The relation between eHealth literacy and healthy lifestyle behaviours in pregnant women

The aim of this study was to determine the relationship between eHealth literacy and healthy lifestyle behaviours among pregnant women. This cross-sectional study was conducted in five family health centres in a city in the western part of Turkey. The study sample consisted of 201 pregnant women who were admitted to the five family health centres between September and December 2022. A socio-demographic questionnaire, the eHealth Literacy Scale and the Healthy Lifestyle Behaviours in Pregnancy Scale were used to collect data. Multiple linear regression analysis was used to explore predictors of health-promoting behaviours. The mean score of the eHealth Literacy Scale was 29.37 ± 6.20. The mean score of the Healthy Lifestyle Behaviours Scale was 119.69 ± 13.58. Multiple linear regression showed that predictors of healthy lifestyle behaviours among pregnant women were eHealth literacy, using internet to access health information and gestational age. eHealth literacy was found to be an important factor affecting the healthy lifestyle behaviours of pregnant women. This study highlights the importance of considering pregnant women's eHealth literacy in interventions aimed at improving healthy lifestyle behaviours.

Effect of hyperbaric oxygen in hepatopulmonary syndrome: an innovative experimental study

OBJECTIVE

This study aimed to analyze the effect of hyperbaric oxygen treatment (HBOT) in hepatopulmonary syndrome (HPS).

MATERIALS AND METHODS

Five-month-old female Wistar-Albino rats were randomly divided into three groups: Group I, the control group; Group II, the cirrhosis group; and Group III, the cirrhosis group + HBOT group. Rats were exposed to HBO sessions (2.4 atm./60 min) for 20 days. Animals were sacrificed 24 hours after the last HBO session. Biochemical analysis, oxygenation parameters, NO and NO synthase (NOS) levels, histopathological changes in the liver and lungs, and pulmonary artery diameter were measured.

RESULTS

A total of 24 rats (10 rats were included in Group I, six rats in Group II, and eight rats in Group III) weighing 220-250 g were included in the study. Significant differences were observed for NO and NOS (9.10±1.05 to 12.17±1.85 μmol/L, p<0.05 and 0.46±0.31 to 1.17±0.39 U/ml, p<0.05, respectively) at baseline and day 36 only in group II. Inflammatory cell infiltration and bronchial injury were significantly increased in group II compared to group I (p=0.007 and p=0.008, respectively) but not in group III (p=0.266 and p=0.275, respectively). Pulmonary artery diameter was significantly lower in group III compared with group II at all sites in both lungs (p<0.05).

CONCLUSIONS

HBOT may be a promising treatment for HPS by reducing NO and NOS activity, perialveolar arteriolar dilation, lung inflammation, and injury and guiding future clinical trials.

Knowledge and Perceptions About Cervical Cancer and Human Papillomavirus, and Relationship with E-health Literacy, and Affecting Factors Among Female University Students

Purpose: The aim of this study is to reveal female university students' knowledge and perceptions about cervical cancer (CC) and human papillomavirus (HPV), and relationship with e-health literacy (e-HL). It also aims to determine the predictors affecting CC and HPV. Methods: A cross-sectional study was conducted with 589 female university students in Türkiye. Data were collected using a "Cervical Cancer and HPV Awareness Questionnaire" and an "E-health Literacy Scale (e-HLS)." Analysis involved Pearson correlation analysis, Independent Sample t-test, one-way analysis of variance, and Linear Regression analysis. Results: Results indicate that female students exhibited a low level of knowledge and perception about CC and HPV. Only 2.90% of students reported being vaccinated, while 39.90% had sexual experience. Higher knowledge levels were observed among married individuals, those familiar with HPV and the HPV vaccine, those who had undergone Pap smear tests, sexually active individuals, and consistent condom users. e-HL had a positive impact on knowledge and perceived threat about CC and HPV. The affecting predictors for knowledge about CC and HPV were found to be e-HLS (β = 0.911), having prior knowledge of HPV (β = 0.201), and being aware of the HPV vaccine (β = 0.172). In terms of perceived threat, the affecting predictors were e-HLS (β = 0.207), having heard of HPV (β = 0.101), and having knowledge of the HPV vaccine (β = 0.092). Conclusion: e-HL emerged as a crucial predictor positively influencing knowledge and perceptions about CC and HPV. This suggests the potential for organizing digital health campaigns to enhance awareness and understanding of CC and HPV.

The frequency of bicycle helmet use among college students and health beliefs for bicycle helmet attitude

Objective: The aim of this study is to determine the frequency of bicycle helmet use among college students and health beliefs about bicycle helmet attitude. Participants: Turkish university students (n = 799). Methods: This descriptive and cross-sectional study was conducted over the period 2019. A sociodemographic and cycling related questionnaire form and the Bicycle Helmet Attitudes Scale were used in the data collection. Descriptive statistics, t-test, Anova and Kruskal Wallis tests were used in the statistical analysis. Results: Only 10.4% of students wear a bicycle helmet. Students who using bicycle helmets had higher benefit health belief scores compared to those who didn't, while barrier health belief scores were lower. There is a significant relationship between health belief scores for bicycle helmet attitude and gender, obeying traffic rules, thinking about helmet (unnecessary/disturbing/expensive/ridiculous) and helmet use. Conclusion: In this study, the frequency of using bicycle helmets is very low.

Nursing students' knowledge and attitudes about dementia: A cross-sectional study

AIM

This study aimed to determine knowledge and attitudes of nursing students about dementia and factors affecting them.

BACKGROUND

With the increased aging population in the world including Turkiye, the prevalence of dementia is on the rise. Nursing students must have knowledge of dementia to offer high-quality, evidence-based nursing care to people who have dementia. Nursing students' attitudes towards dementia directly affect the quality of the care that they give. A positive attitude contributes to provision of more empathetic and personalized care for people with dementia.

DESIGN

A cross-sectional design.

