Amaç: Kardiyak cerrahi sonrası gelişen aritmiler, sık görülen komplikasyon olmasına rağmen,genellikle önceden bir risk belirlemek olanaksızdır. Bu çalışmanın amacı pediatrik popülasyondakardiyak operasyon sonrası gelişen ritim bozukluklarının tür ve sıklığını saptamaktır. Yöntem:Ocak 2008- Aralık 2015 tarihleri arasında çocuk kardiyoloji ünitesinde izlenen kardiyak operasyongeçirmiş, 2-17 yaş arası, 124 pediatrik hastanın (59’u kız, 65’i erkek) 24 saatlikholtermonitorizasyon kayıtları retrospektif olarak değerlendirildi. Hastaların demografiközellikleri, preoperatif tanıları ve geçirdikleri cerrahi girişim tipleri kaydedildi. Bulgular: Altmışsekiz hastada (%54.8) aritmi olduğu saptandı. En sık görülen ritim bozuklukları supraventrikülerekstrasistol (SVE) ve ventriküler ekstrasistol (VES) olup her ikisinin de görülme sıklığı %15.3 idi. Buiki ritim bozukluğunun birlikte görülme oranı % 12.9 bulundu. Kızlarda SVE ve VES görülme oranıbiraz daha yüksekti. SVE ve VES riski sırasıyla atriyal septal defekt tamirinde %26.3 ve %7.9,ventriküler septal defekt tamirinde %10.5 ve %15.8, tüm düzeltme yapılan Fallottetralojisinde ise%4.5 ve %9.1 bulundu. Atriyal septal defekt tamiri yapılan bir hastada supraventriküler taşikardi,ventriküler septal defekt tamiri ve tüm düzeltme yapılan Fallottetralojisi olan iki hastada ise sürekliolmayan ventriküler taşikardi izlendi. Sonuç: Kardiyak operasyon geçiren hastaların izlemindearitmi gelişebileceği bilinmeli ve hastalara düzenli holter EKG izlemleri yapılmalıdır. Bu çalışmadaen sık görülen postoperatif aritmi tiplerinin SVE ve VES olduğu ve atriyal septal defekt, ventrikülerseptal defekt ve Fallottetralojisi operasyonlarının aritmiler için risk faktörü olduğu gösterilmiştir.

Aim: Although arrhythmia is a common complication after cardiac surgery, it is usually impossible to identify a risk in advance. The aim of this study is to determine the type and frequency of arrhythmias developing after cardiac surgery in the pediatric population. Method: 24 hour holter monitorization records of 124 pediatric patients (n:59 girl, n:65 boy) aged 2-17 who undergo cardiac surgery were retrospectively evaluated between January 2008 and December 2015. Patients' demographic characteristics, preoperative diagnosis and types of cardiac surgery were recorded. Results: 68 (%54.8) patients had arrhythmia. The most common arrhythmias were supraventricular extrasystole (SVE) and ventricular extrasystole (VES), and the frequencies of both were 15.3%. The rate of both rhythm disorders being at the same time was 12.9%.The rate of SVE and VES were slightly higher in girls. Respectively, the risk of SVE and VES were found as %26.3 and %7.9 in atrial septal defect repair surgery, 10.5% and 15.8% in ventricular septal defect repair surgery, 4.5 and 9.1% in total corrected fallot tetralogy. Supraventricular tachycardia in a patient with atrial septal defect repair surgery, non-sustained ventricular tachycardia in two patients with all corrected Fallot tetralogy and ventricular septal defect repair surgery were observed. Conclusion: It is known that patients undergo cardiac surgery may develop arrhythmian and regular holter ECG follow-ups should be performed. In this study The most common postoperative arrhythmia types are SVE and VES and atrial septal defect, ventricular septal defect, and tetralogy of Fallot have been shown to be risk factors for arrhythmias.

Aim of this research is to determine the accessibility levels of disabled people to health services, to identify the problems they have experienced in reaching health services, and to summarize them to remove obstacles. The research was carried out on a total of 300 disabled people from three different hospitals operating in Konya using face-to-face surveys. "Disability Individual Health Service Usage Inventory" developed by researchers was used in the collection of data. Descriptive statistics and chi-square test were applied on the collected data. 65.7% of the respondents are male, 58.3% are married, 42.0% are in the age group of 31-50, 46.7% are primary school graduates and 37.7% have general health insurance. 32.7% of the handicapped stated that they applied to the health institution at least once every two weeks, 52.0% had problems in accessing the health facilities and 58.3% of them had difficulty in moving in the hospital. 52.0% of the disabled people surveyed within the scope of the research indicated that the health services provided for the disabled are sufficient. According to the results of the research; it has been determined that they have encountered problems such as transportation, disabled car park use, hostess service for disabled, lack of movement within the health facility, use of the priority right, postponement of the health facilities' operations for other days. Policy makers, local authorities and hospital managers need to take the necessary precautions to make the solution of the problems and to make it easier for disabled people to benefit from health services.