Ahmet Topuzoğlu

Percentiles of oxygen saturations in healthy term newborns in the first minutes of life

The aim of this study was to establish the reference values of preductal oxygen saturation (SpO2) in healthy infants immediately after birth. SpO2 recordings of 200 term neonates (vaginal group;n=150 and cesarean group;n=50) with regular respiratory pattern were evaluated. The median SpO2 values in the first, fifth and tenth minutes were 71, 92, and 98% in vaginal deliveries and 70, 79, and 96% in cesarean deliveries, respectively. SpO2 was significantly lower in the cesarean group at any time after the first minute of life (p<0.0001). The time needed to reach a SpO2>90% was three times longer in cesarean deliveries. Healthy neonates are poorly saturated immediately after birth. The duration to reach a SpO2>90% was longer in infants born by cesarean deliveries.

The Prevalence of Headache and Its Association With Socioeconomic Status Among Schoolchildren in Istanbul, Turkey

Objective.— The etiology and pathogenesis of migraine and other types of headache are still under discussion. An interaction of organic, psychological, and psychosocial factors is operative. In this study, we aimed to determine the prevalence of headache and its association with socioeconomic status among schoolchildren.

Association of sleep duration with socio‐economic status and behavioural problems among schoolchildren

Aim:  In this population‐based study, we aimed to determine the total sleep duration (TSD), its association with socio‐economic status (SES) and behavioural symptoms among schoolchildren.

Comparison of three neonatal pain scales during minor painful procedures

Objective. There is no single or widely accepted method to define pain in neonates. The aim of this study was to compare three different neonatal pain scales in the estimation of the pain response to minor painful stimuli in healthy term neonates. Method. Thirty healthy neonates were included in the study. Video recordings of infants during heel prick blood sampling were evaluated by two observers according to the Neonatal Infant Pain Scale (NIPS), the Neonatal Facial Coding System (NFCS), and the Douleur Aiguë du Nouveau-né (DAN). Crying times of infants were recorded, and the correlation between the three pain scales and crying time was calculated. The pain scores and inter-observer variability were analyzed. Results. The highest correlation between the crying time and each of the three different neonatal pain scales was found for NIPS (r = 0.74, p<0.001), while similar results were found for the DAN scale (r = 0.67, p <0.001) and the NFCS (r = 0.67, p<0.001). Inter-observer variability was similar for the three scales (NFCS r = 0.95; DAN r = 0.97; NIPS r = 0.96). NFCS had a coefficient of variation (CV) of 59.8 ± 32.2%. The DAN scale and NIPS had similar CV values (41.5 ± 26.1% and 43.2 ± 31.6%, respectively), but these values were significantly lower than that of NFCS. Conclusion. All three scales provided comparable results, with a slight difference favoring NIPS. Therefore, NIPS can be used to evaluate pain during minor painful procedures in neonates.

Do perceived health risks outweigh the benefits of modern contraceptives? A qualitative study in a suburban population in Istanbul, Turkey

Objectives To evaluate the health concerns and the perceived non-contraceptive benefits of modern contraceptive methods through utilizing qualitative methods. Methods Six focus group discussions were carried out with a total of 53 married women in a socio-economically disadvantaged community in Istanbul, Turkey. Results Women had a vague knowledge of the mechanism of menstruation. Some women believed that the uterus was filled with blood—termed ‘dirty blood’—which should be eliminated during menstruation in order to stay healthy. For this reason, amenorrhoea was recognized as the important disadvantage of the progestin-only injectable contraceptives. While the participants mentioned fallacious and exaggerated side effects related to modern methods they did not recognize their non-contraceptive benefits. Most women gained the information concerning side effects through their social networks. Sometimes the information acquired was based on rumours that biased women against the modern contraceptives. Conclusions Women outweighed the risks, some of which were fallacious and exaggerated, against the benefits of modern contraceptives. It is crucial to address health concerns of women and what they ‘heard’ from their peers during counselling sessions. Also the non-contraceptive health benefits of modern methods should be well emphasized. Since informal sources are prevalent, the effectiveness of peer education should be studied in this community.

The influence of gender roles on health seeking behaviour during pregnancy in Turkey

Objectives To explore the impact of gender roles in relation to health seeking behaviour during pregnancy and childbirth. Methods The study was conducted in neighbourhoods with low antenatal care rates in three provinces of Turkey. The study population consisted of pregnant women who never got or discontinued antenatal care and their peers, families and community leaders. Sixteen focus group discussions and 125 in-depth interviews were conducted with a total of 239 participants. Results Pregnancy and childbirth are interwoven strongly with gender roles. Since the patriarchal system acknowledges women through the means of childbirth, women are expected to have many children. Hence women experience pregnancy as a burden and are not motivated to seek antenatal care. During pregnancy, only ‘serious’ conditions are considered as legitimate reasons for accessing care. However, the decision regarding whether a pregnant woman is seriously sick or not belongs to the responsibilities of elder women, which delays service use. Conclusions Providing information regarding the value of antenatal care also to elder women is essential in increasing the demand to the services. Incorporating gender perspectives into daily health practice and maintaining access to high quality reproductive care services are vital in reducing the gender based barriers to care.

