INTRODUCTION: Leishmaniasis is a disease, caused by intracellular protozoan parasites, commonly seen all over the world and in the Mediterranean region. This study aimed to determine retrospectively the epidemiological properties of Cutaneous Leishmaniasis cases which were diagnosed and treated. Pinpointing areas of endemic and epidemiological characteristics of the patients were asked to contribute to the newly formed health policy.
METHODS: The data from The Cutaneous Leishmaniasis cases which were diagnosed and notified to the state hospital, university hospital and public health directorate, between 2010 and 2015 were analysed and categorized (376 cases) according age group, sex, occupation, diagnosis of the month, incidence, health care organization and district.
RESULTS: 376 Cutaneous Leishmaniasis cases were notified and 176 patients (%46.8) were male, 200 (%53.2) were female. The highest rate was between 0 and 9 years with 143 cases (%38.1). Then housewives and retired group were 74 (%19.7) cases.The most cases were reported in February, March (129 cases), and the least in September (9 cases). When analysed by district, the highest number of cases was Mut district 222 cases (%59) then Tarsus with 92 (%24.5). According to the regions, the highest incidence of KL is Mut, Bozyazı and Tarsus. 213 cases was the highest amount at the government hospital and least üniversity hospital.
DISCUSSION AND CONCLUSION: The majority of cases were detected in Mut and at an increasing rate in Tarsus. Therefore fortheseregions, it has been determined thati dentification of health screening, public health, education and vector control work is to be doneregularly throught the year.

INTRODUCTION: Patients with end-stage renal disease (ESRD) are more susceptible to adverse events and even deaths from infectious diseases than normal populations. Infection is an important cause of mortality among hemodialysis patients. Most of these deaths are diseases that can be protected by vaccination. Vaccination rates in dialysis patients are still not at the desired level. In a training and research hospital, we performed a questionnaire study to investigate the vaccination status with routine vaccines in ESRD patients receiving hemodialysis treatment and to determine the causes of low rates if any. Our aim was to increase awareness of vaccination.
METHODS: This study was performed among patients who have received hemodialysis treatment in education and research hospital. The questionnaire forms have been prepared for the purpose of determining the information and opinions of the patients about vaccines and vaccination. Data were analyzed using SPSS 16 Windows. The data are summarized in the form of frequencies and percentages.
RESULTS: The questionnaire was performed to 120 patients during the study period. The mean age of the patients was 52.7 ± 17.3 (17-84) and 69 (57.5%) were female and 51 (42.5%) were male. The numbers of patients who had not vaccinated were 116 (96,7%), 98(81,7%), ninety-eight (81.7%), and 30 (25%) for pneumococcus, influenza, tetanus and hepatitis B, respectively. One hundred and seventeen (97.5%) patients stated that they could be vaccinated in case of doctor's recommendation.
DISCUSSION AND CONCLUSION: As a result of our survey, it was seen that our patients did not have enough knowledge about vaccinations except hepatitis B. Low rates of pneumococcus, diphtheria-tetanus and influenza vaccination was the result of physician indifference. Probably in many dialysis units in our country, pneumococcus, influenza and diphtheria-tetanus vaccinations of patients in chronic dialysis program are ignored. We believe that if hemodialysis physicians improve the knowledge and sensitivity about this issue, immunization rates would be improved.

