24 results on '"Gülşen MERMUT"'
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2. Clinical Evaluation of Fifteen Cases of Hydatid Disease
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Serhat UYSAL, Ayşe UYAN, Meltem IŞIKGÖZ TAŞBAKAN, Oğuz Reşat SİPAHİ, Tansu YAMAZHAN, Hüsnü PULLUKÇU, Gülşen MERMUT, Ekin ERTEM, and Sercan ULUSOY
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Hydatid disease ,Echinococcus granulosus ,complication ,echinococcosis ,hydatidosis ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Introduction: Hydatid disease is a zoonotic infection caused by the cestode Echinococcus spp. It is transmitted by ingestion of infectious cestode eggs, especially through dog feces. The two organs most commonly affected are the liver and the lung. In this paper, a series of 15 cases with symptomatic hydatid cysts hospitalized in our clinic and evaluated via consultations are presented. Materials and Methods: Patients, who were treated with hydatid disease between April 2006 and June 2015, were included in the study. Demographic characteristics, symptoms (fever, abdominal pain, pruritus, weakness, icterus, cough, sputum, nausea-vomiting), signs (hepatomegaly, splenomegaly), radiological-laboratory findings, complications, involvements of other body parts and treatment modalities were evaluated retrospectively. Results: Ten (66.7%) of the patients were female. The mean age of the patients was 52.3±18.3 year. Twelve (80%) patients had at least one cystic lesion in the liver. Four cases were complicated with a lung cyst, three with spondylodiscitis, three with splenic cyst, two with renal cyst, two with amoebic liver abscess, one with intraabdominal dissemination and one case was complicated with anaphylactic shock. Seven patients (46.7%) had leukocytosis and three (20%) had eosinophilia. All patients received treatment with albendazole p.o 2x400 mg tablets. The mean duration of treatment was 27.4±18.5 weeks. Conclusion: Hydatid cyst is an infectious disease that may cause severe organ involvement. Patients with hydatid cyst in any part of the body should be checked carefully for other system involvement, including the liver, abdominal and/or retroperitoneal organs.
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- 2015
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3. Antifungal Prophylaxis in Solid Organ Transplant Recipients
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Şebnem ŞENOL, Oya Eren KUTSOYLU, Onur KAYA, Meltem AVCI, Meltem IŞIKGÖZ TAŞBAKAN, Vildan AVKAN OĞUZ, Betil Özhak BAYSAN, Sema Alp ÇAVUŞ, Çiğdem Banu ÇETİN, Çağrı ERGİN, Bülent ERTUĞRUL, Selda SAYIN KUTLU, Murat KUTLU, Gülşen MERMUT, Dilek Yeşim METİN, Barçın ÖZTÜRK, Hüsnü PULLUKÇU, Özge TURHAN, and Nur YAPAR
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Solid organ transplantation ,antifungal prophylaxis ,invasive fungal infection ,posaconasole ,amphotericin B ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Solid organ transplantation (SOT) is a treatment method that improves quality of life and survival of patients with end-stage organ failure. Immunosuppressive treatments given to these patients may predispose to the development of invasive fungal infections (IFI). The incidence of IFI in SOT recipients, which is between 5% and 42%, depends on the organ to be transplanted. Although Candida spp., followed by Aspergillus spp. are the most common microorganisms, among fungal pathogens, this situation varies according to transplant type. The mortality rate associated with these IFI can be high. Therefore, antifungal prophylaxis may be necessary for SOT recipients. Many transplantation centers employ antifungal strategies according to their own experience because of the lack of randomized controlled studies. If the antifungal prophylaxis is given to all patients, antimicrobial resistance and drug-drug interactions may occur. Therefore, it is important to identify patients at a high risk of developing IFI. In this paper, epidemiology, risk factors, literature data and antifungal prophylaxis associated with IFI in liver, kidney, small intestine, pancreas, heart, and lung transplant recipients are reviewed.
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- 2015
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4. Hodgkin Dışı Lenfoma Tanılı Bir Olguda HIV İnfeksiyonunun Gecikmiş Tanısı: Hekimler Hala Farkında Değil mi?
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Hüsnü Pullukçu, Tansu Yamazhan, Gülşen Mermut, Meltem Taşbakan, Dilşah Başkol, and Ege Üniversitesi
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[No Keywords] - Abstract
İnsan immünyetmezlik virüsü (HIV) ile infekte olan hastalarda malignite görülme riski artmıştır. Hodgkin dışı lenfomalar, Kaposi sarkomu ve servikal kanser kazanılmış immünyetmezlik sendromu (AIDS) tanımlayıcı hastalıklar içinde yer almaktadır. Hodgkin dışı lenfomalar içinde en sık difüz büyük B hücreli lenfoma görülmektedir. AIDS ilişkili hodgkin dışı lenfoma tanılı hastanın tedavisinin planlanmasında, kombine antiretroviral tedavi alıyor olması iyi prognoz yönünden oldukça yararlıdır. Bu nedenle yukarıdaki tanıları alan hasta gruplarında HIV tarama testi yapılmalıdır. Farklı bir bakış açısı ile değerlendirilecek olursa HIV ile infekte hastalar pek çok bölüme farklı kliniklerle başvurabilmektedir. Bu nedenle tüm hekimlerin AIDS tanımlayan hastalıklar açısından bilgi ve farkındalık sahibi olması gereklidir. Erken tanı ile tedavi başarısı yüksek olan bu hastalıkta hekimlerin bilinci büyük önem taşımaktadır. Ne yazık ki halen geç tanı almış olgularla karşılaşılmaktadır. Bu yazıda, difüz büyük B hücreli lenfoma tanısıyla dört aydır kemoterapi tedavisi gören ve febril nötropeni tablosunda konsülte edilen, geç HIV infeksiyonu tanısı alan bir olgu sunulmuştur., Malignancy risk is increased in patients infected with the human immunodeficiency virus (HIV). Non-Hodgkin lymphomas, Kaposi’s sarcoma and cervical cancer are among the AIDS-defining diseases. Diffuse large B cell lymphoma is the most common non-Hodgkin lymphoma. Taking combined antiretroviral therapy is associated with good prognosis in the treatment of AIDS-related non-Hodgkin lymphoma. Therefore, HIV screening test should be requested in patient groups with the above-mentioned diagnoses. If evaluated from a different perspective, HIV-infected patients can apply to many departments with different clinics. For this reason, all physicians should have knowledge and awareness in terms of AIDS-defining diseases. The awareness of physicians is of great importance in this disease, which has a high success rate with early diagnosis and treatment. Unfortunately, cases with late diagnosis are still encountered. In this article, a patient treated with chemotherapy for four months with the diagnosis of diffuse large B cell lymphoma, who consulted us as febrile neutropenia and was diagnosed with late HIV infection is presented.
