Zekeriya Akturk

Infrared tympanic thermometer can accurately measure the body temperature in children in an emergency room setting

OBJECTIVE The objective in this study was to compare the accuracy of the tympanic membrane infrared thermometer with the other conventional temperature measurement options. METHODS One hundred and ten randomly selected pediatric patients who admitted to our emergency room were included in the study. Each child underwent simultaneous temperature measurement via rectum, axilla, and external auditory canal. The rectal and axillary measurements were performed using conventional mercury in glass thermometers. The aural measurement was performed using the non-contact infrared thermometer (Braun ThermoScan IRT 1020, Germany). RESULTS On aural measurement, the results of both ears as well as the first, second and third measurements were similar (P<0.01). The mean results of the axillary, rectal and tympanic temperature measurements were 37.46+/-1, 38.18+/-1, and 38.01+/-1.1, respectively. The mean axillary temperature was 0.72 degrees C lower than the mean rectal temperature, and 0.55 degrees C lower than the tympanic temperature. The difference between the mean tympanic and rectal temperatures was 0.17 degrees C. The results of measurements via rectum, axilla and ear were similar (P<0.01). CONCLUSION In conclusion, it is apparent that each of the temperature measurement options has some advantages and disadvantages. An optimal thermometer should have the following features; accurate temperature measurement; ease of application in a short while; safety and absence of potential risks; and tolerability by the patient. Since the aural infrared thermometer meets these criteria, its use in the routine clinical practice appears to be advantageous rather than or complementary to the conventional methods.

Acupuncture decreases matrix metalloproteinase-2 activity in patients with migraine.

Objective To evaluate the effect of acupuncture on the serum matrix metalloproteinase-2 (MMP-2) level and activity in patients with migraine. Methods After baseline testing, eligible patients with migraine according to the criteria of the International Headache Society who volunteered to join the study were included (n=27). The patients received 10 sessions of acupuncture treatment. The points selected were bilateral ST8, ST44, LI4, LI11, LIV3, SP6, GB1, GB14, GB20, GV14, GV20, Yintang, Taiyang and ear Shenmen. Pain was measured using a visual analogue scale (VAS). Short form-36 (SF-36) was used to determine their quality of life. Blood samples were taken before treatment and after the first and last sessions of acupuncture for measurement of MMP-2 concentration and activity. Results The mean VAS was 85.5±16.6 before acupuncture and was significantly decreased to 39.8±20.6 after 10 sessions of acupuncture (p<0.0001). There was a significant increase in all SF-36 scores after acupuncture compared with values before treatment (p<0.0001). No significant differences were found in MMP-2 concentrations before treatment and after the first and last sessions (p>0.05). However, there were significant changes in MMP-2 activity (p<0.0001). Conclusions The results of this study showed a clinically relevant decrease in MMP-2 activity in patients with migraine treated with acupuncture. The mechanism underlying the effect of acupuncture in alleviating pain may be associated with a decrease in MMP-2 activity.

The effect of pedometer use on physical activity and body weight in obese women

Abstract Physical activity and healthy eating are of the utmost importance in treatment of obesity. However obese generally tend to have a sedentary lifestyle. Walking is a form of physical activity that is both simple and can be performed by everyone, but it requires an objective measurement. Number of steps taken during tracking can be recorded with the pedometer, a device used to measure the level of physical activity. We aimed to investigate whether or not using pedometers as a motivational technique to increase the level of physical activity in obese women has an impact on weight loss. Eighty-four obese women who are similar age referring to Ataturk University Faculty of Medicine Healthy Living Clinic, Turkey were randomly divided into two groups. Intervention group were given pedometers, and control group were prescribed similar diet and physical activity with a three-month follow-up plan without pedometers. Mean weight in pedometer group initially was 88.9 ± 8.4 kg, which decreased to 80.2 ± 8.7 kg after the programme. Mean weight in control group was 86.1 ± 9.2 kg at the beginning, and it decreased to 84.7 ± 8.8 kg after three months. It was observed in pedometer group that the mean number of steps 8817 ± 2725 steps/day at the beginning increased to mean 9716 ± 2811 steps/day at the end of the study. Weight, body mass index, body fat percentage and waist circumference measurements decreased more greatly in the pedometer when compared to the control group (p < 0.001). Pedometers may be recommended to obese patients to monitor and increase the level of physical activity and to promote weight loss.

Patient satisfaction with family practice in Turkey: Three-year trend from 2010 to 2012.

Background: After the health reform in 2003, a need emerged to monitor patient satisfaction in Turkey. Objective: To evaluate patient satisfaction with family practice in Turkey and compare with some other European countries. Methods: The study was performed on a countrywide representative sample from all the 81 provinces of Turkey. Data were collected during the years 2010–2012 from patients visiting family practice centres. A three-year repeated cross-sectional study was conducted using the EUROPEP instrument. Twenty-six questions with a five-point Likert scale were applied. Primary outcome measures of the study were the mean EUROPEP scores (min. 1, max. 5). Results: Mean (± SD) EUROPEP scores for the years 2010 (n = 34 472), 2011 (n = 34 764), and 2012 (n = 32 667) were 4.09 ± 0.77, 4.29 ± 0.59, and 4.42 ± 0.54 respectively (F = 1565.37; P < 0.001). The mean satisfaction percentage was calculated as 88.3%. Areas of lowest satisfaction were ‘Being able to speak to the GP on the telephone,’ ‘Getting through to the practice on the phone,’ and ‘Physical conditions of the family practice.’ Conclusion: Although in small increments, patient satisfaction with family practices in Turkey has increased during the last few years.

[Knowledge, attitudes, and behavior of people living in rural areas of Erzurum about Crimean-Congo hemorrhagic fever].

OBJECTIVE After 2002 more and more Crimean-Congo Hemorrhagic Fever (CCHF) cases have been reported and it has become a major public health problem in Turkey. In order to fight CCHF, it is important to inform the public and direct them towards appropriatet attitudes and behavior. Therefore assessment of the effectiveness of health education in the community is essential. METHODS A research was carried out for this purpose in the province of Erzurum between May 2010 and September 2010 through a survey. RESULTS The results depicted that the majority of participants have knowledge that CCHF transmitted by ticks and they should be removed as soon as possible from the body through safe methods. However, in terms of correct attitude and behavior, women were found to have a lower level compared with men. CONCLUSION The training of health workers and an increase in the efforts to make the community, especially the women, aware of this problem is ugently needed.

Delayed diagnosis of a case of Zenker’s diverticulum. What may happen when a family physician does not visit his family physician

Abstract Introduction: Zenker’s diverticulum is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle. It occurs commonly in elderly patients (over 70 years) and the typical symptoms include dysphagia, regurgitation, chronic cough, aspiration and weight loss. Case: We are reporting dysphagia in a 49-years old man who was treated as having Helicobacter Pylori gastritis for three years. Being a family physician himself, the patient applied to specialists in gastroenterology, bypassing primary care. During a casual interview on his symptoms, a family physician referred him to undergo a repeated endoscopy with suspected Zenker’s diverticulum. After being diagnosed with Zenker’s diverticulum, the patient underwent surgical intervention at the department of thoracic surgery and made a full recovery. He regained five kilograms at the end of five weeks after the operation. Conclusion: This case demonstrates once more the importance of history taking and follow-up in medical care. Attentive listening by a family physician could have probably prevented the delay of service in this case.