ABSTRACT
Aim: In the present study, the aim is to determine the approaches of patients to healthcare services before and during the pandemic by comparing the rates of outpatient admissions and hospitalizations to Selcuk University Medical Faculty Hospital throughout the present study. Material(s) and Method(s): The present study is a retrospective, descriptive study. Patients diagnosed with COVID were admitted to Selcuk University Medical Faculty Hospital on March 5, 2020. During the pandemic, no patients diagnosed with COVID were admitted to the adult cardiology, neurology, internal medicine, psychiatry, emergency, general surgery and pediatric emergency, pediatric psychiatry, pediatrics and pediatric surgery polyclinics and services. Hence, these clinics were included in the study. In the study, patients' data who applied to the relevant clinics of Selcuk University Medical Faculty Hospital or were hospitalized in the relevant clinics, including the years 2019, 2020 and 2021, were examined as pre-pandemic (2019) and pandemic period (2020, 2021) quarterly. The parameters of the present study were the pre-pandemic and pandemic period. The data obtained in the study were evaluated with descriptive statistics (as frequency and percentage). Result(s): In the first year of the pandemic, it was determined that both the number of outpatient clinic referrals and hospitalizations to the relevant clinics decreased significantly. Although the impact of epidemic diseases, emerging throughout human history has decreased, the risk they carry is systematically exaggerated, and the fears of the public fueled constantly by the media. Discussion(s): Unfortunately, this fear in society was also reflected in hospital admissions. Therefore, to manage medical services correctly during pandemics, planned and organized psychosocial support services are needed to preserve the mental health of the community as well as to enable appropriate medical interventions.Copyright © 2023, Derman Medical Publishing. All rights reserved.
ABSTRACT
Introduction: Human steroid 5α-reductase 2 (SRD5A2) coded by SRD5A2 gene is an enzyme that catalyzes the reduction of testosterone to dihydrotestosterone. Dutasteride, an SRD5A2 inhibitor, is a widely used antiandrogen for the treatment of benign prostate hyperplasia. Multiple variations have been identified in the SRD5Ar gene. Some of these variations may affect the efficacy and safety of SRD5A2 inhibitors. Dutasteride has also been investigated for intermediate and high-risk nonmuscle- invasive urothelial bladder cancer treatment with the combination of BCG (Bacillus Calmette-Guerin). Objectives: The study aims to evaluate the potential impact of V89L (rs523349) and A49T (rs9282858) variations on the SRD5A2 gene on dutasteride efficacy and safety in bladder cancer patients that have been enrolled in Phase 2 clinical trial entitled 'Efficacy and safety of a 5-alpha reductase inhibitor, dutasteride, added to Bacillus Calmette Guerin (BCG) immunotherapy in the prevention of recurrence and progression of intermediate and high risk non-muscle invasive bladder cancer: A single-arm, Phase 2 clinical trial' Methods: Twenty-one patients on BCG and dutasteride in the Phase 2 clinical trial were included in the study. Genomic DNA was obtained from whole blood samples, and evaluation of V89L (rs523349) (G>C) and A49T (rs9282858) (C>T) variations on the SRD5A2 gene was performed by using TaqMan SNP Genotyping Assay. The severity of the adverse events was graded by the United States National Cancer Institute- Common Terminology Criteria for Adverse Events 5.0. The causality assessment of adverse drug reactions was performed using Liverpool Causality Assessment Tool, Naranjo Algorithm, and World Health Organization-Uppsala Drug Monitoring Centre Causality Assessment System. The response to dutasteride was evaluated as the presence of bladder cancer recurrence. The Chi-Square test was used for testing the relationship between categorical variables. P values of <0.05 were considered significant. Results: All patients were homozygous GG for V89L variation on the SRD5A2 gene. Regarding the A49T variation, only one patient was homozygous CC, 8 patients were homozygous TT and 12 patients were heterozygous TC. One of the 8 patients (%12) was homozygous TT and 3 of 12 patients (%25) were heterozygous TC had bladder cancer recurrence. There was no statistically significant difference between bladder cancer recurrence and A49T variation (p=0.803). None of the adverse events were associated with dutasteride treatment whereas some of the adverse events, mostly urinary tract infections, were associated with the BCG. Other adverse events were upper respiratory tract infections, COVID-19, abdominal pain, vomiting, and loss of appetite. Serious adverse events were coronary artery disease, dyspnea, hypotension, and urethral stricture. None of the serious adverse events were associated with dutasteride or BCG treatment. Conclusion: Neither V89L nor A49T variation on the SRD5A2 gene was found to be associated with the efficacy and safety of dutasteride in medium and high-risk bladder cancer patients. Further studies of these variations with larger sample sizes and/or healthy control groups may lead to a better understanding of the impact of these variations on the efficacy and safety of dutasteride.
ABSTRACT
Background: It is required to determine death anxiety of nursing students so that they who will become healthcare professionals can cope with the fast-spreading and high-mortality diseases such as COVID-19 infection upon graduation, can communicate with infected and dying patients, and can provide patients with the necessary support and care. The purpose of this study is to determine the death anxiety experienced by nursing students due to COVID-19, the related factors. Subjects and methods: This descriptive and correlational study was completed between June and September 2020. The data were collected by using the Socio-demographic and COVID-19 Pandemic Information Form and Death Anxiety Scale (DAS). The student nurses who agreed to participate in the study were asked to fill out an online questionnaire that was sent by the researchers. The study was conducted with 115 nursing students. Results: The DAS mean scores of the nursing students were found to be 8.01 +/- 1.96 When the correlation between DAS scores of the nursing students and their knowledge and attitudes regarding COVID-19 pandemic was examined, it was determined that as their anxiety levels about transmission of coronavirus increased, DAS scores also increased (p=0.037). The scores of death anxiety scale decreased as the level of students' attention to events other than coronavirus, their level of comforting themselves and their belief mentioning that they would heal if they catch coronavirus increased (p<0.05). No statistically significant correlation was found between DAS scores and other knowledge and attitudes of nursing students regarding COVID-19 pandemic (p<0.05). Conclusion: It would be an effective method to provide the training to nursing students, in order to change their negative attitudes and awareness towards COVID-19 related death anxiety and to improve their coping skills for death anxiety and help to reduce the burden of anxiety.