INTRODUCTION: Immunization by vaccination has a crucial role in controlling COVID-19 pandemic. Determination of the factors affecting the effectiveness of the vaccine can increase the success rates. We aimed to investigate the effectiveness of CoronaVac and factors affecting its effectiveness in healthcare workers.
METHODS: This retrospective study included healthcare personnel (n=2666) working at a training and research hospital. Logistic regression analysis was used for analyzing the effects of all variables including vaccination status on the development of COVID-19. Adjusted odds ratios calculated by logistic regression analysis were used to determine the vaccine effectiveness. Stratified analyses were performed for the determination of the interaction/effect modification regarding the vaccine effectiveness.
RESULTS: Mean age of the 2666 healthcare workers included in this study was 37,3±10,2 and 55,8% (n=1488) were females and %44,2 (n=1178) were males. In this study gender and history of COVID-19 infection was found to be an effect modifier for the vaccine effectiveness by the stratified analysis. The effectiveness of the CoronaVac vaccine in preventing development of COVID-19 diagnosed by real-time polymerase chain reaction (RT-PCR) in healthcare workers was 84,5% (95%CI: 73,3-91) in women and 47% (95%CI: 1,7-71,4) in men. Being a medical doctor or a registered nurse, working in ICU or a COVID-19 clinic, a positive history of COVID-19 and COVID-19 vaccination were other protective factors against COVID-19 infection.
DISCUSSION AND CONCLUSION: Determination of the factors affecting the effectiveness of the vaccine can increase the success rates. Vaccination programs may need to be modified if there is a COVID-19 history or gender-related difference in vaccine effectiveness.

INTRODUCTION: In this study, it was aimed to examine samples sent to Antalya Public Health Laboratory (AHSL) with the suspicion of COVID-19 by RT-PCR and to investigate the epidemiological and clinical characteristics of the cases.
METHODS: This study, conducted between 18 March 2020 and 18 May 2020, retrospectively analyzed on 6404 respiratory tract samples that came to AHSL with suspected COVID-19. SARS CoV-2 specific N and Orf1ab gene regions were analyzed with Real Time PCR test in respiratory tract samples. Medical, epidemiological and demographic information of the people who were tested were obtained retrospectively. Chi-square test was used to compare the proportional differences between groups.
RESULTS: 6.2% (n = 398) of 6404 respiratory tract samples were found to be positive. There was a significant difference between the month of the test and the PCR positivity rate (p <0.05). While the rate of being between the ages of 13-44 was lower in PCR positive cases, the rate of being between the ages of 45-64 was higher (p <0.05). In cases where PCR was studied, the positivity rate in women was higher than in men (p <0.05). While the rate of being employed in PCR positive cases was lower, the rate of being in the non-working group was higher (p <0.05). PCR positive cases had less risk factors (p <0.05). PCR positive cases had a lower smoking rate (p <0.05). A statistically significant difference was found between the travel history and especially the travel history abroad and the test results. PCR positive cases had a higher travel history (p <0.05). PCR positive cases had a higher contact history (p <0.05).
98.8% (n = 6326) of the samples included in the study were nasopharyngeal swap samples. There was no statistically significant difference between the presence of symptoms and test results. Although there was no difference with the presence of general symptoms, when individual symptoms were considered, cough, respiratory distress and malaise were proportionally higher in PCR positive cases than PCR negative (p <0.05). There was no significant difference between test results and outpatient follow-up or hospitalization.

DISCUSSION AND CONCLUSION: Since COVID-19 infection is a complex situation with asymptomatic cases, RT-PCR test should be used in community screenings in order to evaluate the epidemic potential in a realistic way. Control mechanisms should be made more effective for people in closed environments and especially in the 45-64 age group.

INTRODUCTION: Objective: The COVID-19 pandemic, caused by SARS-CoV-2 of Coronaviruses types, is a highly infectious disease caused by SARS-CoV-2, which first appeared in China. The presence of comorbid diseases, especially diabetes, and advanced age are determinants of the mortality and morbidity of the disease.
In this study, it was aimed to examine the possible role of Diabetes mellitus (DM) in the course of the 2019 novel coronavirus disease (COVID-19).

METHODS: Methods: In this study, the data of 81 patients who applied to Ankara Polatlı Duatepe State Hospital between January 01 and May 05, 2021 and were confirmed to have COVID-19 and were hospitalized in the COVID-19 service for 5 to 20 days were analyzed. 39 female and 42 male patients were included in the study and the patients were divided into three groups. COVID-19 group (n=26; 10 female, 16 male), COVID-19+DM group (n=28; 13 female, 15 male), and COVID-19+hypertension (HT) group (n=27; 16 female, 11 male). Demographic, clinical, radiological and laboratory records of the patients were reviewed retrospectively.
RESULTS: Results: There was a statistically significant difference between the groups when they matched for age and gender (p<0.05). The mean age of the COVID-19+DM and COVID-19+HT groups was higher than the COVID-19 group (p<0.05). COVID-19 group 55.96±15.545 years, COVID-19+DM 68.29±12.849 years, COVID-19+HT 71.48±11.416 years. Only 32 patients had positive PCR tests, and the rate was 39.5%. The number of patients with CT is 69, and the rate is 85.2%. The number of CT-positive patients is 56 and the positivity rate is 81%. The PCR test positivity rate is lower than the CT positivity rate.
The serum fasting blood glucose (FBG) and C-reactive protein (CRP) levels were significantly higher in the COVID-19+DM group when compared to the COVID-19 group and COVID-19+HT group (p<0.05). The serum sodium (Na) and chlorine (Cl) levels were significantly lower in the COVID-19+DM group when compared to the COVID-19 group and COVID-19+HT group (p<0.05). The serum creatinine and phosphorus (P) levels were significantly higher in the COVID-19+DM group when compared to the COVID-19 group (p<0.05).
The serum hemoglobin (HGB) and hematocrit (HCT) levels were considerably higher in the COVID-19 group compared to the COVID-19+DM group (p<0.05).

