INTRODUCTION: COVID-19 turned into a pandemic in a short time. Healthcare workers are at risk of infection due to their contact with both patients and the society. The aim of this study is to examine the demographic structures of a hospital’s employees diagnosed with COVID-19, to examine the use of antiviral treatment and the factors affecting it, and to compare the case number curves of the hospital and the province.

METHODS: Healthcare workers who had been infected with the COVID-19 virus between 01.06.2020 and 28.02.2021 were included in the study. It is a cross-sectional, retrospective study. The patients were evaluated demographically and epidemiologically, and compliance treatment was examined in healthcare professionals who recommended antiviral drugs.
RESULTS: 390 (56.3%) of the 693 healthcare workers were males. Mean age of the patients was 33,54±9,41. 140 (20.2%) of them had chronic diseases. 173 (25%) were cigarette smokers. 161 (23.2%) individuals stated the source of infection as hospital. 509 (73.4%) had symptoms at the time of diagnosis while symptoms occurred later in 116 (16.7%). The most commonly observed symptoms included fatigue (48%), myalgia (47.5%) and headaches (46.9%). Of 693 patients, 164 (23.7%) did not use antiviral treatment. The distribution of the number of cases by months was similar when examined on the basis of hospitals and provinces. In the logistic regression analysis, those with symptoms at the time of diagnosis used antiviral treatment 1.779 times and those with chronic diseases 1.804 times more.
DISCUSSION AND CONCLUSION: The similarity of the case distribution in the society and among healthcare workers supports the effect of the use of personal protection equipment. In our study, it was observed that healthcare workers with risk factors for severe COVID-19 had higher adherence to antiviral treatment. Along with the vaccination activities and mutations, the clinical course and prognosis of the COVID-19 might change in time. Therefore, surveillance data should be collected from healthcare workers and evaluations should be made through interim analyses. Information about antiviral treatments should be given.

INTRODUCTION: Since the resumption of face-to-face education in October 2020, which was suspended due to the COVID-19 pandemic, coincides with the period when SARS-CoV-2 infection rates in young adults are on the rise. This study focuses on the 2019 corona virus outbreak in young adults, the largest link in the chain of transmission, which can be defined as silent contagious agents. It is aimed to provide epidemiological data by detecting virus disease (COVID-19) seropositivity with two different serological methods, and to evaluate the symptom-test performance relationship of asymptomatic/mild symptom/symptomatic cases.
METHODS: A cross-sectional study was conducted with students studying at Cappadocia University health programs between December 2020 and February 2021 and who will attend practice courses face-to-face. Participants were surveyed about their COVID-19 symptoms and disease histories based on SARS-CoV-2 exposure. For SARS-CoV-2 antibody detection, blood samples were taken from the participants and investigated with a single lateral flow immunoAssay (LFIA, Novatech, Turkey) cassette test. The samples with positive test result were then SARS-CoV-2 Anti-N IgM+IgG; SARS-CoV-2 Anti-S IgM+IgG; SARS-CoV-2 Anti-RBD IgG; It was re-evaluated using the electrochemiluminescence immunoassay (ECLIA) method with the anti-SARS-CoV-2 kit (Roche, Germany).
RESULTS: Of the 239 samples participating in the study, 50 (20.9%) samples that were positive for SARS-CoV2 IgM/IgG according to the LFIA method were then studied again with the ECLIA method. According to the ECLIA result, 72% (36/50) of individuals against both nucleocapsid (N) and spike (S) antigens, and 70% (35) against RBD antigen were seropositive. Based on the ECLIA test results, 239 samples were studied and 50 samples were found to be IgM/IgG positive, with a sensitivity of 64% and a specificity of 93%. Contingence history was reported in 46% (n=23) of patients who were seropositive by both methods, while 30% (n=15) showed a COVID-19 clinic. Fifty four percent (n=27) of the participants reported that they did not have a PCR (polymerase chain reaction) test, but antibody response was observed in all of them. Only 28% (n=14) of seropositive patients reported positive PCR results, and 4% of them stated that they had a chronic disease. It will be important to continue to observe the serological status of young people, particularly in the context of new COVID-19 variants and in the low interest in mass vaccination campaigns targeting young people.
DISCUSSION AND CONCLUSION: It is thought that the performance of ECLIA with rapid casette test does not have a good degree of agreement and confirmation with different immunoassay tests would be more useful for epidemiological surveillance. Especially the new COVİD-19 in the context of the variants and targeting youth due to the lack of interest in vaccination champaigns continue to monitor the serological status of young people it will be important.

