Knowledge and behaviors of veterinary students about rabies: A descriptive study from Turkey.

AIMS: This study aimed to obtain data on the knowledge, behavior, and immunization status of veterinary students about rabies. METHODS AND MATERIALS: The population of this descriptive study consisted of all the 770 students of a veterinary faculty (response rate 85.7%; n = 660). A survey was conducted querying the knowledge and behaviors of the participants about rabies. RESULTS: Of the surveyed students 28.6% (n = 189) stated that they were exposed to animal bites at least once, and 50.3% (n = 95) of these students stated that they were vaccinated following the exposure. Of the participants, 23.6% (n = 156) indicated that they received protective rabies treatment (prophylactic vaccination). About 32.9% (n = 217) of the students taking part in the study had pets at home. Around 70.7% (n = 153) of these students stated that their animals were vaccinated against rabies. A significant relationship was found between having a pet and being bitten by an animal (P < 0.001). 50.5% (n = 333) of the students who participated in the study were competent in knowledge, while 48.3% were competent in behavior. Students competent in knowledge or behavior were considerably more in the clinical classes compared to preclinical classes. A significant relationship in favor of men was found between the sexes concerning both knowledge and behavior levels. CONCLUSIONS: The study revealed deficiencies in the students' awareness levels regarding rabies. Ascertaining a sufficient amount of theory and practice courses on rabies in the veterinary faculty curriculum, starting from earlier classes will contribute to the knowledge and behaviors of the students.

The knowledge, attitudes and practices of soldiers in a gendarmerie command headquarters about family planning and venereal diseases.

The objective of this study was to determine the knowledge, attitudes and practices of young male soldiers about family planning. This was a cross-sectional study conducted at the Gendarmerie Command Headquarters, Elazig City, eastern Turkey, carried out on 14 April 2004. One hundred ninety-one of 209 soldiers who were present at the Gendarmerie Command Headquarters were included in the study. A questionnaire, developed by the researchers evaluating the goals of the study, was filled out by the subjects prior to the Family Planning Seminar given to the soldiers. Data were assessed using SPSS and the chi-square test was used for statistical analysis. Defining family planning correctly, being familiar with planning methods and a knowledge of sexually transmitted diseases (STD) and their prevention was found to be at low levels among soldiers. A knowledge of family planning, birth control methods, identification and prevention of STD was higher with higher levels of education. The most familiar family planning methods were condom and oral contraceptive use. Soldiers constitute one of the most significant target groups for education programs.

Prevalence and factors affecting the use of tobacco, alcohol and addictive substance among university students in eastern Turkey.

This study investigated the prevalence and factors affecting the use of cigarettes, alcohol and addictive substances among university students in Eastern Turkey. This cross-sectional study was conducted on 2258 students at Firat University in the city of Elazig, eastern Turkey. The subjects were students, randomly selected from each department of the university. A questionnaire was administered to the students under direct observation. The mean age of the participants was 21.36 +/- 2.93 years. Twenty-nine point three percent of the students smoked and 26.9% used alcohol. Six point six percent declared they had used an addictive substance other than cigarettes or alcohol at least once during their lifetime. Students who smoked had a higher monthly family income and allowance than nonsmokers (p < 0.05). Smoking was more prevalent among students whose fathers, siblings or close friends also smoked (p < 0.05). The use of alcohol was higher among students whose close friends used alcohol (p < 0.05). Six point three percent of participants stated they knew classmates who used addictive substances other than cigarettes or alcohol, and 12.4% declared they knew friends outside the classroom who used addictive drugs. At Firat University a large proportion of students reported using alcohol or smoking. Access to addictive drugs was also prevalent. Educational programs oriented towards young people must be prioritized in order to raise awareness regarding substance use.

Comparison of the severity of traumatic brain injuries in pedestrians and occupants of motor vehicles admitted to Firat health center: a five-year series in an Eastern Turkish city.

