INTRODUCTION: COVID-19 pneumonia, which has affected the whole world for more than two years, has forced the health system. In this period, when the delivery of health services is in danger, the use of appropriate antibiotics has remained in the background. With this study, we wanted to investigate the effect of changing antibiotic use during the pandemic period on the distribution of microorganisms that cause hospital infections and changing antibiotic resistances.
METHODS: The study was carried out in the Diskapi Yıldırım Beyazıt Training and Research Hospital. Hospital-acquired infections caused by E. coli, Klebsiella penumonia, Enterobacter spp., P. aeruginosa and Acinetobacter spp. between 2016 and 2020 were evaluated for our study. We classified the patients in 2016 as 1st group, 2017 as a 2nd group, 2018 as a 3rd group, 2019 as a 4th group, 2020 as a 5th group. The groups were compared with each other in terms of the rate of hospital-acquired infection, their resistance status and the amount of antibiotics used in the relevant years. The factors that showed significant difference only in the 5th year were attributed to the changing health services during the pandemic period and were examined.
RESULTS: The most commonly used antibiotic in our study was ceftriaxone with a DDD of 150.72. Piperacillin tazobactam and levofloxacin were the second and third most commonly used antibiotics, respectively.The amount of piperacillin + tazobactam use attributed to the pandemic period is significantly higher in the 5th year than in the 1st, 2nd, 3rd and 4th years. Meropenem, levofloxacin, and colistin, which had increased usage during the pandemic period, were not attributed to the pandemic period since they did not differ with all other groups in pairwise comparisons.
There was no change in the rates of microorganisms causing hospital infections for the pandemic period.
Piperacillin resistance rate at 5th years for Klebsiella pneumonia and E.coli was significantly higher than at 1, 2, 3 and 4 years. There was a positive correlation between the use of piperacillin/tazobactam and piperacillin resistance for Klebsiella pneumoniae and E.coli.
DISCUSSION AND CONCLUSION: In our study, we found that the use of piperacillin/tazobactam and levofloxacin in our hospital increased significantly during the pandemic period.There was no significant increase in the correlation between increasing antibiotic use and antibiotic resistance. Resistant strains, which will be triggered by the increasing amount of antibiotic consumption during the pandemic period, will be a problem that should be followed up in the coming years.

INTRODUCTION: The Coronavirus Disease 2019 (COVID-19) pandemic continues to negatively affect Turkey, as it does many other areas all over the world. One effect of COVID 19 has been the significant expenditure increases in health services in post-pandemic countries. Our aim for this study was the following: determining the frequency of outpatient, inpatient, and intensive care treatment in COVID 19 cases, the factors affecting the rates of inpatient and, intensive care treatments, and examining the changes in healthcare costs according to patient characteristics.
METHODS: This research is a cross-sectional record review. The universe of this study is composed of outpatients and inpatients that have been treated after being diagnosed with COVID 19 as from March 11, the date the pandemic was first seen in Turkey, to November 30, 2020. Within the scope of the study, data relating to the COVID-19 diagnosis, comorbidity, age (<50 and ≥50), and gender were obtained from all primary, secondary, and tertiary healthcare institutions in the province.
RESULTS: When the invoices of the inpatients who received no intensive care treatment were examined, it was found that the bills of the male patients aged 50 years and older and those with comorbidities were statistically significantly higher. In the patient groups receiving both clinical and intensive care, the mean amount of invoices of female patients and those aged 50 and older were found to be higher than male patients (p <0.05). In addition to, In all other patient groups, it has been determined that the invoice amounts are below the patient costs, that is, the invoice amounts do not cover the patient cost.
DISCUSSION AND CONCLUSION: The disease is more severe in those aged 50 and older, those with comorbidities, and it is more severe and more common in males. Consequently, bill amounts and costs of these patients were found to be higher than those of the opposing groups. As a result, the rate of men getting the COVID-19 disease is higher than women. The disease is more severe in males in hospitalized patients, in ≥50 age group, and in patients with comorbidities. In parallel with these, the invoice amounts and costs of these patients are higher than the opposite groups. In general, the treatment costs of the patients are higher than the invoice amounts and they carry great risks for the future in ensuring the sustainability of the service. Ensuring sustainability in healthcare services depends on the ability of healthcare institutions to obtain invoices to cover their costs. COVID-19 not only creates a big economic burden for reimbursement institutions but also brings a great economic burden for the institutions that provide the service.

