Lot quality survey: an appealing method for rapid evaluation of vaccine coverage in developing countries – experience in Turkey

<p>Abstract</p> <p>Background</p> <p>Vaccine-preventable diseases cause significant morbidity and mortality worldwide and in developing countries in particular. Information on coverage and reasons for non-vaccination is vital to enhance overall vaccination activities. Of the several survey techniques available for investigating vaccination coverage in a given setting, the Lot Quality Technique (LQT) remains appealing and could be used in developing countries by local health personnel of district or rural health authorities to evaluate their performance in vaccination and many other health-related programs. This study aimed to evaluate vaccination coverage using LQT in a selected semi-urban setting in Turkey.</p> <p>Methods</p> <p>A LQT-based cross-sectional study was conducted in Kecioren District on a representative sample of residents aged 12–23 months in order to evaluate coverage for routine childhood vaccines, to identify health units with coverage below 75%, and to investigate reasons for non-vaccination.</p> <p>Results</p> <p>Based on self-reports, coverage for BCG, diphtheria-pertussis-tetanus (DPT-3), oral polio-3, hepatitis-3, and measles vaccines ranged between 94–99%. Coverage for measles was below 75% in five lots. The relatively high educational and socioeconomic status of parents in the study group alone could not minimize the "considerable" risk of vaccine-preventable diseases in the District and dictates a continuity of efforts for improving vaccination rates, with special emphasis on measles. We believe that administrative methods should be backed up by household surveys to strengthen vaccination monitoring and that families should be trained and motivated to have their children fully vaccinated according to the recommended schedule and in a timely manner.</p> <p>Conclusion</p> <p>This study identified vaccine coverage for seven routine vaccines completed before the age of 24 months as well as the areas requiring special attention in vaccination services. The LQT, years after its introduction to health-related research, remains an appealing technique for rapid evaluation of the extent of a variety of local health concerns in developing countries, in rural areas in particular, and is very efficient in determining performance of individual subunits in a given service area. Training of local health personnel on use of the LQT could expedite response to local health problems and could even motivate them in conducting their own surveys tailored to their professional interests.</p

Fungus Ball in Concha Bullosa: A Rare Case with Anosmia

Concha bullosa is the pneumatization of the concha and is one of the most common variations of the sinonasal anatomy. The histopathological changes caused by the infections which arise from the impaired aeration of conchal cavity are frequently found. Fungus ball of the nasal cavity is an extremely rare, fungal infection with only three cases reported previously. In this paper, we present the fourth fungus ball case which developed within a concha bullosa and presented with anosmia

Tansiyon pnömotoraksı taklit eden dev bül

Göğüs grafisinde, tansiyon pnömotoraksı, bir hemitoraksta geniş radyolüsenite ve mediastinal yapıları karşı tarafa itmiş olarak izleriz. Dev bül de geniş radyolüsen görünümü ve mediastinal şift oluşturarak tansiyon pnömotoraksı taklit edebilir. Sunduğumuz olgu dev akciğer bülü olan 35 yaşında bir kadındır. Dev bül acil serviste tansiyon pnömotoraks olarak teşhis edilerek göğüs tüpü takılmıştır. Tansiyon pnömotoraks ile dev bülü ayırt etmek çok zordur. Bu iki çok benzer antitenin tedavileri tamamen farklıdır. Bundan dolayı anamnez, fizik muayene ve radyolojik incelemede, doğru tanı için çok dikkatli olmalıyız.In the chest X-ray, we observe tension pneumothorax (TPX) as wide radiolucent view in a hemithorax and pushing the mediastinal structures contralateral. Giant bulla may mimic TPX with wide radiolucent view and mediastinal shift. The present report includes giant pulmonary bulla in 35-year-old woman. The giant bulla was diagnosed as a TPX in emergency, and chest tube was performed. The differentiation between TPX and a giant bulla may be very difficult. The therapies of these two similar entities are completely different. So that, we must be careful about anamnesis, physical examination and radiology for true diagnosis

Effect of white tea consumption on serum leptin, TNF-α and UCP1 gene expression in ovariectomized rats

Background: Obesity and dyslipidemia due to estrogen deficiency are among the important health problems in menopausal women. Increasing evidence reports the anti-obesity and anti-hyperlipidemic properties of tea polyphenols. However, the effect of white tea (WT) with high polyphenol content on overweight and lipid profile is uncertain. Here, we aimed to examine the effects of long-term WT consumption on serum leptin, tumor necrosis factor- alpha (TNF-α) and uncoupling protein 1 (UCP1) mRNA gene expression in ovariectomized (OVX) rats. Methods: Adult rats were divided into four groups (n = 8): (i) sham, (ii) OVX, (iii) WT and (iv) OVX + WT. WT was given at a dose of 0.5% w/v for 12 weeks. In the study, body weight, serum leptin, TNF, estradiol (E2) levels, lipid profile and UCP1 mRNA gene expression in brown adipose tissue (BAT) were evaluated. Results: There was a significant increase in body weight of OVX rats, which was decreased following WT consumption. While leptin and E2 levels decreased in the OVX group, TNF levels increased. There was no difference between the NF-κB levels of the groups. In addition, BAT UCP1 mRNA expression was significantly decreased in OVX groups, while WT treatment stimulated UCP1 activity. Conclusion: We explain the stimulatory effect of WT on weight loss mainly by the induction of UCP1 gene-mediated thermogenesis and suppression of inflammation. Therefore, we suggest that prolonged WT consumption may have beneficial effects in limiting excess weight gain caused by estrogen deficiency

