Although tension-type headache (TTH) is the most common primary headache in the world, much fewer studies on its pathophysiology have been carried out in comparison to other primary headaches. Inflammatory processes are important in the pathophysiology of both peripheral and central pain. Studies on the role of inflammatory markers in TTH patients are limited. Therefore, in this study, it was aimed to examine the role of inflammatory parameters in TTH. 199 TTH patients and 154 control participants were involved in this study. C-reactive protein (CRP) and high-density lipoprotein (HDL) levels and neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), monocyte/lymphocyte (MLR), HDL/monocyte and Immature/Total granulocyte ratios in all patients reviewed retrospectively. CRP value and immature/total granulocyte ratio were found to be significantly higher in the patient group when compared to the control group. No difference was found between NLR, PLR, MLR, and HDL/Monocyte ratios. There was no difference in NLR, MLR, immature/mature granulocyte ratios, and CRP values between the genders in the patient group. Median values of PLR, HDL, and HDL / monocyte were found to be higher in males. The fact that there is no difference in most of the inflammatory parameters in TTH and there is a significant difference in the immature/total granulocyte ratio is a new finding on this subject. There is no other study in the literature examining the immature/total granulocyte ratio in headaches.

In the provision of health services, health institutions should be perceived as an enterprise to use limited resources most effectively and efficiently, evaluate them optimally and ensure production efficiency. Therefore, cost information enables the most efficient utilization of resources in hospital enterprises and allows managers to use decision-making mechanisms most accurately. This study was conducted to determine and compare the costs of prolonged hospitalizations in the cardiovascular surgery intensive care unit of a university hospital. Our study was descriptive and retrospective. The hospitalizations in the cardiovascular surgery intensive care unit of the hospital were analyzed according to the prolonged hospitalization criteria determined by the social security institution. 29 extended hospitalization patient bills were determined in three years. The mean age of the prolonged hospitalization of patients was 67 years, the duration of hospitalization was 680 days, and the mean hospitalization day was 18.64. The items with the highest expenditure in prolonged hospitalization of patients were determined as drug costs, general applications and intervention costs, medical consumables costs, and laboratory costs. The increase in costs during the hospitalization and treatment process is mainly due to medication, general practices, interventions, and medical consumables. Related decision-makers should make root-cause analyses, and plans should be made to reduce costs.

Skin diseases are among the reasons for frequent hospital admissions and bring a significant burden. The aim of this study is to determine the pattern of skin diseases in our dermatology outpatient clinic in a tertiary care hospital in Türkiye. Pediatric and adult patients evaluated in our dermatology outpatient clinics for the first time were included in this cross-sectional observational designed study between January and March 2023. The characteristics of the patients, including age, gender, duration of disease, anatomic localization of the disease, and complaint counts, were recorded in the data collection form. Diagnoses were grouped according to gender, age, and complaint counts. A total of 1381 patients with 1772 skin problems were included in the study. 62.3% of the patients were female (n=860), and 37.7% (n=521) were male. The age range was between 0 and 98 years. The most common diseases were acne (18%), dermatophytosis (8.1%), viral warts (6.5%), seborrheic dermatitis (4.8%), other dermatitis (4.8%), follicular disorders (4.6%), pruritus (3.7%), scabies (3%), benign neoplasms (3%), and urticaria (3%), respectively. 23.4% of the patients (n=324) had at least two complaints. The maximum number of complaints at one visit was 5. The probability of reporting more than one complaint was higher in women and those whose first complaint was on the scalp. In this analysis to determine the patterns of skin diseases, acne, dermatophytosis, and viral warts were found to be important problems. The number of complaints at one visit may vary according to gender and localization.

