Evaluation of knowledge levels and attitudes of health management department students about epilepsy disease; a cross-sectional study.

AIM: We aimed to evaluate the knowledge levels and attitudes of the students of the Department of Health Management about epilepsy. METHOD: This descriptive and cross-sectional study was conducted with the voluntary participation of 238 health management department students in their first and third years of study who were registered at the Faculty of Health Sciences summer school exam. We collected the data through a research questionnaire form and the Epilepsy Knowledge and Attitude Scales. RESULTS: Girls accounted for 66.6% (n = 157) all participants, 53.4% of them were 1st year (n = 127), whereas 46.6% (n = 111) were third-year students. Their mean age was 19.97 ±â€¯1.46 years. Among these participants, 52.9% grew in the province (n = 126), 20.6% were smoking, 5% had epilepsy, and 36.6% had relatives with epilepsy. The mean epilepsy knowledge scale score was 5.64 ±â€¯4.41 and the mean epilepsy attitude scale score was 52.55 ±â€¯9.98. The third-year students' epilepsy knowledge score was significantly higher than their first-year counter parts (p < 0.001). We found no statistically significant difference between the first and third-year participants in attitude scores (p = 0.907). A moderate positive correlation was found between the students' knowledge level scores about epilepsy and their total attitude scores (r = 0.405, p < 0.001). The female students had a more positive attitude toward epilepsy and higher scores on the epilepsy knowledge scale than their male counterparts (p = 0.001, p = 0.005, respectively). Students who knew someone with epilepsy had higher epilepsy knowledge and attitude scale scores than those who did not (p = 0.001, p = 0.005 respectively). CONCLUSION: The epilepsy knowledge levels and attitude scale scores of health management students were found to be low. Third-year students were found to have higher knowledge levels than first-year students but there was no statistically significant difference between their attitude scores. More education opportunities should be provided for students of the Department of Health Management about this common chronic disease.

Assessment of testes with two-dimensional Shear Wave Elastography in patients with operated inguinal hernia.

AIM: We compared the two-dimensional shear-wave elastography (2D-SWE) values between the testes with same side operated inguinal hernia (IH) and the contralateral testes, as well as the testes of healthy volunteers without IH. MATERIAL AND METHODS: A total of 189 participants (117 unilateral [117 testes] and 8 bilateral operated IH patients [16 testes] and 64 healthy volunteers [128 testes]), providing a total of 378 testicles, were investigated prospectively. All patients underwent B-mode ultrasonography (US) and 2D-SWE examinations. Operation type, the period between diagnosis and operation, the period since the operation, testes volumes, and 2D-SWE values were compared. RESULTS: The B-mode US finding of the testes were normal in all participants. The mean testes' volume of same side operated IH was significantly lower comparing to contralat-eral testes and the healthy group (p<0.001). The 2D-SWE values of the testes with same side operated IH were significantly higher comparing to the contralateral testes and the healthy group (p<0.001). There was a statistically significant correlation between 2D-SWE values and IH severity, as well as the duration of the hernia (p=0.001). There was no significant correlation between the IH severity and testes volume (p=0.285). No significant difference was found between the direct and indirect IH in terms of testicular volume and SWE values and between the duration of the hernia, the time after sugery, testicular volume and SWE values according to operation techniques(p>0.005). CONCLUSIONS: The 2D-SWE can be used as an effective imag-ing method to evaluate testicular stiffness with objective numerical values, to estimate the severity of histologic damage in patients with operated IH.

Evaluation of COVID-19 phobia and the feeling of loneliness in the geriatric age group.

OBJECTIVE: Social isolation and quarantine are unusual precautions taken all over the world against the COVID-19 pandemic. Some legal sanctions were made in order to protect vulnerable age groups such as the geriatric population, to make them stay at home. These measures, which are vital for pandemic management, have negative psychological effects on elderly individuals. The aim of this study was to reveal how pandemic process affected individuals over 65 years old psychosocially. MATERIALS AND METHODS: Socio-demographic characteristics questionnaire, the COVID-19 Phobia Scale (C19P-S) and the Loneliness Scale for the Elderly individuals were used. Descriptive analysis, Mann-Whitney U-test, Kruskal-Wallis test, Pearson correlation analysis were performed for data analysis. RESULTS: A total of 130 elderly people (80 women, 50 men) were included in the study. Of the participants, 61.5% were women, 67.7% were married and mean age was 71.53 ± 5.57 (min. 65-max. 87) years old. The C19P-S scores were significantly higher in women, singles, people living alone, those living in an apartment, and those with higher economic and educational level (P = .001). There was a strong positive correlation between age and total loneliness score. Loneliness scores were significantly higher in singles, those with higher levels of education and income, those who live alone, who was a relative of a healthcare worker, and whose relatives were infected with COVID-19 (P < .05). CONCLUSION: Our study revealed that elderly individuals, who have to comply with social isolation rules, have increased fear and loneliness due to coronavirus. Considering this situation, timely psychological treatment and social support measures should be taken.

