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Volume : 54 Issue : 2 Year : 2024

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ZEYNEP KAMIL MEDICAL JOURNAL - Zeynep Kamil Med J: 54 (2)
Volume: 54  Issue: 2 - 2023
FRONTMATTERS
1.Cover

Page I

2.Editorial Board

Pages II - IX

REVIEW ARTICLE
3.An effective model in the health innovation ecosystem: TUSEB technology transfer
Yeliz Doğan Merih, Mehmet Emin Aktan, Erhan Akdoğan
doi: 10.14744/zkmj.2022.07088  Pages 53 - 61
In the study, it was aimed to present the current situation of Technology Transfer Offices (TTO) and their examples in different countries, to give information about the pioneering studies of the Health Institutes of Türkiye (TUSEB) in the field of health science and technologies, to include the scope, duties and the organizational structure, stakeholders and the holistic studies of TUSEB TTO carries out. TUSEB TTO, which continues its activities within a strategic plan that takes into account the development plan objectives and the priorities determined by the Presidency and the Ministry of Health; prioritizes objectives such as meeting Türkiye’s need for advanced technology and innovation in the field of health science and technologies, and supporting all processes from idea to product. In addition, TUSEB TTO is a health-focused coordination center where health professionals, engineers, academicians, and students with innovative ideas, as well as various public institutions, investors, universities, technoparks, incubation centers, and important organizations such as active institutions and NGOs can collaborate. TUSEB TTO plays an active role in the creation of the health innovation ecosystem with its activities such as leading studies in the field of health science and technologies, raising awareness with trainings that will cover all processes of health innovation, coordinating innovative ideas at all stages leading to the product, and creating the necessary collaborations.

ORIGINAL RESEARCH
4.The relationship between proteinuria and fetal-maternal complications: A retrospective analysis
Aysun Alcı, Yunus Emre Purut, Gülchin Babayeva, Bekir Sıtkı Isenlik
doi: 10.14744/zkmj.2022.57873  Pages 62 - 67
INTRODUCTION: This is retrospective research aimed at investigating the relationship between preeclampsia indicators and fetal-maternal results. Two hundred six women were enrolled in the study who were 25–42 weeks pregnant: 103 with preeclampsia and 103 in the control group. Control patients presented to Antalya Education and Training Hospital Obstetrics and Gynecology Clinics between January 2012 and 2015.
METHODS: The pregnant women enrolled in the study were asked about their demographic features. Blood pressure is measured. Time of hospitalization, hematologic and biochemical parameters, type of delivery, cesarean indication if done, and maternal-fetal complıcations were recorded. Furthermore, the characteristics of newborns were recorded. The relationship between categorical variables was analyzed using Fisher’s exact test or Pearson’s Chi-square test. If the number of samples was <50, the Shapiro–Wilk test was used, and if it was more than 50, the Kolmogorov–Smirnov test was used. The groups were analyzed for statistically significant differences using the Mann-Whitney U-test or Student’s t-test. The relationship between continuous variables not correlated with normal distribution and ordinal variables was examined using Spearman’s correlation test, and continuous variables correlated with normal distribution were analyzed using Pearson’s correlation test.
RESULTS: The delivery type of patients with +2 and +3 positive proteinuria was cesarean section, and 65% had antihypertensive therapy. One-quarter (26.3%) of patients with fetal IUGR and 55.2% needed a blood transfusion, and the difference between the +1 and no proteinuria groups was significant (p<0.05). The best predictor of the duration of maternal hospitalization was proteinuria, followed by diastolic blood pressure, and the difference was significant (p<0.05). Systolic blood pressure, SGOT, LDH, BUN, and uric acid values were positively and significantly correlated (p<0.05). The best predictor of neonatal birth weight was proteinuria, which was significant (p<0.05).
DISCUSSION AND CONCLUSION: The results of this trial show that proteinuria is an indicator that correlates with maternal and neonatal outcomes.

