Journal of Contemporary Medicine <p><strong><u>Journal of Contemporary Medicine (J Contemp Med)</u></strong></p> <p>Journal of Contemporary Medicine (J Contemp Med) is an open access, international, quarterly, peer-reviewed journal publishes articles of authors from Turkey and abroad with special emphasis on original research.<br><br>The journal publishes original research articles in all brances of medicine (clinical and research), family health care, epidemiology, biostatistics, public health administration, national health problems, medical anthropology and social medicine, invited annotations and comments, invited papers on recent advances, clinical and epidemiological diagnosis and management review article, short communication/brief reports, letters to the editor, case reports, etc. The journal covers population based studies, impact assessment, monitoring and evaluation, systematic review, meta-analysis, clinic-social studies etc., <strong>related to any domain and discipline of medicine</strong>, especially relevant to national priorities, including ethical and social issues.&nbsp; It is published quarterly and available in&nbsp; only online version.&nbsp;</p> en-US (Resul YILMAZ) (Resul YILMAZ) Mon, 31 Dec 2018 00:00:00 +0000 OJS 60 The Relationship between the Grade of Cervical Spondylosis and the Flow Volume of Vertebral Arteries <p><strong>Aim:</strong> While the earliest symptom of cervical spondylosis is neck pain, a variety of symptoms arise with osteophytes pressuring the neurovascular structures. Our aim is to investigate the possible relationship between the cervical spondylosis grading and the total debit of the vertebral arteries (VA).</p> <p>&nbsp;</p> <p><strong>Method:</strong> 142 patients with vertebrobasilar system Doppler US and cervical MRI were included in the study. Doppler US was performed with the head in neutral position; The VA V2 segment was assessed in 1/3 section of the neck. After the arterial diameter and flow characteristics were determined, the debit was automatically calculated by the device. The grade(G) of spondylosis in cervical MR was determined by the criteria of osteophyte formation, intervertebral disc height and vertebral end-plate degeneration based on Kellgren et al.'s staging.</p> <p>&nbsp;</p> <p><strong>Findings:</strong> There was no statistically significant difference between the consecutive stages of G1, G2, G3, and G4 in terms of VA (Tukey HSD);but there is a significant difference between G1 and G3, between G1 and G4, and between G2 and G4. As the stage increases, the debit decreases significantly(p&lt;0.01). When the cases were categorized as G0,1,2 <em>mild spondylosis</em> and G3-4 <em>severe spondylosis</em>, there was a significant difference between two groups (Independent sample T-test). The VA debit was significantly lower in severe spondylosis(p&lt;0.01).</p> <p>&nbsp;<strong>Result:</strong> We think that discal and osseous changes occurring in severe spondylosis, may have a negative impact on total VA debit. We recommend Doppler US examination for vertebrobasilar system especially when severe cervical spondylosis is detected.</p> Esin Derin Çiçek Copyright (c) Mon, 31 Dec 2018 00:00:00 +0000 Evaluation of urethral structure after hypospadias surgery with uroflowmetry <p>Aims:Uroflowmetry is a simple, noninvasive, easy to use and objectively interpretable urodynamic study. Uretral stenosis is the most common late complication after hypospadias surgery. The aim of this study was to evaluate the possible postoperative meatal stenosis in patients who were operated for hypospadias in our clinic with uroflowmetry.</p> <p>Material and Methods:The patients with hypospadias operated in our clinic between January 2015 and January 2017 were determined as our study group.Uroflowmetry and urine flow measurements were performed at least two months after the operation. After uroflowmetry measurement, the residual urine volume was measured by ultrasound device in pediatric surgery clinic. The estimated bladder volumes were calculated according to the age of the patients.</p> <p>Results: The median age of the patients was 7.5 (3-14). In the postoperative period, 9 (19.5%) of the patients had complaints of narrow urination and urination as a clinical complaint. No statistically significant difference was found between the two groups in terms of uroflowmetry results, maximum flow rate, time to reach maximum flow rate, total urine flow time, mean flow rate and residual urine volume (p&amp;gt; 0.005).Sixteen patients (25.4%) in the postoperative group were smaller than &amp;lt;-2SD according to the Siroky nomogram and were in the obstruction group.</p> <p>Conclusions: Uroflowmetry is an easy-to-use noninvasive test used to assess early obstruction and to diagnose a urethral stricture following hypospadias surgery. When compared with the literature, the maximum flow rate in uroflowmetry measurements is less than 10 ml / s, the average flow rate is low, the voiding curve is the plateau curve and the five-percentile according to the nomograms and the voiding curve smaller than -2 SD results are evaluated in terms of urethral obstruction and urethral dilatation planning is important.