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Öğe Bir eğitim ve araştırma hastanesine başvuran adölesan gebelerin tıbbi, sosyal ve hukuki açıdan incelenmesi(2021) Meral, Orhan; Şener, Aslı; Şen, TeomanAmaç: Adölesan gebelikler ülkemizde ve dünyada önemli bir halk sağlığı sorunu olarak karşımıza çıkmaktadır. Bu gebeliklerin önlenebilmesi için her ülke kendi iç politikalarını düzenlemiştir. Ülkemizde de evlilik ve cinsel ilişki yaş sınırları kanunla belirlenmiştir. Bu çalışmada Ocak 2018 – Ağustos 2020 tarihleri arasında Çiğli Eğitim ve Araştırma Hastanesi’ne başvuran, yapılan muayene ve tetkikler sonucunda gebe olduğu belirlenen 18 yaş altı olguların incelenerek, elde edilen verilerin literatürle tartışılması amaçlanmıştır.Materyal ve Metot: Çalışma kapsamına alınan 18 yaş altı 260 gebe olguya ait tıbbi kayıtlar Hastane Bilgi Yönetim Sistemi üzerinden incelenmiştir. Veriler SPSS programı (versiyon 22.0) ile analiz edilmiştir. Analiz için Fisher Exact ve Pearson ki-kare testleri kullanılmıştır.Bulgular: Adölesan gebelerin ilk hastane başvurusuna yaşları 13-17 arasında değişmekte olup ortalaması 16,4±0,7 olarak hesaplanmıştır. Medeni durum bilgisine ulaşılan 39 olgudan 31’inin (%79,4) resmi nikâhlı, 4 olgunun (%10,3) ise bekâr olduğu görülmüştür. Adölesanların gebe olduklarının belirlendiği ilk başvurularında gebelik haftaları 3 ila 41 hafta arasında değişmekte olup, 142 olgunun (%54,6) gebeliğinin üçüncü trimesterde olduğu tespit edilmiştir.Sonuç: Eğitim kurumlarında cinsel sağlık derslerinin yaygınlaştırılması, sağlık kurumlarında adölesan gebeliklerin zararları konusunda hizmet veren polikliniklerin oluşturulması, adölesan gebeliğin kişi ve toplum sağlığı üzerine olumsuz etkilerinin ve ayrıca bir suç teşkil edebileceği gibi hukuki sonuçlarının topluma yeterince duyurulmasının faydalı olacağını düşünmekteyiz.Öğe Characteristics of non-urgent visits in emergency department(2021) Baykan, Onur; Meral, Orhan; Öztürk, Tayfun; Gönüllü, HayriyeAim: In recent years, the number of patients using the emergency department is increasing and majority of these patients constitute non-emergency patients. In this study, it was aimed to examine the green field patients who applied to the emergency department of a tertiary hospital by non-urgent reasons and define the socio-demographic characteristics, the reasons for preferring the emergency department, to assess the rate of urgency defined by the participant, and to contribute to the literature by obtaining data for our country. Materials and Methods: This is a cross-sectional study in which the subjects were selected among the whole green area patients applied to emergency department in between 02 and 11 November 2018. Among these patients, the subjects who did not accept to be included to the study and didn’t fulfill the inclusion criteria were excluded. As a result, a total of 716 patients who accepted to be in the study and fulfilled the inclusion criteria were included to the study. Then, a questionnaire for the aim of assessing the socio- demographic characteristics and the reasons for preferring the emergency department, involving a scale to define the self-report of urgency were applied to those 716 volunteered patients. Results: In our study, 23.9 % of a total of 5644 patients applied to emergency department in between 02 and 11 November 2018 were grouped as non-urgent green area patients by the triage personnel. Of these green area patients those who accepted to be included to the study and fulfilled the inclusion criteria; 356 were female (49.7 %) and 360 were male (50.3 %). When the participants were evaluated according to their level of educations, 5.4 % were illiterate, 4.1 % were literate but had no school graduate, 30.6 % were primary education graduates and 13.4 % were university graduates. According to the reasons for choosing the emergency department, 48.2 % of the patients stated that they applied to the emergency department in need of emergency treatment, 22.5 % of the visitors declared that they were unable to get permission from their work in their working hours and 13.1 % of the visitors applied due to their opinion that things were progressing faster in the emergency department. In addition, the patients were asked to scale their urgency in a 10-point scale and the mean rate of urgency defined by the participants in the self-report scale was found to be 6 points (0-10) and negative correlation was observed between education levels and urgent levels. Conclusion: In this study, we obtained descriptive data about the green field patients who applied to the emergency department by non-urgent reasons, defined their socio-demographic characteristics, revealed the reasons for non-urgent applications to the emergency department, and assessed the self-rate of urgency defined by the participants. Since it can be predicted that the overcrowding generated by these non-urgent visits has negative effects and consequence on patients and employees; we consider that this study and similar studies may be helpful in describing the current problem, may help to solve the problem by contributing to the literature.