Objective: Problem-based learning (PBL) is a student-centered small
group study and active learning method. It aims to provide students
with the skills of self-learning, learning to learn, and ...solving realworld
problems and is used as a learning method in many medical
faculties. In this study, it was aimed to examine and evaluate the
perceptions and opinions of Bezmialem Vakif University Faculty of
Medicine students about PBL applications and all processes.
Methods: For this purpose, a questionnaire consisting of 16
questions was prepared and applied to first, second and third term
students in Bezmialem Vakıf University Faculty of Medicine. In this
questionnaire, students’ perceptions and opinions were evaluated
with a five-point Likert scale and an open-ended question.
Results: According to the results, overall satisfaction was found to
be 3.67 on average. These ratios were; 3.85 in the first term students,
3.54 in the second term students, and 3.66 in third term students.
As a result, the highest satisfaction was achieved in the proposition
“PBL participants are always respectful to the group” with a score
of 4.19. The proposition “PBL trainers help to discuss problems
in every way” was found to get the lowest score (3.57). The other
lowest score (3.59) was achieved in the prosposition “Everyone
comes prepared for the second session in PBL sessions”. Conclusion: With these data, accurate decisions can be made about
which steps should be considered in our practices and the aspects
that need to be improved. Our goal is to organize PBL sessions in
each committee in the preclinical term.
Objective: The World Health Organization, National and
international accreditation bodies emphasize that physician
candidates should also receive training in environments where they
can see and ...recognize the health problems and health system of
the society in which they live. The aim of this study is to evaluate
community-based medical education practices in Bezmialem Vakıf
Faculty of Medicine education program.
Methods: Beginning from the first period of our medical
education for community based medical education and community
recognition program practices; visits to community health
centers, family health centers, childrens' houses from social work
instutitions, hospice, tuberculosis dispensary, as well as Bezmialem
Public Health Days as an education and service project in society
and the Forensic Medicine Institute has been planned as application
areas. All applications were made in the training program on
predetermined dates and the feedbacks received from the students
were evaluated using the thematic analysis method. The feedback of
each program was evaluated as a separate category and analyzed on
the themes of education efficiency, fitness for purpose, adequacy of
the organization.
Results: The students expressed their satisfaction with these
educational activities and community visits to the community.
However, they stated that the applications in the pre-clinical
period were close to exam dates, problems such as disruptions in
transportation, that they wanted to communicate with more people
in the institutions they went to and that the applications should be
extended for a longer period of time. Conclusion: Physicians need to be aware of the health and social
problems of the society in which they live and to be aware of
them. It has been determined that the applications of our faculty
are well integrated into the educational programs and that many
of the knowledge they have gained in theory has strengthened in
the application areas in the primary care. Children’s Houses and
Darülaceze visits have been found to be beneficial for preclinical
students in terms of getting to know the community and raising
awareness. The students' suggestions were discussed in the relevant
boards and reflected in the next year’s curriculum.
There is no standard practice for the sustainability of medical education in epidemics such as Covid-19 and disasters affecting society. Synchronous or asynchronous trainings have been carried out in ...some of universities and colleges that have distance education technical infrastructure, during the Covid-19 pandemic. If every student has access to information technologies and the skills of the instructors who will prepare and deliver the training increase their ability to use information technologies, there is no problem in the implementation and maintenance of theoretical lessons. During the Covid-19 pandemic, we had to go to distance education, which we had not yet implemented at Bezmialem Vakıf University Faculty of Medicine. During this period, we applied asynchronous and synchronous education models (mixed model) for theoretical lessons. However, the fact that practical and internship applications were carried out by distance education - although videos about skills and practices were shot and uploaded to the system - it was not possible to replace the formal education. Distance education is inevitable for the continuity of education in epidemic and disaster situations. However, after the epidemic and disaster situations have passed, practical and internship practices should be carried out as much as possible in addition to distance education in medical education. In normal times, distance education can only be used to support formal education in medical education. As a result of all these evaluations and experiences we gained in the Covid 19 pandemic, we think that synchronous/synchronous distance education applications will improve over time and contribute to medical education.