METHOD

The study was performed with 784 nursing students at six universities in Turkiye. Data were collected using a socio-demographic questionnaire, the Dementia Knowledge Assessment Scale and the Dementia Attitudes Scale. Data were analyzed using an independent samples t-test, one-way ANOVA and multiple linear regression analysis. Factors predicting knowledge and attitudes about dementia were examined using multiple linear regression analysis.

RESULTS

The mean age of the nursing students was 20.37 ± 1.85 years. Of all the nursing students, 82.9% were female, 15.1% were living with an older person, 5.5% had a family member with dementia, 9.8% had prior experience with dementia care and 19.4% received education about dementia. The students had inadequate knowledge of dementia (13.01 ± 6.66 out of 34), but a moderately positive attitude towards dementia (82.53 ± 12.44). Female gender (β = 0.087), increased year of study (β = 0.346), living in the city center (β = 0.070), having a family member with dementia (β = -0.081) and receiving education about dementia (β = 0.103) had a positive effect on the knowledge about dementia. Knowledge of dementia (β = 0.226), living in a city (β = 2.371) and prior experience in dementia care (β = 0.097) positively affected the attitudes about dementia.

CONCLUSION

Findings of the study suggest that curricula of undergraduate nursing education in Turkiyeshould be improved. Positive effects of education about dementia and clinical experience on knowledge and attitudes regarding dementia reveal a need for a change in the duration and quality of education about dementia.

Comparison of extraperitoneal and intraperitoneal laparoscopic procedures for intracranial pressure increase: a prospective clinical study

OBJECTIVE

According to the literature, higher levels of both intracranial pressure (ICP) and intraabdominal pressure (IAP) are related in a way that suggests a causal relationship. An increase in ICP can cause major neurological problems both during and after laparoscopic surgery. In this study, we aimed to examine the increase in ICP between totally extraperitoneal (TEP) inguinal hernia repair and laparoscopic cholecystectomy.

PATIENTS AND METHODS

We investigated 52 individuals who underwent laparoscopic surgery for the treatment of inguinal hernia (n = 26) or had a laparoscopic cholecystectomy (n = 26). The optic nerve sheath diameter (ONSD) was assessed before the procedure (T0), 10 minutes after carbon dioxide insufflation (T1), and immediately before extubation (T2).

RESULTS

There were significant differences in the ONSD values between the two groups as a function of time (p = 0.001). In terms of ONSD, the laparoscopic cholecystectomy value (LV) group showed a greater shift from T0 to T1 and T2 than the inguinal hernia value (HV) group. At T1, the ONSD values of both groups were considerably higher than those of T0 and T2. The impact of the extraperitoneal and transperitoneal laparoscopic methods on ICP was investigated. The ONSD value reached its maximum at T1 in both groups. At all measurement periods, the ONSD values of the LV group were noticeably higher than those of the HV group.

CONCLUSIONS

The diagnostic accuracy of ONSD ultrasonography is an important approach for determining the ICP level. During the decision-making process of TEP inguinal hernia repair, this study can guide medical professionals in the evaluation of elevated ICP.

The association between Patient Assessment of Chronic Illness Care Scores and quality of life in type 2 diabetes patients

Background

Chronic illness care is an important factor for health promotion in diabetes since it affects health outcomes such as quality of life.

Aims

The aim of this study was to investigate the relationship between the Patient Assessment of Chronic Illness Care and the quality of life in type 2 diabetes patients.

Methods

The study used a cross-sectional and correlational design. The sample included 317 patients with type 2 diabetes. A socio-demographic and disease-related questionnaire form, the Patient Assessment of Chronic Illness Care (PACIC) scale and the WHOQOL-BREF Quality of Life Scale were used to collect data.

Results

According to the regression analysis, the stronger predictor affecting all domains of quality of life was the overall PACIC. This study demonstrated the importance of satisfaction level of chronic illness care in the improvement of quality of life. Therefore, the factors affecting the satisfaction level with chronic care services should be determined to improve the quality of life of patients. In addition, healthcare based on the chronic-care model should be provided in the care of the patients.

Conclusions

PACIC had an important effect on quality of life of the patients. This study demonstrated the importance of satisfaction level on chronic illness care in the improvement of quality of life.

Does onlay mesh placement in emergency laparotomy prevent incisional hernia? A prospective randomized double-blind study

PURPOSE

The objective of this study is to assess the effectiveness and safety of onlay mesh closure of emergency midline laparotomy to prevent incisional hernia.

METHODS

This is a prospective randomized double-blind study and was carried out in the General Surgery Clinic, Konya City Hospital, from August 1, 2020 to August, 1, 2021. The study included 108 patients who were randomly grouped in 2 groups: patients with conventional abdominal closure and closure using additional onlay mesh (1:1). The follow-up period was for a year. The primary outcome was the incidence of incisional hernia and secondary outcomes were clinical data like complications, hospital length of stay, re-operations.

RESULTS

It was observed that incisional hernia was present in 14 patients (27.4%) in conventional abdominal closure group and was in 2 patients using mesh (4%), (p = 0.001). Clavien-Dindo 3B complications were in rise in conventional closure group (p = 0.02). Of all complications, burst abdomen was significantly more common in conventional closure group (p = 0.04). The rate of surgically treated complications were higher in conventional closure group (p = 0.02). Clavien-Dindo 3A complications were more common in patients with contaminated wound in mesh group (p = 0.02).

CONCLUSION

The use of mesh while closing the abdomen in emergency midline laparotomy reduces the risk of incisional hernia. Thus, to lower the risks of incisional hernia and its complications, prophylactic mesh can be used in high-risk patients.

Validity and reliability of the Spiritual Health Scale-Short Form for Turkish nursing students

OBJECTIVE

This study aimed at assessing the validity and reliability of the Turkish version of the Spiritual Health Scale-Short Form (SHS-SF).

METHODS

The methodological research was conducted with Turkish nursing students (n = 310). The sociodemographic question form and the SHS-SF were used as data collection instruments. The Content Validity Index, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analyses (CFA) were used for the validity of the scale, and Internal Consistency and Cronbach's Alpha reliability coefficient for its reliability.

