Neonatal tetanus in Turkey; what has changed in the last decade?

dikici, bunyamin/0000-0001-7572-6525WOS: 000259222800001PubMed: 18713452Background: Neonatal tetanus (NT) is still considered as one of the major causes of neonatal death in many developing countries. The aim of the present study was to assess the characteristics of sixty-seven infants with the diagnosis of neonatal tetanus followed-up in the Pediatric Infectious Diseases Ward of Dicle University Hospital, Diyarbakir, between 1991 and 2006, and to draw attention to factors that may contribute (or may have contributed) to the elimination of the disease in Diyarbakir. Methods: The data of sixty-seven infants whose epidemiological and clinical findings were compatible with neonatal tetanus were reviewed. Patients were stratified into two groups according to whether they survived or not to assess the effect of certain factors in the prognosis. Factors having a contribution to the higher rate of tetanus among newborn infants were discussed. Results: A total of 55 cases of NT had been hospitalized between 1991 and 1996 whereas only 12 patients admitted in the last decade. All of the infants had been delivered at home by untrained traditional birth attendants (TBA), and none of the mothers had been immunized with tetanus toxoid during her pregnancy. Twenty-eight (41.8%) of the infants died during their follow-up. Lower birth weight, younger age at onset of symptoms and at the time admission, the presence of opisthotonus, risus sardonicus and were associated with a higher mortality rate. Conclusion: Although the number of neonatal tetanus cases admitted to our clinic in recent years is lower than in the last decade efforts including appropriate health education of the masses, ensurement of access to antenatal sevices and increasing the rate of tetanus immunization among mothers still should be made in our region to achieve the goal of neonatal tetanus elimination

ANADOLU PSIKIYATRI DERGISI-ANATOLIAN JOURNAL OF PSYCHIATRY

Objective: The purpose of this study was to find out the relationship between separation individuation and depression in university students. Methods: The sample consisted of 1026 first grade students of Celal Bayar University consisted the sample of this research a Sociodemographic Form, The Separation Individuation Test of Adolescence (SITA) and Beck Depression Inventory (BDI) were used in this study. Statistical significance of the relationship between SITA subscale scores and BDI scores was assessed by Pearson correlation test and between SITA subscale scores and depression according to the cut-off values of BDI was assessed by using Student's Nest. Results: 20.6% of the students had depression according to the cut-off values of BDI. The mean score of the BDI was 10.98 +/- 9.02. There was a statistically significant negative correlation between the scores of SITA subscales 'peer enmeshment, 'practicing-mirroring' and 'healthy separation' which indicates positive separation individuation process and BDI scores when there was a statistically significant positive correlation between the scores of SITA subscales which indicates difficulties with separation individuation issues 'separation anxiety', 'engulfment anxiety, 'dependency denial' and 'rejection expectancy' and BDI scores. The scores of 'separation anxiety, 'engulfment anxiety, 'dependency denial' and 'rejection expectancy' subscales of SITA were significantly higher in the students with depression according to the cut-off values of BDI when healthy separation subscale scores were significantly higher in the students with depression according to the cut-off values of BDI. Conclusion: In this study, it has seen that there was a relationship between depression and separation-individuation process in adolescence. Difficulties with separation individuation issues in adolescence, in other words failure in achieve developmental tasks during adolescence could cause depression. (Anatolian Journal of Psychiatry 2009; 10:174480

KLINIK PSIKOFARMAKOLOJI BULTENI-BULLETIN OF CLINICAL PSYCHOPHARMACOLOGY

Objective: In this study, it is aimed to compare the level of Brain-Derived Neurotrophic Factor (BDNF) of patients with migraine and fibromyalgia to that of depressive patients and healthy subjects in order to answer the question whether stress is related to pain syndromes. Methods: In the migraine group 27 patients and in the fibromyalgia group 19 patients without any previous antidepressant treatment and psychiatric diagnosis were included. In the depression group, 24 patients with at least eight weeks of antidepressant-free period were invited to the study. In the depression group no co-morbid diagnosis in the first axis was made. Twenty-six subjects without any previous psychiatric diagnosis and psychiatric treatment consisted the control group. For making diagnosis of depression and other first axis disorders Structured Clinical Interview for DSM-IV (SCID-1) was used in all study groups. For the assessment of the severity of depression Hamilton Depression Rating Scale (HAM-D) was applied. The diagnosis of migraine was made according to the criteria of International Headache Society. For the diagnosis of the fibromyalgia the criteria of American College of Rheumatology was used. The severity of pain was assessed with visual analogue scale (VAS) in the migraine and fibromyalgia groups. Serum BDNF was kept at -70 degrees C before testing, and assayed with an ELISA Kit (Promega; Madison, WI, USA), after dilution with the Block and Sample solution provided with the kit. The data were subjected to Kruskal Wallis Test in the comparison of serum BDNF levels. Results: The serum BDNF level of the depression group (21.2 +/- 11.3 ng/ml) was statistically lower (p < 0.0001) than the level of the migraine group (32.2 +/- 10.1 ng/ml), fibromyalgia group (30.7 +/- 8.9 ng/ml) and the control group (31.4 +/- 8.8 ng/ml). The level of BDNF was not significantly different in the migraine, fibromyalgia and control groups. There was no significant correlation between serum BDNF levels, and age and gender. In pain syndromes there was no signification correlation between serum BDNF levels, and mean scores of HAM-D and VAS (r= 0.085; p= 0.579 and r= 0.191; p= 0.204 respectively). Similarly there was no significant correlation between serum BDNF levels and HAM-D scores in the depression group (r=0.122; p= 0.579). Conclusions: Even though the pain syndromes were suggested to be associated with stress, in this present work, serum BDNF level as one of the markers of stress does not support this hypothesis. This might be related to the factor that in pain syndromes such as fibromyalgia or migraine, serum BDNF level may be affected by the alteration in peripheral platelet functions. Furthermore in a limited chronic stress serum BDNF levels tend to be not affected and this may play a significant role in our results