Knowledge levels and attitudes about organ donation and transplantation among university students

OBJECTIVE: The aim of the present study was to determine knowledge levels and attitudes about organ donation and transplantation among university students. METHODS: This descriptive study was performed with third-grade students of medicine, pharmacy, and law at a university. Samples weren’t selected in the study and it was executed with 145 students who had agreed to participate in the study. The data was collected using a questionnaire of 19 questions. Descriptive statistics were used to analyze the data. RESULTS: 71.7% of students had positive views about transplantation of their own organs to a suitable recipient, with half of them giving being useful to others as a reason. Among students who had negative views about organ donation, the most important reason given was that it would mean a loss of bodily integrity. 44.1% of participants had positive views about transplantation of their relatives’ organs to another person after death. 51.7% of participants had positive views about transplantation of the organs of a homeless person to another person after death. CONCLUSION: Students had generally positive views about organ donation. However; organ transplantation and donation should be included in the students’ educational programs in order to increase positive attitudes and organ donations, and transform attitudes into behaviors.

Does transient hypothyroxinemia influence metabolic bone disease of prematurity

Abstract Objective: To investigate the relationship between Metabolic Bone Disease (MBD) and Transient Hypothyroxinemia of Prematurity (THOP). Method: One hundred twenty-four infants, born in Marmara University Hospital with a gestational age ≤34 weeks, were enrolled. Clinical features were recorded. Serum TSH, free T4, total T4, calcium, phosphorus and total Alkaline Phosphatase (ALP) levels were determined in the first and third postnatal weeks. MBD was defined as a phosphorus level <4.5 mg/dl and/or ALP >900 IU/l. THOP was defined as a serum free and/or total thyroxine level lower than −1 SD for gestational age at the 7th postnatal day. Result: THOP was diagnosed in nineteen (15.3%) patients. MBD was diagnosed in 52 (41.9%) at the 3rd month. Low birth weight, low gestational age and prolonged parenteral nutrition were associated with MBD. Multivariate analysis documented a significant relationship solely between MBD and gestational age. Conclusion: The risk of MBD does not increase significantly in babies with THOP.

1287 Does Cord Seperation Time has an Effect on Omphalitis

Background and Aim There is still controversy regarding the optimal umbilical cord care and the relationship between cord separation and omphalitis. The aim of our study is to investigate the impact of different umbilical cord care practices on the cord seperation time and omphalitis. Methods We included 514 newborns and randomly randomized them into six groups (Group 1: dry care (n:72); groups 2 (n:69), groups 3 (n:69) and 4 (n:76): a single application of 70% alcohol, 4% chlorhexidine or povidon-iodine in the delivery room, groups 5 (n:73) and 6 (n:62): a single application of 70% alcohol or 4% chlorhexidine in the delivery room and continued until discharge) and 421 of them completed the study. Umbilical cord was examined on the 2nd day and between 5–7 days of life for the signs of omphalitis. Babies were followed up for one month and cord seperation time was recorded. Results Cord separation time was the shortest for group one (6.40 ±1.36 day) and the longest for groups 3 and 6 (9.57±3.12 days and 9.58±4.07 days) (p<0.001). Omphalitis was detected in eight patients (1.9%) and there was no significant difference between the groups. There was no relationship between umbilical cord separation time and incidence of umbilical cord infection (p>0.05). Conclusion Our study showed that the mean time of cord separation was significantly shorter (6.40±1.36 days) in the dry cord care group and the longest in both chlorhexidine groups. However, cord seperation time did not have an impact on the rate of omphalitis.

Çocuklarda sünnetin idrar yolu enfeksiyonu sıklığı üzerine etkisi Özgün Araştırma

Ozet Amac: Cocuklarda yenidogan donemi sonrasi yapilan sunnetin idrar yolu enfeksiyonu sikligi uzerine etkisini degerlendirmektir nbsp; Gerec ve Yontem: Idrar yolu enfeksiyonu geciren yaslari 1 70 ay ortanca 5 ay arasinda 56 erkek cocuk calismaya alindi Tum hastalara bobrek ultrasonografisi ve dimerkaptosuksinik asit sintigrafisi basvuruda uygulandi ldquo;Iseme sistouretrografisi rdquo; secilmis hastalara yapildi Otuz uc hastada vezikoureteral reflu tespit edilmedi 23 hastada 1 3 dereceli vezikoureteral reflu vardi Hastalardan duzenli araliklarla idrar kulturleri alindi idrar yolu enfeksiyonu idrar kulturunde gt;105 cfu ml tek bir organizmanin uremesi olarak tanimlandi Idrar ornegi basina sayi ve takip suresi ay boyunca gecirilen idrar yolu enfeksiyonu sikligi sunnet oncesi ve sonrasi degerlendirilerek karsilastirildi nbsp; Bulgular: Idrar yolu enfeksiyonu sikligi kultur basina sunnet oncesi ortanca 0 33 IR; 0 21 ve sunnet sonrasi 0 0 IR; 0 50 bulundu Takip suresi boyunca gecirilen idrar yolu enfeksiyonu sikligi sunnet oncesi ortanca 0 37 IR; 0 51 ve sunnet sonrasi 0 0 rsquo;di IR; 0 0 Vezikoureteral reflusu olmayanlar ve dusuk dereceli reflusu olanlar icin ayri ayri analiz yapildiginda benzer sekilde sunnet sonrasi idrar yolu enfeksiyonu sikliginin her iki grupta azaldigi goruldu Cikarimlar: Bu calismada yenidogan donemi sonrasi yapilan sunnetin vezikoureteral reflusu olan ve olmayan hastalarda idrar yolu enfeksiyonu sikligini azalttigi gosterilmistir Turk Ped Ars 2010; 45: 137 40 Anahtar sozcukler: Cocuk idrar yolu enfeksiyonu sunnet