Increased Circulating Fetuin-A Levels in Patients with Atrial Fibrillation

Abstract Background Biomarkers related to the pathogenesis of atrial fibrillation (AF) have attracted the attention of experts. One of these recently studied biomarkers is Fetuin-A. Objectives This study aimed to evaluate the relationship between serum Fetuin-A levels and AF. Methods This study used the convenience sampling method, based on inclusion criteria and consent to participate in the study. The Shapiro-Wilk test was used to confirm the normal distribution of all continuous variables. Categorical variables were presented using absolute and relative frequencies. Both groups (48 patients with AF and 47 controls) were compared in terms of biochemical, hematological, and echocardiographic findings and Fetuin-A. the Chi-square or Fisher's exact test were used to compare groups concerning categorical variables. Continuous variables were compared using the independent samples t-test. P<0.05 was considered statistically significant. Results Serum Fetuin-A values increased in AF patients when compared to the controls (544±49 μg/mL versus 484±46 μg/mL, p=0.001). Moreover, Fetuin-A level was independently associated with AF — AOR = 0.978, 95%; confidence interval (CI) 0.969-988, p < 0.001. The cut-off values in Fetuin-A levels in patients with AF were >511.80 μg/mL with a sensitivity of 75% and a specificity of 73% — area under the curve (AUC) = 0.804, 95% CI = 0.715 - 0.892. Conclusions According to this study, there was a relationship between serum Fetuin-A levels and AF, regardless of conventional cardiovascular risk factors. Therefore, Fetuin-A may play a role in the pathophysiology of AF. Prospectively designed cohort studies are necessary to assess whether or not the results can be generalized for other populations.

Suicidal thoughts and attempts among married women who experience intimate partner violence in Türkiye.

Background: Suicide is one of the main causes of premature death and an important health concern globally because of its current rising prevalence. Aims: To investigate suicidal thoughts and attempts among married women who have experienced intimate partner violence in Sivas, Türkiye. Methods: This cross-sectional, population-based survey was conducted between January and December 2019 among 2243 currently married women aged 15-49 years, who had been residing in the centre of Sivas Province, Türkiye, for ≥ 6 months. Multistage clustered random sampling was used in the survey. The 12-item General Health Questionnaire was used for the measure of mental health, while the violence items were measured using the Conflict Tactic Scales-2. The data were analysed using SPSS version 16.0. Results: Prevalence of suicidal thoughts and attempts was 9.5% and 4.8%, respectively. Multivariate logistic regression analysis showed that age < 25 years, mental health problems, being a victim of violence during childhood or marriage, and insufficient income were associated with suicidal thoughts. Age < 25 years, mental health problems, being a victim of violence during childhood or marriage were associated with suicidal attempts. Conclusion: Intimate partner violence is a risk factor for poor health among women, including mental health, and it could result in suicidal thoughts and attempts. Intimate partner violence against women should be addressed by the relevant authorities to reduce suicidal thoughts and attempts, especially among younger women.

Eosinophil Cell Count Predicts Mortality in the Intensive Care Unit after Return of Spontaneous Circulation.

BACKGROUND: Eosinophils constitute 1%-5% of peripheral blood leukocytes, less in the presence of acute infections (referred to as eosinopenia). Studies indicate that eosinopenia can be used as a prognostic predictor for chronic obstructive pulmonary disease exacerbation, sepsis, or acute myocardial infarction disease. There are only a few studies about predicting mortality in emergency departments and intensive care units (ICUs). Prognostic studies about patients in ICUs are generally carried out using different scoring systems. We aimed to analyze if the eosinophil count can estimate the prognosis among non-traumatic patients who underwent cardiopulmonary resuscitation and were hospitalized in ICU thereafter. METHODS: The data were evaluated of 865 non-traumatic adult patients (>18 years of age) who were admitted with cardiopulmonary arrest or developed cardiopulmonary arrest during clinical follow-ups. Admission venous blood sample tests, complete blood count, and biochemical laboratory results were recorded. Arterial blood gas results were also evaluated. The mean results of the recorded laboratory results were compared between the surviving and non-surviving patients groups. RESULTS: There was a significant difference between the two groups in regard to platelet, eosinophil count, pH, PaO2, SaO2, and HCO3- (P<0.001 for all). In the multiple linear regression analysis, eosinophil counts were found to be an independent factor (odds ratio=0.03, 95% confidence interval 0.33-0.56, P<0.001) associated with the mortality after cardiopulmonary resuscitation. CONCLUSION: Because admission eosinophil counts can be measured easily, they are inexpensive biomarkers that can be used for predicting the prognosis among the patients who have return of spontaneous circulation and are treated in ICUs.

