Single Port vs. Four Port Cholecystectomy--Randomized Trial on Quality of Life.

BACKGROUND: Classical laparoscopic cholecystectomy involves four ports while most novel 'single port' technique only requires one incision on the abdominal wall. This technique is thought to decrease surgical trauma and improve cosmesis although there are reports pointing out that classical laparoscopic cholecystectomy is also feasible in terms of cosmesis. OBJECTIVES: In this study we tried to determine if there are certain advantages in quality of life after single port surgery which would justify its utilization instead of classical laparoscopic cholecystectomy. MATERIAL AND METHODS: This is a prospective randomized study which enrolled 30 patients randomized either into classical laparoscopic cholecystectomy or single port surgery. The primary endpoint was patient satisfaction after surgery. This was assessed with short form 36 and gastrointestinal quality of life index (first preoperatively and then 3 months postoperatively) and a visual analogue scale on the first and seventh days. RESULTS: There was not a statistically significant difference between groups in the emotional role, social functions, mental health, vitality and general health subscales of short form 36. At the end of 12 weeks, both groups demonstrated increases in the gastrointestinal and social subscales of the gastrointestinal quality of life index. There was not a statistically significant difference between groups when the visual analogue scale scores on first and seventh days were compared. CONCLUSIONS: The equal length of hospitalization, patient quality of life and pain perception and the longer operative times, high likelihood of incisional hernia and surgical site infection call into question the utilization of single port surgery, as it does not seem to confer an advantage over classical laparoscopic cholecystectomy.

Frailty among elderly adults in a rural area of Turkey.

BACKGROUND: The elderly population is growing in Turkey, as it is worldwide. The average age of residents in rural areas of Turkey is relatively high and is gradually increasing. The purpose of this study is to summarize the fitness and frailty of elderly adults living in a rural area of Turkey characterized by a relatively low level of socioeconomic development. MATERIAL/METHODS: This study was designed as a prospective, cross-sectional study, and was conducted in a rural area of Kars Province. A total of 168 elderly adults (≥65 years old) from 12 central villages were included in the study. The Fried Frailty Criteria was used to assess the frailty of the participants. In addition to frailty, the physical, social, and mental status of elderly adults was examined. RESULTS: The prevalence of frailty in this rural area of Turkey was 7.1%.The study group ranged in age from 65 to 96 years (mean 72.70±7.73 years), and 53.6% were female. Among the elderly adult group, 84.3% had not completed elementary school, and 43.29% had a monthly income of ≤500 Turkish liras ($200). No significant relationship was identified between gender and frailty. There was a statistically significant relationship between frailty and older age, lower education level, lower economic level, co-morbidities, polypharmacy, diabetes, chronic obstructive pulmonary disease, gastric disease, arthritis, generalized pain, benign prostatic hyperplasia, urinary incontinence, auditory impairment, impaired oral care, caregiver burden, impaired cognitive function, depression, or a lack of social support (social isolation). CONCLUSIONS: It is believed that this study will contribute considerably to understanding the health status and needs of elderly adults in Turkey and the health problems of this population as well as to planning the development of public health and geriatric services based on regional needs.

The relationship between quality of life and the severity of psoriasis in Turkey.

BACKGROUND: Patients with psoriasis experience a low quality of life and high treatment burden: OBJECTIVES: To assess psoriatic patient quality of life using the Dermatology Life Quality Index (DLQI) in the Northeastern Anatolia region of Turkey. Additionally, we evaluated the correlation between the DLQI and the clinical severity of psoriasis and examined demographic data and their relationship with the DLQI and psoriasis severity: MATERIALS AND METHODS: This study was a single-center, prospective, cross-sectional study at the University of Kafkas, Kars, Turkey. 127 adult patients were included in the study. The Turkish version of the DLQI was used. To measure psoriasis severity, the Psoriasis Area Severity Index (PASI) and Body Surface Area (BSA) were simultaneously evaluated. The patient demographics were compared with quality of life and the severity of psoriasis: RESULTS: DLQI scores ranged from "very large" to "extremely large" in 61% of the patients. The psoriasis severity (BSA and PASI) was "mild" in 63% of patients. The quality of life was significantly affected in cigarette smokers and in patients whose disease included nail involvement. The PASI and BSA scores of patients with scalp and nail involvement were significantly higher. A significant, positive correlation was found between disease duration and the severity of psoriasis. BSA correlated with PASI: CONCLUSION: The quality of life of psoriasis patients is strongly reduced. A significant relationship was found for DLQI with nail psoriasis and smoking. A linear, positive correlation was detected between the DLQI and BSA but not between the DLQI and PASI.

Health risks faced by Turkish agricultural workers.

BACKGROUND: Individuals who make a living through agriculture and animal husbandry are faced with a variety of physical and psychological health risks. In many international studies, it has been shown that these risks can result in disease. The purpose of this study is to summarize the health risks faced by Turkish agricultural workers. MATERIALS AND METHODS: This study used a nonrandom, convenience sample. The biopsychosocial health statuses of 177 farmers from 11 central villages in Kars, Turkey, were examined. RESULTS: It was determined that the depression rate among the study group was 62.1%, the rate of physical health problems was 52.0%, and the rate of social isolation was 53.7%. There was a statistically significant difference between the depression scale scores and lower education levels, having ≥ three children, and physical health problems, as well as the physical condition of the farmers' homes. There was a significant difference between poor physical health and older age, lower education levels, having ≥ three children, and social isolation. CONCLUSIONS: In providing data-based evidence, it is believed that this study will contribute considerably to understanding the causality of health problems in this population and in planning the development of public health and veterinary services based on regional needs.