INTRODUCTION: When the medicine leaflets of drugs and food supplements are examined, it is seen that the contents are not fully reflected to the user. For this reason, the person who will use drugs or food supplements does not have the opportunity to access reliable information about whether there is a substance in their content that is not suitable for their own belief and culture; even if he wishes for such a thing, he cannot reach sufficient information about where to access this information. The information on the Internet, on the other hand, presents an information pollution appearance that lacks scientific competence in general and has not been adequately audited. The aim of this study is to determine the opinions and preferences of the users regarding the transparency of the contents of pharmaceutical and food supplement products in line with their own needs.
METHODS: The sample of the study was made by 888 prescribers who applied to pharmacists, and the answers given to the questionnaire with 16 questions gave the results of the study. The data were evaluated by descriptive and analytical statistical methods.
RESULTS: Participants consisted of volunteers with an average age of 40.05, 92.9% living in cities or big cities, and 62.2% women. The educational level of the participants was 54.9% primary education and 43.2% higher education. When 33.2% of volunteers used medication at least once a day or week, 66.8% stated that they sick or rarely used medication. When 92.7% of the participants read the medicine leaflet or read the medicine leaflet whenever necessary, 92.7% of the participants thought that they should inform the physician or pharmacist about the contents of the drugs, 44.5% of the drug the health professions were informed about it. 94.8% of the volunteers wanted to know whether they were addictive substances in medicines or food supplements, a substance that could cause allergic reaction, alcohol or pigs, 80.8% of the participants would search for alternative ways, 10.8% he would deny the treatment.
DISCUSSION AND CONCLUSION: It was concluded that patients wanted the information showing the contents of medicines or food supplements to enter the pamphlets to reflect the requirements of their religious beliefs. Considering this issue while preparing the medicine leaflets has been considered as an issue that needs to be taken into account both in terms of patient rights and consumer rights.

INTRODUCTION: .Clostridium difficile (C. difficile) is a Gram-positive, anaerobic, spore-forming bacterium that spreads via the fecal-oral route.Causes asymptomatic carriage or mild diarrheal diseases such as pseudomembranous enterocolitis. Clostridium difficile is the commonest cause of nosocomial and antibiotic-associated diarrhea in North America and Europe. It can produce two toxins called A and B. Strains producing toxins can lead to a more serious disease picture that causes megacolon, perforation or septic shock. The use of molecular methods with high specificity and sensitivity has become widespread in recent years.The use of molecular methods with high specificity and sensitivity, which are easier to apply in diagnosis, and to obtain rapid results, has become widespread in recent years.

In this study, it was aimed to evaluate Clostridium difficile results determined by polymerase chain reaction (PCR) from stool samples.
METHODS: 109 fecal samples that came to our laboratory between January 2017 and September 2018 on suspicion of Clostridium difficile infection were tested with the GeneXpert C. difficile PCR (Cepheid, CA, AD) method. The data obtained are interpreted as positive, negative or invalid results.
RESULTS: A total of 109 samples were tested. 66 (61%) of the stool samples belonged to male and 43 (39%) female patients. Twenty-five (23%) of the patients were under the age of 18 and 36 (33%) under the age of 18 years. Of the samples, 26 (24%) were from intensive care units, 60 (55%) were from services and 23 (21%) were from polyclinics. It was found 109 from stool samples. 9 (8%), C. difficile PCR test toxin B positive, 100 (92%) negative.

DISCUSSION AND CONCLUSION: The most important cause of nosocomial diarrhea is C. difficile. The main predisposing factor of infection is the use of antibiotics. Prophylaxis or even one dose of antibiotic therapy may be sufficient for the development of C. difficile infection. Rapid and accurate diagnosis by PCR is important for early initiation of treatment.