INTRODUCTION: In this study, it is aimed to evaluate the level of disease knowledge, healthy lifestyle, quality of life and the relationship between of them in type 2 diabetic individuals.
METHODS: The study was conducted with 101 type 2 diabetic individuals who were referred to the Boron Center Family Health Center between June-October 2016. A questionnaire consisting of general characteristics, Healthy Lifestyle Behavior Scale II, Quality of Life Short Form 36, and Knowledge Level of Disease Questionnaire was applied to all individuals who applied to the center at the related dates by face to face. Body weight and height measured accoruding to tehniques and body mass index were calculated.
RESULTS: Out of 32.6% and 60.5% of the individuals were overweight and obese, respectively. The mean HbA1c level of individuals was 8.0±2.1. The mean total cholesterol, HDL and body mass index of females were found higher than males (p<0.05). Physical function, physical role strength, energy and pain averages of SF-36 components were higher in males than females (p<0.05). While more adoption of healthy lifestyle behaviors is related to the increase of quality of life, increase of disease knowledge level is related to healthy lifestyle behaviors such as health responsibility, nutrition, spiritual development and stress management and increase in quality of life (p <0.05).
DISCUSSION AND CONCLUSION: The quality of life of women with diabetes is lower than that of men. Healthy lifestyle behaviors in diabetic individuals are related to quality of life and can affect disease knowledge level, healthy lifestyle behaviors and quality of life. Self-management including healthy lifestyle behaviors is therefore important in terms of ensuring metabolic control and increasing quality of life. Metabolic control parameters such as abdominal obesity, body composition and HbA1c as well as the body mass index need to be studied with a wider multicentral sample size that examines the disease knowledge level, healthy lifestyle behaviors and quality of life interactions in diabetic individuals. In addition, intervention studies may be useful in evaluating the effect of quality of life on individuals with type 2 diabetes by providing training to improve disease knowledge and self-management skills.

INTRODUCTION: Obesity is the most important public health problem of the 21st century. The prevalence of obesity in the community has led people to search for weight loss. In addition to lifestyle changes such as increasing physical activity, eating behavior changes, different body weight protection methods are developed and many of these methods are offered under the name of weight loss products. The aim of this study is to determine the herbal product use approaches for weight loss in women and to determine the factors affecting the use of herbal products.
METHODS: This descriptive study was conducted on women aged 18-65, who live in Denizli province, who attend the sports courses twice a week. The research was carried out with 612 participants. The questionnaire was applied to individuals through face-to-face interviews.

RESULTS: Approximately half of women use herbal products (41.3%) and a great majority of the participants (70.4%) do not mention their products to their doctors or pharmacists. More than a half of the participants use of herbal products in the forms of tea 62.8%. Most of the participants (54.5%) buy such products from herbalists. It has been detected that 50.6% of the participants use herbal products everyday. Less than a half of them (35.2%) state that they get the necessary information and usage method from their neighbours and relatives. 26.3% of the participants have nausea-vomiting. 79.4% of the females advise the herbal products they use themselves to others. A great majority of them are married and have graduated from university. Top 5 dry herbs are cinnamon (12.6%), flax seed (11.5%), oat (11.2%), black sesame (10.6%) and black pepper (8.5%). Garlic (24.6%), lemon (22.9%), parsley (11.5%), tomato (8.3%) and mint (7.8%) are mostly used as fresh herbs. Green tea (20.5%), sage (7.1%), linden (6.9%), cherry stalk (6.1%) and rosemary (5.2%) are preferred as herbal tees. Lemon (39.4%), cabbage (17.0%), onion (12.8%), garlic (11.7%) and tomato (4.3%) are used as herbal juice. Top 6 popular imported herbal drogs are herbalife (39.0%), green coffee (11.4%), pepper pill (10.5%), apple chromium (9.5%), golden berry (5.7%) and chocolate slim (5.7%).


DISCUSSION AND CONCLUSION: There are still deficiencies in supporting the effectiveness of the use of these products which are sold on various platforms. These products can lead to many side effects which can lead to death. In addition to the necessary regulations on herbal products, toxicological examinations and evidence-based data should be evaluated.

