Medical Doctor

Background Dry eye disease is a common age-related disease in the world. Vitamin B12 is an essential factor in maintaining eye health and has antioxidant properties that protect the surface of the eye from damage caused by harmful factors, such as reactive oxygen species. Hyaluronic acid polymer is also similar to natural eye tears with its biocompatibility and physical properties. This polymer is one of the important components of the extracellular matrix. Objective Due to the lack of formulations containing the combination of vitamin B12 and hyaluronic acid in the country and the appropriate effects of these two compounds for dry eyes, this study formulates and analyzes the stability of eye drop formulation based on hyaluronic acid and vitamin B12. Methods First, the formulation of hyaluronic acid and vitamin B12 solution with borate buffer was prepared and the stability of vitamin B12 was evaluated. Next, the physicochemical properties of the prepared formulations were evaluated and a sterile ophthalmic solution was prepared from the selected formulations under aseptic conditions. Finally, by choosing the final formulation, accelerated stability was achieved. Results Accelerated studies after six months showed that the amount of vitamin B12 and its ultraviolet absorption did not decrease, and the physicochemical properties, such as solution pH, color, and viscosity did not change. Conclusion This formulation could be a good candidate for industrial production and long-term stability studies are recommended.

Background: Patient registration with a primary care providers supports continuity in the patientprovider relationship. This paper develops a framework for analysing the characteristics of patient registration across countries; applies this framework to a selection of countries; and identifies challenges and ongoing reform efforts. Methods: 12 jurisdictions (Denmark,

Zehirlenme; yaralayýcý veya öldürücü bir madde ile oluþan kimyasal reaksiyon sonucunda genellikle ölüm, yaralanma veya kuvvette azalma ile karakterize bir olay olarak tanýmlanýr (1). Dozaþýmý terimi ise; genel anlamda kasýtlý olarak toksik dozda ilaç alýmý olup, intihar amaçlý ilaç kullanýmý buna örnek olarak gösterilebilinir (1).

A medical resume is an important document containing a summary of patient care while they are in hospital. The filling of the medical resume affects the claim process of the National Health Insurance (NHI) program. Medical resume is filled by Medical Doctor in Charge (MDiC). A preliminary study at private hospital "RSI Jemursari Surabaya" showed 86.67% incomplete BPJS claim files because there were no medical resumes. The purpose of this study was to analyze the level of medical obedience in filling medical resume and the factors that influenced based on individual characteristics. It was a descriptive quantitative study, and the measuring tools used in this study consisted of questionnaire, observation, and checklist of medical resume sheet. Variables for individual characteristics in this study included gender, age, length of employment, employment status, and specialization groups. Analysis in this study used cross tabulation. The results showed that the obedience of medical resume filling was good. MDiC that tended to be less obedient in filling medical resume had the characteristics of being a woman, aged more than 40 years old, having length of employment for more than five years, being in the group of partner-doctor, and classified as non-surgical doctor. MDiC's obedience in filling medical resume can be improved by providing socialization of the importance of medical resume and making compliance of medical resume filling as an indicator of performance appraisal.

Gi rifl: Öğrencilerin klasik eğitimle aldıkları temel tıp bilimleri bilgilerini klinik yıllara ve klinik pratiğe taşıyamadıkları ve probleme dayalı öğrenimin (PDÖ) bu eksiği kapatabileceği ifade edilmektedir. Teorik farmakoloji eğitimini tamamlamış olan üçüncü sınıf öğrencilerinin çocukluk çağı zehirlenmeleri hakkındaki bilgi düzeylerinin hazırlanmış PDÖ senaryosu ile ölçülmesi amaçlandı. Gereç ve Yöntem: Bu çalışmada 2009-2010 akademik yılının 2. yarıyılı ortasında 2. PDÖ senaryosu olarak uygulanan bir çocukluk çağı zehirlenme olgusu öncesinde ve sonrasında araştırmacılar tarafından hazırlanan bir anket formu rastgele örnekleme yöntemiyle seçilen PDÖ gruplarına isimsiz ve gönüllülük temelinde uygulandı. Demografik bilgiler, zehirlenme vakası karşısında tutumlarını ve bilgi düzeylerini ölçmeye yönelik açıkkapalı uçlu sorular ile öncelik sıralaması yapma şeklindeki ifadelerden oluşan anket formunun değerlendirilmesinde sayılar, yüzdeler ki-kare ve Student-t testi kullanıldı. Bulgular: Çalışma grubunda, ön testte 89 öğrenci, son testte 96 öğrenci yer aldı. Refik Saydam Hıfzıssıhha Ulusal Zehir Danışma Merkezi (UZEM) verilerine göre çok sık zehirlenme başvurusu yapılan maddelerden oluşturulan listeye verilen yanıtlarda örneğin; losyon, banyo köpüğü, kozmetikler, suluboya ve kalaminli losyonlar gibi öğrencilerin ön testte toksik dedikleri maddeler son teste anlamlı olarak doğru cevaplanmıştı (p<0,05). Toksik oldukları halde öğrenciler tarafından ön testte nontoksik olarak işaretlenen örneğin anti-depresanlar, kalsiyum kanal blokerleri, oral antidiyabetikler gibi pratikte çok sık kullanılan ilaçlar ile ilgili bilgilerde de doğru cevap sayısı anlamlı olarak artmıştı (p<0,05). Bu 40 madde için ön testte ortalama doğru bilgi puanı 17,52±5,82 iken son testte 27,89±8,79'a yükselmiştir (p<0,001). Sonuç: Bu çalışmanın sonuçları teorik olarak farmakoloji bilgisi almış öğrencilere uygulanan PDÖ senaryosunun çocukluk çağı zehirlenme vakaları açısından öğrencilerde bilgi artışına sebep olduğunu göstermektedir. (Gün cel Pe di at ri 2011; 9: 68-74) Anah tar ke li me ler: Zehirlenme, çocuk, probleme dayalı öğrenme, öğrenciler, tıp SUM MARY In tro duc ti on: It is stated that students cannot carry their knowledge on basic medical sciences that they gained with classical education to clinical classes and clinical practice and problem based learning (PBL) can compensate this drawback. It was aimed to evaluate the effect of PBL scenario written on this topic on level of knowledge about childhood poisoning of third class students who completed the most of theoretical pharmacology education. Materials and Method: A questionnaire form prepared by researchers was applied to randomly chosen PBL groups without writing names and on the basis of voluntariness before and after a case of childhood poisoning which was applied as the second PBL scenario in the second midterm of 2009-2010 academic years. Numbers, percentages, chisquare and student's t-test were used for evaluation of the questionnaire form comprised Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce

The paper investigates experiences of employees and middle managers in relation to the transition from working from office to working from home in the context of COVID-19 pandemic in Romania. Three online focus groups were conducted to explore working experience in the new mode of work. The conclusions are multifaceted, covering four dimensions: time, spatial, social and technical, and point out how employees and middle managers understand the transition and what impact telework had on their job satisfaction and work productivity.

The dissertation explores the ends of medicine in Catholic theology. It focuses on the study, from a theological and teleological viewpoint, of two concepts: caring and curing. The main question is: What is the relationship between caring and curing as ends of medicine in Catholic theology?The method is theological with the study of the Bible, the Fathers of the Church and the Magisterium of the Catholic Church, with adding philosophical (or ethical) and theological traditional and modern sources.The dissertation is divided into four parts: Part One is a biblical study which begins with the Old Testament where God appears as the only one who can cure illnesses. But a reflection on wisdom includes the role of physicians who cooperate in God’s plan for the well-being of humanity. The New Testament, especially the parable of the Good Samaritan, confirms that care is the primordial end of medicine. However, this does not mean that cure is a secondary end. In Part Two, we present the ima...

The study entitled 'Attitude of Couples towards Family-Planning' was conducted with an aim to assess the knowledge, understanding and attitude of couples towards family planning across the two ecological settings of Jammu district. The influence of education on the attitude under consideration was also evaluated. Sample for the study comprised 200 married couples drawn from Jammu district through stratified random sampling technique. The tools for data collection included interview schedule, questionnaire and a rating scale. The results witnessed a high prevalence of illiteracy and associated ignorance among rural masses (35%) especially regarding the concepts and measures of family planning (χ 2 = 14.24, Sig. 1%). Majority of rural respondents especially women folk (51%) were unaware of concepts related to family planning. Condoms were by far the most favourable contraceptive measures across both settings (81% males and 77.5% females) followed by birth spacing pills (39%). The appropriate knowledge regarding other measures e.g. Copper-T (13.5%) and male sterilization was lacking. Further, urban respondent entrusted the contraceptive responsibility on their respective partners (43% males, 44% females), while rural couples (74% females and 64% males) followed the same age-old traditional concept of male dominance and superiority. Television and magazines were found to be the major accessible sources of information. Results from rating scale revealed a major difference (χ 2 = 54.66, Sig. 1%) in the attitude of respondents. Education was found to be significantly associated with the respective attitude of respondents towards family planning.

Araştırmalar / Researches ÖZET Öz kıyım amaçlı adölesan ve erişkin ilaç zehirlenmeleri arasındaki farklılıklar Amaç: İlaç zehirlenmeleri acil servislere önemli başvuru nedenlerinden biridir. Bu konuda adölesanlar ile erişkinler arasında yapılmış karşılaştırmalı çalışmalar nadirdir. Bu çalışmada adölesan ile erişkin yaş grubu arasındaki ilaç zehirlenme olgularını karşılaştırarak, demografik ve klinik özelliklerinin tanımlanması ve alınabilecek önlemlerin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: 1Haziran 2009-30 Haziran 2010 tarihleri arasında Acil Tıp Kliniği'ne başvuran adölesan yaş grubu (9-19 yaş) ve erişkinyaş grubu (19 ve üstü yaş) ilaç zehirlenme olguları geriye dönük olarak değerlendirildi. Hastaların yaş, cinsiyet, ilacı ne amaçla aldığı, tedavide antidot kullanımının olup olmadığı, tek veya çoklu ilaç alıp almadığı, aldığı ilacın hangi gruptan olduğu, hastanede kalış süresi ve klinik sonuçlar kaydedildi. Bulgular: Çalışmaya toplam 278 hasta alındı. Hastaların %39.2'si adölesan (n=109), %60.8'i erişkindi (n=169). Adölesan erkek %15.6 (n=17) iken, erişkin erkek %20.1 (n=34), adölesan kadın %84.4 (n=92), erişkin kadın %79.9 (n=139) olarak bulundu. Ortalama yaş adölesan grupta 16.68±1.774 yıl iken erişkin grupta 27.87±7,264 yıl idi. Tedavide antidot kullanımı adölesanlarda %30 (n=3) iken, erişkinlerde %70 (n=7) idi. Özkıyım amaçlı ilaç alımı adölesanlarda %39.2 (n=109), erişkinlerde %60.8 (n=169) idi. Çokluilaç alımı adölesanlarda %51.9 (n=42) , erişkinlerde %48.1 (n=39) idi. Zehirlenmeye neden olan ilaç grubu adölesanlarda %46.9 (n=23) parasetamol iken, erişkinlerde %65.2 (n=30) antidepresan ilaçlardı. Hastaların hastanede kalış süresi adölesan grupta 1.19±0.775 saat iken, erişkin grupta 1.15±0.617 saat idi. Hiçbir hastamız hayatını kaybetmedi. Sonuç: Akut zehirlenmeler acil servisler için önemli bir medikal sorundur. Özkıyım amaçlı en yaygın yöntem ilaç alımıdır. Hem erişkinlerde hem adölesanlarda ilaç zehirlenmeleri, kadınlarda daha yaygındır. Özkıyım amaçlı ilaç zehirlenmeleri erişkinlerde adölesanlaragöre daha fazladır. Kullanılan ilaç grubu olarak ilk sırada adölesanlarda parasetamol iken, erişkinlerde antidepresan ilaçlardır. Çoklu ilaç alımı ise adölesanlarda erişkinlere göre daha fazladır. Risk faktörleri belirlenerek bunlara yönelik önlemlerin alınması ve toplumsal eğitim faaliyetlerinin planlanması yoluyla bu tür zehirlenme olgularının sayısının azaltılabilmesi mümkündür.

