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Introduction: Health tourism, defined as travels aimed to improve the physical and mental health of individuals, is growing day by day in parallel with developing technology and transportation. Factors influencing the preference of Türkiye in health tourism include cost, tourism opportunities, and cultural characteristics, as well as health facilities, staff, doctors, and the quality level of service. Due to the focus of human health, the service delivery which is very sensitive should be carried out by qualified workforce. With their role in protecting patients from unnecessary tests and treatments and facilitating effective participation in clinical decision-making processes, family physicians are also involved in the health tourism process and advocate. It is aimed to improve the service provision both qualitatively and quantitatively to meet the predicted increase in the health tourism sector in our country. In line with the realization of these goals, education and training activities offered by higher education institutions come into prominence. It’s aimed in our study to quantitatively investigate the adequacy of education in the field of health tourism in our country and to assess it in light of current data.Methods: The data of the cross-sectional and descriptive study were collected during the 2023-2024 academic years. Education programs and the number of students in the field of health tourism between 2018-2023 at 18 institutions under the Council of Higher Education (YOK) and The Measuring, Selection and Placement Center (OSYM) were examined. Obtained data were brought together with health tourism data published by the Turkish Statistical Institute (TUIK), the International Health Services Inc. (USHAS), and the Association of Turkish Travel Agencies (TURSAB).Results: In Türkiye, for the first time in 2014, associate degree education started to be provided in the " Health Tourism Business" department within the Vocational School. This department, which is available in 9 universities today, has the highest percentage among associate degree preferences. Master's degree program level trainings in health tourism continue in 9 universities across 3 different departments: "Health Tourism", " Health Tourism Business " and "Health Tourism Management". Doctoral level education is provided in 1 university in the department of "Health Tourism". It is observed that the number of students and graduates enrolled in education programs in the field of health tourism is increasing every year. On the other hand, there is still no undergraduate program in this field in Türkiye. According to the data published by TUIK and USHAS, the number of visitors coming to our country for health tourism and the value of income is increasing every year. On the contrary, the number of students and graduates has not increased at the same rate in recent years.Conclusions: The number of programs and quotas in the field of health tourism opened in universities is gradually increasing. However, when evaluated together with the increase in the number of visitors coming to our country for health tourism over the years, it has been revealed that the number of qualified staff trained to meet the increasing need is still not at the desired level.

Abstract Background Enterocytozoon bieneusi is the most common species found in humans. Although E. bieneusi has been investigated in humans, genotype profile of E. bieneusi is not known in Türkiye. Methods In this study, we screened E. bieneusi in patients (n = 94) with different types of malignant solid tumors by Real Time PCR and then sequenced E. bieneusi positive samples. All cancer patients were undergoing chemotherapy and had diarrhea. Moreover, as control groups, we also screened E. bieneusi in patients with diarrhea (n = 50) and without diarrhea (n = 50). Results Among all patients analyzed, 33 (17%) were found to be E. bieneusi-positive. As the patients were categorized, the molecular prevalence of E. bieneusi increased to 25.5% among cancer patients with diarrhea. However, the molecular prevalence of E. bieneusi was found to be lower in patients with presenting only diarrhea (8%) and patients without diarrhea (10%). The high molecular prevalence value detected among cancer patients with diarrhea was also statistically significant compared to other patient groups (P = 0.00112 and P = 0.0269). Among the 33 Real Time PCR positive samples, 10 of them were amplified by nested PCR and among these 10 samples, 6 of them were successfully genotyped. The phylogenetic tree showed the presence of D and Type IV which were also identified in stray cats living in İzmir in our previous study. Conclusions High molecular prevalence value indicates the importance of screening stool samples of cancer patients with diarrhea for E. bieneusi and genotyping results indicate that D and Type IV are circulating between humans and cats.

Abstract Severe acute respiratory syndrome coronavirus 2 had devastating consequences for human health. Despite the introduction of several vaccines, COVID-19 continues to pose a serious health risk due to emerging variants of concern. DNA vaccines gained importance during the pandemic due to their advantages such as induction of both arms of immune response, rapid development, stability, and safety profiles. Here, we report the immunogenicity and protective efficacy of a DNA vaccine encoding spike protein with D614G mutation (named pcoSpikeD614G) and define a large-scale production process. According to the in vitro studies, pcoSpikeD614G expressed abundant spike protein in HEK293T cells. After the administration of pcoSpikeD614G to BALB/c mice through intramuscular (IM) route and intradermal route using an electroporation device (ID + EP), it induced high level of anti-S1 IgG and neutralizing antibodies (P

Intellectual disability is a disorder that affects the child's daily social and practical skills. For this reason, unhealthy diet, sedentary lifestyle and physical movement limitation are the most common lifestyle problems in children with intellectual disabilities. Parents' opinions, attitudes, alexithymic conditions and social skill levels are effective in the participation of students with intellectual disabilities and other special needs in sports education. The aim of this research is to examine the problems encountered by students with intellectual disabilities in their participation in sports education in terms of parents' opinions. The study is based on the Socio-Ecological Model (SEM), one of the social model theories, as a theoretical framework. The research is a case study, one of the qualitative research approaches. In this research, the study group was reached by the maximum variation sampling method. Parents of children with intellectual disabilities in different cities of Turkey were included in the research in the 2021-2022 academic year. During the research process, three different study groups receiving special education and rehabilitation center, special lower class and inclusive education were studied. Data were collected by individual interview technique. The data obtained from all three groups were thematic analysis and analyzed by creating codes, categories and themes. As a result of the analysis of the data obtained, the findings were collected under four main themes in accordance with the theoretical framework. These are individual problems, social problems, problems caused by the physical environment and problems caused by politics. As a result of the research, it was determined that, according to the parents, the reason why their children with intellectual disabilities cannot participate in sports training is primarily due to problems arising from society. This situation can be evaluated within the exosystem and macro system according to SEM. Based on this model, which focuses on the individual and examines the effects on the individual, the two systems located at the outermost center have the greatest impact on individuals with intellectual disabilities.

Abstract Background Bartonella henselae is one of the most commonly identified Bartonella species associated with several human diseases. Although B. henselae was detected in humans and cats in Turkey, they have not been genotyped previously. Therefore, this study aimed to genotype B. henselae samples (n = 44) isolated from stray cats using the multi-locus sequence typing (MLST) method. For this aim, eight different housekeeping markers were amplified by nested PCR and then sequenced to reveal sequence types (STs) of B. henselae samples. Results Allelic profiles obtained from 40 B. henselae isolates (90.9%) were compatible with available allelic profiles in the MLST online database. However, allelic profiles obtained from the remaining 4 B. henselae isolates (9.1%) were incompatible with the database. Among B. henselae isolates with compatible allelic profiles, 5 different STs including ST1, ST5, ST9, ST35 and ST36 were identified according to the B. henselae MLST online database. ST35 was the most prevalent ST with a prevalence rate of 29.5% (13/44), followed by ST36 with a prevalence rate of 22.7% (10/44). In addition, ST5 (16%, 7/44) and ST9 (18.2%, 8/44) were also among the prevalent STs. The prevalence of ST1 was 4.5% (2/44). For B. henselae isolates with incompatible allelic profiles, we recommended a new ST called ST38. Conclusion The present study genotyped B. henselae samples isolated from stray cats in Turkey for the first time and ST1, ST5, ST9, ST35, and ST36 as well as a new sequence type named ST38 were identified among these B. henselae isolates.

