INTRODUCTION: On December 31, 2019, the WHO reported pneumonia cases of unknown etiology in China and on January 7, 2020, the causative agent was identified as a new coronavirus. The disease has become a pandemic. Physicians are the leading medical staff in the epidemic. This study was conducted to determine the knowledge and awareness levels of the physicians working in primary, secondary and tertiary hospitals about the COVID-19 outbreak.
METHODS: This study, was designed as a cross-sectional and descriptive study. A survey was conducted electronically to 378 physicians. Questions were asked about the physicians' demographic characteristics, occupational information, duration of employment, whether they got education on the COVID-19 outbreak and the microbiological characteristics of the virus. Statistical significance level was taken as 5% to evaluate the results and TURCOSA program was used for calculations.
RESULTS: Of the 378 physicians participating in the study, 57.70% were male and 42.30% were female. The median age of physicians was 35 (24-64) years. At the time of the survey, 47.80% of the physicians were trained and 52.20% were not trained. The median level of knowledge score of the general practitioners was 11 (7-17), and the median level of knowledge score of specialists was 11 (5-16), and there was no significant. There was a significant difference between the trained and non-trained physicians in terms of knowledge level score.
DISCUSSION AND CONCLUSION: We found that, attending physician’s speciality was not important on awareness about COVID-19. The most important factor was training on pandemic given to physicians.

INTRODUCTION: Mushroom poisoning has seasonal characteristics and is an important health problem. A good outcome is expected in the early period(30min-6 hours). There is a high risk of serious complications in late symptoms (after 6 hours). We aim to evaluate the epidemiological evaluation of fungal poisoning in 10 years period and to investigate the difference between early and late poisonings and the factors that cause mortality and morbidity.
METHODS: The data of patients aged 18 years and older who applied to the emergency department with mushroom poisoning between June 2011 and June 2020 were retrospectively evaluated.
RESULTS: We evaluated 163 patients, and 90 (55.20%) patient were male. The median age of the patients was determined as 46.00 (33.00-58.00). Patients most often applied in June. 16 patients had dizziness, 14 had altered mental status. 58 (53.40%) of the patients had early poisoning. Early poisonings were mostly applied in spring, late poisonings in the autumn season. ALT was determined to be higher in the late poisoning group (p = 0.003). 61.80% of late poisonings and 35.60% of early poisonings were hospitalized (p = 0.005). Patients could be discharged, although 3 of late poisonings developed kidney failure and 1 had a resistant infective picture.
DISCUSSION AND CONCLUSION: It is thought that mortality is reduced thanks to early diagnosis, easy access to the hospital, and improvements in treatment. In cases with nonspecific symptoms (such as nausea, sweating, change of consciousness), mushroom poisoning should be questioned.

INTRODUCTION: Labor is known to cause severe pain; therefore, it can lead to significant stress, anxiety, and even depression. We investigated the effect of listening to music from the end of the active stage of labor until the completion of episiotomy repair on pain, anxiety, stress, and depression levels.
METHODS: The study includes 90 pregnant patients that were planned to have vaginal delivery between 2017 and 2019. We played music starting from the end of the active phase of the 1sth stage of labor until the completion of the repair of restrictive mediolateral episiotomy. The subjects were randomly divided into three groups: classical music (n = 30), Turkish pop music (n = 30), and control group (n = 30). The control group was only provided with a headset that would reduce noise. We used DASS-42 to evaluate stress, anxiety and depression, and the Visual Analogue Scale for Pain (VAS) to evaluate pain. We compared the results of the three groups.
RESULTS: The anxiety and depression scores of the three groups were not significantly different; however, stress findings were significantly lower in the Turkish pop music group. We observed that this result was majorly associated to the working status of the mother. The pain results of the three groups were not significantly different.
DISCUSSION AND CONCLUSION: Music should be noted that this effect is especially prominent when the music is in the patient’s native tongue. Also, we conclude that playing music is not as effective as expected in relieving pain caused by episiotomy.