</p> Yusuf Atakan Baltrak Copyright (c) Mon, 31 Dec 2018 00:00:00 +0000 Prevalence of coeliac disease in autoimmune liver disease and primary biliary cholangitis <p>Background: Coeliac disease (CD) is a small bowel disease, which occurs upon exposure to dietary gluten. CD is often associated with dermatitis herpetiformis, autoimmune thyroid disease, type 1 diabetes mellitus and autoimmune liver diseases. Autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) are the most common autoimmune liver diseases. In this study, we investigated the prevalence of CD in patients with PBC, AIH and overlapping PBC + AIH&nbsp; in our Hospital.</p> <p>Methods: Ninety-nine patients with PBC, AIH and overlapping AIH + PBC were included in this study. Specific serum antibodies and specific duodenal biopsy results are&nbsp; used&nbsp; for&nbsp; diagnosis&nbsp; of&nbsp; CD.</p> <p>Results: Ninety-nine patients with PBC (n = 47; F: 95.7%; age: 53 ± 10 years), AIH (n = 23; F: 100%; age: 48 ± 12 years) and overlapping AIH + PBC (n = 29;F : 96.6%; age: 51 ± 10.9 years) were included in this study.Three patients (6.4%) in the PBC group, one patient (3%) in the PBC + AIH group and two patients (8.7%) in the AIH group were serologically and histologically diagnosed with CD.</p> <p>Conclusion: Anti-gliadine antibody (AGA) positivity or anti-endomysium antibody (EMA) positivity alone was not sufficient for CD diagnosis. We suggest using both tests for CD screening to achieve more accurate results. In cases of positive CD-specific antibody results, we advise confirming the diagnosis by histopathological examination of duodenal biopsies.</p> Genco Gencdal Copyright (c) Mon, 31 Dec 2018 00:00:00 +0000 Our Postoperative Adjuvant Immunotherapy and Chemotherapy Experience in Malignant Melanom <p>Malignant melanoma is a melanocyte-derived tumor with an increasing prevalence that is responsible for 65% of the deaths from skin cancers. Its primary treatment consists of total excision. Postoperative adjuvant therapy is administered to improve the overall and disease-free survival. This study was undertaken to assess the effect of postoperative adjuvant immunotherapy and chemotherapy in patients with malignant melanoma.<br><br><strong>Methods</strong>:&nbsp;<br>This was a prospective, single-arm study. A total of 31 patients meeting the inclusion criteria received high dose adjuvant interferon and/or decarbazine postoperatively. The demographic data, disease stage, surgical procedures, and the overall and disease-free survival during the follow-up period were recorded. Statistical analyses were performed.<br><br><strong>Results</strong>:&nbsp;<br>Of the study participants 18 (58%) were male and 13 (42%) were female, with a mean age of 52.6 years. The average duration of follow up was 17.58 months. The &nbsp;average overall survival was 11 months and the average disease-free survival was 10 ± 1.6 months.<br><br><strong>Conclusion:</strong>&nbsp;<br>Postoperative adjuvant immunotherapy was previously reported to improve the disease-free survival in patients with malignant melanoma, and similarly adjuvant immunotherapy + chemotherapy was also found to improve the overall and disease-free survival. Our data represent the interim results of the follow-up, with more data to be collected regarding disease-free and overall survival with further follow-up.<br><br></p> Musa Zorlu Copyright (c) Mon, 31 Dec 2018 00:00:00 +0000 Evaluation of adherence to cardiovascular risks, admission to education / counseling and adherence to the recommendations of adult patients who apply to Family Health Centers: A multi-center cross-sectional study <p><strong>Aim</strong>: Cardiovascular system diseases (CVD), especially coronary heart disease, are among the leading causes of death all over the world. . In this study, we aimed to evaluate the patients' lifestyle status and to find out whether they have received training / counseling in addition to the recommendations they have received.<strong>Methods:</strong> This cross-sectional study was performed between April 1, 2013 and May 15, 2013 in Istanbul. The study consisted of adult patients older than 18 years of age who were admitted to five different family health centers. The questionnaire was created by modifying the questionnaire used in a previous study conducted by the researchers according to primary health care services. All patients included in the study applied a face-to-face questionnaire consisting of socio-demographic variables, previous training or counseling, smoking cessation, healthy eating, hypertensive, diabetic or cholesterol-lowering diet counseling and compliance with these recommendations. Weight and height were measured by family physicians during the examination of the patient. <strong>Results:</strong> A total of 948 patients, 672 women (70.9%) and 276 men (29.1%) were included in the study. The mean age was 42.64 ± 14.35. Of the participants, 644 people (67.9%) received any advice, and 367 (38.7%) were any counseling / training fields. The participants were asked about open-ended questions about their recommendations, training / counseling, and whether they met these recommendations. <br><strong>Conclusi</strong><strong>on:</strong> Although people who are admitted to the Family Health Center are insufficient against cardiovascular risk factors, they receive some suggestions, but their compliance rates are quite low. Although the rates of education / counseling areas are lower with the recommendation, the compliance rates are significantly higher than the ones taking the lead. Further analytical and qualitative studies aimed at increasing patient compliance and increasing compliance rates will provide important data for centralizing the goals of the patient, one of the major paradigms in the management of multiple complex processes.