This study aims to review the literature about the emotional problems experienced by mobbing victims in the workplace and present a research model. Defined as a severe source of social stress in the workplace, mobbing systematically involves protracted and escalating conflicts with frequent abusive acts against the target person. Mobbing significantly impacts a victim’s emotional health, which can cause various psychiatric, psychosomatic, and psychosocial issues. Studies have shown that mobbing victims often suffer from anxiety, depression, irritability, psychosomatic symptoms, and sleep disturbances. In addition, they may experience low self-esteem, a lack of social skills, and a sense of submission. The consequences of mobbing go beyond the individual and affect their families and relatives. In this research, a literature review is conducted about the causes, manifestations, and consequences of mobbing. A research model is designed to emphasize the importance of cognitive behavioral techniques in combating emotional problems caused by exposure to mobbing behaviors in the workplace.

Neurofibromatosis type 1 (NF1) is an autosomal dominantly inherited disease affecting multiple organ systems and showing many different clinical symptoms. The severity of the disease varies from person to person and progresses gradually over the years. In this study, 17 NF1 patients who had a definite diagnosis were evaluated in terms of genetic, ophthalmological, and nervous system investigations. Approximately 5000 patients who visited medical genetics clinic between 2012 and 2022 are recorded in our archive. In 17 of these patients, a definitive genetic diagnosis was made. In the course of the study, the researchers collected some clinical parameters such as antenatal, intrapartum, and postpartum history and family history. In the family history, the researchers did a detailed pedigree with at least 3 generations of analysis, questioned parental kinship, looked for similar members in families, and identified inheritance patterns of the disorder. Peripheral venous blood samples were taken from the patients and sent to a commercial laboratory for gene panels or WES while the karyotyping was carried out in our laboratory. After obtaining the definitive genetic diagnosis of all patients, we compiled a table with the other parameters we questioned. This study presented the genotype and phenotype findings of NF1 patients. Ophthalmological symptoms in patients were also examined. These new-generation genetic disease diagnosis methods can be routinely used in clinical practice by medical geneticists. The diagnosis of a disease is one step ahead of its treatment. Because if the necessary diagnosis is not made, treatment of the disease is not possible. While this situation was more difficult in the past, nowadays, with the developing technology, diseases can be diagnosed more easily. In NF1 disease, more information can be obtained as a result of genetics, imaging, and examinations of other branches.

The objective of this research is to investigate the relationship between phubbing levels and the empathy attitude of college students. In our descriptive and correlational study, data were gathered from 528 college students studying in the undergraduate program of a university in Eastern Türkiye. Personal information form, Phubbing Scale, and Empathic Tendency Scale were employed as data collection forms. The research’s findings were examined using the SPSS 22.00 package program, and all analyses were judged significant if the p-value is less than 0,05 (p<0.05). The average total scores of the college students were found to be 42.77±19.09 on the Generic Scale of Phubbing (GSP) and 62.52±7.56 on the Empathic Tendency Scale (ETS). We found a significant difference between the mean phubbing and empathic tendency scores of college students and the number of book readings per week, the number of friends, and the meeting with friends weekly. The conclusion was that there was a strong negative and significant association between students’ total mean scores on the ETS and GSP scales (r=-0.581, p=0.00).

The study was executed as cross-sectional to unearth the effect of thanatophobia and professional commitment on compassion fatigue in nurses in Türkiye. This study is cross-sectional. 521 nurses were reached by using the regional stratified method. Data were collected online via Google forms between July and November 2021.Data were obtained with the Sociodemographic and Occupational Characteristics Questionnaire, the Compassion Fatigue Short Scale, the Thanatophobia Scale and the Scale of Commitment to the Nursing Profession. Data were evaluated using the number, percentage, mean, standard deviation, t-test, One way ANOVA, and using correlation and regression analysis. The mean age of the nurses was 32.22±7.51. Nurses acquired a moderate score on the Compassion Fatigue (64.63±30.89), Thanatophobia (30.69±12.26), and Professional Commitment (67.66±14.33) scales. Thanatophobia predicted Compassion Fatigue at a rate of 41.2% in terms of providing care to a terminally ill patient and thinking about quitting the profession in the near future. Nurses acquired a moderate score on the Compassion Fatigue, Thanatophobia and Professional Commitment scales. It is recommended to evaluate Compassion Fatigue, Thanatophobia, and Professional Commitment in nurses regularly, to provide training for nurses who cared for patients who have fear of death or who have died, to rotate nurses working in this field, and to strengthen the collaboration among employees to increase their commitment to the profession.

Clinicians both have the responsibility to take care of the patients and to facilitate students to learn. Having different responsibilities at the same time can be stressful for medical teachers and can affect their identity as medical teachers. The aim of the study is to determine and identify approaches to the teaching of medical teachers in a university hospital. The methodology of the research is qualitative research. The educational case study method was used to develop an in-depth understanding of medical teachers’ teaching approaches. We asked the meaning of being a medical teacher, the related factors with teaching, and their best experiences of teaching by individual indepth interview. Nine individual in-depth interviews were held with participants. The most experienced medical teacher has the 27-year of experience and the junior one has 6 months of experience. Three main themes have emerged. The issues at clinical education, teachers’ perspectives on clinical education, and the roles of students and teachers at clinical education. Our study shows the residents, nurses, peer students have roles in clinical education in addition to medical teachers. One of the issues is the limitation to standardize clinical education for each student. All participants mentioned they become an academician for the greater good. The medical teachers are expecting the students to have a high level of situated interest. However, increasing students’ situated interest is up to their prior knowledge of the context, the characteristics of the learning activity, the learning environment, and the approach to the teaching of medical teachers.

It was aimed to determine whether there is a difference in mortality and symptoms between patients, aged 60 years or above, with hypertension (HT) and Coronavirus disease 2019 (COVID-19) infection and those without any chronic disease. The population of the study, which was conducted as a retrospective case-control study, consisted of 2747 HT patients diagnosed with COVID-19 and aged 60 years or above. While 170 patients with HT diagnosis formed the case group, 170 patients without any chronic disease formed the control group from the sample. In this study, the time from diagnosis to death was found to be shorter in the presence of HT in COVID-19 patients, while males diagnosed with COVID-19 had higher rates of intensive care unit admittance, intubation and mortality than females irrespective of HT. The presence of HT was determined not to affect symptoms in patients diagnosed with COVID-19. The most common symptoms were fatigue, cough, body ache, fever, headache, and sore throat in HT and control groups and the symptoms were similar in both groups. Further studies are recommended to reveal the relationship between HT, considered one of the most important risk factors for COVID-19, and adverse outcomes related to COVID-19.

This study aimed to determine the barriers, vaccine hesitancy and attitudes towards the to the COVID-19 vaccine in Türkiye. A cross-sectional study included 2031 people aged 18 years and older living in Türkiye. Data were collected through an online questionnaire created by the researchers in line with the literature and the Attitudes towards the COVID-19 Vaccine (ATV-COVID-19) scale. In total, 1043 participants (51.4%) defined themselves as vaccine hesitant. The most-motivating factor for vaccination was protecting self and family, while thinking that vaccines are unsafe was the most common barrier against vaccination. Compared to females, being male (OR=0.770) had a 1.3-times (1/0.770) protective effect from vaccination hesitancy, while one unit increase in the ATV-COVID-19 score (OR=0.080) was 12.5-times (1/0.080) protective. As a result of the study, it was observed that there was a high level of vaccine hesitancy due to mistrust of COVID-19 vaccines or fear of side effects. In addition, vaccine hesitancy was associated with gender and the level of attitude towards the vaccine.

