Diyabetik Ayak Enfeksiyonları: DÜZELTME - Araştırma Makalesi

Introduction: Diabetes mellitus (DM) has become an important international public health problem considering that its prevalence has increased rapidly in Turkey and all over the world in recent years. A serious and common chronic complication of DM is diabetic foot. Objective: We aimed to evaluate diabetic patients and to determine the prognosis and other effective factors associated with diabetic foot ulcers in patients. Method: In this study, 64 patients diagnosed with diabetic foot infection between 2012 and 2020 were included. Demographic, clinical and laboratory findings, bilateral lower extremity arterial and venous Doppler ultrasonography findings, underlying diseases, wound width, antibiotics used in treatment were obtained retrospectively. Results: A total of 64 patients, 21 females (33%) and 43 males (67%), were included in the study. Of these patients, 33 (52%) were using oral anti-diabetics and 19 (30%) were using insulin. 53% of the patients had a diagnosis of peripheral artery disease and (62.5%) coronary artery disease. 3 (4.7%) had chronic kidney disease and 2 (3%) were receiving haemodialysis treatment. Hypertension was present in 30 (47%) of the patients. 27 (42%) patients had a wound width ≥5cm. Right foot was more commonly affected (n=40, 62.5%). In 10 (16%) patients, the microorganisms grown in deep tissue culture were Klebsiella pneumoniae in 3 patients, Klebsiella oxytoca in 1 patient, Methicillin-resistant Staphylococcus aureus in 2 patients, Morganella morganii in 2 patients, Serratia marcescens in 2 patients. Conclusion: With proper evaluation of diabetic foot ulcers, infection-related morbidity, hospitalisation, length of hospital stay and major limb amputation rates can be reduced.Giriş: Son yıllarda tüm dünyada ve Türkiye’de görülme sıklığının hızla arttığını göz önüne alırsak Diabetes mellitus (DM); önemli bir uluslararası halk sağlığı sorunu haline gelmiştir. Diyabetik ayak DM'nin ciddi ve sık görülen kronik komplikasyonlarından biridir. Amaç: Bu çalışmada diyabetik hastaları değerlendirerek ; hastalarda diyabetik ayak ülserleri ile ilişkili prognoz ve diğer etkili faktörleri ortaya koymayı amaçladık. Yöntem: Çalışmamız 2012 ile 2020  yılları arasında,diyabetik ayak enfeksiyonu tanılı 64 hasta dahil edilmiştir. Hastaların demografik, klinik ve laboratuvar  bulguları,bilateral alt extremite  arteriyel ve venöz Doppler ultrasonografi bulguları,altta yatan hastalıkları, yara genişliği, tedavide kullanılan antibiyotikleri retrospektif olarak elde edilmiştir. Bulgular: Çalışmaya 21 kadın (%33) ve 43 erkek (%67) olmak üzere toplam 64 kişi dahil edilmiştir. Bu hastaların 33’ü (%52) oral anti diyabetik kullanırken 19’u (%30) insülin kullanmakta idi.Hastaların %53’ünde periferik arter hastalığı  ve (%62,5) koroner arter hastalığı  tanısı vardı. 3’ü (%4,7) Kronik böbrek hastalığı  olup 2’si (%3) hemodiyaliz tedavisi almaktaydı. Hastaların 30’unda (%47)  Hipertansiyon  mevcuttu.Yara genişliği ≥5cm olan 27 (%42) hasta mevcuttu. Hastalarda sağ ayak etkilenmesi (n=40, %62,5) daha fazlaydı. 10  (%16 ) hastanın  derin doku kültüründe üreyen mikroorganizmalar ise 3 hastada Klebsiella pneumoniae, 1 hastada Klebsiella  oxytoca , 2 hastada Metisiline dirençli Staphylococcus aureus, 2 hastada  Morganella morganii ,2 Serratia marcescens tespit edildi. Sonuç: Diyabetik ayak ülserlerinin uygun şekilde değerlendirilmesi ile infeksiyona bağlı morbidite, hastaneye yatış, hastanede kalış süresi ve major ekstremite ampütasyonu oranları azaltılabilmektedir

Evaluation of Sharp Object Injuries in Healthcare Personnel Working in Diyarbakır Gazi Yaşargil Training and Research Hospital

Introduction: Health-care providers are at risk of infection because of being in contact with patients or a variety of materials that may be infected by patients. Sharp objects injuries can cause transmission of blood-borne diseases in healthcare workers. In this study it was aimed to evaluate injuries that occurred between January 2013 and May 2015 and analyse measures which can be taken against injuries. Materials and Methods: Sharp objects injuries occurred in Diyarbakir Gazi Yaşargil Training and Research Hospital between January 2013 and May 2015 were evaluated retrospectively. Results: Fifty-seven healthcare workers (17 male, 40 female) presented with sharp object injuries. The rate of percutaneous injury was 88% (n:50). According to occupational groups, sharp instrument injuries were mostly observed in nurses (58%). Recapping of needles after injection was the most common cause of injury (28%). Needle tip was the most common tool causing injury (86%). Conclusion: Using universal precautions can reduce the risk of blood-borne infections by preventing contact with blood and body fluids among healthcare workers. To plan in-service practical training programs and repeat them at regular intervals may be useful in minimizing percutaneous injuries

Seroprevalance of rickettsioses among healthy individuals in Mersin province, Turkey

Objective: Studies relevant to rikettsial biology, its pathogenesis and diagnosis  have increase due to the increase of rickettsioses incidents in the world, particularly over the the past two decades. We investigated the seroprevalence of the ricketsia disease in the Mersin province of Turkey. Methods: This study included 450 healthy individuals aged 5 years and over, who had attended family health centers in Mersin city center. Serum samples collected during November 2011 were evaluated. Rickettsia antibody assays were used indirect immunofluorescenc techniques. Data were analyzed using a descriptive analysis, the Chi-Square Test and the Student T Test for comparison of variables. Results: The prevelance of ricketsia positivity was determined as 9.8%. The seropositivities were higher in males, in the unemployed, in the occupational risk groups, in people who live in rural regions, in people who work in gardens/farms, in picnickers, in countryside walkers, in hunters, in owners of livestock, in people with no history of rash diseases. When the relationship of spotted fever group (SFG) seropositivity the risk factors was investigated, there was no statistical significance. Conclusion: According to our study rickettsial disease is detected in Mersin and it was seen that the rickettsiosis disease need for more comprehensive studies to show the prevalence in all of Turkey.Keywords: Rickettsioses, seroprevelance, antibodies</p