INTRODUCTION: Crimean-Congo hemorrhagic fever (CCHF) develops in one-fifth of the individuals infected with the CCHF virus. The clinical course progresses very rapidly and can result in death within 7-10 days. The aim of this study is to determine whether there is a difference between the PCR-positive period and the IgM-positive period in terms of laboratory findings and to investigate the effect of the difference, if any, on the course of the disease.
METHODS: Results of 5131 serum samples submitted to public health laboratories for the diagnosis of CCHF between January 1, 2015, and December 31, 2017, were included in the study. PCR and IFA IgM test results of these samples and other laboratory findings of the patients were evaluated. Findings were compared between fatal and non-fatal cases.
RESULTS: When laboratory results of the PCR-positive period and IgM-positive period were compared, there was a statistically significant difference in terms of creatinine value, presence of thrombocytopenia (<150,000), platelet count below 20,000, and creatine kinase (CK), lactate dehydrogenase (LDH) and international normalized ratio (INR) levels (p < 0.05). In the PCR-positive period, all of these findings were observed to increase detrimentally for the patient. In fatal cases; Presence of thrombocytopenia, platelet count of ≤20,000/µL, > 2.5 mg / dL creatinine level, and CK, LDH and INR values were found to be significantly higher (p < 0.05).
DISCUSSION AND CONCLUSION: In our study, the PCR-positive period, or the period in which viremia continues, was found to be a critical period in which all findings deteriorated for the patients. Furthermore, the presence of thrombocytopenia with platelet levels below 20,000/µL was the most common mortality-related finding (p<0.001). CK, LDH, and INR elevations were determined as other findings related to mortality. We believe these results will assist clinicians in predicting the prognosis and clinical management of the disease.

INTRODUCTION: Altmetrics, or alternative-metrics, have recently emerged as a web-based metrics measuring the impact of an individual article in social media accounts with an emphasis on the public attention/engagement with the research output. Aim of this study is to perform mid-2020 altmetric analysis of top-100 articles about COVID-19 that provoked the most online attention.
METHODS: Altmetric Explorer search was performed in June 3th, 2020. After ranked by altmetric attention score (AAS: an automatically calculated weighted count of all of the attention a research output has received in social media), articles that are not related by COVID-19 were excluded and the first-100 COVID-19-related articles were analyzed. Variables evaluated were (I) AAS, (II) dimensions-badge (interactive visualizations that showcase the citation data origins for individual publications), (III) month of publication, (IV) distribution of web-sources, (V) demographic-breakdown type distributions of citations, (VI) geographic-breakdown type distributions of citations, (VII) level-of-evidence (decided using SIGN-Criteria) (VIII) Q-categories of scientific journals, and (IX) h-index. Descriptive and correlational statistics were performed. Kruskal-Wallis test was used for AAS and dimensions-badge value comparisons while post-hoc analyses were performed by Dunn test. Spearman correlation coefficients were calculated to detect linear relationship between numerical variables. Analyses were performed by SPSS-23.0 and p<0.05 was considered statistically significant.
RESULTS: Most (74%) of the disseminated articles were published in Q1-journals while evidence levels were mostly level-3 and level-4. Content of the first 3 articles was about the impact of non-pharmaceutical interventions, origin of COVID-19 and chloroquine usage, respectively. There was no significant difference between AAS in different months (p=0.673) but dimensions-badges in January were significantly higher (p<0.05). There was a weak positive correlation between AAS and dimensions-badge (r=0.250; p=0.017).
DISCUSSION AND CONCLUSION: Dimensions-badge and AAS results revealed that academia discussed COVID-19 much more in the first-month of pandemic, but then interests continued parallelly in academia and other social media platforms, including public. Academicians have discussed experiences of large-patient series but public preferred what is potentially protective or risky for them. Although enormously fast accumulation and dissemination of new scientific publications were witnessed, it seems sens-clinique rather than strict evidence-based-advice transferred to journals. Because infodemic is another emerging problem, every scientist should be ethically more responsible about the publication they choose to disseminate. Interpretations/public-messages of scientists might also be critical, given the fact that only 15% of discussed Covid-19 articles was in level-1 and level-2 evidence.

