Contraception knowledge status of marriage applicants couples in the Van city

This study was performed to determine ofcontraception knowledge levels and planning contraceptionmethods after marriage that couples have applied tofamily planning center in the Van city.Methods: Study has planned as descriptive manner. Thisstudy was performed on 255 couples who have appliedfor official wedding procedure to Van maternal and childhealth and family planning center between September2010 - January 2011. Participants were determined on avoluntary basis. Questionnaires were filled out by familymedicine face to face with couples.Results: Totally, 21.3% percent of women, 23.5% percentof men have primary school degree. 18% of women,93.4% of men have a profession. 12.1% percent of womenand 12.9% percent of men does not have any knowledgeabout contraceptive and 43% of couples do not consideruse any contraceptive method after marriage. The resultshas shown that when evaluate the couples, in terms ofthe distribution of contraception information, the coupleshave more information about condoms, pills, coil, injectionand withdraw methods then tube ligation, implants,spermicides, vasectomy and the calendar methodsConclusion: Van region has a low socio-economic status.The couples should be informed about family planningbefore marriage, to talk about advantages of collaborationbetween the couples about birth control methodchoice.Key words: Reproductive health, family planning, contraceptio

The potential role of BMI, plasma leptin, nesfatin-1 and ghrelin levels in the early detection of pancreatic necrosis and severe acute pancreatitis: A prospective cohort study

AbstractBackground: Early prediction of disease severity in acute pancreatitis (AP) is crucial. The aim of this study was to investigate the body-mass index (BMI), plasma leptin, nesfatin-1 and ghrelin levels as potential markers predicting peripancreatic necrosis and severity in acute pancreatitis. Methods: In the study period, 97 consecutive patients with AP were prospectively analysed. Severe AP was defined according to the Atlanta Criteria. BMI was also calculated. To measure plasma Leptin, Nesfatin-1 and Ghrelin concentrations, the blood samples were obtained from patients within 24 hours of admission. Results: Out of 97 patients, 92(70 females, 22 males) were considered eligible for analysis. Of the 92 patients, 30 patients (32.6%) were assessed as severe pancreatitis. BMI and leptin levels were significantly higher in patients with severe pancreatitis. The pooled sensitivity and specificity of BMI as a predictor for the development of pancreatic necrosis were 0.90(95%CI = 0.56–0.99) and 0.70(95%CI = 0.58–0.79), respectively; with an overall area under curve value of 0.78.The pooled sensitivity and specificity of leptin levels as a predictor for development of pancreatic necrosis were 1(95%CI = 0.69–1) and 0.73(95%CI = 0.62–0.82),respectively; with an overall area under curve value of 0.82.Nesfatin-1 and ghrelin levels showed no significant difference in patients with mild pancreatitis (6.97 ± 0.84 ng/ml and 2.3(1.0–9.9);respectively) and severe pancreatitis (6.74 ± 0.65 ng/ml and 2.0(1.9–9.9); respectively) (p = 0.1923 and 0.8531;respectively). Conclusion: BMI and plasma leptin levels both were correlated with the severity of pancreatitis. Leptin levels showed better area under the curve, sensitivity and specificity values compared to BMI in prediction of pancreatic necrosis.Nesfatin-1 and ghrelin levels were not found to be predictors of the severity of disease

Severity and Management of patients with Snake and Scorpion Envenomation Admitted to an Intensive Care Unit in Southeastern Turkey: A retrospective study

