Impact of an educational meeting on knowledge and awareness of general practitioners on upper respiratory tract infections

Objectives: This study aimed to evaluate knowledge ofprimary care physicians regarding the use of antibioticsfor the upper respiratory tract infections (URTIs) and thespecific outcomes of a health educational meeting in twocities using a self -administered questionnaire.Materials and methods: A standard questionnaire wasfilled by the participants before and after the meeting. Thequestionnaire had seven questions about definition, epidemiology,diagnosis and treatment of URTIs. The knowledgeand approaches of practitioners concern about diagnosisand antibiotic use in URTIs were evaluated. Theproportion of overall satisfied answers before and afterthe meeting was compared.Results: Totally 110 primary care physicians joined intothe study. Before the educational meeting, more than30% of participants stated that the at least 50% of thecausative agents of the URTIs are bacteria. Eighty-eightpercent declared that anaerobes or Neisseria are not theplausible causative agents in URTIs. Only 14% of them indicatedthat procaine penicillin is the primary agent for thetreatment of Streptococcus pyogenes. On the other hand,95% of survey participants considered that penicillin isthe first choice for URTI with Beta-hemolytic Streptococcus.After the educational meeting, most of participants’knowledge showed a significant improvement in knowledge.There were a significantly more correct answers toall questions after the educational meeting compared tobefore the meeting. (27.7% of doctors before vs.92.7%after, p<0.001).Conclusion: As a conclusion, attending the educationalmeetings helps primary care physicians’ to increase theirknowledge and it provides to gain a standard approach intheir professional life

Current Approach To Chronic Hepatitis B Therapy

Kronik hepatit B (KHB) karaciğer sirozu, karaciğer yetmezliği ve hepatosellüler kanser gibi hayatı tehdit eden komplikasyonlara neden olabilen ciddi bir enfeksiyon hastalığıdır. KHB tedavisinin ana hedefi bu komplikasyonların önlenmesi ve viral yükün azaltılmasıdır çünkü mevcut antiviral tedaviler, Hepatit B virüs enfeksiyonunu tamamen temizlemekte yetersizdir. Bu makalede KHBde uygulanan antiviral tedavinin güncel durumu ve antiviral ilaçlar özetlenmiştir.Chronic hepatitis B (CHB) is a serious infectious diseases, leading to life threatening complications such as liver cirrhosis, hepatic decompensation and hepatocelluler carcinoma. The main goal for treatment of CHB is to prevent these complications, and to reduce the viral load, because current antiviral therapies are inadequate to eradicate Hepatitis B virus infection. In this article, current state of antiviral therapy of CHB and antiviral drugs were summarized

Mastoiditin komplikasyonu sonucu gelişen proteus mirabilis menenjitine ba?li beyin absesi: Olgu sunumu

Meningitis and intracranial abscess due to Proteus mirabilis is seen especially in the neonatal period and among the patients with immune deficiency. It was learned that 35 years old male patient who applied to the emergency room with ongoing fever, nausea and vomiting for three days have had their upper left jaw tooth out 10 days ago. As clinical and laboratory to patients with acute bacterial meningitis empirical ceftriaxone 2x2 gr/day parenteral was started. The cranial MR of the patient, that has P. mirabilis producing in their blood and cerebrospinal fluid (CSF) culture, was taken at the seventh day of hospitalization as his complaints started again. In the MR, abscess was detected in the left temporal brain of the patient and a surgical treatment was applied. Complete healing was seen eight week treatment with antibiotics after surgery. During application it was though that meningitis has occurred due to the dental surgery, however after the temporal BT, mastoiditis was detected. It was thought that meningitis and brain abscess developed on the patient was caused by mastoiditis. Even with sensitive antibiotics if no recovery is observed in patients with meningitis, intracranial abscess should be considered, also it should not be forgotten that in adults and patients with no immune deficiency meningitis due to P. mirabilis may develop. © 2010 Düzce Medical Journal

Brain abscess due to proteus mirabilis meningitis as a complication of mastoiditis: case report

