The effect of video presentation showed in the outpatient clinic waiting area on the success of inhaler device use in chronic respiratory diseases.

BACKGROUND/AIM: Nonadherence to inhalation therapy and incorrect inhalation technique is an important problem for optimal disease management in patients with chronic respiratory disease. The aim of the study is to investigate the effectiveness of an inexpensive and effortless method which would be able to improve the inhalation technique of patients. MATERIALS AND METHODS: The video showing the correct use of inhaler devices was played continuously for 3 months in the waiting room of the chest diseases polyclinic, on the big screen TV. The patients, who were not prompted to watch the video, were divided into two groups, as those who visited the outpatient clinic before (n = 300, Group 1) and after (n = 300, Group 2) the video playback began. Patients' ability to use their own inhaler devices was observed without intervention, scored according to the standard 'Ability of Inhaler Device Use' scale and the two groups were compared. RESULTS: The inhaler use skill of the patients in the second group was significantly higher except for the Turbuhaler. In Group 2, among the "video watchers" subgroup, there was significant improvement in all device types. CONCLUSION: Presentation of the use of inhaler devices on the screens in the waiting area of the outpatient clinics of health facilities will provide significant benefits and allow reducing the failure of treatment due to incorrect/incomplete device usage.

Development, validity and reliability study of a compliance scale for the COVID-19 outbreak prevention recommendations

Background/aim: During the intense periods of the COVID-19 pandemic, legal measures were taken for its containment. However, since legal precautions cannot be implemented continuously, hand washing, mask usage and obeying social distance rules are important in combating the pandemic. Complying with these rules is mostly individual decisions. The behavior of individuals has a prominent place in the course of the pandemic. In this study, we aimed to develop a scale which could measure compliance with outbreak measures. Materials and methods: This study was conducted in two stages after evaluation of the content validity of the item pool formed by the research group by experts. For construct validity, the scale subdimensions were determined in 250 people between the ages of 18-70 years at the first stage and the definitive version of the 20-item scale was constructed. In the second stage, exploratory factor analysis was repeated in a group of 484 people, and confirmatory factor analysis was performed. Cronbach's alpha coefficients, Spearman-Brown coefficients, test-retest methods were used to determine reliability. Results: The variance explanation of the scale consisting of 20 items and two subdimensions in the explanatory factor analysis is 63.434% (n = 484). Confirmatory factor analysis resulted in CMIN/DF = 3.540, RMR = 0.043, NFI Delta 1 = 0.928, TLI rho 2 = 0.939, CFI = 0.947, RMSEA = 0.072, SRMR = 0.0368. Cronbach's alpha value of the scale is 0.95; and the Spearman Brown coefficient equal length analysis resulted in 0.928. The temporal consistency of the scale was evaluated with the test-retest method (P = 0.893). The structure, content validity, temporal consistency, item discrimination, and internal consistency were evaluated and found to have acceptable valid, reliable properties. Conclusion: The outbreak prevention recommendation compliance scale is a valid and reliable tool with which compliance with the prevention plans can be evaluated.

Tolerability to paracetamol and preferential COX-2 inhibitors in patients with cross-reactive nonsteroidal anti-inflammatory drugs hypersensitivity.

BACKGROUND: Acetylsalicylic acid/aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used drugs that may cause hypersensitivity reactions in a substantial proportion of patients. Physicians ought to be aware of these situations. OBJECTIVE: We aimed to present the clinical characteristics and rates of tolerability to cyclooxygenase (COX)-2 inhibitor analgesics in patients who had admitted due to multiple cross-reactive type of NSAID hypersensitivity. METHODS: The files of the patients who had admitted with multiple NSAIDs-induced symptoms were investigated retrospectively. Age, sex, underlying diseases, clinical manifestation, skin test results, and drug provocation test results were analyzed. RESULTS: In 105 patients with multiple cross-reactive type of NSAID hypersensitivity, we found the rate of cross-reactivity to any of the relatively safe alternatives including paracetamol, meloxicam, and nimesulide to be 16.1%. The rate of cross-reactivity to these relatively safe drugs was significantly higher in patients with a history of anaphylaxis induced by NSAID intake (p = 0.006). CONCLUSION: The diagnosis of COX-1-mediated multiple NSAID hypersensitivity can be often established with a detailed history. Although rare, severe hypersensitivity reactions may be observed in these patients. Undesired situations for both patients and physicians may be avoided by testing relatively safe paracetamol and COX-2 inhibitors in experienced centers.

