INTRODUCTION: Medication overuse headache (MOH) is the third most common type of headache following migraine and tension-type headaches, and its iatrogenic origin is important. Our aim is to evaluate the frequency of MOH, the severity of pain and its relation with comorbid psychiatric disorders among patients presenting with headaches.
METHODS: Two patient groups were formed: those with MOH and those without MOH. Patients' gender, age, headache duration, monthly headache attack frequency, monthly analgesic use and type, presence of anxiety and depression, and pain severity were evaluated.
RESULTS: 38 (69.10%) of the MOH patients had a history of migraine, and 17 (30.90%) of them had a tension headache. Paracetamol + non-steroidal anti-inflammatory was the most commonly used analgesic in 37 patients (67.28%). Depression was observed in 33 (60%) of the patients with MOH, and anxiety was observed in 12 (21.82%). Depression was observed in 30 (18.29%) and anxiety in 42 (25.60%) of the 164 patients who did not use medication excessively. There was no significant difference in age, gender, headache duration and type between the two groups. The frequency of attacks (monthly), presence of depression and pain severity were significantly higher in the MOH group.
DISCUSSION AND CONCLUSION: Knowing this disease is important primarily in terms of preventing its development and if it has developed, early diagnosis and treatment. We think that raising awareness of patients who apply to primary care polyclinics in terms of excessive analgesic use will decrease the incidence of MOH.

INTRODUCTION: This study aimed to evaluate the test results of patients whose RT-PCR test result was negative, but thorax CT findings were compatible with COVID-19 and their infectiousness in terms of contacts.
METHODS: The study was designed as cross-sectional, descriptive research. In the first group, thorax CT revealed findings compatible with COVID-19 pneumonia, and the RT-PCR test result was negative. In the second group, thorax CT revealed findings compatible with COVID-19 pneumonia, and the RT-PCR test result was positive. Data collected were assessed with SPSS 21.0 software program. The significance level was accepted as 5%.
RESULTS: Of the participants, 54.41% were male, and 45.59% were female. There was no significant difference between the two groups in terms of contact environment and status of being a healthcare worker and exitus. There was no difference between the first and second groups in terms of the number of contacts. The rate of sample collection was higher in the second group. The number of people who had contact with the patients and positive RT-PCR test results was higher in the first group.
DISCUSSION AND CONCLUSION: Even if patients have negative RT-PCR test results for COVID-19, they are still infectious.

INTRODUCTION: Asthma is a disease that affects the quality of life and is characterized by chronic airway inflammation associated with airway hypersensitivity. Although there are worldwide accepted treatment guidelines in the treatment of asthma, most patients use Complementary and Alternative Medicine (CAM) methods for many reasons, such as both insufficiencies in treatment and fears of side effects and long-term medication. This study aimed to determine the use of complementary & alternative medicine and the attitudes of families in children followed with the diagnosis of asthma.
METHODS: This descriptive study was carried out in children diagnosed with asthma between the ages of 3-17. A questionnaire was applied to the patients' relatives to determine CAM methods. The Holistic CAM Questionnaire was applied to determine the attitudes of their families.
RESULTS: It was determined by families that they prefer using CAM to “Do everything possible to fight the disease” (46.46%) and use this information with the recommendation “Family members/friends/neighbors/relatives” (56.30%). It was found that they used CAM methods 66.53% between 1-6 months, and they thought that the use of the CAM method achieved 53,94% success in treatment. It was determined that families with dissatisfaction and hopelessness from medical treatment had a positive attitude of 25 (20-39) with complementary and alternative medicine and were statistically significant(p=0.035).
DISCUSSION AND CONCLUSION: It was found that the use of CAM is high in families with asthma in their children and that they have a positive attitude towards CAM use. The increasing use of CAM shows the need for healthcare professionals to be informed about this issue.

INTRODUCTION: Low back pain that is localized between the inferior costal margin and inferior gluteal folds and that can reflect legs is a common health problem and a leading cause of disability. Chiropractic is a non-invasive and inexpensive treatment method used for low back pain. The aim of our study was to evaluate the effects of chiropractic and isometric exercises on pain and functionality related to low back pain.
METHODS: Patients diagnosed with low back pain in the policlinic examination were taken in the study. Sixty patients consisting of 30 females and 30 males were randomly divided into two groups. Chiropractic application and lumbar isometric exercise were created for the first group, and a lumbar isometric exercise program was created for the second group. The exercise program was applied to both groups five days a week for four weeks by a physiotherapist. Chiropractic treatment was applied by the same doctor two days a week for four weeks. During the application, a high-speed, low amplitude manipulation technique was used in chiropractic. Visual Analog Scale (VAS) was used to score pain, and Oswestry Disability Index (ODI) was used to evaluate functionality before and after treatment. The range of motion was evaluated by goniometer measurement.
RESULTS: VAS and ODI scores decreased statistically significantly with treatment in both groups, while the range of motion in the lumbar spine increased significantly before and after treatment. VAS rest, VAS motion, and ODI scores were statistically significantly lower, and the increase in range of motion was higher in patients who received exercise and chiropractic compared to patients who only received exercise. Any adverse effect did not appear in both groups during the treatment.
DISCUSSION AND CONCLUSION: We think that chiropractic and exercise are effective on pain and functionality in low back pain, and they are more effective when applied together.

