Application of Fractional SPRSPR Psychological Disease Model in Turkey and Stability Analysis

Psychological diseases and their treatment are problems related to public health. According to data from the World Health Organization, about a billion people have either mental illness or substance use disorder problems in 2017. Mental, neurological diseases and substance use disorders account for 30 percent of the global non-fatal disease burden and 10 percent of the global disease burden. It is noted that in the world Dec 2005 and 2015, the incidence of mental health diseases increased by about 16 percent. In this study, we have created a fractional-order mathematical modeling for the population of individuals suering from psychological diseases in a society. In this model, the total population was divided into three compartments: individuals who did not receive psychological treatment (S), individuals who received psychological support (P) and individuals who recovered after completing psychological treatment (R). As a fractional derivative, we used the Caputo derivative definitions. Numerical solutions were obtained with the help of Euler method by performing stability analysis related to the fractional SPR model created for the mathematical model of psychological patients. Thus, it was interpreted by creating dynamics for the number of individuals with psychological problems in a population

Second trimester abortion as a cause of maternal death: a case report

Each year, an estimated 529 000 maternal deaths occur worldwide. In literature, it is known that  maternal mortality can occur during pregnancy, peripartum and also in postpartum period. Although very rare, maternal deaths may occur after spontaneous abortion. In present case, 37 year old G5P4  (Caesarean Section) women was admitted to Adnan Menderes University, Obstetrics and Gynecology  clinic with diagnosis of missed abortion at 18 weeks' gestation. She had been hospitalized in the public maternity hospital for five days due to abortus incipience and prolapse of amnion membranes but had no  contractions. Fetal heart beats ceased at the second day of hospitalization. Medically induced abortion  was recommended but not accepted by the patient. At the fifth day of hospitalization, she was referred to our clinic due to deterioration of general health condition, low blood pressure and tachycardia. In  emergency department, it was determined that she was not oriented, had confusion, had blood pressure  of 49/25 mmHg and tachycardia. In ultrasonographic examination, 18 week in utero ex fetus was  determined and there was free fluid in abdominopelvic cavity. The free fluid was suspected to be amniotic fluid due to rupture of uterus. Laparotomy was performed, no uterine rupture, hematoma or atony was observed. However during laparotomy, a very bad smelling odor, might be due to septicemia, was felt in the operation room. Cardiac arrest occurred during that operation. In autopsy report, it was concluded that maternal death was because of remaining of inutero ex fetus for a long time. In conclusion, although very rare, maternal deaths after spontaneous abortion may occur. Because spontaneous abortion is a common outcome of pregnancy, continued careful, strict monitoring and immediate treatment of  especially second trimester spontaneous abortion is recommended to prevent related, disappointing, unexpected maternal deaths.Key words: Second trimester, spontaneous abortion, maternal death

Postmastectomy irradiation in breast in breast cancer patients with T1-2 and 1-3 positive axillary lymph nodes: Is there a role for radiation therapy?

<p>Abstract</p> <p>Background</p> <p>We aimed to evaluate retrospectively the correlation of loco-regional relapse (LRR) rate, distant metastasis (DM) rate, disease free survival (DFS) and overall survival (OS) in a group of breast cancer (BC) patients who are at intermediate risk for LRR (T1-2 tumor and 1-3 positive axillary nodes) treated with or without postmastectomy radiotherapy (PMRT) following modified radical mastectomy (MRM).</p> <p>Methods</p> <p>Ninety patients, with T1-T2 tumor, and 1-3 positive nodes who had undergone MRM received adjuvant systemic therapy with (n = 66) or without (n = 24) PMRT. Patient-related characteristics (age, menopausal status, pathological stage/tumor size, tumor location, histology, estrogen/progesterone receptor status, histological grade, nuclear grade, extracapsular extension, lymphatic, vascular and perineural invasion and ratio of involved nodes/dissected nodes) and treatment-related factors (PMRT, chemotherapy and hormonal therapy) were evaluated in terms of LRR and DM rate. The 5-year Kaplan-Meier DFS and OS rates were analysed.</p> <p>Results</p> <p>Differences between RT and no-RT groups were statistically significant for all comparisons in favor of RT group except OS: LRR rate (3%vs 17%, p = 0.038), DM rate (12% vs 42%, p = 0.004), 5 year DFS (82.4% vs 52.4%, p = 0.034), 5 year OS (90,2% vs 61,9%, p = 0.087). In multivariate analysis DM and lymphatic invasion were independent poor prognostic factors for OS.</p> <p>Conclusion</p> <p>PMRT for T1-2, N1-3 positive BC patients has to be reconsidered according to the prognostic factors and the decision has to be made individually with the consideration of long-term morbidity and with the patient approval.</p

Ege tıp öğretim elemanlarının sürekli mesleki gelişim konusundaki eğitim gereksinimlerinin belirlenmesi

Amaç: Ege Üniversitesi Tıp Fakültesinde görevli olan öğretim elemanlarının sürekli mesleki gelişimini (SMG) sağlayacak eğitici gelişim programlarının planlanması için eğitim gereksinimlerinin belirlenmesi amacıyla gerçekleştirilmiştir. Gereç ve Yöntem: Aralık 2019-Şubat 2020 ayları arasında yapılan kesitsel tipte araştırmadır. Ege Üniversitesi Tıp Fakültesinde görevli olan 225 öğretim elemanına ulaşılmıştır. Araştırmanın verilerini öğretim elemanlarının eğitim gereksinimlerini belirlemeye yönelik hazırlanan dijital anket formu ile toplanmıştır. Veriler, SPSS 21 paket programında değerlendirilmiştir. Verilerin analizinde dağılım istatistikleri (frekans, yüzde, ortalama, standart sapma) kullanılmıştır. Bulgular: Öğretim elemanlarının %61,6’sı (n:98) Dâhili Bilimler, %17’si (n:27) Cerrahi Bilimler, %21,4’ü (n: 34) Temel Bilimlerde görev yapmaktadır. Öğretim elemanları SMG etkinliklerini ayda dört saat, belli zamanlarda tekrarlanan modüler program ve en az 2-5 öğretim yöntemi ile yürütülmesini istedikleri belirlenmiştir. Sürekli mesleki gelişim etkinliklerinde eğitim becerileri olarak asistanların ve Dr. Öğr. Üyelerinin eğitim becerileri konusunda ihtiyaçları olduğu saptanmıştır. Araştırma becerileri olarak asistan ve uzmanların yayın hazırlama ve bilimsel toplantı, diğer öğretim elemanlarının araştırma planlama konusunda gereksinimlerinin olduğu belirlenmiştir. Kişisel gelişim ve uygulama becerileri olarak asistan ve uzmanların bilimsel toplantı, diğer öğretim elemanlarının ise kişisel gelişimlerini destekleyecek eğitimlere ihtiyaçlarının olduğu belirlenmiştir. Sonuç: Eğitici gelişim programlarının planlanmasında eğiticilerin gereksinimlerinin ve isteklerinin belirlenmesi sürekli mesleki gelişim etkinliklerinin başarısını etkilemektedir. Saptanan eğitim gereksinimleri doğrultusunda sürekli mesleki gelişim etkinlikleri düzenlenmesi önerilmektedir