Investigation of cesarean sections at Konya Training and Research Hospital Obstetrics and Gynecology Department between 2010 and 2015

Objective: Analysis of the annual distribution of cesarean sections and indications between 2010 and 2015 in our clinic. Material and methods: Medical records of 10,437 cesarean section patients from a total number of 24,283 deliveries performed at Department of Obstetrics and Gynecology between 2010–2015 were evaluated retrospectively. The indications for Cesarean section were analyzed and compared based on years. Results: The lowest cesarean section rate was 18.67% in 2011 and the highest rate was 24.5% in 2013, and the annual rates were close to each other in this 6-year period (p > 0.05). History of uterine surgery was the indication with the highest rate of 49.52%, while fetal distress was the second most frequent with 12.53%; presentation anomalies were observed as the most frequent third indication with 7.55%, and umbilical cord prolapse was the least frequent indication with 0.33%. Conclusions: Patient education about normal delivery and providing means for pain control during normal delivery, improvement in physical conditions of the clinics, frequent and regular training of the assisting staff with obstetrics physicians are important to diminish the rates of primary cesarean sections. In addition, a normal delivery after a previous cesarean section must be encouraged

Effects of IVF therapies on metabolic, endocrine and inflammatory status in IVF-conceived pregnancy

Rationale In vitro fertilization (IVF) is a common treatment for infertility. In mice, IVF is associated with development of glucose intolerance. However, human data are limited regarding the metabolic, endocrine and inflammatory effects of IVF therapy in IVF‐conceived pregnancies. Objective To explore effects of IVF therapies on metabolic, endocrine and inflammatory parameters in IVF‐conceived pregnancy. Methodology Twelve‐week prospective observational study of adult normoglycaemic women, BMI 18.5‐38 kg/m2 and ≤ 39 years awaiting IVF therapy. Fasting blood samples were collected at baseline and 12 weeks, and serum analysed for reproductive hormones, glucose, lipids, insulin sensitivity, thyroid status, adiponectin inflammatory marker and lipopolysaccharide‐binding protein (LBP). Results Two hundred and seventy‐five women were analysed: 158 IVF‐conceived pregnant women and 117 with failed IVF. Compared with baseline, nonpregnant women had significant (P < .001) increases in 12‐week glucose (86.04‐87.62 mg/dL), insulin (8.72‐9.37 µIU/mL), HOMA‐IR (1.9‐2.1), T‐Chol (169.5‐174.9 mg/dL), TG (71.0‐83.7 mg/dL) and HDL‐C (52.0‐54.11 mg/dL) levels. At 12 weeks, pregnant women also had (P < .001) increases in T‐Chol (177.5‐199.5 mg/dL), TG (73.5‐126.78 mg/dL) and HDL‐C (55.3‐65.1 mg/dL), while a significant reduction in glucose (86.15‐82.19 mg/dL), HbA1c (5.3‐5.08%) and TSH (1.71‐1.36 µIU/mL) levels from baseline. Adiponectin and LBP levels remained the same in either group. Conclusion In vitro fertilization hormonal therapy impairs glucose and insulin levels; these effects are masked in early pregnancy. Changes in lipid profile occur following IVF therapies regardless of pregnancy outcome. Neither adiponectin nor LBP is affected by IVF therapies and during early IVF‐conceived pregnancy

Sağlık Bilimleri Fakültesi Öğrencilerinin Sağlık Okuryazarlığı Düzeyleri: Kesitsel Bir Çalışma

