The effect of antimicrobial policy implementation on carbapenem resistance: A university hospital experience

Objective: The resistance of Gram-negative bacteria to antibiotics is a global issue that leads to increased mortality and treatment costs. The aim of this study is to see how a newly formed carbapenem control team affected the prevalence of carbapenem-resistant Gram-negative rods and antibiotic consumption expenses in 2017 compared to the year before.Methods: The rate of carbapenem antibiotic usage in Intensive Care Units and Bone Marrow Transplantation services, as well as the findings of culture materials obtained from various body parts of the same patients, between January 1, 2016, and December 31, 2017 were assessed.Results: While there was an ordinary restriction on carbapenem consumption in 2016, carbapenem consumption has been more restricted in 2017. The carbapenem-resistant Gram-negative bacteria patterns of culture materials are examined and compared with Defined Daily Dose data of carbapenems. After the restriction, a significant decrease in the consumption of carbapenems was detected. The decline in carbapenem-resistant Gram-negative bacteria and decreasing antibiotic consumption were found to have a moderately positive correlation (r=0.641, p=0.02). A 60.9% decrease was observed in carbapenem costs after carbapenem restriction, on the other hand, an increase in other unrestricted antibiotics was apparent.Conclusion: Antimicrobial restriction policies can help minimize the rate of carbapenem-resistant Gram-negative rods, which is a serious problem in healthcare. We demonstrated that a decrease in carbapenem-resistant Gram-negative rods isolation rates can lead to a decrease in healthcare-associated infections. Although there is no decrease in the direct antibiotics cost, a drop in carbapenem-resistant may lower the expenses of drastic consequences of infections with carbapenem-resistant and its cost. we can conclude that the Antibiotic Control Policy should be modified based on this new information

Mapping the intersections of sustainability, circular economy, and consumer behavior: A bibliometric review on food waste

The topic of food waste, which is considered to be an important focus within the framework of the Sustainable Development Goals of the United Nations (UN), has created a wide academic research area as well as guiding the policies implemented on this issue. Many researchers closely interested in the topic have produced academic studies that address food waste from various perspectives. Food waste at the consumer level is an important issue in terms of protecting the natural environment and using resources efficiently, considering future generations. This study aims to evaluate academic studies in this field and figure out the recent trends. The method utilized for this aim is selected to be bibliometric analysis. The results of the study, clarifying the trend topics, relevant authors, countries, sources, motor, niche and emerging themes regarding the field are expected to be useful for policymakers, practitioners, and consumers

Clinical outcomes and treatment patterns of primary central nervous system lymphoma: Multicenter retrospective analysis

Objectives: Primary central nervous system lymphoma (PCNSL) is a rare malignant disease with poor prognosis. Its low incidence leads to challenges in decision-making for treatment. As a matter of fact, there is still no consensus on the appropriate treatment modalities. In this context, the objective of this study is to investigate and comparatively assess the efficacies of several treatment modalities in the treatment of PCNSL. Methods: Thirty-four patients diagnosed with PCNSL at 5 different hematology centers between 2007 and 2021 were included in the study. Patients’ data from all five centers were collected retrospectively. Since ibrutinib is not approved for this indication in Turkey, consent for off-label use of ibrutinib is obtained from each patient. Ethics committee ap-proval was obtained on June 9, 2021 with decision number 2021/18-05. Results: The median age of the patients was 59 (min.: 22, max.: 78) years. The male-to-female ratio was 1.26/1. Nineteen (55.9%) patients had Eastern Cooperative Oncology Group (ECOG) performance score of ≥2. Fifteen (44.1%) patients had normal lactate dehydrogenase (LDH) levels and only 14.7% of the patients had B symptoms at the time of diagnosis. Magnetic resonance imaging (MRI) revealed a single mass lesion in 14 (41.2%) patients. As an induction therapy, meth-otrexate-based regimen was administered in 29 (85.3%) patients. Only 14 of the 34 patients received 4 or more cycles of high-dose methotrexate (MTX). About 32.4% of the patients received radiation therapy (RT) during follow-up as a part of induction therapy. Five patients received only RT due to poor performance status. Ibrutinib was administered in 5 patients for refractory disease. It was determined that four or more cycles of MTX treatment increased progression-free survival (PFS) (p=0.031) and overall survival (OS) (p=0.012). Moreover, RT improved PFS (p=0.023). Considering that the complete response achieved by induction therapy influences long-term survival, achievement of the best response to the treatment regimens administered in combination with new agents may prolong survival (PFS: p=0.01, OS: p=0.023). Conclusion: The findings of this study indicate that the initial response to treatment is crucial. Additionally, it was found that high-dose MTX treatment should be administered for 4 cycles or more in order to achieve the best results. Furthermore, it was determined that ibrutinib monotherapy was well-tolerated in our patients with relapsed/refractory disease, with excellent clinical benefits. In conclusion, a combination therapy consisting of high-dose MTX, ibrutinib, and rituximab appears to be a promising initial treatment approach in appropriate patients

