Effect of rural practice observation on the anxiety of medical students.

INTRODUCTION: The aim of this study is to identify the level and causes of anxiety of sixth year medical students related to working in a rural area and the effect of a 1-day mobile rural health service observation on their anxiety. METHODS: In the Ondokuz Mayis University Medical School in Samsun, Turkey, 212 students participated in a 1-day mobile rural health service led by a family physician. Between June 2011 and June 2013, during their family medicine internship, each student completed a structured questionnaire and a State-Trait Anxiety Inventory (STAI) before and after the observation. RESULTS: A total of 85.8% of the students preferred to work in an urban area compared to 14.2%, who preferred a rural area. Currently, 89.6% of the students live in an urban area while 84.4% had lived in an urban area during most of their childhood. A total of 18.5% had no opinion about living conditions in a rural area, 71.7% thought they would be able to deal with the challenges, and 52.4% said the idea of working in a rural area made them anxious. Those students who had lived in a rural area as a child were found to be less anxious about working in a rural area. The association between the preferred work area and the student's anxiety about working in a rural area was statistically significant (p<0.001). Of the students, 76.8% thought that rural areas are more difficult places to work; a major reason for this as stated by 76.4% was the desire to have access to easy transportation. Difficult living conditions was noted by the students as their main reason for not wanting to work in a rural areas. Of the students, 77.8% answered that the 1-day rural health service observation positively affected their perspective on working in a rural area. There were 102 (48.1%) anxious students before the observation and the total decreased to 87 (41%) after the observation. CONCLUSIONS: Difficult living conditions were the main reason for students' anxiety about working in a rural area. Most of the students answered that the curriculum positively affected their perspective. Medical schools should provide students with the rural primary care environment experience, which would decrease their anxiety.

Urinary tract infections in unplanned pregnancies and fetal outcome.

AIM: Many pregnant women are exposed to antibiotics for urinary tract infections during pregnancy. Our aim is to bring attention to antibiotherapy in unplanned pregnancies. METHOD: Among the 511 cases followed by our 'Toxicology Information and Follow-up Service' for drug exposure during pregnancy, 101 cases, unaware of their pregnancy, had been prescribed antibiotics and urinary antiseptic drugs in the first trimester of their unplanned pregnancies. The data on the outcome of these pregnancies and the babies were evaluated in this study. RESULTS: Of the 511 cases, 101 pregnant women were exposed to nine kinds of drugs. Seventy-five cases had healthy babies; two had babies with major malformations; one had a baby with congenital hypothyroidism; five had spontaneous abortions; and eight cases underwent induced abortions. The outcomes of eight pregnancies are unknown. Two pregnancies are still continuing without any problem. One baby had a fetal renal anomaly; however, the physical examination did not reveal any other malformations. The baby died 4 hours after delivery. Another baby had atrial septal defect, a major malformation, and one baby had congenital hypothyroidism. CONCLUSION: Urinary tract infection is one of the most frequently seen complications of pregnancy. Our study indicated that the possibility of pregnancy should be considered when prescribing antibiotics for urinary tract infections in women of reproductive age.