15,2) Anti-HIV pozitifanneye emzirmemesi konusunda bilgi vermediğini belirtti. Doğum sırasında HIVRNA düzeyleri >1000 kopya/mL veya viral yükü bilinmeyen Anti-HIV pozitifgebede IV zidovudin uygulanmasının bebeğe bulaş riskini azalttığını bilenler 79(%63,2) iken HIV (+) anneden doğana profilaksi amaçlı altı hafta zidovudinkullananlar 55’tir (%44). Anti-HIV (+) annenin doğum şekli için “Viral yükü, Aim: In this study,it was aimed to investigate the knowledge, attitudes and behaviors ofgynecologists and obstetricians (G/O) during pregnant management in terms ofHIV.Material and Methods: Online questionnaire was reached to G/O physicians to determine relevantknowledge about HIV (+) pregnant management. Information was evaluated by MSExcel.Results: Of thetotal 125 participants, 52 (41.6%) were male, 86 (68.8%) were specialistphysicians, 13 (10.4%) were research assistants, 34 (27.2%) had 20 years ormore professional experience, 115 (92%) of the pregnant women regularly ask foranti-HIV tests, 77 (61.6%) of them had anti-HIV positive pregnant patients atleast once, 49 (39.2%) have followed anti-HIV positive pregnant women so far,51 (40.8%) had given birth to at least one anti-HIV positive pregnant woman. 19(15.2%) of the physicians didn’t give information to HIV positive mothers notto breastfeed. 79 (63.2%) of those who know that IV zidovudine administrationin an HIV positive pregnant with HIVRNA levels> 1000 copies/mL and 55 (44%)of those who use zidovudine for six weeks for prophylaxis. For HIV(+) maternal delivery type, 35 (28%) of those who stated thatcesarean section had no advantage in terms of transmission in the pregnant witha viral load

Leishmaniasis is a parasitic disease that is transmitted to humans by the bites of infected female phlebotomine sandflies. In the diagnosis of cutaneous leishmaniasis (CL), in the smear samples, the demonstration of the parasite by microscope remains a gold standard method. However, it becomes difficult to diagnose the parasite since the number of amastigotes in chronic cases with a lesion of one year or longer is very low. Due to many factor such as patients primarily do not to take any notice these lesions in their bodies, do not apply to health institutions or late applied, receive wrong treatment; the diagnosis and treatment are delayed. In addition, it is been worse prognosis by add secondary infection to lesions and wounds become chronic. For this reason, molecular methods are used in addition to microscopic examination in chronic suspected CL cases. It was aimed to reveal of the molecular diagnostic value in chronic suspected CL cases by polymerase chain reaction (PCR) in the smear belonging to Turkish patients that reported to be evaluated clinically because it can not be seen Leishmania amastigotes in microscopic examination. Smear of 50 Turkish patients who were clinically reported of the evaluation of chronic CL were selected. These samples were smears belonging to suspected CL patients that applied Hatay Mustafa Kemal University, Faculty of Medicine, Parasitology laboratory from different polyclinics and were decided to be evaluated clinically as a result of microscopic examination because they came from endemic regions (such as Hassa, Altınözü, Yayladağı). DNA was isolated from selected samples and PCR was performed using 13A, 13B primers targeting the kinetoplastid DNA (kDNA) region. The samples found positive by PCR were typed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis using LITSR and L5.8S primers targeting internal transcribed spacer (ITS-1) region. Of the 50 smear samples, 17 (34%) were determined positive with 13A, 13B primers targeting the kinetoplastid DNA (kDNA) region. Positive samples were also found to be positive with LITSR and L5.8S primers targeting ITS-1 region. The PCR products obtained from PCR with ITS-1 gene region were digested with the restriction endonucleases BsuRI (HaeIII). As a result of PCR-RFLP analysis, it was determined that 11 of Leishmania tropica, one of Leishmania major and five of Leishmania infantum/donovani out of 17 samples. Chronic CL can be confused with skin diseases such as sarcoidosis, tuberculosis, malignant tumors. In particular, chronic CL cases can be escaped the attention for many reasons such as failure to diagnose correctly, insufficient microscope experience, fail to see due to low number of parasites. For this reason, it was concluded that PCR, which is a molecular method, should be used in chronic suspected CL samples which are negative for the parasite by microscopic examination.