INTRODUCTION: We aimed to evaluate adherence and determine the factors that are related to adherence in patients on levothyroxine therapy.
METHODS: Patients older than 18 years old and using levothyroxine for primary hypothyroidism were recruited. Demographical and clinical features, practices of using levothyroxine, and compliance were evaluated through a questionnaire. Those who answered the frequency of not using/skipping the drug as never/rarely, sometimes, and frequently/often were grouped as high, medium, and low adherence, respectively.
RESULTS: Data of 335 patients -282(84.18%) female and 53(15.82%)- male, with a mean age of 47.36±12.50 were analyzed. 330 (98.50%) patients were taking levothyroxine in the morning, and 332 (99.10%) were taking fast. 8(%2.41) patients were taking the drug just before the meal, and 66(19.88%) were taking it in 15 minutes. 66.66% of 145 patients using a medication that interferes with the absorption of levothyroxine were using it less than 2 hours of levothyroxine. There were 218 (65.08%) high, 98 (29.25%) medium and 19 (5.67%) low adherence patients. Drug adherence was not associated with demographical features, the cause and duration of hypothyroidism, the presence of comorbid disease, and thyroid hormones. Higher education level and familial thyroid disease were associated with high adherence (p=0.008 and p=0.013, respectively).
DISCUSSION AND CONCLUSION: Drug adherence was medium/ low in 34.92% of hypothyroid patients. A considerable amount of patients did not leave enough time between levothyroxine and meal or other medications. For effective treatment of hypothyroidism, it is important to inform patients about hypothyroidism and levothyroxine use and increase drug compliance.

INTRODUCTION: In this study, it was aimed to evaluate the knowledge, attitude, and practices of the personnel providing health services in the Department of Health Services in Ankara Provincial Health Directorate about COVID-19.
METHODS: The data of our cross-sectional type of study was collected between the dates of 26 October-November 30, 2020, and 85% percent of the pre-defined population was reached. Statistical evaluation was performed with number and percentage distributions and chi-square test.
RESULTS: The average knowledge score of the personnel was found to be 9.35±1.02. Out of 10 knowledge questions, 7 were answered correctly over 91%. 60.6% of respondents answered all knowledge questions correctly. A statistically significant difference was found in the level of knowledge according to profession and level of education (p<0.001). 47.6% of participants exhibited exactly the right practice, and a statistically significant difference was found in the level of practice by profession, gender and education level (p<0.05).


DISCUSSION AND CONCLUSION: Considering the lower level of knowledge and practice of non-health professional groups, comprehensive in-service training for health professionals should further contribute to the fight against the pandemic.

Due to the prolonged life expectancy worldwide, the number of individuals in need of home care and palliative care is increasing. In the process of palliative care, the needs of patients and caregivers that affect the quality of life and can contribute to daily life activities should be identified. The COVID-19 pandemic, which is spreading rapidly all over the world, and the changes it has made to social life have affected individuals with chronic diseases and/or long-term care patients. The needs and service demands of palliative care patients and their families may vary during their processes. The epidemic increases the demand for health services in society and has a compelling effect on health systems. In this case, remote access auxiliary support services may be raised in order to carry out medical care monitoring of patients. Although tele-medicial/tele-health applications are not a substitute for a face-to-face meeting between physician and patient in terms of medical service delivery, interest in these applications is increasing day by day to protect vulnerable patient groups from the risk of transmission and to ensure the continuity of care services. In this review, the discussion of the changing care needs of patients in need of palliative care and home care during the pandemic process and the use of new tools to meet health demands in a way that includes less risk will be reviewed.

Osteoarthritis (OA) is a chronic and degenerative musculoskeletal disease that causes involvement in all joints and destroys the articular cartilage and subchondral bone. Although OA mostly affects large joints such as the knee and hip joints, it most commonly affects the knee joint. Its prevalence increases with age, and it is most common in patients over 65 years of age. OA etiology is multifactorial. It includes structural and mechanical reasons. A large number of patients apply to the physician with these complaints because of the pain in the affected joint causes limitation of movement and consequently loss of function. The aim of OA treatment is to relieve the patient's complaints. Conservative treatments such as patient information and education, diet, analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, intra-articular injections are recommended in the current literature. When such conservative treatments are not sufficient, surgical treatment may be considered. OA is one of the major diseases that cause a decrease in the quality of life in primary care, and family physicians should focus on counseling in order to create patient education and lifestyle changes. In this review, the approach to patients with knee OA who applied to the Primary Healthcare Institution is explained in the light of current treatment guidelines.

Increased incidence of strokes in young adults could result in more emergency department visits for ischemic stroke evaluation. Diagnosing a young patient with neurological symptoms as conversation disorder without exploring other potential diagnoses can be detrimental and at times result in mortality. In our case, we present a 30-year-old female who develops left extremities weakness after a stressful event. In this case, early diagnosis and intervention provided a dramatic improvement in patients' health status and prognosis. This case emphasizes the importance of early neurological exams and imaging studies in the diagnosis of stroke.

Pandemic periods are one of the reasons patients have difficulty accessing healthcare services. Even diseases such as diabetes mellitus with a high prevalence and easy to diagnose today may delay the diagnosis of patients. Likewise, difficulties may be experienced in the follow-up of these patients due to pandemic period restrictions. We presented 1 diabetes mellitus patient delayed in diagnosis during the COVID-19 pandemic period and 2 diabetes mellitus patients who had difficulties in follow-up due to pandemic restrictions in this case reports.