Güneydoğu Türkiye'de terör saldırılarında sivillerdeki vasküler yaralanmaların analizi

Türkiye'nin Güneydoğusu'nda meydana gelen teröre bağlı vasküler yaralanmalar ve mor-- talite göstergelerini incelemek. Gereç ve Yöntemler. Ocak 2012--Ağustos 2015 arasında teröre bağlı vasküler yaralanması olan 88 hasta (82 erkek, yaş 24418.1) bu retrospektif çalışmaya alındı. Travmatik amputasyon, yaygın doku kaybı, ciddi sinir hasarina bağlı amputasyon ve baş yaralanması olan hastalar çalışmaya alınmadı. Hastalar yaralanmanın ciddiyeti ve mekanizması, travma lokalizasyonu ve cerrahi tedavi şekillerine göre değerlendirildi. Bulgular: Kırkaltı (%52.3) hastada alt ekstremite, 19 (%21.6) hastada üst ekstremite, 13 (%14.8) hastada alt ve üst ekstremitede vasküler yaralanma vardı. Ayrıca boyun (n=3; %3.4), toraks (n=2; %2.3), abdomino--pelvik (n=5; %5.7) yaralanmalar da vardı. Yaralanmaların 23'ü (%26.1) mermi, 54'ü (%61.4) şarapnel, 11'i (%12.5) patlama sebebiyle meydana gelmişti. Hataların 38'i (%43.2) hastaneye geldiklerinde hipovolemik şoktaydı. Kırk (%45.5) hastada izole arter, 42 (%47.7) hastada arter ve ven, (%6.8) hastada sadece ven yaralanması vardı. Yirmisekiz (%31.8) hastada otojen greft, 10 (%11.4) hastada sentetik greft kullanıldı. Onsekiz (%20.5) hastada vasküler ligasyon yapıldı. Yedi (%8) hastada postoepratif akut böbrek hasarı gelişti. Yirmisekiz (%31.8) hastada yara enfeksiyonu gelişti. Çalışmamızda erken dönem mortalite oranı %18.2 (16 hasta)'dir. Hipovolemik şok (p<0.0001), akut böbrek yetmezliği (p=0.002) ve masif kan transfüzyonu (p=0.007) mortalite prediktörleridir. Sonuç: Teröre bağlı bağlı vasküler yaralanmalarda multi--disipliner yaklaşımla hipovolemik şok tedavi edilmeli, akut renal yetmezlik engellenmeli ve acil kompleks vasküler cerrahi girişimler planlanmalıdır.To evaluate the results of terror related vascular injuries and predictors of mor-- tality caused by these injuries in South--Eastern Turkey. Material and Methods: Eighty--eight patients (82 men, 24.4 8.1 years) who had vasculary trauma in terrorist attacks between ]anuary 2012--August 2015 in South--Eastern Turkey included in this retrospective study. Patients with traumatic amputations, ex-- tensive tissue losses, amputations after severe nerve damage and head injuries were excluded. Study pa-- tients were analyzed according to the mechanism and severity of injury, location of trauma, and surgical treatment options. Results: Forty-six (52.3%) patients had lower limb, 19 (21 .6%) patients had upper limb, 13 (14.8%) patients had both upper and lower limb vascular injuries. Other vascular injuries involved neck (n=3; 3.4%), thorax (n=2; 2.3%), abdomino--pelvic (n=5; 5.7%) locations. Twenty--three (26.1%) of them were caused by bullets, 54 (61.4%) by shrapnel and 11 (12.5%) by bombs and explosions. Thirty--eight (43.2%) of these patients were in hypovolemic shock at admittance. Forty patients (45.5%) had isolated arterial, 42 (47.7%) patients had both artery and vein, (6.8%) patients had isolated vein injuries. Auto-- genous grafts were used in 28 (31.8%) patients, and synthetic grafts were used in 10 (11.4%) patients. Vas-- cular ligations were performed in 18 (20.5%) patients. Seven (8%) patients had acute renal injury and 28 (31.8%) patients had wound infections postoperatively. Overall in--hospital mortality rate was 18.2% (16 patients). Hypovolemic shock (p&lt;0.0001), acute renal failure (p=0.002) and massive blood transfusion (p=0.007) were the main predictors of mortality. Conclusion: Vascular injuries in terror--related trauma victims require multidisiplinary urgent treatment of hypovolemic shock, preventive measures to avoid acute renal failure and immediate complex vascular surgery

Does On-Pump Normothermic Beating-Heart Valve Surgery with Low Tidal Volume Ventilation Protect the Lungs?

Background: Postoperative pulmonary dysfunction following cardiopulmonary bypass (CPB) usually develops secondary to the inflammatory process with contact activation, hypothermia, operative trauma, general anesthesia, atelectasis, pain, and pulmonary ischemia/reperfusion due to cross-clamping. The aim of the present study was to evaluate the effects of an on-pump, normothermic, and beating-heart technique and of low-volume ventilation on lung injury