INTRODUCTION: This study aims to determine the approaches and level of knowledge of family medicine residents and specialists about asymptomatic bacteriuria in pregnancy.
METHODS: This is a cross-sectional study conducted between March and August 2018, with easy sampling, reaching the maximum number of physicians through the website we designed for this project. A questionnaire containing 19 questions created by the researchers was applied to family medicine residents and specialists in Turkey, after filling voluntary consent forms. SPSS 21 statistics program was used for descriptive statistical analyzes.
RESULTS: A total of 252 people, 166 (65.9%) family medicine residents (FMRs), 86 (34.1%) family medicine specialists (FMSs) participated in the study. During the pregnancy follow-up, 102 physicians (27 FMSs and 75 FMRs) requested complete urinalysis (CUA) and urine culture together. In order to be able to diagnose asymptomatic bacteriuria in urine culture, 55 of FMSs (64.0%) and 91 of FMRs (54.8%) gave the correct answer to the question that the number of bacteria should be more than 105. In the treatment of asymptomatic bacteriuria during pregnancy, it was determined that the FMSs and FMRs mostly preferred ampicillin. Most of the participants in the study were aware of the complications of Trimethoprim-Sulfamethoxazole (TMP-SMX) used in the treatment.
DISCUSSION AND CONCLUSION: According to our study; We found that the knowledge level of family medicine specialists and residents about asymptomatic bacteriuria during pregnancy was insufficient. For this reason, we think that conducting new studies on this subject in the literature and involving a large number of participants will increase awareness of this issue.

INTRODUCTION: Breast milk is the physiological food that contains the nutrients the baby needs. This study aimed to evaluate the effect of breastfeeding training on breastfeeding knowledge levels and self-efficacy scale and to emphasize the importance of breastfeeding.
METHODS: Our study was a cross-sectional study. 409 women aged between 18-34 years who were admitted to the obstetrics policlinics of Ankara Atatürk Training and Research Hospital between October 1, and December 1, 2018, were reached. All women who participated in the study were administered a questionnaire assessing their knowledge of breastfeeding. The antenatal self-efficacy scale was applied to pregnant women and the postnatal self-efficacy scale was applied to postnatal women.
RESULTS: For pregnant women, a statistically significant difference was observed between the groups in terms of the mean scores of the breastfeeding self-efficacy scale (57.81±9.97 and 47.22±12.40 p=0,005). A statistically significant difference was observed between the groups in terms of the knowledge level of breastfeeding (7.61±1.25 and 6.77±1.73 p<0,001). A statistically significant difference was observed between the groups in terms of the average awareness about the benefits of breastfeeding. For the postnatal women, a statistically significant difference was observed between the groups in terms of the mean scores of the breastfeeding self-efficacy scale. (58.98±6.74 and 49.44±8.83 p<0,001). No statistically significant difference was observed between the groups in terms of breastfeeding attitude level (5.74±078 and 5.51±1.09 p=0,195).
DISCUSSION AND CONCLUSION: The quality of education should be increased, and more support should be given to the mother's breastfeeding process in the postpartum period.

INTRODUCTION: Food addiction which is a non-homeostatic behavior that contributes to obesity is a highly discussed issue recently. In the present study, we aimed to determine the prevalence of food addiction among obese people and related factors who applied to our obesity outpatient clinic.
METHODS: Yale Food Addiction Scale (YFAS) and Depression, Anxiety, Stress Scale (DASS)-21 were applied to the 202 participants admitted to a Training and Research Hospital obesity outpatient clinic within 6 months who gave written consent. The patients were divided into two groups as individuals with and without food addiction. The prevalence of food addiction in the total sample and the difference between the two groups were evaluated.
RESULTS: The prevalence of food addiction among participants was 35.10%. There were no significant differences between the groups with and without food addiction in terms of age, gender, smoking status, having a history of childhood obesity, a family history of obesity, and exercising habit. The Body Mass Index (BMI) of the group with food addiction was significantly higher than the group without food addiction. The depression, anxiety, and stress scores of the participants with food addiction were significantly higher than those without food addiction.
DISCUSSION AND CONCLUSION: In this study, it has appeared that food addiction is prevalent among obese individuals. For this reason, we consider that early diagnosis and treatment of this disorder will make a significant contribution to obesity treatment.