INTRODUCTION: Early diagnosis of autoimmune disorders is critical in order to prevent complications, morbidity and mortality. Detection of autoantibodies has played a consolidate role in diagnosis of systemic autoimmune disorder. Anti-nuclear antibodies (ANA), as detected by indirect immuno-fluorescence antibody (IIFA), are hallmarks of autoimmune connective tissue diseases. Identification of the specific extractable nuclear antigens (ENA) is warranted because this may further differentiate between the distinct types of autoimmune connective tissue diseases.In this study, were analyzed retrospectively that Extractable Nuclear Antigen test results in patients with positive Anti-Nuclear Antibody tests
METHODS: Antinuclear antibodies were tested for a total of 3000 patients admitted to various clinics of Ondokuz Mayıs University Medical Faculty. 1: 100 dilution of each serum sample was used, and the presence of ANA and staining pattern was evaluated with ANA-IFA. ENA was investigated by immunoblotting in 640 ANA positive sera.
RESULTS: When we look at the distribution of ANA patterns in positive samples; granular 173 (27.03%), granular and cytoplasmic granular 98 (15.31%), homogenous and granular 67 (10.47%) were the most common. When the ENA profiles of the ANA-positive samples were examined, 557 (83.7%) were found to be positive and 83 (12.97%) were negative. According to our study, SSA (26.88%), SSB (17.81%), Sm / RNP (17.66%) were the first three places in the ENA positivite.
DISCUSSION AND CONCLUSION: First screening with ANA test,then looking at different antigens with the immunoblot test will facilitate the diagnosis of the autoimmun disease.

INTRODUCTION: In this study, It was aimed to investigate what are the factors that cause superficial mycoses and how often they are present in the Van region.
METHODS: This study was made in specimens taken from 1074 patients with superficial fungal infection. Of these specimens, 342 (31.84 %) foot, 237 (22.07 %) hand, 208 (19.37 %) haired skin, 197 (18.34 %) body, 47 (4.38 %) inguinal region and 43 (4 %) nail specimens were taken.
Before taken all specimens were examined microscopically, later on, in order they were inoculated in two Sabouraud Dextrose Agar (SDA), Potato Dextrose Agar (PDA), Mycobiotic Agar (MBA) and Dermatophyte Selective Agar (DSA) for izolate of agent. One of this inoculation was incubated in room temperature at 22-26°C, the other was incubated in the incubator at 37°C.
Izolated dermatophytes were examined microscopically on growth rate, surface appearence, surface shape, surface pigment occurence in bottom of colony, reproduction quality in room temperature and at 37°C, later on hyphae and spore structures of dermatophytes were examined microscopically, preparing lactophenol cotton blue by selophan band method. In addition, urease and hair perforating examination were used.

RESULTS: Of 1074 samples, it was found in 215 (20.02%) direct microscopy positive, in 221 (20.58%) culture positive. Agent was isolated in 179 dermatophytes and 42 Candida in totally 221 samples.
In 179 dermatophytes isolated from culture; 93 (51.96%) T. rubrum, 51 (28.49%) T. mentagrophytes, 13 (7.26%) T. violaceum, 9 (5.03%) T. schoenleinii, 8 (4.47%) E. floccosum, 3 (1.68%) T. tonsurans and 2(1.15%) T. verrucosum were found.
Distribution of isolated dermatophytes the most seen in different body areas in nails and foot was T. rubrum, in body and inguinal region was T. mentagrophytes, in haired skin was T. violaceum, T. rubrum and T. mentagrophytes were isolated at the same rate in hands.

DISCUSSION AND CONCLUSION: In this study conducted in the Van region, It is interesting that it has never been found Microsporum genus dermatophytes.