Type 1 Diabetes Mellitus (T1DM) is an important chronic health problem of childhood. Cooperation of parents and teachers is necessary in diabetes management. In our cross-sectional study, a 3-part questionnaire evaluating the educational status of teachers for T1DM was used. Questions consisting of 4 factors were asked about the level of knowledge, awareness, living with diabetes, and school life with diabetes. In scoring the answers given to the questions in the first part, each correct answer was recorded as +1 point, each incorrect answer as -1 point, and ‘I have no idea’ as 0 points. The total score ranged from -21 to +21 points. Those who scored 11 points or more were considered to have a sufficient level of knowledge and awareness about T1DM. The validity of the first part of the scale, KMO and Bartlett’s test score, was found to be 0.94. The reliability of the first part of the scale, Cronbach’s alpha value, was 0.91. The mean score of the first part of the scale was 9.3±5.1, and range was between -3 to 19 points. In our study, the number of those who scored 11 points or more in the questions measuring the level of knowledge and awareness about diabetes were 268 (46.4%). We observed that the level of knowledge and awareness about diabetes in schools in our province is not sufficient.

International Association for the Study of Pain (IASP) assigned a committee for setting a definition of pain, in year 1979. Despite many criticisms and suggestions, the definition introduced in year 1979 has been kept almost unchanged, except for the slight changes made in years 1986, 1994, and 2011. Since the criticisms from various philosophical and scientific disciplines increased in the recent period, the association assigned a team of 14 researchers and clinicians, who were at the forefront in their disciplines, in year 2018 to revise the definition. Slight modifications were suggested for the definition and explanation in year 2020. In this paper, the definition of pain suggested in year 2011 is examined first. Then, the alternative definitions and criticisms from the scientific and philosophical actors are discussed and, finally, the criticisms addressing the definition proposed in 2020 are reviewed after assessing the definition.

Physician migration, which maintains global importance in terms of health ethics, is a phenomenon that has gained momentum in Türkiye throughout the recent years. However, there are limited studies on this subject, and no research has been found that addresses the issue in terms of health ethics and rights. In this regard, this study is likely to contribute to a better understanding of Türkiye’s physician migration. Furthermore, draw some attentions for solutions and health policies through the lens of physician and patients’ rights. The population of the retrospectively designed study consists of research proposals related to physician migration in the Turkish Grand National Assembly and the statements of members of parliament in the general assembly proceedings during the same period. Data obtained from transcripts that were searched using keywords such as “physician,” “doctor,” “health,” “migration,” and “foreign countries” were coded and subjected to content analysis using a qualitative method. Multifaceted findings emerged in the context of physician and patient rights in the categories of “reasons,” “consequences,” and “solutions”. It was observed that certain rights were more affected by the process, that rights were interdependent, and that structural regulations in the healthcare system were necessary for their fulfillment. There is a need for legislation that would concretely demonstrate physician rights in a legal status. In the context of physician rights, the prominence of “reasons” and the emphasis on patient rights in the “consequences” category also point to a significant ethical dilemma. The dilemma between the autonomy of the physician and the principle of justice, which is central to the ethical debate about physician migration, has been confirmed, indicating a need for further in-depth research on this topic. The purpose of this study is to evaluate how physician migration, which has recently increased in Türkiye, is addressed by members of the Turkish Grand National Assembly in terms of physician and patient rights.

In this study, it is aimed to determine the correlation between histopathologic-immunohistochemical factors, tumor subtypes and fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) parameters such standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) in breast cancer (BC). Initial PET/CT examination of 110 histopathologically proven BC patients (age ranging 27-92, mean age 56.18 ± 14.59) were included in this retrospective study. The relationship between histopathological-immunohistochemical factors, tumor subtypes and PET/CT parameters were analyzed by regression analysis. The mean SUV max value of 110 breast tumors was 7.73 ± 5.62 (range 1.4 - 34.15). Histological subtypes were; invasive ductal carcinoma (n:94, 85.5%), invasive lobular carcinoma (n=6, 5.5%) and other types (n=10, 9.1%). The distribution of BC subtypes was as follows; Luminal A (Lum A) (n=38; 34.5%), Luminal B (Lum B) (n=56; 50.9%), HER2-positive (n=3; 2.7%) and Triple Negative (TN) (n=13; 11.8%). Univariate regression analysis revealed significantly higher SUV max values in ductal carcinomas than lobular carcinomas (p=0.03). SUVmax values of the Lum B, HER2 positive and TN groups were higher than Lum A group (p=0.03, p<0.001, p<0.001 respectively). Univariate regression analyses also showed that the MTV and TLG values of TN group were significantly higher than Lum A group (p=0.011, p=0.007, respectively). In multivariate regression analyses, no significant difference was observed in above mentioned groups. MTV, TLG and SUVmax values significantly correlated with histopathological-immunohistochemical factors and tumor subtypes in BC. So that, these parameters can be used to predict the tumors’ behavior.

A close relationship between labor and the placenta is known. The study of gene expression profiles describing the effects of labor on placental tissue has accelerated in recent years. This study aims to compare the expression levels of GDF15, ADM, SERPINE1, NOS3, IL 6, TNF-α genes in placental tissues discarded after vaginal deliveries with labor pain and elective cesarean deliveries before the onset of labor pain. For this purpose, placental tissues of vaginal deliveries with labor pain (n=9) and elective cesarean deliveries without labor pain (n=9) were collected immediately after births. RNA extracted from tissues (umblical cords and deciduas). Gene expression analyzes were performed by Real-time PCR method. TNF-α gene expression levels in decidua and umblical cord tissues in vaginal deliveries with labor pain were higher than in elective cesareans without labor pain, and NOS3, ADM, SERPINE1 gene expression levels were low. GDF15 and IL-6 gene expression levels were high in the umblical cord tissues and were low in the decidua in vaginal deliveries with labor pain compared to elective cesareans without labor pain. The high level of GDF15 gene expression in the vaginal deliveries with labor pain umblical cord tissues was significant (p<0.05). Changes in gene expression between different types of birth may help us to understand how labor pain affects gene expression levels. These results suggest that labor pain affects different tissues in different ways. The “birth experience” of a placenta that has experienced pain stress is absolutely different to others process. Since birth pain is a natural stress, it can be a light in determining the effects of the differences in cesarean section on the baby and the mother. Gene expression alterations may cause labor starting and progressing, or just be an result of labor.

The development and use of new drugs have accelerated in proportion tothe increase in understanding of the pathogenesis of rheumatological diseases. In the treatment of rheumatological diseases, regular and proper use of drugs prevents disease progression and protects the patient from potential exacerbations and complications. The readability of patient information leaflets (PILs) increases treatment compliance. In this study, it was aimed to evaluate the readability levels of PILs of frequently prescribed drugs in rheumatology practice. A total of 182 frequently prescribed medications in rheumatology practice were randomly selected. The PILs of these drugs were scored according to Ateşman and Bezirci-Yılmaz readability scales and their readability levels were thus determined. It was determined that the PILs could be read with 11-12 years of education and high school education on average according to Ateşman and Bezirci-Yılmaz readability scales respectively. Considering the fact that the mean schooling level in Türkiye is 6.5 years, the readability levels of the PILs of frequently prescribed medications in rheumatology practice are well above this level. It is suggested that the current readability of the PILs is adjusted in accordance with the patients’ level of understanding and education and arrangements to increase the readability levels are made.