DISCUSSION AND CONCLUSION: Conclusion: When all the data we obtained in our study are evaluated; we determined that the comorbidity effect of DM is important in the clinical course of patients infected with the COVID-19 virus. We think that SARS-CoV-2 pneumonia patients with diabetes may be more severe than those without diabetes in terms of organ damage, and inflammatory variables, and are more likely to evolve to a worse prognosis, regardless of whether the additional comorbidities were present or not.

INTRODUCTION: The aim of this study to evaluation of water/fluid intake of inpatient's relatives and affecting factors.
METHODS: In this descriptive study, 608 relatives of inpatient were included, between June-July 2019. The data were collected by using face-to-face interview method with a questionnaire form. In the evaluation of daily fluid intake sufficiency from beverages and water, NAM’s recommendation of 2.2 L/day fluid intake for females, 3.0 L/day for males was taken as a basis. The values by gender groups equal to these amounts or above were evaluated as sufficient while the values below these amounts were considered as insufficient fluid intake. In data analysis, SPSS 23.0 statistical package program was used.
RESULTS: In this study, the amount of water intake of patient relatives staying full time in the hospital was found as 1361.0±796.9 (0-5000) ml/day and the fluid intake was 1826.8±998.2 (0-6600) ml/day. According to based on the recommendations of National Academy of Medicine (NAM), it was determined that 482 (79.3%) of the patient relatives consume insufficient amount of fluid and 126 (20.7%) patient relatives were sufficient. It was found that daily water and fluid intake amounts of males, having jobs and daily fluid intake of participants staying in hospital for more than 3 days were high (p<0.05). According to the statements of patient relatives related to change in their water consumption amount compared to other times, it was seen that the water consumption of 66 (10.9%) relatives increased, 262 (43.1%) relatives did not changed and 280 (46.0%) relatives decreased.
DISCUSSION AND CONCLUSION: In the study, it was found that daily water intake amount of patient relatives staying full time in the hospital was 1.4 L/day and the amount of fluid intake was 1.8 L/day. Daily fluid intake amount of 79% of patient relatives was lower than the amount recommended by NAM for adult male and female groups. The amount of water and fluid intake of women, those not working in an income generating work, those living in another city/abroad and those who stated that their water intake amount decreased in the hospital was found lower.

INTRODUCTION: Thiamine deficiency (TD) during the developmental period is a very rare condition in the developed countries but it is becoming more frequent in the worldwide because of worsened socioeconomic status at some communities. Thiamine has many metabolic and structural functions in the brain especially in the developmental period. Postnatal TD may cause long-lasting affects in the brain. Chronic TD causes hearning deficit but the effects of postnatal TD to the central auditory processing during adulthood have not been investigated sufficiently. The loadness loudness dependence of auditory evoked potentials (LDAEP) provides a well established marker of the central serotonin activity. Beside, paired-click responses (PRs) are associated with glutamatergic/GABAergic transmission. İnvestigating these responses and underlying oscillations that reflect the neuronal correlate of auditory processing provides important information about auditory changes due to TD condition.
METHODS: Rats were divided in to two group as follows; Control whose dams fed with normal diet (C), thiamine deficient whose dams fed with thiamine_deficient diet during postnatal period (TD). At adulthood, we recorded AEPs and PRs and analyzed LDAEP, components and spectral changes to unrevael the network alterations.
RESULTS: The N1/P2 responses for two loadest stimulus were significantly increased in the TD group versus the C group. In parallel, higher LDAEP value was obtained in the TD group. As gamma level was significantly attenuated in the TD group, elevated theta/alpha response was observed in the TD group compared with the C group. For PRs, higher N1 response to second stimuli and lower supppression rate detected in the TD group. Concominant increament of theta responses to second stimuli was observed in the TD group.
DISCUSSION AND CONCLUSION: Postnatal TD causes degenerative changes with long-term implications observed in auditory network dynamics which could be partly explained by altered serotonergic and glutamatergic/GABAergic transmission.