INTRODUCTION: Escherichia coli (E. coli) is the most common pathogen of bacterial infections worldwide and is responsible for 80% of urinary tract infections (UTIs). In recent years, resistance to antimicrobials used in the treatment of infections caused by E. coli has been increasing all over the world, and it is necessary to constantly monitor resistance rates and update empirical treatment recommendations in order to prevent treatment failure and increase in treatment costs.
METHODS: In this study, antimicrobial resistance rates of E. coli strains grown in urine culture samples sent from all polyclinics to Malatya Training and Research Hospital Microbiology laboratory between 2015-2019 were retrospectively investigated. Conventional methods and Vitek 2 Compact automated system (BioMérieux, France) were used for the identification of bacteria in plaques with significant growth and for antimicrobial susceptibility testing (AST). AST results were determined as sensitive and resistant according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines.

RESULTS: It was detected significant growth in 14.8% (22636/153006) of urine cultures of outpatients over a five-year period, and identification and ASTs were studied. E. coli constituted 68.3% (15475/22636) of the identified factors. The antimicrobial drugs with the highest resistance rates were ampicillin (65.2%), amoxicillin/clavulanate (38.5%), trimethoprim/sulfamethoxazole (36.3%), cephalexin (35%) and cefuroxime (31.3%) respectively. The least resistance rates were found against carbapenems (0.6-2.1%), fosfomycin (3.6%), nitrofurantoin (5.8%) and amikacin (7.5%), respectively. Quinolone resistance rates were found to be 16.7% for levofloxacin, 19.1% for ciprofloxacin and 21.9% for norfloxacin.

DISCUSSION AND CONCLUSION: In the guideline of the Infectious Diseases Society of America (IDSA), trimethoprim/sulfamethoxazole is recommended as the first choice in the treatment of UTI, and quinolones are recommended as an alternative. In addition, international treatment guidelines do not recommend the use of antimicrobials with resistance rates higher than 20% in the empirical treatment of uncomplicated lower UTIs. In our study, the resistance rates of levofloxacin, ciprofloxacin and norfloxacin were close to each other and seemed appropriate for empirical treatment, but the rate of trimethoprim/sulfamethoxazole resistance was high (36.3%). It is thought think that ampicillin, amoxicillin, amoxicillin/clavulanate, trimethoprim/sulfamethoxazole and cephalosporins with high resistance rates are not suitable for empirical treatment, with an ESBL (extended spectrum ß-lactamase) rate of 26.1% in E. coli isolates isolated from community-acquired patient urine samples over a five-year period. Based on the results of our study, it is thought that fosfomycin is the first drug of choice for empirical treatment in outpatients with its advantage of single-dose oral use, high patient compliance and low side-effect profile, and nitrofurantoin is an alternative especially in the empirical treatment of non-complicated UTIs.

