Acıbadem Sağlık Bilimleri Dergisi
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Item The Effect of Personal Face Mask Use on Hearing Sensitivity Awareness(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Topdağ, Deniz Özlem; Uğur, EmelABSTRACT Background and Objectives: The speech information obtained from the acoustic cue alone is not sufficient. The visual component of speech is crucial for speech perception. This study aims to show that individual hearing sensitivity awareness has increased due to the blocking of visual components of speech as a result of the use of personal face masks with the Covid 19 pandemic. Subjects and Methods: A scale was prepared with questions that measured individuals’ ability to use auditory stimuli in various conditions before and after the pandemic. The scale prepared consists of two sections and a total of 15 items. The questions in the first section are about pre-pandemic hearing loss awareness, and the second section is about post pandemic hearing loss awareness. The age average of 1046 people included in the study was 49.47 ± 11.06. Results: Those who do not feel the need to repeat what was spoken in face-to-face meetings before the pandemic need to repeat what was spoken significantly after the pandemic (p<0.001). The findings show the increased need to repeat spoken words in individuals who wear face masks. Also, people have trouble recognizing speech in noisy environments is due to the absence of visual speech cues, compared to the absence of such trouble before the pandemic. Conclusion: The use of personal face masks in the post-pandemic period has changed the awareness of individual hearing sensitivity due to the disappearance of the visual element of speech.Item Is it Really Necessary to Perform Colposcopy in Patients with Ascus and HR HPV Positivity?(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Özaltın, SelinABSTRACT Introduction: Papanicolaou (Pap) smear is a very important screening method for detection of cervİcal cancer or cell changes that can lead to it. Atypical squamous cells of undetermined significance (ASCUS) is the most common abnormality seen among all cervical cytologies with the percentage of 4-5% . Human papillomavirus (HPV) infection is regarded as a major cause of cervical intraepithelial neoplasia (CIN) and cervical cancer. Colposcopy is recommended for all women with high-grade squamous intraepithelial lesion (HSIL) and atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H) for cervical cancer screening . It is also recommended for high-risk HPV (HR HPV) positive women with ASCUS. The aim of this study is to evaluate the importance of colposcopy in patients with ASCUS and HR HPV positivity. Materials and Methods: We performed a retrospective study approved by the ethics committee of Acıbadem University. Women with diagnosis of ASCUS and HR HPV positivity who underwent colposcopic evaluation at 2 different gynecologic oncology clinics of our university from January 2011 to January 2019 were included in our study. The age range was from 21 to 48 and the mean age of patients’ was 29. Subjects who were pregnant, hysterectomized or had previous cytological abnormalities were excluded. Conclusion: In this study, we aimed to evaluate the significance of colposcopy in patients with ASCUS and high-risk HPV positivity, especially strains 16 and 18. As mentioned in some other studies, immediate colposcopy is an expensive screening procedure for further evaluation of ASCUS .Item Effect of Treatment Modality on Mobility and Quality of Life in Unstable Intertrochanteric Fractures(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Karademir, Gökhan; Bilgin, Yücel; Demirel, Mehmet; Polat, Gökhan; Erşen, Ali; Kızılkurt, Taha; Büget, Mehmet İlke; Yazıcıoğlu, ÖnderABSTRACT Purpose: The aim of the study was to investigate mobility and quality of life in patients who underwent osteosynthesis with proximal femoral nail (PFN), or arthroplasty for unstable intertrochanteric fractures. Methods: Treatment outcomes of 117 patients (76 Female/41 Male) who were treated with PFN (Group 1, n=66), hemiarthroplasty (Group 2, n=42), or total hip arthroplasty (Group 3, n=9) between 2008 and 2014 were retrospectively evaluated. The mobility of the patients was evaluated with the Palmer and Parker mobility score, and the quality of life was evaluated with the Barthel quality of life index. Results: The mean ages in the groups were 83.51 (range, 75-97) years, 84.72 (range, 75-109) years, and 83.37 (range, 75-94) years; respectively. The mean follow-up periods were 23.26 (range, 3-43.9) months, 19.24 (range, 3-38) months, and 20.1 (range, 3-40) months; respectively. There was no statistically significant difference between the 3 groups in terms of age and follow-up time (p>0.05). Palmer-Parker mobility scores were 6.23 for Group 1, 3.68 for Group 2, and 4.22 for Group 3. Barthel Indexes were 68.73 for Group 1, 37.75 for Group 2, and 52.77 for Group 3. Group 1 had a statistically significantly higher Palmer-Parker mobility and Barthel Index score than Group 2 and Group 3 (p<0.001). Conclusion: We concluded that osteosynthesis with PFN was more advantageous than hemiarthroplasty or total hip arthroplasty in terms of mobilization and quality of life in patients who were operated on for unstable intertrochanteric fracture.Item How should Travel-Related Malaria Management in Emergency Departments of Non-endemic Countries? Single-center Study(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Gün, Cem; Aldinç, Hasan; Çınar, Orhan; Yaylacı, Serpil; Yılmaz, Gürdal; Türkmen, SühaABSTRACT Purpose: Advancements in air travel enabled an increase in traveling to malaria-endemic countries such as those in sub Saharan Africa. An increase in the incidence of imported malaria accompanied these advancements. This study aims to summarize how malaria patients who have imported the disease into non-endemic countries present to the emergency departments and to enlighten physicians in emergency departments by providing suggestions for practical approaches to handling such situations. Methods: This study was conducted retrospectively in a university hospital, from January 1, 2014 to March 1, 2022. Eight years of emergency department records of patients who were examined in the emergency department with a suspected, or definitive diagnosis of malaria were included in the study. Epidemiological and clinical characteristics were evaluated. Results: 892 patients were admitted to the emergency department with suspicion of malaria. Thirty of these patients were diagnosed with malaria, and 846 of the 892 patients were members of airline cabin crews. 94.3% (n=798) of the cabin crew did not use prophylactic medication for malaria. The mean age of the patients was 33.2±8.5. Twenty-five patients were diagnosed via peripheral blood smears, and the remaining three patients were diagnosed with polymerase chain reaction (PCR). Rapid diagnostic tests were positive in 26 out of 28 patients. Conclusion: The risk of acquiring malaria is still high despite short-term visits and airport-limited stays. Travel history should be routinely asked of patients with fever by emergency physicians. Education of people traveling to malaria endemic countries, including cabin crew, regarding malaria prophylaxis and protective measures to prevent mosquito bites plays a crucial role in preventing malaria.Item Electroencephalography and Neuroimaging Markers of Poor Prognosis in Hypoxic-Ischemic Brain Injury(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Tavşanlı, Mustafa Emir; Seçkin, MustafaABSTRACT Purpose: Hypoxic-ischemic brain injury (HIBI) can cause coma.Several factors may affect the outcome after HIBI and prediction of the prognosis is challenging in clinical practice.Magnetic Resonance Imaging (MRI) and Electroencephalography (EEG) are two reliable tools to predict the possible outcome after brain damage.We aimed to test the utility of MRI and EEG in predicting the outcome by exploring specific lesion and electrophysiological patterns. Method: Patients admitted to the intensive care unit (ICU) due to hypoxic-ischemic brain injury between January 2017 and March 2020 were retrospectively reviewed.Patients over 18 years of age with a history of cardiac arrest or respiratory problems leading to hypoxic-ischemic brain injury were included in the study. Glasgow Coma Score (GCS) was used as a clinical measure for the level of consciousness.All patients had a Glasgow Coma Score (GCS) of <8 and had both MRI and EEG investigations.Patients were classified as having Poor Outcome (PO) and Good Outcome (GO).Poor outcome defines either death or lack of recovery in consciousness (GCS<8).MRI findings that could lead to a coma state were classified as “MRI-positive”, otherwise were classified as “MRI-negative”. Modified Hockaday Scale was used for grading of EEG. Results: Nineteen patients with HIBI were included. In the MRI-positive group, 87.5% of the patients had poor outcome whereas the remaining 12.5% had good outcome. In the MRI-negative group, 45.5% of the patients had poor outcome whereas the remaining 54.5% had good outcome. According to the Modified Hockaday EEG Grading System, 91% of the patients