A rare case of cardiac alveolar echinococcosis without any complications for eight years

[Abstract Not Available

Management of persistent coccydynia with transrectal manipulation: Results of a combined procedure

WOS: 000431533600030PubMed ID: 29234884We compared the results of manual therapy combined with steroid injection with single steroid injection in the treatment of persistent coccydynia. Combined therapy was performed in 21 patients (Group 1) and steroid injection in 23 patients (Group 2). We compared two groups and investigated the combined therapy group in details. Patients were classified according to the underlying cause, BMI, anatomic type of coccyx and duration of symptoms (<6 or 6 months). Mean age was 30.5 years at the time of procedures. Mean followup time was 27.8 months. VAS scores were decreased in both groups but combined therapy group had much more better results. Complete pain relief was achieved in 61.9% of patients in Group 1 whereas it was only 17.4% in Group 2. In 23.8% of Group 1, the VAS score was significantly decreased but the feeling of uncomfortability persisted. This was 73.9% in Group 2. We had no relapse in Group 1 but in Group 2 the relapse rate was 56.5%. Underlying cause, body mass index, anatomic type of coccyx and duration of symptoms had no effect on results. Manual therapy combined with steroid injection would be an alternative method in case of persistent coccydynia. It is a safe and easy option before surgical treatment

The efficacy of cinacalcet in the treatment of hyperparathyroidism in Turkish hemodialysis patient population

WOS: 000393291900012OBJECTIVE: Cinacalcet reduces parathyroid hormone levels by increasing the sensitivity of the parathyroid gland to calcium. in this study, we firstly aimed to evaluate the efficacy of cinacalcet in Turkish hemodialysis patients. MATERIAL and METHODS: 4483 hemodialysis patients were screened and 469 patients who had used cinacalcet were included in the study. the patients were divided into 4 groups according to drug usage durations (Group 1: 3 months, Group 2: 6 months, Group 3: 9 months and Group 4: 12 months). the patients' Parathormone, Ca, P and CaxP levels at the 3rd, 6th, 9th and 12th months were compared to the start of treatment and previous months. RESULTS: the levels of Parathormone, Ca, P and CaxP significantly decreased compared to their initial levels in all groups (from 1412 pg/ml to 1222 pg/mL for Parathormone, p< 0,001) in the 3rd month. However, this reduction was not continued in the subsequent months (Parathormone: 1381 pg/ml for the 12th month). CONCLUSION: Cinacalcet may not provide adequate benefit in control of hyperparathyroidism in Turkish hemodialysis patient population

The effects of Covid-19 on physical medicine and rehabilitation in Turkey in the first month of pandemic

Objectives: The outbreak of novel coronavirus-2019 (COVID-19) has affected Turkey very seriously, as well as all around the world. Many urgent and radical measures were taken due to the high contagious risk and mortality rate of the outbreak. It is noteworthy that isolation recommendations and the provision of health services for pandemic have a negative impact on Physical Medicine and Rehabilitation (PMR) services. In this study, we aimed to evaluate the effects of COVID-19 on the PMR services and physiatrists immediately after the first month of pandemic in Turkey. Patients and methods: An online survey consisting of 45 items was sent to the members of the Turkish Society of Physical Medicine and Rehabilitation. The main goal of the survey was to evaluate the changes in the provided service of PMR and conditions of physiatrists one month after the first reported COVID-19 case in Turkey. Results: A total of 606 PMR specialists and residents responded to the survey. The mean number of the patients visited the outpatient clinics was 148.2 +/- 128.5 per week before the pandemic, it significantly decreased to 23.4 +/- 33.1 per week after the first month of the reported first COVID-19 case. Similarly, the mean number of the patients of inpatient service significantly decreased from 21.7 +/- 39.3 per week to 2.5 +/- 10.0 per week after the first month of the pandemic. Most of the residents (69%) reported that their training was seriously affected due to pandemic. From the economic aspect, 69.2% of the participants who were working at private hospitals reported a decrease in their monthly salary, and 21% of them were sent to an unpaid vacation. A total of 21.9% of private-practice institutions paused their services. During the first month, 46.9% of the participants were assigned to the different services such as COVID-19 inpatient service, emergency or COVID-19 outpatient clinics. According to the Republic of Turkey, Ministry of Health guideline and algorithm, 15.7% of the physicians were in the category of healthcare workers with suspected COVID-19. Conclusion: The COVID-19 pandemic affected seriously both the services and the PMR physicians as early as the first month. This effect is expected to become worse, when the duration of pandemic prolongs. Proper arrangements and measures should be planned to ameliorate the negative effects of the pandemic on the patients and PMR physicians

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Bilgisayar sistemlerinde parola güvenliği üzerine bir araştırma

Bu tezde, bilgisayar sistemlerinde kullanılan parola seçim eğilimleri arastırılmıs ve zayıf parolaların sistemlerde kullanımının engellenmesi amacıyla kullanılan öncül parola denetim yöntemleri incelenmistir. Türk kullanıcılara ait gerçek parolalar sifrelendikten sonra kırılmaya çalısılarak ve parolalar üzerinde istatiksel incelemeler yapılarak kullanıcı eğilimleri belirlenmeye çalısılmıstır. Ayrıca, karar ağacı modeli yönteminin kullanıldığı öncül bir parola denetim yazılımının (Hyppocrates) Türkçe parolalar için kullanılabilmesi amacıyla, eldeki bu parolalar ile çesitli deneyler yapılmıstır. Belirlenen kullanıcı eğilimleri sunulmus ve karar ağacı modeli kullanan öncül parola denetimi yazılımlarının, Türkçe parolaların denetlenmesinde etkin kullanılabilmesi için önerilerde bulunulmustur