RESULTS

The EFA revealed that five factors accounted for 66.49% of the variance. According to the CFA, the factor loadings for the 24-item scale ranged from 0.40 to 0.91. Goodness-of-fit indices were as follows: χ2/df = 2.39, RMSEA = 0.06, CFI = 0.92, TLI = 0.91, IFI = 0.92. The item-total correlation for the scale items ranged from 0.37 to 0.65. The alpha coefficient for the scale was 0.91.

SIGNIFICANCE OF RESULTS

It is important to identify the level of spiritual health of nurses and nursing students with a valid and reliable scale. The SHS-SF was found to be a reliable and valid scale for use in the Turkish language and culture. The scale can be used for evaluating spiritual health levels among Turkish nurses and nursing students. This will provide an opportunity for planning appropriate interventions to improve the spiritual health level of nurses and nursing students.

The effect of COVID-19 pandemic on lifestyle-related behaviours in Turkey: A web-based cross-sectional study

Background

The COVID‐19 pandemic and restrictions imposed to eradicate it have affected healthy lifestyle‐related behaviours.

Aim

The aim of this study was to determine the effect of COVID‐19 on lifestyle‐related behaviours.

Methods

This cross‐sectional web‐based survey research was performed with a convenience sample of 1020 adults residing in Turkey. Data were collected with self‐report data collection tools on 8–28 April 2021: a sociodemographic characteristics form and the impact of COVID‐19 on lifestyle‐related behaviours questionnaire.

Results

Eating behaviours, physical activity and sleep patterns of the participants were negatively affected during COVID‐19 pandemic (p < 0.001). More than half of the participants experienced weight gain during the pandemic. Also, stress levels and smoking increased (p < 0.01). The participants reported having changes in their lifestyles most frequently due to the fear of COVID‐19 infection, stress, decreased motivation, closure of the facilities for social and sports activities and increased food prices. Predictors of lifestyle‐related behaviours were found to be education (β = .189), income (β = −.101), residing in a village (β = .113) and the presence of a chronic disease (β = .075) (p < 0.001).

Conclusions

During the pandemic, COVID‐19‐related restrictions should be applied whilst taking account of both social distancing measures and maintenance of healthy lifestyle‐related behaviours. Nurses should offer counselling for maintenance of healthy lifestyle‐related behaviours.

What is already known about this topic?

Studies performed at the beginning and during the course of COVID‐19 pandemic in different countries have shown that lifestyle‐related behaviours are negatively affected.

Few studies have used a valid and reliable tool to determine the effect of COVID‐19 on lifestyle‐related behaviours.

The effect of COVID‐19 on lifestyle‐related behaviours has not been examined from a nursing perspective.

What this paper adds?

In the present study, which was performed at a time when night curfews and weekend shutdowns were imposed in Turkey, lifestyles of the participants were found to be negatively affected.

More than half of the participants gained weight and had increased stress and smoking and a decreased sleep quality.

The negative effect on lifestyle‐related behaviours was more severe in participants with low education and income levels, living in a village and suffering from a chronic disease.

The implications of this paper:

Restrictions introduced during the pandemic should both take account of social distancing measures and allow healthy lifestyle‐related behaviours.

Nurses playing a role in first line health care services should offer education and counselling for maintenance of healthy lifestyle‐related behaviours by utilizing information and communication technology (e.g., video calls).

The relationship between self-efficacy of diabetes management and well-being in patients with type 2 diabetes

Background

Self-efficacy is defined as the ability of an individual to perform an action successfully or her/his perception of being able to control events. The self-efficacy perception of diabetes management may affect well-being of the patient.

Aims

This study aimed to examine the relationships between self-efficacy of diabetes management and well-being in patients with type 2 diabetes.

Subjects and Methods

The study used a descriptive correlational design. Sample of the study included 200 patients with type 2 diabetes. Sociodemographic and disease-related questionnaire form "Self-Efficacy Scale for Diabetes Management" and "Well-Being Questionnaire" have been used as data collection tools. Multiple linear regression analysis was performed to explore the predictors of well-being in patients with type 2 diabetes.

Results

Self-efficacy level, age, level of compliance with treatment, and state of doing exercise were found to be statistically significant predictors of well-being in type 2 diabetic patients. Self-efficacy level for diabetes management was found to be the strongest predictor of well-being in patients with type 2 diabetes.

Conclusion

Self-efficacy level of diabetes management is a factor that affects well-being in type 2 diabetes patients and it should be considered during interventions for improving the well-being of patients.

Association of electronic health literacy with health-promoting behaviours in adolescents

AIM

This study aimed to determine the electronic health (e-health) literacy level of high school students and its relationship with their health-promoting behaviours.

METHODS

This was a cross-sectional study conducted between April and May 2018. The study sample consisted of 409 students, who were aged between 14 and 19 years old, in three high schools located in the city centre of Denizli. Multiple regression analyses were performed to examine the predictive variables for six dimensions of health-promoting behaviours.

RESULTS

In this study, the mean (SD) e-health literacy score of 27.89 (6.19) was slightly above moderate level. e-Health literacy was found to significantly predict all six dimensions of health-promoting behaviours positively, that is, e-health literacy was determined to predict the dimensions of nutritional behaviours (β = 0.64, P < 0.001), life appreciation (β = 0.55, P < 0.001), social support (β = 0.72, P < 0.001), exercise (β = 0.36, P < 0.001), stress management (β = -0.22, P < 0.001) and health responsibility (β = 0.68, P < 0.001).

CONCLUSION

With e-health literacy significantly predictive of health-promoting behaviours, nurses are recommended to consider the e-health literacy levels of adolescents in the health-promoting programs they design.

Validity and reliability of the Turkish version of Geriatric Health Promotion scale

BACKGROUND

A measure for healthy lifestyle behaviours of older adults would enable the development of effective and target-based health promotion strategies.

