INTRODUCTION: The aim of this study was to determine the rate of HPV and cervical pathologies in Syrian women admitted to the gynecology-oncology outpatient clinic.
METHODS: 659 Syrian refugee patients admitted to the gynecology oncology outpatient clinic between January 2014 and September 2018 were included in the study. Pregnant women, women who underwent a hysterectomy, and those with a history of HPV vaccine were excluded from the study. Demographic data [age, socioeconomic status, educational status, smoking habits, parity, age of first intercourse, body mass index (BMI)] and clinical information (cervical smear, HPV genotype and cervical biopsy results) of the patients were evaluated. The statistical significance level was accepted as p <0.05.
RESULTS: During the study period, a total of 659 Syrian women who meet our study criteria admitted to our clinic. The mean age of Syrian patients included in the study was 25.13 ± 4.20 years, 23.60 % were married before the age of 18, and the educational status of 73.50% of patients were at high school and above. HPV DNA positivity was found in 5.30% (35/659) of the Syrian refugee women. In our study, HPV 16 was found in 22.80% (8/35); HPV 18 was positive in 17.60% (6/35); and other high-risk types were seen in 59.60% of patients. 97.60% of the patients (643/659) had normal smear results, while 1.40% (9/659) had ASCUS; 0.30% (2/659) had ASCH; 0.60% (4/659) had LSIL; and HSIL was present in 0.10% (1/659) of patients.
DISCUSSION AND CONCLUSION: The rate of HPV in Syrian patients was similar to women in our country, and the most common (except HPV 16 and 18) are other types of high-risk HPV. Considering that the Syrian citizens will stay in our country for a longer period of time, more effective cervical cancer screening programs should be applied to the Syrian women who have already suffered from great difficulties and the information deficiencies about vaccination must be eliminated.

INTRODUCTION: This study aims to investigate the relationship between digital technology screen exposure time and sleep duration in Alpha generation children. We hypothesize that children with longer screen exposure time and digital technology in the bedroom will have a negative impact on sleep duration.
METHODS: A total of 128 parents with children between the ages of 1-96 months were included in the study. A semi-structured evaluation form was used by the researchers to investigate demographic information, the use of technological devices, the presence of technological devices in the bedroom and sleep-related behaviors.
RESULTS: The distribution of technological devices in the children's bedroom was as follows; 46% television, 28.5% mobile phone, 11.2% computer and 14.3% tablets. It was found that the use or exposure of technological devices was highest (157.3 minutes) in children aged 25-48 months. When we examined the relationship between the duration of screen use /exposure of children and sleep time, it was found that there was a statistically significant relationship between total screen time and total sleep time (p=0.0001). There was no statistically significant relationship between screen time before bedtime, sleep onset time and total sleep time.
DISCUSSION AND CONCLUSION: It was seen that the most common technological device in children's bedroom was television and the group with the least sleep time was between 25-48 months and the children who were under the influence of the most technological devices before sleeping were children aged 1-48 months. It was observed that the increases in screen time in children was associated with a decrease in sleep duration but did not affect sleep time by having a technological device in the bedroom.

INTRODUCTION: Breast cancer is the most common type of cancer in women and accounts for 15% of cancer-related deaths. One of the strongest risk factors of breast cancer development, as well as high breast density, factors such as age, birth, breastfeeding, hormone replacement therapy also affect cancer development. In this study, it was aimed to evaluate the effects of sociodemographic data, breast density, presence of menopause, hematological and histopathological findings in women diagnosed with breast cancer.
METHODS: The examination, surgery and histopathological results of 154 patients who were referred to the Breast Unit and underwent mammography examination and tru-cut biopsy after the examination and diagnosed with cancer were analyzed retrospectively. According to the mammography findings, who underwent tru-cut biopsy due to suspected cancer and subsequently diagnosed as cancer, 154 patients’ examination, surgery and histopathological results were retrospectively reviewed. 140 patients were included in the study. Breast intensity was recorded from the patients' age, education and marital status, first menstrual age, first gestational age, number of pregnancies, age of first delivery, hormone replacement therapy, and BI-RADS classification results from mammography reports. After obtaining tumor diameter, grade, lymph node metastasis and whether there was lymphovascular invasion from the histopathology report, it was divided into groups according to TNM (tumor- lymph node- metastasis) classification. Neutrophil leukocyte/lymphocyte and platelet/lymphocyte ratios were calculated from the blood count values of the patients.
RESULTS: Of the 140 patients diagnosed with breast cancer, 32 were premenopausal and 108 were postmenopausal. While the mean body mass index (BMI) of premenopausal patients was 26.53 ± 3.05 kg / m2, the BMI of postmenopausal patients was 29.63 ± 5.60 kg / m2 and their BMI was statistically significantly higher than that of premenopausal patients. (p <0.001). It was found that mammographic breast density decreased while the age and body mass index of breast cancer patients increased (p <0.001, p = 0.013 respectively). It was observed that mammographic breast density increased in patients with high gestational age and first birth age (p<0.001). In mammography reporting of postmenopausal patients, BI-RADS was reported more frequently than 5 and 6 premenopausal patients (p=0.03). In mammography reporting of postmenopausal patients, BI-RADS 5 and 6 were reported more frequently than premenopausal patients (p=0.03). The mean platelet count of premenopausal patients, which is one of the hematological parameters, was 257.38 ± 65.70 (thousand), while that of postmenopausal patients was 293.31 ± 75.02 (thousand). The mean platelet / lymphocyte ratio was 131.31 ± 33.76 in premenopausal patients, while it was 161.11 ± 59.26 in post-menopausal patients. Platelet count and platelet / lymphocyte ratio were statistically significantly higher in postmenopausal patients (p=0.011 and p<0.001, respectively). No statistically significant difference was found in neutrophil and lymphocyte count.
DISCUSSION AND CONCLUSION: In conclusion, this study shows that if the platelet / lymphocyte ratio is high in postmenopausal patients with high breast density, this should be considered as a bad prognostic factor for family physicians and clinicians. During the evaluation of patients, breast density, presence of menopause and social-demographic data should also be taken into consideration.

