INTRODUCTION: Throughout history, antimicrobial medications are responsible for the well being of many cases in the world; however it is now perceived as a group of medicine which is becoming less effective due to its widespread use. Inappropriate use of these medication increases antimicrobial resistance of the human body as well as causing many medical, economical and public health related issues. The purpose of this study is to evaluate inappropriate use of antibiotics for in-patients and to diagnose adverse effects related to such use in addition to determining the most common causes of such adverse effects.
METHODS: 400 in-patients who were using antibiotics were observed and inappropriate use of antibiotics was evaluated to diagnose adverse effects related to such use. The study was conducted empirically.
RESULTS: 400 in-patients who were using antibiotics were observed during the study. 107 of the patients (%27) were being warded in the internal diseases department and 293 of them (%73) were being warded surgical departments. Antibiotic usage indications of the patients who were included in this study were analysed under three main topics: prophylactic, empirical and casual analysis. In surgical departments, 84% of the patients started antibiotics use prophylactically. Prophylactic treatments had %95.5 inconvenience rate. On the other hand, internal diseases departments had a completely different antibiotic use indication and were 89% empyrical. Internal diseases departments that proceeded with empyrical treatment had 10.5% inconvenience rate. Side effects of antibitiocs use were observed on 9.3% of the patients in the internal diseases departments and on %3 of the patients in the surgical departments. Analyzing the patients in which Infection Diseases were evaluated %12 of the patients were observed to have an inconvenience timing of treatment period. All of the inconveniences were due to departmental doctors’ failure to comply with the recommendations of the infectious diseases department.
DISCUSSION AND CONCLUSION: As a result, we strongly believe that adverse effects of inappropriate antibiotics use shall be prevented by employing sufficient amount of qualified infectious disease specialists in hospitals.

INTRODUCTION: Objective: Mental activity and physical activity appears to affect body functions differently. Both activities appear to have impact on reproductive functions of the women. Aim of the current study was to compare the students undertaking mental activity-based education (MABE) and physical activity-based education (PABE) on menstrual cycle parameters.
METHODS: Methods: A total of 390 female students participated to the study. However, the students who were using any drugs (painkiller, contraceptives etc.) were removed and the groups consisted of 171 MABE students (faculty of medicine) and 169 PABE students (faculty of sports sciences). Participants were asked to provide information about their menstrual cycles, sleep quality, pain perception. Moreover, they filled in a questionnaire about their preferences for visual, verbal, gustatory, mental, auditory, and physical activities.
RESULTS: Results: Length of the menstrual cycle was similar between the MABE and PABE (29.5±0.3, 29.0±0.2 days, respectively, p>0.05) but length of menstruation was longer in MABE students (6.0±0.1 and 5.5±0.1 days, p=0.007). MABE students fall asleep quicker in the night, slept 1 h less and woke up earlier with better sleep quality. PABE students wanted to do shopping and have their hair cut and dyed while MABE students wanted to chat with a friend or make a voyage.
DISCUSSION AND CONCLUSION: Conclusions: Longer menstrual bleeding in MABE students requires special attention as it may result in iron deficiency anemia. Moreover, different physiological (i.e., menstruation, sleep-wake cycle) characteristics and everyday life priorities suggest that format of education and social activities of female students might require differential approaches for each education types.

INTRODUCTION:
Syphilis and HIV have similar transmission routes. Several studies have found evidence between the increase in HIV incidents and Syphilis incidents. Both Syphilis and HIV cases have increased in recent years. In this study, we investigated the correlation of HIV infection with Syphilis infection via clinical and laboratory findings.