AIM

This study aimed to test the validity and reliability of the Turkish version of Geriatric Health Promotion scale among older people in Turkey.

DESIGN

This was a methodological study that was conducted between June and August 2018.

METHODS

A total of 321 volunteer older individuals, who were admitted to local health centres, participated in this study. A questionnaire, including sociodemographic data form, and the Geriatric Health Promotion scale were used to collect data. Content and construct validity was established using validity analyses.

RESULTS

The reliability of the scale was confirmed by its internal consistency (α = .82) and test-retest reliability (0.86). Exploratory factor analysis for the six-factor construct explained 64.7% of the total variance. Factor loads of each item ranged from 0.44 and 0.91. Confirmatory factor analysis indicated that the theoretical constructs had a perfect fit with data obtained. These data establish that the Turkish version of the Geriatric Health Promotion scale was valid and reliable.

CONCLUSION

The Turkish version of the Geriatric Health Promotion scale is a reliable and valid instrument that can be used in the evaluation of health-promoting behaviours among older individuals.

The prevalence of insomnia and its risk factors among older adults in a city in Turkey's Aegean Region

AIM

Experienced by many older adults, insomnia is a significant public health problem that requires the attention of health-care professionals and researchers. This study aimed to identify insomnia and its risk factors among community-dwelling older adults.

METHODS

This cross-sectional study was conducted in Denizli, Turkey. The study sample consisted of 360 elderly individuals aged 60 years and older who were admitted to one of six family health centres for any reason between 29 March 2016 and 17 June 2016. Data were collected by using a descriptive form for the elderly and the Insomnia Severity Index. The χ² test was used to compare independent variables and insomnia status. Logistic regression analysis was used for the variables that were found to be significant at the end of the single-variable analysis.

RESULTS

The mean age of the subjects, all of whom lived at home, was 69.52 ± 8.36 years. Insomnia was quite common among them (51%), and its severity was low (8.51 ± 5.56). At the end of logistic regression analysis, a moderate perception of health (OR = 10.859, 95%CI: 3.532-33.385) and the number of medications used (OR = 3.326, 95%CI: 1.014-10.907) were identified as risk factors for insomnia.

CONCLUSION

Based on the results of this study, we can state that insomnia is common among older adults. Therefore, older adults who are admitted to health-care institutions should be evaluated for insomnia. Factors identified as affecting insomnia were health perception and the number of medications used. Given that health perception and polypharmacy are associated with chronic disease management, helping the elderly to effectively manage chronic diseases may alleviate insomnia.

Influence of caregiver burden on well-being of family member caregivers of older adults

BACKGROUND

Caregiving to older adults is one of the most important social issues associated with aging. While caregiving provides a suitable care and supportive environment for older adults, changes in the lives of caregiving family members also affect their health. The aim of this study was to examine the effect of care burden on the well-being of family members providing care for older adults.

METHODS

The study used a cross-sectional design. The study sample included 363 family caregivers of older adults. Socio-demographic questionnaire form, Burden Interview and Caregiver Well-Being Scale were used as data collection tools. Multiple linear regression analysis was performed to explore the predictors of well-being in the family caregivers of older adults.

RESULTS

The caregiver burden mean score was 32.63 ± 15.72 and Caregiver Well-Being Mean score was 159.38 ± 24.55. Caregiver burden, perceived health status of the older adults, marital status, perceived health status of caregiver and social support of caregiver were found to be statistically significant predictors of well-being in family member caregivers of older adults. Caregiver burden level was found to be the strongest predictor of well-being in the family caregivers of older adults.

CONCLUSION

Results showed that caregiver burden had an important effect on well-being of the caregiver. For this reason caregiver burden should be considered during interventions for improving well-being in family caregivers of older adults. Findings of our study revealed the necessity of showing special attention to caregivers by healthcare professionals and the importance of conducting interventional studies that aim to reduce caregiver burden in order to promote well-being.

[Intercultural Sensitivity of University Students Studying At Health-Related Departments and Some Associated Factors]

Aim

This study was carried out to determine cultural sensitivity levels and affecting factors among the students who were studying at health-related departments.

Method

The study had a cross-sectional design. The universe of the study consisted of 1127 students who were studying at 1^st and 4^th years in nursing department of institute of health sciences, school of physical therapy and rehabilitation and medical faculty of a state university. 523 students who agreed to participate in the study and who were attending school on the day of data collection constituted the sample of the study. The data of the study were collected using a socio-demographic data form and Intercultural Sensitivity Scale. Descriptive statistics were used in data analysis. In addition, t test was used in paired groups, and one-way variance analysis (ANOVA) was used in more than two groups.

Results

The mean score of the students from Intercultural Sensitivity Scale was found to be 3.88±0.64. It was determined that cultural sensitivity was higher among the students who had interaction with people from different cultures, whose opinions about their jobs changed positively during their education, who wanted to attend student exchange programs and who spoke a foreign language (p<0.05).

Conclusion

In this study, the cultural sensitivity level of the students was found to be at a good level. In addition, gender, interaction with people from different cultures, participation in student exchange programs and knowledge of a foreign language were found to have a bearing on cultural sensitivity. Based on these results, the promotion of collaborations which would create opportunities allowing students to interact with individuals from different cultures might be offered. This would support them in the improvement of their language qualifications and would enable participation of more students in student exchange programs abroad.

The relationship between attitudes toward aging and health-promoting behaviours in older adults

BACKGROUND

Identifying the factors that are associated with health-promoting behaviours in older adults is necessary to increase their willingness and motivation to participate in health-promotion activities. Understanding context-specific attitudes in relation to their influence on health-promoting behaviours is crucial in designing efficient interventions that foster health-promoting behaviours among older adults.

AIM

This study aimed to examine the relationships between attitudes towards aging and health-promoting behaviours in older adults in Turkey.

