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    Breastfeeding patterns, beliefs and attitudes among Kurdish mothers in Diyarbakir, Turkey
    (Wiley, 2005) Saka, G; Ertem, M; Musayeva, A; Ceylan, A; Kocturk, T
    Aim: The aim was to rapidly assess existing breastfeeding patterns, beliefs and attitudes in the province of Diyarbakir, a socio-economically disadvantaged region of Turkey. Methods: A cross-sectional survey exploring demographic and breastfeeding patterns was carried out among 921 mothers with children 6-18 mo of age. Results were quantitatively analysed. Focus group interviews dealing with beliefs and attitudes were separately carried out among 107 mothers and analysed by qualitative content analysis. Results: Nearly all mothers had breastfed their infants at some time, but exclusive breastfeeding was rare. About 62.2% of the mothers had waited for at least 24 h before initiating breastfeeding. Almost half of the infants received sweetened water as a first feeding. There was agreement on the superiority of breastfeeding and awareness of its contraceptive effect. Early introduction of sugared water, water and supplementary feeds was considered desirable. Working in the fields and pregnancy were considered situations counteracting breastfeeding. Conclusion: The attitude to breastfeeding was highly positive, but more information is needed to encourage the use of colostrum, discourage early supplementation and promote exclusive breastfeeding during the first 6 mo of life.
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    An epidemic caused by measles virus type D6 in Turkey
    (Turkish J Pediatrics, 2005) Ceylan, A; Ertem, M; Korukluoglu, G; Acemoglu, H; Kara, IH; Erten, PG; Arslan, C
    In this study, the extent of measles outbreak was investigated in the Idil and Cizre counties of Sirnak Province. New cases determined in patients who applied to primary care clinics and those detected during home visits were evaluated. In 2001, a total of 2,143 cases reported in Sirnak Province were signified as a probable outbreak. Three hundred and thirty-three patients in Cizre and 219 patients in Idil applied to the primary care clinics. Of the cases, in Cizre 8.4% (n=28) and in Idil 6.4% (n=14) were infants aged nine months and younger who had not yet been vaccinated. Totally, 17 new cases (8 in Cizre and 9 in Idil) in the exanthema phase were determined during home visits and these were considered as outbreak cases. Virus isolation was achieved in 12 cases. All isolates were sent to the Centers for Disease Control (CDC) for genotyping and classified as D6 group. In conclusion, measles epidemics are still seen in our country. Therefore, measles outbreaks necessitate intensive intervention by physicians who are employed in primary health care services.
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    Induced abortion and effecting factors of ever married women in the Southeast Anatolian Project Region, Turkey
    (Bmc, 2004) Bozkurt, AI; Özcirpici, B; Ozgur, S; Sahinoz, S; Sahinoz, T; Saka, G; Ceylan, A
    Background: Nearly 10% of the population of Turkey lives in the Southeast Anatolian Project ( SEAP) region. The population growth rate and the rate of unintended pregnancies are high and family planning services are insufficient in this region. Lifetime induced abortion rate is also high in this region. Public health problems of the SEAP region were investigated in the SEAP Public Health Project in 2001 and 2002. As it is one of the most important health problems of the women living in this region; induced abortion was also investigated in this project. Methods: An optimumsample size representing the rural and urban area of the region ( n = 1150) was chosen by the State Institute of Statistics by a sampling method proportional to size. 1126 of the area's 1150 houses have been visited and data about induced abortions have been obtained by applying a questionnaire to 1491 ever married women who live in the region. Results: It has been found that 9.0% of these women who had at least one pregnancy in their life had at least one induced abortion. The lifetime induced abortion per 100 pregnancies was found to be 2.45. The primary reason given for induced abortions was wanting no more children ( 64.6%). Lifetime induced abortions were 5.3 times greater with women using a family planning method than women not using family planning methods. Lifetime induced abortions were 4.1 times greater with unemployed women than working women. Most of the women have used private doctors in order to have an induced abortion. Although 32.29% have not yet begun to use a contraceptive method after their last induced abortion, 43.75% of the women have since started to use an effective contraceptive method. 23.96% of them have begun to use an ineffective contraceptive method. Conclusions: Induced abortion is still an important problem at the SEAP region. The results of the study remind us that unemployed women and women who have more than four children is our target group in the campaign against induced abortions. Most of the women use private doctors in order to have an induced abortion. Thus, priority must be given to educate private gynecologists with respect to induced abortion. After induced abortions, a qualified family planning consultant can be given to women and they can be secured to use a suitable contraceptive method.
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    Neonatal tetanus in the south-eastern region of Turkey
    (Oxford Univ Press, 2004) Ertem, M; Çakmak, A; Saka, G; Ceylan, A
    Neonatal tetanus is an important health problem with an estimated 500 000 deaths per year worldwide, particularly in developing countries. We analysed 56 cases of neonatal tetanus (NNT), retrospectively, who were admitted to Diyarbakir Children State Hospital between 1994 and 2001. In 1998 an intervention in a childcare intensive unit was conducted, which included a nurse education programme, increasing the number of nurses and other health staff, and more qualified management of cases. The mean age of patients was 7.9 days at admission, and the male:female ratio was 1:6. Eleven per cent of the cases had body weight under 2500 g. The mean hospitalization period was 9.9 days. All patients were born at home without medical help and 28.6 per cent were from urban areas. The case fatality rate that was formerly 88.5 per cent, decreased to 53.6 per cent by the intervention conducted in 1998. Based on our findings, we can say that improved hospitalization conditions and intensive care may reduce mortality. Enforcing preventive policies both in rural and urban areas is of great importance in the least developed regions.
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    A special risk group for hepatitis E infection: Turkish agricultural workers who use untreated waste water for irrigation
    (Cambridge Univ Press, 2003) Ceylan, A; Ertem, M; Ilcin, E; Ozekinci, T
    Untreated waste water usage in agriculture is an important health-threatening issue which could affect both workers' and the public's health. In this study we researched hepatitis E infection in 46 of 57 farmers who used untreated waste water in agriculture. We compared them with 45 persons of the same socio-economic status and age. Anti-HEV seropositivity was 34.8% in the workers and 4.4% in the control group. We suggest that this type of irrigation is an important potential risk for hepatitis E infection.
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    Trace elements and oxidative stress in chronic obstructive pulmonary disease
    (Saudi Med J, 2005) Isik, B; Isik, RS; Ceylan, A; Calik, O
    Objectives: Many trace elements have activator or inhibitor roles in the antioxidative defense systems in diseases such as chronic obstructive pulmonary diseases (COPD). In this study, we aimed to show the levels of trace elements with action in oxidative stress, and to show the levels of malondialdehyde (MDA) as a marker of oxidative stress, and the activity of paraoxonase (PON1) as an antioxidant in COPD and smokers. Methods: We included 25 patients with COPD, and 20 healthy non-smokers in the study. We selected them from the hospitalized patients at the Hospital of Dicle University, Turkey, between April 2003 and January 2004. The clinical condition of the patients was stable. Results: The serum copper (Cu) and MDA concentrations in COPD patients were higher than the control group. There were no differences in zinc (Zn) concentration and Cu/Zn ratio between COPD patients and the control group. We found lower serum PON1 activities in COPD patients compared with the control group. There was no statistically significant difference in Zn concentration and Cu/Zn ratio between smokers and non-smokers in COPD. There were statistically significant differences in Cu, MDA concentrations and serum PON1 activities between smokers and non-smokers in COPD. Conclusions: We could suggest that trace elements such as Cu, oxidants and antioxidants such as MDA and PON1 have roles in oxidative stress, and in COPD.