Comparison of Endovenous Laser and Radiofrequency Ablation in Treating Varices in the Same Patient.

Introduction: To compare endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in different legs in the same individual in patients with venous insufficiency. Methods: Sixty patients with bilateral saphenous vein insufficiency were included. EVLA or RFA was applied to one of the patient's legs and RFA or EVLA to the other leg. Results: EVLA and RFA complications were hyperemia at 20.7% and 31.0%, ecchymosis at 31.0% and 51.7% and edema at 27.6% and 65.5%, respectively. The rate of recanalization was 6.8% in the RFA group. No recanalization was observed in EVLA group. The level of patients satisfied with EVLA was 51.7%, compared to 31.0% for RFA, while 17.2% of patients were satisfied with both procedures. Times to return to daily activity were 0.9 days in the EVLA group and 1.3 days in the RFA group. Conclusion: EVLA procedure may be superior to RFA in certain respects.

A Comparison of Sexual Function, Psychological Status, and Sociodemographic Characteristics of Turkish Men within Polygamous and Monogamous Marriages.

BACKGROUND: A limited number of studies within the literature have entailed objective evaluations of psychological, sexual, and emotional features of women within polygamous marriages. However, there is a lack of studies reporting these features among polygamous and monogamous men. AIMS: The aim of this study was to investigate sociodemographic characteristics, sexual function, and psychological status of polygamously and monogamously married men. STUDY DESIGN: Cross-sectional study. METHODS: The study sample comprised two groups: 35 polygamous and 45 monogamous men in Kahramanmaras Province, Turkey. Door-to-door surveys covered sociodemographic factors and adopted Beck Depression Inventory (BDI), and International Index of Erectile Function - Erectile Function Domain (IIEF-EFD) scales. RESULTS: Polygamous men showed considerably higher IIEF-EFD scores (p<0.05). While the median score of IIEF-EFD was 25.0 for polygamous men, it was 22.0 for monogamous men. A comparison of the two groups revealed that polygamous men had lower BDI scores. However, the difference between the groups was statistically non-significant (p>0.05). Odds ratios and 95% confidence intervals of monogamous men for erectile dysfunction and depression were 14.4 (95% CI: 3.1-67.5) and 7.4 (95% CI: 0.9-61.9), respectively. The main reasons for multiple marriages reported by polygamous men, in descending order, were: 1) decreased satisfaction of sexual desires by a wife (37.1%); 2) falling in love with the second wife (22.8%); and 3) incompatibility with the first wife (17.1%). However, 62.9% of them responded negatively to the question: "Would you recommend polygamous marriage to other men?" CONCLUSION: Our results showed that polygamous men had higher erectile function and lower depression scores than monogamous men. Further studies investigating the effects of polygamy on men's psychosexual function are warranted. Additionally, studies that address the perspectives of offspring and women's expectations within polygamous marriages should be conducted.

Comparison of Endovenous Laser and Radiofrequency Ablation in Treating Varicose Veins in the Same Patient.

PURPOSE: To compare endovenous laser ablation (EVLA) and radiofrequency venous ablation (RFA) in different legs in the same patients with venous insufficiency. METHODS: Sixty patients with bilateral saphenous vein insufficiency were included. Endovenous laser ablation or RFA was applied to one of the patient's legs and the remaining procedure, RFA or EVLA, to the other leg. RESULTS: Minor complications in EVLA and RFA were hyperemia at 20.7% and 31.0%, ecchymosis at 31.0% and 51.7% and edema at 27.6% and 65.5%, respectively. The rate of recanalization was 6.8% in the RFA group. No recanalization was observed in the EVLA group. The level of patients satisfied with EVLA was 51.7%, compared to 31.0% for RFA, while 17.2% of patients were satisfied with both the procedures. Times to return to daily activity were 0.9 days in the EVLA group and 1.3 days in the RFA group. CONCLUSION: The EVLA procedure may be superior to RFA in certain respects.