Proteus mirabilis’e bağlı menenjit ve intrakraniyal apse gelişimi, özellikle neonatal dönemde ve immün yetmezliği olan bireylerde görülmektedir. Acil servise; üç gündür devam eden ateş, bulantı ve kusma yakınmalarıyla başvuran 35 yaşında erkek hastanın, 10 gün önce sol üst çeneden diş çektirdiği öğrenildi. Klinik ve laboratuar olarak akut bakteriyel menenjit ile uyumlu olan hastaya ampirik seftriakson 2x2 gr/gün parenteral başlandı. Kan ve beyin omurilik sıvısı (BOS)’nda P. mirabilis üreyen hastanın; yatışın yedinci gününde yakınmalarının tekrar başlaması üzerine, kranial MR çekildi. MR’da sol temporalde beyin apsesi saptanan hastaya cerrahi tedavi uygulandı. Cerrahi sonrası sekiz haftalık antibiyotik tedavisi ile tamamen iyileşme görüldü. Başvuru sırasında menenjitin dental cerrahiye bağlı oluştuğu düşünülen hastada, daha sonra çekilen temporal BT sonrası mastoidit tespit edildi. Olguda gelişen menenjit ve beyin absesinin mastoidite bağlı olduğu düşünüldü. Menenjit olgularında, duyarlı antibiyotiğe rağmen düzelme saptanmaması durumunda intrakranial apse düşünülmeli, erişkin ve immün yetmezliği olmayan olgularda da P. mirabilis’e bağlı menenjit gelişebileceği unutulmamalıdır.Meningitis and intracranial abscess due to Proteus mirabilis is seen especially in the neonatal period and among the patients with immune deficiency. It was learned that 35 years old male patient who applied to the emergency room with ongoing fever, nausea and vomiting for three days have had their upper left jaw tooth out 10 days ago. As clinical and laboratory to patients with acute bacterial meningitis empirical ceftriaxone 2x2 gr/day parenteral was started. The cranial MR of the patient, that has P. mirabilis producing in their blood and cerebrospinal fluid (CSF) culture, was taken at the seventh day of hospitalization as his complaints started again. In the MR, abscess was detected in the left temporal brain of the patient and a surgical treatment was applied. Complete healing was seen eight week treatment with antibiotics after surgery. During application it was though that meningitis has occurred due to the dental surgery, however after the temporal BT, mastoiditis was detected. It was thought that meningitis and brain abscess developed on the patient was caused by mastoiditis. Even with sensitive antibiotics if no recovery is observed in patients with meningitis, intracranial abscess should be considered, also it should not be forgotten that in adults and patients with no immune deficiency meningitis due to P. mirabilis may develop

Alterations of Serum Copper and Zinc Levels, and Copper/Zinc Ratios Among Patients with Brucellosis

Tegin, Ibrahim/0000-0002-5661-7195; Geyik, Mehmet Faruk/0000-0002-0906-0902WOS: 000309698500011Objective: To determine the alterations of serum copper (Cu) and zinc (Zn) levels and Cu/Zn ratio in patients with brucellosis. Material and Methods: A total of 170 individuals were included in the study. Of these, 45 (26.5%) currently had acute or sub-acute brucellosis, 35 (20.6%) were previously diagnosed with acute or sub-acute brucellosis and successfully treated, and 90 (52.9%) were healthy volunteers. After fasting overnight for 10 hours, 5 ml of venous blood was taken from all subjects. Serum Cu and Zn levels were measured using a Unicam 929 Atomic Absorption Spectrophotometer. SPSS 16.0 was used for data analysis. Results: Mean serum Cu levels of 45 patients with acute or sub-acute brucellosis, 35 patients previously diagnosed with acute or sub-acute brucellosis and 90 healthy volunteers were 88.6 +/- 26, 58.7 +/- 13 and 56.7 +/- 16 mu g/dL, respectively. Mean serum Zn levels of 45 patients with acute or sub-acute brucellosis, 35 patients previously diagnosed with and treated successfully for acute or sub-acute brucellosis and 90 healthy volunteers were 38.3 +/- 12, 58.5 +/- 14, and 55.8 +/- 13 mu g/dL, respectively. Serum Cu levels (p<0.001) and Cu/Zn ratios (p<0.001) were statistically significantly higher while serum Zn levels (p<0.001) were lower in patients with acute or sub-acute brucellosis when compared to the individuals who previously diagnosed with acute or sub-acute brucellosis and the healthy volunteers. Conclusion: This study revealed significant alterations of serum Cu and Zn levels, and Cu/Zn ratios in patients with acute or sub-acute brucellosis. Serum Cu, Zn, and Cu/Zn ratios may be available biomarkers in the course of acute or sub-acute brucellosis