INTRODUCTION: Musculoskeletal disorders are a group of disorders that affect the joints, bones, and muscles, causing long-term disability. The aim of the present study was to examine the usefulness of herbal products in musculoskeletal system pain.
METHODS: This descriptive sectional study included 98 individuals who applied to Outpatient Clinic with chronic musculoskeletal system pain, who were 18 years old and over, who had reported using herbal products for more than a week and who were willing to participate in the study. The individuals were subjected to a 26-item questionnaire form which was prepared by the authors and which questioned sociodemographic characteristics of the participants and their use of herbal products.
RESULTS: It was found that 7.09% of the individuals with musculoskeletal system pain used herbal products. The most common six products used by the individuals in decreasing order were horse chestnut gel (19.38%), olive oil (15.30%), okra seed (13.26%), plane tree leaves (10.20%), juniper oil (8.16%) and black cumin oil (7.14%). Of all individuals, 57.14% of them (n = 56) reported that they did not need to notify physicians about their herbal product use.
DISCUSSION AND CONCLUSION: It is clear that patients resort to the use of herbal products in musculoskeletal system pain. In order to have better outcomes with the herbal products used in therapy, patients should be informed about the proper dose, duration, indication and time, and side effects and drug interactions of herbal products. Patients should be encouraged about informing their physicians and healthcare providers about their use of herbal products.

INTRODUCTION: Premature newborns are defined as babies born before 37 weeks of pregnancy and after 22 weeks of pregnancy as a viability limit. Aim of this study was to analyze growth characteristics at the age of second and third age and prevention of metabolic diseases that may occur in adult age at an early phase.
METHODS: This study was conducted as a retrospective cohort study between May 2018 and October 2018 in 18 different Family Medicine Outpatient Clinics in Rize, Central district. All participants were at least 3 years old and their follow-up visits made by the same family physicians for 3 years.
RESULTS: It was found that 54.66% of babies were males(n=123), 45.33% of them were females(n=102). According to BMI (Body Mass Ýndex) evaluations, 19.11% of babies were overweight(n=43), 16% of them were obese(n=36) at the age of two and 20% of them were overweight (n=45), 13.33% of them were obese(n=30) at the age of three. The mean Hb levels of the mothers whom children were obese at the age of two were statistically lower than the others (p<0.001).
DISCUSSION AND CONCLUSION: According to WHO, worldwide prevalance of childhood overweight and obesity was 6.70% in 2010 and it is expected to reach 9.10% in 2020. When we searched reasons of high overweight and obesity prevalance, there wasn't significant difference related with maternal factors and feeding patterns. We found significant relationship between maternal anemia and being overweight and obesity at the age of two.

INTRODUCTION: In the geriatric population, body response to trauma changes with age-varying physiology. Scoring systems are studied in many patient groups and diseases in terms of hospitalization requirement and prognosis prediction. In this study, we aimed to determine the demographic characteristics of patients over 65 years of age who applied to the emergency department with trauma, and to evaluate the RTS score together with the form of trauma.
METHODS: The study is a prospective, cross-sectional study. Trauma patients aged 65 and over who applied to a university hospital emergency room between 01/12 / 2017- 31/05/2018 were included in the study. Demographic data, vital signs, physical examination findings, imaging, laboratory results, erythrocyte suspension (ES) requirement, patient outcomes, and in-hospital and 28-day mortality were recorded. RTS scores of all patients were calculated.
RESULTS: During the study period, 4898 geriatric patients applied to the emergency department. 229 patients with the inclusion criteria were included in our study. 153 (66.81%) of the study patients were women and the median age was 79 (IQR 72-86). The most common comorbid disease in patients was hypertension (n = 109, 47.59%). The most common complaint was to drop. The median RTS of the patients was found to be 12. When the last diagnoses of the patients were analyzed, it was seen that soft tissue trauma (YDT) (31.87%) and femur / hip fracture (23.58%) were the most common. Compared to normal and low patients according to RTS scores, it was observed that the group with low Alzheimer / dementia, presence of previous stroke, erythrocyte suspension requirement and mortality rate were higher (p <0.001, p = 0.002, p <0.001, p = 0.002, respectively).
DISCUSSION AND CONCLUSION: With the development of living standards, the elderly population is increasing in our country. Accordingly, the probability of the elderly population exposed to trauma also increases. In our study, we showed that the patients were admitted to the emergency room most frequently due to mechanical or non-mechanical fall, the most common injury area was extremity / pelvis, and the presence of Alzheimer's / dementia and previous stroke, ES requirement and mortality rate were higher in the group with low RTS score.