Background and objectives: Meningitis is one of the most common infectious of the central nervous system (CNS), defined as an inflammation of the meninges. LIF is a potent proinflammatory factor. Cerebrospinal fluid (CSF) contains the growth factors and cytokines whose concentrations have been changed in most neurological diseases. The aim of this study was to determine the LIF concentration of serum and CSF in the children with bacterial meningitis. Material and Methods: In this study, the total protein concentration (TPC) and LIF in the serum and CSF of normal subjects and children with bacterial meningitis were measured by enzyme linked immunosorbent assay (ELISA). Results: the Values of serum TPC for children with meningitis (74.17±7.73 g/L) and controls (73.50±7.28 g/L) are not different significantly (P=0.7), and the TPC in the CSF of children suffering from meningitis and controls are 35±0.03 and 0.34±0.05 g/L, respectively (P=0.65). The concentration of serum LIF for childre...

Over the last few years, the military healthcare system undergone restructuration. Under this process, healthcare units under this system, aimed at attaining efficiency gains, through clearer focus and specialization on specific areas of care. In August 2012, military units were merged, forming a single unit.

This study was designed for assessing the impacts of related progress on organization‘s innovation capacity and organizational learning, with the assumption that it will ease ensuring participation of employees to the decision taking progress performed for making choice among the choices, sharing, interpreting and transferring the information needed during choice. Data was analyzed with Pearson correlation and linear regression analyses using the data collected from academicians Selcuk University Selcuklu Faculty Medicine‘s Hospital with the survey prepared by using developed scales with an intensive organization. It was determined that there is a strong, positive and meaningful relation between employees‘ participation to decision making progress and the organization‘s innovation capacity and organizational learning, and the related process (in accordance with the results of studies previously made on the subject) affects innovation capacity and organizational learning in positive way.

Avaliar e caracterizar o papel da especialidade de Imunoalergologja (IA) no apoio a doentes internados ao cuidado de outras especialidades. Métodos: Revisão dos pedidos de colaboração realizados ao serviço de IA entre janeiro de 2018 a junho de 2019, através da consulta dos processos clínicos dos doentes, com colheita de dados demográficos, motivo de internamento e do pedido de colaboração, diagnóstico imunoalergológico e orientação. Resultados: Foram identificados 177 pedidos de colaboração correspondentes a 157 internamentos de doentes com idade entre os 7 meses e os 89 anos, 52% dos quais do sexo feminino. Os pedidos mais frequentes resultaram da suspeita de reação de hipersensibilidade a fármacos (83%), seguido de pedidos para apoio na decisão terapêutica e exacerbação de asma. Os 177 pedidos originaram 446 visitas médicas de IA a internamentos (média de 2,6 visitas/ /doente). A suspeita de hipersensibilidade a fármacos foi confirmada em 64% dos casos, com diagnóstico de reações cutâneas graves em 19% e anafilaxia em 6%. A taxa de mortalidade foi de 5,1%, e 46,2% foram posteriormente avalia

Insecticides have a great importance in the increase of agricultural productivity and maintaining of public health. However, they can cause serious poisoning cases and even deaths at times due to accidental, intentional or occupational exposures. Thus insecticide poisoning cases are encountered frequently in Turkey as well as throughout the world. The first part of this review focused on the toxicological profiles of various insecticide groups (organophosphates, organochlorine insecticides, pyrethrines, pyrethroids, amitraz and other insectides (avermectines, diethyl-m-toluamid (DEET) and neonicotinik acid derivatives), and diagnosis and treatment of poisoning with those insecticides marketed in Turkey. In the second part, the studies on insecticide poisonings which were conducted in Drug and Poison Centers, Institutes of Forensic Science, Departments of Forensic Medicine, University and State Hospitals and Medical Centers in Turkey were evaluated with the aim of contributing the whole picture of the situation in Turkey. In review of these reports it was found that the most frequently occurred cases resulted from exposures with organophosphate compounds, and females were more vulnerable than males. It is noteworthy that there are numerous reports in Turkey regarding poisoning cases with amitraz, which was used mostly as a veterinary drug, especially in children despite no cases in the developed ÖZET İnsektisitler, hem tarımsal üretimin artırılmasında hem de ev ve toplum sağlığında çok önemli bir yere sahiptir. Ancak üretim, ambalajlama ya da kullanımları sırasında gerekli özenin gösterilmemesi ya da intihar gibi suistimale bağlı olarak, kazai, kasti veya mesleki temas nedeniyle ciddi zehirlenmelere hatta bazen ölümlere yol açabilmektedirler. Tüm dünyada olduğu gibi ülkemizde de insektisitlerle zehirlenme olgularına sıklıkla rastlanmaktadır. Bu çalışmanın ilk bölümünde ülkemizde pazarlanmakta olan insektisit grupları olan organofosfatlar, organoklorlular, piretrinler ve piretroidler, amitraz ve diğer insektisitlerin (avermektinler, dietil-m-toluamid (DEET) ve neonikotinik asit türevleri) genel özellikleri, toksik etkileri, zehirlenme tanı ve tedavi yaklaşımları konusundaki bilgiler sunulmuştur. İkinci bölümde ise Türkiye'de pestisit / insektisit zehirlenmelerinin epidemiyolojisi ve tedavi yaklaşımları konusunda ilaç ve zehir bilgi merkezleri, adli tıp enstitüleri, üniversitelerin adli tıp ana bilim dalları, üniversite hastaneleri, devlet hastaneleri veya sağlık merkezleri tarafından bildirilmiş olan çalışma örnekleri değerlendirilerek Türkiye genelini kapsayan tablonun oluşturulmasına katkıda bulunulması hedeflenmiştir. Bu raporların değerlendirilmesinde en sıklıkla olguların organofosfatlı bileşiklere maruziyet sonucunda geliştiği, özellikle intiharlarda olmak üzere kadınların daha duyarlı olduğu belirlenmiştir. Gelişmiş ülkelerde rastlanılmamakla

