ISSN / EISSN : 1907-3062 / 2407-2230
Current Publisher: Universa Medicina (10.18051)
Total articles ≅ 186
Latest articles in this journal
Universa Medicina, Volume 39, pp 153-161; doi:10.18051/univmed.2020.v39.153-161
Background The majority (80%) of spontaneous subarachnoid hemorrhage (SAH) cases are caused by cerebral aneurysm rupture. The reported case fatality rate of aneurysmal SAH is still as high as 25 to 50%. Even though studies on aneurysmal SAH have been conducted, the mechanism and factors contributing to its mortality have not yet been clearly understood. The present study aimed to determine the predictors of mortality in aneurysmal SAH.Methods This was an observational analytic cross-sectional study. Data of 264 patients with aneurysmal SAH was obtained retrospectively from the medical records. Age, degree of consciousness, blood pressure, absence of aneurysmal treatment and mortality were collected. The simple and multiple logistic regression were used to analyze the data.Results The in-hospital mortality rate of aneurysmal SAH was still very high, with 140 (53.1%) patients dying during hospitalization. Simple logic regression analysis showed that patients with older age, lower Glasgow Coma Scale (GCS) score, higher mean arterial pressure (MAP) and no aneurysm treatment had higher in-hospital mortality risk. However, multivariate logistic regression showed that the strongest in-hospital mortality predictor was higher MAP (aOR 2.29; p=0.025), while younger age (aOR 0.39; p=0.006) and aneurysm treatment (aOR 0.34; p=0.006) were independent protective factors against in-hospital death.Conclusion Patients with higher mean arterial pressure on initial measurement had higher risks of mortality. More endovascular neurointervention facilities are needed to decrease the mortality rate of aneurysmal SAH.
Universa Medicina, Volume 39, pp 199-206; doi:10.18051/univmed.2020.v39.199-206
BACKGROUNDThe application of Standard Precautions (SP) has become a significant challenge for healthcare workers, especially in developing countries, endangering their safety and increasing their exposure to blood-related pathogens. This study was aimed at exploring the factors related to nurses’ compliance with the practice of SP.METHODSA cross-sectional study was conducted on 120 nurses working at a hospital in Palembang. Health Belief Model components of the subjects were recorded through questionnaires. A 12-point observation form assessed the nurses’ SP compliance. Multiple logistic regression models were used to explore factors associated with nurses’ compliance.RESULTSThe results showed that 56.7% of participants had good compliance, although the five moments of hand hygiene still needed to be improved. The study revealed that the proportion of the operating room and emergency room nurses who complied with the SP was larger than the proportion of those who worked at the other wards (OR=2.57, 95% CI 1.51-4.36). The nurses who had received training also showed a larger proportion of compliance with SP than those who had not been trained (OR=2.70, 95% CI 1.07-6.79).CONCLUSIONNurses’ behavior to SP was significantly associated with the adequacy of the training and work unit. It is suggested that the practice of SP was also influenced by enabling factors and subjective norms. Adequate training of nurses, provision of infection prevention equipment, and assessment of occupational exposures need to be introduced.
Universa Medicina, Volume 39, pp 207-211; doi:10.18051/univmed.2020.v39.207-211
BackgroundUpper extremity deep vein thrombosis (UEDVT) is a rare condition, in which job-related arm movements and repetitive, forceful or overhead arm activities have been recognized as the predisposing factor for this condition. UEDVT can occur among informal porters. This report describes a case of UEDVT in an informal porter due to manual lifting of heavy goods and reviews the literature for occupational reports of this condition.Case descriptionA 35-year-old male informal porter presented with marked swelling, pain, and numbness of his right arm 3 days after a prolonged episode of lifting heavy goods. A Doppler ultrasound showed thrombosis in the right subclavian and axillary veins and laboratory tests found elevated D-dimer. Patient was diagnosed as having axillo-subclavian thrombosis and treated with low molecular-weight heparin. One month after the last follow-up, patient returned to work with modified capacity and after 3 months of return to work, patient was able to resume his regular duties without impairment or disability.ConclusionThe occupation of informal porter should be considered a risk factor for upper extremity deep vein thrombosis (UEDVT), thus the occupational medicine physician should be aware of this condition in the context of manual workers. Detailed occupational history to aid the diagnosis and future risk assessment are needed, and education for preventing UEDVT should be provided to porters.
