Acute ischemic stroke in young adult: Atrial fibrillation, hyperthyroidism, and COVID-19 collaboration.

Atrial fibrillation is a frequently detected cardiac arrhythmia in the etiology of ischemic stroke. The incidence of atrial fibrillation and the risk of it causing ischemic stroke increase significantly with age; it is rare in young people. It is known that the risk of developing atrial fibrillation is high when there is a background of hyperthyroidism. COVID-19 is thought to cause thromboembolic events, cardiac pathologies, and endocrine disorders. A 54-year-old presented with right-sided hemiplegia and motor aphasia of 1.5 h duration. On evaluation, he tested positive for SARS-CoV-2 imaging was suggestive of acute pons ischemia and found to have hyperthyroidism and atrial fibrillation. It is clear that atrial fibrillation, which is highly unlikely to cause ischemic stroke in young adults, may develop due to hyperthyroidism. COVID-19 has been suggested as a cause of atrial fibrillation and hyperthyroidism. It is also thought to be involved in the etiology of stroke by causing hypercoagulation or triggering vasoconstriction through the renin-angiotensin system.

Assessment on risk and stress of resident doctors during the COVID-19 pandemic.

INTRODUCTION: It has been noted that post-traumatic stress disorder symptoms could be common in physicians who have experienced a traumatic event. The aim of this study was to determine the prevalence of post-traumatic stress disorder and contributing risk factors among resident doctors working in a tertiary care hospital during the COVID-19 pandemic. METHODOLOGY: A cross-sectional study was conducted via an online survey from May to July 2020. Sociodemographic characteristics, exposure to the coronavirus, application of personal hygiene rules, presence and use of personal protective equipment, anxiety and prevalence of post-traumatic stress disorder were investigated. RESULTS: In total, 17.8% (n = 40) of 225 resident doctors who participated in the study had post-traumatic stress disorder. Working at a department serving to COVID-19 patients increased the risk of post-traumatic stress disorder by 2.9 times (OR = 2.936, p = 0.003) while contacting positive patients increased this risk by 2.6 times (OR = 2.607, p = 0.023) and lack of personal protective equipment by 3.6 times (OR = 3.656, p = 0.018). Anxiety scores were statistically significantly higher in women, married and those living with their parents or spouses and children (p = 0.049; p = 0.011; p = 0.004, respectively). CONCLUSIONS: Working in a department serving to COVID-19 patients, contact with positive patients and lack of personal protective equipment were risk factors in the emergence of post-traumatic stress disorder in resident doctors. Anxiety was also found to be greater in women, married and those living with their families.

Contraceptive use and fertility behaviour among Syrian migrant women.

OBJECTIVES: This study aimed to investigate fertility behaviours and contraceptive use among Syrian migrant women in western Turkey. METHODS: An epidemiological, single-centre, cross-sectional, descriptive study was conducted. The survey collected data on sociodemographic characteristics and types of marriage, use of contraceptive methods and fertility behaviours among 223 Syrian migrant women. RESULTS: The women's mean (± standard deviation) age range was 29.6 ± 9.1 (range 18-49) years; 29.6% had no formal marriage status; 61.0% had had an arranged marriage. The mean age at first pregnancy was 19.5 ± 3.4 (13-39) years; 26.4% had become pregnant before the age of 18. In total, 94.2% of participants had knowledge of contraceptive methods. However, 47.5% did not use contraception and the main reason for this was to become pregnant again. Intrauterine devices and oral contraceptive pills were known as contraceptive methods by 67.7% and 72.2% of women, but used by only 16.1% and 8.5%, respectively. Withdrawal (22.0%) was the most used contraceptive method. There was a risk of unwanted pregnancy in 13.0% of participants. Arranged marriage and low educational level were determined to be risk factors for adolescent pregnancy. CONCLUSION: Although Syrian migrant women were aware of contraceptive methods, the rate of method use was low.

