Osman Yüksel

Hacettepe University, Engüri, Ankara, Turkey

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Publications (85)173.58 Total impact

  • Journal of the American Geriatrics Society 10/2014; 62(10). · 4.22 Impact Factor
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    ABSTRACT: To investigate the diagnostic utility of beta 2 microglobulin (B2-M) levels and analyze this correlation with the activity of inflammatory bowel disease (IBD).
    World journal of gastroenterology : WJG. 08/2014; 20(31):10916-20.
  • The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 08/2014; 25(4):437. · 0.48 Impact Factor
  • Journal of the American Geriatrics Society 08/2014; · 4.22 Impact Factor
  • The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 04/2014; 25(2):220-221. · 0.48 Impact Factor
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    ABSTRACT: Many noninvasive serum markers have been studied to determine the liver fibrosis score (LFS). In this study, we aimed to investigate the association between thrombopoietin (TPO) levels and the stage of liver fibrosis in patients with chronic hepatitis B (CHB). Seventy-seven patients (64 active and 13 inactive) with CHB were included in this cross-sectional study. Patients were divided into three groups: In group 1, patients with mild or no fibrosis (F0, F1); in group 2, patients with significant fibrosis (F2-F4); and in group 3, inactive CHB carriers. Digital patient records were used to access pre-treatment laboratory findings including HBV DNA, HBeAg, ALT, AST, total bilirubin, PLT, albumin, INR. Liver biopsies were examined by experienced pathologists in our hospital who were blinded to the data of the patients. Serum TPO levels were measured using commercial ELISA kit. Serum TPO levels were significantly lower in patients with active CHB compared with the inactive carriers (528 vs 687.1 p=0.003). There was no statistically significant difference in TPO levels between the patients with and patients without significant fibrosis (568.9 vs 459.8 p=0.367). Correlation analysis with respect to ALT, AST, TPO, HBV-DNA level, platelet count, histological activity index (HAI) and liver fibrosis score was performed. TPO was only weakly positively correlated with AST, ALT and HBV-DNA levels (r=0.269 p=0.018; r=0.341 p=0.002; r=0.308 p=0.006; respectively) and no correlation in TPO with LFS and HAI was found (r=0.140 p=0.270, r=0.162 p=0.201; respectively). TPO was not associated with significant fibrosis (p=0.270). In conclusion, TPO levels were decreased in active CHB patients compared with inactive carriers but there was no correlation between TPO levels and the stage of fibrosis in active CHB.
    International Journal of Clinical and Experimental Medicine 01/2014; 7(5):1430-4. · 1.42 Impact Factor
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    ABSTRACT: Acute pancreatitis is the acute inflammation of pancreas and peripancreatic tissues, and distant organs are also affected. The aim of this study was to investigate the effect of Urtica dioica extract (UDE) treatment on cerulein induced acute pancreatitis in rats. Twenty-one Wistar Albino rats were divided into three groups: Control, Pancreatitis, and UDE treatment group. In the control group no procedures were performed. In the pancreatitis and treatment groups, pancreatitis was induced with intraperitoneal injection of cerulein, followed by intraperitoneal injection of 1 ml saline (pancreatitis group) and 1 ml 5.2% UDE (treatment group). Pancreatic tissues were examined histopathologically. Pro-inflammatory cytokines (tumor necrosis factor-α), amylase and markers of apoptosis (M30, M65) were also measured in blood samples. Immunohistochemical staining was performed with Caspase-3 antibody. Histopathological findings in the UDE treatment group were less severe than in the pancreatitis group (5.7 vs 11.7, p = 0.010). TNF-α levels were not statistically different between treated and control groups (63.3 vs. 57.2, p = 0.141). UDE treatment was associated with less apoptosis [determined by M30, caspase-3 index (%)], (1.769 vs. 0.288, p = 0.056; 3% vs. 2.2%, p = 0.224; respectively). UDE treatment of pancreatitis merits further study.