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- 2020
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5. Diş Hekimliği Fakültesi çalışanlarının hepatit A, hepatit B, hepatit C ve HIV enfeksiyonu yönünden değerlendirilmesi
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Hüseyin Aytaç Erdem, Gülşen Mermut, Meltem Taşbakan, İmre Altuğlu, Çiğdem Yildirim, Hüsnü Pullukçu, and Tansu Yamazhan
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Health Care Sciences and Services ,General Medicine ,Sağlık Bilimleri ve Hizmetleri ,Health care workers,needlestick-sharp injury,occupational exposure ,Sağlık personeli,kesici-delici alet yaralanması,mesleki maruziyet - Abstract
Aim: Occupational exposure to blood and other potentially infectious body fluids, and sharp injuries, poses a significant risk to blood-borne infections for healthcare workers. The aim of this study is to evaluate the serology of Hepatitis A, Hepatitis B, Hepatitis C and HIV infection and determine the knowledge level of healthcare workers about the risk of occupational exposure.Materials and Methods: 89 healthcare workers who applied to Ege University Medical Faculty Hospital Infectious Diseases outpatient clinic were evaluated with a questionnaire about knowledge levels of occupational injury and attitudes though screening their status by serological test along with Hepatitis A, Hepatitis B, Hepatitis C and HIV infection.Results: 66 of the participants (74%) were female and 23 (26%) were male. The mean age was 39.94 ± 12.54 years (min-max; 24-66 years). 41 people (46%) who defined occupational injuries were identified with a history of 56 injuries. Of these, 19 (34%) had needlestick injury, 22 (39%) had penetrating stab wounds, and 15 (27%) had blood/patient excretion on the eye. As a result of injuries, hepatitis B, hepatitis C and HIV transmission were not observed.Conclusion: Due to the possibility of mucosal contact with blood or body fluids, we think that it is important to inform healthcare workers in terms of hepatitis B, hepatitis C and HIV transmission and raise awareness through practices aimed at reducing these injuries., Amaç: Kesici delici alet yaralanmaları yanında kan ve diğer potansiyel enfekte vücut sıvılarıyla her türlü mesleki maruziyet sağlık çalışanları için kan yoluyla bulaşan enfeksiyonlar açısından önemli bir risk teşkil etmektedir. Bu çalışmada sağlık çalışanlarının bilgi düzeyleri ve mesleki maruziyet riski nedeniyle Hepatit A, Hepatit B, Hepatit C ve HIV enfeksiyonu yönünden serolojik değerlendirilmesi amaçlandı.Gereç ve Yöntem: Ege Üniversitesi Tıp Fakültesi Hastanesi Enfeksiyon Hastalıkları polikliniğine başvuran 89 sağlık çalışanının 10 soruluk bir anket ile mesleki yaralanma, bilgi düzeyleri ve tutumları ile birlikte Hepatit A, Hepatit B, Hepatit C ve HIV enfeksiyonu yönünden durumları serolojik testle değerlendirildi.Bulgular: Çalışanların 66’sı (%74) kadın, 23’ü (%26) erkek olup, yaş ortalaması 39.94± 12.54 yıl (min-maks;24-66) idi. Mesleki yaralanma tanımlayan 41 kişi (%46) 56 yaralanma öyküsü tanımlandı. Bunların 19’u (%34) iğne batması, 22’si (%39) kesici delici alet yaralanması, 15’i (%27) göze kan/ hasta çıkartısı sıçraması şeklindeydi. Bu yaralanmalar sonucu hepatit B, hepatit C ve HIV bulaşı olmadığı test sonuçları ile görüldü.Sonuç: Kan ya da vücut sıvılarıyla mukozal temas ihtimali olması nedeniyle hepatit B, hepatit C ve HIV bulaşı açısından sağlık çalışanlarının bilgilendirilmesi ve bu yaralanmaları azaltmaya yönelik uygulamalarla farkındalık yaratılmasının önemli olduğunu düşünmekteyiz.
