1,721,346 research outputs found
Family Medicine Residency Training: Where, How Much, How and When?
Get PDFKARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882WOS: 000372103700013In this article, it will be discussed of the setting and the importance of the family medicine residency training in field related workshop framework that was made in the WONCA Europe Conference 2015. Family medicine residency training consists of three basic pillars: Rotations in hospital and other health care facilities, educational activities in family medicine departments and training in primary care settings. Between 1985 and 2011, formal residency training was consisted only of hospital rotations. With the rapid growth of family medicine departments in universities and clinics in research and training hospitals since 1995, educational activities of departments have increasingly been an important part of residency training. In 2011, with the acceptance of new core curriculum by TUK (Specialty Board in Medicine) obligatory rotations were decreased to 18 months. After a long term effort, necessary regulatory changes have been made to enable residency training in primary care. Although valuable contributions have been made by Turkish Association of Family Physicians (TAHUD), Turkish Board of Family Medicine (TAHYK) and Academy of Family Medicine residency training in primary care settings is still needed to be discussed and clarified
GERIATRIC POPULATION AND FORENSIC TRAUMAS
Get PDFkarakus, ali/0000-0003-1358-3201; KARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882; Kandis, Hayati/0000-0001-9151-6050WOS: 000296697200003Introduction: The lessening in the functions of body by aging increases traumatic injury risk. Materials and Method: The cases of the age 65 and over, who referred to Kirikkale High Specialization Hospital Emergency Service, between January 2007-June 2009, and had undergone forensic trauma were evaluated from the points of sex, age, monthly cumulative distribution, cause of trauma, way of transferring, pathologies, Glasgow coma scale, follow up duration, rates of hospitalization and mortality. Results: Of the 224 cases, 155 (69.2%) were male and 69 (30.8%) were female. The range of age was 65-98. Most of the cases occurred between 5th-8th months. Motor-vehicle accident was the most frequent cause. 178 (79.5%) cases were taken to hospital by private automobiles. Soft tissue injury was the most frequent pathology. The mean score of Glasgow coma was 14.5 +/- 1.6. The follow up duration time was 4.8 +/- 2.2 hours. 38 (17%) cases were hospitalized and followed 5.4 +/- 3.5 days. 8 cases (3.6%) were died. Conclusion: After comprehensive physical examination, the necessary tests of geriatric trauma patients should be done and the follow up should be prolonged. Also, it is necessary not to avoid hospitalization that should be kept under control during the follow up and early period
Evaluation of Clinical Effectiveness of Self-Monitoring Blood Glucose Level in Patients with Type 2 Diabetes Mellitus Treated with Non-Insulin Regimens in Duzce: Primary Care-Based Study
Get PDFKARA, ISMAIL HAMDI/0000-0003-2022-1882; Ankarali, Handan Camdeviren/0000-0002-3613-0523; KARA, ISMAIL HAMDI/0000-0003-2022-1882WOS: 000363103000003Objective: Self-monitoring blood glucose (SMBG) is frequently recommended, beside its controversial efficacy. Herein, it was aimed to evaluate frequency of SMBG and its efficacy among patients with type 2 diabetes (T2DM) in primary care settings in Duzce Province of Turkey. Methods: The cross-sectional and primary care-based study enrolled a total of 680 patients with T2DM treated with oral anti-diabetic agents. Status of SMBG was recorded as non-use, daily, weekly and monthly. Metabolic and glycemic indexes were compared according to statuses of SMBG use. Results: Over the two-third of the patients were user of SMBG. The frequency of daily, weekly and monthly use of SMBG was 13.2%, 32.1% and 24.5%, respectively. Of them, the majority have irregularly used SMBG (59.4%). However, the ratio of patients who have regularly used SMBG was just 24.3%. No significant difference was observed between statuses of SMBG in glycemic indexes of HbA1c, Fasting blood glucose and post-prandial blood glucose (p=0.655, p=0.721 and p=0.389). Conclusions: Although the high and irregular use of SMBG, there was no difference between status of SMBG. Therefore, the family physicians should consciously advice self-monitoring blood glucose. It should be recommended after the patients are competent and empowered with education for its use. Further investigations should be carried out to general idea on clinical effectiveness SMBG in Turkey
