Browsing by Author "Soysal, Dilek Ersil"

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Citation - WoS: 1
Brittle Diabetes Needs Patient Centered Treatment and Lifestyle Modification in the Rural
(Gazi Univ, Fac Med, 2022) Gokdemir, Ozden; Ersil Soysal, Dilek; Soysal, Dilek Ersil
The 'brittle' type 1 diabetes mellitus is characterized by severely fluctuating blood glucose levels, recurrent and long hospital admissions, and disruption of quality of life. When the case is brittle, it is more difficult to manage diabetes mellitus in the rural Turkey than in urban areas. We present a case of 33-year-old male patient with brittle type 1 diabetes mellitus for over 15 years. His life was a vicious cycle of episodes of hyper and hypoglycemia needing hospitalization approximately every 5 or 6 months for the regulation of his blood glucose levels. A family physician attributed the problem to stressful life circumstances. The patient has been divorced for many years, lost contact with his children and had difficulties in managing his life alone. A family physician counseled him using non-pharmacologic approaches. She arranged diet based on the patient's eating patterns, preferences, and metabolic goals. Macronutrient proportions were individualized. He learned carbohydrate counting and administered insulin for each meal based on the carbohydrate content. He quitted smoking. His socialization developed through psychiatric interventions. Despite lacking regular exercise, lifestyle modification helped the patient achieve more stable plasma glucose levels, avoid being 'brittle' and improve his quality of life in this rural context.
Citation - WoS: 2
Citation - Scopus: 2
Long-Lasting Follow-Up With Low-Dose Steroid in an 18-Year Male With Rosai-Dorfman Disease
(Hindawi Ltd, 2020) Karakus, Volkan; Dere, Yelda Morgul; Ersil Soysal, Dilek; Soysal, Dilek Ersil
Rosai-Dorfman disease (RDD) is a rare and benign pathology of sinus histiocytosis of unknown etiology. Lymphadenopathy is the predominant clinical manifestation, but diverse organs can also be affected. Histological features involve S-100+ histiocytes with characteristic nuclear features within the enlarged sinusoids of the lymph nodes. The clinical course is unpredictable, but is often benign with spontaneous resolution of disease in most patients. We report a patient with bilateral massive enlargement of cervical, axillary, and inguinal lymph nodes, moderately enlarged spleen, and a weight loss of 15 kg. Excisional biopsy from the cervical lymph node showed that the dilated sinusoids were infiltrated by lymphocytes, plasma cells, and large histiocytes with CD 68 and S-100 protein positive. Due to the slow progression of the disease, oral prednisolone with a body weight of 1 mg/kg was started in March 2016. The steroid dosage has been adjusted many times during the clinical follow-up. After 33 months, steroid treatment resulted in partial shrinkage of lymph nodes, the spleen returned to its normal size, and the patient gained weight. After 38 months of follow-up, no systemic symptoms, sign, or extranodal involvement were detected, and the patient continued with low-dose steroid treatment.
Multidisciplinary Case-Based Small Group Discussions To Integrate Basic Medical Sciences With Clinical Situations
(Walter De Gruyter Gmbh, 2022) Şemin, Makbule İlgi; Ersil Soysal, Dilek; Seval Çelik, Yasemin; Hayran, Murvet; Demir, Ayse Banu; Ozkaya, Ali Burak; İnan, Sevinç; Akdoğan, Gül; Semin, Ilgi; Soysal, Dilek Ersil; Seval-Celik, Yasemin
Objectives Integration of the basic medical sciences with clinical medicine motivates medical students by showing how the fundamental concepts they have learned will come into their future practice. In this context, we created clinical integration sessions (CIS) in our first-year medical curriculum. Methods The instructors of different disciplines wrote the clinical scenarios together. The scenarios were discussed in five sessions with 39 first-year students. The first session's scenario consisted of four brief anemia cases. The next four sessions included a single case, according to the feedback of the students. Students formed groups of 7-8 participants. In the first 2 h, the scenarios were discussed in the groups and questions were answered by the students. In the third hour, the instructors answered the questions together with the students. After the first CIS, written feedback obtained from the students via a survey. Results The survey provided positive feedback on the benefits of active learning within small group discussions, and most of the students thought that their background was sufficient to solve the cases, with some literature search. Conclusion The scenarios, which provide multidisciplinary integration of basic medical sciences and clinical medicine, can be useful educational materials.