Acanthamoeba species are free-living amoebae isolated from many ecological areas such as swimming pools, dams, lakes, soil, and air filters. These amoebae are usually causing granulomatous amebic encephalitis and amebic keratitis in immunosuppressive individuals. In this study, the reproductive potential and morphological changes determined of Acanthamoeba castellanii trophozoite and cyst forms exposed to three different active substances derived from benzothiazole. Furthermore, the cytotoxic potential of these active substances determined by XTT analysis. In the study, axenic cultures prepared for Acanthamoeba castellanii cyst and trophozoite forms and parasite exposed to different concentrations of active substances. Cell counts of parasite cultures were performed at the 30 minutes, 1st, 6th, 12th, 24th, and 48th hour periods. As a result of the study, the reproductive potential suppressive effects of all three substances on Acanthamoeba castellanii trophozoites and cysts were determined. The most effective of these substances was 2-Amino-6(trifluoromethoxy)-benzothiazole. In the first three concentrations of this substance (0.1%, 0.05%, 0.025%), no determined trophozoite and cysts at the end of twenty four. Due to its strong ameobicidal effect, it is thought that 2-Amino-6(trifluoromethoxy)-benzothiazole may be a new therapeutic agent in diseases caused by acanthamoeba parasites by supporting this study with animal experiments.

Amaç: Bu çalışma, Türkiye’den elde edilen Leishmania spp. izolatlarının kanlı agar ve çikolata agardaki koloni oluşumlarının izlenmesi ve farklılıklarının karşılaştırılması, tek bir hücreden oluşan koloni elde edilerek gerektiğinde genetik çalışmalarda kullanılması amacıyla planlanmıştır. Yöntem: Çalışmamızda kullanılan kanlı agar ve çikolata agarın gerekli ön hazırlık aşamaları yapıldıktan sonra steril petri kaplarına dökülmesi ile besiyerleri hazırlanmıştır. Kullanılan Leishmania spp. izolatları üniversitemiz bünyesinde bulunan Parazit Bankası’ndan sağlanmıştır. Leishmania spp izolatlarının, ITS1 ve hsp70 bölgesine özgü primer ve problar kullanılarak genotiplendirilmesi yapılmıştır. Türlere göre ayrılan izolatların NNN besiyerinde kültürü yapılmış ve üreyen promastigotlar RPMI 1640 sıvı besiyerlerine aktarılarak logaritmik faza girmeleri beklenmiştir. Logaritmik faza giren promastigotların çikolata agar ve kanlı agara ekimleri yapılmış ve 25°C’lik etüve kaldırılarak gün aşırı takip edilmiştir. Bulgular: Etüvden çıkarılarak incelenen plaklarda inkübasyonun 7. gününde çikolata agarda herhangi bir koloni oluşumu gözlenmezken, kanlı agarda Leishmania tropica, Leishmania infantum ve Leishmania donovani de koloni büyüklüklerinin ortalama 0.9 mm olduğu, Leishmania major’de ise ortalama 0.8 mm olduğu saptanmıştır. Plaklara yapılan ekimin 28. gününde ise çikolata agarda L. tropica, L. major, L. infantum ve L. donovani’deki ortalama koloni büyüklükleri sırasıyla 1.0 mm, 0.9 mm, 1.0 mm ve 0.8 mm olarak gözlemlenirken, kanlı agardaki koloni büyüklükleri sırasıyla 3.1 mm, 3.1 mm, 3.3 mm ve 3.0 mm olduğu belirlenmiştir. Sonuç: Plaklara yapılan ekimlerin takibi sonucunda tüm suşların 7., 14., 21. ve 28. günlerdeki koloni oluşumlarının kanlı agarda daha hızlı olduğu saptanmıştır. Kanlı agarın Leishmania spp. ile ilgili yapılması planlanan genetik çalışmalar ve diğer çalışmalarda kullanılmasının uygun olabileceği sonucuna varılmıştır. Objective: This study was planned with the aim of comparing the reproduction differences of Leishmania isolates, obtained from Turkey, on chocolate and blood agars, colony growth views on agar plates and to attain colonies from single cell to utilize for genetic