Pestisit zehirlenmeleri genellikle kimyasalın intestinal yol ile intihar amaçlı alınması sonucu oluşurken, parenteral (perkutan veya intravenöz) enjeksiyon yolu ile zehirlenmeler oldukça nadir görülmektedir. 19 yaşında erkek hastayı sol antekübital bölgeden parenteral yolla miktarını bilmediğimiz deltametrin ve dimethoat etken maddeli tarım ilacını enjekte ettikten sonra kardiyak arrest gelişmesi üzerine yoğun bakım ünitesine kabul edildi. Üç gün takip edilen hasta multiorgan disfonksiyonu gelişmesi sonucu kaybedildi. Literatürde pestisit zehirlenmelerine sık rastlanmakla birlikte bu şekilde bir miks pestisit intoksikasyonuna rastlanmamıştır. Bu nedenle nadir görülen bu olgunun yoğun bakım sürecini ve sonrasındaki otopsi ve toksikolojik analiz sonuçlarını paylaşmayı amaçladık. Organophosphate poisoning generally occurs due to intestinal absorption of the ingested drug for suicidal attempt, parenteral (percutaneous and intraveneous) poisoning is very rare in human. A 19 year old male...

Giriş: Öğrencilerin klasik eğitimle aldıkları temel tıp bilimleri bilgilerini klinik yıllara ve klinik pratiğe taşıyamadıkları ve probleme dayalı öğrenimin (PDÖ) bu eksiği kapatabileceği ifade edilmektedir. Teorik farmakoloji eğitimini tamamlamış olan üçüncü sınıf öğrencilerinin çocukluk çağı zehirlenmeleri hakkındaki bilgi düzeylerinin hazırlanmış PDÖ senaryosu ile ölçülmesi amaçlandı. Gereç ve Yöntem: Bu çalışmada 2009-2010 akademik yılının 2. yarıyılı ortasında 2. PDÖ senaryosu olarak uygulanan bir çocukluk çağı zehirlenme olgusu öncesinde ve sonrasında araştırmacılar tarafından hazırlanan bir anket formu rastgele örnekleme yöntemiyle seçilen PDÖ gruplarına isimsiz ve gönüllülük temelinde uygulandı. Demografik bilgiler, zehirlenme vakası karşısında tutumlarını ve bilgi düzeylerini ölçmeye yönelik açıkkapalı uçlu sorular ile öncelik sıralaması yapma şeklindeki ifadelerden oluşan anket formunun değerlendirilmesinde sayılar, yüzdeler ki-kare ve Student-t testi kullanıldı. Bulgular: ...

Aim: In our study, we aimed to evaluate intoxication cases who were admitted to the Umraniye Training and Research Hospital. Methods: Medical records of 277 cases with intoxication who applied to the Umraniye Training and Research Hospital between January 01st 2015 and March 31st 2015 were retrospectively analyzed in terms of demographic characteristics, origin, treatment and outcome. Results: 127 (45.8%) of the 277 cases were female and 150 (54.2%) were male. 62.8% were in the 18-29 age range and 25.3% were in the 30-39 age range. Intoxication most frequently occurred on weekends. The patients were most frequently admitted to the hospital at night. When the forms of poisoning were evaluated, 121 (43.7%) were due to medical drugs, 89 (32.1%) synthetic cannabinoids and 54 (19.5%) CO. Analgesics and tricyclic antidepressants were the most commonly used drugs in acute intoxications. The consultation rate of the suicidal cases with a psychiatrist was 24.9%. Conclusions: Analgesics and tricyclic antidepressants were the most used drugs in acute intoxications. Synthetic cannabinoids constituted an important proportion of the intoxication cases. Despite these results, consultation of the cases with suicidal attempts with a psychiatrist was reported at a very low percentage. Consultation with a psychiatrist of all patients who attempt suicide should be encouraged.

The study aimed to investigate the range of experiences and attitudes of Croatian medical doctors (MDs) related to vaccination and vaccine hesitancy. In January 2021 three asynchronous online focus groups were held using MRQual, a web-based platform, which included 46 MDs from all three levels of the healthcare system in Croatia. NVivo, a qualitative data analysis software package, was used for the thematic analysis of collected data. The participants expressed a high level of support for the Croatian immunization program and vaccines in general. However, some skepticism was expressed regarding new vaccines and the regulatory processes of their approval. A significant number of participants raised concerns over the approval of COVID-19 vaccines, especially given their rapid development. The results also revealed that the process of communication with patients is often based on the very elaborate categorizations of patients based on previous experience, which leads to prioritizing an...