INTRODUCTION: Healthcare staff are under the risk of needle stick and sharp object injuries due to their occupational exposure. In this study, it has been aimed to evaluate needle stick and sharp object injuries that occurred in the last 5 years in Abant Izzet Baysal University Training and Research Hospital.
METHODS: 58 needle stick and sharp object injuries occurred in Abant Izzet Baysal University Training and Research hospital between 2014 and 2019, were evaluated.
RESULTS: : 42 (%72.4) of 58 cases were women and 16 (%27.6) of them were men. According to their profession, most of them were nurses with a percentage of 65.5. %84.5 of the cases were needle stick injury and most injured body parts were right hand with %53.4 and left hand with %46.6. It was revealed that %93.1 of exposed workers had protective equipment during the injuries. When the distribution of the injuries was classified by years, it was found most injuries were in 2018 and 2019. It was determined that %53.4 of exposed workers had 0 or 1 year of occupational experience. Compared to the others, women and educated workers were found to have a correct approach after the injuries with a statistically significant difference.
DISCUSSION AND CONCLUSION: In our study, consistent with the literature, most of the exposed workers were nurses and incidents were needle stick injuries by a majority. The initial conditions for the prevention of needle stick and sharp object injuries are proper follow-up of notifications concerning this issue and providing an effective employee safety policy. Having universal precautions, organizing educations at regular intervals, reducing the workload of healthcare staff and providing safe and practical equipment maybe the other conditions to prevent these injuries.

INTRODUCTION: The aim of this study is to search if using thiol/disulphide homeostasis together with Neutrophile Lymphocyte Ratio (NLR) which are oxidative stress markers in patients who apply to the emergency service with carbon monoxide intoxication is useful regarding diagnosis or not.
METHODS: The study was performed prospectively with 45 patients who applied to the emergency service between 01.01.2014 - 01.03.2015 and who were included in the study and 40 healthy persons who were determined as control group. Thiol/disulphide homeostasis parameters (Thiol, disulphide, disulphide / native thiol, disulphide / total thiol, native thiol / total thiol) and NLR which are oxidative stress markers were studied in the patient and control groups by a method which was developed newly by Erel and Neþelioðlu.
RESULTS: In persons with carbon monoxide intoxication, a significant difference was detected in NT, TT, index 3 and NLR rates according to the control group. NT, TT and index 3 were found lower in the patient group, and NLR mean values were found higher in the patient group (p =0.005, < 0.001, = 0.032, < 0.001 respectively).
DISCUSSION AND CONCLUSION: To use NLR together with thiol/disulphide homeostasis parameters in the diagnosis of carbon monoxide intoxication is useful regarding diagnosing in these patients.

INTRODUCTION: This study aimed to evaluate the efficiency of menstruation hygiene training given to trainable intellectual disability adolescent girls.
METHODS: The study was conducted as a pretest-posttest quasi-experimental study. It was carried out with educable intellectual disability adolescent girls attending a Special Education and Application Center (School) located in the central county of Ankara province. The study was completed with 25 participants. Data were collected through a “personal information form” and “menstrual skills assessment form”. The researchers given education to participants to gain sanitary pad replacement skills. The menstrual pad replacement skills of them were followed before and after the training. The follow-ups were extended to the first and the sixth month after the training. Data were evaluated by computer.
RESULTS: The mean age of the participants in the study was 16.56 ± 1.00 (14-18). All of them had already got periods. Their menstrual process was found to be in the normal cycle. The median score for pre-interventional pad replacement skill was 16.00 (minimum: 0- maximum: 36). The post-interventional score for the first follow-up was 36.00 (minimum: 22- maximum: 36), it was 36.00 (minimum: 24- maximum: 36) in the second follow-up, and the difference was found strong evidence in support of the alternative hypothesis (p<0.001).
DISCUSSION AND CONCLUSION: It was revealed that the training given trainable intellectual disability adolescent girls by nurses by using video and dolls was an effective method for having intellectual disability adolescents gain pad replacement skills.

