Özgür Erdem

Maternal Near-Miss (MNM) has become globally recognized as an indicator of pregnancy, birth and the first 42 days of postpartum care services. The World Health Organization has taken a new approach to detail and better analyze maternal deaths. The clinic-based criteria to evaluate maternal care and the quality of related care services have been developed. This is a retrospective case-control study that was conducted in a tertiary hospital. In the study, the medical files of all patients admitted to the intensive care unit during the five-year period between 2018 and 2022 were examined. All patients who met the MNM criteria of WHO during pregnancy, birth and puerperium were included in the case group of the study. Meanwhile, the participants in the control group were selected from mothers who gave birth in the same hospital between August 15 and October 31, 2023 and did not develop any complications during puerperium, using the systematic sampling method. Data collection was performed using an interviewer-administered structured questionnaire and data abstraction. In this five-year period, 198 mothers were diagnosed with MNM. In our study, the prevalence of MNM was found as 218/100.000. The most common laboratory changes that met the MNM criteria were elevated lactate levels (38.89%), acidosis (24.24%) and acute thrombocytopenia. Patients were most frequently admitted to the intensive care unit due to hemorrhage (23.74%), placental abruption (18.18%), pre-eclampsia (15.66%) and cesarean Sect. (10.10%), respectively. The frequency of co-morbidities (Diabetes mellitus, Hypertension, Asthma, Hypothyroidism, etc.) in patients diagnosed with MNM (n = 48; 26.67%) was found to be 5.5 times that of the control group (n = 25; 6.20%) (p < 0.001). It can be said that co-morbidities directly affect the course of motherhood. the education level and family income were found higher in the MNM group compared to the control group. In this regard, the results of our study differ from the studies in the literature in terms of the effects of the education level of mothers and the economic status of families. The effects of socioeconomic and cultural factors on MNM may vary.

This study aimed to determine the incidence of congenital hypothyroidism in Turkey’s Diyarbakir Province and assess the development and growth conditions of people with congenital hypothyroidism. Patients born between 2011-2019 and diagnosed with congenital hypothyroidism within the scope of the newborn screening program were included. The medical records of these patients were retrospectively reviewed. The length and weight for age, weight for length, and body mass index standard deviation scores were calculated. We investigated the treatment status of the patients, whether their relatives had a similar disorder, and the presence of consanguinity between parents. Blood samples were collected from 380,592 newborns. As a result of further tests, 498 newborns were diagnosed with congenital hypothyroidism (incidence: 1/764). Demographic and anthropometric data of 241 patients were analyzed. The patients comprised 46.9% (n = 113) females and 53.1% (n = 128) males. It was determined that 44.4% of the individuals had transient congenital hypothyroidism and 53.6% had permanent congenital hypothyroidism. The parents of 29.8% of the individuals diagnosed with transient congenital hypothyroidism and 44.2% of the individuals diagnosed with permanent congenital hypothyroidism were consanguineous (P = .02). According to the latest anthropometric assessment, 6.8% of individuals diagnosed with congenital hypothyroidism had a weight z-score below −2 SD and 16.9% had a length z-score below −2 SD. The incidence of congenital hypothyroidism was higher in our region. The ratio of consanguinity between parents was higher in patients diagnosed with permanent congenital hypothyroidism than in those diagnosed with transient congenital hypothyroidism. According to the most recent follow-up, weight and age were found to be similar in patients with transient and permanent congenital hypothyroidism.