The efficacy of dexamethasone treatment in massive enteric bleeding in typhoid fever

Geyik, Mehmet Faruk/0000-0002-0906-0902WOS: 000263789900025PubMed: 19211432

Yılan ısırığı olgularında yılan zehirinin serum bakır, çinko ve magnezyum seviyesi üzerine etkisi

Amaç: Yılan ısırıkları Türkiye'nin doğu ve güneydoğu bölgelerinde sık görülen önemli bir problemdir. Bu çalışmada yılan ısırığı vakalarında serum bakır (Cu), çinko (Zn) ve magnezyum (Mg) düzeylerindeki değişiklikler araştırıldı.Yöntemler: Çalışmaya 40 yılan ısırıklı hasta ile kontrol amaçlı 80 sağlıklı gönüllü alındı. Yaklaşık 10 ml venöz kan çalışmaya alınan her bir bireyden alındı. Serum eser element düzeyleri Atomik Absorbsiyon Spektormetre cihazı kullanılarak ölçüldü. Bulgular: Çalışmaya alınan 40 yılan ısırıklı hastanın yaş ortalaması 40,1 12 yıl olup, 18'i (% 45) erkek idi. Sağlıklı 80 bireyin yaş ortalaması 40,6 10 yıl olup, 36'sı (% 45) erkek idi. Yılan ısırıklı hastaların serum Cu, Zn, ve Mg düzeyleri sırasıyla 75,8 20,9; 86,9 25,2 ve 1201 562 µg/dL bulundu. Sağlıklı gönüllülerin serum Cu, Zn, and Mg düzeyleri sırasıyla 57,6 17,2; 55,8 12,4 ve 1454 278 µg/dL bulundu. İstatistiksel olarak sağlıklı gönüllüler ile karşılaştırıldığında, yılan ısırıklı hastaların serum Cu ve Zn düzeylerinde anlamlı bir artış (p 0.001) ve serum Mg düzeylerinde anlamlı bir düşüş (p0,001) saptandı.Sonuç: Yılan zehiri, yılan ısırığı olan hastaların serum Cu, Zn ve Mg düzeyleri üzerinde anlamlı değişimler oluşturmaktadır. Yılan zehrinin serum eser element düzeylerinde oluşturduğu bu değişimlerin ileri düzey çalışmalarla araştırılması yılan ısırığı olan hastaların tedavisinde yeni gelişmeler sağlayabilir.Objective: Envenoming resulting from snakebites is a common devastating problem that is frequently seen in eastern and southeastern regions of Turkey. This aim of this study is to observe the changes of snake venom on serum copper (Cu), zinc (Zn), and magnesium (Mg) levels in patients with snakebite.Materials and Methods: Patients with snakebite and healthy individuals as control group were included in the study. Overall 10 ml venous blood sample was taken from each study individuals. Serum trace elements were measured using an atomic absorption spectrophotometer. Results: Forty patients with snakebite and 80 healthy individuals in the control group were included in the study. The mean age of the patients with snakebite was 40.1 ±12 years; of these, 18 were male (45%). The mean age of the 80 healthy individuals was 40.6 ±10 years; of these, 36 were male (45%). Serum Cu, Zn, and Mg levels of patients with snakebite were 75.8 ±20.9, 86.9 ±25.2, and 1201 ±562 µg/dL, respectively. Serum Cu, Zn, and Mg levels of healthy individuals were 57.6 ±17.2, 55.8 ±12.4, and 1454 ±278 µg/dL, respectively. There were statistically significant increasing in serum Cu and Zn levels (p< 0.001), and decreasing in serum Mg levels (p0.001) in patients with snakebite when compared to healthy individuals. Conclusion: Snake venom produces significant alterations on serum Cu, Zn, and Mg levels in patients with snakebite. Investigating of these changes caused by snake venom through further studies may provide novel developments in the treatment of patients with snakebite. J Microbiol Infect Dis 2013; 3(2): 71-7

