Ac�badem �niversitesi Sa�l�k Bilimleri Dergisi - 2017; 8(4)

REGION SELECTION IN SUBCUTANEOUS HEPARIN APPLICATIONS

Bahar �ift�i, G�l�in Av�ar — 2017-09-01

Drug applications becoming increasingly complex with the development of technology that require knowledge and skills and constitute an important part of nursing functions. Today, drugs that are widely used for diagnosis, treatment and prevention of diseases, sometimes leads to significant complications despite the therapeutic effects. Subcutaneous injection which is one of the primary responsibilities of nurses, constitutes an important part of drug administration. In subcutaneous drug applications, the choice of site is as important as the injection technique. The purpose of this review is to analyze the advantages and disadvantages of subcutaneous injection sites relative to each other and to review the previous studies of site selection in subcutaneous injection application.

EVALUATION OF THE EFFECT OF MENOPAUSAL COMPLAINTS AND MENOPAUSAL ATTITUDES OF CLIMACTERIC WOMEN ON THE QUALITY OF SEX LIFE

Nuriye Erba�, G�lbahtiyar Demirel — 2017-09-01

Objectives: The present study was undertaken with the aim of identifying the quality of sex life among climacteric women and the correlation between the quality of sex life and menopausal attitudes and complaints. Study Design: The study sample was constituted of 359 menopausal women, a minimum of elementary school education was required, who presented for treatment at the Departments of Gynaecology and Obstetrics of Sivas Public Hospital and Cumhuriyet University Research and Application Hospital between 1 September and 1 December 2014. The study was conducted using the use of a 23-item �Personal Information Form�, a 20-item �Scale of Menopausal Attitudes, a 15-item �Review List for Menopausal Complaints�, and an 18-item �Sex Life Quality Scale�. The data were evaluated on averages, standard deviations, percentages, independent two-sample t-test, and regression analysis while statistical significance was examined at the level of 0.05 with the use of the SPSS 14 package. Results: According to the study, increases in the scores on the scale of menopausal attitudes lead to increases in the scores on the sex life quality scale. Among menopausal complaints, lack of sleep-fatigue, irritability-tension, joint-muscle pain, constipationhaemorrhoids, dry-flaky skin, loss of pubic hair, dyspareunia, loss of interest in sex, frequent-painful micturition, irregular menstruation exhibited statistically significant differences with scores obtained from the sex life quality scale (p<0.05). Conclusion: According to the study results, it was identified that less menopausal complaints and positive menopausal attitudes among climacteric women will have a positive effect on the quality of their sex life.

Entrapment Neuropathies of The Lower Extremities

Meral Bayramo�lu — 2017-09-01

Peripheral nerves of the lower extremities might be compressed on their course where the anatomic configuration puts them in a vulnerable position. Neuropathic states can also be the result of any kind of trauma which directly injures the nerves or leads to a state of inflammation around the nerves. A wide variety of etiologies, as well as clinical presentations, may lead to diagnostic challenges for the clinician. The main symptom of a peripheral neuropathy is paresthesia. This could be accompanied by pain and numbness depending on the severity of the compression. The lumbosacral plexus, which arises from the ventral rami of the L1-S3 roots, serves the lower extremities. There are particular anatomic sites where the nerves are more vulnerable. A clear identification of the anatomic course, and motor and sensory distribution of each nerve arising from the lumbosacral plexus, is critical in localizing the injury and planning the optimal treatment. Electrodiagnostic studies help localize the site of the lesion, give a clue about the severity and potential recovery, and help differentiate any plexopathy and/or radiculopathy. Imaging studies, mostly magnetic imaging, can be ordered to help confirm the entrapment or exclude other pathologies. Most, but not all, of the cases can be treated by conservative measures. Common entrapments of the lower extremities, namely, meralgia paresthetica, femoral, obturator, sciatic, peroneal and tibial neuropathies will be discussed in this review.

NON-PHARMACOLOGICAL PAIN RELIEF METHODS OF INVASIVE PROCEDURES IN CHILDREN

Esma S�l� U�urlu — 2017-09-01

Infants and children in pediatrics clinics are often exposed to painful procedures in medical care and treatment. Studies have shown that nonpharmacologic methods, combined with pharmacologic methods, in the treatment of pain due to invasive procedures enhance the effectiveness of pharmacologic pain alleviation methods. This study aims to determine the appropriate nonpharmacological methods of pain relief to be applied by pediatric doctors and nurses for the purpose of increasing the prevalence of their use in pediatric clinics.

