Impact of -455G/a polymorphism of the ß-fibrinogen gene on platelet aggregation in patients with acute coronary syndrome.

We aimed to investigate the association of aspirin and/or clopidogrel low response with -455G/A polymorphism of ß-fibrinogen in patients with acute coronary syndrome (ACS). We enrolled 114 consecutive patients (mean age 61 ± 7, 31 female [27.2%], 83 male [72.8%]) with a first ACS. The diagnostic criteria for ACS were based on current guidelines. The -455 G/A ß-fibrinogen polymorphism genotype distribution in the patient group was determined as the following: 54.4% GG homozygote, 39.5% GA, and 6.1% AA homozygote. Clopidogrel low response was present in 25 (21.9%) patients, aspirin low response in 21 (18.4%) patients, and dual antiplatelet low response in 9 (7.9%) patients. In our study, no difference was observed in terms of the distribution of -455 G/A ß-fibrinogen polymorphism between the groups with and without aspirin and/or clopidogrel or dual antiplatelet low response in the patient group who underwent aspirin and clopidogrel treatment for ACS (P > .05).

The changing rate of suspected rabies bites after begin to act animal shelter in erzurum city.

OBJECTIVE: We aimed to evaluate the relationship between establishing an animal shelter in Erzurum and the number of suspected rabies bites between the years 2005 and 2012. MATERIALS AND METHODS: A retrospective, repeated cross-sectional study was planned in Erzurum in the year 2013. Records between the years 2005 and 2012 were obtained from the Communicable Diseases Department of the Erzurum Health Directorate. Data for 5789 cases exposed to suspected rabies bites were analyzed. RESULTS: 5789 suspected rabies bites were encountered in Erzurum between the years 2005 and 2012. After establishing the animal shelter in 2009, 4239 dogs were collected from the streets within four years and 426 of them were released after immunization. Additionally, the following services were given in the animal shelter between 2009 and 2012: immunization of 2935 dogs, sterilization of 1735 dogs, and release of 2082 dogs back to the street. 4-years before the establishment of the animal shelter, the number of dog-bites had decreased from 3403 cases to 2386 cases; 4-years after the establishment of the shelter, it declined by 29.8%. While there were 1096 suspected rabies cases during the year 2008, this ratio decreased by 40.9% after the establishment of the animal shelter in the year 2009. During the year 2010, where we had the highest number of homeless dog collection to the animal shelter, the decrease in suspected rabies bites reached the maximum decrease, namely 51.0%. Spearman correlation analysis showed a strong negative correlation between the number of collected animals and suspected rabies bites (r = -0,862; p=0.006). CONCLUSION: Suspected rabies cases are common in Turkey and some cases of rabies are encountered. The number of suspected rabies bites in Erzurum has decreased significantly after establishing the animal shelter. It is an evident that establishing rehabilitation centers for homeless animals in all cities will have an important role in controlling zoonotic diseases including rabies.

The protective effect of amiodarone in lung tissue of cecal ligation and puncture-induced septic rats: a perspective from inflammatory cytokine release and oxidative stress.

Sepsis is a serious medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. Amiodarone is a class III antiarrhythmic agent, a multichannel blocker (Ca++, Na+, and K+), and a noncompetitive α- and ß-adrenergic blocker in cardiac cells. The present study aimed to determine whether amiodarone was protective against experimentally induced cecal ligation and puncture sepsis in rat lung tissue. The relationship between its probable protective effect and antioxidant/anticytokine action biochemically and histopathologically was also examined. Five groups of rats were used, each composed of 20 rats: (1) the sham-operated control group; (2) the CLP group; (3) the 25-mg/kg amiodarone-treated control healthy group; (4) the 50-mg/kg amiodarone-treated CLP group; and (5) the 50-mg/kg amiodarone-treated CLP group. A CLP polymicrobial sepsis model was applied to the rats. All groups were sacrificed 16 h later, and lung and blood samples were analyzed histopathologically and biochemically. Twenty-five and 50 mg/kg amiodarone decreased the level of interleukin (IL)-1ß, IL-6, and tumor necrosis factor-α in serum and 8-iso-prostaglandin F2α level in lung tissue. They increased the activities of superoxide dismutase and levels of total glutathione in lung tissues of rats. Histopathological scores and examinations were in accordance with the biochemical results. Histopathological analysis revealed significant differences in inflammation scores between the sepsis group and the other groups. The CLP + amiodarone 50 mg/kg group had the lowest inflammation score among CLP groups. Our results indicate that administration of amiodarone prevented oxidative stress and cytokine action and protected lung tissue during sepsis cascade.

