Publications by authors named "Naim Nur"

26 Publications

  • Page 1 of 1

Frontal QRS-T angle as a predictive marker for myocardial damage in acute carbon monoxide poisoning.

Hum Exp Toxicol 2021 Nov 24:9603271211043477. Epub 2021 Nov 24.

Faculty of Medicine, Department of Emergency Medicine, 52954Sivas Cumhuriyet University, Sivas, Turkey.

Introduction: The present study was undertaken to investigate the prognostic value of the frontal QRS-T angle associated with adverse cardiac outcomes in patients with carbon monoxide (CO) poisoning in early stages in the emergency department.

Materials And Methods: The data of 212 patients with CO poisoning who were admitted to the ED between January 2010 and May 2020 were retrospectively analyzed. The frontal QRS-T angle was obtained from the automatic reports of the EKG device.

Results: Compared to patients without myocardial damage, among patients with myocardial damage, statistically high creatinine, creatine kinase MB, cardiac troponin I, and frontal QRS-T angle values were found ( < 0.001 for all parameters), while the saturation of arterial blood pH and arterial oxygen values were found to be lower ( = 0.002 and < 0.001, respectively). The frontal QRS-T angle values were correlated with creatine kinase, creatine kinase-MB, cardiac troponin I, and oxygen saturation (SpO) in arterial blood (r = 0. 232, = 0.001; r = 0. 253, = < 0.001; r = 0. 389, = < 0.001; r = -0. 198, = 0.004, respectively). The optimum cut-off value of the frontal QRS-T angle was found to be 44.5 (area under the curve: 0.901, 95% confidence interval: 0.814-0.988, sensitivity: 87%, specificity: 84%).

Conclusions: The frontal QRS-T angle, a simple and inexpensive parameter that can be easily obtained from 12-lead surface electrocardiography, can be used as an early indicator in the detection of myocardial damage in patients with CO poisoning.
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http://dx.doi.org/10.1177/09603271211043477DOI Listing
November 2021

An Assessment of Intimate Partner Femicide in the Name of Honour in Turkey: A Retrospective Epidemiological Study.

Authors:
Naim Nur

Psychiatr Danub 2021 ;33(2):152-157

Department of Public Health, School of Medicine, Cumhuriyet University, 58140 Sivas, Turkey,

Background: Honour killing (HK) is the most extreme form of domestic violence. Given the scarcity and reliability of data on the phenomenon, the present study focuses on the epidemiological pattern of HK in Turkey, where many cases of the HK are considered unreported or/and falsely described.

Subject And Methods: Data for this retrospective epidemiological study was collected through newspaper reports on intimate partner femicide (IPF) that published between January 1 2010 and December 31 2015. The proportion of HK was estimated according to independent variables by means of regression analysis.

Results: The femicide cases has increased during the study period. The proportion of the HK cases was 14%. Logistic regression analysis showed that being at the younger ages (odds ratio, OR=2.0, r=0.70, P<0.001) and using other methods such as strangulation, hanging, electrocution or poisoning were the factors associated with HK (OR=1.8, r=0.60, P=0.004).

Conclusions: Given the continued increase in the rate of the IPF cases in Turkey, where HK related information is scarce, newspaper reports can be a good monitoring tool. Data collection and monitoring systems are crucial to find the best effective prevention strategies, particularly for HK. Policies to reduce the HK cases should be including support to women, especially at the younger ages.
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http://dx.doi.org/10.24869/psyd.2021.152DOI Listing
July 2021

Identifying variables in relation to health-related quality of life among married women of reproductive age in Sivas Turkey.

Authors:
Naim Nur

Women Health 2020 May-Jun;60(5):534-546. Epub 2019 Oct 6.

Department of Public Health, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey.

A cross-sectional study was performed to identify the factors associated with health-related quality of life (HRQoL) among 1,236 married Turkish women aged 15-49 years, in the urban area of Sivas, between January and July 2017. Multiple logistic regression analyzes showed that being unemployed [adjusted odds ratio (AOR) = 1.73, 95% confidence interval (CI) = 1.18-2.25], and having an unsatisfying sexual life (AOR = 1.54, 95% CI = 1.17-2.03), a chronic illness (AOR = 1.66, 95% CI = 1.27-2.17), more than three children (AOR = 1.38, 95% CI = 1.03-1.86), and experienced domestic violence (AOR = 2.15, 95% CI = 1.55-2.98) were associated with worse mental HRQoL. Having less than a high school education (AOR = 2.00, 95% CI = 1.33-3.02), a chronic illness (AOR = 2.49, 95% CI = 1.88-3.30), a history of abortion (AOR = 1.59, CI = 1.09-2.31), and experienced domestic violence (AOR = 1.71, 95% CI = 1.21-2.40) were associated with worse physical HRQoL. These findings suggest that health care providers or policy makers should pay special attention to unemployed women who are less educated, have more than three children and those having unsatisfied sexual lives, chronic illness, domestic violence experience and abortion history to enhance their HRQoL.
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http://dx.doi.org/10.1080/03630242.2019.1674441DOI Listing
September 2020

Cancer Incidence Rates by Age and Gender in Sivas Province of Turkey, 
2004-2014.

