Rabin Saba

Publications of Rabin Saba

• [Clinical evaluation of forty-four patients with necrotizing fasciitis].

  Authors: Ozge Turhan, Seyit Ali Büyüktuna, Dilara Inan, Rabin Saba, Ata Nevzat Yalçın

  Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES. 01/2011; 17(1):29-32.

  Necrotizing fasciitis is a rare but life-threatening soft-tissue infection primarily involving the superficial fascia and subcutaneous tissue. We conducted a retrospective study of 44 patients withNecrotizing fasciitis is a rare but life-threatening soft-tissue infection primarily involving the superficial fascia and subcutaneous tissue. We conducted a retrospective study of 44 patients with necrotizing fasciitis between 2004 and 2008 in Akdeniz University Hospital, Department of Infectious Diseases and Clinical Microbiology and other departments. The aim of this study was to determine the causative agents of the necrotizing fasciitis, and the localization, predisposing factors, and comorbid conditions. We found that diabetes mellitus, trauma and surgery were the most important predisposing factors. Moreover, the lower extremity and perianal region were the most frequently involved sites. Polymicrobial agents were the most frequent and the mortality was found as 25%. In conclusion, necrotizing fasciitis cases followed in our hospital were evaluated in this study.

• Aspergillus alliaceus and Aspergillus flavus co-infection in an acute myeloid leukemia patient.

  Authors: Betil Ozhak-Baysan, Ana Alastruey-Izquierdo, Rabin Saba, Dilara Ogunc, Gozde Ongut, Aysen Timuragaoglu, Gokhan Arslan, Manuel Cuenca-Estrella, Juan Luis Rodriguez-Tudela

  Medical mycology : official publication of the International Society for Human and Animal Mycology. 04/2010; 48(7):995-9.

  We report a case of a pulmonary infection caused by Aspergillus flavus and Aspergillus alliaceus in an acute myeloid leukemia patient. These isolates were identified using traditional andWe report a case of a pulmonary infection caused by Aspergillus flavus and Aspergillus alliaceus in an acute myeloid leukemia patient. These isolates were identified using traditional and sequencing-based molecular methods.

• Knowledge, attitudes and behaviour of students from a medicine faculty, dentistry faculty, and medical technology Vocational Training School toward HIV/AIDS.

  Authors: Ozge Turhan, Yesim Senol, Timucin Baykul, Rabin Saba, Ata Nevzat Yalçin

  International journal of occupational medicine and environmental health. 01/2010; 23(2):153-60.

  With increasing numbers of HIV/AIDS patients, physicians, dentists, and nurses taking care of these patients should have sufficient knowledge of the disease, and their attitude and behaviour shouldWith increasing numbers of HIV/AIDS patients, physicians, dentists, and nurses taking care of these patients should have sufficient knowledge of the disease, and their attitude and behaviour should be proper. In our study, we aimed to examine the level of knowledge about HIV/AIDS among students from a medicine faculty, dentistry faculty, and medical technology vocational training school, to investigate attitudes and behaviour, and differences between first- and last-year students (if any) and to determine students' perception of the importance of this disease for our country and our world. This descriptive study comprised first-year and last-year students of Akdeniz University Faculty of Medicine, Akdeniz University Medical Technology Vocational Training School (MTVTS), and Süleyman Demirel University Faculty of Dentistry. A questionnaire was administered to a total of 357 students. Lack of the relevant education is obvious among all three occupational groups in our study. The importance of HIV/AIDS as a public health problem all over the world should be emphasized more, and awareness of all humanity should be augmented.

• Hepatobiliary fascioliasis: sonographic and CT findings in 87 patients during the initial phase and long-term follow-up.

  Authors: Adnan Kabaalioglu, Kagan Ceken, Emel Alimoglu, Rabin Saba, Metin Cubuk, Gokhan Arslan, Ali Apaydin

  AJR. American journal of roentgenology. 11/2007; 189(4):824-8.

