Prevalence and distribution of musculoskeletal disorders causing unfitness for military service among young adult men: an epidemiologic study

The aim of this cross-sectional epidemiologic study was to investigate the prevalence and distribution of musculoskeletal disorders causing unfitness to Turkish Military Service. This study has been carried out by examining the medical reports of 1.777.500 people who applied to the Turkish Armed Forces for military service between 2009-2011. Age and geographic region of individuals were compiled and organized in groups. Musculoskeletal disorders were classified mainly as fracture sequel, spine disorders, absence of phalanges, extremity amputation, aggressive or multiple benign tumors of bones and pes planus. Unfitness to military service caused by musculoskeletal disorders was found to be 6.53% in 2009, 7.10% in 2010 and 7.28% in 2011. The prevalence of musculoskeletal diseases has increased by years. The prevalence of fracture squeal by years was found to be 2.83% in 2009, 3.10% in 2010 and 3.03% in 2011. In this study, the most common musculoskeletal disorders were: limitation of joint mobility [0.89%], degeneration of joint surface [0.69%], lower and upper limb discrepancies [0.60%], posterior fusion surgery [0.59%] and the absence of the phalanges in hand [0.51%]. We found an increase in both the prevalence of posterior fusion surgery and the absence of the phalanges in study group. These results has given information about severe musculoskeletal disorders among young adult male in Turkey. New studies including young adult female will add important information to our knowledge about musculuskelatal problems in our community

prevalence and causes of visual impairment in young Turkish men

To explore the causes and prevalence of visual impairment in young Turkish men. The health examination data of the candidates that are saved in National Defense Ministry of Turkey was used. The data of the candidates examined between 1 January 2009 and 31 December 2011 were evaluated. The total number of the candidates was 1777500. The candidates requiring advanced examination are referred to secondary and tertiary examination hospitals. Fourteen thousand eight hundred sixty two[14862] out of 1777500 candidates were declared unfit for compulsory military service because of ophthalmic causes. The prevalence of ophthalmologic diseases causing unfitness for military service was found 0.746% for 2009, 0.871% for 2010 and 0.889% for 2011. These included high refractive errors which was the most frequent pathology causing unfitness [40.1%]. Nonsurgical retina, vitreous and optic nerve diseases were the most frequent cause of visual impairment [0.212%]. Corneal and lens pathologies were the second most frequent cause of blindness [0.101%]. The data bank in National Defense Ministry analyzed in this study is not directly intended to explore the causes and prevalence of visual impairment in Turkey. However this study gives considerable knowledge about the causes and prevalence of visual impairment in Turkey

QT dispersion increases with low glomerular filtration rate in patients with coronary artery disease

We aimed to evaluate the relationship between estimated glomerular filtration rate [eGFR] and QT dispersion [QTd] in patients with coronary artery disease [CAD]. Sixty patients [mean age 62.72 +/- 12.48 years] included 46 male, [mean age 60.89 +/- 12.70 years] and 14 female [mean age 68.71 +/- 9.86 years] were enrolled in this study. Patients were divided into 2 groups according to their eGFR using the 6 variable MDRD equation. Group 1 consisted of patients with estimated eGFR < 60 ml/min/1.73m[2] and Group 2 consisted of patients with eGFR >/= 60 ml/min/1.73m[2]. Baseline patient characteristics were homogeneous in both groups except for age, gender and smoking. Also, the extent of CAD was similar in both groups [p > 0.05] QTd values were found higher in group 1 than those of group 2 [57.23 +/- 40.65 ms vs. 31.23 +/- 14.47 ms, p = 0.002]. After adjustment for age, gender and smoking using one-way ANCOVA test, statistically significant difference in QTd still existed between the groups [p=0.038]. QTd tends to be higher in patients with poor renal function independent of severity of angiographical CAD. QTd may be a potentially useful non-invasive test in the management of patients with poor renal function, especially those with CAD

Annealing of Co-Cr dental alloy: effects on nanostructure and Rockwell hardness

PURPOSE: The aim of the study was to evaluate the effect of annealing on the nanostructure and hardness of Co-Cr metal ceramic samples that were fabricated with a direct metal laser sintering (DMLS) technique. MATERIALS AND METHODS: Five groups of Co-Cr dental alloy samples were manufactured in a rectangular form measuring 4 x 2 x 2 mm. Samples fabricated by a conventional casting technique (Group I) and prefabricated milling blanks (Group II) were examined as conventional technique groups. The DMLS samples were randomly divided into three groups as not annealed (Group III), annealed in argon atmosphere (Group IV), or annealed in oxygen atmosphere (Group V). The nanostructure was examined with the small-angle X-ray scattering method. The Rockwell hardness test was used to measure the hardness changes in each group, and the means and standard deviations were statistically analyzed by one-way ANOVA for comparison of continuous variables and Tukey's HSD test was used for post hoc analysis. P values of <.05 were accepted as statistically significant. RESULTS: The general nanostructures of the samples were composed of small spherical entities stacked atop one another in dendritic form. All groups also displayed different hardness values depending on the manufacturing technique. The annealing procedure and environment directly affected both the nanostructure and hardness of the Co-Cr alloy. Group III exhibited a non-homogeneous structure and increased hardness (48.16 +/- 3.02 HRC) because the annealing process was incomplete and the inner stress was not relieved. Annealing in argon atmosphere of Group IV not only relieved the inner stresses but also decreased the hardness (27.40 +/- 3.98 HRC). The results of fitting function presented that Group IV was the most homogeneous product as the minimum bilayer thickness was measured (7.11 A). CONCLUSION: After the manufacturing with DMLS technique, annealing in argon atmosphere is an essential process for Co-Cr metal ceramic substructures. The dentists should be familiar with the materials that are used in clinic for prosthodontics treatments.

