Browsing by Author "Kurt, Ö"
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Item E.histolytica/dispar Cases Diagnosed in Ege University Medical Faculty Parasitology Outpatient Clinic Between January 2010 to June 2011Ünver, A; Oyur, T; Kurt, Ö; Töz, SÖ; Turgay, NFor definitive diagnosis of amoebiasis, The Ministry of Health requires the detection of Entamoeba histolytica (E. histolytica) trophozoites that ingested red blood cells in Trichrome-stained smears or E. histolytica-specific adhesin antigen with ELISA. Stool samples of 51 patients admitted to the Outpatients Clinic of Ege University School of Medicine Department of Parasitology between January 2010 and June 2011 were suspected to have E. histolytica/dispar cysts or trophozoites in wet mount examinations and stained with Trichrome. Examination of these smears revealed that 49 samples were positive for E. histolytica/dispar Thirty-three samples were tested for the positivity of E. histolytica-specific adhesin antigen with a commercial ELISA kit (Entamoeba CELISA-Path; CeLLabs Pty. Ltd., Brookvale, Australia) and 23 were found to be positive. Our results indicated an elevation of figures of amoebiasis cases in recent years. It is concluded that application of different methods for the diagnosis of E. histolytica infections as suggested by The Ministry of Health is essential for correct reports of peripheral laboratories.Item The effectiveness of the Culture for Dientamoeba fragilis from the StoolKurt, Ö; Girginkardesler, N; Öbilgin, A; Ok, UÜObjective: In the identification of Dientamobea fragilis, Polymerase chain reaction (PCR) is by far more sensitive than microscopic examination of permanent-stained smears, while it is faster and less labour-intensive than culture; however, it is expensive. We aimed to assess the sensitivity of culture and compare the efficacies of three culture media: Robinson's medium (RM), Dobell's medium (DM) and Talis's Medium (TM), for the identification of D. fragilis. Materials and Methods: Stool samples of 104 individuals admitted to Manisa Celal Bayar University Hospital with complaints such as abdominal pain, itching, meteorism and diarrhea, and no detection of D. fragilis in the initial examination of trichrome-stained smears of their stools, were cultivated in RM, DM and TM on the same day. Results: Trophozoites of D. fragilis were detected in 11 of 104 (10.6%) samples, where all were positive in RM, while 3 and 4 of 11 were also positive in DM and TM, respectively. Two samples were found to be positive in all three media. RM was by far the leading medium to supply vast numbers of trophozoites. Conclusion: These results indicate that culture is more effective than microscopic examination of permanent stained smears of stools to identify D. fragilis when PCR is not available, and RM could be the first choice for culture as it supplies huge amounts of trophozoites useful for further molecular studies.Item Rural life, lower socioeconomic status and parasitic infectionsBalcioglu, IC; Kurt, Ö; Limoncu, ME; Dinç, G; Gümüs, M; Kilimcioglu, AA; Kayran, E; Özbilgin, AThis study was conducted both to assess the prevalence of parasitic infections in two neighboring villages of Manisa province in Turkey, with different socioeconomic levels and investigate the influences of some individual and environmental factors on these infections. A total of 100 school children were enrolled and their cellophane tape and stool samples were examined for parasites. Pediculus capitis infestation was diagnosed by visual inspection of the hair. Although the prevalences of both intestinal parasitosis and pediculosis were high in both villages, there was a statistically significant difference for pediculosis, but not for intestinal parasitosis. Lack of social security and father's regular job were found to be highly correlated with all parasitic infections. Pediculosis was more common in younger children, girls and those in crowded families. These results indicate not only the high prevalence of parasitic infections, but also the urgent need for the improvement of basic health services and infrastructure in the rural areas, crowded with poorer immigrant population. (c) 2007 Elsevier Ireland Ltd. All rights reserved.Item Are Regular Controls Conducted in Schools Adequate in Lowering the Incidence of Head Lice (Pediculus