METHODS: In this study, the files of patients who were followed up with the diagnosis of syphilis by the Infectious Diseases and Clinical Microbiology Clinic of Mersin University Faculty of Medicine and Mersin Toros State Hospital between 2017 - 2019 were retrospectively reviewed and the rate of HIV coinfection and related factors were investigated.
RESULTS: Fifty – one patients with syphilis were included in the study. 39 (76.5%) of the patients were male and 12 ( 23.5 % ) were female. The mean age of the patients was 36.5 years. Due to the retrospective nature of our study, we could not obtain information about sexual preferences or other risk factors.
Genital chancre was the most common finding in the primary stage, whereas the rash was the most common finding in the secondary stage. At presentation, 4 patients were primary, 9 patients were secondary and 38 patients were in latent syphilis stage. HIV positivity was detected in 23 patients (45%). Primary and secondary stage were significantly more common in HIV positive cases and latent syphilis was common in HIV negative cases (p =0.007). All 4 patients in the primary stage had HIV positivity. Similarly, 6 of 9 patients in the secondary stage were HIV positive and 3 were negative. Of the 39 patients with latent stage, the majority ( 64% ) were HIV negative.

DISCUSSION AND CONCLUSION: The frequency of syphilis and HIV has increased in recent years and c oinfections arecommon. According to data from the United States Center for Disease Control and Prevention, about half of homosexual men with primary and secondary syphilis are infected with HIV. In our study, the primary and secondary stage were significantly more common in HIV positive cases.
The primary and secondary stages of syphilis will be seen more frequently with the spread of HIV.
HIV coinfection in patients with syphilis is higher than the rate of coinfection in HIV patients.
Therefore, we think that if the individuals diagnosed with syphilis can be followed for longer years as long as they do not change behavior, this rate may increase to higher values.
In conclusion, Syphilis should be considered in the diagnosis of rash patients. In addition, screening for HIV in syphilis - infected patients and planning trainings for sexually transmitted diseases with treatment are very important to prevent HIV transmission.

INTRODUCTION: Delirium is a common psychiatric disorder in advanced cancer but there are a few reports about delirium in patients with lung cancer. We aimed to investigate the predictors of delirium occurring in patients with lung cancer regardless of surgery.


METHODS: A total of 212 patients over the age of 18 hospitalized with lung cancer for any reason between 2013-2019 were retrospectively investigated in this research. Patients diagnosed with delirium between these dates were determinded and patients with concurrent lung cancer diagnosis were selected for this study. A similar number of patients over the age of 18 diagnosed with lung cancer but not diagnosed with delirium in the same period were also defined as the control group. Patients were diagnosed with delirium by the criterias of the Diagnostic and Statistical Manual of Mental Disorders V. criterias during their hospitalization by psychiatrist consultant physician. Age, gender, comorbidities, durations of hospital stay, laboratory parameters at the time of diagnosis (biochemistry. hemogram), the type of lung cancer and existing organ metastases of the patients were recorded from the patient files and hospital information system. Neutrophil to lymphocyte ratio and paletelet to lymphocyte ratio were calculated and recorded. The patients with lung cancer were divided into two groups as patients diagnosed with delirium and without delirium and they were compared.

RESULTS: Of the 212 patients, 93.9% of the were male and the average age of the patients was 63.45 ± 8.68 (38-91) years in our study. The number of the patients with delirium was 126 and the median diagnostic age of the patients with delirium was determined to be 64.00 (59.00-71.00) years. Although the median levels of white blood cell (WBC), neutrophil, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were higher, the median level of lymphocyte was found to be lower in the group with delirium (p <0.05 ). According to the logistic regression analysis, it was determined that the absence of accompanying COPD, metastasis, pneumonia and heart disease as well as being a male, increased the delirium risk.
DISCUSSION AND CONCLUSION: NLR and PLR which are systematic inflammatory markers, are associated with delirium and lung cancer. Increased NLR and PLR are significant risk factors for delirium in hospitalized patients with lung cancer and maintaining a low level of an inflammation may help prevent delirium. Male gender and acute illnesses requiring hospitalization may also increase the risk of delirium.