A Comparison of 1,470-nm Endovenous Laser Ablation and Radiofrequency Ablation in the Treatment of Great Saphenous Veins 10 mm or More in Size.

BACKGROUND: To compare 1,470-nm endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in the treatment of patients with great saphenous vein diameters of 10 mm or more. METHODS: One hundred twenty consecutive patients presenting to the cardiovascular surgery department with a great saphenous vein diameter exceeding 10 mm at the saphenofemoral junction between January and December 2013 were included in the study. The first randomly selected 60 patients (group 1) received 1,470-nm EVLA and the other 60 patients (group 2) received RFA. Patients were assessed on the second day, the first week, and the first, third, and sixth months. Major and minor complications were recorded. RESULTS: Minor complications in EVLA and RFA were hyperemia at 20% and 30% (P = 0.50), ecchymosis at 16.7% and 48.3% (P = 0.02), and edema at 40.0% and 65.5% (P < 0.08), respectively. No major complication was observed in any patient. Recanalization developed during monitoring in 3 patients in the RFA group, a rate of 5%. No recanalization was observed in the EVLA group. Success rates in the EVLA and RFA groups were 100% and 95%, respectively. Mean time to return to daily activity was 0.7 days in the EVLA group and 1.4 days in the RFA group (P < 0.006), whereas mean time to return to work was 1.8 days in the EVLA group and 2.2 days in the RFA group (P < 0.07). There was no statistically significant difference between the groups in terms of pain during the procedure or postoperatively. Less pain was reported in the EVLA during both (P < 0.02). CONCLUSIONS: EVLA using a 1,470-nm radial fiber is superior to RFA in the treatment of saphenous veins larger than 10 mm in diameter.

Longitudinal pulmonary functional loss in cotton textile workers: a 5-year follow-up study.

BACKGROUND: Occupational exposure to cotton dust causes several diseases affecting the lungs, but only limited information is available on effects of long-term exposure. In this study, we aimed to evaluate longitudinal changes in selected parameters of pulmonary function in textile workers. MATERIAL AND METHODS: This prospective cohort study began with 196 textile workers in 2006 and was completed in 2011 with 49 workers. We used standardized tests for pulmonary function on participants on the first day of the workweek in June of 2006 and 2011. Environmental samples of cotton dust were gathered with a vertical elutriator. Loss of pulmonary function was assessed based on gender and smoking status. RESULTS: The mean number of years participants worked in the textile factory was 7.61 ± 1.83 years, and the mean age was 35.3+5.8 years. The annual FEV1 loss of all workers was 53.2 ml, giving a ratio of annual FEV1 loss to baseline FEV1 of 1.4%. Pulmonary function parameters of all participants in 2011 were significantly lower than those in 2006 (for all, p<0.05). In both surveys, pulmonary function in current smokers was lower, but this difference was not significant (p>0.05). CONCLUSIONS: This study provides the first data on pulmonary functional loss in Turkish textile workers and supports the findings of other cohort studies that workers with long-term exposure to cotton dust may lose some pulmonary function. The ratio of annual FEV1 loss to baseline FEV1 appears to be a more accurate and comparable method than annual FEV1 loss for evaluating pulmonary functional loss.

Effect of Turkish classical music on blood pressure: a randomized controlled trial in hypertensive elderly patients.

