Evaluation of the Effect of Vitamin D Treatment on Cardiac Function in Non-Obese Female Adolescents with Vitamin D Deficiency in Türkiye: A Cross-Sectional Study.

BACKGROUND: Vitamin D deficiency may cause adverse effects on the cardiovascular system as well as many other systems. The risk of vitamin D deficiency increases during adolescence, when the growth rate is high, due to reasons such as limited sun exposure, inadequate dietary calcium, and vitamin D intake. AIM: To evaluate the effect of daily 2000 IU vitamin D supplementation for 12 weeks on cardiac function in non-obese adolescent girls with vitamin D deficiency. METHODS: This cross-sectional study was carried out between September 2021 and June 2022. A total of 108 non-obese adolescent girls having 25-hydroxyvitamin D [25(OH)D] levels below 12 ng/mL were given daily 2000 IU vitamin D orally for 12 weeks. Serum levels of 25(OH)D, alkaline phosphatase, parathormone, calcium, phosphate, and cardiac function were determined before and after treatment. RESULTS: After treatment, the 25(OH)D levels were above 20 ng/mL in 90.8% of the adolescents. The parathormone and alkaline phosphatase levels decreased, while the phosphate levels increased. Echocardiographic tissue Doppler studies showed positive changes in some systolic and diastolic function indicators. In addition, the myocardial performance index decreased from 0.42 ± 0.03 to 0.40 ± 0.03 (P < 0.001) in the left ventricle, from 0.43 ± 0.03 to 0.38 ± 0.03 (P < 0.001) in the right ventricle, and from 0.41 ± 0.04 to 0.38 ± 0.02 (P < 0.001) in the interventricular septum after vitamin D treatment as compared to pretreatment. CONCLUSION: It was observed that administration of 2000 IU vitamin D treatment for a period of 12 weeks to non-obese adolescent girls with vitamin D deficiency contributed positively to cardiac systolic and diastolic function.

The effect of knowledge levels of individuals receiving basic first aid training in Turkey on the applications of first aid.

OBJECTIVES: To evaluate the knowledge level of individuals who attended a first aid training update program, and to determine the factors affecting their approaches in such cases. METHODS: This is a descriptive cross-sectional study. The sample of the research consists of 747 individuals (laypersons) who applied to the first aid training update organized in an institution in Istanbul providing health education between 01.02.2018 and 01.08.2018, and who agreed to participate in the research. These first aid trainings are provided by healthcare professionals who have first aid certificate of authority within the scope of first aid regulation. Data were collected using the "Participant Information Form" and the "Basic First Aid Knowledge Level Evaluation Form". RESULTS: The participants administered first aid within the three years of time following their basic first aid training course (24.6%). They administered first aid primarily in emergency cases of fainting (29.6%) and the majority of them (95.7%) did not perform cardiopulmonary resuscitation during their basic first aid effort. Of the participants, 73.9% answered incorrectly the question: "The letter 'A' in the abbreviation ABC of basic life support administration stands for airway". In our study, it was also found that there was a significant relationship between the total knowledge score and the number of trainings update and first aid intervention in the last three years (P < 0.05, P < 0.001, respectively). CONCLUSIONS: It was determined that individuals had a high level of knowledge about basic first aid and one-quarter of the participants had administered first aid in the last three years. In order for individuals not to lose their knowledge and skills gained through first aid training; updating training and providing first aid training programs to individuals in society can be a guide for bystanders who provide faster and sufficient first aid in cases of emergency.

Factors affecti̇ng health-promoting behavi̇ors i̇n nursi̇ng students: A structural equation modeling approach.

