Chronicles of Precision Medical Researchers

Knowledge and Opinions of Consultant and Resident Anesthesiologists on the Features and Use of Defibrillators and Automatic External Defibrillators: A Cross-Sectional Survey Study in Turkiye

2024-02-18T22:06:26+03:00

Abstract

Objective: When there is a rhythm like ventricular fibrillation or pulseless ventricular tachycardia, prompt and effective defibrillation is the critical intervention in cardiac arrest. Therefore, knowing what to do and being familiar with the instruments used for this purpose is vital. The present study aimed to investigate the possibility of insufficient knowledge and opinions of consultant and resident anesthesiologists about defibrillators and to put forward constructive proposals for reforming, if necessary.

Material and Methods: This cross-sectional survey study included consultant and resident anesthesiologists. We sent questionnaires to 467 anesthesiologists via e-mail. The questionnaire included demographics, working status, duration, residency institution, workplace, experience with the defibrillator and automated external defibrillator (AED), previous cardiopulmonary resuscitation (CPR) training, and technical knowledge of defibrillators &AEDs.

Results: Three hundred and forty (72.8%) anesthesiologists filled out the questionnaires. Their mean age was 38.3±8.3 years. Twenty-five percent of them were residents. Of the anesthesiologists, 325(95.6%) used a defibrillator, 129(37.9%) witnessed out-hospital cardiac arrest, 69(20.3%) used AEDs, and 216(63.5%) attended CPR courses. There are significant differences in opinions and knowledge of anesthesiologists about defibrillator/defibrillation when compared to working duration, workplace, being a consultant, and having a previous CPR course.

Conclusion: Experience and information about defibrillators among anesthesiologists seem to be lacking. Continuous retraining through the guidelines can be considered as a possible updating method.

Evaluation Of The Relationship Between Vitamin Supplement Use Levels And Diagnoses Of Patients Referred To Dermatology Outpatient Clinic

2024-03-06T15:09:19+03:00

Amaç: Bu çalışmada cilt hastalığı olan hastaların D vitamin düzeyleri ile takviye vitamin kullanımının farklı dermatolojik hastalıklar ve bu hastalıkların yol açtığı şikayetlerin üzerindeki etkisinin değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Çalışma, Temmuz- Eylül 2023 tarihleri arasında Deri ve Zührevi Hastalıkları Polikliniği’ne başvuran, 15-79 yaş aralığındaki 150 hasta üzerinde yapıldı. Tanımlayıcı ve kesitsel tipte yapılan bu çalışmada 18 sorudan oluşan bir anket uygulandı.

Bulgular: Katılımcıların yaş ortalaması 37,07±15,95 idi (min:15 yıl median:33 yıl max:79 yıl) ve bu katılımcıların %56,7’(n=85)ini kadınlar oluşturmaktaydı. Erkeklerin yaş ortalaması 35,01 ve kadınların yaş ortalaması 26,45 idi. 45 yaş üzeri hastalarda takviye ürün kullanımının diğer yaşlara göre daha az olduğu görüldü ve bunun istatistiksel olarak anlamlı olduğu saptandı(p=0,015).

Sonuç: Vitamin takviyesi ile ilgili yeni araştırmalar ortaya çıkmaya devam etmektedir ve gün geçtikçe daha önemli bir konu haline gelmektedir. Özellikle hem dermatologlar hem de aile hekimleri tarafından sıkça reçete edilen ve gerektiği durumlarda kullanılması önerilen D vitamini takviyesinin hem bizim çalışmamızda hem de daha farklı ve geniş çaplı çalışmalarda önemli olduğu gözlenmiştir.

Anahtar kelimeler: D vitamini takviyesi, cilt hastalıkları, aile hekimliği

The Effect of Homecare on Mortality in Post-operative Hip Fracture Patients

2024-02-18T21:57:53+03:00

Abstract Objectives: Hip fractures are an important cause of mortality in the geriatric population. Even if a patient’s general condition is good in the post-operative period, mortality is often observed due to complications after patient discharge. This study aimed to investigate the effect of homecare services on mortality after hip fracture surgery. Study Design: Retrospective Data Research Method: Between October 2013 and September 2018, a total of 228 patients who underwent surgery for hip fractures were retrospectively reviewed for homecare services follow up documents. Age, type of homecare service, number of homecare visits, whether the patient was healthy or exitus, and the otherwise healthy period after fracture treatment were recorded, and the relationships between these facts were statistically analyzed using the Pearson correlation method. Results: 82 (43.3%) of 189 patients who did not receive homecare services and 7 (18.9%) of 37 patients who did receive homecare services were recorded as exitus. The average number of homecare visits to patients receiving homecare services was 5.13. There is a strong correlation between the number of homecare visits and post-operative life expectancy (p< 0.01). The number of homecare visits reduced the exitus numbers significantly (p< 0.05). Both of these correlations were found to be stronger in patients younger than 65 years.

