Establishing the use of melatonin as an adjuvant therapeutic against paraquat-induced lung toxicity in rats.

It is well known that the intake of paraquat (PQ) causes severe tissue injury leading to numerous fatalities. Considering that the main target for PQ toxicity is the lung and involves the production of reactive oxygen and nitrogen species, transcription factors and inflammatory cytokines, it may be hypothesized that the combination of a potent antiinflammatory and antioxidant agent may counteract more of PQ's effects than an antiinflammatory agent alone. For this purpose, combination of dexamethasone (Dex) and melatonin (Mel) was compared with Dex alone. A total of 40 male Wistar albino rats were divided into four groups as control, PQ, Dex only, and Dex plus Mel. The animals were given intraperitoneally a toxic dose of 19 mg/kg PQ dissolved in 1 ml saline. Control animals were injected with the same amount of saline only. A dose of 1 mg/kg Dex was administered 2 hrs after PQ administration. In the combination treatment group, 20 mg/kg Mel was given with Dex. All drugs were given every 12 hrs for a total of six doses. Five animals in PQ group and three animals in Dex only group died by the end of the study. No deaths occurred in the Dex+Mel group. Dex exerted improvements in several oxidative and antioxidative parameters. However, combination treatment provided beneficial effects against PQ toxicity far greater than Dex alone. This difference was also apparent when tissues were histologically compared. In conclusion, Mel exhibited strong additive beneficial effects with Dex and can be considered as a safe treatment modality against PQ toxicity.

Evaluation of the effect of cola drinks on bone mineral density and associated factors.

The aim of the study was to determine bone mineral density changes caused by consumption of cola drinks and the associated factors. Thirty Sprague-Dawley rats were divided into four groups. Groups 1 and 2, consisting of 10 male and 10 female rats, respectively, were provided with as much food, water and cola drinks as they wanted. Groups 3 and 4, consisting of five rats each, received only rat chow and water. The bone mineral density of the rats was measured using dual energy X-ray absorptiometry at the end of 30 days. The blood values and weights of the animals were also determined. The oesophagus and kidneys were removed for histopathological examination. The weight gain was higher in the groups consuming cola drinks than the control group rats (P < 0.05). Water consumption decreased 5.9 times while total fluid consumption increased 1.6-1.9 times in the group consuming cola drinks. No significant change was detected in the blood calcium levels. There was a significant decrease in the bone mineral density of test groups when compared to the control groups (P < 0.05). While we did not detect any pathological oesophageal changes in the rats consuming cola drinks, examination of the kidneys revealed general glomerular congestion and intertubular bleeding. We suggest that the decrease in bone mineral density might be related to the renal damage caused by cola drinks in addition to other related factors.

Reproductive health education of conscripts in Turkish Armed Forces: first evaluation of training courses.

BACKGROUND: In the frame of the Reproductive Health Program of Turkish Armed Forces, conscripts have been given 1-day participatory, interactive courses by the field military medical trainers in all military garrisons. METHODS: Pre- and posttest knowledge levels of soldiers were tested by 25 true-false questions. Demographic characteristics and test scores were routinely transferred from the training rooms to the reproductive health database by authorized field trainers using the network of the army. Two hundred forty-eight thousand seven hundred ninety-six soldiers with perfect entrance of data have been selected for descriptive analyses. RESULTS: Of all the soldiers, 39.2% were born in 1984. Primary school graduates have constituted the largest group with 34.4%. Only 7.4% of the soldiers were married. The mean precourse score was 65.7% +/- 15.4%, while the postcourse score was 83.5 +/- 12.73% (SD) (p < 0.001). Those who used to live in the east region of Turkey have obtained significantly lower scores on both pre- and posttests in comparison to scores of those who used to live in other regions (p < 0.001). Groups based on five educational levels have obtained significantly different scores, ascending gradually from uneducated to the higher educational level (p < 0.001). The ratio of increase in knowledge was highest in the groups with the lowest educational level and unmarried (p < 0.001). CONCLUSION: Training courses seem to succeed in increasing the knowledge of conscripts, particularly of those with a low socioeconomic and cultural status. However, it requires time to determine whether this increase in knowledge level with promote behavioral change positively and will improve young males' own and their partners' reproductive health status.

