INTRODUCTION: Water-borne diseases can be transmitted by spring water and also be transmitted after the transportation of clean water. Therefore, disinfectant effect should be maintained until reaching to all end users.
The aim of this study is to explore the effect of 6360 numbered law of New Metropolitan Municipality on water control for 2013 and 2015 years in Tekirdağ on microbiological pollution and case rate of acute gastroenteritis infection.


METHODS: The suitability of water controls at network and follow-up level concerning 2013 and 2015 for Tekirdağ province and case rates of acute gastroenteritis at province level regarding the same years caused by microbiological pollution were obtainedfrom electronic data bases of Public Health Directorate of Tekirdağ. The difference before and after the legislation was analysed by Wilcoxon signed ranks test.
RESULTS: Data from 341 drinking water safety point for years 2013 and 2015 were analysed. In 2013 and 2015 the contamination rate in monitoring points was 35% and 18%, respectively. There was a significant decrease in contamination rates comparing 2013 and 2015 data both in rural and urban residences (p<0.05). When analysing districts of Tekirdağ, the decrease between two years were significant in Ergene, Hayrabolu, Süleymanpaşa and Şarköy. For urban and rural settlements significant decrease was observed in microbiological contamination rates of rural parts in Ergene, Hayrabolu, Süleymanpaşa and Şarköy (p<0.05). The decrease in Süleymanpaşa was significant for urban settlement (p<0.05). No significant decrease was identified for acute gastroenteritis infection rates for the whole province and each of its districts when 2013 and 2015 data was compared (p>0.05).
DISCUSSION AND CONCLUSION: The legislation brought favourable changes in drinking water considering microbiological contamination particularly in rural part of Tekirdağ. Monitoring data other metropolitan municipalities should be evaluated for similar changes. If the changes are thought to be similar to these results considerably, centralization of institutions which performs water and sewage operations can be considered and new arrangements for cities with no metropolitan municipality may be established.

INTRODUCTION: It is important to choose the correct screening titer in immunoflourescent assay for ANA. Recently, 1: 160 titer is used worldwide, particularly after the suggestion of CDC (Centers for Disease Control) and WHO (World Health Organisation). In our country, 1: 100 is the mostly accepted titer for screening as a cutoff point. In this study, our aim was to check the ideal screening titer for Turkish society and investigate the convenience of suggested 1: 160 screening titer for our country.
METHODS: Between January- February 2015, a total of 400 patients (healthy blood donors and patients with autoimmune rheumatic diseases- has been diagnosed or followed) were included in the study. Serum samples taken from donors and patients worked ANA test with two different commercial (Aesku and Euroimmun) kits by 1: 100 and 1: 160 screening titers. Microscobic evaluation determinated by blind and automated system (Helios). The serum samples detected positive by 1: 100 and 1: 160 titers worked again with 1: 320, 1: 640…1: 5120 titers. In the end sensivity and specificity of the ANA test was figured out. Also cut-off values of the test was figured out by ROC curve analyse.
RESULTS: In healthy group the frequency of positivity is 8%, whereas in patients group it is 92%.
In healthy group distribution of ANA titer positivity is: in 1: 100 titer 44%, in 1: 160 31%, in 1: 320 19% and in 1: 640 6%.
In healthy group in 1: 160 distribution of ANA patern is: dense fine speck (dfs 70) 56%, speck 25%, nucleolar 12,5%, centromere 6.5%.
In patients’ group distribution of ANA titer positivity is: in 1: 100 1%, in 1: 160 3%, in 1: 320 26%, in 1: 640 25%, in 1: 280 34%, in 1: 2560 8% and in 1: 5120 3%.
In patients group in 1: 160 distribution of ANA patern is: speck 55%, homogeneous 24%, nucleolar 11%, centromere 5%, nuclear dots 3% and nuclear membrane 2%.
In 1: 100 screening titer sensitivity is 87.2% and specificity is 67.7% detected and in 1: 160 screning titer sensitivity is detected as 74% and specificity as 85.8%. The optimum cut-off value is found to be 1: 160 i ROC curve analysis.

