Person: SANCAR, MESUT
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SANCAR
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MESUT
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Publication Metadata only Aprepitant in the Treatment of Subacute Sclerosing Panencephalitis: A Randomized, Double-Blind, Placebo-Controlled Study(ELSEVIER SCIENCE INC, 2020) ARMAN KANDIRMAZ, EMİNE; Oncel, Ibrahim; Sancar, Mesut; Konuskan, Bahadir; Arioz, Filiz; Tezcan, Songul; Arman-Kandirmaz, Emine; Parlak, Safak; Gumeler, Ekim; Anlar, BanuBackground: Aprepitant is a neurokinin-1 receptor antagonist approved for the treatment of chemotherapy-induced nausea. We aimed to investigate the safety and efficacy of aprepitant in patients with subacute sclerosing panencephalitis. Methods: A randomized, double-blind, placebo-controlled study was conducted in patients with subacute sclerosing panencephalitis assigned to receive two courses of aprepitant 250 mg/day orally or placebo for 15 days with an interval of two months between courses. Primary end points were safety and tolerability, and secondary end point was clinical improvement or stabilization assessed by subacute sclerosing panencephalitis scoring system. Electroencephalography (EEG), brain magnetic resonance imaging, and cerebrospinal fluid measles-specific immunoglobulin G index were evaluated before and after treatment. Results: Sixty-two patients with subacute sclerosing panencephalitis were allocated to aprepitant (n = 31, median age 18 years) or placebo (n = 31, median age 22 years) group. Fifteen patients left the study within the first six months and 12 patients left between six and 12 months. Aprepitant was well tolerated and treatment-associated adverse events were similar to those described in the treatment of nausea. Clinical status at six and 12 months' follow-up did not differ between aprepitant and placebo groups. Post-treatment EEG scores at 12 months were better in the aprepitant group (P = 0.015). Cerebral atrophy on magnetic resonance imaging increased in both groups, whereas measles-specific immunoglobulin G index decreased in the placebo group. Conclusions: In this first clinical trial of aprepitant treatment in patients with subacute sclerosing pan encephalitis, the drug was safe and well tolerated. No clinical effect was observed. A modest improvement in EEG findings might justify trials for longer periods because EEG changes can precede clinical findings in subacute sclerosing panencephalitis. (C) 2020 Elsevier Inc. All rights reserved.Publication Metadata only Drug related problems identified by clinical pharmacist at the Internal Medicine Ward in Turkey(SPRINGER, 2018) SANCAR, MESUT; Abunahlah, Nibal; Elawaisi, Anfal; Velibeyoglu, Fatih Mehmet; Sancar, MesutBackground Drug-related problems (DRPs) interfere with patient optimal therapeutic outcomes and may be associated with higher morbidity, mortality and healthcare expenditures. Objective This study aimed to identify DRPs and their causes in a Turkish hospital. Setting Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Internal Medicine Ward, Istanbul, Turkey. Method Cross-sectional study included a total of 100 patients. Patient demographics, medications, and history were evaluated. Data regarding recent medications were analyzed by two clinical pharmacists and an Internal Medicine physician. The DRPs were identified via V7.0 PCNE classification. Lexicomp(A (R)) was used to assess the drug-drug interactions. UpToDate(A (R)) recommendations and national guidelines were applied in the assessment of compliance with approved medication procedures. Main outcome measures Number and causes of the potential DRPs. Results At least one potential DRP was seen in 80% of the patients and 163 potential DRPs were identified (average = 1.6 DRPs/patient). The most common causes of DRPs were errors in drug selection (44.78%), dose selection (27.61%) and medication procedures (21.47%). There were significant correlations (p < 0.05) between DRPs and age (r = 0.4), number of drugs used (r = 0.32), duration of hospitalization (r = 0.25), renal impairment (r = - 0.34) and inflammation (r = 0.31). Conclusion The majority of the patients had DRPs. Patients with renal impairment, inflammation, polypharmacy or an extended hospital stay had a much higher chance of developing DRPs.Publication Open Access Investigation of drug-related problems in patients hospitalized in chest disease wards: A randomized controlled trial(2023-01-10) SANCAR, MESUT; BEKTAY M. Y., SANCAR M., OKYALTIRIK F., DURDU B., İZZETTİN F. V.Copyright © 2023 Bektay, Sancar, Okyaltirik, Durdu and Izzettin.Objective: According to the World Health Organization (WHO), chest diseases are among the 10 diseases that cause the highest mortality worldwide. Drug-related problems (DRPs), readmission, and antimicrobial resistance are critical problems in chest disease wards. Active involvement of clinical pharmacists (CPs) who are focused on reducing the risks of potential problems is needed. The aim of this study is to investigate the effects of pharmaceutical care (PC) services on the pulmonology service. Method: A randomized controlled trial at a university hospital in Istanbul was conducted between June 2020 and December 2021. The participants were randomized into the control group (CG) and intervention group (IG). In the CG, CPs identified and classified the DRPs according to Pharmaceutical Care Network Europe v9.0 (PCNE) and provided solutions to DRPs for the IG. The effect of PC services was evaluated by the number and classification of DRPs, and readmissions within 30 days were compared between the two groups. Results: Out of 168 patients, 82 were assigned to the IG. The average number of medicines administered per patient in the CG and IG was 14.45 ± 7.59 and 15.5 ± 6.18, respectively. In the CG and IG, the numbers of patients with DRPs were 62 and 46, respectively. The total number of DRPs was 160 for CG and 76 for IG. A statistically significant difference was found in favor of the IG, in terms of the number of patients with DRPs, the total number of DRPs, and readmission within 30 days (p < 0.05). Conclusion: In this study, CP recommendations were highly accepted by the healthcare team. Pharmaceutical care services provided by CPs would decrease possible DRPs and led to positive therapeutic outcomes. Cognitive clinical pharmacy services have beneficial effects on health care, and these services should be expanded in all settings where patients and pharmacists are present.Publication Metadata only Evaluation of potentially inappropriate medication utilization in elderly patients with cancer at outpatient oncology unit(SAGE PUBLICATIONS LTD, 2019) OKUYAN, BETÜL; Paksoy, Ceylan; Ozkan, Oznur; Ustaalioglu, Bala B. O.; Sancar, Mesut; Demirtunc, Refik; Izzettin, Fikret V.; Okuyan, BetulBackground The aim of the study was to evaluate potentially inappropriate medication use in elderly patients with cancer. Method This study was conducted at outpatient oncology clinic from December 2014 to March 2015 among elderly cancer patients. Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment criteria were used to identify potentially inappropriate medication in elderly patients. Results Among 114 cancer patients 55.26% of them were male and the mean age of them was 71.78 +/- 5.50 (years). The most common concurrent diseases were hypertension in 45 (39.47%) and diabetes in 26 (22.81%) patients. Polypharmacy (>= 5 medications) was seen in 94.73% of them. Eighteen patients (15.79%) utilized medications inappropriately according to Screening Tool of Older Person's Prescriptions criteria. Medication omissions were identified in 112 patients (98.25%) with Screening Tool to Alert doctors to Right Treatment criteria. Conclusions Clinical pharmacists could improve the current prescribing practices in elderly patients with cancer by assessing potentially inappropriate medications.Publication Metadata only The effect of pharmacist-led education on inhaler use skills in hospitalised patients with chronic obstructive pulmonary disease(BMJ PUBLISHING GROUP, 2015) OKUYAN, BETÜL; Sancar, Mesut; Sirinoglu, Yasemin; Okuyan, Betul; Karagoz, Turan; Izzettin, Fikret VehbiObjective To assess patient inhalation skills and the effect of pharmacist-led education on these skills in chronic obstructive pulmonary disease (COPD) patients using inhalers in a hospital setting. Methods Pre- and 1month post-intervention were evaluated by scoring essential steps during inhaler use for each inhaler device. Results 41 patients participated in the study (mean age 64.3611.78 years, range 29-83 years). The female-male ratio was 7:34. Patients' inhaler administration skills were found to be improved by pharmacist-led education (p<0.05). Conclusions Evaluation of accurate inhaler device usage in patients with COPD should be performed periodically, and