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- 2020
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6. The Evaluatıon of Antıfungal Consumption: Multi Central Point-Prevalence Survey of Western Turkey
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Sebnem SENOL, Oya Özlem EREN KUTSOYLU, Özge TURHAN, Sema ALP ÇAVUŞ, Meltem IŞIKGÖZ TAŞBAKAN, Şerife Barçın ÖZTÜRK, Selda SAYIN KUTLU, Çiğdem Banu ÇETİN, Onur KAYA, Betil ÖZHAK, Hüsnü PULLUKÇU, Bülent ERTUĞRUL, Murat KUTLU, Gülşen MERMUT, Cagri ERGİN, Dilek Yeşim METİN, Nur YAPAR, and Vildan AVKAN-OGUZ
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Infectious Diseases ,Antifungal consumption,point prevalence,invasive fungal infections ,General Materials Science ,nokta prevalans ,Enfeksiyon Hastalıkları ,Antifungal kullanımı ,Antifungal kullanımı,nokta prevalans,invaziv fungal infeksiyonlar ,invaziv fungal infeksiyonlar - Abstract
Giriş ve Amaç: Son yıllarda yeni ajanların da kullanıma girmesiyle birlikte antifungal tüketimi giderek artmıştır. Bu durum, direnç gelişimi konusunda endişelere neden olmaktadır. Ülkemizde antifungal tüketimine ait veriler oldukça sınırlıdır. Bu çalışmada, Türkiye’nin batısındaki yedi üniversite hastanesinde yatan hastalarda antifungal kullanımının değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Çalışma ekibi tarafından hazırlanan antifungal kullanım formu, tüm merkezler tarafından, aynı gün içinde, antifungal kullanan tüm hastalar için, nokta prevalans yöntemi ile dolduruldu, elde edilen veriler SPSS programı ile değerlendirildi.Bulgular: Toplam hasta sayısı 4969 idi. Hastaların 112(%2.2) ’si antifungal tedavi almaktaydı. Bu 112 hastanın verileri değerlendirildiğinde; antifungal kullanan hastaların 56 (%50)’sı hematoloji-onkoloji, 20 (%17,8)’si yoğun bakım (YB), 23 (%20,5)’ü dahili bilimler ve 13 (%11,6)’ü cerrahi bilimlerde izlenmekteydi. En sık kullanılan antifungal flukonazol [44(%39,3)] olup %34.1’i profilaksi amacı ile kullanılmaktaydı. Tedavilerin %38’i hedefe yönelik, %26.8’i ampirik ve %18,8’i preemptif olarak tanımlanmıştı. Yattığı kliniğe göre tedavi endikasyonları değerlendirildiğinde en çok pre-emptif antifungal kullanımı hemato-onkoloji kliniğinde %71.4 (15/21) görülürken ampirik tedavi en çok yoğun bakımlarda %50 olmuştur.Sonuç: Çalışmamızda antifungal tüketim oranı %2.2 olup, antifungal ajanlar daha çok hematoloji ve dahili birimlerde kullanılmıştır. Antifungal tedaviye başlama nedeni en fazla 'kanıtlanmış mantar infeksiyonu' olarak gözlenmiştir. En sık izole edilen patojenler Candida türleri olmasına rağmen, antifungal ajan seçimi hastanın yattığı kliniğe bağlıdır. Antifungal tüketim açısından yedi merkez arasında anlamlı fark gözlenmemiştir. Bu durum ülkemizdeki antifungal kullanımı politikası ile açıklanabilir. Bu sonuçlara bağlı olarak her hastane kendi verilerini izlemelidir ve izole edilen fungal patojenlere göre antifungal tedavi politikası geliştirilmelidir., Objective: Antifungal consumption has increased in recent years due to new agents on the market. This increase leads to concern about drug resistance. Data about antifungal prescription in our country is limited. The aim of this study is to evaluate antifungal consumption in seven university hospital.Materials and Methods: A form was designed to record patients’ data. The antifungal consumption at the west side of Turkey in seven University Hospital were evaluated by point prevalence. Hospitalized patients with antifungal treatment were determined and the designed forms were filled at the scheduled day. SPSS was used to determine significance of data.Results: There were 4969 hospitalized patients totally and 112 (2.2%) of them were treated with antifungal agents at the day of point-prevalance. Out of 112 patients 56 (50%) were in hematology-oncology, 20 (17.8%) in ICU (intensive care unit), 23 (20.5%) in internal medicine and 13 (11.6%) in surgery clinics. Fluconazole [44 (39.3%)] was the most used antifungal agent, 34% of them had been using oral fluconazole for prophylaxis. All of the treatments, 38% were defined as targeted, 26.8% as empirical and 18.8% as pre-emptive. When the treatment indications were evaluated according to the clinic, the most pre-emptive antifungal usage was in the hemato-oncology clinic, 71.4% (15/21), while the empirical treatment was mostly used as 50% in the intensive care units.Conclusion: In this study antifungal consumption rate was 2.2%. Antifungal agents were mostly used in hematology and internal medicine clinics. The reason of starting an antifungal treatment was ‘proven fungal infection’ mostly. Although the most frequent isolated pathogens were Candida species, the choice of antifungal agent depended on the clinic where the patient was hospitalized. There was no significantly difference between the university hospitals according to antifungal consumption. This may be explained by the antifungal prescription policy in our country. Depending on this results the hospitals should monitor their own fungal pathogens. And according to isolated fungal pathogens antifungal treatment policy should be improved
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- 2022
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7. Multicenter Analysis of Anidulafungin Use in Invasive Candida Infections
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Dilek Yeşim Metin, Çağri Ergin, Murat Kutlu, Özge Turhan, Mustafa Bülent Ertuğrul, Vildan Avkan Oğuz, Oya Özlem Eren Kutsoylu, Nur Yapar, Betil Özhak, Barcin Ozturk, Hüsnü Pullukçu, Meltem Taşbakan, Çiğdem Banu Çetin, Selda Sayin Kutlu, Sema Alp Çavuş, Gülşen Mermut, Onur Kaya, and Şebnem Şenol Akat
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medicine.medical_specialty ,business.industry ,lcsh:QR1-502 ,Candidemia ,Anidulafungin ,Candida infections ,Central venous catheters ,lcsh:Microbiology ,lcsh:Infectious and parasitic diseases ,Internal medicine ,medicine ,Candida species ,lcsh:RC109-216 ,business ,medicine.drug - Abstract
Introduction: Fungal infections are vital problems worldwide and their incidence have increased along with changing patient profile. Particularly candida species is still the most commonfungal agent, and the significance of non-albicans candida species have gained importance in recent years. In the present study, it was aimed to evaluate retrospectively the risk factors and distribution of candida species in patients with invasive candida infections, who were treated with anidulafungin., Materials and Methods: In the first three years (1 January 2012 to 31 December 2014) when anidulafungin came out in our country, we retrospectively evaluated the data of the patients with invasive candida infections who were treated by anidulafungin for more than 48 hours in seven university hospitals. Data were recorded to the case report forms., Results: Two hundreds and fifty-seven patients were included into the study. Fifty-six percent of the patients were male and mean age was 58.57 +/- 19.5 years. Two hundreds and three patients (79%) were hospitalized in intensive care units, 37 (14.3%) in internal medicine services, and 17 (0.07%) in surgery services. As previously described, we detected antibiotic usage in the last month (%96.9), presence of urinary catheter (90.3%) and presence of central venous catheter (82.1%) as risk factors for invasive candida infections. More than half of the patients (57.1%) with central venous catheter had candidemia. Sixty-six (47.7%) of the blood isolates were Candida albicans, 33 (23.7%) were Candida parapsilosis, 17 (12.2%) were Candida tropicalis and 13 (9.4%) were Candida glabrata. During follow up, 64.5% of 124 patients whose catheters couldn't be taken off and 47.6% of 86 patients whose catheters could be taken off died. During anidulafungin treatment, one anaphylaxis, one skin eruption and one thrombocytopenia were seen as side effects., Conclusion: In our study, we found that removal of central venous catheter of the patients with candidemia was a positive effect on mortality. We suggest that patients with candidemia, insisting on catheter removal besides antifungal treatment is necessary. We observed that anidulafungin is an effective and safe choice in invasive candida infections.