The causes of humeral shaft fractures are mostly high-energy traumas such as falling, hitting, traffic accident, and gunshot wounds. It may also occur as a result of simple falls due to osteoporosis in elderly patients. In surgical treatment, there are options such as intramedullary nail, plate-screw fixation and external fixator treatment. External Fixator Treatment it is the primary treatment option for soft tissue damage, open fractures, gunshot wounds, segmental bone loss, pseudoarthrosis, nonunion, and major vascular injuries. The purpose of the present study was to present the functional results of Axial External Fixator Treatment, which we often apply in humerus shaft fractures in our clinic. A total of 30 patients, who had gunshot wounds, multisystem injuries, open fractures, and advanced age comorbid problems, and who underwent Axial External Fixator Treatment due to humerus shaft fracture between January 2016 and January 2019 were included in the study. Disabilities of the Arm, Shoulder, and Hand (DASH) scores were used in clinical evaluations. Visual Analogue Scale (VAS) was used to evaluate the pain intensity in patients subjectively. Also, the results of patients with advanced age comorbid problems were compared with other patients. After a 12-month follow-up, significant improvements were detected in DASH scores. Although fracture union was later in patients with advanced age comorbid problems than in other patients, no differences were detected between union rates, clinical outcomes, and the surgical processes.We think that it is a more appropriate surgical technique than other surgical methods, due to its shorter surgical time and less invasiveness in patients with advanced age, high comorbidity and multisystem damage.

Vitamin A and its derivatives are essential for embryonic development, but an overdose of vitamin A is toxic to the offspring. The placenta is an interface that nourishes and protects the embryo. Although there are numerous publications on the effect of vitamin A on the placenta, there is insufficient information on the changes in the morphology of this organ caused by different doses. The aim of our study was to demonstrate the effect of retinyl palmitate administered at different doses on the volume of the placenta and its component, the decidua. Pregnant rats were divided into 6 groups between gestation day 10 and 12. The first group received 10.000 IU/kg, the second group 20.000 IU/kg, the third group 50.000 IU/kg, the fourth group 100.000 IU/kg and the fifth group 200.000 IU/ kg oral vitamin A. The control group received 1 ml of corn oil on the same days. On day 19 of gestation, placentas were collected and 5 µm sections were stained with Massons’s trichrome. The volumes of total placenta and decidua were estimated using the Cavalieri volume estimation method. All placental volumes of the experimental groups were larger than those of the control groups. The decidual volume increased abruptly at a dose of 50.000 IU/kg and remained higher than the control volume at higher doses. The ratio between the decidual and placental volumes increased at 50.000 IU/kg and was smaller than the control at 200.000 IU/kg. A large placental volume is thought to be an indicator of placental insufficiency. Although our results suggest that an increase in placental volume above 10.000 IU/kg may have a negative effect on placental function, we conclude that the imbalance between decidual and placental volume above 50.000 IU/kg strengthens the suggestion that placental insufficiency may have increased after this dose.

In this study, thiol/disulfide homeostasis in the liver tissues of high-fructose-fed rats was investigated in conjunction with the changes in the main hepatic detoxification enzyme, glutathione S-transferase (GST). Additionally, the effects of well-known probiotics namely Kefir, Lactobacillus helveticus, and Lactobacillus plantarum supplementation on the thiol/disulfate contents and GST activity and gene expression levels were analyzed. Fructose, administered as a 20% solution in drinking water for 15 weeks, developed an animal model of metabolic syndrome in male Wistar rats. Kefir, L. helveticus, and L. plantarum supplementations were given by gastric gavage once a day during the final 6-weeks. The changes in hepatic GST were determined with kinetic-optimized spectrophotometric enzyme assays and qRT-PCR. Total thiol, native thiol, and disulfide levels were analyzed using (5,5-dithio-bis-(2-nitrobenzoic acid) as a chromogenic agent. High-fructose consumption reduced total and native thiol contents while increasing disulfide levels in the liver tissues of rats. Kefir and L. plantarum normalized the thiol levels and all probiotics reduced disulfide contents. High fructose augmented total GST activity but reduced the GST-Mu isoform. L. helveticus and L. plantarum normalized the total and GST-Mu activity, respectively. These results demonstrated a shift toward disulfide formation in the hepatic tissues of rats fed with high fructose. A possible reason would be the increase in total GST activity that uses the free glutathione, the main native thiol source in cells, as a substrate. Besides, probiotics such as Kefir, L. helveticus, and L. plantarum have an improving effect on thiol/disulfide homeostasis as well as main detoxification enzymes.