training regarding the inhaler device should be reconsidered according to the needs of patients.Publication Open Access The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment(MARMARA UNIV, 2019-11-15) SANCAR, MESUT; Izzettin, Fikret Vehbi; Celik, Sevda; Acar, Rezzan Deniz; Tezcan, Songul; Aksoy, Nilay; Bektay, Muhammed Yunus; Sancar, MesutThis study was carried out on patients who were under anticoagulation treatment with warfarin, at the outpatient cardiology clinic. The aim was to determine the effectiveness of pharmacist consultation, education, and intervention on each patient's therapeutic results. A cross-sectional randomized trial has been done. Twenty-five patients were included in the study. The Oral Anticoagulation Knowledge (OAK) Test, Short Form-36 (SF-36) and Duke Anticoagulation Satisfaction Scale (DASS) were applied. Patients resumed their routine anticoagulation treatment and INR and complications were recorded during the study. Additionally, patients received patient education, consultation on lifestyle and anticoagulant usage issues from a pharmacist. The same tests were applied again to the patients on the 90th day of the study and the results were compared with the initial test. Maintenance of INR within the target range and complication rates were compared before and after the intervention. Pre-test and post-test results of the patients revealed statistically significant improvements on the physical and mental score components of the SF-36 (p = 0.001; p = 0.001), OAK test scores (p <= 0.001) and the (negative) limitations and burdens and positive effects components of the DASS (p = 0.005; p < 0.001; p = 0.001). The successful maintenance of INR within target range was significantly higher (p = 0.027). The positive effects of pharmacist consultation and education on therapeutic results were demonstrated.Publication Metadata only Protective effect of ferulic acid on cisplatin induced nephrotoxicity in rats(ELSEVIER, 2017) OKUYAN, BETÜL; Bami, Erliasa; Ozakpinar, Ozlem Bingol; Ozdemir-Kumral, Zarife Nigar; Koroglu, Kutay; Ercan, Feriha; Cirakli, Zeynep; Sekerler, Turgut; Izzettin, Fikret Vehbi; Sancar, Mesut; Okuyan, BetulThis study aims to determine the potential protective effects of ferulic acid against cisplatin-induced nephrotoxicity and to compare its effect with curcumin, a well-known protective agent against cisplatin- induced toxicity in rats. Administration of cisplatin resulted in high BUN (Blood Urea Nitrogen), creatinine, MDA (Malondialdehyde), MPO (Myeloperoxidase), TOS (Total Oxidative Status), PtNT (Protein Nitrotyrosine) levels (p < 0.05). Histological observations showed abnormal morphology of kidney; in addition with appearance of TUNEL positive cells indicating apoptosis in cisplatin administered group. HO-1 (Heme Oxygenase-1) levels measured by RT-PCR (Real Time Polymerase Chain Reaction), and TAS (Total Antioxidative Status) revealed antioxidant depletion due to cisplatin toxicity in animals (p < 0.05). All parameters showed improvement in groups treated with ferulic acid (p < 0.05). Ferulic acid treatment was found significant in preventing oxidative stress, increasing antioxidative status and regaining histological parameters to normal, indicating nephroprotective and antioxidant effects of this phenolic compound.Publication Open Access Ethanol extract of Cotinus coggygria leaves accelerates wound healing process in diabetic rats(TAYLOR & FRANCIS LTD, 2016-11) ŞEN, ALİ; Aksoy, Halil; Sen, Ali; Sancar, Mesut; Sekerler, Turgut; Akakin, Dilek; Bitis, Leyla; Uras, Fikriye; Kultur, Sukran; Izzettin, Fikret VehbiContext:Cotinus coggygria Scop. (Anacardiaceae) leaves that were used as wound healing in traditional Balkan and Anatolian folk medicine, could be potentially effective in treating diabetic wounds.Objective: This study investigates biochemical and histological effects of ethanol extract of C. coggygria (CCE) on excision wound model in diabetic rats.Materials and methods: This study was conducted on diabetic Wistar albino rats, which were injected by a single dose (50mg/kg i.p.) streptozotocin. Afterward an excision wound model was created in all animals; diabetic control rats were applied topically simple ointment and diabetic treatment rats were applied topically 5% (w/w) ointment with CC, once a day during the experimental period. Malondialdehyde, glutathione and hydroxyproline levels in wound tissues were investigated at the end of 3rd, 