Effect of cigarette smoking on serum methylarginine and α-klotho levels.

BACKGROUND AND AIMS: Smoking causes many diseases such as cardiovascular, lung diseases, stroke and premature aging. However, the role of smoking in the pathogenesis of these diseases is unclear. Increasing evidence suggests that methylarginine pathway metabolites and α-klotho may be strong markers for pathologies such as premature aging, endothelial dysfunction, and oxidant damage. Therefore, the study aimed to measure the serum levels of arginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), N-monomethyl-l-arginine (L-NMMA), and α-klotho levels in smokers. METHODS AND RESULTS: This case-control analytical study included 65 smokers and 71 non-smokers. Sociodemographic characteristics, routine biochemistry parameters, Framingham risk scores and Fagerström Nicotine Dependence Test (FTND) were recorded. Serum methylarginine and α-klotho levels were analyzed by tandem mass spectrometry and enzyme-linked immunosorbent assay (ELISA), respectively. Serum ADMA (p < 0.001), L-NMMA (p = 0.024), SDMA (p < 0.001) levels of smokers were higher than non-smokers, and serum α-klotho (p < 0.001) and arginine levels (p < 0.001) were lower. There was a positive correlation between serum ADMA levels with FNDT, age and pack/year in smokers, while there was a negative correlation between klotho levels and age. A positive correlation was found between serum ADMA levels, Framingham risk score and age in non-smokers. CONCLUSION: Smoking is related to premature aging and is a strong risk factor for various diseases such as cardiovascular, inflammatory, and renal diseases. Elevated serum methylarginine and decreased serum klotho levels were found in smokers. Therefore, our findings suggest that smoking may be involved in the pathogenesis of these diseases by affecting α-klotho and methylarginine-related pathways.

The Relationship between Mindful Eating and Body Mass Index and Body Compositions in Adults.

INTRODUCTION: Obesity and overweight are important public health problems. Mindfulness can promote healthier living and dietary habits, which might support weight loss. This study aimed to evaluate the relationship between eating awareness and body mass index (BMI) and body composition in adults. METHODS: This cross-sectional analytical study was conducted with 446 volunteers. The heights, weights, and waist circumferences of the participants were measured, and bioelectrical impedance analyses were performed. A sociodemographic information form prepared by the researchers and the Turkish version of the Mindful Eating Questionnaire (MEQ) were administered to the volunteers. RESULTS: In this study, 31.2% (n = 139) of the participants were overweight and 46.9% (n = 209) were obese. There was no statistically significant relationship between gender and BMI. The total mean MEQ score was found to be 88.26 ± 13.3 (53-144). The awareness scores of women of normal weight were statistically significantly higher than those of women with obesity (p = 0.001). There was no difference between BMI categories and awareness scores among male participants. While participants with obesity had higher scores for eating disinhibition, their eating control, eating discipline, and interference scores were lower than those of participants with normal weight (p < 0.001). A weak statistically significant correlation was found between the awareness subdimension of the scale and the ages, BMIs, waist circumferences, and body fat rates of the participants. CONCLUSION: It was observed that mindful eating was lower in women with overweight and obesity than that in women with normal weight. We believe that it is important to increase awareness of eating in order to protect against the diseases caused by obesity and for a healthy life.

Internet addiction, substance use and alexithymic dimensions in two different faculties' students.

OBJECTIVES: The aim of this study was to evaluate the relationship between internet addiction, substance use and alexithymia among students of education faculty and medical faculty. METHODS: This cross-sectional analytical study included 1,257 faculty students aged 18 and over, studying at Meram Medical Faculty and Ahmet Kelesoglu Faculty of Education. Young's Internet Addiction Scale, Toronto Alexithymia Scale, Fagerström Tobacco Addiction Test and CAGE alcohol use tests were applied to collect data. RESULTS: The mean age of the participants was 21.12 ± 1.96 years, 71% (n = 893) of them were females and 29% (n = 364) were males, 37.9% (n = 477) were training at medical faculty, 62.1% (n = 780) were training at the faculty of education. Of the students, 1.5% were internet addicts, 15.3% were possible addicts, and 22.8% had alexithymia. Internet addiction was higher in those with higher alexithymia scores (p < 0.001). Internet addiction was significantly higher in male students, the third grade, ones with lower academic success, students who work their lessons less than 2 hours a week. Internet addiction was also significantly higher in smokers and alcohol users (p < 0.001). While there was a low negative correlation between the first internet using age and internet addiction (p < 0.001), there was a moderately significant positive correlation between spending uninterrupted time on the internet and internet addiction (p < 0.001). CONCLUSION: In this study, it was determined that the teacher and doctor candidates, who are studying at the faculties of education and medicine, were at risk of internet addiction. A teacher or a doctor who cannot develop social skills due to excessive internet use will not be a good model to communicate correctly with the target population.

