Hamit Sırrı Keten

Effects of smokeless tobacco (Maras powder) use on carotid intima media thickness

Background The aim of this study was to investigate the effects of smokeless tobacco (Maras powder, Nicotiana rustica Linn) on carotid intima media thickness. Material/Methods The study included 32 Maras powder users presenting to our Family Medicine outpatient clinic and 30 non-users of Maras powder as a control group. Carotid intima media thickness was measured by duplex ultrasonography. Results All the participants were male. The mean duration of Maras powder use was 27.3±11.6 years. Carotid intima media thickness was 0.73±0.20 mm in the Maras powder users and 0.49±0.14 mm in the controls. Blood pressure measured before Maras powder use in Maras powder users was similar to that measured in the control group (p>0.05). Systolic blood pressures were 136.6±12.4 mmHg and 109.7±9.7 mmHg after 30–60 minutes using Maras powder in the Maras powder users and in the controls, respectively. Diastolic blood pressures were 87.2±6.1 mmHg and 62.8±8.1 mmHg after 30–60 minutes using Maras powder in the Maras powder users and the controls, respectively. Carotid intima media thickness was significantly correlated with systolic blood pressure (r=0.613, p<0.001) and diastolic blood pressure (r=0.612, p<0.001). Conclusions Carotid intima media thickness was higher in Maras powder users than in nonusers of the powder. Increased carotid intima media thickness can be associated with an immediate increase in systolic and diastolic blood pressures. Therefore, attempts to increase public awareness about smoking should also be directed towards prevention of Maras powder use.

The Prevalence of Hepatitis B and C Among Prisoners in Kahramanmaras, Turkey

Background Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are among the most important health issues in Turkey. Human immunodeficiency virus (HIV) infections are less frequently observed in the country. The individuals who had blood transfusions, patients undergoing hemodialysis, and intravenous drug addicted individuals, people who had tattoos/piercings, communal living environments, contamination of a family member, and prisoners are the main risk groups. Objectives The current study aimed to discuss the prevalence and the genotypes of hepatitis and HIV infections among a specific group, namely individuals incarcerated in prisons. Patients and Methods Two-hundred and sixty-six prisoners sentenced for crimes such as robbery, sexual assault, assault substance abuse or selling drugs in the Kahramanmaras closed prison were recruited for the study. Demographic data and the presence of hepatitis B, hepatitis C and HIV were investigated in the study subjects. Results Out of the 266 cases included in the study, 89.5% were male, 10.5% were female and the mean age was 31.21 ± 8.99 years. Risk factors were detected in 27.4% of the subjects. Out of the 73 subjects, among whom the risk factors were detected, 20.3% had intravenous substance use, 3.8% had a history of operation/transfusion, 1.9% had a history of indentation and 1.5% had unprotected sexual contact. The rate of hepatitis B surface antigen (HBsAg) positivity was 2.6%, the ratio of anti-HBs positive subjects was 35.0% and immunity was achieved with vaccination in 43% of the subjects. Anti-HCV was positive in 17.7% of the prisoners and the genotype 3 and genotype 1 were 68.1% (n = 32) and 2.1% (n = 1), respectively. Conclusions Continued substance abuse among most of the drug addicted individuals in prisons, common use of injection materials, tattoos and other circumstances that cause blood contact increase the risk of blood-borne infections.

Evaluation of adult attention deficit hyperactivity disorder in smokers and Maras powder users

Abstract Background: The aim of this study was to evaluate adult attention deficit and hyperactivity disorder (ADHD) in smokers, Maras powder users and non-users of tobacco products by using the Adult Attention Deficit and Hyperactivity Disorder Self-report Scale (ASRS). Methods: The study was performed on 446 males presenting to family health centers in Kahramanmara, Turkey. Of 446 participants, 104 were Maras powder users, 133 were smokers and 209 were volunteers not using any tobacco products. Data were collected with a questionnaire composed of questions about socio-demographic features and features of smoking and Maras powder use, and the Fagerström Nicotine Dependence Scale and the ASRS. P < 0.05 was considered significant. Results: The mean age of the participants was 33.94 ± 10.68 years (min = 18, max = 64). There was no significant difference in age between the study groups (P = 0.089). Thirty-one participants (7.0%) received scores higher than the cut-off value (≥ 14 points) for the short form of the ASRS. Twenty-one participants (4.7%) achieverd scores higher than the cut-off value (≥ 44 points) for the ASRS. The smokers received the highest scores of 8.42 ± 3.79 for all the subscales of the short version of the ASRS, 26.87 ± 10.46 for the ASRS, 12.57 ± 6.47 for the attention deficit subscale and 14.30 ± 5.35 for the hyperactivity and impulsivity subscale. Conclusion: Higher rates of the smokers and the Maras powder users had symptoms of ADHD. Considering nicotine may decrease symptoms of ADHD, it can be assumed that the rates of the smokers and Maras powder users with ADHD are higher.

