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Level of Knowledge and Awareness of Diabetic Emergencies Among Turkish Bus Drivers: Example of the Mediterranean Region
Get PDFThe objective of this research was to determine the level of knowledge and awareness of diabetic emergencies among Turkish bus drivers.
Methods. The universe of this descriptive and cross-sectional study was all the individuals working as bus drivers in the Mediterranean Region between January-June 2019, and the study sample was 1292 drivers who met the inclusion criteria of the research. Data were collected by the Personal Information Form and the Diabetic Emergency Information and Awareness Survey Form. Descriptive statistics, the Mann-Whitney U test and the Kruskal-Wallis test were used in data evaluation.
Results. The average age of bus drivers participating in the study was 38.29 ± 9.44 years, while their average work experience was 12.50 ± 8.92 years. Among them, 14.9% of bus drivers had a diabetic family member; 23.7% of bus drivers had a first aid certificate; 11.5% of bus drivers received diabetes-related training. The average score of drivers for the level of knowledge and awareness regarding diabetic emergencies was found to be 15.39 ± 4.72. There was a statistically significant difference between the drivers’ average scores for the level of knowledge and awareness and their age, education status, work experience, the presence of chronic disease, the presence of a diabetic family member, the presence of a first aid certificate, diabetes-related training, the place of receiving this training variables (p < 0.05).
Conclusions. Bus drivers were found to have above average levels of knowledge and awareness of diabetic emergencies. Bus drivers are recommended to be trained on diabetic emergencies and raising awareness of diabetes mellitus to ensure a proper intervention in case of emergencies in individuals with diabetes mellitus during travels
Wellens’ Syndrome: Focus on Diagnosis and Choice of Myocardial Revascularization Strategy
Get PDFAbstract. Wellens’ syndrome is an extremely relevant issue in modern cardiology. Wellens’ syndrome is quite often untimely diagnosed, and the patient’s management is the same as in case of unstable angina. Since without myocardial revascularization, widespread myocardial infarction develops within the following days or weeks, myocardial revascularization is needed as soon as possible. Characteristic changes on the electrocardiogram in case of Wellens’ syndrome include biphasic (type A) or inverted (type B) T waves in leads V2-V3, which sometimes are seen in other precordial leads. There must be a history of recent angina in addition to these electrocardiogram changes. Troponin is usually negative; however, it can be slightly elevated. Sometimes, patients with classic electrocardiogram changes and clinical picture typical for Wellens’ syndrome do not show hemodynamically significant stenosis of the left anterior descending artery typical for this syndrome. In such cases, “pseudo-Wellens’ syndrome” is observed. Three cases of angiographically confirmed Wellens’ syndrome and one case of pseudo-Wellens’ syndrome are presented in this paper. All the patients with Wellens’ syndrome had significant lesions of the left anterior descending artery. One patient had a triple-vessel lesion, and the other two had a single-vessel lesion. Troponin I was within normal limits in one patient, and slightly elevated and in the other two. These patients underwent successful myocardial revascularization (percutaneous coronary intervention); pharmacological therapy was prescribed.Резюме. Синдром Wellens’ є надзвичайно актуальним питання сучасної кардіології. Досить часто у реальній клінічній практиці трапляються випадки невчасної діагностики синдрому Wellens’, а тактика ведення пацієнта є такою як при нестабільній стенокардії. Зважаючи на те, що у найближчі декілька днів або тижнів без реваскуляризації міокарда розвивається інфаркт міокарда із залученням багатьох сегментів лівого шлуночка, потрібно провести якомога швидше реваскуляризацію міокарда. При синдромі Wellens’ характерними змінами на ЕКГ є двофазні (тип А) або інвертовані (тип В) зубці Т у відведеннях V2-V3, які іноді поширюються й на інші грудні відведення. Важливо, що крім цих змін повинен бути напад ангіонозного болю у анамнезі. Тропонін зазвичай негативний, але іноді може бути дещо вищим норми. Разом з тим у деяких пацієнтів із класичними змінами на ЕКГ та клінічною картиною, характерною для синдрому Wellens’ при коронароангіографії не виявляють характерного для цього синдрому гемодинамічно значимого стенозу передньої міжшлуночкової гілки лівої коронарної артерії. У таких випадках йдеться про pseudo-Wellens’ syndrome. У статті описано 3 випадки синдрому Wellens’, підтверджених ангіографічно та один випадок pseudo-Wellens’ syndrome. У всіх пацієнтів із синдромом Wellens’ виявлено ураження передньої міжшлуночкової гілки лівої коронарної артерії. У одного пацієнта спостерігалося трьохсудинне ураження, у двох інших – односудинне. Тропонін у одного пацієнта був у межах норми, а у двох інших дещо перевищував норму. Цим пацієнтам проведено успішно реваскуляризацію міокарда шляхом стентування ураженого проксимального сегемнта передньої міжшлуночкової гілки лівої коронарної артерії, а також призначено медикаментозне лікування.
