Exploring the determinant of flu vaccine hesitancy among Turkish population: a cross-sectional study

Background: Although influenza is a contagious and widespread viral disease, its impact on public health is controlled by vaccination programs. However, anti-vaccination sentiment is also increasing in society. This study aims to explore the factors influencing influenza vaccine hesitancy. Methods: Between November 2020 and January 2021, a cross-sectional observational survey was carried out in Turkey. To investigate the extent of vaccine hesitancy among individuals, an online questionnaire was created using Google Forms. Data were collected using an exponential non-discriminative snowball sampling technique. Besides internal consistency reliability, chi-square was performed. Statistical significance was defined as p < 0.05. Results: This research encompassed a cohort of 172 respondents, with an average age of 53.5±14.3 years within the total sample. Most participants (126, 73.25%) were above 45. The participant group was predominantly female (93, 54.1%), and most had achieved a high school or university education (117, 66.2%). Out of the participants, 123 individuals (71.5%) reported having a chronic ailment. Among the 172 participants, 118 (68.6%) exhibited no reluctance to receive the influenza vaccine, while 54 (31.4%) expressed vaccine hesitancy. There was a notable statistically significant distinction in the level of knowledge regarding influenza vaccines (p<0.001, χ²= 20.482). Conclusion: Lack of information, perceived harms, lack of trust in pharmaceutical companies, and experiences are among the most important determinants of anti-vaccination. Pharmacists may have a potential role in the leading part of the healthcare team in the fight against anti-vaccination in the community

Treatment of coronavirus disease 2019: a comprehensive review

The new type of Coronavirus (SARS-CoV-2) is a highly contagious pathogen that causes severe acute respiratory syndrome and can be transmitted from human to human. COVID-19, which has been declared as a pandemic by the world health organization and is infected with more than 50 million people, is also responsible for the death of more than 1 million people. There is no sufficient data from randomized clinical trials that any potential treatment improves outcomes in COVID-19 patients. Chloroquine and hydroxychloroquine, antivirals such as favipiravir, lopinavir/ritonavir, immunomodulatory agents tocilizumab, siltuximab, and sarilumab, and anti-inflammatory drugs such as steroids are used for the treatment of COVID-19. Repurposing drugs can provide new treatment options faster than discovering new drugs due to the known safety profiles of existing drugs. On the other hand, there are new drug and vaccine trials for COVID-19. Many researchers, governmental or non-governmental institutions having clinical trials for COVID-19 drugs and vaccines. In this comprehensive review, we investigate the clinical features, management, and treatment of COVID-19 and possible adverse effects and important information related to drugs used for COVID-19. For future preparedness and readiness, new laws and legislations should be constituted. Besides, emergency teams and budgets should be prepared as well.

Evaluating the clinical significance of diazepam binding inhibitor in alzheimer's disease: A comparison with inflammatory, oxidative, and neurodegenerative biomarkers

Introduction: Alzheimer's disease (AD) is one of the pathologies that the scientific world is still desperate for. The aim of this study was the investigation of diazepam binding inhibitor (DBI) as a prognostic factor for AD prognosis. Methods: A total of 120 participants were divided into 3 groups. Forty new diagnosed Alzheimer patients (NDG) who have been diagnosed but have not started AD treatment, 40 patients who diagnosed 5 years ago (D5YG), and 40 healthy control groups (CG) were included in the study. Levels of DBI, oxidative stress, inflammatory, and neurodegenerative biomarkers were compared between 3 groups. Results: Plasma levels of DBI, oligomeric Aβ, total tau, glial fibrillary acidic protein, α-synuclein, interleukin (IL) 1β, IL6, tumor necrosis factor α, oxidative stress index, high-sensitive C-reactive protein, and DNA damage were found higher in D5YG and NDG as compared to CG (p < 0.001). On the contrary, plasma levels of total thiol, native thiol, vitamin D and vitamin B12 were lower in D5YG and NDG as compared to CG (p < 0.001). Discussion: DBI may be a potential plasma biomarker and promising drug target for AD. It could help physicians make a comprehensive evaluation with cognitive and neurodegenerative tests

Identification of Drug-Related Problems and Investigation of Related Factors in Patients with COVID-19: An Observational Study

