Mount Fuji Sign: A Rare Complication of Meningitis

Acute bacterial meningitis is a critical condition also because of associated complications and sequelae besides being a life-threatening infection. The complications may develop due to disease itself, diagnostic procedures or treatment. Pneumocephaly is defined as the presence of air in the cranial cavity. Pneumocephalus of spinal origin may be associated with spinal trauma, penetrating injury, tumors, and infections resulting from iatrogenic causes such as lumbar puncture. Here, we present a case of a 22-year-old male with the diagnosis of acute bacterial meningitis in whom pneumocephalus occurred after lumbar puncture. In this study, we aimed to draw attention to a rare complication of lumbar puncture

Assessment of Interest of Healthcare Employees in Distance Training in the Coronavirus Disease-2019 Pandemic Process

Introduction:In-service healthcare personnel training is an ongoing process. However, emerging unknowns require momentary planning. The Coronavirus disease-2019 (COVID-19) pandemic has made distance training (DT) compulsory for healthcare employees (HE). Thus, it is important to learn about their interest levels. This study investigates the interest of HE in DT during the pandemic process.Methods:The research population consisted of 3,442 personnel registered to take the “HE COVID-19” training at research and training hospital in 2020. The population of the study consisted of all personnel employed at research and training hospital and registered for the training. The study was planned retrospectively for reaching all personnel whose training registrations were made between 17.03.2020 and 15.04.2020. This study was used the data of the personnel who completed the “HE COVID-19 Training” within the scope of the announcements that were made as DT as reported on the Hospital Training System.Results:The total training completion rate of the participants was found to be 90%. When the interests of the HE in the DT in the process of the COVID-19 pandemic were compared, no statistically significant difference could be observed in the participation rates of the specialist doctors, resident doctors, and nurses (p=0.094). The rate of the resident doctors to complete the training until the second announcement was significantly lower compared to the specialist doctors and nurses (specialist doctor vs. resident doctor p=0.044; nurse vs. resident doctor p<0.001). The rates of completing the training after two announcements were significantly higher among the resident doctors than the specialist doctors and nurses and among the specialist doctors than the nurses (respectively p=0.018, p<0.001, p=0.018).Conclusion:Continuous training must ensure that HE are adequately prepared to deal with public health emergencies such as the COVID-19 pandemic. DT should be prioritized in the Emergency Action Plan

An Evaluation of Hepatitis A Seroprevalence and Vaccination Status in Patients with HIV/AIDS: Data from A 20-year Period

Introduction:Hepatitis A infection, caused by the hepatitis A virus (HAV), is a non-chronic disease that can be prevented with vaccination. It is a significant cause of morbidity in adults. Homosexually active males, drug users, the homeless, and prisoners are at a greater risk of HAV infection. This study aimed to determine the hepatitis A seroprevalence and vaccination rates of people living with human immunodeficiency virus (HIV) followed up in our clinic.Methods:A retrospective examination was made of the polyclinic files and laboratory test results in the hospital information system of 1,326 patients aged >18 years, who were diagnosed with HIV/AIDS and followed up in the Infectious Diseases Polyclinic of University of Health Sciences Turkey, Haseki Training and Research Hospital between September 30, 2002 and September 30, 2022.Results:Anti-HAV immunoglobulin G (IgG) positivity was present in 1090 (82.2%) patients. As age increased, anti-HAV IgG positivity also increased, females were significantly more affected, no difference was determined between nationalities, and there was seen to be a significant decrease in the positivity rate over the time period of the study. The positivity rate was determined to be significantly high in heterosexual patients. The hepatitis A vaccination rate was determined to be 16.9%, and serology was examined in 60% of the patients after vaccination. The response to vaccination was determined to be 91.6% in the patients with serology examination.Conclusion:Although improvements in sanitation and vaccination in childhood have provided a decrease in HAV seropositivity, the key populations must be informed about vaccination and vaccination adherence is ensured to prevent small outbreaks

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: Epidemiological Changes in the World and Turkey

Human Immunodeficiency Virus/Acquired Immunodeficiency syndrome pandemic has spread and affected the whole world. The features of the disease and the structure of the virus make it difficult to control the disease and epidemic. This disease, classified as a chronic disease, can be treated with antiretroviral drugs developed in recent years. It is important that countries follow population characteristics for disease epidemiology in terms of disease transmission. The fact that patients cannot reach treatment due to discrimination is one of the most important factors in the spread of the disease. Means of protection should be managed separately for each group, and education and screening programs should be implemented for vulnerable groups. The target is that 90% of patients are diagnosed, 90% are treated and viral suppression is maintained in 90% of patients

Comparison of the Resistance of Diabetic Foot Isolates with Community and Intensive Care Unit Resistance Rates