7th, and 14th days. Histopathological examination was also performed.Results: Hydroxyproline content was significantly increased in the CCE treated group versus control after the 3rd and 7th days (15.33 versus 11.83; 19.67 versus 15.67mg/g, p<0.05; respectively). A statistically significant elevation in glutathione at the end of 3rd, 7th, and 14th days (5.13 versus 1.58, p<0.05; 4.72 versus 1.88, p<0.05; 3.83 versus 1.88mol/g, p<0.05, respectively) and a statistically significant decrease in malondialdehyde level at the end of 7th day (4.49 versus 1.48nmol/g, p<0.05) were determined in the treated group versus control group. These results were also supported by histological analyses.Discussion and conclusion: These findings indicate that CCE accelerated the cutaneous wound healing process in diabetic wounds, in confirmation of its traditional use.Publication Metadata only Adverse drug reactions due to drug- drug interactions with proton pump inhibitors: assessment of systematic reviews with AMSTAR method(TAYLOR & FRANCIS LTD, 2016) OKUYAN, BETÜL; Yucel, Emre; Sancar, Mesut; Yucel, Aylin; Okuyan, BetulIntroduction: Many systematic reviews resulted in claims on drug-drug interactions (DDIs) with proton pump inhibitors (PPIs). Such a large number begs for consensus on the clinical significance of findings.Areas covered: We critically evaluated the safety of PPI use with respect to DDIs with a meta-review of systematic reviews published between 1978 and 2015. We assessed the evidence by their reliability, repeatability, transparency, and objectivity according to the Assessment of Multiple Systematic Reviews (AMSTAR) criteria.Expert opinion: Clinicians must assess risks for each PPI for certain comorbid conditions. DDIs don't substantiate class effect for PPIs; each PPI could induce unique DDIs. Concomitant use of PPIs with thienopyridines (e.g. clopidogrel) could be justified in patients without strong affinity to cytochrome CYP2C19 and with high risk of bleeding (e.g. patients with prior upper gastrointestinal bleeding, Helicobacter pylori infection, advanced age, steroid treatment, and nonsteroidal anti-inflammatory drug use). DDIs could occur in an AIDS subpopulation treated with highly active antiretroviral therapy (HAART). DDIs exist for cancer patients undergoing targeted therapy. Hypomagnesemia could increase in the setting of advanced age and polypharmacy. Omeprazole poses high risks owing to its pharmacokinetic DDI profile. Future systematic reviews should incorporate these additional risks for better clinical guidancePublication Metadata only The impact of pharmacist-led smoking cessation program at community pharmacy(2012-01-01) SANCAR, MESUT; OKUYAN, BETÜL; Atalay L., SANCAR M., OKUYAN B., Izzettin F. V.Amaç: Çalışmada, bir serbest eczanede klinik eczacı tarafından yürütülen ‘nikotin replasman tedavisiyle (nikotin sakızı ve nikotin tabletini içeren) sigara bırakma programının bir yıllık sonuçlarının değerlendirilmesi amaçlanmıştır. Yöntem: Çalışma Haziran 2009 - Haziran 2010 tarihleri arasında gerçekleştirilmiştir. İlk görüşmede katılımcıların demografik ve klinik verileri toplanmış ve her bir katılımcıya ‘Fagerstrom Nikotin Bağımlılık Testi’ uygulanmıştır. Daha sonra klinik eczacı tarafından katılımcılar sigaranın zararları hakkında bilgilendirilmiş ve her bir katılımcının bağımlılık derecesine göre uygun OTC (tezgah üstü ilaç- reçetesiz ilaç) nikotin replasman ürünü tavsiye edilmiştir. Katılımcılar klinik eczacı tarafından on iki ay boyunca yüz yüze veya telefonla yapılan düzenli görüşmelerle takip edilmiştir. Bulgular: Çalışmaya katılan 33 katılımcının yaş ortalaması 41.57±11.90 (aralık: 24-66 yıl) olarak hesaplanmıştır. Fagerstrom Nikotin Bağımlılık Testi sonuçlarına göre katılımcıların onbeşinde düşük nikotin bağımlılığı, dokuzunda orta bağımlılık ve kalan dokuz katılımcıda ise yüksek nikotin bağımlılığı saptanmıştır. Hastaların ikisi bir yıllık takipte kaybedilmiş, çalışma 31 hasta ile tamamlanmıştır. Çalışma sonunda, klinik eczacı danışmanlığında serbest eczanede yürütülen sigara bırakma programıyla bir yıl boyunca takip edilen otuz bir katılımcının yirmisinin (%64.5) sigara kullanmayı bıraktığı görülmüştür. Sonuç: Bu bilgiler ışığında, eğitimli ve kolay ulaşılabilir sağlık mensupları olan eczacıların sigara bırakma programlarında aktif rol almaları gerekmekte olduğu sonucuna ulaşılmıştır. Anahtar sözcükler: Sigara bırakma, klinik eczacılık, nikotin replasman tedavisi