Frequency of sarcopenia and associated outcomes in patients with chronic obstructive pulmonary disease

Background/aim: We aimed to evaluate the prevalence of sarcopenia and associated outcomes in patients with chronic obstructive pulmonary disease (COPD). Materials and methods: This cross-sectional study was performed on 219 patients aged 50 years and over who were diagnosed with chronic obstructive pulmonary disease (COPD) according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The study included 196 (89.5%) male and 23 (10.5%) female patients. The mean age of the patients was 66.9 ± 10.1 years. To diagnose sarcopenia, muscle function was determined by a gait speed test. Muscle strength was assessed with a hand dynamometer and muscle mass was measured with a bioelectrical impedance analysis device. Pulmonary function tests and six-min walking tests were also performed. The modified Medical Research Council (mMRC) dyspnoea scale was used to evaluate all the participants. Our sample consisted of sarcopenic patients at different stages (17 presarcopenic patients (7.8%), 32 patients with sarcopenia (14.6%), 65 patients with severe sarcopenia (29.7%), and 105 nonsarcopenic patients (47.9%). Results: Sarcopenia was significantly associated with age, BODE (body mass index (BMI), airflow obstruction, dyspnoea, and exercise capacity) index, GOLD spirometric classification, mMRC dyspnoea scale score, BMI, and educational status. Sarcopenia in COPD patients was firmly related to the severity of the disease and its prognosis. The prevalence of sarcopenia increased in severe and very severe COPD cases. The dyspnoea score was higher, and exercise capacities were lower in sarcopenic patients. Conclusions: Sarcopenia in COPD patients was closely related to the severity of COPD and a negative prognosis. The frequency of sarcopenia increased in severe and very severe COPD cases. Dyspnoea scores were higher and exercise capacities were lower in patients with sarcopenia. In patients with COPD, a diagnosis of sarcopenia should be considered, and preventive measures should be taken before irreversible changes develop.

Visceral Adiposity Index Levels in Patients with Hypothyroidism.

OBJECTIVE: To assess visceral adiposity index (VAI) as a sign of cardio-vascular diseases (CVD) in hypothyroidism patients and to compare CVD risks in overt or subclinical hypothyroidism patients. MATERIALS AND METHODS: Sixty-eight hypothyroidism patients (29 with overt and 39 with subclinical hypothyroidism) and 33 age- and gender-matched control patients were included. VAI levels were calculated with the following formula: (waist circumference (WC)/[36.58+(1.89xbody mass index (BMI))])x[(triglyceride (TG) (mmol/L)/0.81)x(1.52xhigh-density lipoprotein cholesterol (HDL-cholesterol) (mmol/L))] and (WC/[39.68+(1.88xBMI)])x[(TG (mmol/L)/1.03)x(1.31xHDL-cholesterol (mmol/L))], respectively. RESULTS: While body weight (p < 0.01), BMI (p < 0.01), TG and VAI levels (p < 0.01) were higher in hypothyroidism patients than controls, HDL-cholesterol levels were lower (p = 0.02). When patients were divided to groups as subclinical (n = 39) and overt hypothyroidism (n = 29) and compared with each other and controls (n = 33), body weight (p = 0.02 and p = 0.02, respectively), BMI (p = 0.01 and p < 0.01, respectively) and TG (p < 0.01 and p = 0.03, respectively) were higher in overt and subclinical hypothyroidism groups than controls. HDL-cholesterol was lower only in the group with overt hypothyroidism than controls (p = 0.01). Although found similar to each other in overt and subclinical hypothyroidism groups, VAI levels were observed to be higher in both groups than controls (p < 0.01 and p = 0.02, respectively). In correlation analysis, a positive correlation was determined between thyroid stimulating hormone (TSH), BMI and VAI levels (p = 0.03 and p < 0.01, respectively). CONCLUSIONS: Due to the association between increased VAI levels, and metabolic syndrome and CVDs, we consider that several measures should be promptly taken to decrease these risk factors, and further studies with a larger sample size should be performed.