Öğe Comparison of the reliability of the “GÖK Atlas” and the “Gilsanz-Ratib Atlas” in the Determination of bone age in Turkish children(2022) Öcal, Zeynep Ayvat; Meral, OrhanAim: In this study we aimed to evaluate which of the GÖK and GR atlases is more compatible with chronological age in Turkish children aged 5-10 years. Material and Method: In this study, the wrist radiographs of patients aged 5-10 years who applied to İzmir Bakırçay University Çiğli Training and Research Hospital due to trauma were retrospectively analyzed. A total of 360 wrist radiographs were evaluated. Bone age estimates in both groups were compared with chronological ages. Results: In the correlation analysis, the prediction rate with 1-difference tolerance is 88.9% in the GR atlas and 76.7% in the GÖK atlas, while both atlases predict 99% correctly with two-difference tolerance. GR Atlas 168 (46.2%) and GÖK Atlas 147 (40.8%) predicted correctly regardless of gender and age. Of the correct estimations, 53.5% in the GR atlas and 57.8% in the GÖK atlas were male cases. İn male age group at the age of 6 and 10, the GR atlas is more successful, at the age of 7, the GÖK Atlas is more successful, and at the age of 5, 8, and 9 the success of both atlases is the same. İn female age group at the age of 5,7, 8, and 10 the GR atlas is more successful, at the age of 6 and 9 the GÖK Atlas is more successful Conclusion: The GR Atlas was more accurate than the GÖK Atlas. Both the GR Atlas and the GÖK Atlas predicted more accurately in males. Since reference values for bone age can change with environmental and genetic factors all over the world, it is beneficial for all races to create atlas models with multicenter studies in order to establish their own standards.Öğe Comparison of trace element (selenium, iron), electrolyte (calcium, sodium), and physical activity levels in COVID-19 patients before and after the treatment(Elsevier Gmbh, 2022) Özdemir, Kadirhan; Saruhan, Ercan; Benli, Tuba Kaya; Kaya, Gözde; Meral, Orhan; Yavuz, Melike Yüksel; Şen, TeomanObjective: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), a worldwide health problem, is the cause of 2019 coronavirus disease. This study aimed to compare the trace element (selenium and iron), electrolyte (calcium and sodium), and physical activity levels of COVID-19 patients before and after COVID-19 treatment. Method: This prospective study was conducted in patients diagnosed with COVID-19 (n = 15). Trace element (selenium and iron), electrolyte (calcium and sodium), and physical activity levels of the patients were compared before and after the treatment. Result: Most of patients had selenium deficiency (86.7 %), iron deficiency (73.3 %), calcium deficiency (66.7 %) and sodium deficiency (46.7 %) before COVID-19 treatment. The most important improvements were seen in iron deficiency (from 73.3 % to 26.7 %) and sodium deficiency (from 46.7 % to 13.3 %) after the treatment. Selenium, iron, calcium, and sodium levels of the patients were significantly higher after the treatment (p < 0.05). The patients had low physical activity before and after COVID-19 treatment. In addition, no statistically significant difference was found in the comparison of physical activity levels (p > 0.05). Conclusion: This study indicated that selenium, iron, calcium, and sodium levels and deficiencies might improve after treating patients with COVID-19. However, the results of this study showed that the physical activity levels of COVID-19 patients might remain stable and low throughout the treatment process.Öğe Determination of serum trace elements (Se, Fe, Zn), macrominerals (Ca, Na, Cl), and physical activity levels in COVID-19 patients(Dustri-Verlag Dr Karl Feistle, 2022) Özdemir, Kadirhan; Saruhan, Ercan; Meral, Orhan; Kaya, Gözde; Benli, Tuba Kaya; Bakar, Yeşim; Kızıloğlu, İlkerObjective: This study mainly aims to determine serum trace elements, macrominerals, and physical activity levels in COVID-19 patients compared to healthy con-trols. Materials and methods: This prospec-tive study was conducted among COVID-19 patients (group I, n = 20) and healthy con-trols (group II, n = 20). Serum trace element levels (Se, Fe, and Zn), macrominerals (Ca, Na, and Cl), vitamin D, ferritin, and physical activity levels were determined. Results: Of the participants in group I, 90% had Se defi-ciency, 65% had Fe deficiency, and 35% had Zn deficiency. In addition, 45% of the par-ticipants in group II had Se deficiency. There was Ca deficiency (60%), Na deficiency (40%), and Cl deficiency (30%) in COVID-19 patients. Healthy controls did not have any macromineral deficiencies. The trace ele-ment levels including Se, Fe, and Zn were not statistically significant (p > 0.05); how-ever, the micromineral levels including Ca, Na, and Cl were significantly lower between groups (p < 0.05). There were vitamin D de-ficiencies in 90% and 70% of the participants in group I and group II, respectively. Ferritin levels were significantly higher in group I than group II (p < 0.05). All the participants had low physical activity levels in group I, and 40% of the participants had low physi-cal activity levels in group II. Conclusion: This study showed that COVID-19 patients might have lower Ca, Na, and Cl levels than healthy adults. In addition, high rates of Se, Fe, Ca and vitamin D deficiencies, and ferritin lev-els may be seen in COVID-19 patients. More-over, COVID-19 patients may have low levels of physical activity.