Acceptance of the COVID-19 vaccine will play a crucial role in combating the current pandemic. Vaccine rollouts have started in most countries. To reach the desirable vaccine coverage and to enhance its uptake, it is imperative to assess vaccine hesitancy. Methods: To assess the current vaccine acceptability in Austria and its influencing factors, an online survey was created and comprised fifteen questions segmented into a sociodemographic part and the acceptance and influencing factors of the approval of the COVID-19 vaccine. Results: In total, 70% of the 1350 respondents thought that the COVID-19 vaccine is an effective way to prevent and control the virus, while 13% disagreed and 17% were uncertain. Further, 71% approved the rapid development and rollout of the vaccine, while 55% were willing to accept the vaccine as soon as it became available, 18% did not want to get the vaccine, 17% wanted to delay, and 10% were already vaccinated. Conclusions: The results show a generally po...

Araştırmalar / Researches ÖZET Öz kıyım amaçlı adölesan ve erişkin ilaç zehirlenmeleri arasındaki farklılıklar Amaç: İlaç zehirlenmeleri acil servislere önemli başvuru nedenlerinden biridir. Bu konuda adölesanlar ile erişkinler arasında yapılmış karşılaştırmalı çalışmalar nadirdir. Bu çalışmada adölesan ile erişkin yaş grubu arasındaki ilaç zehirlenme olgularını karşılaştırarak, demografik ve klinik özelliklerinin tanımlanması ve alınabilecek önlemlerin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: 1Haziran 2009-30 Haziran 2010 tarihleri arasında Acil Tıp Kliniği'ne başvuran adölesan yaş grubu (9-19 yaş) ve erişkinyaş grubu (19 ve üstü yaş) ilaç zehirlenme olguları geriye dönük olarak değerlendirildi. Hastaların yaş, cinsiyet, ilacı ne amaçla aldığı, tedavide antidot kullanımının olup olmadığı, tek veya çoklu ilaç alıp almadığı, aldığı ilacın hangi gruptan olduğu, hastanede kalış süresi ve klinik sonuçlar kaydedildi. Bulgular: Çalışmaya toplam 278 hasta alındı. Hastaların %39.2'si adölesan (n=109), %60.8'i erişkindi (n=169). Adölesan erkek %15.6 (n=17) iken, erişkin erkek %20.1 (n=34), adölesan kadın %84.4 (n=92), erişkin kadın %79.9 (n=139) olarak bulundu. Ortalama yaş adölesan grupta 16.68±1.774 yıl iken erişkin grupta 27.87±7,264 yıl idi. Tedavide antidot kullanımı adölesanlarda %30 (n=3) iken, erişkinlerde %70 (n=7) idi. Özkıyım amaçlı ilaç alımı adölesanlarda %39.2 (n=109), erişkinlerde %60.8 (n=169) idi. Çokluilaç alımı adölesanlarda %51.9 (n=42) , erişkinlerde %48.1 (n=39) idi. Zehirlenmeye neden olan ilaç grubu adölesanlarda %46.9 (n=23) parasetamol iken, erişkinlerde %65.2 (n=30) antidepresan ilaçlardı. Hastaların hastanede kalış süresi adölesan grupta 1.19±0.775 saat iken, erişkin grupta 1.15±0.617 saat idi. Hiçbir hastamız hayatını kaybetmedi. Sonuç: Akut zehirlenmeler acil servisler için önemli bir medikal sorundur. Özkıyım amaçlı en yaygın yöntem ilaç alımıdır. Hem erişkinlerde hem adölesanlarda ilaç zehirlenmeleri, kadınlarda daha yaygındır. Özkıyım amaçlı ilaç zehirlenmeleri erişkinlerde adölesanlaragöre daha fazladır. Kullanılan ilaç grubu olarak ilk sırada adölesanlarda parasetamol iken, erişkinlerde antidepresan ilaçlardır. Çoklu ilaç alımı ise adölesanlarda erişkinlere göre daha fazladır. Risk faktörleri belirlenerek bunlara yönelik önlemlerin alınması ve toplumsal eğitim faaliyetlerinin planlanması yoluyla bu tür zehirlenme olgularının sayısının azaltılabilmesi mümkündür.

len bir kişide, ölüm nedeninin kesin olarak saptanmasında otopsinin yeri çok önemlidir. Bu nedenle otopsi, tıbbi uygulama hatası durumunun saptanması ve kanıtlanmasında çok büyük değer taşır. Otopside elde edilen bulgu-Ö ORĐJĐNAL ARAŞTIRMA / ORIGINAL RESEARCH.

Over the last few years, the military healthcare system undergone restructuration. Under this process, healthcare units under this system, aimed at attaining efficiency gains, through clearer focus and specialization on specific areas of care. In August 2012, military units were merged, forming a single unit.

Mantar zehirlenmeleri tüm dünyada sıkça görülen önemli bir sorundur. Erişkinlerde mantar zehirlenmeleri tüm akut zehirlenme vakalarının yaklaşık %7'sini oluşturmaktadır. Klinik, mantarın cinsine göre hafif bir bulantı kusmadan, karaciğer yetmezliğine kadar değişmektedir. Bu çalışmada, Ocak-Aralık 2002 tarihleri arasında Dr. Behçet Uz Çocuk Hastanesi Acil Servisi'ne mantar zehirlenmesi nedeni ile başvuran 21 olgu retrospektif olarak değerlendirildi. Olguların 11'i (%52) kız, 10'u (%48) erkekti. 21 olgunun 9'unun (%43) 10 yaş ve üzerinde olduğu ve 17'sinin (%81) sonbahar aylarında başvurduğu belirlendi. En sık geliş şikayeti; 17 olguda (%81) bulantı ve kusma, 5 olguda (%24) buna ek olarak ishal idi. 7 olguda (%33) kolinerjik semptomlar, 3 olguda karaciğer yetmezlik bulguları ve 6 olguda (%28) nörolojik bulgular vardı. Ölüm 3 olguda (%14) karaciğer yetmezliği nedeni ile olurken 18 olgu (%85) sekelsiz iyileşti. Sonuç olarak, İzmir ili ve çevresindeki mantar zehirlenmelerinin genellikle 10 yaşın üzerinde ve sonbahar aylarında gerçekleştiği ve karaciğer yetmezliği gelişenlerin dışında çoğunlukla sekelsiz iyileştiği saptanmıştır. Mantar zehirlenmeleri, çocukluk çağı