    International Journal of Clinical and Experimental Medicine 01/2014; 7(5):1313-8. · 1.42 Impact Factor
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    ABSTRACT: The incidence of acute pancreatitis is increasing recently. The aim of this study is to investigate the effect of Ankaferd Blood Stopper (ABS) on experimental model of cerulein induced acute pancreatitis in rats.
    International Journal of Clinical and Experimental Medicine 01/2014; 7(7):1676-83. · 1.42 Impact Factor
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    ABSTRACT: Apoptosis plays a role in epithelial and mucosal injury, which is 1 of the mechanisms in the pathogenesis of ulcerative colitis. Apoptotic cells increase as a result of injured mucosa in ulcerative colitis and serum M 30 levels increase in epithelial cell apoptosis. In this study, we aimed to evaluate the relation between M 30 serum levels and ulcerative colitis activity. Eighty patients with ulcerative colitis and 40 healthy controls were enrolled into the study. The patient group consisted of 31 extensive colitis, 30 left-sided colitis, and 19 proctitis. The activity of ulcerative colitis was determined with clinical and endoscopic findings. Serum M 30 levels, acute phase reactants, and biochemical tests were analyzed in all subjects. Serum M 30 levels in patients with active ulcerative colitis were significantly higher when compared with the healthy controls (165.6 ± 60.6 and 129.6 ± 37.4; P = 0.003). Serum M 30 levels in active left-sided colitis patients was significantly higher when compared with patients in remission phase (180.6 ± 58.5, 141.5 ± 35.4; P = 0.044). When we exclude patients with ulcerative proctitis, M 30 levels in active ulcerative colitis patients were significantly higher than that the patients in remission phase (174.0 ± 63.5, 135.0 ± 29.9; P = 0.017). We found that M 30 levels increase in patients with active ulcerative colitis. Our findings support the role of apoptosis demonstrated by serum M 30 levels in the pathogenesis of active ulcerative colitis.
    Inflammatory Bowel Diseases 08/2013; · 5.12 Impact Factor
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    ABSTRACT: To the Editor The most common causes of colonic obstruction in adults are malign tumors, diverticular disease, and volvulus (1). Acute colonic obstruction due to bladder distention (globe vesicale) is highly rare. To the best of our knowledge, just few cases have been reported in the literature (2, 3). Here, we present a case of acute colonic obstruction associated with globe vesicale and its treatment with a urinary catheter in a simple and timely fashion. A 75-year-old male patient was hospitalized in the neurology clinic with a diagnosis of cerebrovascular disease as a sequel. He was consulted in our clinic for the complaints of abdominal distention, nausea, inability to pass intestinal gas and constipation, as well as severe abdominal pain for 3 days. The physical examination revealed abdominal sensitivity with palpation, distention, dullness with a downward opening, and tenderness. The rectal examination was normal. A plain X-ray image showed widespread air-fluid levels in the colon and small intestines (Figure 1). The laboratory findings were within normal limits. Based othese findings, we established the diagnosis of ileus. The presence of dullness with a downward opening was suspected to may be a sign of globe vesicale. An urinary catheter was inserted into the bladder throughout the urethra, and a total of 4000 ml urine was discharged. The clinical status and plain film of the patient improved upon performing urinary catheter application (Figure 2), and the patient discharged gas and stool. Based on the clinical and laboratory findings of the patient, the diagnosis was considered to be acute colonic obstruction associated with globe vesicale. In the follow-up with an urinary catheter, ileus did not develop again. It should be kept in mind that globe vesicale may be an etiological factor in patients presenting with clinical features of acute ileus, especially in elderly male subjects, and this condition can be treated in a simple and rapid manner using a urinary catheter.
