Trends in traditional and complementary medicine practices in Turkey: Results of two consecutive surveys 2012-2018.

OBJECTIVE: To determine the knowledge, opinions, experiences and trends regarding herbal treatment, traditional medicine and other complementary and alternative medicine. METHODS: Two cross-sectional studies were conducted at Meram Faculty of Medicine Hospital, Konya, Turkey, in 2012 and 2018, comprising subjects of either gender aged >18 years. Data was collected using a survey form prepared in the light of relevant literature. Data was summarised and compared between the two studies. RESULTS: Of the 810 subjects in the two studies, there were 405(50%) in 2012 with a mean age of 32.5±14.0 years, while the remaining 405(50%) were part of the 2018 study with a mean age of 34.4±13.8. There were significant differences between the two group of subjects about the use and indications of traditional and complementary medicine as those who believed traditional and complementary medicine was proper to use increased and those who believed it should not be used decreased significantly (p<0.001). There was a twofold increase in the use of social media as the source of relevant information (p<0.001). CONCLUSIONS: Significant changes in trends related to the use of traditional and complementary medicine between 2012 and 2018 were observed.

Assessment of smoking in adolescents - a sample from vocational education centre.

OBJECTIVE: The aim of this study was to analyse the knowledge and attitudes about smoking in young people between 16-20 years of age, who were both working and attending the Vocational Education Centre. METHODS: This study was conducted with high school students at the Vocational Education Centre. The socio-demographic questionnaire and the Fagerström Test of Nicotine Dependence (FTND) were applied to the students using a face-to-face interview technique. Secondly, interactive educations on smoking-free life and smoking-related diseases were given. At last, CO (carbon monoxide) levels and respiratory functions were evaluated. RESULTS: Of the students 92.9% were males, 37.4% were 16 years, 35.8% were 17 years and 26.9% were 18-20 years old. Among 46.9% of smokers, 75.8% started smoking before 15 years of age, 86.1% were living with smokers. While 70.5% of smokers smoked more than 10 cigarettes daily, 61.3% smoked their first cigarette in the first half hour after waking up. Of the smokers, 28.8% were highly dependent, 13.0% were very highly dependent. CO levels were significantly higher in those who smoked in the workplace, who smoked mostly in the morning time, and those who started smoking at 7 years of age and younger (p < 0.05). FEV1, FVC, FEF25-75 values of morning smokers were significantly lower (p < 0.05). CONCLUSION: Unfortunately, the first smoking age was very low, the first cigarette of the day was lit in a short time after waking up, and family/friend's attitudes and behaviours were encouraging in this age group. More attention should be paid to this issue and especially new preventive projects should be implemented to protect young people from smoking.

Inhaled Dry Powder Mannitol Treatment in Pediatric Patients with Cystic Fibrosis: Evaluation of Clinical Data in a Real-World Setting.

Background: Cystic fibrosis (CF) is a genetic disorder, in which defective clearance of airway secretions leads to progressive lung function loss. Inhaled mannitol is used to increase sputum and mucociliary clearance. There are little data from real-world studies on the effectiveness of mannitol in children. Our objective was to evaluate the spirometry and clinical results of mannitol in pediatric patients. Methods: We retrospectively reviewed the records of 30 children and adolescents with CF receiving inhaled mannitol who were already on recombinant human deoxyribonuclease (rhDNase) treatment. The change in forced expiratory volume in 1 second (FEV1) from baseline at 2-4 months was the primary outcome. Secondary measures were other spirometry results, body mass index (BMI), hospital admissions, sputum characteristics, and positive bacterial colonization. Results: Compared to baseline, we found significant improvement in percent predicted FEV1 at 2-4 months of treatment; 84.50 (58.00-99.00) vs. 96.00 (66.00-106.00) (P = 0.0007). The absolute change in FEV1 was +11.5% at 2-4 months, +6.5% at 5-7 months, and +4% at 8-12 months. Also, significant improvements in other spirometry results were observed. Adolescents had significantly lower FEV1 results, but the improvement in their lung function was sustained for a more extended period than children. Mannitol provided easier sputum removal, increased sputum volume, significant decline in hospitalizations, and significantly fewer patients with positive sputum cultures. A significant increase in BMI at 8-12 months was observed. Cough was the most frequent adverse effect. Conclusion: In a real-world setting, our results demonstrated that adding mannitol to rhDNase therapy is tolerable in pediatric patients with CF and may provide improved spirometry and clinical outcomes. In addition, our results showed that mannitol provided recovery in overall lung function at 2-4 months, which was sustained up to 12 months together with improved BMI, easier sputum removal, and a decline in bacterial colonization and hospital admissions. However, cough was the most frequent side effect.

Relationship between acanthosis nigricans, acrochordon and metabolic syndrome in patients with lichen planus.