Endoscopic and histopathological findings of upper gastrointestinal tract lesions in pediatric age group

2023-12-24T18:15:17+03:00

Objective: Upper gastrointestinal (GI) tract endoscopy is a diagnostic procedure utilized to identify pathologies within this region, establish treatment plans, and determine prognoses. This procedure, commonly employed in adults, is now considered safe for use in pediatric patients. The objective of this study was to conduct a retrospective analysis of the results obtained from upper GI endoscopies performed on pediatric patients at a single center.

Methods: During the period between September 2017 and March 2020, we conducted an assessment on a total of 488 patients who were aged between 5 months and 17 years and who underwent upper GI endoscopy and biopsy at the Pediatric Gastroenterology Department of X Hospital.

Results: Over a period of 30 months, a total of 488 pediatric patients underwent upper GI endoscopy procedures, during which biopsies were obtained. The most common complaints reported were abdominal pain and retrosternal burning/bitter water in the mouth. The most frequently observed lesions during the endoscopy procedure were gastritis, duodenitis, and ulcer. Analysis of biopsy specimens revealed that chronic gastritis was the most common lesion found in the stomach, while chronic duodenitis and esophagitis were the most common lesions detected in the duodenum and esophagus, respectively. Helicobacter pylori infection was identified in 195 cases, with ulcers testing positive for H. pylori in 39.1% of these cases. The ulcers resolved after undergoing eradication treatment. Intestinal metaplasia was observed in eight patients, while gastric atrophy was found in three. Sixty-four patients were diagnosed with celiac disease, and as a result, a gluten-free diet was initiated. Additionally, Barret esophagus was detected in four patients.

Conclusion: Endoscopic procedures are becoming increasingly significant in diagnosing pediatric patients due to their ease of use under appropriate sedation and low incidence of complications. These procedures are crucial in ensuring accurate diagnosis and avoiding unnecessary treatment for children

Red Cell Distribution Width Is Related to Pulse Wave Velocity in Patients With Chronic Kidney Disease

2024-02-27T01:59:14+03:00

Giriş: Kırmızı hücre dağılım genişliği (RDW), farklı anemi türlerinin tanısında rutin olarak kullanılan bir parametredir. Son çalışmalar genel popülasyonda ve kardiyovasküler hastalığı olan hastalarda RDW'nin mortalite ile ilişkisini göstermiştir. Ancak kronik böbrek hastalığında (KBH) RDW ile ilgili çalışma sayısı yetersizdir. Kronik böbrek hastalarında RDW ile aterosklerozun habercisi olan arteriyel sertlik arasındaki ilişkiyi değerlendirdik.

Yöntemler: Bu kesitsel çalışma, Konya Eğitim ve Araştırma Hastanesi nefroloji polikliniğinde takip edilen prediyaliz hastaları ile gerçekleştirildi. Nabız dalga hızı (PWV) ve augmetasyon indeksi Mobil-O-Graph NG (İ.EM GmbH Stolberg Almanya) arteriyografi cihazı kullanılarak belirlendi. Carotis İntima Media Kalınlığı (CIMT) değerlendirildi. Hariç tutma kriterleri, koroner arter hastalığı, serebrovasküler hastalık, kanama veya malignitenin varlığıydı.

Bulgular: Toplamda 3 ila 5 arası KBH'li 259 hasta çalışmaya dahil edildi. Medyan RDW %13,8 idi. RDW değerleri ortancanın üzerinde olan hastaların karotis intima media kalınlığı, BMI, PWV ve daha düşük hemoglobin ve eGFR değerleri, RDW değerleri ortancanın altında olan hastalara göre anlamlı derecede yüksekti. RDW yaş, BMI, CIMT ve PWV ile pozitif korelasyon gösterdi ve albümin, ferritin, hemoglobin, eGFR ile negatif korelasyon gösterdi.

Sonuç: Bulgular, yüksek RDW'nin arteriyel sertlik ile pozitif yönde ilişkili olduğunu göstermektedir. RDW, kronik böbrek hastalığında subklinik aterosklerozun erken tanınmasını sağlamak için faydalı olabilir.