Universa Medicina, Volume 39, pp 192-198; doi:10.18051/univmed.2020.v39.192-198
BackgroundDiazinon is a widely used pesticide to eradicate agricultural pests globally with the potential to cause harmful effects on humans by generating free radicals and depleting endogenous antioxidants. Soy flour possesses high antioxidant effect. This study evaluated the nephroprotective effect of soy flour on diazinon-induced nephrotoxicity in rats. MethodsAn experimental laboratory study was carried out involving 30 male Wistar rats were randomly divided into five groups of 6 rats. The normal control (Kn) and the negative control (K-) groups received normal saline, the treatment groups (K1, K2, K3) received 10%, 15%, and 20% soy flour in distilled water, respectively, on day 1 to day 28. Subsequently, for five days, all groups received diazinon 40 mg/kg, except for the normal control group. Blood urea nitrogen (BUN) and creatinine levels were measured at the end of the study. The Kruskal Wallis test with the post hoc Mann Whitney U test were used to analyze the data. ResultsBlood urea nitrogen and creatinine levels were lower in all treatment groups (K1, K2, K3) compared to the negative control group (K-), while the K3 level was the lowest (24.28 ± 1.56 mg/dL and 0.93 ± 0.14 mg/dL). There was a significant decrease in BUN and creatinine levels in the experimental rats of the 15% and 20% soy flour groups (K2, K3) compared to the negative control group (K-).ConclusionAdministration of soy flour (Glycine max (L.) Merr.) had a nephroprotective effect in preventing increases in BUN and creatinine levels of diazinon-induced nephrotoxic male Wistar rats.
Universa Medicina, Volume 39, pp 178-183; doi:10.18051/univmed.2020.v39.178-183
BackgroundThe World Health Organization has warned that cigarette smoking is an avoidable risk factor for endothelial injury. Myogenin might play a role in muscle metabolism and energy utilization. Electrolytes and minerals are involved in most cellular activities. The objective of this study was to compare myogenin and electrolyte levels between adult male cigarette smokers (CS) and non-smokers (NS). MethodsA cross-sectional study was conducted involving 90 subjects, consisting of 55 CS and 35 NS. The sandwich enzyme-linked immunosorbent assay was used to determine myogenin levels while the ion-selective electrode method was used to determine electrolyte levels. The levels of sodium, potassium, and chloride and the body mass index (BMI) were measured. Mann-Whitney and independent t-test were used to analyse the data. Results The BMI of CS was significantly lower than that of NS (p < 0.05). The mean serum levels of sodium (145.23 ± 1.87), potassium (4.00 ± 0.31) and chloride (103.95 ± 1.60) were significantly higher in the CS than in the NS (these being 142.38 ± 2.49, 3.83 ± 0.33, and 101.48 ± 2.08, respectively) (p<0.05). Myogenin levels (44.24 ± 14.60 pg/mL) tended to decrease in the CS group compared to the NS group (59.66 ± 61.73 pg/mL), but the difference was statistically not significant (p=0.769).Conclusion The study demonstrated that higher concentrations of sodium, potassium and chloride with lower concentrations of myogenin in smokers may be associated with higher risk of skeletal muscle tissue injury probably due to the inability of the affected small blood vessels to transport electrolytes to tissues.
Universa Medicina, Volume 39, pp 184-191; doi:10.18051/univmed.2020.v39.184-191
BackgroundPoor air and mask quality in the work environment increase the risks of inflammation, reactive oxygen species (ROS) production, ongoing oxidative stress, and superoxide dismutase 3 (SOD3) levels in the airways. The study aimed to investigate the effect of the Nephrolepis exaltata - Hibiscus rosa-sinensis (NE-HRS) combination herbal mask on the airways, as measured by ROS and SOD3 levels in the nasal wash of textile industry workers.MethodsThis was a pre- and post-test randomized controlled trial, consisting of 30 subjects with ³5-year working time, conducted for eight weeks and monitored every ten days. Subjects were randomized into 3 groups, regular surgical mask group (n=10), NE-HRS combination herbal mask group (n=10) and factory mask group (n=10). SOD3 and ROS levels were determined using ELISA. Data were analyzed with One-way ANOVA and multiple comparison tests.Results ROS levels decreased significantly in all groups (p=0.004). Regular surgical masks decreased ROS levels by 67.90 ± 50.66 pg/mL, NE-HRS combination herbal masks by 49.91 ± 45.06 pg/mL, and factory masks by 193.96 ± 128.36 pg/ml. SOD3 levels also decreased but not significantly (p=0.053). Differences in ROS levels between surgical mask and NE-HRS combination herbal mask was not significant (p=0.796). ConclusionHerbal masks laminated with NE-HRS combination significantly reduced ROS levels among textile industry workers. NE-HRS combination herbal masks have a similar protective effect to the regular surgical mask.
