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Öğe Birth types and opinion on caesarean section of women who gave birth within last 10 years in diyarbakir(2011) Ceylan A.; Yigitalp G.; Saka G.; Ertem M.Objective: In this study we aimed to determine the alteration of birth types by years and opinion of women on caesarean section (C/S) who gave birth within last 10 years in Diyarbakir. Material and Methods: A cross sectional study was conducted in the area of 12 primary healthcare centres in Diyarbakir between March and April 2010. In each primary healthcare centres area it was planned to reach 50 mothers (25 women not working and 25 working women) who had at least one child less than 10 years old and totally 497 women were interviewed. A structured questionnaire including sociodemographic features, birth types within last ten years and opinions about C/S was introduced to women. For intermittent variables percentage distributions, for continue variables arithmetic means were calculated and chi square analyse was used for cross tabulates. Result: Mean age of mothers was 30.6 ± 5.6 and 53.3% of women was housewives. 57% of health workers, 43,5% of other employed women and 29.4% of housewives had at least one C/S during their lives. 64,9% of women who had C/S were satisfied with it. Having no labor pain 49.2% and facing with no problems 17.8% were the reasons for C/S satisfaction shown by women. The unsatisfaction reasons were pain (27.4%), late wound healing (24.2%) and abdominal fat fall (6.5%). During 10 years, 497 women gave 833 births. 30.8% of them was C/S. Birth types according to years were dramatically changed. Thirteen point seven percent of children born ten years ago were delivered by C/S while this ratio was 31.2% in 5 years old children and 46.3% in 0-12 months children. Conclusion: Within last 10 years, C/S births had been increased gradually and decision of both physicians and families had played an important role in this reason. Copyright © 2011 by Türkiye Klinikleri.Öğe Clinico-epidemiologic study of cutaneous leishmaniasis in Diyarbakir Turkey(Dermatology Online Journal, 2006) Aytekin S.; Ertem M.; Yadran O.; Aytekin N.Cutaneous leishmaniasis (CL) is a zoonotic disease, endemic and notifiable in southeastern Turkey. We investigated clinical features, individual characteristics, and environmental factors of affected patients, and identified additional patients with CL in Diyarbakir. In 2002 we studied the epidemiology of CL in Dedeköy and Durabeyli towns in Diyarbakir Province. We evaluated patients with any skin lesions. A questionnaire including demographic details was completed by each patient. Clinical details of lesions and other dermatological findings were recorded. We walked around the town and surveyed it for environmental factors. CL was diagnosed in 78 individuals aged 1-85 years (mean age of 20). Although all age groups were affected, the majority of patients were under age 20. The lesions ranged from approximately 0.5 to 20 cm. They were located on the face (46.7%), upper extremity (23.2%), lower extremity (5.1%), and other sites. Different types of lesions were observed such as nodule with crust, nodule with osseous crust, violaceous infiltrative plaque with vegetative nodule, erysipelas-like plaque verrucous annular plaque, and eczema-like plaques. The incidence of CL is increasing in Dicle and Durabeyli towns and the clinical appearance may vary greatly.Öğe A comparative study of a gonadotropin-releasing hormone agonist and finasteride on idiopathic hirsutism(2000) Bayhan G.; Bahçeci M.; Demirkol T.; Ertem M.; Yalinkaya A.; Erden A.C.Objective: To compare the efficacy of finasteride and GnRH agonist in the treatment of idiopathic hirsutism. Methods: Sixty women with hirsutism were randomly assigned to receive either 5 mg of finasteride or long-acting GnRH agonist (depot leuprolide 3.75 mg) intramuscularly monthly for six months. Main outcome measures: Hirsutism scores were measured according to the Ferriman-Gallway scoring system, and side-effects were monitored for six months of treatment. Blood samples were taken at each visit for assessment of endocrine (FSH, LH, estradiol, progesterone, total and free testosterone, androstenedione, DHEAS-S, 17-OH-P, SHBG), biochemical, and hematologic parameters. Results: All of the patients treated with finasteride or GnRH agonist showed neither menstrual abnormalities nor side-effects. The mean percent change (±SD) in hirsutism scores in the GnRH and finasteride groups was 36%±14% and 14%±11% at six months, respectively. Serum total testosterone, free testosterone, androstenedion and DHEA-S showed a meaningful decrease in patients treated with GnRH agonist. On the other hand, only serum total testosterone and free testosterone levels decreased with finasteride treatment (p<0.05 and p<0.0001, respectively).Öğe Disability and chronic disease prevalence in the individuals aged 55 years or older in Di?yarbakir(2000) Turhano?lu A.D.; Saka G.; Karabulut Z.; Kilinç Ş.; Ertem M.The elderly population is an age group that increased most rapidly in the population of the world and life expentancy period is showed gradually increasing through the development of the treatment of the chronical diseases. Health problems are primary trouble due to the increasing of the elderly population and it is important to determine the details of the problems associated with the health of the elderly people. This study was scheduled to determine the ratios of disability, the frequency of chronical disease diagnosed and the ratio of the dependence on activities of daily life on the elderly people living in a specific region of Diyarbakir. Five hundredten elderly individuals were enrolled for this study. The mean age was 66.31±6.4 years, 233 (%45.7) of individuals were male and 277 (%54.3) were female. It was found that 95 (%18.5) of elderly people had disabilities (92 (%18.04) acguired, 3 (%0.59) congenital). It was found that the number of individuals who had one disability were 59(%11.57), two