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Discover Ephesus with Private Ephesus Tours

2014 October 30

ephesus-amphitheatre-1_234_nx4One of the most important historical places of our country is Ephesus which is close to Kusadasi, Izmir. The city was founded in 1000 BC. The city is also known as the center of early period of chiristinity. It is assumed that city is visited by 1.5 million every year. read more…

Historical Runaway Anzac and Ephesus

2014 October 21

It is one of the most ancient cities of the world. The city belonged to the ancient Greece. It was also a seaside city. It was the most developed city during the old times. The city was also the most important commercial trade center in that century. The history of the Ephesus goes back to 10th century BC. read more…

Prefabrik Yapı Considers Ecological Awareness at Every Product and Service

2014 September 30

As the main company of Hekim Holding, Prefabrik Yapı is active in the construction industry since 1989. We developed innovative zero carbon Mars production system and we produce sustainable, ecologic containers, houses and commercial buildings since 2010.

Prefabrik Yapı provides containers, camp buildings, armored security cabins, ecological buildings, sales and kiosk cabins, steel structures and other prefabricated solutions suitable for any kind of rural or urban environment. read more…

Modern and Practical Solutions For Every Kind of Evnironment

2014 September 18

Piraziz International Service Solutions provides steel structure prefabricated buildings and affordable housing solutions suitable for any kind of rural or urban environment. Our products can be used in fields like emergency accommodation units, healthcare centers and hospitals, site camps for general contracting projects, administration and office buildings, site camps for mining projects, site camps for oil and gas projects, freezer and cold rooms and defense and military camps. read more…

Hight Quality Products Effective Solutions

2014 September 15

pirazizint.comPrefabricated buildings are very modern and effective solutions with their small carbon footprint, lower cost and applicability to almost every kind of urban and rural environment.

We, as Piraziz International Service Solutions, provide steel structure prefabricated buildings and affordable housing solutions to be used in fields like site camps for general contracting projects / mining projects / oil and gas projects, also emergency accommodation units, healthcare centers and hospitals, administration and office buildings, freezer and cold rooms and defense and military camps. read more…

Plastic Surgery Site:

2014 July 4

 Before going for a plastic surgery everybody will search about all the minor and major details about it. Because when you are going for a plastic surgery you want it to be the best and safest. Its use has been increased very dramatically in previous days. It is worldwide available and people are becoming crazy about this surgery, as everybody wanted to look beautiful. Earlier it was restricted to the celebrities only but nowadays most of the people who can afford it are undertaking this surgery. read more…

Tough Decisions about Concussions

2011 October 12

Decisions like the one Texas Longhorn Nolan Brewster recently made to quit playing football are tough.  I am not one of the physician taking part of his care, so I do not know all the specifics.  But having had similar conversations with my patients, I can understand the process he has gone through.  The Sport becomes part of the athletes’ identity.  In the case of a top college football player, it is also a potential source of future income for himself and his family.  But when the safety of the athlete becomes a major concern, sometimes this tough decision is the right decision.  This decision did not happen overnight.  It involves the discussion of the whole family along with a multi-disciplinary approach with coaches, trainers, and medical professions.  I always recommend consultation with a sports psychologist when concussions start affecting the normal routine for an athlete, and especially when decisions about quitting or changing a sport is involved.  Depression is among the possible symptoms of concussions and cumulative head injury.  For an athlete who needs to find a new identity, strong family support and a good sports psychologist are the most important things going forward.  I wish Nolan Brewster much luck and success on the next chapter of his life.

Pediatric Sports Injuries on NYU’s Doctor Radio: Sirius/XM 81 on August 22 @ 6pm

2011 August 16

On Monday, August 22nd at 6pm, I will be on NYU’s Doctor Radio talking about Pediatric Sports Injuries.  If you have Sirius or XM Satellite Radio, tune in to listen, and call in if you have any questions!  That’s NYU Doctor Radio Sirius/XM 81 @ 6pm on Monday August 22nd.


Triathlons for Children

2011 August 13

Here are some pictures of the Nautica NYC Triathlon last weekend. I was there as a physician volunteer and was at the swim exit and then at the finish line. The NYC Triathlon is an Olympic distance event which covers a distance of 1.5K Swim, 40K Bike, and 10K Run. The swim is done on the Hudson River, the bike is along the West Side Highway, and then it finishes with a run through Central Park.

This got me thinking about triathlons for children. Currently, there are a number of triathlon events around the world geared toward children of all ages. In 2009, the New York Times did an article about this as well. In one triathlon, the youngest child to participate was 3 years-old. Before anyone becomes outraged at this, keep in mind that swimming, biking, and running are all things that children as young as 3 can do. Training for a triathlon may actually be better for overall development than many other popular sports like baseball and football since it incorporates various skill sets and utilizes the entire body. Triathlon events for children are great as long as everyone involved keeps some key points in mind:

1. Keep it fun: The emphasis should be on exposing the child to something enjoyable. While adults treat their own triathlon races as a competition between each other or trying to achieve a personal best, these events for children should not be timed or scored for record purposes.