Oman Med J 2019 Mar;34(2):126-130

Department of Public Health, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.

Objectives: We sought to evaluate the trends in age-standardized incidence rates of cancer by gender, age, and types in the Sivas province of Turkey from 2004 to 2014.

Methods: Data were obtained from the Sivas Public Health Department Cancer Unit and the Cumhuriyet University Hospital Cancer Record Unit for the studied period. Data were presented as incidence rates by age, gender, and cancer site using world age-standardized incidence rate (ASR-W) per 10 populations.

Results: Of the 13 377 registered new cases of cancer during the study period, 43.1% (5771) were female, and 56.9% (7606) were male. The ASR-W of all cancers was 205.2 per 10 in males and 168.0 per 10 in females. The ASR-W was increased for both genders over the 11-year period. The greatest incidence cancer type in males was prostate cancer (ASR-W = 35.8) followed by lung (ASR-W = 33.9), colorectal (ASR-W= 19.0), urinary (ASR-W = 18.4), and stomach (ASR-W = 17.3) cancer. Among females, thyroid (ASR-W= 37.5) was the cancer type with the greatest incidence followed by breast (ASR-W = 27.7), colorectal (ASR-W = 11.7), lymphoma (ASR-W = 10.4), and stomach (ASR-W = 10.0) cancer.

Conclusions: The cancer incidence rate in males has remained higher than in females from 2004 to 2014, and an increased incidence of various cancers was observed in both genders. Raising public awareness about the risk factors for cancer and the development of appropriate and effective screening programs to provide more reliable data for cancer prevention and control programs in Sivas province is necessary.
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http://dx.doi.org/10.5001/omj.2019.24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425054PMC
March 2019

Level of mother-baby bonding and influencing factors during pregnancy and postpartum period.

Psychiatr Danub 2018 Dec;30(4):433-440

Cumhuriyet University Faculty of Health Sciences, Department of Midwifery, 58140, Sivas, Turkey,

Background: Bonding is the process of an emotional relationship between mothers and babies. Pregnancy and postpartum periods are most important of developing a mother-child bonding. Here we aimed to determine the level of mother-baby bonding and identify the influencing factors during pregnancy and the postpartum period and to examine the relationship between bonding level during pregnancy and the postpartum period.

Subjects And Methods: This cross-sectional descriptive study included twelve districts across a range of socioeconomic structures. Every district was selected by a simple random sampling method. Data were collected with Prenatal Attachment Inventory, Mother-to-Infant Bonding Scale, Center for Epidemiologic Studies' Depression Scale and Beck Anxiety Inventory. The study included two home visits. The first visit at gestational age ≥35 weeks and second visit on the seventh or eighth day of the postpartum period. The study was conducted with 227 pregnant women.

Results: We found that, 50.7% pregnant women had prenatal depression and 36.6% pregnant women had postpartum depression. We detected a negative association between depression level during pregnancy and the postpartum period with mother-baby bonding in the postpartum period (r=0.174, p=0.009; and r=0.221, p=0.001, respectively). A negative correlation was detected between anxiety level and mother-baby bonding level in the postpartum period (r=0.151, p=0.023). It was found that when the prenatal attachment level increases, the level of postpartum bonding is also increases (r=0.297, p=0.000).

Conclusions: Depression and anxiety levels were higher during pregnancy than the postpartum period. Depression level during pregnancy and postpartum period depression and anxiety level negatively affected mother-baby bonding in the postpartum period. We found that as prenatal attachment level increases, the level of postpartum bonding also increases.
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http://dx.doi.org/10.24869/psyd.2018.433DOI Listing
December 2018

Health-related Quality of Life and Associated Factors Among Undergraduate University Students.

Oman Med J 2017 Jul;32(4):329-334

Department of Public Health, Cumhuriyet University, Sivas, Turkey.

Objectives: The aims of this study were to explore factors associated with health-related quality of life (HRQOL) among students of Cumhuriyet University, Turkey.

Methods: This cross-sectional study involved 1751 undergraduate students. HRQOL was measured using the Turkish version of 36-Item Short Form Health Survey questionnaire. We looked at the effect of sociodemographic characteristics (e.g., gender, age, drinking, and smoking) on the individual HRQOL domains.

Results: Place of residency (odds ratio (OR) = 3.947 for role emotion dimension), smoking status (OR = -2.756 for role physical dimension), received amount of pocket money (OR = 2.463 for mental health dimension), and body mass index (OR = 1.463 for mental health dimension) were the factors significantly associated with the HRQOL.

Conclusions: Young students' HRQOL is affected by socioeconomic, demographic, and behavioral factors. To improve student's HRQOL, any health-promoting strategies should focus on modifiable risk factors and socioeconomic supports for students.
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http://dx.doi.org/10.5001/omj.2017.62DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5534238PMC
July 2017

Association of risk factors with smoking during pregnancy among women of childbearing age: an epidemiological field study in Turkey.

Authors:
Naim Nur

Sao Paulo Med J 2017 Mar-Apr;135(2):100-106. Epub 2017 Apr 3.

