INTRODUCTION: Large platelets have more prothrombotic factors and aggregate more rapidly. In this study, our aim was to investigate the changes of mean platelet volume (MPV) in patients with acute ischemic stroke (AIS).
METHODS: Fifty-seven patients (25 female, and 32 male; mean age: 72.1 ± 12.9 years) hospitalized with diagnoses of acute ischemic stroke were enrolled in the study. Mean platelet volume (MPV) was assessed in blood samples obtained within 6 hours after the onset of ischemic stroke. Data obtained were compared with those of the controls (14 female, 14 male, mean age: 59.3 ± 15.1 years). Also AIS patients were divided into two groups according to usage of antiplatelet drugs and presence of previous stroke and MPV values compared between groups.
RESULTS: A significant difference was not detected between the patients, and the control group as for gender, and mean ages. When data of the cases and those of the control group were compared, any significant difference between both groups as for MPV and platelet counts could not be detected. Usage of antiplatelet drugs and a history of an ischemic stroke have not a significant impact on MPV.
DISCUSSION AND CONCLUSION: Our findings do not support the hypothesis that MPV has a role in the occurrence of AIS. Besides, usage of antiplatelet and previous incident of ischemic stroke does not induce any meaningful change on MPV values.

INTRODUCTION: In this study we aimed to investigate the effects of vitamin D supplementation on cardiac functions in stage III-IV systolic heart failure patients with concomitant vitamin D deficiency.
METHODS: This prospective study was carried out in 33 stage III or IV systolic heart failure patients (13 women, mean of 66.82 ± 10, 41 years, ranging from 35 to 86) with vitamin D deficiency. Serum 25-hydroxyvitamin D levels less than 20 ng/mL were accepted as vitamin D deficiency. All patients’ left ventricular ejection fraction, interventricular septum and posterior wall thickness at baseline and after vitamin D supplementation were measured with Area-Length method. In addition, all patients’ serum albumin, calcium, phosphorus and parathyroid hormone levels were determined at baseline and after the treatment. Serum 25 (OH) D levels were measured with by chromatographic method. All patients were treated with vitamin D (in the first 8 weeks, 50000IU/week of Ergocalciferol, in the remaining 6 weeks 14000IU/day Cholecalciferol and 1000mg/day Calcium) and followed for 14 weeks, while their routine medical therapy was not changed during the follow-up period.
RESULTS: The mean levels of serum calcium and albumin were increased significantly after the treatment (9.17±0.67 vs. 9.45 ± 0.42 mg/dL, p=0.017, 3.96 ± 0.45 vs. 4.06 ± 0.35 g/dL, p=0.035, respectively). Serum parathyroid hormone levels were decreased significantly (81.28 ± 71.27 vs 52.26 ± 19.12 pg/mL, p=0.003), while ejection fraction was increased significantly (36.3 ± 6.52 vs. 38.55 ± 6.06 %, p<0.001) after the treatment.
DISCUSSION AND CONCLUSION: Vitamin D supplementation in patients with advanced systolic heart failure can lead to improvement of systolic function via its effects on parathyroid hormone, calcium and phosphorus.

INTRODUCTION: Helicobacter pylori (H. pylori) is a atypical gram-negative bacteria preferring gastric mucosa which also have bizarre multisystem effects extended to some malignancies, hematologic and vascular disorders through some not well defined pathophysiologic pathways. While the explanation of the reason of the coincidence of renal-gall bladder stones, it was previously suggested that there may be a shift mechanism of intestinal microbial flora, from Oxalabacterformigenesthat may reduce the risk of renal stone by consuming intestinal oxalate, to H. pylori which is known to induce gallstone by unknown mechanism. In this study we aimed to investigate the relation between H. pylori and urinary system disease.
METHODS: We retrospectively evaluated the data of the 155 patients who underwent gastric biopsy for any reason in Fatih Sultan Mehmet Research & Training Hospitalbetween 2008 and 2013.Patients divided into two groups according to the H. pylori positivity.
RESULTS: It was found out that the urinary system stone coincidence for the groups with H. pylori+ (n: 110) and H. pylori - (n: 45) were 9 and 1 respectively.
DISCUSSION AND CONCLUSION: We think that this coincidence of stone and H. Pylori positivity is due to the possible systemic influence such as vascular and/or endoluminal sickness due to the H. pylori other than directs bacteriologic colonization. There is strong evidence that H. pylori have some role in the atherosclerotic procedure. The vascular theory of Randall plaque formation at renal papilla and subsequent calcium oxalate stone development that suggests microvascular injury of renal papilla in an atherosclerotic-like fashion results in calcification near vessel walls that eventually erodes as a calculus format into the urinary system. Briefly, theories of stone and atherosclerosis seemed to be overlap and H. pylori is one of the factors of both processes.