BACKGROUND: Traumatic brain injury is the leading cause of death of people in motor vehicle (MV) accidents, which have been increasing in number in developing countries. A retrospective study was undertaken to evaluate all cases admitted to the emergency department of the authors' institution with suspected injury after involvement in a MV-related accident between January 2000 and January 2005. MATERIAL/METHODS: During the study period a total of 2014 cases were admitted: 1258 were occupants of motor vehicles and 756 were pedestrians. Cases with traumatic brain injury were evaluated with respect to gender, age, Glasgow Coma Scales (GCS), and death. RESULTS: Five hundred thirty-two of the cases (386 male, 146 female, mean age: 26.8+/-20.3 years) involved in MV accidents experienced traumatic brain injuries, of which 299 were MV occupants and 233 were pedestrians. The pediatric (< or =16 years: 65.4%) and elderly (> or =65 years: 64.7%) groups were frequently involved as pedestrians in MV accidents; adults 17-64 years of age were involved as pedestrians at a lower rate (25.4%, p<0.001). The GCS values of the pedestrian victims were significantly lower than those of the MV occupants on admission (p<0.001). CONCLUSIONS: The results show that improvements in car safety have reduced life-threatening conditions for occupants of motor vehicles, but this does not include pedestrian safety. There is great need for practical strategies to reduce or prevent MV accident-related injuries among pedestrians, especially for the pediatric and elderly groups who are most exposed to these injuries.

Identification of the risk factors for osteoporosis among postmenopausal women.

OBJECTIVES: The aim of this study was to determine the effect of different durations of menopause at the time of bone mineral density (BMD) measurement and of different age at menopause intervals on the prevalence of osteopenia and osteoporosis among untreated postmenopausal women. We also assessed related factors leading to low BMD. METHODS: A total of 2769 postmenopausal women who had not taken any anti-osteoporosis treatment and/or hormone replacement therapy were divided into three groups according to duration of menopause at the time of BMD measurement. The women were also evaluated in four different age groups according to their age at menopause onset. Multinomial logistic regression analysis was used to determine related factors leading to low BMD. Investigated parameters include demographic characteristics, plasma glucose, lipids, and lipoproteins. RESULTS: According to World Health Organization (WHO) criteria, among 2769 patients, 449 (16.2%) were identified as having osteoporosis, 1085 (39.2%) as having osteopenia, and 1235 (44.6%) as having normal BMD. Osteoporosis was determined in 10.6% and 16.2% of women with menopause duration of 0-3 years and 4-7 years, respectively, whereas this rate was 31.9% in women with menopause duration of over 7 years (p = 0.001). The percentages for osteopenia remained constant among the three different menopause durations (0-3 years: 37.2%, 4-7 years: 42.1%, and >7 years: 40.9%). Thirty percent of women with age at onset of <40 years were osteoporotic. However, the percentages of women with osteoporosis among the other age groups were similar (40-46 years: 18.3%, 47-52 years: 14.1%, and >52 years: 15.4%). The percentages for osteopenia remained relatively constant among the four age groups (36.7, 40, 39.1 and 39%). According to the multinomial logistic regression analysis, duration of menopause at the time of BMD test and parity were positively correlated with both osteoporosis and osteopenia, while glucose level was negatively correlated with both osteoporosis and osteopenia. Age at menopause was negatively correlated only for osteoporosis. Low-density lipoprotein cholesterol (LDL-c) level may be accepted as a clinically significant factor for osteopenia (OR: 1.01; CI(95%): 1.00-1.02). No differences were determined in the prevalence of osteopenia and osteoporosis in women with menopause duration of >7 years when evaluated according to the four menopause age groups as described before (p = 0.74). Contribution to the regression model was 0.8% by age at menopause, 5.6% by menopause duration at time of BMD measurement, 5.8% by both factors. CONCLUSION: According to our results, osteoporosis is related more to the duration of menopause at the time of BMD measurement rather than the age at menopause among untreated postmenopausal women. High parity was determined as another risk factor for low BMD.

Prevalence and consultation behavior of self-reported rectal bleeding by face-to-face interview in an Asian community.