Günümüz çağında gelişen bilimsel teknoloji, hayatımızın büyük bir kısmını kolaylaştırmaktadır. Özellikle tıbbi açıdan gelişen teknoloji yaşam süresini uzatmaya yönelik olsa da uygulanan tedaviler, ...umudun kaybedildiği hastalar için zorlu bir süreç haline gelebilmektedir. Bu süreç, hasta ve hasta yakınlarına en uygun bakımın verilmesi, fiziksel ve psikososyal problemlerin erken bir zaman diliminde belirlenmesi ve yaşam kalitesinin arttırılması gibi temel ihtiyaçların hastane ortamlarında ya da özel bakım veren merkezlerde yapılmasını zorunlu kılmaktadır. Hasta ve hasta yakınlarının ihtiyacı olan ve son zamanlarda daha fazla üzerinde durulan “yaşam sonu bakım” ya da “palyatif bakım” insani bir hak olarak da karşımıza çıkmaktadır. Palyatif bakım multidisipliner ekip anlayışıyla hareket eden bir oluşumu karşımıza çıkarmaktadır. Ekibin içinde yer alan sağlık çalışanları, hasta ve hasta yakınlarının ihtiyaçlarını geniş bir şekilde değerlendirebilen kişiler olmakla yükümlüdür. Özellikle bakımın içinde yer alan, hasta ve yakınlarına gerekli bakım ve desteğin sağlanması konusunda bilgi ve becerilerini sürekli gelişime açık tutabilen hemşireler önemli bir role sahiptir. Hemşireler etkili bir iletişim halinde, bakımın önemli bir bölümünü oluşturmaktadır. Hastanın içinde bulunduğu durum nedeniyle, ihtiyaç duyduğu bakım yalnızca hasta yakınları tarafından karşılanamaz. İşte burada hastanın ve hasta yakınlarının fiziksel, psikolojik ve ekonomik olarak yaşadıkları sıkıntılar, tıbbi müdahalenin de içinde olduğu bir savaş haline gelebilmektedir. Hemşireler bu konuda üzerilerine aldıkları sorumluluklar karşısında tam donanımlı olmak yükümlülüğündedir. Karşılaşılabilecek herhangi bir problemin en aza indirilebilmesi, mesleki motivasyonun düşmemesi ve en iyi hizmetin sunulabilmesi adına palyatif bakım eğitimlerine daha fazla ağırlık verilmelidir.
Scientific technology that has been developing in our era facilitates a big part of our life. Although technology which has been developing especially in the field of medicine aims at extending the life span, the treatments can be a challenging process for the hopeless cases. This process requires to provide some basic needs in hospital settings or in private care centres, such as providing the most appropriate care to patients and their relatives, identifying physical and psychosocial problems at an early time, and improving the quality of life. “Palliative care” or “end of life care” in other words which is needed by patients and their relatives and has been highly placed emphasis on more recently, appears as a human right. Palliative care requires to act with a multidisciplinary team approach. The health care professionals in the team are obliged to be able to evaluate the needs of patients and their relatives broadly. Especially, nurses who can keep their knowledge and skills open to continuous improvement in providing necessary care and support to patients and their relatives have an important role. Nurses are an important part of care in effective communication. The care that the patient needs due to the situation he/she is in cannot be met only by the relatives of the patients. At this point, the physical, psychological and economical problems experienced by the patient and their relatives can become a war that includes medical intervention. Nurses are obliged to be fully equipped in the face of the responsibilities imposed on them. Palliative care trainings should be given more attention in order to minimize any problems, to avoid professional motivation and to provide the best service.
Aim: This study was prepared to analyze the “Code Blue” application and results in Hitit University Erol Olçok Training and Research Hospital.
Material and Method: Whole of the code blue calls issued ...in our hospital in 2019 were retrospectively examined and evaluated within the framework of the necessary legal permissions. In this context, arrival time of the code blue team at the scene, CPR performance, duration, results of application and demographic information of patient, place, date and time data were collected. The obtained data were analyzed using the SPSS (Statistical Package for Social Science).