Risk Factors for Multi-Drug-Resistant Pseudomonas aeruginosa Infections in a University Hospital-A Case Control Study

WOS: 000375099700002Purpose: This study aims to determine the risk factors associated with multi-drug-resistant Pseudomonas aeruginosa (MDR-Pa) infections. Methods: A case control study was conducted at the Dicle University Hospital which is 1150-bed tertiary care teaching hospital in Diyarbakir, Turkey. The study cases were recruited from patients with nosocomial MDR-Pa infections. Two control cases were arranged to compare risk factors of MDR-Pa infections. One of the control groups was composed of patients with non-MDR-Pa infections and the other group with non-MDR Gram-negative bacterial infections except P. aeruginosa. Results: Overall, 225 patients were included in the study, 75 with MDR-Pa infections, 150 control cases (75 non-MDR-Pa and 75 MDR Gram-negative non P. aeruginosa infections). The incidence of MDR-Pa infections was found as 3.1/1,000 admissions. Multivariate analysis showed that multiple invasive procedures (Relative Risk 24.57 (95% Confidence Interval 4.45-135.73) p10 days) (RR 4.68 (CI=2.09-10.49) p<0.001), were found to be risk factors for MDR-Pa. Conclusions: This study revealed that severity of clinical course and carbapenem use are significant risk factors for MDR-Pa infections

RAPID COMMUNICATION Efficacy and safety of pegylated-interferon a-2a in hemodialysis patients with chronic hepatitis C

AIM: To evaluate the efficacy and safety of pegylatedinterferon alpha-2a in hemodialysis patients with chronic hepatitis C. METHODS: Thirty-six hemodialysis patients with chronic hepatitis C were enrolled in a controlled and prospective study. All patients were treatment naive, positive tested for anti-HCV antibodies, and positive tested for serum HCV-RNA. Twenty-two patients received 135 μg peglyated-interferon a-2a weekly for 48 wk (group A). The remaining patients were left untreated, eleven refused therapy, and three were not candidates for kidney transplantation and were allocated to the control group (group B). At the end of the treatment biochemical and virological response was evaluated, and 24 wk afte

Brucellar epididymo-orchitis in southeastern part of Turkey: an 8 year experience

OBJECTIVE: the different clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis (BEO) reporting to the reference hospital in Southeastern Anatolia of Turkey. MATERIAL AND METHODS: in this study, 27 male patients with brucellosis, who presented with epididymitis or epididymo-orchitis (EO) at the university hospital in Diyarbakir from 1998 to 2006, were included. They were compared with the other male patients. Positive blood culture or high agglutination titers of > 1/160 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. RESULTS: fourteen patients had unilateral EO. Leukocytosis was present in 10 patients; all of them had initial agglutination titers of > 1/160 and 10 patients had a positive blood culture. All patients received combined therapy with streptomycin for the first 21 days (or oral rifampicin for 6-8 weeks) with doxycycline or tetracycline for 6-8 weeks. All showed improvement, fever subsided in 3-7 days, and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year. CONCLUSION: in brucellosis-endemic areas, clinicians encountering EO should consider the likelihood of brucellosis. In this study, young age was the most common risk factor, and leukocytosis and high CRP level were the most common laboratory findings. Most cases were unilateral. All patients responded to medical management very well. Conservative management with combination antibiotic therapy was adequate for managing BEO. Conclusively, brucellosis must be considered as a cause of orchitis, especially in endemic regions like Turkey