DISCUSSION AND CONCLUSION: In our study, the ideal screening titer of 1: 160 for ANA test was confirmed. The screening titer of 1: 160, as proposed by CDC and WHO, is found confident to use in the laboratories in Turkey.

INTRODUCTION: In this study, it was aimed to investigate seroprevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B core antibody (anti-HBcIgG), hepatitis C surface antibody (anti-HCV) and hepatitis A virus antibody (anti-HAV IgG) in pregnant women admitted to Izmir Aegean Obstetrics and Gynecology Training and Research Hospital.
METHODS: This study was planned as a descriptive, retrospective and cross-sectional study.2003 pregnant women, who admitted to pregnancy clinic of Izmir Aegean Maternity and Gynaecology Training and Research Hospital and were directed to blood drawing centre between December 1, 2010 and September 30, 2011 were included in the study. A written consent form was obtained from whom accepted to participate in the study. A questionnarie including age, occupation, education, vaccination status and risk factorswas applied to the pregnant women. After the questionnaire, the blood samples which were taken from pregnant women were evaluated in terms of HBsAg, anti-HBs, anti-HBcIgG, anti-HCV and anti-HAV IgG antibodies. Blood samples were evaluated by ELISA technique.
RESULTS: The mean age of 2003 pregnant women participated in the study was 27±3 (18-44) years. In terms of occupational distribution, 89.70% were housewives, 5.4% were workers, 3.6% were freelancers, 1.1% were officers and 0.2% were students. As risk factors, being an intrafamilial transmitted hepatitis carrier was 3.6%, having had c-section was 9.4%, having had other operations 4.3%. Four percent of pregnant women had history of hepatitis B vaccination.HBsAg positivity in 1.14%, anti-HBs posivity in 17% ( past and recovered infection or vaccination), both anti-HBcIgG and anti-HBs positivity in 13.4%, anti-HBs positivity in 3.6%, anti-HCV positivity in0.7% and anti-HAV IgG positivity in 88.2% was detected.
DISCUSSION AND CONCLUSION: In our study, except HBsAg positivity rate, other parameters were found to be consistent with previous studies. Based on the rate of salt anti-HBs (3.6%), the low rate of HBsAg positivity was not associated with efficient vaccination. Low HBsAg positivity suggests that pregnant women who participated in our study were aware of prevention of hepatitis andits transmission paths. It has been contemplated that other hepatitis seroprevalence studies that will be carried out will contribute health policies in terms of public health.

INTRODUCTION: This study aims to evaluate the play doughs which are sold in bookstores located in Duzce and are mostly used in the pre-school education institutions in terms of bacteriological due to its closely relation to child health.
METHODS: In total 50 samples from 5 different containers which belong to 10 different companies were included in the study. Each of the containers was evaluated in six times as pre-play, first post-play day, first post-play week, second post-play week, third post-play week and fourth post-play week. Firstly Gram staining, later conventional methods such as catalase test, glucose test, nitrat test, voges proskauer test and Phoenix 100 BD automatize system were used for the identification of the bacteria in the samples in which growth existed. Z-test fordifferences between two dependent proportions was used for determining statisticallythe growth in pre-play and post-play period.
RESULTS: In the analysis done it figured out that while no growth existed in any culture of two companies (20%) out of 10, growth in all cultures of two products existed. In consequence of identification it was determined that all the bacteria reproducing were Bacillus licheniformis and Bacillus cereus which belong to Bacillus genus. It was determined that 51 (33%) of all Bacillus were B. licheniformis and 104 (67%) of them were B. cereus. In consequence of the culture study done after play, it was seen that bacterial growth decreased a little in play dough although it did not make sense statistically from first day to fourth week.
DISCUSSION AND CONCLUSION: The growthing pathogen can cause health problems such as initially food poisoning and eye infections, and edible label on most of paly dough containers available in market and used in pre-school institutions in order to strengthen hand muscles of children makes the situation worse and more dangerous. Besides, the reliability of some play douhgs which can threaten child health in our country in the sense of bacteriological were emphasized for the first time according to the literature search done.

