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SummaryIntroductionChanges in left atrial (LA) size and function are associated with adverse clinical events. Recently, duration of diabetes mellitus (DM2) has been found to be positively associated with increased LA volume and impaired LA function. This study was performed, using two-dimensional echocardiograpy, to evaluate the changes in LA volume and function in patients with DM2 with a disease duration of six months, and to assess the parameters that affect LA volume and function.MethodsFifty-six patients (28 male, age: 52.6 ± 6.5 years) with DM2 and 56 controls (24 male; age: 50.1 ± 7.0 years) were enrolled in the study. Each subject underwent conventional twodimensional echocardiography to assess LA volume (indexed maximal LA volume: Vmax, pre-atrial contraction volume: Volp, minimal LA volume: Vmin) and LA function [passive emptying volume – passive emptying fraction (PEV – PEF), active emptying volume – active emptying fraction (AEV – AEF), total emptying volume – total emptying fraction (TEV – TEF)].ResultsLA diameter, indexed Vmax, Volp, Vmin, AEV and TEV were found to be significantly higher in the DM2 group compared with the controls (p < 0.05). Indexed Vmax, Volp and Vmin were significantly correlated with HbA1c level, body mass index (BMI), high-sensitivity C-reactive protein and uric acid levels, mitral A wave, E/E′ ratio and A′ wave. According to multivariate analysis, age and BMI had a statistically significant effect on LA volume.ConclusionImpaired LA function may be present in patients with newly diagnosed DM2. BMI and increasing age caused LA enlargement and LA volumes that were independent of the effects of hypertension and DM2.

Objective: In this study, it is aimed to detect the presence of anxiety in healthcare professionals who are and are not infected with the new type of coronavirus (Covid) and to reveal the underlying causes of this anxiety. Methods: This analytical and descriptive study was conducted with 188 healthcare professionals working at University of Health Sciences Turkey Tepecik Training and Research Hospital between 1-30 July 2020. Covid anxiety and perceived stress scale were administered to the participants along questionnaire.The statistics of the study were made with the SPSS 18.0 program. The statistically significant if the “p” value was less than 0.05. Results: 40.43% (n=76) of the whole group consisted of individuals who were positive for the polymerase chain reaction test 59.57% (n=112) were health workers who were not diagnosed with Covid-19. Those who worked in Covid-19 wards or outpatient clinics were more likely to be infected with coronavirus and was statistically significant (p=0.014). No statistical significance was observed in terms of the total score of the Coronavirus Anxiety Scale between those infected with Covid-19 and those not (p=0.349). Conclusion: There are data that all healthcare professionals are concerned and exhausted during the Covid-19 pandemic. The lack of a difference in anxiety levels between those infected with Covid-19 and those not indicates that healthcare professionals still have concerns about the pandemic. A widespread and effective psychosocial support provided by institutions will reduce the negative atmosphere in the health system.

Diabetes is a multifactorial disorder posing a great challenge to public health. In this study, we aimed to evaluate the relationship between depression, coping strategies, glycemic control and patient compliance in type 2 diabetic patients. Total 110 outpatients (mean (SD) age: 57.9 years (10.5), 56.4% were females) with type 2 diabetes mellitus were included in this descriptive and cross-sectional study. They were followed-up in the endocrinology outpatient clinic at Baskent University Istanbul Hospital Turkey. A questionnaire including items on sociodemographics, patient compliance, Beck Depression Inventory (BDI) and Ways of Coping Questionnaire (WCQ) were used. Glycemic control was measured by HbA1c levels. Mean depression score was 12.6(9.2) with moderate to severe depression in 30.9% of study participants. Overall scores for BDI, fatalism and helplessness approaches were significantly higher among females compared with male patients. Depression scores were correlated positively to duration of disease (r=0.190, p=0.047), fatalistic (r=0.247, p=0.009), helplessness (r=0.543, p=0.000) and avoidance (r=0.261, p=0.006) approaches, and negatively to educational status (r=-0.311, p=0.001) and problem solving-optimistic approach (r=-0.381, p=0.000). Likelihood of depression was frequent, consistent with literature and was associated with gender, educational status, coping strategies, duration of diabetes and patient compliance with treatment in our study. Screening for depression and patient education may improve the quality of life in diabetic patients.