  OBJECTIVE: The purpose of our study was to describe the initial and long-term imaging findings in hepatobiliary fascioliasis. CONCLUSION: Most patients with fascioliasis have typical hepatobiliaryOBJECTIVE: The purpose of our study was to describe the initial and long-term imaging findings in hepatobiliary fascioliasis. CONCLUSION: Most patients with fascioliasis have typical hepatobiliary imaging findings. It is important to know that residual fibrotic or necrotic foci may remain for years after cure. Long-term complications are rare in fascioliasis, and malignancy or cirrhosis related to the disease has not been observed.

• Seroepidemiology of fascioliasis in the Antalya region and uselessness of eosinophil count as a surrogate marker and portable ultrasonography for epidemiological surveillance.

  Authors: Ozge Turhan, Metin Korkmaz, Rabin Saba, Adnan Kabaaaliogu, Dilara Inan, Latife Mamikoglu

  Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive. 01/2007; 14(4):208-12.

  BACKGROUND: Fascioliasis is a great tropical disease all over the world so we tried to investigate the incidence of fascioliasis in the Antalya region of Turkey and also to find an answer to theBACKGROUND: Fascioliasis is a great tropical disease all over the world so we tried to investigate the incidence of fascioliasis in the Antalya region of Turkey and also to find an answer to the question if initial ultrasonographic examination (US) and eosinophil count is a predictive sign in diagnosis of fascioliasis. MATERIAL AND METHODS: In this study, 597 adult persons were included. All cases were examined for eosinophilia and antibodies against Fasciola hepatica by enzyme linked immunosorbent assay (ELISA). 344 of them were examined by portable US. RESULTS: ELISA was positive in 18 (3%) of 597 persons. This rate is appropriate for the definition of mesoendemic region for human fascioliasis. Among seropositive people only 2 (11.11%) cases had eosinophilia (p =0.3). US findings were not related to fascioliasis. CONCLUSIONS: Future epidemiologic studies are required in order to find the real situation of fascioliasis in Turkey as in the world and initial US and eosinophil count is not useful predictive method for fascioliasis prevalence.

• Cytomegalovirus antigenemia and outcomes of patients undergoing allogeneic peripheral blood stem cell transplantation: effects of long-term high-dose acyclovir prophylaxis and preemptive ganciclovir treatment.

  Authors: Volkan Hazar, Aynur Ugur, Dilek Colak, Rabin Saba, Gulsun Tezcan, Alphan Kupesiz, Ihsan Karadogan, Meral Gultekin, Akif Yesilipek, Levent Undar

  Japanese journal of infectious diseases. 09/2006; 59(4):216-21.

  Cytomegalovirus (CMV) disease is a frequent cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation. In order to investigate the relationships betweenCytomegalovirus (CMV) disease is a frequent cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation. In order to investigate the relationships between antigenemia, high-dose acyclovir (HDACV) prophylaxis, preemptive ganciclovir (GCV) therapy, and outcomes, we analyzed the records of 105 patients, including both pediatric and adult populations, who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) and who were at risk for CMV reactivation and disease (both recipient and donor seropositive). All received HDACV until neutrophil engraftment, but prophylaxis was continued till post-transplant day 180 only in pediatric patients in conjunction with weekly CMV pp65 antigenemia monitoring. Antigenemia-guided preemptive strategy with GCV was used for all patients. CMV antigenemia developed in 45 patients (42.9%) and CMV disease in 13 (12.4%). The frequencies for antigenemia were 31.3 and 63.2% in pediatric and adult groups (P = 0.002). All CMV diseases were in the adult group (P<0.001). Age at transplantation, underlying disease, long-term HDACV prophylaxis and acute graft versus host disease (aGVHD) were all found to be a significant risk factors for antigenemia. All of these factors other than aGVHD and conditioning regimen were also the significant risk factors for CMV disease. However, when we analyzed the pediatric and adult patients separately, dropping "long-term HDACV prophylaxis," none of these parameters were significant risk factors for CMV disease. In conclusion, we hypothesize that long-term HDACV prophylaxis in the GCV era results in a low incidence of CMV reactivation and disease in patients undergoing PBSCT.

• The effects of recurrent Pseudomonas aeruginosa infection on pulmonary parenchyma and vasculature in rats fed on a cholesterol-rich diet.