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- 2019
8. Delayed Diagnosis of HIV Infection in a Patient with Non-Hodgkin Lymphoma: Are Physician Still Not Aware?
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Dilşah BAŞKOL, Gülşen MERMUT, Tansu YAMAZHAN, Meltem IŞIKGÖZ TAŞBAKAN, Hüsnü PULLUKÇU, and Ege Üniversitesi
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Lymphoma ,AIDS-defining illnesses ,hemic and lymphatic diseases ,Febrile neutropenia ,lcsh:QR1-502 ,HIV ,lcsh:RC109-216 ,lcsh:Microbiology ,lcsh:Infectious and parasitic diseases - Abstract
Malignancy risk is increased in patients infected with the human immunodeficiency virus (HIV). Non-Hodgkin lymphomas, Kaposi’s sarcoma and cervical cancer are among the AIDS-defining diseases. Diffuse large B cell lymphoma is the most common non-Hodgkin lymphoma. Taking combined antiretroviral therapy is associated with good prognosis in the treatment of AIDS-related non-Hodgkin lymphoma. Therefore, HIV screening test should be requested in patient groups with the above-mentioned diagnoses. If evaluated from a different perspective, HIV-infected patients can apply to many departments with different clinics. For this reason, all physicians should have knowledge and awareness in terms of AIDS-defining diseases. The awareness of physicians is of great importance in this disease, which has a high success rate with early diagnosis and treatment. Unfortunately, cases with late diagnosis are still encountered. In this article, a patient treated with chemotherapy for four months with the diagnosis of diffuse large B cell lymphoma, who consulted us as febrile neutropenia and was diagnosed with late HIV infection is presented.
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- 2020
9. A Case of Chickenpox Developing 11 Years after Renal Transplantation
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Hüsnü Pullukçu, Aygul Celtik, Meltem Taşbakan Işikgöz, Deniz Akyol, Gülşen Mermut, and Ege Üniversitesi
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Transplantation ,Pediatrics ,medicine.medical_specialty ,Chickenpox ,business.industry ,medicine.disease ,vaccination ,Nephrology ,renal transplant ,medicine ,Surgery ,business - Abstract
In solid organ transplant recipients, it is recommended that the necessary vaccinations be completed at least 4 weeks before transplant. Chickenpox infection in adulthood can lead to serious clinical conditions such as pneumonia, hepatitis, and central nervous system infections. Herein, the case of chickenpox in a 36-year-old female patient with renal transplantation for end-stage renal disease due to vesicoureteral reflux 11 years previously and without a history of chickenpox or its vaccination before and after transplantation is reported. In this case, because of the development of thrombocytopenia associated with intravenous acyclovir, treatment was successfully concluded with oral valacyclovir.
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- 2020
10. El bileği fleksör tendonlarında tüberküloz tenosinoviti
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Levent Küçük, Meltem Işikgöz Taşbakanz, Melike Demir, Gülşen Mermut, Cengiz Çavuşoğlu, Hüsnü Pullukçu, and Ege Üniversitesi
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,medicine ,Surgery ,Critical Care and Intensive Care Medicine ,business ,Dermatology ,0-Belirlenecek - Abstract
[Özet Yok]
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- 2019
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11. Multidrug Resistant Bone-Joint Tuberculosis: Difficult Process in Diagnosis and Treatment
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Mehmet Sezai Taşbakan, Meltem Taşbakan, Cengiz Çavuşoğlu, Hüsnü Pullukçu, Sinan Mermer, and Gülşen Mermut
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medicine.medical_specialty ,business.industry ,Multidrug resistant tuberculosis ,lcsh:QR1-502 ,Bone-joint tuberculosis ,lcsh:Microbiology ,lcsh:Infectious and parasitic diseases ,Multiple drug resistance ,Joint Tuberculosis ,Mycobacterium tuberculosis complex ,medicine ,lcsh:RC109-216 ,Intensive care medicine ,business - Abstract
Tuberculosis is one of the oldest known diseases in the World, and it is still an important cause of mortality and morbidity in our country. Despite the improvements in diagnosis and treatment, resistance to anti-tuberculosis drugs still remains a serious problem. In this report, a multidrug-resistant bone-joint tuberculosis case was presented.
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- 2019
12. [Tuberculous tenosynovitis in wrist flexor tendons]
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Melike, Demir, Levent, Küçük, Gülşen, Mermut, Hüsnü, Pullukçu, Cengiz, Çavuşoğlu, and Meltem, Işıkgöz Taşbakan
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Male ,Tendons ,Wrist Joint ,Humans ,Mycobacterium tuberculosis ,Tenosynovitis ,Wrist ,Tuberculosis, Osteoarticular - Published
- 2019
13. The effect of Attention Deficit and Hyperactivity Disorder on Antiretroviral Treatment and Appointment Adherence among adults living with HIV
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Hayriye Elbi, Serhat Uysal, Demet Gulpek, Gülşen Mermut, Deniz Gökengin, Figen Kaptan, and Özen Önen Sertöz
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Turkey ,Population ,Human immunodeficiency virus (HIV) ,HIV Infections ,030312 virology ,medicine.disease_cause ,Microbiology ,Medication Adherence ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Virology ,Antiretroviral treatment ,Prevalence ,Medicine ,Attention deficit hyperactivity disorder ,Humans ,030212 general & internal medicine ,education ,Aged ,0303 health sciences ,education.field_of_study ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Executive functions ,Antiretroviral therapy ,Infectious Diseases ,Anti-Retroviral Agents ,Attention Deficit Disorder with Hyperactivity ,Attention deficit ,HIV-1 ,Parasitology ,Female ,business - Abstract
Introduction: The most prominent characteristic of adult attention deficit hyperactivity disorder (ADHD) is impulsive behavior and deficits in executive functions, which require long-term organization and discipline. This may have serious implications in terms of adherence to treatment among adults living with HIV (PLWH). This study aimed to determine the prevalence of ADHD among non-perinatally infected PLWH and its effect on adherence to antiretroviral treatment (ART) and scheduled appointments. Methodology: The PLWH admitted to our centers between January 2012 and February 2016 were invited to the study. ADHD diagnosis was made according to the novel criteria guided interviews. The first ART interruption for ≥ 6 days per month (≤ 80%) was defined as ‘‘ART-event’’ and the first non-attendance of any scheduled appointment was defined as ‘‘appointment-event’’. Kaplan-Meier plot with a Log-rank test was used for event-free adherence (EFA). Results: Twenty-five patients out of 85 were diagnosed with ADHD (29.4 %) which was significantly higher than the highest percentage reported (7.3 %) for the general population (p < 0.0001). Both ART-event (p = 0.0002) and appointment-event (p = 0.02) were significantly higher among ADHD participants compared to those without. Additionally, both ART-EFA (p = 0.00014) and appointment-EFA (p = 0.023) were significantly shorter among ADHD participants compared to those without. Conclusion: ADHD is significantly higher in adult PLWH and people with ADHD had a significant tendency for non-adherence to ART and follow-up. Screening for ADHD as well as providing treatment when required would be beneficial to achieve and maintain virologic success.
