Epidemiology of Tuberculosis with comparison of the efficacy of culture, real-time PCR and direct microscopy in the diagnosis of tuberculosis

Aim: Despite the developments every passing year, tuberculosis is still a major public health problem in Turkey and in the world. Early and correct diagnosis is important for the control of the disease. The aim of this study is to investigate the diagnostic efficiency of the culture (Lowenstein Jensen), real-time PCR (Abbott m2000rt, Bosphore MTBC Detection Kit) and direct microscopic examination of acid-resistant bacillus stained with Ehrlich-Ziehl-Neelsen (EZN), and the study was performed by evaluating the samples coming to our laboratory retrospectively over a 4-year period. Material and Methods: The samples sent to our mycobacteriology laboratory between January 2016 and December 2019 were evaluated retrospectively. The effects of direct microscopy and real-time PCR method were compared based on culture as a reference method. Results: Sensitivity, specificity, positive predictive value and negative predictive value of direct microscopy were calculated as 45%, 99.9%, 96.4%, 96.9%, respectively, in pulmonary samples and as 21.7%, 100%, 98.8%, 98.8%, respectively, in extrapulmonary samples. Sensitivity, specificity, positive predictive value and negative predictive value of real-time PCR were calculated as 80%, 98.3%, 98.8%, 97.3%, respectively, in pulmonary samples and as 62.5%, 99.2%, 50%, 99.5%, respectively, in extrapulmonary samples. Discussion: Although direct microscopic examination method is a cheap, simple, fast and highly specific test, its sensitivity is low. Therefore, patients with suspected tuberculosis should be evaluated together with culture, besides direct microscopy. It was observed that the sensitivity of direct microscopy was lower in extrapulmonary samples compared to pulmonary samples. The real-time PCR method has high sensitivity and specificity, and also gives fast results

Media freedom and the role of ideology

Media freedom is crucial for good governance but what leads to free media? Does the ideology of media outlets tend to make media outlets independent from the influence of the incumbent party? In the political economy of media literature, the ideology of media outlets are usually seen as a negative factor for media freedom. Using a formal model, this paper demonstrates that the ideology of media outlets can rather promote media freedom by acting as a safeguard against media capture by the government. In the model, I label media outlets as adversarial and non-adversarial ones, and demonstrate that the media capture becomes harder as the proportion of adversarial media outlets in a country increase. I also show that the media capture becomes less likely as the level of opposition by the adversarial media outlets increases. Case studies from Turkey and Peru support the implications of the model

Correlation of suicidal thoughts and toxoplasmosis in patients with depression

Objective We investigated the correlation between serum anti-Toxplasma gondii IgG and suicidal thoughts in depressive patients. Methods Depressive patients with (n = 100) and without (n = 100) suicidal thoughts along with 100 healthy control subjects were recruited for this study. In all three groups, a semi-structured clinical interview form called Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) Axis-I Disorder (SCID-I), Hamilton Depression Rating Scale (HAMD), suicidal behavior scale, and a sociodemographic data form were completed. Sera from all participants were taken, and anti-toxoplasma IgG was measured by Enzyme Linked Immunosorbent Assay (ELISA)-Chemiluminescent Microparticle Immunoassay. Statistical analysis of the data was performed. Results The serum anti-toxoplasma IgG levels of patients with suicidal thoughts were significantly higher than those without suicidal thoughts and the controls, which were 80.04 +/- 40.66, 78 +/- 14.82, and 19.98 +/- 14.65, respectively, p < 0.001. There was no correlation between toxoplasma IgG and HAMD score in patients lacking suicidal thoughts (r = -0.112, p = 0.463). Conclusion This study shows a correlation between seropositivity for anti-Toxoplasma gondii IgG and depression with suicidal thoughts

Investigation of the relationship between hemogram parameters and procalcitonin levels in patients with psychiatric diseases