INTRODUCTION: In this study, applicability of an in-vitro ELISA method, which reduces or eliminates the need for animal trials in establishing the efficacy of inactive Newcastle disease vaccines was investigated.
METHODS: For this purpose, the efficacy of nine (9) inactivated Newcastle disease vaccines and two non-Newcastle related vaccines (negative controls) were evaluated by in-vivo and in-vitro methods. As in-vivo tests, vaccines were applied to the Spesific Pathogen Free (SPF) chicks and antibody response was determined via hemagglutination inhibiton test. As in-vitro, antigen amount in vaccines were calculated with a sandwich ELISA test based on the determination of hemagglutinin and neuraminidase levels developed for inactive Newcastle vaccines. Relative potency values of vaccines were calculated by using the parallel line analysis method with Combistats statistical analysis software program by using optical density results obtained from ELISA test.
RESULTS: Hemagglutination inhibition test results were found to be between 23,3 and 26,1; immunization/challenge results ranged between 56 and 136 PD50 and ELISA test results were between 6,02 and 98,23 antigen units. A correlation was found between the ELISA test and in-vivo methods. Sensitivity and specificity were found to be %89, %100 respectively.
DISCUSSION AND CONCLUSION: In our study according to these results, we have demonstrated the ability of ELISA method to give similar results on the same samples, its compatibility with the standard procedure and its applicability under laboratory conditions.

INTRODUCTION: Vitamin D is a steroid hormone, about 80-90% of which is produced by the skin. On the other hand, its deficiency is very common and its treatment is of great importance due to its multisystem effects. In addition to factors affecting vitamin D levels such as skin color, sunscreen used, geographical location, and obesity, there are also studies related to the effect of skin thickness. It was aimed to determine the effect of skin thickness and subcutaneous adipose tissue measurements on vitamin D results in the areas where there is the most contact with the sunlight in our body, in the study.
METHODS: A total of 116 (71 female, 45 male) volunteers were included in the study. The results of vitamin D in the last month, demographic data, height, and weight were recorded. Skin thickness and subcutaneous adipose tissue measurements performed by ultrasound were recorded from the forehead, cheek, hand dorsum, umbilicus, and trochanter major regions.
RESULTS: The exposure time to the sun (r=0.637, p<0.001), the statistically significant difference between the results of the trochanter major subcutaneous adipose tissue (r=0.347, p<0.001) and subcutaneous adipose tissue of the umbilical region (r= 0.022, p=0.020), hand dorsum skin thickness (r= 0.242, p=0.010) and vitamin D level (p<0.05). Statistically, a significant difference was found between the umbilicus skin thickness and vitamin D level (r=0.087, p<0.001).
DISCUSSION AND CONCLUSION: The question of “whether vitamin D deficiency is pandemic?” is sought worldwide, and the reasons for deficiency are still being studied. The literature on skin thickness has a limited number of studies evaluated by objective data. In particular, the thickness of the hand dorsum skin, and the effect of regional obesity on vitamin D in our study, which reveals the importance of exposure time to sunlight, are remarkable. However, to demonstrate the effects of skin thickness, many areas of our body need to be evaluated.

INTRODUCTION: Despite the rapidly developing diagnosis and treatment strategies in recent years, breast cancer is the most common type of cancer in women and is the cause of cancer-related death. Embelin is a potent XIAP inhibitor and a compound with antiestrogenic effects. In our study, we aimed to investigate the antitumoral activities of Embelin, which shows its effects through different cellular pathways, in two different human breast cancer cell lines, hormone receptor negative (MDA-MB-231) and positive (MCF-7) and we compared the effects of Embelin with tamoxifen and docetaxel, which are currently widely used in the treatment of breast cancer.
METHODS: To demonstrate the effects of Embelin at the cellular level, cytotoxicity analyzes and IC50 calculations were performed with a real-time cell electronic detection system (xCELLigence). For all subsequent studies, cells were treated with the IC50 dose of Embelin which determined in cytotoxicity assays and histopathological and immunohistochemical (Ki-67, Bax, Bcl-2, Cyclin D1) analyzes were performed.
RESULTS: As a result of cell cytotoxicity analyzes, it was observed that Embelin had an antiproliferative effect in both cancer cell types in a dose and time dependent manner. IC50 values were calculated as 63 µM for MCF-7 and 64 µM for MDA-MB-231 from the proliferation curve graphs of Embelin exposed cells. As a result of the examination of the preparations stained with Hematoksylin-Eosin (H&E) and Ki-67, it was found that the cell number and Ki-67 proliferation index decreased (p<0.05) in cancer cells treated with Embelin. In order to analyze the effects of Embelin on the cell cycle, when we examined the preparations stained with Cyclin D1, it was observed that embelin decreased the Cyclin D1 levels required for the S1 phase of the cell cycle (p<0.05). In order to see the effect of Embelin on apoptotic pathways, preparations stained with proapoptotic Bax and antiapoptotic Bcl-2 were examined. Accordingly, while Bax expression level increased (p<0.05), Bcl-2 expression level decreased (p<0.05).
DISCUSSION AND CONCLUSION: In general, Embelin inhibits cancer cell proliferation in both breast cancer cell types, depending on dose and time. We found that Embelin was statistically more effective at the molecular level when compared to both Tamoxifen and Docetaxel, especially in hormone receptor-negative MDA MB-231 cells. By concluding that it is more effective especially in hormone receptor-negative breast cancer, Embelin may be an alternative new antitumoral agent in the treatment of breast cancer in the future. The results of this study may guide for in vivo studies in future.