INTRODUCTION: Toxoplama gondii, Toxocara spp, and antinuclear antibodies (ANAs) have been reported as a cause of abortion. To determine the prevalence rate of T. gondii, Toxocara spp, and ANAs in aborted women, and to investigate the association between infection and the number of the sociodemographic estimated risk factors.
METHODS: This study was carried out in aborted women referred to the Qaem hospital in Mashhad city (Razavi Khorasan Province). Serum samples were examined for the presence of Antinuclear Antibody (IgG antibodies), anti-Toxoplasma gondii IgG and IgM antibodies, and IgG anti-toxocariasis spp antibodies by ELISA (Enzyme-Linked Immunosorbent Assay) kit. Data like contact with animals' cats and dogs, age, and Type of cause of abortion (in most cases) were collected as risk factors for the prevalence of infection
RESULTS: Out of 162 total samples of pregnant women were collected, 28% were positive for T.gondii IgG, and 2% IgM, anti-Toxocara spp IgG antibodies were detected in 12% and Antinuclear antibodies detected in 31% in pregnant women with abortion. Co-infection of T.gondii and Toxocara spp detected in 9%, also ANAs detected in cases with T.gondii in 24% and 10% with Toxocara spp.ANAs showed positivity with co-infection of T.gondii and Toxocara spp in 8%. This study showed a significant association between infection of each T.gondii, Toxocara spp, and ANAs with age and animal contact such as cats and dogs.
DISCUSSION AND CONCLUSION: This study revealed that the prevalence of T.gondii, Toxocara spp in pregnant women with abortion is common and detection of ANAs is considered as a cause of abortion.

INTRODUCTION: Acinetobacter baumannii is an important causative agent of ventilation-associated pneumonia capable of long-term survival in the hospital setting. Increasing resistance to antibiotics effective against this pathogen is of concern. In this study, the antibiotic resistance profiles of A. baumannii strains grown in endotracheal aspirate (ETA) cultures in intensive care units and the effect of the COVID-19 pandemic on the resistance profiles in our province where the highest number of cases were observed in our country for a long time were investigated.
METHODS: Our study included 74 A.baumannii isolates isolated from ETA samples that was sent to our laboratory from the intensive care units of Bafra State Hospital between January 2019 and December 2020. Bacteria were identified using conventional methods and a semi automatic bacterial identification system Vitek-2 (bioMérieux, France). The antibiotic susceptibility tests of the isolated strains were studied in accordance with the European Committee for Antimicrobial Susceptibility Testing (EUCAST) standards. Antibiotic susceptibility of A. baumannii strains was tested with Vitek-2 system.
RESULTS: The mean age and standard deviations of 18 patients before the COVID-19 pandemic and 56 patients after the pandemic were found to be 83.0 ± 8.3 and 70.5 ± 14.9 (p<0.001), respectively. A statistically significant difference was found between the distributions of gender by years (p= 0.025). While 55.6% of the patients were female in 2019, 73.2% of the patients in 2020 were male. There was no difference between the two periods in terms of death rates (p=0.628) and respiratory support needs (p=0.191). It was determined that the pandemic increased the number of isolated A. baumannii by 311%. For the two periods, resistance was greatest for piperacillin/tazobactam, ceftazidime, ciprofloxacin and against imipenem. Examinig the two periods, amikacin resistance was seen to a lesser extent in 2020.
A statistically significant difference was found between tigecycline resistance rates according to years (p<0.001). While the tigecycline susceptibility of strains was 88.9% in 2019, it was found to be 26.8% in 2020. 11.1% of the strains in 2019 and 64.3% in 2020 were found to be moderately susceptible. In this study, colistin resistance was observed in one (1.4%) of all isolates, while tigecycline resistance was detected in five isolates (6.8%). One isolate (1.4%) was susceptible to all antibiotics except ceftazidime.
When the multi-antibiotic resistance of 73 A. baumannii isolates was examined, multidrug resistant (MDR) was 22.9% (n: 17), extensive drug resistance (XDR) was 74.3% (n: 55), pandrug resistance (PDR) was 1.4% (n: 1). Although there was a statistical difference in amikacin, meropenem and tigecycline resistances before and after the pandemic, no difference was found between the resistance patterns (p=0.281).