Factors affecting exhaled carbon monoxide levels in coffeehouses in the Western Black Sea region of Turkey
Get PDFKARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882; Kandis, Hayati/0000-0001-9151-6050WOS: 000288949000001PubMed: 20858650The aim of this study was to evaluate indoor air quality and factors affecting expired carbon monoxide (CO) levels in a coffeehouse environment. This cross-sectional study was conducted at 16 randomly selected coffeehouses in Duzce, Turkey, during November 2007 to March 2008. A total of 547 people, average age 46.72 +/- 17.03 (19-82) years, participated. The selected coffeehouses were divided into four groups: (1) smoking, (2) nonsmoking, (3) old-style and (iv) new-style coffeehouses. Prior to entering the coffeehouse, exhaled CO levels in smokers (mean 21.17 +/- 6.73 parts per million [ppm]) were significantly higher than those for nonsmokers (6.51 +/- 4.56 ppm; p < 0.001). Measurements taken after 2 hours in the coffeehouse also showed significantly higher CO concentrations for smokers (22.72 +/- 5.31 ppm), compared to nonsmokers (6.51 +/- 4.56 ppm; p < 0.001). It was determined that CO levels inside coffee shops were above the WHO guidelines. Exhaled CO levels in nonsmokers are influenced by the ambient CO levels as a result of the use of cigarettes in coffeehouses in addition to the structure of coffeehouses
Naproxen-induced fixed drug eruption: A case report
Get PDFKARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882WOS: 000296157700016PubMed: 21357631Naproxen is a non-steroidal anti-inflammatory drug (NSAID) widely used for symptomatic relief of arthritis and other painful disorders, such as dysmenorrheal. Pruritus is the most common side effect of naproxen. Fixed drug eruption (FDE) due to naproxen is a rarely reported side-effect. No previous report has declared cross-reactivity between naproxen and other propionic acid derivatives. A 28-year-old man, presented with edematous and erythematous patchy lesion along with pruritus and inflammation on lip, have been suffering since 3 hours. It started after taking naproxen 550 mg for headache. On detailed inquiry, he defined similar symptom which recurred after whenever he took naproxen. Based on clinical and histopathological findings, it is evaluated as naproxen-induced FDE. We have tested cross-reactivity between naproxen and other propionic acid derivatives, and then we obtained negative result for oral provocation test with flurbiprofen. Here, we present a case of naproxen-induced FDE of 28-year-old man, by overviewing literatures
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Evaluation of Elderly Patients at Check-Up Polyclinics for Anemia, Serum Folate and Cobalamin Levels
Get PDFKARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882; Kandis, Hayati/0000-0001-9151-6050WOS: 000285648800011Introduction: It was aimed to evaluate CBC analyses (HCT, MCV, MCH, MCHC, RDW and PLT), folic acid, cobalamin, serum iron and serum iron binding capacity and make a comparison according to gender in patients >50 years applied to check-up outpatients' clinic. Material and Method: 20 male and 35 female, total 55, consecutive patients who have median age 59.0 (50-85) yrs, applied to check-up polyclinic were included. Result: While median B12 vitamin and folic acid levels in men as follows: 170 (1501000) pg/mL and 6.4 (6.3-7.7) ng/mL; these values for women as follows: 261 (1501000) pg/mL and 9.3 (1.8-17.7) ng/mL (P<0.01 and P<0.01), consecutively. Cobalamin deficiency is common in both of gender. It was determined that cobalamin deficiency in male was 70%, and in female, 45.7%, (P=0.07), consecutively. Folic acid level is found in only one female case as <2 ng/mL. TSI% is lower in female (in male as 26.6% vs. in female as 18.1%; P<0.0001). MCV in eight (14.5%) cases was below 80 fL and MCV in nine (16.4%) cases was above 90 fL; however, MCV in none of cases was above 100 fL. Conclusion: In periodical examination of elderly, a high level of cobalamin deficiency could be determined; also the prevalence of cobalamin deficiency could be changed with accepted cut-off level. Present study showed it is important to consider cobalamin and iron deficiency in periodical examination of elderly