with a score of Grade 4 and above had poor outcome whereas only the remaining 9% had good outcome. Conclusion: Although MRI is a valuable clinical marker, EEG seems to be more reliable for predicting prognosis in HIBI.The modified Hockaday scale can be useful for determining the cut-off points for the prediction of poor prognosis.Item Assessment of the Relationship between University Students’ Food Consumption and Anthropometric Measurements and Phase Angle(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Ekici, Merve; Arıtıcı Çolak, GözdeABSTRACT Purpose: This study was carried out to assess the relationship between university students’ food consumption and anthropometric measurements, and phase angle (PA). Methods: The study was conducted with a total of 240 students between the ages of 18-25 studying at the Department of Nutrition and Dietetics at Agri Ibrahim Cecen University Health School. Research data were collected using a questionnaire that included about demographic information and questions about physical activity levels and three day food consumption record was taken. Lastly, anthropometric measurements of the students were performed by the researcher in person. Results: The study’s findings revealed that the students’ energy intake was lower than their energy expenditures. The body mass indexes (BMI), and waist circumferences of female and male students were calculated as 21.8 ± 3.2 kg/m2 and 23 ± 3.4 kg/m2 , and 75.2 ± 8.1 cm and 85 ± 10 cm, respectively. The PA was 5.7 ± 0.5º in female students and 6.7 ± 0.5º in male students (p<0.05). Conclusion: The study’s findings revealed that male students had significantly higher PA values. The PA values of female students were found to have increased with BMI, waist circumference, and body muscle mass values. There was also no significant relationship between students’ PA values and and food consumption levels regardless of gender.Item The Efficacy of Low-Dose Enoxaparin in Psoriasis(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Demircioğlu, Deniz; Atakan, NilgünABSTRACT Psoriasis is a frequently encountered inflammatory skin disease with unclear etiology and no curative therapy. Enoxaparin is a low-molecular weight heparin analogue. Heparin and its analogues in low doses have antiproliferative and immunomodulatory effects. Low-dose enoxaparin has inhibitory effects on T cell-mediated immune reactions. T lymphocytes play a key role in the immunopathogenesis of psoriasis. The aim of this study was to evaluate the efficacy of low-dose enoxaparin in the treatment of psoriasis. Twenty-three patients with chronic plaque and guttate psoriasis were enrolled in an open study. Patients were given subcutaneous injections of 5 mg enoxaparin once weekly for a total of 6 weeks. There was a statistically significant difference between the PASI (Psoriasis Area and Severity Index) scores at the beginning and at the 6th week follow up (p=0.008). Four out of 23 patients (17%) showed marked improvement (≥50% reduction in PASI score), 8 patients (35%) showed moderate improvement (25-49% reduction in PASI score), 5 patients (22%) were unchanged (<25% reduction in PASI score). Six patients (26%) experienced worsening with a corresponding increase in the PASI scores. Based on these findings, 52% of patients were considered to get benefit from enoxaparin treatment. No systemic side-effects due to enoxaparin were observed. The only local side-effect recorded in 7 patients (30%) was ecchymosis at the injection site. Low-dose enoxaparin, which appears to be safe, is a candidate to become a future alternative in the treatment of psoriasis. Further studies assessing the optimum dose and duration of treatment, as well as patient subgroups that will benefit most from enoxaparin treatment are warranted. In addition, efficacy of enoxaparin in psoriasis should be compared to those of standard therapeutic modalities.Item Effects of Anemia on Clinical Outcomes in Hospitalized Patients with COVID-19 Pneumonia(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Kurtoğlu Gümüşel, Hilal; Görmez, Selçuk; Özçağlayan, Ömer; Pamukçu, BurakBSTRACT Objective: We aimed to examine the role of anemia on clinical outcomes including intensive care unit (ICU) admission and mechanical ventilation (MV) in coronavirus disease 2019 (COVID-19) patients. Materials and methods: Totally 175 hospitalized COVID-19 patients were retrospectively included. Patients with a hemoglobin level of <12 g/dL in women and <13 g/dL in men constituted the anemic group, while COVID-19 patients with normal hemoglobin levels constituted the non-anemic group. A