INTRODUCTION: Acute gastroenteritis is an important cause of mortality and morbidity, especially in pediatric patients. Furthermore, it is a public health problem that increases health spending in the economic. Rotavirus and adenovirus-induced gastroenteritis is one of the most common causes of severe diarrhe a world wide in young children. In this study, it was aimed to determine the distribution of adenovirus and rotavirus frequency according to sex, age and season in acute gastroenterit is patients who applied toour hospital.
METHODS: Stool sample swith suspected acute gastroenteritis, sent from different clinics and policlinics to Elazığ University of Health Sciences Education and Research Hospital Medical Microbiology laboratory between the dates of 1 December 2015 and 30 November 2017 were investigated.The results of the rotavirus and adenovirus antigen test stool specimens were analyzed retrospectively. A qualitative immunochromotographic combo fast cassette test (ACRO BİOTECH, U.S.A) kit was used for the rotavirus and adenovirus antigen test.
RESULTS: Of the 6618 samples were positive 631 (9.5%) for rotavirus and 170 (2.6) for adenovirus.When adenovirus and rotavirus positivity rates were examined, it was seen that there was no difference according to sex. Rotavirus was detected more frequently in the winter season and adenovirus was detected more in the summer. When the distribution of viral antigen positivity rate saccording to age groups is examined; the highest positivity rate in our study was found in rotavirus 12,9% at between 0-12 months, 11.1% at between13-24 months, and adenovirus 3.7% at the interval of 0-12 months.
DISCUSSION AND CONCLUSION: Rotavirus infection, which is usually responsible for acute diarrhea, is increasing in winter and adenovirus is increasing in summer. We also observed that rotavirus infection was the most common in winter and adenovirus infection was in summer.Inpresent study, the incidence of rotavirus and adenovirus infections was also highest in patients under three years of age.In addition, more patients were admitted toour hospital in 2017 than in 2016. When we consider the acute gastroenteritis frequency, which are cause of adenovirus and rotavirus for our region, it is important to be diagnosed quickly in terms of prevent the complications and unnecessary use of antibiotics

INTRODUCTION: Viral pathogens are the most common cause of acute gastroenteritis in developed and developing countries. The objective of this study was to determine the prevalence of rotavirus and enteric adenovirus, and to investigate age, sex, and seasonal-related distribution in patients with acute gastroenteritis, retrospectively
METHODS: A total of 2885 stool specimens obtained from patients with acute gastroenteritis, admitted to our hospital between January 2012 and December 2017 were included in the study. The presence of rotavirus and enteric adenovirus antigen in the stool samples were investigated by qualitative immunochromatographic method (ABON Biopharm Rota/Adeno, China).
RESULTS: In this study, rotavirus and/or adenovirus antigens were detected in 610 (21.1%) out of 2885 patient specimens. Rotavirus antigen positivity was found between 10.5-28.5%, adenovirus antigen positivity was 6.1-29%, and both rotavirus and adenovirus antigen positivity was detected between 3.5-64.9%. Viral antigens positivity was detected as 47.4% in female patients and 52.6% in male patients.There was no statistically significant difference between viral antigen positivity and gender (p=0.406).Rotavirus and adenovirus positivity rates were found most commonly in the 13-24 months age group (p <0.001).The rate of rotavirus antigen positivity in winter months (p<0.05) and enteric adenovirus antigen positivity in autumn (p <0.0001) was found to be statistically significant.When the frequency of rotavirus and adenovirus was evaluated according to the seasons; Rotavirus positivity was the highest in winter season (p<0.05).Adenovirus positivity was the highest in autumn but this rate was found to be statistically significant compared to only spring season (p<0.0001).
DISCUSSION AND CONCLUSION: The results of this study indicated that in our region, rotavirus and adenovirus have an important frequent cause of acute gastroenteritis, especially in childhood. Routine detection of viral agents, especially rotaviruses, by rapid immunochromographic tests in patients with acute gastroenteritis, especially during autumn and winter will ensure early diagnosis and prevent inappropriate use of antibiotics. In addition, vaccination for rotavirus gastroenteritis should be considered in neonates.