2. Keep it age and individual-child appropriate: All events that I have seen have specified distances based on age. But parents must also be aware of what is appropriate for their child. Not all children have the same ability, and putting a child into a race just because he/she is within the “age category” is not always correct. Courses must also be designed for appropriate ages.

3. Keep it safe: Overall, the triathlon is a safe event. But there are no specific guidelines out there yet for safety. Accidents are more likely to happen in the swim and bike sections of the race. All events should have appropriate personnel and equipment at hand for emergencies.

4. Don’t Over-do it: The main concern for children are that they have open growth plates, and injury to them can have significant consequences on their development. There is limited data on the injury rates of these events. Studies from kids’ marathons have suggested that rates of injury on the day of the race are less than adults. There needs to be more studies in this regard, and there also needs to be studies on injuries during training for the events. As with all sports, overuse injuries can occur from improper training. Over-training can lead to injuries as well as mental burn-out. Consult with your pediatrician or a pediatric sports medicine specialist if you are planing to start your child on a training program.

Running, Biking, and Swimming are great for children. If your child loves to do all three, try a triathlon!

Beat the Heat: Heat Illness in Children

2011 July 24

It has been an extremely hot summer so far in all parts of the United States. Record highs are being set all over the country. Today we will discuss exertional heat illness in children so you can be better prepared to identify and prevent this in our children as they continue to be active throughout the summer months.

Why is temperature regulation important?

Our bodies are made to function at an optimal core temperature of 98.6°F (37°C). The “thermal neutral” zone in which we operate is 36.5 – 37.5°C . When the temperature deviates too much from that, temperature sensitive structures such as body enzymes and other proteins begin to denature, and essential processes start to fail. Extreme cold slows down metabolic processes and at temperatures below 33°C we lose consciousness. In extreme heat, temperatures above 42°C are not compatible with life.

How do we temperature regulate?

Even without activity, our body is generating heat at a rate that would increase our core temperatures by over 1°C per hour. When we are exercising hard, that heat generation can increase 10-fold. Therefore our bodies are equipped under normal circumstances to dissipate the heat. The main methods of heat dissipation are: radiation, convection, conduction, and evaporation. Radiation is the primary way in which heat is dissipated when the skin temperature is greater than air, but when air temperature exceeds the skin temperature, evaporation becomes the primary method of cooling. This happens in the form of sweating (humans), and panting (dogs). When normal functions of heat dissipation are not working correctly, or when heat generation exceed heat loss, the body is in danger of a spectrum of heat-related illnesses from heat cramps, heat exhaustion, and heat stroke.

Why are children at greater risk than adults?

Children are more susceptible to heat illness because they have:
1. Greater surface area to body mass ratio
2. Lower rate of sweating
3. Higher temperature at initiation of sweating
4. Slower rate of acclimatization to heat

Tips on beating the heat?

1. Stay indoors or in a shaded area during the hottest part of the day. Schedule practices or events before 11am and after 6pm.
2. Pre-hydrate! Dehydration increases the risk of EHI.
3. Hydrate on a regular schedule during and after exercise. Thirst is a poor indication of hydration status, especially in children. A good starting point is 4 to 6 ounces of fluid every 15 minutes for a 90-lb child.
4. Check the weight! Checking your child’s weight before and after exercise will give you an idea if hydration was adequate. Weight loss of greater than 2.5% indicates dehydration.
5. Get acclimatized. The body can take 1-2 weeks to get adjusted to the heat, so avoid strenuous practices in the beginning. Start light and gradually increase.
6. Wear appropriate clothing. Keep it light on the hottest days.
7. Know the symptoms of heat exhaustion and heat stroke:
Heat exhaustion: Athletes can be sweaty, ashen in color and complaining of weakness, headache, dizziness, irritable, nauseous or vomiting.
Heat stroke: Athletes can have similar symptoms as heat exhaustion, but can also be dry, hot, and flushed, and will also have confusion, delayed response or other change in mental status. Rectal temperature if taken will be >104°F.
8.If your child has any medical problems that may affect their ability to temperature regulate, discuss with your pediatrician.

What should you do if you suspect heat exhaustion or heat stroke?

1. Get the athlete out of the sun, and indoors or into a shaded area.
2. Oral hydration and cooling with active cooling techniques such as removing excess clothing, drinking cool water, sponging the body with cool water, placing ice pack in the armpits, and groin.
3. Have the athlete evaluated by a medical professional as soon as possible.
4. If there is any change in responsiveness or other mental status change, be concerned about heat stroke. Call 911 and initiate rapid cooling if possible.

Wishing everyone a safe, happy, and fun summer!