Utility of 2-Dimensional Shear Wave Elastography for Assessment of the Bladder Wall in Children With Acute Cystitis.

OBJECTIVES: The aim of this study was to investigate the efficacy of 2-dimensional (2D) shear wave elastography (SWE) in the diagnosis of acute cystitis (AC) in children. METHODS: Between June 2019 and March 2020, 126 children with AC and 126 healthy participants were prospectively investigated by 2D SWE and B-mode ultrasound. Elastographic measurements were performed by drawing the contours of the posterior wall of the bladder between the ureter orifices using a free region of interest. The quantitative 2D SWE values of the patients and the healthy group were compared. RESULTS: The mean 2D SWE values of the bladder wall were significantly higher in patients with AC compared to the healthy group (P = .001). On B-mode ultrasound imaging, the bladder wall thickness of patients with AC was higher than that in the healthy group (P = .001). On 2D SWE, when the cutoff value used was 9.25 kPa, the sensitivity, specificity, positive predictive value, and negative predictive value were 92.1%, 88.1%, 89.3%, and 92.6%, respectively, whereas when the cutoff value used was 1.72 m/s, the sensitivity, specificity, positive predictive value, and negative predictive value were 90.5%, 88.9%, 89.1%, and 90.7%. There was a statistically significant positive correlation between the 2D SWE values and wall thickness measurements (P < .001). CONCLUSIONS: Two-dimensional SWE is a noninvasive, fast, and effective imaging method to evaluate the bladder wall in children with AC.

Assessment of thyroid gland vascularity with superb microvascular imaging in healthy children and its relationship with potential factors.

Objectives To define thyroid gland vascularity index (VI) values in healthy children with the superb microvascular imaging (SMI) method and to assess whether or not there is a correlation with potential factors that may affect these values. Methods This prospective study included a total of 138 children, their ages varying from 3-17 years. Cases were divided into three subgroups according to age: 3-6, 7-12 and 13-17 years. Gender, age, height, weight, body mass index (BMI), thyroid-stimulating hormone (TSH) and free thyroxine (fT4) values were recorded. Volume and SMI measurements were performed with a 14 L5 mHz linear transducer. VI measurements were performed in the transverse and longitudinal planes and correlation with basic descriptive data was researched. Results Mean age was 11.14 ± 3.34 years and BMI was 19.95 ± 4.92. VI values were 4.59 ± 2.34 in the right lobe and 4.23 ± 2.73 for the left lobe, with no significant difference identified. There were no significant differences in mean VI for all parenchyma regarding gender and age groups. While there was no correlation identified with mean VI for all parenchyma with TSH and fT4, there was, however, a negative correlation with BMI. Conclusions Reference VI values for normal thyroid glands in healthy children and adolescents were defined with the SMI method. There was no correlation between the VI values and age, gender, volume, TSH and fT4 values, while there was a negative significant correlation with BMI.

Assessment of thyroid gland elasticity with shear-wave elastography in Hashimoto's thyroiditis patients.

PURPOSE: We aimed to investigate the use and effectiveness of Shear-Wave Elastography (SWE) in Hashimoto's Thyroiditis (HT) diagnosis and compare the SWE values in HT patients with asymptomatic volunteers. METHODS: The thyroid gland parenchyma of 74 patients whose clinical and laboratory findings and ultrasonography (US) features were indicative of HT and 75 healthy, asymptomatic participants with normal laboratory values were examined using SWE. Their thyroid parenchymal echoes and thyroid gland volume were measured using B-mode US examination. Elastographic measurements were made by plotting the boundaries of thyroid gland by hand, using Free Region of Interest (ROI). The quantitative SWE values [meters/second (m/s) and kilopascal (kPa)] were compared betweent the patients and the controls. The correlation analyses between the SWE measurements and the autoantibodies [Anti-thyroid peroxidase antibody (TPOAbs) and anti-thyroglobulin antibodies (TgAbs)], thyroid-stimulating hormone (TSH), freetriiodothyronine (fT3), free-thyroxine (fT4), and thyroglobulin levels were performed. RESULTS: The mean thyroid SWE measurement values of HT group were significantly higher than the asymptomatic group (p < 0.001). This study proposes 29.45 kPa or 2.77 m/s as a sensitive-spesific cut-off value for HT. We revealed significant positive association between SWE values and TgAb levels, gland volume, TgAb, TPOAb levels, and a significant negative association between SWE and echogenicity (p < 0.001). CONCLUSION: In the assessment of HT, SWE is a highly sensitive imaging method to estimate the degree of fibrosis and to provide objective numerical values.