Objective:Clinical prognosis of coronavirus disease-19 (COVID-19) may be severe and unexpected. Patients may quickly progress to respiratory failure, infections, multiple organ dysfunction, and sepsis. The main objective of this study is to investigate the drug-related problems of patients with COVID-19 and related factors.Method:A prospective observational study was conducted on patients with COVID-19 between September 2020 and May 2021. Patients’ demographics, comorbid diseases, prescribed medicines and laboratory findings were recorded. Drug-related problems (DRPs) were identified by a clinical pharmacist according to recent guidelines, UpToDate® clinical decision support system and evidence-based medicine.Results:The median age of 107 patients was 64 and 50.46% of them were male. The median number of comorbidities was 3 (2-4) per patient. The majority of the patients had at least one comorbidity (88.79%) other than COVID-19 and the most frequent comorbidities were hypertension, diabetes mellitus and coronary artery disease. The total number of DRPs was recorded as 201 and at least one DRP was seen in 75 out of 107 patients. The median number of DRPs was 2 (0-8). In multivariate model, number of comorbidities (odss ratio (OR)=1.952; 95% confidence interval (CI)=1.07-3.54, p<0.05, number of medications (OR=1.344; 95% CI=1.12-1.61, p<0.001), and serum potassium levels (OR=5.252; 95% CI=1.57-17.56, p<0.001) were the factors related with DRPConclusion:This study highlights the DRPs and related factors in patients with COVID 19 in hospital settings. Considering unknown features of the infection and multiple medication use, DRPs are likely to occur. It would be beneficial to consider the related factors in order to reduce the number of the DRPs

Göğüs hastalıkları servisinde klinik eczacılık hizmetlerinin geliştirilmesi ve değerlendirilmesi

Amaç: Bu klinik eczacılık çalışması ile, göğüs hastalıkları servisinde klinik eczacılık hizmetlerinin geliştirilmesi ve değerlendirilmesi amaçlanmaktadır.Objective: The aim of this study is to develop and evaluate clinical pharmacy services in the pulmonology service

Kalıtsal epilepsiler

Mutations in genes encoding the formation of ion channels may cause epileptic syndromes. These epileptic syndromes are generally divided into generalized and partial epilepsies. Among the causative agents of generalized epilepsy showing mendelian or non-mendelian inheritance; mutations in sodium channel, calcium channel, GABAA receptor and nicotinic receptor can be listed. Generalized epilepileptic syndromes with mendelian inheritance are Genetic Epilepsy With Febrile Seizures Plus, Autosomal Dominant Juvenile Myoclonic Epilepsy, and Epilepsy Associated With CLCN2 Gene Mutation. Generalized epileptic syndromes with non-mendelian inheritance are JME and Juvenile Absence Epilepsy With Generalized Tonic-Clonic Seizures. The epilepsies of newborns and infants with a single gene inheritanceare classified into three categories: Benign Familial Neonatal Convulsions, Benign Familial Infantile Convulsions, and Benign Familial Neonatal-Infantile Seizures. Autosomal dominant partial epilepsies are examined under the headings of Autosomal Dominant Nocturnal Frontal Lobe Epilepsy, Familial Mesial Temporal Lobe Epilepsy, Familial Lateral Temporal Lobe Epilepsy, and Autosomal Dominant Partial Epilepsy With Auditory Features. While various mutations in different ion channels can produce similar phenotypes, a certain mutation on the same gene can cause different phenotypes. This review provides a summary of the epilepsy classification on the genetic basis and pathophysiological effects of neural channelopathies causing epileptic syndromes.İyon kanallarının oluşumunu kodlayan genlerde meydana gelenmutasyonlar epileptik sendromlara neden olabilir. Bu epileptiksendromlar genel olarak jeneralize ve parsiyel olarak ikiyeayrılmaktadır. Kendi içerisinde mendelyan ve non-mendelyan geçişgösteren jeneralize epilepsilere neden olan etkenler arasında sodyumkanalı, kalsiyum kanalı, GABAA reseptör ve nikotinik reseptörmutasyonları gösterilebilir. Mendelyan geçiş gösteren jeneralizeepilepileptik sendromlar; febril nöbetler ile karakterize, otozomaldominant formlu juvenil miyoklonik, CLCN2 gen mutasyonuylailişkili, kalsiyum kanalı alt birimlerindeki mutasyonlarla ilişkiliepilepsiler şeklinde farklılaşmaktadır. Non-mendelyan geçişgösteren jeneralize epileptik sendromları ise juvenil miyoklonikve juvenil absans jeneralize tonik-klonik nöbetli epilepsilerdir.Parsiyel özellik gösteren tek gen kalıtımı ile gerçekleşen Yenidoğanve Süt Çocuğu Epilepsileri, Selim Ailesel Neonatal, Selim Aileselİnfantil Konvülzionlar ve Selim Ailesel Neonatal-İnfaltil Nöbetlerbaşlıklarıyla 3 sınıfta toplanmaktadır. Otozomal dominantparsiyel epilepsiler ise Otozomal Dominant Noktürnal FrontalLob, Ailesel Meziyal Temporal Lob, Ailesel Lateral TemporalLob, Değişken Odaklı Ailesel Parsiyel Lob Epilepsisi başlıklarıaltında incelenmektedir. Farklı iyon kanallarında meydana gelençeşitli mutasyonlar benzer fenotipler oluşturabilirken, aynı genüzerinde meydana gelen belli bir mutasyon da farklı fenotiplereneden olabilir. Bu derleme epileptik sendromlara neden olan nöralkanalopatilerin genetik tabanı ve patofizyolojik etkileri üzerindenepilepsi sınıflandırmasına ait bir özet sunmaktadır.United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Dental & Craniofacial Research (NIDCR