Ключові слова: Синдром Wellens’, передня міжшлуночкова гілка лівої коронарної артерії, інфаркт міокарда, реваскуляризація, стентування.
 
Cluster Analysis of Myelin Nerve Fibers of the Periferal Nerve
Get PDFOne of the unsolved issues in neuromorphology is the classification of myelin nerve fibers (MNF). Objective: to use cluster analysis to classify the sciatic nerve MNF.
Material and methods. The work was performed using 5 one-year-old male Wistar rats. Semi-thin sections were stained with methylene blue. MNF morphometry was performed using ImageJ, and statistical processing – using the software environment R.
Results of the study. Ward’s and k-means methods were used to cluster the MNF. Three clusters of MNFs are defined and their parameters are determined. The presented algorithm for adapting the literature data to the format of the obtained results includes determining the total average for the combined set of each indicator and the total variance, which is the sum of intragroup and intergroup variances.
Conclusions: 1) for the classification of MNF it is advisable to use cluster analysis; 2) clustering should be performed according to the transsection areas of the axial cylinder and myelin sheath; 3) the number of clusters is determined by the agglomerative method of Ward, and their metrics – by the iterative method of k-means; 4) three clusters of MNF of the rat sciatic nerve differ in the transsection areas of the fibers, the axial cylinder and the myelin sheath and the percentage of nerve fibers; 5) when comparing identical indicators according to the obtained and literature data, the results were equivalent in the areas of the axial cylinder and myelin sheath and their shape coefficients, despite the fact that the classification of myelin fibers and their morphometry was performed using different methods
Profile of Digital Mammography Findings in Patients with Histopathologically Proven Ductal Carcinoma in Situ (DCIS): A Retrospective Study
Get PDFBreast carcinoma is a heterogeneous group of tumors with a wide spectrum of clinical presentations, lesion characterization and diagnostic evaluation. Ductal carcinoma in situ accounts for 15%-20% of breast carcinomas detected in screened populations. Ductal carcinoma in situ has a variable appearance on mammography. The use of mammography has become as a very helpful tool for the early detection of larger number of patients with ductal carcinoma in situ and, thus, offering timely surgery and the need for the appropriate radiation treatment to patients. This study was undertaken as a hospital-based retrospective study to evaluate the varied spectrum of mammographic findings in 57 women with histopathological diagnosis of ductal carcinoma in situ. The spectrum of mammographic findings of ductal carcinoma in situ was found to vary widely. A thorough and vigilant inspection of a mammogram is necessary for all the patients to avoid the possibility of missing early diagnosis of this entity, since the findings are very subtle. Most cases show microcalcifications on mammograms and their early detection can help in early diagnosis, thereby offering conservative surgical approach to a patient. Microcalcifications can be present isolated or in association with a mass. These are mostly clustered in distribution followed by regional, segmental and ductal pattern of distribution. The morphology of microcalcifications is mostly amorphous, followed by pleiomorphic and fine heterogenous types. Hence, the mammogram must be interpreted with strict vigilance and proper attention to all aspects for early and correct diagnosis of ductal carcinoma in situ to help in proper guidance of its treatment
Aromatherapy and Quitting Smoking
Get PDFToday, the treatment approaches recommended for smoking cessation are pharmacological and behavioral therapy. Both approaches are reported to be effective alone; however, when used together, the success rate increases. Modern medicine methods, however, often have a negative image due to cost, complexity and limitations in human life. For this reason, complementary and alternative therapies are widely used in the community for the treatment of many diseases in every age group. When people are asked why they prefer complementary and alternative therapies, the most important reason seems to be to improve quality of life by providing symptom control. Other reasons include economic problems, the lack of health insurance, the improvement of quality of life, the influence of the media and the environment, a strong belief that it will help, disappointment of conventional treatment failure, the noninvasiveness of most complementary and alternative therapies, fear of medical treatments, dissatisfaction with the current health system, medicines. Avoiding side effects can be called as a desire to have more control over health decisions. Contrary to many pharmacological and behavioral treatments that investigate the effectiveness of smoking cessation, only a few studies have included complementary and alternative treatments. Complementary treatment methods such as aromatherapy are thought to be regularly included in smoking cessation programs and their use should be ensured/expanded
Effects of Siam Weed (Chromolaena odorata) Leaf Extract on Crude Oil-induced Toxicity
Get PDFThe objective of this study was to investigate the effects of the different extracts (aqueous, ethanol and blended mixture) of Chromolaena odorata leaves on Wistar rats feed with crude petroleum (CP) tainted feed (4 ml/100 g diet).