BACKGROUND: The purpose of this study is to evaluate the effectiveness of the Mindfulness-based Stress Reduction program applied to a sample of Turkish nursing students. METHOD: The study was designed as a randomized controlled trial. Program sessions of 90-95 minutes were given twice a week for 12 weeks. The data were collected using the Nursing Education Stress Scale, the Mindfulness Scale, and the Stress Management Styles Scale. RESULTS: A statistically significant difference was found in the mean post-test and mean follow-up scores obtained by the control group and the experimental group on the Nursing Education Stress Scale and its sub-dimensions. On the Mindfulness Scale, a statistically significant difference was found between the mean pre-test and post-test scores obtained by the experiment and control groups. CONCLUSION: The results derived from this study suggest that the mindfulness-based stress reduction program is effective in reducing the stress experienced by students during nursing education, increasing their mindfulness, strengthening their coping mechanisms for stress, increasing their use of self-confident and optimistic approaches, and decreasing their use of the helpless approach.

General Surgery Operating Room Practice in Patients with COVID-19.

The virus COVID-19, which emerged in China in December 2019, was announced by the World Health Organization as a pandemic in January 2020. It is known that infection is not severe and may even progress without symptoms in patients who have come into contact with COVID-19. Although various organizations have been informed about how to take measures to protect the patient and the surgeon in case of diseases requiring urgent or elective surgery in people infected with COVID-19 or in cases with high suspicion, there is still no definite judgment between patients, physicians and health authorities. In this study, which was prepared with the initiative of the Turkish Surgical Association, we tried to shed light on what should be done and how surgeons should act in patients whose operation is mandatory in light of the available data.

Return to outdoor walking, car driving, and sexual activity following elective inguinal hernia repair: surgeons' perspective versus patients' reality.

PURPOSE: To determine the time to resumption of outdoor walking, car driving, sports, and sexual activity following elective inguinal hernia repair, and to reveal if there are differences between surgeons' recommendations and patients' real return times. METHODS: A questionnaire including questions about recommendations to hernia patients for times to resume outdoor walking ability without assistance, driving and sexual intercourse after an elective inguinal hernia repair was sent to surgeons. Also, a short questionnaire was sent to patients who had undergone elective inguinal hernia repair to search the exact times for resuming these physical activities. RESULTS: Surgeons' thoughts and recommendations to their patients varied significantly. The range of recommendations were same day to 20 days for outdoor walking, and same day to 3 months both for driving and sexual intercourse. Patients' actual resumption of postoperative activities were 1-14 days for outdoor walking, 1 day to 3 months for driving, and 1 day to 2 months for sexual intercourse. When the answers from the two questionnaires were compared, it was observed that the mean times for resumption of outdoor walking and sexual intercourse were significantly longer in the patients' lives than recommended by the surgeons. Patients ≥ 60 years were able to walk outside, drive, and participate in sexual activity earlier than the younger patients. Bilateral and recurrent hernia repairs caused slower resumption of different activities in comparison to primary hernias. CONCLUSIONS: Patients reported that times for resumption of outdoor walking, driving, and sexual activity were significantly longer than those recommended by surgeons. Age, BMI, bilateral repair, and recurrent hernias were found to be factors affecting return time to different activities.

Attitudes of Community-Leading Occupational Groups Towards Mental Illnesses: The Sample of a City in Western Turkey.

This descriptive study aims to determine attitudes of community-leading occupational groups towards mental illnesses. The sample of this descriptive study consisted of a total of 1100 participants from clergymen, headmen, teachers, policemen and primary healthcare professionals working in Düzce, Turkey. Data were collected using the Personal Information Form and the Beliefs Toward Mental Illness Scale-BTMIS. Occupational groups were determined to have moderate beliefs about mental diseases according to their BTMIS scale total scores. The occupational groups that had most negative beliefs toward mental illnesses were headmen, police officers, teachers, healthcare professionals and clergymen, respectively. Data were evaluated using descriptive statistics of mean, standard deviation, minimum, maximum, and percentage. Community-leading occupational groups should be actively involved in anti-stigma activities to change quickly and effectively community attitudes towards mental illnesses.

Relationship between mental health of nursing students and coping, self-esteem and social support.