Amaç: Üniversite öğrencilerinin çoğunun sağlıklarını olumsuz yönde etkileyebilecek olan yaygın durumlar mevcuttur. Aynı zamanda, ilerde sağlık hizmeti verecek olan bireylerin toplumun beklentilerini yerine getirebilmesi, toplumun sağlıkla ilgili sonuçlarını iyileştirmesi ve topluma örnek oluşturması açısından sağlık okuryazarlığı düzeylerinin yüksek olması beklenmektedir. Bu çalışmada, sağlık bilimleri fakültesinde öğrenim gören lisans öğrencilerinin sağlık okuryazarlığı düzeylerinin belirlenmesi amaçlanmıştır. Yöntem: Çalışma Eylül- Kasım 2022 tarihleri arasında 296 öğrenci ile kesitsel olarak tamamlandı. Veriler bir sosyal medya uygulaması üzerinden çevrimiçi anket aracılığıyla toplandı. Verilerin analizinde t testi, tek yönlü ANOVA, post-hoc bonferroni, kruskal wallis, Tamhane’s T2, spearman korelasyon analizi uygulandı. Bulgular: Öğrencilerin sağlık okuryazarlığı düzeyinin, toplam ölçek puanına göre 106,54±15,75 puanla “yeterli” olduğu bulundu. Kadın öğrencilerin puanları erkek öğrencilere oranla daha yüksek olduğu görüldü (t= 3,846, p= 0,000). Dördüncü sınıftaki öğrencilerin puanları diğer bütün alt sınıflara göre anlamlı olarak daha yüksekti (F=7,028, p=0,000). Kendine ait bilgisayarı olduğunu belirten öğrencilerin olmayanlara göre (t=2,277, p=0,023), internet erişimi olan öğrencilerin olmayanlara göre ölçek puanları anlamlı olarak daha yüksek bulundu (t=2,145, p=0,033). Teknolojik yeterli olma durumu ile ölçek puanı arasında pozitif yönlü anlamlı bir ilişki görüldü (r=.214, p=0,000). Hemşirelik bölümündeki öğrencilerin ölçek puanları diğer bölümlerdekilere göre anlamlı olarak daha düşük bulundu (F=15,315, p=0,000). Sonuç: Bu çalışmada, Sağlık Bilimleri Fakültesi öğrencilerinin sağlık okuryazarlığı düzeylerinin yeterli olduğu saptanmıştır. Sağlık okuryazarlığı düzeyini daha üst seviyelere taşımak adına eğitimciler öğrencilere liderlik edebilir

LIFESTYLE FACTORS INFLUENCING THE PREVALENCE OF SKIN DISEASES AT A PRIMARY CARE CENTER IN KARACHI

Background: To determine the burden and assess the risk factors of skin diseases in Primary Health Care Centers in Karachi. Methods: A total of 360 patients came to the primary health care center over the span of 6 months from May 2017 to October 2017 .Out of them 151 had some sort of dermatological ailment. They were examined thoroughly for skin lesions and interviewed. Data was collected by reading out questionnaires to the patients, and filled accordingly. Results: It was observed in our study that 151(41.9%) patients presenting to primary care center had dermatological complaints. Mean age determined was 25 years. 87% of the study population was female whilethe rest were males. In our study, skin ailments were broadly divided into 3 categories out of which chronic skin conditions ( 43%) like lichen planus, alopecia and pityriasis alba turned out to be most common, followed by infectious skin diseases ( 36.4%) such as scabies, tineas and impetigo. Least recurring were allergic skin disorders ( 20.5%)such as atopic dermatitis. Sharing of personal items and animal contact were statistically significant variables and had strong association with skin ailments. While overcrowding, family history of similar skin condition and past personal history of same skin condition were not determined to be significantly associated with the presentation. Conclusion: Our study shows a spectrum of skin diseases prevalent in high numbers in our population. This identifies the need for qualified family physicians with special training in dermatology to treat the masses effectively and decrease the morbidity. Detailed counseling should be offered to avoid sharing of clothes and minimizing animal contact as muchsince possible since skin diseases are mostly contagious. Community awareness programs should be conducted in which personal hygiene should be discussed. Scarcity of water is a social issue prevalent in this area so some policies regarding this issue should be imposed to improve the situation

A cost‑utility analysis comparing endovascular coiling to neurosurgical clipping in the treatment of aneurysmal subarachnoid haemorrhage