The illness of Sultan Mahmud II, the 30th Sultan of the Ottoman Empire and the 109th Islamic Caliph, started to be discussed after his death. In this study, the possible illnesses of Sultan Mahmud II, his illness process and death were analysed by comparing the claims and explanations made by his physicians during his illness and death. The research includes: the incomplete document of Abdülhak Molla, the chief physician of the period; the book titled Deux Annees de l’Histoire d’Orient 1839-1840 (Two Years in the East 1839-1840) written by Edmond De Cadalvene and Emile Barrault; the book titled Relation Officielle de la Maladie et de la Mort du Sultan Mahmud II (Sultan Mahmud II’s Illness and Death) by Mac Carthy and Konstantin Kara Todori. The Illness and Death of Sultan Mahmud II), published in 1841; and, three reports sent by Karl Ambros Bernard to the Austrian government on different dates based on Jakob Neuner. In the light of current medical knowledge, the above-mentioned information and documents about the sultan’s illness suggest that Sultan Mahmud II suffered from “lung cancer” and “alcohol withdrawal syndrome”. It was concluded that his death was due to sepsis developing as a result of the infection caused by the disease and the deterioration of metabolite balances in the body.

The aim of our study was to determine the factors responsible for COVID-19 vaccination acceptance and hesitancy in patients with drug allergies. We prepared a survey to understand the thoughts, hesitancies and experiences about COVID-19 vaccination and COVID-19 infection in patients with drug allergies and statistically examined the results. A survey study was applied to 76 patients who were admitted to Ankara University Internal Medicine Allergy and Immunology Department with drug allergies. 38 patients who were vaccinated and 38 patients who weren’t were compared. Among the 38 patients who were vaccinated, 34 (89.5%) chose Biontech vaccine, 4 (10.5%) chose Sinovac vaccine. Among the patients who weren’t vaccinated, 28 (73.7%) explained they weren’t vaccinated because of drug allergies. Educational statuses were statistically significantly different (p=0.026) among vaccinated and non-vaccinated patients, lower in vaccinated patients. Vaccinated patients thought the vaccine reduced the possibility of COVID-19 infection and complications, which was significantly different (p<0.01). Non-vaccinated group significantly feared the possible allergic reaction to the COVID-19 vaccine, more than the vaccinated group (p=0.028). Fear of the possible side effects of the COVID-19 vaccine (p<0.001) and the thought of the COVID-19 vaccine being associated with unpredictable effects were significantly more evident in the non-vaccinated group (p<0.001). In conclusion, our study analyzed multiple factors in drug allergy patients regarding vaccine acceptance, rejection, and hesitancy for the first time in literature, similar studies with larger samples can also contribute to the literature in the future.

COVID-19 pandemic and measures to combat the pandemic caused an increase in the risk of violence against women. In this study, it was aimed to examine the change in violence crimes against women evaluated in a tertiary forensic medicine clinic over a two-year period by focusing on periods of lockdown and domestic violence. Victims of violence against women who admitted to our center between 01/01/2020 and 12/31/2021 were included in the study. Patient files and forensic reports were used to acquire information regarding the age, date of the incident, relationship of the offender, type of incident, usage of weapons, injuries sustained, and if the incident was domestic violence. The ages of 121 cases evaluated ranged from 10 to 88 years, and the mean age was 36.1 (SD=17.6) years. When the mean number of incidents per day was examined, it was shown that cases of domestic violence were most common during the lockdown period. When all cases were considered together, it was shown that the highest mean number of cases occurred in the first days following the restrictions. Violence against women increased during the periods of the pandemic. In cases of domestic violence, as expected, the most significant rise occurred during lockdown periods. The 24-hour period following the lockdown application has been identified as the most intensive time of violence against women during the pandemic.

Tibia shaft fractures are common in all age groups. For these fractures; Conservative and surgical treatment methods are available. In surgical treatment, numerous surgical methods such as plate screw fixation, external fixator, and titanium elastic nail and K-wire fixation have been defined. The aim of the present study was to present the results of patients for whom external fixator combined with titanium elastic nails or titanium elastic nails alone were applied due to tibia shaft fractures. The study included 40 patients treated for tibia shaft fracture in our clinic between January 2016 and January 2019. Combined external fixator (EF) fixation was applied to patients who were found to be instable after Titanium elastic nail (TEN) application during the surgery. In clinical evaluation, Flynn classification, time to fracture union, fluoroscopy count, reoperation and time to full weight bearing were used. The results of patients for whom EF combined with TEN were applied were compared with the patients who had only TEN. Thirty patients were treated using TEN and 10 patients using EF combined with TEN. After 12 months of follow-ups, fracture union was achieved in all patients. There were 5% sagittal and 2.5% coronal plane angulation. Patients developed angular deformity of an average of 2.43 ± 1.9 degrees in the coronal plane and 2.65 ± 1.9 degrees in sagittal plane. Lower percentages of angular and rotational deformity were observed compared to the literature. Despite the disadvantages of using a greater number of fluoroscopy and longer operation periods in patients who underwent TEN+EF, these patients were mobilized earlier. It was concluded that combined EF application is a more feasible method in patients with pediatric tibia shaft fracture for whom stable fixation cannot be achieved with TEN.

In the present study, the purpose was to compare the postoperative early and mid-term results of Eversion Carotid Endarterectomy (ECEA) and Classical Carotid Endarterectomy (CCEA) techniques used in the surgical treatment of carotid artery disease. A total of 269 patients who underwent carotid endarterectomy (105 ECEA and 164 CCEA) were included in the study. The 1st, 6th, and 12th-month follow-ups of 266 patients were performed because three patients died in the early postoperative period. All patients were started on acetylsalicylic acid, clopidogrel, and statin treatment in the postoperative period. When the postoperative results were evaluated, it was found that the cross-clamp and operation times of the surgeries performed with the ECEA technique were shorter than the CCEA at statistically significant levels (p=0.0002). Although there statistically significant differences were detected in terms of bleeding/drainage, need for reoperation because of bleeding, and restenosis, ECEA had more positive results than CCEA, and there were no statistically and proportionally significant differences between the two methods in terms of postoperative stroke and mortality. Considering the experience of the surgical team, the use of the ECEA technique has more positive results in terms of operation time and cross-clamp time compared to CCEA. We think that extending the follow-up periods of patients in the postoperative period and conducting multicenter studies with more patients would be more accurate in comparing these two methods.