INTRODUCTION: Child labour is an interdisciplinary issue including the child rights dimension. Child rights training for non-governmental organizations in the means of forfeiture and keeping the rights of children gives crucial responsibility to NGO leaders. The research is done to assess the change of child rights knowledge level of NGO leaders via training.
METHODS: The research is experimental and it is accomplished in 4 pilot cities (Adana, Mersin, Ordu, Manisa) in four months between March and June 2018 and 123 persons took part in it. The study is supported by a UNICEF project cooperation with The Confederation of Turkish Tradesmen and Craftsmen (CTTC) and Hatay Mustafa Kemal University (HMKU). In the frame of the research, the leaders are given a four hours of training on child rights and child labour. Child labour survey form and child rights attitude scale is applied to the leaders before and after the training. The permission for the research is got from HMKU Ethics Committee. Gathered data is analyzed by SPSS 22, examined by Kolmogorov-Smirnow test in the means of distribution and then inter-groups Mann-Whitney U test / Kruskal Wallis test is used. Wilcoxon test is used before and after the training and p>0.05 is accepted as meaningful.
RESULTS: As a result of the research findings, child rights scale points average of NGO leaders are 97.52±10.95 before training for preliminary test; and 99.02±10.71 after training for posttest. Acquired values gathered before and after child rights training are statistically meaningful (p=0.01). The effect of training compared to the gender of leaders (M/F), working position (President/Worker), working experience (0-11 years), age variables is not statistically meaningful (p>0.05). On the other hand, education level of leaders is statistically meaningful depending on the cities that the research accomplished.
DISCUSSION AND CONCLUSION: Child rights knowledge level could be increased via the training of NGO leaders. The trainings should be increased considering the regional results depending on the pilot studies.

INTRODUCTION: The objective of this study is to examine the validity and reliability of the Primipara Breastfeeding Motivation Scale (PBMS).
METHODS: This is a methodological study conducted with 400 primiparous women who have applied to the Ümraniye Training and Research Hospital in the Istanbul Province between December 2017 and December 2018, and who are in their postnatal 6th month. The study data were obtained using the Turkish language version of the “Data Collection Form” and the “Primipar Breastfeeding Motivation Scale”. The PBMS measurements were tested by conducting validity and reliability analyses. The validity analysis for the data was conducted using the content validity index, the exploratory factor analysis, the confirmatory factor analysis, the reliability analysis, the Pearson product-moment correlation coefficient, and the Cronbach’s Alfa reliability coefficient. In evaluating the data, number/percentage, t test on dependent and independent groups, correlation analysis, Cronbach’s α analysis, and exploratory and confirmatory factor analysis were used. It was understood that motivation increased parallel to an increase in points on a scale with four sub-dimensions.
RESULTS: PBMS is a 37-item scale developed to evaluate the postnatal breastfeeding motivation in primipara. A test-retest measurement was conducted at fortnightly intervals in order to evaluate the constancy of the scale in time. As a result, no difference was found between point averages (p=0.435). In the internal consistency analysis conducted to determine the scale’s reliability, the reliability coefficient was found as α=0.884 for the value ascribed to breastfeeding dimension, α= 0.825 for the self-effectiveness dimension, α= 0.686 for the midwife support dimension, and α=0.873 for the expectation of success dimension.
DISCUSSION AND CONCLUSION: It was found that the Turkish language version of PBMS is a valid and reliable tool in identifying the breastfeeding motivation of mothers.

INTRODUCTION: Medical students are observed to feel depressive, anxious and stressful due to intensive medical education program along with other individual factors. This study aims at investigating the prevalence of depression, anxiety and stress levels and their potential determinant among medical students on before and after the exam in newly-established Medical Faculty of Kirsehir Ahi Evran University in Turkey.
METHODS: This study was carried out on before and after the first Commitee Exam by conducting 42-item Depression, Anxiety and Stress Scale with General Information Form that includes questions regarding health, academia and socieconomic-related factors between October and November 2018.
RESULTS: In total, prevalence of depression, anxiety and stress were found as 34.04%, 48.94%, 32.62% and 43.71%, 49.67% and 37.09% on pre and post-exam, respectively. Even though statistically unsignificant, Phase-II students had the highest depression (p=0.228 and p=0.512), anxiety (p=0.428 and p=0.083) and stress scores (p=0.125 and p=0.853) on both pre and post exam. Male students were more likely to feel depressed (p=0.044 and p=0.018), anxious (p=0.392 and p=0.209) and and stressed (p=0.736 and p=0.977) compared to females in overall in terms of their scores. Depression, anxiety and stress levels were mostly associated with health-related factors either pre or post-exam. Socieconomic determinant were found to be mostly associated with stress levels.
DISCUSSION AND CONCLUSION: High prevalence of anxiety was observed on both before and after the exam. Depression, anxiety and stress prevalences were found to be increasing on post-exam, therefore academic and social support systems are suggested to be provided for medical students.