INTRODUCTION: This study aimed to investigate the relationship between urinary incontinence and fatigue level and sleep quality during pregnancy.
METHODS: This descriptive and cross-sectional study was conducted in 311 pregnant women (literate, in an age range of 18-49 years, singleton pregnant, able to communicate, did not get pregnant as a result of infertility treatment, without a urinary tract infection or a chronic disease) who were presented to the pregnant polyclinic of a maternity hospital between January and March 2020. The data were collected using a personal information form, Incontinence Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS).
RESULTS: In our study, the mean age of the participants was 27.25±5.641 years, and the mean gestational week was 29.46±9.581. 61.10% of the pregnant women (190) had urinary incontinence; sleep quality of them was “bad” in 68.80% (214). 46.60% (145) of the pregnant women were "fatigued". In our study, there was a significant positive and low-level correlation between the ISI and the PSQI mean scores (r=0.209; p <0.001); no significant correlation was found between ISI and the YSS (p=0.184).
DISCUSSION AND CONCLUSION: In our study, as the urinary incontinence level increased, poor sleep quality increased. There was no relationship between urinary incontinence and fatigue levels in pregnant women. During antenatal, health care professionals should evaluate the urinary incontinence, sleep quality, and fatigue levels of pregnant women, and require care practices should be offered involving coping strategies and treatment modalities in pregnant women with incontinence.

INTRODUCTION: Peer victimization (PV) can be defined as a student or group of students deliberately and continuously harming or harassing another student or a group of students. Studies show that one out of every three students in our country is exposed to peer bullying in physical, verbal, emotional, or exclusion forms. In our study, it was aimed to compare the knowledge levels of family physicians and pediatricians, who are expected to be in contact with children exposed to PV, about this subject.
METHODS: Between October 2015 and February 2016, 122 family physicians and 109 pediatricians who were randomly selected among the physicians working in Ankara province were reached and their level of knowledge on peer victimization was evaluated.
RESULTS: The knowledge levels of the physicians in both groups about PV were found to be substantially similar. Pediatricians encountered PV significantly more frequently than family physicians (p <0.001; X2 = 15.766). On the other hand, physicians in both branches had similar awareness in recognizing the indirect symptoms of PV (p = 0.429; X2 = 0.625). It was seen that very few of the participants received special training on PV.
DISCUSSION AND CONCLUSION: In addition to parents and teachers, physicians who see the child for any reason have responsibility for PV, which is common in our country and the world. It will be beneficial to increase the knowledge and awareness of family physicians and pediatricians who most frequently communicate with school-age children, especially about detecting the psychosomatic symptoms originating from PV and taking action.

INTRODUCTION: It is reported that there are more than 340 million people who are either overweight or obese aged between 5-19. Obesity starting in childhood and adolescence leads up to metabolic syndrome, cardiovascular diseases and hastens the atherosclerotic process. The aim of our study is to evaluate risk factors for cardiovascular diseases and the prevalence of metabolic syndrome in overweight and obese adolescents.
METHODS: The study population comprised overweight and obese adolescents aged 11–18 years. After taking all anthropometric measurements and blood samples; cardiovascular risk according to the REGODCI scoring system and prevalence of metabolic syndrome according to the International Diabetes Federation were examined.
RESULTS: 150 overweight and obese adolescents were included. 115 (76.70%) subjects were determined as obese. MetS was seen in 22% (n=33); cardiometabolic risk (CMR) was seen in 46.60% (n=80) of the participants. A statistically significant difference between systolic blood pressure, TG/HDL, and BMI of participants diagnosed with MetS was detected (p = 0.040, p= 0.012, p < 0.001, respectively). A significant correlation was found between CMR and participants’ BMI, TG/HDL, waist-hip ratio (p = 0.001, p = 0.001, p= 0.034, respectively). According to the ROC analysis for MetS, the area under the curve was 0.826, the cutoff value was 2.59 with 72% sensitivity and 72% specificity; and for the CMR the area under the curve was 0.652, the cutoff value was 2.06 with 65% sensitivity and 63% specificity.
DISCUSSION AND CONCLUSION: Obesity is an independent risk factor for both MetS and CMR, and it should be treated immediately after diagnosis. TG/HDL ratio may use as a predictor factor for MetS (over 2.59) and for CMR (over 2.06) in overweight and obese adolescents.