INTRODUCTION: Viral hepatitis and human immunodeficiency virus (HIV) infections are important health problems in our country as well as all over the world. We aimed to investigate the distribution of seropositivity of HBsAg, anti-HBs, anti-HCV and anti-HIV according to years, genders and age groups in patients who applied to our hospital.
METHODS: Results of HBsAg, anti-HBs, anti-HCV and anti-HIV tests performed during 2015-2019 in our hospital were reviewed retrospectively. 77562 serum samples were studied for HBsAg, 45045 for anti-HBs, 73223 for anti-HCV and 71061 for anti- HIV of a total of 266891 samples. The tests were analysed using chemiluminescent microparticle immunoassay (Architect i 1000, Abbott, USA) and electro-chemiluminescence immunoassay (Cobas 6000,Roche Diagnostic GmbH, Germany) methods. Data were collected from the database of our hospital. Data were analyzed using the SPSS software ver. 24.0. Chi-Square (χ2) analysis and Fisher's Exact test were used for comparison of categorical variables. The p< 0.05 was considered statistically significant.
RESULTS: HBsAg, antiHBs, anti-HCV and anti-HIV positivity were 2.3 % (1808/77562), 46.6% (20975/45045), 0.6% (456/73223) and 0.05% (35/71061) respectively. Of the 1808 patients were positive for HBsAg, 55% were males, 45% were females. Of the 456 anti-HCV positive patients, 63.6% were females and 36.4% were males. When assessed by age groups, HBsAg positivity was found to be the highest in the age group 31-50 (38.1%) and lowest in the age group ≤ 18 (0.6%). Anti-HCV positivity was found to be the highest in the age group ≥65 (32%) and lowest in the age group ≤ 18 (2%). All patients who were found to be anti-HIV positive were male and the highest positivity rate was between the ages of 19-30.
DISCUSSION AND CONCLUSION: Our HBsAg, anti-HBS, anti-HCV and anti-HIV results were found to be similar with the country statistical data. There was significant difference in the seropositivity of HBsAg (p<0,001), anti-HCV (p<0,05) and anti-HIV (p<0,001) during the measurement period.

INTRODUCTION: Human papillomavirus (HPV) infection is the most common sexually transmitted disease and can be prevented by vaccination. The most important factors affecting the vaccination rates may be parents’ knowledge levels and opinions on the issue and their total income levels. Moreover, parental hesitancy against vaccination, including even those in the national vaccination programs, has recently gradually increased in Turkey and worldwide. Ultimately, in this study, it was aimed to determine parents’ knowledge and opinions on the HPV vaccination and the factors affecting their vaccination decisions.
METHODS: This cross-sectional descriptive study was conducted with 552 parents of 9-18-year-old daughters and sons at two research hospitals in 2020 in Turkey. Face-to-face interviews were carried out to collect data on the parental knowledge levels and attitudes regarding HPV vaccination, as well as reasons for refusal.
RESULTS: Of the 552 parents, 438 were mothers and 114 were fathers. More than half of the parents (69%) stated that they had not heard of HPV vaccines. After a short briefing, the parents were separately asked about their thoughts on having their daughters and sons vaccinated with HPV. The majority of the parents with daughters (76.7%; among 532) and 74.6% of 508 parents with sons were positive for vaccination. After informed of the cost of vaccines and the required number of doses, 11.2% of the parents (n=62) stated that they would not have their children vaccinated even if the vaccine was provided by the state for free. The main reason for such an approach may be since they did not have enough information about vaccines [59.6% (n = 37)].
DISCUSSION AND CONCLUSION: Most of the parents did not have enough information about HPV vaccines. The parental vaccine acceptance rates were significantly affected by the paid vaccination. Healthcare professionals have a great responsibility for enlightening families on raising vaccination awareness and increasing vaccine acceptance rates among parents.

INTRODUCTION: Although Coagulase Negative Staphylococci (CoNS) species are among the microbiota members of the skin and mucosal surfaces, they cause infections especially related to medical devices such as catheters. Nowadays, antibiotic resistance is an important public health problem and rational use of antibiotics is of great importance in the treatment of bloodstream infections caused by CoNS species. The aim of this study was to investigate the antibiotic resistance profile and some virulence genes of CoNS isolates that cause catheter related bacteremia.
METHODS: In our study, 43 CoNS strains isolated from patients hospitalized in Manisa Celal Bayar University Hospital between 2016-2017, were evaluated for their susceptibility to ampicillin, clindamycin, mupirocin, linezolid, tigecycline, tetracycline, cefotaxime, gentamicin, vancomycin, ciprofloxacin, erythromycin and fusidic acid. The presence of clonal relationships and some virulence factors were also investigated. Susceptibility of cefoxitin (methicillin) was determined by disk diffusion and susceptibilities of other antibiotics were determined by microdilution method. AacA-aphD and aphA3 for aminoglycoside resistance, mecA and mecC for methicillin resistance, tetK and tetM for tetracycline resistance, ermA, ermB, ermC, msrA for macrolide-lincosamide-streptogramin (MLS) type B resistance, icaA, IS256, nucA and sasX virulence genes were investigated by polymerase chain reaction (PCR). Clonal relationships at species level were examined by Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR.
RESULTS: Considering all species of CoNS examined, the highest and the lowest resistance rates were observed for ampicilin (93 %) and linezolid (2 %), respectively. There wasn’t any resistant CoNS isolate to tigecycline and vancomycin. We found that all the examined CoNS species were generally clustered in different clones. We detected mecA, aacA-aphD, aphA3, ermB, ermC and msrA antibiotic resistance genes as well as icaA, IS256 and sasX virulence genes in the studied strains.
DISCUSSION AND CONCLUSION: The results of our study revealed that the examined CoNS isolates causing bacteremia had acquired resistance to commonly used antibiotics and that these strains harboring various virulence genes. Therefore, those isolates and their infections should be carefully monitored.