Objective:Acanthamoeba, one of the free-living amoeba, has been detected in many environmental samples, mainly in water, soil and air. Acanthamoeba keratitis and granulomatous amoebic encephalitis are among the most important clinical manifestations caused by Acanthamoeba. In this study, it was aimed to determine the sensitivity of the rapid loop mediated isothermal amplification (LAMP) test designed with primers specific to Acanthamoeba 18S rRNA gene to detect more rapidly the presence of Acanthamoeba in clinical and environmental samples.Methods:Acanthamoeba strain grown in culture was diluted in 200 μL as 1x106 trophozoites and DNA was isolated, and the amount of DNA was determined by Nano-Drop Spectrophotometer. The purified DNAs were diluted from 1000 pg to 0.001 pg and used in colorimetric and fluorescence-based LAMP reactions. The LAMP reaction mixture was incubated for 60 minutes at 63 °C in a total volume of 25 μL.Results:To determine the sensitivity of the test, positivity of Acanthamoeba genomic DNA was observed at 1, 10, 100 and 1000 pg/reaction in both colorimetric and fluorescence-based LAMP tests. The lowest analytical sensitivity of both calorimetric and fluorescent LAMP assay was determined as 1 pg/reaction. In addition, as a result of LAMP reaction applied with other parasite DNAs to evaluate the specificity of the test, no LAMP product was detected in calorimetric and 1% agarose gel electrophoresis, except for positive control, and the specificity of the test was determined as 100%.Conclusion:It has been demonstrated that the LAMP assay designed by targeting 18S rRNA gene of Acanthamoeba has a detection limit of 1 pg of genomic DNA. It is promising that LAMP test is more sensitive and faster than culture method, as well as simple, inexpensive and highly sensitive. For this reason, it is thought that developed test can be applied in the diagnosis of Acanthamoeba in environmental and clinical samples.

Education is widely recognized as a key driver of social and economic development. However, in Pakistan's Balochistan province, the education sector faces numerous challenges and issues that hinder its progress and development. This paper aims to identify and analyze the key issues and challenges facing the education sector in Balochistan. The research is based on a comprehensive review of the relevant literature, policy documents, and reports. The study identifies several key challenges, including inadequate infrastructure and facilities, inadequate funding, low teacher qualifications and training, high dropout rates, gender disparity, and limited access to education. Moreover, political instability, security concerns, and cultural barriers further exacerbate these challenges. The study proposes several recommendations to address these challenges, including increasing funding and investment in the education sector, improving teacher training and professional development programs, enhancing governance and management of schools, implementing targeted interventions to address gender and social disparities, and participation in education reform initiatives.

Abstract A series of novel Er3+-doped bismuth-germanate glasses containing different tungsten concentrations with a molar composition of 97.5[(75 − x)GeO2–25Bi2O3–(x)WO3]–2Sb2O3–0.5Er2O3 (x = 5, 10, 15, 20, and 25 mol%) were fabricated. Their thermal properties are measured by differential scanning calorimetry. A structural investigation by Raman spectroscopy suggested that changes occurred in the glass network by WO3 incorporation. By laser excitation at 980 nm, a strong emission from Er3+ ions at 1532 nm is observed, while the WO3 addition caused changes in the emission spectra. The emission cross-section spectra of Er3+ are calculated by both McCumber and Füchtbauer–Ladenburg theories and their comparison showed these theories yielded slightly different results, but in both cases, the calculations showed that a gain signal in L-band can be achieved when 30% of the Er3+ ions are at the excited state. This study proves that the Er3+-doped bismuth-germanate glasses are suitable for optical fiber amplifier applications operating at C- and L-band.

Purpose This study aims to compare five implant-supported rehabilitation concepts of an edentulous mandible and determines the most biomechanically advantageous technique. Materials and methods Five models with implants in different configurations were created: All-on-4 concept (two anterior axial and two posterior distally curved implants), All-on-4v4 concept (four distal curved interforaminal implants), All-on-4W (two anterior mesial curved interforaminal implants and two posterior distally curved implants), the All-on-3 concept (one anterior axial and two posterior distally curved implants), and the treofil system (three interforaminal implants with titanium bar guide support). For this study, bone-level (4.3 × 13 mm) implants of Nobel Biocare and implants of the treofil system (5 × 13 mm) were used. Spherical loads were applied from the canine and molar regions to evaluate the tension, compression and von Mises stresses by applying 3D finite element analysis. Results Among the alternative concepts, treofil system were the most successful treatment option in biomechanical terms. On the other hand, All-on-3 concept was found to be the last method of choice. This was because of the high stresses on cortical and trabecular bones in most conditions. Conclusion The result of this study shows that the treophylline system is the most successful treatment option despite its technical details. Alternatively, classical All-on-4 and All-on-4v4 techniques are biomechanically successful treatment options.

Al esaslı alaşımlar havacılık, otomotiv ve savunma sanayi gibi birçok sektörde kullanılmaktadır. Düşük yoğunlukları ve yüksek özgül mukavemet özellikleri, Al ve alaşımlarını mühendislik malzemeleri olarak kullanılabilir hale getirir. Al esaslı alaşımlar seramik partiküller ile takviye edildiğinde yüksek sertlik ve mukavemete sahip yeni nesil mühendislik malzemeleri olarak kullanılabilirler. Bu çalışmada Al2O3 partikülleri Al-Cu-Mg matrisine ağırlıkça %10, %20 ve %40 oranında mekanik alaşımlama (MA) yöntemiyle takviye edilmiş ve 560 oC, 500 MPa pres koşullarında sıcak pres (SP) yöntemiyle preslenmiştir. MA işleminden sonra partikül boyutu ölçümleri, partikül boyutlarının azaldığını ortaya çıkarmıştır. Al-Cu-Mg ve Al2O3 partiküllerinin MA işlemi öncesi partikül boyutu ölçüm sonuçları sırasıyla 212,434 μm ve 89,208 μm olarak ölçülmüştür. MA işlemi sonrası partikül boyutları %10, %20 ve %40 Al2O3 takviyeli numuneler için sırasıyla 14,224 μm, 13,747 μm ve 10,885 μm olarak ölçülmüştür. %10, %20 ve %40 Al2O3 içeriği ile üretilen numunelerin sertlik değerleri sırasıyla 146,867 HV (0,5), 165,290 HV (0,5) ve 206,843 HV (0,5) olarak ölçülmüştür.

In this study, the Ball-Plate stabilization system is designed to control with image processing algorithms. The position of the ball is aimed to control by tilting the plate on which the ball is located at a certain position and velocity. The system has two rotational degrees of freedom and is unstable. In the system, two DC motors are used as an actuator, and a camera is used as a feedback sensor. The camera captures the position of the ball and image processing algorithm calculates the that position to blance the plate..PID control is selected for servo motors. Thus, the position of the ball can be controlled so that it converges to the desired point on the plate. Realtime tests are conducted, and Maximum Overshoot and Steady State Error are calculated for both the x and y-axis, and results are given in figures. For the setpoint (15 cm, 15 cm) the Maximum Overshoot and Steady State Error were measured at 40.6% - 8% on the x-axis and 48.6% - 8.6% on the y-axis, while for the setpoint (10 cm, 10 cm). The Maximum Overshoot and Steady State. Error were measured at 40.6% - 8% on the x-axis and 48.6% - 8.6% on the y axis

Toxoplasma gondii (T. gondii) that can infect most warm-blooded animals and humans, is an obligate intracellular apicomplexan parasite with a wide host range. About one-third of the world’s population is infected with this parasite. While toxoplasmosis progresses asymptomatically in individuals with a strong immune system, it can cause serious clinical manifestations and death in immunocompromised individuals. The parasite is transmitted to humans through the consumption of water and food contaminated with cat feces, as well as raw or undercooked animal products, congenital infection and blood/organ transplantation. Additionally, T. gondii is often observed in farm animals such as sheep and goats. Clinical manifestations and abortions caused by T. gondii in sheep and goats lead to enormous economic loss worldwide. There is a commercial vaccine against T. gondii, called Toxovax (MSD, New Zealand) that can only be used in sheep. For these reasons, there is a need for innovative T. gondii vaccine that is harmless, easily produced, which can prevent losses and be used in all living things. Advances in immunology, molecular biology, genetic, biotechnology and proteomics bring new perspectives to vaccine studies. Studies in innovative vaccine studies against T. gondii have accelerated with the discovery of new antigens by in vitro screenings, and bioinformatic analyzes, the use of various expression systems and new adjuvant types. Recombinant protein vaccines are biotechnological vaccines that are frequently preferred due to their rapid and easy production in various expression systems, availability of very and high purity products, ease of manipulation and stimulation of both cellular and humoral immune responses. Recombinant protein vaccines, developed by biotechnological methods, are promising tools for providing a protective immune response against toxoplasmosis. In this review, an overview of the parasite complex life cycle, its pathogenesis, humoral and cellular immune responses in the host, and recombinant protein vaccine studies developed against the parasite are presented.