INTRODUCTION: Malaria is an important mosquito-borne disease that affects half of the world's population (mainly in tropical and subtropical countries). The contents of internet videos, though popular sources of public health information, are often unverified and questionable.
METHODS: In this study, the contents of the most relevantly viewed 150 videos (58 videos in English and 39 videos for Turkish were selected for further analysis) regarding malaria were analyzed on Youtube which is a popular source of health information.
RESULTS: All videos had a total of 14 373 885 views, with 281 199 likes, 4810 dislikes, and 24 339 comments. The health information websites (n=38, 39.2%) were the major source of all videos. According to the source, there was a significant difference between Turkish and English videos (p<0.001). Health information websites are dominant sources for English videos (53.4%) and news agencies are dominant sources for Turkish videos (48.7%). The videos (23.7%) uploaded from the news channels were coded as news updates. 66 videos were classified as useful (68.0%, English (n=54), Turkish (n=12)) and 8 were classified as misleading (8.24%, English (n=2), Turkish (n=6)). The number of views, likes, views/day, and video power index (VPI) in the useful videos were higher than misleading videos. The length was positively correlated with the number of views, dislikes, likes, comments, views/day, and VPI. The DISCERN score of videos was positively correlated with length, the number of views, dislikes, likes, comments, views/day, and VPI.
DISCUSSION AND CONCLUSION: In today's globalizing world, it is more important to create contents that will provide accurate information about malaria for the people living or traveling in endemic areas on the internet platforms like YouTube.

INTRODUCTION: Crimean-Congo hemorrhagic fever (CCHF) is a fatal zoonotic disease that is endemic in Tokat. The aim of this study was to investigate the demographic, clinical and laboratory findings of the patients presenting with tick bite, to discuss the necessity of laboratory tests in early stage, and to evaluate the follow-up and treatment results of patients with CCHF.
METHODS: In this study, cases applied to a Turhal State Hospital between 1 May - 30 September 2019 with tick bite were evaluated. Symptoms and laboratory tests were evaluated on the 3rd, 7th, 10th and 14th days after the patients' arrival. Patients with suspected CCHF were hospitalized and viral genome and/or specific antibody tests were performed for diagnosis. Demographic, clinical and laboratory data of the patients were obtained from hospital automation system.
RESULTS: In this study 105 male (59%), a total of 178 cases were evaluated. Their ages ranged from 1 to 89 years. Most of the cases were applied in June (n = 56, 31.8%). Of the cases, 115 (64.6%) were engaged in agriculture and animal husbandry, 144 (80.9%) were admitted to the hospital on the first day of tick bite, 88 (49.4%) of them, tick were removed by the health employeer in hospital. Four patients (2.24%) were diagnosed as CCHF. The incubation time was 1-13 days. Statistically headache, myalgia and nausea were significantly higher in CCHF group but there was no significant difference in any laboratory findings.
DISCUSSION AND CONCLUSION: In cases presenting with tick bite, the tick should be removed with a suitable technique, immediately. Performing laboratory tests at regular intervals in patients without symptoms is not a guide for early diagnosis of CCHF and it is not cost effective. If leukopenia, thrombocytopenia, AST, ALT and LDH elevations are detected in patients with nausea, headache and myalgia after tick bite, they should be carefully monitored for CCHF.