To investigate the frequency of vitamin D deficiency in relation to demographics, clinical diagnosis, season of measurement and laboratory parameters in adult out-patients. Descriptive, retrospective study concerning evaluation of the initial 25-hydroxyvitamin D (25(OH)D) levels determined at admission in relation to demographics, clinical diagnosis, season of measurement and laboratory parameters. 25(OH)D levels ,20 ng/ml were classified as deficiency, 20–30 ng/ml as insufficiency and .30 ng/ml as sufficiency. Out-patient clinics at a tertiary care centre. A total of 2488 adult patients (mean age: 53?3 (SD 15?2) years; 85?2% were females) admitted to out-patient clinics at Baskent University Istanbul Hospital were included. Mean level of 25(OH)D in the overall population was 17?4 (SD 11?5) ng/ml while insufficiency and deficiency were evident in 24% and 66% of patients, respectively. Mean 25(OH)D levels in males .45 years old were higher than in their female counterparts (19?4 (SD 11?3) ng/ml v. 17?8 (SD 12?2) ng/ml; P,0?05). Mean 25(OH)D levels obtained in summer (18?6 (SD 11?1) ng/ml) and autumn (23?3 (SD 13?6) ng/ml) were significantly higher than levels in spring (16?1 (SD 10?3) ng/ml) and winter (14?6 (SD 10?2) ng/ml; P,0?01). Mean 25(OH)D levels were determined to be significantly lower in obese patients compared with non-obese patients (15?6 (SD 10?4) ng/ml v. 17?6 (SD 11?6) ng/ml; P,0?05). Levels of 25(OH)D were significantly negatively correlated with serum parathyroid hormone levels (r520?194; P,0?001) while significantly positively correlated with phosphorus (r50?059; P,0?01) and HDL cholesterol (r50?070; P,0?01) levels. Our findings indicate that vitamin D deficiency is very common among out-patients in Turkey, regardless of gender and age, especially among obese people and during winter and spring.

[LANGUAGE= \"English\"] INTRODUCTION: An increase in the levels of inflammatory biomarkers is observed in coronavirus disease (COVID-19). Coagulopathy occurring during the course of the disease has also been associated with inflammation. In our study, we aimed to evaluate the coagulation parameters according to the severity of inflammation in patients with early stage COVID-19 disease.METHODS: The study was carried out retrospectively in a third-level hospital between April 8 and August 20, 2020. The patients were divided into two groups according to polymerase chain reaction (PCR) results. Non-COVID-19 group consisted of 72 patients with negative, and COVID-19 group consisted of 247 patients with positive PCR results. According to the serum C-reactive protein (CRP) levels the COVID-19 patients were divided into three groups as follows: Group1 (CRP<10 mg/L; n=105), Group 2 ( CRP 10-50 mg/L; n=72), and Group 3 (CRP >50 mg/L; n=70). Age, CRP, and coagulation parameters including fibrinogen, D-dimer, aPTT, and PT were compared between the groups.RESULTS: There were significant differences between the non-COVID-19 and COVID-19 patients in terms of age, CRP and coagulation parameters. Likewise, there was a significant difference among 3 groups regarding coagulation parameters. In the multinomial logistic regression analysis, only level of D-dimer was an independent risk factor among all groups, while PT was an independent risk factor between Groups 1, and 3.DISCUSSION AND CONCLUSION: Our findings suggest that coagulopathy occurs in the early stage in relation to the severity of inflammation. For the diagnosis of COVID-19 disease and the detection of thrombotic complications; it is important to monitor results of the coagulation tests along with markers of inflammation from the early stages of the disease.