  Authors: Omer Ozbudak, Candan Ogus, Rabin Saba, Cengiz Turkay, Nursel Sahin, Gülay Ozbilim, Bahar Kiliçarslan

  Experimental lung research. 08/2006; 32(7):275-85.

  It has been demonstrated that both hypercholesterolemia and infectious agents are contributing factors in atherosclerosis but their combined effect on the pulmonary vascular bed is not known. ToIt has been demonstrated that both hypercholesterolemia and infectious agents are contributing factors in atherosclerosis but their combined effect on the pulmonary vascular bed is not known. To answer this question, the authors tried to demonstrate the effects of recurrent infection on pulmonary parenchyma and vascular system in cholesterol-fed rats. Sixty-six rats were randomly divided into 4 groups: Groups I (control), II (cholesterol-rich diet), III (recurrent pulmonary Pseudomonas aeruginosa infection), IV (cholesterol-rich diet + recurrent infection). After 6 months serum cholesterol levels didn't increase in any of the groups. Central pulmonary artery wall thickness was increased in group IV (P < .0001). Although not significant, peripheral pulmonary artery wall thickness was increased in group IV. In rats fed on a cholesterol-rich diet, recurrent infection caused a significant increase in atherosclerosis, although serum cholesterol levels didn't increase. Infection and cholesterol-rich diet have a synergistic effect on atherosclerosis in the pulmonary vascular system in rats even in the absence of hypercholesterolemia.

• Device-associated nosocomial infection rates in Turkish medical-surgical intensive care units.

  Authors: Dilara Inan, Rabin Saba, Ata Nevzat Yalcin, Murat Yilmaz, Gozde Ongut, Atilla Ramazanoglu, Latife Mamikoglu

  Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. 05/2006; 27(4):343-8.

  OBJECTIVE: To describe the incidence of device-associated nosocomial infections in medical-surgical intensive care units (MS ICUs) in a university hospital in Turkey and compare it with NationalOBJECTIVE: To describe the incidence of device-associated nosocomial infections in medical-surgical intensive care units (MS ICUs) in a university hospital in Turkey and compare it with National Nosocomial Infections Surveillance (NNIS) system rates. DESIGN: Prospective surveillance study during a period of 27 months. Device utilization ratios and device-associated infection rates were calculated using US Centers for Disease Control and Prevention and NNIS definitions. SETTING: Two separate MS ICUs at Akdeniz University Hospital, Antalya, Turkey. PATIENTS: All patients were included who presented with no signs and symptoms of infection within the first 48 hours after admission. RESULTS: Data on 1,985 patients with a total of 16,892 patient-days were analyzed. The mean overall infection rate per 100 patients was 29.1 infections, and the mean infection rate per 1,000 patient-days was 34.2 infections. The rate of ventilator-associated pneumonia was 20.76 infections per 1,000 ventilator-days, the rate of catheter-associated urinary tract infection was 13.63 infections per 1,000 urinary catheter-days, and the rate of catheter-associated bloodstream infection was 9.69 infections per 1,000 central line-days. The most frequently isolated pathogens were Pseudomonas species among patients with ventilator-associated pneumonias (35.8% of cases), Candida species among patients with catheter-associated urinary tract infections (37.1% of cases), and coagulase-negative staphylococci among patients with catheter-associated bloodstream infections (20.0% of cases). CONCLUSION: We found both higher device-associated infection rates and higher device utilization ratios in our MS ICUs than those reported by the NNIS system. To reduce the rate of infection, implementation of infection control practices and comprehensive education are required, and an appropriate nationwide nosocomial infection and control system is needed in Turkey.

• Characteristics and analysis of risk factors for mortality in infective endocarditis.

  Authors: Hakan Leblebicioglu, Hava Yilmaz, Yesim Tasova, Emine Alp, Rabin Saba, Rahmet Caylan, Mehmet Bakir, Ayhan Akbulut, Bilgin Arda, Saban Esen

  European journal of epidemiology. 01/2006; 21(1):25-31.