INTRODUCTION: Feeding with breastmilk is the ideal way of baby feeding. In this study, we aimed to examine the available data of our breastfeeding support center and the mothers' breastfeeding attitudes. We believe that this study will allow further research to contribute to breastfeeding support.
METHODS: This prospective study included 50 mothers and their babies who applied to our breastfeeding support center. The research data were obtained by data collection form questions and were evaluated by using ‘statistical package for the social sciences’ (SPSS) 18 package program.
RESULTS: The mean age of the mothers included in the study was 28 ± 6,23 and ranged between the ages of 16-40. Pregnancy number of the mothers was 3.71 ± 2.59 (min: 1- max: 12). 32% of the women had 4 or more living children. The mean number of abortions was 1.90 (min: 1- max: 8). The rate of delivery by normal spontaneous vaginal way was 1.86 ± 1.05 and this is higher than cesarean delivery rate (0.21 ± 1.05). 60% of the babies were boys and 40% were girls. The mean infant age was 2.83 ± 3.38 (min: 0- max: 16) weeks. The rate of breastfed infants was 20%. 62% of the babies received bottle feeding supplements in addition to breast milk. When the reasons for hospitalization of infants were examined; low respiratory infection rate was 42% (20% pneumonia, 22% bronchitis), preterm delivery rate was 24%, neonatal jaundice rate was 8%, urinary tract infection rate was 8% and anomaly rate was 2%. The mean hospitalization time of the infants was 16.5 days. 96% of the mothers had milk. On the test weighing, the average amount of milk that the babies sucked from their mother was 20 ml. The most common reason for voluntary outpatient care is the mothers' concerns about milk adequacy.
DISCUSSION AND CONCLUSION: The importance of breastfeeding is a well-known fact. Early and unnecessary starting of additional foods and methods other than breastfeeding should be avoided. The fact that newborn babies are separated from their mothers due to reasons such as hospitalization and treatment affects the breastfeeding behavior of the mother negatively. It was observed that mothers need breastfeeding support training during the long and difficult period of breastfeeding. There is a need for remedial arrangements for effective initiation and maintenance of breastfeeding.

INTRODUCTION: The aim of this study is the evaluation of comorbidities in hospitalized patients with community-acquired pneumonia (TGP) and to investigate in the light of the literature.
METHODS: This retrospective, cross-sectional study was conducted in the Department of Chest Diseases. 142 patients with TGP between 2017-2019 were enrolled in the study. The data were obtained from the medical records of the patients. Demographic features, comorbidities and clinical findings of the patients were recorded. In the subgroup analysis, patients aged 65 and over were separately evaluated and their comorbid status was examined.
RESULTS: The mean age of 142 patients were 59.68 ± 20.35 (min 18-max 95). There were 54 (38%) women and 88 (62%) men. Comorbidities were presented in 80 patients (56.30%). The most common comorbidities were cardiovascular diseases (41.50%), diabetes mellitus (23.90%) and chronic lung diseases (19%). Half of the patients with TGP were 65 years old or older. The patients were divided into two groups according to over 65 years and under. Comorbidities were compared in two groups. Comorbidities were found to be higher in patients over the age of 65 years as expected (p=0.001). There were significant differences between the two groups in terms of cardiovascular diseases and diabetes mellitus (p=0.001, p=0.049, respectively). There was a positive correlation between age and comorbidities (p=0.001, r=0.512, respectively).
DISCUSSION AND CONCLUSION: Comorbidities in TGP are very important in determining the severity of the disease and treatment. Comorbidities are accompanied in most patients, especially in the increasing population of elderly patients. In this study, half of the patients hospitalized due to TGP consisted of patients aged 65 and over. In these patients should evaluate swallowing function especially in patients with neurological diseases. Also, primary health care and vaccination are important. Timely measures will ensure the elderly population to live more comfortably and reduce health costs. It will be beneficial to increase the number of geriatric centers in our country.

