Summary Background Coronavirus disease 2019 (COVID-19) is an acute inflammatory respiratory disease. Osteopontin (OPN) is a glycoprotein expressed in various cell types, such as bone, immune, smooth muscle, epithelial and endothelial cells. It also acts as a regulator of immune response. The aim of the present study was to reveal the place of serum osteopontin levels in predicting severity among patients with COVID-19. Methods This study included 84 patients, 43 female and 45 male. Patients were divided into 2 groups, group 1 non-severe group ( n : 48), group 2 severe ( n : 40). Demographic data, neutrophil, lymphocyte, platelet, white blood cell counts, albumin, procalcitonin, C‑reactive protein (CRP) and OPN levels were recorded. The OPN levels and these inflammatory parameters of the two groups were compared. Results There were no significant differences in terms of gender (female/male 25/23 vs. 18/22) and platelet count (178 K/μL vs. 191 K/μL) between the groups ( p > 0.05). Ages (57.7 ± 17.0 years vs. 71.4 ± 12.8 years), procalcitonin (0.07 vs. 0.24 ng/mL), CRP (17 vs 158 mg/l), neutrophil count (3.7 vs 5.64 K/μL), WBC counts (5.38 vs 7.85 K/μL) and number of deaths (0 vs 26) ( p < 0.001). The OPN levels (98.5 vs 13.75 ng/mL, p = 0.002) were found to be statistically higher, in group 2 than group 1. Conclusion The present study showed that OPN can be used to predict the severity in patients with COVID-19.

SUMMARY BACKGROUND Coronavirus Disease 2019 is an acute inflammatory respiratory disease. It causes many changes in hemogram parameters. Low albumin levels are associated with mortality risk in hospitalized patients. The aim of the present study is to reveal the place of neutrophil count to albumin ratio in predicting mortality in patients with COVID-19. METHODS 144 patients, 65 females and 79 males, were included in the study. Patients were divided into 2 groups. Group 1 was the non-severe group (n:85), and Group 2 was severe (n:59). Demographic data, neutrophil, lymphocyte and platelet counts, albumin and C-reactive protein (CRP) levels were recorded. Neutrophil count to albumin ratio (NAR) was calculated by dividing the absolute neutrophil counts by the albumin levels. The NAR and levels of the two groups were then compared. RESULTS There were no significant differences in gender and platelet count (201 vs. 211 K/mL) between the groups (p>0,05). Ages (62.0 ± 14.3 vs 68.6 ± 12.2 years), albumin (33.1 vs 29.9 gr/L), CRP (33 vs 113 mg/l), neutrophil count (4 vs 7.24 K/mL), WBC counts (6.70 vs 8.50 K/mL), NAR values (113.5 vs 267.2) and number of Death (5 vs 33) were found to be statistically higher (p <0.001) in Group 2 than in Group 1. The NAR value of 201.5 showed mortality in all patients with COVID-19 to have 71.1% sensitivity and 71.7% specificity (AUC:0.736, 95% CI: 0.641-0.832, p<0.001) CONCLUSION The present study showed that NAR levels can be a cheap and simple marker for predicting mortality in patients with COVID-19.