INTRODUCTION: The aim of this study is to evaluate the relationship between phenotypic features and ovarian and adrenal steroid hormones in women with polycystic ovary syndrome.
METHODS: Fifty volunteer women aged 18-39 who were diagnosed with PCOS according to Rotterdam criteria, were included in our study. The patients were divided into groups according to their body mass index, whether they had menstrual disorders and whether they had hirsutism. The modified Ferriman Gallway score was used to evaluate hirsutism. Ovarian and adrenal steroid hormones, lipid profiles and levels were studied from plasma samples taken after fasting 8-10 hours at the menstrual cycle day is 2-5. Steroid hormones were analyzed by liquid chromatography sequential mass spectrophotometry (LC-MS / MS) method.
RESULTS: We found that the level of free Testosterone in overweight-obese patients were higher than in normal weight patients and this is statistically significant (p=0.037). Women with menstrual disorders, DHT, androstenedione and total testosterone levels were higher in women with regular menses, and this difference is significant (respectively, p=0.021 p=0.010 p=0.049). Androsterone levels of women diagnosed with PCOS were significantly higher in women without hirsutism than in women with hirsutism (p=0.024).
DISCUSSION AND CONCLUSION: Methods for measuring plasma steroid levels, which is accepted as one of the most sensitive LC-MS/MS method was used in this study, women with PCOS revealed high levels of free testosterone in the group with high body mass index. There was no difference between the androgen levels women with and without hirsutism. The fact that the symptoms of hirsutism in women with PCOS do not have a significant relationship with laboratory findings is due to the fact that clinical hyperandrogenism occurs as a result of the interaction of many factors, such as genetic, enzymatic and receptor level differences, except for plasma androgen levels. The high level of some of the androgen parameters in women with menstrual disorders can be explained by the influence of the hormonal microenvironment on folliculogenesis.

INTRODUCTION: Ficus carica (Fig) is a leafy tree of Moraceae, which is used in local traditional medicine to treat various diseases. Recent studies revealed an impressive anti-cancer efficiency of F. carica extracts in different types of cancer cells. This study aimed to investigate the anti-cancer effects of F. carica extract on colon cancer cell line HT-29 and bone cancer cell line MG-63.
METHODS: The human colon cancer cell line HT-29 and bone cancer cell line MG-63 were used to investigate the effects of F. carica extract. The effects of F. carica on cell viability were evaluated using MTT [3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide] assay. Complementary analyses for evaluating membrane integrity and toxicity were performed by estimating LDH (lactate dehydrogenase) assay. Mechanisms of cell death were analyzed using MuseTM Annexin-V and TUNEL assays. Cell-cycle distribution was examined using flow cytometri analysis.
RESULTS: The results demonstrated that F. carica extract caused a significant decrease in cell viability in cancer cells in a dose-and time-dependent fashion, but not in the healthy cell line. According to MTT analysis, the optimal activity of F. carica in MG-63 and HT-29 cell lines was determined in 48 h at 1: 100 dilution and 24 h at 1: 10 dilution, respectively. In addition, the cell viability did not drop below 50% in the hFOB 1.19 cell line at any dose and time interval, indicating that F. carica was not cytotoxic to normal cells. The LDH activity in culture media showed that F. carica had cytotoxic effects on cancer cell lines. A significant increase in LDH activity in the cultured media through the loss of membrane integrity during apoptosis pathways was observed in cancer cells, whereas the extract did not have a cytotoxic effect in the control cell line. According to HPLC analysis, F. carica used in this study contained 8.17063x10-1 mg/L protocathecuic acid. Cell cycle analysis showed that the F. carica extract did not affect the MG-63 cell line, but caused an arrest at the S phase in HT-29 cells. In TUNEL assay, fluorescent staining was detected in cancer cell lines that underwent apoptosis, while there was no staining in control cells. The Annexin-V and Dead Cell Assay confirmed apoptosis in both cancer cell lines.
DISCUSSION AND CONCLUSION: F. carica was found to have anti-cancer effects on both colon and bone cancer cell lines. While F. carica extract can activate different types of cell death in cancer cell lines, it did not cause any cytotoxic effects on healthy cells. A possible mechanism for the anti-cancer activity of F. carica is through induction of apoptosis as observed in the colon cancer cell line HT-29 and bone cancer cell line MG-63.

