Thirteen-year surveillance results of acute flaccid paralysis cases in Southeast Turkey and the effect of refugee movements on surveillance results.

OBJECTIVE: Acute flaccid paralysis (AFP) is a major neurological problem. Turkey has accepted over 4 million refugees since 2011 due to the wars in neighbouring countries. In the long term, refugees can have adverse effects on the limited resources of health, sanitation, water supply, foodstuff, and shelter services of host countries, precipitating the transmission and spread of enteroviruses causing AFP. This study examines the 13-year surveillance and incidence of AFP cases in southeast Turkey, and questions possible impact of refugee movements on these parameters, comparing the periods before (2007-2010) and after (2011-2019) 2011, when the refugee movements emerged. METHODS: The records of cases reported from southeast part of Turkey with suspected AFP between January 2007 and December 2019 were reviewed retrospectively. RESULTS: Of the patients, 121 (58.5%) were male. Mean age was 80.36 ± 46.67 months. Eighty-five (41.1%) were aged 60 months or younger. The number of patients under 60 months increased significantly after 2011. Mean incidence was calculated as 0.88 cases/100,000 person years versus 1.58 cases/100,000 person years in the period before and after 2011, respectively. Guillain-Barré syndrome (GBS) was the most common cause of AFP in both periods. As of 2011, however, the incidence of acute transverse myelitis increased approximately 4 times and GBS decreased proportionally. Non-polio enteroviruses were the most frequent isolates, detected from 9.1% of stool samples. CONCLUSION: Although refugee movements appear to may have adverse effects on AFP incidence and surveillance outcomes, larger studies involving the whole country, particularly at places where no refugees settled, are needed to achieve more conclusive evidence.

Evaluation of patients diagnosed with congenital hypothyroidism by newborn screening between 2011-2019 in Diyarbakir, Turkey.

This study aimed to determine the incidence of congenital hypothyroidism in Turkey's Diyarbakir Province and assess the development and growth conditions of people with congenital hypothyroidism. Patients born between 2011-2019 and diagnosed with congenital hypothyroidism within the scope of the newborn screening program were included. The medical records of these patients were retrospectively reviewed. The length and weight for age, weight for length, and body mass index standard deviation scores were calculated. We investigated the treatment status of the patients, whether their relatives had a similar disorder, and the presence of consanguinity between parents. Blood samples were collected from 380,592 newborns. As a result of further tests, 498 newborns were diagnosed with congenital hypothyroidism (incidence: 1/764). Demographic and anthropometric data of 241 patients were analyzed. The patients comprised 46.9% (n = 113) females and 53.1% (n = 128) males. It was determined that 44.4% of the individuals had transient congenital hypothyroidism and 53.6% had permanent congenital hypothyroidism. The parents of 29.8% of the individuals diagnosed with transient congenital hypothyroidism and 44.2% of the individuals diagnosed with permanent congenital hypothyroidism were consanguineous (P = .02). According to the latest anthropometric assessment, 6.8% of individuals diagnosed with congenital hypothyroidism had a weight z-score below -2 SD and 16.9% had a length z-score below -2 SD. The incidence of congenital hypothyroidism was higher in our region. The ratio of consanguinity between parents was higher in patients diagnosed with permanent congenital hypothyroidism than in those diagnosed with transient congenital hypothyroidism. According to the most recent follow-up, weight and age were found to be similar in patients with transient and permanent congenital hypothyroidism.

Examining the effect of COVID-19 vaccines on the menstrual cycle: A study from Turkey.

Concerns about a possible relationship between vaccination against Coronavirus Disease 2019 (COVID-19) and menstrual disorders have been raised in the media. In addition, different studies have shown that the COVID-19 vaccine may be associated with menstrual changes. This study was conducted to investigate the effects of COVID-19 vaccines on the menstrual cycle in women. This cross-sectional descriptive study was conducted between August 16 and September 17, 2021. Data were collected through a self-administered questionnaire via an online form sent to the participants through social media. Data of 586 women were included in this study. A total of 82.4% (n = 483) of the participants were aged between 31 and 50 years. The BioNTech vaccine (2 doses) was administered to 75.8% (n = 444), Sinovac (3 doses) to 9.0% (n = 53) of the participants. 53.1% (n = 311) of the women experienced changes in their menstrual cycles. The most common menstrual changes after vaccination were delayed menstruation (n = 176; 30.0%) and prolonged menstrual duration (n = 132; 22.5%). Menstrual delay, prolonged menstrual duration, heavy bleeding, and early menstruation were more common in women than prior to receiving the vaccine (P < .05). More than half of the women experienced menstrual cycle changes after receiving the COVID-19 vaccine. Women experienced significantly higher rates of menstruation delay, prolonged menstrual duration, heavy bleeding, and early bleeding compared to before vaccination.