Amaç: Bu çalışma Türkiye’de bulunan aile hekimliği anabilim dalları, öğretim üyesi, uzmanlık öğrencisi ve uzman sayılarının nicel olarak incelenmesi amacıyla yapılmıştır. Yöntem: Kesitsel tanımlayıcı tipteki bu çalışmada Türkiye’de bulunan üçüncü basamak aile hekimliği klinikleri ve anabilim dalları incelendi. Aile hekimliğindeki mevcut öğretim üyesi sayısı, asistan sayısı ve varsa yetiştirdikleri uzman hekim sayıları araştırıldı. Türkiye’deki her aile hekimliği kliniği veya anabilim dalına Mart-Nisan 2022 tarihlerinde telefon, e-mail veya WhatsApp uygulaması üzerinden ulaşılarak anabilim dalları /klinikler ile ilgili veriler toplandı. Bulgular: Araştırmamızda 105 tane üçüncü basamak aile hekimliği kliniği veya anabilim dalının mevcut olduğu tespit edildi. Türkiye’deki bu 105 aile hekimliği kliniğinde çalışan öğretim üyesi sayısını incelediğimizde 104 doktor öğretim üyesi, 86 doçent ve 74 profesör olduğu saptandı. Türkiye’de şu ana kadar 211 kişinin doçentlik sürecini tamamlayarak Yüksek Öğretim Kurumundan aile hekimliği alanında “doçent unvanı” aldığı tespit edildi. 211 kişiden 93’ünün profesörlük kadrosuna atandığı saptandı. Halen Türkiye’de 3727 Aile hekimliği asistanı ve 4107 aile hekimliği uzmanı olduğu saptandı Sonuç: Türkiye’de ilk anabilim dalının kurulmasından bugüne kadar geçen yaklaşık 30 yıllık zaman zarfında bir tıpta uzmanlık alanı olarak tanınan aile hekimliğinin; nicel ve nitel gelişiminde iyi bir ivme kazandığı görülmektedir. Diğer taraftan artan asistan ve anabilim dalı sayısına göre öğretim elemanı sayısının geride kaldığı saptandı. Bu durumun eğitim kalitesinde gerilemeye neden olmaması için yeni akademisyenlerin yetişmesine öncülük edilmelidir.

Objective: This study was conducted to evaluate the prevalence and transmission routes of COVID-19 in healthcare personnel working in the hospital and the compliance with control measures. Material and Methods: In this study, hospital employees who were tested positive for COVID-19 between April 2 and September 30, 2020, were included. Out of the 1100 employees in the hospital, 80 were tested positive for COVID-19. A face-to-face survey was conducted with 66 healthcare workers that had COVID-19 positive PCR test results but returned to work only after their test results became negative. Results: The prevalence of COVID-19 among the hospital employees was calculated as 7.3% (80/1100). In the study, 66 healthcare workers who were found to be positive for COVID-19, were included. The mean age of the employees was found to be 39.1 ± 8.3 (Min-Max: 23-57) and 71.2% of them were male. COVID-19 was detected most in nurses, emergency room workers (12.1%) and polyclinic workers (12.1%). It was determined that 30.3% (n=20) of COVID-19 positive employees had contact with infected colleagues in the hospital and 19.7% (n=13) had contact with infected household members. 78.7% of the employees had never worked in areas designated for COVID-19. Among employees, the level of compliance with measures of wearing a mask (94%) and ensuring hand hygiene (92%) was found high, while the level of compliance with 1.5-meters social distance (59%) was found low. Conclusion: In a short period of time like the first six months of the pandemic, 7.3% of the hospital workers were infected with COVID-19. Among employees, the level of compliance with the social distance rule was found low. It was determined that 78.7% of the infected employees had never worked in units designated for COVID-19. This shows that areas that are not designated for COVID-19 should not be ignored.

