The Effect of Rosmarinic Acid on Wound Healing of Nasal Mucosa in the Rats.

BACKGROUND: The nose can be damaged by environmental pollutants and foreign bodies, as well as a result of trauma, infection or surgical interventions. Proper healing of the damaged nasal mucosa is important for health. OBJECTIVE: There is no study in the literature investigating the effects of rosmarinic acid on mucosal healing. The aim of this study was to investigate the effect of rosmarinic acid on nasal mucosal healing. METHODS: 21 male, adult Spraque Dawley albino rats were divided into three groups as the control group, the local treatment group in which rosmarinic acid was applied locally to the nasal mucosa, and the systemic treatment group in which rosmarinic acid was injected intraperitoneally. The wound area was obtained by creating a trauma area by inserting a 10 mm interdental brush through the right nasal nostril into the right nasal cavities of all animals. For the following 15 days, the treatment agent was applied as indicated once a day and on the 15th day the animals were decapitated and tissue samples taken from the nasal mucosa were prepared for histopathological examination. The preparations were examined in terms of cellular hyperplasia, goblet cell hypertrophy and degeneration, leukocyte infiltration, cilia loss and degeneration, edema and vascular dilatation, and they have been classified into four categories as mild (+), moderate (++), severe (+++) and very severe (++++). RESULTS: There was a significant difference between the groups in terms of all parameters evaluated, and there is a decrease in the intensity of the parameters with transition from the control group to the local group and from there to the systemic group. CONCLUSION: Systemic rosmarinic acid administration showed an enhancing effect on the healing of experimentally induced nasal mucosal injury due to its possible anti-inflammatory effect.

Premarital hemoglobinopathy screening program results of a province in the Black Sea region of Turkey: three years' experience.

OBJECTIVES: Hemoglobinopathies are a global public health problem with high mortality and morbidity and very expensive treatment. Disease can be reduced and prevented with hemoglobinopathy screening tests. It is possible to identify carriers with the hemoglobinopathy screening program applied in many countries of the world and in Turkey. This study aims to evaluate the results of the national premarital hemoglobinopathy screening program carried out in primary healthcare institutions. METHODS: The research is of epidemiological and cross-sectional type. Electrophoresis results examined within the scope of the premarital hemoglobinopathy screening program in Samsun between 1 January 2019 and 31 December 2021 were evaluated retrospectively. Age, gender, year of screening, and hemoglobinopathy screening results were obtained from the records. In the statistical analysis of the data, p < 0.05 was accepted. RESULTS: The median age of 52,338 people screened under the hemoglobinopathy screening program was 29.0 (16.0-86.0) years. About 54.1% (n = 28,309) of those who were screened were female, and it was found that the least screening was done in 2020 (n = 15,765 (30.1%)). As a result of the screening, the frequency of the ß-thalassemia (ß-thal) trait was 1.37% (n = 676), the frequency of the abnormal HbS was 0.04% (n = 20). The frequency of ß-thal trait was statistically significantly higher in 2020 (1.5%) compared to other years (p = 0.029). When the results were analyzed by gender, the rate of women with abnormal HbS (3.7%) was significantly higher than the others (p = 0.017). CONCLUSIONS: This study presents the results of the national hemoglobinopathy screening program in Northern Turkey and the ß-thal and the abnormal HbS rates were found to be low. The data obtained will be useful in monitoring hemoglobinopathy disorders and evaluating the current program's effectiveness in the future. It will allow decision-makers to implement policy changes and prioritize new programs.

Impact of the COVID-19 pandemic on tuberculosis patients and tuberculosis control programs in Turkey, review and analysis.

BACKGROUND: Many infectious diseases, including Tuberculosis (TB), have been put in the background with the COVID-19 pandemic. This study aimed to evaluate the changes in the number of TB patients, the parameters of the TB patients and tuberculosis control programs in the first year of the COVID-19 pandemic in Turkey when compared to the previous year. METHODS: All TB patients who were recorded in Samsun province between March 1, 2019 and February 28, 2021 were included in this retrospective study. The data were analyzed in 2 groups as the COVID-19 period (March 2020 and February 2021) and the Pre-COVID-19 period (March 2019 and February 2020),the demographic and microbiological characteristics of the tuberculosis patients in both periods were compared according to months and years p < 0.05 was considered statistically significant. RESULTS: The total number of TB patients was 320, although it was 172 in the Pre-COVID-19 period, it was 148 in the COVID-19 pandemic period. It was found that the TB incidence rate (IR) was 15.32%, the total number of examinations performed in TB dispensary decreased 33.54%, and the total number of contact examinations decreased by 53.54% during the pandemic period. The mean age of the patients decreased significantly during the COVID-19 period (p = 0.047), and it was found that culture positivity rates and smear positivity rates increased compared to the previous year (7.97%, p = 0.166, 1.86%; p = 0.507, respectively). SARS-CoV-2 PCR test result was found to be (-) in 46 (82.1%) of the 56 TB patients who were examined. CONCLUSIONS: In the present study, it was found that the incidence of TB, the number of examinations, and the number of contact examinations decreased at significant levels. The decrease in TB patients was mostly in the first 3 months when COVID-19 precautions and restrictions were intense. As a conclusion, it was observed that the application of TB patients to the healthcare institution and TB control were affected negatively by the COVID-19 pandemic.