ANADOLU PSIKIYATRI DERGISI-ANATOLIAN JOURNAL OF PSYCHIATRY

Objective: The aim of this study was to determine the knowledge and attitudes of patients attending a psychiatric outpatient clinic towards depression and factors that influenced them. Methods: This study is carried out on patients who attending Psychiatric Outpatient Clinic of Celal Bayar University Hospital. The study was carried out in 200 subjects who have been selected by systematic sampling method. In this study, a 32-item questionnaire designed for rating the attitudes toward depression by PAREM (Psychiatric Research and Education Centre) was used by adding one item to find out the attitudes toward depression. In addition, a 8-item sociodemographic questionnaire designed by authors and a 5-item questionnaire which was designed by authors and included the patients knowledge and opinions about their illness and illness characteristics of patients were applied. Results: Most of the subjects (83.5%) believed that depression due to social problems. Half of subjects stated that they would not get married with a person with depression (50.5%). Twenty-eight of subjects stated that patients with depression might be aggressive. The patients suffering from a depressive episode toward depression answered the items Mrs. F. has a somatic disease (p=0.030), Persons with depression don't recover completely (p=0.003) and persons with depression are aggressive (p=0.029) as I agree more than the patients not suffering from a depressive episode; but answered the items I can work with a person with depression (p=0.004) and I would get married to a person with depression as I agree less than the patients not suffering from a depressive episode. Conclusions: Psychiatric outpatients have more correct knowledge than lay people about depression and treatment of depression. Most of the patients believed that depression is associated with social problems. Attitudes of the psychiatric outpatients toward patient with depression are more positive and more tolerant than lay people. However, patients with depressive episode have more negative and discriminative attitudes toward patients with depression and desire for social distance from patients with depression. (Anatolian Journal of Psychiatry 2009; 10: 100-108

SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY

Background The aim of this study was to determine the public's attitudes and their correlates towards patients with schizophrenia in rural areas. Methods The study was carried out in a village near Manisa City, Turkey. Two hundred and eight subjects completed the public survey form which consists of ten items screening demographic and health status and 32 items rating attitudes towards schizophrenia. Results Half of the subjects stated that persons with schizophrenia are aggressive and that they should not be free in the community. More than half of the subjects stated that they would be irritated about having a neighbour with schizophrenia (61.5%), that they would not rent their home to a person with schizophrenia (58.2%), that they do not want to work with a person with schizophrenia (61.1%), and that they would not get married to a person with schizophrenia (85.6%). Conclusions The public in rural areas sufficiently recognises schizophrenia but has a tendency to stigmatise schizophrenic patients. Their attitudes are generally negative and rejective. They do not want close contact with schizophrenic patients. Interpretation of schizophrenia as a mental illness leads to more negative attitudes and increases the social distance

The Clinical Burden of Allergic Rhinitis in Five Middle Eastern Countries: Results of the Snapshot Program

Background The SNAPSHOT program provides current data on the allergic rhinitis burden in the adult general population of five Middle Eastern countries (Egypt, Turkey, Kuwait, Saudi Arabia and the United Arab Emirates, the latter three grouped into a Gulf cluster). Methods A multi-country, cross-sectional, epidemiological program conducted by telephone in a random sample of the adult general population; quotas were defined per country demographics. Subjects were screened for allergic rhinitis using the Score For Allergic Rhinitis questionnaire. Current prevalence (last 12 months) was estimated. Disease severity and control were assessed using the Allergic Rhinitis and its Impact on Asthma classification and Rhinitis Control Assessment Test respectively. Quality of sleep, impact on daily activities and quality of life were measured using the Epworth Sleepiness Scale, Sheehan Disability Scale and EuroQol Five-Dimension questionnaire respectively. Multivariate logistic regression analyses were used to investigate risk factors and co-morbidities. Results 1808 of 33,486 subjects enrolled in the SNAPSHOT program fulfilled the case definition for allergic rhinitis. Prevalence was 3.6% [95% CI 3.2–4.0%] in Egypt, 6.4% [95% CI 5.9–6.9%] in Turkey and 6.4% [95% CI 6.0–6.9%] in the Gulf cluster. Risk factors identified were country, co-morbid asthma and income. Subjects with allergic rhinitis reported a significantly lower quality of life compared to the general population (p < 0.0001). Overall, 55% of allergic rhinitis subjects were moderate/severe and 33% were uncontrolled. Both these groups reported impaired quality of life and quality of sleep and increased impairment of daily activities compared to mild/well-controlled subjects (p < 0.0001). Conclusions Although the observed prevalence of allergic rhinitis in these Middle Eastern countries is low compared to western countries, its burden is considerable. Allergic rhinitis in general, and specifically uncontrolled and severe disease, results in a negative impact on quality of life, quality of sleep and daily activities.PubMedWoSScopu