INTRODUCTION: In our study, we aimed to investigate the demographic and clinical characteristics of healthcare workers in Northwest Syria during the pandemic, which is a vulnerable area in terms of public health.

METHODS: In this study, the demographic and clinical characteristics of the healthcare workers who had Covid-19 infection and applied to the ACU (Assistance Coordination Unit) laboratories that were supported by the World Health Organization in the Northwestern Syria Region were retrospectively investigated.

RESULTS: 2596 healthcare workers were included into the study. 38.5%(n = 1000) of the participants were female and 61.5%(n = 1596) were male. The average age of the participants was 33.4∓8.9. According to the profession, the majority of them were nurses(n = 1037). In addition, among all, there were 380(14.6%) doctors, 335(12.9%) community health workers and 196(7.6%) cleaners. In northwest Syria, 953 health workers from Aleppo Region and 1643 from Idlib Region were included in our study. COVID-19 infected healthcare workers were identified as 277 people in Azez, 214 people in Al Bab and 206 people in Afrin located in the Aleppo Region; 770 people in Idlib center and 675 people in Harim located in the Idlib Region. Among those included in the study, 275(10.6%) were asymptomatic and 2321(89.4%) were symptomatic. Most of them(n = 2235, 86.1%) had mild symptoms. The most common symptoms were fever(n = 1702, 65.6%), dry cough(n = 1435, 55.5%) and fatigue(n = 1230, 47.4%).

DISCUSSION AND CONCLUSION: In our study, we have presented a cross-sectional analysis of almost all COVID-19 infected healthcare workers in northwest Syria in the second half of 2020. In our study, we have presented a cross-sectional analysis of almost all COVID-19 infected healthcare workers in northwest Syria in the second half of 2020.In the light of the data of our study, in Northwest Syria, where the internal turmoil continues; insufficient physical conditions of the places where the healthcare services are provided, uncontrolled movement of the crowded population, the failure to comply with isolation measures and the insufficient number of healthcare workers may have paved the way for the high infection rate among the healthcare workers. Among the limitations of our study, we can mention the fact that the diagnosis of COVID-19 infection was evaluated according to the results of the PCR test, but the data of the employees with Covid-19 positive findings in CT scans are not available in the digital database.

INTRODUCTION: In the new coronovirus (COVID-19) pandemic, emergency healthcare services work on the frontline with land and air ambulances and face serious challenges. Until now, data on the care of COVID-19 patients and transport by European air ambulance systems are very limited. During the pandemic period, many domestic and international COVID-19 patients were transferred by air ambulances. In this study, we aimed to reveal the analysis of COVID-19 patients transported by our air ambulance system and how the transfers took place.
METHODS: Our study is a retrospective cohort study. Patients who were diagnosed with COVID-19 as a result of real time PCR and transferred by fixed wing air ambulance between 15.04.2020 and 31.12.2020 were included in the study. The information of the cases was obtained from the Ministry of Health Emergency Health Services Automation System (ASOS) and flight records. Flight time, age, gender, hospitalization status (ward / intensive care unit), vital signs, treatment received (nasal oxygen, Non-invasive mechanical ventilator (NIMV), mechanical ventilator), transportation patterns and post-transport disinfection procedures were recorded.
RESULTS: Between the study dates, the number of patients with a definite diagnosis of COVID-19 according to real time PCR results with fixed wing ambulance was 80. 85% of the patients were male and the mean age was 44.7 ± 14.0 years. The average flight time for these patients was 492.2 ± 270.8 minutes. 87.5% (n = 70) of the COVID-19 patients were hospitalized in the inpatient service and 12.5% (n = 10) in the intensive care unit. 2.5% (n = 2) CPAP therapy, 3.8% (n = 3) mechanical ventilator follow-up, 22.5% (n = 18) IV fluid therapy and 71.3% (n = 57) received nasal oxygen therapy. Medical team used Personal Protective Equipment (PPE) in transferring all patients. 97.5% (n = 75) of the patients were transferred in the Portable Isolation Unit (PIU) and 2.5% (n = 5) were transferred without isolation.
DISCUSSION AND CONCLUSION: Transport and care of COVID-19 patients seem appropriate even for long periods from the air. Proper use of PPE and PIUs can provide security for personnel in charge of air transport of COVID-19 patients.