AIM: The aim of this study was to investigate the relationship between the mental health of Turkish nursing students and the stress experienced during their education, their ways of coping, self-esteem, social support and individual factors. BACKGROUND: Studies on nursing students have shown that students who were not in possession of effective coping strategies were at risk of presenting psychiatric symptoms when under stressful conditions. METHODS: This was a cross-sectional, case-control study. The sample consisted of 516 nursing students who were studying in an undergraduate program in Turkey. Participants provided data on sociodemographic characteristics by completing the Nursing Education Stress Scale, Coping Behavior Inventory for Nursing Students, Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, and the General Health Questionnaire. RESULTS: The main factors which were considered to affect the mental health of nursing students, including "total stress" and "self-esteem" scores, "general health" evaluation, "satisfaction with school life" and "presence of a negative event within the last year", were included in all models of the General Health Questionnaire analysis. Analysis of the data indicated that these factors had strong relationship with mental health of the nursing students. DISCUSSION: It is recommended that the mental health of students be monitored throughout the nursing education period and that preventive practices should be established in order to forestall mental health problems amongst nursing students. CONCLUSION: The stress levels of nursing students should be monitored in order to facilitate their ability to cope with stressful situations during their training, and components for coping with stress should be included in the curricula of nursing departments.

The relationship between educational stress, stress coping, self-esteem, social support, and health status among nursing students in Turkey: A structural equation modeling approach.

BACKGROUND: Nursing education can be a stressful experience. To fully benefit from this experience and develop a positive professional identity, it is essential for nursing students to effectively cope with education-related stress. PURPOSE: The aim of the study was to investigate the relationships between nursing students' education-related stress and stress coping, self-esteem, social support, and health status. METHOD: This study utilized a cross-sectional, descriptive, and correlational design. The sample consisted 517 nursing students from a bachelor program in Turkey during the 2014-2015 academic year. Participants provided data on sociodemographic characteristics as well as completing the following instruments: Nursing Education Stress Scale, Coping Behavior Inventory for Nursing Students, Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, and General Health Questionnaire. Relationships were examined using multivariate structural equation modeling. RESULTS: Results indicated that nursing students' stress coping levels were affected by self-esteem and social support. Additionally, this interaction appears to affect general health status. Although the direct effect of stress on coping was non-significant, its overall effect was significant within the model. CONCLUSION: It is necessary to conduct further intervention studies examining the role of self-esteem and social support in facilitating nursing students' stress-related coping during their education.

Comparison of inguinal hernia repairs performed with lichtenstein, rutkow-robbins, and gilbert double layer graft methods.

Tension-free repairs are performed commonly in inguinal hernia operations. The objective of the present study is to compare the outcomes of three different tension-free repair methods known as Lichtenstein, Rutkow-Robbins, and Gilbert double layer. One-hundred and fifty patients diagnosed with inguinal hernia were randomly split into three groups. The comparisons across groups were carried out in terms of operation length, postoperative pain, femoral vein flow velocity, early and late complications, recurrence rates, length of hospital stay, time required to return to work, and cost analysis. No difference was found between the groups regarding age, gender, type and classification of hernia, postoperative pain, and late complications (p > 0.05). Operation length was 53.70 ± 12.32 min in the Lichtenstein group, 44.29 ± 12.37 min in the Rutkow-Robbins group, and 45.21 ± 14.36 min in the Gilbert group (p < 0.05). Mean preoperative and postoperative femoral vein flow velocity values were 13.88 ± 2.237 and 13.42 ± 2.239 cm/s for Lichtenstein group, 12.64 ± 2.98 and 12.16 ± 2.736 cm/s for Rutkow-Robbins group, and 16.02 ± 3.19 and 15.52 ± 3.358 cm/s for the Gilbert group, respectively. Statistical difference was found between all the groups (p < 0.001). However, no difference was determined between the groups regarding the decrease rates (p = 0.977). Among early complications, hematoma was observed in one (2 %) patient of Lichtenstein group, five (10 %) patients of Rutkow-Robbins group, and three (6 %) patients of Gilbert group (p = 0.033). Cost analysis produced the following results for Lichtenstein, Rutkow-Robbins, and Gilbert groups: US $157.94 ± 50.05, $481.57 ± 11.32, and $501.51 ± 73.59, respectively (p < 0.001). Lichtenstein operation was found to be more advantageous compared with the other techniques in terms of cost analysis as well as having unaffected femoral blood flow. Therefore, we believe that Lichtenstein repair is still the most appropriate surgical option in patients diagnosed with inguinal hernia.