5.Knowledge, attitudes, and perceptions of COVID-19 vaccine among health-care professionals
Leyla Kaya, Esra Keles, Zahide Kaya
doi: 10.14744/zkmj.2022.25986  Pages 68 - 74
INTRODUCTION: The objective of the study is to understand COVID-19 vaccine perspectives among health-care workers (HCWs) in the early phase of COVID-19 pandemic.
METHODS: This cross-sectional study was carried out between February and March 2021, 2 weeks after the Turkish government approved nationwide COVID-19 vaccinations for adults over 18-year-old age. Several online platforms were used to distribute the questionnaires. We followed the snowball sampling technique. An online questionnaire including sociodemographic information, vaccination attitudes, and perceived causes of COVID-19 pandemic was used.
RESULTS: A total of 128 HCWs with a mean age of 30.97±8.07 years were included. The average score of the research-assistant physicians obtained from the “Conspiracy” sub-dimension was significantly lower than that obtained by the nurses, mid-wives, medical secretaries-laborants, and technicians (all p<0.05). There is a weak negative correlation between considering that the vaccine is safe and the mean scores obtained from all sub-dimensions of the scale (all p<0.05). HCWs had concerns about difference between vaccines obtained significantly higher mean scores from the “Conspiracy” and “Environment” factors subscales than those who were not concerned (all p<0.05).
DISCUSSION AND CONCLUSION: This study found that over half of HCWs were hesitant about the safety, effectiveness, and brand of vaccines even though they were vaccinated. The higher scores regarding belief and environmental factors indicated decreased the trust and confidence in vaccines among HCWs in the early COVID-19 pandemic.

6.Comparison of endocervical curettage and endocervical brush during unsatisfactory colposcopy for endocervical sampling in human papillomaviruses positive women
İrem Şenyuva, Şirin Küçük
doi: 10.14744/zkmj.2022.91328  Pages 75 - 79
INTRODUCTION: Comparison of endocervical curettage (ECC) and endocervical brush (ECB) in women with human papillomaviruses (HPV) positive who had unsatisfactory colposcopy for endocervical sampling.
METHODS: Women who underwent ECC and ECB during an unsatisfactory colposcopy were retrospectively investigated. The results were classified as normal, inadequate, low, and high-grade lesions for compiling the two methods.
RESULTS: In the 44 cases, the mean age was 45.75±9.71; seven of the 44 cases were low-risk HPV, while 37 were high-risk HPV. Normal results were reported in 19.4% of ECB and 32.8% of ECC (p>0.05). Unsatisfactory results were observed in 56.3% of ECB and 37.5% of ECC (p>0.05). Low-grade epithelial abnormalities were detected more in the ECB (p=0.001). ECB was not superior to ECC in high-grade lesion detection (p>0.05).
DISCUSSION AND CONCLUSION: Low-grade lesions were diagnosed with ECB, while high-grade lesions were detected with ECC. ECB is a simple and less painful technique and can be used during unsatisfactory colposcopy in low-grade lesions, but more studies are needed.

7.Nutritional status and depression during pregnancy
Pınar Geyik, Elvan Yılmaz Akyüz
doi: 10.14744/zkmj.2022.57984  Pages 80 - 87
INTRODUCTION: During the pregnancy, the mood may be changeable and depression may have negative consequences for pregnant and infants. The aim of this study was to investigate the relationship between nutritional status and depression in all trimesters.
METHODS: The study was conducted with 140 women who were in the 1st trimester of pregnancy and admitted to the Pregnancy Unit of Haydarpaşa Numune Training and Research Hospital of Health Sciences University. In this study the Edinburgh Postnatal Depression Scale (EPDS) was administered, and personal information and 24-h food consumption were recorded. This scale and dietary record were repeated in the 2nd and 3rd trimesters.
RESULTS: According to EPDS scores, In the 1st and 2nd trimesters, the weekly consumption frequency of milk, yogurt, red meat, and legumes were significantly different in terms of the risk of depression (p<0.05). In all trimesters, the weekly consumption frequency of fish and types of bread were significantly different according to EPDS scores (p<0.05). Dietary energy, protein, fat, tryptophan, and iron were found to be correlated with EPDS scores in all trimesters (p<0.0001).
DISCUSSION AND CONCLUSION: Pregnancy depression may affect the woman and the fetus negatively. For example, depression may cause developmental retardation in the fetus. The fact that some foods and regular consumption of meals are associated with depression shows that the risk of depression in pregnant women may be affected by nutrition.