The elderly face very challenging situations due to their mental and physical conditions. Like the other country in the world, Bangladesh Government has enacted laws to protect the elderly rights. However, the law does not seem to represent what the elderly actually needs. Therefore, 385 elderly people, aged between 60 and 90 years were surveyed to understand their expectations from family, society, and government. There were 57.1% men and 42.9% women. Most of the elderly (80%) were educated. Just over half (53.5%) had ordinary mental and physical health, while a quarter (31.4%) had good status. More than half (53%) of the participants required 2000–5000 BDTK (Bangladeshi Taka) equivalent to $20-50 to cover monthly treatment expenditures. The majority (67.3%) felt government Old Age Allowance should be increased to BDT 5,000 ($50). Of 13.8% of individuals experienced harsh discourse from family because of the cost of therapy. However, 16.9% of people choose not to respond to this question. More than half (57.4%) of the respondents’ thought caregivers were insufficient. One-third felt that legislation should be changed to take care of parents (33.5%) and One-third felt that children should take care of more (33.5%). Some (3.6%) thought that children should act as they did in their childhood respectively. Almost half (44.2%) of respondents did not know that the elderly should receive a separate senior citizen card for preferential treatment, yet 51.9% thought this. Some (44.7%) felt the elderly should get priority in any queue and discounts in Bus/Uber/Rickshaw. Results also showed that expectation is more than the service provided. Further, a one-stop elderly care clinic is required to provide integrated care and support for the quality of life of the elderly.

This study aims to determine the attitudes of nurses towards medical errors and related factors. The study was designed as a descriptive and cross-sectional study. A total of 119 nurses completed a questionnaire on personal information and Medical Errors Attitude Scale. It was determined that nurses’ attitudes towards medical errors were positive. It was found that nurses’ awareness of medical errors and reporting errors was high. The medical error perception of nurses with less years of work experience in the unit was found to be more negative. Many medical errors are actually caused by preventable conditions. At this point, the best way to prevent medical errors is to create an institutional culture based on patient safety. Within the scope of quality control studies in health institutions, the development of patient safety culture and development of nurses’ attitudes towards medical errors should be supported.

Examining the Coronavirus disease 2019 (COVID-19) vaccination rates and associated factors for acceptance of vaccination in pregnant women during the pandemic. The present study has a cross-sectional survey-based design that evaluated 448 pregnant women, and data were collected between October 1 and December 31, 2021. A composite questionnaire with an instrument was utilized in the survey to examine vaccine rates, including sociodemographic data, maternal characteristics, vaccination history, and reasons for not vaccinating. The vaccination rate was 48% (n=216). The main concerns and barriers to non-vaccination were: (i) concerns about pregnancy (82.9%), (ii) possible vaccine side effects (76.3%), and (iii) insufficient trust in the reliability of the vaccine (20.3%). A multiple logistic regression analysis revealed that following factors affect COVID-19 vaccination rate: first trimester of pregnancy [Odds ratio (OR): 3.40 (95% confidence interval (CI):1.84-6.27), p<0.001], age 35 and over [OR: 2.96 (95% CI:1.40-6.27), p=0.004], active working status [OR: 4.88 (95% CI:2.57-9.23), p<0.001]. Our study indicated that rates of COVID-19 vaccination are still low in pregnant women. Pregnant females constitute a special vulnerable part of the community. Therefore, targeted communication is needed to raise awareness of vaccine safety in healthcare professionals and pregnant women, and strategies to solve vaccine hesitation. In addition, post-vaccination monitoring is required to collect additional data.

Telemedicine has been appreciated as a smart solution to bridge the gaps in the delivery and coverage of healthcare worldwide. With the great impetus to integrate this service into primary healthcare facilities, evaluating its usability should be an ongoing process. This study aimed to quantitatively evaluate the usability of telemedicine from the primary healthcare physicians’ perspective in Oman. The evaluation was conducted using a cross-sectional study design. A self-administered online questionnaire was developed and validated as a scale to evaluate the usability of telemedicine as a safe and useful communication channel and outpatient record. Following a pilot study, the questionnaire was distributed to a sample of primary healthcare physicians who ran telemedicine clinics in Oman during 2020-2022. The questionnaire was completed by 143 primary healthcare physicians from different governorates. The total mean scale and subscale scores were computed. In addition, the frequency distribution of responses to each question was presented. The results showed that the total mean scale score of the usability of telemedicine in our clinics was 3.43/5.00. The subscale scores of the usability of telemedicine as a safe and useful service, the usability of telemedicine as a communication channel, and the usability of telemedicine as an outpatient record were 3.42/5.00, 3.23/5.00, and 3.99/5.00, respectively. In conclusion, the current telemedicine service in Oman’s primary healthcare facilities has some usability features, but there is still much room for improvement. With logical reasoning, a framework of potential determinants was inferred and proposed to improve the usability of telemedicine services in the future and comply with the principles of biomedical ethics.