  OBJECTIVE: The aim of our study was to establish the etiology of and risk factors for infective endocarditis (IE) and determine the prognostic factors for adverse outcome during hospital admission inOBJECTIVE: The aim of our study was to establish the etiology of and risk factors for infective endocarditis (IE) and determine the prognostic factors for adverse outcome during hospital admission in a Turkish population. MATERIAL AND METHODS: Between January 2002 and January 2004, the clinical and laboratory features of 112 consecutive adult patients (>18 years) with diagnosis of IE who were referred to the infectious diseases clinics/departments of 17 teaching hospitals in Turkey were evaluated. Cases of IE were defined according to the modified Duke Criteria. Mortality was defined as death occurring within 30 days or during hospital stay period. Univariate and multivariate analyses were performed to predict the factors related to fatal outcome. RESULTS: A total of 112 consecutive patients presented with 101 definite and 11 probable IE episodes were defined according to the modified Duke Criteria. The mean age was 45.2+/-19.9. Fifty percent of the patients were male. Ninety (60.4%) of the 112 patients had risk factors for IE and 48 (42.9%) of them had >or=2 risk factors. On the other hand, 49.1% of patients had cardiac risk factors. Blood cultures were positive in 94 (83.9%) cases. Staphylococci were the most common agents (50.0%), followed by streptococci (28.7%) and enterococci (16.0%). Native cardiac valves were detected in 93 (83%) of the episodes of suspected IE. Valvular involvement was present in 103 (92%) patients; the mitral valve, alone or in combination with other valves, was affected in 70 (62.5%) of the patients. Echocardiography detected vegetations in 105 patients (93.8%). The mortality rate was 28.6%. Three factors were independently associated with mortality: haemodialysis OR: 14.5 (95% CI: 1.5-138.2), mobile vegetation OR: 4.8 (95% CI: 1.5-15.4) and mental alteration OR: 4.1 (95% CI: 1.1-15.6). CONCLUSION: Mortality is still high in IE. Our data indicate that patients with altered mental status, mobile vegetation, or on haemodialysis had poorer prognosis.

• [Comparison of the serological tests used for the laboratory diagnosis of brucellosis]

  Authors: Cemal Ciftçi, Feryal Oztürk, Asil Oztekin, Hicran Karaoğlan, Rabin Saba, Meral Gültekin, Latife Mamikoğlu

  Mikrobiyoloji bülteni. 08/2005; 39(3):291-9.

  Brucellosis which is an important public health problem is a zoonotic disease that causes economic loss, and seen all over the world as well as in our country. The aim of this study was to compareBrucellosis which is an important public health problem is a zoonotic disease that causes economic loss, and seen all over the world as well as in our country. The aim of this study was to compare the results of Rose Bengal test, standard tube agglutination test (STA), Coombs tube agglutination test, Rivanol tube agglutination test and ELISA (IgA, IgG and IgM) method, in patients who were suspected to have brucellosis. Blood and serum samples collected from 77 patients were included to the study. Blood cultures were performed from all of the patients and Brucella spp were isolated in 35 (45.4%) of them. At least one of the serological tests for Brucella was found positive in 62 samples (80.5%). When culture positivity accepted as the gold standard, the sensitivities of the tests were calculated as follows; 100% for Rose Bengal, 94.3% for STA, 97.1% for ELISA IgG, 94.3 for ELISA IgA and 71.4 for ELISA IgM. No prezone phenomenon was observed in the samples. Brucella Coombs tube agglutination test did not increase the chance of diagnosis of brucellosis, unlike the results of previous studies. We found that Rose Bengal and STA tests were still efficient methods for brucellosis serodiagnosis. The results of rivanol tube agglutination test were similar to STA test, and this test can be used especially in patients with brucellosis relapse. ELISA test detecting IgA and IgG antibody titers together found to be effective methods increasing the chance of brucellosis diagnosis, and could be helpful for follow up of brucellosis.

• A case of right-side infective endocarditis with ventricular septal defect.

  Authors: Ozge Turhan, Rabin Saba, Aytil Belgi, Dilara Inan, Hicran Karaoglan, Ata Nevzat Yalcin

  Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive. 04/2005; 13(1):39-41.

