INTRODUCTION: This research was carried out to determine the problems regarding purchase, storage and use of the orthopedic medical supplies in clinic, to put forward the proposed solutions and to specify the reasons for focusing on orthopaedic materials.
METHODS: In this study, face to face interviews and the survey prepared by the researchers were used and implemented in 2011. The random sampling method was applied and 181 individuals responded to the survey completely were identified as a sample.
RESULTS: 9 incomplete surveys were not assessed. In the survey, five point likert scale was applied and the survey was evaluated by the help of the SPSS 15,0 statistical software. Orthopedic and traumatology physicians along with purchasing and warehouse managers were included in the scope of the research. However, physician assistances were excluded from the scope.
DISCUSSION AND CONCLUSION: The survey has been filled out by officials with experienced in research. In general, it is identified that people encountered with the problems during the usage of orthopaedic materials in the clinic by the rate of 72.4%, and during purchasing and storage stages by the rates of 66.9% and 52.5%, respectively. Different solutions for these problems have been identified. The most important reason for focusing on orthopaedic medical devices is to improve the quality of service. This research is assumed to be supportive of managerial decisions regarding top management of orthopaedic medical supplies.

INTRODUCTION: Lifting head of bed is the easiest and most important way to prevent ventilator-associated pneumonia (VAP) in intensive care unit (ICU).
METHODS: In our study we investigated contribution of reminding this application.
RESULTS: Prospective study was done in 22 bed intensive care unit (ICU) during December 2010 and January 2011. None of the staff other than researchers were aware of this observational study. Every day during December 2010 at 8.00 a.m and 5.00 p.m 22 ICU bed head position were recorded whether their heads were 30-45 degrees elevated or horizantal.
DISCUSSION AND CONCLUSION: During January 2011, nurses responsible for beds were told to lift bed head positions and bed head positions were recorded again. Infection nurse noted aspiration or VAP cases every two months. Values were summarized with descriptive method. One patient had VAP and died 12th day of stay in December 2010 In January 2011; 3 VAP, 1 aspiration pneumonia were observed and they stayed total 64 days in ICU and one of these was died. Reminding of lifting bed head positions at certain hours, during shift changes reduce inappropriate bed head position. This method which is used in reducing the risk of VAP and aspiration pneumonia, shortens ICU stay, contribute country income, decrease aspiration related mortality.

INTRODUCTION: Concordence of intestinal metaplasia with Helicobacter pylori infection and the role of Helicobacter pylori in pathogenesis of intestinal metaplasia have been reported in many reviews.
METHODS: The aim of this study to evaluate the frequency of Helicobacter pylori and concordance of intestinal metaplasia in Siverek.
RESULTS: We evaluated totally 157 endoscopic biopsies retrospectively. H.pylori was found in 69 (%43.9) patients.
DISCUSSION AND CONCLUSION: There is no a significantly relation between positivity of Helicobacter pylori and intestinal metaplasia.

INTRODUCTION: In this study, we aimed to correlate the BI-RADS scores and histopathologic results of lesions detected by mammography and/or sonography in our clinic. Positive and negative predictive values, sensitivity and specificity for each category were also calculated and compared with the literature in order to evaluate quality of care in our department.
METHODS: 9703 patients referrring to the mammography department of Haydarpafla Numune Training and Research Hospital between May 2008 and December 2010 were included in the study. BI-RADS scores obtained with mammography and complementary sonography were compared with pathology findings, as determined by means of fine needle, core needle or excisional biopsies.
RESULTS: 419 lesions in 9703 patients received pathological evalution. BI-RADS category 1,2 and 3 were radiologically considered to be benign and those in category 4 or 5 malignant. Out of 175 lesions in category 1, 2 or 3, 169 were benign and 6 malignant; while out of 244 lesions in categoy 4 or 5, 136 lesions were benign and 108 were malignant. The respective sensitivity was calculated as 94.5 %, specificity as 55.4%, positive predictive value 43 % and negative predictive value 95.6 %.
DISCUSSION AND CONCLUSION: The sensitivity, specificity, positive and negative predictive values calculated in our study were found to be consistent with those from other studies in the literature. However, a high number of biopsy procedures were carried out for lesions in the radiologically benign lesions on the request from other clinicians, revealing benign findings as expected. Thus integrating BIRADS lexicon into the daily practice, not only for radiologists but also for clinicians diagnosing and treating breast diseases, will contribute to the cost-effectiveness and improvement of patient care.

