Non-ketotic hyperglycaemia presenting as epilepsia partialis continua

AbstractEpilepsia partialis continua (EPC) is a rare epileptic syndrome, observed in various cortical lesions and also in metabolic disorders. We report the case of a 57-year-old patient with EPC as the first manifestation of hyperosmolar non-ketotic hyperglycaemia (NKH) of diabetes mellitus. Computed tomography (CT) and magnetic resonance imaging (MRI) were normal. Initial laboratory data revealing serum glucose 1540mg/dl, and serum osmolality 391mOsm/l confirmed the diagnosis. Electroencephalography (EEG) showed ictal discharges in the ipsilateral hemisphere during focal seizures. Seizures are resistant to anticonvulsant treatment and respond best to insulin and rehydration. Focal motor seizures or EPC are commonly a symptom of NKH in the elderly patients. We recommend that in such cases a metabolic disorder such as diabetes mellitus be ruled out

Emotional Connection, Cognitive Engagement and Post-Experience Behaviours in Religious Site Visits: A Search on Mawlana Museum in Konya, Turkey

This study looks at different motives that tourists experience for their vacations and visit different holiday destinations. Tourist experiences are more than physical travels to places. Therefore, major tourist destinations associate themselves with sacred people e.g. St. Philipius or Virgin Mary, sometimes a Sufi such as Mawlana or Khoja Ahmed Yasawi. These associations with the sacred people create emotional connections and cognitive engagements with these destinations. These emotional connections and cognitive engagements in turn lead to destination loyalty. Within this context, this study specifically aims at (1) exploring the effects of religious sites on emotional connections and cognitive engagements, (2) investigating how emotional connections affect tourists’ post experience behaviours, and (3) finding how cognitive engagements affect tourists’ post experience behaviours. The survey was conducted on the visitors to the Mawlana museum in Konya, Turkey between the months of December 2016 and April 2017. The findings show that the emotional connection factors affect the recommended intentions in high rates and the cognitive engagement factors create the re-visit intentions in high rates

ACUTE EFFECT OF CIRCUIT AEROBIC AND TRADITIONAL AEROBIC TRAINING ON HAMSTRING FLEXIBILITY IN SEDENTARY WOMEN

The aim of this study is investigation of acute effect of circuit aerobic exercise and traditional aerobic exercise on hamstring muscle flexibility in sedentary women. Forty four sedentary women voluntarily participated in this study as subject. Subjects divided two groups as circuit aerobic training group (n=24), and traditional aerobic training group (n=20). For hamstring flexibility, modified sit and reach test was used. The test was applied three times as: before warm-up (T1), after immediately warm-up (T2), and after immediately exercise (T3). For warm-up intervention, 15 min mild running and static stretching were performed. Traditional aerobic exercise intervention consisted of 30 min moderate interval treadmill running. Circuit aerobic exercise intervention consisted of 30 min, 3x4 station (bench-step, jumping rope, cycling, treadmill running), and all station maintained to 3 min load with 2 min rest. Both training intervention performed at 65-75% HRmax that controlled with chest band. For statistical analysis, 2x3 mixed factor ANOVA and Bonferroni correction were used. Hamstring flexibility determined in the traditional aerobic exercise group as T1 by 13.90±4.22 cm, T2 by 19.90±4.55 cm, T3 by 29.45±6.54 cm; in the circuit aerobic exercise group as T1 by 21.20±6.89 cm, T2 by 24.08±6.67 cm, T3 by 25.62±6.67 cm. Differences between the three measurements of both groups were found statistically significant (p < 0.05). There were significant differences between T3 and T1-T2; and between T2 and T1 in both groups (p < 0.05). Differences in traditional aerobic exercise group were found more significant than circuit aerobic exercise group (p < 0.05). In summary, it could be said that hamstring flexibility increased after aerobic exercise, and at this point, traditional aerobic exercise has one step ahead of circuit aerobic exercise.  Article visualizations

Obez bireylerde vücut ağırlık kontrolünün antropometrik ölçümler ve bazı biyokimyasal parametreler üzerine etkisi