Frontal QRS-T angle as a predictive marker for myocardial damage in acute carbon monoxide poisoning.

INTRODUCTION: The present study was undertaken to investigate the prognostic value of the frontal QRS-T angle associated with adverse cardiac outcomes in patients with carbon monoxide (CO) poisoning in early stages in the emergency department. MATERIALS AND METHODS: The data of 212 patients with CO poisoning who were admitted to the ED between January 2010 and May 2020 were retrospectively analyzed. The frontal QRS-T angle was obtained from the automatic reports of the EKG device. RESULTS: Compared to patients without myocardial damage, among patients with myocardial damage, statistically high creatinine, creatine kinase MB, cardiac troponin I, and frontal QRS-T angle values were found (p < 0.001 for all parameters), while the saturation of arterial blood pH and arterial oxygen values were found to be lower (p = 0.002 and p < 0.001, respectively). The frontal QRS-T angle values were correlated with creatine kinase, creatine kinase-MB, cardiac troponin I, and oxygen saturation (SpO2) in arterial blood (r = 0. 232, p = 0.001; r = 0. 253, p = < 0.001; r = 0. 389, p = < 0.001; r = -0. 198, p = 0.004, respectively). The optimum cut-off value of the frontal QRS-T angle was found to be 44.5 (area under the curve: 0.901, 95% confidence interval: 0.814-0.988, sensitivity: 87%, specificity: 84%). CONCLUSIONS: The frontal QRS-T angle, a simple and inexpensive parameter that can be easily obtained from 12-lead surface electrocardiography, can be used as an early indicator in the detection of myocardial damage in patients with CO poisoning.

An Assessment of Intimate Partner Femicide in the Name of Honour in Turkey: A Retrospective Epidemiological Study.

BACKGROUND: Honour killing (HK) is the most extreme form of domestic violence. Given the scarcity and reliability of data on the phenomenon, the present study focuses on the epidemiological pattern of HK in Turkey, where many cases of the HK are considered unreported or/and falsely described. SUBJECT AND METHODS: Data for this retrospective epidemiological study was collected through newspaper reports on intimate partner femicide (IPF) that published between January 1st 2010 and December 31st 2015. The proportion of HK was estimated according to independent variables by means of regression analysis. RESULTS: The femicide cases has increased during the study period. The proportion of the HK cases was 14%. Logistic regression analysis showed that being at the younger ages (odds ratio, OR=2.0, r=0.70, P<0.001) and using other methods such as strangulation, hanging, electrocution or poisoning were the factors associated with HK (OR=1.8, r=0.60, P=0.004). CONCLUSIONS: Given the continued increase in the rate of the IPF cases in Turkey, where HK related information is scarce, newspaper reports can be a good monitoring tool. Data collection and monitoring systems are crucial to find the best effective prevention strategies, particularly for HK. Policies to reduce the HK cases should be including support to women, especially at the younger ages.

Identifying variables in relation to health-related quality of life among married women of reproductive age in Sivas Turkey.

A cross-sectional study was performed to identify the factors associated with health-related quality of life (HRQoL) among 1,236 married Turkish women aged 15-49 years, in the urban area of Sivas, between January and July 2017. Multiple logistic regression analyzes showed that being unemployed [adjusted odds ratio (AOR) = 1.73, 95% confidence interval (CI) = 1.18-2.25], and having an unsatisfying sexual life (AOR = 1.54, 95% CI = 1.17-2.03), a chronic illness (AOR = 1.66, 95% CI = 1.27-2.17), more than three children (AOR = 1.38, 95% CI = 1.03-1.86), and experienced domestic violence (AOR = 2.15, 95% CI = 1.55-2.98) were associated with worse mental HRQoL. Having less than a high school education (AOR = 2.00, 95% CI = 1.33-3.02), a chronic illness (AOR = 2.49, 95% CI = 1.88-3.30), a history of abortion (AOR = 1.59, CI = 1.09-2.31), and experienced domestic violence (AOR = 1.71, 95% CI = 1.21-2.40) were associated with worse physical HRQoL. These findings suggest that health care providers or policy makers should pay special attention to unemployed women who are less educated, have more than three children and those having unsatisfied sexual lives, chronic illness, domestic violence experience and abortion history to enhance their HRQoL.