  A 28-year-old woman previously known to have a ventricular septal defect presented with fever, headache, abdominal pain and nausea. Positive blood culture of methicillin-sensitive StaphylococcusA 28-year-old woman previously known to have a ventricular septal defect presented with fever, headache, abdominal pain and nausea. Positive blood culture of methicillin-sensitive Staphylococcus aureus and the detection of vegetation attached to the right ventricular wall near the ostium of the ventricular septal defect confirmed diagnosis of infective endocarditis. After four weeks' treatment with proper antibiotics the patient recovered.

• Daily antibiotic cost of nosocomial infections in a Turkish university hospital.

  Authors: Dilara Inan, Rabin Saba, Filiz Gunseren, Gozde Ongut, Ozge Turhan, Ata Nevzat Yalcin, Latife Mamikoglu

  BMC infectious diseases. 02/2005; 5(1):5.

  BACKGROUND: Many studies associated nosocomial infections with increased hospital costs due to extra days in hospital, staff time, extra investigations and drug treatment. The cost of antibioticBACKGROUND: Many studies associated nosocomial infections with increased hospital costs due to extra days in hospital, staff time, extra investigations and drug treatment. The cost of antibiotic treatment for these infections represents a significant part of hospital expenditure. This prospective observational study was designed to determine the daily antibiotic cost of nosocomial infections per infected adult patient in Akdeniz University Hospital. METHODS: All adult patients admitted to the ICUs between January 1, 2000, and June 30, 2003 who had only one nosocomial infection during their stay were included in the study. Infection sites and pathogens, antimicrobial treatment of patient and it's cost were recorded. Daily antibiotic costs were calculated per infected patient. RESULTS: Among the 8460 study patients, 817 (16.6%) developed 1407 episodes of nosocomial infection. Two hundred thirty three (2.7%) presented with only one nosocomial infection. Mean daily antibiotic cost was 89.64 dollars. Daily antibiotic cost was 99.02 dollars for pneumonia, 94.32 dollars for bloodstream infection, 94.31 dollars for surgical site infection, 52.37 dollars for urinary tract infection, and 162.35 dollars for the other infections per patient. The treatment of Pseudomonas aeruginosa infections was the most expensive infection treated. Piperacillin-tazobactam and amikacin were the most prescribed antibiotics, and meropenem was the most expensive drug for treatment of the nosocomial infections in the ICU. CONCLUSIONS: Daily antibiotic cost of nosocomial infections is an important part of extra costs that should be reduced providing rational antibiotic usage in hospitals.

• Hand hygiene compliance in a hematology unit.

  Authors: Rabin Saba, Dilara Inan, Derya Seyman, Gulcan Gul, Yeşim Yiğiter Senol, Ozge Turhan, Latife Mamikoğlu

  Acta haematologica. 02/2005; 113(3):190-3.

  Transmission of pathogens from the hands of health care workers (HCWs) is the main cause of nosocomial infections, and hand hygiene is the single most important procedure to prevent it. At present,Transmission of pathogens from the hands of health care workers (HCWs) is the main cause of nosocomial infections, and hand hygiene is the single most important procedure to prevent it. At present, little is known about the adherence of HCWs to hand hygiene procedures in hematology units, where the patients are at high risk for acquiring hospital infections. In a prospective observational study, two observers monitored the hand hygiene compliance of HCWs in a hematology unit during 30-min observation periods distributed randomly during the daytime over 2 months. The prevalence of compliance with hand hygiene was 26% on 638 observed occasions. The noncompliance was higher among nurses [odds ratio (OR) 3.52, 95% confidence interval (CI) 1.85-6.70] and other HCWs (OR 1.72, 95% CI 0.98-3.02) compared to physicians. The compliance rate differed from 4 to 60% depending on the activity. The lowest compliance rate (4%) was observed before patient care and the highest (60%) was after insertion of invasive devices. When we classified the occasions for hand hygiene into 'before' and 'after' activities, the compliance rates were 9 and 36%, respectively (OR 5.6, 95% CI 3.4-9.0). In conclusion, noncompliance with hand hygiene was high in this hematology unit, especially among nurses and before activities. Variations with the type of HCW and activity suggest that targeted educational programs and feedback control may be useful.

• Human fascioliasis: MR imaging findings of hepatic lesions.