Understanding Parental Perspectives on Childhood Vaccines: Examining Attitudes and Behaviors of Parents with Young Children

2024-01-03T23:14:02+03:00

Abstract

Introduction

Vaccine hesitancy is a current and global problem. In order to increase social acceptance of vaccination, it is recommended to determine the local situation and propose solutions per cultural norms. Studies have shown that vaccine hesitancy is a steerable situation and that the bond of trust between the health worker and the parent increases vaccine acceptance. In our study, we aimed to examine the attitudes and behaviors of participating parents regarding childhood vaccines.

Material and Method

The study population was home-parents with children aged 0-24 months who agreed to participate by snowball sampling method. Participants completed the "Parental Attitudes Towards Childhood Vaccinations" scale (Bulun et al.) and sociodemographic data form online. An information form was sent to all participants, and informed consent was obtained.

Study permission was obtained from the Istanbul Medipol University ethics committee on 22.03.2022 with the number E-10840098-772.02-1923.

Results

A total of 138 participants were reached online. Of the parents reached, 87.76% (n:86) were mothers, and 66.33% (n:65) had one child. 95.88% (n:93) of the participants reported being married. 53.61% (n:52) of the participants had completed undergraduate education. 98 questionnaires with appropriate age groups and complete answers were evaluated. The number of participants who decided not to vaccinate was 16 (16.33%), while 10 (10%) participants stated that they postponed vaccination. 73% (n: 72) of the participants thought vaccination was more effective than natural immunization. 69.38% (n: 68) of the participants reported trusting the information they received about vaccines. Again, 69.38% (n:68) of the participants reported that they could openly discuss their concerns about vaccines with healthcare professionals. 63% of the participants stated they had no hesitation about childhood vaccines. All participants reported that they would get vaccinated when they had other children. When asked about the sources of information about childhood vaccines, 92.78% (n: 90) of the participants stated that they obtained information from healthcare professionals. In comparison, 53.61% (n: 52) of the participants reported using online sources.

Discussion/Conclusion:

Numerous studies have highlighted that vaccine ambivalence, recognized as a major global issue, can be addressed effectively through collaborative efforts with families via non-judgemental, empathic, supportive, and tailor-made family interviews with solution-oriented approaches. Our study group observed that the concerns raised align with the literature, although epidemiological studies in our country remain limited. When attempting to find scientific solutions by comprehending the family's concerns, it is crucial to reassess the situation during each interaction and persistently pursue solutions with patience, especially regarding child health and societal impacts.

Key Words: Vaccination Hesitancy, Parents, Vaccination, Trust

Comparison of clinical features and outcomes of foreign bodies in the cervical oesophagus and thoracic oesophagus treated with rigid esophagoscopy in adults: 10 years of experience.

2024-03-07T01:07:07+03:00

Aim: We aimed to compare the clinical features and outcomes of foreign bodies (FBs) in the cervical and thoracic oesophagus treated with rigid esophagoscopy in adults.

Material and Method: This single-centre study was designed as a retrospective study at a tertiary health centre between March 2010 and December 2020. The clinical records and files of patients over 18 treated with rigid esophagoscopy due to oesophageal FBs were reviewed. The cases were divided into the cervical and thoracic oesophagus groups, according to where FBS were stuck. Outcomes were evaluated as complications and mortality occurring in the first 30 days after FB intake. Since there was no mortality in any patient, outcomes were only complications.

Results: Of the 194 patients, 119 (61.3) were female, and the mean age was 48.45±16.10 years. The most common FB localisation was the cervical oesophagus, with 88.7%, and the remainings at the thoracic oesophagus. The morbidity rate of the study was 4.6%, with no mortality. In comparing the groups, non-bone FBs were detected more frequently in the thoracic oesophagus group (p=0.036). Dysphagia was common in FBs in the cervical oesophagus group, and chest pain in FBs in the thoracic oesophagus group (p<0.001). Length of hospital stay (p=0.018), morbidity rate (p=0.011), and additional surgical intervention (p=0.034) were higher in patients with a FB in the thoracic oesophagus.

Conclusion: FBs in the thoracic oesophagus are challenging to manage due to high morbidity rates, perforation rates, and hospital stays.