</p> Arzu Ayraler Copyright (c) Mon, 31 Dec 2018 00:00:00 +0000 An Investigation of Rotavirus Frequency in Childhood Gastroenteritis <p><strong>Introduction</strong>: Rotavirus is the most common viral pathogen in childhood gastroenteritis worldwide. The objective of this study was to determine the frequency of rotavirus in children with diarrhoea in Karabuk province and to investigate their relationship with age, gender and season.</p> <p><strong>Materials and Methods:</strong> Stool rotavirus antigen results of 0-12 years old children with diarrhoea who admitted to Karabuk University Educational and Training Hospital between January 2016 and December 2016 were examined retrospectively. The presence of rotavirus antigen in stool samples were detected by using immunochromatographic method. Distribution of rotavirus infections according to age, gender and seasons were investigated. &nbsp;</p> <p><strong>Results:</strong> Rotavirus antigen was detected in 195 (6.7%) of 2879 stool samples. The frequency of rotavirus was determined similar in both genders. Rotavirus seropositivity was highest among children aged 25-60 months. Rotavirus infection was most commonly observed during spring season (11.8%).</p> <p><strong>Discussion and Conclusion:</strong> In our region, rotavirus should be considered as a cause of gastroenteritis in children under five years of age in the spring season. Rapid detection of rotavirus in stool samples is crucial. Early diagnosis of rotavirus infection will prevent unnecessary antibiotic consumption. So, it will contribute to policies regarding rational antibiotic usage. Therefore, it is advisable to perform rotavirus antigen test in primary health care facilities for the diagnosis of gastroenteritis routinely.</p> Nergis AŞGIN Copyright (c) Mon, 31 Dec 2018 00:00:00 +0000 Moral sensitivity questionnaire (msq): Turkish adaptation of the validity and reliability <p><strong>Aim:</strong> The research was carried out in a methodological design with the aim of determining that the validity and reliability of the Moral Sensitivity Questionnaire (MSQ).</p> <p><strong>Materials and Methods</strong><strong>: </strong>The universe of the research population constituted from physicians and nurses working in the surgery, intensive care and reanimation, psychiatry, oncology and hematology departments of two universities and 10 public hospitals located within the provincial borders of Istanbul. Since the validity and reliability study data cannot be generalized to a universe, the general and working universe cannot be determined. However, the analyzes should be done on a sufficient number of individuals. For this reason, a total of 180 physicians (n = 90) and nurses (n = 90) who accepted to participate in the study formed the sample group. The data were obtained by using the "Individual Information Form" and the “Moral Sensitivity Questionnaire (MSQ)” developed by Lutzen, Johansson and Nardström. The Moral Sensitivity Questionnaire consists of 30 items and 6 sub-dimensions (Autonomy, Providing Benefit, Holistic Approach, Conflict, Application, Orientation). The Moral Sensitivity Questionnaire that is a Likert-type scale is rated between 1 point (fully agree) and 7 point (I do not agree at all). One point indicates high sensitivity and 7 points indicate low sensitivity. The lowest score of the scale is 30 while the highest score is 210.</p> <p><strong>Results:</strong></p> <p>Language equivalence and cultural adaptation of ADA made with back translation method. Consultation with a specialist&nbsp; method was used to ensure content validity. Intermittent method was used for evaluating of time invariance with test-retest analysis. A total of 180 healthcare workers, 90 physicians and 90 nurses, were treated twice with 3 weeks intervals. In order to determine the internal consistency of ADA, the Cronbach's alpha value was found to be 0.81-0.83 in the first application and 0.83-0.84 in the second, and the total value was 0.84. The ADA's item total score correlation was found to be 0.09-0.61 in the first application (r 1) and 0.04-0.57 according to the sub-dimensions of the questionnaire (r 2); In the second application, it was determined as 0.09-0.61 according to the questionnaire and between 0.01-0.55 according to the sub-dimensions. Test-retest correlation coefficient was found to be between 0.81-0.99.</p> <p><strong>Conclusion: </strong>The Moral Sensitivity Questionnaire, consisting of six sub-dimensions of 30 items adapted to Turkish, is a tool that can be used to determine the ethical sensitivity in physicians and nurses, providing adequate validity and reliability in terms of its adaptation to Turkish culture.</p> Hale Tosun Copyright (c) Mon, 31 Dec 2018 00:00:00 +0000