Potasyum Klorür özellikle çocuklarda akut gastroenterit sonucu ortaya çıkan hipopotasemi tedavisinde intravenöz infüzyon yoluyla kullanılır. Hızlı verilmesi ani ölümlere neden olabileceğinden dikkatli kullanılmalıdır. Sunulan olguda potasyum klorür stajyer hemşire tarafından ateş düşürücü olduğu düşünülerek IV puşe şeklinde uygulanmış olup akut gastroenterit tedavisi gören çocuğun ani ölümüne neden olmuştur. Olgu, yardımcı sağlık personelinin eğitiminin önemini, tedavi amacıyla kullanılan etken maddelerin yanlış kullanımda zararlı sonuçları olabileceğini ve çok da masum olmayabileceklerini, yardımcı sağlık personelinin kusur değerlendirmesinin adli tıbbi açıdan önemini göstermek amacıyla sunulmuştur.

Paroxysmal Permanent Junctional Reciprocating Tachycardia (PJRT) is caused after rapid and sudden pacing of excitatory foci in atrioventricular junction. While it happens mostly in infants and children, it is rarely seen in adults. A 30-year-old female came to our emergency department repeatedly with the chief complaint of palpitation. She was later diagnosed with PSVT and throughout her several referrals, she received adenosine or verapamil depending on her condition. Consequently, her rate was controlled. In the period of pregnancy, these attacks became frequent. For delivery, she was admitted to our intensive care unit due to cardiac concerns. Throughout her hospitalization, a relation between feeding and attacks were observed; furthermore, attacks were controlled by stimulating gag reflex. Finally, with the diagnosis of PJRT, she underwent ablation therapy. PJRT is usually triggered by some drugs or situation like pregnancy and swallowing. Ablation is the definite and choice treatment in adults.

Background: Health care workers (HCWs) are a high-priority group for COVID-19 vaccination for several reasons. Health behavior theory-based studies on the intention or acceptability of COVID-19 vaccination among Indonesian HCWs is lacking. Using an integrated behavioral model, this research sought to identify Indonesian health care workers’ intentions to obtain COVID-19 vaccines. Methods: A countrywide cross-sectional questionnaire-based survey was conducted. The questionnaire was constructed on the basis of IBM (integrated behavioral model) constructs and scored on a seven-point bipolar scale. A hierarchical multivariable regression was used to evaluate the fit of the predictor model as well as the correlations between variables in the study. Results: 3304 people responded to the survey. A model combining demographic and IBM characteristics predicted 42.5 percent (adjusted R2 = 0.42) of the COVID-19 vaccination intention. Vaccination intention was associated with favorable vaccine ...

En el presente trabajo se reseñan los aspectos más significativos de la vida y obra del Dr. Alberto Germán Mora Docampo y se resaltan los elementos más importantes de su etapa estudiantil, especialmente de la universitaria, donde se destacó por su disciplina, constante estudio, modestia y humanismo, a la vez que descubrió su pasión por la cirugía y decidió luchar desde entonces por la justicia social y la Revolución. Sus cualidades humanas y la destacada participación en las organizaciones políticas y de masas, así como los numerosos reconocimientos, premios, distinciones y condecoraciones que le fueron otorgados, lo conceptúan como paradigma de la medicina cubana.

Children under the age of 5, will likely all be offered vaccination against SARS-CoV-2 soon. Parental concerns over vaccination of children are long standing and could impede the success of a vaccination campaign. In the UK, a trusted source to inform vaccination choices is the NHS website. Here we used a randomized controlled experiment of framing effects in NHS information content for COVID-19 and flu with 550 mothers under the age of 5. We compared both vaccination offers following two commonly used frames in vaccination informational campaigns: alerting to the risks of no vaccination for the child itself vs. those in their community. We find that vaccination intention was twice as high when risks to the child are emphasized, relative to risks to the community. Exploratory analyses suggest that these effects may differ between white and non-white mothers. Whilst communication directed at adult vaccination against COVID-19 generally focuses on risks of infecting others, communicat...

Despite mandatory vaccinations in Poland, the final decision on vaccination in children is taken by their parents or legal guardians. Understanding parents&#39; attitudes and opinions regarding vaccinations is essential for planning and undertaking extensive and properly targeted educational actions aimed at preventing their hesitancy. In 2016, a cross-sectional study was conducted in the Silesian Voivodeship (Poland) in 11 randomly selected educational institutions. The authors&#39; self-administered questionnaire contained 24 mixed-type questions. It was distributed among 3000 parents or legal guardians of children aged 6-13 years; prior consent of the relevant bioethics committee had been obtained. The response rate was 41.3% ( = 1239). Data were analysed using descriptive and analytical statistics, and focused on parental opinions regarding the safety of vaccines. Results of simple and multivariable analyses showed that perceived risk of adverse vaccine reaction (AVR), contraind...