INTRODUCTION: Southeast Anatolia was influenced by the desert dust coming from Syria On October 14, 2018. It was observed that the transportation of dust clouds to Ankara led to a decrease in visibility and an increase in air pollution. In our study, it was aimed to investigate the relationship between the dust exposure and the admission made to our emergency department since that date.
METHODS: One hundred forty-three of the patients who were included in the study were admitted to the emergency room before dust exposure (group 1) and 203 (group 2) after dust exposure (group 2).
According to the Ministry of Environment and Urbanization report, PM10 values have been between 52.8-175 µg/m3 for 1 week starting from October 14th. It was determined that these values increased between 21-145 µg / m3 according to the pre-dust transport.

RESULTS: A total of 346 patients were included in the study. The number of patients who applied before dust exposure was significantly higher than that of the previous ones (p = 0.001). Groups were similar in terms of gender (p = 0,200).
The complaint of cough increased significantly [37 (27.6%), 97 (72.4%); p = 0.001]. Group 1 and group 2 cases were compared to the diseases leading to the emergency department, whereas lung diseases increased significantly (p = 0.001). 83 (40%) cases who presented with dyspnea or cough due to dust only and no other disease in lung disease, and 16 (7.9%) cases with heart failure outside the lung were found.

DISCUSSION AND CONCLUSION: As a result of our study, it has been found that dust transport leads to a significant increase in respiratory symptoms and the rate of referral to the emergency department. Due to the geopolitical position of our country, dust transport is a major public health problem.

INTRODUCTION: The aim of the study is to evaluate the performance of urine strip analysis for predicting manual microscopic urine analysis.
METHODS: Urine samples, which were ordered from patients with suspected urinary tract infection (UTI), and which were analyzed with both microscopic and strip analysis, were included in the study. Sensitivity, specificity, positive and negative likelihood ratios (LR +, LR-), pre- and post-test odds and post-test probability for cut-off values of “trace”, “1+”, “2+”, “3+” of erythrocyte-strip (Eryth-S) and leucocyte-strip (Leuc-S) tests were calculated. Bayes theorem was used to determine conditional probability. Area under curve (AUC) of ROC was calculated.
RESULTS: The AUC for Leuc-S and Eryth-S was 0.923 and 0.975, respectively. The Leuc-S test in “1+” and Eryth-S test in “trace” cut-off value had adequate sensitivity and specificity (>80%). Leuc-S of “3+” and Eryth-S of all cut-off values for LR+ value; Leuc-S of “trace” and Eryth-S of “trace” and “1+” for LR- value were significantly different for post-test probability(<0,1). Periodic prevalence rate of UTI was calculated as 5.95%. According to the microscopic analysis, the post-test probability of UTI was 39% for Leuc-S “3+” and 74% for Eryth-S “3+”.
DISCUSSION AND CONCLUSION: The urine strip analysis was found to be sufficient in predicting the positivity of leukocytes and erythrocytes in manual microscopic analysis. The diagnostic accuracy differs according to the estimation values in the urine strip analysis. We think that our study will provide awareness on this issue and will have an impact on determining test requests of physicians in patients with UTI and preventing unnecessary test requests.

INTRODUCTION: Largely due to the widespread use of unleaded petrol and lead-free dyes, the lead toxicity nowadays is associated with occupational exposure rather than environmental exposure in adults.