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- 2019
14. Multicenter Analysis of Anidulafungin Use in Invasive Candida Infections
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Meltem IŞIKGÖZ TAŞBAKAN, Oya EREN KUTSOYLU, HÜSNÜ PULLUKÇU, SELDA SAYIN KUTLU, Barçın ÖZTÜRK, ONUR KAYA, ÖZGE TURHAN, Şebnem ŞENOL AKAT, Sema ALP ÇAVUŞ, MURAT KUTLU, Gülşen MERMUT, DİLEK YEŞİM METİN, BETİL ÖZHAK, ÇAĞRI ERGİN, ÇİĞDEM BANU ÇETİN, MUSTAFA BÜLENT ERTUĞRUL, VİLDAN AVKAN OĞUZ, and Nur YAPAR
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Enfeksiyon Hastalıkları ,Tıbbi Araştırmalar Deneysel ,Mikrobiyoloji - Abstract
Giriş: Tüm dünyada fungal infeksiyonlar önemli bir sorun olup değişen hasta profili ile birlikte sıklığı artmıştır. Özellikle kandida halen ensık karşılaşılan fungal etken olup son yıllarda albikans dışı kandidaların önemi artmıştır. Bu çalışmada, invaziv kandida infeksiyonu nedeniyletedavi edilen hastaların gerçek yaşam verileriyle anidulafunginin etkinliğinin ve yan etkilerinin retrospektif olarak değerlendirilmesiamaçlanmıştır. İkincil amaç hastaların risk faktörlerinin değerlendirilmesidir.Materyal ve Metod: Yedi üniversite hastanesinde 1 Ocak 2012-31 Aralık 2014 tarihleri arasında invaziv fungal infeksiyon tanısı ile 48saatten daha uzun süre anidulafungin tedavisi alan hastaların verileri retrospektif olarak değerlendirildi. Veriler oluşturulan formlarakaydedildi.Bulgular: Çalışmaya yedi merkezden toplam 257 hasta dahil edilmiştir. Hastaların 144 (%56)’ü erkek, yaş ortalaması 58.6 ± 19.5 yıldı.Hastaların 137 (%53.3)’si dahili bölümlerde [100 (%72.9)’ü yoğun bakım], 120 (%46.7)’si cerrahi bölümlerde [103 (%85.3)’ü yoğunbakım] idi. Hastalarda tanımlanmış risk faktörü olarak son bir ayda antibiyotik kullanımı, üriner kateterizasyon ve santral venöz katetervarlığı saptanmıştır. Santral venöz kateter 210 (%82.7) hastada vardı. Santral venöz kateteri olan hastaların 120 (%57.1)‘sinde kankültürü pozitifti. Kateteri çekilen 86 hastanın 41 (%47.6)’inin, çekilmeyen 124 hastanın 80 (%64.5)’inin mortalite ile sonuçlandığı görülmüştür.Kan kültüründe üreyen etkenlerin %47.7’si Candida albicans , %23.7’si Candida parapsilosis, %12.2’si Candida tropicalis idi.Anidulafungin tedavisi boyunca bir hastada anafilaksi, bir hastada cilt erüpsiyonu, bir hastada ise trombositopeni yan etkisi görülmüştür.Sonuç: Çalışmamızda kateter kaynaklı kandidemi olgularında kateterin çıkarılmasının gerekliliği vurgulanmaktadır. Ayrıca anidulafungininetkin ve yan etkilerinin az olduğu izlenmekle birlikte diğer ekinokandinlerle karşılaştırmalı prospektif çalışmalara ihtiyaç duyulmaktadır.
- Published
- 2019
15. Clinical Evaluation of Fifteen Cases of Hydatid Disease
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Hüsnü Pullukçu, Ayşe Uyan, Oğuz Reşat Sipahi, Sercan Ulusoy, Meltem Taşbakan, Serhat Uysal, Ekin Ertem, Gülşen Mermut, Tansu Yamazhan, and Ege Üniversitesi
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Microbiology (medical) ,Pathology ,medicine.medical_specialty ,Pediatrics ,Echinococcus granulosus ,General Immunology and Microbiology ,business.industry ,lcsh:R ,lcsh:Medicine ,complication ,Disease ,Hydatid disease ,lcsh:Infectious and parasitic diseases ,hydatidosis ,Infectious Diseases ,echinococcosis ,parasitic diseases ,Medicine ,lcsh:RC109-216 ,business ,Clinical evaluation - Abstract
WOS: 000219732100013, Introduction: Hydatid disease is a zoonotic infection caused by the cestode Echinococcus spp. It is transmitted by ingestion of infectious cestode eggs, especially through dog feces. The two organs most commonly affected are the liver and the lung. In this paper, a series of 15 cases with symptomatic hydatid cysts hospitalized in our clinic and evaluated via consultations are presented. Materials and Methods: Patients, who were treated with hydatid disease between April 2006 and June 2015, were included in the study. Demographic characteristics, symptoms (fever, abdominal pain, pruritus, weakness, icterus, cough, sputum, nausea-vomiting), signs (hepatomegaly, splenomegaly), radiological-laboratory findings, complications, involvements of other body parts and treatment modalities were evaluated retrospectively. Results: Ten (66.7%) of the patients were female. The mean age of the patients was 52.3 +/- 18.3 year. Twelve (80%) patients had at least one cystic lesion in the liver. Four cases were complicated with a lung cyst, three with spondylodiscitis, three with splenic cyst, two with renal cyst, two with amoebic liver abscess, one with intraabdominal dissemination and one case was complicated with anaphylactic shock. Seven patients (46.7%) had leukocytosis and three (20%) had eosinophilia. All patients received treatment with albendazole p.o 2x400 mg tablets. The mean duration of treatment was 27.4 +/- 18.5 weeks. Conclusion: Hydatid cyst is an infectious disease that may cause severe organ involvement. Patients with hydatid cyst in any part of the body should be checked carefully for other system involvement, including the liver, abdominal and/ or retroperitoneal organs.
