Rubella seroprevalence in children in Dogankent, a rural area of Adana province in Turkey, January-February 2005.

A cross-sectional study was performed to determine the rubella seroprevalence in 331 children aged between 0 and 59 months in Turkey who were not vaccinated for rubella and lived in the area covered by Dogankent Health Center, a rural area with a large proportion of residents of low socioeconomic status. Rubella seropositivity was found to be low, with 17.5%, increased with age and low socioeconomic level, and was particularly high in children who live in a household with one member going to school, and in children of uneducated parents (p<0.05). The asymptomatic infection rate was 98.3%. There was no significant difference in seropositivity with regards to the gender, history of rubella infection, size of the household, or number of children at home (p>0.05). Rubella vaccine has only been included into the national vaccination programme in the form of the measles-mumps-rubella (MMR) vaccine since 2006 and is performed at the age of 12 months, in the first year of primary school and at the age of about 15 years. In order to eliminate rubella and congenital rubella syndrome, it is necessary that use of MMR vaccine is expanded to include the children born before 2006.

Comparison of hairbrush, toothbrush and cotton swab methods for diagnosing asymptomatic dermatophyte scalp carriage.

BACKGROUND: Tinea capitis may also present as a minimal infection, termed carrier state. Anthropophilic dermatophytes (i.e. Trichophyton tonsurans and Trichophyton violaceum) have been generally associated with high rates of asymptomatic carriage. OBJECTIVES: The aim of this study was to compare the efficacy of the hairbrush, toothbrush and cotton swab methods for diagnosing scalp carriage as well as to determine the prevalence and related dermatophyte species for both asymptomatic and symptomatic tinea capitis in Adana Province, Turkey. PATIENTS AND METHODS: A screening study was carried out between February 2006 and May 2006, covering three schools and a total of 1560 children with 857 (54.9%) boys and 703 (45.1%) girls, aged between 7 and 17 years (10.6 +/- 2.3 years). The diagnosis was made by using three of the methods mentioned above with inoculation onto Sabouraud glucose agar. RESULTS: Symptomatic tinea capitis was not detected in the study; however, 21 (1.3%) asymptomatic carriers, with 9 (42.9%) boys and 12 (57.1%) girls, aged 7 to 13 years (9.7 +/- 1.9 years) were detected. The diagnosis was made via hairbrush in 13, via cotton swab in 4 and via toothbrush in 4. The mean age (P = 0.075) and gender differences were found to be statistically insignificant (P = 0.26). The most common isolated species was Trichophyton mentagrophytes var. mentagrophytes (90.4%) followed by Trichophyton audouinii (4.8%) and Microsporum gypseum (4.8%). Nine children had Arab origin (P = 0.005), and 12 had immigrated from the south-eastern region of Anatolia, Turkey. The screening of 32 households of 21 children with asymptomatic carriage enabled the researchers to detect the carrier state in three mothers and one sister, resulting in a total of four households (12.5%), with T. mentagrophytes var. mentagrophytes isolated, by hairbrush method in three cases and cotton swab in one case. If the methods were to be used alone, the prevalence of asymptomatic carriage would be found as 1.0% (16 of 1592) in the hairbrush, 0.3% (4 of 1592) in the toothbrush and 0.3% (5 of 1592) in the cotton swab methods; whereas the combined use of these three methods could reveal a total prevalence of 1.6% (25 of 1592). The hairbrush method was significantly found to be more effective in detecting dermatophyte fungi than the toothbrush (P < 0.01) and the cotton swab methods (P < 0.05). There was also a statistically significant difference between the use of a single method and the combination of all other three methods (P < 0.005). CONCLUSIONS: In summary, it was found that the prevalence of asymptomatic carriage did not cover symptomatic tinea capitis prevalence (1.6% vs. 0%), and the dominant species was zoophilic T. mentagrophytes (92%, 23 of 25). Asymptomatic carriage was not found to be related to age, gender and the coexistence of other dermatophytoses; however, race (Arab origin) was found to be the only risk factor. For laboratory diagnosis, no method was found to be nominated as a gold standard; hence, a combined use of diagnosing methods was suggested.

Etiological and demographical characteristics of acute adult poisoning in Adana, Turkey.