Background: Snake and scorpion envenomation is a common public health problem in many regions of the world. Life-threatening emergencies may occur in patients with snake and scorpion envenomation; therefore, these patients may be required intensive care unit (ICU) follow-up. Our objective was to present the demographic and clinical characteristics, treatment modalities and short term outcomes of patients with snake and scorpion envenomation who followed up in our tertiary hospital ICU. Methods: Patient records were retrospectively searched and snake or scorpion envenomation patients with ICU stay were identified with relevant keywords and ICD-10 codes between January 2010 and September 2019. All cases with ICU stay were included for study analysis, regardless of patient age. Scorpion and snake envenomation managed in outpatient clinic were excluded from our data. Poisoning severity score (PSS) system was used to present signs and symptoms and PSS was calculated. Primary and critical care treatment modalities were identified and analyzed. Results: Forty patients (25 with snake bites [62.5%] and 15 with scorpion sting [37.5%]) were included in this retrospective study. Local and systemic effects have been reported in 33 (82.5%) and in 27 patients (67.5%), respectively. Majority of patients suffered from pain or disturbances in sensory neural, hematological, cardiovascular or metabolic systems. Median PSS was 2 (0-4) and median length of stay in ICU was 2 days (1-12). Mortality rate was 2.5%. Antivenom immunoglobulins (n=32, %80.0), systemic antibacterial agents (n=24, 60%), and paracetamol (n=21, 52.5%) were the most common systemically administered treatments. Surgical interventions were performed in 4 patients (10%) Conclusions: We reported that snake and scorpion envenomation were mostly admitted to the ICU with local and/or systemic symptoms for advanced monitoring and observation. Although life treating emergencies and mortality was uncommon in our study, we think that these patients should be closely followed up in ICU

The Experience of Ibrutinib in Chronic Graft-Versus-Host Disease in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: Single Center Experience

Introduction:Chronic graft-versus host disease (GVHD) is a serious complication that develops in 35-50% of patients in the late period after allogeneic hematopoetic stem cell transplantation. About half of the patients are resistant to corticosteroids, which is the first-line treatment of chronic GVHD, and therefore new treatment options that can be effective in chronic GVHD are needed. In the present study, we aimed to share our experience with the use of ibrutinib therapy in patients with steroid-resistant chronic GVHD who have previously received multiple lines of systemic therapy.Methods:The characteristics and clinical outcomes of steroid-resistant chronic patients with GVHD receiving ibrutinib were retrospectively reviewed.Results:A total of 10 steroid resi-stant chronic patients with GVHD who received ibrutinib was included. While 50% of the patients had more than one organ involvement, 50% had a single organ involvement. The most commonly affected organs were the skin and liver. The patients received a median of three lines of systemic therapy before ibrutinib. After a median of 210 days of ibrutinib usage, the complete response rate of patients was 40% and the partial response rate was 40%. Corticosteroids were completely discontinued in 30% of patients after ibrutinib were initiated. Before ibrutinib, patients were given a median of 0.3 mg/kg methylprednisolone. The median methylprednisolone dose after ibrutinib was 0.03 mg/kg.Conclusion:Ibrutinib therapy causes a quite high overall response in steroid resistant chronic patients with GVHD and appears to be a good option in these patients

The Ki-67 proliferation index predicts recurrence-free survival in patients with dermatofibrosarcoma protuberans

Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma that originates from the dermis or subcutaneous tissue in the skin. While its prognosis is generally favorable, disease recurrence is relatively frequent. Because morbidity after repeated surgery may be significant, an optimized prediction of recurrence-free survival (RFS) has the potential to improve current management strategies. The purpose of this study was to investigate the prognostic value of the Ki-67 proliferation index with respect to RFS in patients with DFSP. We retrospectively analyzed data from 45 patients with DFSP. We calculated the Ki-67 proliferation index as the percentage of immunostained nuclei among the total number of tumor cell nuclei regardless of the intensity of immunostaining. We constructed univariate and multivariate Cox proportional hazards regression models to identify predictors of RFS. Among the 45 patients included in the study, 8 developed local recurrences and 2 had lung metastases (median follow-up: 95.0 months; range: 5.2−412.4 months). The RFS rates at 60, 120, and 240 months of follow-up were 83.8%, 76.2%, and 65.3%, respectively. The median Ki-67 proliferation index was 14%. Notably, we identified the Ki-67 proliferation index as the only independent predictor for RFS in multivariate Cox proportional hazards regression analysis (hazard ratio = 1.106, 95% confidence interval = 1.019−1.200, p = 0.016). In summary, our results highlight the potential usefulness of the Ki-67 proliferation index for facilitating the identification of patients with DFSP at higher risk of developing disease recurrences

The impact of Ki-67 index, squamous differentiation, and several clinicopathologic parameters on the recurrence of low and intermediate-risk endometrial cancer