Objective: Using proper antibiotics in diabetic foot infections can save an extremity. The goal of this study was to determine the antibiotic susceptibility of the most frequent isolates from diabetic foot infections, to compare these results with those for species obtained from both intensive care unit and community-acquired infections, and to re-evaluate the empirical antimicrobial therapy in diabetic foot infections. Material and Methods: Antibiotic susceptibility testing was performed on bacteria from diabetic foot cultures, ICU and community-acquired infections. Skin and soft tissue samples of a total of 181 patients have been studied. Sensitivity to ampicillin/ sulbactam (SAM), ciprofloxacin (CIP), piperacillin/tazobactam (TZP), cefoperazone/sulbactam (SCF), amikacin (AN), meropenem (MEM) and cefepime (FEP) has been investigated. Results: Among the samples, reproduction was detected in 154 (85%), 132 of which (79.5%) contained gram-negative bacteria (46 Enterobacter spp, 36 Pseudomonas spp, 30 Acinetobacter spp, 20 others). Resistance of bacteria isolated from diabetic foot cultures was less than the one of bacteria isolated from ICU and more than the one from community-acquired infections. However, an increased resistance was detected to ciprofloxacin, frequently used in urinary infections, in agents from community-acquired infections. Conclusion: In conclusion, due to the risk of possible loss of tissue/extremity and possible antibiotic resistance, treatment should be started empirically and continued considering the culture results. (The Me di cal Bul le tin of Ha se ki 2011; 49: 137-40

Blood Transfusion Applications Nurse Survey: Truths, Known to be Truths, Changes, Errors

Aim: Safe transfusion is one of the important steps in blood transfusion. This survey study evaluates the level of education and awareness of our nurses about safe blood transfusion. Method: 192 nurses working in our hospital were surveyed. Results: Only 16% of the participants were 40 years old or older, 18% worked for more than 20 years, 20% were high school graduates, and 25% of them never received training on blood transfusion (BT). All participants have been acquired awareness on cross match and record control. However, 20% were hesitant about the necessity of patient consent. It was observed that there was information confusion about premedication, and 25% were misinformed about blood transfusion procedures. For BTrelated reactions, 67% and 40% could exactly identify the symptoms and the findings, respectively. Of the participants, 15% were misinformed about the necessity of emergency kit and 50% were aware of what to be performed in case of a BT reaction. Discussion: Since increasing the safety in BT process is highly related to the level of knowledge and awareness of the transfusion nurses, it is important to establish inservice training programs and safety control systems. (The Me di cal Bul le tin of Ha se ki 2011; 49: 145-

Macrolide-Lincosamide-Streptogramin B (Mlsb) Resistance Phenotype in Staphylococcal Isolates

Aim: The aim of this study was to determine the incidence of macrolide-lincosamide-streptogramin B (MLSB) resistance in staphylococcal isolates from various clinical samples. Methods: In this study, we included a total of 100 staphylococcal isolates, 35 Staphylococcus aureus and 65 coagulase-negative staphylococci (CNS), from specimens obtained from patients followed up in our hospital between 2009 and 2010. Methicillin resistance of these isolates was determined using cefoxitin disc diffusion method. MLSB resistance was investigated by D-test method using erythromycin and clindamycin disks. Results: Of 35 S. aureus isolates, 14 were methicillin-resistant (MRSA) and 21 were methicillin-sensitive (MSSA). Of 65 CNS isolates, 41 were methicillin-resistant (MRCNS) and 24 were methicillin-sensitive (MSCNS). In 79 strains, there was at least one MLSB resistance phenotype. The most frequent resistance phenotypes were inducible (35%) and constitutive (30%) among all isolates, while the constitutive one was more common in S. aureus strains (62%). Conclusion: Since the resistant community- and hospitalacquired staphylococcal infections have become a therapeutic problem, it is very important to detect MLSB resistance routinely in microbiology laboratories. D-test is a cheap and reliable diagnostic method which can be performed in every laboratory. In order to prevent treatment failure, D-test should be routinely used and the results should be reported to the clinician before starting a therapy with MLSB group of antibiotics. (The Me di cal Bul le tin of Ha se ki 2011; 49: 102-4

A Case of Diabetic Foot due to Aeromonas sobria and Extended Spectrum Beta-Lactamases Positive Escherichia coli

Diabetic foot has a complicated pathogenesis and is a clinically variable situation that can range from minor vascular and neuropathic lesions to osteomyelitis and necrosis, which result in amputation; this non-stable disorder appears in the inframalleolar region. The risk factors are the duration of diabetes, improper foot hygiene, minor trauma, presence of smoking and alcohol use, peripheral neuropathy, peripheral angiopathy, and history of diabetic foot and immune system deficiency. Diabetic foot infections are commonly polymicrobial. We present in this study the case of a 65-year-old male farmer with diabetic foot who had several other underlying disorders affecting several systems. Diabetic foot (right) initiated from the lateral region of the fourth and fifth metatarsals and extended to the plantar surface, and had a purulent, deep, ulcerous soft tissue involvement. The patient was evaluated as grade III according to Wagner classification with the etiology of extended spectrum beta-lactamase positive Escherichia coli and Aeromonas sobria. He is under a multidisciplinary treatment with ertapenem