Özgür Erdem

Effects of Ramadan Fasting on Biochemical and Hematological Parameters and Cytokines in Healthy and Obese Individuals

BACKGROUND The typical nutritional plan in Ramadan may have beneficial influences on the inflammatory state, as well as on metabolic and anthropometric parameters. We aimed to investigate the effects of Ramadan fasting on biochemical and hematological parameters and cytokines in healthy and obese individuals. METHODS This study was performed during the Ramadan holy month (September and October 2007). The study group consisted of 10 obese males and the control group consisted of 10 males with a normal body mass index (BMI), who were admitted to the Family Medicine Outpatient Clinic of Dicle University Medical Faculty in Diyarbakir, Turkey, and who indicated that they were going to fast throughout the entire month of Ramadan. Individuals with any acute or chronic disease or medication during the study were excluded. Height, weight, BMI, and waist and hip circumferences were measured. High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), urea, creatinine, insulin, total protein, albumin, C-reactive protein (CRP), lactic dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and cytokine levels were evaluated. RESULTS The average age of the participants was 27.4 ± 5.2 years. Of the study group, 7 fulfilled the criteria of metabolic syndrome. Significant weight reduction, significant decrease in BMI, and significant decrease of homeostasis model assessment of insulin resistance (HOMA-IR) and fasting blood glucose (FBG) were observed in study group; weight and BMI reduction were insignificant and no significant change was observed in FBG levels, but a significant increase was observed in HOMA-IR in the control group. Post-Ramadan systolic and diastolic blood pressure values, serum white blood cells (WBC) count, interleukin-2 (IL-2), IL-8, tumor necrosis factor-α (TNF-α, TG, and ALT levels were significantly lower in both groups compared to pre-Ramadan values. CONCLUSION Ramadan fasting has beneficial influences on the inflammatory state, as well as metabolic and anthropometric parameters.

Postpartum depresyon görülme sıklığı ve tarama yöntemleri

Postpartum Depression is the most common complication of the delivery and affects approximately 10%-15% of women who had just gave birth. During a period in which women believe that they should be happy, the depressive mood experienced by most women leads to feelings of guilt, hiding the symptoms, and postpartum depression to be overlooked. Although the incidence of serious psychiatric disorders during pregnancy is low, it is reported that the incidence shows a dramatic increase during the postpartum period and this risky period may continue up to six months, one year or even two years. As the onset of postpartum depression is insidious it can easily be overlooked if the patient’s seeking help is not supported, especially when the severity of postpartum depression is mild or moderate. In these cases, postpartum depression may persist for a long time and at last it can be so severe that hospitalization would be needed. Therefore, early diagnose is very important and primary care physicians and other health care workers should be alert. Postpartum Depression should be diagnosed using reliable descriptive methods in puerperant women. The scales such as Postnatal Depression Screening Scale, Beck Depression Inventory, Edinburgh Postnatal Depression Scale and State-Trait Anxiety Inventory, all of which were tested for validity and reliability in our country can be used during follow-up of pregnant and puerperal women. OZET

The Characteristics of Families who rejected Vaccination during the Mop-up Oral Polio Vaccination Campaign and Their Reasons of Rejection: A Family Health Center Experience

OZET Amac: Mop-Up Polio asi kampanyasi, cocuk felcinin ortadan kaldirilmasi icin uygulanan asilama calismalaridir. Bu calismada amacimiz, Diyarbakir’da bir aile sagligi merkezi bolgesinde Mop-up oral polio asi (OPA) kampanyasi kapsaminda cocuklarina OPA yapilmasini reddeden ailelerin ozelliklerinin ve asiyi reddetme nedenlerinin belirlenmesidir. Yontem: Veriler Mop-up OPA kampanyasinda, cocuklarina asi yapilmasini reddeden ailelerle yuz yuze gorusulerek elde edildi. Anket formu; aile ve cocuklarin sosyo-demografik ozellikleri ve OPA’nin reddedilmesi ile ilgili 14 sorudan olusturuldu. Bulgular: Kampanya boyunca 1250 cocuk asi programina alindi. Bunlardan 38 tanesi (%3.04) asiyi reddetti. Asisi yaptirilmayan bu cocuklarin yas ortalamasi 23.2±17.7 ay idi. En kucugu 3 gunluk ve en buyugu ise 59 aylik idi. Ankete cevap veren aile bireyleri incelendiginde; %71’ini cocugun annesi (n=27), %8’ini cocugun babasi (n=3) ve %21’ini ise cocugun diger yakinlari (n=8) olusturmaktaydi. Asiyi reddeden ailelerin cocuklarinin %94.7’sinin diger asilari; Saglik Bakanligi Ulusal asi takvimine gore tam iken (n=36), %5.3’unun ise diger asilarinin eksik oldugu (n=2) tespit edilmistir. Cocuklarin %81.6’sina daha once OPA yapilmis iken (n=31) %18.4’une ise hic yapilmamistir (n=7). Sonuc: Asilama faaliyetlerinin yurutulmesinde ebeveynlerin egitim seviyeleri ve farkindalik duzeyleri hedeflenen asilama oranlarina ulasilmasi icin onemlidir. Yapilacak asi kampanyalarinda ailelerin asilama konusunda egitilmesi ve farkindaliklarinin arttirilmasinin asi retlerini azaltacagi kanaatindeyiz.