Background & Objective: Subacute Granulomatous Thyroiditis (De Quervain’s Thyroiditis) is an acute painful inflammatory disease of the thyroid. We aimed to investigate easily accessible and cheap hemogram based parameters of Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) in the follow up of inflammatory thyroid disease. Methods: Patients admitted to Sakarya University Education and Research Hospital Endocrinology and Metabolism Outpatient Clinic and diagnosed as Subacute Granulomatous Thyroiditis between May 2017 and November 2018 were included in the study. Hemogram, thyroid function tests and acute phase values ​​of these patients were recorded and compared with the values ​​after treatment and disease recovery. On the sixth month, thyroid function tests were repeated and the rate of permanent hypothyroidism was screened. The relationships between initial hemogram parameters and acute phase reactants were evaluated. Results: Total 71 patients were included in our study. 60 (84.5%) were female and 11 (15.5%) were male. The F/M ratio was found to be 6/1. Mean age was 43 ± 9.95 years. Receiver Operating Characteristics (ROC) Curve Analysis was performed and values for Area Under the Curve (AUC) for NLR and PLR, respectively, were 0.739 (95% CI 0.657-0.820 p<0.0001) and 0.772 (95% CI 0.694-0.850 p<0.0001), which are significant and associated with disease activity. However, the AUC for MPV parameter was: 0.578 (95% CI 0.484-0.672 P: 0.10) and was not significant. The cut off values defined as 2.4 (80% sensitivity and 51% specificity) for NLR and 146.84 (83% sensitivity and 54% specificity) for PLR for the acute phase of the disease. In the Correlation Analysis, NLR and PLR values ​​were significantly correlated with ESR and CRP parameters, which are the most commonly used acute phase reactants. Conclusion: According to the present study, we believe that the NLR and PLR parameters will be of benefit in the follow-up the disease, accurately demonstrate the inflammatory load in the acute phase of the disease, and correlate with the common acute phase reactants. doi: https://doi.org/10.12669/pjms.36.2.1063 How to cite this:Cengiz H, Varim C, Demirci T, Cetin S. Hemogram parameters in the patients with subacute thyroiditis. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1063 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction: BRAF V600E activating mutation is the most frequent genetic abnormality in the pathogenesis of papillary thyroid carcinoma. We aimed to evaluate the association between BRAF V600E mutation and well-established prognostic clinicopathological characteristics as well as iodine exposure. Material and methods: From 2000 to 2012, the data of PTC patients admitted to Dr. Lutfi Kirdar Kartal Education and Research Hospital in Turkey were reviewed retrospectively. Clinicopathological parameters were collected. BRAF V600E mutation was analysed by DNA sequencing method in tumour specimens. We hypothesised that BRAF V600E mutation prevalence is positively correlated with prolonged iodine exposure and expected to be higher in the second half of the recruitment period due to the increment in time spent from the iodisation process of the table salt in our country. Thus, iodine exposure was categorised as short-term (2000-2006) and long-term (2006-2012). Results: A total of 197 patients were accrued. The study population predominantly consisted of conventional variant. A statistically significant relationship was observed between BRAF V600E mutation presence and age (p = 0.03), conventional variant PTC (p = 0.00002), T4 stage (p = 0.002), vascular invasion (p = 0.036), thyroid capsule invasion (p < 0.00001), extrathyroidal tissue invasion (p < 0.00001), and lymph node metastasis (p < 0.00001). When categorised as long-term and short-term, iodine exposure was not statistically significantly related with BRAF V600E mutation; however, there were far more PTC cases in the long-term group (86.3% vs. 13.7%). Conclusion: We revealed that BRAF V600E mutation is associated with adverse clinicopathological parameters. There appeared to be no relation between long-term iodine exposure and BRAF V600E .

Background & Objective: The relationship between thyroid disorders and dyslipidemia has now been clearly demonstrated, but the relationship between thyroid autoimmunity and dyslipidemia in euthyroid patients is still controversial. Our aim in this study was to determine whether there is a risk of dyslipidemia in our patients with euthyroid hashimoto thyroiditis. Methods: Fifty-five autoantibody positive hashimoto patients and 55 antibody negative control groups who came to Sakarya University Medicine Faculty Endocrinology Outpatient Clinics between January 2018 and November 2019 were included in our case control study. The groups were similar in terms of age, cardiovascular risk factors and BMI. Both groups were compared according to the lipid profile results. Results: All type of lipids; including LDL (p = 0.008), HDL (p = 0.041), triglyceride (p = 0.045) and total cholesterol (p = 0.002), were higher in the patient group, and these differences were statistically significant. Anti-TPO and Anti-TG antibody titers and lipid levels were evaluated by separate correlation analysis. There was a significant positive correlation between Anti-TPO and LDL (r = 0.331, p <0.001), triglyceride (r = 0.267, p = 0.005) and total cholesterol (r = 0.316, p = 0.001), however no significant correlation was observed between Anti-TPO and HDL. Similarly, there was a significant positive correlation between Anti-TG and LDL (r = 0.318, p = 0.001), triglyceride (r = 0.218, p = 0.022), and total cholesterol (r = 0.301, p = 0.001), but HDL correlation relationship was not detected. Conclusion: The relationship between thyroid autoimmunity and dyslipidemia has been demonstrated in our study even in the euthyroid phase. Whether antibody positive patients should be followed more closely for dyslipidemia and cardiovascular events is still controversial. This question will be answered with larger randomized controlled trials. doi: https://doi.org/10.12669/pjms.37.5.3883 How to cite this:Cengiz H, Demirci T, Varim C, Tamer A. The effect of Thyroid Autoimmunity on Dyslipidemia in patients with Euthyroid Hashimoto Thyroiditis. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.3883 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Childhood obesity has reached alarming dimensions all around the world. In this study, our objective is to determine the prevalence of childhood obesity in the secondary education as well as genetic, cultural and environmental factors giving rise to obesity, nutritional habits, family history and activity status.Methods: The research was performed on 750 students aged between 14-18. Body Mass Index (BMI= weight/height2 (kg/m²)) and Relative Body Mass Index (Rel BMI)  values of each child were calculated by making use of their height and weight measurements. An evaluation was made through the use of a questionnaire form consisting of 46 questions that questioned the family history, nutritional habits and activity status of the children at issue.Results: About 41.7% of 750 children incorporated into the study were female, whereas 58.2% of them were male. The age distribution was between the age range, 14-18. According to BMI values, 12.3% of the children were overweight, while 4% of them were obese. According to Relative BMI values, on the other hand, 10.4% of the children were overweight, whereas 12.9% of them were obese. When the children’s nutritional habits, activity status and family history were evaluated, we ascertained that doing physical exercises irregularly, consuming pastry foods at home and the presence of obesity history within the family had all led to the development of obesity as well as being overweight (p <0.05).Conclusions: In these research subjects comprising children of secondary education, we showed that the nutritional habits, cultural nutritional differences and the insufficiency in physical activities as well as the genetic susceptibility in children could be the determinants in obesity development.

