Acta Medica Ruha
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The Silent Danger Encountered in the Early Period After the 2023 Kahramanmaraş -Türkiye Earthquake: Carbon Monoxide Poisoning: Research Article
No full textIntroduction: Carbon monoxide (CO) poisoning is a clinical condition that is difficult to diagnose. It is encountered more frequently and is more challenging to diagnose during disasters, where clinicians are primarily focused on health problems directly caused by the disaster, and living conditions are harsh and deviate from standard living conditions.
Objective: This study aims to examine carbon monoxide poisoning, one of the dangers that may arise from deteriorated living conditions following disasters, and to draw attention to this insidious threat.
Method: The study included patients who were admitted to the emergency department with suspected carbon monoxide poisoning after the major earthquake on February 6 in Hatay province, and whose preliminary diagnoses were confirmed by blood gas tests. General characteristics of the patients, such as age and gender, their prognosis, and treatments received were obtained by retrospectively reviewing hospital records. The data were analyzed using the SPSS 23 program.
Results: After the February 6 earthquake, 61.1% of the patients who applied to the emergency clinic with CO poisoning were women, and 63% of them built shelters with their own means and created their own heating facilities. It was determined that the fire lit inside the shelter was lit for heating purposes.
Conclusion: As a result of the adverse development of seasonal conditions immediately after the earthquake, it was seen that people affected by the earthquake tried to meet their heating needs with their own means and that shelters such as tents or huts were especially dangerous. It is recommended that people affected by the earthquake be warned about this issue through mass communication means
Monoclonal Gammopathy with Isolated CA 19-9 Elevation: A Rare Case: Case Report
No full textObjective: CA 19-9 is a tumor marker used in the diagnosis of pancreatic and gastrointestinal cancers, but its isolated elevation can also be seen in benign conditions.
Method and Result: A 48-year-old man presented with complaints of abdominal pain and malaise and a CA 19-9 level of 500 U/mL. Imaging studies did not show malignancy. Serum protein electrophoresis revealed IgG class monoclonal protein and bone marrow biopsy was normal. The patient was diagnosed with monoclonal gammopathy of unknown significance. Six months later, CA 19-9 level decreased to 300 U/mL and no malignancy developed.
Conclusion: Isolated CA 19-9 elevation may be associated with causes other than malignancy and may be related to monoclonal gammopathy. In such cases, careful evaluation and unnecessary procedures should be avoided
Historical Development And Economic Impact Of Physiotherapy: Research Article
No full textIntroduction: Physiotherapy is a healthcare discipline focused on promoting functional mobility, preventing disability, and enhancing quality of life through evidence-based interventions.
Objective: This study aimed to evaluate the historical institutionalization of physiotherapy and its economic reflections in global health systems.
Methods: A literature-based review was conducted using international policy documents, historical reports, and economic evaluation studies addressing physiotherapy’s development and integration into healthcare systems.
Results: Findings indicated that physiotherapy evolved from wartime rehabilitation efforts into a professionalized and cost-effective healthcare service. Recent digital transformations have further expanded its clinical, preventive, and economic scope.
Conclusion: Physiotherapy has become a strategic component of global health systems, contributing both to patient-centered care and to sustainable health economics. Its integration into wellness models and digital health platforms underscores its growing multidisciplinary importance
Impact of Comorbidities on Physical Activity in Children with Cerebral Palsy: Research Article
No full textIntroduction: Cerebral palsy (CP) is commonly associated with various comorbidities that may affect children's engagement in physical activity. This study aimed to investigate the individual and cumulative effects of common comorbid conditions on physical activity participation in children with CP.
Objective: To examine how different comorbidities influence physical activity levels in children with CP.
Methods: A cross-sectional study was conducted with 67 children diagnosed with CP (aged 5–18 years). Data on comorbidities, including visual and hearing impairments, learning disabilities, scoliosis, hip dislocation, epilepsy, and hydrocephalus, were collected via parent-reported questionnaires. Physical activity participation was assessed using the Physical Activity Questionnaire for Children (PAQ-C).
Results: Children with learning disabilities, scoliosis, and hip dislocation had significantly lower PAQ-C scores compared to those without these conditions (p < 0.001 for each). No statistically significant differences were observed between children with and without visual or hearing impairments. A significant negative correlation was found between the total number of comorbidities and physical activity levels (r = -0.438, p < 0.001).
Conclusion: Not all comorbidities equally affect physical activity in children with CP. Learning difficulties, orthopedic problems, and multiple coexisting conditions are particularly associated with decreased activity. These findings underscore the importance of individualized and multidisciplinary strategies to address these barriers and enhance physical activity participation among children with CP
Relationship Between Upper Gastrointestinal Tract Bleeding And Seasonal Meteorological Parameters: Research Article
No full textIntroduction: Determining the relationship between seasons, circadian rhythm and weather has been addressed in many studies since triggering factors may contribute to the incidence of diseases.
Objective: We sought to investigate the association between meteorological factors and the occurrence of peptic ulcer bleeding.