Endometrial endometrioid carcinoma (EEC) represents approximately 75-80% of endometrial carcinoma cases. Three hundred and thirty-six patients with EEC followed-up in the authors’ medical center between 2010 and 2018 were included in our study. Two hundred and seventy-two low and intermediate EEC patients were identified using the European Society for Medical Oncology criteria and confirmed by histopathological examination. Recurrence was reported in 17 of these patients. The study group consisted of patients with relapse. A control group of 51 patients was formed at a ratio of 3:1 according to age, stage, and grade, similar to that in the study group. Of the 17 patients with recurrent disease, 13 patients (76.5%) were Stage 1A, and 4 patients (23.5%) were Stage 1B. No significant difference was found in age, stage, and grade between the case and control groups (p > 0.05). Body mass index, parity, tumor size, lower uterine segment involvement, SqD, and Ki-67 index with p<0.25 in the univariate logistic regression analysis were included in the multivariate analysis. Ki-67 was statistically significant in multivariate analysis (p = 0.018); however, there was no statistical significance in SqD and other parameters. Our data suggest that the Ki-67 index rather than SqD needs to be assessed for recurrence in patients with low- and intermediate-risk EEC

The relationship between religious programs broadcast on television and university students' religious attitudes and behaviors: a sample in Adana.

TEZ10374Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 2016.Kaynakça (s. 52-54) var.xi, 62 s. : tablo ; 29 cm.Din kavramı, sosyal bilimlerin başlangıcından itibaren sosyal bilimciler tarafından pek çok farklı bakış açısıyla çalışılan eski -önemli bir kavram olup, din kurumu da en temel toplumsal kurumlardan birisidir. Din olgusunun üç temel üzerinde yapılandığını söylemek mümkündür; inanç, ibadet ve ahlak. Bu üç temel ile ilgili çok farklı unsurlar etkili olabilmektedir. Aile, din eğitimi veren okullar-kurumlar, akraba çevresi, arkadaş grupları gibi unsurların yanı sıra, son yıllarda televizyon kanallarında yayınlanan dini programlar da dini tutum ve davranışlar konusunda yadsınamaz bir işlevi üstlenmişlerdir. Ülkemizde son yıllarda bu tür programların sayısının artması, insanların dini programları izlemeyi tercih ettikleri gerçeğini gözler önüne sermektedir. Din konusunda televizyonun bir etkisi olup olmadığı, etkisi var ise ne kadar etkili olduğu noktası da araştırmamızın temelini oluşturmaktadır. Konu sınırlandırılması bakımından televizyon kanallarındaki dini programların üniversite gençliğine etkisini araştırmakla, araştırmamızın sonucunda daha sağlıklı ve işlevsel bilgiler elde edilmiştir. Bu amaçla araştırmamızda Çukurova Üniversitesi Balcalı Kampüsü’nde Lisans eğitimi veren Fakültelerde öğrenim gören 440 öğrenciye anket uygulanmıştır. Araştırma sonucunda, dini programları izleme durumu ve sıklığı ile üniversite gençliğinin din tutum ve davranışları arasında anlamlı ilişkiler olduğu istatistiksel olarak tespit edilmiştir. Elde edilen bulgular, televizyonlarda yayınlanan dini programların üniversite öğrencilerinin dini tutum ve davranışlarını değiştirdiği ve dini bilgilerini arttırdığı sonucuna ulaşmamızı sağlamıştır.The concept of religion is an old-important concept that has been studied by social scientists with many different perspectives since the beginning of social sciences, and religion is one of the most fundamental social institutions. The phenomenon of religion is considered to be constructed on three bases; faith, worship and morality. Very different elements in relation these three bases can be effective. Beside family, religion education schools, institutions, relatives, and friends groups, religious programs broadcast on television channels in recent years have played an undeniable role in religious attitudes and behaviors. The increase in the number of such programs in our country in recent years reveals the fact that people prefer watching religious programs. The basis of our study is to identify whether, or to what extent, television has effects on religion. As to the limitation of topic, more healthy and functional information has been obtained in our study by investigating the effect of religious programs broadcast on television channels on young university students. For this purpose, 440 student questionnaires were administered to the students who were enrolled in the undergraduate faculties at Çukurova University Balcalı Campus. Results of the study show that there is a statistically significant relationship between the state and frequency of watching religious programs and the religious attitudes and behaviors of university students. Findings indicate that religious programs broadcast on television change the religious attitudes and behaviors of university students and increase their religious knowledge.Bu çalışma Ç.Ü. Bilimsel Araştırma Projeleri Birimi tarafından desteklenmiştir. Proje No: İF2014YL1

