Aim: Investigation of whether alternative intradermal (ID) and subcutaneous (SC) vaccination methods, which may be applied with low doses lowering the costs respectively in the rates of 1/10 and 1/4 when compared with classical IM 20 µg. hepatitis B vaccination method, provide or not sufficient protective antibody titers. Method: 597 subjects consisting of hospital staff, students and risk groups, in whom measurement of antibody titers after 3 doses of vaccine was available, were enrolled in the study, and 483 subjects, in whom measurement of antibody titers after 4 doses of vaccine was achieved, fullfilled the study. Recombinant hepatitis B vaccine (Euvax B) was applied at 0, 1, 2 and 12 months intervals to IM group with standard 20 µg dose, to ID group with 2 µg dose and to SC group with 5 µg dose. Antibody measurements were done at 3rd and 13th months. Results: While seroprotection rates were respectively 96.6 %, 91.9 % and 88.2 % in IM, ID and SC groups at the 3rd month; they were 98.8 %, 95.6 % and 92.5 % at the 13th month.. While the safest application route in view of side effects appears to be SC route, the most frequent local side effect was seen in ID group and the most frequent systemic side effect in IM group. None of these side effects leaded to interrupting the vaccination. Conclusion: While ID hepatitis B vaccination appears to be an efficient method lowering the cost of vaccination in a rate of 9/10, alternative to classical IM vaccine application route; SC hepatitis B vaccine application route appears to be an efficient method lowering the cost vaccination in a rate of 3/4 according to IM vaccine application route, because of its ease of application.

Aim: In this study, we decided to investigate the ratio of Listeria monocytogenes and the other Listeria spp. in meat and meat products in Van City Center. Methods: For his purpose; 100 mince meats, 50 meats, 25 (garlic-flavoured) sausage, 25 salamis, 25 sausage and 25 preserve of dried meats were used. The method suggested by USDA-FSIS has been used for the determination of Listeria species. Results: As the result of the study, Listeria species were isolated in 73 %(73/100) of mince meats, in 74 %(37/50) of meats, in 76% (19/25) of (garlic-flavoured) sausage, in 16 %(4/25) of salamis, in 44 %(11/25) of sausage and in 32 %(8/25) of preserve of dried meats. It was established that the mince meat was mostly contaminated by L. innocua, (garlic-flavoured) sausage and preserve of dried meats were mostly contaminated by L. monocytogenes and salami was mostly contaminated by L. welshimeri. Conclusion: In conclusion, it is assumed that a potential problem for public health could arise, if meat and meat products are consumed raw or uncooked.

Aim: The long-term survival and quality of life of patients on hemodialysis (HD) is dependent on the adequacy of dialysis via an appropriately placed vascular access. Vascular access failure remains a significant problem in haemodialysis. Complications of dialysis access represent major cause of morbidity in dialysis patients. The purpose of this study was to evaluate the incidence of early and long term patency rates of arteriovenous fistula (AVF) and results of surgical treatment in chronic renal failure patients. Method: Between January 1997 and December 2004 AVF operations in 114 chronic renal failure cases for vascular access were investigated. Non-dominant arm was chosen for the operation. Of the 114 cases, 63 (55.3%) were male and 51(44.7%) were female .The mean age was 45.5±14.4 years. Results: In total, there were 39 (29.53%) radiocephalic, 86(65.15%) brachiocephalic, and 7(5.3%) brachiobasilic AVF. Overall, early failure was occured in 18 (13.63%) cases and late failure occured in 8 (6.06%) cases. Early failure statistically more frequent in distal fistula (23.07%) when compared to proximal (9.67%) ones. (p<0.05). In late phase, there was no significant difference between proximal and distal fistula in terms of success rates. (p>0.05) In 31 (23.48%) of the fistula operations complication developed. Conclusion: Although the success rate of distally located AVF operations was lower than the proximal ones, this location should be preferred in order to provide subsequent availability of brachial location.

Aim: The aim of our study was to evaluate 45 children with megaloblastic anemia that are followed and treated in Yuzuncu Yil University Hospital between 1997 and 2005. Methods: Patients records were evaluated retrospectively. The diagnosis of megalaoblastic anemia was obtained according to findings of bone marrow and peripheral blood smear and the serum level of vitamin B12 and folic acid. Results: Fifteen (%33.3) of the children were female and 30(%66.) were male. The average age was 34.4 months (9-174 month). Pallor, weakness and anorexia were the most common symptoms. Folic acid and vitamin B12 deficiency was obtained 3 and 42 cases respectively. The average values of complete blood count were as follows; Hb:5.5 g/dl, MCV:96.3fl, WBC:9334/mm3 and RDW:24,2. Proteinuria was obtained in 6 (13,3 %) cases. All patients treated with parenteral Vit B12 and oral folic acid recovered. Iron deficiency anemia developed in 3 of our patients after the treatment. The MCV values were below the 90 fl at first admission in 1/3 of our patients with megaloblastic anemia. Conclusion: We emphasize that megaloblastic anemia can occur without macrocytosis and well balanced feeding especialy in the pregnant women and infant to prevent anemia is very important in our region.

