Regulation of Dietary Habits: The effect of losing weight on quality of life.

OBJECTIVE: This study aimed to investigate the effects of regulation of nutritional habits on quality of life by applying Short Form (SF-36) Quality of Life Scale. METHODS: SF-36 was administered through face-to-face interviews to a total of 129 individuals (112 female, 17 male) aged 18-65 years. Anthropometric measurements, body mass index, and waist circumference measurement were undertaken simultaneously. The changes in weight, body mass index, waist circumference measurement, and SF-36 scores were compared at baseline and three months after modification of dietary habits. RESULTS: At three months after the regulation of dietary habits, a statistically significant decrease was found in weight, body mass index, and waist circumference measurements (p<0.05). Overall improvement was observed in all the quality of life parameters assessed with SF-36, and among them, the sub-scales of general health, bodily pain and vitality were statistically significant (p<0.05). The improvement in these sub-scale scores was similar to the literature. CONCLUSION: The individuals who lost weight through adopting healthy dietary habits had increased SF-36 scores, indicating the positive effect of regulating diet on their quality of life.

Evaluation of the effects of disabilities due to traffic accidents on the quality of life using SF-36 health survey.

OBJECTIVE: The purpose of this study was to investigate the impact of disabilities caused by traffic accidents on quality of life using the SF-36 health survey. METHODS: The study group included 168 patients (30 females and 138 males) injured in traffic accidents referred to the Department of Forensic Medicine to obtain health reports indicating their degree of disability. One hundred twenty-two cases comprised the control group. The degree of disability for the injured body parts was determined based on the related section of the Disability Regulation for patients regarded as recovered based on examination and consultation. Quality of life was calculated using the SF-36 survey. Patients were additionally evaluated using the physical and mental component summary PCS/MCS) scores. RESULTS: A statistically significant difference was observed between the groups in terms of the injured body parts. The femur, tibia and/or fibula, vertebrae, radius and/or ulna and the humerus were the most frequently fractured bones. The degree of disability in the patient group was 19.22 ± 17.73. Together with the scores of the eight subscales of SF-36, the PCS and MCS score in the patient group were significantly lower when compared to the control group (p<0.05). CONCLUSION: An update is required in the Disability Regulation, including the addition of items on deterioration in the quality of life and pain, and the use of the SF-36 scale may be beneficial in this regard.

Evaluation of growth and neurodevelopment in children with congenital heart disease.

BACKGROUND: Children with congenital heart disease are under risk of delayed growth and development. We evaluated physical growth parameters and neurodevelopment in these patients in comparison with normal children and examined the effect of hemodynamic status. METHODS: Patients with congenital heart disease (n= 76) and healthy children (n= 51) aged 1-72 months applied to Mersin University Hospital, Mersin, Turkey were included. Patients with heart failure and those requiring intervention or surgery were classified as hemodynamically impaired (HI group, n= 30), and the others, hemodynamically normal (HN group, n= 46). Growth parameters including weight, height, body mass index (BMI), mid-arm circumference (MAC), and triceps skin fold thickness (TSF) were measured and standard deviations (SD) were determined. Functional development was assessed by Denver Developmental Screening Test-II (DDST II). RESULTS: MAC and BMI values of the group with impaired hemodynamic status were significantly lower than the hemodynamically normal and control groups (MAC P < 0.05 and BMI P < 0.01). In the DDST II, the group with hemodynamic abnormality had more failures in gross motor and fine motor skills than HN group and controls (gross motor P= 0.011, P < 0.001 and fine motor P= 0.028, P= 0.001, respectively) and more failures in language development than the control group (P= 0.001). CONCLUSION: The results showed the importance of hemodynamic status in growth and neurodevelopment of children with congenital heart disease. Besides routine growth parameters, more detailed examinations such as BMI, MAC, TSF, and developmental screening tests appear useful in identifying children with cardiac disease who are under risk for delayed growth and development.

Effects of antiepileptic drug therapy on heart rate variability in children with epilepsy.