disabilities were 23 (%4.51), three and more disabilities were 13 (%2.55). Visual, audial and orthopedic disabilities were found the most. There were found that 169 (%33.1) had visual disturbances and 110 (%22.2) of elderly people had audio disturbances and the number of elderly people using hearing apparatus was 6 (%1.2). The number of elderly people using walking stick was found 58 (%11.4), tripot was 5 (%1) and quadripot was 1(%0.02). it was found that 3 (%0.58) of elderly people stayed most of the day in bed, 16 (%3.3) of these could were active only at home, don't have the ability to gou out home, 71 (%13.92) of these were independent at home, but needed help out of home, and 420 (%82.35) of these were independent in the activities out of home. When the groups were compared, it was found that the individuals who were 75 years old and older had higher dependency levels than others (p<0.01). Hypertension, osteoporosis and osteoarthritis were the most seen chronical diseases in the elderly people of this study and rheumatoid arthritis and osteoarthritis as chronical diseases were found to effect the daily life. Also it was found that the individuals who were 75 years old or older had spent most of their time at home and needed help to go outside.Öğe The effects of flutamide on lipid profile, insulin sensitivity, hirsutism and gonadotrophins in women with polycystic ovary syndrome(1999) Bahceci M.; Tuzcu A.; Dursun M.; Ertem M.; Yukselen V.In this study, we evaluated metabolic changes and the effects of flutamide in 22 women with PCOS. Flutamide was administered for a 6-month period in a dose of 750 mg/day. The basal and after treatment body mass index, waist: hip ratio, blood glucose, insulin, lipids, Ferriman-Gallwey scoring (FGS), gonadotrophins, testosterone, trasaminazed and glucose: insulin (G:I) ratio were measured. For comparison, ANOVA was used. The sixth month mean FGS was significantly lower than the basal values (18.5±7.4 and 12.5±4.5, P<0.01). The mean basal G:I ratio was 3.31±1.12 and 6.21±2.53 at the sixth month. The sixth month G:I ratio was significantly higher (P<0.001). The total and LDL-cholesterol were decreased by flutamide (from 144±23 to 123±23 and from 88±32 to 60±25 mg/dl respectively. P<0.02 and P<0.01), whereas, the HDL-cholesterol level was increased with flutamide (from 44.8±3.9 to 46.5±3.2 mg/dl and P<0.001). LH (from 14.7±6.7 to 8.4±3 mlU/ml), LH/FSH ratio (from 3.4±1.7 to 1.9±0.6), total testosterone (from 0.87±0.29 to 0.61±0.18 ng/ml) and free testosterone (from 4.29±1.18 to 2.14±0.9 pg/ml) were decreased by flutamide (P<0.05). Thus, we reached three conclusions: 1-Flutamide may improve insulin insensitivity. 2-In PCOS, flutamide decreases total and LDL-cholesterol, and increases HDL-cholesterol. 3-Flutamide may improve the LH/FSH ratio and induce a decrease in testosterone.Öğe Maternal beliefs and attitudes concerning neonatal jaundice in Southeast Turkey(Turkiye Klinikleri, 2009) Çakmak A.; Ertem M.; Zeyrek D.; Ataş A.; Karazeybek H.Objective: Neonatal Jaundice (NNJ) is a symptom in which the recognition, treatment and prognosis depend on the mother's beliefs, attitudes and behavior. Mothers may play an important role in the management of this disease. Particularly in developing regions, some traditional healing methods (THMs) are used by mothers or other caregivers. In this study, we described the regional healing methods and mothers' beliefs and attitudes for NNJ. Material and Methods: Between 01 May 2005 and 13 December 2007, all mothers of infants with NNJ were interviewed using a questionnaire to collect demographic data and information regarding their beliefs and attitudes for NNJ. Frequency distributions and Chi square analyses were used to compare mothers who used THMs with those who did not. Results: A THM was used by 41.9% of the mothers. Of the mothers under 25 years of age, 62.9% had used a THM, although there was no significant difference between the age groups. There were invasive and harmful THMs known or used by mothers such as "cutting the infant's post auricular area", "puncturing the infant's earlobe", "cutting the infant's palate" and "burning the infant's body". There were also some non-invasive methods like "sunning the infant" and "placing yellow cloths on the infant's face or bed". Conclusion: Application of harmful THMs for NNJ was revealed in the study population. Recognition of those THMs may enable health professionals to develop preventive methods of avoidance. Copyright © 2009 by Türkiye Klinikleri.Öğe Prevalence of PTSD and related factors in communities living in conflictual area: Diyarbakir case.(2008) Yasan A.; Saka G.; Ertem M.; Ozkan M.; Ataman M.OBJECTIVE: In this study, we aimed to investigate the distribution of Post-Traumatic Stress Disorder (PTSD) among adults who were living in the Diyarbakir city center. METHOD: Data was obtained from 708 participants that represented the demographic structure of Diyarbakir. Houses to be visited were determined in collaboration with the Turkish Institute of Statistics. RESULTS: The prevalence of traumatic life experience was 47.9%. Most prevalent traumatic life experiences were forced emigration and witnessing of a case of murder or injury. The lifelong and current PTSD prevalence was 34.9% and 15.1% respectively. We concluded that the prevalence of traumatic experiences and subsequent PTSD was high among people who were living in areas of conflict, and treatment opportunities were inadequate. CONCLUSION: An important finding of this study is the association between the range of prevalence rates of traumatic experiences and risk factors for PTSD in an armed conflict region in Turkey. There is a need for studies that will also include people living in rural areas in order to understand the full picture of problems encountered by those in areas of conflict. Moreover, we believe in the importance of an effective approach of institutional and occupational organizations not to leave these people alone with their traumatic experiences.