Total oxidant capacity, total antioxidant capacity, ischemic modified albumin, microRNA levels, and their relationship with psoriasis area and severity index.

Aims To examine the differences in the levels of microRNA, ischemic modified albumin (IMA), total oxidant capacity (TOC), and total antioxidant capacity (TAC) of persons with and without psoriasis and, in the case group, the relationship between these parameters and psoriasis area and severity index (PASI). Methods Blood samples were collected from patients and healthy participants to examine levels of these parameters. Results The mean serum TOC level was higher in the case group. The mean serum TAC and IMA levels were significantly lower in the case group (P <0.001). It was observed that the mean serum miR-203 and miR-146a levels were increased in psoriasis patients. It was determined that there was only a significant positive weak correlation between miR-203 and PASI (r = 0.232, P = 0.027). Limitations The small sample size, not controlling serum albumin and not evaluating the effects of the treatment agents used by the patients on oxidative and inflammatory processes. Conclusion In the case group changes in the mean serum TOC and TAC levels provide evidence that oxidative stress may play a critical role in disease pathogenesis. The increase in the mean serum miR-203 and miR-146a levels suggest the possibility of therapies targeting these microRNAs as a new option.

Frequency, severity and risk factors for restless legs syndrome in healthcare personnel.

OBJECTIVE: To evaluate the frequency, severity, and risk factors for restless legs syndrome (RLS) in healthcare personnel. METHODS: This cross-sectional study was performed at the Outpatient Family Medicine Clinic of Meram Medical Faculty in Konya, Turkey and included 354 healthcare personnel who were working at the Meram Medical Faculty Hospital between October 2010 and June 2011. The International RLS (IRLS) rating scale was used to calculate RLS severity. The RLS symptoms positive patients were investigated for neurological examination. RESULTS: Of all the participants, 277 (78.2%) were female. The overall prevalence of RLS according to the 4 essential criteria in the participating healthcare personnel was 15% (n=53) (16.9% male, 14.4% female). Gender (p=0.726) and age (p=0.197) were not significantly related to RLS. According to the International Restless Legs Syndrome Study Group (IRLSSG) the severity scale for RLS, of the RLS positive patients, 16% were classified as mild (n=8), 40% as moderate (n=21), and 44% as severe (n=24). Approximately, 54.7% of 53 RLS patients had a positive family history of the disorder. CONCLUSION: Restless leg syndrome is a treatable disorder; however, it is still widely misdiagnosed by physicians. The history of the patient and family is very important in the diagnosis of RLS.

Effects of COVID-19 Fear on Society's Quality of Life.

The COVID-19 pandemic is an important factor affecting the health of people worldwide, as well as a source of fear, stress, and anxiety. The aim of this study was to determine the level of fear caused by the COVID-19 pandemic in Turkish society and evaluate its effects on quality of life. The sociodemographic information form, COVID-19 Fear Scale (FCV-19S), and WHOQOL-BREF Quality of Life Scale were applied to the participants. A total of 705 people, who were accessed via the internet, responded willingly to the study, which was planned as a cross-sectional analytical study. The mean FCV-19S score was 17.4 ± 5.9 (7-32) points. Fear points were higher among females than males (p < 0.001), and among single individuals than among those who were married (p = 0.049). Fear scores were low for tradesmen, those with low educational status, and those with high income levels (p < 0.001). According to the WHOQOL-BREF Scale, the FCV19S of those with very good quality of life was low (p = 0.042), and the FCV-19S of those who were not satisfied with life was high (p < 0.001). Statistically, a weak negative correlation was detected between the fear scores, and physical health and psychological health (r = - 0.190, r = - 0.198, p < 0.001). Fear level varies according to gender, education, and income level, regardless of age. As fear increases, quality of life decreases, and physical and psychological health were negatively affected. The authors believed that the outcome of the study would help inform the public about COVID-19, as well as cope with the psychological effects and fears of COVID-19.

The goiter prevalence and urinary iodine levels among adolescents.