INTRODUCTION: Healthy child follow-up is mostly carried out by family physicians working in primary care and their parents.The aim of our study is to draw attention to the responsibilities of families in healthy child follow-up, to raise awareness and to determine their relationship with health literacy situations.
METHODS: The study was planned as an observational and cross-sectional survey.It was carried out on parents with children between the ages of 0-5 years followed up in a family health center in Ankara.648 families were invited to study.We developed a structured questionnaire and used Turkey Health Literacy Scale(TSOY-32) in order to measure the parents' health literacy.After obtaining the necessary permissions, the questionnaire was filled through the face-to-face questionnaire application method.
RESULTS: 269 families agreed to participate in the study.The median score of total TSOY-32 was calculated as 32.3 and it was included in the “limited-problematic” health literacy group.It was determined that the TSOY-32 scores were significantly higher in high education and good income levels and among working parents.It was determined that the parents who “regularly make their children’s follow-ups by themselves” have higher health literacy total and component scores than the parents who “follow-up by their doctor’s calling”.
DISCUSSION AND CONCLUSION: Health literacy knowledge level scores of the families were lower than expected.Health literacy is an important factor in raising awareness of health-related responsibilities for building a healthy society.This study has made awareness among families in terms of what to do about child follow-up,and contributed to the literature on a more careful,healthy and conscious follow-up on the identified issues.

INTRODUCTION: The overdiagnostic analyses can be performed for evaluation of thyroid nodules which are commonly seen pathology in the population. Diagnostic tests in the evaluation of thyroid nodules, commonly-seen pathology in the population, mostly cause overdiagnosis. In fact, serum calcitonin(SC) measurement is a sensitive and specific method in the diagnosis of medullary thyroid cancer(MTC). If the patients with Bethesda Category III(atypia of undetermined significance -AUS) cytologies have also high risk clinical and ultrasonographical features, they can be evaluated for thyroidectomy. In this study, we aimed to evaluate the value of screening with serum calcitonin in patients with cytologies of Bethesda I and III categories.
METHODS: The medical records of patients who had thyroidectomy between 2007-2018 were screened retrospectively. The patients with preoperative calcitonin, cytology results and postoperative histopathology reports were included in the study.
RESULTS: Of the 6905 thyroidectomized patients, 881 had SC values. SC levels were evaluated as <2, 2-10 and >10pg/mL and classified as Group 1, 2, and 3; respectively. 217 patients(24.6%) had nondiagnostic(ND) and 275(31.2%) had AUS cytologies. The gender distribution was similar between ND and AUS groups(p=0.7). However, SC levels of group 1, 2, and 3 were found in 84.8%, 14.3%, and 0.9% of patients with ND, it was found in 82.9%, 15.6%, and 1.5% in patients with AUS cytologies, respectively(p=0.786). In histopathology, malignancy was detected in 30% of patients with AUS and 11.6% patients with ND(p=0.006). Calcitonin levels of patients with malignant histopathology were evaluated in 82.9%, 15.4%, and 1.7% of patients as Group 1, 2, and 3, respectively. This was similar compared to patients with benign histopathology (p=0.16). In the present study, 2 female patients had high calcitonin levels(144pg/mL and 655pg/mL). Both patients had preoperative AUS cytologies and final malignant histopathologies.
DISCUSSION AND CONCLUSION: We think that preoperative assessment of serum calcitonin levels can be useful in treatment decision of patients especially with Bethesda Category III thyroid nodules such as in follow-up and extent of surgery for cases planning surgery.