    The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 08/2013; 24(4):372-373. · 0.48 Impact Factor
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    ABSTRACT: To the Editor Approximately 1% of colonoscopic polypectomies results in hemorrhage (1). The risk of hemorrhage is higher particularly in polyps located in the right colon, larger than 2 cm, of sessile type, and with thick stalk. Moreover, the risk is also increased in patients that are on antiaggregants or anticoagulants (2, 3). In endoscopic treatment of postpolypectomy hemorrhage, some methods as epinephrine injection, thermal coagulation, hemoclip, or combination of these methods are used, as in the treatment of peptic ulcers (4). Here, we present a case of postpolypectomy hemorrhage that was successfully treated with a non-standard treatment approach which involved a combined method of band ligation by the use of hemoclips and band ligation. To the best of our knowledge, no case of this kind has been presented in the literature to date. A 65-year-old female patient was admitted to our outpatient clinic with the complaint of constipation. The colonoscopic evaluation of the patient revealed a wide-based polyp of 1 cm in diameter at the 15 th cm of the rectum. After submucosal lifting of the base of the polyp using saline, polypectomy was performed with a polypectomy snare. After polypectomy, pulsating hemorrhage was noted on the base of the polyp. Two hemoclips were set on the upper and lower edges of the mucosa for hemostasis. Because of sustained hemorrhage, a single rubber band was placed on the area of hemorrhage in a manner to keep the clips within the area (Figure 1). The hemorrhage stopped and no more bleeding was observed in the following control. Adenocarcinoma was detected in the pathological evaluation of the polyp. The tumor did not have surgical margins. The patient was consulted with the surgery department because of submucosal invasion. Besides the use of hemoclips or endoscopic band ligation to overcome postpolypectomy bleeding, there is also an option to prevent such kind of hemorrhages. Routine endoscopic band ligation applied before polypectomy examination in pedinculated or semi-pedinculated polyps with heads of 1 cm or greater was shown to be an efficient technique to prevent postpolypectomy bleeding (5). In conclusion, although it is not listed among the standard treatment approaches for postpolypectomy hemorrhages, the band ligation applied at the hemorrhagic area combined with hemoclips may be an alternative treatment option for the management of persistent postpolypectomy hemorrhages despite the application of primary treatment modalities.
    The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 08/2013; 24(4):375-376. · 0.48 Impact Factor
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    ABSTRACT: Background/aims:During removal of intragastric balloon, there is a great deal of gastric undigested food even after an eight-hour starvation. Bromelain, a proteolytic enzyme existing in the pineapple juice seems to be a good choice for the undigested food remnants in the stomach. We aimed to investigate the effect of drinking pineapple juice on dissolving food remnants in patients undergoing endoscopic procedure for removal of intragastric balloon. Materials and Method: In this study, we included patients who had undergone endoscopic placement of intragastric balloon (BIB®, BioEnterics Intragastric Balloon, Inamed Health, CA, USA) between February 2009 and March 2012. First 8 patients were asked to fast the whole night before the procedure (at least 8 hours) and to apply clear liquid diet for 3 days before the endoscopic removal. A great amount of food remnants was seen in the stomach during the endoscopic balloon removal procedure. A second endoscopic procedure was planned 3 days later and, in order to decrease the food remnants, the patients were asked to drink 1 L pineapple juice per day. The next 11 patients were also advised to drink 1 liter per day of 100% pineapple juice for 3 days before the endoscopic removal. Results:Totally, 19 obese patients (17 female, 2 male) were included in the study. Mean age was 38,68±7,95 years, mean weigh was 124,23±19,30 kg, and mean body mass index was 49,73±9,22 kg/m 2 . There was undigested food in the stomach during endoscopic removal in the first 8 patients. However, no undigested food in the stomach was found at the second endoscopic examination. In the other 11 patients, no food remnants were observed after taking pineapple juice prior to the endoscopic removal procedure. Conclusion: Drinking pineapple juice for 3 days before endoscopic balloon removal seems to be effective in dissolving food remnants in the stomach. Drinking pineapple juice may be recommended in all patients undergoing endoscopic procedure for removal of intragastric balloon.