INTRODUCTION: Carbapenems are commonly used in treatment of severe infections caused by P. aeruginosa. However, carbapenem-resistant P. aeruginosa isolates have increased in recent years and have become a public health threat. The objective of this study was to compare in vitro activities of cefiderocol, imipenem/relebactam and other antibiotics against clinical isolates of carbapenem-resistant P. aeruginosa.
METHODS: A total of 92 carbapenem-resistant P. aeruginosa isolates (all isolates were resistant to imipenem according to both CLSI and EUCAST; all isolates were resistant to meropenem according to CLSI; 84 isolates were resistant and 8 isolates were 'I - Susceptible, increased exposure' to meropenem according to EUCAST) were included in the study. Susceptibility of isolates to cefiderocol, imipenem/relebactam, imipenem, aztreonam, ciprofloxacin, levofloxacin and gentamicin were determined by disk diffusion method. Susceptibility of isolates to meropenem, piperacillin/tazobactam and ceftazidime were determined by gradient diffusion method. Results were interpreted according to CLSI and EUCAST criteria.
RESULTS: The most active antibiotic tested against isolates were cefiderocol. All isolates were susceptible to cefiderocol using CLSI criteria, whereas 97.8% of isolates were susceptible to cefiderocol using EUCAST criteria. Gentamicin was the most active antibiotic after cefiderocol. Eighty-seven percent of isolates were susceptible to gentamicin. The imipenem/relebactam susceptibility rate among isolates were 66.3% and 73.9% according to CLSI and EUCAST criteria, respectively. Levofloxacin showed the lowest in vitro activity against isolates. The levofloxacin resistance rate among isolates were 70.7% and 82.6% according to CLSI and EUCAST criteria, respectively.
DISCUSSION AND CONCLUSION: Cefiderocol may be an option for treatment of infections caused by carbapenem-resistant P. aeruginosa.

INTRODUCTION: Hemodialysis is a life-saving invasive procedure in patients with chronic renal failure (CRF). However, in this procedure, infections, which often cause patient deaths, may develop due to catheter application. These infections are detected by monitoring the blood and/or catheter cultures of the patients. In the study, an analysis of the blood culture results of patients with CRF undergoing hemodialysis was performed in order to contribute to the epidemiological data.
METHODS: In this study, the culture results of patients who were thought to have catheter infection in the Hemodialysis Unit of SBU Samsun Training and Research Hospital between 2017 and 2020 were evaluated retrospectively. Blood cultures sent to the laboratory were incubated in the hemoculture device (Render, China) for one week and the presence of growth was monitored. Identification and antibiogram procedures were performed with the automatic bacteria identification device VITEK® 2 (BioMérieux, France).
RESULTS: Of the 56 patients whose blood culture was requested considering catheter-related bacteremia and catheter infection, 34 (60.7%) were male and 22 (39.3%) were female. The mean age of the patients was 62.38±14.8. Various pathogens were isolated from 35 (62.5%) of the patients. Two different bacteria grew together in 5 (8.9%) of the cases. Coagulase negative staphylococci alone or together with another organism were the most frequently reproduced organisms with a total of 24 strains (42.9%), followed by S. aureus with a total of 6 strains (10.7%). Other organisms isolated from blood cultures were Pseudomonas aeruginosa (5.4%), Enterococcus faecalis (3.6%), E.coli, Enterobacter cloacae complex (3.6%), and Klebsiella pneumoniae (1.8%). Of the coagulase-negative staphylococci, 17 (70.8%) were resistant to penicillin and 18 (75.0) to methicillin. Of the S. aureus strains, 3 (50.0%) were found to be resistant to penicillin and 3 (50.0%) to methicillin. A statistically significant difference was found between CNS and S. aureus growth in blood cultures (p<0.05).
DISCUSSION AND CONCLUSION: High rates of bacteria were isolated from blood cultures of hemodialysis patients in our hospital. This result makes it necessary to draw attention to aseptic conditions in the hemodialysis process. Monitoring of blood and catheter cultures, detection of causative agents and evaluation of antibiogram results will play a key role in preventing infections and taking necessary precautions in hemodialysis patients.

INTRODUCTION: Bacteremia is a serious condition that causes hospitalization and increases mortality. Gram negative bacteria are frequently isolated as causative agents. The aim of this study was to evaluate the distribution and antimicrobial resistance of the gram negative bacteria isolated from blood cultures in our hospital.
METHODS: Gram negative bacteria isolated from blood culture samples sent to the microbiology laboratory between 2016-2019 were retrospectively analyzed. The blood cultures were performed by BacT/ALERT 3D (bioMérieux, France) and Render-BC128 (China). Bacterial identification and antibiotic susceptibility tests were performed using conventional methods and BD Phoenix 100 (BD Phoenix System, Beckton Dickinson, ABD) automated systems.
RESULTS: A total of 10315 blood cultures obtained from hospitalized patients between 2016 and 2019 were evaluated. Microbial growth was detected in 3177 (30.8%) of the blood cultures. Gram negative bacteria were isolated in 873 (27.5%) blood cultures and were included in the study. Among gram negative bacteria, Escherichia coli (38.7%) and Klebsiella pneumoniae (12.3%) species are the most common pathogens. In our study, E.coli strains showed the highest resistance to ampicillin (76.6%), K.pneumoniae and other Enterobacterales species to amoxicillin-clavulonate (65.9% and 43.9%), Acinetobacter baumannii to carbapenems (95.4%), Pseudomonas aeruginosa to ciprofloxacin (26.1%). The most susceptible antibiotics were carbapenems and amikasin for Enterobacterales, amikasin and gentamycin for P.aeruginosa, amikasin and trimethoprim-sulfamethaxazole for A.baumannii.
DISCUSSION AND CONCLUSION: In our study, the frequency of gram-negative bacteria growth in blood culture was found to be 27.5%, similar to literature data. It was observed that the determined bacterial distribution was compatible with different studies. Blood culture is the most important test in the diagnosis of bacteremia and in directing the right treatment. Thedistribution of microorganisms isolated in bacteremia and their antibiotic resistance rates changes by center. For this reason, it was think that each hospital should determine its own data at regular intervals and guide antibiotic selection according to these results.