Trauma is a condition that affects the body’s structure and results from outside factors. After heart disease and cancer, it is the most common cause of death across all age categories. For a variety of causes, people are routinely exposed to traumatic vertebral, thoracic pathologies and rib fractures. Ribs can be harmed by simple falls, impacts, and blunt injuries as well as broken due to car accidents and falling from a height. Magnetic resonance imaging or computed tomography are used to diagnose these fractures. In this study, non-linear complex methods were used to categorize gender and age by utilizing thoracic pathologies, fractures or cracks in the body as a result of traffic accidents or falling from a height, which have the feature of being a case in forensic issues. The most important data in the classification of gender and age were determined by Multivariate Adaptive Regression Spline (MARS) method. Although autopsy should be utilized in these situations, complex regression methods is intended to have an impact on quick and accurate decision-making about events in order to speed up or direct the process in the field of forensic medicine. As a result, the effectiveness of the experts subsequent predictions will be increased by the preliminary findings produced by real-world data and artificial intelligence algorithms or complex non-linear regression problems.

The present study aimed to investigate the determinants of academic performance among third-year students in the Faculty of Medicine. A survey consisting of 45 questions was administered to 357 third-year students in the academic year 2017-2018, with a response rate of 233 participants. The academic achievement was assessed by evaluating the grade point average (GPA) scores, with a threshold of 3. The results revealed that several factors were significantly associated with a GPA score of 3 and above, including age (p=0.011), relationship with parents and positive parental attitude (p=0.001), staying with family (p=0.015), and school selection to “be a doctor” (p=0.044). The results also showed that negative parenting behaviors and smoking were associated with an increased risk of academic failure. However, no significant association was found between academic performance and gender, physical exercise, parents’ education, and employment status. This study highlights the crucial factors impacting academic achievement in medical education. The results demonstrate the importance of age, relationship with parents, parental attitude, reasons for choosing a medical school, smoking habits, and extracurricular activities in determining GPA outcomes. The findings have important implications for the future planning of students, the development of education, and the formulation of new policies.

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.

Protecting the health and safety of nurses and other health professionals taking an active role during the COVID-19 pandemic is important. Risks not understood by health professionals and inadequate working conditions cause concern and lead to ethical problems. This qualitative research study was conducted to gain an understanding of the difficulties and emotions nurses experience, and their awareness of the ethical problems experienced while providing nursing care in the COVID-19 clinic. Data was collected by two different methods; deep conversation and semi-structured interview and evaluated by content analysis. Using an empirical phenomenological approach, data analysis concluded with two main themes and eight sub-themes. The average age of the nurses is 32.8±6.7, 91.1% are female, 73.3% have a bachelor’s degree. Average weekly work hours before COVID-19 pandemic was 43.3± 4.6, after the pandemic 37.8± 5.5, 86.7% expressed that the care patients with COVID-19 received was adequate. The emotions experienced by the participants are positive, negative and ambivalent. During the COVID-19 outbreak, nurses were dominated by negative emotions intensified with the ethical issues surrounding the safety of patients, colleagues, families and themselves. Nurses primarily experience ethical problems related to their, patients’, colleagues’ and families’ safety. Positive emotions expressed by nurses; hopefulness, heroism, joy and success because of the patients’ recovery, respect and emotions of gratitude. Some of the difficulties experienced by the participants are difficulties in care due to protective gear worn, difficulty reaching the physician and communication problems. Different studies can be planned regarding the factors affecting healthcare professional-patient communication during the COVID-19 care and treatment process.

COVID-19 is an infectious disease that is transmitted by the respiratory tract and was first identified in the Wuhan province of China. The causative agent of the disease is SARS-CoV-2. There is little known about this disease and its agent, which affected the whole world in a short time and became a pandemic. Molecular interactions between COVID-19 and chronic respiratory diseases are unknown. In this study, we examined the patients admitted to our outpatient clinic with the diagnosis of Asthma and Chronic Obstructive Pulmonary Disease (COPD) exacerbation. We investigated how much of the exacerbations during the pandemic period are caused by the COVID-19 virus and whether there have been any changes in the treatment of and approaches to exacerbations stemming from COVID-19. COVID-19 was detected in 135 of the patients. Clinically, fever, myalgia, and headache findings were significantly more common in patients with a positive COVID-19 PCR CoV 2 test in patients who were diagnosed with an attack of Asthma or exacerbation of COPD (p<0.001). The number of hospitalizations, the need for intensive care, the need for ventilation support, and the number of mortality were high in asthma and COPD patients with positiveSARS- CoV-2 tests (p<0.05 ). Based on the results of our study, patients with COPD and asthma exacerbations due to COVID-19 should be evaluated from a wider perspective. As is known, chronic diseases are poor prognostic factors for COVID-19, but asthma and COPD chronic disease are prominent among them. If there is a need for different approaches for the treatment of these patients, these approaches should be determined urgently.

Surgical intervention is the treatment procedure of many diseases of the submandibular gland such as sialolithiasis, chronic sialoadenitis, and tumors. This study aims to analyze the management, outcomes, and complications of transcervical submandibular gland excision cases of a tertiary clinic and to discuss the results in light of the current literature knowledge. 120 cases who applied to a tertiary otorhinolaryngology clinic between 2014-2019 and who underwent submandibular gland excision were analyzed retrospectively. Postoperative histopathological results revealed that 108 cases were benign and 12 of cases were malignant. The most frequent benign pathology was chronic sialoadenitis in 82 cases. The most common non-malignant tumor was pleomorphic adenoma in 16 cases. Although the result obtained with fine-needle-biopsy was benign in 2 patients, the histopathological result after surgery was malignant (adenocarcinoma in 1 patient, mucoepidermoid carcinoma in 1 patient). As complications of surgery; marginal mandibular nerve injury in 11 cases (permanent in 2 cases) and hematoma in 7 cases were noted. A benign fine-needle aspiration biopsy result does not necessarily exclude malignancy in submandibular gland masses. As a result, we found that the percentage distribution of our submandibular gland histopathological results is consistent with the literature. Although marginal mandibular nerve injury is one of the most common complications of submandibular gland excision, transcervical submandibular gland excision is still a reliable surgery.

Medical malpractice could result from personal reasons such as negligence, carelessness, ignorance, lack of skills, and insufficiency in patient care. The aim of the authors of this study to determine the knowledge, views, experiences and observations of midwives about malpractice. The study was carried out between April-September 2013, on 75 midwiwes working in three different hospitals in a city of Turkey. The semi-structured interview form developed by researcher has been used. It has been determined that the causes of malpractice are mostly thought by midwives as inability and inexperience in profession (90.7%), carelessness (86.7%) and lack of attention (40%). It has been determined that 24% of the midwives has witnessed a faulty medical practice and 5.4% of midwives make medical errors. The most observed types of medical errors encountered by midwives; umbilical cord prolapses due to amniyotomy prematurely (42.7%), damage to the anal sphincter during episiotomy (62.7%) and forgetting foreign object after repair of episiotomy (32%). At the end of the study has appeared should be giving importance to vocational training and postgraduate service training for reducing medical errors and protection from malpractice midwives.

Hemangiomas of the larynx can be divided in two main forms: infantile and adult. The infantile form is more common in the subglottis and the adult form is usually found at or above the level of the vocal cords. Laryngeal hemangioma of the vocal cord is a very rare condition. We present a case of a 39-year-old female with a large hemangioma of the left vocal cord causing hoarseness and respiratory distress. The lesion was surgically removed successfully at our center.