Endemic goiter and iodine deficiency are among the worldwide major public health problems of today. We aimed to research the goiter prevalence and the urinary iodine level of school children. In this descriptive study, 1,847 school children in Konya aged between 10 and 18 years were included. Urinary iodine level was measured. The mean value of iodine excretion in urine was 198 +/- 46.61 microg/L. In 40 students (2.2%), the urinary iodine level was < 100 microg/L. Six of these students (0.3%) had moderate iodine deficiency. Thyroid hyperplasia was found with palpation method in 128 students (6.9%). Ultrasonographically, five female students had solid nodule, and one male student had multiple nodules. In our study, no severe iodine deficiency was found. According to the results of our study, the mandatory iodization program in Konya has been conducted successfully.

Importance of Measured Body Fat, Visceral Adiposity Index, and Lipid Accumulation Product Index in Predicting Cardiometabolic Risk Factors.

Background: Obesity, which is defined as excessive fat accumulation in the body, is an important public health problem. Objective: The aim of this study was to compare measured body fat and the visceral adiposity index (VAI) and lipid accumulation product (LAP) index used to predict cardiometabolic risk (CMR) factors. Methods: This study was performed retrospectively by scanning the files of 817 participants who had bioelectrical impedance analysis (BIA) results and routine blood tests. The VAI and the LAP index were calculated using the appropriate formulas. Results: Of the 817 participants included in the study, 67.9% (n = 555) were female, 32.1% (n = 262) were male, and the mean age was 36.14 ± 11.4 (18-65) years. The mean body mass index (BMI) was 29.90 ± 6.6 kg/m2 and 24.2% (n = 198) of the participants were of normal weight (BMI <25 kg/m2), while 75.8% (n = 619) were overweight or obese (BMI ≥25 kg/m2). Body fat quantity was higher in females than in males. As BMI increased, the body fat quantity measured by BIA also increased (P < 0.001). The mean LAP index of men was higher than the mean LAP index of women in both the normal-weight group and the obese group (P = 0.025 and P = 0.033, respectively). One unit increase in visceral fat percentage resulted in a 77.9% increase in CMR. Conclusions: It may not be sufficient to use only BMI to predict obesity and related cardiometabolic diseases. According to the study findings, it was determined that the increase in visceral fat percentage significantly increases the CMR.

The relation between visceral fat markers and cardiometabolic disease risks in psoriasis patients.

OBJECTIVE: Psoriasis is a chronic, inflammatory disease that appears with variable trigger factors. We know that obesity and other metabolic syndrome criteria are high in psoriasis patients. The aim of this study is to evaluate the relationship between visceral fat markers, risk of cardiometabolic disease, and psoriasis area severity index (PASI) in individuals with and without psoriasis. METHODS: A total of 203 subjects, 102 psoriasis patients and 101 healthy individuals, were included in the study. Lipid accumulation product (LAP) index, visceral adiposity index (VAI), plasma atherogenicity index (PAI), body mass index (BMI), PASI, triglyceride (TG), and high-density lipoprotein cholesterol (HDL-c) values were measured. RESULTS: LAP index, VAI, PAI, BMI, and TG levels were significantly high (p<0.001) and HDL-c levels were significantly low (p=0.009) in patients with psoriasis compared to healthy individuals. CONCLUSION: LAP index, VAI, and PAI calculations can be recommended as a potential biomarker for early diagnosis of cardiometabolic diseases common in patients with psoriasis.

Effects of smoking on patients with obstructive sleep apnea syndrome.