INTRODUCTION: Individuals living in rural areas can build water tanks to meet their water needs. Sometimes he / she uses these tanks for himself / herself and sometimes with several families. The study aimed to define the conditions of use and quality of domestic water tanks that are used individually or jointly by people living in rural areas in Trabzon.
METHODS: The study type is descriptive and data were collected in 10 provinces of Trabzon between April 16 - June 4, 2015. First of all, the aim of study was explained to the individuals who applied to the Family Health Centers / Community Health Centers in the selected provinces on these dates. Then, research data were collected with face-to-face questionnaire application method with people who uses domestic water tank which is not connected to the city network. A total of 282 domestic water tank users have been reached.
RESULTS: According to the participants, 95.7% of the water coming to the water tanks was spring water. 96.8% of water tank users use their tanks every day. 82.6% of tanks are on the soil / in the garden, 84.8% of them were plastered concrete tanks, 87.9% of them were covered and 62.1% of them hadair shaft. Water in 18.1% of the tanks were always chlorinated. Regarding the analysis of the suitability of water for drinking and use; 41.1% were analyzed anytime before data collection, and 24.1% of the analyzed ones had abnormal results. 46.4% of the users continued to use the water tank even though there was detected abnormality in the analysis. Regarding the cleaning of the water tanks; 4.3% of the tanks had never been cleaned and 76.7% of the cleaned tanks were mechanically cleaned. 77.3% of the participants stated that infectious diseases, 66.3% outbreaks and 34.0% chronic diseases would occur when water tanks were not cleaned. 14.9% of the participants think that there is no harm in not cleaning the water tanks.
DISCUSSION AND CONCLUSION: In the study, it was found that domestic water tanks that were used individually or jointly by people living in rural areas were uncontrolled and unrestrained.

INTRODUCTION: Identification of vector species and determination of physical and ecological features of their breeding places is essential in implementation of scientific based mosquito control activities. In this study, it is aimed to identify Anopheles species by morphological method and determination of physical and ecological characteristics of their breeding places in Şanlıurfa territory.
METHODS: Mosquito larvae were collected between September 29 and October 03, 2009 from determined 9 breeding places in Birecik, Eyyübiye, Haliliye, Harran, Siverek and Viransehir districts of Şanlıurfa province where malaria cases had been reported and four instar larvae were identified morphologically according to keys of DuBose ve Curtin (1965), Merdivenci (1984) and Darsie and Samanidou-Vojadjoglou (1997).
Essential ecological parameters of water in breeding places were measured. Temperature and dissolved oxygen were measured by using ExStik® DO600 (Extech Instruments-USA); pH and conductivity were measured by using Hanna Instruments 98129 pH / Conductivity /TDS Tester (Hanna Instruments-Germany) and salinity was measured using ExStik®II EC400 Conductivity/TDS / Salinity/Temperature Meter (Extech Instruments-USA).
RESULTS: Of the 274 four instar larvae collected, 231 (%84,3) were identified as An. sacharovi and 41 (%14,96) of them were identified as An. superpictus. Two (0,73%) samples identified as Anopheles genus, species discrimination could not be done. In %88,89 (n=8) of nine breeding places An. sacharovi and in %11,11 (n=1) of total breeding places An. superpictus found to be dominant species according to the morphological results. Malaria vector An. sacharovi detected in all breeding places which had different pH values, dissolved oxygen proportions, electrical conductivity, water temperature and salinity proportions with horizontal vegetation. The limits of tolerance for essential ecological parameters of species found to be as: pH – 7,77-9,18 (mean 8,53); electrical conductivity – 310-1100 (µS/cm) (mean 496,91); dissolved oxygen (mg/l) – 1,64-13,06 (mean 9,67); temperature of water – 20,3-25,8 °C (mean 23,46); salinity 0,15-0,55 ppt (mean 0,24). The limits of tolerance for essential ecological parameters of An. superpictus species in study area measured as: pH 8,48; electrical conductivity 710 µS/cm; dissolved oxygen 8,91 mg/l; temperature of water 25,8 °C; salinity 0,35. In statistical analysis of physical and ecological characteristics of mosquito breeding places; no significant dif¬ference between pH values (p=0,189) was found between An. sacharovi and An. superpictus breeding places but significant dif¬ference have been found in water temperature (p= 0,0000001), electrical conductivity (p= 0,0000001), salinity (p= 0,0000001) and dissolved oxygen (p= 0,001) values.
DISCUSSION AND CONCLUSION: An. sacharovi is thought to be considered to be primary malaria vector in Şanlıurfa Province as it can become the dominant species in malaria endemic areas and also in areas where transmission reoccur due to its ecological flexibility. In this context, vector control strategies in Şanlıurfa should be revised and planning should be done according to the characteristics of the vector.