Toxoplasma gondii (T. gondii) is an obligate intracellular parasite that can infect almost all warm-blooded animals, including humans, and one-third of the global population is thought to be infected with this parasite. Infection can occur through consumption of contaminated food, contact with an infected host, or congenital transmission. While toxoplasmosis is asemptomatic in people with a healthy immune system, it can cause severe infections in people with a suppressed immune system or with immunodeficiency. In addition to causing diseases in humans, it also causes infections in livestock and may result in stillbirth and abortion in sheep and goats. There is no 100% effective medicine or vaccination against the parasite that causes major clinical symptoms and financial losses. There is a need for an effective, safe, and durable vaccine that can provide protective immunity for use in humans and animals. Vaccination studies against toxoplasmosis have gathered speed since the 1990s. Today, studies can be carried out to develop effective and safe vaccines depending on the developments in molecular biology, biotechnology, and immunology. DNA vaccines are a promising vaccine platform against toxoplasmosis because they are easy to produce, they are safe, they do not need a cold chain, and they can stimulate both humoral and cellular immune responses. This review provides an overview of the complex life cycle, pathogenesis, and epidemiology of the parasite; the immune response that develops in the host against the infection it causes; and the DNA vaccines developed against toxoplasmosis and these vaccines.

Abstract Background Bartonella spp. are vector-borne pathogens that cause zoonotic infections in humans. One of the most well-known of these is cat-scratch disease caused by Bartonella henselae and Bartonella clarridgeiae, with cats being the major reservoir for these two bacteria. Izmir, Turkey is home to many stray cats, but their potential role as a reservoir for the transmission of Bartonella to humans has not been investigated yet. Therefore, the aim of this study was to investigate the prevalence of Bartonella species and their genetic diversity in stray cats living in Izmir. Methods Molecular prevalence of Bartonella spp. in stray cats (n = 1012) was investigated using a PCR method targeting the 16S-23S internal transcribed spacer gene (ITS), species identification was performed by sequencing and genetic diversity was evaluated by haplotype analysis. Results Analysis of the DNA extracted from 1012 blood samples collected from stray cats revealed that 122 samples were Bartonella-positive, which is a molecular prevalence of 12.05% (122/1012; 95% confidence interval [CI] 10.1–14.2%). Among the Bartonella-positive specimens, 100 (100/122; 81.96%) were successfully sequenced, and B. henselae (45/100; 45%), B. clarridgeiae (29/100; 29%) and Bartonella koehlerae (26/100; 26%) were identified by BLAST and phylogenetic analyses. High genetic diversity was detected in B. clarridgeiae with 19 haplotypes, followed by B. henselae (14 haplotypes) and B. koehlerae (8 haplotypes). Conclusions This comprehensive study analyzing a large number of samples collected from stray cats showed that Bartonella species are an important source of infection to humans living in Izmir. In addition, high genetic diversity was detected within each Bartonella species.

Abstract Background Cryptosporidium spp. are obligate intracellular apicomplexan parasites transmitted to humans and other animals by contaminated water, food, or direct contact. They mainly cause gastrointestinal symptoms, although subclinical infections are also common. Cats are primarily infected by host-adapted Cryptosporidium felis while C. parvum and C. muris have also been detected in some cases. In this study, the molecular prevalence of Cryptosporidium spp. was investigated by screening 399 fecal samples collected from stray cats using nested PCR targeting the 18S rRNA gene for the first time in Turkey. Additionally, Cryptosporidium PCR-positive samples were genotyped by nested PCR- restriction fragment length polymorphism (RFLP), and subsequently, amplicons of 18S SSU rRNA were sequenced. They were further subtyped by amplification and sequencing of the gp60 gene. Results Among fecal samples screened, 12 of them (3%) were found to be Cryptosporidium-positive, and according to RFLP and sequencing of 18S rRNA gene, all positive samples were identified as C. felis. Subtyping analyses at the gp60 gene showed that C. felis isolates belonged to the XIXa subtype family, which are closely related to human subtypes of the parasite. Conclusions The results of this study are important in terms of indicating the potential role of stray cats for transmission of Cryptosporidium spp. to humans or other animals. Also, the presence of XIXa, which is the dominant subtype family of C. felis in cats and humans was shown for the first time in stray cats of İzmir, Turkey.

Abstract Background Discovery of new Toxoplasma gondii serotyping epitopes is important due to reports showing the influence of genotype on the severity of toxoplasmosis. In Turkey, genotypes belonging to type II, type III and Africa 1 lineages were mainly detected. The present study focused on to find out epitopes with high discriminative capacity to serotype these genotypes using well characterized strains isolated from Turkey. Methods To meet this objective, GRA6 and GRA7 genes were sequenced from strains belonging to the type II, III and Africa 1 lineages, and B cell epitopes inside these sequences were predicted by Bcepred and additional docking analysis was performed with B cell receptor. Based on these analyses, 22 peptides harboring lineage specific epitopes were synthesized. Then, the serotyping potency of these peptides was tested using peptide ELISA and well categorized serum samples collected from stray cats infected with genotypes of the different lineages type II (n:9), III (n:1) and Africa 1 (n:1). As a result of peptide-ELISA, a serotyping schema was constructed with peptides that show high discriminative capacity and this assay was validated by sera collected from humans after an outbreak (n:30) and mother/newborn pair sera (n:3). Later, the validated serotyping schema was used to serotype a larger group of human (n:38) and cat (n:24) sera. Results Among 22 peptides, GRA6II/c, GRA7III/d, and GRA6 Africa 1/b epitopes have shown discriminative capacity. During the validation of peptide-ELISA, the serotype of toxoplasmosis outbreak and mother/newborn cases were detected to be serotype II. Moreover, the analyses in a larger group showed that serotype II was prevalent in humans and stray cats. Conclusions Overall, the results showed that the serotyping schema could be successfully used to serotype T. gondii infections caused by type II, III and Africa 1 genotype.