    The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 08/2013; 24(4):330-333. · 0.48 Impact Factor
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    ABSTRACT: Abstract Gastric cancer is the fourth most frequent cancer and the second cause of cancer-related deaths worldwide. The early diagnosis of gastric cancer is fundamental in decreasing the mortality rates. It has been shown that MPV level is a sign of inflammation in hepatocellular carcinoma and pancreatic adenocarcinoma. The aim of this study is to examine whether MPV would be a useful inflammatory marker for differentiating gastric cancer patients from healthy controls. Thirty-one gastric cancer patients and 31 age-sexes matched healthy subjects included into the study. Patients with hypertension, hematological and renal disease, heart failure, chronic infection, hepatic disorder and other cancer were excluded from the study. MPV level was significantly higher in pre-operative gastric cancer patients compared to healthy subjects (8.31 fL vs. 7.85; p: 0.007). ROC analysis suggested 8.25 fL as the cut-off value for MPV (AUC: 0.717, sensitivity: 61%, specificity: 81%). Surgical tumor resection resulted in a significant decrease in MPV level (8.31 fL vs. 7.55 fL; p: 0.001). No significant difference was found in MPV level between the post-operative group and control subjects. We did not find statistically significant difference between MPV and TNM stages. In conclusion, changes in MPV values may be used as an easily available biomarker for monitoring the healthy patients for GC risk and may prompt physicians to make an early diagnosis of GC.
    Platelets 03/2013; · 2.24 Impact Factor
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    ABSTRACT: Abstract Background Antibodies to soluble liver antigen (anti-SLA) are specific serological markers of autoimmune hepatitis (AIH). The clinical significance and frequency of anti-SLA have never been reported among AIH patients from Italy and Turkey. To retrospectively assess the estimated prevalence, sensitivity, specificity and clinical significance of anti-SLA in AIH and various liver diseases. Methods A total of 986 patients who had been tested for serum anti-SLA were included in study. The presence of anti-SLA was detected using recombinant enzyme linked immunosorbent assay and immuno-blot. The general characteristics and outcome of patients were obtained from their medical records. Results Antibodies to SLA were found in 30 (3%) of 986 patients. Of these, 27 (90%) had AIH and its variants, whereas the remaining three (10%) had primary biliary cirrhosis. The prevalence of anti-SLA was 9% in AIH patients from Italy and 15% in patients from Turkey. The specificity of these antibodies was 99.5%, whereas sensitivity was 11%. The positive predictive and negative predictive values were 90% and 77.5% respectively (95% confidence interval). Biochemical remission was achieved in 90% of anti-SLA positive AIH patients, but relapse after immunosuppressive withdrawal or during maintenance therapy was observed in 53% of the patients. Conclusions Seropositivity for anti-SLA occurs at similar frequencies in AIH patients from different geographical regions and ethnic groups. The sensitivity of anti-SLA is low, but it has high specificity for AIH. Additional studies are necessary to prove clinical significance of anti-SLA in AIH.
    Liver International 02/2013; Volume 33,(Issue 2):(pages 190–196).
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    ABSTRACT: BACKGROUND AND AIM: The aim of this study was to assess and compare the performance of a series of non-invasive tests to detect fibrosis in patients with chronic hepatitis B (CHB). PATIENTS AND METHODS: Seventy-six patients with CHB, whose blood samples were collected and biopsies were done on the same day, were included in this study. Pre-treatment calculations of aspartate aminotransferase to platelet ratio index (APRI), Forn's index, FIB-4, S-index, Shanghai Liver Fibrosis Group's index (SLFG) and Hepascore(®) were done and relations with mild and advanced fibrosis and cirrhosis were assessed. Post-treatment values of APRI, Forn's index, FIB-4, S-index with oral antiviral agents were also investigated. RESULTS: APRI, S-index, SLFG, FIB-4, Forn's index and Hepascore(®) had 0.669, 0.669, 0.739, 0.741, 0.753, 0.780; retrospectively Area Under the Receiver Operating Characteristic Curve (AUROC) for significant fibrosis. APRI, Forn's index, S-index, FIB-4, SLFG, and Hepascore(®) had 0.681, 0.714, 0.715, 0.738, 0.747, 0.777 retrospectively AUROC for advanced fibrosis. APRI, SLFG, FIB-4, Forn's index, S-index, and Hepascore(®) had 0.741, 0.742, 0.768, 0.779, 0.792, 0.824 retrospectively AUROC for cirrhosis. APRI, Forn's index, FIB-4 and S-index were significantly lower in post-treatment group compared with pre-treatment group (P-values: <0.05, 0.001, 0.003, 0.018; respectively). CONCLUSION: Hepascore(®) showed the best performance to predict significant fibrosis. Our study also suggests that the use of non-invasive test to predict fibrosis in patients with CHB may reduce the need for liver biopsy and may help to monitor the efficacy of treatment.