ABSTRACT. The D727E germline polymorphism in the thyroidstimulating hormone receptor gene (TSHR) may cause genetic susceptibility to the development of goiter. Therefore, in this study we investigated allele frequencies and genotype distributions of the TSHR D727E polymorphism, their association with clinical parameters, and the development of goiter in the Turkish population. We investigated the TSHR D727E polymorphism in 123 patients and 97 healthy subjects using the polymerase chain reaction-restriction fragment length polymorphism technique. Peripheral blood was used for DNA 2 H.I. Gözü et al. Genetics and Molecular Research 15 (3): gmr.15038504 extraction. Although no significant difference was found in TSHR D727E polymorphism frequencies between the patients with nodular goiters (26/123 patients, 21.1%) and the controls (12/97 patients, 12.4%) (P = 0.107), the frequency of the TSHR D727E polymorphism in the hyperthyroid+subclinical hyperthyroid patient groups (23%) was significantly higher than in the control subjects (12.4%) (P = 0.024). In this study, nodular goiter presented significantly earlier in GC genotype patients (mean age 35 years) than in CC genotype patients (mean age 42 years) in the hyperthyroid group (P = 0.009). More importantly, TSH levels in the GC variant controls were closely significant lower (1.26 ± 0.49) than in the CC variant controls (1.74 ± 0.84) (P = 0.053). The TSHR D727E polymorphism might be involved in the pathogenesis of toxic multinodular goiter (TMNG). Moreover, this polymorphism might be an indication of early-onset TMNG. However, development of MNG is multifactorial. Therefore, further case-control studies with larger populations are required to verify these observations.

Objectives: We aimed to determine the effect of short-term intensive insulin therapy (SIIT) on long-term glycemic control in newly-diagnosed Type-2 diabetes mellitus (nT2DM) patients. Methods: In this retrospectively study conducted at Sakarya University Medical Faculty Training and Research Hospital Outpatient Clinic between 2016 and 2019, 65 nT2DM patients were enrolled soon after their SIIT was initiated and were followed for at least a year. Intensive insulin treatment was discontinued after three or 12 months in a total of 65 (23–73-year-old) patients who had been newly diagnosed with T2DM. Intensive insulin therapy was discontinued when glycemic control and the target Glycated Hemoglobin (HbA1c) level had been attained, after which oral anti-diabetic drug (OAD), long-term insulin, and diet therapies were pursued. Results: There was a significant decrease in mean HbA1c from 11.25±1.96% to 6.67±1.07%. Fasting plasma glucose (FPG) was found to be an independent predictor of whether intensive insulin therapy could be discontinued after three months in a model that included FPG, HbA1c, and body mass index measured at baseline. Patients with FPG >13.8 mmol/L were 7.6 times more likely to require intensive insulin therapy beyond three months. There were significant decreases in HbA1c and low-density lipoprotein-cholesterol concentration, but no change in C-peptide between baseline and 3 months of therapy. Conclusion: These results demonstrate that in nT2DM patients, intensive insulin therapy could be effective on long-term glycemic control and high FPG prior to three months of SIIT may predict poor long-term glycemic control. doi: https://doi.org/10.12669/pjms.37.7.4013 How to cite this:Karacaer C, Demirci T, Cengiz H, Varim C, Tamer A. The effect of short-term intensive insulin therapy in newly-diagnosed Type-2 diabetic patients. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4013 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.