MD. Professor, Department of Public Health, School of Medicine, Cumhuriyet University, Sivas, Turkey.

Context And Objective:: Smoking during pregnancy is an important risk factor for maternal and infant health that is preventable. This study aimed to investigate the risk factors associated with smoking behavior during pregnancy.

Design And Setting:: A household-based probability sample survey of 1,510 women was conducted in the center of the city of Sivas, Turkey, between September 2013 and May 2014.

Methods:: The prevalence of smoking during pregnancy was estimated according to independent variables by means of regression analysis.

Results:: The prevalence of smoking during pregnancy was 16.5%. Logistic regression showed that being at a relatively young age (odds ratio, OR = 1.92, P = 0.025 for 15-24 age group; and OR = 2.45, P = 0.001 for 25-34 age group), having a low educational level (OR = 1.76, P = 0.032), being unmarried (OR = 1.48, P = 0.002) and living in an extended family (OR = 1.98, P = 0.009) were the factors associated with the risk of smoking during pregnancy.

Conclusions:: Systematic attention should be paid to socioeconomic inequalities, to support women towards quitting smoking before or at an early stage of their pregnancies. Younger women and particularly those in lower socioeconomic groups should be targeted. This will lead to better pregnancy status, especially among young women.
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http://dx.doi.org/10.1590/1516-3180.2016.021921102016DOI Listing
October 2017

[Analysis of intestinal ameobiasis in patients with diarrhea by adhesin antigen test and direct microscopy].

Turkiye Parazitol Derg 2014 ;38(3):155-8

Sivas Numune Hastanesi, Mikrobiyoloji Laboratuvarı, Sivas, Türkiye.

Objective: In this study, we aimed to research the frequency of intestinal amebiasis in patients who applied with diarrhea retrospectively for a year and compare direct microscopic analysis and ELISA adhesin antigen test for Entamoeba histolytica procedures.

Methods: The fecal matter sample of 259 patients with diarrhea who applied to the Sivas Numune Hospital Microbiology Laboratory between February 2012 and March 2013 were studied. Samples were evaluated with direct microscopic analysis and Entamoeba histolytica adhesin antigen test (E. histolytica II, Techlab, Blacksburg, USA).

Results: In the patients who applied to our laboratory with an amebiasis diagnosis, the mean age was detected as 40.12±19, and the positivity range of the Entamoeba histolytica adhesin antigen test was detected as 25.1% (n=65). In ELISA adhesin test-positive patients 24.6% (n=16) trophozoites, cyst, abundant leukocytes and erythrocytes were detected, and in 6 patients (3.1%), ELISA adhesin antigen test was negative. There was no difference between males and females (p>0.05), but between-season difference was detected (p<0.05).

Conclusion: Direct microscopic analysis may be inadequate in the differential diagnosis of E. histolytica/ and E. dispar and discrimination of Entamoeba cyst and/or trophozoites from other cellular elements (esp. leukocytes). Furthermore, we thought that the E. histolytica monoclonal ELISA adhesin test is useful for the differential diagnosis of pathogenic E. histolytica and nonpathogenic E. dispar.
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http://dx.doi.org/10.5152/tpd.2014.3478DOI Listing
November 2014

Association between domestic violence and miscarriage: a population-based cross-sectional study among women of childbearing ages, Sivas, Turkey.

Authors:
Naim Nur

Women Health 2014 ;54(5):425-38

a Department of Public Health, Faculty of Medicine , Cumhuriyet University , Sivas , Turkey.

Violence against women is a global issue, with ramifications for the reproductive health of women. The current study examined the relation of domestic violence (DV) to miscarriage among women who were victimized during their last pregnancy. The study was conducted in Sivas city center, in Turkey. Associations between self-reported DV and miscarriage were analyzed using multiple regression modeling. Physical and/or sexual DV during the last pregnancy was reported by 10.0% and 6.2% of women, respectively. Women who experienced physical violence were 2.5 times as likely (Odds Ratio (OR) = 2.47, 95% confidence interval [CI]: 1.37-4.84, p = .003) to have experienced a miscarriage than women who did not report physical violence. These findings suggest that victims who experience physical violence during the last pregnancy may be more likely to experience miscarriage. Preventing DV, especially physical violence, may, therefore, be beneficial for avoiding adverse pregnancy outcomes.
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http://dx.doi.org/10.1080/03630242.2014.897676DOI Listing
August 2014

Socioeconomic disparities among ever-married Turkish women who had unintended pregnancies and abortions in a middle Anatolian city.

Authors:
Naim Nur

Women Health 2012 ;52(7):716-29

Department of Public Health, Cumhuriyet Univerisity, Sivas, Turkey.