Introduction: This study aimed to evaluate the relationship between the hemogram parameters and the levels of procalcitonin, serum C-reactive protein, and inflammation in inpatients with psychiatric disorders. Material and methods: The study population consisted of 549 inpatients treated between January 2018 and December 2020. Data were obtained retrospectively from computer records and inpatient files. Only the first hospitalization of each patient was evaluated, and 199 patients were included in the study. The researchers examined the parameters including platelet activation, neutrophil lymphocyte ratio, monocyte lymphocyte ratio, platelet count, mean platelet volume, platelet distribution width, platelet lymphocyte ratio, and procalcitonin levels in patients and compared them with findings obtained from a control group. Results: Increased levels of C-reactive protein and decreased levels of platelets were observed in patients with schizophrenia, bipolar disorder, depressive disorder, and anxiety disorder. Increased platelet distribution width, platelet lymphocyte ratio, and neutrophil lymphocyte ratio were observed in patients with schizophrenia. The patients with bipolar disorder had increased mean platelet volume while patients with depressive disorder had an increased monocyte lymphocyte ratio. Procalcitonin levels increased in patients with anxiety disorder and depressive disorder. Discussion: Platelet activity can be an important criterion to investigate the etiopathogenesis underlying the inflammatory process in schizophrenia, bipolar disorder, depressive disorder, and anxiety disorders. To our knowledge, this is the first study to describe a positive correlation between increased monocyte lymphocyte ratio and procalcitonin levels in depressive disorder, and a positive correlation between increased procalcitonin levels and anxiety disorder and depressive disorder

The Relationship between Ethical Leadership and Bullying Behavior: The Mediating Role of Organizational Justice

Ethical leadership plays a key role in the establishment of a school environment where negative behaviors such as mobbing and bullying seen less. Although there have been some studies on the relationship between ethical leadership and bullying behavior, potential determinants explaining this relationship needs further exploration. The purpose of the current study was to examine the mediating role of organizational justice in relationship between ethical leadership and bullying behavior. The participants were 551 teachers working in three different central districts in Konya, Turkey. Data was collected using the Ethical Leadership Scale to measure teachers’ perceptions of ethical leadership, Negative Acts Questionnaire to measure teachers’ perceptions of bullying, and Organizational Justice Scale to measure teachers’ perceptions of organizational justice. Results revealed that ethical leadership and organizational justice was negatively correlated with bullying behavior. Besides, organizational justice partially mediated the relationship between ethical leadership and bullying behavior in which ethical leadership had both direct influence on bullying behavior and indirect influence through organizational justice. In the light of these findings, recommendations were given for further research and administrative applications. Keywords: Ethics, Ethical leadership, School principals, Bullying behavior, Organizational justice

Determination of saturated hydraulic conductivity of Konya plain soils with parallel drains method using steady-state flow equation

Bu çalışmada, Konya ovasında Hooghoudt denklemi kullanılarak paralel dren yöntemi ile toprakların ortalama doygun hidrolik iletkenliği (Ksat) belirlenmiştir. Çalışmada dren boru çapı 0.1 m, derinliği 1.70 m ve uzunluğu 80 m olan, 40 m dren aralığına sahip, 3 dren hattı ve oluklu plastik borulardan oluşan bir pilot deneme alanından elde edilen veriler kullanılmıştır. Zarf malzemesi olarak, dren derinliğindeki toprağın özelliklerine göre belirlenen kum-çakıl karışımı kullanılmıştır. Testlerde, sistemde serbest akış sağlandıktan sonra drenaj çıkışlarındaki debiler ve iki dren orta noktasındaki hidrolik yükler aynı anda ölçülmüştür. Elde edilen veriler değerlendirilerek Konya Ovası’ndaki akiferin geçirgenliğinin 7.282 m² gün-¹, ortalama hidrolik iletkenliğin (Ksat) 2.867 m gün-¹, ve alt ve üst sınırlarının %90 olasılıkla 2.461<Ksat<3.273 m gün-¹ olduğu belirlenmiştir.In this study, the average saturated hydraulic conductivity (Ksat) of the soils in the Konya plain was determined by the parallel drain method using the Hooghoudt equation. In the evaluations, data was obtained from a pilot trial area with a drain pipe diameter of 0.1 m, a depth of 1.70 m, and a length of 80 m, with 40 m drain spacings, 3 drain lines, and corrugated plastic pipes were used. The sand-gravel mixture determined according to the soil properties at the drainage depth was used as the envelope in the drainage system. In the tests, the drainage flows at the drainage outlets and the hydraulic heights at the midpoint of the two drains were simultaneously measured after free flow was achieved in the system. By evaluating the data obtained, it has been determined that the permeability of the aquifer in the Konya plain is 7.282 m²d-¹, the average hydraulic conductivity (Ksat) is 2.867 m d-¹, and its lower and upper limits are 2.461<Ksat<3.273 m d-¹with 90% probability

