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Öğe Altitude: Is determinant for tuberculosis incidence?(2006) Tanrikulu A.Ç.; Abakay A.; Abakay Ö.; Alp A.In the last year, there have been very important improvements about tuberculosis (TB) all over the world. In this study, it was researched TB control studies at two cities in Turkey between 1999 and 2003 in order to determined the factors affecting to TB prevalence. The forms using those dispensaries in two cities to informing about diagnosis and treatment of TB have been investigated retrospectively. In This period, 2387 new TB patients were determined in Diyarbakir, 1844 (77.2 %) of them were pulmonary TB and 543 (22.8 %) extrapulmonary TB. 691 (37.5 %) with pulmonary TB were smear positive. In same period, 375 new TB patients were determined in Kars, 276 (73.6 %) of them were pulmonary TB and 99 (26.4 %) extrapulmonary TB. 50 (18.1 %) patients with pulmonary TB were smear positive. The average incidence of TB was 37.55/100000 in Diyarbakir and 19.59/100000 in Kars (p<0.05). The average incidence of pulmonary TB was 29.04/100000 in Diyarbakir and 14.53/100000 in Kars (p<0.05). The altitude at Diyarbakir is 660 meters and 1768 meters in Kars. According to research from the State Planning Organization of Turkey, there has been an important difference regarding the rates of urbanization and rates of literacy between two city (p<0.05). It was thought that the significant difference regarding incidence of TB between two cities was due to the difference of altitude of those city (2.3 times). Moreover, it was thought that some socioeconomic parameters could be affective on TB prevalence. However, some extensive study should be carrying out to clearly understand the factors affecting TB prevalence.Öğe Close contacts examination and chemoprophylaxis care level of Diyarbakir no 1 tuberculosis control dispensary(2006) Abakay A.; Abakay Ö.; Tanrikulu A.Ç.; Coşkunsel M.The preventive chemothreapy is important for preventing of tuberculosis in the close contacts. This regard the close contacts of tuberculosis patients are evaluated carefuly. In this study we investigated retrospectively 1986 close contacts of 360 tuberculosis patients who registered Diyarbakir No. 1 Tuberculosis Control Dispensary. In the tuberculosis patients, the mean age 31.5±16.1 years, 218 (% 60.6) cases were male and 142 (% 39.4) cases were female. Examinations reasons of tuberculosis patients were as 280 (% 77.8) and 74 (% 20.6) individual examination and close contact examination, respectively. It was found that index cases were as % 75 of pulmonary tuberculosis and % 25 extra pulmonary tuberculosis. Pulmonary tuberculosis cases were as % 63.7 of smear positive % 36.3 of smear negative. In the close contacts, the mean age 20.2±16.9 years, 948 (% 47.8) cases were male and 1038 (% 52.2) cases were female. It was found that mean 5.51±2.96 close contacts per a tuberculosis patient were recorded. It was found that examination was not made in the 596 (% 30) cases of close contacts. The number of examinated cases of close contacts was 1390. Examination results in the examinated cases were as follows respectively: preventive chemothreapy was applied in 264 (% 18.9) of the cases; active tuberculosis disease were determinated in 32 (% 2.3) of the cases; BCG was applied in 92 (% 6.7) of the cases; second control examination was suggested in 14 (% 1.1) of the cases. Preventive chemothreapy should be applied in 631 (% 45.4) of the examinated close contacts according to National Tuberculosis Guideline. However, it was found that preventive chemothreapy was not applied. It was determinated that the examinated rate was decreased because of the index cases were uneducated and unemployed and the examinated rate was not decreased because of the index cases were uninsured. Conclusion: Some defects were established in the care of tuberculosis control dispensary. It is thought the defects can be corrected by means of the application National Tuberculosis Guideline and the increasing education activities.Öğe Comparison of approaches in tuberculosis diagnosis between dispensary and chest diseases clinics and defects into practice(2006) Abakay A.; Abakay Ö.; Tanrikulu A.