capitis) Infestation?Balcioglu, IC; Kurt, Ö; Limoncu, ME; Ermis, VÖ; Tabak, T; Oyur, T; Muslu, H; Kavur, H; Görgün, S; Girginkardesler, N; Yereli, K; Bilaç, C; Özbel, YIn the present study, school children of similar age-groups from two villages of Manisa province, namely Osmancali and Maldan, were examined in regular time periods to monitorize the changes in the incidence of head lice (Pediculus capitis). A total of 2091 children (1565 in Osmancali and 526 in Maldan) were combed with a newly-designed lice comb (PDC (R), KSL Consulting, Helsinge, Denmark) four times in May and November in 2008 and 2009. The assessment of the results was conducted with SPSS (R) v.15 program using CHAID and logistic regression analysis. The results of the periodic examinations of the children showed that the infestation rate of girls were found to be higher significantly compared to boys (P<0.001), and the incidence of head lice infestation in boys from Osmancali was found three times higher than the incidence in boys in Maldan (P=0.002). In addition, regular dry combing and treatment lowered the infestation rates among girls significantly (P=0.001). According to the results of the study, regular dry combing of school children with specially-designed lice combs may be essential for the control of this common infestation, especially in rural areas.Item Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural TurkeyKurt, Ö; Balcioglu, IC; Burgess, IF; Limoncu, ME; Girginkardesler, N; Tabak, T; Muslu, H; Ermis, Ö; Sahin, MT; Bilac, C; Kavur, H; Özbel, YBackground: Dimeticone 4% lotion was shown to be an effective treatment for head louse infestation in two randomised controlled trials in England. It is not affected by insecticide resistance but efficacy obtained (70-75%) was lower than expected. This study was designed to evaluate efficacy of dimeticone 4% lotion in a geographically, socially, and culturally different setting, in rural Turkey and, in order to achieve blinding, it was compared with a potential alternative formulation. Methods: Children from two village schools were screened for head lice by detection combing. All infested students and family members could participate, giving access to treatment for the whole community. Two investigator applied treatments were given 7 days apart. Outcome was assessed by detection combing three times between treatments and twice the week following second treatment. Results: In the intention to treat group 35/36 treated using dimeticone 4% had no lice after the second treatment but there were two protocol violators giving 91.7% treatment success. The alternative product gave 30/36 (83.3%) treatment success, a difference of 8.4% (95% CI-9.8% to 26.2%). The cure rates per-protocol were 33/34 (97.1%) and 30/35 (85.7%) respectively. We were unable to find any newly emerged louse nymphs on 77.8% of dimeticone 4% treated participants or on 66.7% of those treated with the alternative formulation. No adverse events were identified. Conclusion: Our results confirm the efficacy of dimeticone 4% lotion against lice and eggs and we found no detectable difference between this product and dimeticone 4% lotion with nerolidol 2% added. We believe that the high cure rate was related to the lower intensity of infestation in Turkey, together with the level of community engagement, compared with previous studies in the UK.Item In vitro Efficacy of Quercus infectoria Oliv. and Achillea millefolium L. Extracts Against Blastocystis spp. IsolatesÖzbilgin, A; Durmuskahya, C; Kilimcioglu, AA; Kayalar, H; Kurt, Ö; Ermis, VÖ; Tabak, T; Östan, IBlastocystis is a common intestinal parasite that can inhabit the intestinal tract of humans and many animals. Despite it was firstly described almost 100 years ago; many subjects are still under debate about Blastocystis, including its life-cycle, pathogenic potential and treatment of infected individuals. Historically, local plant species have been used for therapeutic purposes by the local people of Anatolia. Here, hexane and methanol extracts of two local plants, Quercus infectoria (Fagaceae) and Achillea millefolium, which have been used against diarrhea in Anatolia, were examined for their in vitro efficacies against Blastocystis. LC50 and EC50 values of the plant extracts were determined by Brine Shrimp and Graphpad Prism 5 (R) methods, respectively. The results showed that LC50 (500 mu g/ml) and EC50 (198.8 mu g/ml) concentrations