INTRODUCTION: Meta-analysis by PRISMA guidelines was performed. We performed a systematic search of published studies in national and international databases from 1990 to 2019. Of the remaining 440 Articles, only 26 studies were included in this meta-analysis. The Cochrane Q statistic was calculated to assess the heterogeneity of results in studies. Heterogeneity among studies was evaluated using the I2 statistics. The effect size was estimated by reported with its 95% confidence interval
METHODS: : Meta-analysis by PRISMA guidelines was performed. We performed a systematic search of published studies in national and international databases from 1990 to 2019. Of the remaining 440 Articles, only 26 studies were included in this meta-analysis. The Cochrane Q statistic was calculated to assess the heterogeneity of results in studies. Heterogeneity among studies was evaluated using the I2 statistics. The effect size was estimated by reported with its 95% confidence interval
RESULTS: Based on the 26 selected articles, the pooled prevalence of Staphylococcus aureus and MRSA was 24,0 % [95% confidence interval (CI): 0,19-0,29] and 16,0 % (95% CI: 0,12-0.21), respectively. Heterogeneity between studies (I² = 95,62, p=0.000 for Staphylococcus aureus and I² = 81,10 p =0.000 for MRSA) was found, so a random-effects model was used for the meta-analysis. This study is registered in the PROSPERO database (ID= CRD42018117306)
DISCUSSION AND CONCLUSION: Hospital infections are a significant problem for our country as it is all over the World. Healthcare workers may act as reservoirs for the spread of MRSA to patients and other healthcare workers. The most critical step in preventing hospital infection from hospital staff is training in hospital infection and hygiene. Cost-effective health policies should be developed in Turkey for the control and Prevention of hospital infections and resistant microorganisms.

INTRODUCTION: Exercise important tool to regulate body energy metabolic system activity by increasing mechanical activity or hormonal effects. In this study, we aimed to examine effects of aerobic exercise on levels of irisin, which increases energy expenditure and nesfatin-1, which suppress energy intake and their connection with CK, which reflects increased muscle injury.
METHODS: Total of 30 healthy sedentary male preformed 30 min of aerobic running exercise work intensity associated with their anaerobic threshold. Blood samples were taken before and after exercise. Serum irisin nesfatin-1 and creatine kinase (CK) were analysed.
RESULTS: During exercise serum irisin and CK levels increased in all subjects (16.4% and 25.7%, respectively). Despite the mean values increased statistically significant, nesfatin-1 levels did not increased in all subjects (12.1%). There was a positive statistically significant correlation between increase of irisin and CK levels.
DISCUSSION AND CONCLUSION: Consequently, exercise induced skeletal muscle activity may cause increase in CK and irisin levels. Nesfatin-1 hormones may not seem to be exercise-induced hormone and did not correlate with increased muscle activity. Moderate intensity aerobic exercise may provide beneficial effects on body energy regulatory systems by altering metabolic hormones.