Propolis alleviates 2,3,7,8-Tetrachlorodibenzo-p-dioxin-induced histological changes, oxidative stress and DNA damage in rat liver.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) induces hepatic damage. Propolis exhibits antioxidant properties and several studies suggest that supplementations with antioxidants can influence hepatotoxicity. Therefore, the aim of the current study was to explore the effectiveness of propolis in alleviating the toxicity of TCDD in the liver of rats. Animals were divided into six groups, namely, TCDD (0.75 and 8 µg/kg body weight (bw)), propolis (50 mg/kg bw), TCDD (0.75 and 8 µg) plus propolis (50 mg/kg bw), and control, respectively. Rats were intraperitoneally administered with their respective doses daily for 21 days. In rats that received a high dose of TCDD, the antioxidant enzymes were significantly decreased and the serious pathological findings were established. Also, the rate of hepatocyte micronucleus (HMN) was increased after treating with TCDD. The reactions of enzymes in control and low-dose group were weak. The frequencies of HMN and liver histology were similar to both the groups. The presence of propolis with TCDD alleviated its pathological effects in hepatic tissue. Propolis also prevented the suppression of antioxidant enzymes in the livers of animals exposed to TCDD and displayed a strong protective effect against HMN. It can be concluded that propolis has beneficial influences and was able to antagonize TCDD toxicity in the liver.

[Knowledge, attitudes, and behavior of people living in rural areas of Erzurum about Crimean-Congo hemorrhagic fever]. / Erzurum Ili Kirsalinda Halkin Kirim Kongo Kanamali Atesi Hakkinda Bilgi, Tutum ve Davranislari

OBJECTIVE: After 2002 more and more Crimean-Congo Hemorrhagic Fever (CCHF) cases have been reported and it has become a major public health problem in Turkey. In order to fight CCHF, it is important to inform the public and direct them towards appropriatet attitudes and behavior. Therefore assessment of the effectiveness of health education in the community is essential. METHODS: A research was carried out for this purpose in the province of Erzurum between May 2010 and September 2010 through a survey. RESULTS: The results depicted that the majority of participants have knowledge that CCHF transmitted by ticks and they should be removed as soon as possible from the body through safe methods. However, in terms of correct attitude and behavior, women were found to have a lower level compared with men. CONCLUSION: The training of health workers and an increase in the efforts to make the community, especially the women, aware of this problem is ugently needed.

An intervention study for viral hepatitis. Peer-led health education among high school students.

OBJECTIVE: To check the effectiveness of peer-led education in improving the knowledge, attitudes, and behavior of high school students regarding viral hepatitis (VH). METHODS: This study was conducted at 29 high schools in Erzurum city center, Turkey between February and May 2007. The study design is a prospective before-and-after intervention trial. In this study, 2930 students from 29 different schools were included. A total of 559 volunteer students were trained as peer educators. These students applied a standard education to their peers. RESULTS: The total knowledge scores of peer educators before was 7.99 ± 2.73, and 13.91 ± 3.85 after peer-training (p=0.000). The total knowledge scores of other students increased from 7.27 ± 2.85 to 11.20 ± 4.21 (p=0.000). There was an increase in all correct answers to the knowledge questions after the intervention (p=0.000). Response to the questions exploring attitude of students towards people infected with hepatitis virus significantly changed after the training (p=0.002). There was also a significant positive change in the behaviors after the intervention (p=0.000). CONCLUSION: The significant increase in the knowledge of students trained by their peers proves this method is effective to be utilized in the prevention strategies regarding VH infections. Further studies with long term follow-up would be useful to demonstrate the long term value of peer education.

Interactions between exhaled CO, smoking status and nicotine dependency in a sample of Turkish adolescents.

The aim of this study was to show the interactions between nicotine dependency, exhaled carbon monoxide (CO) and smoking status including environmental passive tobacco smoke exposure in a sample of Turkish adolescents. This study was a cross-sectional research conducted among high school students of Erzurum province (n=536). The level of exhaled CO of all participants who accepted to participate in the study was measured by Microbio CO Analyzer (Microbio Med). Nicotine dependency was measured by a six-item version of the Fagerstrom Tolerance Questionnaire. Mean age of the adolescents was 17.0 +/- 1.6 (median: 17) and 77.1% were male. Of the study population, 30.2% and 11.4% of the students were regular and occasional smokers, respectively. Non-smokers who were exposed to environmental tobacco smoke had significantly (p<0.01) higher exhaled CO levels (2.8 +/- 2.6 ppm) than not-exposed non- smokers (1.8 +/- 1.9 ppm). Only 8.6% of adolescents who reported themselves to be a regular smoker had 7 ppm and higher exhaled CO. There was a statistically significant and positive correlation between exhaled CO levels and nicotine dependency after controlling for environmental tobacco smoke exposure and cigarettes per day (partial correlation, r=0.334, p=0.004). Exhaled CO can be used as a predictor of smoking status and environmental tobacco smoke exposure and an indicator of nicotine dependency in adolescents.

Prevalence of vitamin D deficiency rickets in the eastern part of Turkey.