INTRODUCTION: The aim of this study was to determine the prevalence of polypharmacy in male and female patients over 65 years of age and to investigate its relationship with sociodemographic characteristics.
METHODS: This was a cross-sectional descriptive study conducted between 1 May 2019 and 1 August 2019 through a face-to-face interview in patients aged 65 or above who applied to Gemerek State Hospital Family Medicine Clinics. The questionnaire prepared by the researchers following the literature review was applied by researchers.
RESULTS: Mean age of this study including 358 individuals (n=198 women (55.3%) and n=160 men (44.70%) was 71.20 ± 6.60 years (range: 65-95). The incidence of polypharmacy was 38.78%. The proportion of women (44.42%) with polypharmacy was higher than that of men (31.89%), it was statistically significant (p<0.001). Aut of 9.09% among women did not use any drugs, while 24.37% of men did not use any drugs (p<0.001). The frequency of polypharmacy is not affected by marital status, income level, education level, place of residence, alcohol or smoking.
DISCUSSION AND CONCLUSION: The main findings of the present study are that the polypharmacy is widely seen among elderly, more comman among women than men and having atleast a cronic desease an important risf factor for polypharmacy.

INTRODUCTION: This study was conducted to examine the nonpharmacological method uses of patients with irritable bowel syndrome.
METHODS: 344 irritable bowel syndrome patients who referred to Aðrý State Hospital Internal Medicine outpatient clinic between January and June 2017 were included in this descriptive study. A questionnaire form was used in the collection of research data. Standard deviation, average, percentage, minimum and maximum values were used in the assessment of data.
RESULTS: It was found that 10.80% of the patients included in the study used nonpharmacological methods. It was determined that 70.24% of the patients using non-drug methods used herbal methods. It was found that of the patients who used herbal methods, 18,91% drank mixed herbal tea, 16,21% drank chamomile tea, 2,70% drank apricot tea, 5,40% drank green tea, 2,70% drank fennel tea and 2,70% drank mint tea; while 10,81% ate apricot, 8,10% ate vegetable and fruit and 2,70% ate linseed with yogurt. 13.51% of the patients were found to have abdominal massage, 10.80% were found to have exercise, 8.10% were found to have hot application and 5.40% were found to do handicrafts. 2.70% of the patients were found to listen to music and 2.70% were found to drink too much water. 64.90% of the patients were found to use their medication in addition to nonpharmacological methods.
DISCUSSION AND CONCLUSION: It was found that irritable bowel syndrome patients had low levels of nonpharmacological methods and the most used method was herbal methods, while methods used other than nonpharmacological methods were massage, exercise, hot application and handicraft, listening to music and drinking too much water. All of the patients who used the non-pharmacologic method stated that the methods they used had positive effects on their complaints. It is recommended for the effects, adverse effects and possible drug interactions of non-pharmacologic methods used by irritable bowel syndrome patients to be investigated.

INTRODUCTION: Pulmonary function tests are a necessary and applicable method in the practice of family medicine. Our aim in this study was to determine the utilization rates of spirometry or peak-flow meter devices among family physicians who work in Turkey and the factors that influence this usage.
METHODS: This descriptive study included physicians working in the family medicine system in Turkey. Surveys were sent to physicians via e-mail. When a sufficient number of responses(n=380) were obtained in two months (May 2018-July 2018), the study was terminated.


RESULTS: Among the responding physicians, 81.50% (n=310) had a peak-flow meter and 1.50% (n=59) had a spirometer, while11% (n=42) of the physicians had neither of these devices. On the other hand, 66.30% (n=252) of the physicians stated that they did not use the spirometer or peak-flow meter, 6.60% (n=25) used the peak-flow meter, and 3.70%(n=14) used the spirometer. When asked about the reasons for not using the existing devices, the most common reason was that they thought that the tests were not effective in family medicine and the second most common reason was not knowing how to use them. It was found that, 79.70% (n = 303) of physicians requested a course on spirometry and peak-flow meter.

DISCUSSION AND CONCLUSION: It was determined that the usage rates of peak-flow meter or spirometry devices, which are required in family medicine, are very low. In order to provide better service in primary care, more training is needed, both in medical faculties and after graduation.