Introduction: The present study was carried out to investigate the effect of Ramadan fasting on human psychology among healthy volunteer people.Methods: In this cross-sectional type study, the universe of the research is composed of healthy volunteer people who registered at the Kayapınar Peyas family health centre in Diyarbakır and declared they planned to fast at the month of Ramadan in 2017. A questionnaire form including a sociodemographic questionnaire and Turkish version of the Depression Anxiety Stress Scale (DASS-42) was formed. The online questionnaire technique was used to obtain the data via e-mail and smartphone. The study was conducted during the summer of 2017. The survey conducted to the same healthy volunteer group one weak before Ramadan (May 22-26) and at the end of Ramadan (June 21-25). SPSS 21.0 statistical package was used in the data analysis. The statistical analyses were considered significant if p<0.05.Results: 73 healthy volunteer subjects with no known health problems and who were not in the risk groups in terms of mental and physical health were included in the statistical evaluation. According to the DASS score, when the pre-Ramadan scores of the samples were compared to the post-Ramadan scores; depression (p=0.001), anxiety (p=0.01) and stress (p =0.002) scores were found to be lower at the end of Ramadan. When compared to the pre-Ramadan scores of the samples and the post-Ramadan scores; anxiety (p< 0.05) prevalence was found to be lower at the end of Ramadan. Conclusion: The results of the current study demonstrated that fasting in the month of Ramadan have been effective in diminishing stress, anxiety, and depression levels.

Günümüzde çok yaygın kullanılan internet ve sosyal medya önemli bir sağlık enformasyon kaynağıdır. Bu araştırmada amacımız, hayatın her alanında baş döndürücü bir hızla yaygınlaşarak kullanılan internet ve sosyal medya ile ilgili aile hekimlerinin alışkanlıklarını incelemek ve bu yeni iletişim araçlarını mesleklerini icra ederken ne kadar ve nasıl kullandıklarını belirlemektir. Tanımlayıcı tipteki bu araştırmanın evrenini Türkiye’de birinci basamakta sağlık hizmeti veren aile hekimleri oluşturmaktadır. Verilerin elde edilmesinde online anket tekniği kullanıldı. Elde edilen veriler SPSS 15.0 paket programı kullanılarak bilgisayara aktarıldı, frekans ve yüzde analizleri yapıldı. Çalışmamıza 716 doktor katıldı. Birinci basamakta çalışan hekimlerin kullandıkları sosyal medya araçlarını incelediğimizde %89,1’i WhatsApp, %78,5’i Facebook, %40,8’i Instagram, %33,7’si Twitter kullanırken, %1,8’i hiçbir sosyal medya aracını kullanmadığını bildirdi. “Her aile sağlığı merkezinin bir sosyal medya hesabı olmalıdır.” önermesine katılımcıların %39,8’i “katılıyorum” derken; %60,2’si katılmadığını ifade etti. Sosyal medya farklı toplum katmanlarında olduğu gibi hekimler arasında da büyük rağbet görmektedir. Ancak bu rağbet mesleki alana ve sağlık alanına yeterince yansıtılmamaktadır. Sağlık kuruluşlarının sosyal medya hesapları geliştirilerek yaygınlaştırılabilir ve bu alanda daha etkili bir iletişim ağı tesis edilebilir.

ÖZET Amaç: Mop-Up Polio aşı kampanyası, çocuk felcinin ortadan kaldırılması için uygulanan aşılama çalışmalarıdır. Bu çalışmada amacımız, Diyarbakır’da bir aile sağlığı merkezi bölgesinde Mop-up oral polio aşı (OPA) kampanyası kapsamında çocuklarına OPA yapılmasını reddeden ailelerin özelliklerinin ve aşıyı reddetme nedenlerinin belirlenmesidir. Yöntem: Veriler Mop-up OPA kampanyasında, çocuklarına aşı yapılmasını reddeden ailelerle yüz yüze görüşülerek elde edildi. Anket formu; aile ve çocukların sosyo-demografik özellikleri ve OPA’nın reddedilmesi ile ilgili 14 sorudan oluşturuldu. Bulgular: Kampanya boyunca 1250 çocuk aşı programına alındı. Bunlardan 38 tanesi (%3.04) aşıyı reddetti. Aşısı yaptırılmayan bu çocukların yaş ortalaması 23.2±17.7 ay idi. En küçüğü 3 günlük ve en büyüğü ise 59 aylık idi. Ankete cevap veren aile bireyleri incelendiğinde; %71’ini çocuğun annesi (n=27), %8’ini çocuğun babası (n=3) ve %21’ini ise çocuğun diğer yakınları (n=8) oluşturmaktaydı. Aşıyı reddeden ailelerin çocuklarının %94.7’sinin diğer aşıları; Sağlık Bakanlığı Ulusal aşı takvimine göre tam iken (n=36), %5.3’ünün ise diğer aşılarının eksik olduğu (n=2) tespit edilmiştir. Çocukların %81.6’sına daha önce OPA yapılmış iken (n=31) %18.4’üne ise hiç yapılmamıştır (n=7). Sonuç: Aşılama faaliyetlerinin yürütülmesinde ebeveynlerin eğitim seviyeleri ve farkındalık düzeyleri hedeflenen aşılama oranlarına ulaşılması için önemlidir. Yapılacak aşı kampanyalarında ailelerin aşılama konusunda eğitilmesi ve farkındalıklarının arttırılmasının aşı retlerini azaltacağı kanaatindeyiz.