Owen Wright, Music Theory in Mamluk Cairo, The Ġāyat al-Maṭlūb fῑ ‘Ilm al-Adwār wa-’l-Ḍurūb by Ibn Kurr, SOAS Musicology Series

Owen Wright tarafından incelenen Ğayetü’l-Matlûb fî İlm el-Edvâr ve ed-Durûb adlı eser, Ebû Abdullah Şemseddin Muhammed b. İsa b. Hasan b. Kurr el-Bağdadî (bundan sonra İbn Kurr) tarafından yazılmıştır. Yazarın ifadesiyle bu kitap, “XIV. yüzyılın ilk yarısında Kahire’de müzik biliminin temsilcisi olarak değerlendirilen tek teorik metindir” (sayfa 1). Yazarımız Wright, Memlûk dönemi müzikologlarından İbn Kurr’un söz konusu eserinin; ritmik teorileri, biçimsel yapıları ve fasıla analizleri hakkında bilgi vermekle beraber, özellikle tetrakort türleri ve ölçümlerini öne çıkaran geleneksel Arap kuramsal çalışmalarından (sistematik metinlerden) nasıl farklılaştığını açıklamalarla ortaya koyar. Böylece eser, İbn Kurr’un farklılığını ortaya koyarken aynı zamanda Mısır uygulamalarını yansıtan özgün materyaller hakkında da bilgi verir. Wright, el-Kindî’den İbn Kurr’a Arap müzik teorisini genel hatlarıyla açıklar. Özellikle bölgesel farklılıklar olup olmadığı ve 1258 Moğol baskınından sonra Bağdatlı müzisyenlerin durumları ve yayılmaları üzerinde durarak Arap müzik kuramı tarihini çözer

The Establishment of Ramadan Principality

Ramadan Principality is a Turkish state which was established in Cukurova, having Adana as center, in 14th century. Uc Ok Turcoman, constituting this state, were Turkish raider lords who served Mamluks from the beginning of the establishment. They showed maximum effort during the campaigns by Mamluks onto the Armenians living in Cukurova, and after the collapse of this state, they secure their position in that region as being subject to Mamluks. Insomuch that Ramazan Beg, signified as “Turcoman Emir”, was accommodated by Mamluks Sultan in Cario, and dressed Khalat. Mamluks attached great importance to the region forming the north border in which Ramadanids was established. They formed three regentships named as Ayas, Tarsus and Sis and constantly supervised these three cities by sending regents from the capital city, Cairo. Despite the attitude of Mamluks, Ibrahim Beg, successor of Ramadan, who took courage from the achievements of Dulkadirids, allying with them revolted against Mamluks, but this revolt did not produce result and moreover cost his life. Since the histories of Ramadan and Dulkadir Principalities, established as subjected to Mamluks in close regions, crossed with each other’s frequently, activities of Dulkadirids will also be mentioned where relevant. But what we know about Turcoman is limited to the information given by Mamluks’ chronicles

