[Show abstract][Hide abstract] ABSTRACT: Aim:
Complementary and alternative medicine (CAM) is commonly used all over the world, and herbal medicines are the most preferred ways of CAM. The aim of this study was to determine the frequency of herbal medicine use among patients with chronic diseases.
A cross-sectional descriptive study was conducted from April 2014 to December 2014 among patients who had been diagnosed with diabetes mellitus (DM), hypertension (HT), and hyperlipidemia (HL) in Family Medicine Department of Dışkapı Yıldırım Beyazıt Training and Research Hospital, in Ankara. A questionnaire about herbal drug use was applied by face to face interview to the participants.
A total of 217 patients were included in this study. The mean age of the participants was 56.6 ± 9.7 years (55 male and 162 female). The rate of herbal medicine use was 29%. Herbal medicine use among female gender was significantly higher (P = 0.040). Conventional medication use was found to be lower among herbal medicine consumers. There was no relationship between herbal medicine use and type of chronic disease, living area, and occupation or education level. Most frequently used herbs were lemon (39.6%) and garlic (11.1%) for HT, cinnamon (12.7%) for DM, and walnut (6.3%) for HL.
In this study, herbal medicine use was found to be higher among patients who had been diagnosed with chronic diseases. Therefore, physicians should be aware of herbal medicine usage of their patients and inform them about the effectivity and side effects of herbal medicines.
[Show abstract][Hide abstract] ABSTRACT: Breast-cancer-related lymphedema (BCRL) is a common complication of breast cancer treatment. Informing patients about BCRL can contribute to decrease their risk of developing the condition or prevent it from progressing further. In order to educate patients about BCRL effectively, clinical knowledge of clinicians must be adequate. In study, we aimed to reflect BCRL knowledge and attitude of Turkish primary care physicians (PCPs). This questionnaire-based study was conducted by face-to-face interview method. The participants included actively working PCPs from all parts of Turkey. The questionnaire elicited data on physicians' demographics, the BCRL knowledge, self-reported BCRL knowledge, referral patterns, and education. A total of 314 PCPs with a mean age of 36.9 % ± 8.1 years (mean ± standard deviation) were included in the study. Median BCRL knowledge score of all study group was 15 (11-18) [median (25-75 % range)]. PCPs who received education about BCRL during their medical faculty and/or residency periods had significantly higher knowledge scores (p = 0.005). Of PCPs, 94.9 % indicated to make a BCRL referral for a breast cancer patient. Among them, 55 % preferred to make a referral to a general surgeon, 28.2 % to an oncologist, and 16.8 % to a physical medicine and rehabilitation specialist. Assessment of factors related with BCRL should be part of routine evaluation of patients with breast cancer in primary care. Education of PCPs about BCRL is warranted in order to improve the BCRL care.
Journal of Cancer Education 07/2015; DOI:10.1007/s13187-015-0880-6 · 1.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Although independent associations of complete blood cell count (CBC) parameters with type 2 diabetes mellitus (T2DM) were reported, data about associations of those parameters with bone mineral density (BMD) are limited. Furthermore, the impact of tbl2DM on BMD remains unclear. Therefore we aimed to evaluate the associations of haematological parameters with BMD in elderly female patients with or without tbl2DM and to estimate the differences in BMD between diabetic and non-diabetic patients.
The records of patients who had been referred for BMD analysis to nuclear medicine division of Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey between May 2013 and October 2013 were reviewed.
A total of 275 patients (66 with tbl2DM, 209 without tbl2DM; mean age 72.1 ± 5.4 years) were included into study. White blood cell (WBC) counts, lumbar spine BMD (LSBMD) and femoral neck BMD (FNBMD) were found to be significantly higher in diabetic patients. There was an inverse association between haematocrit (Hct) and LSBMD in diabetic group. (r = - 0.330; P = 0.008). The association remained significant after further adjustment for age, duration of menopause and body mass index (BMI).
Diabetic patients had higher BMD levels compared to non-diabetic individuals. Regardless of the mechanisms, Hct could be a readily available potential candidate to identify diabetic patients with osteoporosis (OP).