INTRODUCTION: Youth are at high risk for reproductive health problems and adolescent health monitoring has entered a new routine during family medicine follow-ups Our study was planned in order to determine the students’ knowledge level and educational needs on reproductive health who have just begun to Faculty of Nursing.

METHODS: A questionnaire was applied by face-to-face interview method to the students who had recently registered to Hacettepe University Nursing Faculty in the 2019-2020 academic year in this descriptive study. In the evaluation of the data, the mean and standard deviation for continuous variables and frequency table for qualitative data were used. The Chi-square test was used to test the relationship between qualitative data. Statistical analysis was done with the SPSS v.23 package program.
RESULTS: 120 students were included in the study. The school (75.80%) was in the first place among students' sources of information on reproductive health. The most common contraceptive method was the pill (80.80%). The most common answer to the question of what sexually transmitted diseases are was the Human Immunodeficiency Virus (85.80%). The most wanted topic to learn was sexually transmitted diseases with 51.70%. There was no statistically significant relationship between students' age, gender, economic status, the school they graduated from, and their level of knowledge.
DISCUSSION AND CONCLUSION: Young people don't have sufficient and correct knowledge about reproductive health. More attention should be given to planning their training. In addition, the family physician, who monitors adolescents between the ages of 10-21 and provides counseling services on reproductive health, plays an especially important role to acquire accurate and reliable information.

INTRODUCTION: The use of alcohol-based hand disinfectants (ABHD) is recommended in the COVID-19 pandemic. In this study, it was aimed to analyze the content of ABEDs in our country and to discuss the findings in the light of literature.
METHODS: ABHDs in our country were searched on the Google search engine. Content information of the commercial product was saved. Data were analyzed under 5 headings: according to the alcohol ratio, the presence of ethyl and / or isopropyl alcohol, the presence of other disinfectants, the presence of the moisturizer and the formulation recommended according to the World Health Organization (WHO).
RESULTS: The most frequently observed alcohol ratios were as follows: 70%, 75%, 65% and 80%. 21% of the products have only ethanol, 15% have only isopropyl alcohol, 34% have ethanol and isopropyl alcohol. Hydrogen peroxide was observed in 6.5% of the products. 44% of the products had glycerin, 10% had glycerin and lanolin. The formulation suggested by WHO was exactly observed in one product.
DISCUSSION AND CONCLUSION: Sars-CoV-2 virus can be inactivated by ethanol (> 75%) and isopropanol (> 70%). One of the WHO formulations contains 80% ethanol and the other 75% isopropanol. Alcohol ratio was 70% and above in more than half of ABHDs in our country. These were ethyl and / or isopropyl alcohol. Only one product complied with the WHO formulation. As a result, the most important step for hand hygiene in the COVID-19 pandemic should be the selection of ABHD with the appropriate formulation.

INTRODUCTION: This study aims to investigate the dynamic thiol-disulfide balance in the early period of patients diagnosed with acute pulmonary thromboembolism in the emergency department.
METHODS: Serum thiol-disulfide levels in venous blood samples drawn from 58 patients diagnosed with acute pulmonary embolism in the emergency department were analyzed using the newly developed Erel-Neþelioðlu method, and the results were compared with the measurements of the healthy control group. In the emergency department, the pre-diagnosis of pulmonary embolism was considered with clinical and laboratory findings and confirmed with contrast-enhanced thorax computed tomography angiogram.
RESULTS: Mean native thiol and total thiol levels were significantly lower in pulmonary embolism patients compared to the control group (308.53 ± 78; 414.13 ± 50.86; p <0.002; 346.03 ± 81.13; 453.05 ± 52.46 μmol/l, p <0.003 respectively). Disulphide/native thiol and disulphide/total thiol ratios were found to be significantly higher in pulmonary embolism patients compared to the control group (p <0.001).
DISCUSSION AND CONCLUSION: Thiol-disulfide balance is altered oxidatively in patients with pulmonary embolism. This may play a role in the pathogenesis of the disease.