Çukurova in Mamluks Period

Memlûkler'in Çukurova bölgesi ile ilgilenmeleri Sultan Baybars döneminde başlamıştır. Çukurova'da yerleşik Küçük Ermenistan Krallığı Memlûkler için ciddî bir dış tehdid idi. Nitekim bu krallık, Haçlılar ve Moğollarla işbirliği halinde olup her fırsatta Memlûk topraklarına saldırıyordu. Bu sebeple Memlûkler gerek askerî ve siyasî gerekse iktisadî saikler sebebiyle bölgeye defalarca sefer düzenlenmişlerdir. Bu Seferler sırasında Adana, Tarsus, Ayas gibi önemli kaleler Türkmenlerin de yardımı ile bir bir ele geçirilmiştir. Nihayet 1375 yılında başkent Sis ele geçirilerek Küçük Ermenistan Krallığı'na son verilmiştir. Memlûkler, Küçük Ermenistan Krallığı'nı ortadan kaldırdıktan sonra, doğrudan Kahire'den atanan Ayas, Tarsus ve Adana nâibleri eliyle bölgede nüfûzlarını tesis etmişlerdir. Ancak Çukurova'da yerleşik ve Memlûklere tâbi Ramazanoğulları beylerinin isyanları ve Çukurova'ya mücâvir Karamanoğulları ve Dulkadiroğulları Beyliklerinin bölgeye yaptıkları saldırılar, Memlûkleri bir hayli meşgul etmiştir. Sultan Barsbay zamanından itibaren Çukurova'da kurulan güçlü otorite, hızla yükselen Osmanlı Devleti'nin Çukurova'ya göz dikmesi ile sarsılmıştır. Osmanlılar bölge üzerinde söz sahibi olmak istedikleri için Türkmenlerle yakın münâsebetler kurmuşlar ve bu sebeple Memlûklerle çatışmışlardır. Bu çatışmalar Memlûkler ve Osmanlılar arasında uzun süren savaşlara sebep olmuş, Memlûkler bu savaşlardan ekseriyetle galip ayrılmış olsalar da iktisadî yönden büyük darbe almışlardır. İki devlet arasında düşmanca sürdürülegelen bu münâsebetler, Fâtih'in oğlu II. Bâyezid zamanında dostâne devam etse de ondan sonra hükümdar olan oğlu Yavuz Sultan Selim zamanında yerini düşmanlığa bırakmıştır. Yavuz, Dulkadiroğulları Beyliği'ni ele geçirmiş, Safevîleri mağlub etmiş ve Anadolu siyasî birliğini kurmuştur. Ardından Memlûk toprakları üzerine sefere çıkmıştır. 1516 yılında Merc-i Dâbık ve 1517 yılındaki er-Reydâniyye Savaşlarında Memlûk Devleti sona ermiş ve toprakları kâmilen Osmanlı Devleti'nin eline geçmiştir. Neticede Suriye, Mısır, Hicaz ve bu meyanda Çukurova Bölgesi de Osmanlı hâkimiyetine girmiştir.Relation of Mamluks with Cukurova region had began from the period of Sultan Baibars. Cilicia Armenian Kingdom was a serious foreign threat for Mamluks. Thus the Kingdom was in contact with the crusaders and Mongols, and it was attacking to Mamluk's lands in all oppurtunity. Therefor Mamluks had attacked to the region time after time becauseof the military and political factors and also economical needs. During the attacks, important castles as Adana, Tarsus, Ayas had been captured with the Turkmans supports. At last Mamluks had captured the capital city Sis, and put an end to Cilicia Armenian Kingdom in 1375. Mamluks had established their power on the region through the Adana, Tarsus and Ayas regent who were appointed from Cairo directly after the Cilicia Armenian Kingdom had came an end. But revols of Ramazanogulları (depended to Mamluks and settled in Cukurova) and attacks of Dulkadirogulları and Karamanogulları (settled neighborig to Cukurova) to the region had kept busy Mamluks a lot. The stick authotiry that had been established since the period of Sultan Barsbay was shaken by Ottomans (rised from the east rapidly). Because Ottomans had coveted to Cukurova. Since Ottomans wanted to be dominate on the region friendly relations had been established with Turkmens so Ottomans had clashed with Mamluks. The clashes had caused long time wars between Mamluks and Ottomans. Mamluks had came out Victorious from most of the wars but they had had big shocks economicaly. Even if hostality beetwen two states went on friendly during the period of II. Beyazit after Fatih, left it's place hostality again at the period of Yavuz Sultan Selim. Yavuz had fixed his direction to the east, captured Dulkadirogulları beat Safewi and established political unity in Anatolia. After that he had gone to war on the lands of Mamluks. He had beat Mamluks at the battle fields of Mercidabık in 1516 and Reydaniye in 1517. Mamluk state had come an end and lands of the state had passed to Ottomans. At last Syria, Egypt, Hicaz and also Cukurova region had passed to Ottoman reign