[Show abstract][Hide abstract] ABSTRACT: Background
Brucellosis produces a variety of nonspecific hematological abnormalities. The aim of the present study was to evaluate the hematological findings in childhood brucellosis.Methods
Medical records of children with brucellosis, admitted to a tertiary hospital in one year period were analyzed retrospectively.ResultsSixty-nine patients (mean age = 14.5 (±3.3) years) were diagnosed with brucellosis. The most common hematological finding was thrombocytopenia (n = 11, 15.9%). Thrombocytosis was detected in 5 (7.3%) patients, leucopoenia in 4 (5.8%), anemia in 3 (4.3%), and bicytopenia in 3 (4.3%). None of the patients had pancytopenia. Blood culture was positive for Brucella spp. in 41 patients (59.4%). Among those patients with blood culture positivity, six (14.6%) had a serum agglutination test (SAT) titer of 1/80 or lower. Platelets (PLTs) count was significantly lower in bacteremia positive group. The OR (95% CI) of bacteremia in terms of PLTs count for cut off point of 200,000/mm3 was found to be 0.148 (CI = 0.031-0.718) and the RR was found to be 1.718 (CI = 1.244-2.372); p = 0.010.Conclusions
Brucellosis should be kept in mind in the differential diagnosis of isolated thrombocytopenia in pediatric patients from endemic areas.
Pediatrics International 05/2015; DOI:10.1111/ped.12688 · 0.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Dear Sir,Despite the availability of effective preventive and curative medications for osteoporosis (OP), and guidelines for its diagnosis and management, few individuals are treated for OP.1 Data are scarce about the treatment practices against OP in Turkey. Our objective was to describe the patterns of use of medication for OP in a sample of Turkish patients who had been clinically referred for bone mineral density (BMD) analysis at nuclear medicine division of Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey between May 2013 and October 2013.
The Journal of Clinical Pharmacology 11/2014; 54(11). DOI:10.1002/jcph.381 · 2.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background
Adenosine deaminase (ADA) activity has been discovered in several inflammatory conditions; however, there are no data associated with cutaneous anthrax. The aim of this study was to investigate serum ADA activity in patients with cutaneous anthrax.
Sixteen patients with cutaneous anthrax and 17 healthy controls were enrolled. We measured ADA activity; peripheral blood leukocyte, lymphocyte, neutrophil, and monocyte counts; erythrocyte sedimentation rate; and C reactive protein levels.
Serum ADA activity was significantly higher in patients with cutaneous anthrax than in the controls (p<0.001). A positive correlation was observed between ADA activity and lymphocyte counts (r=0.589, p=0.021) in the patient group.
This study suggests that serum ADA could be used as a biochemical marker in cutaneous anthrax.
Medical science monitor: international medical journal of experimental and clinical research 07/2014; 20:1151-1154. DOI:10.12659/MSM.890472 · 1.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Family caregivers of patient in long-term care facilities often have high rates of stress, burden and psychological illness. A descriptive study was carried out with 63 caregivers. Caregivers were asked to complete a demographic questionnaire, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Short form 36 (SF-36), which measures health related quality of life (QoL). The majority of caregivers were female (79.4%), and most often the daughter of the patient in long-term care (47.6%). The mean BDI score of the sample was 18.8 and the mean BAI score was 20.0. Almost all the mean scores referring to the QoL were decreased (lower than 50), with the exception of mental health. On the SF-36 questionnaire, the lowest scores were observed on the role-emotional, rolephysical, social functioning and vitality scales of the SF-36.
[Show abstract][Hide abstract] ABSTRACT: Objective: Recent studies have reported an increasing prevalence of childhood hypertension. Obesity is probably the most important risk factor. The relationship between hypertension and BMI in children has not been studied in Ankara, which is the second largest city in Turkey. Design: Cross-sectional study analysing direct data on height, weight and blood pressure of students. Setting: Population-based study in Ankara, the capital city of Turkey. Subjects: In three schools, 2826 students aged 7-12 years. Results: The overall prevalence of hypertension was 7.9%. Among the 222 hypertensive children, 124 (56%) were boys and ninety-eight (44%) were girls (P = 0.40). In the whole group, 3.6% had only systolic hypertension, 0.7% had only diastolic hypertension and 3.5% had both systolic and diastolic hypertension. The prevalences of overweight and obesity were both 13.9%. BMI was significantly correlated with blood pressure (P < 0.001). Overweight and obesity were more common in boys (P < 0.001). Conclusions: Hypertension was more common than has been reported in other studies. Blood pressure measurement should be routine and frequent in children, especially obese children.