INTRODUCTION: The supplementary study which aims to determine the use of herbal products among university students and their families has been conducted with 855 participants.
METHODS: The questionnaire form has been applied to individuals through face-to-face meeting.
RESULTS: More than a half of the participants are female and single. More than a half of the males are university graduates. The average ages of males' and females' are 35.2±10.52 and 30.7±11.8 years, respectively. Females use more herbal products than males do. Females' use of herbal products on the purpose of weight-loss (30.6%) is more than that of the males (15.1%). More than a half of the males (57.6%) prefer herbal products in the case of common cold. Females' use of herbal products in the forms of tea and tablets (76.0% and 9.5%) is more than that of males (4.0% and 36.6%). Most of the participants (male: 75.8% female: 86.6%) buy such products from herbalists. More than a half of them (male: 51.5% female: 56.0%) state that they get the necessary information and usage method from their neighbours and relatives whereas one third of them (male: 39.4% female: 26.7%) indicate that they use the products without doing any research beforehand. It has been detected that 19.2% of the males and 24.5% of the females use herbal products twice or three times a week and that 49.4% of the females use such products more than a year. A great majority of the participants do not mention their products to their doctors. Top 5 dry herbs used in 95 products analyzed are black pepper (37.1%), cinnamon (30.1%), black sesame (28.4%), red pepper (24.5%) and thyme (23.8%). Carrot (34.0%), olive (33.2%), pomegranate (32.0%), parsley (27.9%) and walnut (24.0%) are mostly used as fresh herbs. Green tea (34.5%), linden (32.5%), rose hip (29.2%), bee balm (21.2%) and fennel (19.0%) are preferred as herbal teas.
DISCUSSION AND CONCLUSION: As a result of this research, it was determined that the high use of herbal products. But, majority of the individuals got herbal products from the herbalist and they did not share herbal products with their doctor. This situation should be taken seriously by healthcare professionals and damage to the health of the patient should be avoided by making the necessary information.

INTRODUCTION: Bloodstream infections are the most common nosocomial infections and significant reasons for mortality and morbidity. Early diagnosis and treatment are of vital importance in terms of patient prognosis. Blood culture is the most reliable method for the diagnosis of bacteremia and sepsis. The aim of this study was to identify the microorganisms isolated from the blood cultures sent to xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Medical Microbiology Laboratory from various clinics between January 2011 and December 2014 and to determine antibiotic resistance profiles of these microorganisms.
METHODS: Blood cultures were studied by the BACTEC 9120 (Becton-Dickinson Diagnostic Instrument Systems, USA) automation system. The identification of the microorganisms was carried out by both conventional methods and BD Phoenix Automized Microbiology Identification System (Becton Dickinson and Company, Sparks, USA) Antibiotic susceptibility of the bacteria was studied with Kirby-Bauer disc diffusion method and evaluated as regards the criteria of Clinical Laboratory Standards Institute (CLSI).
RESULTS: A total of 50.850 blood cultures taken from 22.366 patients were examined in this study and reproduction was detected in 7.510 (14.7%) of the cultures. 4.894 (67.5%) of the reproduced microorganisms were Gram positive cocci (71% plasma coagulase negative staphycoccus, 9% Staphylococcus aureus, %9 Enterococcus sp., and %6 Streptococcus sp.), 181 (2.4%) were Gram positive bacillus, 2105 (28%) were Gram negative bacillus (32.9% E.coli, 23.9% Klebsiella sp., 16% Pseudomonas aeruginosa, 13% Acinetobacter sp., and 5.8% Enterobacter sp.), 21 (0.27%) were anaerobe bacteria and 305 (4%) were fungus type (96.7% Candida sp.). Methicillin resistance was detected as 34% in plasma coagulase negative staphycocci and 20.9% in S. aureus. Vancomycin resistance in enterococcus was determined as 13%. Broad-spectrum beta-lactamase formation was found as 34% in E. coli and 50% in Klebsiella sp. Carbapenemase production was detected as 8% in E.coli and 17% in Klebsiella sp.
Resistance rates of E.coli and Klebsiella sp to ampicillin was respectively as 44.7% and 100%, to gentamicin as 26% and 27%, to amicasin as 15% and 17%, to amoxicillin+clavulanate acid as 30% and 35%, cefuroxime as 41% and 51%, to cefepime as 35% and 50%, to ceftazidime and cefotaxime as 36% and 50%, and to ciprofloxacin as 39.5% and 31.8%. Resistance rates of Acinetobacter sp. and P.aeruginosa to ceftazidime was respectively as 78% and 22%, to ciprofloxacin as 64% and 12.6%, to imipenem as 63.6% and 26.5%, to gentamicin as 56% and 11.8%, to amicasin as 53% and 7%, to piperacillin + tazobactam as 58% and 12%, to cefepime as s61% and 16.6%, to cefotaxime as 74.7% and 22%, and to cefoperazone + sulbactam as 56.7% and 11%.
DISCUSSION AND CONCLUSION: It is understood that Staphylococci resistant to methicillin, which is a significant problem in our hospital, bacteria like E. coli and Klebsiella, and bacteria like Pseudomonas and Acinetobacter are multiple-drug resistant and that this resistance has undergone a change over time.