AIM: In the literature, there are no data examining the association with lichen planus with acanthosis nigricans and acrochordon, which are skin findings of metabolic syndrome (MS). MATERIALS: A total of 108 lichen planus (LP) patients, age and sex-matched 109 controls, 217 patients in total were prospectively included in the study. RESULTS: Metabolic Syndrome was found in 55 (50.9%) of 108 patients with lichen planus and 36.7% in the control group. The frequency of MS in the lichen planus group was found to be significantly higher than that in the control group (P = .03). The incidence of acanthosis nigricans (AN) was statistically higher in the LP group (P = .009). In addition, while 38 of 47 AN patients in the LP group had MS, 17 of 61 patients without AN had MS, and the presence of MS was found significantly higher in LP patients with AN (p˂0.001). The incidence of acrochordon was statistically higher in the LP group (P = .03). In addition, while 43 of 62 patients with acrochordon in the LP group had MS, 12 of 46 patients without acrochordon had MS, and the presence of MS was found significantly higher in patients with LP with acrochordon (P Ë‚ .001). CONCLUSION: In our study, it was found that skin findings such as AN and acrochordon increased in patients with lichen planus. This increase was also observed in lichen planus patients with metabolic syndrome. Therefore, the association of acanthosis nigricans and acrochordon may be a predictive of metabolic syndrome in patients with lichen planus admitted to the dermatology outpatient clinic.

The Relationship between COVID-19 Severity and Bacillus Calmette-Guérin (BCG)/ Mycobacterium tuberculosis exposure history in healthcare workers: a multi-center study.

The COVID-19 pandemic has brought countries' health services into sharp focus. It was drawn to our group's attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine.

Evaluation of skin problems and dermatology life quality index in health care workers who use personal protection measures during COVID-19 pandemic.

The aim of this study was to evaluate the skin problems and dermatological life quality of the health care workers (HCWs) due to personal protection equipment (PPE) use, who are at high risk for COVID-19 infection. A questionnaire about HCWs' PPE use, their skin symptoms, and prevention, management methods and Dermatology Life Quality Index (DLQI) was fulfilled. The median age of 440 participants was 33.5 (21.0-65.0) years old. Skin problems were found to be 90.2%, the most common were dryness, itching, cracking, burning, flaking, peeling and lichenification. The presence of skin problems (P < .001) was higher in those who did not use moisturizers. Of all, 22.3% (n = 98) stated that the use of PPE increased the severity of their previously diagnosed skin diseases and allergies (P < .01). Only 28.0% (n = 123) stated that they know the skin symptoms that may develop by using PPE. The proper hand washing rate was higher as education level increased (P < .001). Skin problems were higher in those using mask with metal nose bridge (P: .02 and P: .003, respectively). As the mask using period prolonged, acne was more common (P: .02). DLQI was significantly affected in women (P = .003), and with increased skin problems related to PPE (P < .001). It is important to organize trainings on prevention and management of possible skin symptoms due to PPE use according to guidelines.

Patient Knowledge, Attitudes, and Behaviors Associated with Organ Donation.

BACKGROUND This study compared the knowledge, attitudes, and behaviors associated with organ donation and transplantation among patients undergoing dialysis versus those visiting family health centers (FHCs). MATERIAL AND METHODS This cross-sectional study included patients undergoing hemodialysis treatment at the Meram Medical Faculty and those visiting FHCs in Meram district for other reasons. RESULTS The study participants were 128 individuals visiting FHCs and 111 patients undergoing dialysis. Of these, 169 individuals (70.7%) correctly answered the question "What is brain death?" The knowledge level in the FHC group was higher than that in the dialysis group. Less than half of the individuals indicated willingness to donate an organ. Furthermore, subjects in the dialysis group were more likely than those in the FHC group to answered "no" to the question "Would you be willing to donate an organ to someone of a different religion?" CONCLUSIONS Positive attitude towards organ transplantation and donation does not necessarily reflect positive behavior these 2 groups.

Traditional practices of Konya women during pregnancy, birth, the postpartumperiod, and newborn care.

BACKGROUND/AIM: The purpose of the present study was to identify traditional practices and the extent to which they are practiced by mothers during pregnancy, birth, the postpartum period, and newborn care. MATERIALS AND METHODS: This study was conducted in the city center of Konya (Turkey). Data were collected through questionnaires completed by volunteers. The research sample comprised 450 mothers, all of whom had given birth to at least one live baby. The forms were completed during face-to-face interviews. RESULTS: Some traditional pregnancy practices were followed by 70.7% of the participants. Of the women who performed these practices, 57.4% consciously chose foods they craved, tried not to take nutrients believed to be unsuitable in pregnancy, and took nutrients believed to influence the sex of the baby; 85.6% reported breastfeeding their babies in the first 4 h after birth and 9.7% waited for the first call to prayer (azan) to start breastfeeding. Additionally, 72.2% of the mothers reported performing kirklama (making the forties), a ceremony performed to celebrate the 40th day after a baby's birth. CONCLUSION: Most of the women who participated in the study still followed some traditional practices and rituals during pregnancy and the postpartum period. Therefore, health care professionals should provide health education that accounts for the women's cultural and social environment.