ABSTRACT: The aim of this study is to scrutinize the individuation process of Murakami Haruki’s protagonist, who feels a stark sense of loss and lack, in the novel Dance Dance Dance. The paper also focuses on “the other side” and death motifs that frequently emerge as the story goes. Sheep Man, Kiki and Gotanda represent the “shadow” of the protagonist. This article argues that the protagonist’s confrontation with his “shadow” - Sheep Man by entering his room, which symbolizes the other side enables him to reach his core identity. Unable to reunite with Kiki, the protagonist who experiences incompleteness, reaches integrity with Yumiyoshi which reveals Murakami’s deep understanding of the individual’s continual struggle as a lack of being. This study not only examines the protagonist’s search of “objet petit a” with Lacanian pscychoanalysis but also his struggle with his “shadow” during his individuation process with Jung’s “shadow” archetype as well as the persona archetype that emerge in the novel. This study attempts to contribute to Murakami Haruki studies to comprehend the inner self of the narrator in the novel, who experiences fragmentation utilizing both Lacanian psychoanalytic theory and Jungian psychoanalysis which provides a much more elaborate discussion on the unconscious functioning of the protagonist. ÖZ: Bu çalışmanın amacı Murakami Haruki’nin Dans Dans Dans romanında eksiklik ve yitirme duyguları hisseden başkişinin geçtiği bireyselleşme sürecini irdelemektir. Makalede ayrıca romanda sıklıkla yinelenen öteki taraf ve ölüm motiflerine odaklanılmaktadır. Koyun Adam, Kiki ve Gotanda başkişinin “gölge”sini temsil ederler. Bu makale, başkişinin “gölge”si - Koyun Adam ile öteki tarafı simgeleyen odasına girerek onunla yüzleşmesinin, başkişinin öz kimliğine ulaşmasını sağladığını savunmaktadır. Kiki ile bir araya gelemeyen ve tamamlanmamışlık deneyimleyen başkişinin Yumiyoshi ile bütünlüğe kavuşması Murakami'nin eksik özne olarak bireyin sürekli mücadelesi konusundaki derin anlayışını ortaya çıkarmaktadır. Bu çalışmada, başkişinin “objet petit a” arayışının Lacancı psikanaliz ile tartışılmasının yanı sıra başkişinin bireyselleşme sürecinde “gölge”siyle mücadelesi de romanda ortaya çıkan Jung’un “gölge” arketipi ve persona arketipleriyle birlikte incelenecektir. Başkişinin bilinçdışı işleyişleri hakkında çok daha ayrıntılı bir tartışma olanağı sunan hem Lacancı psikanalitik kuram hem de Jungçu psikanalizden yararlanan bu çalışma, parçalanma yaşayan bu romandaki anlatıcının iç benliğini irdelemede Murakami Haruki çalışmalarına katkıda bulunmaya çalışmaktadır.

Objective:Neospora caninum is a protozoon parasite that has a worldwide distribution and mainly causes abortion in cattle and current serological evidence shows that the disease may be also zoonotic. Wild birds play a role as a reservoir of the disease in nature. The study aimed to determine the prensence of N. caninum in wild birds.Methods:In this study, the presence of neosporosis in wild birds (n=55) including 22 different species found in the western side of Turkey, was investigated by polymerase chain reaction (PCR). In addition, PCR positive samples were confirmed by sequencing, BLAST, and phylogenetic analysis using MEGA7.Results:Obtained results showed that the presence of N. caninum DNA was 5.45% (3/55) in brain-heart homogenates wild birds. The bird species which were found positive for N. caninum were little owl (Athene noctua), common buzzard (Buteo buteo), and little tern (Sternula albifrons). According to phylogenetic analysis and BLAST, all samples were compatible with reference N. caninum isolates.Conclusion:To the best of authors’ knowledge, this is the first study detecting N. caninum in little tern. In future studies, it may be interesting to investigate the prevalence of N. caninum in other wild animals to elucidate the transmission properties.

BACKGROUND: Cryptosporidium spp. is a protozoan parasite that infects many vertebrate animals, including humans. Since Cryptosporidium spp. can cause chronic life-threatening diarrhea and severe malabsorption in immunocompromised patients, we investigated the prevalence of this parasite among patients undergoing chemotherapy for malignant solid tumors. OBJECTIVE: Investigate the prevalence of Cryptosporidium spp. in stool samples. DESIGN: Cross-sectional. SETTING: Tertiary care. PATIENTS AND METHODS: Stool samples were collected from adult patients with malignant solid tumors receiving chemotherapy and diarrhea. Cryptosporidium spp. prevalence was determined using Ziehl–Neelsen staining, ELISA, and real-time PCR targeting of the COWP gene. MAIN OUTCOME MEASURE: The prevalence of Cryptosporidium spp. in patients undergoing chemotherapy for malignant solid tumors. SAMPLE SIZE: 94 RESULTS: The prevalence was 2.1% (2/94), 5.3% (5/94), and 5.3% (5/94) as detected by Ziehl–Neelsen staining, real-time PCR and ELISA, respectively. The prevalence reached 8.5% (8/94) using all results obtained from the three methods. Among eight positive stool samples, four were positive by at least two different methods (Ziehl–Neelsen staining-ELISA or ELISA-real-time PCR) whereas the remaining four were positive by either ELISA or real-time PCR. CONCLUSION: These findings show the risk of cryptosporidiosis in cancer patients and the necessity to use at least two diagnostic methods during the diagnosis of cryptosporidiosis to reach more accurate and trustworthy results. LIMITATIONS: Further studies with a larger sample size are recommended. CONFLICT OF INTEREST: None.

Abstract Background The emergence of tick-borne disease is increasing because of the effects of the temperature rise driven by global warming. In Turkey, 19 pathogens transmitted by ticks to humans and animals have been reported. Based on this, this study aimed to investigate tick-borne pathogens including Hepatozoon spp., Theileria spp., Babesia spp., Anaplasma spp., Borrelia spp., and Bartonella spp. in tick samples (n = 110) collected from different hosts (dogs, cats, cattle, goats, sheep, and turtles) by molecular methods. Methods To meet this objective, ticks were identified morphologically at the genus level by microscopy; after DNA isolation, each tick sample was identified at the species level using the molecular method. Involved pathogens were then investigated by PCR method. Results Seven different tick species were identified including Rhipicephalus sanguineus, R. turanicus, R. bursa, Hyalomma marginatum, H. anatolicum, H. aegyptium, and Haemaphysalis erinacei. Among the analyzed ticks, Hepatozoon spp., Theileria spp., Babesia spp., and Anaplasma spp. were detected at rates of 6.36%, 16.3%, 1.81%, and 6.36%, respectively while Borrelia spp. and Bartonella spp. were not detected. Hepatozoon spp. was detected in R. sanguineus ticks while Theileria spp., Babesia spp., and Anaplasma spp. were detected in R. turanicus and H. marginatum. According to the results of sequence analyses applied for pathogen positive samples, Hepatozoon canis, Theileria ovis, Babesia caballi, and Anaplasma ovis were identified. Conclusion Theileria ovis and Anaplasma ovis were detected for the first time to our knowledge in H. marginatum and R. turanicus collected from Turkey, respectively. Also, B. caballi was detected for the first time to our knowledge in ticks in Turkey.

Abstract Background Cytidine monophospho-n-acetylneuraminic acid hydroxylase (CMAH) gene associated with blood groups in cats encodes CMAH enzyme that converts Neu5Ac to Neu5Gc. Although variations in CMAH gene of pedigree cats have been revealed, the presence/lack of them in non-pedigree stray cats is unknown. Therefore, the present study aimed to investigate the variations in CMAH gene and the quantity of Neu5Ac and Neu5Gc on erythrocytes of non-pedigree stray cats (n:12) living in İzmir, Turkey. Also, the frequency of blood types was determined in 76 stray cats including 12 cats that were used for CMAH and Neu5A/Neu5Gc analysis. Results In total, 14 SNPs were detected in 5’UTR as well as in exon 2, 4, 9, 10, 11 and 12 of CMAH gene. Among these SNPs, -495 C > T in 5’UTR was detected for the first time as heterozygous in type A and AB cats, and homozygous and heterozygous in type B cats. The remaining 13 that have been detected in previous studies were also found as homozygous or heterozygous. Both Neu5Gc and Neu5Ac were detected in type A and AB cats. In type B cats, only Neu5Ac was detected. Among two type AB cats, the level of Neu5Ac was found higher in cat carrying heterozygous form (T/C) of 1392T > C. The prevalence of type B cats (67.1 %) was higher than others. Conclusions The presence of a new SNP as well as previous SNPs indicates that more variations can be found in stray cats with a more comprehensive study in the future. Also, the high prevalence of type B cats demonstrates the possible risk of neonatal isoerythrolysis among stray cats living in İzmir, Turkey.