Turkey, especially its eastern part, has been accepted as endemic for vitamin D deficiency rickets (VDDR). In a study performed by our team in the region in 1998, the incidence of VDDR was 6.09% in children aged between 0-3 years. In 2005, the Ministry of Health initiated a free vitamin D supplementation campaign nationwide for every infant to eradicate VDDR. In this study, we aimed to investigate the prevalence of VDDR in children aged between 0-3 years in order to evaluate the effectiveness of this campaign. Between March 2007 and February 2008, 39,133 children aged between 0-3 years who were brought to different pediatric outpatient clinics in Erzurum, Turkey, were examined for VDDR. VDDR diagnosis was made by radiological and biochemical findings in the cases who were initially suspected of having clinical VDDR. During a one-year period, 39 (0.099%) of the 39,133 patients were diagnosed with VDDR. None of the cases with rickets was taking vitamin D supplementation. The most frequent physical findings were rachitic rosary, enlargement of the wrists, and craniotabes. The laboratory findings of the cases were compatible with VDDR; serum calcium (Ca) 7.5 +/- 1.9 mg/dL, PO4 4.4 +/- 1.3 mg/dL, alkaline phosphatase (ALP) 1,341 +/- 823, 25-hydroxyvitamin D (25 (OH) D) 5.8 +/- 2.9 ng/mL, intact parathyroid hormone (iPTH) 240 +/- 106 pg/mL. It was concluded that, although VDDR has been a continuing childhood health problem, a nationwide free vitamin D supplementation campaign initiated by the government appeared to be effective in eliminating VDDR.

Seroprevalence of human brucellosis in rural endemic areas in eastern Turkey.

In this cross-sectional, community-based study, sera were obtained from 573 subjects. Brucella sero-positivity was detected in 5.4% according to the standard tube agglutination test, rising to 11.9% when the Rose-Bengal test was used. Brucellosis is a serious public health problem in eastern Turkey.

Impact of pharmaceutical promotion on prescribing decisions of general practitioners in Eastern Turkey.

BACKGROUND: Commercial sources of information are known to have greater influence than scientific sources on general practitioners' (GPs) prescribing behavior in under developed and developing countries. The study aimed to determine the self-reported impact of pharmaceutical promotion on the decision-making process of prescription of GPs in Eastern Turkey. METHODS: A cross-sectional, exploratory survey was performed among 152 GPs working in the primary health centers and hospitals in Erzurum province of Eastern Turkey in 2006. A self-administered structured questionnaire was used. The questionnaire included questions regarding sociodemographics, number of patients per day, time per patient, frequency of sales representative visits to GPs, participation of GPs in training courses on prescribing (in-service training, drug companies), factors affecting prescribing decision, reference sources concerning prescribing and self-reported and self-rated effect of the activities of sales representatives on GPs prescribing decisions. RESULTS: Of 152 subjects, 53.3% were male and 65.8% were working at primary health care centers, respectively. Mean patient per day was 58.3 +/- 28.8 patients per GP. For majority of the GPs (73.7%), the most frequent resource used in case of any problems in prescribing process was drug guides of pharmaceutical companies. According to self-report of the GPs, their prescribing decisions were affected by participation in any training activity of drug companies, frequent visits by sales representatives, high number of patient examinations per day and low year of practice (p < 0.05 for all). CONCLUSION: The results of this study suggest that for the majority of the GPs, primary reference sources concerning prescribing was commercial information provided by sales representatives of pharmaceutical companies, which were reported to be highly influential on their decision-making process of prescribing by GPs. Since this study was based on self-report, the influence reported by the GPs may have been underestimated.

Seroepidemiology of poliovirus antibody among the children in Eastern Turkey.

BACKGROUND & OBJECTIVE: Data on immunization are generally based on questionnaire methods or evaluation of health records in most of the developing countries like Turkey. Therefore, serological studies are useful to appraise the impact of vaccination programmes and to improve immunization policies. This serological study was undertaken to determine the immunity status of children to poliovirus in Eastern Turkey. METHODS: A cross-sectional and community-based field study was done with the sampling method of 30 clusters recommended for field studies. A total of 204 children aged 2-71 months were included. Complement fixation test was used to measure antibody titres to poliovirus serotypes. Subjects with serum antibody titres as 1:10 and lower were accepted as seronegative. A semi-structured questionnaire and official records of health care units were used to gather information about status of vaccination. RESULTS: Of the 204 children included, 54.4 per cent were boys and mean age was 31.5 +/- 19.8 months; 26.5 per cent of the children were seronegative. According to official records 64.7 per cent of subjects were full vaccinated. Sensitivity and specificity of official health records were 83.6 and 67.3 per cent in relation to immunity status of children, respectively. Regarding number of OPV doses given to children, the sensitivity and specificity of parents recall in relation to official records were 98.0 and 17.4 per cent, respectively. INTERPRETATION & CONCLUSION: Approximately, one of four children was determined to be seronegative. This high seronegativity brings risk to control of polio in Eastern Turkey which is at the post-elimination era since 1998. Additionally, parents recall did not provide reliable information to predict the immunity status and number of OPV doses given to children.