prevalence of disorders causing disability in young adult males in Turkey between 2009-2011

Objective: Disability is one of the significant problems that the public faces as regards social aspects, economics, public health and politics. Our aim was to review the prevalence of diseases causing disabilities in young adult men who are declared "unfit for military service" in Turkey after medical examination

Methods: We reviewed the prevalence of diseases among 113,175 young adult men who were referred for medical examination between 2009 and 2011

Results: Prevalence of unfitness for military service was 5.56% in 2009, 6.74% in 2010 and 6.77% in 2011. Leading causes for young adult men to be rejected from military service was intellectual disability 6.88, hearing loss 3.71, epilepsy 1.59, schizophrenia 1.54 and diabetes mellitus 1.47 per thousand people

Conclusion: Screening for the prevalence of disability conditions is an important data source for policies to be developed. Supporting such survey with community based studies in different populations in future shall be beneficial for improvement of policies in social and health fields

Sexual perception: an overlooked psychological barrier to nursing

Patient care is one of the most important functions of nursing. Nurses are responsible legally and ethically to take care of male patient without any discrimination. Sexuality perceptions and embarrassment effect negatively on intimate care particularly between male patients and female nurses. In this study we aimed to; determine nurses' attitudes, towards male patient and evaluate some factors that can improve this situation. This cross sectional study was performed from March-June 2009, in Gulhane Military Medical Academy School of Nursing. A total of 300 female nursing students voluntarily participated out of 310 students, and responded to the questionnaires. The questionnaire comprised of 29 questions 8 questions were about socio-demographic characteristics of participants, and 21 questions were about attitude towards male patient. Results showed that [71.3%] students indicated that performing any application to a male patient was as easy as performing on a female patient 78.3% indicated that same age male patients were the most difficult age group for taking care. Calculated attitude point of Year III students about body cleaning, rectal lavage, perineal cleansing, rectal tube application, and naso-gastric tube applications are higher than other students'. Similarly; the attitude was more positive among the students that chose their school intentionally, than others as regards taking care of a male patient which was considered as easy as performing to a female patient. Many students have negative attitudes towards specific physical care needs of male patients, especially genital area related applications. Applied education methods, professionalism and providing ethical information and insight can resolve this gap

Knowledge and attitudes toward complementary and alternative medicine amongst Turkish nursing students

To evaluate the knowledge and attitudes of the Nursing School Students on Complementary and Alternative Medicine [CAM]. This cross-sectional study was conducted among students of Gulhane Military Medical Academy Nursing School during March/April 2010. The sociodemographic characteristics of participants and their knowledge and attitudes towards CAM were collected by using a structured questionnaire developed by researchers. Out of a total of 354 students, only 91.2% of those students [n=323] participated in the study. The sources of information were stated as television and radio 80.3% [n=265], internet69.0% [n=223], newspapers and magazines 68.1% [n=220], friends 48.6% [n=157], and books 32.5% [n=105] by participants. While the mostly known first three CAM practices were hypnosis [59.4%], prayer [58.5%], and herbal therapies [52.6%], those which were stated as most effective were massage [81.4%], herbal therapies [69.3%], and prayer [56.0%]. Almost five out of six students [82.7%, n=267] stated that CAM therapies should be included into their curriculum. The distribution of the responses for the item, "Complementary therapies are a threat to public health" had statistically significant difference between the classes [p<0.001]. The first year, second year and third year class students had more positive attitude for CAM than the fourth year class students. It is suggested that the lectures on CAM practices should be included into the curriculum of the nursing students who are enthusiastic about learning them which will have a positive impact on their education and training

Prevalence of obesity, abdominal obesity and the associated factors among a group of Turkish adults

The purpose of this study was to determine the prevalence of obesity and abdominal obesity and some causative factors. In this cross-sectional study were included 1066 adults [527 men, 539 women] ranging in age from 18 to 59 years old studying in Ankara, Turkey. Weight, height, waist and hip circumferences of adults were measured, Body Mass Index [BMI] and Waist Hip Ratio [WHR] were calculated. The association between age, nutritional factors and BMI, waist circumference and WHR were evaluated. The overall prevalence of obesity was 9.7% and overweight was 34.8%. The prevalence of abdominal obesity was 21.6% in men, 41.4% in women. Obesity and abdominal obesity was positively associated with daily energy intake, percentage of energy from fats, sugar intakes, whereas it was negatively associated with daily fiber, calcium intake and age. It would be useful to examine the factors related to obesity and abdominal obesity in the prevention of obesity in adults