Çalışma, 01 Aralık 2014-01 Mart 2015 tarihleri arasında İstanbul ili Pendik ilçesinde özel bir hastanenin diyet polikliniğine zayıflama amacıyla 1 ay içerisinde başvuran ve herhangi bir sağlık sorunu olmayan, yaş aralığı 20-45 yıl arası olan, obez 50 gönüllü kadın üzerinde yapılmıştır. Çalışmada bireylere demografik özelliklerini ve beslenme bilgilerini almak için bir defa anket ve üç defa üç günlük besin tüketim kaydı formu uygulanmıştır. Çalışmaya katılan bireylerin yaş ortalaması 33.10±6.86’dır. Çalışmaya 16 (%32) preobez, 34 (%68) obez birey katılmıştır. Çalışmaya dahil olan bireylerin 2 aylık takipte kaybettikleri ağırlık, BKİ, bel çevresi, kalça çevresi, yağ yüzdesi ve yağ ağırlık sırasıyla 5.71±2.19 kg, 2.26±0.88 kg/m2, 5,46±3.01 cm, 4,62±2.37 cm, %1.84±1.18, 3.59±1.66 kg’ dır. Araştırmaya katılan bireyler çalışma süresi boyunca en az 4.4 kg, en fazla 6.5 kg ağırlık kaybetmişlerdir. Çalışmaya katılan bireylerin çalışma sonunda uygulanan diyete bağlı olarak kan biyokimyasal parametrelerindeki değişikliklere bakıldığında açlık kan şekerinde ortalama 2.02±7.86mg/dL, hemoglobin değerinde ortalama 0.08±0.56 mg/dL, total kolesterol değerinde ortalama 10.96±16.47 mg/dL, LDL kolesterol değerinde ortalama 7.91±15.46 mg/dL, HDL kolesterol değerinde ortalama 1.86±6.57mg/dL düşüş gözlenmektedir. Bireylerin üç günlük besin tüketim öykülerinden elde edilen enerji, karbonhidrat, protein ve yağ tüketimlerinin birinci, ikinci ve üçüncü tüketim kayıtları arasında istatistiksel olarak anlamlı bir fark gözlenmemiştir (p>0.05). Vitamin ve mineral tüketimleri incelendiğinde birinci, ikinci ve üçüncü tüketimleri arasında istatistiksel olarak anlamlı bir fark gözlenmemiş fakat DRI değerleri ile karşılaştırıldığında A vitamini, B2 vitamini, B6 vitamini, C vitamini, fosfor ve çinko mineralleri tüketimleri istatistiksel olarak anlamlı derecede yüksek, B1 vitamini, potasyum ve demir mineralleri anlamlı olarak düşük gözlenmiştir (p<0.05). Vücut ağırlık kaybı ile karbonhidrat ilk ve son tüketimleri farkı(r=0,324; p<0,05) arasında pozitif doğrusal ve istatistiksel olarak anlamlı bir ilişki vardır. Bireylerin posa ilk ve son tüketimi farkı ile HDL kolesterol ilk ve son değeri farkı arasında negatif doğrusal ve istatistiksel olarak anlamlı bir ilişki vardır (r=-0,320; p<0,05). Bireylerin diyete uyum durumları ile ilk ve son biyokimyasal parametreleri farkı karşılaştırıldığında total kolesterol farkı ve LDL kolesterol farkı istatistiksel açıdan anlamlı farklılık göstermektedir (p<0,05). Çalışma sonunda preobezlerin %68.8’ i vücut ağırlıklarının %5-10’ unu, %31.3’ ü vücut ağırlıklarının %5’ i ve altında, %25.0’ ı %10 ve üstünde vücut ağırlığı kaybetmiş; obez bireylerin ise %76.5’ i vücut ağırlığının %5-10’ u, %23.5’ i %5’ i ve altında, %29.4’ ü %10 ve üstünde vücut ağırlığı kaybetmişlerdir. Bireylerin total kolesterol azalması ortalaması vücut ağırlığının %5-10 kaybeden obezlerde en yüksektir (15.3±16.16 mg/dL), preobezlerde ise %5’ i ve altında vücut ağırlığı kaybeden bireylerdedir (12±0.0 mg/dL’ dir. Bu sonuçlara göre %5-10 vücut ağırlık kaybının preobez ve obez bireylerde kan lipidlerini azaltabileceği söylenebilir. This study was conducted to determine the effects of the body including mass control on anthropometric measurements and some blood parameters on obese individuals. This study was conducted on 50 healthy preobese and obese women aged between 20-45 who consulted the Diet Policlinic of a private hospital in Pendik, Istanbul for the purpose of losing weight between December 2014 and March 2015. An individual demographic characteristics and nutritional information once the threeday food consumption survey and registration form three times to get implemented. The study included 15 (32%) preobese, 34 (68%) obese women whose ages mean 33.10±6.86 years. After a 2-month follow up, the average weight loss, BMI, waist circumference mean, hip circumference mean, fat percentage mean and fat mass average were 5.71±2.19 kg, 2.26±0.88 kg/m2, 5.46±3.01 cm, 4.62±2.37 cm, 184±1.18%, 3.59±1.66 kg respectively. The volunteers particiating in the study lost a minimum of 4.4 kg and maximum of 6.5 kg weight during the study period (2 months). Upon observing the changes in blood biochemical parameters as a result of the diet applied on the participants in the study, an average reduction of 2,02±7.86 mg/dL in starvation blood sugar, 0.08±0.56 mg/dL in hemoglobin value, 10.96±16.47 mg/dL in total cholesterol value, 7.91±15.46 mg/dL in LDL Cholesterol, and 1.86±6.57 mg/dL in HDL Cholesterol was noted. Individuals obtained from a three-day-dietary record energy, carbohydrate, protein and fat consumption between first, second and third consumption records was not observed a statistically significant difference (p>0.05). When analyzed vitamin and mineral consumption in te first, second, and a statistically significant difference was not observed between the third consumption. But compared with DRI values range from vitamin A, vitamin B2, vitamin B6, vitamin C, phosphorus and zinc minerals consumption was significantly higher, vitamin B1, potassium and iron minerals was signicantly lower (p<0.05). There is a positively linear and statistically significant relationship between weight loss and consumption of carbohydrate (r=0.324; p<0.05). There is a statistically significant and negatively linear relationship between HDL cholesterol biochemical parameters and fiber consumption (r=-0.320; p<0.05). Total cholesterol diffference and LDL cholesterol difference values show statistically significant differences (p<0.05) when evaluated according to the compliance of participants to the diet. The difference between the initial and final values of total cholesterol, LDL cholesterol levels and hemoglobin is higher in participants indicating compliance with the diet. At the end of the study preobese 68.8% of the lost weight 5-10% of body weight, 31.3% of the lost weight below 5% of body weight, 25% of the lost weight over 10% of body weight; obese 76.5% of the lost weight 5-10% of body weigt, 23.5% of the lost weight below 5% of body weight, 29.4% of the lost weight over 10% of body weight. According to these results; 5- 10% or more than 10% body weight loss may decrease the blood biochemical parameters in preobese and obese subjects