INTRODUCTION: Obesity is seen at many parts of the world and has become one of the main issues of public health. Obesity is the consequence of genetic, behavioral, environmental, physiological, social and cultural variables resulting in energy imbalance and encouraging unnecessary accumulation of fat. In our country, as in other countries, the incidence of obesity is increasing day by day. It has been shown that obesity contributes to the development of many risky diseases such as cancer, cardiovascular diseases, diabetes, hypertension. Another important disease group accompanying obesity is immune system diseases. Inflammation changes and immune cell functions in obese individuals play an important role in the pathophysiological effects of obesity. Obesity is a multifactorial and complex disease. Natural killer (NK) cell is cytotoxic lymphocytes, which is essential element of innate immune system. The human killer cell immunoglobulin‐like receptors (KIR) which is a class of transmembrane glycoproteins expressed on NK cell as well as a subgroup of T cell. KIR2DL4 is atypical KIR which varies by other family members in terms of cellular location, signaling, specificity of ligands, as well as protein function. The aim of the study was to investigate the relationship between KIR2DL4 polymorphisms and obesity.
METHODS: 50 obese (BMI> 30) and 50 non-obese (BMI <30) individuals participated in the study. After collecting blood samples, DNA isolations and PCR reaction, the relevant regions of the KIR2DL4 gene were amplified and digest with the suitable enzyme. Allele and genotype frequencies were calculated by direct counting and genotype distributions in the groups were compared by chi-square analysis.
RESULTS: No statistically significant association was found between obesity and rs649216, rs660773 polymorphisms (p>0.05). However, a significant difference was determined as a result of the comparison of genotype frequencies of KIR2DL4 rs660437– 9769 C > A polymorphism between obese and control group (p=0.004). CC genotype frequency was found to be higher in obese group (44%) than in control group (24%).
DISCUSSION AND CONCLUSION: rs660437 C allel frequency was significantly higher in obese group, so it might be a risk factor for the development of the disease (p=0.004).

INTRODUCTION: Malignant catarrhal fever (MCF), is a sporadic disease with high mortality caused by a group of viruses that is classified in Herpesviridae, in subfamily Gammaherpesvirinae and genus Macavirus. Alcelaphine herpesvirus-1 (AlHV-1) and ovine herpesvirus-2 (OvHV-2), are two pathogens in Macavirus genus that play an important role in the etiology of the disease. OvHV-2 of which the sheep is asymptomatic carrier worldwide, is transmissed to cattle with close contact and results in a lymphoproliferative and fatal disease of MCF. Husbandry of cattle and sheep together or selling of the species in animal markets in close contact have a key role in spreading of OvHV-2. In this study we aimed to investigate a bull that was purchased in a market in 2017 Festival of Sacrifice, after 3 weeks of incubation period, that had symptoms of opacity in the eyes, nasal and ocular mucopurulent discharge and accompanying nervous system symptoms.
METHODS: We used conventional polymerase chain reaction to investigate virus presence from blood and swab samples. Amplicons that were obtained from PCR were sequenced and raw data of sequences were compared to references previously recorded to GenBank. Phylogenetic analysis was performed with MEGA 5.0 software.
RESULTS: After PCR analysis of blood and swab samples, targeting tegument protein coding region of OvHV-2, an amplicon of 380 bp was obtained. Sequencing and phylogenetical analyses revealed that OvHV-2 strain in this study was closely related to India, Egypt and Iraqi strains and relatively distant to German, Canadian, Brazilian and African strains.
DISCUSSION AND CONCLUSION: We conclude that, in Muslim Countries unregulated animal markets which are formed during Festival of Sacrifice have significant risk of spread for OvHV-2 and different species should not be sold together in these areas.

INTRODUCTION: Healthcare-associated infections (HAI) are a global problem of increasing importance all over the world. HAI’s, which are difficult to treat are possible to prevent. Therefore, the importance of infection control strategies has increased around the world. The application of several measures together (bundle) has been published more effective than the application of infection control measures separately. The purpose of this study was to assess the effects of the urinary catheter care bundle on catheter-associated urinary tract infections (CA-UTI).
METHODS: Between June 2015 and December 2020, the rates of urinary catheter care bundle compliance and the effects on CA-UTI rates were evaluated in intensive care units at XXX University Hospital. The diagnosis of CA-UTI was made according to the diagnostic criteria of the National Health Care-associated Infections Surveillance Guidelines. The urinary catheter care bundle consists of three parameters: 1. Continuation of the catheter insertion indication; 2. The catheter is below the level of the bladder; 3. Cleaning the catheter twice a day with a soapy sponge.
RESULTS: Urinary catheter care bundle compliance and standardized infection rates (SIR) of CA-UTI were assessed between June 2015 and December 2020. In 2015, bundle compliance was 0.80 (0.75-0.83), 0.88 (0.84-0.90) in 2016, 0.89 (0.87-0.91) in 2017, 0.90 (0.88-0.91) in 2018, 0.88 (0.85-0.89) in 2019, and 0.87 (0.84-0.88) in 2020. CA-UTI SIRs were 4.06 in 2015, 2.91 in 2016, 2.3 in 2017, 1.52 in 2018, 1.74 in 2019, and 2.81 in 2020. When the effect of the urinary catheter care bundle (in the years 2015-2018) is analyzed, it corresponds to a reduction of approximately 60%. "Catheter cleaning twice a day with a soapy sponge" was found to have the lowest compliance across all years.
DISCUSSION AND CONCLUSION: We observed that as bundle compliance increased, our CA-UTI rate decreased. However, the fact that our SIR values are >1 indicates that our infection control measures are inadequate. These findings imply that bundle components should be reviewed and/or that bundle compliance observation is lacking. Bundles can be used as an incentive to provide consistent and disciplined maintenance, but they are only one component of a larger improvement strategy. While main infection control systems (such as isolation, surveillance, and hand hygiene) are in routine, bundle applications should be integrated into these systems.