INTRODUCTION: This study aims to investigate Chest CT findings and RT-PCR results in patients hospitalized with suspicion of COVID-19.
METHODS: Between 15 March and 15 May 2020, patients hospitalized in Yozgat City Hospital with suspicion of Covid-19 were evaluated retrospectively. Chest CT findings were classified according to the modified COVID-19 reporting system created for this study. RT-PCR reference diagnostic test was accepted and the diagnostic performance of CT was evaluated.
RESULTS: A total of 498 patients [54±22 (0; 96)] were included in the study. The number of male patients [323 (65%)] was higher than female [175 (35%)]. RT-PCR test was positive in 94 (19%) of the patients. Patients with positive test results were found to be younger than negative ones. Chest CT was positive in 173 (35%) patients: 13% COVID-19 typical findings, 7% high suspect findings, 15% low suspect findings. The sensitivity of CT was 49%, the specificity was 69%, and the sensitivity of RT-PCR was 69%. Infiltrations in CT positive cases were seen in the following areas: 52% in both lungs, 40% in all lobes, 34% in lower lobes, 47% in the posterior, 43% in the anterior and posterior lung regions, 60% in the peripheral, 30% peripheral and central lung regions.
DISCUSSION AND CONCLUSION: The sensitivity of chest CT in the diagnosis of COVID-19 was relatively low, but had high specificity. It may be more beneficial to use CT for rapid diagnosis in regions with a high prevalence of COVID-19. Using a standardized report format to evaluate CT findings seems necessary for patient management.

INTRODUCTION: This study aims to evaluate demographic and clinical characteristics of the emergency department (ED) cases with a diagnosis of temporomandibular joint (TMJ) dislocation alongside the patient management of these cases.
METHODS: Our single-center and retrospective study was conducted at the ED of Eskisehir Osmangazi Health, Practice and Research Hospital in 10 years and 10 months (01.01.2010-30.10.2020). All 18 years and older patients diagnosed with TMJ dislocation at the ED during the studied period were included in the study. The information on demographics, dislocation type and mechanism, medical history of repeated dislocation, imaging, application of reduction, reduction outcome, and necessity of sedo-analgesia were obtained from the patients’ records. The lack of data required for analysis in the records was taken as an exclusion criterion.
RESULTS: When the file records were examined 113 cases were diagnosed with TMJ dislocation in ED. 66 cases were primary admissions and 47 cases were recurrent admissions of these cases. Primary applications are evaluated; the mean age was 42.74±20.83 and 69.7%(n=46) were women. The joint dislocation was present in 56.1%(n=37) bilaterally. 98.5%(n=65) of them were non-traumatic. When all the cases were evaluated, it was determined that 91.2%(n=103) did not perform radiological imaging. During reduction, it was observed that sedo-analgesia was applied in 13.3%(n=15) cases. It was observed that 98.2%(n=111) of the reduction applications resulted successfully. No complication records of the cases were found.
DISCUSSION AND CONCLUSION: Management of TMJ dislocation is important for patient comfort and joint function. Emergency physicians successfully manage acute TMJ dislocation, which they rarely encounter.

INTRODUCTION: To study changes in dynamic thiol/disulfide homeostasis (TDH) in patients with acute aortic dissection (AAD).
METHODS: In our study, the medical records of patients who applied to Ankara Atatürk Training and Research Hospital between January 2015- January 2018 and were found to have AAD on computed tomography of the thorax were retrospectively reviewed. There were two groups in the study, one AAD group, and the other healthy volunteers' group. First, thiol and disulfide levels were determined with the spectrophotometric method defined by Erel and Neþelioðlu, natural thiol (NT), total thiol (TT), and disulfide (D) levels, and their ratios were calculated (index 1: D / NT, index 2: D / TT, index 3: NT / TT). We compared these two groups in terms of Oxidative stress parameters.
RESULTS: A total of 40 patients with AAD and 38 age-matched healthy volunteers were included in this study. There was no significant difference between the two groups in terms of gender and age (p=0.923, p=0.401, respectively). The AAD group had significantly lower natural thiol and total thiol (p<0.001), but disulfide levels were similar (p=0.360). Oxidative stress parameters were not statistically significant in terms of mortality.
DISCUSSION AND CONCLUSION: We found significantly lower thiol/disulfide homeostasis in patients with AAD, particularly native thiol and total thiol. We think that oxidative stress theory may play a role in the pathophysiology of AAD and oxidative stress parameters may guide the diagnosis.