Abstract Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral infection caused by Crimean-Congo hemorrhagic fever virus (CCHFV). Serological screening of CCHF is important and current ELISA use antigens prepared from virus which is expensive due to requirement of high bio-containment facilities. In this study, we aimed to develop a new recombinant ELISA. For this purpose, CCHFV genome were expressed as 13 proteins in E. coli and among them abundantly purified recombinant Nucleocapsid protein (rNP) and Mucin-like variable domain (rMLD) were used as antigen in ELISA (Rec-ELISA). Rec-ELISA using rNP, rMLD and a combination of both (rNP/rMLD) were probed with acute (n = 64; collected between days 1 and 7 after onset of symptoms), convalescent (n = 35; collected 8 days after onset of symptoms), consecutive sera (n = 25) of confirmed CCHF cases and control sera (n = 43). The sensitivity and specificity of Rec-ELISA using rNP/rMLD were 73% and 98% in acute cases and 97% and 98% in convalescent cases. The median interquartile absorbance value to discriminate the acute and convalescent phases of CCHF was significantly higher with ELISA using rNP/rMLD (P 0.05) and rMLD (P = 0.001). These results indicate that the Rec-ELISA using rNP/rMLD may be very useful to diagnose convalescent CCHF cases especially in field studies.

Abstract In the genome of SARS-CoV-2, the 5′-terminus encodes a polyprotein, which is further cleaved into 15 non-structural proteins whereas the 3′ terminus encodes four structural proteins and eight accessory proteins. Among these 27 proteins, the present study aimed to discover likely antigenic proteins and epitopes to be used for the development of a vaccine or serodiagnostic assay using an in silico approach. For this purpose, after the full genome analysis of SARS-CoV-2 Wuhan isolate and variant proteins that are detected frequently, surface proteins including spike, envelope, and membrane proteins as well as proteins with signal peptide were determined as probable vaccine candidates whereas the remaining were considered as possible antigens to be used during the development of serodiagnostic assays. According to results obtained, among 27 proteins, 26 of them were predicted as probable antigen. In 26 proteins, spike protein was selected as the best vaccine candidate because of having a signal peptide, negative GRAVY value, one transmembrane helix, moderate aliphatic index, a big molecular weight, a long-estimated half-life, beta wrap motifs as well as having stable, soluble and non-allergic features. In addition, orf7a, orf8, and nsp-10 proteins with signal peptide were considered as potential vaccine candidates. Nucleocapsid protein and a highly antigenic GGDGKMKD epitope were identified as ideal antigens to be used in the development of serodiagnostic assays. Moreover, considering MHC-I alleles, highly antigenic KLNDLCFTNV and ITLCFTLKRK epitopes can be used to develop an epitope-based peptide vaccine.

Amaç: Bu çalışmanın amacı, transvers maksiller darlığı (TMD) olan yetişkin hastalarda transpalatal distraktör ile yapılan cerrahi destekli maksiller genişletmenin (TPD+CDMG) faringeal havayolu boyutları üzerindeki etkisini araştırmaktır.Gereç ve Yöntem: Bu çalışmaya 5 mm’den fazla TMD’si olan hastalar dahil edildi. Bütün hastalara genel anestezi altında, standart Le-Fort I osteotomisi ve maksillada orta hat osteotomisini takiben maksiller genişletme uygulandı. Dört ay sonrasında apareyler çıkartılarak transpalatal ark uygulandı. Hemen ameliyat öncesinde ve distraktör sökümünden en az 6 ay sonra alınan konik ışınlı bilgisayarlı tomografi görüntüleri üzerinde Dolphin 3D Surgery Görüntüleme yazılımının havayolu modülü kullanılarak, faringeal havayolunun nazofaringeal, retropalatal, retroglossal bölümlerinin hacimleri ve faringeal havayolunun en küçük kesit alanı ölçüldü. Sürekli değişkenler için normal dağılım varsayımı Shapiro-Wilk testi ile kontrol edildi ve dağılım tipine göre testler seçildi. Bağımlı yapıda olan TPD+CDMG öncesi ve sonrası ölçümler arasındaki farklılık test edilirken, normal dağılıma sahip olan ölçümler için eşleştirilmiş t-testi, normal dağılıma sahip olmayan ölçümler için ise Wilcoxon testi kullanıldı. İstatistiksel anlamlılık düzeyi p≤0.05 olarak kabul edildi.Bulgular: Çalışmaya 9’u kadın (%42.9), 12’si erkek (%57.1), toplam 21 hasta dahil edildi. Hastaların yaş ortalaması 22.8±5.7; takip süresi ortalaması 22±11.1 ay olarak bulundu. Retropalatal, retroglossal ve toplam havayolu hacmi ve faringeal havayolunun minimum kesit alanı için TPD+CDMG öncesi ve sonrasında yapılan ölçümler arasında istatistiksel olarak anlamlı fark bulunamadı. Ancak, nazofarinks hacmi için TPD+CDMG öncesi ve sonrası ölçümler arasında anlamlı fark tespit edildi (p≤0.05).Sonuç: TPD+CDMG sonrası nazofarinks hacminde önemli artış olduğu bulunurken, faringeal havayolunun diğer bölgelerindeki hacimsel ve kesitsel değişikliklerin önemli düzeyde olmadığı bulunmuştur.

Amaç: Bu çalışmanın amacı çocuklarda dentigeröz kist (DK) nedeni ile gömülü kalan dişlerin, marsüpyalizasyon sonrası sürmesini incelemek ve hangi faktörlerin ilişkili dişlerin sürmesinde belirleyici olduğunu araştırmaktır.Gereç ve Yöntem: DK nedeni ile gömülü kalan daimi dişleri olan ve marsüpyalizasyon yapılan 63 çocuk hastanın kayıtları, sürmeyi etkileyebilecek faktörler açısından değerlendirildi. Hastalar dişlerin sürmesi ve sürmemesine göre iki grupta incelendi. Çalışmada sürmeyi etkileyebilecek faktörler; yaş, cinsiyet, dişin derinliği, dişin açısı, kök gelişimi, dişin sürmesi gereken boşluk ve dişin meziyo-distal boyutu arasındaki oran, kistin boyutu ve obturatör/yer tutucu kullanımı olarak belirlendi.Bulgular: Diş derinliği ortalaması sürmeyen grupta 11,1±3,2 mm, süren grupta 8,1±3,9 mm olarak bulunurken; gömülü dişlerin açı ortalaması sürmeyen grupta 41,5±22,6 süren grupta 27,9±21,3 derece olarak bulundu. Lojistik regresyon analizinde de bu iki faktör dişlerin kendiliğinden sürmemesi ile ilişkiliydi. Sonuç: Tedavi kararı verilirken, DK ile ilişkili gömülü dişlerin marsüpyalizasyon sonrası sürüp sürmeyeceğinin tahmin edilmesinde dişin derinliği ve açısı önemli faktörler olarak değerlendirilebilir. Ayrıca sürmesi geciken daimi dişlerin varlığında DK tespit edilmesi durumunda tedaviye gömülü dişlerin fizyolojik sürme zamanlarından önce başlanması, normal sürme zamanı ile tedaviye başlama yaşı arasında çok uzun süre yoksa obtüratör/yer tutucu yapılmaması tavsiye edilebilir.