INTRODUCTION: Hypertension is one of the common cardiovascular diseases in which many factors play a role in its development. The deoxycorticosterone acetate (DOCA)-salt model is an experimental model that is widely used in the investigation of the pathogenesis of essential hypertension. Although this model can successfully mimic essential hypertension in humans, both the rate and magnitude of blood pressure increase with unilateral nephrectomy does not fully reflects the clinical situation in most hypertensive patients. In this study, it was investigated the effects of prolonged administration of DOCA-salt without nephrectomy on blood pressure, body weight, heart and kidney functions of rats
METHODS: Male Wistar Albino rats (8-week-old) were used in the study. DOCA-salt hypertension model was induced by DOCA injection (20 mg/kg, s.c.) twice a week and and by adding salt (1% NaCl and 0.2% KCI) to drinking water for 12 weeks. Systolic blood pressures and body weights of all rats were measured weekly. At the end of the experiment, blood samples were taken from anesthetized rats and centrifuged, and plasma was collected. Right atrium and left papillary muscle tissues were isolated from rats. Phenylephrine, isoprenaline and acethylcholine-induced rhythmic activity and contractions of tissues were recorded in the isolated organ bath. Blood urea nitrogen (BUN) and creatinine levels were measured in plasma samples.
RESULTS: 12 weeks DOCA-salt administration without nephrectomy were significantly elevated systolic blood pressure of rats. The DOCA-salt application did not cause a decrease in the body weight of the rats. While the right atrium was not affeced to acethylcholine; the phenylephrine-induced alpha adrenergic receptor mediated contractile responses were increased and the isoprenaline-induced beta adrenergic receptor-mediated contractile responses were decreased in hypertensive rats. The DOCA-salt administration increased plasma BUN and creatinine levels of rats.
DISCUSSION AND CONCLUSION: These findings suggest that 12 weeks DOCA-salt administration without nephrectomy caused cardiac and renal changes associated with hypertension and could be used in hypertension studies as a noninvasive animal model.

INTRODUCTION: The aim of this study is to investigate the parasite prevalence, species and factors affecting parasite positivity in patients with digestive system complaints in Ordu Province in Turkey.
METHODS: 317 patients who presented with gastrointestinal complaints were included in the study. A questionnaire including; socio-demographic characteristics of the patients, lifestyle and digestive system complaints was applied. Cellophane band method, nativ-lugol, sedimentation and Modifiye kinyoun acid-fast methods were used for the diagnosis of fecal parasites. After the samples were prepared and stained, they were examined under a microscope.
RESULTS: Parasite positivity was detected in 205 (64.66%) of 317 patients. Blastocystis spp. constitutes 34.1%, 34.7% of Cryptosporidium spp and 16.1% of Entamoeba coli. The incidence of helminths was 2.8% and the incidence of protozoa was 97.2%. 73.7% of the parasite positive patients were in the age group of 40 years and over, 72.7% were women, 81% were married, 65.6% were middle-income, 48.3% had a primary and secondary education level. 58.5% lived in villages, 74.1% were housewives / unemployed. 77.6% of the parasite positive patients lived in the nuclear family, 51.2% were using city water, 93.7% were eating vegetables predominantly. In 9 (4.4%) of the patients with parasite positivity, no parasite was detected at the first examination, and it was detected in the 2nd and 3rd Bakers. The complaints of salivation in Entamoeba coli, Blastocystis spp. and Cryptosporidium spp, and allergy, rectal itching, drooling, increased appetite were significantly higher in Enterobius vermicularis (p <0.05).
DISCUSSION AND CONCLUSION: It has been observed that there is a high rate of parasites in patients presenting with digestive complaints. Mostly Blastocystis spp., Cryptosporidium spp species were observed in Ordu Province. Patients who present with the complaint of digestion, especially those whose complaints do not improve, should definitely be evaluated in terms of parasites and the preliminary diagnosis of parasitosis should not be immediately ruled out, even if the first stool examination is negative.