BACKGROUND AND AIM: Although rectal bleeding is a common gastrointestinal symptom, there are very few community-based studies, and all of these studies were conducted in the West. So far the epidemiologic characteristics of rectal bleeding have not been defined in an Asian country. We aimed to characterize self-reported rectal bleeding and its association with functional bowel disorders in Turkey. Factors affecting healthcare-seeking behavior were reviewed as well. SUBJECTS AND METHODS: In this study, 760 subjects were chosen randomly. Questionnaires were completed by nurses during face-to-face interviews with each participant. RESULTS: Of the 707 (93%) subjects included in this study, 9.5% had functional dyspepsia, 8.6% had irritable bowel syndrome (IBS), 24.5% had functional constipation, and 13.8% had functional abdominal bloating. The prevalence of rectal bleeding in the previous year was 14.7%. The recent onset of rectal bleeding was 2.7%. Rectal bleeding was more common among subjects younger than 45 years. Subjects who had functional constipation or constipation-dominant IBS reported rectal bleeding more frequently than others. The rate of consultation was only 41.3% among the subjects with rectal bleeding. Subjects aged > or =45 years and who had marked bleeding or bleeding more than twice a day or fear of cancer sought healthcare more frequently than others. CONCLUSION: Rectal bleeding is as common a symptom in Turkey as in Western countries. Advanced age and fear of cancer were independent predictors of consultation behavior in this group.

Experience of workplace violence during medical speciality training in Turkey.

AIMS: To determine the type, extent and effects of workplace violence among residents during postgraduate speciality training in various departments of medical schools in Turkey. METHODS: A cross-sectional survey was conducted in seven medical schools representing all geographical regions of Turkey. All physicians in speciality training in the selected medical schools were asked to complete a semi-structured 'violence questionnaire' addressing the type (emotional, physical and sexual) and extent of violence experienced, the perpetrators of the violence and the victim's reactions to the experience. RESULTS: A total of 1712 residents out of 2442 completed the questionnaire. In all, 68% indicated they had experienced some form of workplace violence, 67% had experienced verbal violence, 16% had experienced physical violence and 3% had experienced sexual violence. The victims' most prevalent reactions to violence included being deeply disturbed but feeling they had to cope with it for the sake of their career (39%), being distressed (26%) but considering that such events are common in all occupations and discounting it and being confused and bewildered and unsure how to respond (19%). The most frequently named perpetrators of verbal violence were relatives/friends of patients (36%) and academic staff (36%), followed by other residents/senior residents (21%), patients (20%), heads of department (13%) and non-medical hospital staff (6%). CONCLUSIONS: Physicians in speciality training in medical schools in Turkey are subject to significant verbal, physical or sexual violence. Precautions to prevent such exposure are urgently needed.

Can "chromohysteroscopy" help target endometrial biopsy in postmenopausal bleeding?

A preliminary study was conducted to evaluate the value of endometrial dying during diagnostic hysteroscopy. Twenty-two postmenopausal bleeding cases without hysteroscopic findings were included in the study. Before the random endometrial biopsy 5 ml of methylene blue (1%) was instilled into the uterine cavity. Staining was observed in 19 of the cases. Tissues were obtained from both stained and non-stained areas with grasping forceps. "Chromohysteroscopy" led the diagnosis of three more endometrial pathologies; two more cases of endometritis and one more case of endometrial hyperplasia. In conclusion, chromohysteroscopy seems like a new avenue worth pursuing for better diagnoses of unexplained endometrial pathologies.

A survey of rate of victimization and attitudes towards physical violence among school-aged children in Turkey.

BACKGROUND: Violence of any type is a serious issue in the lives of many children from all racial, cultural and economic backgrounds, and is a topic of enormous societal concern in any society. The purpose of this study was to examine the rate of exposure to violence as victims, and attitudes towards physical violence among school-aged children in eastern Turkey. METHODS: All the basic education schools in Elazig, a typical eastern Anatolian city, were included. A total of 3725 fifth and sixth graders were asked to answer survey questions about the rate of physical violence exposure in their everyday lives and whether they thought the violence was an 'acceptable' behaviour. RESULTS: The mean age of participants was 12.8 years with 46.8% boys and 53.2% girls, and their socio-economic status ranged from low-income to upper middle class. Seventy-four per cent of school-aged children reported exposure to at least one case of physical violence in their lives, and 43.4% reported experiencing physical violence within previous 12 months. Higher rates of exposure to physical violence were reported by boys than girls (P = 0.0001). Of the victims, 33.8% regarded physical violence as an acceptable or inevitable way of solution or responding to life events. CONCLUSIONS: Results from the self-report of the receiving end of violent behaviours indicate that physical violent victimization is at an alarmingly high rate among children of eastern Turkey, and a significant per cent of these victims approves violence as a way of solution.