Aim. This study aims to determine the knowledge level of the female primary healthcare workers about breast cancer and to reveal their attitude and behaviors about breast self-examination and mammography. Methods. This cross-sectional study was conducted on female primary healthcare workers who work in family health centres. 91% () of female primary healthcare workers agreed to participate in the study. The questionnaire consisted of three parts: sociodemographic characteristics, knowledge about breast self-examination, and actual practice of breast self-examination. Results. The mean (SD) age of the female primary healthcare workers was (range, 20–54 years). The healthcare workers who practiced breast self-examination had significantly higher knowledge level () than those who had not. The respondents had high knowledge level of breast self-examination; however, the knowledge level of breast cancer and mammography screen was low. Conclusions. While the female primary healthcare workers in this study had adequate knowledge of breast self-examination, this is not reflected in their attitudes and practices. Emphasis should be laid on breast self-examination in undergraduate and postgraduate courses for primary healthcare workers, since they are mostly involved in patient education. Aim. This study aims to determine the knowledge level of the female primary healthcare workers about breast cancer and to reveal their attitude and behaviors about breast self-examination and mammography. Methods. This cross-sectional study was conducted on female primary healthcare workers who work in family health centres. 91% () of female primary healthcare workers agreed to participate in the study. The questionnaire consisted of three parts: sociodemographic characteristics, knowledge about breast self-examination, and actual practice of breast self-examination. Results. The mean (SD) age of the female primary healthcare workers was (range, 20–54 years). The healthcare workers who practiced breast self-examination had significantly higher knowledge level () than those who had not. The respondents had high knowledge level of breast self-examination; however, the knowledge level of breast cancer and mammography screen was low. Conclusions. While the female primary healthcare workers in this study had adequate knowledge of breast self-examination, this is not reflected in their attitudes and practices. Emphasis should be laid on breast self-examination in undergraduate and postgraduate courses for primary healthcare workers, since they are mostly involved in patient education.

Doğum Sonrası Psikoz ÖZET Postpartum psikoz, doğum sonrası dönemde ortaya çıkan psikiyatrik bozuklukların en şiddetlilerindendir. Doğum sonrası dönemde %0.1-0.2 oranında görülebilmektedir. Doğumdan sonraki 3-14. günlerde görülmekle birlikte %80'inde belirtiler ilk bir ay içinde ortaya çıkmaktadır. Ailede psikiyatrik hastalık öyküsü olanlarda risk daha fazladır. Gençlerde, primiparlarda ve daha önce ruhsal bozukluk öyküsü olanlarda daha sık görülmektedir. Doğum sonrası östrojen ve progesteron konsantrasyonlarındaki ani düşmenin postpartum psikoz nedeni olabileceği ileri sürülmüştür. Kliniği yorgunluk uykusuzluk gibi belirtilerle başlayabilir. Sanrılar veya halüsinasyonlar gibi psikotik özellikler geliştirirse hasta bebeğe veya kendisine zarar verebilir