A sample of paediatric residents' loneliness-anxiety-depression-burnout and job satisfaction with probable affecting factors.

OBJECTIVE: To assess levels of anxiety, depression, loneliness, burnout and job satisfaction among paediatric Residents, and how they influence each other. METHODS: The cross-sectional study was conducted at Necmettin Erbakan University, Meram, and Konya Meram Education and Research Hospital, Turkey from January to June 2011, and comprised paediatric Residents and their counterparts from other departments who formed the control group. While maintaining confidentiality, a questionnaire was used to collect data that had elements of the University of California, Los Angeles, Loneliness Scale, Hospital Anxiety and Depression Scale, Maslach Burnout Inventory and Minnesota Job Satisfaction Questionnaire. SPSS version 13 was used for statistical analysis. RESULTS: Overall there were 74 Residents in the study; 43 (58%) working with the paediatrics department, and 31 (42%) in the control group. Overall mean age was 27.60 ± 2.25 years. Residents who were not satisfied with the city they were living in, with their professional career and who would not choose the same career given a second chance were feeling more lonely and had higher loneliness scores (p < 0.05). In contrast, anxiety among female Residents who were unsatisfied with their professional career and working conditions was significantly high (p < 0.05). Positive correlation was detected between the burnout levels of Residents and their anxiety, depression and loneliness scores (r = 0.74; r = 0.65; r = 0.36). In terms of intrinsic, extrinsic and total job satisfaction, there was an obvious negative correlation (r = -0.57; r = -0.54; r = -0.61). CONCLUSION: Working conditions and professional liability were the main factors affecting the Residents. Informed decision and career willingness may help them feel better.

Early surgical abortion: safe and effective.

OBJECTIVES: To evaluate patients' characteristics and complications of surgical abortion performed at an early gestation, compared to later gestations. METHODS: A total of 4310 women with unintended pregnancies attending the family planning unit of a government maternity hospital in Konya, Turkey, were included retrospectively. Abortions were carried out from 6 weeks' up to 10 weeks gestation. RESULTS: The gestational age in 62% of the cases was between 6 weeks and 6 weeks + 6 days. Only 8.5% of the 4310 women had used a modern contraceptive method, and 16% had had a surgical abortion for an unplanned pregnancy previously. These women were younger, had more siblings, and a shorter time had elapsed since their last pregnancy when compared to women who never had an abortion. There were four failures (0.09%). The rate of retained products of conception (RPCs) was 1.9% in women aborted between six and six (+ 6) weeks' gestation, and 6.2% (p < 0.001) in those aborted later. Women who had had a surgical abortion previously more often had RPCs than those who never had (16% vs. 1%, respectively, p < 0.001). Of the 151 women with RPCs, 65 (43%) had been using an intrauterine device prior to surgical abortion. CONCLUSION: Early surgical abortion (at six-six(+ 6) weeks' gestation) generates few complications. Delaying surgical abortion until a somewhat later gestation causes complication rates (particularly RPCs) to increase.

Assessment of effects of pre- and post-training programme for healthcare professionals about breastfeeding.

This retrospective study assessed the effects of pre- and post-training programme for healthcare professionals about breastfeeding. The study included 3,114 mothers who had children aged 1-72 month(s). Their knowledge and behaviours relating to breastfeeding were evaluated. The mothers were randomly divided into two groups: the 'before' group included 2,000 women who were not informed about breastfeeding, and the 'after' group comprised 1,114 women who had been informed about breastfeeding. 56.2% and 66.1% of the mothers started breastfeeding within 30 minutes after delivery, respectively, in the before and the after group (chi2 = 29.31, p < 0.001). 16.7% and 36.5% gave exclusive breastfeeding for six months (chi2 = 72.85, p < 0.001), and 28.5% and 23.7% stopped breastfeeding within the first five months (chi2 = 17.20, p = 0.002). Ninety-four percent delivered in a hospital or in a primary healthcare centre. Therefore, prenatal and postnatal breastfeeding education and support courses may improve a woman's chance of starting and continuing to breastfeed her baby. In terms of the number of antenatal check-ups, since the differences between the two groups were significant (chi2 = 390.67, p = 0.000), the importance of the training programme about breastfeeding was highlighted. Follow-up interventions after training are suggested.