INTRODUCTION: Public knowledge about and attitude towards sun protection practices are important factors in attempts to avoid skin cancer and other harmful effects of sun exposure. Such are the awareness levels of the students of medicine or their educators as they deliver the information to the general public and shape public health policies. The aim of this study was to reveal the knowledge and attitudes of the faculty members and students of medicine and of arts/sciences at a Turkish university towards the effects of sun exposure and protection.
METHODS: This descriptive cross-sectional study was conducted by administering a 37-item questionnaire to students and faculty members in the School of Arts/Sciences, School of Medicine, and Vocational School of Medical Sciences at Hitit University. The questions were formulated to evaluate the participants’ level of knowledge regarding the effects of sun exposure and protection, the source of their knowledge about these subjects, and their behaviors related to environmental factors. Responses were subjected to statistical analyses with appropriate tools and methods.
RESULTS: The study included a total of 217 participants with an average age of 26.0 ± 9.2 years: 145 (66.8%) students and 72 (33.2%) faculty members. Of these, 118 (55.1%) were female and 151 (69.6%) were in medical fields. A great majority of the participants (n=204, 94%) had used sunscreens, and sunscreens with SPF>30 were the most commonly used ones (%44). Brand (45.2%) and high SPF (46.2%) were the most frequently considered aspects when buying sunscreens. A comparison of subgroups of participants based on gender, position, and area of study indicated some differences in knowledge and practices related to sun exposure and sun protection.
DISCUSSION AND CONCLUSION: Although students and faculty members of medical areas had generally higher level of knowledge about the issues surrounding sun exposure and protection in comparison with those from non-medical backgrounds, there is still a significant knowledge deficit about the severity of associated risks and some room for improvement even among the students and faculty members of medical schools. The methods and media channels that would be used to increase public awareness should be adapted according to the demographic characteristics of target audiences. Further studies with a more comprehensive and well-managed data collection tools and a larger sample from more diverse set of institutions are warranted to determine the overall picture in the target population of this study.

INTRODUCTION: Thyroid hormone plays a significant role in the regulation of body metabolism and thyroid gland dysfunction is commonly seen in individuals with diabetes mellitus (DM). The aim of this study is to evaluate the relationship between hypothyroidism, body fat mass (BFM) and metabolic parameters in patients with DM.
METHODS: The study included patients with DM aged 18 years and above, who admitted to the Diabetes Unit of our hospital between December 2017 and May 2018. The files of all participants were reviewed retrospectively. All participants included in the study were divided into two groups according to the presence of hypothyroidism. Body mass index (BMI), total extremity fat mass (TEFM), total body fat mass (TBFM), trunk fat mass (TFM) and body fat percentage (BFP) of all participants were measured by bioelectrical impedance analysis. Hemoglobin A1c (HbA1c), triglyceride, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and C-peptide levels of the patients were evaluated. Targeted TSH levels in the treatment of hypothyroidism were defined 0.4-2.5 mU/mL in young and middle-aged individuals, 3-6 mU/mL in the 65-80 years of age, and ≤10 mU/mL in individuals older than 80 years of age.
RESULTS: A total of 620 patients with DM were included in the study and 141 (22.74%) of them had hypothyroidism. Thyroid regulation was achieved in 55 (39.01%) of the participants with hypothyroidism. Of female patients with hypothyroidism, BMI was 35.18±6.03 kg/m2, while it was 33.79±6.19 kg/m2 in patients without hypothyroidism (p=0.035). In male patients with hypothyroidism, BMI was 30.58±3.85 kg/m2, while it was 30.75±4.80 kg/m2 in patients without hypothyroidism (p=0.865). In female patients with and without hypothyroidism, HbA1c was 7.51±1.91% and 8.12±2.02%, respectively (p=0.004). However, in female patients with and without thyroid regulation, HbA1c was 6.73±1.21% and 7.95±2.10%, respectively (p=0.001).
DISCUSSION AND CONCLUSION: In females with hypothyroidism, BMI and TEFM were significantly higher, while there was no such difference in males. Furthermore, HbA1c levels were higher in females without hypothyroidism and HbA1c was lower in those with thyroid regulation. No significant difference was observed in terms of HbA1c levels in males with hypothyroidism.

INTRODUCTION: The aim of the study was to observe knowledge, attitudes and behavior of mother’sabout childhood vaccinationand related factors affectingtheir perspectives on immunization services and their hesitations about vaccination.
METHODS: This cross-sectional descriptive and qualitative study was carried out between August 2018 and May 2019 with 350 mothers who applied to 4 Family Health Centers for any reason in the central districts of Hatay. A questionnaire was administered to 350 mothers about their knowledge, attitudes and behaviors about childhood vaccines. The questionnaires were filled in by face-to-face interview method after informing the participants about the study and obtaining consent from the participants. A semi-structured in-depth interview form was administered to 30 randomly selected subjects. All interviews were recorded with voice recorder after approval. SPSS software was used for cross-sectional analysis and p <0.05 was considered significant. Content analysis method was used to evaluate the data at qualitative stage. Codes that can be extracted from sentences were composed. The proper themes that were subject to the thematic coding were removed after the composed codes. All interview data were coded and interpreted and reported, afterwards.

RESULTS: Of 350 mothers participated in the study. 31.71% (n: 111) were between the ages of 30-39, 73.43% (n: 257) were housewives and 30.29% (n: 106) were primary school graduates. 60.57% (n: 212) of the mothers stated that there was a lack of information about paid vaccines. The most commonly known and received paid vaccines were flu (33.33% n: 46) and rotavirus vaccines (24.64% n: 34). The most common vaccines in the national drug calendar to mothers were MCC (14.83%), varicella (14.53%) and tetanus (13.92%), respectively. According to the analysis of the interviews, participants emphasized that vaccines are necessary for their children, but attention should be paid to the content of the vaccines and the storage conditions of the vaccines.