Shear Wave Elastography Evaluation of Testes in Patients With Varicocele.

We aimed to determine histological damage in patients with varicocele by comparing the elasticity of their affected testes with that of their normal contralateral testes as well as normal testes of control subjects without varicocele using shear wave elastography (SWE). In total, 48 patients with varicocele (96 testes) and 52 control subjects (104 testes) were included in this study. Shear wave elastography values were measured in the longitudinal plane using an oval region of interest that covered as much of the testicular contours as possible. Fifty testes with varicocele were classified as group A, 46 normal contralateral testes of the same patients as group B, and 104 normal testes of control subjects as group C. The normal group C testes were randomly chosen from patients who had applied for ultrasonography for any reason and agreed to participate in the study. The testicular volume and SWE values were compared between these 3 groups. The average age of the patients was 28.45 years, and no significant difference in age was found between the 3 groups (P = 0.665). A significant difference in the testicular volume was found between groups A and C (P = 0.014). The SWE values were significantly higher in group A than in groups B and C (P < 0.001). No significant correlation was observed between the testicular volume and SWE values in any of the groups. Our results showed that SWE can be used as an effective technique to assess testicular stiffness in patients with varicocele to predict interstitial fibrosis and the severity of histological damage.

Quantitative Assessment of Thyroid Gland Vascularization With Vascularization Index Using Color Superb Microvascular Imaging in Pediatric Patients With Hashimoto Thyroiditis.

The study aimed to investigate the effectiveness of the vascularization index (VI) obtained using superb microvascular imaging (SMI) technique in the diagnosis of Hashimoto thyroiditis (HT). The thyroid glands of 80 patients with HT and 107 healthy, asymptomatic participants were examined using SMI. The thyroid parenchyma echogenicity was evaluated, and the thyroid gland volume was measured. Vascularization index measurements were performed by manually drawing the contours of the thyroid parenchyma using the free region of interest with color 2-dimensional SMI VI mode. The quantitative VI values of the patients and the asymptomatic group were compared. Correlations between VI values and thyroid autoantibodies and thyroid hormone levels were analyzed. The mean VI value of the thyroid gland was 4.74% ± 1.96% in the asymptomatic group and 12.45% ± 5.87% in HT patients with a statistically significant difference (P < 0.001). Hashimoto thyroiditis can be diagnosed with 86.3% sensitivity and 82.2% specificity when 6.00% VI value was designated as the cutoff value. There was a positive significant correlation between the VI value and the thyroid-stimulating hormone, antithyroglobulin antibodies, anti-thyroid peroxidase antibody levels (P < 0.05); however, no significant correlation was found between the VI values and thyroglobulin and free thyroxine levels (P > 0.05). There was a significant negative correlation between the VI values and the parenchyma echogenicity and positive significant correlation between the thyroid gland volume and the antithyroglobulin antibody and anti-thyroid peroxidase antibody levels (P < 0.05). The VI obtained using the SMI technique can be effectively used as an imaging method for the diagnosis of HT because of its high sensitivity and specificity in representing objective, quantitative numerical values.

Experience of Using Shear Wave Elastography Imaging in Superficial Venous Insufficiency of the Lower Extremity.

We investigated the effectiveness of shear wave elastography (SWE) in patients with lower extremity superficial venous insufficiency (VI). A total of 138 symptomatic patients, 51 asymptomatic volunteers, and a total of 359 lower extremities (257 symptomatic, 102 asymptomatic) were examined. All participants underwent Doppler ultrasound (US) evaluation to determine VI and SWE measurements performed by manually drawing vein wall and perivenous tissue with free region of interest at the great saphenous vein (GSV) and small saphenous vein (SSV). The GSV, SSV diameter, VI, and volume flow of reflux were compared with the SWE values. The SWE values of the symptomatic group for GSV and SSV were significantly higher than those of the asymptomatic control group regardless of whether VI was detected by Doppler US (P < 0.001). There was a statistically significant increase in SWE values for the symptomatic group who were diagnosed as having reflux in GSV and SSV (P < 0.001). A significant positive correlation between increased GSV, SSV diameter, and SWE values was seen (P < 0.001). Venous insufficiency can be diagnosed with a 84.7% sensitivity and 84.2% specificity when 2655 m/s was designated as cutoff value, and with a 85.4% sensitivity and 84.2% specificity when 22,350 kPa was designated as the cutoff value in GSV. Venous insufficiency can be diagnosed with a 84.3% sensitivity and 82.4% specificity when 2845 m/s was designated as cutoff value, and with a 85.7% sensitivity and 84.4% specificity when 27,100 kPa was designated as the cutoff value in SSV. Shear wave elastography may be used effectively in addition to conventional Doppler US examination in diagnosing and following VI.