INTRODUCTION: It is important to know medical students' perception and anxiety who confronts patient-disease concepts every day. Because, physicians' health perceptions are creating healthy living behaviors for them, affecting the process of helping and understanding their patients. This study aimed to compare first three grade students of the faculty of medicine and sociology thus determining the health perception and health anxiety levels in two university examples.
METHODS: In this cross-sectional, descriptive study, Faculty of Letters, Department of Sociology and Faculty of Medicine's volunteer students took a questionnaire including demographic questions, Health Perception Scale (HPS) and Health Anxiety Scale (HAS). For statistics frequency, percentage, mean, independent t-test, One-way Anova and correlation tests were used. p<0.05 was considered significant.
RESULTS: In the study, 345 questionnaire forms were evaluated. The mean age was 19,84±1,69, which included 107(%31)sociology students, 235(%68)women, 87(%25) of rural origin, and 259(%75,70) of middle income. Mean HAS and HPS scores were 50.17 ± 5.66 and 17.59 ± 5.78. Medical students HAS score (49.41 ± 5.62) was significantly lower than sociology students' score (51.86 ± 5.41) (p= 0.000). The mean HPS for medical and sociology students were 17.97 ± 5.63 and 16.74 ± 6.05, respectively. High in medical students but not significant (p=0.068). Although mean HAS scores differ significantly between genders (p=0.019), HPS scores doesn’t (p=0.206).
DISCUSSION AND CONCLUSION: Significantly lower perception of health of students studying in medical school, health anxiety, though not significant, is important, and further research is required.

INTRODUCTION: Health communication competencies of the family physicians and patients in our country, who have an important role in the execution of primary health care services, will yield time efficiency and economic benefits in the implementation of preventive and curative health services. However, there is no scale to assess that competency in our country. Therefore, validity and reliability of the “health communication competency scale” in Turkey is to be applied in this research.
METHODS: The questionnaire of 253 patients and 253 family physicians were analyzed. Kaiser-Meyer-Olkin (KMO) statistics were used to measure the adequacy of the sample size for the Exploratory Factor Analysis application. “Cronbach alpha” values of the factors obtained for reliability analysis were calculated.
RESULTS: Health Communication Competence Scale has yielded (a) two factors in terms of analysis of basic components related to the self competencies of the physicians with Eigen value bigger than 1, (b) two factors in terms of the of the physicians’ evaluation of the patients’ competences, (c) three factors in terms of the self competences of the patients, (d) three factors in terms of patients’ evaluation of the physicians’ competences.
DISCUSSION AND CONCLUSION: Cronbach's alpha value for physicians’ competence in health communication is found quite high in self competence factor 1: 0.95, self competence factor 2: 0,97, other competence factor 1: 0,94, other competence factor 2: 0,95. Cronbach's alpha value for patients’ competence in health communication is found quite high like physicians’.

INTRODUCTION: The aim of this study was to determine the knowledge, behavior and attitudes of resident doctors training in the Research and Training hospitals of Ankara Province, except Family Medicine Residents.
METHODS: The study included 180 research assistants, a 27-question questionnaire was given to the physicians to evaluate the level of knowledge and attitudes about rational drug use.
RESULTS: While prescribing drugs, 65.6% of the physicians (n = 118) described how and which way the patients’ response to treatment can be. 41.7% (n = 75) of the physicians never prescribed their patients without examination. Among the questions that assess knowledge level of physicians on drugs, the questions with which physicians found themselves most sufficient were related to drug indication (%18,9, n=31) and daily dose (%18.3, N=30); on the other hand the questions with which physicians found themselves least sufficient were related drug prices (%10,4, n=17). Of the physicians, 2.2% (n = 4) thought that they were very sufficient in terms of rational drug use, whereas 35.8% (n = 64) thought that they were sufficient, 54.2% (n = 97) thought that they had moderate competence and 7.8% (n = 14) thought that they were insufficient in rational drug use.
DISCUSSION AND CONCLUSION: In addition to education in rational drug use, the necessary administrative arrangements should be made to protect and support learned attitudes and behaviors. Therefore, in order for physicians to reach objective information, pre- and post-graduate education in our country should be reviewed.

