İbrahim Başhan

Left ventricular function in patients with polycystic ovary syndrome: a Doppler echocardiographic study.

PURPOSE Polycystic ovary syndrome (PCOS) is frequently accompanied by the presence of cardiovascular risk factors. The aim of this study was to determine and compare the echocardiographic profiles of patients with PCOS with those of healthy subjects by using conventional echocardiographic methods and tissue Doppler imaging. METHODS The study population consisted of 26 untreated patients with PCOS and 24 healthy controls who were mathced with respect to age and body mass index. In addition to standard two dimensional and M-mode measurements, color Doppler M-mode of left ventricular inflow propagation velocities (Vp), pulmonary venous flow measurements, transmitral valve flows and tissue Doppler imaging of the mitral annulus and basal wall were recorded. RESULTS There were no significant differences between patients with PCOS and control subjects with respect to ejection fraction, mitral E/A ratio, deceleration time, isovolumic relaxation time, Vp and pulmonary venous velocities. The tissue Doppler profiles of patients with PCOS were also found to be similar to those of controls. CONCLUSION This study suggests that there are no significant differences in certain conventional and tissue Doppler echocardiographic measures of cardiac function between patients with PCOS and healthy control subjects.

Regulation of Dietary Habits: The effect of losing weight on quality of life

Objective: This study aimed to investigate the effects of regulation of nutritional habits on quality of life by applying Short Form (SF-36) Quality of Life Scale. Methods: SF-36 was administered through face-to-face interviews to a total of 129 individuals (112 female, 17 male) aged 18-65 years. Anthropometric measurements, body mass index, and waist circumference measurement were undertaken simultaneously. The changes in weight, body mass index, waist circumference measurement, and SF-36 scores were compared at baseline and three months after modification of dietary habits. Results: At three months after the regulation of dietary habits, a statistically significant decrease was found in weight, body mass index, and waist circumference measurements (p<0.05). Overall improvement was observed in all the quality of life parameters assessed with SF-36, and among them, the sub-scales of general health, bodily pain and vitality were statistically significant (p<0.05). The improvement in these sub-scale scores was similar to the literature. Conclusion: The individuals who lost weight through adopting healthy dietary habits had increased SF-36 scores, indicating the positive effect of regulating diet on their quality of life.

The Effect of Daily Walnut Consumption on Dyslipidemia

The aim of this study was to investigate the effect of daily walnut consumption on dyslipidemia in dietary. Within a year, the patients who have been suggested taking walnut or not in their individual dietary were scanned retrospectively and randomized into 2 groups. The first group consists of 72 cases (only those taken on the diet program) and the second group consists of 73 cases (walnut consumption in regulated diet). Baseline blood lipid parameters and anthropometric measurements were assessed in both groups and compared with values at 3rd month. values < 0.05 were considered statistically significant. In addition, Maras 18 walnut cultivar was analyzed to determine the fatty acid profiles by chromatographic technique. When comparing lipid parameters at baseline and at the 3rd month, total cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, and triglyceride levels significantly decreased and high-density lipoprotein cholesterol levels significantly increased. As compared with the end of 3rd month values of the groups, the reduction in total cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, triglyceride levels of the subjects group (walnut consumption in regulated diet) were significantly higher than the control group (only regulated diet). Also, there was no significant difference in increase on high-density lipoprotein cholesterol levels between the groups. The results showed that daily consumption of walnut improved blood lipid levels. However, more extensive studies are needed on therapeutic usage in dyslipidemia.

The Use of Simulation in Continuing Professional Development: A Comparison of Family Physicians’ Awareness in Mersin and in Ann-Arbor