INTRODUCTION: Medical staff working in surgical branches are at serious risk for HBV, HCV and HIV infections. The aim of this study is to retrospectively determine the preoperative HBsAg, anti-HCV and anti-HIV seroprevalence in surgical patients of our hospital in the Eastern Anatolian Region of Turkey.
METHODS: Preoperative HBsAg, anti-HCV and anti-HIV seroprevalence of 9720 patients who were hospitalized for surgery between January 2017 and November 2018 were researched retrospectively.
RESULTS: Three thousand nine hundred and seventy six (40.9%) of the preoperative patients were female and 5744 (59.1%) were male. Anti-HIV negative was found in all patients, whereas HBsAg positivity was detected in 194 (2%) patients and anti-HCV positivity was found in 68 (0.7%) patients. HBsAg positivity was found in 48 (1.2%) of female patients, 146 (2.5%) of male patients. In terms of anti-HCV, 25 (0.6%) of female patients and 43 (0.7%) of male patients were positive. Maximum positivities was observed at 51-60 age range whereas minimum positivity was at 11-20 age range.
DISCUSSION AND CONCLUSION: Although the results of our study, in which more patient results were evaluated compared to similar studies in terms of number, were similar to those in other studies; HBsAg rates were slightly lower in our study, and it was related to the overall decline of HBV infections as a result of vaccination. Regardless of regional seroprevalances of HBsAg, anti-HCV and anti-HIV, it should be taken into consideration that the disease could be at window phase, so all patients must be accepted as vectors and medical staff must take extra personal precautions during surgery.

INTRODUCTION: To evaluate ocular involvement in inflammatory bowel diseases (IBD) with optical coherence tomography (OCT) and to determine whether the detected parameters can be a disease activation criteria.
METHODS: 57 eyes of 30 patients with Ulcerative colitis (UC), 32 eyes of 16 patients with Crohn's Disease (CD) and 78 eyes of 53 healthy individuals were included in our study. Retinal Nerve Fiber layer (RNFL), Ganglion cell layer (GCL ++), Central macular thickness (CMT) and Choroidal thickness (CT) measurements were done by OCT. Crohn's Disease Activity Index (CDAI) was also detected in patients with CD. Blood C reactive protein (CRP), neutrophil, hemoglobin (HGB), and sedimentation values were measured in patients with UC and CD.
RESULTS: The mean age was 38.6±8.8 years in CD, 42.9±12.2 years in UC, and 53.7±12.6 years in the control group. In CD, RNFL was significantly thicker and GCL ++ was significantly thiner when compared with the control group. CMT values and CDAI values show a statistically significant negative correlation. There was negative correlation between CT and CDAI levels.
UC patients were not different in RNFL compared to the control group, but GCL ++ was thinner. Superior RNFL was thicker in patients with UC. There was no difference in CMT and CT measurements in all groups.
The levels of HGB in the serum were significantly higher in the UC group than in the CD group. A significant difference was not detected when the levels of serum CRP, neutrophil, and sedimentation of the UC group compared with the CD group.
DISCUSSION AND CONCLUSION: RNFL and GCL ++ thickness evaluation may show ocular involvement in patients with inflammatory bowel disease.

INTRODUCTION: Toxoplasma gondii is a protozoan parasite that exhibits intracellular placement, capable of infecting all animals, including humans. Although it is mostly asymptomatic in cats and humans, it can cause serious symptoms in low-immune individuals and pregnant women. In this study, the presence of T. gondii antibodies was investigated by Sabin-Feldman Dye Test (SFDT) in cats brought to private veterinary clinics in Ankara and Kas region. The study contributed to existing data on the seroepidemiology of toxoplamosis in cats, which is of public health and animal health importance.
METHODS: In this study, the Sabin-Feldman Dye test, which is considered the gold standard, was used. The T. gondii strain needed for testing is T. gondii TR01 strain, which was maintained at the National Parasitology Reference Laboratory, the Department of Microbiology Reference Laboratories and Biological Products, The General Directorate of Public Health of the Ministry of Health, and the analysis procedures were carried out here. Blood samples from cats brought to veterinary clinics in Ankara and Kas region were collected for the study and SFDT was studied at 1/4, 1/16, 1/64, 1/256, 1/1024 titers with serums obtained.
RESULTS: A total of 50 cats, 30 of them female and 20 of them male, were included in the study between the ages of 2 months and 15 years. According to this study, 24% seropositivity was found. 10 of the seropositives gave positivity at 1/16 titers and 2 gave positivity at 1/64 titers. 4 (33,33%) of female cats and 8 (66,66%) of male cats were seropositive. No coincidences were found between race and age. The rate in household cats was 66,66%, street cats 25% and positivity in both household and street cats was 8,33%. Seropositivity of cats fed dry and wet food was higher than those fed raw.
DISCUSSION AND CONCLUSION: It should be taken into account that this parasite can be found not only in stray cats, but also in domestic cats, and the necessary information studies should be arried out for this purpose.