Corneal stromal depth of the demarcation line in accelerated corneal cross-linking' with different concentrations of riboflavin solutions

PurposeThe aim of this study is to compare the effect of different riboflavin solutions (hypotonic and isotonic) used during accelerated corneal cross-linking (CXL) on the mean depth of the demarcation line (DDL) formed in corneal stroma.MethodsThis prospective, cross-sectional study included 38 eyes of 26 patients. All patients underwent accelerated CXL due to progressive keratoconus. When the corneal epithelium was removed, 17 eyes of 12 patients with corneal thickness 400 mu m as Group 2. Hypotonic riboflavin was applied to Group 1 patients, and isotonic riboflavin to Group 2 patients. Anterior segment optical coherence tomography was performed on all patients by two independent observers at the end of the first and third months.ResultGroup 1 included 5 male and 7 female patients with an average age of 25.18.0years, whereas Group 2 included 7 male and 7 female patients with an average age of 31.8 +/- 10.12years. At the end of the first month, the mean DDL in Group 1 and Group 2 was 180.32 +/- 10.26 and 287.21 +/- 15.01 mu m, respectively. This difference was statistically significant (p<0.05).Conclusion Application of different riboflavin solutions was observed to have an effect on measured corneal thickness after saturation and the depth of the demarcation line. The use of hypotonic riboflavin results in swelling of the cornea and more superficial localization of the stromal demarcation line after CXL