Results: Between 01.01.2019 and 31.12.2019 a total of 748 code blue notifications were evaluated. The average time for the blue code team to reach the patient was 2.06 minutes. Code blue call was made mostly in intensive care units, by nurses and in January. Patients who underwent code blue intervention 55.89% of them were male and 44.11% were female. Code blue calls were requested the most was the range of 61-80 ages. The oldest patient who received CPR was 105 years old, and the youngest was 2 years old. Besides, code blue call reason is most respiratory+cardiac arrest (243), cardiac arrest (199) and respiratory arrest (109). The results of the whole code blue interventions in 2019, it was figured out that 401 of the patients were dead, 135 of them were taken into intensive care, 173 of them were monitored in the service, 25 people were transferred to the emergency, 12 calls were wrong calls and 2 calls for exercise.
Conclusion: The internationally determined intervention period for the patient to not lose his vital functions to survive is 2 -5 minutes. As a result, code blue application in our hospital has been successfully implemented in accordance with the standards, with effective and rapid intervention.
The coronavirus disease 2019 (Covid-19) pandemic has influenced the whole world, where after the first case was diagnosed in Turkey, educational activities were suspended and partial curfews were ...implemented. This study was conducted to assess the concerns faced by the medical students about their professional life due to the disrupted educational activities and related psychological effects.
This is a cross-sectional survey study, conducted with self-administered questionnaires on Bezmialem Vakif University medical students, during the pandemic. The questionnaire consists of queries about demographics, environmental factors, Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) scales.
A total of 178 students participated in the study, with a female-to-male ratio of 5:2. Of the total respondents, 19.7% were experiencing severe anxiety, 17.4% moderate anxiety, and 37.1% mild anxiety, according to the GAD-7; and 13.5% of the respondents were experiencing severe depression, 21.9% moderate-severe depression, and 23% mild depression according to the PHQ-9. There was no statistically significant difference between the grades in terms of GAD-7 or PHQ-9 scores. Male participants were more likely to have suicidal thoughts (
= 0.013). According to our study, the factors with the highest influence on students were as follows: "Major changes in personal life," "Disruption in educational activities," and "Covid-19 related anxiety of loss of relatives and contamination or infection." On average, women voted higher points for "Covid-19 related anxiety of loss of relatives and contamination."
We found that a significant portion of students regardless of their year in medical school were profoundly affected by the pandemic process as is shown by their anxiety and depression scores. The disruption in educational activities is one of the main factors of these effects, and we believe that these should not be ignored, as they could in the future lead to a series of problems for medical education and students alike.
The present work focuses on a local survey of free-living amoebae (FLA) that cause opportunistic and nonopportunistic infections in humans. Determining the prevalence of FLA in water sources can ...shine a light on the need to prevent FLA related illnesses. A total of 150 samples of tap water were collected from six districts of Sivas province. The samples were filtered and seeded on nonnutrient agar containing Escherichia coli spread. Thirty-three (22%) out of 150 samples were found to be positive for FLA. The FLA were identified by morphology and by PCR using 18S rDNA gene. The morphological analysis and partial sequencing of the 18S rDNA gene revealed the presence of three different species, Acanthamoeba castellanii, Acanthamoeba polyphaga, and Hartmannella vermiformis. Naegleria fowleri, Balamuthia mandrillaris, or Sappinia sp. was not isolated during the study. All A. castellanii and A. polyphaga sequence types were found to be genotype T4 that contains most of the pathogenic Acanthamoeba strains. The results indicated the occurrence and distribution of FLA species in tap water in these localities of Sivas, Turkey. Furthermore, the presence of temperature tolerant Acanthamoeba genotype T4 in tap water in the region must be taken into account for health risks.