DISCUSSION AND CONCLUSION: A significant number of mothers were found to lack information about vaccines.Regarding vaccines, mothers were most concerned about vaccine content and storage conditions.Providing accurate and appropriate information by health professionals is important for eliminating missing or incorrect information owned by individuals.

INTRODUCTION: The first diagnostic tool for the diagnosis of occupational asthma and rhinitis is clinical history, which inquires about the nature of symptoms and their relationship to work and specific occupational exposures. The present study aims to search for the presence of symptoms related to occupational asthma and/or rhinitis among health care workers.
METHODS: With an open questionnaire health-care workers employed in bacteriology, biochemistry/hematology, pathology and dental laboratories in tertiary health-care centers were questioned about the presence of symptoms regarding occupational asthma and rhinitis as well as the relationship of their symptoms with the workplace.
RESULTS: Of 230 subjects (165 females, 65 males) mean age was 34.39 ± 0.51 and they were exposed at work for a mean duration of 10.13±0.49 years. Work-related symptoms were positive in 172 (%74.78) subjects for about 4.92±0.42 years. All subjects employed in the pathology department and most of the ones (92.19%) in dental hospital and more than half of employees of bacteriology (72.92%), biochemistry/hematology laboratories (50.63%) were symptomatic. The most commonly reported symptoms by participants were nasal and ocular whereas other symptoms were found to be respiratory, constitutional and dermatological. 54.65% of the subjects were able to identify a specific agent related to their symptoms. Of the patients 88.37% stated that their symptoms were worse on the days when they came to work; 50.58% that their symptoms were intensified progressively throughout the week; 20.93% and 8.14% stated that they continued to be symptomatic during the weekend and long term holidays, respectively. Although being aware of the symptoms only %55.81 of the subject were willing to be tested in the clinic.
DISCUSSION AND CONCLUSION: The majority of the health-care workers working in tertiary centers have work-related symptoms involving one or more systems. However, most of them ignore their symptoms and are not willing to be evaluated for occupational asthma and/or rhinitis. Health-care workers should be informed about occupational health and their workplace conditions should be improved.

INTRODUCTION: Health literacy is the degree of capacity of individuals to understand and process health information, services that are necessary to make appropriate, accurate health decisions. This study was conducted to determine the health literacy levels and health responsibilities of the students studying in the nursing department of the Faculty of Health Sciences.
METHODS: The sample of the study consisted of 406 university students who accepted to study. Questionnaire form, rapid assessment of adult literacy in health form and health-promoting lifestyle behaviors scale were used as data collection tools. Mean and percentages were used for evaluation.
RESULTS: 75% of the students stated that they mostly understood medical terms written in the documents in health institutions. The mean score of the health literacy assessment form was 63.6 ± 0.9. According to the results of the health literacy test, 92.9% of the students had a sufficient level of health literacy by taking 61-66 points. The mean scores of students' health responsibility were 23.8 ± 5.38, and the item with the lowest level of participation was “I attend training sessions on subjects that concern my health”, and the item with the highest participation was “I tell the doctor or a healthcare professional about the unusual signs and symptoms in my body”.
DISCUSSION AND CONCLUSION: In line with the results of the study, it was determined that the basic level health literacy of nursing students was good. It is recommended that the study be applied to students outside the nursing department, awareness raising in terms of health responsibility and the integration of the concept of health literacy into health education.

INTRODUCTION: The aim of this study is to examine the effects of coping attitudes on quality of life in patient with stroke.
METHODS: This descriptive study was conducted between October 2018 and June 2019. The sample data were collected from 360 patients who had been admitted to neurology and physiotherapy clinics at a training and research university hospital and a government hospital in Karabuk. Data of the study were collected by the COPE inventory and the Stroke-Specific Quality of Life Scale. SPSS 25.0 program was used in the statistical analysis. Binary logistic regression analysis was used to determine the effect of coping attitudes on quality of life. P <0.05 and p <0.001 values were considered statistically significant.
RESULTS: Active coping (OR: 1.31 [95% CI 1.094–1.579]; p<0.05), restraint (OR: 1.173 [1.022–1.347]; p<0.05),humor(OR: 1.143 [1.023–1.276]; p<0.05) and alcohol/substance use(OR: 1.128 [1.008–1.262]; p<0.05), which are coping with the disease, were found to be significant predictors of on quality of life.
DISCUSSION AND CONCLUSION: Active coping, restraint, humor and alcohol / substance use are factors that negatively affect quality of life. When and how often these factors are used in stroke patients' lives should be examined carefully. it is recommended to develop stroke rehabilitation programs with training and multidisciplinary team to improve patient coping attitudes and quality of life.

