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Öğe Acquired Inhibitors to Coagulation Factors in a Male Patient with Systemic Lupus Erythematosus: A Case Report and Review of the Literature(Akad Doktorlar Yayinevi, 2012) Erdem, Ozgur; Ayyildiz, Orhan; Aybak, MehmetAcquired coagulation inhibitors are rare but acquired bleeding diathesis caused by autoimmune depletion or dysfunction of coagulation factors can be life-threatening. This occurs most frequently in elderly patients who lack disease associations. Acquired coagulation inhibitors may also arise in association with systemic lupus erythematosus (SLE). The groups of patients who suffer from SLE most frequently are women in their 2nd to 4th decade. In this case, we present a 22-year-old man with systemic lupus erythematosus who developed an acquired inhibitory to factor II, VIII, IX, X and von Willebrand factor (vWF).Öğe Are Primary Health Care Workers Aware of Cervical Cancer Risk?(Asian Pacific Organization Cancer Prevention, 2014) Can, Huseyin; Erdem, Ozgur; Oztekin, Coskun; Celik, Sercan Bulut; Onde, Mete; Celepkolu, Tahsin; Ongel, KurtulusBackground: We here examined the awareness of female health employees (doctors, nurses, midwives) working in primary health care service about cervical cancer and its risk factors. Additionally attitude and behavior for gynecologic examination and pap smear screening wwere researched. Materials and Methods: This cross-sectional, descriptive study con cerned female health employees working at primary health care services in two southern cities of Turkey, over a four month period in 2013. Participants were recently or previously sexually active research was explained and verbal informed consent was obtained face to face. The questionnaire consisted of two parts; socio-demographic characteristics and level of knowledge about cervical cancer and its risk factors. Results: The average age of the participants (midwives 43.7%, n=143; nurses 40.4%, n=132; doctors 6.4%, n=21; emergency medical technicians and others, 9.5%, n=31; total, n=327) was 30.9 +/- 6.41 years. 64.2% (n=210) were working in Diyarbakir and 35.8% (n=117) in Batman. A large proportion reported low knowledge and inadequate screening practice Conclusions: Health employees should be better informed about the importance of screening for cancers, given their preventive roles for the general population.Öğe Effects of Ramadan Fasting on Biochemical and Hematological Parameters and Cytokines in Healthy and Obese Individuals(Mary Ann Liebert Inc, 2011) Unalacak, Murat; Kara, Ismail Hamdi; Baltaci, Davut; Erdem, Ozgur; Bucaktepe, P. Gamze ErtenBackground: The typical nutritional plan in Ramadan may have beneficial influences on the inflammatory state, as well as on metabolic and anthropometric parameters. We aimed to investigate the effects of Ramadan fasting on biochemical and hematological parameters and cytokines in healthy and obese individuals. Methods: This study was performed during the Ramadan holy month (September and October 2007). The study group consisted of 10 obese males and the control group consisted of 10 males with a normal body mass index (BMI), who were admitted to the Family Medicine Outpatient Clinic of Dicle University Medical Faculty in Diyarbakir, Turkey, and who indicated that they were going to fast throughout the entire month of Ramadan. Individuals with any acute or chronic disease or medication during the study were excluded. Height, weight, BMI, and waist and hip circumferences were measured. High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), urea, creatinine, insulin, total protein, albumin, C-reactive protein (CRP), lactic dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and cytokine levels were evaluated. Results: The average age of the participants was 27.4 +/- 5.2 years. Of the study group, 7 fulfilled the criteria of metabolic syndrome. Significant weight reduction, significant decrease in BMI, and significant decrease of homeostasis model assessment of insulin resistance (HOMA-IR) and fasting blood glucose (FBG) were observed in study group; weight and BMI reduction were insignificant and no significant change was observed in FBG levels, but a significant increase was observed in HOMA-IR in the control group. Post-Ramadan systolic and diastolic blood pressure values, serum white blood cells (WBC) count, interleukin-2 (IL-2), IL-8, tumor necrosis factor-alpha (TNF-alpha, TG, and ALT levels were significantly lower in both groups compared to pre-Ramadan values. Conclusion: Ramadan fasting has beneficial influences on the inflammatory state, as well as metabolic and anthropometric parameters.