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- 2018
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16. Acute Purulent Meningitis or Opportunistic Infection Due to HIV?
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Damla Akdağ, Hüsnü Pullukçu, Gülşen Mermut, Tansu Yamazhan, Meltem Işıkgöz Taşbakan, Sercan Ulusoy, and Ege Üniversitesi
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Mikrobiyoloji ,Enfeksiyon Hastalıkları - Abstract
…
- Published
- 2018
17. Acute Purulent Meningitis or Opportunistic Infection Due to HIV?
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Meltem Taşbakan, Tansu Yamazhan, Sercan Ulusoy, Damla Akdağ, Hüsnü Pullukçu, and Gülşen Mermut
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Acute purulent meningitis ,business.industry ,Opportunistic infection ,Immunology ,Human immunodeficiency virus (HIV) ,medicine ,lcsh:QR1-502 ,lcsh:RC109-216 ,medicine.disease_cause ,business ,medicine.disease ,lcsh:Microbiology ,lcsh:Infectious and parasitic diseases - Published
- 2018
18. Evaluation of Hospital-Acquired Stenotrophomonas maltophilia Infections
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Meltem AVCI, Onur ÖZGENÇ, Seher Ayten COŞKUNER, Berna BOZCA, Gülşen MERMUT, Ebru ÖKTEM, Neslihan GENÇ, Sabiha ATMACA, and Gülşen GÜLOĞLU
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Stenotrophomonas maltophilia ,Nosocomial infections ,lcsh:QR1-502 ,lcsh:RC109-216 ,lcsh:Microbiology ,lcsh:Infectious and parasitic diseases - Abstract
Introduction: This study was performed to evaluate the incidence, risk factors, clinical characteristics, antimicrobial susceptibility patterns, and crude mortality of hospital-wide hospital-acquired Stenotrophomonas maltophilia infections. Patients and Methods: A prospective surveillance study was performed from January 2000 through December 2009. Hospital-acquired infections were defined according to the standard definitions of the Centers for Disease Control and Prevention (CDC). Results: During the study period, hospital-acquired S. maltophilia infection was diagnosed in 52 patients. S. maltophilia constituted 1.1% of hospital-acquired infection isolates and 1.5% of gram-negative microorganisms. The overall incidence was found as 2.1 per 10.000 hospital admissions. Patients with hospital-acquired S. maltophilia infection were documented in surgical wards (38%), medical wards (31%), and the intensive care unit (31%). The clinical manifestations were pneumoniae (38%), surgical site infection (25%), central venous catheter-related bloodstream infection (13%), urinary system infection (13%), peritonitis (6%), and skin and soft tissue infection (4%). The most common underlying diseases were malignancies (37%), chronic renal failure (15%), and cardiac failure (15%). Eighty-eight percent of the patients were on antibiotic treatment before infection. The most common antibiotics prescribed before the onset of infection were carbapenems and third-generation cephalosporins. The crude mortality was found as 13.5%. Trimethoprim-sulfamethoxazole (94%) and ciprofloxacin (79%) were found to be the most effective antibiotics against S. maltophilia. Conclusion: The incidence and mortality rate of S. maltophilia infections were found lower in our hospital. As S. maltophilia is associated with a high mortality rate and has high resistance to many currently available broad-spectrum antibiotics, it should be kept in mind in the etiology of a wide range of nosocomial infections in patients with risk factors.
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- 2010
19. Antifungal Prophylaxis in Solid Organ Transplant Recipients
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Nur Yapar, Meltem Taşbakan, Murat Kutlu, Dilek Yeşim Metin, Sema Alp Çavuş, Gülşen Mermut, Onur Kaya, Sebnem Senol, Oya Özlem Eren Kutsoylu, Meltem Avci, Özge Turhan, Vildan Avkan Oğuz, Barcin Ozturk, Çiğdem Banu Çetin, Betil Özhak Baysan, Çağrı Ergin, Hüsnü Pullukçu, Bülent Ertuğrul, and Selda Sayin Kutlu
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Microbiology (medical) ,Antifungal ,posaconasole ,medicine.medical_specialty ,General Immunology and Microbiology ,medicine.drug_class ,business.industry ,lcsh:R ,lcsh:Medicine ,invasive fungal infection ,Gastroenterology ,amphotericin B ,lcsh:Infectious and parasitic diseases ,Infectious Diseases ,Solid organ transplantation ,antifungal prophylaxis ,Internal medicine ,medicine ,lcsh:RC109-216 ,business - Abstract
Solid organ transplantation (SOT) is a treatment method that improves quality of life and survival of patients with end-stage organ failure. Immunosuppressive treatments given to these patients may predispose to the development of invasive fungal infections (IFI). The incidence of IFI in SOT recipients, which is between 5% and 42%, depends on the organ to be transplanted. Although Candida spp., followed by Aspergillus spp. are the most common microorganisms, among fungal pathogens, this situation varies according to transplant type. The mortality rate associated with these IFI can be high. Therefore, antifungal prophylaxis may be necessary for SOT recipients. Many transplantation centers employ antifungal strategies according to their own experience because of the lack of randomized controlled studies. If the antifungal prophylaxis is given to all patients, antimicrobial resistance and drug-drug interactions may occur. Therefore, it is important to identify patients at a high risk of developing IFI. In this paper, epidemiology, risk factors, literature data and antifungal prophylaxis associated with IFI in liver, kidney, small intestine, pancreas, heart, and lung transplant recipients are reviewed.