"Chromohysteroscopy" for evaluation of endometrium in recurrent miscarriage.

PURPOSE: "Chromoendoscopy" results in 34 recurrent miscarriage (MR) patients in whom conventional hysteroscopy did not show any apparent endometrial pathology. METHOD: 5 ml of 1% methylene blue dye was introduced through the hysteroscopic inlet. RESULTS: The study group was classified according to the staining characteristics. Group I included 19 patients in whom focal dark staining was observed. Group II included 15 patients in whom diffuse light blue staining was observed. There was no significant difference between the two groups in age, smoking, status, BMI, number of miscarriages and in mean gestational age of the miscarriages. Time to hysteroscopy after the last miscarriage was shorter in Group I (63.9 vs 95.3 days). Then, the study group was classified according to the histopathology result. Group I included ten cases of endometritis while Group II included 24 cases with a normal histopathology. The mean number of miscarriages was higher in Group I (3.4 vs 2.5). CONCLUSION: Chromohysteroscopy improves the efficacy of hysteroscopy in RM cases and is warranted after three miscarriages in two cycles time.

The association between intron 4 VNTR, E298A and IVF 23+10 G/T polymorphisms of ecNOS gene and sildenafil responsiveness in patients with erectile dysfunction.

The objective of the study was to determine the association between intron 4 variable number of tandem repeats (VNTR), E298A and IVF 23+10 G/T polymorphisms of ec-NOS gene and sildenafil responsiveness in patients with erectile dysfunction (ED). Ninety-six patients who were evaluated for ED between November 2003 and June 2004 and 167 healthy individuals representing the normal population as controls were included in the present study. The patients were evaluated by medical history, five-item version of International Index of Erectile Function, serum glucose, testosterone levels and lipid profiles. Sixty-seven patients received four consecutive doses of sildenafil from 25 to 100 mg according to the response. The ec-NOS gene intron 4 VNTR, E298A and IVF 23+10 G/T polymorphisms were evaluated in the isolated DNA blood samples obtained from the patient group with ED (n=96), from the group received sildenafil (n=67) and from the healthy group (n=167). Genotype distributions of ec-NOS gene intron 4, E298A and IVF 23+10 G/T polymorphisms in the patient group were similar to those in the healthy group. The frequency of the ec-NOS gene intron 4 genotype were found as bb=41.7%, ab=50% and aa=8.3% in the sildenafil responders and bb=93.5% and ba=6.5% in the sildenafil non-responders. This finding was statistically significant. Statistical analysis of ec-NOS gene E298A and IVF 23+10 G/T polymorphisms did not reveal any significant difference between sildenafil responders and non-responders. These findings may indicate that 'a' allele of ec-NOS gene intron 4 VNTR polymorphism associates with a better sildenafil response.

Prevalence of domestic violence during pregnancy in a Turkish community.

This study was carried out to determine the prevalence and risk factors for domestic violence victimization of women during pregnancy by intimate partner throughout marriage in a Turkish community. Pregnant women living in the servicing area of selected health centers in Elazig were considered for the study and data were obtained through a questionnaire. A total of 249 pregnant women, mean age 26.8 +/- 5.2 years and the mean gravidity 2.6 +/- 1.7, were involved. Of the 249 women, 28.9% were exposed to at least one case of physical violence throughout matrimony, 12.4% being abused during the previous year and 4.8% during the current pregnancy, 30.5% were exposed to verbal insult and 4.4% exposed to sexual abuse during the current pregnancy. In addition, 25.7% were exposed to one or more types of domestic violence during previous pregnancies. There was a significant correlation between the rate of violent victimization and number of children, and the partner's alcohol habits and socioeconomical status of the families (p < 0.05). Results from the self-report of the receiving end of violent behaviors indicate that the rates of any type of intimate partner violence were very high among pregnant women in this studied Turkish population. Efforts to reduce the incidence of this women's rights and public health problem should be given high priority.