BACKGROUND: Existing studies suggest that music therapy can have favorable effects on hypertension and anxiety. We therefore set out to investigate the effect of Turkish classical music. OBJECTIVES: To investigate whether Turkish classical music has positive effects on blood pressures and anxiety levels in elderly patients. DESIGN, SETTING AND SUBJECTS: This was a randomized controlled trial performed on 60 hypertensive patients living in a local elderly home in Adana, Turkey. METHODS: Following the completion of a socio-demographic form for each patient, Hamilton anxiety scale was applied. Thereafter, the subjects were randomly divided into two equal-size groups and were allowed to either listen to Turkish classical music (music therapy group) or have a resting period (control group) for 25 min. OUTCOME MEASURES: The primary and secondary outcome measures were blood pressure and Hamilton anxiety scale scores, respectively. RESULTS: The mean reduction in systolic blood pressure was 13.00 mmHg in the music therapy group and 6.50 mmHg in the control group. The baseline adjusted between treatment group difference was not statistically significant (95% CI 6.80-9.36). The median reductions in diastolic blood pressures were 10 mmHg both in the music therapy and control groups. The between treatment group difference was not statistically significant (Mann-Whitney U test, P = 0.839). The mean reduction in HAMA-A was 1.63 in the music therapy group and 0.77 in the control group. The baseline adjusted between treatment group difference was not statistically significant (95% CI 0.82-1.92). CONCLUSION: The study demonstrated that both Turkish classical music and resting alone have positive effects on blood pressure in patients with hypertension.

Sociodemographic variables and depression in Turkish women from polygamous versus monogamous families.

In this study, we aimed to determine the different sociodemographic variables of polygamous and monogamous wives, and the relationship between depression and polygamous marriage. Seventy-nine polygamous wives and 73 monogamous wives from Kahramanmaras, located in southern Turkey, were interviewed. After reviewing the data, we suggest that there is a statistically significant difference between polygamous wives and monogamous wives in terms of Beck Depression Inventory (BDI) scores. The results highlighted many implications for clinical practice and for future research. Additional research needs to be conducted in order to investigate the effects of polygamy on women's mental health.

Plasma selenium levels in Turkish women with polycystic ovary syndrome.

OBJECTIVE(S): To evaluate selenium (Se) levels in serum and their relation with hyperandrogenism and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS) and in control subjects. STUDY DESIGN: Women with any gynecological problem who presented to the Kahramanmaras Sutcuimam University Medical Faculty Gynecology and Obstetric Outpatient Clinic were invited to participate. Group 1 consisted of 36 cases with a diagnosis of PCOS according to the 2003 Rotterdam Consensus Criteria, and Group 2 (control group) consisted of 33 age- and BMI-matched healthy women. In all cases, serum total testosterone (tT), dihydroepiandrostenedione-sulfate (DHEAS), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), insulin, glucose (mg/dL), total cholesterol (TC) (mg/dL), high density lipoprotein-cholesterol (HDL-C) (mg/dL), low density lipoprotein-cholesterol (LDL-C) (mg/dL), triglyceride (TG) (mg/dL) and Se levels were measured. RESULTS: The level of FSH was significantly lower, and the levels of LH, E2, tT, and DHEAS were significantly higher in group 1 than in group 2 (p<0.05). The hirsutism score was significantly higher among PCOS women compared to the control group (p<0.05). Although insulin levels and HOMA-IR were markedly increased in the PCOS group compared to the control group, the differences were not significant (p>0.05). The plasma Se level was significantly lower in PCOS women compared to the control group (p<0.05). When we combined the all women in two groups, regarding them as one group (combined group, n=69), a negative correlation between Se and LH and tT was present (p<0.05). CONCLUSION(S): Our results show decreased plasma concentrations of Se and a negative correlation between Se and LH, tT in women with PCOS. These results indicate that Se may play a role in the pathogenesis of PCOS related with hyperandrogenism.

Increased enthesopathy in patients with familial Mediterranean fever: evaluation with a new sonographic enthesitis index.