Introduction: With the intent to promote using simulation in Continued Professional Development (CPD) in Turkey, we examined Turkish Family Medicines (FM) in Mersin and United States FMs in Ann-Arbor attitudes toward simulation and resources used in CPD programs to identify preferred teaching methods and subject areas that might benefit from the use of simulation for training. Method: A survey-based needs assessment was disseminated via email to FM Associations in Mersin (MAHDER) and in Ann-Arbor (AFMRD). Participants completed the 2-part survey that included demographics and 10 items across three domains (reasons for CPD, preferred resources, learning modalities) rated on 5-point rating scales (5=highest). Top factors and rating differences across participants’ country, gender, stage in career, were evaluated using a many-facet Rasch model. Results: Two-hundred, seventy-three FMs completed the survey. Top reason for participation in CPD was “Willingness to try new things” for both FMs in Mersin and Ann-Arbor. FMs in Mersin indicated “Simulation-based training” had higher importance as a learning modality than FMs in Ann-Arbor, but reported less use of simulation for CPD. Other detailed findings and their implications are discussed. Conclusions: Findings suggest that FMs in Mersin feel that simulation is an important educational modality for CPD but it is not widely employed. This suggests that there are opportunities for the development of novel, simulation-based CPD curricula targeted to FM physicians in Mersin. with potential expansion to other developing countries. Giris: Turkiye’de, Surekli Mesleki Gelisim (SMG) de simulasyon kullanimini tesvik etmek amaciyla, Turkiye’nin Mersin ilindeki aile hekimleri ile Amerika’nin Ann-Arbor bolgesindeki aile hekimlerinin egitimlerinde simulasyon kullaniminin, hangi egitim metodlarinda ve konu alanlarinda fayda saglayabilecegini belirlemek icin SMG programlarinda simulasyon ve kaynak kullanim aliskanliklari arastirildi. Yontem: Mersin (MAHDER) ve Ann-Arbor (AFMRD) aile hekimleri derneklerine mail yoluyla degerlendirme anketleri gonderildi. Katilimcilarin tamamladiklari anket, demografik verileri ve uc alani kapsayan (SMG sebepleri, tercih edilen kaynaklar, ogrenim modaliteleri) 5 lik skalada degerlendirilen (5= en yuksek) 10 soruluk 2 kisimdan olusmustu. Katilimcilarin ulke, cinsiyet, ve kariyerlerine gore temel faktorler ve puanlama farkliliklari many-facet Rasch teknigi kullanilarak degerlendirildi. Bulgular: 273 aile hekimi anketi tamamladi. Mersin ve Ann-Arbor daki aile hekimlerinin herikisi icin de, SMG’ye katilimda en onemli faktor “yeni seyleri denemeye isteklilik’’ idi. “Simulasyon temelli egitimi’’ bir ogrenme sekli olarak, Mersin’deki aile hekimleri, “Ann-Arbor’’ daki aile hekimlerine gore daha onemli bulduklarini, ancak SMG’de daha az kullandiklarini belirttiler. Diger sonuclar ve uygulamalar tartisildi. Sonuc: Bu bulgular, Mersin’deki aile hekimlerinin SMG’de simulasyon kullaniminin onemli bir egitim sekli oldugunun farkinda olduklarini ancak yaygin olarak kullanmadiklarini gostermistir. Bu durum Mersin’deki ve diger gelismekte olan ulkelerdeki aile hekimlerine yonelik yeni, simulasyona dayali SMG mufredatinin gelistirilmesi icin firsatlar oldugunu onermektedir.

Using Simulation-Based Education to Improve Residents’ Clinical Decision Making Skills in Developing Countries

Background: Recently, a significant increase occured in the use of medical simulation technology for teaching and assessment. Improved patient safety during medical education has driven simulation-based education (SBE), particularly in resident education. Although many countries have integrated SBE into their undergraduate programs, some developing countries, including Turkey, have been slow to apply SBE into their graduate programs. We propose a review of existing examples of SBE used which may promote the implementation of similar curricula in developing countries. Methods: To derive a representative sample of relevant curricula, we performed a web-based literature review using the search terms “simulation” and (“ graduate, resident”) and (“clinical decision-making” or ‘‘clinical reasoning”) and “training’’. Results: Of the 83 original articles, ten resulting articles were relevant to SBE used to support residents’ clinical decision-making in six clinical areas. We summarize the ten curricula and discuss them in the context of three primary considerations (course administration, content development, and assessment program evaluation) so they may be applied in similar graduate curricula in Turkey and others. Conclusions: It is obvious that simulation-based education offers benefits. In particular, graduate-level training programs used to support clinical decision-making are critical to the development of competent physicians around the world.