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This double-blind, randomized, prospective study was conducted to compare the analgesic and sedative efficacy of fentanyl and meperidine in orthopedic closed reduction of fractures and dislocations undertaken in the emergency department. Seventy consecutive adult patients with fractures or dislocations suitable for reduction were randomized to receive fentanyl (1 mcg/kg; n = 36) or meperidine (0.5 mg/kg; n = 34) in combination with midazolam (0.02 mg/kg). Vital signs and alertness scale scores of the patients were monitored. The Visual Analog Scale (VAS) was used to determine the degree of pain. There was no statistically significant difference between the VAS mean scores of the fentanyl and meperidine groups (t test, P = .772). The need for additional analgesic drugs was significantly more frequent in patients receiving meperidine (P = .018). No adverse events, such as hypotension or respiratory depression, were noted. Euphoria occurred in one patient in the fentanyl group. Although dose requirements differ, fentanyl and meperidine provide effective and reliable analgesia in closed reduction of fractures and dislocations.

Background. Health literacy is a holistic structure of belief systems and personal philosophy, which consists of functional, critical, and communication skills that explain medical decision-making.Objectives. The study aimed to determine the levels of health literacy and the variables that affect it in patients who were admitted to family health centers (FHCs). Material and methods. This cross-sectional study, which was performed in a Central Anatolia City (Eskisehir), included patients who were admitted to FHCs (n = 1,055) between May and June 2017. Data were collected using a questionnaire consisting of 27 questions about the patient's sociodemographic characteristics, the resources that are available to them with health-related information, their accessibility to this information and healthcare institutions, and the Turkish Health Literacy Scale. Results. The mean health literacy score of the participants was 29.57 ± 9.27. Health literacy levels of participants were problematic in 38.6% and inadequate in 27.5% of the subjects. According to the results of logistic regression analysis, the probability of having a high level of health literacy in FHC patients was halved for each age increase; it increased by 2.5-fold for graduates of secondary education, by 3.1-fold for high-school graduates, by 3.3-fold for those holding an undergraduate degree, by 1.5-fold for participants who did not suffer from a disease that requires regular medication, by 2.7-fold for individuals most commonly admitted to private hospitals in case of any health problem or disease, and by 0.6-fold for subjects who did not see a family physician in the last six months. Conclusions. The health literacy level of the population of Eskisehir is affected by unchangeable and changeable factors.

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