INTRODUCTION: Although it is known that mean platelet volume (MPV), red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) are predictive for arterial trombosis and adverse events, it is not clear whether they help in the diagnosis of deep vein thrombosis. The aim of the study was to evaluate it. For this purpose MPV, RDW, NLR and LMR were measured and compared between in patients with DVT and control groups.
METHODS: In a retrospective study, a total of 144 subjects (77 patients with DVT, 67 control) were examined. Mean platelet volume, RDW, NLR and LMR were calculated and compared between the groups. It was investigated whether there was a correlation between D-dimer values and MPV, RDW, NLR, LMR.
RESULTS: Mean platelet volume, RDW and NLR values were significantly higher in the patient group than in the control group (9.68±1.89 vs. 8.9±1.01, p=0.003, 12.77±3.67 vs. 11.15±2.16, p=0.002 and 1.91±0.84 vs. 1.51±0.54, p=0.001, respectively). On the other hand LMR was lower in the patient group (6.27±3.14 vs. 8.85±3.92, p<0.001). There was a positive correlation between D-dimer and MPV, RDW, NLR while there was a negative correlation between D-dimer and LMR (r=0.693, p<0.001, r=0.896, p<0.001, r=0.798, p<0.001 and r = -0.287, p=0.011, respectively).
DISCUSSION AND CONCLUSION: Mean platelet volume, RDW and NLR increase but LMR decrease in patients with DVT. These results suggesting that these markers may help in the diagnosis of acute DVT.

INTRODUCTION: Mean platelet volume (MPV) is an index of platelet activation. In this study, we aimed to evaluate the relationship between in patients with COPD and cardiovasculary disease who present to chest diseases department and MPV.
METHODS: : Smoker 535 (71.80%) and non-smoker, 210 (28.20%) subjects were compared for MPV and other parameters. Accordingly, patients with and without COPD were compared in terms of MPV and other parameters.
RESULTS: The levels of white blood cells (Wbc), hemoglobin (Hgb) and hematocrit (Htc) in smokers were statistically significantly higher than non-smokers (p<0.001). The level of MPV in smokers was statistically higher than non-smokers [the levels of MPV were, 10.10 (8-14.20), 9.60 (6.40-11.80),respectively p<0.001]. There were 106 cases of COPD among smokers. The differences in levels of platelets and MPV between patients with COPD and nonsmoker patients without COPD were [10.20 (8.30-14), 9.60 (6.40-11.80), respectively p=0.001] statistically significant. Also, MPV levels of COPD patients with cardiovascular comorbidities (CVC) were higher than that of the patients without CVC.
DISCUSSION AND CONCLUSION: In this study, higher MPV and higher platelet values have been shown in smokers and COPD patients compared with non- smokers. As a result, consider that high MPV levels may increase the tendency to thrombosis, with COPD. However, further larger studies are warranted about the relationship of COPD with MPV and CVC.

INTRODUCTION: The aim of this study was to test the validity and reliability of oral self-examination form according to adaptation it Turkish.
METHODS: Methodological research was conducted in December 2019-January 2020 in Izmir. Steps of oral self-examination developed by Müller &Heller (2013) were adapted to Turkish. Oral self-examination includes simple eight steps. Language adaption, content validity index, factor analysis, Kendall's W coefficient of concordance test, Kuder Richardson 21 and pilot study were carried out.
RESULTS: The content validity index was found 0,97. After the analysis, Kendall W was found 0,88 (p = 0,519). The total variance explained by the single factor is 71.24%. Kuder Richardson 21 value of the form was calculated as 0.94.
DISCUSSION AND CONCLUSION: Oral self-examination form is an early diagnostic tool for early diagnosis of oral cancer, valid and reliable tool. The form consists of one dimension and eight steps.

INTRODUCTION: The aim of our study is to determine the change in the neutrophil / lymphocyte ratio (NLR), which is an inflammatory marker of obesity in patients who lose weight with lifestyle changes.
METHODS: Our study was conducted with 74 obese female patients who significantly lost weight with six-month lifestyle changes in the obesity outpatient clinic. Patients with acute or chronic inflammatory disease and diabetes were excluded from the study. Clinical data, anthropometric measurements and laboratory results were collected from the patients' files retrospectively.
RESULTS: The mean age of the patients was 49.24±9.89 years. Weight and BMI values of the patients at the beginning of the study were 95.44 ±15.60 kg and 37.75±5.74 kg/m² and at the end of the sixth month 87.99±15.70 kg and 34.78±5.78 kg / m² respectively. The fasting plasma insulin, C peptide levels and HOMA of the patients the beginning and at the sixth month of the study were 12.96 uU/ml and 9.19 uU/ml (p = 0.015) and 2.74 ng/ml to 2.29 ng/ml and 3.31 to 2.03 respectively (p = 0.021). The NLR values of the patients who lost weight decreased significantly compared to baseline values (p = 0.004). There was no significant difference between baseline and sixth month CRP values (p = 0.586).
DISCUSSION AND CONCLUSION: As a result, it was found that there was a significant decrease in NLR value together with a decrease in insulin resistance when weight loss was achieved with lifestyle changes in obese women.