Opinions of high school students in central Elazig about elderliness.

METHODS: Students attending five different types of high schools in central Elazig (a city in Turkey) during the 2009-2010 school year constitute the study population. One class was randomly selected from each high school. Out of 650 students, 640 participated in the study. The data were evaluated by using the SPSS program; percentage, mean, and chi-square analyses were used. FINDINGS: Of all the students, 41.7% defined the elderly as those who are 60 years of age or older. When asked the question "What does elderliness mean to you?", the majority of the students, 27.2%, responded "peace and resting". The second most common answer, given by 23.6% of students, was "sickness/tiredness"; 16.6% responded "wisdom/experience". Many students (30.3%) stated that the most difficult thing about living with the elderly was their interference in everything; 30.6% of students stated that there was no difficulty at all. According to 42.7% of the students, the greatest problem that the elderly face is health. Of all of the students, 58.3% stated that they feared growing old. CONCLUSION: Our study has concluded the following: 1) High school students have a conventional perception of elderliness and 2) They embrace the elderly and think that perspectives on elderliness will change through education.

Aspartame induces angiogenesis in vitro and in vivo models.

Angiogenesis is the process of generating new blood vessels from preexisting vessels and is considered essential in many pathological conditions. The purpose of the present study is to evaluate the effect of aspartame on angiogenesis in vivo chick chorioallantoic membrane (CAM) and wound-healing models as well as in vitro 2,3-bis-2H-tetrazolium-5-carboxanilide (XTT) and tube formation assays. In CAM assay, aspartame increased angiogenesis in a concentration-dependent manner. Compared with the control group, aspartame has significantly increased vessel proliferation (p < 0.001). In addition, in vivo rat model of skin wound-healing study showed that aspartame group had better healing than control group, and this was statistically significant at p < 0.05. There was a slight proliferative effect of aspartame on human umbilical vein endothelial cells on XTT assay in vitro, but it was not statistically significant; and there was no antiangiogenic effect of aspartame on tube formation assay in vitro. These results provide evidence that aspartame induces angiogenesis in vitro and in vivo; so regular use may have undesirable effect on susceptible cases.

Metformin in the treatment of patients with non-alcoholic steatohepatitis.

BACKGROUND: Increased insulin resistance is the major pathogenic mechanism in the development of non-alcoholic steatohepatitis. AIM: To investigate the therapeutic effect of metformin, a well-known insulin-sensitizing agent, in the treatment of non-alcoholic steatohepatitis. METHODS: Thirty-six patients with non-alcoholic steatohepatitis were randomized into two groups. The first group was given lipid and calorie-restricted dietary treatment alone, and the second group was given metformin 850 mg b.d. plus dietary treatment, for 6 months. The changes in biochemical, sonographic and histological parameters were compared. RESULTS: The mean serum alanine/aspartate aminotransferase, insulin and C-peptide levels decreased and the index of insulin resistance improved significantly from baseline in the group given metformin. The mean changes in these parameters in the metformin group were significantly greater than those in the group given dietary treatment alone. Although more patients in the metformin group showed improvement in the necro-inflammatory activity, compared with the group given dietary treatment alone, no significant differences in necro-inflammatory activity or fibrosis were seen between the groups. CONCLUSION: The data suggest that improvement of the insulin sensitivity with metformin may improve the liver disease in patients with non-alcoholic steatohepatitis.

Inhibition of inducible nitric oxide synthase reduces bacterial translocation in a rat model of acute pancreatitis.