8.Altered expression of kisspeptin in polycystic ovarian syndrome; can we rely on?
İpek Ulu, Aytaj Jafarzade
doi: 10.14744/zkmj.2023.28863  Pages 88 - 92
INTRODUCTION: Polycystic ovarian syndrome (PCOS) is a complex endocrinopathy that affects women in reproductive age. Although the pathogenesis is still unclear, the abnormal secretion of luteinizing hormone, follicular-stimulating hormone due to the alterations in hypothalamic–pituitary–gonadal (HPG) axis, is demonstrated to be the major cause. Kisspeptin is a hypothalamic peptide under the influence of KISS1 gene. Based on the fact that it affects gonadotropin-releasing hormone (GnRH) secretion, it is thought to play a role in the development of PCOS. Furthermore, kisspeptin may be determined as a possible biomarker for this syndrome. Due to the complex relationship between kisspeptin and the HPG axis, we aimed to reveal the association of serum kisspeptin level with PCOS in women.
METHODS: The study was designed as a prospective study in Koru Ankara Hospital. A total of 88 women were included in the study. Forty four of them were diagnosed with PCOS according to the Rotterdam criteria. Serum kisspeptin measurements were performed using an enzyme-linked immunosorbent assay kit.
RESULTS: In the present study, PCOS patients showed statistically significant lower serum kisspeptin levels compared to controls.
DISCUSSION AND CONCLUSION: Although kisspeptin is thought to play a role in PCOS by irregularly stimulating GnRH neurons, the definite mechanism remains still unclear. Clarifying the underlying role of kisspeptin in PCOS may provide valuable information for the future gene treatments.

9.Rotavirus infection and relationship between blood groups
Erdal Sarı, Özlem Erdede, Nihan Uygur Külcü, Eda Sünnetçi Silistre
doi: 10.14744/zkmj.2022.68442  Pages 93 - 96
INTRODUCTION: Rotavirus is currently one of the most common causes of acute gastroenteritis and dehydration in children worldwide. There are some clinical studies about the relationship between rotavirus gastroenteritis and histo-blood group antigens in different centers of the world, and results have been obtained. In this study, we aimed to explore the association of rotavirus gastroenteritis with histo-blood group antigens in children, if any present.
METHODS: This retrospective study included 208 patients. The rotavirus test was positive in stool examination of 208 cases included in the study. In the control group, 241 newborn babies born in the hospital delivery room between January 1, 2010, and December 31, 2011, were included in the study. The blood groups of the cases were recorded by checking their medical records.
RESULTS: This study was conducted by looking at the blood group of 449 cases, 208 patient groups, and 241 control groups. It was determined that 90 of 208 cases were blood type A (43.3%). Statistically, it was determined that the patients and control groups having A blood group did not have a relationship with the prevalence of rotavirus gastroenteritis (p>0.05).
DISCUSSION AND CONCLUSION: Rotavirus-induced gastroenteritis is still an important public health problem worldwide, especially in the first 3 years of age. In our study, in rotavirus-positive gastroenteritis, blood group A was found to be the highest with 43.3%, but no significant difference was shown when compared with the control group (p>0.05). While a significant relationship has been shown with the blood group in Rotavirus-induced gastroenteritis, there are also studies showing the opposite. Our study, including 208 cases, shows that rotavirus infection is not related to the blood group.

10.Effect of gender and parental educational level on Denver Developmental Screening Test-II in healthy children aged 6 months to 6 years
Nazan Neslihan Doğan, Nedim Samancı, Erdal Sarı
doi: 10.14744/zkmj.2022.88156  Pages 97 - 101
INTRODUCTION: The present study aimed to evaluate healthy children using the Denver Developmental Screening Test-II (DDST-II) and to investigate the relationship between developmental outcomes, gender, and parents’ educational level.
METHODS: Children aged between 6 months and 6 years who had no underlying disease were evaluated using the DDST-II. The test results and demographical data were recorded.
RESULTS: Among the 114 enrolled children, 100 cases (46 girls and 54 boys) were evaluated using the DDST-II. According to the results, 86% of the study population had normal development and 14% had abnormal development. When we compared children in terms of gender, there was no significant difference between the DDST-II test results and the success rates in personal-social (PS), fine motor, gross motor, and language development observed (p>0.05). However, a significant relationship was detected between DDST-II success rates and maternal education level (p=0.001). The language development of the children of mothers with a higher education level was also significantly better (p=0.021). The low educational level of the fathers was found to be related to the children’s abnormal developmental findings (p=0.005).
DISCUSSION AND CONCLUSION: The maternal educational level directly determines the success rates of the DDST-II and the language skills of their children. Paternal educational level affects children with abnormal developmental findings. No gender-related differences were found in PS, fine motor, gross motor, and language areas of DDST-II.