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Introduction: Orthostatic hypotension (OH) affects 5–20% of the population. Our study investigates the presence of OH in diabetic nephropathy (DNP) patients and the factors affecting OH in comparison ...with nondiabetic chronic kidney disease (NDCKD) patients. Method: Patients presented to the nephrology clinic, and those who consented were included in the study. DNP was defined by kidney biopsy and/or clinical criteria. NDCKD patients of the same sex, age, and eGFR were matched to DNP patients. Demographic parameters and medications were obtained from the records. OH was determined by Mayo clinic criteria. The same researcher used an electronic device to measure blood pressure (BP). All samples were taken and analyzed the same day for biochemical and hematologic parameters and albuminuria. Results: 112 (51 F, 61 M, mean age: 62.56 ± 9.35 years) DNP and 94 (40 F, 54 M, mean age: 62.23 ± 10.08 years) NDCKD patients were included. There was no significant difference between DNP and NDCKD groups in terms of OH prevalence (70.5 vs. 61.7%, p = 0.181). Male patients had significantly higher OH prevalence than female patients (74.7 vs. 60.0%, p = 0.026). There was no significant difference in change in systolic BP between the groups (24.00 10.00–32.00 mm Hg vs. 24.00 13.75–30.25 mm Hg, p = 0.797), but the change in diastolic BP was significantly higher in the DNP group (8.00 2.00–13.00 mm Hg vs. 6.00 2.00–9.00 mm Hg, p = 0.025). In the DNP group, patients with OH had significantly higher uric acid levels than those without OH (7.18 ± 1.55 vs. 6.36 ± 1.65 mg/dL, p = 0.017). And, 73.7% of patients on calcium channel blockers developed OH (p = 0.015), and OH developed in 80.6% of 36 patients on alpha-blockers (p = 0.049). Conclusion: OH prevalence is very high in CKD, and etiology of CKD does not have a statistically significant effect on the frequency of OH, despite a difference that could be meaningful clinically. Therefore, patients with CKD are checked for OH, with or without concurrent diabetes mellitus. Evaluation of postural BP changes should be a part of nephrology practice.
Fibromyalgia syndrome (FMS) is one of the most frequent forms of chronic widespread pain, with a reported prevalence of 3-10% in the adult population. Clinical presentation of the typical pain and ...the presence of associated somatic and psychological symptoms form the basis of the diagnosis. FMS is associated with nervous system dysfunction and neurotransmitters act as targets of a number of drugs approved for fibromyalgia. However, although the underlying mechanisms in FMS are not yet known precisely, many hypotheses have been put forward. Considering the relation between fibromyalgia and irritable bowel syndrome (IBS), altered gut microbiome could be associated with fibromyalgia. In this study, it was aimed to investigate the variation of intestinal microbiome levels in patients with FMS compared to healthy controls. For the investigation of the microbiome, fecal samples were collected from a cohort of 54 patients with FMS and 36 healthy individuals. Those with any mental and/or physical illness in the control group were excluded from the study. The FMS patient group was determined according to the "American College of Rheumatology (ACR)" 2010 diagnostic criteria. The fecal samples were stored at -80°C until use and were thawed on ice; for each extraction, 0.3 g of faeces were weighed. Extraction of DNA was carried out with commercial kit according to the manufacturer's recommendations. Samples were compared using 16S rRNA gene amplification with specific primers of Bacteroidetes, Firmicutes, Enterobacter, Lactobacillus, Streptococcus and Bifidobacterium by the real-time PCR method. According to our results, while the increase of Bacteroidetes and Bifidobacterium was statistically significant (p<0.05), Firmicutes decreased (p<0.001) in the patient group. No statistically significant results were found for Enterobacter, Streptococcus and Lactobacillus (p> 0.05). When the relationship between bacteria was evaluated, a high statistically significance and negative correlation was found between Bacteroidetes and the percentage of Firmicutes (r= -0.778, p<0.001),while a moderate statistical significance and positive correlation was observed between the percentage of Enterobacter and Bifidobacterium (r= 0.460, p= 0.005). The results suggest that the gut microbiota may play a role in fibromyalgia. The balance of Firmicutes and Bacteroidetes phyla in the gut is known to have important effects on intestinal homeostasis. In summary, it is clear that large-scale further research in larger cohorts will be effective in understanding the relationship between the gut microbiome and FMS and evaluating possible treatment options.
Abstract
Dermanyssus gallinae is a blood parasite of wild birds, but it is also a pest in the poultry industry. It occasionally bites mammals and thus rarely creates skin problems such as itching, ...papules, vesicles, and dermatitis. A 92-year-old man presented with severe itch on his head, particularly at night. He had been misdiagnosed with senile pruritus and treated with antihistamines and topical corticosteroids with temporary relief of the symptoms. On the basis of clinical and parasitological findings, D. gallinae dermatitis was diagnosed. Decontamination of the patient's immediate environment was not helpful. The patient was successfully treated using a 1% permethrin shampoo once a week for 2 weeks. During 3 months of follow-up he was free of symptoms. The case is of significance because most dermatologists have difficulty identifying ectoparasitoses, such as those that arise within new or atypical conditions.
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