  Authors: Can Cevikol, Kamil Karaali, Utku Senol, Adnan Kabaalioğlu, Ali Apaydin, Rabin Saba, Ersin Lüleci

  European radiology. 02/2003; 13(1):141-8.

  Our objective was to describe MR imaging findings of liver lesions in human fascioliasis. The MR imaging of the liver was performed in 29 patients with fascioliasis. Seventeen patients were women andOur objective was to describe MR imaging findings of liver lesions in human fascioliasis. The MR imaging of the liver was performed in 29 patients with fascioliasis. Seventeen patients were women and 12 were men, with a mean age of 47.5 years (age range 17-75 years). Hepatic lesions were grouped into five types based on their signal characteristics. Three patients had normal imaging findings. One or more lesions were observed in the other 26 patients. The lesion types and the frequency of appearances were as follows: hyperintensity of the liver capsule on T2-weighted images (n=16, 55.2%); ill-defined slightly hyperintense areas on T2-weighted images (n=18, 62.1%); lesions which were hypointense on T1-weighted and hyperintense on T2-weighted images (n=10, 34.5%); hypointense on T1-weighted images and centrally hypo- or hyperintense, surrounded by peripherally less hyperintense area on T2-weighted images (n=4, 13.8%); and hypointense foci or ill-defined hypointense areas on T1- and T2-weighted images (n=10, 34.5%). We describe the MR imaging features of the disease. Our findings may help the differential diagnosis in which fascioliasis should be added to the list.

• The effect of granulocyte colony-stimulating factor in the treatment of Escherichia coli peritonitis with or without ceftriaxone in a nonneutropenic rat model.

  Authors: Rabin Saba, Muhsin Güler, Dilara Inan, Dilara Oğünç, Sakir Atalay, Latife Mamikoğlu, Filiz Günseren

  Surgery today. 02/2003; 33(7):504-8.

  PURPOSE: To investigate the effect of granulocyte colony-stimulating factor (G-CSF) in the treatment of Escherichia coli peritonitis with and without ceftriaxone in a nonneutropenic rat model.PURPOSE: To investigate the effect of granulocyte colony-stimulating factor (G-CSF) in the treatment of Escherichia coli peritonitis with and without ceftriaxone in a nonneutropenic rat model. METHODS: The rats were divided into five groups: control group (C) receiving physiological saline; peritonitis group (P) infected intraperitoneally with a live bacterial suspension of E. coli; peritonitis and antibiotic group (PA) receiving ceftriaxone 3 h after being infected; peritonitis, antibiotic, and G-CSF group (PAG) receiving G-CSF and antibiotic 3 h after infection; and peritonitis and G-CSF group (PG). RESULTS: All rats in group C survived. Any animals which did not survive died within 24h after inoculation. A significantly higher rate of survival, 95%, was observed with antibiotic treatment alone (PA), in comparison to the G-CSF-treated groups, PAG and PG, 52% and 57%, respectively. CONCLUSION: No beneficial effect of G-CSF treatment was seen in the E. coli peritonitis and antibiotic therapy remains the basic treatment for this disease.

• Pediatric fascioliasis: report of three cases.

  Authors: Adnan Kabaalioğlu, Kağan Ceken, Rabin Saba, Reha Artan, Can Cevikol, Saim Yilmaz

  The Turkish journal of pediatrics. 45(1):51-4.

  Fascioliasis is an uncommon hepatobiliary disease in children. Ultrasonographic, computed tomography (CT) and magnetic resonance imaging (MRI) findings of the disease have been thoroughly describedFascioliasis is an uncommon hepatobiliary disease in children. Ultrasonographic, computed tomography (CT) and magnetic resonance imaging (MRI) findings of the disease have been thoroughly described in the last decade. These radiological findings play an important role in the differential diagnosis of the disease since it may clinically mimic several hepatobiliary and systemic diseases. We report three children with fascioliasis, emphasizing the radiological findings in both the hepatic and biliary phases of the disease. If radiological findings are not appropriately interpreted, the diagnosis may be overlooked or delayed. In all three cases the serological confirmation was performed by ELISA method. Patients were treated with oral triclabendazole and soon recovered.