Cancer Incidence Rates by Age and Gender in Sivas Province of Turkey, 2004-2014.

OBJECTIVES: We sought to evaluate the trends in age-standardized incidence rates of cancer by gender, age, and types in the Sivas province of Turkey from 2004 to 2014. METHODS: Data were obtained from the Sivas Public Health Department Cancer Unit and the Cumhuriyet University Hospital Cancer Record Unit for the studied period. Data were presented as incidence rates by age, gender, and cancer site using world age-standardized incidence rate (ASR-W) per 105 populations. RESULTS: Of the 13 377 registered new cases of cancer during the study period, 43.1% (5771) were female, and 56.9% (7606) were male. The ASR-W of all cancers was 205.2 per 105 in males and 168.0 per 105 in females. The ASR-W was increased for both genders over the 11-year period. The greatest incidence cancer type in males was prostate cancer (ASR-W = 35.8) followed by lung (ASR-W = 33.9), colorectal (ASR-W= 19.0), urinary (ASR-W = 18.4), and stomach (ASR-W = 17.3) cancer. Among females, thyroid (ASR-W= 37.5) was the cancer type with the greatest incidence followed by breast (ASR-W = 27.7), colorectal (ASR-W = 11.7), lymphoma (ASR-W = 10.4), and stomach (ASR-W = 10.0) cancer. CONCLUSIONS: The cancer incidence rate in males has remained higher than in females from 2004 to 2014, and an increased incidence of various cancers was observed in both genders. Raising public awareness about the risk factors for cancer and the development of appropriate and effective screening programs to provide more reliable data for cancer prevention and control programs in Sivas province is necessary.

Level of mother-baby bonding and influencing factors during pregnancy and postpartum period.

BACKGROUND: Bonding is the process of an emotional relationship between mothers and babies. Pregnancy and postpartum periods are most important of developing a mother-child bonding. Here we aimed to determine the level of mother-baby bonding and identify the influencing factors during pregnancy and the postpartum period and to examine the relationship between bonding level during pregnancy and the postpartum period. SUBJECTS AND METHODS: This cross-sectional descriptive study included twelve districts across a range of socioeconomic structures. Every district was selected by a simple random sampling method. Data were collected with Prenatal Attachment Inventory, Mother-to-Infant Bonding Scale, Center for Epidemiologic Studies' Depression Scale and Beck Anxiety Inventory. The study included two home visits. The first visit at gestational age ≥35 weeks and second visit on the seventh or eighth day of the postpartum period. The study was conducted with 227 pregnant women. RESULTS: We found that, 50.7% pregnant women had prenatal depression and 36.6% pregnant women had postpartum depression. We detected a negative association between depression level during pregnancy and the postpartum period with mother-baby bonding in the postpartum period (r=0.174, p=0.009; and r=0.221, p=0.001, respectively). A negative correlation was detected between anxiety level and mother-baby bonding level in the postpartum period (r=0.151, p=0.023). It was found that when the prenatal attachment level increases, the level of postpartum bonding is also increases (r=0.297, p=0.000). CONCLUSIONS: Depression and anxiety levels were higher during pregnancy than the postpartum period. Depression level during pregnancy and postpartum period depression and anxiety level negatively affected mother-baby bonding in the postpartum period. We found that as prenatal attachment level increases, the level of postpartum bonding also increases.

Health-related Quality of Life and Associated Factors Among Undergraduate University Students.