of the methanol extract of A. millefolium were lowest compared to other extracts, its anti-Blastocystis activity was found to be comparable to metronidazole and it showed no cytotoxic activity. These initial results suggest that the methanol extract of A. millefolium may be a novel option for the treatment of Blastocystis infections in humans in future, if confirmed by further, larger-scale studies.Item Feconomics®: A Simple, Novel and Fast Technique for Stool Concentration in Parasitology LaboratoryKurt, Ö; Akyar, I; Görgün, S; Kocagöz, T; Özbilgin, AFeconomics (R) is a new ready-to-use kit for fecal concentration that eliminates the need for centrifugation and floatation by using absorbent beads. To assess its efficacy in the diagnosis of intestinal parasites, a comparative, double-blind study was conducted in the Parasitology Laboratory of Celal Bayar University Medical School. Stools (Group I, n=251) submitted for routine ova and parasite examination were concentrated with both routine formalin ethyl acetate concentration (FEAC) technique and Feconomics (R). Since the number of helminthes identified in the stool samples of patients were very low, helminthes obtained from the animal models in the laboratory were included (Group II, n=11). The iodine-stained samples of all stools and some of the positive samples stained with Gomori's trichrome and Kinyoun's acid fast stain were read by specialists. In Group I, 103 of 251 (41.04%) samples were found to be positive for one or more intestinal parasites; among them, 76(30.28%) and 96(38.25%) stools were found to be positive with FEAC and Feconomics (R), respectively, and the difference was significant (P=0.000). Same parasites were identified with both methods among all 11 samples in Group II. There was no difference between the methods for the morphological integrity and visual appearances of the parasites having cyst or egg forms; yet, it was noticed that the vegetative forms of the parasites were only identified with Feconomics (R). Review of our data indicated that Feconomics (R) may be suggested as a fast and effective fecal concentration method for Parasitology laboratories owing to the identification of higher number of parasites compared to FEAC, and parasites with only vegetative forms such as Dientamoeba fragilis.Item Serological levels of zinc, copper and iron elements among Giardia lamblia infected children in TurkeyErtan, P; Yereli, K; Kurt, Ö; Balcioglu, IC; Onag, ABackground : Giardiasis, an intestinal protozoan infection caused by Giardia lamblia , is common in Turkey, especially among children aged between 2- and 14-years-old. Effects of giardiasis on serological levels of zinc, copper and iron elements were assessed in this study. Methods : A total of 45 children, aged between 2- and 14-years-old, who were admitted to the Pediatrics Department of Celal Bayar University Medical School with gastrointestinal complaints and diagnosed as having giardiasis by stool examinations in the Parasitology Department, were enrolled as the study group (SG). The control group (CG) consisted of 45 age-matched healthy children. Serological levels of zinc, copper and iron were measured by atomic absorption spectrophotometer in all samples. Results : As a result of the study, serum zinc levels were 67.43 +/- 17.72 mug/dL and 145.20 +/- 9.13 mug/dL, copper levels were 198.45 +/- 39.14 mug/dL and 150 +/- 21.14 mug/dL and iron levels were 87.98 +/- 18.31 mug/dL and 160.45 +/- 45.40 mug/dL, in SG and CG, respectively. When compared separately as SG and CG, there was a statistically significant difference between the serological levels of all these elements. Conclusion : These results revealed that giardiasis increased the serological levels of copper, like other infectious agents. However, zinc and iron levels decreased during giardiasis due to malabsorption.Item A comparison of metronidazole and single-dose ornidazole for the treatment of dientamoebiasisKurt, Ö; Girginkardesler, N; Balcioglu, IC; Özbilgin, A; Ok, ÜZRecent reports of the pathogenic potential of Dientamoeba fragilis have underlined the need for an effective treatment against this colon-dwelling protozoan. Metronidazole is a well-known and commonly used anti-protozoal agent, but another 5-nitroimidazole derivative, ornidazole, may be preferable, where available, because of its longer half-life and fewer side-effects. This