Evaluation of family physicians' anxiety during the COVID-19 process: provincial example from Turkey.

BACKGROUND: In the natural progression of COVID-19, recovery usually takes months in most cases. Comprehensive evaluation of underlying complications requires a holistic approach as in primary health care, which creates additional workload and stress for family physicians. METHODS: The descriptive-cross-sectional study was carried out in 226 family physicians in Samsun, Turkey. Ethical permissions were obtained to conduct the study. State-Trait Anxiety Inventory scale was used as data collection tool. RESULTS: 214 physicians were included in the study. The majority of the participants in the study were female. Most of the family physicians were not specialist physicians. Most of them were married. The majority of family physicians do not smoke and did not have any chronic diseases. The trait anxiety score of the physicians was 43.40 ± 8.50, and the situational anxiety score was 48.09 ± 11.55. The correlation between trait anxiety and situational anxiety was positive and significant. Gender difference did not make a significant difference on anxiety. Anxiety was significantly higher in patients with chronic disease. Marital status, having a child, and a history of COVID disease do not have a significant effect on anxiety. CONCLUSION: At the beginning of the COVID pandemic, the greatest struggle was given in secondary and tertiary healthcare institutions. In the following process, this burden shifted to primary health care institutions. This situation has increased the workload and stress of family physicians working in primary care. Therefore, it also increased perceived anxiety. Individuals with high trait anxiety scores have higher state anxiety scores.

Evaluation of age-related changes in middle-ear structures by wideband tympanometry.

BACKGROUND: Presbycusis is bilateral sensorineural hearing loss associated with the progressive degeneration of cochlear and central auditory pathways with aging. AIMS/OBJECTIVES: We aimed to reveal age-related changes in middle ear function by using wideband tympanometry (WBT). MATERIALS AND METHODS: Fifty-eight patients diagnosed with presbycusis were compared to 52 audiologically healthy participants. WBT measurement was performed on both ears via wideband click stimulus with a tympanometer device using probe tone frequencies of 226-8000 Hz. RESULTS: There were no statistically significant differences detected among the resonance frequencies or maximum absorbance ratios measured in both ears between groups (p > .05). The mean absorbance of the right and left ears at 4000 and 8000 Hz was statistically higher in the patient group than in the healthy controls (r = 0.038, 0.030; l = 0.015, 0.012). Moreover, mean compliance values were found to be significantly lower in the patient group than in the control group (r = 0.030 and l = 0.040). CONCLUSION: The significant differences detected in compliance and absorbance values for high frequencies in presbycusis patients were remarkable. Thus, it has been shown that WBT yields an advantage compared to traditional tympanometry in the diagnosis and treatment of middle ear diseases.

Evaluation of stillbirths and infant mortality before and during the COVID-19 pandemic: a retrospective study.

OBJECTIVE: The maternal-child health services remain an important indicator to look at how different countries have handled the pandemic. This study aims to investigate the effect of the COVID-19 pandemic on maternal and child healthcare use and evaluate data on stillbirths and infant mortality. METHODS: In this descriptive, cross-sectional study, a retrospective analysis was performed on 293 stillbirths and 324 infant deaths, which occurred in Samsun Province of Turkey between 1 March 2018 and 1 March 2021. The study period was examined in three groups as pre-pandemic period 1 (1 March 2018-28 February 2019), pre-pandemic period 2 (1 March 2019-29 February 2020) and pandemic period (1 March 2020-28 February2021). RESULTS: The study found that the share of difficulties in delivering health-care services to the families (may be due to reasons such as difficulty in accessing health services for those living in rural areas, disruption of the referral chain) in stillbirths and infant deaths has decreased during the COVID-19 pandemic compared to previous years (p = 0.037 in stillbirths, p = 0.002 in infant deaths). The mean number of follow-up visits during pregnancy has partially reduced during the pandemic (p > 0.05). Other variables of the health-care services have remained similar to years before the pandemic (p > 0.05). The rate of families without health insurance (p = 0.001 in stillbirths, p = 0.001 in infant deaths) and unemployed persons contributing to family budget (p = 0.012 in stillbirths, p = 0.016 in infant deaths) has significantly decreased during the pandemic. CONCLUSIONS: In our study, it was determined that the variables of stillbirth and infant mortality during the COVID-19 pandemic period, and maternal and child health services in primary care and hospitals continued to provide services in a similar way to the pre-pandemic period. Compared to pre-pandemic periods during the COVID-19 pandemic, it was found that while the number of stillbirths was similar, there was a significant decrease in infant mortality.