We report a case of distal subungual onychomycosis of the thumb of the right foot of a 25-year-old female. Nail examination was examined in our laboratory and distal subungual onycomycosis was detected. In direct microbiological examination septate hyphae was observed by using % 20 KOH. Scraping of nail was cultured on two Sabouraud's dextrose agar with cycloheximide and without cycloheximide slants at 25C˚ for one week. Growth of colony was observed in without cycloheximide slants. The same brown colonies were produced on repeated cultures by using Sabouraud's dextrose agar without cycloheximide. After growth of colony, slide cultures were prepared and brown-colored septated hyphae, perithecia, lemon- shaped ascospores were observed by light microscopy. The causative agent was identified as Chaetomium globosum based on DNA sequencing and mycological examination. Using CLSI M38-A2 microdilution method, minimum inhibitory concentration values of amfotericin B, fluconazole, itracanozole, miconazole, ketoconazole, flucytosine voriconazole were determined as 4, >64, 1, 0.125,0.125, >64, 0,5 μg/ml respectively. Fluorocytosine and fluconazole were determined as resistant for Chaetomium globosum and the best effective antifungal was determined as miconazole and ketoconazole. The patient was treated by using oral itraconazole (250 mg /a day) and local application of amorolfine 5% nail lacquer for 12 weeks.

We report on the case history of catheter-related Ochrobacturm antropi (O.antropi) bacteraemia developed in 4 years old girl with pre-B cell ALL (Acute Lymphoblastic Leukemia) who is taking chemotherapy. At the start of chemotherapy babyport (portacath) was implanted. The patient who had 38.5 degrees fever after block chemotherapy was diagnosed as neutropenic fever and simultaneously peripheral and catheter blood cultures (BacT/ALERT 3D, bioMerieux, France) were taken. The first, second and fourth days of blood cultures taken from catheter were positive, whereas peripheral blood cultures were negative simultaneously. VITEK 2 (bioMerieux, Fransa) and BD Phoenix 100 (Becton Dickinson, USA ) automated systems were used to identification of bacteria, and O.antropi was identified. The isolate was susceptible to imipenem and meropenem, and resistant to cefepime, piperacillin-tazobactam, cefoperazon-sulbactam, amikacin, trimethoprim-sulfamethoxazole, ciprofloxacin, ofloxacin, levofloxacin. The cultures were negative on the fifth and sixth days of therapy therefore the catheter was not removed. O.antropi should be considered as agent pathogen with catheter related infection especially in the immunocompromised patients.