Waterpipe smoking, internet addiction and depression: A public health problem trio?

BACKGROUND: Waterpipe smoking and Internet addiction may result in a new public health problem globally. This study aimed to explore waterpipe use among a large group of adolescents and its association with Internet use, mental health, primarily depression and their demographic characteristics. METHODS: Using a stratified random sampling method, 2054 tertiary school students aged 14-18 years were recruited in 2019. Demographical information and use of tobacco products (eg, waterpipe) were explored and compared with severity of Internet addiction and mental status. RESULTS: A total of 288 (14.0%) adolescents had ever used waterpipe. Multivariate logistic regression analyses suggested that being male (OR = 2.55 and 95% CI = 1.98-3.30; P = .0001), being depressed (OR = 1.62 and 95% CI = 1.24-2.11) and excessive Internet use (OR = 1.94 and 95% CI = 1.50-2.52; P = .0001) were significantly associated with waterpipe use. Family income and parents' educational status showed no relationship with waterpipe smoking. CONCLUSIONS: We suggest that adolescents who are depressed and who use the Internet excessively are at an increased risk for waterpipe use, independent of income and parenteral education.

Intimate partner violence management and referral practices of primary care workers in a selected population in Turkey.

BACKGROUND: Violence against women is a significant public health problem and primary care workers (PCWs) have a crucial role in managing violence against women. However, though intimate partner violence (IPV) is frequently seen in primary care, most cases remain unreported. AIMS: This study aims to investigate family physicians' (FPs') and co-working midwifes/nurses' (M/Ns') explanations about their responses to women disclosing IPV and the reasons for their actions. METHODS: We conducted a cross-sectional survey via a face-to-face administered questionnaire interview involving 266 PCWs in a selected area in Turkey. We questioned the reasoning behind inappropriate responses such as not examining the patient and document findings, not recording a code of violence, and not notifying the police in the case of a disclosure of IPV. RESULTS: We surveyed 129 FPs and 137 M/Ns. We found that the disclosure of IPV in primary care is very high, but more than one-third of physicians and half of M/Ns respond inappropriately. Reasons for inappropriate response varied. The majority believed that the victim would continue to live with her batterer, making any report ineffective. Some expressed concern for the women's and their own personal safety, citing an increase in assault cases by perpetrators in the last few years. Many indicated a lack of knowledge about management of violence cases. CONCLUSION: Multiple barriers challenge PCWs in helping abused women. Common behaviours, safety concerns, and a lack of knowledge seem to be the major barriers to responding appropriately to IPV. To address this issue appropriately, protective measures for both parties - PCWs and violence victims - need to be enacted and a supportive constitutional and societal organization is required. Screening and identification should lead to interventions that benefit the victims rather than harming them.

Epidemiology of atopic dermatitis in primary schoolchildren in Turkey.

The present study aimed to investigate the prevalence of atopic dermatitis in primary schoolchildren in Denizli, Turkey, and to determine the possible risk factors for atopic dermatitis in home environment. A self-administered questionnaire was handled to the parents of 2,100 children aged 7 to 15 years, from three randomized primary schools and 1,644 (78.9%) completed and returned the questionnaire. The questionnaire included the United Kingdom Working Party diagnostic criteria and asked about conditions that could affect the course of atopic dermatitis. The prevalence of atopic dermatitis and coexisting factors that may affect the course of the disease were evaluated in 1,644 children (825 girls and 819 boys). The prevalence of atopic dermatitis was detected as 4.9%. Passive smoking, heating systems either in the house or in the child's bedroom, and the number of people living in the house had no significant effect (p > 0.005). The difference in prevalence of atopic dermatitis between developed and developing countries is striking. The determination of the factors that have an influence in this issue will probably enable us to change the course and frequency of atopic dermatitis.

Determinants of adolescent pregnancy in an urban area in Turkey: a population-based case-control study.