studies. Method: After preparation of blood agar and chocolate agar used in our study, the media were prepared by pouring into sterile petri dishes. The Leishmania isolates, used, were obtained from the ParasiteBank, located within our university. Genotyping was done by using primers and probes specific to ITS1 and hsp70. The isolates, separated according to species, were cultured in NNN medium and promastigotes were transferred to RPMI-1640 and were expected to enter into logarithmic-phase. Promastigotes entering logarithmic-phase were inoculated on chocolate and blood agar. Plates were transferred to 25°C and were controlled every other day. Results: No growth was observed on chocolate agar on 7th day of incubation on plates, while colony size of Leishmania tropica, Leishmania infantum and Leishmania donovani were found to have an average of 0.9 mm and mean colony size of Leishmania major was 0.8 mm on blood agar, On 28th day of cultivation, average colony size of L. tropica, L. major, L. infantum and L. donovani on chocolate agar was observed as 1.0 mm, 0.9 mm, 1.0 mm and 0.8 mm, respectively, while colony size on blood agar was determined as 3.1 mm, 3.1 mm, 3.3 mm and 3.0 mm, respectively. Conclusion: On 7,14,21,28th days, colony size of all the strains were found to be better and their growth were faster on blood agar. It has been concluded that blood agar may be suitable for reproduction of Leishmania for genetic and other studies planned.

Amaç: Bu çalışma, Türkiye’den elde edilen Leishmania spp. izolatlarının kanlı agar ve çikolata agardaki koloni oluşumlarının izlenmesi ve farklılıklarının karşılaştırılması, tek bir hücreden oluşan koloni elde edilerek gerektiğinde genetik çalışmalarda kullanılması amacıyla planlanmıştır. Yöntem: Çalışmamızda kullanılan kanlı agar ve çikolata agarın gerekli ön hazırlık aşamaları yapıldıktan sonra steril petri kaplarına dökülmesi ile besiyerleri hazırlanmıştır. Kullanılan Leishmania spp. izolatları üniversitemiz bünyesinde bulunan Parazit Bankası’ndan sağlanmıştır. Leishmania spp izolatlarının, ITS1 ve hsp70 bölgesine özgü primer ve problar kullanılarak genotiplendirilmesi yapılmıştır. Türlere göre ayrılan izolatların NNN besiyerinde kültürü yapılmış ve üreyen promastigotlar RPMI 1640 sıvı besiyerlerine aktarılarak logaritmik faza girmeleri beklenmiştir. Logaritmik faza giren promastigotların çikolata agar ve kanlı agara ekimleri yapılmış ve 25°C’lik etüve kaldırılarak gün aşırı takip edilmiştir. Bulgular: Etüvden çıkarılarak incelenen plaklarda inkübasyonun 7. gününde çikolata agarda herhangi bir koloni oluşumu gözlenmezken, kanlı agarda Leishmania tropica, Leishmania infantum ve Leishmania donovani de koloni büyüklüklerinin ortalama 0.9 mm olduğu, Leishmania major’de ise ortalama 0.8 mm olduğu saptanmıştır. Plaklara yapılan ekimin 28. gününde ise çikolata agarda L. tropica, L. major, L. infantum ve L. donovani’deki ortalama koloni büyüklükleri sırasıyla 1.0 mm, 0.9 mm, 1.0 mm ve 0.8 mm olarak gözlemlenirken, kanlı agardaki koloni büyüklükleri sırasıyla 3.1 mm, 3.1 mm, 3.3 mm ve 3.0 mm olduğu belirlenmiştir. Sonuç: Plaklara yapılan ekimlerin takibi sonucunda tüm suşların 7., 14., 21. ve 28. günlerdeki koloni oluşumlarının kanlı agarda daha hızlı olduğu saptanmıştır. Kanlı agarın Leishmania spp. ile ilgili yapılması planlanan genetik çalışmalar ve diğer çalışmalarda kullanılmasının uygun olabileceği sonucuna varılmıştır., Objective: This study was planned with the aim of comparing the reproduction differences of Leishmania isolates, obtained from Turkey, on chocolate and blood agars, colony growth views on agar plates and to attain colonies from single cell to