Laboratories provide services focused on reliable, accurate and timely results in accordance with the present technological conditions. As Quality work is a requirement for laboratories, ISO/IEC 17025 “General Requirements for the Competence of Testing and Calibration Laboratories” standard means competence in this field.
That when practices and activities described in Quality Management System (QMS) documentation and/or standards are not fulfilled is defined "Non-Conformity". It is very important to eliminate problems due to findings obtained from the audits performed TURKAK according to ISO/IEC 17025 and also internal audits for continuity and improving the quality system.
When overall audits examined; major and minor non-conformities identified in first audit, just after establishment of Quality System, differ from the ones in next audits. After the system operates, major non-conformities decrease and minor non-conformities increase but these can be eliminated by corrective actions.
Requirements for the accreditation of the experimantal/calibration laboratory are defined in TS EN ISO/IEC 17025 standard and routinely applied accreditation audits are performed due to specified conditions in this standard. The terms and conditions to be fulfilled by this standard is described in the section under the heading of 4. Article "management requirements" and 5. Article "technical requirements".
In this report, the findings identified in the laboratory audit is compiled, tried to be determined in which areas concentrated. Especially, it is seen that laboratories have deficiencies, experiencing difficulties on these matters which of the Standard in clause 4.1, 4.3, 4.7, 4.11 of Management requirements and in clause 5.2, 5.4, 5.5, 5.10 of Technical requirements, in the Audit. These clauses are the basic conditions of the system such as; Organization, document control, Service to the customer, Corrective action and provides the implementation of the system.such as Personnel, Validation of methods, the Equipment and Reporting the results.
Common non-conformities and determinations detected after accreditation audits performed with the scope of ISO/IEC 17025 Standard are considered to be a benefical and to give guidance for accredited or will be accredited identical laboratories.

The components obtained from natural products have been used in many fields such as medicine, pharmacy and biology throughout the history. Some important new commercial drugs have been obtained from natural molecule using as a model in the cancer field. Studies for the development of cytotoxic agents were an important step for the discovery of new anticancer drugs. Large structural diversity of natural components and their bioactivity potential may serve to improve the therapeutic potential with molecular modification. The number of studies on the anticancer activity of lichen components has increased in last few years. Lichens are symbiotic organisms of fungus and algae or cyanobacteria. Lichens synthesize a great variety of secondary metabolites. Lichen secondary compounds have many possible biological activities such as antiviral, antitumor, antibacterial and antiherbivore and antioxidants. In recent years, one of the most important features of lichen secondary metabolites will also be candidate molecules in the treatment of anticancer therapy in the medical and biotechnology studies. Elucidation of the molecular basis of cancer related processes and also apoptosis are provide to great utility in finding alternative drugs for treating cancer. In this review research the knowledge about lichen secondary metabolites, the potential for effective use in the treatment of cancer, all molecular mechanisms in cancerous processes and mainly apoptosis pathway.

Gene therapy is used for developing strategies for the treatment of genetic diseases and it is a promising technique for people with incurable diseases. A successful gene therapy includes the transfection of plasmids with related transgenes into the target cells. The transfer of the DNA molecule to target cell is the main problem of the gene therapy studies which directed researchers to find an effective way of transfection. The transfection of DNA is commonly achieved by a vector because of the limited insertion ability of the DNA into the cells and the possibility of enzymatic degradation of DNA molecule. These vectors are grouped into two categories as viral and non-viral. Adenovirus, adeno-associated virus, herpes simplex and retrovirus are the main examples of viral vectors. Non-viral vectors are grouped into two as physical and chemical methods. The physical methods are microinjection, particle bombardment - gene gun, electroporation, sonoporation, laser beam and magnetofection. The chemical methods are consisted of liposomes which were developed as an alternative to the viral vectors. These vectors must have 3 important features for the transfer of the related gene into the cell nucleus. Those are disguising the negative charge of the DNA, condensing the DNA molecule and protecting it from the intracellular nuclease activity. Non-viral transfection systems such as liposomes are preferred rather than viruses, because of being non-immunogenic, ease in formation and simple scale-up process in industrial production. Liposomal vectors have a diversity in morphology and in release characteristics, which they can be used in tissue targeting and they can protect plasmid DNA from the attacks of degradative nucleases. DNA - cationic lipid complexes were used in different DNA transfer protocols in various cell types since defined as a potential transfer system in 1987 and is still being researched for the clinical gene therapy studies. This review is highlighting the chemical and physical methods of gene therapy as a novel and promising technique for the treatment of cancer and genetic disorders.