The prevalence of nutritional anemia in pregnancy in an east Anatolian province, Turkey.

BACKGROUND: Anemia is considered a severe public health problem by World Health Organization when anemia prevalence is equal to or greater than 40% in the population. The purpose of this study was to determine the anemia prevalence with the associated factors in pregnant women and to determine the serum iron, folate and B12 vitamin status in anaemic pregnants in Malatya province. METHODS: This is a cross-sectional survey. A multi-sage stratified probability-proportional-to-size cluster sampling methodology was used. A total of 823 pregnant women from sixty clusters were studied. Women were administered a questionnaire related with the subject and blood samples were drawn. Total blood count was performed within four hours and serum iron, folate and B12 vitamin were studied after storing sera at -20 C for six months. RESULTS: Anemia prevalence was 27.1% (Hb < 11.0 gr/dl). Having four or more living children (OR = 2.2), being at the third trimester (OR = 2.3) and having a low family income (OR = 1.6) were determined as the independent predictors of anemia in pregnancy. Anemia was also associated with soil eating (PICA) in the univariate analysis (p < 0.05). Of anaemic women, 50.0% had a transferrin saturation less than 10% indicating iron deficiency, 34.5% were deficient in B12 vitamin and 71.7% were deficient in folate. Most of the anemias were normocytic-normochromic (56.5%) indicating mixed anemia. CONCLUSIONS: In Malatya, for pregnant women anemia was a moderate public health problem. Coexisting of iron, folate and B vitamin deficiencies was observed among anaemics. To continue anemia control strategies with reasonable care and diligence was recommended.

The Treatment Approach and Social Support Needs for Patients with Breast Cancer.

OBJECTIVE: Breast cancer is the most common type of cancer in women both in developed and developing countries. It has a higher mortality rate in low and middle income countries due to the late-stage diagnosis. The principal aim of this study was to investigate what patients with breast cancer did before presenting to Turgut Özal Medical Center and its relationship with late stage diagnosis. The study also aimed to identify the level of patients' perceived social support. MATERIALS AND METHODS: The study included 200 patients with breast cancer who were treated at the chemotherapy unit during 2013 and 2014. RESULTS: The mean age of the patients was 51.16±1.10 years and 60% of the women were graduates of elemantary school. The majority of patients (69.5%) noticed breast mass as the first symptom and 56.5% were diagnosed at later stages. Thirty-four percent of the patients delayed their visit to a health care centers after realizing the first symptom. No statistically significant relationship was determined between women's education level, residential area, age, the first symptom noticed, stages of tumor, and patients and system-related delay (p>0.05). In terms of family history of breast cancer, there was a significant difference between patient-related and system-related delays (p<0.05). The family support score (24.8±4.6) was higher than those of friends and husbands (23.8±5.5, 21.3±6.4, respectively). The husband support score was statistically different in terms of intimacy between women and their husbands after disease (p<0.001). CONCLUSION: It can be concluded that overcoming barriers related to patients and the system will lead to early-stage diagnosis, which in turn will result in higher survival rates of patients with breast cancer. As awareness and knowledge level of women about cancer increases, they will visit health care centers earlier where they can receive more comprehensive treatment.

University hospital physicians' attitudes and practices for smoking cessation counseling in Malatya, Turkey.

The aim of the study is to determine attitudes and self-reported practices performance for smoking cessation counseling of the physicians working at a university hospital in Malatya, Turkey. All physicians who were providing health care to adult patients in 19 outpatient clinics at the hospital were administered a self-reported questionnaire. Of the physicians, 26.5% reported that they were always asking about their patients' smoking history and 22.6% were always advising their smoker patients to quit. Men non-smoker physicians more often practiced counseling than men smoker physicians. Negative attitudes of physicians about smoking cessation counseling negatively effected their practices. Negative attitudes were significantly higher among men smoker physicians than non-smokers but attitudes did not differ among female smoker and non-smoker physicians. The findings showed that smoking cessation counseling was rarely practiced by physicians and physicians' practices differed by their smoking behavior, departments and attitudes towards smoking cessation.

Evaluation of the effects of novel nafimidone derivatives on thermal hypoalgesia in mice with diabetic neuropathy.

OBJECTIVE: Diabetic neuropathy (DN) is a common complication in Diabetes Mellitus. The streptozotocin-induced diabetic rodent is the most commonly used animal model of diabetes and increased sodium channel expression and activity were revealed in this model. At this study, we evaluated the effect of three different nafimidone derivatives which have possible anticonvulsant activity on disorders of thermal pain sensation in diabetic mice. STUDY DESIGN: Randomized animal experiment. MATERIAL AND METHODS: Mice were divided randomly into five groups (5 mice per group): Control, Diabetes, Dibetes+C1, Diabetes+C2, Diabetes+C3. We used hot and cold plate, and tail-immersion tests for assessment of thermal nociceptive responses. RESULTS: Compared with the control group, the hot-plate response time and the number of paw liftings on cold plate as important indicators of loss of sensation increased, but no significant difference (p>0.05) was found in tail-immersion response time test in diabetes group. C3 compound moved it back to control group levels in the all of three tests. C1 and C2 compounds were effective only in cold-plate test. CONCLUSION: Nafimidone derivatives may be effective in the cases where epilepsy and diabetes occur together since it has shown efficacy against "loss of sensation" which evolves in diabetic neuropathy over time as well as its antiepileptic effect.

Physical, emotional and sexual violence during pregnancy in Malatya, Turkey.

BACKGROUND: In Turkey, violence against women was established as a critical area of concern related to women and various prevention strategies have been developed since 1980. There are limited numbers of studies on violence during pregnancy in the country. This study was performed to determine the prevalence of physical, emotional and sexual violence during pregnancy in Malatya province and the associated factors. METHODS: A cross-sectional interview survey was conducted among pregnant women living in Malatya province between October 2003 and May 2004. Stratified probability-proportional-to-size sampling methodology was used for selecting the study population. A total of 824 pregnant women from 60 clusters were studied. Association between violence prevalences and womens' sociodemographic, fertility and behavioural characteristics were evaluated. RESULTS: During pregnancy 31.7% of women were exposed to any form of violence. Emotional violence was the most frequently reported form (26.7%), followed by sexual (9.7%) and physical violence (8.1%). Regular smoking [odds ratio (OR) 1.6], unwanted pregnancy (OR 1.8), living in urban area (OR 1.5), low education level of husband (OR 1.7), low family income (OR 1.9) and being in second trimester (OR 1.4) were determined to be the main predictors of overall violence during pregnancy. CONCLUSIONS: Violence during pregnancy is a common public health problem in Malatya. Low education level in partners, low family income, husband's unemployment, urban settlement, unwanted pregnancy and smoking should alert health staff towards violence at pregnancy and training of health personnel on the subject is recommended.