METHODS

The study used a descriptive-correlational design. A convenience sample of 448 community-dwelling older adults who were 65 years and older and cognitively intact were selected from 6 family health centres in the city of Denizli in Turkey. The data were collected between March and June of 2014 using the Attitudes to Aging Questionnaire and the Health-Promoting Lifestyle Profile II. Multiple linear regression analysis was performed to explore the predictors of health-promoting behaviours.

FINDINGS

Attitudes toward aging, the psychosocial loss subscale, and education were statistically significant predictors of health-promoting behaviours. Attitudes toward aging were the strongest predictor of health-promoting behaviours in older adults.

CONCLUSION

Attitude towards aging is a factor that affects health-promoting behaviours, and it should be considered during interventions for improving health promoting behaviours.

The effect of chronic constipation on the development of inguinal herniation

OBJECTIVE

To investigate the effect of constipation on the development of inguinal herniation and type of herniation using the Constipation severity scale.

METHODS

A total of 100 patients who underwent surgical inguinal hernia repair (study group) and 100 healthy volunteers without inguinal herniation (control group) were included in this study. The constipation severity scale was administered to all patients. The type of the herniation was classified using Nyhus scale during surgery and the side of the herniation was recorded on completed questionnaires. The obstructive defecation sub-scale score, colonic inertia sub-scale score, pain sub-scale score, and the total score were recorded for each patient and the association between constipation and the development of inguinal herniation was investigated.

RESULTS

The mean age of patients in Group 1 and 2 was 40.92 ± 17.80 and 33.71 ± 9.13, respectively. There was a significant difference between the two groups in terms of obstructive defecation and colonic inertia sub-scale scores (p < 0.01). In addition, except for the pain sub-scale score, there were significant differences between Nyhus hernia types with regard to sub-scale scores of the constipation severity scale in patients in Group 1 (p < 0.01).

CONCLUSION

Significantly higher obstructive defecation subscale, colonic inertia subscale, pain subscale, and total scores in the study group as compared to controls shows that constipation may represent an important etiological factor for the development of inguinal herniation.

Impact of allyl disulfide on oxidative damage and liver regeneration in an experimental hepatectomy model

BACKGROUND

We investigated the effects of allyl disulfide (agarlic extract) on tissue damage, regeneration, proliferation and oxidative damage in an experimental liver resection model.

MATERIALS AND METHODS

In the study, 24 female Wistar albinorats weighing approximately 200-250 g were used. Group 1:The rats in the experimental group all received a 70%hepatectomy and were fed an Allyl disulfide (30 μg kg day,Allyl disulfide, Sigma-Aldrich, formula: C6H10S2, CASNumber: 2179-57-9, formula weight: 146.27 g mol) in supplement to a regular diet for 1 week both preoperatively and postoperatively. Group 2: The rats in the control group also underwent a 70% hepatectomy and were given regular food and water for 1 week both preop and postop. Group 3: In the sham group, all rats were sacrificed 7 days after surgery. Forbiochemical evaluation, SGOT, SGPT, bilirubin, CRP and MDA were studied. In a histopathological examination, the fattening of the liver tissue, existence of (macro-micro vesicular),fibrosis, pleomorphism at hepatocyte nuclei, portal inflammation, existence of intralobular inflammatory cells,dilation at sinusoids, congestion, congestion at the central vein, regeneration, existence of Kupffer cells in the sinu soidallumen and ki-67 proliferation index at hepatocytes were examined.

RESULTS

A significant difference between group 1 and group2 was observed regarding the existence of regeneration,(p:0.06), the occurrence of nuclear pleomorphisms (p:0,001)and the fibroblast activity status (p:0.001). Significant differences were found between the experimental groups in regard to Kupffer cell increase and dilation and the hyperemiastatus in the sinusoid lumens (p:0.013 and p:0.001,respectively). In the Allyl disulfide group, the proliferation index was significantly higher than that of the other groups(p:0,001), while the average plasma MDA value was lower than that of the other groups (p: 0,042). No significant differences were found among the groups with respect to tissue MDA values (p:0,720). No significant difference was found for SGPT (ALT) and SGOT (AST) levels between Group 1 and the other groups (p:0.247 and p:0.539, respectively).The average total bilirubin (T. Bili) values were 0,12,0,08 and 0,04 in the allyl disulfide group, control group andSham group, respectively. This difference among the groups is statistically significant (p:0.001). The average direct bilirubin (D. Bili) values were 0,06, 0,02 and 0,02 in the allyl disulfide group, control group and Sham group, respectively.This variation among the groups is also statistically significant (0.001).

CONCLUSION

We observed that the use of Allyl disulfide supplementation after major hepatectomy has a positive impact on liver regeneration, proliferation and oxidative damage.

ABBREVIATIONS

Postop: post-operative, Preop: pre-operative,SGOT(AST): serum glutamic oxaloacetic transaminase,SGPT(ALT): serum glutamate-pyruvate transaminase, CRP:C- Reactive protein, MDA: Malondialdehyde, DAS: Garlicextract diallyl sulfide, AGE: aged garlic extract.

REVERSIBLE CLINICAL AND MAGNETIC RESONANCE IMAGING FINDINGS IN LATE-ONSET COBALAMIN C DEFECT

Cobalamin C (Cbl C) disease is an inborn error of intracellular cobalamin metabolism. Two distinct clinical types are defined according to the age of onset. We describe an 8 year old girl with late-onset Cbl C disease presenting with neuropsychiatric symptoms. Mutation analysis revealed homozygous c.394C>T (p.R132X) mutation in the MMACHC gene. Serial magnetic resonance imaging (MRI) before and after the treatment are provided. MRI of the brain before treatment showed bilateral patchy focal hyperintensities in the white matter and cortical atrophy. After treatment with intramuscular hydroxycobalamin, oral folinic acid, oral betaine, normalization of MRI findings can be achieved in addition to clinical improvement. We present this case to draw attention to the reversibility of clinical and MRI findings in the late onset Cbl C disease after treatment.