Public Health Nutrition 05/2014; 17(11):1-6. DOI:10.1017/S1368980014000846 · 2.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Asymmetric dimethylarginine (ADMA), the main endogenous inhibitor of nitric oxide synthase, is considered to be associated with endothelial dysfunction. High ADMA levels have been shown to be related with disorders causing vascular inflammation such as hypertension, hypercholesterolemia, atherosclerosis, chronic heart failure, stroke and sepsis. Cutaneous anthrax (CA) is a serious infectious disease which may cause vasculitis. The aim of the study was to investigate the serum ADMA levels in patients with CA.
A total of 35 serum samples of the patients with CA and 18 control sera were tested for ADMA levels using ADMA ELISA kit (Immunodiagnostik AG, Bensheim, Germany).
ADMA levels were found to be significantly higher in the patients group than the controls (p < 0.001). In addition, ADMA levels were found to be positively associated with sedimentation rates (R = 0.413; p = 0.026), and inversely associated with international normalized ratio (INR) levels (R = -0.46; p = 0.011). A cut-off value of 0.475 of ADMA had a sensitivity of 74.3%, specificity of 77.8%, and accuracy of 75.5% in the diagnosis of CA.
Although the exact mechanism still remains unclear, ADMA levels could be related to immune activation in CA. In addition, these data might suggest the higher ADMA levels in patients could be due to the perivascular inflammation and vasculitis in CA.
Annals of Clinical Microbiology and Antimicrobials 03/2014; 13(1):12. DOI:10.1186/1476-0711-13-12 · 2.19 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Aim: Low serum vitamin D and calcium levels as well as high parathyroid hormone (PTH) levels are the most important risk factors in osteoporosis. The aim of our study was to estimate the optimal vitamin D status needed to prevent a rise in PTH concentrations in postmenopausal women.
Materials and methods: A total of 197 postmenopausal women who were at the menopausal period for at least 1 year and who had body mass indexes (BMIs) <25 kg/m2 were recruited between November 2011 and February 2012. Patients were evaluated by dividing them into 4 age groups (39–50 years, 51–60 years, 61–70 years, and >70 years).
Results:The mean age of patients was 60.8 ± 10.9 years. Serum 25-hydroxyvitamin D3 [25(OH)D3] levels were lower than 10 ng/mL in 94 patients (47.7%) and lower than 20 ng/mL in 167 (84.8%) patients. The mean vitamin D level was lowest in group 2 (51–60 years), but the difference was not statistically significant (P = 0.57). PTH levels were higher than 75 pg/dL in 52 patients, and 65.4% of those patients (n = 34) had vitamin D insufficiency (<10 ng/mL).
Conclusion: Vitamin D insufficiency was very common in our study population (84.8%). Treatment should be aimed at achieving a 25(OH)D3 level, at which no further suppression of PTH occurs. Further studies are needed to increase awareness among physicians that with optimal vitamin D levels a rise in PTH and subsequent bone loss is prevented .
Turkish Journal of Medical Sciences 11/2013; 43(6):990-994. DOI:10.3906/sag-1211-88 · 0.50 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Unlabelled:
Low serum 25-hydroxyvitamin D3 (25(OH)D) levels have been associated with insulin resistance and cardiovascular diseases. The influences of gender, puberty and adiposity on vitamin D status and the relationship between 25(OH)D and cardiometabolic risk factors in obese and non-obese children were studied. A retrospective analysis was carried out on 168 Turkish children during late winter. Age, gender, puberty, body mass index (BMI), 25(OH)D levels and cardiometabolic risk factors including lipid profiles, high-sensitivity C-reactive protein and insulin resistance index calculated by homeostasis model assessment (HOMA-IR) were evaluated. The median age of the study population was 11 (4-16) years, and 102 children (60.7 %) were prepubertal. Overall, 98.2 % of patients had 25(OH)D levels lower than 20 ng/mL (median 10.0 (4.0-21.3) ng/mL). The 25(OH)D levels did not correlate with BMI. However, an inverse correlation was seen between serum 25(OH)D and HOMA-IR (rho = -0.656, p = 0.006) and insulin (rho = -0.715, p = 0.002) in pubertal obese subjects. Female gender and puberty were all negatively associated with 25(OH)D.