INTRODUCTION:
METHODS: The study was conducted in Intensive Care Unit of Fatih Sultan Mehmet Research and Education Hospital during January 2009 - August 2011. Out of 1236 patients who admitted to our unit during this time, 501 geriatric patients aged over 65 years were included in the study. They were evaluated according to predefined parameters and clinical conditions during weaning from the mechanical ventilator. Research parameters were recorded by a third person without any influence on the decisions of the attending intensive care unit doctor and the administered routine treatment protocols. Along with demographical properties, APACHE and SOFA scores, order of the day to be attached to ventilator, number of days on ventilator support, the process of weaning, whether they received positive inotropic support during treatment, and conditions at time of discharge were recorded.
RESULTS: Mortality rate was found to be 59.6% in geriatric patients; there was a positive relation between age and mortality at borderline significance (p=0.05). Mortality rate was higher in patients receiving inotropic support compared to those not receiving it (p<0.001). APACHE-II and SOFA scores were found to be remarkably associated with mortality (p<0.001). Of the 414 cases (82.63%) who were supported with mechanical ventilators; 117 (28.26%) could be weaned, and all weaned cases could be discharged. There was statistically significant relation between the number of days on ventilator support and the outcome (p<0.001).
DISCUSSION AND CONCLUSION: Geriatric patients generally constitute an exclusive patient group in intensive care units due to acute exacerbations of chronic health issues or problems involving multiple organ systems. Elderliness is associated with reduction in cardiopulmonary and renal reserves and high comorbidity rate. In addition to the relationship between mortality and age, it was determined that secondary diseases were also significantly related with mortality as well as the primary disease. Patients who received inotropic agents and/or whose weaning process was prolonged also had significantly higher mortality rates. There was remarkable association between APACHE II and SOFA scores and mortality. Intensive care indications for patients with multiple organ failure at advanced age are still controversial in different cultures.

INTRODUCTION: Nosocomial infections have been a significant problem since the 19th century. Decontamination of surfaces surrounding the patient is key in infection control of the hospital (1). We aimed to compare the efficiency of didecyl dimethyl ammonium chloride currently used in our clinic for surface decontamination and benzalkonium chloride, a product of nanotechnology.
METHODS: In F.S.M training and research hospital intensive care unit, two groups of 8-bed isolated areas at separate ends of the ward were named area A and B. Twice a day for two months benzalkonium chloride was applied to area A and didecyl dimethyl ammonium chloride to area B for surface cleaning. For the study samples were taken from 20 different surfaces including the nurse’s stand, phone, keyboard, monitors and ventilators for seven consecutive days 12 hours after cleaning. At the second phase of this study, 24 hours effect of benzalhcolium chlorid was studied and the data of two components was statically compared.
RESULTS: At the first phase of the study In 140 samples from areas A and B no statistically significant difference was found in number of bacterial growths (p: 0.605; p>0.05). At the second phase of this study, 140 samples from areas where drug A or B was used no significant difference was found between numbers of bacterial growth (p=0,637; p>0,05).
DISCUSSION AND CONCLUSION: Nosocomial infections come with serious socioeconomic cost. Several factors involving the patients and the hospital are involved in these infections. Hand hygiene, cleaning and education and training of personnel in the ICU may be effective in reducing ICU infections.
As a result of this study, admission of benzalcholium chlorid is effective. It should be used in terms of cost and labor gain.

Oxymetholone is a very potent anabolic steroid. It has also great effects on improving muscle mass and having an healthy/athletic look. That causes Oxymetholone abuse common among body builders and amateur athletes. Here we present a 32 year old male patient with rhabdomyolysis due to the use of unprescribed oxymetholone for bodybuilding. His plasma level of creatine kinase increased up to 3436 U/L. And also, he had no alcohol, strenuous physical exertion, trauma, surgery, or recent viral infection and had not taken any other medications except oxymetholone known to induce rhabdomyolysis. In conclusion, we see that it is easy to reach anabolic steroids without prescription by internet and also public gyms in recent years. Thus, emergency physicians should be aware of anabolic steroid usage in the differential diagnosis of healthy and athletic looking rhabdomyolysis patients.

Pregnancy and postpartum period induces physiological and hormonal changes that may cause hypertensive and hemorrhagic complications. Headache can be observed; it is a frequent symptom. Early detection and diagnosis is crucial to provide appropriate management and treatment success. In this case report as multiple intracerebral hemorrhage and cerebral venous thrombozis with multiple intracerebral hemorrhage occurring as fatal complications of vasculitis during postpartum period.

The most common cause of lower extremity claudication are peripheral artery disease (PAD) in adults, and degenerative orthopedic diseases. Rather than PAD associated with atherosclerosis in children, congenital cutis marmoratus telangiectasis, chronic compartment syndrome, popliteal artery entrapment syndrome (PAES) and medial tibial syndrome which leads to atypical claudication should be excluded. PAES which holds the lower extremity arteries in young men, is a congenital anomaly that causes critical limb ischemia. Bilateral involvement is often. Here w present a 14-year-old male patient diagnosed with popliteal artery entrapment syndrome (PAES) who has bilateral extremity claudication.

Proton pump inhibitors (PPIs) are now one of the most widely used classes of drugs. PPIs have an excellent safety profile and it is unusual for a patient to stop these drugs because of side effects. Long-term, sometimes lifetime use is becoming increasingly common, often without appropriate indications. Therefore the long-term potential adverse effects are receiving increasing attention. There is one area which attracts much attention and generally has been poorly studied, is that the long-term effects of chronic acid suppression on the absorption of vitamins and nutrients. In this article, the studies about the effects of chronic PPI usage, on vitamin B12, iron, calcium, and magnesium absorption,and the infectious consequences as well as the gastric effects due to chronic usage were examined systematicaly.