Anatolian Clinic Journal of Medical Science / Anadolu Kliniği Tıp Bilimleri Dergisi

8-15

Authors: Funda Koçak, İlker İnanç Balkan, Aygül Doğan Çelik, Bülent Durdu, Aslıhan Demirel, Serap Gencer, Hava Yılmaz, Fatma Ekşi Polat, Bahri Teker, Aziz Öğütlü, Aynur Engin, Alper Şener, Mesut Yılmaz, Serpil Öztürk Özkan, İlknur Esen Yıldız, Derya Öztürk Engin, Muhammed Emin Doğan, Oğuz Karabay

Aim: We aimed to determine the rates of compliance with current guidelines for practices of perioperative antimicrobial prophylaxis (PAP) and the factors affecting these rates. Materials and Methods: Four hundred and ten surgeons from seven different branches attended the survey conducted between May 30 and June 30, 2013, in fifteen different centers. A 40-question questionnaire consisting of multiple choice and open-ended questions was prepared and applied by interviewing the surgeons.Results: The mean age was 38.01 ± 9.1 years; and 83.4% of the participants were male. Of the surveyed surgeons 46.2% stated that they had no information about the existence of any guidelines for surgical prophylaxis in their institutions and 34% stated that institutional guidelines were available and their prophylaxis practices were in accordance with them. Surgeons who were trained on surgical prophylaxis within the last three years were found to have a statistically higher (p<0.001) rate of compliance with the guidelines. Compared to surgeons from other branches, compliance rates in cardiovascular surgeons were statistically significantly higher (p=0.012). The duration of prophylaxis applied was longer than 24 hours in 56% of the participants. In procedures involving drains, 63.7% of the surgeons stated that they preferred to terminate surgical prophylaxis after removing the drainage tube. It was found that urologists used second and third generation cephalosporins statistically significantly more frequently (p<0.001; p=0.002). Of the surgeons 87.6% stated that they did not rotationally change the antibiotics they used for surgical prophylaxis. It was found that 33% of the centers did not have 24-hour infection consultation and microbiology laboratory facilities. The question “What are the most important reasons for failure in compliance with surgical prophylaxis guidelines?” was left unanswered by 50% of the participants. The most important reasons of incompliance were found to be “lack of regular feedback about hospital infections and the pathogenic microorganisms” (30%), “failure in application of the prophylactic agent in accordance with the timing and dosing determined by the healthcare personnel” (27%), and physicians’ view that institutional PAP guidelines were insufficient (17%). Discussion and Conclusion: Besides the existence of institutional guidelines for the establishment of evidence-based PAP practices, it is also crucial to provide active participation of surgical healthcare units in the preparation of these guidelines and to maintain regular training and feedback meetings and active communication between medical branches.

24-29

Authors: Mehmet Ali Sungur, Handan Ankaralı, Şengül Cangür

Aim: The rate of statistical software use among researchers today is very high. In this study we aimed to develop a web-based decision tree at the least possible confusion level that can provide guidance in choosing the appropriate test statistics for researchers who want to perform the basic statistical analyses in univariate models on their own. Materials and Methods: The decision tree developed as a guide in determining the appropriate test statistics in the statistical analysis of simple or multiple univariate models was created by using PHP and JavaScript languages. Technical information on the concepts and tests was provided in pop-ups for the guide user’s convenience. Results: The questions posed within this decision tree that is quite easy to reach and use help reduce possible appropriate methods by fixing the research’s aim, design and data type and lower the researcher’s possibility to make mistakes due to lack of knowledge or misguidance. In addition, the information provided on the existence and nature of more advanced statistical methods emphasizes for the researcher the importance of consulting with an expert during the statistical analysis of a study’s results.Discussion and Conclusion: Choosing the right test is crucial for the accuracy and reliability of findings to be obtained from a statistical analysis. What is essential is the ability to choose the right test for statistical analysis, not the ability to perform a statistical test or use statistical software. In addition to emphasizing the importance of consulting with an expert, a decision tree as developed in this study will contribute to lowering the possibility of making mistakes of researchers who want to perform statistical analyses on their own, at least while their choice of method.

36-45

Authors: Dilek Akkuş, Aysel Karaca, Dilek Konuk Şener, Handan Ankaralı

Aim: Tobacco and alcohol use among adolescents is an important issue that has been frequently addressed in recent years. In this study we aimed to determine the prevalence of tobacco and alcohol use among high school students and the factors affecting the use of these substances. Materials and Methods: This cross-sectional study was carried out with 1997 students from three different high schools in the 2015–2016 academic year. All of the students who volunteered were included in the study that was designed by cluster sampling method. The data were analyzed by mean, standard deviation, number and frequencies, chi-square and multiple polytomous logistic regression analyses. Results: The rate of the students who have smoked at least once in their lives was found to be 35%, and the rate of those who were smoking almost every day 20.1%. These rates for alcohol use were 18.7% and 1.8%, respectively. It was found that the rates of tobacco and alcohol use were statistically significantly higher in students from industrial vocational high schools, male students, 12th grade students, students who perceived their academic success to be low, students who had received a disciplinary punishment, and those who were frequently absent from school, had gotten into trouble with the police, had friends using tobacco, alcohol or another substance, or had undergone psychological treatment (p<0.001). Discussion and Conclusion: The rates of tobacco and alcohol use among the students were found to be similar to those reported in studies previously performed in Turkey and other countries. Based on these results, we suggest that preventive/protective interventions be planned at schools by taking into consideration the individual, familial, and school characteristics of pre-high school students.

50-52

Authors: Ibrahim Adak, Ilyas Kaya, Murat Coskun

Hyperhidrosis (excessive sweating) is a rarely reported side effect of methylphenidate treatment in young subjects with attention-deficit/hyperactivity disorder. There are few reports of hyperhidrosis associated with methylphenidate overdose in children and adolescents with diagnosis of ADHD. Here we report a case of an adolescent boy who developed hyperhidrosis after taking osmotic-controlled release oral delivery system methylphenidate (Concerta®) for his attention-deficit/hyperactivity disorder.

58-63

Authors: Pervin Somer, E. Elif Vatanoğlu-Lutz

Although the great achievements in today’s medicine offer remedies for many illnesses, there are still cases where physicians are helpless despite their highly improved technological abilities and medical knowledge. Patients who cannot get well despite such medical treatments or have been diagnosed with a terminal illness might seek different solutions. In this context, applications of traditional and complementary medicine become prominent. We can also see that Western medicine is not as distant as it used to be toward traditional and complementary medicine. It is noticeable in the recent literature that physicians worldwide now tend to be knowledgeable with these practices, and that although they do not make them a part of their treatments yet, they inform their patients about them and do research on them. In this paper, the new Regulations on Traditional and Complementary Medicine in Turkey is evaluated from legal and ethical perspectives.