INTRODUCTION: To compare the reverse transcription-polymerase chain reaction (RT-PCR) test results and chest computerized tomography (CT) findings in pediatric patients with a pre-diagnosis of COVID-19.
METHODS: The thorax CT examinations and RT-PCR test results were retrospectively evaluated in 177 children. According to the test results, the patients were divided into two groups as ‘COVID-19-positive’ and ‘COVID-19-negative’.
RESULTS: In the COVID-19-positive group, 65.71% of the patients with a family history of COVID-19 (p<0.01). In the same group, 50.00% of patients with normal CT findings were older than 16 years (p<0.01), and single-lobe involvement was more common (54.54%, p<0.01). The most observed CT finding was consolidation with ground-glass opacities (GGO) in both groups. Fibrotic bands (51.46%, p<0.01), reticular pattern (34.95%, p<0.01), atelectasis (9.71%, p<0.01), mosaic perfusion (26.21%, p<0.01), and pleural effusion (19.42%, p<0.01) were mostly seen in the COVID-19-negative group. In patients with underlying diseases, the sensitivity values were calculated as 0.441 for CT and 0.863 for the RT-PCR test.
DISCUSSION AND CONCLUSION: In patients with a family history of COVID-19, the chest CT showed focal GGO with or without consolidation as the most common finding. If CT findings diffuse and severe, the patient most likely does not have COVID-19. The RT-PCR test results are more reliable than CT in children with underlying diseases.

INTRODUCTION: Thyroid hormones (TH) play a significant role in cardiovascular (CV) homeostasis. When the effect of TH on the CV system has been examined, especially in recent years, "euthyroid sick syndrome (ESS)" has attracted attention. In this study, we aimed to investigate the correlation between ESS, which is frequently observed in hospitalized patients with have systemic disease, and the brain natriuretic peptide (BNP) level.
METHODS: In this cross-sectional study, 78 ESS patients who were hospitalized for various systemic diseases and a control group of 67 euthyroid patients were included. Patients who have heart failure (HF) with clinical and/or laboratory findings, renal failure, chronic liver disease, renal parenchymal disease, known hyperthyroidism or hypothyroidism, taking a thyroid hormone, using steroids, using antithyroid drugs, known to affect the BNP level Patients using medication were excluded from the study. The serum brain natriuretic peptide (BNP) levels, biochemical examinations, acute phase reactants, and echocardiography findings were analyzed.
RESULTS: Serum BNP was significantly higher in ESS patients compared to the control group. Serum free thyroxine (fT4) level was positively correlated, and serum free triiodothyronine (fT3) and thyroid stimulating hormone (TSH) levels were negatively correlated with BNP. Furthermore, it was determined that serum BNP level was positively correlated with positive acute-phase reactants (high-sensitivity C-reactive protein, ferritin) and negatively correlated with albumin, which is a negative acute-phase reactant.
DISCUSSION AND CONCLUSION: ESS is associated with an increase in serum BNP. In critically ill patients without CV disease, a low level of fT3 may contribute to the development of cardiac dysfunction. We consider that the patient's age, admission diagnosis, acute-phase reactants, and inflammatory cytokines should be considered in addition to thyroid hormones while evaluating BNP levels in ESS.