Researchers undertook a cross-sectional study to examine socioeconomic disparities, unintended pregnancies, and decisions about induced abortions among ever-married women in the urban area of Sivas, Turkey. The data for the present study were gathered from a randomly-selected, household-based probability sample of 1,264 ever-married Turkish women. Unintended pregnancies accounted for 46.2% of total pregnancies and, of these, 30% ended in induced abortion. The proportion of induced abortion among all pregnancies was 21.7%. Multiple logistic regression analyses with adjusted odds ratios (aOR) showed that being aged less than 35 years (aOR = 2.14, p < 0.001), having less than a high school education (aOR = 2.18, p < 0.001), being unemployed (aOR = 2.77, p < 0.001), having more than three children (aOR = 1.54, p = 0.006), and having lower income (aOR = 2.11, p < 0.001) were associated with unintended pregnancies. Among women with unintended pregnancy, having more than three children (aOR = 3.06, p < 0.001), lower income (aOR = 3.39, p < 0.001), and age less than 35 years (aOR = 2.57, p < 0.001) were associated with induced abortion. These findings suggest that lower socioeconomic status was associated with induced abortion among women facing an unintended pregnancy. Women who experience unintended pregnancies, who have lower socioeconomic status and education level, should be the target group for midwives and other relevant healthcare providers for educational efforts regarding family planning and contraception.
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http://dx.doi.org/10.1080/03630242.2012.721875DOI Listing
December 2012

Turkish school teachers' knowledge and attitudes toward HIV/AIDS.

Authors:
Naim Nur

Croat Med J 2012 Jun;53(3):271-7

Department of Public Health, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.

Aim: To assess Turkish school teachers' knowledge, attitudes, and misconceptions of HIV/AIDS.

Methods: This cross-sectional descriptive study was conducted in Sivas, Middle Anatolian province of Turkey, from January to May 2009. We selected and interviewed 898 teachers using a simple systematic sampling method.

Results: All respondents heard about AIDS. Most knew that it could be transmitted by infected blood (98.0%) and sexual contact (93.4%) and some (33.2%) thought that it could be transmitted by mosquitoes. Although the majority of them strongly agreed or agreed with the statement that "people with AIDS should be helped, supported and treated" (98.0%), about 40% and 70% of them, respectively, agreed or strongly agreed with the statement that infected people should be quarantined. Young teachers with a higher level of knowledge about HIV/AIDS had more positive attitudes.

Conclusion: This study provided basic information on school teachers' AIDS knowledge and attitudes and showed that various misconceptions of HIV transmission were a matter of concern. A considerable number of respondents with undesirable attitudes toward HIV/AIDS indicates the need for education of teachers on the subject.
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http://dx.doi.org/10.3325/cmj.2012.53.271DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3368290PMC
June 2012

The effect of intimate partner violence on mental health status among women of reproductive ages: a population-based study in a middle Anatolian city.

Authors:
Naim Nur

J Interpers Violence 2012 Nov 30;27(16):3236-51. Epub 2012 Apr 30.

Cumhuriyet University, Sivas, Turkey.

Violence against women has been recognized as both a major public health problem and a human rights violation worldwide. Research has documented the association between physical/sexual intimate partner violence (IPV) and mental health, measured by the 12-item General Health Questionnaire (GHQ-12) among women in reproductive age. This study underlines that different types of IPV is independently associated with mental health status. Results also show effects of IPV on mental health may not only be immediate but also be long term. These findings suggest that efforts to identify women with mental health problems should include screening for the types and history of IPV victimization.
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http://dx.doi.org/10.1177/0886260512441255DOI Listing
November 2012

A study of the prevalence of developmental anomalies of the external ear among preschool children in Sivas, Turkey.

Turk J Pediatr 2011 Sep-Oct;53(5):528-31

Department of Otolaryngology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.

The objective of the current study was to detect the prevalence of developmental anomalies of the external ear among children between aged 4-6 years old in Sivas, Turkey. This cross-sectional study was conducted among 1,096 preschool children. Among the 1,096 children examined, 8 had accessory auricle, and prevalence of the anomaly was calculated at 0.7%. Fifty-one prominent ear deformities (4.6%) were detected among the children. One limitation of the study is that the prevalence of developmental anomalies of the external ear may have been underestimated. In fact, such surveys should be conducted on large random or stratified samples of entire populations. Thus, the true prevalence could be slightly higher, and the apparent difference may not be a racial one.
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February 2012

Breast cancer knowledge and screening behaviors of the female teachers.

Authors:
Naim Nur

Women Health 2010 Jan;50(1):37-52

Department of Public Health, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.

Breast cancer is the most frequently occurring cancer in women. The objective of this study was to determine the level of knowledge about risk factors for breast cancer and screening behaviors among 468 female teachers who work in Sivas, Turkey. In this cross-sectional survey, a self-administered, structured questionnaire was used for data collection. Up to one-half (52.4%) of the teachers thought that they had enough knowledge about breast cancer. The sources of that information were television (59.0%), newspapers (48.9%), and health professionals (24.1%); 58.5% of the teachers had a sufficient knowledge level about breast cancer risk factors. The most frequently reported risk factor was family history of breast cancer (94.9%), followed by getting older, high fat diet and having a first child at a late age (68.6%, 51.7%, and 45.1%, respectively). No significant differences were found in knowledge by age groups, having breast-related complaints, teaching experience, or marital status. Among the teachers, 43.9% had performed breast self-examination; yet only 10.5% of them performed it monthly. Only 22.3% of the teachers reported having at least one clinical breast-examination. Among the 136 women over the age of forty years, only 37.5% had had at least one mammogram. A significant association was noted between level of knowledge about breast cancer risk factors and use of breast self-examination. Also, being married and having breast-related complaints were significantly related to practicing clinical breast-examination and mammography. This study revealed a relatively low awareness about the knowledge and practice of screening methods among teachers. The relatively low rates of breast self-examination, clinical breast-examination, and mammography practiced by this group of teachers are of concern and suggest that increased awareness of these methods, their value, and how they should be conducted is needed.
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http://dx.doi.org/10.1080/03630241003601087DOI Listing
January 2010