OBJECTIVES: The aims of this study were to explore factors associated with health-related quality of life (HRQOL) among students of Cumhuriyet University, Turkey. METHODS: This cross-sectional study involved 1751 undergraduate students. HRQOL was measured using the Turkish version of 36-Item Short Form Health Survey questionnaire. We looked at the effect of sociodemographic characteristics (e.g., gender, age, drinking, and smoking) on the individual HRQOL domains. RESULTS: Place of residency (odds ratio (OR) = 3.947 for role emotion dimension), smoking status (OR = -2.756 for role physical dimension), received amount of pocket money (OR = 2.463 for mental health dimension), and body mass index (OR = 1.463 for mental health dimension) were the factors significantly associated with the HRQOL. CONCLUSIONS: Young students' HRQOL is affected by socioeconomic, demographic, and behavioral factors. To improve student's HRQOL, any health-promoting strategies should focus on modifiable risk factors and socioeconomic supports for students.

Association of risk factors with smoking during pregnancy among women of childbearing age: an epidemiological field study in Turkey.

CONTEXT AND OBJECTIVE:: Smoking during pregnancy is an important risk factor for maternal and infant health that is preventable. This study aimed to investigate the risk factors associated with smoking behavior during pregnancy. DESIGN AND SETTING:: A household-based probability sample survey of 1,510 women was conducted in the center of the city of Sivas, Turkey, between September 2013 and May 2014. METHODS:: The prevalence of smoking during pregnancy was estimated according to independent variables by means of regression analysis. RESULTS:: The prevalence of smoking during pregnancy was 16.5%. Logistic regression showed that being at a relatively young age (odds ratio, OR = 1.92, P = 0.025 for 15-24 age group; and OR = 2.45, P = 0.001 for 25-34 age group), having a low educational level (OR = 1.76, P = 0.032), being unmarried (OR = 1.48, P = 0.002) and living in an extended family (OR = 1.98, P = 0.009) were the factors associated with the risk of smoking during pregnancy. CONCLUSIONS:: Systematic attention should be paid to socioeconomic inequalities, to support women towards quitting smoking before or at an early stage of their pregnancies. Younger women and particularly those in lower socioeconomic groups should be targeted. This will lead to better pregnancy status, especially among young women.

Association of risk factors with smoking during pregnancy among women of childbearing age: an epidemiological field study in Turkey / Associação de fatores de risco com tabagismo durante a gravidez em mulheres em idade fértil: estudo epidemiológico de campo na Turquia

ABSTRACT CONTEXT AND OBJECTIVE: Smoking during pregnancy is an important risk factor for maternal and infant health that is preventable. This study aimed to investigate the risk factors associated with smoking behavior during pregnancy. DESIGN AND SETTING: A household-based probability sample survey of 1,510 women was conducted in the center of the city of Sivas, Turkey, between September 2013 and May 2014. METHODS: The prevalence of smoking during pregnancy was estimated according to independent variables by means of regression analysis. RESULTS: The prevalence of smoking during pregnancy was 16.5%. Logistic regression showed that being at a relatively young age (odds ratio, OR = 1.92, P = 0.025 for 15-24 age group; and OR = 2.45, P = 0.001 for 25-34 age group), having a low educational level (OR = 1.76, P = 0.032), being unmarried (OR = 1.48, P = 0.002) and living in an extended family (OR = 1.98, P = 0.009) were the factors associated with the risk of smoking during pregnancy. CONCLUSIONS: Systematic attention should be paid to socioeconomic inequalities, to support women towards quitting smoking before or at an early stage of their pregnancies. Younger women and particularly those in lower socioeconomic groups should be targeted. This will lead to better pregnancy status, especially among young women.