SHIFTING PARADIGMS: EXPLORING ENARODUSTAT FOR ANEMIA IN CHRONIC KIDNEY DISEASE IN A META ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Objective: Anemia commonly accompanies chronic kidney disease (CKD). Erythropoiesis-stimulating agents (ESAs), such as darbepoetin, are initiated for anemia in CKD. Additionally, hypoxia-inducible factor (HIF) prolyl hydroxylase inhibitors have demonstrated efficacy in treating CKD-associated anemia. This meta-analysis aims to compare the efficacy, safety, and tolerability of enarodustat in anemic CKD patients.Case report Methodology: A systematic search of Cochrane CENTRAL, Ovid Medline R, PubMed, and Web of Science databases up to March 1, 2024, was conducted. Randomized controlled trials (RCTs) directly comparing enarodustat with darbepoetin were included. Data from four unique RCTs comprising an inverse variance-weighted random-effects model were utilized for the main analysis. Primary efficacy outcome measures included hemoglobin (Hb) change at weeks 4-6 and during follow-up, while primary safety outcomes focused on serious adverse events (SAEs). Subgroup analyses were performed based on dialysis status and prior use of ESA for the primary outcome. Results: Four RCTs with 7 reports involving 586 patients were included in the main analysis. Enarodustat demonstrated superiority to control in terms of change in Hb levels at week 4-6 (RR 0.76, 95% CI 0.02 to 1.50, I2=96%, p=0.04) but non-inferiority during follow-up (MD 0.66, 95% CI -0.22 to 1.53, I2=91%, p=0.14). Enarodustat exhibited comparable effects for safety and tolerability parameters such as SAEs (RR 1.17, 95% CI 0.72 to 1.91, I2=0%, p=0.52), any adverse events (RR 0.95, 95% CI 0.82 to 1.08), any adverse events leading to discontinuation (RR 0.90, 95% CI 0.37 to 2.20), diarrhea (RR 1.50, 95% CI 0.05 to 43.15), hypertension (RR 0.89, 95% CI 0.43 to 1.84), and all-cause mortality (RR 0.63, 95% CI 0.08 to 5.08). Subgroup analysis by dialysis status revealed nonsignificant differences for change in Hb levels at week 4-6 and during follow-up, but comparator-based subgroup analysis demonstrated a significant difference only when comparing to placebo at week 4-6. Conclusion: Enarodustat exhibits promise as a treatment option for anemia associated with CKD, demonstrating superiority to control in terms of Hb change at week 4-6 and non-inferiority during follow-up. Moreover, it demonstrates comparable safety and tolerability profiles to darbepoetin, making it a potential alternative in the management of CKD-related anemia

Postmenopausal osteoporosis

Throughout their life, women pass through various stages such as adolescence, reproduction, climacteric states and ageing; each of these periods has its specific physiological, psychological and social problems. Postmenopausal osteoporosis which is one of the health problems of climacteric period is the most important health problem. Osteoporosis is a skeletal system disease that increases the propensity to bone fractures related to the decrease in bone mass. According to the WHO criteria, osteoporosis is defined as a BMD that lies 2.5 standard deviations or more below the average value for young healthy women (a T-score of <−2.5 SD). The World Health Organization states that throughout the world, over 200 million people experience bone mineral density loss and approximately 40% of the affected people are women at the age of 50 or over. In the WHO Study Group meeting on Assessment of fracture risk and its application to screening for postmenopausal osteoporosis, osteoporosis has been recognized as an established and well-defined disease that affects more than 75 million people in the United States, Europe and Japan. Osteoporosis causes more than 8.9 million fractures annually worldwide, of which more than 4.5 million occur in the Americas and Europe. Osteoporosis is not only a major cause of fractures, it also ranks high among diseases that cause people to become bedridden with serious complications. These complicationsmay be life threatening in elderly people. As a result, the purposes should involve preventing fractures in postmenopausal osteoporosis with medical therapy approaches, improving symptoms related to the disease, and increasing bone mineral density and quality of life. In addition to the physiological problems of the women with postmenopausal osteoporosis, it is important to keep in mind that the women should be evaluated as a whole with their psychosocial problems