Knowledge and behaviours related to herbal remedies: a cross-sectional epidemiological study in adults in Middle Anatolia, Turkey.

Authors:
Naim Nur

Health Soc Care Community 2010 Jul 15;18(4):389-95. Epub 2010 Mar 15.

Department of Public Health, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.

The use of herbal remedies is common in Turkey. This study aimed to define the patterns of herbal remedy use among subjects aged 18 or above and to describe factors associated with use of herbal remedies. A cross-sectional study was conducted with a multistage sampling method between September 2007 and April 2008. A total of 3876 adults participated (98.1% response rate), and 1518 (39.2%) admitted using herbal remedies (95% CI 37.6-40.7%). Univariate analyses showed that compared with non-users, herbal users were mostly female, were more highly educated and were more likely to live in smaller households of one to four people. Logistic regression showed that being aged 18-27 (OR = 1.23, P = 0.028), being female (OR = 2.22, P < 0.001), being educated in a secondary school (OR = 1.47, P < 0.001) or high school (OR = 2.77, P < 0.001), perceiving their health status as 'good' (OR = 2.61, P < 0.001) and having health-related problems (OR = 2.80, P < 0.001) were the factors associated with the use of herbal remedies. The most commonly used herbs were lime, mint, rosehip and lemon. The reasons for using herbal remedies included that they are natural products (79.8% of the 1518 users), for health enhancement (58.9%) and to overcome health problems (32.2%). The decision to use herbal remedies was mainly based on recommendations from the mass media (45.1%). Only 29.1% of users obtained information from their physicians or health providers, and only 37.9% informed their doctors. Nearly three in five people in this study reported using a herbal remedy to overcome health problems or for health enhancement. Herbal remedies are likely to be used by the young people, females, those with higher education, those with good or excellent perceived health status and those with chronic illness, and it seems essential to offer informational programmes for them. The lack of communication on herbal remedies between patient and physician needs to be addressed.
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http://dx.doi.org/10.1111/j.1365-2524.2010.00911.xDOI Listing
July 2010

Leptin and bone mineral density in haemodialysis patients.

Ann Acad Med Singap 2009 Apr;38(4):374-4

Department of Internal Medicine, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.

Introduction: There are very few data about relations between leptin and bone mineral density (BMD) in regular haemodialysed patients. We aimed to examine the relationship of serum leptin levels with BMD values in dialysed patients. We also assessed whether leptin is a significant predictor of BMD in haemodialysed patients.

Materials And Methods: Leptin levels were studied using commercially available kits and BMD values were calculated using dual energy X-ray absorptiometry (DEXA) at femoral neck and distal radius in 74 (30 men and 44 women ) haemodialysis patients.

Results: BMD values at the femoral neck and distal radius did not differ significantly between the 2 genders. BMD at the distal radius correlated positively with bone alkaline phosphatase (BAP) (r = 0.503, P = 0.005) in male patients and correlated positively with phosphorus (r = 0.343, P = 0.02) in female patients. The time ondialysis treatment was longer in men (59 +/- 48 vs 44 +/- 41) but the difference was not statistically significant. Leptin levels were negatively correlated with BMD at the distal radius (r = -0.250 and P = 0.03) in all patients. Serum leptin levels were also correlated with body mass index (BMI) in all the patients (r = 0.749 and P = 0.001) and in both genders (r = 0.653 and P = 0.001 in women, r = 0.704 and P = 0.001 in men). In multivariate regression analysis, it was found that leptin level was not an independent determinant of BMD at all skeleton sites measured.

Conclusions: There was significant difference between the 2 genders with reference to leptin levels, BMI, phosphorus and creatinine. Serum leptin levels are not significant predictors of BMD in the current study.
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April 2009

The risk factors for and prevalence of coronary artery disease in heavy vehicle drivers.

Saudi Med J 2009 Feb;30(2):272-8

Department of Public Health, Cumhuriyet University, Sivas, Turkey.

Objective: To investigate the frequencies of risk factors and the prevalence of coronary heart disease (CAD) in heavy vehicle drivers.

Methods: This cross-sectional type study was conducted between November 2004 and September 2006 in heavy vehicle male drivers registered with the Sivas Professional Drivers Association, Sivas, Turkey. From 400 individuals, 200 heavy vehicle male drivers, and 200 control subjects, 90% were reached for the sample. A questionnaire including sociodemographic specifications, body mass index (BMI), and risk factors for CHD was performed and some blood and physiologic parameters such as lipid profiles, fasting glucose level, resting ECG, were checked in all individuals; if required exercise ECG and angiography was performed.