Asthma is a chronic disease characterized by the presence of inflammatory agents in the airways, and diagnosis and treatment are based on clinical questioning, physical examination, laboratory results, and spirometric analysis. This study investigated the effect of asthma alone on routine laboratory parameters in adults and whether an idea about the course of the disease can be obtained using these parameters. Two hundred and fourteen patients with known asthma history, diagnosed, and treated according to guidelines, were included in our study. Among all patients and between gender-specific groups, total cholesterol (CHOL), HDL, LDL, VLDL, triglyceride (TG), albumin, total protein (TP), lactate dehydrogenase (LDH), glucose, urea, creatinine, C reactive protein (CRP), FeNO, SII, INR, and complete blood count value parameters of the patients were analyzed. When we consider all asthma patients, we found that the mean glucose, LDH, CRP, TG, FeNO, and INR values outpaced the upper limit of the reference range. In contrast, the mean HDL value was below the reference range for all patients. In addition, our study found a significant correlation between triglyceride levels within the biochemical parameters with FeNO and SII). Finally, when we compared the mean values of gender-specific groups, we found a statistically significant difference between VLDL, HDL, TG, CRP, FeNO, creatinine, lymphocyte, eosinophile, basophile, and hemoglobin. CRP, LDH, TG, FeNO, SII, and INR levels may help clinicians in adult patients with stable asthma. In addition, differences depending on gender could be observed in the biochemical parameters of asthma patients.

High consumption of fructose might lead to obesity, diabetes, and metabolic syndrome in the long term. Recent studies demonstrated the induction of insulin resistance in the liver tissues by down-regulation of insulin signaling pathway elements. Glycogen synthase kinase-3 (GSK-3), one of the insulin signaling elements, suppresses the β-catenin function that is required for cell proliferation and integrity. This study is designed to demonstrate the effects of fructose on the proliferation of rat hepatocytes and its effects on GSK-3 and β-catenin expression. Accordingly, rat hepatocytes were treated with different concentrations of fructose, and cell proliferation was followed with an xCELLigence real-time cell analysis system. Besides, gene and protein expression levels of GSK-3β and β-catenin were evaluated in fructose-treated cells with qRT-PCR and Western blot, respectively. The results demonstrated proliferative effects of fructose at low doses (0-25-50 mM), but cytotoxic properties are pronounced at higher doses (100-150 mM). The IC50 value was calculated as 140±7 mM fructose for Clone-9 cells. Molecular effects of fructose over GSK-3β and β-catenin appeared at gene and protein levels at 100- and 150-mM concentrations at which GSK-3β were suppressed. Conversely, high-dose fructose leads to β-catenin induction as a compensatory mechanism to counteract the antiproliferative effects of fructose at these doses. In conclusion, high-dose fructose-induced cytotoxicity activates a compensatory molecular mechanism involving β-catenin induction which might protect the cells in the long-term fructose exposure.

Composite tissue transplantation has gained a new dimension in line with advanced technological developments. In extremity losses, the traditionally implemented procedure is to enable the extremity to regain its functionality through replantation instead of transplantation. On the other hand, innovative studies are also carried out to sup-port and strengthen the human body and improve the problematic body functions for increasing patients’ quality of life. Studies on developing biomechatronic systems, which are related to biology, neurology, biophysics, me-chanics, biomedical and tissue engineering, electronics, and computer sciences, are in progress, which indicates that a transformation has occurred in the approaches to composite tissue transplantation. This study aims to gener-ate ideas about determining a conventional limit in the interventions towards the human body against the techno-logical and scientific developments and to perform a value analysis on such interventions. This study was designed within the framework of the methodology of medical ethics and in the light of the slippery slope argument. The process of transformation from the medical procedures that aim to protect patients’ bodily integrity to the inno-vative practices that provide an opportunity to bionically turn healthy human bodies into the half machine and half-human is investigated in the light of the slippery slope argument. This study indicated that the value-related problems regarding this issue are related to the principles of respect for autonomy, beneficence, non-maleficence, and justice. The limit to be determined for the practices that aim to protect the patients’ bodily integrity and in-crease their quality of life and that are not life-saving depends on the distinction between an ill body and a healthy body. A meticulous clinical perspective and legislative regulations that prevent the instrumentalization of humans are required so as not to roll down to undesirable places on a slope. Advanced technological developments are implemented in medicine, protecting human dignity should be adopted as a fundamental value.

A study was done on 385 people who survived from COVID 19 to assess the prevalence, symptom, and severity of COVID 19 of permanent residents of Dhaka city, Bangladesh during the second wave of corona manifestation. Data were collected purposively from a government and a private hospital, and general people taking treatment from home. A significant number of respondents took treatment from the Hospital during 2nd wave of COVID 19. Two-third of participants endured moderate (67.5%) type of suffering followed by mild (18.7%) and severe (13.8%) type of suffering. Most of the participants were married (88.8%) and female (51.2%). There was no significant difference between females and males suffering and the risk and severity of COVID 19 (p=694). Most of the participants (70%) had comorbidity. Time to recover from symptoms had significant relation with symptom patterns. One-third of the respondents (33%) required 4-7 days to recover from suffering. A little higher than a quarter (27.8%) recovered within 8 to 14 days and more than a quarter 105 (27.3%) recovered by 8-12 days respectively. Most of the respondents had a fever, cough, body ache and fatigue, sore throat, and breathing difficulty. Only (7.3%) had diarrhea (3.9%) and smell loss 13 (3.4%). People of permanent residence of Dhaka city suffered from COVID 19 irrespective of sex, education, professional status. They had comorbidity, required 8-14 days of hospitalization, and endured the moderate type of suffering of COVID-19.

The internal turmoil, that broke out in Syria, started a mass migration movement towards Turkey in 2011. This migration movement, which proved to be an important social phenomenon, individuals from many different cultures have experienced coexistence for compulsory reasons. On top of that experience they were subjected to, the addition of a highly complicated process of acculturation, and the risk factors which immigrants and ethnic minority groups faced caused them to classify as vulnurable regarding health. The aim of this study is to assess how the preferred acculturation strategy of Syrian asylum seekers, who found themselves living along with different cultures, their negative or positive experiences and the risk factors they face affects their health, and health perceptions. The research was designed as a phenomenological research. In-depth interviews were conducted with 24 participants, who were included in the study, using the purposive sampling strategies, homogeneous case sampling and criterion sampling technique. In addition to the usage of code book obtained from the literary works related to the field using the deductive method, the data recorded by observing and the notes from interviews were reduced to themes, categories and codes using the inductive method. The study is grouped under three main themes, namely acculturation strategy of Syrian asylum seekers, risk factors affecting the healths of Syrian asylum seekers and health perception of Syrian asylum seekers. Statistical analysis of the data was carried out by using descriptive analysis and content analysis provided in the MAXQDA 2020 pro-package program. Although the participants heavily express their opinions in favor of seperationg strategy, which is one of the acculturation strategies, this is followed by an integration strategy. Furthermore, the participants were observed to have been subjected to discrimination and rejection, and in this process, facing risk factors mainly social, psychological, environmental, physical and barriers affecting healthcare procurement. Multiple relational analysis show that an intense relationship was found between the participants who preferred the separatist strategy and the risk factors affecting their health. It was observed that the participants who reported good health perception before migrating; due to the most reported social risk factor, economic barriers, reported negative health perception after migrating. The majority of participants who preferred the integration strategy reported good health perception both before and after migration.