logistic regression analysis was performed to investigate the role of anemia and serum ferritin value for prediction of ICU and MV requirement. Results: Of patients, 46 (45.7%, 21 men) had anemia and 129 (68.2%, 88 men) had normal hemoglobin levels. The ICU requirement and MV rates were significantly higher in anemic group compared to non-anemic group (30.4% vs. 15.5%, respectively; p=0.028 and 23.9% vs. 10.9%, respectively; p=0.030). Median length of hospital and ICU stay was longer in patients with anemia (10.5 days vs. 8 days, respectively; p=0.047 and 0 days vs. 0 days, respectively; p=0.027). Anemia and ferritin were significant risk factors for ICU admission in univariate model and multivariate model [OR: 2.384 (95% CI: 1.084-5.246), p=0.031] vs. [OR: 2.738 (95% CI: 1.130-6.635), p=0.026] and [OR: 5.058 (95% CI: 1.968-12.998), p=0.001] vs. [OR: 4.218 (95% CI: 1.521-11.697), p=0.006]. Anemia was also a risk factor for MV [OR: 2.582 (95% CI: 1.075-6.197), p=0.034]. Conclusion: Requirement for therapy in ICU and MV were high among anemic COVID-19 patients. Anemia is also associated with prolonged length of stay in hospital and ICU.Item Eating Behaviours of Lactating Women Differ by Infant Age and Maternal BMI(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Köse, Gizem; Demir, Eftal GeçgilABSTRACT Purpose: In lactation, women experience major changes in their lives as new internal and external demands for attention and care for themselves and the baby, also body mass index due to eating behaviours. Our aim was to define relationships between mindful eating and eating behaviours of breastfeeding mothers by baby’s age and maternal BMI. Methods: This cross-sectional study was conducted between October-November 2021 with 302 lactating mothers without chronic disease. Our study was approved by Ethics Committee of the Acibadem Mehmet Ali Aydinlar University. A questionnaire form that examined demographic data and Mindful Eating Questionnaire (MEQ-30) were applied. Anthropometric variables were reported by participants due to Covid-19 pandemic. Results: Mean age of our participants was 30.6±4.2 years. Mothers with obesity had lowest score in MEQ-30 (p<0.001). Lactating mothers who were underweight had highest MEQ-30 score (p<0.001). It was shown that lactating mothers have highest MEQ-30 score in the first 6 months, and MEQ-30 scores decreased as baby grows (p<0.001). Conclusion: Lactation period can be an appropriate time to bring about long-term changes in eating behavior. Healthcare professionals and teams can apply treatments focused on eating behavior and mindful eating for mothers with obesity in terms of their physical and emotional health, especially after the 6th month of breastfeeding.Item Relationship of Self-Compassion with Anxiety and Depressive Symptoms in Infertile Women(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Ganime Aygün, Elif; Sancak, Barış; Ağırbaş, Ürün ÖzerABSTRACT Purpose: Infertile women have a higher rate of psychiatric symptoms compared to fertile women while depression and anxiety are among the most common psychiatric disorders in this group. Self-compassion might be a variable in predicting depression, anxiety and stress. The study aimed to evaluate self-compassion in infertile women and to examine its relationship with depression and anxiety levels. Methods: This cross-sectional study included a total number of 122 participants. The study group (n=50) consisted of women who applied to the gynaecology and obstetrics clinic for infertility treatment and were recruited consecutively. The control group (n=72) was recruited from hospital staff and their relatives, of the similar age and gender as the study group. The participants filled Self-Compassion Scale (SCS) and Hospital Anxiety and Depression Scale (HADS) in addition to sociodemographic data form. Results: SCS scores were significantly lower, and HADS scores (both depression and anxiety) were significantly higher in the study group, compared to the control group. There was a negative correlation between SCS and HADS scores (p < 0.001), indicating that lower self-compassion levels are associated with increased depression and anxiety. Duration of infertility treatment was not correlated with SCS and HADS scores (p > 0.05). Conclusion: Infertile women have higher levels of depression and anxiety while self-compassion is an influential factor in maintaining psychological well-being and preventing anxiety and depressive symptoms in this group. Self-compassion based or other interventions targeting psychological well-being of infertile women would be beneficial.