Urinary methylmalonic acid in patients with acute myocardial infarction

To investigate urinary methylmalonic acid [uMMA] levels and their relationship with markers of myocyte necrosis and inflammation in patients with acute myocardial infarction [AMI]. The study participants consisted of 80 consecutive patients with AMI and 72 age- and sex-matched consecutive controls. Of the patients, 38 had ST segment elevation myocardial infarction [STEMI] and 42 had non-ST segment elevation. All patients with STEMI underwent fibrinolytic therapy. Routine laboratory tests included troponin-I, creatinine phosphokinase MB [CK-MB], high-sensitivity C-reactive protein [hs-CRP], vitamin B12, folate, homocysteine and methylmalonic acid analyses. uMMA measurements were made by a spectrophotometric method. uMMA levels were significantly higher in patients with AMI than in controls [10.1 vs. 5.2 mmol/mol creatinine, p < 0.001] and higher in patients with anterior MI compared to those with non-anterior MI [18.9 vs. 8.7 mmol/mol creatinine, p < 0.001]. In addition, uMMA levels were significantly higher in patients without successful reperfusion compared to those with successful reperfusion. In patients with STEMI, a strong positive association was found between urinary MMA and plasma hs-CRP levels [r = 0.81, p < 0.001], symptom duration [r = 0.91, p < 0.001] and wall motion score [r = 0.60, p = 0.006]. More importantly, a strong positive association was observed between uMMA and the size of myocardial infarction in patients without successful reperfusion [for CK-MB r = 0.81, p = 0.013; for wall motion score r = 0.82, p = 0.012]. uMMA levels were elevated in patients with AMI and, as such, may be a candidate biochemical indicator of larger infarct size and enhanced inflammation in patients with AMI

Determination of the attitudes of Turkish infertile women towards surrogacy and oocyte donation

To determine the attitudes toward gestational surrogacy and egg donation amongst the Turkish married infertile females. This descriptive study was carried out in a maternity hospital. Patients were 250 married women who had applied for infertility treatment. Of the participants [n=250], 60 females [24.0%] answered positive attitude for surrogate motherhood and 65 [26.0%] for egg donation. Among the participants who stated positive response, 30 [50.0%] females stated that identity of the surrogate mother was not important. Among the participants who stated positive response to accept egg donation from someone [n=65], "only from someone whom I do not know" was the most common answer [n=30, 46.2%].We consider that, oocyte donation and surrogate motherhood will have the potential to empower women and increase their status in society in near future. These techniques also have frightening potential for deepening their exploitation and unsolved ethical dilemmas

Knowledge of and attitudes toward complementary and alternative medicine amongst medical students in a Turkish medical school

To determine the knowledge level and attitude of Gulhane Military Medical School students towards complementary and alternative medicine [CAM]. This descriptive study was conducted on April 2008. Total 401 students participated in the study. The questionnaire contains demographic questions, and multiple-choice questions related to 14 frequently used CAM therapies. We also asked 5 more questions to asses' students' attitudes toward CAM. Information was collected through a questioner with multiple choice questions related to fourteen frequently used CAM therapies. Knowledge of meditation, Tai Chi, ayuverdic medicine, massage, reiki, spirituality [pray] and herbal therapy were found statistically different between male and female students. Hypnosis was the most known modality in all medical classes. We found that internet was the main source of information about CAM modalities for both gender. The proportion of students who believe the benefits of CAM modalities in medicine was found 64.9%. Although the positive attitude toward CAM was found to be high in our study group, it is lower than most of the studies conducted in different countries

comparison of different hemorrhoidectomy procedures

To evaluate the pain level, analgesic consumption, operation time, bleeding and early complications after open and closed hemorrhoidectomy using a harmonic scalpel [HS] and classical methods. Between January 2005 and January 2006, 87 patients with grade III-IV hemorrhoids, admitted in General Surgery Clinic, Gulhane Military Medical Academy, Ankara, Turkey were enrolled in the study. They were randomized into open HS [n=22], closed HS [n=22], Miligan Morgan [n = 22], and Ferguson [n = 21] hemorrhoidectomy. Patients were evaluated for postoperative pain, painkiller consumption, bleeding and operation time. Bleeding volume was significantly lower in Groups I-II [p < 0.001]. Operation time was significantly shorter in Group I [p < 0.001]. Postoperative pain and pain at the time of first defecation, was significantly lower in Groups I-III [p < 0.001] compared with the other 2 groups and lower during days 2-6 in Group I compared to the Group III [p < 0.004]. Visual Analogue Scale results were similar in Groups II and IV. Analgesic consumption in Groups I-III was significantly lower than Groups II-IV [p < 0.001]. Oral analgesic consumption during 2-5 postoperative days was lower in Group I than in Group III [p < 0.007] and similar in closed hemorrhoidectomy group. The use of HS in hemorrhoidectomy reduces postoperative pain, analgesic consumption, operation time, and bleeding. Harmonic scalpel hemorrhoidectomy is an effective, comfortable, and safe procedure. Use of suture in hemorrhoidectomy is a major cause of postoperative pain