RESUMO CONTEXTO: Fumar durante a gravidez é um fator de risco importante para a saúde materna e infantil e que pode ser evitado. O estudo teve como objetivo investigar os fatores de risco associados com o comportamento de fumar durante a gravidez. TIPO DE ESTUDO E LOCAL: Inquérito por amostragem probabilística de base domiciliar de 1.510 mulheres foi realizado no centro da cidade de Sivas, Turquia, entre setembro de 2013 e maio de 2014. MÉTODOS: A prevalência do hábito de fumar durante a gravidez foi estimada de acordo com as variáveis independentes por meio da análise de regressão. RESULTADOS: A prevalência do hábito de fumar durante a gravidez foi de 16,5%. A regressão logística mostrou que estar em idade relativamente jovem (odds ratio, OR = 1,92, P = 0,025 por grupo de idade 15-24e OR = 2,45, P = 0,001 para a faixa etária 25-34), com alto nível de escolaridade (OR = 1,76, P = 0,032), sendo solteira (OR = 1,48, P = 0,002) e vivendo em família grande (OR = 1,98, P = 0,009) foram os fatores associados ao risco de fumar durante a gravidez. Parto prematuro e baixo peso ao nascer foram mais frequentes entre as fumantes. CONCLUSÕES: Atenção sistemática deve ser dada às desigualdades socioeconômicas para apoiar mulheres a parar de fumar antes ou na fase inicial da gravidez, tendo como alvo mulheres mais jovens, e particularmente aquelas de grupos socioeconômicos mais desfavorecidos. Isso conduzirá a um melhor estado de gravidez em mulheres, especialmente às jovens.

[Analysis of intestinal ameobiasis in patients with diarrhea by adhesin antigen test and direct microscopy]. / Ishalli Hastalarda Baðýrsak Amebiyazýnýn Adezin Antijen Testi ve Direkt Mikroskopi ile Incelenmesi.

OBJECTIVE: In this study, we aimed to research the frequency of intestinal amebiasis in patients who applied with diarrhea retrospectively for a year and compare direct microscopic analysis and ELISA adhesin antigen test for Entamoeba histolytica procedures. METHODS: The fecal matter sample of 259 patients with diarrhea who applied to the Sivas Numune Hospital Microbiology Laboratory between February 2012 and March 2013 were studied. Samples were evaluated with direct microscopic analysis and Entamoeba histolytica adhesin antigen test (E. histolytica II, Techlab, Blacksburg, USA). RESULTS: In the patients who applied to our laboratory with an amebiasis diagnosis, the mean age was detected as 40.12±19, and the positivity range of the Entamoeba histolytica adhesin antigen test was detected as 25.1% (n=65). In ELISA adhesin test-positive patients 24.6% (n=16) trophozoites, cyst, abundant leukocytes and erythrocytes were detected, and in 6 patients (3.1%), ELISA adhesin antigen test was negative. There was no difference between males and females (p>0.05), but between-season difference was detected (p<0.05). CONCLUSION: Direct microscopic analysis may be inadequate in the differential diagnosis of E. histolytica/ and E. dispar and discrimination of Entamoeba cyst and/or trophozoites from other cellular elements (esp. leukocytes). Furthermore, we thought that the E. histolytica monoclonal ELISA adhesin test is useful for the differential diagnosis of pathogenic E. histolytica and nonpathogenic E. dispar.

Association between domestic violence and miscarriage: a population-based cross-sectional study among women of childbearing ages, Sivas, Turkey.

Violence against women is a global issue, with ramifications for the reproductive health of women. The current study examined the relation of domestic violence (DV) to miscarriage among women who were victimized during their last pregnancy. The study was conducted in Sivas city center, in Turkey. Associations between self-reported DV and miscarriage were analyzed using multiple regression modeling. Physical and/or sexual DV during the last pregnancy was reported by 10.0% and 6.2% of women, respectively. Women who experienced physical violence were 2.5 times as likely (Odds Ratio (OR) = 2.47, 95% confidence interval [CI]: 1.37-4.84, p = .003) to have experienced a miscarriage than women who did not report physical violence. These findings suggest that victims who experience physical violence during the last pregnancy may be more likely to experience miscarriage. Preventing DV, especially physical violence, may, therefore, be beneficial for avoiding adverse pregnancy outcomes.

Socioeconomic disparities among ever-married Turkish women who had unintended pregnancies and abortions in a middle Anatolian city.