DISCUSSION AND CONCLUSION: It has been observed that the most effective antibiotics against A. baumannii are colistin and tigecycline. It was determined that the COVID-19 pandemic did not change the resistance pattern rates. It is thought that success in fighting this infection will increase when each hospital determines its own resistance patterns, updates empirical treatment protocols based on their results, and clinicians use appropriate antibiotics early.

INTRODUCTION: Chemicals called insecticides are frequently used in agricultural control and cause toxic effects on non-target organisms, especially mammals. Exposure to insecticides may induce hematoxicity. This research is appertaining to the possible property of ferulic acid, utilized as nutritional supplement, to mitigate oxidative stress process caused via dimethoate.
METHODS: Male Wistar rats were divided into six groups, randomly (six animal each). Animals were treated orally via gavage with ferulic acid (30 mg/kg body weight, everyday for 28 days) prior to treatment of low or high doses of dimethoate (3 mg/kg body weight, everyday for 28 days 1/100 LD50 and 30 mg/kg body weight, everyday for 4 weeks 1/10 LD50, respectively).
RESULTS: Exposuring rats to dimethoate for 4 weeks contributed oxidative stress process with a rise in malondialdehyde levels of rats’ erythrocytes. Also, treatment of dimethoate induced alterations in antioxidant defence system of erythrocytes as monitored by the increase in the activities of antioxidant enzymes such as glutathione peroxidase, glutathione-S-transferase, catalase and superoxide dismutase. Additionally, dimethoate caused DNA damage, too. Pretreatment with ferulic acid remediated the detriment caused via dimethoate, as ascertained by detention of lipid peroxidation, improvement of glutathione peroxidase, glutathione-S-transferase, superoxide dismutase and catalase activities and also DNA damage.
DISCUSSION AND CONCLUSION: Dimethoate, an insecticide, has caused serious toxic effects on blood tissue of rats. Therefore, the conscious use of dimethoate should be ensured, its use should be minimized and development of different methods should be encouraged that replaced these chemicals in agricultural control. The present findings indicate that ferulic acid may amelierate dimethoate-caused oxidative stress process and DNA damage by altering antioxidant defense system and decreasing lipid peroxidation in blood.

INTRODUCTION: Determination of glomerular filtration rate is essential for kidney functions in obesity. Creatinine and cystatin c are used to determine glomerular filtration rate. Cystatin-c increases with the increase of adipose tissue. The study investigates the use of cystatin-c in calculating the glomerular filtration rate in obese individuals.
METHODS: One hundred thirteen obese women were used in the study. The height of the patients was measured barefoot on a flat surface. A whole-body analysis was performed by bioimpedance device (Tanita-BC418), and body weight, body mass index (BMI), fat percentage, fat mass, fat-free mass were detected. Biochemical data were evaluated retrospectively. CKD-EPI-GFR (Chronic Kidney Disease Epidemiology Collaboration equation glomerular filtration rate), GFR-epi-cr (creatinine-GFR), GFR-epi-cysc (cystatin c -GFR) and GFR-epi-cre-cysc (combined-GFR) values were calculated from the measured cystatin-c and creatinine values.
RESULTS: We found that GFR-epi-cr decreased with age and BMI, increased with height, GFR-epi-cysc decreased with age, BMI, fat percentage, fat mass, increased significantly with height, GFR-epi-cr-cysc decreased with age, BMI, fat percentage, fat mass. GFR-epi-cr, GFR-epi-cysc, GFR-epi-cr-cysc decreased with HCRP (High-C-reactif protein). Creatinine increased with age and decreased with GFR-epi-cr, GFR-epi-cysc, GFR-epi-cr-cysc. Cystatin-c increased with age, body weight, BMI, fat percentage, fat mass, and decreased GFR-epi-cr, GFR-epi-cysc, GFR-epi-cr-cysc.
DISCUSSION AND CONCLUSION: Cystatin-c can pass through kidney glomeruli easily and used in GFR calculation. We found that while cystatin-c increases with increased adipose tissue in obese individuals, GFR-epi –cysc ve GFR-epi-cr-cysc decreased. As well, HCRP increased with the fat percentage and fat mass. These results are essential in terms of inflammation, which is evident with the increase in adipose tissue, affects kidney functions in obese individuals. Our study is essential in raising awareness about GFR calculation and parameters used in the follow-up of kidney functions in obese individuals.Our study shows that to use of cystatin-c may give wrong results to calculate GFR and fto ollow up of kidney functions in obese individuals.