Results: The drivers' weight, body fat mass, triglycerides, very low-density lipoprotein, and BMI means were higher than the control group at a statistically significant level, and their mean high-density lipoprotein level, which is a protective factor for CAD, was lower than the control group at a statistically significant level. In the drivers' group, 9 of the 109 exercise ECGs (8.3%), and in the control group 3 of 61 (4.9%) were evaluated as abnormal. In 5% of the drivers, the exercise test was evaluated as positive and this prevalence was 1.7% in the control group (p=0.081). A total of 3.3% of the participants had a positive exercise ECG.

Conclusion: Periodic health check-ups for heavy vehicle drivers would allow for the diagnosis of heart disease at an early stage and the initiation of necessary treatment. Health education for this group could also have a part in the decrease and elimination of some risk factors for CAD.
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February 2009

Prevalence and associated factors of day wetting and combined day and night wetting.

Urol Int 2008 16;81(1):54-9. Epub 2008 Jul 16.

Family Medicine, Medical School, Sivas, Turkey.

Background: This study was conducted to determine the prevalence of diurnal enuresis (DE) and its association with background variables among children aged 5-15 years living in Sivas and Kahramanmaraş, Turkey.

Methods: The parents of 1,760 children voluntarily completed a questionnaire consisting of 42 items under supervision of a researcher.

Results: Overall, the reported prevalence of DE was 4.2%, with a tendency to decrease with increasing age and with no difference between genders. Smoking during pregnancy, delayed initiation and dealing with the child by punishment in toilet training, urination frequency, urgency, soiling, arousal difficulty, urinary infection history, lower school performance, poor social adaptation, wetting history in the family, were all significantly prevalent among diurnal enuretics (p < 0.05). Socioeconomic or sociodemographic factors based on families and stressful life events were not associated with DE (p > 0.05). 63.9% of all parents reported some level of concern about the wetting problem and 51.7% of the diurnal enuretics had previously visited a physician.

Conclusions: The prevalence of DE in our sample is not too different from the prevalence rates reported previously from Turkey and other countries. This type of enuresis seems to be more associated with an organic neurological or urological disorder than is nocturnal enuresis.
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http://dx.doi.org/10.1159/000137641DOI Listing
December 2008

Prevalence of hypertension among high school students in a middle Anatolian province of Turkey.

J Health Popul Nutr 2008 Mar;26(1):88-94

Department of Public Health, Faculty of Medicine, Cumhuriyet University, 58140-Sivas, Turkey.

Hypertension may lead to irreversible damages in vital organs, such as heart, brain, and kidney, and may cause death in children if treatments are not given despite early diagnosis. This cross-sectional epidemiological study was conducted during 1 January-31 March 2004 to investigate the prevalence of hypertension among high school students. The study cohort included 1,041 students of six high schools, who were selected from among 14,789 students of 26 high schools in Sivas province of Turkey, using the cluster-sampling method. A questionnaire was used for collecting information from students on age, gender, smoking, and whether they or their families have any diseases. Blood pressure, height, and weight of the participitants were determined by the research group. Students whose repeated systolic or diastolic blood pressures were higher than the 95th percentile were considered to be hypertensive patients. Hypertension was prevalent among 4.4% (n=45) of the students. There was a significant correlation between prevalence of hypertension and body mass index. No significant correlation was found between prevalence of hypertension and other variables, such as smoking, age, gender, and family history of diabetes. The results suggest that hypertension is an important public-health problem among high school students. The results also showed that the body mass index was an important parameter in hypertension in such a study group. Researchers should consider overweight a causative risk factor for development of hypertension in early-onset groups.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740676PMC
March 2008

Validity of the CA125 level in the differential diagnosis of pulmonary tuberculosis.

Jpn J Infect Dis 2008 Jan;61(1):68-9

Department of Chest Diseases, Faculty of Medicine, Cumhuriyet Univerity, Sivas, Turkey.

The aim of the current study was to determine the possible crucial role of cancer antigen 125 (CA125) in the diagnosis of pulmonary tuberculosis (PTB). The CA125 levels of study and control groups were statistically compared. In a total of 146 patients that were included in the current study, 30 had active PTB, 37 inactive PTB, 28 community-acquired pneumonia (CAP), 25 pleural or pulmonary malignancies, and 13 patients exacerbation of chronic obstructive pulmonary disease. The mean CA125 levels in PTB, inactive PTB, CAP, and pleural-pulmonary malignancies were 118.46 +/- 248.41, 40.80 +/- 50.95, 47.76 +/- 60.76, and 57.77 +/- 65.59, respectively. For active-inactive discrimination of PTB, with a cut-off level of >35 U/ml, the sensitivity, specificity, positive predictive value, and negative predictive value of CA125 were 63, 59, 56, and 67%, respectively. Increased CA125 levels were detected in active PTB in the current results. The current results also show that high level CA125 should be reconsidered in the prediagnosis and/or discrimination of active and inactive PTB patients.
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January 2008

Emergency room cases of mushroom poisoning.