The prevalence and risk factors of low back pain in the eastern Black Sea region of Turkey.

BACKGROUND: Low back pain (LBP) is a public health problem commonly seen in all societies. OBJECTIVE: The aim of this study was to determine the prevalence and specific risk factors of low back pain (LBP) in the central and outlying districts of the province of Trabzon, a Black Sea region of Turkey. METHOD: A random sample of 7897 (4006 men and 3789 women) adults was collected by using sampling techniques of stratification. In this study questionnaires were completed at face-to-face interviews with participants selected on the basis of place of residence, gender and age group. The used variables in this study were: use of cigarettes, status of marriage, level of education, and presence of chronic disease, the prevalence of lifetime LBP and of LBP in the preceding year. Chronic LBP was determined as being present for more than 6 weeks. RESULTS: The lifetime prevalence of LBP in the general population was determined at 62.1%. Prevalence in the preceding year was 46.1%, and that of LBP lasting more than six week was 18.1%. Lifetime prevalence of LBP, prevalence of LBP in the preceding year and prevalence of pain lasting more than six week were all statistically significantly higher in women (p< 0.001). Use of cigarettes, female gender, marriage, a low level of education and presence of chronic disease were identified as independent risk factors for LBP (p< 0.001). CONCLUSION: Lower back pain is a common public health problem. Recommendations were made for local health services to prevent LBP, including health education through combating chronic diseases, reducing cigarette consumption, improvement of working environments and life styles.

Intravenous Versus Oral Antibiotic Prophylaxis Efficacy for Elective Laparoscopic Cholecystectomies: a Prospective Randomized Controlled Trial.

The aim of the present prospective randomized controlled trial is to compare the effectiveness of intravenous and oral antibiotic prophylaxis for cost and surgical site infection in elective laparoscopic cholecystectomy. Three hundred twenty patients were split into two groups as to include 160 patients in each, and they were evaluated in a prospective and randomized fashion. While one group was subjected to 1 g cefazolin via intravenous route during anesthesia induction, other group received 1 g cephalexin monohydrate via oral route 1 h prior to the operation. Demographic findings and operation results of the patients were compared by analyses. Our 320 patients (278 females and 42 males) received elective cholecystectomy and were followed up for a period of 6-26 months. Each group had 160 patients. Both groups were similar with regard to demographic characteristics and inclusion criteria. Among all, only five (1.5 %) cases demonstrated postoperative surgical site infection. Surgical site infection at postoperative period was determined in three (1.8 %) cases of intravenous prophylaxis group and two (1.2 %) cases of oral prophylaxis group. There was no statistically significant difference between the groups in terms of surgical site infection. Oral antibiotic prophylaxis can be used in elective laparoscopic cholecystectomy prophylaxis due to its cost-effective, reliable nature, and low surgical site infection rate.

Evaluation of the temperament and character properties of patients with ankylosing spondylitis.

PURPOSE: The aim of this study was to evaluate temperament and character of ankylosing spondylitis (AS) patients and to examine the association between these specific temperament and character properties and clinical variables. PATIENTS AND METHODS: This study involved 73 AS patients. Temperament properties of patients were evaluated using Cloninger's Temperament and Character Inventory (TCI). Association between clinical variables and specific temperament features were evaluated using correlation and regression analyses. RESULTS: Forty eight (65.8 %) of the study participants were men and the mean age was 42 ± 11.4 years. There was slight negative correlations between self directedness (S) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores (p = 0.01, r = - 0.30), and between the Visual Analog Scale (VAS) and reward dependence (RD) scores (p = 0.03, r = - 0.26). Regression analysis showed that correlations between BASDAI and S, and between VAS and RD scores were statistically significant. CONCLUSION: Our study showed that the dimensions temperament and character are related to disease activation, and disease course is more severe in patients who have low scores in these TCI dimensions. Therefore, we suggest that evaluating temperament and character properties of AS patients will help clinicians to predict treatment compliance and motivation of patients during disease course.