Evaluation of patient satisfaction with family physicians after implementation of family medicine in Turkey
Get PDFSaritas, Ayhan/0000-0002-4302-1093; Saritas, Ayhan/0000-0002-4302-1093; KARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882WOS: 000301754800019Patient's satisfaction is a desired out-come measure of quality of health care. It is direct feedback measurement and easy method. We aimed to evaluate level of patient's satisfaction with family physician after family medicine implementation at primary care settings in Turkey. This cross-sectional study was conducted in Turkey between January and May 2011 in 45 family medicine offices. The self-administered study survey including EURO-PEP tool was delivered with hand-out by researchers who were not family physicians to patients admitted to family health center. They were collected in closed-box. 1500 surveys were distributed. 1112 surveys were returned. Response rate was 74.13%. Of them, 54% (601) was female and 46% (511) was male. Mean age was 36.1+/-13.9 years-old. Overall rate of patient satisfaction was 70.9%. Rate for high satisfaction level (good-excellent) ranked between 53.5% and 82.4%. Item of" listening to patients" was rated by patients as highest satisfaction (82.4%). Item related with accessibility to physicians on phone was rated as lowest satisfaction (53.5%) by patients. Level of patient satisfaction with clinical behavior was considerably better than health care organization. In conclusion, the study showed that level of patient satisfaction was relatively high, especially with clinical behavior. The patients were less satisfied with health care organization, particularly with accessibility to physicians via phone and waiting time. We observed that patient satisfaction was improved, compared to before implementation of family medicine, and additionally lower than north European countries, but similar with some of the south European ones
N-Acetyl cysteine and erdosteine treatment in acetaminophen-induced liver damage
Get PDFKARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882; karakus, ali/0000-0003-1358-3201; Saritas, Ayhan/0000-0002-4302-1093; Saritas, Ayhan/0000-0002-4302-1093; Kandis, Hayati/0000-0001-9151-6050WOS: 000340203500009PubMed: 23070635Objective: This study is aimed to investigate the efficacy of erdosteine usage in acetaminophen-induced liver damage and to compare it with N-acetyl cysteine (NAC) in the treatment and prevention of liver toxicity due to overdose of acetaminophen. Methods: The rats were separated into the following six groups of seven rats each: control group; acetaminophen (1 g/kg, orally); acetaminophen (1 g/kg, orally) + erdosteine (150 mg/kg/day, orally); acetaminophen (1 g/kg, orally) + NAC (140 mg/kg loading dose, followed by 70 mg/kg, orally); NAC (140 mg/kg loading dose, followed by 70 mg/kg, orally); erdosteine (150 mg/kg/kg, orally), subsequently. In all the groups, potential liver injuries were evaluated using biochemical and hematological analyses, oxidant-antioxidant parameters and histopathological parameters. Results: In acetaminophen-treated group, levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total oxidant status (TOS) in the blood, prothrombin time (PT) and international normalized ratio (INR) were significantly increased when compared with controls. However, total antioxidant capacity (TAC) and glutathione (GSH) levels were decreased in group treated with acetaminophen, when compared with control group. Levels of AST, ALT and TOS, PT and INR were decreased in groups treated with NAC and erdosteine after acetaminophen administration, but the levels of TAC and GSH were increased. Histopathological improvements were observed in the groups treated with NAC and erdosteine after acetaminophen administration. Conclusion: The present study demonstrated that, in the prevention of liver damage induced by acetaminophen intoxication, an early treatment with a single dose of erdosteine was beneficial instead of NAC administration.Emergency Physicians Association of TurkeyThe authors thank the Emergency Physicians Association of Turkey for the financial support and its valued contribution
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