Öğe Estimation of sex from computed tomography images of skull measurements in an adult Turkish population(Sage Publications Ltd, 2021) Meral, Orhan; Meydan, Reyhan; Toklu, Belkis Betül; Kaya, Ahsen; Karadayı, Beytullah; Acar, TürkerBackground Nowadays, data on the anthropometric measurements of populations is needed in many areas, especially forensic and legal. Using various methods, researchers obtain various data such as race, sex, and age, and thus provide identification of the material used. Morphological or metric methods are often used for identification. Purpose To evaluate the usefulness of the results of skull measurements using computed tomography (CT) to determine sex in a Turkish population. Material and Methods We analyzed 300 male and 300 female CT images of Turkish individuals with an age range of 21-50 years. Maximum cranial length, maximum cranial breadth, bimastoid diameter, bizygomatic diameter, and bigonial breadth were measured by CT tomography. All data were subjected to discriminant function analyses for estimating sex. Intra-observer and inter-observer variances of the measurements were examined using intraclass correlation coefficient analysis. Results Discriminant function analysis indicated that there was a significant difference between male and female with 88% accuracy. Discriminant function for estimation of sex was obtained with satisfactory accuracy rates for the parameters used. Conclusion This study confirms that skull measurements show sexual dimorphism in the Turkish population, and also suggests that it may be useful to use CT to assess skull anthropometric measurements.Öğe Sexing from the orbital measurements using computed tomography images and discriminant function analysis in Turkish population(Taylor & Francis Ltd, 2023) Meral, Orhan; Toklu, Belkıs Betül; Meydan, Reyhan; Kaya, Ahsen; Karadayı, Beytullah; Acar, TürkerThe main goal of identification in forensic sciences is to estimate characteristics such as sex, age, stature, and ancestry. One of the regions of the human skeleton that most clearly shows sexual dimorphism is the skull. This study aims to evaluate whether the orbital dimensions could be used for sex estimation using Computed Tomography. We examined the orbital measurements of adult Turkish individuals (300 males and 300 females) aged 21-50. We measured Orbital Width, Orbital Height, Biorbital Breadth, and Interocular Breadth by Computed Tomography. The data of the variables showed a normal distribution; therefore, functions of uni/multivariate variables were obtained using Discriminant Function Analysis. Using Discriminant Function Analysis, a significant difference between men and women was determined with an accuracy of 73%. The orbital measurements of the adult Turkish population showed limited forensic significance for sex estimation. Conversely, their potential for examining the interpopulation and intrapopulation differences have been shown.Öğe Üroloji alanıyla ilgili tıbbi uygulama hatası(2022) Kaplan, Gazel; Çağlayan, Alper; Meral, OrhanHekimlerin tıbbi, idari adli ve etik sorumlulukları bulunmaktadır. Bünyesinde çok sayıda risk barındıran hekimlik mesleğinde istenmeyen olumsuz durumların meydana gelmesi neticesinde hasta veya hasta yakınları tarafından yargı mercilerine tıbbi hatalar yönünden başvurulabilmektedir. Son yıllarda gerek ülkemizde gerekse de dünyada tıbbi uygulama hatası iddiasıyla yapılan şikâyet başvurusu ve açılan dava sayısında belirgin artışın olduğu bilinmektedir. Özellikle cerrahi branşlarda meydana gelen istenmeyen durumlar neticesinde tıbbi hata bulunduğu yönünde davalar olduğu yapılan birçok çalışmada bildirilmektedir. Uzayan yargılama süreçleri, istenen hapis cezaları, ödenen yüklü tazminatlar vs. defansif tıp uygulamalarının da artışına neden olmaktadır. Bu çalışmada, Üroloji alanına yönelik tıbbi uygulama hatası iddiasıyla başlatılan yargı süreçlerinden Danıştay’a yansıyan davalarının incelenerek, en üst idari yargı merci olan Danıştay’ın yerel mahkeme ve üniversite kararlarına bakış açısı değerlendirilecektir. Bir cerrahi branş olan Üroloji alanında görev yapan hekimler için hasta ve hasta yakınları tarafından tıbbi hata iddiasında bulunulması riski azımsanmayacak düzeydedir. Ülkemizde daha önce benzer nitelikte bir çalışma yapılmamış olduğundan sunulan çalışmanın literatüre katkı sağlayacağı düşüncesindeyiz.
