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Purpose Time‐dependent surgical instrument contamination and the effect of covering during arthroplasty have not been investigated. This study aimed to evaluate time‐dependent contamination of surgical instruments and the effect of covering on contamination as well as to perform bacterial typing of contaminated samples. The hypothesis was that covering the surgical instruments would decrease contamination rates. Methods Sixty patients who underwent total knee arthroplasty were randomized and divided into two groups: surgical instruments covered with a sterile towel or surgical instruments left uncovered. K‐wires were used to extract microbiological samples. The K‐wires were placed in a liquid culture medium at 0, 15, 30, 60, 90, and 120 min. After 24‐h incubation period, samples from liquid cultures were cultured on blood agar using swabs. Samples with growth after 48 h were considered contaminated. Microscopic, staining, and biochemical properties were used for bacterial typing. Results Bacterial growth started after 30 and 60 min in the uncovered and covered groups, respectively. An increase in the number of K‐wires contaminated with time was detected. At least 10,000 CFU/mL bacterial load was observed in the culture samples. Contamination was more significant in the uncovered group. A statistically significant difference in contamination was found between the uncovered and covered groups at 30‐, 60‐, 90‐, and 120 min (p = 0.035, p = 0.012, p = 0.024, and p = 0.037, respectively). The most common bacteria on the contaminated instruments were coagulase‐negative Staphylococci (60.4%), Staphylococcus aureus (22.9%), and Streptococcus agalactia (16.7%), respectively. Conclusion The risk of contamination increases with time. However, it may decrease if surgical instruments are covered. In the clinical practice, empiric antibiotic regimens based on the type of identified microorganisms in this study may be developed for postoperative periprosthetic joint infection prophylaxis. Level of evidence Prognostic, Level II.

Background & Objective: Liver and intestines are anatomically and physiologically linked. Zonulin is a protein modulating intercellular tight junctions and regulating intestinal permeability. Copeptin was studied as a marker of systemic circulation disorders in research about vasopressin and was associated with liver disease prognosis. Serum zonulin and copeptin levels were measured in patients with diagnosis of chronic hepatitis B (CHB) with the aim of easing antiviral treatment management in clinical applications and to investigate the association with normal population and viral load. Methods: Analysis included the serum of 30 CHB patients and 17 controls. HBV-DNA real-time PCR tests were completed. CHB patients were divided into three subgroups according to viral load in serum. Zonulin and copeptin levels were measured using ELISA kits. Results: Serum zonulin and copeptin levels were significantly low in CHB patients compared to controls (p<0.001). When CHB subgroups are investigated in terms of serum zonulin and copeptin levels, there was an inverse correlation observed with significant difference (p<0.01, p<0.05). Conclusion: The negative correlation between serum zonulin and copeptin with HBV-DNA load revealed in our study shows they may be used to monitor treatment. Zonulin and copeptin assays provide the possibility of developing new approaches to CHB diagnosis and monitoring. doi: https://doi.org/10.12669/pjms.35.3.144 How to cite this:Calgin MK, Cetinkol Y. Decreased levels of serum zonulin and copeptin in chronic Hepatitis-B patients. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.144 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.

The seroprevalence of antibodies to Toxoplasma gondii among children with autism Objective: Although attempts have been made to explain the pathogenesis of autism spectrum disorders (ASD) with many factors such as genetic, immunological, environmental, and infectious agents, this mechanism remains for the most part unknown. Toxoplasma gondii is a parasite that is investigated in many psychiatric diseases. This work examines whether toxoplasmosis plays a role in the pathogenesis of ASD through a seroprevalence study.Method: This study is based on a comparison of 102 children with ASD and 51 healthy children. In addition to routine laboratory tests, a sociodemographic form and a childhood autism rating scale were completed and the participants' anti-toxoplasma IgM and IgG titers were requested.Results: In 3 ASD children (2.9%) and in 1 control (2%), IgG positivity was identified. All subjects were negative for IgM. There was no statistically significant difference found between the two groups in terms of toxoplasma seropositivity.Conclusion: Our data does not confirm the involvement of toxoplasmosis in the etiopathogenesis of ASD. ÖZET Otizmli çocuklarda Toxoplasma gondii antikorlarının seroprevalansıAmaç: Otizm spektrum bozukluğu patogenezi genetik, immünolojik, çevresel ve enfeksiyöz ajanlar gibi pek çok nedenle açıklanmaya çalışılmasına rağmen hala büyük oranda nedeni bilinmeyen bir durumdur.Toxoplasma Gondii de çok sayıda psikiyatrik hastalıkta araştırılmış bir parazittir. Bu çalışmada ASD patogenezinde toxoplasmosisin rolü olup olmadığı seroprevelans çalışması ile araştırılmıştır. Yöntem: Yüz iki OSB'li çocuk ve 51 sağlıklı çocuk karşılaştırılmıştır. Rutin labarotuar testlerinin yanında sosyodemografik form ve çocukluk çağı otizm derecelendirme ölçeği uygulanmış ve anti-toksoplazma IgM ve IgG titreleri istenmiştir. Bulgular: Üç OSB'li çocuk (%2.9) ve 1 kontrolde (%2) IgG pozitif bulunmuştur. Bütün deneklerde IgM negatif olarak bulunmuştur. İki grup arasında toxoplazma seropozitivitesi açısından istatistiki olarak anlamalı bir fark bulunamamıştır. Sonuç: Ulaştığımız bu bilgi OSB etyopatogenezinde toxoplazmozisin bir ilgisinin olduğunu desteklememektedir.

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Objectives: The role of endoplasmic reticulum (ER) stress in the pathogenesis of hepatitis B virus (HBV) has been reported. However, serum levels of glucose-regulated protein (GRP) 78 which is an ER stress marker both in tissue and circulation have not been reported yet. This study aimed to evaluate serum GRP78 levels in patients with chronic HBV infection. Materials and Methods: A total of 60 patients with HBV infection and 50 control subjects were included in this study. According to HBV-DNA levels, patients with HBV infection were subdivided into low, mild and high HBV-DNA subgroups (n=20, in each). Serum GRP78 level was measured by ELISA and then correlation analysis was performed between GRP78 and alanine aminotransferase (ALT), aspartate aminotransferase (AST), HBV-DNA or hepatitis B surface antigen (HBsAg). Results: HBsAg levels were significantly higher in each HBV subgroup compared to controls. ALT and AST levels were significantly increased in the high HBV-DNA subgroup. There was no significant difference in serum GRP78 level between controls and HBV subgroups and no correlation between serum GRP78 levels andother variables. Conclusion: As a result of our study, there was no relationship between the serum level of GRP78 and the HBV infection parameters. Since ER stress is an important mechanism in HBVrelated liver injury, other ER stress markers, such as GRP94, might be examined in future studies.