11.The role of upper middle arm circumference in the detection of malnutrition in diabetic children
Aysun Ata, Didem Gülcü Taşkın
doi: 10.14744/zkmj.2022.05924  Pages 102 - 105
INTRODUCTION: Type 1 diabetes (T1D) is a chronic disease that requires continuous insulin therapy. The study aimed to screen the prevalence of malnutrition in children with T1D by measuring the mid-upper arm circumference (MUAC) and to compare the Z scores with the body mass index-standard deviation score (BMI-SDS) of Turkish children.
METHODS: In this cross-sectional study, patients who were followed up with the diagnosis of T1D in the Adana City Training and Research Hospital Pediatric Endocrinology Outpatient Clinic and admitted to the follow-up outpatient clinic between June and September 2022 were included in the study.
RESULTS: Of the 94 patients included in the study, 52 (55.3%) were female and 42 (44.7%) were male. While 7 (7.4%) patients had a weight SDS for an age value below -2, seven (7.4%) patients had a height SDS for an age value below -2. According to BMI SDS values, 61 (64%) patients were found to have normal weight, 18 (19.1%) patients had mild malnutrition, and four (4.3%) patients had moderate malnutrition. According to the MUAC Z-score, 52 (55.3%) patients had normal weight, 30 (31.9%) had mild malnutrition, 5 (5.3%) had moderate malnutrition, and 1 (1.1%) had severe malnutrition. It was noteworthy that 18 (60%) of 30 patients with mild malnutrition, according to MUAC-SDS, were in the normal weight group according to BMI-SDS. It was found that there was a strong positive correlation between the BMI (kg/m2) value of the patients and the arm circumference (cm) (r=0.867; p<0.001).
DISCUSSION AND CONCLUSION: In conclusion, the prevalence of malnutrition in children with T1D was at very high rates, at 23.4% according to BMI-SDS values and 38.3% according to MUAC Z-score values. In addition, MUAC is an easy and effective method that can be applied in every case of malnutrition screening if standard percentiles of malnutrition are developed for Turkish children.

12.Retinopathy of prematurity requiring treatment; incidence and risk factors in a tertiary center
Emre Dincer, Osman Kızılay, Gökhan Çelik, Güner Karatekin
doi: 10.14744/zkmj.2022.04764  Pages 106 - 111
INTRODUCTION: While retinopathy of prematurity (ROP) is the leading cause of blindness in children, understanding the pathogenesis and protection from the risk factors are crucial in neonatal practice. In this retrospective study, we aimed to evaluate our clinic’s incidence and risk factors for ROP cases requiring treatment.
METHODS: Preterm babies with gestational age ≤34 weeks and birth weight ≤1700 g who underwent ROP examination were included in the study. Demographic data, antenatal risk factors, and clinical features of patients with ROP requiring treatment and patients with no treatment requirement were compared. Logistic regression analyses were made to determine independent risk factors.
RESULTS: The study included 214 patients with a median of 1550 g birth weight and 33 weeks of gestational age. Treatment was required for 26 of the patients. BW and GA were significantly lower (p<0.01, p<0.01, respectively), and ventilation support duration, need for resuscitation in the delivery room, surfactant administration, grade ≥2 intraventricular hemorrhage, premature-preterm rupture of membranes, bronchopulmonary dysplasia (BPD), and need for red blood cell transfusions (p<0.01, p<0.01, p=0.04, p<0.01, p=0.023, p=0.027, p<0.001, p<0.001; respectively) were significantly higher in the treatment-requiring group. Lower gestational age (95% CI: 0.442–0.921, p=0.02) and BPD (95% CI: 1.117–11.01, p=0.032) are determined as independent risk factors. No patient between BW of 1500–1700 gr and GA of 32–34 weeks required treatment for ROP.
DISCUSSION AND CONCLUSION: Risk factors must be clearly identified to reduce the incidence of ROP, and the need for treatment and precautions must be taken to prevent preterm babies from developing visual disturbances.

ERRATUM
13.Erratum

doi: 10.14744/zkmj.2023.79663  Page 112
Abstract |Full Text PDF

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