utilize for genetic studies. Method: After preparation of blood agar and chocolate agar used in our study, the media were prepared by pouring into sterile petri dishes. The Leishmania isolates, used, were obtained from the ParasiteBank, located within our university. Genotyping was done by using primers and probes specific to ITS1 and hsp70. The isolates, separated according to species, were cultured in NNN medium and promastigotes were transferred to RPMI-1640 and were expected to enter into logarithmic-phase. Promastigotes entering logarithmic-phase were inoculated on chocolate and blood agar. Plates were transferred to 25°C and were controlled every other day. Results: No growth was observed on chocolate agar on 7th day of incubation on plates, while colony size of Leishmania tropica, Leishmania infantum and Leishmania donovani were found to have an average of 0.9 mm and mean colony size of Leishmania major was 0.8 mm on blood agar, On 28th day of cultivation, average colony size of L. tropica, L. major, L. infantum and L. donovani on chocolate agar was observed as 1.0 mm, 0.9 mm, 1.0 mm and 0.8 mm, respectively, while colony size on blood agar was determined as 3.1 mm, 3.1 mm, 3.3 mm and 3.0 mm, respectively. Conclusion: On 7,14,21,28th days, colony size of all the strains were found to be better and their growth were faster on blood agar. It has been concluded that blood agar may be suitable for reproduction of Leishmania for genetic and other studies planned.

Leyşmanyazis, enfekte dişi tatarcıkların ısırmasıyla insanlara bulaşan paraziter bir hastalıktır. Kutanöz leyşmanyazisin (KL) tanısında dermal kazıntıdan alınan örneklerde, mikroskopta parazitin gösterilmesi altın standart bir yöntem olarak yerini korumaktadır. Ancak bir yıl ve daha uzun süreli lezyonu bulunan kronik olgularda amastigot sayısı çok az sayıda olduğundan saptamak zordur. Hastaların öncelikle vücutlarında çıkan bu lezyonları dikkate almamaları, sağlık kurumlarına başvurmamaları veya geç başvurmaları, yanlış tedavi almaları gibi birçok nedenden ötürü tanı ve tedavi gecikmektedir. Ayrıca, lezyonlar üzerine sekonder enfeksiyon eklenerek prognoz kötüleşmekte ve yaralar kronikleşmektedir. Bu nedenle, kronik KL şüpheli olgularda mikroskop ile inceleme yöntemine ek olarak moleküler yöntemlerden faydalanılmaktadır. Bu çalışmada, mikroskop incelemesi sonucunda Leishmania amastigotları görülmeyen ancak klinik olarak KL açısından değerlendirilmesi rapor edilmiş şüpheli kronik KL Türkiye başlangıçlı olgulara ait dermal kazıntı preparatları seçilerek polimeraz zincir reaksiyonu (PCR) yöntemi kullanılarak leyşmanyazis tanısında moleküler yöntemin tanı değerinin ortaya konması amaçlanmıştır. Hatay Mustafa Kemal Üniversitesi Tıp Fakültesi Parazitoloji Laboratuvarına farklı polikliniklerden gelen KL şüphesi ile başvurmuş ve mikroskop incelemesi sonucunda endemik bölgelerden geldikleri kaydedilmiş (Hassa, Altınözü, Yayladağı gibi), klinik olarak kronik KL açısından değerlendirilmesi rapor edilmiş Türk hastaya ait dermal kazıntı preparatları (n= 50) çalışmaya dahil edilmiştir. Örneklerden DNA izolasyonu yapılarak tüm Leishmania türlerine özgü kinetoplastit DNA (kDNA) bölgesini hedefleyen 13A, 13B primerleri kullanılmıştır. PCR ile pozitif bulunan örnekler internal transcribed spacer (ITS-1) bölgesini hedefleyen LITSR ve L5.8S primerleri kullanılarak “polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)” yöntemi ile tür tayini yapılmıştır. Toplam 50 adet dermal kazıntı örneğinden 17 (%34)’si kDNA bölgesini hedefleyen 13A, 13B primerleri ile pozitif olarak bulunmuştur. Pozitif bulunan örnekler ITS-1 bölgesini hedefleyen LITSR ve L5.8S primerleri