INTRODUCTION: Because of various problems in the differential diagnosis of non-tuberculous mycobacteria (NTM), clinicians may ignore these opportunistic bacteria. DNA is usually extracted from the bacterial culture in polymerase chain reaction (PCR)-based molecular methods, which have been successfully applied in recent years in the diagnosis of extrapulmonary mycobacterial infections such as mycobacterial keratitis, as well as in mycobacterial identification and drug resistance determination in patients with suspected pulmonary tuberculosis. Considering the difficulties experienced in culture, especially in mycobacteria, it is thought that DNA extraction not only from culture but also directly from clinical samples will shed light on the development of rapid and accurate diagnostic protocols. In this study, it was aimed to investigate the presence of mycobacteria along with microbial agents in corneal scraping samples of patients with keratitis.
METHODS: Corneal scraping samples were collected for bacteriological and mycological examinations from 43 patients diagnosed with keratitis at Balcalı Hospital of Çukurova University Faculty of Medicine between September 2016 and April 2017. In addition to routine bacterial and fungal cultures, in mycobacteriological examination, samples were inoculated in Löwenstein-Jensen (LJ) and Mycobacterium growth indicator tube (MGIT) 960 liquid system, and direct preparations were stained with the Ehrlich-Ziehl-Neelsen (EZN) method and examined microscopically. The existence of mycobacteria was also investigated by polymerase chain reaction (PCR) testing using specific primers targeting the hsp65 gene region after DNA extraction directly from corneal scraping samples.
RESULTS: No mycobacterial colonization could be detected in any of the corneal scraping samples as a result of mycobacteriological examination performed by both phenotypic and molecular methods. It was determined that various bacteria, except mycobacteria, were isolated from 39.5% of the 43 patients with keratitis evaluated, this rate was 47.1% in women and 34.66% in men. It was determined that the most frequently isolated bacterial agent was Staphylococcus epidermidis (23.3%), and the mixed colonization rate was 16.3%. Although there was no relationship between the results of bacteriological and pathological examinations and the diagnosis groups, gender, and age, it was statistically significant that additional eye disease accompanying keratitis was seen at older ages (p=0.036).
DISCUSSION AND CONCLUSION: Although no mycobacteria were detected in our study, it is the first study in which mycobacteria were investigated by a molecular method in direct corneal scraping samples. It was concluded that early and accurate diagnosis of overlooked mycobacterial cases would enable rapid drug resistance detection and treatment strategies to be planned more rationally, in the light of studies to be conducted with larger populations. In particular, the treatment of almost all keratitis cases (95%) with fluoroquinolones and/or amikacin, which are the most important therapeutic options for multidrug-resistant tuberculosis (MDR-TB) and TDM infections, suggests that mycobacterial colonization and infectivity may be temporarily suppressed. However, this may result in our exposure to infections caused by mycobacteria resistant to these drugs in the near future.

INTRODUCTION: The COVID-19 disease, which has affected the whole world, has seriously challenged the health system. In this period when the delivery of health services is in danger, understanding how the disease affects different parts of the human body has remained in the background. This study was conducted to identify patients with ocular complaints and findings from inpatient COVID-19 patients.
METHODS: A cross-sectional, retrospective study was conducted in individuals aged 18 years and older who were followed up and treated for COVID-19 in a tertiary hospital between 25 March 2020 and 31 March 2021. Electronic health records of all patients were reviewed. In adition Procalcitonin, urea, and neutrophil levels were compared between patients with and without ocular symptoms.
RESULTS: A total of 7060 patients with positive COVID-19 tests were included. The mean patient age was 60.89±16.96 years. 52.8% (n=19) of the patients were female and 47.2% (n=17) were male. The ophthalmology consultation rate was 0.5% with a total of 36 patients. The most common symptom was visual changes in 47.2% (n=17) of the patients. The second most common ocular pathology was chemosis, followed by conjunctival hyperemia and eye irritation. 100% of the patients exposed to keratopathy had a history of intensive care. (p<0.001). However, it was observed that the visual changes were not directly related to the intensive care unit. 88.2% of these patients did not have a history of intensive care (p<0.001). Significant elevations in the compared laboratory findings were observed in patients with ocular findings.
DISCUSSION AND CONCLUSION: It was also emphasized that COVID-19 affects the eyes at a low rate, but ocular findings may remain in the background, especially in patients who have been hospitalized for a long time and at the first admission to the hospital Although procalcitonin, urea and neutrophil counts were found to be higher in patients with ocular symptoms, it was not found that these patients affected the rate of admission to the intensive care unit.

INTRODUCTION: Health systems are increasingly concerned about the sustainability of health services due to factors such as increasing demand and costs worldwide. While countries seek to secure safe and quality health care, they also struggle with increasing costs. It is now recognized that health systems must go beyond their therapeutic role. Public health services adopting the principle of keeping individuals healthy are the most rational and cost-effective tools that can be used to compensate for these problems. Public health can help improve the effectiveness of health services by bringing a societal perspective to the organization of health services.
METHODS: Efficiencies of the health systems of 27 OECD countries between 2010 and 2018 were calculated using the Dynamic Network Data Envelopment Analysis method. Public health and hospital services system efficiencies and overall system performance are examined. The variables to be analyzed were alcohol consumption, primary health care expenditures, average life expectancy, maternal mortality rates for the public health system, hospital beds, physicians, inpatients and outpatient numbers for the hospital service system. The connection between the public health system and the hospital service system is based on vaccination rates and diabetes-based hospitalization numbers. In addition, the relationship between the periods is provided by preventive mortality rates for the public health system and the treatment of the hospital service system.
RESULTS: The average efficiency scores of the countries were calculated; nine countries were efficient. The number of public health systems evaluated as efficient was eleven, and the number of efficient hospital service systems was eighteen. According to Malmquist index results, the total factor productivity of all countries has increased except for five countries.
DISCUSSION AND CONCLUSION: Considering the input and connection projections of ineffective health systems, health systems need to improve their use of inputs and take precautions against lifestyle-related diseases, maternal mortality, and preventable and treatable mortalities. Despite the progress made in the eight-year period, it is clear that there is still a long way to go.