OBJECTIVES: We aimed to investigate the relationship between the presence and severity of obstructive sleep apnea (OSAS) and smoking using pulmonary function tests and polysomnographic data. MATERIALS AND METHODS: This analytical cross-sectional study was done by retrospectively examining the files of patients who applied to the Meram Medical Faculty Chest Diseases Sleep Laboratory between 07.01.2016 and 30.12.2018. Three-hundred and thirty-three patients who were diagnosed with OSAS or simple snoring by polysomnography (PSG) were included in the study. RESULTS: Those involved in the study; 17.1% were simple snoring [apnea-hypopnea index (AHI) < 5]; 15.3% were mild OSAS (AHI: 5-15); 30.6% were moderate OSAS (AHI: 16-30); 36.9% were severe OSAS (AHI > 30), and 48.6% of the study participants never smoked. There was a significant correlation between the number of pack-years, minimum O2 saturation, mean O2 saturation, ratio of sleep time to total sleep time with oxygen saturation below 90%, %NREM 3 sleep time, Hb, HTC values, and FEV1/FVC values. According to the results of multiple linear regression analysis; the effect of package-year, age, and BMI on OSAS severity was found to be statistically significant (ß = 0.153 P = 0.004, ß = 0.123 P = 0.025, ß = 0.208 P < 0.001, respectively). CONCLUSION: It was revealed that patients with severe OSAS were heavy smokers, and increased smoking increased the OSAS severity both by increasing the AHI and by reducing the oxygen saturation overnight. One unit increase in the package-year results in a 15.3% increase in the AHI.

The relationship between sex steroids, insulin resistance and body compositions in obese women: A case-control study.

BACKGROUND: Obesity causes many health problems and affects the quality and duration of life negatively. We aimed to investigate the relationship between sex steroids, insulin resistance and body compositions in obese women. METHODS: This study was carried out on a sample of 150 premenopausal women who were referred to the Outpatient Clinic of Family Medicine between 2014-2015. A survey about their socio-demographic characteristics was carried out, and anthropometric parameters were measured. LDL-C, HDL-C, total cholesterol, triglyceride, glucose, insulin, sex hormone binding globulin (SHBG), estradiol, dehydroepiandrosterone sulfate (DHEA-S), total/free testosterone levels were measured in the blood. Body compositions were assessed with a bioelectrical impedance device. For insulin resistance, Homeostasis Model Assessment (HOMA-IR) was calculated. RESULTS: In our study, a significant association was found between high glucose, total cholesterol, LDL-C, TG, insulin, insulin resistance and low HDL-C, SHBG, DHEA-S levels with obesity (p<0.05). There was no statistically significant relationship between estradiol, total/free testosterone and obesity (p>0.05). CONCLUSIONS: In our study, high glucose, total cholesterol, LDL-c, TG, insulin, insulin resistance and low HDL-C, SHBG, DHEA-S levels were associated with obesity. This relationship leads to many diseases, especially diabetes mellitus and cardiovascular disease. Therefore, obesity is a disease that needs to be monitored closely, frequently and treated properly.

Auditory P300 event-related potential in tobacco smokers.

The aim of this study was to elucidate the chronic effects of tobacco smoking on the P300, a neurophysiological index of cognitive function. Prospective study participants were recruited from a family medicine polyclinic. We selected 32 right-handed smokers who had smoked more than 15 cigarettes per day, by inhalation, for more than 2 years. The control population consisted of 32 right-handed, age-matched healthy individuals who had never smoked. Event-related potentials (ERPs) were recorded with the auditory "oddball" two-tone discrimination task. The data from the central (Cz) and frontal (Fz) electrodes were analyzed. The P300 and N1 amplitudes at Fz were lower in the study population compared to the control group. The early component of ERP, the measure of mental speed (N1) latency at Fz was prolonged in the study group compared to the controls, possibly because early cognitive processes such as sensory input or initial encoding of sensory information were delayed in this group. For those who smoke, a decreased N1 amplitude might indicate delayed information processing and possibly short-term memory disturbance. Thus, chronic tobacco smoking may produce prefrontal cognitive dysfunction.

The effects of smoking on vascular endothelial growth factor and inflammation markers: A case-control study.

BACKGROUND AND AIMS: Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease characterized by long-term poor airflow. Tobacco smoking is the most common cause of COPD. In this study, we aimed to assess the vascular endothelial growth factor (VEGF) and inflammation markers on smokers and non-smoking individuals. METHODS: Our study was a case-control study and 175 individuals who want to give up smoking constituted the case group. As a control group, 175 individuals who never smoked. RESULTS: The mean age of 350 participants was 35.83 ± 13.11 years. Educational status of the non-smokers was significantly higher than that of the smoking group (P < .001). When smoking and non-smoking groups were compared in terms of VEGF and interleukin-6 (IL-6), it was found that these values were statistically higher in smokers than non-smokers (P < .001). The levels of IL-10 were found to be higher in non-smokers than in smokers (P < .001). Although a moderate positive correlation was found between VEGF and IL-6 levels (r = .486, P < .001), there was a weak negative correlation between VEGF and IL-10 (r = -.210, P < .001). A weak negative correlation was found between IL-6 and IL-10 (r = -.185, P < .001). CONCLUSIONS: In our study, IL-6 inflammatory marker and VEGF levels were found to be high and IL-10 anti-inflammatory marker was discovered to be low in smokers. For this reason, raising awareness in the society about the harms of smoking and encouraging people to give it up have become more challenging to counteract the inflammatory effects of smoking in human body and to prevent many smoking-related diseases.