Saudi Med J 2006 Jun;27(6):858-61

Department of Internal Medicine, Medical School, Cumhuriyet University, Sivas 58140, Turkey.

Objective: To describe the pattern of mushroom poisoning in adults.

Methods: We investigated patients presenting at the Emergency Room, Medical School Hospital, Cumhuriyet University, Turkey between 1999 and 2003 with complaints of mushroom poisoning. They were kept under observation in the emergency unit and Anesthesia Department intensive care unit. We evaluated the demographical features of the patients, laboratory data, vital signs, and applied treatment and results.

Results: Seventy-eight patients aged between 19-72 (40.27 +/- 16.09) were studied, 52 were females (67%), and 26 were males (33%). It was established that 90% (70) of the patients had picked wild mushrooms, and 67.9% (53) had done so in springtime. Methods of cooking were as follows: 30 patients (38.4%) grilled the mushrooms, 28 patients (35.8%) stir fried, and 20 patients (25.6%) consumed mushrooms uncooked. Onset of symptoms was mostly (43.5%) within the first hour of consumption. The most common (42.3%) symptoms were gastrointestinal complaints. Upon examining laboratory results, 17.9% revealed variations in hematological parameters, impairment in renal functions in 6 patients (7.6%), hematuria in 10 patients (12.8%) and 15.3% had primarily elevated liver enzymes. Seventy-four patients (97%) completely recovered and were discharged. However, 2 patients (2.8%) who consumed raw mushrooms died due to acute hepatic failure. There was a 20-year-old patient at week 31 of her first pregnancy who had consumed uncooked wild mushrooms. She developed gastrointestinal symptoms and mild loss of consciousness within the first half hour. She received quadruple therapy and completely recovered.

Conclusion: The results of the study indicated that the public, as well as the cultivators, were rather unconcerned and uneducated regarding this issue. Efforts aimed at overcoming this problem will decrease the number of mushroom poisoning cases, will help to save on treatment costs, and more importantly, reduce patient mortality.
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June 2006

Relationship between serum leptin levels and body composition and markers of malnutrition in nondiabetic patients on peritoneal dialysis or hemodialysis.

J Chin Med Assoc 2005 Dec;68(12):566-70

Department of Internal Medicine, Medical School, Cumhuriyet University, Sivas, Turkey.

Background: Leptin is a protein hormone secreted by adipocytes, regulating body fat and food intake. It has been reported that serum leptin levels are high in patients with chronic renal failure, and this fact has been associated with malnutrition and body composition changes in patients on hemodialysis. This present study investigated the relationship between plasma leptin concentrations and body composition and markers of malnutrition in nondiabetic patients diagnosed with end-stage chronic renal failure, treated with continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis (HD).

Methods: A total of 152 HD and 32 CAPD patients were enrolled into the study. The body compositions of the patients were established by utilizing a Body Composition Analyzer. Triceps skinfold thickness (TSFT) was measured by using a Harpenden Skinfold Caliper. Serum leptin level was detected by radioimmunoassay in ng/mL through employing a DPC Gambyt-CR gamma counter. Standard laboratory methods were used for measuring the remaining parameters (total protein, albumin, blood urea nitrogen, creatinine, hemoglobin, hematocrit, high-sensitivity C-reactive protein [hsCRP]).

Results: No significant difference was observed between the HD and CAPD groups regarding leptin levels. Leptin levels of female patients in both groups were markedly higher when compared with those of men (p = 0.001). Plasma leptin levels in total, as well as for both male and female HD and CAPD patients, significantly correlated positively with age, percent fat, fat mass, body mass index and TSFT (p = 0.001). Serum leptin levels were not found to be correlated with length of time on dialysis, lean body mass, total body water, hsCRP, total protein and albumin levels (p > 0.05).

Conclusion: The data obtained in this study indicated that serum leptin levels could be instrumental markers in establishing body fat ratio, as well as in determining metabolic and nutritional factors in patients with chronic renal failure.
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http://dx.doi.org/10.1016/s1726-4901(09)70095-4DOI Listing
December 2005

Doping and performance enhancing drug use in athletes living in sivas, mid-anatolia: a brief report.

J Sports Sci Med 2005 Sep 1;4(3):248-52. Epub 2005 Sep 1.

Department of Orthopaedic Surgery, Faculty of Medicine, Cumhuriyet University , Sivas, Turkey.