Öğe Evaluation of post-graduate training effect on smoking cessation practice and attitudes of family physicians towards tobacco control(E-Century Publishing Corp, 2014) Turker, Yasemin; Aydin, Leyla Yilmaz; Baltaci, Davut; Erdem, Ozgur; Tanriverdi, Mehmet Halis; Sariguzel, Yunus; Alasan, FatihObjective: Family physicians (FPs) are cornerstone for tobacco control. It was aimed to compare the effect of training on their smoking cessation practice, knowledge level and attitudes towards smoking and tobacco control. Methods and materials: The cross-sectional and multi-centered study was carried out using structured survey modified WHO based questionnaire. It was delivered to 1500 FPs randomly selected among approximately 23000 family physicians across the country. The study survey was self-reported by FPs, assessing their knowledge, attitudes, status of post-graduate training, and practice about tobacco control. Participants were assigned into two groups as non-trainee groups (Group 1) and post-graduate trainee (Group 2). Results: The mean age was 38.4 +/- 7.1 years-old. The percentage of male and female FPs in the study was 53.1% and 46.9%. The ratio of family physicians who participated in training program Group 2) was 26.5% (n = 327). The ratio of female FPs who participated the SCP training course was significantly higher than that of male FPs (27.3% versus 22.5%, p = 0.035). There was no significant difference for smoking status between groups (p = 0.686). When the number FPs whose consulted by the smokers over = 5 a week was compared, the ratio of FPs was significantly higher in group 2 than group 1 (p < 0.001), but overall ratio of FPs (2.8%) who consulted within a week smokers was considerably lower Statements of Competence and confidence items stated by all FPs were 24.2% and 32.2%, respectively. Physicians who had attended post-graduate training on SCP were more competent and confident, compared to non-trained FPs (p = 0.002 and p = 0.001). Conclusion: Post-graduate training on tobacco control improved self-confidence and competence of FPs. With post-graduate training, significant improvement was seen in practical skills of physicians. A continuing training program should be introduced to FPs, to engage them for smoking cessation practice.Öğe Postpartum Blues and Postpartum Depression(Duzce Univ, 2009) Erdem, Ozgur; Bez, YasinPostpartum blues which is seen during the postpartum period is a transient psychological state. Most of the mothers experience maternity blues in postpartum period. It remains usually unrecognized by the others. Some sensitive families can misattribute these feelings as depression. In this article, we tried to review the characteristics of maternity blues and its differences from depression. We defined depression and presented the incidence and diagnostic criteria, of major depression as well as the risk factors and clinic findings of postpartum depression. Thus, especially at primary care we aimed to prevent misdiagnosis of both maternity blues and depressionÖğe Postpartum Psychosis(Duzce Univ, 2014) Erdem, Ozgur; Bez, YasinPostpartum psychosis is the one of the most severe psychiatric disorder that can be seen during postpartum period. It can be seen between 0.1-0.2 % ratios at postpartum period. It is generally seen in the first two weeks after delivery but in almost 80% of the cases can also be seen until the end of the first month. Risk increases for those who have a positive family history of psychiatric disorder. It is seen more often in primipars, young and those who have psychological disorder history before delivery. Abrupt decrease of serum concentrations of estrogen and progesterone after delivery is suggested in its etiology. Early symptoms of postpartum psychosis may be insomnia and fatigue. The patient may give harm to her baby or herself if develops psychotic features including delusions or hallucinations. Suicidal ideas and suicide attempts may be more prominent than they occur in postpartum depression. It should be treated immediately and effectively due to suicide or homicide risks. If it can not be treated with antipsychotic drugs then electroconvulsive therapy (EKT) can be an alternative treatment option. Ninety-five percent of the treated patients with postpartum psychosis recover usually in 2-3 months period. Health workers practicing in first step can play important roles in detection and early management of patients with postpartum psychosis.