INTRODUCTION: Background and objective: Trichomonas vaginalis is considered to be the most prevalent cause of non-viral sexually transmitted infections globally and is a major health issue in developing countries. Since this flagellate protozoan parasite is associated with vaginitis, urethritis, cervicitis, and also pregnancy is one of the factors affecting trichomoniasis in women. Our aim is to identify the prevalence of trichomoniasis and the associated risk factors in pregnant women in the age group of 17-40 in the city of Zahedan (Southeast of Iran).
METHODS: A cross-sectional study was conducted on 514 pregnant women who had referred to a midwifery clinic in Zahedan. Direct microscopic examination and Dorset egg medium culture were used to detect T. vaginalis in pregnant women. The demographic and personal records, along with the associated risk factors were collected using a questionnaire and then analyzed using the Frequency to calculate the age average, chi-square test, independent t-test with SPSS software version 20.


RESULTS: The results showed that in 514 pregnant women, by the direct method, both the direct and culture methods and only culture method, 29(5.64%), 24(4.67%), and 24(4.67%) were reported positive sample for T. vaginalis, respectively. According to this result, there were significant differences between trichomoniasis and history of STI (OR=12,6; 95%CI=3,9-40,6) and previous abortion (OR = 6.840, CI: 2.906-16.100)and Vaginal discharge (OR= 2.9; 95%CL= 1.2-7.1) and Vaginal discharge (OR= 2.9; 95%CL= 1.2-7.1) and Antenatal care (OR=0.2; 95%CL= 0.1-0.7) in the studied infected pregnant women (pv<0.05).
DISCUSSION AND CONCLUSION: This study has raised several important points that could contribute to the research on infectious diseases of pregnancy were also discussed. This data proves that trichomoniasis during pregnancy should be considered an important health issue. Furthermore, by using parasitological diagnostic tests in pregnant women, the complications of trichomoniasis can be prevented for both the mother and the fetus

INTRODUCTION: Candida species are among the most common causes of bloodstream infections and are associated with serious morbidity and mortality. Especially with the increasing number of patients receiving chemotherapy and other immunosuppressive treatment, developments in transplantation surgery, widespread use of broad spectrum antibiotics, the incidence of bloodstream infections caused by Candida species has increased in the last two decades. With the increase in the incidence of candidiasis, other Candida species are also increasing. With this change, increasing resistance to conventional treatments is also reported. In this study, it was aimed to evaluate the species distribution, resistance pattern, risk factors and clinical course in candidemia cases in the intensive care unit with a 3-year retrospective analysis.
METHODS: Hospital infection surveillance forms and medical records of patients who were followed up in Neurology Intensive Care Unit of our hospital's and diagnosed with candidemia between January 2017-December 2019 were retrospectively evaluated.
RESULTS: In our study, Candida species were isolated in at least one blood culture from a total of 25 patients. The average age of the patients is 75.7 ± 11.8 (min 49-max 91). The average hospitalization day of the patients in the intensive care unit was 94.6 ± 63.7 (min 14-max 270) days. Non albicans Candida was isolated in twenty-three (92%) of the patients. The most common species (92%) among non albicans candida is C. parapsilosis. Fluconazole resistance was 76% (n = 19) in patients with candidemia, and no resistance was found against anidulafungin and caspofungin. The mean period from admission to the detection of reproduction was 47.9 ± 26.9 days, six patients (24%) received fluconazole and nineteen (76%) received anidulafungin therapy. All patients had a history of antibiotherapy before kandidemia was detected, and the average duration of antibiotherapy before candidemia was 49.8 ± 28.3 (min 9-max 120) days. Mortality developed in 76% (n = 19) of the patients.
DISCUSSION AND CONCLUSION: We believe that the most common cause of candidemia is C.parapsilosis and high fluconazole resistance are important factors that should be considered in the treatment of these life-threatening infections in the neurology intensive care unit of our hospital.