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- 2015
20. Comparison of Risk Category Predictions of Framingham Risk Score (FRS), Atherosclerotic Cardiovascular Disease Risk Score (ASCVD), Systematic Coronary Risk Evaluation (SCORE) and Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) in HIV Infected Patients
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Funda Şimşek, Gülşen Mermut, Dilek Yagci Caglayik, Volkan Korten, Serhat Ünal, Deniz Gökengin, Ahmet Çağkan İnkaya, Taner Yildirmak, Gülhan Eren, Muzaffer Fincanci, and İç Hastalıkları
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0301 basic medicine ,medicine.medical_specialty ,Framingham Risk Score ,business.industry ,Overweight ,Poster Abstract ,medicine.disease ,030112 virology ,Obesity ,Surgery ,03 medical and health sciences ,Abstracts ,0302 clinical medicine ,Infectious Diseases ,Oncology ,Acquired immunodeficiency syndrome (AIDS) ,Interquartile range ,Internal medicine ,Diabetes mellitus ,medicine ,030212 general & internal medicine ,medicine.symptom ,Family history ,business ,Adverse effect - Abstract
Background Cardiovascular disease (CVD) is a major cause of mortality in HIV infected patients. Agreement between commonly used risk prediction equations for classification of high-risk individuals is varied in different populations. We aimed to compare the degree of agreement of four CVD risk calculators in a multicenter cohort. Methods A cross-sectional study was conducted among adult HIV patients who are followed in five tertiary centers between July 2016 and February 2017. Inclusion criteria were: age 40–74 years, without known CVD and not receiving statins. All necessary information to calculate risk scores were collected during follow-up visits with a standardized form. Web-based tools for each score were used for calculations. Persons were considered at higher risk if 10-year CVD risks ≥20% with FRS-CVD, >10% with SCORE for high-risk countries, >7.5% for ASCVD, and 5 year risk ≥5% with DAD or if they had additional risk factors defined for each score for automatic high-risk stratification. Based on the interpretation of CVD risk, the patients were placed in two categories: low/medium and high/very high. Agreement between scores was assessed by Cohen’s kappa (κ) statistics. Results Of 667 patients who were active during the study period, CVD scores of 527 HIV-infected patients (82% male) were assessed. Median (interquartile range) age was 48 (43–54) years. Prevalence of CVD risk factors were: 11% family history of early-onset CVD, 50% current smokers, 57% overweight or obese, 22% hypertension, and 8% diabetes mellitus. The prevalence of high CVD scores or risk equivalents was high ranging from 20.3% to 36.3%. The DAD-full, DAD-reduced, ASCVD and SCORE had 83.9%, 85%, 83.5% and 93.2% agreement compared with the FRS-CVD (κ = 0.55, 0.59, 0.61 and 0.80), respectively. European AIDS Clinical Society, European Society of Cardiology, Adult Treatment Panel-III and 2013 American College of Cardiology/American Heart Association guidelines would recommend statin therapy for 35.1%, 21.8%, 31.9% and 36.4% of patients, respectively. Conclusion We found moderate/substantial agreement among risk prediction tools evaluated in this study. Agreement was high for lower scores and at higher ages. Whether those scores accurately estimate risk at population level needs further evaluation. Disclosures All authors: No reported disclosures.
- Published
- 2017
21. HIV/AIDS Hastalarının sosyal ve sağlık sorunları: İzmir, Türkiye
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Şükran Köse, Aliye Mandıracıoğlu, Yusuf Özbel, Figen Kaptan, Gülşen Mermut, and Ege Üniversitesi
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medicine.medical_specialty ,lcsh:R5-920 ,Patient ,business.industry ,Prevention ,Stigma (botany) ,General Medicine ,medicine.disease ,Bioinformatics ,Social issues ,Metropolitan area ,Focus group ,AIDS/HIV ,Health problems ,Health personnel ,Health services ,Stigma ,Acquired immunodeficiency syndrome (AIDS) ,Family medicine ,Discrimination ,medicine ,Original Article ,business ,lcsh:Medicine (General) ,Genel ve Dahili Tıp - Abstract
Amaç: HIV/AIDS hastalarının ve yakınlarının hastalığın yaşamlarını nasıl etkilediğinin ve damgalanma deneyimlerinin saptanmasıdır. Gereç ve Yöntem: Çalışma İzmir’de yer alan üç devlet hastanesinin katılımı ile gerçekleştirilmiştir. Altı odak görüşmesi 32 HIV/AIDS hastası ve 11 yakınının katımı ile gerçekleştirilmiştir. Ayrıca katılımcılar HIV/AIDS hastalığı ve damgalanma hakkında soruları içeren bir anket formunu tamamlamışlardır. Bulgular: Odak grup görüşmelerinin sonuçlarına göre hasta ve yakınlarının belirttiği en önemli sorunlar, toplumla ilgili sosyal problemler, damgalanma ve sağlık hizmetlerine erişimdir. Hasta ve yakınlarının hastalık hakkında bilgilerinin de yetersiz, ayrımcılık konusunda duyarlı olduğu saptanmıştır. Sonuç: HIV pozitif hasta ve yakınlarının desteklenmesi ve eğitilmeleri gerektiği belirlenmiştir. Hastaları izleyen sağlık personelinin daha fazla çaba göstermesi gerekmektedir., Objective: the aim of this study was to describe how AIDS, as well as the stigma associated with it, affects the lives of HIV positive patients and their family members. Materials and Methods: Three large state hospitals in the metropolitan area of Izmir participated in the study. Six focus groups were conducted with people infected with HIV (n=32) and their family members (n=11). Participants were asked to fill out a questionnaire to assess their HIV/AIDS knowledge and to convey how the stigma had affected them. Results: the most important problems identified were society and work-related social problems and access to health services. the patients and their family members stated that education was needed to correct misconceptions about HIV and to help them cope with related problems. We found that patients and their family members were sensitive about disclosure. Conclusion: We determined the education, counseling and support needs of HIV-infected patients and their families. Additionally, we found that health personnel who monitor the patients should make more efforts on patients‘ education and counselling.