The association between vitamin D status and BMI is complex, and it does not seem to be altered by mild obesity. In addition, potential influence of puberty should be kept in mind while assessing the relationship between serum 25(OH)D and cardiometabolic risk factors.
European Journal of Pediatrics 10/2013; 173(3). DOI:10.1007/s00431-013-2177-2 · 1.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: There are not enough age-specific studies of secondary prevention in elderly stroke patients in Turkey. The aim of our study is to investigate comorbid diseases and the actual cholesterol levels of elderly home-care stroke patients.
Materials and Methods:This is a descriptive study done by screening the files of the stroke patients visited by home health care personnel between January 01 and December 31, 2012. Lipid profiles and comorbid diseases were investigated in stroke patients aged 65 years or older.
Results: A total of 112 stroke patients were recruited to the study. Most common comorbid diseases along with stroke were hypertension and diabetes mellitus. Total cholesterol, triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels were 173.6 ±46.2 mg/dL, 130.8 ±64.3
mg/dL, 40.5 ±12.9 mg/dL and 105.0 ±36.9 mg/dL respectively. The mean total cholesterol, HDL and LDL levels seemed to increase with age, however there were not statistically significant differences between age groups. However, there was a significant difference of TG levels between age groups 65-74 years
and >85years (P = 0.02). Among patients, 53.6% had LDL levels higher than 100 mg/dL and 82.1% had LDL levels higher than 70 mg/dL.
Conclusion: Dyslipidemia is found to be frequent among stroke patients and in secondary prevention; hypercholesterolemia is undertreated in older patients, mainly in this age subgroup.
[Show abstract][Hide abstract] ABSTRACT: Abstract Interest in childhood metabolic syndrome (MetS) has increased substantially due to the increasing prevalence of childhood obesity on a global scale. Early recognition of MetS is critical in order to delay the development of cardiovascular disease (CVD). In this study, we evaluated the relationship between complete blood count (CBC) parameters and MetS among pre-pubertal children which may provide evidence in support of using low cost, readily available clinical haematological parameters for the detection of MetS. A retrospective analysis was carried out on 330 (125 lean vs. 205 overweight) Turkish pre-pubertal children who attend to a paediatric outpatient clinic. Age, gender, puberty, body mass index, CBC parameters, cardiometabolic risk factors including lipid profiles, high sensitive serum reactive protein (hsCRP) and insulin resistance index calculated by homeostasis model assessment (HOMA-IR) were evaluated and compared among lean, overweight children and children with MetS. The mean age of the study population was 7.4 ± 1.9 years. In both gender, the mean values of mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were significantly lower and red blood cell (RBC), platelet (PLT) counts were significantly higher in overweight children. Overall, 8.4% (n = 28) of patients met the criteria of MetS. Children with MetS had higher levels of PLT and lower levels of mean platelet volume (MPV). Of all the haematological parameters analysed, PLT was positively, whereas MPV was negatively correlated with MetS in girls. In addition, MPV was inversely correlated with fasting blood glucose, HOMA-IR, low density lipoprotein-cholesterol (LDL-C) and low density lipoprotein-cholesterol/high density lipoprotein-cholesterol (LDL-C/HDL-C) ratio in girls after adjusting for confounding factors. The risk analyses of MetS in terms of MPV quartiles showed that the adjusted OR (95% CI) for the lowest vs. the highest quartile was 7.71 (1.45-40.89) in girls. These data might suggest that MPV could be another feature of MetS in pre-pubertal girls and might be used as a surrogate marker for MetS in clinical settings.