INTRODUCTION: Employee sustainable performance is an ideal state of employees to work and be productive throughout their lives. The goal is to meet the future working needs of the organization. In this study, it was aimed to make its validity and reliability of the Employee Sustainable Performance (ESP) scale by adapting it to Turkish.
METHODS: The Employee Sustainable Performance (ESP) Scale developed by Ji et al. was used to reach the data of the study. The original scale has 10 items and one factor. For the validity and reliability analyzes of the study, a total of 316 health workers working in a training and research hospital operating in Ankara were included in the sample. The questionnaire used was applied face to face to health workers. Within the scope of the study, first of all, language validity was ensured. Then, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed for construct validity. Finally, internal consistency test was performed for reliability analysis.
RESULTS: As a result of the analysis, the Turkish language validity of the original scale in English was ensured. Afterwards, Then, EFA was performed and the Kaiser-Meyer-Olkin value was found to be within the normal range with 0.94 and the Barlett Test of Sphericity was significant (X2= 3039.130, df = 45, p<0.05). In addition, according to the results of EFA performed using principal component analysis method, a total of 10 expressions in the ESP scale were grouped under a single factor. This single factor explains 71.81% of the total variance. Then, CFA was performed and it was determined that all of the fit indices were within acceptable limits. Thus, it has been demonstrated that the ESP scale is valid. Finally, Cronbach’s alpha coefficient was calculated as 0.956 for the reliability of the scale, and the scale was found to be highly reliable.
DISCUSSION AND CONCLUSION: Human resources play an important role in determining sustainable strategies in organizations. It can be said that the realization of sustainable performance will be an important factor in increasing the quality and motivation of the employees. In this context, the sustainable performance of the employees will be measured and managed appropriately by using the valid and reliable ESP scale.

INTRODUCTION: Arboviruses are a group of viruses transmitted by arthropods, and are characterized by a wide geographic distribution that causes various infections in humans, both in the enzootic and urban cycles, in environments associated with the presence of vectors. Dengue (DENV), Chikungunya (CHIKV), Zika (ZIKV), yellow fever, and West Nile virus (WNV) infections are increasingly public health problems that spread throughout the world. The best known vectors of these viruses are the invasive vectors of Aedes aegypti and Aedes albopictus. The aim of this study is located in the Black Sea in northeastern Turkey located in established populations of A. aegypti and A. albopictus was to investigate the presence of viruses transmitted by mosquito species.
METHODS: From April to October 2016, it was studied on mosquitoes in the provinces from the western border gate to the province of Ordu and areas with entry points to the inner regions. A total of 267 mosquitoes were collected from 51 different regions of the Black Sea region. All samples were tested for the presence of Dengue, Chikungunya, Zika, and West Nile virus.
RESULTS: A total of 267 mosquito samples, 38 A. aegypti and 229 A. albopictus, were obtained, of which eight were male and 259 were female. No positivity was detected in terms of DENV, CHIKV, ZIKV and WNV in A. aegypti and A. albopictus mosquitoes included in the study. No positivity was found in panflavivirus.
DISCUSSION AND CONCLUSION: The fact that none of the investigated viruses were detected in A. aegypti and A. albopictus mosquitoes is an important data that vectors in this region have not yet encountered DENV, CHIKV, ZIKV and WNV. In our country, where cases of foreign travel related to these viruses are seen, there may be a possibility of autochthonous transmission in case of encountering viruses that will come from outside and existing vectors. For this reason, similar studies should be carried out in other regions and healthy and up-to-date maps should be created in terms of vector and virus tracking. Thus, when the presence of these viruses entering the country is detected, it will be possible to take quick and effective measures.