OBJECTIVES: The aim of this study was to determine the frequency of enthesopathy in familial Mediterranean fever by using a newly developed sonographic method, the Madrid Sonographic Enthesitis Index (MASEI). METHODS: The study included 50 consecutive patients with familial Mediterranean fever and 57 healthy sex- and age-matched control participants. Six entheseal sites (olecranon tuberosity, superior and inferior poles of the patella, tibial tuberosity, and superior and inferior poles of the calcaneus) on both lower limbs were evaluated. All sonographic findings were identified according to MASEI. Validity was analyzed by receiver operating characteristic curves. P < .05 was considered significant. RESULTS: Mean total enthesitis scores ± SD were 7.54 ± 4.99 for patients and 3.63 ± 3.03 for controls (P < .001). No statistically significant correlation was found between the MASEI score and familial Mediterranean fever duration or colchicine treatment duration. There was no difference between the MASEI score and the presence or absence of arthritic involvement among the patients. The area under the receiver operating characteristic curve was 0.74 (95% confidence interval, 0.649-0.839). When analyzed by sex, men with familial Mediterranean fever had significantly higher MASEI scores than women (P < .05). CONCLUSIONS: This study showed significant enthesopathy in patients with familial Mediterranean fever. The findings support the hypothesis that familial Mediterranean fever and spondyloarthropathy may have common inflammatory mechanisms and suggest that the MASEI scoring system can be incorporated into clinical protocols for studying patients with familial Mediterranean fever in daily practice.

Sonographic evaluation of subclinical entheseal involvement in patients with Behçet disease.

OBJECTIVE: The aim of the current study was to determine the prevalence of subclinical entheseal involvement in patients with Behçet disease via ultrasound using a newly developed method, the Madrid sonography enthesitis index. SUBJECTS AND METHODS: The study was conducted with 36 patients with Behçet disease and 46 healthy sex- and age-matched control subjects. All patients with Behçet disease who had no clinical evidence of arthritis or enthesitis underwent an ultrasound examination. All sonographic findings were identified according to the Madrid sonography enthesitis index. Madrid sonography enthesitis index values of patients and control subjects were compared by Student t test and Mann-Whitney U test. Validity was analyzed by receiver operating characteristic curve. RESULTS: Total enthesitis score was 12.16 ± 6.16 among patients with Behçet disease and 2.06 ± 2.18 among healthy control subjects (p < 0.001). The receiver operating characteristic curve established an ultrasound score greater than 4.5 in the Behçet disease group as the best cut-off point differentiating case subjects from control subjects. This cutoff was exceeded by 88.8% of the patients with Behçet disease. When the Madrid sonography enthesitis index score in each affected enthesis was evaluated, patients with Behçet disease had significantly higher scores than did control subjects when all entheseal sites were compared (all p values < 0.05). CONCLUSION: This is the first study to our knowledge to show significant subclinical enthesopathy of the triceps tendon enthesis in patients with Behçet disease who had no arthritic involvement. These data suggest that the Madrid sonography enthesitis index scoring system for sonographic detection of enthesopathy should be incorporated into the clinical protocol for evaluating patients with Behçet disease in routine clinical practice.

Estradiol plus drospirenone therapy increases mammographic breast density in perimenopausal women.

OBJECTIVE: To investigate the effects of 17ß-estradiol 1mg plus drospirenone 2mg (E2/DRSP) treatment on mammographic breast density in perimenopausal women. STUDY DESIGN: In this prospective study, 80 healthy perimenopausal women aged 41-49 years were enrolled and assigned to either E2/DRSP (n=40) or a control group (n=40). Mammograms were performed at baseline and after 12 months of treatment. Mammographic breast density was quantified according to the Wolfe classification. RESULTS: We demonstrated an increase in mammographic breast density in 37% (95% CI (confidence interval): 18.8-55.3%) of women treated with E2/DRSP after 12 months. The percentage of women with increased density was 0% (95% CI: 0.0-0.0%) in the control group. The difference in breast density between the E2/DRSP group and the control group was statistically very significant (p<0.001). CONCLUSIONS: E2/DRSP therapy for 12 months in perimenopausal women significantly increased mammographic breast density in comparison to a control group. Further long-term and large scale prospective studies are needed to evaluate this issue.

Religious officials' knowledge, attitude, and behavior towards smoking and the new tobacco law in Kahramanmaras, Turkey.