In this study, we aimed to evaluate the effect of monocyte/high-density lipoprotein (MHR), which is associated with systemic inflammation: on prolonged hospitalization in patients with mild acute pancreatitis. Patients hospitalized for acute edematous pancreatitis between 01.01.2021 and 31.12.2021 were retrospectively screened. Arrival Ranson scores of the patients were calculated. Those with a Ranson score <3 were considered as mild acute pancreatitis and were included in the study. Patients with mild acute pancreatitis were divided into 2 groups with a hospital stay of <8 days and ≥8 days. Monocyte/HDL, biochemical and metabolic parameters were compared between the groups. The study was conducted with a total of 39 patients, 23 male (59%) and 16 female (41%). While 28 (71.8%) of the patients were discharged within <8 days, 11 (28.2%) were hospitalized for ≥8 days. Group ≥8 days was considered as prolonged hospitalization. It was determined that the monocyte/HDL ratio was significantly higher in the group with prolonged hospitalization between the groups. In univariate analyzes, it was determined that the presence of Diabetes Mellitus and MHR increased the risk of prolonged hospitalization by 5.25 times and 1.085 times, respectively. In the multivariate analysis of these two parameters, MHR was found to be an independent risk factor for prolonged hospitalization. It was concluded that monocyte/HDL can be used as a simple and reliable parameter to predict the duration of hospitalization in patients with mild acute pancreatitis.

We report a case of an 81-year-old woman, who developed acute kidney injury (AKI) during treatment of gout with naproxen. The patient’s other comorbidities were chronic kidney disease grade G3b, chronic heart failure with permanent atrial fibrillation, arterial hypertension, osteoarthritis and osteoporosis. After excluding other causes of AKI, a presumptive diagnosis of NSAID-induced acute interstitial nephritis was established. Because of multiple comorbidities and anticoagulation, renal biopsy was not attempted. Since we observed no improvement after naproxen discontinuation, steroid-pulse therapy was initiated, with subsequent oral steroid follow-up. As a result, after several days we achieved improvement in renal function, with complete recovery after couple of months. In conclusion, we suggest that aggressive steroid therapy be considered for patients with presumptive diagnosis of NSAID-induced interstitial nephritis, especially when comorbidities and general state preclude invasive diagnostic measures.

To investigate the differences between the levels of psychological resilience and coping with stress among individuals presenting with conversion symptoms and general medical symptoms to the emergency department. A comparative-descriptive research study was conducted on 118 patients (n = 59) who presented with conversion symptoms (n = 59) and general medical symptoms (n = 59) from the Kafkas University Health, Practice and Research Hospital, Emergency Department. The research data were collected using a general information form, the Stress Coping Styles Scale (SCSS) and the Brief Resilience Scale (BRS). In addition to descriptive statistical methods, chi-square analysis and t-test were used in the evaluation of differences between groups. The mean age of the participants in the conversion symptoms group was 28.10 ± 13.49 and 25.69 ± 7.85 in the control group. The mean score obtained by the participants in the control group on the BRS was found to be significantly higher than that of the participants in the conversion symptoms group (p <0.05). There was no significant difference between the groups in terms of the mean scores on the subscales of the SCSS (p > .05). Psychological resilience levels were low in patients presenting with conversion symptoms. Based on this finding, individuals presenting to health centers with conversion symptoms would greatly benefit from the development of therapeutic interventions that aim to improve psychological resilience.