Characteristics of tuberculosis-related deaths and risk factors: a retrospective cohort study in Samsun province of Turkey.

OBJECTIVES: Tuberculosis (TB) remains one of the top ten leading causes of death worldwide despite effective therapy. The present study aims to examine the characteristics of TB-related deaths in Samsun Province and to determine the risk factors. METHODS: In this retrospective registry-based cohort study, the medical records of patients registered with Samsun Tuberculosis Control Dispensary between 1 January 2018 and 31 December 2019 were retrospectively reviewed. The Cox proportional-hazards model was used to determine the factors associated with the risk of death in patients with TB. RESULTS: The treatment outcomes of a total of 382 patients were reviewed. It was found that the treatment was successful in 346 patients (90.6%), and 31 patients (8.1%) died before or during TB therapy. The median survival time of patients who died during the therapy was 1.86 months (95% CI = 0.07-5.17 months), and more than 50% (13/25) of the deaths occurred in the first two months of the treatment. Age above 70 years (HR 15.06 (3.33-67.95)), male gender (HR 2.74 (1.02-7.33)), pulmonary TB (HR 2.92 (1.002-8.52)), multidrug-resistant (MDR) tuberculosis (HR 1.69 (1.22-12.75)), and a delay in the treatment of more than ten days (HR 2.71 (1.22-6.04)) were identified as risk factors associated with mortality in TB patients (p < 0.05). CONCLUSION: The majority of deaths in our cohort occurred within the first two months after starting the treatment. Advanced age, male sex, a new diagnosis of TB, pulmonary TB, MDR-TB, and a treatment delay of more than ten days after diagnosis increased the risk for mortality during antituberculosis treatment.

A retrospective evaluation of laboratory parameters and hyperuricemia in patients with acne vulgaris under systemic isotretinoin treatment.

BACKGROUND: Acne vulgaris is a chronic inflammatory disease affecting the pilosebaceous unit. Systemic isotretinoin (SI) is an effective, synthetic vitamin A derivative in the treatment of resistant acne or nodulocystic acne. This study aimed to investigate uric acid levels and laboratory parameters in patients receiving isotretinoin treatment. MATERIALS AND METHODS: This study included 114 patients who were under SI treatment of 0.2-0.5 mg/kg/day aged between 17 and 44 years old. We retrospectively evaluated total cholesterol, triglyceride, aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea, creatinine, creatinine kinase, uric acid, thrombocyte (Plt), and leucocyte (WBC) levels prior and on the fourth month of the treatment from the patients' records and compared these data statistically. RESULTS: The AST, creatinine kinase, cholesterol, triglyceride, and thrombocyte levels were significantly different (p<.001, p<.001, p<.001, p<.001, and p=.02, respectively), and no statistically significant differences were noted among the uric acid, creatinine, ALT, and WBC levels in the comparison of the baseline values and values at the fourth month of treatment (p>.05). CONCLUSIONS: SI treatment of 0.2-0.5 mg/kg/day did not make significant alterations on serum uric acid levels. Besides, all alterations occurred within normal ranges.

The Economic Burden of Vertigo: Results From the Hospitalized and Outpatients.

OBJECTIVE: Vertigo and dizziness are the common presenting concerns in emergency departments and outpatient clinics, accounts for approximately 15% to 20% of adults annually. We aimed to evaluate economic burden of vertigo on health-care system and work productivity in association between clinic characteristics of in- or outpatients. METHODS: A total number of 2289 patients diagnosed with peripheric (noncentral) vertigo were evaluated retrospectively. The direct medical costs associated with vertigo classified as medication, consumable, imaging, and laboratory. In addition, the indirect costs were associated with lost working days. The overall economic impact of vertigo assessed via total expenditure for diagnosis and treatment. RESULTS: The mean duration of hospitalization was 5.6 ± 4.3 days and working day lost was 9.47 ± 3.90 days. The overall impact on work productivity of disease was 15.35 ± 6.11 days. The overall mean direct cost including all expenditure items associated with vertigo care was $250.25 ± $1479.62 per patient. The overall cost associated with vertigo was found to be statistically increased in the male, aged ≥65 years, widow or divorced, and hospitalized patients. CONCLUSIONS: Our findings clearly indicate that a vertigo-dizziness management program based on patients' risk factors may achieve to reduce hospitalizations and cost of hospital care as well.