BACKGROUND: Tobacco control effort should be first started in people that are looked upon as role models for the general population. We aimed to determine the knowledge, attitude, and behavior of religious officials towards smoking and the new tobacco law. METHOD: The study group was comprised of 492 Imams and 149 Quran course instructors working in Kahramanmaras city of Turkey, 641 religious officials in total, and our survey form was applied on 406 (63.3%) of those religious officials who agreed to participate in the study. RESULTS: Twenty-eight (6.9%) participants were current smokers and 35 (8.6%) were ex-smokers. 99.8% of the religious officials believed that smoking was harmful and/or prohibited in terms of religion. While 43.6% respondents thought smoking was "haram" (forbidden by Islam), 56.2% believed it was "makruh" (something regarded as reprehensible, though not forbidden by God according to Islam). 85.2% of the participants were aware of the recent tobacco law. 55.5% of the respondents, who were aware of the recent tobacco law, evaluated their knowledge level on the law as adequate, whereas 44.5% evaluated it as inadequate 92.4% of the participants noted that religious officials should play active roles in tobacco control effort. CONCLUSION: Smoking rate among religious officials is much lower than that of general public. In order to help religious officials to take a more active role on this issue, they should be trained on the subject and appropriate platforms should be established.

Medical faculty and school of health student knowledge of and behavior regarding swine flu and vaccine, in Kahramanmaras, Turkey.

This study was carried out to determine Medical Faculty and School of Health student knowledge of and behavior regarding swine flu and vaccine. The study was carried out at Kahramanmaras Sutcuimam University School of Health among the medical faculty and students. All 296 students of the Kahramanmaras Sutcuimam University School of Health and 76 students of the Faculty of Medicine were supposed to participate in the study. Ninety-six point one percent of the students in the study know high fever was one of the symptoms of swine flu, 91.8% said it was spread directly by sneezing or coughing and 95.5% knew washing hands with soap and water especially after coughing and sneezing, should be done to reduce the.risk of infection. Sixty-five point four percent of students knew fatigue and body aches were adverse effects of the swine flu vaccine. Only 9.6% of students received the pandemic flu vaccine. Their knowledge regarding symptoms and methods of spread was low, but regarding measures taken for prevention was high. Both swine flu knowledge and vaccine knowledge were higher in those who received the flu vaccine than in those who did not receive it. In pandemic situations, training should be given immediately to medical, midwifery and nursing students who are models for society.

Status of pandemic influenza vaccination and factors affecting it in pregnant women in Kahramanmaras, an eastern Mediterranean city of Turkey.

BACKGROUND: Pregnant women are a target group for receipt of influenza vaccine because there appears to be an elevated mortality and morbidity rate associated with influenza virus infection in pregnant women. The goal of this study is to determine the factors affecting the decisions of pregnant women in Turkey to be vaccinated or not for 2009 H1N1 influenza. METHODOLOGY: We enrolled 314 of 522 (60.2%) pregnant women who attended to the antenatal clinics of the Medical Faculty of Kahramanmaras Sutcuimam University's Department of Gynecology and Obstetrics between December 23, 2009, and February 1, 2010. We developed a 48-question survey which was completed in a face-to-face interview at the clinic with each pregnant woman. PRINCIPAL FINDINGS: Of the 314 pregnant women, 27.4% were in the first trimester, 33.8% were in the second trimester, and 38.8% were in the third trimester. Twenty-eight pregnant women (8.9%) got vaccinated. Of all the women interviewed, 68.5% stated that they were comfortable with their decisions about the vaccine, 7.3% stated they were not comfortable, and 24.2% stated that they were hesitant about their decisions. The probability of receiving the 2009 H1N1 vaccine was 3.46 times higher among working women than housewives, 1.85 times higher among women who have a child than those who do not, and 1.29 times higher among women with a high-school education or higher than those with only a secondary-school education and below. Correct knowledge about the minimal risks associated with receipt of influenza vaccine were associated with a significant increase in the probability of receiving the 2009 H1N1 vaccine. CONCLUSIONS/SIGNIFICANCE: The number of pregnant women in the study group who received the 2009 H1N1 vaccine was very low (8.9%) and two-thirds of them stated that they were comfortable with their decisions concerning the vaccine. Our results may have implications for public health measures to increase the currently low vaccination rate among pregnant women. Further studies are required to confirm whether our findings generalize to other influenza seasons and other settings.