study compared the efficacies of metronidazole and ornidazole in a group of 112 patients with dientamoebiasis. Patients were randomised into two treatment groups: group 1 (n = 56) received metronidazole for 5 days, 20 mg/kg/day for children and 1.5 g/day for adults, in three oral doses, while group 2 (n = 56) received a single oral dose of ornidazole, 30 mg/kg for children and 2 g for adults. Stool samples were examined on the seventh and 14th days after treatment, and clinical symptoms were recorded to evaluate the efficacy of treatment. A statistically significant difference was recorded between the efficacies of ornidazole and metronidazole, both parasitologically (92.9% vs. 69.6%, p 0.001) and clinically (96.4% vs. 76.8%, p 0.001). Patients in the metronidazole group reported more side-effects than patients in the ornidazole group, none of whom required termination of treatment. These results suggest that single-dose ornidazole may be an important alternative agent for the treatment of dientamoebiasis.Item Efficacy of azithromycin in a murine toxoplasmosis model, employing a Toxoplasma gondii strain from TurkeyDegerli, K; Kilimcioglu, AA; Kurt, Ö; Tamay, AT; Özbilgin, AA murine toxoplasmosis model with Balb/C mice was used to investigate the therapeutic and prophylactic efficacy of azithromycin in a native strain of Toxoplasma gondii. Initially, seven groups-four studies and three controls-were established and 10(3) tachyzoites of this native strain of T. gondii were injected intraperitoneally to the mice in groups 1, 2, 3, 4 and 7. Azithromycin was given to groups 1-4 at different times of infection orally between 100 and 300 mg/kg/day for 10 days. Azithromycin was found to be effective at 200 mg/kg/day and above in the prophylaxis, at 250 mg/kg/day and above in the treatment of toxoplasmosis. These results suggest that azithromycin is effective in the prophylaxis and early infection of a highly virulent strain of T. gondii, and it doubled the survival time in the late infection. Azithromycin could be an alternative treatment regimen for human toxoplasmosis, if supported by further clinical investigations. (C) 2003 Elsevier B.V. All rights reserved.Item Giardiasis treatment in Turkish children with a single dose of ornidazoleÖzbilgin, A; Ertan, P; Yereli, K; Tamay, AT; Kurt, Ö; Degerli, K; Balcioglu, IC; Ok, ÜZ; Onag, AThis study was designed to compare the treatment efficacy of single dose of ornidazole with 5 d treatments of ornidazole and metronidazole in children with giardiasis. 175 children, between 2 and 15 y old, whose stool samples were found to be positive for Giardia lamblia cysts and/or trophozoites by either saline-Lugol, formalin-ethyl acetate or trichrome staining, were enrolled in the study. Of these children, 105 were treated with a single dose of ornidazole: 35 with 30 mg/kg, 35 with 25 mg/kg and 35 with 20 mg/kg; 35 were treated with 25 mg/kg per day of ornidazole for 5 d in 2 doses and 35 children were treated with 20 mg/kg per day metronidazole for 7 d in 3 doses. All cases were examined on the 7th, 10th and 14th days after treatment by the same methods; clinical symptoms were also evaluated. Giardia lamblia was eradicated in 34 of 35 (97%), 34 of 35 (97%) and 33 of 35 (94%) patients treated with 30, 25 and 20 mg/kg single doses of ornidazole, respectively. Eradication was achieved in all 35 patients treated with 25 mg/kg per day ornidazole for 5 d and in 31 of 35 (89%) patients treated with metronidazole. There was no statistically significant difference among doses of ornidazole ( p > 0.05); however, all ornidazole treatment regimens were significantly more effective than metronidazole treatment ( p < 0.05). No important side-effects were detected in any patients and clinical symptoms disappeared in all. Single-dose ornidazole treatment could be considered as a proper and effective alternative method for the treatment of giardiasis in children.Item In Vitro Cultivation of Plasmodium berghei: Application of Drug Resistance Tests with Chloroquine and ArtesunateÖstan, I; Kurt, Ö; Özbilgin, AThe aim of this study is to assess the drug resistance testing of Plasmodium berghei after short-term culture in vitro. First stage, the life cycle of the malaria parasites was completed in an average of 24 h inside the red blood cells in vitro. Second stage, the inhibition rates of Chloroquine and Artesunate on the