Endovascular coiling (EC) has been identifed in systematic reviews and meta-analyses to produce more favourable clinical outcomes in comparison to neurosurgical clipping (NC) when surgically treating a subarachnoid haemorrhage from a ruptured aneurysm. Cost-efectiveness analyses between both interventions have been done, but no cost-utility analysis has yet been published. This systematic review aims to perform an economic analysis of the relative utility outcomes and costs from both treatments in the UK. A cost-utility analysis was performed from the perspective of the National Health Service (NHS), over a 1-year analytic horizon. Outcomes were obtained from the randomised International Subarachnoid Aneurysm Trial (ISAT) and measured in terms of the patient’s modifed Rankin scale (mRS) grade, a 6-point disability scale that aims to quantify a patient’s functional outcome following a stroke. The mRS score was weighted against the Euro-QoL 5-dimension (EQ-5D), with each state assigned a weighted utility value which was then converted into quality-adjusted life years (QALYs). A sensitivity analysis using diferent utility dimensions was performed to identify any variation in incremental cost-efectiveness ratio (ICER) if diferent input variables were used. Costs were measured in pounds sterling (£) and discounted by 3.5% to 2020/2021 prices. The cost-utility analysis showed an ICER of−£144,004 incurred for every QALY gained when EC was utilised over NC. At NICE’s upper willingness-to-pay (WTP) threshold of £30,000, EC ofered a monetary net beneft (MNB) of £7934.63 and health net beneft (HNB) of 0.264 higher than NC. At NICE’s lower WTP threshold of £20,000, EC ofered an MNB of £7478.63 and HNB of 0.374 higher than NC. EC was found to be more ‘cost-efective’ than NC, with an ICER in the bottom right quadrant of the cost-efectiveness plane—indicating that it ofers greater benefts at lower costs. This is supported by the ICER being below the NICE’s threshold of £20,000–£30,000 per QALY, and both MNB and HNB having positive values (>0)

Mobile care app development process: using the ADDIE model to manage symptoms after breast cancer surgery (step 1)

The use of mobile applications is widespread in patient monitoring or education today. This study aims to describe the design and development process of a mobile app that supports patient self-care after breast cancer surgery. We used the ADDIE model to develop and test the mobile app. ADDIE (Analysis, Design, Development, Implementation, Evaluation) is a systematic approach based on a standard instructional design model for creating training materials. The model consists of fve phases, each with its own set of steps. Once the steps within each phase are completed, the model progresses to the next phase, ultimately resulting in a “usable” product. Diferent team collaborations were established within each phase, and support was obtained from multiple experts during the design process. Thanks to this model, the information that patients need was transformed into a technological product. This article, which explains the stages of the product design process for mobile applications, provides information that may be helpful to researchers working on similar products.No sponso

O R I G I N A L P A P E R .r . Determination of the Herbal Products Used by Patients with Ischemic Heart Disease Prior to Surgery

Abstract Objective: To determine the herbal product usage status of patients with the diagnosis of ischemic heart diseases (IHDs), who had been hospitalized for coronary by-pass grafting surgery. Methods: Among the patients hospitalized in the cardiovascular department for cardiac surgery due IHDs between October 2009 and May 2010, those who were over 18 years of age and who met the inclusion criteria were included in the study. Data were collected using Form 1 (demographic data) and Form 2 (data of herbal use) which were developed by the researchers. Results: Ninety-seven (32.55%) of 298 patients included in the study had mentioned a type of herbal product use in the three months previous to the study. Statistically significant differences were found between the demographic characteristics of the patients with or without herbal product use, including gender, educational status, the place they lived in, the occupational status, other diseases and the age (p&lt;0.05). It was determined that none of the participants (n=298) had any information on the possible interaction of the drugs with the herbal products, and that none of the herbal product users (n=97) had informed the healthcare providers about the subject. Conclusion: Cardiovascular diseases constitute an important group of diseases which may only be diagnosed and treated by evidence-based, multidisciplinary approaches, and they remain the leading causes of all deaths. It is considered that the use of herbal products by the recommendations of friends or the people in the media is extremely dangerous