The knowledge, attitude and behavior related to the tuberculosis and approaches of tuberculosis therapy by the physicians providing first step service

Before a performed education of tuberculosis for physicians who give first step treatment in our city center, a questionnaire was applied to the participants to evaluate the knowledge, attitude, behavior and approach to the treatment. The 66 practicing physician having an employment period of 64.88 +/- 39.42 months were coming from tuberculosis eradication dispensers at the rate of 3%, and from heath center at the rate 97%. The percentage of facing with tuberculosis patients in physicians, exclude who work in tuberculosis eradication dispensers, per year was median 7.30 +/- 9.77 (0-50). 21.2%, of the physicians determine that disease could be spread by only with respiratory tract, 77.3% of them consider that other than respiratory tract and 59.1% of them deemed that the most important factor is living in the same place with a tuberculosis patient and 75.8% of them determine that for a certain diagnosis the sputum examination is enough. 80.3% of the participants said that in our country conditions PPD must be done for the diagnosis. When the most important 4 tuberculosis drugs are asked only 16.7% of the physicians include morphozinamide as a first choice tuberculosis therapy. 48.5% of the physicians deemed that the therapy duration must be at least 6 months. 74.2% of them determine that follow up the disease must be made by sputum plus another examination, 93.9% of them indicated that the tuberculosis patients must be reported to tuberculosis eradication dispensers. When the hepatotoxicity is occurred, only 27.3% of the physicians could interfere the necessary implementation. 74.2% of them determine that the most important problem in control of tuberculosis is about diagnosis, therapy and follow up. When the directly observed treatment short course (DOTS) strategy is asked 16.7% of them gave correct answer. 34.9% of the first step physicians think that tuberculosis eradication dispensers is the primary responsible center in the control of tuberculosis but 53% of them think that tuberculosis eradication dispensers is inadequate in this subject. In conclusion, the first step practice physicians who work in Elazi? city center have insufficient knowledge and it is needed periodically postgraduate education.     

Sex after seventy: a pilot study of sexual function in older persons

IntroductionLimited information is available regarding sexual functioning among adults aged 70 years and older.AimsTo assess sexual functioning among older men and women, and ascertain patient–physician communication patterns about sexual functioning.MethodsProspective participants were approached prior to scheduled appointments with their primary care physician. In-depth sexual histories were obtained along with data on their demographic, medical, psychological, and cognitive status.Main Outcome MeasuresSexual functioning was assessed using standardized questionnaires, and simple yes/no questions were administered to ascertain information regarding patient–physician communication practices about sex.ResultsOf the 74 eligible patients approached, 50 (68%) participated. The participants had a mean age ± standard deviation (SD) of 81 ± 6 years and most (56%) were women. Eighteen percent of the women and 41% of the men were sexually active. The most commonly reported sexual activity was intercourse for men and masturbation for women. Among the women, the most commonly cited reason for being sexually inactive was “no desire,” whereas for most men, it was “erectile dysfunction.” Sexual function scores for women were low across each category (lubrication, desire, orgasm, arousal, pain, and satisfaction.) For men, low sexual function scores were found in the domains of erectile function, orgasm, and overall satisfaction, but not desire. Only 4% of the women (vs. 36% of men) reported initiating a discussion about sexual function with their physician in the past year, whereas 7% of the women (vs. 32% of men) reported that their physician inquired about the topic in the preceding year. Finally, 32% of the women (vs. 86% of men) felt that physicians should initiate discussions about sexual function.ConclusionIn this study of older adults, a minority reported current sexual activity. Among sexually inactive women, most did not wish to resume activity, whereas desire for sexual activity remained high among men, despite substantial problems with erectile dysfunction. Smith LJ, Mulhall JP, Deveci S, Monaghan N, and Reid MC. Sex after seventy: A pilot study of sexual function in older persons.     

Teratogenic effects of propineb on rat skin

The dithiocarbamates are known to cause dermatitis, conjunctivitis, rhinitis, pharyngitis and bronchitis in humans. The experimental group received Propineb (obtained from Bayer) concentrations of 400 ppm in distilled water five days a week (treatment time three weeks) administered orally by gasric pit. Acute oral LD50 for male rats has been found to be 8,500 mg/kg (Worthing, 1983). The control group (n = 10) received only distilled water. At ultrasonographical examination, there were no resorbed fetuses or stillborns during or after propineb administration. It can be clearly seen that the body weights of the experimental group of litters are lower than those of the control group (p < 0.001). However, the mean length of the experimental litters was identical to the control group of litters (p > 0.05). Under microscopical examination, increased keratinization and hyperplasia were observed in the epidermal cells.     

Psychological evaluation of self-inflicted burn patients: suicide or parasuicide?

Self-inflicted burns have an increasing incidence all around the world. There is a high mortality and morbidity rate among these patients. We retrospectively analysed the psychiatric characteristics of self-inflicted burn patients. The results showed that these attempts are somewhat different from suicidal acts and may be defined as parasuicides. The treatment and rehabilitation strategies of so called parasuicidal burns are discussed.     

Airway wall thickness in patients with COPD and healthy current smokers and healthy non-smokers: assessment with high resolution computed tomographic scanning

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction caused by emphysema or airway narrowing, or both. Recently airway dimensions have been measured using high-resolution computed tomography (HRCT). To evaluate large and small airway dimensions by HRCT and compare them with pulmonary function tests in patients with COPD and in smokers with or without airflow obstruction. METHODS: We used HRCT scanning to measure airway wall thickness at the segmental and sub-segmental levels in COPD patients (group II, stage II, n = 17, and group III, stage III, n = 5), healthy current smokers (group I, n = 10) and healthy non-smokers (group 0, n = 10). RESULTS: FEV1 was lower in patients with severe or moderate COPD than in healthy current smokers and non-smokers. FEV1 was lower in group I than group 0 (p < 0.005). There was no statistically significant difference between patients with moderate COPD and severe COPD in the ratio of airway wall thickness to outer diameter (T/D ratio) or the percentage wall area (WA%). Both groups II and III had higher T/D ratios than group I (p < 0.01), and group I had a higher T/D ratio than group 0 (p < 0.001). Both groups II and III had higher WA% than group I (p < 0.01 and p < 0.05, respectively), and group I had a higher WA% than group 0 (p < 0.001). A negative correlation was found between airway wall thickness and FEV1. CONCLUSIONS: Computed tomography measurements of large and small airway dimensions are useful for evaluating lung function in patients with COPD and healthy current smokers. Airway wall thickening is inversely related to the degree of airflow obstruction and positively related to cumulative smoking history.     

Intraurethral prostatic cyst: A rare cause of infravesical obstruction

A case is reported here of symptomatic intraurethral anterior midline prostatic cyst in a 52-year-old man whom transurethral resection of the cyst was performed successfully establishing the resolution of voiding symptoms.