Knowledge levels about Crimean-Congo hemorrhagic fever among midwifery and nursing students in Kahramanmaras, Turkey.

The aim of this study was to determine the knowledge levels of students in the Midwifery and Nursing Departments of the School of Health Sciences in Kahramanmaras Sutcuimam University (KSU) about Crimean-Congo hemorrhagic fever (CCHF) and to examine the factors influencing those knowledge levels. The study was conducted between April-June 2009 in the School of Health Sciences, KSU, Turkey. All the midwifery and nursing students in the School of Health Sciences at that time, 296 individuals, were included in the study. Questionnaire forms, developed from literature data and comprised of 66 questions, were given to the students, and they were asked to fill them out. Twenty-four point seven percent of the students were not available, thus 223 students(75.3%) were included in the study. Seventy-five point three percent of students stated a viruse was the cause for CCHF, 78.9% stated CCHF is seen between April and September in Turkey, and 80.7% stated there was no vaccine avaiable against it. Ninety-three point three percent of the study group stated that CCHF was transmitted by tick bite, 75.8% and 53.4% stated CCHF can be transmitted by exposure to blood of an infected animal or direct contact with an acutely infected animal, respectively. Thirty-three point two percent of students stated CCHF had no specific treatment. The mean knowledge score of students regarding CCHF was 54.6 +/- 14.8. The CCHF scores of the nursing students were significantly higher than those of the midwifery students. The CCHF knowledge scores did not vary by age or college year.

Effects of environmental lead pollution, smoking, and smokeless tobacco (Maras powder) use on blood lead level.

One hundred sixty-four adult male volunteers (29 controls [Group 1] and 135 combi drivers) enrolled in the study. The combi drivers were divided into three groups as nonusers of either Maras powder or cigarette (Group 2), smokers (Group 3), and users of Maras powder (Group 4). Blood lead levels (BLLs) were analyzed by atomic absorption spectrophotometer. BLL was detected as 2.8 +/- 2.3 microg/dL in Group 1 (n = 29); however, it was 3.5 +/- 1.6 microg/dL in Group 2 (n = 33), 3.8 +/- 2.4 microg/dL in Group 3 (n = 62), and 3.9 +/- 2.4 microg/dL in Group 4 (n = 40). BLL in Group 1 was found significantly lower than other groups (p < 0.05). The use of cigarette or Maras powder by the drivers did not give rise to a marked difference on the BLLs (p > 0.05). BLL of (combi) drivers was detected to be significantly higher than nondrivers; however, it was still under the hazardous level of 10 microg/dL announced by WHO. Although there are publications reporting that usage of tobacco increases the level of lead in blood, both smoking and use of Maras powder did not affect BLL markedly in our study.

Emergency contraception: knowledge and attitudes of Turkish nursing and midwifery students.

OBJECTIVES: To assess the knowledge and attitudes of emergency contraception (EC) among nursing and midwifery students of a university in the Eastern-Mediterranean region of Turkey. METHODS: The survey was conducted among 210 nursing and midwifery students. RESULTS: One hundred and twenty-five participants (59.5%) knew at least one method of EC. One hundred and fourteen participants (54.3%) had heard about emergency contraceptive pills (ECPs), but only 17 (8.1%) knew what they contained. Rates of hearing about ECPs were statistically higher in third and fourth classes than first and second classes, and in midwifery students than in nursing students (P < 0.001). In spite of their very unsatisfactory level of knowledge, 166 students (79.0%) thought that ECPs should be sold in pharmacies. CONCLUSION: The nursing and midwifery students we assessed have a very insufficient knowledge of EC. Probably therefore, many are prejudiced against it. They should be much better acquainted with this modality of contraception since, after graduation, they will play an important role in the dissemination of information about EC in the population.