2014-01-01, Ozder, ACLAN, Eker, Hasan Huseyin, ÖZDER, ACLAN

The aim of this study was to compare mean platelet volume (MPV) in patients with type 2 diabetes mellitus (T2DM), in subjects with impaired fasting glucose (IFG), and in non-diabetic controls. A total of 201 adults with T2DM and 201 subjects with IFG from the Family Medicine out-patient clinic as well as 201 healthy controls were included in the study. We measured blood fasting glucose, complete blood count and LDL-cholesterol and compared the results between the groups enrolled. In the patients with diabetes and subjects with IFG, MPV was significantly higher (10.66 ± 0.94 fL and 10.49 ± 0.96 fL, respectively ) as compared to the non-diabetic group (10.04 ± 1.01 fL) (p = 0.000). Among the diabetic subjects, a positive statistical Pearson correlation was seen between MPV and HbA1c levels (r = 0.357; p = 0.000) and fasting blood glucose (FBG) levels (r = 0.306; p = 0.000). The mean MPV in patients having HbA1C < 7.5% was 10.17 ± 0.83 fL and significantly lower than that of patients with HbA1c ≥ 7.5% (10.80 ± 0.92 fL) (p = 0.001). MPV could be used as a simple and cost-effective tool to monitor the progression and control of T2DM and thereby in preventing vascular events in primary health care.

2014-12-06, Ozder, ACLAN, ÖZDER, ACLAN

Background: Diabetes is characterized by chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. We aimed to research association between serum lipid profile and blood glucose, hypothesizing that early detection and treatment of lipid abnormalities can minimize the risk for atherogenic cardiovascular disorder and cerebrovascular accident in patients with type 2 diabetes mellitus. Methods: Fasting blood glucose (FBG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG) and glycated haemoglobin (HbA1c) levels were evaluated. A hepatic ultrasound was performed for every diabetic to evaluate hepatosteatosis. The study was done from January 2014 to June 2014 among 132 patients with T2DM who were admitted to outpatient clinic of Family Medicine department in a university hospital. The patients whose taking multi-vitamin supplementation or having hepatic, renal or metabolic bone disorders (including parathyroid related problems) were excluded from the study for the reason that those conditions might affect the carbohydrate and lipid metabolism in diabetes. Test of significance was calculated by unpaired student's t test between cases and controls. Correlation studies (Pearson's correlation) were performed between the variables of blood glucose and serum lipid profile. Significance was set at p<0.05. Results: Results of serum lipid profile showed that the mean values for TC, TG, HDL and LDL in female patients were 227.6 ± 57.7 mg/dl, 221.6 ± 101.1 mg/dl, 31.5 ± 6.7 mg/dl and 136.5 ± 43.7 mg/dl, respectively. The mean values for TC, TG, HDL and LDL in male patients were 219.1 ± 34.7 mg/dl, 250.0 ± 100.7 mg/dl, 30.2 ± 7.4 mg/dl and 125.7 ± 21.4 mg/dl, respectively. Significantly higher mean serum levels of TC, TG and LDL and significantly lower mean serum levels of HDL were noted in patients with diabetes (p<0.001). FBG showed significant positive correlation with TC (p<0.05) and TG (p<0.05). Significant correlations were observed between serum levels of TC, TG, LDL and hepatosteatosis and HbA1c (p<0.05). Conclusions: The study showed widespread lipid abnormalities in the course of diabetes triggered dyslipidemia as hypercholesterolemia, hypertriglyceridemia, elevated LDL and decreased HDL. This study proposes the predominance of hyperlipidemia over increased prevalence of diabetic dyslipidemia.

2015-01-01, Ozder, ACLAN, Eker, Hasan Huseyin, ÖZDER, ACLAN

Objectives: Sleep disorders can affect health and occupational performance of physicians as well as outcomes in patients. The purpose of this study was to assess the prevalence of excessive daytime sleepiness (EDS) measured by the Epworth Sleepiness Scale (ESS) among academic physicians at a tertiary academic medical center in an urban area in the northwest region of Turkey, and to establish a relationship between the self-perceived sleepiness and the quality of life using the EuroQol-5 dimensions (EQ-5D). Material and methods: A questionnaire prepared by the researchers after scanning the literature on the subject was e-mailed to the academic physicians of a tertiary academic medical center in Istanbul. The ESS and the EQ-5D were also included in the survey. The e-mail database of the institution directory was used to compile a list of active academic physicians who practiced clinical medicine. Paired and independent t tests were used for the data analysis at a significance level of p < 0.05. Results: Three hundred and ninety six academic physicians were e-mailed and a total of 252 subjects replied resulting in a 63.6% response rate. There were 84 (33.3%) female and 168 (66.7%) male academic physicians participating in the study. One hundred and eight out of 252 (42.8%) academic physicians were taking night calls (p < 0.001). Ninety study subjects (35.7%) felt they had enough sleep and 84 (33.3%) reported napping daily (p < 0.001). In our sample, 28.6% (N = 72) of the physicians felt sleepy during the day (ESS score > 10) (p < 0.001). In the case of the EQ-5D index and visual analogue scale of the EQ-5D questionnaire (EQ-5D VAS), the status of sleepiness of academic physicians was associated with a poorer quality of life (p < 0.001). Conclusions: More than a 1/4 of the academic physicians suffered from sleepiness. There was an association between the poor quality of life and daytime sleepiness. There was also a positive relationship between habitual napping and being sleepy during the day.

2013-07-16, Ozder, ACLAN, TEKER, Bahri, Eker, Hasan Huseyin, Altindis, Selma, KOCAAKMAN, Merve, Karabay, Oguz, ÖZDER, ACLAN

Background: This is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers) regarding bio-medical waste management. Methods: The study was conducted on 240 volunteers during June – August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions). A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups. Results: 67.5% (162) of participants were female. 42.5% (102) are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers. A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test) and others who had not (p<0.01). It was observed that information levels of all healthcare managers who had received training on waste management had risen at the completion of that training session. Conclusion: On the subject of waste management, to have trained healthcare employees who are responsible for the safe disposal of wastes in hospitals is both a necessity for the safety of patients and important for its contribution to the economy of the country.

2014-01-01, Ozder, ACLAN, SEKEROGLU, Mesut, Eker, Hasan Huseyin, ÖZDER, ACLAN

The aim of this study was to assess the quality of life and degree of satisfaction with the treatment of patients with type 2 diabetes mellitus (T2DM) in primary health care in Turkey. A total of 180 adults with type 2 diabetes mellitus from the Family Medicine out-patient clinic were included in the study. Participants were asked to fill out a self-report survey to collect data via two well validated scales, including the Turkish version of the Audit of Diabetes Dependent Quality of Life (ADDQoL) instrument and the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Overall average weighted impact score for the study group was -2.73 ± 2.56. Diabetes mellitus has the largest impact on enjoyment of food (mean ± SD impact rating: -1.63 ± 1.50). The mean score of the DTSQ was 21.02 ± 8.07 (range from better to worse: 36 to 0) for the entire group. Presence of diabetes-related complication was significantly related with lower treatment satisfaction scores (mean ± SD = 23.08 ± 7.32 without complications; mean ± SD = 18.48 ± 8.36 with complications, P = 0.003). Physicians working in primary care should be equipped with more recent knowledge of diabetes treatment in order to tailor more appropriate treatment strategies from current guidelines.