Öğe The Reasons of Vaccination Rejection during the Mop-up Oral Polio Vaccination Campaign: A Family Health Center Experience(Duzce Univ, 2017) Erdem, Ozgur; Toktas, Izzettin; Celepkolu, Tahsin; Demir, VasfiyeObjective: Mop-Up Polio Vaccination Campaign is a movement which goals to reach the target of eliminating polio. Our aim in this study is to determine the characteristics of the families who have rejected oral polio vaccination (OPV) of their children within the OPV Campaign in a family health center and to examine the reasons of rejecting the vaccination. Methods: The data was obtained through a survey in face-to-face interviews which were performed with the families who have rejected the vaccination of their children within the Mop-Up Oral polio vaccination campaign. The survey form consisted of 14 questions about the socio-demographic features of the families and children, and the reasons of refusing oral polio. Results: 1250 children were included in the vaccination program during the campaign. 38 families of the children (3.04%) declined vaccination during the campaign, the average age of the children were 23.2+/-17.7 months. The youngest one was three days old and the eldest one was 59 months old. Looking over the family members who took the survey, it is seen that 71 % of those were the mothers (n=27), 8% of those were the fathers (n=3) and 21% of those were the relatives (n=8). It was discovered that 94.7 % of the families of the children who rejected OPA vaccination got other vaccinations according to the Ministry of Health National Vaccination Calendar (n=36), whereas 5.3% of those children lacked of other vaccinations (n=2). Though 81.6% of the children were given OPA beforehand (n=31), 18.4% were not given at all (n=7). Conclusion: Levels of educational and awareness are important in reaching the targeted vaccination rates in the conduction of vaccination works. We believe that on the vaccination campaigns to be conducted, informing the families about vaccination and increasing their awareness will decrease the vaccination rejections.Öğe Screening mixed depression and bipolarity in the postpartum period at a primary health care center(W B Saunders Co-Elsevier Inc, 2016) Celik, Sercan Bulut; Bucaktepe, Gamze Erten; Uludag, Aysegul; Bulut, Ibrahim Umud; Erdem, Ozgur; Altinbas, KutsatIntroduction: Mixed depression is a clinical condition accompanied by the symptoms of (hypo)mania and is considered to be a predictor for bipolar disorder. Compared to pure major depression, mixed depression is worse in progress. There are limited data on the prevalence of mixed depression since it is a relatively new entity. Therefore, the present study aimed to investigate the prevalence of mixed depression during the postpartum period which is risky for mood disorders. Methods: The study included 63 postpartum women. The participants were administered Beck Depression Scale, Edinburgh Postnatal Depression Scale (EPDS), Mood Disorders Questionnaire (MDQ), and Modified Hypomania Symptom Checklist-32 (mHCL-32). Results: The MDQ scores of the women with expected depression according to the EPDS cut-off scores, were significantly higher than the women with lower EPDS scores (t = 4.968; p < 0.001). The modified hypomania scores were significantly higher in the women with higher depression scores compared to the women under EPDS cut-off scores (t = 4.713; p < 0.001). According to the EPDS and BDS results, 27 (42.9%) and 14 (22.2%) women needed additional clinical examination for depression, respectively. In addition, 3 (4.8%) women require additional clinical examination for bipolar disorder. The scores for the first item of MDQ were above the cut-off value in 11 (17.5%) women. According to the mHCL-32 results, 50 (79.4%) women had at least 1 symptom, 45 (71.4%) women had at least 3 symptoms, and 43 (68.3%) women had at least 5 symptoms of mixed depression. Conclusion: Postpartum mixed depression should be promptly diagnosed by using appropriate diagnostic tools, particularly by primary health care physicians. Patients with mixed depression should be closely monitored to avoid manic switch. (C) 2016 Elsevier Inc. All rights reserved.