DEMAND ANALYSIS AND DEMAND FORECASTING: APPLICATION FOR A PRIVATE HOSPITAL

Çalışmanın amacı, Ankara'daki bir özel hastanede Ekim 2009-Ekim 2010 tarihleriarasında sağlık hizmetlerinden faydalanan hastaların özelliklerini belirlemek ve buna bağlıolarak, gelecekteki klinik ve poliklinik hastalarının profilini ortaya çıkarmak ve böylecehasta hizmetlerinin planlamasını yapmaları için sağlık yöneticilerine yardımcı olmaktır.Çalışmanın örneklemini 270 hasta oluşturmaktadır. Veriler, hastanenin halkla ilişkilerbiriminin yapmış olduğu hasta memnuniyet anketlerinden ve elektronik hasta kayıtlarındanyararlanarak toplanmıştır. Verilerin istatistiksel analizinde ki-kare testi uygulanmıştır.Çalışma sonunda, hastaların eğitim durumları ile bir sonraki sağlık sorunlarında hastaneyitercih etme durumları arasındaki ilişkinin anlamlılık değeri 0,059 olarak bulunmuş veilişkinin anlamlı olmadığı sonucuna ulaşılmıştır. Hastaların mesleklerine ilişkin sonuçlarincelendiğinde ise ilişkinin anlamlılık değeri 0,01 olarak belirlenmiş ve ilişkinin anlamlıolduğu sonucuna varılmıştır. The purpose of this study, at a private hospital in Ankara between October 2009-October 2010 to determine particulars of outpatients and inpatients that using health careservice and therefore profile of outpatients and inpatients build up in the future and thusaid to health care management who make planning of patient services. The populationconsists of 270 patients. The data collected from patient satisfaction surveys and electronicpatients records are used by public relations department of hospital. Chi square test isimplemented in statical analysis of the data. At the end of study, significant level ofcorrelation between educational background of patients with patients' electing to hospitalin next health problems are found 0,059 and reached the conclusion that correlation is notsignificant. In addition to when are analyzed results about profession of patients,significant level of correlation are found 0,01 and concluded that correlation is significant

Cure for Fear During the COVID-19 Pandemic Process: Self-Compassion

COVID-19 not only creates vital physiological effects on human health, but also creates serious mental effects. Increasing death numbers, emerging new variants and uncertainties about the pandemic process cause people to fear. Increasing the individual protective factors during this period will prevent the emergence of fear even in a negative process such as a pandemic. Accordingly, one of the potential concepts that can help protect individuals from the negative effects of COVID-19 is thought to be self-compassion. The self-compassion that an individual will show to himself while going through these difficult times can be the salve for the fear of COVID-19 and the mental problems it causes during this period. In this direction; In this review, it is aimed to reveal the relationship between the fear of COVID-19 and the concepts of self-compassion. PubMed, PubMed Central (PMC), Google Scholar databases were searched and six studies were found that examined the fear of COVID-19 and the concept of self-compassion together. When studies are examined, it is reported that individuals with high self-compassion levels experience less fear of COVID-19 and reduce mental problems such as depression and anxiety disorder due to fear of COVID-19. The results of this review will raise awareness of mental health professionals that intervention studies focusing on self-compassion should be applied both to patients in clinical settings and to society in terms of preventive mental health

Investigation and evaluation of the impacts of the proposals related with the Golden Horn Cultural Valley Project on Galata area