INTRODUCTION: Stress causes neuropsychiatric diseases such as depression and anxiety in the person by affecting emotions, opinions and behaviors. In this study, the aim was to investigate the therapeutic effects of tDCS on depression and anxiety disorders that occur after sub-chronic stress.
METHODS: 40 male Wistar rats weighing 290-310 g were divided into four groups as control, tDCS, stress and stress+tDCS. Restraint stress was applied for 7 days (2 h/day) as a stress model. Rats in the tDCS and stress+tDCS groups were performed the stimulation of 1 mA anodal tDCS for three consecutive days from the 5th day of stress exposure. On the 7th day of the experiment, the anxiety and depression behaviors of the rats were evaluated with the open field test and the elevated plus maze test.
RESULTS: No significant changes were found in the locomotor activity, elevated plus maze test data between control and tDAS groups. In the stress group rats compared to the control group, there was a significant decrease in the locomotor activity levels (p <0.001), while a significant increase was observed in the data indicator of anxiety (p<0.001). In the stress + tDAS group compared to the control group, there was a significant decrease in the data indicator of anxiety following tDAS application (p <0.05), but no significant difference was found in the results of locomotor activity.
DISCUSSION AND CONCLUSION: In conclusion, our data showed that tDCS stimulation may have an effect on sub-chronic stress-induced anxiety and depression behaviors.

INTRODUCTION: The aim of this study was to find the efficient medium to bind an anticancer drug, Doxorubicin (DOX), to a synthesized polymer, methoxy poly(ethylene glycol)-block-polycaprolactone (mPEG-b-PCL) via pH sensitive hydrazone bonds and to determine the amount of conjugated drug.
METHODS: DOX conjugation was carried out in two different media (dimethyl sulfoxide (DMSO) and methanol-trifluoroacetic acid (MeOH-TFA)). The amount of conjugated drug was determined with two different methods. One method was applied the dissolution of the conjugate in chloroform: methanol (Ch: MeOH, 1: 1 v/v) solution without considering pH responsiveness, and the other method was after breaking pH sensitive hydrazone bonds in acidic media (using three different media as 0.1 M hydrochloric acid (HCl), concentrated HCl (12 M HCl) and concentrated sulfuric acid (18.3 M H2SO4)).
RESULTS: The highest conjugation efficiency was obtained when the conjugation was achieved in MeOH-TFA solution, and for the polymer-drug conjugates after the treatment with concentrated sulfuric acid.
DISCUSSION AND CONCLUSION: It was concluded that, MeOH-TFA method was a good method for conjugation of DOX to mPEG-b-PCL copolymer, and H2SO4 (18.3 M) method was better than any other present in literature for determination of the amount of DOX linked to the polymer via hydrazone conjugation

INTRODUCTION: In this study, antiproliferative and cytotoxic effects of different concentrations of curcumin on cervical cancer Hep2C cells were investigated with microscopic methods and MTT assay.
METHODS: Hep2C (Human carcinoma cancer cell line, ATCC: CCL-23) cells were cultured. For cytotoxicity evaluation Hep2C cells exposed to curcumin at different concentrations of 30 µg/ml, 15 µg/ml, 7.5 µg/ml, 3.7 µg/ml, 1.9 µg/ml, 0.9 µg/ml, 0.45 µg/ml for 24 hours These Hep2C cells are evaluated with MTT assay. The IC50 value of the agent for 24 h of exposure was detected. The graph of the absorbance data obtained by the Spectramax I3 device. Viability values of Hep2C cells calculated from the absorbances obtained from MTT assay are gained. The preparations were observed based on changes in nuclei and structures using a inverted microscope (Leica Microsystems). Nontreated cells were used as negative control and for positive control Hep2C cells were exposed to ammonium molibdate (1mg/ml) for the above given incubation period.
RESULTS: As a result, high doses of curcumin (30 µg/ml, 15 µg/ml, 7.5 µg/ml) showed high antiproliferative and cytotoxic effects on Hep2C cells. The reduction of proliferation and cytotoxic effects were not observed on cervical cancer Hep2C cells treated with lower concentrations of curcumin.
DISCUSSION AND CONCLUSION: Curcumin has been shown that it is non-toxic, can be used as a highly antioxidant and anti-inflammatory agent and has multifaced therapeutic-pharmacological effects. However, researches on the antiproliferative, anti-cancer effects of curcumin in cervical cancer cells is not sufficient. The present study evaluates the antiproliferative and cytotoxic effects of curcumin on human cervical cancer Hep2C cells as the first time. The results of our study support these effects of curcumin on Hep2C cells in a concentration-dependent manner.