Some sociodemographic and diagnostic characteristics of military patients treated in the Department of Medical Oncology, Gülhane Military Medical Academy.

Today, chronic diseases have increased importance. Cancer, for which 10 million new cases are diagnosed around the world each year, is in the lead of such diseases. This study included military personnel with cancer who applied to the Department of Medical Oncology, Gülhane Military Medical Academy, in the period between 1998 and 2003, and it aims to describe some sociodemographic and diagnostic characteristics of the patients. The total number of cases was 938, which included both active duty and retired military personnel with diagnoses of cancer who were given medical care between 1998 and 2003 in the Department of Medical Oncology. For the study group, the five most common diagnoses were lung cancer, colorectal cancer, testicular cancer, non-Hodgkin's lymphoma, and Hodgkin's disease. Although the first three diagnoses among officers were lung cancer, testicular cancer, and Hodgkin's disease, those among retired officers were colorectal cancer, lung cancer, and prostate cancer. Among noncommissioned officers, the first three diagnoses were colorectal cancer, testicular cancer, and Hodgkin's disease for active duty patients and lung cancer, colorectal cancer, and gastric cancer for retired patients. In the group of privates, testicular cancer, Hodgkin's disease, and non-Hodgkin's lymphoma were the first three diagnoses. When we consider the characteristics of cancers, such as high costs of treatment, loss of manpower, and high mortality rates, prevention of cancers and early diagnosis are very important. Because the frequent types of cancers differed for groups according to age and occupation, those characteristics should be considered when cancer screening programs are being developed for the Armed Forces.

Outpatient prescription of oral antibiotics in a training hospital in Turkey: trends in the last decade.

AIM: The aim was to evaluate the changing trends in outpatient prescription of oral antibiotic forms at a Training Hospital in the last decade. MATERIAL AND METHOD: All the outpatient prescriptions during April and May 2004 were evaluated. The diagnosis, the department of the prescriber, the count and generic name of each prescribed antibiotic were all noted. RESULTS: Of the 33,491 outpatient prescripitions, 14.9% included antibiotic (n=5004). The pediatric clinics (26.4%), Ear, Nose and Throat department (13.7%), and the department of Gyneacology and Obstetrics (10.8%) were the leading departments in antibiotic prescriptions. Upper respiratory tract infections (45.4%), urinary tract infection (11.4%) and lower respiratory tract infections (4.2%) shared the first lines of diagnosis stated. Of the antibiotic prescriptions, 96.3% included oral forms. Co-amoxiclav (26.4%), quinolones (11.7%) and cephalosporins (16.5%) were the most frequently prescribed antibiotics. Percent of antibiotic prescriptions based on microbial sensitivity test results was 7.1%. CONCLUSION: Compared with the results of the study carried out 11 years ago; though co-amoxiclav is still the most frequently prescribed antibiotic, many other changes have been observed in antibiotic prescription attitudes.

Association between cigarette smoking and depressive symptoms among military medical students in Turkey.

An association has been documented between two important health concerns, smoking and depression. A cross-sectional study was carried out to explore whether this relationship exists in a sample of Turkish military medical undergraduates. Of a total of 779 military medical undergraduates, 690 agreed to participate in the study. The students completed a self-administered questionnaire including the Turkish adaptation of the Beck Depression Inventory (BDI) and gave a smoking history. It was determined that the smokers among medical students were 2.2 times more likely to have depressive symptoms than nonsmokers. This result extends the significant association between smoking and depressive symptoms in the literature to a sample of Turkish military medical undergraduates.

Morbidity and mortality characteristics of infants hospitalized in the Pediatrics Department of the largest Turkish military hospital in 2001.

A descriptive study was conducted in the pediatric inpatient unit of Gulhane Military Medical Academy, to investigate the morbidity and mortality characteristics of 532 infants hospitalized between January 1 and December 31, 2001, for treatment purposes. Of the study participants, 55.8% were boys and 44.2% were girls. The most common cause of hospitalization was neonatal hyperbilirubinemia (19.7%). The most common admission month was January (12.4%). Of 532 infants, 510 (95.9%) were discharged, whereas 22 patients died in the hospital. Twenty-one patients died in the neonatal period, and respiratory distress syndrome and neonatal sepsis were identified as the most common causes of death. Our finding of associations between male gender and low birth weight and hospital death is consistent with previous knowledge. Despite the high frequencies of pneumonia and gastroenteritis as admission diagnoses, the finding of only one pneumonia-related death and no gastroenteritis-related deaths in the study population is pleasing.