Surgical prophylaxis is one of the areas where antibiotics are used commonly. In this study it is aimed surgical prophylaxis appropriateness and determination of cost analysis in our hospital. The study was performed November 30-15, 2018. 108 patients who underwent surgery in general surgery, orthopedics and neurosurgery clinics have been included in this prospective study. Patient selection was based on the classification of clean and cleancontaminated. Demographics, features of the surgery, applied prophylactic antibiotics and surgical prophylaxis appropriateness were recorded in the forms. All patient information forms were evaluated by infectious disease specialists using the surgical prophylaxis guide. The costs of unnecessary antibiotics were determined. Mean age of 108 patients who underwent a surgical procedure was 52.4 years and 39.8% of the patients were male and 60.2% were female. Of the surgery procedures 75.9% (n:82) were clean and 24.1% (n:26) clean-contaminated. Preoperative 58.3% (63) unnecessary antibiotic prophylaxis was detected. Continuing prophylaxis at a prolonged time were used in 99 (91.7%) patients in the postoperative period. Cefazolin is the most commonly used agent for surgical prophylaxis. The cost of unnecessary and long-term antibiotic use was determined as ₺6983,69. In this study, the time of antibiotic prophylaxis were to be a big problem. Prophylaxis often starts very early and continues for days. The wrong practices in surgical prophylaxis lead to unnecessary antibiotics treatment to the patients and also burden to the budget of the country.

We aimed to evaluate the efficacy and safety of flexible bronchoscopy-guided tracheal intubation during difficult airways. We retrospectively evaluated the hospital records of intubated patients with the assistance of a flexible bronchoscope during 5 years-period, (between January 2015 to 2020). All patients were intubated under general anesthesia. A total of 67 patients were enrolled in the study. The majority of the patients were male (n=42, 62.7%). The mean age was 55.5±15.3 years. Mallampati classification was revealed frequently in class IV in 76.1% of cases. Only one patient with class II is evaluated as having a difficult airway because of obesity. The most frequent 3 indications for endotracheal tube (ETT) insertion (intubation) with the help of a bronchoscope were limitation of the mouth opening (40.3%), obesity (20.9%), and cervical-vertebrate fracture (11.9%). The intubation route was preferred as the oral way in 53 patients and the nasal way in 14 patients. The mean duration for ETT intubation via bronchoscopy guidance was 3.38 minutes. There was no severe complication other than transient oxygen desaturation (SaO2) below 90% (n=8, 11.9%) and epistaxis (n=2, 3%) in the complication records of all patients. Intubation with the help of a flexible bronchoscope is an effective, practical, and safe method in patients with a difficult airway.

It is known that the risk of suicide increases in professionals who are frequently exposed to intensive and stressful working conditions. Health professionals may be susceptible to depression and suicide due to occupational stressors besides risk factors such as violence against healthcare professionals, mobbing and burnout. However, it is noteworthy that there is no institutional data or statistics regarding suicides of healthcare professionals, in Türkiye. In this context, we aimed to reveal sociodemographic characteristics and risk factors related to suicides of health workers by evaluation cases subjected to media. Due to the lack of detailed institutional data, we investigated national media releases and reports between 01/01/2010 and 31/12/2020 in order to extract data regarding suicides of healthcare professionals. Obtained data was discussed in the light of the related literature. During the study period, a total of 138 healthcare professionals were reported to have committed suicide, out of which 69 (50%) were male and 69 (50%) were female. The mean age of the presented cases was 34.79 years. It was determined that 68 (48.28%) victims were medical doctors, and the most frequent suicide method was drug intoxication with a rate of 36.23% (n=50). Health workers’ suicides and dynamics have not been fully revealed and have not been studied sufficiently. In this regard, health policies and a professional approach need to be developed in the light of the information obtained through joint studies by Ministry of Health and Associations/Organizations of Healthcare professionals.

Clinical and laboratory parameters are useful tools to improve success rates in the management of COVID-19 patients. Indices such as NLR, PLR, MHR, SII, AIP and CAR may indicate poor prognosis in predicting poor prognosis in COVID-19. It was aimed to identify such parameters of disease progression in COVID-19 patients by examining demographic data, comorbid conditions, some biochemical and hematological parameters. A retrospective analysis was performed for patients admitted to intensive care unit or pulmonary diseases department or treated on an outpatient basis due to a diagnosis of COVID-19. Patients with positive PCR test and thoracic CT compatible with COVID-19 pneumonia were included in the study. A control group was formed from volunteers of similar age and gender. The study population was divided into four groups as follows: patients admitted to intensive care unit (ICU group); patients admitted to chest diseases department (Inpatient Group); patients treated on an outpatient basis (Outpatient Group); and controls (Control Group). There were 61, 201, and 30 patients in the ICU, inpatient, and outpatient groups, respectively. A total of 96 subjects served as controls. Study groups were comparable with respect to gender distribution. ICU patients had higher NLR, PLR, AIP, SII, and CAR, and lower LMR as compared to other groups. NLR, SII, AIP, and CAR emerged as predictors of ICU admission, while MHR was predictive of inpatient treatment. Certain clinical and laboratory parameters may be useful tools for improving the success of COVID-19 management. High NLR, SII, AIP, CAR, and MHR values may indicate low prognosis in COVID-19 patients.