Abstract Background Toxoplasma gondii is an obligate intracellular parasite that can infect almost all warm-blooded animals, avian species and humans. Toxoplasmosis is asymptomatic in healthy individuals, whereas it may lead to death in immune suppressed or deficient patients. A vaccine against T. gondii is required to prevent consequences of the infection. The aim of this study is to generate a multivalent recombinant protein vaccine against T. gondii. Methods 49 previously discovered antigenic proteins of T gondii were evaluated by their expression level in E. coli and by comprehensive bioinformatics analyses to determine antigenic epitopes. Based on these analyses, six vaccine candidate proteins were selected to generate a hexavalent recombinant protein vaccine adjuvanted with Montanide ISA 50 V. Humoral and cellular immune responses were determined by flow cytometry and ELISA. Vaccinated mice were challenged with T. gondii Ankara strain tachyzoites. Results In mice vaccinated with hexavalent vaccine, strong total IgG (P

The tetanus vaccine is not routinely given to Turkish adults. Protective tetanus immunity decreases with age. Health-care personnel (HCPs), who are role models in the field of health, are a target group in order to achieve a higher rate of tetanus vaccination in the community. This study was designed to evaluate attitudes and coverage regarding tetanus vaccination among a large sample of Turkish HCPs. This cross-sectional epidemiologic study was conducted from July to August 2019. A questionnaire was sent to HCPs using social media. Of the 10,644 HCPs included in the study, 65% were female. Overall, the tetanus vaccination coverage (TVC) among HCPs was 78.5% (95% CI: 77.7%-79.3%). TVC was significantly higher among physicians [83.4% (95% CI: 82%-84.6%); p

Abstract Background Toxoplasma gondii is an opportunistic protozoan parasite that can infect all warm-blooded animals including humans and cause serious clinical manifestations. Toxoplasmosis can be diagnosed using histological, serological, and molecular methods. In this study, we aimed to detect T. gondii RE gene in various human samples by in house and commercial real time polymerase chain reactions. Methods A total of 38 suspected cases of toxoplasmosis [peripheral blood (n:12), amnion fluid (n:11), tissue (n:9), cerebrospinal fluid (n:5), and intraocular fluid (n:1)] were included to the study. An in house and a commercial RT-PCR were applied to investigate the T. gondii RE gene in these samples. Results The compatibility rate of the two tests was 94.7% (37/38). When the commercial RT-PCR kit was taken as reference, the sensitivity and specificity of in house RT-PCR test was 87.5 and 100%. When the in house RT-PCR test was taken as reference, the commercial RT-PCR kit has 100% sensitivity and 96.8% specificity. Incompatibility was detected in only in a buffy coat sample with high protein content. Conclusions Both the commercial and in house RT-PCR tests can be used to investigate T. gondii RE gene in various clinical specimens with their high sensitivity and specificity. In house RT-PCR assay can be favorable due to cost savings compared to using the commercial test.

Amaç:Bu çalışmanın amacı Cukurova University Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi tarafından 2015-2017 yılları arasında tedavi edilen mandibula kırıklarının prevalansı, tedavisi ve komplikasyonlarını incelemektir. Gereç ve Yöntem:Mandibula kırıkları etiyolojiye ve kırıkların lokalizasyonuna göre sınıflandırıldı. Açık redüksiyon ve internal fiksasyon 2.0mm veya 2.4mm fiksasyon sistemleri kullanılarak yapıldı. Kapalı redüksiyonda ark-bar, intermaksiller fiksasyon vidaları veya tel-kompozit splint kullanıldı. Aşağıdaki komplikasyonlar kaydedildi: Geçici parestezi, kalıcı parestezi, maloklüzyon, enfeksiyon, temporomandibular eklem bozukluğu,fiksasyon materyalinin açığa çıkması ve kök hasarı.Bulgular:Ortalama hasta yaşı 32,8±(13,8) idi. Erkekler, çalışmaya dahil edilen vakaların %77.4(n = 65), kadınlar ise % 22.6(n=19) 'sını oluşturdu. Bu çalışmada mandibula kırıklarının nedenleri sırasıyla kişilerarası şiddet(27 olgu,%32,1), trafik kazaları(22 olgu,%26,2) ve düşme (21 olgu,% 25) olarak bulundu. Kırıkların en nadir nedeni spor kazasıydı (6 olgu,% 7,1). En yaygın kırık lokalizasyonu sırasıyla kondil(27,%24.5), ardından angulus (24,% 21,8), korpus (19,%17.3), simfiz / parasimfiz (18,% 16,4) ve alveolar kemik (17, %15,5) idi. Elli hasta açık redüksiyon (% 59,5) ile tedavi edilirken, 29 hasta kapalı redüksiyon (%34.5) ile tedavi edildi. Üç hasta (%3,6) tedavi görmedi. Hastaların 25'inde (%29,7) değişen derecelerde komplikasyonlar gözlendi. Bu çalışmada en sık rastlanan komplikasyon geçici parestezi (%13,1) olmuştur. Bunu temporomandibular eklem rahatsızlığı (%6,0) izlemiştir. Diğer komplikasyonlar seyrek görülmüştür.Sonuç:Farklı merkezlerin hastalarını farklı sosyo-ekonomik bölgelerde ve farklı klinik imkan / kaynak düzeylerinde nasıl yönettiğini anlamak ve güncel tedavi yöntemlerini takip etmek önemlidir. Mandibular kırıkların görülme sıklığı ve nedenleri, toplum içindeki travma modellerini yansıtması açısından daha iyi sağlık politikası stratejileri yürütmek için yol gösterici olabilir.

ÖZ Bu çalışmada 1991 – 2017 yıllarını kapsayan döneme ilişkin Türkiye’nin büyüme muhasebesi analiz edilmiştir. Bu amaçla teorisi Solow büyüme muhasebesine dayanan ve Dünya Bankası’ndan elde edilen verilerle 26 yıllık bir dönemde Türkiye’de büyümenin kaynakları hesaplanmıştır. Büyüme muhasebesi ülke ekonomilerinin hangi faktörlere dayanarak büyüdüğünü görebilmemiz için uygulanabilir ve analiz edilebilir bir yöntemdir. Büyüme muhasebesi sayesinde ekonominin dinamiklerini, artı ve eksilerini görebilmek mümkündür. Büyüme muhasebesinin en önemli sonucu toplam faktör verimliliğinin ölçülmesidir. Toplam faktör verimliliği ise aynı miktar işgücü ve sermayeyle daha fazla çıktı üretebilmek anlamına yani verimlilik artışı anlamına gelmektedir. Bu çalışmada toplam faktör verimliliği hesaplanarak üretime olan katkısı ortaya konmuş ve üretim faktörlerinin payı hesaplanmıştır. Çalışma sonucunda Türkiye’nin ekonomik büyümesinde ki en önemli faktörün fiziksel sermaye birikimi olduğu anlaşılmıştır. Günümüz Türkiye’sinin en önemli sorunlarından olan cari açığında üretimin çok fazla sermayeye malına dayanıyor ve bu sermayenin ise ithalatla sağlanmasından kaynaklanıyor olmasıdır.

Abstract Background Toxoplasma gondii is an obligate intracellular protozoan parasite that causes congenital toxoplasmosis, as well as other serious clinical presentations in immune compromised humans. The parasite has also been recently linked to behavioral diseases in humans and other mammalian hosts. New antigens are being evaluated to develop a diagnostic kit for the diagnosis of acute infection or a protective vaccine. Methods In this study, we have focused on the discovery of new antigenic proteins from T. gondii genomic data using a high throughput protein microarray screening. To date, microarrays containing > 2870 candidate exon products of T. gondii have been probed with sera collected from patients with toxoplasmosis. Here, the protein microarrays are probed with well-characterized serum samples from animal models administered orally with oocysts or tissue cysts. The aim was to discover the antigens that overlap in the mouse profile with human antibody profiles published previously. For this, a reactive antigen list of 240 antigens recognized by murine IgG and IgM was identified using pooled sera from orally infected mice. Results Analyses of screening data have identified plenty of antigens and showed strong immunogenicity in both mouse and human antibody profiles. Among them, ROP1, GRA2, GRA3, GRA4, GRA5, GRA6, GRA7, GRA8, GRA14, MIC1, MIC2 and MAG1 have shown strong immunogenicity and used as antigen in development of vaccines or serological diagnostic assays in previous studies. Conclusion In addition to the above findings, ROP6, MIC12, SRS29A and SRS13 have shown strong immunogenicity but have not been tested in development of a diagnostic assay or a vaccine model yet.