Despite mandatory vaccinations in Poland, the final decision on vaccination in children is taken by their parents or legal guardians. Understanding parents&#39; attitudes and opinions regarding vaccinations is essential for planning and undertaking extensive and properly targeted educational actions aimed at preventing their hesitancy. In 2016, a cross-sectional study was conducted in the Silesian Voivodeship (Poland) in 11 randomly selected educational institutions. The authors&#39; self-administered questionnaire contained 24 mixed-type questions. It was distributed among 3000 parents or legal guardians of children aged 6-13 years; prior consent of the relevant bioethics committee had been obtained. The response rate was 41.3% ( = 1239). Data were analysed using descriptive and analytical statistics, and focused on parental opinions regarding the safety of vaccines. Results of simple and multivariable analyses showed that perceived risk of adverse vaccine reaction (AVR), contraind...

Background: The emergence of several SARS-CoV-2 variants may necessitate an annual COVID-19 booster vaccine. This study aimed to evaluate healthcare workers&#39; (HCWs) acceptance of a COVID-19 yearly booster vaccine, if recommended, and its association with their attitudes and burnout levels. Methods: We used an online self-administered questionnaire to conduct a cross-sectional study of all HCWs in the West Bank and Gaza Strip of Palestine between August and September 2022. We used the Vaccination Attitudes Examination scale to assess HCWs&#39; vaccination attitudes and the Maslach Burnout Inventory to assess work-related Burnout. In addition, we conducted logistic regression to identify factors independently associated with the acceptance of the booster vaccine. Results: The study included 919 HCWs; 52.3% were male, 46.5% were physicians, 30.0% were nurses, and 63.1% worked in hospitals. One-third of HCWs (95% CI: 30.5%-36.7%) said they would accept an annual COVID-19 booster vac...

كچ ي هد هخاش رد نويسايراو دوجو دروم رد هدوب ردان رايسب شرازگ نيا اما دراد دوجو يتاشرازگ يمكش تروئآ نايرش ياه تسا هدشن رشتنم دروم نيا رد يبلطم نونك ات و . مادق هخاش كي كايلس ينايرش هنت ًاتبسن ي اب يمكش تروئآ روطق دودح لوط 25 / 2 يتناس يم رتم دشاب . پچ كيرتساگ هخاش هس هب هنت نيا ، يم ميسقت يلاحط و كرتشم كيتاپه دوش . هخاش چيه يداع تلاح رد يمن موندوئد زا دعب كچوك هدور هب ينايرش هنت نيا زا يا دور . دودح درم كي دسج رد 65 شور اب هك هلاس Grant,s روم نايرش زا يكرتشم هنت هك دش هدهاشم تفرگ رارق يفاكش دبلاك د Common Hepatic هخاش هب دوخ هك هدش ادج يم ميسقت ريز ياه دش : 1 – هخاش ساركناپ هنت و ندرگ يكيدزن رد هك ساركناپ يارب يياه دنتشاد رارق . 2 ساركناپ رس يارب هخاش كي . 3 – هخاش موندوئد يارب يياه . 4 خاش موئليا و مونژژ يارب يگرزب ه يم ادج تسار تمس زا هك دش . 5 يم ادج پچ تمس زا هك يرگيد هخاش و دش يم گرزب هدور يارب تفر . 6 دوجو كايلس هنت و تسار كيئولپيپاورتساگ نيب يطابترا هخاش كي . 7 نايرش ندش ادج Cystic يدبك كرتشم هنت زا . ها زئاح تلع نيا هب شرازگ نيا دروم رد هكلب تسا هدشن شرازگ نونك ات اهنت هن و ه...

T he protracted COVID-19 pandemic has required bravery and sacrifice from clinicians worldwide. After almost two years, though, healthcare workers have been pushed to the limit. While accepting personal risks and suffering overwork and exhaustion in order to care for COVID-19 patients, anger, disgust, and frustration toward unvaccinated patients are increasing. 1 Some clinicians are asking whether COVID-19 vaccination status should be considered in triage allocation of ICU beds. 2 Moral outrage, the "justifiable anger, disgust, or frustration directed toward others who violate ethical values or standards," 3 is widespread. While some patients refuse vaccination for political or libertarian reasons, others face barriers to access. Underserved communities (immigrants, the uninsured, people with limited English proficiency, etc.) may have difficulty accessing vaccination sites. Black, Indigenous, People of Color (BIPOC) communities, impacted by the historical trauma of racism, may be wary in their interactions with healthcare, resulting in vaccine hesitancy even though they have suffered disproportionately from COVID-19 with rates of hospitalization 2.8-3.4 times and death 2-2.4 times the rates of white, non-Hispanic patients. 4 Other patients are vaccine receptive but feel less urgency or prefer familiar caregivers to strangers at mass vaccination sites. Some are concerned about the risks of new mRNA vaccines. Notably, at least 25% of healthcare workers remained unvaccinated as late as June 2021. 5 While many clinicians may be sympathetic to the reasons for vaccine hesitancy recounted above, some patients refuse for political or personal liberty reasons alone. Some think the virus is a hoax or are persuaded by false conspiracy theories. I will call this group the willfully unvaccinated. In such cases, moral outrage among clinicians may be more pronounced. Moral outrage occurs when an ethical standard

Influenza has a significant impact on the health care system and also on production and economic systems. Vaccinated health care workers (HCWs) are more likely to have improved productivity compared to unvaccinated workers. The study aim was to estimate the economic and fiscal impact of an influenza vaccination program for HCWs in Italy. We performed a cost analysis aimed to estimate the indirect costs (productivity losses due to working days lost) and the increase in tax revenues derived from the increase in vaccination coverage among HCWs. Assuming an incremental increase in vaccination coverage of 10% per year over a period of 5 years, total savings could be obtained in terms of a reduction in productivity losses equal to −€4,475,497.16 and an increase in tax revenues of €327,158.84. This revenue could be used to finance other health interventions. Our results are fundamental in view of the sustainability of health systems and of a value-based allocation of health resources. Ther...

