Hüseyin Kurt

<b><i>Background/Aims:</i></b> Magnesium is an essential mineral for many metabolic functions. There is very little information on the effect of magnesium supplementation on metabolic profiles of chronic kidney disease (CKD) patients. The aim of this study was to assess the influence of magnesium supplementation on metabolic profiles of pre-diabetic, obese and mild-to-moderate CKD patients with hypomagnesemia. <b><i>Methods:</i></b> A total of 128 hypomagnesemic, pre-diabetic and obese patients with an estimated glomerular filtration rate between 90 and 30 ml/min/1.73m<sup>2</sup> were enrolled in a randomised, double-blind, placebo-controlled trial. Patients in the magnesium group received 365 mg of oral magnesium (<i>n</i> = 57) once daily for 3 months, while patients in the control group received a placebo (<i>n</i> = 61), also once daily for 3 months. Hypomagnesemia is defined by a serum magnesium level <1.8 mg/dl in males and <1.9 mg/dl in females; obesity is defined as a body mass index ≥30 kg/m<sup>2</sup>; and pre-diabetes is defined as fasting plasma glucose ≥100 but <126 mg/dl. The primary end point of the study was the change in insulin resistance measured by the homeostastic model assessment for insulin resistance (HOMA-IR). <b><i>Results:</i></b> At the end of follow-up, insulin resistance (-24.5 vs. -8.2%, <i>P</i> = 0.007), HOMA-IR index (-31.9 vs. -3.3%, <i>P</i> < 0.001), hemoglobin A1c (-6.6 vs. -0.16%, <i>P</i> < 0.001), insulin (-29.6 vs. -2.66%, <i>P</i> < 0.001), waist circumference (-4.8 vs. 0.55%, <i>P</i> < 0.001) and uric acid (-0.8 vs. 2.2%, <i>P</i> = 0.004) were significantly decreased in terms of mean changes; albumin (0.91 vs. -2.91%, <i>P</i> = 0.007) and magnesium (0.21 ± 0.18 vs. -0.04 ± 0.05 mg/dl, <i>P</i> < 0.001) were significantly increased in those taking magnesium compared with a placebo. The decrease in metabolic syndrome (-10.5 vs. -4.9%, <i>P</i> = 0.183), obesity (-15.7 vs. -8.2%, <i>P</i> = 0.131), pre-diabetes (-17.5 vs. -9.8%, <i>P</i> = 0.140), and systolic (-5.0 ± 14.8 vs. 0.22 ± 14.9 mm Hg, <i>P</i> = 0.053) and diastolic (-3.07 ± 9.7 vs. 0.07 ± 9.6 mm Hg, <i>P</i> = 0.071) blood pressure did not achieve to a significant level after study. <b><i>Conclusion:</i></b> Our data support the argument that magnesium supplementation improves the metabolic status in hypomagnesemic CKD patients with pre-diabetes and obesity.

OBJECTIVES: To determine the validity of fetal kidney length and amniotic fluid index (AFI) in labor dating. METHODS: This prospective study included 180 pregnant women followed up in the outpatient clinic at the Department of Obstetrics and Gynecology, Gaziantep University, Turkey, between January 2014 and January 2015. The gestational age (GA) was estimated by early fetal ultrasound measures and last menstrual period. Routine fetal biometric parameters, fetal kidney length, and amniotic fluid index were measured. We studied the correlation between fetal kidney length, amniotic fluid index, and gestational age. RESULT: The mean gestational age depending on last menstrual period and early ultrasound was 31.98±4.29 (24-39 weeks). The mean kidney length was 35.66±6.61 (19-49 mm). There was a significant correlation between gestational age and fetal kidney length (r=0.947, p=0.001). However, there was a moderate negative correlation between GA and AFI. Adding fetal kidney length to the routine biometrics improved the effectiveness of the model used to estimate GA (R2=0.965 to R2=0.987). CONCLUSION: Gestational age can be better predicted by adding fetal kidney length to other routine parameters.