Foreign bodies in the rectum: an analysis of 30 patients.

PURPOSE: A foreign body in the rectum is a rare clinical entity. These foreign bodies can be classified under two major groups: the ones that are inserted from the anus and the ones that are swallowed and thereafter become stuck in the rectum. METHODS: Data of patients admitted with a foreign body in the rectum between 1988 and 2008 were retrospectively analyzed. A total of 30 patients were reviewed. RESULTS: The most common reason for a foreign body in the rectum was insertion for erotic purposes, which was seen in 19 of the 30 patients. All these patients were male. The remaining 11 patients reported nonerotic causes. The most efficient and implemented therapeutic method was simple extraction during the first examination. CONCLUSIONS: The most common reason for a foreign body in the rectum is insertion for erotic purposes. The first target of therapy should be extraction of the foreign body using the simplest method possible. Meanwhile, protecting the integrity of the intestine is of the utmost importance. The care for maintaining the integrity of the rectum should include an evaluation of the patient's psychological status.

A therapeutic and diagnostic dilemma: granular cell tumor of the breast.

Six to eight percent of granular cell tumors are seen in the breast. Although mostly benign, they rarely have malignant features clinically and radiologically reminding of breast cancer. This may lead to a potential misdiagnosis of breast carcinoma and overtreatment of patients. The final diagnosis is made by immunohistochemical examination. We performed excisional biopsy on a patient who was diagnosed to have a breast mass. The histopathological examination of the mass revealed granular cell tumor.

Incisional hernia in action: the use of vacuum-assisted closure and porcine dermal collagen implant.

In this paper, we describe our experience in the successful use of vacuum-assisted closure (VAC) and porcine dermal collagen (PDC) mesh reconstruction of a complicated contaminated abdominal wall defect resulting from a strangulated incisional hernia with late jejunal perforation in a 57-year-old obese and diabetic woman.

Global attention to Turkey due to desertification.

Desertification has recognized as an environmental problem by many international organizations such as UN, NATO and FAO. Desertification in Turkey is generally caused by incorrect land use, excessive grazing, forest fires, urbanization, industry, genetic erosion, soil erosion, salinization, and uncontrolled wild type plants picking. Due to anthropogenic destruction of forest, steppe flora gradually became dominant in Anatolia. In terms of biodiversity, Turkey has a significant importance in Europe and Middle East. Nine thousands plant species naturally grown in Turkey, one third of them are endemic. Also, endemic species of vertebrates, thrive in the lakes and marshy areas. The studies of modelling simulation of vegetation on the effects of Mediterranean climate during the Roman Classical period by using vegetation history showed that, in 2000 years BP, Mediterranean countries were more humid than today. Turkey is a special place on the global concern in terms of desertification because of biodiversity, agricultural potential, high population, social and economical structure, topographical factors and strategic regional location. Communication among scientists, decision makers and international non-profit organizations must be improved.

The effects of heat stress and sperm quality classification on broiler breeder male fertility and semen ion concentrations.