Bu &ccedil;alışma; &ldquo;K&uuml;lt&uuml;r Vadisi&rdquo; olarak tanımlanmış olan Hali&ccedil; ve &ccedil;evresinin temizlenerek, tarihi ve doğal değerleri ile birlikte yeniden k&uuml;lt&uuml;rel ve sosyal yaşama kazandırılması i&ccedil;in &ouml;nerilen yeni projelerin Galata b&ouml;lgesi &uuml;zerine etkileri; yaya ve mek&acirc;n arasındaki ilişkiyi y&uuml;r&uuml;nebilirlik endekslerine dayanarak inceleyen bir araştırmanın bulgularından yola &ccedil;ıkarak araştırılmaktadır. B&ouml;ylece, olduk&ccedil;a merkezi bir konuma sahip olmasına rağmen şehrin diğer kısımlarından kopuk kalmış olan Galata ve yakın &ccedil;evresinin yaya hareketlilik dokuları incelenerek, s&ouml;z&uuml; edilmiş olan bu yeni kentsel tasarım proje &ouml;nerilerinden Galataport ve Perşembe Pazarı projelerinin, Galata&rsquo;nın yaya hareketlilik dokuları &uuml;zerine olası yansımaları değerlendirilmiştir. Galata&rsquo;da yaya hareketlilik dokularının g&ouml;zlemlenmesi ve tespitini gerektiren uygulamalar &ccedil;alışma kapsamında geliştirilmiştir. Y&uuml;r&uuml;nebilirlik oranları ile ilgili karşılaştırmalar yapılabilmesi ve hareketlilik dokusunu etkileyen &ccedil;evresel fakt&ouml;rlerin tespit edilmesi amacıyla belirlenen değişkenler; g&uuml;venlik, g&ouml;rsel kalite, &ccedil;ekicilik ve konfor, arazi kullanımı, eğim ve erişilebilirlik olarak beş ana başlık altında ele alınmıştır. Erişilebilirlik değerinin belirlenmesinde İngiltere University &nbsp;College London b&uuml;nyesindeki Space Syntax Laboratuarı tarafından geliştirilen bir şehirsel tasarım modeli olan Space Syntax (Mek&acirc;nsal Dizin) y&ouml;nteminden yararlanılmıştır. G&ouml;zlemlenen yaya hareketlilik dokusu bağımlı değişken olarak ele alınarak, belirlenen beş bağımsız değişkenle &ccedil;oklu regresyon yapılmıştır. &Ccedil;oklu regresyon modelinin sonu&ccedil;ları, Galata&rsquo;da yaya hareketlilik oranlarını etkileyen fakt&ouml;rleri %60 oranında a&ccedil;ıklamaktadır. Modele g&ouml;re, yaya hareketlerinde; &ldquo;g&uuml;venlik&rdquo;, &rdquo;erişilebilirlik&rdquo; ve &rdquo;arazi kullanımları&rdquo; değişkenleri belirleyici etkenlerdir. &Ccedil;alışma, ileriki aşamalarda, uygulama modeli sonucunda yaya hareketlerini etkilediği tespit edilen değişkenlerin, hareketlilik dokularını ne oranda ve hangi şekilde etkilediğinin araştırılması i&ccedil;in alt başlıklarda incelenmesinin &ouml;nemini ortaya koymaktadır. &nbsp;Anahtar Kelimeler: Yaya hareketleri, kentsel tasarım, Space Syntax (Mek&acirc;nsal Dizin), y&uuml;r&uuml;nebilirlik.Even though pedestrian movement is one of the critical issues in urban design, a determinate method for evaluation of attractiveness of an area for walkability has not been established yet. This paper presents the findings of a comprehensive study on walkability developed on a historical centre of Istanbul, named Galata that has become segregated in recent years. Although Galata has been a significant region due to its location in the commercial core of Istanbul as well as its architectural, cultural and religious history, the area has been losing its value rapidly. Despite its lively neighborhood that has been developing, Galata remains disjointed and rigidly separated from its surroundings and in the process of deterioration. The study has researched the possible effects of the environmental variables on the levels of activity in urban spaces. The aim is to shed light on key variables that affect the attractiveness of an area for pedestrian movement, which in turn can help to develop an objective methodology to evaluate walkability. This study made use of earlier research that measured the pedestrian attractiveness of spaces, including Space Syntax. Space Syntax specializes in the analysis and design of urban environments and, in particular, the design of pedestrian linkages and public spaces. It makes direct observations of pedestrian and vehicular activity and uses purpose-designed computer programs to forecast the effects of new developments on such patterns. The method is being used in many European countries and gives consistent results. Within the context of the study, the existing pedestrian movement patterns in Galata have been observed and a range of variables have been determined to analyze the relationships. Pedestrian movement levels have been recorded separately for men, women, elderly, teenagers and children. The variables have been evaluated under five headings: 1. Slope of the area, 2. Land use pattern, 3. Visual quality and comfort, 4. Safety and 5. Accessibility (Space Syntax analyses) The data recorded in this study have been analyzed with a multiple regression analysis, in which pedestrian movement levels are considered as the dependent variable. The multi-regression analyses have been carried out for different categories of users (male, female, elderly, teenagers and children) and for both weekday and weekend activity levels separately. The model that explains the pedestrian movement levels with the highest accuracy has been generated with the total pedestrian levels of weekend. This model accounts for 60 % of the variation in pedestrian movement. According to the findings of the model, pedestrian movement levels are explained with three out of five variables: safety, accessibility (Space Syntax integration values) and land use pattern. Golden Horn that lies between Beyoğlu and the Historical Peninsula is being planned as a cultural valley with its 16km long coast. The &ldquo;Cultural Valley&rdquo; project is dealing with the refinement of the coasts and surroundings of Golden Horn and regaining its vitality with its historical and natural values. In this study, the possible effects of these proposals on Galata area have been analyzed through Space Syntax and walkability models. The outcomes of the analyses served to the purpose of evaluating two proposed development projects; Persembe Pazarı and Galataport, which seem to have a far reaching influence in future development of the area. The projects are evaluated under the headings land use, safety &amp; security and accessibility. The results of the evaluation have shown that both the two proposals are likely to have a multiplier effect on pedestrian movement, which is crucial for the vitality of the area. The method and the findings of this study constitute an analytical model that could shed fresh light for future research on walkability as well as for evaluating proposals to regenerate historical city centers that have lost their vitality. The research enables to determine possible problems that may cause socio-economic inactivity such as decrease in accessibility among facilities and by this way contributes not only to practice but also to scientific research. The study suggests the importance of investigating the defined variables in subheadings in order to understand the degree and the aspect of their effects on movement patterns.&nbsp;Keywords: Pedestrian Movement, urban design, Space Syntax, walkability.&nbsp