Evaluation of nursing students' training in medical law

There is no co-ordinated focus on liabilities arising from nurses' medical interventions in terms of occupational, administrative, civil legal and criminal activities. However, the Turkish Criminal Code, the Turkish Medical Ethics Code of Practice, and guidelines for patients' rights offer some framework for the relevant ethical principles and responsibilities of nurses. The aim of this study was to investigate the evaluation of nursing students' training in their legal liabilities. The sample consisted of 309 students who were taking a course entitled 'Nurses' legal liabilities under Turkish criminal and civil law arising from medical interventions'. Data were obtained by means of self-administered questionnaires and McNemar's test was used to evaluate the answers. In conclusion, after their training, a great majority of the students demonstrated an improvement in terms of their percentage of correct answers relating to malpractice. This does not, however, mean that they will not face malpractice charges after graduating, but their increased awareness of the issue may encourage them to make more effort to reduce the risk of mistakes. It is recommended that nursing faculty carry out studies into medical malpractice, that they focus more on this subject in nursing education, and that all nursing schools review their curricula from the point of view of malpractice.

A cross-sectional survey of self-perceived health status and metabolic control values in patients with type 2 diabetes

BACKGROUND

The prevalence of diabetes is increasing worldwide. Diabetes and other chronic disorders play an important role in how patients perceive their health status, this perception being an important component of general health.

OBJECTIVES

The purpose of this study is to determine self-perceived health status and metabolic control in patients with type 2 diabetes and to understand the relationship between perceived health status and metabolic control in diabetic participants.

DESIGN

This is a cross-sectional survey.

SETTING

The research population was diabetes sufferers registered with the Turkish Diabetes Society in Denizli Province, Turkey.

PARTICIPANTS

A convenience sample composed of 110 patients with type 2 diabetes mellitus.

METHODS

The research data were collected using three tools. The first of these was a "Socio-demographic Data Form" to gather information on the diabetes patients. The second was a survey on the patients' self-perceived health (how do rate your state of health in general) in which the patients were asked to rate their own health in one of five categories: very good, good, fair, bad and very bad. For the statistical analysis, the study group was divided into two groups: "good", consisting of those who classified their health as either very good or good; and "poor", those who gave other responses. The third type of data was collected by measuring metabolic control outcomes [glycosylated hemoglobin (HbA(1C)), fasting blood sugar (FBS), non-fasting blood sugar, total cholesterol, high-density lipoproteins (HDL) and triglycerides] for each participant.

RESULTS

Approximately half of the diabetic participants surveyed have poor self-perceived health. In terms of the values of HbA(1C), an important indicator of metabolic control levels, it was found that only 24.5% of the participants surveyed had good metabolic control. There was found to be a statistically significant difference between self-perceived health and levels of HbA(1C); 68% of participants who had high HbA(1C) values evaluated their health as good, whereas 63.9% of those who had poor HbA(1C) values evaluated their health as bad. Age, level of education, mode of treatment, adherence to treatment and level of exercise were factors that were found to have statistically significant differences from, and therefore an influence on, self-reported health.

CONCLUSION

When working with diabetes patients, as soon as the diagnosis has been made, it is recommended that information both on subjective perceptions of health and on perceptions of the illness (health perceptions, health beliefs related to the illness) are evaluated and objective data (metabolic control values) are gathered.

Validity and reliability study of the Turkish version of Health Belief Model Scale in diabetic patients

BACKGROUND

Diabetes mellitus (DM) is an important health problem that leads to severe complications, is the cause of early death, and is showing an increase in frequency. The development of positive health behaviors is extremely important in the treatment of diabetic patients. There are various models that examine the health behaviors of individuals. One of these is the Health Belief Model. This model is very beneficial in explaining factors that affect patients' compliance with their disease.

PURPOSE

This research was planned to measure the validity and reliability of the Health Belief Model Scale in diabetic patients in the Turkish population.

DESIGN

Questionnaire Survey.

SETTINGS

The research population was all of the diabetic patients (4,125) registered with the Turkish Diabetes Society, Denizli Province, Turkey.

PARTICIPANTS

A convenience sample was composed of 352 patients with Type 2 DM.

METHODS

The research data were collected with three tools, a "sociodemographic data form" related to the diabetic patients, the "Health Belief Model Scale in Diabetic Patients," and the "Diabetes Management Self-Efficacy Scale."For validity studies: language validity, content validity, concurrent validity and construct validity were examined. For reliability studies: the tool's internal consistency reliability, Cronbach alpha reliability coefficient, test-retest reliability were examined.

RESULTS

The tool's internal consistency reliability subscales' Cronbach alpha coefficient values ranged from 0.73 to 0.86. For the total tool a Cronbach alpha value of 0.89 was found. In the tool's internal consistency reliability total item correlation the three items that were below 0.30 were removed and the 36 items were reduced to 33 items. The tool's test-retest reliability was 0.90. According to factor analysis the tool contains five subscales of perceived susceptibility, perceived severity, perceived benefits, perceived barriers and recommended healthy behaviors.

CONCLUSION

The Health Belief Model Scale in diabetic patients was determined to be valid and reliable for use in the Turkish population.

Endoscopic clipping versus band ligation in the management of bleeding esophageal varices

BACKGROUND

The effectiveness of endoscopic clipping in the hemostasis of bleeding esophageal varices and the eventual variceal eradication was compared with that of band ligation.

METHODS

Forty patients were enrolled in the study in a prospective manner, 19 of whom received endoscopic clipping (group I) and the remaining (n = 21 patients) received endoscopic band ligation (group II). All patients in this study presented with bleeding from esophageal varices. The patient characteristics (age, sex, Child-Pugh score, variceal grade) were comparable in the two groups. After initial hemostasis, the patients were assigned one of the two forms of endoscopic therapy which was continued in the follow-up sessions until varices were eradicated. Early and late results were compared.