Introduction: Greater than half of cancer patients suffer from the pain, which is the one of the major problems that disrupt the quality of life at, any time during the disease. Pain should be decreased as soon as possible and the maintenance treatment should be planned in these groups of patients. The World Health Organization (WHO) suggests the use of a three-step analgesic ladder approach including non-opioid, weak opioid and strong opioids according to the severity of the pain. However, the pain palliation can’t be accomplished in more than 80% of patients because of the wrong thoughts of health professionals, patients and patients’ relatives about narcotic analgesics.Methods: In this study 72 lung cancer patients, hospitalized between 29 July 2013 to 31 December 2015 at Izmir Katip Çelebi University Atatürk Education and Research Hospital Palliative Care and Support Service were assessed retrospectively about pain palliation.Results: Patients mean ages 61.2 ± 8.2 and 77.8% (56) were male, and 22.2% (16) were female. Patients applied with different complaints such as Inability to feed, pain, general condition disorders, shortness of breath and nausea and 27.8% (20) of patients had only admitted with pain. The median duration of hospital stay was 7 (2-45) days, which is the 18.1% of patients were not given any analgesics. 49.2% (29) of patients have second line treatment, 50.8% (30) had received third line treatment. Hospitalization indication and discharge status of the patients was statistically significant association between analgesic use (p = 0.002; p = 0.03).Conclusion: Cancer pain is the most common symptom affecting the quality of life negatively. Pain management should be well known by clinicians. Success in the treatment of pain patients linked to multidisciplinary approach include the whole psychological and social environment will be possible with the treatment applied by step approach.

Objective: Mastalgia is the most common symptom in women, who has gone under breast imaging. 70% of women face with mastalgia at least once in their lifetime. In our study, we aimed to investigate the examinations and the results of the females referred to our outpatient clinics with mastalgia and to determine the frequency of malignancy.Materials and Methods: Files of all women patients referred to General Surgery Outpatient Clinics between 01.06.2014-31.05.2015 has been investigated retrospectively. Cases only with breast pain complaint (n=789) out of 2798 women has been included in the study. Women with lump in breast, nipple discharge, redness, breast retraction and pregnant and lactating women were excluded. Breast examination findings, ultrasonography (USG), mammography results, whether biopsies are done or not and diagnoses have been investigated retrospectively.Results: Mean age was 42.97±12.36 (16-74) years. 59.7% (n=471) of the women had bilateral mastalgia and 91.1% (n=719) of the breast examinations were found to be normal. USG was required from 664 (84.2%) women and mammography was required from 448 (56.8%) women. Considering diagnoses; fibrocystic changes in 32.3% (n=201), ductal ectasia in 8.8% (n=55), fibroadenomas in 6.1% (n=38), reactive lymphoid hyperplasia in 1.1% (n=7) was observed. Only 1 (0.2%) woman was diagnosed with invasive ductal carcinoma.Conclusion: According to researches, 0.5% of the women with mastalgia were diagnosed with breast cancer. In our study this rate was found as 0.2%. Women with only mastalgia without any abnormality in physical examination should be informed about dealing with pain.

Introduction: The passage from childhood to adulthood is the period when health habits and sexual behaviors start to form. Thus, the topics of sexual health and reproductive health should be approached with priority during this period. The objective of the study is to evaluate the knowledge and behavior of students of the medical faculty with respect to sexually transmitted diseases and prevention methods.Methods: The questionnaire that contains 23 headings created by the researchers after relevant literature reviews was administered to the third-semester students of the Izmir Katip Celebi University Medical Faculty in face-to-face interviews after obtaining their verbal consent. The study data was analyzed using the SPSS 20.0 demo software bundle. Conditions in which the p-value was under 0.05 were regarded as statistically significant.Results: The mean age of the students that participated in the study (n=104) was 21.88 ± 1.9 years of age, 51% (n=53) of the students were female, and 49.0% (n=51) were male. Among the students, 93% stated that they had received education about preventing pregnancy. Two of the most well-known prevention methods by the participants were condoms in 99.0% (n=103) and oral contraceptives in 95.2% (n=99). The rate of correct answers given about all of the risk factors for sexually transmitted diseases (sex workers, polygamy, homosexuality, being sexually active, substance addiction) was 22.1% (n=23).Conclusion: Identifying the level of knowledge in the youth about STDs in early periods, determining the services they require, cooperating with related institutions to review the adequacy of information online, and educating youth about STDs are important in preventing these diseases and also in the treatment of existing diseases before they lead to more problems.

Introduction: The most common and most important symptom in the palliative care patients is severe pain as defined "more terrible than death". In our study, we aimed to determine the effectiveness of palliative pain treatment in cancer patients with pain. Methods: Files of all patients hospitalized in Palliative Care and Support Services for Cancer Patients at Izmir Katip Celebi University Atatürk Research and Training Hospital between 29.07.2013 – 01.02.2016 has been investigated retrospectively. Patients (n=112) with recorded pain scores according to the Visual Analogue Scale (VAS) from 704 patients has been included in the study. Age, gender, diagnosis, VAS scores during hospitalization and discharge of patients included in the study, used analgesic drugs and number of days in treatment have been investigated retrospectively. Results: 57.1% (n=64) of the patients were male and the mean age was 59.8 ± 14.5 years. Considering diagnoses; colorectal cancer in 15.2%, breast cancer in 14.3%, lung cancer in 13.4% and stomach cancer in 11.6% was observed. The patients were inpatient treatment the mean 13.0 ± 11.5 days. The mean VAS pain scores of the patients recorded during hospitalization was 5.2 ± 2.6 and the mean of these values at discharge was 2.2 ± 1.8. In the pain treatment of the patients; using tramadole in 82, fentanyl in 36, acetaminophen in 28 and morphine in 18 was observed. Conclusion: A significant reduction in pain scores of the patients in our study were identified with an effective analgesic treatment. Obstacles to the treatment of pain; the doctors who are lack of information about pain treatment, fears about drug addiction, the patients who hide their symptoms and ignoring to symptom control as can be listed. Symptom management is important in palliative care units and quality of life should be kept at a high level.

ABSTRACTIntroduction: Diabetic foot wounds are one of the most important causes of long duration hospitalizations regarding diabetic patients. Lower extremity amputation risk is 15 to 40 times higher in diabetics compared to normal population. Methods for preventing diabetic foot wounds are providing good blood glucose regulation, appropriate shoe wearing, foot care, toe-nail care, regular foot examinations and patient education. We aimed to investigate the effects of education level of the patients and the caregivers on the diabetic foot wound.Methods: 67 patients having diabetic foot wound applying to General Surgery, Internal Medicine and Diabetes outpatient clinics of Izmir Tepecik Education and Research Hospital in 2009 and 57 caregiver caring for these patients were analyzed prospectively with a face to face questionnaire for a correlation between education levels of patients and caregivers and Wagner staging of patients’ diabetic foot wounds and foot examination findings.Results: It was found that education levels of patients and caregivers did not affect Wagner staging of the wounds (p=0.167), but patients with regular follow-up and previously educated for diabetic foot wounds had a lower stage of wound (p=0.021).Conclusion: Education level of patients and caregivers was not found to be effective on the stage of the wound, but regular clinical follow-up and patient education had an decreasing effect on the stage of wound. Whatever the patients’ education levels are, educations on diabetic foot care and providing regular follow up of patients at risk for diabetic foot will decrease the rates of extremity amputations.

