Biomedical subjects

Nurhan Ince

Publications and source records attributed to Nurhan Ince.

8 recordsLinked to original sources

PubMed2006

Occupational accidents and forensic medicine in Turkey.

In Turkey, evaluation of the ratio of loss of working capacity is made according to various laws and regulations. These laws and regulations use different standards in computing the above-mentioned ratio depending on the professional status of the worker, whether he or she is a member of SSK (Social Security Institution) or ES (The Retirement Pension Institution) system. The aim of this study is to point out at the differences and deficiencies in computing the degree of disability and at the need to bring common standards to these computations. This prospective descriptive research is based on the cases of occupational accidents and occupational diseases brought to the 3rd specialized branch of the Institution of Forensic Medicine (which is the highest ruling instance concerning the decision on this field). Of the 164 accident cases included in this research, 95.1% are males, and 4.9% females. According to distribution by age of the cases, the modal group is respectively (30-39) years for men and (12-19) years for women. 43.8% of the injuries were localized at the hand or wrist. No meaningful statistical relationship could be found between the level of qualification of the workers (skilled-unskilled) and the proportion of those suffering from total disability. For the cases included in the categories 3, 4 and 5 is the ES system; the ratio of disability was similar to those computed according to the SSK system. In conclusion, we would like to insist on the need for our country to amend our laws and regulations according to changing and prevailing conditions and sex differentials and to bring homogeneous standards for all workers.

Accidents, Occupational↗

PubMed2006

Factors influencing treatment compliance among Turkish people at risk for stroke.

Successful management of stroke risk factors depends on adequate knowledge and self-care. The purpose of this study was to examine the factors affecting treatment compliance among people with modifiable stroke risks. We evaluated modifiable risk factors of stroke, recognition of these factors by patients, and patients' compliance with treatment in a teaching hospital. Semi-structured questionnaires were completed using face-to-face interview techniques. A majority (58.3%) of patients were aware of their risk factors for stroke. Awareness of risk factors was statistically significant for the participants carrying risk factors such as heart disease and hyperlipidemia. Compliance of the participants with treatment was mainly affected by the recognition that their disease could be a risk factor for stroke. Awareness of the presence of multiple risk factors and nonsmoker status were positively associated with treatment compliance. Editors' Strategic Implications: The authors provide evidence that the recognition of risk factors and informative healthcare education may decrease the likelihood of and the recurrence of stroke. Future research should document efforts to inform high risk patients and measure their compliance with recommendations.

Adult↗

PubMed2006

[A different approach to trauma scoring].

BACKGROUND: We have compared the Injury Severity Score (ISS) at admission to Emergency Surgery and Trauma Center (ES&TC) with the ISS during autopsy. Cases with ISS less than 14 (defined as preventable deaths) were evaluated and the results were compared with those in other countries. METHODS: The study was performed between January 1, 2000 and December 31, 2002 at Istanbul Medical Faculty TS&ES and the Turkish Council of Forensic Medicine. The 160 autopsies of trauma deaths which could have been performed within this three year period were evaluated. RESULTS: The average age of trauma victims in the study was 32,9+/-15,6 (r=1-79); the majority of victims were males 78,1% (n=125). In four autopsies (3%) ISS were rated as "preventable death" (ISS < or =14). The severely injured (ISS: 16-66) patients with lower survival rates were 96% (n=155). In addition, one case (1%) had an ISS score of 75. In clinical evaluations, ISS scores were found to be between 16-66 (68%), 75 (20%, n=32), and < or =14 (12%; n=19). CONCLUSION: Although it is widely used, difficulties in the applications of ISS still exist. Alcohol, drug, pregnancy and the presence of underlying diseases are the factors contributing to death but not being reflected by ISS. Moreover a difficulty exists in the evaluation of anatomical injuries which are not accompanied by physiological changes. ISS should be improved according to updates. In this way, evaluation of clinics' care quality and standardization of trauma centers can be done more accurately.

Adolescent↗

PubMed2005

The related causes in very early morning onset of stroke.

We investigated the influence of early awakening and related factors on onset of cerebrovascular disease (CVD). Totally 1199 stroke patients, in whom the onset time was known, at 3 reference hospitals were included in this study. The effects of demographic, medical, and pathophysiological factors on the circadian pattern of an unselected series of patients with ischemic stroke were analyzed. Nine-hundred seventeen CVD patients with cerebral infarction (CI), 240 patients with intracerebral hemorrhage (CH), and 42 patients with subarachnoid hemorrhage (SAH) were identified. The greatest portion of strokes (32.5%) occurred between 03:00 and 06:00 a.m. Nearly one half of the strokes in this series occurred in the very early- to mid-morning hours. This analysis of strokes provides strong evidence with a higher risk in the early morning hours (03:00 a.m. to 06:00 a.m.), and lower risk during the night time period (21:00 p.m. to midnight). Approximately 1 of every 3 strokes (1 of 3 ischemic strokes, 1 of 6 hemorrhagic strokes, and 1 of 8 subarachnoid hemorrhages) is attributable to the early morning excess. This difference tried to be explained by three ways: cold weather, religious factors, and physiological mechanisms.

Adult↗

PubMed2005

Skin findings related to chronic usage of anti-epileptic drugs.