infected erythrocytes were determined. The results showed that P. berghei parasites were completed their erythrocytic schizogony in short term in vitro cultivation. In the drug resistance tests with Chloroquine and Artesunate, antiplasmodial resistance did not occur with both drugs and the effect of Artesunate is higher than Chloroquine.Item Two novel serum-free media for the culture of Trichomonas vaginalisLimoncu, ME; Kilimcioglu, AA; Kurt, Ö; Östan, I; Özkütük, N; Özbilgin, ADefinitive diagnosis of Trichomonas vaginalis, one of the common causes of sexually transmitted diseases in Turkey, relies on the microscopic examination of both fresh preparations and culture material of genital secretions and urine. The aim of this study was to compare the diagnostic efficacies of two culture media, serum-free TB1 and TB2, including iron and vitamin B12, respectively, with the well-known medium, TYM. Growth rate reached peak levels 48 h in TYM and 72 h in both TB1 and TB2 after inoculation. The highest amount of viable trophozoites has been obtained from TB1, almost equal to TYM but significantly higher than TB2. Fresh preparations obtained from the vaginal secretions of 119 patients have been examined and vaginal samples have been inoculated in TB1, TB2, and TYM. Viable T. vaginalis trophozoites have been detected in ten (8.4%) of fresh preparations and 11 (9.9%) of each medium. It is concluded that serum-free TB1 medium could be used effectively in both the isolation and maintenance of T. vaginalis culture in vitro.Item General Features of Patients Infected with Dientamoeba fragilis: Assessment of a Cohort of One Hundred Patients from Manisa ProvinceKurt, Ö; Ok, ÜZDientamoeba fragilis is a flagellated protozoon dwelling in the colonic lumen. It was shown that it may cause clinical manifestations which required effective anti-microbial therapy. General features of 100 D. fragilis-infected patients were assessed in a study conducted in the Parasitology Laboratory of Celal Bayar University Hospital. Patients were mostly females, between 18 and 50 years, and almost two-thirds of them were admitted with gastrointestinal complaints such as bloating, abdominal pain, diarrhea and fatigue. Thirty-four of 100 patients were coinfected with Blastocystis sp., while 27 of 83 (32.5%) patients that submitted three cellophane tape samples were coinfected with Enterobius vermicularis. Another significant outcome of the study was that 7 and 6 of 35 patients reported dermatologic complaints as itching and lesions, consecutively. The patients and/or their families were mostly educated, middle-class individuals living in apartments in city centre, using tap water for drinking and do regular hand-washing. The study results suggest that D. fragilis should be regarded as a causative agent in pediatric and adult patients suffering from abdominal pain, diarrhea and intense bloating, and the fresh stool samples should be examined directly or kept in a fixative solution until examination with a permanent-stained smear such as trichrome.Item Clinical CluesKurt, Ö; Özbilgin, AItem Cutaneous leishmaniasis caused by Leishmania infantum in Turkey: reports of two cases diagnosed with genotyping and protein fingerprintingCulha, G; Akyar, I; Zeyrek, FY; Gündüz, C; Kurt, Ö; Ostan, I; Töz, S; Kocagoz, T; Ozbel, Y; Ozbilgin, AItem Cutaneous and visceral tropisms of Leishmania tropica/Leishmania infantum hybrids in a murine model: First report of hybrid Leishmania strains isolated in TurkeyOzbilgin, A; Culha, G; Zeyrek, FY; Töz, S; Gündüz, C; Kurt, Ö; Pratlong, F; Ozbel, YItem The prevalence of intestinal parasites in the province of Izmir, TurkeyDagci, H; Kurt, Ö; Demirel, M; Östan, I; Azizi, NR; Mandiracioglu, A; Yurdagül, C; Tanyüksel, M; Eroglu, E; Ak, MStool samples of a total of 2,047 people in Izmir province were examined by wet mount, formalin ethyl acetate concentration, and trichrome staining methods with an aim to reveal the prevalence of intestinal parasites in Izmir together with related personal and environmental risk factors. Geographical mapping showing the density and variation of the species of intestinal parasites in Izmir was done after all maps were scaled, and the coordinates were determined with GeoMedia5.0(R). The prevalence of the intestinal parasites was found to be 25.6% in Izmir, with a variation between the districts. Blastocystis hominis was the