1. The present study was undertaken to determine the effects of heat exposure on fertility, semen quality, and semen ion concentrations of broiler breeders classified on sperm quality index (SQI) before heat stress. 2. Cobb males (108) were individually caged in 6 temperature-controlled rooms. Each room contained an equal number of males from each of the 4 SQI population quartiles as follows: best (B), good (G), fair (F), and poor (P). Three rooms were heated to 35 degrees C, and the other three rooms were maintained at a constant 23 degrees C as controls. For each SQI group in each room, 15 Leghorn hens were artificially inseminated (5 x 10(7) sperm/hen) once a week for 8 weeks for fertility observations. 3. Body weight, sperm concentration, SQI, and fertility of P males were lower than in the other three SQI groups. Body temperature of the top three SQI groups was increased by heat exposure, but body temperature was not altered by heat stress in the P group. Fertility, sperm viability, and SQI of the top three SQI groups, but not the P group, was decreased by heat stress. Seminal plasma K+ of P males was lower than that of B males. However, seminal plasma Ca2+ concentration of P males was higher than that of B males. 4. In conclusion, high ambient temperatures had more impact on semen quality and fertility of males in the top 75% of the SQI population than in males in the bottom 25% of the population. In addition, calcium ions (Ca2+) appear to play a major role in heat stress infertility.

Fertility of broiler breeders following categorization by the OptiBreed sperm quality index when hens are inseminated with a constant number of sperm.

If semen quality was known prior to insemination, sperm doses could possibly be decreased, maximizing the number of hens inseminated. The sperm quality index (SQI), an indicator of overall semen quality, is determined by the number of deflections in a light path due to sperm movement inside a capillary tube. The objectives of this study were 1) to determine the age at which the SQI becomes a static predictor of semen quality and 2) to determine if fertility of males with a higher SQI responds more favorably to insemination dose reduction than that of males with a lower SQI. Weekly from 23 to 32 wk of age, 144 Cobb males were tested for SQI. At 32 wk of age, males were placed into four groups that represented the SQI population quartiles as follows: poor, fair, good, and best. A fifth SQI group, uncategorized, was created to determine fertility of the original population by mixing equal amounts of semen from each of the four groups. Semen was collected weekly from 33 to 40 wk of age from 18 males in each of the four groups, pooled by group, and used to inseminate 30 hens per group with 50 or 100 million sperm. Eggs were collected daily, incubated, and broken out to determine fertility. Correlation coefficients between weekly SQI results and overall averages for individual males indicated that the SQI stabilized after the birds were 28 wk of age. The main effect for SQI selection revealed that the best SQI group had the highest fertility (88%), which did not differ from the good (83%) or fair group (82%) but was greater than the uncategorized group (80%). Fertilities of the top three groups and the uncategorized group were higher than the poor group (63%) (P < 0.0001, SEM 2.18). In addition, there was an interaction between SQI classification and insemination dose. Fertilities of the top three SQI groups were similar at the 50 and 100 million sperm doses. However, the poor and uncategorized SQI groups had lower fertility at the 50 million dose as compared to the 100 million dose. By categorizing males into SQI groups after 28 wk of age, insemination dose can be reduced, maximizing a male's fertilizing potential.

Elevated body temperature directly contributes to heat stress infertility of broiler breeder males.

Alterations in the male reproductive tract, sperm, or both may be responsible for heat stress infertility of broiler breeder males. The present study was conducted to determine the direct effects of hyperthermia during heat stress on sperm viability, the spermquality index (SQI), and seminal plasma ion concentrations by incubation of semen in vitro at and above normal body temperature. Thirty-seven Cobb males were divided into the upper (best group = B) and lower (poor group = P) 50% of the population according to their SQI. Semen characteristics and seminal plasma ion concentrations (Ca++, Na+, K+, and Cl-) for B and P males were evaluated at two temperature treatments (41.5 and 42.5 C) and four incubation times (0, 30, 60, and 90 min). The results revealed that sperm viability and the SQI were decreased by increasing incubation temperature and duration of exposure. Seminal plasma ion concentrations were not affected by semen incubation temperature; however, plasma Ca++ concentration in the P-SQI group was higher than that of the B-SQI group. Seminal plasma K+ concentration increased in both SQI groups over time. In conclusion, it is apparent that changes in semen characteristics due to elevated body temperature alone contribute to heat stress infertility of broiler breeders.