The objective of this study is to define the etiological and demographical characteristics of the patients applying to the emergency department in Faculty of Medicine, Cukurova University because of poisoning. This retrospective study was carried out by examining the records of 491 people who applied to the main emergency department in Faculty of Medicine, Cukurova University, with the complaint of poisoning between January 1, 2004 and December 31, 2004. It was determined that the reason why 491 of 20 817 persons (2.4%) applied during this term was because of poisoning: 159 (32.4%) of such patients were male and 332 of them (67.6%) were female. It was found that the average age of men was 27.1 +/- 10.5 years and that of women was 24.4 +/- 9.5 years (P = 0.005); 427 of poisoning cases (87.0%) happened intentionally as suicide attempts and 64 of them (13.0%) were accidental. The rate of suicide-purposed poisoning was higher in women and the rate of unintentional poisoning was higher in men (P +/- 0.001). The drugs were accountable for 71.1% of all poisoning cases and the pesticides were accountable for 18.9% of such cases. Poisonings increase during summers. The mortality rate in poisonings was found as 0.8%. The drugs and pesticides in Ckurova region constitute 90.0% of all poisoning cases. The mortality rate in poisoning will be decreased by training the physicians employed in the emergency department about poisoning by drugs and pesticides.

Prevalence of the metabolic syndrome in a Turkish adult population.

AIM: The aim of the present study was to determine the prevalence of the metabolic syndrome using Adult Treatment Panel III (ATP III) criteria in Adana, a southern province of Turkey. METHODS: The randomly selected study population included 1637 adults who were 20-79 yr of age. The presence of > or = 3 of components like hypertension (defined as blood pressure > or = 130/> or = 85 mmHg on two separate examinations, or usage of antihypertensive agents), visceral obesity (waist circumference >88 cm in females and >102 cm in men), low HDL cholesterol level (<1.04 mmol/l in men and <1.29 mmol/l in females), high triglyceride level (a fasting triglyceride level > or = 1.7 mmol/l), fasting glucose level > or = 6.1 mmol/l, or usage of antihyperglycaemic drugs, indicated the metabolic syndrome. RESULTS: The prevalence of the metabolic syndrome was 33.4% and more common in women than in men (39.1 vs 23.7%; p<0.0001). Both women and men with the metabolic syndrome were older than subjects without. In men, frequencies of the metabolic syndrome in urban and rural areas were similar (23.1 vs 24.3%; p>0.05), but were markedly higher among women in rural than urban areas (44.5 vs 31.2%; p<0.0001). CONCLUSIONS: Developing countries like Turkey also need to start action to prevent and treat the components of the metabolic syndrome. Prevention of the modifiable risk factors, such as obesity and physical inactivity, and blood pressure control should be the key strategy for avoiding mortality and financial costs of the healthcare system, especially in view of limited resources.

Detection of insulin resistance in Turkish adults: a hospital-based study.

AIM: The aim of the present study was to investigate the usefulness of insulin sensitivity check indices in our hospital population. METHODS: Both HOMA (insulin X glucose in mmol/l/22.5) and QUICKI (1/log insulin in microu/ml + log glucose in mg/dl) indices were calculated from fasting values in 1,774 subjects from the medical records of Baskent University Adana Hospital. RESULTS: Subjects with diabetes, hyperlipidaemia and central obesity were characterized by significantly higher HOMA and lower QUICKI indices than those of healthy subjects. A fall in the QUICKI index (0.3469 +/- 0.028 in healthy subjects and 0.3247 +/- 0.025 in non-obese diabetics) as well as an increase in HOMA index (2.24 +/- 1.26 in healthy subjects and 3.59 +/- 2.08 in non-obese diabetics) corresponded to metabolic and clinical manifestations of insulin resistance in various groups of subjects. Age, low HDL cholesterol, male sex, type 2 DM and hypertension were independent risk factors for CAD. Age, male sex, waist circumference and CAD were found to be risk factors for hypertension. Fasting insulin and glucose levels contain sufficient information to assess insulin sensitivity over a wide range in a diverse population. The following can be accepted as mean values to assess insulin resistance in our hospital population: 0.3469 +/- 0.028 for the QUICKI index and 2.24 +/- 1.26 for the HOMA index CONCLUSIONS: HOMA and QUICKI indices are simple and reproducible methods for determining insulin sensitivity in humans.

Silent coronary artery disease in patients with type 2 diabetes mellitus.