The aim of this study was to determine the degree to which socioeconomic status is a risk factor for first birth at age 19 or younger in married women in an urban area of Turkey. The research was a population-based case-control study. The study group comprised all married and pregnant women aged 15-19 (adolescent pregnancies) attending primary care centres (144 subjects). Married women between 20 and 29 years of age, experiencing their first pregnancy (adult pregnancies), were determined as the control group (144 subjects). A questionnaire was completed for each subject during face-to-face interviews. Adolescent pregnancy was more frequent in women from families with a low socioeconomic status, as determined by occupation (class) and income; both were associated with adolescent pregnancy. Multiple logistic regression analysis identified seven factors associated with adolescent pregnancy: exposure to violence within the family prior to marriage; families partially opposed or unopposed to adolescent marriage; secondary school or lower education level; lack of social security; living in houses in which the number of persons per room was over 1; unemployed women; and having sisters with a history of adolescent pregnancy.

Safety awareness among laboratory workers.

The purpose of this study was to assess safety awareness among laboratory personnel. The research group, which consisted of 84 subjects (88.4% of 95 persons contacted), completed a questionnaire. Of the study population, 55.9% were male and 44.1% were female. On the subject of how to receive samples, 70.2% of the study group knew the correct answer. In all, 90.5% and 79.8%, respectively, knew what procedures should be followed after injuries or accidents occurred in the laboratory. The lowest number of correct responses on the questionnaire was associated with the topic of waste disposal. Results of this study show that laboratory personnel would benefit greatly from educational initiatives designed to promote laboratory safety.

Adolescent pregnancy in West Turkey. Cross sectional survey of married adolescents.

OBJECTIVE: The purpose of this research was to determine both the fertility characteristics of married adolescent women in Denizli province center and the adolescent pregnancy rate and also some factors that could occur with adolescent pregnancy. METHODS: This cross-sectional study was conducted in the Denizli province center in the year 2001. According to the Turkish Demographic Health Survey 1998 statistics, the percentage of married adolescents between 15-19 years of age who have begun to give birth is 9.3-10.2%. The sample size of 3471 was determined using Epi Info software. To reach this sample size, 5 of the 25 health clinics in Denizli province center were chosen by simple random sampling method. RESULTS: Approximately 6.4% of the adolescents were married, 4.9% had been pregnant as an adolescent, 4.8% had delivered a baby, 23.3% of the married adolescents had never been pregnant, 23.3% were pregnant with their first child, and 51.2% were mothers; 76.7% had been pregnant one or more times. The majority of the married adolescent women in the research group (57.2%) do not use any method of family planning, followed by 15.7% who use an intrauterine device. Age, lower degree of education (less than 8 years) and unemployment were identified as risk factors for adolescent pregnancy. CONCLUSION: The results of this study suggest that although the frequency of adolescent pregnancy in the region is lower than the mean value in Turkey, it is higher compared with other countries. Age, education <8 years and unemployment are risk factors for adolescent pregnancy.

Midwives' approach to genetic diseases and genetic counseling in Denizli, Turkey.

The purpose of this study was to evaluate Denizli midwives' self-reported knowledge of genetic diseases and genetic counseling. Data was collected on forms that obtained information about midwives approaches to basic genetics, genetic disorders, and genetic counseling (response rate = 70.1%). The highest response rate of midwives describing themselves as "knowledgeable" about basic genetic information was for mitosis and meiosis with 4.8%, about genetic disorders was for phenylketonuria with 61.1%, and about genetic counseling was for recommending ultrasonography during pregnancy with 98.1%. The source for basic genetics information for 56.4% of participants was in their school level classes. None of the midwives felt that they had sufficient knowledge about genetic counseling or screening and 76.4% would like to attend an educational course. Even though the midwives have recognized their knowledge deficit they occasionally give genetic counseling. As a result of this study a genetics course is planned for midwives so they can actively participate in the prevention and early diagnosis of genetic diseases.