leading parasite, and the prevalence of parasites was higher in children compared to adults; however, the difference was statistically insignificant. There was also no significant difference between the parasite prevalence and sex, marital status, education, income, frequent eating outside, and habitual raw meat eating. Significant differences were found between the parasite prevalence and crowded families, early immigrants, individuals with no social security, and people living in close contact with their livestock. The parasites were found to be less common among individuals who had been drinking bottled water and living in a house with a sewage system. The results demonstrated a correlation between the intestinal parasites and environmental conditions in our study group. We further plan to expand the study group to cover all regions of Turkey.Item First Report and In Silico Analysis of Leishmania virus (LRV2) identified in an autochthonous Leishmania major isolate in TurkeyKurt, Ö; Mansur, N; Çavus, I; Özcan, O; Batir, MB; Gündüz, C; Sezerman, U; Özbilgin, ALeishmania virus (LRV) has previously been identified in different Leishmania species. Host-LRV interaction is associated with exacerbated clinical manifestations of cutaneous leishmaniasis (CL) and may cause poor therapeutic response. CL cases due to L. major with large skin lesions resistant to routine therapy were recently identified in Turkey. Here, we report the first autochthonous case of cutaneous leislunaniasis caused by LRV-positive Leishmania major, using conventional PCR targeting the viral capsid protein of LRV The lesion of the case was 6 months old, relatively large (4 cm), and did not recover despite three consecutive intralesional applications of glucantime. Assessment of LRV's influence on prognosis and clinical outcomes of leishmaniasis, based on additional studies, is required.Item The current clinical and geographical situation of cutaneous leishmaniasis based on species identification in TurkeyÖzbilgin, A; Töz, S; Harman, M; Topal, SG; Uzun, S; Okudan, F; Güngör, D; Erat, A; Ertabaklar, H; Ertug, S; Gündüz, C; Çavus, I; Karakus, M; Ural, IÖ; Ölgen, MK; Kayabasi, Ç; Kurt, Ö; Özbel, YLeishmaniases are a group of vector-borne diseases caused by the members of Leishrnania genus, and there are three main clinical forms of the infection as visceral, cutaneous, and mucocutaneous. Cutaneous leishmaniasis is a growing public health problem in Turkey due to increasing detection of autochthonous cases caused by L. major and L. donovani in some regions in addition to Syrian imported cases. For this reason, we aimed to evaluate the current epidemiological situation of CL in the view of causative agents and their geographical distribution throughout Turkey. The samples were collected from 356 CL patients admitted to different centers in 18 provinces between January 2013 and December 2016. Direct microscopy, culture (regular and enriched NNN) and molecular techniques (real-time ITS1 PCR and hsp70 PCR/sequencing) were performed. By molecular techniques, 299, 28, 19 and 10 isolates/clinical samples were identified as L. tropica, L. major, L. infant= and L. donovani, respectively. Most of the patients (65.73%) had one lesion usually on their face/head. Dry-nodular type lesions (n = 291) were mainly associated with L. tropica while L. major was mainly found related to wet-ulcerative ones. Leishmaniasis recidivans was also detected in 2.52% among 356 patients. L. tropica was detected as most widespread species causing CL in Turkey. L. infantum and L. major was also found in one third of the provinces. Enriched NNN culture was worked well for isolating the parasite and 346 isolates were successfully grown and stored in liquid nitrogen. The comparison of all diagnostic techniques showed that the parasitological positivity rate could increase if the combination of direct microscopy and real-time ITS1 PCR is used. Besides well-known anthroponotic L. tropica cases, the increasing detection of CL cases caused by zoonotic species, L. infantum and L. major, is one of the most important findings in the present study. In our opinion to ensure timely and accurate diagnosis, proper treatment and countrywide effective control of CL in Turkey a systematic approach is needed on the base of information about characteristics of lesions and patients and epidemiological features of the disease.