Researchers undertook a cross-sectional study to examine socioeconomic disparities, unintended pregnancies, and decisions about induced abortions among ever-married women in the urban area of Sivas, Turkey. The data for the present study were gathered from a randomly-selected, household-based probability sample of 1,264 ever-married Turkish women. Unintended pregnancies accounted for 46.2% of total pregnancies and, of these, 30% ended in induced abortion. The proportion of induced abortion among all pregnancies was 21.7%. Multiple logistic regression analyses with adjusted odds ratios (aOR) showed that being aged less than 35 years (aOR = 2.14, p < 0.001), having less than a high school education (aOR = 2.18, p < 0.001), being unemployed (aOR = 2.77, p < 0.001), having more than three children (aOR = 1.54, p = 0.006), and having lower income (aOR = 2.11, p < 0.001) were associated with unintended pregnancies. Among women with unintended pregnancy, having more than three children (aOR = 3.06, p < 0.001), lower income (aOR = 3.39, p < 0.001), and age less than 35 years (aOR = 2.57, p < 0.001) were associated with induced abortion. These findings suggest that lower socioeconomic status was associated with induced abortion among women facing an unintended pregnancy. Women who experience unintended pregnancies, who have lower socioeconomic status and education level, should be the target group for midwives and other relevant healthcare providers for educational efforts regarding family planning and contraception.

Turkish school teachers' knowledge and attitudes toward HIV/AIDS.

AIM: To assess Turkish school teachers' knowledge, attitudes, and misconceptions of HIV/AIDS. METHODS: This cross-sectional descriptive study was conducted in Sivas, Middle Anatolian province of Turkey, from January to May 2009. We selected and interviewed 898 teachers using a simple systematic sampling method. RESULTS: All respondents heard about AIDS. Most knew that it could be transmitted by infected blood (98.0%) and sexual contact (93.4%) and some (33.2%) thought that it could be transmitted by mosquitoes. Although the majority of them strongly agreed or agreed with the statement that "people with AIDS should be helped, supported and treated" (98.0%), about 40% and 70% of them, respectively, agreed or strongly agreed with the statement that infected people should be quarantined. Young teachers with a higher level of knowledge about HIV/AIDS had more positive attitudes. CONCLUSION: This study provided basic information on school teachers' AIDS knowledge and attitudes and showed that various misconceptions of HIV transmission were a matter of concern. A considerable number of respondents with undesirable attitudes toward HIV/AIDS indicates the need for education of teachers on the subject.

The effect of intimate partner violence on mental health status among women of reproductive ages: a population-based study in a middle Anatolian city.

Violence against women has been recognized as both a major public health problem and a human rights violation worldwide. Research has documented the association between physical/sexual intimate partner violence (IPV) and mental health, measured by the 12-item General Health Questionnaire (GHQ-12) among women in reproductive age. This study underlines that different types of IPV is independently associated with mental health status. Results also show effects of IPV on mental health may not only be immediate but also be long term. These findings suggest that efforts to identify women with mental health problems should include screening for the types and history of IPV victimization.

A study of the prevalence of developmental anomalies of the external ear among preschool children in Sivas, Turkey.

The objective of the current study was to detect the prevalence of developmental anomalies of the external ear among children between aged 4-6 years old in Sivas, Turkey. This cross-sectional study was conducted among 1,096 preschool children. Among the 1,096 children examined, 8 had accessory auricle, and prevalence of the anomaly was calculated at 0.7%. Fifty-one prominent ear deformities (4.6%) were detected among the children. One limitation of the study is that the prevalence of developmental anomalies of the external ear may have been underestimated. In fact, such surveys should be conducted on large random or stratified samples of entire populations. Thus, the true prevalence could be slightly higher, and the apparent difference may not be a racial one.

Knowledge and behaviours related to herbal remedies: a cross-sectional epidemiological study in adults in Middle Anatolia, Turkey.