We aimed to evaluate the clinical characteristics, laboratory and imaging findings, and outcomes associated with the severity of illness of patients admitted to our hospital with possible COVID-19 diagnosis. The patients admitted to our hospital with a possible diagnosis of COVID-19 between March 25 and December 3, 2020, were evaluated retrospectively. In terms of their clinical, laboratory, imaging findings, and mortality were compared between patients discharged and hospitalized with died and survivors. 12470 patients admitted to our hospital with a possible diagnosis of COVID-19 tested by SARS-CoV-2 RT-PCR. Of those tested, 3116 (24.9%) were positive. Of the patients, 2529 (81.2%) were discharged, 587 (18.8%) hospitalized, and 92 (3%) were died. In the comparison of discharged, and hospitalized groups, a significant difference was found in age, symptoms, comorbid diseases, chest CT, laboratory findings, and mortality (p< 0.05). In the comparison of survivor, and dead, the risk of mortality analysis showed similar characteristics. Older age, male gender, comorbidities, lymphopenia, thrombocytopenia, increased levels of CRP, NLR, D-dimer, ferritin, and chest CT findings were significant risk factors. Of the patients who died, 23 (25%) were female and 69 (75%) were male. The outbreak of COVID-19 is a significantly health problem. We were experienced with high numbers of COVID-19 cases and found that age, symptoms, comorbid diseases, chest CT, laboratory findings of inflammation are significant predictors for admission to hospital. Therefore, these risk factors should consider routinely for patients with a high risk of developing severe and critical diseases by clinicians

COVID-19 pandemic has placed a heavy burden on healthcare systems and governments. Health literacy and health behaviors are recognized as strategic public health elements, but they have not received due attention during the pandemic. Health literacy and health behaviors are vital in slowing and controlling the COVID-19 outbreak. The purpose of this research is to examine the health literacy level and health behaviors of individuals in the COVID 19 epidemic. The sample of the study consists of individuals between the ages of 18-65 living in Ankara. An online questionnaire was applied to 384 people who agreed to participate in the research. TürkiyeHealth Literacy Scenario Scale was used to determine the health literacy level of individuals, and the Healthy Lifestyle Behaviors Scale was used to evaluate healthy lifestyle behaviors. As a result, a significant difference was found in the total health literacy scores of the individuals according to their healthy lifestyle, and the health literacy total scores of the individuals with a healthy lifestyle were found to be higher. It has been suggested to raise awareness about health literacy and healthy lifestyle and to raise awareness of the society

Conventional transbronchial needle aspiration (cTBNA) biopsy is a diagnostic minimally invasive technique applied using fibreoptic bronchoscopy (FOB) in the evaluation of mediastinal/hilar lymph nodes. With the development of endobronchial ultrasound (EBUS) devices, transbronchial aspiration needles have been revised for use according to the EBUS guidelines. The main aim of this research was to evaluate the diagnostic success of transbronchial aspiration needles that was produced for EBUS when it was applied with FOB instead of conventional TBNA. A retrospective examination was made with the data of 35 patients applied with FOB TBNA, using needles specifically designed for EBUS and 36 patients with conventional TBNA (cTBNA group), for lung cancer staging or the diagnosis of mediastinal lymphadenopathy between November 2018 and November 2019. Seventy-two and sixty procedures performed on 71 patients were included in the study. Diagnostic efficiency for TBNA and cTBNA groups were 91.4% and 83.3%, respectively. Conventional TBNA is still acceptable when the low cost and ease of application are taken into consideration. In conclusion, improvement of current conventional TBNA needles similar to EBUS-TBNA needles for more efficient aspiration capacity could be the first stepto increasing the TBNA diagnostic yield. Nevertheless, further studies are needed to confirm our results.

The study was aimed to investigate the environmental literacy levels of the nursing students, including the dimensions of environmental knowledge, attitudes, behaviour, and perceptions. It was a descriptive and cross-sectional study, including 292 nursing students who had accepted participation in the study. Data were collected in the fall term of the 2019-2020 academic year using the Sociodemographic Characteristics Form and the Environmental Literacy Scale. According to the results, nursing students’ sub-dimension scores were 12.23±2.96 for environmental knowledge, 66.11±12.25 for environmental attitude, 41.22±6.38 for environmental behaviour, and 10.26±2.08 for environmental perception. The environmental literacy levels of nursing students are at a moderate level. The study found a statistically significant difference between class level, age, gender, father educational status, talking about environmental issues in the family, environmental education status, being involved in the environmental project, source of environmental information, membership of the environmental organizations, and the mean score of the scale (p < 0.05). As a result, it is suggested to plan interventional studies with larger samples to improve the environmental literacy levels of nursing students and to make necessary regulations in the course contents

CYP1B1 is a P450 enzyme involved in activating pro-carcinogens to carcinogens as well as estrogen metabolism. In order to examine the effect of CYP1B1 on cancer metabolism, it should be compared with healthy individuals and whether the polymorphism between healthy individuals and sick individuals is significant. This study aims to screen the CYP1B1*3 and CYP1B1*4 polymorphisms of a group of individuals who have not been diagnosed with cancer to examine the genetic differences of metabolic enzymes in the Turkish population.This study is a cross-sectional type descriptive study.The study included 295 patients without a cancer diagnosis. The research sample includes patients who applied to Ankara University Medical Faculty Hospital and Afyonkarahisar Health Sciences University Research and Application Hospital. The individuals signed voluntary consent forms before participation, and 3 ml blood samples were taken from each. DNA samples were obtained using a DNA isolation kit, and then polymorphism was determined by real-time PCR. The distribution of CYP1B1*3 and CYP1B1*4 polymorphism in healthy individuals was determined. The frequency of CYP1B1*1/*1 (wild type), CYP1B1*1/*3 (heterozygous) and, CYP1B1*3/*3 (mutant) genotypes were found 39.33%, 50.67% and 10.0% respectively. The frequency of CYP1B1*1/*1 (wild type), CYP1B1*1/*4 (heterozygous) and, CYP1B1*4/*4 (mutant) genotypes were found 39.31%, 60.69% and 0% respectively. No individuals with mutant genotype were detected in this genotype (CYP1B1*4).The results show that the genotype frequencies of the CYP1B1*3 gene polymorphism in a Turkish population are similar to other Caucasian populations. However, it was determined that the Turkish population did not show similarity with other races in terms of CYP1B1*4 polymorphism

The aim of this study is to reveal the creativity and innovativeness attitudes of nursing students who receive vocational education, to determine the influencing factors and to increase their awareness of innovation and creativity in nursing. The research was conducted as a descriptive study. The sample consisted of 399 nursing students. To collect data “Personal Information Form”, “Individual Innovativeness Scale Adapted for Nursing”, “Individual Creativity Scale” were used. Descriptive values, Shapiro-Wilk, Chi-square, Student’s-t, ANOVA, Tukey, Pearson Correlation test were used in the evaluation of the data. Ethics committee and institutional permission were obtained for the study. The average age of the participants is 20.82 ±1.69. The total score average of the participants is 59.19 for the Individual Innovativeness Scale and 55.58 for the Individual Creativity Scale. A significant relationship was found between genders, the place lived in the longest, the need for innovative thinking and individual innovativeness total score average. Also, a significant relationship was found between gender, place lived in the longest, participation in scientific activities related to creativity and innovativeness and innovative thinking status and creativity scale average score. The participants were skeptical about individual innovativeness and their creativity score average was at a medium level. The creativity and innovation scale scores of the participants were affected by some sociodemographic characteristics. It is recommended to plan trainings to raise awareness about innovation and creativity.