The aim of this study was to determine the rate of doping and performance enhancing drug use in athletes in Sivas, Turkey, and to analyze the main reasons for the use. This was a cross-sectional study based on a self-report questionnaire. The subjects filled the questionnaires under the supervision of the investigators during interviews. This questionnaire included 24 items describing the population in terms of demographics, sport practice, doping in sport and substance use. Moreover, we assessed the frequency of doping drug use. The number of respondents was 883, of which 433 athletes and 450 healthy non-athletes (control group). The mean age of the total volunteers was 21.8 ± 3.7 yrs. The male and female ratios were 78.2% and 21.8% respectively. Doping and performance enhancing drug usage rate was 8.0% (71cases in 883 subjects). Doping drug use among the athletes was significantly (p < 0.05) higher (14.5%) compared with the non-athletes (1.8%). The agents used were anabolic steroids in 60.5%, l-carnitene in 12.7%, erythropoietin in 5.4%, Na-bicarbonate in 11.3% and creatinine in 14.1% of 71 cases. The reasons for doping use were to have a better body condition in 34 cases (47.9%) and to solve weight (gaining or loosing) problems in 8 (11.3%) cases. Since the potential side effects of doping drugs are not satisfactorily familiar to the most users, the education of athletes on the matter must be a top priority. Key PointsDoping and performance enhancing drug use was 71 (8.0%) in 883 subjects, and it was significantly higher (14.5%) in the athletes compared with the non-athletes (1.8%) in Sivas, Turkey.The rate of athletes who experienced such drugs at least once in their life was 29.0%.The 52.4% of doping and performance enhancing drug users accepted that they were unaware of the drugs full and/or potential side effects.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3887327PMC
September 2005

The prevalence of diabetes and impaired glucose tolerance in Sivas, Central Anatolia, Turkey.

Diabetes Care 2005 Apr;28(4):795-8

Department of Public Health, Cumhuriyet University, Tip Fakültesi, Halk Sağliği AD, 58140 Sivas, Turkey.

Objective: The aim of this study was to determine type 2 diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) prevalence in Sivas, Turkey.

Research Design And Methods: This cross-sectional study was conducted in the city center of Sivas. The study population of 771 subjects was selected by the cluster sampling method from 115,998 individuals aged > or =30 years. Participants with fasting venous plasma glucose concentrations <100 mg/dl were classified as "normal." Diabetes was diagnosed in participants if they had fasting blood glucose levels > or =126 mg/dl. An oral glucose tolerance test (OGTT) was performed in subjects with fasting blood glucose levels > or =100 mg/dl and <126 mg/dl.

Results: According to the fasting blood glucose levels of the 771 subjects, 44 (5.7%) had diabetes. OGTTs were performed in 80 (10.4%) subjects. According to OGTT results, there were 5 subjects with diabetes, 20 subjects with IGT (2.6%), and 55 subjects with IFG (7.1%). The combined prevalence of IFG and IGT was 9.7%. After OGTT, the total number of diabetic subjects was determined to be 49 (6.4%). Twenty-four (3.1%) of the subjects had a previous diagnosis of diabetes. Multivariate analyses showed that age, sex, hypertension, cigarette smoking, obesity, and family history of diabetes were risk factors for type 2 diabetes (P < 0.05).

Conclusions: Diabetes incidence increases with changes in dietary habits and lifestyle. Education is particularly important for public health, as the community may then have required knowledge about the disease and its risk factors.
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http://dx.doi.org/10.2337/diacare.28.4.795DOI Listing
April 2005

The prevalence of sleep related disorders in Sivas, Turkey.

Tuberk Toraks 2005 ;53(1):20-7

Department of Public Health, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.

The prevalence of sleep-related disorders (SRD) in adults in Turkey is unknown. The main objective of our study was to assess the prevalence of SRD in Sivas, Turkey. Adults living in Sivas, a city of Turkey from the central region of Anatolia at 20-107 years of age, in both genders, of the 5339 persons, who attended the survey 2638 (49.4%) were male and 2701 (50.6%) were female. The prevalence of insomnia, habitual snoring, obstructive sleep apnea (OSA) and day time hyper somnolence was 40.3%, 37.0%, 6.4%, 24.0% respectively. The prevalence rates of narcolepsy and nocturnal myoclonus was 30.6%, 40.1% respectively. There was a statistical significance between the persons of above 60 years old and another age groups (p< 0.05). But we did not find any significant difference between smokers and non-smokers, also between males and females about SRD prevalence (p> 0.05). However, sleep apnea prevalence was about 9 times higher in the persons suffering from hypertension than without hypertension. Also sleep apnea prevalence was 12 times higher in the persons suffering from overweight. This study has shown that sleep-disordered breathing (SDB) prevalence in Turkey is as high as in other countries and may be more common.
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June 2005

Seroprevalence of Brucella in an elderly population in mid-Anatolia, Turkey.

J Health Popul Nutr 2003 Jun;21(2):158-61

Department of Public Health, Faculty of Medicine, Cumhuriyet University, 58140-Sivas, Turkey.

Brucellosis is a widespread infectious disease in the mid-Anatolia regions of Turkey. This study investigated the prevalence of Brucella infection in elderly people of this region. In total, 750 elderly subjects were chosen by a simple random-sampling method. Blood samples were evaluated by the Brucella Wright agglutination test. Brucella seropositivity was detected in 24 (3.2%) of the 750 subjects. Although there was no statistical correlation between Brucella seropositivity and sex or educational level (p > 0.05), seropositivity was statistically significant with subjects exposed to risk factors (p < 0.001). It is concluded that Brucella infection is still an important public-health problem in the cities of mid-Anatolia.
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June 2003
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