Evaluation of patients diagnosed with phenylketonuria and biotinidase deficiency by the newborn screening program: a ten-year retrospective study.

BACKGROUND: Phenylketonuria (PKU) and biotinidase deficiency (BD) are autosomal recessive diseases. If they are not identified and treated early, severe intellectual disability and developmental delay occur. This study was conducted to calculate the ten-year incidence of PKU and BD in the Diyarbakir province of Turkey. METHODS: This cross-sectional study included patients born between 2011-2020 and diagnosed with PKU and BD. Patients with a clear diagnosis had their records evaluated retrospectively. RESULTS: Between 2011 and 2020, blood was taken from 417,525 newborns` heels in Diyarbakir province. As a result of further diagnostic testing, 53 PKU (Incidence: 1:7878) and 177 BD (Incidence: 1:2359) were detected. Of the patients with BD, 56% had profound BD and 44% had partial BD. The records of a total of 269 patients (PKU: 25; BD: 123; Hyperphenylalaninemia: 121) were examined. Parents of 65% (n=15) of the patients diagnosed with PKU and 46.6% (n=55) of the patients diagnosed with BD were consanguineous. CONCLUSIONS: The incidence of both PKU and BD was found to be high in our region. The high number of consanguineous marriages was regarded as the most important explanation for the high frequency of these illnesses.

The relationship between environmental air pollution, meteorological factors, and emergency service admissions for epileptic attacks in children.

OBJECTIVE: The aim of this study is to investigate the relationship between exposure to acute air pollution and meteorological factors on the frequency of epileptic attacks in children. METHODS: This retrospective study was carried using patient files from a children's hospital in Diyarbakir, one of the largest cities in Turkey. In the present study, the possible relationship between epileptic attacks seen in children over a 10-year period, two air polluting factors (PM10 and SO2), and the meteorological factors (air pressure, humidity, precipitation, wind speed) affecting them were investigated. The effects of different variables on the number of epilepsy patients admitted to the pediatric emergency department were also evaluated through four different models utilizing Poisson Regression Analysis. RESULTS: According to Model 2 and 3, the strongest relationship of the four Poisson Regression models, there was a significantly increased risk of pediatric emergency department admissions for seizures associated with a 10 µm/m3 increase in PM10 (IRR=1.020; 95% CI: 1.018-1.022); IRR= 1.071; 95% CI: 1.050-1.081; respectively) and 10 µm/m3 increase in SO2 (IRR=1.162; 95%CI: 1.151-1.173; IRR=1.092; 95% CI: 1.042-1.120; respectively). In Model 2, a 1 m/s increase in wind speed decrease the risk of daily of epileptic attack admitted to the emergency department and a 1 °C increase in temperature increased the risk of daily of epileptic attack admitted to the emergency department (IRR=0.840; 95% CI; 0.714-0.987; IRR=1.033; 95%CI: 1.007-1.059; respectively). In Model 3, 1% increase in humidity and 1 m/s increase in wind speed increased the number of daily epileptic attack admitted to the emergency department (IRR=1.008; 95%CI: 1.004-1.011; IRR=1.169; 95%CI: 1.056-1.294; respectively). The daily number of epilepsy patients was statistically significantly affected by the autumn (95%CI: 10.017-19.845) and winter (95%CI: -0.279 to 13.292) seasons. CONCLUSION: Meteorological factors and air pollutants affect the number of pediatric patients admitted to the pediatric emergency department with epilepsy attacks.

Knowledge, Attitudes, and Behaviors about Breast Self-Examination and Mammography among Female Primary Healthcare Workers in Diyarbakir, Turkey.

Aim. This study aims to determine the knowledge level of the female primary healthcare workers about breast cancer and to reveal their attitude and behaviors about breast self-examination and mammography. Methods. This cross-sectional study was conducted on female primary healthcare workers who work in family health centres. 91% (n = 369) of female primary healthcare workers agreed to participate in the study. The questionnaire consisted of three parts: sociodemographic characteristics, knowledge about breast self-examination, and actual practice of breast self-examination. Results. The mean (SD) age of the female primary healthcare workers was 33.1 ± 6.8 (range, 20-54 years). The healthcare workers who practiced breast self-examination had significantly higher knowledge level (P = 0.001) than those who had not. The respondents had high knowledge level of breast self-examination; however, the knowledge level of breast cancer and mammography screen was low. Conclusions. While the female primary healthcare workers in this study had adequate knowledge of breast self-examination, this is not reflected in their attitudes and practices. Emphasis should be laid on breast self-examination in undergraduate and postgraduate courses for primary healthcare workers, since they are mostly involved in patient education.