Relationship between smoking and total antioxidant status, total oxidant status, oxidative stress index, vit C, vit E.

BACKGROUND: Tobacco smoking contains many toxic, carcinogenic and mutagenic chemicals, as well as stable and unstable free radicals. In this study, we aimed to assess the vitamin E, vitamin C and total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) in smoking and non-smoking men. MATERIALS AND METHODS: This case-control analytical study was conducted on 78 smoking and 82 non-smoking men. Fagerström nicotine-dependence test was used to assess the participants' addiction status. Low-density lipoprotein-c, high-density lipoprotein-c, total cholesterol, triglyceride, fasting blood glucose, vitamin E, vitamin C, TAS and TOS levels were determined. RESULTS: The mean age of 160 men who participated in our study was 33.0 ± 10.6 years. The comparison of smoker and non-smoker groups was made in terms of the parameters of TAS, TOS, OSI, vitamin C and vitamin E; it was seen that TAS (P = .003), vitamin C (P < .001) and vitamin E (P < .001) values in non-smokers' group were found significantly higher than smokers. In non-smokers, vitamin C level was 4.3 times more than the smokers. In non-smokers, vitamin E level was 6.9 times more than the smokers. The values of TOS (P < .001) and OSI (P < .001) in smokers were significantly higher than the control group. CONCLUSIONS: The parameters of TAS, vitamin C and vitamin E were significantly higher in the non-smoker group than in the smoker group. The levels of TOS and OSI were higher in the smoker group. It is known that cigarette smoking leads to various diseases because of the free radicals it contains.

The effects of vitamin D supplementation during pregnancy and maternal vitamin D levels on neonatal vitamin D levels and birth parameters.

OBJECTIVE: The current study aimed to measure the levels of vitamin 25(OH)D in pregnant women and in the umbilical cord blood of newborns and to evaluate the association of vitamin D levels with birth parameters. METHODS: This cross-sectional analytic investigation was performed in 100 pregnant women at term and in 100 newborns born to these mothers. Plasma vitamin D level was measured and birth parameters of the babies were recorded. RESULTS: Mean vitamin D levels in pregnant women and cord blood were 11.39 ± 6.24 ng/ml and 8.00 ± 4.95 ng/ml, respectively. Vitamin D levels were found to be higher in the women who had received vitamin D support during pregnancy (p < .001). Height (p = .004), head circumference (p = .003), and chest circumference (p = .005) of newborns born to mothers who had received vitamin D support were higher compared to non-receivers. Maternal vitamin D deficiency (<10 ng/ml) and insufficiency (10-30 ng/ml) was detected in 53.0% and 47.0% of the cases, respectively. None of the women had sufficient levels of vitamin D. CONCLUSIONS: This study established that vitamin D levels were low in maternal and cord blood in spite of the administration program of Ministry of Health in pregnant women. The importance of vitamin D supplementation should be explained to the pregnant women in each visit.

Assessment of effects of pre- and post-training programme for healthcare professionals about breastfeeding.

This retrospective study assessed the effects of pre- and post-training programme for healthcare professionals about breastfeeding. The study included 3,114 mothers who had children aged 1-72 month(s). Their knowledge and behaviours relating to breastfeeding were evaluated. The mothers were randomly divided into two groups: the 'before' group included 2,000 women who were not informed about breastfeeding, and the 'after' group comprised 1,114 women who had been informed about breastfeeding. 56.2% and 66.1% of the mothers started breastfeeding within 30 minutes after delivery, respectively, in the before and the after group (chi2 = 29.31, p < 0.001). 16.7% and 36.5% gave exclusive breastfeeding for six months (chi2 = 72.85, p < 0.001), and 28.5% and 23.7% stopped breastfeeding within the first five months (chi2 = 17.20, p = 0.002). Ninety-four percent delivered in a hospital or in a primary healthcare centre. Therefore, prenatal and postnatal breastfeeding education and support courses may improve a woman's chance of starting and continuing to breastfeed her baby. In terms of the number of antenatal check-ups, since the differences between the two groups were significant (chi2 = 390.67, p = 0.000), the importance of the training programme about breastfeeding was highlighted. Follow-up interventions after training are suggested.