Çocukluk çağı alerjik astım prognozu: 6 yıllık bir klinik izlem çalışması

Objective: There have been few studies on prognosis and factors influencing the prognosis in children with atopic asthma. We intended to evaluate the prognosis, clinical remission rate, and influencing factors of childhood atopic asthma. Methods: In 72 pediatric patients with atopic asthma who were followed up between 2016 and 2022 with a mean follow-up period of 6.03±2.19 years, demographic characteristics, family history, clinical symptoms, pulmonary function test results, and asthma control test scores were evaluated. Totally controlled patients who had not received any asthma treatment for ≥1 year were considered to be in “clinical remission.” Results: The study group included 72 children with atopic asthma (female/male: 28/44), with a mean age of 13.36±1.98 (8-18) years. 12.5% (n=9) of the patients had uncontrolled asthma, 45.8% (n=33) were partially controlled asthma, 41.7% (n=30) were complete controlled asthma. Clinical remission was seen in 23.6% (n=17) patients with total control. Patients who were symptomatic before the age of three and had a persistent course had a lower clinical remission rate (p=0.05). Conclusion: In our study, the clinical remission rate in atopic asthma in early adulthood was 23.6%. Our results reveal that the clinical remission rate was lower in patients who developed symptoms and had persistent wheezing before the age of three.Amaç: Alerjik astımı olan çocuklarda prognoz ve prognozu etkileyen faktörler üzerine az sayıda çalışma yapılmıştır. Biz çalışmamızda çocukluk çağı alerjik astımının prognozunu, klinik remisyon oranını ve katkıda bulunan faktörleri değerlendirmeyi amaçladık. Gereç ve Yöntem: 2016-2022 yılları arasında ortalama takip süresi 6,03±2,19 yıl olan alerjik astım tanılı 72 pediatrik hastada demografik özellikler, aile öyküsü, klinik semptomlar, solunum fonksiyon testi sonuçları ve astım kontrol testi skorları değerlendirildi. Bir yıldan fazla herhangi bir astım tedavisi almayan kontrollü hastalar “klinik remisyonda” kabul edildi. Bulgular: Çalışma grubuna yaş ortalaması 13,36±1,98 olan 72 alerjik astımlı çocuk (kız/erkek: 28/44) dahil edildi. Astım kontrol durumuna göre hastaların %12,5’i (n=9) kontrolsüz, %45,8’i (n=33) kısmi kontrollü, %41,7’si (n=30) tam kontrollü idi. Tamamen kontrol altına alınan olguların %23,6’sında (n=17) klinik remisyon gözlendi. Üç yaşından önce semptomatik olan ve persistan seyirli hastalarda klinik remisyon oranı daha düşüktü (p=0,05). Sonuç: Çalışmamızda erken çocukluk döneminde alerjik astımda klinik remisyon oranı %23,6 idi. Üç yaşından önce semptomları başlayan ve persistan seyirli olgularda klinik remisyon oranının daha düşük olduğunu saptadık

Adverse drug reactions affecting treatment adherence in first-line treatment of asthma: An observational study

BACKGROUND: Asthma is the most common chronic lung disease among children. International guidelines recommend inhaled corticosteroids (ICS) as the first-line daily controller therapy for children with asthma and leukotriene receptor antagonists (LTRA) as the second alternative therapy. Adherence to treatment is the most significant component to optimize the benefits of therapy in asthma. OBJECTIVE: This study aims to investigate the frequency of drug discontinuation due to adverse drug reactions (ADRs) that affect adherence to treatment in children with asthma or asthma and allergic rhinitis using LTRA or ICS as monotherapy. METHODS: The subjects aged 4-18 years with asthma or asthma and allergic rhinitis and using montelukast or ICS as monotherapy were included in the study. They were evaluated in terms of ADRs affecting adherence to treatment in the first and third months of treatment. RESULTS: A total of 468 cases, 356 of whom received montelukast monotherapy and 112 of whom received ICS treatment, with a mean age of 9.10 ± 3.08 (4-17) years, were included in the study. Males constituted 65.6% of the total cases (n = 307). In the first month of follow-up of the cases, it was observed that 4.8% (n = 17) of the patients in the montelukast group could not continue the treatment due to ADR. It was determined that the drug discontinuation rate in the montelukast group in the first month was significantly higher than in the ICS group (P = 0.016), and the risk of drug discontinuation due to ADR in the montelukast group was 1.333 (95% CI, 1.26-1.40) times higher. CONCLUSIONS: As a result, it was observed that the drug was discontinued due to ADR at a higher rate in children with asthma who received montelukast monotherapy compared to those who received ICS monotherapy