Assessment of D-dimer levels in pregnant women diagnosed with COVID-19: A case-control study.

OBJECTIVE: We aimed to evaluate D-dimer levels in pregnant women diagnosed with COVID-19. METHODS: This single-center study was carried out in a tertiary center hospital serving as a pandemic hospital. 151 pregnant women with COVID-19 diagnosis were included as the study group, and 70 healthy pregnant women as the control group. The data were analyzed separately in 3 different trimesters of pregnancy. RESULTS: Of the 221 pregnant women included in the study, 151 had a diagnosis of COVID-19. 70 healthy pregnant women were taken as the control group. It was observed that D-dimer values in pregnancy increased as the trimesters progressed. No significant difference was observed when this was compared with pregnant women with COVID-19 (p = .428, .75, .927 according to the 1st, 2nd and 3rd trimesters, respectively). CONCLUSION: The diagnosis of pulmonary embolism is difficult due to the lack of reliable alternative D-dimer thresholds for pregnant patients. On the other hand, D-dimer elevation continues to be a sign of poor prognosis in patients with COVID-19. The situation remains uncertain in patients who are pregnant and have COVID-19. Maybe D-dimer value should be removed from being a poor prognosis criterion in pregnant women.

How does the ERAS protocol work in patients who underwent cesarean section? (HERMES study).

OBJECTIVE: To assess the effect of the enhanced recovery after surgery (ERAS) protocol for cesarean deliveries (CD) on postoperative outcomes. METHODS: This multicenter prospective cohort study was conducted in six different centers between September 2020 and March 2021 and involved women who underwent either planned or unplanned CD. The primary outcome was time to the first passage of flatus following CD. Secondary outcomes included postoperative pain score, postoperative complications, and patient satisfaction. The protocol included early postoperative oral intake of ice cream and coffee, multimodal analgesia, antiemetic medications, and early ambulation. RESULTS: A total of 448 patients were included. The median time to the first passage of flatus was 10 h in the Hermes group and 18 hours in the control group (P < 0.001). Postoperative visual analog scale scores were significantly higher in the control group. Patient satisfaction scores and the frequency of postoperative complications did not differ between the groups (P = 0.08, P = 0.604, respectively). CONCLUSIONS: The ERAS protocol, including early serving of ice cream and coffee in the early postoperative period, enabled early discharge and a faster return of bowel function. Implementation of the ERAS protocol for patients who underwent planned and unplanned CD appeared to be safe and effective.

International medical students' adaptation to university life in Turkey.

OBJECTIVES: The aim of this study is to determine the adaptation process of international medical school students to university life in Turkey. METHODS: The mixed method design study, including all the international students (n=127) studying at Ege University School of Medicine, is employed. Qualitative data were collected from 23 students selected by purposive sampling technique. Two instruments were utilized for collecting data: Student Adaptation to College Questionnaire (SACQ) and Brief COPE. Focus group interviews were performed for qualitative data collection. RESULTS: The mean SACQ score of the medical students was found to be 407.44 (SD=68.29). The Academic Adjustment category included the themes of educational goals, different studying habits, accommodation, academic advisor, and scholarship. The Social Adjustment category included the themes of social interaction and support, differences, longing for family, discrimination and its effects on social life. The Personal/Emotional adjustment category included themes of psychological and physiological health problems. The Goal Commitment/Institutional Attachment category included themes of academic and social adaptation as well as the student' communication with education management. CONCLUSIONS: This study identifies to light critical issues in supporting international students with adaptation problems to university life in Turkey. It is clear that revising the content of education programs to enable international exchange is not sufficient enough by itself to meet the needs of international students.

Social Perceptions of Breast Cancer by Women Still Undergoing or Having Completed Therapy: a Qualitative Study.

BACKGROUND: Diagnosis and treatment of breast cancer is a crisis situation which effects women's lives physically, socially and spiritually. Investigating women's perceptions of this disease is crucially important for treatment decisions. We therefore determined social perceptions and interpretations of women diagnosed with breast cancer during therapy and in the post-treatment period. MATERIALS AND METHODS: In the study, focus group and in-depth interviews were made with women still undergoing or having completed breast cancer treatment. Some 25 women were included in the research. Content analysis was used in the analysis of the qualitative data obtained after the focus group and in-depth interviews. RESULTS: Some of the women demonstrated positive perceptions towards accepting the disease, whereas others had emotions such as rebellion and anger. The loss of a breast is important with different interpretations. CONCLUSIONS: Women's acceptance or rebellion against the disease varies within their social interpretations after the treatment, as at the stage of diagnosis/treatment. All stages of breast cancer negatively affect the social life of the affected individual as much as her body. Nurses assume crucial roles in coping with these negative effects. Thus, it is necessary to know, and sociologically interpret, what is indicated by the information on what the negative effects concerning the disease are and how they are interpreted.

Sociodemographic aspects of consanguineous marriage in an urban slum of a metropolitan area in Izmir, Turkey.

BACKGROUND: Consanguineous marriage is a common practice in Turkey. Sociodemographic and cultural factors associated with it are still unclear. AIM: The purpose of this study was to investigate the association between sociodemographic and fertility factors and consanguineous marriages in an urban slum of a metropolitan area in Turkey. METHODS: This community-based case-control study was conducted in Bayrakli Municipality health centres. Of the 1243 married women, 85 consanguineously married were included in the case group. A control group in non-consanguineous marriages consisted of 85 women matched to cases according to age and neighbourhood. Information about the subjects' sociodemographic features, fertility history and opinions about consanguineous marriage was collected. RESULTS: Factors that were associated with consanguinity included; having a low level of education (OR = 2.7, CI = 1.1-6.7), a brief duration time in Izmir after migration (OR = 4.7, CI = 1.9-11.6) and consanguineous parents (OR = 3.8, CI = 1.5-9.7). Despite the increased numbers in fertility features and higher perinatal mortality for first cousin marriages, there was no significant difference in the mean numbers of pregnancies, births, stillbirths and living children. CONCLUSION: Time after migration and educational background of women were the main factors associated with consanguineous marriages. Public health interventions to reduce consanguineous marriage in urban areas should target socioeconomically disadvantaged populations in cities.

"I'm healthy": construction of health in disability.

BACKGROUND: The bio-mechanical view of medicine being disabled, implies unhealthiness because these states are not included in the physical and mental medical norms. This study is to show how people with physical disabilities define health and being healthy within a social framework and to demonstrate the impact of social environments on people with physical disabilities given their application of the social model and their process of social construction. OBJECTIVE: This study is to demonstrate that the meaning of health and the definition of oneself as healthy take place in a social-construction process involving an interaction between people and society. METHODS: To attain this goal, a qualitative technique was applied, and qualitative data were obtained. Terms were formed by encoding the data, and themes were formed using the terms. Analysis and interpretation were made based on 5 themes that emerged from the encoding of the research. RESULTS: The qualitative data obtained in the research indicate that being healthy is equal to not being ill, that a disability does not imply unhealthiness for people with disabilities, and that people with physical disabilities interpret their physical adequacy and body images positively. CONCLUSIONS: The results show that people with physical disabilities socially construct their states of being healthy and their states of health and interpret themselves as "healthy" despite the medical model's definition of health. The positive impact of this positive social construction of physical adequacy and body image is evident in their interpretations of themselves as healthy.