Fournier’s gangrene is a rapidly progressive, fatal, necrotizing fasciitis of the perineum and penoscrotal region which requires rapid intervention. This retrospective study compares the surgical outcomes of the fasciocutaneous flap and the embedding of the testicles into the thigh skin, applied for the reconstruction of penoscrotal defects after surgical debridement due to Fournier’s gangrene, in the light of the literature. A total of 110 patients treated for Fournier’s gangrene at Çanakkale Onsekiz Mart University, Faculty of Medicine, Department of Urology, Urology Clinic between 2009 and 2021 were evaluated retrospectively. Among these, 82 patients treated with fasciocutaneous flap and embedding of the testicles into the thigh skin for the reconstruction of penoscrotal defects were included in the study. For these two wound closure methods, the cases were compared in age, hospital stay after debridement, hospital stay after wound closure, size of the debrided area, and postoperative complication parameters. There was no significant difference between the two groups in terms of age, comorbidity (hypertension, diabetes mellitus, etc.), and hospital stay after debridement. However, the length of hospital stay after wound closure and the size of the debrided area were significantly higher in patients with fasciocutaneous flap compared to the method in which the testis was embedded in the thigh. The fasciocutaneous flap application, which we apply for defects larger than 50% of the scrotum or extending beyond the scrotum, is a method that can be preferred by experienced surgeons for wound closure after Fournier gangrene debridement, considering patient comfort, since it does not create tension and blood supply to the testis is more comfortable. However, it would be more appropriate for the clinician to make a profit-loss calculation due to both the length of the operation and its more complex nature and the prolongation of the hospital stay after wound closure.

This study aimed to analyze the data of patients presenting with dizziness at our hospital’s emergency department (ED) by determining the etiology of dizziness and to contribute to the medical data of our country and the literature. This prospective study was conducted with 116 volunteering patients who presented to the Emergency Department of Afyon Kocatepe University, Faculty of Medicine for one year with dizziness complaints. After the anamnesis, physical examination, diagnostic tests (blood tests, Dix-Hallpike maneuver, audiological-vestibular tests, carotid-vertebral artery color Doppler ultrasonography, and computerized brain tomography), and psychiatric interrogation, the patients were divided into four etiology groups: Peripheral, central, psychogenic, and other causes of dizziness. Clinical features were compared between peripheral and central dizziness groups. A total of 116 (3.4%) of patient admissions to the emergency department complained of dizziness. Forty-nine (42.2%) of these patients were male, 67 (57.8%) were female. In the cohort, 33.9% were under 40, and dizziness increased with older age. Seventy (60.3%) patients had no formal education or were primary school graduates. The initial evaluation at the ED revealed that dizziness mostly shifted with the position (71.6%) and was mainly accompanied by headache (67.2%). Based on their diagnosis, 50 patients (43.1%) were in the peripheral group, 30 patients (25.8%) were in the central group, 22 patients (19%) were in the psychogenic dizziness group, and 14 patients (12%) were in the other causes group. Intergroup analysis between peripheral and central vertigo groups identified that the hearing loss, ear fullness, recent upper respiratory tract infection (URTI), nausea, vomiting, and shifting position was statistically significant (p<0.05). Dizziness is one of the common complaints of admission to the ED and may arise from different etiologies. Our study demonstrated that psychogenic dizziness was common in this patient cohort

Abdominal injury is the third leading cause of death due to trauma. In this study, it is aimed to investigate the level of detection of acute trauma pathologies by the emergency medicine physician assistant in abdominal tomography images taken in trauma patients. Contrast-enhanced abdominal tomography images of 207 patients who applied with trauma between 12.15.2020 and 12.15.2021 were included in this study. In order to evaluate the images of the patients, the evaluation of the emergency medicine physician assistant was compared with the radiology official report. Patients’ age, gender, current complaints, symptoms, trauma classification, injury sites accompanying abdominal injury, hospitalization status and mortality rates were analyzed. The statistical distribution of the patients’ demographic and clinical information was calculated. The reports of the patients whose radiology official report was issued and the emergency medicine assistant forms were transferred to the SPSS program as “pathology exists” or “no pathology”. In the study, 79.2% (n=164) were male and 20.8% (n=43) were female. The median age was 33 years. In terms of interpretation of abdominal tomography, a statistically significant correlation was found between the radiologist and the emergency medicine physician assistant in the evaluation of liver, spleen and kidney; intra-abdominal and retroperitoneal hemorrhage, muscle and fascia injury of abdominal wall; vertebral, iliac, ischiatic, pubic bone, sacrum and femoral neck fracture. It was determined that 12.1% (n=25) of the patients were admitted to the intensive care unit and 5.3% (n=11) were died. High sensitivity, specificity, positive and negative predictive values were found in the evaluation of abdominal contrast-enhanced tomography imaging of patients admitted to the emergency department due to trauma by the emergency medicine assistant. We think that these high accuracy values are due to emergency medicine physician assistant’s evaluation of the patient’s history, physical examination and imaging studies as a whole

Chronic Obstructive Pulmonary Disease (COPD) is diagnosed with pulmonary function tests (PFTs). However, since not all patients can be diagnosed with PFTs, some are diagnosed with radiological or clinical findings. The purpose of this study was to define the properties of obstructive airway disease through thoracic computed tomography (CT) and to identify the diagnostic efficacy of CT findings. A total of 160 patients who underwent PFT and thoracic CT assessment July 2018 - January 2019, were retrospectively analyzed. Based on PFT findings, patients were categorized into three groups as having normal, restrictive or obstructive airways. Age, height, weight, and body mass indexes of the groups were recorded. Pulmonary height, width, right-left hemi-diaphragm height, sterno-diaphragmatic angle and retrosternal transparent area length in axial sections were also recorded. Diagnostic efficacies of these parameters in the detection of obstructive airway disease were measured. Of the 160 patients (109 males, 51 females; mean age = 59.5), 91 (56.9) had normal PFT, 58 (36.2%) had obstructive and 11 (6.9%) had restrictive airway disease. Pulmonary height, width, sterno-diaphragmatic angle, and retrosternal transparent area length were significantly higher in patients with obstructive airway disease while the right-left hemi-diaphragm height was significantly lower (p<0.001). About 60-75% sensitivity and specificity were obtained when identifying the obstructive airway disease with these parameters. These values obtained from the axial and sagittal sections could contribute to the diagnosis of obstructive airway disease.