INTRODUCTION: In this study, it was aimed to investigate the antimicrobial effect of 16 different essential oils by commercially sold, against different standard bacterial strains and one clinical bacterial strain and one standard yeast strain.
METHODS: Disc diffusion method was used to test the antimicrobial activity of essential oils, in this study.
RESULTS: Essential oils and inhibition zone values that have the highest effect against the standard strains and the clinical isolate used in the research are as follows: to Thymus vulgaris; Staphylococcus aureus ≥ 50 mm, Acitenobacter baumannii 43 mm, Escherichia coli 35 mm, Enterococcus feacalis 35 mm; Klebsiella pneumoniae 9 mm, Candida albicans ≥ 50 mm; to Melaleuca alternifolia; Staphylococcus aureus 14 mm, Acitenobacter baumannii 19 mm, Escherichia coli 20 mm, Enterococcus feacalis ≤10 mm, Klebsiella pneumoniae 13 mm, Candida albicans ≥ 50 mm; to Mentha piperita; Staphylococcus aureus ≥ 50 mm, Acitenobacter baumannii 20 mm, Escherichia coli 18 mm, Enterococcus feacalis 14 mm, Candida albicans ≥ 50 mm, Klebsiella pneumoniae no inhibition zone was observed.; to Lavandula officinalis; Staphylococcus aureus 16 mm, Acitenobacter baumannii 10 mm, Escherichia coli 11 mm, Enterococcus feacalis 14 mm, Candida albicans 18 mm and Klebsiella pneumoniae no inhibition zone was observed.
DISCUSSION AND CONCLUSION: The essential oils, whose effects were investigated against standard bacterial strains, a clinical bacterial isolate, and yeast strain, it was observed that high antimicrobial activities at different levels. It was observed that thyme, tea tree, mint and lavender essential oils among the essential oils studied had stronger antimicrobial effect than other essential oils. As a result, we think that these essential oils, which we have investigated, may contribute to the study of new antimicrobial substances, and antimicrobial drug due to their high antimicrobial effect.

INTRODUCTION: Leblebi (roasted chickpea) is a traditional snack whose raw material is chickpeas. Commonly consumed in Turkey, and sold in sacks or containers without packages, it manifests diversely as yellow, white, chocolate, spicy and honey sesame. This study aimed to examine the chemical and microbiological properties of the leblebi varieties (yellow, chocolate and spicy) sold through traditional methods (unpackaged, bulk sale) in Turkey’s Çorum city and examine the effects of open sales on these properties.
METHODS: A total of 43 unpackaged leblebi samples, including spicy (n = 14), yellow (n = 16) and chocolate (n = 15) varieties were purchased from vendors in Çorum. One sample of yellow and chocolate leblebi was supplied from the factory. Moisture, ash, NaCl, reducing and total sugar concentrations of the samples were determined according to AOAC, Mohr, DNS and phenol sulfuric acid methods, respectively. To determine the standard deviations of the chemical analysis results, SPSS software was used. The total yeast-mold (YM), mesophilic aerobic bacteria (TMAB), total Enterobacteriaceae (TE) and Staphylococcus aureus (SA) counts of samples were also determined using standards methods.
RESULTS: The moisture, ash, glucose, and total sugar quantities of leblebi samples were found to be compatible with the expected value ranges and the results in the literature. Compared to the samples of yellow and chocolate leblebi taken from the factory, there was no significant increase in the number of total mesophilic aerobic bacteria (TMAB), yeast and mold (YM), Staphylococcus aureus (SA), and the total Enterobacteriaceae (TE) samples sold without packs and these were found to be below legal limits. However, the number of TMAB, YM, SA, and TE of some spicy samples was almost 0.5-5.0 log (CFU/g) higher compared to the sample taken directly from the factory.
DISCUSSION AND CONCLUSION: In conclusion, contrary to what was expected in this study, the microbiological and chemical properties of the unpackaged leblebi samples were not deteriorated due to open sales and that they were within legal limits. However, the microbiological and chemical test results of some spiced leblebi samples were found to be above legal limits. We think this is due to cross contamination due to the seasoning process that takes place in the shop where it is sold.