The Fergana Valley And Struggle For Dominance Of The Great Powers in XIX. Century

Fergana Vadisi, kuzeyden Tanrı Dağları'nın Çotkal silsilesiyle, kuzey doğudan Fergana Dağları'yla, güney yönünden Alay ve Türkistan Dağları'yla çevrilmiş korunaklı bir yerdir. Tarihi süreçte İskitler, Moğollar, Sartlar, Soğdlar gibi birçok kavimlerin yaşadığı Fergana Vadisi'nde, Göktürkler zamanında Türk halklarının sayısında yoğun bir artışın olduğu kaynaklardan bilinmektedir. Çeşitli devletlerin hâkimiyet sahası içerisinde kalan vadi, Timurlular döneminde uzun sayılabilecek bir süre istikrar yaşamıştır. Vadi, XVI. yüzyıldan XVIII. yüzyılın başlarına kadar Buhara Hanlığı'na bağlı olarak kalmıştır. XVIII. yüzyılda Hokand Hanlığı'nın kurulmasıyla el değiştiren vadi, Buhara ve Hokand Hanlıkları arasında sık sık mücadele sahası olmuştur. Birbirleriyle mücadeleye tutuşan Türkistan Hanlıkları, etraflarını saran Rusya gibi büyük devletlerin politikalarını fark edememişlerdir. Bu mücadeleler onların güç kaybetmelerine ve ellerinde olanı da yitirmelerine sebep olmuştur. Sıcak denizlere inme politikasını üç koldan gerçekleştirmeye çalışan Rusya, diğer iki koldan (Balkanlar ve Kafkaslar) güneye inemediği için Türkistan coğrafyasını yegâne hedef olarak görmüştür. Hindistan'daki sömürülerini korumak için yoğun bir diplomasi mücadelesi veren İngiltere, Rusya'nın yayılma siyasetinin karşısındaki en dikkat çeken muhalefetti. İki büyük güç arasındaki "Gölgeler Oyunu"nun kazananı Rusya olmuştur. İngiltere ise Afganistan'ın tampon bölge olmasından duyduğu memnuniyet ile Rusya'nın yayılma siyasetine göz yummuştur. Şöyle ki; XIX. yüzyıl boyunca Hokand Hanlığı sınırları içerisinde olan Fergana Vadisi, 1876'ya gelindiği zaman Rusya'nın hâkimiyetine geçmiştir. Hammadde ve pazar arayışı içerisinde olan Rusya, Fergana Vadisi'nin yeraltı ve yerüstü zenginliklerini yaklaşık olarak 100 yıl boyunca Rusya'ya taşımıştır. Bölge tarihine baktığımız zaman, Fergana Vadisi'nde Türk kültürü ve İslam medeniyetinin hâkim durumda olduğu görülmektedir. İslâm kültürü ve tarikatları, vadide yoğun bir şekilde varlığını yüzyıllarca sürdürmüştür. Hatta bölgede, zaman zaman tarikatlar siyasette belirleyici bir unsur olmuştur. Bu bağlamda, Saçlı İşanlar Tarikatı (Yesevilik tarikatının bir kolu) mensubu olan Dükçü İşan'ın ayaklanması XIX. yüzyıl Fergana tarihine damgasını vuran önemli tarihi olaylardan birisidir. Anahtar Kelimeler: Fergana Vadisi, Hokand Hanlığı, Buhara Hanlığı, Büyük Güçler, Rusya, İngiltere.The Fergana Valley is a sheltered place surrounded by the Çotkal range of the Tian Shan Mountains (Tengri Tagh) in the north, comprising the Ferghana Mountains in the north, the Alay and Turkestan Mountains in the south. The Ferghana Valley where many tribes lived such as Scythians, Mongols, Sikes, Sogdler, is known from the sources of time with an intense increase in the number of Turkish peoples during the The Turkic Khaganate (Göktürk Khaganate) period. The valley, which was within the sphere of dominance of the various states, had a long period of stability during the Timurid period. The valley remained attached to the Bukhara Khanate from the 16th century until the beginning of the 18th century. The valley, which changed hands with the establishment of the Hokand Khanate in the 18th century, often became a field of struggle between the Bukhara and Hokand Khanates. The Turkestan Khanates, struggling against each other, could not realize the policies of the great states such as Russia surrounding them. These struggles have caused them to lose power and lose what is in their hands. Russia, trying to realize the policy of accessing into the warm seas from three branches, considered Turkestan geography as its sole target because it could not reach south from the other two branches (Balkans and Caucasus). The England, which struggled with intense diplomacy in order to protect its colonies in India, was the most noteworthy opposition to Russia's policy of expansion. Russia was the winner of the "Game of Shadows" which took place between two major powers. Britain, on the other hand, welcomed Russia's expansion policy with the satisfaction of Afghanistan being a buffer zone. Namely; Fergana Valley, which was within the borders of Hokand Khanate during the nineteenth century, was dominated by Russia in 1876. Russia that had been in search of raw materials and markets moved the underground and aboveground riches of the Fergana Valley to Russia for approximately 100 years. When we look at the history of the region, it is seen that the Turkish culture and the Islamic civilization are dominant in the Fergana Valley. The Islamic culture and sects have continued its existence intensely for centuries in the valley. In fact, in the region, from time to time the sects were a decisive factor in politics. In this context, the uprising of "Dükçü İşan" (1898), a member of the branch of the "Saçlı İşanlar Sect" (a branch of the Yesevism Sect), was one of the important historical events that marked the 19th century Ferghana history. Key Words: Ferghana Valley, Hokand Khanate, Bukhara Khanate, Great Powers, Russia, England