DEEP PERIPROSTHETIC INFECTION RATES IN TOTAL HIP ARTHROPLASTY AND TOTAL KNEE ARTHROPLASTY PERFORMED WITH LAMINAR AIR FLOW AND SPACE SUITS: SHORT-TERM RESULTS

Vahit Emre �zden, G�ksel Dikmen, �smail Remzi T�z�n — 2017-09-01

Purpose: To investigate the effects of use of laminar airflow and clean-room dress on early and late infections following surgeon total hip arthroplasty (THA) and total knee arthroplasty (TKA). Patients and Methods: Three hundred and sixty seven patients who had undergone 428 primary THA (29 simultaneous bilateral, 32 staged bilateral) and 127 patients who had undergone 211 TKA (29 simultaneous bilateral, 32 staged bilateral) between February 2009 and January 2014 were retrospectively analyzed. Standard operation room with LAF was used in all TKA and THA cases, and clean-room dress in 100% of TKA cases and 99.06% of THA cases. All operations were performed by senior surgeon. The infected and non-infected patients were statistically compared for infection rates including the following criteria; a body mass index (BMI) of 40 and over, active smoking, preoperative positivity in urine culture and in nasal swab culture. Results: Mean follow-up period of the patients following the initial surgery was 36 (range: 6 to 59) months. Late infection rate following THA was 0.46% (n=2) and early infection rate 0.23% (n=1). Early infection rate following TKA was 0.47% (n=1). No significant differences was found in the rates of infection according to positive colonization in the preoperative nasal swab (p=0.27), asymptomatic bacteriuria and positivity in urine culture (p=1.0), a BMI of ≥40 (p=1.0), active smoking (p=0.28) and groups that had different bearing couples (p>0,12). Infection rates were also not different according to simultaneous or staged arthroplasty performance (p>0,05). Conclusion: Deep infection rates of total joint arthroplasties, which were performed in our clinic with the simultaneous use of LAF and clean-room dress were consistant with the literature and we had lower early infection rates as described in some series. Multi-centered and prospective randomized controlled long follow-up studies are needed to demonstrate the effect of LAF and clean-room dress on prevention of early and late periprosthetic infections.

Effects of A Spinal Brace on The Functional Profile of The Feet in Adolescent Idiopathic Scoliosis

G�zde Ya�c�, Yavuz Yakut — 2017-09-01

Purpose: To assess the impact of a spinal brace on the functional profile of the feet in patients with adolescent idiopathic scoliosis (AIS). Patients and Methods: The subjects were 21 female AIS patients with double curves (range: 20��45�). Baropodometry and stabilometry analysis during standing and walking and were performed without bracing and after 7 days of bracing. Plantar force distribution, contact area, foot angle, mean and peak foot pressures, step length, step width, cadence, and gait speed, center of pressure path length and sway velocities and confidence ellipse area were recorded. Results: Bracing did not affect baropodometry parameters during standing (p>0.05). However, left foot plantar contact area was greater, mean pressure and peak pressures on the left foot were lower with bracing compared to without bracing (p<0.05) during walking. Cadence decreased with bracing. There was no change in stabilometry results (p>0.05). Conclusion: Spinal bracing created more symmetrical plantar pressure distribution between the feet during gait. However, bracing tends to alter temporal-spatial walking parameters and disrupt gait in patients with double curve scoliosis.

KNOWLEDGE ABOUT BRUCELLA IN SEMI-URBAN REGIONS

�lken Babao�lu, G�k�e Demir — 2017-09-01

Brucella is one of the most common zoonotic diseases. Lack of information about brucellosis can affect patients� health-seeking behaviors and thus cause constant infectation in semi-urban communities. This study assessed the information about brucellosis in people living in a semi-urban area in Central Anatolia. In this cross-sectional study, a questionnaire with 35 questions was collected. Numerical, percentage distribution chi-square test analysis methods were used in statistical analysis and p<0.05 was accepted as the level of significance. It was determined that 34.8% of the individuals participating in the study had never heard of brucella and 45.6% had learned it from their relatives or neighbors. While only 29.4% of the individuals reported that Brucella can be transmitted to humans by animals, 19.1% said that the infection can be transmitted from animal to animal, and 13.3% stated that one of the households had a diagnosis of brucella by a doctor. There was a statistically significant difference among individuals� knowledge of brucella, their profession, their education and raw milk consumption. In this study evaluating the information about brucella, it appears that participants have insufficient knowledge of brucella and transmission routes. Health education and information on the cause, symptoms, contamination and prevention of brucellosis is necessary to reduce the prevalence of brucellosis in the community. For this reason, there is a need for cooperation between the public health and veterinary sectors.