This study was carried out on 211 physicians working in family health centers in Denizli in order to determine the nutritional habits of these physicians. The target population of the research consisted of all physicians (246 people) working in the primary health care in Denizli city center. No sample selection was conducted since it was desired to reach the entire population; but 85.7% (211 people) of the physicians were able to participate in the research. Research Data were collected from 28 Family Health Centers (FHCs) located in Denizli city center. 33.6% of the physicians included in the study were female and 66.4% were male. 78.7% of the participants in the study were married and 21.3% were single. The mean age of the physicians was 37.0 ± 9.24 years. As a result of the study, it was determined that 53.1% of the physicians were in the overweight and obese group. 30.8% of the physicians included in the study stated that they slept 6 or less hours a day. 28.9% of the physicians stated that they smoked, 40.3% of the physicians stated that they did not exercise at all, and 41.0% of the physicians stated that they exercised irregularly. More than half of the physicians (52.1%) stated that they did not have an adequate and balanced diet, 69.2% of the physicians stated that they did not receive training on nutrition, and 9% of the physicians stated that they did not remember whether they had received any training.
Keywords: Physician; Nutrition; Eating Habits

Long COVID is an emerging condition, with early evidence suggesting it impacts women at a greater rate than men. As we seek to understand long COVID, it is important to consider the holistic impacts of this condition. Therefore, a qualitative perspective was used to explore the experience of those living with long COVID. Eight people from Scotland, who presented as women and Caucasian, participated in this study. A thematic analysis, from a phenomenological perspective, was conducted on data collected during two semi-structured focus groups. Five central themes emerged including: (1) a prolonged, varied, and debilitating illness; (2) barriers to care; (3) predominantly negative experiences of care; (4) fighting to carry the burden; and (5) looking to the future. These themes are linked through an explanatory theory describing a cycle of illness, the work required to break the cycle, and participant’s aims to regain their health and advocate for their condition. The thematic results ...

Background This national qualitative study explores (1) the experiences, observations, and opinions of health care workers (HCWs) about beliefs, socioeconomic, cultural, and environmental characteristics of parents refusing vaccination and (2) regional differences in the identified risk factors; (3) recommended solutions to improve vaccine acceptance in each of 12 regions in Turkey. Methods In total, we carried out 14 individual semi-structured in-depth interviews and 10 focus group discussions with 163 HCWs from 36 provinces. A thematic analysis was performed to explore HCWs’ observations about the parents’ decisions to reject vaccination and possible solutions for vaccine advocacy. Results Within the analyzed data framework, vaccine refusal statements could be defined as vaccine safety, the necessity of vaccines, assumptions of freedom of choice, health workers’ vaccine hesitancy, lack of information about national vaccination schedule and components, not trusting the health syste...

ObjectivesThis study aims to assess the prevalence of health problems (eg, insomnia, binge-eating, substance use and ill health) among UK doctors and to investigate whether occupational distress increases the risk of health problems.DesignThis study reports the analysis of data collected at the baseline stage of a randomised controlled trial (protocol #NCT02838290).SettingDoctors were invited through medical Royal Colleges, the British Medical Association’s research panel and a random selection of NHS trusts across various UK regions.Participants417 UK doctors with an equivalent split of gender (48% males) and seniority (49% consultants).Main outcomes and measuresOutcomes were sleep problems (eg, insomnia), alcohol/drug use (eg, binge-drinking), ill health (eg, backache) and binge-eating (eg, uncontrollable eating). Predictor variables were occupational distress (psychiatric morbidity, burnout, job effort, work-life imbalance, coping with stress through self-blame or substances) and...

Por el interés que puede representar para los lectores de Educación Médica Superior hemos considerado oportuno reproducir el presente artículo publicado en la Revista INFODIR. 2014;18:81-94" "Hay que tener una gran dosis de humanidad, una gran dosis de sentido de la justicia y de la verdad, para no caer en extremos dogmáticos, en escolasticismos fríos, en aislamiento de las masas. Todos los días hay que luchar porque ese amor a la humanidad viviente se transforme en hechos concretos, en actos que sirvan de ejemplo, de movilización".

Background: Health care workers (HCWs) are a high-priority group for COVID-19 vaccination for several reasons. Health behavior theory-based studies on the intention or acceptability of COVID-19 vaccination among Indonesian HCWs is lacking. Using an integrated behavioral model, this research sought to identify Indonesian health care workers’ intentions to obtain COVID-19 vaccines. Methods: A countrywide cross-sectional questionnaire-based survey was conducted. The questionnaire was constructed on the basis of IBM (integrated behavioral model) constructs and scored on a seven-point bipolar scale. A hierarchical multivariable regression was used to evaluate the fit of the predictor model as well as the correlations between variables in the study. Results: 3304 people responded to the survey. A model combining demographic and IBM characteristics predicted 42.5 percent (adjusted R2 = 0.42) of the COVID-19 vaccination intention. Vaccination intention was associated with favorable vaccine ...

Empanelment is a foundational strategy for building or improving primary health care systems and a critical pathway for achieving effective universal health coverage. However, there is little international guidance for defining empanelment or understanding how to implement empanelment systems in low- and middle-income countries. To fill this gap, a multi-country collaborative within the Joint Learning Network for Universal Health Coverage developed this empanelment overview, proposing a people-centered definition of empanelment that reflects the responsibility to proactively deliver primary care services to all individuals in a target population. This document, building on existing literature on empanelment and representing input from 10 countries, establishes standard concepts of empanelment and describes why and how empanelment is used. Finally, it identifies key domains that may influence effective empanelment and that must be considered in deciding how empanelment can be impleme...