It has been known that vitamin D has some immunomodulatory effects and in autoimmune thyroid diseases, vitamin D deficiency was more prevalent. In this study, our aim was to investigate the relationship between thyroid autoantibodies and vitamin D. Group 1 and 2 consisted of 254 and 27 newly diagnosed Hashimoto's thyroiditis (HT) and Graves' disease (GD) cases, respectively; age-matched 124 healthy subjects were enrolled as controls (group 3). All subjects (n = 405) were evaluated for 25OHD and thyroid autoantibody [anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-tg)] levels. Group 2 and group 1 patients had lower 25OHD levels than group 3 subjects 14.9 ±8.6 ng/ml, 19.4 ±10.1 ng/ml and 22.5 ±15.4 ng/ml, respectively (p < 0.001). Serum 25OHD levels inversely correlated with anti-tg (r = -0.136, p = 0.025), anti-TPO (r = -0.176, p = 0.003) and parathormone (PTH) (r = -0.240, p < 0.001). Group 2 patients had higher anti-tg and anti-TPO levels than group 1 and 3 (p < 0.001). In this study, we found that patients with autoimmune thyroid disease (AITD) present with lower vitamin D levels and GD patients have higher prevalence. Since we found an inverse correlation between vitamin D levels and thyroid antibody levels, we may suggest that vitamin D deficiency is one of the potential factors in pathogenesis of autoimmune thyroid disorders.

[LANGUAGE= \"English\"] INTRODUCTION: This study aims to investigate the prevalence of coronavirus disease 19 (COVID-19) vaccination, the level of COVID-19 fear, and associated factors among university students.METHODS: This study is a cross-sectional study participated by university students from Maltepe University, Türkiye, between September 23 and November 26, 2021. An online questionnaire form was used in the study due to the pandemic. The questionnaire included sociodemographic and related COVID-19 characteristics and the fear of COVID-19 scale (FCV-19S).RESULTS: A total of 3216 university students, 2276 (70.8%) female, participated in this study. Three thousand ninety-two (96.1%) were vaccinated against COVID-19. The FCV-19S scores of those vaccinated against COVID-19 were 18.0±7.2, while the FVS scores of those who were not vaccinated were 15.7±8.3 (p=0.001). When the factors affecting vaccination with COVID-19 were evaluated by regression analysis, it was determined that the history of COVID-19 infection (OR=1.837, 95% CI=1.173–2.876, and p=0.008), FCV-19S (OR=1.041, 95% CI=1.014–1.070, and p=0.003), and recommending the COVID-19 vaccine to others (OR=24.585, 95% CI=15.658–38.602, and p<0.001) had an effect on vaccination.DISCUSSION AND CONCLUSION: This study revealed that the overall vaccination frequency among university students is >96%, with different hesitancy frequency among university departments. Medical and health science students have the lowest frequency of vaccine hesitancy and lowest fear levels, suggesting that they know the COVID-19 process, and its consequences, and have accurate information about vaccines.

Aim:Enuresis (EN) is a common problem in childhood. Family physicians have an important role in revealing children with EN. The aim of this study was to assess the knowledge and attitude of family medicine (FM) residents regarding the diagnosis and treatment of enuresis in children.Materials and Methods:Family medicine residents of the University of Health Sciences, İzmir Tepecik Training and Research Hospital were invited to complete a questionnaire concerning enuresis in children. Those who had completed their paediatrics rotation training were defined as group 1, and those who had not completed their paediatrics rotation as group 2. The responses were compared between the groups.Results:Sixty (88%) of the FM residents agreed to complete the survey. The mean age of the participants was 28.7 (25-35) years, 38 (63%) had completed their paediatrics rotation (group 1). The question about the age of night-time bedwetting was more often answered correctly in group 1 (19/38) (p=0.025). In the question on the symptoms of non-monosymptomatic enuresis; the constipation option was marked as a symptom by only 15 of the participants (25%), with 13 (87%) being in group 1 (p=0.03). The correct response rates to the questions about other symptoms of non-monosymptomatic enuresis, the causes of secondary enuresis, the need for treatment, treatment options and the follow-up of patients with enuresis were similar between groups 1 and 2.Conclusion:As a result of this study, more correct answers, which revealed adequate knowledge and experience regarding enuresis, were obtained from those who had concluded their paediatrics rotation.