INTRODUCTION: Translocation of bacteria from the gut into pancreatic necrosis is an important factor in the development of septic complications and mortality in acute pancreatitis. S-methylisothiourea (SMT) is an inducible nitric oxide synthase inhibitor that has been shown to decrease bacteria] translocation in sepsis and thermal injury. AIM: To investigate whether SMT could affect bacterial translocation in acute necrotizing pancreatitis. METHODOLOGY: Forty-five Sprague-Dawley rats were studied. Acute pancreatitis was induced in Group I and Group II by injection of taurocholate and trypsin into the common biliopancreatic duct. Group III underwent laparotomy with the manipulation (but not cannulation) of the pancreas and received saline injection. Group I rats received normal saline as a placebo, and Group II rats received SMT after surgery for 2 days. At 48 hours, blood was drawn for serum amylase determinations. Bacterial translocation to mesenteric lymph nodes and distant sites (pancreas, liver, and peritoneum) were examined. A point scoring system of histologic features was used to evaluate the severity of pancreatitis. RESULTS: Plasma amylase levels and pancreatic histologic score were significantly reduced in Group II rats given SMT compared with those in Group I rats given saline (p < 0.01, p < 0.05, respectively). All Group I rats had bacterial translocation to mesenteric lymph nodes compared with 7 of 12 rats in Group II (p < 0.05). There was no difference in bacterial translocation to distant organs between the two groups, although rates tended to be lower in Group II compared with Group I (p > 0.05). Bacterial counts in the pancreas were significantly reduced in Group II rats compared with those in Group I rats (p < 0.05). CONCLUSION: Treatment with SMT appears to have ameliorated the course of acute pancreatitis; however, mortality was not affected.

The measurement of exhaled carbon monoxide in healthy smokers and non-smokers.

The measurement of exhaled carbon monoxide (CO) level may provide an immediate, non-invasive method of assessing smoking status. The aims of this study were to use a portable CO monitor to compare the exhaled CO levels in established smokers and non-smokers. The exhaled CO levels were measured in 322 subjects (243 healthy smokers, 55 healthy non-smokers, 24 passive smokers) who applied to healthy stand during the spring student activity of Firat University in Elazig. Exhaled CO concentration was measured using the EC50 Smokerlyser. The mean exhaled CO level was 17.13+/-8.50 parts per million (ppm) for healthy smokers and 3.61+/-2.15 ppm for healthy non-smokers, and 5.20+/-3.38 ppm for passive smokers. There were significant positive correlation between CO levels and daily cigarette consumption, and CO levels and duration of smoking in healthy smokers (r=+0.550, P<0.001, r=+0.265, P<0.001, respectively. Spearman's test). When smokers and non-smokers were looked at as a whole, a cutoff of 6.5 ppm had a sensitivity of 90% and specificity of 83%. In conclusion, exhaled CO level provides an easy, an immediate way of assessing a subject's smoking status.

Effect of hyperbaric oxygen on experimental acute distal colitis.

It has been demonstrated that hyperbaric oxygen (HBO) is useful as an adjunctive therapy for Crohn's disease. However, its effects on ulcerative colitis have not been investigated. In the present study, HBO was tested for acetic acid-induced colitis, and antioxidant systems were evaluated to clarify its possible mode of action. Thirty-six Sprague-Dawley rats were randomly divided into three groups: sham control (Group I), colitis induced by acetic acid without any therapy (Group II), colitis induced by acetic acid and treated with HBO (Group III). HBO was given for 5 days, 2 sessions per day at 2.5-fold absolute atmosphere pressure (ATA) for a period of 90 min in rats in which colitis had been induced (Group III). Rats were sacrificed on the 5th day after the procedure. Superoxide dismutase (SOD), malondialdehyde (MDA) and glutathione peroxidase (GSH Px) activity were measured in the intestinal tissue and erythrocyte lysate. MDA and GSH Px were also determined in the plasma. Whereas MDA levels in erythrocyte, plasma and intestinal tissue were decreased, the levels of GSH Px and SOD were significantly increased in Group III as compared to those of Group II. The results of our study suggest that hyperbaric oxygen therapy has beneficial effects on the course of experimental distal colitis and that antioxidant systems may be involved in its mode of action.