Alzheimer hastalığında Traskraniyal Manyetik Stimülasyon (TMS) uygulamaları üzerine sistematik bir derleme

Alzheimer's disease (AD), is characterized by its progressive feature and loss of cognitive functions, is common among dementia types. There is no curative treatment of the disease today. In recent years, transcranial magnetic stimulation (TMS) techniques together with drug therapy have been explored by experts considering that they will produce beneficial results. Repetetive TMS (rTMS) can modulate cortical excitability and prevent long-term neuroplastic changes. The aim of this study is an updated and comprehensive systematic review of studies using TMS/rTMS in AD patients. Our study was designed as a systematic review prepared according to the PRISMA guideline. In this study, English and Turkish AD-TMS articles that entered the literature published between 2002 and 2017 were included. Randomized and non-randomized controlled clinical studies on humans evaluating the effectiveness of rTMS applications at different concentrations, durations and different regions in AD have been reviewed. The databases we used were Pubmed (R), MEDLINE (R), Webofscience (R), EMBASE (R), Turkiye Atif Dizini (R). Keywords were "TMS, rTMS, Alzheimers Disease" used in our search, 116 artticles complied with the determined protocol were identified and 14 were included in our study. The studies presented in this review, show the therapeutic potential of rTMS in AD patients. Benefits of rTMS were to communicate with patients and especially caregivers in their daily activities, thereby improving their QoL. The possibility of using TMS to increase neuroplasticity is promising not only to improve our understanding of brain plasticity mechanisms, but also to design new neurorehabilitation strategies.İlerleyici özelliği ve bilişsel fonksiyonların kaybı ile karakterize olan Alzheimer hastalığı (AH), demans türleri arasında sık karşılaşılanıdır. Hastalığının günümüzde küratif bir tedavisinin yoktur. Son yıllarda ilaç tedavisinin yanında transkraniyal manyetik stimülasyon (TMS) tekniklerinin, uzmanlar tarafından faydalı sonuçlar oluşturacağı düşünülerek araştırılmaktadır. Tekrarlı TMS (rTMS) kortikal uyarılabilirliği modüle edebilir ve uzun süreli nöroplastik değişiklikleri önleyebilir. Bu çalışmanın amacı, AH hastalarında TMS/rTMS kullanan çalışmaların güncellenmiş ve kapsamlı bir sistematik derlemesini oluşturmaktadır. Çalışmamız PRISMA kılavuzuna göre hazırlanmış bir sistematik derleme olarak tasarlanmıştır. Araştırmamızda 2002-2017 tarihleri arasında literatüre girmiş İngilizce ve Türkçe AH-TMS araştırmaları taranmıştır. Farklı yoğunluklarda, sürelerde ve farklı bölgelere yapılan rTMS uygulamalarının AH’de etkinliğini değerlendiren randomize ve non-randomize kontrollü klinik çalışmalar gözden geçirilmiştir. Taramadan kullandığımız veri tabanları Pubmed®, Medline®, Webofscience®, EMBASE®, Türkiye Atıf Dizini®’dir. Taramamızda anahtar kelime olarak “TMS, rTMS, AH” kullanılmıştır. Hayvanlar ve deney modellerinde yapılan çalışmalar taramamız kapsamında dışlanmıştır. Belirlenen protokole uygunluğu bulunan 116 makale belirlenmiş ve 14’ü çalışmamıza dahil edilmiştir. Bu derlemede sunulan çalışmalar, AH’den etkilenen bilişsel alanlardan bazılarına fayda sağlayan, demansı iyileştiren ve işlevsellikte daha iyi performansa neden olan etkileri gözlemleyerek AD hastalarında rTMS’nin terapötik potansiyelini göstermektedir. rTMS’nin spesifik faydaları, günlük aktivitelerinde hastalar için, özellikle de bakıcı ve hastalıkla ilişkili davranışla iletişim kurma yetenekleri, böylece yaşam kalitelerini iyileştirme ve hatta erken koşullar için tıbbi hizmetlerin kullanımını sınırlandırma ve kurumsallaşma. Beyin stimülasyonunu nöroplastisiteyi artırmak için bir araç olarak kullanma olasılığı, sadece beyin plastisite mekanizmaları hakkındaki anlayışımızı geliştirmek için değil, aynı zamanda yeni nörorehabilitasyon stratejileri tasarlamak için de umut vericidir