Evaluation of Breast Cancer Risk Levels and Its Relation with Breast Self-Examination Practices in Women.

OBJECTIVE: This study was performed to determine the breast cancer risk levels and its relation with the frequency of breast self-examination practices in women who were 20 years old and over. MATERIALS AND METHODS: This descriptive study was conducted on 867 women, who were 20 years old and over presenting to a family medicine outpatient clinic for any reasons. The participants filled in the "Breast Cancer Risk Assessment Form" which is recommended to assess the risk of breast cancer by the Ministry of Health. The participants' risk levels have been classified as low, medium, high, and the highest risk. RESULTS: The mean age of the participating women was 38.2±13.4 years, 69.7% (n=604) were married, 54.8% (n=475) were housewives, 33.9% (n=294) were working, 42.7% were graduated from primary school. The average risk score of the patients for breast cancer was 131.26 ±45.11 (50-325). As a result of this study, 87.3% (n=757) of the women were identified as having a low breast cancer risk, 12.6% (n=109) medium and 0.1% (n=1) of them were identified as having a high risk. The data demonstrated that 75.5% (n=655) of the women weren't doing breast self-examination (BSE). The rate of previous breast USG or mammography screening was 33.7% (n=292). There were no statistical relations between the breast cancer risk levels and BSE (p=0.396). CONCLUSION: The risk of developing breast cancer was low among the women in the study group and breast self-examination rates were insufficient. In addition to training women by emphasizing the importance of breast self-examination in early diagnosis, the breast cancer risk questionnaire - an easy to implement, simple and costless tool - is recommended to be administered in the primary health care centers.

Evaluation of the mini-mental state examination among the elderly people in Konya, Turkey.

OBJECTIVE: To evaluate cognitive function by using the Mini-Mental State Examination (MMSE) among the elderly people in Konya, Turkey, and to examine the acceptance, and screening efficacy of the MMSE in the family medicine practice setting. METHODS: A descriptive and cross-sectional study was carried out between 15th December 2004 and 15th February 2005, in Konya, Turkey. Two hundred elderly people were included in the study. Participants were selected from the cases who were at least 65 years of age and older. Cognitive levels were assessed with the MMSE. Two different MMSE forms for educated and uneducated individuals were applied. Socio-demographic characteristics, orientation, registry memory, attention and calculation, recall, and language status were determined. The data were evaluated with SPSS 10.0 software. RESULTS: Participants of 65 years of age and older (36.5% women, n=73 and 63.5% men, n=127) were included in this study. The age interval of participants was 65 and 85, and the mean age was 71.02 (SD=4.569). Of the participants, 66% (n=132) were uneducated, and 34% (n=68) were educated. The mean score of MMSE was 23.33 (SD=4.799). The score of MMSE was considered as normal when the value was 24 and over. Of the participants, 57% (n=114) were evaluated as normal score and 43% (n=86) as abnormal score. The female mean MMSE score was 21.808 (SD=5.352). The male mean MMSE score was 24.204 (SD= 4.230). It was observed that cognitive impairment was higher among women than men (p=0.002). When we compared the cognitive status, there was no significant difference between uneducated and educated people (p>0.05). The cognitive function of participants with a dominant left hand was significantly lower than those with a dominant right hand (p=0.027). CONCLUSION: Family physicians should be able to competently diagnose, evaluate, and initiate treatment in most patients with dementia. Physicians should be familiar with psychometric instruments such as the MMSE. These instruments are useful both to diagnose Alzheimer`s dementia and follow patients on therapy. The MSSE should be used by family physicians of elderly patients, as early diagnosis and treatment will enable patients to retain the greatest possible functional capacity, and may allow families to care for the patient successfully for a longer period. Consequently, early diagnosis and aggressive treatment are crucial for people with dementia.