    Gastroentérologie Clinique et Biologique 02/2013; · 0.80 Impact Factor
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    ABSTRACT: BACKGROUND & AIMS: Data are limited on the efficacy and safety of tenofovir and entecavir when given for more than 1 year to patients with hepatitis B-related cirrhosis. We investigated the long-term safety and efficacy of these antiviral drugs in patients with chronic hepatitis B virus (HBV) infection, with compensated or decompensated cirrhosis, and compare results with those from lamivudine. METHODS: We performed a retrospective analysis of data from 227 adult patients with chronic HBV infection who were diagnosed with cirrhosis, beginning in 2005, at 18 centers throughout Turkey; 104 had decompensated cirrhosis, 197 were treatment naïve before 72 received tenofovir (followed for 21.4±9.7 months), 77 received entecavir (followed for 24.0±13.3 months), and 74 received lamivudine (followed for 36.5±24.1 months). We collected data on patient demographics and baseline characteristics. Laboratory test results, clinical outcomes, and drug-related adverse events were compared among groups. RESULTS: Levels of HBV DNA <400 copies/mL were achieved in 91.5%, 92.5%, and 77% of patients receiving tenofovir, entecavir, or lamivudine, respectively. Levels of alanine aminotransferase normalized in 86.8%, 92.1%, and 71.8% of patients that received tenofovir, entecavir, and lamivudine, respectively. Child-Turcotte-Pugh scores increased among 8.5% of patients that received tenofovir, 15.6% that received entecavir, and 27.4% that received lamivudine. Frequencies of complications from cirrhosis, including hepatic encephalopathy, variceal bleeding, hepatocellular carcinoma, and mortality were similar among groups. Lamivudine had to be changed to another drug for 32.4% of the patients. CONCLUSION: Tenofovir and entecavir are effective and safe for long-term use in patients with compensated or decompensated cirrhosis from HBV infection.
    Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 10/2012; · 5.64 Impact Factor
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    ABSTRACT: Background: The exact etiology of irritable bowel syndrome (IBS) remains unclear. Curative treatment is not available and current treatment modalities are mainly directed against the predominant symptoms. There are a few studies reporting the beneficial effects of transcutaneous electrical stimulation in patients with chronic constipation, gastroparesis, and functional dyspepsia. Aim: To investigate whether transcutaneous electrical stimulation is an effective procedure in IBS patients. Methods: IBS patients were randomly placed in vacuum interferential current (IFC) and placebo groups. Both treatments consisted of 12 sessions administered over 4 weeks. Symptoms due to IBS were documented via questionnaires, including the IBS Global Assessment of Improvement Scale, numeric rating scales, visual analogue scale, and IBS Quality of Life Scale at the beginning of, end of, and 1 month after the treatment. Results: Patients in the therapy (29 cases) and placebo (29 cases) groups were homogeneous with respect to demographic data and gastrointestinal system symptoms. When compared to the beginning scores, severity of abdominal discomfort, bloating, and abdominal distension and rumbling improved significantly in either interference or placebo groups at both the end of treatment and 1 month after treatment. In the IFC group, severity of symptoms continued to decrease significantly at 1 month after treatment when compared to scores at just the end of treatment, whereas in the placebo group severity of these symptoms did not change significantly on numeric severity scales. Also, the visual analogue scale of the first month after treatment continued to decrease significantly when compared to the level at the end of treatment in the IFC group. Total quality score increased significantly in the IFC group. Conclusions: Vacuum IFC therapy can significantly improve symptoms and quality of life in patients with IBS. It may represent a novel treatment modality for drug-refractory IBS patients.