INTRODUCTION: Infection is one of the common reasons requiring hospitalization in geriatric patients. In this study, it was aimed to investigate the epidemiology, clinical and laboratory findings, and factors affecting mortality in inpatient geriatric infections.
METHODS: Patients aged ≥65, who were followed up in the Infectious Diseases Ward of the 500-bed training and research hospital, between January 2016 and December 2018, were included in the study. Demographic data such as age, sex, comorbidity, number of drugs used, source of infection of the patients were recorded. Clinical and laboratory data of the survivors and nonsurvivors, and results of the cultures were recorded. Factors affecting mortality were also evaluated.
RESULTS: Two hundred and five patients were included in the study. The mean age of the patients was 75.06 ± 7.33 and 117 (57%) of them were female. Fifty six56 (27.3%) of the infections were healthcare releated. Ninety-five percent of the patients had at least one comorbidity. The most common comorbidities were hypertension, malignancy, diabetes mellitus, and coronary artery disease. Eigthy-six point five percent of the patients were using at least one drug. The mean number of drugs used by the patients was 3.8 ± 2.86. The most common diagnoses of the patients were pneumonia (37%), urinary system infection (30.7%), and soft tissue infection (19.5%). Forty-nine point seven percent of the patients had used antibiotics and 35.6% had been hospitalized at least once during the last three months Chronic kidney failure, healthcare-associated infection, a need to change in the initial antibiotic treatment and the need for intensive care were found to be risk factors for mortality.
DISCUSSION AND CONCLUSION: Physiological effects of aging and comorbidities predispose to infection in elderly patients,. resulting with frequent antibiotic use and hospitalization. Infections with resistant microorganisms and drug-drug interactions due to multiple drug use should be taken into consideration in empirical antibiotic treatment of these patients.

Obesity is defined as a chronic metabolic disorder in which excessive and abnormal fat accumulation that negatively affects health. Obesity is one of major burdens to health services due to its increasing worldwide prevalence in the recent years and associations with metabolic and chronic diseases such as type 2 diabetes, heart diseases, hypertension and various types of cancer. Lifestyle and behavior modification interventions, especially the modification of diet and physical activity level, are still important cornerstones for the prevention and treatment of obesity. In addition to lifestyle modifications, the potential of plant based products in obesity management has gained great attention in recent years. Phytochemicals are bioactive components naturally found in fruits, vegetables, cereals, and other plant based products, and generally responsible for the organoleptic properties of plants, such as color, taste and smell. It is known that dietary bioactive components have antioxidant, hypolipidemic, hypotensive, antiatherogenic, antidiabetic, hepatoprotective, neuroprotective, anticancer and anti-inflammatory properties that promote health. Dietary phytochemicals with potential benefits in the prevention and treatment of obesity and related complications include polyphenols, terpenoids, organosulfurs, and phytosterols. Recent studies show that bioactive components with antioxidant and anti-inflammatory activity can support weight loss by increasing thermogenesis and total energy expenditure and reducing oxidative stress and inflammation. In addition, it is reported that phytochemicals can regulate physiological and molecular pathways involved in obesity, including their role in adipogenesis. In this review, the potential roles of dietary phytochemicals in the suppression of adipose tissue development and preadipocyte differentiation, induction of apoptosis of present adipocytes and stimulation of lipolysis, thereby, reduction of body fat mass; and also in suppression of appetite and reduction of dietary energy intake, and hence management of body weight were discussed within the framework of the evidence obtained from in vitro, in vivo and epidemiological studies.