The prevalence and level of awareness for metabolic syndrome among primary health care professionals in the Southeastern Anatolia

1) Dicle Üniversitesi Tıp Fakültesi Aile Hekimliği Anabilim Dalı, Diyarbakır 2) Dicle Üniversitesi Tıp Fakültesi Biyokimya Anabilim Dalı, Diyarbakır 3) Dicle Üniversitesi Tıp Fakültesi Halk Sağlığıi Anabilim Dalı, Diyarbakır 4) Merkez 11 Nolu ASM, Batman 5) Katip Çelebi Üniversitesi Tıp Fakültesi Aile Hekimliği Anabilim Dalı, İzmir 6) Adıyaman Üniversitesi Tıp Fakültesi Aile Hekimliği Anabilim Dalı, Adıyaman 7) Yenişehir 7 Nolu ASM, Diyarbakır 8) Çınar Devlet Hastanesi, Diyarbakır 9) Yenişehir 5 Nolu ASM, Diyarbakır 10) Dicle Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Diyarbakır

The relationship between iron defi ciency anemia and gestational status in women

Cocukluk caginda fi zik muayene ve laboratuar yontemleri ile netlestirilmeden yuksek doz D vitamini kullanilmasi onemli yan etkilere yol acabilmektedir. Bu olgu sunumunda dort ay icinde gelisme geriligi nedeni ile bes kez D vitamini ampul (300.000 U) verilen 13 aylik kiz cocugunun klinik ve laboratuar bulgulari degerlendirilmistir. Iatrojenik subklinik D hipervitaminozu tanisi oyku, laboratuar ve radyolojik bulgularla konuldu. Tetkiklerinde hiperkalsemi, parathormon dusuklugu, 25(OH) D vitamin duzeyinin yuksekligi, hiperkalsiuri ve meduller nefrokalsinozis saptandi. Bu olgu sunumunda yanlis ve gereksiz yuksek doz D vitamini kullanimi ve komplikasyonlarinin degerlendirilmesi amaclanmistir.Brucella infection is a systemic disease. It rarely causes local infections like hepatitis in gastrointestinal system. In this article we would like to present an acute hepatitis case related to brucella infection that followed up in our clinic. A male, 30 year-old patient hospitalized due to common muscle pain, high fever and vomiting. During the physical examination the patient\s skin, scleras and mucosal membranes were icteric, the liver was 2-3 cm palpable and tender. Laboratory fi ndings were as follows: AST:1190 U/L; ALT:715 U/L; GGT:961 U/L; ALP:369 U/L; total bilirubin:4.6 mg/dL; direct bilirubin:2.1 mg/dL. Viral markers were found to be negative. We started treatment with streptomicine and doxicycline since, the patient\s standard brucella tube agglutination test was positive (1/60) and brucella spp produced in his blood culture. From the second day of the treatment, we started to get clinical response. On the 17th day of the treatment, he discharged from the hospital because ALT, AST and bilirubine level were found normal and his treatment was completed to the 8 weeks. Brucella is continuing to be an important health problem especially who live in surrounding countryside and have to keep in mind in the differential diagnosis of the acute hepatitis.Adnexal masses have been more frequently detected after common use of ultrasonography (USG). In this study follow-up and management protocol of an adnexal mass during pregnancy was reviewed in the light literature fi ndings. Adnexial masses during pregnancy are managed according to preliminary diagnosis, pregnancy weeks, symptamotology, USG and examination fi ndings and family\s preference. Due to complication risk of surgical operation in pregnancy, appropriate treatment protocols should be prepared in order to fi nd best approaches. In conclusion, adnexes should be carefully examined with obstetrical USG and indication for surgical operation should be made more carefully.