ile de pozitif olarak saptanmıştır. ITS-1 gen bölgesiyle yapılan PCR sonucunda elde edilen ürünler BsuRI (HaeIII) enzimi kullanılarak kesilmiştir. PCR-RFLP analizi sonucunda 17 örneğin 11’i Leishmania tropica, biri Leishmania major ve beşi Leishmania infantum/donovani olarak tanımlanmıştır. Kronik KL; sarkoidoz, tüberküloz, malign tümörler gibi deri hastalıklarıyla karışabilmektedir. Özellikle, kronik KL olguları doğru tanı konulamaması, mikroskop deneyiminin yeterli olmaması, parazit sayısının az olması nedeniyle görülememesi gibi pek çok sebepten gözden kaçabilmektedir. Bu nedenle kronik KL şüphesi olan ancak mikroskop inceleme yöntemi ile parazit saptanamayan örneklerde moleküler yöntem olan PCR’nin kullanılmasının gerektiği sonucuna varılmıştır, Leishmaniasis is a parasitic disease that is transmitted to humans by the bites of infected female phlebotomine sandflies. In the diagnosis of cutaneous leishmaniasis (CL), in the smear samples, the demonstration of the parasite by microscope remains a gold standard method. However, it becomes difficult to diagnose the parasite since the number of amastigotes in chronic cases with a lesion of one year or longer is very low. Due to many factor such as patients primarily do not to take any notice these lesions in their bodies, do not apply to health institutions or late applied, receive wrong treatment; the diagnosis and treatment are delayed. In addition, it is been worse prognosis by add secondary infection to lesions and wounds become chronic. For this reason, molecular methods are used in addition to microscopic examination in chronic suspected CL cases. It was aimed to reveal of the molecular diagnostic value in chronic suspected CL cases by polymerase chain reaction (PCR) in the smear belonging to Turkish patients that reported to be evaluated clinically because it can not be seen Leishmania amastigotes in microscopic examination. Smear of 50 Turkish patients who were clinically reported of the evaluation of chronic CL were selected. These samples were smears belonging to suspected CL patients that applied Hatay Mustafa Kemal University, Faculty of Medicine, Parasitology laboratory from different polyclinics and were decided to be evaluated clinically as a result of microscopic examination because they came from endemic regions (such as Hassa, Altınözü, Yayladağı). DNA was isolated from selected samples and PCR was performed using 13A, 13B primers targeting the kinetoplastid DNA (kDNA) region. The samples found positive by PCR were typed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis using LITSR and L5.8S primers targeting internal transcribed spacer (ITS-1) region. Of the 50 smear samples, 17 (34%) were determined positive with 13A, 13B primers targeting the kinetoplastid DNA (kDNA) region. Positive samples were also found to be positive with LITSR and L5.8S primers targeting ITS-1 region. The PCR products obtained from PCR with ITS-1 gene region were digested with the restriction endonucleases BsuRI (HaeIII). As a result of PCR-RFLP analysis, it was determined that 11 of Leishmania tropica, one of Leishmania major and five of Leishmania infantum/donovani out of 17 samples. Chronic CL can be confused with skin diseases such as sarcoidosis, tuberculosis, malignant tumors. In particular, chronic CL cases can be escaped the attention for many reasons such as failure to diagnose correctly, insufficient microscope experience, fail to see due to low number of parasites. For this reason, it was concluded that PCR, which is a molecular method, should be used in chronic suspected CL samples which are negative for the parasite by microscopic examination.