Ç.; Coşkunsel M.Tuberculosis (TB) is an important health problem for our country. Tuberculosis conrol dispensaries (TCD) undertake important functions in application of national TB control programme. In this study, comparison of diagnosis methods in TB is aimed between Diyarbakir No.1 TCD and chest diseases clinics. The data of 360 cases were investigated retrospectively in Diyarbakir No.1 TCD. Systematic sample method was used in the selection of this cases within registered 916 cases between January 200? and December 2004. It was found that cases were as 270 (% 75) pulmonary TB and 90 (% 25) extra pulmonary TB. Pulmonary tuberculosis cases were as 172 (% 63.7) of smear positive 98 (% 36.3) of smear negative. Bacteriological and nonbacteriological methods were used in the 117 (% 72.2) cases and 45 (% 27.8) cases of 162 cases as diagnosed at pulmonary TB chest diseases clinics, respectively. Bacteriological and nonbacteriological methods were used in the 58 (% 64.4) cases and 32 (% 35.6) cases of 90 cases as diagnosed at pulmonary TB Diyarbakir No. 1 TCD, respectively. It was found that the diagnosis of 15 (% 46.8) cases that diagnosed by nonbacteriological methods at TCD was determinated to be as false by chest diseases clinics that have different diagnosis possibility. It was determinated that the mean treatment time was 7.51 ± 2.90 month. It was found that the 56 (% 15.6) cases were made some errors according to treatmet regime or treatment time. The false rate was found to be high when used nonbacteriological methods at TCD. National TB programme is suggested that smear negative cases are sent to health centers having different diagnosis possibility. As a result of, our study is in agreement this suggestion.Öğe Comparison of tuberculosis screening results obtained at centrum and village schools(2007) Abakay A.; Abakay Ö.; Çetin Tanrikulu A.Severity forms of tuberculosis (TB) can be seen more frequent in chilhood. Therefore, preventive cases are important at children. Tuberculosis screening was made by The TB Control Eleventh Group Presidency on the primary school students at total seven schools in Diyarbakir (three school located at centrum and four schools locate at villages), at November, 2005. Total 1181 children containing 681 from centrum and 500 from villageswere taken tis study. In the centrum children. 334 (49.1 %) were female and 347 (50.9 %) children were male and the mean age 6.99±0.97 (6-13) years. In the villages children, 277 (55.4 %) were female and 223'ü (44.6 %) children were male and the mean age 7.94±1.65 (5-13) years. It was found that the numbers of children that not made Bacillus Calmette-Cuerin (BCG) vaccine were 360 (52.9 %) and 121 (24.2 %) at centrum and villages, respectively. The tuberculin skin test (TST) mean diameters were 1.35±1.8 mm, 3.5±4.15 mm and 10.33±2.96 mm at no BCG children, one BCG scar group and two BCG scar group, respectively. It was found that the TST mean diameter were 2.6±3,5 mm 2.8±3.7 mm and at children in centrum and villages, respectively. The diameter difference between centrum and villages was not found to be meaningful statistically in the no BCG group, two BCG scar group and all children (p>0.05). The diameter difference between centrum and villages was found to be meaningful statistically in the one BCG scar group (p<0.05). It was found that total 14 TST containing 12 no BCG group and 2 one BCG scar group were positive in all children. It was determinated that the vaccine rate was fairly low interestingly in the centrum. Increasingthe BCG vaccine number increased meaningfully the TST mean diameter. The vaccine rate must be increased because of it was found that increasing the BCG vaccine number increased meaningfully the TST mean diameter.Öğe An overview of thrombolytic treatment for pulmonary embolism: A single Centre experience(Acta Medica Mediterranea, 2014) Şen H.S.; Abakay Ö.; Sezgi C.; Yilmaz S.; Taylan M.; Kaya H.; Tanrikulu A.C.Introduction: A massive pulmonary embolism (MPE) has a poor prognosis and high mortality. Thrombolytic therapy is preferred in patients with life-threatening symptoms such as hypotension, cardiogenic shock, and right ventricular failure due to the risk of severe bleeding. Materials and methods: This is a retrospective analysis of patients who were hospitalized with the diagnosis of pulmonary embolism (PE) and given thrombolytic therapy in the chest diseases clinic of a tertiary university hospital between January 2008 and November 2013. Results: The subjects' mean age was 59.54 ± 13.76 years. Fourteen of 39 patients who were treated with thrombolytic therapy were male (35.89%) and 25 (64.10%) were female. The symptoms experienced by the patients included dyspnea in 39 patients, chest pain in 35 patients, hemoptysis in 6 patients, syncope in 13 patients and cough in 10 patients. Risk factors were advanced age (> 60 years) in 19, immobilization in 19, malignancy in 3, major surgery in 11 patients. The in-hospital mortality analysis showed that 32 patients were discharged and 7 patients died. Four patients died from their pulmonary embolism and 3 patients died because of a major bleeding complication. Conclusions: Pulmonary embolism is a disease that may lead to death within hours secondary to acute right heart failure. Early diagnosis and treatment can be life saving. Thrombolytic therapy has been shown to improve hemodynamic parameters in the early period post-PE. An increased risk of bleeding is one of the most important drawbacks of thrombolytic therapy. Nonetheless, it can be a life-saving therapy in properly selected patients.