This study aims to identify the characteristics of lead exposure cases and evaluate working environment based on workers’ statement in a sector where lead monitoring is not routinely performed during health surveillances and to examine the outbreak of lead toxicity. Moreover, we aimed to start a discussion on management and treatment of these cases in our country.
METHODS: This descriptive study conducted in hospital which is authorized to diagnose occupational diseases between April and November 2018. In order to evaluate the sociodemographic characteristics, working life characteristics, workplace environment and risk factors and lead toxicity complaints of 34 cases with the elevated blood lead level (BLL), a 38 item questionnaire form was applied. Physical examination findings, laboratory findings, comorbidities and treatment protocols were obtained from the medical records.


RESULTS: 8.3% (n = 34) of the workers applied with a preliminary diagnosis of lead toxicity. Median duration of work was 26 months, average working time was 53.3±7.2 hours/week. The mean BLL was 44.0 ±5.1 μg/dl at the workplace surveillance, 38.4±11.1 μg/dl determined in the hospital and 36.1±8.9 μg/dl during hospital check. The Blood antimony (Sb) level was 5.5±1.4 μg/dl and mean blood manganese (Mn) level were 17.8±5.9 μg/L and 1.5±0.8 μg/L after the 15-day hospitalization.

DISCUSSION AND CONCLUSION: The iron and steel processing sector is among the sectors that should be carefully monitored in terms of lead, Mn, and Sb exposure. The legislations and the exposure limits of toxic metals and the biological limit values should be updated in accordance with scientific data. Chelation treatment of patients with clinical findings should be planned by confirming the accumulation of lead in bone tissue.

INTRODUCTION: Hepatitis A, which is commonly seen worldwide, continues to be an important public health problem, especially in developing countries. This study is aimed to evaluate person, place and time characteristics of reports on Hepatitis A that presented at National Public Health Congresses organized between 1988-2018.
METHODS: This descriptive study is conducted between March 1-May 1 2019. Sample size of the study is not calculated and is aimed to reach the entire study group. It is planned that the reports books presented at the 20 congresses, the first of which took place in 1988 and the final one took place in 2018, would be evaluated. However, neither the electronic nor printed copies of the fifth and seventh congresses are available, and could not be included in the study. Study data is collected using a 22-item data collection form. Numerical data are expressed as mean±standard deviation and median (min-max); categorical data are expressed as frequency distributions and percentages.
RESULTS: A total of 31 reports related to Hepatitis A were included in the study. Of the 18 congress reports books, 11 had at least one report related to the subject. Years with the largest number of reports were 2012 (n=5) and 2017 (n=5). The highest number of studies were conducted in Central Anatolia region (n=8) and Aegean region (n=6). The median number of authors of the studies was 4.00 (1.00-12.00). Ten of the studies (32.3%) were in the form of oral presentations, 16 were descriptive (51.6%), 11 were cross-sectional (35.5%), and 4 (12.9%) were other types such as interventional and cohort. Twenty (64.5%) of the studies were conducted on real persons and 11 (35.5%) were based on records.
DISCUSSION AND CONCLUSION: As a result of the study, it is concluded that the number of reports sent to the National Public Health Congresses are insufficient and that many of the reports are of descriptive and cross-sectional type.