Leishmaniasis, seen in tropical and subtropical regions, is an infectious disease caused by the protozoan parasite Leishmania species. There are three main forms of leishmaniasis: cutaneous, mucocutaneous and visceral leishmaniasis. Cutaneous leishmaniasis (CL) has become an increasing problem as the number of travels around the world increases and people go to work in endemic areas. Turkey has received great numbers of immigrants in recent years, from its neighboring countries like Iraq, Islamic Republic of Iran, Afghanistan, Turkmenistan and the Syrian Arab Republic because of the political instabilities in these countries as well as the job opportunities caused by large-scale development projects undertaken by Turkey. In this report, imported CL cases detected in five truck drivers transporting from Hatay to Turkmenistan, Syria, Saudi Arabia, Iran and Georgia, Uzbekistan and Azarbaijan countries were presented. The patients admitted to Mustafa Kemal University, Faculty of Medicine Dermatology Policlinic, with wound complaints on their bodies were directed to the Department of Parasitology to obtain smear samples from their wounds. The age range of the patients were 38 to 43 years. Patients with wound trail for a period ranging from one month to one year had a number of lesions varying between 2-7 and in all cases, a smear preparation was prepared from the lesions for diagnostic purposes. Clinical material obtained from five patients with pre-diagnosis of CL was firstly examined with Giemsa stain. Samples taken from the patients were inoculated into modified NNN (Novy-MacNeal-Nicolle) medium for the evaluation of the presence of the promastigotes. Promastigotes obtained from the inoculated medium were also genotyped using the ITS1 region. In all of the slides prepared from the clinical material taken from the patients amastigotes were determined. The growth of promastigotes were observed in only three of the clinical specimen inoculated media. The genotyped three species were Leishmania tropica, Leishmania infantum/donovani and Leishmania major. In this study, the importance of support for the diagnosis of different microbiological methods used in the diagnosis of leishmaniasis infection which occurred during the outbreaks of the disease has been put forward. In addition, it was aimed to draw attention to the importance of imported CL cases in our country diagnosed in five truck drivers making transportation from Hatay to Turkmenistan, Syria, Saudi Arabia, Iran, Georgia, Uzbekistan and Azerbaijan.

Objective Two pentavalent antimonials, meglumine antimoniate (Glucantime®, France) and sodium stibogluconate (Pentostam®, England), are used to treat cutaneous leishmaniasis (CL) in Turkey. The present study, serving as a guidebook for young researchers, aims to provide basis for conducting drug resistance tests and active ingredient scanning in in vitro and in vivo models. Methods A CL isolate kept in liquid nitrogen was initially thawed and genotyped by real-time polymerase chain reaction (PCR) using ITS1 prob. In vitro and in vivo tests were conducted to determine drug resistance against meglumine antimoniate and sodium stibogluconate. Hemocytometry and XTT (sodium 3,39-[1-(phenylaminocarbonyl)-3,4-tetrazolium]-bis (4-methoxy-6-nitro) benzenesulfonic acid hydrate) methods were used to investigate in vitro drug resistance. CL mouse models were used to analyze in vivo drug resistance. Results The isolate was determined as Leishmania tropica by genotyping by PCR on the internal transcribed spacer 1 (ITS1) gene region. In in vitro drug resistance tests, sodium stibogluconate was observed to be more effective than meglumine antimoniate, but there was no statistically significant difference between the two (p > 0.05). It was observed that the footpad lesions of the animals started to shrink afterward the 5th week of infection following treatment with these agents, and parasitologic recovery was observed at the end of 3 months. Conclusions With an aim to be used as a guidebook for young researchers, active ingredient scanning and drug resistance tests in both in vitro and in vivo models were presented in the current study.