INTRODUCTION: The aim of this study was to evaluate the annual weight loss rate and the number of visits to obesity follow-up and to provide more effective follow-up of the patients with obesity follow-up.
METHODS: In this retrospective study, there is no history of additional metabolic disease or drug use in obesity followed by at least one year in Obesity Outpatient Clinic of Istanbul Medeniyet University, Göztepe Training and Research Hospital. Patients over 18 years of age with a body mass index (BMI) of ≥30 mg/m2 were included in the study. The annual weight loss rates were calculated by calculating the results of an annual weight gain.
RESULTS: The average annual weight loss in 243 patients was 6.9 ± 5.9 kg, and the average annual weight loss rate was 7.12 ± 5.75%. At the end of a year follow-up, 63.4% of the patients lost 5% weight with lifestyle intervention. A cut off value of 11 was found to be significant for the number of visits with a 5% weight loss. There was a statistically significant relationship between the annual weight loss rate and the number of visits.
DISCUSSION AND CONCLUSION: Lifestyle intervention is a very effective and applicable method in the treatment of obesity. Since this treatment is a feasible method in the primary care unit, as the number of visits increases, the success rate of treatment increases and the strategies to be included in the first step should be determined.

INTRODUCTION: Hemoptysis is a life-threatening condition and requires immediate diagnosis and treatment. Herein this study, our aim was demonstrate our single center experience of super selective arterial embolization in cases of massive hemoptysis, to describe the demographic and clinical data of those patients, to evaluate the success rate of the intervention and to document the complications.
METHODS: In this study, total of 72 patients who admitted to our tertiary center’s emergency service or chest diseases department and underwent endovascular treatment were enrolled. The demographic and clinical data were analyzed retrospectively.
RESULTS: The median age was 55 years (min-max; 22-78). 25 patients (34.70%) were female whereas 47 (65.30%) were male. 16 patients was diagnosed with lung cancer (squamous cell / adeno cancer), 7 alveolar hemorrhage, 1 pulmonary metastasis of malign melanoma, 2 mediastinal and hilar mass of unknown origin, 4 tuberculosis, 4 pulmonary thromboembolism, 1 sarcoidosis, 2 pneumonia, 1 cirrhosis and hepatopulmonary syndrome and 34 patients with bronchiectasis. The embolized vessel was right bronchial in 32 cases, left bronchial in 9, bilateral in 15, costobronchial trunk in 10 and non-bronchial in 6 patients. The most common angiographic pattern was vascular hypertrophy followed by vascular irregularity and blush. The immediate clinical success was 100%. Rebleeding occurred in 12 patients due to recanalization of the vessel. The most common complication was chest pain.
DISCUSSION AND CONCLUSION: In experienced hands, arterial embolization is the most effective and minimally invasive procedure for treat­ing massive and recurrent hemoptysis.This study confirms the efficacy and safety of the intervention

INTRODUCTION: To assess the effects of umbilical cord clamping time on risk of postpartum depression.
METHODS: The study included pregnant cases giving birth after 36 weeks from 24 January 2020 to 01 April 2020 in our clinic. Those with previous depression history, chronic disease, multiple pregnancy, puerperant women with impaired hemodynamics after birth, and neonates with poor Apgar score after birth or who required resuscitation were not included. The postpartum umbilical cord clamping time was classified according to the World Health Organization as late 1 minute or more and early under 1 minute. Patients were evaluated in two groups according to this grouping. During the follow-up examination performed in the postpartum 1 month, the risks in terms of postpartum depression were evaluated with the Edinburgh Postpartum Depression Scale given to the patients in the outpatient clinic.
RESULTS: The study included 176 pregnant cases with birth after 36 weeks. Both groups were not observed to be different in terms of sociodemographic characteristics, obstetric history and birth information (p≥0,05). In both groups, mean EPDS points were identified as 11.07±1.97 in the late clamping group and 13.23±1.61 in the early clamping group and this was statistically significant (OR=6.36; p<0.001).
DISCUSSION AND CONCLUSION: With our study results, we identified that cases with late clamping of the umbilical cord had lower risk of postpartum depression