High nitrate intake impairs liver functions and morphology in rats; protective effects of α-tocopherol.

The aim of this study was to determine the effect of high dose nitrate ingested in drinking water, on liver enzymes and histopathology, liver weight/body weight (lw/bw) ratio, serum and liver malondialdehyde (MDA) levels and osmotic fragility in Sprague-Dawley rats. These parameters were compared on 40 rats divided into four groups; control animals (group A) drank filtered tap water containing maximum 10mg/L nitrate while treatment groups drank 200mg/L (group B), 400mg/L (group C) and α-tocopherol plus 400mg/L (group D) nitrate containing water ad libitum for 60 days. As a result, lw/bw ratio increased significantly (p<0.05) among rats that consumed water with 400mg/L nitrate. Osmotic fragility increased significantly in treatment groups (p<0.05 versus control). Liver but not serum MDA levels increased in group C (p<0.05 versus control). Group A showed normal hepatic lobular architecture and histology. After nitrate administration, there was hepatocellular degeneration with increased intercellular space of the liver cells in groups B and C. Liver MDA, osmotic fragility and liver histology have returned to nearly normal in group D. These findings show clearly that high nitrate ingestion can cause pathological changes in liver histology and functions. Moreover, α-tocopherol can prevent these effects, possibly through antioxidant properties.

How medical students use the computer and Internet at a Turkish military medical school.

The aim of this study was to determine how medical students use the computer and World Wide Web at a Turkish military medical school and to discuss characteristics related to this computer use. The study was conducted in 2003 in the Department of Public Health at the Gulhane Military Medical School in Ankara, Turkey. A survey developed by the authors was distributed to 508 students, after pretest. Responses were analyzed statistically by using a computer. Most of the students (86.4%) could access a computer and the Internet and all of the computers that were used by students had Internet connections, and a small group (8.9%) had owned their own computers. One-half of the students use notes provided by attending stuff and textbooks as assistant resources for their studies. The most common usage of computers was connecting to the Internet (91.9%), and the most common use of the Internet was e-mail communication (81.6%). The most preferred site category for daily visit was newspaper sites (62.8%). Approximately 44.1% of students visited medical sites when they were surfing. Also, there was a negative correlation between school performance and the time spent for computer and Internet use (-0.056 and -0.034, respectively). It was observed that medical students used the computer and Internet essentially for nonmedical purposes. To encourage students to use the computer and Internet for medical purposes, tutors should use the computer and Internet during their teaching activities, and software companies should produce assistant applications for medical students. Also, medical schools should build interactive World Wide Web sites, e-mail groups, discussion boards, and study areas for medical students.

Training enlisted men on sexually transmitted diseases and preparation of a training model.

Sexually transmitted diseases (STDs) are serious public health concerns in many countries. One of the main strategies in prevention of STDs is training people who are at high risk for STDs. We aimed to train enlisted men in the Turkish Armed Forces while they served their compulsory military service because every healthy Turkish man has to complete this service and they are at high risk for STDs, as well. This study contains two main parts: trainer training and training of enlisted men. The target groups are health noncommissioned officer school students for the trainer training and enlisted men serving in a military medical academy for STD training. For both groups, we prepared and applied different training programs considering each group's knowledge needs on the topic. To describe knowledge needs, we administered a pretest on both groups. First, we trained candidate trainers, then they trained the enlisted men. We evaluated both programs comparing pre- and posttest results. In both programs, mean test scores of the groups increased significantly. Success levels of the groups also increased significantly after using a cutoff point for test scores. With respect to relative effectiveness, attributed effectiveness, and effectiveness ration, the trainers training program was more effective than the other. As a result, our approach to training enlisted men as young adults is effective. We should evaluate the limitations of the study and consider our experiences to make the program more effective.

Relation between Machiavellianism and job satisfaction in a sample of Turkish physicians.