Toxoplasma gondii is a protozoon parasite that causes congenital toxoplasmosis, as well as other serious clinical presentations, in immune compromised humans. Analyses of the prevalence and genotyping of strains from the definitive host and intermediate hosts will help to understanding the circulation of the different strains and elucidating the role of the genotype(s) in human toxoplasmosis. Turkey has a specific geographic location bridging Africa, Europe, and Asia. We hypothesized that T. gondii strains may have been transferred to Turkey from these continents via migratory birds or vice versa. The present study aimed to assess the prevalence of toxoplasmosis in wild birds of prey of İzmir and Manisa provinces as well as genetically characterize T. gondii strains from these wild birds to show the relation between bird strains and neighboring stray cats as well as human strains previously isolated in Turkey. Tissues obtained from 48 wild birds were investigated for the presence of T. gondii DNA and then bioassayed in mouse. Isolated strains were genotyped using 15 microsatellite markers. The prevalence of T. gondii DNA was found to be 89.6% (n: 43/48) in wild birds. Out of 43 positive samples, a total of 14 strains were genotyped by 15 microsatellite markers. Among them, eight were type II, three were type III and three were mixture of genotypes (two type II/II and one was II/III). These are the first data that showed the presence of T. gondii and types II and III genotypes in wild birds of Turkey. Moreover, Africa 1 was not detected. In addition, cluster analysis showed that T. gondii strains within type II and III lineage have close relation with strains previously isolated from stray cats in İzmir. Further studies are required to isolate more strains from human cases, other intermediate hosts, and water sources to reveal this relation.

Objective: Impairment of continuity of the sleep due to arousals and stage changes commonly experienced by the patients with chronic obstructive pulmonary disease (COPD) cause sleep problems associated with insomnia or hypersomnia. These resultant sleep problems lead to impaired quality of life in the patients with COPD. The aim of this study was to evaluate complaints related to sleep-alertness in the patients with COPD in the setting in which subjective sleep tests and polysomnography investigation using scales of quality of life are unavailable. Materials and Methods: The present study included 70 patients with COPD (33 were men and 37 were women). First, the patients with symptoms of COPD were evaluated clinically and COPD was staged based on degree of restriction of airflow (GOLD 2011). Sleep-alertness situation of all patients was evaluated using Epworth Sleepiness Scale (ESS) and Pittsburgh Scale of Seep Quality (PSSQ). Results: No statistically significant relationship was observed between stage of COPD and results of subjective sleep tests. Conclusion: Although these results indicate that stage of disease does not impact sleepiness and quality of sleep in the patients with COPD, they support the fact that presence of COPD alone negatively affected quality of sleep.

Toxoplasma gondii causes congenital toxoplasmosis in newborns resulting with fetal anomalies. Determining the initiation time of infection is very important for pregnant women and current serological assays have drawbacks in distinguishing the recently acute toxoplasmosis. Diagnosis of recently acute infection may be improved by using stage specific antigens in serological assays. In the present study, the diagnostic value of sporozoite specific SporoSAG, bradyzoite specific BAG1 proteins and GRA1 protein expressed by all forms of the parasite have been evaluated ELISA using sera systematically collected from mice administered orally with tissue cyst and oocysts. The anti-SporoSAG IgM antibodies in sera obtained from mice infected with oocysts peaked significantly at days 1, 10, and 15 (P

Currently, some Toxoplasma gondii genotypes are being associated with serious clinical presentations. A recent report showing the Africa 1 genotype in two local congenital toxoplasmosis cases acquired in Turkey formed the basis of this study because atypical Africa 1 genotype is most frequently detected in animals and patients from sub-Saharan Africa. Since stray cats are considered as the linkage between wild life and urban life in T. gondii transmission, the present study aimed to isolate and characterize T. gondii strains circulating in stray cats of İzmir (Western Turkey). A secondary objective was to determine toxoplasmosis seroprevalence in this cat population. Tissues obtained from 100 deceased stray cats were bioassayed and isolated strains were genotyped using 15 microsatellite markers. In addition, toxoplasmosis seroprevalence was analyzed in 1121 cat sera collected from several large veterinary clinics in İzmir. Among the 22 isolates, 19 were Type II (86.3%), two were Type III (9%) and one was Africa 1 genotype (4.5%). The overall seropositivity rates in cats were 42-48% and 33.4-34.4% according to IFA and ELISA, respectively. Seroprevalence in deceased cats was significantly higher than in healthy cats (P = 0.0033). Finding both the major clonal Type II lineage together with the Type III lineage also found in Middle East, and an atypical genotype, Africa 1 appears consistent with the specific geographic location of Turkey between three continents and raises the possibility of transportation of these strains between continents through trade routes or long distance migratory birds. In addition, the first large study of toxoplasma seroprevalence in a stray cat population was also reported. The relatively high seropositivity rates and the variety of T. gondii genotypes confirm the local stray cat population as a risk factor for human toxoplasmosis in İzmir.

COVID-19 has changed the way we teach. Today, we have become far more experienced in the delivery of distance education and use of online tools. However, the quality of distance education and learning outcomes have become a matter of ongoing debate. Just as higher education aims to develop high-level skills in its students, researchers are seeking ways to perform valid and reliable assessment in distance education. Institutions and educators are also in search of assessment tools that can help prevent instances of cheating and plagiarism. However, performance-based assessment tools may also offer options to measure both high-level skills and in limiting cheating behaviors. In this study, we used the take-home exam as a formative remote assessment tool as a local case in Turkey. We surveyed the views of 43 undergraduate students about the quality of take-home exams as a remote assessment tool. The results showed that participants had a high quality perception about the use of take-home exam, especially with regards to being kept informed about evaluation and scoring, rapid assessment, the provision of feedback, and consistency of scope between assessment and course content. Whereas students highly perceived the use of take-home exams, they reported more moderate views regarding take-home exams increasing the level of interaction with their peers. The results of this study suggest that the use of take-home exams is significantly preferred by higher education students, that it is a reliable and distinctive way to measure students' academic performance, and may increase student-teacher interaction through its formative use.

Amaç: Bu çalışmada Türkiye’nin İzmir ilindeki eğitim araştırma hastanelerinde aile hekimliği uzmanlık eğitimi alan asistanların rahim içi araç (RİA) hakkındaki bilgi, tutum ve görüşlerini tespit etmek amaçlanmıştır. Ayrıca yapılan kadın doğum rotasyonunun bilgi düzeyine etkisi de bu kapsamda irdelenmiştir.Materyal ve Metot: 2013 Haziran ve Temmuz aylarında, Türkiye’nin İzmir ilindeki tüm eğitim ve araştırma hastanelerinde eğitim alan 61 aile hekimliği asistanı ile yüzyüze görüşülerek anket uygulandı. Anket soruları, bakırlı ve hormonlu (levonergestrel) RİAlar hakkında bilgi düzeyini ölçmek üzere, Dünya Sağlık Örgütü (DSÖ) kontraseptif kullanımı için tıbbi uygunluk kriterleri (4. baskı) baz alınarak hazırlandı. Bakırlı ve hormonlu RIAların nulliparite, adolesan dönem, HIV pozitifliği, sigara içilmesi, diyabet varlığı, ektopik gebelik, pelvik inflamatuvar hastalık öyküsü varlığı, obezite, hipertansiyon, menoraji, myom varlığı, uterin kavite distorsiyonu, demir eksikliği anemisi, derin ven trombozu, meme kanseri öyküsü varlığı, üriner sistem hastalığı ve epilepsi durumlarındaki kullanılabilirliğini sorgulayacak 16 soru hazırlandı. Kullanılabilirlik durumunun cevapları da 4 seçenekli DSÖ kontraseptif kullanımı için tıbbi uygunluk kriterleri (4.baskı) esas alınarak değerlendirildi. Araştırmaya katılımda gönüllülük kriteri esas alındı.Bulgular: Araştırmaya 61 aile hekimliği asistanı katıldı. Asistanlardan kadın hastalıkları ve doğum rotasyonu yapanların oranı %63,9, RIA uygulaması yapmış olanların oranı ise %45,9 olarak saptandı. Asistanlardan daha önce RİA uygulaması yapma, kadın hastalıkları ve doğum rotasyonunu tamamlama ve meslekteki tecrübe süresinin sorulara doğru cevap verme ile ilişkisi incelendi. Kadın doğum rotasyonu yapanların bakırlı RİA sorularına doğru cevap verme oranı istatiksel olarak anlamlı şekilde yüksek idi (p