Materials and methods: Twenty-five male Wistar rats weighing 140 -180 g were used for this study. The rats were kept one in a cage. Group A which was the control was allowed diet free of crude oil and were not treated with any of the extracts. Group B were exposed to a diet contaminated with crude oil that contained 4ml of crude oil per 100 gram of animal feed without treatment. Groups C-E were fed with diets contaminated with 4ml of crude oil per 100g of feed and treated with 500mg/Kg-1 bodyweight of aqueous, ethanol and blended mixture of ethanol and aqueous extracts, respectively. The respective extracts and blended mixture were given daily to the rats via oral gavage in line with body weights. The study was for duration of twenty eight days after which the rats were sacrificed under sedation with chloroform. This was followed with collection of blood samples and organs of interest. All samples were stored at 40C and used within forty eight hour for various biochemical analyses.
Results: There were significant decrease in haematological indices, liver proteins, oxidative enzymes, and antioxidant enzymes when compare with Group 1. Also, liver function maker enzymes, white blood cells (WBC), and malondialdehyde (MDA) were significantly increased by petroleum intoxication. Significant increase were observed in Hb, PCV, RBC, SO, MO, XO, SOD, CAT, albumin, total protein in the serum, liver and kidney; as against decreases in WBC, AST, ALT, ALP and MDA in rats fed crude petroleum (CP) tainted feed that was treated with C. odorata extract.
Conclusion: This study showed that administration of C. odorata leaves extracts to rats prevented health risk associated with crude petroleum toxicity
Abdominal Ascariasis: Where to Focus on Imaging Studies
Get PDFObjective: To assess the various presentations of abdominal ascariasis and their imaging features for developing a comprehensive radiological evaluation protocol.
Methods: Demographic and clinical profile of 84 patients with abdominal ascariasis was noted. Patients were divided into 2 groups with age less than 20 comprising Group A and those with age greater than 20 Group B. All the patients had a routine lab workup and a dedicated USG scan to look for objective evidence of intestinal or hepatobiliary ascariasis. Any history of previous intervention (cholecystectomy or ERCP) was also sought.
Results: Abdominal ascariasis is more common in females observed in 62% of our patients. Peripheral eosinophilia was observed in 70 (83%) patients. We had 74 (88%) patients with intestinal ascariasis with 2 patients having appendicular ascariasis. Biliary ascariasis was observed in 20 (24%) patients and pancreatic ductal ascariasis in 6 (7%) patients. We found peritoneal ascariasis in 1 (2%) pediatric patient and 2 (3%) patients in our study had ascariasis associated with the liver abscess. OCH was observed in 4 patients while 2 patients presented with worm cholecystitis.
Conclusion: Peripheral eosinophilia can be used to select patients in endemic regions for undergoing a dedicated USG scan. USG is the investigation of choice for both intestinal and hepatobiliary ascariasis. Worm migration is more common in adults and is especially prevalent in individuals with previous history of ERCP or cholecystectomy
Clinical Manifestations of Periodontal Tissue Diseases in Patients with Rheumatoid Arthritis Who Live in Anthropogenically Loaded Areas
Get PDFThe objective of the study is to clinically assess the condition of periodontal tissues in patients with rheumatoid arthritis, living in anthropogenically loaded and environmentally friendly areas and in people with generalized periodontitis without concomitant somatic diseases.
Materials and methods. There were examined 137 patients, including 82 patients with generalized periodontitis of the I degree (subgroups A) and the II degree (subgroups B) with rheumatoid arthritis, living in anthropogenically loaded areas (group I), environmentally friendly areas (group II) and without concomitant somatic diseases living in environmentally friendly areas (group III). Control group – included 18 healthy people.
Periodontal tissues were evaluated according to the indices: Greene-Vermillion, PMA, periodontal index offered by Russel and the depth of periodontal pockets.
Results. Women (80%) dominated in each group, patients with generalized periodontitis of the II degree of severity dominated, too.