The use of herbal remedies is common in Turkey. This study aimed to define the patterns of herbal remedy use among subjects aged 18 or above and to describe factors associated with use of herbal remedies. A cross-sectional study was conducted with a multistage sampling method between September 2007 and April 2008. A total of 3876 adults participated (98.1% response rate), and 1518 (39.2%) admitted using herbal remedies (95% CI 37.6-40.7%). Univariate analyses showed that compared with non-users, herbal users were mostly female, were more highly educated and were more likely to live in smaller households of one to four people. Logistic regression showed that being aged 18-27 (OR = 1.23, P = 0.028), being female (OR = 2.22, P < 0.001), being educated in a secondary school (OR = 1.47, P < 0.001) or high school (OR = 2.77, P < 0.001), perceiving their health status as 'good' (OR = 2.61, P < 0.001) and having health-related problems (OR = 2.80, P < 0.001) were the factors associated with the use of herbal remedies. The most commonly used herbs were lime, mint, rosehip and lemon. The reasons for using herbal remedies included that they are natural products (79.8% of the 1518 users), for health enhancement (58.9%) and to overcome health problems (32.2%). The decision to use herbal remedies was mainly based on recommendations from the mass media (45.1%). Only 29.1% of users obtained information from their physicians or health providers, and only 37.9% informed their doctors. Nearly three in five people in this study reported using a herbal remedy to overcome health problems or for health enhancement. Herbal remedies are likely to be used by the young people, females, those with higher education, those with good or excellent perceived health status and those with chronic illness, and it seems essential to offer informational programmes for them. The lack of communication on herbal remedies between patient and physician needs to be addressed.

Breast cancer knowledge and screening behaviors of the female teachers.

Breast cancer is the most frequently occurring cancer in women. The objective of this study was to determine the level of knowledge about risk factors for breast cancer and screening behaviors among 468 female teachers who work in Sivas, Turkey. In this cross-sectional survey, a self-administered, structured questionnaire was used for data collection. Up to one-half (52.4%) of the teachers thought that they had enough knowledge about breast cancer. The sources of that information were television (59.0%), newspapers (48.9%), and health professionals (24.1%); 58.5% of the teachers had a sufficient knowledge level about breast cancer risk factors. The most frequently reported risk factor was family history of breast cancer (94.9%), followed by getting older, high fat diet and having a first child at a late age (68.6%, 51.7%, and 45.1%, respectively). No significant differences were found in knowledge by age groups, having breast-related complaints, teaching experience, or marital status. Among the teachers, 43.9% had performed breast self-examination; yet only 10.5% of them performed it monthly. Only 22.3% of the teachers reported having at least one clinical breast-examination. Among the 136 women over the age of forty years, only 37.5% had had at least one mammogram. A significant association was noted between level of knowledge about breast cancer risk factors and use of breast self-examination. Also, being married and having breast-related complaints were significantly related to practicing clinical breast-examination and mammography. This study revealed a relatively low awareness about the knowledge and practice of screening methods among teachers. The relatively low rates of breast self-examination, clinical breast-examination, and mammography practiced by this group of teachers are of concern and suggest that increased awareness of these methods, their value, and how they should be conducted is needed.

Leptin and bone mineral density in haemodialysis patients.

INTRODUCTION: There are very few data about relations between leptin and bone mineral density (BMD) in regular haemodialysed patients. We aimed to examine the relationship of serum leptin levels with BMD values in dialysed patients. We also assessed whether leptin is a significant predictor of BMD in haemodialysed patients. MATERIALS AND METHODS: Leptin levels were studied using commercially available kits and BMD values were calculated using dual energy X-ray absorptiometry (DEXA) at femoral neck and distal radius in 74 (30 men and 44 women ) haemodialysis patients. RESULTS: BMD values at the femoral neck and distal radius did not differ significantly between the 2 genders. BMD at the distal radius correlated positively with bone alkaline phosphatase (BAP) (r = 0.503, P = 0.005) in male patients and correlated positively with phosphorus (r = 0.343, P = 0.02) in female patients. The time ondialysis treatment was longer in men (59 +/- 48 vs 44 +/- 41) but the difference was not statistically significant. Leptin levels were negatively correlated with BMD at the distal radius (r = -0.250 and P = 0.03) in all patients. Serum leptin levels were also correlated with body mass index (BMI) in all the patients (r = 0.749 and P = 0.001) and in both genders (r = 0.653 and P = 0.001 in women, r = 0.704 and P = 0.001 in men). In multivariate regression analysis, it was found that leptin level was not an independent determinant of BMD at all skeleton sites measured. CONCLUSIONS: There was significant difference between the 2 genders with reference to leptin levels, BMI, phosphorus and creatinine. Serum leptin levels are not significant predictors of BMD in the current study.