Knowledge, attitudes and behavior about breast cancer in women presenting to Early Cancer Diagnosis, Screening and Education Centre in Kahramanmaras, Turkey

This study was performed to investigate knowledge, attitudes and behavior about breast cancer in the women applying to Early Cancer Diagnosis, Screening and Education Centre. The study included 96 women applying to Early Cancer Diagnosis, Screening and Education Centre between 1 January 2013 and 1 February 2014. The women were offered information about the study and those giving written informed consent were enrolled in the study. A questionnaire created by the researchers was used to collect data. The mean age of participants was 40.28±9.21 years (min=18, max=62). Seventy-eight participants (81.3%) reported that the most frequent cancer was breast cancer and 16 participants (16.7%) reported that uterine cancer was the most frequent cancer. Breast cancer was reported to appear in all stages of life by 73 participants (76%), in old age by 13 participants (13.5%) and in young people by 10 participants (10.4%). Information about breast cancer was found to be offered to 37 women (38.5%) by health staff and 24 women (25%) by radio/TV programs. Fifty-four women (56.3%) performed breast self-examination, but 42 women (43.8%) did not perform the examination. Thirty-four women aged 40 years and older (61.8%) and 20 women aged younger than 40 years (48.8%) were found to carry out breast self-examination, though there was not a significant difference between them (P=0.203). The study showed that the women did not have sufficient knowledge about breast cancer. In addition, the women did not implement methods used for early diagnosis of breast cancer.

Knowledge of and attitudes towards Crimean-Congo hemorrhagic fever in patients presenting to family health centers in Kahramanmaraş, Turkey

The aim of this study was to reveal knowledge of and attitudes towards Crimean-Congo hemorrhagic fever in patients presenting to family health centers in Kahramanmaras, Turkey. The study was carried out on 98 patients presenting to five family health centers in Kahramanmaras, Turkey, in February 2014. The patients were informed about the study and those giving written informed consent were included in the study. The mean age of the patients was 36.01±13.43 years (18-68). Out of 98 patients included in the study, 41 (41.8%) were males and 57 (58.2%) were females. None of the patients were offered education about Crimean-Congo hemorrhagic Fever. Eighteen patients (18.4%) noted that they had sufficient information about the disease, but 80 patients (80.6%) noted that they did not have sufficient information. Forty-three patients (43.9%) wanted to receive education about the disease, but 55 (56.1%) did not want to get education. Thirty-six males (87.8%) and 43 females (75.4%) noted that they heard about the disease before. Twelve points three percent of the females and 2.4% of the males found it right to kill ticks by pressing a cigarette lit on it or by lighting it. Thirtyfour females (82.9%) and 44 males (77.2%) reported that Crimean-Congo hemorrhagic fever could be transmitted by tick bites. The results of the study revealed that the patients presenting to family health centers did not have sufficient information and did not have desired attitudes towards Crimean-Congo hemorrhagic fever.

Dikkat Eksikliği Hiperaktivite Bozukluğu olan ergenlerin bağlanma örüntüleri ve ebeveynlerdeki ADHD’nin bağlanma üzerine etkisi