Methods: This study was conducted retrospectively, endoscopic reports, gender, day, month, year and season of admission were recorded in patients with peptic ulcer-related gastrointestinal bleeding. Throughout the study period, data on daily average temperature (°C), daily average atmospheric pressure (mb), daily average relative humidity (%), and maximum wind speed (m/s) were analyzed and compared.
Results: Endoscopy was performed in 176 patients with upper intestinal bleeding. 67% (n=118) of the patients were male. The average age of the patients was 59.87±19.19 years. The highest number of patients was found in winter (n=54, 30.7%) and highest number was found in March (n=20, 11.40%). However, there was no significant variation in proportion of patients admitted across different seasons (p=0.109). In addition, regression analysis revealed that daily meteorological parameters alone had no effect on upper gastrointestinal bleeding due to peptic ulcer.
Conclusion: The highest number of patients was found to be in winter and the lowest in spring. However, while a negative correlation was observed between the number of patient admissions and mean air temperature, this correlation was not statistically significant. There was a positive correlation between daily mean relative humidity and daily mean atmospheric air pressure, but meteorological parameters alone were not effective in the number of patients admitted with gastrointestinal bleeding (GIB)
Evaluation of Physiotherapy and Rehabilitation Undergraduate Students’ of Clinical Practice Skills: Research Article
No full textIntroduction: Clinical practice courses in physiotherapy are very important for training clinically competent physiotherapists. The quality of students' clinical skills training can be enhanced by rigorously monitoring and assessing their performance in these environments.
Objective: To evaluate the observations and practices in the course forms used in the clinical practice education of physiotherapy students.
Methods: In this descriptive study, the clinical practice education of fourth-year physiotherapy students was evaluated with forms filled out by 170 students in the 2022-2023 academic year.
Results: Students achieved the minimum number of observations and applications specified in the forms for each application. The observations, evaluations and applications made by the students in clinical practice are as follows: It was found that there were exercise applications with 10.37%, electrotherapy applications with 9.49% and some evaluation methods (pain, joint range of motion and muscle strength) with 5.4%. On the other hand, there was limited participation in some neonatal assessments/applications and some specific electrotherapy (biofeedback, iontophoresis and hydrotherapy) approaches. Students mostly participated in exercises for general physiotherapy and neurological rehabilitation units. The students used electrotherapy methods mainly in pediatric and orthopedic therapies.
Conclusion: The clinical practice forms tried for the first time in this study made a limited contribution to monitoring the clinical practice performance of students. Forms have the potential to provide feedback to students and educators in areas such as planning and supervision. Ensuring that students are involved in the development of the forms and getting their views can be useful
Comparison of Stress Levels of High-Risk and Low-Risk Pregnant Women: Research Article
No full textIntroduction: Pregnancies can be classified as “low-risk” and “high-risk” in terms of risk situations during pregnancy.
Objective: The purpose of this study is to determine the stress levels of high-risk and low-risk pregnant women.
Method: This experimental study included 300 pregnant women who applied to the Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine between September and November 2022.
Results: When we evaluated the participants, who were divided into 2 groups according to their stress scores, the most stressed group was in group 1 according to the scale result. According to the scale result, continuous variables are generally similar between the groups. When the variables between these groups are taken into account, it is seen that only the weeks of pregnancy are different. The reason why this difference is significant is that group 1 is in an earlier week of pregnancy than group 2. According to this result, we can say that there is more stress in the earlier weeks of pregnancy.
Conclusion: As a result of our study, especially in the early weeks of pregnancy, high-risk pregnant women experience more stress due to uncertainty about their pregnancy. Health professionals providing perinatal care to women should plan family support and psychological therapy programs, especially in the early weeks, for pregnant women with high-risk pregnancies
Pyelolithotomy In Pelvic Ectopıic Kidney: Case Report: Case Report
No full textIntroduction: Urinary system stone diseases are among the most common diseases in urology practice. Treatment methods are decided according to the size, location and number of the stone, but in rare diseases such as ectopic pelvic kidney, the decision must be made according to the kidney structure, vessels and stone. In this case report, the pyelolithotomy performed on the 29 mm stone of the patient with pelvic etopic kidney was tried to be explained in the light of the literature.
Case: A thirty-two-year-old male patient was diagnosed with a 29 mm stone in the right pelvic kidney and renal pelvis as a result of the examinations performed at the hospital where he complained of abdominal pain. With the subsequent examinations and preparations, the patient underwent a pyelolithotomy operation modified with appropriate steps for the pelvic kidney.
Discussion and Conclusion: ESWL, PNL, RIRS, laparoscopic surgery techniques can be applied in pelvic ectopic kidney. Studies have reported the success of ESWL as 54-81%, the success of PNL as 80%, and the success of laparoscopic and robotic surgeries as 80-100%. Although the success of minimally invasive methods is high, the stone burden is below two centimeters in most of these studies. Although open surgery seems to be the last choice, in this anomaly where the surgical technique is not fully determined and the approach is case-specific, open surgery should be considered and the technical approach and dissection steps should be determined.Giriş: Üriner sistem taş hastalıkları üroloji pratiğinde çok sık görülen hastalıklardandır. Taşın büyüklüğüne, yerine ve sayısına göre tedavi yöntemlerine karar verilir ancak ektopik pelvik böbrek gibi nadir görülen hastalıklarda böbrek yapısına, damarlarına ve taşa göre karar vermek gerekir. Bu vaka raporunda, pelvik etopik böbreği bulunan hastanın 29 mm büyüklüğündeki taşına yapılan piyelolitotomi literatür eşliğinde aktarılmaya çalışılmıştır.