Mucormycosis is an invasive fungal infection caused by mold fungi of the Mucarales order, which progresses quite rapidly and has a high mortality despite effective treatment. Conditions such as diabetes mellitus, cancer immunotherapy, stem cell transplantation are risk factors for mucormycosis. In this study, we aimed to report a case of rhinocerebral mucormycosis that we followed in our hospital. A 20-year-old female patient with known type 1 diabetes was admitted to the otolaryngology outpatient clinic of our hospital with complaints of sore throat, neck, headache, weakness and numbness on her face.The patient was admitted to the ward due to the presence of bloody nasopharyngeal discharge in the physical examination. The patient, who entered diabetic ketoacidosis on the first day of hospitalization and disorder of consciousness, was admitted to the intensive care unit. In the magnetic resonance (MR) imaging of the patient, fluid signals in the paranasal sinuses and both mastoid cells and areas suggestive of mucormycosis or invasive Aspergillus were observed in the nasopharynx and soft tissues adjacent to the nasopharynx. Acute ischemic lesions were observed in the diffusion MRI of the patient. In the culture of the nasopharyngeal swab, hyphal structures without septa and branching at right angles were seen and it was decided that they were mucareles. In the nasopharyngeal biopsy material taken from the patient, hyphal structures and rhizoid structures were seen pathologically suggestive of mucormycosis. The patient was started on amphotericin B 250 mg treatment. The patient died on the 35th day of her hospitalization, not responding to cardiopulmonary resuscitation. It should be kept in mind that such opportunistic fungal infections can be seen in patients with suppressed immune system such as diabetes mellitus, and it will be difficult to control the infection due to its rapid spread.

Appropriate early treatment is crucial for prognosis in invasive fungal infections (IFIs). Antimicrobial susceptibility has generally an important role for treatment options and clinical outcome. “The European Committee on Antimicrobial Susceptibility Testing (EUCAST)” and “The Clinical and Laboratory Standards Institute (CLSI)” defined standard procedures and recommendations on interpretations of minimum inhibitory concentrations (MICs). However, they do not include epidemiological cut-off values (ECOFFs) and/or clinical breakpoints (CBPs) for every fungi and antifungal agent, so only MIC values can be shared to guide clinicians. Microbiological resistance is determined by interpreting the in vitro MICs with comparison of CBPs. There are many mechanisms that lead to antifungal resistance (AFR). There are increasing trends in fluconazole and echinocandin resistance for yeasts and in triazole resistance for molds. Although clinical reflections of these high MICs are sometimes very obvious, there is insufficient data to show in every fungi. Clinical resistance is the event that an infection does not resolve for various reasons despite appropriate treatment, and can be attributed to many reasons. Thus, every infection caused by susceptible organism is not always successfully treated, every infection caused by resistant organism is not always a failure. The aim of this review is to create an overall perspective to antifungal susceptibility testing and notify current condition of AFR worldwide and in our country. As IFIs show epidemiological changes and become more frequently recognized, studies on the use of antifungals have also increased, while AFR has come to the fore as one of the current problems. With Candida auris, it is clear that it is necessary to put an end to the relative “ignorance of fungi”.