INTRODUCTION: Evaluation of the signal peptide complement C1r/C1s, Uegf, and Bmp1 (CUB), and epidermal growth factor-like domain-containing protein-1 (SCUBE-1) levels and carotid intima media thickness (CIMT) between the group of patients with and without recurrent pregnancy loss (RPL).
METHODS: This prospective and single-center study included 20-40-year-old 30 patients with and 30 patients without a history of RPL. No patients with any anatomical, hereditary, or endocrinological thrombophilic defects were included. Comparison of SCUBE-1 levels and CIMT were made between the patient and control groups.
RESULTS: There were no statistically significant differences between patients and control groups in terms of demographic characteristics except for gravidity, parity and miscarriages.The mean SCUBE-1 level in the RPL group was statistically significantly higher compared to the control group (16.44±5.43 vs.10.17±5.19, respectively, p=0.001). The mean CIMT value in RPL patients was statistically significantly higher than that of the control group (0.60±0.09 vs.0.44±0.07, respectively, p=0.001).
DISCUSSION AND CONCLUSION: High levels of serum SCUBE-1 and CIMT in RPL may suggest that ischemia and endothelial dysfunction may be involved in the etiology of RPL. Future studies may shed light on the diagnosis, treatment, and management of RPL.

Frequency of application to primary health care servces with syncope is quite high. Especially in the presence of recurren syncope attacks, even if the healing process is fast, the etiology should be investigated, and the necessary research and clinical tests should be done to make a differential diagnosis. In our case, we presented a patient who was admitted to our Family Medicine Outpatient Clinic due to syncope and was diagnosed with cardiovascular syncope due to pericardial effusion.

Primary health care is a health service produced by health institutions where people apply for a variety of reasons, where a large part of the society is treated and referred to the second and third levels when it’s necessary and where preventive medicine practice is provided. Family physicians, who are located in the closest and most accessible position to the society, make the diagnoses related to different medical branches after the necessary examinations. Nausea and vomiting in patients presenting with undifferentiated symptoms in primary care, may accompany central nervous system, vestibular system, gastrointestinal system or psychological diseases. This case is presented to emphasize the importance of nausea and vomiting in primary care and that many systemic diseases should be considered in differential diagnosis.

In an adult female who has been using asthma treatment for years but has not benefited from the treatment, flattening was noted in the inspiratory and expiratory curves of spirometric evaluation. Subsequent examination revealed the presence of subglottic stenosis as the underlying pathology of fixed upper airway obstruction.

Pesticides are chemicals that are widely used in many areas of life, especially in agriculture. There is always a risk of toxicity if agricultural workers do not have sufficient knowledge and experience about the use of pesticides and preventive measures are inadequate. In the literature, there are references to acute toxic effects of pesticides as well as their chronic effects, such as cancer, diabetes, high blood pressure, cardiovascular diseases, and neurological disorders. In addition to these chronic effects, early-onset and rapidly developing chronic kidney disease has been reported in agricultural workers over the past two decades, which progresses to end-stage renal disease. The renal biopsies that have been performed on these patients showed chronic tubulointerstitial changes. This disease, observed in agricultural workers, is either referred to as “Chronic Kidney Disease of unknown cause (CKDu)” or "Mesoamerican nephropathy," in reference to the region where it was first identified. It is argued that heat stress and pesticides play an active role in its etiology. From this point of view, countries with high pesticide use that are affected by climate change are referred to as "countries in the risk group". The use of pesticides is increasing in Turkey, which is also adversely affected by climate change caused by global warming. Greenhouse workers in particular are more exposed to heat stress and pesticides, since they work in a closed environment. Therefore, preventive measures and awareness are particularly important in these regions, as the disease progresses without symptoms.