INTRODUCTION: Sülfite and derivatives are a major toxic agent that enters the body by inhalation and nutrition especially in developing countries. Sodium metabisulphite (SMB; Na2S2O5), which is a sulfite derivative, is a widely used preservative in food, beverages and medicines, has been reported to exert toxic effects when it is consumed above the daily safe dose. However, the effect of long-term consumption of SMB on heart function remains unknown. In our study, we aimed to determine the effects of chronic SMB administration on cardiomyocyte contraction and ionic currents.
METHODS: For this purpose, 3-month-old male rats were used and divided into two groups: control (KON) and SMB. SMB (100 mg / kg / day) was administered for 6 weeks by gavage. Cell isolation was performed by Langendorff apparatus. Cannulated hearts were perfused for 3–5 min to remove the remaining blood with Ca2+-free solution and this was followed by perfusion with the Tyrode’s solution containing 1 mg/ml collagenase for 20–25 min. All recordings were taken from freshly isolated left ventricular myocytes of a rat heart. The contraction and relaxation kinetics of cardiomyocytes were evaluated by recording the change in sarcomere length under field stimulation. Myocyte shortening, action potential (AP), potassium currents and L-type Ca2+ currents (ICa,L) were recorded. via voltage clamp technique.
RESULTS: : Chronic SMB administration caused a significant decrease in the contraction of myocytes along with prolongation in the repolarization phase of AP and decrease in the amplitude but no change was observed in the contraction kinetics. However the resting membrane potential shifted to more positive values. Chronic SMB application significantly reduced the transient outward potassium currents of ventricular myocytes, but did not affect the tail currents and inward rectifier potassium currents. In addition, SMB did not change the density of ICaL althoug it elicited a shift to more positive potentials in the activation curve.
DISCUSSION AND CONCLUSION: According to the results obtained in our study and considering that its daily consumption can reach toxic doses, it has been shown that SMB can cause abnormal changes in cardiac functions by modulating voltage-sensitive ionic currents in the heart. Molecular mechanisms of SMB-induced negative inotropic effect may contribute to the pathogenesis of SMB-associated cardiovascular diseases.

Turkey is in a risky position in terms of tick types and tick-borne diseases. Ticks can be vectors of many infectious agents such as bacteria, viruses, and parasites. Rickettsiosis is a zoonotic disease transmitted by ticks, lice, fleas, and mites. It is characterized by fever, rash, eschar at the bite site (tache noire). Since the clinical picture and laboratory findings are nonspecific, they can be confused with other tick-borne diseases. Epidemiological history should be questioned well in cases with fever and rash in spring and summer months when ticks are active. In this article, a forty-six-year-old male patient whose complaints started after tick bite and who was hospitalized with the pre-diagnosis of Crimean-Congo Hemorrhagic Fever was presented. His complaints were high fever, headache, and arthralgia. A lesion compatible with "tache noire" was detected in the tick bite place, and maculopapular rash developed on the body in the late period. With his detailed epidemiological history, it was learned that he was in an endemic area during tick exposure. Rickettsia conorii seropositivity was detected in the case. He has been successfully treated with doxycycline therapy.

Scorpions are arthropods covered with a thick layer of chitin, whose adult individuals have a length of 11,5-220 mm. Due to their venomous sting and predation nature, humans usually fear them. In scorpion envenomation, it is necessary to apply antivenom especially for patients with severe symptoms. Turkey is a suitable country for scorpion life in terms of climate. Today, in World, there are 2512 species of scorpions in 21 families and 195 genera. When it considered the increase in recent years in Turkey, some authories report that the number of scorpion species will increase and reach up to 50. Although most venomous scorpion species known in Turkey is Leirus abdullahbayrami, scorpion antivenom is produced from Androctonus crassicauda. The studies show that the antivenom from A.crassicauda in Turkey has been produced in a continuous manner since 1942 and more effected than other antivenoms. A.crassicauda, which is shown as one of the 5 most poisonous scorpions in the world, is about 90 to 100 mm in length, in dark brown or black color, its claws are very chunky and its tail is very curved. It is one of the most important species of medical terms in Turkey. A. crassicauda was found more in the region of Southeastern Anatolia in Turkey, but less Eastern Anatolia. It is stated that the responsible scorpion is A.crassicauda in the majority of patients who admitted to the hospital especially with complaints of scorpion stings in the Southeastern Anatolia region. Scorpion sting events being mostly during the summer period and is still continues to be a major problem both in Turkey and the world's other countries. The scorpion antivenom produced from A.crassicauda has taken its place as the national monograph of the Turkish Pharmacopoeia, which was prepared for the first time after many years. This abstract provides detailed information on the history of antivenom preparations in Turkey, starting from the foundation of the Republic of Turkey up until the present day.