INTRODUCTION: In this study, it was aimed to evaluate the certified health training programs coordinated by the Ministry of Health from the perspective of the participants, with different dimensions.
METHODS: This research is a descriptive cross-sectional study. The population of the research consists of those who participated in any of the certified trainings coordinated by the Ministry of Health, during the research period. Research data were collected through the online questionnaire prepared in Google Forms. Survey questions have been prepared by the researchers, considering the general objectives of certified trainings, literature research and expert opinion. The questionnaire form consists of five parts. In the first part, there are seven multiple-choice and short-answer questions to obtain the personal information of the participants. In the other four sections, there are five-point Likert-type statements that the participants can evaluate the training program, ranging from “strongly disagree” to “strongly agree”. The second part is prepared for the content of the education (11 questions), the third part is for the educational environment (four questions), the fourth part is for the material of the education (four questions), and the fifth part is for the evaluation of the education as a whole (four questions). Descriptive statistics and comparative analyzes were used in the analysis of the data.
RESULTS: 1,013 people who received one of the certificated trainings in Operating Room Nursing, Pediatric Intensive Care Nursing, Neonatal Intensive Care Nursing and Intensive Care Nursing participated in the study. While 60.12% (609) of the participants are female, 99.01% (1003) are nurses, 56.27% (570) of them are undergraduates and 77.99% (790) work in the operating room, the mean age is 28.03 years and the mean working time is 5.84 years. Participants gave a mean of (out of 5) a minimum score of 4.50, a maximum of 4.59, and an overall score of 4.55 for the questions regarding the evaluation of education. The mean score given by the participants to the questions has been found to differ by gender, the institution where the education is given, the type of certified education, the occupation year, the education level, and the type of unit they currently work in.
DISCUSSION AND CONCLUSION: It was concluded that the participants generally found the certified training programs successful. Compared to others, the less experienced, younger and high school- graduated participants benefit more from the certified trainings.

The World Health Organization (WHO) defined the use of tobacco products as a preventable global epidemic. WHO has determined the policy topics that countries should implement to prevent this epidemic, known as MPOWER for short. It follows the activities of countries for these topics and publishes them in annual reports. As a result of the studies carried out under the leadership of WHO, the use of tobacco products by countries has decreased. The use of tobacco products, which was 32.7% in the world in 2000, is expected to decrease to 20.4% in 2025. In our country, it is predicted to decrease from 32.9% to 29.9% in the same way. Our country has successfully implemented the policy package within the scope of WHO's Framework Convention on Tobacco Control, and as a result, it has become one of the two countries that fully implemented MPOWER measures at the highest level of success. Companies that manufacture and sell tobacco products have launched new products in the face of these developments. The most popular of these products are Electronic Nicotine/Non-Nicotine Delivery Systems (ENDS/ENNDS) and Heated Tobacco Products (HTPs). The fact that the target audience of these new products is mostly 13 years old and over and their rapid spread among young people has led to the opening of new fronts in the war against tobacco.
The rapid spread of new products was influenced by the fact that their appearance was designed to attract young people, presented as an alternative to cigarettes, and created a perception of less harm. Studies have shown that these products are not harmless. WHO has stated that reducing the damage does not reduce the risk in terms of human health. The second most important factor affecting the use is the different perspectives and legal regulations of countries on these new products. While some countries have banned it, some countries have allowed its sale. This review aims to provide detailed In this review, about the legal regulations made in our country regarding novel and emerging nicotine and tobacco products

This digest was prepared to draw attention to the importance of health literacy in cancer awareness, relationship between cancer awareness and health literacy is examined in view of current information.
Cancer ranks the second among the causes of death in our country and in the world. In the highly globalizing World, due to the population increase accompanied by aging, an increase in cancer disease is observed. This causes physical, emotional, and financial burdens on social health systems, so, cancer remains a significant public health issue.
According to a World Health Organization report, 9.6 million people worldwide died of cancer in 2018, or one in six people. Cancer, falls into the category of non-communicable disease, is a chronic disease that progresses slowly, lasts for a long time with treatment, and monitoring which disrupts the quality of life of persons.
Early diagnosis of cancer by persons and society, and awareness of people about it, with adequate knowledge about what they must do are fundamental steps for cancer awareness. Cancer is socially considered a malignant disease and public awareness about it is based on health literacy.
According to the “Turkish health literacy level and related factors survey” conducted in 2017, health literacy level of 68.9% population was concluded as “inadequate and problematic”. For the adequacy of health literacy level, individuals should access information sources, understand, and apply the information correctly.
Awareness of cancer and level of health literacy play an important role in the early diagnosis of cancer to start earlier treatment. In societies with insufficient health literacy levels, low health care and preventive health services, raise the rates of non-communicable diseases, premature deaths. Because of negative social health provisions health care expenses increase. Countries should implement strategies for prevention, diagnosis, and treatment by raising cancer awareness, since cancer is a serious threat to public health. In this context, information is available concerning the effectiveness of various intervention programs aiming individuals’ own health to respect and improve their health by self-protection. Developing social awareness in health using various methods with correct steps will be effective in achieving a reasonable increase in the level of health literacy. Primarily the level of health literacy will be determined and following activities will constitute the pathfinder in terms of quality and quantity.It is obvious that in societies with a high level of health literacy, existence of higher awareness of cancer is a fact. To increase public health literacy level and cancer awareness, primarily health service providers, receivers of this service, and, other social institutions should share responsibilities in developing various methods of intervention