Mısır’a Uygulanan Haçlı Ekonomik Ambargosu Karşısında Çerkes Memlûkleri

Çeviren : Fatma Akkuş YiğitBu çalışma, Çerkes Memlûk Devleti’ni1 zayıflatmak için çeşitli yöntemler uygulayan Haçlı kuvvetleri karşısında ayakta kalan Çerkes Memlûk Devleti tarihinin önemli bir yönünü aydınlatmayı amaçlar. Kullanılan en bariz yöntem, Memlûkler üzerinde Haçlı ekonomik ambargosunun dayatılması olmuştur

Armenian – Mamluks Relations

Armenians, were able to establish a state on their behalf in consequence of the Crusades and do not miss the great historical opportunity, in Cilicia (Çukurova). Armenian Kingdom of Cilicia in the vicinity of Cukurova have been fed with the support of the Crusader States and Cyprus, and especially after being subjected to the Il-Khans in their regions had reached a certain strength. However, the Armenians, they apply their attacks and with trade embargoes, they were made themselves the target of the Mamluk State. By the capacity of a single state to stop the Mongols in the region, proved the power of the Mamluks, and it was not possible to remain silent this situation. From 1260, the Armenian capital, Sis, reduced date that until 1375 the period of time, as a result of political, struggle, almost continuous-time war between Mamluks and the Armenians, Mamluk had been the empire continue to existing side, In this study, 115 years of laying down the Mamluk-Armenian relations, will be presented with detailed information about the subject

Psychiatric factors associated with normal coronary angiography among angina like chest pain patients

Purpose: This psychiatric and cardiological study aim to compared patients with normal coronary angiography and coronary hearth disease patients with respect to sociodemografic features, psychiatric comorbidities, anxiety and depression level, mental and physical quality of life. We also determined associated factors with normal coronary patients. Material and Methods: Eighty-seven patients with normal coronary angiography (NCA) and thirty-one coronary artery disease (CAD) patients were included the study after coronary angiography. Groups were compared with regard to sociodemographic characteristics, comorbid psychiatric disorders and Beck Anxiety (BAI) and Beck Depression (BDI) Inventories and Health Related Quality of Life (SF-36) scale scores. Results: There was statistically significant difference between the groups in terms of age, gender, marital status, occupation, family history for psychiatric disorders. Mental disorders were found in 82.8% of the patients with NCA and in 48.1% of the patients with angiographic coronary disease. The patients with NCA have a higher prevalence of psychiatric comorbidity, family history of psychiatric disorder, are relatively young, female and unmarried. There was significant difference in pain, general health and social function subgroups of quality of life scale between groups. The impact of mental and physical quality of life with NCA patients were as significant as those with CAD. Conclusion: The present study revealed that prevalence of psychiatric co morbidities is high and impairment in quality of life is notable in the patients with NCA patients

Health Promotion in Preschool Children

The key for individuals to live in health and well-being is the development of healthy living habits. In order for a healthy life habit to be formed, the relevant behaviors must be acquired in the preschool period. This study aimed to promote health knowledge among children attending preschool through health education. The study was designed using the qualitative case study design. The Personal Information Form and Health Hunter Children Follow Health Interview Form were used as data collection tools in the study. Health education activities were implemented in order to improve children’s knowledge about health. Activities consisted of physical activity, personal hygiene, injury prevention, sleeping habits, healthy nutrition, healthy life, and paramedic and treatment services categories. Activities were applied to children twice a week for eight weeks. As a result of the study, an improvement was observed in children’s knowledge about health. The answers given by the children before and after the Health Education Activities were collected in the categories of nutrition, safe life, illness status, well-being, hygiene, environmental health, and sports