Evaluation of the Body Image and Self-Esteem in Behcet�s Syndrome

2017-09-01

Aim: This study was aimed at the evaluation the body image and self-esteem in Behcet�s Syndrome (BS). Methods: This cross-sectional descriptive study was carried out at a hospital�s rheumatology outpatient clinic in Eski�ehir between June 1 and July 31, 2015. The study population consisted of 225 subjects who presented with BS (n=136) and healthy subjects (n=89). The research instruments used were Individual Information Form, Body Image Scale and Coopersmith Self-Esteem Scale. The data was analyzed using the program SPSS 21.00. Results: For the BS patients participating in the study, the mean age was 42.89�11.56, the mean disease duration was 10.90�9.04 and mean treatment duration was 9.48�8.83 years. For the healthy, control group subjects, mean age was 35.64�8.57 years. Results indicated that the BS patients reported median body image score and self-esteem scores significantly lower than healthy control subjects (p=0.002, p<0.001 respectively). There was a positive correlation between body image and self-esteem scores in both of groups (r=0.302; p<0.001, respectively). Conclusion: Our preliminary findings indicate that negative body image and self-esteem are affected by BS. Therefore, it is important for health professionals to assess the body image and self-esteem issues of BS patients.

EFFECT OF POSTPARTUM DEPRESSION ON MATERNAL ATTACHMENT

Seyhan �ankaya, Sema Dereli Y�lmaz, Ruveyde Can, Neslihan De�erli Kodaz — 2017-09-01

Objective: This study was conducted as a definitive study, in order to analyze the effect of the depression experienced by mothers in postpartum period, on maternal attachment. Material and Methods: The study was conducted with 227 volunteer mothers all from six different family health centers located in the Konya city center who agreed to participate in the study, and whose pregnancies were between 4 and 6 months. For the data collection; a questionnaire form was used to investigate the mothers� socio-demographic and obstetric characteristics, and characteristics of infants by evaluating Maternal Attachment Inventory (MAI) and Edinburgh Postpartum Depression Scale (EPDS). The data were analyzed with SPSS software. Results: The MAI total scores of the mothers who had vaginal delivery, had planned pregnancies, had a child or children over two years old, who breastfed their children, who had good relationships with their spouses, whose spouses took active rolls in baby care, had friends to talk to in case they had problems, were all high. However, their EPDS score averages were low and the difference between the two scores was found statistically significant (p<0.05). The mean of the Maternal Attachment Inventory scores of the mothers was 94.3�9.2, and mean of the EPDS scores was 9.7�5.6. Conclusion: In conclusion, postpartum depression affects maternal attachment unfavorably. Health care personnel working during the first phases of mother-baby bonding should especially be aware of the factors which may affect mother-baby attachment, and as a first priority tackle the mothers� care needs in the postpartum period. They should make the mothers� adaptation to the role of motherhood easy and help to reduce the problems in the postpartum period.

CHROMOBLASTOMYCOSIS, A CASE REPORT

2017-09-01

Chromoblastomycosis caused by Dematiacea fungi family is a rare fungal infection which is usually reported in tropical regions. A 75-year-old male patient presenting with a painless nodule on the dorsum of his foot for one and a half month was diagnosed as chromoblastomycosis confirmed by histopathological and conventional histochemical evaluation of the punch biopsy taken from the lesion. This case is presented because of its rarity and the silent clinical presentation of the condition.

TRICHILEMMAL TUMOR ON THE SCALP: A CASE REPORT

Yakup �il, Hakan Ye�il, ��kr� Y�ld�r�m — 2017-09-01

Introduction: Trichilemmal tumor is a rare benign neoplasm derived from outer sheath of the hair follicle. Tumor�s highly aggressive malign subtypes are also described. Physical examination of the presented case revealed a trichilemmal cyst on the scalp, but histopathologic examination confirmed the diagnose of trichilemmal tumor. Case presentation: 21-year-old male patient had skin lesions on the scalp for one year. It was showing the properties of a trichilemmal cyst. Excision was performed under local anesthesia. Histopathologic examination was reported as a trichilemmal tumor which continues to the surgical margins. Wide excision was performed in the second operation. Body screening tests performed and the results were within normal limits. The patient is still under follow-up. Result: Trichilemmal cyst is encountered very common in physical examination and often operated routinely. Here, with the related literature, we present a rare case of trichilemmal tumor, which is commonly excised and misdiagnosed as trichilemmal cysts.