- Published
- 2012
22. Improving Knowledge and Attitudes of Health Care Providers Following Training on HIV/AIDS Related Issues: A Study in an Urban Turkish Area
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Sukran Kose, Aliye Mandiracioğlu, Gülşen Mermut, Yusuf Özbel, Figen Kaptan, and Ege Üniversitesi
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knowledge ,medicine.medical_specialty ,training ,Turkish ,business.industry ,Human immunodeficiency virus (HIV) ,HIV ,General Medicine ,health personnel ,medicine.disease_cause ,medicine.disease ,language.human_language ,Acquired immunodeficiency syndrome ,Health personnel ,Nursing ,Acquired immunodeficiency syndrome (AIDS) ,attitude ,Family medicine ,Health care ,medicine ,language ,business - Abstract
WOS: 000302272100014, Objective: The objective of the study was to assess HIV/AIDS related knowledge, attitudes and risk perception among health care providers in Izmir. Material and Methods: A pretest and posttest patterned intervention study was conducted in 2007 among health care providers participating in a training course on HIV/AIDS and universal precautions. The participants consisted of 158 health care professionals from 7 public hospitals and 2 public dental clinics. Information was collected regarding demographic details, HIV/AIDS related knowledge, attitudes and perceptions about patients at the beginning and the end of the course. Pre- and post-training dichotomous point scale scores were compared. Results: Of the participants, 72.6 % were females. Only 30.0 % of the respondents reported a scalpel or needle stick injury at least once last year. Some of the participants (40%) thought that it was necessary to take extra infection control precautions for patients with HIV. The average pre- and post-training mean knowledge scores were 9.32 +/- 2.1 (3-13) and 12.76 +/- 2.3 (5-17), respectively. The mean pre- and post-training beliefs scores were 12.37 +/- 3.1 (3-19) and 15.57 +/- 3.8 (6-22), respectively. There were significant differences in the pre- and post-training mean scores of the responses related to attitudes toward patients with AIDS. Conclusion: There was improvement in knowledge and negative attitudes on patients with AIDS at the end of the training. The results of this study suggested that the negative attitudes of health care providers towards individuals with AIDS due to the fear of transmission and inadequate knowledge could be improved with training.
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- 2012
23. The State of Kuwait Sponsors Publication of the English Translation of the Classic Latin Text De humani corporis fabrica by Andreas Vesalius
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Gui-Jie Liu, Alpay Ari, Adekunle Dawodu, Abdulnabi T. Al-Attar, Kwang Ho In, Azu Owunwanne, Obaid Almutairi, Sujatha Mogili, Abdurrahman Kara, Ebru Öktem, Maha Bilal, Hana Al-Majed, Pamir Isik, S.T. Balogun, Ibrahim Nahar, Bomin Yan, Satz Mengensatzproduktion, Bahattin Tunç, Nuannoi Chudapongse, Veli Vural, Ming Gong, Kejun Zhang, Vecdi Evren Genç, Ali Ilgın Olut, Majeda S. Hammoud, Ali Bay, Sang-Hoon Park, Lancelot Pinto, Jianhua Huang, Madhukar Pai, Guang-Tao Lu, Qing Yang, Xue-Zheng Lin, Haifaa H. Al-Mousa, Nasser Yehia A. Aly, Montaser Ismail, Hao Chen, Wei Gao, Thaier Almuaili, Xuefeng Zheng, Jassim Al-Suwaidi, Nese Yarali, Xiaofeng Wu, Yuan Gao, Nawras Ajaj, Wehad Altorah, Ahmed Abdelalim, Samuel G Schumacher, Kanchana Poompachee, Huai-Ping Dong, F.A. Fehintola, Xiaoyi Liu, Gülşen Mermut, Claudia M. Denkinger, Sulaiman Al-Rashaidan, Ivan Duris, Dalu Kang, Mohammad Z. Haider, Mehmet Vasfi Özer, Dong Chen, Amnah Shaghouli, Yan-Xin Chen, Abdullah Al-Taiar, Onur Özgenç, Li-Juan Zheng, Esma Altinel, Khaled Al-Jarallah, Seher Ayten Coskuner, Arife Polat Düzgün, Adel Al-Awadhi, Mohamed A.A. Moussa, Maytham Alyousefi, Sang Yeub Lee, Jiaqi Wu, Timothy Woodlock, Qiugen Wang, Meltem Avci, Karen R Steingart, Diaa Shehab, Chul Hwan Kim, Fang Wang, Eun Joo Lee, Druck Reinhardt Druck Basel, Li Wang, S.B. Adeoye, Nidal Asaad, Abdulrahman Al-Tmimy, Barış Saylam, Le-Xin Wang, Pavel Babusik, Faruk Coşkun, Bruce Ovbiagele, and Jasmine Grenier
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State (polity) ,business.industry ,media_common.quotation_subject ,Medicine ,General Medicine ,business ,Latin text ,Classics ,media_common - Published
- 2012
- Full Text
- View/download PDF
24. The Social and Health Problems of People Living with HIV/AIDS in Izmir, Turkey
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Sukran Kose, Aliye Mandiracioglu, Gulsen Mermut, Figen Kaptan, and Yusuf Ozbel
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AIDS/HIV ,Discrimination ,Patient ,Prevention ,Stigma ,Medicine (General) ,R5-920 - Abstract
Objective: The aim of this study was to describe how AIDS, as well as the stigma associated with it, affects the lives of HIV positive patients and their family members. Materials and Methods: Three large state hospitals in the metropolitan area of Izmir participated in the study. Six focus groups were conducted with people infected with HIV (n=32) and their family members (n=11). Participants were asked to fill out a questionnaire to assess their HIV/AIDS knowledge and to convey how the stigma had affected them. Results: The most important problems identified were society and work-related social problems and access to health services. The patients and their family members stated that education was needed to correct misconceptions about HIV and to help them cope with related problems. We found that patients and their family members were sensitive about disclosure.Conclusion: We determined the education, counseling and support needs of HIV-infected patients and their families. Additionally, we found that health personnel who monitor the patients should make more efforts on patients’ education and counselling.
- Published
- 2012
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