Impaired cardiac autonomic function may contribute to the risk of sudden unexpected death in epilepsy. Heart rate variability (HRV) is a useful tool for the detection of sympathetic-parasympathetic balance of autonomic nervous system. In the present study, epilepsy patients who had never received antiepileptic medication and those whose seizures have been successfully controlled with antiepileptic drugs were compared with each other and a control group in order to investigate the effects of epilepsy and various antiepileptic drugs on HRV. HRV were tested via 5 min ECG monitoring in 92 patients and 83 controls. Time domain parameters including SDNN, RMSSD and the frequency domain parameters including HF (reflects parasympathetic activity) and LF (reflects sympathetic activity) were assessed. In this group, 78 patients were using antiepileptic drugs including valproic acid (n=33), oxcarbazepine (n=19), phenobarbital (n=11), combined regimens (n=10) and other drugs (n=5), while 14 patients had never received antiepileptic medication. For both of the epilepsy patients groups with or without treatment, time domain parameters were found to be significantly suppressed. In addition, parasympathetic activity was found to be decreased (HF was decreased, LF/HF ratio was increased) in epilepsy patients without antiepileptic drug therapy. Our results indicate that seizure control with antiepileptic drugs may help to improve the cardiac autonomic function impairment in epilepsy patients.

What clues are available for differential diagnosis of headaches in emergency settings?

The correct diagnosis of headache disorders in an emergency room is important for developing early management strategies and determining optimal emergency room activities. This prospective clinical based study was performed in order to determine demographic and clinical clues for differential diagnosis of primary and secondary headache disorders and also to obtain a classification plot for the emergency room practitioners. This study included 174 patients older than 15 years of age presenting in the emergency room with a chief complaint of headache. Definite headache diagnoses were made according to ICHD-II criteria. Classification and regression tree was used as new method for the statistical analysis of the differential diagnostic process. Our 174 patients with headache were diagnosed as basically primary (72.9%) and secondary (27.1%) headaches. Univariate analysis with cross tabs showed three important results. First, unilateral pain location caused 1.431-fold increase in the primary headache risk (p = 0.006). Second, having any triggers caused 1.440-fold increase in the primary headache risk (p = 0.001). Third, having associated co-morbid medical disorders caused 4.643-fold increase in the secondary headache risk (p < 0.001). It was concluded that the presence of comorbidity, the patient's age, the existence of trigger and relaxing factors, the pain in other body parts that accompanies headache and the quality of pain in terms of location and duration were all important clues for physicians in making an accurate differentiation between primary and secondary headaches.

Importance of electromyography and the electrophysiological severity scale in forensic reports.

Forensic reports on traumatic peripheral nerve injuries include dysfunction degrees of extremities, which are arranged according to the Turkish Penalty Code. The aim of this study is to discuss the role and importance of electromyography while preparing forensic reports in the cases of traumatic peripheral nerve injuries and the usefulness of scoring systems. A modified global scale, recommended by Mondelli et al., was used to assess the electrophysiological impairment of each peripheral nerve. Forensic reports of 106 patients, reported between 2002 and 2004, were evaluated. Thirty-four percent of the cases were reported as "total loss of function," 41.5% were reported as "functional disability," and there were no dysfunctions in the other cases in forensic reports that were prepared based on Council of Social Insurance Regulations of Health Processes and Guide prepared by the Council of Forensic Medicine and profession associations of forensic medicine. When we rearranged these forensic reports based on the electrophysiological severity scale (ESS), it was clearly found that all of the score 2 cases and 86.7% of the score 3 cases corresponded to "functional disability" and 91.4% of the score 4 cases correspond to "total loss of function." We found a significant correlation between the ESS and functional evaluation in peripheral nerve injury cases. Evaluation of functional disabilities in peripheral nerve injuries with the ESS represents a standardized and objective method used for forensic reports.

Demographical, aetiological and clinical characteristics of poisonings in Mersin, Turkey.

BACKGROUND: As acute poisoning continues to be an important public health problem, and represents a frequent cause of admission in emergency departments, there is a constant need to have up to date information about it. The aim of this retrospective study was to evaluate the demographical, aetiological and clinical characteristics of acute poisonings who were admitted to a university hospital in the south part of Turkey. METHODS: The data of 195 acute poisoning patients who were admitted to the Emergency Department of Mersin University were retrospectively studied. RESULTS: Most poisonings occurred in the age range 0-6 years (57.5%) for children and 17-25 year (46.7%) for adults. The overall female to male ratio was 1.26. Drugs were the most common cause of poisonings (55.4%). Among the drug poisonings, psychotropics (41.7%) were the most frequent agent, followed by analgesics (20.4%). 67.7% of the cases presented to the emergency department within 3 hours of poisoning and the procedures for elimination of poison were performed in most of them. The clinical status of the patients on arrival was generally good. 69.2% of the patients were hospitalized. The mean duration of hospitalization was 2.4+/-2.8 days. 41.8% of the suicidal cases had a history of psychiatric disorders; 92.8% of the patients were discharged home after toxicological treatment; 2.6% of the cases died. CONCLUSION: Further studies are necessary to collect more data and these data will be helpful not only for determining risk factors of acute poisonings but also for developing education and prevention programmes.