This study was conducted to find out the effects of cultural intelligence, which is one of the strategies used in managing intercultural differences, and emotional intelligence which enables individuals to understand and manage their own emotions, to understand others’ emotions and develop their self-confidence, on care behaviour, which is the basis of the nursing profession. This descriptive and cross-sectional study was conducted in a city hospital between 01.09.2019 and 01.03.2020. The data were collected from nurses in the hospital who volunteered to participate in the study within the dates above. The sample was not selected, and 225 nurses who volunteered to participate in the study were included in the study. The total mean score of the participants from the cultural intelligence scale was 47.558±12.092, while the full scores from the factors were 7.9208±2.857 (min 4-max 20) for metacognitive factor, 15.963±4.89 (min 6-max 30) for cognitive aspect, 12.004±3.656 (min 5-max 25) for motivational factor and as 11.821±3.493 (min 5-max 25) for behavioural factor. The total mean score of the participants from the Caring Behaviors Inventory was 5.053±0.819, while the total scores from the factors were 5.045±0.823 for the assurance factor, 5.208±1.240 for the knowledge and skill factor, 4.994±0.831 for respectful factor and 4.949±0.842 for connectedness factor. The total mean score of the participants from the Emotional Intelligence Scale was 141.367±18.656, while the full scores from the factors were 44.563±5.96 for optimism/mood regulation, 18.940±4.15 for the use of emotions and 33.493±7.565 for evaluation of emotions. Cultural intelligence and emotional intelligence were found to have an effect on caring behaviours of nurses. Although there was no direct significant correlation between cultural intelligence total score and caring behaviours total score, there was a significant correlation between cultural intelligence factors and caring behaviours. There was a significant correlation between caring behaviours of nurses with high emotional intelligence.

This study aimed to draw attention to sadness and ensure that the sense of sadness experienced by nurses during the COVID-19 pandemic is noticed. During the pandemic, the sadness of nurses who have the most and close contact with patients should be evaluated. Support programs that would increase psychological resilience should be implemented for them to experience sadness at the lowest levels possible. If healthcare system managers improve the conditions that lead to nurses experiencing sadness and provide the necessary support to them, nurses will feel safe and perform their jobs willingly and enthusiastically.

Aside from general body fluid fluctuation, hemodialysis (HD) may cause changes in ocular fluid balance, resulting in changes in subfoveal choroidal thickness (SFCT) and other ocular parameters. As a result, the purpose of this study was to investigate the effects of hemodialysis on the reproducibility of SFCT measured by spectral domain-optical coherence tomography (SD-OCT). Twenty-six HD (26 eyes) patients had their pre- and post-HD SFCT measured, and the results were compared for reproducibility. Following a thorough ophthalmic examination, SD-OCT was performed three times in a row during a single session. The same physician measured SFCT after automatically identifying choroid with a software caliper. Reproducibility parameters, including intra-class correlation coefficients (ICCs), coefficients of variation (COV), and test-retest variability (TRTV) were then calculated. Males made up 53.85% of the 26 HD patients. There was a significant IOP difference between pre-HD (16.42±3.14 mmHg) and post-HD (14.21±2.78 mmHg) (P<0.001). SFCT decreased significantly from pre-HD 243.50±10.23 μm to post-HD 234.29±9.41 μm (P<0.001). ICC value increased significantly after HD, rising from 0.948 to 0.989 (P<0.001, for all). Pre- and post-HD COV values were 1.6% and 0.65%, respectively. Also, pre- and post-HD TRTV values were 7.864±1.996 μm and 3.074±1.536 μm, respectively. In this study, the reproducibility of SFCT as measured by OCT was lower during pre-HD compared to post-HD. Post-HD SD-OCT assessment appears to improve the reliability of clinical outcomes in the diagnosis and monitoring of HD patients.