Job satisfaction is affected by many factors. A consistent negative correlation between Machiavellianism and Job satisfaction was shown by many previous studies. To estimate this association in a sample of Turkish people, 361 physicians were selected among the total number of 5,959 working in Ankara City Center. A self-administered questionnaire including the Mach IV scale and Job Satisfaction scale developed by Kasapoglu was applied to the subjects. Student t test and Pearson correlation were used for analysis. The correlation of -.25 between Job Satisfaction and Machiavellianism scores was significant and consistent with the mean scores on Job Satisfaction between the Machiavellian and Nonmachiavellian groups. Although the present association is small, the inverse value is consistent for Mach IV scale scores with job satisfaction in the literature.

An investigation of the prevalence of depressive symptoms in newly recruited young adult men in Turkey.

The aim of this study is to determine prevalence of depressive symptoms among newly recruited young adult men in the Turkish army. This cross-sectional study was conducted to determine the prevalence of depressive symptoms in this population and to identify associations between depression and socio-demographic characteristics. The Beck Depression Inventory (BDI), adapted for Turkey, was used to assess self-reported experiences of depression among 2910 young adult males who had been recently recruited, according to Turkish law, into the army. It was found that 29.9% (n=835) of the recruits had depressive symptoms. The relationship between the level of depressive symptoms of the recruits and the recruits' settlement type, educational level, income status, smoking and drinking status and level of interest in sports was statistically evaluated. Recruits who smoked or drank, who had low incomes and who were uninterested in sports had higher BDI scores. The prevalence of depressive symptoms (29.9%) found in this study is higher than rates found in studies of non-military populations in Turkey. The higher rate of depression may reflect problems in adapting to an environment that was significantly different from their previous lives in terms of environmental factors and life style, and that had strict disciplinary rules and a heavy physical workload.

The quality of groundwater for certain chemicals in military fields in Ankara.

OBJECTIVE: The goal of this study was to determine the quality of groundwater for certain chemicals from all wells for the military units in Ankara (the capital city of Turkey) to evaluate special situations like a nuclear, biological, and chemical attack. METHOD: The quality of underground water has been evaluated chemically by examining 34 different water specimens. Various chemical parameters and heavy metals have been assessed in these samples by using an ion meter and atomic absorption spectrophotometer. RESULTS: Nitrate and chloride have been assessed at a higher rate with the levels exceeding maximum contaminant levels. Mercury, arsenic, aluminum, iron, conductivity, and salinity have also had levels exceeding maximum contaminant levels for each of them according to the levels set by the World Health Organization. CONCLUSION: This study has given us some powerful clues that underground water in Ankara is at a growing risk to be contaminated mainly with nitrate and chloride. Although more detailed investigations are necessary for a better evaluation, it is clear that preventive measures should be implemented or improved.

Smoking prevalence in military men, and factors affecting this.

The aim of the present study was to determine smoking prevalence among noncommissioned officers and privates and the factors affecting it. This study was carried out in a division of 20,000 soldiers. One of every 10 names on the roster was chosen at random. Responses were received from 1,822 subjects (91.1%), all male, in the final month of their 18-month military service with a mean age of 20.3 +/- 2.2 years. Individuals performing their military service were surveyed using a self-administered, anonymous, personal, and voluntary questionnaire. It was determined that 1,160 (63.7%) of the participants were smokers: 180 (9.9%) were occasional smokers, and 980 (53.8) were heavy smokers. For the fathers of the participants, these rates were 15.4% and 40.5%, respectively. The frequency of smoking was found to be higher in subjects who had high incomes, who had high levels of education, whose fathers smoked, and who were raised in environments in which there were many smokers. It was determined that 31.4% of subjects had begun smoking within the previous 2 years during their period of military service.

Determination of the reasons for unfitness for military service in Turkey.

This study aims to evaluate the frequencies and diagnosis types of cases in which young adult males were classified as unfit for military service before or during military service. This cross-sectional study was conducted between November 1998 and October 1999 by investigating the military medical board records of 21,985 "unfit" cases. Unfit for military service decisions were based on any of 436 different diagnoses. Twenty-three diagnosis types, each with a frequency of greater than 1.0%, collectively accounted for the majority of cases (59.2%). Initial medical examinations before service detected 64.0% of cases, whereas the remaining 36.0% were detected during service. Initial medical examinations can be a remarkable data source to determine the health profile of a young adult male population. High rates of failure in initial medical examinations call for improvements to initial medical examination procedures, which should eventually lead to cost savings for the military.