Journal of Academic Research in Medicine 

About: Journal of Academic Research in Medicine is an academic journal published by Galenos Yayinevi. The journal publishes majorly in the area(s): Medicine & Internal medicine. It has an ISSN identifier of 2146-6505. Over the lifetime, 346 publications have been published receiving 417 citations. The journal is also known as: JAREM.

The Reflux Finding Score: Reliability and Correlation to the Reflux Symptom Index

Abstract: Objective: To evaluate the correlation between the reflux symptom index (RSI) and the reflux finding score (RFS) in the patients with voice-related problems and to investigate the reliability of RFS. Methods: Fifty-four patients presenting with the complaint of voice abnormality were included in the study. Patients were asked to complete an RSI score sheet, and they were examined by rigid laryngostroboscopy. Laryngostroboscopic examinations of the patients were evaluated and rated with RFS by three different otolaryngologists blinded to patient information in two different sessions to evaluate intra-rater and inter-rater reliability. The correlations between RSI and RFS, for both total RFS and individual variables from RFS, were investigated. Results: Sixty-three percent were female and 37% were male, with a mean±SD age of 39.09±14.43 years. RSI ranged from 4 to 31, and RFS ranged from 8 to 22. All three raters demonstrated highly consistent intra-rater and inter-rater reliability for both total RFS and individual variables from RFS. There was a highly significant statistical correlation between RSI and total RFS (r=0.696; p=0.0001). Individual variables from RFS, except the posterior commissure hypertrophy, also demonstrated a significant positive correlation with RSI scores (p<0.05). Conclusion: RFS is a simple scale that could easily be administered with high intra-rater and inter-rater reliability for the evaluation of laryngopharyngeal reflux. RSI is highly correlated with both total RFS and all the individual variables from RFS, except posterior commissure hypertrophy. (JAREM 2015; 5: 68-74)

Sensitization Prevalence of Children with Allergic Rhinitis for Inhalant and Food Allergens in the Province of Sakarya, Turkey

Abstract: Objective: Sensitization prevalence studies have been rarely reported in children with allergic rhinitis from different regions of Turkey, and the exact rates of some sensitizations in humid regions such as Sakarya are still unknown. The aim of this study was to explore what kind of allergens play a role in sensitizations of allergic rhinitis patients during childhood in the Sakarya province of Turkey. Methods: This cross-sectional study involves 623 patients, 1–18 years of age, who have allergic rhinitis symptoms and were referred to the only pediatric allergy outpatient clinic in Sakarya between May 2013 and June 2015. Firstly, a questionnaire containing demographic data and patient history was completed. The multiple skin prick test system was used to detect sensitization. With 0 x 0 mm negative control, any positive test result with an allergen was defined as a wheal ≥3 mm diameter. Results: Overall, 289/623 (46%) children showed a positive response. 37% of them were found to have multiple sensitizations. Among the 289 patients, there were sensitizations to pollens (252/289: 87%), mites (51%), grasses (66%), trees (21%), molds (8%), animals (6%), and foods (6%). Sensitizations above 5 years of age were as follows: grasses, 72% (168/233); mites, 49.4%; trees, 24.5%; molds, 6.9%; and animals, 6%. Under 5 years were as follows: mites, 59% (33/56); grasses, 42.9%; foods, 25%; molds, 10.7%; trees, 5.4%; and animals, 3.6%. Conclusion: There were significant sensitizations detected for pollens and mites. Overall, a lower sensitization (8%) to molds is found in our patients who were referred to us from the humid Sakarya province.

Neonatal Acute Kidney Injury

Abstract: Acute kidney injury (AKI) is characterized by a sudden deterioration in kidney function that results in the accumulation of nitrogenous waste products (e.g., urea) and alters the regulation of extracellular fluid volume, electrolytes, and acid-base homeostasis. Although the criteria for neonatal acute kidney injury have varied, a frequently used definition is a serum creatinine level of more than 1.5 mg/dL.The causes of neonatal acute kidney injury are multiple and can be divided into prerenal, renal, and postrenal categories. Prerenal azotemia is the most common type of acute kidney injury in the neonate and may account for up to 85% of all cases. There are currently no specific medical therapies to treat AKI. The basic approach in management of AKI should be planned according to the underlying etiology. To maximize the chance for survival, the clinician must support the cardiorespiratory system, maintain maximal nutrition, balance homeostasis, and manage the consequences of AKI. The prognosis for neonates with acute kidney injury is variable, and largely related to the infant’s underlying medical condition, with mortality rates ranging from 14% to 73%. (JAREM 2013; 3: 53-9)