RESULTS

Initial hemostasis was achieved in all patients in group I but two patients in group II required clip ligation for initial hemostasis because of the failure in band ligation. Those two were treated with band ligation in the follow-up sessions. A total of 224 clips in 53 treatment sessions and 296 bands in 82 treatment sessions were placed in group I and group II, respectively. The rates of complete variceal eradication were 89% and 76% in group I and group II, respectively (p > 0.05). The median number of required treatment sessions for complete eradication of the varices was significantly lower in group I than group II (3 versus 4, p = 0.013). Three patients from group I (15%) and seven patients from group II (33%) were readmitted for variceal bleeding during the follow-up period (p > 0.05).

CONCLUSIONS

With the advantages of high initial hemostasis rate, decreased risk of rebleeding, and fewer treatment sessions needed for variceal eradication, endoscopic clipping is as effective as band ligation, or perhaps more effective in the treatment of bleeding esophageal varices.

The management of liver hydatid cysts by percutaneous drainage

OBJECTIVE

To investigate the effect of percutaneous drainage on liver hydatid cysts.

DESIGN

A retrospective case study.

SETTING

Department of Surgery, Selçuk University, Konya, Turkey.

PATIENTS

Forty-five patients with 83 liver hydatid cysts (types I and II according to the classification of Gharbi and colleagues) followed up for a mean of 30 months (range from 14 to 36 months).

INTERVENTION

The cysts were drained percutaneously with ultrasonographic guidance and then irrigated with 0.05% silver nitrate solution through a fine needle. Albendazole was administered 48 hours before percutaneous drainage and for 2 months after the procedure to prevent the implantation of spilled scolices.

MAIN OUTCOME MEASURES

Complications of the procedure, decrease in size of the cyst cavity, recurrence and dissemination of the cysts.

RESULTS

All the cysts were treated successfully by percutaneous drainage. Anaphylactic shock developed in 1 (2.2 %) patient, and mild allergic reactions were observed in 2 (4.4 %) patients during the interventional procedure. Follow-up ultrasonography and CT demonstrated a statistically significant (p < 0.01) decrease in the mean cyst size. Recurrence and dissemination were not observed during the follow-up period.

CONCLUSION

Percutaneous fine-needle aspiration and drainage is effective for managing cystic liver hydatid disease in selected cases.

Does estrogen cause low conversion rates in laparoscopic cholecystectomies for acute and chronic cholecystitis in women?

Laparoscopic cholecystectomy is the preferred treatment for symptomatic cholelithiasis. Severe local inflammation and scar formation are commonly responsible for conversion to open surgery. Fibrosuppressive effects of estrogen on peritoneal inflammatory conditions could provide low, dense fibrosis or scar formation around the gallbladder and make laparoscopic cholecystectomy easier in women and we believe that male sex is a conversion factor in laparoscopic cholecystectomy.

Effect of laparoscopic cholecystectomy on platelet aggregation

The purpose of this study was to investigate the effect of laparoscopic cholecystectomy on platelet function. We operated on 40 women with symptomatic gallbladder stone, 20 of whom (study group) underwent laparoscopic cholecystectomy and 20 of whom (control group) open cholecystectomy. Patients with a history of bleeding, abnormal platelet count, or systemic disorders and those who were on salicylates, heparin, or oral anticoagulants were excluded. Blood parameters were checked at the beginning and the end of the operation, including platelet aggregation using adenosine 5'-diphosphate (ADP), collagen, and ristocetin in a whole-blood aggregometer. Platelet aggregation was evaluated by percent aggregation. Platelet aggregation due to collagen and ristocetin increased significantly at the end of the operation in the study group (p < 0.001). Aggregation due to ADP did not differ significantly from the start to the end of the operation. Control group results did not show any differences. Although the clinical findings of aggregated platelet are not frequently observed in practice, we suggest that laparoscopy increases platelet aggregation.

The effects of splenic artery ligation in an experimental model of secondary hypersplenism

OBJECTIVE

To induce hypersplenism in rats by splenic vein ligation and to investigate the effects of splenic artery ligation in this model.

BACKGROUND

Selective arterial embolisation and splenic artery ligation (SAL) are used in the treatment of secondary hypersplenism in some medical centres but these methods are not common.

MATERIALS AND METHODS

Thirty male Saprague-Dawley rats were allocated to three groups (n = 10). The first group underwent laparotomy, the second and third groups underwent laparotomy and splenic vein ligation. At the end of the third week, laparotomy was performed in the first and second groups and splenic artery ligation in the third group. Erythrocyte, leukocyte and platelet counts were performed weekly. At the end of the sixth week, the animals were sacrificed and the spleens were taken for histopathologic examination.

RESULTS

In the second and third groups, after splenic vein ligation, the erythrocyte and platelet counts were significantly reduced at the end of the second week (p < 0.01). In the second group, which underwent splenic vein ligation only, the levels remained low throughout the experiment. In the third group, after splenic artery ligation, there were rises in both erythrocyte and platelet counts; the levels were similar to the levels in the control group at three weeks after splenic artery ligation (p > 0.05). No significant changes were observed in the leukocyte counts throughout the experiment (p > 0.05).

CONCLUSIONS

Splenic vein ligation successfully induces experimental secondary hypersplenism. This state can be ameliorated by splenic artery ligation.

Transanal electrovaporisation of rectal tumours

OBJECTIVE

To present our early results with endoscopic transanal electrovaporization of rectal tumours.

DESIGN

Retrospective study.

SETTING

Department of Surgery, Faculty of Medicine, University of Selçuk.

SUBJECTS

10 patients, 4 with malignant and 6 with benign lesions.

INTERVENTIONS

Vaporization of the tumour using a new ridged roller electrode, the VaporTrode, and a standard 24F urological resectoscope.

MAIN OUTCOME MEASURES

Morbidity and recurrence.

RESULTS

There were no complications and all adenomas were vaporized completely. 2 patients with obstruction required a further treatment 3 and 5 months later because of recurrence. Median duration of operation was 22.5 minutes (range 10-38) and median duration of hospital stay was 3 days (range 1-4).

CONCLUSION

The VaporTrode is a safe and potentially useful tool for transanal excision of rectal tumours, the long term efficacy of which should be tested in larger series of patients.