Retrospective Analysis of Pediatric Patients with Vitamin B12 Deficiency

2024-03-07T20:21:43+03:00

Background/Aims: Vitamin B12 (cobalamin) is an important vitamin that plays a role in vital events. This study examines and analyzes patients with vitamin B12 deficiency in a specific region in a wide range of age groups, including infants, and different etiological data like absorption disorders.

Methods: 275 patients with vitamin B12 deficiency aged 0-18 years who were followed and treated in the Hematology outpatient clinic at a 3rd level training and research hospital during 3 years, were analyzed retrospectively.

Results: 120 (43.6%) patients were female of a total of 275 patients with vitamin B12 deficiency. The mean vitamin B12 level was 159.78±33.98 pg/ ml, the mean hemoglobin level was 11.47±2.27 g/dL, and the MCV was 81.51±10.37 fL. 100 patients were under one year of age. 22% of mothers of the infants had vitamin B12 deficiency, while 20.9% of mothers had levels of vitamin B12 that can be presumed border value. 32% of patients had iron deficiency. Another leading factor for vitamin B12 deficiency was Helicobacter Pylori(HP) infection and the frequency was 10.2%. The 87% of causes that evoked vitamin B12 deficiency were nutritional. The expected increment in vitamin B12 and complete blood count values were observed after treatment.

Conclusions: Vitamin B12 deficiency becomes widespread in the first two years of life and infants are at risk. Another important factor is HP. Eradication of this infection could treat vitamin B12 deficiency.

The Multi-Dimensional Effect of COVID-19 Infection on Pregnancy Process and Mode of Delivery Investigation

2024-02-27T01:52:43+03:00

Background: The aim of this study was to investigate the obstetric and neonatal outcomes of pregnant women with COVID-19 infection.

Material and Method: In this study, pregnant women with COVID-19 infection who applied to Lokman Hekim University Ankara Hospital between 01 July, 2021, and 31 December, 2021, in what week and how the pregnancy period ended, whether they received treatment for COVID-19 infection, which drugs they used, age, gravida, parity, hemogram, liver and kidney function tests, fasting blood sugar levels, vitamin D levels, thyroid function tests, Blood groups, intrauterine sex, abortion, premature birth, premature rupture of membranes, fetal weight, cesarean indications for those who had a cesarean section, and whether the babies stayed in the neonatal intensive care unit were examined.

Results: 82 pregnant patients with COVID-19 infection were included in the study. While the average age of the patients was 29.62±4.96 years, the gestational age at which they had COVID-19 was 21.41±9.54, HB 10.62±1.49, HCT 30.78±6.88, PLT 195.32±76.90, birth week 35±8.70 and birth weight 3295.70±517.41. While the gravida of 65.9% is in the 1-2 group, 34.1% is in the 3-5 group. 52.4% have parity. The parity average of those who have parity. It is 1.47±0.59. 23.2% had abortion. The average abortion rate for those who had an abortion was 1.26±0.56. All of them do not have intaruterinex. The delivery method for 32.9% is vaginal birth, while 31.7% is cesarean section. .72% do not have EMR.

Conclusion: In this study, there was no maternal death due to COVID-19 infection, but the need for neonatal intensive care was observed to increase. In conclusion; considering all the data we obtained from the study, we think that COVID-19 infection during pregnancy affects obstetric and neonatal outcomes.

Diagnosis and Treatment Results of Patients with Nasolabial Cysts

2024-03-01T22:35:43+03:00

Objective: Nasolabial cysts are benign nonodentigenic cysts that occur in the anterior maxillary area. The standard treatment is defined as cyst excision via inraoral sublabial approach. We aimed to review the patients who had nasolabial cysts and underwent surgery in the light of the literature.

Material and method: Nine patients who underwent surgery for nasolabial cyst between October 2014 and January 2014 were included in the study. All patients underwent computed tomography for the size and neighborhood of the cyst. All patients underwent cyst excision via inraoral sublabial approach under general anesthesia. Patients were followed up for 12 months for recurrence.

Results: Seven of the patients were female and two were male with a mean age of 42.22 (±11.81) years. All patients complained of swelling causing facial asymmetry. The size of the smallest cyst was 18 mm and the diameter of the largest cyst was 40 mm (mean 29±8.84). Paranasal computed tomographs in the coronal plane showed smooth-surfaced cystic lesions without erosion of the bones. No recurrence was observed at a mean follow-up of 6.7 (±2.99) months.

Conclusion: Although nasolabial cysts are rare, they should be considered in the differential diagnosis of patients presenting with a mass in the nasal vestibule causing facial asymmetry.