INTRODUCTION: Although the incidence of abscess has decreased recently because of using effective antibiotic therapy, it has still observed rarely. Our aim in this study was to assessment clinical and etiologic features of lung abscess that was arouse from necrotizing lung infection due to pyogenic bacteria, in our clinic
METHODS: 11 in patients with lung abscess [F/M=2/9, mean age: 44 (23–65) years] were reviewed at Süreyyapasa Hospital in the 3rd Clinic from 2004 to 2008, retrospectively.
RESULTS: The most common predisposing factors included; delayed of pneumonia treatment, diabetes mellitus and age (respectively n=4,3,3). The most frequent symptoms were cough-sputum and weakness (respectively n =9,6). There were no differences in radiologic zones of lung abscess. Bacteriological examination was not confirm to ethology. Fiberoptic bronchoscopy was extremely used to differentiate diagnosis and bacteriological sampling (n=9). Antibiotics such as amoxicillin-sulbactame and/ or clindamisine have been used to treatment for a long period, usually four weeks to four months. While all cases were complete clinical and laboratory improvement; in five patients complete radiological improvements and other five of them recovered with radiologic sequel, one case was stable radiological feature and no patient had to be operated.
DISCUSSION AND CONCLUSION: As a conclusion; in patients with lung abscess which were follow up in our clinic were improved by empiric antibiotic treapy, although insufficient of detected of bacteriologic agents.

INTRODUCTION: The aim of this study is to determine the understanding level of pregnants living in Yozgat about the consquences of normal vaginal childbirth and caesarean section on pelvic flor health.
METHODS: A total 322 patients referred to our clinic between July 2011- January 2012 included to this cross-sectional study. The patients were divided into the four groups according to the maternal educational level. Group 1 was consist of women who never went to school. In Group 2, the patients had a certificate of elementary school. In Group 3, women had a certificate of high school. Group 4 was containing subjects graduated from university. A detailed questionnaire was addressed to the participating women by face-to-face interviewing method. Both demographic information and the subject’s knowledge about pelvic flor status after vaginal birth or caesarean section were assessed.
RESULTS: The association between maternal educational level and the awareness of the pregnant about the outcome of the delivery type on pelvic floor was investigated. The percentage of ‘no’ answers were getting significantly higher to the questions of whether vaginal delivery or caesarean section increase the urinary incontinence while the education of subjects increased (p<0.05). Interestingly, 65.9% of the patients said ‘yes’ to the question of whether exercises of the muscles of pelvic area help lessen the bladder and/or bowel problems (p<0.05).
DISCUSSION AND CONCLUSION: The patients paticipated our study reported that urinary incontinence after pregnancy was increased independant with the birth type. The subjects believed the protective effect of pelvic muscle strengthening exercises on urinary and/or fecal incontinence were statistically more.

INTRODUCTION: In recent 20 years survival of preterm infants increased with development in perinatal and neonatal intensive care units. In our study, demographic features, clinical findings and prognoses of 59 preterm infants with gestational ages ≤36 week were evaluated.
METHODS: The most highest mortality rate was determined in the group of infants who were <999g ( 31,5%) and ≤28 week (26,3%). Duration of ventilation was 4,52±10,2 days, duration of CPAP was 1,5±2,12 days.
RESULTS: The BPD rate was 6,7%, in infants <28 week was 15,8 %. There was no difference between the BDP rates in the groups in terms of birth weight and the gestational age (p>0.05). The IVH (stage 2-3) rates were statistically higher in infants ≤28 weeks (p<0.01). ROP rate was 6,7%; in inflates <1000g was 18,8%. The ROP was significantly higher in the 500-999g group (p: 0,027).
DISCUSSION AND CONCLUSION: In conclusion; the survival rates of inflates <28 we eks and <1000g fallowed at our Neonatal Intensive Care Unit are notably high; and rates of the early neonatal complication such as BPD, ROP, IVH and NEC are lower.