Aim: In this study we decided to investigate the role of Stenotrophomonas maltophilia (S.maltophilia) at nosocomial infections and the antimicrobial susceptibility of the microorganism that has gained importance in nosocomial infections and infections of immuncompromised patients. Methods:For his purpose, 62 S. maltophilia were isolated from different samples and also from different clinics at microbiology laboratory. 28 of the isolates were from pediatrics unit (45%), 12 were from otorhinolaryngology (19%), 6 were from internal medicine( 10% ) and 4 from urology (7%). 16 of the isolated S. maltophilia strains were from urine samples (25.8%), 8 of them were from ear samples (12.9%), 7 of them were from blood samples ( 11.3%), and 20 of them were from aspiration fluid samples (32.2%). Results: According to the results of the antimicrobial susceptibility tests that we performed; S.maltophilia strains were found susceptible at high rates to imipenem (65%), ciprofloxacin (64%) and amikacin (53%). More than 90% of the S. maltophilia strains were resistant to nitrofurantoin, cephazolin, trimethoprim, tetracycline, cefuroxime and ampicillin. Conclusion: According to the results of our study; because of the detected high resistance rates to antimicrobials at nosocomial infections that caused by S. Maltophilia, antimicrobial susceptibility tests must be performed; if not possible quinolones and aminoglycozides can be a good choice for ampiric treatment.

Dermatophytes are fungi that can cause infections of the skin, hair, and nails due to their ability to utilize keratin. The dermatophytes consist of three genera: Epidermophyton, Microsporum and Trichophyton. In this study, we aimed to investigate the whole skin sites, nails and hairy skin of the students of physical education department . We performed direct examination (with 15% KOH on slides ) and culturing [with Sabouraud Dextrose Agar (SDA), Potato-Dextrose Agar (PDA)and Mycobiotic agar] to investigate the lesions. As a total 40 students were researched and 27 suspicious lesions were determined , 17 of them were found as positive by direct examination; 4 (10%) of them were identified as Malessezia furfur and 3 (7.5%) of them were identified as Trichophyton rubrum by culturing. We think that research on sportsmen who are at risk of fungal infections and their education about protecting from fungal infections should be useful and important on early diagnosis.

Aim: Most of the emergency operations for obstetrics and gynecology were cesarean sections. Anesthetic management depends on the indication and emergency of the operation as well as the patient’s physical status and approval of the anesthesia technique. The purpose of this study was to evaluate anesthetic methods that were employed in two years period in our clinic. Methods: During this study emergent obstetric and gynecological operations have been evaluated by investigating the anesthesia charts in a retrospective manner. Demographic data, techniques of anesthesia, duration of surgery, Apgar scores of the new-borns, presence of new-born resuscitation, and drugs used in regional anesthesia and the level of sensorial blockade, anesthetic choice and muscle relaxant drugs of induction and management have been recorded. Result and Conclusion: Most of the emergent operations of gynecological and obstetric surgery performed were cesarean sections (92%). Decision of anesthetic technique was especially made according to urgency of the operation. We figured out that it was frequently general anesthesia. The Apgar scores of the newborns were statistically higher in patients undergoing spinal anesthesia than general anesthesia. Forty three percent of patients refused the regional anesthesia technique although it was indicated due to the social and cultural levels of our patients are not high enough to judge between the anesthetic methods. The use of spinal anesthesia should be increased for emergency cesarean deliveries.

When anticholinergic poisoning was not defined in time, it has been fatal. Atropa belladonna L. poisons with the effect of anticholinergic. In this article, we report as a result of taking this plant who presented to the emergency department in acute anticholinergic crisis. A 64 years old male was brought to the emergency department with signs and symptoms (nausea, headache, meaningless speechs, palpitation, redden face and urinary retantion) consistent with anticholinergic poisoning. On examination, the patient were hypertension, fever, tachycardia, midriazis, flushing and drying mouth. It was thought that the patient had poison, depending on these findings. The plant, brought later was Atropa belladona L.. Because of not being physostigmine, the treatment of the patient was approached as a conservative. After gastric lavaj was implemanted, it was started to the active cool. The patient was monitorized and his agitation taken under control by benzodiazepin. The periferic cooling and acetaminophen was given for temperature control. Consequently Atropa belladonna L. poisoning must be considered for intoxications that present with anticholinergic crisis.

Toxocariasis is a parasitic disease caused by Toxocara cati and canis which lives in the bowel of cats and dogs. In this article, a case of toxocarıasis in a 5-year- old boy with epilepsy who presented with hypereosonophilic syndrome is presented. We would like to emphasize that parasitic diseases can be presented with very different clinical pictures.

Growth represents a sentinel for the general health of a child. The distinction between normal and abnormal growth may be difficult sometimes. In this rewiev, short stature and its etiology were investigated in the light of the literature.