Yalın Yönetim ve Örgütsel Güvene Yönelik Algının Örgütsel Özdeşleşmeye Etkisi: Özel Bir Hastanede Araştırma

Bu çalışmada yalın yönetim, örgütsel özdeşleşme ve örgütsel güven değişkenleri arasındaki ilişkilerin incelenmesi amaçlanmıştır. Çalışmanın evreni, İzmir ilinde bulunan özel bir hastanede görev yapan hemşireler ve diğer sağlık çalışanlarından oluşmaktadır. Çalışmada örneklem seçilmemiş, tüm evrene erişilmeye çalışılmış ve böylece 121 kişi çalışmaya katılım sağlamıştır. Çalışmada yapılan analizler sonucunda katılımcıların yalın yönetim, örgütsel özdeşleşme ve örgütsel güven algılarının yüksek düzeyde olduğu tespit edilmiştir. Çalışmada gerçekleştirilen korelasyon analizine göre, yalın yönetim ile örgütsel özdeşleşme; yalın yönetim ile örgütsel güven ve örgütsel özdeşleşme ile örgütsel güven arasında pozitif ve orta düzeyde ilişkiler tespit edilmiştir. Regresyon analizine göre yalın yönetim algısının örgütsel özdeşleşme üzerindeki toplam varyansın %26.6’sını ve örgütsel güven üzerindeki toplam varyansın %33.9’unu; örgütsel güven algısının ise örgütsel özdeşleşme üzerindeki toplam varyansın %38.9’unu açıkladığı belirlenmiştir

Pseudobullous Anetodermic Pilomatricoma

Pilomatricoma (PM) is an asymptomatic, slowly growing, benign skin tumour originating from primitive cells of the hair matrix and hair shaft and appears mostly on the head, neck, and the upper extremities. Typical lesion is usually characterized by a solitary, firm, deep-seated dermal or subcutaneous nodule, covered by normal or erythematous skin, and usually varying in size from 0.5 to 3 cm. Bullous appearance can occur on the lesions of bullous PM and anetodermic PM which are located in the rare atypical forms of PM. Here, we present an 11-year-old girl with an anetodermic PM on her right arm that showed thick-walled flaccid bullous formation over it