Maternal and fetal diabetes are directly associated with increased morbidity and mortality risk. Along with this increased risk, the incidence of congenital malformations in newborns also increases depending on the mother’s diabetes. Vitamin K1 is used as a therapeutic and protective agent in diabetes and various clinical conditions. For this reason, it was aimed to investigate the effect of vitamin K1 on chick embryo hearts immunohistochemically and morphologically by creating type 1 diabetes mellitus with streptozotocin in a chick embryo model. In our study, 5 different experimental groups will be created and a total of 50 SPF fertilized eggs, 10 in each group, will be used. The first group will be the control group, the second group will be the diabetes group, and the other three groups will be the treatment groups given different doses of vitamin K1. All solutions will be given on the 12th day of incubation, and the hearts of all embryos will be analyzed immunohistochemically and morphologically on the 18th day of incubation. It was determined that the weight, length and ventricular thickness of the chick embryo hearts were statistically significantly decreased in the streptozotocin group compared to the control group embryo hearts. It was determined that the heart weights, lengths, and ventricular thicknesses increased depending on the dose of vitamin K1 compared to the streptozotocin group in the groups therapeutically administered vitamin K1 (p<0.05). In addition, caspase-3 expression was also evaluated in our study, and a statistically significant increase was found in the streptozotocin group compared to the control group. Again, as a result of vitamin K1 administration, caspase-3 expressions decreased depending on the applied dose (p<0.05). In conclusion, it was concluded that the therapeutically applied vitamin K1 to diabetes mellitus reduces the degenerative and hyperplastic effects of diabetes mellitus.

Within the ASSISTANCE Project (Adapted Situation Awareness Tools and Tailored Training Scenarios for Increasing the Capabilities and Enhancing the Protection of First Responders) the development of a novel and advanced training programme is currently underway to adapt to the needs and characteristics of first responders. Once the methodology was ready, a complete training curriculum was prepared in order to probe the concept of the European training network based on online Virtual Reality platforms. The curriculum is composed of subjects, which have been developed with a stepwise approach, taking into consideration the pre-requisites needed for each subject and a gradual increase in difficulty and complexity. These subjects can be divided into two different types: theoretical subjects, which will be taught through the Moodle server and practical subjects, which will be taught through the performance of different virtual scenarios with the available Virtual Reality platforms. Each subject definition includes a short summary of the subject, their main, general and specific objectives as well as their preferred evaluation method and the pre-requisites needed. This paper presents the ASSISTANCE training methodology and the curriculum developed including the preliminary scheduling needed to complete all the proposed subjects.

For last years, the consequences of the implication of daylight saving time has been discussed frequently, daylight saving time haseffects on many field of the daily routine such as electricity consumption, human health, performance, behavior and well-being ofindividuals. Since the cabinet decision in 2016, Turkey has been implementing the summertime throughout the whole year in order tosave energy. Therefore, the main aim of this study is to analyze the effects of this change on economic growth and labor productivityby employing quarterly data for the time period 2006:Q1 and 2018:Q1 for Turkey and Threshold AR model in order to incorporate thenonlinear behavior in considered time series. The results show significant effect of this policy change on economic growth and laborproductivity as well as nonlinear behavior in the time series due to continuous fluctuations in the data throughout time which can beclassified into at least two regimes as recession and expansion. As a conclusion, the policy makers should evaluate the effects ofdaylight saving time (DST) on different indicators before the changes in the implementation.

Objective: The incidence of prostate adenocarcinoma (PCa) is increased with the use of prostate-specificantigen (PSA). In the current study, we aimed to investigate the impact of 5- alpha- reductase inhibitors (5-ARI) on pathological progression in patients followed by active surveillance (AS).Material and methods: Records of 69 patients with localized prostate cancer under AS (PSA ≤15 ng/mL,PSAD ≤0.20, ≤cT2c, Gleason sum ≤3+3, the number of cancer positive cores ≤3) were evaluated retrospectively.Patients were followed-up with quarterly PSA testing and semiannual digital rectal examinationduring the first 2 years, and semiannual PSA testing thereafter. Repeat biopsies were done annually andwhenever indicated by clinical findings. Pathological progression was defined as increasing Gleason grade,number of cancer-positive cores, and/or increasing percentage of cancer in any core.Results: Patients using (29/69: 42%) and not using (40/69: 58%) 5-ARI were followed for a median of 39(IQR: 23-45) and 23.5 (IQR: 17-37.5) months, respectively. Pathological progression was observed in 32%(22/69) of the patients at a median of 25 (IQR: 18-39) months. Pathological progression was observed in34.5% (10/29) and 30% (12/40) of the patients using and not using 5-ARI, respectively (Log-rank p=0.4151).Definitive treatment was done in 31% (9/29) and 47.5% (19/40) of the patients using and not using 5-ARI,respectively. Patients who did not use 5-ARI received definitive treatment earlier (Log-rank p=0.0342). Onmultivariate analysis, more than 2 cancer-positive cores (HR: 11.62) and age (HR=0.94) were independentlyassociated with pathological progression (p<0.05), rather than 5-ARI use (p=0.148).Conclusion: More than 2 cancer- positive cores at the initial biopsy was the strongest covariate associatedwith pathological progression; these patients should not be offered AS. There was no impact of 5-ARI useon pathological progression in AS.

Modernizm ile postmodernizm mukayesesi yapıldığında postmodernizmin, modernizmin duvarları- nı zorlayan hatta ona eleştiri getiren bir yapısının olduğu görülmektedir. Modernizm, bütün bilim ve sanat alanlarında tektipleştirici bir tavır ortaya koymuştur. Pozitif bilimlerin ve beraberinde sekülerizmin temel alındığı modernist yaklaşımda insan aklının, mükemmeliyetçiliğinin ve laboratuvarın dışında kalan her şeye ya şüpheyle bakılmış ya da yok sayılmıştır. Batı modernizminin gelişimi ve dünyaya hâkimiyet biçimi, kendi ekonomik sistemi olan kapitalizmle paralellik de taşımıştır. Modernizmin bu katı tutumu karşısında, yeni arayışlar postmodernizmi doğurmuş ve bu durum bilimsel bilginin de sınırlarını değiştirmeye başlamıştır. Bu süreçte bir yandan disiplinlerarası bir bilim anlayışı sosyal bilimlere uzanan bir boyutta gelişim gösterirken bir yandan da yerelin ön plana çıktığı bir döneme girilmiştir. Bu duruma halk kültürü açısından bakıldığında, bir dönem “öteki”, “taşralı” ya da “geri” olarak nitelenen halk kültürü unsurlarının, kent yaşamının her ala- nında ve resmî kültürde karşılık bulduğu gözlemlenebilir. Halk hekimliği ya da geleneksel tıp uygulamaları da bu süreçte modern tıbbın sınırlarını zorlamaya başlamıştır. Modern tıbbın reddetmesine karşın dünyanın pek çok bölgesinde varlığını koruyan söz konusu bu geleneksel uygulamalar, modern tıbbın yetmediği ya da insanları ikna edemediği durumlarda başvurulan bir yöntem olmuştur. Gelinen noktada halk hekimliği uy- gulamalarının Batı da dâhil olmak üzere resmî kurumlar tarafından tekrar gündeme alındığı görülmektedir. Türkiye’de Sağlık Bakanlığı’nın ve üniversitelerin bu konuda çalışmaları mevcuttur. Postmodern yaklaşım ve söylem, halk hekimliğini bu şekilde öne çıkartırken halk hekimliği uygulamalarını kapitalizmin istediği bi- çimde işlemektedir. Diğer bir deyişle, modernizme bir karşı duruş gibi gözüken postmodernizm, modernizmle kapitalizm arasındaki ilişkiye dokunmamakta ve öne çıkardığı bütün yerellikleri aynı modernizmin yaptığı gibi kapitalizmin hizmetine sunmaktadır.