INTRODUCTION: Factor V Leiden(FVL) Mutation is one of the most common causes of genetic risk factors for thrombosis. In this study, we aimed to determine the frequency of, and association to arterial and venous thrombosis with FVL Mutation in patients diagnosed with thrombosis in the last two years in Haydarpafla Numune Research and Training Hospital.
METHODS: In this observational, case-controlled, retrospective study; patients diagnosed with thrombosis between the years 2008-2010 in the Internal Medicine, Neurology, and General Surgery Clinics who had this diagnosis comfirmed by radiological methods: and had Factor V Leiden Mutation screening done were chosen. Following DNA isolation from peripheral blood, FVL 1691 nucleotide mutation was searched using Melting Curve Analysis following Real-Time PCR. NCSS (Number Cruncher Statistical System) 2007&PASS 2008 Statistical Software (Utah, USA) programs were use for statistical analysis.
RESULTS: Two groups were formed for the study. Group 1 consisted of 67 patients diagnosed with thrombosis and group 2(control group) consisted of 22 healthy inviduals. Group 1 had a mean age of 42,94±14,52 (Mean ± 1SD), 37 (%55,2) of whom were female and 30 (%44,8) were male; whereas Group 2’s mean age was 42,09±11,19 (Mean ± 1SD), consisting of 13 (%59,1) female and 9 (%40,9) male healthy people. 18(%26.9) of 67 patients and 5(%22.7) of 22 healthy people tested positive for FVL mutation. Of the 18 patients of group 1 who tested positive for FVL mutation, 16(%23.9) were heterozygote mutant and, 2(%3) were homozygote mutant.
DISCUSSION AND CONCLUSION: Although FVL mutation is frequent enough in our country to contemplate gene polymorphism, heterozygote FVL mutation doesn’t seem to be a risk factor for either arterial or venous or central or periphery thrombosis by itself. Due to the small number of patients in the study we were not able to assess the risk for homozygote mutation. However, it seems likely that in the presence of FVL mutation, the risk for thrombosis is related to the other present risk factors.

Bilateral humerus diapyhsis fracture after a tonic clonic seisure is a rare condition. In this report we presented a 33 years old male patient admitted to emergency department with bilateral shoulder pain and after diagnostic workup patient was diagnosed as bilateral humeral head osteonecrosis caused by bilateral humeral anatomical neck fracture without dislocation. Patient was diagnosed as Stiffman Syndrome (SMS) with accompanying tonic clonic seisures and right shoulder was treated with partial shoulder prothesis. Recurrent seisures did not allow the surgical team to perform any surgical intervention for left shoulder. Patient died because of generalised stifness and systemic diseases. Seizure related syndromes should always be kept in mind in patients with anatomical humeral neck fractures without a history of trauma or dislocation.

Accessory breasts are an uncommon entity. They may present as asymptomatic masses or cause symptoms such as pain or restriction of arm movements. They may prove to be a diagnostic challenge if found in locations along or outside the mammary line. Aberrant breast tissue in patients with the possibility of malignancy, functional and cosmetic reasons, complaints, considering excision biopsy should be applied in the early period.We reported a case of accessory axillary breast and reviewed this anomaly.

Cystosarcoma phyllodes is an uncommon breast neoplasm.It is a fibroepithelial tutor composed or an epithelial and a cellular stromal component. These tumors are usually benign. There are no specific symptoms or radiological images to distinguish phyllodes tumor from fibroadenoma; therefore, histological examination is mandatory for diagnosis. The most important component of therapy is wide surgical excision, and mastectomy is necessary only when free margins cannot be achieved despite of re-excusion(s). Involvement of axillary nodes is rare, and routine axillary dissection is not indicated. Fortunately, the majority of these tumors are benign, and treatment maximizes breast conservation with free infiltration margins surgery, given that this fact is the most important factor to prevent local recurrence. In this article, we describe a rare case of diagnosed the benign Cystosarcoma phyllodes in a 53-year-old woman applied to breast conservation surgery.

Lipoma arborescens is a rare intra-articular lesion with unknown etiology characterised by extensive villous proliferation of the synovial membrane and hyperplasia of subsynovial membrane and hyperplasia of subsynovial fat tissue and typically located in the knee. Clinically,the most common finding is a slow-growing painless swelling,accompanied by intermittent effusion of the joint.‹n this article, localised unilateral wrist that is unusual for lipoma arborescens is reported.