Amac: Bu calismada Dikkat Eksikligi Hiperaktivite Bozuklugu (DEHB) olan ergenlerin baglanma oruntuleri ve ebeveynlerinde DEHB bulunmasinin ergenlerin baglanma oruntuleri uzerine olan etkilerinin arastirilmasi amaclanmistir. Materyal ve Metot: Arastirmaya DEHB tanisi olan 30 ergen ve onlarin ebeveynleri, kontrol grubuna ise 30 saglikli ergen ve onlarin ebeveynleri dahil edildi. Katilan ergenler 12-17 yas araliginda idi. DEHB ve kontrol grubundaki ergenlere; sosyodemografik veri formu ve Iliski Olcekleri Anketi (IOA-E) verilmis ve K-SADS (Okul cagi cocuklari icin duygudurum bozukluklari ve sizofreni gorusme cizelgesi – Şimdi ve yasam boyu versiyonu) ile Wechsler Cocuklar Icin Zeka Olcegi (WISC-R) uygulanmistir. Calismaya alinan ergenlerin ebeveynlerinin DEHB belirtilerini sorgulamak amaciyla Wender-Utah Derecelendirme Olcegi (WUDO) ve Eriskin Dikkat Eksikligi Hiperaktivite Bozuklugu Oz Bildirim Olcegi (ASRS) kullanilmistir. Bulgular: Arastirma sonucunda deneklerimizin IOA-E’dan aldiklari skor ortalamalarina bakildiginda tum baglanma tipleri bakimindan DEHB ve kontrol gruplari arasinda anlamli bir fark bulunmamistir. Ebeveynlerinde DEHB olan ergenlerin kayitsiz baglanma oruntusu skorlari anlamli oranda yuksek oldugunu saptanmistir. Sonuc: DEHB’li ergenler ile saglikli ergenlerin baglanma oruntulerinin benzer oldugu gorulmustur. Ayrica ebeveynlerde DEHB bulunan DEHB’li ergenlerin kayitsiz baglanma oruntusune sahip oldugunu ortaya koyulmustur.

Ergenlerde ve Ebeveynlerinde Dikkat Eksikliği Hiperaktivite Bozukluğu Bulunmasının Ergenlerin Bağlanma Örüntüleri Üzerine Etkisi

Amac: Bu calismada Dikkat Eksikligi Hiperaktivite Bozuklugu (DEHB) olan ergenlerin baglanma oruntuleri ve ebeveynlerinde DEHB bulunmasinin ergenlerin baglanma oruntuleri uzerine olan etkilerinin arastirilmasi amaclanmistir. Materyal ve Metot: Arastirmaya DEHB tanisi olan 30 ergen ve onlarin ebeveynleri, kontrol grubuna ise 30 saglikli ergen ve onlarin ebeveynleri dahil edildi. Katilan ergenler 12-17 yas araliginda idi. DEHB ve kontrol grubundaki ergenlere; sosyodemografik veri formu ve Iliski Olcekleri Anketi (IOA-E) verilmis ve K-SADS (Okul cagi cocuklari icin duygudurum bozukluklari ve sizofreni gorusme cizelgesi – Şimdi ve yasam boyu versiyonu) ile Wechsler Cocuklar Icin Zeka Olcegi (WISC-R) uygulanmistir. Calismaya alinan ergenlerin ebeveynlerinin DEHB belirtilerini sorgulamak amaciyla Wender-Utah Derecelendirme Olcegi (WUDO) ve Eriskin Dikkat Eksikligi Hiperaktivite Bozuklugu Oz Bildirim Olcegi (ASRS) kullanilmistir. Bulgular: Arastirma sonucunda deneklerimizin IOA-E’dan aldiklari skor ortalamalarina bakildiginda tum baglanma tipleri bakimindan DEHB ve kontrol gruplari arasinda anlamli bir fark bulunmamistir. Ebeveynlerinde DEHB olan ergenlerin kayitsiz baglanma oruntusu skorlari anlamli oranda yuksek oldugunu saptanmistir. Sonuc: DEHB’li ergenler ile saglikli ergenlerin baglanma oruntulerinin benzer oldugu gorulmustur. Ayrica ebeveynlerde DEHB bulunan DEHB’li ergenlerin kayitsiz baglanma oruntusune sahip oldugunu ortaya koyulmustur.

The Effect of Attention Deficit Hyperactivity Disorder of Parents and Adolescents on Attachment Patterns of the Adolescents