Open drainage versus overlapping method in the treatment of hepatic hydatid cyst cavities

In order to compare the results of open drainage and overlapping methods, 58 consecutive patients with uncomplicated hepatic hydatid disease were investigated between January 1990 and January 1997. The cavities were obliterated by overlapping method in 26 patients and were left open into the peritoneal cavity following partial pericystectomy in 32 patients. Postoperative complications and follow-up results of ultrasonography (US) and computed tomography (CT) were compared between the two groups. In total, there were 56 cysts in the obliterated group and 83 cysts in the open drainage group. There was no significant difference in age, sex, mean diameter of the cysts, US features of the cysts according to the Gharbi classification, and median follow-up. Mean hospital stay was 10 days in the overlapping group and 7.5 days in the open drainage group (P = 0.033). No postoperative complication was observed in the obliterated group and nearly half of the cyst cavities could not be detected in the early postoperative period by US and CT. Pleural effusion (n = 1) and biliary fistula (n = 1) were detected in the open drainage group which disappeared spontaneously. In the open drainage group, US and CT surveillance revealed that the cyst cavities were reduced in size and the echo pattern was changed in the early postoperative period, whereas the appearance changed into pseudotumor view in the late postoperative period. In conclusion, the cyst cavities disappear perfectly in the overlapping group. Treating the cyst cavity by open drainage is an easy, effective and safe technique. Open drainage can be a 'method of choice' for patients with multiple hydatid cysts and for cysts where management is difficult or unamenable to other methods, but the residual cyst cavities may be misinterpreted as a new cyst by an inexperienced radiologist.

Effect of octreotide (Sandostatin 201-995) on bile flow and bile components

Octreotide (Sandostatin 201-995) has an inhibitory effect on gastric, intestinal, and pancreatic secretions and hepatic and splachnic blood flow. We examined the effects of octreotide on bile flow and bile components in 10 patients with T-tube choledochostomy. A Fogarty balloon catheter was inserted distal to the T-tube of these patients for measurement of bile flow and bile components. Bile samples were obtained to analyze bile acid, phospholipid, lipoprotein, and cholesterol, and bile flow measurements were performed every 15 min for a period of 90 min before study and after normal saline and octreotide administrations. While octreotide had an inhibitory effect on bile flow, the concentrations of bile acid, phospholipid, and lipoprotein in bile were increased with octreotide.

Is urinary bladder pressure a sensitive indicator of intra-abdominal pressure?

BACKGROUND AND STUDY AIMS

The accuracy of transurethral bladder catheter pressure in reflecting intra-abdominal pressure is well defined in experimental studies and case reports but not in controlled clinical trials.

PATIENTS AND METHODS

We compared bladder pressure with insufflator pressure during laparoscopic cholecystectomy in 40 patients. Measurements were made at four pressure levels of the insufflator: 0, 5, 10 and 15 mmHg.

RESULTS

When the insufflator displayed 0, 5, 10, and 15 mmHg (0, 6.8, 13.6 and 20.4 cmH2O), and the mean bladder pressures measured 2.5 +/- 1.4, 7.3 +/- 1.5, 12.9 +/- 1.6 and 19.7 +/- 1.5 cmH2O, respectively. The two measurements correlated well with each other (r = 0.973, P < 0.0001).

CONCLUSION

We concluded that bladder pressure measured by transurethral catheter was equal to insufflator pressure during laparoscopy, and that this was a valid indicator of intra-abdominal pressure.

Anophthalmia-Waardenburg syndrome: a report of three cases

We report on 2 Turkish families with children who had bilateral anophthalmia, upper and lower limb abnormalities, mental retardation and consanguineous parents. We have evaluated the 2 cases in the first family and the only case in the second as anophthalmia-Waardenburg syndrome. This is an extremely rare autosomal recessive syndrome.

Serum thyroid hormones and pituitary response to thyrotropin-releasing hormone in epileptic children receiving anti-epileptic medication

Thyroid hormones and pituitary function were assessed in 49 children with epilepsy who were receiving either a single medication of carbamazepine, phenobarbital and valproate or a combination of carbamazepine with phenobarbital or valproate. All therapeutic regimens except valproate monotherapy were associated with low levels of circulating thyroxine, free tri-iodothyronine and free thyroxine. Carbamazepine with valproate was associated with the lowest serum concentration of thyroid hormones. It seems probable that accelerated hormone metabolism is responsible for these hormonal changes. However, all drug regimens also had effects on the function of the hypothalamic pituitary axis. Because of these findings, thyroid hormones should be checked frequently during anti-epileptic drug treatment, although clinical hypothyroidism was not seen in our patients.

[Serum and tissue silver levels after burns treated with silver compounds]

This study was performed in order to investigate serum and tissue silver levels in burns which were used 10 percent silver nitrate as a topical agent. We formed four groups of animals and pulverized 10 percent silver nitrate solution to the first group (GI) that included ten rabbits of which backs were burned by boiling water and silver sulphadiazine cream to second group (GII) with nine rabbits. We carried out 10 percent silver nitrate solution to the first control group (GIII) and silver sulphadiazine cream to the second control group (GIV) each of which had seven animals with unburned skin. We obtained blood samples from every animal before and after application of topical agent on the 1st, 3rd, 7th, 15th, 21st and 28th. We determined serum and tissue silver levels by atomic absorption spectrophotometer in kidney and liver of the animals which were sacrificed on the 28th day. In first and second groups we found that serum silver values reached on 3rd day to the maximum level and then the values decreased gradually. We also determined that diminution of the serum silver levels were prominent following on 15th day. It was shown that there was no silver in the serum on 28th day except four animals. The silver deposition in the liver was much more than in the kidney. Between these two groups there was significant difference neither in the serum on the same days nor the tissue silver levels. According to these data it was concluded that serum and tissue silver levels with 10 percent silver nitrate used in burns produced no difference from that of 1 percent silver sulphadiazine cream.