Salmonella is a gram-negative, motile, non-spore-forming, facultative anaerobic bacterium belonging to the Enterobacteriaceae family. There are several subtypes that can cause disease in humans and animals. Infection can be caused by food,such as eggs,poultry, contaminated waters, and can also be monitored after contact with animals.In humans, it may present with different clinics ranging from asymptomatic carriage to enteric fever. Factors such as the age of the host, immunosuppressive status and additional comorbidities may be effective in the course of the disease.Extraintestinal complications can be observed during the course of enteric fever clinic. Among these complications,clinical conditions such as endocarditis,visceral abscess, osteomyelitis can be considered. In this case, we presented the myocarditis clinic in a patient who presented with vomiting, chest pain and diarrhea, and Salmonella was found in the stool.

Pasteurella multocida (PM) is a gram negative coccobacillus which is frequently isolated from oropharyngeal secretions of domestic animals such as cats and dogs. For typical isolates from propable sources such as cat bite or scratch, the presence of indole-positive and oxidase-positive, gram-negative bacilli, non-growing on MacConkey agar, is usually sufficient for identification of Pasteurella multocida. Both animal bites and scratches typically cause soft tissue infections which tend to have favorable outcomes with appropriate medical treatment, however, they may also cause serious clinical conditions such as osteomyelitis, pneumonia, endocarditis, sepsis and meningitis. Here, a case of soft tissue infection due to Pasteurella multocida in a 61 year- old diabetic female who had a history of dog bite on her left leg, was presented in the light of the literature.

Parasitic diseases were known to be problematic mostly in developing countries. Recently the prevalence of oral parasitic infections being reported more frequently in developed countries. Oral cavity is the typical residence for particular organisms. These microorganisms are found more commonly in patients with poor oral hygiene, periodontal disease, and immune suppression. The aim of this review was to provide the data about oral lesions related to parasitic diseases and their roles in pathophysiology of oral diseases. It also discusses current approaches to diagnosis and treatment options of parasitic infections.

As a result of the work initiated by the World Health Organization with the slogan ‘’ Safe blood begins with me ‘’, the understanding of quality in blood banking and transfusion medicine has begun to be felt more clearly. In our country, quality studies in transfusion medicine gained momentum with the ‘’ Safe blood supply project ‘’. For blood service units, quality has gone beyond the understanding of ‘’ write what you do, do what you write ‘’ and become a part of the safe blood supply process. The fact that the understanding of the quality management system made its presence felt more intensely created the need for blood service units to express the positive contributions of the quality management system with concrete indicators. Monitoring the processes in transfusion medicine with the quality indicators to be established can be the targeted concrete evidence. Quality indicators are also important for evaluating and comparing the performances of blood service units. There are various studies on establishing quality indicators in transfusion medicine at national and international level. However, quality indicators for transfusion centers were barely mentioned in these studies. There are no standardized quality indicators for transfusion centers at the national level. In our article, we evaluated the deficiencies in quality indicators in blood banking and transfusion medicine in Turkey. We have developed exemplary quality indicators by making use of international and national studies. We believe that in the future, more comprehensive studies will be carried out and standardized blood banking and transfusion medicine quality indicators approved by the competent authority will be established.