Time to change to improve health: clinical pharmacy and pharmaceutical care education in Turkey

The practice of clinical pharmacy had a positive impact on the profession by giving pharmacists more job opportunities. Moreover, the pharmacy began to gain the status it deserved, which was lost many years ago. In this paper, we aimed to give a brief explanation of the clinical pharmacy philosophy and definition of pharmaceutical care. What are the general and specific roles of clinical pharmacists in the modern world healthcare system? Also, how to implement clinical pharmacy in education to obtain competent pharmacists. We shared our observation and experience, specifically on the progress of implementation of clinical pharmacy education in Turkey. The stepwise method has been successfully followed in the implementation of clinical pharmacy education in Turkey. In the undergraduate program, the first step taken was the addition of clinical courses, such as the role of clinical pharmacy, patient education, etc. and practical hospital rounds (internal medicine, pediatrics, and surgery). The post-graduate program, such as master (MSc) and doctoral (Ph.D.) degrees, also offered to prepare clinically oriented pharmacy academicians. The continuous education programs were structured to implement clinical pharmacy idea for the pharmacists in practice. In conclusion, the stepwise approach significantly smoothed the transition from the product-oriented to the patient-oriented pharmacy education. Moreover, the adoption of the skills education system to educate pharmacists needs to review the policy regularly and gradually change it accordingly

Attitudes of medicine, pharmacy, and dentistry students about psychostimulant use to enhance cognition

Introduction The use of psychostimulant drugs to increase academic success is common among young people. There is no study examining this issue in Turkish population. In this study, the prevalence, attitudes, knowledge, and ethical evaluations of Pharmacological Cognitive Enhancement (PCE) in university students were investigated. Method A structured online survey was carried out with 1148 undergraduate and postgraduate (master, PhD and residency) students in different faculties of Medicine, Dentistry and Pharmacy in Turkey. Comparisons between groups, correlation and regression analysis about associated variables were made. Results The general prevalence of PCE in our study was found to be 7.4%. The highest prevalence was seen in the faculty of medicine (8.4%), among the residency students (15.5%). There was no significant difference prevalence of PCE between the faculties. Education level, smoking, study performance satisfaction, and knowledge level were found to be factors associated with PCE. Around 40% of PCE users stated that they used it with the recommendation of their friends. PCE users had a lower perception of harm and risk, and rated the use of it as more acceptable and normal behaviour. Conclusion PCE is a method used by young with high knowledge, low study performance satisfaction, to increase their academic success, especially during exam periods. Peer effect is an important factor in increasing prevalence