The Protective Effects of Omega-3 Fatty Acids and Sesame Oil on Cyclosporine-A Induced Liver Apoptosis

Abstract: Objective: Cyclosporine A (CsA) is the most effective and widely used immunosuppressant in solid organ transplantation and autoimmune diseases. Despite its benefits, the clinical use of CsA is limited by its nephrotoxic and hepatotoxic properties. Omega-3 fatty acids (O-3) comprise a family of unsaturated fatty acids that consist of α-linolenic acid, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) which has antioxidant properties. On the other hand, sesame oil (SO) contains many constituents, including a variety of antioxidant vitamins, glycerol esters of different fatty acids, and sesamol, which was recently reported to be a potent antioxidant, etc. In our study, we aimed to investigate the potential protective effects of O-3 and SO against CsA-induced liver apoptosis in rats. Methods: Seven groups of 7 rats/group were treated with saline/drugs for 15 days. In group 1, only saline was given orally (Po). In group 2, subcutaneous (s.c.) CsA was administered (15 mg/kg/day). In group 3, CsA (15 mg/kg/day; sc) and SO (1 ml/kg, Po) were given. In group 4, CsA (15 mg/kg/day; sc) and O-3 (100 mg/kg; Po) were given orally. In group 5, CsA (15 mg/kg/day; sc) and SO (1 ml/kg; Po) and O-3 (100 mg/kg; Po) were given synchronously. In group 6, only SO (1 ml/kg; Po) and in group 7 only O-3 (100 mg/kg, Po) were given. 24 h after the last treatments animals were sacrificed and livers were extracted. Apoptotic cells in liver tissues were counted using the TUNEL method. Results: In the group treated with CsA (Group 2), the number of apoptotic hepatocytes was significantly higher than the control group (Group 1) (p<0.001). Groups treated with SO (Group 3) or O-3 (Group 4) or both (Group 5) in addition to CsA have a reduced apoptotic cell count compared to CsA-treated group, but still significantly higher than the control group (p<0.001 for all 3 groups). Furthermore, the apoptotic cell count in the groups treated with SO-alone and O-3-alone were as low as in the control group. Conclusion: We indicated for the first time that O-3 and SO treatment has a protective effect against apoptosis induced by CsA in rats. Moreover, our study also revealed that SO and O-3 do not show any pro-apoptotic effects on the liver. The mechanisms underlying hepatoprotection of SO and O-3 may be related to both their free radical scavenging properties and indirect effects as a regulator of antioxidative systems. Thus, SO and O-3 can be candidates as good chemoprotectants. (JAREM 2011; 1: 8-11)

Retrospective Evaluation of Family Medicine Outpatient Clinic Profile at a Tertiary Hospital in İzmir

Abstract: Objective: Primary Health Care is defined as, the health institutions and the produced services where diagnostic procedures and treatment of 95% of admitted patients are performed, besides referring patients to secondary and tertiary hospitals in certain circumstances and serving preventive health care. In this study we assess two-month patient profiles and develop recommendations based on the data obtained from our outpatient clinics in a tertiary hospital. Methods: This is a cross-sectional study in which 1708 patients whom were referred to a tertiary hospital family medicine outpatient clinic in Izmir between 1.11.2015 and 31.12.2015 were evaluated retrospectively. Age, gender, smoking behavior, admission requests, diagnoses, consultation, laboratory tests and prescription data of patients were obtained. Results: The mean age of patients enrolled in the study was 47.11±16.70 years and 545 (68.2%) patients were women. The average of application per patient was 1.5±1.2 to a family medicine outpatient clinic in a tertiary hospital. The most common admission was the demand for physical examination with 500 patients (62.6%). The most common complaints in the physical examination group were stomach related complaints (15%), abdominal pain (12.4%) and body pain (11.0%). Among the 500 patients, 398 (79.6%) were investigated by laboratory tests, 289 (57.8%) were prescribed, and 108 (21.6%) were referred to other clinics. The rheumatology clinic was the most commonly referred to with 22.2% (n:24) of patients. Conclusion: It is important to give an appropriate education during resident training and encourage continuing medical education about monitoring and management of chronic diseases, vaccines, child and pregnancy surveillance issues and other commonly observed complaints in order to provide quality primary care services.