The purpose of this study was to estimate the prevalence and risk factors of silent CAD in asymptomatic type 2 diabetic patients aged over 40 years. A total of 172 asymptomatic type 2 diabetic patients, mean age 54.42 years, with normal resting electrocardiogram were included in the study. Technetium-99m (Tc-99m) tetrofosmin cardiac single photon emission computed tomography myocardial scintigraphy with exercise testing or dipyridamole injection was performed on all patients. If this test was positive, coronary angiography was carried out and was considered to be positive with a stenosis of > or =70%. Abnormal perfusion pattern was found in 14 patients (8.14%). Significant coronary artery stenosis was found in 13 subjects (7.56%), confirming a high positive predictive value (92.86%) of this diagnostic procedure. A significant correlation was observed between silent CAD and male sex, retinopathy, hypertension, post-prandial blood glucose level, and low HDL-cholesterol level. Sex (OR=4.026; 95% CI, 1.187-13.659), hypertension (OR=5.564; 95% CI, 1.446-21.400) and retinopathy (OR=3.766; 95% CI, 1.096-12.948) were risk factors for CAD. Overall, 14.06% of asymptomatic male patients with type 2 diabetes mellitus presented silent CAD with significant angiographically documented coronary stenosis. This finding, along with the high positive predictive value of a noninvasive technique, indicates that routine screening for silent CAD would be useful in this patient subgroup especially when they have retinopathy or hypertension.

A recurrent aphthous stomatitis case due to paediatric Behçet's disease.

Behçet's disease is a rare condition in children and characterized by a triad of recurrent aphthous stomatitis, genital ulceration and uveitis. The aetiology is unknown, but systemic vasculitis is the main pathology. The oral lesions resemble Sutton disease, which is another form of recurrent aphthous stomatitis (RAS) that composes approximately 10 per cent of cases and is known as major aphthous stomatitis, can easily be overlooked if the other symptoms are not questioned. We presented a 12-year-old girl with the initial complaint of recurrent aphthous stomatitis. During the follow-up period, we observed the other cardinal signs of the Behçet's disease.

[Family planning services utilization increases for migrant workers]. / Utilisation accrue des services de planification familiale par les travailleurs migrants.

PIP: Between April and October 1989 in Turkey, interviews with more than 3000 migrant workers working in the cotton fields of Dogankent were conducted to examine their attitude towards family planning and their utilization of family planning services. Researchers wanted to evaluate a family planning program which was integrated into 3 primary health centers in Adana. The workers tended to be young. The average family size was 4.3. 40% of the women have had an induced abortion. 62% have already lost a child. 70% of the migrant workers were illiterate. A family planning team (a physician, a public health professional, a nurse, and a midwife) would meet under the tents of the migrant workers outside of work hours to speak to 15-20 persons about the principles of family planning. The team would return once a month to provide contraceptives and to determine the needs and demands of each person. When the migrant workers returned to their home villages in eastern Turkey, the team would give them an official letter addressed to the physicians of the health centers in their village to achieve follow-up care. Almost 80% of the 300 workers who originally used a traditional family planning method accepted effective family planning methods (e.g., IUD, oral contraceptives [OCs], condoms, spermicide tablets, and tubal ligation). At the end of the family planning program, almost 50% of the 3000 workers used modern contraception. Prior to its inception, the modern contraception use rate was only 10%. 78% of them used OCs or condoms. The remaining used spermicide tablets or IUDs.^ieng

Residual efficacy of pirimiphos methyl (Actellic) on Anopheles sacharovi in Cukurova, Turkey.

Village-scale trials of 50% emulsifiable concentrate (EC) and 40% wettable powder (WP) formulations of pirimiphos methyl (Actellic) were carried out against Anopheles sacharovi in Cukurova, Turkey. Susceptibility tests with wild caught, gonoactive and composite aged An. sacharovi over a range of chemical concentrations resulted in 100% mortality after exposure for 60 min to a 0.5% active ingredient concentration. Surface treatments of Actellic 50% EC at 0.9 g/m2 caused a significant decrease in parous rate and a 96.9% reduction in resting density. Persistence on concrete, wood, zinc and plywood was still high at the time of the second spray round, more than 7 wk postspray and ranged from 73% (zinc) to 98% (plywood). More than 50% mortality was still recorded 8 wk postspray using 1.6 g/m2 WP on wood, plywood, zinc and thatch substrates.

Family planning practices of migrant farm-workers: a methodological approach.

"This is a methodological study concerning the family planning practices of the migrant farm-workers in the Dogankent region [of Turkey]. The workers were given health services and education about family planning methods during off-work hours. Out of the 3,022 subjects starting the study, 304 of whom were already benefiting from some kind of (traditional or modern) family planning methods: 1,393 ended up...with using effective methods...." (SUMMARY IN TUR)