INTRODUCTION: This study was conducted in order to assess the impact of Gender Awareness Training on gender role attitudes of women workers.
METHODS: The research was conducted with a pre-test – post-test model in a non-randomized single group with a quasi-experimental research design. The participants of the study were 166 female workers who work in a factory. During the research, the workers were given an 8-hour training on gender awareness in 4 sessions. Before the training, a questionnaire form investigating the socio-demographic characteristics of workers and the Gender Roles Attitude Scale (GRAS) were applied to the workers as a pre-test. After training, the change in gender role attitudes was identified by means of post-test. Descriptive statistics, independent-t, and chi-square test, Anova, and Paired t-test were used for analyzing the data. Before starting the research, permission from the ethical committee and factory management was taken.
RESULTS: The women whose education level was high school, whose economic condition was middle, and who lived in the district have more problems for being female. The total scores of the participants from the Gender Roles Attitude Scale have increased from (155.45±17.48) to (149.72±19.54) as before the training program and after the training program(p=0.006).
DISCUSSION AND CONCLUSION: At the end of the training, it was found out that there has been an increase in women’s total gender role attitude scores, in the sub-dimensions such as female gender role attitude and traditional gender role attitude.

In these worse days of the COVID-19 pandemic, it was reported that similar clinical pictures were observed after a while in those who suffered from the disease suggesting possible cases of reinfection. Some of these cases were among healthcare workers. These reports have raised serious concerns about the natural immunity gained against COVID-19. We report here two possible cases of reinfection in healthcare workers for the first time in Turkey. The first case was a 21-year-old male nurse working in a COVID-19 intensive care unit. RT-PCR test was reported positive on August 10 after complaints of weakness, severe muscle pain, and sore throat. The patient, who received treatment and was followed up according to the protocol, returned to work when two consecutive RT-PCR tests were negative on August 25-26. After 76 days, the patient who presented with complaints of weakness, severe muscle pain, sore throat, and diarrhea had again a positive RT-PCR. The second case was a 28-year-old female doctor working in a COVID-19 clinic. Her RT-PCR test was performed on 25 August after complaints of fatigue, severe muscle pain, headache, cough, anosmia, and dysgeusia accompanied by sub febrile fever were reported positive. She returned to work after two RT-PCR tests on September 10 and 15 were reported negative. Seventy-one days later, the RT-PCR test taken after complaints of fatigue, muscle pain, sore throat, headache, sub febrile fever, and occasional dry cough was evaluated as positive. The cases were discussed in detail with the review of the literature.

Methemoglobinemia is the presence of excessive methemoglobin in the blood. Methemoglobinemia is a rare but clinically important condition that should be considered among the differential diagnoses of cyanosis. It is a fast and relatively easy-to-diagnose procedure. In the treatment of emergency patients; high current O2 (HFO2) is important to ensure saturation of available hemoglobin. Methylene blue is the first-line treatment in asymptomatic patients with symptomatic methemoglobinemia (signs of hypoxia such as chest pain, shortness of breath, or confusion) or with MetHb levels> 20%. A 19-year-old female patient was brought to our emergency department after taking 2.5 grams of dapsone for suicide purposes from another center when the level of methemoglobinemia measured in blood gas was measured as 34%. Hyperbaric oxygen therapy was applied for 90 minutes to the patient who did not respond to high flow oxygen therapy. In this case report, we wanted to describe a patient with hypoxic and cyanotic methemoglobinemia who did not respond to standard methylene blue therapy.

Obesity is one of the most important health problems of our age. The prevalence of obesity has been increasing all over the world, affecting not only adults but also children and adolescents. Obesity causes many health problems including cardiovascular diseases, hypertension, diabetes, some types of cancer, respiratory system diseases, and musculoskeletal diseases. In addition, behavioral factors causing obesity and changes in the body caused by obesity may also threaten oral and dental health. In the literature, there have been many studies regarding the effect of obesity on dental caries, periodontal disease, and saliva. The current review aims to increase the awareness of health professionals on oral and dental health problems caused by obesity.

The sharp rise in gender diversity has led to an increased likelihood of general health workers encountering this group of patients. Awareness and approach of physicians working in primary health care about the sexual orientation and gender identity of the patients are important to provide a qualified and comprehensive health service. In this context, considering the health needs of transgender individuals and the problems they experience in accessing health services, the management of these people in primary care requires special attention. Primary, secondary and tertiary prevention services can be provided for trans men and trans women in primary health care. Ideally, a multidisciplinary approach including primary care physicians, psychiatrists, endocrinologists, and surgeons should be adopted for healthcare services for transgender people. The aim of this review is to determine the principles of the management of transgender people and the health services that should be provided to them using current guidelines and to assist physicians in providing primary healthcare services to these patients.