Amaç: Kutanöz leishmaniasis (KL) tedavisinde ülkemizde antimon bileşiklerinden meglumin antimonat (Glucantime®, Fransa) ve sodyum stiboglukonat (Pentostam®, İngiltere) kullanılmaktadır. Çalışmamız, bu konuda çalışmalar planlayan genç araştırmacılara rehber olacak şekilde, in vitro ve in vivo modellerde ilaç direnç testlerinin ve etken madde taramalarının yapılmasına temel ve kaynak oluşturması amacıyla planlanmıştır. Yöntemler: Bir KL izolatı sıvı nitrojenden çıkarıldıktan sonra internal transcribed spacer 1 (ITS1) problu gerçek-zamanlı polimeraz zincirleme reaksiyonu (PZR) testi uygulanarak genotiplendirilmiştir. Meglumin antimonat ve sodyum stiboglukonat’a karşı ilaç direncini belirlemek için in vitro ve in vivo direnç testleri uygulanmıştır. In vitro ilaç direncini araştırmak için hemositometre ve XTT (sodium 3,39-[1-(phenylaminocarbonyl)- 3,4-tetrazolium]-bis (4-methoxy-6-nitro) benzene sülfonik asit hidrat) yöntemleri, in vivo ilaç direncini araştırmak için ise farelerde KL modelleri kullanılmıştır. Bulgular: Kullanılan izolatın PZR ile ITS1 bölgesine göre yapılan genotiplendirmeyle Leishmania tropica olduğu saptanmıştır. In vitro ilaç direnç testlerinde meglumin antimonat’a göre sodyum stiboglukonat’ın daha etkili olduğu görülmüş fakat istatistiksel olarak belirgin bir fark görülmemiştir (p>0,05). In vivo çalışmalarda ise meglumin antimonat ve sodyum stiboglukonat tedavisinin ayaktaki lezyonları enfeksiyonun 5. haftadan sonra küçültmeye başladığı ve 3 ay sonunda her iki ilacın uygulandığı gruplarda klinik ve parazitolojik iyileşme olduğu görülmüştür. Sonuç: Çalışacak genç araştırmacılar için rehber niteliğinde olacak şekilde in vitro ve in vivo modelde ilaç direnç testleri ve etken madde tarama yöntemleri temel ve basit olarak verilmiştir. Objective: Two pentavalent antimonials, meglumine antimoniate (Glucantime®, France) and sodium stibogluconate (Pentostam®, England), are used to treat cutaneous leishmaniasis (CL) in Turkey. The present study, serving as a guidebook for young researchers, aims to provide basis for conducting drug resistance tests and active ingredient scanning in in vitro and in vivo models. Methods: A CL isolate kept in liquid nitrogen was initially thawed and genotyped by real-time polymerase chain reaction (PCR) using ITS1 prob. In vitro and in vivo tests were conducted to determine drug resistance against meglumine antimoniate and sodium stibogluconate. Hemocytometry and XTT (sodium 3,39-[1-(phenylaminocarbonyl)-3,4-tetrazolium]-bis (4-methoxy-6-nitro) Benzenesulfonic acid hydrate) methods were used to investigate in vitro drug resistance. CL mouse models were used to analyze in vivo drug resistance. Results: The isolate was determined as Leishmania tropica by genotyping by PCR on the internal transcribed spacer 1 (ITS1) gene region. In in vitro drug resistance tests, sodium stibogluconate was observed to be more effective than meglumine antimoniate, but there was no statistically significant difference between the two (p>0.05). It was observed that the footpad lesions of the animals started to shrink afterward the 5th week of infection following treatment with these agents, and parasitologic recovery was observed at the end of 3 months. Conclusions: With an aim to be used as a guidebook for young researchers, active ingredient scanning and drug resistance tests in both in vitro and in vivo models were presented in the current study.