Universa Medicina, Volume 39, pp 212-223; doi:10.18051/univmed.2020.v39.212-223
Triage is a familiar concept for all who work at the forefront of the treatment of patients and the emergency medical staff know their duty in different situations including crisis and epidemics. Accordingly, the coronavirus outbreak has also a major effect on the emergency department (ED) as it changes the routine ED function. Our main question was what are the main triage challenges in the recent pandemic and how we could overcome these challenges? Therefore, a search of the main Web databases was performed for articles published till May 1st, 2020 using various related keywords. In various steps, the title, summary, methodology, results, and discussion of the selected studies were assessed to find out the recent triage strategies in the COVID-19 outbreak. Hence, all the available and related English review articles, case series, and experimental studies were evaluated. Among 200 studies initially reviewed, 59 met the study criteria for the final assessment. COVID-19 puts a significant load on public health services and potential damage to social and psychiatric situations by marked morbidity and mortality. In line with the various presentations and according to the changing of the COVID-19 epidemic to a worldwide pandemic problem, the management and treatment protocols changed several times. Accordingly, the local and even global hospital protocols were changed as well. The first simple concept of coronavirus triage in an emergency department is the separation of COVID-19 infected patients from the others. This approach has been practiced around the world. Changing the ED layout from a usual triage or fast track set to an isolated room is necessary for such a pandemic situation. It is very important to consider staff communication and the application of PPE. All the efforts should be taken to protect patients as well as the medical staff from unnecessary exposure and infection; this serves to keep the health facilities working well in the outbreak and diffusion of SARS-CoV-2.
Universa Medicina, Volume 39, pp 162-170; doi:10.18051/univmed.2020.v39.162-170
Background Orthorexia nervosa (ON) describes a pathological obsession with proper nutrition that is characterized by a restrictive diet, ritualized patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure. Limited health literacy may play a role in the onset and progression of orthorexia. The aim of this study was to determine the relationship between health literacy and ON among urban schoolteachers.MethodsThis cross-sectional study was conducted in central Black Sea region of Turkey with 420 primary and secondary schoolteachers aged between 18 and 51 years. A questionnaire form including socio-demographic characteristics was used. The Orthorexia Nervosa Questionnaire (ORTO-15) was used to assess orthorexia nervosa behavior and the Turkey Health Literacy Scale (TSOY-32) to assess health literacy. Simple binary and multiple binary logistic regression analyses were carried out to verify the associations between the variables.ResultsOf the study group 46.4% were in the 40-49 year age group, 53.8% were male, 78.6% had ON and 93.6% had limited health literacy. Nearly all of the orthorexics (96.4%) had limited health literacy. Female gender, Instagram use and limited health literacy was significantly associated with ON. Limited health literacy increases the risk of ON 4.85 times among teachers (aOR=4.85;95% C.I. : 2.15-10.94;p=0.000).ConclusionThe current findings suggest that limited health literacy is the strongest risk factor for ON among urban schoolteachers. School health literacy and social media literacy programs can open a new window into revealing ON.
Universa Medicina, Volume 39, pp 151-152; doi:10.18051/univmed.2020.v39.151-152
World Health Organization (WHO) defines zoonotic diseases (zoonoses) as those diseases and infections which are naturally transmitted between vertebrate animals and humans. More than 250 zoonoses have been described, over 60% of pathogens that cause diseases in humans are zoonoses of animals, and 75% of emerging infectious diseases. Most pandemics are caused by zoonoses.
Universa Medicina, Volume 39, pp 171-177; doi:10.18051/univmed.2020.v39.171-177
BackgroundHealth literacy is vital for people’s ability to manage health. It has been known for a long time that the importance of education in increasing health literacy is an undeniable fact. The first aim of this study was to investigate the health literacy levels of employees working in different business lines receiving service from the occupational health and safety unit. The second aim was to reveal how health literacy levels are affected according to the training duration.MethodsA cross-sectional study was conducted on 202 employees receiving service from the Karabuk occupational health and safety unit. The employees were divided into three groups as workers, officers and others. All employees were given the questionnaire consisting of 31 questions including sociodemographic characteristics and the adult health literacy scale. A face-to-face interview was performed with each of the employees. Kruskal-Wallis H and Mann-Whitney U tests were used to analyze the data.ResultsThe range of adult health literacy scale scores of the employees was 4-23. There was no significant difference in adult health literacy scale scores between age groups (p=0.38). The percentage of employees who received more than 16 hours training course was 19.3%, 20.6%, and 46.7% for workers, civil servants and other employees, respectively. Adult health literacy scale scores increased in proportion to the amount of training the employees received (p=0.001).ConclusionThis study reveals that occupational health training has a positive effect on health literacy.