    Digestion 07/2012; 86(2):86-93. · 1.94 Impact Factor
  • The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 06/2012; 23(3):309-10. · 0.48 Impact Factor
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    ABSTRACT: To assess the prevalence of concurrent extrahepatic autoimmune diseases in patients with autoimmune hepatitis (AIH)/primary biliary cirrhosis (PBC) overlap syndrome and applicability of the 'mosaic of autoimmunity' in these patients. The medical data of 71 AIH/PBC overlap patients were evaluated for associated autoimmune diseases. In the study population, 31 (43.6%) patients had extrahepatic autoimmune diseases, including autoimmune thyroid diseases (13 patients, 18.3%), Sjögren syndrome (six patients, 8.4%), celiac disease (three patients, 4.2%), psoriasis (three patients, 4.2%), rheumatoid arthritis (three patients, 4.2%), vitiligo (two patients, 2.8%), and systemic lupus erythematosus (two patients, 2.8%). Autoimmune hemolytic anemia, antiphospholipid syndrome, multiple sclerosis, membranous glomerulonephritis, sarcoidosis, systemic sclerosis, and temporal arteritis were identified in one patient each (1.4%). A total of 181 autoimmune disease diagnoses were found in our patients. Among them, 40 patients (56.4%) had two, 23 (32.3%) had three, and eight (11.3%) had four diagnosed autoimmune diseases. A large number of autoimmune diseases were associated with AIH/PBC overlap patients. Therefore, extended screening for existing autoimmune diseases during the routine assessment of these patients is recommended. Our study suggests that the concept of 'mosaic of autoimmunity' is a valid clinical entity that is applicable to patients with AIH/PBC overlap syndrome.
    European journal of gastroenterology & hepatology 05/2012; 24(5):531-4. · 1.66 Impact Factor
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    ABSTRACT: In the follow up of chronic hepatitis B infection (HBV), a significant correlation between quantitative HBsAg titer measurement and HBV DNA level, and moreover with intrahepatic covalently closed circular DNA was already shown. However, besides their impact on long-term follow up, they are really expensive methods, and not available widespread. We aimed to investigate the utility of qualitative measurement of HBsAg titer in prediction of virologic response at the end of the first year of anti-viral treatment in chronic HBV infection. A total of 70 patients receiving anti-viral therapies for chronic HBV infection were included into the study. The patients were evaluated according to Hbe Ag status and response to treatment. The determinations used in the study (biochemical, virologic responses, primary non-response) were accepted as it was described in AASLD. Qualitative HBsAg titer increased significantly in both HBeAg positive and negative patients (p values 0.002 and < 0.000). Increasing of HBsAg titer in first three months is more dramatic in responder group, however the difference was disappeared at the sixth and twelve moths on follow up. Similarly, a fast increasing in anti-HBe titer in HBeAg negative chronic HBV patients was related with higher response at the end of first year therapy. However, the changings at the 12th month of anti-viral treatment were similar in both responder and non-responder groups. In conclusion, the fast increase in qualitative measurement of HBsAg titer seemed to be a predictor of higher anti-viral medication success in chronic HBV patients. However, this meaningful increasing was disappeared on the follow up, particularly after the six months examination.
    Annals of hepatology: official journal of the Mexican Association of Hepatology 05/2012; 11(3):320-5. · 1.67 Impact Factor

Publication Stats

341 Citations
173.58 Total Impact Points

Institutions

  • 2014
    • Hacettepe University
      • Department of Gastroenterology
      Engüri, Ankara, Turkey
  • 2009–2014
    • Dışkapı Yıldırım Beyazıt Training and Research Hospital
      Engüri, Ankara, Turkey
  • 2010
    • Ankara University
      • Department of Gastroenterology
      Ankara, Ankara, Turkey
  • 2006–2009
    • Ankara Numune Training and Research Hospital
      Engüri, Ankara, Turkey
  • 2003–2009
    • Yüksek İhtisas Hastanesi, Ankara
      Engüri, Ankara, Turkey