INTRODUCTION: COVID-19, a novel virus with no treatment and medical intervention strategy other than supportive treatment, necessitated prevention and containment measures. Quarantines, lock-downs, school closures and many other types of interventions converged as cases and the number of deaths has increased. Causality and linkage between measures and their effects have become a concern. This study aims to compare the country policies (Italy, Spain, France, United Kingdom, Germany and Turkey) in terms of stringency levels and the dates interventions put into effect for containment of the pandemic and explore its effects on numbers of cases and deaths.
METHODS: The Government Response Stringency Index (GRSI), which is created to measure stringency of government measures against COVID-19 was used for the comparisons. In order to compare countries’ policies and their effects on case and death statistics, we initially aggregated the stringency data of countries and compiled them with logistic numbers of cases and deaths. Additionally, variation between country responses could be more apparent by decomposing the total stringency score to individual policy components.
RESULTS: Number of cases and deaths, intervention stringency levels and components of policies were compared. The number of cases per million population was higher than other countries for Spain and Italy despite their more stringent measures. Turkey had the least cases per million value with relatively less stringent policies. The number of deaths per million population and stringency levels was higher for French, Italy, and Spain. Turkey and Germany seem to control at least the number of deaths with less stringent measures. United Kingdom had the least stringent scores but a considerable number of deaths. After close investigation of countries’ stringency patterns with first case dates, it can be observed that Turkey is diverse from any other country, having taken action for any type of intervention before or concurrent with the first case, as the other countries had taken the measures weeks after their first cases.
DISCUSSION AND CONCLUSION: Inconsistency of perspective towards the outbreak and delay for implementation led European countries to take strict precautions against Covid-19 for longer period of time for the next phases of intervention. Turkey took action earlier than other nations before the number of cases increased, and reached less number of cases and deaths with less stringent measures. Comparison between intervention stringency levels and policy enforcement rapidity of selected countries highlighted the importance of implementation of measures on time.

Hafnia alvei is a gram-negative bacillus found in human gastrointestinal flora. It was first described in 1954. It is known that this microorganism, which may be a community-acquired or health care-associated infection agent, cause only one epidemic to date. In addition to, the number of cases with death is quite low. In this study, we present a case of community-acquired urinary tract infection caused by Hafnia alvei in a 71-year-old male patient with diabetes mellitus, hypertension and cerebrovascular diseases. The patient was treated with ciprofloxacin (seven days). Hafnia alvei can be treated with aminoglycosides, quinolone antibiotics and 3rd generation cephalosporins. In order to protect against these microorganisms which are rarely infectious agents, community and health professionals need to be informed and raised awareness. The development of various strategies for this may prevent infections. Therefore, internal medicine, infection control and public health nurses and other health professionals are recommended to work multidisciplinary.

All over the world, tuberculosis (TB) is one of the most common 10 diseases that affect millions of people and result in death. Nowadays, there has been a significant decrease in mortality rates due to the improvement in TB diagnosis and effective treatment methods. However, TB is still a public health problem that remains important.. TB is still among the most common non-obstetric causes of maternal mortality in the developing countries. Genital tuberculosis (GTB) is considered to be one of the important causes of infertility, pelvic pain, chronic pelvic inflammatory disease, dyspareunia and abnormal uterine bleeding. Therefore, negative consequences of GTB can be prevented or minimized by early diagnosis, appropriate and effective treatment.
GTB often develops secondary to pulmonary TB or extrapulmonary TB foci in the kidneys, meninges, skeletal system and gastrointestinal system. The TB bacillus infects the genital system in 4 ways: 1- Hematogenous spread, 2-Lymphatic spread, 3- Descending direct spread, 4- Primary infection of the genitalia with sexual intercourse. In addition, the disease can be spread by the peritoneal dialysis in renal failure. The genital organs affected by GTB, in the order of frequency are; Fallopian tubes (90-100%), uterine endometrium (50-60%), cervix (5-15%), uterine myometrium (2-5%), vulva and vagina (1-2%).
TB causes infertility by causing tubal damage and impaired endometrial receptivity in the genital tract. Endometrial damage resulting in intrauterine adhesions, menstrual abnormalities and impaired endometrial receptivity increases recurrent pregnancy losses and ectopic pregnancy risks. In addition, GTB should not be ignored for the differential diagnosis of pelvic masses. The most realistic treatment approach for the infertile patients with GTD is to direct the patients to the assisted reproductive techniques after evaluation of the endometrium. However, it should be kept in mind that pregnancy outcomes are not very successful with assisted reproductive techniques.
Appropriate screening procedures for high-risk populations are extremely crucial for the prevention of gynecological, obstetric and reproductive adverse outcomes, and TB eradication. Recently, immigration rate has been increasing rapidly in Turkey, as all over the world. Therefore, TB, which is seen as a forgotten disease today, should be kept in mind in our gynecological and obstetric practice.