The highest depth of periodontal pockets was 5.02±0.11 mm in the IB subgroup and differed significantly from this figure in the IIB subgroup 1.07-fold (pIB-IIB<0.05) and from that in the IIIB subgroup 1.2-fold (pIB-IIIB<0.001). The value of the Greene-Vermilion index in patients with GP of the I degree of development in all subgroups A corresponded to “unsatisfactory”. In patients with GP of the II degree of development, the state of hygiene corresponded to “bad” in subgroups IB, IIB and was 3.04±0.11 points (pIB-IIB˂0.01, pIB-IIIB˂0.001, pIB-K˂0.001); 2,63 ± 0.07 points (pIIB-IB˂0.01, pIIB-IIIB˂0.001, pIIB-K˂0.001), in ІІІB – “unsatisfactory”. According to the indicators of the PMA index in patients with GP of the I degree of severity, we’ve found the average severity degree of gingivitis (within the range of 43.25±2.02 – 48.06±1.46%) and severe degree of gingivitis in patients with the GP of the II degree >50 %. The highest indicator of periodontal index was found in the IB subgroup – 6.16±0.10 points (pIB-IIB˂0.01, pIB-IIIB˂0.001, pIB-K˂0.001), which indicated a severe form of periodontitis.
Conclusion. Most often, GP in patients with RA was diagnosed in women, most of whom were patients with GP of the II degree (most in group I – 69.04%). The highest depth of periodontal pockets was 5.02±0.11 mm in the IB subgroup. The performed clinical and index assessment of periodontal tissues in patients of three groups indicates a more severe course of GP of the I and II degree in patients with rheumatoid arthritis living in anthropogenically loaded areas (IA, IB subgroups)
Study of Salivary Stress Factor Activity in Patients with Diabetes Mellitus During the Period of Adaptation to Complete Removable Laminar Dentures
Get PDFDiabetes mellitus is referred to as non-communicable epidemic of the 21st century and the fight against diabetes is one of medical and social challenges. One of its complications is damage to periodontal tissues that is accompanied by tooth loss. Any removable denture is a foreign body being a stress factor for the oral cavity.
The objective of the research was to study dynamic changes in the activity of stress factor indicators, namely salivary cortisol, glucose and alpha-amylase levels in diabetic patients after prosthodontic treatment with complete removable laminar dentures.
Materials and Methods. For this study, patients at the age of 45 to 74 years were divided into two groups: Group I included 52 edentulous patients with type 2 diabetes mellitus who were treated with acrylic resin complete removable laminar dentures; Group II comprised 52 edentulous patients without endocrine pathology who were treated with acrylic resin complete removable laminar dentures as well. Saliva served as the study material. The enzyme-linked immunosorbent assay was used to determine salivary cortisol levels. Glucose concentration in saliva was determined by a unified enzymatic method. Alpha-amylase activity was determined by the enzymatic colorimetric method.
Results. According to the research results, before prosthodontic treatment, salivary cortisol levels of patients with diabetes mellitus were 2.4 times higher as compared to patients without somatic pathology. In phase I of adaptation to complete removable laminar dentures, in patients with diabetes mellitus, salivary cortisol concentration increased drastically by 1.4 times as compared to the indicator before prosthodontic treatment (5.61±0.83 ng/ml vs. 4.02±0.65 ng/ml, p<0.01), while in the group of patients without endocrine pathology, cortisol levels increased by 1.2 times; salivary glucose level of patients with diabetes mellitus increased by 1.3 times, while in patients without endocrine pathology, it increased by 1.1 times; in patients of Group I, salivary alpha-amylase levels increased by 1.2 times, while in patients of Group II, salivary alpha-amylase concentration increased by 1.05 times.
Conclusions. In patients with diabetes mellitus, changes in saliva composition indicate a significant reduction in the adaptation mechanisms, that complicates and significantly prolongs the period of adaptation to complete removable laminar dentures
Mycotic Infection (Fungal Ball) of the Paranasal Sinuses: A Clinicopathological Observation
Get PDFMycotic infections of the nasal cavity and paranasal sinuses represent a wide spectrum of disorders that vary in clinical presentation, histopathologic appearances, and biological significance. The second most common form is a fungal ball.
The objective of the research was to describe the cases of paranasal sinus fungal ball found in the files of patients with chronic rhinosinusitis.
Materials and Methods. There were demonstrated clinical and histopathological data of two patients.
Results. A 42-year-old woman and a 40-year-old man with chronic hypertrophic sinusitis had a large amount of friable cheesy mass in the maxillary sinus. The female patient previously underwent upper dental arch sanation. Histology revealed dense laminated masses of matted fungal hyphae that were separate from the mucosa. Sinonasal mucosa showed mild chronic inflammation (male) and severe non-specific chronic active inflammation (female). No evidence of fungal invasion in the mucosa was found.
Conclusions. Fungal ball represents a non-invasive form of mycotic rhinosinusitis with favourable prognosis. Biopsy examination plays an important role in the diagnostic process. Although the diagnosis can also be achieved by polymerase chain reaction assays, biopsy is the only way to explore the status of an inflammatory damage to adjacent tissue and, thus, to rule out potential invasive mycotic sinus disease with much worse clinical outcome