OBJECTIVE: Chronic type skin reactions are defined as unwanted effects of drugs. As there are more benign conditions, skin findings related to chronic usage of anti-epileptic drugs (AEDs) have not been studied previously. In this study, we investigate the skin findings associated with the chronic usage of AEDs. METHODS: The study was conducted in the Post, Telephone and Telegraph Training and Research Hospital between May 2002 and January 2003 during a 6-month work period. Skin lesions were first assessed individually, and then their correlations with AEDs were examined. Skin findings were then divided into skin disease groups to evaluate statistical significance. The prevalence of skin findings occurring in 62 epileptics was compared with that of an age-matched group of 33 non-epileptics. RESULTS: The rate of skin findings defined in the workgroup was 85.5%, while it was 84.8% in the control group. The most common skin findings were acneiform eruptions for both groups. There was no significant differences between the work and study group as for skin findings (p>0.05). Alopecia was the only skin condition related to AED usage and it was seen in 4 patients (6.5%) using valproate (p<0.05). None of the 11 patients with infectious skin findings were using valproate, and that was the only significant relationship between antiepileptic drugs and skin diseases (p=0.015). CONCLUSION: The inflammatory skin diseases were the most commonly seen problem in both patients and controls. The alopecia ratio with valproate usage in our patient group was similar to literature reports.

Adolescent↗

PubMed2004

Serum vitamin B12 and folic Acid levels in acute cerebral atherothrombotic infarction.

Hyperhomocysteinemia is an independent risk factor for atherothrombotic cerebral stroke. Vitamin B12 and folic acid are important determinants of homocysteine metabolism. We aimed to evaluate the relationship, if present, between vitamin B12 and folic acid levels and acute cerebral stroke in this study. Blood aliquots drawn within 24 hours after the stroke from hospitalized patients (n=66) with the diagnosis of acute ischemic cerebrovascular episode and also blood samples from 38 healthy controls without any vascular risk factor were analyzed. With a competitive, chemoluminescence assay, serum levels of vitamin B12 and folic acid were measured in blood samples taken within 24 hours after the stroke. The differences and correlations were tested using frequency test, student-t test and multivariate analysis. Mean serum vitamin B12 levels were significantly lower in the patients than in the control subjects, 245.40 (S.D.: 72.9) and 343.2 (S.D.: 113.0) pg/ml respectively (p=0.0001). This difference was independent from other risk factors. Likewise, mean serum folic acid levels were lower in the patients than in the control subjects, 4.62 (S.D.: 1.94) and 5.97 (S.D.: 1.19) ng/ml, respectively (p=0.003). Mean serum levels of vitamin B12 and folate at the convalescence phase were 253.05 (S.D.: 68.78) pg/ml and 4.48 (S.D.: 2.08) ng/ml, respectively; the values obtained at the acute phase were not significantly different from the values obtained at the convalescence phase. We conclude that low vitamin B12 and folic acid concentrations are associated with an increased risk of stroke, and the relationship for vitamin B12 is independent from the other known modifiable stroke risk factors. For understanding the effects of B12 and folate in stroke patients, more detailed follow-up studies with long period are needed.

Acute Disease↗

PubMed2004

A model in environmental training--The University / Elementary School / Municipality Cooperation.

This study targets development of an effective training scheme model that can be implemented at elementary school level with focus on recovery and recycling of wasted papers in Turkey. For this purpose, three schools were chosen from a district within Istanbul. They were separated from one another as full intervention (FI), semi-intervention (SI) and control (C) schools. Different levels of educational activities carried out in the schools, mostly in the FI school, were directed toward being informative as regards recycling and the development of a positive attitude. Afterwards, in order to evaluate the effects of the training, paper wastes were collected in recycle bins placed at appropriate points in schools and weighed on a weekly basis. Quite a significant result was found (p = 0.0001), when the difference was calculated through the Kruskal Wallis Variance Analysis method, regarding the weekly average amount of paper in each of the three schools against per person. Furthermore, when the results were evaluated and compared as to the ones before the 2.5 months summer vacation and the ones after it, the seven measurements taken before (p = 0.001) and the eight taken afterwards (p = 0.0001), were found to have valid differences, once again, as against schools. The results show that the approach we provided to education is an effective method not only for the collection of paper wastes but also for applications in various areas of health education.

Analysis of Variance↗

PubMed2003

Filicide cases in Turkey, 1995-2000.

AIM: To determine socio-demographic features and criminal liability of individuals who committed filicide in Turkey. METHOD: The study involved 85 cases of filicide evaluated by the 4th Specialized Board of the Institute of Forensic Medicine in Istanbul in the 1995-2000 period. We assessed the characteristics of parents who committed filicide (age, sex, education level, employment status, and criminal liability) and children victims (age, sex, own or stepchild), as well as the causes of death. RESULTS: There were 85 parents who committed filicide (41 fathers and 44 mothers) and 96 children victims. The mean age of mothers who committed filicide (52% of filicides) was 26.5-/+7.7 years, and the mean age of fathers (48% of filicides) was 36.1-/+10.0 years (t=-5.00, p<0.001). Individuals diagnosed with psychiatric disturbances, such as schizophrenia (61%), major depression (22%), imbecility (10%), and mild mental retardation (7%), were not subject to criminal liability. Almost half of parents who committed filicide were unemployed and illiterate. CONCLUSION: Filicide in Turkey was equally committed by mothers and fathers. More than half of the parents were diagnosed with psychiatric disorders and came from disadvantageous socioeconomic environments, where unemployment and illiteracy rates are highly above the average of Turkey.

Adolescent↗