OBJECTIVE: The aim of this study was to evaluate the clinical and histopathological effects of two different dosages of alcohol extract of Tarantula cubensis (Theranekron) on open wounds. METHOD: A total of 24 Sprague-Dawley rats were randomly divided into Tarantula cubensis extract (TCE1, n=8) 1/10 diluted, TCE (TCE2, n=8), and (3) vehicle-control (0.2 ml of 96 % ethanol, n=8) groups. Experimental full-thickness 1 x 1cm wounds were created on dorsum skin. TCE or vehicle were given systemically by subcutaneous injections on postoperative days 1 and 4. Wound planimetry and procurement of biopsies was performed on days 4, 8, 12 and 16. RESULTS: The mean non-epithelialised wound area in the vehicle-control group was significantly larger than in the TCE1 group on days 4, 8, 12 and 16, and in the TCE2 group on days 8, 12 and 16 (p<0.05). The mean percentage of wound contraction was significantly higher in the TCE1 and TCE2 groups than in the vehicle control group on days 8, 12 and 16 (p<0.05). Histopathologically, wound healing was characterised by a significant decrease in the neutrophil counts and a significant increase in neovascularisation; neither were effected by TCE. CONCLUSION: Our results suggest that alcohol extract of Tarantula cubensis accelerates epithelialisation and, thus, has beneficial effects on open wound healing in rats.

PURPOSE: To evaluate the effect of diabetic polyneuropathy on choroidal thickness in type 2 diabetes patients. METHODS: Forty-one diabetic polyneuropathy (DPN) patients with no or mild retinopathy, 50 non-DPN diabetic patients with no or mild retinopathy, and 42 healthy controls without any retinal complaint were included in the study. All participants underwent detailed ophthalmic examinations. Choroidal thickness (CT) measurements were performed by the same independent technician in the morning between 9 and 11 AM to avoid diurnal variations. Perpendicular CT was measured from the outer edge of the hyperreflective retinal pigment epithelium to the inner sclera at seven locations: the fovea; and 500, 1000, and 1500 μm temporally and nasally to the fovea. RESULTS: The groups were age and sex matched (P > 0.05). The mean subfoveal CT values were significantly different in groups with a thickening trend from control to non-DPN and DPN (P < 0.01). The mean values for subfoveal CT in control, non-DPN, and DPN groups were 241.12 ± 52.71, 279.82 ± 51.42, and 304.71 ± 54.92 μm, respectively. The same thickening trend was also evident in all other six measurement points with statistical significance (P < 0.01). CONCLUSIONS: Diabetic patients had increased CT compared to healthy controls. The presence of neuropathy in diabetes patients caused additional choroidal thickening, compared to nonneuropathic patients.

PURPOSE: To evaluate the effects of acetylsalicylic acid (aspirin) on tear film parameters and dry eye disease. METHODS: Fifty-seven patients using low-dose aspirin regularly for antiaggregant purposes as well as 49 controls, who required antiaggregant treatment but who had not yet started, were included in the study. Tear osmolarity, tear break-up time (TBUT), Schirmer and Oxford grading of ocular surface staining were performed on all patients and dry eye symptomatology was assessed using the ocular surface disease index questionnaire (OSDI). RESULTS: The mean osmolarity was 302.11 ± 16.22 mOsm/L in the aspirin group and 313.88 ± 19.57 mOsm/L in the control group (P < 0.01). The mean Schirmer's score was 24.16 ± 10.52 mm and 21.94 ± 10.11 mm (P = 0.232), TBUT was 13.61 ± 3.31 s and 10.39 ± 4.46 s (P < 0.01), OSDI score was 5.15 ± 5.98 and 16.94 ± 14.17 (P < 0.01), and Oxford score was 0.12 ± 0.33 and 0.12 ± 0.44 in aspirin and control groups, respectively (P = 0.99). Dry eye diagnosis was lower in the aspirin group, but statistical significance was present only in TBUT and osmolarity-based dry eye diagnosis (P ≤ 0.01). In terms of symptom-based dry eye diagnosis with the threshold of OSDI ≥23, none of the aspirin group had dry eye diagnosis, whereas 32.6% of the control group had the diagnosis (P < 0.01). CONCLUSIONS: The use of low-dose aspirin might be great option for treatment of ocular surface inflammatory disease through increasing TBUT and decreasing tear osmolarity with a resultant symptomatic satisfaction.