Olgu: Otuz iki yaşında erkek hasta, karın ağrısı şikayeti ile başvurduğu hastanede yapılan tetkikler sonucu sağ pelvik böbrek ve renal pelviste 29 mm taş tanısı konuyor. Sonrasında yapılan tetkik ve hazırlıklarla beraber hastaya piyelolitotomi operasyonu pelvik böbreğe uygun adımlarla modifiye edilerek uygulandı.
Tartışma ve sonuç: Pelvik ektopik böbrekte ESWL, PNL, RIRS, laparoskopik cerrahi teknikleri uygulanabilmektedir. yapılan çalışmlarda ESWL’ nin başarısı %54-81, PNL’ nin başarısı %80, laparoskopik ve robotik cerrahilerin başarısı %80-100 olarak bildirilmiştir. Her ne kadar minimal invaziv yöntemlerin başarısı yüksek olsa da bu çalışmaların büyük kısmında taş yükü iki santimetrenin altındadır. Her ne kadar açık cerrahi son tercih gibi görünse de cerrahi tekniğinin tam olarak belirlenmediği ve yaklaşımın vakaya özel olduğu bu anomalide açık cerrahi göz önünde bulundurulmalı ve teknik yaklaşım, diseksiyon adımları belirlenmelidir
The Role of Nurses as Guides in Inflammatory Bowel Diseases: Review Article
No full textInflammatory Bowel Diseases are a group of chronic and recurrent inflammatory disorders affecting the gastrointestinal system, with unknown etiology. Crohn's Disease and Ulcerative Colitis are the most common subtypes, associated with physical symptoms and psychosocial issues that negatively impact the quality of life. The management of Inflammatory Bowel Diseases requires a multidisciplinary approach, and the guiding role of nurses is critical for symptom management, treatment adherence, and enhancing patients' quality of life.
Nurses actively participate in symptom management, nutritional counseling, psychosocial support, and patient education, creating individualized care plans tailored to patients' needs. Specifically, nutritional management, psychosocial support, and educational strategies help alleviate symptoms and improve treatment adherence. Additionally, the utilization of health technologies, such as mobile health applications and tele-health services, facilitates patient follow-up and enhances treatment processes.
Psychosocial support services assist patients in managing stress, depression, and anxiety, thereby positively impacting their quality of life. Moreover, support groups and counseling services reduce social isolation and strengthen psychological resilience. Nurses play a crucial role in patient education and raising public awareness, which helps reduce social stigma and improves patients' compliance with treatment.
This review highlights the importance of nursing guidance in the management of Inflammatory Bowel Diseases and provides a guiding perspective for future research. Multidisciplinary teamwork, individualized care plans, and the integration of digital health applications are effective strategies for improving the quality of life of Inflammatory Bowel Diseases patients. In this context, strengthening the educational and counseling roles of nurses is essential for effective Inflammatory Bowel Diseases management
Increased Number Of Encrusted D-J Stents In Our Clinic During The Covid-19 Pandemic And The Reliability Of Ureteroenoscopy (Rigid/Flexible) In Removing Encrusted D-J Stents: Research Article
Get PDFIntroduction: Stent encrustations that develop due to the D-J stent being forgotten or left in the body for a long time are one of the major causes of these side effects and complications.
Objective: To examine the effect of the coronavirus disease 2019 (COVID-19) pandemic on the frequency of encrusted (petrified) D-J (double j) stent cases treated during the pandemic and the effects of the encrusted D-J stent on our patients.
Methods: The data of 27 patients who underwent D-J stent removal due to encrusted stent between March 2019 and March 2021 were analyzed retrospectively. The age of the patients, duration of ureteral stenting, size and location of the encrustation were examined.
Results: The mean age of the patients was 46.56 ± 14.78 years. The mean length of stent stay in the body was 217.15 ± 472.08 days. The mean incrustation size was 386.96 ± 541.26 mm2. Eight of the patients had severe D-J stent incrustation, 3 had moderate D-J encrustation, and 16 had mild D-J encrustation. During the COVID-19 pandemic, there was a 200% increase in the number of cases. The encrusted D-J stents of all our patients were successfully removed via ureteroenoscopy by breaking the encrusted parts of the stents using a holmium laser, achieving complete stone removal.
Conclusion: Due to the Covid-19 pandemic, there has been a significant increase in the number of encrusted D-J stents. Ureterorenoscopy/flexible ureterorenoscopy is an effective treatment method for removing the encrusted D-J stent using holmium laser and achieving complete stone removal