Do totally occlusive nasal packs after nasal surgery increase the risk of immediate respiratory distress during recovery from anesthesia?

OBJECTIVES: This study aims to compare the risk of immediate respiratory distress (IRD) during the recovery of anesthesia between the nasal surgery with totally occlusive nasal packing and non-respiratory tract-related surgeries. PATIENTS AND METHODS: A total of 300 patients (180 males, 120 females; mean age 30.1±8.2 years; range 18 to 52 years) were included in the study. The patients were assigned to one of two age- and sex-matched groups according to surgery type: 1) patients undergoing nasal surgery with totally occlusive nasal packs for nasal septum deviation or 2) patients undergoing non-respiratory tract surgeries for various diseases. Immediate respiratory distress was defined as any unanticipated hypoxemia, hypoventilation or upper-airway obstruction (stridor or laryngospasm) requiring an active and specific intervention. RESULTS: The patients who underwent nasal surgery with totally occlusive nasal packs had a 6.25 times higher risk of IRD than the patients who underwent non-respiratory tract surgery during recovery from general anesthesia. Smokers had a 4.8 times higher risk of having IRD than non-smokers during the post-extubation phase. There were no significant differences in the incidence of IRD between males and females. CONCLUSION: Based on our study results, totally occlusive nasal packs and smoking were associated with poor extubation status at the end of the surgical procedure.

Mental health problems in children with uncomplicated epilepsy; relation with parental anxiety.

Mental health problems and parental anxiety in children with epilepsy were investigated. Parents of 83 children with epilepsy and 172 healthy children were asked to complete Strengths and Difficulties Questionnaire for their children and State-Trait Anxiety Inventory for themselves. In those with epilepsy, 39.8% (n: 33) were girls, 60.2% (n: 50) were boys and their mean age was 9.34 ± 3.99 years. Control group was more successful in school (p < 0.001). Emotional problems score in children with epilepsy was higher than control group (p < 0.001). Case group's behavior problems and attention deficit hyperactivity scores were higher (p < 0.001, p=0.009 respectively). Prosocial behavior scores of the control group were significantly higher (p=0.004). State (p=0.001) and trait (p=0.001) anxiety levels of parents of children with epilepsy were higher. Children with epilepsy have more neuro-behavioral problems; and their parents have greater anxiety levels. Physicians should be in contact with children with epilepsy for the psychological health of the family besides seizure control.

Attitudes toward and factors affecting influenza vaccination among physicians and nurses of a tertiary-care hospital in the Central Anatolia region of Turkey.

AIM: Similar to most international health care organizations, the Turkish Ministry of Health strongly recommends influenza vaccination for health care professionals. The aim of this study was to assess the vaccination rates and attitudes of physicians and nurses during the 2011 to 2012 seasonal influenza vaccination at a tertiary-care hospital of the Turkish Ministry of Health. METHODS: This was a descriptive cross-sectional study. The study participants were physicians and nurses working at the Konya Training and Research Hospital, located in the Central Anatolia region of Turkey. Self-reported (anonymous) questionnaires were given to 192 physicians and 411 nurses (N = 603) who agreed to participate between November 1 and 30, 2011. Frequencies, percentages, chi-square tests, and logistic regression tests were used for statistical analyses. RESULTS: Women comprised 64.1% (n = 387) of the participants, and 63% (n = 380) of participants had been working for ≥ 5 years. The seasonal influenza vaccination rate for all participants during the 2011 to 2012 season was 16.7% (n = 101). Although 9.5% (n = 57) of the study group had a chronic disease, 71.9% (n = 41) did not receive influenza vaccination (P < 0.05). Additionally, 40.8% (n = 240) reported ≥ 2 cases of influenza annually, and 82.9% (n = 204) had not been vaccinated. For 12.9% (n = 78) of participants, influenza caused absenteeism from work. Approximately 45% (n = 271) of participants had never been vaccinated, 27% (n = 163) were vaccinated in 2010, and 21.2% (n = 128) planned on being vaccinated in 2012. Among the vaccinated group, 56.4% (n = 57) experienced no side effects, 29.7% (n = 30) experienced local side effects, and 22.8% (n = 23) developed influenza-like syndrome. CONCLUSION: Similar to other studies in the literature, vaccination rates were not at the desired level. According to our Hospital Infection Committee reports, vaccination rates at our hospital were lower compared with vaccination rates of the 2009 H1N1 pandemic. The underlying causes of health care professionals abstaining from influenza vaccination should be further evaluated.