INTRODUCTION: The aim of this study was to review our institutional experience with the clinical characteristics, imaging findings, and therapies in Neurofibromatosis type 1 (NF1) and defining the patients according to the USA- National Institute of Health (NIH) diagnostic criteria and comparing them with the literature.
METHODS: Clinical and imaging findings of 18 children with NF1, treated at our hospital from January 2015 to January 2019, were retrospectively evaluated.
RESULTS: The study group included 18 children diagnosed with NF1 according to NIH diagnostic criteria. Thirteen patients were female and 5 were male. The median age at admission was 8 years (1-17 years). The presenting symptoms were cafe-au-laits spots in 16 cases, abdominal pain in 1 case and jaw swelling in 1 case. All patients had cafe-au-lait spots, 9 (50%) axillary / inguinal freckles, 13 (72.22%) lisch nodules, 3 (16.66%) bone lesions, 1 (5.55%) neurofibromas and 1 (5.55%) plexiform neurofibromas. Short stature was detected in 3 (16.66%) cases. One of them was evaluated as growth hormone deficiency. Of the 10 patients attending school, 5 (27.77%) had poor school performance. Two of these cases (11.11%) were being diagnosed with ADHD. On magnetic resonance imaging, 6 (33.33%) cases had hamartomatous lesion and 1 (5.55%) case optic glioma.
DISCUSSION AND CONCLUSION: We found that the clinical and radiological findings of the patient group were consistent with the literature. Multidisciplinary follow-up of patients throughout the lifetime is necessary for the early detection, follow-up and treatment of complications.

INTRODUCTION: Increased thyrotrophin receptor antibody (TRAb) was associated with thyroid cancer risk and aggressivity in patients with Graves disease. This relation was not investigated in patients with toxic nodular goiter (TNG) and toxic multinodular goiter (TMNG). We aimed to evaluate association between TRAb and thyroid cancer in patients with TNG and TMNG.
METHODS: Patients who underwent thyroidectomy with a preoperative diagnosis of TNG and TMNG were reviewed retrospectively. Among 370 patients, TRAb was available in 191 TMNG and 30 TNG patients.
RESULTS: TRAb was positive in 24 (10.86%) of 221 patients with TNG/TMNG. Histopathological result was malignant in 71 (32.13%) and benign in 150 (67.87%) patients. TRAb was positive in 7 (9.86%) of 71 malignant and 17 (11.33%) of 150 benign patients (p=0.742). Age, sex, serum thyrotrophin, free triiodothyronine, free thyroxine, anti-thyroid peroxidase and anti-thyroglobulin positivity, and histological tumor type did not differ between patients with positive and negative TRAb (p=0.393, p=0.401, p=0.403, p=0.903, p=0.877, p=0.788, p=0.540, and p=0.357, respectively). There was papillary thyroid cancer (PTC) in 7 (29.17%) patients with positive TRAb and 57 (28.93%) patients with negative TRAb (p=0.357). The variant of PTC was classical in 5 (71.43%) patients with positive and 50 (87.72%) patients with negative TRAb (p=0.242).
DISCUSSION AND CONCLUSION: In this study, we showed that TRAb positivity did not increase the risk of malignancy in patients with TNG/TMNG.

INTRODUCTION: The purpose of this study was to compare the patency rate outcomes and efficacy of percutaneous transluminal angioplasty (PTA) versus percutaneous transluminal stenting (PTS) for the treatment of central vein stenosis and occlusion in hemodialysis patients.
METHODS: A total of 71 chronic hemodialysis patients (36 males, 35 females) with 142 events of central venous stenosis or occlusion underwent 109 endovascular interventions between March 2013 and June 2018. The clinical follow-up of the patients was performed with control venography at 1, 3, and 6 months, and then at 6-month intervals for asymptomatic patients.
RESULTS: PTA was applied to 45 patients and PTS to 26 patients during the study period. At 3, 6,12 and 24 months, primary patency rates were 97.74%, 88.23%, 73.76% and 50.76% respectively in the PTA group and 96.23%, 92.34%, 65.96% and 47% in the PTS group. Assisted primary patency at 3, 6, and 12 months was 97.73%, 90.76%, and 75.92% respectively in the PTA group and 96.25%, 84.38%, and 79.87% in the PTS group. No statistically significant difference was determined between the groups in respect of primary and assisted patency rates (p=0.216, p=0.121). The average number of interventions in the PTS group (2.62± 1.23) was significantly higher than that in the PTA group (1.43±0.62).
DISCUSSION AND CONCLUSION: Endovascular treatment is a safe and effective method in the management of central vein occlusion. PTS does not result in longer patency in the treatment, but conversely incurs greater costs and necessitates more interventions to provide patency. Therefore, PTS should only be preferred for PTA-resistant lesions or concurrent lesions.