Amac: Bu calismada Dikkat Eksikligi Hiperaktivite Bozuklugu (DEHB) olan ergenlerin baglanma oruntuleri ve ebeveynlerinde DEHB bulunmasinin ergenlerin baglanma oruntuleri uzerine olan etkilerinin arastirilmasi amaclanmistir. Materyal ve Metot: Arastirmaya DEHB tanisi olan 30 ergen ve onlarin ebeveynleri, kontrol grubuna ise 30 saglikli ergen ve onlarin ebeveynleri dahil edildi. Katilan ergenler 12-17 yas araliginda idi. DEHB ve kontrol grubundaki ergenlere; sosyodemografik veri formu ve Iliski Olcekleri Anketi (IOA-E) verilmis ve K-SADS (Okul cagi cocuklari icin duygudurum bozukluklari ve sizofreni gorusme cizelgesi – Şimdi ve yasam boyu versiyonu) ile Wechsler Cocuklar Icin Zeka Olcegi (WISC-R) uygulanmistir. Calismaya alinan ergenlerin ebeveynlerinin DEHB belirtilerini sorgulamak amaciyla Wender-Utah Derecelendirme Olcegi (WUDO) ve Eriskin Dikkat Eksikligi Hiperaktivite Bozuklugu Oz Bildirim Olcegi (ASRS) kullanilmistir. Bulgular: Arastirma sonucunda deneklerimizin IOA-E’dan aldiklari skor ortalamalarina bakildiginda tum baglanma tipleri bakimindan DEHB ve kontrol gruplari arasinda anlamli bir fark bulunmamistir. Ebeveynlerinde DEHB olan ergenlerin kayitsiz baglanma oruntusu skorlari anlamli oranda yuksek oldugunu saptanmistir. Sonuc: DEHB’li ergenler ile saglikli ergenlerin baglanma oruntulerinin benzer oldugu gorulmustur. Ayrica ebeveynlerde DEHB bulunan DEHB’li ergenlerin kayitsiz baglanma oruntusune sahip oldugunu ortaya koyulmustur.

Factors affecting general sleep pattern and quality of sleep in pregnant women

Objective: To investigate factors affecting general sleep pattern and sleep quality in pregnant women. Materialds and Methods: We assessed all pregnant women applied to Department of Obstetrics and Gynecology in Training and Research Hospital, School of Medicine, Kahramanmaraş Sütçü İmam University between 01 January 2014 and 01 March 2014. The participants were informed prior to the study and 100 pregnant women who gave their informed consent were included in the study. Questionnaires consisting sociodemographic characteristics, pregnancy history and the Epworth sleepiness scale were applied to the patients. Factors affecting general sleep pattern and sleep quality in pregnant women were compared. Results: The mean age of 100 pregnant women was 27.9 years (min=16, max=42). The mean gestational age of participants was found to be 24.8 weeks (min=5, max=40). In obstetric history, 9% of women previously had a stillbirth and also 25% of women previously had curettage performed. There were tobacco use in 6% of participants and 6% of patients previously had been to the hospital due to a sleep disorder. The mean excessive daytime sleepiness scale score of pregnant women were found to be 4.56. There were no significant difference among the patients regarding regular exercise (p=0.137), tobacco use (p=0.784), accompanying disease (p=0.437) and excessive daytime sleepiness scale score. Conclusion: In our study, patients who had a complaint of sleep disorder before and who were previously admitted to a health center for this problem, were also found to suffer from the same problem during pregnancy. Treatment of sleep disorders in preconception period for women planning pregnancy is important in terms of mother and the baby’s health. Pregnant women should be informed about factors reducing sleep quality during pregnancy.

Oral Candida carriage and prevalence of Candida species among Maras powder users and non-users

INTRODUCTION The aim of this study was to investigate Candida carriage and species in Maras powder users and non-users. MATERIAL AND METHODS This study included 100 volunteering men in 12 cafés in the city of Kahramanmaras, Turkey. A questionnaire composed of questions about socio-demographic features and Maras powder use was filled in by the participants. Culture specimens were obtained from bilateral buccal mucosa and dorsum of the tongue with a sterile cotton-tipped swap. The specimens were inoculated in Sabouraud Dextrose Agar (SDA). RESULTS The mean age of the participants was 48.0 ± 12.5 years (min = 20, max = 70). Fifty-four percent of the Maras powder users and 22% of the non-users were Candida carriers. The difference between the groups was significant (P = 0.001). The most frequently isolated species was Candida albicans at a rate of 44% in the Maras powder users and at a rate of 18% in the non-users. Other frequent species were Candida glabrata at a rate of 6% in the Maras powder users and 2% in the control group and Candida tropicalis at a rate of 4% in the Maras powder users and 2% in the nonusers. CONCLUSION We found that a significantly high rate of the Maras powder users was Candida carriers. It should be kept in mind that opportunistic infections may be caused by Candida species in Maras powder users especially with immunosuppressive conditions since Candida species are likely to lead to such infections in cases of immunosuppressive diseases.